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Mr. Robin Cook : To ask the Secretary of State for Health whether he has any information on the staffing and management arrangements of mental nursing homes registered to take detained patients with particular
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reference to the responsibilities of such homes under the Mental Health Act 1983 ; and what plans he has to increase the information available on such mental nursing homes.Mr. Dorrell : The numbers of registered mental nurses and registered nurses for the mentally handicapped in registered mental nursing homes are reported to the Department by district health authorities in return KO36. The figures for 31 March 1989 were 1,050 full-time and 714 part-time registered mental nurses and 142 full-time and 65 part-time registered nurses for the mentally handicapped. We have no plans to collect any other information on the staffing of mental nursing homes.
Registered mental nursing homes are subject to the Registered Homes Act 1984 and must meet the requirements of that Act before they can be registered. Homes registered to take patients detained under the Mental Health Act 1983 must comply with all the relevant sections of that Act, including those concerning patients' rights while detained and access to the mental health review tribunals and the Mental Health Act Commission. The responsibilities of managers of registered mental nursing homes under the 1983 Act are broadly comparable to those of managers of NHS hospitals.
Mr. Robin Cook : To ask the Secretary of State for Health what was the number of detained patients cared for in mental nursing homes during 1990 ; and how many mental nursing homes are registered to take detained patients.
Mr. Dorrell : The latest available information is for 31 March 1989 when there were 89 patients detained under the Mental Health Act 1983 in private mental nursing homes in England. This does not include patients cared for under contractual arrangements with health authorities. On the same date there were 60 mental nursing homes registered under part II of the Registered Homes Act 1984 and authorised to detain patients.
Trent Regional Health Authority
Mr. Redmond : To ask the Secretary of State for Health if he will give details of the number of hospital beds by district health authority in the Trent regional health authority (a) in 1979, (b) in 1985 and (c) for the latest date for which he has figures.
Mr. Dorrell : The information requested is given in the tables.
Number of beds available in Trent regional health
authority and
district health authorities 1979, 1985, 1989-90
Years |1979 |1985 |1989-90
--------------------------------------------------------
Regional total |31,711 |29,391 |24,554
North Derbyshire |1,722 |1,749 |1,574
South Derbyshire |4,208 |3,535 |2,700
Leicestershire |5,140 |5,045 |4,436
North Lincolnshire |2,815 |2,110 |1,413
South Lincolnshire |1,894 |1,768 |1,481
Bassetlaw |403 |433 |409
Central Nottinghamshire |1,997 |1,794 |1,484
Nottingham |4,198 |3,931 |3,334
Barnsley |962 |1,134 |1,111
Doncaster |1,808 |1,879 |1,657
Rotherham |1,331 |1,251 |1,129
Sheffield |5,233 |4,771 |3,828
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Number of inpatients treated in Trent RHA and DHAs-1979, 1985,
1989-90
Finished hospital stayFinished consultant e
|1979 |1985 |<1>1989-90
--------------------------------------------------------------------
Trent regional health |464,917 |578,370 |698,776
authority
North Derbyshire |22,989 |28,185 |37,345
Southern Derbyshire |47,540 |53,724 |61,608
Leicestershire |74,454 |95,365 |110,970
North Lincolnshire |25,751 |29,279 |36,600
South Lincolnshire |23,535 |31,003 |39,124
Bassetlaw |9,111 |11,953 |15,110
Central Nottinghamshire |32,095 |36,472 |43,221
Nottingham |73,992 |97,291 |117,018
Barnsley |21,449 |27,512 |32,908
Doncaster |28,103 |39,936 |47,926
Rotherham |27,805 |30,727 |38,380
Sheffield |78,093 |96,923 |118,566
<1> Figures for 1989-90 refer to finished consultant episodes and
should not be directly compared with earlier figures (discharges
and deaths).
In 1988-89 when data were collected on both bases, finished
consultant episodes in Trent regional health authority exceeded
discharges and deaths by 8 per cent.
Energy Efficiency
Mr. Pendry : To ask the Secretary of State for Health what specific measures his Department has taken to promote energy efficiency ; what further measures his Department intends to take to promote energy efficiency ; and by what amount and what percentage of its total energy bill his Department's energy bill has been reduced over the past year.
Mr. Dorrell : The national health service has met the target of reducing energy consumption by 1.5 per cent. a year suggested by the Public Accounts Committee in 1980-81 and there is a commitment to save a further 15 per cent. in consumption over the next five years. Guidance is provided by the Department's "Encode" and the performance of regional health authorities is monitored by the national health service management executive.
It is estimated that £379 million has been saved in the national health service in the last 10 years due to reductions in energy consumption, changes in fuel prices and rationalisation of the estate. The latest annual figures which have been validated are for 1986-87 and they show a saving of £4.7 million representing 2 per cent. of the total energy bill for that year.
National Health Service Trusts
Mr. Robin Cook : To ask the Secretary of State for Health if he will list the name, address and telephone number of each national health service trust.
Mrs. Virginia Bottomley : The information requested has been placed in the Library.
Mr. Hinchliffe : To ask the Secretary of State for Health what guidance has been given with regard to the charging by national health service trusts of local authority social services departments for services currently provided freely by local health authorities.
Mrs. Virginia Bottomley : No guidance is being given to trusts on systems for charging local authorities for
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services. The powers for national health service trusts to charge for services are no different from the powers which continue to be available to health authorities. Health services to individual patients remain free at the point of delivery. Local authorities remain responsible for determining charges to clients for social care which they arrange or provide.Mr. Hinchliffe : To ask the Secretary of State for Health what is his Department's policy towards national health service trusts who may wish to make direct community care provision.
Mrs. Virginia Bottomley : National health service trusts can enter into contracts with district health authorities for the provision of any health service including community health services. National health service trusts may make direct community care provision for local authorities if they wish, bearing in mind that the funding of such provision is subject to section 7 of the Health and Medicines Act 1988.
Mr. Hinchliffe : To ask the Secretary of State for Health what arrangements have been made for national health service trusts to purchase the services of hospital-based local authority social workers.
Mrs. Virginia Bottomley : Local authorities will provide hospital social work services to national health service trusts on the same basis as to the rest of the hospital and community health services.
Dental Charges
Mr. Battle : To ask the Secretary of State for Health what was the average dental charge in 1988-89 and in 1990-91.
Mr. Dorrell : The average dental charge in England for the financial year 1988-89 was £19.84. The figure for 1990-91 is not yet available.
British Sign Language
Mr. Malcolm Bruce : To ask the Secretary of State for Health which national health service district general hospitals in England and Wales provide British sign language interpreters for deaf people ; and which charge for this service.
Mr. Dorrell : This information is not held centrally.
Food Safety
Mrs. Maureen Hicks : To ask the Secretary of State for Health what progress is being made to ensure that United Kingdom food hygiene standards are maintained throughout the European Community.
Mr. Dorrell : Major changes are being introduced in England and Wales from 1 April to improve food hygiene by the appropriate use of temperature controls during production, distribution and sale. The controls apply to food whether produced in this country for consumption here or for export and to foods which have been imported. Different food hygiene requirements apply in individual member states of the European Community. Where the European Commission puts forward proposals for European standards the views of the United Kingdom Government are fully represented.
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Young Offenders
Mr. Ashley : To ask the Secretary of State for Health how many and what percentage of local authorities have their own secure accommodation available for young people for whom it is judged necessary.
Mrs. Virginia Bottomley : On 31 December 1990, 26 local authorities, 24 per cent., in England provided secure accommodation. All local authorities have access to this national network of secure facilities.
Mr. Ashley : To ask the Secretary of State for Health how many local authority secure places were made available to other local authorities willing to pay for them, in the last year for which figures were available.
Mrs. Virginia Bottomley : Of the 1,417 admissions to secure accommodation in England during the year ending 31 March 1989, 775 were placed by local authorities which did not provide such facilities ; 11 were placed by local authorities outside England, and 60 were placed by my right hon. Friend the Secretary of State.
Mr. Ashley : To ask the Secretary of State for Health how many local authority secure homes for young people have been closed in the last five years ; and what proportion this is of the total at the beginning of the period for which figures are available.
Mrs. Virginia Bottomley : In January 1986 there were 46 community homes providing secure units. Ten (22 per cent.) of these units have since closed permanently, primarily because the associated open part of the home has become surplus to the requirements of the local authority. A further four such secure units are currently temporarily closed while the local authority reviews their long-term future.
Mr. Hinchliffe : To ask the Secretary of State for Health what representations he has received from chief constables with regard to the availability of secure accommodation for young persons.
Mrs. Virginia Bottomley : There have been no representations from chief constables specifically about the availability of secure accommodation. The Department has received comments from the Association of Chief Police Officers (ACPO) on the draft regulations and guidance on secure accommodation that were issued for consultation under the Children Act 1989. ACPO's comments will be taken into account when the final version of these regulations and guidance are prepared.
Care Homes
Mr. Hinchliffe : To ask the Secretary of State for Health if he will list his estimate of the number of local authority care home trusts ; and in which local authorities they are located.
Mrs. Virginia Bottomley : This information is not collected centrally.
Mr. Hinchliffe : To ask the Secretary of State for Health what steps his Department is taking to encourage the development of short-term respite care in both the local authority and the private sectors to avoid permanent admissions to care homes.
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Mrs. Virginia Bottomley : The Government's White Paper "Caring for People" makes it clear that respite care has an important part to play in supporting carers and enabling dependent people to continue living in the community. The White Paper also asks local authorities to promote the involvement of and make maximum use of the non-statutory sector in improving community care.
The Department has awarded a grant to the National Association of Family Based Respite Care and has funded research at Bristol university about respite care for families with children with a mental handicap.
The report "Care for a Change", produced by the Department's social services inspectorate and published in 1987, a copy of which is available in the Library, gives guidance to local authorities on the provision of respite care.
Mr. Hinchliffe : To ask the Secretary of State for Health what guidance is issued to registration authorities regarding arrangements that may be made by private care and nursing homes for insurance cover for contents, liability, and loss of revenue.
Mrs. Virginia Bottomley : None. These are matters for the organisations concerned.
Mr. Hinchliffe : To ask the Secretary of State for Health what evaluation he has made of the implications of the growth in private care homes for the type of resident now accommodated in local authority part III accommodation.
Mrs. Virginia Bottomley : It is the Government's policy, set out in the White Paper "Caring for People", to encourage the contribution the independent sector can make in providing residential care for vulnerable people, in order to increase the choice for individuals and promote competition among providers. It is for individual local authorities in drawing up their community care plans to identify the range of services required to meet their population's community care needs, assemble information about current and prospective demand and supply of services in their locality, and secure a supply of appropriate services.
Mr. Hinchliffe : To ask the Secretary of State for Health what is his current estimate of the capital investment needed by local authorities to bring the structural standards of local authority residential care homes up to the level required by his Department.
Mrs. Virginia Bottomley : It is for local authorities to determine their capital needs for personal social services. The assessment of the need for structural work to be carried out in local authoritty residential care homes depends upon a number of factors, including the condition and suitability of the premises in the light of the standards they apply, as registration authorities, to independent homes, the extent to which they need to retain their own homes, and the availability of resources. Only local authorities themselves can carry out such an assessment.
Mr. Hinchliffe : To ask the Secretary of State for Health what guidance has been issued to local authorities with regard to the criteria which may be applied to the size of private care homes when contracts for the provision for care are being placed.
Mrs. Virginia Bottomley : It is for local social services authorities and health authorities, which are the
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registration authorities for independent homes, to judge whether a home is of an acceptable size, in the light of such factors as the premises, staffing levels, the level of care required for residents and the quality of life offered.Guidance has been issued to local authorities about the size of new local authority residential care homes. The code of practice for residential care, "Home Life," a copy of which is available in the Library, advises that the size of the building and the proposed number of residents should be considered in the context of the stated aims of the home. We would expect local authorities to have regard to this guidance when arranging contracts with private care homes.
Mr. Hinchliffe : To ask the Secretary of State for Health if a local authority's statutory responsibilities for residents in local authority care home trusts differ in any way from their responsibilities for residents in local authority part III accommodation.
Mrs. Virginia Bottomley : Local authorities have a statutory duty to provide residential accommodation for persons who, by reason of age, infirmity or any other circumstances, are in need of care and attention which is not otherwise available to them. This duty can be exercised by social services authorities either by providing the individual with accommodation in a local authority residential care home or by sponsoring them in an independent sector residential care home.
Mr. Hinchliffe : To ask the Secretary of State for Health what steps are being taken by his Department to develop alternatives to the institutional model of care for elderly or disabled people.
Mr. Dorrell : We are firmly committed to a policy of community care which enables elderly and disabled people, with appropriate support, to live in their own homes or in small homely settings in the community for as long as this is feasible and sensible.
The White Paper "Caring for People" made clear that health and local authorities are expected to work closely together in preparing community care plans that are compatible and comprehensive. Following the passage of the National Health Service and Community Care Act 1990, the Department issued guidance to assist authorities in this task and to develop good practice. We have continued to stress the key role of the voluntary sector in this process and the importance of ensuring that the wishes of the elderly or disabled person are taken carefully into account.
Social Service Placements
Mr. Hinchliffe : To ask the Secretary of State for Health if he will list the total number of special agency placements by local authority social services departments for each year since 1979.
Mrs. Virginia Bottomley : Information about the number of such placements is not available centrally.
Community Care
Mr. Hinchliffe : To ask the Secretary of State for Health what feasibility studies his Department have undertaken into the comparative costs and benefits of differing forms of community care provision ; and what were the results.
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Mrs. Virginia Bottomley : The Department has undertaken a number of such studies in particular those carried out by the personal social services research unit at the University of Kent. They have shown that the costs and benefits of community care are dependent on a range of factors with a complex interrelationship. Copies of relevant studies will be placed in the Library.
Child Welfare
Mr. Hinchliffe : To ask the Secretary of State for Health if he has any proposals to bring forward legislation on transferring responsibilities for child welfare within local authorities.
Mrs. Virginia Bottomley : There are no such proposals.
Social Services
Mr. Hinchliffe : To ask the Secretary of State for Health if he has any proposals to transfer the responsibility for the provision of personal social services from local authorities to district health authorities or national health service trusts.
Mrs. Virginia Bottomley : There are no plans to do so.
Home Care
Mr. Hinchliffe : To ask the Secretary of State for Health how many local authorities currently operate a 24-hour, seven days a week home care service.
Mrs. Virginia Bottomley : This information is not collected centrally.
Special Agency Placements
Mr. Hinchliffe : To ask the Secretary of State for Health what assessment he has made of the financial implications for local authorities of the increased use of special agency placements by social services departments.
Mrs. Virginia Bottomley : In deciding on appropriate finance for local authorities the Government take account of local authorities' assessments of the cost to social services departments of changes in policy, demand and demography.
North Devon Health Care Trust
Mr. Speller : To ask the Secretary of State for Health if he will place in the Library a copy of his letter, dated 4 December 1990, and that of his Parliamentary Under-Secretary of State, Baroness Hooper, dated 14 January 1991, both addressed to the hon. Member for Devon, North, indicating the deferral of the application for establishing a North Devon health care trust ; and if he will make a statement.
Mrs. Virginia Bottomley [pursuant to the reply, 22 January 1991, c. 161] : My right hon. Friend the Secretary of State has now decided to approve the application from Northern Devon Healthcare, formerly known as North Devon Healthcare, to be an NHS trust. The criteria adopted in considering trust applications were previously listed on 4 December 1989 at columns 77-82. They included : that the establishment of a trust will give clear benefits and improved quality of service to patients ;
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that management has the skills and capacity- -including strong, effective leadership, sufficient financial and personnel management expertise and adequate information systems--to run the unit effectively ;that senior professional staff, especially consultants, are involved in the management of the unit.
In the case of the Northern Devon Healthcare Trust my right hon. Friend agreed, in response to a request from the sponsors, to defer the establishment of the trust at the time he made his decision to approve 56 NHS trusts.
My right hon. Friend has now decided, after careful thought and after having taken into account comments made during the consultation, to approve this application for trust status. The management team has now established itself and obtained the involvement of senior professional staff. The unit can now take advantage of NHS trust status.
TRADE AND INDUSTRY
Computers (Security)
Mr. Colvin : To ask the Secretary of State for Trade and Industry what measures he is taking to ensure the security of (a) his Department's computers in-house and (b) lap-top personal computers when used by his civil servants outside his Department's offices.
Mr. Leigh : It is not Government policy to disclose details of the protective security measures for safeguarding computers used for official purposes. To do so would be of assistance to potential attackers and therefore reduce the effectiveness of the measures. These measures are kept under review.
The Gulf Crisis
Mr. Michael : To ask the Secretary of State for Trade and Industry what steps he is taking to enable British businesses directly affected by the economic impact of the Gulf crisis to weather the financial problems facing them at the present time.
Mr. Leigh [holding answer 22 January 1991] : None. It is for businesses themselves, in consultation with their banks and financial advisers to consider what measures are appropriate to their specific circumstances. DTI regional offices are, however, giving priority to the needs of affected companies to help them find new markets. My Department is also taking appropriate action to assist British industry in playing a significant part in the reconstruction of Kuwait after its liberation.
Local Government
Mr. Tony Banks : To ask the Secretary of State for Trade and Industry if he will provide a table of expenditure of his Department's programmes of grant aid and support to industry in 1989-90, broken down by programme and cross-tabulated by standard region, with Greater London shown as a separate region, and including programmes of grant and other financial aid and also programmes of advice and training.
Mr. Leigh [holding answer 22 January 1991] : A regional breakdown of expenditure on the Department of Trade and Industry's regional programmes and for other industrial support under the Industrial Development Act 1982, including the consultancy initiatives, is provided in
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the appendices to the Industrial Development Act 1982 annual report for the year ended 31 March 1990. A regional breakdown of expenditure on other programmes is not available, nor is separate information available for Greater London, except at disproportionate cost, but the total level of expenditure on each of the Department's programmes is shown in the appropriation accounts for 1989-90.Iraq (Loans)
Mr. Corbyn : To ask the Secretary of State for Trade and Industry if he will list the total number of Export Credits Guarantee Department loans outstanding to Iraq, and the cost, per year for 1986, 1987, 1988, 1989 and 1990 of facilities to promote British trade with Iraq.
Mr. Sainsbury [holding answer 23 January 1991] : I refer the hon. Member to the answer I gave him on 17 October 1990, Official Report, column 837. There are currently 19 ECGD supported loans outstanding to Iraq.
The total cost by year of the various trade promotion facilities available for Iraq could be provided only at disproportionate cost.
HOME DEPARTMENT
Energy Efficiency
Mr. Pendry : To ask the Secretary of State for the Home Department what specific measures his Department has taken to promote energy efficiency ; what further measures his Department intends to take to promote energy efficiency ; and by what amount and what percentage of its total energy bill his Department's energy bill has been reduced over the past year.
Mrs. Rumbold : The Department's initiatives have focused on the prison estate. Energy efficiency has been promoted on the estate in the following ways :
the use of low-energy light units ;
the use of high-frequency light units ;
improved insulation of distribution pipework ;
the installation of decentralised boiler systems using gas ; the use of automatic controls for lighting ;
the introduction of building management systems ;
water surveys ;
energy surveys ;
improved heat distribution ;
building insulation ;
the use of low-energy equipment ;
the use of fuel additives ;
waste-derived fuel trials ;
zone control of heating ;
the use of condensing boilers ; and
the use of workshop heating controls.
Reductions in energy bills have resulted from tariff analysis, maximum demand analysis and power factor reduction.
Future measures will include the following :
the evaluation of combined heat and power systems and of waste gas fuel ;
considering the use of contract energy management ; staff training ; and equipment evaluation and testing.
The energy bill for the prison estate was reduced from £19.43 million in 1988-89 to £19.2 million in 1989-90, a reduction of 1.2 per cent. despite an increase of 2.5 per cent. in the size of the estate.
We intend to introduce a programme of similar measures in non-prison estate buildings in 1991-92. It is not possible to provide the information requested on costs
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