House of Commons Hansard Debates for 5 Jun 1990

Mrs. Virginia Bottomley : Vulnerable groups such as children, those on low incomes and people with certain special medical needs continue to be entitled to free NHS sight tests. There are no plans to make this a universal entitlement.

Westminster and Chelsea Hospital

22. Mr. David Evans : To ask the Secretary of State for Health what is the revised estimate of the cost of the proposed Westminster and Chelsea hospital.

Mr. Dorrell : The estimated cost of the Westminster and Chelsea hospital is approximately £203 million. This figure

Column 573

is based on the estimated construction cost of around £178 million plus equipment and fees. The estimates take account of expected inflation over the period of the contract which is due for completion in mid-1992.

National Health Service Trusts

23. Mr. Fatchett : To ask the Secretary of State for Health what information he has as to how many ballots of staff and patients on the question of the formation of self-governing trusts have resulted in majorities in favour.

74. Mr. Dunnachie : To ask the Secretary of State for Health what information he has as to how many ballots of staff and patients on the question of the formation of self-governing trusts have resulted in majorities in favour.

91. Mr. Cunliffe : To ask the Secretary of State for Health what information he has as to how many ballots of staff and patients on the question of the formation of self-governing trusts have resulted in majorities in favour.

Mr. Kenneth Clarke : We are aware that ballots on the establishment of National Health Service trusts have taken place in a number of units. However, we have consistently made clear that it would not be sensible for changes in management of National Health Service services to be subject to ballots. Applications for National Health Service trust status will not be invited until Parliament has approved the necessary legislation. Staff and the local community will then have an opportunity to express their views on individual proposals before any decisions are made.

27. Mr. Salmond : To ask the Secretary of State for Health what information he has on the number of ballots that have been held in hospitals which are considering opting out ; and whether any of these have shown a majority in favour of such a course of action.

32. Mr. McLeish : To ask the Secretary of State for Health what evidence he has of the views of National Health Service staff or patients for the formation of self-governing trusts.

37. Mr. Sillars : To ask the Secretary of State for Health what information he has on the number of ballots that have been held on hospitals which are considering opting out ; and whether any of these have shown a majority in favour of such a course of action.

54. Mr. McKelvey : To ask the Secretary of State for Health what evidence he has of the views of National Health Service staff or patients for the formation of self-governing trusts.

103. Mr. Andrew Welsh : To ask the Secretary of State for Health what information he has on the number of ballots that have been held in hospitals which are considering opting out ; and whether any of these have shown a majority in favour of such a course of action.

Mrs. Virginia Bottomley : I refer the hon. Members to the reply my right hon. and learned Friend the Secretary of State gave the hon. Members for Moray (Mrs. Ewing) and for Dundee, East (Mr. McAllion) earlier today.

38. Mr Vaz : To ask the Secretary of State for Health what is the latest estimate of his Department's expenditure on preparation for the formation of self-governing trusts.

Column 574

76. Ms. Short : To ask the Secretary of State for Health what is the latest estimate of his Department's expenditure on preparation for the formation of self-governing trusts.

97. Mr John P. Smith : To ask the Secretary of State for Health what is the latest estimate of his Department's expenditure on preparation for the formulation of self-governing trusts.

100. Mr Turner : To ask the Secretary of State for Health what is the latest estimate of his Department's expenditure on preparation for the formulation of self-governing trusts.

Mrs. Virginia Bottomley : Expenditure on preparing for the establishment of National Health Service trusts is not separately identified.

Dental Checks

24. Mr. Rogers : To ask the Secretary of State for Health if he will now remove the charge on dental checks.

59. Mr. McWilliam : To ask the Secretary of State for Health if he will now remove the charge on dental checks.

Mr. Kenneth Clarke : I refer the hon. Members to the reply I gave to the right hon. Member for Morley and Leeds, South (Mr. Rees) and the hon. Member for Newham, North-East (Mr. Leighton) earlier today.

Hip Replacements

25. Mr. Teddy Taylor : To ask the Secretary of State for Health what is the current waiting time for hip replacement operations ; and if he will make a statement.

Mrs. Virginia Bottomley : The latest information held centrally about waiting times by operation is for 1985 and is published in "1985 Hospital in-patient enquiry main tables for England series number MB4 No. 27", a copy of which is available in the Library. Information on waiting times in 1988-89 for specific types of operation is expected to be available shortly.

National Health Service (Inflation)

26. Mr. Caborn : To ask the Secretary of State for Health what is his estimate of the inflation figure for the Health Service over the next 12 months.

41. Mr. Boyes : To ask the Secretary of State for Health what is his estimate of the inflation figure for the Health Service over the next 12 months.

47. Mr. Buckley : To ask the Secretary of State for Health what is his estimate of the inflation figure for the Health Service over the next 12 months.

66. Mr. Bradley : To ask the Secretary of State for Health what is his next estimate of the inflation figure for the Health Service over the next 12 months.

Mr. Dorrell : The Government do not make estimates of inflation in the National Health Service before the end of the financial year concerned.

Ambulance Services

29. Mr. Nellist : To ask the Secretary of State for Health what plans he has to safeguard the provision of the out-patient ambulance service ; and if he will make a statement.

Column 575

Mrs. Virginia Bottomley : Responsibility for providing patient transport services will continue to lie with health authorities.

Maternity Services

31. Mr. Terry Fields : To ask the Secretary of State for Health what action his Department is taking following the publication of the National Audit Office report on maternity services.

44. Ms. Gordon : To ask the Secretary of State for Health what action his Department is taking following the publication of the National Audit Office report on maternity services.

48. Mrs. Fyfe : To ask the Secretary of State for Health what action his Department is taking following the publication of the National Audit Office report on maternity services.

80. Mr. Flannery : To ask the Secretary of State for Health what action his Department is taking following the publication of the National Audit Office report on maternity services.

Mrs. Virginia Bottomley : The National Audit Office reported that, despite the halving of infant mortality rates between 1985 and 1987, there remained wide-ranging geographical variations in the incidence of infant mortality. Last July, in the Government reply to the first report from the Social Services Committee (Session 1988-89) on "Perinatal, Neonatal and Infant Mortality" (Cm 741), we announced a major new initiative to address this problem. The National Audit Office endorsed our approach and we are taking its findings into account in its implementation.

Figures just published by the Office of Population, Censuses and Surveys in its weekly monitor bulletin of 16 May, a copy of which is available in the Library, show that the decline in infant mortality continued in 1989 and rates are now lower than in any previous year.

General Practitioner Practices (Staff)

33. Dr. Woodcock : To ask the Secretary of State for Health what is the number of practice staff in the average general practitioner service practice.

Mrs. Virginia Bottomley : The average number of practice staff per partnership qualifying for direct reimbursement was 6.3 (3.7 whole-time equivalents) in 1988, the latest year for which figures are available.

Wessex Regional Health Authority

34. Mr. Key : To ask the Secretary of State for Health when he last met the chairman of Wessex regional health authority.

Mrs. Virginia Bottomley : My right hon. and learned Friend the Secretary of State last met Mr. Buchanan at his meeting with regional chairmen on 16 May.

Preventive Medicine

35. Mr. Knapman : To ask the Secretary of State for Health what recent additional preventive medicine initiatives have been mounted by his Department.

Column 576

Mr. Dorrell : I refer my hon. Friend to the reply my hon. Friend the then Parliamentary Under-Secretary of State gave my hon. Friend the Member for Welwyn, Hatfield (Mr. Evans) on 23 January at column 670. Additional preventive medicine initiatives mounted by the Department since 23 January include :

(a) support for a wide range of programmes to prevent the spread of HIV infection through local authorities and health authorities, voluntary bodies and the Health Education Authority, whose latest mass media campaign was launched on 14 February 1990.

(b) the launch of the latest national drug publicity campaign in February at a cost of £3.8 million. Its aim is to maintain the current level of awareness about the dangers of drug misuse among young people. Complementary regional campaigns are being run in Yorkshire, Mersey and West Midlands.

(c) the funding by the Department, through the Health Education Authority, of the appointment of regional alcohol misuse co-ordinators in each of the 14 health regions. Their tasks include encouraging all the relevant agencies within their regions to co-operate in ensuring that help is available for people who misuse alcohol or are at risk of doing so, and in promulgating the importance of drinking sensibly. National Drinkwise Day on 12 June will provide a focus for health education about the dangers of alcohol misuse.

(d) as part of the "Look After Your Heart" programme a national fitness survey, jointly sponsored by the Department of Health, the Health Education Authority, and the Sports Council in conjunction with Allied Dunbar, was launched on 20 February 1990 to measure the nation's fitness. This entails the study of at least 6,000 adults of all ages to explore the relationship between exercise, fitness and health.

(e) as a further contribution to the "Look After Your Heart" programme, the national Heartbeat Award scheme was launched on 26 April 1990. This award is intended to encourage caterers to play an active role in reducing coronary heart disease by promoting healthy food choices, smoke-free areas and good standards of food hygiene. The award is endorsed and implemented by the Institute of Environmental Health Officers.

(f) together with the Health Education Authority and regional health authorities, 28 regional "Look After Your Heart" officers are in the process of being appointed and

(g) the preparation, with the Health Education Authority, of a further phase of a major education campaign on vaccination and immunisation due to be launched in September 1990. This has already been piloted in the north- west region.

National Health Service, North Debyshire

36. Mr. Skinner : To ask the Secretary of State for Health if he will meet a delegation of North Derbyshire health authority members to discuss cuts in the National Health Service ; and if he will make a statement.

Mr. Dorrell : Members of North Derbyshire health authority should discuss any concerns they have with the chairman of the Trent regional health authority which is the body responsible for allocating North Derbyshire's resources. National Health Service funding has risen to £29.1 billion this year and is well ahead of inflation on any measure ; North Derbyshire's budget of £64.1 million represents an increase of nearly 3 per cent. over last year.

Column 577

Out-patient Departments

39. Mr. Gale : To ask the Secretary of State for Health whether any initiatives are being taken to improve out-patient departments.

Mrs. Virginia Bottomley : The following initiatives have been taken by the Department to improve out-patient departments :

i. Out-patient Demonstration Projects--Aims

As part of the Government's drive to raise quality standards in hospitals, the Department is supporting six demonstration projects in out-patient departments at a total cost of £750,000. The aim is to improve the quality of services and make them more responsive to the needs of consumers by providing care in pleasant physical surroundings with better facilities, clear information to patients and effective appointment systems. The first results will be disseminated as good practice advice to the health service later this year.

ii Demonstration Projects to be Funded 1990-91

Some five more projects are likely to be funded in 1990-91. Health authorities and units will be informed in June 1990 which projects have been selected.

iii. Waiting Times in Out-patients

A report issued in December 1989 on "Reducing Waiting Time in Out-patient Departments' is now being followed up by development of a visual simulation package to assist NHS out-patient departments in planning efficient appointment systems.

iv. Role of Nurses and other Non-Medical Staff in Out-patients A departmental study report on "The Role of Nurses and other Non-Medical Staff in Out-patient Departments" was issued to health authorities in March 1990. The report contains proposals for changing the skill mix of qualified and non-qualified staff better to reflect the nature of tasks undertaken and to make the best use of available resources.

GP Contracts

40. Mr. Favell : To ask the Secretary of State for Health whether he has received any representations claiming that patients are being removed from doctors' lists as a result of the new general practitioners' contract.

Column 578

Mr. Kenneth Clarke : I have received a number of such representations and I have had the facts investigated wherever possible. None of these cases has proved to result from the GPs' new contract and some well-reported complaints have proved to be quite inaccurate. As I have repeatedly said, it is dishonest and unprofessional for GPs to suggest that the Government's new contract justifies the removal of any patient from a practice list.

43. Mr. Brandon-Bravo : To ask the Secretary of State for Health what assessment he has made of the effect of the new general practitioners' contract on the family doctor service.

49. Mr. Kennedy : To ask the Secretary of State for Health if he will make a statement on the operation of the new general practitioner contracts.

69. Mr Charles Wardle : To ask the Secretary of State for Health what assessment he has made of the effect on service to patients of the new general practitioners' contract.

Mrs. Virginia Bottomley : I refer my hon. Friends and the hon. Member to the reply my right hon. and learned Friend the Secretary of State gave the hon. Member for Cunninghame, South (Mr. Lambie) on 1 May at columns 517-18.

General Practitioners (Expenditure)

Mr Robin Cook : To ask the Secretary of State for Health what was the level of his Department's funding, in cash and constant prices, of expenditure by general practitioners on practice staff and premises in each year since 1979.

Mr Kenneth Clarke : The information requested is in the following table and shows that annual public expenditure on these items has almost trebled in real terms over the period.

Column 577


Expenditure by FPCs (England): 1979-80-1990-91 Practice Staff and Premises      

<1> Delated using GDP Deflator.                                                 

<2> Figures for 1979-80 to 1988-89 are taken from Summarised Accounts (England),

 and show direct reimbursement of 70 per cent. of the cost of practice staff,   

direct reimbursement of rent and rates and improvement grants. The rest of the  

cost of practice staff is reimbursed indirectly through GPs' fees and           

allowances.                                                                     

<3> 1989-90 figures are on a similar basis but show provisional out-turn.       

<4> 1990-91 figures are preliminary allocations for cash limited expenditure on 

direct reimbursement of practice staff costs, cost rents and improvement grants 

and estimated non cash limited expenditure on other rent and rates.

Column 579

Family Planning

42. Ms. Armstrong : To ask the Secretary of State for Health what proposals he has for the improvement of family planning services.

46. Mr. David Young : To ask the Secretary of State for Health what proposals he has for the improvement of family planning services.

85. Mr. Wilson : To ask the Secretary of State for Health what proposals he has for the improvement of family planning services.

86. Mr. Doran : To ask the Secretary of State for Health what proposals he has for the improvement of family planning services.

Mrs. Virginia Bottomley : The day-to-day management of family planning services is a matter for individual health authorities since they can best judge local circumstances and priorities. The Government continue to regard family planning as an important preventive service and guidance issued by the Department of Health makes it clear that health authorities should ensure that full use is made of family planning services, and that a proper balance is struck between services provided by specialist clinics and those provided by GPs.

Community Health Councils

50. Mr. Norman Hogg : To ask the Secretary of State for Health if he will make a statement on the future of community health councils.

73. Mr. George Howarth : To ask the Secretary of State for Health if he will make a statement on the future of community health councils.

Mr. Dorrell : I refer the hon. Members to the reply I gave the hon. Member for Clydesdale (Mr. Hood) earlier today.

Hospital Appointments

52. Mr. Barry Field : To ask the Secretary of State for Health what is the average waiting time for a hospital appointment ; and what was the figure 12 months ago.

Mrs. Virginia Bottomley : This information is not collected centrally.

NHS (Maintenance)

56. Mr. Martlew : To ask the Secretary of State for Health what is his latest estimate of the cumulative backlog of maintenance for the National Health Service.

63. Mr. Morgan : To ask the Secretary of State for Health what is his latest estimate of the cumulative backlog of maintenance for the National Health Service.

64. Mr. Morley : To ask the Secretary of State for Health what is his latest estimate of the cumulative backlog of maintenance for the National Health Service.

89. Mr. Meale : To ask the Secretary of State for Health what is his latest estimate of the cumulative backlog of maintenance for the National Health Service.

Mr. Dorrell : I refer the hon. Members to the reply my hon. Friend, the then Parliamentary Under-Secretary of

Column 580

State, gave the hon. Members for Pontefract and Castleford (Mr. Lofthouse) and for Leigh (Mr. Cunliffe) on 23 January at column 656.

Needle Exchange Schemes

57. Mr. Strang : To ask the Secretary of State for Health if he will make a statement on his policy towards the establishment of needle exchange schemes to reduce the spread of HIV among injecting drug misusers.

Mrs. Virginia Bottomley : We issued guidance to health authorities in September 1988 on establishing syringe exchange schemes. We estimate that there are currently some 120 schemes in England and schemes are now starting in Wales. Selected schemes continue to be monitored. Overall, our aim is to determine their effectiveness in changing drug misusers' behaviour away from practices which carry a risk of acquiring or transmitting HIV infection.

King's College Hospital

58. Mr. Simon Hughes : To ask the Secretary of State for Health whether King's College hospital has expressed interest in becoming a self- governing hospital trust.

Mrs. Virginia Bottomley : Yes.

Bury DHA

60. Mr. Sumberg : To ask the Secretary of State for Health what additional resources have been made available to Bury district health authority for 1990-91.

Mr. Dorrell : In 1990-91 additional cash resources will be made available by the North Western regional health authority to Bury health authority amounting to £2,723,200 which represents an increase of 9.3 per cent. over the previous year. Taken together with about £1 million efficiency savings, this will enable service developments of over £1.4 million to go ahead this year.

Hospital Doctors

62 Mr. Sayeed : To ask the Secretary of State for Health if he will make a statement on current consideration of the pay and conditions of hospital doctors in the National Health Service.

83. Mr. Paice : To ask the Secretary of State for Health if he will make a statement on current consideration of the pay and conditions of hospital doctors in the National Health Service.

Mrs. Virginia Bottomley : Hospital doctors' pay has risen by more then 33 per cent. in real terms since 1979. For details of the 1990 pay settlement for National Health Service hospital doctors, I refer my hon. Friends to the reply my right hon. Friend the Prime Minister gave my hon. Friend the Member for Gainsborough and Horncastle (Mr Leigh) on 1 February at columns 260-62.

We have recently issued detailed guidance to health authorities on consultant's contracts. By 1 April 1991 all hospital consultants will have job plans agreed with local managers setting out their main responsibilities and their fixed commitments in the National Health Service.

The issue of junior doctors' hours remains a priority for the Government. I recently met representatives of all the

Next Section

Home Page