Not only will injured and disabled New Zealanders suffer painfully long wait times in order to see a physiotherapist but, worse still, they may see their therapists heading overseas if working conditions don't improve soon, warns Jonathon Warren, president of the New Zealand Society of Physiotherapists (NZSP).
Clinics in some rural areas have already closed and some physiotherapists have either gone overseas or left the profession. Job advertisements are failing to attract new recruits.
Positions being advertised in the NZSP newsletter had almost doubled from 69 vacancies in April 2005 to 110 in April 2007.
"We keep people moving. We get them back to work and play," emphasizes Mr Warren. He said physiotherapy plays a vital role in keeping New Zealanders healthy.
The society has never had a review of funding arrangements in the 30 years it has supplied its services to Accident Compensation Corporation (ACC). Additionally, Mr Warren said, with ACC as a monopoly purchaser they have had no right or avenue to negotiate the price they are given.
In Kaitaia it is a no-win situation, physiotherapist Carol Green said. She now works at Kaitaia Hospital having left private practice two month's ago.
The waiting time is around twelve weeks. Hospital in-patients are treated first and with what time they have left they have to prioritise outpatients Ms Green said.
"Right here in Kaitaia we have two full time physios... it is not enough. People travel long distances, the price of petrol has gone up, and even if you can get to a physio, you can't get one."
A shortage of treatment options results in doctors repeatedly signing the same certificate saying patients are not fit for work, she said. "But how can they get them fit for work if they can't get the right treatment?"
"In a low socio economic area it has huge implications for families – who are only just managing on their workloads and then they (go on) eighty percent of their income and they don't manage to make their payments," Ms Green said.
An independent review of physiotherapy funding and its operations was carried out last year as part of a confidence and supply agreement between the government and New Zealand First.
"These guys played it by the book, followed the rules, had a review, hadn't got militant like other people in the health professions," Peter Brown, Deputy Leader, New Zealand First said. "But the government delivered zilch."
The Review of the Way Physiotherapy Services are Funded and Accredited by ACC found ACC's funding arrangements "unsustainable" and recommended a minimum and immediate thirty-three percent increase. While the government agreed to the recommended operational changes, a decision on the funding was deferred until the recent budget announcements.
The budget's failure to offer any funding at all stunned the society. "The government is courting disaster for us and our patients," believes Mr Warren. "As soon as the budget came out, I got an email from two senior physios and they said, 'that's it'. They are leaving."
In a letter to ACC Minister, Maryan Street, Mr Warren asked if government policy had changed and whether "physiotherapists must donate their services to patients".
"We're incredibly disappointed. The government has totally ignored the advice of its own reviewer."
"We have a caring profession which works with utmost integrity. People will still be out there treating patients but they will actually be taking on the cost of the scheme themselves because they are actually donating part of their services. They really care about their patients."
The review was extremely costly for the government, ACC and the Physiotherapy society, Mr Warren said.
Miss Street has acknowledged that the 2008 budget was a disappointment for the Society.
However, she pointed out in a letter to N.Z. Doctor, that prioritising funding allocations sought by the many treatment providers showed that other areas were more important. "For example, I considered funding for informal caregivers who provide home-based services for injured ACC claimants and determined this was a more urgent priority..."
The budget allocated $46.5 million for home based care.
Caregivers should be remunerated, Mr Warren said in response. "But if you don't have physios able to rehabilitate these people-you can throw more and more into home care because they wont be able to look after themselves if they are not getting rehabilitation."
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