There are many ways to increase capacity in the current NHS set-up - changing the administration/scheduling systems and clinical methodology being just two. It is quite possible to treble capacity without increasing the existing workforce but even if you do, that will still prove insufficient. When you consider there are over 10 million elderly people, 2.5 million diagnosed diabetics and an estimated 1.5 million people with other contributory 'risk' factors such as rheumatoid arthritis, lower limb ischemia & etc, many of whom need podiatric intervention, then increasing capacity from 2.1 million patients to 6 million is simply not enough to meet the demand.
Whether or not NHS management are happy with the use of the private sector is irrelevant. It is the government that sets health policy not middle management (although that's what has been happening of late). What we as a profession need to do is to secure from government a commitment on what care they would like us to provide to society on their behalf (i.e. that they will pay for) and what care the public should bear themselves. It may be that we are left with a small core salaried workforce - for acute and specialist work based in hospitals or specialist centres - but there may also be some commitment for general practice podiatry and I would submit that this is best served through an independent practice network which can take on a component of NHS care. But we are a long way from that scenario at the moment - not least because the existing practice network in the UK is of such variable standards that it warrants serious concern should NHS care be so disposed.
What is needed is for government to support such a scheme in the same way that it supports general medical and dental services by way of practice grants and incentives (and of course, funding), but they will only do so if we can convince the establishment that podiatry has a social value – current and potential – and that those practising in this field are responsible and competent in their care.
When I see sight of the SoCaP policy I will comment further.
Yours sincerely
Mark Russell
Last edited: Nov 18, 2004