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Mr. Freeman : For details of the United Kingdom heart transplant programme I refer my hon. Friend to the statement made by my right hon. and learned Friend the Secretary of State for Health on 14 December 1988 at column 602. I regret that we do not collect statistics on heart transplantation in other countries in the European Community.

Diet

Mr. Adley : To ask the Secretary of State for Health if he will make a statement on the nation's health in relation to dietary matters.

Mr. Freeman : The nation's nutritional health can best be assured if people eat a balanced diet, not too much or too little of any food.

There is evidence that some people do not eat a balanced diet. For instance the Government accept that the current rates of cardiovascular disease might be lessened if people's intakes of fat and particularly saturated fatty acids, were to be reduced. Further information about the national diet is emerging from the results of the dietary and nutritional survey of British adults, undertaken by OPCS in association with the Department of Health and the Ministry of Agriculture, Fisheries and Food, which are now being analysed.


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Hospital Cleaning

Mr. Wray : To ask the Secretary of State for Health what type of information is centrally gathered by his Department regarding the impact in National Health Service hospitals in (a) England, (b) Scotland and (c) Wales of the privatisation of cleaning services ; and whether such information refers to (i) the present standards of cleaning works, (ii) savings for health boards in England, Scotland and Wales and for the United Kingdom as a whole and (iii) working conditions of the cleaning staff of such private contractors.

Mr. Mellor : Since the launch of the competitive tendering initiative in 1983, health authorities in England have been required to put their cleaning services out to tender. Information collected centrally, following the initiative, concerned the progress made by authorities in implementing the policy, the award of contracts and the savings generated. Virtually all domestic services have now been tendered with about 80 per cent. of the tenders being won in-house. Savings on these services total over £80 million.

No information is held centrally on standards, which is a matter for health authorities, or on conditions of service for staff of private contractors, which is a matter for the companies concerned and their employees.

Information about Scotland and Wales is a matter for my right hon. and learned Friend the Secretary of State for Scotland and my right hon. Friend the Secretary of State for Wales.

Post-operative Treatment

Ms. Walley : To ask the Secretary of State for Health what National Health Service post-operative treatment is available, similar to that found in other European countries ; in which areas post-operative treatment can be obtained under the National Health Service ; and if he will make a statement.

Mr. Freeman : Any post-operative treatment which the responsible doctors deem to be clinically necessary is normally provided on the National Health Service. If the hon. Member knows of difficulties which have been experienced with any particular form of such treatment perhaps she would let me know.

Nurses' Pay

Mrs. Gillian Shephard : To ask the Secretary of State for Health what was the median level of earnings for nurses expressed as a proportion of average earnings in each year from 1983-84 to the most recent available date.

Mr. Mellor : We cannot derive the information requested from the data on earnings which are held centrally.

Cancer Screening

Mr. Harry Greenway : To ask the Secretary of State for Health if he will make a statement on his further plans for the screening of women for cervical cancer.

Mr. Freeman : Comprehensive guidance to health authorities and family practitioner committees on cervical cancer screening services was issued in January 1988. All


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district health authorities in England have now implemented computerised call and recall systems. All women aged 20 to 64 are to be invited for screening by March 1993--unless their general practitioner has indicated that they should be excluded--and recalled at least every five years. We shall continue to monitor progress.

Mrs. Ray Michie : To ask the Secretary of State for Health what representations he has received concerning the psychological effects on patients of the current system of cervical cancer screening.

Mr. Freeman : None. Nevertheless we recognise the importance of minimising the anxieties women might have about participation in the cervical cancer screening programme. We have asked health authorities to aim their local health education programmes at encouraging women to respond positively to their screening invitations and to ensure that women who require treatment following their test are offered counselling and support.

Midwives (Cornwall and Isles of Scilly)

Mr. Matthew Taylor : To ask the Secretary of State for Health what representations he has received regarding the regrading of midwives in the Cornwall and Isles of Scilly health authority.

Mr. Mellor : The Department has received some 50 written representations, including a petition from the Cornwall branch of the Royal College of Midwives.

Salaries

Mr. Ian Taylor : To ask the Secretary of State for Health what discretion is allowed to regional health authorities in determining clinical and nursing salary scales.

Mr. Mellor : The salaries of nurses employed in the National Health Service are determined by reference to national salary scales, with appropriate supplements for staff working in London. These are set in the light of the recommendations of the independent nurses pay review body and health authorities currently have no discretion to vary these salary scales.

Protection Orders (Northumberland)

Mr. Ronnie Campbell : To ask the Secretary of State for Health how many children were regarded as under protection orders on a month to month basis in Northumberland in 1988.

Mr. Mellor : Information about the number of children removed to a place of safety is collected centrally on an annual basis only. The number in 1988 in Northumberland was 25 and is given in the provisional feedback "Children removed to a place of safety, year ending 31 March 1988, England" ; copies are available in the Library of the House.

School Nurses (Statistics)

Mr. Cousins : To ask the Secretary of State for Health how many nurses are engaged in educational medicine and the care of children in hospitals ; and if he will give similar figures for the last five years.

Mr. Mellor : The total number of nursing staff employed in the school health service in England at 30 September each year from 1983 to 1987 was :


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Year                  |Wholetime equivalents                      

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

1983                  |2,890                                      

1984                  |2,910                                      

1985                  |2,920                                      

1986                  |2,810                                      

1987                  |2,790                                      

Note: These figures exclude nursing staff employed in special     

schools.                                                          

Mr. Cousins : To ask the Secretary of State for Health how many nurses in educational medicine and the care of children in schools were in each grade before and after the recent grading review.

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

Certificate of School Nursing

Mr. Cousins : To ask the Secretary of State for Health what pay enhancements were offered to nurses acquiring the certificate of school nursing in each of the last five years, and before and after the recent grading review.

Mr. Mellor : The new clinical grading structure is designed to recognise and reward the possession of post basic nursing qualifications, including the certificate of school nursing. The Department's guidance to health authorities is that the minimum grade appropriate for posts which require first level registration and the school nursing certificate is scale E.

Possession of the certificate was not a factor in grading prior to the introduction of the new structure. No additional allowances are or were payable to those who have acquired the certificate.

Listeriosis

Mr. Hinchliffe : To ask the Secretary of State for Health if, in any of the notified cases of listeriosis in 1987 and 1988, there was any evidence of a vector other than food.

Mr. Freeman : Three of the 546 listeria cases reported to the public health laboratory service in 1987 and 1988 were

microbiologically confirmed as being food associated. No vector was identified in the other cases.

Food Poisoning

Mr. Hinchliffe : To ask the Secretary of State for Health what action he is taking to reduce the incidence of food poisoning.

Mr. Freeman : Apart from regular liaison with the food industry and enforcement agencies, action is being taken on a number of fronts. The Department of Health and the Ministry of Agriculture, Fisheries and Food have a number of studies under way on a range of subjects ; the public health laboratory service, in addition to its routine monitoring of laboratory reports, also has in train a number of specific studies. The Department is working with the manufacturing and retail sectors of the food industry on the prevention and control of contamination in foods.

On a wider front, the Department is jointly responsible with the Ministry of Agriculture, Fisheries and Food for the Food Act and legislation made under it. A review of both the Act and the food hygiene regulations is under way.


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We are considering what further action is necessary.

Elderly Persons' Homes (Calderdale)

Mrs. Mahon : To ask the Secretary of State for Health what was the total cost, and to which Government Departments, of funding private and voluntary homes for the elderly in Calderdale in each year from 1979.

Mr. Freeman : Private and voluntary homes are not funded directly by the Government.

Mrs. Mahon : To ask the Secretary of State for Health how many places there were in (a) local authority elderly persons homes and (b) private homes for elderly persons in Calderdale in each year since 1979.

Mr. Freeman : The information readily available for the period relates to the number of places in homes for elderly people and younger physically handicapped people. Information for the years ending 31 March 1981 to 1986 is published in "Residential Accommodation for Elderly and Younger Physically Handicapped People : All Residents in Local Authority, Voluntary and Private Homes Year ending 31 March 1981 to Year ending 31 March 1986 England", a copy of which is available in the Library. The information for the year ending 31 March 1980, and provisional information for the year ending 31 March 1987, is given in the table.


Number of places in residential care homes in Calderdale local                                                                      

authority for elderly people and for younger physically handicapped                                                                 

people, as at 31 March, 1980 and 1987                                                                                               

Year                  |Local authority homes|Voluntary homes      |Private homes        |All homes                                  

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

1980                  |656                  |91                   |131                  |878                                        

1987<1>               |702                  |32                   |438                  |1,172                                      

<1> Provisional.                                                                                                                    

Operations (Waiting Lists)

Mrs. Mahon : To ask the Secretary of State for Health how many people waiting for operations (a) nationally and (b) in Calderdale, have been removed from waiting lists because they became ill, in each year since 1979.

Mr. Mellor : We do not collect the information requested centrally.

Private Health Sector (Calderdale)

Mrs. Mahon : To ask the Secretary of State for Health how many private beds were available, and how many consultant hours were worked, in the private health sector in Calderdale in each year since 1979.

Mr. Mellor : The only available information centrally is given in the table.


Number of beds in private        

hospitals, homes and clinics     

registered                       

under section 33 of the          

Registered Homes Act             

1984-Calderdale                  

health authority                 

Year       |Total beds           

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

1982       |141                  

1983       |145                  

1984       |168                  

1985       |272                  

1986       |340                  


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Cook-Chill Food

Mr. Hinchliffe : To ask the Secretary of State for Health what steps his Department has taken to ensure the public can safely consume cook-chill food from supermarkets that store such food in systems that contravene his Department's 1980 guidelines.

Mr. Freeman : This Department, in consultation with the Ministry of Agriculture, Fisheries and Food and the food industry, is drawing up guidelines for cooked-chilled manufactured food sold from retail outlets. The proposed guidelines will cover storage and display conditions and will take account as appropriate of the

recommendations in the Department's existing guidelines on pre-cooked chilled catering foods.

Mr. Hinchliffe : To ask the Secretary of State for Health what action he is taking following the publication of the results of a survey into food hygiene in National Health Service hospitals in England and Wales undertaken by the Institution of Environmental Health Officers which indicated that the cook-chill processes in 19 per cent. of the hospitals surveyed between 1 April 1987 and 31 March 1988 did not comply with his Department's 1980 guidelines.

Mr. Freeman : Health authorities have been asked to provide information on standards of hygiene in their kitchens including those involving cook-chill and this will be carefully considered for further action.

Mr. Hinchliffe : To ask the Secretary of State for Health (1) how many members of the Yorkshire regional health authority have declared a pecuniary interest in cook-chill catering ; and when these interests were declared ;

(2) how many members of the Wakefield district health autority have declared a pecuniary interest in cook-chill catering ; and when these interests were declared.

Mr. Freeman : None. But as recorded in the DHA minutes, one member of Wakefield health authority gave notice on 25 November that he had received an invitation to join/advise a company specialising in 100 per cent. sterile food. I understand the company currently operates on the continent but has plans to undertake marketing trials in the United Kingdom.

Mrs. Mahon : To ask the Secretary of State for Health what advice he is giving to Calderdale health authority on cook-chill in the light of the recent new evidence on listeria.

Mr. Freeman : The advice contained in the 1970 guidelines on cook- freeze catering, as amended by the guidelines on pre-cooked chilled foods published in 1980, is still operational. As my right hon. and learned Friend the Minister of Health said in his reply of 14 December to the hon. Member for Stoke-on-Trent, South (Mr. Ashley) at column 601 we are satisfied that provided these guidelines are carefully followed, microbiologically sound food will be produced.

Mr. Hinchliffe : To ask the Secretary of State for Health, if it is possible for cook-chill food to be supplied from the private sector to National Health Service hospitals with food production units within the requirements of his Department's 1980 guidelines on cook-chill food.


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Mr. Freeman : I refer the hon. Member to my reply to him on 17 January at column 114

Mr. Hinchliffe : To ask the Secretary of State for Health if, pursuant to his answer to the hon. Member for Wakefield of 16 January 1988, the public health laboratory service of cook-chill food has included food supplied to hospital patients.

Mr. Freeman : The public health laboratory service survey referred to in my reply of 16 January at column 43 includes cook-chill food supplied by NHS hospitals.

Water Fluoridation

Mr. Fatchett : To ask the Secretary of State for Health (1) what action his Department intends to take in the light of the proposals by the Severn-Trent water authority to give notice to terminate the agreement by which fluoridated water is supplied from the Elan valley reservoir to Birmingham, Solihull and adjacent areas unless by 1 February his Department and the Water Authorities Association resolve the current dispute over the terms of the indemnity granted to water suppliers ;

(2) what are the terms of the indemnity granted to water suppliers who have previously agreed to requests for fluoridation schemes ; how the indemnity offered to water suppliers for new schemes has been implemented since the Water (Fluoridation) Act 1985 ; how such indemnities were implemented before that Act ; and what extensions to the existing indemnity have been offered to the Water Authorities Association in recent negotiations with his Department.

Mr. Freeman : I refer the hon. Member to my reply to the hon. Member for Birmingham, Perry Barr (Mr. Rooker) on 16 January at columns 41-42 which said that a copy of the terms of the indemnity for water undertakers had been placed in the Library. The only major change to the indemnity since the passage of the Water Fluoridation Act 1985 has been the withdrawal of cover in the event of a legal challenge to the powers of water undertakers to add fluoride to the water supply. This is because the Act itself removed any doubt about these powers.

We are considering the terms of the indemnity following representations from the Water Authorities Association.

Cyclotron (Expenditure)

Mr. Fearn : To ask the Secretary of State for Health on what grounds he made his decision to spend £6 million on a cyclotron to be sited at St. Thomas's hospital ; and if he will make a statement.

Mr. Mellor : On 7 June 1988 Ministers approved a grant of £6 million to the Cyclotron trust as a contribution towards the charitable funds it is raising to install a Cyclotron at St. Thomas's hospital. The decision was made on the understanding that the Neutron therapy the cyclotron can provide, can give relief from the effects of certain cancers. Ministers decided to support the voluntary fund raisers in order to make such treatment more widely available to NHS patients.


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Hospital Pharmacists and Pharmacy Technicians

Mr. Fearn : To ask the Secretary of State for Health if he will list, by regional health authority the number of vacant posts in 1988 for hospital pharmacists grade 1 and grade 2 and pharmacy technicians.

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

ENVIRONMENT

Housing Finance

Mr. Allen : To ask the Secretary of State for the Environment if he will make available to hon. Members any evidence collected from local authorities which supports his answer of 19 December, Official Report, column 42, that his proposals on housing finance will not significantly affect council house rents either in Nottingham or nationally.

Mr. Trippier : My earlier reply explained that my right hon. Friend's proposals for capital expenditure and finance were not expected to have any impact on council house rents. We have made separate proposals on housing finance, suggesting new machinery for subsidising local authority housing revenue accounts. The effect these proposals will have on council rents will depend partly on the way we choose to operate the system year by year, and partly on the decisions taken by individual local authorities, who will retain ultimate responsibility for setting their own rents.

Water Act 1973

Mr. Wigley : To ask the Secretary of State for the Environment (1) if he will list the directions made by his Department under section 30 of the Water Act 1973 since the implementation of the Act, giving the date of each such direction, the authority to which it applied and the nature of the change to which the direction referred ; (2) what directions he has made for the charges schemes under the provisions of section 31(3) of the Water Act 1973 since that Act came into force, giving the date and the authorities subject to such directions in each instance.

Mr. Moynihan : No directions were given under section 30(5) and none have been given under section 3(4) of the Public Utility Transfers and Water Charges Act 1988 which has replaced it. No directions have been given under section 31(3).

Mr. Wigley : To ask the Secretary of State for the Environment on what dates since the implementation of the Water Act 1973 he has made regulations under section 32(2) of that Act with respect to the installation of meters.

Mr. Moynihan : No regulations were made under section 32(2) of the Water Act 1973, which was repealed by the Public Utility Transfers and Water Charges Act 1988. Two sets of regulations have been made under section 5 of the 1988 Act : the Water (Meters) Regulations 1988 No. 1048 and the Water (Meters) (Amendments) Regulations 1988 No. 1288. These were made on 14 June 1988 and 25 July 1988 respectively.


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Alexander Fleming House

Mr. Heddle : To ask the Secretary of State for the Environment (1) if he will publish details of any plans to carry out a scheme of refurbishment to Alexander Fleming house, London SE1 ;

(2) if he has any plans to list Alexander Fleming house, Elephant and Castle, London SE1 under the Town and Country Planning Acts as a building of architectural significance.

Mr. Chope : Alexander Fleming house is a leased building and the landlord has yet to take a final decision about a major refurbishment. I have no plans to list this building under the Town and Country Planning Acts.

Housing Starts

Mr. Heddle : To ask the Secretary of State for the Environment if he will publish in the Official Report the figures for private sector housing starts for each year since 1979.

Mr. Trippier : Figures of private sector housing starts appear in table 6.1(a) of "Housing and Construction Statistics, 1977-1987", a copy of which is available in the Library.

Inner City Regeneration

Mr. Heddle : To ask the Secretary of State for the Environment what steps he proposes to take to encourage local authorities to use simplified planning zones to facilitate private sector investment in inner city regeneration.

Mr. Chope : My Department has already issued advice on the preparation of SPZ schemes (PPG5), on the statutory procedures (circular 25/87), and on the application of environmental assessment procedures in these areas (circular 24/88). Promotional literature has been widely circulated to local planning authorities, businesses and other organisations involved in regenerating inner city areas. SPZ schemes have already been established at Derby and Corby and other schemes in preparation include those at Birmingham, Enfield, Rotherham, Cleethorpes and Glanford/Scunthorpe.

Economic Development Projects

Mr. Boateng : To ask the Secretary of State for the Environment if the proposed new economic development power will contain restrictions to prevent local authorities assisting in providing wages or salaries for staff in economic development projects.

Mrs. Virginia Bottomley : Restrictions on the use of the new power will be set out in regulations on which we shall consult local government. The Government do not believe that local authorities should be giving long- term direct subsidies to wages and salaries of private-sector firms.

Water (Privatisation)

Mr. John Evans : To ask the Secretary of State for the Environment what plans his Department has developed to ensure adequate investment in the sewage system infrastructure after the privatisation of the water supply industry.


Column 305

Mr. Moynihan : Capital programmes costing £900 to £1,000 million have been developed by water authorities, aimed at bringing substandard sewage treatment works into compliance with their discharge consents by March 1992. It will be for the proposed National Rivers Authority to ensure that these programmes are satisfactorily implemented, and to monitor the performance of sewage treatment works to ensure an acceptable standard of continuing performance.

Housing (New Towns)

Mr. Soley : To ask the Secretary of State for the Environment whether the Government intend to continue with the management agency agreement to take over the running of all housing in new towns.

Mr. Trippier : The management of their rented housing stock is entirely a matter for new town development corporations. The decision to offer a management agency agreement to anyone is taken by the board of the development corporation. The Government have no standing in these matters.

Fire Service and Civil Defence

Mrs. Mahon : To ask the Secretary of State for the Environment how much in percentage terms ratepayers pay for their fire service in each of the fire and civil defence authority areas outside London.

Mrs. Virginia Bottomley : In 1987-88 the precept incomes of fire and civil defence authorities expressed as percentages of rates paid by all ratepayers in each metropolitan area are as follows :


Area               |per cent.          

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

Greater Manchester |4.3                

Merseyside         |2.9                

South Yorkshire    |3.9                

Tyne and Wear      |4.4                

West Midlands      |3.4                

West Yorkshire     |4.8                

Estate Action

Mr. Greg Knight : To ask the Secretary of State for the Environment what is the increase in provision for the Estate Action programme for 1989- 90.

Mr. Trippier : The Estate Action provision for 1989-90 has been increased by £40 million to £190 million, which is 36 per cent. more than the current year's provision.

Sites of Special Scientific Interest

Mrs. Ann Taylor : To ask the Secretary of State for the Environment when was the last time a code of guidance as to sites of special scientific interest was issued.

Mrs. Virginia Bottomley : The code of guidance was issued in November 1982. A revised code is in preparation and it is expected to be submitted for approval by Parliament later this year.

Water

Ms. Walley : To ask the Secretary of State for the Environment which of the 31 water supplies subject to


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