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NHS Funding
Mr. Robert Banks : To ask the Secretary of State for Health what is the figure in real terms for the increase in funding (a) for the National Health Service as a whole and (b) for the Harrogate district health authority since May 1979.
Mr. Freeman : Harrogate health authority was established on 1 April 1982. Prior to that date Harrogate formed part of the North Yorkshire area health authority and district based figures were not collected centrally.
The table shows the real terms increase in gross revenue expenditure between 1982-83 and 1987-88 (the latest year for which figures are available) :
£ million
|1982-83 |1987-88 |Real terms percentage
|increase<1>
------------------------------------------------------------------------------------------------------------------------------------
All RHAs and SHAs 8,141.2 10,243.5 10.1
Harrogate health authority 20.1 25.3 13.2
<1>Using the GDP deflator.
Since then health authorities have received further real terms increases bringing the total estimated increase over the period 1982-83 to 1989-90 nationally, and in Harrogate health authority to over 14 per cent.
Small Shops (Licensing)
Mr. Fearn : To ask the Secretary of State for Health whether he has any plans to introduce a licensing system aimed at smaller shops, to ensure that they are fit and responsible enough to sell eggs and other produce.
Mr. Freeman : The Government have been consulting a large number of organisations on a thorough review of food legislation, including proposals for the registration of food premises. We shall be bringing forward legislation as soon as the parliamentary timetable permits.
Community Health Councils
Mr. Redmond : To ask the Secretary of State for Health what reviews or surveys are being carried out or planned into community health councils in England and Wales ; with what terms of reference ; and if he will make a statement.
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Mr. Mellor : No such review is being carried out or planned by the Department. I understand that the Association of Community Health Councils in England and Wales has recently endorsed a report from a panel of inquiry into the role and organisation of community health councils, and we will be considering the report carefully.
Child Migrant Schemes
Mr. Michael J. Martin : To ask the Secretary of State for Health how many children were sent to New Zealand and Australia by voluntary organisations under the child migrant schemes in each year since 1964.
Mr. Mellor : We do not hold this information centrally.
Community Care
Sir John Farr : To ask the Secretary of State for Health if, in drawing up his White Paper on community care, he will take account of the views expressed to him by CARE, Kibworth, Leicester, about funding an individual when a local authority declines to top up its proportion of the cost involved.
Mr. Mellor : We are pleased to receive views from all interested parties about our proposals for community care and will take them into account in preparing the White Paper to be published in the autumn. I am afraid that we are unable to trace the correspondence from CARE in Kibworth referred to by my hon. Friend, and I would be grateful if he could arrange for a copy to be sent to me.
Swimming
Mr. Thurnham : To ask the Secretary of State for Health how many fatalities have occurred in each of the last 10 years as a result of members of the public swimming in reservoirs and other waters not designated for recreational use in (a) the United Kingdom, (b) North West England, and (c) Bolton ; and if he will make a statement.
Mr. Freeman : The information requested based on details recorded at time of death registration could be provided only at disproportionate cost.
Nurses and Midwives (Grading)
Mr. Frank Field : To ask the Secretary of State for Health if he will break down the information given in his answer to the hon. Member for Thurrock (Mr. Janman), on 11 July at column 468, about bids by district health authorities for additional financial allocations from the sum available in 1988-89 for flexible pay settlements for nursing and midwifery staff to show the number of bids in respect of midwifery staff, the grades of the posts concerned, and the number of such bids which were accepted.
Mr. Mellor : Four bids were received in respect of posts clearly designated as midwifery, covering 152 staff. Of these three were accepted, covering 146 staff graded at D, E and F, and one was rejected, covering six staff at grade I.
A further 10 bids were received in respect of units related to maternity where the greater proportion of the posts may be filled by midwives. These were all accepted, and covered 267 staff at grades C to G.
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Cholesterol Tests
Mr. Alton : To ask the Secretary of State for Health (1) what guidelines his Department issues for the use of over-the-counter tests for blood cholesterol levels ;
(2) if his Department has any plans to regulate the sale and use of over- the-counter cholesterol tests.
Mr. Freeman : We have not issued any guidelines on the use of over- the-counter tests for blood cholesterol levels and there are no current plans to regulate the sale and use of such tests.
Mr. Alton : To ask the Secretary of State for Health what steps his Department has taken to establish the accuracy of over-the-counter tests for blood cholesterol levels.
Mr. Freeman : The Department is funding an evaluation of the two most commonly used machines for measuring blood cholesterol levels in the United Kingdom, involving testing both under laboratory conditions and in GP clinics. The work is being carried out by Mr. Peter Broughton of Wolfson research laboratories in Birmingham, and includes accuracy testing, and investigation of performance variation when carried out by skilled and non- laboratory trained operatives. The final report will be available by the end of the year.
Mr. Alton : To ask the Secretary of State for Health what plans his Department has to introduce nation wide blood cholesterol level screening for adults ; and if he will make a statement.
Mr. Freeman : We have invited the Standing Medical Advisory Committee to advise on the cost-effectiveness of wider cholesterol testing in the prevention and treatment of heart disease.
Correspondence
Mr. Cran : To ask the Secretary of State for Health how many letters were received from, and sent to, hon. Members by his Department in (a) January and (b) the whole of this session up to 1 July.
Mr. Freeman : The Department received 1,165 letters from, and despatched 1,176 letters to, hon. Members in January. In the whole of this session up to 1 July 14,348 letters were received and, by that date 10,615 replies sent.
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NHS Reform
Mr. Vaz : To ask the Secretary of State for Health how many community health councils have made representations to his Department opposing the Government's White Paper "Working for Patients"; and if he will make a statement.
Mr. Mellor : We have received a number of representations from community health councils. These generally welcome the proposals in the White Paper aimed at enhancing standards of patient care. Some express support for other proposals or raise questions on specific issues. I regret that it is not possible to quantify the representations in the way the hon. Member requests.
Mr. Kirkwood : To ask the Secretary of State for Health whether his proposals for medical audit announced in "Working for Patients" will be extended to professional groups other than doctors; and if he will make a statement.
Mr. Mellor [holding answer 19 July 1989] : Obviously in the care of the patient a number of professions are involved and it is important that work on developing audit measures is complementary. Whilst "Working for Patients" focused mainly on the care and treatment provided by doctors, work to establish audit in other health professions is taking place. For example, an important part of the Department's project "Making Best Use of Nursing Skills" is concerned with developing a nursing audit package.
Waiting Lists, Hampstead
Sir Geoffrey Finsberg : To ask the Secretary of State for Health what are the waiting list figures for June 1988 and June 1989 in respect of the Hampstead health authority.
Mr. Mellor : The latest published figures, for September 1988, show 4,386 patients on Hampstead health authority's waiting list. The figure for September 1987 was 3,706. Provisional figures for March 1989 suggest a substantial reduction, to below the September 1987 level.
Food Poisoning
Mr. Alan Williams : To ask the Secretary of State for Health how many cases of botulism, salmonella enteriditis, salmonella typhimurium, listeriosis and other types of food poisoning have been detected and reported since 1983 for each month of each year.
Mr. Freeman : The information is not readily available in the form requested. Annual figures for 1983 to 1988 are given in the tables. It is not known how many of the campylobacter infections are food-borne.
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|1983 |1984 |1985 |1986 |1987 |1988
---------------------------------------------------------------------------------------------------------------------
Number of cases of principal types of food poisoning detected or reported 1983-88 (England and Wales)
Clostridium botulinum |- |- |- |- |1 |-
Salmonella enteriditis |1,774 |2,071 |3,096 |4,771 |6,858 |15,427
Salmonella typhimurium |7,785 |7,264 |5,478 |7,094 |7,660 |6,444
Other salmonellas |5,596 |5,392 |4,756 |5,111 |6,014 |5,607
Listeriosis |115 |115 |149 |137 |259 |<1>291
Number of incidents (outbreaks and isolated cases) of other types of food poisoning reported 1983-88 (England and Wal
Clostridium perfringens |68 |68 |64 |61 |<1>51 |<2>-
Staphylococcus aureus |17 |10 |13 |11 |<1>13 |<2>-
Bacillus sp |24 |28 |22 |26 |<1>24 |<2>-
Laboratory reports of campylobacter infections |17,299 |21,049 |23,619 |24,844 |27,415 |<1>28,761
<1> Provisional
<2> Not yet available
Source: PHLS
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Regional Secure Units
Mr. Soley : To ask the Secretary of State for Health whether he intends to seek to amend section 66(1) of the Health Services and Public Health Act 1968 in order to include visitors to patients in regional secure units.
Mr. Freeman : There are no plans to amend this section of the 1968 Act.
Small Businesses
Mr. David Shaw : To ask the Secretary of State for Health if he will make a statement on the achievements of his Department and his policies in helping small businesses over the last 12 months compared with the previous 12 months ; and if he will publish the performance indicators by which his Department monitors those achievements and the statistical results of such monitoring.
Mr. Freeman : A booklet has been produced and a series of seminars held on how to do business with the NHS. Other initiatives include the issuing of a mission statement on electronic data interchange which encourages small firm involvement and progress has been made on harmonisation of European standards of equipment, which will assist small businesses in their future trading in Europe. Equal opportunity to trade on a value for money basis underpins all contracts with non-NHS organisations, the details of these are not collected centrally.
Cigarette Advertisements
Mr. Cohen : To ask the Secretary of State for Health whether cigarette advertisements which contain only the warning that smoking when pregnant can injure the baby and cause premature birth, and not a more general health warning linking smoking to lung cancer and other respiratory illnesses, are treated as being in breach of the current code of practices in relation to cigarette advertising ; whether he has any plans to strengthen the current arrangements ; and if he will make a statement.
Mr. Mellor : The warning "Smoking when pregnant can injure your baby and cause premature birth" is one of the six agreed warnings included in the voluntary agreement with the tobacco industry on tobacco products' advertising and promotion, and health warnings. This warning contains important information and we have no plans to discontinue its use. It is used in rotation with five other warnings which highlight the other health risks associated with cigarette smoking. On the question of re-negotiating the current voluntary agreements with the industry, officials have had some preliminary discussions with the Tobacco Advisory Council, and we are considering the way forward.
Salomons Science Theatre
Sir Barney Hayhoe : To ask the Secretary of State for Health what steps he has taken to ensure that the covenants concerning the Salomons Broomhill estate are being fully honoured, and that the science theatre and its fixtures, fittings and contents are being properly maintained and protected against vandalism.
Mr. Freeman : These are matters for which the South East Thames regional health authority is responsible.
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Sir Barney Hayhoe : To ask the Secretary of State for Health when Mr. Frank Holland, MBE, director of the British Piano Museum Educational Charitable Trust, may expect a reply to his letter of 27 April to Mr. K. Lau, regional liaison division of his Department, about the David Salomons science theatre.
Mr. Freeman : A letter was sent to Mr. Holland on 22 May. Officials will write again to Mr. Holland, enclosing a copy of this, in case he did not receive it.
Scientific Staff
Mr. Allan Stewart : To ask the Secretary of State for Health (1) if he will make a statement on the extent of current shortages of National Health Service physicists, biochemists, other scientists and clinical psychologists ;
(2) what is the latest available information on the turnover of National Health Service physicists, biochemists, other scientists and clinical psychologists.
Mr. Mellor : We do not hold the information centrally.
Mr. Allan Stewart : To ask the Secretary of State for Health if he will set up an independent inquiry into the determination of the salaries of National Health Service physicists, biochemists, other scientists and clinical psychologists.
Mr. Mellor : No. The negotiation of pay for these groups is a matter for the appropriate Whitley Council.
Mr. Allan Stewart : To ask the Secretary of State for Health what representations he has received concerning the re-establishment of the link between the pay of scientific civil servants and that of National Health Service physicists, biochemists, other scientists and clinical psychologists ; and if he will make a statement.
Mr. Mellor : We have received numerous letters from hon. Members enclosing letters from constituents who make reference to the pay of scientific civil servants.
Cook-chill Catering
Mr. Hinchliffe : To ask the Secretary of State for Health if he will commission an independent study of the comparative nutritional values of cook-chill methods of hospital catering and the implications for the diet and health of short-stay and long-stay hospital patients and make public the results.
Mr. Freeman : No. I refer the hon. Member to the reply I gave him on 10 July at column 372.
Mr. Hinchliffe : To ask the Secretary of State for Health what is his policy on the size of portions of food to be served to patients when district health authorities are introducing cook-chill meals.
Mr. Freeman : The provision of catering services is the responsibility of local health authorities.
Abortions
Mr. Amess : To ask the Secretary of State for Health how many abortions were performed under ground 6 of the Abortion Act 1967 in each year since 1968.
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Mr. Freeman : The information requested is shown in the table.
Abortions performed under ground 6 of the 1967 Abortion Act, which allows an abortion in an emergency to prevent grave permanent injury to the physical or mental health of the pregnant woman, 1968-88 Year |Total -------------------- 1968 |45 1969 |31 1970 |36 1971 |12 1972 |15 1973 |12 1974 |6 1975 |2 1976 |9 1977 |8 1978 |7 1979 |10 1980 |3 1981 |9 1982 |5 1983 |3 1984 |8 1985 |11 1986 |4 1987 |4 <1>1988 |5 <1> Provisional data.
Mental Health Act Commission
Mr. Wareing : To ask the Secretary of State for Health how many special hospitals there are in the area covered by the Liverpool office of the Mental Health Act Commission ; and if he will list them.
Mr. Freeman : Two ; Moss Side and Park Lane hospitals.
Mr. Wareing : To ask the Secretary of State for Health (1) if he has any plans to close the Liverpool office of the Mental Health Act Commission ;
(2) if he has plans to review the work of the Mental Health Act Commission ; and if he will make a statement ;
(3) what plans he has to centralise the work of the Mental Health Act Commission.
Mr. Freeman : We shall be considering shortly the Commission's review of its functions, organisation, staffing and finance. Centralisation is one of the issues being considered as part of that review. We expect to reach decisions well before the end of the year.
Mr. Wareing : To ask the Secretary of State for Health when he last held discussions with the Mental Health Act commissioners in the north-west ; and what subjects were discussed.
Mr. Freeman : We are in regular contact with the Commission chairman and secretariat, but it has not been the practice to meet commissioners on a regional basis.
Mr. Wareing : To ask the Secretary of State for Health why no Mental Health Act commissioners in the north-west were re-appointed this year ; and what is the position with regard to re-appointments in other regions.
Mr. Freeman : The normal length of appointment as a commissioner is now four years, though some are invited to serve for longer because of the exceptional
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contributions they make. Twenty-nine commissioners appointed by my predecessors complete at least four years in office this autumn, and five have been invited to serve for a further period because of their individual contributions. Two of these are based in the southern region and three in the north eastern region.Child Protection Registers
Rev. Martin Smyth : To ask the Secretary of State for Health what financial resources have been made available to local authorities in the last five years for which figures are available to alleviate the problem of unallocated cases on child protection registers ; and if he will make a statement.
Mr. Mellor : The overall level of central Government's contribution to expenditure by local authorities takes into account services authorities are required to provide. It is however for the authorities themselves to determine how to allocate the funds available to them in the light of local circumstances and overall legislative requirements.
Rev. Martin Smyth : To ask the Secretary of State for Health what information he has as to the number of children on the child protection registers of each London borough and the number in each London borough who have not been allocated to a social worker.
Mr. Mellor : The available information is in the table.
Local Authority |Number<1> ----------------------------------------------------- Camden |279 Greenwich |467 Hackney |176 Hammersmith |226 Islington |280 Kensington |146 Lambeth |565 Lewisham |412 Southwark |873 Tower Hamlets |238 Wandsworth |283 Westminster |138 City of London |0 Barking |77 Barnet |181 Bexley |205 Brent |212 Bromley |203 Croydon |170 Ealing |182 Enfield |106 Haringey |296 Harrow |70 Havering |53 Hillingdon |147 Hounslow |118 Kingston-upon-Thames |75 Merton |118 Newham |317 Redbridge |134 Richmond-upon-Thames |76 Sutton |95 Waltham Forest |208 <1> Children on Child Protection Registers.
We do not hold information about unallocated cases centrally and it could be obtained only at disproportionate cost.
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Foster Care Placements
Rev. Martin Smyth : To ask the Secretary of State for Health what information he has as to the number of foster care placements by each London borough which are outside the boundaries of those boroughs ; and whether any local authorities have reported to him any difficulties in recruiting foster carers.
Mr. Mellor : The latest available information is as follows :
Children in care at 31 March 1987<1> boarded out by London authorities in the area of other authorities who were not boarded out with a relative or friend and were not living in a relative's household Local authority |Number<3> ------------------------------------------------------- Camden |137 Greenwich |49 Hackney |204 Hammersmith and Fulham |103 Islington<2> |- Kensington and Chelsea |75 Lambeth |244 Lewisham<2> |- Southwark |248 Tower Hamlets |177 Wandsworth |147 Westminster |78 City of London |3 Barking and Dagenham |30 Barnet |13 Bexley |50 Brent |91 Bromley |34 Croydon |41 Ealing |92 Enfield |44 Haringey |96 Harrow |20 Havering |28 Hillingdon |18 Hounslow |59 Kingston Upon Thames |18 Merton |44 Newham |103 Redbridge |58 Richmond Upon Thames |12 Sutton |34 Waltham Forest |56 <1>Figures for 1987 are provisional and subject to revision. <2>Figures for Islington and Lewisham were not available. <3>Children in care who were boarded out in the area of another local authority and were not boarded out with a relative or friend.
We understand that some local authorities are not successful in recruiting within their own areas a sufficient number and range of foster parents for children requiring placements.
Indicative Prescribing Budgets
Mr. Anthony Coombs : To ask the Secretary of State for Health by what means general practitioners will monitor their indicative prescribing budgets ; and if he will make a statement.
Mr. Kenneth Clarke : The Government indicated in working paper 4 of the NHS review series ("Indicative Prescribing Budgets for General Medical Practitioners") that the ideal way of providing information at all levels to operate the indicative prescribing budget scheme was an enhancement of the existing prescribing analyses and cost system known as PACT.
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Our feasibility studies have confirmed that PACT can be speeded up, and made more frequent and more comprehensive. I have therefore asked the Prescription Pricing Authority and my Department to develop PACT to provide all general practitioners with monthly budgetary statements from April 1991. These budgetary statements will normally be provided no more than four weeks after the month in which the relevant prescriptions were dispensed. Existing PACT reports will continue to be provided.I will continue to hold discussions with interested parties before deciding upon the detailed content and format of these reports and other associated improvements to PACT. I shall also be making available PACT data aggregated at family practitioner committee level to all family practitioner committees and regional health authorities from 1 August 1989 to enable them to prepare for indicative prescribing budgets.
My decision will take away from general practitioners the burden of paperwork which might otherwise be associated with the introduction of indicative prescribing budgets. An enhanced PACT will also provide regional health authorities and family practitioner committees with information they need both to set and to monitor budgets. Indicative prescribing budgets will take full account of the fact that some patients and groups of patients, for example elderly people, diabetics and patients on home dialysis, need a greater volume of drugs or more expensive drugs than others. The scheme will ensure that budgets fully reflect these costs. There will be no disincentive to practices to accept such patients or to begin to prescribe expensive medicines to existing patients, if there is a clinical need to do so.
Overseas Visitors (Fees)
Mr. Madden : To ask the Secretary of State for Health in what circumstances British citizens may be charged fees as overseas visitors for treatment within the National Health Service ; and if he will make a statement.
Mr. Freeman : Residence in the United Kingdom, not citizenship, is the measure of qualification for hospital treatment without charge under the National Health Service. British citizens not ordinarily resident in the United Kingdom will be charged as overseas visitors for NHS hospital treatment.
General practitioners have the discretion whether to accept a visitor as a NHS patient. If a visitor is unable to find a GP willing to accept him onto the GP's list, he can apply to the family practitioner committee which will allocate him to a GP who must then accept him as a NHS patient.
Disability
Mr. Alfred Morris : To ask the Secretary of State for Health on how many occasions in 1989 meetings to discuss the implementation of section 7 of the Disabled Persons (Services, Consultation and Representation) Act 1986 have been held between his Department and (a) the local authority associations and (b) the National Association of Health Authorities ; on how many occasions meetings have been arranged but subsequently cancelled at the request of his Department ; and if he will make a statement.
Mr. Mellor [holding answer 19 July 1989] : Officials had arranged to meet representatives of the local authorities
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associations and the National Association of Health Authorities in February but this was deferred to March to allow further preparatory work to be done. The National Association of Health Authorities was invited but did not send a representative. At that meeting it was agreed that officials would work on identifying the processes likely to be required for assessment purposes and costings before another meeting is held. No further meeting has yet been arranged.Magnetic Resonance Scanners
Mr. Cousins : To ask the Secretary of State for Health if he will list the locations at which nuclear magnetic resonance scanners are available within the National Health Service.
Mr. Freeman [holding answer 20 July 1989] : Nuclear magnetic resonance scanners are located on the following National Health sites in the United Kingdom :
Royal Infirmary, Aberdeen
Southern General, Glasgow
Royal Infirmary, Edinburgh
Queens Medical Centre, Nottingham
Hammersmith Hospital, London (RPMS)(2)
National Hospital, London (2)
St. Bartholomew's, London
National Heart, London
Mount Vernon, London
Guy's, London
Camden Children's, London
John Ratcliffe, Oxford
Addenbrookes, Cambridge
Frenchay, Bristol
Walsgrave, Coventry
Royal Marsden, Sutton
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