§ Mr. Carter-Jonesasked the Secretary of State for Social Services, in view of dissatisfaction among substantial numbers of amputees that the best materials, facilities and technologies are not being used to assist limbless people, if he will review his policy regarding amputees; and if he will make a statement.
§ Mr. PrenticeI am satisfied that the materials and technologies used in the manufacture of artificial limbs and the facilities available for limbless people are of the highest standard and I have no evidence of substantial dissatisfaction among amputees. Nevertheless, matters are kept under continuous review by the Department with the object of making improvements wherever possible, and we are always open to suggestions.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services (1) if he will arrange for courses to be made available for limb fitters to acquire knowledge of anatomy and biology as well as the technical details of design and fabrication of limbs; what is his view on the importance of retraining and updating in such skills; and if he will make a statement;
(2) in view of the lack of encouragement and opportunity available for limb fitters to acquire a professional structure for their specialist work, if he will ensure suitable minimum qualifications are achieved before limb fitters are allowed to be employed in limb fitting; and if he will make a statement;
(3) if he will arrange for opportunities for training and education in prostheses to be available throughout the United Kingdom similar to those at the national centre of the University of Strathclyde.
§ Mr. PrenticeI refer the hon. Member to my reply on 2 November 1979 in which 57W the training requirements and opportunities for limb fitters were fully set out.—[Vol. 972, c. 685–6.]
§ Mr. Carter-Jonesasked the Secretary of State for Social Services, in view of the unsatisfactory nature of the accommodation in many of the artificial limb centres, if he will provide better facilities for clinical observation and greater privacy where fitting and waiting takes place; and if he will make a statement.
§ Mr. PrenticeMost artificial limb and appliance centres are already situated in purpose-built premises which provide facilities of a high standard for private clinical examination and limb fitting. A new building to replace the present Sheffield centre is under construction and our provisional building programme includes improvements in six other centres.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services to what extent the artificial limb service uses the best products, techniques and methods of other countries; if he will encourage a trawl for the best possible appliances, irrespective of cost, in view of the hardship caused; and if he will make a statement.
§ Mr. PrenticeOfficers of the Department are sufficiently in touch with work going on in other countries to be in a position to take advantage of any significant new developments. Some limb patients in this country have been provided under the NHS with limbs which include components manufactured abroad.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services, in view of the hardship experienced by many amputees because their prostheses do not always fit satisfactorily, and in view of the fact that sometimes such prostheses cause consequential disability, if he will take steps to remedy this; and if he will make a statement.
§ Mr. PrenticeThere is a well-established procedure for remedying the cause of the trouble. The patient need only make an appointment to attend the limb fitting centre from which the appliance was supplied or, if more convenient, the nearest centre.
58W
§ Mr. Carter-Jonesasked the Secretary of State for Social Services to what extent the personal choice of patients is taken into account when new or modified limbs are being provided; if he is satisfied with the standard of inspection and quality control within the service; and if he will make a statement.
§ Mr PrenticeSo far as is practicable the prescribing doctor takes account of any preferences the patient may express. I am satisfied with the standard of inspection and quality control arrangements within the service.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he is satisfied with the amount of training opportunity given to people receiving a prosthesis for the first time, or amputees receiving new or modified prostheses; and if he will make a statement.
§ Mr. PrenticeYes. The artificial limb and appliance centre medical officer will prescribe appropriate training for any amputee where this is clinically indicated.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will consider providing workshops placed in close proximity to limb fitting centres so that the work can be undertaken on the spot; if he will take steps to encourage the quicker repair and modification of limbs; and if he will make a statement.
§ Mr. PrenticeWorkshop facilities are already provided at limb fitting centres. The Department monitors delivery times in the limb service and continuously seeks ways of effecting improvements.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will consider the development of a limb fitting team to include the surgeon, the limb fitter, the physiotherapist and the social worker, in view of the importance of raising the professional status of the limb fitter; and if he will make a statement.
§ Mr. PrenticeGenerally, there is already a satisfactory level of co-operation among those responsible for the patient's care, and the value of the contribution made by the limb fitter is recognised. I support and encourage such co-operation.
59W
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will consider whether the employment of limb fitters independent of his Department's commercial contractors would be to the advantage of the patient and the limb fitter; and if he will make a statement.
§ Mr. PrenticeI have no reason to think that the present structure of the limb service is to the disadvantage of the patient.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will arrange for good hostel-type accommodation to be made available for amputees who have to travel long distances for limb fitting or modification; and if he will make a statement.
§ Mr. PrenticeThe geographical spread of the 27 limb fitting centres in England ensures that all patients are able to attend within the day. In exceptional circumstances, for example, where there is need for a longer clinical assessment, hospital accommodation is arranged.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will take steps to make the user of a prosthesis more aware of what facilities and equipment are available; and if he will make a statement.
§ Mr. PrenticePatients can and do discuss their problems with the medical officers at the artificial limb and appliance centres and when there is a choice of prosthesis are advised accordingly. All medical officers in the limb service are advised of new prosthetic developments.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will take steps to remedy the hardship and suffering caused by long waits for appointments, and long waiting periods in crowded clinics for new or modified prostheses; and if he will make a statement.
§ Mr. PrenticeIn general, appointments are arranged immediately a prosthesis is ready for fitting or delivery. The system provides for amputees to be given two weeks' notice of appointment. Economic use of ambulances largely dictates the number of patients present in the centre but most of these are purpose-build and their size and design take full60W account of the maximum numbers to be catered for. Refreshment facilities are normally available and staff are on hand to assist patients as necessary. If the hon. Member would let me know of any particular cases I shall arrange for further inquiries to be made.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services (1) what representations he has received from the British Limbless Ex-Servicemen's Association relating to criticisms from users of the artificial limb services about poor individual workmanship and the quality of materials used in the production of new limbs and on major repairs; and if he will make a statement;
(2) what representations he has received from the British Limbless Ex-Servicemen's Association regarding the artificial limb service; what representations he has received regarding an improvement in this service; and if he will make a statement.
§ Mr. PrenticeI met the British Limbless Ex-Servicemen's Association in October 1979, when general criticisms were made both of the artificial limb service and of the limbs themselves.
I am always seeking improvement to the service and particularly in the time taken to manufacture and repair limbs, a subject which is currently being discussed with the manufacturers. There is no evidence of deterioration in the standard of workmanship or quality of materials used in the manufacture of artificial limbs.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services (1) what is the policy of his Department on the desirability of reforming and modernising the limb fitting service;
(2) if he will consider fully integrating the limb service with the National Health Service; and if he will make a statement.
§ Mr. PrenticeThe limb fitting service is always under review and changes are introduced as necessary.
Those engaged in the limb service are in close and constant touch with their colleagues engaged on complementary work in the National Health Service. I have no present plans for transferring the limb service to the National Health Service.
61W
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he is satisfied with the present functioning of the bio-mechanical research and development unit; if he will consider a rapid technical reassessment of the needs of amputees; and if he will make a statement.
§ Mr. PrenticeThe bio-mechanical research and development unit at Roehampton has made, and continues to make, valuable contributions to the development of artificial limbs and related aids for the rehabilitation of disabled people. Technological development of prostheses is a continuing process both in this and in other countries, with which the unit has links and there would not appear to be any significant gain to be achieved in a technical reassessment of needs at this time.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what action he will take to remedy the gap in the provision of artificial limbs for the elderly; if he will establish assessment units to decide between a crutch or a wheelchair; and if he will take action to provide a modified, simple support appliance for elderly amputees.
§ Mr. PrenticeThere is no gap in the provision of prostheses or aids for the elderly. The needs of the patient are determined by the doctor in charge, due account being taken on the patient's age and disability.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services if he will follow the practice in Europe of providing prostheses for recreation, sports and swimming for young amputees; and if he will make a statement.
§ Mr. PrenticeProstheses and other aids are available on prescription in this country for sporting and recreational activities.