As a provider of various interventions including physiotherapy services, you may be surprised to read that I agree with most of what Michael Faulkner said in his article.

Being one of the longest established providers of intervention services in the insurance industry, IPRS has amassed a significant amount of data regarding the effectiveness of intervention programmes.

This data continues to confirm that managed interventions, of which physiotherapy is one, play an important part in reducing the cost and duration of a variety of conditions.

Research, funded by anyone, into the benefits of physiotherapy would clearly be a complete waste of time since there are significant amounts of objective research from all over the world that demonstrate the benefits of this discipline. What is not clearly understood in this country is how the various interventions can work together most effectively to reduce the duration of an injury, thereby reducing the losses incurred and then the claims costs.

The provision of physiotherapy as a standard, unmanaged service will not yield the levels of cost benefit required to justify the use of these types of service as a claims tool.

If these services are being used as added value gimmicks, they must be measured for added value; if they are used as a claims tool, they must be used differently and measured as a claims tool.

At the same time, considerations must be given to the role that the public sector and the government plays in the administration of intervention services. These services do not simply benefit injured parties, insurers and employers. Well-managed treatment programmes administered to personal injury claimants will also help to ease pressure on the NHS and, ultimately, government funding.

The debate should centre around the question: How is the public sector going to help the insurance sector to manage the costs of injuries in the fairest, most cost effective manner, resulting in the best outcome for all concerned?

As we all know, the NHS has begun to claw back various costs from motor insurers as a result of road traffic accidents. How long will it be before the employers' liability insurers are being asked to fund treatment of work related injuries? This could soon be a reality.

Unfortunately, the government is unlikely to offer financial recompense to insurers who are paying for the private treatment costs of accident victims. At the very least, the powers that be should let insurers have a say in how (or indeed, if) the NHS provides the treatment that they are going to have to pay for anyway.

Only through rapid treatment and good case management can costs be cut and extra benefits be perceived.

We should not be distracted by the relatively insignificant amount currently spent by insurers on physiotherapy.

David Bingham
Managing director

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