Why Physiotherapy Shouldn’t Come Cheap: The Cost of Undervaluing the Profession

By Phin Robinson

Since qualifying in 2001, there has been an immense shift in the opportunities and developments in our profession. When I qualified, physiotherapy was predominantly focused within acute hospitals and community settings, with several private practices around the country.Having specialised in musculoskeletal physiotherapy, after a few years of rotations, I was part of the early rollout of the Agenda for Change programme. Although this was largely welcomed, it did lead to a national down-banding in many instances and may have fuelled the increase in private practitioners moving out of the NHS. Although there were medico-legal processes occurring, there was not a significant medico-legal physiotherapy demand until the mid-2000s with the rise of whiplash claims, which continued until the whiplash review [1] was undertaken from 2016 to 2019.

I was part of the review process with the Department of Justice, leaders from insurance and legal entities, and was amazed at the devaluing of physiotherapy in the eyes of both insurance and legal bodies. This reduction in value is not necessarily driven by the referring parties but our profession itself. If we as physiotherapists don't recognise our value in the skills that we have learned and developed - in many cases over years of postgraduate training - and ensure this is reflected in the fees we command, then we cannot expect referral organisations to act any differently.

Over the last few years, but particularly recently, I have seen an increasing trend for private practice to undercut a reasonable level.