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Mrs. Dunwoody : To ask the Secretary of State for Health what is the cost to the National Health Service of the inspection of private hospitals twice yearly ; whether any fees charged cover the costs of such visits ; and where and how the information collected is reported to his Department.
Mr. Mellor : Fees for the inspection and registration of private nursing homes and private hospitals are set by the Department at a level which covers the full costs incurred in providing this service. Fees collected in 1987-88, the latest year for which figures are available, amounted to £1.97 million.
Health Authorities are requested to submit annually to the Department memorandum trading accounts.
Paper 1. Self-governing hospitals.
Paper 2. Funding and Contracts for Hospital Services.
Paper 3. Practice Budgets for General Medical Practitioners. Paper 4. Indicative Prescribing Budgets for General Medical Practitioners.
Paper 5. Capital Charges.
Paper 6. Medical Audit.
Paper 7. NHS Consultants : Appointments, Contracts and Distinction Awards.
Paper 8. Implications for Family Practitioner Committees.
Mr. Ashley : To ask the Secretary of State for Health if he will set up an inquiry into the establishment levels of environmental health officers, the frequency of inspection of food premises and means of limiting the number of cases of food poisoning.
The committee on the microbial safety of food, whose terms of reference I announced on 21 February, will be able to examine all factors connected with food safety and foodborne illness, including environmental health matters.
Mr. Hinchliffe : To ask the Secretary of State for Health what steps he takes to ensure that catering systems concerned with food production for the community ensure the restraint of the growth of food-borne pathogens.
Mr. Kenneth Clarke : Caterers are legally required to produce food which is safe to eat. Local authorities enforce that requirement by reference to food law and, as appropriate, other guidance and guidelines relevant to good hygienic practice in the producers and sellers premises.
Mr. Win Griffiths : To ask the Secretary of State for Health how much each health authority spent in 1988 on the fees paid to medical employment agencies for providing locum services for their hospitals ; and what was the highest, lowest and average hourly rate paid by each health authority.
Mr. Mellor : Expenditure information derived from the annual accounts of district health authorities, regional health authorities (RHAs) and special health authorities for London postgraduate teaching hospitals (SHAs) in England for 1987-88 has been placed in the Library.
Information on the hourly rates paid by each health authority is not held centrally.
Mr. David Porter : To ask the Secretary of State for Health if he will list all the categories of people entitled to free prescriptions ; and if he will make a statement on whether he has any plans to change the system.
(a) Children under 16.
(b) Young people aged under 19 who are in full-time education. (
(c) Women aged 60 or over, and men aged 65 or over.
(d) People receiving Income Support or Family Credit, and their dependents.
(e) People who qualify for exemption from NHS charges on low income ground, and their dependents.
(f) Expectant mothers, or women who have had a baby within the last 12 months.
(g) Patients with a continuing physical disability which prevents him or her leaving home without the help of another person. (
(h) Patients who have a permanent fistula which requires a continuous surgical dressing or an appliance.
Column 66(i) Patients who suffer from epilepsy requiring continuous anti-convulsive therapy.
(j) Patients who suffer from one of the following disorders for which specific substition therapy is essential
Diabetes insipidus or other forms of hypopituitarism
Addison's disease or other forms of hypoadrenalism
In addition, war and Ministry of Defence disablement pensioners do not have to pay prescription charges for medication which is prescribed for their accepted disability.
We have no present intentions to make any alterations to the scheme.
Mr. Hinchliffe : To ask the Secretary of State for Health, pursuant to his answer to the hon. Member for Wakefield on 2 February, Official Report, column 342, when his Department was first made aware of the information on the incidence of listeriosis contained in his answer to the hon. Member for Wakefield on 20 February, Official Report, column 528.
Mr. Kenneth Clarke : Yes. These 1980 guidelines relate to cook-chill catering. We remain satisfied that food produced in accordance with these guidelines will be safe for the consumer and will protect against danger from listeria monocytogenes.
Mr. Hinchliffe : To ask the Secretary of State for Health (1) pursuant to his answer of 20 February, Official Report, column 528, how many cases of listeriosis were described by the consultant microbiologist from Plymouth health authority on 9 July 1988 ; (2) how many of the patients in Plymouth referred to in his answer of 20 February, Official Report, column 528, developed the symptoms of listeriosis after their admission to hospital.
Mr. Kenneth Clarke : These questions are a matter for the consultant microbiologist mentioned. He has confirmed to my officials that there is no evidence to suggest that any cases of listeriosis have arisen from the consumption of meals prepared by the cook-chill catering system used by the Plymouth health authority.
Mr. Wray : To ask the Secretary of State for Health what is the latest information regarding debts owed by the private medicine sector to the National Health Service for the use of installations and facilities of the National Health Service.
Mr. Hinchliffe : To ask the Secretary of State for Health which agency is responsible for the care of dependent elderly persons asked to leave private residential homes because of their inability to meet increases in fees charged.
Mr. Mellor : Under section 21 of the National Assistance Act 1948 and directions issued by the Secretary of State, a local authority has a statutory duty to make arrangements to provide residential accommodation for persons ordinarily resident in its area who by reason of age, infirmity or other circumstances are in need of care and attention which is not otherwise available to them.
We would therefore expect the local authority to be consulted where an elderly person was unable to meet an increase in the fee charged by a private or voluntary residential care home.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will take action to ensure that proprietors of private residential or nursing homes are not allowed to handle their residents' personal finances.
Mr. Mellor : The code of practice for residential care, "Home Life", recommends that those involved in the running of a home should not, except as a last resort, become involved in the handling and management of a resident's financial affairs. It is also the policy of my right hon. Friend the Secretary of State for Social Security, not to appoint those in charge of a residential care home or nursing home to act for a resident in receipt of social security benefits unless no other course is open.
The Residential Care Homes Regulations governing standards in residential care homes were amended from August last year, so that the registered person is now required to keep a record showing for each individual resident any money or other valuables received on his behalf and how it has been spent or disposed of by the registered person. Where, exceptionally, a registered person is appointed to act on behalf of the resident for the purpose of his income support benefit, arrangements are being made for the local authority to be notified by the Department of Social Security's local offices of such appointment so that the authority's inspector can see that these records are being maintained. They will also be able to report to the local offices any suspected misuse of benefit.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will take steps to ensure that health authority staff are not permitted to own, manage or have interests in private residential or nursing homes.
Mr. Mellor : Individual health authorities already have a clear responsibility to satisfy themselves that their employees' interests do not conflict with those of the authority. I look to the authorities to ensure that such conflicts do not arise.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will consider delaying proposed closures of hospitals in order that the hospitals concerned could consider taking advantage of the possibility of the new status proposed in the White Paper, "Working for Patients."
Mr. Kenneth Clarke : No. The White Paper makes it clear that self- governing status should not be sought simply as an alternative to necessary closure. The Health Service must not retain hospitals which are redundant to its needs. Closures are very often made as a result of the development of better alternative services and so should continue to be made.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will bring forward proposals to legislate for the joint registration of private or voluntary homes and schools by local authority education and social services departments.
Mr. Mellor : There are no proposals to change the current arrangements whereby certain private and voluntary residential establishments which provide education are registered as schools. The Department and the Department of Education and Science maintain close liaison when appropriate on these establishments as do Her Majesty's inspectorate of schools and the social services inspectorate.
Mr. Bendall : To ask the Secretary of State for Health what further delay there has been in going out to tender on the construction contract for the new general hospital in Redbridge on the Goodmayes site ; and if he will take action to expedite this project.
Mr. Freeman : I understand that the North East Thames regional health authority is reassessing the financial consequences of this project at present. The decision on when to proceed rests with the regional health authority.
Mr. Hinchliffe : To ask the Secretary of State for Health why each district health authority in the Yorkshire regional health authority area was asked to comment on the decision to introduce cook-chill catering ; what was the purpose of this consultation ; and what were the responses received from each authority.
Mr. Kenneth Clarke : It is the policy of the Yorkshire regional health authority to consult district health authorities on major proposed changes in policy affecting their services. We do not hold information on the nature of responses centrally and these sensible procedures on the part of the regional health authority are not a matter for me.
Mr. Hinchliffe : To ask the Secretary of State for Health what are the procedures planned for the reheating of cook-chill food in staff canteens in Wakefield hospitals to ensure that the requirement of the Yorkshire regional health authority's expert group for food to be served within 15 minutes of reheating is complied with.
Mr. Kenneth Clarke : It is entirely a matter for the Wakefield health authority, and not for me, to ensure that its safe and satisfactory proposals for the long-overdue introduction of cook-chill catering in its hospitals are complied with in practice. Cook-chill catering is now a normal feature of National Health Service catering throughout the country and has proved to be a safe and satisfactory system of catering so long as my Department's guidelines are heeded.
Mrs. Mahon : To ask the Secretary of State for Health why Mr. Brian Birchall, chairman of the Yorkshire regional health authority catering group, advised staff at the Halifax general hospital in February 1988 that a decision on the implementation of cook-chill catering across the Yorkshire region had already been taken.
Mr. Kenneth Clarke : I do not know anything about any meetings with staff in Halifax and I do not see why I should be expected to know. I do not propose to intervene in a local decision-making process which is entirely a matter for the Yorkshire regional health authority which has my complete confidence in its handling of its sensible decision to introduce cook-chill catering across its region.
Mrs. Mahon : To ask the Secretary of State for Health why plans for the new Halifax hospital development were changed in early 1988 to include cook-chill catering before the Yorkshire regional health authority had made its decision to introduce cook-chill in the region on 24 March 1988, and before formal consultation with Calderdale health authority had taken place.
Mr. Kenneth Clarke : I assume that the health authorities concerned took this decision in the usual way and I do not regard it as any part of my responsibilities to intervene in or answer for their day-to-day decision making. Cook-chill is now a normal feature of much National Health Service catering throughout the country and has proved to be a safe and satisfactory system of catering so long as my Department's guidelines are heeded.
Mr. Hinchliffe : To ask the Secretary of State for Health what assessment he has made of the potential risk of food poisoning arising from operation of cook-chill installations in breach of his 1980 guidelines.
Mr. Kenneth Clarke : The guidelines are designed to ensure the production of safe food. Depending on the circumstances, departure from the guidelines may present a risk of food poisoning. Responsibility for the safe operation of cook-chill catering is a matter for local management.
Mr. Wray : To ask the Secretary of State for Health what is the number of staff in his Department qualified (a) to inspect contamination in drinking water and (b) to advise on matters regarding contamination of drinking water.
Advice on the medical aspects of contamination requires an input from several disciplines and depending on the cause of contamination a number of different members of the Department's medical and scientific staff will be qualified to contribute.
Contamination of drinking water might be by micro-organisms, chemicals, or radiation. In providing advice to the Government on such issues the Chief Medical Officer is supported by two divisions (containing medical and scientific staff), can call upon the public health laboratory service and other specialist organisations, and obtain advice from committees of independent experts.
Mrs. Gorman : To ask the Secretary of State for Health what is the annual cost to the National Health Service of prescriptions of anti- depressants and tranquillisers to women in the 45 to 60 years age group.
Mr. Kenneth Clarke : We do not collect this information centrally in the form requested. But in England in 1987 the net ingredient cost of prescriptions for anti-depressants and sedatives and tranquillisers dispensed by community pharmacists was £28.9 million and £14.3 million respectively.
Mr. Mellor : Throughout the world much research into HIV infection among male and female prostitutes is in progress. Studies so far completed show widely differing results. A number of studies are under way in several major cities in the United Kingdom which should help to provide more information in the future from which to make estimates of the prevalence of HIV in prostitutes.
Mr. Benn : To ask the Secretary of State for Health what action he has taken to ban oral tobacco products, including Skoal Bandits, following the announcement made by the then Parliamentary Under-Secretary of State on 26 February 1988 ; what representations were made by the United States Government on this matter ; and when the report of the committee set up by the Government on carcinogenicity in oral tobacco, oral snuff and Skoal Bandits will be published.
Mr. Freeman : The Government are considering the representations we have received on our proposal to ban certain oral tobacco products, and we will make an announcement as soon as possible. Although no formal representations have been received from the United States Government, we are aware of their views.
No specific committee has been set up to look into this matter, but the carcinogenicity of oral tobacco products, has been considered by the expert advisory committee on carcinogenicity on a number of occasions. Advice has been forwarded to Ministers on each occasion, but there are no plans to publish a formal report.
Ms. Ruddock To ask the Secretary of State for Health what information he has on research findings on the viability of viruses found in faeces.
Mr. Freeman [holding answer 14 February 1989] : I am not aware of any recent specific projects on this subject. However, it has been established that children recently vaccinated with oral polio vaccine continue for some time to excrete the vaccine in faeces.
Viruses such as rota virus are frequently identified in the faeces of children with viral gastro-enteritis, but the likely yield of such viruses diminishes with time. Faeces containing virus particles are potential sources of infection although the duration of infectivity depends on the dose of virus particles and the environmental conditions.
Mr. Hinchliffe : To ask the Secretary of State for Health, pursuant to his reply to the hon. Member for Wakefield, 26 January, Official Report, column 714, what information was available to the regional health authority on Mr. Tony Prendergast's qualifications when it nominated him as one of the two professional assessors on the most recent appointment board for the post of district general manager of the Wakefield health authority.
Mr. Ron Davies : To ask the Secretary of State for Health when his Department ceased to require deferred inspections of food imported into the United Kingdom but not inspected at the point of entry by port health authorities ; and if he will make a statement.
Mr. Roger Freeman [holding answer 24 February 1989] : The Imported Food Regulations 1984 provide that under certain circumstances, inspection of food imported into the United Kingdom may be deferred to a place other than the port of entry. These regulations are still current. If the hon. Member has any particular case in mind perhaps he would write to me.