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Mr. Cousins : To ask the Secretary of State for Health (1) what additional or revised guidance was issued on the use of radiation medicines on patients in the National Health Service between 1972 and 1988 ; and if he will provide an estimate of the number of radiation medicines in use in each of those years ;
(2) which of the recent recommendations of the International Committee on Radiological Protection on the use of radiation physics medicines he proposes to accept and which he does not.
Mr. Freeman : The Medicines (Administration of Radioactive Substances) Regulations 1978 regulate the administration of radioactive substances to patients or volunteers (which I assume to be what is meant by the term radiation physics medicines) used by the hon. Member. The Administration of Radioactive Substances Advisory Committee (ARSAC) was established in 1980 to advise Health Ministers on the granting of authorisations for the use of such substances. ARSAC produce "Notes for Guidance on the Administration of Radioactive Substances to Persons for Purposes of Diagnosis, Treatment or Research", first published in 1980, and subsequently revised in 1984 and 1988. A copy is issued to each applicant. The most recent publications of the International Commission on Radiological Protection (ICRP) dealing with radioactive medicinal products were ICRP publication 52 "Protection of the Patient in Nuclear Medicine" (1987) and ICRP publication 53 "Radiation Dose to Patients from Radiopharmaceuticals" (1988). Both these documents were taken into account when the 1988 revision of the "Notes for Guidance" was produced. This publication gives details of effective dose equivalents which are in line with those recommended by the ICRP. Exceptionally on the advice of ARSAC the Secretary of State may authorise procedures resulting in higher effective dose equivalents. Additional guidance on the use of radioactive medicinal products was given in the "Code of Practice for the Protection of Persons against Ionizing Radiations arising from Medical and Dental Use" (1972), and is included in the "Guidance Notes for the Protection of Persons Against Ionising Radiation arising from Medical and Dental Use" (1988).
Some aspects of the administration of radioactive medicinal products are also subject to the Ionising Radiations (Protection of Persons undergoing Medical Examinations or Treatment) Regulations 1988, issued to all health authorities under cover of health circular HC(88)29.
Column 68Information is not held centrally as to the number of radioactive medicinal products in use prior to 1980. While a breakdown cannot be given of the radioactive medicinal products in use in any given year since the establishment of ARSAC in 1980, authority has been given for the use of 876 different radioactive medicinal products at various times in the eight years since its inception.
Mr. Cousins : To ask the Secretary of State for Health how many new courses of treatment using radiation physics medicines within the National Health Service were begun in each year since 1983 ; and what was the total caseload in each year.
Mr. Freeman : I have taken the term "radiaction physics medicines" to mean radioactive medicinal products. I regret that information about the number of treatments using radioactive medicinal products, and the total caseloads for each year, is not held centrally.
Mr. Cousins : To ask the Secretary of State for Health how many medical physicists were working in radiotherapy in the National Health Service in each of the last five years ; and how many of those were on the basic grade.
Mr. Alton : To ask the Secretary of State for Health whether there are regulations governing the fate of the placental tissue after (a) an abortion and (b) a normal delivery of a child ; and if he will make a statement.
Mr. Freeman : There is a long-standing arrangement under which health authorities can make available placenta to the Institut Merieux. I understand this is used for therapeutic purpose (for example the manufacture of albumen and gamma globulin) and that a small handling charge is paid to the participating health authorities to cover storage costs. We understand from the Institut Merieux that it does not collect from National Health Service hospitals placenta which becomes available as a result of abortions.
Mr. Alton : To ask the Secretary of State for Health how much money passed between Liverpool health authority and the Institut Merieux in France in the last financial year for which figures are available.
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Mr. Barron : To ask the Secretary of State for Health when he expects the appeals procedure to be completed within the Rotherham area health authority on the current National Health Service regrading structure.
Mr. Meale : To ask the Secretary of State for Health if he will list the closure of all National Health Service hospitals and other National Health Service properties in the Trent regional health authority area since 1979.
Mr. Freeman : It is important to note that closures are very often balanced by openings or other reprovision elsewhere. The hospitals or units approved for total or partial closure from 1979 to end 1987 in the Trent regional health authority are in the table.
Hospital and District |Partial or total closure ------------------------------------------------------------------------------------------------- 1979 Nightingale, Derbyshire |tc Wales Court, Sheffield |tc 1980 Newstead, Nottinghamshire |pc Middlewood, Sheffield |pc Adbolton Hall, Nottinghamshire |tc 1981 Skegness and District, Lincolnshire |pc Highbury, Nottinghamshire |pc Smedley Memorial, Derbyshire |tc Parwich, Derbyshire |tc Tuxford Hostel, Nottingham, Lincolnshire |tc Firs Maternity, Nottinghamshire |tc Nottingham Womens, Nottinghamshire |tc Thornbury, Sheffield |tc St. Josephs, Sheffield |tc Hallwood Isolation, Sheffield |tc 1982 Markfield, Leicestershire |tc Chesterfield and North Derbyshire Royal Hospital, North Derbyshire |tc Alexandra Woodhall Spa, North Lincolnshire |tc Foxby Hill, Gainsborough, North Lincolnshire |tc 1983 Walton, North Derbyshire |pc Ellen Towle, Leicestershire |pc Leicestershire Royal Infirmary, Leicestershire |pc Groby Road, Leicestershire |pc Zachary Merton Recovery Home, Leicester |tc Ashgate Maternity Home, North Derbyshire |tc Ashgate Annexe E, North Derbyshire |tc Blakely, South Derbyshire |tc Morton, North Derbyshire |tc Draycott, South Derbyshire |tc The Retreat Hostel, South Derbyshire |tc Boston General, North Lincolnshire |tc 1984 Forest, Central Nottinghamshire |pc Victoria, Central Nottinghamshire |pc Debdale Hall Recovery Home, Central Nottinghamshire |tc Lawn Hospital, North Lincolnshire |tc Swallownest, Doncaster |tc Darley Hall Maternity, North Derbyshire |tc Corbar Hall Maternity, North Derbyshire |tc Coppice Hospital, Nottingham |tc Aughton Court Hospital, Rotherham |tc Scott Road and Commonside Hostels, Sheffield |tc Derwent Hospital, South Derbyshire |tc 1985 Carey House, South Lincolnshire |tc 1986 Pastures Hospital, The Grange Childrens Unit, Southern Derbyshire |pc Pastures Hospital, Beech House, Southern Derbyshire |pc Pastures Hospital, Masson Ward, Southern Derbyshire |pc Market Harborough and District, Leicestershire |pc Rutland Memorial Leicestershire |pc St. Marys Hospital, Melton Mowbray, Leicestershire |pc Ashby de la Zouch and District, Leicestershire |pc Ridgeway, North Derbyshire |tc Moorfield, North Derbyshire |tc Rykneld Hospital, South Derbyshire |tc Queen Mary Maternity House, South Derbyshire |tc Etwall Hospital, South Derbyshire |tc Glengate, Leicestershire |tc Kibworth Hall, Leicestershire |tc 1987 Buxton Cottage, North Derbyshire |pc Manor, Southern Derbyshire |tc Makeney, Southern Derbyshire |tc Bosworth Park Infirmary, Leicestershire |tc Chest Clinic, Leicestershire |tc
Mr. Hinchliffe : To ask the Secretary of State for Health what action he is taking as a result of the recommendations concerning the discharge of elderly persons from hospital contained in the recent joint statement published by the Association of Directors of Social Services and the British Geriatrics Society, a copy of which he has been sent.
Mr. Freeman : The Department plans to issue, in the next few weeks, a booklet entitled "The Discharge of Patients From Hospital", which covers discharge arrangements for all patients, including elderly persons. This booklet will be circulated to all health authorities under a health notice. The statement the hon. Gentleman refers to will be included in the list of further reading on questions of good practice which is to be given as an appendix to the booklet.
Mr. Hinchliffe : To ask the Secretary of State for Health what is his latest estimate of the annual saving to the Government as a result of informal carers looking after the sick, elderly and handicapped in the community.
Mr. Freeman : The Government recognise the valuable contribution made by informal carers looking after sick, elderly and handicapped people in the community. There is no reliable basis on which to quantify that contribution.
Mr. Evennett : To ask the Secretary of State for Health what information he has regarding the steps being taken by the London ambulance service to implement recommendations 32, 33, and 34 of the Fennell report.
Recommendation 32 : The LAS has brought forward to the current year (1988- 89) the purchase of equipment which will improve its ability to monitor the position and timing of front line ambulances. Recommendation 33 : The LAS has revised its major accident plan which will ensure that the emergency control vehicle will be mobilised immediately whenever four or more ambulances are sent to an incident.
Recommendation 34 : An on-call roster for senior officers will be introduced in place of the present voluntary arrangement. The LAS is also discussing with the London emergency services liaison panel what further action is necessary to strengthen the links between all emergency services.
|c|Nursing Staff in Post<1><2> in Mental Illness Area of Work-England by Regional Health Authority-at 30 September 1987|c| Wholetime equivalents<5> Qualified Nurses<3> Learners<4> Region |Registered (First Level)|Enrolled (Second Level) |Students |Pupils ---------------------------------------------------------------------------------------------------------------------------------------------------------- Northern |1,470 |920 |460 |100 Yorkshire |1,740 |890 |570 |60 Trent |2,040 |1,120 |690 |120 East Anglian |810 |440 |220 |40 North West Thames |1,730 |930 |510 |90 North East Thames |1,770 |950 |470 |90 South East Thames |1,320 |670 |160 |40 South West Thames |1,670 |700 |640 |80 Wessex |1,270 |580 |390 |40 Oxford |790 |290 |210 |10 South Western |1,390 |730 |460 |50 West Midlands |2,080 |1,230 |920 |130 Mersey |1,280 |910 |370 |50 North Western |1,830 |1,110 |510 |50 London Post Graduate Special Health Authorities |290 |90 |70 |- |--- |--- |--- |--- England |21,480 |11,570 |6,630 |930 <1> Excludes administrative nursing staff, agency staff and unqualified nursing staff. Includes staff working in the hospital and community services. <2> Due to occupation coding problems the 1987 figures for some regions, and therefore England, are not comparable with those for previous years. <3> Includes qualified staff who do not hold the RMN or EN(M) qualification. <4> Includes qualified staff undertaking a further basic nurse course. <5> Figures independently rounded to nearest ten (10) wholetime equivalents. Source: Department of Health: Annual Census of NHS Non-Medical Manpower.
Mr. Thurnham : To ask the Secretary of State for Health how many organs have been donated for transplantation in the North West regional health authority area during each of the last five years ; and how many transplant operations have taken place.
Mr. Freeman [holding answer 31 January 1989] : According to information reported to the United Kingdom transplant service, the number of organs retrieved from, and transplants performed in, hospitals in the North Western regional health authority during the last five years is as follows :
|c|Cadeveric organs retrieved|c| |1984|1985|1986|1987|1988 --------------------------------------------------- Kidney<1> |94 |87 |84 |93 |119 Heart and heart/lung |- |7 |9 |20 |28 Liver |- |6 |9 |11 |23
|c|Transplants performed, NHS entitled recipients only|c| |1984|1985|1986|1987|1988 --------------------------------------------------- Kidney |77 |81 |107 |81 |130 Heart and heart/lung |- |- |- |10 |29 Liver |- |- |1 |2 |- <1> A donor has been counted twice if both kidneys were donated. 1988 figures are provisional.
Ms. Harman : To ask the Secretary of State for Health if he will list those hospitals which he considers eligible for National Health Service hospital trust status as set out in the White Paper, "Working for Patients".
Mr Kenneth Clarke [holding answer 9 February 1989] : Any hospital which meets the criteria in chapter 3 of the White Paper would be eligible. I do not understand why the hon. Member recently produced a list, readily and publicly available, of the 320 largest acute hospitals in the NHS and claimed that they were the only eligible hospitals.
Mr. Kenneth Clarke [holding answer 9 February 1989] : I propose that National Health Service hospital trusts will be given an interest-bearing debt equal to the value of their initial assets. The terms, including repayment provisions, will be set by the Government at the time.
Mr. Kenneth Clarke [holding answer 9 February 1989] : I will consider whether to publish the evaluation of the resouce management initiative at the first six sites when I have received it. That evaluation will of course be used to improve the detailed implementation of resource managment systems in other hospitals.
Ms. Harman : To ask the Secretary of State for Health (1) where a district health authority, under the White Paper on the National Health Service, has contracted with an out-of-district hospital for a particular service, whether patients will have the choice of getting treatment for that service within the district ;
(2) where, under the White Paper on the National Health Service, a district health authority has contracted with a hosiptal outside its district to provide a particular service, whether patients from that district health authority will have to travel to the out-of-district hospital for that service.
Mr. Kenneth Clarke [holding answer 9 February 1989] : Hospital patients are not necessarily best or most conveniently treated within the administrative boundaries of their district health authorities. The White Paper's proposals will make it possible for NHS funds to cross those boundaries when patients and GPs choose treatment elsewhere--for example, because waiting times are shorter. When placing contracts each DHA will need to take account of the existing referral patterns of local GPs, and will be free to place contracts with more than one hospital. They will need to discuss with GPs the possibility of changing existing patterns of referral if they believe that better value for money can be obtained by doing so. DHAs will also need to allow for referrals by GPs to hospitals with which no contracts have been placed, keeping some funds in reserve for this purpose.
Ms. Harman : To ask the Secretary of State for Health how health authorities are to be reimbursed for accident and emergency admissions from patients outside their own district of residence under the proposals in the National Health Service White Paper.
Mr. Kenneth Clarke [holding answer 9 February 1989] : My proposals on meeting the costs of accident and emergency admissions will be spelt out in a working paper on funding and contracts to be issued shortly.
Ms. Harman : To ask the Secretary of State for Health, under the White Paper, whether the cost of treatment will be a factor in determining where health authorities place contracts for surgical operations.
Mr. Kenneth Clarke [holding answer 9 February 1989] : In all decisions about surgical treatment now, as throughout the history of the NHS, and in every health care system the cost of treatment is a factor, but by no means the only one.
Ms. Harman : To ask the Secretary of State for Health whether non- executive members of the new health authorities proposed by the National Health Service White Paper will be drawn exclusively from people who live in the area covered by the authority.
Mr. Kenneth Clarke [holding answer 9 February 1989] : The estimated £1,250,000 cost of the launch of the review includes the total cost of the nationwide teleconference and follow-up regional meetings ; the communications packs containing videotape programmes, other visual aids and speaking notes ; and associated printed material. It is not possible at this stage to put precise costs on each.
I am sure it has been well worth the cost and effort to explain to 1 million NHS employees, responsible for £18 billion expenditure in England alone, what the White Paper proposals mean for their jobs, careers and their patients.
Mr. Hoyle : To ask the Secretary of State for Health if he is providing (a) office accommodation and (b) privileged access to Government records to the hon. Member for Derbyshire, South (Mrs. Currie).
Mr. Kenneth Clarke : By convention, former Ministers are allowed reasonable access to the papers which they handled when they were in office. Departments make suitable arrangements for this on request. The former Parliamentary Under-Secretary of State for Health, made such a request and has been given the temporary use of a room in the Department and the part-time assistance of an administrative officer to manage and safeguard the papers. I understand that several former Ministers of this and former Governments have been given similar facilities in various Departments in recent years.
Mr. Luce : I meet the chairman of the Arts Council on a regular basis. He keeps me appraised of all Arts Council business, although questions of funding for individual arts bodies are matters for the council.
Mr. Luce : The design of Government forms is a matter for individual Departments, many of which have adopted their own distinctive styles and colours. Since the Government's forms initiative began in 1982, Departments have made good progress in producing forms and leaflets which are more attractive, easier to understand and simpler to complete. Government forms now regularly win awards from the plain English campaign. I am committed to continue this work until every form is a good form. If the right hon. Member has a particular form in mind, and will write to me, I shall bring it to the attention of the Minister concerned.