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THE PROVISION of foot care for the elderly is so inadequate in the west of Haringey that some of the most frail pensioners face having to pay nearly £50 just to get their toenails cut.
The sad state of chiropody services in Haringey - according to elderly users - was revealed at a meeting of the Muswell Hill Pensioners Action Group (MHPAG).
Elderly people who are otherwise healthy but can't cut their own toenails or treat foot infections themselves, perhaps because of arthritis, cannot get free foot care on the NHS and may turn to private clinics to get the treatment done.
Janet Shapiro, MHPAG chairwoman, said: "The NHS has cut down on who's entitled to see a podiatrist. Even when they are entitled the appointments are much more infrequent than they used to be.
"A podiatrist would pick up all sorts of problems that might lead to problems with knees and so on."
Another MHPAG member, who wished to remain anonymous, said he had been told of an elderly lady who couldn't cut her toenails, couldn't afford to go private, and was "kicking walls trying to break her nails".
Esther Singer, who is in her 80s and lives by the now-closed Fortis Green Clinic on Fortis Green, added: "I went to the Rutland Health Centre to register and was told, 'You can't register, you have to register through St Ann's Hospital.'
"It's what I call a balls up. I went to the Clock Tower Practice in Crouch End and I have been told it's £30 there, and for a home visit it's £48. When you think the basic pension is about £87 per week, that's a third of a week's pension."
She added: "You have to have a pre-existing condition and go to St Ann's Hospital to get assessed. It seems such a cock-eyed system."
A free nail-cutting service offered at a luncheon club near Turnpike Lane was staffed by people only trained to cut nails - not deal with verruccas or corns.
"Most of us have worked for the major years of our lives and it is not as if they have not contributed to these funds and services," added Mrs Singer.
When the Journal called GP surgeries in Muswell Hill, we were told chiropody services were available only to elderly people if the GP referred them to the clinics.
This would happen with any illness that renders the foot liable to infection, ulceration or gangrene such as diabetes or rheumatoid arthritis. A Help The Aged spokesman said it was campaigning for foot care to be "mainstreamed" again.
Helen Brown, deputy chief executive at Haringey Teaching Primary Care Trust, said: "Haringey TPCT's foot health service treats patients who are assessed as high risk. This helps to ensure the service provides appropriate care for those most in need."
She added that a number of luncheon clubs provide a nail-cutting service for non-high-risk groups, and those with "non-risk" conditions can use "foot health education sessions" and learn how to care for their feet.
Foot care services "have not changed in the recent past," she said, and an advice service is planned for older people who fall to address foot care.
"It's what I call a balls up. I went to the Clock Tower Practice in Crouch End and I have been told it's £30 there, and for a home visit it's £48. When you think the basic pension is about £87 per week, that's a third of a week's pension."
"Balls up" it may be but ( we are all fully conversant with that )
£48 quid for a home visit ?? traffic & parking + time ?? pretty cheap I think
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When you think the basic pension is about £87 per week, that's a third of a week's pension."
But all the additional allowances bring it up to around £200 a week for a single person, suddenly spending 2 hours of a professionals time £50 is not too sad especially as it's only 6/7 times a year.
All these people that moan & groan about this aspect must realise, the allowances have gone up and are paid direct for them to spend the money on what THEY WANT .
The price of that is, services are reduced.
Perhaps I should have been a hairdresser, perm every couple of weeks for a tenner a time ( all cash) .
No regulation to price me out of the market and taken over an 12 week period ? Dearer than me
Kicking nails against the wall ,pulling teeth out with pliers ??
Proritise your health care and stop bloody moaning or put up with the inevitable infections that will occur in the end, OR accept your feet are an important part of your body and look after them properly!!
Have had a bout of the very same spleen ache myself.
Sure my views RE: nail care n NHS are pretty well known by now.....................
Methinks am in agreement, aforementioned blue rinse brigade should cough up or shut up whining.
My nan (lovely story) aged 85, 6o cigs a day, Bingo every day (in her slippers dun't ya know)
Tis a scouser thang. Shops daily, farts LOUDLY & draws £200.00 war widows pension every week.
She can regularly be heard yelling up the street in a broad scouse accent to the local hairdresser, '' Faye can you fit me in for a blow job on saturday?''
Nail care isn't an issue though 'cos our twirlys a shirropodist dunt ya know!
But, if it was she would put her hand in her pocket because that is what would be required, same as if she wants a blow job from Faye. (She's the best in Knowsley village if you require her services.
Sorry about the family album, just had to let my lil spleen run with it.
Regards as always,
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
DDT and Twirly you sound like a pair of resentful 10 year olds down the bottom end of the play ground - you know the place, where the biggest holes have organised themselves and the school swots have all the poshest marbles. You want them and haven't got a plan of how to get your mucky little mits on them.
So whilst you reckon you run competitive businesses, planning for threats taking advantage of the current political situation, you clearly do not.
If your appointment books are full all of the time you are not charging enough. Forget what the old folks are saying. Ignore how they court the media for the sympathetic vote. Rise above the encouragement Age Concern gives to these situations and appreciate how much your professional body supports you in engaging with all this umet need.
Mine has done nothing to engage its business members.
So its down to me all on my lonesome to develop a business plan that fits in nail cuts - into all those spare few minutes. Easy life. Easy work. Easy money.
Super premium work. Standard work. Economy work.
Dead dogs. Cash cows. Rising stars.
Nails surgery. Corns and Callus. Toenail cutting.
Are you getting the message?
Toenail cutting=a permenant rising star because you can fit it in where you want, how you want and as many as you want generating total income. Profit all the way.
So how about fitting in a nail cut at under half of what you charge for your standard treatment, market it to the old folks with a unique selling point and see what happens?
I've done it and my profit soars.
So fancy a game of marbles girls and boys?
GB
P.S I am eternally grateful to all my family for supporting me through my education, for supporting me through the early stages of my business. To them I owe my living and as the senior members get older it is my pleasure to be their 1st class Podiatrist and loved one.
Last edited by George Brandy : 10th November 2007 at 03:19 PM.
Sorry about the somewhat infantile humour and I apologise if it offends ( just a bit of fun, lighten up fella)
I have just finished watching the "remembrance day festival" from the Albert hall on the telly which as usual made me weep and feel so humble and proud to live a country with a way of life that was fought for over 2 world wars and set by their sacrifice = THE ELDERLY of today.
George you don't have exclusive rights on caring ( not meant as a knock back)
I have worked with the elderly for 40 years of my life 24 of them doing things in situations you probably cant even imagine.
So I have done the apprenticeship!!
The elderly of today want every thing as it used top be, provided for them in the form of services nailcare being one of them.
The system has changed. They now get the money instead to spend on what they want including aspects of their personal care.
The trouble is now, they want both !!
I don't make the rules George I just work within them and frankly as you seem to feel that I am "making a fortune" out of the elderly, it may interest you to know I have just sent out letters to several of my "home visits" to inform them "their next visit will be their last from me".
Why ?
Coz of the traffic ,parking ( or lack of it) the nonsense of me spending hours sterilising my instruments in bags ,putting notes on my computer, paying insurance, tax, hpc fees, CPD costs (yes I /they pay for that as well) clinical waste disposal, phone, car running costs, accountancy fees, speed cameras road humps and the like and then working in a situation with energy saving light bulbs, dogs & cats slobbering over me / my instruments and all the time the "elderly telling me how much their hairdresser charges and how expensive I am.
Sorry George I did 24 years of people telling me "what a nice chap I was and how brave I was" etc but when I sustained an injury which stopped me continuing in that profession I got dumped on a pittance of a pension, and no one gave a S**t.
I owe a duty of care TO MY FAMILY so I make no apology for running a profitable business. If anyone comes to my practice I can assure them of a professional service carried out in CLEAN modern surroundings with the latest technology ( which the patients pay for don't forget, I do re-invest in my business) and is performed with sterile instruments and complies with all regulation.
That is THEIR CHOICE take it or leave it.
If they would sooner register with age concern for £18 then buy their nippers for £10 and pay someone another tenner to cut their nails irrespective of the fact they have rheumatoid or are diabetic then get on with it ( probably still ever so happy the hairdresser only charges a tenner every 2 weeks) ( not forgetting the vets bills for the scraggy cat or dog)
Gimme a break George !!!
I will no longer run myself into the ground for a group of people that in the main are perfectly able to afford routine footcare but are unwilling to pay for it, sorry.
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P.S I am eternally grateful to all my family for supporting me through my education, for supporting me through the early stages of my business. To them I owe my living
Well lucky you George!!
I was dumped by my former profession at 40 years old with 2 young children and a mortgage, I had 3 jobs on the go while I completed my training and took out a £30.000 mortgage to build an equip my surgery NO ONE helped me with that ( and I'm talking 20 year ago values) .
So excuse me again if I seem a little peaked at your post:(
It may be "news" but is it worth reporting here? Haven't we all "plowed this field" to death already?
Certainly there are far more interesting & educational items on this Podiatry forum but I & I am sure others are reminded on a regular basis RE: nail cutting etc.
Yes the the discussion is getting tired & most definately 'done to death,' but when Newsbot posts an item then surely it's to generate further discussion should people choose to join in.
George,
No apology from me though.
I am interested to know how much you are charging for nail care?
Do you charge an increased amount for a home visit? Or would that jeopardise the Sainthood?
DDT,
I am in total agreement RE: The freedom we hold so dear today is that which was fought & won by the sacrifice of others. Indeed there are others still fighting.
Not that it will be of interest but purely because I feel I wish to share the following.
Today I (& many others) will join in the 11am silence. I will lay a wreath in memory of my father. Although he did not die in active service, he served for 29 years in the Parachute regiment.
He saw active service in Aden & Borneo & was awarded the LSGC, GSM & the MSM. Earlier this year he was posthumously awarded the Pingat Jasa Malaysia medal from Malaysias High Commissioner.
OAPs are were we are all heading if we're lucky to live that long.
Please George come down off that pedastal you could fall!
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
George you don't have exclusive rights on caring ( not meant as a knock back)
Now you do surprise me. I don't take this as a knock back as my post was anything but caring - indeed outlining the barest bones of a business plan to take advantage of the NHS discharge policy from a business perspective.
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I don't make the rules George I just work within them and frankly as you seem to feel that I am "making a fortune" out of the elderly, it may interest you to know I have just sent out letters to several of my "home visits" to inform them "their next visit will be their last from me".
Go back and read my post again. I don't think you are making enough! Especially if you're not prepared or too busy to fit in a few simple nail cuts for some quick profit. Sit down with a pen and paper and work out how much time you spend on a PNA, work out the costs involved and then take all that time divide it up into nail cuts on an economy fee then realise what part of your business could make you the most money. A dead simple exercise.
Oh and well done you for shedding your home visits. I did it years ago. Best business decision ever and now if patients want a home visit they pay dearly to buy that benefit - for all the reasons you list. Some do buy the benefit and those that complain go elsewhere. Its business.
DDT, you still come across as mightily resentful and we're really on the same side. Lets not debate this through personal philosophy. Lets take a united stance on the profession surviving. Podiatry is a profession so badly represented by its professional bodies that the NHS and governement continually call the shots.
I seem to recollect that not long ago you were arguing for a unified profession. You wanted open access into SCP, without examination, for all HPC registered Podiatrists levelling out the playing field on examination standards and bringing all Pods up to the same educational standard. You rejected the continuing role of FHP trainers.
But now you see no problem handing over the "care of the foot" to a much lower tier of minimally trained volunteers because you don't see why you should cut toenails. Somewhere on Pod Arena there is another thread discussing "who trained FCA's" so lets not go down that route but lets acknowledge the role the NHS has in creating a whole army of minimally trained footcarers who are entering the market as "NHS trained or even qualified" FHP's under the guise of Age Concern Volunteers or even salaried Social Enterprise workers. How long before they set up as commercial nail cutters and callus removers?
So when that happens your fees will come under greater pressure so I hope you have plans to specialise with your Foot scan technology because soon that is the only way you are going to "make money". Sadly this OK in the affluent South East where there is a populus to support a business that relies on specialism but what about those Pods who work in less populated areas who rely on core podiatry?
Should podiatry be forced into specialism via NHS/government policy? Or should we stand the ground and fight for core skills to be retained as ours? Remember the specialisms within our profession can be done by anybody. The core skills cannot.
So what future for Podiatry and for your business? I think it very much depends on which scenario you believe in. If you go for specialism I think George and DDT will be out of the game with volunteers providing cheap footcare nationwide but if you manage your business well and include core podiatry, then the future is less bleak.
DDT, now you have seen the light to send your home visit patients elsewhere fill those idle moments with an economy nail cut you will make a difference - financially to yourself.
Its only human nature to demand a free service when you were led to believe in the 1960's that footcare was free. Having a good moan is theraputic too but it isn't going to change a thing. Rise to the challenge.....and for goodness sakes man have some fun while you work.
No apology from me though.
I am interested to know how much you are charging for nail care?
Do you charge an increased amount for a home visit? Or would that jeopardise the Sainthood?
No apology required. None was sought.
I trust my response to DDT explains my position regarding home visiting. It is a premium rate service for all the reasons DDT gave - even for a nail cut. It is charged at a rate well above my clinic fee and yes people buy this benefit.
What do I charge for a nail cut? Now Twirly that's cheating. How much would you value a 10 minute nail cut? Remember a patient must attend for a full price assessment appointment 1st. I don't make the rules. Its a standard of practice according to HPC.
So you are based in South Yorkshire - traditionally an area of industry, farming and mining. I guess you should be pitching your general fee at £28-£30? Home visits at what £45 - £50? So how about a daring business proposition with those nail cuts at £10-£15? I realise it is below you to cut nails but £10-15 x 4 an hour, 6 if you're organised. Goodness me Twirly, excellent business.
Age Concern see the same business opportunity.
Quote:
Please George come down off that pedastal you could fall!
Thank you for even suggesting a sainthood but no pedastal to fall off as am totally grounded and committed to the business of podiatry. Shame we can't unite on core value, standards and business opportunities.
So what sort of OAP do you reckon you will be - as individualistic as the ones who buy my benefits or a moaner you so disparagingly paint in your previous posts? I guess your beef will be the loss of pension rights when you get to retirement.
Today I (& many others) will join in the 11am silence. I will lay a wreath in memory of my father. Although he did not die in active service, he served for 29 years in the Parachute regiment.
He saw active service in Aden & Borneo & was awarded the LSGC, GSM & the MSM. Earlier this year he was posthumously awarded the Pingat Jasa Malaysia medal from Malaysias High Commissioner.
You must be very proud , as was I with my relatives
One a Chindit ( wifes side) got the M M amongst others, and Royal Engineer (My side) who saw service all over the world.
Watched the parade today, again moved to tears.
Cheers
Derek
Hi George
Quote:
I don't think you are making enough! Especially if you're not prepared or too busy to fit in a few simple nail cuts for some quick profit
Sorry George not into "quick profits"
If I find after initial assessment the Pt only requires " a nail cut " and we charge£10 / £15 to do it suddenly everyone that comes through the door expects it all done for£10 / £15 coz the "words got round"
Sorry cant be asked.
I am fortunate in a way as I only work 3 / 4 days a week ( through choice) and I can fill my time to suit myself and yes somewhat specialising in Biomx.
Quote:
DDT, you still come across as mightily resentful and we're really on the same side
No George NOT resentful, and I have been onside with you on many occasions on Forums for you to know that.
Quote:
I seem to recollect that not long ago you were arguing for a unified profession
And still believe that passionately and also that a patients toe nails are part of their feet and as such, it is part of my remit to cut them. I therefore DON'T agree with Age concern or anyone else for that matter ( I have a real hate for these "nail studios popping up in my area and sorting out infections caused by them).
I was informed by a Physio at a nursing home the other day how she went to cut toe and fingernail at an age concern center. I informed her I had arrived at the home to treat someone with a shoulder problem that needed massage and exercise ( I wasn't) but she ran bleating to the manager)
So yes I still fight our corner wherever I can.
Quote:
and for goodness sakes man have some fun while you work.
I still enjoy what I do but after 45 years of working, the golf course is becoming more and more attractive as a place of enjoyment :)
Following the recent more or less complete shut down of foot care services in our immediate area, we set up an OAP nail care service, similar to described above. Following an assessment at full price, patients can attend for a 10 minute appointment at half normal clinic fee for nail cutting. This works quite well, as I can see 6 patients in an hour. This seems reasonable as the patient gets basic foot care at a reasonable price, and the clinic doesn't lose out financially.
I still enjoy what I do but after 45 years of working, the golf course is becoming more and more attractive as a place of enjoyment
Do I assume retirement beckons and your business plan is beginning to address this?
Nice position to be in but there are many following on in your footsteps that are setting out in private practice running into a brick wall of NHS dictats and finding the going tough. Can't get paid employment, can't make enough profit in PP to survive.
So St George on his mighty pedestal, along with many others, wishes to stop the rot of discarding nail cutting into the social sector and engage with the 65+ with the funds to pay. If quick profit doesn't suit, refer to someone else or engage with an associate.
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If I find after initial assessment the Pt only requires " a nail cut " and we charge£10 / £15 to do it suddenly everyone that comes through the door expects it all done for£10 / £15 coz the "words got round"
So who sets the rules in your practice? The patients or DDT? I guess its the patients. Effective practice management, precise staff training and an invitation to the service user to purchase nail cuts prevents false expectation.
Can't believe you still go aound Old Peoples Homes! Goodness me!! Get a grip.
Off to share a beer with my old dad, 87, kept the 8th Armoured Division on the road with his engineering skills. Comes with attitude. Doesn't take kindly to 11/11. Reminds him too much of what he lost. Doesn't dwell just gets on with his life.
Nice position to be in but there are many following on in your footsteps that are setting out in private practice running into a brick wall of NHS dictats and finding the going tough. Can't get paid employment, can't make enough profit in PP to survive.
So they make a living at £10 a time do they
Quote:
So who sets the rules in your practice? The patients or DDT? I guess its the patients.
I suppose to a degree every practice is managed by the "rules" the Pt sets coz if the Pt's are unhappy word gets round and suddenly you don't have a practice.
But the final decision is ALWAYS mine.
I try to be ever so fair to people ( and yes sometimes fairer than I should be) but I earn a reasonable living and have a good reputation.
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Can't believe you still go around Old Peoples Homes! Goodness me!! Get a grip.
Yep still got an end of life care home and a psycho geri one in the same complex ( another goodwill gesture when I took it over as a favour to another pod as she became seriously ill and couldn't find anyone to take it over , now neither can I )
But I have a 90 year old Aunt that is now in there being very well looked after so...
Quote:
Off to share a beer with my old dad, 87, kept the 8th Armoured Division on the road with his engineering skills. Comes with attitude. Doesn't take kindly to 11/11. Reminds him too much of what he lost. Doesn't dwell just gets on with his life.
Have one for me as well George and give him my thanks and best wishes :)
Believe you me, these guys never forget. It is with them every waking moment.
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I suppose to a degree every practice is managed by the "rules" the Pt sets coz if the Pt's are unhappy word gets round and suddenly you don't have a practice.
The HPC sets the rules. The patient either buys the benefit of the standards the rules dictate or they go elsewhere. Some patients appreciate a legal, safe and effective practice. Patients should never set the rules. This is the worst mistake any private practitioner can ever make when setting up in practice. Believe you me - been there done that.
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Hi Tim
That's what George is advocating
If it works for you and anyone else GREAT
Just not where I want to go with my practice at this point in time.
Cheers M8
Derek
Think your post to Tim says it all. A low cost nail cutting service does not fit your business plan but it does for many private practitioners nationwide when offered in amongst other premium rate products or services. It engages with a sector of people who would not necessarily choose your practice and a patient who starts on a nail cut may choose to purchase from the other range of services your practice sells. Selling ethically, now there is another concept....that's great fun too. A patient comes in for a nail cut -£10 and ends up buying £500 of nail surgery then she can DIY in future.
Good luck with however you choose to run your business DDT. What suits one doesn't suit another.
Stems from when i first graduated and eligibility for NHS care was
Women over 60
Men over 65
The above is sexist discriminatory and illegal
Mental handicap
Physical Handicap
Children under 16 or in full time education up to 18.
Si if you were a diabetic of 35 you had to live another 25 years to be seen.
Arrant Nonsense and discriminatory.
Now the only criteria is that your foot limb is at risk regardless of sex age disability.:)
Much fairer and equitable.
When i first worked for NHS we had 2 year waiting lists so people applied 2 years before they became eligible. And they were buggered if they were ever going to be discharged before death.
There is no perfect system so you takes the money and provides the best service to those at greatest risk.
I wonder if these peoples Fido or Tiddles are denied health care at vets due to costs????
Foot care 'scandal' for OAPs
)
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