Myoelectric Hands (Hansard, 15 December 1978)

§ Mr. Alfred Morris:

I am glad to have this further opportunity to report progress to the House. The first child was fitted with the hand in this country in August. To date 16 children have received the 468W hand. The programme will continue at the rate of one a week until the 25 children to be included in our trial have been fitted. The trial started as soon as a supply of the hands could be obtained and includes every child known to my Department who falls within the criteria of age and medical condition set for the trial. I very much want the trial to succeed and, for this reason, our choice of criteria was informed by the experience of Dr. Sörbye himself. These criteria can, of course, be widened in the light of our experience to include younger and older children.

Following individual manufacture and fitting of the socket, each child comes with a parent to either the Roehampton or Manchester limb fitting centre for an initial period of intensive training. This lasts for a week and is on a residential basis. Care is provided by a team consisting of doctors, prosthetists, occupational therapists and social workers, with support from engineers and technicians. After the initial training, during which the parents are shown how to help with further training at home, regular and frequent reviews are necessary to continue the training, to monitor progress and to ensure that the socket continues to fit properly.

Fitting has proceeded satisfactorily and, in general, the children seem to be accepting the hand well. Our experience is still much too limited to draw firm conclusions, however, since at the most it covers only 20 weeks from the time of our first fitting. Again, the reliability of the hand is giving some cause for concern. The hands so far fitted to the first sixteen children have required 42 repairs. one of the first patients in the trial has already required 17 repairs to the hand; in this case we have, on four occasions, supplied a total replacement hand to avoid leaving the child without one. We are working closely with the manufacturer in his attempts to resolve these problems.

The need to acquire experience of the prosthesis, and to assess its reliability before wider use is considered, has been amply confirmed. I am very conscious that parents of children not included in the trial are anxious for their children to be supplied with the hand as soon as possible. Quite apart from the essential need for a trial, the rate of supply of 469W hands from the manufacturer is such that we could not have gone any faster. On the question of private supply of the hand, Dr. Sörbye made it clear to me in June that his commitments precluded his treating private patients from this country for the forseeable future. I reported this to the House at the time and Dr. Sörbye confirmed to me last week that this is still the position.

My Department's main problem so far has not been one of resources, but of supply of the hand. We purchased over 50 per cent. of the production batch of the hands which became available after we decided to launch the trial. Moreover, we have already reserved 40 per cent. of the next production run which is due in early 1979. Supplies to countries other than Scandinavia and this country account for only 9 per cent. of the production so far. This demonstrates the level of our involvement in this development.

I can assure the House that there will be no avoidable delay in concluding the trial and will be glad to keep the House informed of further progress. A British company is developing a similar type of hand and has recently accelerated its work on the assumption that we may be able to bring the myoelectric hand into more general supply for children. We shall consider this carefully and sympathetically in the light of progress.