Podiatry Services

Nick Smith Excerpts

Wednesday 4th December 2013 Westminster Hall

[Nick Smith (Blaenau Gwent) (Lab)]

I congratulate my hon. Friend on securing this debate. I recently visited the foot clinic at the Aneurin Bevan hospital in Ebbw Vale in my constituency about a fortnight ago, and I spoke to the fantastic podiatrists there. They told me about the huge and growing demands on their services because of diabetes. Does he agree that raising awareness of diabetes and the effect that it can have, particularly on people’s feet, is really important?

[Andy Sawford]

I thank my hon. Friend for his supportive intervention. He is absolutely right that diabetes can cause problems for people’s feet. Also, by examining people’s feet, the podiatrist can diagnose cases of diabetes and ensure that people get the treatment, help and support that they need. I am concerned that some of the estimated 850,000 people who are undiagnosed might continue to go undiagnosed if podiatrists are not able to provide proper, professional attention to people’s feet when they come into contact with them.

The National Institute for Health and Care Excellence clinical guidance on the prevention and management of diabetic foot complications sets out a foot care management plan to reduce the risk of problems occurring in those with diabetes. It is the clear view of the Society of Chiropodists and Podiatrists that there are not enough podiatrists to comply with the NICE clinical guidelines. We might expect the society to make that argument, but it chimes with my concerns locally that we have lost 16 podiatrists in our area. At a time of increasing diabetes, a reduction in podiatrists gives me real cause for concern, because the society’s view might be right.

Some 500,000 hospital beds in England each year are occupied by people with diabetic foot ulceration—more than all other diabetes complications combined. Only breast and prostate cancer have a higher mortality rate than diabetic foot ulceration. The number of amputations in England has risen from 5,700 in 2009-10 to more than 6,000 in 2010-11. It is reported that, given the increasing incidence of diabetes, more than 7,000 amputations will be performed on people with diabetes in England alone by 2014-15, unless urgent action is taken. If we look at our acute hospital budgets and compare the costs of a bed and of performing an operation and amputation—not to mention the impact on the individual concerned—we see that an increase in amputations in our area could prove far more expensive than continuing to provide the podiatry services that people have come to expect.

Does the Minister accept that the prevention and management of foot disease in people with diabetes is an essential component of every commissioned diabetes pathway, and does she share my concern that 80% of amputations each week are preventable? That is a stark figure. Can she give me an undertaking that clinical outcomes for vulnerable older people, including those with diabetes, will not worsen in Northamptonshire?

I wish to mention briefly some other issues in the short time I have left. By standardising best practice in the work of podiatrists in the UK, there is the potential to make net savings and reduce the number of accident and emergency admissions and amputations. NICE clinical guideline 119 looks at best practice. I hope that the Minister will consider how we can make sure that that guideline is followed in Northamptonshire with the resources available.

Finally, there needs to be greater parliamentary and public attention to podiatry issues. I very much welcome hon. Members’ attendance at this brief debate, and their interest and support. The subject is not particularly glamorous. Toenails, amputations and ulcerations are not things we want to think about over our breakfast, but they are important issues, particularly for some of the most frail and vulnerable people.