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Mr. Freeman : This is a rare infection in this country. The national blood transfusion service is preparing for a study to monitor the prevalence of this infection in blood donations. As part of these preparations, an investigation of the methods available for identifying the infection is underway.
Mr. Bermingham : To ask the Secretary of State for Health what information he has on the total number of complaints registered against representatives of pharmaceutical companies in each of the last five years in relation to financial and other incentives offered to general practitioners for the prescribing of specific products ; and if he will make a statement.
Mr. Mellor : None. Pharmaceutical industry sales promotion conduct is regulated by the industry's code of practice. Complaints alleging unacceptable conduct are considered by the code of practice committee of the Association of the British Pharmaceutical Industry (ABPI). The Royal College of Physicians has issued advice on "The Relationship between Physicians and the Pharmaceutical Industry".
Mr. Anthony Coombs : To ask the Secretary of State for Health whether he is yet in a position to announce the composition of the NHS policy board and the NHS management executive proposed on the White Paper, "Working for Patients."
Sir Roy Griffiths (Deputy Chairman).
The Minister of State for Health.
The Parliamentary Under Secretary of State for Health.
Sir Donald Acheson Chief Medical Officer, Department of Health. Sir James Ackers, Chairman of West Midlands Health Regional Authority.
Professor Cyril Chantler, Professor of Paediatric Nephrology at Guys Hospital.
Column 419Mrs. Julia Cumberlege, CBE, Chairman of South West Thames Regional Health Authority.
Sir Graham Day, Chairman of the Rover Group and Cadbury Schweppes.
Sir Kenneth Durham, Chairman of Woolworth holdings and Deputy Chairman of British Aerospace.
Sir Christopher France, CB, Permanent Secretary at the Department of Health.
Mr. Duncan Nichol, CBE, Chief Executive of the NHS Management Executive.
Sir Robert Scholey, CBE, Chairman of British Steel.
The policy board will determine the strategy, objectives and finances of the NHS in the light of Government policy, and will set objectives for the management executive and monitor whether they are achieved.
The NHS management executive members will be :
Mr. Duncan Nichol, CBE, Chief Executive
Mr. Graham Hart, CB, Director of Operations
Mr. Michael Fairey, Director of Information and
Ms. Sheila Masters, Director of Finance
Mr. Peter Wormald, Director of Personnel
Dr. Ron Oliver, CB, Medical Director
Miss Patsy Wright-Warren, Nursing Director
Mr. Bryan Rayner, CB, Director, Family
Mr. Idris Pearce, CBE, Estates Adviser
The executive will deal with all operational matters relating to both the hospital and community health service and the family practitioner service, within the strategy and objectives set by the policy board.
"Working for Patients" emphasised the need to distinguish in our central management of the NHS between strategy--making clear the direction the Government want the service to follow--and the operational tasks involved in putting that strategy into practice. In other words, it is Ministers' job to set a framework of policies, priorities and resources and, within that, to leave managers to manage and to answer for their performance.
This is reflected in the different roles of the policy board and the management executive. I am delighted that, as chairman of the policy board, I shall be able to draw on such a wide range of experience and achievement and that the chief executive of the management executive will lead an equally strong team.
Mr. Mellor : The evaluation points to some encouraging features of schemes, in particular the ability of some to attract significant numbers of injectors--many of whom have not been in contact with services before-- and to help regular attenders make or sustain changes in risky behaviour. However, the research also shows that schemes have a high turnover of clients and are less good at attracting women, younger injectors and those with a short history of injecting drug misuse. They tend to attract those injectors who have already made, or are motivated to make changes in their behaviour.
We have concluded that exchange schemes and other measures to make sterile injecting equipment more readily available--such as, where appropriate, sales by pharmacists and provision by general practitioners in the context of treatment of drug misusers--can be potentially valuable components of the wider-ranging strategy we need to
Column 420prevent the spread of HIV-infection amount and from drug misusers. This strategy must also include the development of readily accessible advice and treatment services where drug misusers can get help with drug problems, and with reducing their risk of acquiring or transmitting HIV-infection through drug using or sexual behaviour. At the same time, we continue to attach the utmost importance to tackling the misuse of drugs itself, both by the interdiction of supplies and through effective education and information to discourage young people from starting to take drugs.
We have increased to over £14 million the funds available to health authorities from 1989-90 for services for drug misusers, including measures to prevent the spread of HIV-infection, in order that such a strategy may be implemented. In Scotland and in Wales £2 million and £1.6 million respectively are being provided for this purpose. We will circulate the key findings of this recent research in order that they may be taken into account in planning and developing services.
Ms. Harman : To ask the Secretary of State for Health what was the budget of the Health Education Council for each year from 1978-79 to 1986- 87, expressed as actual expenditure and as a percentage of total National Health Service spending for England.
Health Education Council budget Financial year |Actual expenditure |<1>As percentage of total |NHS spending for England |£ million |Per cent. -------------------------------------------------------------------------------------------------------- 1978-79 |3.7 |0.06 1979-80 |4.5 |0.06 1980-81 |5.0 |0.05 1981-82 |6.6 |0.06 1982-83 |8.6 |0.08 1983-84 |9.3 |0.08 1984-85 |9.6 |0.07 1985-86 |10.1 |0.07 1986-87 |10.15 |0.07 <1> Total NHS spending for England has been taken as the total revenue and capital expenditure of regional and district health authorities and the special health authorities for the London postgraduate teaching hospitals plus the expenses of the Dental Estimates board and the Prescription Pricing authority. The administrative expenses of family practitioner committees and their total expenditure on family practitioner services (net of patients' charges) have also been included. Figures used represent annual outturn figures, not adjusted for inflation.
Ms. Richardson : To ask the Secretary of State for Health whether desiccated liver powder is categorised as a food supplement or a pharmaceutical product ; and whether he will make a statement about the importing of desiccated liver powder in relation to the Imported Food Regulations 1984.
Mr. Mellor [holding answer 2 May 1989] : The decision whether desiccated liver powder is regarded as a food supplement or a pharmaceutical product for purposes of the imported food regulations rests with the port health authority responsible for the application of the regulations
Column 421at the port of entry. It is for the authority to make this decision on the basis of the facts which are available to it at the time of import, relating to the end use of the powder.
Mrs. Mahon : To ask the Secretary of State for Health if he will state by rate of population per 1,000 by age group, for years 1980 to 1989, the number of cases of assistance to persons during the year provided by (i) Calderdale, (ii) Bradford, (iii) Kirklees, (iv) Leeds, (v) Wakefield, (vi) Oldham and (vii) Rochdale for (a) installation of telephone and attachments, (b) payment of telephone rentals, (c) installation of other communications equipment, (d) installation of television, (e) payment of television licence or rental, (f) supply of radio, (g) supply of personal aids, (h) adaptation to non-local authority property and (i) holidays.
Mr. Mellor [holding answer 11 May 1989] : Tables showing available information in respect of year ended 31 March 1980 to 31 March 1987 have been placed in the Library. Information in respect of subsequent years has not been collected centrally.
Mrs. Ann Winterton : To ask the Secretary of State for Health if he will call for a report from the chairman of the Trent regional health authority on the wording used in the advertisement for two consultant gynaecologists placed by the authority in the Lancet of 8 April.
Mr. Mellor [holding answer 16 May 1989] : No. but officials have drawn to the attention of the regional health authority the guidance issued in 1975 and 1979 by the then Chief Medical Officer concerning advertisements for consultant posts in obstetrics and gynaecology.
Mr. O'Brien : To ask the Secretary of State for Health what advice he has given to the chairman of the Wakefield family practitioner committee on requests made to the chairman of the family practitioner committee to discuss the White Paper, "Working for Patients ;" and if he will make a statement.
Mr. Mellor [holding answer 16 May 1989] : None, although the chairman did send me copies of a recent exchange of correspondence with the hon. Member. I note that the chairman offered to arrange a meeting between representatives of the committee and hon. Members representing local constituencies to discuss the future implementation of the White Paper, which is the task assigned to the committee. I hope that hon. Members will take up that offer and I am writing to the chairman to encourage him to pursue it.
Mr. O'Brien : To ask the Secretary of State for Health when his Department received a request for copies of the White Paper, "Working for Patients," to be supplied to members of the Wakefield family practitioner committee ; and if he will make a statement.
Mr. Mellor [holding answer 16 May 1989] ; Copies of the White Paper were sent to all family practitioner committees at the time of publication. It was for each committee to arrange its own internal distribution and to obtain any additional copies it might need.
Mr. O'Brien : To ask the Secretary of State for Health if he has received from the Wakefield family practitioner committee any proposals for a health profile giving details of demands on services ; and if he will make a statement.
Mr. Mellor [holding answer 16 May 1989] : No. We have recommended that all family practitioner committees should prepare a health profile of the area in collaboration with the district health authority as part of their own planning process. I understand that such a document in respect of Wakefield is in the course of preparation. We do not ask that the document should be sent to the Department except at the time of a performance review.
Mr. Speller : To ask the Secretary of State for Health if he will take steps to ensure that treatment for IVF in the South West regional health authority area is available free of charge for patients living in north Devon as it is for patients living in Bristol.
Mr. Freeman [pursuant to his reply, 15 May 1989 c. 80-81 ] : I now understand that the infertility treatment available for a limited number of patients in north Devon is gamete intra fallopian transfer (GIFT) and not in vitro fertilisation (IVF) as previously stated. I am sorry we did not get this right.
Mr. Channon : I have today published, with the agreement of my right hon. and learned Friend the Secretary of State for Scotland and my right hon. Friend the Secretary of State for Wales, a consultation paper entitled "New Roads by New Means--Bringing in Private Finance". It covers England, Scotland and Wales. Copies have been placed in the Library of the House.
The Government are committed to providing a transport infrastructure suited to the needs of a modern economy. We showed that commitment in the plans contained in the White Paper, "Roads for Prosperity", published on 18 May, which dealt with roads in England. The White Paper was largely concerned with publicly-financed road schemes, but the private sector is playing an important and growing role in providing transport infrastructure. I see great potential opportunities for the private sector to finance and build more of our roads and bridges, complementing our greatly expanded road programme. My aim is to make full use of the innovation, enterprise and management efficiency of the private sector in improving the road network and in providing better value for money for taxpayers and road users. Our consultation paper proposes a way forward.
Column 423We have already started. From the international partnership on the Channel tunnel to local partnerships with councils on road schemes, the initiative and flair of the private sector have been making their impact. We already have an example of the successful involvement of private finance in a major national road scheme. The
Dartford-Thurrock bridge, the first privately financed road scheme this century, is our starting point. The private sector is also tendering for the second Severn bridge.
This is a new field. There have been uncertainties for potential promoters. The consultation paper addresses these issues. For example, it describes a new approach by the Government to the question of additionality--the possible effect of private financing on the Government's total roads expenditure, which has been of considerable concern to the private sector. We give the assurance that we will not subtract the cost of privately financed roads from public sector provision on a scheme-by-scheme basis. This decision on additionality reinforces our belief that private sector schemes will provide the opportunity for more roads than would otherwise have been built. The Government are concerned to achieve the most cost- effective provision of roads. Where appropriate, this will involve comparing privately financed schemes with their public sector alternatives. In future, however, no such comparison will be required unless the road scheme concerned is already in the programme or enjoys a high degree of monopoly.
The consultation paper proposes measures to make it easier for roads financed by contributions from developers to be built. It also concludes that new procedures are needed to authorise privately financed tolled roads. It makes detailed proposals for those new procedures, which would require primary legislation.
Privately-financed tolled roads will take the form of concessions, broadly similar to those for the Channel tunnel and the Dartford-Thurrock bridge. I would usually grant a concession after a competition. Competitions will help to ensure the best value for road users. In addition, EC law will require that concessions should be the subject of competitions. For these reasons, exclusive rights will not usually be conferred on promoters ; but commercially confidential innovations will be protected, and originators of ideas will be given a place on the short list for the competition.
There will be an order-making procedure to authorise the roads and the tolls to be charged. The promoter would ask me to make the necessary orders. Where there are objections, there would be public inquiries to ensure that full regard is paid to the environment, and to protect the rights of affected individuals. The promoter would consult widely before applying for the required orders. All relevant orders would be considered at the same inquiry.
The Government will keep up the momentum of the private finance initiative. "New Roads by New Means" announces our intention to establish an early competition for a privately financed scheme to increase road capacity in the Birmingham-Manchester corridor. I can also announce today that I intend to hold a competition for the Birmingham northern relief road.
"New Roads by new Means" is a consultation document. We are asking for comments by 14 July. I want to encourage people with ideas to come forward and help me to take this exciting initiative forward, and so to improve the road network still more for industry and motorists.
Mr. Grocott : To ask the Secretary of State for Transport if he will provide as much information as possible about his Department's expenditure on commercial television advertising, without breaching commercial confidentiality, over each of the past five years.
Mr. Peter Bottomley : The Department of Transport's planned expenditure on commercial television advertising airtime in 1989-90 is £1.7 million. This relates to our campaign against drinking and driving.
Our objective in buying airtime is to obtain equivalent "reach" in respect of our target audience in each of the television areas. Expenditure is proportionately higher in the south (the areas covered by Television South, London Weekend Television, Thames Television and Television South West) because the cost of airtime is higher. I have already provided information on the Department's expenditure over the past five years, during which time the same principle of equivalent "reach" has applied.
Dr. Godman : To ask the Secretary of State for Transport what provisions his officials have made for allowing stricken tankers into Kilbrannan sound ; what consultations were conducted concerning this matter with locally based commercial fishermen who fish the sound, before his officials took their decision ; which other interested parties were consulted ; and if he will make a statement.
Mr. Portillo : In answer to the first part of the hon. Gentleman's question, no particular areas around United Kingdom are designated by the Department to be safe havens for stricken tankers and if a tanker is seriously damaged and needs shelter it will seek the nearest available. The Department holds general navigation details of the United Kingdom coast and such environmental details as is available. In the event of an incident it will advise and consult to the extent that time will allow all relevant local authorities before agreeing to or taking action to prevent, the tanker's intended movements.
Mr. Moore : I have no plans to do so. However, the House will know that when the additional help that we are giving to pensioners is introduced this autumn it will not affect the amount of transitional protection they are receiving.
40. Mr. O'Brien : To ask the Secretary of State for Social Security how many people in (a) Leeds and (b) Wakefield lost transitional payment benefit from April 1989 for the current year ; and if he will make a statement.
Mr. Peter Lloyd : Information will not be available for housing benefit transitional payments until the final closing date of 30 June 1989 has been reached and all applications have been received, assessed and payments made which are backdated to April 1988. To date, 184 people are no longer receiving transitional payments because their capital has increased to over £8,000 and payments have ceased for 72,234 people whose transitional payments were £2.00 per week or less, although their overall benefit income will have increased at April 1989.
An estimated 610,000 income support claimants ceased to need transitional protection following this year's benefit uprating. These people now receive more benefit income by way of income support than they got through supplementary benefit.
30. Mr. David Evans : To ask the Secretary of State for Social Security what resources have been committed by his Department over the past year to ensuring that those eligible for benefits are aware of their entitlement.
Mr. Peter Lloyd : In financial year 1988-89, a total of £12.7 million was spent in promoting awareness of the Department's benefits. This sum includes advertising and publicity leaflets. In addition freeline social security offers a free general advice and information service on social security matters and is now receiving more than 900,000 calls yearly. The Department is currently running an advertising campaign, including television, to make people aware of their entitlement to family credit and to encourage them to claim. This campaign is costing £4.8 million.
36. Mr. Robert Hicks : To ask the Secretary of State for Social Security if he has any plans to improve the financial position of the retired and others dependent upon fixed incomes no longer entitled to benefit entitlements following the recent changes in the arrangements for social security payments and housing benefit ; and if he will make a statement.
Mr. Peter Lloyd : We undertook to monitor the effects of the reforms and as a result have already acted to improve the benefit position of certain vulnerable groups. Last April we acted quickly to raise the capital limit for housing benefit to £8,000 bringing 100, 000 people (nearly all pensioners) back into benefit. Recently we announced further help for two particular groups. From October there will be improvements in income support and housing benefit for older and disabled pensioners ; including husbands and wives some 2.6 million people will be better off as a result. From July certain 16 and 17-year-olds will benefit from changes to the income support rules and all 16 and 17-year-olds receiving housing benefit only will see an improvement in their benefit position.