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(i) No expansion of the existing service should be undertaken without prior approval
by the Council.
(ii) The appropriate Whitley Council scale of payments to chiropodists should be
observed.
(iii) The accounts of the association should be kept in such a way as to show the
expenditure and income on the chiropody service separately from the general account
of the association and in such detail as the Council might require.
(iv) Patients should be required to contribute towards the cost of treatment as in
Council clinics, i.e., 3s. per treatment, subject to abatement according to means.
Most of the voluntary organisations had previously made a flat rate charge, but, in some
instances, allowed free treatment in case of great hardship. Representations were made by
some of the associations that individual assessment under the Council's scale would be
an administrative task they could not undertake. It was therefore agreed that a simplified
method should be adopted. It soon became clear, however, that few, if any, of the old
people would be liable to make any contribution towards the cost of treatment under the
Council's scale. In December, 1960 the Council decided that no charge should be made
for treatment in its foot clinics to persons receiving old age or normal retirement pensions
and voluntary organisations were asked to implement this decision in respect of the services
provided by them.
Towards the end of the year it was apparent that the combined effect of the implementation
of the Council's scale of charges (as against the flat rate charge) and the under-estimation
of expenditure by some organisations (mainly on account of fees to chiropodists)
would cause the estimate of £12,000 for grants to be exceeded. Although final figures
will not be available until all accounts have been submitted and scrutinised it is anticipated
that the final figure will be of the order of £19,000 and authority was given for payments
up to this amount.
Treatment—The Cope Committee defined chiropody as the treatment of superficial
ailments of the feet and the maintenance of the feet in good condition. That the Council's
chiropodists follow this definition is evident from the fact that the majority of treatments
provided at the foot clinics are for superficial excrescences (corns, callosities, etc.) and for
malformed nails. Advice is also given on shoe fitting, foot hygiene and exercises. As will
be seen from the table below the majority of treatments are given to elderly persons and the
aim is to enable them to remain mobile. For those who are unable to reach a clinic by any
other means and for whom a domiciliary service is not available, arrangements are made
for transport to and from the clinic. The continued demand on the ambulance service
makes the provision of transport a matter of increasing difficulty and every effort is made
to economise in its use for the chiropody service.
The following tables show the attendances at the Council's foot clinics since 1949 with
an analysis according to age groups for the last three years:

81
F