Are fitness to practise assessments of physiotherapy students with disabilities discriminatory? - Abstract

Relevance: Policy, strategy and influencing or research, education and practise. Purpose: This research explored fitness to practise regulations and considered whether they might be discriminatory for students with disabilities. The Health and Care Professions Council (HCPC) that regulates the physiotherapy profession in Britain has fitness to practise requirements that include a requirement to be of ‘good health’. They also require qualification programmes to consider a student's potential to meet future fitness to practise regulations. As disability is closely associated to health within our society these requirements may create a social barrier to an increase in the representation of people with disabilities in the physiotherapy profession. Methods/analysis: Data was collected by documentary analysis of the HCPC fitness to practise policy alongside qualitative data collected from semi-structured interviews with a representative from the HCPC and students with disabilities, about their perceptions of the fitness to practise requirements. Results: The findings of the research suggest that fitness to practise when linked to health or disability is a contentious area. Whilst the HCPC has move away from medical confirmation of fitness, registrants are still required to give a self-declaration. The assumption that a therapist's health or impairment poses a threat to patient safety continues to underpin fitness to practise policies. Furthermore, the assessment of students’ potential fitness to practise during the admissions process creates a dilemma for students with disabilities, causing some to withhold disclosure, preventing them from accessing the learning support to which they are entitled. This dilemma seems strongest for students with a physical impairment who are subjected to health screening assessments, which they find intimidating. Discussion and conclusions: In 2007 the Disability Rights Commission recommended the withdrawal of all fitness to practise policies. With the introduction of the Equality Act 2010, which imposed a Public Equality Duty on all public organisations (including the National Health Service and Higher Education) it might be time to remove health and disability from fitness to practise. The HCPC has competency levels that stipulate the minimum requirements of a registrant for safety and efficiency. These coupled with the Health and Safety at work Act 1974 should be sufficient to protect patients. It would seem that the difficulties encountered by students with physical impairments may be associated with the implicit assumptions that physiotherapists possess high levels of physical fitness or ‘sportiness’, and therefore any student who does not fit this image is subjected to health assessment with the threat of withdrawal from the course. This assessment could be interpreted as pre-employment screening, which the Equality Act 2010 states is discriminatory. Impact and implications: The British government has been encouraging the National Health Service to increase the number of employees with disabilities to reflect the population that they serve. This will only be achieved if fitness to practise policies are addressed as these form a potential environmental barrier for students with disabilities applying to become health professionals. Creating greater diversity within the physiotherapy profession will only benefit both the profession and our patients/clients.