years' qualifying service who were serving on an engagement which, if completed, would have entitled them to a service pension. The total number of service allowances in issue under this Warrant on 31st March, 1927, was 2,193. 15. Former War and Pre-War Disabilities.-Increases of pension under the Royal Warrants of 26th September, 1921, and 13th March, 1925, issued in connection with the Pensions Increase Acts, 1920 and 1924, were granted in 3,068 cases. Under the Royal Warrant of 1st November, 1920, which provides for the increase to Great War rates of pensions granted in respect of disabilities sustained in former wars, 2,239 awards were in payment on 31st March, 1927, of which 2,296 v ere permanent. Under the Re-assessment of Pre-War Disability Warrant of 28th September, 1923, 231 awards were in payment on 31st March, 1927. Under the Re-assessment of Former War Disability Pensions Warrant of 25th April, 1925, 210 awards were in payment on 31st March, 1927. 16. Widows and Children.-Approximately 2,000 awards to widows and motherless children were made during the year. About three-quarters of these cases were dealt with under the provisions relating to grants to widows and children of pensioners whose deaths took place more than seven years after discharge or demobilsation. Special attention was given to the difficulties experienced by War Pensions Committees in dealing with children in the care of the Minister under Section 9 of the War Pensions Act, and to other problems associated with the administration of pensions and allowances for children. The various difficulties were discussed with the Central Advisory Committee and at Meetings with Chairmen of War Pensions Committees which were held by the Minister and the Parlimentary Secretary at various centres during the year. One difficulty which was stressed related to the position of the motherless child who needed some temporary assistance after pension had ceased to be payable. To meet this type of case a scheme was introduced at the close of the year whereby a portion of the pension of a motherless child between the age of 14 and 16, who is in employment and earning wages, may be reserved and accumulated by the Ministry on behalf of the child with a view to a small capital sum being available for the child's benefit when pension ceases. In announcing the scheme, notes on the training, placing in life, and after-care of children in the care of the Minister, were also issued for the guidance of War Pensions Committees in dealing with this responsible and difficult part of their work. 17. Parents and Dependants.-A considerable number of claims to pension on grounds of incapacity for self-support and pecuniary need were received from parents of men who were 64074 A 3 killed in action or died of wounds. These belated claims are the natural consequence of increasing age and infirmity on the part of parents of the men who lost their lives during the war. In many instances the need pension was granted in substitution for a flat rate or pre-war dependence pension of lesser amount, which was already in issue. The policy of awarding need pensions for an indefinite period where the factors of need and incapacity are of a reasonably permanent nature was continued. Out of 26,000 cases dealt with under this procedure up to 31st March last, 16,000 awards have been stabilised, thus avoiding the trouble and expense of further investigation, except in individual cases where some material and permanent change of circumstance arises. 18. Issue of Pensions.-The amount of work in connection with the payment of pensions showed some diminution. Allowance forms, payable orders, and money orders, to the number of over 51 millions, had to be prepared to enable payment of pension to be obtained. A number of these forms were examined later for verification of the payments. The number of letters and other documents received in, and despatched from, Pension Issue Office alone during the year exceeded eight millions. In July, 1926, the Issue Office at Pilton, Edinburgh, was closed, and the work relating to pensioners absorbed by the main office at Acton without increasing the staff at Headquarters. No difficulties have arisen on account of the transfer. 19. Issue of Retired Pay, &c., abroad.-Except as regards a few special cases, the Ministry has taken over the responsibility, hitherto discharged by the Assistant Paymaster-General, for securing the payment, in the Dominions and abroad, of retired pay and pension awarded to disabled officers and nurses, and the widows, children, and other relatives of deceased officers and nurses. MEDICAL BOARDS, TREATMENT, &c. 20. Medical Boards.-The total number of examinations carried out by Medical Boards during the year amounted to 89,837, a reduction of 47,295 on the previous year's figures. Of this total the Boards specially constituted with a view to the consideration of a final award, examined 60,862 cases (4,897 officers and 55,965 "other ranks "), while Re-Survey Boards, and Boards for the examination of Article 9 claims were responsible for 24,682 cases (1,865 officers and 22,817 "other ranks "). These figures fall short of the previous year's totals by 27,717 and 17,232 respectively. 21. In-patient Treatment.-The continued decline in the numbers of disabled men requiring in-patient treatment has been accompanied by a proportionate reduction in the special facilities provided by the Ministry for this purpose. Seven institutions of this type, with a total bed accommodation of 700, have been closed. The closures include the Special Neurological Hospital at Saltash, as it was found that the accommodation of this nature at Orpington, Harrowby, and Edenhall would meet all requirements. In addition, expiration of lease necessitated surrender by the Ministry of the institution at Ewell for non-certifiable mental cases, and the institution at Beckett Park, Leeds, for general medical and surgical cases. Alternative accommodation for the former was secured at Queen Alexandra's Hospital, Cosham, Portsmouth, on relinquishment of these premises by the War Office, and for the latter at Chapel Allerton, near Leeds. At the end of the year the number of institutions (including hospitals under the direct control of the Ministry) reserved for the in-patient treatment of war disabilities, which could not be adequately provided for otherwise, was 46, with a total bed accommodation of 6,625 The arrangements with civil hospitals for the treatment of pensioners continued satisfactorily. 22. Mental Diseases.-The general arrangements for the treatment of the insane have been continued as heretofore. Periodic inspection of the service patients in the various County and County Borough Mental Hospitals has been continued by the Ministry's mental specialists, and transfers from these institu tions to the special institutions at The Old Manor, Salisbury, and Kirkburton, Huddersfield, have been effected as occasion required. 23. Out-patient Treatment.-As is revealed by the comparative figures given in Appendix VII to this Report, there has been a further notable decline during the year in the number of pensioners requiring out-patient treatment. Accordingly, the number of Ministry clinics used for this purpose was reduced from 79 to 72. It was felt advisable, however, to add to the number of civil institutions to which pensioners could on occasion conveniently be referred for out-patient treatment on the basis of a capitation payment by the Ministry, and the number of these clinics at the end of the year reached 165, an increase of two on the previous year. 24. Artificial Limbs and Surgical Appliances. During the year under review 7,674 artificial legs were issued. Of these 5,829 were metal legs. The corresponding figures for the preceding year were 10,058 and 8,329 respectively. Artificial arms were issued in 1,080 cases, that number being somewhat lower than in 1925-1926, when 1,169 cases were fitted. The bulk of the total supply of 8,754 limbs represented renewals of previous issues; 172 were, however, supplied in respect of post discharge amputations, of which there were 151 during the year. Repairs to artificial limbs were effected in 45,571 cases. At the end of the year the total number of pensioners for whose artificial limbs. the Ministry is responsible was 36,795, of whom 1,779 were officers. The change of policy inaugurated on the 1st September, 1925, as the result of recommendations made by a Committee of experts, including representatives of limbless officers and men, presided over by Colonel Sir Godfrey Collins, K.B.E., C.M.G., M.P., viz., that types of metal limbs should be limited to two, and that the number of makers should be reduced to two (vide page 7 of report for the year 1925-1926), has given satisfaction to limbless pensioners generally, and has secured economy in the expenditure of public money. As regards wooden artificial limbs, the Ministry pattern light wooden leg has now reached a high standard of efficiency. The below knee wooden leg in particular can now be made actually lighter in weight than the metal leg for a similar amputation, and has the further advantage of being less liable to get out of order and easier to repair. Surgical boots numbering 17,100 pairs were supplied during the year, 860 of these being first issues, and the remainder renewals. In addition, 25,321 pairs of surgical boots were repaired. Other surgical appliances such as leg and arm instruments, belts, trusses, special supports, aural appliances, &c., were supplied in 12,469 cases, 2,879 being first issues; and in 2.106 further cases repairs were effected. The demand for surgical boots and appliances remains practically constant. Arrangements have been made with 114 firms in various parts of the British Isles for the supply at agreed rates of surgical boots and appliances, and for their repair. 4,687 artificial eyes were fitted. In 569 cases the eye was made specially to suit the exceptional character of the injury. Spectacles were supplied to 509 pensioners, 115 being of a special type for cases of facial injury or of greatly injured vision. In addition, the Ministry's depot supplied on behalf of other Government Departments 125 eyes and 943 pairs of spectacles. First issues of 123 hand-propelled tricycles and 149 invalid chairs were made during the year to seriously disabled pensioners, and 167 tricycles and 19 chairs were renewed. Since the establishment of the Ministry of Pensions, 3,865 hand-propelled tricycles, 1,100 Merlin chairs for indoor use, 626 bath chairs, 161 spinal carriages, and 62 tricycles or chairs of special type have been provided, making a total of 5.814 of all types. Spare handpropelled tricycles and chairs are kept at various centres throughout the country for temporary loan to pensioners whose machines have to be withdrawn for overhaul or repair. 25. Supplies to Institutions, &c.-In continuance of former policy, central and local contracts were arranged for the supply of food to 20 Ministry institutions affecting 5,115 patients and staff. In view of diminished requirements it has been found more economical to arrange local contracts for the supply of meat, instead of the former arrangement by which a firm of agents. was employed to purchase centrally and distribute supplies direct to institutions. Medical and surgical stores required by hospitals, clinics, and medical boards, were delivered direct to the institutions as required. Grateful acknowledgments are due to the British Red Cross Society, which continued to supply games and comforts for the benefit of patients in hospital. SPECIAL GRANTS COMMITTEE. 26. Allowances and Grants.-New allowances, as follows. were awarded by the Committee : Allowances to supplement pension: Officers, officers' widows and dependants Men's widows and dependants ... 176 ... 158 8 12 The value of the allowances in payment at 31st March, 1927, was £77,726 a year in respect of 1,984 officers and their dependants, £208 a year in respect of 9 nurses and their dependants, and £545 a week in respect of 1,147 men and their dependants.* The Committee made 979 new grants towards the cost of education of the children of deceased and disabled officers and men, and at the end of the year 5,883 such grants were in issue. In addition, similar grants under the Royal Warrant in respect of the children of deceased and disabled officers were administered with those under the regulations of the Committee, and at the end of the year 2,510 such grants were in issue, making a total of 8,393. These grants, which are in respect of school fees and expenses, represent a total annual expenditure of approximately £165,000. 27. Questions of forfeiture.-The Committee decided in 497 cases (including 65 in which there had been administration in trust) that pension had become forfeited; and in 282 instances (121 being cases in which pension had previously been suspended), administration in trust was recommended. In 325 cases it was found possible to re-issue pension direct, one after suspension, and 324 after a period of administration. There were 1,018 fresh cases involving the question of forfeiture referred to the Committee during the year. It was held in 481 of these that the allegation had not been substantiated, or that the facts did not necessitate either forfeiture or administration in trust. 28. Care of Children.-Under Section 9 of the War Pensions (Administrative Provisions) Act, 1918, it is the duty of the Minister to make provision for the care of children of men who have died as a result of their service, in cases where they are found to be suffering from neglect or want of proper care. As authorised by the Act, the Minister delegated these functions to the Special Grants Committee. * The apparent disproportion as between officers and men is explained by the fact that allowances for wives and children of disabled officers are granted by the Committee on a discretionary basis, whereas in the case of men of non-commissioned rank allowances are paid under the Royal Warrant and not by the Special Grants Committee. |