Shades of Gray

If there is one skill the Chartered Society of Physiotherapy needs in a new chief executive, it is the ability to make after-dinner speeches without causing an uproar.

Paul Lambden's short but colourful spell in the job ended in resignation last October after several weeks of bruising publicity about his address to the annual dinner.

The choice of Phillip Gray as his successor will have led many members to breathe a sigh of relief. Mr Gray, who starts work on 1 June is a safe choice - but not a boring one.

He is a known quantity at the CSP, having worked there as industrial relations director for 11 years. He is credited with founding the union function at the CSP and was awarded a fellowship for the achievement in 1996.

By then he had left to become labour relations director at the Royal College of Nursing, the post he leaves to become chief executive back at CSP.

What will he find there? The leadership crisis was a distraction at a time when major debates on The New NHS white paper and Our Healthier Nation green paper were gathering steam, but he believes the officers and staff have coped remarkably well.

He thinks the whole affair, in which there were claims of rifts between the union and the professional sides of the society, pulled any opposing factions together.

'I think the tensions there may have been - though I wasn't there, of course - are significantly less. I see my role as being a uniting one. The CSP is an organisation with plural strengths.'

At this month's annual representatives' meeting, he found a willingness to recognise the strengths that people bring to the whole of physiotherapy, he says.

A gifted communicator, Mr Gray's ability to deliver a soundbite and a plain English explanation of a complex issue was seen less often in public at the RCN, where general secretary Christine Hancock usually does the big interviews.

It is a quality that the physiotherapists will hope to use to raise their profile and increase their influence.

The therapists' newspaper, Therapy Weekly, regularly publishes news items recording professionals' dismay at being snubbed, excluded or ignored. How can therapists make their voices heard without appearing to whinge?

Mr Gray clearly sees strength in numbers. 'I think you can expect to see increasingly effective co-operation between the professions allied to medicine,' he says. An alliance on industrial relations was announced last year and the hint is that there is scope for similar developments on other fronts.

'What we have got to do is get over the message that physiotherapists have a major role to play in delivering better public health,' he says.

'It's about the practical contribution we make, not how worthy we are,' he says.

He sees a parallel between the therapists' frustrations and the nurses' position back in 1990-91, when the previous wave of reforms was underway. Nurses complained that the white papers of the day were focused entirely on doctors and pushed hard to be included in future plans.

This time around, nurses are named clearly as partners in the commissioning process and other reforms. Pulling the professions allied to medicine into the same sort of position must be on the agenda.

But for many managers, the biggest problem with physiotherapists lies not so much in understanding their value as in recruiting qualified staff in the first place.

Physiotherapy, Mr Gray says, has the highest vacancy rate in the NHS - currently in the region of 20 per cent. The shortfall persists despite an increase in training places of more than 50 per cent, reflecting the growing demand for physiotherapists, both in the NHS and outside.

Unlike many other NHS professionals, physiotherapists can opt out into a well-established private practice network. Industry and the voluntary sector recruit physiotherapists too - and many are choosing to leave the NHS, with this year's staged pay award and other factors contributing to disillusionment.

'Pay has not moved in eight to 10 years. The staged award was an extreme mistake. For a comparatively small amount of money - pounds86m saved on nurses and the professions allied to medicine - it caused an enormous amount of damage. We have go to ensure it doesn't happen again,' says Mr Gray.

He believes managers should help to put pressure on too - or face losing more staff to other sectors that treat graduate staff more generously.

He also urges managers locally to bring the professions allied to medicine in on family-friendly initiatives and to foster one of the best retention tools of all - well-managed, effective services where physiotherapists can learn and develop professionally.

Anyone who has worked with professionals but not belonged to their particular tribe knows that eventually you face someone who expresses amazement and slight disappointment that you are a 'non-nurse', 'non-physiotherapist' or whatever.

How does Mr Gray cope as one of the most senior 'nons' in the business?

'I don't pretend to be an expert in physiotherapy itself,' he says.

'I believe I am an expert in the needs of physiotherapists, the directions in which the profession wants to develop and in my ability to help act as a voice for physiotherapists in conjunction with the many understanding members of the profession.'