Disabled People and Employment

A Study of the Working Lives of Visually Impaired Physiotherapists

Sally French

• Publisher: Routledge
• Year: 2017
• Print ISBN:
  9781138726123
• eBook ISBN:
  9781351752459
• Topic: Politics & International Relations
• Subtopic: Social Policy
• Index: Politics & International Relations

This title was first published in 2001. Providing a detailed account of the working lives of visually impaired physiotherapists in Britain, this study also presents an overview of the employment position of disabled people in the UK, and is underpinned by a social model which views disability in terms of societal barriers rather than in terms of impairment.

Introduction

This book and the research upon which it is based, is about disabled people and their employment. It focuses in particular on the barriers disabled people experience at work and the ways in which they overcome, minimise or manage these barriers. It is hoped that this book will provide insights into how disabled people experience and cope with their work at a practical, personal and social level and how changes in legislation, policy and values can impact on their working lives.

Although there are many studies concerning disabled people and employment (see chapter 2), there is very little from the perspective of disabled people themselves (Barnes et al 1998). Kitchin et al state:

There has been little research to tease out and document the specific mechanisms, structures and processes that underlie disabled people's access to the labour market; or how these processes interact and manifest themselves in different contexts; or an indication of the experiences of disabled people seeking access to the workplace or their experiences within the workplace. (1998: 788)

This book, aims to investigate employment from the direct experiences and perspectives of disabled people themselves. It is based upon a study of visually impaired physiotherapists but it is likely that much of what they experience can be generalised to other disabled people. The book is written from the author's PhD thesis (French 2000) where detail of methodology is given.

Visually Impaired People in the Physiotherapy Profession

Visually impaired people have been accepted for registration by the professional body of physiotherapy (now the Chartered Society of Physiotherapy) since 1916 but have been formally trained since 1895, This can, in many ways, be viewed as an historical accident as physiotherapy developed from massage which visually impaired people traditionally practised (Barclay 1994) (see Chapter 3). Physiotherapy is unique among the professions in recruiting substantial numbers of visually impaired people who, until 1995, received their training in a special college run by the Royal National Institute for the Blind (RNIB). Visually impaired people are, however, employed in other professions including social work and law (Simkiss et al 1998).

The Profession of Physiotherapy

Physiotherapy originated from nursing at the end of the 19th century and originally consisted of treatments using massage. Over the years, however, it has undergone many developments and is now the largest profession supplementary to medicine in Britain with approximately 26,000 people registered as members of the Chartered Society of Physiotherapy (CSP). In the recent career literature of the CSP, physiotherapy is defined as follows:

...a healthcare profession which views human movement as central to the health and well-being of individuals. Physiotherapists identify and maximise movement potential through health promotion, preventive health care, treatment and rehabilitation. The core skills used by chartered physiotherapists include manual therapy, therapeutic exercise and the application of electrophysical modalities. Fundamental to the physiotherapist's approach, however, is an appreciation of the psychological, cultural and social factors which influence their clients and the patients' own active role in helping themselves. (1998: 2)

They go on to say that:

Chartered physiotherapists work to combat a range of physical problems, in particular those associated with neuromuscular, musculoskeletal, cardiovascular and respiratory systems. (1998: 3)

Physiotherapy is a diverse health care profession with opportunities to work in many specialities and many settings. Physiotherapists work within the National Health Service (NHS), special schools, private practice and industry. Specialities include, sports injuries, intensive care, orthopaedics, mental health, learning difficulties, palliative care, paediatrics and neurology. Physiotherapists are also involved in health education and health promotion. This book will focus primarily on visually impaired physiotherapists working within the NHS in a wide variety of specialities.

Physiotherapy became an 'all degree' profession in 1992 and has gradually been transferred from small NHS colleges to the university sector. Courses lead to a B.Sc. Honours degree in Physiotherapy after a three or four year period of study. There is now considerable variation among the courses but they all contain theoretical, practical and clinical components. All the courses are validated, not only by the universities, but by the CSP and the Council for Professions Supplementary to Medicine (CPSM) which administers state registration.

To work within the NHS it is necessary to become State Registered. Once qualified, physiotherapists usually practise as junior physiotherapists for approximately two years within the NHS. They then progress to the grade of Senior 2. In both of these clinical grades physiotherapists usually 'rotate' to different specialities in order to gain wide experience. The top clinical grade within the NHS is that of Senior 1 which many physiotherapists achieve within the first five years of their career. In this grade physiotherapists usually specialise in a particular area and frequently have the responsibility of teaching and assisting junior staff and physiotherapy students.

The higher physiotherapy grades are managerial culminating in the post of District Manager where the post holder manages the physiotherapy services, or the whole rehabilitation service, of an entire health district. The lower managerial grades involve the management of a smaller number of physiotherapists and frequently combine clinical with managerial duties. Many physiotherapists move out of the NHS into private practice or industry and a small minority become lecturers of physiotherapy and move to the university sector.

Physiotherapists are expected to remain active learners throughout their careers and there are a wide variety of courses available from Masters Degrees in Physiotherapy to short courses run by clinical interest groups of the CSP and in-service training. In recent years the CSP has promoted its Professional Development Diary as a tool to document continuing professional development (CSP 1994a). It is likely that continuing professional development will be mandatory within the next few years as it will become necessary for physiotherapists to re-register periodically with the State Registration Board and to do this they will need to show evidence of competence to practise (Physiotherapy 1994a). The Professions Supplementary to Medicine Act (1960) is currently being reviewed with this in mind.

An Outline of the Study

The research on which this book is based was undertaken in two phases over a period of eight years. A survey of visually impaired physiotherapists and sighted physiotherapists was undertaken in 1989-90. Two research tools were used; a questionnaire (involving both the sighted and the visually impaired sample) and semi-structured interviews (involving a proportion of the visually impaired sample only). All the physiotherapists were practising in Britain either privately, in industry, in special schools or within the NHS.

In the questionnaire study the sample of visually unpaired physiotherapists was compared with the sample of sighted physiotherapists on a wide range of demographic, personal and employment issues. These data provide a general overview of the employment situation of visually impaired physiotherapists at that time and a comparison of visually impaired physiotherapists with their sighted colleagues.

The 45 semi-structured interviews were based on the individual responses in each research respondent's questionnaire. This data is used inchapter 4 on the history of visually impaired people in the physiotherapy profession, chapter 5 which compares visually impaired physiotherapists with sighted physiotherapists on a wide selection of demographic and work related factors, in chapter 8 on the changing work environment and inchapter 9 where three personal narratives of visually impaired physiotherapists are presented and analysed.

The second phase of the research was undertaken in 1996-97. Twenty of the 45 visually impaired physiotherapists who had been interviewed in phase one of the study were contacted and interviewed again. Only physiotherapists who were working in the NHS were included in this sample although some of them combined this with part-time private work. A semi-structured interview format was used with each respondent with the emphasis on the barriers they experience at work and the strategies they use to overcome, minimise or manage these barriers. People working in private practice were not included as it was decided to focus the study on the experiences of visually impaired physiotherapists working within the NHS which was judged to be an organisation run with the needs of non-disabled employees in mind.

The interviews provide an opportunity to compare the employment situation of the same physiotherapists eight years later which covers a time of considerable change in terms of health and disability legislation, policy and practice. (For full details of the research methodology, readers are referred to French 2000.)

The Rationale for the Study

There are several unique features regarding visually impaired physiotherapists in Britain which makes them an interesting group to study and constitutes an area of research where new insights into disability and employment may be gained. Physiotherapy is the only profession where visually impaired people have, over the course of this century, been accepted in substantial numbers and their special college, which existed from 1915 to 1995, was the only example of a segregated college of higher education in Britain (Teager 1987).

The data from this sample may help to overturn 'taken for granted' assumptions about the ability of disabled people generally, and visually impaired people in particular, to undertake highly skilled, professional work. It is noted in chapter 2 that only approximately 25 per cent of visually impaired people of working age in Britain are employed (Bruce et al 1991) although Simkiss et al (1998), with a smaller sample, give a figure of 32 per cent.

The study is longitudinal, spanning eight years, and many of the physiotherapists had been practising for 20 or 30 years. This provides an historical dimension to the study as the physiotherapists were able to reflect on changes in disability policy and the impact this has had on their employment, changes in health policy and how this has affected their role, changes in themselves as they grow older, and changes in the attitudes and practices within institutions, and within society generally, towards disabled people, for example 'equal opportunity' policies and the impact of the Disability Discrimination Act (DDA) (1995).

The interaction among these and other factors has the potential to provide ne...

Table of contents

• Cover
• Half Title
• Dedication
• Title
• Copyright
• Contents
• List of Figures
• List of Tables
• List of Abbreviations
• Introduction
• Bibliography
• Index