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Council Responses to Motions at the Annual Representative Conference

These resolutions from the Annual Representative Conference in Belfast in September 1993 were either passed or (in one case) remitted directly to Council. At its meeting on December 15, 1993, Council considered responses on the basis of comments from committees and individuals, and adopted them as published here. The motions are shown in bold and the responses in medium type. The initials in parentheses after the comments identify the responsible department or committee where act ion remains outstanding - E = Education, IR = Industr ial Relat ions, PA = Professional Affairs, PR = Public Relations, P&R = Policy and Resources Committee, PPC = Professional Practice Committee. A further response on action taken will be made before the 1994 Conference.

Education 1. In the light of the recent decision by the West Midlands RHA to cut training places in the West Midlands, the CSP should initiate some means of monitoring the effect on recruitment and retention of staff, and the consequential provision of physiotherapy services nationally, with a view to urge the Government to review the policy of regional self- sufficiency as outlined in Working Paper 10.

The Chartered Society has consistently urged the need for a national overview, and has therefore participated actively with regions in the balance sheet exercise designed to co-ordinate regional responses. The proposed abolition of Regional Health Authorities creates new uncertainties, and we will continue to press for a more strategic approach to physiotherapy education. The CSP has been active in pressing for the retention of, and improve- ment in, the Joint National Manpower Initiative. (EAR)

3. The CSP, through its Industrial Relations and Education Departments, should recommend to all physiotherapy training establishments that they take steps to raise the level of undergraduate awareness of the variations in terms and conditions of employment in today’s NHS.

A considerable amount of information is made available on indus- trial relations issues to schools, both through visits and through written material. The information packs sent to.first year and final year students have recently been amended to take account of recent industrial relations developments. The Student Executive Committee discussed this issue in some detail, and its conclusions are set out in a full-page article in the November 1993 issue of fhysiotberapy. (EAR)

5. The CSP should strongly campaign for the maintenance of a rotational system among junior and senior II physiotherapy staff, by actively supporting and advising physiotherapy managers working in NHS trusts to ensure staff development and to uphold the broad base of clinical expertise in a wide range of specialties.

The Chartered Society hopes that members will join in this campaign at local level, which also points up the need for physio- therapy managers at trust level in order to provide such rotational systems. The Society remains committed to its policy on the expe- rience needed by newly qualified physiotherapists which can be obtained only through rotational appointments. (YPA)

CSP Structure 8. Now that we are affiliated to the TUC the CSP should follow the example of other trade unions and move this conference to earlier in the year, to allow issues raised by our members to be taken forward to the TUC Conference where appro- priate.

Council will keep under review the optimum date for the Society’s Congress, though dates and venues have been booked until 1996. It should be noted that there are various regional and specialist TUC conferences throughout the year, and it is not clear that a move of the Society’s conference would necessarily be advanta- geous, particularly as the Society is only allowed to submit two motions to the main TUC Congress. If members have particular concerns they would like to submit for consideration, then they can do so through their Board representative to Council.

9. The increasing demands on- personal time of professional activity are leading to the demise of local Branches. The CSP Council should review the structure and the role of Boards and Branches and facilitate open debate about future methods of networking with the membership.

Council believes that Branches have a valuable role to play and that most have a viable future. But it recognises that they are very dependent on a few activists and that their role is changing, partic- ularly in the light of the growing local activities of Specific Interest Groups. The twice-yearly meetings of Branch officers offer an opportunity for continuing review of the Branch network and Council will be responsive to the views expressed. (P&R)

10. In order to maintain and enhance the professional and educational function of the CSP, and in view of the possible development of a merged trade union, the CSP should encourage Branches to ensure that committee members are elected from various workplaces within the Branch.

The CSP has recently revised the Branches regulations and model constitution. It is for Branches to decide on their internal organisa- tion but it is clearly desirable that they should be as broadly based as possible.

11. This Conference agrees that it should be mandatory for Branch representatives to a Board to sit on the Branch execu- tive committee and report back regularly to the Branch, in order to be more representative of the membership.

This is expressly provided for in the model constitution.

13. The CSP should consider setting up an education bursary in the Centenary year instead of purchasing gifts for Royalty as this would provide a lasting benefit to the profession.

Council believes that the gift will be of lasting benefit to the profes- sion. It also honours one of its most distinguished Fellows (the sculptor was Mrs Berta Bobath), and gives more members a chance to see her work, since it has been provisionally agreed that the gift can be housed at the Society’s offices. The sums involved could not have supported a worthwhile bursary.

15. The CSP should offer support, in the form of a capitation fee, to the Occupational Groups as well as to the Clinical

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Interest Groups, in equal recognition of the amount of work which their members carry out for the Society.

Council is fully appreciative of the amount of work which the Occupational Groups carry out for the Society and, particularly, of the contribution made by their officers. It is still considering whether to make a capitation payment, bearing in mind that membership of these groups is open only to certain members of the Society, whereas any member with the appropriate interest or a specified level of expertise can join a Clinical Interest Group. (P&R)

16. The CSP should reimburse child-minding and carers’ expenses necessarily incurred for attendance at CSP meet- ings.

For an experimental period of six months, there will be a limited scheme for reimbursement of expenses incurred by members attending meetings of Council and of Committees which report direct to Council. This will enable the Scale of demand, and hence cost, to be assessed. (P&R)

Public Relations 18. The Public Relations Department should publish its strategic national advertising and promotion plan on a yearly basis. The plan should state the PR aims, target groups and the chosen national media. This will greatly assist and support physiotherapists to promote and dramatically increase their professional profile at local level.

The department will be happy to share with members its general approach to promoting the profession. However despite the steady increase in resources allocated to PR work it would be unrealistic to contemplate any national advertising, for example, as the costs are enormous. Nor would national advertising necessarily be useful in achieving the Society’s PR aims. However, the Society does use all parts of the media for different aspects of its media work; that means thousands of outlets at national, regional and local levels. The key players are members truly willing to promote their profession -and Council regrets how few want to do so. (PR)

20. In view of the threat to professional specialists in the NHS, it is vitally important that our professional expertise is recog- nised. This conference therefore calls on the CSP for a promotional thrust In our Centenary year, highlighting our varied professional skills, thus providing the profession with a central bank of promotional material for the future.

The whole purpose of the Society’s Centenary effort, as originally drawn up in 1991, is to use the year to promote the Society, the profession as a whole, particular aspects of physiotherapy and spe- cific campaigns. This effort will be undertaken at national, Board, Branch, Specific Interest Group and individual level. The specialist skills of members will be fully celebrated. (PR)

Equal Opportunities 21. The CSP should continue to develop, implement and monitor ongoing equal opportunities policy for the profes- sion. This should encompass entry into both training and employment, thereby increasing the potential for recruitment from under-represented groups and enabling the CSP to reflect more accurately the community it serves.

Council welcomes this motion, and agrees that equal opportunities issues should have a high priority within the Society. The Equal Opportunities Working Party will lead this work.

Health and Social Policy 22. The CSP should take political action in opposition to the social causes of ill health.

It would be wrong for the CSP to take action which could be construed as party political, but it will certainly campaign and comment on issues of concern to physiotherapists as health professionals. The White Paper ‘The Health of the Nation’ ignored the social causes of ill health, and these certainly deserve more attention than the Government gives them. (PA)

23. This conference calls on the CSP to make strong repre- sentation to the Government to ensure proper and adequate resourcing of its current ideology in the Community Care Act, to prevent it from taking its usual ‘Pontius Pilate’ stance when the reality hits the rhetoric.

The CSP strongly believes that community care should be adequately funded. However, a pre-requisite of any representa- tions would be evidence of under-resourcing of physiotherapy Services in the community, and we look to members to provide this in order that any such campaign could be mounted. The CSP will be providing briefing material to help members to judge what community care should involve and hence to assess whether it is underfunded. (PA)

25. The formation of GP fund-holders has effectively created a two-tier health service. The CSP needs first to monitor the effects of this on physiotherapy services, and then to produce clear guidelines to ensure that all patients receive the same high standards of physiotherapy care.

The Society will seek to establish the scale of the problem caused by fund-holding, and to physiotherapy in particular, and will then consider whether further guidance to members is appropriate. It is, however, already clear that the existence of GP fund-holders means that there is differential access to services; and in some cases limitations imposed by fund-holders’ contracts are incompat- ible with high quality care. (PNIR)

26. This conference calls on the CSP to initiate a united campaign with other organisations, to highlight the two-tier system caused by GP fund-holding, and to ensure free and equal health care for all.

The CSP will take suitable opportunities to campaign on issues of differential access to health care and of unreasonable limitations on treatment plans. The possibilities of mounting such campaigns jointly with other professions will be explored. It will also collaborate with other unions in raising issues through the TUC Health Services Committee and will liaise with non-affiliates such as the British Medical Association. (IR)

Professional Practice 28. In view of the potential threat to chartered phy siothera- pists by the emergence of new undergraduate therapy courses (eg sports injuries and rehabilitation), the CSP should exert its influence with the CPSM to prevent their graduates being employed in the NHS.

The Chartered Society is concerned that people who are not State registered physiotherapists might be employed by general practi- tioners, and will continue to monitor this carefully. It would also be concerned about NHS employment of staff not eligible for State registration to undertake tasks which should fall to physiothera- pists, and will take appropriate action if there is evidence that this is happening. (PNIR)

29. The specialist physiotherapist should have his/her partic- ular expertise protected within trusts. The CSP should encourage trusts to acknowledge the role of the therapist with specialist skills, within both hospital and community-based practice.

The Professional Practice Committee will be reviewing the difficult questions raised by the concept of a specialist within physio- therapy. However, this need not inhibit the Society from providing evidence to trusts on the importance of employing therapists with the appropriate expertise and it will take every opportuntty of doing

31. In the light of increasing calls for rationalisation of services this conference calls upon the CSP to produce a policy that resists the potential introduction of generic thera- pists.

The Chartered Society monitors carefully any initiatives of this sort, and is sceptical as to their justification. It will oppose any schemes which put care at risk or threaten members’ job security. (PNIR)

so. (PPC)

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32. Conference recognises that patient-focused care may be implemented in a way which represents a real threat to clin- ical autonomy and effective, professional patient care. Conference therefore urges the CSP to work closely with other trade unions and professions to form and implement policy on this issue.

The Chartered Society carefully monitors development of patient- focused care initiatives, and is already working closely with other trade unions and professions on them. While in some cases their implementation may be acceptable, we have reacted appropriately to problems, and each case is judged on its merits. (IWPA)

33. Conference believes that the role of senior clinicians working in rehabilitation is being undermined by rehabilita- tion consultants. The CSP should establish a working dialogue with the British Medical Association to monitor this situation and to prevent loss of clinical autonomy within this area of work.

The Society will continue to promote the work of physiotherapists in the fields of rehabilitation. It will seek to develop contacts, perhaps in conjunction with the other therapy professions, with representative organisations of the medical profession to try to ensure that all professions work together harmoniously. (PA)

Service Management 35. We call upon the CSP to recognise that NHS reform and the changing style of NHS management have created a situa- tion in which superintendents are increasingly experiencing a conflict of interests in their role as both managers and staff physiotherapists; therefore we wish to see both the profes- sional affairs and the trade union side become pro-active on this issue.

It has to be recognised that a degree of conflict is endemic in the role of the manager. The CSP supports managers who are aiming to provide high quality physiotherapy services, and will help them as far as it can if they find themselves in any form of conflict of interest. It is particularly concerned about the load that has been placed on some junior managers who have had insufficient management training and experience for the role that has been imposed on them.

Industrial Relations 36. Following the CSPs affiliation to the TUC we call upon the Society to recognise that 'unity is strength' and consequently to promote solidarity and co-operation between ourselves and other unions at national, regional and local level. At the same time we wish to see an ongoing debate about the role of the CSP within the wider trade union movement.

The CSP collaborates closely with other health service trade unions including TUC affiliates and other professional bodies. The CSP participated actively in the TUC emergency day on the NHS on November 20 in token of that solidarity. The CSP will continue to develop this role. (IR)

37. In view of the increased responsibility of stewards in local bargaining, the CSP should actively campaign with other trade unions to reverse the Government's policy with regard to funding for trade union education and training.

The withdrawal of grants for trade union education and training will have a significant effect on the CSPs finances, and the CSP will join in any TUC efforts designed to reverse the policy. (IR)

38. The CSP should actively campaign with and support other unions in the fight to preserve public sector jobs in view of job losses caused by the Government's spending constraints.

The CSP will participate in campaigns to preserve public sector jobs, as well as taking direct initiatives where physiotherapists' jobs are threatened, working with TUC-affiliated and non-affiliated organisations. (IR)

39. This Conference believes that the CSP should ensure that employers of physiotherapists honour their 'acquired rights' obligations in line with the existing Transfer of Undertakings (Protection of Employment) Regulations and subsequent EC rulings.

The CSP will shortly be issuing a briefing paper on the implications of the acquired rights directive and the UK regulations. Its full support will be given to any members whose jobs are threatened in circumstances where the directive might apply. The CSP partici- pates in the work of the TUC in this area. (IR)

40. This conference believes that the Tomlinson Report for London represents only one illustration of the failure of the internal market in the NHS, which led to loss of patient care, jobs, and career structure. Conference therefore calls on the CSP to use its Centenary year to pursue a nationwide and co- ordinated campaign to protect careers and jobs for physio- therapists, and comprehensive services and choice for patients.

Council agrees that the problems of the internal market are by no means confined to London, and campaigning opportunities will be sought to emphasise the issues identified in the motion. (IR)

41. This Conference welcomes the principle of the clearing house but believes its criteria should be widened. We call on the Society to ensure that there is full consultation with the staff side of the GWC in the operation of the clearing house.

The CSP pressed for the widening of the clearing house to cover staff in outer London, those in the starting grade and those whose short-term contracts had expired, at the three months review of the working of the clearing house. Because few physiotherapists had been threatened with redundancy, the Management Side refused to change its present policy, but the CSP will press the issue again as necessary. Through the PTA and Whitley Council the CSP meets regularly with London Implementation Group. (IR)

Health and Safety 42. As stress-related illness increases in NHS employees, the CSP must redouble its efforts to highlight and campaign against the causes, these being job insecurity, redundancies, increasing workload, isolation and low pay settlements.

The CSP recognises the anecdotal evidence of the increasing stress on NHS staff, whether this shows as illness or as other maladaptive behaviour such as increased smoking or drinking. It will do whatever it can to highlight these issues and to counteract the pressures on members. (IR)

43. The CSP must be aware of the increasingly personal dangers to physiotherapists working alone, in either the community or on-call situations, and should therefore publlsh safety guidelines at a national level, to incorporate into national health and safety guidelines.

With the increased number of staff working in the community, or in other isolated settings, its views of personal safety are clearly of increasing importance. Revised guidance is in preparation for members, drawing on advice from campaigning bodies such as the Suzy Lamplugh Trust, accepted best practice and the experi- ence of other professions. (IR)

Pay and Conditions Emergency Motion EM1. Conference condemns the Government's decision to allow no increase in the salary bill for the public services. Conference believes that this is a totally unwarranted interfer- ence with the Pay Review Body and the national bargaining process. Conference rejects the concept of 'productivity increases' for clinical staff and believes that the effect of this decision will be seriously detrimental to patient care, to professional quality and standards and the NHS as a whole as well as to physiotherapists and their families. Conference urges the Society to make the strongest possible protest to the Government, emphasising these disastrous effects and to

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mount a campaign, individually and with other public sector unions to oppose this scandalous imposition.

The Chancellor‘s Budget statement and the Management Side’s position have created an uncertain future for NHS pay. The CSP will support the TUC, PTA, and GWC’s responses and oppose the policy through all appropriate means. (IR)

44. We call upon the CSP to continue to publicise this year’s 1.5% pay award and the knock-on effect it will have on the economy as a whole. The CSP through its members should also vigorously campaign against any tampering with the decision of the Pay Review Body next year in an effort to maintain its independent nature.

The Society will join in TUC campaigns on public sector pay, and through the PTA Committee will warn the Government of a virulent response 1 it again interferes with, or fails to implement, the Pay Review Body’s report. (IR)

45. The CSP should ensure that members are made fully aware of the dangers of accepting jobs on short-term contracts by urgently pu&lishing widely available guidelines.

The CSP will produce appropriate guidance for members on the dangers of accepting jobs on short-term contracts, and will seek to persuade employers to confine their use to situations where they can be clearly justified. (IR)

46. This Conference calls on the CSP to campaign actively against ‘new style’ flexible working practices, such as ‘annu- alised hours’ in the NHS which discriminate against employee choice.

The CSP will continue to encourage members at local level to oppose changes in employment contracts which are designed to disadvantage staff. The Industrial Relations Department will continue to provide members with advice and information and monitor developments in flexible working. (IR)

47. Workers’ rights are being insidiously eroded; part-time workers are particularly vulnerable. We ask the CSP to use its newlycreated trade union connections to campaign against this trend.

The CSP will continue to work with the TUC and its officers to enhance workers’ rights. (IR)

48. The CSP should actively protect physiotherapists’ right to retire at 55, with retention of the special option to retire early.

The Government has now made formal proposals for abolition of the present arrangements for female physiotherapists to retire at 55, for new entrants to the superannuation scheme. The CSP will oppose this move, which fails to take account of the stresses of work in physiotherapy. (IR)

49. In the light of the recent media coverage of the NHS Superannuation Scheme which suggests that this scheme will be unable to fulfil its promise to its contributing members - that is our CSP members - we ask that the CSP seeks assurances from the Government that our members will receive the guaranteed pension right - at the least the minimum that is so stipulated within the present scheme.

The NHS superannuation scheme is not a funded scheme, and therefore relies on the public credit. The CSP has sought an assur- ance from the Government that this continues to remain an unbreakable national obligation. (IF?)

50. Conference believes that the CSP should actively camp aign for the equalisation of the State pension age to 60, rather than 65, thereby ensuring that no pension rights are discrimi- nated against.

The CSP will apply to affiliate to the State Pension at 60 Alliance. (W

51. The CSP should produce guidelines for employers relating to working time being allocated to employees for involvement in professional affairs. These guidelines would highlight the benefits this allocation would have in improving standards and quality of patient care.

A leaflet explaining the benefits to employers of active involve ment in professional affairs will be produced though it must be recognised that it has to be persuasive and not mandatory on employers. (IWPA)

Conference also referred back to Council its response to motion 8, set out below.

8. This Conference believes that direct employment of physio- therapists by GPs is likely to cause severe fragmentation of the services currently provided by the local hospital or community units. Therefore the CSP should actively camp- aign against such direct employment of individual physiother- apists.

The 1992 response readas follows.

The Society has recently adopted a policy arguing against direct employment of individual physiotherapists by GPs, and it will press this policy at national level to government departments and to health authorities. It will encourage GPs to ensure that they engage chartered and State registered physiotherapists and will urge them to purchase services from NHS provider units.

Council further responds as follows:

Council believes it to be very important that GPs should have appropriate information available to them on how best to procure a physiotherapy service. It agreed that this should make reference to all established providers, while continuing to advise of the disad- vantages of direct employment by GPs.

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