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Mrs. Virginia Bottomley : As my right hon. Friend the Secretary of State for Health announced on 16 January, £35 million will be made available through the waiting list fund in 1991-92 to tackle long waiting times.
Leicestershire Health Service
16. Mr. Vaz : To ask the Secretary of State for Health if he will make a further statement on the state of the health service in Leicestershire.
Mr. Dorrell : I am pleased to announce that since 1979 the number of in-patients treated by Leicestershire health authority has increased by 60 per cent., the number of out-patients has increased by 43 per cent. and the number of day case patients has increased by 65 per cent. Leicestershire health authority has a capital programme for the 1990's which total over £100 million involving developments at Leicester royal infirmary and Glenfield hospital together with the expenditure of £14 million on the complete reprovision of hospital services in Loughborough.
National Institute for Biological Standards and Research
17. Mr. Irvine : To ask the Secretary of State for Health if he will make a statement on the achievements to date in research work by the National Institute for Biological Standards and Research.
Mr. Dorrell : Since it was founded in 1972, the institute's major role has been the development of international standards for biological medicines, in which it has an international reputation. It has also been in the forefront of biomedical research, which includes AIDS vaccine research and work on improving vaccines against polio and influenza.
Children Act 1989
18. Mr. McCartney : To ask the Secretary of State for Health what representations he has received regarding the implementation of the Children Act 1989.
Mrs. Virginia Bottomley : I have received many constructive responses to consultative papers on this subject from a wide range of organisations and individuals.
Competitive Tendering
19. Mr. Douglas : To ask the Secretary of State for Health if he will make a statement on his Department's guidelines concerning competitive tendering within the NHS.
Mr. Waldegrave : I see scope for much wider use of competitive tendering to test and improve the efficiency
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and cost-effectiveness of national health service support services. It is primarily for managers at operational level to identify where tendering for services offers the best opportunities for improved value and service to patients.Hospital Beds, London
21. Mr. Tony Banks : To ask the Secretary of State for Health how many hospital beds have been closed in Greater London hospitals in the past three years.
Mrs. Virginia Bottomley : We do not routinely collect this information centrally, since bed numbers are not a good indicator of levels of service in the NHS. It is for each health authority to determine the level and mix of health service provision in its area, taking account of local circumstances and the increased resources available to them.
Physiotherapists, London
22. Mr. Wigley : To ask the Secretary of State for Health how many trained physiotherapists there are currently employed by the NHS ; and whether he has any plans to increase this number.
Mrs. Virginia Bottomley : The latest available information for England relates to 30 September 1989 and shows that there were 9,750 (whole -time equivalents) qualified physiotherapists in post. Any further increase in this number will be for health authorities to determine in the light of local circumstances.
Gulf War Casualties
23. Mr. Nellist : To ask the Secretary of State for Health what provisions Coventry health authority has made to facilitate treatment of potential victims of the Gulf war.
Mr. Dorrell : Health authorities' plans for dealing with casualties from hostilities in the Gulf involve hospitals throughout the NHS. It is for health authorities to allocate cases to particular hospitals and information on which hospitals will be used is not available centrally.
Medical and Dental Education
24. Dr. Twinn : To ask the Secretary of State for Health what is the Government's financial commitment to postgraduate and continuing medical and dental education.
Mrs. Virginia Bottomley : The Government have an ongoing financial commitment to postgraduate and continuing medical education which we regard as an essential ingredient in the delivery of high standards of patient care. From April 1991 we are making available an additional £5.8 million to assist in the introduction of a system to improve the management of postgraduate and continuing medical education in regions. I announced recently that £46 million has been secured for the development of medical audit in 1991-92. Regions will have to allocate appropriate funds to meet the resource implications of medical audit for postgraduate education.
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Health Authority Managers
25. Mr. Wilshire : To ask the Secretary of State for Health how many health authorities now share a general manager with another health authority ; and what is his policy towards encouraging such an arrangement.
Mrs. Virginia Bottomley : This information is not held centrally ; the appointment of a general manager is a matter for the health authority concerned. Regulations allow an executive member of one authority to be an executive member of a similar type of authority.
NHS Capital Expenditure
26. Mr. Dunn : To ask the Secretary of State for Health if he will indicate capital expenditure in the national health service in the year 1978-79 and for the latest year for which figures are available, adjusted for inflation.
Mr. Dorrell : Total national health service gross capital expenditure in England in 1978-79 at current (1990-91 prices) was £943 million. Total capital spending this year is expected to be £1, 668 million. This figure includes the effects of redefinition of capital expenditure (an additional £112 million). Without taking this into account national health service capital expenditure has risen by 65 per cent. in real terms since 1978-79.
Nurses' Grading
27. Mr. Butler : To ask the Secretary of State for Health if he will make a statement on the progress of hearing nurses' appeals against their grading.
Mrs. Virginia Bottomley : Information on nursing appeals to employing authorities is not collected centrally.
Junior Doctors' Hours
28. Mr. Arbuthnot : To ask the Secretary of State for Health if he will make a statement on the latest progress concerning the reduction of hours worked by junior hospital doctors.
Mrs. Virginia Bottomley : I refer my hon. Friend to the reply that I gave to the hon. Member for Glasgow, Maryhill (Mrs. Fyfe) on 18 December at column 151 .
Elderly and Disabled Persons
29. Mr. Hinchliffe : To ask the Secretary of State for Health if he has any proposals to amend the statutory duties of local authorities towards elderly and disabled persons.
Mrs. Virginia Bottomley : There are no plans to amend statutory duties of local authorities beyond the changes already set out in the National Health Service and Community Care Act 1990 and the intention to make provision for the registration of small homes.
Competitive Tendering
30. Mr. David Evans : To ask the Secretary of State for Health what estimate he has as to the comparative cost to the NHS each year as a result of competitive tendering in the catering, laundry and cleaning services as against in-house servicing.
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Mrs. Virginia Bottomley : Total annual savings being achieved as a result of competitive tendering for these three services are estimated to be in the order of £120 million : private contracts account for some 27 per cent. of that total. The management costs of tendering for these services is insignificant against the net savings being achieved.
Dental Treatment
Mr. Leighton : To ask the Secretary of State for Health (1) how many people over 18 years resident in the London borough of Newham or nearest equivalent area for which figures are available received free dental treatment by qualifying for an AG2 certificate in the years 1986-87 to 1989 -90 ;
(2) how many people over 18 years of age in England and Wales received free dental treatment by qualifying for an AG2 certificate in the years 1986-87 to 1989-90 ; and if these figures could be made available for each district health authority area.
Mr. Dorrell : This information is not available in the form requested.
NHS Staff (Pensions)
Mr. Carrington : To ask the Secretary of State for Health whether there have been any recent changes to pension arrangements for national health service staff.
Mr. Dorrell : New arrangements for the payment of additional voluntary contributions (AVCs) are being introduced into the national health service (England and Wales) pension scheme from 1 February 1991. The new facility will give members of the scheme more choice about the way in which extra pension benefits, within Inland Revenue limits, can be provided. Those who wish to pay additional pension contributions will now be able to contribute towards a money-purchase AVC arrangement with the Equitable Life Assurance Society. They will be able to choose the type of additional cover they want to buy and the method of investment. AVCs may be used to increase the member's own pension, dependants' pensions or the lump sum payable on death. The member can choose to invest contributions in a with-profits or a unit-linked investment or, by a link with the Woolwich building society, in a deposit account.
The new scheme will run alongside existing AVC facilities in the NHS pension scheme. The additional choice which staff will now have accords with the Government's continuing commitment to improving the choice individuals have about their pension arrangements and the way their pension contributions are invested.
Secure Units
Miss Lestor : To ask the Secretary of State for the Health Department when the consultation paper on provision of new secure units will be published ; and if he will make a statement.
Mrs. Virginia Bottomley : The consultation paper, "The remand of alleged juvenile offenders", issued by my right hon. Friend the Home Secretary on 4 February, contained proposals which call for some increase in the overall number of secure places provided by local authorities. We hope to discuss the implications of these proposals with the local authority associations as soon as possible.
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Nurse Prescribing
Mr. Fishburn : To ask the Secretary of State for Health what is the outcome of the consultation on the report of the advisory group on nurse prescribing ; and what proposals he has to introduce a system of limited drug prescribing for qualified nurses.
Mrs. Virginia Bottomley : I refer my hon. Friend to my reply to my hon. Friend the Member for Torridge and Devon, West (Miss Nicholson) on 4 February.
Tobacco Products
Mr. David Martin : To ask the Secretary of State for Health what steps he has taken to implement the EC directive on the labelling of tobacco products.
Mr. Waldegrave : Officials have written today to the major interests concerned to allow them three months to comment on draft regulations to implement this directive. In implementing the directive, I have proposed as far as possible to maintain the existing system for testing tar and nicotine yields of cigarettes. I have also proposed, insofar as the directive allows any flexibility in the matter, to choose those health warnings which seem likely to be most effective in alerting the consumer to the terrible health risks involved in smoking. I have placed a copy of the draft regulations in the Library.
Children (Grandparents' Access)
Mr. O'Hara : To ask the Secretary of State for Health if he will seek to make changes in the law to allow access for grandparents to grandchildren who have been taken into care.
Mrs. Virginia Bottomley : The Children Act 1989, which will be implemented on 14 October 1991, makes new provisions regarding contact with children who are the subject of a care order. The Act provides that any person who has obtained the leave of the court to do so may apply for an order determining the contact which is to be allowed between the child and that person.
This provision enables people with whom the child has previously had a close relationship to keep in touch with that child while he is in the care of the local authority. If the grandparent was the beneficiary of a residence order made under section 8 of the Act immediately prior to the care order being made, he will be one of those automatically entitled to reasonable contact.
Where a child is being looked after by a local authority on a voluntary basis, contact is a matter for agreement between parents, foster parents and the authority. Authorities will have a duty to promote reasonable contact between the child and his
relatives--including a grandparent--where this is consistent with the child's welfare.
Incontinence Pads
Mr. Hinchliffe : To ask the Secretary of State for Health what is his policy with regard to health authorities charging for the supply of incontinence pads to residents of private care or nursing homes.
Mr. Dorrell : Health authorities are not empowered to charge for the incontinence pads which they may, at their
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discretion, supply to people living in private residential homes. Private nursing homes were specifically excluded from the free supply arrangements promulgated in 1974, since the treatment such homes provide would normally include any necessary services or equipment and the cost would be covered by the fees or charges paid to them by or on behalf of the patients (including those paid by a health authority under contractual arrangements). Under section 7 of the Health and Medicines Act 1988 health authorities may supply such goods to nursing homes for a fee which includes an element of profit. The Department is on the point of initiating a review of arrangements for the supply of incontinence pads to people living in their own homes or in private residential care.Embossed Literature Service
Mrs. Rosie Barnes : To ask the Secretary of State for Health if he will review the value of the grant for the embossed literature service.
Mr. Dorrell : The level of grant aid for the embossed literature service in 1991-92 will be determined in the light of the available resources and competing demands for funds and taking into account the criteria applicable to grants made under section 64 of the Health Services and Public Health Act 1968.
Community Health Councils
Mr. Wray : To ask the Secretary of State for Health if he will take steps to ensure that community health councils keep their full rights to attend health authority meetings and to speak even during confidential parts of such meetings.
Mr. Dorrell : As members of the public, CHC members and staff have the right under the Public Bodies (Admission to Meetings) Act 1960 to attend health authority meetings. Whether or not they are asked to speak, or allowed to attend confidential parts of such meetings, has always depended, and will continue to depend, upon the decision of the chairman of the meeting.
NHS Trusts
Mr. Robert Hughes : To ask the Secretary of State for Health which regional or district health authorities in England have employed outside financial consultants to prepare business plans for direct management unit or NHS trust status ; in each case which consultants were employed ; and what was the cost to each regional or district health authority.
Mrs. Virginia Bottomley : This information is not available centrally.
Mr. Robin Cook : To ask the Secretary of State for Health (1) if he will publish his Department's estimate of the cash value of the return on capital element of the contract prices to be charged by each NHS trust in the 1991-92 financial year ;
(2) if he will publish the figures used for establishing the external financing limits of each of the NHS trusts ;
(3) what is the planned level of capital spending by each NHS trust in the 1991-92 financial year.
Mr. Dorrell [holding answer 4 February 1991] : National health service trusts are free to manage their
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affairs within their external financing limits. It is not appropriate to publish the detailed information underlying the calculations of external financing limits.Abortions
Ms. Richardson : To ask the Secretary of State for Health if he will make it his policy to issue guidance to regional health authorities that abortions should be treated as urgent operations if non-urgent beds have to be cleared to deal with Gulf war casualties ; and if he will make a statement.
Mrs. Virginia Bottomley : There is no need for health authorities to prepare for Gulf casualties by emptying beds until significant ground operations begin. The decision as to whether an abortion should be treated as an urgent operation is a matter for the clinical judgment of the doctors concerned in each individual case.
Community Care
Mr. Campbell-Savours : To ask the Secretary of State for Health whether he is actively considering removing elements of community care provision from local authority to health authority control.
Mrs. Virginia Bottomley : The respective roles of local and health authorities in the provision of care in the community are as set out in the White Paper "Caring for People", copies of which are available in the Library.
ENVIRONMENT
Housing Repair Agencies
Mr. David Porter : To ask the Secretary of State for the Environment if he will make a statement on the future role he plans for housing repair agencies and their relationships with local authorities.
Mr. Yeo : On 19 October 1990 my hon. Friend the Member for Salisbury (Mr. Key) announced that the Government would provide a grant of 50 per cent. towards the running costs of approved schemes from 1 April 1991, to be channelled through local housing authorities which would also be responsible for identifying the needs of their areas and for securing the establishment and operation of appropriate schemes.
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He also announced that a central co- ordinating body would be set up to undertake developmental and training work, monitor progress and provide advice to individual schemes ; and I am now pleased to be able to announce that, having carefully considered the submissions put to us by various potentially suitable organisations, we have decided to invite Care and Repair Ltd. to take on that role from 1 April this year. My Department is currently discussing the details of a four-year contract with them.Bus Subsidies
Mr. Robert Banks : To ask the Secretary of State for the Environment if he will list the authorities giving subsidies to bus companies with the amounts involved for 1990-91 and the cost to each charge payer.
Mr. Key : The information requested is not available.
NRA Staff
Mr. Steinberg : To ask the Secretary of State for the Environment if he will list, by profession, the numbers of staff currently employed by the National Rivers Authority with science
qualifications.
Mr. Baldry : The information requested is not held by my Department. I have however asked the chairman of the National Rivers Authority to reply direct to the hon. Member.
Derelict Gas Works
Mr. Steinberg : To ask the Secretary of State for the Environment what information he has on the number of derelict sites that were previously used by gas works.
Mr. Trippier : Figures for the number of derelict sites that were previously used as gasworks are not available.
Non-metropolitan Councils
Mr. Simon Coombs : To ask the Secretary of State for the Environment if he will list, in ranking order of loan debt per capita, the top 20 non- metropolitan district councils with their level of debt, their population, and the political party which currently controls them.
Mr. Key : The information is as follows :
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List of Non-Metropolitan District Councils
(Top 20 in Ranking order of loan Debt per Capita)
Council |Rank |Outstanding |Population<1>|Debt |POL Control
|Debt |Per Capita
|£ million
-----------------------------------------------------------------------------------------------------
Nottingham | 1 |423.9 |273,500 |1,550 |NOC
Harlow | 2 |108.8 |71,300 |1,526 |Labour
Stevenage | 3 |111.4 |74,000 |1,505 |Labour
Norwich | 4 |175.6 |117,400 |1,496 |Labour
Kingston on Hull | 5 |339.8 |245,100 |1,386 |Labour
Crawley | 6 |115.0 |84,500 |1,361 |Labour
Middlesbrough | 7 |187.0 |142,700 |1,310 |Labour
Blackburn | 8 |167.2 |135,700 |1,232 |Labour
Redditch | 9 |95.3 |78,100 |1,220 |Labour
Thamesdown |10 |203.7 |170,200 |1,197 |Labour
Scunthorpe |11 |65.7 |59,600 |1,102 |Labour
Tamworth |12 |76.0 |69,000 |1,101 |Labour
Bracknell |13 |114.2 |104,600 |1,092 |Conservative
Sedgefield |14 |93.3 |88,300 |1,057 |Labour
Portsmouth |15 |194.1 |184,000 |1,055 |NOC
Northampton |16 |193.0 |184,000 |1,049 |Conservative
Hartlepool |17 |89.8 |88,700 |1,012 |Labour
Leicester |18 |278.1 |279,700 |994 |Labour
Luton |19 |167.6 |169,900 |986 |Conservative
Brighton |20 |139.2 |143,100 |973 |Labour
(NOC=No Overall Control)
<1> Total resident population at 30 June 1989 (OPCS estimate)
Recycling
Mr. Harry Greenway : To ask the Secretary of State for the Environment, further to his answer to the hon. Member for Thurrock (Mr. Janman), of 19 December 1990, Official Report, column 167, what criteria he uses to assess whether sites for recycling are environmentally unviable ; and what assessment he has made of the environmental viability of the waste disposal site under construction behind Greenford station.
Mr. Baldry : The assessment of the environmental impact of any new recycling or waste transfer and disposal facility is a matter for the local planning and waste regulation authorities, which, in the case mentioned by my hon. Friend, are the London borough of Ealing and the London Waste Regulation Authority. It would be wrong to comment on the merits of any application which could come before my right hon. Friend the Secretary of State for the Environment on appeal.
London Docklands Development Corporation
Mr. Blunkett : To ask the Secretary of State for the Environment (1) how many jobs have been created in the London Docklands development corporation since 1981 ; and how much each job has cost through the allocation of public money ;
(2) what is the number of jobs created in the London Docklands development corporation ; and how many are (a) additional jobs and (b) transfers.
Mr. Portillo : About 45,000 jobs have come to London docklands since 1981, of which an estimated 13,500 are in companies which have set up in the urban development area and some 31,500 in companies that have relocated there.
It is impossible to distinguish between expenditure leading to job creation and that leading to other regeneration benefits.
Landfill Sites
Mr. Vaz : To ask the Secretary of State for the Environment if he will list the number and names of landfill sites in England and their approximate acreage.
Mr. Baldry : This information is not available centrally and it would be too expensive to collect.
Domestic Water Supplies
Mrs. Ann Taylor : To ask the Secretary of State for the Environment what advice his Department has given to water companies about adding chlorine or other disinfectants to domestic water supplies during the present crisis in the Gulf.
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Departmental Architects
Mr. Steen : To ask the Secretary of State for the Environment how many architects and support staff have been employed (a) full and (b) part time, in each of the last five years, in his Department ; and what has been the cost to the Exchequer in each year.
Mr. Heseltine : I will write to my hon. Friend.
Wetlands
Mrs. Ann Taylor : To ask the Secretary of State for the Environment when deciding the locations for dumping of dredgings what consideration is taken of whether a site meets the criteria for designation as a wetland of international importance under the Ramsar convention and as a special protection area under the EC directive on the conservation of wild birds and is therefore of greater than local importance.
Mr. Trippier : The Nature Conservancy Council recommends to the Government sites which meet the criteria for designation as wetlands of international importance under the Ramsar convention and special protection areas under the EEC birds directive. The factors which are taken into account when considering any development proposal affecting a Ramsar site or special protection area, or site identified as being a potential special protection area, are set out in DOE circular 27/87.
Mrs. Ann Taylor : To ask the Secretary of State for the Environment whether he will call in for his own consideration the proposal made by the Port of London authority to dump dredgings on Cliffe marshes, Kent.
Mr. Yeo : I refer the hon. Member to my reply of 4 February at column 41 to the hon. Member for Glanford and Scunthorpe (Mr. Morley).
Sport
Mr. Pendry : To ask the Secretary of State for the Environment if he will list the recommendations of the report of the School Sport Forum, "Sport and Young People : Partnership and Action," which required action by his Department ; what action has been taken to implement each recommendation ; what are the reasons where the recommendation has not been implemented in full ; and what further action his Department intends to take.
Mr. Key : I refer the hon. Member to the answer given today by my hon. Friend the Minister for Sport.
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