N.H.S. Note 11.
Medical and Surgical Appliances
Pants can obtain free any medical or surgical appliance which is prescribed for Com under tile National Health Service. This does not mean, however, that when a patient gets a statement that a certain appliance is necessary he can get it where he likes and send in the bill to the State. Appliances may be obtained cither:-
1.
2.
Under the General Practitioner Service or
Through the Hospital and Specialist Services.
1. Under the General Practitioner Service
The appliances which General Practitioners may order for their patients under Part IV are set out in Part I of the Third Schedule of the National Health Service (General Medical and Pharmaceutical Services) Regulations, 1948.
The list is restricted to about 40 specific itens ranging from cotton wool and bandages to elastic stockings and vaporisers. In some cases the grade or quality of
In other cases these appliances is or will be laid down in the Official Drug Tariff. they must be of a grade or quality not lower than the grade or quality originally used for medical purposes.
The normal procedure, where a doctor thinks his patient needs. one of these appliances, is for the doctor to write out an order for one on an N.H.S. prescription form; this order is taken by the patient, or someone on his behalf, to a chemist or maker of surgical appliances taking part in the National Health Servico, who supplies the appliances free of charge. In rural areas, whore a patient would have difficulty in getting his prescriptions dispensed by a chemist, the doctor may himself supply the appliance.
Certain initial difficulties have occurred and the list of appliances mentioned will be kept under review. Under Part IV spare parts of atomisers and douches are replaced free of charge when the G.P. orders this; for trusses and clastic hosiery it is not considered that repair or replacement of parts is practicable and the G.P. should be asked to prescribe a new appliance.
2. Through the Hospital and Specialist Services
When a patient needs an appliance not on the list of items which General Practitioners can prescribe, he becomes the responsibility of the Hospital and Specialist Services. He should again begin by going through his G.P. but that is merely because G.Ps, are the normal channels through which patients should go to a hospital. The responsibility for prescribing the appliance will rest with the hospital and not with the G.P.
Hospital Specialists are not limited to any list of appliances. They can prescribe whatever medical or surgical appliances they decide is necessary for the patient, varying from artificial limbs to surgical belts and including surgical boots, shoes, log irons etc, etc.
When the specialist has prescribed he will arrange for the hospital to place an A fitter from the firm order with the firm of appliance makors with which it deals. will, if necessary, see the patient and the bill will be paid by the Health Service.
The appliances provided free arc of a first-class standard and no question arises of "botter" types being available on extra payment. With most appliances more expensive types cannot be provided under the Health Service even if the patient is willing to pay the extra cost. To this the only exceptions are glasses, dentures and
as soon as arrangements have been completed) artificial limbs.
Appliances supplied through the Hospital Servico are replaced or repaired when necessary. This is done free of charge except when it is necessitated by the patient's carelessness,
When any defect which has developed in an appliance is of a kind affecting its modical function the patient should take it to a hospital (if possible the one at
ich the liance was prescribed) where a prescription for renoval or repair will be
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