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Column 149
HEALTH
Cigarette Advertising
Mr. Marlow : To ask the Secretary of State for Health if he will list the statutory provisions relating to the EC's powers concerning cigarette advertising.
Mr. Dorrell : The Commission is proposing a new draft directive on tobacco advertising, the text of which is not yet available. Previous drafts have been based on article 100A of the treaty establishing the European Economic Community.
Nurses' Pay
Mr. Robin Cook : To ask the Secretary of State for Health what was the total level of expenditure on pay for nurses, in cash and constant prices, in each year since 1973.
Mr. Waldegrave : The information requested for the financial years since NHS reorganisation on 1 April 1974 is shown in the table. The level of expenditure in 1989-90 reflects the transfer of many senior nurse managers from the nursing and midwifery pay structure to general senior management pay categories, a planned reduction in the overall number of students in training and other factors.
NHS expenditure on salaries and wages-nursing
and midwifery
staff
Total salaries and wages costs
|£000 |£000
|(cash) |(at 1989-90
|prices)
------------------------------------------------
1974-75 |761,521 |3,201,069
1975-76 |985,114 |3,298,763
1976-77 |1,122,979 |3,311,980
1977-78 |1,220,263 |3,165,533
1978-79 |1,375,652 |3,218,475
1979-80 |1,679,338 |3,367,308
1980-81 |2,338,084 |3,961,953
1981-82 |2,554,240 |3,947,322
1982-83 |2,747,676 |3,964,759
1983-84 |2,858,812 |3,942,959
1984-85 |3,074,483 |4,035,413
1985-86 |3,261,598 |4,059,776
1986-87 |3,566,025 |4,291,889
1987-88 |4,013,321 |4,580,604
1988-89 |4,750,229 |5,052,819
1989-90 |5,028,195 |5,028,195
Annual accounts of regional and disrict health
authorities in England and those of the special
health authorities for the London postgraduate
teaching hospitals. (Predecessor authorities
for the years prior to 1982-83).
NOTES TO THE TABLE
1. The figures are gross pay costs including
employers' national insurance and
superannuation contributions. Expenditure on
non-NHS (agency, etc.) staff is also included.
2. The figures for earlier years have been
expressed at 1989-90 prices by the use of Gross
Domestic Product deflators.
NHS Trusts
Mr. Robin Cook : To ask the Secretary of State for Health if he will publish the names of those people nominated to be chairs of second-wave NHS trusts.
Mr. Waldegrave : An announcement of the names of the chairmen of second-wave NHS trusts will be made after the trusts have been formally established.
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Intestinal and Stomach Cancer
Mr. Pawsey : To ask the Secretary of State for Health what evidence his Department has on links between diet and the incidence of intestinal and stomach cancer, with particular reference to the consumption of red meat.
Mr. Dorrell : Comparisons of diet and the incidence of intestinal cancer in different groups have prompted hypotheses of a possible increase in risk from the consumption of red meat or its fat content, but the evidence is inconclusive.
The Department is not aware of any suggested link between the consumption of red meat and an increased risk of stomach cancer.
Vaccines
Mr. Barry Field : To ask the Secretary of State for Health how many reported reactions there have been to vaccines in the last year for which figures are available ; which vaccines were reported ; what were the reactions ; and whether any of these resulted in permanent disabilities.
Mr. Dorrell : There were 748 reports of suspected adverse reactions to vaccines in 1990 ; some of these reports may have featured more than one vaccine and/or more than one reaction. The report of a suspected adverse reaction does not necessarily imply a causal relationship.
The following vaccines were involved :--
Anthrax
BCG
Diphtheria
Hepatitis B
Influenza
Measles
Measles/mumps/rubella
Polio
Rubella
Tetanus
Typhoid
Whooping cough
Yellow fever
The reactions reported fell into the following categories :-- Application site disorders
Arrythmias
Auditory and vestibular
Autonomic nervous system
Bleeding and clotting disorders
Cardiovascular disorders
Central nervous system
Collagen disorders
Endocrine disorders
Fetal disorders
Gastro-intestinal disorders
General disorders
Hepatic disorders
Intra-cardiac disorders
Male reproductive disorders
Metabolic and Nutritional
Muscular Skeletal disorders
Other special senses
Peripheral vascular disorders
Psychiatric disorders
Resistance mechanism
Respiratory disorders
Skin and appendages
Urinary disorders
Visual disorders
White blood cell disorders
A number of the reports indicated that, at the time of reporting, the patient had not yet recovered. A number of these patients have subsequently recovered.
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Cash Limits
Mr. Arbuthnot : To ask the Secretary of State for Health whether any changes will be made to the cash limits and running cost limits for his Department in 1991-92.
Mr. Waldegrave : Subject to parliamentary approval of the necessary supplementary estimates, the following changes will be made : The cash limit for class XIII, vote 1 (hospital, community health, family health services (part) and related services, England) will be increased by £162,196,000 from £16,247,836,000 to £16,410,032,000. This increase allows for an additional £157,719,000 to help provide, from 1 April 1991, for the pay awards recommended in the 1991 reports of the review bodies for nursing staff, midwives, health visitors and professions allied to medicine, and on doctors' and dentists' remuneration, as announced by my right hon. Friend the Prime Minister on 31 January 1991 and for a transfer of £4,758,000 from class XI, votes 2 (Department of Education and Science, higher and further education) and 3 (Department of Education and Science, student awards, loans and compensation payments) in respect of public sector higher education. These increases are partially offset by transfers of £191, 000 to class XVI, vote 8 (hospital and community health services, family practitioner services (part) and other health services, Wales) in respect of occupational therapy training and £90,000 to class XIII, vote 3 (see below) in respect of a child health care initiative. The cash limit for class XIII, vote 3 (Department of Health, administration, miscellaneous health services and personal social services, England) will be increased by £43,118,000 from £683,351,000 to £726,469,000. The increase provides for £1,281,000 to meet, from 1 April 1991, the review body recommendations mentioned above ; for £42,000,000 for grants to haemophiliacs infected with HIV ; for a net transfer of £847,000 from class XIV, vote 4 (Department of Social Security, administration and miscellaneous services) following a reapportionment of costs between the two Departments ; for transfers of £90,000 from class XIII, vote 1 (see above) in respect of a child health care initiative and £14,000 from class IV, vote 2 (Department of Trade and Industry, support for industry, international trade, statutory and regulatory work, consumer protection and
administration) in respect of research undertaken by the laboratory of the Government chemist and the national physical laboratory. The increases are partially offset by a transfer of £1,114,000 to class XI, vote 2 (Department of Education and Science, higher and further education) in respect of social work training. The Department's running cost limit is decreased by £733,000 from £253,625,000 to £252,892,000.
The increases have been charged to the reserve and therefore do not add to the planned total of public expenditure.
Cigarette Consumption
Mr. Amos : To ask the Secretary of State for Health if he will provide the source of his information that cigarette consumption in the Netherlands declined by 41 per cent. over the period 1975 to 1987 ; and whether this figure is for both manufactured cigarettes and hand-rolling tobacco together, or for only one of these categories.
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Mr. Dorrell : The original source of this information is the Central Bureau for Statistics, the Netherlands. The figure relates only to manufactured cigarettes. It was recently published in the United Kingdom in Waterson M. J. "Advertising and Tobacco Consumption : An Analysis of the two Major Aspects of the Debate" International Journal of Advertising, 1990, 9, 59-72, a copy of which is available in the Library.
Tobacco Advertising
Mr. Amos : To ask the Secretary of State for Health if priority will be given to the removal of tobacco advertising, not only from shops visible from schools and playgrounds, but also from shops close to schools and playgrounds.
Mr. Dorrell : The new voluntary agreement between the tobacco industry and the Government on tobacco advertising will require the industry to remove 50 per cent. of all permanent shopfront advertising over five years. The terms of the agreement will mean that the industry must give priority to removing signs clearly visible from schools. It is these signs which cause greatest concern to the Government.
Mr. Amos : To ask the Secretary of State for Health if the agreement with the tobacco industry announced recently to limit external permanent advertising on shops will apply to advertising stuck to the interior of shop windows facing outwards.
Mr. Dorrell : The agreement will cover permanent advertising material of this type, specifically window friezes and full window dressings.
Mr. Amos : To ask the Secretary of State for Health if he will list the types of external permanent advertising material on shops to which his agreement with the tobacco industry will not apply.
Mr. Dorrell : No specific categories of external permanent advertising material on shops are excluded from the agreement.
Mr. Amos : To ask the Secretary of State for Health what method will be used to measure the 50 per cent. reduction in permanent external tobacco advertising material on shop fronts.
Mr. Dorrell : Once the agreement has been concluded, the committee for monitoring agreements on tobacco advertising and sponsorship will engage independent consultants to monitor compliance with this aspect of the agreement. The methodology used by the consultants will be agreed between them and the committee. This matter will be covered in the committee's annual reports.
Mr. Amos : To ask the Secretary of State for Health if he will commission an independent survey of the extent of tobacco advertising material on shops, comparable with those conducted for the committee for monitoring agreements on tobacco advertising and sponsorship by MAS Research Marketing and Consultancy Ltd. and reported in its first and second reports.
Mr. Dorrell : The precise nature of the independent consultancy work to be undertaken in monitoring compliance with the agreement is a matter for the committee for monitoring agreements on tobacco advertising and sponsorship.
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Mr. Amos : To ask the Secretary of State for Health if he consulted the medical profession before concluding his agreement with the tobacco industry on advertising.Mr. Dorrell : We have not yet finally concluded the agreement. We are fully aware of the medical profession's views on this matter. The Department's own medical advisers took an active part in the negotiations.
Mr. Amos : To ask the Secretary of State for Health what steps he is taking to ensure that there is no increase in shop-front tobacco advertising in the period before the new voluntary agreement with the tobacco industry comes into effect.
Mr. Dorrell : The reference date for the number of permanent shopfront signs advertising tobacco will be 1 July 1991. The industry has given firm assurances that it is not its intention to use the period before 1 July to make significant increases in the number of such signs.
Registration : proposals for change"
Mr. Foulkes : To ask the Secretary of State for Health what representations he has received following the publication of the White Paper on "Registration : proposals for change", (Cm. 939).
Mr. Dorrell : There has been generally a widespread welcome for the proposals made in the White Paper.
Secular Marriages
Mr. Foulkes : To ask the Secretary of State for Health what further consideration he has given to the form of service, person performing the service, authorised buildings and greater flexibility in the arrangements for secular marriages ; if he will now consider introducing legislation to enable secular marriages to be carried out by magistrates, mayors or provosts, to allow them to take place in civic and other specified buildings, and to allow greater flexibility in the services ; and if he will make a statement.
Mr. Dorrell : The proposals in Cm. 939 are designed to give greater flexibility in the form of civil marriage ceremony and the choice of venues where such ceremonies may be conducted. The Government intend to introduce legislation to give effect to those and other proposals in the White Paper as soon as other parliamentary business allows. The Government have no plans to allow civil marriages and the attendant responsibilities to be carried out by anyone other than registration officers.
South Yorkshire Ambulance Service
Mr. Hardy : To ask the Secretary of State for Health how many representations he has received during the past six months from residents in South Yorkshire expressing support for the transfer of the South Yorkshire ambulance service to trust status.
Mrs. Virginia Bottomley [pursuant to her reply, 20 May 1991 c. 394] : I regret that the identification of Yorkshire regional healtauthority as being responsible for the public consultation exercise on the trust application from the South Yorkshire ambulance service was incorrect. Trent regional health authority is conducting this exercise.
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HOME DEPARTMENT
Correspondence
Mr. Livingstone : To ask the Secretary of State for the Home Department what caused the delay in replying to the letter of 25 September 1990 to the Minister of State responsible for prisons from the Member for Brent, East about his constituent, Ms. R. Louis ; and for what reasons could a copy of the reply not be faxed to him on 23 May.
Mrs. Rumbold : It is regretted that the hon. Member's first letter of 25 September 1990 was lost at prison service headquarters during reorganisation and the reply not provided until the receipt of his further letter of 4 April. A copy of the reply was faxed to the House of Commons for the attention of the hon. Member on 23 May.
Indecency
Mr. Chris Smith : To ask the Secretary of State for the Home Department if, pursuant to the answer to the hon. Member for Islington, South and Finsbury of 20 December 1990, Official Report, column 334, he will call for a report from the Commissioner of Police of the Metropolis on any changes made since that date to force instructions contained in the Metropolitan police force instruction manual or elsewhere relating to police operations to detect possible offences of indecency ; and whether clearer guidance has been provided.
Mr. Peter Lloyd : I understand from the Metropolitan police that no such changes have been made since 20 December 1990, although this is being kept under review. The Metropolitan police instruction manual includes directions to officers as to the procedures to be followed in a wide range of street duties. It contains no specific instructions relating to the detection of offences of indecency. This is because the action to be taken by officers must be determined primarily by the circumstances of each particular case, within the overall guidelines.
Visas
Mr. Alfred Morris : To ask the Secretary of State for the Home Department what discussions are taking place with the European Community concerning the validity of visas issued by one member state throughout the Community ; and if he will make a statement.
Mr. Peter Lloyd : The question of co-operation between member states on visa matters is currently under discussion in the EC intergovernmental fora which are examining a draft convention on the crossing of external frontiers. It is too early to predict the outcome of those discussions.
Cash Limits
Sir John Wheeler : To ask the Secretary of State for the Home Department whether he intends to make any changes to the 1991-92 cash limits within his responsibilities and to his Department's running costs limits.
Mr. Kenneth Baker : Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class IX, vote 3, will be increased by £12,872,000, from £878,445,000 to £891,317,000. At the same time the Home
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Office running costs limit will be increased by £9,007,000 from £1, 294,993,000 to £1,304,000,000. This mainly reflects the additional provision sought in connection with an increase in the number of asylum applications.£9,000 of the increase will be offset by a transfer of provision from the Cabinet Office (class XIX, vote 1). The balance of £12,863, 000 will be charged to the reserve and will not therefore add to the planned total of public expenditure.
WALES
Standard Assessment Tasks
Mr. Barry Jones : To ask the Secretary of State for Wales if he will visit (a) Sandycroft C. P. school and (b) Connah's Quay Bryn C. P. school, to discuss standard assessment tasks with staff members.
Sir Wyn Roberts : Although we have no immediate plan to visit these schools, my right hon. Friend and I have discussed assessment tasks with teachers in several schools we have recently visited. The Welsh Office in conjunction with HMI and the School Examinations and Assessment Council will be holding a one day conference at the end of June for primary teachers and advisers from all LEAs in Wales to discuss this year's assessment arrangements for seven-year-olds.
Residential Homes
Mr. Barry Jones : To ask the Secretary of State for Wales what policy initiatives he plans concerning homes in Wales for the elderly mentally infirm.
Mr. Nicholas Bennett : We recognise the vulnerability of elderly people with mental infirmities and the need for adequate networks of care for them and of support for their families and friends who provide care.
Where it is no longer possible for an individual to stay in his or her own home, admission to residential, nursing home or hospital care should be a positive choice based on a full assessment of realistic alternatives. Such care should be in appropriately designed and staffed, locally based accommodation.
Our detailed policies and programme of action are set out in the Welsh Chapter of the White Paper "Caring for People : Community Care in the Next Decade and Beyond" (Cm 849), in the guidance on social care plans published by the Welsh Office in September 1990 and in the all-Wales mental illness strategy published in May 1989. Copies of these documents are in the Library of the House.
These are being carried into effect through complementary county plans for mental illness services and social care more generally which are to be published by April 1992. Earmarked Welsh Office funds under the mental illness strategy, the elderly initiative and the new grant scheme to promote more flexible forms of community care for elderly people and those with physical or sensory disabilities are helping to develop the required patterns of local services.
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