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Mr. Wareing : To ask the Secretary of State for Health if he has any plans to increase the budget of the Committee on Safety of Medicines.

Mr. Mellor : Budget allocations for 1988-89 are still under consideration.

Tranquilliser Addiction

Mr. Wareing : To ask the Secretary of State for Health if he will introduce legislation to enable him to fund local groups formed to combat tranquilliser addiction.

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Mr. Mellor : My right hon. and learned Friend the Secretary of State has powers under section 64 of the Health Services and Public Health Act 1968 to make grants to voluntary organisations. These grants are usually made to national organisations for their headquarters costs rather than to local bodies.

Health authorities also have powers to make grants to voluntary organisations. They are responsible for the development of services locally, which may include funding voluntary organisations. We have allocated £9.5 million in the current financial year to regional health authorities specifically for the development of services for those experiencing problems with drugs, including prescribed drugs such as tranquillisers.


Mr. Nigel Griffiths : To ask the Secretary of State for Health if he will give the estimated numbers of people dying from hypothermia and the number of other cold-related deaths for each year since 1980 ; and if he will outline the steps being taken by his Department to reduce the numbers of such deaths.

Mrs. Currie : The numbers of deaths where hypo-thermia is recorded on the death certificate, either as primary or secondary cause of death, for England and Wales, are as follows :

Year             |Number of Deaths                 


1980             |596                              

1981             |685                              

1982             |664                              

1983             |538                              

1984             |555                              

1985             |827                              

1986             |837                              

1987             |<1>559                           

1988             |<2>363                           

<1> Provisional.                                   

<2> Provisional figure, to end of November.        

Many causes of death are cold-related, in that the number of deaths from them increases in winter. However, hypothermia is the only cause that can be directly identified as a cold-related disease from mortality statistics.

We have again this winter launched the "Keep Warm Keep Well" campaign, in co-operation with Age Concern, Help the Aged and Neighbourhood Energy Action to offer advice on sensible self-help and the help available from statutory and voluntary services. I have sent a copy of the campaign booklet to the hon. Member and placed copies in the Library. Further copies can be obtained by telephoning the winter warmth helpline on 0800 289404.


Mr. Alton : To ask the Secretary of State for Health if he will meet representatives of midwives working in the Merseyside regional health authority's area to discuss their grievances concerning regrading.

Mr. Kenneth Clarke : I shall be meeting national representatives of the Royal College of Midwives, including the president and the general secretary, on Wednesday 7 December. I cannot intervene directly in individual grievances which can be resolved by employing

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authorities following the agreed appeal process. I suspect that much of the sense of grievance felt by some midwives in Merseyside is caused by misunderstanding of the basis of the grading exercise which the Royal College of Midwives and other trades unions agreed to.

Mr. Alton : To ask the Secretary of State for Health whether any account was taken of length of service or clinical experience when regrading midwives by the Mersey regional health authority.

Mr. Kenneth Clarke : The Health Service trades unions and management agreed that the grading of midwifery posts should be determined on the basis of the duties and responsibilities of postholders at 1 April 1988. The grading definitions reflect the different levels of clinical experience and responsibility called for in different posts and the grades allocated to midwives therefore take account of their clinical skills. Because the agreement entered into by the Royal College of Midwives and the other parties specified that posts and not individuals were being graded, length of service was not taken into account in determining grading.

Mr. Alton : To ask the Secretary of State for Health how many deliveries were carried out by midwives in each of the last five years ; and what percentage this is of the total number of deliveries.

Mr. Mellor : We do not hold this information centrally.

Mr. Alton : To ask the Secretary of State for Health what account is taken when regrading midwives of the training and completion of a certificate in midwifery by practitioners.

Mr. Kenneth Clarke : All holders of midwifery posts are required to possess the qualification of registered midwife (RM) and this is the only registrable qualification which is needed to practise as a midwife. Possession of this qualification entitles the holder of a midwifery post to be placed at least as grade D in the new grading structure--agreed by Health Service trade unions and management.

Mr. Alton : To ask the Secretary of State for Health how many years' experience a midwife needs before she achieves grade G.

Mr. Kenneth Clarke : Health Service trades unions and management have agreed that grading should be determined by the duties and responsibilities of the post held by the individual not by the number of years he or she may have spent in midwifery practice. Therefore the grading definitions do not prescribe periods of experience.

Organ Transplants

Sir Michael McNair-Wilson : To ask the Secretary of State for Health what are the latest figures for organ transplants in the United Kingdom, organ by organ ; and what has been the variation in availability of organs over the past five years.

Mrs. Currie : The latest figures provided by the United Kingdom Transplant Service of organ transplants in the United Kingdom from 1 January 1988 to 25 November 1988 are as follows :



Kidneys    |1,500            

Hearts     |255              

Heart/Lung |93               

Lungs      |16               

Livers     |219              

Corneas    |<1>1,336         

<1> Estimated figure.        

It is not possible to give precise figures for the variation in availability of organs. However, the number of kidney transplants roughly reflect the variation in donor organ availability. The full-year figures for kidney transplants for the last five years were :

Year Kidneys

1983 1,144

1984 1,443

1985 1,336

1986 1,493

1987 1,485

From January 1989, health authorities will be asked to audit all deaths in intensive care in order to assess the number of potential organ donors.

Foreign Patients (Treatment)

Mr. Bernie Grant : To ask the Secretary of State for Health, pursuant to his answer to the hon. Member for Tottenham, Official Report, 30 November, which countries have arrangements which enable them to refer patients for free treatment in the United Kingdom under the National Health Service ; what these arrangements are ; and why these arrangements do not apply to British dependencies in the Caribbean.

Mr. Mellor : There are bilateral health agreements between the United Kingdom and 25 other signatories. Generally these provide only for immediately necessary treatment for conditions arising during the course of a visit. However, seven of these agreements allow for patients to be referred to the United Kingdom specifically for treatment free of charge. The grounds for allowing this vary : for the Channel Islands, the Isle of Man, Malta and Gibraltar, the referral provision aims to achieve a balance of costs of providing health care to visitors on each side ; similar considerations apply in the agreement with Yugoslavia ;

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for the USSR, the provision is to enable patients from both countries to benefit from certain highly specialised care ; for the Falkland Islands, the provision was made to take account of the particular difficulties faced by the islanders in obtaining specialist care following the conflict with Argentina.

We are not aware of similar considerations applying in the case of residents of the British territories in the Caribbean.

Mental Illness

Mr. Goodlad : To ask the Secretary of State for Health if he will list by health regions the mental hospitals which are scheduled to (a) open and (b) close in (i) the current and (ii) the next year.

Mrs. Currie [holding answer 28 November] : The table lists the mental illness hospitals which are, so far as we are currently aware, scheduled to open or close in (i) 1988-89 and (ii) 1989-90.


Regional Health Authority |Open                     |Close                                              


Yorkshire                 |-                        |Broadgate (ii)                                     

Trent                     |-                        |St. John's Lincoln (ii)                            

North-East Thames         |East Ham Memorial (ii)   |-                                                  

South Western             |Glenside (i)             |Horton Road (i)                                    

West Midlands             |-                        |Powick (i)                                         

Oxford                    |Campbell (ii)            |-                                                  

(i) 1988-89.                                                                                            

(ii) 1989-90.                                                                                           


Agency System

56. Mr. Rowe : To ask the Minister for the Civil Service whether he can announce any further progress on the setting-up of the agency system.

Mr. Luce : Two agencies have been set up, about 30 more have been announced and more are in the pipeline. I shall be making a progress report to the House before too long.


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