CSP Policy of Equal Opportunity for Part-timers

CSP Policy of Equal Opportunity for Part-timers PHILLIP GRAY M S B~ S ~ Director of Industrial Relations. Chartered Society of Physiotherapy

Introduction THE CSP Industrial Relations Committee has agreed a new policy of equal opportunity for part-time physiotherapy staff. This paper has also been discussed in the CSP Courv5l. Comment on the policy or the paper are welcome. The Society will be seeking through persuasion, education and local or national agreements to improve the position of parttime staff by practical policies. These changes are not going to happen overnight. They are dependent on a great deal of hard work and persuasion, with both managers and other staff, over a lengthy period. Yet the committee believes that certain aspects of the policy can be quickly implemented, such as a greater use of job sharing by physiotherapists who want part-time work, without disruption to the service. Other policies will need longer negotiations. Nevertheless, the Society will be moving the cause of part-timers high up on its agenda for negotiations. It is recognised that resolving the problems of part-timers will not resolve all the disadvantages which women may face at work, but it will be a significant start. This paper looks in some detail a t the reasons why a changed policy on part-timers is necessary. These include the serious and growing shortages of physiotherapists, the demographic changes which will reduce the number of 18-year-oldsavailable for training, and growing pressure from NHS managementlgovernment Ministers. The paper goes on to look at the current disadvantages and unfair treatment of part-timers; the action being taken by other non-NHS employees to assist matters; and the changing legal position which is making discrimination against part-timers unlawful. A series of policy options are discussed to improve conditions for part-time physiotherapy staff (including changing attitudes, job sharing, creche facilities, changes in Whitley agreements, and flexible hours). Finally, it summarises the policy and gives the likely first steps in achieving change. Today there is an urgent need t o reconsider the position of part-time staff. The serious and growing shortage of physiotherapists to meet the expanding demand within and outside the NHS meanc that a major effort must be made to attract back physiotherapists who are not working, or retain staff with young families. Part-time working is an essential part of that strategy. This view is not just that of the Society. Recent speeches by Mr Len Peach, chief executive of the NHS Management Board, and Mr Tony Newton, the Minister of State for Health, have emphasised the central role of part-time working in the future of the Health Service. For example, Mr Newton at a recent conference said that ‘encouraging part-time and

physiotherapy, May 1988, vol 74, no 5

flexible hours is absolutely essential if current manpower problems are to be overcome’.

Why Bother About Part-time Staff? Approximately 37% of physiotherapists and CSP members work on a part-time basis. This is a substantial proportion of our membership and yet t o date the Society has not had any concerted policy to improve the position of part-time staff or deal with their disadvantages. The action which has been taken has been on a purely ad hoc basis (eg the neyotiations in 1980 to enable part-timers to be paid emergency duty pay). (i) Extent of Part-time Working In 1985/86, 37% (4,044) of the total of 10,756 physiotherapists included in the CSP manpower survey, worked part-time. It seems that the number of part-timers in physiotherapy has been slowly increasing. This proportion would be in line with the pattern in the economy generally where the number of part-time staff (part of the so-called ’flexible workforce’) has been increasing. Approximately onethird of the total UK workforce (5,139,000) are in part-time employment. The vast majority of part-timers are women (Hakim, 1987). The UK national statistics and recent studies provide a fascinating insight into the current and future patterns of employment. Seventy per cent of all mothers with children are now working. Only 8 % of them are in the traditional nuclear family - husband at work, wife at home looking after t w o or more children (Mintel Survey, 1988). However, other research indicates that women in professional and managerial jobs are less likely to return t o work than their counterparts in lower-grade jobs (possibly because of more prosperous families) (Hirsch, 1986). Most women give up work after the birth of their first child, but at least half return to work within four years. Much has been written on the reasons for the expansion of ’flexible’ and part-time working. One of the reasons given is the dependability of part-time staff. In physiotherapy this may be reflected in the fact that in 1985/86 staff turnover among full-time physiotherapists was 20.3%, whereas staff turnover among part-timers was only 8.5%. (ii) Manpower Shortages in Physiotherapy An urgent reason for reconsidering the attractiveness of part-time physiotherapy working is the current crisis in physiotherapy manpower. The latest surveys indicate that approximately 9 % of all physiotherapy-funded vacancies are unfilled (even though employers wish to fill them). At the present rate of continued growth in demand for physiotherapy posts this shortage will increase to approximately 13% by 1990, unless action is taken to improve the situation. The Society and the PT‘A Whitley Council Staff Side have put forward a triple strategy of expanding the numbers of . students in schools, improved retention of qualified staff, and attracting back the large number of physiotherapists who no longer work in the NHS. A significant number of this latter group are physiotherapists who are not working because of

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Annex 1: Projections of the number of 18-year-olds by social class in Great Britain (000s) ~

I

II

IllN

Social class IllM

56 66 70 63 61

186 202 21 3 183 21 3

93 93 85 62 67

329 343 31 1 21 5 242

Year 1980 1985 1990 1995 2000

Total

IV

V

165 145 96 72 73

52 46 30 19 25

88 1 893 801 61 3 68 1

I professional, I1 intermediate, IllN skilled non-manual, IllM skilled manual, IV semi-skilled, V unskilled. School leaver supply trends (England onlyl Thousands

All leavers

1

700600500400-

300

1 - I . . . . , - ~ . - , . . . . , . . . . , .' .

1975176

1980/81

1985/86

1990/91

1995/96

child care or dependent relative responsibilities. (Itshould be noted that research indicates that there are now as many women at home taking care of dependent relatives as those taking care of children.) Changing conditions to make NHS working more attractive to part-timers is an approach which stands a much better chance of speedy results than the important, but more complicated question of expanding student numbers (becausethat is dependent on adequate numbers of teachers, funding and demographic impacts). Part-time working is already well established in physiotherapy and therefore provides a suitable basis on which to build.

(iiil Demographic Changes The difficulties faced by the profession with the manpower crisis are strongly reinforced by the serious drop in the population of 18-year-olds with qualifications suitable for entry into physiotherapy which is expected over the next few years (Meager, 1987). The trough is likely to be in the early 1990s. By 1993, the 18-year-old population will have fallen by 35% from its high point of 1983. The number with A-levels in 1993 will have dropped by 21%, the numbers with five 0levels by 34%. (see annex 1). The result will be a much greater competition for 18-year-olds from educational institutions, employers, professions and the CSP. Nursing, for example, currently takes one-quarter of girls available for employment who have five or more 0-levels. By 1993, because of rising demands for nurses and the decline in the 18-year-old population, nursing could be trying to recruit one-third of these girls. That could make the position increasingly difficult even in an attractive profession such as physiotherapy, against strong competition from other employers and higher education degrees. (It may also give backing to the argument that physiotherapy should become an all-degree profession in order to attract candidates who would otherwise go into higher education.) There is evidence that physiotherapy is already being hit by the decline in the peak numbers of 18-year-oldsfrom 1983. The number of applicants for places in physiotherapy schools, through the CSP Clearing House, declined between 1984 and 256

1987 by 47%. It is quite true that there still remain 2 % applicants for every place, but it is likely to be very difficult to sustain that level of demand for physiotherapy places in the light of the coming demographic changes. It seems that the total number of applicants is currently dropping each year. Given the need to expand the number of training places to meet manpower demands in physiotherapy, the profession may be very hard pressed to maintain and expand the necessary training places in the early- to mid-1990s in a tight labour market for 18-year-olds with much competition. This is not to indicate that strong action should not be taken to expand training places and improve the attractiveness of physiotherapy to potential recruits. It is to emphasise that other avenues (including the attraction of physiotherapists not currently active through facilities for part-time working) are vital. Improvements t o the manpower position require a series of inter-related actions which include improving the attractiveness of the profession through better salaries and conditions of employment, expanding schools and teaching numbers where possible, and expanding equal opportunities for women with family responsibilities to return to work on a flexible basis. It could also include encouraging mature students into the profession; expanding the number of men from its present low level of 5%; encouraging re-entering and retraining of qualified staff who ceased to practise sometime ago, and so on. The rest of this paper concentrates on one of these: the status, opportunities and conditions of part-time physiotherapy staff. Problems for Part-timers in Physiotherapy In 1986/87, 22% of all the physiotherapists leaving the NHS left for reasons of maternity and child care. It cost approximately €20,000 t o train each physiotherapist, plus further costs in the courses and specialist expertise which they gain in their work. It therefore should be a source of alarm that the NHS will lose many of these professional career women when they start a family. The women find themselves choosing between statutory or NHS maternity leave, followed by an immediate return to a full-time career - or no job at all, because part-time opportunities seem very limited. Faced with those options, many give up work altogether and hope to resume their careers later on. This may represent a vast waste of money and loss of skills and experience for the employing organisations. Many other physiotherapists may take maternity leave, then fail t o identify a way of combining their job with the care of a baby, and so leave employment altogether. The length of these breaks may be anything from t w o to ten years. But there is research evidence t o indicate that even for the individuals concerned, retaining a foothold in the job market and retaining the opportunity to keep skills up to date is wiser than giving up work altogether and hoping to be recruited again later on (Hirsch, 1986). Physiotherapists wishing to return part-time, however, face a series of problems, some of which are listed below.

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(i) Attitudes The extent of part-time working does not seem to be clearly understood in the physiotherapy profession. Although there is very strong support for part-timers among the majority of managers, it is not unfair to suggest that there seems t o be a bias against part-time working among some physiotherapy managers and staff. This is reflected in an unwillingness t o create part-time posts or to enable staff to return from maternity leave on a part-time basis. It is reported that some Districts have a total ban on the employment of part-time staff or a ban in certain grades. A quote from a research report on nurses may have some elements of applicability in physiotherapy (although with less of a male bias): 'The Davies and Rosser Report shows how, originally, nursing was a profession for the single woman who dedicated her life to it, using caring skills which are seen to be an extension of women's work in the home. While the marital and family status of women in the profession has changed, the profession has developed along male career lines since the First World War when there was an increase in the number of men with general nursing experience. The present career structure does not accommodate these changes for women in that it does not recognise a need for career breaks, and it does not recognise outside commitments which are as emotionally and physically demanding as those made by the job itself and which may require flexible working hours' (Davies and Rosser, 1987). (ii) Career Progression and Status The major source of complaints to the CSP about the position of part-timers over the past ten years has been in relation to their status and career progression. There has been a persistent problem, reflected in many letters to the Journal, Therapy Weekly and the CSP Industrial Relations Department of well-qualified and experienced clinicians, in perhaps the senior I grade, finding it impossible to get part-time posts in their own authority after maternity leave and being forced to take junior or senior I1posts as the only ones available It seems likely that by this process, the largest number of part-timers are to be found in the bottom grades of the profession. For example, in 1986187 there was a clear block at senior I I level, where between 35% to 50% of part-time staff may be stuck. Until 1981, physiotherapists who found themselves in this position and who were subsequently promoted back to their higher grade did not have any of their previous service counted and had to start from the beginning again in their new grade. This aspect was corrected by a new agreement in 1981 which enables previous service in the higher grade to be counted for incremental purposes on promotion back into that grade. But the basic problem of persistent down-grading of physiotherapists undertaking part-time work and the waste of experience and skills which this may involve, seems fairly common. It also seems that part-time staff have fewer opportunities for promotion and much slower progression than do fulltime staff. There are very few part-timers in the management grades and indeed there still exists a requirement in the PT'A agreements that 'the Joint Secretaries should be consulted' before part-timers are appointed into superintendent IV grades. (This provision is never exercised these days.) No study has been undertaken of the promotion pattern for part-time physiotherapists.However a recent research project for nurses indicated that the average time taken from initial qualifications to reach nursing officer grade for women with no career breaks was 14.5 years and women with career

physiotherapy, May 1988, wol74, no 5

weaks 22.7 years. Women who took a break and worked fulltime took 19.1 years and women who took a break and worked part-time fcr a period took 27 years on average. The average time for all men was 8.4 years and for all women 17.9 years (Davies and Rosser, 1987).

(iii) Flexible Hours The problem of flexible hours is reflected in the difficulties Dutlined above in physiotherapists obtaining suitable parttime employment. However, it seems that managers who are willing to create part-time posts are willing to create them with hours which enable physiotherapists with children of school age to deposit and pick up their children. Problems do arise with the difficulties of part-timers with family responsibilities getting involved with on-call systems in particular instances. More could be done to make these flexible hours more flexible. fiv) Holidays Many physiotherapists with children at school would find the opportunity t o take all or part of the school hdidays off work a distinct advantage. Before 1974, the main source of such employment in physiotherapy was work in special schools for handicapped children where physiotherapists worked on a similar basis to teachers, with the same holidays. After 1974 with the transfer back into the NHS of physiotherapists employed in such schools, these provisions have become much less generous, but still exist. It is likely to be an uncommon pattern in hospital departments for physiotherapists. Holidays are likely t o be one of the most difficult problems to resolve for part-time staff. Full-time staff may feel that it is unfair if part-time staff are all allowed school holidays if that means that full-time staff cannot take these holiday periods. (v) Child Care There is now an almost total absence of facilities for child care within the NHS. A few hospitals have creche facilities but these have become very rare. The NHS does not provide any financial assistance to staff who are obliged to employ child minders or nannies. The costs of such private child care are high and there is no income tax relief available on it. In many instances this will make the economics of working parttime for physiotherapists impossible. In a recent study undertaken by the District Physiotherapist in Greenwich (Freeman, 19871, questionnaires were sent out to nonpractising physiotherapists (or married women with children) to ask what would influence them to return. Seventy-four per cent were influenced by the level of pay 'as child care is expensive and therefore the difference was not adequate t o encourage return'. The report quotes present child care costs as varying between €100a week for a nanny t o €15 a week for a creche. Set against the average weekly take-home pay of a PAM professional at the top of the lowest grade of about €116, it is easy t o see why some PAMs would not be encouraged to return to work. In the few instances where health authorities provide creche facilities, the taxation system compounds the problem by applying a full tax charge to the value of the benefit being provided. In fact creche facilities provided by an employer are taxed as a benefit at four times the rate of taxation on company cars! (vi) Training: Loss of Skill and Career Breaks

A number of local initiatives have been taken over the past few years to try to establish reorientation and retraining

257

Annex 2: Hours needed t o qualify for statutory employment rights Rights

Less than eight hours

Eight but less than 16 hours

16 hours or more

Written statement of employment Changes in those terms referred to in statement ltemised pay statement Guarantee pay Remuneration on suspension on medical grounds Time off for carrying out trade union duties Time off for trade union activities Time off for public duties Time off for safety representatives Time off to look for work or to make arrangements for training for future employment Time off for ante-natal appointment

No right No right

Five years Five years

13 weeks One month

No right No right No right

Five years Five years Five vears

No qualifying period One month One month

No right No right No right Two years No right

Five years Five years Five years Two years Five years

No qualifying period No qualifying period No qualifying period Two years' Two years

Notice of dismissal Written statement of reasons for dismissal Unfair dismissal

No right No right

No qualifying period Five years at beginning of 11th week before conf inement Five years Five years Five vears

No qualifying period

Maternity payhight to return

No qualifying period No right

No right No qualifying period No qualifying period

Five years No qualifying period No qualifying period

Redundancypay Dismissal or action short of dismissal for trade union membership or activities Sex or race discrimination and equal pay

No right

Two years at beginning of 11th week before confinement

One month Six months Two years if employment began after 1.6.85, or if employment began before that date in firms of 20 or less employees. One year if employment began before 1.6.85 in firms of over 20 employees. Two years No qualifying period

No qualifying period

'This is not a strict requirement, regulation 3(4) of the Safety Representatives and Safety Committee Regulations 1977 (SI No 500) states that a safety representative 'shall so far as is reasonably practicable either have been employed by his employer throughout the preceding five years or have had at least two years' experience in similar employment'.

courses for physiotherapists who have been out of practice for lengthy breaks. This remains very patchy and seems to be entirely dependent on the energy of particular local physiotherapy managers. There is no national initiative and no clear way of communicating t o physiotherapists undertaking a career break that such facilities exist. There is certainly no facility for regular updating sessions for physiotherapists who still wish to continue with a career break, other than the information they will acquire through the Journal or through attendance a t Branch meetings (which because they are in the evening may not be easy for mothers to attend). Iviil Dependent Relatives An unknown number of physiotherapists are out of employment because of the need to take care of dependent relatives. Again, for this group of staff, the opportunities for part-time employment may have significant advantages. (viii) Disadvantages in National Agreements Part-time staff in the NHS have disadvantages on pensions, if they work less than 18 hours per week, and overtime. It does not appear that there are many other national agreements that place them at a specific disadvantage. This may not be the case in employment outside the NHS. The Legal Position on Part-time Working Annex 2 shown above contains the list of statutory

258

employment rights which apply to part-time staff. Some of these are covered in the NHS by the national agreements. But in general terms it can be seen that staff who work less than eight hours per week do not have many statutory rights. Staff working between eight and 16 hours per week have to work for five years before having a right to a number of these statutory provisions. Nevertheless, recently there have been a number of legal changes and challenges which are improving the position. The ones of particular note to physiotherapy are as follows: (i) The refusal of part-time work may constitute unlawful discrimination. An insistence that a job should be done on a full-time basis can be judged to be indirect discrimination. In the case of Holmes v The Home Office (1984). the Home Office was found to have unlawfully discriminated against Ms Holmes in stating that unless she continued to work fulltime she would not be allowed to remain in her job. It was extremely difficult for Ms Holmes to comply with this demand because of her family responsibilities. The Industrial Tribunal found that the requirement for full-time work in the job done by Ms Holmes was not justifiable and therefore constituted unlawful discrimination. Given the fact that many departments already have part-time staff, it may be very difficult for physiotherapy managers to argue that it is impossible to employ staff on a part-time basis a t all, or in particular posts. More widespread publicity given to this legal position may be helpful.

Physiotherapy, May 1988, vd 74, no 5

(ii) The Courts have developed the concept of 'indirect' pay discrimination from the 1970 Equal Pay Act. Hence, if parttime employees are predominantly women, and they are offered less favourable pay or other contractual benefits than are full-timers, they may have an equal-pay claim. And this proposition was strongly reinforced by the recent decision in Bilka-Kaufhaus v Weber, where the European Court of Justice held that the exclusion of part-timers from a company pension scheme was a breach of Article 119 of the Treaty of Rome the equal pay principle. Rights under Article 119 are directly enforceable in tribunals and this gives further scope for parttime employees to challenge any differential treatment. (iii) A proposed EEC directive on part-time work may go some way to ending the present discrimination against part-time workers. It is at present being blocked by the UK Government but it is strongly supported by the other EEC members. The draft directive includes a number of minimum rights for parttime workers including the right to receive the same treatment as full-time workers in the same situation (except where different hours of work itself objectively justifies different treatment); the right not to be discriminated against in regard to working conditions, dismissal, collective agreements, union representation or access to vocational training/ promotion facilities; the right to agreements in writing on the nature of part-time work, the hours of work and the arrangements and distribution of hours (particularly applicable to those working less than eight hours); and a series of other proposals which already exist in NHS agreements.

The Way Forward (i) Encouraging a More Favourable Attitude to Part-time Work This is a long-term education process but one which can be reinforced by changes in national agreements, and making physiotherapy staff more aware of the existing manpower shortage and the need t o recruit staff should make the position more favourable in getting this message across. The education process and training will have to involve the Society's publications, stewards, managers and teachers both within and outside the NHS. We start off from a position where many physiotherapy managers and staff have a favourable view of part-time staff. It is necessary to encourage others to change their views. (ii) Opportunities for Part-time Working The Society should place increased emphasis on encouraging an expansion of part-time opportunities for physiotherapists. This again is an educational process but it may also involve applying the existing rights. Not only is there the legal position under the case of Holmes v The Home Office outlined above (which could make a refusal to allow part-time work unlawful), but there is also a useful provision in the NHS maternity leave agreement on which very little emphasis has been placed. In order to retain the right to the maternity pay which is given, staff have the possibility ol seeking part-time work instead of the full-time post whicb they previously occupied. An authority is not compelled, under that provision, to grant the request for part-time work, but the agrecment does say that such a request 'will not be unreasonably refused'. If it is unreasonably refused, il provides a ground for directly challenging that decisior through the grievance procedure. The Society is not aware of any cases which have been taken in this way or any regulai use which has been made of this provision.

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liii) Formal Career Breaks A number of large companies in the private sector, such as National Westminster Bank, Barclays Bank and British Rail, have established schemes of formal long or short career breaks which aim t o retain the link of valuable staff with the employer in a range of different schemes. It starts from the interesting finding from recent research that women in professional and managerial jobs are, if anything, less likely to return to full-time work than their counterparts in lowergrade jobs. Women in less skilled jobs seem to take maternity leave with the shortest duration. This, of course, may have something to do with the economic position of the family involved. Rather than lose valuable and expensively trained staff, these employers are devising schemes t o encourage them to return to work or provide a system of formal updating and continued links with the employer. The evidence so far, limited as the present schemes are, is that they have been successful. The career break schemes start from the premise that the answer for most women, faced with the need for child care, or even some cases of dependent relatives, is a period of several years (varying considerably between individuals), combining different proportions of time at home, and in fulltime and part-time employment. The more flexible the arrangements can be, the less it is necessary for a woman to give up work altogether for several years. Employers may not wish to pressurise career women to remain in continued employment if they want several years of full-time child care. However, most employers, including those in the NHS, still effectively force women out of their jobs by offering hours and locations of work which cannot be combined with time spent in the care of young children. Formal 'long-break schemes' allow much longer periods of absence than normal maternity leave (usually up to five years) followed by a return t o a full-time career. Usually there is a minimum service requirement, for example, five years, and often a requirement that the woman should have, say, 20 years of working time ahead of her when she returns from the break. Normally, one break only is allowed with a fixed maximum length (eg five years). A very important condition of the break scheme is that the women concerned must keep in touch during the break from work through the post and occasional meetings. Some of the schemes also include a requirement that the women should return to work for a minimum of t w o weeks each year for reorientation and updating sessions and also to enable them to practise their skills. Guaranteed re-entry is given t o those within this scheme. One formal long-break scheme does already exist within the NHS. Doctors are paid an allowance of approximately f350 towards professional expenses such as journals. In return they are expected t o maintain contact by carrying out a certain number of sessions per year. A second form of these schemes is where employers, without giving a formal guarantee, give a commitment to look Jery favourably on ex-employees who have had children and wish to return to work. To a certain extent this already exists inside the NHS, but on an informal basis. A more formalised system could he1p. A third form of the schemes may involve a longer break than the normal maternity leave, with a possibility of part-time employment which could encourage a return to active employment earlier than the maximum of five years' leave. It is likely that many women would prefer a more gradual parttime return and may not necessarily want to concentrate their

259

child bearing and rearing into one five-year period. (iv) Job Sharing Job-sharing schemes are fairly extensive throughout industry and the economy, but have so far only had limited application in the NHS. It seems that some physiotherapy managers already encourage job sharing. The Society aims t o produce a pack of information on this topic. It normally involves splitting a full-time job in half between t w o individuals who wish t o return on a part-time basis. Thus, a senior I physiotherapist w h o wishes t o return on a half-time basis after maternity leave may be able t o find another suitable person who could take up the other half-time post or the physiotherapy manager may find one. This helps t o eliminate the problems which managers perceive in filling the gap left by allowing a previously full-time post t o be turned into a part-time post. There is also evidence that it has a considerable advantage in particular situations (eg singlehanded working) in preventing the professional isolation of physiotherapists. Some arrangements also include the possibility of the other person covering for sick leave of the other partner. However, job sharing is dependent upon good co-operation between the individuals sharing the job t o ensure proper co-ordination. This is no more than is already expected between part-time staff w h o are handing over patients or notes to other part-timers or full-time staff. (v) Flexible Hours There are many forms of flexible hours arrangements and agreements. Part-time working itself is a form of flexible hours. In this aspect it is important that, wherever possible, part-time staff are able t o start and finish at times which will enable them to deposit children at nurseries, schools or child minders and to collect them at appropriate times. This may need t o be tailored t o individuals and is not an easy organisational issue for the manager concerned. The current severe shortage of physiotherapists does mean that a number of part-timers are able to negotiate the exact hours which they choose or are able t o work because of other commitments, w i t h the agreement of the manager. Encouragement for the physiotherapy managers t o do this could be made more formal. Flexible hours also exist in other forms, such as variation on 'flexi-time'. The Society is not aware of any flexi-time arrangements being formally negotiated in physiotherapy. It may not be appropriate, but it may be worth considering, particularly for part-time staff. This would involve a commitment to a set number of hours per week, or per month. The flexibility comes in by allowing individuals the right t o complete those hours by starting late or finishing early on particular days, or even missing particular days and making up for the time later. It has t o be ensured that the individuals doing this are working within a particular time span when the department is open and the patients are available. For physiotherapists there will undoubtedly be difficulties in ensuring the proper planning of patient attendances. (vi) School Holiday Absences Physiotherapists with children of school age w h o are abk t o work full-time or part-time during school terms may finc it significantly more difficult during the school holidays. Thi: may discourage them altogether from taking on a full-timt or part-time post during term times. A number o organisations, in the public and the private sector, havc

260

extended arrangements t o enable people to take unpaid, or occasionally paid, leave during the school holidays. However, the IR Committee has decided not t o include these holidays as part of its new policy because of the problems they can produce with full-time staff. (vii) Child Care Facilities The organised provision of creche or other child care facilities by health authorities at reasonable rates would be a very major step in encouraging physiotherapists with children below school age t o return t o work on a full- or parttime basis. Firm backing will be given t o the national moves which are developing t o encourage creche facilities. The tax problem of child care facilities which was outlined above can be tackled directly by political pressure along with many other organisations pursuing the same subject. (viii) Training and Orientation Schemes Considerably more can be done t o establish and encourage reorientation and possibly retraining schemes for physiotherapists w h o have been out of the profession for several years. This has been largely left t o local initiative of District physiotherapists. !t appears that they have been very successful in encouraging physiotherapists who are not working to reconsider a return to employment and to establish a link w i t h a particular health authority which is providing such retraining or reorientation. The courses help a number of physiotherapists who have been out of physiotherapy for a number of years, feel at a considerable disadvantage in applying for jobs, and may have considerable anxieties about taking on the responsibilities of a post because they fear their skills have got out of date. Organised reorientation courses could help greatly to overcome this problem.

(ix) National Changes The needs of physiotherapists both inside and outside the NHS have t o be considered. Inside the NHS, Ministers have recently established a 'National Steering Group on Equal Opportunities for Women in the NHS'. It is aimed at improving both the working lives and career opportunities of female employees in the NHS. Its particular orientation is trying t o address some of the current problems of morale, attitudes t o women, high turnover and the demographic changes which will affect recruitment. The chairman, Victor Flintham, recently said: 'It is essential for the NHS not only to attract female employees but also t o develop their potential and retain their expertise in this nationwide multidisciplinary organisation.' They are in the process of issuing an information resource pack which will be published in stages. One of those reports will look at the organisation of work in the management of work breaks. It will be awaited with interest. However, the resource pack will be purely information for health authorities and will therefore still require negotiations at national and local level t o bring them about. In the NHS, part-time employees already have the right, in most instances, t o terms and conditionspro rata to those of full-time members of staff. The exceptions are issues such as pension rights and promotion opportunities. Physiotherapists employed outside the NHS are not so fortunate and they may be faced with instances where they are not paid pro rata t o full-time employees or have the same entitlement t o benefits such as sick pay, paid holidays, pensions or training schemes.

physiotherapy, May 1988,vol74, no 5

Agreed Policy Objectives for the CSP on Part-time Working The CSP IndustrialRelations committee has agreed a series of policy objectives. These will become a priority in both national and local negotiations. A number will be dependent on building co-opetation and goodwill among physiotherapists over a lengthy period. Some of them, such as the promotionof job-sharing, will have action taken on them quickly. Others will need detailed and more long-termdevelopment. But they demonstrate the Society's commitment to improving the position of part-time physiotherapy staff. The Society is ahead of most other organisations in advancing these proposals. 0 To help secure a greater recognition of the status and

0 To negotiate at local level (through the stewards) further

development of flexible hours arrangements where this is feasible within the patient care system.

importance of part-time working and its contribution to the manpower needs of the profession. employment of part-time staff. To encourage physiotherapy managers t o extend the opportunities for part-time working. To negotiate nationally as an amendment t o the National Health Service maternity leave agreement, arrangements to give staff returning from maternity leave, who wish it, the right to be offered part-time employment at their existing grade. To negotiate at national and local level (through the stewards) arrangements to establish job-sharing schemes and to extend their use where this is the wish of the physiotherapists who want t o undertake job sharing. To negotiate at national level, formal career-break schemes which could enable physiotherapists t o take extended maternity breaks while maintaining their links with their employer such as those relating t o doctors.

To negotiate at national and local level the establishment by health authorities of free or reasonably-priced child-care facilities. To press the Government for appropriate tax relief on such facilities. 0 .To ensure that part-time schemes or flexible-hour arrangements also take account of the care needs of physiotherapists with dependent relatives. 0 Part-timers should have equal access t o study leave. 0 To ask the Education Committee t o consider urgently the establishment of orientation and retraining schemes, to be implemented by local managers, for physiotherapists returning t o employment after several years' absence. 0 To pursue further any changes in current terms and conditions of employment, inside or outside the NHS, which place part-time staff at a disadvantage. 0 To review these objectives in the Industrial Relations Committee at regular intervals.

REFERENCES Hakim, C (1987). 'Trends in the flexible workforce', Employment Gazette. Mimtel Survey (1988). Women 2000. Hirsh, W (1986).'Career re-entry: Driving away the talent', Manpower Policy and Practice, spring.

Meager, N (1987). 'School leavers: Here today, gone tomorrow', Manpower Policy and Practice, autumn. Davies, C and Rosser, J (1987).Processes of Discrimination: A report on a study of women working in the NHS, DHSS. Freeman, J (19871. Survey of Physiotherapists Not in Employment in Greenwich. Unpublished.

In Other Journals

The N e w Zealand Journal of Physiotherapy 1987, vol 15, no 3, December

0 To oppose firmly any District which has a ban on the 0

0

0

0

These current awareness lists aim to help readers keep upto-date with articles of interest in overseas physiotherapy publications and those for other professions in the UK. They are not comprehensive and the full texts are not available from the Chartered Society - they should he found in medical lihraries. The figures at the end of each line refer to the page numbers.

The Australian Journal of Physiotherapy

1987, v o l 3 3 , no 4 Patterns of improvement in neurological functioning of children with minimal cerebral dysfunction with physiotherapy intervention. P Watter, M I Bullock. 215-224. Water exercises for the frail elderly: A pilot programme. C Rissel. 226-232. Sensory and motor nerve conduction velocities following therapeutic ultrasound. J F Kramer. 235-243. What physiotherapists in private practice do: The effects of sex and training on clinical behaviour. J K Dennis. 245-252. Overuse injury: The experience from a patient's perspective. R Rowland. 262-267.

fWsiotherapy, May 1988, vol 74, no 5

0

The maintenance of sensory motor performance after physiotherapy intervention for minimal neurological dysfunction. P Watter, M I BUllOck. 6-8. Treating the non-European patient - A personal experience. K Peebles. 11. Ultrasound physiotherapy. E L Bydder, S M Grant. 12-13.

The South African Journal of Physiotherapy

1987, v o l 4 3 , no 4 , November Is therapeutic intervention necessary for all clumsy children? P M Leary. 109-110. Motoric competence, behavioural confidence and classroom function. P K Hansford. 111-115. A pressure-regulated 'bagging' device - A pilot study. L A Rhodes. 117-120. Positive pressure physiotherapy - A new device. J D Ireland, I D Hill, L M Davids. 121-122. Re-education of functional movement after severe closed-head injury in the sub-acute and post-two-year period. M Wilson. 123-125.

1988, v o l 4 4 , no 1, February Total care of the back patient. G du Toit. 5-7. Managing low back pain: A dynamic approach. S Hulett, D Constant. 8-10. The clinical difference between cervical headache and other vertebral pain. J Edeling. 11-14. Loose bodies in the peripheraljoints - Using diagnosis and treatment as developed by Dr James Cyriax. 17-20.

26 1

Physiotherapy Canada

1987, vol39, no 6, November/Decernber lntracranial hypertension: Implications for the physiotherapist. M L Borozny. Key words: lntracranial pressure, intracranial compliance, intracranial hypertension, physiotherapy. 360-366. The effects of mechanical vibration in patients with acute exacerbations of chronic obstructive pulmonary disease. P M Brown, J Manfreda, D S McCarthy, S Macdonald. Key words: Obstructive lung disease, sputum, oximetry. 371-374. Amputee visitor program. F R Fisher. Key words: Amputee, rehabilitation, visitor. 385-388. 1988, vol40, no 1, January/February Psychological benefits of a lifestyle modificationprogram for Workers’ Compensation recipients. T E Hannah, E Hannah, D Mosher, L Vardy. 10-15. Knee pain muscle torquest in patellofemoralsyndrome. D Macintyre, J Wessel. Key words: Isokinetic, patellofemoral pain syndrome, knee extensors and flexors. 20-24. Compliancewith and effectivenessof chest physiotherapyin cystic fibrosis. A T Muszynski-Kwan, R Perlman, B A Rivington-Law. Key words: Cystic fibrosis, physical therapy, sputum, co-operative behaviour. 28-32. Reproducibilityof tests of respiratory muscle performancein chronic obstructive pulmonary disease. J Richardson, W D Reed, L Dunn, R L Pardy. Key words: Chronic obstructive pulmonary disease, respiratory muscle, diaphragm training, strength. 34-39.

Update

The journal of postgraduate general practice 1988, vol36, no 4, February 16 The child with a limp. M F Macnicol. 1678, 1681, 1682, 1685, 1686. Examining the knee. E Gambrill. 1728, 1730-32. Recovery from mastectomy. I Levi. J V Roberts, M Baum. 1734, 1736-38, 1741-42. Occupational medicine in British Airways. K G Smith. 1745, 1746, 1748, 1749, 1751.

The British Journal of Occupational Therapy

1987, vol50, no 10, October Special golden jubilee issue to mark 50 years of publication. No 11. November Remedial therapy referral times for stroke patients. R J Simpson. 379-380. A mesh sheet adjustable tibia1 brace with an integral heel cup. M W Cunliffe. 390-392. 1988, vol51, no 1, January A problem-basedlearning occupational therapy course: The second year. J Busuttil. 8-10. A test battery to measurethe recovery of voluntary mowment control following stroke. A J Turton, C M Fraser. 11-14. No 2, February Stress in occupational therapy: How to cope. C Craik. 40-43. Practical aspects of stress management. C Cox. 44-47. Biofeedback and the computer. F Crofts, J Crofts. 57-59. No 3, March Planning for change in education. M Green. 78-80. Annual survey of occupational therapy students: reasons for dropout. C F Paterson. 81-83. Relaxing in primary health care. G Westland. 84-88.

The Health Service Journal

1987, vol97, no 5073, October 22 Robbing Peter to pay Paul: Paramedical training. J Williams. 1233. Performingfor healthy life: Performance indicators. G 8eales. 1234. Time to change culture: Individualperformancereview. P Key. 1235.

No 5074, October 29 Too important for the experts: Information strategies. E Korner. 1258-1260. Private costs in profile: Diagnosis related groups. J Coles, N Coles. 1261. 1988, vol98, no 5082, January 7 Physiotherapy online. A Rankin. 21.

INTERNATIONAL CONFERENCE ON WHEELCHAIRS AND & SPECIAL SEATING Dundee, September 12-16,1988 The Conference is intended for medical practitioners, nurses, therapists and engineers in the design, prescription and supply of wheelchairs and special seating. The programme will examine “state of the art” practises through a series of invited presentations from an international faculty.

Topics will include: needs, basic principles, assessment and prescription, seating and wheelchair systems, associated devices, information sources, standards and testing, service organisations and research and development priorities. A major scientific and commercial exhibition will be mounted in association with the Conference. Preliminary programme and registration forms from:

Secretariat, Dundee ’88, Dundee Limb Fitting Centre, 133 Queen Street, Broughty Ferry, Dundee, Scotland. 262

Physiotherapy, May 1988, VO/ 74,

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