I join others in congratulating Alex Rowley on bringing this important debate to the Parliament and on the content of his speech. He is absolutely right that the issue sits in the wider context of workforce planning and the inadequacy of the current position.
I thank the Chartered Society of Physiotherapy for its very informative briefing.
There is no doubt in my mind about the value of physiotherapy, whether that is to do with its positive impact in reducing the number of hospital admissions, speeding up discharge from hospital or supporting people at home to live independent lives and move away from a reliance on social care. Physiotherapy is worth its weight in gold.
Like much of the NHS, the physiotherapy service would be nothing without its staff. However, there are simply not enough of them to meet demand. As Sue Webber said, vacancy rates are at a record high, at an average of 11 per cent across Scotland. The consequences are longer waiting times and additional pressure on existing staff and services.
We need much better workforce planning, and we need an increase in the number of training places to meet future demand. Although I am mindful of what Ruth Maguire said, I note that, in NHS England, the number of training places has increased by 42 per cent in the past 10 years—there was a further 18 per cent increase just in 2021-22 alone. By contrast, Scotland’s undergraduate physiotherapy programmes have shown virtually no increase since 2015. That simply is not good enough in the context of increasing demand.
There are steps that the minister could take. Physiotherapy could be made a controlled subject for workforce planning in higher education, which would increase the number of places. As Alex Rowley said, funding and learning routes could be established, and things such as apprenticeship models could be considered. The funded MSc physiotherapy bursary scheme could be maintained, and education and funding could be provided to support advanced practice. Taken together, those measures would go some way towards alleviating the pressure. I urge the minister to set out the concrete action that she intends to take to address the matter.
The issue is so important because we will not fulfil our ambition to deliver more primary care services without an expansion in workforce numbers. Physiotherapists are being brought into GP surgeries to help patients with musculoskeletal conditions. That is a good thing, because it enhances patient care, better integrates services and reduces GP workloads. There is also less testing, less prescribing and fewer secondary care referrals. That is better for the patient.
There are also further opportunities in primary care. There will be patients with complex comorbidities, and physiotherapists with advanced practice skills can reduce the reliance on GPs and inappropriate hospital admissions.
As Ruth Maguire eloquently said, there are opportunities in women’s health—in pelvic, obstetrics and gynaecology services—that might lead to surgery being avoided.
There is huge potential for community rehabilitation to reduce the number of people who become needlessly disabled and to contribute to their leading full and active lives.
Physiotherapy is good for patients and reduces the pressure on secondary care. We know that there is a beneficial impact for patients, GPs and secondary care if more physiotherapy can be delivered in primary care, but there are simply not enough physiotherapists.
If the Government agrees that that is the right direction of travel, we must see the warm words matched by action. Let us see an increase in the number of training places, and let us see that now.
