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Concern over unregulated surgeons

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BBC London's Asad Ahmad's report contains images you may find disturbing.

By Anna Cavell
BBC London News

BBC London has discovered that there are almost 80 "surgeons" operating in the NHS whose surgical qualifications are not recognised by any statutory body.

Podiatric Surgeons are chiropodists who go on to learn surgical techniques to operate on feet and ankles. But BBC London has learned that there is no independent body which accredits these training courses.

Furthermore, these surgeons do not have to be medical doctors, they usually hold a BSc in chiropody and a masters degree in the theory of podiatric surgery but as chiropodists they are not qualified to be admitted for traditional surgical training within the Royal College of Surgeons.

The employer is responsible for ensuring that they (podiatric surgeons) are competent to undertake the role and that patient safety is not compromised.
Department of Health

There are almost 80 "podiatric surgeons" working in NHS hospitals, some of them have even been awarded the title of Consultant, a situation which causes much confusion among patients who believe they're being operated on by medical doctors.

After years of playing sport Huw Foxall, from west London, developed a problem with his feet. He was diagnosed with hammer toes and a bunion and was referred to a podiatric surgeon.

After a long and gruelling operation, gangrene set in.

"The cast was taken off and the foot was a truly awful sight, it was absolutely black and blue. The chap in the plaster room who took it off said he'd never seen anything like it except when people had been mangled in some sort of industrial accident."

Mr Foxall had to have his big toe amputated and says he would never had agreed to the operation if he'd known the podiatric surgeon wasn't a qualified doctor.

'Ambitious chiropodists'

We contacted the Department of Health to ask why surgeons with unaccredited qualifications are permitted to operate in NHS hospitals.

They replied: "The Department of Health has previously expressed concern to the Society of Chiropodists and Podiatrists about the use of the term "surgeon" which is protected for healthcare professionals who have a medical qualification as recognised by the GMC for doctors."

In the early 1990s the Department of Health published a document called "Feet First" which promoted the idea of chiropodists with some surgical training performing procedures within teams.

It's common for chiropodists to do minor skin surgery - removing in-growing toenails and corns for example. But a group of ambitious chiropodists realised that there was nothing to prevent them from doing ever more complex surgery.

In a presentation called "Crossing Professional Boundaries" to the Society of Podiatrists and Chiropodists, one member of the society quoted a podiatric surgeon as saying:"We were fully aware at the time that there was nothing in law to stop us from doing bone surgery… and that loophole is what we used…it would be very difficult for the law of the land to stop you."

The Society of Chiropodists and Podiatrists established the Faculty of Podiatric Surgery as an educational establishment and the body chiropodists would apply to for training as a podiatric surgeon.

On its website the faculty says its qualifications are registered under the Health Professions Council. But when asked about this registration, the HPC told BBC London: "There isn't a specific podiatric surgery course on our accredited list."

Patient safety

The Society website also claims that a podiatric surgeon can apply for an NHS post after being awarded a fellowship at their own faculty of podiatric surgery, as well as the Royal College of Surgeons in Edinburgh.

But the RCS in Edinburgh told us that they don't have a single podiatric surgeon as a fellow, and yet there are 80 of these surgeons working in the NHS.

In contrast, a medical doctor training in England to become a surgeon would need to complete a training programme recognised by the Royal College of Surgeons, which in turn is overseen by the Post Graduate Medical Education Training Board - the statutory body responsible for all postgraduate medical training.

The Department of Health says: "The employer is responsible for ensuring that they (podiatric surgeons) are competent to undertake the role and that patient safety is not compromised."

If you've been affected by anything in this article, please contact the Health Professions Council on 0800 328 4218.




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