No White Flag for White MADAM - In response to the letter from Margaret McGee (October, page 581) re the CSP's 'political' campaign against the NHS White Paper, I am unclear who the 'activists' frequently alluded to are. Does this sinister band include the many Chartered physio- therapists who are:

Passive Motion MADAM - In response to Mrs Paull's letter regarding continuous passive motion (CPM) in Canada ('Letters', September), I must express my complete agreement with her remarks about the monitoring of CPM by an orthopaedic physiotherapist, and the educaxion of medical colleagues, nursing staff and patients.

Unfortunately, the use of CPM in the VK seems to have many differences from its use in Canada, not least being the fact that most physiotherapists only use the CPM with knee replacement patients. This is not only wasting what is an expensive but effective treatment technique, but also not using the equipment to treat injuries it was originally designed for!

However, in some areas of the country, CPM is being used almost exclusively with trauma patients, particularly those suffering intra-articular fractures of peripheral joints. I hope that this trend will spread, and with it, the stimulus to conduct much needed research into this treatment method.

SALLY P DAVIES MCSP Cardiff

Paper writing to their MPs in an effort to

discover more information than that imparted in the single line in the whole White Paper devoted to physiotherapy; 0 signing petitions demanding the preser- vation of a free iocal NHS which provides all services, be their turnover high or low; 0 arranging public meetings about the future of the NHS at which representatives of a/ / parties are invited to contribute; - to name but three?

Ms McGee recommends that we grasp the opportunity to negotiate. This is ironic in view of the fact that the NHS Review was conceived by the Government, in secret, with no consultation or negotiation with any Health Service organisations. It was produced as a direct result of a funding crisis in the NHS and is remarkable for the fact that it does not address the underfunding issue at all. Furthermore, it is difficult to believe that Mr Clarke wishes to engage in 'con- structive dialogue' when he has consistently refused to meet with representatives of the CSP to allow discussion of our concerns.

The recent meeting with Mr Mellor occurred only as a result of sustained pressure from campaigning physiotherapists, and although helpful, left many questions unanswered.

I feel that these so called 'activists' have achieved much by their efforts and far from waving the white flag, we should redouble our efforts to win the war.

JULIE SMALLWOOD MCSP Skelmersdale, Lancs

Standards in Sport

MADAM - I note with interest the criticisms of my article 'Diagnosis and treatment of sacroiliac joint dysfunction' ('Letters', October).

May I ask Mr Newton and Mr Downie for their evidence that such techniques are dangerous as I found none in my literature search. Indeed, I have worked with doctors on the FA medical committee and they were very interested in this approach.

Mr Newton and Mr Downie failed to

Carlson House School MADAM - We read with great sadness of the death of Mrs Esm6 Chambers Millward MCSP (n6e Bayley) in a recent edition of your publication.

Mrs Millward was employed at one time as physiotherapist in our school, Carlson House, which was started due to the initiative of a group of parents whose children had cerebral palsy. We notice in the obituary this is referred to as the Cadbury Trust Carlson House School, which description is incorrect. The school did, of course, receive help from the Trust, but the main connection was the fact that Mr Paul Cadbury was a founder member of this Association and he had a daughter, Margaret, who had cerebral palsy.

We would however, wish to extend our sincere condolences to members of Mrs Millward's family in their sad loss.

E R HURD Midland Spastics Association Birmingham

mention in their letter that their experience of such injuries is at the FA National Rehabilitation Centre where they are employees of the same organisation running courses for non-State registered physio- therapists in football clubs. I await with interest their letter crit icising their employer's advertisement in the October issue of Physiotherapy, page xxii.

I have taught on such courses along with Mr Brian Brockie (whose article appeared in the October Journal) and Mr Graham Smith, a member of the CSP Council. If such courses are to be run, is it not better they are taught safe effective early treatment measures? At no time are electrotherapy, manipulation and so on taught on these courses, participants being told to be aware of their limitations and seek professional help. The trend in football now is to use these people as basic first-aiders with a State-registrable physiotherapist in a consultancy role.

If Mr Grieve cares to contact me directly I will send him a photocopy of his work I used from the first edition. I never intended to associate Mr Grieve with my views; 1 would have been exceedingly surprised if he had agreed with them.

1 have received many letters from physio- therapists who have found my techniques useful, as well as many satisfied patients. I merely meant to describe an interesting phenomenon which I had found helpful and invite readers to try it. Therefore I would appreciate constructive criticism of the method after it had been tested, rather than 'gut' reactions.

D J WILSON BA MCSP DipTP Nottingham

Refresher and Updating Courses MADAM - Is there a need? Are they being provided? How long should they be and what should they contain?

Members thinking of returning to the service after a break and willing to fill in a questionnaire are invited to contact me. Or if they are running or planning to run a course I would like to known more on the structure, content and so on.

Anyone who can help with my research for a CMS management project is asked to write to me at the address below.

ANNETTE ORPEN MCSP (Mrs) Bradford on Avon Hospital Berryfields Bradford on Avon Wiltshire BA15 1TA

Biofeedback for Posture Control

MADAM - I am currently working with a teenage girl with cerebral palsy who has poor postural awareness. This is emphasised when she is sitting in her wheelchair.

I am investigating the use of the REM biofeedback monitor to help her with this problem, but as it is quite an expensive piece of equipment, 1 wondered whether any other physiotherapists had used it with similar aims.

Before buying the equipment I would be very interested to hear if anyone has used it with any success.

JACKIE DANVERS MCSP Westbrook School Thoresby Road Long Eaton Derbyshire

Retirement Thanks MADAM - May I through Physiotherapy express my warm and sincere thanks to all those who contributed to the retirement gifts which were presented to me at a dinner on September 23.

I have been overwhelmed by the number of messages of congratulations which were sent when I was awarded the MBE in the Queen's Birthday Honours list. Still more wrote to me sending good wishes for retirement. To all these friends and to those who could not be at the dinner, I extend a deep and heartfelt thank you for making the end of my physiotherapy career so happy and memorable.

DOREEN CANEY MBE BA FCSP DipTP Solihull, West Midlands

See also page 640.-Editor.

Correction We regret that owing to an incorrect precis

of committee discussion, the report of the proceedings of Council in the August issue of Physiotherapy contained a misleading statement about future Congresses of the World Confederation for Physical Therapy. Although regional conferences will be held, the need for a world forum remains, and there are no plans to discontinue the world Congresses, which are enthusiastically supported by The Chartered Society of Physiotherapy.

644 physiotherapy, November 1989, vol 75, no 1 1