There are 3,807 chiropodists employed in the NHS, which is a 15.9 per cent. increase since 1997. It is for local primary care trusts to determine local priorities for access to chiropody.
I am grateful to the Minister for that reply, but will he give the House his estimate of the number of patients with foot problems who have been deemed to be low risk and thus discharged from NHS care and forced to look in the voluntary and private sectors to find the specialist chiropody services that they need? What plans does he have to draw up guidelines on the management and treatment of foot problems to lay down a patient's minimum entitlement to NHS care and remove the current postcode lottery of entitlement to foot care?
Once upon a time there was such guidance on who should have access to chiropody services, but it was scrapped in 1994 under the previous Government. We have simply moved to a situation in which local primary care trusts are responsible for ensuring that everyone in their areas has access to the foot care that they need. Most PCTs are concentrating specialist problems on specialist chiropodists and thus leaving other organisations, such as those in the voluntary sector, to deal with less specialist needs, but each PCT has the responsibility to ensure that everyone in its area has access to the appropriate foot care.
A number of senior citizens go to private chiropodists for their care. Has my hon. Friend assessed how many of those chiropodists will fail to register with the new Health Professions Council? One chiropodist in my constituency said that the process is very bureaucratic and expensive. My constituent would like to see automatic registration for anyone who has three years' experience. He thinks that the number of practising chiropodists will fall because they will no longer be able to practise under that title. That might cause a crisis and, obviously, difficulties for those who are receiving treatment under the NHS as well.
I understand the issue that my hon. Friend raises. These are matters, first, for the Health Professions Council. More importantly, they are negotiated closely with the professional bodies representing chiropodists and podiatrists. We try to meet their registration needs. Although individual chiropodists may have views about the democratic nature of the requirements for registration, I can assure my hon. Friend that the professional bodies that represent podiatrists are having their views closely adhered to by those who have to implement these arrangements.
I can certainly do that. The figures are roughly similar to the number of new starts in each year since we came to power. The total number of procedures carried out each year is roughly the same. There is a slight decrease, and that entirely reflects the fact that more specialist podiatrists are concentrating on specialist processes that take longer than the old, simple foot care procedures that are now being undertaken by people who are not specialists. That is good value for money. The assertions of Opposition Members that there is a massive removal of people from NHS podiatry services is simply not true. Like the Opposition's announcements yesterday from the shadow Chancellor of the Exchequer, their figures just do not add up.
I can give my hon. Friend that assurance. Since 1997, there has been a 33 per cent. increase in the number of people training for this speciality.