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Mr. Mellor [holding answer 31 January 1989] : Medicines containing the antibiotic substance neomycin were introduced in the early 1950s. There was then no general statutory requirement for pre-marketing approval of the type introduced by the Medicines Act 1968. It is not now possible to be precise about the date of introduction or the conditions of marketing. Reports of ototoxicity (damage to the ear, including deafness) associated with injections of neomycin led to discussion in the medical literature in the early 1960s of the risks of deafness. The injectable forms were subjected in 1966 to the Therapeutic Substances Act (TSA) 1956. TSA control was more limited than the comprehensive system under the Medicines Act 1986. Its chief objects were to ensure purity and potency. The risk of ototoxicity associated with all forms of neomycin was reported by the later 1960s.
Over the period 1963 to 1988, 14 suspected cases of
neomycin-associated deafness were reported to the Committee on Safety of Medicine (CSM) and its predecessor the Committee on Safety of Drugs (CSD). These reports derive from all formulations of neomycin. It is not meaningful to extrapolate from these reports. As with all prescription-only medicines, the decision in balancing the benefit of treatment of individuals against the risk of unwanted effects is a matter for clinical judgment. I am advised that clinical use of neomycin has become progressively selective with appreciation of the risks of ototoxicity, which the licensing authority (LA) and advisory bodies have played their part in fostering. Centrally available information is held on the number of hospital in-patient cases treated for burns and scalds. The latest available figure is an estimate of 11,190 for 1985, but there is no central information as to whether they were treated with neomycin.
Medicines containing neomycin are subject to all the normal prescription- only controls. Data sheets inform doctors of the risks of ototoxicity. Moreover, in addition to the control of the products, the substance neomycin itself is controlled under the Medicines (Control of Substances for Manufacture) Orders 1971 and 1985 (SI 1971/1200 and SI 1985/1403) : Individual batches are tested by the National Institute for Biological Standards and Control.
The CSM issued a warning to all doctors in 1977 :
"The association of deafness with the parenteral use of neomycin is well established. The Committee on Safety of Medicines have recently received reports of deafness following topical administration of aerosol preparations containing neomycin used in the treatment of extensive skin damage resulting from burns or other causes.
The Committee urge the profession to report any case of ototoxicity which they suspect may have resulted from topical administration of aerosol or any other preparations containing neomycin or other antibiotics."
Column 506The CSM issued a reminder in 1981 in the Current Problems publication to all doctors :
"The Committee on Safety of Medicines wishes to remind doctors that when otitis externa is treated topically with preparations containing chlorhexidine aminoglycoside antibiotics (eg neomycin, framycetin) or polymxins in patients who have a perforation of the tympanic membrane, there is an increased risk of drug-induced deafness. It is therefore important to ensure that there is no perforation in such patients before prescription of these preparations."
The LA reviewed in 1979-80 with advice from the Committee on Review of Medicines (CRM), some medicines with neomycin which had been on the market before the Medicines Act was brought into effect ; were mainly anti- diarrhoea products ; generally, the result was to limit permitted indications for use and require additional warnings in product literature of the products which remained licensed. Other neomycin products are brought under scrutiny as part of the review of all pre-Act medicines.
The independent "British National Formulary" distributed by the Department to all NHS doctors and pharmacists contains explicit warnings.
Discussions have begun with the medical profession with a view to developing voluntary means of access to medical records. It could be counterproductive to anticipate the outcome.
It is for individuals who consider that they may have been made deaf by the use of neomycin to take advice. It would be inappropriate to prejudice such advice or any proceedings which might arise by a general statement or by inquiry into numbers affected or by attempting to identify individuals, for which there is no feasible central mechanism.
Mr. Mellor [holding answer 2 February 1989] : Health and local authorities provide a wide range of services to meet the needs of individuals. Health authorities provide hospital in-patient care where this is appropriate, NHS nursing home provision and community nursing support for those able to live in the community, whilst local authorities provide residential domiciliary and day-care services. We encourage health and local authorities to plan and work jointly with the voluntary and private sectors, to ensure that a comprehensive range of provision is available.
A range of social security benefits is also available to help people who live in their own homes.
Mr. Mellor [holding answer 2 February 1989] : The most recent advice was set out in Circular HC(88)43, which gave guidance to health authorities on preparing short-term plans for 1989-90 and making any necessary revisions to existing strategic plans. A copy of this circular has been placed in the Library. The relevant references are in appendix 4.
Mr. Holt : To ask the Secretary of State for Health what discussions have taken place with employment training agencies on the loss of hot meal services to retirement pensioners in the East Cleveland area.
Mr. Freeman [holding answer 2 February 1989] : I understand that the East Cleveland employment training group luncheon clubs project has been carried forward into employment training. Loftus Employment Training has been appointed as the training manager and is actively considering ways of ensuring the project's continued
Column 508future within employment training. I also understand that Training Agency officials are available to help in this process as necessary.
Mr. Robin Cook : To ask the Secretary of State for Health if he will publish a table showing the relevant figures in table 14.1 of Cm. 614 adjusted by the hospital and community health services pay and price deflator.
Hospital and Community Health Services-Current Expenditure £ millions |1983-84|1984-85|1985-86|1986-87|1987-88 -------------------------------------------------------- Cash figures table 14.1 Cm. 614 Gross |8,882 |9,386 |9,886 |10,623 |11,730 Net |8,628 |9,120 |9,607 |10,320 |11,402 Figures adjusted by HCHS Pay and Price deflator Gross |11,461 |11,446 |11,469 |11,522 |11,730 Net |11,133 |11,122 |11,145 |11,193 |11,402
The table sets out HCHS current expenditure figures from 1983-84, adjusted by the HCHS pay and price deflator for the years in which it is available. These figures do not take account of income from cash releasing cost improvements which, in the years shown, provided a significant contribution to the total resources available for service development.
Mr. Robin Cook : To ask the Secretary of State for Health if he will list the hospitals participating in the resource management initiative and those hospitals that will join the initiative in the next two years.
Royal Huddersfield Infirmary
Royal Hampshire County
The acute resource management initiative will be extended over a phased period to the main acute hospitals in England. No decision has yet been taken on which particular hospitals will join the initiative in the next two years.
71. Mr. Allen : To ask the Minister for the Civil Service what changes he expects to take place in (a) the training of the Civil Service and (b) related matters as a consequence of dismantling of internal frontiers in Europe in the run up to 1992.
Mr. Luce : The Civil Service has for some time been preparing for the single European market. Departments are developing their training to respond to this opportunity, including the use they make of the courses in European affairs run by the Civil Service college. Details of
Column 508these courses are contained in the college brochure "European and International Affairs", a copy of which I am placing in the Library of the House.
Mr. Lee : At 31 December 1988 there were 1,214 job clubs open for business. I refer my hon. Friend to the reply given to my hon. Friend the Member for Bury, North (Mr. Burt) on 27 January at column 810.
Mr. Baldry : To ask the Secretary of State for Employment how many representations he has received following the publication of his Department's survey on the long-term unemployed in London ; and if he will make a statement.
Mr. Lee : My right hon. Friend has not received any representations following the publication of the results of the two London surveys covering employers and the longer-term unemployed, in London, respectively.
There has of course been widespread interest in the research findings, which reveal that there are 150,000 job vacancies in London, at a time when almost 300,000 people are claiming benefit as unemployed.
At least one third of the vacancies require no special qualifications or experience, although many of London's longer-term unemployed do have academic or vocational qualifications, with nearly one in 10 possessing degrees. Many also have experience in management and other skilled occupations.
A quarter of the longer-term unemployed interviewed had not looked for work in the previous week. Many of those who said that they were actively looking for work used methods different from those favoured by employers in filling vacancies. Some of the London unemployed need
Column 509the opportunity to retrain in up-to-date skills, and we now have employment training for them. Others need to look more intensively for the jobs to which they are already well-suited. The surveys underline the importance of the measures which the Government are taking to ensure that benefit is drawn only by those who are genuinely unemployed.
BTA is already involved in a range of promotional activities to stimulate Japanese travel to Great Britain. BTA has also commissioned a study of the Japanese tourism market in conjunction with DTI.
|Number ------------------------ 1984 |263,000 1985 |265,000 1986 |283,000 1987 |358,000 1988 |396,000
Ms. Mowlam : To ask the Secretary of State for Employment if he will provide figures on the number of (a) fatal, (b) major and (c) minor accidents to YTS trainees reported to the Manpower Services Commission/Department of Employment Training Agency for each year from 1984 to 1988, giving the average age of trainees involved.
Mr. Cope : The table shows the number of (a) fatal (b) major and (c) minor accidents to YTS trainees for each year from 1984 to 1987. Figures for the full years of 1988 are not yet available. From the 1 April 1986 changes in legislation on the reporting of accidents were introduced which had the effect of reclassifying some accidents from minor category to the major category--for example, broken wrists and ankles.
The figures in brackets show the number of major and minor accidents under the previous reporting system. The average age of trainees involved could be obtained only at disproportionate cost.
Accidents<1> Major injuries<2> Minor injuries Year |Fatalities|Riddor |Nador |Riddor |Nador ----------------------------------------------------------------------------- 1984 |4<3> |- |190 |- |1,725 1985 |4<4> |- |201 |- |1,885 1986 |7<5> |305 |(221) |1,624 |(1,708) 1987 |7<6> |427 |(262) |2,466 |(2,631) <1> Training Agency accident figures for YTS are compiled on a similar basis to those prepared by the Health and Safety Executive on employed persons. However, agency figures will include a number of accidents, in particular road traffic accidents during scheme time and accidents to trainees in educational establishments which may not have been reportable to the Executive had the individuals been employed. <2> Up to 31 March 1986 major injuries were classified according to the severity criteria laid down in the Notification of Accidents and Dangerous Occurrences Regulations 1980. From 1 April 1986 major injuries have been classified according to the severity criteria laid down in the Reporting of Injuries, Disease and Dangerous Occurences Regulations 1985. <3> This figure includes 2 road traffic accidents. <4> This figure includes 1 road traffic accident. <5> This figure includes 3 road traffic accidents. <6> This figure includes 2 road traffic accidents.
Mr. Nellist : To ask the Secretary of State for Employment on how many occasions in each of the last 10 years his Department has (a) accepted and acted upon or (b) not accepted or acted upon, Civil Service appeal board recommendations concerning his Department's unfair conduct in disciplinary matters ; and if he will make a statement.
Mr. Lee : The information requested is not readily available and can be obtained only at disproportionate cost. Generally speaking rejection of Civil Service appeal board recommendations is not common in my Department.
Mr. Paice : To ask the Secretary of State for Employment what steps he is taking to reduce duplication between YTS, the technical and vocational education initiative, CPVE and other vocational courses.
Mr. Cope : This area is being carefully looked at and a number of lessons are emerging, including developments in records of achievement and vocational qualifications. We will continue to work towards reducing duplication to ensure progression for young people to obtain higher levels of attainment while maximising the increased choices available to young people as they move from school to work.
Mr. Cash : To ask the Secretary of State for Employment if he will make a statement about the Training Agency's support for equal opportunities in training and employment for members of ethnic minorities.
First, the Government will increase the provision within employment training for unemployed people who need training in English as a second language. There will be extra finance for supplementary grants for this kind of training ; extra money for the assessment of people who need such training ; and staff involved in the programme will receive training in the relevant expertise and, for the year beginning 1 April 1989, consultancy advice. These improvements to employment training will cost £1.3 million per year.
Secondly, there will be a major initiative to increase the use of open and flexible learning in English as a second language. A total of £200,000 per year will be available to identify good open learning materials, to commission new material if necessary, and to promote its use.
Thirdly, the Government are to extend the new programme "Business Growth Training" which was announced by my right hon. Friend the Secretary of State on 24 January ( Official Report, 25 January, column 550 ). In inner city target areas, firms receiving help under the programme for outside advice on training will be eligible for up to two-thirds of the total cost of their project, rather than the normal one-half maximum. A further £5,000--on top of the £15,000 maximum--would be available for such projects, whether or not in inner cities, to fund training which helped to increase equal opportunities for ethnic minority employees of the firm concerned. I am asking the Training Agency to ensure that each of its area offices with a concentration of ethnic minority employees in its area sets up appropriate projects of this kind. The annual cost of this extension of "Business Growth Training" would be £1 million in a full year. These new measures will supersede the present funding of the net running costs of industrial language training units totalling £2.2 million in 1988-89. Their original purpose was to provide training in basic English for first generation immigrants in employment. But while members of ethnic minorities in the work force are employed largely by private sector firms, the proportion of private sector employers helped by the units is small. The location of units does not fully reflect the distribution of ethnic minorities in the work force. And, the units focus on people in employment, whereas those in the greatest need are unemployed.
The new arrangements announced today will create new business opportunities for the units. In order to give them time to adjust, their direct funding will therefore be extended from 31 March to 11 August 1989.
I am confident that the new arrangements will help members of the ethnic minorities more and more effectively.
Mr. Kirkwood : To ask the Secretary of State for Defence (1), pursuant to his reply to the hon. Member for Roxburgh and Berwickshire on 13 July 1988, Official Report, columns 238-39, what is the reason for the decline in the amount of low flying taking place over southern Scotland in the first three months of 1988 ; and if he will provide an updated table showing the latest available figures for the numbers of movements and complaints in 1988 ; (2) if the figures for low flying aircraft movements over southern Scotland in his written answer to the hon. Member for Roxburgh and Berwickshire, 1 May 1987, Official Report, column 298, and 13 July 1988, columns 238-39, include movements in low flying area 13 ; and if he will make a statement.
Mr. Neubert : Pursuant to the reply provided by my predecessor, my hon. Friend the Member for Kettering (Mr. Freeman) on 13 July 1988, columns 238-39, I regret that an error was made in the calculation of the proportion of United Kingdom low flying movements over southern Scotland in the first three months of 1988. The correct figure is 7.1 per cent. The latest available figures for the numbers of movements in and complaints from southern Scotland are as follows :
|1 January to 31 October |1988 ---------------------------------------------------------------------------------- Movements in southern Scotland |17,049 Complaints from southern Scotland |285
The figures for movements in southern Scotland do not include movements in low flying area 13.
Dr. Thomas : To ask the Secretary of State of Defence how many contracts for research or development have been awarded to United Kingdom universities and other institutions of higher education under the strategic defence initiative programme ; and what is their total worth.
Dr. Thomas : To ask the Secretary of State of Defence how many United Kingdom universities and other institutions of higher education have so far received contracts for research or development under the United States of America strategic defence initiative programme.
Mr. Kennedy : To ask the Secretary of State for Defence if he will detail the matters under consideration in the course of his current review of military low flying, the time-scale involved and the consideration given to possible public consultation ; and if he will make a statement.
Mr. Neubert : There is no review of military low flying taking place. However, as part of a continuous monitoring of the United Kingdom low flying system, a programme of reviews of avoidance areas is carried out and changes made when necessary, reflecting changes on the ground,
Column 513and aimed at spreading low flying more evenly and enchancing flight safety, while at the same time reducing, where possible, the disturbance to those on the ground.
Mr. Ashley : To ask the Secretary of State of Defence, pursuant to the answer to the right hon. Member for Stoke-on-Trent, South, Official Report, 13 January, column 782 (1) at what level records are kept of the submissions for redress of complaint by service men ; what categorisation of complaints is made ; whether a report is prepared of the number of complaints made in each category ; and what information is required centrally ;
(2) what effort would be required to obtain from existing records the number of submissions for redress of complaint relating to racial discriminniation or abuse ; what would be the cost ; if he will provide as much information as is accessible ; and if he will make a statement.
Mr. Neubert : Submissions for redress of grievance are retained as permanent records on the individual's service documents. Complaints may be made orally or in writing and are normally resolved at unit level. Commanding officers have a duty to investigate all complaints seeking redress and if the complainant is dissatisfied with the decision the rules provide for the complaint to be submitted to each subsequent level in the chain of command and ultimately to the service boards. Complaints investigated by the special investigations branch are categorised according to the nature of the offence (assault, theft, etc).
Central records are kept only of cases submitted to the service boards. To obtain the information requested by the right hon. Gentleman would involve disproportionate cost, requiring individual returns from many thousands of service establishments world wide of cases settled at unit level.
Dr. Thomas : To ask the Secretary of State for Defence if he will publish a table listing for (a) Wales, (b) Scotland, (c) England, (d) The Federal Republic of Germany, (e) Cyprus and (f) the Falkland Islands the number of complaints received in 1988 by his Department concerning the low flying of Royal Air Force or Royal Navy planes and seeking a reduction in this activity.
Mr. Neubert : My Department does not keep central records of complaints made about low-flying aircraft other than those involving activity in the United Kingdom low flying system. The total number of complaints received in 1988 is not yet available.
Dr. Thomas : To ask the Secretary of State for Defence what proportion of the annual defence budget has been allocated to nuclear weapons design, production, maintenance and deployment in each year since 1979.
Mr. Archie Hamilton : Estimated spending on strategic nuclear forces is shown in table 2.3 of volume 2 of the 1988 statement on the Defence Estimates (Cm 344-II). Since 1979, this spending has represented the following proportions of the defence budget :
|Per cent. ------------------------------ 1979-80 |1.5 1980-81 |1.5 1981-82 |2.2 1982-83 |2.3 1983-84 |2.4 1984-85 |2.3 1985-86 |2.8 1986-87 |3.6 1987-88 |4.7 1988-89 |<1>5.6 <1> Provisional estimate.
Mr. Cohen : To ask the Secretary of State for Defence if he will list the United States military construction projects in the United Kingdom for which funding approval was given in fiscal year 1989, giving for each project its location, the nature of facilities to be constructed and an estimate of when the project will achieve operational status.
Mr. Archie Hamilton [holding answer 31 January 1989] : I understand from information provided by the United States authorities that the following United States military construction projects have been funded for fiscal year 1989. Information regarding the operational status of these projects is unavailable. The dates given reflect when the facilities will be ready for occupation.
Base and facility |Ready for occupation ------------------------------------------------------------------------------------------------------------- RAF Bentwaters Recreation centre |March 1991 Sound suppressor support |September 1989 RAF Feltwell Passive defence equipment store |January 1990 RAF Lakenheath DEB communications building |March 1990 Alter/add to composite medical facility |May 1993 Semi-hardened communications facility |May 1990 Menwith Hill station Expansion of operations facilities |March 1991 RAF Mildenhall Child development centre |July 1990 Alter/add to water storage |June 1991 Alter/add to operations facility |August 1990 RAF Upper Heyford Upgrade/add to vehicle maintenance facility |<1> RAF Welford Fire station |September 1990 Munitions igloos |May 1990 <1> Although funding has been approved for this project, it is currently under United States Air Force review.
Mr. Cohen : To ask the Secretary of State for Defence what is the latest information he has about United States military construction projects in the United Kingdom and its dependent territories for which funding approval is being sought for the United States fiscal years 1990 and 1991, giving for each project its location, the nature of the facilities to be constructed and an estimate of when each project will achieve operational status.
Column 515operational status is not available. I understand from information provided by the United States authorities that funding approval for the following United States military construction projects is currently being sought.
Automotive vehicle maintenance shop
Enlisted bachelor quarters and mess hall
Defence communications system site security
Alter/add to physical fitness facility
Conventional munitions shop
Squadron operations facility
RAF Barford St. John
Add to/upgrade fire station
Alter munitions storage facility
Central post office
RAF Christmas Common
Defence communications system site security
Operations building annex
Digital European backbone facility
Jet fuel storage/hydrant refuelling system
Upgrade water storage and distribution system
Chemical warfare protection--squadron operations facility Storm drainage disposal
Jet fuel storage
Upgrade sewage treatment plant
RAF Upper Heyford
Alter munitions storage facility
Combat readiness centre
Chemical warfare protection--squadron operations facility F-111 add to and alter flight simulator facility
F-111 add to avionics maintenance shop
F-111 add to engine shop
Department of Defence dependent schools
Bicester elementary school
Upwood elementary school addition
Defence medical support activity
RAF Chessington (contingency hospital)
RAF Lanark (fleet contingency hospital)
Naval communications utilities support upgrade
Pay and personnel support office