In response to your lead article this week, The NHS puts its' Foot in it, I would be interested to discover if any of your other readers had similar experiences to that of Mr Parker (News Shopper, November 10).

Although Bromley PCT has arranged for Mr Parker to receive chiropody treatment, I suspect there are many other people in a similar predicament to him, and the PCT is not keen to advertise this fact.

I recently heard an interview on the BBC's Radio Four Today programme, where Stephen Ladyman, a Government Health Minister with special responsibility for chiropody/podiatry, defended the Government's position on NHS chiropody provision.

The article was highlighting the fact 986,000 patients in the UK had been discharged from chiropody services in the past year. Allowing for cured patients and deaths, this still left a very high number who, like Mr Parker, are being denied chiropody services.

Mr Ladyman's response was the responsibility for the provision of NHS chiropody services was devolved to local PCTs.

Each PCT, therefore, has its own policy on accessibility to services, hence the term postcode provision of services differing from district to district.

The question one needs to ask of the PCT is, do we in Bromley borough get the level of chiropody service based on the needs of the patients or do we get what it is deemed the PCT can afford?

Unfortunately, like Mr Parker and his wife the numbers of patients requiring chiropody treatment are escalating with an ageing population and a significant increase in disorders such as diabetes which require screening and treatment.

If there is a significant number of patients who cannot access the chiropody services, then they need to have their voice heard, perhaps through the channel of News Shopper or via Sue Sulis of Bromley Community Care Protection Group.

I doubt chiropody patients have much say in the allocation of services in the PCT except when embarrassing cases like the one reported needs to be smoothed over.

A R Wood Chislehurst


For too long chiropody/podiatry has been the Cinderella of the NHS.

As a chiropodist in the private sector, I frequently have patients referred to me, unable to get treatment elsewhere and whose story's mirror that of Mr Parker's.

Couples are told to tend to one another, while one partially-sighted woman was told "go away, buy yourself a nail file and file one toe nail each day".

I inquired at the local clinic about its policy on nail cutting and was told "we are chiropodists, not a nail cutting service".

Nails keep growing, often thickening with age, becoming impossible for arthritic hands to deal with, assuming the feet can actually be reached.

The increasing discomfort which results means the patient is reluctant or unable to wear proper shoes and, therefore, go out.

They can finish up housebound, all for the want of a regular nail trim.

Stella Etheridge Coney Hall