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Mr. Fearn : To ask the Secretary of State for Health what representations he has received concerning the current organisation of hearing aid services.
Mr. Mellor : Sixty-two representations have been received calling attention to the recent proposals made by the Royal National Institute for the Deaf.
Mr. Colvin : To ask the Secretary of State for Health if he will make a statement on the "Hearing Aids--the Case for Change" proposals brought forward by the Royal National Institute for the Deaf.
Mr. Mellor : The suggestions for changes in hearing aid services which have been made by the Royal National Institute for the Deaf are being carefully considered.
Audiology Services
Mr. Fearn : To ask the Secretary of State for Health when he last met representatives of the Royal National Institute for the Deaf to discuss audiology services.
Mr. Mellor : The most recent meeting on this subject between the Department and representatives of the Royal National Institute for the Deaf was at official level and took place on 25 November 1988. The then Minister of State for Health--my right hon. Friend the Member for Braintree (Mr. Newton)--and my hon. Friend the Minister for the Disabled met representatives of the institute on 29 June 1988 to discuss their views on audiology services.
Midwives (Pay)
Mr. Colvin : To ask the Secretary of State for Health when he last met the Royal College of Midwives to discuss its rates of pay.
Mr. Mellor : My right hon. and learned Friend the Secretary of State met the president and the general secretary of the Royal College of Midwives on 7 December. They had a friendly and useful discussion on a range of issues arising from the 1988 pay award and associated regrading exercise, which gave midwives an average pay increase of over 20 per cent. last year.
Waiting Lists
Mr. Harry Barnes : To ask the Secretary of State for Health if he will give the latest available figures for the number of people on waiting lists in the area of the Trent regional health authority, and the percentage of those on waiting lists who have been waiting for (a) six months or more and (b) one year or more.
Mr. Mellor : I refer the hon. Member to the publication "Hospital In -patient waiting lists--England at 30 September 1988--National Regional and District summaries", copies of which have been placed in the Library.
Social Workers
Mr. Burt : To ask the Secretary of State for Health what are the names, professional qualifications and occupations of members of the Central Council for the Education and Training of Social Workers.
Mr. Mellor : The names and occupations of members of the Central Council for Education and Training in Social
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Work are set out in the list. There is currently one vacancy on the council. A new council will be appointed from 1 September 1989. We do not hold centrally information concerning the professional qualifications of members.Central Council for Education and Training-- in Social Work-- Membership of Council as at 9 March 1989 Chair
Professor B. Saul--Vice Chancellor, University of York
Other Members
Kina, Lady Avebury--Planning Co-ordinator, Tower Hamlets, Social Services Strategy Group
Mrs. V. Benjamin--Training Officer, Gwynned Social Services Department
Dr. B. R. Bewley--Senior Lecturer and Consultant, Department of Information and Planning, St. George's Hospital, London
Mr. M. G. Clarke--Director, Local Government Training Board Mr. P. Cresswell--Social Worker, Speke, Liverpool
Miss J. D. Ford--Lecturer/Acting Head of Department, Department of Social Administration and Social Work, University of Glasgow Miss. S. Hall-- Principal Officer, Research and Development Barnardo's
Miss M. C. Hartnoll--Director of Social Work, Grampian Regional Council, Aberdeen
Miss S. Irwin--Director of Social Services, Northern Health and Social Services Board, Northern Ireland
Councillor Mrs. D. N. James--Chair, Social Services Committee, Surrey County Council
Mr. D. N. Jones--General Secretary, British Association of Social Workers
Mrs. T. Jowell--Director, Community Care Special Action Project, Birmingham Social Services Department
Dr. G. H. Michael--Senior Lecturer in Social Work, University of Ulster
Mr. E. Morrell--Chief Probation Officer, West Midlands Probation Service
Professor J. O'Neill--Former Director (retired), Trent Polytechnic, Nottinghamshire
Professor P. Parsloe--Head of Department/Professor of Social Work, University of Bristol
Professor G. Pearson--Head of School of Social Work, Middlesex Polytechnic
Mrs. C. C. Pryde--District Officer, Social Work Department, Motherwell, Scotland
Councillor B. M. Scott--Vice-Chairman, Social Work Committee, Strathclyde Regional Council
Mr. P. G. Senior--Senior Probation Officer (Training), South Yorkshire Probation Service, and Senior Lecturer in Social Work, Sheffield City Polytechnic
Mr. J. W. Small--Assistant Director, Social Services Department, London Borough of Hackney
His Honour Judge E. Stockdale--Circuit Judge
Mr. T. C. Storrie--Principal, Cassio College, Watford
Dr. R. G. Walton--Director of School of Social Work, University College, Cardiff
Mr. Burt : To ask the Secretary of State for Health how many post- qualifying social work courses specialising in mental health and mental disorder have been approved by the Central Council for Education and Training of Social Workers ; and how many students completed these courses in each year since 1983.
Mr. Mellor : During the period that the Approved Social Worker (ASW) Examining Board was in being (1983-1986), 1,660 candidates working with mentally ill people were successful in ASW examinations. Since 1986 the Central Council for Education and Training in Social Work has approved 60 training courses for ASWs in local authorities with places for approximately 900 students. In addition, since the 1983-84 academic year CCETSW have approved the following relevant post-qualifying courses :
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(a) Mental illness disorder : seven specialist courses with an output of 91 social work students and 36 non- social work students ; ((b) Mental handicap : six specialist courses which have provided an output of 11 social work and 16 non-social work students ; (
(c) Other post-qualifying training courses : a further 103 social work students undertook options in this area of work as part of other post- qualifying studies.
Parallel Imports
Mr. Hayes : To ask the Secretary of State for Health if he will make it his policy not to issue product licences for parallel imports for products originating from countries that are not members of the pharmaceutical inspection committee.
Mr. Mellor : No. The United Kingdom product licence (parallel import) scheme covers products from any member state of the European Community. To discriminate against those member states which are not members of the pharmaceutical inspection convention (PIC) might be interpreted as a quantitative restriction on imports and as such would offend article 30 of the treaty of Rome.
Medical Control Agency (Director)
Mr. Hayes : To ask the Secretary of State for Health when he will make an announcement regarding the appointment of a director for the Medicines Control Agency.
Mr. Mellor : The appointment of Dr. Keith H. Jones as the first director of the Medicines Control Agency was announced on 3 March 1989. A copy of the press release is in the Library. The agency will come into operation from 1 April 1989.
Mr. Cohen : To ask the Secretary of State for Health if it is Her Majesty's Government's policy to expand the provision of genito-urinary clinics ; and if he will make a statement.
Mr. Mellor : I wrote to regional health authorities on 28 February announcing that for 1989-90 the Department was doubling the resources available to the National Health Service for the prevention of HIV infection and the provision of services related to HIV infection and AIDS from £58.6 to £129.5 million. In the letter I asked authorities to give particular prominence in the use of the extra money to substantial upgrading of genito-urinary medicine services.
Psychiatric Care
Mr. Cohen : To ask the Secretary of State for Health (1) whether every regional health authority area contains secure psychiatric units ; how many such units there are in each region ; and what steps are being taken to provide further such units ;
(2) how many secure units are available to his Department for accommodating mentally disturbed individuals ; whether they are available for use by mentally disturbed prisoners ; what capacity is available for this purpose ; and if he will make a statement.
Mr. Freeman : Every regional health authority, except South West Thames, has a regional secure unit and many
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also have interim secure facilities. Officials are to meet representatives of South West Thames Regional Health Authority in April to discuss their proposals for secure provision. Following is a list of regional secure units and interim secure facilities.Column 330
All these units are able to take mentally disturbed prisoners where it is clinically appropriate.Column 329
|c|Regional secure units: summary of latest position-December 1988|c|
|c|("MI" denotes mental illness hospital, "MH" denotes mental handicap hospital. This applies to the main hospital, not necessarily to the|c|
|c|patients admitted to the Unit. The dates shown for opening are when the Unit first admitted patients.)|c|
Region and regional bed |Permanent RSU(S) |Declared interim secure
target (basis: 20 per |completed under |facilities
million population) |construction/proposed
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Northern-62 |Hutton Unit, St. Lukes Hospital, Middlesbrough (MI) 25 beds-
|opened November 1980
Yorkshire-71 |Newton Lodge, Fieldhead Hospital, Wakefield (MH) 48 beds- |Broadgate Hospital, Beverley (MI) 2 Units
|opened July 1984 |-38 beds (Total)
|Clifton Hospital, York (MI) 15 beds
|Storthes Hall Hospital, Huddersfield (MI) 11
| beds
|High Royds Hospital, Ilkley (MI) 16 beds
|Stanley Royd Hospital, Wakefield (MI) 8
|beds
Trent-91 |Arnold Lodge, Towers Hospital, Leicester (MI) 45 beds-30 beds
| now open-opened July 1983.
|A network of local intensive care facilities for the mentally ill and
| mentally impaired is being developed throughout the region to
| complement the RSU
East Anglian-36 |Norvic Clinic, St. Andrews Hospital, Norwich (MI) 36 beds-
|opened May 1984
North West Thames-69 |Three Bridges Unit, St. Bernards wing of Ealing Hospital, Ealing
| (MI) 40 beds-opened November 1986
North East Thames-74 |Unit at Runwell Hospital, Wickford, near Southend (MI) 10 beds |Friern Hospital, New Southgate (MI) 10
|-opened September 1983. Four additional beds opened |beds-operational August 1986
|October 1988
|Proposed
|Friern Hospital, Southgate (MI) 32 beds |Hackney Hospital (MI) 12 beds: available
|Homerton Hospital (MI) 30 beds. (Scheme starts 1990-91) |from December 1987
South East Thames-72 |Bethlem Royal Hospital<1> (MI) 30 beds-opened August 1985
|Cane Hill Hospital, Coulsdon (MI) 15 beds-opened October 1984
|Oakwood Hospital, Maidstone (MI) 15 beds-opened May 1985
|Bexley Hospital (MI) 15 beds-opened June 1985
|Hellingly Hospital, Hailsham (MI) 15 beds-opened June 1986
South West Thames-58 |A 15 bed unit in the London area is in the planning stage. The unit
|will function in association with eight district and supra-district
|intensive care units (MI) throughout the region. The MH
|strategy is under review
Wessex-53 |Ravenswood House, Knowle Hospital, Fareham (MI) 31 beds-
|opened January 1985
Oxford-44 |Sycamores Unit, Borocourt Hospital (MH) 14 beds-opened June |Nine places opened in July 1987. The
|1987 |remaining five places opened in a phased
|manner in late 1988, early 1989
|Marlborough House, Milton Keynes (MI) 12 beds |To open December 1988 with six, increase to
|12 over the next few months
|Rotherfield Unit, Fair Mile Hospital, Wallingford (MI)-14 beds, due to be completed over the next few months|To open 10 April 1989 with four patients initially
South Western-63 |Butler Clinic, Langdon Hospital, Dawlish (MH) 30 beds-opened |Interim unit of 10 places is proposed for
|June 1983 |Glenside Hospital pending the opening of
|Fromeside Clinic, Glenside Hospital, Bristol (MI)-30 beds |the Fromeside Clinic
West Midlands-104 |Reaside Clinic, Rubery Hill Hospital, Birmingham (MI) 100 beds |Coleshill Hall Hospital, Birmingham (MH)
|-40 beds opened October 1987; to be increased to 70 in April |eight beds
|1989; to 84 in April 1990; to 100 in April 1991
Mersey-50 |Scott Clinic, Rainhill Hospital, Prescott, Liverpool (MI) 50 beds
|-opened August 1983
North Western-82 |Gardiner Unit (Adolescent) Prestwich Hospital, Manchester (MI)
|20 beds-opened January 1985 |Preston (MI) 24 beds. The future of the
|Edenfield Centre (Adult) Prestwich Hospital, Manchester (MI) 88 |Langdale Unit will need to be considered
|beds-opened July 1986 (66 beds open only) |as part of the contraction of Whittingham
|Hospital
<1> The question of the closure of some of these beds is under consideration.
Drugs
Mr. Michael Morris : To ask the Secretary of State for Health how many companies have not agreed their annual financial return under the PPRS for the following years (a) before 1985, (b) 1985, (c) 1986 and (d) 1987.
Mr. Mellor : The number of annual financial returns under the pharmaceutical price regulation scheme not yet cleared for each of the years concerned is as follows :
|Number
-----------------------
pre 1985 |1
1985 |3
1986 |6
1987 |28
Mr. Michael Morris : To ask the Secretary of State for Health to what extent, in settling pharmaceutical company annual financial returns under the PPRS, he is taking into consideration the general return to British industry as reflected in the FT 500 index or comparable index.
Mr. Mellor : The renegotiation of the pharmaceutical price regulation scheme in 1986 included agreement on percentage rates of return on capital employed for the years 1986-87 and 1987-88. From 1988-89, the Department is required to review the rate of return each year on the basis of principles set out in the scheme. These include taking account of any "significant alterations since the last PPRS rate change in the underlying average return on capital of British industry as brought out for example in relevant changes in the FT 500 index." This requirement is being followed in the Department's operation of the scheme.
Mr. Michael Morris : To ask the Secretary of State for Health how many pharmaceutical companies supplying the National Health Service have not applied for a price increase in each of the last five years.
Mr. Mellor : The information requested, for companies providing full financial returns under the pharmaceutical price regulation scheme, is as follows :
|Number
---------------------
1984 |29
1985 |38
1986 |37
1987 |30
1988 |31
Mr. Michael Morris : To ask the Secretary of State for Health what was the indexed aggregate cost of National Health Service medicines supplied under the PPRS in relation to general inflation from 1986.
Mr. Mellor : We do not have the information in the form requested.
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The table shows the indexed aggregate expenditure in NHS medicines in total in 1986-87 and 1987-88 ; this includes expenditure on generic drugs which are not covered by the PPRS.
|1986-87|1987-88
-------------------------------------------------------------
Indexed aggregate expenditure on NHS
medicines in total |100 |110.7
Index of GDP deflator |100 |105.3
Mr. Michael Morris : To ask the Secretary of State for Health (1) what discussions have been and are taking place on amending the grey area of PPRS ; when an interim review is scheduled ; and if he will make a statement ;
(2) what discussions have been and are taking place on amending the research and development allowance element of PPRS ; when an interim review is scheduled ; and if he will make a statement.
Mr. Mellor : There have been discussions between officials of the Department and representatives of the pharmaceutical industry clarifying the Department's implementation of the provisions in the pharmaceutical price regulation scheme relating to "grey area" excess profits and research and development support arrangements. No amendments to the scheme's provisions are being considered. The scheme provides for either party to request a review "after not less than three years"--i.e. from October 1989.
Mr. Michael Morris : To ask the Secretary of State for Health what was the total amount spent on drugs in the National Health Service per head of population for each year in the last 10 years.
Mr. Mellor : The information requested is as follows :
|c|Total
expenditure on
drugs in the NHS,
per head of
population|c|
|Total
--------------------
1978-79 |17.22
1979-80 |19.43
1980-81 |23.26
1981-82 |26.74
1982-83 |30.59
1983-84 |33.88
1984-85 |36.39
1985-86 |38.76
1986-87 |41.42
1987-88 |45.71
Mr. Michael Morris : To ask the Secretary of State for Health what was the total amount spent on drugs in the National Health Service per head of population in real terms for each year in the last 10 years.
Mr. Mellor : The information requested is as follows :
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|c|Total
expenditure on
drugs in the NHS
per head of
population, at|c|
|c|1987-88
prices<1>|c|
|£
--------------------
1978-79 |35.34
1979-80 |34.11
1980-81 |34.48
1981-82 |36.09
1982-83 |38.53
1983-84 |40.81
1984-85 |41.73
1985-86 |42.17
1986-87 |43.61
1987-88 |45.71
<1> Adjusted in
line with the GDP
deflator.
Mr. Michael Morris : To ask the Secretary of State for Health what was the total amount spent on drugs in the National Health Service in real terms for the last 10 years.
Mr. Mellor : The information requested is as follows :
|c|Total expenditure on drugs
in the NHS, at 1987-88
prices<1>|c|
|£ million
------------------------------
1978-79 |1,648
1979-80 |1,593
1980-81 |1,613
1981-82 |1,690
1982-83 |1,803
1983-84 |1,912
1984-85 |1,959
1985-86 |1,987
1986-87 |2,061
1987-88 |2,167
<1> Adjusted in line with the
GDP deflator.
NHS (Review)
Mr. John Evans : To ask the Secretary of State for Health what further representations he has received on his White Paper on the review of the National Health Service.
Mr. Kenneth Clarke : I have received a number of representations on the White Paper. Many still have questions but I have been very pleased by the positive and constructive nature of many of them.
Junior Hospital Doctors (Working Hours)
Mr. Cousins : To ask the Secretary of State for Health how far the target maximum of one night in three rota commitment for junior hospital doctors has been achieved in each year from 1982 in terms of (1) the number of such rotas and (2) the number of doctors working them.
Mr. Mellor : The information in the form requested is not readily available. The number of junior hospital medical and dental staff in England and Wales who were contracted for 84 hours (broadly equivalent to a one in three rota commitment) or less is estimated to have increased from 9,796 at 30 September 1986 to 10,724 at 30 September 1987.
Mr. Cousins : To ask the Secretary of State for Health what is the average number of contracted hours of duty of junior hospital doctors.
Mr. Mellor : The average weekly number of contracted hours of duty of junior hospital doctors in England and Wales was 83 on 30 September 1987. A survey in 1985 showed that the average weekly number of hours actually worked as against on duty was 57.
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Mr. Cousins : To ask the Secretary of State for Health how many junior hospital doctors are known to have contracted hours of duty in excess of 104 hours per week.
Mr. Mellor : In England and Wales on 30 September 1987, 1,463.
Consultants (Support Staff)
Mr. Cousins : To ask the Secretary of State for Health how many additional staff other than consultants have been assessed as necessary to support consultants in acute specialties under circular EL 88 P82.
Mr. Mellor : Health authorities will report their staffing proposals under this circular to the Department in October this year.
Hospital Trusts
Mr. Cousins : To ask the Secretary of State for Health how many appointments he expects to make to self-governing hospital trusts assuming 250 such trusts and a board of 10 ; and if he will estimate the value of such appointments assuming the chairpersons of such trusts were remunerated on the present basis of district health authority chairs and the other directly appointed members received £1,000 each.
Mr. Kenneth Clarke : As the hon. Member will be aware from chapter 3 of the White Paper "Working for Patients", I shall be responsible for appointing the chairman of each National Health Service hospital trust and up to three out of a possible five non-executive members. I am considering the question of remuneration for the chairman and non-executive members. There is little point in calculating the value of these appointments on the basis of assumptions plucked out of the air.
Health Authorities (Allocations)
Mr. Cousins : To ask the Secretary of State for Health (1) if he will provide exemplifications of allocations to regional health authorities on a weighted capitation basis for 1988-89 and 1989-90 on the assumption that direct payments between regions have the same net effect as cross- boundary flow adjustments ;
(2) if he will list the cash allocations to regional health authorities for 1984-85 and subsequently both before and after later cross-boundary flow adjustments, and expressing those adjustments as a percentage of the initial allocation.
Mr. Freeman : Under the resource allocation working party method of resource allocation, inter-regional flows were taken into account by adjusting the weighted populations used to determine target shares of resources available. Within the formula, their impact on weighted populations was relatively small. Actual allocations reflected the acceptable pace of change towards these targets over time. It is therefore not possible to disaggregate the cash element of cross-boundary flows in regional health authority allocations to date.
Prescribing Costs
Mr. Tim Smith : To ask the Secretary of State for Health if he will list the per capita prescribing cost for each family practitioner committee in England and Wales in 1987-88.
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Mr. Mellor : The information relating to Wales is a matter for my right hon. Friend the Secretary of State for Wales. The net ingredient cost per capita of prescriptions dispensed by community pharmacists, appliance contractors and dispensing doctors for each family practitioner committee in England in 1987 was as follows :
F.P.C. |Average NIC per person £ ------------------------------------------------------------------------------------------ Avon |31.27 Barking and Havering |32.08 Barnet |30.80 Barnsley |40.78 Bedfordshire |31.60 Berkshire |30.66 Bexley and Greenwich |29.69 Birmingham |38.34 Bolton |34.84 Bradford |35.20 Brent and Harrow |32.76 Bromley |30.31 Buckinghamshire |30.05 Bury |41.44 Calderdale |37.33 Cambridgeshire |30.73 Camden and Islington |31.36 Cheshire |35.41 City, Hackney, Newham and Tower Hamlets |34.11 Cleveland |38.59 Cornwall |37.75 Coventry |35.68 Croydon |29.87 Cumbria |36.65 Derbyshire |32.96 Devon |35.58 Doncaster |38.21 Dorset |39.31 Dudley |31.64 Durham |38.19 Ealing, Hammersmith and Hounslow |31.87 East Sussex |37.96 Enfield and Haringey |29.96 Essex |32.15 Gateshead |37.00 Gloucestershire |29.74 Hampshire |32.53 Hereford and Worcester |31.66 Hertfordshire |31.03 Hillingdon |31.65 Humberside |37.35 Isle of Wight |40.53 Kensington, Chelsea and Westminster |37.13 Kent |34.17 Kingston and Richmond |32.97 Kirklees |32.81 Lambeth, Lewisham and Southwark |31.27 Lancashire |40.65 Leeds |36.05 Leicestershire |32.58 Lincolnshire |38.08 Liverpool |40.08 Manchester |37.84 Merton, Sutton and Wandsworth |31.79 Newcastle-upon-Tyne |36.99 Norfolk |35.67 North Tyneside |44.66 North Yorkshire |33.94 Northamptonshire |30.96 Northumberland |36.37 Nottinghamshire |31.16 Oldham |35.60 Oxfordshire |28.94 Redbridge and Waltham Forest |34.39 Rochdale |38.21 Rotherham |34.17 Salford |44.22 Salop |33.10 Sandwell |39.41 Sefton |36.72 Sheffield |34.79 Solihull |34.73 Somerset |33.68 South Tyneside |37.62 St. Helens with Knowsley |36.58 Staffordshire |33.56 Stockport |36.92 Suffolk |33.02 Sunderland |41.15 Surrey |31.16 Tameside |37.26 Trafford |40.92 Wakefield |38.90 Walsall |39.35 Warwickshire |34.13 West Sussex |36.66 Wigan |39.90 Wiltshire |31.04 Wirral |40.09 Wolverhampton |37.98
Mr. Tim Smith : To ask the Secretary of State for Health what information is available about per capita prescribing costs for individual general practitioners or general practitioner practices.
Mr. Mellor : A prescribing information system, known as PACT, provides GPs within a practice with information on the number of items per patient and the average cost per patient for their practice, compared with the FPC average. The practice average is calculated using the number of patients on the practice list.
Performance-related Pay (Sunderland)
Mr. Mullin : To ask the Secretary of State for Health if he will give details of the bonus paid in 1988 to the Sunderland district general manager and each of his unit general managers.
Mr. Mellor : No. Additions to salary paid under the
performance-related pay scheme are confidential between managers and their employing authority.
NHS Policy Board
Mrs. Mahon : To ask the Secretary of State for Health (1) if he will list the professional qualifications of each member of the new National Health Service policy board ;
(2) if he will summarise what expertise and experience in the management and planning of health care provision each member of the new National Health Service policy board has.
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