than he can refuse to serve people who want their
own cough cures or vitamin pills—so long as the materials used in them are not under legislative ban.
Auxiliaries
—Chiropodists
A few .months ago the Queen's anent was given to legislation bearing the title 'Profes- sions Supplementary to Medicine Bffr; and among the professions listed was Chiropody.
Chiropodists have long aspired to the same rights in connection with feet as dentists have in connection with teeth. They are still far from their goal, but they have acquired a formal, if grudging, recognition from the profession that they are a respectable and trust- WOlihy faculty, capable of conducting their own affairs; and they have won the blessing or the Ministry of Health.
tur the paradox remains that though chiro- dined to independence, and would welcome greater freedom and the recognition of the chiropodist as a specialist. But these differing attitudes are largely a matter of degree. Both organisations have codes of ethics which forbid members to advertise and insist that when a case is beyond the scope of chiropody the patient must be advised to consult a doctor. Perhaps nine out of ten members of both bodies are en- gaged in private practice. Fewer than 700 mem- bers of the Society hold appointments under the NHS; appointments are also held by some Institute members. It is estimated that Society members carry out about 12,000,000 treatments a year, and that the number of treatments given during the same time by Institute members is about 2,500,000.
NHS by an orthopcedic consultant or a g.vilS hospital. The great bulk of the treatment pirien by chiropodists is consequently to their sei,,vate Patients, who have to pay for it them- ir 'es. Contributions to national insurance bring steee relief for their suffering feet only to the few. iiiletkaeles hearing aids, dentures and wigs can tiN. .'e obtained at nominal cost under the e Health Service--but not chiropodial reatinent. 1: iS a curious situation. With so many painful ten walking the country today vigorous pro- nasttsin rnight be expected at this gap in the tak-nal welfare services. Not so: painful feet in tehthe Place today that toothache used to fill gron-e lives of our ancestors—a constant back- at .-ild of suffering which is passively accepted - Inevitble. shScimnle of this passivity is due to the very real c, e-age of trained chiropodists. That skilled bee for the feet is not easy to obtain is largely ptiebaptise of a widespread reluctance on the al ac's ... 4 11 to demand it. Many people are alarmed at or shy of chiropodial treatment. They tb:Igine that the cure will hurt them even more pederlt the in tey areay suffer, nd hey sus- inithat iPa t willh l be accompanieda t personal by -,711 Similar prejudices had to be overcome anientists in the early days of their profession, under extensive public education will have to .be Shows dell n ahen before the foot health of the nation The any considerable improvement. ter' he uninitiated are apt to regard chiropody in narn, s of corns, fallen arches, and ingrowing toe- riot's. Such ailments do, indeed, occupy the atten- kg,,11,,,,q the chiropodist, but his professional 'edge embraces a great deal more. beundamentally, he is a practitioner who has an trained to understand fully the structure ofd function of the foot, its relation to the rest Ordthe body, and the nature of its various dis- ph ers. He has been trained in biology, chemistry, tcYsies, anatomy, physiology, dermatology, prac- anadl and clinical chiropody, therapeutics, surgery The chiropodist, therefore, is to be regarded as a specialised practitioner in a limited, though important, field. He has been grounded in ortho- dox medicine within the limits of his specialty. And he is welcomed as an ally by the medical profession in general; not simply because of the thoroughness of his training, but because some years ago a tacit agreement was reached with the profession about what territory chiropodists could consider their own: and the chiropodists have been careful to remain within it (in this they differ from, say, the osteopaths, who have never reached a similar demarcation agreement with the profession).
The British Medical Association recognised chiropody as a profession ancillary to medicine in 1938 after the Royal College of Physicians and the Royal College of Surgeons of England had agreed, in the previous year, to approve a panel of examiners in medical subjects to conduct the professional examinations of those bodies which later amalgamated to form the Society of Chiropodists. This was quickly followed by the setting up of a Chiropody Group Council by the Board of Registration of Medical Auxiliaries, and in 1939 the first Register of Medical Auxi- liaries (Chiropodists) was published, paving the way early in the war for the appointment of qualified chiropodists to Army and RAF units and to Royal Ordnance factories.
Chiropodists have two professional organisa- tions which are recognised by the Government. These are the Society of Chiropodists, with a membership of around 4,000, and the Institute of Chiropodists, of which the membership is about 1,000. The difference between these two bodies lies largely in their attitude to the medical profession: the members of the Society confine their practice within a definition agreed with the profession; the Institute is somewhat more in- Some public authorities are anxious to expand their provision of chiropody, and chiropodists are naturally also anxious to help. But their co- operation frequently has to be given at consider- able financial sacrifice. The fee fixed by the National Whitley Council for a half-day's attendance at a public clinic is 37s. 6d.; most chiropodists could earn this sum many times over if they gave the time to their own practice. The salary scale, too, for a public appointment as a chiropodist is usually between ft 1 and £14 a week—low by present-day standards.
Many people, including chiropodists, hope that the services of private practitioners will be used more extensively now that the Minister of Health has allowed local health authorities to extend their chiropody services for old people, the physically handicapped, and expectant (Continued on page 644)
THE BROTHERS M
Tom Stacey
"He gets closer to Africa than any English writer I have ever read." Spectator "an insight into emergent Africa that few other books have attempted." Time & Tide "really gets under the skin of black and white." Reynolds News "vivid, honest, moving." News Chronicle "Nothing else this week approaches this
stature." The Guardian 25s SECKER & WARBURG mothers. In the past, this restricted service of local health authorities has been carried out in clinics by full-time and part-time chiropodists. As staff becomes available these clinics are likely to be increased, but some authorities are already employing private practitioners on a fee basis for each treatment, thus preserving the personal relationship between chiropodist and patient. the public stoically endure their painful feet or are driven to seek relief privately.
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