Re: Angliss V.E. "Holte revisited--a review of the quality of prosthetic treatment".

The standards recommended at the United Nations Inter regional Seminar on Standards for the Training of Prosthetists in Holte, Denmark, in 1968 were universally accepted as being ideal, practical and economical. As these standards and the services to patients are not always observed, world wide, a study was made to investigate the situation in Australia. Australia is a federation with responsibility for health and education vested in six States. The Federal Government is the principal taxing authority with the States dependent on it for financing services. The isolation of Australia led the Government during 1960 to send a rehabilitation medical officer to survey the system in Europe and North America. The best features of overseas practice became the basis for updating an Australian Service and establishing the Central Development Unit. The Artificial Limb Service is based on clinical care, formal inservice training of limb makers and fitters, patient training by therapists and the purchase of components from mass producers. The Service is answerable to lay and medical staff in the State Branches and to the Central Office of the Department, located in Canberra. The division of responsibility between the State and Federal Governments seems to lead to competition for control of services rather than to an integrated plan for Prosthetic-Orthotic training with services. Industrial conflict due to a perceived threat of the supplanting of apprentices by formally trained prosthetists-orthotists has also adversely affected development.(ABSTRACT TRUNCATED AT 250 WORDS)