- Email: [email protected]
Council Responses to Resolutions from the Annual Representatives Conference
Choosing a Chair MADAM - I see from an itern in the middle of page 736 of the December 1989 issue of Physiotherapy that we are now electing pieces of furniture. Is this an attempt to add to the seating in the CSP extension? May I extend my sympathies to Barbara Edmonds, Amanda Squires and Margot Hawker on becoming chairs, and add my fervent hope that they did not find the transformation too uncomfortable and that it will not interfere with their professional skills. JEAN ABBOTT MCSP Leicester
Trees Are Saved! MADAM - It has long been an unfortunate fact that if one repeats a fallacy often enough, it becomes accepted as truth. Your correspondent in the November issue under the heading of 'Save The Trees' has obviously been misled in this way, but C E Rawding can help to keep subscription
increases down and still have a clear conscience that the environment is not thereby being denuded of trees. The paper industry has obviously not been very good at publicising its own excellent record in looking after the forests which are its source of raw material. We all know that the farmer replants his fields after the harvest but there seems to be a lack of awareness that the forester does likewise. Re-afforestation is carried out on a massive scale in all the major pulp and paper producing areas of the world. The forests of Scandinavia and Finland are a significant source of paper products for Europe and, as a result of replanting, the current annual volume regrowth in these forests is up to 30% greater than the annual cut - hardly a loss to the environment. Another popular misconception seems to be that the paper trade is somehow responsible for the destruction of the rainforests. I am sure that you know that this is patent nonsense and that the rainforests are disappearing for quite different reasons.
The merits or otherwise of so-called junk mail are a separate issue; mine recently included a circular and leaflet from Friends of the Earth soliciting support in a campaign to save the Amazon Rainforest! IAN PEARSON Director, Crosleys Paper Mill Agents
Huntington's Chorea MADAM - The Association to Combat Huntington's Chorea (COMBAT) has drawn together a group of professionals who are interested in the management of people with Huntington's chorea. I am writing on behalf of this group, who would be interested to hear from anyone involved with these patients and their families. Please contsct Jane Leeman, Patient Care Adviser, COMBAT, 108 Battersea High Street, London S W l l 3HP. CHRISTINE BOWES MCSP London SW15
Council Responses to Resolutions from the Annual Representatives Conference Resolutions carried and remitted a t the Representatives Conference were discussed by relevant standing committees and their responses were amended and approved by Council. These are given here in bold type, preceded by the original resolutions in medium type. Motions preceded by an asterisk ( " 1 were not discussed a t the conference and were remitted t o Council. 1. Care in the community by health professionals is spasmodic and unstructured. The Government is exploiting both the carers and all community workers by seriously under-funding this essential service. The CSP should actively campaign to increase the funding of the community service. Council fully accepts that better co-ordination of care in the
community is needed, and that the resources presently provided are inadequate. The Society will therefore press for the increased funding of community-based physiotherapy and other services.
2. As the Government has now accepted the recommendations of Griffiths 11, the CSP should pressure it for adequate resources to implement the proposed changes fully.
Our response to the White Paper will stress the need for adequate resources to implement the community care strategy, and in particular to ensure the provision of physiotherapy to all those who need it. 4. In the light of political and demographic changes physiotherapy should be where the people and problems are. Council agrees with this sentiment, and intends to reflect it in policy development.
6. In view of the Government's White Paper offering more money to acute specialties, the CSP should make the Government aware of the valuable service offered by physiotherapists to chronically sick and disabled people. Council believes that good practice in physiotherapy generates its own publicity. However, the Society will do as much as possible to draw attention both to areas of good practice in physiotherapy services for chronically sick and disabled people and the lack of resourcesfor services to these people. A report due to be published
Physiotherapy, January 1990, vol76, no 1
during 1990 from the Professional Practice Committee's Physical Disabilities Working Party will identify the services physiotherapists should be offering to this client group. 8. The administration of substances by injection is an appropriate part of physiotherapy practice. Council will undertake a comprehensive review of the use of injections by physiotherapists and a further report will be made
on this. 9. There should be a national body to research manufacturers' claims. Are our machines effective or for effect? Council believes that manufacturers should accept the responsibility to demonstrate the efficacy of their treatment modalities and that they are willing to support further research into their claims. The Centre for Physiotherapy Research is currently undertaking a literature search on the availability of evidence of efficacy of electrotherapy equipment. This will be reported to the Electrotherapy Sub-committee of the Professional Practice Committee which will move the findings forward.
64. Although the profession welcomes the debate that the publicity about the Peto Institute has brought to the attention of the public, we feel that they have many misconceptions about the value of conductive education available to children because of biased publicity by the media. The CSP should redress the balance by publicly highlighting the professional expertise already available in this country and that resources are not currently available to allow this expertise to be used to its full potential.
Council agrees that there are too few resources for the treatment of children with cerebral palsy. It encourages, and will assist, members to promote their own work to redress the balance of publicity given to the Peto Institute.
21
13. The CSP should continue to keep physiotherapy skills the remit of Chartered Physiotherapists, and should strongly resist the extended role of the physiotherapy helper. Council considers that it is for Chartered physiotherapists to decide on the tasks that can be delegated to helpers and others. Their training should reflect the pattern of practice of physiotherapists locally. 14. The Society should object to any increase in the number of helpers at the expense of physiotherapy posts due to either proposals in the NHS Review or initiatives being introduced in the area of helpers' training. Council considers that helpers can extend the value of the service of physiotherapists but should not be seen as a substitute for them. 16. Physiotherapy helpers do not need a formalised training. Council considers that helpers should receive training appropriate to their needs, and that this should be recognised by a relevant National Vocational Qualification, as should be expected for any employee. The current work being undertaken on the competencies required by helpers will indicate the subjects that need to be covered in this training. 18. The CSP should state publicly that the use of the Youth Training Scheme (YTS) members or similar, as a source of cheap labour, is both detrimental to the profession and useless to the trainee. The primary aim of the YTS is t o provide effective training, and Council would be very concerned if trainees were t o be seen as cheap labour. There is likely t o be only limited scope for placement of such trainees in physiotherapy departments. "19. There should be more open access to physiotherapy departments for general practitioner (GP) referrals rather than employing their own Chartered physiotherapists, Council believes that all GPs should have access to a full range of appropriate physiotherapy services. "20. The income generated from increasing numbers of private patients in National Health Service hospitals should be distributed more evenly through departments involved in their treatment. The extra moneys made available to physiotherapy departments would be invaluable for books, new equipment, education, etc. Council believes that physiotherapy departments should be adequately resourced; they should not have t o rely on particular sources of income such as are suggested in this motion. 21. In the light of the Department of Health request that the number of physiotherapy training places should be increased by 100, the CSP should actively oppose the closure of Guy's and St Thomas' physiotherapy schools until such extra places are provided in new schools. Council greatly regrets the decision of the South East Thames Health Authority to close both schools, but considers that it is now too late to take any further action to oppose these closures. It wholly accepts that additional places for Physiotherapytraining are required, but these cannot be provided in the way suggested. In particular: (a) There will be no national examinations for intakes from 1987. The St Thomas' school has not submitted an internalised course and it will be too late to prepare one. (b) There is no guarantee that staff can be retained beyond autumn
1992. (c) The available clinical placements are being replanned t o serve King's College and Brighton Polytechnic. 23. The CSP should increase its efforts to facilitate an all-graduate profession. Council accepts the importance of an all-graduate profession, but notes that the CSP has done everything within its means to facilitate this. It will continue to do so. Half the 1989 entry are registered on degree courses. 24. The CSP should oppose the proposed student 'top-up loan' scheme as being disadvantageous to physiotherapy students in the future and should campaign to maintain the present full source funding for physiotherapy student grants. Council agrees. The Society has already responded to the initial White Paper on loans, and will continue t o oppose them.
22
26. The CSP pre-registration curriculum is unsuited to the reality 3f the clinical situation. See 28.
27. The CSP should emphasise the preventive role of physiotherapy juring training and that therapists should be aware of the maintwance of health as well as the treatment of illness. See 28.
28. Obstetrics and gynaecology should be a compulsory placement In student training. The content of the undergraduate training is being reviewed by the Curriculum Review Group at the moment, and these points will be considered by them in preparing their report. 30. The resources of schools of physiotherapy should be drawn upon 3y those organising post-registration education courses. Council agrees, and will draw this to the attention of principals 3f schools of physiotherapy. 31. CSP validated courses should be standardised andlor graded according to: (a) The level of experience of the course participants. (b) The number of hours devoted to theory and practice, supervised and unsupervised, during the specified length of the course. (c) The objectives and methods of theoretical and practical evaluation of the participants. (d) The setting and making of papers, and the designing and appraisal of practical assessments or project work. Council agrees. The development of the master plan for postregistration education is expected t o involve separate procedures for validation of longer courses and recognition of shorter skillsbased courses. "33. If research is to have direct implications on clinical practice, the CSP should attempt to assess the significance of published work and report to members through the most appropriate channels. Council considers that it is not appropriate for the Chartered Society to use its limited resources actually to assess research. This is a matter for individual practitioners, departments, journal clubs and educational institutions.
34. Patient examination to identify their level of competence should not form part of an interview process for physiotherapists. Council supports this motion. 35. The CSP should strongly campaign for the provision for creche facilities in hospitals particularly in view of the manpower crisis and the need to retain staff following maternity leave. Council will certainly campaign for expanded childcare support for members. It has proposed to the Review Body that anymoney available for recruitment and retention initiatives should be devoted to the provision of vouchers for childcare. 36. CSP should strongly campaign for better study leave for physiotherapists to enable them to attend during working hours post-qualification courses necessary to their professional development. Council hopes that the recently concluded agreement on study leave will be of assistance here. The Society will press for its effective implementation, and will also campaign for possible further improvements.
37. The CSP should lobby Parliament for statutory funding of postgraduate education on a par with the medical profession. Council agrees that it is right that physiotherapists should have a contractual right t o postgraduate education, appropriate to their needs; though the best tactical method for achieving this will need to be judged in the light of circumstances.
38. The Society should reaffirm its support for its trade union function and be prepared to fight for recognition within any new system introduced by the White Paper. Council indeed reafirms its support for its trade union function. It will continue to expect t o be recognised throughout the NHS, and would fight any withdrawal of recognition. 39. Due to the uncertainty of the future of the NHS, together with increased workloads, the stress suffered by all grades of staff is liable to precipitate 'burn-out syndrome' on a national scale! The CSP should take steps to combat this syndrome before it reaches epidemic proportions. See 41.
W", January 1990, ~0176,no 1
40. The CSP should press for independent counselling and support for NHS staff. See 41.
41. With the increased workload for physiotherapists in the NHS, the CSP should produce health and safety guide lines for the welfare of staff and patients. The Health and Safety Sub-committee will undertake a study of the impact of workloads on practice, and consider what support can be given to members. 42. The introduction of Regional pay agreements would lead to inequalities in the provision of health care and must be resisted. The Society would oppose the introduction of local pay variations which it believes would be divisive, and would only transfer shortages from one locality to another. 43. The CSP must be prepared to oppose any attempt to abolish Whitley Council terms and conditions of employment. The Society will oppose most strenuously any attempt to abolish the present National Whitley Council terms and conditions of employment, or the Review Body.
44. The CSP should not endorse the principle of performance-related pay as this will inevitably lead to professional suicide. The CSP has no current policy on the question of performancerelated pay. 46. The Chartered Society of Physiotherapy should fight the introduction of the White Paper, rather than accept its inevitability by 'making the best of a bad job', thereby selling out the whole profession. The CSP's approach has been t o concentrate on the specific issues which cause concern, and fight these. It does not accept the review's implementation as inevitable; there is scope to change the most objectionable features. 47. The CSP, as part of its financial policy, should set aside an adequate and on-going campaign fund to counteract measures against patients' or the profession's interest - such as the introduction of the NHS White Paper. Council accepts the importance of adequate funds to campaign against measures which are against the interest of the patients or the profession. However, rather than create a specific campaign fund, issues will be considered as they arise, and funds allocated as necessary. 48. The CSP should continue to enlighten the general public on the effects that the White Paper will have on them and their local physiotherapy services. Information to the public is an important part of the CSP's campaign on the White Paper. 49. The CSP should admit that the hidden agenda within the White Paper is privatisation, and should therefore strongly fight to prevent this happening in accordance with current Society policy. The CSP would certainly fight privatisation of the NHS most strongly if this were to be proposed. 51. The CSP should take steps to ensure that the profession's right to manage itself is not undermined in the light of possible developments in the NHS. Council agrees that the profession's right t o manage itself is central to the future of the profession, and will certainly take steps to ensure this right is maintained. 52. Within the proposed changes in the Government White Paper, there is a danger that 'prescription' physiotherapy will re-emerge. As a profession we must prevent this and maintain our professional status and right to decide on clinical diagnosis/treatment. The professional autonomy of physiotherapy is already affirmed in the Rules of Professional Conduct. Council will continue to insist on the full professional responsibility of members and the unacceptability of a prescriptive relationship with members of other health professions. "53. The physiotherapy profession is suffering from a period of apathy. With the proposed changes in the Government White Paper, now is the time to snap out of this attitude and encourage a more positive, forward-thinking profession. Council does not accept the premise on which this motion is based. But it will continue to encourage the advance of the profession.
physiotherapy, Januaty 1990, vol76, no 1
54 With the advent of the firqt National Representatives Conference, he CSP must be seen to reflect the views of the grass-roots nembership Council is here publishing its response t o motions passed by the :onference, which includes details of proposed action on each issue. Zouncil is certainly committed to responding to members' needs. 55 Council should more accurately reflect the composition of he membership of the Chartered Society of Physiotherapy Council believes that its present constitution gives opportunities or all parts of the membership to be represented. The present :omposition of Council is as in the table:
Numbers in types of post when first elected Present to Council employment -leads of schools of physiotherapy 3ther physiotherapist educators 3istrict physiotherapists Senior superintendents Superintendents 111 and below >rivate practitioners In sports medicine In occupational health Students Researcher
4 7 6 3 10 4 1 1 2 1
5
6 9 5 6 4 1 1
2
0
56. In order to fufil the role of chairman of Council without :ompromise to the individual or employer, this Chartered 3hysiotherapist should be seconded on a full-time basis from W h e r employing authority for a fixed term by the CSP. The Policy and Resources Committee has recently discussed in depth the arrangements for support of the senior officers of the Society, and of the chairman of Council in particular, and will sontinue t o keep the matter under review. However, it considers t unlikely that all employers would allow a member of staff t o be seconded for t w o years, and also noted that some potential candidates for chairman would not be in a position t o accept a secondment in a different part of the country. 59. The Industrial Relations Department and its regional structure in particular should be developed and expanded in order to respond to existing and probable increasing industrial relations problems in health care services. The Policy and Resources Committee has agreed a general strategy for the development of the Industrial Relations Department, which will be implemented as resources allow. A further senior industrial relations post was filled earlier during 1989, by internal promotion, and the resulting vacancy for an industrial relations officer is to be filled shortly. The Policy and Resources Committee has agreed in principle that a further industrial relations officer post should, in accordance with the strategy, be created from mid-1990. 61. The Chartered Society of Physiotherapy should adopt alternative methods for producing policy documents and reports and should have the mechanism to produce policy decisions more quickly, rather than trailing behind other professional organisations. Council believes that the Chartered Society has shown its ability to produce an instant reaction to newly published documents and to produce a considered response within the required timescale. It believes that, in general, the present methods of establishing the Society's policy are appropriate. It does not believe that we necessarily trail behind other professional organisations. 63. The CSP should improve the level of public awareness of the role of Chartered physiotherapists, the valuable service which they provide, and re-open the issue concerning protection of the title 'physiotherapist' from misuse by non-qualified practitioners, particularly in the light of the recent White Paper. The Chartered Society has asked for a comprehensive review of the regulatory arrangements for physiotherapy, and of the Professions Supplementary to Medicine Act 1960 in particular. It will continue to press for this review, which would give an opportunity t o examine the possibility of protection of titles. The titles of Chartered physiotherapist and State Registered physiotherapist are already protected.
23
Trees Are Saved! MADAM - It has long been an unfortunate fact that if one repeats a fallacy often enough, it becomes accepted as truth. Your correspondent in the November issue under the heading of 'Save The Trees' has obviously been misled in this way, but C E Rawding can help to keep subscription
increases down and still have a clear conscience that the environment is not thereby being denuded of trees. The paper industry has obviously not been very good at publicising its own excellent record in looking after the forests which are its source of raw material. We all know that the farmer replants his fields after the harvest but there seems to be a lack of awareness that the forester does likewise. Re-afforestation is carried out on a massive scale in all the major pulp and paper producing areas of the world. The forests of Scandinavia and Finland are a significant source of paper products for Europe and, as a result of replanting, the current annual volume regrowth in these forests is up to 30% greater than the annual cut - hardly a loss to the environment. Another popular misconception seems to be that the paper trade is somehow responsible for the destruction of the rainforests. I am sure that you know that this is patent nonsense and that the rainforests are disappearing for quite different reasons.
The merits or otherwise of so-called junk mail are a separate issue; mine recently included a circular and leaflet from Friends of the Earth soliciting support in a campaign to save the Amazon Rainforest! IAN PEARSON Director, Crosleys Paper Mill Agents
Huntington's Chorea MADAM - The Association to Combat Huntington's Chorea (COMBAT) has drawn together a group of professionals who are interested in the management of people with Huntington's chorea. I am writing on behalf of this group, who would be interested to hear from anyone involved with these patients and their families. Please contsct Jane Leeman, Patient Care Adviser, COMBAT, 108 Battersea High Street, London S W l l 3HP. CHRISTINE BOWES MCSP London SW15
Council Responses to Resolutions from the Annual Representatives Conference Resolutions carried and remitted a t the Representatives Conference were discussed by relevant standing committees and their responses were amended and approved by Council. These are given here in bold type, preceded by the original resolutions in medium type. Motions preceded by an asterisk ( " 1 were not discussed a t the conference and were remitted t o Council. 1. Care in the community by health professionals is spasmodic and unstructured. The Government is exploiting both the carers and all community workers by seriously under-funding this essential service. The CSP should actively campaign to increase the funding of the community service. Council fully accepts that better co-ordination of care in the
community is needed, and that the resources presently provided are inadequate. The Society will therefore press for the increased funding of community-based physiotherapy and other services.
2. As the Government has now accepted the recommendations of Griffiths 11, the CSP should pressure it for adequate resources to implement the proposed changes fully.
Our response to the White Paper will stress the need for adequate resources to implement the community care strategy, and in particular to ensure the provision of physiotherapy to all those who need it. 4. In the light of political and demographic changes physiotherapy should be where the people and problems are. Council agrees with this sentiment, and intends to reflect it in policy development.
6. In view of the Government's White Paper offering more money to acute specialties, the CSP should make the Government aware of the valuable service offered by physiotherapists to chronically sick and disabled people. Council believes that good practice in physiotherapy generates its own publicity. However, the Society will do as much as possible to draw attention both to areas of good practice in physiotherapy services for chronically sick and disabled people and the lack of resourcesfor services to these people. A report due to be published
Physiotherapy, January 1990, vol76, no 1
during 1990 from the Professional Practice Committee's Physical Disabilities Working Party will identify the services physiotherapists should be offering to this client group. 8. The administration of substances by injection is an appropriate part of physiotherapy practice. Council will undertake a comprehensive review of the use of injections by physiotherapists and a further report will be made
on this. 9. There should be a national body to research manufacturers' claims. Are our machines effective or for effect? Council believes that manufacturers should accept the responsibility to demonstrate the efficacy of their treatment modalities and that they are willing to support further research into their claims. The Centre for Physiotherapy Research is currently undertaking a literature search on the availability of evidence of efficacy of electrotherapy equipment. This will be reported to the Electrotherapy Sub-committee of the Professional Practice Committee which will move the findings forward.
64. Although the profession welcomes the debate that the publicity about the Peto Institute has brought to the attention of the public, we feel that they have many misconceptions about the value of conductive education available to children because of biased publicity by the media. The CSP should redress the balance by publicly highlighting the professional expertise already available in this country and that resources are not currently available to allow this expertise to be used to its full potential.
Council agrees that there are too few resources for the treatment of children with cerebral palsy. It encourages, and will assist, members to promote their own work to redress the balance of publicity given to the Peto Institute.
21
13. The CSP should continue to keep physiotherapy skills the remit of Chartered Physiotherapists, and should strongly resist the extended role of the physiotherapy helper. Council considers that it is for Chartered physiotherapists to decide on the tasks that can be delegated to helpers and others. Their training should reflect the pattern of practice of physiotherapists locally. 14. The Society should object to any increase in the number of helpers at the expense of physiotherapy posts due to either proposals in the NHS Review or initiatives being introduced in the area of helpers' training. Council considers that helpers can extend the value of the service of physiotherapists but should not be seen as a substitute for them. 16. Physiotherapy helpers do not need a formalised training. Council considers that helpers should receive training appropriate to their needs, and that this should be recognised by a relevant National Vocational Qualification, as should be expected for any employee. The current work being undertaken on the competencies required by helpers will indicate the subjects that need to be covered in this training. 18. The CSP should state publicly that the use of the Youth Training Scheme (YTS) members or similar, as a source of cheap labour, is both detrimental to the profession and useless to the trainee. The primary aim of the YTS is t o provide effective training, and Council would be very concerned if trainees were t o be seen as cheap labour. There is likely t o be only limited scope for placement of such trainees in physiotherapy departments. "19. There should be more open access to physiotherapy departments for general practitioner (GP) referrals rather than employing their own Chartered physiotherapists, Council believes that all GPs should have access to a full range of appropriate physiotherapy services. "20. The income generated from increasing numbers of private patients in National Health Service hospitals should be distributed more evenly through departments involved in their treatment. The extra moneys made available to physiotherapy departments would be invaluable for books, new equipment, education, etc. Council believes that physiotherapy departments should be adequately resourced; they should not have t o rely on particular sources of income such as are suggested in this motion. 21. In the light of the Department of Health request that the number of physiotherapy training places should be increased by 100, the CSP should actively oppose the closure of Guy's and St Thomas' physiotherapy schools until such extra places are provided in new schools. Council greatly regrets the decision of the South East Thames Health Authority to close both schools, but considers that it is now too late to take any further action to oppose these closures. It wholly accepts that additional places for Physiotherapytraining are required, but these cannot be provided in the way suggested. In particular: (a) There will be no national examinations for intakes from 1987. The St Thomas' school has not submitted an internalised course and it will be too late to prepare one. (b) There is no guarantee that staff can be retained beyond autumn
1992. (c) The available clinical placements are being replanned t o serve King's College and Brighton Polytechnic. 23. The CSP should increase its efforts to facilitate an all-graduate profession. Council accepts the importance of an all-graduate profession, but notes that the CSP has done everything within its means to facilitate this. It will continue to do so. Half the 1989 entry are registered on degree courses. 24. The CSP should oppose the proposed student 'top-up loan' scheme as being disadvantageous to physiotherapy students in the future and should campaign to maintain the present full source funding for physiotherapy student grants. Council agrees. The Society has already responded to the initial White Paper on loans, and will continue t o oppose them.
22
26. The CSP pre-registration curriculum is unsuited to the reality 3f the clinical situation. See 28.
27. The CSP should emphasise the preventive role of physiotherapy juring training and that therapists should be aware of the maintwance of health as well as the treatment of illness. See 28.
28. Obstetrics and gynaecology should be a compulsory placement In student training. The content of the undergraduate training is being reviewed by the Curriculum Review Group at the moment, and these points will be considered by them in preparing their report. 30. The resources of schools of physiotherapy should be drawn upon 3y those organising post-registration education courses. Council agrees, and will draw this to the attention of principals 3f schools of physiotherapy. 31. CSP validated courses should be standardised andlor graded according to: (a) The level of experience of the course participants. (b) The number of hours devoted to theory and practice, supervised and unsupervised, during the specified length of the course. (c) The objectives and methods of theoretical and practical evaluation of the participants. (d) The setting and making of papers, and the designing and appraisal of practical assessments or project work. Council agrees. The development of the master plan for postregistration education is expected t o involve separate procedures for validation of longer courses and recognition of shorter skillsbased courses. "33. If research is to have direct implications on clinical practice, the CSP should attempt to assess the significance of published work and report to members through the most appropriate channels. Council considers that it is not appropriate for the Chartered Society to use its limited resources actually to assess research. This is a matter for individual practitioners, departments, journal clubs and educational institutions.
34. Patient examination to identify their level of competence should not form part of an interview process for physiotherapists. Council supports this motion. 35. The CSP should strongly campaign for the provision for creche facilities in hospitals particularly in view of the manpower crisis and the need to retain staff following maternity leave. Council will certainly campaign for expanded childcare support for members. It has proposed to the Review Body that anymoney available for recruitment and retention initiatives should be devoted to the provision of vouchers for childcare. 36. CSP should strongly campaign for better study leave for physiotherapists to enable them to attend during working hours post-qualification courses necessary to their professional development. Council hopes that the recently concluded agreement on study leave will be of assistance here. The Society will press for its effective implementation, and will also campaign for possible further improvements.
37. The CSP should lobby Parliament for statutory funding of postgraduate education on a par with the medical profession. Council agrees that it is right that physiotherapists should have a contractual right t o postgraduate education, appropriate to their needs; though the best tactical method for achieving this will need to be judged in the light of circumstances.
38. The Society should reaffirm its support for its trade union function and be prepared to fight for recognition within any new system introduced by the White Paper. Council indeed reafirms its support for its trade union function. It will continue to expect t o be recognised throughout the NHS, and would fight any withdrawal of recognition. 39. Due to the uncertainty of the future of the NHS, together with increased workloads, the stress suffered by all grades of staff is liable to precipitate 'burn-out syndrome' on a national scale! The CSP should take steps to combat this syndrome before it reaches epidemic proportions. See 41.
W", January 1990, ~0176,no 1
40. The CSP should press for independent counselling and support for NHS staff. See 41.
41. With the increased workload for physiotherapists in the NHS, the CSP should produce health and safety guide lines for the welfare of staff and patients. The Health and Safety Sub-committee will undertake a study of the impact of workloads on practice, and consider what support can be given to members. 42. The introduction of Regional pay agreements would lead to inequalities in the provision of health care and must be resisted. The Society would oppose the introduction of local pay variations which it believes would be divisive, and would only transfer shortages from one locality to another. 43. The CSP must be prepared to oppose any attempt to abolish Whitley Council terms and conditions of employment. The Society will oppose most strenuously any attempt to abolish the present National Whitley Council terms and conditions of employment, or the Review Body.
44. The CSP should not endorse the principle of performance-related pay as this will inevitably lead to professional suicide. The CSP has no current policy on the question of performancerelated pay. 46. The Chartered Society of Physiotherapy should fight the introduction of the White Paper, rather than accept its inevitability by 'making the best of a bad job', thereby selling out the whole profession. The CSP's approach has been t o concentrate on the specific issues which cause concern, and fight these. It does not accept the review's implementation as inevitable; there is scope to change the most objectionable features. 47. The CSP, as part of its financial policy, should set aside an adequate and on-going campaign fund to counteract measures against patients' or the profession's interest - such as the introduction of the NHS White Paper. Council accepts the importance of adequate funds to campaign against measures which are against the interest of the patients or the profession. However, rather than create a specific campaign fund, issues will be considered as they arise, and funds allocated as necessary. 48. The CSP should continue to enlighten the general public on the effects that the White Paper will have on them and their local physiotherapy services. Information to the public is an important part of the CSP's campaign on the White Paper. 49. The CSP should admit that the hidden agenda within the White Paper is privatisation, and should therefore strongly fight to prevent this happening in accordance with current Society policy. The CSP would certainly fight privatisation of the NHS most strongly if this were to be proposed. 51. The CSP should take steps to ensure that the profession's right to manage itself is not undermined in the light of possible developments in the NHS. Council agrees that the profession's right t o manage itself is central to the future of the profession, and will certainly take steps to ensure this right is maintained. 52. Within the proposed changes in the Government White Paper, there is a danger that 'prescription' physiotherapy will re-emerge. As a profession we must prevent this and maintain our professional status and right to decide on clinical diagnosis/treatment. The professional autonomy of physiotherapy is already affirmed in the Rules of Professional Conduct. Council will continue to insist on the full professional responsibility of members and the unacceptability of a prescriptive relationship with members of other health professions. "53. The physiotherapy profession is suffering from a period of apathy. With the proposed changes in the Government White Paper, now is the time to snap out of this attitude and encourage a more positive, forward-thinking profession. Council does not accept the premise on which this motion is based. But it will continue to encourage the advance of the profession.
physiotherapy, Januaty 1990, vol76, no 1
54 With the advent of the firqt National Representatives Conference, he CSP must be seen to reflect the views of the grass-roots nembership Council is here publishing its response t o motions passed by the :onference, which includes details of proposed action on each issue. Zouncil is certainly committed to responding to members' needs. 55 Council should more accurately reflect the composition of he membership of the Chartered Society of Physiotherapy Council believes that its present constitution gives opportunities or all parts of the membership to be represented. The present :omposition of Council is as in the table:
Numbers in types of post when first elected Present to Council employment -leads of schools of physiotherapy 3ther physiotherapist educators 3istrict physiotherapists Senior superintendents Superintendents 111 and below >rivate practitioners In sports medicine In occupational health Students Researcher
4 7 6 3 10 4 1 1 2 1
5
6 9 5 6 4 1 1
2
0
56. In order to fufil the role of chairman of Council without :ompromise to the individual or employer, this Chartered 3hysiotherapist should be seconded on a full-time basis from W h e r employing authority for a fixed term by the CSP. The Policy and Resources Committee has recently discussed in depth the arrangements for support of the senior officers of the Society, and of the chairman of Council in particular, and will sontinue t o keep the matter under review. However, it considers t unlikely that all employers would allow a member of staff t o be seconded for t w o years, and also noted that some potential candidates for chairman would not be in a position t o accept a secondment in a different part of the country. 59. The Industrial Relations Department and its regional structure in particular should be developed and expanded in order to respond to existing and probable increasing industrial relations problems in health care services. The Policy and Resources Committee has agreed a general strategy for the development of the Industrial Relations Department, which will be implemented as resources allow. A further senior industrial relations post was filled earlier during 1989, by internal promotion, and the resulting vacancy for an industrial relations officer is to be filled shortly. The Policy and Resources Committee has agreed in principle that a further industrial relations officer post should, in accordance with the strategy, be created from mid-1990. 61. The Chartered Society of Physiotherapy should adopt alternative methods for producing policy documents and reports and should have the mechanism to produce policy decisions more quickly, rather than trailing behind other professional organisations. Council believes that the Chartered Society has shown its ability to produce an instant reaction to newly published documents and to produce a considered response within the required timescale. It believes that, in general, the present methods of establishing the Society's policy are appropriate. It does not believe that we necessarily trail behind other professional organisations. 63. The CSP should improve the level of public awareness of the role of Chartered physiotherapists, the valuable service which they provide, and re-open the issue concerning protection of the title 'physiotherapist' from misuse by non-qualified practitioners, particularly in the light of the recent White Paper. The Chartered Society has asked for a comprehensive review of the regulatory arrangements for physiotherapy, and of the Professions Supplementary to Medicine Act 1960 in particular. It will continue to press for this review, which would give an opportunity t o examine the possibility of protection of titles. The titles of Chartered physiotherapist and State Registered physiotherapist are already protected.
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