Anne McCoy AM

Chief Physiotherapist, The Royal Children’s Hospital Melbourne  

Early Days

In 1964 prior to the commencement of the Physiotherapy Course in Victoria, each student was required to do a 2 week placement as a Nurse’s Aide. Anne’s setting was the Polio Ward at Fairfield Hospital which had a profound impact and an unforgettable learning experience. Here people with the long-term effects of poliomyelitis were managed in Iron Lungs which mechanically provided their only means to breathe.

At the completion of the 3 year Diploma Course, registration to practice was granted by the Masseuse Registration Board, and Anne gratefully commenced her preferred career in paediatrics at the Royal Children’s Hospital (RCH).

Working in the different specialist areas at RCH, Anne found working in the Burns Unit the most challenging. The Lara bush fires had occurred in the late 1960’s impacting a couple of family groups with their children suffering enormously from severe burn injuries.

In 1970 Anne travelled to the UK and worked for a brief time at the Hospital for Sick Children, Great Ormond Street London.  The pay was 11 pounds per week which barely covered rental costs.

Leading the Physiotherapy Department

 In 1974  Anne was appointed as Head of the Physiotherapy Department saying she would undertake the role for 3 years, at which time a review of her role and performance should be undertaken. She was 27 years of age, unaware that her position would continue for 30 years.  

A Turning Point

A major turning point occurred when Physiotherapy education was transferred to Lincoln Institute of Health Sciences in Carlton. Courses to upgrade qualifications were implemented and in 1976 the medical referral ethics was rescinded. Anne then converted her Diploma to a Bachelor of App Sc(Phyt) along with a Post Graduate Diploma in Rehabilitation Medicine. Both qualifications were offered through Lincoln Institute of Health Sciences. The latter was the first multi-disciplinary course of its kind, bringing together a range of health professional working in the rehabilitation field.

Whilst it was accepted practice that adults required rehabilitation after a head injury, accident or disease, it was questioned both within RCH and in community circles, as to whether children required such a service. The course highlighted that the rehabilitation needs of children was an inequity issue and needed to be a priority at RCH.   Advocating for a hydro pool at the hospital became a priority too and when a major redevelopment of the hospital occurred in 2011 a hydrotherapy pool became an integral part of the hospital’s rehabilitation services.

Significant Changes in Delivery of Care

A major change caused a shift in emphasis in the PT department from caring for outpatients to inpatients. In the department’s 1976 annual report for the first time inpatient care had outnumbered outpatient care

To meet these challenges the department’s 2 year Paediatric Training programme became more formally established, involving rotations through the specialist paediatric units, being the only one of its kind in Australia. To address the needs of community-based PTs, Anne was a founding member of the Paediatric Special Interest Group later auspiced under the APA.  Paediatricians at RCH generously gave their time to provide the latest understanding and treatment of paediatric conditions.

 A multi-disciplinary team approach to children and their families became a priority reflecting the different needs of each presenting child. The establishment of a significant collegiate relationship with the paediatricians and allied health teams consequently developed. Long term relationships with a family and their child facilitated an enriching and rewarding experience, often fulfilling their request to be an advocate at medical appointments.

Mentoring

With a paucity of paediatric physiotherapists in rural and remote area of Victoria and Australia, Anne and members of the PT department enjoyed a mentorship role respecting the role of their community colleagues without the supportive peer system experienced at RCH.  At the APA Anne advocated for a formal Mentorship Programme to be established by the profession which has now occurred.

Evaluation of  Care

In the 1980’s there was a call to all health practitioners regarding an imperative to evaluate one’s clinical care and practice. How did one demonstrate that the patient had received quality care at an acceptable cost and were they satisfied with the outcome of their treatment?

Following an initial focus on medical practitioners eventual attention turned to the allied health professions. Physiotherapy took a lead by developing quality assurance programs for their colleagues at APA Victoria Branch level, in time taking on a National QA Committee responsibility. In 1983 Anne was offered a Kellogg Fellowship, by the W.K.Kellogg Foundation, United States of America, (USA). Its purpose was to visit states within the USA to review their Health Accreditation and Quality Assurance programmes and conduct educational programmes for allied health on her return.

A Further Turning Point

A further turning point for the physiotherapy profession occurred when the School of Physiotherapy was established at the University of Melbourne (UOM) in 1991. This development initiated a partnership between the PT School and the PT Departments as Clinical Schools. For the first time PT at RCH was funded for clinical education in line with their medical colleagues. This development was transformative, forming a collaborative partnership for all clinical education decision making.  

Whilst reluctant to undertake a PhD whilst Head of Department, Anne commenced a Master of Science (UOM) rather than a preferred Master of Physiotherapy. In 1991 the new School of Physiotherapy (UOM) was currently establishing their undergraduate programme, hence a Masters degree in Physiotherapy was not on offer.  Anne completed a MSc in 1995.

In 1997 a Joint Appointment was initiated involving Associate Professor Mary Galea (UOM) and the Physiotherapy Department RCH. This relationship set the groundwork for senior physiotherapists in the department to undertake paediatric research under Prof Galea’s guidance, leading in time to world recognized physiotherapy research.

Advances in Technology

Anne had been concerned about the variability of surgical outcomes for these children, without access to objective findings provided through a paediatric gait laboratory. A Working Party at RCH was established and a proposal to the Hospital’s Executive was submitted to provide a Paediatric Gait Laboratory. After four years of advocacy the Working Group was abandoned.

In 1992 with the support of her medical colleagues Anne pursued a Churchill Fellowship to travel to centres in the UK, Canada and USA where this approach to a child’s surgery had commenced.

Whilst plans to overseas centres were in their final phase of organization an orthopaedic surgeon Associate Professor Kerr Graham from Belfast visited RCH to interview for the vacant Professor of Orthopaedics position. He stated that conditional on his appointment was the hospital’s commitment to provide a gait analysis service. Advocacy for this paediatric service gathered further momentum.

The Fellowship provided vital information and the eventual building of a free-standing Gait Laboratory occurred due to a significant donation from the Hugh DT Williamson Foundation. In 1995 the first Paediatric Gait Laboratory in Australia was realized.

Contributions to Hospital-Wide Initiatives

In 1998 an invitation to join the Aboriginal Liaison Advisory Committee was one of her most significant Committee experiences. She learned from the aboriginal staff about the fear aboriginal families held when attending RCH due to past experiences when children had been removed from their care. Anne appreciated the critical presence of the aboriginal workers in allaying anxiety when aboriginal families attended the hospital 

On the 26 May, 1998 the first National Sorry Day was held throughout Australia to commemorate the Stolen Generations-Aboriginal and Torres Strait Islander children recognizing the intergenerational impact that this policy continued to have on Aboriginal families.  The Physiotherapy Department organized small coloured ribbons in red, yellow and black for the staff to wear, along with SORRY badges.  

In 2000 Anne was humbled to receive Honoured member status on behalf of the APA. Later that year she was further honoured to receive the Chairman’s Medal at RCH.  After 30 years as Head of the Physiotherapy Department at RCH Anne decided the time had come to retire. The APA Paediatric Group, Victoria Branch initiated an inaugural award in her name.

Her retirement provided an opportunity to pursue an unmet need for rural families experiencing difficulty in accessing Physiotherapy close to home. Through the generous support of the Hugh DT Williamson Foundation, the Malcolm M Menelaus Rural Physiotherapy Training Project in the Goulburn Valley Victoria was established in 2008. Under the direction and curriculum development of Dr Elizabeth Williams OAM, Senior Lecturer in PT at the School of Rural Health (UOM) a Postgraduate Certificate (Paediatrics) was offered to rural physiotherapists bringing together a partnership of the School of Rural Health (UOM), Goulburn Valley Health, rural community agencies and RCH.

This latter period in her life saw her involvement in  advocacy groups related to the detention of refugees especially children, along with promoting Indigenous education and Reconciliation.

In 2006 Anne was awarded membership within the Australian Honours system becoming a Member (AM) in recognition of her contribution to the development of paediatric physiotherapy and to the community.