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Column 716of music and drama was opened in 1988 and the first phase of a new building for the national library of Scotland in Edinburgh will be opened later this year ; the second phase will be completed in 1994. The Government have done more than any previous Administration to secure the future of the Gaelic language. A new specific grants scheme for Gaelic education, designed to improve the quality of Gaelic teaching and curriculum in schools, was introduced in 1986. Grants under the scheme amount to £0.85 million in the current year. In addition, substantially increased resources have been allocated to a range of organisations providing support for Gaelic language and culture.
In Northern Ireland, the Government have pursued the policy of combating terrorism, within the rule of law, by the most effective means available. In the implementation of this policy, the security forces have conducted themselves with great courage and skill ; many terrorists have been apprehended, much material has been recovered, and a large number of terrorist operations have been frustrated, which would otherwise have added to the tragic toll of death and suffering.
The Government have continued to implement the Anglo-Irish Agreement, and have used its machinery further to improve security co-operation.
The Government's efforts to find an agreed basis on which greater responsibility can be devolved to the elected representatives of the people of Northern Ireland have continued.
A key objective of Government policy is to regenerate the private sector in Northern Ireland and release the region's potential for economic growth. To this end, the industrial development organisations in Northern Ireland have promoted over 75,000 jobs, while the youth training programme has provided opportunities for an estimated 84,300 entrants with some 32,000 man years of work provided by the action for community employment scheme. At any time, some 29, 000 persons are benefiting from a wide range of employment and training resources. Legislation has been introduced to secure equality of opportunity in employment.
Belfast city centre has been revitalised both in terms of housing and commerce. Housing conditions have shown improvement, with a considerable reduction in the level of unfitness and a significant increase in the level of owner occupation.
In July 1988, the Government launched the "making Belfast work" programme designed to address the social, economic and environmental issues in the most disadvantaged area of Belfast. In addition to substantial mainstream programmes, a further £65 million has been made available in the period 1988-89 to 1991-92.
Proposals have been developed, with a view to early implementation, for the reform of the educational system to improve educational standards and for the provision of new opportunities and incentives for existing schools seeking to promote integrated education. Substantial programmes have been maintained in Northern Ireland for agriculture, health and personal social services, environmental services and social security.
Since the establishment of WINvest in 1983, Wales has secured some 290 inward investment projects from overseas companies promising some 36,000 new or safeguarded jobs and involving almost £2 billion of capital
Column 717investment. Notable successes include Ford's £700 million investment at Bridgend and Swansea and Bosch's £100 million project at Miskin.
Wales, with 5 per cent. of the United Kingdom's population, achieved, in terms of related new jobs, 20 per cent. of all inward investment into the United Kingdom in 1987 and 22 per cent. in 1988. This compares with 6 per cent. in 1979.
Since 1979, the Government have committed nearly £250 million--at today's prices--to the land reclamation programme in Wales, one of the largest and most sustained programmes in Europe, and the Welsh Development Agency has constructed over 11.5 million sq ft of factory space, with a job potential of about 35,000.
The success of the Development Board for Rural Wales is indicated by an estimated 4.5 per cent. increase in the population of the area covered by the Board between 1979 and 1987.
Three enterprise zones set up by the Government are located in Wales : at Swansea, Delyn and the Milford Haven waterway. Over 8,500 people are currently employed in these zones, of whom 3,600 are in new jobs.
The Government have supported the rapid spread of local enterprise agencies in Wales, of which there are now 24. Such agencies have had £9.7 million of central Government assistance and they estimate that they have helped to create over 20,000 jobs.
Seasonally adjusted unemployment in Wales has fallen in each of the last 34 consecutive months to a total in April 1989 of 105,000--a fall of 66,900 or 5.3 percentage points from 14.1 per cent. to 8.8 per cent.
The number of self-employed in Wales is currently 148,000--a substantial increase on the 1981 figure.
Since their introduction in 1982, urban development grants of around £37 million have been awarded to 75 projects throughout Wales. These will bring forward a total private sector investment of nearly £173 million. The scheme has now been superseded by a simplified grant mechanism, urban investment grant, which was introduced on 1 April 1989. To date, 180 inquiries have been received and grants of just over £1 million have been awarded on two projects.
As part of the Government's policy for inner cities, the Cardiff Bay development corporation was established in 1987 to regenerate the urban areas of south Cardiff. The corporation has produced a comprehensive regeneration strategy for its area ; acquired some 300 acres of land ; completed site investigations for major land reclamation schemes ; and completed several environmental and community projects. In 1989-90, some £22 million will be made available to the corporation.
In June 1988, the Government launched a three-year programme of action designed to improve economic, environmental and social conditions in the south Wales valleys. Expenditure on key activities involving the promotion of investment, the creation of jobs and environmental improvement in the valleys is expected to total some £500 million over the life of the programme, and to help stimulate private sector investment of around £1 billion. In the first seven months of the programme unemployment in the valleys has fallen faster than elsewhere in Wales, by over 5,000 since the programme was launched. Factory lettings by the Welsh Development Agency in the valleys have been at record levels since the valleys programme was announced, running at two new lettings a week in the first nine month of 1988-89.
Column 718The WDA has made great progress in its factory building programme--some 492,500 sq ft of factory space was started in 1988-89, against a target of 450,000 sq ft. The WDA's derelict land clearance programme is well under way and will lead to the clearance of some 2, 500 acres over the life of the valleys programme. 3Is (Investors in Industry) now expects to provide over £5 million of venture capital for valleys investments in 1988-89 compared with the earlier forecast of £2.5 million. Welsh Office offers of regional selective assistance and regional development grant made up to the middle of January 1989 have covered projects involving 7,500 new jobs and private investment of £180 million. 21 projects have been supported by the Welsh Development Agency under its valleys small loan scheme.
In addition, the valleys enterprise loan scheme has funded 26 projects at a total cost of £315,500, and the community enterprise scheme has funded 11 projects amounting to £70,000.
Urban programme allocations totalling nearly £18 million for 1989-90 have been directed to the valleys area--over 65 per cent. more than in 1987 -88, the year before the valleys programme was launched. The Wales tourist board has launched the first phase of a major new marketing campaign designed to attract more visitors to the valleys. Health services in the valleys have received support, with two new health centres at Blaengwynfi and Gwaun-Cae-Gurwen. Ten more valleys health projects will be funded in 1989-90.
Owner-occupation has increased from 59 per cent. of housing stock in 1979 to 69 per cent. Almost 71,000 public sector dwellings have been sold to their tenants under the right to buy and voluntary terms since 1980, and over 57,000 new homes have been built for sale. Since 1979, over 15,000 dwellings have been provided by housing associations for sale or rent to help people in housing need. Housing for Wales (Tai Cymru) was set up under the Housing Act 1988. Between 1979 and 1986, the proportion of Welsh households lacking basic amenities more than halved and this progress has been continued over the last three years. Over 162,000 home improvement grant schemes for private sector dwellings have been completed since July 1979, with a value of £479 million. In the same period, £446 million has been spent on the renovation of local authority housing stock. Since 1982, over 8,300 dwellings have been improved under enveloping schemes. Expenditure on the health services in Wales has risen by almost 45 per cent. after allowing for general inflation between 1978-79 and 1989-90. Nearly £700 million at current prices will have been invested in the capital estate of the hospital and community health services in the period April 1979 to March 1990 : five major hospitals have been completed with a sixth due for completion before the end of this year. The number of staff directly concerned with patient care has increased by over 21 per cent. since 1979, and 28 per cent. more in-patients and 21 per cent. more out- patients were treated in 1987 than in 1979.
Current expenditure on education in Wales, excluding school meals and milk, was provisionally 10.9 per cent. higher in real terms in 1987-89 than in 1978-79. Pupil numbers dropped by 16.1 per cent. in the same period ; and expenditure per nursery/primary pupil rose by over 27 per cent. from £792 to £1,004, and per secondary pupil by over 36 per cent., from £1,090 to £1,488, their best ever levels.
Column 719The number of students on courses of advanced further education in the public sector rose from 9,000 in 1979-80 to 14,500 in 1987-88, an increase of 61 per cent.
Since 1979, almost £900 million has been spent on providing some 140 miles of motorway and trunk roads in Wales. In addition over £240 million has been spent on structural renewal and on general maintenance. The road programmes for the 1990s have been set out in the new edition of "Roads in Wales" published on 10 April 1989. Since 1979-80, overall net resources to the WTB have increased by 185 per cent., including an increase of 135 per cent. in support of projects creating almost 4,000 jobs.
The Government's direct financial support for the Welsh language has increased annually from £0.2 million in 1979-80 to around £4.6 million in 1989-90. Since the Government decision to set up the Welsh fourth television channel in 1982, S4C has been an outstanding success in both artistic and employment terms. In July 1988, the Government established the Welsh Language Board to advise on all matters relating to the use of Welsh in the public and private sector. A major expansion scheme at the national museum of Wales is in progress.
Column 720suffering from (a) schizophrenia and (b) all mental illness ; and what percentage each figure was of total expenditure on health services ;
(2) what is the current annual cost per patient to the National Health Service of the care and treatment of patients suffering from (a) mental illness and (b) schizophrenia psychoses ;
(3) how much was spent in the last year on the care and treatment of patients suffering from schizophrenia ; and what percentage that figure represented of total expenditure on (a) mental and (b) all health services.
Mr. Freeman : Information specifically on the total expenditure incurred on and the treatment costs of patients suffering from schizophrenia is not collected centrally. For costing purposes all hospitals are classified into one or other of a series of standard types which reflect the principal use to which their beds are allocated and costing returns in respect of community health services show expenditure relating to the main areas of activity only. Thus, the table shows the available information by region on hospitals categorised as "Mental Illness" for the financial years 1984-85 to 1986-87, but excludes the growing volume of activity in psychiatric units in acute and other hospitals and within community health services which is not identifiable separately.
The average cost in England of maintaining an in-patient in hospitals categorised as "Mental Illness" was £44.05 per day in 1986-87-- equivalent to some £16,000 per annum.
We intend to publish a volume in the series "Health Services Costing Returns" covering the financial year 1987-88 this summer.
Revenue Expenditure on Hospitals Categorised as "Mental Illness" -------------------------------------------------------------------------- Northern |53,150 |9.06 |55,341 |8.92 |57,780 |8.69 Yorkshire |60,176 |9.15 |62,327 |8.91 |63,883 |8.54 Trent |68,557 |8.62 |74,271 |8.81 |78,973 |8.64 East Anglia |31,488 |9.39 |34,273 |9.57 |36,333 |9.33 North West Thames |68,511 |9.77 |73,968 |10.15 |74,047 |9.52 North East Thames |69,895 |7.93 |71,224 |7.79 |75,608 |7.75 South East Thames |74,529 |9.65 |65,218 |8.08 |76,136 |8.88 South West Thames |69,969 |11.93 |72,672 |11.95 |74,067 |11.39 Wessex |49,980 |10.36 |51,132 |10.09 |55,041 |10.02 Oxford |26,661 |6.98 |27,553 |6.85 |29,431 |6.78 South Western |56,016 |9.81 |57,490 |9.53 |57,891 |8.91 West Midlands |82,548 |8.98 |85,875 |8.82 |89,801 |8.55 Mersey |46,221 |9.56 |46,977 |9.25 |47,681 |8.78 North Western |31,127 |3.82 |33,243 |3.86 |35,215 |3.82 |---- |---- |---- |---- |---- |---- All regions Total |788,828|8.80 |811,564|8.60 |851,887|8.41 Sources:- "Health Services Costing Returns" and annual acccounts of regional and district health authorities-1984-85 to 1986-87. Notes: 1. The revenue expenditure for the mental illness hospitals includes expenditure on in-patients, out-patients and day patients. 2. The figures used for total revenue expenditure are for hospital and community health services revenue expenditure incurred by regional and district health authorities. HCHS includes hospital, community, ambulance, blood transfusion and other services.
Mr. Spearing : To ask the Secretary of State for Health if, pursuant to his written answer of 10 May to the hon. Member for Newham, South concerning a charge made by the nurse central clearing house (NCCH) for pre -registration application of £6, Official Report, column 454
Column 720he will consider re-imbursing that body for the costs incurred, as part of his responsibilities for encouraging recruitment for the nursing profession.
Mr. Wolfson : To ask the Secretary of State for Health what is the percentage of labour turnover nationally per annum in the nursing profession within the National Health Service ; and whether he will provide figures for the best, worst and average regions.
Mr. Mellor : We do not have information of this nature centrally at present. Information on the number of nurses joining and leaving National Health Service employment is however now being collected, and should be available later this year.
Mr. Freeman : During the financial year 1987-88, 3,331 day cases were treated by Halton district health authority. This is an increase of 29 per cent. over the 1986 figure of 2,575 day cases. Some patients previously classified as a day case may now be classified as a ward attender. There were 688 ward attenders in Halton during 1987-88.
Mr. Hinchliffe : To ask the secretary of State for Health what discussions (a) his Department, (b) the Yorkshire regional health authority and (c) the Wakefield district health authority have had or plan to have with relatives of the late Mr. Benjamin Sykes, the benefactor of the hospital, regarding the proposed closure of Snapethorpe hospital, Wakefield.
Mr. Freeman : Neither the Department of Health, the Yorkshire regional health authority, nor the Wakefield district health authority has any record of discussions with relatives of the late Benjamin Sykes, and there are no plans for such discussions. The hospital site and buildings were vested in the Secretary of State under the NHS Act 1946 free of any trust.
Mr. Hinchliffe : To ask the Secretary of State for Health which treatments previously available to patients at Snapethorpe hospital, Wakefield, are not currently available in alternative hospitals within the Wakefield health authority.
Mr. Freeman : Infectious disease beds were provided at Snapethorpe hospital until 1978, when the service was transferred to Seacroft hospital, Leeds Eastern health authority. Pre-convalescent beds were provided at Snapethorpe hospital until 1979 and are not currently provided within the district. These service changes were consulted upon at the time and endorsed by the local community health council.
Column 722health authority to withdraw from discussions with the Wakefield district council regarding the possibility of a scheme of joint use of Snapethorpe hospital ; and what were the reasons for this instruction.
Mr. Hinchliffe : To ask the Secretary of State for Health pursuant to his reply of 22 May, if he will require a report from the Wakefield health authority as to why plans for the building of houses on the site of Snapethorpe hospital, Wakefield, were drawn up by officers of that authority before the members of the authority had resolved to close the hospital.
Mr. Mellor : I refer the hon. Member and my hon. Friend to my reply to the hon. Member for Wallsend (Mr. Garrett) and my hon. Friend the Member for Batley and Spen (Mrs. Peacock) on 10 May 1988, at columns 450-51.
(2) whether he has any plans to improve access to care for mothers-to-be ;
(3) whether he has any plans to ensure maternity care is provided near to home to avoid women having to travel long distances for antenatal and postnatal care ;
(4) whether he has any plans to improve postnatal care ; (5) whether he has any plans to provide more antenatal care in the community ;
(6) what is Her Majesty's Government's policy on whether maternity services should be based on an integrated pre-planned service or on emergency admission ; what steps are being taken in respect of this policy ; and if he will make a statement.
Mr. Freeman : The proposals in "Working for Patients" are designed to improve all NHS services and apply as much to maternity as to any other service. The Government recognise the importance of continuity and accessibility of care throughout pregnancy and the need for close co- operation among professionals and with parents, particularly in planning the management of a pregnancy in accordance with the wishes of the mother- to-be. Under the White Paper's proposals maternity services will, therefore, continue to be provided locally for those wishing to make use of them and in order to cover emergency situations. The proposals are also designed to increase people's choice of where care is obtained, particularly for people living in large towns. It will remain for local decision how best to meet local needs.
Column 723From the Department's monitoring of the implementation of the Maternity Services Advisory Committee's recommendations, which include specific advice on improving accessibility to antenatal and postnatal care, it is evident that significant improvements have been made. We believe that the emphasis placed by the White Paper on putting patients first will stimulate further improvements. A questionnaire package, which has been developed by the Office of Population Censuses and Surveys at the request of the Department, will shortly be made available to all district health authorities to assist them in seeking to establish women's opinions on the maternity services provided to them.
Mr. Tony Lloyd : To ask the Secretary of State for Health what projects concerning medical audit have been financed by regions for further study ; and what criteria he put forward for the regional health authorities to use in drawing up their submissions.
Mr. Mellor : We have set up a central fund to support medical audit projects. We have asked regional health authorities to submit up to five bids each in priority order for consideration by a supervisory panel. Regions will be expected to contribute at least half the cost of each project. The guidance to regions indicted that priority would be given to projects involving large numbers of clinicians, particularly if they covered a whole unit, district or region. We hope to announce the results shortly. In addition, several regions have set up their own schemes to support medical audit projects.
Mr. Mellor : This issue remains under review. The British Standards Institution published its revised condom standard (BS 3704-1989) on 30 March. It has been approved under the Consumer Protection Act 1987 and the Approval of Safety Standards Regulations 1987, which makes it easier for action to be taken, for example, by trading standards officers, against suppliers of condoms which do not meet the standard.
Mr. Chris Smith : To ask the Secretary of State for Health how many companies are licensed by the Office of Population Censuses and Surveys to analyse and re-supply small area statistics from the 1981 census.
Mr. Chris Smith : To ask the Secretary of State for Health what total royalties have been received by the Office of Population Censuses and Surveys for each year since 1981 from the companies which are licensed by the Office of Population Censuses and Surveys to analyse and re-supply small areas statistics.
Mr. Freeman : The total revenue received each financial year by the Office of Population Censuses and Surveys from companies with agreements to hold and supply small area statistics from the 1981 census is shown in the table.
Financial year |Total revenue (£) ------------------------------------------------------ 1982-83 |27,980 1983-84 |105,583 1984-85 |47,889 1985-86 |163,297 1986-87 |136,759 1987-88 |66,015 1988-89 |55,924
Mr. Chris Smith : To ask the Secretary of State for Health how many companies which sold small area statistics under licence from the Office of Population Censuses and Surveys also hold on computer names and addresses of members of the public collected from the electoral register.
Mr. Gorst : To ask the Secretary of State for Health (1) if he has any plans to introduce measures for the training of social workers in order to prepare them more adequately for work with mentally ill people ;
(2) if he has discussed with the Association of Teachers in Social Work Education ways in which social workers can be trained to deal more adequately with mentally ill people.
Mr. Mellor : The Central Council for Education and Training in Social Work (CCETSW) is the statutory body responsible for social work training. To date some 90 per cent. of local authorities have produced a programme of CCETSW approved training for approved social workers under the Mental Health Act 1983. All qualifying courses for social workers are expected, according to CCETSW's minimum requirements, to include some training in mental illness. CCETSW has also approved a number of post- qualifying courses specialising in mental illness or with options in this area of work. We have had no discussions with ATSWE about training for those social workers dealing with mentally ill people.
Mr. Fearn : To ask the Secretary of State for Health if he has any plans to ensure that all dental assistants and other persons who assist qualified dental surgery assistants have had a full course of vaccinations against hepatitis B and a follow up positive seroconversion ; and if he will make a statement.
Mr. Freeman : The Joint Committee on Vaccination and Immunisation has advised that vaccination against hepatitis B should be considered for all dentists, dental students, dental assistants and others who may come into direct contact with patients, but whether any individual should be vaccinated must depend on the views of their medical adviser.
Column 725dental services ; if they would have been liable to pay for the same treatment when provided by general dental practitioners ; and if the bridge prescriptions proposed by a general dental practitioner or hospital and community dental services will be subject to the same prior approval requirement as are prescriptions proposed by general practitioners.
Mr. Freeman : Hospital and community dental service out-patients who are not exempt are expected to meet the same NHS charge of dentures and bridges as are patients treated by general dental practitioners. Patients who are exempt are people under 18, full-time students under 19, pregnant women and nursing mothers, and people on low incomes. In addition, no charges are payable in the hospital and community dental service by people who have undergone operative procedures affecting the mandible, the maxilla or the soft tissues of the mouth as part of treatment for invasive tumours. There is no prior approval requirement in the hospital or community dental service.
(2) if he will break down the number of abortions performed at 32 Parkfield road, Liverpool 17, into the categories specified in the Abortion Act 1967 ; and at what number of weeks' gestation those abortions took place.
Mr. Freeman : The Department of Health has recently renewed the grant-aid awarded to the Pain Relief Foundation under section 64 of the Health Services and Public Health Act 1968, and has agreed to provide funding of £8,500 per annum for the three years 1989-90 to 1991-92.
Mr. Atkinson : To ask the Secretary of State for Health when he expects to make a decision on the provision of manufacturers' site identification on labels of pharmaceutical products ; and if he will make a statement.
Mr. Mellor : We cannot yet say. The proposal to require site declaration was particularly controversial and account must be taken of comments received in consultation before decisions are reached on MLX 167 proposals as a whole.
Column 726the Library, noted that medical defence subscriptions had trebled between 1986 and 1988 and were continuing to rise. The NHS currently spends an estimated £30 million per year through a scheme whereby two thirds of subscription costs are re-imbursed. At present the cost of providing an NHS indemnity is expected to be comparable.
Mr. Wolfson : To ask the Secretary of State for Health if he will give the average cost to health authorities of employing an individual hospital doctor supplied by agencies and the salary and emolument costs of a doctor directly employed by the National Health Service.
Mr. Mellor : We do not have the information in the form requested. However, as an example the cost of directly employing a senior house officer in the National Health Service for 72 hours duty in a week is estimated at £470, whereas we have advised health authorities that the maximum they should pay an agency supplying a doctor to do this work is £774. That advice was issued by me on 25 November 1988. It pegged the maximum permissible payments to agencies to 1987-88 levels and those levels remain in force.
Mr. Freeman : There are two registers of bone marrow donors in the United Kingdom. One is run by the Anthony Nolan Research Centre and is a charitable organisation ; the other is the British Bone Marrow and Platelet Donor Panel, which was compiled in collaboration with the National Blood Transfusion Service. The use of donor registries is a matter for the judgment of individual clinicians, responsible for the care of patients who might benefit from a bone marrow transplant.
Mr. Leighton : To ask the Secretary of State for Health (1) what discussions he has had on joint action between local authorities and health authorities to seek to reduce the perinatal mortality and infant mortality rates to at least 8 per 1,000 in every regional health authority ;
(2) what action he has taken on the recommendation of the Social Services Committee's first report on perinatal, neonatal and infant mortality, in particular the recommendations that the target objectives of regions and districts should be reflected in their resource allocations.