No opportunities for physios

The shortage of jobs for physio graduates is mainly a result of the HSE's recruitment freeze, writes Ronan McGreevy.

AFTER YEARS of their predecessors facing into the best employment conditions for those leaving college in Ireland, recent graduates have to now contend with age-old problems of lack of opportunity and the spectre of emigration.

Cutbacks in the health services and a recruitment freeze has left many health-related graduates facing the dole queues as soon as they finish their studies.

The problem is most acute in the area of physiotherapy where graduates are almost exclusively dependent on the public sector to get a start in their professional lives and where there have been cutbacks in recruitment for the past two years.

Of the 140 who graduated from University College Dublin, the University of Limerick, Trinity College Dublin and the Royal College of Surgeons of Ireland (RCSI) this year, 72 (more than half) are unemployed or working outside their chosen field and only 22 are in part-time or full-time employment as physiotherapists.

Emigration is already a reality for 25 of the 145 physiotherapists who graduated from the four colleges last year and 23 are still unemployed. Less than half are working full-time in Ireland despite being in the job market for a year-and-a-half.

Conor Lavery (22), who graduated from the Royal College of Surgeons last month, is currently carrying out administrative work in the offices of the Irish Society of Chartered Physiotherapists (ISCP) and has been unable to get a job since last June when he left college.

Only six of his class of 25 are in full-time employment and half are unemployed.

"There are people like myself who are doing anything we can do to get by. It's better than nothing. Its not ideal by any stretch of the imagination, but it is money," he said.

"Nobody from my class has emigrated yet because we only graduated a few weeks ago and everybody stayed at home for that, but I know there are seven or eight who are planning to go away in the New Year.

"Most are talking about going to New Zealand where they are crying out for physiotherapist graduates and I have heard talk about Australia and Canada as well. I've already seen a lot of the world, so I'm not interested in moving from here."

ISCP chief executive Ruaidhri O'Connor said the shortage of opportunities for graduates was a direct result of the recruitment freeze in the Health Service Executive (HSE) which has been operational since last year though the problems relating to graduate unemployment date back to 2006.

The situation is so bad, he believes, that half of this year's class will emigrate next year and the society has been giving refresher courses to graduates so they do not lose their skills.

"We would have been aware of about 100 posts which were available this time last year in the health service. They are no longer available," he said.

"As temporary contracts come up, they are not being renewed. If women go on maternity leave or somebody goes on leave of absence, they are not being replaced.

"There is a panel of 600 physiotherapists within the HSE and it is working through them as some opportunities arise but, with the squeeze on recruitment and the overall ceiling on numbers in the health service, it is, unfortunately, affecting front-line services.

"We are not the only ones affected by cutbacks, but our problems started sooner than anyone else's."

Mr O'Connor said the number of physiotherapy graduates had increased dramatically since the Bacon Report in 2001 predicted a severe shortage of physiotherapists within the health service this decade.

The Disability Act of 2004 and the Special Educational Needs Act also identified a shortage of physiotherapists in front-line services.

Under the Special Educational Needs Act, all children under six are entitled to an assessment of need, but the ISCP believes the follow-up physiotherapy services are not there at present.

He said the decision to cut the number of physiotherapists was "penny-wise, pound-foolish" and would end up costing the HSE more in the long term.

"Because of the non-recruitment for vacant posts in the acute hospital sector, there is a consequent effect on the rehabilitation services within those hospitals," he said.

"There is a significant waiting list for physiotherapy services because the more urgent cases are being prioritised."

Therapists have a major role in other aspects of the service which can lead to significant cost savings to the Exchequer such as ensuring that the elderly can be more mobile and they can also facilitate the accelerated discharge of patients from hospitals.

"It's short-term savings that will have long-term cost implications because patients who need physiotherapy will be more dependent on the public health system."

The ISCP said it wanted the HSE recruitment section not to affect front-line physiotherapists and that recruiting physiotherapists should be prioritised because of the potential cost savings across the health service.

Labour Party Deputy Mary Upton described unemployment rates among physiotherapists as a "scandal".

She said the Government had actively encouraged people to enter the physiotherapy profession and the number of those employed has increased by 141 per cent or by 836 since 1997.

However, she said the number in employment was now dwarfed by those who had recently graduated and were unable to find employment.

"The scandal of encouraging people to choose a career and then removing their employment opportunities when they graduate is yet another poor decision by this error-prone Government," she said.

She believes the cutbacks in physiotherapist numbers are contrary to the Acute Hospital Bed Capacity Review which recommended primary and non-critical care as the way forward.

"It is time for the Government to concentrate on providing the primary care centres up and down the country, rather than concentrating on providing tax breaks for private hospitals or paying consultants to treat their public patients through the National Treatment Purchase Fund."

In a statement, the HSE said the number of staff grade physiotherapists had increased by 124 or 30 per cent over the past five years.

The statement said the HSE was committed to putting in place some service developments (older persons, primary care, disabilities) deferred from 2007 which would require additional physios and had committed additional resources in the 2008 budget for enhancing certain services which would also create additional posts.

It pointed out that a national competition for staff grade physiotherapists was held in April 2007 and a panel has been operating since March 2008 and is being used to fill temporary and development posts for staff grade physiotherapists as they arise.