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Mr. Mellor : The resource allocation working party formula governs allocation to regional health authorities. In making allocations to district health authorities, regions are not expected strictly to follow RAWP principles. The Wessex regional health authority in 1988-89 allocated revenue resources of £81,326,000 to east Dorset and £40,188,000 to west Dorset. Since 1982, when they were established, east Dorset's allocation has increased by 15.4 per cent. in real terms. West Dorest, which is nearer to its regional target, has received a 4.1 per cent. increase.

Children in Distress

14. Miss Lestor : To ask the Secretary of State for Health if he will introduce precautionary measures to prevent unsuitable individuals from establishing telephone counselling services for children in distress ; and if he will make a statement.

Mrs. Currie : No. I have no reason to believe that this is necessary. If the hon. Member has evidence of unsuitable operation of such services she should send it to the police and the director general of Oftel Telecommunications.

AIDS and HIV

15. Mr. Tony Banks : To ask the Secretary of State for Health if he will adopt as his policy the model policy and guidance on AIDS and HIV infection services provided by the Association of London Authorities.

Mr. Mellor : It is important that local authorities should respond positively to the challenge of HIV infection and AIDS. Government Departments have issued guidance to assist authorities in this, but it is for individual authorities to decide whether and to what extent they wish to adopt the model policy developed by the Association of London Authorities.

27. Mr. Strang : To ask the Secretary of State for Health what representations he has received following his announcement that health authorities will screen patients anonymously for HIV.

79. Mr. Yeo : To ask the Secretary of State for Health what representations he has received regarding his decision to introduce anonymous blood tests for AIDS.

Mr. Mellor : None.

32. Sir David Price : To ask the Secretary of State for Health if he will give his reasons for not accepting the advice of the Select Committee on Social Services relating to the anonymised screening of blood for HIV.

Mr. Mellor : I refer my hon. Friend to the reply given by my right hon. and learned Friend the Secretary of State to the hon. Member for Edinburgh, East (Mr. Strang) on 2 December at columns 439-40.

Patients (Statistics)

17. Mr. Knox : To ask the Secretary of State for Health how many patients were treated in National Health


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Service hospitals in the most recent year for which figures are available ; and what were the comparable figures for 1978-79.

Mr. Mellor : There were 6.62 million in-patient cases treated in National Health Service hospitals in England during the 1987-88 financial year. Earlier figures were for calendar years and in 1979 5.40 million in- patient cases were treated, a rise of over a million or more than 22 per cent.

Mentally Handicapped People

18. Mr. Devlin : To ask the Secretary of State for Health what new proposals his Department has to improve care for the mentally handicapped.

Mrs. Currie : Our current policy is to develop at local level, in collaboration with statutory and voluntary agencies, a comprehensive and integrated range of health and social services for mentally handicapped people and their families.

To this end the Department this year issued guidance to health authorities that by 1991 every district should have policy statements and action plans for meeting the needs of mentally handicapped people including those with special needs.

Grading

20. Mr. Fearn : To ask the Secretary of State for Health if he has any plans to meet representatives of the nursing unions to discuss the regrading of nurses and midwives.

24. Mr. Canavan : To ask the Secretary of State for Health whether he will now arrange to meet trade union representatives of Health Service employees to discuss regrading.

Mr. Kenneth Clarke : I met representatives of the Royal College of Nursing on 5 December 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 action continues.

I 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.

28. Ms. Mowlam : To ask the Secretary of State for Health what representations he has recently received from nursing unions concerning the current regrading procedure.

49. Mr. Evennett : To ask the Secretary of State for Health what representations he has recently received concerning the regrading of midwives by district health authorities.

Mr. Kenneth Clarke : I have received a number of representations about the re-grading exercise for nurses and midwives, including some from trade unions. I have made it clear, however, that I will not meet representatives of trade unions engaged in attempting to organise industrial action. Neither the Royal College of Nursing nor the Royal College of Midwives have done so and I


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therefore met representatives of these Colleges on, respectively, 5 and 7 December. Both unions joined me in condemning industrial action, and agreed to support measures designed to help the appeals process work more quickly and effectively. We agreed to continue our efforts to dispel some misunderstandings which appear to have arisen over the regrading exercise. As a result of these friendly and constructive meetings, I am more certain than ever that the new grading structure will come to be seen as a turning point in securing a properly rewarded career structure for the country's nurses and midwives.

33. Mr. Illsley : To ask the Secretary of State for Health what percentage of nurses who have received a new grade under the recent review procedures (a) nationally and (b) in the Barnsley district health authority have appealed against their grade.

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

64. Mr. Win Griffiths : To ask the Secretary of State for Health how many appeals have been made by nurses against their new grading ; and when he expects the appeals procedure to be completed.

78. Mr. Nellist : To ask the Secretary of State for Health how many appeals are currently being heard concerning health workers' regrading ; and if he will make a statement.

Mr. Kenneth Clarke : Appeals against grading are a local matter and we do not hold information centrally on the number of appeals lodged. I recognise the importance of dealing with appeals quickly as well as fairly and I have


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asked RHA chairmen to adopt a number of measures designed to speed up the appeals system. These include setting up officer level investigations to resolve any obvious mistakes and points of difficulty before the formal appeal stage is reached, and establishing wherever possible more than one appeals' panel. The great majority of officer level investigations for current appeals can be completed by the end of January, and I shall be discussing with chairmen whether it will be possible to have completed the appeals process locally by the spring. However, I have made it clear that no appeals will be heard in any unit from staff who are not working normally so long as they continue their industrial action.

65. Mr. Tim Smith : To ask the Secretary of State for Health if he will make a statement on the nurses' grading dispute.

Mr. Kenneth Clarke : The vast majority of nurses and midwives are working normally and are very satisfied with the outcome of this year's pay award and the associated regrading exercise. This is hardly surprising because it gives them an average pay increase of 17.9 per cent. at a cost to the taxpayer of almost £1,000 million.

Mr. Morley : To ask the Secretary of State for Health how many nursing, midwifery and health visiting staff from each of the old grades have been assimilated to each of the new grades in the recent clinical grading structure in Scunthorpe district health authority.

Mr. Mellor [holding answer 12 December 1988] : The information requested is given in the table.


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The new clincial grading structure for nursing, midwifery and health visitor staff                                                                                                                 

Percentage of old clinical grades assimilated to each of thenew clinical grades on the basis of duties and responsibilities on 1 April 1988:                                                       

Scunthorpe                                                                                                                                                                                         

                                              Numbers transferred to                                                                                                                               

                                              each new clinical grade                                                                                                                              

Previous grade                |Staff in post |A             |B             |C             |D             |E             |F             |<1>G          |H             |I                            

                              |(whole time                                                                                                                                                         

                              |equivalents)                                                                                                                                                        

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Nursing Auxiliary             |265.30        |245.80        |19.50         |-             |-             |-             |-             |-             |-             |-                            

Staff Nursery Nurse           |4.20          |-             |4.20          |-             |-             |-             |-             |-             |-             |-                            

Enrolled Nurse<2>             |238.70        |-             |-             |150.40        |88.30         |-             |-             |-             |-             |-                            

Enrolled District Nurse<2>    |1.70          |-             |-             |-             |1.70          |-             |-             |-             |-             |-                            

Senior Enrolled Nurse<2>      |1.40          |-             |-             |-             |1.40          |-             |-             |-             |-             |-                            

Staff Nurse<2>                |227.30        |-             |-             |-             |67.70         |143.90        |15.70         |-             |-             |-                            

Staff Midwife<2>              |17.50         |-             |-             |-             |-             |17.50         |-             |-             |-             |-                            

Deputy Sister<2>              |11.60         |-             |-             |-             |-             |5.00          |6.60          |-             |-             |-                            

Nursing Sister II<2>          |137.00        |-             |-             |-             |-             |-             |59.20         |77.00         |0.80          |-                            

Midwifery Sister II<2>        |41.50         |-             |-             |-             |-             |-             |14.30         |27.20         |-             |-                            

District Nurse (Sister II)<2> |37.90         |-             |-             |-             |-             |-             |1.20          |33.70         |3.00          |-                            

Nursing Sister I              |1.00          |-             |-             |-             |-             |-             |-             |-             |1.00          |-                            

Midwifery Sister I            |-             |-             |-             |-             |-             |-             |-             |-             |-             |-                            

Health Visitor                |36.20         |-             |-             |-             |-             |-             |-             |35.20         |1.00          |-                            

Senior Nurse 8                |5.00          |-             |-             |-             |-             |-             |-             |-             |4.00          |1.00                         

Senior Nurse 8 (Midwife)      |1.00          |-             |-             |-             |-             |-             |-             |-             |1.00          |-                            

Senior Nurse 7                |14.50         |-             |-             |-             |-             |-             |-             |-             |-             |14.50                        

Senior Nurse 7 (Midwife)      |3.00          |-             |-             |-             |-             |-             |-             |-             |-             |3.00                         

Clinical Teacher              |3.30          |-             |-             |-             |-             |-             |-             |-             |3.30          |-                            

Fieldwork Teacher             |5.00          |-             |-             |-             |-             |-             |-             |-             |5.00          |-                            

Practical Work Teacher        |6.00          |-             |-             |-             |-             |-             |-             |-             |6.00          |-                            

Tutor                         |6.00          |-             |-             |-             |-             |-             |-             |-             |-             |6.00                         

Tutor Midwife                 |0.50          |-             |-             |-             |-             |-             |-             |-             |-             |0.50                         

                                                                                                                                                                                                   

Post Basic Students                                                                                                                                                                                

Enrolled                      |19.00         |-             |-             |19.00         |-             |-             |-             |-             |-             |-                            

Staff Nurse                   |2.00          |-             |-             |-             |2.00          |-             |-             |-             |-             |-                            

Deputy Sister                 |-             |-             |-             |-             |-             |-             |-             |-             |-             |-                            

Sister II                     |-             |-             |-             |-             |-             |-             |-             |-             |-             |-                            

                                                                                                                                                                                                   

Others                        |-             |-             |-             |-             |-             |-             |-             |-             |-             |-                            

                              |-------                                                                                                                                                             

Totals                        |1,086.60      |245.80        |23.70         |169.40        |161.10        |166.40        |97.00         |173.10        |25.10         |25.00                        

<1>Excludes some additional G posts which health authorities have indicated they intend to create in future on existing two-sister wards.                                                          

<2>Excludes Post Basic Students.                                                                                                                                                                   

Community Care

21. Dr. Godman : To ask the Secretary of State for Health what representations he has received on the implementation of the recommendations of Sir Roy Griffiths' report on community care.

Mr. Kenneth Clarke : I refer the hon. Member to the reply that I gave to the hon. Member for Barnsley, East (Mr. Patchett) earlier.

37. Mr. Randall : To ask the Secretary of State for Health what recent representations he has received about future policies on community care.

39. Mr. Tom Clarke : To ask the Secretary of State for Health what representations he has received seeking expedition of his response to the Griffiths report on community care.

40. Mr. Harry Barnes : To ask the Secretary of State for Health what representations he has received on the implementation of the recommendations of Sir Roy Griffiths' report on community care.

53. Mr. Martlew : To ask the Secretary of State for Health what recent representations he has received about future policies on community care.

59. Mr. Allen McKay : To ask the Secretary of State for Health what recent representations he has received about future policies on community care.

66. Mr. O'Brien : To ask the Secretary of State for Health what representations he has received on the implementations of the recommendations of Sir Roy Griffiths' report on community care.

74. Mr. Ronnie Campbell : To ask the Secretary of State for Health what recent representations he has received about future policies on community care.

Mr. Mellor : I refer the hon. Members to the reply to my right hon. and learned Friend the Secretary of State to the hon. Member for Barnsley, East (Mr. Patchett) earlier today.

Medical Personnel (Statistics)

22. Mr. McLoughlin : To ask the Secretary of State for Health, what are the net increases in the numbers of doctors, dentists, nurses and midwives since 1979.

Mr. Mellor : The overall changes in doctors, dentists, nurses and midwives between September 1979 and September 1987 are :


                                              |Whole-time equivalents|Percentage change                            

-------------------------------------------------------------------------------------------------------------------

Medical                |Increase              |4,030                 |+11.1                                        

Dental                 |Decrease              |50                    |-1.7                                         

Nursing                |Increase              |42,430                |+12.5                                        

Midwifery              |Increase              |3,170                 |+15.5                                        

Bolton General Hospital

23. Mr. Thurnham : To ask the Secretary of State for Health if he has any plans to visit the new genito-urinary department at Bolton general hospital ; and if he will make a statement.

Mrs. Currie : I have no plans to visit the Bolton general hospital in the near future. The new genito-urinary medicine department has been developed at a cost of £116,000. The facilities that it contains will allow the provision of improved services for the counselling, diagnosis and treatment of patients with genito-urinary infections, including those with conditions related to the HIV infection.

RAWP (Northern Region)

25. Mr. Amos : To ask the Secretary of State for Health when he expects the funding for the Northern regional health authority will be brought up to the resources allocation working party level.

Mr. Mellor : We hope to be able to announce the 1989-90 resource allocations to regional health authorities shortly. The Government are considering the National Health Service management board's report on the review of the resource allocation working party (RAWP) formula in the wider context of the National Health Service review. Longer-term resource allocation decisions will be informed by the outcome of that wider review.

Hypothermia

26. Mrs. Golding : To ask the Secretary of State for Health what plans he has to assist elderly people to combat hypothermia during the winter months.

30. Mr. Bradley : To ask the Secretary of State for Health, what plans he has to assist elderly people to combat hypothermia during the winter months.

61. Mr. Cunliffe : To ask the Secretary of State for Health what plans he has to assist elderly people to combat hypothermia during the winter months.

63. Mr. Frank Cook : To ask the Secretary of State for Health what plans he has to assist elderly people to combat hypothermia during the winter months.

Mrs. Currie : On 17 November the Government launched this years "Keep Warm Keep Well" campaign. This is a health promotion campaign designed to give people information and advice about how to combat the risks of cold weather and is supported by the Departments of Health, Social Security, Environment, Welsh Office and Energy and several voluntary organisations.

As well as supporting the "Keep Warm Keep Well" campaign, the Department of Social Security provides cold weather payments, the Department of the


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Environment runs the home insulation grants scheme, and the Department of Energy supports Neighbourhood Energy Action, which organises community insulation projects.

We printed around 750,000 copies of the campaign booklet and there has already been sufficient demand to order a reprint. The telephone helpline on 0800-289404, the Winter Warmth line, is receiving around 200 calls a day.

Mr. Meale : To ask the Secretary of State for Health what advice his Department gives to the elderly about wrapping up more warmly during winter periods.

Mrs. Currie : Advice on keeping warm in winter is given in the "Keep Warm Keep Well" campaign.

We firmly believe that vulnerable people should be encouraged to take sensible precautions including dressing warmly in cold weather.

Office Space (London)

29. Mr. Bidwell : To ask the Secretary of State for Health if he will make a statement on his Department's plans to rent further office space in central London.

Mr. Kenneth Clarke : We have no plans to rent additional space in central London. We intend to relocate the work of at least 1,000 posts away from the south east to areas where recruitment is easier and rents lower. We plan to vacate some buildings which are in areas of London with high rents.

Medical Techniques

31. Mr. Adley : To ask the Secretary of State for Health if he will make a statement on the effect of improved medical techniques on his Department's budget.

Mr. Mellor : There is no precise measure of the resource implications of medical advance, which can both raise or lower costs of treatment and care.

Pensioners (Health in Winter)

34. Mr. Steinberg : To ask the Secretary of State for Health if he plans to give any further advice to pensioners on keeping healthy during the winter months.

45. Mr. Loyden : To ask the Secretary of State for Health if he has received any representations from pensioners or pensioners' organisations about the advice given by the Under-Secretary of State, the hon. Member for Derbyshire, South (Mrs. Currie) at Reading, on the subject of keeping healthy during the winter.

46. Mr. Buckley : To ask the Secretary of State for Health if he plans to give any further advice to pensioners on keeping healthy during the winter months.

48. Mr. Ashton : To ask the Secretary of State for Health if he has received any representations from pensioners or pensioners' organisations about the advice, given by the Under-Secretary of State, the hon. Member for Derbyshire, South (Mrs. Currie) on the subject of keeping healthy during the winter.

76. Mr. Haynes : To ask the Secretary of State for Health if he plans to give any further advice to pensioners on keeping healthy during the winter months.


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77. Mr. Michael : To ask the Secretary of State for Health if he has received any representations from pensioners or pensioners' organisations about the advice given by the Under-Secretary of State, the hon. Member for Derbyshire, South (Mrs. Currie) on the subject of keeping healthy during the winter.

Mrs. Currie : I refer the hon. Members to the reply that I gave to the hon. Members for Edinburgh, Central (Mr. Darling) and for Wentworth (Mr. Hardy) earlier today.

Resource Management

35. Mr. Irvine : To ask the Secretary of State for Health what assessment he has made of the results of pilot projects on resource management in hospitals.

Mr. Mellor : The pilot projects will, in accordance with the agreement entered into by the joint sponsors of the initiative, the NHS management board and the joint consultants committee of the British Medical Association be evaluated fully in October 1989. Recently, interim progress reports have been produced by the various sites and organisations involved in the initiative. These reports indicate that good progress has been made, the commitment of local doctors and staff has been strong and parts of the approach can already usefully be recommended to other health authorities.

Medical Diagnoses

36. Mr. Holt : To ask the Secretary of State for Health what new arrangements his Department is planning to ensure that untried and untested medical diagnoses are properly validated before acceptance within the profession and the courts.

Mrs. Currie : No new arrangements are planned. It is a matter for the clinical judgment of individual clinicians to decide what use they should make of novel diagnostic techniques. On occasion, to assist the medical profession, we issue guidance with the help of the standing medical advisory committee, as with the diagnosis of child sexual abuse. The courts reach their decisions on the basis of the evidence put to them.

Food Poisoning

38. Mr. Ashley : To ask the Secretary of State for Health what proposals he has received which could help to reduce the incidence of food poisoning.

Mrs. Currie : The Food Act 1984 and the Food Hygiene Regulations are being reviewed and it is proposed to include provisions giving greater control over suspect food and hazardous food premises, making food hygiene training of food handlers a statutory requirement and extending statutory temperature control of food from the catering sector to include food sold by retail.

Specific measures are of course introduced to deal with particular food poisoning problems, as in our present concern over salmonella in eggs.

Eggs

Mr. Meale : To ask the Secretary of State for Health (1) if he will make it his policy to require eggs to carry Government health warnings ;

(2) what advice his Department is issuing to employers and employees about eating eggs.


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Mr. Kenneth Clarke : The matter must be kept in proportion. As a sensible precaution, those most at risk--the elderly, the sick, babies and pregnant women--should follow the advice of the chief medical officer and eat only eggs that have been cooked until the white and yolk are solid. However, the risk is very small and healthy people can continue to eat eggs cooked however they wish. We will continue to reassure people on these points as necessary.

Mr. Fearn : To ask the Secretary of State for Health if he will give consideration to involving local government environmental health departments in the control of egg production.

Mr. Kenneth Clarke : Environmental health departments of local authorities are responsible for environmental issues arising from egg production and for hygiene issues post-production.

We have asked them to assist in promulgating my Department's advice to manufacturers, caterers and consumers locally. We have no current plans to involve them in the control of egg production.

Midwives

41. Mr. Flannery : To ask the Secretary of State for Health if he has any plans to discuss conditions of service with representatives of the midwives.

Mr. Kenneth Clarke : Negotiations over the terms and conditions of nurses' and midwives' employment are a matter for the relevant Whitley council. However, I met representatives of the Royal College of Midwives on 7 December and had a friendly and useful discussion about a range of issues, including the new grading structure and the appeals process.

72. Mr. Alton : To ask the Secretary of State for Health what account was taken of clinical experience when setting the grades of midwives ; and what representations he has received from Merseyside midwives concerning their regrading.

Mr. Mellor : I have received some 50 representations from midwives in the Mersey region. I have nothing to add to what I told the House in the debate on the Adjournment on 7 December at columns 407-16.

NHS (Yorkshire)

42. Mr. Riddick : To ask the Secretary of State for Health what steps he is taking to improve efficiency in the National Health Service in the Yorkshire region.

Mr. Mellor : Ministers and the National Health Service management board regularly review the performance of all regional health authorities, culminating in an annual ministerial review meeting after which an action plan is set for the coming year. Yorkshire RHA's latest review was in July. A record of that meeting, together with the action plan for 1988-89 which included a number of measures to improve efficiency, was placed in the Library.

Donor Cards

43. Mr. Kirkhope : To ask the Secretary of State for Health if he will make a statement on progress on the current campaign on donor cards.


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Mrs. Currie : As a result of the Department's advertising campaign and media concern, particularly television, public interest in organ donation is high. So far this year some 14 million cards have been distributed compared with 5 million last year.

The range of high street outlets for the cards has been considerably extended through the Department's recent joint venture with the Healthcare Foundation and other initiatives are being discussed. The Departments of Health and Social Security recently issued donor cards to all members of staff.

Kidney transplants in the United Kingdom have risen by 76 per cent. between 1979 and 1987 and other organ transplants have also increased. This year has been a particularly good year for transplants. Because of excellent publicity at the beginning of the year, the first six months saw a 32 per cent. increase in transplants over last year. We expect that 1989 will be a record year for donations.

Health Care Facilities

44. Mr. Nicholas Bennett : To ask the Secretary of State for Health what progress is being made towards the establishment of an internal and external market in the provision of health care facilities in the National Health Service.


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