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Ms. Primarolo : To ask the Secretary of State for Health if he will review the advice given to doctors in the Committee on Safety of Medicines bulletin "Current Problems, No. 21", January 1988, in the light of the findings of the Association of Community Health Councils of England and Wales.
Mrs. Virginia Bottomley : The advice on benzodiazepines, dependence and withdrawal symptoms published in "Current Problems No. 21" remains valid and is summarised in the latest edition of the "British National Formulary" which the Department issues free to all doctors.
Dependent Adults
Miss Emma Nicholson : To ask the Secretary of State for Health (1) if he will give consideration to legislation to provide dependent adults with legal status, basic rights and social protection should their carer be unable to provide for them ;
(2) what powers exist for the appropriate authorities to ensure that the rights and health of dependent adults are safeguarded in the event of their carer being unable to provide for them ;
(3) what protection exists to safeguard the care of dependent adults in the event of their carer being unable to provide for them ;
(4) what steps he plans to take to ensure that dependent adults' personal and medical welfare is properly protected by effective liaison between all interested professional parties in the event of their carer being unable to provide for them.
Mr. Freeman : Section 47 of the National Assistance Act 1948 and sections 115 and 135 of the Mental Health Act 1983 empower local authorities to take action to safeguard the welfare of dependent people who are not receiving proper care. The exercise of these powers is a matter for the local authority concerned which will need to keep in touch with the appropriate health authority. When failures of care come to light we ask the authorities for reports which are carefully studied to see whether any action is called for.
Contraception
Mr. John Evans : To ask the Secretary of State for Health if he will make a further statement on women and the Dalkon shield contraceptive device.
Mrs. Virginia Bottomley : There are no plans for Government intervention in relation to this matter of litigation in the United States courts. For the initial claims deadline, the court itself directed, and approved, publicity by the Dalkon shield manufacturers. Further extensions of the deadline have received independent media publicity. It is for individual health authorities to decide whether they wish to direct their resources to specific activity on this matter. Our longstanding advice has been that they should be as helpful as possible with regard to the release of information.
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Petrol
Ms. Harman : To ask the Secretary of State for Health how many health authority vehicles run on (a) unleaded petrol, (b) leaded petrol, (c) diesel and (d) have three-way catalytic converters.
Mr. Freeman : The information in the form requested is not available centrally and the cost of obtaining it would be disproportionate. All regional and district health authorities in England are implementing a lead -free policy and are converting their vehicles at the earliest opportunity.
Energy Efficiency
Ms. Harman : To ask the Secretary of State for Health if he plans to issue guidelines to health authorities requiring them to carry out an energy audit for health authority buildings, identify priority areas for energy saving and segregate fuel bills for each building.
Mr. Freeman : The Department has issued comprehensive guidance, the national energy code (ENCODE), on all aspects of energy efficiency for health care buildings including the need for energy audit and prioritising energy saving measures. Recommendations for separate metering where applicable will be issued shortly.
We have no plans to require health authorities to undertake a formal energy audit.
Ms. Harman : To ask the Secretary of State for Health if he will require health authorities to establish an energy management unit and allocate responsibility for energy efficiency to one member of staff for each building.
Mr. Freeman : The comprehensive guidance, the national energy code (ENCODE), on energy efficiency published by the Department recommends a level of energy management and responsibility appropriate to the size of the estate and potential for energy savings.
Environmental Audit
Ms. Harman : To ask the Secretary of State for Health if he plans to require health authorities to carry out an environmental audit on (a) energy consumption, (b) purchasing policy, (c) waste arising and disposal methods, (d) pollution from health authority premises and (e) environmental training.
Mr. Freeman : Health authorities are expected to comply with all relevant statutory legislation. We have no plans to require them to carry out environmental audits on energy consumption, purchasing policy, waste arising and disposal methods, pollution from health authority premises or environmental training.
Environment Policy
Ms. Harman : To ask the Secretary of State for Health (1) if he will allocate funds for implementing an environment policy for the National Health Service ;
(2) if he will draw up an environment policy for the National Health Service.
Mr. Freeman : It is for health authorities to decide on their overall environmental policies and the allocation of associated resources.
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Ms. Harman : To ask the Secretary of State for Health if he will include as items for the regional review by Ministers (a) any adverse impact of health authority practices on the environment and (b) any adverse impact of environmental factors on public health within the region.
Mr. Freeman : This year public health issues were discussed with each region in preparation for regional reviews, which are now normally conducted by the chief executive of the management executive. Where there are serious concerns about these or other specific areas, they are raised at the review itself. Management action is taken in relation to the impact of health authority practices on the environment as they arise.
Ms. Harman : To ask the Secretary of State for Health if he will issue guidance banning the use by health authorities of products proven to be environmentally damaging where an alternative is available.
Mr. Freeman : No. We consider that, as responsible public bodies, health authorities should be able to take account of all relevant factors, including environmental factors and statutory requirements, in securing best value for money in their purchasing policies.
Ms. Harman : To ask the Secretary of State for Health if he will list those health authorities which have regular planning and consultative meetings with local authority environmental health officers ; and what exchange of information there is between them.
Mr. Freeman : I regret that this information is not collected centrally.
Ms. Harman : To ask the Secretary of State for Health if he will make a statement about health authorities as (a) consumers, (b) waste producers and (c) polluters.
Mr. Freeman : It is for health authorities to ensure that they perform their duties effectively, efficiently and responsibly with due regard to the effects on the environment.
Ms. Harman : To ask the Secretary of State for Health if he will require health authorities to monitor progress on their environment policies and practice and report to him.
Mr. Freeman : The Department already monitors a number of key aspects of health authorities' environmental policies and practices and will continue to do so.
Ms. Harman : To ask the Secretary of State for Health whether there is an environmental component in the training and qualification of (a) nurses, (b) doctors, (c) radiographers, (d) hospital administrators and (e) health visitors.
Mrs. Virginia Bottomley : The information requested is as follows :
(a) Nurses and health visitors : The standard and content of training for nurses and health visitors is determined by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting. (b) Doctors : The General Medical Council recommend the curriculum for undergraduate medical students.
(c) Radiographers : The Council for the Professions Supplementary to Medicine through its Radiography Board, is responsible for regulating the professional education of radiographers.
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(d) Hospital Administrators : Health authorities and the National Health Service Training Authority are responsible for the standard and content of training for hospital administrators.Air Pollution
Ms. Harman : To ask the Secretary of State for Health if he will list the health authorities premises which have boilers and incinerators giving rise to air pollution problems.
Mr. Freeman : Information on health authority premises where boiler and incinerator are known to give rise to air pollution problems is not available centrally but all installations are expected to comply with current legislation.
Waste Management
Ms. Harman : To ask the Secretary of State for Health if there is a staff member specifically responsible for waste management in each health authority.
Mr. Freeman : The information requested is not available centrally. It is for health authorities to determine responsibilities for waste management. As far as clinical waste is concerned, the Department has issued guidance to health authorities which recommends that it should be the responsibility of a designated officer within each authority.
Lead Piping
Ms. Harman : To ask the Secretary of State for Health what percentage of health authority buildings have lead piping.
Mr. Freeman : Information is not available on the extent to which lead piping is installed within health care buildings. All current guidance recommends the use of copper piping.
Recycling
Ms. Harman : To ask the Secretary of State for Health which health authorities provide collection facilities for (a) glass, (b) paper and (c) cans for recycling.
Mr. Freeman : I regret that this information is not held centrally.
Ms. Harman : To ask the Secretary of State for Health what percentage of National Health Service stationery is (a) 100 per cent. recycled and (b) not recycled.
Mr. Freeman : National contracts for copy paper and listing paper for computer use do make provision for the use of recycled paper. No figures are yet available to show the percentage of recycled paper used. However, it is unlikely that the use of 100 per cent. recycled stationery will be significant. Large quantities of chemicals are necessary to achieve a desirable standard of whiteness in the paper. This calls into question the level of benefit to the environment, and can involve higher costs of production than ordinary paper.
Chlorofluorocarbons
Ms. Harman : To ask the Secretary of State for Health whether he has issued guidance to health authorities requiring them to phase out the use of chlorofluorocarbons as sterilant gases.
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Mr. Freeman : Regional supplies directors were advised at a meeting of the national procurement group in September 1988 that the small-scale use of chlorofluorocarbons in sterilisers as a carrier gas for ethylene oxide should be avoided, if possible, since pure ethylene oxide and ethylene oxide/carbondioxide mixtures were available as satisfactory alternatives.
Nurses
Mr. Frank Field : To ask the Secretary of State for Health (1) how many enrolled nurses have been turned away from conversion to first-level nursing places in the last year ;
(2) what is the current average waiting list for an enrolled nurse conversion course.
Mrs. Virginia Bottomley : This information is not held centrally.
Mr. Frank Field : To ask the Secretary of State for Health how many practising enrolled nurses there are in the United Kingdom.
Mrs. Virginia Bottomley : This information is not collected centrally. Information provided by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting about the numbers in the United Kingdom who have paid the periodic fee and were therefore on the effective register shows that on 31 March 1989 there were 158,500 people who held an enrolled nurse qualification.
Mr. Corbyn : To ask the Secretary of State for Health if he will list by health district (a) the current nursing staff establishment, (b) the number in post at the latest available date and (c) the number who had left the National Health Service in the preceding year.
Mrs. Virginia Bottomley [holding answer 3 November 1989] : Information on the number of nursing and midwifery staff employed in each district health authority in England at 30 September 1988 is given in the table.
We do not collect information on nursing staff establishments centrally. Reliable information on the numbers leaving the National Health Service last year is not yet available.
Doctors and Dentists
Mr. Adley : To ask the Secretary of State for Health if he will make a statement on his latest meetings with doctors and dentists.
Mr. Kenneth Clarke : I have frequent formal and informal meetings with doctors and dentists, mostly very amicable, constructive and supportive of our objectives. I met the British Dental Association on 27 September when I reached full agreement with it on the terms of its new contract. I met the British Medical Association on 18 October to discuss the implementation of our proposals in the White Paper "Working for Patients" and had a friendly and constructive discussion.
Residential Care
Mr. Malins : To ask the Secretary of State for Health what progress has been made on the Government's initiative announced in February for improving life for people in residential homes ; whether he proposes to take
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any further action on the recommendations of the committee on residential care chaired by Lady Wagner ; and if he will make a statement.Mrs. Virginia Bottomley : In February we announced our intention to launch a development programme aimed at improving life for people in residential homes, based on recommendations of the committee chaired by Lady Wagner.
We have appointed five agencies to carry forward important recommendations from the committee's report "Residential Care : A Positive Choice". Work has now begun and will continue for the next three years at a total cost of around £2.2 million. This initiative aims at better training for staff in homes, better information for the public in making choices, effective, accessible and widely known arrangements for making suggestions and complaints, a closer relationship between homes and their local communities and better management of homes. Cost-effective ways of achieving these objectives will be explored through a wide range of development projects. The results of these activities will be made widely and regularly available to national and local agencies concerned and will be independently assessed.
The thrust of many of the committee's recommendations, for example on the organisation and funding of community care, has been taken into account in the wider context of community care development and will be reflected in the forthcoming White Paper.
The committee's recommendations on setting and maintaining standards have been incorporated in our proposals to achieve even-handedness in inspection of residential care homes, as between independent and local authority homes, through the setting up of inspection units in social services departments at arms length from the management of local authorities' own homes. Issues concerning children and young people, on which the Wagner committee made recommendations, are covered in the Children Bill, including education and health needs of children in care, keeping siblings together wherever practicable and appropriate, the needs of ethnic minority groups and accommodation for young people leaving care. And we are considering issuing guidance on encouraging and enabling people in residential care homes to manage their own finances where they are capable of doing so.
The Wagner committee has done a valuable service in pointing the way to better standards. The Government are playing their part in responding to its report. We also look to local authorities and private and voluntary agencies, to whom much of the report was primarily addressed, to take those messages to heart and act on them.
The selected agencies and their fields of activity are as follows :
Basic training programmes for care staff : the National Institute for Social Work ;
Ways of increasing contacts between homes and their local communities and a wider role for volunteers : the Social Care Association (Education) ;
Methods of self-assessment and performance evaluation by managers : the Polytechnic of North London ;
Ways of providing information to help people in choosing a home or alternative to residential care : the Policy Studies Institute. The department of government, Brunel university will co-ordinate this activity, provide an information service and publish an independent assessment of the programmes.
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In addition the Department's social services inspectorate will develop procedures for dealing with suggestions and complaints.
National Health Service staff in post in England nursing and
midwifery by district health authority<1> at
30 September 1988
|Whole time equivalent<2>
---------------------------------------------------------------------------------------
Total England |403,880
Northern RHA HQ |70
Hartlepool |860
North Tees |1,280
South Tees |2,650
East Cumbria |1,600
South Cumbria |1,120
West Cumbria |1,160
Darlington |1,170
Durham |1,180
North West Durham |730
South West Durham |1,620
Northumberland |3,170
Gateshead |1,400
Newcastle |5,200
North Tyneside |970
South Tyneside |970
Sunderland |2,600
Yorkshire RHA HQ |120
Hull |2,660
East Yorkshire |1,610
Grimsby |1,300
Scunthorpe |1,240
Northallerton |530
York |2,300
Scarborough |890
Harrogate |1,170
Bradford |2,740
Airedale |1,440
Calderdale |1,570
Huddersfield |1,990
Dewsbury |970
Leeds Western |3,420
Leeds Eastern |3,310
Wakefield |2,000
Pontefract |1,070
Trent RHA HQ |100
North Derbyshire |2,270
South Derbyshire |3,980
Leicestershire |6,570
North Lincolnshire |2,230
South Lincolnshire |2,110
Bassetlaw |680
Central Nottingham |2,250
Nottingham |5,670
Barnsley |1,700
Doncaster |2,560
Rotherham |1,850
Sheffield |6,310
East Anglian RHA HQ |50
Cambridge |2,600
Peterborough |1,780
West Suffolk |1,660
East Suffolk |2,640
Norwich |3,950
Great Yarmouth and Waveney |1,410
West Norfolk and Wisbech |1,300
Huntingdon |770
North West Thames RHA HQ |<3>-
North Bedfordshire |1,380
South Bedfordshire |1,900
North Hertfordshire |1,020
East Hertfordshire |1,050
North West Hertfordshire |3,060
South West Hertfordshire |1,240
Barnet |2,870
Harrow |1,430
Hillingdon |2,050
Hounslow and Spelthorne |2,030
Ealing |1,760
Brent |2,000
Paddington and North Kensington |2,050
Riverside |3,910
North East Thames RHA HQ |110
Basildon and Thurrock |2,180
Mid-Essex |1,910
North East Essex |2,980
West Essex |1,670
Southend |2,000
Barking, Havering and Brent |3,350
Hampstead |2,120
Bloomsbury |3,210
Islington |1,510
City and Hackney |2,620
Newham |1,410
Tower Hamlets |2,390
Enfield |1,500
Harringey |1,350
Redbridge |1,520
Waltham Forest |2,660
South East Thames RHA HQ |10
Brighton |2,250
Eastbourne |1,700
Hastings |1,280
South East Kent |1,610
Canterbury and Thanet |2,590
Dartford & Gravesend |1,880
Maidstone |1,580
Medway |1,640
Tunbridge Wells |1,890
Bexley |1,580
Greenwich |2,050
Bromley |2,180
West Lambeth |2,370
Camberwell |2,310
Lewisham and North Southwark |3,550
South West Thames RHA HQ |120
North West Surrey |1,640
West Surrey and North East Hampshire |1,340
South West Surrey |1,750
Mid-Surrey |1,820
East Surrey |1,740
Chichester |1,370
Mid-Downs |1,780
Worthing |1,570
Croydon |2,300
Kingston and Esher |1,550
Richmond, Twickenham and R. |1,260
Wandsworth |2,940
Merton and Sutton |2,590
Wessex RHA HQ |10
East Dorset |3,210
West Dorset |1,820
Portsmouth and South East |3,930
Southampton and South West |4,180
Winchester |1,310
Basingstoke and North Hampshire |1,780
Salisbury |1,440
Swindon |1,860
Bath |3,120
Isle of Wight |1,030
Oxford RHA HQ |70
East Berkshire |2,310
West Berkshire |2,870
Aylesbury Vale |1,710
Wycombe |1,250
Milton Keynes |730
Kettering |1,510
Northampton |2,410
Oxfordshire |4,150
South Western RHA HQ |80
Bristol and Weston |3,470
Frenchay |2,690
Southmead |2,160
Cornwall and Isles of Scilly |2,900
Exeter |3,300
North Devon |1,000
Plymouth |2,890
Torbay |1,850
Cheltenham |1,350
Gloucester |2,490
Somerset |3,130
West Midlands RHA HQ |130
Bromsgrove and Redditch |1,150
Herefordshire |1,200
Kidderminster |1,280
Worcester |1,700
Shropshire |2,740
Mid-Staffordshire |1,760
North-Staffordshire |4,190
South-Staffordshire |1,900
Rugby |460
North Warwickshire |1,490
South Warwickshire |1,910
Central Birmingham |2,860
East Birmingham |1,400
North Birmingham |1,380
South Birmingham |2,610
West Birmingham |2,540
Coventry |2,600
Dudley |2,070
Sandwell |1,490
Solihull |1,150
Walsall |1,960
Wolverhampton |2,210
Mersey RHA HQ |70
Chester |1,730
Crewe |1,790
Halton |630
Macclesfield |1,580
Warrington |2,350
Liverpool |5,160
St. Helens and Knowsley |2,580
Southport and Formby |1,230
South Sefton |2,290
Wirral |2,770
North Western RHA HQ |120
Lancaster |2,120
Blackpool Wyre and Fylde |2,540
Preston |2,490
Blackburn Hymburn and Ribb |1,930
Burnley Pendle and Rossend |3,240
West Lancaster |920
Chorley and South Ribble |610
Bolton |1,900
Bury |1,100
North Manchester |2,450
Central Manchester |2,070
South Manchester |3,120
Oldham |1,480
Rochdale |1,170
Salford |3,320
Stockport |2,160
Tameside and Glossop |1,420
Trafford |1,230
Wigan |2,110
London Post Graduate SHA's
The Hospital for Sick Children |1,240
The National Hospital |410
Moorfields Eye Hospital |190
The Bethlem Royal Hospital |720
The National Heart and Chest |640
The Royal Marsden Hospital |460
Hammersmith and Queen Charlottes |1,230
Eastman Dental Hospital |10
LAS |<3>-
BTS |70
PHLS |10
Other |10
<1> Including unqualified nursing and midwifery staff and agency staff.
<2> Figures independently rounded to nearest ten (10) whole time equivalents.
<3> Indicates less than five (5) whole time equivalents.
Source: Department of Health (SM13) annual census of NHS non-medical manpower.
Drug Deaths
Mr. Tom Clarke : To ask the Secretary of State for Health how many deaths per year in the United Kingdom are attributable to the use of hard drugs.
Mr. Freeman [holding answer 3 November 1989] : The exact information requested is not available. The table shows the number of deaths attributable to certain drugs in the United Kingdom 1986-88.
Numbers of deaths attributable to certain drugs, United
Kingdom
1986-88
|1986|1987|1988
--------------------------------------------------------
Drug dependence or addiction<1> |63 |65 |56
Other drug abuse or intoxication<2> |16 |14 |21
Other poisoning by drugs<3> |105 |129 |128
<1>Morphine type.
Heroin, Methadone, Opium, Opium alkaloids and other
derivatives, Synthetics with morphine-like effects.
Cocaine.
Coca leaves and derivatives.
Combinations of morphine type drugs with any other.
<2>Morphine type.
Cocaine type.
<3>Opiates and related narcotics.
Codeine (methylamorphine), Heroin (diacetylmorphine),
Pethidine (mepiridine), Methadone, Morphine, Opium (
alkaloids).
Surface and infiltration anaesthetics.
Cocaine, Lignocaine, Procaine, Tetracaine.
ENVIRONMENT
Planning Guidance
8. Mr. Patrick Thompson : To ask the Secretary of State for the Environment what comments he has received on his proposal to drop the special prescription in favour of development from the draft PPG3 planning guidance note.
Mr. Howard : None so far, although a number of informal responses indicate a generally favourable reaction to our draft guidance.
Toxic Waste
17. Mr. Trotter : To ask the Secretary of State for the Environment what steps he is taking to deal with the problems of disposing of toxic wastes.
Mr. Heathcoat-Amory : I am preparing legislation, to be introduced at the earliest opportunity, to strengthen the
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law on waste disposal. This will include a duty of care on waste producers and improved controls over the disposal or treatment of waste. I shall also be issuing a consultation paper on the review of the special waste regulations shortly.Sewage Works
19. Mr. Evennett : To ask the Secretary of State for the Environment whether he intends to introduce legislation to provide local authorities with powers to abate odour nuisance from sewage treatment works.
Mr. Trippier : We are currently considering the possibility of doing so.
European Community Water Directives
20. Mr. Matthew Taylor : To ask the Secretary of State for the Environment when he last discussed United Kingdom compliance with European Community water directives with the Community environment commissioner ; and if he will make a statement.
Mr. Chris Patten : I discussed United Kingdom compliance with the drinking water directive with Commissioner Ripa when I attended the meeting of the Environment Council in Brussels in September.
76. Mr. Win Griffiths : To ask the Secretary of State for the Environment if he will make a statement on progress towards reaching agreement with the Commission of the European Communities on plans for the implementation of the drinking water directive, 80/778/EEC, and the bathing water directive, 76/160/EEC.
Mr. Howard : I refer the hon. Member to the answer that I gave on 30 October to my hon. Friend the Member for Brigg and Cleethorpes (Mr. Brown), Official Report, columns 261-62.
42. Mr. Livsey : To ask the Secretary of State for the Environment by what date the United Kingdom will meet the requirements of European Council directives on water quality ; and if he will make a statement.
Mr. Howard : In the majority of cases the United Kingdom already meets the requirements of the various European Community directives concerning water quality. For the remainder of cases measures are in hand to achieve these, notably in the case of the directives on the quality of drinking water and bathing waters, where timetabled improvement programmes have been submitted to the Commission of the European Communities.
Dioxins
21. Mr. Cousins : To ask the Secretary of State for the Environment what standards there are for the control of the emissions of dioxins in processes of burning or incineration.
Mr. Heathcoat-Amory : It is impractical at present to set specific limits for emissions of dioxins, as the monitoring and analysis of these compounds is complex, slow and expensive. Emissions of dioxins are therefore controlled in the United Kingdom, as in the European directives on municipal waste incineration plants, through effective control of combustion conditions and the fitting and use of suitable abatement equipment.
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Home Ownership
22. Mr. Battle : To ask the Secretary of State for the Environment whether his Department has plans for additional assistance to people seeking to become home owners.
34. Mr. Bradley : To ask the Secretary of State for the Environment whether he has any plans to help people into home ownership.
70. Mr. Haynes : To ask the Secretary of State for the Environment whether he has any new proposals to assist first-time home owners.
Mr. Howard : The Government will continue with the policies which have enabled there to be 3 million more home owners today than in 1979.
69. Mr. French : To ask the Secretary of State for the Environment if he will estimate the level of home ownership in the south-west of England.
Mr. Chope : Estimates of the number and percentage of dwellings in owner-occupation in the South West region are given in table 9.4 of "Housing and Construction Statistics 1978-1988", a copy of which is available in the Library.
South Africa (Sporting Links)
23. Mr. Canavan : To ask the Secretary of State for the Environment what recent steps he has taken to discourage sporting links with South Africa.
Mr. Moynihan : The sixth conference of European Ministers responsible for sport which I attended in Reykjavik from 30 May to 1 June 1989 agreed a resolution concerning apartheid in sport and discouraging sporting contact with South Africa. The resolution has been adopted by the Committee of Ministers and I have asked the Sports Council to circulate a copy of it to the governing bodies of sport.
In August I wrote to the chairman of the Test and County Cricket Board and the president of the Rugby Football Union about the proposed tours to South Africa restating the Government's commitment to the Gleneagles agreement and our policy of seeking to discourage sporting contact with South Africa. I asked for copies of my letters to be passed on to individual players who had accepted invitations to visit South Africa.
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