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Prescribing
Mr. Nicholas Winterton : To ask the Secretary of State for Health (1) what discussions she had with ICI Pharmaceuticals prior to her announcement of the extended limited list system for national health service prescribing ;
(2) what discussions she had with representatives of the pharmaceutical industry about possible alternative ways of reducing the NHS drug budget prior to her announcement of the extensions to the limited list system for national health service prescribing ; (3) what alternative methods of reducing the overall national health service drugs budget she considered prior to the recent announcement of the extensions to the limited list prescribing system ; and why, in each case, those alternatives were rejected ; (4) what consultations she had with representatives of the Royal College of General Practitioners to discuss the medical implications of extending the limited list prescribing system to those categories which were included in her recent announcement.
Dr. Mawhinney : The selected list scheme has been in place since 1985, and has helped to control the growth in the national health service drugs bill, without adverse effects on patient care. Extending the scope of the scheme to ten new therapeutic categories will not affect the basic structure of the scheme. As now, decisions on individual drugs will be taken on the basis of advice from the independent advisory committee on NHS drugs, comprising doctors, dentists and pharmacists appointed after consultation with relevant professional organisations, and after the manufacturers concerned have been given the opportunity of making representations to the Committee.
Advance consultation with professional organisations, representatives of the pharmaceutical industry or individual manufacturers on the proposal to extend the scope of the scheme was not therefore, in the Government's view, appropriate. As my right hon. Friend the Secretary of State made clear in her announcement on 12 November, we intend to have discussions with the
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pharmaceutical industry, and the medical and pharmaceutical professions, about the drugs bill, and we expect other possible ways of controlling overall expenditure to be considered in the course of those discussions.Sir Michael Grylls : To ask the Secretary of State for Health if she will make a statement providing full details of representations which she received prior to the announcement of an extension to and adoption of the limited list prescribing system ; and which representations specifically support the inclusion in that list of each of the new categories of product which will now be included in the system.
Dr. Mawhinney : No such representations were received.
Accident and Emergency Units
Mr. Tony Lloyd : To ask the Secretary of State for Health (1) if she will establish an inquiry into the resourcing, planning and co-ordination of accident and emergency units in Greater Manchester ; and if she will make a statement ;
(2) if she will arrange for an investigation into the number of occasions during November when more than one accident and emergency unit was closed in the central and south Manchester areas, and into the impact on patients ; and if she will make a statement.
Dr. Mawhinney : North Western regional health authority co-ordinates the provision of accident and emergency services across Greater Manchester. A working party into the provision of these services has recently concluded its work. The hon. Member may wish to contact Sir Bruce Martin, the chairman of North Western RHA, for information about the working party and for details of accident and emergency services.
Homeless People
Mr. Corbyn : To ask the Secretary of State for Health what guidance the Government issues to local authorities on the health and welfare of homeless people.
Mr. Yeo : Prime responsibility for the health of homeless people, as for others in its area, lies with the relevant health authority. Recent guidance to local authorities which includes references to the health and welfare of homeless people is contained in the homelessness code of guidance (published by the Department of the Environment, the Department of
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Health and the Welsh Office) and in this Department's guidance on the implementation of our care in the community policies.Mr. Corbyn : To ask the Secretary of State for Health how many homeless people attended outpatients departments in each London hospital in the latest available year.
Mr. Yeo : This information is not collected centrally.
Mr. Corbyn : To ask the Secretary of State for Health what estimate she has made of the number of homeless people in London who do not have access to a general practitioner.
Mr. Yeo : All homeless people, have the right of access to a general practitioner. To encourage and improve this access, the Department of Health is funding a number of special projects, in London and elsewhere, where a significant need has been demonstrated which the normal arrangements do not meet. These projects are based on a doctor, often supported by other professional staff, holding surgeries in places, such as day centres, where homeless people tend to congregate.
Dentists
Mr. Blunkett : To ask the Secretary of State for Health what are her estimates for gross payments per dentist in 1992-93 and net income per dentist after expenses in 1992-93.
Dr. Mawhinney : We estimated that the new fee scale, introduced on 8 July 1992, would deliver a gross income of about £88,000 to the average dentist. However, the full effects of the revised fee scale are not yet apparent, and it is too early to revise the estimate of either dentists' gross earnings or net income in 1992-93. Dentists should, however, still receive several thousand pounds more than the target average net income recommended by the Review Body on Doctors' and Dentists' Remuneration.
Mr. Blunkett : To ask the Secretary of State for Health if she will publish a table showing the average gross payments for a general dental practitioner for each of the first 10 months of 1992-93 broken down into (a) adult item of service, (b) continuing care, (c) child item of service and (d) capitation.
Dr. Mawhinney : The information requested (the latest available for the last 10 months) is set out in the table.
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|c|General dental services (England): average gross payment to dentists in 1992-93|c|
|Adult item of |Continuing care|Child item of |Capitation |Entry payments |Gross
|service |service
|£ |£ |£ |£ |£
--------------------------------------------------------------------------------------------------------------------------------
January |5,018 |590 |310 |884 |175 |6,978
February |5,458 |613 |359 |810 |220 |7,460
March |5,551 |621 |381 |845 |239 |7,637
April |5,665 |631 |374 |871 |229 |7,770
May |5,278 |643 |361 |896 |224 |7,402
June |5,331 |661 |364 |915 |177 |7,447
July |5,337 |674 |369 |930 |171 |7,481
August |5,211 |613 |375 |940 |161 |7,302
September |4,553 |594 |328 |959 |140 |6,573
October |4,468 |602 |349 |976 |126 |6,521
|---- |---- |---- |---- |---- |----
Total |51,870 |6,242 |3,570 |9,026 |1,861 |72,570
Note:
The above figures were obtained by dividing expenditure on the GDS in England, excluding direct reimbursement of business rates
and other payments made by FHSAs, by the number of general dental practitioners in England at 30 June 1992 (14,865). These data
are not compatible with the data used by the Dental Rates Study Group.
Residential Homes
Mr. Hinchliffe : To ask the Secretary of State for Health if she will state the latest estimate for the number of places in (a) private residential or nursing homes, (b) voluntary residential or nursing homes and (c) local authority residential homes and express each element as a percentage of the total number of places.
Mr. Yeo : Information which separately identifies private and voluntary nursing homes is not available. The total number of beds in nursing homes (including beds in dual registered homes) at 31 March 1991 was 124,300.
Provisional estimates of the numbers of places in adult residential care homes (including dual registered homes) as at 31 March 1992 are :
|Places |per cent. of total
-------------------------------------------------------------------------------
Private homes |172,800 |52
Voluntary homes |55,400 |17
Local authority homes |105,400 |31
The figures include only those private and voluntary homes which have registered under the Registered Homes Act 1984, and so exclude for instance, homes with fewer than four residents. Unstaffed local authority homes are not included in the figures.
Community Care
Mr. Hinchliffe : To ask the Secretary of State for Health (1) in calculating the territorial distribution of the social security transfer element of the community care funding available from April 1993 what assumptions were made concerning the numbers, in percentage terms, of future residents of private or voluntary care or nursing homes who would be placed in establishments outside their own local authority boundaries ;
(2) what correcting mechanisms to take account of migration have been included in the distribution arrangements for community care funding with effect from April 1993.
Mr. Yeo : The overall level of cross-boundary flows was taken into account in deciding the respective weighting to be given to the two parts of the distribution formula--whether according to standard spending assessment or according to the current pattern of income support expenditure. A standard spending assessment distribution would tend to favour those authorities most likely to place residents in homes outside their boundaries, and so the less weight that is placed on the income support element of the formula, the less need there is to adjust it for migration.
Mr. Hinchliffe : To ask the Secretary of State for Health what allowance has been made for support costs after 1993-94 in the arrangements for community care funding with effect from April 1993.
Mr. Yeo : In each successive year after 1993-94, the amount of the previous year's special transitional grant for
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community care, including the additional amount of £140 million which has been made available in 1993-94 in respect of authorities' new responsibilities, will be included in the personal social services standard spending assessment control total and distributed through the revenue support grant.Pharmaceutical Industry
Mr. Elletson : To ask the Secretary of State for Health what assessment her Department has made of the likely effect of the Government's proposed extension of the limited list on the pharmaceutical industry's international competitiveness and its export achievements.
Dr. Mawhinney : I refer my hon. Friend to the reply I gave the hon. Member for Linlithgow (Mr. Dalyell) on 26 November at column 810. The relative competitiveness of the United Kingdom pharmaceutical industry and its export achievements depend on many factors in both the United Kingdom and other key pharmaceutical markets.
ENVIRONMENT
Environmental Sustainability
Mr. Dafis : To ask the Secretary of State for the Environment if he will make it his policy to ensure that structural fund regulations are amended to include a commitment to environmental sustainability as a vital component of regional policy during the United Kingdom's presidency of the EC.
Mr. Maclean : Draft regulations covering the future operation of the structural funds are still awaited and it is unlikely, therefore, that negotiations will start during the United Kingdom's presidency. However, when negotiations commence, the Government will be concerned to achieve closer integration between Community environmental policy and the structural funds.
Charities (Planning Applications)
Mr. Milburn : To ask the Secretary of State for the Environment (1) how many planning applications have been received by local authorities from registered charities in each year since 1985 ; (2) what plans he has to allow local authorities to waive planning application fees from registered charities ; and if he will make a statement ;
(3) what is the estimated cost of waiving local authority planning application fees from registered charities.
Mr. Baldry : Information on the number of planning applications and the fee revenue received from registered charities is not collected. Planning application fees are determiend by the type of development proposed rather than by the nature of the applicant. Under the existing statutory provisions, local authorities have no power to waive fees. I have no plans to allow them to do so.
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Earth Summit
Mr. Simon Hughes : To ask the Secretary of State for the Environment if he will list the dates by which Her Majesty's Government expects to ratify each of the agreements made at the Earth summit ; and if he will make a statement.
Mr. Maclean : We are seeking to ratify the framework convention on climate change and to establish the basis on which we can ratify the convention on bilogical diversity by the end of 1993.
Ozone Depletion
Mr. Simon Hughes : To ask the Secretary of State for the Environment if he will introduce a leakage prevention programme for all refrigeration and air conditioning equipment owned and operated by his Department ; if he will publish targets for reductions in leakages ; and if he will make a statement.
Mr. Maclean : My Department has a comprehensive green housekeeping strategy in place which aims to prevent leakages of ozone-depleting refrigerants through the regular servicing of refrigeration and air conditioning equipment. It deals with the scrutiny of materials used by contractors, the storage and disposal of ozone-depleting substances and compliance with the professional codes of practice.
Mr. Simon Hughes : To ask the Secretary of State for the Environment if he will implement a refrigerant recycling and reclaim policy covering all departmental equipment current using chlorofluorocarbons and hydrochlorofluorocarbons ; if he will publish targets for departmental reuse and recycling ; if he will implement an equipment conversion and replacement programme for all departmental uses of CFCs and HCFCs ; and if he will make a statement.
Mr. Maclean : My Department already has a policy on its use of ozone -depleting substances. It is included in its statement on green housekeeping which was published in March 1992 and, among other things, commits the Department to eliminating the use of substances such as CFCs, halons, carbon tetrachloride and 1,1,1 trichloroethane. It also stipulates that the chemicals being replaced should be recycled in products where no alternative is available.
The policy is being implemented through a comprehensive green housekeeping action plan which was issued to departmental operational managers in October.
The Department does not presently have sufficient information to publish targets for departmental reuse and recycling.
Property Services Agency
Mrs. Helen Jackson : To ask the Secretary of State for the Environment if he will list those firms bidding by 26 June to take over the duties of the Property Services Agency ; and which firms were shortlisted.
Mr. Redwood : Seven firms bid by 26 June to purchase the PSA projects of which WS Atkins ; Carl Bros ; the Pell Frischmann/Sir William Halcrow Consortium ; and Tarmac were shortlisted. Names of those not shortlisted are regarded as commercially confidential but will of course be available to the National Audit Office.
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Mrs. Helen Jackson : To ask the Secretary of State for the Environment on what commercial basis Tarmac was offered the contract to run the Property Services Agency.
Mr. Redwood : Tarmac was not offered a contract to run the Property Services Agency. PSA Projects was offered for sale by open competition and Tarmac was the successful bidder.
Sewage Works
Mr. Pawsey : To ask the Secretary of State for the Environment what percentage of sewage works for each water company comply with the standard set by the National Rivers Authority.
Mr. Maclean : The most recent information, relating to 1990, is contained in this year's "Digest of Environmental Protection and Water Statistics", and in my Department's recent report "The UK Environment", copies of which are in the House Library. Overall in 1990, 92 per cent. of sewage treatment works complied with their consent conditions, compared with 77 per cent. in 1986 and 83 per cent. in 1988.
Whales
Mr. Simon Hughes : To ask the Secretary of State for the Environment upon what grounds EC member states can derogate from prohibitions on the killing of whales contained in (a) the habitats directive and (b) the Convention on International Trade in Endangered Species regulation EEC No. 3626/82 ; and if he will make a statement.
Mr. Maclean : I refer the hon. Member to article 16 of council directive 92/43/EEC. There are no provisions for derogations of the type described in Council Regulation (EEC) No. 3626/92.
Local Government Finance
Ms. Armstrong : To ask the Secretary of State for the Environment what amount of money he assumes will be raised in local authority capital receipts by (a) Wear Valley district council, (b) Derwentside district council and (c) Durham county council as a result of the measures announced in the autumn statement.
Mr. Robin Squire : I have not made any estimates of these receipts at the level of individual local authorities. Authorities have provided their own forecasts of the receipts they expect to receive during 1992-93 and this information is available in the Library of the House.
Rent Arrears, Northamptonshire
Mr. William Powell : To ask the Secretary of State for the Environment what is his estimate of rent arrears in each district in Northamptonshire at the latest convenient date.
Mr. Baldry : I refer my hon. Friend to the answer I gave on 2 July 1992 to the hon. Member for Hamilton (Mr. Robertson) at column 675 .
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Travel Times
Mr. Llwyd : To ask the Secretary of State for the Environment what measures are taken by his Department to promote zoning schemes linking residential, commercial and recreational areas so as to keep travel times to a minimum.
Mr. Baldry : The Department has issued preliminary advice to local planning authorities on how development patterns may influence the need to travel, and promote choice of more energy-efficient means of transport, in "Planning Policy Guidance" (PPG) note 12. The Department will be publishing shortly the results of research commissioned jointly with the Department of Transport on the part which land-use planning measures could play in achieving these objectives. Some of its findings will be reflected in a revised version of PPG 13 on transport and planning, a draft of which will be issued for consultation in the next few months.
Specific advice on locational policies in development plans designed to influence travel patterns in relation to industrial and commercial development and small firms was issued in November in a revised version of PPG 4. Equivalent advice for retail development is given in the consultation draft of PPG 6, issued in October.
Water
Mr. Pawsey : To ask the Secretary of State for the Environment (1) what is the total number and percentage of English homes directly served by mains water supplies ; and if he will make a statement ; (2) what is the total number of homes directly served by mains water supplies for each of the EC member countries ; and if he will make a statement.
Mr. Maclean : The "Levels of Service Report 1990-91", published by OFWAT, lists 23,594,000 domestic properties that are served by mains water supplies for England and Wales. These account for approximately 99 per cent. of the population for England and Wales. Figures are not available for properties in England separately, or for other EC member countries.
Mr. Pawsey : To ask the Secretary of State for the Environment what plans his Department has to improve co-operation and liaison between the water companies and British Waterways ; and if he will make a statement.
Mr. Maclean : The relationship between British Waterways and the water companies is a matter for the board and the companies.
Mr. Pawsey : To ask the Secretary of State for the Environment when he next plans to meet the chairman of the regional water companies ; and what matters will be discussed.
Mr. Maclean : Ministers have had a number of meetings in recent months with the chairman of British Waterways, at which, among other things, matters of strategic policy and board appointments have been discussed. But the Secretary of State has at present no plans to meet him.
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Sheltered Housing
Ms. Walley : To ask the Secretary of State for the Environment what proposals he has to transfer the care element of the warden service in sheltered housing from housing accounts to the social services budget ; and if he will make a statement.
Mr. Baldry : A recent Court of Appeal judgment cast doubt on housing authorities' powers to provide care services and charge their costs to the housing revenue account. To avoid disruption to these important services, we are seeking powers in the Housing and Urban Development Bill to legitimise all housing authorities' arrangements in connection with care services.
The Government's policy is that the housing revenue account should be a landlord account. We therefore propose that these new powers would be temporary only. But before any decisions are taken about the timing of any change in the arrangements, or about how the services would be provided thereafter, or about how their costs would be accounted for, there will be full consultation with all parties early in the new year. When considering how best to implement any new arrangements we shall consider all the financial and administrative issues to ensure that support continues to be available to those who need it.
Running Costs
Mr. Sproat : To ask the Secretary of State for the Environment what progress he has made in achieving the target of a reduction of 1.5 per cent. in his Department's running costs for the present financial year, in the first half of this financial year ; and what specifically has been saved, by what means and in what areas of his responsibility.
Mr. Howard : The Department's annual report for 1993, which is currently being prepared, will show that between 1986-87 and 1991-92 the Department increased it's efficiency by about 4 per cent. a year. These figures reflect a measurement of administrative output throughout the Department and not merely of running costs. The savings have been achieved primarily by the increased use of information technology and the implementation of more efficient and effective management controls. As a consequence, the Department has been largely able to absorb the cost of additional policy initiatives. Equivalent figures for the current financial year are not yet available, but will be published in the departmental report in early 1994.
Falkland Islands
Mr. Shersby : To ask the Secretary of State for the Environment what information he has concerning the decision of the Property Services Agency International to withdraw from the contract to build the road from Mount Pleasant airport to Newhaven in the Falkland Islands ; and if he will make a statement.
Mr. Redwood : Discussions on the completion of the road are taking place between Property Services Agency International and the Falkland Islands Government in the light of the run down of PSAI's workload.
City Challenge and Urban Programme
Mr. Bowis : To ask the Secretary of State for the Environment what resources will be available for city challenge and the urban programme in 1993-94.
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Mr. Howard : City challenge and urban programme resources will rise from a total provision of £319 million in 1992-93 to £408 million in 1993-94, underlining the Government's continued commitment to urban regeneration. In addition, the 57 urban programme authorities will have an estimated £500 million in extra spending power in 1993-94 as a result of the changes I announced on 13 November in the capital receipts rules. To complement these resources, I have decided to make available up to £20 million in uncommitted urban programme resources in 1993-94 through a new urban partnership fund (UPF) which will combine with local authorities' usable capital receipts and other funding, including private finance, to promote urban regeneration. Details of the UPF are included in guidance to local authorities, copies of which have been placed in the Library of the House.
Wildlife Trade
Dr. Twinn : To ask the Secretary of State for the Environment what changes will be made in controls on the wildlife trade from 1 January 1993 ; and if he will make a statement.
Mr. Maclean : The main controls on the wildlife trade will remain unaltered but the establishment of the single market will make it impractical to retain controls on some imports and exports. We propose to compensate for this by strengthening controls within the United Kingdom.
There are controls throughout the European Community on trade in species protected by the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). These cover imports from and exports to non- EC countries of all species listed on the CITES appendices and also include prohibitions on the sale of specimens of endangered species. They are supported by systems of permits and certificates issued and recognised by all member states. This system will remain fully operational on 1 January. Within the United Kingdom, we have an extensive system of controls to restrict sales of specimens of native species. Within Great Britain, this was strengthened in October to include a further 90 species and will remain unchanged from1 January next year.
At present, we also control the import and export of many species not listed on CITES, under the Endangered Species (Import and Export) Act 1976. From 1 January, it will no longer be possible to retain these controls in relation to trade within the European Community. Given the future freedom of movement within the Community, we have looked carefully at whether we should continue to control trade in non-CITES species with non-EC countries. We have concluded that it is only sensible to do so where most other member states have similar controls, because otherwise our restrictions could be evaded very easily by routing trade through EC neighbours. This means that from 1 January 1993 controls under the Endangered Species (Import and Export) Act 1976 will apply only to the import of the skins of harp and hooded seal pups. We are writing to traders giving details of the species which will not require import export licences.
We are determined that these changes should not result in any significant loss of protection for species which require it. We urged the European Commission last year to bring forward proposals to strengehen EC-wide controls and this they have done. We have made good progress during our presidency of the European
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Community towards achieving agreement on a new regulation which would extend EC controls on the wildlife trade to more species than are covered at present by the 1976 Act. We expect this regulation to be adopted next year. Further, freedom of movement within the Community will make it particularly important to have effective controls within member states and the Environment Council on 20 October took the view that a good deal of discretion on these should continue to rest with individual countries.We therefore propose to strengthen controls applied within this country. As a first step, we propose to extend sales controls to some 200 species formerly protected by import and export restrictions and which our scientific advisers, the Joint Nature Conservation Committee, consider would otherwise be at risk from trade. We propose too to review how the operation of all our wildlife sales controls may be made more effective. We are consulting interested organisations about the scope of the review which will be undertaken over the course of the next year.
Personal Social Services SSA
Dr. Wright : To ask the Secretary of State for the Environment what plans he has to review the children's element of the personal social services standard spending assessment and the area cost adjustment to ensure equity between local authorities ; and if he will make a statement.
Mr. Robin Squire : [holding answer 30 November 1992] : My right hon. and learned Friend announced his proposals for standard spending assessments (SSAs) for 1993-94 on the 26 November 1992. There now follows a period of consultation during which representations about any aspects of SSAs will be carefully considered.
Water Industry
Mr. Fatchett : To ask the Secretary of State for the Environment what was the cost of regulation in 1991-92 for the water industry ; and what is the expected corresponding figure for 1992-93.
Mr. Maclean [holding answer 30 November 1992] : Different aspects of quality regulation fall to the drinking water inspectorate (DWI) and National Rivers Authority (NRA). The Office of Water Services (OFWAT) regulates prices.
In addition to its regulatory functions the DWI provides technical and scientific advice to my right hon. Friends, the Secretaries of State for the Environment and for Wales. DWI's total costs for 1991-92 were £1.4 million, and for 1992-93 are expected to be £1.6 million.
The NRA spent in total £35 million in 1991-92, and expect to spend £41 million in 1992-93, on licensing and monitoring of discharges : approaching two thirds of this is attributable to water industry discharges. The NRA spent a further £8 million in 1991-92, and expect to spend £9 million in 1992-93, on licensing and enforcement of abstractions : the proportion attributable to the water industry is not readily available.
The Director General for Water Services's "Annual Report 1991", a copy of which is in the Library, records that in 1991-92 OFWAT's budget was £6.29 million, and for 1992-93 is £7.52 million.
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Local Authority Capital Receipts
Mr. Betts : To ask the Secretary of State for the Environment if he will list the level of capital receipts held by each local authority at the end of year 1991-92 and which they are unable to spend according to current rates, together with the level of capital spending by each authority in 1991-92.
Mr. Robin Squire [holding answer 30 November 1992] : Local authorities are not required to identify the reserved part of capital receipts from other amounts which have been set aside as provision to meet credit liabilities (PCL). Information on the total amount set aside as PCL at 31 March 1992 is not yet available. The most comprehensive information relates to 31 March 1991 : this is in the Library of the House.
I am arranging for provisional information on gross capital expenditure in 1991-92, as reported to the Department by local authorities, to be placed in the Library of the House.
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