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Mr. Freeman : The translation of returns from dentists to the Dental Practice Board into schedules of payments for family practitioner committees to make to them is already fully computerised. A pilot trial to test the feasibility and value of electronic data transmission between dentists and the Dental Practice Board is currently in progress, involving 60 dentists in 26 practices in England and Wales. A full report on the trial is expected in July.
Mr. Sean Hughes : To ask the Secretary of State for Health whether he has held an internal inquiry into the late arrival of form FPN 472 relating to dental charges ; and what redress is available through departmental machinery for the general dental practitioners in the event of subsequent under-remuneration.
Mr. Freeman : Family practitioner notice 472 advised dentists of changes in dental charges as from 1 April 1989. The department distributed the notice to family practitioner committees (FPCs) in time for them to deliver to dentists before the changes came into effect. In a very small number of cases there was a delay of a few days in the transmission of the notice from FPCs to dentists. There is no reason why this should lead to any under-remuneration.
Abortions
Mr. Amess : To ask the Secretary of State for Health how many (a) consultants and (b) nurses have taken a conscientious objection to abortion under section 4 of the Abortion Act 1967 ; and what have been the comparable figures each since 1968.
Mr. Freeman : This information is not collected centrally.
Mr. Amess : To ask the Secretary of State for Health if he will give a breakdown by regional health authority of the total number of abortions performed in England and Wales under the Abortion Act 1967 ; in each region, how many of these abortions were performed to save the life of the mother ; and what percentage the latter represents of the former.
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Mr. Freeman : The exact information requested could be provided only at disproportionate cost ; the nearest readily available information, covering the years 1970 to 1987, is shown in the table. Number of notifications of (a) total abortions, (b) abortions performed under grounds of 5 or 6 of the 1967 Abortion Act, by area of usual residence, England and Wales 1970 to 1987.
Area of usual residence |A |B |Percentage B of A ------------------------------------------------------------------------------------------------------------------------ England and Wales |2,137,120 |251 |0.012 Wales |101,393 |15 |0.015 Northern |98,905 |21 |0.021 Yorkshire |120,448 |12 |0.010 Trent |159,398 |28 |0.018 East Anglia |64,424 |8 |0.012 North West Thames |258,054 |24 |0.009 North East Thames |229,278 |15 |0.007 South East Thames |184,154 |11 |0.006 South West Thames |156,905 |14 |0.009 Wessex |89,641 |24 |0.027 Oxford |90,772 |7 |0.008 South Western |108,272 |14 |0.013 West Midlands |230,402 |18 |0.008 Mersey |91,559 |13 |0.014 North Western |153,515 |27 |0.018 Note: A=Total abortions 1970-87 inclusive. B=Performed under grounds 5 or 6. <1> The Act allows abortions to be performed in emergency to save the life of the pregnant woman (ground 5) or to prevent grave permanent injury to the physical or mental health of the pregnant woman (ground 6). <2> 1970-73: Hospital regions. 1974-87: Regional health authorities.
Mr. Amess : To ask the Secretary of State for Health what is the total number of abortions that have so far been performed in the United Kingdom under the Abortion Act 1967 ; how many of these abortions were performed in emergency to save the life of the mother ; and what percentage this latter figure represents of the former.
Mr. Freeman : The total number of notifications of legal terminations, to resident and non-resident women, carried out in the United Kingdom under the terms of the Abortion Act 1967 from 27 April 1968 to 31 December 1987 is 2,960,234. Of these 142 (0.005 per cent.) were performed under ground 5 of the Act, in emergency to save the life of the pregnant woman.
Complete United Kingdom data for 1988 are not yet available ; currently available data, which are provisional, are as follows :
<
|Total |Ground 5
------------------------------------------------------------
England and Wales
(1 January to 30 September 1988) |137,103 |<1>4
Scotland
(1 January to 31 December 1988) |10,003 |0
<1>(0.003 per cent. of total).
Note The Abortion Act 1967 does not apply in Northern
Ireland.
Mr. Amess : To ask the Secretary of State for Health what percentage of abortions performed on girls under the age of 16 years have been carried out in (a) non-National Health Service premises and (b) pay beds in National Health Service hospitals in each of the last five years for which figures are available.
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Mr. Freeman : No data on the number of terminations performed in pay beds in National Health Service hospitals are collected centrally. The other data requested are shown in the table.
Number of notifications of (a) total abortions and (b) those
performed in non-NHS premises, on girls under 16 years of age,
England and Wales, 1983-87
|A |B
Year |Total number |Performed in non-NHS|Percentage B of A
|premises
---------------------------------------------------------------------------------------------------------
1983 |4,566 |1,898 |41.6
1984 |4,609 |1,971 |42.8
1985 |4,427 |1,874 |42.3
1986 |4,240 |1,734 |40.9
1987 |4,075 |1,747 |42.9
Mr. Amess : To ask the Secretary of State for Health what representations he has received (a) supporting and (b) opposing a reduction in the upper time limit for abortions to 20 weeks ; what percentage the latter represents of the former ; and if he will make a statement.
Mr. Freeman : Since March 1989 we have received 25 representations ; 14 supported a reduction in the time limit. None referred specifically to a 20-week limit.
Seat Belts
Mr. Amess : To ask the Secretary of State for Health what is his estimate of the saving to the National Health Service as a result of the compulsory wearing of front seat belts, in each year since 1983 ; and if he will make a statement.
Mr. Freeman : No precise estimate has been made. The introduction of compulsory wearing of front seat belts has undoubtedly saved the lives of some of those involved in road traffic accidents. However, many of those whose lives have been saved have instead received injuries with consequent costs to the National Health Service which would not previously have been incurred.
Mental Health
Mr. Andrew Smith : To ask the Secretary of State for Health how many staffed hostels for discharged psychiatric patients provided by (a) local authorities and (b) voluntary bodies are available for (i) short-term accommodation andd (ii) long-term accommodation.
Mr. Freeman : The information is not collected centrally in the form requested. The numbers of homes, hostels and residential places for mentally ill people in each local authority in England is published in "Homes and Hostels for Mentally Ill and Mentally Handicapped People (A/F 11)". A copy of the 1986 publication is in the Library ; and a copy of the 1987 publication, which it is hoped will be available shortly, will also be placed in the Library.
Mr. Andrew Smith : To ask the Secretary of State for Health if he will list the health districts which have care registers for patients with special mental health needs ; and when he plans to direct other districts to establish such registers as recommended in the report of the inquiry into the care and after-care of Miss Sharon Campbell.
Mr. Freeman : This information is not collected centrally. Planning guidance, issued to health and local
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authorities in July 1988, requires each district to have developed by 1991 a "care programme" to provide a system of co-ordinated continuing care for people chronically disabled by mental illness. Further guidance being prepared by the Department will include the need for a register of patients.Mr. Andrew Smith : To ask the Secretary of State for Health what plans he has to implement the recommendations of the inquiry into the care and after-care of Miss Sharon Campbell that he issue a written summary, classifying their statutory duties to provide after-care for former mentally disordered patients, to health and local authorities.
Mr. Freeman : This recommendation is under consideration.
Mr. Andrew Smith : To ask the Secretary of State for Health what steps he has taken to ensure that employing authorities have issued guidelines to staff in respect of violence from clients, and the reporting of such incidents of violence, as recommended in the report of the inquiry into the care and after-care of Miss Sharon Campbell.
Mr. Freeman : The Health and Safety at Work legislation places a statutory duty on employers to provide a safe working environment for their staff and the Health and Safety Executive published "Preventing Violence to Staff" with general guidance on this subject last year. Complementing this for the health and personal social services are : The report, "Violence to Staff, DHSS Advisory Committee on Violence to Staff", chaired by Lord Skelmersdale, which was issued at the same time as the Sharon Campbell report to directors of social services and NHS general managers and the report of the Association of Directors of Social Services, "Guidelines and Recommendations to Employers on Violence Against Employees" which was sent to local authorities in 1987. Last February we issued a video on violence to staff to directors of social services and to general managers. When issuing the video we said the aim was that authorities should use the Skelmersdale report and the video to stimulate constructive discussions amongst members, managers at all levels, staff and their representatives about the development of strategies and the other recommendations in the Skelmersdale report, which included the need for staff to report violent incidents. We said also this material should be useful in training courses to increase the awareness among the staff and managers of the problem of violence and what might be done to counteract it.
At law it is for local authorities and health authorities, as the employers of the staff in these services, to take appropriate action and this was generally considered to be the best level at which action should be taken.
Mr. Andrew Smith : To ask the Secretary of State for Health when he plans to issue the guidelines about psychiatric case management and community care reviews, as recommended in the report of inquiry into the care and after care of Miss Sharon Campbell ; and to whom these guidelines will be made available.
Mr. Freeman : Further guidance to health and local authorities is being prepared on the components of "care programmes".
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Doctors and Nurses (Derbyshire)
Mr. McLoughlin : To ask the Secretary of State for Health what were the numbers of doctors and nurses in Derbyshire in 1979 ; and in the latest year for which figures are available.
Mr. Mellor : The available information is given in the tables. Due to the 1982 NHS re-organisation, consistent data is not available for earlier years for these Districts.
NHS Staff in post in North Derbyshire and South
Derbyshire
District Health Authorities
At 30 September Whole time equivalents
District health authoMedical and Nursing and Midwi
<3><3>
|1982 |1987 |1982 |1987
<1>WTE <1>WTE
--------------------------------------------------
North Derbyshire |84 |88 |1,875|2,161
Southern Derbyshire |202 |184 |3,939|3,947
Source: D of H (SM13) Annual Censuses of NHS
Medical and Non-Medical Manpower.
<1> All figures independently rounded to nearest
whole time equivalent (WTE).
<2> Figures includes permanent paid, honorary and
locum staff and exclude all consultants and
senior registrars whose contracts are held by the
regional health authority. The district health
authority where those
staff work cannot be identified centrally. There
will therefore be more doctors and dentists
actually working in North Derbyshire and Southern
Derbyshire district health authorities than are
accounted for in the table.
<3> Includes agency nursing and midwifery staff.
FPC staff in post
|Number of all |Number of nurses |Whole-time equivalent
|practitioners
--------------------------------------------------------------------------------------------------------------
1982 |452 |52 |28
1987 |507 |103 |56
Note: The number of doctors include all general medical practitioners (unrestricted and restricted principals,
assistants and trainees) for which Derbyshire family practitioner committee was responsible. Also the number
of nurses employed by those doctors, and their whole-time equivalent.
Grading Returns (Derbyshire)
Mrs. Beckett : To ask the Secretary of State for Health if he will make available the grading returns received from the Southern Derbyshire district health authority.
Mr. Mellor : The grading returns specified the number of nursing and midwifery staff in each old grade that were assimilated to each of the new clinical grades. This information is given in the table.
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The new clinical grading structure for nursing, midwifery and health visitor staff
Numbers of old clinical grades assimilated to each of the new clinical grades on the basis of duties and responsibilities on 1 April 1988: South
Derbyshire
Previous grade Staff<3> (WhoNumbers transferred to
each new clinical grade
|Equivalents)|A |B |C |D |E |F |<2>G |H |I
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Nursing Auxiliary |941.53 |853.73 |79.80 |8.00 |- |- |- |- |- |-
Staff Nursery Nurse |18.10 |- |11.70 |6.40 |- |- |- |- |- |-
Enrolled Nurse<1> |603.21 |- |- |307.44 |275.59 |20.18 |- |- |- |-
Enrolled District Nurse<1> |10.44 |- |- |- |10.44 |- |- |- |- |-
Senior Enrolled Nurse<1> |40.60 |- |- |- |27.50 |11.39 |1.71 |- |- |-
Staff Nurse<1> |657.48 |- |- |- |169.07 |451.03 |37.38 |- |- |-
Staff Midwife<1> |50.00 |- |- |- |16.89 |33.11 |- |- |- |-
Deputy Sister<1> |18.37 |- |- |- |- |- |17.33 |1.00 |- |-
Nursing Sister II<1> |451.92 |- |- |- |- |- |264.02 |174.22 |13.69 |-
Midwifery Sister II<1> |106.13 |- |- |- |- |- |40.95 |65.28 |- |-
District Nurse (Sister II)<1> |94.33 |- |- |- |- |- |- |94.33 |- |-
Nursing Sister I |5.00 |- |- |- |- |- |- |2.00 |2.00 |1.00
Midwifery Sister I |2.00 |- |- |- |- |- |- |2.00 |- |-
Health Visitor |94.53 |- |- |- |- |- |- |94.53 |- |-
Senior Nurse 9 |53.00 |- |- |- |- |- |- |11.00 |34.00 |8.00
Senior Nurse 8 (Midwife) |11.00 |- |- |- |- |- |- |5.00 |5.00 |1.00
Senior Nurse 7 |33.60 |- |- |- |- |- |- |- |15.60 |15.00
Senior Nurse 7 (Midwife) |1.00 |- |- |- |- |- |- |- |1.00 |-
Clinical Teacher |22.16 |- |- |- |- |- |- |- |22.16 |-
Fieldwork Teacher |10.75 |- |- |- |- |- |- |- |10.75 |-
Practical Work Teacher |32.00 |- |- |- |- |- |- |3.00 |29.00 |-
Tutor |19.53 |- |- |- |- |- |- |- |- |19.53
Tutor Midwife |6.00 |- |- |- |- |- |- |- |- |6.00
------- |------- |------- |------- |------- |------- |------- |------- |------- |------- |-------
Post basic students
Enrolled |23.00 |- |- |23.00 |- |- |- |- |- |-
Staff Nurse |56.00 |- |- |- |40.00 |16.00 |- |- |- |-
Deputy Sister |- |- |- |- |- |- |- |- |- |-
Sister II |- |- |- |- |- |- |- |- |- |-
------- |------- |------- |------- |------- |------- |------- |------- |------- |------- |-------
Others |4.21 |2.21 |- |- |- |- |- |- |- |2.09
------- |------- |------- |------- |------- |------- |------- |------- |------- |------- |-------
Totals |3,365.89 |855.94 |91.50 |344.84 |539.49 |531.71 |361.29 |452.36 |133.23 |55.53
<1> Excludes post basic students
<2> Excludes some additional 6' posts which health authorities have indicated they intend to create in future on existing two-sister wards.
<3> Staff in post plus vacancies.
Column 101
Listening Devices
Mr. Cran : To ask the Secretary of State for Health whether electronic surveillance listening devices are used by any organisation or agency acting on its behalf ; and if he will make a statement.
Mr. Freeman : As referred to in the Younger report on privacy, electronic listening devices are sometimes used in the observation of patients in hospitals.
Hospitals (Policy Decisions)
Mr. Wray : To ask the Secretary of State for Health whether prior to his proposals in the White Paper "Working for Patients", he gathered information on the amount of time necessary to make decisions on general policy for the management of hospitals, and specifically on (a) organisation of services for in-patients and out-patients, (b) co- ordination of time-tables for staff-rotas and (c) organisation and control of funding exercises required for (i) adequate pay rewards for the medical, nursing and auxiliary staff, (ii) demands for changes in numbers of hospital staff and (iii) adequate provisions for the good operation of the different hospital units.
Mr. Kenneth Clarke : We undertook a comprehensive review of all relevant aspects of the NHS before bringing forward our proposals for change.
Hearing Loss
Mr. Vaz : To ask the Secretary of State for Health, if he plans to provide to the public more information and a wider education programme on the facts surrounding loss of hearing.
Mr. Freeman : The Department publishes the booklet "How to use your hearing aid" which is issued free to all NHS hearing aid users. It gives useful general advice and includes reference to other services which may be of help to hearing impaired people. The Department of Social Security publishes leaflet NI 207 on occupational deafness which explains how industrial injuries disablement benefit may be claimed. There are no plans to issue any additional guidance at present. The Royal National Institute for the Deaf has however, referred to the need for better information for consumers in their "Fair Hearing" campaign document "Hearing Aids--The Case for Change", and we shall be considering this along with the other proposals that it has put forward.
Mr. Vaz : To ask the Secretary of State for Health (1) if he has any plans to implement the Royal National Institute for the Deaf proposal, set out in the document "Hearing Aids--a Case for Change", for a new system of dispensing hearing aids, and helping the deaf or hard of hearing to obtain help ;
(2) if he will make a statement on his Department's review of its policy on hearing aid provision and services ; what proposals he has to improve counselling to those who are deaf or hard of hearing ; and if he will make a statement.
Mr. Mellor : We are grateful to the Royal National Institute for the Deaf for their comprehensive package of proposals relating to the provision of hearing aids. We
Column 102
have now received their refined proposals which take into account the comments they have received from other interested organisations. The issues involved are complex and because of the wide-ranging implications of any change in the present system of provision, we shall need to take time to consider them, in the light of the views of all concerned. We shall of course bear fully in mind the need for rehabilitation and after-care services for those who are deaf or hard of hearing.Mr. Vaz : To ask the Secretary of State for Health if he will take steps to widen the range of hearing aids available on the National Health Service to cover cosmetically designed hearing aids.
Mr. Mellor : The National Health Service range of hearing aids is provided to ameliorate loss of hearing rather than for cosmetic reasons. In -the-ear hearing aids, which are sometimes regarded as more cosmetically acceptable, can be provided where an NHS consultant can see clear clinical reasons for doing so. Skin tone hearing aids are available in each of the NHS series of behind-the-ear aids.
Mr. Vaz : To ask the Secretary of State for Health (1) if he will implement stricter regulations concerning compensation and maintenance cover for users of hearing aids ;
(2) what is his policy towards free maintenance of hearing aids in the public and private sectors.
Mr. Mellor : Routine maintenance of all hearing aids issued under National Health Service arrangements is free. However, the cost of repair or replacement of a hearing aid may be recovered in cases of repeated loss or damage from patients or parents of children who are patients. Hearing aids provided by the private sector are the responsibility of my right hon. and noble Friend the Secretary of State for Trade and Industry.
Retinal Conditions
Mr. Nicholas Winterton : To ask the Secretary of State for Health if he will list those centres within the National Health Service which currently specialise in the treatment of retinal conditions.
Mr. Freeman : All district health authorities have access to ophthalmology departments which treat retinal conditions, although some may have a particular interest in certain retinal conditions.
Mr. Nicholas Winterton : To ask the Secretary of State for Health what information he has concerning centres currently undertaking research into retinal conditions.
Mr. Freeman: The Department is currently funding research for the screening of diabetic patients for diabetic retinopathy at Oxford, Sheffield and Exeter. A report of this work will be submitted later this year.
We are aware that work in this area is also being funded by some medical research charities.
Cryptosporidia
Mr. Robin Cook : To ask the Secretary of State for Health what is his Department's officials' involvement in investigations of the incidence of cryptosporidia in the water supply.
Column 103
Mr. Freeman : An official of the Department is medical secretary to the expert group on cryptosporidium in water supplies, which was announced on 2 March by my hon. and learned Friend the Minister of State for Water and Planning at column 286 ; another attends its meetings as an observer. The Department monitors other outbreaks of cryptosporidiosis, irrespective of source, in association with the communicable disease surveillance centre which collects data on this disease.
Higher Diploma Examinations
Ms. Harman : To ask the Secretary of State for Health if he will raise with the relevant professional bodies the recommendation of the Hoffenberg committee that questions about brain stem death organ transplantation and related matters should be asked from time to time in higher diploma examinations in medicine, surgery and anaesthesia.
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Mr. Freeman : The medical royal colleges are responsible for deciding the content of their examinations. However, officials wrote to the Conference of medical royal colleges on 10 November 1988, drawing attention to the relevant recommendation of the Hoffenberg report.
Body Scanners
Mr. Dave Nellist : To ask the Secretary of State for Health if, pursuant to his answer to my hon. Friend the Member for Don Valley (Mr. Redwood) of 10 May, Official Report, column 450, and the hon. Member for Coventry, South-East, 23 May, Official Report, column 488, he will take steps to obtain the information on whole body scanners in the West Midlands regional health authority ; and if he will make a statement.
Mr. Freeman : The information requested is given in the table.
Column 103
Type of Whole Scanner in |Location in West Midlands |Installation date |Main source of funding use ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- CT |Birmingham Childrens Hospital |1986 |Public Appeal/Health Authority CT |Birmingham General Hospital |1988 |Health Authority CT |Corbett Hospital Dudley (District Consortium includes Kidderminster and Bromsgrove) |1985 |Public Appeal/Health Authority CT |Coventry, Walsgrave Hospital |1976 |Public Appeal CT |Coventry, Walsgrave Hospital |1988 |Health Authority MRI<1> |Coventry, Walsgrave Hospital |1988 |Public Appeal/Health Authority CT |Good Hope Hospital, North Birmingham |1987 |Public Appeal CT |Midland Centre for Neurosurgery, Sandwell |1976 |Health Authority/DoH CT |Midlands Centre for Neurosurgery, Sandwell |1984 |Health Authority CT |Mobile Unit, serving Hereford/West and East Birmingham/ Burton/Walsall |1985 |Health Authority CT |New Cross, Wolverhampton |1987 |Health Authority CT |North Staffs Royal Infirmary |1983 |Public Appeal CT |North Staff Royal Infirmary |1987 |Health Authority CT |North Staffs Royal Infirmary |1987 |Health Authority CT |Q E Medical Centre, Central Birmingham |1984 |Health Authority CT |Robert Jones and Agnes Hunt, Oswestry, Shropshire |1986 |Health Authority CT |Ronkswood, Worcester |1989 |Public Appeal CT |Sandwell D G Hospital |1985 |Public Appeal CT |Walsall |1989 |Health Authority <1> Magnetic Resonance Imager In the next 12 months, new CT scanners are planned at Dudley road hospital, West Birmingham, and Selly Oak hospital, South Birmingham, both to be funded from health authority sources.
Creutzfeldt Jakob Dementia
Mr. Ron Davies : To ask the Secretary of State for Health, pursuant to his answer of 18 May, Official Report, column 289, what alternative methods of monitoring Creutzfeldt Jakob dementia he is considering.
Mr. Freeman : We are seeking to establish a national register of all cases of Creutzfeldt-Jakob disease, validated by experts in this field. A similar methodology has been used with success in the past : details can be found in the Journal of Neurology, Neurosurgery and Psychiatry (1975) Vol. 38, pages 210-13 and (1988) Vol. 51, 1113-19.
Mr. Ron Davies : To ask the Secretary of State for Health what information his Department now possesses about the incidence of Creutzfeldt Jakob dementia.
Mr. Freeman : The mean annual mortality rate of Creutzfeldt-Jakob disease in England and Wales for the last period studied in detail (1980-84 inclusive) was 0.49 million. Currently, Creutzfeldt-Jakob disease is given on death certificates as the underlying cause of death in about 30 deaths a year.
Column 104
Wakefield Family Practitioner Committee
Mr. O'Brien : To ask the Secretary of State for Health if he has issued guidelines on the number of members of the Wakefield family practitioner committee that should be appointed to meet hon. Members representing local constituencies ; and if he will make a statement.
Mr. Mellor : We have issued no such guidelines. It is a matter for individual FPCs to decide the level of representation at particular meetings.
Mr. O'Brien : To ask the Secretary of State for Health if he issued guidelines to the Wakefield family practitioner committee on when the White Paper "Working for Patients" should be considered and discussed ; and if he will make a statement.
Mr. Mellor : We have issued no such guidelines. I welcome discussion by FPCs on the implications for implementing locally the proposals contained in the White Paper.
Column 105
Mr. O'Brien : To ask the Secretary of State for Health whether the chairman of the Wakefield family practitioner committee has been appointed an agent on behalf of the Secretary of State ; and if he will make a statement.
Mr. Mellor : FPCs are the Secretary of State's agents responsible for administering and managing family practitioner services. Chairmen and members are appointed by the Secretary of State and are accountable to him for the discharge of these duties.
Anaesthetics (Consent)
Mr. Amess : To ask the Secretary of State for Health if he will seek to introduce legislation to require that the parent or guardian of a minor signs the consent form for general anaesthetic ; and if he will make a statement.
Mr. Freeman : Arrangements for ensuring that patients (and parents or guardians where appropriate) are informed about proposed treatments and for obtaining their consent are under review. Revised guidance will be issued as soon as the review has been concluded. The Government has no plans to introduce legislation.
Population Statistics
Mr. Robin Cook : To ask the Secretary of State for Health what is the population of each district health authority, the mortality rate for those aged under 75 years in each district health authority and the number of people aged over 85 years in each district health authority.
Mr. Freeman : Estimates of resident population for district health authorities in England at mid-1987 are given in the tables. Mortality rates for particular age groups in each area can be provided only at disproportionate cost.
Estimated resident population at mid-1987
Thousands
Regional and District |All ages |Aged 85+
Health Authorities in
England
--------------------------------------------------------------------------------------------------------
Northern |3,076.8 |36.8
Hartlepool |89.8 |0.9
North Tees |175.9 |1.5
South Tees |288.8 |2.6
East Cumbria |177.7 |2.5
South Cumbria |172.2 |2.8
West Cumbria |136.9 |1.4
Darlington |124.0 |1.6
Durham |235.2 |2.6
North West Durham |86.3 |1.1
South West Durham |153.2 |1.7
Northumberland |300.9 |3.8
Gateshead |206.9 |2.5
Newcastle |282.7 |4.3
North Tyneside |192.9 |2.4
South Tyneside |156.3 |2.0
Sunderland |297.1 |2.9
Yorkshire |3,604.7 |49.1
Hull |301.9 |3.9
East Yorks |192.2 |2.9
Grimsby |158.8 |1.8
Scunthorpe |193.7 |2.1
Northallerton |113.9 |1.5
York |263.4 |3.5
Scarborough |144.4 |3.0
Harrogate |135.4 |2.3
Bradford |337.2 |4.1
Airedale |173.9 |2.9
Calderdale |194.8 |2.9
Huddersfield |212.1 |2.9
Dewsbury |163.7 |1.7
Leeds Western |362.3 |5.7
Leeds Eastern |346.7 |4.7
Wakefield |144.1 |1.5
Pontefract |166.2 |1.7
Trent |4,646.3 |57.2
North Derbyshire |362.0 |4.6
South Derbyshire |527.0 |6.4
Leicestershire |879.4 |10.8
North Lincolnshire |270.6 |3.2
South Lincolnshire |304.0 |4.4
Bassetlaw |104.9 |1.1
Central Nottinghamshire |288.5 |3.2
Nottingham |614.4 |7.8
Barnsley |221.5 |2.3
Doncaster |290.1 |3.0
Rotherham |251.7 |2.5
Sheffield |532.3 |7.8
East Anglian |2,013.7 |28.9
Cambridge |273.0 |3.9
Peterborough |205.0 |2.0
West Suffolk |226.8 |2.7
East Suffolk |321.3 |5.2
Norwich |468.9 |8.1
Great Yarmouth and Waveney |197.6 |3.2
West Norfolk and Wisbech |187.9 |2.8
Huntingdon |133.3 |1.2
North West Thames |3,488.3 |44.6
North Bedfordshire |249.6 |2.6
South Bedfordshire |276.4 |2.5
North Hertfordshire |185.6 |1.9
East Hertfordshire |295.6 |3.4
North West Hertfordshire |261.1 |3.1
South West Hertfordshire |244.6 |3.4
Barnet |305.9 |4.6
Harrow |200.1 |3.3
Hillingdon |231.0 |3.1
Hounslow and Spelthorne |281.1 |3.8
Ealing |296.9 |3.8
Brent |256.6 |2.9
Paddington and North Kensington |120.6 |1.5
Riverside |283.4 |4.6
North East Thames |3,771.5 |52.6
Basildon and Thurrock |281.5 |2.4
Mid Essex |289.9 |3.2
North East Essex |304.5 |5.5
East Essex |252.0 |2.5
Southend |323.3 |5.5
Barking, Havering and Brentwood |455.8 |5.6
Hampstead |109.8 |2.0
Bloomsbury |128.8 |2.3
Islington |168.7 |2.3
City and Hackney |192.1 |2.4
Newham |206.5 |2.5
Tower Hamlets |159.0 |2.1
Enfield |261.5 |4.3
Haringey |193.7 |2.7
Redbridge |230.1 |3.6
Waltham Forest |214.5 |3.6
South East Thames |3,635.4 |60.8
Brighton |299.0 |6.8
Eastbourne |232.5 |6.8
Hastings |166.6 |5.0
South East Kent |266.6 |4.7
Canterbury and Thanet |303.0 |6.5
Dartford and Gravesham |219.6 |2.2
Maidstone |197.1 |2.2
Medway |328.5 |3.3
Tunbridge Wells |195.8 |3.3
Bexley |220.6 |2.7
Greenwich |216.6 |2.8
Bromley |298.2 |4.4
West Lambeth |161.7 |2.5
Camberwell |212.3 |2.8
Lewisham and North Southwark |317.6 |4.8
South West Thames |2,959.6 |50.1
North West Surrey |206.4 |2.9
West Surrey and North East Hampshire |275.1 |2.7
South West Surrey |181.3 |3.2
Mid Surrey |165.2 |2.6
East Surrey |182.8 |2.7
Chichester |180.2 |4.1
Mid Downs |276.3 |3.5
Worthing |243.5 |8.0
Croydon |319.2 |4.3
Kingston and Esher |175.9 |3.1
Richmond, Twickenham and Roehampton |231.9 |4.3
Wandsworth |189.2 |2.8
Merton and Sutton |332.6 |5.9
Wessex |2,905.6 |46.5
East Dorset |448.1 |10.6
West Dorset |200.5 |3.8
Portsmouth and South East Hampshire |529.7 |7.2
Southampton and South West Hampshire |418.8 |6.4
Winchester |210.4 |2.7
Basingstoke and North Hampshire |217.2 |2.2
Salisbury |121.1 |2.0
Swindon |230.2 |2.5
Bath |402.7 |6.3
Isle of Wight |126.9 |2.8
Oxford |2,501.8 |82.1
East Berkshire |359.7 |3.6
West Berkshire |451.7 |4.7
Aylesbury Vale |144.3 |1.5
Wycombe |269.8 |3.2
Milton Keynes |170.8 |1.2
Kettering |255.0 |3.2
Northampton |306.8 |3.6
Oxfordshire |543.6 |6.4
South Western |3,205.5 |54.7
Bristol and Weston |367.2 |6.1
Frenchay |220.6 |3.1
Southmead |232.4 |3.1
Cornwall and Isles of Scilly |453.1 |7.5
Exeter |306.1 |6.4
North Devon |133.4 |2.6
Plymouth |329.9 |5.0
Torbay |240.5 |6.3
Cheltenham and District |210.6 |3.5
Gloucester |311.6 |4.1
Somerset |399.9 |7.0
West Midlands |5,197.7 |57.3
Bromsgrove and Redditch |166.9 |1.2
Herefordshire |156.0 |2.4
Kidderminster and District |101.7 |1.2
Worcester and District |240.6 |3.2
Shropshire |396.5 |4.7
Mid Staffordshire |311.3 |2.9
North Staffordshire |461.1 |5.4
South East Staffordshire |255.1 |2.1
Rugby |85.2 |0.9
North Warwickshire |174.0 |1.7
South Warwickshire |255.0 |2.8
Central Birmingham |180.7 |2.5
East Birmingham |197.6 |2.2
North Birmingham |163.7 |1.9
South Birmingham |246.3 |3.1
West Birmingham |209.9 |2.0
Coventry |308.9 |3.3
Dudley |302.6 |3.1
Sandwell |298.4 |3.7
Solihull |203.9 |1.9
Walsall |261.8 |2.1
Wolverhampton |250.5 |2.9
Mersey |2,408.7 |30.3
Chester |177.0 |2.1
Crewe |247.8 |2.7
Halton |143.1 |1.2
Macclesfield |179.3 |2.4
Warrington |185.4 |1.7
Liverpool |476.0 |7.0
St. Helens and Knowsley |348.7 |3.1
Southport and Formby |118.7 |2.6
South Sefton |178.5 |2.2
Wirral |354.1 |5.3
North Western |3,991.1 |51.4
Lancaster |130.4 |2.6
Blackpool, Wyre and Fylde |318.8 |6.6
Preston |126.7 |1.8
Blackburn, Hyndburn and Ribble Valley |268.6 |3.3
Burnley, Pendle and Rossendale |227.8 |2.9
West Lancashire |106.7 |0.7
Chorley and South Ribble |194.7 |1.8
Bolton |262.3 |3.1
Bury |173.7 |2.2
North Manchester |142.9 |1.8
Central Manchester |125.0 |1.6
South Manchester |182.1 |2.4
Oldham |219.5 |2.5
Rochdale |214.2 |2.4
Salford |237.7 |3.2
Stockport |291.1 |3.6
Tameside and Glossop |245.7 |2.8
Trafford |216.1 |2.9
Wigan |307.2 |3.1
Source: OPCS 1987 mid-year estimates
Table file CW890606.058 not available
Speech Therapists
Mr. Janner : To ask the Secretary of State for Health how many speech therapists are employed by the Leicestershire health authority with special responsibility for work in schools ; how many vacancies the Leicestershire health authority has for such speech therapists and for how long these vacancies have been open ; what recruitment efforts are being made to fill these positions and whether these efforts include salary incentives ; and if he will make a statement.
Mr. Mellor : We do not hold the information centrally in the form requested. The hon. Member may care to write to the chairman of Leicestershire health authority for the information he seeks.
Medical and Dental Education
Mr. Knox : To ask the Secretary of State for Health what progress has been made by the steering group on undergraduate medical and dental education.
Mr. Kenneth Clarke : The steering group, which contains representatives of all the major bodies concerned with undergraduate medical and dental education, was set up in November 1987 following a conference called by the permanent secretaries of my Department and the Department of Education and Science ( Hansard, column 577-8, 18 November 1987). The steering group has now produced an interim report which clarifies the roles and responsibilities of the bodies concerned and makes recommendations relating to the principles underlying undergraduate medical and dental education, and to improved planning, management and information. I have today placed copies of the report in the Library.
Column 109
Paragraph 4.30 of "Working for Patients" emphasised the Government's continuing commitment to maintaining the quality of medical education and research, and said that the steering group would develop its work and make recommendations in the light of the proposals in the White Paper.The group began this second phase of its work by considering arrangements for the payment of the service increment for teaching (SIFT) which is designed to offset the excess service costs associated with medical education. The group has recommended that SIFT should continue to be paid through NHS channels and according to the following four principles which I have accepted.
(i) SIFT should be allocated to regions, pro-rata to student numbers ;
(ii) Regions or Districts, as appropriate to local curcumstances, taking advice from medical and dental schools, should contract with hospitals (including self-governing hospitals) to provide service facilities for teaching in return for SIFT payments ;
(iii) SIFT payments should be made in consultation with medical and dental schools and reflect the teaching activity in each hospital--if the number of students increased or decreased, the allocation of SIFT should be reconsidered ;
(iv) while in the past sub-regional allocation of SIFT had been unspecific in many cases, in future payments from regions should be clearly identifiable to all parties as a recognition of the service costs of teaching.
The group has further work in hand and will offer recommendations as soon as they reach conclusions on the issues they must address.
Sight Tests
Mr. Knox : To ask the Secretary of State for Health when he will lay regulations relating to consumer safeguards on sight tests ; and if he will make a statement.
Mr. Kenneth Clarke : I intend shortly to lay before the House the Sight Testing (Examination and Prescription) Regulations. I have considered carefully comments made in the course of consultation on these regulations and I have decided in the light of those received that all sight tests, whether National Health Service or private must include a refraction, an eye examination and other tests appropriate for individual patients. In addition all patients will be given a copy of their optical prescription to enable them to shop around for spectacles in order to ensure that the competition which has developed in the optical market continues to grow. The regulations will not apply to people having sight tests for employment or insurance purposes or who are resident in hospital or who are referred to their general practitioner for further investigations or treatment. These will be the only exceptions.
In reaching my decision I noted with interest the intention of the General Optical Council to carry out within the next 12 months a wide-ranging programme of investigations in connection with my consultation document on sight tests. I have made it clear that I shall reconsider the sight test regulations in the light of the council's report.
Column 110
TRANSPORT
Roads (London)
Mr. Spearing : To ask the Secretary of State for Transport if any of the new roads being considered by his London assessment studies, or the extension of the North Circular road across the east London river crossing are included in the list of projects for consideration as part of his toll road proposals.
Mr. Channon : The consultants reports on the assessment studies are expected in the summer. It is too early to say what road schemes may flow from the studies and whether any will involve tolls. I refer the hon. Member to my answer of 16 May on the East London River Crossing at column 113.
Listening Devices
Mr. Cran : To ask the Secretary of State for Transport whether electronic surveillance listening devices are used by his Department or by any organisation or agency acting on its behalf ; and if he will make a statement.
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