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much time should be spent on it. The Government are making available additional resources--£31 million in 1990-91--to ensure that medical audit is adequately supported and that doctors are able to participate in it without detriment to their other duties.Leukaemia and Lymphoma (West Cumbria)
Dr. Cunningham : To ask the Secretary of State for Health whether he has received the results of the case control study of leukaemia and lymphoma in young people resident in West Cumbria recommended in the report of the independent advisory group chaired by Sir Douglas Black in 1984.
Mr. Freeman : Yes. The results of the case control study, which was commissioned and funded by the Department of Health, have been published today. I am arranging for copies to be placed in the Library.
The study was undertaken by the Medical Research Council epidemiology unit at Southampton, in response to the first recommendation of the Black advisory group's report on cancer incidence in West Cumbria.
The study documents an association between the excess of leukaemia and non- Hodgkin's Lymphoma in children living in the vicinity of Sellafield, and employment of the fathers of the affected children at Sellafield over the period 1950 to 1985.
In particular, the study documents an association between the raised incidence in children of leukaemia and non-Hodgkin's Lymphoma and the recorded level of external radiation dose received by the father before conception of the affected child.
The Government note with concern the results of the study, and recognise the anxieties that it must cause to those who might be at risk. In view of its importance, the results have been referred to the Committee on Medical Aspects of Radiation in the Environment (COMARE) for its urgent consideration and preliminary advice, following its next meeting in March.
COMARE will also be considering the study in conjunction with the results of other studies, completed, under way or planned, recommended in the Black report or by COMARE in its second and third reports, and accepted by Government.
The following studies, which have been funded by Government, have already been completed :
Birth and School Cohort Studies in the area around Sellafield'. A reanalysis of the data from the Northern Children's Cancer Registry'.
Other relevant studies already under way include :
A case control study of young people registered as cases of leukaemia or lymphoma in the Dounreay area'.
Birth and School Cohort Studies in Thurso and around Dounreay'. A case- control study of childhood leukaemia and other cancers in West Berkshire and North Hampshire, in which the Ministry of Defence establishements at Aldermaston and Burghfield are situated'. Finally, plannned work includes detailed epidemiological studies to obtain more information on the possible health effects in the offspring of parents occupationally exposed to radiation. These studies should start in the near future.
In addition, subject to the agreement of the individuals concerned, the Health and Safety Executive will set up an
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investigation which will be conducted by the Nuclear Inspectorate in co-operation with British Nuclear Fuels plc and the workforce. This investigation will examine in detail both the internal and external radiation doses, and chemical occupational exposure histories, of the parents of the affected children. This may help in identifying any common factors which may be relevant.In the meantime, the nuclear industry will wish to consider this report and the possible implications for its workforce, including the need for counselling.
I am advised that the average annual external radiation doses for workers at Sellafield during the late 1960s and the early 1970s were in the range about 12-13 millisieverts (mSv).
Improvements in plant design and radiation protection standards in the 1970s and 1980s have led to a substantial reduction in average external radiation doses, with four-fold reduction between 1974 and 1989. For 1989 the average annual external dose was about three mSv. The current statutory annual dose limit for people occupationally exposed to radiation is 50 mSv. The National Radiological Protection Board advised, following new data on cancer induction in exposed individuals, that doses should be kept below 15 mSv per year on average, over a number of years.
The Health and Safety Commission has recently issued a consultative document containing proposals to carry this recommendation forward, by the institution of an investigation into the individual circumstances whenever the average is exceeded. The consultative document also stresses for the same reason the increased need to keep doses as low as reasonably practicable.
Interpretation of this study is not straightforward. Until the results have been confirmed or not, and possible mechanisms elucidated, no definitive statement can be made on the possible risk to individuals.
If the effects are demonstrated to be related to external radiation, then on the basis of the evidence from annual doses, only workers receiving relatively high doses might be at risk. There would be a limited number of such workers in the nuclear industry and industries using industrial radiography. COMARE has been asked to advise on this and will report in due course.
(1) Investigation of the possible increased incidence of cancer in West Cumbria'--Report of the Independent Advisory Group, Chairman : Sir Douglas Black. HMSO 1984.
(2) Investigation of the possible increased incidence of leukaemia in young people, near the Dounreay Nuclear Estabishment, Caithness, Scotland'-- COMARE 2nd Report. HMSO 1988.
(3) Report on the incidence of childhood cancer in the West Berkshire and North Hampshire area, in which are situated the Atomic Weapons Research Establishment, Aldermaston, and the Royal Ordnance Factory, Burghfield'-- COMARE 3rd Report. HMSO 1989.
Food Safety
Mr. Knox : To ask the Secretary of State for Health if he will make a statement on the report of the Richmond committee on the microbiological safety of food.
Mr. Kenneth Clarke : Sir Mark Richmond submitted to Ministers on 18 January part 1 of his committee's report. It is being published today.
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In this part, the committee has examined the incidence of food poisoning and its main causes (salmonella, campylobacter and listeria), outbreak management, surveillance arrangements, food manufacture, the poultry meat industry and the general legislative framework. My colleagues and I welcome it as a constructive and thorough document. We shall follow up positively its many useful recommendations. We trust that others to whom recommendations are addressed, in particular the food industry and environmental health authorities, will examine it to see how the level of food safety in this country can be further raised. We shall certainly draw it to their attention.The committee's proposals for licensing in due course go further than the Government feel to be necessary. We do, however, see the value of the committee's views on prior notification and we intend to introduce a simple system of prior registration which would not impose unnecessary administrative burdens, but would help business and enforcement authorities alike.
The report indicates support for the Government's Food Safety Bill which the committee felt accommodates many of its views. Because we believe that many of the recommendations in the report call for early action and some are relevant to the Food Safety Bill now before Parliament, the Government have decided to publish their immediate response to the recommendations. This is set out in a paper which is being put into the Library.
My right hon. Friends and I are most grateful to the committee for its hard work so far. It has stated that in part 2 of its report it will examine the arrangements for Scotland and Northern Ireland ; catering, retailing and the home ; and other important foods. We are therefore extending the committee's life and asking it to finish its work by 31 July 1990.
Halifax General Hospital
Mrs. Mahon : To ask the Secretary of State for Health whether the new Halifax general hospital will be built within the current timetable.
Mr. Freeman : Subject to the determination of its capital programme by the regional health authority, the project for the new Halifax general hospital, now known as Calderdale district general hospital, is programmed to start on site in December 1992 and is due for completion in December 1995.
Nursing Students
Mr. Kennedy : To ask the Secretary of State for Health whether he has any plans to uprate the bursaries paid to nursing students pursuing Project 2000 courses of nursing education in the light of the report of the review body on nurses' pay.
Mrs. Virginia Bottomley : I cannot add to the reply that I gave to the hon. Member on 4 December 1989 at column 69.
Wakefield Health Authority
Mr. Hinchliffe : To ask the Secretary of State for Health (1) if he will call for a report from the chairman of Wakefield health authority on how many functions have been held by the authority to give time out to senior
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managers in order to consider management structure within a possible self-governing trust ; where these functions were held ; and what was the full public cost ;(2) if he will call for a report from the chairman of Wakefield health authority as to when the district finance officer of the authority was informed in writing of his suspension from duty ; (3) if he will call for a report from the chairman of Wakefield health authority on why the locks on the door of the office of the district finance officer of the authority were changed shortly after his recent suspension from duty ;
(4) if he will call for a report from the chairman of Wakefield health authority on the reasons for the suspension from duty of the district finance officer of the authority ; and if he will make a statement ;
(5) if he will call for a report from the chairman of Wakefield health authority as to why senior managers of the authority spent the night of 12 February at the Crown hotel, Boroughbridge, North Yorkshire ; what was the purpose of their stay and the full cost to be met from public funds ; and whether he will make a statement ; (6) if he will set up an independent inquiry into the circumstances leading up to the suspension from duty of the district finance officer of Wakefield health authority.
Mrs Virginia Bottomley : These are matters for local management who are currently dealing with them.
Mr. Hinchliffe : To ask the Secretary of State for Health if he will make it his policy to instruct his Department's director of audit to carry out a full audit of Wakefield health authority's hospitality account and to make the report public.
Mrs. Virginia Bottomley : My right hon. and learned Friend the Secretary of State does not intend to instruct the Department's director of audit to carry out an audit of the Wakefield health authority's hospitality account.
Wandsworth Health Authority
Mr. Nigel Griffiths : To ask the Secretary of State for Health if he will list the increase or decrease in the numbers of (a) bed spaces, (b) wards and (c) hospitals in the Wandsworth health authority area since 1986.
Mr. Freeman : Between 1986 and 1989 the average daily number of beds available fell from 2,234 to 2,095 and the number of hospitals in the district fell from 5 to 4. Similar information on wards is not held centrally and the hon. Member may wish to contact the chairman of Wandsworth health authority.
Mr. Nigel Griffiths : To ask the Secretary of State for Health (1) if he will list the underspend or overspend figures for Wandsworth health authority's budget on a monthly basis between January 1985 and October 1989 ;
(2) if he will place in the Library the accounts of Wandsworth health authority covering (a) 1986, (b) 1987 and (c) 1988.
Mr. Freeman : The detailed financial budget information requested is not collected centrally. I refer the hon. Member to the chairman of the Wandsworth health authority, who may be able to assist with the information sought and supply copies of the authority's annual accounts.
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NHS Funding
Mr. Robin Cook : To ask the Secretary of State for Health if he will place in the Library copies of all correspondence from his Department to the National Health Service units on the issues of the National Health Service trust and general practitioner fund holding.
Mr. Robin Cook : To ask the Secretary of State for Health if he will publish a table in the Official Report showing the relevant figures in table 13.3 of Cm 1013 adjusted by the hospital and community health service current, hospital and community health service capital and the FPS current pay and price deflators to the year 1988-89.
Mr. Freeman : The information requested is contained in the reply which I gave the hon. Member on 13 February at columns 157-59 .
ENVIRONMENT
Devon County Council
Sir Peter Emery : To ask the Secretary of State for the Environment what advice he is willing to give to Devon county councillors before they decide on their projected budget for 1990-91 ; and what is his assessment of the opportunity for them to make a change in their budget.
Mr. Chris Patten : In setting their budget the councillors should take a hard look at the services the county council provides, and make sure that they are satisfied that charge payers will be getting full value for money. They should consider whether they can justify the proposed expenditure on each of these services to their charge payers, and look into the scope for contracting services out where this would be more efficient. The key point that they should bear in mind is that £1 saved is £1 off the community charge.
Local Government Finance
Mr. Rooker : To ask the Secretary of State for the Environment when he expects to reply to the letter from the hon. Member for Birmingham, Perry Barr dated 23 November 1989, which asked for a response to the statement by the leader of Birmingham city council on the revenue support grant settlement and its implications for poll tax in Birmingham.
Mr. Chope : My hon. Friend the Minister for Local Government and Inner Cities, wrote to the hon. Member on 12 February.
Mr. Austin Mitchell : To ask the Secretary of State for the Environment whether his November estimate of the amount of poll tax payable in 1990-91 per adult compared to rates took account of any transitional reliefs.
Mr. Chope : The provisional assumed charges published on 6 November, and the assumed charges published on 11 January, include safety net contributions or receipts and any transitional special grant but take no account of community charge benefit or transitional relief, which are paid to individuals, not to areas. The effect of community
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charge benefit and transitional relief is that charge payers in receipt of either or both will pay less than the personal community charge for the area.Mr. Fraser : To ask the Secretary of State for the Environment what criteria he will adopt when giving consideration to the capping of the poll tax.
Mr. Chope : I refer the hon. Member to the answer I gave to the hon. Member for Bradford, North (Mr. Wall) on 24 January at column 739.
Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will list the number and weighting of all indices of need in the grant-related expenditure and standard spending assessment and the effect of the changes made in both on the financial allocations.
Mr. Chope : The formula used to calculate grant-related expenditure assessments for 1989-90 was set out in the Rate Support Grant Report (England) 1989-90, approved by the House on 19 December 1988. The formulae for assessing standard spending assessments are set out in the Revenue Support Grant Distribution Report (England), debated in the House on 18 January 1990. The new
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standard spending assessments are the result of extensive research and discussion with local authority representatives. They are composed of fewer elements than grant-related expenditure assessments and each element is based on understandable factors of direct relevance to the services provided by local authorities.Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will give the grant-related expenditure allocations 1989- 90 and the standard spending assessments allocations for 1990-91 for each district in Humberside and the percentage increase or decrease ; and if he will explain the reasons for the divergence.
Mr. Chope : The table provides the information requested. Standard spending assessments follow from extensive research and discussion with local authority representatives. They are composed of fewer individual service elements than grant-related expenditure assessments, with each element based on simple understandable factors of direct relevance to the services provided by local authorities.
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1990-91 SSAs-Cash changes from adjusted 1989-90 GREs
|1989-90 GRE |Adjusted 1989-90|1990-91 SSA |Cash change
|GRE |(column 3 minus
|column 2)
|£ million |£ million |£ million |Per cent.
|(1) |(2) |(3) |(4)
--------------------------------------------------------------------------------------------------------
Beverley |5,161 |5,063 |5,624 |11.1
Boothferry |3,633 |3,487 |4,743 |36.0
Cleethorpes |4,760 |4,653 |4,617 |-0.8
Glanford |4,117 |4,036 |4,932 |22.2
Great Grimsby |7,622 |7,347 |7,019 |-4.5
Holderness |2,483 |2,425 |2,994 |23.5
Kingston upon Hull |27,416 |26,223 |25,149 |-4.1
East Yorkshire |4,448 |4,307 |5,071 |17.7
Scunthorpe |4,750 |4,468 |4,365 |-2.3
Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will give the scaling factors used to calculate stages 2 and 3 of the standard spending assessment, specifying how they were arrived at ; and if he will show how they were used in arriving at the standard spending assessment for Grimsby borough council.
Mr. Chope : The method used to calculate the scaling factors for standard spending assessments is set out in paragraph 3.3 of section 3 of the Revenue Support Grant Distribution Report (England), approved by the House on 18 January. The factors used in deriving the SSA for Great Grimsby are :
Other Services
Other Services--District level : 0.9999
Other Services--County level : 1.1047
Flood Defence : 1.0124
Coast Protection : 1.0193
Interest Receipts : 0.0287
Capital Financing
Debt Charges : 0.9569
Capital Expenditure Charged to Revenue Account : 0.3014 Interest on Capital Receipts to shire districts : 0.3926 Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will list the factors and indicators taken into account in assessing (a) grant-related expenditure allocations and (b) standard spending assessments and his reasons for the differences between the two.
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Mr. Chope : I refer the hon. Member to the answer I gave him today.
Mr. Austin Mitchell : To ask the Secretary of State for the Environment what were the grant-related expenditure allocations for Grimsby for 1986-87 to 1989-90, together with his proposed standard spending assessment figures of November 1989 and his final standard spending assessment figures in January ; and if he will outline the reasons for the differences between the last two.
Mr. Chope : The figures requested for Great Grimsby are as follows :
Grant Related
Expenditure
Assessment
|£000's
----------------------
1986-87 |7,288
1987-88 |6,855
1988-89 |6,969
1989-90 |7,622
The figures for 1986-87 to 1988-89 are those determined in the latest supplementary report for the relevant year. The 1989-90 GRE is a settlement figure.
The standard spending assessment (SSA) for Great Grimsby issued as part of the November consultation was £7.053 million. The final SSA is £7.019 million. The main
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reason for the difference is the replacement of an estimated credit approval used in calculating the capital financing element with a figure based on actual credit approvals.Mr. Hayes : To ask the Secretary of State for the Environment whether the Government's spending assumption for the area safety net and the community charge transitional relief scheme and the figures for assumed spending by local authorities in England in 1990-91, issued by his Department on 11 January, represent the amount he considers it appropriate for each authority to spend in 1991.
Mr. David Hunt : No. It is an authority's standard spending assessment (SSA) for the year which is intended to represent the amount of revenue expenditure which it would be appropriate for the authority to incur in that year to provide a standard level of service consistent with my right hon. Friend the Secretary of State's view of the amount of revenue expenditure which it would be appropriate for all authorities to incur. This latter amount is net total standard spending, as defined in the Revenue Support Grant Distribution Report (England), which the House approved on 18 January 1990.
The Government's spending assumption--and the assured charge based on it-- does not represent the Government's view of what an authority could or should spend or charge. Nor does it represent a Government target or guideline for, or a prediction of, spending and charges by individual local authorities next year. The spending assumption, based on 1989-90 rate income and grant, adjusted for changes in function and increased to be consistent with total standard spending of £32.8 billion for 1990-91, is a reference point for the calculation of the area safety net and of the assumed charge for the purposes of the transitional relief scheme. Both of these measures are designed to give an appropriate degree of protection from changes arising from the move from the old system to the new. They are not designed to protect people from changes arising from individual authorities' spending decisions for which they are accountable to their electorate.
Mr. Patrick Thompson : To ask the Secretary of State for the Environment if he will estimate the distribution of changes in the percentage of net income paid in (a) domestic rates in 1989-90 and (b) community charge in 1990-91, if community charges are set at the level assumed for the calculation of 1990-91 revenue support grant entitlements.
Mr. David Hunt : I have today placed in the Library a note updating figures on the impact on household finances of the community charge system. The figures are based on the assumed community charges published in January. They show that three out of five households would pay less with the community charge than they would have paid had rates continued. The actual gains for households will depend on spending decisions by their local authorities. Higher spending than we have assumed will result in higher community charges, just as it would also have resulted in higher rate bills.
The analysis compares 1989-90 rate levels with 1990-91 community charges. Since these are at different price levels, the results are presented in terms of changes in percentage of net income paid in rates and community charge. The figures show that 60 per cent. of households (11.4 million) gain from the new system--88 per cent. of single pensioner households and 82 per cent. of other
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single adult households gain from the new system ; community charge is particularly good news for households in the lowest income band. On average, they will see a 26 per cent. reduction in the percentage of their income paid to local government as a result of the new system. This is because community charge benefits will be more generous than rate rebates and because many of the single adult households benefiting from the change are on low incomes. The message is clear. The community charge with its benefit system is fair. Contrary to claims made by opponents of the community charge, many of the lowest income households should gain from the changes being made. But for the full benefits of the community charge to be felt, local authorities must control their expenditure. High spending will lead to high community charges just as it would lead to high rate bills. Those high bills would be the responsibility of local authorities, not the Government.Mr. Lord : To ask the Secretary of State for the Environment when he expects to make a report under the Personal Community Charge (Relief) (England) Regulations 1990 (S.I., 1990, No. 2).
Mr. Chris Patten : Over the next three years the community charge transitional relief scheme will reduce personal community charges for about 6 million people by £710 million during the changeover from domestic rates to the new system. Most charge payers would pay no more than £3 per week more than they did in rates, where councils spend in line with the Government's assumptions.
I have today laid the Community Charge Transitional Relief Report (England), as required by these regulations, which sets out the assumed community charges for the purposes of the scheme : these are as announced on 11 January in connection with the revenue support grant settlement for 1990-91. Copies of the report are being sent to local authorities and to the local authority associations. Local authorities will be reimbursed in full for the income forgone as a result of the abatement of community charges. In addition they will receive grant in respect of administrative costs.
When the community charge transitional relief scheme was announced I met the local authority associations and made it clear that authorities' reasonable costs incurred in preparing for and administering the scheme would be reimbursed in full. KPMG Peat Marwick McLintock, management consultants, were commissioned to undertake an independent study of these costs. They have had discussions with 31 local authorities, software suppliers, and have met the local authority associations to discuss their views on the operation of the scheme and on methods for cost reimbursement. They have now submitted their report and copies of the recommendations and cost summary have been placed in the Libraries of the Houses of Commons and Lords : copies of the complete report will be available shortly.
In the light of the report, I am today announcing detailed proposals for consultation with the local authority associations for the reimbursement of these costs. I propose that authorities' preparation costs for the scheme, largely for computer software and related expenditure, should be reimbursed in full on the basis of the actual expenditure incurred, as confirmed by the authority's auditor. The consultants' report estimates preparation costs to be about £7 million in total.
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I propose that the general administrative costs which authorities will incur as a consequence of the scheme, in particular dealing with inquiries, should be reimbursed at a flat rate of 27p per charge payer, with an allowance for higher costs in London. On this basis, the administrative costs grant would be about £9.5 million in total. The report recommends that the cost of dealing with applications from elderly and disabled persons and the cost of issuing any second bills to charge payers should be reimbursed on the basis of an amount per application and an amount per bill. I propose that applications should be reimbursed at a rate of £3 per charge payer for each application made, including the cost of dealing with unsuccessful applications.I continue to expect that wherever possible authorities should send out bills in good time reflecting entitlement to community charge benefit and transitional relief where appropriate. However, where bills are sent out without taking into account transitional relief, and second bills have to be issued, I propose that the cost of printing and postage for such bills should be reimbursed at a rate of 50p each. This would not apply where the second bill relates to a substitute charge.
The total cost of this package of grant aid to meet authorities' costs would be about £21 million. These proposals and a copy of the recommendations and cost summary have been sent to the local authority associations for their comments before final decisions are made.
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