MOBILE CLINICS

Item

Title: MOBILE CLINICS
extracted text: Co ro v 'I '

RF_COM_H_78_SUDHA

rnnpc FOUNDATION MOBILE CLINIC - A BOON

Community Participation in any program is a must lor its sustained continuity. The
Coorg foundation which was established in!994 by Late Darbari Seth, Chairman of the

then. Consolidated Coffee Limited. The vision and mission was to promote and secure
the welfare of the people of Coors and to help resolve the economic, ecological.

environmental and social problems of the district. The chosen areas of intervention were
n

11*1

b.

iiduCutlGu

c. Spoils
d. Cuinire and

The available corpus through judicious and systematic investments applied the funds
ve five sectors. Nearly 24% (ending March 2003) of the total

cxpciidituic ol the trust has occn spent on heal Ur care, for the upiiftmcnt and betterment
of ’neahh in Coors.

Historically the need to provide Primary Health Care to people was identified and

promoted by ‘ Medical Education and support manpower (Srivastava) committee. ‘Alma

Ata’ declaration (1978) emphasised this. ‘Health for all by 2000 AD became the
password. National health policy oi India both 1983 and 2002 emphasized this aspect in
varying intensity. Primary Health Care delivery was never sidelined. These policies also

got reflected in medical education. The ‘Rome’ (Re-orientation of medical education)

program carried this philosophy further. Mobile clinics made its appreance in a
systematic manner from the Government side. The philosophy of mobile clinics supplied

by Government of India were to be attached to teaching hospitals/medical colleges.
Under the program they will be utilized

for providing curative services in the rural

areas and for training the under gr aduates arid interns. The mobile clinic would visit the

3/17/04

?•

rural areas attached to the (Primary Health Care) PHC with students, interns. The mobile

clinics will visit the rural areas attached to the PHC on a predetermined Programs
regularly. Publicity ’ information to the community is a must and the PHC is also taken

into confidence. This program was not only designed to enable the clinical skills and

procedures of the interns but also to provide opportunity to the intern to understand the

rural socio-cuiiuiai mileu. They were also to be involved in collection of baseline data,
and actively participate in the health, promotion and specific protective activities such as
communicable diseases control, including immunization, maternal and child health care.
family welfare services, Health education nutrition, counseling and rehabilitation,

Mobile clinics as a means for providing rural health services has its origin in Rajasthan.

The Government of Rajasthan started the mobile surgical unit in 1955 to provide surgical
facilities in rural Rajasthan. Bv 1967 the unit developed into a four hundred bed mobile
hospital fully equipped with operation theatre, laboratory, blood transfusion unit, x’ray
van, denial unit and captive generator apart from the curative activity this mobile

hospital was also providing health education and family planning advise. The
programme had the support ol medical colleges in Rajasthan and it worked well. By

1970 Government ofTndia, sanctioned twenty one medical colleges with mobile
hospitals with fifty bed training units. On again Government of India made and attempt
to introduce mobile clinic sendee through a new scheme called ‘Chittaranjan multi

purpose mobile training-cum service hospital, during early 1970’s. However, very little
is known about its efficiency, suitability', desirability and cost benefit in rendering Rural

xlcaitii services. Hus model has been by and large used by NGO’s, Corporate Groups,
more as a service car e, social responsibility’, etc.

There has also been an argument that the local PHC’s did not meet the requirements of
the community, and therefore to meet the shortfall these mobile clinics were being used.

One fails to understand the ethical issues where the mobile clinic visits periodically
asking the people to fund themselves when the mobile clinic is absent. What ever be the

argument / counter arguments mobile clinic has in its own way provided health inputs to

the community. At there door steps when there was none. The quint essence of the

philosophy of mobile clinic is summarized by ministry of Health Government of India.
. Deal with al! aspect of immunization, detection and cure of diseases, whether

existing in a remote village or in tire nearest urban slum. Il is imperative in the
achievement of such an objective. Mass immunization, treatment oflocally endemic

diseases, maternal and child health seivices, carrying out minor surgical interventions,
including operations under the family welfare program, prevention of blindness, school
health programmes etc are duly covered”. The mobile clinics, according to the
authorities can also be gainfttlly used for the screening and treatment of specially

vulnerable population groups in backward areas, tribal belts, and in pockets where
outbreak of epidemics is threatened if the communications and programme scheduling
could be properly inflated.

The Coorg Foundation invited Community Health Cell to review the working of mobile
clinic in Kbdtigu District and recommend improvements to the ongoing programme.

evolve a suitable strategy, through the experience gained by the mobile clinic personal;
so as .o make the programme mo^e meaningful and effective, iltere was no terms of
reference but had to be evolved during the briefing, by the Chief Medical Officer. Rural
India Health Project (RIHP). who also was the Director (medical) of TATA Tea which

coordinated the programme.

METHODOLOGY:

Keeping hi view the time factor available to the consultant the following plan of action
was evolved. Keeping Amathy as the base from where the Coorg Foundation Mobile

Clinic (CFMC) starts the longest route of mobile clinic traversed on either side was
considered. In route to either side identified halts of mobile clinic were for taken for

review. (See Diagram). During the following four days discussions with the designated
mobile clinic Doctor / staff? driver, were held. At the place of halt local PRI (Panchayat

Raj Institution) representatives were met and discussions held about the mobile clinic, its
use, effectively, their own observations and reflections, patients who came for medical

help from the mobile clime, were interviewed - as an exit interview. There was no
prepared schedule an unstructured checklist was used. The questions related to

the frequency of their visit
<•'

iilC quality Oi SviViCC prOViuUu

y meir suggestions for improvement

> Their responsibility towards the organization which is extending the service.

Diagram showing the Coorg Foundation Mobile Clinic. Route and the places visited by the consultant, (not

to scale)

N APOKT U

KKABE

HALGUNDA

CHAMBEBELLUR

I
\

AMATHY
+ R1HP

POLLIBETTA
THOCHAMKERI

i KUTTA
NALKERi'Mi Kivi?

TATACOFFEE LTD HQ

THE CLINIC :

Coorg foundation mobile clinic (CFMC) usually functioned out of the local pancliayal
hail (where ever provided) or the local PRT’s I youth club members provided alternative
place —youth club building / or Anganwadi space was provided.

CFMC doubled up as medical records department (MRD) where the patient had to

register and get his OPD card after being examined by the Doctor (who also kept a
register arid recorded), patient came back tor drugs / laboratory (it necessary) tests and
dressings (if necessary). Registration. Laboratory Test. Chemist, Administrative
Assistant ail these roles were performed by one single individual. The driver provided

physical and moral support to the single staff.

The medical records presented nearly 1500 plus OPD cards but no review has been made
about patient’s revisits and their usage. It looked a very few were regular users where s a

large segment remained as one time user.

There was no epidemiological study made them the medical records. The OPD register

which was with the doctor gave data necessary for a systematic review of the operational
feasibility of the CFMC. As no effort was made by the organization one had to depend

upon the opinions expressed by the attending doctor. No doubt the opinions expressed by

the doctor wore valid and would hold itself — for scientific scrutiny. But in the absence of

a systematic study the information would only be an opinion and no conclusions be
drawn.

The place provided by the local PRT’s was good. However the place had to be vacated
for other programs. For eg. One of the panchayat buildings was the storeroom for food

grains - (mid day meal scheme). 1 he doctor had to sit in a hall and conduct his clinic.
There was no examination Room/Private enclosure for him to examine the patients.
There were places where the local youth chib members/elders of the village had taken

measures to provide such facility to the visiting doctor who had the privacy to examine
tilC paliCHu

The opportunity gained and the confidence built by the doctor with the local population
was good and the community was prepared to pick up creative ideas Tt would be
productive exercise if peoples representatives were called, for a dialogue on the Coorg

Foundation and action plan evolved so that the CFMC would be an landmark.

There were also FRI representatives who did not know Coorg Foundations Philosophy

and its plan of action. Scholarship distribution to meritorious students, providing grants

for the construction of youth club buildings, upgrading playgrounds were mentioned
where as the Mobile Clinic activity took a back scat.

The OPD was very thin. It ranged between 07 to 20 patients during one cycle. It is

necessary io make a costing slimy oi the whole program, so that the lime ol inc
professionals can be optimally used.

A quick review of the OPD registers showed the regular users of the CFMC were diabetic
patients who needed periodic blood check up. Tt was well summarized by a patient. That

“they had to phone the Village Panchayat Office to ascertain the arrival of CFMC, they

then would come to the mobile clinic and get the tests done, t he tests were costed
nominally Assured Quality Drug were the major advantages to patients.

The Diabetic patients came from upper middle class strata (Planters) where as the labor
class and other members of the community who came from lower economic strata were

present in relatively less number.

When ever there was as an emergency for eg. A laborer getting hurt the planter would
himself bring the laborer to CFMC. if it was the day of visit, and the medical treatment

provided.

The other users ol the clinic were old people ol the area who came for advise. Once

again they represented very small segment.

The time span by the team on travel is quite substantial where as the time span on the
actual clinic time is little. It should not be misunderstood that the clinic get closed
earlier. This is primarily because of very thin outpatients.

Reasons that were identified io explain the thin attendance were :

1. The Labour class could not use the facility as they would be working inside the
plantation - since the CFMC arrives during working hours. They will not be able to

use the medical service.

2. The frequency of visit is onece a week. The spectra of non-availability of medical

assistance during emergency is well known, by the service seekers. Hence
alternative avenues are explored by them.

3. CFMC doctor at times is forced to give prescriptions if the drug required for the

patient in question is not available in the mobile clinic. This situation will send the
patient to seek advice and sendee at the same place, preferably the. nearest town.
4. The proximity' io the nearest town gave the freedom to the patient to choose, a doctor

of his choice, who was available at all, times.
5. Absence of lady medical officer in CFMC kept women patients away from clinic.

PATIENTS
‘EXIT INTERVIEW' of the Patients identified following positive points -

1. fhe strict Itenary of the CFMC was appreciated.

2. The concern, of the CFMC staff was appreciated.
3. The quality of drug, the price, laboratory services were sufficient.

Where as

4. absence of lady medical officer was pointed out

5. Uni lateral decision of stopping the mobile clinic periodicity by the authorities was

criticized.
6. The need to conduct multi disciplinary camps especially skin (dermatology) eye

^opthaniv/logy) was iCcjuestcd.
7. The need to rebuild the confidence of community towards RJHP Amathy was
expressed.

Tire lower strata patients who were present during the visit were not able to contribute to

the above process. They did recognize the presence of CFMC, and were happy as long
it met their need. If it was not there they had other alternatives (Private practitioners).
Therefore either the continuity or stoppage ol CFMC did not matter much to them.

PR! Representatives, other Government Lines Staff, General Problems.

During the field work except for one center in all the other centers Panchayatraj

representatives both office bearers and secretary were met and discussions held.

New members who were elected did not even know about the philosophy of Coorg
Foundation, there knowledge about CFMC was absolutely NIL-. 1 he fact that number of
visits which CFMC use to make earlier was reduced, did not prompt these

representatives to voice there protests, to the authorities concerned. They accepted the
fact that thev had not initiated anv dialogue in this regard, with Coorp Foundation

The Government line staff specially Anganwadi workers, and staff of PHC had several

observations to make. Tn the absence of CFMC the poor were left to the exploitations of

private practitioners. A more humane and sensitive approach would have solved
problems of CFMC, and would have been a meaningful input to the people of Coorg.

Willi the Mid-day meal scheme in operation PHC stall had to monitor the programme on

a day io day basis along with other vertical programmes. These additional work drew
them away from their parent departments work. Since the villages were isolated and
scattered, health workers often found it difficult to reach remote areas which were

partially being served by CFMC. The absence of this facility, they felt, would pose
more problems to the deprived-'margenalized communities.

The general public were equally concerned about the CFMC occasional presence.

They

argued that if the}' were also taken to confidence by the powers that be this unique

programme could be a trendsetter to other states.

Coorg Foundation Health Division was not ignorant of these issues in the field. With a
very minimal staff they were trying to handle a problem of high magnitude. Needless to

say should the organization wants to bring aooul equity in there service to the people 01

coorg the need io rejuvenate, reorient, reorganize the programmes which would bring

about remarkable changes in the operation of CFMC is more wanting. The following
suggestions could be considered :

> Involving local PRC’s or Sub Centers: with Karnataka taking a lead in India in the
Health sector - Taskforce in Health, State Health Policy, it would not be a difficult

task to get the active participation of Government Health Department. With a

corporate giant like TATA’s the CFMC could be better bandied. The District Health
Officer could be made a permanent invitee to meetings where local PHC doctors or
his representative participate in meetings conducted by CFMC unit and views

exchanged. The Activity of CFMC should not limit itself to as service providers but

involve community in this task of providing Health care delivery’.

> PPI representatives, local youth club member representatives, women representative
school teachers, anganwadi workers and other important leaders be brought together

in health issues to be the working group over seeing the activism of CFMC and also
providing assistance.

> The route plan of the CFMC and time should be so fixed to coincide with the local
holiday for the laborer, local shandy so that the community' is able to get the
maximum ocncirl from the CFMC.

'r The present method of passing the benefits of drug price to the community is

appreciated, however the iaboratoiy charges could be comparatively raised. It would
be better if a cost benefit analysis be made, to enable the hospital to revise the service
changes.

The need to enlarge the scope of CFMC is felt in Health education.
xoCHvIa^

mg patients and referring them io Apex Hospital ai Amadiy.

> Conducting health education program in the local school.
> Well baby clinic and expectant mothers clinic once every month with the attendance

of lady doctors.

> Involving local anganwadi workers with the help of CDPO (ICDS) Department
would sow the seeds of health related issues with the children.

> The need to identify and train community health workers from among the laborers
themselves could give the program a belter sense of direction.

STAFF :

The existing staffs are small and are tied down to the clinical work. Under the

circumstances they are executing their responsibilities to the optimal level. But with

oetter support irom me community and additional field staff could help the program

move forward. The need to take fresh look at the entire program is necessary.

It is not necessary to withdraw the programme since it has already made its presence and
gained the confidence of the people of the area. Instead the scope could be widened with
the active participation of the community. This opportunity cannot be missed since it

has been painstakingly built.

Help the Aged

A Help the Aged advice leaflet

RADAR

I the disability network

Keeping active and mobile is the key to an independent
life. There is a great deal we can do to remain mobile many conditions which may affect us in later life can be
prevented, eased or even cured altogether by being a little
more active each day.

This leaflet looks at how to remain active and mobile, and
at the range of help and advice available. Addresses of the
helpful organisations mentioned in the text are given at
the end of the leaflet.

Health and fitness
Keeping fit and healthy will help you to stay mobile and
independent. It is never too late to change your diet or take up
some form of exercise to improve your suppleness, strength and
staying power.

Physical activity
Whatever your age, regular, safe and enjoyable physical activity is
an essential part of maintaining a healthy way of life. There are
many benefits, from strengthening bones to ensuring that your
heart and lungs stay in their best condition. The fact that you will
feel better inside and out is a bonus. That doesn’t mean we have
to try and become Olympic athletes; it is just a question of
increasing what we do already.

Being active and taking more
exercise can also be lots of fun!
Age is no barrier to taking up a
new sport or physical activity.
Getting fit has lots of other
advantages too - feeling livelier
and more active, meeting new
people, enjoying a new activity.

2

If you don’t get much exercise at present, it’s a good idea to start
gently and then build up. That way, your body will gradually get
used to being more active, and you are far less likely to strain any
muscles. If you are having medical treatment, talk to your doctor
first before taking up a vigorous activity or exercise.

There are so many different ways to keep fit - you should be able
to find one you enjoy! If you prefer an individual sport, you could
I take up walking, cycling or swimming; if you prefer company, there
are classes and clubs for many activities which are a good way of
meeting like-minded people. Many local authorities run classes for
older people and some have classes specially for people with
medical conditions such as heart disease and arthritis. Ring up
your local sports centre or your council to find out what is
available in your area.

If you have mobility problems at the moment, ask your doctor or
physiotherapist for an exercise programme or class which will
meet your needs. An organisation called EXTEND trains teachers
to give “movement to music” classes to older or disabled people.
If you would like to find out about any teachers in your area, write
to EXTEND, 22 Maltings Drive,Wheathampstead, Herts AL4 8QJ.
Please enclose a stamped addressed envelope, and a cheque or
postal order for £ I, to help cover their costs.

' Overweight?
Surplus pounds can be a health hazard. They make it harder to
enjoy exercise, may make any problems with arthritis worse, and
can increase the risk of heart and chest troubles, diabetes,
backache and varicose veins - all of which are likely to make you
less mobile. If your mobility is severely restricted because of your
weight, then it is time to seek specialist help through your doctor.
If you need to lose weight, the emphasis should be on cutting back
on certain foods (such as very sugary or fatty foods), and not total
restriction.

3

It is very important to have a varied diet so you get all the
nutrients you need for good health. Remember it’s not healthy to
be underweight, either! For further information on a healthy diet,
see Help the Aged’s leaflet “Healthy Eating”.

Smoking
It is never too late to give up smoking. No matter what your age, it
is the single most effective action you can take to improve your
health. Your breathing will become easier, your circulation will
improve and you will reduce the risk of developing diseases which
can restrict your mobility. If you would like advice on giving up
smoking, or cutting down the amount you smoke, the organisation
QUIT has a freephone helpline you can call on 0800 002200.

Arthritis, rheumatism and mobility
Rheumatic diseases affect at least 8 million people in Britain every
year. Pain and stiffening in joints and muscles can seriously affect
your mobility. However, help is available. Your doctor may be able
to prescribe drugs to relieve your symptoms, a physiotherapist can
give help with special exercises and an occupational therapist can
give advice on mobility aids and on protecting your joints. Your
doctor should be able to refer you to a physiotherapist or an
occupational therapist for this sort of help.
You may be interested in alternative forms of medicine. However,
consult your doctor first for a diagnosis of your condition. You can
get details of registered practitioners in different forms of
alternative medicine from the Institute for Complementary
Medicine. Write to the Institute for Complementary Medicine,
PO Box 194, London SE16 IQZ. Please enclose three first-class
stamps to help cover their costs.

4

Help is at hand
If you are having problems getting about, help is at hand! There are
many different kinds of “mobility aids”, and if you find one that is
right for you, you may regain much of your independence. The
simplest mobility aid is a walking stick which can be helpful if just
one of your legs needs extra support. If both your legs need
support, then you may need to use two walking sticks, a walking
frame or a rollator (see below). If you find it very difficult to walk
at all, then you may need a wheelchair. If you are able to walk but
find it difficult or tiring to get about as easily as you used to, then a
“personal vehicle” may be worth considering (see page 8).

Walking sticks, walking frames and rollators
It is important that your walking stick is the correct length. It
should be level with the wrist crease when your arm is held by
your side. If two walking sticks are being used to give balance, they
need to be longer because they will be held in front of you. A
walking stick should have a rubber end called a “ferrule” which
prevents it from slipping. Ferrules wear out quickly so they need
to be checked regularly. Replacements can be bought from large
chemists. Walking frames give even more support, are stable, and
help increase confidence. Rollators are wheeled frames which are
easier to manoeuvre and do not break up the pattern of walking.
They are good for people with moderate balance problems.
Walking sticks, walking frames and rollators are all available free.
Your doctor may refer you to the local hospital’s physiotherapy or
occupational therapy department, or your local social services
department may provide them. Always seek advice from a
physiotherapist or an occupational therapist on which walking
aid is most suitable for you and on how to use it.

5

Wheelchairs
The NHS provides wheelchairs free to people who need them on a
permanent basis. You don’t have to be a full-time user, you may just
need to use one regularly once or twice a week. If you think you
need one, discuss it with your doctor, hospital consultant,
physiotherapist or occupational therapist. They will fill in an
application form and the chair will then be supplied by your local
Wheelchair Centre. In some areas, you may be able to refer
yourself directly to the Wheelchair Centre; ask your local
Community Health Council if this is possible. You will find their
details in your local telephone book.
Wheelchairs come in a wide variety of types and designs, so do
think carefully about your own particular needs. For example,
think about whether you will be using the chair indoors, outdoors
or both. How long will you use it each day? Will you need to
pack it away in a car? Ask your doctor, hospital consultant,
physiotherapist or occupational therapist for advice.

The Disabled Living Foundation, the Mobility Information Service,
the Banstead Mobility Centre and the Mobility Trust can all offer
advice on choosing a wheelchair. Disabled Living Centres have a
range of wheelchairs on display which can be tried out by
appointment. Contact the Disabled Living Centres Council to find
the nearest Centre to you.

You may be able to get a wheelchair on loan from:
•
•
•

your local social services department or hospital
your local British Red Cross (a small fee may be payable)
your local Shopmobility scheme (see page I I)

6

equipment for daily living
If you have restricted mobility, everyday activities such as getting
out of the bath, doing the housework or climbing the stairs, may
begin to cause problems. However, there are a great many aids and
adaptations which can make things very much easier. The Disabled
Living Foundation and Disabled Living Centres can offer advice on
what is available. You may be able to obtain the aids you need
following an assessment by an occupational therapist from your
1 local social services department.

If your home needs to be adapted on a larger scale, you might like
to contact the Centre for Accessible Environments, who are happy
to offer advice to people with disabilities. A local Disabled Living
Centre may display larger equipment such as stairlifts (a chair that
travels along a rail at the side of the stairway) so that you can try
out what is available.
You may also be able to get a disabled facilities grant from your
council to help you with the cost of adapting your home. Your
local social services department or Citizens Advice Bureau should
be able to advise you.

Second-hand equipment
. If you want to buy or sell second-hand equipment, for a small cost
' you can subscribe to the Disability Equipment Register. You will
receive monthly lists of equipment both for sale and wanted. For
an information pack about the register contact: Disability
Equipment Register, 4 Chatterton Road.Yate, Bristol BS37 4BJ.
Telephone: 01454-318818.

A local Disabled Living Centre may also know of second-hand
equipment for sale in your area. Some companies buy and sell
second-hand equipment, such as electric wheelchairs, and these
may come with a limited guarantee.

7

Possible places to see and try out equipment
•

the occupational therapy department of the local hospital

•
•
•

your local social services department
the Disabled Living Foundation
local Disabled Living Centre

Personal vehicles
There are several types of small battery
or petrol-operated “personal vehicles”
available commercially. They can be
driven on pavements at up to 4 mph and
some can be driven into shops. They cost
from about £ 1,500 to buy when new.
Another category of vehicle can be driven on the road at up to 8
mph. It is important to consider local traffic conditions and general
road safety when thinking about buying a personal vehicle.

For further information, see “Powered wheelchairs, scooters and
buggies - a guide to help you choose”, available for £2. 75 from the
Research Institute for Consumer Affairs, 24 Highbury Crescent,
London, N5 I RX. Telephone: 0171-704 5200. The Mobility
Information Service and the Disabled Living Foundation can also
give you advice.

Cars
If you have mobility problems, your own car can make all the
difference to your independence. Several organisations offer
information and advice about buying and driving a car specially
adapted for a person with a disability. These include the Mobility
Information Service, the Mobility Advice and Vehicle Information
Service (MAVIS) and the Banstead Mobility Centre.

8

Notability
An organisation called Notability helps people to use the higher
rate mobility component of their Disability Living Allowance (DLA)
or their War Pensioners Mobility Supplement to buy powered
wheelchairs, personal vehicles and cars through a hire purchase
scheme. However, your DLA or Mobility Supplement won't
necessarily cover all the costs: you may also have to pay a deposit,
the cost of necessary adaptations, insurance, running costs and so
on. Do check exactly what you will need to pay before committing
yourself.

Exemption from VAT and road tax
People with disabilities do not have to pay VAT on equipment for
daily living, wheelchairs, personal vehicles or on cars which have
been specially adapted to carry a disabled person in a wheelchair.
For more details, see leaflet 701/7/94,“VAT reliefs for people with
disabilities”, available free from your local VAT office (look under
“Customs and Excise” in the phone book).
People who receive the higher rate mobility component of
Disability Living Allowance don’t usually have to pay Vehicle Excise
Duty (road tax) on their car. For further information, see RADAR’s
mobility fact pack 3,“Money Matters” available for LI.

Orange Badge Scheme
If you have difficulty walking, or you are registered blind, or you
have a disability which affects both your arms, you may be entitled
to an Orange Badge. You should apply to your local social services
department or if you live in Scotland, to the Chief Executive of
your regional or island council. There may be a small charge. The
Orange Badge can either be used in your own car, or someone
else’s car that you use regularly. The Orange Badge allows you to
park on yellow lines, in spaces marked for disabled people, and at
parking meters with no charge or time limit.

9

The scheme operates throughout England, Scotland and Wales, with
the exception of central London. For further information, you can
get a copy of “The Orange Badge Scheme” leaflet, by writing to the
Department of Transport, Mobility Unit, Zone I /1 I, Great Minster
House, 76 Marsham Street, London SWIP 4DR.

Getting around
If you do not have the use of a car, and you use public transport to
get around, you may be able to get help with your travel costs. If
you have difficulty using public transport, there may be a local
transport scheme which can help.

Public transport
Bus and train passes are available for senior citizens and disabled
people in most areas. They enable you to travel either free, or at a
reduced rate, on local buses and trains. For more details about
what is available in your area, you should contact your local council.

If you travel by train, you can apply for either a Senior Railcard (for
people over 60), or a Disabled Person’s Railcard. For a yearly
charge, the railcard will enable you to buy most rail tickets at a
reduced rate. You can get an application form and further details
from your local station.
Many coach companies also offer discounts to senior citizens. You
should contact your local coach station to find out what they offer.

Local transport schemes
Volunteer drivers use their own cars to provide a door-to-door
service. These schemes are often run by voluntary organisations,
such as the Women’s Royal Voluntary Service (WRVS) and
Volunteer Bureaux. Your local council may also offer a similar
service.

10

Dial-a-Ride/Ring-a-Ride schemes
use converted cars and minibuses
to provide a door-to-door service
for older and disabled people. They
will take you wherever you wish
within a local area. You will need
to book in advance and you may
have to pay a mileage cost.

Shopmobility schemes loan wheelchairs and scooters to help older
disabled people to shop independently. You can get a directory of
all Shopmobility schemes by sending a stamped addressed envelope
with a 39p stamp to the National Federation of Shopmobility.
Some WRVS groups also operate a special shopping service for
people with disabilities. Contact your local WRVS group to find
out what they can offer.

If you live in Greater London and have a disability, you may be
entitled to a Taxicard. This will enable you to use taxis at a
reduced rate. For more details, contact the London Mobility Unit,
New Zealand House, 80 Haymarket, London SWIY 4TZ.
Telephone: 0171-321 2480.

Where to find out about transport schemes in your area
•
•
•
•
•

a disability organisation in your area, or the local
Disablement Information and Advice Line (DIAL)
your local social services department
the Transport Co-ordinating Officer at the council
your local WRVS
Community Transport Association on 0161-367 8780

Travel advice
There are several organisations who offer
information and advice about travel and
transport. Tripscope can help you plan
any trip, whether it is a short everyday
journey or a long distance holiday.
The Holiday Care Service can help
people with mobility problems find an
appropriate holiday. RADAR publishes
an annual holiday guide for disabled people
entitled “Holidays in the British Isles”. This
costs £7.50 including postage and packing.

Financial help
If you are under 65 and have difficulties getting around, you may be
able to claim a social security benefit called Disability Living
Allowance (or DLA). There are two parts to Disability Living
Allowance.
• DLA care component - for people who need help with
personal care.
• DLA mobility component - for people who have difficulty
walking or getting around.

DLA mobility component is paid at two rates:

o Higher rate: to qualify for this rate, you must be unable to
walk, or have great difficulty walking, or be in serious danger if
you do walk.
o Lower rate: you can qualify for this rate even if you can walk.
However you must need guidance or supervision from
someone else to make sure you are safe or to help you find
your way around in a strange place.
12

To claim DLA, your disability must have started before the age of
65 and you must claim before your 65th birthday. If you qualify
for DLA, you will either receive it for life or for a fixed term.
The higher rate of DLA mobility component can be used to help you
buy a powered wheelchair, a personal vehicle or a car through the
organisation Notability (see page 9 of this leaflet for more details).

p Sadly, if you become disabled after your 65th birthday, you can’t get
extra money to help with the costs of getting around. However, you
may be able to claim a benefit called Attendance Allowance to
help with the costs of your personal care.
For further information on Disability Living Allowance and
Attendance Allowance, see Help the Aged's leaflet “Claiming
Disability Benefits”.

Incapacity Benefit and retirement

e

Incapacity Benefit replaced Invalidity
Benefit and Sickness Benefit from
13 April 1995. Generally, you can’t
claim Incapacity Benefit after reaching
pension age (60 for women, 65
for men).

If you are receiving Incapacity Benefit
when you reach pension age, you will
either remain on Incapacity Benefit,
or change to the State Retirement
Pension. This will depend on which
rate of Incapacity Benefit you are
receiving. Help the Aged’s leaflet
“Claiming Disability Benefits” gives
details about Incapacity Benefit, and how it
affects people who were on Invalidity Benefit.

13

Helpful addresses
DIAL UK
(Disablement Information and
Advice Line)

Arthritis Care
18 Stephenson Way
London NWI 2HD
Tel: 0171-916 1500
Helpline 0800 289 170
(l2-4pm, Mon-Fri)

Park Lodge,
St Catherine’s Hospital
Tickhill Road
Balby, Doncaster
South Yorks DN4 8QN
Tel: 01302-310123

Banstead Mobility Centre
Damson Way
Fountain Drive
Carshalton
Surrey SM5 4NR
Tel:OI8l-77O 1151

Disability Scotland
Princes House
5 Shandwick Place

Edinburgh EH2 4RG
Tel: 013 1-229 8632

British Red Cross Society
9 Grosvenor Crescent
London SWIX 7EJ
Tel: 0171-235 5454

Disability Wales
Llys Ifor
Crescent Road
Caerphilly
Mid Glamorgan CF83 IXL
Tel: 01222-887325

Centre for Accessible
Environments
Nutmeg House
60 Gainsford Street
London SEI 2NY
Tel: 0171-357 8182

Disabled Living Centres
Council
c/o Disabled Living Centre
TheVassall Centre
Gill Avenue
Bristol BSI6 2QQ
Tel: 01 179-585 130

Citizens Advice Bureau
See your local telephone book

Community Health Council
See your local telephone book

Disabled Living Foundation
380-384 Harrow Road
London W9 2HU
Helpline: 0870 603 9177

14

Holiday Care Service

National Federation
of Shopmobility

2nd Floor
Imperial Buildings

85 High Street

Victoria Road

Horley

Worcester
WR1 2ET

Surrey RH6 7PZ

Tel: 01905-617761

Tel: 01293-774535

•

RADAR (Royal Association
for Disability and
Rehabilitation)

Mobility Advice and Vehicle
Information Service (MAVIS)
OWing
Macadam Avenue

12 City Forum
250 City Road
London ECIV8AF

Old Wokingham Road Crowthorne
Berkshire RG45 6XD
Tel: 01344-661000

Tel: 0171-250 3222

Social Services Department

Mobility Information Service

see telephone book under the

Unit 2,Atcham Estate
Shrewsbury
Shropshire SY4 4UG
Tel: 01743-761889

name of your local council

Tripscope
The Courtyard
Evelyn Road
London W4 5JL
Tel: 08457 585641

Mobility Trust
A 50 High Street
Hungerford
Berkshire RGI7 0NE
Tel: 01488-686335

WRVS
see your local telephone book or
contact:
WRVS Headquarters
Milton Hill House
Milton Hill
Abingdon
Oxfordshire OX 13 6AF
Tel: 01235-442900

Motability
Goodman House
Station Approach
Harlow
Essex CM20 2ET
Tel: 01279-635666

15

Help the Aged produces a range of free advice leaflets for senior citizens.
Financial Leaflets
© Can You Claim It?
9 CheckYourTax
9 Claiming Disability Benefits

O Managing A Lump Sum
O Questions on Pensions
O Thinking About Money

Housing and Home Safety Leaflets
• Fire
• Housing Matters
• Keep Out the Cold
9 Living Alone Safely

© Residential Care
9 Safety in Your Home
• Security in Your Home

Health Leaflets
O
O
C
9
9
G

Bereavement
Better Hearing
Better Sight
Fight the Flu
Fitter Feet
Healthy Bones

O
®
®
©
9

Healthy Eating
Incontinence
Keeping Mobile
Managing Your Medicines
Shingles

For copies of any of these leaflets, please write to the Information Department.

You can also contact Help the Aged for information about:
®
9
a
O
9

SeniorLine - Help the Aged’s advice and information service on 0808 800 6565
SeniorLink - special telephones and pendants to call for help - call 01483-729678
Gifted Housing - donation of your home in return for life-long care
Will Information Pack - information relating to making or changing your will
Insurance - contact Help the Aged Insurance Services on 0800 41 31 80

This leaflet is endorsed by the Royal Association for Disability and
Rehabilitation (RADAR).

Help the Aged
St James’s Walk
London ECIR OBE
Telephone: 0171-253 0253

Help the Aged

SeniorLine is a free national advice and information service run by
Help the Aged for senior citizens, their relatives, carers and friends.
Telephone: 0808 800 6565
Minicom: 0800 26 96 26
9am to 4pm, Monday to Friday.Your call will be free of charge

Company limited by guarantee. Registered in England No. 1263446. Registered Charity No. 272786.

Spring 1999

Media: RF_COM_H_78_SUDHA.pdf

Export

Not viewed