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NHS Operations
Mr. Redmond : To ask the Secretary of State for Health if he will list by regional health authority, and specialty, national health service operations that can be performed within six weeks waiting time.
Mrs. Virginia Bottomley : The time patients wait depends on the severity and urgency of their condition and not on the intended treatment or operation. About half all patients admitted to hospital from the waiting lists are admitted in five weeks or less.
Tattoos (Removal)
Mr. David Porter : To ask the Secretary of State for Health (1) what estimate has been made of expenditure involved in the removal of tattoos within the NHS for the last year for which figures are available ; and if he will make a statement.
(2) what percentage of the in-patient waiting lists for 1990-91 were cases relating to the removal of tattoos ; and if he will make a statement ;
(3) what estimate he has made of the total number for the current year on NHS in-patient and out-patient waiting lists who require removal of tattoos ; what percentage of total waiting lists these represent ; and if he will make a statement ;
(4) what information he has showing by region the numbers of patients waiting for tattoo removal in the NHS and the percentage of the whole waiting list represented by this group in each case in (a) 1990-91 and (b) the current year.
Mrs. Virginia Bottomley : Waiting list information is available centrally by specialty only and not by the intended method of treatment or operation. Out-patient waiting list information is not collected centrally. No estimate has been made of expenditure involving the removal of tattoos.
Personal Social Services
Mr. Ashley : To ask the Secretary of State for Health when his Department proposes to put out to consultation its guidance to local authorities on charging for personal social services ; and if he will make a statement.
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Mrs. Virginia Bottomley : Officials are already consulting the local authority associations on a new financial assessment for people in residential care, to take effect from April 1993. Preliminary work to produce guidance about charges for day and domiciliary services has also commenced, and will involve the local authority associations. For both there will be further consultation in 1992.
Children Act 1989
Mr. Fearn : To ask the Secretary of State for Health how much funding local authorities have received from his Department to implement the Children Act 1989.
Mrs. Virginia Bottomley : I refer the hon. Member to the reply I gave to the hon. Member for Leicester, East (Mr. Vaz) on 5 December at column 199.
After-care Support
Mr. Fearn : To ask the Secretary of State for Health how much funding local authorities receive for after-care support programmes.
Mrs. Virginia Bottomley : I refer the hon. Member to the reply I gave to the hon. Member for Wolverhampton, South-East (Mr. Turner) on 9 December at columns 331-32.
Private Health Care
Mr. Andrew Smith : To ask the Secretary of State for Health what procedure patients should use for activating the commitment in paragraph 9.6 of the White Paper "Working for Patients".
Mrs. Virginia Bottomley : District health authorities and GP fundholders are responsible for securing health services that reflect the needs and preferences of their residents and patients. They have the freedom to purchase services from provider units within their own or another health authority, from NHS trusts or from the independent sector. The choice of service provider will depend on a local assessment of people's needs, the relative quality and
cost-effectiveness of the services on offer, and the views of local people. District health authorities will be able to establish people's preferences in a number of ways, including discussions with local GPs, community health councils and other local organisations, and local surveys. Patients will be able to make their preferences known direct to GP fundholders.
Medical Records (Access)
Mr. Fatchett : To ask the Secretary of State for Health if he will set out the guidance issued by his Department on a patient's right of access to medical records ; and if he will make a statement.
Mr. Dorrell : The NHS Management Executive issued guidance to the NHS in August, entitled "Access to Health Records Act 1990--A Guide for the NHS", under cover of HSG(91)6. A copy of the guidance is available in the Library.
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National Health Service Expenditure
Mr. Nicholas Winterton : To ask the Secretary of State for Health (1) what was the estimated percentage change in real terms, adjusted for pay and price increases in the NHS, for hospital and community health services expenditure in 1991-92 ;
(2) what was the estimated percentage change in expenditure in real terms, adjusted for pay and price increases in the NHS, on family practitioner services current in 1991-92 ;
(3) what was the percentage change in estimated current expenditure in real terms, adjusted for pay and price increases in the NHS, on local authority personal social services in 1991-92 ;
(4) what was the estimated percentage change in real terms, adjusted for pay and price increases in the NHS, in total NHS expenditure in 1991-92 ;
(5) what was the percentage change in real terms, adjusted for pay and price increases in the NHS, for health and community health services current expenditure in 1990-91 ;
(6) what was the percentage change in expenditure in real terms, adjusted for pay and price increases in the NHS, on family practitioner services current in 1990-91 ;
(7) what was the estimated percentage change in current expenditure in real terms, adjusted for pay and price increases in the NHS, on local authority personal social services in 1990-91 ;
(8) what was the percentage change in real terms, adjusted for pay and price increases in the NHS, in total NHS expenditure in 1990-91.
Mr. Dorrell [holding answer 9 December 1991] : Column A of the table shows the estimated percentage change in hospital and community health services current, family health services current, total national health service and total personal social services expenditure adjusted for changes in input unit costs. Figures on this basis for 1991-92 are not yet available.
Changes in input volumes are however an inadequate guide to the level of services the NHS can be expected to achieve, since they do not reflect the continuing success of NHS management in increasing the efficiency with which it uses resources.
Columns B and C therefore give the percentage change in expenditure for each of the programmes for 1990-91 and 1991-92 (estimated) in real terms that is after adjustment by the gross domestic product deflator.
|A |B |C
Percentage Percentage change in
change in expenditure after having
expenditure been adjusted by the
in 1990-91 GDP deflator in
|after
|having been
|adjusted for
|changes in
|input unit |1990-91 |1991-92
|costs |estimate
-----------------------------------------------------------------------
Gross HCHS Current |5.0 |4.0 |6.2
Gross FHS Current |-0.6 |4.2 |3.0
Gross NHS Current |2.5 |3.3 |5.2
Net PSS Current |3.3 |3.6 |2.6
Note:
Calculated against the existing indicies of HCHS and FHS in service
inflation. These are however currently under review.
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Dental Health
Mr. Couchman : To ask the Secretary of State for Health (1) if he will specify the various considerations which led the Health education authority booklet, "Enjoy Healthy Eating", to advise caution in the consumption of dried fruit in order to avoid the harmful effects on teeth, and to encourage the consumption of fruit with no reference to its effect on teeth ;
(2) what was the basis of tests carried out to determine the cariogenicity of the various foods, drinks and snacks referred to an pages 19 to 21 of the Health Education Authority's booklet.
Mr. Dorrell [holding answer 13 December 1991] : The advice provided in the Health Education Authority booklet is based on the expert advice of the Committee on the Medical Aspects of Food Policy. The COMA report "Dietary Sugars and Human Disease" (1989) stated that the experience of caries was positively related to the amount of non-milk extrinsic sugars in the diet and the frequency of their consumption.
In order to reduce the risk of dental caries COMA recommended that consumption of NME sugars by the population should be decreased. The food items for which the HEA advised caution in consumption, including dried fruits, contain NME sugars. Epidemiological evidence suggests that fresh fruit, as eaten by humans, appears to be of low cariogenicity.
The recommendations made by COMA have taken account of available scientific evidence as explained in the dietary sugar report. The report is available in the Library.
HOUSE OF COMMONS
Kiosk
39. Mr. Harry Greenway : To ask the Lord President of the Council what plans there are to extend the range of items on sale in the House of Commons kiosk ; and if he will make a statement.
Mr. MacGregor : The range of souvenirs stocked in both kiosks is kept under continual review. The kiosk in Bellamy's holds a limited range of foodstuffs, pharmaceutical products and other useful items. There is little scope to extend that range, although there may be changes in individual items held in response to demand.
Select Committee Reports
40. Mr. Campbell-Savours : To ask the Lord President of the Council what proposals he has to secure the early debate of Select Committee reports.
Mr. MacGregor : I have at present no proposals for any changes in the existing arrangements. Subject to pressures of business in the House I hope to find time for debate on some Select Committee reports during this Parliament.
Working Hours
41. Mrs. Gorman : To ask the Lord President of the Council if he will make a statement on the progress being made on reforming the working hours of the House of Commons.
Mr. MacGregor : A recent example of reforming the working hours of the House has been that, since they were
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set up in January, the European Standing Committees have made a significant contribution to reducing the burden of late-night debates on the Floor.My hon. Friend will be aware that a number of right hon. and hon. Members have either submitted written memoranda or given oral evidence to the Select Committee on Sittings of the House.
Special Standing Committees
Mr. Beith : To ask the Lord President of the Council when a Special Standing Committee set up under Standing Order No. 91 last considered a Bill ; and whether he will make a statement on this procedure.
Mr. MacGregor : The last Bill to be considered by a Special Standing Committee was the Matrimonial and Family Proceedings Bill [Lords] in the 1983-84 Session.
The Government will continue to consider the possible use of this procedure in appropriate cases where this is compatible with the overall management of their legislative programme.
Visitors (Security)
Mr. Simon Coombs : To ask the Lord President of the Council if security arrangements for visitors to the Palace of Westminster are maintained at the same level during the parliamentary recesses.
Mr. MacGregor : It has been the long-standing practice of Leaders of the House not to comment on matters of security within the Palace of Westminster. I can, however, inform my hon. Friend that the security arrangements for access are the same whether the House is in recess or not.
DEFENCE
Executive Agencies
Mr. McAllion : To ask the Secretary of State for Defence if he will list the post, grade and maximum salary payable, including performance- related element, in each case where appointments from the private sector have been made at grade 7 or above in respect of each of the executive agencies in his Department.
Mr. Kenneth Carlisle : Excluding chief executive posts, appointments from the private sector at grade 7 or above have only been made in two of the eight agencies in my Department to date. The table shows the standard civil service rate for the grades specified including discretionary pay for performance.
Agency |Grade |Numbers em- |1991-92 max-
|ployed from |imum salary
|private sector|including per-
|formance ele-
|ment (£ )
-----------------------------------------------------------------------------
Meteorological
Office<1> |5 | 2 1st post |39,402-52,122
| 2nd post |39,402-46,724
|7 |1 |27,819-33,175
Defence Research
Agency |7 |1 |27,819-33,175
<1> The difference between the two grade 5 maxima relates to the
number of range points and the performance element applicable in
each case.
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Mr. McAllion : To ask the Secretary of State for Defence when the last annual report was published and when the next one is due for each of the executive agencies in his Department.
Mr. Kenneth Carlisle : The Meteorological Office and the Hydrographic Office were the first two agencies to be established in April 1990. Their reports for 1990-91 were published in July 1991. Their next annual reports, together with the first annual report for the other six agencies in my Department, are due to be published in July 1991.
Mr. McAllion : To ask the Secretary of State for Defence (1) how many staff were in post on the date that each of the executive agencies in his Department were established as executive agencies ; and how many staff are in post now in each case ;
(2) if he will list those new facilities for staff, including nurseries and health care schemes, which have been introduced since the establishment of each of the executive agencies in his Department ;
(3) how much was spent on events and publicity surrounding the launch of each of the executive agencies in his Department ; and whether the cost was borne by the parent Department or the new agency.
Mr. Kenneth Carlisle : This is a matter for the chief executives of the executive agencies and defence support agencies. I have asked them to write to the hon. Member.
Mr. McAllion : To ask the Secretary of State for Defence what is the maximum salary payable to the chief executive, including performance- related elements and the length of time of the chief executive's contract for each of the executive agencies in his Department.
Mr. Kenneth Carlisle : Three chief executive appointments in MOD have been made following open competition. The details of these are shown in table 1. Chief executive positions in the five other MOD "next steps" agencies were filled by the existing head of the organisation. The details are shown in table 2.
Table 1
Chief executive appointed following open competition
Agency |Period of contract|Salary
|£
-------------------------------------------------------------------------------------------
Defence research agency |3 years |140,000
Meteorological office |5 years |<1>65,000
Service children's schools (north
west Europe |3 years |<2>55,417
<1> New chief executive appointed with effect from 2 January 1992.
Within standard civil service range for grade 2, plus discretionary
performance bonus of 15 per cent. of salary.
<2> Standard civil service rate for grade 4 which includes
discretionary payments for performance. This post also attracts
London weighting and foreign cost of living allowances.
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<1> Standing civil service rate for grade 3 which includes discretionary payments for performance. <2> Standard civil service rate for grade 4 which includes performance related elements.
Trident
Mrs. Fyfe : To ask the Secretary of State for Defence, further to his answer of 15 November, Official Report, column 703, what is his estimate of the cost of cancelling (a) the entire Trident submarine programme, (b) the building projects at Coulport and Faslane, under the liquidated damages clauses in the contracts, if such cancellations took place (1) on January 1992, (2) on 1 April 1992, (3) on 1 July 1992, (4) on 1 October 1992, or (5) on 1 January 1993.
Mr. Kenneth Carlisle : As I advised the hon. Member on 15 November at column 703, cancellation costs would be based on an assessment of contractors' properly incurred liabilities at the time of cancellation. Such liabilities would need to be negotiated at that time with the companies concerned. It would not be sensible, therefore, to speculate on what these might be, especially as it is not this Government's policy to cancel the Trident programme.
Nuclear Weapons Tests
Mr. Flynn : To ask the Secretary of State for Defence what has been the cost to the United Kingdom of radioactive decontamination and rehabilitation of the sites where the United Kingdom has tested nuclear weapons, or conducted weapons-related tests, at (a) Christmas island, (b) Monte Bello island, (c) Maralinga, (d) Emu field, (e) Potton island and (f) Nevada nuclear test site ; and what is his estimate of the further costs that will be needed to complete the environmental restoration of these sites.
Mr. Archie Hamilton : The cost to the United Kingdom of decontamination and site restoration of the former United Kingdom atmospheric nuclear weapon test sites following completion of the programme in the 1960s could be provided only at disproportionate cost.
No further costs are anticipated in respect of either Christmas island or the Monte Bello islands.
The Australian Government are currently seeking a contribution from the United Kingdom for additional work at Maralinga and Emu field, but the United Kingdom view is that the 1968 and 1979 agreements absolve the United Kingdom from any liability to contribute. There have been no firings involving radioactive materials at Potton island.
No costs have been incurred for rehabilitation of the Nevada test site and the future management of the site is a matter wholly for the United States.
NAAFI
Mr. Hoyle : To ask the Secretary of State for Defence when he intends to implement the recommendations contained in the National Audit Office study of Management Services (Organisation) Division dealing with the financial relationship between his Ministry and NAAFI.
Mr. Archie Hamilton : There has been no National Audit Office study into the financial relationship between my Department and NAAFI. An MOD efficiency scrutiny
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has been carried out, however, and some of its recommendations have been implemented. Others will be considered further when the effect that the restructuring of the armed forces will have on the NAAFI have been analysed.Regimental Memorabilia
Mr. Hoyle : To ask the Secretary of State for Defence what steps he is taking to satisfy himself that the President of the Service Institute and President of the Regiment Institute shops are abiding by their charter to sell only regimental memorabilia.
Mr. Archie Hamilton : President of the Service Institute and President of the Regiment Institute shops do not operate under a charter, but are permitted to sell goods including, but not solely, memorabilia, providing they are not in competition with the NAAFI.
Battalions
Mr. John Browne : To ask the Secretary of State for Defence what are the average costs of maintaining (a) a British foot guards battalion and (b) a battalion of the equivalent of the Royal Air Force Regiment in (i) London, (ii) the United Kingdom and (iii) Germany.
Mr. Archie Hamilton : I refer my hon. Friend to the answer I gave my hon. Friend the Member for Davyhulme (Mr. Churchill) on 15 November, column 703.
Records are not maintained in a way which enables the other information requested to be provided.
NORTHERN IRELAND
Child Benefit
Mr. Nicholas Brown : To ask the Secretary of State for Northern Ireland what would be (a) the first year and (b) the full year costs of raising child benefit to £9.55 (i) for 1991-92 and (ii) 1992-93, including increases in linked means-tested and national insurance benefits, for Northern Ireland.
Mr. Hanley : The rates of child benefit from April 1991 were £8.25 for the eldest eligible child and £7.25 for each other child and were increased to £9.25 and £7.50 respectively from October 1991. The estimated gross cost of increasing child benefit from those rates to £9.55 for each child throughout 1991-92 would be about £36 million. If the October 1991 rates had applied throughout 1991-92, the cost would reduce to around £29 million. The gross full year costs in 1992-93 of paying £9.55 for all children, instead of the rates of £9.65 and £7.80 which will be in payment from April 1992, would be about £21 million.
National Insurance
Mr. Nicholas Brown : To ask the Secretary of State for Northern Ireland if he will estimate for 1991-92 the numbers paying national insurance contributions in Northern Ireland, distinguishing (a) between the different classes of contribution and (b) between employees and employers.
Mr. Hanley : Social security operational matters are the responsibility of Mr. Alec Wylie, chief executive of the
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Social Security Agency. He will write to the hon. Member and copies of his reply will be placed in the Library and the Public Information Office.Daniel Doherty
Mr. Maginnis : To ask the Secretary of State for Northern Ireland if he will publish details of the evidence that Daniel Doherty, who was shot dead by the security services at Gransha hospital in Londonderry on 6 December 1984 was, at that time, engaged in a terrorist operation.
Dr. Mawhinney [holding answer 5 December 1991] : It is not the practice to publish details of police investigations. The death of Daniel Doherty was fully investigated by the RUC, and the report passed to the Director of Public Prosecutions, who directed "no prosecution" of the soldiers involved.
However, I believe that it is widely accepted that Daniel Doherty was engaged in terrorist activities when he was killed.
ENVIRONMENT
Housing
Mr. Ken Hargreaves : To ask the Secretary of State for the Environment, further to his reply of 11 November to the hon. Member for Wansdyke (Mr. Thompson) about resources for housing in 1992-93, Official Report, columns 397-98, if he will now announce the Housing Corporation's approved development programme, local authorities' housing investment programme allocations, the distribution of resources for estate action and housing action trusts and the housing revenue account subsidy determinations.
Mr. Heseltine : I am today making a number of dispositions for the use of housing resources in 1992-93.
First, gross expenditure by the Housing Corporation will be £1,770 million, rising to £2,004 million in 1993-94 and £2,052 million in 1994-95. A total of 50,900 new homes will be approved next year, 25 per cent. more than this year, three times higher than in 1990-91. I now expect that completions next year will be 60 per cent. higher--at 43,000--than this year ; this is an increase of 24 per cent. on previously published projections.
The corporation expects a very much higher output than previously projected, partly because of falling construction costs and property prices, but also because of increases in the more cost-effective elements of the programme. Next year's rented programme is expected to attract double the amount of private finance secured in 1991-92. At least 27,000 of the newly approved units will be targeted to benefit the homeless. These remain our most urgent priority. Next year, the corporation will be introducing a major new programme of "do-it-yourself" shared ownership of which 80 per cent. will be targeted on existing local authority and housing association tenants. Its move into home ownership will release rented accommodation for immediate use in housing the homeless.
As previously made clear, from 1992-93 resources for the corporation's new rented and housing for sale programmes will be allocated among the corporation's
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regions using the housing needs indicator, without "damping" to reflect past shares. This will direct resources where they are most needed. Even with the removal of damping, all regions will gain compared with 1991-92, most substantially. Details of the programme are being published in the corporation's News Supplement Series, copies of which are being placed in the Library.Today I am informing local housing authorities of their housing investment programme allocations for 1992-93, some £1.7 billion in total. A total of £1,300 million of these resources are general-purpose allocations, or "annual capital guidelines". In October I confirmed to local authorities that 40 per cent. of these would be distributed on the basis of a statistical assessment of local housing needs, but this year, for the first time, authorities have competed for shares of 60 per cent. of the resources, with the Department assessing their performance and the quality of their proposals. My regional offices have scrutinised authorities' strategy statements and bids, against known criteria, meetings were held with authorities, and Ministers have reached decisions in the light of controllers' advice.
We were particularly impressed by the resourcefulness and quality of some 50 authorities which were well ahead of the field in pursuing effective policies. However, 25--about 79 per cent.--were disappointingly poor and fell far short of the standards their tenants and other people locally have the right to expect. I am placing a list in the Library of the names of the authorities in each region who comprise these groups.
In reaching our final decisions we also took into account other relevant factors such as specific problems or needs and allowed for commitments, and for peaks and troughs in expenditure. For up to 31 authorities these discretionary awards were topped up to honour assurances we had given a year ago as to the minimum allocations they should expect. Some of the more disappointing authorities have been saved, by this topping up, from the full rigours of the new performance assessment. Nonetheless, for about 90 per cent. of authorities the proposed allocations were greater than the minimum level we were committed to. For 90 per cent. therefore, the size of the allocation was directly affected by the performance assessment and the exercise of discretion.
The Department's regional controllers will today be telling councils the broad assessments made and will offer follow-up meetings to discuss, where appropriate, the aspects of performance where improvements could be made.
A further £400 million has been allocated to private sector renewal, in the form of "specified capital grants", to assist councils in their grant aid to private owners and in their expenditure on renewal areas, etc. Forty per cent. was allocated by statistical assessment of renewal needs ; 60 per cent. was distributed mainly on the basis of authorities' spending patterns.
I am depositing tables in the Library showing the 1992-93 allocation to each authority of the annual capital guideline and of specified capital grant. Together these comprise the housing investment programme allocations.
I am also reviewing the scope for my Department's regional offices, which already advise me on these HIP allocations, to play a greater role in allocating other DOE resources to local authorities, on a more corporate basis.
Substantially increased resources are given for estate action. A total of £364 million is available, an increase of
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over one third--£96 million--on the £268 million made available this year. This demonstrates our commitment to the most rundown estates and confirms the strategy announced last July by my hon. Friend the Minister for Housing and Planning.Almost £160 million is available for distribution to new schemes, of which £115 million will be set aside to start or speed up large-scale regeneration schemes next year. The remainder will support traditional small and medium-sized estate action schemes. I am, therefore, today inviting over 25 authorities to proceed with 32 large regeneration schemes and 80 authorities to work up a further 100 small and medium-sized schemes for approval. These schemes will involve over £900 million of public and private investment over the next few years. The names of successful authorities and schemes are set out in tables placed in the Library.
Before I give final approval to any scheme I shall expect the local authority to demonstrate that its proposals accord with published guidelines, particularly with regard to housing management and the diversification of tenure and that they have been developed in consultation with tenants, the local community and the private sector.
I have also provided for a major expansion of the programme of housing action trusts. A total of£215 million has been set aside for spending on HATs over the next three years, sufficient for the established HATs in North Hull and Waltham Forest, and for further HATs in four new areas.
Preliminary discussions have taken place with authorities interested in pursuing the HAT option in Liverpool, Brent, Birmingham and Tower Hamlets. I am now satisfied that these should go to the next stage.
As in Hull and Waltham Forest, the projects should be a co-operation between tenants, the local authority and central Government. Some of the feasibility studies are well advanced. Subject to the outcome of these, and after full consultation with tenants, there will be formal ballots of tenants in these areas. If tenants vote in favour, the House will be asked to approve orders establishing the trusts.
As to the current expenditure, I have today issued the housing revenue account subsidy determinations for 1992-93. I am placing copies of the determinations in the Library.
On subsidy allowances for management and maintenance, I confirm the proposals to increase allowances by 6.5 per cent. overall and to distribute the increase by a new system of targeted allowances reflecting the problems faced by different authorities. As a result about £93 million more will be directed to authorities with the greatest need. This is in addition to a general 3.5 per cent. increase in allowances which all authorities will receive. For rent guidelines, I am confirming the proposal for an average rent increase of 9.5 per cent. This will result in an average increase of guidelines of £2.44 a week over the guideline rents which apply this year with a range of between £1.20 and £4.50 in individual councils. Responsibility for setting actual rents however remains with individual local authorities. Housing benefit will normally meet the whole of any rent increase for the two thirds of tenants receiving it.
These various allocations continue the redirection of resources towards the housing association movement and further develop our measures to help the most neglected
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