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Mrs. Virginia Bottomley : Progress towards the World Health Organisation health for all by the year 2000 targets is reviewed periodically. The last two reports of progress
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were published in the Chief Medical Officer's report "On The State of the Public Health for the year 1989" and in an annex to "The Health of the Nation", June 1991, copies of which are available in the Library.NHS Reforms
Mrs. Dunwoody : To ask the Secretary of State for Health how much consultation occurred on the recent national health service reforms before they were instituted.
Mr. Dorrell : The NHS reforms White Paper "Working for Patients", was published in January 1989. The Government have always been prepared to consider constructive proposals for implementation of the policies it set out. The NHS and Community Care Bill was introduced to Parliament on 22 November 1989, where it was subject to the scrutiny of both Houses, and the NHS and Community Care Act received Royal Assent on 29 June 1990. Under the Act NHS hospitals and other units seeking to apply for NHS trust status are obliged to conduct a three-month period of consultation with their local community health council and other bodies as appropriate.
Asthma
Mr. Butler : To ask the Secretary of State for Health what information he has on the reasons behind the apparent increase in the prevalence of asthma.
Mr. Dorrell : Unfortunately, and despite the availability of effective preventive therapy, the prevalence of asthma and the occurrence of acute asthma attacks has been rising. This is not a phenomenon confined to this country. New Zealand and the United States of America have seen similar increases. There are a number of possible reasons, including increased levels of pollution, but firm evidence that this is a cause of the increased prevalence of asthma is lacking.
Community Care
Mr. Andrew Bowden : To ask the Secretary of State for Health what mechanisms exist to facilitate co-ordination between Government Departments on community care.
Mrs. Virginia Bottomley : Close contact is maintained through ministerial and official groups.
Back Pain
Mr. Campbell-Savours : To ask the Secretary of State for Health (1) how many awards the Health Service Superannuation Branch makes each year to staff suffering back pain or back injury for (a) National Health Service permanent injury benefit and (b) National Health Service temporary injury benefit ;
(2) what is the number of claims each year for national health service ill- health retirement pensions because of back pain or back injury ;
(3) what is the amount of national health service ill-health retirement pensions paid out each year for retirement due to back pain or back injury ;
(4) how many claims the national health service's superannuation branch receives each year for (a) national health service permanent injury benefit and (b) national health service temporary injury benefit, due to back pain or back injury ;
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(5) what is the total amount of (a) permanent injury benefit or (b) temporary injury benefit paid out each year to national health service staff suffering back pain or back injury ;(6) how many ill-health retirement pensions awards the national health service makes each year for retirement due to back pain or back injury ;
(7) what is the total number of awards paid for (a) national health service permanent injury benefit and (b) national health service temporary injury benefit ;
(8) what is the total number of claims each year for national health service ill-health retirement pensions ;
(9) what is the total amount of national health service ill-health retirement pension paid out each year ;
(10) what is the total number of claims each year for (a) national health service permanent and (b) national health service temporary injury benefit ;
(11) what is the total amount paid out each year for all awards of (a) national health service permanent injury benefit and (b) national health service temporary injury benefit ;
(12) what is the total number of ill-health retirement pension awards the national health service makes each year.
Mrs. Virginia Bottomley : In England and Wales during 1990-91, the NHS pension scheme received approximately 7,400 applications for ill-health retirement pension of which 7,092 were awarded. In the same year, approxi- mately 1,200 permanent injury benefits were claimed and 1,097 were awarded. Six hundred and thirty of these were one-off lump sum payments, the remainder included a continuing pension. By the end of the year, continuing injury benefit pensions totalled 2,636. Total permanent injury benefit expenditure for the year was £6,493,000, including one-off lump sums and pensions increase. Total temporary injury allowance expenditure was £1,441, 000.
Details of temporary injury allowance numbers, separate costs for ill- health retirement pensions and applications, awards or expenditure divided by medical condition are not available centrally and could be obtained only at disproportionate cost.
There are parallel schemes for the NHS in Northern Ireland and Scotland. Information for these is a matter for my right hon. Friends the Secretaries of State for Northern Ireland and for Scotland.
Disabled People
Mr. Alfred Morris : To ask the Secretary of State for Health if he will make a statement on the European Community's HELIOS programme promoting the economic and social integration of disabled people.
Mr. Dorrell : The Government have supported all aspects of the European Community's HELIOS programme promoting the economic and social integration of disabled people since it was agreed by the Council of Ministers in 1988. In order to determine what benefits the programme has provided for United Kingdom participants, an independent evaluation of the United Kingdom's part in the programme is being prepared by a team of researchers from Southampton university.
Discussions are currently taking place in the Council's working groups to establish a further five-year programme, HELIOS II, to run from 1992 to 1996.
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Hospices
Sir Robert Rhodes James : To ask the Secretary of State for Health what has been the total value of extra help provided by the Government for hospices over the last 12 months.
Mrs. Virginia Bottomley : The Government have earmarked funds of £17 million this year to enable health authorities in England to increase the support they give to voluntary hospices, bringing the total estimated NHS contribution to £41 million. This is in addition to the cost of specialised palliative care services provided directly by the NHS, estimated at £21 million. These sums do not include social security benefits for hospice residents, which I understand the Department of Social Security does not separately identify.
Nasogastric Feeding Tubes
Mr. Terry Davis : To ask the Secretary of State for Health what is the estimated cost of nasogastric feeding tubes being available on prescription from general practitioners.
Mrs. Virginia Bottomley : I am not able to add to the reply I gave the hon. Member on 11 November at column 409.
Tobacco Advertising
Mr. Fearn : To ask the Secretary of State for Health how many representations he has received on the banning of tobacco advertising ; how many of these were in favour and how many against ; and if he will make a statement.
Mr. Dorrell : A total of 614 representations have been received on this subject ; these contain arguments both in favour of and against banning tobacco advertising.
Radiotherapy
Mr. Henderson : To ask the Secretary of State for Health what was the waiting time for patients needing radiotherapy treatment for cancer at each hospital in the Northern regional health authority area in May 1991 ; and what is the latest waiting time for those patients.
Mrs. Virginia Bottomley : There are no patients waiting for in- patient radiotherapy treatment at any of the hospitals in the Northern region in May 1991 or at present. Out-patients--non-urgent cases--in Newcastle general hospital were waiting for an average of four weeks in May 1991 ; this has increased to an average of six weeks. New facilities costing £3.2 million now coming on stream will reduce the waiting time to four weeks by early spring 1992.
Mr. Henderson : To ask the Secretary of State for Health if he will increase the level of funding to the Northern regional health authority to provide for the repair of inoperative radiotherapy equipment.
Mrs. Virginia Bottomley : Northern regional health authority is currently investing £3.2 million at Newcastle general hospital in the most up-to-date radiotherapy facilities in the United Kingdom including the latest linear accelerator equipment. The regional health authority announced on 9 November that an additional £190,000 has been allocated to the hospital for an additional
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consultant and radiography staff. It is expected that this will have a speedy effect on waiting times. Non-urgent cases waiting times will reduce to about four weeks by February 1992.Mr. Henderson : To ask the Secretary of State for Health how many patients in the Northern regional health authority area who were on the waiting list for radiotherapy treatment have died in the current year before receiving treatment ; and if he will make a statement.
Mrs. Virginia Bottomley : This information is not available.
Mr. Henderson : To ask the Secretary of State for Health if he will initiate a full inquiry into the treatment of cancer patients in the area of the Northern regional health authority.
Mrs. Virginia Bottomley : No. I understand from the chairman of Northern regional health authority that 4,600 patients have been treated by the Northern RHA in 1990-91 : an increase of 11.3 per cent. over the previous year. This level of radiotherapy treatment is entirely consistent with levels and patterns of treatment in England as a whole.
Abortion
Mrs. Ann Winterton : To ask the Secretary of State for Health what action he has taken to fulfil the commitment given in his response to the tenth report of the Social Services Committee in Session 1989-90 on the conscience clause of the Abortion Act 1967 that he would draw to the attention of medical schools the recommendation that candidates for places at such schools should not be asked questions about their attitudes to abortion, and upon what date that action was taken.
Mrs. Virginia Bottomley : Officials of the Department of Education and Science wrote to the Committee of Vice-Chancellors and Principals of the United Kingdom on 9 May 1991 asking them to draw the attention of medical schools to the Committee's recommendation. The CVCP wrote to the deans of medical schools on 24 May 1991.
Mrs. Ann Winterton : To ask the Secretary of State for Health if he will make a statement on the effectiveness of the monitoring system for advertisements for hospital posts referred to in his response to the tenth report of the Social Services Committee in Session 1989-90 on the conscience clause of the Abortion Act 1967 ; how many breaches of guidelines have been monitored ; and what action has been taken in each of those cases.
Mrs. Virginia Bottomley : These monitoring arrangements have identified one breach of the guidelines. The health authority concerned was contacted and withdrew the advertisement.
Patients Charter
Sir John Stanley : To ask the Secretary of State for Health how many patients in (a) England and (b) the United Kingdom are likely to fall within the ambit of the patients charter at any one time.
Mr. Dorrell : The rights set out in the patients charter apply to everyone entitled to NHS care in England, and
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the national standards defined in the charter apply to all NHS providers in England. Information relating to Wales, Scotland and Northern Ireland is a matter for my right hon. Friends the Secretaries of State for Wales, for Scotland and for Northern Ireland.Wheelchairs
Mr. Churchill : To ask the Secretary of State for Health what is the weight of the current national health service-issue wheelchair for the disabled ; when was the last significant change in the design and weight ; and what plans he has for introducing and making available through the national health service a new, significantly lighter weight design of wheelchair.
Mr. Dorrell : The target weight for an adult self-propelled wheelchair, including leg rests, foot rests and arms, detailed in the current NHS performance specification is 36lb. The NHS purchases wheelchairs to performance specifications which in 1990 replaced the previous Disablement Services Authority design specifications. Lighter weight wheelchairs from a number of suppliers are also available through the NHS.
Oral Health Strategy Group
Mr. Shersby : To ask the Secretary of State for Health if he will publish the names and current responsibilities of the members of the oral health strategy group convened by the chief dental officer together with the group's terms of reference ; and if he will make a statement concerning the discussions which took place at the meeting held on 4 and 6 October.
Mr. Dorrell : The oral health strategy group comprises :
Members
Mr. R. B. Mouatt (Chairman)--Chief Dental Officer, Department of Health.
Miss M. R. Edwards--Assistant Secretary, Department of Health. Professor J. J. Murray--Department of Child Dental Health, University of Newcastle-upon- Tyne.
Professor C. J. Smith--Department of Oral Pathology, Charles Clifford Dental School, Sheffield.
Mr. N. B. A. Entwistle--Advisory Board in General Dental Practice, Faculty of Dental Surgery, Royal College of Surgeons of England. Senior Dental Officer, Community Dental Service dental research and information unit, University of Wales.
Mr. W. Allen--General dental practitioner and Regional Adviser in general dental practice.
Mr. R. C. Ward--Consultant in dental public health, East Suffolk Health Authority.
Dr. S. Griffiths--Regional Director of Public Health, SW Thames Regional Health Authority.
Professor M. A. Lennon--Department of Community Dental Health, University of Liverpool.
Professor A. Sheiham--Department of Community Dental Health, University College and Middlesex Hospitals, London.
Mr. G. O. Taylor--Consultant in dental public health and Regional Dental Officer, North Western Regional Health Authority.
Miss J. Todd--Statistician, Dental Practice Board.
Professor N. H. F. Wilson--Department of Conservative Dentistry. Turner Dental School, Manchester.
Mr. R. Thompson--Association of Community Health Councils of England and Wales.
Mrs. F. M. Baker (Secretary)--Dental officer, Department of Health. Observers
Mr. N. K. Colquhoun--Chief Dental Officer, Scotland.
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Mr. D. M. Heap--Chief Dental Oficer, Wales.Mr. W. Collins--Chief Dental Officer Northern Ireland.
The group's terms of reference are :
To revise the 1981 oral health strategy and to advise on the development of an oral health strategy for England, in particular to :
define oral health ;
assist in the development of a consultative document which would invite nationwide comment on the development of an oral health strategy ;
identify areas of oral health where there is a need for and an opportunity to effect a reduction in avoidable oral disease and where concerted activity could bring major measurable health gain ; set a framework of the best possible information on current status against which progress could be measured ;
establish clear targets which could be translated into effective action to meet them and to indicate the manner in which those targets might be achieved."
The first meeting of the group considered the opportunities for health gain afforded by a new oral health strategy and the issues to be addressed in the consultative document. Issues considered ranged over health promotion and education, models of disease prevention, inter-agency activity, consumer participation, care delivery, and primary and secondary care boundaries.
Adult Population
Sir John Stanley : To ask the Secretary of State for Health what is the current adult, over 18 years, population of the United Kingdom extrapolated from the latest available census information.
Mr. Dorrell : The United Kingdom population aged 18 and over at mid- 1990, the latest available, is estimated to be 44.28 million. The corresponding projected population at mid-1991 is 44.42 million according to the Government Actuary's latest, 1989-based, projections. These figures take no account of the 1991 census. Estimates of the population at mid-1991 reflecting the 1991 census are expected to be available in September 1992.
Mr. Frank O'Noroe-O'Neil
Mr. Meacher : To ask the Secretary of State for Health if he will investigate what additional assistance is available to Mr. Frank O'Noroe- O'Neil of 29 Lamberton road, Braintree, Essex, in meeting the cost of his prescriptions, an eye test and spectacles for three distances.
Mrs. Virginia Bottomley : Help under the NHS low income scheme is available for those with limited financial resources who do not otherwise qualify for exemption from NHS charges. No claim has been received from Mr. O'Noroe-O'Neil. Officials will contact him to explain the exemption arrangements and how a claim for help may be made.
HOUSE OF COMMONS
Committee on Medical Aspects of Food Policy
Ms. Walley : To ask the Lord President of the Council what account the House of Commons Refreshment Department has taken of the recommendations of the Committee on Medical Aspects of Food Policy.
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Mr. MacGregor : As part of a continuing policy of seeking to provide nutritious and appetising food of a good standard for Members, their staff, and staff of the House, the Refreshment Department retains and follows the advice of a qualified nutritional consultant. That advice takes account of the various studies and conclusions of the Committee on Medical Aspects of Food Policy, including those contained in the recent report of the panel on dietary reference values.Cre che
Mr. Meacher : To ask the Lord President of the Council, pursuant to his answer of 5 November, Official Report, columns 59-60, if he will undertake to inform the Transport and General Workers Union parliamentary branch of the progress of discussions on and plans for the establishment of a nursery on the parliamentary estate.
Mr. MacGregor : It is anticipated that, as appropriate, Members, the staff associations representing their staff, the House of Commons Whitley committee and the Departments of the House will be brought into discussions on any plan to establish a child care facility in the parliamentary estate.
EMPLOYMENT
Health and Safety
Mr. Campbell-Savours : To ask the Secretary of State for Employment what is the total number of accidents reported each year by all employers to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1985.
Mr. Jackson : The available information is provided in the table.
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Occupational injuries reported to the Health and Safety Executive<1>,
under the Reporting of Injuries, Diseases and Dangerous
Occurrences Regulations 1985<2>
1986-87 to 1989-90<3>
Number of injuries<4>
Year |Employees |Self- |Members |Total
|employed |of public<5>
------------------------------------------------------------------------------
1986-87 |161,442 |1,734 |13,859 |177,035
1987-88 |157,831 |2,068 |11,953 |171,852
1988-89 |158,376 |2,701 |11,593 |172,670
1989-90 |161,884 |3,221 |10,251 |175,356
<1> Excludes injuries reported to local authorities and HSC agency
inspectorates, namely the petroleum engineering division of the Department of
Energy and the railway inspectorate.
<2> Includes a small number of injuries reported to the explosives
inspectorates under explosives legislation.
<3> Year beginning 1 April.
<4> Fatal, major and where appropriate, other injuries causing incapacity for
work for more than three days.
<5> Members of public injured as a result of someone else's work
activity-over three-day injuries are not reportable for members of the
public.
Mr. Campbell-Savours : To ask the Secretary of State for Employment what is the total number of manual handling or back injury-related accidents reported each year by all employers to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1985.
Mr. Jackson : The total number of manual handling or back injury- related accidents reported each year by all employers to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1985 is set out in the table. Column 1 gives the number of manual handling injuries and column 2 the number of back injuries. Column 3 shows the number of back injuries which arise from manual handling injuries.
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Injuries to employees reported<1> to HSE's factory and agricultural inspectorates
Year<2> |Manual |Back injuries |Back injuries |Manual
|handling |caused by |handling
|injuries<3> |manual |injuries
|handling |reported to
|other HSE
|inspectorates<4>
------------------------------------------------------------------------------------------------------
1986-87 |45,985 |29,610 |20,372 |<5>
1987-88 |46,967 |29,958 |21,031 |2,208
1988-89 |47,823 |30,312 |21,315 |1,707
1989-90 |49,231 |30,693 |21,706 |1,304
<1> Fatal, major and over three day injuries reported under the Reporting of Injuries, Diseases and
Dangerous Occurrences Regulations 1985.
<2> Years commencing 1 April.
<3> Injuries caused by handling, lifting, carrying and awkward movement.
<4> Reports made to HSE's mines, quarries, explosives and nuclear installations inspectorate.
<5> Not available.
On 7 November the Health and Safety Commission published a consultative document containing proposals for regulations and guidance aimed at reducing this toll of injury. The proposals are also a response to the European Commission directive on manual handling the implementation of which is due by 31 December 1992.
Mr. Campbell-Savours : To ask the Secretary of State for Employment what is the number of manual handling or back injury-related accidents reported each year by the
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national health service to the Health and Safety Executive under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1985.Mr. Jackson : The number of injuries reported each year by the national health service is not readily available and could be provided only at disproportionate cost.
The table shows the total number of manual handling related or back injuries to employees occurring in all medical and other health services between 1986-87 and 1989-90.
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Date of Number of reported<2> injuries
accident<1>
|Manual |Back injuries |Back injuries
|handling |caused by
|related<3> |manual handling
--------------------------------------------------------------------------------
1986-87 |2,937 |2,259 |1,861
1987-88 |4,113 |3,124 |2,644
1988-89 |4,471 |3,456 |2,931
1989-90 |4,943 |3,768 |3,202
<1>Years beginning 1 April.
<2>Fatal, major and other injuries causing incapacity for work for more than
three days reported to HSE's factory and agricultural inspectorates under the
Reporting of Injuries, Diseases and Dangerous Occurrences Regulations, 1985.
<3>Injuries caused by handling, lifting, carrying and awkward movement.
On the 7 November the Health and Safety Commission published a consultative document containing proposals for regulations and guidance aimed at reducing this toll of injury. The proposals are also a response to the European Commission directive on manual handling, the implementation of which is due by 31 December 1992.
Redundancies, Merseyside
Mr. Parry : To ask the Secretary of State for Employment how many people have been declared redundant on Merseyside over the past three months.
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