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Canada Complaint
The object of introducing this n e w position is to provide more support for members w r i t i n g for t h e Journal, a n d thus provide readers with better professional articles. A redesign is also being undertaken following a market research exercise and it is hoped t h a t members will notice t h e difference and like w h a t they see w h e n t h e ' n e w look' is implemented.
Constant Scrutiny The items o n t h e previous page represent s o m e of t h e main changes t h a t are taking place in your organisation this year. In addition, of course, t h e everyday business o f providing a quality service t o members goes on: t h e professional and industrial relations advice; t h e w o r k o f promoting t h e profession; a n d t h e administrative task o f running t h e Society. The Society's services are under constant scrutiny because t h e CSP's f u n c t i o n is t o serve members' professional needs. So if y o u feel there is an area that is n o t being covered now, d o let u s know. If y o u tell us
Changing Approaches MADAM - Having just returned from t w o years working in Africa I read David Henderson's article 'Elective in Central Africa' (May 1991) with particular interest. The article itself, however, left me with some questions about the approach to rehabilitation services which came over as being rather in the western mould, from which most people working in this sphere are trying to move away. It is becoming increasingly recognised by agencies in development work that an imposed or top-down approach to helping a community is in the long run counterproductive. Most groups including the World Health Organisation are advocating the support of grass-root structures, enabling community members (and in this case particularly disabled people themselves) to bring about the changes that they feel would be most beneficial in their situation. This is a much more consultative and educative process, involving the identification and inclusion of local leaders and the training of many indigenous health workers to go out to villages and discover the needs and help the patients and parentskarers to overcome them in the most appropriate fashion. Mr Henderson claims to have gained a basic understanding of Third World physiotherapy and has attempted to communicate to us what that means, I would question whether we can even talk in those terms. Certainly the Third World can benefit a lot from some physiotherapy skills, but those working in the field must have a much broader approach. We must think not about physiotherapy but about rehabilitation, and not about the therapists and what they are achieving, but about the disabled people and other concerned individuals in the community and what they have to offer, how they can be helped to help themselves and others, and what they can teach us. Indeed this dePhysiotherapy, July 1991, vol77, no 7
w h a t y o u want, Council a n d t h e Bedford Row staff c a n t r y to provide it. Please address any comments o n t h e Society's services to either Toby S i m o n or t h e head of t h e relevant department. Revised subscription rates for 1992 were approved a t t h e Council meeting o n June 5 (as reported on page 000). In deciding -to s e t t h e subscription a t a level which will mean t h a t some long-term planned changes in services may have to b e postponed, Council t o o k t h e v i e w t h a t it would b e wcong to ask members t o dig deeper into their pockets in t h e present economic climate. An in-depth review of t h e Society's expenditure is n o w being undertaken in order t o examine t h e value of everything we do. It m a y b e t h a t we could provide a service more costeffectively t h a n w e d o now; it may b e that a n existing service is no longer essential. T h e aim of t h e exercise is t o ensure t h a t your subscription is wisely a n d effectively used. in t h e interests o f t h e Drofession.
professionalisation method of care is one that we would do well to consider in this country too. I for one would like us as physiotherapists to consider and discuss much further the contribution that we can make to rehabilitation in the Third World and ways in which we should change our approaches and attitudes, and how we should be expanding our knowledge base in order to have the most to contribute. Perhaps there are others who have or who would like to have experience in this most rewarding of specialties, and would like to contact me to discuss the topicafurther? LINDA PROSSER MCSP 9 0 Egerton Road Bishopston Bristol BS7 8HP
Canada Complaint MADAM - Like Jon Pearson MA MCSP of Bristol (March, 1991). I also have a complaint about the Canadian system. I obtained a job in a general hospital in Ontario last August. Four months, and €150 later, I received my work authorisation and handed in my resignation in England. I rented my house and had almost sold my car before receiving a phone call from the Board of Directors of Physiotherapy for Ontario. This informed me that I was not eligible for registration as my initial training was as a remedial gymnast. This came as quite a shock because when I contacted the Board last year it had not made it clear that ex-remedial gymnasts were not eligible for registration in Ontario. I qualified from Pinderfields College in Wakefield in 1985 and went on to pass my complementary skills course, in Preston, in 1986. Since then I have worked as a physiotherapist in hospitals and special schools. I cannot understand why my qualifications, training and experience, which are valued by Britain, and many other
countries, are considered unacceptable in one province in Canada. The Board offered me no exam, saying the only way I could be considered would be if I went to university (in Canada), to convert my diploma into a BSc degree, and even then it could not guarantee my registration at the end. I hope that by sharing my experience with others I can prevent the disappointment and expense that I have had as a result of the inflexibility of the Ontario registration system. JANE GARNER MCSP DipRG&RT Barnsley
Threat to Specialist Care MADAM - I am writing as a senior physiotherapist with clinical expertise in obstetrics and gynaecology. I am concerned that some of the GP fund-holding practices, rather than 'seeking centres of excellence' as the Government claims, are in fact choosing t o have their patients treated by generalist physiotherapists with no specialist expertise. This is because it is less expensive to employ a physiotherapist within the practice, than to refer to a specialist physiotherapist at the District general hospital. I fear that the standard of physiotherapy given to, for example, a patient suffering from incontinence, or a pregnant woman with low back pain due to hormonal laxity, will inevitably drop. This must also be the case within other specialties such as orthopaedics and neurology. If I, or a member of my family, suffered from a sports injury, or underwent a knee replacement, I would not expect them to be treated by an obstetric physiotherapist! JEANNE M MclNTOSH MCSP Chairman Education Sub-committee of The Association of Chartered Physiotherapists in Obstetrics and Gynaecology 459
Constant Scrutiny The items o n t h e previous page represent s o m e of t h e main changes t h a t are taking place in your organisation this year. In addition, of course, t h e everyday business o f providing a quality service t o members goes on: t h e professional and industrial relations advice; t h e w o r k o f promoting t h e profession; a n d t h e administrative task o f running t h e Society. The Society's services are under constant scrutiny because t h e CSP's f u n c t i o n is t o serve members' professional needs. So if y o u feel there is an area that is n o t being covered now, d o let u s know. If y o u tell us
Changing Approaches MADAM - Having just returned from t w o years working in Africa I read David Henderson's article 'Elective in Central Africa' (May 1991) with particular interest. The article itself, however, left me with some questions about the approach to rehabilitation services which came over as being rather in the western mould, from which most people working in this sphere are trying to move away. It is becoming increasingly recognised by agencies in development work that an imposed or top-down approach to helping a community is in the long run counterproductive. Most groups including the World Health Organisation are advocating the support of grass-root structures, enabling community members (and in this case particularly disabled people themselves) to bring about the changes that they feel would be most beneficial in their situation. This is a much more consultative and educative process, involving the identification and inclusion of local leaders and the training of many indigenous health workers to go out to villages and discover the needs and help the patients and parentskarers to overcome them in the most appropriate fashion. Mr Henderson claims to have gained a basic understanding of Third World physiotherapy and has attempted to communicate to us what that means, I would question whether we can even talk in those terms. Certainly the Third World can benefit a lot from some physiotherapy skills, but those working in the field must have a much broader approach. We must think not about physiotherapy but about rehabilitation, and not about the therapists and what they are achieving, but about the disabled people and other concerned individuals in the community and what they have to offer, how they can be helped to help themselves and others, and what they can teach us. Indeed this dePhysiotherapy, July 1991, vol77, no 7
w h a t y o u want, Council a n d t h e Bedford Row staff c a n t r y to provide it. Please address any comments o n t h e Society's services to either Toby S i m o n or t h e head of t h e relevant department. Revised subscription rates for 1992 were approved a t t h e Council meeting o n June 5 (as reported on page 000). In deciding -to s e t t h e subscription a t a level which will mean t h a t some long-term planned changes in services may have to b e postponed, Council t o o k t h e v i e w t h a t it would b e wcong to ask members t o dig deeper into their pockets in t h e present economic climate. An in-depth review of t h e Society's expenditure is n o w being undertaken in order t o examine t h e value of everything we do. It m a y b e t h a t we could provide a service more costeffectively t h a n w e d o now; it may b e that a n existing service is no longer essential. T h e aim of t h e exercise is t o ensure t h a t your subscription is wisely a n d effectively used. in t h e interests o f t h e Drofession.
professionalisation method of care is one that we would do well to consider in this country too. I for one would like us as physiotherapists to consider and discuss much further the contribution that we can make to rehabilitation in the Third World and ways in which we should change our approaches and attitudes, and how we should be expanding our knowledge base in order to have the most to contribute. Perhaps there are others who have or who would like to have experience in this most rewarding of specialties, and would like to contact me to discuss the topicafurther? LINDA PROSSER MCSP 9 0 Egerton Road Bishopston Bristol BS7 8HP
Canada Complaint MADAM - Like Jon Pearson MA MCSP of Bristol (March, 1991). I also have a complaint about the Canadian system. I obtained a job in a general hospital in Ontario last August. Four months, and €150 later, I received my work authorisation and handed in my resignation in England. I rented my house and had almost sold my car before receiving a phone call from the Board of Directors of Physiotherapy for Ontario. This informed me that I was not eligible for registration as my initial training was as a remedial gymnast. This came as quite a shock because when I contacted the Board last year it had not made it clear that ex-remedial gymnasts were not eligible for registration in Ontario. I qualified from Pinderfields College in Wakefield in 1985 and went on to pass my complementary skills course, in Preston, in 1986. Since then I have worked as a physiotherapist in hospitals and special schools. I cannot understand why my qualifications, training and experience, which are valued by Britain, and many other
countries, are considered unacceptable in one province in Canada. The Board offered me no exam, saying the only way I could be considered would be if I went to university (in Canada), to convert my diploma into a BSc degree, and even then it could not guarantee my registration at the end. I hope that by sharing my experience with others I can prevent the disappointment and expense that I have had as a result of the inflexibility of the Ontario registration system. JANE GARNER MCSP DipRG&RT Barnsley
Threat to Specialist Care MADAM - I am writing as a senior physiotherapist with clinical expertise in obstetrics and gynaecology. I am concerned that some of the GP fund-holding practices, rather than 'seeking centres of excellence' as the Government claims, are in fact choosing t o have their patients treated by generalist physiotherapists with no specialist expertise. This is because it is less expensive to employ a physiotherapist within the practice, than to refer to a specialist physiotherapist at the District general hospital. I fear that the standard of physiotherapy given to, for example, a patient suffering from incontinence, or a pregnant woman with low back pain due to hormonal laxity, will inevitably drop. This must also be the case within other specialties such as orthopaedics and neurology. If I, or a member of my family, suffered from a sports injury, or underwent a knee replacement, I would not expect them to be treated by an obstetric physiotherapist! JEANNE M MclNTOSH MCSP Chairman Education Sub-committee of The Association of Chartered Physiotherapists in Obstetrics and Gynaecology 459