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HEALTH
Milk Tokens
Mrs. Dunwoody : To ask the Secretary of State for Health how many firms supplying liquid milk against welfare tokens have indicated that they no longer intend to participate in the scheme after the changes proposed by his Department ; and what proposals he is making to ensure that beneficiaries do not suffer.
Mr. Freeman : A total of 115 out of a total of 17,000 suppliers have indicated an intention to cease participation
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in the scheme. However, very few beneficiaries have reported that their normal supplier has refused to accept tokens. Local social security offices are able to offer advice about alternative suppliers. Where, exceptionally, the local office is satisfied that a token cannot be exchanged for milk a beneficiary can receive a payment in lieu.NHS Trusts
Mr. Pendry : To ask the Secretary of State for Health what provisions will be made for people with disabilities in self-governing trust hospitals.
Mrs. Virginia Bottomley : Under the Bill proposals, district health authorities will be responsible for planning and securing through contracts a comprehensive range of services, which will include services for people with disabilities, to meet the health care needs of their population. In doing this they will contract with a range of service providers, including NHS trusts.
Mr. Pendry : To ask the Secretary of State for Health what application the Disabled Persons (Services, Consultation and Representation) Act 1986 will have to people with disabilities in self- governing trust hospitals.
Mrs. Virginia Bottomley : National Health Service trusts will remain an integral part of the NHS and will accordingly remain subject to a range of legislation which applies to NHS facilities.
Nurses
Mr. Stern : To ask the Secretary of State for Health how many regrading appeals for nurses remain outstanding in each regional health authority.
Mrs. Virginia Bottomley : Information concerning appeals to employing authorities in England is not collected centrally.
Mr. McAllion : To ask the Secretary of State for Health if he will list in the Official Report the different kinds of conversion courses currently available to nurses within the National Health Service in England and Wales.
Mrs. Virginia Bottomley : The English National Board for Nursing, Midwifery and Health Visiting has approved courses to enable enrolled nurses to convert to being registered general nurses, registered mental nurses, registered nurses in mental handicap, first level nurses trained in the nursing of sick children, and registered general nurses and district nurse (joint qualification). Individual courses approved by the board can vary in a number of respects. Increased use is being made of distance and open learning approaches. Recognition of prior learning can mean that the traditional 52-week conversion course can be reduced in length to as little as 26 weeks. The hon. Member may wish to approach my right hon. Friend the Secretary of State for Wales about the position in Wales.
Therapy
Mr. Ashley : To ask the Secretary of State for Health how many qualified (1) speech therapists, (2) physiotherapists and (3) occupational therapists are employed centrally by his Department ; and in each category what are the numbers employed in the National Health Service.
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Mr. Freeman : The Department currently employs one speech therapy officer, two physiotherapy officers and two occupational therapy officers, all full-time. The speech therapy officer and one physiotherapy officer are on secondment from the National Health Service. One occupational therapy officer is on secondment from a local authority. The table shows the whole-time equivalents of qualified therapists employed in the National Health Service at 30 September 1988, the latest date for which figures are available :
|Number
--------------------------------------
Physiotherapists |9,590
Occupational therapists |4,870
Speech therapists |2,730
Mr. Ashley : To ask the Secretary of State for Health if he will increase the number of qualified speech therapists employed centrally by his Department to oversee policy designed to overcome the gap between the 20.5 speech therapists (whole-time equivalents) per 100, 000 population required if current methods of intervention were maintained and assistants were used, and the 5.7 national average figure per 100,000 now available.
Mr. Freeman : No. The Department's speech therapy officer is already actively working with other officials to consider the problem of matching the supply and demand for speech therapy. I refer the right hon. Member to the reply that I gave him on 26 March at column 46.
Mr. Ashley : To ask the Secretary of State for Health if he will list the duties of the therapy officers employed by his Department.
Mr. Freeman : The duties of the therapy officers are to provide advice and support to Ministers and to other officials on matters concerned with all aspects of policy for the development of therapy services, including education and employment, in the National Health Service, local government and the voluntary and private sectors, to assist in taking forward policies relating to these services, and to liaise with professional bodies and other relevant organisations and services.
Mr. Ashley : To ask the Secretary of State for Health what representations he has received regarding the review of the functions of therapy officers ; and if he will state the objectives of the review.
Mr. Freeman : The objectives of the review are set out in the terms of reference which are as follows :
(a) to review the value and costs of the service provided to the Department by the therapy officers ;
(b) to consider other models for the provision of advice on therapy matters to the Department ;
(c) to advise on whether the present arrangements constitute the most effective use of resources for the provision of this advice ; (
(d) if not, to advise on whether an alternative model or models would be more effective, and if so which, and
(e) without prejudice to the consideration of other models, to review the budgetary and management arrangements for therapy officers employed by the Department, and to make recommendations.
Apart from the letter which the right hon. Member sent my right hon. and learned Friend the Secretary of State on 29 March we have received no representations about the review.
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Access to Ministers
Mr. Ashley : To ask the Secretary of State for Health if (1) the therapy officers, (2) the chief medical officer and (3) the chief nursing officer in his Department have direct access to him.
Mr. Freeman : Therapy officers give advice on a wide range of professional issues to policy branches which take it into account as appropriate in offering advice to Ministers. The chief medical officer and the chief nursing officer have direct access to my right hon. and learned Friend the Secretary of State.
Health Reform Group
Mr. Michael Morris : To ask the Secretary of State for Health, pursuant to his answer to the hon. Member for Bury, South (Mr. Sumberg) of 20 February, Official Report, column 695, what is the Health Reform Group ; and who are its members.
Mrs. Virginia Bottomley : The Health Reform Group is an independent group of medical practitioners who support the Government's proposals to improve the Health Service. We have no details of its membership.
Awards
Ms. Armstrong : To ask the Secretary of State for Health what is the annual cost of running his Department's office of the central committee on distinction awards.
Mrs. Virginia Bottomley : The total cost for the year ended 31 March 1989 (the latest available) was £131,188. This figure was made up as follows : Department of Health staff costs £81,684, committee members' expenses £32,954 and salaries of the chairman and vice-chairman of the advisory committee on distinction awards £16, 550.
Ms. Armstrong : To ask the Secretary of State for Health what criteria are used when making hospital consultants merit awards.
Mrs. Virginia Bottomley : There are no formal criteria for awards. The chairman of the advisory committee on distinction awards issued general guidelines to members of the regional and higher awards committees this year and a copy has been placed in the Library. The committees look for qualities such as clinical excellence, special achievement in direct services to patients, training, teaching and research and outstanding management effort.
Ms. Armstrong : To ask the Secretary of State for Health whether he will publish the number of holders of hospital consultants' merit awards in each district health authority.
Mrs. Virginia Bottomley : The Department does not maintain statistics on distinction awards in each district health authority.
Drug Budgets
Mr. Michael Morris : To ask the Secretary of State for Health when he expects to issue the further working paper on the implementation of indicative drug budgets to which he referred in his answer to the hon. Member for Northampton, South of 30 January, Official Report, column 130.
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Mrs. Virginia Bottomley : We intend to publish in May a further working paper on the operation of the indicative prescribing scheme.Mr. Michael Morris : To ask the Secretary of State for Health how soon after the month end the monthly statement on prescribing costs will be issued to general practitioner practices, family practitioner committees and regional health authorities.
Mrs. Virginia Bottomley : Monthly statements of expenditure on drugs, medicines and listed appliances prescribed by general practitioners will normally be issued at all levels within four weeks of the end of the month in which the costs were incurred.
Medical Negligence
Mr. Wigley : To ask the Secretary of State for Health how much he estimates it will cost his Department in the current financial year for payments that arise from claims of compensation for medical negligence.
Mr. Freeman : For 1990-91 the cost of payments in compensation for medical negligence by hospital doctors is estimated at £50 million for the United Kingdom. Not all of this will be met by health authorities. On 1 January 1990 the financial responsibility for this compensation was transferred from the medical defence organisations to the National Health Service. Because hospital doctors in the National Health Service are no longer required to subscribe to a medical defence organisation, English health authorities have about £27 million (£34 million United Kingdom) available in 1990-91 from the contributions made by them as employers to doctors' subscriptions.
In addition, under the arrangements for the transfer of financial responsibility the medical defence organisations have set up funds from their reserves which health authorities can draw on to help meet the cost of the more substantial cases which should enable the cost to be kept within the original provision for subscriptions.
Mr. Wigley : To ask the Secretary of State for Health how many brain -damaged children have been awarded compensation for medical negligence in the past five years ; what has been the average size of award in each year : and what have been the highest and lowest awards.
Mr. Freeman : This information is not available centrally.
General Practitioners
Mr. Michael Morris : To ask the Secretary of State for Health what are the most recent available figures for average general practitioner list sizes ; and what steps are being taken to have more up-to-date figures available.
Mrs. Virginia Bottomley : Information provided by family practitioner committees (FPCs) in census returns enable the Department to calculate average list sizes.
The average general practitioner list size for England at 1 October 1988 (the latest available) was 1,999.
From 1 April 1990 all family practitioner committees will have computer systems for general practitioner payments. The intention is that the Department's information requirements will be taken directly from these rather than from manual returns as currently.
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It is expected that this will lead to more timely submission of data for the 1 October 1990 census and beyond.Dead Register
Mr. Key : To ask the Secretary of State for Health if he will make a statement about the future of the dead register currently maintained by the Office of Population Censuses and Surveys.
Mr. Freeman : The dead register consists of more than 80 million index cards stored by local authority area. These cards relate to people who changed address, left the country, died or changed name during the period of national registration between 1939 and 1952. The space needed for computerisation of the National Health Service central register has necessitated moving the dead register away from the Office of Population Censuses and Surveys site and it is now costing nearly £50,000 per annum in storage.
The main usage is for medical research studies and currently there are very few users. The Office of Population Censuses and Surveys considers that it is unnecessary to maintain the dead register for its own core needs and has approached the Medical Research Council about the need to maintain it for medical research purposes. In the event that this is considered necessary the Office of Population Censuses and Surveys would need payment. A decision is required by the summer when the renewal of the storage contract is due.
Ambulance Dispute
Mr. Cohen : To ask the Secretary of State for Health what is the final cost to each regional health authority of cover using police and armed forces and other bodies during the ambulance workers' dispute ; and what was the total cost to public funds of the dispute.
Mr. Tony Banks : To ask the Secretary of State for Health if he will give details of his latest estimate of the total costs arising out of the recent ambulance dispute ; and how much has been (a) paid and (b) requested from authorities responsible for providing (i) military, (ii) police and (iii) non-NHS ambulance services during the period of the dispute.
Mrs. Virginia Bottomley : The cost to the end of February 1990 (the last month for which bills have been received from the Ministry of Defence) was £4.8 million. The final cost of military assistance is not yet known.
Information is not held centrally about the cost to regional health authorities of using police and other non-military bodies during the recent dispute.
Defensive Medicine
Mr. Wigley : To ask the Secretary of State for Health what research his Department has undertaken on defensive medicine in the United Kingdom.
Mrs. Virginia Bottomley : None. The introduction of medical audit will ensure that doctors examine the nature and appropriateness of the care that they provide.
General Practitioners, Cumbria
Mr. Martlew : To ask the Secretary of State for Health if he will review the decision of the Cumbria family practitioner committee to allow the general practitioner
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practice of Dickinson, Wheeler and Reed specifically to exclude the area Raffles, and Raffles in Carlisle, from their practice.Mrs. Virginia Bottomley : No. I understand that the practice concerned is in Dalston and some distance from Carlisle in a rural area. This practice has never encouraged people from the urban area to register with it. There are in fact some 40 doctors serving the population of Carlisle, including the two estates.
OVERSEAS DEVELOPMENT
Uganda
Mr. Ernie Ross : To ask the Secretary of State for Foreign and Commonwealth Affairs how much aid, and in what form, was given by Her Majesty's Government to Uganda for each of the last five years.
Mrs. Chalker : Gross British bilateral aid to Uganda over the period 1984-88, the latest five-year period for which figures are available, was as follows :
£ millions
|1984 |1985 |1986 |1987 |1988
---------------------------------------------------------------------
Programme aid |1.126 |0.206 |0.005 |0.016 |17.126
Other financial aid |0.474 |2.123 |1.524 |2.980 |2.941
Technical assistance |2.701 |2.867 |2.784 |3.510 |6.392
Pensions |0.939 |0.896 |0.852 |1.996 |0.354
Emergency aid |0.173 |0.244 |1.056 |0.070 |0.436
Debt relief |1.667 |1.660 |1.166 |0.983 |0.631
Commonwealth Development
Corporation |1.175 |1.189 |2.624 |0.710
|-------|-------|-------|-------|-------
Total |7.080 |9.171 |8.576 |12.179 |28.590
In addition, Britain's share of multilateral aid to Uganda over the period 1984-87 was :
Section |Bill |Date |Type of Order
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
1979-80 |Education (No.2) |2 April 1980 |Supplemental
|Social Security |22 May 1980 |Supplemental
|Housing |6 August 1980 |Supplemental
1980-81 |Transport |28 July 1981 |Supplemental
|British Nationality |26 October 1981 |Supplemental
1981-82 |Oil and Gas (Enterprise) |24 June 1982 |Supplemental
|Employment |25 October 1982 |Supplemental
1984-85 |Local Government |8 July 1985 |Supplemental
|Transport |29 October 1985 |Supplemental
1985-86 |Gas |21 July 1986 |Supplemental
|Social Security |23 July 1986 |Supplemental
1986-87 |Local Government Finance |11 March 1987 |Supplemental
|Abolition of Domestic Rates etc. |13 May 1987 |Supplemental
| (Scotland)
1987-88 |Social Security |14 March 1988 |Free-standing
|Education Reform |18 July 1988 |Supplemental
|Local Government Finance |20 July 1988 |Supplemental
|Firearms (Amendment)} |Supplemental
|Schools Boards (Scotland)} |2 November 1988 |Free-standing (one order
|Housing} |11 November 1988 |covering 2 bills)
1988-89 |Prevention of terrorism (Temporary |14 March 1989 |Supplemental
| Provisions
|Official Secrets |2 May 1989 |Supplemental
|Water |3 July 1989 |Supplemental
|Local Government and Housing} |Free-standing (one order
|Employment} |8 November 1989 |covering 2 bills)
|Self-Governing Schools etc. (Scotland)|14 November 1989 |Supplemental
1989-90 (up to |Education (Student Loans) |4 April 1990 |Free-standing
and including
18 April 1990
Figures for later years are not yet available.
Grassland Research
Mr. Dalyell : To ask the Secretary of State for Foreign and Commonwealth Affairs when he expects he will be able to make a statement on the outcome of the Minister for Overseas Development's contacts with Professor Hall about grassland research.
Mrs. Chalker : My officials will be holding discussions with Professor Hall and other interested parties such as the Natural Resources Institute during the next six weeks. I will therefore be writing to the hon. Member at the end of May, by when we should know the position.
Caribbean
Mr. Butler : To ask the Secretary of State for Foreign and Commonwealth Affairs what is the current level of assistance given to islands in the Caribbean.
Mrs. Chalker [pursuant to her reply, 2 April 1990, c. 418] : I regret that the reply that I gave my hon. Friend
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omitted the separate but substantial sums provided to Jamaica through the Commonwealth Development Corporation. In 1988 these amounted to £14.647 million.DUCHY OF LANCASTER
Lancashire Estates (Income)
60. Mr. Jack : To ask the Chancellor of the Duchy of Lancaster what are the principal determining factors which affect the income of the estates for which he is responsible in Lancashire.
Mr. Kenneth Baker : The factors which affect the income of the estates are, in general, those affecting the agricultural economy. Most of the farms are dairy units and I am pleased to say that the farmers concerned have adapted well to the regime of milk quotas.
Local Government Finance
61. Mr. Hind : To ask the Chancellor of the Duchy of Lancaster what representations he has received from tenants of the Duchy regarding the community charge.
Mr. Kenneth Baker : I have had no representations from Duchy tenants either for or against the community charge.
Visits
62. Mr. Sumberg : To ask the Chancellor of the Duchy of Lancaster when he next intends to pay an offical visit to the Duchy.
Mr. Kenneth Baker : I have no plans to do so in the very near future.
Mr. John Evans : To ask the Chancellor of the Duchy of Lancaster when he next expects to visit St. Helens.
Mr. Kenneth Baker : I have no plans to visit St. Helens at present.
Official Duties
63. Mr. Tony Banks : To ask the Chancellor of the Duchy of Lancaster how much time he has spent on Duchy business since the last time he answered oral questions.
Mr. Kenneth Baker : I spend up to a quarter of my time carrying out my duties as Chancellor of the Duchy of Lancaster and as a member of the Government.
HOUSE OF COMMONS
Guillotines
Mr. Richard Shepherd : To ask the Lord President of the Council when guillotines were first introduced on Lords amendments ; and if he will list all such guillotines and supplemental guillotines since 1979.
Sir Geoffrey Howe : The first occasion on which an allocation of time order governing consideration of Lords amendments was made was on 27 April 1953, when a supplemental order guillotining debate on Lords amendments to the Transport Bill was agreed to.
The following allocation of time orders relating to consideration of Lords amendments have been made since the beginning of the 1979-80 Session :
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Section |Bill |Date |Type of Order
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
1979-80 |Education (No.2) |2 April 1980 |Supplemental
|Social Security |22 May 1980 |Supplemental
|Housing |6 August 1980 |Supplemental
1980-81 |Transport |28 July 1981 |Supplemental
|British Nationality |26 October 1981 |Supplemental
1981-82 |Oil and Gas (Enterprise) |24 June 1982 |Supplemental
|Employment |25 October 1982 |Supplemental
1984-85 |Local Government |8 July 1985 |Supplemental
|Transport |29 October 1985 |Supplemental
1985-86 |Gas |21 July 1986 |Supplemental
|Social Security |23 July 1986 |Supplemental
1986-87 |Local Government Finance |11 March 1987 |Supplemental
|Abolition of Domestic Rates etc. |13 May 1987 |Supplemental
| (Scotland)
1987-88 |Social Security |14 March 1988 |Free-standing
|Education Reform |18 July 1988 |Supplemental
|Local Government Finance |20 July 1988 |Supplemental
|Firearms (Amendment)} |Supplemental
|Schools Boards (Scotland)} |2 November 1988 |Free-standing (one order
|Housing} |11 November 1988 |covering 2 bills)
1988-89 |Prevention of terrorism (Temporary |14 March 1989 |Supplemental
| Provisions
|Official Secrets |2 May 1989 |Supplemental
|Water |3 July 1989 |Supplemental
|Local Government and Housing} |Free-standing (one order
|Employment} |8 November 1989 |covering 2 bills)
|Self-Governing Schools etc. (Scotland)|14 November 1989 |Supplemental
1989-90 (up to |Education (Student Loans) |4 April 1990 |Free-standing
and including
18 April 1990
Sound System
Dame Elaine Kellett-Bowman : To ask the Lord President of the Council whether he will make a statement on the sound system in the House.
Sir Geoffrey Howe : During recent months, I have received a number of representations from hon. and right hon. Members about the quality of the sound in the Chamber and the matter has also been raised several times on the Floor of the House.
The sound system in the Chamber has been under review for the last 10 years, originally under the aegis of the former Sound Broadcasting Committee. The Select Committee on Televising of Proceedings of the House inherited the responsibilities of the Sound Broadcasting Committee and has continued to keep the issue under active consideration. When the Select Committee came into being in 1988 it was decided that, although there might be doubts about the efficiency of the sound system, there should be no attempt to make significant changes either for or during the television experiment. The sound system in the Chamber at present is, therefore, almost exactly the same and works under exactly the same system of operation as it has done for more than five years.
There were complaints earlier this year that microphones at the Dispatch Box were not providing a good signal of the Front-Bench speakers. A series of experiments were undertaken with different microphones at the Dispatch Box and new placings of the microphones above the Government and Opposition Front-Bench speakers. The present microphones and their placings,
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designed to overcome the loss of audibility when Front-Bench speakers turn to address Members behind them, provide the best combination so far.There have also been complaints about the quality of reception in the small loudspeakers in the back of the Benches. The level of amplification has not, as had been suggested, been lowered to suit the demands of broadcasting. In fact the level of sound has been raised as far as possible without causing feedback but it is clear that some Members still have difficulty in hearing when there is a lot of noise in the Chamber. During the Easter recess, therefore, an inspection was carried out with the support of the BBC research department to evaluate the extent to which the existing amplification equipment is performing to its original specifications and to identify possible alternative systems for later tests.
This work is part of a study being undertaken by a working party under the chairmanship of the supervisor of broadcasting. The working party is examining the technical options for the modernisation or replacement of the sound system. In addition, Mr. Richard Wright, head of sound operations for news and current affairs at the BBC, has been appointed as a specialist adviser to the Select Committee and will also assist the working party in its deliberations. The working party will report to the Chairman of the Select Committee by early June. As a separate issue, the working party will also address the question of sound quality in Committee Rooms.
However, the general conclusion likely to be reached is that the sound system, which was installed several decades ago, is unlikely to have an effective life beyond the next five
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years. Given the inevitably long lead-time associated with drawing up the specifications and costings for a new system, and with approval by the House and installation, it is vital that work should begin now.The first practical steps towards identifying the tecnnical options have already been taken, with the recent installation on the Opposition side of the Chamber of a single new type of smaller "capacitator" microphone. This has produced good results in terms of audibility, although a problem of reduced physical stability needs further work.
It is, however, important to stress that the constraints of the layout and architecture of the Chamber will always limit the scope for improvement in audibility. The simultaneous requirement for the House to be able to hear the Member with the Floor speaking at a normal volume, whilst avoiding undue distraction from the inevitable background noise in a lively debating Chamber, is likely to stretch even the most up-to-date technology to its limits. When the House is very noisy only a system of individual microphones and individual hearing aids would be able to cope ; and this, it has always been understood, would be unacceptable to the House.
The overriding concern of the Select Committee will be to ensure that the House is equipped with as efficient a system of sound reinforcement as possible, subject only to the practical constraints I have outlined.
SOCIAL SECURITY
Widows' Benefit
Mr. Dewar : To ask the Secretary of State for Social Security how many widows in Scotland are in receipt of widows' benefit.
Mrs. Gillian Shephard : As at 31 March 1989, the latest date for which figures are available, the number of widows in Scotland in receipt of widow's benefit was 39,000.
Local Government Finance (Rebates)
Mr. Dewar : To ask the Secretary of State for Social Security how many people were receiving (a) domestic rates and (b) poll tax rebates in Scotland in each year from 1986-87 ; and if he will express the figures as a percentage of total domestic ratepayers or poll tax payers.
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