§ Lord DenhamMy Lords, with the leave of the House, I shall arrange for a Statement that will be made in another place this afternoon by my honourable friend Mr. John Major, the Minister of State for Social Security and the Disabled, on the McColl Report on disablement services to be printed in the Official Report.
Following is the Statement:
"With permission, Mr. Speaker, I wish to make a Statement on the Government's response to the McColl Report on the Artificial Limb and Appliance Services. As the House will know, these important services are administered directly by my department and the working party were invited to consider them and to make recommendations for the improvement of efficiency and patient care. I am most grateful to the members of the working party for the comprehensive and dedicated manner in which they tackled this task.
"The report made wide ranging and detailed recommendations, concerning the organisation and management of the services; the nature of the contracts for the supply of limbs; the quality of the limb fitting services; and the desirability of closer links between the full range of hospital, community care and local authority services. Action has been taken already to implement many of the recommen-dations.
"We have strengthened substantially the top management of the limb and appliance services by appointing a general manager to head a specialist disablement services division; supported by a new director of operations, and a new director of procurement from the NHS.
"We now propose to extend the principle of general management throughout the limb and appliance service in order to implement the far reaching changes we envisage. We intend to reorganise the service into regions with boundaries that are co-terminous with those of the NHS. Each region will be headed by a senior manager responsible for the entire limb and appliance service in that area. We are also, as I told the House on 17th February, improving the range of wheelchairs that are provided. Pilot projects to improve transport arrangements for patients are under way and improved management systems are already in place.
"We believe the quality of limb fitting by prosthetists is vital to patient welfare. The McColl Report was critical of the level and quality of prosthetic training. We agree that it should be improved. We wish to see professional training and the status of prosthetists upgraded. We have therefore established a joint working party with the limb industry and the Orthotic and Prosthetic Training and Education Council (OPTEC) to review
938 speedily the present arrangements for prosthetic training and to make recommendations for improvement. We have already received an interim report from the working party and expect a final report within three months—I shall report further to the House when this is received. I anticipate that implementation of any recommendations will make provision both for initial training leading to a qualification and subsequent in-service training.
"We also agree with the McColl Report that we should seek improved contracts for the supply of artificial limbs. We are therefore pressing the limb industry to agree to new contractual arrangements that will increase competition and encourage a quicker and more flexible service. Discussions with this aim in mind are continuing and we attach great importance to this principle.
"One of the most important conclusions of the McColl Working Party was that it would he inappropriate for the limb and applicance services to remain under the direct control of the DHSS. I wish to make clear that we accept that recommendation and propose to act on it.
"We have therefore decided to establish an interim management board, in the form of a special health authority, with effect from 1st July this year. The authority will be accountable directly to me. I am delighted to announce that my noble friend the Lord Holderness has agreed to be chairman of the new authority. My noble friend is a distinguished former Member of this House and has a long and proven record of commitment to disabled people. I have no doubt that he will be an excellent chairman.
"We envisage the board will have about eight members and their names will be announced shortly following further consultation with the chairman. We shall of course also have regard to the provisions of the Disabled Persons (Representation and Consultation) Act in appointing board members. However, the House may care to know that I have already invited Professor Ian McColl, chairman of the McColl Working Party, to join the Board as vice-chairman so that the views and knowledge of the working party will be readily available. I am delighted to report that Professor McColl has accepted and I know this view is shared by my noble friend.
"The McColl Report identified an imperative need for stronger links with the occupational therapy, physiotherapy and rehabilitation services offered by the NHS. We agree with this recommen-dation. To achieve this aim in the interests of patient care we have concluded that, in the longer term, the right organisational framework for the limb and appliance service would be alongside these services within the regional and district HAs. This is also the view of the recent report on disability published by the Royal College of Physicians.
"Clearly, however, this is a far-reaching change which cannot in our view be carried into effect immediately. The process of transition will need very careful management to safeguard the interests of all involved—whether patients or staff. We shall expect the new authority to complete this task in time for integration to take place on 1st April 1991. 939 The instrument establishing the authority will set this as the end date.
"The new authority will have a threefold responsibility: to oversee the planning for the eventual transfer of the services; to build upon the improvements already under way; and to run the service for this transitional period. It will have power to appoint its own senior staff. The SHA will be given its own budget for 1987–88 and planning figures for the two following years. Special arrange-ments will be made to safeguard the level of funding available throughout the period of the SHA's life and for a period after integration with health authorities. The authority will also be charged with devising safeguards to ensure that continuity of the services is maintained following integration.
"Staff who are currently employed in the service will be invited to work for the new authority. Their existing terms and conditions will apply and the authority will be required to ensure that their interests are protected. Discussions with trade unions and staff will begin today.
"The authority will be responsible for the whole of the artificial limb service, for the wheelchair service and for the provision of appliances to war pensioners. The Government are committed to ensuring that the status of war pensioners continues to be recognised. We will ensure that the new authority reflects that commitment. Decisions on the future of the artificial eye service will be taken when the current review of the service is complete but this may also be added to the SHA's responsibilities. The departmental vehicle schemes will remain directly administered by the DHSS.
"The decisions I have announced today represent the most far reaching changes in the artificial limb and appliances service since its inception. They follow the recommendations of the working party. They meet the aspirations of disabled people and I am confident they will improve the services available to them. I believe it is right to end the uncertainty of recent years.
"The Government look forward to working with the new authority to build a better future for the patients they will serve."