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(a) Perinatal mortality rate by country 1979 to 1987
Country Year
|1979 |1980 |1981 |1982 |1983 |1984 |1985 |1986 |1987
----------------------------------------------------------------------------------------------------------
England |14.6 |13.4 |11.7 |11.2 |10.3 |10.0 |9.8 |9.5 |8.9
Wales |15.6 |12.8 |14.1 |11.1 |11.3 |10.5 |10.2 |10.3 |9.2
Scotland |14.1 |13.1 |11.6 |11.5 |10.6 |11.0 |9.8 |10.2 |8.9
Germany, Federal Republic |<3>12.6|<3>11.6|<3>10.5|<3>9.6 |<3>9.3 |<3>8.6 |<3>7.9 |<3>7.6 |n.a.
Sweden |<1>9.1 |<1>8.7 |<1>7.7 |<1>7.8 |<1>7.3 |<1>7.3 |<4>7.3 |n.a. |n.a.
France |<3>13.8|<3>12.9|<3>12.3|<3>11.9|<3>11.4|<3>11.2|<3>10.7|<3>10.4|n.a.
United States of America |<2>13.9|<4>14.1|<1>13.4|<4>15.2|<4>14.5|<4>14.0|n.a. |n.a. |n.a.
Rates provided are as published in:
<1> United Nations "Demographic Yearbook".
<2> World Health Organisation "World Health Statistics Annual".
<3> The Statistical Office of the European Community "Eurostat Demographic Statistics".
<4> No rate published in volumes, calculation made from data provided in <1> and <2> above.
|c|(b) Neonatal mortality rate by country 1979 to 1987|c|
Country Year
|1979 |1980 |1981 |1982 |1983 |1984 |1985 |1986 |1987
------------------------------------------------------------------------------------------------
England |8.2 |7.6 |6.6 |6.2 |5.8 |5.5 |5.3 |5.2 |5.0
Wales |8.4 |7.9 |8.1 |6.9 |6.7 |5.7 |5.8 |5.6 |5.0
Scotland |8.7 |7.8 |6.9 |7.1 |5.8 |6.4 |5.5 |5.2 |4.7
Germany, Federal Republic |<3>8.6|<3>7.8|<3>7.0|<3>6.3|<3>5.9|<3>5.5|<3>5.0|<3>4.8|n.a.
Sweden |<2>5.3|<2>4.9|<3>4.5|n.a. |n.a. |n.a. |<4>4.1|n.a. |n.a.
France |<3>6.0|<3>5.8|<3>5.5|<3>5.3|<3>5.0|<3>4.7|<3>4.6|<3>4.3|n.a.
United States of America |<2>8.9|<4>8.5|<4>8.0|<4>7.7|<4>7.3|<4>7.0|n.a. |n.a. |n.a.
Rates provided are as published in:
<1> United Nations "Demographic Yearbook".
<2> World Health Organisation "World Health Statistics Annual".
<3> The Statistical Office of the European Community "Eurostat Demographic Statistics".
<4> No rate published in volumes, calculation made from data provided in <1> and <2> above.
|c|(c) Infant mortality rate by country 1979 to 1987|c|
Country Year
|1979 |1980 |1981 |1982 |1983 |1984 |1985 |1986 |1987
----------------------------------------------------------------------------------------------------------
England |12.8 |12.0 |10.9 |10.8 |10.0 |9.4 |9.2 |9.5 |9.1
Wales |12.4 |11.4 |12.6 |10.6 |10.7 |8.8 |9.8 |9.5 |9.5
Scotland |12.8 |12.1 |11.3 |11.4 |9.9 |10.3 |9.4 |8.8 |8.5
Germany, Federal Republic |<3>13.6|<3>12.7|<3>11.6|<3>10.9|<3>10.2|<3>9.6 |<3>9.0 |<2>8.5 |n.a.
Sweden |<1>7.5 |<1>6.9 |<4>7.0 |<1>6.8 |<2>7.2 |<2>6.4 |<2>6.7 |<2>5.9 |n.a.
France |<3>10.0|<3>10.0|<3>9.7 |<3>9.5 |<3>9.1 |<3>8.3 |<3>8.3 |<2>7.9 |n.a.
United States of America |<1>12.9|<1>12.6|<2>11.9|<1>11.5|<2>10.9|<1>10.6|<2>10.5|<2>10.4|n.a.
Rates provided are as published in:
<1> United Nations "Demographic Yearbook".
<2> World Health Organisation "World Health Statistics Annual".
<3> The Statistical Office of the European Community "Eurostat Demographic Statistics".
<4> No rate published in volumes, calculation made from data provided in <1> and <2> above.
National Health Service (Staff Training)
Mr. Gordon Brown : To ask the Secretary of State for Health if he will provide an estimate of the cost of training (a) a state registered nurse, (b) an operating theatre nurse, (c) a speech therapist, (d) a consultant and (e) a junior hospital doctor.
Mr. Mellor : The estimated cost of training a registered general nurse over a three-year course is £14,000. The figure excludes that part of the cost of the trainee's remuneration and other costs estimated to represent the value of the contribution the trainee makes to patient services. The other costs requested are not held centrally.
National Health Service Reform
Ms. Harman : To ask the Secretary of State for Health which interested parties will be consulted by his Department over the composition of the list of treatments included in budgets for general practitioners.
Mr. Kenneth Clarke : My Department will be discussing the composition of the list of treatments included in practice budgets for general medical practitioners with the profession and with National Health Service managers. Specific invitations to discuss working papers 3 and 4 have been issued to the general medical services committee and the Royal College of General Practitioners.
Ms. Harman : To ask the Secretary of State for Health what is the formula which will determine the weighting
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element of the capitation allowance payable to general practitioners under the terms of working paper and of the White Paper on the National Health Service.Mr. Kenneth Clarke : The relative weights to be included in the capitation formula will be determined after the discussions with interested parties, referred to in the working paper on indicative prescribing budgets for general medical practitioners, have taken place.
Ms. Harman : To ask the Secretary of State for Health if it is his intention that where a group practice opts out of the budget-holding scheme for general practitioners the practice income will be preserved at the level of the last year of budget holding.
Mr. Kenneth Clarke : If a practice decides to leave the practice budget scheme, the normal remuneration arrangements for general medical practitioners will apply.
Ms. Harman : To ask the Secretary of State for Health whether he will publish the evidence relating to working paper 3 of the White Paper on the National Health Service, in respect of practice budgets offering general practitioners an opportunity to improve the quality of their services.
Mr. Kenneth Clarke : Practice budgets will offer general medical practitioners an opportunity to improve the quality and standard of service to patients. Those practices with budgets will be able to decide how to make the most effective use of funds in order to provide the best possible service to their patients. The proposed development of
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medical audit should ensure the maintenance and indeed raising of standards both generally and in participating practices. Improving the quality of family doctor services is also a major objective of the White Paper "Promoting Better Health". The proposals set out in "General Practice in the NHS : A New Contract", published in February, should achieve that objective by better rewarding those doctors whose standards are high and who provide a wide range of high quality services geared to patients' needs.Ms. Harman : To ask the Secretary of State for Health what mechanisms will be introduced to ensure impartial judgments are made as to the appropriateness of patient referrals to accident and emergency units in order to meet the requirements of the White Paper on the National Health Service that accident and emergency referral would not be used as a substitute for out-patient referral.
Mr. Kenneth Clarke : Health authorities will be expected to make arrangements at hospital level to monitor attendances to ensure that referrals to accident and emergency units are not used as a substitute for out-patient referrals.
Ms. Harman : To ask the Secretary of State for Health what formulae will be used to measure relative need for services provided by general practitioners who become budget-holders under the terms of the Government's White Paper on the National Health Service.
Mr. Kenneth Clarke : We are now considering the precise method of determining the relative need for services by patients. The practice budget scheme will be structured so that general medical practitioners have no financial incentive to refuse to treat any categories of patients.
Ms. Harman : To ask the Secretary of State for Health what mechanisms exist, or will be established, within regional health authorities, to enable them to adjudicate in disputes arising over the treatments to be included within general practitioner's budgets, as proposed in working paper 3 of the White Paper on the National Health Service.
Mr. Kenneth Clarke : Regional health authorities already have medical advice available to them which could be used for this purpose.
Ms. Harman : To ask the Secretary of State for Health what evidence he has collected on whether doctors will seek to remove patients from their lists on budgetary grounds where the costs of investigation and treatment are borne by general practitioner's practices.
Mr. Kenneth Clarke : Practice budgets will be set at a level which will reflect the relative need for services by patients registered with the practice. The elderly will attract a higher contribution to the budget than the young, and in exceptional cases adjustments will be made in respect of individual patients who need more costly treatment.
The Government do not believe that doctors will seek to remove patients from their lists on budgetary grounds nor be slow to accept patients. If, however, a practice did adopt a policy of selective registration, it could have its budget withdrawn by the RHA.
Ms. Harman : To ask the Secretary of State for Health how he proposes to adjust indicative budgets for general
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practitioners to accommodate practices which initially have below average prescribing costs but rapidly increase their diagnosis and treatment rates for common conditions.Mr. Kenneth Clarke : We accept that the properly planned introduction of improved patient services, such as screening for certain conditions, may lead to an increase in prescribing of particular drugs. Practices intending to introduce such services will need to discuss their plans in advance with the family practitioner committee so that the financial implications can be fully considered when allocating prescribing budgets to practices.
As set out in working paper 4, "Indicative Prescribing Budgets for General Medical Practitioners", the FPC will be expected to compare expenditure with its budget profile and also information on what is prescribed and dispensed. They will be expected to investigate any significant diversions of actual and planned expenditure and take early and effective action. The FPC will be expected to accept and accommodate reasonable explanations for the variation.
Preventive Services
Ms. Harman : To ask the Secretary of State for Health what research has been conducted to establish the effect of attaching a financial cost to preventive services provided by general practitioners on uptake of these services.
Mr. Kenneth Clarke : Health promotion and illness prevention are central to the Government's objectives for general practitioner services. As made clear in "General Practice in the NHS : A New Contract", published in February, the Government will make the provision of health promotion a specific requirement in general practitioners' terms of service, and will introduce a health promotion sessional payment.
As working paper 3, "Practice Budgets for General Medical Practitioners", makes clear, the Department will discuss with the medical profession whether budgets should be set at a level which includes the cost of diagnostic investigations associated with health prevention and screening or whether they should be excluded from the scope of the scheme and charged to the patient's DHA.
Plastic Surgery
Sir John Farr : To ask the Secretary of State for Health what is the average waiting time for plastic surgery patients who have not yet been admitted to hospital (a) in the Leicestershire health authority, (b) in the Trent region and (c) nationally.
Mr. Mellor : Average waiting times for those awaiting admission to hospital are not available centrally. The numbers on the waiting list are analysed by time waited and a percentage distribution based on this information is given in the table.
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|c|Percentage distribution of cases on the in-patient waiting
list by time|c|
|c|waited, as at 30 September 1988, Plastic surgery specialty|c|
Months waited
|0 to 2 |3 to 5 |6 to 8 |9 to 11|12+
------------------------------------------------------------------
Leicestershire
District Health
Authority |18 |10 |10 |9 |53
Trent Regional
Health Authority |12 |12 |10 |10 |57
England |14 |12 |9 |7 |58
Smoking
Mr. Simon Coombs : To ask the Secretary of State for Health what has been the level of expenditure by the Health Education Authority and the Health Education Council, in the last five years for which figures are available, on publicity and other materials designed to discourage smoking.
Mr. Mellor: The figures (actual expenditure) are as follows :
|c|Health Education Council|c|
|Campaigns/associated
|expenditure £
---------------------------------------------------------------
1983-84 |2,629,708
1984-85 |1,624,221
1985-86 |2,345,704
1986-87 |1,118,025
|c|Health Education Authority|c|
|1987-88 £
----------------------------------------
Campaigns/Promotion |562,635
Publications |170,776
These figures do not reflect total spending, since smoking health education is included in many other authority programmes, such as "Look After Your Heart", cancer, and the young people's programme. On 25 January 1989 my right hon. Friend the Prime Minister announced a new £2 million a year campaign over the next four years, to be run jointly by the Department of Health and the Health Education Authority, aimed at halving the proportion of teenagers who smoke.
Lipid-lowering Drugs
Mr. Simon Coombs : To ask the Secretary of State for Health what information he has on the level and cost of prescribing lipid-lowering drugs for the last 12 month period for which figures are available ; and what were the comparable figures for the corresponding periods over the previous five years.
Mr. Mellor : The number of prescriptions for and net ingredient cost of lipid-lowering drugs dispensed by community pharmacists in England in each of the last six years was as follows :
|Number of Prescriptions|Net Ingredient Cost (£
|(thousand) |million)
------------------------------------------------------------------------------------------------
1987 |261 |4.7
1986 |241 |3.4
1985 |238 |2.8
1984 |239 |2.4
1983 |240 |2.2
1982 |264 |2.1
Private Hospitals
Mr. Allen : To ask the Secretary of State for Health what provision there is for the inspection of private hospitals.
Mr. Mellor : District health authorities are required to inspect each private hospital at least twice a year. Inspections may be unannounced and "out of hours".
Mr. Allen : To ask the Secretary of State for Health if he will list the names and ownership by company of private hospitals operating in each of the English health regions.
Mr. Mellor : This information is not collected centrally. However, "Laing's Review of Private Health Care 1988," a copy of which is in the Library, gives details of private hospitals.
Water Supplies
Mr. Allen : To ask the Secretary of State for Health how many hospitals or other National Health Service units receive water from (a) boreholes and (b) non-mains sources.
Mr. Freeman : Information on the number of hospitals or other NHS units receiving water from boreholes or other non-mains sources is not available. Health authorities are, however, required to comply with the water byelaws in force and comprehensive advice on water supply and quality was issued to them most recently in the DH code of practice, the control of legionellae in health care premises.
Mr. Allen : To ask the Secretary of State for Health what inspection is undertaken of water supplies used (a) in the Queen's medical centre, Nottingham and (b) in National Health Service hospitals as standard procedure.
Mr. Freeman : In general, responsibility for the quality of water, from whatever source, rests with the appropriate water authority. The quality of water stored and distributed within all health care premises is mainly governed by inspection and maintenance of plant and equipment in those premises and I refer to my other reply to him today.
Operation Statistics
Mr. Allen : To ask the Secretary of State for Health how many operations were contracted out to private hospitals in the Trent regional health authority ; and at what cost during 1988.
Mr. Mellor : The information is not available in the form requested. The latest available figures for Trent are for the 1986 calendar year and show a total of 816 discharges and deaths of patients receiving treatment under contractual arrangements with institutions outside the NHS. Expenditure in the Trent region on contractual
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arrangements for patient treatment with non- NHS hospitals and homes was about £1,189,000 in 1986-87. This is a total figure and so includes sums incurred under contracts with voluntary and other organisations as well as private hospitals as such.Whitley Council Negotiating Machinery
Mr. Galbraith : To ask the Secretary of State for Health if he has any plans to review the Whitley council negotiating machinery.
Mr. Kenneth Clarke : Not at the moment. The White Paper "Working for Patients" records our objective progressively to introduce greater local flexibility into the determination of NHS pay and conditions of service. This will require changes in the nature and scope of national agreements but not necessarily in the present central negotiating machinery.
Wakefield District Health Authority
Mr. Hinchliffe : To ask the Secretary of State for Health on how many occasions since its inception Wakefield district health authority has amended a policy decision in respect of a proposed closure or change of use of health buildings following public consultation in accordance with his Department's circular HSC(15)207.
Mr. Freeman : Such information is not collected centrally. The hon. Member may wish to contact the chairman of Wakefield health authority in the event that such detail is held locally.
Spina Bifida
Mr. Thurnham : To ask the Secretary of State for Health how many patients were treated for spina bifida during each of the last three years ; what was the cost per patient ; and if he will make a statement.
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Mr. Freeman : The information requested for the last three years for which data are available centrally is given in the following table.
|c|Estimated number
of in-patients with
main diagnosis of
spina bifida|c|
|c|(ICD 741)<1>,
discharged from
National Health
Service non-|c|
|c|psychiatric
hospitals,
England|c|
|Number
---------------------
1983 |2,390
1984 |1,960
1985 |2,070
<1>
ICD-International
Classification of
Diseases: 9th
revision.
The cost of hospital treatment is estimated at £1,500 per in-patient stay at 1987-88 prices. Expenditure on care of patients in the community cannot reliably be estimated from data held centrally.
Mr. Thurnham : To ask the Secretary of State for Health (1) what percentage of pregnant woman were screened for spina bifida during the last three years, listed by regions ;
(2) how many pregnant mothers were screened for spina bifida during the last three years ; what was the cost per patient ; and if he will make a statement.
Mr. Freeman : This information is not collected centrally. However, I understand that it is common clinical practice to offer screening for spina bifida to pregnant women.
Neural Tube Defects
Mr. Thurnham : To ask the Secretary of State for Health (1) how many pregnancies were terminated because of neural tube defects during each of the last three years ; and if he will make a statement ;
(2) what percentage of pregnant women had terminations for neural tube defects during each of the last three years, listed by regions.
Mr. Freeman : The information is shown in the table.
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|c|Number of (a) conceptions, (b) terminations with central nervous system malformation in foetus<1> as principal medical condition,|c|
|c|England and Wales, Regional Health Authority of usual residence, 1985 to 1987|c|
1985 1986 1987
|(a) (000's) |(b) |(b) as a percentage of|(a) (000's) |(b) |(b) as a percentage of|(a) (000's) |(b) |(b) as a percentage of
|(a) |(a) |(a)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
England and Wales |797.2 |520 |.07 |818.9 |557 |.07 |841.1 |531 |.06
Regional Health Authorities
Northern |46.1 |44 |.1 |46.6 |36 |.08 |47.1 |56 |.12
Yorkshire |56.2 |27 |.05 |57.4 |45 |.08 |58.7 |33 |.06
Trent |69.1 |45 |.07 |70.9 |63 |.09 |72.6 |56 |.08
East Anglian |28.6 |21 |.07 |30.1 |24 |.08 |30.7 |23 |.07
North West Thames |63.2 |23 |.04 |64.5 |20 |.03 |66.4 |25 |.04
North East Thames |69.3 |40 |.06 |71.2 |38 |.05 |74.5 |43 |.06
South East Thames |59.4 |25 |.04 |62.9 |25 |.04 |65.0 |29 |.04
South West Thames |46.0 |22 |.05 |47.5 |20 |.04 |48.9 |18 |.04
Wessex |41.8 |34 |.08 |43.5 |45 |.1 |44.5 |29 |.07
Oxford |39.3 |24 |.06 |40.9 |34 |.08 |42.1 |25 |.06
South Western |44.7 |21 |.05 |45.9 |36 |.08 |47.3 |28 |.06
West Midland |85.6 |66 |.08 |87.3 |42 |.05 |89.6 |45 |.05
Mersey |38.8 |36 |.09 |39.4 |25 |.06 |40.0 |45 |.11
North Western |65.9 |49 |.07 |66.5 |49 |.07 |68.5 |46 |.07
<1> International classification of diseases (9th revision) 655.0
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Nursing Home Owners (Payments)
Ms. Harman : To ask the Secretary of State for Health what payments are made by nursing home owners to general practitioners to facilitate their provision of primary care and other services.
Mr. Mellor : Under his terms of service a general practitioner, except in certain specified circumstances which are not relevant here, may not accept a fee or any other remuneration for any treatment which he gives to a person for whom he is responsible to provide general medical service.
Nurses (Regrading)
Dr. Godman : To ask the Secretary of State for Health if nurses who commenced post-registration training on or after 1 April 1988 have the right of appeal concerning their recent clinical grading ; and if he will make a statement.
Mr. Mellor : Yes. All nursing and midwifery staff whose posts were regraded have the right of appeal under the general Whitley council appeals procedure.
Skin and Hair Cream
Mr. Fearn : To ask the Secretary of State for Health what information he has on the levels of chlorinated biphenyls and organophosphates found in lanolin-based skin and hair creams with particular reference to nipple and breast creams.
Mr. Freeman : None. Chlorinated biphenyls are not used for animal treatment and organophosphates are used
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in a way that should leave minimal residues in the lanolin used for manufacturing these creams. The main supplies provide very tight specifications for lanolin used in cosmetics.Child Care
Mr. Paice : To ask the Secretary of State for Health what was the total public expenditure on (a) local authority day nurseries, (b) local authority playgroups and (c) other day care facilities for each year from 1975 to 1988 in (i) cash and (ii) real terms ; and what was the total number of children participating in each type of provision for each year, together with the percentage that total was of all children in the three to four years age group.
Mr. Mellor : Information is not collected centrally on the exact age of children participating in each type of day care.
Table 1 gives the net current expenditure by local authorities for the years 1975-76 to 1986-87 inclusive. Data for 1987-88 are not yet available.
The information available centrally on the numbers of children participating in local authority provision for children under five is published annually in "Children's day care facilities, at 31 March, England" (A/F/6), copies of which are available in the Library. Table 2 gives these figures, expressed as a percentage of all children aged three and four years.
Information for 1988 is not yet available.
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|c|Table 1|c|
|c|Net current expenditure by local authorities (i) Cash|c|
£ thousands
(a) Day nurseries (b) Playgroups (c) Child minding (d)Family centres
Year |Local authority|Other |Local authority|Other |Local authority|Other |All
------------------------------------------------------------------------------------------------------------------------------------------------
1975-76 |23,919 |433 |1,489 |420 |- |- |854
1976-77 |29,555 |581 |1,866 |523 |- |- |1,017
1977-78 |32,769 |726 |2,177 |486 |- |- |1,160
1978-79 |36,704 |950 |2,222 |743 |- |- |1,832
1979-80 |43,034 |1,119 |3,200 |688 |- |- |2,247
1980-81 |56,952 |1,147 |4,019 |524 |- |- |3,081
1981-82 |64,657 |1,570 |4,708 |670 |- |- |3,948
1982-83 |71,427 |1,657 |5,265 |524 |934 |842 |5,170
1983-84 |77,830 |1,619 |5,417 |530 |1,505 |1,258 |6,291
1984-85 |83,030 |1,713 |5,686 |613 |1,917 |1,489 |7,655
1985-86 |84,180 |1,914 |6,037 |804 |2,831 |1,418 |13,526
1986-87 |95,779 |1,972 |8,008 |967 |3,517 |1,496 |13,367
(ii) In real terms at 1986-87 prices (GDP deflator)
1975-76 |66,480 |1,202 |4,140 |1,168 |- |- |2,374
1976-77 |72,511 |1,425 |4,577 |1,283 |- |- |2,496
1977-78 |70,693 |1,567 |4,696 |1,047 |- |- |2,502
1978-79 |71,404 |1,849 |4,323 |1,445 |- |- |3,564
1979-80 |71,774 |1,866 |5,337 |1,148 |- |- |3,748
1980-81 |80,123 |1,614 |5,654 |737 |- |- |4,335
1981-82 |82,882 |2,013 |6,035 |859 |- |- |5,061
1982-83 |85,507 |1,984 |6,303 |627 |1,118 |1,008 |6,189
1983-84 |89,046 |1,852 |6,198 |606 |1,722 |1,439 |7,198
1984-85 |90,523 |1,868 |6,199 |668 |2,090 |1,623 |8,346
1985-86 |87,012 |1,978 |6,240 |831 |2,926 |1,466 |13,981
1986-87 |95,779 |1,972 |8,008 |967 |3,517 |1,496 |13,367
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|c|Table 2: Local authority provision of day care for children, England, 1975-87: Numbers as a percentage of children aged three and four<1>|c|
Day nurseries Playgroups Child minding
As at 31 March |Children on registers of|Children placed and paid|Children on registers of|Children placed and paid|Places available with |Children placed and paid
|facilities provided by |for by local authorities|facilities provided by |for by local authorities|local authority provided|for by local authorities
|local authorities |in other facilities |local authorities |in other facilities |childminders |with other childminders
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
1975 |1.81 |0.08 |0.20 |0.30 |<2>- |0.05
1976 |1.97 |0.11 |0.20 |0.31 |<2>- |0.07
1977 |2.19 |0.12 |0.19 |0.36 |<2>- |0.09
1978 |2.35 |0.12 |0.20 |<3>- |<3>- |<3>-
1979 |2.48 |0.14 |<3>- |0.44 |<3>- |<3>-
1980 |2.68 |0.17 |0.22 |0.40 |<3>- |<3>-
1981 |2.90 |0.18 |0.24 |0.39 |<3>- |<3>-
1982 |3.00 |0.15 |0.26 |0.49 |0.23 |0.18
1983 |2.91 |0.13 |0.28 |0.63 |0.20 |0.22
1984 |2.87 |0.12 |0.25 |0.78 |0.19 |0.18
1985 |2.76 |0.13 |0.27 |0.81 |0.10 |0.25
1986 |2.95 |0.15 |0.27 |0.97 |0.13 |0.33
1987 |2.93 |0.15 |0.28 |1.03 |0.15 |0.42
<1> Information on the exact age of children using each type of provision is not collected centrally; some children using day care provision are aged under three
<2> Data not available
<3> Data available, but not reliable
Notes:
Information about the number of children attending family centres is not collected.
General Practitioners
Ms. Harman : To ask the Secretary of State for Health (1) how many general practitioner practices there are in each family practitioner area ; and what is the average list size in each family practitioner area to England ;
(2) how many general practitioner practices there are with 11,000 or more patients for each family practitioner committee area in England.
Mr. Mellor : A table giving the information requested as at 1 October 1987 (the latest date for which figures are available) has been placed in the Library.
Hospital Trusts
Ms. Harman : To ask the Secretary of State for Health whether the level of remuneration proposed for chairs and non-executive directors of National Health Service hospital trusts will be in line with the existing payments made to chairs of health authorities.
Mr. Kenneth Clarke : I am considering the question of remuneration for the chairmen and non-executive members of National Health Service hospital trusts.
Community Health Councils
Ms. Harman : To ask the Secretary of State for Health what will be the rights of community health councils in relation to non-National Health Service agencies providing hospital services under contract to health authorities as proposed by the National Health Service White Paper ; and how they will be resourced to meet the additional work load arising.
Mr. Kenneth Clarke : Rights of community health councils will not change as a result of the White Paper proposals. I do not therefore foresee that they will experience any problem over carrying out their statutory duty to represent the interests of National Health Service patients in their districts. They receive adequate resources for that purpose and the White Paper does not impose any additional duties or burdens upon them.
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Ambulances (Costs)
Mr. Flynn : To ask the Secretary of State for Health if he will list the current average cost of purchase of an ambulance.
Mr. Freeman : Based on annual returns from all regional health authorities the average overall cost of purchase of first line ambulances in 1988-89, including VAT, was £21,568 for glass reinforced plastic vehicles and £20,291 for van conversions.
Eyes and Teeth (Tests)
Mr. Flynn : To ask the Secretary of State for Health if he will give the cost in 1988 of providing free tests for eyes and teeth.
Mr. Mellor : Information on costs is available only by financial year. The estimated cost in England of sight tests provided under the general ophthalmic service in 1988-89, the final 12 months before withdrawal of the universal entitlement to National Health Service sight tests is £114 million. The cost to the general dental service of National Health Service dental examinations in 1987-88, the last full year in which no patient charges were levied for examinations, was £113 million.
Computer Consultants
Mr. Tim Smith : To ask the Secretary of State for Health what was the total amount spent by his Department in 1988 on management and computer consultancy contracts, excluding hardware and software purchases ; and if he will list each management or computer consultancy contract awarded by his Department in 1988, giving in each case the name of the consultancy firm and the subject of the assignment.
Mr. Mellor : The estimated total expenditure in 1988 on health- related consultancy contracts was £2.413 million.
Expenditure was from a joint health and social security budget and has had to be apportioned where consultants were engaged on projects covering both health and social security matters.
Column 95
A list giving details of each health-related management or computer consultancy awarded in 1988 has been placed in the Library.Blood Transfusion Service (West Midlands)
Ms. Walley : To ask the Secretary of State for Health how much blood has (a) been at the disposal of (b) been provided to private hospitals by the West Midlands regional blood transfusion service for each of the years ; 1988-89, 1987-88 and 1986-87.
Mr. Freeman : The latest information held centrally for the West Midlands regional blood transfusion service is as follows :
|Number of useable blood |Number of units of blood
|donations collected |supplied to non-NHS
|hospitals
----------------------------------------------------------------------------------------------------
1986 |192,599 |10,154
1987<1> |192,468 |9,086
<1> Provisional figures.
Operating Department Assistants
Mr. Hoyle : To ask the Secretary of State for Health, pursuant to his answer to the hon. Member for Warrington, North of Friday, 17 March, Official Report, column 388, when the working group of the management side of the professional and technical staff B Whitley council examining the pay and grade structures of operating department assistants will make its report.
Mr. Mellor : I understand that the PTB management side's working group expects to report back in time for its conclusions to influence pay negotiations this year.
Hon. Member for Derbyshire, South
Mr. Hoyle : To ask the Secretary of State for Health, pursuant to the answer to the hon. Member for Warrington North, of 20 February, Official Report, column 525, who will pay the £170 for the administrative officer who is managing and safeguarding papers which are being consulted by the former Parliamentary Under-Secretary of State at his Department.
Mr. Kenneth Clarke : The cost of £170 for managing and safeguarding the papers being consulted by the former Parliamentary
Under-Secretary of State will be met by my Department in accordance with long standing practice in these matters.
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