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Service Catering
Mr. O'Neill : To ask the Secretary of State for Defence whether British meat is provided in service establishments.
HEALTH
Medicines Control Agency
Mr. Rost : To ask the Secretary of State for Health on what basis the Medicines Control Agency is obliged to recover all its running costs.
Mrs. Virginia Bottomley : The Evans Cunliffe report, a copy of which is available in the Library, on the control of medicines recommended inter alia that the full cost of the regulation of medicines should be recovered from industry.
This was one of the recommendations which Ministers accepted and the effect of this on fees was explained in the Department's consultative letter of 22 December 1988 (MLX 175) a copy of which is available in the Library.
I also refer my hon. Friend to the reply I gave him on 6 June at column 629.
Mr. Rost : To ask the Secretary of State for Health what activity study of the Medicines Control Agency has recently been carried out ; and if he will publish the results.
Mrs. Virginia Bottomley : A confidential activity analysis of the Medicines Control Agency was recently
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carried out by independent consultants. The information is being used in the current review of the Medicines Control Agency's fee structure.Mr. Rost : To ask the Secretary of State for Health whether the Medicines Control Agency is presently subject to exemption from gross running costs control.
Mrs. Virginia Bottomley : The Medicines Control Agency--MCA--was approved for exemption from 1989-90 on the basis that the necessary information systems would be introduced that year. However, the MCA has experienced greater difficulty than anticipated in putting those systems into effect, and therefore the operation of the exemption attributes relating to its expenditure has been suspended temporarily, pending review in the current public expenditure survey. Under these temporary arrangements any increase in the MCA's gross expenditure as well as the funding of such an increase is required to be discussed and agreed with Treasury. In the meantime, the MCA has been working to meet the requirements for restoration of full exemption from gross running cost control and has continued to plan the restructuring of its fee income on the basis that the full exemption will be restored.
Mr. Rost : To ask the Secretary of State for Health what are the reasons for the difference between the figure given in the supply estimates for 1990-91 for the expenditure of the Medicines Control Agency and that quoted in his Department's letter to the hon. Member for Erewash of 6 April.
Mrs. Virginia Bottomley : The expenditure and income figures given in the supply estimates for 1990-91 represent payments and estimated receipts of cash voted and required for the operational costs of the Medicines Control Agency during the financial year 1990-91. Voted provision includes capital expenditure but excludes payments to the civil superannuation vote. The figures quoted in the Department's letter of 6 April are derived from accrual accounting and take into account depreciation, notional staff insurance, superannuation costs as well as interest on capital employed, and so on.
Mr. Rost : To ask the Secretary of State for Health whether it is open to the Medicines Control Agency to charge fees based on turnover.
Mrs. Virginia Bottomley : I have nothing to add to the reply I gave my hon. Friend on 6 June at column 629.
Mr. Rost : To ask the Secretary of State for Health in what circumstances he envisages using the powers granted under the Health and Medicines Act 1988 to charge fees based on turnover through the Medicines Control Agency.
Mrs. Virginia Bottomley : I refer my hon. Friend to the reply I gave him on 21 May 1990 at column 630. Section 21 of the Health and Medicines Act clarified the basis under which regulations could be made in relation to an annual fee and also validated the basis on which previous annual fees had been charged. Any such proposals would be preceded by full consultation as is required under Section 129(6) of the Medicines Act 1968.
Mr. Rost : To ask the Secretary of State for Health whether Treasury guidelines cover the inclusion of work connected with the European Communities in those activities of the Medicines Control Agency of which the costs are to be met by licence fees.
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Mrs. Virginia Bottomley : No Treasury guidelines have been issued specifically referring to EC work and the Medicines Control Agency. The rules which govern the factors to be taken into account in fixing fees under the Medicines Act 1971 are set out in the Medicines (Fixing of Fees Relating to Medicinal Products for Human Use) Order 1989 (SI 1989 No. 684) a copy of which is available in the Library. Schedule 1 to that order sets out the functions which are to be taken into account in fixing fees under the 1971 Act, and schedule 2 details the matters to be taken into account in determining the cost of those functions. In relation to EC work I refer my hon. Friend to paragraphs 5 and 10(b) of schedule 1 and paragraph 1 of schedule 2.AIDS
Mr. Kirkwood : To ask the Secretary of State for Health what further steps are being taken further to educate the general public about the risks of AIDS.
Mrs. Virginia Bottomley : We are fully committed to taking effective action to prevent the spread of HIV in all sections of the United Kingdom population. In the absence of a vaccine against HIV infection or a cure for AIDS, public education remains the cornerstone in our strategy and we continue to spend more on AIDS health education than on any other single health education programme.
The expert symposium convened by the United Kingdom Health Departments and the Health Education Authority on 24 November 1989 was successful in keeping this issue before the public and in providing a sound scientific basis for further campaign work at all levels about this serious threat to public health.
The Health Education Authority has already launched an effective TV and press campaign building on the conclusions reached at the symposium. The HEA is developing further campaign material and has also launched a campaign to warn young holidaymakers about the risks of casual sex while away from home. Targeted work aimed at influencing the behaviour of specific groups will also continue including among those whose activities may place them at particular risks of HIV infection.
To support this work we have encouraged health authorities to work with other statutory and voluntary agencies to develop local programmes for HIV prevention and have made new money available for this. We have also asked health authorities to appoint HIV prevention co-ordinators to spearhead this work and to pay particular attention to developing genito-urinary medicine and drug misuse services because of the crucial part both must play in HIV prevention. We are also committed to continued support for the national AIDS helpline which acts as a valuable resource in support of our public education work.
We are determined to make further progress in the area of women and AIDS. This will be the theme of World AIDS Day 1990 on 1 December. Women have a central role in preventing the spread of HIV as health educators, carers and mothers.
We will continue to give high priority to HIV prevention and to ensure that health authorities and the health professions bring this into the mainstream of their work.
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Mr. Strang : To ask the Secretary of State for Health what were the cumulative totals on 31 December 1987, 30 June 1988, 31 December 1988, 30 June 1989, 31 December 1989 and 30 June 1990 of (a) people who have died with AIDS, (b) people with AIDS including those who have died and (c) HIV antibody positive persons (i) in England by patient characteristic, (ii) in the United Kingdom by patient characteristic, (iii) in each of the regional health authority areas in England, (iv) in total in England and (v) in total in the United Kingdom.
Mrs. Virginia Bottomley : Information is not available in the specific form requested and special analyses to obtain this could be provided only at disproportionate cost. The hon. Member might find it helpful to see the AIDS HIV quarterly surveillance tables produced by the public health laboratory service AIDS centre and communicable diseases Scotland unit. These contain detailed data on HIV and AIDS surveillance. Copies will be placed in the Library.
Mr. McAllion : To ask the Secretary of State for Health what is his assessment of the annual cost to the national health service arising from the treatment of a patient suffering from AIDS.
Mrs. Virginia Bottomley : Spending on care for AIDS patients is not separately identified. This year, £127.5 million has been made available to health authorities in England as a contribution towards the costs of work to prevent the spread of HIV infection and the provision of diagnostic, treatment, care and support services for people infected with the virus, including those with AIDS.
Respite Care
Ms. Walley : To ask the Secretary of State for Health if he will make a statement on his policy on the need for provision of respite care in the proposals for community care.
Mrs. Virginia Bottomley : Respite care has an important part to play both in supporting carers and enabling dependent people to continue living in the community. Local authorities already have power to arrange short term admissions to care for this purpose. It is for the authority concerned to decide what facilities to provide in individual cases, taking account of the views of the person concerned and their carers.
Authorities are required to charge for residential care they provide or arrange but have discretion to limit the charge payable in the first eight weeks of any admission to the statutory minimum--currently £37.50 a week.
Disabled People
Mr. Tom Clarke : To ask the Secretary of State for Health what responses he has received from the local authority associations to his Department's letter of19 February regarding the implementation of the Disabled Persons (Services, Consultation and Representation) Act 1986.
Mr. Dorrell : We received a response dated 4 July setting out the associations' initial thoughts and suggesting a meeting on 12 July. This meeting was subsequently postponed at the request of the associations.
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NHS Reforms
Mr. Thurnham : To ask the Secretary of State for Health if he will make a statement on the progress of the implementation of reforms to the national health service.
Mrs. Virginia Bottomley : Progress on the implementation of the reforms set out in the White Paper "Working for Patients" is proceding according to plan. The number of formal applications received so far from hospitals and units to become National Health Service trusts is 58. We expect about 400 GP practices are likely to undertake preparatory work to become fund holders in April 1991. So far, there have been about 150 expressions of interest to hold practice funds in 1992-93. It would not be practicable to phase in all the proposals set out in the White Paper "Caring for People" from the same date, but we will begin to implement them from 1 April 1991.
NHS Trusts
Mrs. Wise : To ask the Secretary of State for Health what is his estimate of the total amount of interest-bearing debts facing proposed self -governing hospital trusts which is now to be written off.
Mr. Dorrell : None of the potential NHS trusts have any interest bearing debts at present. When an NHS trust is set up it will be given an originating capital debt. Part of this debt will bear interest and will have to be repaid ; as will interest bearing loans which a trust takes out to finance its activities. There are no plans to write off these debts or loans.
Mr. Blunkett : To ask the Secretary of State for Health what restraint will apply to national health service trust hospitals to avoid pre-empting public sector borrowing requirement assumptions for national health service capital spending ; and if he will make a statement.
Mr. Dorrell : NHS trusts' borrowing for capital spending will be constrained by the size of their external financing limits. These will be set annually for each trust taking account of its forward business plan and available resources.
Family Planning
Ms. Primarolo : To ask the Secretary of State for Health if he will bring forward proposals to improve family planning services.
Mrs. Virginia Bottomley : I refer the hon. Member to the replies I gave my hon. Friend the Member for Bournemouth East (Mr. Atkinson) on 19 June at column 508 and on 27 June at columns 249-50.
Community Care
Mr. Allen : To ask the Secretary of State for Health what plans he has to ensure that assessments of possible need for social care are carried out by local authority staffs before a patient is discharged from hospital, so that continued in-patient treatment can be offered if no appropriate care outside hospital is available.
Mrs. Virginia Bottomley : Health authorities, in conjunction with local authorities, are already responsible for developing individual discharge plans that ensure a
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continuity of health and social care. The existing circulars on hospital discharges--HC(89)5 and LAC(89)7--copies of which are available in the Library, instruct health authorities to start planning for discharge at as early a stage as possible, giving local authorities adequate notice to assess and provide for social care needs.Mentally Ill People
Mr. Allen : To ask the Secretary of State for Health how many patients were discharged from mental illness hospitals for the latest available year (a) in total, (b) in under one month, (c) in under three months and (d) in under six months.
Mr. Dorrell : The information available centrally is given in the following table. The number of discharges is greater than the number of patients treated as some will be admitted more than once in a year.
A
Discharges by duration of stay 1987-88
Mental illness specialty
|Number
-----------------------------------------------------------------
Total discharges |181,400
Length of stay
Less than one month |117,960
One month or more but less than three months |45,250
Six months or more but less than one year |14,250
Mental Health Act Commission
Mr. Kirkhope : To ask the Secretary of State for Health if he has yet responded to the third biennial report of the Mental Health Act Commission.
Mr. Dorrell : I have today written to Mr. Louis Blom-Cooper QC, chairman of the Mental Health Act Commission, thanking the commission for all the excellent work over the period 1987 to 1989 summarised in its third biennial report, which my right hon. and learned Friend the Secretary of State laid before the House on 14 December 1989. I also included with my letter more detailed papers produced in the Department of Health, Home Office, Welsh Office and Department of Social Security responding to a number of specific points made in the report. The chairman of the Special Hospitals Service Authority has also written to the chairman of the Mental Health Act Commission responding to points made about the special hospitals. I have placed copies of my letter and the other documents in the Library.
Medicines Commission
Mr. Burns : To ask the Secretary of State for Health when he expects to receive the annual report of the Medicines Commission for 1989.
Mrs. Virginia Bottomley : I have received the report and copies have today been laid before both Houses of Parliament in accordance with the requirements of section 5(2) of the Medicines Act 1968. Bound volumes will shortly be placed in the libraries containing the 1989 reports of the Medicines Commission, the Committee on Safety of Medicines, the Veterinary Products Committee, the British Pharmacopoeia Commission, the Committee on the Review of Medicines and the Committee on Dental and Surgical Materials.
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I am glad to pay tribute to the highly valuable work done by the distinguished members of the Medicines Act advisory bodies and thank them warmly for the time and effort which they contribute to the public interest in this most important field.Centre for Applied Microbiology and Research
Mr. Key : To ask the Secretary of State for Health if he will now make a further statement about the future of the Centre for Applied Microbiology and Research at Porton Down near Salisbury.
Mr. Dorrell : I have nothing to add to the reply my hon. Friend the then Parliamentary Under-Secretary of State gave my hon. Friend on 19 April at column 990. A further statement will be made as soon as there is any substantial development to report.
Intensive Care Units
Mr. Tony Lloyd : To ask the Secretary of State for Health how many intensive care units there are ; and what is the total number of beds in such units which have (a) a one-to-one nurse to patient relationship, (b) at least four beds per unit, (c) more than 250 admissions per annum and (d) full-time residential cover.
Mr. Dorrell : This information is not collected centrally.
Mr. Tony Lloyd : To ask the Secretary of State for Health on what basis he assesses the provision by district health authorities of intensive care treatment.
Mr. Dorrell : The provision of treatment in intensive care is a matter for clinicians. The facilities required are determined by health authorities in the light of local needs.
Radon Gas
Mr. Ward : To ask the Secretary of State for Health what funding has been made available by his Department for research into the health risks of radon gas.
Mr. Dorrell : The Department sponsors the National Radiological Protection Board which is conducting a
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substantial research programme into the effects of radon. A total of £4.7 million was committed by the Department of Health to the NRPB in 1989-90. The Department together with the Department of Environment, the NRPB and the Imperial Cancer Research Fund, is funding a research project entitled "A Study into the Effects of Radon in Houses" at the cancer epidemiology unit, Oxford. Total Government funding for the study, until the end of the financial year 1989-90, was nearly £88,000 of which £31,355 was provided by the Department of Health.Old Medicines
Mr. Ward : To ask the Secretary of State for Health what steps his Department is taking to encourage the public to return old and unwanted medicines.
Mrs. Virginia Bottomley : Old and unwanted medicines are collected regularly by pharmacies, even in the absence of locally organised DUMP-- disposal of unwanted medicines and pills--campaigns.
The Department supports the role of the Royal Pharmaceutical Society and local environmental health and district health authorities in organising, publicising and disposing of returned medicines from DUMP campaigns, and in educating the public to dispose of medicines safely.
Electoral Registration
Mr. Harry Barnes : To ask the Secretary of State for Health if he will list the numbers of parliamentary constituencies in (a) England, (b) Scotland, (c) Wales and (d) Northern Ireland, showing in each case how many constituencies experienced (i) an increase and (ii) a decrease in electoral registration in the periods (i) 1987 to 1988, (ii) 1988 to 1989 and (iii) 1989 to 1990.
Mr. Dorrell : The information requested is given in the table.
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Number of parliamentary constituencies --------------------------------------------- England |283|240|253|270|286|237 Wales |23 |15 |27 |11 |34 |4 Scotland<1> |18 |54 |15 |57 |38 |33 Northern Ireland |11 |6 |12 |5 |14 |3 <1>The parliamentary electorate remained unchanged in one Scottish constituency between 1989 and 1990.
NHS (Food Sales)
Mr. Speller : To ask the Secretary of State for Health if he will take steps to prevent food products purchased by national health service institutions at special trade terms from being resold at discounted prices.
Mr. Dorrell : No. Since the passing of the Health and Medicines Act (1988), national health organisations have been allowed to sell goods and services at a profit to the private sector. The Government have made it clear to health authorities in the White Paper and follow-up guidelines that they should seek opportunities for sensible income generation as one way of increasing funds
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available for patient care. The core business of the NHS Supplies Organisation nevertheless remains the provision of a service to the national health service.Orthotic Service
Mr. Ashley : To ask the Secretary of State for Health what action his Department has taken following the recommendations of the national health service management consultancy services in its study of the orthotic service, which was published in October 1988 ; and if he will make a statement.
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Mrs. Virginia Bottomley : Comments received on the report are being considered. We are reviewing future arrangements for orthotic contracts with a view to introducing revised arrangements from 1 July 1991.Hospital Discharges
Mr. Ashley : To ask the Secretary of State for Health if he will list the number of (a) physically handicapped people, (b) mentally handicapped people and (c) mentally ill people who were discharged from hospital
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after a period of treatment lasting (i) one month, (ii) three months and (iii) six months, during each of the last five years.Mr. Dorrell : The information available centrally is given in the table. The number of discharges is greater than the number of patients treated as some will be admitted more than once in a year.
--------------------------------------------------------------------------------------------
(a) Physically handicapped people.
No information is available centrally.
(b) Mentally handicapped
Less than 1 month |27,549 |31,548 |34,380 |36,155
One month or more but less than 3 months |1,208 |1,213 |1,188 |1,178
Three months or more but less than 6 months |326 |303 |378 |405} |570
Six months or more but less than 1 year |256 |285 |309 |566}
(c) Mental illness
Less than 1 month |109,757|112,759|116,919|115,868
One month or more but less than 3 months |48,591 |48,574 |50,323 |50,245
Three months or more but less than 6 months |10,396 |11,219 |11,408 |11,645}|14,250
Six months or more but less than 1 year |4,697 |5,043 |4,921 |5,149}
<1>For 1987-88 the figures given are for finished district spells which are not strictly
comparable with the discharges shown for earlier years.
Wheelchairs and Seating
Mr. Ashley : To ask the Secretary of State for Health if he has received the report by the Leonard Cheshire Foundation on its wheelchair and seating project ; and if he will make a statement.
Mr. Dorrell : The report has not been formally submitted to the Department. I understand a copy of the report has now been made available to the Disablement Services Authority and that a meeting has been arranged with the director of the Leonard Cheshire Foundation.
Mr. Ashley : To ask the Secretary of State for Health what representations he has received from the Disablement Services Authority concerning the level of funding required for the provision of special seating for disabled people ; and if he will make a statement.
Mr. Dorrell : The Disablement Services Authority has brought the matter of funding for special seating for severely disabled people to our attention on several occasions and in particular at the formal reviews of the authority in 1988 and 1989. As a result, we have provided £1 million for this purpose from the present year onwards.
Mr. Ashley : To ask the Secretary of State for Health what representations he has received concerning the level of funding required for the provision of special seating for disabled people ; and if he will make a statement.
Mr. Dorrell : We have received a small number of recent letters from voluntary organisations. The Disablement Services Authority, which has the primary responsibility for the provision of special seating for severely disabled people in wheelchairs, has been allocated an additional £1 million specifically for this purpose from 1990-91 onwards. District health authorities continue to provide some special seating.
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Prosthetic and Orthotic Courses
Mr. Orme : To ask the Secretary of State for Health what representations he has received about the concern caused to patients, doctors, voluntary organisations and paramedical professional staff by the delay in funding the training of orthotists and prosthetists at Salford ; and if he will make a statement.
Miss Lestor : To ask the Secretary of State for Health what representations he has received concerning, and what action he proposes to take to meet, the shortfall of skilled prosthetists and orthotists arising from the delay in establishing the relevant courses at Salford ; and if he will make a statement.
Mrs. Virginia Bottomley : Representations about funding for training have been received from the Orthotic and Prosthetic Training and Education Council, the London School of Prosthetics and the National Association of Limbless Disabled, and from some individuals. We have discussed the provision of a degree level course for orthotists and prosthetists at Salford with the Orthotic and Prosthetic Training Committee Universities Funding Council, Salford university and Salford polytechnic. Because of the complex issues involved, no decision is expected for some time.
Until the start of a new degree course, the Orthotic and Prosthetic Training and Education Council, which has responsibility for training of orthotists and prosthetists, are making plans to continue present training arrangements.
NHS Statistics
Sir Norman Fowler : To ask the Secretary of State for Health (1) how many in-patient cases are now being treated in the national health service ; what is the
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percentage difference between this figure and the figures in 1987, 1983 and 1979 ; and whether he will make a statement ;(2) how many day cases are now being treated in the national health service ; and what is the percentage difference between this figure and the figures in 1987, 1983 and 1979.
Mr. Dorrell : A total of 6.59 million in-patient cases were treated in NHS hospitals in England during 1988-89, the latest date for which figures are available ; this is 1 per cent. less than in 1987-88, 9 per cent. more than in 1983, and 22 per cent. more than in 1979. A total of 1.02 million day cases were treated in NHS hospitals in England during 1988 -89, the latest date for which figures are available ; this is 15 per cent. more than in 1987-88, 25 per cent. more than in 1983, and 72 per cent. more than in 1979.
Sir Norman Fowler : To ask the Secretary of State for Health what savings to the health servide have been made from the introduction of the selected list of drugs ; and whether he will make a statement.
Mrs. Virginia Bottomley : In 1985-86 the Selected List Scheme saved £75 million on the drugs bill. It is not possible to make meaningful estimates for subsequent years, but there is good reason to believe that significant savings continue to be made.
Whooping Cough
Sir Norman Fowler : To ask the Secretary of State for Health what is the current estimated vaccination rate against whooping cough currently ; what is was in 1978, 1979 and 1987 ; and whether he will make a statement.
Mr. Dorrell : The percentage vaccination rates in England against whooping cough for the earlier years quoted were :
|Number
----------------------
1978 |31
1979 |35
1987-88 |73
The latest year for which confirmed figures are available is 1988-89, when the uptake in England was 75 per cent. I am delighted to say, however, that the COVER--cover of vaccination evaluated rapidly--programme at the public health laboratory service board's communicable disease surveillance centre has recently reported results which demonstrate that at May this year vaccination coverage on whooping cough had reached 82 per cent. for England. Several district health authorities are believed to have reached coverage of 90 per cent. or more. These figures do not take account of the effect on uptake of the immunisation bonus payments for general practitioners, introduced in the new contract from April this year, or of the acceleration to two, three, and four months of the schedule for vaccinating infants against diphtheria, tetanus, whooping cough and poliomyelitis, which began on 1 May. We hope that both these developments will lead to even better coverage.
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Needle Exchange Schemes
Mr. Strang : To ask the Secretary of State for Health how many needle exchange schemes are currently operating in each regional health authority area in England.
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