Member Organisation Presentation

1. Member Organisation Presentation New Zealand Scot Thomson

2. 3 Key Issues • Staff retention and recruitment (especially experienced staff) • Difficulty diversifying practice • ACC funding / uncertainly of contracts

3. Issue 1-Staff Retention-Part A Changing mindset of newly graduated staff and younger therapists Difficulty retaining young staff for more than 2-3 years Employers conscious of the risk of investing CPD time and money in young staff Employers bonding young staff in return for CPD commitment. This ensures employers get a return for the CPD investment.

4. Issue 1-Staff Recruitment-Part B New graduates and younger staff are looking more closely at the CPD that prospective employers offer – especially if bonding is part of an employment agreement Larger practices are better positioned to offer structured CPD to attract younger staff Smaller practices with less resources at times have difficulty attracting younger staff

5. Issue 1-Staff Recruitment and Retention In areas with larger populations amalgamation of practices to share resources is one option that may be a sensible way forward. This may address not only the staffing issues but would build a stronger financial business that would have more opportunities to offer new graduates.

6. Issue 2 – Difficulty Diversifying Practice New Zealand’s government funded ACC was established in 1974 and now is where the majority of private practice physios generate their income from. Private practices generate between 75% - 90% of their income from ACC The reliance on ACC has seen most private practices narrow their focus to injury management and musculoskeletal problems. Other services eg managing lifestyle related problems, cardio-respiratory problems, neurological problems are largely ignored

7. Issue 2 – Difficulty Diversifying Practice Over time private practice skills and experience have narrowed to injury management and treating musculoskeletal conditions. Leaving the ‘comfort zone of ACC’ proving difficult Extra time and energy needed to look at new service opportunities while still maintaining the ‘ACC income stream’ lack of motivation to change especially from older practice owners – young physios have no ‘change agent’ role model to follow

8. Issue 2 – Difficulty Diversifying Practice The challenge for the profession is to encourage younger therapists to look at career opportunities outside of injury management and musculoskeletal physiotherapy Progress is being made on this front by Physio New Zealand 2012 – focus on arthritis management and breathing disorders 2013 – focus on pelvic floor disorders and continance

9. Issue 2 – Difficulty Diversifying Practice Diversification will take time Kiwis address health issues ‘once’ they happen not ‘before’ they happen Kiwi physios looking to diversify will need to do their market research especially when looking to sell new services to a nation of people who seek help when they are hurt. Seeking different career opportunities is one matter but changing the attitudes of a nation is another challenge altogether!

10. ACC Funding / Uncertainly of Contracts ACC provides the majority of income for private practice physios in New Zealand This heavy reliance on one source of income is a major business risk!

11. ACC funding / uncertainly of contracts Business risks include Periodic change in government in NZ – left leaning governments have supported the monopoly position of ACC in NZ. Right leaning governments support competition in the market with the addition of private insurers in the market 1999 experiment failed abysmally!

12. ACC funding / uncertainly of contracts Business risks (cont) Increased compliance costs to be eligible for a contract Limiting the number of contracts given and preference given to large entities who have national or significant geographical coverage. ACC giving only short term contracts eg 2 years with no medium term certainty for practice owners who continue to invest capital or take on debt to finance business development

13. The link between Issue 2 and Issue 3 The more diverse practices are the less business risk and the greater certainty of income there is. This also increases the saleable value of the practice because goodwill can be seen to exist past the expiry of the ACC contracts that practices have.