task of health promoters is to uncover and hold
up to scrutiny their values and beliefs.
Health promotion is a broad and complex concept which demands of physiotherapists a comprehensive
understanding of the meaning of health and well-being Figure 10.8 What does this have to do with health? A
education. Central to moving towards more health- promoting practice is shifting the emphasis from medical and behavioural change approaches towards more client- centred and social change approaches. This shift would involve a broadening of the physiotherapist’s role and working in partnership with those engaged in health pro- motion outside ‘traditional’ health and social services, such as architects, community workers and political cam- paigners. This would involve many skills, not least those of communicating with a wide range of people from diverse disciplines. As Scriven (2005) points out, this is no easy task within the NHS where resources are restricted and where curing disease takes precedent over promoting health. A holistic approach towards health and well-being challenges a medicalised view of individuals and extends thinking and activity beyond the individual to the broad social, economic, cultural and political context locally, nationally and internationally (Figure 10.8).
CONCLUSION
In this chapter we have examined relationships within physiotherapy practice and have discussed how these rela- tionships might change to encompass current reasoning, knowledge, policy and legislation. As front line workers in the NHS it is vital that physiotherapists understand the meaning of health, illness and disability from the perspec- tive of patients and clients, and that the physiotherapy service is run flexibly and imaginatively so that people who may benefit from it can use it with ease and conven- ience and in ways that facilitate their aspirations and goals. Improving health, in its broadest sense, is not just about medicine, but necessitates involvement in areas such as housing, employment, education, leisure, out- reach services and community regeneration. It also demands working with rather than on or for people.
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