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Lord James Douglas-Hamilton [holding answer 25 June 1990] : The Government have no immediate plans to introduce a new system of improvement and repairs grants in Scotland. Resources for housing capital expenditure in 1991-92 will be allocated, as in previous years, on the basis of local authorities' relative needs and with reference to their capital programmes and housing plans.
Procurator Fiscal, Orkney
Mr. Wallace : To ask the Secretary of State for Scotland what savings he anticipates will be made in the present financial year as a result of downgrading the post of procurator fiscal in Orkney from a full- time to a part-time appointment.
Lord James Douglas-Hamilton [holding answer 25 June 1990] : The present arrangements for discharging the duties of the procurator fiscal, Orkney are expected to save £25,000 in the current financial year.
HEALTH
Community Care
124. Mr. Hinchliffe : To ask the Secretary of State for Health if he has made an estimate of the additional costs to be incurred by local authorities in 1991-92 due to the new legislation on community care ; and if he will make a statement.
Mr. Dorrell : I refer the hon. Member to the reply that I gave the hon. Member for Carlisle (Mr. Martlew) on 23 May at column 199 .
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Departmental Research (Expenditure)
Dr. Thomas : To ask the Secretary of State for Health what was the total identifiable expenditure on research by his Department in each year since 1979 ; what proportion was awarded on a
customer-contractor basis ; and what proportion of his total departmental budget was expended on research for each year.
Mr. Dorrell : Research and development by the Department of Health, all of which is managed on the customer-contractor principle, is funded through the research budgets for health and personal social services, procurement directorate, national health service information technology and building and engineering.
For 1988-89, the latest year for which out-turn figures are available, the total such expenditure was £15.8 million, forming 0.086 per cent. of total Department of Health expenditure. Available information for earlier years has been published in the Cabinet Office Annual Review of Government Funded Research and Development.
South London Hospital for Women
Mr. Cox : To ask the Secretary of State for Health what recent discussions he or officials in his Department have had, and with whom, on the future use to be made of the now closed South London hospital for women.
Mr. Dorrell : None. We understand that the West Lambeth health authority has plans to submit an approval in principle submission to the South East Thames regional health authority for a proposal to use the site to meet a variety of health needs in the area.
NHS Trusts
Mr. Teddy Taylor : To ask the Secretary of State for Health if he will make a statement on the basis on which financial help will be provided to health authorities after the establishment of hospital trusts in their areas.
Mrs. Virginia Bottomley : All district health authorities will receive a revenue allocation with which to purchase services for their residents whether from NHS trusts, directly managed units or the private or voluntary sectors.
Minor Surgery
Mr. Rathbone : To ask the Secretary of State for Health what encouragement the Government are giving to general practitioners to undertake more minor surgery.
Mrs. Virginia Bottomley : We are keen to encourage more GPs to provide minor surgery, which is a service popular with patients. The GPs' new contract introduces for the first time specific remuneration for this work. GPs admitted to the minor surgery List will receive a sessional payment of £100 provided they perform at least five of the procedures listed in the regulations each quarter. A GP is allowed to claim no more than three sessional payments a quarter. Where a GP carries out minor surgery on behalf of a partnership or group practice he or she may claim a higher number of payments in a quarter up to a maximum of three times the number of partners or members of the group. These arrangements will provide a strong incentive to GPs to extend their skills, resulting in an enhanced
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service to their patients. In consequence, patients will be saved the inconvenience of attending out-patients departments.Project 2000
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health what recent representations he has received from the Royal College of Nursing on the implementation of Project 2000.
Mrs. Virginia Bottomley : None. We understand that my right hon. Friend the Prime Minister has recently received a letter concerning the implementation of Project 2000 from Christine Hancock, the General Secretary of the Royal College of Nursing.
Lyme Disease
Mr. Colvin : To ask the Secretary of State for Health how many cases of Lyme disease were reported in the last 12 months.
Mr. Dorrell : In 1989, a total of 16 laboratory reports of Lyme disease in England and Wales were received by the public health laboratory service's communicable disease surveillance centre. The provisional number of reports received for the first five months of 1990 was five.
Births Basildon
Mr. Amess : To ask the Secretary of State for Health if he will list the number of babies born at Basildon hospital in each of the last seven years.
Mr. Dorrell : Births at particular hospitals have only been analysed by OPCS since 1989. However, records analysed by the Basildon and Thurrock district health authority give the following information.
Year |Number of
|births
-------------------------------
1983 |2,323
1984 |2,378
1985 |2,455
1986 |2,397
1987 |2,470
<1>1988-89 |2,646
<1>1989-90 |2,695
Source: Basildon and Thurrock
district health authority.
<1> Financial year.
Mr. Amess : To ask the Secretary of State for Health if he will list the numbers of babies born in (a) Basildon constituency and (b) the Basildon and Thurrock district health authority area in each of the last seven years.
Mr. Dorrell : The information requested is given in the tables.
Live and still births for Basildon borough
constituency
|Livebirths |Stillbirths
------------------------------------------------
1982 |1,418 |9
1983 |1,435 |9
1984 |1,420 |7
1985 |1,461 |4
1986 |1,418 |4
1987 |1,462 |6
1988 |1,523 |9
1989 |1,589 |3
Live and still births for Basildon and Thurrock
DHA
|Livebirths |Stillbirths
------------------------------------------------
1982 |3,827 |25
1983 |3,901 |20
1984 |4,010 |18
1985 |4,143 |16
1986 |4,057 |19
1987 |4,297 |13
1988 |4,460 |23
1989 |4,420 |11
Hospital Laundering
Mr. Robert G. Hughes : To ask the Secretary of State for Health, pursuant to his answer of 6 March, Official Report, column 579, if he will detail the relevant monitoring arrangements to ensure that health authorities take account of all relevant expenditure when determining the cost of their in-house laundering and dry cleaning facilities.
Mrs. Virginia Bottomley : To ensure independent assessment those involved in compiling an in-house tender and service costing are expressly excluded from participation in the tender evaluation exercise. All costings are also open to scrutiny by the relevant district health authority, the regional health authority and to internal and external auditors.
Children (Social Services)
Mr. Allen : To ask the Secretary of State for Health if he will make it his policy to collect the statistics necessary to estimate the number of children who are not receiving care from local authority social services and social workers in cases in which there is a statutory duty to provide such care.
Mrs. Virginia Bottomley : There are no present plans to do so. The regional offices of the social services inspectorate will continue to monitor the situation within their areas.
Waiting Lists
Mr. Jack : To ask the Secretary of State for Health if he will make a statement on the waiting list initiative.
Mrs. Virginia Bottomley : I refer my hon. Friend to the reply that I gave my hon. Friend the Member for Birmingham, Northfield (Mr. King) on 18 January at columns 403-4.
NHS Manager
Mr. Bowis : To ask the Secretary of State for Health if he will make a statement on the number of managers within the national health service.
Mrs. Virginia Bottomley : Managers may be employed in a wide range of professions and disciplines in the National Health Service ; there is no single definition on which a total figure could be based. About 900 general manager posts, and an estimated 8,000 at senior and middle manager level, are currently included in management pay arrangements.
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Health Authorities
Mr. Skinner : To ask the Secretary of State for Health whether he will introduce measures to ensure all members of health authorities are directly elected ; and if he will make a statement.
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Obstetrics
Mr. Michael : To ask the Secretary of State for Health how many junior doctors are employed in obstetrics on a whole-time equivalent basis in the National Health Service in each regional health authority in England in the current year ; and how many were employed in each of the past five years.
Mrs. Virginia Bottomley : The information requested is given in the table.
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Hospital junior doctors in Obstetrics and Gynaecology showing whole time equivalents at 30 September each year Year |1988 |1987 |1986 |1985 |1984 |1983 -------------------------------------------------------------------------- England |1,866.7|1,725.7|1,758.3|1,761.7|1,762.4|1,768.9 Northern |124.7 |125.7 |135.5 |134.8 |135.5 |137.2 Yorkshire |121.8 |103.3 |126.1 |120.7 |116.0 |130.9 Trent |183.1 |169.8 |175.5 |167.2 |163.8 |159.9 East Anglia |67.1 |70.0 |64.0 |65.4 |64.5 |66.4 North West Thames |166.9 |148.8 |142.1 |157.8 |145.9 |150.9 North East Thames |183.6 |159.1 |180.3 |185.1 |177.0 |175.9 South East Thames |142.4 |139.7 |128.8 |124.8 |130.8 |129.4 South West Thames |102.0 |100.4 |100.7 |96.0 |95.8 |99.6 Wessex |67.8 |76.3 |72.4 |78.3 |98.4 |77.2 Oxford |99.9 |93.1 |91.9 |93.8 |84.0 |86.3 South Western |115.0 |93.9 |96.0 |90.7 |94.1 |92.6 West Midlands |190.6 |178.3 |176.7 |177.8 |170.8 |169.4 Mersey |90.8 |91.0 |77.3 |91.8 |91.2 |101.3 North Western |178.6 |159.0 |176.0 |169.8 |165.1 |168.2 SHAs |32.4 |20.4 |14.5 |7.3 |29.5 |23.7 Source: Medical and dental census. Notes: 1. Includes permanent paid and honorary staff. 2. Junior doctors includes senior registrar, registrar, senior house officer and house officer.
Central Blood Laboratories Authority
Mr. Andrew Smith : To ask the Secretary of State for Health what negotiations are taking place, or scheduled to take place, with the United States firm, Baxters, in relation to the Central Blood Laboratories Authority operations at Elstree and Churchill hospital, Oxford ; what are the terms of reference of the negotiations ; when he expects them to be completed ; and what plans he has to report publicly on the outcome.
Mr. Dorrell : The Central Blood Laboratories Authority conducts regular negotiations with other organisations in the plasma fractionation industry with a view to gaining access to methods and processes which might lead to more efficient utilisation of the plasma received from the National Blood Transfusion Service. Baxter Inc is one such company. These negotiations are commercially sensitive and remain confidential.
Regional Health Authorities
Mr. Corbett : To ask the Secretary of State for Health (1) what account he took of the additional costs of PTB and A and C pay restructuring when deciding cash allocations to regional health authorities ;
(2) whether the increased cost consequences of PTB and A and C pay restructuring are to be met from additional central funding or out of existing regional health authority and district health authority allocations.
Mrs. Virginia Bottomley : Health authorities should meet increases in prices and pay, including the costs of restructuring negotiated in the Whitley councils, from their cash allocations, income generation schemes and cost improvement programmes.
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The PTB and A and C pay restructurings were negotiated in 1989. By the end of the two year period 1989-90 to 1990-91, the gross extra resources available to the National Health Service in England will have increased by over £4 billion or 20 per cent.Corwin
Mr. Ashley : To ask the Secretary of State for Health what action has been taken by the Committee on Safety of Medicines on the drug Corwin ; and if he will make a statement.
Mrs. Virginia Bottomley : I refer the right hon. Member to the reply that I gave my hon. Friend the Member for Newbury (Sir Michael McNair- Wilson) on 21 June at columns 677-78.
Mr. Ashley : To ask the Secretary of State for Health what estimates there are of the number of prescriptions of Corwin to patients with severe heart conditions.
Mrs. Virginia Bottomley : I refer the right hon. Member to the reply that I gave the hon. and learned Member for Montgomery (Mr. Carlile) on 21 June at column 678. Prescriptions do not indicate the nature of severity of the patient's condition.
Mr. Ashley : To ask the Secretary of State for Health if he will request the Committee on Safety of Medicines to re-evaluate the evidence about the heart drug Corwin and to reconsider its recommendations.
Mrs. Virginia Bottomley : The safety profile of Corwin has been closely monitored since its introduction onto the market in May 1988 by inclusion on the Committee on Safety of Medicine's (CSM) intensive monitoring scheme
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for all newly marketed products. The CSM has reviewed all the evidence related to the safety profile of the product on a number of occasions. Restrictions have been placed on the use of the product following re-consideration by CSM as recently as January 1990. Doctors were informed of these restrictions in a letter from ICI Pharmaceuticals, who market the product, and in CSM's bulletin "Current Problems" number 28, a copy of which is available in the Library. The use of Corwin is now to be initiated only in hospital after careful assessment of the patient who is to be regularly followed up. The CSM is satisfied that the product can be used safely if these recommendations are followed, but will continue to monitor the situation carefully.Drug Safety
Mr. Ashley : To ask the Secretary of State for Health if he will give consideration to adopting in the United Kingdom the United States Food and Drug Administration's system of publishing summary basis of approval reports when a product licence is given to a pharmaceutical drug.
Mrs. Virginia Bottomley : The Commission of the European Community (EC) suggested publication of a summary basis of approvals in proposals for a future licensing system for licensing in the EC. Further proposals are expected from the Commission soon and we shall consider these carefully. Section 118 of the Medicines Act 1968 currently prohibits disclosure of information obtained for the purposes of the Act.
Mr. Ashley : To ask the Secretary of State for Health if he will request all pharmaceutical companies to inform the Committee on Safety of Medicines when they withdraw a licence application to the United States Food and Drug Administration for a drug which has a British licence and to give the reason for the withdrawal.
Mrs. Virginia Bottomley : There are standard provisions attached to every product licence granted to a medicinal product in the United Kingdom. These provisions require the licence holder to inform the licensing authority of any information that casts doubt upon the continued validity of the data which was submitted for the purpose of the assessment of safety, quality and efficacy of any medicinal product to which the licence relates. Licence holders are also required to provide details of adverse reaction reports received worldwide by them. These statutory requirements provide sufficient safeguards to ensure that the licensing authority and the Committee on Safety of Medicines are informed of all relevant issues relating to a licensed medicinal product by the pharmaceutical company holding the licence.
Mr. Ashley : To ask the Secretary of State for Health if he will make public all discussions in the Committee on Safety of Medicines on matters pertaining directly to patients' health.
Mrs. Virginia Bottomley : The deliberations of the Committee on Safety of Medicines (CSM) are confidential. Information on potential problems with medicines is sent regularly to all prescribers by means of CSM's "Current Problems" bulletin ; in the case of major drug safety hazards the professions are alerted by means of a letter from the Chairman. Other means of publicity may be used
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when necessary. Drug prescribing information and guidance is also available from a number of other sources, for example the British National Formulary, which the Department issues free to all doctors twice yearly.Mr. Ashley : To ask the Secretary of State for Health if he will introduce legislation requiring the Committee on Safety of Medicines to consider whether or not a drug is more efficacious than other drugs already on the market before it grants a product licence.
Mrs. Virginia Bottomley : There are no plans to amend section 19(2) of the Medicines Act 1968 which requires the licensing authority to leave out of account any question of relative efficacy.
Mr. Ashley : To ask the Secretary of State for Health if he will make it his policy to request the Committee on Safety of Medicines, whenever there is a withdrawal of a licence application to the United States Food and Drug Administration for a drug which has a British licence, to re-evaluate the safety evidence.
Mrs. Virginia Bottomley : The licensing authority would consult the Committee on Safety of Medicines (CSM) in the event of important new information being made available in relation to a medical product which was licensed in the United Kingdom. Withdrawal of a licence application made to the United States Food and Drug Administration could occur for a number of reasons. In the United Kingdom holders of product licences for medicinal products are required to inform the licensing authority of any information that casts doubt upon the continued validity of data which were submitted for the purpose of the assessment of safety, quality and efficacy of the licensed product. Licence holders are also required to provide details of adverse reaction reports received by them.
Elderly Patients
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health what the daily per capita food allowance is for elderly patients in continuing care in the NHS in England.
Mr. Dorrell : The decision as to the level of dietary requirements rests with each individual health authority.
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health (1) what steps he is taking to ensure continuing care provision in the NHS for elderly people in England ;
(2) whether he will list by region the number of beds in continuing care for elderly people which have been contracted out in England ; (3) whether he will list, by region, the number of beds available in continuing care for elderly people in the NHS in England.
Mr. Dorrell : The information requested is not held centrally. The Government consider continuous nursing care services to be an integral part of NHS provision for elderly people who require them. There are several ways in which the NHS may arrange the provision of long-term, or continuous nursing care, where it is needed : by provision of community nursing to the patient's own homes ; a long stay geriatric ward ; in some districts, a NHS nurse managed unit ; or by beds in private nursing homes paid for under contractual arrangement. It is for local health authority management to decide the nature of the continuous care service it provides, in the light of local needs and circumstances and the overall level of provision.
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Hospitals (Health and Safety)
Mr. Corbett : To ask the Secretary of State for Health whether specific additional funding will be available to meet the cost of implementing health and safety measures in hospitals as required by recent changes in the law.
Mr. Dorrell : Resources to enable health authorities to meet their responsibilities under health and safety legislation are included within existing financial allocations. The level of expenditure is for individual authorities to assess in the light of their own local circumstances.
Beverley Lewis
Mr. Ashley : To ask the Secretary of State for Health whether his Department has completed its consideration of the reports from the health and social services authorities and the coroner's report on the death of Beverley Lewis ; and what further action he intends to take.
Mr. Dorrell : We have received and are carefully considering these reports, and shall soon be in a position to decide what further action would be appropriate.
Child Migrants Trust
Mr. Allen : To ask the Secretary of State for Health if he will attend the opening of the Child Migrants Trust office at 8 Kingston road, West Bridgford, Nottingham NG2 7AQ ; and if he will make a statement.
Mr. Kenneth Clarke : I have written to the Child Migrants Trust expressing my regret that due to a long-standing prior ministerial engagement to visit a hospital I am unable to attend the opening of the office on 29 June. I hope that the occasion will be enjoyable and that the opening will be an important stage in the work of the trust. The Government have made a grant of £20,000 to the trust to support that work.
Family Planning Services
Mr. Atkinson : To ask the Secretary of State for Health if he has any plans to improve the family planning service provided by (a) general practitioners, including women doctors and (b) health authorities ; and if he will make a statement.
Mrs. Virginia Bottomley [pursuant to her reply, 19 June 1990, column 508] : People should be free to choose their source of family planning advice. We look to all health authorities to provide a full range of family planning services to meet the particular needs and preferences of the local population and to strike a proper balance between services provided by specialist clinics and general practitioners. Ninety eight per cent. of general practitioners provide family planning services and advice. Women have increasingly turned to GPs for planning and advice so that now about two thirds of the 4 million people who make use of the service each year in England go to their general practitioners.
The letter to regional general managers referred to in my earlier reply, a copy of which has been placed in the Library, reaffirms previous guidance on family planning services. This particularly emphasised the need to give choice to encourage full take up, the need for separate, less formal, arrangements for young people and their wider health role for instance in cervical smear testing.
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Spending on NHS family planning services has increased in recent years. Annual spending on NHS family planning services has risen from £37.7 million in 1979 to £90.3 million in 1987-88.Children at Risk
Mr. Hinchliffe : To ask the Secretary of State for Health if his Department intends to issue an explanatory circular to local authorities regarding the conduct of case conferences on children at risk, following the recent Court of Appeal ruling on disclosure of social work records.
Mrs. Virginia Bottomley [holding answer 25 June 1990] : The conduct of case conferences will be addressed in a revision of "Working Together", in the light of the Children Act, and in training materials commissioned from Nottingham university under the Depatment's central training initiative.
DEFENCE
Regiments
Mr. Allen : To ask the Secretary of State for Defence, further to his reply of 14 June, Official Report, columns 326-27, concerning regiments ; if he will give the numbers of people employed in or connected with each regiment listed.
Mr. Archie Hamilton : As at 30 April 1990, the total trained strength of the Army was 136,869. The number of Army personnel employed at each of the arms and services of the Regular Army on that date is as follows :
|Officers|Soldiers|Total
--------------------------------------------------------------------
Staff Officers |787 |- |787
Household Cavalry and Royal
Armoured Corps |1,186 |8,930 |10,116
The Royal Regiment of Artillery |1,256 |10,981 |12,237
Corps of Royal Engineers |1,333 |11,579 |12,912
Royal Corps of Signals |1,073 |9,787 |10,860
Infantry |3,470 |32,392 |35,862
Army Air Corps |324 |1,250 |1,574
Royal Army Chaplains
Department |154 |- |154
Royal Corps of Transport |896 |8,124 |9,020
Royal Army Medical Corps |918 |2,513 |3,431
Royal Army Ordnance Corps |1,002 |6,135 |7,137
Corps of Royal Electrical and
Mechanical Engineers |968 |12,692 |13,660
Corps of Royal Military Police |144 |2,120 |2,264
Royal Army Pay Corps |440 |1,499 |1,939
Royal Army Veterinary Corps |29 |123 |152
Small Arms School Corps |29 |104 |133
Military Provost Staff Corps |7 |95 |102
Royal Army Educational Corps |499 |- |499
Royal Army Dental Corps |207 |190 |397
Royal Pioneer Corps |102 |1,158 |1,260
Intelligence Corps |272 |905 |1,177
Army Physical Training Corps |49 |351 |400
Army Catering Corps |164 |3,985 |4,149
Army Legal Corps |58 |- |58
General Service Corps |3 |- |3
Long Service List Soldiers |- |766 |766
Queen Alexandra's Royal Army
Nursing Corps |490 |958 |1,448
Women's Royal Army Corps |311 |4,061 |4,372
A complete breakdown could be provided only at disproportionate cost.
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Low Flying
Sir John Farr : To ask the Secretary of State for Defence what steps he has taken to research the relationship between the heights at which (i) RAF Tornados and (ii) Tornados operated by the Luftwaffe are regularly flown and the respective accident rates for these forces.
Mr. Neubert : None. The total number of accidents involving Tornados flown by either the RAF or the Luftwaffe would form too small a statistical sample to enable meaningful conclusions to be drawn.
However, after any RAF aircraft accident, a board of inquiry investigates the full circumstances (in which aircraft height may or may not be a relevant factor) and makes recommendations to minimise the risk of recurrence.
Missiles
Dr. Thomas : To ask the Secretary of State for Defence whether he has received any representations from allies in the North Atlantic Treaty Organisation favouring the cancellation of the deployment of the tactical air-to-surface missile and Tomahawk missiles on British soil.
Dr. Thomas : To ask the Secretary of State for Defence how many representations he has received concerning the deployment of the tactical air-to-surface missile and Tomahawk missiles in the United Kingdom ; and how many have been opposed to the deployment.
Mr. Archie Hamilton : In the last year we have received about 20 letters from right hon. and hon. Members and members of the public concerning the deployment of United States TASM and Tomahawk missiles to the United Kingdom. Most of these letters have been related to CND propaganda campaigns opposing, among other things, the possible deployment of TASM to the United Kingdom.
Atomic Weapons Establishment
Mr. O'Neill : To ask the Secretary of State for Defence whether, in the course of his inquiry into the atomic weapons establishment, Sir Francis Tombs was given access to commercially confidential information.
Mr. Neubert : No information which was classed as commercially confidential was given to Sir Francis (now Lord) Tombs in the course of his inquiry into the Atomic Weapons Establishment.
Mr. O'Neill : To ask the Secretary of State for Defence what safeguards have been established to ensure that all the companies competing for the contract to manage the atomic weapons establishment had equal access to commercially useful information.
Mr. Neubert : All potential bidders for the management contract at the atomic weapons establishment were given a detailed invitation to tender document, attended a bidders conference and site tour and were given full opportunity to raise additional queries during an extensive pre-bid inquiry phase.
Mr. O'Neill : To ask the Secretary of State for Defence whether he has decided to retain the safety division of the atomic weapons establishment after the introduction of private contractors.
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Mr. Neubert : Safety will continue to be given the highest priority at the atomic weapons establishment after the introduction of a management contractor and the subsequent full contractorisation of the establishment. The safety division will become part of the contractorised establishment and will be supplemented by an additional layer of safety oversight from MOD.
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