Overseas contribution

The article on working overseas (Overseas aid, 7 September) is excellent.

However, I believe people within the UK healthcare system need to recognise overseas work as worthwhile in order for the reflection you advocate to be noticed.

I spent a year in Haiti after the quake, as I couldn’t get a job in the UK when I qualified. But when I got back here, I was told by NHS senior physios that as someone newly qualified, I shouldn’t have been working in Haiti, I shouldn’t have been working so autonomously and that I should play down my work in Haiti on my supporting statement.

So, despite gaining more skills, experience and confidence while I was away, I am now sitting here feeling completely demoralised, undervalued and confused, not to mention still unable to get consistent work in the UK.

I do now have work, after nearly two years of trying, as a band 5 bank position in a hospital with wonderful seniors and colleagues that do value my time in Haiti.

Disaster relief is hard and brings many challenges. I think more people should go abroad and see for themselves just how difficult it can be, how much you can learn and develop. Working abroad may not be NHS experience, but it’s still valid to professional and personal development.

I’ve just finished my second contract in my new bank role. I’m off to Libya in a couple of days to work as a paid physiotherapist for a well-established emergency response organisation.

I just hope that the NHS will eventually give me an opportunity to do the job I worked so very hard to train for.
Joanna Woodrow,by email

Whiplash backlash

Earlier this year Jack Straw MP revealed to us, ‘the insurance world’s dirty secret,’ following his investigation into questionable practices in the world of whiplash claims management. Unfortunately, he also jumped on the bandwagon that views the world of whiplash as one where – and I quote – ‘dodgy doctors’ treat ‘trivial injuries.’

Mr Straw’s comments were soon followed by a BBC One Panorama programme (The Great Car Insurance Scandal, 11 July) with lurid secret film of criminal gangs crashing cars in order to defraud insurance companies. This programme suggested that a ‘significant proportion of whiplash claims are fraudulent’. Unfortunately it did not put a number to this so-called ‘significant proportion’.

What is glaringly lacking from these very high-profile statements is support for the genuinely whiplash-injured patient.

A plethora of studies consistently demonstrate rupture, bleeding and micro fracture of the facet joints of the spine following whiplash injuries. At rear impact speeds of only 7 mph, the car occupant’s head acceleration is in the region of 12 to 14g. This compares to 6g in F1 drivers during high-speed corners.

The average female driver’s head weighs about 80lbs within milliseconds of the rear impact and, as every physiotherapist knows, our physical reaction times are so slow that the strain occurs before the muscles can contract to help protect the joints.

Research suggests that 20-25% of whiplash-injured patients will have permanent high levels of pain and disability many years following their accident.

Of course fraud and conscious exaggeration exist. But it is so unfortunate that Mr Straw and the BBC did not use their opportunity to tell the world about the current state of the evidence: that for a quarter of those injured by whiplash it is a painful and disturbing experience that carries potentially profound and long term consequences.
Chris Worsfold, Specialist Physiotherapist in Whiplash Injury and Neck Pain, Kent Neck Pain Centre, Tonbridge, Kent

Burning Question

I’m concerned about a patient care issue in my trust. How do I raise this?

If you feel you need to whistleblow over a criminal offence, failure to comply with a legal obligation, a health and safety issue/patients being at risk, a miscarriage of justice or any concealing of the above,check your employer’s whistleblowing policy first. It is likely that you will only be covered to make a ‘disclosure in good faith’ if you have raised your concerns internally first to specific individuals.Your policy may allow you to escalate your concerns internally or externally with specific organisations such as: Health and Safety Executive, Health Professions Council or Public Concern at Work.

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