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HEALTH
Children Act 1989
10. Mr. Olner : To ask the Secretary of State for Health if she will make a statement on the operation of the Children Act 1989, since its implementation.
Mrs. Virginia Bottomley : There has been a positive and enthusiastic response to the Act from those in the statutory and voluntary sector. The Children Act is the most important step forward this century in the protection afforded vulnerable children in our society. The Act is
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operating well. At the end of this year I shall be submitting a report to Parliament on the first year of the Act in operation.Elderly People
11. Mr. Bowis : To ask the Secretary of State for Health what guidance on good practice she gives hospitals and health authorities on the provision of long-term hospital accommodation for the elderly.
Mr. Sackville : We made it clear in "Caring for People" that we expect health authorities to purchase continuous residential health care for those highly dependent elderly people who need it. We believe that such care is best provided in small, homely units in the community.
Health Promotion
13. Mr. Enright : To ask the Secretary of State for Health what recent representations she has received regarding the proposed White Paper on health promotion.
Dr. Mawhinney : About 2,100 responses have now been received in response to the "Health of the Nation" Green Paper. We welcome this evidence of the very wide interest in the Government's initiative to improve health. We intend to publish our White Paper shortly.
Residential Care
14. Miss Lestor : To ask the Secretary of State for Health when she last met representatives of the Social Care Association to discuss residential care.
Mr. Yeo : We last met representatives of the Social Care Association in October 1990. Officials are in regular touch with the association.
17. Mr. Bryan Davies : To ask the Secretary of State for Health what assessment she has made of the adequacy of the resources to be transferred to local authorities for funding residential care.
Mr. Yeo : We are committed to providing adequate resources to enable local authorities to meet their new community care responsibilities. Decisions on the transfer and the overall level of resources required will be taken in the context of this year's local government expenditure survey.
Air Ambulance Service (Cornwall)
15. Mr. Matthew Taylor : To ask the Secretary of State for Health what financial support her Department has given to the Cornwall first air ambulance service.
Mr. Sackville : The capital and running costs of Cornwall air ambulance service are provided by charitable donations. The paramedical services are provided by the Cornwall Community Healthcare Trust.
Aids
16. Mr. Cash : To ask the Secretary of State for Health what action the United Kingdom is taking through the World Health Organisation and the European Community to combat the global spread of AIDS.
Mr. Yeo : The United Kingdom has been an active supporter of the World Health Organisation's global
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programme on AIDS since its inception and is currently the third largest donor. As a member state of the European Community, we provide support for the various EC AIDS initiatives, namely the "Europe against AIDS" programme, the AIDS task force and the EC biomedical and health research programme, which has a substantial AIDS component. The United Kingdom participates in the development of advice for the Council of Health Ministers through the ad hoc group on AIDS. We provide support for the European Community's AIDS progamme for developing countries through our contribution to the European Development Fund and the Community budget.Hospital Trusts
18. Mr. Nigel Evans : To ask the Secretary of State for Health how many hospitals or units expressed an interest in acquiring NHS trust status (a) for April 1991, (b) for April 1992 and (c) for April 1993 ; and if she will make a statement.
Dr. Mawhinney : A total of 83 hospitals and units expressed an interest in becoming NHS trusts from 1991, 66 applied and 57 were established. In the following year 130 expressed interest, 110 applied and 103 were established. The current position for the third wave of applications is that 154 hospitals and units have expressed an interest in becoming NHS trusts from April 1993 and 151 have so far applied. This is more than in either of the first two waves. This shows that staff and managers in the NHS increasingly are seeing trusts as the best way to improve services for patients.
27. Mr. Welsh : To ask the Secretary of State for Health how many applications she has received for hospital trust status ; and if she will make a statement.
Dr. Mawhinney : I refer the hon. Member to the reply I gave the hon. Member for Moray (Mrs. Ewing), earlier today.
28. Mr. Gill : To ask the Secretary of State for Health what progress has been made in Shropshire towards practice budgets for doctors and trust status for hospitals.
Dr. Mawhinney : There are currently five GP fund holders in Shropshire serving 12.7 per cent. of the population. A further four practices have applied for fund-holding status from April 1993, and if successful, 23 per cent. of the population of Shropshire will then be served by GP fund holders.
We have received two formal applications for trust status from units in Shropshire : one from the Princess Royal hospital in Telford ; and one from Shropshire mental health services. These applications are now out for formal public consultation.
Health Authorities, Cumbria
19. Mr. Martlew : To ask the Secretary of State for Health what proposals she has to alter the boundaries of the three district health authorities in Cumbria.
Mr. Sackville : None at present. Northern regional health authority, together with its district health authorities (DHAs) and family health services authorities are currently considering the best way to develop DHAs' central role in purchasing health care on behalf of their residents ; including the possibility of joint working with neighbouring authorities.
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Malpractice and Fraud
20. Mr. Fatchett : To ask the Secretary of State for Health if she will introduce a code of practice designed to protect the position of those NHS employees who draw attention to malpractice and fraud ; and if she will make a statement.
Mr. Sackville : It is important that all NHS staff should express professional concerns about health service issues to their managers. Employing authorities need to acknowledge this duty, but they must also retain the right to take action in cases of improper disclosure of confidential material, such as personal patient information. Staff aggrieved by any disciplinary action taken by their employer have recourse to established grievances procedures.
Private Health Care
21. Mr. Campbell-Savours : To ask the Secretary of State for Health what figures she has for the number of persons making private health care arrangements in west Cumbria.
Mr. Sackville : This information is not collected centrally.
Building Projects
22. Sir Michael Neubert : To ask the Secretary of State for Health how many national health service building projects have been completed in England since 1979 ; and how many are under way.
Dr. Mawhinney : More than 600 capital schemes, each costing more than £1 million, have been completed in the national health service since 1979. A further 400 such schemes are in various stages of planning, design and construction, of which 105 are currently under construction.
Abortion
23. Mr. Alton : To ask the Secretary of State for Health how many late abortions of pre-born children occurred after 18 weeks gestation during the last 12 months for which figures are available.
Mr. Sackville : There were 5,061 abortions over 18 weeks notified under the Abortion Act 1967 in England and Wales in the period 1 October 1990 to 31 September 1991, 2.8 per cent. of the total number.
Mr. Alton : To ask the Secretary of State for Health how many sterilisation and abortion operations have been performed on mentally disabled women in the last 12 months for which figures are available ; what criteria were used in arriving at these decisions ; and how many girls, under the age of 16 years, have been sterilised in the last 12 months for which figures are available, and on what grounds.
Mr. Sackville : Information about the number of sterilisation operations is not available in the form requested. Details of the medical condition recorded on abortion notification forms--including unspecified mental retardation--are given in table 27 of the 1990 "Abortion Statistics" (Series AB No. 17) published by the Office of
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Population Censuses and Surveys, a copy of which is available in the Library. The criteria for reaching decisions vary from case to case and can involve relatives and carers, and possibly reference to the courts. The national health service "Hospital Episode Statistics" show that only one female sterilisation operation was performed on a patient under the age of 16 in England in 1990-91.Mr. Alton : To ask the Secretary of State for Health what guidelines are issued to health authorities concerning the use of amniocentesis and chorionic villus sampling tests ; how many tests were made under each procedure in the last year for which figures are available ; how many pregnancies ended in spontaneous abortions following testing ; how many ended in clinical abortions ; how many babies born after being tested by CVS were discovered to have a physical or mental handicap ; what evidence she has of links between the CVS test and disability ; and if she will make a statement.
Mr. Sackville : Guidelines to providers of maternity services on the use of tests for fetal abnormalities are contained in the first report of the Maternity Services Advisory Committee : "Maternity Care in Action-- Antenatal Care", at paragraph 4.27. Copies are available in the Library. Information on the number of tests carried out under each procedure is not held centrally.
Information on the number of pregnancies which end in miscarriage following testing is not held centrally. Studies have indicated that amniocentesis is associated with miscarriage in one or two cases in every 200 where the procedure is used. It is more difficult to estimate the level of the association between miscarriage and chorionic villus sampling (CVS), because studies are unable to identify women who would have miscarried among those who request and have termination of pregnancy following a diagnosis of cytogenic abnormality. A recent randomised controlled trial carried out by the Medical Research Council compared CVS with amniocentesis and found that a woman undergoing CVS has a one in 20 less chance of a successful outcome to her pregnancy than a woman undergoing amniocentesis in the second trimester of pregnancy.
Information on the number of pregnancies which ended in a termination following testing is not held centrally. It is likely that the majority of such terminations would be for chromosomal abnormality in the fetus, and in 1990 this condition was reported in 273 terminations (England and Wales).
Following reports of a possible association between the use of CVS and the occurrence of limb reduction defects, an investigation was made by the European registration of congenital anomalies and twins (EUROCAT) into seven of its registries, covering 600,000 births. The investigation did not demonstrate a significantly increased risk associated with exposure to CVS in the areas covered by these seven registries.
We are not aware of any evidence linking CVS with mental handicap.
Community Care
24. Mr. John Evans : To ask the Secretary of State for Health when she next expects to meet representatives of local authorities to discuss the implementation of the National Health Service and Community Care Act 1990.
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Mr. Yeo : We have regular and constructive meetings with representatives of the local authority associations at which we discuss many aspects of social services provision including the implementation of our community care policy. We are next due to meet on 1 July.
Waiting Lists
25. Mr. Watts : To ask the Secretary of State for Health how many in-patients are waiting longer than a year for treatment ; and what was the comparable number (a) in March 1979 and (b) in March 1991.
Mr. Sackville : Provisional figures for 31 March 1992 are given in the table. These show that between March 1979 and March 1992 the total number of in-patients waiting over a year fell by 63 per cent.
In-patients waiting over 1
year
|Number
|waiting
-------------------------------
March 1979 |185,195
March 1991 |170,065
March 1992 |<1>68,650
<1> Based on provisional
figures from regional health
authorities.
Mr. Redmond : To ask the Secretary of State for Health if she will arrange to collect centrally statistics on (a) first out-patient waiting lists, (b) in-patient 12 to 24 month waiting lists and (c) in-patient 0 to 12-month waiting lists.
Mr. Sackville : Figures for out-patient waiting times are not collected centrally, but all health authorities are required under the patients charter to publish information on the local standards they have set for waiting times for first out-patient appointments and on performance against these targets. The Department regularly publishes statistical bulletins which include the numbers of people waiting for in-patient and day case hospital treatment in the 0 to 12 and 12 to 24 month categories. The most recent information for the six months to September 1991 was published on 4 June. For provisional figures covering the period up to 30 April 1992, I refer the hon. Member to the reply I gave my hon. Friend the Member for Uxbridge (Mr. Shersby) on 10 June at columns 219-20.
Residential Homes
26. Mr. Robert Ainsworth : To ask the Secretary of State for Health if she has any proposals to change the current arrangements for the monitoring and inspection of private care or nursing homes.
Mr. Yeo : I refer the hon. Member to the reply I gave the hon. Member for Dundee, East (Mr. McAllion) earlier today.
Maternity Services
Mr. Cousins : To ask the Secretary of State for Health what was the number of home confinements as a percentage of all live births in each NHS region since 1987.
Mr. Sackville : The information requested is shown in the table.
Home confinements as a percentage of all live births 1987-1991
Regional Health Authority |1987 |1988 |1989 |1990 |1991
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
England and Wales |0.9 |0.9 |1.0 |1.0 |1.1
Northern |0.4 |0.5 |0.5 |0.4 |0.5
Yorkshire |0.8 |0.9 |0.9 |0.8 |0.8
Trent |0.8 |0.8 |0.9 |0.9 |1.0
East Anglian |1.5 |1.6 |1.6 |1.6 |1.6
North West Thames |0.8 |0.7 |0.9 |1.0 |1.1
North East Thames |1.1 |1.1 |1.2 |1.3 |1.5
South East Thames |1.2 |1.4 |1.4 |1.7 |1.8
South West Thames |0.9 |1.0 |1.1 |1.1 |1.4
Wessex |0.9 |0.9 |1.1 |1.1 |1.2
Oxford |0.7 |0.8 |1.0 |0.9 |1.1
South Western |1.1 |1.4 |1.5 |1.7 |1.8
West Midlands |0.9 |0.8 |0.9 |0.9 |0.8
Mersey |0.5 |0.7 |0.7 |0.6 |0.8
North Western |0.6 |0.6 |0.8 |0.8 |0.7
Adoptions
Mr. Jonathan Evans : To ask the Secretary of State for Health what representations were made to the Romanian Committee for adoptions by the United Kingdom Government concerning the conditions on age of prospective adoptive parents incorporated in the agreement signed by the Department of Health on 19 March.
Mr. Yeo : The age of prospective adopting parents seeking to adopt a child from Romania was one of more than 40 conditions contained in the draft agreement prepared by the Romanian Committee for Adoptions in January this year. They were the subject of detailed negotiations with the committee before the agreement was signed on 19 March 1992. Discussions between the Department of Health, acting on behalf of the United Kingdom health departments, and the Romanian Committee for Adoptions took place between January and March prior to a team of officials from the Department of Health visiting Romania and continuing negotiations direct with the committee.
The conditions contained in the agreement with the United Kingdom are essentially the same as for the signatories of 11 other countries. Without this agreement in place, prospective adopters are unable to apply to adopt a Romanian child.
Dentistry
Mr. Gordon Prentice : To ask the Secretary of State for Health what was the number of people aged (a) 18 years and below and (b) over 19 years who received out-patient dental treatment from the Burnley, Pendle and Rossendale district health authority in each year from 1985, and from Burnley Health Care since its establishment as an NHS trust.
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Dr. Mawhinney : This information is not available centrally. The hon. Member may wish to contact Mr. W. Ashworth, chairman, Burnley, Pendle and Rossendale health authority and Mr. J. H. C. Rawson, chairman, Burnley health care NHS trust for details.
Finance
Ms. Lynne : To ask the Secretary of State for Health how much has been allocated in joint finance money by regional health authorities in England ; and what proportion has been spent on projects for people with learning disabilities.
Mr. Yeo : Allocations to regional health authorities in England for joint finance total £134.696 million in 1992-93. Information is not collected centrally on spending by client group.
Euthanasia
Mr. Alton : To ask the Secretary of State for Health if she will make a statement on the guidance she gives to health authorities about the receipt from patients of advance directives commissioning their killing by euthanasia administered by doctors and nurses.
Mr. Sackville : We have issued no guidance to health authorities on such directives. Patients are fully entitled to make known in advance their views on possible future medical treatment. Any health professional, however, whilst taking account of the patient's wishes, is bound by the law, and cannot be required to take any action which conflicts with this.
South Yorkshire Ambulance Service
Mr. Redmond : To ask the Secretary of State for Health what representations she has received and what data she has in her possession concerning delays in (a) reception of 999 calls at the headquarters of the South Yorkshire ambulance service, (b) the dispatch of emergency calls from that headquarters and (c) the arrival of ambulance at an emergency incident ; and what were the comparative figures for (i) 24 months, (ii) 36 months and (iii) 48 months ago.
Mr. Sackville : No recent representations have been received about the performance of the service.
Call logging equipment in use at service headquarters during the last 18 months has shown that on average, 999 calls coming into service control take approximately five seconds to be answered. The latest activation and response time figures are given in the tables.
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Patient Transport Services 1988-89-1991-92 Quality of service for South Yorkshire Ambulance Service Table 1 Activation time 1988-89 |1989-90 |1990-91 |<1>1991-92 -------------------------------------------------------------------------------------------- Total number of emergency calls |57,580 |58,842 |64,863 |64,073 Number where activation within three |50,516 |44,412 |56,041 |55,782 minutes Percentage of calls where activation |87.7 |75.5 |86.4 |87.1 within three minutes
Patient Transport Services 1988-89-1991-92 Quality of service for South Yorkshire Ambulance Service Table 1 Activation time 1988-89 |1989-90 |1990-91 |<1>1991-92 -------------------------------------------------------------------------------------------- Total number of emergency calls |57,580 |58,842 |64,863 |64,073 Number where activation within three |50,516 |44,412 |56,041 |55,782 minutes Percentage of calls where activation |87.7 |75.5 |86.4 |87.1 within three minutes
War Pensioners
Mr. Colvin : To ask the Secretary of State for Health what changes there have been since 1990 in the guidance given by her Department on priority treatment for war pensioners ; and if she will make a statement.
Mr. Yeo : There have been no changes. New guidance will be issued in the near future.
Disability
Mr. Battle : To ask the Secretary of State for Health how many people claiming disability working allowance also receive health benefits ; and if she will make a statement.
Dr. Mawhinney : This information is not available.
Diabetes
Mr. Battle : To ask the Secretary of State for Health whether Reflolux meters for monitoring blood count in the treatment of diabetics are available on prescription.
Dr. Mawhinney : A meter may be provided through the hospital service if the consultant in charge of the patient's care considers it clinically necessary. Meters are not available on prescription.
Liver Transplants
Mr. Pickthall : To ask the Secretary of State for Health what is the annual cost of liver transplantation in the national health service.
Mr. Sackville : In the year ending 31 March 1992 expenditure on liver transplantation and associated follow-up services amounted to £13.7 million.
Mr. Pickthall : To ask the Secretary of State for Health if she will make a statement on the provision for liver transplantation in the national health service ; and what information she has on the number of patients waiting for, and in the convalescent period after, such transplants and the estimated distances such patients have to travel for treatment.
Mr. Sackville : The number of liver transplants performed in the United Kingdom rose from 21 in 1982 to 419 in 1991. A total of 64 patients were reported to be awaiting liver transplants at 30 April 1992. There are no figures held centrally on the numbers of people in convalescence following liver transplants.
Information on the distances patients have to travel for transplant treatment is not collected centrally. There are
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six designated centres where liver transplants are performed. Two of the hospitals are in London ; the others are in Cambridge, Birmingham, Leeds and Newcastle. The provision of designated liver transplant centres is kept under constant review.Parliamentary Questions
Mr. Hoyle : To ask the Secretary of State for Health in how many answers from her Department to parliamentary questions in (a) the current and (b) the last session of Parliament hon. Members have been advised to contact the chairman of a district health authority ; and if she will make a statement.
Mr. Sackville : Eleven so far in this Session and 33 in the 1991-92 Session.
NHS Finance
Mr. Hoyle : To ask the Secretary of State for Health if she will make it her policy to collect centrally information on the amount of over or under-spending and the throughput of patients in each of the last five years of major general hospitals in each region.
Mr. Sackville : There are no current plans to require this information to be collected centrally.
Mr. Hoyle : To ask the Secretary of State for Health if she will list (a) the amount of over and under-spending in each of the last five years and (b) the throughput of patients over each of the last five years in the Warrington health authority.
Mr. Sackville : The information about over and under spending is not held centrally. The hon. Member may wish to contact Mr. D. Hannah, the chairman of Warrington health authority, for details. The information requested on throughput of patients is given in the table.
Throughput of patients (patients treated per available
bed):
Warrington Health Authority
|Cases |Available |Throughput
|treated |beds
-------------------------------------------------------
1986 |<1>28,228 |2,434 |12
1987-88 |<1>30,330 |2,180 |14
1988-89 |30,334 |2,056 |15
1989-90 |32,300 |1,797 |18
1990-91 |<2>34,023 |1,532 |22
Source: SH3, KH03, KP70.
<1> The figures for 1986/1987-88 have been converted
from the old measurement of discharges and deaths into
the present measurement of finished consultant
episodes. During 1988-89, information on patient cases
treated was collected on both bases to facilitate this
conversion.
<2> The figures for 1990-91 are provisional.
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Charitable Fund Raising
Mr. Battle : To ask the Secretary of State for Health whether she will consider introducing guidelines for hospital trust charitable fund- raising organisations to avoid them competing for business with charitable fund raising for hospices.
Mr. Sackville : It is not for the Government to direct trustees of hospitals in their fund-raising ventures. We believe that the detail of fund-raising events are best decided at local level in the light of local needs and priorities.
Child Care
Ms. Coffey : To ask the Secretary of State for Health if she will make money available to local authorities so that schools can provide pre- school and after-school care for children of working parents.
Mr. Yeo : It is inappropriate to use public funds to help all parents pay for day care services for their children. Public funds should be targeted on children in need.
Multiple Sclerosis
Ms. Glenda Jackson : To ask the Secretary of State for Health what proposals she has to resite the Association for Research into Multiple Sclerosis following the proposed closure of the Central Middlesex hospital ; and if she will take account of the needs of multiple sclerosis sufferers at present treated there.
Mr. Sackville : I am not aware of any proposals to close Central Middlesex hospital.
The hospital provides accommodation and other assistance to the charity Action Research into Multiple Sclerosis. I understand that the charity's centre at the hospital has run into serious financial problems, putting at risk the therapy and diagnostic services it has been providing for between 400 and 500 patients.
The Department of Health agreed in May to provide £75,000 to the Central Middlesex hospital to avoid disruption of treatment for patients.
Blood Transfusion Service
Mrs. Mahon : To ask the Secretary of State for Health if she has any plans to introduce screening for human T-cell leukaemia in the blood transfusion service.
Mr. Sackville : I refer the hon. Member to the reply I gave the hon. Member for Wakefield (Mr. Hinchliffe) on 15 June 1992 at columns 415-16.
TRANSPORT
M25
Mr. Wilshire : To ask the Secretary of State for Transport when he expects to complete his consultations and to publish his proposals for improving the M25 motorway between junctions 11 and 16.
Mr. Kenneth Carlisle : The Department announced its plans for improving the M25 last September. The next step will be a public exhibition of its proposals for increasing
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the capacity of the M25 beyond dual four lanes between junction 12 to 15. Work on widening the motorway to dual four lanes between junctions 15 and 16 is expected to start in the autumn. Consultants have not yet been appointed to investigate options for providing additional capacity between junctions 11 and 12.
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