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"Working for Patients" are designed to increase efficiency and should therefore have an additional impact on unjustifiable cost variations.Nurses
Mr. John Marshall : To ask the Secretary of State for Health if he will make a statement about the number of nurses employed by the National Health Service.
Mr. Mellor : Provisional figures for September 1988 show the total number of nursing and midwifery staff (including agency) in the NHS in England as 404,000 whole-time equivalents, an increase of 45,000 (12.6 per cent.) since September 1979. The numbers of qualified nurses and midwives continue to increase and in 1988 the proportion was 60 per cent. of the total number of nursing and midwifery staff compared with 54 per cent. in 1979.
NHS Reform
Mr. John Evans : To ask the Secretary of State for Health how many representations he has received from general practitioners in favour of his proposals to reform the Health Service ; and how many he has received against.
Mr. Mellor : I refer the hon. Gentleman to my reply to my hon. Friend the Member for Northampton, South (Mr. Morris) on 5 May, at column 265.
Mr. Teddy Taylor : To ask the Secretary of State for Health how many letters he has received from the general public about his National Health Service reform proposals ; and if he will make a statement.
Mr. Mellor : We have received in excess of 4,000 letters from members of the public about the White Paper, "Working for Patients".
Mr. John Marshall : To ask the Secretary of State for Health what the pay will be for a general practitioner with 2,000 patients who achieves all the targets contained in the new general practitioner contract.
Mr. Mellor : The levels of fees and allowances payable from April 1990 under the new GPs contract will be determined in the light of the recommendations to be made by the Review Body on Doctors' and Dentists' Remuneration in its next report. We have agreed with the general medical services committee's negotiators to submit joint evidence to the review body later this year.
Mental Health Act Commission
Mrs. Gillian Shephard : To ask the Secretary of State for Health whether any decision has yet been taken on the centralisation of the administration of the Mental Health Act Commission.
Mr. Mellor : No. We shall be giving further consideration to this in the light of the recommendations made in the report of the commission on its review of its functions, organisations, staffing and finance, which is expected shortly.
Pharmacists
Mr. Anderson : To ask the Secretary of State for Health, further to his answer of 19 April, what proportion of the amounts due to pharmacists from 1978 to 1988 was in respect of profits ; and how much was in respect of reimbursement of costs.
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Mr. Mellor : The total amounts due, and the amounts due for costs and profit for England and Wales as shown in the balance sheets prepared with representatives of the profession, are :
£ million
|Total amounts due |Amounts due for costs |Amounts due for profit
-------------------------------------------------------------------------------------------------------------------
1978 |142.0 |121.8 |20.2
1979 |170.9 |148.1 |22.8
1980 |215.2 |177.9 |37.3
1981 |238.9 |189.1 |49.8
1982 |280.2 |225.9 |54.1
1983 |324.8 |269.3 |55.5
1984 |350.3 |291.2 |59.1
1985<1> |96.6 |78.3 |18.3
1985-86 |383.7 |313.5 |70.2
1986-87 |415.0 |342.3 |72.7
1987-88 |485.8 |407.2 |78.6
<1> 1 January 1985 to 31 March 1985.
Hospitals (Self-Government)
Mr. Tony Lloyd : To ask the Secretary of State for Health how many hospitals in the north-west have expressed interest in opting out ; and if he will make a statement.
Mr. Mellor : RHAs are currently considering expressions of interest in individual hospitals becoming self governing. They have been asked to send the expressions of interest to the Department, together with their comments, by 31 May.
Mr. Hinchliffe : To ask the Secretary of State for Health if community health councils will be accorded the same rights in relation to proposals for the self-governing status of particular hospitals as they currently enjoy in relation to closure proposals.
Mr. Tony Lloyd : To ask the Secretary of State for Health what consultation rights Central Manchester community health council will have in any decision of the Central Manchester district health authority to seek self-governing status for its hospitals.
Mr. Mellor : Community health councils will be consulted on local applications for self-governing status and my right hon. and learned Friend will consider their views when deciding on applications.
Mr. Hinchliffe : To ask the Secretary of State for Health managers whose hospitals opt for self-governing status will qualify for incentive payments under the arrangements for performance-related pay.
Mr. Mellor : This will be for individual hospital trusts to decide.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will bring forward proposals to enable the local public to determine through secret ballots whether particular hospitals should have self-governing status.
Mr. Hinchliffe : To ask the Secretary of State for Health (1) by what means he expects regional health authorities to gauge the views of local communities on proposals for particular hospitals to have self- governing status ;
(2) what advice he has given to regional health authorities in processing proposals for the self-governing
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status of particular hospitals when such proposals are strongly opposed by many of those deemed to have an interest in the hospitals concerned.Mr. Mellor : Regional health authorities were given general advice in National Health Service review working paper No. 1--"Self-Governing Hospitals", published on 20 February 1989. Regional health authorities will determine precisely how they publicise applications and seek the views of those with an interest.
Private Patients (Bolton)
Mr. Thurnham : To ask the Secretary of State for Health what was the revenue generated from private patients at hospitals in Bolton in 1988 ; and what were the comparable figures for each of the last five years.
Mr. Mellor : We do not hold this information centrally. My hon. Friend may wish to pursue his inquiry with Mr. T. Taylor, chairman of Bolton health authority.
Immunisation
Mr. Thurnham : To ask the Secretary of State for Health how many children have been immunised with the new measles, mumps and rubella vaccine since its introduction in October 1988.
Mr. Mellor : Immunisation uptake figures for 1988-89 will not be available until later this year. However, from the launch of measles, mumps and rubella vaccine last October to the end of March, 1.4 million doses were distributed to health authorities. The number of children in the recommended priority groups (aged 15 months and four to five years) who became eligible for the vaccine in that period was 600,000.
Harts Hospital (Sale)
Mr. Cohen : To ask the Secretary of State for Health what were the proceeds of the sale of Harts hospital ; and how much has been directly returned to Waltham Forest health authority.
Mr. Freeman : The net proceeds of the sale of Harts hospital were £29.3 million. Capital allocations are a matter for the regional health authority concerned.
Ethnic Monitoring
Mr. Janner : To ask the Secretary of State for Health whether his Department has conducted monitoring exercises in compliance with the code of the Commission of Racial Equality and the Equal Opportunity Commission, respectively, separate from the Department of Social Security ; whether his Department plans to do so ; whether his Department plans to maintain records of the ethnic origins of its staff and officers separate from the Department of Social Security ; and whether he will make a statement.
Mr. Mellor : The action taken by the then Department of Health and Social Security in support of its equal opportunities policy will continue in the Department of Health and will follow the guidance in the codes of practice of the Commission for Racial Equality and the Equal Opportunity Commission. This action includes the monitoring of personnel policies and procedures.
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Work is in hand to ensure that the staff records, including ethnic origin data, of the Department of Health and the Department of Social Security can be separately identified. I shall write to the hon. and learned Member when this is completed.Departmental Staff
Mr. Janner : To ask the Secretary of State for Health how many and what percentage of officers in each of grades 1, 2, 3, 4, 5, 6 and 7, respectively, in his Department are (a) women and (b) from ethnic minorities.
Mr. Mellor : We do not have the information in the form requested because records are held on combined basis with the Department of Social Security. I refer the hon. and learned Member to the information in the reply to him by my hon. Friend the Parliamentary Under-Secretary of State for Social Security on 22 March 1989 at column 679.
Human Insulin
Mr. Cousins : To ask the Secretary of State for Health what is the volume and value of human insulin imported into the United Kingdom in each year since 1983 ; what proportion this represents of the total human insulin used in the United Kingdom each year since 1983 ; and whether any checks are made as to whether this human insulin was purchased or donated voluntarily.
Mr. Mellor : All "human insulin" is manufactured, either by modification of porcine insulin or using biotechnology to produce in the laboratory a product which has the same chemical characteristics as insulin occurring naturally in humans. For this reason it is commonly referred to as "human insulin", though it is not, as might be assumed, derived from human sources. All such human insulin sold in the United Kingdom is now imported, although there was some manufacture up to 1987. Information on amounts sold was given in my reply to the hon. Member for Sedgefield (Mr. Blair) on 21 December 1988, at column 325.
Weil's Disease
Dr. Godman : To ask the Secretary of State for Health if he will publish a table showing the number of deaths, by occupational category, and by region, from Weil's disease in each of the past 20 years ; and if he will make a statement.
Mr. Freeman : The information requested is not wholly available : details of the deceased's occupation were not coded in some of the past 20 years.
Number of deaths due to Weil's disease<1> by standard region of usual
residence and occupation, 1968-87.
Year |Total |Region |Occupation<2>
---------------------------------------------------------------------------------------------------------------------------------------
1968 |8 |East Midlands |n/a
|Yorks and |n/a
|Humberside (2)
|South East (4) |n/a
|East Anglia |n/a
1969 |6 |Yorks and |n/a
|Humberside
|South East (2) |n/a
|Wales |n/a
|West Midlands |n/a
|South West |n/a
1970 |3 |Yorks and |Agricultural machinery
|Humberside (2) |drivers aged under 15
|South West |Food processors (nec)
1971 |3 |South East (2) |Labourers, others (nec)
|Labourers, building and
|contracting
|Wales |Labourers, others (nec)
1972 |9 |East Anglia |Farmers, farm managers,
|market gardeners
|North |Proprietors and managers,
|sales
|South West (2) |Construction workers (nec)
|No occupation
|South East (4) |Agricultural workers (nec)
|Farmers, farm managers,
|market gardeners
|Construction workers (nec)
|Farmers, farm managers,
|market gardeners
|North West |Farmers, farm managers,
|market gardeners
1973 |2 |Wales |n/a
|Yorks and |n/a
|Humberside
1974 |1 |West Midlands |n/a
1975 |5 |South East |Construction workers (nec)
|South West (2) |Agricultural workers (nec)
|Farmers, farm managers,
|market gardeners
|East Midlands |Aged under 15
|North Western |No occupation
1976 |2 |South Western |n/a
|Yorks and |n/a
|Humberside
1977 |2 |East Midlands |n/a
|North Western |n/a
1978 |3 |Northern |n/a
|Yorks and |n/a
|Humberside
|South East |n/a
1979 |3 |South East (3) |Farmers, horticulturists,
|farm managers
|Labourers
|Teachers (nec)
1980 |4 |South East (2) |Farmers, horticulturists,
|farm managers
|Not stated including
|housewife
|South West |Chefs, cooks
|Wales |Sales representatives
|(property and service)
|other agents
1981 |1 |South West |Not stated including
|housewife
1982 |2 |South East |All other in farming and
|related
|Wales |Gardeners and grounds-
|men
1983 |1 |Wales |Labourer, coal mines
1984 |- |- |-
1985 |3 |South West |Other proprietors and
|managers (sales)
|West Midlands |Butchers, meat cutters
|Yorks and |Man-made fibre makers
|Humberside
1986 |1 |East Midlands |Refuse collectors, dustman
1987 |1 |South East |Farm workers
<1> International Classification of Diseases (ICD) codes 100.0 Leptospirosis icterohaemorrhagica plus 100.9. Leptospirosis
unspecified.
<2> Occupations are coded using the 1970 and 1980 OPCS Classification of Occupations.
n/a = Not available.
(nec) = Not elsewhere classified.
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AIDS
Mr. Kirkwood : To ask the Secretary of State for Health if he will list the projects undertaken by the Health Education Authority on AIDS since its inception ; what the budget for each project was ; whether each project was approved by his Department ; and what projects suggested by the authority have not received departmental approval.
Mr. Mellor : Information is not available in exactly the form requested because the HEA's work on AIDS is not funded on a project by project basis. The procedure followed is that the HEA draws up an operational programme which is discussed with Ministers in the authority's annual accountability review. Once the operational programme and budget for AIDS have been agreed the Health Education Authority discusses with the Department (and for United Kingdomwide mass media work, with the other Health Departments also) detailed proposals for implementing the operational programme. These arrangements are intended to ensure that material which is distributed is consistent with overall Government policy on HIV prevention. The work on HIV/AIDS carried out the the HEA is set out in "AIDS Programme Paper 4 : The First Annual Report : October 1987 to September 1988", a copy of which has been placed in the Library.
Mr. Kirkwood : To ask the Secretary of State for Health if he will make a statement on the advice received from the Health Education Authority regarding policy towards AIDS ; and what has been his response to the advice received.
Mr. Mellor : One of the functions of the Health Education Authority is to give advice to Government on health education issues, including those relating the HIV/AIDS. This can be given formally or informally, privately or publicly and at various levels and the Government take account of this in reaching decisions on aspects of policy on HIV infection and AIDS.
Kreutzfeldt-Jacob Dementia
Mr. Ron Davies : To ask the Secretary of State for Health when he expects to be able to announce his decision as to whether to introduce reporting procedures in respect of Kreutzfeldt-Jacob dementia.
Mr. Freeman : We have no plans to do so. Following the recommendation of the Southwood committee on bovine spongiform encephalopathy consideration is being given, however, to the most effective way of ensuring cases of this disease are monitored.
Drugs (Quality)
Mr. Michael Morris : To ask the Secretary of State for Health whether his Department monitors the percentage of generic pharmaceutical supplies to hospitals which are rejected on the grounds of failing to meet quality standards.
Mr. Mellor : The Department does not carry out such monitoring centrally. It is for individual health authorities, as purchasers of medicines, to satisfy themselves as to the quality of those pharmaceuticals.
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Clinical Waste
Mr. Hoyle : To ask the Secretary of State for Health what steps he has taken to ensure that health authorities are handling and disposing of clinical waste safely.
Mr. Freeman : I have recently called for all health authorities to carry out a special review of their arrangements for handling and disposing of clinical waste. Their reports confirmed that the vast majority of health authorities conform to the guidance set out in the Health and Safety Commission document, "The Safe Disposal of Clinical Waste."
In the few exceptional cases where the guidance has not been fully implemented, the main principles of segregation in colour coded bags and incineration are followed. Where contractors are used, the contract is being closely monitored. The Department is taking action to ensure that the guidance is complied with in all respects.
Shropshire league of friends
Mr. Biffen : To ask the Secretary of State for Health if, in view of the continuing widespread concern over health care in Shopshire, he will now see a delegation of the Shropshire league of friends following its correspondence with him on 17 March ; and what response he has made to its claim that it is statutorily entitled to such consideration.
Mr. Kenneth Clarke [holding answer 17 May 1989] : I have told the Shropshire hospitals league of friends that I see little to be gained by discussion of the decisions taken last year, which are now settled and behind us. I have left open the possibility of receiving a delegation from the league of friends and other interested groups if any further proposals concerning health care in Shropshire came to me for decision. Decisions about the financing of health care in Shropshire are of course for the West Midlands regional health authority and day-to-day management decisions are the responsibility of the Shropshire district health authority.
I am aware of no claim by the leagues of friends that they are statutorily entitled to send a delegation to see me.
AGRICULTURE, FISHERIES AND FOOD
Brain Offal
Mr. Colvin : To ask the Minister of Agriculture, Fisheries and Food if he will make a statement on steps being taken by his Department to ban brain offal from the food chain.
Mr. Ryder : Following publication of the Southwood report on bovine spongiform encephalopathy, I announced that I intend, as a precautionary measure, to introduce legislation prohibiting the sale of baby foods contaning brains or other specified offal. I hope to circulate draft regulations for public consultation shortly.
Common Agricultural Policy
Mr. Teddy Taylor : To ask the Minister of Agriculture, Fisheries and Food what amount of the £155 million to be provided to United Kingdom farmers in consequence of the recent common agricultural policy price agreement will be provided by the EEC, Her Majesty's Government and the consumer respectively.
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Mr. MacGregor : Approximately one half is expected to be financed by the Exchequer either directly, or indirectly from the European Community, with the remainder being borne by consumers. The total impact on the retail prices index (all items) is estimated to be very small, at most one twentieth of 1 per cent.
Product Labelling
Mr. Thurnham : To ask the Minister of Agriculture, Fisheries and Food if he has had any discussions with food manufacturers regarding the labelling of products with full ingredients and additives ; and what is the Government's policy on the use of additives in food.
Mr. Ryder : I and my colleagues frequently meet food manufacturing and other interests to discuss a wide range of topics, including food labelling. Government policy on food additives is to ensure that additives are approved only after rigorous examination for need and safety in use by independent committees. Ministers are advised on this by the Food Advisory Committee and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment.
Milk
Mr. Knapman : To ask the Minister of Agriculture, Fisheries and Food if he will make a statement on green top milk.
Mr. Donald Thompson : I have nothing to add to the reply my right hon. Friend gave to my hon. Friend the Member for Basingstoke (Mr. Hunter) on 23 February, at columns 712-13.
Salmonella
Mrs. Ann Winterton : To ask the Minister of Agriculture, Fisheries and Food, pursuant to his reply of 10 May, Official Report, column 459, whether he will make it his policy to ban the import of consignments of eggs which are found to be contaminated with salmonella.
Mr. Donald Thompson : For technical and legal reasons it is not feasible to detain consignments of imported eggs pending testing for salmonella, which takes a number of days. However, where any sample is found to be contaminated with invasive salmonella, the Commission is informed and follow-up action taken with the member state concerned, with a view to eradication of the problem at source.
Mrs. Ann Winterton : To ask the Minister of Agriculture, Fisheries and Food on how many occasions
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in the latest 12 months for which figures are available consignments of imported eggs have been (a) checked for salmonella infection and (b) found to be infected with salmonella.Mr. Donald Thompson [pursuant to his reply, 10 May 1989, c. 459] : Two of the samples taken from consignments of eggs in the last month have now been shown to be positive for salmonella.
In one of these cases, salmonella enteritidis PT4 was identified on the shells of eggs packed in the Netherlands. I have drawn this result to the attention of the Dutch Minister, so that measures can be taken to eradicate the problem at source.
An invasive type of salmonella was not identified in the other sample.
Dr. David Clark : To ask the Minister of Agriculture, Fisheries and Food how many man-years he estimates will be spent on salmonellosis in each of the field and veterinary investigation services, and at the central veterinary laboratory, in the next year.
Mr. Donald Thompson : The information is as follows :
|Man years
-----------------------------------------------------
Field service |28.5
Veterinary investigation service |85.0
Central veterinary laboratory |25.5
Bovine Spongiform Encephalopathy
Mr. Cohen : To ask the Minister of Agriculture, Fisheries and Food what is the latest figure he has available for the number of cattle in Britain infected with bovine spongiform encephalopathy.
Mr. Donald Thompson : Up to 12 May, 4,570 cases of BSE had been confirmed in Great Britain.
Dr. David Clark : To ask the Minister of Agriculture, Fisheries and Food (1) how many man-years have been spent by his Department on bovine spongiform encephalopathy in the last year, by grade, and by service ;
(2) how many man-years he expects to be spent on bovine spongiform encephalopathy by his Department in the next year, by grade, and by service.
Mr. Donald Thompson : The information is as follows. Manpower forecasts are not subdivided by grade for 1989-90.
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<1>1988-89 1989-90
Service |Band A |Band B |Band C |Band D |Total |Total
----------------------------------------------------------------------------------------------------------------------------
State veterinary service |3 |32 |14 |25 |74 |90
Ministry of Agriculture, Fisheries and Food animal health group |<2> |1 |1 |3 |5 |5
Ministry of Agriculture, Fisheries and Food regional administration |- |0.5 |1 |12 |13 |14
<1> Grade bands:
A-Grades 1 to 6.
B-SEO-7 and equivalents.
C-EO-HEO and equivalents.
D-Clerical and industrial grades.
<2> Less than 0.5.
Source: Ministry of Agriculture, Fisheries and Food MINIM.
Dr. David Clark : To ask the Minister of Agriculture, Fisheries and Food how many cases of bovine spongiform
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encephalopathy are being identified, on average, in each week by antemortem inspection ; and if he will make a statement.Mr. Donald Thompson : On average, 140 to 150 suspected cases of bovine spongiform encephalopathy are being identified each week by antemortem inspection.
Mr. Ron Davies : To ask the Minister of Agriculture, Fisheries and Food what discussions he has had in the European Council of Ministers on bovine spongiform encephalopathy and its transmission.
Mr. Ron Davies : To ask the Minister of Agriculture, Fisheries and Food, pursuant to his reply to the hon. Member for Caerphilly, 4 May, Official Report, columns 195-96, which animal species are involved in experiments on the transmission of bovine spongiform encephalopathy ; what have been the results to date ; and if he will make a statement.
Mr. Donald Thompson : Transmission experiments are taking place in hamsters, mice, calves, sheep, goats, marmosets and pigs. So far, only mice have been affected.
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Dutch Elm Disease
Mr. Adley : To ask the Minister of Agriculture, Fisheries and Food if he will make a statement on the research programme into Dutch elm disease ; and if there are any prospects for the elimination thereof.
Mr. Ryder : The Forestry Commission continues to commit significant resources to research on Dutch elm disease, which complements research being carried out in other countries. There is no prospect of eliminating the disease, and the commission's research programme is mainly aimed at finding ways of reducing its incidence. In addition, work is being conducted on the potential role of disease-resistant elms.
Farm Diversification Scheme
Mr. Ron Davies : To ask the Minister of Agriculture, Fisheries and Food how many applications his Department has received under the farm diversification scheme for each six-month period since its inception ; how many have been successful in each period ; and what has been the cost involved.
Mr. Ryder : The information is as follows :
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Period |Applications received |Applications approved ----------------------------------------------------------------------------------------------------------- 1 January 1988 to 30 June 1988 |682 |528 1 July 1988 to 31 December 1988 |405 |288 1 January 1989 to 30 April 1989 |308 |136
Mr. Ron Davies : To ask the Minister of Agriculture, Fisheries and Food if he will provide a breakdown of the number of successful applications under the farm diversification scheme for each county in England and Wales.
Mr. Ryder : I regret that the information requested is only available by the divisional offices of Departments and not by counties. Approved applications for farm diversification capital grants for the period 1 January 1988 to 30 April 1989 were as follows :
Division |Number approved ------------------------------------------------ Beverley |38 Carlisle |32 Newcastle |35 Northallerton |49 Nottingham |37 Worcester |39 Preston |20 Crewe |57 Chelmsford |34 Huntingdon |32 Norwich |43 Lincoln |23 Guildford |36 Maidstone |62 Oxford |36 Exeter |127 Gloucester |79 Taunton |87 Truro |87 Caernarvon |19 Carmarthen |70 Llandrindod |58 Ruthin |16
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Mr. Ron Davies : To ask the Minister of Agriculture, Fisheries and Food if he will provide a breakdown of the number of successful applicants under the farm diversification scheme for each type of project eligible under the scheme.
Mr. Ryder : The number of enterprises in approved applications for farm diversification capital grants in England and Wales for the period 1 January 1988 to 30 April 1989 were as follows :
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