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Mental Health
75. Mr. David Nicholson : To ask the Secretary of State for Health what progress has been made on the capital fund for mental health projects.
117. Mr. Robert G. Hughes : To ask the Secretary of State for Health if he will give further details of the capital loan fund for mental health projects.
Mr. Freeman : The intention is that the capital loans fund will operate from 1 April 1990. The total sum committed over the three years from that date will be £50 million. An executive letter is being issued to health authorities, which provides details of the new arrangements and asks for bids by the end of March for the year 1990-91.
General Practitioners (Earnings)
77. Mr. Watts : To ask the Secretary of State for Health if he will state the average earnings of a general practitioner in the current year and the year 1979 ; and if he will make a statement.
Mrs. Virginia Bottomley : The intended average gross income for general medical practitioners was £17,327 in 1979-80 and £45,761 in 1989-90, an increase of 31 per cent. in real terms. The average GP also received an income of £5,955 in 1979-80 in direct reimbursement of certain expenses : the 1989-90 figure is estimated to be £21,475, an increase of 79 per cent. in real terms.
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Homeless People
78. Mr. Blunkett : To ask the Secretary of State for Health what provision he has made for the health care needs of homeless people in 1990- 91 and the subsequent year.
Mr. Freeman : It will be for individual health authorities and family practitioner committees to assess and meet the health care needs of all those, including any homeless, within their areas of responsibility. The Department, however, is funding several voluntary organisations helping the homeless and has funded two projects in London designed to promote new models of primary care. Following an encouraging evaluation, it is hoped that similar schemes will be developed elsewhere, In addition, the Department is examining what further measures could be taken to help those homeless who are mentally ill.
North West RHA
81. Mr. Hind : To ask the Secretary of State for Health how many patients were treated by the North West regional health authority in 1978- 79 and 1988-89 as inpatients, outpatients and day patients ; and if he will make a statement.
Mr. Freeman : The information requested is as follows :
|1979 |1989 |Per cent.
-----------------------------------------------------------------
In-patient cases
(including day cases) |563,787 |809,868 |+43
Day cases |70,608 |136,020 |+93
Out patients (new cases) |699,717 |779,084 |+11
Park Hospital, Liverpool
82. Mr. Terry Fields : To ask the Secretary of State for Health if he will intervene with Liverpool regional health authority to prevent the closure or rundown of Park hospital in the Broadgreen constituency ; and if he will make a statement.
Mr. Freeman : I refer the hon. Member to the reply that I gave the hon. Member for Liverpool, Riverside (Mr. Parry) earlier today.
Regional Health Authorities (Resources)
84. Mr. Colin Shepherd : To ask the Secretary of State for Health if he will give further details of the new system of distributing resources to regional health authorities.
Mr. Freeman : The new system was set out in paragraphs 4.8 to 4.10 of "Working for Patients" and in paragraphs 1.1 to 1.6 of Working Paper 2 : "Funding and Contracts for Hospital Services", copies of which are available in the Library. For further details, I refer my hon. Friend to the replies that I gave the hon. Member for Newcastle upon Tyne, Central (Mr. Cousins) on 10 January at column 663 and today.
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Social Workers
85. Mr. Atkinson : To ask the Secretary of State for Health if he has received any recent representations from the Association of County Councils about a shortage of qualified social workers.
Mrs. Virginia Bottomley : We have no record of recent representations from the Association of County Councils on this issue. We are aware of the problems faced by some local authorities in attracting and retaining suitably qualified staff and of the steps that they, as employers, are taking to improve the position. The response by local authorities to the Department of Health's two training support programmes targeted at staff working with elderly people and those working in the field of child care, indicates that many social services departments will be enabled to increase significantly the number of their staff seconded to social work qualifying courses. The Department will keep under review possible measures to increase intakes to qualifying courses in social work.
Children Act
86. Mr. Caborn : To ask the Secretary of State for Health if he will make a statement on the progress being made with the implementation of the Children Act 1989.
108. Mr. Rees : To ask the Secretary of State for Health if he will make a statement on the progress being made with the implementation of the Children Act 1989.
Mrs. Virginia Bottomley : I refer the right hon. Member to the reply that I gave to the hon. Member for Caerphilly (Mr. Davies) earlier today.
Regional Allocations
Mr. Cousins : To ask the Secretary of State for Health whether, pursuant to his reply to the hon. Member for Newcastle upon Tyne, Central on 10 January, Official Report, column 663, he will publish a table showing in the case of each National Health Service region in 1990-91 (a) the basic allocation for population, (b) the effect of adjusting for morbidity, (c) the effect of adjustments for the relative costs of services to seven age bandings and (d) the damping effect of phasing in the new allocation system over three years.
Mr. Freeman [holding answer 15 January 1990] : The information requested is given as follows in the form of allocation shares of the resources available nationally. Table 1 shows how these shares are changed as the various weighting factors within the new allocation formula are applied and table 2 the effect on 1990-91 of phasing the new formula over three years :
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Table 2
--------------------------------------------------
Northern |6.63 |6.63 |0.00
Yorkshire |7.59 |7.53 |-0.06
Trent |9.51 |9.45 |-0.06
East Anglian |4.02 |3.96 |-0.06
North West Thames |7.41 |7.45 |0.03
North East Thames |8.61 |8.72 |0.09
South East Thames |8.36 |8.23 |-0.13
South West Thames |6.49 |6.49 |0.00
Wessex |5.91 |5.77 |-0.13
Oxford |4.48 |4.56 |0.08
South Western |6.76 |6.65 |-0.11
West Midlands |10.47 |10.59 |0.11
Mersey |5.08 |5.26 |0.16
North Western |8.66 |8.72 |0.06
|-------|-------|-------
Total |100.00 |100.00 |0.00
<1>Over three years.
Table 2
--------------------------------------------------
Northern |6.63 |6.63 |0.00
Yorkshire |7.59 |7.53 |-0.06
Trent |9.51 |9.45 |-0.06
East Anglian |4.02 |3.96 |-0.06
North West Thames |7.41 |7.45 |0.03
North East Thames |8.61 |8.72 |0.09
South East Thames |8.36 |8.23 |-0.13
South West Thames |6.49 |6.49 |0.00
Wessex |5.91 |5.77 |-0.13
Oxford |4.48 |4.56 |0.08
South Western |6.76 |6.65 |-0.11
West Midlands |10.47 |10.59 |0.11
Mersey |5.08 |5.26 |0.16
North Western |8.66 |8.72 |0.06
|-------|-------|-------
Total |100.00 |100.00 |0.00
<1>Over three years.
Tranx Advice Centre
94. Mr. Ashley : To ask the Secretary of State for Health if he has had any further discussions about the means of avoiding the closure of the Tranx tranquilliser advice centre.
Mr. Roger Freeman : No. Officials wrote to Tranx (UK) Ltd in December explaining that, because the statutory authorities are not prepared to fund local elements of the service that Tranx (UK) Ltd provides and given the constraints on central funds, the Department is unable to offer the organisation any further grant aid.
Doctors' Pay
98. Mr. Kirkwood : To ask the Secretary of State for Health when he expects to be in a position to publish his reaction to the pay review body's recommendation on doctors' pay.
Mr. Kenneth Clarke : The doctors' and dentists' review body reports directly to my right hon. Friend the Prime Minister, who will announce the Government's decision in due course.
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Hospital Building
99. Mr. Butler : To ask the Secretary of State for Health if he has any plans for improving value for money in the hospital building programme.
Mr. Freeman : A number of initiatives aimed at improving the value for money of the hospital building programme are already in hand. These include a review of the procedures leading up to the approval of new building schemes, a review of the Department's procedural framework for processing building schemes in the NHS, and a review of project management. Each of these reviews will be reporting this year. The Department will continue to develop its building guidance, which has led to significant improvement in the value for money of new hospital building schemes.
The NHS reforms are expected to provide further incentives to improve the performance of the programme, and the future involvement of the Audit Commission in the NHS will bring the management of the estate, including the building programme, into sharper focus.
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Sarum 89 Group
101. Mr. Key : To ask the Secretary of State for Health whether he will consider further representations from the "Sarum 89" group of doctors in Salisbury, following study of their alternative White Paper on National Health Service reform.
Mr. Freeman : I have now held several useful meetings with the Sarum 89 group and I am grateful for their time and energy. We are always willing to consider fresh representations from this group on the detailed implementation of the Government's proposals to improve the Health Service.
Cervical Cancer
102. Ms. Armstrong : To ask the Secretary of State for Health what discussions he has had with the Northern regional health authority with regard to the incidence of cervical cancer ; and if he will make a statement.
Mrs. Virginia Bottomley : The incidence of and mortality from cervical cancer varies considerably geographically and within various groups within the population. The main strategy for dealing with the disease is through a programme of early detection based on population screening programmes. I understand from the Northern regional health authority that it is well within target in covering its population through a comprehensive screening programme.
109. Mr. Summerson : To ask the Secretary of State for Health what change there has been in the number of deaths from cervical cancer between 1978 and 1988 ; and if he will make a statement.
Mr. Freeman : The information is shown in the table :
Deaths from cancer of the cervix in England and Wales for the years 1978 to 1988 Year |Deaths --------------------- 1978 |2,153 1979 |2,087 1980 |2,068 1981 |2,017 1982 |1,932 1983 |1,959 1984 |1,899 1985 |1,957 1986 |2,004 1987 |1,903 1988 |1,942
North East Thames RHA
105. Mr. Squire : To ask the Secretary of State for Health if he will give details of the hospital capital programme in the North East Thames region for 1990-91.
Mr. Freeman : The capital programme for North East Thames regional health authority for 1990-91 includes the following major schemes : Schemes for which there is a Contractual Commitment
Whittington--Phase 1
Mile End--Geriatric Unit
Chase Farm Enabling Works
Whipps Cross Development
St. Bartholomews--New Theatres
Schemes not yet with a Contractual Commitment
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Princess Alexandra DevelopmentChase Farm Main Development
Goodmayes DGH
Broomfield--Phase VII
Colchester--Phase IV
Bloomsbury--Hospital Development
Broomfield, Colchester and Bloomsbury are subject to the approval of Ministers. Further details of the capital programme can be obtained from North East Thames regional health authority.
Infant Deaths
110. Mr. Michael Brown : To ask the Secretary of State for Health if he will give for the years 1979 and 1988 the rate of infant deaths within the first week of birth and the number of stillbirths.
Mr. Freeman : The information is shown in the table :
Early neonatal mortality rate and the number of stillbirths in
England and Wales for the years 1979 and 1988
|1979 |1988
--------------------------------------------------------------------
Early neonatal mortality rate per 1000 livebirths |6.75 |3.89
Stillbirths |5,125|3,382
Cornwall First Air Ambulance
118. Mr. Harris : To ask the Secretary of State for Health if he will make a contribution to the cost of the Cornwall First Air Ambulance.
Mr. Freeman : It is for local health authorities to determine the level of and extent of services that they provide, taking into account the available resources and the competing demands upon them. However, the Department is funding an evaluation of this local initiative.
General Practitioners
120. Mr. Irvine : To ask the Secretary of State for Health how many general practitioners there are in the National Health Service now ; and how many there were in 1979.
Mrs. Virginia Bottomley : At 1 October 1988 (the latest year for which figures are available) there were 25,322 unrestricted general medical practitioners in England compared with 21,357 at 1 October 1979--an increase of 18.6 per cent.
Mr. Kirkwood : To ask the Secretary of State for Health for how many days general practitioners on duty over a weekend will be expected to work continuously under the new contract for general practitioners.
Mrs. Virginia Bottomley : There are no specific requirements in the GPs' new contract for weekend duties or for working continuously. The responsibility placed upon GPs by regulations to provide all necessary and appropriate personal medical services for their patients on a 24 hours a day basis remains unchanged. Existing arrangements for delegating this responsibility also remain unchanged. The new requirement introduced by the National Health Service (General Medical and Pharmaceutical Services) Amendment (No. 2) Regulations 1989 is that GPs who are full time will be required to be available for surgery consultation and home visits for a minimum of 26 hours a week over five days at times convenient to their patients.
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Hospital Services (Rural Areas)
122. Mr. Latham : To ask the Secretary of State for Health whether he will make a statement on his Department's policy on the provision of hospital services in rural areas.
Mr. Freeman : Small hospitals can play a valuable role in providing a range of services if that is what is needed locally. Under the proposals of the National Health Service and Community Care Bill, district health authorities will have responsibility for ensuring provision of a comprehensive range of services for their resident population. They will be able to take full account of the services offered by small hospitals in deciding where to place contracts.
Human Immunodeficiency Virus
123. Mr. Strang : To ask the Secretary of State for Health what is the latest evidence as to the efficiency of the heterosexual transmission of the human immunodeficiency virus ; and whether he will make a statement.
Mrs. Virginia Bottomley : I refer the hon. Member to my earlier reply to him on 11 December 1990 at column 502. A number of scientific journals have contained articles on this topic ; these include the British Medical Journal (18 February 1989, pp 401-2, 411-15) and "AIDS 1988 2" (supplement 1) pp S49-56, copies of which are available in the Library.
Generic Medicines
Mr. Atkinson : To ask the Secretary of State for Health if he has received any recent representations on the quality control of foreign generic medications, including those from European Community countries ; and if he will make a statement.
Mrs. Virginia Bottomley : We have received no representations to date.
National Health Service Trust, Barnsley
Mr. Illsley : To ask the Secretary of State for Health whether he has received any representations regarding the setting up of a National Health Service trust in Barnsley.
Donor Cards
Mr. Vaz : To ask the Secretary of State for Health how many people were estimated to carry (a) kidney donor cards and (b) other organ donor cards, in each of the last 10 years ; and if he will make a statement.
Mr. Freeman : This information is not available in the form requested.
We now issue a single multi-organ donor card, which makes provision for the donation of individually specified, or all, organs. Different sample surveys produce varying estimates of donor card ownership, but it appears likely that between 20 and 30 per cent. of the general public now possess a donor card. Possession of donor cards has risen substantially over the past decade. A survey carried out in November 1978 found that only 10 per cent. of those questioned possessed a signed card.
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Soviet Union
Mr. Wigley : To ask the Secretary of State for Health what communications he has received from his counterpart in the Soviet Union.
Mr. Kenneth Clarke : I was delighted to meet and host a dinner for Academician Chazov, the Minister for Health of the USSR, during his visit to the United Kingdom as a guest of Her Majesty's Government at the end of October last year, and for Mr. Gromyko, Deputy Minister of Health in the USSR, when he was here last week to discuss health trade matters. I have also received correspondence from Academician Chazov.
Regional Health Authorities
Mr. Vaz : To ask the Secretary of State for Health how many black and Asian people are currently serving on regional health authorities ; and if he will name them.
Mrs. Virginia Bottomley : The information that the hon. Member requests is not available centrally. We do not monitor the ethnic composition of regional health authorities.
NHS Staff
Mr. Vaz : To ask the Secretary of State for Health how many posts in the National Health Service are either nominated by him or need his consultation before they are filled.
Mrs. Virginia Bottomley : My right hon. and learned Friend the Secretary of State does not nominate, nor is he consulted upon, the appointment of staff to posts in the National Health Service. Employment matters are entirely the responsibility of individual health authorities. So far as the appointment of chairmen and members of health authorities are concerned, details of those for which my right hon. and learned Friend the Secretary of State is responsible were given in my reply to the hon. Member for Leicester, East on 12 December 1989 at columns 623-24.
Sterilisation Treatment
Mr. Redmond : To ask the Secretary of State for Health (1) if he will list by district health authority in the Trent regional health authority the waiting times for women patients requesting National Health Service sterilisation treatment ;
(2) if he will list by regional health authority the waiting times from women patients requesting National Health Service sterilisation treatment ;
(3) if he will list by regional health authority, and by district health authority, the waiting times for colposcopy.
Mrs. Virginia Bottomley : Information on waiting time for individual procedures is not collected centrally.
Schizophrenia
Mr. Thurnham : To ask the Secretary of State for Health how many people suffering from schizophrenia have been released from mental institutions (a) in the United Kingdom and (b) in the North West region, during each of the last five years.
Mr. Freeman : The number of discharges of patients treated for a main diagnosis of schizophrenia from
Column 679
National Health Service mental illness hospitals and units for the last five available years, 1982-86, for England and the North Western regional health authority are shown in the table. The figures relate to discharges and cannot be related to individual patients ; a patient may be admitted more than once in a year.
|England |North Western
| RHA
--------------------------------------------------------
1982 |24,594 |2,348
1983 |25,336 |2,331
1984 |25,934 |2,683
1985 |26,225 |2,875
1986 |26,077 |2,621
The figures for Wales and Northern Ireland are a matter for my right hon. Friends the Secretaries of State for Wales and for Northern Ireland respectively. The figures for Scotland are a matter for my right hon. and learned Friend the Secretary of State for Scotland.
Community Pharmacy Contractors
Mr. Sayeed : To ask the Secretary of State for Health why it was decided to retain a cost plus system of remuneration and year-end review for medical practitioners and to terminate arrangements for community pharmacy contractors in England and Wales.
Mrs. Virginia Bottomley : The arrangements for determining the remuneration of the professions providing family practitioner services are designed to reflect the different circumstances of each profession. The "cost plus" system of determining pharmacists' remuneration was brought to an end last year because it provided insufficient incentives to efficiency in the dispensing of medicines. We expect the measures contained in the White Papers "Promoting Better Health" and "Working for Patients" to improve value for money and raise standards of care in general practice.
Under-fives Provision
Mr. Roger King : To ask the Secretary of State for Health what additional moneys he has allocated to voluntary organisations for the small grants scheme for under-fives in this financial year.
Mrs. Virginia Bottomley : I am pleased to announce that the Department has just increased the amount allocated to voluntary organisations for the small grants scheme for under-fives and their families by £101,000. The additional allocations are as shown in the table :
Organisation |Additional
| allocation
|£
----------------------------------------------------------------------------
Pre-School Play Groups Association |50,000
National Council for Voluntary Child Care
Organisation (Child Care) |10,000
National Childminding Association |10,000
National Toy Libraries Association (Play Matters) |11,000
National Playbus Association |10,000
Home Start Consultancy |10,000
This brings the total allocation to £425,000 in 1989-90.
Welfare Milk Scheme
Mr. Madden : To ask the Secretary of State for Health (1) what representations he has received about the effects of changes to the welfare milk scheme ; how many people in Bradford are now receiving weekly milk tokens ; what groups of people are entitled to milk tokens ; what estimates he has made of the number of people in Bradford who will no longer receive doorstep delivery of welfare milk ; and if he will make a statement ;
(2) what representations he has received about the impact upon those engaged in milk distribution from the discounting of welfare milk tokens ; and if he will make a statement.
Mr. Freeman : A period of eight months' consultation and discussion with interested parties preceded the announcement of the price to be paid by the Government for liquid welfare milk. There are no changes in the welfare milk scheme as far as recipients are concerned. Since the announcement my noble Friend Baroness Hooper met representatives of the dairy trade on 10 January to discuss implementation. Specific points about the revised pricing structure were further discussed between officials and the trade on 16 January. Early-day motions have been tabled, seeking reconsideration of our decision, and the regulation bringing the change into effect has been prayed against. In addition, a number of hon. Members have written expressing the concerns of their constituents.
Information about the number of welfare milk beneficiaries by area is not available, but we do not anticipate any changes since the scheme itself remains unchanged. Milk tokens will continue to be issued in respect of pregnant women and children under five in families receiving income support and to handicapped children aged five to 16 who, because of their handicap, are registered at a school. The revised pricing structure does not affect beneficiaries entitlement to welfare milk nor the way in which they choose to obtain it.
Emergency Services
Mr. McFall : To ask the Secretary of State for Health how many departmental employees who are classified as emergency services receive shift allowances and incremental payments.
Mr. Freeman : None, in the Department of Health.
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