Mr President,

I am delighted to have been asked to speak at your Annual Convention.

I would like to start by paying tribute to the work which chiropodists and podiatrists do, both in the public and the private sector. I have no difficulty - although the Minister might! - in saying that independent practitioners play a vital role in healthcare and without their commitment, it would not be possible to meet the needs of many patients - particularly those requiring chiropody and podiatry linked to chronic back conditions and diabetes.

Mike Batt has asked me to speak particularly about regulation of the profession.

In order to do so, I would like to start by considering the background to the Government's controversial decision to set up the proposed Health Professions Council as it has.

We all know that during the 1990s, there was mounting concern about professional negligence in the NHS.

This is shown by the fact that complaints against doctors have risen threefold since the early 1990s. Compensation for medical blunders has gone up by 50% in the last four years. Doctors such as Harold Shipman, Rodney Ledward and James Wisheart became household names for all the wrong reasons. Regrettably, the Bristol Royal Infirmary Inquiry concluded that the failures were not just those of individuals, but that the whole system had failed on occasions, because there were no regular checks on procedures.

It is also the case that incidents of mistreatment by other health professionals have also been widely reported.

Against this background, the Government took powers in the Health Act 1999 to modify existing arrangements for the regulation of healthcare professionals.

The NHS Plan set out changes to self-regulatory bodies to make them smaller with more lay representation; to speed up decisions and to develop accountability.

The Kennedy Report into the Bristol Royal Infirmary cases reinforced the call for strengthened regulation and supported the idea of what it called an overarching body for the regulation of health professionals. It envisaged a body bringing together the GMC and the Nursing and Midwifery Council, amongst others, to ensure an integrated and co-ordinated approach to setting standards, monitoring performance, inspection and validation.

It would be independent of Government and report to Parliament as well as the Secretary of State for Health.

It would be known as The Council for the Regulation of Health Care.

There will be :

a new Nursing and Midwifery Council to replace the UK Central Council of Nursing, Midwifery and Health Visiting

a new Health Professions Council to replace the Council for Professions Supplementary to Medicine and

reform of the GMC.

All will be smaller bodies with more lay representation.

They will provide representatives to the overarching body, The Council for Regulation of Health Care.

The Shadow Health Professions Council was appointed on 27 April 2001. It has 25 members: one for each profession and equal lay representation. But, there have been criticisms of the "extra bureaucracy" which this would involve, notably by the Central Council of Nursing and Health Visitors.

The Shadow body will have no legal power or status until April 2002 and an Order in Council is required to be passed by Parliament in order to give legal cover to the body. The Government had said that the Ordern Council would be laid in October 2001, then debated and passed - with one and a half hours allocated in each House - by December 2001. However, it has not so far been laid and it is now November 3rd.

There have been complaints by MPs that the Health Professions Council covers too many professions and that the Government approach does not take account of the lack of similarity in the qualifications and clinical practice of these professions. But the Government seems committed to it.

They say that the Health Professions Council combines the regulation of the independent and state sectors together under one body and aims to protect the use of professional descriptions such as "podiatrist" or "physiotherapist".

There are criticisms by other professions, but the main concern seems to be amongst Chiropodists and Podiatrists.

As you know, the profession is about equally split between public and private practice. Chiropody and Podiatry is unique amongst the 12 professions covered by The Health Professions Council in having such an equal split.

While The Society of Chiropodists and Podiatrists represents the State Registered Chiropodists, The SMAE Institute and The British Chiropodists and Podiatrists Association is much older and is the largest Association for independent practitioners.

It seems that SOCAP will be little affected by The Health Professions Council. They will be registered automatically for the new body and are represented on it.

You, however, as members of the independent sector will not be represented and you may be required to sit a test of competence. What an astonishing proposal!

I understand that this is now the subject of "negotiation" and all of us here today will be hoping that the outcome is positive. It would be wrong if 8000 private sector practitioners were unable to work.

There is a serious potential danger here. Patients need Chiropodists and Podiatrists. If obstacles are put in the way of private practitiones, the public sector could not cope with the workload. As an illustration of this, you may be aware of a worrying development in North Lincolnshire, where the Primary Care Trust has put forward proposals to "grade patients" for access to chiropody services. The stated aim is only to treat people who have both a medical and a chiropody need. This is as clear a case of rationing as you will find and underlines the fact that demand for independent practitioners will continue to rise in the future.

Conservatives recognize the important balance to be struck between necessary regulation and too much red tape.

We also value the private sector for the high standards, choice and accessibility that it brings.

It is nonsense for Alan Milburn to talk of "expanding choice without compromising equity", as he did in a speech to the Fabian Society, while at the same time, proposing a Health Professions Council, which has no private sector representation for the Chiropodists' profession.

So what am I doing about it, as Shadow Health Minister? Well, we will continue to put pressure on Alan Milburn to change his mind. Only last week, I tabled four Parliamentary Questions on this subject. When I have his replies, I will pass them on.

The Conservatives believe in proper regulation and an emphasis of patient safety but we also believe that basic agreement needs to be reached before legislation is laid. We must ensure a level playing field for independent and public practitioners. All chiropodists and podiatrists should have a fair and equal chance.

We share your concerns.