Dear Stephen
Thanks for yours. I am sure that you are correct in that there are places
available for the training of Podiatric Surgeons. The difficulty seems to
be in creating the services/units.
Please guard your Orthopaedic Surgeon very carefully! (S)he is the
exception which proves the rule. If I can offer any help, please let me
know.
Bill
----- Original Message -----
From: "Stephen Moore" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, March 31, 2002 9:47 PM
Subject: Re: Alan Milburn Speech to Allied Health Professions Conference
> Dear Bill,
>
> Thank you for your comments, I would have to say that I do not have any
> figures to support my comments with regard to the increased number of
> Podiatric Surgeons or surgical units. This was largely based upon my
> impressions at conference and on conversations with members (in the bar
> etc.) they seemed to present a very positive picture, with more people
> undertaking the training and undertaking surgery, development of (I
thought)
> more surgical pupillage places (some I think advertised within the SCP
> journal).
>
> I am saddened to hear that this is not so, as Podiatric Surgery is again
one
> of those areas where Podiatrists have I believe made a real impact on
health
> care provision/standards of care. My local Orthopaedic Surgeon, has
> experience of working in the USA, he has a positive view of Podiatry and
was
> surprised that my department did not do foot surgery (other than nail
> surgery - phenolisation).
>
> Podiatric Surgery is sadly lacking in Scotland and an area that needs
> developing. There will be a limit I think to the number of surgical posts
> simply because of the small population in Scotland and its geography, but
> nevertheless a real need.
>
> With regard to the development of a General Podiatric Council, I
reluctantly
> agree with you, I know that we will not (happy to eat my words if proved
> wrong) achieve a GPC through the HPC, but just feel we need to demonstrate
> that we have tried this route, but failed. If that makes any sense? It
> certainly does not preclude using other routes/mechanisms at the same
time;
> this makes me sound uncomfortably like a politician :-)
>
> Kind regards
>
> Stephen
> ----- Original Message -----
> From: "Wm.J. Liggins" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Sunday, March 31, 2002 12:44 PM
> Subject: Re: Alan Milburn Speech to Allied Health Professions Conference
>
>
> > Dear Stephen
> >
> > Could you please list the new Podiatric Surgical units created over,
say,
> > the last 18 months, and the new Consultant Podiatric Surgeon posts?
This
> is
> > not a 'loaded' question, but as a Podiatric Surgeon I am unaware of any
> new
> > units/posts which have not been the result of expansion from adjacent
> > services or the result of work by individual Podiatric Surgeons.
> > Whilst not wishing to enter the private/NHS fray (I carry out both NHS
and
> > private treatment), I cannot agree that there is even a remote
possibility
> > of creating a General Podiatry Council from within the HPC. That body
> would
> > see it as the first of a 'death by a thousand cuts' and strenuously
oppose
> > it. From your posting I think that we all agree the ideal outcome,
there
> is
> > simply disagreement on the way to get there. Perhaps a discussion with
> the
> > representative body of the Chiropractors would be a reasonable step?
> > John Mason is absolutely right. To put it more crudely, if someone is
> > burying you in a trench of ordure there are only two reactions possible.
> > One is to lie down and invite them to carry on shovelling, the other is
to
> > stand up and throw it back. I submit that we are guilty of doing the
> > former, whilst we SHOULD be doing the latter.
> >
> > Bill
> > ----- Original Message -----
> > From: "Stephen Moore" <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Saturday, March 30, 2002 11:13 PM
> > Subject: Re: Alan Milburn Speech to Allied Health Professions Conference
> >
> >
> > > Akbal,
> > >
> > > I hate to disappoint you or ruin your master plan, but I have worked
> > within
> > > the NHS for over 18 years, I have seen great advances made within the
> > > Profession, within the health service.
> > >
> > > Whilst I have long supported the 'Dental Model', I voiced this as part
> of
> > > the Feet First Consultation in 1992-3? and again at the workshops
> arranged
> > > by the DOH to revisit 'Feet First' in 1997-8? (never been good with
> > dates),
> > > this model is seriously flawed and would need modification (speak with
> > your
> > > local private & NHS dentists). We need a modified model!
> > >
> > > I have NO desire to work in the 'Private sector' and object to
'someone'
> > > choosing my professional career path for me. Added to that I am a
> Podiatry
> > > Service Manager and member of the Faculty of Management. Putting
> Podiatry
> > > solely within the Private sector will solve nothing and will in my
> opinion
> > > actually damage the profession and lose us even more excellent
> > > practitioners.
> > >
> > > I not completely sure about your figures, 60% working within private
> > sector?
> > > I thought it was more like 45% with a proportion of these working in
> both
> > > NHS and Private sectors! But this is not important.
> > >
> > > I would argue that whilst many advances have indeed come initially
from
> > > individuals working within the private sector, most of these advances
> have
> > > only prospered and gained wider recognition and acceptance by being
> > advanced
> > > within the NHS.
> > >
> > > For example, Podiatric Surgery is now well established within the NHS,
> > with
> > > more Consultant posts emerging, more surgical units being established.
> > Some
> > > Podiatric Surgeons have been working within the NHS for over 20 years
> > (Nick
> > > Gilbert and Tom Galloway, for example).
> > >
> > > Many specialist fields would not be as advanced or as established
> without
> > > the NHS i.e. Biomechanics, Diabetes, Rheumatology, Paediatrics.
Research
> > > (just starting to emerge). We ARE starting to influence the Public
> Health
> > > agenda and I hope that not too far into the future you will see
genuine
> > > 'Podiatry Public Health posts. For the first time Podiatry in the
> Western
> > > Isles, has been specifically metioned within the Director of Public
> > Health's
> > > Annual Report, for our work in developing a Patient Held Record for
> > Diabetic
> > > patients presenting with foot ulceration, developing an integrated
Foot
> > > Ulcer Programme and (this is the important bit) preventing patients be
> > > admitted to hospital and having limb amputations.
> > >
> > > You do Podiatry Service Managers a great disservice, many of these
> > > professional advancements you enjoy and many of the thousands of
> Podiatry
> > > Posts within the NHS, would not exist/be established without many
> managers
> > > over many years, working tirelessly with little financial reward ( and
> all
> > > too often without the support of the Society of Chiropodists and
> > > Podiatrists).
> > >
> > > Managers need support and need expert advisory networks, and YES a
> career
> > > structure. I would agree that the Faculty of Management has not been
an
> > > outstanding success and not as radical and energetic as ACCO,
disbanding
> > it
> > > however, is not the answer, that would result in another ACCO forming,
> > what
> > > WE need to do is make the faculty more effective and more responsive
to
> > the
> > > needs of its' members.
> > >
> > > When I entered the NHS in 1983, many services were run by numerous
> private
> > > practitioners, the service was very poor, the facilities extremely
poor
> > (on
> > > one memorable occasion I was expected to treat patients in a female
> > toilet -
> > > well the previous Podiatrist had done so for years!). Sadly, many (not
> > all)
> > > of these practitioners were 'in it' for the money, fraud was common
> (e.g.
> > > practitioners claiming fees for deceased patients) and the profession
> had
> > a
> > > very poor image and little respect.
> > >
> > > The picture has changed dramatically and whilst still not yet perfect
> (one
> > > other reason I am a manager), we still have clinical facilities that
> fall
> > > short of our professional standards this is not unique to the NHS (how
> > many
> > > private practices have you visited!) and Podiatrists are still paid
too
> > > little. There are many examples of excellent service, highly trained
and
> > > respected practitioners.
> > >
> > > The Podiatry Service in the Western Isles, which is small and remote
> (and
> > > not the best NHS Podiatry Service in the world - this isn't a
> > commercial!),
> > > has I believe in its own small way helped progress the profession. We
> have
> > > an 'Open Referral System', we provide input and support to both the
> > Diabetic
> > > and Rheumatology Teams, we undertake 90+% of all of the nail surgery (
> > > increasingly on high risk patients), we have our own orthotics
> laboratory
> > > and run a weekly Foot ulcer clinic. We work on a daily basis with (not
> > for)
> > > a multitude of consultant staff and have gained their trust when it
> comes
> > to
> > > admitting or discharging patients to hospital. To give you one simple
> > > example of the benefits for the profession of remaining within the
NHS,
> > just
> > > yesterday afternoon, we had one Consultant Orthopaedic Surgeon and a
> > > Consultant General Physician in the department discussing patients
with
> my
> > > staff. Our General Surgeons are also familiar with the location of the
> > > department, having jointly managed a number of patients with severe
> > > ischaemia and/or foot ulceration. How often does this happen in
private
> > > practice? The profession within the NHS is influencing strategic
> decision
> > > making at the highest level for example I am a member of a Scottish
> > > Executive Committee, I am aware of at least one colleague who is a
> member
> > of
> > > an NHS Board, my colleagues are members of various Health Board
> committees
> > > (Tissue viability, Health Promotion, Surgical Clinical Management
Team,
> > > Partnership Forum etc.).
> > >
> > > I had the dubious pleasure on Wednesday evening of announcing to at
the
> > AGM
> > > of our Local Health Care Cooperative, that Podiatry was no longer a
> 'PAM'
> > > but a 'AHP', it was greeted with bewildered disbelief, with questions
> like
> > > what is a Allied Health Professional? How can the HPC manage/represent
> so
> > > many different professions? That sounds daft!
> > >
> > > The strength of Podiatry (and I believe we do have influence), lies
> within
> > > our diversification, we had a good deal of interest in our profession
at
> a
> > > recent careers fair, this I believe was in part due to demonstrating a
> > > Doppler and neurothesiometer (children like gadgets) and the fact that
> we
> > do
> > > so much and in different market sectors (NHS, Private, Commercial,
> Sports
> > > and Leisure etc.).
> > >
> > > We have many excellent Practitioners, many excellent public, private
and
> > > commercial sector services, we must use this diverse strength to
ensure
> an
> > > effective and satisfying future for the profession, whilst securing
high
> > > levels of safety for the public.
> > >
> > > We have a professional body (SCP), we have a 'HPC', we have to work
> within
> > > these structures to secure a General Podiatric Council.
> > >
> > > Kind regards
> > >
> > > Stephen Moore
> > > (Head of Podiatry, NHS Western Isles)
> > > ----- Original Message -----
> > > From: "Akbal Randhawa" <[log in to unmask]>
> > > To: <[log in to unmask]>
> > > Sent: Saturday, March 30, 2002 9:06 AM
> > > Subject: Re: Alan Milburn Speech to Allied Health Professions
Conference
> > >
> > >
> > > > ----- Original Message -----
> > > > From: "podiatry" <[log in to unmask]>
> > > > To: <[log in to unmask]>
> > > > Sent: Friday, March 29, 2002 10:43 PM
> > > > Subject: Re: Alan Milburn Speech to Allied Health Professions
> Conference
> > > >
> > > >
> > > > > Dear Bill and all
> > > > >
> > > > > How I agree with your comments about govt intentions.
> > > > > They are hell bent on destroying professional independence in UK
> > > > healthcare.
> > > > > I would also add that the law is not far behind.
> > > > > If you believe this then you should understand how impossible it
was
> > to
> > > > > progress a Podiatry Council.
> > > >
> > > > I am not sure that this is at all so, we know that the HPC is
already
> > > > failing simply because they have had to ask the existsing Boards to
> > > > continuing to function despite having had 1 year to plan their
> > operations.
> > > I
> > > > suggest it is time that the Society pulled thier support, I
certainly
> > > > believe that this thoughly undemocratic body that obviously couldn't
> > > > oragnise a piss up in a brewery never mind professional regulation
for
> > 12
> > > > seperate distinct professions. It is a matter of some shame that we
> have
> > > > council members involved in this destruction, we as a body simply do
> not
> > > > have a leg to stand on if we continue to support this body and
> certainly
> > > > help the ministers destroy our professionality.
> > > >
> > > > They legislation in the Health Act still allows for a General
> Podiatric
> > > > Council to be created by Order in Council. We also have the option
of
> > our
> > > > own Act so know we have 2 options more than we have ever had. We
need
> to
> > > > tell the Government that this is what we want, and refuse to stand
> down
> > > > until we get it.
> > > >
> > > > 60% of our profession(state registered) work within the private
> sector,
> > we
> > > > can encorage and help more (with financial support) to enter the
> private
> > > > sector, this will show the government that we can act to maintain
our
> > > > professional credability in the private sector and this will put the
> > > brakes
> > > > on their NSF's etc. It does mean that the Faculty of Management will
> > cease
> > > > to exist but this is probably no bad thing. If they want Podiatry in
> the
> > > NHS
> > > > then they will just have to pay alot more and accept that we are
> > > independent
> > > > clinicians, the one thing they haven't done so far (profession
> > > supplementary
> > > > and allied health profession etc)
> > > >
> > > > > The govt have made it clear that they would oppose totally any
such
> > > > attempt
> > > > > to
> > > > > create an independent body.
> > > >
> > > > So what!! DO we have to help them, I suggest we dump all talks with
> the
> > > DoH
> > > > redardless of the subject, if they want to impose change, let them,
we
> > > will
> > > > retain the moral high ground the simple fact they will not have
> anybody
> > > > advising them, including the unregistered I would guess, they cannot
> > make
> > > > changes that will not affect our human rights.
> > > >
> > > > > The DOH intend to destroy the professions ability to fight the
> > > > restructuring
> > > > > and dumbing of UK
> > > > > healthcare.
> > > >
> > > > I agree absolutely, but we are helping them and we should cease
> > > immediately.
> > > >
> > > > Akbal
> > > >
> > > > -----------------------------------------------------------------
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