Dear David

I know I’ve been more than critical in the past towards policy implemented
by podiatry managers, but I wonder if you could allow me a response.

With the benefit of hindsight and a little experience. I think part of the
problem lies in the duality of roles that the Society has to undertake
namely; to act as a representative body and to function as a trade union
to some of its membership. When general management was first introduced
into the NHS back in 1983, it should have been obvious that there would be
a conflict of interest within the operation of some of the professional
organisations. We don’t seem particularly adept at planning for the future
so I’m not apportioning any blame, but with an increasingly divisive gap
between managerial and clinical structures within the NHS, it should have
been obvious that there would be a need for separate representation at
some time during ‘modernisation’.

One of the issues that crystallised that thinking for me was when NHS
Trusts started discharging patients wholesale because there was
insufficient funding to service the demand. This issue created tension
within the professional body. On one hand, officers were concerned that
patients were being removed from lists; quite understandably so. But on
the other, there was a reluctance to highlight the issue because it was
some of their members who were implementing the policy. It was one of the
reasons I resigned from the Society and that situation still exists today.

I do not want to demonise podiatry managers. They have been responsible
for some of the most important developments in clinical practice in
Britain and they have served as mentors for many grateful practitioners.
Your list to Akbal doesn’t do justice to all the hard work that’s been
carried out in Scotland. But when there is such division in roles between
the various environments that podiatrists work in – managerial and
clinical; public, and private – perhaps there needs to be a rethink in
trade union representation in all the various fields?

I do think there can be a spirit of co-operation between all sectors; that
is to be strived for. But occasionally there are times when there is
incompatibility over some issue and the need for separate counsel is
essential. When that doesn’t happen there is an inevitable breakdown in
the relationship. There is a natural drive in people for justice and it
can only be served by independent counsel.  If it doesn’t happen the
result is division and resentment and I think that’s what happened to
podiatry.

Maybe the answer in podiatry is to separate the roles in the professional
organisation? Allow managers membership but not voting rights or trade
union representation. Instead of a Faculty on Managers have an NHS
Advisory Board. The professional organisation must be seen to be
independent; to be acting in the best interests of the individual not the
organisation. The NHS is a customer of the profession; it should never be
allowed to dictate direction, no matter how well intentioned. That should
be a matter for its members. No doubt you’ll kick me into touch!

Kind regards

Mark Russell

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