BRITISH MEDICAL JOURNAL

1293

4 NOVEMBER 1978

CORRES PONDENCE Wheelchairs Patrick Jenkin, MP; Maureen A Tudor, .............. MB; J W Koten ........ Hospital equipment "Which?" ............. P V Scott, FFARCS ....... Chronic spinal arachnoiditis R G Grainger, FRCP .................. Deficiencies in parenteral nutrition H Connor, MRCP, and others; C A J Wardrop, MRCPATH, and others ........ Nutrition and the cancer patient A J Strain, BSc, and others ............ Clarinettist's cheilitis .......... T C Hindson, FRCPED ...... Flautist's chin L D Gardner, MRCPSYCH .............. Medical and dental problems of musical instruments J D Jago, MDSC ........ .............. Treatment of childhood cancer: effects on gonads S M Shalet, MRCP, and others .......... Normality and abnormality in psychiatry J G Edwards, FRCPSYCH ................ Drug treatment of psychiatric patients in general practice I H McKee, MB; C H Gill, MRCGP ...... Preventing deaths from malaria ............ A W Macara, FFCM ...... Trouble with children's feet H T H Wilson, FRCP; Seonaid I D Bird, MB; A E Mackinnon, FRCS; R J Brereton, FRCS; G S Pathakji, FRCS ..............

1293

1294 1294

1294 1295

1295 1295

1295 1295 1296

1296 1296

1297

"Run for fun" D A Heath, MRCP, and A M Bold, FRCPATH; I D Adams, MD ...................... "What Sex is All About" S E Ellison, FRCGP .................... Executive screening ............. A R Bailey, MRCP ....... Use of foot for cardiac massage J M Cundy, FFARCS ...... ............ Rape and the laboratory Elizabeth M Wilson, PHD .............. Teaching of geriatric medicine B C Kundu, MRCP .................... Ventricular tachycardia during exercise testing P H M Carson, FRCP, and Rosalind A

Phillips,

MB

..........................

1298 1298

1298 1298 1298

1298

1299

"Crucifixion" crucified .......... 1299 G Discombe, FRCPATH ...... Polymorphism in drug metabolism L Balant, MD, and others .............. 1299 Breathing other people's smoke G Aston, MRSH; B H Burne, MFCM, and N J Billington, MRSH .................... 1299 Postgraduate education in therapeutics A Smith, FRCGP, and others ............ 1300 Carcinoma of the breast in women under 30 Vera Jones, MB, and A Slater, MB ........ 1300 How to organise an international medical meeting Lyn Wilson .......................... 1300 Mycosis fungoides treated by PUVA and mustine hydrochloride A W P du Vivier, MD, and Dorothy I ............... 1300 Vollum, MRCP .........

Correspondents are urged to write briefly so that readers may be offered as wide a selection of letters as possible. So many are being received that the omission of some is inevitable. Letters must be signed personally by all their authors. As stated each week in "Instructions to authors" no letter will be acknowledged unless a stamped addressed envelope or an international reply coupon is enclosed. Delivery of wheelchairs

SIR,-On 2 September you published a brief editorial commenting on your article from the Wolfson Centre by P Dorsett, K S Holt, and A Wisbeach, in which it was alleged that the delays in the availability of wheelchairs were caused by the DHSS, which made economies by slow ordering from approved manufacturers. This was such a serious allegation that I considered it merited investigation and I duly took up the matter with the Minister for the Disabled. He has now given me a categorical assurance that the DHSS is not seeking economies by slow ordering. In his letter he states that "it is our policy to hold central, and wherever possible, local stocks of a wide range of wheelchairs covering the needs of users from childhood to advanced years. These stocks embrace some proprietary wheelchairs as well as models that are manufactured to the Department's own specification and within each model range non-standard as well as standard wheelchairs. This range meets about 85O of the annual demand for wheelchairs. Our aim is to extend these stocks so that we have readily available any wheelchair in reasonably frequent de-

mand, but progress along these lines will have to be subject to the availability of the necessary resources." I accept this, but the question remains: why should there be delays (which extend to spares as well as to complete chairs) ? I am afraid that one does not need to look beyond the cumbersome bureaucratic procedures which seem inevitably to follow whenever the public sector undertakes services of this nature. At a recent exhibition of aids for the disabled at Swansea, organised by the Wales Council for the Disabled, I discussed this issue with a number of suppliers who were exhibiting their products. They were, to a man, quite certain that substantial administrative economies could be made, and a much more efficient service achieved, if individual clients could choose their appliances-with the help, of course, of the appropriate medical or paramedical adviser-and then recover the cost by reimbursement. Such arrangements operate in other countries (Eire is an example); I wonder if any of your readers have experience of such systems. It is certain that one cannot be satisfied with

Persistent excretion of salmonellas M van Schothorst and H J Beckers ...... 1301 Grommets and swimming P E Roland, FRCSED .................. 1301 Royal College of Surgeons of Edinburgh: reform of fellowship examinations A W Wilkinson, PRCSED .1301 Dental anaesthetic fees: all is now clear C F Scurr, FFARCS .................... 1302 Use and abuse of medical women F Mary White, MB .................... 1302 The Glanvill case R A Keable-Elliott, FRCGP .............. 1302 Withdrawal by HJSC from the Review Body M E Denyer, MRCP, and S 0 Fradd, MB.. 1302 Clinical medical officers ............. 1302 J S Horner, FFCM ....... An Irish look at the present consultant contract K W Beetham, MB .................... 1303 Pay claims J F Dracass, MB ........ .............. 1303 Prescribing and family planning Margaret M O'Meara, MB .............. 1304 Private practice and the reduction of pay-beds J J Shipman, FRCS, and others .......... 1304 Points Sympathetic overactivity in tetanus (Dr H Hortnagl); Scombrotoxic fish poisoning (J P Telling and R M Kupfer); Preinjection skin swabbing (J N McArthur); African travel (W E van Heyningen); Are automatic gear boxes hazardous for driving? (L Rendell-Baker); Treatment of migraine (C Cockburn).... 1304

the existing system. It may have performed adequately in the past. I doubt whether many agree that it does so today. PATRICK JENKIN House of Commons, London SW1

SIR,-The leading article (2 September, p 648) and subsequent article "Delivery of wheelchairs to disabled children" (p 688) by P Dorsett and others are very apt. Wheelchairs are essential to the disabled. When will the powers that be realise that wheelchairs to the disabled are their legs ? Would the Ministry tolerate over six months' delivery wait for their cars ? We are able to prescribe both hand and power propelled chairs for our 253 patients, but it still takes six weeks for Blackpool to approve any chair, then another six weeks at least elapses before actual delivery. Is it not possible for the Minister for the Disabled to force manufacturers of wheelchairs to provide a continuous supply of chairs to all appliance centres, and even for such centres to have a stock to ensure immediate delivery ? MAUREEN A TUDOR Royal Hospital and Home for Incurables, Putney, London SW15

SIR,-I wish to comment on your leading article (2 September, p 648) discussing some of the problems causing delays in the delivery of wheelchairs. Our organisation, the joint medical services

Delivery of wheelchairs.

BRITISH MEDICAL JOURNAL 1293 4 NOVEMBER 1978 CORRES PONDENCE Wheelchairs Patrick Jenkin, MP; Maureen A Tudor, .............. MB; J W Koten ...
225KB Sizes 0 Downloads 0 Views