House of Commons Hansard Debates for 19 Mar 1990

Hepatitis B

Mr. Ashley : To ask the Secretary of State for Health how many health authorities actively offer vaccination against hepatitis B for those identified as belonging to high risk groups.

Mr. Freeman : This information is not held centrally.

Mr. Ashley : To ask the Secretary of State for Health if he will make it his policy to include refuse collectors among the high risk groups for whom vaccination against the hepatitis B virus is recommended.

Mr. Freeman : It is not our intention to do so.

Mr. Ashley : To ask the Secretary of State for Health what advice his Department has issued to sexually transmitted diseases clinics regarding vaccination of patients and staff against the hepatitis B virus.

Mr. Freeman : The Department has issued the following advice on hepatitis B vaccination to health authorities whose responsibilities include genito-urinary medicine clinics :

(i) Chief Medical Officer's letter 1982--CMO(82)13 ;

(ii) Executive letter 1988--EL(88)P/125.

Advice on hepatitis B and other vaccinations is also contained in the memorandum "Immunisation against Infectious Disease" which is prepared for the health departments by the joint committee on vaccination and immunisation (JCVI). It is issued free to all doctors, including consultants in charge of GUM clinics.

The Health Education Authority publishes a booklet "Guide to A Healthy Sex Life" which includes information on hepatitis B vaccination. The authority is reviewing this and other publications on sexually transmitted diseases.

Column 474

Copies of all these documents are available in the Library.

Mr. Ashley : To ask the Secretary of State for Health what discussions he has had with organisations representing medical staff regarding the risks of contracting the hepatitis B virus and the availability of vaccination.

Mr. Freeman : No such discussions have been held.

Mr. Ashley : To ask the Secretary of State for Health what information he has as to the number of drug addicts who have been vaccinated against the hepatitis B virus.

Mr. Freeman : This information is not held centrally.

Mr. Ashley : To ask the Secretary of State for Health what information he has as to the prevalence of the practice of offering the hepatitis B vaccine after an incident in which the patient may have contracted the virus ; and if he will make a statement.

Mr. Freeman : Reports on needlestick or other injuries where hepatitis immunoglobulin has been given are collated by the PHLS communicable disease surveillance centre. The reports for 1989 (provisional data) show that hepatitis B vaccination was recommended in 62 per cent., not recommended in 11 per cent. and in 27 per cent. this information was not recorded on the reporting form.

Mr. Ashley : To ask the Secretary of State for Health what information he has regarding incidents in which refuse collectors have been tested for infection by the hepatitis B virus after being wounded by discarded needles in refuse.

Mr. Freeman : This information is not held centrally.

Mr. Ashley : To ask the Secretary of State for Health what steps his Department is taking to ensure that drug addicts dispose of used needles in a safe manner.

Mr. Freeman : The Department of Health has made over £14 million available to health authorities in 1989-90 to enable drug services to expand and develop in such a way as to make contact with more drug misusers in order to offer help and advice on safer behaviour. Money from this allocation is used to fund exchange schemes, which encourage drug misusers to return their used equipment when obtaining sterile needles and syringes. There are about 120 such schemes in England.

In addition, we are monitoring arrangements in Scotland whereby drug misusers are provided with personal sharps containers for the return of used equipment to a safe disposal facility. Some English drug services are also issuing personal containers. We know of some other experimental disposal facilities such as "hole in the wall" sharps boxes, deliberately located in areas where needles and syringes are discarded.

Cardiothoracic Surgery

Mr. Jack : To ask the Secretary of State for Health when he intends to provide a substantive reply to the question tabled by the hon. Member for Fylde for priority written answer on 6 March about specialist units carrying out cardiothoracic surgery.

Mrs. Virginia Bottomley : I gave my hon. Friend a substantive reply to his question on 16 March 1990.

Column 475

Prescribing Analyses and Costs

Mr. Michael Morris : To ask the Secretary of State for Health (1) why there has been no dispensing information level 1 from PACT since September 1989 ;

(2) why there has been no prescribing information level 1 from PACT since September 1989.

Mrs. Virginia Bottomley : Level 1 PACT reports are issued on a quarterly cycle to all prescribing and dispensing general practitioners. Reports have been issued on time since September 1989 to all FPCs and GPs.

Drug Costs

Mr. Norman Hogg : To ask the Secretary of State for Health if he will list those drugs which on an average doctor's prescription cost less than the prescription charge.

Mrs. Virginia Bottomley : A list setting out those preparations which had an average net ingredient cost per prescription of less than the prescription charge in 1988--the latest year for which figures are available--has been placed in the Library. The list shows preparations in an abbreviated form, but has an explanatory list of abbreviations attached. It is possible to produce a list containing the full names of preparations only at disproportionate cost. The list contains 2,323 preparations--less than one third of the 7, 124 different preparations dispensed by pharmacies and appliance contractors in that year. The net ingredient cost does not represent the full cost to the NHS of dispensing a prescription, this being made up, when prescriptions are dispensed by pharmacies, of the net ingredient cost, less discount, plus dispensing fees, on-cost and container allowance. Because of the extensive exemption arrangements, over 75 per cent. of prescriptions are dispensed free.

Road Accidents

Mr. Adley : To ask the Secretary of State for Health if he will estimate the cost to the National Health Service, for the latest year for which figures are available, of all road accidents.

Mr. Freeman : Data on the actual cost to the National Health Service in England of road accidents is not collected by the Department. However, the Department of Transport has estimated the medical and ambulance costs associated with the treatment of road accident victims in Great Britain at around £160 million in 1988.

Newton Lodge Secure Unit

Mr. O'Brien : To ask the Secretary of State for Health whether, in view of the absconding of a patient on the evening of 11 March from the Newton Lodge secure unit, he will initiate an inquiry into security at Newton Lodge ; and if he will make a statement.

Mr. Freeman : This is a local matter for the health authority concerned. I have written to Sir Bryan Askew, chairman of Yorkshire regional health authority, to alert him that the hon. Member may contact him.

Column 476

Surrogacy Arrangements Act 1985

Sir Trevor Skeet : To ask the Secretary of State for Health how many prosecutions have been undertaken under the Surrogacy Arrangements Act for negotiating commercial arrangements contrary to section 2.

Mrs. Virginia Bottomley : None.

Sir Trevor Skeet : To ask the Secretary of State for Health what records and information he has of the surrogacy arrangements reached between interested parties.

Mrs. Virginia Bottomley : None.

Sir Trevor Skeet : To ask the Secretary of State for Health whether Her Majesty's Government propose any amending legislation to the Surrogacy Arrangements Act 1985 ; and whether he is prepared to put into regulations the ethical guidelines issued by the British Medical Association.

Mrs. Virginia Bottomley : The Human Fertilisation and Embryology Bill currently before Parliament contains an amendment to the Surrogacy (Arrangements) Act 1985 to make surrogacy contracts unenforceable, an issue referred to in the ethical guidelines recently issued by the British Medical Association. Matters of this kind are generally best left to codes of practice such as that which clause 25 of the Bill will require the new authority to prepare.

Energy Conservation

Mr. Morgan : To ask the Secretary of State for Health what studies he has commissioned into the relative energy conservation merits of (a) pre -world war one, (b) inter-war, (c) post-war and (d) new hospital buildings ; what further studies he will commission into this subject ; and if he will publish any available information or figures.

Mr. Freeman : The monitoring of energy efficiency in NHS hospitals in England and Wales is a continuous process. The data produced by the NHS does not distinguish between the variety of buildings within the estate.

Studies in England have majored on the development of low energy hospital buildings with the object of minimising energy consumption. The results of these studies are being used to promote energy efficiency in all new buildings and where appropriate in existing buildings. In 1985 the Welsh Office assumed responsibility for energy matters in Wales.

Dentists

Mr. Teddy Taylor : To ask the Secretary of State for Health if he will make a statement outlining the guarantees which dentists are required to provide to patients on National Health Service work ; and if he will further state any conclusions from these responsibilities in respect of dentures.

Mr. Freeman : If after investigation by its dental services committee a family practitioner committee considers that a dentist has acted in breach of his terms of service, it may recommend the recovery from the dentist of any expenses reasonably and necessarily incurred by the patient as a result of the dentist's failure, and pay such sum to the patient.

Column 477

Any complaint relating solely to the fit and efficiency of a denture may be considered by a denture conciliation committee set up by the FPC. This committee may eventually recommend that the contribution made by the patient to the cost of the denture should be repaid, either wholly or in part, where expenses have been incurred in obtaining dentures from another dentist.

Mr. Teddy Taylor : To ask the Secretary of State for Health what discussions he has had recently with the British Dental Association and the Dental Laboratories Association in relation to dentures and denturism ; and if he will make a statement.

Mr. Freeman : We have not had any recent discussions with the British Dental Association or the Dental Laboratories Association about the provision of dentures or denturism, nor have we been requested to do so.

Junior Hospital Doctors

Mr. Wareing : To ask the Secretary of State for Health what currently are the hours of work of junior hospital doctors in each regional health authority area in England and Wales ; and if he will make a statement.

Mrs. Virginia Bottomley [holding answer 12 March 1990] : The information is not readily available in the form requested and I refer the hon. Member to the reply I gave to the hon. Member for Livingston (Mr. Cook) on 8 February at column 770. I shall be meeting representatives of the Joint Consultants Committee, the British Medical Association and NHS management before Easter to consider how to take this important issue forward.

Neuroblastoma

Mr. Alfred Morris : To ask the Secretary of State for Health, pursuant to his answer to the right hon. Member for Manchester, Wythenshawe, Official Report, 12 December 1989, column 631, what is his estimate of the cost of producing the requested information on the number of deaths from neuroblastoma.

Mr. Freeman [holding answer 14 March 1990] : Approximately £1, 600. National mortality statistics do not routinely identify neuroblastoma as a cause of death, and this figure represents the estimated staff cost of identifying and extracting this information from the death certificates of all children who have died from cancer.

DHA Chairmen

Mr. Robin Cook : To ask the Secretary of State for Health if he will place in the Library for each chairman of each district health authority, including new appointments, the curriculum vitae and relevant qualifications submitted in relation to their appointment.

Mrs. Virginia Bottomley [holding answer 15 March 1990] : District health authority chairmen are appointed on the basis of their personal qualities and experience. We do not look for any specific qualifications. We look for people of ability with the knowledge and drive to provide leadership to the officers of their authority. They must also hold a deep commitment to the NHS. The chairmen's curricula vitae are submitted to us in confidence.

Column 478

ENVIRONMENT

Crown Suppliers

Mr. Campbell-Savours : To ask the Secretary of State for the Environment what is the estimated value of the work the Property Services Agency and the Ministry of Defence have guaranteed to award TCS over the next three years.

Mr. Chope : Neither Department has given any guarantees to the Crown Suppliers in relation to future purchases from it of supplies, although PSA is discussing with the Crown Suppliers a commercial agreement which would involve PSA undertaking to buy routine furniture and furnishings for PSA's own offices subject to the requirements of the EC and GATT rules and to PSA's continuing satisfaction on service and prices. The estimated value of such an undertaking is estimated to be £1 million in each of the years 1990-91, 1991-92 and 1992-93. The Ministry of Defence's plans are a matter for my right hon. Friend the Secretary of State for Defence.

Mr. Campbell-Savours : To ask the Secretary of State for the Environment why the Property Services Agency and the Ministry of Defence were asked to guarantee TCS work.

Mr. Chope : The Property Services Agency and the Ministry of Defence were not asked to guarantee TCS work. They are each discussing commercial agreements with the Crown Suppliers because agreements were considered likely to be to the mutual advantage of the parties involved.

Local Government Finance

Mr. Atkinson : To ask the Secretary of State for the Environment if he will state the expenditure of the Dorset county council and Bournemouth borough council for 1989-90 and 1990-91 ; what the domestic rate poundage and average rate for the Bournemouth ratepayer was for 1989-90 and what it would have been for 1990-91 ; what the community charge for Bournemouth would have been for 1989-90 and what it is for 1990-91 ; and if he will make a statement on the outcome taking account of the revenue support grant for both authorities.

Mr. Chope : Paragraphs 3.1(i) to (v) of the Revenue Support Grant Transition Report (England) explain the calculation made of the amount of income received by each local authority in 1989-90 comparable with 1990-91 levels. The calculation produces a 1989-90 income of £257.3 million for Dorset county council and £15.6 million for Bournemouth borough council.

In 1989-90 the average domestic rate poundage in Bournemouth was 219.5p, producing an average domestic rate bill--before any allowance for rebates-- of £480.

Illustrative 1989-90 community charges were published in July 1989 and showed a figure of £234 in Bournemouth, after taking account of the transitional arrangements.

Information for 1990-91 based on returns received from local authorities will be placed in the Library shortly.

It is our intention, when community charges are finally set, to say what the increase would have been in domestic rates had that taken the place of the community charge.

Mr. Robert B. Jones : To ask the Secretary of State for the Environment (1) whether he will set out a table

Column 479

showing for Hertfordshire county council (a) the budget for net expenditure for 1989-90, (b) the budget for net expenditure for 1990-91, (c) the increase in net expenditure between 1989- 90 and 1990-91, (d) the net addition to balances budgeted for 1990-91 and (e) the percentage rate increase that would have occurred had the domestic rating system still been in place and no change in domestic rateable value occurred ;

(2) whether he will set out a table showing (1) for Durham county council and (2) for Darlington borough council (a) the budget for net expenditure for 1989-90, (b) the budget for net expenditure for 1990-91, (c) the increase in net expenditure between 1989-90 and 1990-91, (d) the net addition to balances budgeted for 1990-91 and (e) the percentage rate increase that would have occurred had the domestic rating system still been in place and no change in domestic rateable value occurred ;

Mr. Chope : Net current expenditure in 1989-90 for these authorities is as follows :



Net current expenditure 1989-90

Budgeted net current expenditure and budgeted net additions to balances in 1990-91 are not yet available. It is our intention when community charges are finally set to say what the increases would have been if domestic rates had taken the place of the community charge.

Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will publish a table showing for Lancashire the estimated percentage of the adult population, including spouses, now paying rates, the percentage expected to be chargeable to the poll tax and the number expected to contribute the same as or less than at present.

Column 480

Mr. Chope : The information requested is not available.

Mr. Tredinnick : To ask the Secretary of State for the Environment what recent representations he has received about the replacement of the community charge with a system of raising local government finance based on a local income tax.

Mr. Chope : I continue to receive representations on a wide range of issues relating to the abolition of domestic rates.

Mr. Hayward : To ask the Secretary of State for the Environment (1) if he will list the 10 London boroughs with the largest per capita overspend against his Department's standard spending assessment ; and if he will indicate that overspend ;

(2) if he will list the 10 metropolitan boroughs with the largest per capita overspending against his Department's standard spending assessment ; and if he will indicate that overspend ;

(3) if he will list the 10 shire counties with the largest per capita overspend against his Department's standard spending assessment ; and if he will indicate that overspend.

Mr. Chope : I intend to place a summary of the information returned from local authorities in the Library of the House after information has been received from all authorities.

Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will give for each district authority of Humberside (a) the safety net figure, (b) the low rateable value allowance, (c) the increase or decrease of standard spending assessment and grant-related expenditure and (d) the loss or gain from unified business rate, all on a per capita basis.

Mr. Chope : The information requested is shown in the following table :

Column 479



£/adult

Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will give for each district authority the amount taken out of reserves by that authority and, where relevant, the county authority and per capita effect on the poll tax in that authority area.

Mr. Chope : I intend to place a summary of the information returned from local authorities in the Library of the House after information has been received from all authorities.

Mr. David Nicholson : To ask the Secretary of State for the Environment if he will give the estimated total amount

Column 480

of local government spending per head (a) for 1989-90 and (b) 1990-91 for each of the counties of Somerset, Devon and Dorset, each of the London boroughs of Lambeth, Camden, Islington, Wandsworth and Westminster and each of the metropolitan boroughs of Birmingham, Bradford, Manchester and Sheffield.

Mr. Chope : Following is the available information. I intend to place a summary of the information on 1990-91 budgets in the Library of the House when information has been received from all authorities.

Column 481



£/adult

Mr. Allen : To ask the Secretary of State for the Environment when he anticipates informing local authorities of his definition of mentally impaired for the purposes of community charge rebates.

Mr. Chope : People who are severely mentally impaired are exempt from the personal community charge providing they are in receipt of one of a number of qualifying benefits and a certificate from a registered medical practitioner, stating that for the purposes of the community charge they are severely mentally impaired.

The Personal Community Charge (Exemption for the Severely Mentally Impaired) Order 1990 was made on 6 March. The order amends the qualifying benefits and the definition of severely mentally impaired, in order to bring in such people as those suffering from Alzheimer's disease and senile dementia. Copies have been sent to charging authorities and placed in the Library of the House of Commons. People who are exempt from the personal community charge do not need to claim community charge benefit.

Mr. Allen : To ask the Secretary of State for the Environment when his Department expects to inform local authorities which 19-year-olds are on appropriately defined full-time courses for the purposes of entitlement to community charge rebates.

Mr. Chope : My Department wrote to all charging authorities on 16 November 1989 explaining the range of courses it intends to define in regulations, for the purposes of extending exemption from the personal community charge to certain people under the age of 20 who are in full-time further but not higher education. A copy of the letter is in the Library of the House of Commons. Regulations will come into force by 1 April 1990.

People who are exempt from the personal community charge do not need to claim community charge benefit.

Mr. Spearing : To ask the Secretary of State for the Environment what estimate he has made of (a) the national sum to be collected from ministers of religion and their immediate families in respect of the community charge and (b) by how much this is likely to differ from receipts by local authorities from rating demands on them or on church bodies responsible for their accommodation.

Mr. Chope : The information requested is not available.

Mr. Austin Mitchell : To ask the Secretary of State for the Environment if he will give for each district authority

Column 482

in England (a) the increase or decrease in Government assessment of spending levels, standard spending assessment against grant-related expenditure, for that authority and each authority contributing to the poll tax total, (b) his estimate of the number of households qualifying for transitional relief and (c) the safety net figure for that authority.

Mr. Chope : I have today placed in the Library a table showing the available information. In calculating the change between adjusted grant- related expenditure and standard spending assessment at column (a) , the grant-related expenditures and standard spending assessments of precepting authorities have been allocated between their constituent authorities in proportion to relevant population. I have no estimates of numbers qualifying for transitional relief in individual authorities.

Next Section

Home Page