Welcome
Wednesday, 2 May 2007
Jim Odell - Who Am I What do I Stand For?
I will give a promise that, if elected, I will answer any questions directly and take the time to discuss issues with UK chiropractors in whatever forum they desire.
My background is varied. Originally I trained as an engineer, moved into sales and marketing and then management consulting before returning to my real roots – musculoskeletal interests, or as I prefer chiropractic to be considered - neuromusculoskeletal.
During my early career I trained to be a fitness instructor, and took courses in sports science and owned a health club. So, really as a chiropractor I have come back to where I started from. The only difference is that I now bring a whole package of skills that I think will serve chiropractic well on the GCC.
I like to think I can combine the experience that comes with age, and the enthusiasm that comes from seeing what is possible with new eyes.
For those of you who like qualifications I have a BSc in Physics, Master’s degree in business administration, a post graduate diploma in marketing, a BSc in Chiropractic and I am currently half way through a Masters in Biomechanics.
What do I Bring to the GCC?
Chiropractic
As a relatively new recruit to the profession. I am unencumbered by past beliefs and attitudes and will move between models of chiropractic with ease and understanding. I have developed, and continue to develop approaches to working with the NHS. As well as having gained funding from 4 PCTs in my area, I currently have one yearly contract with a PCT for funded NHS treatments and anticipate 2 more in the next 12 months. I have liaised with the Department of Health on chiropractic issues and was one of only 5 chiropractors to be personally invited to the launch of the musculoskeletal services framework.
In order to continue to develop my skills and input back to Chiropractic I am completing an MSc biomechanics, developing research into chiropractic adjustments and research and write a regular feature on different conditions for a chiropractic magazine.
Engineering
Having trained originally as an engineer I am comfortable with research, scientific and technical approaches and able to put together logical, practical solutions to problems. However, whilst I believe in research I also know that ‘there are more things in heaven and earth....(Horatio)’ and that just because we cannot prove something yet does not make it invalid. We must combine research with an open mind.
Business
For my sins I am also an experienced sales and marketing professional having written and read hundreds of thick and often tedious documents. I have played politics with both UK and overseas government officials and in many business organisations. I bring the skills of writing and more importantly, implementing numerous communication strategies, organisational changes and process reorganisations.
I would like to think that I am an all rounder, with the skills and attitudes necessary to work alongside all of the people and organisations, within and outside of chiropractic, that are required to move our profession forward.
Jim Odell - Manifesto Issues. Philosophy & Technique
This section will be short simply because my position is very clear.
I really don’t mind what technique a chiropractor uses or where they qualified. As long as they are safe and competent and have their patients’ best interests at heart. I have no bias.
I don’t mind what their individual philosophies and beliefs are because they will end up treating those patients that like the approach. It is the patient’s choice and the GCC should be ensuring that patients continue to have access to the full range of chiropractic philosophies and techniques.
Jim Odell - Manifesto Issues. The Associations
The MCA, BCA, UCA each has its own remit for being, and some of their rational is given below:
The MCA is the professional body for all McTimoney-trained chiropractors, and was formed to protect and support them. Another key role of the MCA is to uphold and promote the essential principles of chiropractic as developed by the late John McTimoney.
UCA aim to ensure the public has access to principle centered chiropractic care by:Continuing education of the public. Continuing education of the chiropractic profession. The funding of research into principle centered chiropractic. The encouragement of chiropractic as a career
The BCA aim to promote, encourage and maintain high standards of conduct, practice, education and training within the profession in the UK. The BCA also supports and encourages the development of chiropractic research projects, supporting the progression of the profession in the UK and world-wide.
Yes there are similarities in the words, but all fall short of what is needed to develop chiropractic in the UK. Where is the intent to work with each other, to jointly develop for the benefit of the whole profession? This is not in conflict with representing the wishes of your members.
In my experience, the majority of members in all of the Associations just want to earn a decent living and expect something useful back for their membership fees.
However, it is often the attitudes and motives of some of the higher ranking members of the Associations that gain prominence, and are then taken as the views of their members and our profession.
Just imagine how the profession might be different if there was one voice for chiropractic - if we positively promoted chiropractic and its differences rather than using negative campaigning tactics amongst ourselves?
Idealistic? Perhaps? We can but hope. With the right people in place we might just make a difference and I would like to be one of those people.
Jim Odell - Manifesto Issues. The NHS Debate
The NHS Debate
I don’t think many (if any) chiropractors would want to be absorbed into the NHS.
However, I think it may be short sighted not to become more involved in some of the new areas of contract provision becoming available.
That said, it is an individual decision, and just because a door is opened doesn’t mean everyone has to go through. However, with the door closed we are always going to be seen as ‘alternative’ and continue to be listed along side ‘Indian Head Massage’ as we are in some NHS literature at the moment.
It is not a simple case of working within or outside of the NHS. There are opportunities for the profession to work ‘with’ the NHS if individual Chiropractors want that.
It takes effort and support within the profession to drive this forward.
I am in regular discussion with PCT’s, have successfully had patients from 4 PCTs fully funded as individual cases, have an annual contract with one PCT for fully funded NHS chiropractic treatment, and would expect to get at least 2 more in the next 12months.
One of my personal goals is to see Chiropractic funded for 6 treatments on the NHS as standard practice – but as chiropractors I don’t think we should be made to accept NHS patients.
Trying to push the profession towards becoming medics does not help our position with them and for many of us it is not the reason we became chiropractors. If you want to be a medical doctor then I would suggest retraining as one is the answer.
If elected I would be working for a productive move forward within an integrated NHS-chiropractic relationship and greater awareness and understanding of chiropractic amongst health professionals. This is where my experience can help.
Jim Odell - Manifesto Issues. The Role of The GCC
I believe the GCC does have an important and necessary role to play in the regulation and development of chiropractic, which is why I am standing for election. But, like all organisations I have ever examined, it must change with the environment and this is where I feel the weakness lies.
Recent research tells us that as a profession we have little confidence in the GCC. It is my belief that the cause of this ‘lack of confidence’ is a direct result of the Chiropractors on the GCC fighting amongst themselves and navel gazing rather than making an effort to work together for the good of the profession.
Some of the things I would like to see tackled as a matter of priority outlined below:
Greater Transparency in Decision Making
We all have knowledge of past actions, such as that against the Chiropractic-uk website which seemed to transpire through nebulous methods of decision making. I challenged the GCC on the process and rationale for this action without huge success. This highlighted for me just how little we know about how decisions are made on our behalf. It is my belief that the majority of decisions made by council should be openly accessible by any chiropractor that asks. The Due Process for decision making should be clear, open and transparent so that if necessary we can, as chiropractors, challenge decisions on a level playing field.
If elected I would work to help make this a reality.
A Review of the Efficacy of Processes Currently in Place with Particular Emphasis on Professional Conduct Cases
There is far too much to talk about here, but we all know improvements can with the right will, be made to reduce the cost, inadequacies and apparent unfairness of the overall complaints procedure.
In the CHRE 2005 GCC performance report it states that ‘one area for development should be to consider whether to commission an audit of its Investigating Committee’s decisions, once the audit of its Professional Conduct Committee’s decisions has been completed’. I may be out of date but as a working chiropractor I have not seen much happening here. I think the audits should go further and examine the whole of the key processes and not just the outcomes of the PCC decisions.
In 2005 the GOsC undertook a review of their complaints process and produced a more cost effective approach. Yet when I asked a current member of the GCC about benchmarking to see if the GCC could improve he simply said ‘we are doing a better job based on fact the GCC had more complaints’…needless to say I don’t agree.
Let’s look at some figures comparing GOsC and the GCC (unfortunately we don’t have the GCC 2006 figures yet)
As with any organisation in a changing environment, we must stop and check whether it is still fit for purpose and examine the key processes that underpin its method of working. I believe the skills I developed outside of the chiropractic profession can be put to good use here.
Increased emphasis on promoting the Profession
This is one of my main platforms. Ask yourself just how far we have come in the last 5 years in terms of visibility, awareness, understanding and acceptance within the main stream health care professionals or indeed, within the vast majority of the public.
Whilst some may argue it is a lost cause because of the Foster Report (and The Regulation of Healthcare Professionals in the 21st century), the reality is that when I spoke to the Department of Health last month, no decisions on implementing changes to ‘promotion’ have yet been made by the Government on this issue.
What was most telling is that the GCC did not put up a fight to keep promotion of chiropractic as part of their remit.
And even if Government plans do change things, we still have time to make a difference.
The response from a chiropractic member of the GCC to a question on promotion of the profession at a meeting last year (minuted) stated:
‘promotion tends to be viewed as promoting individual chiropractor’s business, but the government saw it as promoting the interests of the whole profession’
Now I don’t know about you, but I never thought for one minute any chiropractor believed ‘promoting the profession’ to be about promoting individual business – but that is what this member of the GCC seems to think the mass of chiropractors believe!
It is my view that most of the GCC representatives have little, if any, experience of strategic marketing and communications, which is why they would like to remove it from the GCC remit and why they make comments as above.
However, if the current regime and the Government plan to drop promotion, I have some questions:
Why can’t some of our fees be ring-fenced and the promotion managed by an independent third party – like the College of Chiropractors? We could even have a Chiropractic Profession Magazine - like the Osteopaths - that represented all views.
The Associations could each contribute and have some space of their own.
If elected this is one area I can promise to bring real weight to the GCC for the time we have left. I spent many years working with major organisations in strategic and operational marketing, and it doesn’t take much to see that the GCC is downplaying this aspect of its role.
Or if we drop a quarter of the GCC remit, do we see a reduction in fees?
Comparing the General Osteopathic Council and GCC brings up an interesting anomaly considering how similar we are to each other.
The GOsC registration fees as a new graduate are £375, payable in a lump sum or by ten monthly instalments. The fee for the second year will be £500 and for the years thereafter £750.
Limits on Actions to Reduce the Diversity in Chiropractic
There is, and have always been, arguments about the ‘best technique’ or the ‘best way to educate’, or the ‘best way to treat’. In part it is the fatuous internal politics and arrogant attitudes amongst a small number of people that have led to the divisions in our profession and confusion amongst patients about exactly what is Chiropractic?
I have heard chiropractors of all types denigrating other techniques and seen websites and articles doing the same. Why?
There is enough work for everyone and, in my experience, patients make their own choices about whether they like and/or benefit from a particular technique, which is often more to do with the Chiropractor than the technique.
As long as we are safe, competent and ethical we should be encouraging the diversity and increasing the numbers of people benefiting from chiropractic, not simply wanting one particular form of Chiropractic to dominate. The best chiropractors will always take from many techniques to the benefit of their patients.
However, on a personal note, I would like to believe that all chiropractors would distance themselves from colleagues that mislead patients in any way for personal gain.
Increased Support and Encouragement for Additional Colleges of Chiropractic
In the 2005 GCC Performance report it states that a Key issue/challenge is the
‘need to increase the number of education providers, with a better geographical spread’
And followed it with ’As a matter of policy, the Education Committee takes a supportive,
developmental approach in its dealings with education providers’
We have seen the nature of this ‘closeness’ with the McTimoney College recently and whether you like or dislike the course, the mode of learning or the technique I think any outsider would agree that the final approach taken did not seem to be supportive and developmental.
If we are to increase the access to Chiropractic we must increase both the number of students and the number of educational establishments that offer Chiropractic.
This is a subject close to my heart as live ‘up North’ and we have nothing up here. If elected I would like to work with like-minded group to facilitate the opening of a northern college of Chiropractic.
Jim Odell - Manifesto Issues. Revalidation
The White Paper ‘Regulation of Health Professionals in the 21st Century’ has kicked up some important issues for Chiropractors, not least the prospect of revalidation based on risk.
Personally I think it is important for Chiropractors to recognise that whilst this process is not the invention of the GCC (as some I have spoken to seem to think) the final scope will be based on what comes forward from the Profession. It is this final scope that must be carefully debated and where my concerns lay.
My concern is that, if handled badly, revalidation could be just another stick that forces many chiropractors to leave the register and become manipulators or osteomyologsits. I would like to think that, if elected, my pre-Chiropractic career gives me a great advantage over the ‘long time’ and ‘committee’ chiropractors. I have designed and implemented key processes in a range of companies that had to be both efficient and effective.
On the face of it, a revalidation should present no problems for safe competent chiropractors, and if it follows the suggestion within the medical profession that ‘..the appraisal process will encompass both summative and formative components…’ and becomes a developmental process then all the better.
However, as with all Government documentation the devil is definitely in the detail and for me some of the key issues are:
• The definition and purpose of revalidation as ’…a mechanism that allows professionals to demonstrate that they remain up to date and fit to practise.’
This is an easy phrase but, if we take just how we ‘demonstrate’, we start down a long tenuous path, let alone ‘up-to date’ which implies some organisation determines what ‘up-to-date’ is.
• The use of the terms ‘relicensure’ and ‘specialist recertification’ as applied to specialists in the medical profession. Does this mean that potentially any chiropractor that lists themselves as for example a paediatric chiropractor or a sport injury chiropractor will have to be ‘recertified’ for these activities over and above just being a chiropractor?
• The report also says:
Professionals will fall into one of three groups for revalidation:
1. employees of an approved body – revalidation carried out as part of the routine staff management or clinical governance system
2. self-employed staff providing services commissioned by NHS primary care organisations – revalidation processes built into the relevant NHS arrangements and carried out under the supervision of the commissioning organisation
3. all others – regulatory bodies develop direct revalidation arrangements.
This introduces immediate ambiguities: some Chiropractors will fall into group 2, and the majority into group 3. If you, like me, fall into Group 2 then must we accept their revalidation processes? This then raises the question of whether we have to do two revalidation processes or will being in Group 3 cover us for Group 2 and vice versa?
I also have concerns that the current GCC have apparently used the risk assessment factors from the report and placed us in the high risk category. The list is simplistic to the extreme and to have already agreed in principle that we are a high risk group, based on this, is slightly worrying, but not unchangeable.
And whilst I do agree that the skill of differential diagnosis is a vital element of any process, it is not necessarily the key measure.
There must be a sensible approach to the revalidation of chiropractors and if the basis of the revalidation approach is to be on risk, we must consider very carefully how the assessment of risk is made.
One danger is that individuals in our profession who want a dynamic or radical shift in chiropractic towards the ‘medical mode’ will create a revalidation process that reflects medical and not chiropractic risk.
Whilst defining risk is fraught, the difficult part is managing implementation of the process. Not simply how, but by whom. Can the GCC really do this and if not who will and how much will it cost? These are all issue up for debate in the next few years and ones for which I would use past experience to good use on behalf of our profession - if you choose to elect me.
Tuesday, 1 May 2007
Jim Odell - Manifesto Issues. Growth of Chiropractic
In the CHRE 2005 report the GCC highlighted that a key challenge is to increase the number of education providers, with a better geographical spread, in order to increase the number of chiropractors.
The GCC website still says: “Chiropractic is a fast-growing independent health care profession in the United Kingdom”
The Reality
If you examine some basic statistics you will see that in the last 5 years much of the growth in the profession has been as a result of Chiropractors trained outside the UK (about 300) and each year some 80 chiropractors vanish from the register (quote from GCC). In fact in 2004/5 143 left the register and in 2005/6 219 (10% of the profession) left the register. No new colleges have been established in England. We are in fact a profession in the doldrums.
Given the current situation, I am currently struggling to understand why anyone in their 20’s would want to train to be a Chiropractor when it is now quicker (and probably cheaper) to train to be a medical doctor, even with their current problems.
I don’t have an answer but I do know that if the profession continues as it is and if past performance is a measure of future, which it will be if the people with the ‘old’ mentality are elected, then you will see a relative decline in our numbers.
You, like me, are probably fed up with the limited and often negative press chiropractic receives in the UK. When I entered the profession I couldn’t believe the amount of infighting that goes on within a profession of around 2000 people.
As a profession we must start working together to overcome differences and take UK chiropractic into a more secure future.