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General Practitioners

Mr. Nellist : To ask the Secretary of State for Health what plans he has to ensure that the maximum number of patients for whom any doctor can receive payment is 2,500 ; and if he will make a statement.

Mrs. Virginia Bottomley : There are no plans to place a limit on the number of patients for whom a doctor can receive payment. List sizes have been falling steadily for a number of years with the average now below 2,000.

Mr. Robin Cook : To ask the Secretary of State for Health if he will publish the budgets allocated to each general practitioner fundholding practice (a) in total and (b) per patient registered with the practice.


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Mr. Dorrell : Budgets for general practitioner fund-holding practices are approved by regional health authorities and this information is therefore not held centrally.

Mr. Nellist : To ask the Secretary of State for Health how many general practitioners in Britain have over 3,000 patients on their list ; how many of these are single-handed ; and how many serve inner-city areas.

Mrs. Virginia Bottomley : At 1 April 1991, the latest date for which figures are available, there were 2,563 general practitioners in England with a personal list size of over 3,000 patients, of whom 394 are working single-handed. Information about the number of these doctors serving inner- city areas is not readily available and could be obtained only at disproportionate cost. The information relating to Wales and Scotland is a matter for my right hon. Friends the Secretaries of State for Wales and for Scotland.

Occupational Therapy

Mr. Vaz : To ask the Secretary of State for Health if he will bring forward proposals to change the funding of occupational therapy training ; and if he will make a statement.

Mrs. Virginia Bottomley : The proposal contained in "Working for Patients Paper 10 : Education and Training", to devolve the moneys for the funding of occupational therapy training from the Department's central control to the regional health authorities was implemented on 1 September 1991. Copies of working paper 10 are available in the Library.

There are no plans for further changes.

Diabetics

Mr. McMaster : To ask the Secretary of State for Health what representations he has received encouraging him to provide diabetics with free needles for use in treatment ; if he has any plans to make such provision either generally or to particular groups of diabetics ; and if he will make a statement.

Mrs. Virginia Bottomley : Since April 1990 we have received 88 letters from hon. Members and 24 other items of correspondence referring to provision from general practitioners of needles for use with injection pen systems for diabetics. Disposable syringes with integral needles and disposable needles for glass barrelled syringes are already available on GP prescriptions.

We are considering whether injection pen systems including needles for all diabetics requiring insulin treatment should be available on prescription. The pricing and cost implications of various systems are currently under review.

North East Thames RHA

Mr. Corbyn : To ask the Secretary of State for Health (1) if he will list all items, by district of the North East Thames regional health authority, of committed capital spending for the current financial year and planned for 1992-93, 1993-94 and 1994-95 ; and the sources of funds for this ;


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(2) if he will list all the sources by district of the North East Thames regional health authority of capital receipts for the financial years 1988-89, 1989-90, 1990-91 and 1991-92 and expected for the next two financial years.

Mr. Dorrell : Information at this level of detail is not available centrally. The hon. Member may wish to contact Mr. Tim Chessels, the chairman of North East Thames regional health authority, for details.

Hospital Social Workers

Ms. Harman : To ask the Secretary of State for Health if he will make a statement about hospital social workers in London.

Mrs. Virginia Bottomley : Responsibility for providing social work services to hospitals rests with local authorities under arrangements established in 1974. We are discussing with the local authority associations how a system of funding could be organised by local authorities so that the demands which an authority's residents make on the service are more accurately reflected.

Islington and Bloomsbury Hospitals

Mr. Corbyn : To ask the Secretary of State for Health what plans there are for the future use of the Royal Northern hospital and the Highgate wing of the Whittington hospital of Islington and Bloomsbury health authority.

Mr. Dorrell : I understand that all in-patient services have been transferred from the Royal Northern hospital to the Whittington hospital. Over the next two to three years, following further development at the Whittington hospital, day surgery, out-patient and diagnostic services will also be relocated to the Whittington. Community based services such as genito-urinary medicine and alcohol abuse clinics are intended to remain on the Royal Northern site. The district and regional health authority intend to dispose of surplus land at the Royal Northern as it is vacated.


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I understand that the Highgate wing of the Whittington hospital is currently occupied by administrative staff who will be relocated as soon as alternative accommodation has been found. The site will then be sold.

NHS (Administrative Posts)

Ms. Harman : To ask the Secretary of State for Health (1) how many new administrative posts have been created in each regional health authority as a result of the recent changes in the national health service ;

(2) if he will estimate the cost of creating new administrative posts in England in 1990-91 to implement recent national health service changes.

Mrs. Virginia Bottomley : Information is not held centrally about specific posts. In 1990-91 additional funds of around £300 million were provided to implement the changes and improvements associated with the NHS review. Some £200 million of this was for revenue expenditure in the hospital and community health services on additional consultants, medical audit, information technology, for strengthening personnel and finance functions, and for training. It is not possible to estimate what proportion of these funds was spent on establishing new administrative posts.

Ambulances

Ms. Harman : To ask the Secretary of State for Health if he will list for each ambulance authority, including ambulance trusts, the numbers of (a) urgent vehicles and (b) non-urgent vehicles.

Mr. Dorrell : The tables show the types and numbers of vehicles owned by each ambulance authority in 1988-89. This is the latest year for which the information is available.

The information is collected from the annual survey of ambulance authorities carried out by York ambulance authority.


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Ambulance service-Survey 1988-89                                                                                                                                                                                          

Table 1-Ambulance service vehicles                                                                                                                                                                                        

                              Ambulances                                                                                                                                                                                  

                             |Two-trolley         |Two-trolley         |Sitting case        |Sitting case        |Car (with                                                                                               

                             |emergency           |dual                |seats only          |seats               |seats plus          |or without          |more seats          |ambulance                                

                                                  |purpose             |(under 14)          |stretcher           |lift                |stretcher           |with or             |service                                  

                             |A                   |B                                        |capacity            |mechanism           |capacity)           |without             |vehicles                                 

                                                                                                                                                           |stretcher or        |used to                                  

                                                                                                                                                           |wheelchair          |transport                                

                                                                                                                                                           |capacity            |patients                                 

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Avon                         |36                  |24                  |34                  |-                   |21                  |-                   |1                   |116                                      

Bedfordshire                 |36                  |-                   |20                  |1                   |8                   |1                   |-                   |66                                       

Berkshire                    |32                  |-                   |10                  |-                   |27                  |-                   |-                   |69                                       

Buckinghamshire              |43                  |-                   |18                  |-                   |13                  |-                   |-                   |74                                       

Cambridgeshire               |40                  |-                   |6                   |-                   |14                  |-                   |-                   |60                                       

Cheshire                     |52                  |-                   |8                   |39                  |13                  |-                   |-                   |112                                      

Cleveland                    |52                  |-                   |29                  |-                   |4                   |-                   |-                   |85                                       

Cornwall and Isles of Scilly |66                  |2                   |-                   |-                   |2                   |-                   |-                   |70                                       

Cumbria                      |54                  |-                   |19                  |2                   |12                  |2                   |-                   |89                                       

Derbyshire                   |22                  |76                  |9                   |18                  |7                   |-                   |-                   |132                                      

Devon                        |101                 |-                   |5                   |-                   |1                   |-                   |-                   |107                                      

Dorset                       |40                  |-                   |2                   |10                  |10                  |-                   |-                   |62                                       

Durham                       |31                  |-                   |11                  |52                  |8                   |5                   |1                   |108                                      

Essex                        |-                   |116                 |6                   |-                   |8                   |-                   |-                   |130                                      

Gloucestershire              |27                  |-                   |5                   |2                   |40                  |-                   |-                   |74                                       

Hampshire                    |100                 |-                   |10                  |-                   |9                   |-                   |-                   |119                                      

Hereford and Worcester       |59                  |6                   |-                   |-                   |19                  |3                   |4                   |91                                       

Hertfordshire                |53                  |-                   |43                  |9                   |23                  |2                   |-                   |130                                      

Humberside                   |-                   |107                 |24                  |-                   |22                  |11                  |-                   |164                                      

Isle of Wight                |-                   |-                   |-                   |-                   |-                   |-                   |-                   |-                                        

Kent                         |-                   |154                 |29                  |9                   |14                  |-                   |-                   |206                                      

Lancashire                   |91                  |51                  |7                   |-                   |24                  |1                   |-                   |174                                      

Leicestershire               |95                  |-                   |19                  |25                  |-                   |2                   |-                   |141                                      

Lincolnshire                 |70                  |19                  |6                   |-                   |-                   |-                   |-                   |95                                       

Norfolk                      |-                   |69                  |28                  |1                   |2                   |-                   |-                   |100                                      

Northamptonshire             |31                  |1                   |27                  |-                   |16                  |1                   |-                   |76                                       

North Yorkshire              |41                  |30                  |2                   |-                   |35                  |10                  |-                   |118                                      

Nottingham                   |44                  |18                  |-                   |64                  |-                   |5                   |-                   |131                                      

Oxfordshire                  |-                   |44                  |3                   |-                   |12                  |-                   |-                   |59                                       

Shropshire                   |37                  |13                  |2                   |-                   |14                  |-                   |-                   |66                                       

Somerset                     |35                  |-                   |8                   |-                   |11                  |-                   |-                   |54                                       

Staffordshire                |75                  |33                  |25                  |-                   |2                   |5                   |-                   |140                                      

Suffolk                      |34                  |-                   |2                   |2                   |42                  |1                   |-                   |81                                       

Surrey                       |-                   |72                  |19                  |21                  |5                   |-                   |-                   |117                                      

Sussex East                  |-                   |80                  |12                  |-                   |2                   |-                   |-                   |94                                       

Sussex West                  |-                   |74                  |9                   |-                   |-                   |1                   |-                   |84                                       

Warwickshire                 |25                  |14                  |19                  |-                   |-                   |9                   |-                   |67                                       

Wiltshire                    |40                  |4                   |2                   |-                   |11                  |-                   |-                   |57                                       

                             |-------             |-------             |-------             |-------             |-------             |-------             |-------             |-------                                  

Total                        |1,462               |1,007               |478                 |255                 |451                 |59                  |6                   |3,718                                    

Source: Information obtained from York ambulance survey.                                                                                                                                                                  

A: Two-trolley emergency vehicles are used for emergencies only.                                                                                                                                                          

B: Two-trolley dual purpose vehicles are used for emergency and non-emergency journeys.                                                                                                                                   

Table file CW911014.051 not available

Table 2-Ambulance service vehicles                                                                                                            

                          Ambulances                                                                                                          

                         |Two-trolley |Two-trolley              |Sitting case|Sitting case|Sitting case|Car (with   |Bus-14 or                

                         |emergency   |dual        |seats only  |seats       |seats plus  |or without  |more seats  |ambulance                

                                      |purpose     |(under 14)  |stretcher   |lift        |stretcher   |with or     |service                  

                                                                |capacity    |mechanism   |capacity)   |without     |vehicles                 

                                                                                                       |stretcher or|used to                  

                                                                                                       |wheelchair  |transport                

                                                                                                       |capacity    |patients                 

----------------------------------------------------------------------------------------------------------------------------------------------

Northern RHA             |81          |-           |76          |-           |29          |-           |-           |186                      

Yorkshire RHA            |12          |187         |31          |-           |128         |23          |-           |381                      

Trent RHA                |51          |29          |76          |7           |13          |5           |-           |181                      

London Ambulance Service |360         |-           |265         |-           |269         |-           |-           |894                      

West Midlands RHA        |172         |76          |62          |-           |7           |2           |20          |339                      

Mersey RHA               |-           |138         |125         |-           |8           |1           |-           |272                      

North Western RHA        |216         |90          |29          |54          |-           |-           |-           |389                      

                         |-------     |-------     |-------     |-------     |-------     |-------     |-------     |-------                  

Total                    |892         |520         |664         |61          |454         |31          |20          |2,642                    

Ms. Harman : To ask the Secretary of State for Health if he will list for 1990 for each ambulance authority, including ambulance trust, the numbers of patients carried (a) on urgent journeys and (b) on non-urgent journeys.


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Mr. Dorrell : The table shows the number of patient journeys by priority for each ambulance authority in 1989-90. This is the latest year for which the information is available.


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Table 1                                                                                                                              

Patient Transport Services 1989/90                                                                                                   

Number of patient-journeys by priority                                                                                               

All cases (England)                                                                                                                  

Ambulance authority              |Emergency          |Urgent             |Special, planned   |Total                                  

-------------------------------------------------------------------------------------------------------------------------------------

England                          |1,520,278          |846,183            |12,020,142         |14,386,603                             

                                                                                                                                     

Non-Metropolitan                                                                                                                     

Cleveland                        |24,967             |14,163             |145,685            |184,815                                

Cumbria                          |10,159             |5,014              |152,591            |167,764                                

Durham                           |26,941             |11,226             |201,150            |239,317                                

Humberside                       |39,900             |22,107             |391,403            |453,410                                

North Yorkshire                  |23,811             |13,984             |226,880            |264,675                                

Derbyshire                       |28,362             |22,474             |181,951            |232,787                                

Leicestershire                   |23,031             |24,612             |150,439            |198,082                                

Lincolnshire                     |13,832             |14,713             |140,941            |169,486                                

Nottinghamshire                  |46,753             |22,002             |323,744            |392,499                                

Cambridgeshire                   |14,975             |10,191             |206,765            |231,931                                

Norfolk                          |21,871             |20,324             |243,894            |286,089                                

Suffolk                          |10,495             |7,778              |262,891            |281,164                                

Bedfordshire                     |15,212             |6,404              |109,085            |130,701                                

Hertfordshire                    |26,221             |12,985             |182,165            |221,371                                

Essex                            |48,294             |19,620             |387,388            |455,302                                

East Sussex                      |36,718             |13,208             |357,870            |407,796                                

Kent                             |41,519             |21,219             |268,485            |331,223                                

Surrey                           |33,505             |3,570              |378,177            |415,252                                

West Sussex                      |22,443             |7,658              |95,954             |126,055                                

Dorset                           |20,171             |18,404             |270,852            |309,427                                

Hampshire                        |17,872             |14,604             |221,205            |253,681                                

Wiltshire                        |12,781             |13,217             |238,162            |264,160                                

Isle of Wight                    |3,546              |3,224              |18,543             |25,313                                 

Berkshire                        |26,119             |9,344              |119,204            |154,667                                

Buckinghamshire                  |12,281             |6,815              |124,833            |143,929                                

Northamptonshire                 |16,883             |13,332             |104,603            |134,818                                

Oxfordshire                      |11,988             |7,951              |170,999            |190,938                                

Avon                             |16,973             |10,848             |179,128            |206,949                                

Cornwall and Isles of Scilly     |15,184             |12,276             |49,966             |77,426                                 

Devon                            |25,646             |21,661             |487,780            |535,087                                

Gloucestershire                  |11,980             |12,903             |132,263            |157,146                                

Somerset                         |10,392             |11,876             |143,288            |165,556                                

Herefordshire and Worcestershire |12,200             |8,330              |197,823            |218,353                                

Shropshire                       |10,665             |10,419             |86,844             |107,928                                

Staffordshire                    |34,127             |15,463             |179,867            |229,457                                

Warwickshire                     |11,277             |14,953             |60,893             |87,123                                 

Cheshire                         |29,413             |17,303             |270,811            |317,527                                

Lancashire                       |29,639             |14,717             |255,573            |299,929                                

                                                                                                                                     

Metropolitan                                                                                                                         

Northumbria Metropolitan         |70,563             |66,591             |609,148            |746,302                                

West Yorkshire Metropolitan      |107,536            |64,948             |984,355            |1,156,839                              

South Yorkshire Metropolitan     |44,412             |37,200             |482,817            |564,429                                

London Ambulance Service         |187,262            |42,103             |796,358            |1,025.723                              

West Midlands Metropolitan       |93,082             |69,365             |554,559            |717,006                                

Mersey Metropolitan              |101,399            |24,006             |433,045            |558,450                                

Greater Manchester Metropolitan  |77,878             |31,078             |439,765            |548,721                                

Source: KA32                                                                                                                         

DH Statistics and Management Information (SM12B) 1990.                                                                               

Ms. Harman : To ask the Secretary of State for Health if he will list for each ambulance authority, including ambulance trusts, the numbers of whole-time equivalent staff working on (a) urgent services and (b) non- urgent services.

Mr. Dorrell : Information in the form requested is not collected centrally. The table gives numbers of whole-time equivalent ambulance staff for each health region and for the London Ambulance Service. This is the latest information held and predates the creation of trusts.

Deployment of staff on emergency and non-emergency duties will depend on management assessment of local need.


NHS ambulance staff by Regional Health Authority  

as at                                             

30 September 1990                                 

Whole time equivalents<1>                         

Regions           |Ambulance staff                

--------------------------------------------------

Northern          |1,320                          

Yorkshire         |1,560                          

Trent             |1,890                          

East Anglia       |790                            

North West Thames |540                            

North East Thames |550                            

South East Thames |860                            

South West Thames |660                            

Wessex            |940                            

Oxford            |800                            

South Western     |1,460                          

West Midlands     |1,850                          

Mersey            |880                            

North Western     |1,580                          

London Ambulance  |2,460                          

                  |---                            

  England Total   |18,130                         

Source: Department of Health (SM13) Annual Census 

of NHS Non-medical Manpower.                      

<1>All figures are independently rounded to the   

nearest ten (10) whole time equivalents.          

Ms. Harman : To ask the Secretary of State for Health if he will list for each ambulance authority, including ambulance trusts, the 1991-92 revenue budget.

Mr. Dorrell : This information is not collected centrally.

Intermediate Treatment Fund

Mr. Morgan : To ask the Secretary of State for Health (1) what consultations he has had with the intermediate treatment fund concerning the reduced funding announced in his Department's letters of 12 April 1990 and 18 July 1991 ;

(2) what representations he has received concerning the reduction of funding from his Department to the intermediate treatment fund.

Mrs. Virginia Bottomley : In addition to representations made by the intermediate treatment fund itself, 37 letters have been received from voluntary organisations expressing support for the work of the fund. I met the chairman and representatives of the members and officers of the intermediate treatment fund on 6 March 1991 to discuss funding arrangements and have offered a further meeting early in the autumn of 1992 to review the matter in the light of the fund's progress in securing alternative sources of funding to meet its core costs.

The original agreement between the Department and the Rainer Foundation to establish the intermediate


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treatment fund in 1978 include a Government commitment of three years financial support. In practice we will have consistently grant-aided the fund for 15 years when our current three-year grant totalling just over £1 million expires in March 1993. During that period local authorities have increased their expenditure on intermediate treatment from £3 million in 1978-79 to some £36 million in 1990-91. In addition the fund has become increasingly successful in securing additional funds for intermediate treatment projects from non- Government sources.

Resources for supporting the voluntary sector have increased considerably in recent years. But the calls on them to provide "start-up" support for promising innovations have also increased. This, combined with the fund's established success in all its objectives and the substantial increase in local authority spending in this area justifies the phasing down of our direct financial support, so that other ventures can benefit as the fund itself has done.

Smoking

Mr. Michael : To ask the Secretary of State for Health (1) what fresh assessment he has made of the relationship between smoking and angina ;

(2) what fresh assessment he has made of the relationship between smoking and premature deaths from coronary thrombosis.

Mr. Dorrell : Over one in five deaths from coronary heart disease are smoking related. Cigarette smoking increases the risk of having heart attack by two or three times compared with the risk for non-smokers. Although smoking is an important risk factor for myocardial infarction and sudden coronary death, research studies indicate that it is not for angina pectoris when not complicated by a myocardial infarction. However, the 1989 United States Surgeon General's report found that smokers who have angina pectoris have a higher risk of death than non-smokers, and have a poorer long-term prognosis after a myocardial infarction. A copy of the report could be made available to the Library.

Mr. Michael : To ask the Secretary of State for Health what fresh assessment he has made of the connection between smoking and premature deaths from lung cancer.

Mr. Dorrell : Smoking is the major cause of lung cancer. Nine out of 10 deaths from lung cancer are smoking related. Epidemiological evidence has shown that the risk of lung cancer increases with the number of cigarettes smoked, the degree to which smoke is inhaled, and the age at which the smoking habit is started.

Mr. Michael : To ask the Secretary of State for Health what fresh assessment he has made of the health benefits to be gained from a reduction in smoking.

Mr. Dorrell : The Government are continuously assessing new medical evidence on the benefits of reducing smoking. Reducing or stopping smoking has major health benefits resulting in improvements in the quality and length of life. In particular, there is a reduction in the risk of lung cancer, other cancers, heart attack, stroke and chronic lung disease. In addition, women who stop smoking before becoming pregnant have no greater risk of having a low birth weight baby than women who have never smoked.


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Mr. Michael : To ask the Secretary of State for Health what fresh assessment he has made of the relationship between smoking and peripheral vascular disease.

Mr. Dorrell : In 1989 the United States Surgeon General published a report "Reducing the Health Consequences of Smoking--25 Years of Progress", which reviewed all the current research on smoking-related disease. This report, a copy of which could be made available to the Library, stated that in relation to peripheral vascular disease ; (

(a) cigarette smoking is a cause of and the most powerful risk factor for arteriosclerotic peripheral vascular disease : (

(b) epidemiological and clinical studies have demonstrated that cigarette smokers have a higher prevalence of both symptomatic and asymptomatic lower extremity arterial disease ;

(c) diabetes mellitus and cigarette smoking are important risk factors for lower extremity arterial disease and subsequent amputation.

Mr. Michael : To ask the Secretary of State for Health what fresh assessment he has made of the relationship between smoking and chronic bronchitis.

Mr. Dorrell : Smoking is the major cause of chronic bronchitis. Nine out of 10 deaths from chronic bronchitis and emphysema are smoking related.

Form E111

Mr. Onslow : To ask the Secretary of State for Health whether he has yet received any response from the French authorities to his reminders about the unlimited validity of forms E111 issued in the United Kingdom to holders ordinarily resident here ; and what explanation he has been given for the time taken to respond.

Mr. Dorrell : We have been assured that the French authorities do accept that British-issued E111s may legitimately have unlimited validity and that all local sickness insurance offices in France have been reminded of this.

Operating Theatres

Mr. Spearing : To ask the Secretary of State for Health if he will obtain from each health service region, health authority, or trust for the period 1 January to 31 June 1991, or nearest equivalent period, for each operating theatre within their jurisdiction, the number of days it was not in commission, and the reasons.

Mr. Dorrell : Information is not available centrally and could be obtained only at disproportionate cost.

Tobacco Advertising

Mr. Michael : To ask the Secretary of State for Health whether he will make it his policy to ban the advertising and promotion of tobacco and tobacco products.

Mr. Dorrell : The evidence to suggest that such a ban would reduce the prevalence of smoking is equivocal. The United Kingdom has developed effective anti-smoking campaigns over the years, and smoking prevalence has been reduced from 45 per cent. in 1974 to 32 per cent. now. The Government are satisfied that the voluntary agreements which they have negotiated with the tobacco industry continue to be an effective way to control tobacco advertising and promotion. The new agreement that my


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right hon. Friend the Secretary of State announced on 9 September includes significantly tougher measures to control tobacco advertising and promotion.

Heroin-based Drugs

Mr. Spearing : To ask the Secretary of State for Health what consultations he has had with his colleague Ministers in the European Community concerning the use within the United Kingdom by the national health service and other authorised persons of effective heroin-based drugs commonly used to relieve pain and distress of those terminally ill with cancer ; and if he will make a statement.

Mr. Dorrell : None.

Tranquillisers

Mr. Spearing : To ask the Secretary of State for Health what response he has made to representations he has received concerning addiction to medically prescribed and publicly funded tranquillising drugs ; and if he will make a statement concerning the funding of self-help groups formed by involuntary addicts.

Mr. Dorrell : We believe that the prescribing of any drug must be left to the clinical judgment of the doctor. The Government have ensured, however, that information on the consequences of prescribing, and withdrawal from, tranquillisers is available to doctors. The Government believe that the services offered by self-help groups are best provided locally. Regional health authorities have received earmarked funding since 1986-87 for the express purpose of expanding and developing local drug misuse services. Health authorities are expected to assess the need for services locally and to fund appropriate services to meet the needs of drug misusers including those dependent on prescribed drugs.

Children Act 1989

Mr. Michael : To ask the Secretary of State for Health what he estimates as being the total additional cost that will fall on local authorities in order to implement the Children Act in full (a) in the present financial year and (b) in a full financial year.

Mrs. Virginia Bottomley [pursuant to her reply, 20 June 1991, c. 300] : I regret that my reply contained an error. The £139.9 milliopreviously quoted as the increase in personal social services for children, including specific grants, over the equivalent figure for 1990-91 was wrong. That increase should have read £239.9 million, an 18.4 per cent, increase in the standard spending for personal social services for children.

Community Health Councils

Mr. Redmond : To ask the Secretary of State for Health, if he will establish for community health councils rights of access to information on, and for monitoring of, the manner in which Exchequer money allocated to fundholding general practitioners for the purpose of purchasing services is used, similar to those afforded community health councils in relation to expenditure by district health authorities as purchasing authorities.

Mr. Dorrell [pursuant to his reply, 16 July 1991, c. 138] : District health authorities retain overall planning


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responsibility for all patients, including those on the lists of fundholding GPs. This provides the mechanism for the community health council to raise any concerns or questions they may have.

World Health Organisation

Mr. Robert Banks : To ask the Secretary of State for Health if he will list for (a) 1988-89, (b) 1989-90 and (c) 1990-91 the funds received by the World Health Organisation from the United Kingdom and other donor countries.

Mr. Dorrell [pursuant to his reply, 22 July 1991, c. 402] : The amount of voluntary contributions to the World Health Organisation for the 1988-89 financial year should have read £6,430,000 and not £9,780,000.

AGRICULTURE, FISHERIES AND FOOD

Environmental Hazards

Mr. Dunnachie : To ask the Minister of Agriculture, Fisheries and Food if his Department has considered the recommendation of the royal commission on environmental pollution that the Genhaz system of checks on potential environmental hazards be instituted prior to release of any experimental plants to which genes have been added ; and if he will make a statement.

Mr. Baldry : I have been asked to reply.

The Department of the Environment is grateful for the continuing benefit accruing as a result of initiatives by the Royal Commission on Environmental Pollution. The Genhaz system as expounded in its 14th report is a welcome contribution and is currently undergoing careful examination by officials in the Department. We will be responding to the report in due course.

Salmonella

Mr. Andrew Welsh : To ask the Minister of Agriculture, Fisheries and Food what research has been undertaken of the degree to which poultry flocks can be entirely free of salmonella bacteria, and on the level of presence of salmonella which may reasonably be tolerated.

Mr. Maclean : MAFF is currently undertaking research to reduce the incidence and spread of salmonella in poultry by the development of vaccines and improved methods for its detection. Research is also in progress to determine the factors responsible for causing disease.

Mr. Andrew Welsh : To ask the Minister of Agriculture, Fisheries and Food if he will give figures showing the incidence of reported cases of salmonella in live poultry in each of the last five years.

Mr. Maclean : Separate figures for isolations of salmonella from live poultry are not available. The number of incidents of salmonella in poultry reported under the Zoonoses Order 1975 and the Zoonoses Order 1989 in the calendar years 1986 to 1990 were as follows :



Year       |Number of            

           |reported             

           |isolations           

---------------------------------

1986       |838                  

1987       |692                  

1988       |1,162                

1989       |1,926                

1990       |2,842                

<1> Poultry comprises: domestic  

fowls, turkeys, ducks, geese,    

guinea fowl, pheasants,          

partridges, quail and pigeons.   

Samples submitted for testing    

can include poultry carcases and 

cloacal swabs or faeces from     

live poultry.                    

Mr. Andrew Welsh : To ask the Minister of Agriculture, Fisheries and Food what evidence he has received regarding ovarian transmission of salmonella ; and from where.

Mr. Maclean : Salmonella enteritidis has been isolated from the ovaries of many birds which have been exposed to natural or experimental infection. A number of published papers have reported the isolation of S. enteriditis from eggs. S. enteriditis was recovered from the yolk of eggs in the USA by Timoney and others "(1989) Veterinary Record, 125 600-601". In the United Kingdom there is published work by Humphrey and others "(1989) Epidemiology and Infection 103 , 415" and Humphrey and others "(1991) Epidemiology and Infection 106, 489-496".

Zoonoses Orders

Mr. Andrew Welsh : To ask the Minister of Agriculture, Fisheries and Food if he will state the number of zoonoses orders issued per month since January 1989.

Mr. Maclean : Details of all notices served under the Zoonoses Order 1975 and the Zoonoses Order 1989 for all species since January 1989 are not available. However, during the period from 1 January 1989 to 29 September 1991, 318 notices were served declaring infected premises where Salmonella enteritidis or Salmonella typhimurium had been confirmed as present in poultry flocks.

Leatherjackets

Mr. Pike : To ask the Minister of Agriculture, Fisheries and Food if he will estimate the financial loss to the United Kingdom agricultural industry caused by leatherjackets ; what are the circumstances in which such loss occurs ; and how information on damage caused by leatherjackets is collected and assimilated.

Mr. Maclean : MAFF is funding a survey of organic cereal fields in England and Wales, assessing levels of leatherjacket damage and other pest, disease and weed problems. The results of this survey will be collated and made available to farmers in due course. I am writing separately to the hon. Member with further details of the type of loss and damage caused by this species.

Bird Damage

Mr. Pike : To ask the Minister of Agriculture, Fisheries and Food if he will estimate the financial loss to the United Kingdom agricultural industry caused by the (a) carrion hooded crow, (b) collared dove, (c) great black-backed gull, (d) lesser black-backed gull, (e) herring gull, (f) jackdaw, (g) jay, (h) magpie, (i) rook, (j) house sparrow, (k) starling and (l) wood pigeon ; what are the circumstances in which such loss occurs ; and how information on damage caused by those species is collected and assimilated.


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Mr. Maclean : These bird species, which are listed in schedule 2 part II of the Wildlife and Countryside Act 1981, are recognised as agricultural pests or as species which pose a potential risk to public health. Whilst detailed financial information is not available on the losses which are caused the advisory services gather information on the effects of these birds in the course of their work. I am writing separately to the hon. Member with details.

North-east Salmon Fishery

Sir Michael Shaw : To ask the Minister of Agriculture, Fisheries and Food (1) what assessment he has made of the record of the north-east salmon fishery in matters of conservation ;

(2) if he will exclude the north-east salmon fishery from planned conservation measures.

Mr. Curry : My Department, together with the Scottish Office, has been undertaking a review of all the salmon net fisheries off north-east England and eastern Scotland in accordance with the requirements of section 39 of the Salmon Act 1986.

Our report will be presented to Parliament shortly.

Food Safety

Mr. Redmond : To ask the Minister of Agriculture, Fisheries and Food what controls he has issued in the last five years in respect of the agricultural food processing and water industries to ensure that food and drink do not injure the consumer.

Mr. Maclean : It was, under section 1(2) of the Food Act 1984, and is, under section 7(1) of the Food Safety Act 1990, an offence to supply food and drink which has been rendered injurious to health.

Bovine Spongiform Encephalopathy

Sir Richard Body : To ask the Minister of Agriculture, Fisheries and Food how many cases of BSE have been identified in cattle of the pure beef breeds.

Mr. Maclean : Up to and including 27 September 1991, 350 cases of BSE have been confirmed in cattle of the pure beef breeds.


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