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Column 75average waiting list times and numbers of patients currently on the waiting lists for ophthalmological procedures in (a) the Oldham health authority, (b) the health authorities covering the Greater Manchester area and (c) on average in England and Wales.
Ophthalmology Departments, NHS hospitals, England |Number of patients<1> on|Median waiting time of |in-patient waiting list |patients treated<2> |at 31 March 1988 |during quarter ending 31 |March 1988 -------------------------------------------------------------------------------------------------------- Oldham DHA |712 |20 weeks Greater Manchester area<3> |5,772 |Not available Average for the 152 DHAs in England which provide 420 in-patient treatment |approx. |11 weeks <1>On a comparable basis with previous statistics. <2>In-patients and day cases. <3>Aggregate of 12 DHAs.
Mr. Ashley : To ask the Secretary of State for Health if he will set up an independent committee to investigate the way in which the General Medical Council deals with complaints against doctors and to make recommendations for the future ; and if he will include on the committee representatives from his own Department, the Ombudsman's office, the Lord Chancellor's office, the Association of Community Health Councils, the Patients Association and the Consumers' Association.
Mr. Mellor : The GMC is an independent statutory body. In 1987 it established a working party to review the procedures of the council in relation to disciplinary cases in which it is alleged that a doctor has seriously neglected or disregarded his professional responsibilities to patients. The GMC sought evidence from organisations representing patients and the health professions. We have no plan to set up a separate independent committee.
Mr. Ashley : To ask the Secretary of State for Health what is the current membership of the General Medical Council ; how many members are (a) elected doctors and (b) lay people ; and if he will take steps to increase the number of lay people on the General Medical Council so that there is no majority of elected doctors.
The Medical Act 1983 provided that there should be a majority of elected members over other members. We have no plans to change the legislation.
Mr. Ashley : To ask the Secretary of State for Health if he will take steps to require the General Medical Council to deal with all complaints referred to it rather than rely on its present policy of first requiring a National Health Service investigation that establishes that there is a serious case.
Column 76determine cases of serious professional misconduct in whatever way it considers appropriate. I understand that the GMC has no general policy of referring complaints to the relevant NHS authority but that each case is looked at on its merits. However, where appropriate the council will advise complainants if a matter appears suitable for investigation by the NHS.
Mr. Ashley : To ask the Secretary of State for Health what information about medical complaints made to the General Medical Council regarding doctors working in (a) private medicine, (b) the National Health Service, (c) the prison medical service, (d) the forces medical service, is routinely passed on to his Department ; in the last year for which figures are available, how many such complaints were received by the General Medical Council ; and how many were rejected by (i) General Medical Council staff, (ii) the preliminary screener, (iii) the preliminary proceedings committee, (iv) the professional conduct or health committees.
Mr. Ashley : To ask the Secretary of State for Health if he will require the General Medical Council to adopt identical procedures for handling all the medical complaints it receives, regardless of whether they concern doctors operating in the National Health Service, in private medicine or in the prison or forces medical services.
Mr. Mellor : It is for the General Medical Council to determine its procedures, but there are lay members on each General Medical Council committee which considers cases in which a question of serious professional misconduct arises.
Mr. Ashley : To ask the Secretary of State for Health if he will take steps to ensure that transcripts are made of all hearings before the professional conduct committee of the General Medical Council, and that these are made available to all interested parties at reasonable cost.
Mr. Mellor : The GMC is required to arrange that a shorthand writer is appointed to take notes of hearings before the professional conduct committee. The solicitor to the council is required to provide on request a transcript of those parts of the proceedings at which the parties are entitled to be present. The charges levied for such transcripts are a matter for the GMC.
Mr. Mellor : The 1987 annual report of the GMC refers to a statement approved by the council on this matter. The council considers deliberate falsification of case notes to be unethical and a doctor so doing is liable to disciplinary proceedings if reported to the council.
Mr. Ashley : To ask the Secretary of State for Health how many doctors with qualifications obtained only from other European Economic Community countries have been registered by the General Medical Council ; what proportion this is of all registered doctors ; and, in the past five years, what has been the rate of change of applications for registration from European Economic Community trained doctors.
Mr. Mellor : We have figures only for the period June 1976 to December 1987 in which the GMC registered 3,301 doctors who obtained their qualifications in other EC states. We do not have information on how many have taken up practice or remained on the register and this figure cannot be directly compared with the total of 136,959 doctors registered.
The figures for EC doctors registered in the past five years and the rates of change are given in the table.
|Registrations|<1>per cent. -------------------------------------------------------- 1983 |325 |+ 40 1984 |300 |- 8 1985 |332 |+ 11 1986 |443 |+ 33 1987 |995 |+125 <1>Increase/decrease on previous year.
Mr. Ashley : To ask the Secretary of State for Health how many doctors with qualifications obtained only from countries outside the European Economic Community have been registered by the General Medical Council ; what proportion this is of all registered doctors ; and, in the past five years, what has been the rate of change of applications for registration from non-European Economic Community trained doctors.
Mr. Mellor : I regret that we do not have information on the total number of doctors on the medical register who qualified outside the European Community. Since 1980 a total of 21,596 such doctors have been registered. We do not have information on how many took up practice or remained on the register and this figure cannot be directly compared with the total of 136,959 doctors registered at the end of 1987.
The number of overseas doctors registered in the last five years and the rates of change are given in the table.
Year |Registrations|Percentage<1> -------------------------------------------------------- 1983 |1,996 |-11 1984 |2,052 |+3 1985 |1,991 |-3 1986 |1,955 |-2 1987 |2,151 |+10 <1> Increase/decrease on previous year.
Column 78any other body to ensure that all doctors trained in other parts of the European Economic Community or in non- European Economic Community countries meet standards of professional training equivalent to those laid down by the royal colleges.
Mr. Mellor : Under the terms of the Medical Act 1983 the General Medical Council accepts for registration the primary qualifications laid down in EC directives for recognition within member states. The Act also specifies that doctors from non-EC countries must have qualifications which the council can accept as equivalent to those required for United Kingdom registration. The General Medical Council also has a general function to assess which postgraduate EC qualifications are equivalent to United Kingdom counterparts. There are no equivalent formal provisions for doctors who have obtained postgraduate qualifications in non EC-countries, but the medical royal colleges are considering ways of assessing the post graduate qualifications of non-EC doctors applying under their sponsorship schemes.
Mr. Ashley : To ask the Secretary of State for Health in the past five years, whether the General Medical Council has provided him with information regarding the cases that have come before their professional conduct committees ; and whether any of these originated from an individual's complaint.
The minutes of the professional conduct committee are published by the GMC and indicate whether a case originates from an individual complaint.
Mr. Ashley : To ask the Secretary of State for Health what procedures there are to ensure that practising doctors keep abreast with advances in medical knowledge ; and to what extent these are controlled by his Department.
Mr. Mellor : Every registered medical practitioner is responsible for keeping up to date with medical knowledge appropriate to his or her chosen specialty. We allocate funds for the provision of courses and other educational activities and for the expenses of attending such activities. The content of educational activities is largely determined by the profession itself.
As the White Paper "Promoting Better Health" states (paragraph 3.48), we propose to introduce a new postgraduate education allowance payable to family doctors who maintain regular programmes of education and training throughout their careers.
Mr. Mellor : We are seeking the views of the professional bodies on the duties to be placed on sight testers as part of our consultations on implementing the optical provisions of the Health and Medicines Act. We shall consider any proposals they may make for conducting an examination of the eye to detect injury, disease or abnormality.
Mr. Ashley : To ask the Secretary of State for Health if, in addition to the arrangements he is making for blood relatives of those who have glaucoma to be identified and advised to have an eye test, he will provide for these tests to be free.
Mr. Ashley : To ask the Secretary of State for Health if he anticipates any increase or decrease in the numbers of people suffering from glaucoma in the next five years ; and which age groups will be most affected.
Mrs. Currie : The prevalence of glaucoma increases with age. Due to an increasingly aging population it is likely that the numbers of people suffering from glaucoma will increase in the next five years. The age group most affected will be those over 60.
Mrs. Currie : The figures giving the number of registrations due to blindness caused by glaucoma are collated only every 10 years. In the year ending 31 March 1981, the latest date for which figures are available, there were 1,149 new blind registrations as a result of glaucoma. We do not have information on how many of these resulted from failure to detect the disease at an early stage. However, people with a close relative who has glaucoma who are themselves over the age of 40 should ensure that they have a regular eye check.
Mr. Ashley : To ask the Secretary of State for Health (1) how many new cases of glaucoma are detected each year on average ; (2) how many people suffer from glaucoma ; and how many of them are being medically treated.
The estimated total number of in-patient admissions treated in National Health Service hospitals in England for glaucoma in 1985, the latest year for which data are held centrally, was 13,510.
Column 80including those less well off and competition in the optical market should keep any private fees at modest levels. Opticians will determine the level of any fees for those not entitled to an NHS sight test. We believe that people will continue to have periodic sight tests as at present.
Mr. Mellor : I refer the hon. Member to my reply to the hon. Member for Romsey and Waterside (Mr. Colvin) on 14 November 1988 at column 476 which lists the number of sight tests in the years 1978 to 1987.
Mr. Mellor : The most common cause of registered blindness in England at all ages is degeneration of the macula and posterior pole. For children up to 15 years of age the most common cause is congenital abnormalities of the eye, and for the 16 to 64 group it is diabetic retinopathy.
Mr. Mellor : We have no current plans to review the system for dealing with negligence claims. Negligence is determined in the courts. The civil justice review has examined court procedures. Its recommendations to speed up and to reduce the costs of litigation are under consideration.
Mr. Fearn To ask the Secretary of State for Health if he will publish a list showing how nurses and midwives were regraded in each district health authority in the Merseyside region and the guidelines used in this regrading exercise ; and if he will specify (a) the amount of finance allocated to Southport and Formby health authority and the national average sum allocated to health authorities and (b) the grades awarded to Southport and Formby health authority and those awarded nationally.
Mr. Mellor : I refer the hon. Member to my replies to my hon. Friend the Member for Staffordshire, Moorlands (Mr. Knox) on 28 November 1988 and to the hon. Member for Warrington, North (Mr. Hoyle) on 2 December 1988.
Nursing and midwifery staff (including agency staff<1>) England 30 September 1987 Regional health authority |Wholetime equivalent<2> ------------------------------------------------------------------------------------------ England |404,040 Northern |27,540 Yorkshire |30,390 Trent |37,970 East Anglian |15,980 North West Thames |27,790 North East Thames |34,320 South East Thames |30,780 South West Thames |23,930 Wessex |23,160 Oxford |17,180 South Western |27,430 West Midlands |43,180 Mersey |22,020 North Western |37,250 London Post Graduate Special Health Authorities |5,140 Source: Department of Health Annual Census of NHS Non-Medical Manpower. <1>Includes all qualified registered and enrolled nurses, midwives, learners and unqualified nursing staff. <2>Figures are independently rounded to nearest ten (10) wholetime equivalents.
Ms. Harman : To ask the Secretary of State for Health what instructions have been issued by him to members of employing authorities who formally hear the appeals from nurses arising from the regrading exercise.
(2) if he will specify for each of the last three years how many nurses lodged formal appeals within each region.
Mr. Bernie Grant : To ask the Secretary of State for Health whether his Department is monitoring the regrading exercise for nurses, on the basis of racial or ethnic origins ; and if he will make a statement.
Ms. Harman : To ask the Secretary of State for Health if he will make it his policy to meet staff side representatives to discuss the negotiations over nurses and midwives and to accept their requests for binding arbitration.
Mr. Kenneth Clarke : I am meeting representatives of the Royal College of Nursing today and representatives of the Royal College of Midwives on 7 December. I am not prepared to meet representatives of those trades unions whose members are taking part in industrial action over the current regrading exercise while that industrial action continues.
Column 82I should also make it clear that negotiations over the terms and conditions of nurses' and midwives' employment are a matter for the relevant Whitley council. I cannot take over the role of the Whitley council management side and direct meetings between me and trade union leaders should not be seen as a substitute for Whitley council discussions. In any event, I see no scope for arbitration over the details of a regrading exercise which has now been satisfactorily completed after years of negotiation with trades unions which wanted a new grading structure.
Mr. Hinchliffe : To ask the Secretary of State for Health (1) what charge the public health laboratory service laboratory at Seacroft, Leeds, is proposing to make to the Wakefield health authority for monitoring its cook-chill catering ;
(2) if he will list those members of staff of the Leeds public health laboratory service who advised the Yorkshire regional health authority on the safety of cook-chill catering.
Mr. Hinchliffe : To ask the Secretary of State for Health if any representative of Her Majesty's Government or the public health laboratory service attended the major conference on listeria monocytogenes at Rohnert Park, California, between 2 and 5 October.
Mr. Wareing : To ask the Secretary of State for Health how many of the reports of suspected adverse reactions received by the Committee on Safety of Medicines during 1986 and 1987 were submitted by pharmaceutical companies.
|£ ---------------------------------------------- Members' fees and expenses |95,000 Communications with doctors: "Current Problems" |85,000 Viewdata |34,000 Follow-up of yellow cards |15,000 Other means |9,000 Other administrative expenses |25,000 Contingency Reserve-not spent |197,000 |------- |460,000 Note: £29,000 of the reserve originally earmarked for the production costs of a video, "Help Make Medicines Safer"-to encourage doctors to report adverse reactions-was met from another DHSS budget. Reserves were also held in case an urgent safety warning to doctors had been needed.
Date <1>Members ---------------------------- 1986 30 January |20 |(3) 27 February |15 |(1) 26 March |17 |(2) 30 April |16 29-30 May |20 |(2) 26 June |16 24 July |19 |(4) 25-26 September |18 |(3) 23 October |15 20 November |16 18 December |17 |(1) 1987 29 January |18 26-27 February |23 |(4) 26 March |20 30 April |17 27-28 May |23 |(3) 25 June |18 23 July |17 24 September |17 |(2) 29-30 October |19 |(2) 26 November |20 17 December |20 <1> For all or part of proceedings. Note: The number in brackets is the number of those present who were appointed as temporary members for the meeting in question.
Mr. Wareing : To ask the Secretary of State for Health who is the present chairman of the Committee on Safety of Medicines ; who is responsible for the appointment ; what is the term of office of the chairman ; and if it is renewable.
Mr. Mellor : Professor William Asscher BSc, MD, FRCP, dean of St. George's hospital medical school, London. The appointment was made by Health Ministers for a renewable period of three years which expires on31 December 1989.
Mr. Wareing : To ask the Secretary of State for Health how many of the current members of the Committee on Safety of Medicines are women ; whether he has any plans to increase the number of women members ; and if he will make a statement.
Column 84Campaign and the Women's National Commission, to make suggestions for membership appointments to the committee, as well as to the Medicines Commission, Committee on Review of Medicines and Committee on Dental and Surgical Materials, to serve from January 1990. We will appoint the members we consider best qualified to carry out the committee's statutory functions. The letter inviting names for nomination includes the following :
"Ministers would be pleased to increase the proportion of women members on these bodies, so women with appropriate expertise and experience would be particularly welcome."
A copy of the letter has been placed in the Library.
Name of Member |Meetings Attended |Possible Attendance ------------------------------------------------------------------------------------------- Professor A. W. Asscher |21 |22 Professor T. G. Booth |8 |<2>11 Professor A. M. Breckenridge |21 |22 Professor C. M. Castleden |7 |<1>11 Professor J. G. Collee |11 |<2>11 Mr. W. M. Darling |9 |<1>11 Professor J. W. Dundee |9 |<1>11 Professor P. H. Elworthy |22 |22 Professor A. T. Florence |16 |22 Professor Sir Abraham Goldberg |11 |<1>11 Professor D. G. Grahame-Smith |10 |<1>11 Professor M. W. Greaves |16 |22 Dr. J. M. Holt |10 |<1>11 Professor David Hull |7 |<1>11 Professor H. S. Jacobs |16 |22 Dr. W. A. Jerrett |11 |<2>11 Professor M. J. S. Langman |9 |<3>12 Professor D. H. Lawson |9 |<2>11 Mr. F. E. Loeffler |11 |<2>11 Dr. E. Mayne |10 |<2>11 Professor J. O'D McGee |10 |<2>11 Professor A. E. M. McLean |11 |<3>12 Professor S. R. Meadow |10 |<2>11 Dr. S. A. Montgomery |11 |<2>11 Professor G. Nuki |10 |<2>11 Dr. B. L. Pentecost |18 |22 Professor M. D. Rawlins |19 |22 Dr. J. W. G. Smith |6 |<1>11 Professor M. P. Vessey |19 |22 Dr. D. M. B. Ward |8 |<1>11 Professor H. K. Weinbren |10 |<1>11 <1> 1986 only. <2> 1987 only. <3> Member in 1987; appointed for only one meeting in 1986.