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Average equivalent resources of disabled adults compared with average equivalent income of the general population, by region (£ per week) Disabled Adults General Population |Non pensioner family |Pensioner family units|All family units |Non pensioner family |Pensioner family units|All family units |units |units (Average Equivalent (Average Equivalent Resources) Income) ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ North |97.40 |79.00 |87.30 |118.10 |88.00 |110.70 Yorkshire and Humberside |87.30 |77.60 |81.50 |121.10 |95.30 |113.70 North West |84.50 |80.20 |81.80 |122.40 |83.20 |113.40 East Midlands |91.00 |77.60 |82.90 |130.60 |94.00 |121.30 West Midlands |83.60 |88.20 |86.30 |124.20 |83.30 |114.50 East Anglia |89.60 |78.20 |82.00 |144.90 |92.10 |131.50 Greater London |100.00 |88.80 |92.60 |165.80 |96.40 |149.20 South East<1> |99.50 |85.20 |90.10 |152.10 |107.60 |141.70 South West |102.20 |90.60 |94.60 |140.20 |87.80 |126.50 Wales |88.60 |83.40 |85.50 |136.70 |107.00 |128.30 Scotland |84.70 |83.40 |84.00 |134.50 |90.60 |124.00 <1> Except Greater London. Sources: Disabled adults - OPCS Survey of Disability (data collected in 1985). General population - 1985 Family Expenditure Survey. Notes: 1. The data are obtained from sample surveys and are subject to sampling error. Sampling errors on results broken down by regions are considerably larger than those in the original, national table. (Table 5.4 in the second report of the OPCS surveys of disability: "The financial circumstances of disabled adults living in private households"). 2. Further breakdown of the data shown in the table is not possible: sample numbers are too small for the figures to be statistically reliable.
Mr. Churchill : To ask the Secretary of State for Health what has been the percentage increase in average earnings since May 1979, to the latest date for which figures are available of (a) doctors, (b) nurses, and (c) medical scientific officers.
Average earnings |Medical Practitioners|Nurses and Midwives ---------------------------------------------------------------------------------------- Percentage increase April 1980-April 1988 |211.2 |195.0 Notes: 1. Source: New Earnings Survey 1988. 2. Directly comparable data is not available for National Health Service scientific officers. 3. Earnings are for employees on adult rates of pay whose pay was not affected by absence. 4. The figures do not include increases paid from 1 April 1988. 5. Medical practitioners include hospital medical staff, consultants and community physicians as well as general practitioners. 6. Nurses and midwives figure is based on earnings of female staff (currently 90 per cent. of nurses).
Mrs. Wise : To ask the Secretary of State for Health if he will make it his policy that in the event of a successful pilot study he will make additional money available to the Disablement Services Authority for the provision of battery powered indoor-outdoor wheelchairs.
Mr. Mellor : The Disablement Services Authority is financing the present pilot study from within its present resources. If the authority concludes that additional resources are needed it will no doubt justify such a request to my right hon. and learned Friend the Secretary of State which will be considered in the public expenditure survey process.
Mr. Mellor : We have already published our proposals for the organisation of health services in the White Paper "Working for Patients". The pattern of care for frail elderly people will evolve over the next few years as these proposals are implemented. We will announce our proposals for future policies on community care, following Sir Roy Griffiths' report "Community Care--An Agenda for Action" before the recess.
Column 148Live births occurring at St. Pauls Wing, Hemel Hempstead General Hospital, 1983-86.
Year |Live births ------------------------------------ 1983 |1,145 1984 |1,080 1985 |1,096 1986 |1,136
Mr. Turner : To ask the Secretary of State for Health, further to his reply of 14 June, Official Report, column 424, what is the rationale of replacing chairmen of family practitioner committees who have long service on that committee with chairmen who have no service on that committee.
Mr. Mellor : It has been our policy to recruit a proportion of new chairmen for family practitioner committees at each biennial appointments round. A total of 25 new chairmen were appointed as part of the 1989 round and a further 29 existing chairmen were re-appointed. The two vacancies referred to in my earlier reply have since been filled by Mr. D. Kleeman (Enfield and Haringey) and Mr. L. G. Knox (Redbridge and Waltham Forest) who are lay persons new to service in FPCs. The 36 other chairmanships had previously been made for a period--in most cases of four years--ending on 31 March 1991. It would not be appropriate for me to comment on a decision relating to a particular chairmanship.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from infectious diseases ; and what are the Government's plans to reduce that number.
The Government are pursuing a number of measures to reduce this rate of mortality and, in particular, are taking action to ensure that immunisation uptake rates increase.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from food poisoning ; and what are the Government's plans to reduce that number.
Mr. Freeman : The provisional estimate for the number of deaths in 1988 associated with food poisoning is 62. The Government's commitment to a comprehensive range of measures on food safety was made again in the Opposition day debate on 21 June at columns 342-90.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from sexually related diseases ; and what are the Government's plans to reduce that number.
Mr. Freeman : The provisional estimate of the number of people who died from sexually related diseases (excluding AIDS) in 1988 is 32. To improve the treatment and prevent the spread of sexually transmitted diseases the Government have made available extra resources for the upgrading of genito-urinary clinics.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from smoking-related diseases ; and what are the Government's plans to reduce that number.
Mr. Mellor : It is estimated that at least 110,000 people died from smoking-related diseases in Great Britain in 1987. The Government's health education programme is designed to inform people about the risks of smoking and to encourage them to give up the habit. The system of voluntary agreements with the tobacco industry provides controls over the advertising and promotion of cigarettes and has resulted in a reduction of average cigarette tar yields from 21mg in 1972 to 13mg now. In January of this year the Prime Minister announced a major new teenage smoking campaign, aimed specifically at teenagers, which will cost over £2 million per year for the next three years.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from alcohol-related diseases ; and what are the Government's plans to reduce that number.
Mr. Freeman : The provisional figure for deaths where the underlying cause was alcohol dependence, non-dependent abuse of alcohol, chronic liver disease and cirrhosis and toxic effect of alcohol for 1988 in England, Wales and Scotland is 3,933. Government action to tackle health and social alcohol-related harm is co-ordinated by the ministerial group on alcohol misuse. Action taken by the group is set out in its first annual report, copies of which are available in the Library.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from heart diseases ; and what are the Government's plans to reduce that number.
Mr. Freeman : The latest provisional figure for 1988 for the number of people who died from heart disease in Great Britain is 202,000. The risk of heart disease can be lessened by changes in lifestyle. Together with the Health Education Authority, the Department is supporting and developing the "Look After Your Heart" campaign as an ongoing initiative to combat the high level of heart disease in England. "Look After Your Heart" has two main aims--to increase awareness about the risk of heart disease and to encourage people to avoid it ; and to provide practical help with regard to a healthy diet, stopping smoking, taking more exercise and making other changes to the way they live.
Much other work is going on, particularly to discourage smoking--which is a key factor in causing heart disease--and excessive consumption of alcohol. Under changes to general practitioners' terms of service, they will be required to offer patients regular check-ups and personal advice on health issues, including those directly related to heart disease.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from drugs and from drug-related diseases ; and what are the Government's plans to reduce that number.
Column 150non-dependent abuse of drugs is 221 for 1988 in England, Wales and Scotland. The Government are actively pursuing a wide -ranging strategy to reduce the supply of and the demand for drugs.
Sir David Price : To ask the Secretary of State for Health what is his latest estimate of the number of British people who die each year from cancer ; and what are the Government's plans to reduce that number.
Mr. Freeman : Cancer was registered as the primary cause of death of 160,661 people in the United Kingdom in 1987. The incidence of cancer increases with age, and the death rate tends to reflect the increasing age of the population. The goal of the Europe Against Cancer programme, which the Government are supporting, is to reduce the number of cancer deaths in the Community projected for the year 2000 by 15 per cent. This is being taken forward through programmes of public and professional information on prevention and detection, the evaluation and implementation of screening techniques, and through the co-ordination of research into the causes and treatment of cancer. It is also important to acknowledge the progress made by the Health Service and voluntary organisations in lengthening the survival and improving the care and support of people who eventually die from cancer. The Government will continue to encourage them to achieve the highest possible standards in this field.
Mr. Hinchliffe : To ask the Secretary of State for Health if he has any proposals to enable district health authorities or local authorities to top up the financial contributions that residents in private residential or nursing care pay towards the costs of their care where the residents concerned have entered private care because the authorities cannot provide such care.
Mr. Mellor : In his report on community care, Sir Roy Griffiths made recommendations for the future funding of patients in private nursing and residential care homes. We are considering these and will bring forward our proposals before the summer recess.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will introduce provisions for a right to stay in private residential or nursing home care for residents whose financial resources are no longer sufficient to meet their residential fees.
Mr. Mellor : No. The arrangements for people living in a private residential care or nursing home are for the proprietor and the individual concerned. Statutory services remain as an alternative source of care.
Mr. Hinchliffe : To ask the Secretary of State for Health (1) if he will take action to deal with the practice of private residential and nursing homes charging for extras over and above their quoted fees and imposing such charges after people have been in residence for a considerable time ;
(2) what is his policy on allowing private residential and nursing homes to obtain medical requisites from the National Health Service and selling them to residents at a profit.
Column 151the patient and not something on which we would wish to intervene. However we would expect the fees to cover all necessary services, including medical requisites. It makes sense for proprietors to buy requisites at the best possible price and for the patient to share in any consequent savings.
Mr. David Hinchliffe : To ask the Secretary of State for Health (1) what action he is taking to ensure that the full hospital discharge procedure, outlined in his Department's draft circular issued during early 1988, is followed when hospitals are discharging patients into private residential or nursing homes ;
(2) what guidance his Department offers to authorities in relation to patients discharged from hospitals whose only option on discharge is to enter private residential or nursing care which they cannot afford ;
(3) what rights an individual patient who is being discharged from hospital care has to dispute his allocation to private residential or nursing care ;
(4) who is responsible for arranging the care of a patient whom a hospital consultant states must be discharged but needs continuing 24-hour care.
Mr. Freeman : Circular HC(89)5 which was issued to health authorities in February 1989, together with a booklet "Discharge of Patients from Hospital" emphasised that proper arrangements should be made for any necessary continuing care before patients are discharged from hospital. Arrangements, including care in a private residential or nursing home, should be made in good time and be acceptable to the patient and his/her relatives or carers. No NHS patient should be placed in a private nursing or residential care home against his/her wishes if it means that she or he will be personally responsible for the home's charges. Future responsibility for care will be a matter for local arrangement.
Mr. Fearn : To ask the Secretary of State for Health (1) what information he has on the percentage fall in the number of people having eye tests since charges for tests were introduced in April ; (2) what is the average amount that opticians now charge for eye tests ; and what information he has on the number of optometrists who absorb the cost in their charges for treatment.
Mr. Mellor : We do not yet have information either on the number of people having sight tests or on the current level of charges. We expect to have some information later in the year when the market is more stable.
Mr. Fearn : To ask the Secretary of State for Health what is the cost to date of advertisements to encourage people to have eye tests ; whether he has any plans to redirect future advertising costs to the reduction in cost to patients of eye tests ; and whether he will make a statement.
Mr. Mellor : We agreed early last year to participate with the optical profession in an eye care awareness campaign and we contributed £0.25 million. There is no provision for any funds for further advertising and therefore no re-directing of funds can be considered.
Mr. Mellor : A fee of £10.40 is paid to ophthalmic opticians and £8.69 to ophthalmic medical practitioners for an NHS sight test. We do not collect figures centrally for sight tests undertaken as part of treatment in NHS hospitals.
Mr. Fearn : To ask the Secretary of State for Health (1) what savings have resulted from the introduction of eye test charges ; (2) whether the introduction of eye tests has resulted in a saving to public funds.
Mr. Fearn : To ask the Secretary of State for Health whether there has been an increase in the number of patients referred to hospital ophthalmology departments for eye tests since the introduction of charges for eye tests ; and if he will make a statement.
Mr. Michael : To ask the Secretary of State for Health what assessment he has made of the consistency of health checks in respect of food and food products in each member state of the European Community ; and what steps he will take to ensure that the public of the United Kingdom is protected during the approach to the integrated single European market and after its completion.
Mr. Freeman : The Government are wholly supportive of the need for a European-wide food safety policy. We have been a party to the agreement on five "framework" directives on food labelling, additives, food for particular nutritional use, materials and articles in contact with food and official inspection. This last is very relevant because it will require food for export to another member state to be inspected in the same way as food intended for consumption within the member state. More importantly, it will be backed by a proposed directive on food hygiene with the aim of harmonising standards. Even with completion of the single market, the United Kingdom will be able to take action on the ground of public health either under article 36 of the treaty of Rome or guarantees provided under the relevant directive.
Aside from legislation, the Government participate in a number of Europe- wide committees and working groups established to deal with specific food safety issues.
Mr. Michael : To ask the Secretary of State for Health whether he will make it his policy that controls over food for human consumption should continue to come under the care of environmental health officers ; and whether he will press the European Community to recognise this approach.
Mr. Freeman : Environmental health officers, trading standards officers, veterinary officers and meat inspectors all enforce controls over food for human consumption. Within the European Community the British Government are continuing to make representation when appropriate.
Column 153Community directives and regulations of recognition that the work of environmental health officers in the United Kingdon is geared towards food safety and food hygiene.
Mr. Mellor : It remains our intention to introduce legislation on human fertilisation and embryology during this Parliament. There will be a free vote on alternative draft clauses on human embryo research, one banning such research completely, the other permitting it under strict controls.
Mr. Andrew Smith : To ask the Secretary of State for Health if he has any plans to change the grants system for student nurses under Project 2000 into a top-up loans scheme, should the latter proceed for students in higher education.
Mr. Mellor : Bursary levels for Project 2000 students will be kept under review in the light of recruitment and retention trends and future changes in student income support arrangements, including loans.
Mr. Andrew Smith : To ask the Secretary of State for Health if, in relation to the grants system for student nurses under Project 2000, he will list the projected numbers of students, and costs of the grants, with administrative costs itemised separately for each of the first 10 years of operation of the scheme.
Mr. Mellor : This information is not available. Thirteen demonstration districts have received approval from the Department to run Project 2000 training from the autumn of 1989. The number of students at any one time, the cost of the grants, and administrative costs will depend on a number of factors including the rate of implementation of Project 2000 in England. No decisions have yet been taken on this.
Mr. Dobson : To ask the Secretary of State for Health if he will give for each regional health authority, special health authority and district health authority in England for 1987, the numbers of staff in the following groups (a) medical and dental, (b) nursing and midwifery, (c) administrative and clerical, (d) ancillary, (e) other employees and (f) total employees, expressed in terms of (i) the actual number of employees and (ii) wholetime equivalents.
Mr. Sayeed : To ask the Secretary of State for Health whether, in view of the publication by the European Bureau of Consumer Unions of comparative drug costs in European Community states, he has anything to add to his answer of 26 January, Official Report, column 712.
Mr. Mellor [holding answer 29 June 1989] : I have nothing of substance to add to my response to the earlier question to which my hon. Friend refers. The latest analysis of prices by the European Bureau of Consumer Unions, which I understand updates the material in an earlier study by the same organisation, is the most recent in a series of such studies by various organisations produced over several years which have generally indicated a similar pattern of overall price differentials for pharmaceutical products in the different member states of the European Community.
Mr. Gregory : To ask the Secretary of State for Health if the proposals in the White Paper, "Working for Patients" will result in any disincentive for doctors to have ostomists on their lists ; and if he will make a statement.
Mr. Mellor [holding answer 3 July 1989] : The scheme will be structured to take full account of the fact that some patients, such as ostomists, may need potentially high cost treatment. Indicative prescribing budgets will fully reflect these costs and there will be no disincentive to GPs to accept such patients on their lists.
Mr. Gregory : To ask the Secretary of State for Health if the proposals in the White Paper, "Working for Patients" will result in any restriction on the provision of ostomy appliances ; and if he will make a statement.
Mr. Mellor [holding answer 3 July 1989] : No. Decisions about the provision of appliances for ostomy patients will remain a matter for the clinical and professional judgment of the medical and nursing staff working with the patient.
Mr. Wareing : To ask the Secretary of State for Health how many district appeals against the clinical regrading of nurses had been heard by 30 April ; how many were still waiting to be heard ; and if he will make a statement.
Mr. Terry Davis : To ask the Secretary of State for Health (1) whether he will list in the Official Report the parliamentary constituencies used by the Birmingham family practitioner committee for the purpose of assessing whether there are enough general practitioners in a particular area ;
(2) which areas in the city of Birmingham are currently classified as restricted by the medical practices committee.
Mr. Mellor [holding answer 3 July 1989] : The practice area classifications used by the Birmingham family practitioner committee are based on the 1974 parliamentary divisions for the city of Birmingham. These are : Edgbaston, Erdington, Hall Green, Handsworth, Ladywood, Northfield, Perry Barr, Selly Oak, Small Heath, Sparkbrook, Stechford, Sutton Coldfield and Yardley. Of these, Erdington, Small Heath and Yardley are classified as restricted.
Mr. Madden : To ask the Secretary of State for Health whether the medical records of persons intending to reside overseas for up to a year (a) can be transferred to their doctor in the country they are living in temporarily and (b) can be made available to the persons concerned for them to pass to their doctor on arrival ; and if he will make a statement.
Mr. Mellor [holding answer 3 July 1989] : When people go abroad for more than three months the medical records held by their family doctor are returned to their local family practitioner committee. Most doctors are willing to provide a summary of a patient's relevant medical history for the patient to take to the new doctor overseas. However, they are not required to do this and they may make a charge.
Mr. Rooker : To ask the Lord President of the Council how many right hon. and hon. Members regularly pay staff via the Fees Office ; how many staff employees of Members are paid via the Fees Office ; and how many contracts of employment of Members' staff have been lodged with the Fees Office.
Column 156where they are practicable. It is intended to make further significant improvements in respect of non-smoking areas once the additional facilities in phase I of the new parliamentary buildings are in operation. Until that time the Catering Sub-Committee considers that it would be inappropriate to impose a complete ban on smoking in the Members' Cafeteria and impossible to introduce any non- smoking section within it.
Mr. Fry : To ask the Lord President of the Council whether he has any plans to seek to ensure that all paper used in the House, including stationery available for hon. Members, is made from re-cycled paper.
Mr. Wakeham : Many of the stationery items supplied to the House are already made from re-cycled material. The Accommodation and Administration Sub-Committee is fully aware of the need to increase the use of re-cycled paper at every suitable opportunity and has instructed the authorities of the House and HMSO to keep it informed of any significant developments, particularly any that might enable the first-class stationery used by right hon. and hon. Members to be made from re-cycled material.
The Library will accept, for reference purposes, other supporting documents which might be considered to be appropriate.