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Postgraduate Students

Sir William Shelton : To ask the Secretary of State for Education and Science what was the number of United Kingdom students enrolled in postgraduate studies in the United Kingdom in each year since 1979.

Mr. Jackson : The numbers of home students enrolled in postgraduate studies in United Kingdom public institutions are as follows (thousands).


                   |Number (Thousands)                   

---------------------------------------------------------

1979-80            |81.5                                 

1980-81            |84.8                                 

1981-82            |85.0                                 

1982-83            |84.6                                 

1983-84            |87.1                                 

1984-85            |91.0                                 

1985-86            |90.7                                 

1986-87            |100.2                                

1987-88            |103.7                                

These figures exclude the Open University (1,300 in 1986-87).

School Governors

Mr. Cartwright : To ask the Secretary of State for Education and Science what evidence he has of the extent to which places for parents' representatives on school governing bodies are being filled by parents who are teachers employed at other schools ; and if he will make a statement.

Mrs. Rumbold : The Government have commissioned the National Foundation for Educational Research to conduct a survey of a sample of school governing bodies, and their membership. One of the questions concerns the occupational background of governors.

Mr. Cartwright : To ask the Secretary of State for Education and Science what steps he is taking to ensure that appropriate training is available to school governors in the light of their increased responsibilities under local management schemes.

Mrs. Rumbold : Local education authorities have a duty to make any necessary training available to school governors. The Government are paying education support grant on nearly £5 million of local authority expenditure on school governor training in England this year. Government funds have supported the production of national training materials on the local management of schools. We are discussing with LEAs and others the scope for further national initiatives.


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First Aid and Fire Safety

Mr. Cartwright : To ask the Secretary of State for Education and Science what steps he has taken to establish the existence of effective fire safety and first aid arrangements in schools and colleges ; and with what result.

Mr. Butcher : Responsibility for fire safety and first aid arrangements in maintained schools and colleges rests with the local education authorities.

Guidance on fire safety is contained in the Department's "Building Bulletin No. 7", and in September 1987 the Department issued a note of guidance on arrangements for first aid provision in schools and colleges to all authorities.

University Staff (Pay)

Mr. Franks : To ask the Secretary of State for Education and Science if he will make a statement on the recent pay agreement between the management and staff sides in the universities.

Mr. Kenneth Baker : The Government have today accepted proposals put forward by the university employers and staff sides for salary increases for non-clinical academic staff in 1989-90. I am pleased that these provide for greater flexibility and differentiation in the salaries of lecturers and professors to take account of merit and market conditions. The Government have agreed that an extra £37 million should be made available for university staff pay this year, with corresponding sums in future years.

The universities have also provided evidence of satisfactory progress with the appraisal of their staff. I have accordingly authorised the Universities Funding Council to release to universities the £67 million which was conditional on the production of that evidence.

EDUCATION AND SCIENCE

Teachers (Re-entrants)

Mr. Thornton : To ask the Secretary of State for Education and Science if, further to his reply to the hon. Member for Crosby 13 April, Official Report, columns 629-30, he will publish a similar table for the year ended March 1987 showing (a) re-entrants to maintained nursery, primary and secondary schools by sector, (b) re-entrants to maintained secondary schools by graduate status and degree subjects and (c) re- entrants to maintained secondary schools by sex and age.

Mr. Kenneth Baker [holding answer 13 June 1989] : Figures for the year ending March, 1987 (and also revised figures for 1986) of qualified teachers re-entering full-time service in maintained nursery, primary and secondary schools in England are as follows :


                                                      |Year ending 1986|1987                             

---------------------------------------------------------------------------------------------------------

Re-entrants to maintained nursery,                                                                       

  primary and secondary schools by                                                                       

  sector                                                                                                 

Re-entrants to nursery and primary                                                                       

  schools                                                                                                

    number                                            |8,150           |8,650                            

    as a percentage of all entrants to                                                                   

    these schools                                     |64              |62                               

                                                                                                         

Re-entrants to secondary schools                                                                         

    number                                            |6,880           |6,770                            

    as a percentage of all entrants to                                                                   

    these schools                                     |49              |48                               

                                                                                                         

Re-entrants to nursery, primary and secondary schools                                                    

    number                                            |15,030          |15,420                           

    as a percentage of all entrants to                                                                   

    these schools                                     |56              |55                               

                                                                                                         

Re-entrants to maintained secondary                                                                      

  schools by graduate status and                                                                         

  degree subject                                                                                         

Graduate re-entrants                                  |3,680           |3,600                            

                                                                                                         

Of which, number whose degree                                                                            

  subject is:                                                                                            

    Mathematics                                       |240             |230                              

    Physics                                           |110             |90                               

    Other Sciences                                    |520             |550                              

    Geography                                         |210             |200                              

    Economics and other social sciences               |280             |290                              

    English                                           |550             |550                              

    History                                           |280             |280                              

    Modern languages                                  |430             |420                              

    Other subjects                                    |1,060           |990                              

Non-graduate re-entrants                              |3,210           |3,170                            

                                                                                                         

Re-entrants to maintained secondary                                                                      

  schools by sex and age                                                                                 

Men re-entrants                                       |1,430           |1,510                            

Of which, number aged:                                                                                   

    less than 30                                      |300             |240                              

    30-34                                             |340             |350                              

    35-39                                             |310             |350                              

    40-44                                             |190             |250                              

    45-49                                             |140             |150                              

    50 or over                                        |150             |160                              

                                                                                                         

Women re-entrants                                     |5,460           |5,260                            

Of which, number aged:                                                                                   

    less than 30                                      |670             |520                              

    30-34                                             |1,180           |1,040                            

    35-39                                             |1,860           |1,710                            

    40-44                                             |1,020           |1,110                            

    45-49                                             |430             |550                              

    50 or over                                        |300             |320                              

Teachers

Mr. Thornton : To ask the Secretary of State for Education and Science (1) how many full-time teachers in maintained secondary schools in England left full-time service in the maintained sector at or beyond normal retirement age in the year to March 1987 ; (2) if, further to his reply to the hon. Member for Crosby of 27 April, Official Report, columns 619-20, he will publish a similar table for the year ended March 1987 showing an analysis by age and sex of leavers below normal retirement age ;

(3) if, further to his reply to the hon. Member for Crosby, 13 April, Official Report, columns 630-32, he will publish a similar table for the year ended March 1987 showing full-time teachers in maintained secondary schools leaving full-time service before normal retirement age ; and if he will estimate the number of teachers retiring early in that year.


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Mr. Kenneth Baker [holding answer 13 June 1989] : Figures for the year ending March 1987 (and also revised and corrected figures for 1984 -86) of full-time teachers in maintained secondary schools in England leaving full-time service in the maintained sector are as follows :


Number of claimants receiving supplementary benefit income support by statistical category                                                                                                                                                                  

Local office      |<1>May 1979      |May 1980         |May 1981         |May 1982         |May 1983         |May 1984         |May 1985         |May 1986         |May 1987         |May 1988         |<2>May 1989                                          

                E |1,631            |1,647            |2,758            |4,020            |4,914            |5,298            |5,328            |5,181            |4,002            |3,765                                                                  

Doncaster East  A |1,449            |1,383            |1,582            |1,903            |2,212            |2,910            |3,111            |3,270            |3,629            |3,013            |3,210                                                

ILO             P |2,686            |2,683            |2,744            |2,751            |2,889            |2,889            |2,899            |2,904            |3,059            |3,131            |3,143                                                

                  |---              |---              |---              |---              |---              |---              |---              |---              |---              |---              |---                                                  

Total             |5,766            |5,713            |7,084            |8,674            |10,015           |10,788           |11,308           |11,502           |11,869           |10,146           |10,118                                               

                                                                                                                                                                                                                                                            

                E |1,652            |1,942            |3,560            |5,127            |6,131            |6,501            |7,061            |6,676            |5,249            |4,734                                                                  

Doncaster East  A |1,964            |2,007            |2,157            |2,630            |2,900            |3,607            |3,920            |3,961            |4,621            |4,153            |4,209                                                

ILO             P |3,531            |3,536            |3,528            |3,876            |3,600            |3,760            |3,551            |3,495            |3,644            |3,516            |3,452                                                

                  |---              |---              |---              |---              |---              |---              |---              |---              |---              |---              |---                                                  

Total             |7,147            |7,485            |9,245            |11,633           |12,631           |13,868           |14,143           |14,517           |14,941           |12,918           |12,395                                               

                                                                                                                                                                                                                                                            

                E |1,036            |1,225            |1,958            |2,856            |3,344            |3,416            |3,695            |3,905            |3,488            |3,067            |3,054                                                

Doncaster East  A |1,236            |1,186            |1,365            |1,495            |1,771            |2,228            |2,392            |2,476            |2,595            |2,355            |2,618                                                

ILO             P |1,904            |1,864            |1,878            |1,990            |2,079            |2,052            |2,016            |1,983            |2,000            |1,844            |1,815                                                

                  |---              |---              |---              |---              |---              |---              |---              |---              |---              |---              |---                                                  

Total             |4,176            |4,275            |5,201            |6,341            |7,194            |7,696            |8,103            |8,364            |8,083            |7,266            |7,487                                                

<1> E = claimants required to be available for work.                                                                                                                                                                                                        

A = claimants not required to register for work.                                                                                                                                                                                                            

P = pensioners.                                                                                                                                                                                                                                             

<2> 1989 data are provisional and subject to amendment.                                                                                                                                                                                                     

Source: 100 per cent. count of cases in action; this will include a number of cases where benefit payments have ceased but other action is continuing.                                                                                                      

The figures for leavers under 60 in the years ending March 1986 and 1987 include about 3,800 and 3,100 early retirements respectively.

SOCIAL SECURITY

Family Credit

Mr. Cohen : To ask the Secretary of State for Social Security (1) how many families in receipt of family credit also receive a local authority rent rebate and a rate rebate ;

(2) how many families in receipt of family credit also receive a local authority rate rebate.

Mr. Peter Lloyd : Provisional information suggests that in May 1988, 62,000 families receiving some form of housing benefit were also receiving family credit. Further information is not available.

Mr. Cohen : To ask the Secretary of State for Social Security how many of the families receiving family credit are estimated to be entitled to (a) a rent rebate and (b) a rate rebate.

Mr. Peter Lloyd : Information from the 1985-86 family expenditure survey (FES), updated to 1988-89, suggests


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that of the families receiving family credit 7.4 per cent. would be entitled to a rent rebate or rent allowance only ; 17.6 per cent. to a rate rebate only ; and 5 per cent. to both a rent rebate-allowance and rate rebate.

Departmental Agencies

Mr. David Nicholson : To ask the Secretary of State for Social Security how his Department's agencies will improve service to the public.

Mr. Jack : To ask the Secretary of State for Social Security how the Department of Social Security agencies will improve service to his social security customers.

Mr. Peter Lloyd : The establishment of agency status for Social Security operations will enable us to carry forward and strengthen our existing strategy for improving service to the public. In particular agencies will ensure :

delegation of decision-making to the lowest possible level giving a quicker, more sensitive response to local needs ;

clear objectives for the quality of service to be achieved, expressed as performance targets, and ;

effective performance measurement to ensure that those targets are met.

Mobility Allowance

Mr. Cran : To ask the Secretary of State for Social Security what plans he has to undertake a full review of the regulations concerning the payment of mobility allowance ; and if he will make a statement.

Mr. Scott : We shall look at mobility allowance, in common with other benefits for people with disabilities, in the light of the findings of the OPCS surveys of disability.

Children

Mr. Redmond : To ask the Secretary of State for Social Security how many children in the Don Valley constituency are dependent upon (a) income support and (b) family income supplement or family credit for the latest year he has figures (i) in total, and (ii) as a percentage of all children in South Yorkshire.

Mr. Peter Lloyd : I regret that this information is not available.

Availability for Work

Mr. Redmond : To ask the Secretary of State for Social Security (1) if he will list (a) the number of claimants of all supplementary benefits, (b) the number of claimants of supplementary pensions, (c) the number of claimants of supplementary allowances and (d) the numbers of claimants of supplementary benefits required to be available for work, in respect of his Department's local offices in Doncaster, and the Mexborough area, for April of each year from 1979 to 1989 ;

(2) if he will list (a) the total number of claimants receiving income support, (b) claimants of income support receiving pensioner premiums and (c) the number of claimants of income support required to be available for work, in respect of his Department's local offices in Doncaster, and the Mexborough area, for April of each year from 1979 to 1989 ;

Mr. Peter Lloyd : The information is as follows :


Column 417


Number of claimants receiving supplementary benefit income support by statistical category                                                                                                                                                                  

Local office      |<1>May 1979      |May 1980         |May 1981         |May 1982         |May 1983         |May 1984         |May 1985         |May 1986         |May 1987         |May 1988         |<2>May 1989                                          

                E |1,631            |1,647            |2,758            |4,020            |4,914            |5,298            |5,328            |5,181            |4,002            |3,765                                                                  

Doncaster East  A |1,449            |1,383            |1,582            |1,903            |2,212            |2,910            |3,111            |3,270            |3,629            |3,013            |3,210                                                

ILO             P |2,686            |2,683            |2,744            |2,751            |2,889            |2,889            |2,899            |2,904            |3,059            |3,131            |3,143                                                

                  |---              |---              |---              |---              |---              |---              |---              |---              |---              |---              |---                                                  

Total             |5,766            |5,713            |7,084            |8,674            |10,015           |10,788           |11,308           |11,502           |11,869           |10,146           |10,118                                               

                                                                                                                                                                                                                                                            

                E |1,652            |1,942            |3,560            |5,127            |6,131            |6,501            |7,061            |6,676            |5,249            |4,734                                                                  

Doncaster East  A |1,964            |2,007            |2,157            |2,630            |2,900            |3,607            |3,920            |3,961            |4,621            |4,153            |4,209                                                

ILO             P |3,531            |3,536            |3,528            |3,876            |3,600            |3,760            |3,551            |3,495            |3,644            |3,516            |3,452                                                

                  |---              |---              |---              |---              |---              |---              |---              |---              |---              |---              |---                                                  

Total             |7,147            |7,485            |9,245            |11,633           |12,631           |13,868           |14,143           |14,517           |14,941           |12,918           |12,395                                               

                                                                                                                                                                                                                                                            

                E |1,036            |1,225            |1,958            |2,856            |3,344            |3,416            |3,695            |3,905            |3,488            |3,067            |3,054                                                

Doncaster East  A |1,236            |1,186            |1,365            |1,495            |1,771            |2,228            |2,392            |2,476            |2,595            |2,355            |2,618                                                

ILO             P |1,904            |1,864            |1,878            |1,990            |2,079            |2,052            |2,016            |1,983            |2,000            |1,844            |1,815                                                

                  |---              |---              |---              |---              |---              |---              |---              |---              |---              |---              |---                                                  

Total             |4,176            |4,275            |5,201            |6,341            |7,194            |7,696            |8,103            |8,364            |8,083            |7,266            |7,487                                                

<1> E = claimants required to be available for work.                                                                                                                                                                                                        

A = claimants not required to register for work.                                                                                                                                                                                                            

P = pensioners.                                                                                                                                                                                                                                             

<2> 1989 data are provisional and subject to amendment.                                                                                                                                                                                                     

Source: 100 per cent. count of cases in action; this will include a number of cases where benefit payments have ceased but other action is continuing.                                                                                                      

Late Claims

Mr. Galbraith : To ask the Secretary of State for Social Security if he will give (a) the number of claims for income support where entitlement has been recognised but the claim has been disallowed on the grounds of late submission, (b) the total value of these claims, (c) the number of such claims appealed against with the number successful and (e) the cost of dealing with these claims and appeals.

Mr. Peter Lloyd : The information requested is not readily available and could be obtained only at a disproportionate cost.

Benefits

Mr. Canavan : To ask the Secretary of State for Social Security what was the total number of recipients of supplementary benefit or supplementary pension or income support for each year from 1969 to the present.

Mr. Peter Lloyd : The information is as follows :


                      |Supplementary Benefit|All claimants        |Supplementary                              

                                                                  |pensioners<1>                              

--------------------------------------------------------------------------------------------------------------

November 1969         |2,688,000            |1,875,000            |813,000                                    

November 1970         |2,738,000            |1,902,000            |836,000                                    

November 1971         |2,909,000            |1,919,000            |990,000                                    

November 1972         |2,911,000            |1,909,000            |1,002,000                                  

November 1973         |2,675,000            |1,844,000            |831,000                                    

November 1974         |2,680,000            |1,807,000            |872,000                                    

December 1975         |2,793,000            |1,679,000            |1,113,000                                  

December 1976         |2,960,000            |1,687,000            |1,274,000                                  

November 1977         |2,991,000            |1,738,000            |1,253,000                                  

November 1978         |2,932,000            |1,738,000            |1,195,000                                  

November 1979         |2,855,000            |1,723,000            |1,132,000                                  

December 1980         |3,118,000            |1,694,000            |1,423,000                                  

December 1981         |3,723,000            |1,738,000            |1,895,000                                  

December 1982         |4,267,000            |1,781,000            |2,486,000                                  

December 1983         |4,350,000            |1,651,000            |2,699,000                                  

December 1984         |4,609,000            |1,683,000            |2,926,000                                  

February 1986         |4,938,000            |1,717,000            |3,221,000                                  

May 1987              |4,896,000            |1,727,000            |3,169,000                                  

May 1988              |<3>4,352,000         |<3>1,719,000         |<3>2,632,000                               

Source: Annual Statistical Enquiries.                                                                         

<1> Claimants over pension age (65 for men, 60 for women).                                                    

<2> Claimant, or any partner, aged 60 or over.                                                                

<3> Latest available estimates.                                                                               

There was no Annual Statistical Enquiry in 1985: the one due in December that year was deferred until         

February 1986.                                                                                                

EC Social Charter

Mr. Teddy Taylor : To ask the Secretary of State for Social Security if he will seek to establish from the European Commission whether the directives on a Euro-pension for the elderly and for a minimum entitlement for unemployment benefit, as proposed in the Community "Charter for Fundamental Social Rights" 89-248-final, will fall to be presented to the Council on the basis of majority voting.

Mr. Peter Lloyd : The voting procedure for Commission proposals depends on the articles of the treaty of Rome on which they are based. The articles which cover social security require unanimity.

HEALTH

Cochlear Implants

15. Mr. Ashley : To ask the Secretary of State for Health what steps he proposes to take to ensure that cochlear implants are readily provided by the National Health Service for those profoundly deaf patients who could benefit from them.

Mr. Mellor : Provision of cochlear implants is a matter for health authorities in the light of their assessment of local needs and priorities. This is an important new development and I have asked officials to review the


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position to see whether some form of additional help from the centre would be possible. Given the complexity of the funding issues involved, no early decision will be possible.

NHS Reform

17. Mr. Amos : To ask the Secretary of State for Health if he will make a statement on the future provision of resources for teaching and training of doctors under the proposals in the White Paper, "Working for Patients."

Mr. Kenneth Clarke : In the White Paper we emphasised the Government's continuing commitment to maintaining the quality of medical education. We recognised that hospitals in which teaching and research take place incur higher costs as a result, and said that we had decided to accept that the service increment for

teaching--(SIFT)--should be enhanced. More recently, I announced in a written reply to my hon. Friend the Member for Staffordshire, Moorlands (Mr. Knox) on 6 June that we have agreed to improve means for the distribution of SIFT. We have also stressed the importance we continue to attach to the postgraduate training of doctors, and our intention is that hospitals should not be placed at an unfair disadvantage or advantage in the distribution of resources by undertaking such training.

18. Mr. Anthony Coombs : To ask the Secretary of State for Health if he will make a statement on the intended effects of the increased capitation element in the new general practitioners' contract for patient care.

Mr. Mellor : By increasing the proportion of general practitioners' income which comes from capitation payments we will be encouraging greater competition in the family doctor service. This will ensure a better service for patients by giving GPs a greater incentive to provide the best possible range and quality of service to all patients.

20. Dr. Michael Clark : To ask the Secretary of State for Health how patient care will be affected by the proposals to allow large general practitioner practices to hold their own budgets.

32. Mr. Waller : To ask the Secretary of State for Health what are the implications for patient care of the proposals for general practitioners' practices to operate their own budgets.

Mr. Mellor : The introduction of practice budgets, in common with our other proposals for the National Health Service, will lead to even higher standards of service and better quality of care for patients. General practitioners who choose to have budgets will for the first time hold the purse-strings to finance the treatment of their patients which falls within the scope of the budget. This will mean that hospitals will become more responsive to the needs of GPs and their patients. Practice budget holders will also be able to transfer funds between the different elements of the budget which will provide them with greater flexibility in meeting the individual needs of their patients. Greater freedom in managing their own budgets will enhance the clinical freedom of the doctors involved.

22. Dr. Twinn : To ask the Secretary of State for Health how the proposals in the White Paper "Working for Patients" on medical audit will affect patient care.


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Mr. Mellor : The objectives of developing a comprehensive system of medical audit as proposed in the White Paper is to enhance the overall quality of care given to patients in the National Health Service.

23. Mrs. Gillian Shephard : To ask the Secretary of State for Health what are the intended effects of the changes in composition of the family practitioner committees proposed in the White Paper "Working for Patients".

Mr. Mellor : I refer my hon. Friend to the reply given to my hon. Friend the Member for Gillingham (Mr. Couchman) on 23 May 1989, at columns 482-83.

25. Mr. Sumberg : To ask the Secretary of State for Health how many requests for information he has now received from hospitals inquiring about the possibility of obtaining self-governing status.

Mr. Kenneth Clarke : People or groups interested in self-governing status have been advised to direct inquiries in the first instance to their regional health authority. RHAs have so far notified my Department of a total of 179 expressions of interest, including a number of units which feature more than one hospital.

27. Mr. Gill : To ask the Secretary of State for Health how the proposals to allow hospitals to become self-governing National Health Service hospitals will affect patient care.

70. Mr. Hannam : To ask the Secretary of State for Health if he will explain the effects of the proposals to allow hospitals to become self -governing.

Mr. Mellor : Self-governing hospitals will remain firmly within the NHS and there will be safeguards to ensure that essential local services continue to be provided locally. But they will have far more freedom to take their own decisions on the matters which affect them most without detailed supervision from above. This will give patients more choice, produce a better quality service and encourage other hospitals to do even better in order to compete.

29. Mr. Hayes : To ask the Secretary of State for Health what will be the benefits for patient care of the indicative drug budgets proposed in the National Health Service White Paper.

48. Mrs. Maureen Hicks : To ask the Secretary of State for Health how much account has been taken under the proposals for prescribing budgets of the needs of patients in receipt of drugs on a long-term basis.

66. Mr. French : To ask the Secretary of State for Health how patient care will be affected by the proposals in the White Paper "Working for Patients", for indicative drug budgets.

Mr. Mellor : Indicative prescribing budgets will provide a further incentive to general practitioners to examine their prescribing patterns critically and in particular to avoid excessive and unncessary prescribing. This is very much in the best interests of patients and more economical prescribing will release money for other forms of patient care in the NHS,. We have made it clear that the amount allocated to a practice for its indicative prescribing budget will take into account the presence on the practice's list of


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patients, such as the elderly or chronically sick, who need drugs on a longer-term basis. All patients will always get the drugs they need.

30. Mr. Livsey : To ask the Secretary of State for Health what percentage of consultants' contract hours he expects to be devoted to administrative work as a result of the proposals in the White Paper on the National Health Service.

Mr. Mellor : We are not making any estimate of the time consultants will spend in administrative work, but we expect--and would wish to see-- consultants taking an increasing management role, as "Working for Patients" makes clear, through the devolution of managerial responsibility, the extension of resource management, and the establishment of self-governing hospitals.

36. Mr. Raffan : To ask the Secretary of State for Health what representations he has received concerning the proposals contained in the White Paper "Working for Patients", relating to medical audits.

Mr. Mellor : The proposal to develop a comprehensive system of medical audit in the NHS has been widely welcomed and the medical profession supports the concept of audit and consider it a central part of the doctor's obligation to his patient.

38. Mr. Conway : To ask the Secretary of State for Health whether he has received any expressions of interest from general practitioners' practices about operating their own practice budgets.

Mr. Mellor : Although we have not yet asked GPs to register formally their interest in becoming budget holders, we are encouraged by the level of interest from eligible practices.

39. Mr. McLoughlin : To ask the Secretary of State for Health what effect the proposals in the National Health Service White Paper will have on the distance that patients will have to travel for treatment.

Mr. Mellor : Surveys suggest that many people are willing to travel for better and quicker treatment. In setting contracts for services district health authorities will take full account of the wishes of patients and there will be no question of patients being expected to travel unreasonable distances.

43. Mr. Flannery : To ask the Secretary of State for Health what are the conditions which have to be fulfilled before the authorities in a National Health Service hospital apply to be self governing ; and if he will make a statement.

Mr. Mellor : The main criteria were set out in the White Paper "Working for Patients" and working paper (1) "Self-governing Hospitals". Further details are given in the document "Self Governing Hospitals : An Initial Guide" published last week and copies are available in the Library.

44. Mr. Gregory : To ask the Secretary of State for Health how the additional £40 million to assist with the implementation of the National Health Service reforms will be allocated.

49. Mr. Franks : To ask the Secretary of State for Health if he will give further details of the recently announced extra £40 million for the implementation of the health service reforms.


Column 422

Mr. Mellor : I refer my hon. Friends to my reply to the hon. Member for Newcastle upon Tyne, Central (Mr. Cousins) on 26 June, at columns 315- 16 .

46. Mr. Rooker : To ask the Secretary of State for Health what is the cost to the latest date of the promotion and information relating to his White Paper "Working for Patients".

Mr. Kenneth Clarke : I am introducing into the NHS a system of regular direct communications with the staff which I believe is necessary for any large organisation and certainly for one which employs over 1 million people. It is misleading to compare this with public advertising or political promotion campaigns of the kind being conducted by the BMA and other interest groups. The cost of the communications exercise to inform the staff and management of the NHS about the White Paper proposals is approximately £1.25 million. Estimated expenditure on the next stage of information for NHS staff about self-governing hospitals will be some £750,000. The only expenditure on material aimed at the public included in these sums is the cost of :

(a) a leaflet for the public on the White Paper proposals, costing £117,000 ;

(b) a further leaflet to be made available to the general public on request in the local areas of units which have expressed an interest in becoming self governing, costing £13,000.

47. Mr. David Davis : To ask the Secretary of State for Health whether he has any plans to privatise self-governing hospitals.

Mr. Mellor : No.

50. Mr. Michael Brown : To ask the Secretary of State for Health how patients' choice will be affected by the proposals in the White Paper "Working for Patients".

56. Mr. Burt : To ask the Secretary of State for Health if he will make a further statement on the implications for patient choice of the proposals in the White Paper "Working for Patients."

Mr. Mellor : A fundamental aim of the White Paper proposals is to make the Health Service more responsive to the needs of patients. We will stimulate better services to patients by encouraging suitable hospitals to apply for self-governing status, by delegating responsibility to local level and by allowing money for patients' treatment to cross administrative borders. GPs will be able to improve the service they offer their patients by applying for their own budgets. Patients will be able to choose their GPs on the basis of the services they offer. We intend to raise the performance of all hospitals and GPs to that of the best. The reformed Health Service will offer a better quality of service and better value for money.

52. Mr. Macdonald : To ask the Secretary of State for Health what further representations he has received in respect of his proposals to cash -limit general practitioners' budgets.

Mr. Mellor : I refer the hon. Member to the reply I gave earlier today to the hon. Member for Oxford, East (Mr. Smith).

53. Mr. Latham : To ask the Secretary of State for Health whether he will make a statement on the outcome of his consultations to date on the White Paper "Working for Patients".


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Mr. Kenneth Clarke : Consultations are continuing and have been useful. In particular, I have held many meetings with members of the medical profession and have established that, despite some remaining important disagreements, there is a substantial area of agreement. There is almost universal agreement with the aims of the White Paper to produce a better NHS for patients giving medical treatment free at the point of delivery regardless of means and financed largely as now out of general taxation.

I also judge that the great majority of doctors accept the need for a framework of quality control, in the form of medical audit ; the distribution of resources in a way which ensures that "money follows the patient" ; and improved systems of financial management using modern information technology. The BMA has told me in meetings that it accepts these three proposals but it has fundamental disagreements with the details of our proposed reforms to implement them. Unfortunately, it and the great majority of doctors have no alternative proposals of their own. The BMA has been discouraging its members from putting constructive alternative proposals to me.

58. Mr. Carttiss : To ask the Secretary of State for Health how the proposals in the White Paper "Working for Patients" will affect general practitioners' freedom to refer patients for treatment.

Mr. Kenneth Clarke : The new arrangements will enable general practitioners to play a more direct part in deciding which hospitals will provide services for their patients. GP practice budget holders will be able to refer patients to hospitals which provide the best care and shortest waiting times irrespective of administrative boundaries. Those practitioners who do not hold budgets will be consulted extensively before DHAs place contracts with hospitals based on GPs' wishes and there will be provision for GPs to make extra-contractual referrals.


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