As part of that exercise, and as noted in the above article, the DWP has produced a Frequently Asked Questions list that sets out is response to a number of issues, together with a mythbusting section that seeks to dispel some of the concerns expressed to date in the media.  The FAQ list can be found here.

Other views

As a balance, Disability Rights UK has also produced a fact sheet that sets out its current understanding of the DLA/PIP arrangements.  It holds the view that the main thrust of the PIP proposal is to save money and it notes that the assessment tests are more strict than those in DLA.  The fact sheet can be found here.

Background

There are approximately 500,000 people in the UK who currently receive Disability Living Allowance but could no longer be eligible for the proposed PIP.  In his interview, Mr Duncan Smith said there had been a 30% rise in the the number of claimants in recent years, with the annual cost of the benefits soon to reach £13bn. As part of the proposed PIP, up to two million claimants would have their claims reassessed in the next four years.  Only those considered to be in need of support following this reassessment would qualify for PIP.

His views

Mr Duncan Smith said “We are creating a new benefit, because the last benefit grew by something like 30% in the past few years. It’s been rising well ahead of any other gauge you might make about illness, sickness, disability or for that matter, general trends in society. A lot of that is down to the way the benefit was structured so that it was very loosely defined. Second thing was that in the assessment, lots of people weren’t actually seen. Third problem was lifetime awards. Something like 70% had lifetime awards, (which) meant that once they got it you never looked at them again. They were just allowed to fester.”

He went on to discuss the potential for amputees (including ex-servicemen and women) to no longer being entitled to disability benefits as their everyday mobility was not affected by their prosthetic limbs.  “It’s not like incapacity benefit, it’s not a statement of sickness. It is a gauge of your capability. In other words, ‘Do you need care, do you need support to get around?’. “Those are the two things that are measured. Not, ‘You have lost a limb.’”

Commentary

As we noted in our original response to the DWP consultation on the proposed PIP (which can be read here), one of its underlying aims was to to address the current levels of fraud and to reduce public spending. While this approach is entirely reasonable, it should not be achieved at the expense of those who have a clear and legitimate requirement for assistance resulting from limb loss.  Mr Duncan Smith takes the view that the loss of a limb does not automatically relate to the need for support.  While, in some instances, this may be true (at least in the short term), it does suggest a worrying lack of understanding of the effects of amputation and what is required on a daily basis to cope with the demands of being an amputee.

While there are amputees who are very fortunate in being able to carry on with life after amputation without the need for assistance, the fact remains that amputees (even those who do their level best to carry on with life and do not accept that they are disabled), will experience problems due to ill fitting or poorly suited prosthetic limbs.  Older amputees also encounter further issues that arise as a consequence of wearing a prosthetic limb.  These often result in increased joint pain or arthritis and  shortness of breath.  Such problems make even short journeys more difficult. As a general point, it should be noted that the ability to deal with a prosthetic limb tends to lessen over time due to the effects of ageing and to the demands that wearing a prosthesis places on the body.

Lower limb amputees may be able to walk reasonably well on one day (a good day), but then be unable to walk for the next few days due to sores, abrasions or ulcers on their stump or the part of their limb that abuts the socket of their prosthesis. Without a proper fit, a prosthetic limb cannot be worn with comfort or the necessary degree of control; factors which render even the most advanced prosthesis inadequate.  Some may be able to walk for short distances, but longer trips can prove to be difficult, particularly where inclines, steps, uneven or slippery surfaces are involved.  This is where the Blue Badge scheme that those with DLA are able to access, is a positive help in that it allows amputees to use disabled parking spaces close to the shops and facilities that they need to access on a regular basis.

The apparent lack of appreciation or awareness by the DWP and the Government is why we sought  to have the needs of amputees recognised in the proposed PIP assessment.  We asked that those undertaking the assessments must be intimately involved in the form of disability under review (i.e. from our perspective – that person would need to be an amputee AND a consultant/surgeon/prosthetist).  Without this level of understanding,  it is unlikely that the situation faced by the applicant will be properly understood.  To that end, we are actively working with the DWP on the proposed assessment criteria to be used in PIP.

This will range from the standard of care provided at limb centres, through socket fit and the choice of prosthesis to limb repair and maintenance.

Your views

We would be pleased to receive your views on topics relating to prosthetic limb provison and care that could be included in the questionnaire or specific questions that you would like to see raised. We are looking to compile the questionnaire by the end of May for issue next month. Please email your topics or questions to Sue Moody at sue@limbless-association.org

We we hoping to feature regular road tests of amputee friendly vehicles in future issues of the magazine but unfortunately, the writer has had a change in his personal circumstances and will not be able to produce any articles for us.  If you are able to pass on your interests in motoring, and would be happy to contact vehicle manufacturers in order to organise a test drive of a car, please contact Liz Granirer, the editor of Step Forward at liz.granirer@gmail.com

Christine Mitchell will now step up to be the acting chair for the board and if anyone wishes to contact her please email her on christine@limbless-association.org or board@limbless-association.org

Researchers also found that up to four-fifths of  the cost of treating diabetes related issues (such as kidney failure, nerve damage, and amputation – approximately 100 per week at present) could be avoided through investment in improved preventative measures and the management of the condition once it has been diagnosed.

Impact Diabetes

The report, which was published in the Diabetic Medicine journal, also looked at the indirect costs of living with the condition, such as those related to increased periods of illness, the loss of earnings through an inability to work and the need for care.  The report found that the total of these indirect costs, in addition to direct patient care in the UK, stands at £23.7 billion and is predicted to rise to £39.8 billion by 2035/36.  The report highlights this in order to emphasis both the human and financial incentive to seek to better manage the disease.

Views

Barbara Young, chief executive of Diabetes UK, was quoted as saying “This report shows that without urgent action, the already huge sums of money being spent on treating diabetes will rise to unsustainable levels that threaten to bankrupt the NHS. “But the most shocking part of this report is the finding that almost four-fifths of NHS diabetes spending goes on treating complications that in many cases could have been prevented.

“The failure to do more to prevent these complications is both a tragedy for the people involved and a damning indictment of the failure to implement the clear and recommended solutions. Unless the Government and the NHS start to show real leadership on this issue, this unfolding public health disaster will only get worse.”

In response to the publication of the report, the Department of Health said: “We agree that diabetes is a very serious illness and one that has a big impact on the NHS. “That’s why we are tackling the disease on three fronts. “First, through prevention of Type 2 diabetes – encouraging people to eat well and be more active. Second, by helping people to manage their diabetes through the nine annual health care checks performed in primary care. And by better management of the condition in hospital.”

The latest report covers the period 7 October 2001 – 31 March 2012 and is compiled from a number of databases and other sources. Amputations are classified in two ways, namely:

• Traumatic or surgical amputation – this can cover loss of a part or all of a toe or finger up to the loss of complete limbs

• Significant multiple amputees – an amputation at or above a wrist or elbow on more than one limb.

Observations

The report does not provided a breakdown of the injuries experienced or the exact number involved in order to prevent possible identification of the individuals concerned. In this regard, all numbers less than 5 have been suppressed. As a result, the actual numbers quoted are subject to rounding and are not factually correct. For this reason, it is not possible to gain a clear picture of the number of amputees that might be expected to present at a Disablement Services Centre following their eventual discharge.

It is also the case that the data used in relation to personnel being given medical discharges through a Medical Board is not presented in statistical form. Such discharges do not cite the principal disability as the reason for leaving the service and some Medical Boards may not take place until months or even years after the initial event or injury. Indeed, some earlier injures may not be the later problem that presents the final reason for a discharge.

Treatment

Since 2001, the University Hospital Birmingham Foundation Trust has been the main receiving centre for military casualties with Queen Elizabeth Hospital taking the majority. Following treatment at Queen Elizabeth or 1 of 4 other hospitals in Birmingham, rehabilitation is carried out at Headley Court in Surrey. This provides advanced rehabilitation and also prosthetics.

Afghanistan

The following table sets out the number of surviving UK service personnel who sustained a partial or complete limb amputation resulting from injuries whilst on duty in Afghanistan.

Notes

1. ~ = suppressed data in accordance with DASA rounding policy

2. These figures include partial or complete amputations for either upper or lower limbs

Iraq

The following table sets out the number of surviving UK service personnel who sustained a partial or complete limb amputation resulting from injuries whilst on duty in Iraq.

Notes

1. ~ = suppressed data in accordance with DASA rounding policy

2. These figures include partial or complete amputations for either upper or lower limbs

These two tables suggest a total to date of 262 amputees, which is approximately 65% of the level anticipated by the Department of Health in its post Murrison report assessment of the situation regarding forthcoming demand on the NHS. However, this figure is likely to be distorted as it includes partial amputations, including fingers and toes.

Significant multiple amputees

As a subset of the two above tables, the following table summarises the number of surviving UK service personnel that sustained significant multiple amputations (SMA) as a result of injuries whilst in either Iraq or Afghanistan.

Notes

1. ~ = suppressed data in accordance with DASA rounding policy

If this table more accurately represents the likely amputees that will, at some point, require NHS care following discharge from the armed forces, then a total to date of 93 is approximately 23% of the total being anticipated by the Department of Health. This is welcome news, both in terms of the level of service personnel sustaining this form of injury and also when considering the potential demand that may be placed on NHS services in the future.

Your passport to a smooth journey

A simple guide has been produced by the Equality and Human Rights Commission that includes eight top tips for disabled and less mobile passengers when they fly.  This can be read here or can be downloaded here.  Alternatively, a hard copy can be ordered by following this link.

Key facts

This relates to the whole of the air travel process and not just the flight itself. It also covers the booking of flights, arrival at the airport, checking in, getting on and off the plane and leaving the airport.  The regulation applies to tour operators and travel agents as well as to airports and airlines which means that tour operators and travel agents must pass on an individual’s requirements to the airlines, and they in turn must inform the airports of the individual services required.

The Equality and Human Rights Commission can be contacted should you have a complaint  or require advice in relation to air travel.  It is responsible for dealing with complaints about airports in England, Scotland and Wales, and any airlines flying from them. It can advise you of your rights and what further action you can take.  In doing so, complaints must be made within the statutory limit of six months less one day. Unfortunately, the Commission will not be able to assist you after this stage.

Where?

These spaces in front of the Palace of Westminster, by Admiralty Arch and in Trafalgar Square will be allocated by ballot for:

• one wheelchair user and one personal assistant or carer
• one disabled person with a travel chair or other small mobility aid and one personal assistant.

How?

If you would like to be entered in to this ballot, please email your name, postal address and your date of birth to DJBallot@culture.gsi.gov.uk by 23:59 on Sunday 29 April.  You will need to confirm that you are a Blue Badge user and whether you need space for:

• your wheelchair;
• your personal assistant or carer;
• your travel chair; or
• another mobility aid (please specify).

Good luck if you decide to apply!

On his JustGiving page, James says that he choose to raise money for the Limbless Association because he was inspired by his girlfriend Veronica who lost her left leg in December 2010 after being hit by a truck at Marble Arch. He felt that if she could learn how to walk again in the eight months since leaving hospital in April 2011, then he could run the 26.2 miles in the London Marathon.  He goes on to say that since becoming more aware of the amputee and limbless community, he has found that there are many people doing a lot more than he was with his four limbs.  As a result, he viewed the Marathon as both a personal challenge and an opportunity to raise money for a charity close to his heart.  Click here to visit his JustGiving page.

We congratulate and thank James on his efforts.  His story of the race can be read below.

James’ story

What a way to see London! I’d been warned to take it easy on the first half as it’s easy to get carried away, so I chatted with the other runners and soaked up the cheer from the locals as we went past. I think I lost my focus a bit as I hit the half way point about 20 minutes behind where I should have been. Then there’s the long curve out into Docklands which most people say is the hardest part. I think I’d have to agree, but once you’re through here, the crowd starts getting really thick and noisy, which is great, and then you’re heading back into town towards the park.

That final stretch is really uplifting – as they say, the last six miles is all crowd! I managed to pick up the pace for this approach to Buckingham Palace and made it over the line in 4h45m – a bit over my target of 4h30, but finishing was the important thing!

The weather held out just long enough and friends and family managed to rendezvous in a little pub and celebrate the runners’ achievements.