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Health: Sports Medicine

Volume 689: debated on Thursday 22 February 2007

asked Her Majesty’s Government:

Whether the current level of expertise in sports medicine in the National Health Service is sufficient to guarantee adequate help to those who do not have access to private healthcare.

My Lords, sport and exercise medicine is the newest medical specialty in the UK, and we are looking to expand it as part of workforce development across England. Local development plans will need to include action to recruit and develop the appropriate staff required to deliver those services.

My Lords, I thank the noble Lord for that reply. Does he agree with Charles Galasko, president of the Faculty of Sport and Exercise Medicine, that not having sufficient doctors in the community means that those who have suffered, for instance, soft tissue injury end up going to casualty, having several weeks’ referral before they receive physiotherapy, and then having injuries that are more chronic and intractable, and thus cost the NHS considerably more money. That probably also interferes with their work patterns.

My Lords, that is a very persuasive argument, which is why we have taken the initiative in working with the medical profession to develop this new specialty. We should recognise that often GPs in primary care do an excellent job in relation to some sports injuries, and my understanding is that an increasing number of muscular-skeletal clinics have been set up to deal with the very issues that the noble Lord suggested, and in quick time.

My Lords, how many of those special clinics have been set up, given that the Minister said there was an increasing number? How many are in major regional hospitals?

My Lords, the clinics that I am aware of are in St George’s London, Leeds, Sheffield, Colchester, Bath and Cardiff. There may be others and I would be happy to write to the noble Baroness about them. It clearly makes sense if you can set up specialist clinics that allow patients to be treated very quickly with early intervention, as the noble Lord suggested. That applies not just to sports injuries but, for instance, to occupational ill health—30 per cent of such cases are muscular-skeletal disease injuries and, again, early action can prevent people having to leave work and go on to incapacity benefit.

My Lords, can the Minister confirm that last summer fewer than 10 per cent of all the graduates on our physiotherapy courses managed to find a job within the NHS? Given that their training costs were in excess of £70 million, that many of those unemployed could well find their way into sports medicine, and that the hospital waiting lists in this area are getting worse, can he assure us that steps are being taken to address this matter? I probably need to declare an interest, in that my daughter runs a physiotherapy department in one of our training hospitals.

Yes, my Lords; while I do not accept the figure given, I understand that there has been a particular challenge this year for newly qualified physiotherapists finding employment within the National Health Service. Only two weeks ago, NHS employers held a summit with various interested parties to discuss this issue. A range of actions have been agreed, including encouraging current basic-grade physiotherapists to apply for higher-graded jobs—thus releasing vacancies for basic-grade physiotherapists—more career advice for physiotherapists and the encouragement of joint appointments between the NHS and the independent sector.

My Lords, is it not the case in National Health Service practices that an increasing burden of administration is falling on the doctor and that more and more treatment is in the hands of the practice nurse? That trend seems irreversible. Admirable though practice nurses are, if you have a sporting injury you would be lucky to find one who would be able to give you the advice that you probably need, even for simple sprains and injuries suffered on the football field.

No, my Lords, that is not my experience, nor is it the experience of many patients. Yes, many staff in primary care are taking on new roles and responsibilities, which often means that patients do not have to go to hospitals because they can have checks in the surgery; but, due to the other changes being made in primary care, GPs actually have more time to deal with patients.

My Lords, is the Minister aware of the danger of the community type of MRSA spreading in sports clubs? In the interest of public health, will he see that there are adequate hygiene facilities?

Yes, my Lords. As the noble Baroness will know, the incidence of community-based MRSA is low in this country, but experience in the US certainly suggests that it can be spread in sports clubs. We have already issued guidance to the health service but we are looking at further guidance. I very much accept that her point is relevant to guidance and advice that should be given to the health service.

My Lords, given that as a society we actively encourage people to do more sport, for both public health and personal health reasons, should we not be rather concerned, as the Minister has already said, about people who get injured and need to be mobile for their jobs? Can he tell us how quickly the workforce development work will ensure that we get more physiotherapists in place and more specialist sports medicine in the NHS?

My Lords, I anticipate that in the near future we will have 40 specialist doctors, in addition to 12 starting training each year. With regard to the recruitment of newly qualified physiotherapists, it is worth bearing in mind that the vacancy rate for physiotherapists has dropped dramatically because of the increase in the number of training places. I fully agree with the noble Baroness’s first point. She will know that the joint strategy between my department and the DWP on health, work and well-being takes as its premise that early intervention, good occupational health services and good support from the NHS will stop many people going off work in the first place, and that applies as much to sports injuries as it does to occupational injuries.

My Lords, does the Minister agree that the definition of sport and sports medicine in this context should apply not just to formal sports and games but to informal types of outdoor recreation, such as rock climbing and cycling?

Yes, my Lords. There should not be a theological dispute about the benefits of organised sport on the one hand and more general exercise on the other; in my view, the two go together. The more we can encourage young people in particular but the population as a whole to engage in exercise, the better it will be for their health and life outcomes.