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Total |2,803 |117 |2,920 (1,660)|10,204 |1,251 |11,676
Injecting drug misusers |66 |20 |86 (38) |1,145 |551 |1,727
Injecting drug user/homo/bisexual |39 |- |39 (19) |92 |- |92
<1>Deaths shown in brackets.
<2>Includes small numbers where sex not specified.
Day Nurseries
39. Sir Gerard Vaughan : To ask the Secretary of State for Health what representations he has had from the Royal Berkshire hospital concerning day nursery provision in the National Health Service.
Mrs. Virginia Bottomley : Since opening the rainbow nursery at the Royal Berkshire hospital on 22 January I have received no representations.
Emergency Calls
40. Mr. Hardy : To ask the Secretary of State for Health what is his estimate of the number of people who have died where there was delay in response to an emergency call by the ambulance service ; and if there has been any monitoring of the recent position in regard to response times.
Mr. Kenneth Clarke : No reasonable estimate can be made on the effect that industrial action is having on patient care, but plainly the unions are organising activities which are designed to reduce and delay the service to patients. I have no evidence yet that the unions' industrial action has definitely caused the death of anyone. Ambulance services continue to monitor their own response times, even where the service is disrupted by industrial action, though the data may then be less reliable.
Health Authority Expenditure
41. Mr. David Nicholson : To ask the Secretary of State for Health how much will be spent on the health authority capital programme in the next financial year.
Mr. Freeman : Total gross spending on the hospital and community health services capital programme in 1990-91 is planned at £1,377 million.
NHS, Cornwall
44. Mr. Matthew Taylor : To ask the Secretary of State for Health if he will make a further statement on the proposed reorganisation of the National Health Service in Cornwall.
Mrs. Virginia Bottomley : There are no proposals to reorganise the National Health Service in Cornwall. Four units have expressed an interest in becoming NHS trusts. Subject to parliamentary approval, applications for formal NHS trust status will be invited later this year and it remains to be seen whether the expressions of interest already received will be taken further.
Social Work Training
Mr. Watson : To ask the Secretary of State for Health if he will make a statement on the future of social work training.
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45. Mr. Alan W. Williams : To ask the Secretary of State for Health if he will make a statement on the future of social work training.
46. Mrs. Wise : To ask the Secretary of State for Health if he will make a statement on the future of social work training.
127. Mr. Turner : To ask the Secretary of State for Health if he will make a statement on the future of social work training.
Mrs. Virginia Bottomley : I refer the hon. Members to the reply I gave the hon. Member for Glasgow, Rutherglen (Mr. McAvoy) on 16 January at column 195.
National Health Service and Community Care Bill
47. Mr. Tony Lloyd : To ask the Secretary of State for Health how much has been spent so far by his Department, by district health authorities and family practitioner committees to prepare for the implementation of the National Health Service and Community Care Bill.
72. Mr. Lofthouse : To ask the Secretary of State for Health how much has been spent so far by his Department, by district health authorities and family practitioner committees to prepare for the implementation of the National Health Service and Community Care Bill.
120. Mr. Leadbitter : To ask the Secretary of State for Health how much has been spent so far by his Department, by district health authorities and family practitioner committees to prepare for the implementation of the National Health Service and Community Care Bill.
Mr. Kenneth Clarke : I refer the hon. Members to the reply I gave the hon. Member for Oldham, Central and Royton (Mr. Lamond) earlier today.
141. Mr. Pendry : To ask the Secretary of State for Health what consideration he has given to the need to ensure good quality service provision under the proposals in the National Health Service and Community Care Bill.
Mrs. Virginia Bottomley : The need to provide good quality services was a primary consideration in drawing up the proposals to improve services contained in the National Health Service and Community Care Bill. Our proposals will ensure high-quality, value-for-money services.
South East Thames Regional Health Authority
48. Miss Hoey : To ask the Secretary of State for Health when he last met the chairman of the South East Thames regional health authority ; and what was discussed.
Mrs. Virginia Bottomley : My right hon. and learned Friend the Secretary of State last met the chairmen of
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regional health authorities, including Sir Peter Baldwin, on 17 January. The main topics discussed were implementation of "Working for Patients" and "Caring for People", and the ambulace dispute.Disabled People
49. Mr. Rowe : To ask the Secretary of State for Health if he will state those local authorities that presently make payments direct to disabled people to make their own care arrangements ; and if he has considered proposals for ensuring such arrangements are made more widespread.
108. Mr. Hannam : To ask the Secretary of State for Health what consideration he has given to enabling local authorities to make payments directly to disabled people to make their own care arrangements.
Mr. Freeman : I refer my hon. Friends to the reply I gave the right hon. Member for Stoke-on-Trent, South (Mr. Ashley) on 15 January at column 83.
Mr. Ashley : To ask the Secretary of State for Health what representations he has received on making arrangements for local authorities to make payments direct to disabled people to make their own care arrangements.
Mrs. Virginia Bottomley : None other than parliamentary questions and an amendment to the NHS and Community Care Bill.
Mr. Boyes : To ask the Secretary of State for Health what recent representations he has received on implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986.
54. Mr. Bidwell : To ask the Secretary of State for Health what recent representations he has received on implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986.
67. Mr. Buckley : To ask the Secretary of State for Health what recent representations he has received on when implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986 is likely to be fully implemented.
99. Mr. Bell To ask the Secretary of State for Health what recent representations he has received on when the Disabled Persons (Services, Consultation and Representation) Act 1986 is likely to be fully implemented.
Mr. Freeman : Since the beginning of this year hon. Members have addressed five parliamentary questions on this issue to my right hon. and learned Friend the Secretary of State. In addition an amendment to the National Health Service and Community Care Bill was put down in Committee, the effect of which would be to implement remaining sections of the Act. The Department has received no letters on this subject in this period.
Corneal Transplants
50. Mr. Hanley : To ask the Secretary of State for Health how many corneal transplants took place in each of the last five years in the National Health Service.
Mr. Freeman : Accurate statistics are not available on the number of corneal transplants performed in the
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National Health Service. The United Kingdom transplant service estimates that the United Kingdom total is in the region of 2,000 transplants per annum.Eye Tests
51. Mr. Norman Hogg : To ask the Secretary of State for Health if he will make a statement on the results of his Department's monitoring of the effects of the introduction of charges for eyesight checks.
91. Mr. Hood : To ask the Secretary of State for Health if he will make a statement on the results of his Department's monitoring of the effects of the introduction of charges for eyesight checks.
107. Mr. Loyden : To ask the Secretary of State for Health if he will make a statement on the results of his Department's monitoring of the effects of the introduction of charges for eyesight checks.
124. Mr. McCartney : To ask the Secretary of State for Health if he will make a statement on the results of his Department's monitoring of the effects of the introduction of charges for eyesight checks.
Mrs. Virginia Bottomley : I refer the hon. Members to the reply I gave the hon. Member for Manchester, Withington (Mr. Bradley) on 23 January at columns 654-55.
Psychiatric Care
55. Mr. Kennedy : To ask the Secretary of State for Health if he will make a statement on his policy towards the long-term development of psychiatric services and care.
Mr. Freeman : The Government's position is set out in chapter 7 of our White Paper "Caring for People".
General Practitioners
61. Mr. Knapman : To ask the Secretary of State for Health how many general practitioners are employed in the National Health Service at present ; and what was the figure in 1979.
Mrs. Virginia Bottomley : I refer my hon. Friend to the reply I gave my hon. Friend the Member for Ipswich (Mr. Irvine) on 23 January at column 678.
Mr. Thornton : To ask the Secretary of State for Health (1) if he will outline the mechanism by which family practitioner committees will be allocated moneys to pay general practitioners for conducting health screening and promotion clinics under the new general practitioner contract ; and if he will make a statement ; (2) if the moneys allocated for family practitioner committees to pay general practitioners for conducting health screening and promotion clinics under the new general practitioner contract will be sufficient to cover clinics in addition to those specifically mentioned in the contract ;
(3) if the moneys allocated for family practitioner committees to pay general practitioners for conducting health screening and promotion clinics under the new general practitioner contract will be a separately devoted budget.
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Mrs. Virginia Bottomley : General medical practitioners will from 1 April 1990 be able to claim fees under the statement of fees and allowances (a copy is in the Library) for providing health promotion clinics. Family practitioner committees have discretion under paragraph 30.2 of the statement to decide which clinics qualify for payment. Subject to parliamentary approval of the necessary supply estimates, claims which are accepted for payment will be met from a non- cash limited vote incorporating provision for the general medical services. Individual FPCs will not be allocated separate budgets for such fees.Mr. Andrew Bowden : To ask the Secretary of State for Health whether he will make a statement on the benefits of the new general practitioner contract for elderly people.
Mrs. Virginia Bottomley : The new GPs' contract to be introduced with effect from 1 April, is to be more performance-related than the present arrangements. GPs are encouraged to meet the needs of particular patient groups. Elderly patients will benefit from these new arrangements. The annual payment to a doctor for each patient over 75 on his list will increase from 1 January 1991 to £31.45. This illustrates the importance the Government attach to the care of these patients. This compares with a payment of £12.40 for those under 65. Family doctors will offer an annual check-up and a home visit to those over 75 with a view to maintaining the quality of life as far as possible.
77. Mr. Andrew Bowden : To ask the Secretary of State for Health what steps he is taking to make it easier for elderly people to be accepted on to a general practitioner's list.
Mrs. Virginia Bottomley : The procedure for registering with a family doctor is unchanged ; it involves the individual patient asking if the doctor will accept him or her as a patient. We have, however, made it easier for people of all ages to change doctors if they wish. In recognition of the additional care and attention that elderly patients sometimes require, the capitation fee for patients aged 65 and over and aged 75 and over are higher than the standard fee for those aged under 65. Under the new contract the capitation fee for the over-75s is to be increased considerably and will be some 2.5 times the fee for the under 65s.
From 1 January 1991 the capitation fee for those over 75 will be £31.45. For those under 65 it will be £12.40.
West Midlands Regional Health Authority
62. Mr. Colin Shepherd : To ask the Secretary of State for Health when he will next meet the chairman of the West Midlands regional health authority to discuss the funding needs of health authorities in the region and the effects of population bias toward the elderly living in rural areas.
Mr. Freeman : My right hon. and learned Friend the Secretary of State has at present no plans to do so.
63. Mr. Beaumont-Dark : To ask the Secretary of State for Health what consideration he has given to the West Midlands health authority plan.
Mr. Freeman : Matters that have been discussed by my right hon. and learned Friend the Secretary of State and the chairman of the West Midlands regional health
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authority have included the regional health authority's plans for Birmingham which were the subject of preliminary local consultation last year. Revised proposals were issued for further local consultation on 30 January, and will be carefully considered as and when they are approved by that authority for submission to Ministers.St. George's Hospital, Tooting
65. Mr. Cox : To ask the Secretary of State for Health what plans he has to visit St. George's hospital, Tooting ; and if he will make a statement.
Mrs. Virginia Bottomley : My right hon. and learned Friend the Secretary of State has no plans to visit St. George's hospital.
Health Authorities (Maintenance Backlog)
66. Mr. John Hughes : To ask the Secretary of State for Health what is the total figure for the estimated maintenance backlog for health authorities.
92. Mr. Illsley : To ask the Secretary of State for Health what is the total figure for the estimated maintenance backlog for health authorities.
94. Mr. George Howarth : To ask the Secretary of State for Health what is the total figure for the estimated maintenance backlog for health authorities.
138. Mr. Henderson : To ask the Secretary of State for Health what is the total figure for the estimated maintenance backlog for health authorities.
Mr. Freeman : I refer the hon. Members to the reply I gave the hon. Members for Pontefract and Castleford (Mr. Lofthouse) and for Leigh (Mr. Cunliffe) on 23 January at column 656.
National Health Service Consultants
69. Mr. Bowis : To ask the Secretary of State for Health whether there has been a change in the number of consultants employed in the National Health Service since 1979.
Mrs. Virginia Bottomley : Yes, the number of consultants has risen from 12,361 in 1979 to 14,950 in 1988 ; an increase of 21 per cent.
Clinical Research
70. Mr. Ashley : To ask the Secretary of State for Health which organisations or individuals have expressed concern that the reorganisation of the National Health Service will damage clinical research and training ; and what replies he has sent.
Mrs. Virginia Bottomley : We have received various representations concerning the effect of our proposals for improving the National Health Service on clinical research and training. In response we have explained the steps we are taking following our commitment in "Working for Patients" to maintain the quality of medical education and research.
GP Contracts
68. Mr. Terry Fields : To ask the Secretary of State for Health what steps he is taking to monitor the impact of the new general practitioners' contracts.
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130. Mr. Fatchett : To ask the Secretary of State for Health what steps he is taking to monitor the impact of the new general practitioners' contracts.Mrs. Virginia Bottomley : I refer the hon. Members to the reply I gave to the hon. Members for Newport, West (Mr. Flynn) and for Sheffield, Hillsborough (Mr. Flannery) on 13 February at column 160.
74. Rev. Martin Smyth : To ask the Secretary of State for Health if he will make a statement about the implications of the new general practitioner contract and his proposals for practice and drug budgets for doctors working with AIDS/HIV patients and drug misusing patients.
Mrs. Virginia Bottomley : The GPs' new contract is intended to raise standards and extend services and will therefore benefit all patients, including those receiving care and treatment for AIDS and drug abuse. Under both the fund holding and indicative drug budgets schemes general practitioners will be able to prescribe for their patients all the medicines they need.
NHS Pay
75. Mr. Holt : To ask the Secretary of State for Health what has been the annual percentage increase in each of the past five years for (a) staff nurses, (b) consultants, (c) ambulance men of five years' service, (d) hospital administrators and (e) regional health officials.
Mrs. Virginia Bottomley : Data are not available for three of the five groups over the period requested. Staff nurses ceased to exist as a separate pay grade on 1 April 1988. Hospital administrators were replaced by general managers from 1984 onwards. Regional health officials is a diverse category of staff with a number of different pay determination arrangements. The table shows settlements of the other two groups.
Percentage settlements in pay years (1 August to 31 July) Years |Consultants |Ambulancemen ---------------------------------------------------- 1984-85 |6.2 |<1>7.8 1985-86 |9.5 |6.0 1986-87 |8.2 |5.0 1987-88 |8.1 |<2>5.4 1988-89 |8.0 |<3>- <1> A salaried pay structure was introduced on 1 March 1986. The level of increase assumed that all productivity increases were achieved. <2> In addition the standard working week was reduced by one hour from 40 to 39 hours. <3> The management side has offered 9 per cent. over 18 months. Staff in the London ambulance service would receive increases ranging from 10.9 to 12.1 per cent. and some 2,000 staff with extended training to NHSTA standards and who are required to use paramedical skills would receive an additional £500 per annum.
Prescribing Costs
78. Dr. Twinn : To ask the Secretary of State for Health if he will clarify how prescribing costs will be monitored.
Mrs. Virginia Bottomley : Prescribing costs will be monitored by means of simple monthly statements sent to general practitioner practices, family practitioner committees and regional health authorities by the Prescription Pricing Authority. These statements will show how much of the budgets have been taken up and project the likely end of year outcome. This will allow practices to monitor
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their own costs without needing to set up their own information systems and will enable regional health authorities and family practitioner committees to monitor the operation of the scheme. The monthly statements will be in addition to the more detailed PACT reports which will continue to be issued quarterly as at present.Women's Health Care
80. Miss Emma Nicholson : To ask the Secretary of State for Health if he will make a statement on his Department's policies on health care for women.
136. Mr. Moss : To ask the Secretary of State for Health what changes have been made in the provision of health care for women in the last 10 years.
Mrs. Virginia Bottomley : We are proud of our record on women's health. Government policies over the last 10 years have brought enormous improvements to the health and well-being of the women in this country.
We have implemented screening programmes for breast and cervical cancers to reduce the number of women who die each year from these diseases. Between 1978 and 1988 deaths from cervical cancer in England and Wales fell by 10 per cent. to under 2,000 women per annum and the death rate per million women aged 20 to 74 years fell by 16 per cent.
There have been great improvements in maternity care and a range of new services, such as prenatal screening for inherited genetic disorders, is widely available. Between 1979 and 1988 perinatal mortality in England fell from 14.6 to 8.7 per 1,000 births ; between 1978 and 1988 the maternal death rate per 1,000 total births in England and Wales fell from 0.11 to 0.06.
Since 1986 one of the Ministers within the Department has taken a special responsibility for women's health. We regularly meet representatives from women's voluntary organisations and this year are helping to support over 30 such organisations by way of the section 64 scheme. The Department also funds research, study days and courses on different aspects of women's health.
Our proposals for the National Health Service of the future will also ensure that the choice of health care services available to women will be extended and that greater attention will be focused on the quality of this care.
Invoice Settlement
81. Mr. French : To ask the Secretary of State for Health if he has issued any guidelines to local health authorities about the settlement of invoices from suppliers.
Mr. Freeman : Specific formal guidance has not been issued to health authorities, but the Treasury publication "Government Accounting" is published by HMSO and contains guidance of general applicability to all bodies under ministerial control. We continue to expect health authorities to meet their obligations within a reasonable time in accordance with contractual requirements and responsible practice, and have sent the Department of Employment booklet "Prompt Payment Please" to all health authorities.
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Dental Charges
82. Mr. Stott : To ask the Secretary of State for Health if he will make a statement on the effects of the introduction of charging for dental inspections.
111. Mr. Steinberg : To ask the Secretary of State for Health if he will make a statement on the effects of the introduction of charging for dental inspections.
Mr. Freeman : I refer the hon. Members to the reply I gave the right hon. Member for Morley and Leeds, South (Mr. Rees) and the hon. Member for Vale of Glamorgan (Mr. Smith) earlier today.
Immunisation
86. Sir Michael McNair-Wilson : To ask the Secretary of State for Health what is the percentage of children aged five years or under who are known to have received some form of immunisation.
Mr. Freeman : This information is not available. However, for the year 1987-88, the percentages of children in England who were born in 1985 and had completed their immunisations by the end of March 1988 were ;
|Percentage
----------------------------------------------------
Whooping Cough |73
Measles |76
Diphtheria, Tetanus and Polio |87
Creutzfeldt-Jakob Disease
88. Mr. Key : To ask the Secretary of State for Health what further funding he will provide for research into Creutzfeldt-Jakob disease ; and if he will make a statement.
Mr. Freeman : The Department of Health has recently commissioned a research project to review the incidence, prevalence and trends of Creutzfeldt-Jakob disease. There are no plans, at present, for the Department to fund further research into this disease.
Capital Charging
89. Mr. Quentin Davies : To ask the Secretary of State for Health if he will make a statement on progress of the capital charging initiative.
Mr. Freeman : The Inland Revenue is currently undertaking a valuation of the National Health Service estate, and the results of this exercise will be available in the Library from April 1990. Health authorities are making good progress in preparing registers of their capital assets, which will enable them to calculate estimated capital charges during the period of shadow operation in 1990-91 described in the working papers Nos. 5 and 9. These estimates will be reviewed before the scheme is fully implemented in April 1991.
116. Mr. Stanbrook : To ask the Secretary of State for Health what implications there will be for hospital nationalisation schemes of his proposal for capital charging.
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