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124. Mr. Arbuthnot : To ask the Secretary of State for Health if he will make a statement on mentally ill patients and the Government's proposals for community care.
Mr. Freeman : I refer my hon. Friend to the reply that my right hon. and learned Friend the Secretary of State gave to my hon. Friend the Member for Wyre Forest (Mr. Coombs) on 14 November at column 193, following which the Government's White Paper on community care entitled "Caring for People" was published.
103. Mr. Matthew Taylor : To ask the Secretary of State for Health if he will make a further statement on the provision of community care for the mentally ill.
Mr. Freeman : Our recent White Paper on community care entitled "Caring for People", published on 16 November, sets out the Government's position on the provision of community care for mentally ill people.
101. Mr. Ashley : To ask the Secretary of State for Health whether the general practitioner services required by disabled people who have left hospitals and institutions to live in the community are considered to be part of a general practitioner's obligation under the National Health Service or to be so exceptional as to require extra payment.
Mr. Freeman : Within the National Health Service, a general practitioner is obliged to provide to his patients all necessary and appropriate personal medical services. This includes arranging for the referral of patients, as appropriate, to any other services provided under the NHS, such as the community nursing services, or by a local social services authority. We have no plans for extra payments to general practitioners for providing these services to disabled patients who are returning to live in the community.
48. Mr. Tom Clarke : To ask the Secretary of State for Health what proposals he has in mind to acknowledge and ascertain the views of carers on policy formulation on community care.
Mrs. Virginia Bottomley : We intend to ensure that representatives of carers are consulted on, and involved in, planning for the implementation of our community care proposals. Officials at the Department meet regularly with national organisations representing carers to discuss matters of common concern and we have already received some initial views on how best to secure the involvement of carers in the implementation process.
Patients
Mrs. Gorman : To ask the Secretary of State for Health how many out- patients are being treated per year by the National Health Service now and what was the figure in 1979.
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39. Mr. Burt : To ask the Secretary of State for Health what is the total number of patients being treated per year by the National Health Service now ; and what was the figure in 1979.43. Mr. Hague : To ask the Secretary of State for Health how many day patients are being treated per year by the National Health Service ; and what was the figure in 1979.
116. Mr. Irvine : To ask the Secretary of State for Health how many in-patients are being treated by the National Health Service at the present time ; and what was the figure in 1979.
125. Mr. Hanley : To ask the Secretary of State for Health how many in-patients were treated on the National Health Service in the years 1978 and 1988.
Mr. Freeman : The information will be contained in a statistical bulletin which is currently being prepared for publication. Copies of the bulletin will be placed in the Library.
Joint Planning
Mr. McAllion : To ask the Secretary of State for Health what steps he is planning to take to improve joint planning in England and Wales.
40. Mr. Ray Powell : To ask the Secretary of State for Health what steps he is planning to take to improve joint planning in England and Wales.
49. Mr. Jack Thompson : To ask the Secretary of State for Health what steps he is planning to take to improve joint planning in England and Wales.
111. Mr. Caborn : To ask the Secretary of State for Health what steps he is planning to take to improve joint planning in England and Wales.
Mrs. Virginia Bottomley : The changes proposed in the White Papers, "Working for Patients" and "Caring for People", provide new and stronger incentives for joint planning. We are currently considering further measures to ensure effective joint planning.
National Health Service Funding
42. Mr. Summerson : To ask the Secretary of State for Health if he will make a further statement on the funding announced for the National Health Service for the year 1990-91.
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56. Mr. Brazier : To ask the Secretary of State for Health how much funding the National Health Service will receive in 1990-91 ; and how much funding it received in 1978-79.
57. Mr. Andrew Mitchell : To ask the Secretary of State for Health what will be the level of funding for the National Health Service in the next financial year ; and what it was in 1979.
79. Mr. Patrick Thompson : To ask the Secretary of State for Health how much the Government will spend on the National Health Service 1990-91 ; and how much it spent in 1978-79.
Mr. Freeman : In 1990-91 the Government plan to spend nearly £22 billion on the National Health Service in England, which taken together with income from land sales, charges and other receipts means that gross expenditure next year will be over £23.3 billion. In addition, if health authorities do no more than they have achieved in recent years they will have a further £150 million from their cost improvement programmes.
In 1978-79 Government spending on the NHS amounted to £6.3 billion and gross expenditure totalled £6.5 billion. Planned expenditure for 1990- 91 represents an increase of 45 per cent. in real terms over and above general inflation.
Mr. Campbell-Savours : To ask the Secretary of State for Health what representations he has received on the level of funding for the National Health Service in the northern region.
Mr. Freeman : We have received no recent representations on the allocation of funds to the Northern regional health authority.
102. Mr. Devlin : To ask the Secretary of State for Health what has been the increase in funding to the National Health Service northern region between 1983 and 1989 ; and what increase has occurred in the number of in- patients, out-patients and day case patients.
Mr. Freeman : The information is given in the tables.
Patients treated in NHS hospitals, Northern regional health authority, 1983 and
1988-89
--------------------------------------------------------------------------------
Change
|1983 |1988-89 |Number |Per cent.
In-patient cases |409,115 |461,033 |51,918 |13
Day cases<1> |66,093 |90,445 |24,352 |37
New out-patients |557,120 |591,378 |34,253 |6
Total out-patient attendances |2,451,627|2,474,700|23,073 |1
<1>1988-89 figure is provisional
Source: 1983, SH3 return, 1988-89 SH3a, KP70, KH09, KH18 returns.
Patients treated in NHS hospitals, Northern regional health authority, 1983 and
1988-89
--------------------------------------------------------------------------------
Change
|1983 |1988-89 |Number |Per cent.
In-patient cases |409,115 |461,033 |51,918 |13
Day cases<1> |66,093 |90,445 |24,352 |37
New out-patients |557,120 |591,378 |34,253 |6
Total out-patient attendances |2,451,627|2,474,700|23,073 |1
<1>1988-89 figure is provisional
Source: 1983, SH3 return, 1988-89 SH3a, KP70, KH09, KH18 returns.
53. Mr. Knox : To ask the Secretary of State for Health what percentage of gross domestic product was spent on the National Health Service in the most recent year for which figures are available ; and what was the percentage in 1978.
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Mr. Freeman : The percentage of gross domestic product spent on the National Health Service was 4.9 per cent. in 1978 and 5.2 per cent. in 1988, the most recent year for which the figures are available.
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Radiation (Compensation)
44. Mr. Speller : To ask the Secretary of State for Health when he will pay the outstanding portion of compensation to those damaged by excessive doses of radiation administered as chemotherapy at the Royal Devon and Exeter hospital, Exeter ; and if he will make a statement.
Mrs. Virginia Bottomley : Settlements are being reached under agreed arrangements between Exeter health authority and representatives of the patients concerned. Some settlements have been made and others are expected to follow shortly. Meanwhile agreed "out of pocket" expenses have been paid without delay.
63. Sir Peter Emery : To ask the Secretary of State for Health on what basis the two senior physicians, who were responsible for the errors that resulted in 207 patients receiving a severe overdose of radiation, have been granted compensation for the loss of their jobs ; and how much compensation has been awarded to each individual.
Mrs. Virginia Bottomley : The severance arrangements for the two physicists concerned are a matter for Exeter health authority.
General Practitioners
50. Mr. John Marshall : To ask the Secretary of State for Health what representations he has received about the general practitioner contract.
Mrs. Virginia Bottomley : I refer my hon. Friend to the reply that I gave to the hon. Member for Leicester, East (Mr. Vaz) on 28 November 1989 at column 222.
71. Mr. John Townsend : To ask the Secretary of State for Health what is the average size of general practitioners' patients lists at the current time ; and what it was in 1979.
104. Mr. David Martin : To ask the Secretary of State for Health how many patients there are on the average general practitioners' list now and in 1979.
Mrs. Virginia Bottomley : The average number of patients on the list of unrestricted principals in England at 1 October 1988 was 1, 999, compared with 2,286 in 1979.
Mr. Kirkwood : To ask the Secretary of State for Health whether he expects new money to be made available for those general practitioners who will work harder in order to gain from the new contract.
Mrs. Virginia Bottomley : General practitioners who work hardest in providing a comprehensive service and thereby attract and keep patients on their lists will be better paid in future. The cost of the new contract is a matter on which the Government is awaiting the advice of the review body on doctors' and dentists' remuneration. The review body's report is expected early in 1990.
Mr. Evennett : To ask the Secretary of State for Health how many general practitioners there are in the National Health Service now and in 1979.
107. Mr. Gale : To ask the Secretary of State for Health what is the number of general practitioners employed by the National Health Service now and in 1979.
Mrs. Virginia Bottomley : The number of unrestricted principals in England at 1 October 1988 was 25,322 compared with 21,357 in 1979.
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85. Sir Geoffrey Johnson Smith : To ask the Secretary of State for Health what is the total number of support staff employed by general practitioners at present and in 1979.
Mrs. Virginia Bottomley : The total number of staff qualifying for direct reimbursement under the ancillary staff scheme increased by 70 per cent. from 33,721 (20,121 whole-time equivalents) in 1979 to 57, 410 (33,863 whole-time equivalents) in 1988. A few general practitioners employ support staff outside the scope of the present scheme ; information about these staff is not collected centrally.
Nurses and Midwives
54. Mr. Alton : To ask the Secretary of State for Health how many regrading appeals by midwives and nurses in England and Wales have been considered ; and how many remain outstanding.
Mrs. Virginia Bottomley : Information on appeals to district health authorities in England is not collected centrally. The position in Wales is a matter for my right hon. Friend the Secretary of State for Wales.
129. Mr. Wigley : To ask the Secretary of State for Health how many representations he has received in support of the Commons Select Committee on Social Services recommendation on midwives' grading ; and if he will make a statement.
Mrs. Virginia Bottomley : We have received a number of representations in connection with the midwives' lobby of Parliament on 23 November. The Government made clear our position on the Select Committee's recommendations in the response that we published in June.
126. Mr. Fearn : To ask the Secretary of State for Health when he last met representatives of the midwifery profession to discuss their grading.
Mrs. Virginia Bottomley : I and my ministerial colleagues have met representatives of midwives on a number of occassions to discuss a range of matters. The issue of grading was specifically raised most recently when the Royal College of Midwives met my right hon. and learned Friend the Secretary of State in December last year.
122. Mr. Anthony Coombs : To ask the Secretary of State for Health how many nurses are employed by the National Health Service now and in 1979.
Mrs. Virginia Bottomley : There were 380,260 whole-time equivalent nursing staff (including agency staff, learners and unqualified staff but excluding midwifery staff) employed in the National Health Service in England at 30 September 1988 compared to 338,070 whole time equivalents at 30 September 1979. The 1979 figure has not been adjusted to take account of the reduction in the nurses working week (from 40 to 37ours) during 1980- 81.
83. Sir Marcus Fox : To ask the Secretary of State for Health how many midwives are employed by the National Health Service now and in 1979.
Mrs. Virginia Bottomley : There were 23,620 whole time equivalent midwifery staff (including agency staff and
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students) employed in the National Health Service in England at 30 September 1988 compared to 20,380 whole time equivalents at 30 September 1979. The 1979 figure has not been adjusted to take account of the reduction in the nurses working week (from 40 to 37ours) during 1980-81.Medical Negligence
55. Sir Michael McNair-Wilson : To ask the Secretary of State for Health how many people received compensation either out of court or after litigation for medical negligence in the past year.
Mrs. Virginia Bottomley : This information is not held centrally and could be obtained only at disproportionate cost.
British Medical Association
58. Mr. Franks : To ask the Secretary of State for Health when he last met the chairman of the British Medical Association ; and what matters they discussed.
131. Mr. Day : To ask the Secretary of State for Health when he last met members of the British Medical Association : and what matters were discussed.
Mrs. Virginia Bottomley : I refer my hon. Friends to the reply that my right hon. and learned Friend the Secretary of State gave to my hon. Friend the Member for Altrincham and Sale (Sir F. Montgomery) and to the hon. Member for Bridgend (Mr. Griffiths) earlier today.
Trent Regional Health Authority
59. Mr. Duffy : To ask the Secretary of State for Health when he next expects to meet the chairman of the Trent regional health authority to discuss allocation of resources to the National Health Service.
Mr. Freeman : At the moment, my right hon. and learned Friend the Secretary of State has no plans to meet Sir Michael Carlisle specifically to discuss resource allocation. However, my right hon. and learned Friend will be meeting all regional chairman in January to discuss a wide range of issues.
Eye Tests
60. Mr. Menzies Campbell : To ask the Secretary of State for Health what research has been carried out on the impact of the number of people seeking eye tests following the introduction of the charge.
Mrs. Virginia Bottomley : We plan to commission a survey shortly into the number of sight tests being carried out. At present the market is still very unsettled and it is too early yet to assess accurately any impact of recent sight testing legislation.
62. Mr. Cummings : To ask the Secretary of State for Health what is his estimate of the reduction in eye examinations following the introduction of charges in the Sunderland, Durham and Hartlepool health authorities.
93. Mr. McCartney : To ask the Secretary of State for Health what is his estimate of the reduction in eye examinations, following the introduction of charges.
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Mr. Lofthouse : To ask the Secretary of State for Health what is his estimate of the change in the number of eye examinations following the introduction of charges.
Mr. Allen : To ask the Secretary of State for Health when the number of general ophthalmic service sight tests carried out since April will be known.
Mrs. Virginia Bottomley : Information is now collected from family practitioner committees on a six-monthly basis. Data for the period April to September 1989 is not yet available ; the Department is still awaiting statistical returns from some family practitioner committees.
Mr. Lewis : To ask the Secretary of State for Health what is his estimate of the reduction in eye examinations following the introduction of charges.
Mr. David Marshall : To ask the Secretary of State for Health what is his estimate of the reduction in eye examinations, following the introduction of charges.
Mrs. Virginia Bottomley : Such estimates have not been made.
Self-governing Hospitals
61. Mr. Michael Brown : To ask the Secretary of State for Health what progress is being made by those hospitals which have expressed an interest in becoming National Health Service self-governing hospitals.
Mrs. Virginia Bottomley : A total of 188 units have expressed interest in NHS trust status. In the reply that my right hon. and learned Friend the Secretary of State gave to my hon. Friend the Member for Maidstone (Miss Widdecombe) on 3 November at columns 389-90 he indicated that 79 units currently intended to prepare draft applications for NHS trust status in 1991. This remains the situation. The decision on whether or not to prepare a formal application for NHS trust status is a matter for the sponsors of the expression of interest in the unit concerned. Applications will not be invited until Parliament has approved the necessary legislation.
Cataract Operations
64. Mr. David Davies : To ask the Secretary of State for Health how many cataract operations each year are being carried out by the National Health Service at the present time ; and what was the figure in 1979.
Mr. Freeman : The estimated number of operations on eye lenses (mainly cataract) performed on in-patients discharged from NHS non- psychiatric hospitals in England in 1986 (the last year for which information is available centrally) and 1979 were 62,200 and 40,110 respectively.
Paramedics
65. Mr. Andrew MacKay : To ask the Secretary of State for Health if he has any plans to set up a new paramedics service separately from hospital drivers.
86. Mr. Colin Shepherd : To ask the Secretary of State for Health what plans he has to restructure the ambulance service.
Mrs. Virginia Bottomley : It is, and will remain, for health authorities to decide the form and extent of patient transport services which best meet their needs.
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Organ Transplants
66. Dame Jill Knight : To ask the Secretary of State for Health what plans he has to improve the supply of human organs for transplant ; and if he will make a statement.
Mr. Freeman : On 16 November I held a seminar on ways of improving the voluntary donation of organs. The discussion covered several alternative approaches to organ donation. Participants discussed the implications of recent research, particularly the audit of deaths in intensive care units which was initiated by the Department of Health. The seminar highlighted a number of questions, mainly of a medical and ethical nature, which require further consideration by those involved in organ donation.
I will shortly be studying the transcript of the proceedings before deciding what further steps may be necessary. I am grateful to my hon. Friend and many others for taking part in the seminar.
Hospital Bed Shortages
67. Mr. Wray : To ask the Secretary of State for Health when he expects present hospital bed shortages to be reduced to 1979 levels.
Mrs. Virginia Bottomley : The treatment of patients is more important than bed numbers. Since 1979, the number of inpatient admissions has risen by over 22 per cent. and the number of day case admissions by over 48 per cent. (both to March 1988), while waiting lists, taken on a comparable basis, have fallen by 6 per cent. (to March 1989).
National Health Service and Community Care Bill
68. Mr. Hayes : To ask the Secretary of State for Health if he will make a statement on the National Health Service and Community Care Bill and services to patients.
99. Mr. Dunn : To ask the Secretary of State for Health if he will make a statement on patient care and the National Health Service and Community Care Bill.
Mrs. Virginia Bottomley : The aim of our proposals is to raise the level of services in all parts of the National Health Service closer to the standards already achieved by the best and so produce a better quality of care for all patients. District health authorities will have the specific responsibility of ensuring the availability of a full range of services for all patients living within their boundaries. They will use contracts to specify the nature and quality of the services to be provided. Hospitals will have more freedom to manage their own affairs and so will be able to respond better and more quickly to individual patients and their general practitioners. Our plans will improve the service on admission to hospital by providing : more reliable appointment times ; better facilities for waiting and counselling ; more information about services available and on clinical matters concerning their own care as well as a wider range of optional extras and amenities.
The effect of these, and the other proposals will be to make the National Health Service more patient conscious and better able to provide high quality services.
North Western Regional Health Authority
69. Mr. Hind : To ask the Secretary of State for Health if he will make a statement on the financing of the North Western regional health authority in 1990-91.
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Mr. Freeman : Allocations to regional health authorities for 1990-91 will be announced later this month in the usual way. All regions will benefit from the extra £2.6 billion resources available for the health service next year in the United Kingdom.
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