§ Sir John Farrasked the Secretary of State for Social Services what steps is he taking to improve the fitting of artificial limbs; and, in particular, if he will ensure that such fittings only take place after the stump has been X-rayed.
§ Mr. MajorA number of initiatives are under way to improve the fitting of artificial limbs in England and Wales. A review of prosthetic training for the longer term is in progress and, in co-operation with the limb firms, we are seeking to ensure that satisfactory arrangements exist to meet the needs of existing prosthetists for mid-career development and training. The centralisation and 289W standardisation of prosthetic training at the London school for prosthetics since October 1985 has contributed to enhanced standards.
We are seeking to negotiate with the limb firms new contractual arrangements which should help raise the level of prosthetic care. We continue to encourage the local fabrication of limbs, both to reduce delivery times and to ensure better fitting sockets, and new casting techniques. Transparent flexible sockets are increasingly used. We are currently negotiating service trials of the computer aided design and manufacture techniques developed by the bioengineering centre to improve socket design. We are planning revised transport and appointments arrangements which will enable prosthetists to spend more time with patients.
The X-ray of a stump before fitting is appropriate only where there is some abnormality or spur. It is the complete stump, in particular the soft tissues, which must be addressed to secure a well-fitting socket. The process of matching the socket to the stump then continues throughout the patient's active life.
We believe that the steps we are taking will lead to a substantial improvement in that process.