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(ii) It was difficult to convince the public in areas without facilities that the Council
could not provide them with a service, when it was known that treatment was provided
elsewhere in London and subsidised out of the county rate levied on all areas. This
applied particularly in South-West London.
(iii) The pressure of work at the existing clinics was such that there were long waiting
lists, and appointments had to be made at intervals of up to three months. It was impracticable,
therefore, apart from the distances which would have to be travelled by
patients, for existing clinics to serve the areas at present without facilities.
(iv) The service was most beneficial for old people. Amongst those attending the
existing clinics were those with limited joint movements, as well as those suffering from
other degenerative diseases associated with old age. It was the opinion of field workers,
based on their experience, that adequate foot treatment was of great assistance in
maintaining a degree of mobility in old people which materially assisted in preventing
deterioration in their condition which would result in their needing hospital or institutional
care.
(v) Some cases were referred to the Council's foot clinics by general practitioners and a
few by hospitals. In areas where no clinics were available it was assumed that similar
cases were referred to hospitals.
(vi) There was evidence, therefore, that the service, where it was available, was
fulfilling a valuable preventive function and that expenditure on it relieved to some extent
the hospital services of reference to them of persons with minor foot complaints.
The deputation from the Council which attended the Ministry in 1954 were informed
that, whilst the Minister was not averse in principle to an expansion of the chiropody service
throughout the country, there was no prospect of his being able to agree to its extension
in the near future because of its cost and the prior needs of other services. It was suggested,
however, that it might be possible for the Council to make increased contributions to the
funds of voluntary organisations prepared to run chiropody clinics.
The Council and the metropolitan borough councils are empowered by section 31 of the
National Assistance Act, 1948 to make contributions to old people's organisations and the
Welfare Committee expressed their willingness to consider on its merits any application
for a grant towards the cost of a chiropody service. In the event, however, it was left to the
metropolitan borough councils to make such grants.
In 1956 the Minister of Health, while still unable to approve of any expansion of the
service, suggested that the existing service in London might be more evenly spread so that
some provision could be made in areas which had no facilities for chiropody. It was emphasised
that the total number of sessions should not be increased nor additional expenditure
incurred and that any clinics established in new areas should be used exclusively for the
priority groups.
The Health Committee agreed to a redistribution, transferring 30 sessions a week from
division 6 (covering the boroughs of Deptford, Greenwich and Woolwich) and three
sessions from division 8 (covering the boroughs of Bermondsey, Lambeth and Southwark).
With some re-allocation of sessons in other divisions it was possible to provide a minimum
service over the whole county, including the establishment of 15 new clinics.
This re-allocation naturally was not easily accepted in those areas where a full service
had been provided by the borough council prior to 1948, particularly in division 6. The
Woolwich Borough Council made representations regarding the reduction of the service
in that borough by 17 sessions a week. Whilst regretting the necessity to re-allocate the
sessions the Council informed the Borough Council that when the opportunity occurred,
steps would be taken to press the Minister of Health again to agree to an extension of the
service.
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