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Mr. Mellor : Estimates from those units which currently provide a cochlear implant service suggest that between 5,000 and 6,000 profoundly deaf people in England might get some benefit from a cochlear implant.

Mrs. Rosie Barnes : To ask the Secretary of State for Health what information is currently issued by his Department to people with a hearing loss.

Mr. Mellor : All National Health Service patients issued with a hearing aid are given a copy of the Department's booklet HA1 "How to use your Hearing Aid", a copy of which is in the Library.

Mrs. Rosie Barnes : To ask the Secretary of State for Health what information he has as to the number of hearing aid users in England and Wales.

Mr. Mellor : Figures provided by the Institute of Hearing Research suggest that around 1.3 million people aged 17 and over in England and Wales use a hearing aid. We have no precise information about the number of children using hearing aids.

Mrs. Rosie Barnes : To ask the Secretary of State for Health when he last reviewed the adequacy of the range of hearing aids available on the National Health Service.

Mr. Mellor : The range of hearing aids available under the National Health Service is kept under constant review by the commodities advisory group advising Mersey regional health authority, which is responsible for the procurement and distribution of all National Health Service hearing aids.

Tobacco Advertising

Mr. Amos : To ask the Secretary of State for Health what regulations currently govern cigarette advertisements in duty-free areas at ports, airports, and other similar areas under United Kingdom jurisdiction under current agreement with the tobacco industry ; whether he will be taking steps in his negotiations with the tobacco industry to include such areas under new regulations ; and if he will make a statement.

Mr. Mellor : The current voluntary agreement with the industry requires companies to

"continue to include a health warning in cigarette or hand-rolling tobacco brand advertising posters for display in lounges, corridors or shops of land duty free areas".

Other forms of advertising in duty free areas are not covered by the voluntary agreement. The Government will consider whether to seek any appropriate extension or clarification of the agreement as regards duty free areas when renegotiating the agreement. Cigarettes sold in United Kingdom duty free shops are however, intended for consumption outside this country.


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Advertising

Mr. Dobson : To ask the Secretary of State for Health what is the latest figure for the estimated spending in 1988-89 by his Department on (a) television advertising, (b) radio advertising, (c) newspaper advertising and (d) other promotional material ; and what is the 1989-90 budget for each of these categories of spending.

Mr. Mellor : Expenditure in respect of Department of Health in 1988- 89 is estimated as :


                           |£ million          

-----------------------------------------------

Television advertising     |1.724              

Radio advertising          |0.161              

Newspaper advertising      |1.176              

Other promotional material |7.413              

The budget for publicity in 1989-90 is £19.586 million. It is not yet possible to say how this sum will be divided between categories of publicity.

Mr. Dobson : To ask the Secretary of State for Health what is the latest figure for the estimated spending in 1988-89 by the Office of Population Censuses and Surveys on (a) TV advertising, (b) radio advertising, (c) newspaper advertising and (d) other promotional material ; and what is the 1989-90 budget for each of these categories of spending.

Mr. Freeman : No expenditure of TV advertising, radio advertising and newspaper advertising is planned by the Office of Population Censuses and Surveys for 1988-89 or 1989-90. The expenditure on other promotional material in 1988-89 is estimated to be £105,000. The corresponding budget figure for 1989-90 is £210,000. These figures include expenditure on or planned for the 1989 census test and 1991 census.

Press and Public Relations

Mr. Dobson : To ask the Secretary of State for Health what are the latest figures for the number of staff presently employed, and the full complement of staff including vacant posts, in the press and public relations office of the Office of Population Censuses and Surveys ; and what is the proposed complement for 1989-90.

Mr. Freeman : The number of staff presently employed in the press and publicity section of the Office of Population Censuses and Surveys is seven. There are no vacancies. The figure includes four staff who have been employed on a temporary basis to work on publicity activities for the 1989 census test and the 1991 census. An additional temporary post is to be added in 1989-90 to work on the 1989 census test and 1991 census.

Mr. Dobson : To ask the Secretary of State for Health what are the latest figures for the number of staff presently employed, and the full complement of staff including vacant posts, in press and public relations offices in (a) the Health Education Authority and (b) the National Health Service generally ; and what are the proposed complements for 1989-90.

Mr. Mellor : The Health Education Authority currently employs three people in its press office and has a vacancy for one public relations officer on the "Look After Your Heart" campaign. In 1989-90 one additional post is planned to deal with the new teenage smoking campaign.


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The employment and numbers of press and information officers in the NHS is a matter for regional and district health authorities and not for the Department of Health. The hon. Member may care to write to the individual regional health authority chairmen.

Mr. Dobson : To ask the Secretary of State for Health what are the latest figures for the number of staff presently employed, and the full complement of staff, including vacant posts, in the press and public relations office of his Department ; and what is the proposed complement for 1989-90.

Mr. Mellor : Functions commonly associated with press and public relations are carried out by the Department's information division. The latest figures for the combined information divisions of the Department of Health and the Department of Social Security are :


                                                |Number       

--------------------------------------------------------------

Staff presently employed                        |77           

Full complement of staff inlcuding vacant posts |80           

Note: Thirty-eight of the above staff are information         

officers.                                                     

Discussions on the proposed complements for 1989-90 are not yet complete.

Mr. Dobson : To ask the Secretary of State for Health (1) what is the latest figure for the estimated spending in 1988-89 by (i) the Health Education Authority and (ii) the National Health Service as a whole on (a) TV advertising, (b) radio advertising, (c) newspaper advertising and (d) other promotional material ; and what are the 1989-90 budgets for each of these categories of spending by (1) the Health Education Authority and (2) the National Health Service as a whole ;

(2) what are the latest figures for (a) the estimated expenditure on press and public relations during 1988-89 and (b) the budget for 1989-90 for both (i) the Health Education Authority and (ii) the National Health Service generally.

Mr. Mellor : A large proportion of the Health Education Authority's expenditure is related to advertising, and promotional work. Expenditure is as follows :


|c|Health Education Authority|c|                                    

                                                |£                  

--------------------------------------------------------------------

1988-89                                                             

    TV advertising                              |2,000,000          

    Radio advertising                           |400,000            

    Newspaper advertising                       |4,450,000          

    Other promotions and material               |1,548,000          

                                                                    

1989-90                                                             

    Advertising (media spit not yet determined) |7,850,000          

    Other promotions and material               |741,000            

For the National Health Service as a whole, this information is not collected separately.

Mr. Dobson : To ask the Secretary of State for Health what is the latest figure for (a) the estimated expenditure by his Department on press and public relations during 1988-89 and (b) the budget for 1989-90.

Mr. Mellor : We do not have the information in the form requested. However the estimated expenditure for


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the combined Departments of Health and Social Security on press and public relations during 1988-89 is £1.344 million.

The budget for the Department of Health for 1989-90 has not yet been agreed.

Mr. Dobson : To ask the Secretary of State for Health what is the latest figure for (a) the estimated expenditure by the Office of Population, Censuses and Surveys on press and public relations during 1988- 89 and (b) the budget for 1989-90.

Mr. Freeman : The total estimated expenditure by the Office of Population Censuses and Surveys on press and public relations activities in 1988-89 is £190,000. The corresponding budget figure for 1989-90 is £340,000. These figures include the salaries of staff employed on these activities, including those working on the 1989 census test and plans for the 1991 census.


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Statistical Staff

Mr. Dobson : To ask the Secretary of State for Health if he will give the latest figures for the number of staff presently employed, and the full complement of staff including vacant posts, by grade, in the statistical divisions in the Office of Population Censuses and Surveys ; if he will differentiate between staff in statistical posts and staff in administrative posts ; and if he will give the staffing complements by grade, and differentiated between statistical and administrative posts, proposed for 1989-90.

Mr. Freeman : The information is shown in the table. This covers all the staff employed in the statistical divisions of the Office of Population Censuses and Surveys including the medical statistics and social survey divisions. It excludes staff employed in the finance personnel and administration division and staff employed in the information technology division. Staff complements as such are no longer used since expenditure is controlled by financial rather than manpower limits. The planned staff figures for 1 October 1989 are therefore less rigid and subject to change.


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                                            |Number in post         |Number planned to be in|Number planned to be in                        

                                                                    |post                   |post                                           

                                            |(1 March 1989)         |(1 March 1989)         |(1 October 1989)                               

--------------------------------------------------------------------------------------------------------------------------------------------

Statistical posts                                                                                                                           

  Grade 5 (Chief Statistician)              |3.0                    |3.0                    |3.0                                            

  Grade 6 (Statistician)                    |2.0                    |2.0                    |2.0                                            

  Grade 7 (Statistician)                    |11.5                   |11.5                   |11.5                                           

  Senior Assistant Statistician             |3.0                    |6.0                    |6.0                                            

  Assistant Statistician2.0                 |2.0                    |3.0                                                                    

                                                                                                                                            

Medical Officer Grades                      |2.5                    |2.5                    |2.5                                            

                                                                                                                                            

Survey Officer posts                                                                                                                        

  Grade 5 (Chief Social Survey Officer A')  |1.0                    |1.0                    |1.0                                            

  Grade 6 (Chief Social Survey Officer B')  |4.0                    |4.0                    |4.0                                            

  Grade 7 (Principal Social Survey Officer) |14.0                   |12.5                   |12.5                                           

  Senior Social Survey Officer              |11.0                   |12.0                   |12.0                                           

  Social Survey Officer                     |4.5                    |5.5                    |5.5                                            

  Assistant Social Survey Officer           |4.0                    |8.0                    |8.0                                            

                                                                                                                                            

Administrative posts                                                                                                                        

  Grade 6 (Senior Principal)                |2.0                    |2.0                    |2.0                                            

  Grade 7 (Principal)                       |12.0                   |11.0                   |11.0                                           

  Senior Executive Officer                  |17.0                   |19.0                   |20.5                                           

  Higher Executive Officer                  |57.5                   |58.0                   |59.0                                           

  Executive Officer                         |93.0                   |110.5                  |111.5                                          

  Administrative Officer and others         |331.0                  |368.5                  |415.0                                          

Blood Transfusion Service

Dr. Marek : To ask the Secretary of State for Health what developments have taken place in the organisation of the blood transfusion service in England and Wales following publication of the study by the National Health Service management consultancy services branch ; and if he will make a statement.

Mr. Freeman : We announced on 28 July 1988 that new arrangements would be made to manage the supra-


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regional and national dimension of the national blood transfusion service (NBTS). Operational responsibility at national level is now exercised on behalf of Health Ministers for England and Wales by the NHS management board and undertaken by its director of operations, in consultation in respect of Wales with the director, NHS Wales. Day-to-day implementation of the national strategy is delegated to the national director of the NBTS and a small supporting staff.


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HEALTH

Stastistical Staff

Mr. Dobson : To ask the Secretary of State for Health if he will give the latest figures for the number of staff presently employed, and the full complement of staff including vacant posts, by grade, in the statistical divisions of (a) the Health Education Authority and (b) the National Health Service as a whole ; if he will differentiate between staff in statistical posts and staff in administrative posts ; and if he will give the staffing complements by grade, and differentiated between statistical and administrative posts, proposed for 1989-90.

Mr. Mellor : In 1988-89 the Health Education Authority employed one statistician, in its public health division. There are also 20 professional posts and one administrative post in the division, and a current vacancy for a statistical assistant. The complement will remain the same for 1989- 90.


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The number of whole time equivalent staff in post in the statistics and information area of work within the administrative and clerical staff group in the NHS (England) at 30 September 1987 was 867 whole time equivalent staff. Of these only four could be separately identified as being statisticians.

We do not collect information on staff vacancies centrally. Staff complements for specific areas of work are a matter for local determination.

Mr. Dobson : To ask the Secretary of State for Health if he will give the latest figures for the number of staff presently employed, and the full complement of staff including vacant posts, by grade, in the statistical divisions in his Department ; if he will differentiate between staff in statistical posts and staff in administrative posts ; and if he will give the staffing complements by grade, and differentiated between statistical and administrative posts, proposed for 1989-90.

Mr. Mellor : Staff in post and vacancies in Department of Health statistical branches at 1 March 1989 are shown in the table :


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                               Staff in post                 Vacancies                                   

                              |Administrative|Statistical   |Administrative|Statistical                  

---------------------------------------------------------------------------------------------------------

Grade 3                       |-             |0.66          |-             |-                            

Grade 5                       |-             |6.00          |-             |-                            

Grade 6                       |-             |-             |-             |-                            

Grade 7                       |1.0           |25.00         |-             |-                            

Senior Assistant Statistician |-             |3.00          |-             |-                            

Assistant Statistican         |-             |3.00          |-             |-                            

Senior Executive Officer      |13.0          |-             |2             |-                            

Higher Executive Officer      |29.0          |-             |3             |-                            

Executive Officer             |53.0          |-             |-             |-                            

Administrative Officer        |56.5          |-             |-             |-                            

Administrative Assitant       |17.5          |-             |-             |-                            

Personal Secretary            |6.0           |-             |-             |-                            

                              |-------       |-------       |-------       |-------                      

Total                         |176.0         |37.66         |5             |0                            

The staffing complement for 1989-90 is expected to be as shown but some adjustments may be made following the split of Department of Health and Social Security.

Privatisation

Mr. Dobson : To ask the Secretary of State for Health what was the total sum paid out in fees to outside organisations in the furtherance of privatisation by his Department in 1979-80 and each year to date ; and what is the estimate for 1989-90.

Mr. Mellor : No expenditure on fees to outside organisations in the furtherance of privatisation of health-related areas of work prior to 1986- 87 has been identified. Expenditure in 1986-87 and each year to date, and the estimated expenditure in 1989-90, are as follows :


Year    |£              

------------------------

1986-87 |63,000         

1987-88 |61,000         

1988-89 |202,000        

1989-90 |250,000        

All expenditure up to and including 1988-89 has been from a joint Health and Social Security budget.


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Management Consultants

Mr. Dobson : To ask the Secretary of State for Health what were the total fees paid out by his Department to management consultants in 1979-80 and each year to date ; and what is the estimate for the current year.

Mr. Mellor : The estimated expenditure from 1984-85 onwards on fees and expenses for management consultants on health matters is as follows :


Year      |£ million          

------------------------------

1984-85   |0.613              

1985-86   |0.479              

1986-87   |2.103              

1987-88   |1.316              

1988-89   |1.347              

The figures are approximate since expenditure up to and including the 1988- 89 financial year is from a joint Health and Social Security budget. In some cases expenditure has been apportioned where consultants have been engaged on both health and social security matters. The figures include social services consultancy and some computer consultancy where these cannot be separately identified. The information for years prior to 1984-85 could be obtained only at disproportionate cost.


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Health Service (Annual Returns)

Mr. Jack : To ask the Secretary of State for health (1) if he will publish in the Official Report a list of annual financial and statistical returns made by district and regional health authorities to his Department ;

(2) if he will publish in the Official Report, for each statistical and financial return, a list showing which regional and district health authorities did not return such information on time ;

(3) which health authorities did not return their financial returns for 1987-88 by the published deadline.

Mr. Freeman : 1987-88 was the first year for the new Ko"rner data sets for hospital activity, patient transport, manpower and finance ; 1988- 89 the first for the community and paramedical services. A list has been placed in the Library showing the statistical and financial returns required for 1987-88 ad 1988-89 including those which existed before the implementation of the Ko"rner review recommendations. Apart from the financial data which are currently submitted by each health authority, the general responsibility for submitting returns to the Department is on regional health authorities, who collate the returns from their districts ; special health authorities submit their returns direct.

There are more than 50 annual returns required for each district to target dates given in the list. It is not practical to expect all these returns to arrive by the appropriate target date (some are at site level and there are nearly 2,500 sites for which returns are made) nor to list, for each, those authorities that missed it. A full analysis would incur disproportionate cost. It is estimated that 93 per cent. of all district-level aggregated returns about hospital patient activity and facilities, 70 per cent. of all manpower returns and some 90 per cent. of all finance returns had been received within three months of the target date. On returns at site level, performance varied between 50 and 80 per cent. completion within three months of the target.

Mr. Jack : To ask the Secretary of State for Health when he will next publish an edition of the Health Service costing returns.

Mr. Freeman : We intend to publish an edition of "Health Service Costing Returns" for 1987-88 during the summer.

Capital Expenditure (North West)

Mr. Thurnham : To ask the Secretary of State for Health if he will make a statement on the progress of capital expenditure work by the North West regional health authority during 1988-89.

Mr. Freeman : Capital expenditure work has progressed as expected during 1988-89. The regional health authority has recently approved its major schemes capital programme for 1989-90 and it is expected that approval for capital projects up to 1991-92 will be given later this year. This is in line with the region's policy of only issuing a firm capital programme on a rolling three-year basis.

Residential Care

Mrs. Mahon : To ask the Secretary of State for Health if he will identify the groups which have carried out studies


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of the costs of residential care and the full costs to public funds of private residential care of which his Department is aware.

Mr. Mellor : I am aware of the following studies of the costs of private and voluntary residential care :

Title and Organisation

Survey of Private and Voluntary Residential and Nuring Homes for the Department of Health and Social Security--Ernst and Whinney. Residential Care Homes Reasonableness of Charges. Reasonableness of Nursing Home Charges--University of York Social Policy Research Unit. National Survey of Independent Residential Care and Nursing Homes--University of Kent Personal Social Services Research Unit/University of York, Centre for Health Economics.

Evaluation of Very Sheltered Housing--Department of the Environment.

Copies of the Ernst and Whinney study and that into the reasonableness of charges in residential care homes are in the Library. The reports of the remaining three studies are awaited. As my reply of 6 March to the hon. Member for Wakefield (Mr. Hinchliffe) at column 421 indicated, none of these studies enable us to draw general conclusions about the full costs to public funds of care in either sector and only limited comparisons have been possible.

Mr. Hinchliffe : To ask the Secretary of State for Health what provisions are made for the care and well being of residents of private homes during change of ownership ; and if he will make a statement.

Mr. Mellor : It is for registration authorities to see that adequate arrangements are made by those running a home for the continuing care of residents during a change of ownership. The code of practice for residential care, "Home Life", advises that proprietors notify the registration authority of any intended change of ownership. Advice to health authorities is that home owners be asked to make completion of sale conditional upon, and not effective until, the home is re-registered. This will avoid the nursing home having to cease operations until the new registration is granted.

Benefit Payments (Delay)

Mrs. Mahon : To ask the Secretary of State for Health if he will adequately compensate the 8,809 claimants waiting for financial help with National Health Service costs for the delay in payment.

Mr. Mellor : I refer the hon. Member to my reply to her on 7 March at column 491 regarding claims for refunds of charges paid while claims have been delayed at the agency benefits unit.

Food Poisoning

Mr. Hinchliffe : To ask the Secretary of State for Health whether there is a risk to the consumer of cook-chill food when his Department's 1980 guidelines are not followed.

Mr. Kenneth Clarke : I refer the hon. Member to my reply of 27 February at column 69.

Mr. Hinchliffe : To ask the Secretary of State for Health how many cook-chill products examined recently by the public health laboratory service were found to contain salmonella.

Mr. Kenneth Clarke : The survey conducted recently by the public health laboratory service was to test for the


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presence of listeria monocytogenes and not for salmonella. However, out of 197 retail ready to eat cooked-chilled poultry and chilled and frozen retail ready-to-eat meals four were found to be positive for salmonella.

Mr. Hinchliffe : To ask the Secretary of State for Health what research his Department has conducted or commissioned into why so many cook -chill products contain listeria monocytogenes ; and with what results.

Mr. Kenneth Clarke : My Department has not carried out any research into why listeria monocytogenes is contained in some cook-chill products. We are working with the food industry to produce a code of practice designed to minimise the possibility of contamination of cook-chill products with listeria monocytogenes.

Waterborne Diseases

Dr. Cunningham : To ask the Secretary of State for Health what were the total numbers of incidents and cases of waterborne disease in the United Kingdom since 1979.

Mr. Freeman [holding answer 28 February 1989] : The figures are not available in precisely the form sought, but during the ten years 1977-86 there were 15 recorded outbreaks of waterborne disease in the United Kingdom comprising 5,955 cases and no deaths. Subsequent observations have indicated that this is likely to be an underestimate.

During the years 1987 and 1988 a further four outbreaks in England and Wales were reported to the PHLS communicable disease surveillance centre. Three of e appthese were due to campylobacter ; two outbreaks affecting over 36 people were associated with consumption of stream/spring water and in the other incident, when several people were taken ill at a youth hostel, organisms were found in the well water. The fourth outbreak, comprising at least 77 cases, was due to cryptosporidium and was associated with a swimming pool.

I am sending to the hon. Member an extract from a published paper which gives further details of outbreaks of waterborne disease in the United Kingdom from 1937.

AGRICULTURE, FISHERIES AND FOOD

Scrapie

Mr. Sean Hughes : To ask the Minister of Agriculture, Fisheries and Food if he will break down the 16 cases of incidence of scrapie in goats in the last five years by year ; and if he will make a statement.

Mr. Donald Thompson : Scrapie is not a notifiable disease but from samples submitted to the Ministry's veterinary investigation centres disease was confirmed in goats as follows :


      |Cases      

------------------

1984  |4          

1985  |0          

1986  |1          

1987  |1          

1988  |10         

Bovine Spongiform Encephalopathy

Mr. Tony Lloyd : To ask the Minister of Agriculture, Fisheries and Food what is his estimate of the future incidence of bovine spongiform encephalopathy ; and if he will make a statement.

Mr. Donald Thompson : It is not possible to predict the future course of the disease with any accuracy. However, having banned the use of feed, which is the most likely cause of the disease, and provided it does not pass from cattle to cattle, the incidence should start to decline after 1992.

Mr. John Evans : To ask the Minister of Agriculture, Fisheries and Food what further action he intends to take in the light of the Southwood report on bovine spongiform encephalopathy.

Mr. Donald Thompson : I refer the hon. Member to the answer given to my hon. Friend the Member for Bromsgrove (Sir H. Miller) on 27 February at columns 89-91.

Mr. Butler : To ask the Minister of Agriculture, Fisheries and Food whether his Department has commissioned research to test the infectivity of bovine spongiform encephalopathy on human cellular material.

Mr. Donald Thompson : No, but trials are under way using marmosets, which are primates.

Mr. Bermingham : To ask the Minister of Agriculture, Fisheries and Food what plans he has to follow up recommendations contained in the report of the working party on bovine spongiform encephalopathy ; and if he will make a statement.

Mr. Donald Thompson : I refer the hon. Member to the reply given to my hon. Friend the Member for Bromsgrove (Sir H. Miller) on 27 February at columns 89-91.


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