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A national chiropody service* (within a reorganised National Health Service)
has been discussed for some years. Whether this is a possibility in the
foreseeable future depends on many factors,not the least administrative and
financial even ignoring the need for recruitment of more trained staff. For
the present within the limits of the agreed scheme, the priority groups i.e.
the aged, and school children are provided with a reasonable service in this
area. Health education, with the emphasis on care of the feet and the imparting
of knowledge on preventive measures forms part of the work in the chiropody
clinics. Supplementing this, school nurses, and others, in their work with
school children lay special emphasis on instructing children in the care of
their feet, and in the selection of footwear. However, the blandishments of
commercial advertising make, and reinforce, the tenets of teenage fashion which
so often nullify our work with the younger generation.
Foot clinics are held at 7 of the Health Department's establishments and
at four other premises. Treatment is provided for corns, callosities and
malformed nails; advice is given on shoe fitting, foot hygiene and exercises.
A total of 35 sessions are held each week by one full-time and 8 part-time
chiropodists. For those unable to attend clinics, 5 of the chiropodists visit
their homes to give treatment. Treatment is free to old persons, to those on
retirement pensions, and to schoolchildren. A charge of 4/- per treatment is
made to other persons, which is abateable in necessitous circumstances.
(Statistics on page 100).
Congenital Defects
Notification of congenital abnormalities under the national scheme recommended
by the Ministry of Health in 1963 continued throughout the year.
Defects found in stillborn and liveborn children within thirty-six hours of
birth are made on birth notification forms by hospital or domiciliary staff,
details of which are as follows:-
Number of babies notified as having
one or more congenital defects 63
Number of stillbirths and livebirths
notified over the same period 3,747
Inward transfer of notifications 197
The rate of malformities per l, 000 total births was 17, the rate for England
and Wales for 1964 being 20.
There are obvious difficulties in assessing the real incidence of congenit al
defects under such a voluntary scheme but some help does flow in maintaining
observation registers, and in follow-up to assess any handicap.
26.