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Mr. Freeman : Written representations on behalf of Burnley, Pendle and Rossendale community health council have been received from three hon. Members, including one from the hon. Member himself. I have replied in writing to the hon. Member.
National Health Service Act 1987 Chapter 49
Health and Social Security Act 1984 Chapter 48
NHS Functions (Directions to Authorities and Administration Arrangements) Regulations 1989. SI1989 No. 51
NHS England and Wales. The Family Practitioner Committees (Membership and Procedure) Regulations 1985. SI1985 No. 213 NHS (General Medical and Pharmaceutical Services) Regulations 1974. SI1974 No. 160
NHS (Family Practitioner Committees Supply of Goods) Regulations 1974. SI1974 No. 191
NHS (Service Committees and Tribunals) Regulations 1974. SI1974 No. 455
NHS (Charges for Drugs and Appliances) Regulations 1980. SI1980 No. 1503
NHS (General Dental Services) Regulations 1973. SI1973 No. 1468 NHS (General Ophthalmic Services) Regulations 1986. SI1986 No. 975 NHS (Payment for Optical Appliances) Regulations 1986. SI1986 No. 976
These are augmented by administrative circulars from time to time issued by my Department.
Mr. Freeman : The competitive tendering initiative launched five years ago concentrated on domestic, catering and laundry services. Virtually all these services have now been subjected to the tendering process. The initiative has generated not only substantial annual savings (almost £110 million) but has provided improved specification of services, more flexible provision, tighter budgetary control
Column 541and improved productivity. In the light of these perceived benefits a number of health authorities have extended, or are planning to extend, the range of services subject to the tendering process, for example portering and security services, estate services, computer services and supplies distribution. Over £1.2 billion of National Health Service services are now subject to routine competition. We shall continue to encourage health authorities to consider competitive tendering as a means of improving efficiency in the way services are delivered thus maximising the resources available for patient care.
46. Mr. Latham : To ask the Secretary of State for Health what response he has made to the representations which he received regarding the proposals of the Leicestershire health authority to close rural maternity units ; and if he will make a statement.
Mr. Freeman : This is at present a matter for the district health authority with the region following consultations on the proposals issued last September. The standard procedure in relation to the closure of health facilities requires Ministers to make the final decision if agreement cannot be reached locally among the community health council and the health authorities. My hon. Friend will appreciate that it would be inappropriate for me to comment at this stage.
Mr. Mellor : Health authorities are responsible for determining the number of consultants they require to meet service needs. Their strategic plans indicate an annual increase in the number of consultants which averages 2 per cent. per annum and regions will be held to account for achieving these plans. In addition to this, "Achieving a Balance", a 10- year plan to reform hospital medical staffing, introduced specific measures to give a further boost to the number of consultant posts.
49. Mr. Atkinson : To ask the Secretary of State for Health when he expects to complete his consideration of the recommendations of the Griffiths report on community care ; and if he will make a statement.
Mr. Mellor : We are actively engaged at present in working up our own proposals for the future of community care. I am mindful of concern that we should reach a conclusion as soon as possible. We hope to be in a position to bring forward our plans in the near future.
51. Mr. Devlin : To ask the Secretary of State for Health what representations he has received from consumer health organisations about the impact on health of the quality or contents of food available in the United Kingdom.
Mr. Freeman : We have not received any such representations. The Secretary of State for Health and the Minister of Agriculture, Fisheries and Food jointly consider all proposals for regulations under the Food Act and are required to consult widely before making such regulations. The consumer organisations are among those whose views are sought and our officials have frequent contacts with these organisations.
53. Mr. Grocott : To ask the Secretary of State for Health what is the cost to the National Health Service of paying private hospitals to treat National Health Service patients in the latest year for which figures are available.
Mr. Mellor : The summarised accounts of health authorities for 1987- 88 record total expenditure on contractual hospitals and homes of £52.4 million. At this stage the figure is provisional as it is subject to audit.
Mr. Mellor : The resource management experiments will be formally evaluated by the Joint Consultants Committee and the NHS Management Board, the joint sponsors of the initiative, in October 1989. Piloting at the reference sites is still continuing. The work to date has already demonstrated the significance of a number of elements. These include the importance of good quality medical records data ; the value associated with involving doctors and nurses in decision making and giving them a sense of ownership of their data ; the importance of involving all staff in the projects and of good quality local management ; the desirability of introducing nurse management and other information systems and the feeding back to managers and clinicians of existing information. These and other issues were discussed at a meeting with RHA chairmen on 18 January.
58. Dr. Goodson-Wickes : To ask the Secretary of State for Health if he will give the number of sex-change operations performed by the National Health Service, both male to female and female to male, for each of the last 20 years, giving the cost to the Exchequer in each case.
Mr. Mellor : I met the Wessex chairman at the region's ministerial review on 10 January. My right hon. and learned Friend the Secretary of State and I saw all chairmen on 18 January and will expect to meet Mr. Buchanan again at our next regular meeting with regional chairmen on 14-15 March.
61. Mr. David Davis : To ask the Secretary of State for Health by what proportion spending on the National Health Service has increased above the rate of inflation since 1979 ; and what is his estimate of the likely figure when the additional resources he has announced for the coming year are taken into account.
63. Mr. O'Brien : To ask the Secretary of State for Health when he intends to make available the amended recommendations concerning the introduction of the cook-chill meals system into hospitals under the charge of the Wakefield district health authority ; and if he will make a statement.
Mr. Kenneth Clarke : Wakefield district health authority is responsible for arrangements for the introduction of the cook-chill meals system in hospitals under its charge and there is no reason why it should not introduce the system forthwith provided it ensures that the existing departmental guidelines on pre-cooked chilled foods are followed. Updated guidelines are nearly ready for publication, but there is no reason to delay the use of cook-chill equipment while we are waiting for publication.
64. Mr. Cousins : To ask the Secretary of State for Health if he will state the number of regional steering groups, concerned with the safety net review of hospital medical staffing, which have issued guidance to their respective district working parties in accordance with his suggested timetable, or later, respectively.
Mr. Mellor : We do not hold this information centrally. We have requested an interim report on progress in carrying out the review of juniors' hours and the safety-net from health authorities by later this month.
Column 544of deaths in the United Kingdom from hypothermia and cold-related diseases in the last winter period for which figures are available.
Mr. Freeman : The latest complete winter period for which figures are available is the winter of 1987-88. The provisional number of deaths registered in the United Kingdom with any mention of hypothermia on the death certificate, irrespective of whether it appeared as the underlying cause of death or did not, for the period October 1987 to March 1988 inclusive, is 449.
Mr. Freeman : We have recently issued detailed guidance to health authorities on this subject. For further information, I refer my hon. Friend to the reply given to my hon. Friend the Member for Uxbridge (Mr. Shersby) on 13 December, at column 555.
We are also carrying out a continuing publicity programme. My reply to my hon. Friend the Member for Skipton and Ripon (Mr. Curry) today gives further details.
Mr. Freeman : The Department's donor card campaign is continuing to progress well. The range of outlets where the cards are available has been expanded and there has been a substantial increase in the number of cards distributed compared with last year.
"Readers Digest" is producing and distributing over 5 million donor cards in its February issue at no cost to the Department. A video for transplant co-ordinators displays and a new range of leaflets will be launched in the spring.
Mr. Mellor : Allocations to district health authorities are a matter for the regional health authorities concerned. However, I understand that in 1988-89 the East Anglian regional health authority made available an additional £6,145,000 to the Norwich health authority. Norwich health authority is also to receive a further sum of about £1.4 million to meet the cost of the nurses regrading exercise.
Mr. Freeman : A major publicity campaign began at the end of December and is planned to continue throughout 1989. It includes national and regional television advertising, and a series of advertisements in the national press. The campaign will complement a comprehensive
Column 545programme of activity involving industry and commerce, local groups, primary health care activity and special promotions.
Mr. Mellor : Gross revenue expenditure in North Western regional health authority increased in 1987-88 by 8.7 per cent. in cash and 3.2 per cent. in real terms over the previous year. The region's initial revenue cash limit for 1988-89 was £1,038.8 million. Subsequent in-year additions have been made for :
|£ million ------------------------------------------- Review Body pay awards |53.5 Waiting lists |2.6 AIDS |0.5 Other services |0.4
As a result expenditure this year is expected to rise by over 9 per cent. compared with 1987-88, a real terms increase of some 3 per cent.
The allocation of funds to districts within the region is a matter for the regional health authority.
87. Mr. Kirkhope : To ask the Secretary of State for Health what progress has been made on major hospital building schemes costing more than £1 million in the Yorkshire regional health authority area.
Mr. Freeman : Information held centrally shows that last year six schemes, each costing more than £1 million, were completed by the Yorkshire regional health authority, including phase 1 of the redevelopment of Staincliffe district general hospital. A further 42 schemes are at various stages of planning, design and construction including major developments at Scunthorpe, St. James hospital, Leeds and St. Lukes hospital, Bradford.
Mr. Freeman : My right hon. and learned Friend, the Secretary of State and my predecessor the hon. Member for Derbyshire, South (Mrs. Currie) last met the chief executive of the Health Education Authority on 8 December 1988 to discuss the "Look After Your Heart" campaign.
Column 546authorities to provide separate facilities for women having abortions and those receiving infertility treatment in National Health Service hospitals ; and if he will make a statement.
Mr. Freeman : Provision of health services is a matter for individual health authorities in the light of local needs and priorities. We would, however, expect health authorities to consider the individual needs of patients, in this respect, as far as is possible.
Mr. Mellor : The chief executive of the National Health Service Management Board will be writing shortly to health authority general managers asking them to submit bids for pump-priming new developments in post-registration nurse training in the high technology specialties.
This follows a survey by the management board of training and development in the high technology specialties. The results of the survey are being sent to health authorities and a copy will be placed in the Library. In addition, the English National Board for Nursing, Midwifery and Health Visiting has been asked to draw up proposals to review the structure of post-registration training in order to widen access and reduce any duplication or overlap between different courses.
Some £4 million will be available in 1989-90 for these complementary activities. This demonstrates the importance we attach to equipping nurses with the skills they need in an increasingly complex health care environment.
Mr. Mellor : My right hon. and learned Friend the Secretary of State had a friendly and useful discussion with the president and the general secretary of the Royal College of Midwives on 7 December. No date was set for a future meeting, but we have regular meetings with the royal college to discuss a wide range of issues and I would expect and hope that this practice will continue.
Mr. Freeman : I refer my hon. Friend to the reply given by my hon. and learned Friend the Minister for Health to my hon. Friend the Member for Nuneaton (Mr. Stevens) on 13 December 1988, at column 550.
Column 547commended to all health authorities in England and Wales, emphasises the crucial importance of helping parents of stillborn children to come to terms with their loss and grief. It gives detailed guidance on the ways in which this can be done. A copy of the report is available in the Library.
The Stillbirth and Neonatal Death Society (SANDS), which has received £75,000 in funding from the Department in the last three years, also makes a valuable contribution by raising awareness of the needs of parents.
Mr. Campbell-Savours : To ask the Secretary of State for Health what representations he has received concerning the transfer of control of care for mentally handicapped persons in Bexley to Social Policy Management Services Ltd.
Mr. Campbell-Savours : To ask the Secretary of State for Health (1) what guidance he issues to local authorities concerning the transfer of responsibility for care of mentally handicapped persons to private companies ;
(2) what is his policy on the privatisation of local authority services for the care of mentally handicapped persons.
Mr. Freeman : No specific guidance has been issued. The Department encourages local and health authorities, which have statutory responsibility for providing care for mentally handicapped people, to work closely together with the private and voluntary sectors to develop a fully integrated range of services tailored to the specific needs of mentally handicapped people in the most cost-effective way.
Mr. Leighton : To ask the Secretary of State for Health what estimate he has made of extra demand for health care consequent upon the development of the docklands area of the London borough of Newham.
Mr. Mellor : It is for health authorities to plan local health services in the light of changing local needs and circumstances. We understand that Newham health authority and the City and East London FPCs, which are responsible for health provision in the docklands area of the London borough of Newham, are working with the London docklands development corporation to ensure that it is able to take account of future demand for health care. The hon. Member may wish to approach the chairmen of Newham health authority and City and East London FPCs for further information.
Mr. Ralph Howell : To ask the Secretary of State for Health on what basis National Health Service land was valued before and after the two dates given in his reply to the hon. Member for Norfolk, North Official Report , 16 November 1987, column 441 , 27 November 1987, columns 319-21 and 19 April 1988, column 382 , and upon whose advice ; and what would be the notional value of this National Health Service estate with planning consent.
Mr. Freeman : My predecessor's reply of 16 November 1987, at column 439 , gave the 1985 existing use value of the NHS estate (£12.7 billion). The existing use value is the summation of the depreciated replacement cost of the buildings and the value of the land on which they stand. The 1987 revaluation increased this figure to £18.1 billion.
My predecessor's reply of 19 April 1988, at column 382 gave the provisional open market value of the estate following the 1987 revaluation. The final calculation of this value gave a figure of £7.4 billion. The open market value, which assumes the most likely planning consent, represents the opportunity cost of the land and buildings.
All valuations are carried out by the chief valuers office of the Inland Revenue.
Mr. Fearn : To ask the Secretary of State for Health, if he will list the receipts from the sales of National Health Service mental hospital property and land since 1979 by regional health authorities in relation to the total receipt of sales of National Health Service property and land, by region, giving anticipated receipts similarly classified for future years.
Mr. Freeman : The most recent information on receipts from sales of surplus NHS property and land by regional health authority was given by my hon. and learned Friend the Minister of State for Health to the hon. Member for Mansfield (Mr. Meale) on 19 December 1988. Information is not routinely collected on sales of surplus NHS property and land defined by functional group and to collect it by means of a special exercise would involve disproportionate cost. Regional health authorities' forecasts of sales proceeds for the current and next three years are set out in the table.
Forecast-receipts from the sale of NHS properties and land £ million Region |1988-89 |1989-90 |1990-91 |1991-92 --------------------------------------------------------------- Northern |5.3 |2.2 |1.3 |0.8 Yorkshire |13.5 |14.0 |0.9 |4.2 Trent |17.2 |11.0 |3.6 |2.9 East Anglian |11.0 |3.0 |3.1 |2.5 North West Thames |45.2 |54.0 |37.2 |50.0 North East Thames |71.0 |58.0 |22.0 |44.8 South East Thames |40.7 |28.0 |21.0 |21.0 South West Thames |25.0 |<1> |<1> |<1> Wessex |20.5 |10.0 |5.0 |5.0 Oxford |17.6 |1.0 |3.2 |0.1 South Western |21.0 |19.7 |3.0 |4.4 West Midlands |11.3 |3.0 |5.7 |5.2 Mersey |8.8 |6.7 |3.6 |1.6 North Western |24.7 |2.5 |0.7 |<1> SHAs |4.2 |22.5 |nil |nil England |337.0 |<2>235.6|<2>110.3|<2>142.5 <1> Not available. <2> Provisional figure.
Mr. Sean Hughes : To ask the Secretary of State for Health what is the number of staff in his Department, by grade, in receipt of local pay additions outside London and the south-east economic planning region ; what are the different amounts paid to staff by grade ; whether this figure varies due to location ; what qualifying period of scale-related criteria is used ; and whether this varies by location.