PARALYSED AND LIMBLESS EX-SERVICE MEN (Hansard, 21 June 1948)

§ Lieut.-Colonel Lipton (Brixton)

I feel that it is hardly necessary to offer any apology for raising one or two matters in connection with the treatment of paraplegic and limbless ex-Service men. This is not the least important of the many beneficial activities being carried out at the moment by the Ministry of Pensions. The remarks I have to make fall into three categories. The first is experimental research, the second is restorative work, and the third can best be summed up under the heading of after-care services.

Under the heading of experimental research there is in existence a useful and important body known as the Standing Advisory Committee on Artificial Limbs. What some of us would like to know is a little more about the activities of this committee, and the extent of the contribution they are making towards alleviating and improving the lot of limbless ex-Service men in this country. There is in existence, of course, at Roehampton an experimental workshop where a lot of useful work is being carried out. Without, in any way depreciating the value of the work that is already being done, I feel, however, that more money could be devoted to this particular activity.

What I. should like to know, and what I hope the Parliamentary Secretary to the Ministry of Pensions will be able to amplify in the course of his remarks, is 1095 whether his Ministry is devoting sufficient energy to research in respect of paraplegia and limbless problems. No one can say that the importance of research in these fields can be over-emphasised. It has become all the more important in view of the imminent inception of the National Health Service. A number of members are concerned about the possible effect of the introduction of the National Health Service upon the research or the development of experimental research so far as these ex-Service men are concerned.

Is the Ministry getting particulars of the very interesting developments that are already taking place in other countries? For example, in Germany for many years they have been using what are called "suction sockets." In this type of limb an artificial leg is held to the natural stump by suction instead of the rather complicated and irksome strapping and suspension which is the usual method at the present moment. The suction socket does represent in my view, and in the view of other people more competent to judge, a very considerable improvement which will add very substantially to the comfort and convenience of these ex-Service men who have to make use of artificial limbs. In America, too, I understand that enormous sums are being devoted to research. While at the Foreign Office level, or as between the two Treasuries, there may be difficulties, or indeed coolness at the present time, I hope that the interchange of ideas between those who are doing research in this country and in America is proceeding apace and that we are taking full advantage of the improvements that are being effected in America so that our own ex-Service men in this country are not left behind in obtaining any benefits or advantages that may be devised to ease the burden of disablement.

Reference has been made in this House and elsewhere to a page-turning device which would be a boon to limbless men who want to read. Reference has also been made on occasions to improved chairs and beds which would also add considerably to their comfort and convenience. Members of the public who saw the recent film "The Best Years of our Lives" were probably very much impressed by the proficiency which a limbless person in that film showed in the 1096 use of an artificial arm and gadgets. Are those gadgets available to the ordinary ex-Service men in this country or was the performance indicated in the film to which I refer something exceptional and out of the ordinary and, therefore, not available to the limbless men in this country?

Another field in which it appears that greater research is required is the possibility of marriage, so far as paraplegic ex-Service men are concerned. In this regard I was particularly struck by an article which appeared in a recent issue of "The Cord," which is a journal of the paraplegic branch of the British Legion—a journal which devotes itself specifically to the problems of the paraplegic patient. In a recent issue an article was written in which one of these men asked whether a paraplegic could ever hope to have children. He asks: "I have heard it is possible but once again, I do not know. Who can tell me? All these things are very real problems even if they are not talked about openly. Until I have got satisfactory answers to them, I cannot persuade myself that I have made a success of living at home."

The next point to which I want to refer is the question of restorative work. To what extent is training afforded, while the limbless or paraplegic are in hospital, in the use of suitable artificial equipment and in the development and training of such faculties which remain to him? It is true that occupational therapy of a kind is carried out in the Ministry of Pensions Hospitals, but there is reason to believe that this occupational therapy is an inadequate substitute for practical vocational training. I have read of one case in which a man complained that after three years in hospital he came back home completely untrained for any kind of job. He says he spent hours making rugs, doing needlework, trying to learn to draw, and to stuff dogs and rabbits, and after all that particular form of occupational therapy, it took him nine months longer to get work simply because he had no training. It may be that a typewriter or a telephone switchboard would be far more useful as a form of occupational training while the patient is in hospital than the devices which I have just mentioned. The Ministry could do more than in the past, I think, by giving occupational training in the hospitals themselves. Now, after some three years of peace, fairly adequate ideas should have 1097 been formed about the kind of jobs men can do with artificial limbs or in a wheeled chair.

My third point is the absolute necessity for a really efficient after-care service after the patient has left hospital. It must be readily admitted that treatment in such case; as these does not end at the hospital gates. Home visitors ought to be visiting these men regularly, especially those who are home-bound, unable to leave their homes, or those who, because of physical infirmities, are unemployable. The homes of men of this kind ought to be fitted with suitable gadgets and their lives made as comfortable as possible. In this respect, welfare officers working in association with the regional officers of the Ministry of Pensions and with voluntary bodies like the British Legion or the British Limbless Ex-Servicemen's Association, could, I think, provide amenities and comforts, and what is not less important, up-to-date advice as to the facilities available to these men under the new social security schemes that are now about to be introduced. I should like to know to what extent pensioners are encouraged to take interest in home handicrafts or the homework scheme of the Disabled Persons Employment Corporation. In this connection I am of the opinion that they should be allowed to earn as much as they possibly can without jeopardising their supplementary allowances. It may be that refresher and rehabilitation courses should be arranged from time to time for these men, in association with the Ministry of Labour, in order to make their lives a little less dreary.

The House has welcomed the recent announcement that the use of cars would be placed freely at the disposal of badly disabled men. I do not know whether my hon. Friend is able to add anything tonight to what the Financial Secretary said on this subject Even if the free cars are not immediately available, improvements could be effected in the three-wheeled motor-propelled vehicle that is available, but which does not provide adequate protection for the user if the weather is inclement. I should like to know, too, what opportunities are afforded to these men for convalescent treatment or change and relaxation. It is not only the men themselves who need a little change and relaxation from time to time, but their wives and families, who 1098 have to do so much in administering to their daily needs. It has been alleged that in a number of cases there has been delay in supplying these men with their appliances, or in repairing those appliances when they get cut of order. Stump socks are said to be in short supply, and this is an additional source of inconvenience. I hope that the Ministry of Pensions is getting sufficient priorities in regard to materials and so forth to enable it to provide the standard of service which the ordinary disabled man ought to have.

It is of vital importance that the fullest possible opportunity should be afforded to these men to lead as normal lives as they possibly can, and to become self-supporting and self-respecting members of the community. The general public does not always realise how great the needs of these men are. Suitable beds, surgical matresses, a self-lifting pole which some of them need, syringes, rubber sheets—a thousand and one things are essential to their creature comforts. Nursing equipment, sterilising apparatus, bed linen and pillows—there are quite a number of things which cannot be met from the ordinary domestic coupon issue, and which are real problems to the paraplegic cases. No doubt the Ministry does useful work, but I should like to be satisfied that everything possible is done in this regard.

Then, again, everything possible in the provision of suitable housing accommodation must occupy a very high place among the priorities. The movement of these men about the house ought to be simplified by fixing handrails, enlarging doorways, substituting ramps for short flights of steps, better types of folding indoor chairs, suitable types of furniture—I should like to hear from my hon. Friend what, if anything, is being done in that respect. In a number of these cases the men have no relative to rely on—they may be elderly, or may have lost their relatives. Are any facilities being provided by way of residential hostels for suitable cases where there is no near relative capable of looking after them? I do not want my remarks to be construed as being unduly critical of the Ministry of Pensions which, under its present Minister, has earned the very high respect of those of us who are interested in this problem. Nevertheless, I hope my hon. Friend will take advantage of this opportunity to let the public 1099 know exactly what is being done for these cases, and what hopes there are in the immediate future of the benefits and advantages already in operation being extended so as to make the lives of these very deserving men as comfortable, happy and normal as they can possibly be made

§ The Parliamentary Secretary to the Ministry of Pensions (Mr. Blenkinsop)

May I first thank my hon. and gallant Friend the Member for Brixton (Lieut.-Colonel Lipton) for raising this matter tonight. I am afraid we in our Department feel—and perhaps it is to our credit—that very rarely do we have the opportunity of saving anything about the work which we are doing today. We are all very conscious of the fact that whatever we may do in the way of money allowances and benefits, and however generously we may try to administer our Department, the work that we do on that side counts for very little as against the importance of the positive health-giving side of our activities in trying to restore these particular groups of ex-Service men to ordinary healthy life. Therefore, I am glad that my hon. and gallant Friend has raised these matters.

First of all, I should like to say something about the work that is being done for the paraplegic in this country. Our ex-Service paraplegic cases constitute a small group. Some 600 men and women from this last war are suffering from this very terrible spinal disease, and 200 of those are still in hospital. It is rather interesting to know that out of the re- 1100 mainder—some 440–70 per cent. are in full and regular employment, in spite of the very terrible nature of this disease, which in the past, was regarded as being more or less incurable. We regard it as some tribute to the work which we are doing that that progress has been made. Men and women who suffer from this disease today can be assured that they are not out of contact with ordinary life as they certainly were in the past.

My hon. and gallant Friend has raised the question of research. On this side of our work, both as regards the paraplegic and the limbless cases, we feel that we are leading the world. It is a broad claim, but I think we can say that, particularly in the paraplegic field, we have shown the world the way in which new treatment can be developed. I think that even our American friends have paid us the tribute of taking the advice of one of our chief consultants in this country in the new work that they are developing over there. We have the closest contact with the United States in this problem and in the problem of the amputee. They know the work that we are doing, and we are in daily contact with the work that they are doing in America. Our doctors have been over in the United States very recently, and in return we have had visits from American doctors and those concerned with these problems, trying to keep in the closest possible touch.

My hon. and gallant Friend raised the question of treatment and after-care. With regard to the paraplegic, the bulk of our treatment work is done at the very modern and well-equipped hospital we have at Stoke Mandeville and two auxiliary centres which we use, one down at Eastbourne and one at the Star and Garter Home, both of which are placed at our disposal through private benevolence. We use the Eastbourne home largely to give the man who has been in hospital a break, and anyone who went there would say it was hard to believe that such excellent conditions could exist. We are very proud indeed of the work which is being done both at Eastbourne and at the Star and Garter, and particularly of the exceptional work which is being done at Stoke Mandeville.

In addition, we are busy with the building of a new hostel at Osterley Park, which will provide in some cases a per- 1101 manent home, but more frequently a temporary home, for paraplegic cases who are undergoing training in practical jobs in many of the factories in that area. With the help of the Ministry of Labour we have secured the co-operation of firms in that part of London, and we can ensure that men, and indeed in some cases women, who are disabled paraplegic cases will be able to secure a steady and regular job at factories in that area, and have at the same time accommodation specially adapted for their use and the medical attention which they need.

I am very hopeful that the new hostel will be available for them by the end of this year. I have indicated that we are doing a good deal on that side of the work. I would like to quote one particular case of which we are rather proud—it is not altogether exceptional—the case of a lieutenant from the Army who is both a paraplegic case and also has suffered a severe lung wound. He came into the Stoke Mandeville Hospital in a very critical condition, and indeed, many felt that there was very little hope for him. Largely due, I think, to the treatment which can now be provided, he recovered a great deal, started a correspondence course in law, and passed his preliminary examination. He went from there, in the chair we provided for him, to Lincoln College, Oxford. He became honorary secretary of the Law Society of his college, and passed his law final last year. Since September he has been in the employment in the legal branch of a large commercial firm. I believe that is now regarded as a typical case. There is no reason why those suffering from this terrible disease should regard themselves as cut off from regular and full employment.

Let me turn briefly to the very important question of the limbless and the work we are doing through the Standing Joint Committee. My hon. and gallant Friend has raised the question of what work is being done by the Committee. He asked whether we were spending enough money, or whether we had cut down in research work. The Cohen Committee, which was set up in 1945, paid tribute to the quality of the limbs which are issued by the Ministry. They pointed out 1102 that the limb issued was a good one, as good as, and in most cases a material improvement on, anything available in any other country in the world. I believe if that was true in 1945, it is far more true today. There is no justification for any complaint about workmanship or anything else. The Standing Committee which was set up following the Cohen Committee, made various recommendations on improvements in limbs, and very many of those recommendations have been carried out including very important research work on the problem my hon. and gallant Friend mentioned, the question of the suction socket. I believe that it may be possible before very long to get rid of all this wretched harness that prevents the amputee feeling he can ever live an ordinary life. I believe that it should be possible in the near future to get rid of that drawback, and to have a limb that looks very like an ordinary limb. So far as the question of the firms supplying the Ministry is concerned, I cannot say anything tonight, but my right hon. Friend will be making an announcement very shortly about it.

I should like to emphasise that we have in this Ministry, in the hospitals dealing with both the paraplegic and the limbless, an excellent service that, as I say, leads the world; but we are conscious that there is a very great deal to be done, and we are always anxious to try to help on that work.

Let me give finally the instance of a limbless man who was a labourer before the war. He lost two arms and a leg, and is now being trained in secretarial work. He has been fitted with two arms, and he is actually doing typewriting work and secretarial work, and he tells us that he is writing much better now than he wrote before the war, before he received his injuries. These things are possible now, and I can assure my hon. and gallant Friend that, very conscious as we are of the work we have done, we are still more conscious of the amount of work that remains for us to do.