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Mr. Cousins : To ask the Secretary of State for Health what are the sources of guidance for the calibration and dose control standards of radiation medicines which he expects health authorities to implement, and the particular sections of such sources which particularly refer to calibration and dose standards ; and if he will place all such guidance in the Library.
Mr. Mellor : In May 1988 executive letter EL(88)P/64 was issued to all health authorities, covering the guidance notes for the protection of persons against ionising radiations arising from medical and dental use, which replaced a code of practice first published in 1957, and most recently revised in 1972. Section 10.46 et seq of the guidance notes deal specifically with calibration and dose standards regarding radioactive substances, (which includes what you refer to as radiation medicines).
The executive letter indicated that the guidance notes provided a guide to good practice and asked managers to bring them to the attention of all relevant staff. All these documents have been placed in the Library.
Mr. Cousins : To ask the Secretary of State for Health when he has asked for all the incidents of radiation overdosage within the National Health Service to be reported to him ; and on what dates such a request was issued to regions or districts.
Mr. Mellor : In 1972 we contributed to a revision of the code of practice for the protection of persons against
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ionising radiations arising from medical and dental use, which was issued to all health authorities. That code called for reporting of instances in which patients had received in excess of a prescribed dose of radiation.The Ionising Radiations Regulations 1985 sent to all health authorities along with health circular HC(85)31, made it mandatory for the Health and Safety Executive to be notified, by the employer, of any incident in which a person undergoing a medical exposure was exposed to ionising radiation, to an extent much greater than that intended. The guidance notes for the protection of persons against ionising radiations arising from medical and dental use published in 1988, to replace the code of practice, gave further guidance on the interpretation of the Ionising Radiations Regulations 1985, and made it clear that all radiation accidents or serious defects involving equipment should be notified immediately to the Department. This document, under cover of executive letter EL(86)P/64, was also distributed to all health authorities.
Mr. Cousins : To ask the Secretary of State for Health how many consultant radiotherapists are actually working in the National Health Service in each of the last five years ; and what percentage of such consultants are full time within the National Health Service.
Mr. Mellor : The available information is set out in the table. Consultants with whole-time NHS contracts are not required to spend the whole of their professional time on NHS work. The number of consultant staff working exclusively in the NHS is not known and, therefore, the percentage given is that for consultants holding whole-time contracts.
n Table: Consultants in Radiotherapy (at 30 September each year) England Numbers Year |All staff<1> |Whole-time |Percentage whole-time -------------------------------------------------------------------------------------------------------------- 1983 |199 |115 |57.8 1984 |195 |107 |54.9 1985 |199 |106 |53.3 1986 |202 |104 |51.5 1987 |204 |100 |49.0 <1> Includes permanent paid and honorary staff, but excludes locum staff.
Mr. Cousins : To ask the Secretary of State for Health (1) what support he has given, or proposes to give, to the nationwide survey of the quality of radiation dosimetry being carried out by the Institute of Physical Sciences in Medicine ;
(2) why he has refused financial support to the Institute of Physical Sciences in Medicine's nationwide survey of the quality of radiation dosimetry.
Mr. Mellor : In 1984 a decision was taken not to support this project from central research and development funds. In terms of its research and development merits it was not of as high priority as competing projects. However, its merits as a quality assurance aid to NHS management was full recognised and the Institute of Physical Sciences in Medicine was advised to seek support from health authorities on this basis.
A number of hospitals have subsequently participated in the survey, including the Royal Devon and Exeter hospital where, in 1988, it played a role in revealing an error in the radiotherapy department. Any further proposals for central funding will be considered on their merits.
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Broadmoor Special Hospital (Deaths)
Mr. Redmond : To ask the Secretary of State for Health if he will list for the last five years the number of deaths that have occurred at Broadmoor special hospital, the cause of death and the number of deaths that were investigated by a public inquiry ; and if he will make a statement.
Mr. Freeman : Deaths of patients at Broadmoor hospital in the five years ended 31 December 1988 are listed in the table. That which occurred on 6 July 1984 was investigated by a public inquiry. But the circumstances of all deaths arising from other than natural causes are fully considered by hospital management to see whether any lessons can be learned.
Date of death |Cause of death
---------------------------------------------------------------------------------------------------------------------
|20 January 1984
10 May 1984 |Stroke/heart attack
6 July 1984 |Inhalation of stomach contents
2 August 1984 |Pulmonary thrombo-embolism/
| carcinoma of colon/acute peritonitis
23 November 1984 |Pneumonia
8 March 1985 |Suicide (hanging)
23 August 1985 |Heart attack
29 April 1986 |Heart attack
6 July 1986 |Heart attack
26 July 1986 |Suicide (hanging)
14 September 1986 |Heart attack
11 November 1986 |Peritonitis/pneumonia
20 May 1987 |Heart attack
21 May 1987 |Pneumonia/lung cancer
11 July 1987 |Suicide (hanging)
10 September 1987 |Choked on food
29 October 1987 |Heart attack
28 January 1988 |Heart attack
8 April 1988 |Cancer of the stomach
29 April 1988 |Respiratory arrest/Cardio myopathy
| (HIV positive)
23 August 1988 |Inhalation of stomach contents/cardio-
| respiratory failure associated with
| Chlorpromazine therapy
7 October 1988 |Pneumonia associated with emphysema
Audiology Technicians
Mr. Robert B. Jones : To ask the Secretary of State for Health what steps he is taking to ensure an adequate supply of audiology technicians for health authorities in the south-east of England.
Mr. Mellor : I refer my hon. Friend to the reply that I gave on 29 November to the right hon. Member for Stoke on Trent, South (Mr. Ashley) at column 197.
Dentists
Mr. Sean Hughes : To ask the Secretary of State for Health whether any additional accountancy fees arising from time taken to answer questions from the dental rates study group are to be fully reimbursed to the dentists concerned.
Mr. Freeman : General dental practitioners' practice expenses, including accountancy fees in connection with NHS work, are reimbursed indirectly through fees paid for NHS dental treatment. These fees are based on the recommendations of the dental rates study group.
Mr. Sean Hughes : To ask the Secretary of State for Health whether British dentists will be free after 1992 to practice within the EEC without further accreditation.
Mr. Freeman : Any United Kingdom dentist with a recognised qualification already has the right to practice within any member state of the EC under directives adoped in 1978.
Dental Reference Service
Mr. Sean Hughes : To ask the Secretary of State for Health what was the cost of the dental reference service in each year from 1983 to 1988 ; and whether he will give separate figures for salaries, travelling, pension contributions, purchase of equipment, accommodation costs, and rental of premises within that overall figure.
Mr. Freeman : The information requested is set out in the table. All figures relate to the financial year and are in £000s.
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Year |Total cost |Estimated salaries |Employers superannuation|Travelling ------------------------------------------------------------------------------------------------------------------------------------------------------ 1983-84 |917 |690 |138 |89 1984-85 |1,051 |796 |159 |96 1985-86 |1,229 |958 |192 |79 1986-87 |1,335 |1,035 |207 |93 1987-88 |1,455 |1,121 |224 |110
It is not possible to provide figures for equipment, accommodation and rentals because these are subsumed in other departmental budgets and cannot easily be identified.
Mr. Sean Hughes : To ask the Secretary of State for Health what was the average number of weeks worked per year by all dental reference officers in each of the years between 1983 and 1988, excluding sick leave, leave, study leave and attendance at courses.
Mr. Freeman : The information requested is as follows :
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Year |Number of weeks ------------------------------------------------ 1984 |42.6 1985 |42.1 1986 |42.3 1987 |42.6 1988 |40.8
Information in respect of 1983 is not available.
Health Authority Chairmen
Mr. Hinchliffe : To ask the Secretary of State for Health if he will take steps to produce a register of interests for chairmen of district and regional health authorities.
Column 277
Mr. Mellor : No, it is not necessary. The statutory position on this is quite clear. Under regulation 14 (1) of the NHS (Regional and District Health Authorities Membership and Procedure) Regulations 1983 a chairman or member of a health authority is required to declare any pecuniary interest, direct or otherwise, in any contract or other matter which is the subject of consideration by the health authority. He may not then take part in any consideration or discussion of the contract (or other matter) or vote in any question in respect of it.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will publish the names of all British regional and district health authority chairmen indicating the length of time in which these persons have held office.
Mr. Mellor : The information requested for regional and district health authority chairmen in England has been placed in the Library. The appointment of health authority chairmen in Scotland is the responsibility of my right hon. and learned Friend the Secretary of State for Scotland, and in Wales and Northern Ireland, of my right hon. Friends the Secretaries of State for Wales and Northern Ireland.
Meningitis
Mr. Hinchliffe : To ask the Secretary of State for Health (1) what was the total number of cases of meningitis recorded in the last year for which figures are available ;
(2) how many fatalities were recorded as a result of meningitis for the last year in which figures are available.
Mr. Freeman : Meningitis can be caused by a number of different organisms. The hon. Member may be particularly interested in meningococcal meningitis. The table shows the number of notifications received for this, plus for all forms of acute meningitis, together with the number of deaths registered with meningococcal meningitis (International Classification of Diseases 9th Revision 036.0) assigned as the underlying cause of death. Notification data for 1988 are as yet uncorrected and provisional, whilst cause of death data are available only for the first three quarters and are similarly provisional. Final data for 1987 are therefore also given.
Number of notifications of all forms of acute
meningitis and
meningococcal meningitis; and death registrations of
meningococcal
meningitis (ICD 9 036.0)
England and Wales 1987-88
|1987 |1988
------------------------------------------------------
Notifications
Acute meningitis<2> |2,542 |<3>3,001
Meningococcal meningitis |1,080 |<3>1,309
Deaths<1>
Meningococcal meningitis |37 |<3><4>31
<1> Plus 28 days and over.
<2> From 1 October 1988 this became known simply as
"meningitis".
<3> Provisional: to allow for corrected disease
notifications/death registrations.
<4> January to September only.
Blood Transfusions
Mrs. Rosie Barnes : To ask the Secretary of State for Health whether there are any plans to seek to change the law to enable doctors to perform life-saving operations, including the use of blood transfusions where necessary, to save the lives of children whose parents refuse consent on religious grounds.
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Mr. Mellor : No, there are no plans to change the law in this area. In an emergency the administration of life-saving procedures on any patient without obtaining consent is a matter for the clinical judgment of the doctor concerned.
Dalkon Shields (Compensation)
Mr. Ashley : To ask the Secretary of State for Health (1) if he will request all health regions which have not already done so to seek out those women who were prescribed Dalkon shields and inform them that it is still possible to claim compensation if they were damaged by it ;
(2) what steps he intends to take to publicise the fact that the date for filing late Dalkon shield compensation claims has been extended to 31 July.
Mr. Freeman : We have no plans for Government intervention in relation to this matter of litigation in the United States courts. For the initial claims deadline, the court itself directed, and approved, publicity by the Dalkon shield manufacturers. Further extensions of the deadline have received independent media publicity. It is for individual health authorities to decide whether they wish to direct their resources to specific activity on this matter. Our longstanding advice has been that they should be as helpful as possible with regard to the release of information.
Hospitals
Mr. Robin Cook : To ask the Secretary of State for Health if he will list the name and health authority of each hospital with more than 250 beds.
Mr. Mellor : The information requested has been placed in the Library.
Perinatal Deaths
Mr. Thurnham : To ask the Secretary of State for Health if he will list the number of perinatal deaths in (a) England, (b) the north-west and (c) Bolton during 1978 and 1988.
Mr. Freeman : Annual figures for 1988 for perinatal deaths are not yet available, so the table shows statistics for 1978 and 1987. Perinatal mortality (stillbirths and deaths in the first week of life) : numbers and rates per 1,000 total live and still births. Usual residents of England, north-west standard region and Bolton metropolitan county district (MCD).
Area of usual residence |1978 |1987
------------------------------------------------------------------------------------------------
England
Number |8,766 |5,742
Rate |15.4 |8.9
North West Region
Number |1,363 |837
Rate |17.0 |9.4
Bolton MCD
Number |68 |29
Rate |19.4 |7.7
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AIDS
Mr. Grylls : To ask the Secretary of State for Health, what safeguards health authorities take to ensure that no one shown by tests to be HIV positive or to have AIDS is allowed to work in National Health Service kitchens.
Mr. Mellor : I am advised that the human immunodeficiency virus is not transmitted through food. There is therefore no reason why people who are HIV positive but otherwise well should not work in National Health Service kitchens. People who are HIV positive or have AIDS who acquire other infections which could be transmitted through food would be subject to the same restrictions on food handling as any other staff with such infections.
Drug Warnings
Mr. Ashley : To ask the Secretary of State for Health how many drug companies have appealed to the Committee on Safety of Medicines against drug warnings which the committee wished to publish ; which companies and which drugs were involved ; and what were the results of the appeals.
Mr. Mellor : Under the Medicines Act 1968, companies have a right of appeal to the Committee on Safety of Medicines (CSM) in respect of CSM's advice to the licensing authority on licensing matters. They have no right of appeal to the CSM about a decision of that committee to issue information or guidance on licensed medicinal products to doctors, dentists and pharmacists.
Mr. Ashley : To ask the Secretary of State for Health if he will seek to amend the Medicines Act so that drug companies are not able to block the publication by the Committee on Safety of Medicines of warning notices about the safety of drugs by an injunction.
Column 280
Mr. Mellor : I have no plans to do so.
Trent Regional Health Authority
Mr. Skinner : To ask the Secretary of State for Health how many people have died of lung cancer in the Trent health region in each year since 1979.
Mr. Freeman : The information is shown in the table ; 1987 is the latest year available.
Number of death registrations with malignant neoplasm of trachea, bronchus and lung (ICD 162)<1> as underlying cause of death to usual residents of Trent regional health authority, 1979-1987 Year |Number of deaths --------------------------------------------------- 1979 |2,938 1980 |3,047 1981 |3,186 1982 |3,046 1983 |3,137 1984 |3,203 1985 |3,340 1986 |3,166 1987 |3,191 <1> International classification of diseases; 9th revision.
Nurses' Grading
Mr. Allen : To ask the Secretary of State for Health if, further to his reply of 26 January, he will make available to the hon. Member for Nottingham, North, the grading returns received from the Trent region and Nottingham district authorities.
Mr. Mellor : The grading returns specify the number of nursing and midwifery staff in each old grade that have been assimilated to each of the new clinical grades. This information is given in the tables.
Column 279
The new clinical grading structure for nursing, midwifery and health visitor staff
Numbers of old clinical grades assimilated to each of the new clinical grades on the basis of duties and responsibilities on 1 April 1988
Numbers transferred to
each new clinical grade
|Staff<1>
Previous grade |(W.T.E.) |A |B |C |D |E |F |G<2> |H |I
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Trent region
Nursing Auxiliary |9,076.50 |8,209.54 |856.96 |10.00 |- |- |- |- |- |-
Staff Nursery Nurse |217.92 |- |208.36 |9.56 |- |- |- |- |- |-
Enrolled Nurse<3> |6,379.63 |- |- |2,749.84 |3,129.68 |499.11 |1.00 |- |- |-
Enrolled District Nurse<3> |340.97 |- |- |- |338.97 |2.00 |- |- |- |-
Senior Enrolled Nurse<3> |371.99 |- |- |4.40 |223.29 |142.09 |2.21 |- |- |-
Staff Nurse<3> |6,632.21 |- |- |- |1,544.90 |4,649.31 |438.00 |- |- |-
Staff Midwife<3> |701.90 |- |- |- |115.14 |577.67 |9.09 |- |- |-
Deputy Sister<3> |395.20 |- |- |- |- |81.84 |305.90 |6.46 |1.00 |-
Nursing Sister II<3> |3,801.63 |- |- |- |- |- |1,726.45 |1,956.47 |114.71 |4.00
Midwifery Sister II<3> |873.51 |- |- |- |- |- |261.20 |609.81 |2.50 |-
District Nurse (Sister II)<3> |1,066.06 |- |- |- |- |- |2.45 |1,054.61 |9.00 |-
Nursing Sister I |57.99 |- |- |- |- |- |3.37 |23.82 |26.80 |4.00
Midwifery Sister I |19.00 |- |- |- |- |- |1.00 |18.00 |- |-
Health Visitor |878.35 |- |- |- |- |- |- |870.75 |7.60 |-
Senior Nurse 8 |331.48 |- |- |- |- |- |2.00 |59.13 |177.35 |93.00
Senior Nurse 8 (Midwife) |38.00 |- |- |- |- |- |- |12.00 |13.00 |13.00
Senior Nurse 7 |300.40 |- |- |- |- |- |- |5.00 |37.60 |257.80
Senior Nurse 7 (Midwife) |36.93 |- |- |- |- |- |- |- |13.00 |23.93
Clinical Teacher |154.56 |- |- |- |- |- |- |3.00 |151.56 |-
Fieldwork Teacher |121.65 |- |- |- |- |- |1.00 |0.53 |120.12 |-
Practical Work Teacher |157.80 |- |- |- |- |- |- |3.00 |154.80 |-
Tutor |197.93 |- |- |- |- |- |- |- |1.00 |196.93
Tutor Midwife |45.16 |- |- |- |- |- |- |- |- |45.16
Post basic students
Enrolled |282.00 |- |- |282.00 |- |- |- |- |- |-
Staff Nurse |936.50 |- |- |- |882.50 |44.00 |2.00 |10.00 |- |-
Deputy Sister |8.00 |- |- |- |- |4.00 |4.00 |- |- |-
Sister II |16.00 |- |- |- |- |- |15.00 |1.00 |- |-
Others |28.11 |3.27 |1.80 |- |0.64 |4.21 |0.74 |7.45 |2.00 |8.00
|------- |------- |------- |------- |------- |------- |------- |------- |------- |-------
Totals |33,469.38 |8,212.81 |1,067.12 |3,055.80 |6,235.12 |6,004.23 |2,775.41 |4,641.03 |832.04 |645.82
Nottingham DHA
Nursing Auxiliary |1,263.58 |1,147.18 |114.40 |2.00 |- |- |- |- |- |-
Staff Nursery Nurse |34.50 |- |32.00 |2.50 |- |- |- |- |- |-
Enrolled Nurse<3> |799.75 |- |- |131.96 |652.83 |14.96 |- |- |- |-
Enrolled District Nurse<3> |27.30 |- |- |- |26.30 |1.00 |- |- |- |-
Senior Enrolled Nurse<3> |103.45 |- |- |1.40 |83.55 |18.00 |0.50 |- |- |-
Staff Nurse<3> |1,045.30 |- |- |- |215.53 |788.18 |41.59 |- |- |-
Staff Midwife<3> |120.82 |- |- |- |23.00 |97.82 |- |- |- |-
Deputy Sister<3> |50.13 |- |- |- |- |2.00 |48.13 |- |- |-
Nursing Sister II<3> |590.90 |- |- |- |- |- |260.86 |328.04 |2.00 |-
Midwifery Sister II<3> |153.10 |- |- |- |- |- |23.13 |129.97 |- |-
District Nurse (Sister II)<3> |112.04 |- |- |- |- |- |- |112.04 |- |-
Nursing Sister I |6.00 |- |- |- |- |- |- |6.00 |- |-
Midwifery Sister I |- |- |- |- |- |- |- |- |- |-
Health Visitor |124.45 |- |- |- |- |- |- |123.45 |1.00 |-
Senior Nurse 8 |71.60 |- |- |- |- |- |2.00 |39.60 |27.00 |3.00
Senior Nurse 8 (Midwife) |7.00 |- |- |- |- |- |- |7.00 |- |-
Senior Nurse 7 |45.00 |- |- |- |- |- |- |5.00 |8.00 |32.00
Senior Nurse 7 (Midwife) |10.93 |- |- |- |- |- |- |- |9.00 |1.93
Clinical Teacher |26.16 |- |- |- |- |- |- |- |26.16 |-
Fieldwork Teacher |14.00 |- |- |- |- |- |- |- |14.00 |-
Practical Work Teacher |24.00 |- |- |- |- |- |- |- |24.00 |-
Tutor |38.03 |- |- |- |- |- |- |- |- |38.03
Tutor Midwife |8.00 |- |- |- |- |- |- |- |- |8.00
Post basic students
Enrolled |35.00 |- |- |35.00 |- |- |- |- |- |-
Staff Nurse |183.00 |- |- |- |183.00 |- |- |- |- |-
Deputy Sister |- |- |- |- |- |- |- |- |- |-
Sister II |- |- |- |- |- |- |- |- |- |-
Others |2.00 |- |- |- |- |- |- |- |- |2.00
|------- |------- |------- |------- |------- |------- |------- |------- |------- |-------
Totals |4,896.04 |1,147.18 |146.40 |172.86 |1,184.21 |921.96 |376.21 |751.10 |111.16 |84.96
<1> Staff in post plus vacancies.
<2> Excludes some additional G' posts which health authorities have indicated they intend to create in future on existing two-sister wards.
<3> Excludes Post Basic Students.
Medical Equipment Management
Mr. Kaufman : To ask the Secretary of State for Health how many different categories of National Health Service staff are employed in the maintenance of patient-connected equipment ; how many people are employed in each category ; and what the change has been in the distribution and usage of these various categories since the Department of Health and Social Security issued its guidance on the management of medical equipment, HEI98, in January 1982.
Mr. Mellor [holding answer 25 January 1989] : There are usually three categories of staff : physicists, technicians and, in some cases, works staff. We do not collect information centrally on the numbers of staff in these categories who are engaged in this type of maintenance work. We have no indication of any changes in usage patterns since the publication of HEI98.
Medical Physics Technicians
Mr. Kaufman : To ask the Secretary of State for Health how many individual health authorities employ medical physics technicians, codes F807-F814.
Column 282
Mr. Mellor [holding answer 25 January 1989] : At 30 September 1987, the latest date for which figures are available, 148 of the 191 district health authorities had medical physics technicians in post and five of the 14 regional health authorities had medical physics technicians in post.
Mr. Kaufman : To ask the Secretary of State for Health how many individual variation orders have been issued to medical physics technicians over the last three years on a monthly basis.
Mr. Mellor [holding answer 25 January 1989] : The number of variation orders issued in respect of staff employed in the medical physics technician grades in the last three years ending 31 December 1988 is as follows :
|1986|1987|1988
------------------------------
January |1 |- |-
February |1 |1 |2
March |1 |1 |-
April |- |1 |-
May |1 |- |1
June |- |1 |2
July |1 |- |-
August |1 |- |-
September |- |- |-
October |- |- |-
November |- |1 |2
December |- |- |-
Medicines Committees
Ms. Primarolo : To ask the Secretary of State for Health whether he will review the membership of the Medicines Commission and Committee on Safety of Medicines in view of the recent revelations of close personal financial links between several members and pharmaceutical companies.
Mr. Mellor [holding answer 30 January 1989] : No. I refer the hon. Member to my reply to my hon. Friend the Member for Derbyshire, West (Mr. McLoughlin) on 13 December 1988, at columns 557-58 .
No-fault Compensation
Mr. Ashley : To ask the Secretary of State for Health if he will initiate discussions with the Association of British Pharmaceutical Industry and organisations representing doctors and patients regarding a no -fault drug damage compensation scheme.
Mr. Mellor [holding answer 31 January 1989] : We have no plans to do so.
Mr. Ashley : To ask the Secretary of State for Health what representations he has received supporting no-fault compensation for those people damaged by prescribed drugs or those given under medical supervision.
Mr. Mellor [holding answer 31 January 1989] : Only those in which the right hon. Member himself has taken part.
Drugs (Side Effects)
Mr. Ashley : To ask the Secretary of State for Health what current procedures are used to ensure that those prescribing drugs are aware of recent findings which may indicate possible side effects or the need for precautions in the use of drugs.
Mr. Mellor [holding answer 31 January 1989] : The Committee on Safety of Medicines (CSM) sends its publication "Current Problems" to all doctors, dentists, and pharmacists in the United Kingdom about three times a year. This covers a wide range of current drug safety issues, and often includes advice and recommendations to prescribers. The CSM also provides occasional articles and letters for medical journals. Particularly urgent issues are notified direct to prescribers using CSM "Dear Doctor" letters.
The Department also funds the distribution to prescribers of a variety of independent publications, including the "British National Formulary", "Drug and Therapeutics Bulletin", "Adverse Drug Reactions Bulletin" and Prescribers' Journal, all of which provide guidance on the prescribing and use of drugs.
Prescribers can also consult product data sheets which contain detailed information about known side effects, contra-indications and other precautions.
Column 284
Drug Addiction
Mr. Alton : To ask the Secretary of State for Health how many patients are being treated within the Mersey regional health authority area for drug addiction ; and what treatment facilities are available.
Mr. Mellor [holding answer 31 January 1989] : In 1986, the latest year for which figures are available centrally, there were 354 admissions with a drug related main diagnosis to NHS mental illness hospitals and units in the Mersey RHA. Also, in the same year, there were 7,506 attendances at NHS drug addiction out-patient clinics. These figures do not represent the number of people involved since an individual could be admitted to hospital or attend an out-patient clinic several times in one year. In any case, most drug misusers are treated in the community for which information is not available centrally.
There are 10 out-patient drug dependency services and two in-patient units in the region. There are also 12 syringe exchange schemes run by health authorities. These services are supported by a number of voluntary sector services including two residential centres and more than 10 providing counselling services to drug misusers and users' families.
Midwives (Regrading)
Mr. Alton : To ask the Secretary of State for Health how many midwives in the Mersey regional health authority area have appealed against their regrading ; and when the appeals will be heard.
Mr. Mellor [holding answer 31 January 1989] : We do not hold this information centrally.
Private Hospitals
Mrs. Dunwoody : To ask the Secretary of State for Health (1) if he will list the occasions on which he has received reports of infringements of the NAHA code of conduct for private hospitals ; what actions he has taken since its inception ; and what further inspections wereheld ;
(2) what sanctions are available to his Department against private hospitals failing to comply with their statutory duty to provide and maintain adequate medical, surgical and nursing equipment ; how often, following inspections by the appropriate district health authority, and an adverse report, he has acted against private hospitals, in the last three- year period ; and what action he proposes to take ; (3) if he will give the dates in 1985-86, 1986-87, 1987-88 and 1988-89 when the following private hospitals were inspected (a) the Wellington Humana, (b) the London clinic, (c) the BUPA hospital, Harpenden, Hertfordshire, (d) the Lister hospital, (e) the Cromwell hospital, Cromwell road and (f) the Portland hospital ; and whether any of the reports were adverse.
Mr. Mellor [holding answer 31 January 1989] : Registration and inspection of private hospitals and nursing homes is wholly delegated to district health authorities who must be satisfied that the statutory requirements are being met. We do not collect centrally details of their inspections. Authorities have power to cancel registration if the statutory requirements are not being observed. No private hospital has been added to the Department's national list of cancelled registrations.
Column 285
SOCIAL SECURITY
Tax-Benefit Tables
Mr. Ralph Howell : To ask the Secretary of State for Social Security what are the reasons for changing the manner of expressing the former earnings of unemployed persons on the tax/benefit tables from whole number decimal places in such a way as to make direct year by year comparisons of tax/benefit more difficult.
Mr. Peter Lloyd : The tables reflect the tax, national insurance, and benefit structures in particular financial years. Nominal earnings levels in any one year cannot be compared directly with the same nominal levels in another because of changes in price levels. The first gross wage level in table II of both the 1986 and 1987 editions gives the precise upper level of former wages which is consistent with the receipt of maximum family income supplement. Higher earnings levels are then shown in £1 steps. In earlier editions, the initial level of former earnings in table II was rounded to the nearest £1. The 1988 tables revert to this presentation. These differences in convention reflect no more than the degree of rounding chosen.
Income Support
Mr. Robin Cook : To ask the Secretary of State for Social Security if he will list the most recently available figure for the income support live load of each of his Department's offices.
Mr. Peter Lloyd : The information is as follows :
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Income Support Load-30 November 1988 London North Manual Count Office |Total live load --------------------------------------------------------- Aylesbury |7,145 Banbury |4,711 Basildon |16,965 Bedford |10,465 Braintree |7,602 Bury St. Edmunds |8,487 Cambridge |12,241 Chelmsford |7,311 Clacton-on-Sea |6,347 Colchester |9,876 Diss |2,726 Dunstable |4,211 Grays |8,611 Great Yarmouth |9,183 Harlow |6,528 Hemel Hempstead |4,879 Hertford |6,785 High Wycombe |7,312 Ipswich |14,921 King's Lynn |14,453 London (Acton) |12,359 London (Barking) |13,344 London (Barnet) |5,878 London (Canning Town) |4,953 London (Cricklewood) |7,297 London (Ealing) |12,869 London (Edgware) |6,746 London (Edmonton) |14,574 London (Euston) |10,416 London (Finsbury Park) |16,503 London (Hackney) |14,524 London (Harlesden) |10,450 London (Harrow) |9,476 London (Hendon) |8,589 London (Highgate) |16,339 London (Hoxton)<1> |11,130 London (Ilford) |13,522 London (Leytonstone) |9,006 London (Neasden) |11,882 London (Notting Hill) |8,884 London (Paddington) |12,131 London (Plaistow) |10,239 London (Poplar) |13,670 London (Romford) |11,037 London (Shoreditch) |9,217 London (Southall) |9,359 London (Stepney) |8,404 London (Stoke Newington) |8,468 London (Thames North) |1,503 London (Tottenham)<1> |15,067 London (Uxbridge) |6,603 London (Walthamstow) |11,641 London (Watford) |6,926 London (Wood Green) |7,513 London (Woodgrange Park) |13,701 Lowestoft |7,218 Luton |12,256 Milton Keynes |9,702 Norwich (Chantry) |12,834 Norwich (Mountergate) |13,618 Oxford |15,842 Peterborough |17,432 Southend-on-Sea |15,673 St. Albans |5,844 Stevenage |9,396 <1> Data are provisional and subject to amendment.
Young People (Benefits)
Mrs. Beckett : To ask the Secretary of State for Social Security if he will list the changes since 1979, and the dates when they occurred (i) in the conditions of entitlement to supplementary benefit and income support of persons aged 19 years in non-advanced education and (ii) in the circumstances in which extra-statutory payments in lieu of benefit can be made to such persons.
Mr. Peter Lloyd [pursuant to his reply, 23 January 1989, c.415- 17] : I regret the answer was incomplete. I should add that from 11 April 1988, on the introduction of income support, extra-statutory payments were made in additional circumstances to certain 19-year-olds in full-time education. Payments were available on application to young people of age 19 who either had no parents or were estranged or separated from them, and who had been receiving supplementary benefit on that basis immediately before the introduction of income support. The payments from the transitional payments unit in Glasgow were made at the rate of supplementary benefit previously paid, and continued up to the end of the 1988 school year or age 20, in the same way as supplementary benefit would have done. These special payments relating to the transition from supplementary benefit to income support are not available to young people who reached age 19 on or after 11 April 1988.
Mr. Cousins : To ask the Secretary of State for Social Security what proportion of the total population of each standard planning region of the United Kingdom was dependent upon income support or its predecessor benefits in each year since 1979.
Mr. Peter Lloyd : I regret that this information could be provided only by social security region and only at disproportionate cost.
Mr. Cousins : To ask the Secretary of State for Social Security how many people are claiming income support in each standard planning region of the United Kingdom ; what were the corresponding figures for each year since 1979 ; and what was the percentage increase over 1979.
Mr. Peter Lloyd : Information about supplementary benefit or income support claimants is not collected by standard planning region. Information by social security region is as follows :
Table 2 Number of claimants in receipt of Supplementary Benefit or Income Support in a week<1>: 1982 to 1988 Thousands Social Security Region |1982 |1983 |1984 |1986 |1987 |1988<2> ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- North Eastern |692 |714 |756 |794 |777 |701 London North |660 |669 |710 |774 |755 |644 London South |579 |582 |626 |680 |664 |581 Wales and South Western |541 |548 |582 |624 |607 |545 Midlands |728 |732 |769 |821 |818 |715 North Western |644 |664 |698 |739 |738 |670 Wales |253 |260 |275 |291 |287 |259 Scotland |423 |440 |468 |506 |535 |499 <1> A week in November or December up to 1984, February 1986 and in May 1987. <2> Figures for 1988 are provisional and subject to amendment. Note: Due to the restructuring of the Regional Organisation in 1982 it is not possible to estimate the percentage increase over 1979. Sources for both tables:1979-1987 Annual Statistical Inquiry. 1988 May Quarterly Statistical Inquiry.
Table 2 Number of claimants in receipt of Supplementary Benefit or Income Support in a week<1>: 1982 to 1988 Thousands Social Security Region |1982 |1983 |1984 |1986 |1987 |1988<2> ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- North Eastern |692 |714 |756 |794 |777 |701 London North |660 |669 |710 |774 |755 |644 London South |579 |582 |626 |680 |664 |581 Wales and South Western |541 |548 |582 |624 |607 |545 Midlands |728 |732 |769 |821 |818 |715 North Western |644 |664 |698 |739 |738 |670 Wales |253 |260 |275 |291 |287 |259 Scotland |423 |440 |468 |506 |535 |499 <1> A week in November or December up to 1984, February 1986 and in May 1987. <2> Figures for 1988 are provisional and subject to amendment. Note: Due to the restructuring of the Regional Organisation in 1982 it is not possible to estimate the percentage increase over 1979. Sources for both tables:1979-1987 Annual Statistical Inquiry. 1988 May Quarterly Statistical Inquiry.
Single Parents
Mr. Redmond : To ask the Secretary of State for Social Security what has been the results to date of the pilot exercises being carried out by officers from his Department at Eastbourne and Leicester benefit offices on single parents' reliance on social security benefits ; if he will list the benefits being claimed and by sex ; what consideration in the exercise is being given to child care provision and job training ; whether this exercise will be carried out at other offices ; and if he will make a statement.
Mr. Peter Lloyd : Independent research exploring the motivations and perceptions of lone parents receiving benefit has been commissioned. It will look at a wide range of lone parents' circumstances including child care arrangements and job training. A pilot of the design of the study is currently under way in Sittingbourne and Leicester. A sample of lone parents receiving income support have been selected at random and invited to participate in the study. The results from this pilot, which is scheduled for completion on 24 February, will be used to ensure that the main study is effective.
The national study will begin in April 1989 in 44 locations across the country and will include lone parents receiving income support or one- parent benefit only. The final report is due in May 1990.
Mr. Simon Burns : To ask the Secretary of State for Social Security if he has any plans to introduce monitoring procedures for one-parent benefit.
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