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Mr. Scott : A total of 1,069 new claims and 832 review applications have been received to date by the two social security offices serving the Birkenhead area following the decision of the commissioners CI/156/88. These are now being processed.
Ms. Short : To ask the Secretary of State for Social Security if he will give details for the latest available date of how long it takes to process attendance allowance applications from the date of claim to the issuing of a decision.
Mr. Blunkett : To ask the Secretary of State for Social Security from what budget the costs of the new entitlements from April 1991 to income support and housing benefit for residents of independent nursing homes or residential care homes will come.
Mr. Blunkett : To ask the Secretary of State for Social Security if he will set out how the new responsibilities for administration and payment of housing benefit will operate for local authority-sponsored residents who are placed in residential care homes or nursing homes outside the placing authority's boundaries.
Mr. Blunkett : To ask the Secretary of State for Social Security (1) how, from 31 March 1991, an increase in the weekly charge for independent nursing home or residential care home fees will affect the benefit entitlement of an income support claimant with preserved rights (a) if the claimant is already receiving the maximum permitted under the ceiling for that category of care and (b) if the amount the claimant is receiving towards the care element is below the ceiling payment for that category ;
(2) on what basis the ceiling payments for care support in respect of income support claimants in residential accommodation with preserved rights from 31 March 1991 will be increased ;
(3) how the preserved rate of income support will be calculated for residents in residential care homes or nursing homes on 31 March 1991.
Mrs. Gillian Shephard : The Government intend to preserve the present scheme of special income support limits for existing claimants who are resident in most homes when the new funding structure is introduced on 1 April 1991. As now, under those arrangements there will be limits to the level of benefit available for different types of care ; those whose fees are at or below the limit will have their charges met in full. Existing arrangements for reviewing the level of the limits will continue.
Column 345Ms. Harman : To ask the Secretary of State for Social Security if he will publish a table showing the value of income support in 1990 for (a) a single person aged under 25 years, (b) a single person aged over 25 years, (c) a lone parent over 18 years with a child under 11 years, (d) a couple over 18 years with two children under 11 years and (e) a pensioner as a percentage of estimated (i) average net male earnings and (ii) average net male manual earnings.
Mr. Blunkett : To ask the Secretary of State for Social Security what representations have been received from organisations that provide hostel accommodation about the financial difficulties they are experiencing as a result of the changes in income support introduced in April 1989 ; and if he will list the nature and extent of the problems that are being experienced.
Mrs. Gillian Shephard : Changes to income support for hostel dwellers were introduced from 9 October 1989. Since that date we have received a small number of representations about financial difficulties resulting from the change. Most problems appear to have been caused by initial difficulties with the administration of housing benefit. Latest indications are that those problems have now been largely resolved satisfactorily.
Mr. Pawsey : To ask the Secretary of State for Social Security when the hon. Member for Rugby and Kenilworth will receive a reply to his letter dated 21 December 1989 referring to Warwickshire welfare rights service.
Mr. Vaz : To ask the Secretary of State for Social Security what plans the Government have to allow exemption certificates to be backdated for homeworkers if they opt to pay the self-employed contribution ; and if he will make a statement.
Mrs. Gillian Shephard : Those homeworkers who are self-employed can apply in the normal way for a certificate of exception from liability to pay class 2 contributions ; if appropriate, the certificate can be backdated for a maximum of 13 weeks. There are no plans to extend these backdating provisions for any group of workers.
Mr. Squire : To ask the Secretary of State for Social Security how many children are receiving child benefit, broken down into (a) England, Scotland and Wales and (b) the English regions and the cost of paying child benefit in each case.
|England |Scotland |Wales ------------------------------------------------------------------------ Number of children |10,253,000|1,094,000 |623,000 Estimated annual amount of child benefit expenditure |£3,851.0m |£410.9m |£234.0m
Mr. Meacher : To ask the Secretary of State for Social Security when he intends to publish any draft regulations concerning students' entitlement to social security benefits ; which bodies he intends to consult regarding any such changes ; and if he will make a statement.
Mrs. Gillian Shephard : The White Paper "Top-up Loans for Students" outlined proposals for removing entitlement to social security benefits from the majority of full-time students. Draft regulations to give effect to these proposals will be published shortly. They will be referred to the Social Security Advisory Committee in the usual way, and will also be subject to consultation with the local authority associations.
Mr. Meacher : To ask the Secretary of State for Social Security what is the administrative cost incurred per £100 paid in benefit for (a) national insurance retirement benefit, (b) income support, (c) the social fund and (d) housing benefit for the latest available year.
Mrs. Gillian Shephard [holding answer 22 January 1990] : Details of the costs of administering social security benefits are published in the public expenditure White Paper. The following information for 1987-88 has been extracted from the latest edition (Cm. 1014) published on 30 January 1990 :
Column 347(a) national insurance retirement benefit-- administrative cost £1.37 per £100 benefit paid
(b) housing benefit--administrative cost £4.30 per £100 benefit paid.
Income support was introduced in April 1988 and figures for administration costs are not yet available. The social fund was introduced in a limited way in 1987-88 for funeral and maternity payments only but no separate figures are available--the cost for 1987-88 is included in the overall supplementary benefit administrative costs for that year.
Sir Ian Gilmour : To ask the Secretary of State for Social Security if he will publish the information contained in the letter to the rt hon. Member for Chesham and Amersham dated 8 January, showing the estimated numbers of working and out-of-work families with children at different income levels in 1986.
Mrs. Gillian Shephard : The information requested is shown in the tables. For statistical reasons, detailed information of this kind should be treated as free-standing annual analyses and not as a time series.
Table one Number of working families with children at various income levels: Great Britain 1986 Thousands Gross weekly Total One Two One wage Two wage Number of dependent children income parent parent families families excluding state families families benefits £ |1 |2 |3 |4 or more ----------------------------------------------------------------------------------------------------------------- Under 80 |150 |20 |130 |150 |10 |60 |50 |30 |10 80-89 |70 |10 |60 |70 |<1>- |20 |30 |20 |<2>- 90-99 |100 |10 |90 |80 |20 |40 |30 |10 |10 100-109 |110 |20 |90 |90 |20 |50 |40 |10 |<2>- 110-119 |90 |20 |70 |70 |20 |60 |20 |10 |10 120-129 |140 |20 |120 |120 |20 |60 |60 |20 |10 130-139 |120 |20 |100 |80 |30 |60 |40 |20 |<1>- 140-149 |130 |10 |120 |80 |50 |60 |40 |20 |10 150-159 |160 |10 |150 |100 |60 |80 |70 |10 |<2>- 160-169 |160 |10 |160 |110 |60 |90 |60 |10 |<2>- 170-179 |190 |10 |180 |110 |80 |70 |90 |30 |10 180-189 |220 |20 |210 |120 |110 |80 |110 |30 |<2>- 190-199 |210 |10 |200 |110 |100 |90 |90 |20 |10 200-219 |380 |10 |370 |160 |220 |180 |140 |50 |10 220-239 |390 |10 |380 |150 |240 |160 |170 |50 |10 240-259 |390 |10 |380 |140 |260 |150 |170 |60 |10 260-279 |330 |<2>- |330 |110 |220 |140 |130 |50 |10 280-299 |300 |10 |290 |100 |200 |140 |120 |30 |10 300 and over |1,690 |20 |1,670 |480 |1,210 |660 |810 |190 |40 |--- |--- |--- |--- |--- |--- |--- |--- |--- Total |5,330 |230 |5,100 |2,410 |2,920 |2,240 |2,280 |650 |150 <1>- Nil. <2>- Less than 5,000. Notes: 1. The figures are derived from the 1986 Family Expenditure Survey and are subject to sampling error. All figures have been rounded to the nearest 10,000 and so rows and columns may not sum exactly to the totals shown. 2. Gross weekly income is the income reported in 1986 without any updating. 3. A "working family" is defined as one where at least one parent is in full-time (30 hours or more) employment or self employment. 4. The figures exclude any families not living in private households. 5. A "two wage family" is one where the second wage exceeds £4 a week.
benefits being received :
Table Two Number of non-working families of working age with children at various income levels: Great Britain 1986 Thousands Gross weekly income including state benefits |Under |£50 to |£60 to |£70 to |£80 to |£90 to |£100 |£110 |£120 |£130 |£140 |£150 |Total |£50 |£59 |£69 |£79 |£89 |£99 |to |to |to |to |to |and |£109£119£129 |£139 |£149 |over Total |100 |40 |100 |200 |230 |170 |170 |130 |60 |60 |20 |190 |1,460 One parent families |80 |30 |90 |150 |90 |90 |80 |60 |30 |20 |10 |40 |760 Two parent families |20 |10 |10 |60 |130 |80 |90 |70 |30 |40 |20 |150 |700 Number of dependent children: One |70 |30 |80 |130 |140 |50 |40 |20 |20 |10 |10 |40 |630 Two |20 |* |20 |60 |70 |90 |60 |50 |10 |20 |10 |90 |520 Three |10 |10 |* |10 |20 |30 |50 |30 |10 |10 |10 |20 |200 Four or more |- |- |- |* |* |* |10 |20 |20 |20 |10 |30 |110 National Insurance benefits being received: None (a) |40 |10 |10 |10 |20 |20 |30 |20 |20 |10 |* |100 |290 (b) |50 |20 |90 |160 |170 |130 |110 |70 |20 |30 |20 |20 |890 UB (a) |* |* |10 |10 |10 |* |10 |10 |- |- |* |10 |60 (b) |- |- |- |10 |10 |20 |10 |10 |10 |10 |- |10 |70 SB/SSP (a) |- |- |- |- |- |* |- |* |- |- |- |- |10 (b) |- |- |- |- |- |- |- |- |* |- |- |- |* IVB (a) |* |- |- |10 |10 |* |10 |* |10 |10 |- |30 |80 (b) |- |- |- |10 |10 |- |- |- |- |- |- |10 |20 Other (a) |- |10 |- |10 |10 |* |* |10 |- |- |- |10 |50 (b) |- |* |10 |- |* |- |* |- |- |- |- |- |10 (a) without supplementary benefit. (b) with supplementary benefit. - nil. * less than 5000. Notes: 1. The figures are derived from the 1986 Family Expenditure Survey and are subject to sampling error. All figures have been rounded to the nearest 10,000 and so rows and columns may not sum exactly to the totals shown. 2. The totals do not coincide exactly with other published statistics. This is due to the different data sources. 3. Income is gross of taxes and national insurance and is the income reported in 1986 without updating. 4. A "non-working family" is defined as one where neither parent is in full-time employment or self employment. 5. The figures exclude any families not living in private households. 6. "Other" National Insurance benefits include industrial disablement and widows benefit.
Table 3 Non-working families of working age with children not in receipt of supplementary benefit (Great Britain 1986) Gross weekly income |Not en- |Entitled but |Total including state benefits |titled to |not claim- |supplemen- |ing sup- |tary benefit |plementary |benefit £ ----------------------------------------------------------------------------------------------------------------------------- Under 50 |<1> |50 |50 50-59 |10 |10 |20 60-69 |10 |10 |10 70-79 |30 |10 |30 80-89 |30 |20 |40 90-99 |30 |- |30 100-109 |50 |<1> |50 110-119 |40 |<1> |40 120-129 |30 |<1> |30 130-139 |20 |- |20 140-149 |10 |- |10 150 and over |140 |10 |150 |-- |-- |-- Total |360 |110 |470 <1> Less than 5,000. Notes: 1. The figures are derived from the 1986 Family Expenditure Survey and are subject to sampling error. All figures have been rounded to the nearest 10,000 and so rows and columns may not sum exactly to the total shown. 2. Income is gross of taxes and national insurance and is the income reported in 1986 without updating. 3. A "non-working family" is defined as one where neither partner is in full-time employment or self employment. 4. The figures exclude any families not living in private households. 5. Inferences cannot be drawn from the number of non-working families with children entitled but not claiming supplementary benefit about the take-up of supplementary benefit.
Column 350January 1987 ; and whether there has been any change in the interpretation of the existing regulations governing the granting of an abridged product licence.
Mrs. Virginia Bottomley : Since January 1987 there have been changes in the data required from applicants in support of an abridged product licence application. This is as a result of directive 87/21/EEC which amended directive 65/65/EEC and new guidelines issued by the EC Committee on Proprietary Medicinal Products entitled "Rules Governing Medicinal Products in the European Community", a copy of which is in the Library. Medical, pharmaceutical and other scientific interpretation of existing regulations was adapted to reflect the revised EC requirements.
Mr. Alfred Morris : To ask the Secretary of State for Health, pursuant to his reply of 18 January, Official Report, column 405, to the right hon. Member for Manchester, Wythenshawe, what information his Department has on the employment prospects, insurance and mortgage status of people who acquired AIDS from blood transfusions under the National Health Service ; and whether the ex gratia payment of £20,000 to people with haemophilia who contracted the virus will be paid in each case of infection if more than one member of a family is infected.
Mrs. Virginia Bottomley [holding answer 31 January 1990] : The Government's decision to make ex gratia grants to people with haemophilia who are also infected with the AIDS virus was a recognition of their unique position. I refer the right hon. Member to the reply my
Column 351right hon. and learned Friend the Secretary of State gave my hon. Friend the Member for Salisbury (Mr. Key) on 23 November 1989 at columns 11-12. A £20,000 lump sum payment will be made to each haemophiliac infected with HIV. In co-operation with the trustees of the MacFarlane Trust a new discretionary trust has been set up and is now making payments.
Mr. Freeman : Research related to Friedrich's Ataxia is currently being supported by the Medical Research Council and in 1988-89 the total cost of research projects which were relevant to Friedrich's Ataxia amounted to £197,000. The Medical Research Council is always willing to consider further soundly based proposals for research funding in competition with other applications. The MRC, which receives grant in aid from the Department of Education and Science, is the main Government agency for the promotion of biomedical and clinical research in the United Kingdom. The Department of Health is not currently funding any research on this subject.
Mr. Henderson : To ask the Secretary of State for Health what was the outcome of his Department's consultation on the draft code of practice on "Communicating information to patients and their access to their own manual health records" ; and if he will make a statement.
Mr. Freeman : Following consultation with the medical profession, it was accepted that a draft code of practice on "Communicating information to patients and their access to their own manual health records" could be used as the basis for a wide consultation exercise, although there was no formal approval of or agreement to it. The draft code was circulated on 23 May 1989 to a wide range of health professional and patient interests bodies and to health authority management. Twenty-five copies of the consultation papers were issued. Some recipients incorporated within their responses comments received from their constituent members. Others copied the document to other interested parties who responded on their own account. Overall, 52 separate responses were received.
From five of the six responses received from bodies representing the medical profession, it is clear that the majority of the profession remains firmly opposed in principle to patients having a right of access to their own health records. It believes that it would be harmful to patients, would result in less comprehensive records, would seriously affect the trust between doctor and patient and would divert resources from patient care. These views are held particularly strongly by the JCC and the GMC. The GMSC's reply to the consultation drew our attention to the conference of local medical committees resolution passed in 1988
"That this conference rejects the principle of open access to their records by patients".
The sixth respondent body regarded the principles as acceptable, on the assumption that doctors could keep separate personal notes, whilst recognising that the
Column 352character of medical record-keeping would be affected. One individual doctor also expressed his opposition to the principle. Of the other 45 respondents, some of whom offered detailed comments including reservations about resource implications, the need to secure co-operation by doctors, procedural difficulties, training requirements and the need for time to allow for administrative and organisational changes, not one has taken a stance against the principle of access to manual records by or on behalf of patients. The Campaign for Freedom of Information doubts whether the medical profession would effectively implement access to medical records on a non-statutory basis. It takes as evidence of the profession's deep-seated resistance to access the fact that it has taken two years to produce even minimum proposals. The Campaign for Freedom of Information has therefore produced a draft Bill aimed at securing statutory rights of patients' access. It has subsequently been adopted as a private Member's Bill by the hon. Member for Newcastle upon Tyne, North (Mr. Henderson). Twelve other respondents share the Campaign for Freedom of Information's view that anything short of legislation will be inadequate and that access can only be assured only by statutory provision. A number of these as well as some hospital and Health Service organisations have given their public endorsement to the Campaign for Freedom of Information's draft Bill. The concerns of the medical profession--that greater access by patients to their records will affect the quality of medical record-keeping to the ultimate disadvantage of both patient and doctor--were brought to the attention of non-medical parties to the consultation exercise. Nevertheless, there is a clear balance of opinion in support of a right of access.
Mr. Simon Burns : To ask the Secretary of State for Health if he will place in the Vote Office a copy of the White Paper he has published on the future of the registration service in England and Wales ; and if he will make a statement.
Mr. Freeman : Yes, the White Paper entitled "Registration : proposals for change", Cm 939, makes recommendations for reforming the system for registering births, marriages and deaths in England and Wales on lines already canvassed in a Green Paper and widely welcomed in consultation.
The White Paper proposes a clear management structure for the registration service, under which its day-to-day running will be squarely in local authority hands while the Registrar General retains responsibility for setting national standards of performance. An end will be made to the legal restrictions on the duties of registrars which at present lessen its cost- effectiveness and the quality of service it can offer to the public. Alongside these structural changes there are proposals which will allow people to marry in any registration district in England and Wales and offer a new choice over the buildings in which civil marriages may take place. The standard period of notice which must be given for a marriage will come down
Column 353from 21 days to 15, but a notice which is given longer in advance will remain valid for six months, rather than three as at present. There will also be changes in all registration procedures to improve the statistical information which is then obtained. Still-birth registrations will be aligned more closely with the procedures for registering deaths, in accordance with the wishes of the parents concerned. A new system will be introduced for notifying deaths which will save informants having always to travel to the district where the death took place in order to register it. There will be short certificates available for death or still-birth, alongside the existing short birth certificate. And there will be an extension of the arrangements whereby Welsh speakers can obtain bilingual certificates of birth and death, so that these are no longer confined to events taking place in Wales.
Finally, the White Paper proposes a distinction between historic registration records--those at least 75 years old--and more recent ones. Although access to all records will be maintained through a right to buy non-official copies of them, there will be new rules governing the purchase of certified copies of recent records for use for official purposes. These will help to curb an abuse which has arisen. By contrast, it is intended that information from the older registration records will be entirely within the public domain. It will be possible to buy either certified or non-official copies of certificates of events which occurred 75 years ago or longer, and it is also proposed that an agency outside the Government should hold copies of these records and provide the browsing facilities which are sought by genealogists, researchers and historians.
Response to the earlier Green Paper shows there will be a widespread welcome for the White Paper proposals. They will modernise and improve the registration service by giving it a new flexibility to respond to public wishes, while at the same time so improving its efficiency as to secure a reduction in its net cost locally and centrally. Nearly all of the changes envisaged will require legislation for their implementation, and the Government hope to introduce this at an early date. Meanwhile, I commend them most strongly to the House.
Mr. Cousins : To ask the Secretary of State for Health, pursuant to his reply of 15 January to the hon. Member for Newcastle upon Tyne, Central, Official Report , column 86 , how many visits were undertaken by regional medical officers each year since 1984 and in which National Health Service regions ; what was his basis for the estimate of saving per practice ; whether the PACT data for the 2,800 practices referred to confirm those savings ; and what was the expenditure per patient on practice lists of the 2,800 practices referred to in each year since 1984.
Mrs. Virginia Bottomley : The number of visits by region to high- cost practices undertaken by regional medical officers is given in my reply to the hon. Member on 16 January, at columns 197-98 . The estimates of savings per practice following a visit to a high-cost practice are based on a comparison of practice prescribing costs before and after the visit using PACT data. Information on the cost per patient for the practices mentioned since 1984 can be obtained only at disproportionate cost.
Mr. Blunkett : To ask the Secretary of State for Health if he will present the information in chart 6 entitled : Estimated cumulative rate of transfer of DSS Care Expenditure in the White Paper, "Caring for People" (Cm. 849) in the form of a table.
Mrs. Virginia Bottomley : The White Paper "Caring for People", Cm. 849, made it clear that the information illustrated in chart 6 was to be kept under review as more detailed information became available. We are currently considering relevant evidence. I will write to the hon. Member when the review has been completed.
(2) pursuant to the answer to the hon. Member for Sheffield, Brightside of 25 January, Official Report, column 857, whether he has considered collecting waiting list figures for audiology and related services at a national level to assist in determining the use of resources to reduce those waiting lists.
Mrs. Virginia Bottomley : In-patient waiting list figures for the specialties of audiological medicine and ear, nose and throat are collected centrally. At 31 March 1989 there were no patients waiting for either in- patient or day case treatment in audiological medicine. We do not collect centrally figures on out-patient waiting lists but health authorities will have these locally as part of their management of local services.
Decisions on the use of resources to reduce waiting lists in particular specialties are for regional and special health authorities to take in the light of local circumstances. Resources available to them include their allocation from the waiting list fund to help tackle the problem of long waits for hospital treatment. Since 1987 regions have used nearly £5.5 million from the fund to treat additional patients in the ear, nose and throat specialty.
Mrs. Virginia Bottomley : There will be a single formal transfer of provision from DSS to local authorities in the 1990 public expenditure survey, covering the years 1991-92, 1992-93 and 1993-94. Provision for both social security and local authorities in subsequent surveys will be determined in the light of the declining number of cases with preserved entitlement under social security rules and the rising demand for local authority services, including demographic changes.
Mr. Blunkett : To ask the Secretary of State for Health whether the placing authority for local authority-sponsored residents placed outside its own boundaries will be responsible for meeting the full costs of the placement by making a payment direct to the establishment ; whether
Column 355the placing authority or the authority where the establishment is based will be responsible for the calculation and payment of the housing benefit ; and if housing benefit paid by the authority where the home is based will be paid direct to the placing authority.
Mrs. Virginia Bottomley : As the White Paper "Caring for People" indicates, the local social services authority which arranges residential or nursing home care will be responsible for meeting the fees agreed with the home, whether this is within its area or not. Housing benefit is a matter for my right hon. Friend the Secretary of State for Social Security, but I understand this will be claimed, as now, from the local housing authority in whose area the home is situated. Precise details of the way income support and housing benefit will be paid are still under consideration.
Mr. Michael Morris : To ask the Secretary of State for Health (1) what was the actual average pharmaceutical company return on capital on sales to the National Health Service under the pharmaceutical price regulations scheme in respect of the years 1981 to 1988 ; (2) what was the average allowable target return on capital on sales to the National Health Service in respect of pharmaceutical companies operating within the pharmaceutical price regulations scheme for each year 1979 to 1989.
Mr. Freeman : The joint evaluation of the resource management initiative six pilot schemes has not been concluded by the Department and the joint consultants committee. The Department is also funding an independent evaluation of the resource management initiative by the health economics research group, Brunel university. Its interim report was published on 18 July 1989. In addition, the Department helped to defray the cost of disseminating the central consultants and specialists committee evaluation of the initiative's six pilot sites. This report was published in October 1989. Copies of both these reports are being placed in the Library.
Column 356transferred from Sefton general hospital to Mossley Hill hospital between December 1989 and January 1990 ; and if he will make a statement.
Mr. Freeman : The Liverpool health authority has already inquired into this and is satisfied that there is nothing to link the deaths of these patients with their transfer from Sefton general hospital to Mossley Hill hospital. These moves were carried out under proper medical supervision and were part of the health authority's carefully planned strategy for rationalisation of geriatric services in the district.
Mr. Doran : To ask the Secretary of State for Health what is the latest information he has on live births and survival at low gestational age, and on live births with estimated gestation of less than 28 weeks, in England and Wales.
Mr. Alton : To ask the Secretary of State for Health whether the following hospitals and clinics in London are licensed to carry out abortions (a) Humana hospital, (b) Cromwell hospital, (c) Hallam medical centre, (d) IVF centre, 100-146 Harley street and (e) Churchill clinic.
Mr. Martlew : To ask the Secretary of State for Health if he will give the latest figures available on the costs to the National Health Service of (a) dental care, (b) treating strokes, (c) treating heart disease and (d) treating cancer ; and if he will make a statement.
Mr. Freeman [holding answer 21 December 1989] : The cost to the NHS of dental care provided by general dental practitioners in England was £674.1 million in 1988-89. This figure includes £14.8 million administration expenditure by the Dental Estimates Board. I regret that information on the precise costs to the National Health Service of treating strokes, heart disease and cancer is not available. However the Department has estimated that the costs in England in 1988-89 were of the order of :
|£ million ----------------------------------------------------------------- Strokes (Cerebrovascular disease) |650 Heart disease (including chronic rheumatic, ischaemic and other forms of heart disease |900 Cancer |1,000 Notes: 1. Estimates include in-patient, out-patient and primary care costs. 2. Estimates derived from costing and activity data from various sources.
Column 357copies of the information that supports the deduction in the Library ; and to which other English National Health Service regions sums equivalent to that amount were given.