Garston Manor: an experiment in rehabilitation.

Abstract

The aim of rehabilitation is to restore the patient to a full life after illness or injury. It has medical, social, and industrial aspects. Medical rehabilitation is largely concerned with the restora tion of physical fitness where this is possible, and with helping the patient to compensate for a disability when this is perma nent. Such help may include the provision of artificial limbs, domestic aids, wheelchairs, and hand-controlled vehicles, as well as alterations to the patient's home. While medical rehabilita tion is primarily the responsibility of the hospital team, many other people may be involved-in particular, the patient's general practitioner and the staff of voluntary organizations, local authorities, and Ministry of Health limb-fitting and appli ance centres. The object of industrial rehabilitation is to find jobs for disabled workers in open industry or in sheltered workshops, to assess the aptitude and skills of those who must be found alternative work, and to provide vocational training for those who must acquire new skills. The 1944 Disabled Persons (Employment) Act made industrial rehabilitation the responsi bility of the Ministry of Labour, now known as the Department of Employment and Productivity. This department provides a job-finding service at some 900 employment exchanges throughout Great Britain; operates 22 industrial rehabilitation units designed to give vocational guidance; sponsors sheltered workshops which are operated by Remploy, local authorities, and voluntary bodies; and provides courses of vocational train ing at Government training centres, commercial and technical colleges, and a small number of residential training centres for tahe more severely disabled. Since 1944 some 200,000 men and women have been admitted to courses at industrial rehabilitation units and over 160,000 have received vocational training, and in this time the Ministry's disablement resettlement officers, better known as D.R.O.s, have found over two and a quarter million jobs for disabled people. Nevertheless, doctors are still not making full use of the facilities provided by the department for their patients. There are many reasons for this, not least the physical separation of the rehabilitation services provided for the disabled by different Ministries. This problem was considered by the Interdepart mental Committee set up under the chairmanship of Lord Piercy in 1953 to review the provisions for the rehabilitation, resettlement, and retraining of disabled persons. Its report, published in 1956, recommended the provision of two or three experimental comprehensive rehabilitation and assessment centres. Such a combined centre would be associated with, and located as closely as possible to, a general hospital. It would provide within the one establishment a variety of services, including a physiotherapy department and remedial gymnasium, and specialist services would be readily available; an industrial workshop would be provided by the Ministry of Labour, and a joint assessment unit established. The Ad Hoc Committee on Rehabilitation set up by the Sheffield Regional Hospital Board (1962) was convinced that comprehensive rehabilitation units should be established to serve a population of about 250,000 and pointed out the neces sity to plan such centres as an integral part of the new hospitals.