H.—lB

(v) Manufacture and Fitting of Artificial Limbs 56. The last report of the Board mentioned that the limb manufacturing and fitting equipment and plant of the McKay Orthopaedic Society had been taken over and entrusted to the Disabled Servicemen's Re-establishment League to operate as part of the new vocational training and recreational centre erected by the Board in Wellington. An up-to-date limb manufacturing and fitting and experimental department of the centre now performs the bulk of the limb manufacturing and fitting work on behalf of ex-servicemen. 57. Since/ the establishment of the limb department at the Wellington Centre it has become increasingly equipped to handle the manufacture and fitting of the various classes of artificial limbs. Notwithstanding this, there is ample room for further development and technical improvement in this field before the Board will regard the position as entirely satisfactory. In particular, there is need for the appointment of a full-time trained orthopaedic surgeon at the Wellington Centre and at any of the other centres where limb manufacturing and fitting are subsequently undertaken, while the establishment and fitting-up of the Auckland Centre, as well as the training of an increasing number of artificial-limb and surgical-footwear manufacturers, require pushing ahead. The Board is moving actively in each of these respects. 58. Table XXI of Appendix II gives details of the progress towards re-establishment of all leg and arm amputees as at 31st March, 1944 ; while Table XXII gives particulars of limb-fitting results to date. (vi) Vocational Training 59. At the Wellington Vocational Training Centre, and at its district workshops in Auckland, Christchu'rch, Dunedin, and Invercargill, the League, with subsidy assistance from the Board, is training a considerable number of disabled men from the present war in addition to other men not the concern of the Board. It is the intention of the Board to erect and entrust to the League for management training centres, similar to the Wellington Centre, in each, of the other main centres, and the erection of the new Dunedin centre is well advanced, there being every likelihood of its being in operation by June of this year. Meantime the League workshops, despite their limited accommodation and facilities, are able to handle the more seriously disabled men transferred to them for training. 60. Specially-devised training, graded to meet the physical and mental conditions of the trainees, is being provided by the League at one or another centre in the following trades and callings : cabinetmaking ; clerical work ; basketwork ; arts and crafts ; artificial-limb , making ; boot-repairing; french polishing; leatherware manufacturing; mop-manufacturing; paua-shell jewellery and trinket manufacturing ; ropeware manufacturing and upholstery. The occupations in which training is provided are steadily extending, as might be expected. 61. Table XXIII of Appendix II gives details of ex-servicemen undergoing training with the Disabled Servicemen's Re-establishment League as at 31st March, while Table XXIV gives details of men absorbed into industry from the League as at the same date. (vii) Therapeutic Employment 62. The provision of employment, whether permanently or temporarily, which will assist the physical recovery and psychological readjustment of the disabled man has throughout been regarded as fundamental. 63. Accordingly disabled men undergoing training in the Vocational Training Centres of the League; have been trained or employed with as much emphasis on their physical and psychological recovery as on the attainment of particular trade skill. A number of men who have been employed at the Vocational and Recreational Centres and who have left of their own accord, or who have been placed from the centres in employment for which they were not trained by the League, has been greatly assisted by the therapeutic value of the work done or attempted in the company of other similarly disabled men at the centres. 64. In the Employment Section of the report the establishment of a Therapeutic Employment or Intermediate Scheme is mentioned. It is expected that the setting-up of local schemes under the general authority will go far towards solving the dual question of what employment men who are not quite fit for normal employment can undertake and how their progress to industrial employability can be hastened. In the next report of the Board it will be possible to evaluate more reliably the contribution which the intermediate scheme is at that point making to the solution of the disabled-man problem. (viii) Possible Establishment of Rest Centre 65. On more than one occasion in its consideration of therapeutic measures the Board has studied the question of whether a special rest centre for ex-servicemen should be established. The central idea behind proposals of this nature is that in order to hasten the post-institutional recuperation of invalided men and develop still further the tuition in occupational therapy these men would probably have received while in hospital a rest centre, midway between the hospital and the vocational centres managed by the Disabled Servicemen's Re-establishment League, would be desirable. 66. The Board has regarded such proposals as possessing a certain merit, but a recent survey of cases of men likely to benefit from such treatment and to be willing to sojourn at a rest centre did not reveal a sufficiently large number of cases to recommend such a measure. Subsequently the position may be otherwise, but in the meantime the Board considers that the provision of suitable light work on specially organized intermediate schemes (described in Section IX B (iii) of this report) accompanied by selective placement in industry renders a special rest centre unnecessary at this stage. (ix) Selective Placement and After-care 67. All the measures so far referred to will not singly or collectively enable the permanent and happy rehabilitation of disabled men unless they arc followed by selective industrial placement—that is to say, all that will have been done up to this stage must be regarded as preparatory to the return of the disabled man, if this is at all possible, to a suitable industrial avocation yielding him the ruling

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