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British Drug Houses

Mr. Strang : To ask the Secretary of State for Employment what investigations were carried out by the Health and Safety Executive following the incident at the British Drug Houses' premises in June 1988 ; when the results of that investigation will be published ; and whether he will place a copy of the results in the Library.

Mr. Nicholls : The Health and Safety Executive (HSE) carried out a full investigation following the incident at the British Drug Houses' premises in June 1988. I will send the hon. Gentleman a copy of the results of the investigation which were published and publicised by HSE at a press conference held on 17 October 1988.

Mr. Strang : To ask the Secretary of State for Employment how many times since 1979 the factory inspectorate has visited the British Drug Houses' premises in Poole, Dorset for the purpose of planned preventive inspections.


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Mr. Nicholls : Since 1979, the number of planned preventive inspections paid to British Drug Houses Ltd. premises in Poole, Dorset by Health and Safety Executive inspectors are as follows :


Number of preventive inspections                            

Address                                     |Number         

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

British Drug Houses Ltd., No. 1 Site,                       

 West Quay Road, Poole                      |6              

British Drug Houses Ltd., Nos. 2 & 3                        

 sites, West Quay Road, Poole               |9              

British Drug Houses Ltd., Broom Road, Poole |4              

YTS

Mr. Nellist : To ask the Secretary of State for Employment what reports have been published by the traininng standards advisory service, since its inception, into (a) quality of training on YTS and (b) health and safety standards on YTS ; and if he will make a statement.

Mr. Cope : The information is in the Library. The training standards advisory service has issued 748 reports on the quality of training in individual YTS schemes to approved training organisations and Training Agency area and regional offices since the service began its formal programme of inspections in April 1987. The annual report of the training standards advisory service for 1987-88 summarised the main findings from inspections carried out by the service during its first year of operation. A copy has been placed in the Library. The training standards advisory service has not published any reports on health and safety standards in YTS schemes.

Spongiform Encephalopathy

Mr. Ron Davies : To ask the Secretary of State for Employment what are the procedures for monitoring for spongiform encephalopathy workers in slaughterhouses, veterinarians and others who come into contact with untreated animal products in the course of their work.

Mr. Nicholls : The Health and Safety Executive is not operating separate procedures for monitoring spongiform encephalopathy and there have been no reported cases of this disease.

Wages Councils

Mr. Rowe : To ask the Secretary of State for Employment if he will now give details of the responses to the 1988 consultation document on wages councils ; and if he will make a statement.

Mr. Cope : Counting replies, there were 394 responses to the consultation document on wages councils. The positions of respondents were as follows :


                             |For abolition    |Against abolition|Inconclusive                       

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

Organisations                                                                                        

Employer organisations with                                                                          

 seats on Wages Councils     |23(a)            |20               |3                                  

Other employer organisations |14(b)            |6                |2                                  

Worker organisation with                                                                             

 seats on Wages Councils     |-                |9                |-                                  

Other worker organisations   |-                |26               |1                                  

Other organisations          |3                |130              |-                                  

                                                                                                     

Individuals (d)                                                                                      

Individual employers on                                                                              

 Wages Council industries    |36(c)            |12               |-                                  

Individual workers in Wages                                                                          

 Council industries          |-                |7                |-                                  

Other individuals            |4                |98               |-                                  

The replies from employer organisations with seats on wages councils show a marked change of view since the 1985 consultations, when the majority wanted the system retained. In each of the six largest wages councils, which embrace 94 per cent. of workers covered by the system, a majority of the employer bodies represented want the councils abolished. Replies from both organisations and individuals raise a number of important points which my right hon. Friend intends to consider in detail before making a final decision on the councils' future later this year.

(a) Includes two respondents who support abolition in the absence of other preferred changes.

(b) Includes three respondents who support abolition in the absence of other preferred changes.

(c) Includes seven respondents who support abolition in the absence of other preferred changes.

(d) Replies with more than one signatory counted as single responses.

Voluntary Unemployment (Disqualification)

Mr. Nellist : To ask the Secretary of State for Employment if he will organise a survey, on a similar but wider basis than that conducted by his Department in November 1986, into voluntary unemployment dis- qualifications to give national, and regional or district, statistics following the increase of the maximum period of disqualifications to 26 weeks.

Mr. Peter Lloyd [holding answer 16 March 1989] : I have been asked to reply.

A survey is currently being carried out to monitor the effects of increasing to 26 weeks the maximum period of disqualification for unemployment benefit in cases of voluntary unemployment. It will cover the first three months of 1989 and will provide information on the numbers and lengths of disqualifications imposed both nationally and regionally. In addition an independent agency has been commissioned to explore the impact of the increased maximum period of disqualification on decisions about leaving or taking work as well as the effects on the circumstances of those who are disqualified. We expect the results, which will be published, to be available in the summer.

ENERGY

Pluto Reactor

Dr. Thomas : To ask the Secretary of State for Energy what is the reason for the UKAEA shutting down its Pluto reactor at the Atomic Energy Research Establishment at Harwell ; and what is the present estimated cost of decommissioning the reactor.

Mr. Michael Spicer : The Pluto materials testing reactor at Harwell will be closed at the end of March 1990 because the prospects of business beyond the end of the


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forthcoming financial year are judged to be insufficient to maintain the operation of two materials testing reactors. The United Kingdom Atomic Energy Authority has said that depending on customer requirements it expects that the other materials testing reactor-- Dido--will continue in operation for several years more. The full programme of decommissioning Pluto is being evaluated by the United Kingdom Atomic Energy Authority. The planning and execution of the decommissioning programme will be carried out in consultation with the Health and Safety Executive.

Calder Hall and Chapelcross

Mr. Cohen : To ask the Secretary of State for Energy if he will direct the chairman of British Nuclear Fuels Ltd. to publish in full the feasibility study currently being undertaken into the development of new nuclear generating plant at Calder hall and Chapelcross when it is completed ; and if he will make a statement.

Mr. Michael Spicer : The feasibility study is a commercial document and publication will be a matter for British Nuclear Fuels plc.

Offshore Installations

Mr. Doran : To ask the Secretary of State for Energy (1) if he will make a statement on the exercise of his statutory obligations in respect of drilling platforms which are (a) parked in United Kingdom waters but not operating or (b) under tow between operating sites ;

(2) at what stage in their operations his Department exercises its statutory responsibility in respect of offshore installations.

Mr. Peter Morrison : My Department exercises its responsibilities in respect of offshore installations involved in the exploration and exploitation of mineral resources in United Kingdom-controlled waters at all stages from project design to installation abandonment.

Mr. Doran : To ask the Secretary of State for Energy (1) if he will list the medical supplies which are required to be carried by offshore installations ; and what steps his Department takes to ensure that operators comply with requirements ;

(2) if he will introduce legislation to define the duties of operators of offshore installations to employ medically qualified personnel ; and if he will make a statement.

Mr. Peter Morrison : The Offshore Installations (Occupational Safety, Health and Welfare) Regulations 1976 require the provision of specified medical stores and medically trained persons on offshore installations. These regulations are kept under continuous review to ensure that they are properly up to-date. My inspectors enforce the requirements of these regulations during offshore inspections.

Electricity Supply Industry

Mr. Hardy : To ask the Secretary of State for Energy what is the required rate of return from new capital investment on the electricity supply industry.

Mr. Michael Spicer : I refer the hon. Member to the answer that I gave to the hon. Member for Sedgefield (Mr. Blair) on 17 March 1989 at column 389.


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HEALTH

Abortion

8. Mr. Burt : To ask the Secretary of State for Health if he will make a statement outlining the process for obtaining consent for a general anaesthetic in order for an abortion to be performed on a girl aged under 16 years, if that girl has asked that her parents are not informed.

Mr. Freeman : In the circumstances described, written consent may be obtained from the patient herself if, in the judgment of the doctor concerned, it is in her best medical interest and she has sufficient maturity and understanding to appreciate what is involved.

14. Mr. Nicholas Bennett : To ask the Secretary of State for Health whether he has any plans to meet representatives of the Islamic Medical Association, the Caring Professions Concern, or the Catholic Doctors Guild to discuss the working of the conscience clause of the Abortion Act 1967.

Mr. Freeman : No requests for a meeting have been received.

15. Mr. Evennett : To ask the Secretary of State for Health when he last paid an official visit to (a) a National Health Service abortion centre and (b) a private abortion centre ; and what was the purpose of that visit.

Mr. Freeman : My colleagues and I make frequent visits to NHS and private hospitals for various purposes. To date, three visits to NHS hospitals which carry out abortions took place this month. The most recent ministerial visit to a private hospital which is also approved under the Abortion Act 1967, took place in July 1988 and was by way of a general interest visit to see the hospital and the facilities offered.

61. Mr. Ken Hargreaves : To ask the Secretary of State for Health what is the most common technique used in the performing of late abortions in private clinics ; and what this technique involves.

Mr. Freeman : I refer my hon. Friend to my reply to my hon. Friends the Members for Erith and Crayford (Mr. Evennett) and for Batley and Spen (Mrs. Peacock) on 24 January at column 531.

71. Mr. McAvoy : To ask the Secretary of State for Health if he will make a statement outlining the specific action which has so far been taken to implement the recommendations of the 1973 Select Committee on abortion.

Mr. Freeman : I assume that the hon. Member is referring to the reports of the Lane committee on the working of the Abortion Act in 1974 and of the Select Committee on the Abortion (Amendment) Bill in 1975 and 1976. Most of their recommendations have been implemented by administrative means,. The operation of the 1967 Act continues to be monitored closely.

73. Mr. Robert G. Hughes : To ask the Secretary of State for Health if he has any plans to introduce new regulations or legislation to curb the growing level of advertising by abortion charities in newspapers.

Mr. Freeman : All advertisements placed by registered pregnancy advice bureaux are subject to the approval of the Secretary of State and further controls are not considered necessary at this time.


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Public Health (Report)

16. Mr. David Evans : To ask the Secretary of State for Health what progress has been made in implementing the recommendations contained in the Chief Medical Officer's report on public health in England.

Mr. Kenneth Clarke : The Government announced last July, that we accepted the principle of a greater commitment to the public health advanced by the Chief Medical Officer's report on "Public Health in England" and that we would be taking a number of steps to carry forward its recommendations.

These include :

issuing general advice to health authorities on the main recommendations affecting their responsibilities including the preparation of annual reports and reviews of staffing

the establishment of a central health monitoring unit

additional funding for an expansion of the epidemiological function of the communicable disease surveillance centre

initial work on updating the current law on infectious disease control.

HM Inspector of Anatomy

17. Mr. Barry Field : To ask the Secretary of State for Health if he will list the duties of Her Majesty's inspector of anatomy.

Mr. Mellor : Under the Anatomy Act 1984, Her Majesty's inspector of anatomy inspects and authorises licences for premises where anatomical examination is to be carried out. He licences teachers of anatomy, undertakes regular visits and site inspections to ensure that the conditions are being carried out.

Working for Patients"

18. Mr. Wilshire : To ask the Secretary of State for Health what provision he is making under the proposals in the White Paper "Working for Patients" for circumstances where a general practitioner overspends on his or her drug budget.

Mr. Kenneth Clarke : FPCs will discuss with practices concerned any significant divergence from planned spending. Where there is a reasonable explanation for the variation the FPC will be expected to accept and accommodate it within its overall budget. If no satisfactory explanation for apparent overspending can be found the FPC will discuss with the practice what remedial action is necessary. Under no circumstances will any practice ever be required to withhold necessary medicine from a patient.

19. Mr. Hannam : To ask the Secretary of State for Health what are the implications of the proposals contained in the White Paper "Working for Patients" for the aims of his policy of care in the community ; and if he will make a statement.

Mr. Kenneth Clarke : Our policy aims in the community care field remain unaltered--to promote the development of community services so that people can return to, or remain in the community and live independently wherever this is best for them. We are currently giving active consideration to the future organisation and management of community care following Sir Roy Griffiths' report and will ensure that our conclusions are consistent with our proposals in "Working for Patients".


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22. Mr. Leigh : To ask the Secretary of State for Health what further responses he has received to the recent White Paper on the future of the National Health Service, "Working for Patients."

Mr. Kenneth Clarke : I refer my hon. Friend to my reply to my hon. Friends the Members for Harrow, East (Mr. Dykes) and for Hendon, South (Mr. Marshall) earlier today.

32. Mr. Wallace : To ask the Secretary of State for Health what provision is to be made for the proper recruitment and training of staff and the additional cost for establishing the information technology and accountancy needed to implement the proposals contained in the White Paper "Working for Patients".

Mr. Kenneth Clarke : It will be the responsibility of health authorities to decide what additional manpower they will need. There will be an even greater need for management training and development of staff. The Health Service Executive together with the NHSTA will be working closely with the service on these activities which still need to be improved further in the NHS quite apart from the implications of the White Paper.

36. Mr. Andrew Bowden : To ask the Secretary of State for Health if it is intended that long-stay hospital care for elderly people will be included in the essential core services to be provided by National Health Service hospital trusts under proposals in the White Paper "Working for Patients".

Mr. Kenneth Clarke : "Core services" is not intended to be a description of essential services but of those services of any kind which must be provided locally. In other words, as was made clear in the White Paper, core services will include all those hospital and community-based services which need to be provided on a local basis on grounds of practicability. But where patients may wish to choose the location of their treatment, districts will--under the new arrangements--be able to buy services in a more flexible way. Some long-stay care for elderly people might fall into either category. It will be for each district to consider, in the light of local circumstances, what its core services should be. It will be the responsibility of every district health authority to ensure that its population has access to a comprehensive range of services.

37. Mr. Grocott : To ask the Secretary of State for Health how many representations he has received from organisations representing Health Service workers or patients supporting the proposals in his White Paper "Working for Patients".

Mr. Kenneth Clarke : As yet, we have received only a few such representations.

44. Mr. Gerald Howarth : To ask the Secretary of State for Health what provision he is making for doctors who choose to operate a practice budget, as proposed in the White Paper "Working for Patients" to treat patients where their budget is overspent.

Mr. Kenneth Clarke : Budget-holding practices will be expected to stay within the agreed budget. But treatment must be available to patients and no circumstances will ever arise in which a practice is required to withhold necessary treatment or medicine from any patient.


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Practices will be permitted to overspend in any one year by up to 5 per cent. of budget, on the basis that a corresponding reduction is made in the budget for the following year. Where overspend is due to genuine clinical needs or the changed circumstances of the practice, the practice would opt for a budgetary review. If a practice consistently overspends by more than 5 per cent. the sanction will be that it may lose the right to have a budget.

45. Mr. Hind : To ask the Secretary of State for Health if he will make a statement on the implications for patient choice of the proposals in the White Paper, "Working for Patients".

Mr. Kenneth Clarke : A fundamental aim of the White Paper proposals is to make the Health Service more responsive to the needs of patients. We will stimulate better services to patients by encouraging suitable hospitals to apply for self-governing status, by delegating responsibility to local level and by allowing money for patients' treatment to cross administrative borders. General practitioners will be able to improve the service they offer their patients by applying for their own budgets. Patients will be able to choose their general practitioners on the basis of the services they offer. We intend to raise the performance of all hospitals and general practitioners to that of the best. The reformed Health Service will offer a better quality of service and better value for money.

46. Mr. Yeo : To ask the Secretary of State for Health what recent representations he has received regarding his White Paper "Working for Patients".

Mr. Kenneth Clarke : I refer my hon. Friend to my reply to my hon. Friend the Member for Hendon, South (Mr. Marshall) earlier today.

49. Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health what recent representations he has received from general practitioners on the documents "Promoting Better Health" and "Working for Patients".

Mr. Kenneth Clarke : I have recently received a considerable number of representations from individual GPs and their representative organisations on the documents "Promoting Better Health" and "Working for Patients". These have been in person, in writing and through the helpline set up to answer GPs' queries arising from the document "General Practice in the NHS--A New Contract" which set out in more detail our plans for the family doctor service.

62. Mr. Franks : To ask the Secretary of State for Health what are the implications of the proposals in his White Paper, "Working for Patients", for waiting lists.

Mr. Kenneth Clarke : Our proposals in the White Paper "Working for Patients" are designed to ensure that all parts of the Health Service offer the best possible service to patients. The better value for money obtained under the new system will in itself ensure an increase in levels of patient care and reduce pressure on waiting lists. To reduce waiting times for non- urgent treatment, the Government are to introduce a scheme under which 100 extra consultants can be appointed over the next three years. We are also changing the funding system used by the Health Service to make sure that patients can receive treatment in hospitals where waiting lists are shortest if they wish.


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69. Mr. Hayes : To ask the Secretary of State for Health what representations he has received from the British Medical Association on "Working for Patients" ; and if he will make a statement.

Mr. Kenneth Clarke : I have yet to receive a formal response from the British Medical Association to the White Paper proposals.

Mr. Teddy Taylor : To ask the Secretary of State for Health if he has given consideration to introducing the White Paper reforms initially on a pilot basis in areas of the United Kingdom ; and if he will make a statement.

Mr. Kenneth Clarke : We gave very thorough consideration to the proposals contained in the White Paper "Working for Patients" during the year in which we carried out a detailed review of the Health Service. I am quite satisfied that the NHS needs reform on the lines proposed to improve its management and to improve the service to patients. Postponing full implementation would lead to uncertainty and anxiety in the Health Service without producing the benefits for patients and staff that will flow from the early introduction of the planned reforms.

Operations (Private Hospitals)

20. Mr. Corbyn : To ask the Secretary of State for Health how many operations in the London area were contracted out to private hospitals and at what cost during 1988.

Mr. Mellor : The latest year for which information is available is 1986. In that year 1,005 patients received surgical treatment under contractual arrangements made between the Thames regions and the private sector. 1987 data will be available later this year. Total expenditure on all contractual arrangements made by the Thames regions in 1986-87 was £19.5 million, and in 1987-88 £22.1 million. Comparable information on expenditure is not recorded by specialty.

Treatment Costs

21. Mr. Hunter : To ask the Secretary of State for Health what steps he is taking to reduce the variations in cost of treatment between different health districts.

Mr. Kenneth Clarke : My Department publishes Health Service indicators annually. These include information on the average cost per acute inpatient case standardised for broad specialty mix. There may be good reasons (such as differences in case-mix not yet identifiable in the statistics) for variations in unit costs. But publication of these variations is intended to prompt action by district health authorities to eliminate unnecessary expenditure. The proposals in "Working for Patients" will provide greater incentives by encouraging both competition and greater regard to

cost-effectiveness.

Self-governing Hospitals

23. Mr. Simon Hughes : To ask the Secretary of State for Health how regional health authorities will be required to consult with the local community on proposals for hospitals seeking self-governing status.

Mr. Kenneth Clarke : Regional health authorities will publicise fully-developed proposals in the relevant local or


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regional media as well as consulting community health councils. They will provide details of the application on request to members of the local community and pass on any responses to me so that I can take them into account in making my decision on the application.

Nurses (Pay)

24. Mr. Janman : To ask the Secretary of State for Health what was the change in nurses' pay in (a) 1975-76 and (b) the latest available year.

Mr. Mellor : Nurses received an average pay increase of 8 per cent. in 1975-76, compared with 17.9 per cent. last year. After allowing for inflation nurses pay fell by 4.3 per cent. in 1975-76 compared with an increase of 12.5 per cent. last year. Nurses will get a further average increase of 6.8 per cent. from 1 April.

Pharmaceutical Price Regulation Scheme

25. Mr. Fearn : To ask the Secretary of State for Health if he has any plans to change the pharmaceutical price regulation scheme.

Mr. Mellor : I have no such plans at present.

General Practitioners (Contracts)

26. Mr. David Martin : To ask the Secretary of State for Health what the effect will be of the proposed general practitioners' contracts on (a) preventive medicine and (b) patient service.

60. Mr. Andy Stewart : To ask the Secretary of State for Health what will be the effects of the proposed general practitioners' contracts on (a) patient service and (b) preventive medicine.

Mr. Kenneth Clarke : The proposals in the report "General Practice in the National Health Service--A New Contract", which I have sent to all GPs, are intended to improve the quality of the family doctor service, and to place greater emphasis on health promotion and the prevention of ill- health. Specific changes which will improve services to patients include regular check-ups, particularly for children and people aged over 75, more health promotion clinics, more minor surgery in the GP's premises to save patients having to attend hospital and the extension of practice teams to include not only practice nurses, but also counsellors, chiropodists, physiotherapists and other health professionals.

As to preventive care, GPs will be encouraged to optimise cover for childhood immunisation and screening for cervical cancer. This will be achieved through target payments to which GPs will be entitled on reaching certain targets.


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