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Psittacosis
Mr. Allen : To ask the Secretary of State for Health if he will make psittacosis a notifiable illness ; and if he will make a statement.
Mr. Dorrell : The Public Health (Control of Diseases) Act 1984 and the Public Health (Infectious Diseases) Regulations 1988 define "notifiable" diseases and list the diseases that are to be notified. A review of this legislation is currently being carried out. A consultation document, "Review of the law on infectious disease control", issued by the Department in October 1989, invited comments on an extensive range of options and proposals for changes to the current law. Section 3 of the document identified the diseases which are currently notifiable and sought views on a number of questions including whether any additional diseases should be added to the list. More than 500 responses to the consultation document were submitted, many of which suggested additional diseases, including psittacosis, that should be made notifiable. Officials are now considering all the responses received. The case for making psittacosis a notifiable disease will be given careful consideration.
Mr. Allen : To ask the Secretary of State for Health whether his Department has investigated the recent outbreak of psittacosis in Nottingham ; and if he will make a statement.
Mr. Dorrell : Local clinicians are responsible for initiating epidemiological investigations. We are satisfied that appropriate action was taken at the time of the outbreak.
Mr. Allen : To ask the Secretary of State for Health what studies his Department has undertaken on psittacosis ; and if he will make a statement.
Spinal Injury Units
Mr. Ashley : To ask the Secretary of State for Health what representations the supra-regional forum has received from spinal injury units on the need for central Government funding for psychologists and peripatetic nurses ; and if he will make a statement.
Column 595
Mrs. Virginia Bottomley : I understand that the supra- regional services advisory group is now receiving applications for funding in 1991-92. It is too early to specify how many spinal injury units will request additional funds for psychologists or peripatetic nurses.Mr. Ashley : To ask the Secretary of State for Health (1) if he will list, for each spinal injury unit, the number of beds in the unit, the number of psychologists and peripatetic nurses employed at the unit and the source of funding for each of these positions ; (2) when the first psychologist was appointed to a spinal injury unit ; and what is the accepted role of psychologists and peripatetic nurses at spinal injury units.
Mrs. Virginia Bottomley : The table shows the average daily available bed numbers. Information on the numbers and funding of psychologists and peripatetic nurses is not available centrally and the question of their role is for determination locally.
|c|NHS Spinal Units, England 1988-89|c|
Hospital site |Average Daily
|Available Beds
----------------------------------------------------------------------------
Hexham General Hospital |34
Pinderfields Hospital, Wakefield |23
Lodge Moor Hospital, Sheffield |43
Royal National Orthopaedic Hospital, Stanmore |20
Odstock Hospital, Salisbury |39
Southport Promenade Hospital |35
Stoke Mandeville Hospital |*
Robert Jones and Agnes Hunt Orthopaedic
Hospital, Oswestry |*
* Data for these spinal units were not separated in the statistical return
from data on other beds and it is not possible to give a useful figure.
Dental and Eye Charges
Mr. Paice : To ask the Secretary of State for Health how much revenue he expects to be raised from dental and eye charges in 1990-91 ; and how much revenue has been raised since the inception of charges at current prices.
Mr. Dorrell : The 1990-91 estimates laid before Parliament show income from patient charges for general dental services in England as £388 million. There are no patient charges in the general ophthalmic service. Certain priority groups, including children and those on low incomes, are eligible for free National Health Service sight tests and vouchers towards the cost of glasses where these are necessary. People not included in these priority groups pay private fees to opticians for ophthalmic services.
National Health Service dental and ophthalmic charges were introduced in 1951. Charges for the supply of National Health Service glasses through the general ophthalmic service stopped from 1 July 1986, when vouchers were introduced. The estimated total revenue collected in England since the inception of these patient charges is set out in the following table :
F
|c|Revenue collected adjusted to 1990-91 prices using the GDP
deflator|c|
Cash total
|£ million|£ million
----------------------------------------------------------------------
Charge income from the General
Dental Service 1951-52 to 1989-90 |2,590 |5,710
Charge income from the General
Ophthalmic Service 1951-52 to 1986-87 |490 |2,080
These totals are based on estimates of the England-only income in the period 1951-52 to 1968-69 ; accounts for these years combined figures for England and Wales. They are gross of any refunds to patients who were incorrectly or inadvertently deemed liable to pay charges.
Competitive Tendering
Mr. Paice : To ask the Secretary of State for Health how much money he estimates has been saved in total by health authorities as a result of compulsory competitive tendering in each of the last five years ; and what likely savings he expects to be made in 1990-91 at current prices.
Mr. Dorrell : An initiative was started in 1983 to encourage health authorities to place contracts through competitive tendering of laundry, domestic and catering services. Up to the end of 1988-89 this initiative had resulted in cumulative savings of £110 million with an additional £6 million savings expected in 1989-90. Estimated savings for 1990-91 are not yet available.
Epilepsy
Mr. Harry Barnes : To ask the Secretary of State for Health how many nuclear magnetic resonance scanners are possessed by the National Health Service ; and what proportions of these are designed for use solely to identify epilepsy.
Mr. Dorrell : I am advised that magnetic resonance scanning is not a useful means of diagnosing epilepsy since most people with epilepsy would have a normal scan.
Food Hygiene Regulations
Dr. David Clark : To ask the Secretary of State for Health if he will make a statement about progress on the proposed amendments to the Food Hygiene Regulations.
Mr. Dorrell : Amendment regulations will be laid before Parliament shortly.
Blood and Blood Products
Mr. Cousins : To ask the Secretary of State for Health for each National Health Service region, what was the cost of purchases of blood and blood products (a) external to the region, and (b) from outside the United Kingdom.
Mr. Dorrell [holding answer 23 May 1990] : The cost of blood for those regions which were net receivers from regional transfusion centres elsewhere in the United Kingdom, for the financial year 1989-90, is given in the table. No blood is imported from outside the United Kingdom.
Information on the value of the blood products supplied by the bio products laboratory (formerly the blood products laboratory) is commercially sensitive. Information on the value of the blood products imported into the United Kingdom is not held centrally either for individual regions or in total.
|c|Costs associated with blood supplied from other regions (net costs)<1>|c| Region |£ ---------------------------------- Northern |- Yorkshire |- Trent |- East Anglian |3,334 North-West Thames |81,091 North-East Thames |156,371 South-East Thames |439,208 South-West Thames |- Wessex |- Oxford |- South Western |- West Midlands |- Mersey |- North Western |- Wales |1,429 <1> The receiving region pays the supplying region a sum to cover its costs of collecting, processing and transport.
Nurseries
Mrs. Gorman : To ask the Secretary of State for Health how many women have children under five years ; how many of these women work ; what the estimated demand for nurseries is ; and how many women who do not go to work place their children in nurseries.
Mr. Dorrell : Not all the information requested is centrally available but such data as can be provided are as follows :
|c|Table 1|c|
|c|Great Britain|c|
|1986 |1988
|per cent.|per cent.
----------------------------------------------------------------
Percentage of women with children
under 5 years |17 |17
Sample base (women aged 16 to 59) |7,478 |7,326
1. Table 1 shows that, in 1986 and 1988, 17 per cent. of all
women of working age had at least one child aged under five
years. Table 2 gives the percentages of these women who, in the
same years, were working full time or part time. The data are
taken from the General Household Survey, which obtains
information from a sample of private households, and are
therefore subject to sampling variability.
|c|Table 2|c|
|c|Great Britain|c|
|1986 |1988
|per cent.|per cent.
-----------------------------------------------------------------
Percentage of women, with children
under 5, who went out to work
Full time |9 |11
Part time |24 |25
|------- |-------
Total going out to work<1> |33 |36
Sample base (women aged 16 to 59
with child(ren) aged 0 to 4 |1,238 |1,281
<1> Includes a few cases for which hours of work were not given.
Notes:
1. Table 1 shows that, in 1986 and 1988, 17 per cent. of all
women of working age had at least one child aged under five
years. Table 2 gives the percentages of these women who, in the
same years, were working full time or part time. The data are
taken from the General Household Survey, which obtains
information from a sample of private households, and are
therefore subject to sampling variability.
2. 1988 is the most recent year in which the survey carried
questions on day care for children under 5. It showed that 6 per
cent. of children under five whose mothers did not go out to
work attended a day nursery. This percentage is based on 1,105
children covered by the survey sample, some of whom would be
from the same family. The percentage of non-working mothers of
children under five whose children attended a day nursery is not
available.
3. No information is available on the demand for nurseries.
Column 598
Kawasaki Disease
Mr. John Hughes : To ask the Secretary of State for Health what assessment he has made of the threat to children's health of (a) meningitis and (b) Kawasaki disease ; how many people in various age groups have died of Kawasaki disease ; and if he will issue information to alert the public to the disease's symptoms.
Mr. Dorrell : The two most important causes of meningitis in childhood are meningococcal meningitis and haemophilus influenza B meningitis. The Public Health Laboratory Service's communicable disease surveillance centre and the Department closely monitor meningococcal meningitis, which is a notifiable disease, so that local outbreaks can be dealt with promptly.
The chief medical officer wrote to all doctors and health authorities in February 1988 about the early management and prevention of spread of meningococcal infection. Copies of the two letters, PL/CMO(88)1 and PL/CMO(88)2, are available in the Library. The Public Health Laboratory Service is paying special attention to the surveillance of haemophilus influenza B meningitis, and there are prospects for the use of effective vaccine following appropriate trials.
Surveillance of Kawasaki syndrome has been con-ducted jointly by the British Paediatric Association and the Public Health Laboratory Service's communicable disease surveillance centre since 1983. A total of 112 reports of Kawasaki disease was received for cases with onset in 1989. This gives an incidence of 1.5 per 100,000 children under five years old.
The following table shows the number of deaths from acute febrile mucocutaneous lymph node syndrome (MCLS), which includes Kawasaki disease, in England and Wales :
A
Year Age
|Under 1 year|1 years |2 years
-----------------------------------------------------------------
1985 |- |- |1
1986 |1 |- |-
1987 |1 |- |-
1988 |1 |- |1
<2>1989 |- |- |-
<1> 9th Revision International Communicable Disease Code 446.1
<2> Provisional
Kawasaki syndrome is a disease mainly of young children and has clinical features similar to other infections. The results of routine investigations may suggest the diagnosis but are not specific. Public information on the disease would not, therefore, assist in early diagnosis of the condition. Greater professional awareness amongst paediatricians in this country of its signs and symptoms would be more appropriate. In this regard, a leading article has recently appeared in the British Medical Journal (21 April 1990), copies of which are available in the Library.
Artificial Sweeteners
Dr. David Clark : To ask the Secretary of State for Health how many members of the Committee on the Toxicity of Chemicals in Food are consultants to companies that are involved with the manufacture, marketing or use of artificial sweeteners in their products ; and if he will make a statement.
Column 599
Dr. David Clark : To ask the Secretary of State for Health, further to his answer to the hon. Member for South Shields on 22 May, if he will name the one member of the Committee on the Toxicity of Chemicals in Food who acts as a consultant to the International Sweeteners Organisation.Mr. Dorrell : It is not our policy to publish details of the outside interests of members of the independent expert advisory committee on toxicity. Members declare, in confidence, to the Department any specific pecuniary relationship between themselves and any company in the field in which the advisory committee operates. When an item in which a member has an interest is discussed the interest is declared and the declaration is minuted.
One member has declared an interest in a company associated with another company which manufactures an artificial sweetener, another member has declared an interest in a company manufacturing an artificial sweetener and a third has declared an interest in an organisation representing manufacturers of artificial sweeteners.
Mentally Ill and Mentally Handicapped People
Mr. Conway : To ask the Secretary of State for Health what changes in expenditure on and statutory provision for services to the mentally ill and mentally handicapped there have been since 1979.
Mr. Dorrell : Gross spending on hospital and community health services for the mentally ill and mentally handicapped increased in real terms by 20 per cent. (to £1,149 million) and 11 per cent. (to £497 million) respectively between 1978-79 and 1986-87, the most recent year for which information is available. Estimated gross expenditure by local authorities for the two groups increased in real terms by 50 per cent. (to £44 million) and 69 per cent. (to £288 million) respectively over the same period.
Since 1979 there have been a number of important changes to the statute law relevant to services, most notably the Mental Health Act 1983 and the Disabled Persons (Services, Consultation and Representation) Act 1986. In addition, further changes are proposed in the NHS and Community Care Bill.
Mr. Wigley : To ask the Secretary of State for Health how the Government intends to meet the provisions of
Column 600
section 7 of the Disabled Persons (Services, Consultation and Representation) Act 1986 with regard to mentally handicapped people leaving long-stay hospitals.Mr. Dorrell : As announced in the White Paper "Caring for People" the Government do not now intend to implement section 7 of the Act. The need to do so will be reconsidered in the light of several years' experience of the introduction of the assessment and case management procedures outlined in the White Paper. Current guidance already stresses the need for health authorities to ensure that there is provision for assessing individuals' particular needs.
Hospital Waiting Lists, London
Mr. Tony Banks : To ask the Secretary of State for Health how many people are currently on hospital waiting lists in the London area ; and what was the figure 12 months ago.
Mrs. Virginia Bottomley : Between 30 September 1988 and 30 September 1989, the latest figures available, the in-patient waiting lists for London health authorities fell from 131,115 to 124,793, a decrease of 4.8 per cent.
Energy Consumption
Mr. Dobson : To ask the Secretary of State for Health (1) if he will give for each year from 1978 the energy consumption, broken down by fuel, of the buildings occupied by his Department, expressing the figures in (a) cash terms, (b) 1978-79 money terms and (c) units of consumption for electricity in kilowatt hours, gas in therms, liquid fuel in litres and solid fuel in tonnes ;
(2) if he will give the number of energy audits carried out in his Department in the last five years and for each audit a statement of its main conclusions ;
(3) if he will give the number of dedicated energy managers in his Department and the number of person years devoted to energy management in the latest year.
Mr. Dorrell : For the whole of the period for which records are available, energy consumption for the Department of Health and the Department of Social Security, formerly DHSS, was jointly managed. I refer the hon. Member to the replies my hon. Friend the Parliamentary Under- Secretary of State for Social Security gave today.
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