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Dr. David Clark : To ask the Minister of Agriculture, Fisheries and Food if he will list all the projects that are currently undertaken at the North Wyke research station ; if he will indicate which projects have been identified as near market and which of these have definite funding from outside bodies and industry ; and if he will make a statement.
Mr. Jackson I have been asked to reply.
The information requested is as follows :
Current (1989-90) Programme Funded by MAFF Commissions and if Near Market
Comparison of the yield potential of permanent grass swards, and re-seeds of contrasting ages. Yes.
Productivity and clover compatibility of late-maturing tetraploid perennial ryegrass under cutting and grazing. Yes.
Yield potential of low-input grazing legumes.
Production and utilisation of grass grown with broad-leaved trees. Nitrogen cycling in grazed grassland as influenced by sward composition, fertiliser input and drainage.
Effects of soil conditions on nutrient availability.
Fertiliser strategies to reduce leaching losses from grazed grass. Establish responses to grazing management with cows grazing permanent grass swards. Yes.
Column 616To improve by supplementation the utilisation of grazed pastures and nutrients derived from them. Yes.
To develop optimum strategies for low-input beef production on long-term grassland including grass/clover swards.
The utilisation of grass-white clover swards for milk production. Physiology of plant/animal interactions in grazing systems. Develop lamb production systems based on long-term grass-white clover swards. Yes.
None of the near-market identified work has yet been picked up by alternative sponsors.
Current (1989-90) Contract programmes showing sponsor
Fertiliser effects on productivity and botanical composition on permanent in Somerset Moors. NCC, MAFF, DOE.
Forms of phosphate fertiliser for grass-clover swards. Timac. Pests and disease control in grassland. Various.
Effects of fertilisers and other inputs on grass and grass-clover productivity. ICI, Farrant.
Mr. Malcolm Bruce : To ask the Secretary of State for Scotland if he will produce a table for each district council showing the total yield from the domestic rate payment, excluding domestic water rates, for 1988-89, showing the breakdown of the amounts attributed to district and regions.
Local Authorities |Yield of Districts |Yield of Regional |Total Yield of Domestic |Domestic Rates 1988-89 |Domestic Rates 1988-89 |Rates 1988-89 ------------------------------------------------------------------------------------------------------------------------ Orkney |1,258 |1,258 Shetland |3,310 |3,310 Western Isles |2,576 |2,576 Berwickshire |480 |2,323 |2,802 Ettrick and Lauderdale |919 |3,879 |4,799 Roxburgh |1,073 |4,115 |5,189 Tweeddale |386 |1,929 |2,314 Clackmannan |2,098 |5,687 |7,785 Falkirk |5,265 |17,493 |22,758 Stirling |5,317 |11,906 |17,224 Annandale and Eskdale |1,067 |4,359 |5,425 Nithsdale |1,697 |6,936 |8,633 Stewartry |692 |3,250 |3,942 Wigtown |714 |3,569 |4,282 Dunfermline |4,114 |17,746 |21,860 Kirkcaldy |5,955 |20,470 |26,425 North East Fife |2,941 |11,273 |14,215 Aberdeen City |8,622 |26,606 |35,228 Banff and Buchan |2,356 |8,141 |10,497 Gordon |1,869 |8,075 |9,944 Kincardine and Deeside |1,111 |5,854 |6,966 Moray |2,003 |8,240 |10,243 Badenoch and Strathspey |240 |1,562 |1,802 Caithness |627 |2,608 |3,235 Inverness |1,487 |8,139 |9,626 Lochaber |607 |2,178 |2,785 Nairn |217 |1,412 |1,629 Ross and Cromarty |1,310 |5,450 |6,760 Skye and Lochalsh |246 |1,065 |1,311 Sutherland |238 |1,301 |1,539 East Lothian |4,324 |14,599 |18,923 Edinburgh City |24,718 |84,960 |109,678 Midlothian |3,566 |12,041 |15,608 West Lothian |5,340 |20,434 |25,774 Argyll and Bute |3,255 |9,764 |13,019 Bearsden and Milngavie |2,265 |9,931 |12,195 Clydebank |2,183 |6,381 |8,564 Clydesdale |2,404 |8,181 |10,585 Cumbernauld and Kilsyth |2,567 |8,867 |11,433 Cumnock and Doon Valley |1,569 |5,262 |6,831 Cunninghame |7,197 |20,012 |27,209 Dumbarton |4,286 |12,857 |17,143 East Kilbride |3,294 |13,129 |16,423 Eastwood |2,378 |13,554 |15,932 Glasgow City |46,654 |100,350 |147,003 Hamilton |5,001 |15,837 |20,838 Inverclyde |4,017 |14,309 |18,326 Kilmarnock and Loudoun |3,653 |11,255 |14,907 Kyle and Carrick |5,751 |19,282 |25,032 Monklands |4,528 |14,337 |18,865 Motherwell |5,785 |20,292 |26,077 Renfrew |9,924 |31,425 |41,349 Strathkelvin |3,840 |13,679 |17,519 Angus |3,220 |12,402 |15,622 Dundee City |10,317 |24,952 |35,269 Perth and Kinross |4,775 |17,735 |22,510 |---- |---- |---- Scotland |237,603 |731,393 |968,996 Notes: 1. Domestic rates are net of domestic rates relief.
Mr. Malcolm Bruce : To ask the Secretary of State for Scotland if he will produce a table for each district council showing the total estimated yield from the community charge and standard community charge, excluding water charges, for 1989-90, showing the breakdown of the amount attributed to district and region.
Mr. Alan Williams : To ask the Secretary of State for Scotland what consequences are envisaged for the Scottish tourist board as the result of the announcements contained in the reply to the hon. Member for Birmingham, Yardley (Mr. Bevan) by the right hon. Member for Sutton Coldfield (Mr. Fowler) on 6 July, Official Report, column 278 ; and if he will make a statement.
Column 618Scottish ambulance service in hospital cars in (a) the eight months prior to August 1988 and (b) the eight months following August 1988.
Number of patients conveyed Period |Number ------------------------------------------------- 22 December 1987-21 March 1988 |3,884 22 March 1988-21 June 1988 |4,333 22 June 1988-21 September 1988 |3,636 22 September 1988-21 December 1988 |2,865 |------ Total |14,718
Figures for 1989 are not yet available.
Mr. Nigel Griffiths : To ask the Secretary of State for Scotland if he will provide additional resources to ensure that district councils are able to provide an adequate number of environmental health officers to tackle the health hazards arising from food ; and if he will make a statement.
Lord James Douglas-Hamilton [holding answer 10 July 1989] : Local authorities have recieved a generous revenue support grant settlement for 1989-90. They should therefore have adequate scope within available resources to fulfill their responsibilities for environmental health.
Column 619Any future requirement for additional resources can be taken into account in subsequent revenue support grant settlements.
Mr. Nigel Griffiths : To ask the Secretary of State for Scotland if he will provide additional resources to ensure that regional councils are able to provide an adequate number of environmental health officers to tackle the health hazards arising from food ; and if he will make a statement.
Mr. Nigel Griffiths : To ask the Secretary of State for Scotland if he will publish (a) the number and (b) the cost of local authorities' environmental health and trading standards officers for each financial year since 1979.
Local authority sales to sitting tenants 1988-89<1> District |Number of sales |Value of receipts |£000 ------------------------------------------------------------------------------ Scotland |24,144 |243,281 Berwickshire |120 |1,254 Ettrick and Lauderdale |159 |1,676 Roxburgh |219 |2,261 Tweeddale<2> |27 |307 Clackmannan |356 |3,568 Falkirk |1,252 |12,416 Stirling |457 |4,729 Annandale and Eskdale |177 |1,933 Nithsdale |417 |3,951 Stewartry |86 |861 Wigtown |132 |1,273 Dunfermline |819 |7,631 Kirkcaldy |778 |6,761 North East Fife |316 |3,372 Aberdeen |643 |8,290 Banff and Buchan |322 |3,641 Gordon |78 |1,075 Kincardine and Deeside |61 |851 Moray |372 |4,331 Badenoch and Strathspey |53 |627 Caithness |93 |935 Inverness |169 |1,997 Lochaber |116 |1,391 Nairn |21 |247 Ross and Cromarty<2> |82 |984 Skye and Lochalsh |27 |338 Sutherland<2> |30 |319 East Lothian |647 |7,868 Edinburgh |2,411 |22,396 Midlothian |570 |7,144 West Lothian |629 |6,297 Argyll and Bute |139 |1,524 Bearsden and Milngavie |51 |616 Clydebank |468 |4,071 Clydesdale |363 |3,777 Cumbernauld and Kilsyth |187 |1,835 Cumnock and Doon Valley |n/a |n/a Cunninghame |789 |7,686 Dumbarton |383 |3,558 East Kilbride |85 |923 Eastwood |78 |866 Glasgow |3,189 |28,742 Hamilton |758 |7,856 Inverclyde |263 |2,455 Kilmarnock and Loudoun |568 |5,421 Kyle and Carrick |775 |7,962 Monklands |n/a |n/a Motherwell |844 |9,082 Renfrew |1,295 |13,248 Strathkelvin |477 |5,356 Angus |386 |4,123 Dundee |812 |6,786 Perth and Kinross |469 |5,198 Orkney Islands |53 |592 Shetland Islands |44 |595 Western Isles |29 |283 <1> Only sales for which complete information is available are included. <2> Returns for question 1 1989 not included. n/a No returns available.
Mr. Peter Lloyd : As at 31 May 1989, the number of claimants in receipt of housing benefit, with either the claimant or the claimant's partner, or both being in receipt of basic state pension, was 2.8 million.
Source : Annual Statistical Enquiry 1988.
Mr. Peter Lloyd : Latest estimates indicate that the number of claimants in receipt of income support, with either the claimant or the claimant's partner, or both, being in receipt of basic state pension, is 1.61 million.
Mr. Peter Lloyd : As at 31 May 1989 approximately 2,000 women aged 60 and over were in receipt of family credit. Information relating to individuals in receipt of both family credit and the basic state pension is not available.
Column 621the number awarded the allowance in that year and (c) the number who lost the allowance because of death or recovery.
Mr. Peter Lloyd : The needs of lone parents were recognised in the social security reforms introduced last year. As well as the family premium, income support and housing benefit have a lone parent premium. In family credit the adult rate for married couples also applies to lone parents. From April families with children who receive income-related benefit had increases over and above those needed to restore their real value of 50p a child.
Unmarried mothers seeking maintenance will also benefit from changes made by the Family Law Reform Act.
Mr. Win Griffiths : To ask the Secretary of State for Social Security if he plans to act on the evidence of the recently published surveys of the Office of Population Censuses and Surveys to improve the lot of disabled people by uprating, extending and improving access to disability benefits ; and if he will make a statement.
Column 622610,487 awards had been made. The total number of claims received includes 48,853 which were either subsequently withdrawn, or were invalid because they were made more than four weeks before the expiry of an existing award. At 7 July 1989, 86,440 claims were still being processed.
|Percentage --------------------------------- 1988 April |32.0 May June |27.0 July |27.8 August |27.0 September |26.4 October |24.9 November |24.8 December |26.1 1989 January |26.9 February |25.6 March |24.4 April |26.2 May |48.8 June |44.8
Valid claims exclude those withdrawn and those made more than four weeks before the expiry of an existing award.
I welcome the opportunity to outline Government policy towards the care in the community of the mentally ill and to indicate the initiatives that we propose to take to improve these services in England. These will, of course, be included in the White Paper on community care to be published this autumn which will set out the finer detail where necessary.
Until the 1960s there was little alternative for those suffering from serious mental illnesses such as schizophrenia to prolonged in-patient care in one of the large and often remote mental hospitals. Scientific advances in the 1950s, particularly the discovery that the symptoms of schizophrenia could often be relieved by drugs, together with the development of community psychiatric services, opened up the possibility that many sufferers could be
Column 623treated on a largely out-patient basis. The vision of a new pattern of services on this basis, reflecting an already occurring fall in the number of hospital beds, and anticipating a further fall, was outlined by the then Minister of Health, Mr. Enoch Powell, in 1961. It was turned into detailed policy under Sir Keith Joseph in the early 1970s, though the White Paper "Better Services for the Mentally Ill"- -was actually published in 1975.
The policy as stated in that White Paper, the development of locally-based hospital and community services, including facilities providing long term asylum for those who need it, and as a consequence the closure of very large mental hospitals, has remained essentially unchanged since, supported by successive Governments. It is founded on scientific and therapeutic advances, and the knowledge that, with the right supporting services, many sufferers can live fuller lives in the community than in institutions.
In our view, this long-standing policy is a civilised and humanitarian one which has benefited many patients who, otherwise, would have been destined to spend their lives in large isolated hospitals. It has also inspired many caring people to work in the psychiatric services. We know it can work. We have examples of services such as those in Buckingham and Hackney, which show what can be done through prevention, early intervention and well co- ordinated care at home working closely with family doctors. I am glad today to be able to reaffirm the Government's commitment to the policy, and our determination to ensure that it is properly implemented. There is no going back to the days when health service care for the mentally ill invariably meant long term institutional care.
Although there are some who question the policy itself, most concerns are about implementation : the pervasive sense that all too often community care means no care : that insufficient resources have been put in place to provide effective alternatives to the old hospitals, where bed numbers have fallen substantially. I would make two points about this.
While we accept that there are deficiencies, it would be wrong to minimise the substantial shift of resources from hospital in-patient provision to community-based services provided by health and local authorities. Over the last ten years for which information is available (1977 to 1987), the number of places for people with a mental illness in local authority, voluntary and private residential homes almost doubled (to 9,000) and there was a 50 per cent. increase in day centre places (to 6,000). On the health service side there has been a 44 per cent. growth in day hospital places (to 19,000) over the same period ; the number of community psychiatric nurses has more than doubled since 1981, and it is estimated that the number of districts with a community mental health centre has doubled every two years throughout the 1980s.
We made quite explicit in last year's guidance to the National Health Service what has always been the intention : that hospitals should close only when proper alternative locally based services were available. When the Secretary of State discussed this issue yesterday with the chairmen of the regional health authorities he made it clear that he will not approve the closure of any mental hospital unless he is satisfied that proper alternative services are in place. This coupled with the requirement to introduce care programmes in 1991, means that no patient will be
Column 624discharged from hospital without proper consideration of his or her need for continuing care and where needs are identified, plans to meet them.
Over the last few months we have been working, and will continue to work, collaboratively with individual regional health authorities to identify the progress that has been made and the problems that have been encountered. Our purpose is not to recriminate over any inadequacies in the past, but to identify what we at the centre need to do to help health authorities implement policy effectively. It is through this work, and discussions with the social services inspectorate and voluntary organisations, that we are building up a region-by-region picture of progress and problems, and I expect to have this around the turn of the year.
To enhance our capacity to undertake this work we have secured the services at the Department of one of the few general managers in the country with experience of developing locally based services and closing a major hospital. Mr. John Jenkins, who played a leading role in the development of services in Exeter and Torbay and the closure of Exminster hospital will be working with us in an advisory capacity from next Monday, and will play a key role in our collaborative work with regional health authorities and the development of any further initiatives or guidance that seem necessary.
I would now like to outline a number of specific policy steps. The first is guidance to health authorities on care programmes. Much concern has been expressed about the adequacy of continuing health service care for psychiatric patients discharged from hospital. Last year, through a health circular, a requirement was placed on district health authorities to initiate, by 31 March 1991, explicit individually tailored programmes for continuing health service care for all such patients. Later this month we will be formally consulting on guidance to authorities on developing these care programmes, which will emphasise the need for locally developed approaches including local registers of vulnerable discharged patients and regular reviews of their needs. We expect to publish the definitive guidance in the autumn. In addition, and we greatly welcome this, the Royal College of Psychiatrists has agreed to draw up minimum acceptable professional standards for assessing patients prior to discharge, and for follow up after discharge. A preliminary statement of good practice is expected from the college in late summer, to be followed by a more substantive one developed in concert with the other professions concerned. These two initiatives will, together, provide much clearer guidance on good practice than currently exists.
As part of our 1990-91 research programme, we plan to commission research which will assist us to evaluate the effectiveness of the care programme initiative.
The second is guidance on compulsory admission to hospital. Another area of current concern is in relation to arrangements for compulsory admission to hospital, and the related issue of compulsory treatment in the community.
On hospital admissions, there seems to be wide agreement that the law is adequate, but concern that its interpretation by practitioners is sometimes not. We believe that these problems will be much reduced once the code of practice for admitting and treating patients compulsorily required under the 1983 Mental Health Act is available. In April we set up an expert group under the chairmanship of Mr. James Collier, with Mr. William
Column 625Bingley, on secondment from MIND to whom we are indebted, as the full-time executive secretary. Work is well advanced, and the code will be laid before the House this autumn.
We understand that in due course the Royal College of Psychiatrists will be giving us its views on the possible role of new legal powers to ensure compulsory treatment in the community. We will then explore this issue with all the interested parties involved. Without prejudicing the discussion, we would need to be very clear both of the benefits, and that they could not be achieved through voluntary means, before seriously considering asking Parliament to create provision for compulsory treatment in the community.
The third is health service resources. Although the issues that I have already referred to are important, we fully understand that underlying much of the current concern is the question of resources. Finance from mental hospital sites provides valuable capital for replacement facilities, but these facilities are needed before hospitals can be vacated. They in turn have to compete for resources with other priorities within capital programmes, and this may hold up the whole process. Existing arrangements offer one way of addressing this problem--with regions lending each other capital to match the timing of planned new developments. Another possible solution is for authorities to enter into agreements with developers to upgrade, purchase and build community facilities for the mentally ill, in return for which they would receive all or part of the vacated site. We plan to invite health authorities to identify sites where this approach would be suitable : the aim will be to bring about the degree of private sector involvement that maximises value for money. We do understand the revenue burden of keeping open old hospitals which will close and new replacement facilities already open. Clearly the quicker older facilities can be closed the lesser the burden of double running and running inefficient emptying facilities. The fourth is local authority resources. Proper social care for the mentally ill in the community is vital. Yesterday the Government confirmed that local authorities would continue to be responsible for the social care of the mentally ill and announced that from 1991 we would be instituting a new, specific grant to local authorities to encourage them to make the necessary contribution to the services required. To encourage joint planning of services, and proper collaboration in relation to care programmes, we are making this grant payable through health authorities as the Secretary of State's agent, on the basis of agreed plans. Further details will be set out in the White Paper on community care, to be published this autumn. The fifth is quality of services. We are very concerned that the new hospital and community facilities that are developing should provide a good quality service. In the wake of scandals about the conditions in some mental hospitals in the 1960s and early 1970s, the health advisory service was established, to keep a watch on standards and encourage better services. I think that it is generally agreed that, over the years the HAS has been successful. We are now examining its work to identify how it might be done even more effectively, and in a way even more relevant to the NHS as it will develop following "Working for Patients".
The sixth is the contribution of the voluntary sector. We believe that a lot can be done, through Departmental
Column 626grants to voluntary organisations, to increase the information, services and mutual help available to the parents and friends of patients. Current grants to voluntary organisations in the mental health field, including mental handicap, are being reviewed with a view to ensuring that we use the nearly £2 million a year that we allocate in a way which best supports patients and their relatives and encourages new initiatives which are of clear and direct benefit.
There are some areas we need to explore more fully as a matter of urgency. I would like to refer to some of the issues that we are aware are causing concerns that we are beginning to address, and on which work will be undertaken in the course of the next year or so. First, the need to improve the ability of general practitioners and others to prevent, detect and treat mental illness. The first of a series of departmentally sponsored conferences on these themes was held in May ; others are planned for the autumn and next spring. In the light of these discussions we will be considering what practical initiatives need to be taken ;
Secondly, the need to provide appropriate services for those among the homeless population who suffer from mental illness. The incidence of mental illness among homeless and destitute men and women in London and other cities has been linked by some to the fall in the number of hospital beds. Research funded by the Department shows that, most commonly, homeless mentally ill people have had care organised outside hospital but have lost touch with the service. We expect to reduce the future numbers losing touch through the measures to which I have already referred. But we need to address the existing problem, and will be doing so in the light of a recent study by the Policy Studies Institute, again funded by the Department, on schemes for delivering primary health care to single homeless people ; Third, the need for adequate arrangements in each health district for emergency care of people suffering from mental illness. In some places this is handled through the normal accident and emergency service ; in others by specialist mental health emergency arrangements. We will be discovering the extent of arrangements and seeking to evaluate alternatives.
Finally, let me summarise what we are announcing at this stage. We reaffirm our commitment to the longstanding policy of locally based hospital and community services, including asylum ; working collaboratively with the regional health authorities, we will ensure that hospitals are not closed before proper alternative provision is made ;
from 1991, we will require district health authorities to have care programmes for those discharged from hospital, upon which we will be issuing guidance, and we propose a new specific grant to local authorities, payable through health authorities, to help meet the social care needs of such patients ;
we are offering health authorities the possibility of, in effect, bringing forward the sale of hospital sites, to fund new facilities such as hospital hostels ;
we propose this autumn to lay before the House a code of practice for the compulsory assessment and treatment of patients suffering from mental disorder in hospital, and will consider, though from a very questioning standpoint, the possibility of new legislation for compulsory treatment in the community ;
we are reviewing the work of the health advisory service, to ensure effective oversight of the quality of locally-based services ;
Column 627we are reviewing our funding of voluntary bodies, to ensure that public funds are used in the most effective way to encourage the development and provision of services for patients and their relatives ;
we are looking at ways of increasing general practitioners' awareness of mental illness and how it can be treated ; theextent and adequacy of emergency services for people with a mental illness, and what can be done to meet the needs of those members of the homeless population in London and elsewhere suffering from mental illness.
Mrs. Virginia Bottomley : Toxic wastes are discharged into the North sea via two main routes : direct discharge by pipe from land-based sources and riverine inputs from direct discharges to rivers. Wastes also enter the North sea from dumping and incineration at sea and general atmospheric deposition. The 1987 quality status report on the North sea confirms that most of the pollution in the North sea comes from rivers.
The combined effect of all United Kingdom rivers flowing into the North sea contributes about 20 per cent. of riverborne pollutants, although the United Kingdom has almost half the North sea coastline. The Rhine and Meuse alone contribute between 40 and 50 per cent. of pollutants carried by rivers.