DISABLED SOLDIERS

Dominion, Volume 12, Issue 102, 24 January 1919, Page 6

DISABLED SOLDIERS

NEW BRITISH MEDICAL DEPARTMENT

SPECIALIST TREATMENT

At the beginning of this year Mr. Hodge, the Minister of Pensions, decided that it was necessary to establish a medical department in connection with the Ministry- to carry out effectively the duty imposed by the terms of the Royal Warrant of providing treatment for all discharged disabled soldiers. He appointed Sir John ' Collie, C.M.G., M.P., as,the Medical Director. Four thousand three hundred discharged men were then under treatment, but tho number now exceeds 30,000. The first step taken by the newly formed Department was to complete arrangements with all existing general hospitals which could spare accommodation to provido treatment of the character required. It soon became obvious that this accommodation was quite insufficient. There are also certain disorders from which the discharged man ■ suffers for which little, if any, accommodation existed; and it has been necessary to provide and arrange for special institutions to deal with them. Six homos of : recovery for men ' suffering from neurasthenia and shell-shock have already been opened, and three more are being rapidly prepared. These institutions are ■ under. the care of specialists on nervous disorders,. and every oppor- j .tunity is given v for effecting complete I cure. , The Note of Personal Interest. It has been decided that special arrangements must be made for the large number of paralysed men. For obvious reasons it is undesirable that cases of this sort should be dealt with in general hospitals. Steps are, therefore, being taken to establish in each comity, in connection with hospitals, separato institutions where these men will bo reajHily accessible to their friends. It would be an addition to thei" already grievous plight if they wjre segregated in one large institution and cut ■ off from personal contact with their friends snd relations. These cases require exceptional treatment, and it is hoped, in addition to what the Medical Department j;an do in the way of service and allowances, to enlist the sympathies of the lord-lieutenants, with a view to the formation of special committees y of in-1 fluential people who will take a personal interest in providing amusements, entertainments; and the various little luxuries and attentions which mean so much to men in this condition. Tho capitation grants sanctioned by tho Treasury will cover only the actual cost of the treatment and nursing, which in these cases is very expensive. Special arrangements have been made at most of the spas for tho treatment of rheumatic cases, and hostels have been_ provided, and are in the course of provision, to accommodate the men.

The large number of orthopaedic cases (which embrace practically all injuries to-limbs) haValso necessitated special arrangements. Orthopaedic surgery has greatly developed during the war; in' fact, so far as adults are concerned, it may be said to have had its inception during the war, and in order to take full advantage of tho knowledge which has been acquired by Army surgeons the Medical Department, after consultation with the War Office, has prepared , a scheme for setting up annexes in*connection with the special military surgical hospitals. The treatment of the discharged men in these annexes will be' kept entirely distinct from that of the serving soldier, but tho supervision tof the treatment, and the decisions as to. operations will be undertaken by the specially skilled staff at the disposal of tiie War Office. In addition, out-patient clinics for orthopaedic treatment of discharged men will' be established as occasion requires. It is expected that in each large town of 50,000' inhabitants ov more a clinic will be "established under the control of the Pensions Ministry; hero, too, the work will be supervised by surgeons from the special 'military surgical hospitals.

The whole administration of tuberculosis treatment for the civilian population, including tho discharged soldier, is iu the hands of the National' Health Insurance Commission, and the Local Government Board is charged with tho responsibility of providing the necessary accommodation. It is not the duty of the Ministry to make this provision, but numerous conferences have been held, and every endeavour hits been made to secure prompt and adequate treatment for discharged men. Arrangements with Hospitals. It has been possible to a large extent to arrange for general medical and surgical treatment at existing hospitals by the payment of capitation rates varying from ss. to 7s. a day. Where Me demand for accommodation has been acute and there has been a possibility of extending a hospital, financial assistance has been given to enable the hospital to carry out the extension and cope with the additional demands made by the treatment of tho discharged men. ' Some hospitals have been acquired for the treatment'of pensioners only. In addition, arrangements have been\jiiado with hospitals specialising in, various diseases, and the facilities afforded by them are available for discharged men. . , <.

In conjunction with the War Office, m Advisory Council has been established to regulate tho supply of efficient masseurs and masseuses f.or the largo number of men requiring massage' and electrical treatment. This council will docide such questions as rates of pay, terms of service, and distribution; but, when engaged, tho. s.taff will be entirely under the control of f]\e Department making use of their services.

The medical examination of the discharged man, in order lo determine whether any, and if so what, treatment is necessary, is undertaken by mbdical referees, who liavo benii appointed throughout the country. Ot these, parttime officers under the Ministry there are at present about 800. ;

Special aural boards.liavo.beon established in London and the provinces to regulate tho award of pensions and determine the treatment and training to be given jnon discharged on account of deafness and the various forms of ear disease. Special aural clinics have also been established for giving out-patients treatment of this character where it cannot ho obtained at hospitals, and classes havo been formed to give instruction in lip-rending to those who are totally deaf.

Besides meeting the increasing demands for all classes of treatment which are now arising, tho Department is busily engaged in preparing its plans for dealing with tho vastly increased number of men which will be dealt with by the Ministry when demobilisation takes place.