§ Sir Hugh Rossiasked the Secretary of State for Social Services (1) how many contractors under separate ownership supply the artificial limb service giving the percentage of limbs each supplied; how much they were paid in 1982–83; what is the contractual basis for payment; what is the basis upon which work is distributed between the contractors; and if he is satisfied with the present contractual arrangements;
(2) what steps he has taken to (a) monitor performance at each artificial limb centre systematically, (b) improve the contractual basis for the supply of limbs to such centres with a view to promoting competitiveness between the suppliers, and (c) create conditions whereby new and local contractors may tender to supply limbs to the centres.
§ Mr. NewtonInformation on the services provided at each artificial limb and appliance centre is collected 127W routinely. Work is in progress to improve the accuracy of this information and to develop the computer facilities needed to make full use of it.
Six contractors supply the artificial limb service in England, but two are members of one group of companies. In 1982–83 the two contractors under common ownership supplied or repaired 78 per cent. of lower limbs; a third supplied or repaired 18 per cent.; and the two small firms 2 per cent. each. The remaining contractor supplied and repaired all upper limbs. The Department paid these contractors a total of £28.165 million in 1982–83.
A prescribing medical officer refers patients to the contractor serving his artificial limb and appliance centre who can in his judgement best meet their prosthetic needs, having regard to such factors as the type of limb required and the likely delivery time.
Contracts provide for payments to be made in respect of each limb supplied or repaired. Prices for each contractor are negotiated on the basis of estimated orders and costs. I expect the working party that I announced in my reply to my hon. Friend on 25 November 1983—[Vol. 49, c.348] — to examine these contractual arrangements and the questions of promoting competitiveness and bringing new contractors into the service.
§ Sir Hugh Rossiasked the Secretary of State for Social Services in what percentage of cases contractors for the supply of artificial limbs to his Department meet their contractual delivery dates; what procedures exist for receiving and dealing with complaints from dissatisfied patients; when changes were last made in these procedures; what penalties exist for unsatisfactory performance by contractors; and in how many cases such penalties are enforced in each year.
§ Mr. NewtonThe percentage of cases in which contractual delivery dates are met fluctuates but averages some 40 per cent. for lower limbs and some 80 per cent. for upper limbs.
No formal procedures have been laid down for dealing with complaints from limb patients. Those made to the Department's staff at an artificial limb and appliance centre can usually be dealt with locally. Complaints made to Ministers or the Department centrally are investigated by reference to local records, inquiries to local medical, administrative and technical staff, or where necessary to the limb contractor. These procedures normally lead to a satisfactory conclusion and have not been changed in recent years.
Where a contractor's performance is unsatisfactory in a particular case it is open to the medical officer to transfer the patient to another contractor if one is available. No central record is kept of such transfers.
§ Sir Hugh Rossiasked the Secretary of State for Social Services how the prices charged by local contractors to artificial limb centres compare with those of the large multi-centre firms.
§ Mr. NewtonThey are lower; but in seeking to draw conclusions from such comparisons it is necessary to have regard to the cost of overheads including distribution, to the wider range of limbs supplied by the larger contractors, and to research and development.