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Barbara Follett: To ask the Secretary of State for Health what evidence the Department has collated of the effect on quality of life that effective foot health care can provide to (a) children, (b) the elderly and (c) other adults. 
Jacqui Smith: We recognise the importance of effective delivery of chiropody/podiatry care especially helping older people maintain their mobility and independence. The National Service Framework for older people says that: specialised falls services which are established should include chiropodists/podiatrists; specialist mental health services for older people should have agreed working and referral arrangements with chiropodists and podiatrists; and it sets a performance measure for numbers/rates of people aged 75+ who access chiropody/podiatry services.
Barbara Follett: To ask the Secretary of State for Health (1) what plans he has to issue guidance to (a) PCTs and (b) health authorities regarding (i) the minimum level of chiropody or podiatry service that should be available to patients and (ii) what level of chiropody or podiatry service should be available to patients wherever they live; 
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Jacqui Smith: No guidance has been issued to strategic health authorities (StHAs) or primary care trusts (PCTs) on levels of national health service chiropody/podiatry services to be commissioned, nor has any assessment been done.
Securing the provision of high quality services
Integrating health and social care locally.
Barbara Follett: To ask the Secretary of State for Health (1) what information his Department has collated on the extent to which the podiatry and chiropody needs of the population are being met by the NHS; 
Jacqui Smith: We recognise the importance of effective delivery of chiropody/podiatry care especially for older people, who make up approximately 18 per cent. of the general population, to maintain their mobility and independence. Other groups using chiropody/podiatry include children, pregnant women, people with diabetes and those with learning disabilities. Many national health service services are increasingly prioritising to ensure that these high-risk groups are treated and access chiropody/podiatry services before others.
The Department has part funded, with the Society of Chiropodists and Podiatrists, a research project by University College Northampton "Do 'low risk' older people need podiatry care". The results are awaited.
Barbara Follett: To ask the Secretary of State for Health (1) how many foot operations have been undertaken in each of the last five years by (a) orthopaedic surgeons and (b) podiatric surgeons; 
Barbara Follett: To ask the Secretary of State for Health (1) what information his Department has collated on the percentage of the population who have consulted a chiropodist or podiatrist in each of the last five years; and what percentage of the population have ever been treated by a chiropodist or podiatrist; 
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total face to face contacts with chiropody services, the numbers of new episodes of care in the year are contained in the statistical report "Chiropody services, summary information for 200001, England". A copy of the report is in the Library and it is also available on the Department's website www.doh.gov.uk/public/kt230001. The previous five years of this data are also available in the Library.
Barbara Follett: To ask the Secretary of State for Health what assessment he has made of the implications for NHS chiropody/podiatry provision of the publication of (a) the NHS policy on older people and (b) the guidelines for the NSF for diabetes. 
Jacqui Smith: The national service framework for older people was published on 27 March 2001. It sets new national standards and service models of care across health and social services for all older people whether they live at home, in residential care or are being cared for in hospital. The NSF recognises the role of chiropody/ podiatry services in that:
specialised falls services which are established should include chiropodists/podiatrists.
specialist mental health services for older people should have agreed working and referral arrangements with chiropodists and podiatrists. and it sets a performance measure for numbers/rates of people aged 75+ who access chiropody/podiatry services.
Jacqui Smith: We acknowledge that there are local and regional variations in national health service chiropody/podiatry services. For example, we know from data collected that trusts have different staffing structures and employ different numbers of staff.
These variations may result from NHS organisations having to clinically prioritise the services they provide to meet local demand for chiropody/podiatry services. Although local demographics may affect service provision levels, for example high level older people population, many services are prioritising for those most at risk such as older people, children, pregnant women, people with diabetes and those with learning disabilities.
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Jacqui Smith: In the NHS Plan we announced new investment in intermediate care and associated services rising to £900 million a year by 200304. In addition, we shall be targeting additional resources, rising to £360 million a year by 200304, to tackle the anomalies and inequities of the present funding system for long-term care. These include free nursing care in nursing homes for current self-funders which was introduced from October 2001. This will benefit around 42,000 people by around £5,000 p.a. A system of deferred payments has been introduced to avoid people having to sell their homes when they first enter residential care. Since April last year, the value of a property has been disregarded for 12 weeks when undertaking the residential care means test. In addition, the Government have established a new independent national body, the National Care Standards Commission, which will regulate social care services, and private and voluntary healthcare from April 2002.
The Government do not accept the royal commission's recommendation that all personal care should be provided free of charge. It would cost more than £1 billion a year to make all forms of personal care free. Spending money in this way would not help improve the quality and range of services for users of long-term care nor would it help achieve stability for providers, which are our priorities.
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