What Can We Say? MADAM - I read Patricia Phillips leading article Gagging (June, page 367) with interest but some concern. Was I really being told by the CSP that I can no longer talk freely to friends and colleagues outside my own NHS Trust? The business arrange- ments of our organisations are directly linked to service structure and therefore to the way that we can practise as clinicians. Surely then to talk about one aspect is to reveal the other1
Disdussion wlth colleagues revealed that we had several different Interpretations of the message of this article. We should be clear exactly what our professional leadershlp Is saylng intt$3 important Issue, and I hope that further dlscusslon and clarlflcatlon wlll be Included in future Issues. Susan Magee MCSP London SW15
patients in bed, denying them movement; physical contact, and also an altered perception of what is often an alien environment.
Despite regular physiotherapy and instruction to nurses about the necessity of regular turning and positioning, we have found these patients tend to be losing a greater range of movement in many joints, especially rotation at the shoulders and hips, than when nursed in conventional beds.
I would be interested to hear if any other professional has similar concerns or has carried out any researchlstudies In this fleld. Carole Napper MCSP Physlotherapy Department Royal Shrewsbury Hospltal (North) Mytton Oak Road Shrewsbury Shropshlre SY3 8BR
Patrlcla Phllllps, chalrman of Councll, replles: I hope It will be helpful to quote from the
notes of a meeting held on July 2 1, 1993, between Sir Duncan Nlchol of the NHSME and chairmen and officers of the professions allied to medicine:
On the question of collaboration between professionals working for different trusts and the difficulties that some trusts raised over intellectual property or commercial secrecy, the National Health Service Management Executive said that it saw this as inappropriate.
Professionals should be able to talk together and should be able to see ways of improving practice as part of their professional links.
Although trusts were grappling with new concepts in relation to intellectual propeq, and should not be inhibited from being able to patent a marketable product, the development of clinical practice should not be subject to coymercial confidentiality restrictions.
Pressure Relief wersus Mobility MADAM - I would like to express my concern aboh the use of specialised pressure-relieving mattresses.
It appears that these are increasingly being used in the nursing management of pressure ardas for patients requiring long- term care.
These mattresses reduce the need for regular turning and correct positioning of
Chronlc Hyperventllatlon MADAM - Patients wlth chronic hyper- ventllation syndrome (CHS) are being referred to physlotherapy departments more and more frequently.
However, as this condition is not yet covered by the core physiotherapy under- graduate curriculum, many therapists do not feel confident to offer effective treatment.
With this in mind a group has recently been set up to further knowledge and pass on expertise, and for discussion and education.
It is our aim to produce an information pack containing not only a list of exper- ienced therapists available around the country for advice and guidance but also a recommended literature list and guide lines on recognising the symptoms of the condition and treatment.
We are sure that there will be a lot of interest in activities of the group and are keen to hear from anyone experienced in treating hyperventilation who would like to join and also from people who are keen to learn more about CHS and wish to acquire a pack.
Readers are invited to contact me at the address below, with details of their experience (or lack of it!) enclosing an SAE for further information. Anne Pitman MCSP Chairman Physiotherapy for Hyperventilation Princess Grace Hospital 45-52 Nottingham Place London W1N 3FD
Down with Massage MADAM - In the proceedings of Council reported in the July issue of Physiotherapy it is reported that the Education Comm- ittee had discussed the importance of massage. Why is it important?
I cannot believe that the CSP seriously considers it appropriate to raise the profile of massage at all, let alone to make it the subject of a conference.
Osteopathy is clearly in the ascendency, inevitably at the expense of physiotherapy. I feel very strongly that this is due in no small part to years of treatment of a myriad pathologies by infra-red and massage.
Can we look forward to a plethora of sound clinlcal trlals supportlng the importance of massage? I doubt that a single paper can be clted that the Brltlsh Medical Journal would remotely conslder publlshing. J E 0 Squier MCSP Cam brldge
Shower Price Relief MADAM - Following my letter in the June issue of Physiotherapy on the high price of the Team Lazy toilet and shower system, Nottingham Rehab has informed me that the price of this product has been reduced to 799. lshbel M Spence MCSP Craigewan, Peterhead
Retirement Thanks MADAM - I would like to thank former students and colleagues of the Royal Orthopaedic Hospital School of Physiotherapy in Birmingham for a memorable retirement reception and joyful evening on July 15.
May I send a special thank you to the many who came to mark my retirement and the great number who sent greetings and donations towards most generous gifts.
I am grateful to all for their good wishes which I warmly reciprocate, and for launching my retirement in such a celebratory and generous way.
To the organisers I extend my heartfelt thanks for all the effort, care and planning that made the evening such a delightful and momentous event. Eva Jahn GradDipPhys MCSP DipTP Birmingham
CHANGES! CHANGES CHANGES! CHANGES! CHANGES! The system for publishing information about courses will change from the October issue onwards. There will then be two types of notice from which to select. Please see page 657 for full details.
Physiotherapy, September 1993, voi 79, no 9