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After reading your article ‘Hands-on physio is barred’ (page 9, 4 April), I felt compelled to write in response to the article and, more specifically, Phil Gray’s published comments.
I am a physiotherapist forced to work in this environment of treatment restrictions and challenged on a daily basis to provide physiotherapy services to patients within these confines.
Very frustratingly, Mr Gray appears to suggest that it was because the service was ‘opened up to competition’ that patients are suffering. This is simply not true.
The problem rests firmly with the NHS provider Principia and their attempt to provide easy access physiotherapy services for a population in excess of 120,000 people for £55,000 per year, something that the providers (who are paid per contact) were never made aware of.
The contract failure is not because the services were opened up to qualified providers, who provide a professional physiotherapy service in local areas in a very cost-effective manner. It’s simply due to bad accounting.
Cost savings to the NHS of a well organised any qualified provider (AQP) contract could include reduced employer financial liability (with lower employers’ national insurance, sick, holiday pay and so on) and reduced responsibility for running costs of departments.
I agree that the ‘advice and guidance’ service in this instance is sub-standard and ‘a disgrace’ as Mr Gray is quoted as saying.
I also believe that the AQP model needs carefully examining and better planning, as on this occasion it failed patients significantly.
Michael Brownlow, by email
Frustrated, from down under
Having read the submission by Belinda Thoday (1 February) about registering in Australia, I appreciate her frustration.
As a UK-trained physiotherapist, I too was frustrated with the process of gaining registration, having a first class honours degree in physiotherapy.
Having worked in Australia in public health systems and private practice for five years I have a much better appreciation of why registration is thought necessary, and I don’t think it’s purely about academic equivalence.
In spite of fundamental similarities, the UK and Australian healthcare systems do work differently. For example, the level of in-service training and ring-fenced continuing professional devleopment (CPD) time was much higher when working in the NHS than it has ever been in the Australian public hospital system.
It is possible that physios in Australia are expected to enter the profession without the need for a high level of support (although CPD is just as important.) Australian physiotherapists perceive their training to be at a much higher level than ours.
That aside, the primary concern is to ensure that the Australian public is safe. Thus, anyone who is not trained in Australia or registered in New Zealand is required to undergo a registration process.
Can you call it unfair if everyone has to do it?
Physios are held in very high regard in Australia. They have a hard-won reputation for being healthcare professionals of the highest quality and long ago challenged the healthcare establishment for the right to be primary care providers.
Blaise Doran, by email
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