§ Mr. Alfred Morris
To ask the Secretary of State For Health if he will list all the bodies which have a statutory duty or powers to provide orthoses, prostheses or special equipment to people with disabilities; if he will specify in each case the particular circumstances in which such equipment can be provided and any restrictions on its use; if he has any plans to rationalise the provision of these services; and if he will make a statement.
§ Mr. Mellor
A wide range of bodies provide equipment to disabled people for purposes including education and 613W employment. Detailed responsibility in fields of health and social services with regard to equipment for disabled are as follows.
The duty to provide the facilities in question for people with disabilities arises from the duty of the Secretary of State under the National Health Service Act 1977 to promote the establishment in England and Wales of a comprehensive health service. This duty is discharged through various bodies.
District health authorities may provide orthotic appliances, footwear and certain types of prosthesis, when the patient has been examined and the appliance etc. prescribed by or under the direction of a consultant, either at a hospital, or at a clinic or on the occasion of a domiciliary visit.
Where provision or renewal of such appliances is recommended, the consultant may, if satisfied that the condition has reached stability, decide that supply be continued for a stated period of up to five years. In the case of breast prostheses and wigs, there is no such limit.
Following referral from a general practitioner to a consultant ophthalmologist, low vision aids may be prescribed through the hospital eye service's low vision clinic.
Hearing aids may be prescribed by a hospital consultant following referral from a general practitioner they are supplied and fitted on free loan by NHS hearing centres.
Communication aids may be prescribed by a hospital consultant to help with speech and language impairment.
Equipment to enable people to be nursed in their own home may be supplied free to out-patients being actively treated or to discharged in-patients, for as long as it is required. This equipment may be on loan and returnable; or consumable.
General practitioners may prescribe certain equipment as items on the drug tariff. This includes some incontinence equipment (but not pads and garments which are obtainable, if necessary, through the community nursing services). People with stomas requiring ostomy equipment are permanently exempt from the usual charges.
The Disablement Services Authority supplies artificial limb prostheses. Its doctors assess people who are referred by their surgeon or general practitioner.
The Disablement Services Authority supplies on loan a range of wheelchairs on the recommendation of any NHS doctor. It will also meet the cost of repair to wheelchairs except in the case of misuse or neglect. Such equipment should be returned when no longer needed.
The Disablement Services Authority also has powers to provide a range of services to war pensioners, including orthopaedic footwear, surgical appliances, hearing aids, wigs and home nursing equipment. (War pensioners may also obtain these services through their local district health authority.)
The Department of Health provides certain services directly.
The Artificial Eye Service provides artificial eyes, cosmetic shells and orbital facial prostheses through its clinics.
Environmental control equipment for severely disabled people may be provided on free loan to people meeting specific criteria as assessed by certain doctors acting on the authority of regional medical Officers (this authority is devolved to district medical officers in some regions).614W
Where they are satisfied of need, local authority social services departments have a duty which includes the provision of facilities to meet the needs of a disabled person. Local authorities may make a charge for such services and, where appropriate, equipment should be returned when no longer required. This equipment includes wheelchairs for temporary use.
The services of the Disablement Services Authority will pass to district health authorities on 1 April 1991 and negotiations are well in hand on the best way of carrying these services forward in future, in the light of local circumstances in each region and district.