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Vaccines
Mr. Skinner : To ask the Secretary of State for Health what action she is taking to speed up the supply of children's HIB vaccines to district health authorities ; and if she will make a statement.
Mr. Sackville : More than 2 million doses of HIB vaccine have been issued to health authorities since the vaccine was introduced on 1 October. The recommended programme for immunisation, which gives priority to the youngest children because they are at most risk from invasive haemophilus disease, required some 850,000 doses in October and November. This has left a substantial balance to allow for the immunisation of older children
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who would otherwise be called in at a later stage in the programme. The objective is to immunise all children under four years of age by September 1993.It is the responsibility of health authorities to arrange equitable distribution of the vaccine they receive, according to requirements, and to make any adjustments to the supply arrangements considered necessary. Continuing supplies of HIB vaccine should ensure that a total of 5 million doses will be distributed in the first six months of the programme.
Family Planning
Ms. Primarolo : To ask the Secretary of State for Health if she will list for every district health authority in England and number of family planning clinics in 1989-90, 1990-91 and 1991-92.
Mr. Sackville : This information is not collected centrally.
Drugs (Labelling)
Ms. Primarolo : To ask the Secretary of State for Health what plans she has to require drug companies to label drugs with Braille symbols.
Dr. Mawhinney : There are no such plans. I understand that the Royal Pharmaceutical Society has had discussions with the industry which is looking at ways of introducing some degree of Braille labelling.
Secure Units (Juveniles)
Mr. Blair : To ask the Secretary of State for Health how many places in secure units for juveniles there are in England and Wales ; and how many places the Government are intending to provide by 1995.
Mr. Yeo : On 30 November 1992 there were 292 places in local authority secure units in England.
Plans are being prepared to provide an additional 60 to 65 secure places in order to implement the new juvenile remand provisions in the Criminal Justice Act 1991 by the mid 1990s.
The information relating to Wales is a matter for my right hon. Friend the Secretary of State for Wales.
Mr. Blair : To ask the Secretary of State for Health what is the current average cost of keeping a juvenile in a local authority secure unit.
Mr. Yeo : Information in the form requested is not collected centrally.
Eyesight and Dental Checks
Mr. Gordon Prentice : To ask the Secretary of State for Health if she will make regulations to restore the right to a free eye test and the right to a free dental check-up.
Social Security Budget
Mr. Blunkett : To ask the Secretary of State for Health what is the adjustment in the amount to be transferred from the social security budget to local authorities from 1 April 1993 in the light of the uprating of benefits announced by the Secretary of State for Social Security on 12 November ; and if she will make a statement.
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Mr. Yeo : The amounts of the transfer which my right hon. Friend the Secretary of State announced on 2 October were based on a calculation made at that time of the resources which the Government would otherwise have provided to finance care through social security payments to people in residential and nursing homes. The transfer was calculated on the assumption of an increase in social security benefit levels of 4.25 per cent. In the event the uprating of social security benefits announced on 12 November amounted to 3.6 per cent., but I do not envisage any adjustment being made to the transfer amounts.
Chemical Entity Medicines
Mr. Dalyell : To ask the Secretary of State for Health, pursuant to her answer of 26 November, Official Report, columns 810-11, if she will name the indigestion remedy, the laxative and the vitamin product that have been granted product licences by the United Kingdom licensing authority since 1985 ; and what was the recommendation of the NHS Advisory Committee on Drugs in each case.
Dr. Mawhinney : The indigestion remedy is Pepulsid which the Advisory Committee on National Health Service Drugs accepted was appropriate for supply on NHS prescription. The laxative is Importal which the committee decided should not be prescribable under the NHS by its proprietary name, although it can be supplied under the generic name Lactitol. The vitamin is Elcarn which has not been considered by the committee ; I understand it may never have been marketed in the United Kingdom.
GPs Fee Scale
Mr. Dicks : To ask the Secretary of State for Health, what recommendations the Doctors' and Dentists' Review Body is planning to make on the fee scale for general medical practitioners in 1993-94 ; and if she will make a statement.
Mrs. Virginia Bottomley : When my right hon. Friend the Prime Minister informed the chairman of the Doctors' and Dentists' Review Body of its amended remit for the coming year, he invited the review body to make recommendations as normal on a fee scale for general medical practitioners that would make provision for their practice expenses and deliver the new intended average net income set by the Government's policy for public sector pay settlements for the coming year.
The review body expressed some reservations about what this might entail. There have been discussions between my officials, the profession, and the DDRB secretariat, to explore the review body's concerns and to see how far the two sides could offer evidence which might help. A good deal of common ground has emerged, but it is now clear that there remain some issues which it would be difficult for the review body to handle in current circumstances.
The Government have therefore concluded that the best course is not to refer these questions to the review body for the 1993-94 pay round. Instead, the Health Departments will pursue them directly with the profession, to a time scale which should allow further progress on the unresolved technical matters. My officials are in touch with the British Medical Association about the arrangements for these discussions.
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Osteopaths
Mr. Wolfson : To ask the Secretary of State for Health what proposals she has to introduce provisions that osteopaths should be trained to minimum standards of competence and be regulated by a governing body capable of enforcing an appropriate code of practice.
Mr. Sackville : The Government are supporting the private Member's Bill by my hon. Friend the Member for Cambridgeshire, North-East (Mr. Moss) to establish a single statutory governing body for osteopaths responsible for developing, promoting and regulating the profession of osteopathy and for setting educational standards and standards of professional conduct.
Limited List Prescribing
Sir Michael Grylls : To ask the Secretary of State for Health what information she has concerning the effectiveness of the limited list prescribing system which is used in each other member country of the European Community which has adopted such a system.
Dr. Mawhinney : I understand that steps have been or are being taken to ensure that the best use is made of resources available for the provision of drugs in a number of member states in the European Community including Germany, France, Italy, Spain and Belgium. We have no information about the extent to which the effectiveness of such schemes has been formally evaluated.
Health-related Projects
Mr. Blunkett : To ask the Secretary of State for Health if she will list the health-related projects currently funded by (a) city challenge and (b) the urban programme.
Mr. Sackville : City challenge funding commenced in April this year and health-related projects are reflected in the action plans of Manchester, Wolverhampton, Nottingham, Newcastle, Wirral, Lewisham, Middlesbrough and Bradford. Plans include a wide range of health promotion projects and others related to primary care, maternity services, drugs prevention, a well woman clinic, health services for ethnic minorities and for elderly people, and family and community health.
The latest information available centrally under the urban programme is for 1991-92. A list of health-related projects for which details are held centrally has been placed in the Library.
Private Ambulance Services
Mr. Blunkett : To ask the Secretary of State for Health (1) what steps she has taken in the last 12 months to monitor the activities of companies providing private ambulance services ; and if she will make a statement ;
(2) what measures she has undertaken to monitor the suitability and qualifications of staff working for private ambulance companies ; and if she will make a statement ;
(3) what guidelines exist governing the operation of private medical services which offer an emergency response service ; and if she will make a statement.
Mr. Sackville : Private ambulance services and their staff are not subject to any specific statute or regulation. It is for the prospective purchasers of private ambulance
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services to satisfy themselves that operators are competent to provide the required service. Private ambulance services do not respond to emergency 999 calls.Mr. Blunkett : To ask the Secretary of State for Health what discussions she or her officials have had with Belmont International Air and Road Ambulance in the last 12 months ; and if she will make a statement.
Research Units
Mr. Blunkett : To ask the Secretary of State for Health if she will list (a) the research units within the NHS funded by her Department, (b) their principal publications in the last four years and (c) any plans for their reorganisation.
Dr. Mawhinney : The Department currently supports 13 research units on rolling contracts. In addition, there are 15 research programmes on fixed-term contracts. None of these contracts is currently held with national health service authorities. The units and programmes are largely based in university departments.
Details of research contracts supported over the past four years are contained in the Department of Health "Handbook of Research and Development", an annual publication, which is available in the Library. A list of units' principal publications is not held centrally. The majority of research units on rolling contracts receive funds from a variety of sources, of which the Department is one.
In respect of plans for reorganisation, I refer the hon. Member to the reply I gave my hon. Friend the Member for Waveney (Mr. Porter) on 2 December.
Mentally Disordered Offenders
Mr. Blunkett : To ask the Secretary of State for Health if she will make a statement on her response to the Reed report on mentally disordered offenders.
Mr. Yeo : I refer the hon. Member to the reply I gave my hon. Friend the Member for Teignbridge (Mr. Nicholls) on 27 November, at columns 873- 74.
Ativan
Mr. Mackinlay : To ask the Secretary of State for Health on what criteria the drug Ativan was originally made available ; and what drugs its availability was intended to supersede.
Dr. Mawhinney : Ativan is a proprietary brand of lorazepam, one of the benzodiazepine group of drugs. It was licensed by the licensing authority on the basis of the normal criteria of quality, efficacy and safety. Whether or not a particular drug is intended to supersede another one is not relevant to the licensing procedure.
Under the selected list arrangements, general practitioners are not permitted to prescribe Ativan tablets under the National Health Service, although lorazepam tablets can be prescribed generically.
Extra-contractual Referrals
Mr. Blunkett : To ask the Secretary of State for Health what plans she has to monitor the system of extra-contractual referrals in the NHS ; and if she will make a statement.
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Mr. Sackville : The level of expenditure on extra-contractual referrals is monitored during the year. There are no plans for additional monitoring.
NHS (Private Investment)
Mr. Blunkett : To ask the Secretary of State for Health if she will make a statement on her plans to attract private investment into the NHS.
Mr. Sackville : Measures already announced by my right hon. Friend the Chancellor of the Exchequer will increase the scope for using private finance in joint ventures with the national health service to improve and extend services. We aim to ensure that NHS patients will benefit from these new freedoms to the greatest possible extent.
Pay Beds
Mr. Blunkett : To ask the Secretary of State for Health if she will publish a table showing for each regional health authority and for England as a whole (a) the number of NHS pay beds and (b) the total revenue generated from those beds for 1989-90, 1990-91, 1991-92 and the projected figures for 1992-93 and 1993-94.
Mr. Sackville : The information available centrally is given in the table.
|c|Number of authorised pay beds in NHS
hospitals|c|
Region |1989-90|1990-91
---------------------------------------------------
Northern |97 |97
Yorkshire |188 |188
Trent |136 |136
East Anglian |108 |108
North West Thames |283 |283
North East Thames |411 |411
South East Thames |333 |333
South West Thames |180 |180
Wessex |116 |116
Oxford |194 |194
South Western |100 |100
West Midlands |276 |276
Mersey |129 |129
North Western |233 |227
Special Health Authorities |178 |178
|-------|-------
England |2,962 |2,956
Data for 1991-92 are not yet available. Nor do we
project this data for future years.
|c|Income from private in-patients|c|
Region |1989-90 £000 (cash)|1990-91 £000 (cash)
---------------------------------------------------------------------------------------
Northern |1,275 |1,408
Yorkshire |3,020 |3,642
Trent |2,064 |1,755
East Anglian |3,953 |4,153
North West Thames |9,936 |11,013
North East Thames |11,598 |13,291
South East Thames |7,007 |8,979
South West Thames |2,449 |2,874
Wessex |1,817 |2,246
Oxford |6,315 |7,421
South Western |2,768 |3,836
West Midlands |3,080 |3,968
Mersey |1,206 |1,499
North Western |3,928 |4,933
Special Health Authorities |12,861 |14,635
|------- |-------
England |73,277 |85,653
Source:
Annual accounts of regional and district health authorities in England and those of
the special health authorities for the London postgraduate teaching hospitals.
Note:
Information derivable from 1991-92 annual accounts will be available shortly. Relevant
figures are not collected in-year and any estimates for 1992-93 or 1993-94 would
consequently be speculative.
Ambulance Service
Mr. Blunkett : To ask the Secretary of State for Health what plans she has to improve the operation of the ambulance service ; and if she will make a statement.
Mr. Sackville : The Government remain committed to the maintenance of high standards by NHS ambulance services.
The patients charter sets performance standards for ambulance emergency response times. Progress towards the achievement of the Government's target of one paramedic per front-line ambulance by 1996 continues and is generally ahead of schedule.
In London the inquiry established by the South West Thames regional health authority has been asked to identify the lessons to be learned for the operation and management of the London ambulance service against the imperative of delivering service of the required standard.
NHS Services (Contracting-out)
Mr. Blunkett : To ask the Secretary of State for Health if she will make a statement on the future of the contracting out of NHS services, in connection with recent European rulings on the transfer of undertakings.
Mr. Sackville : In the national health service market testing has been mandatory for catering, laundry and linen and domestic services since 1983 and a significant amount of work has been put out to commercial contractors. NHS managers have undertaken market testing in some 20 other support services and the NHS is preparing for an enhanced programme of testing as set out in the "Competing for Quality" White Paper.
Contractors and would-be tenderers may have seen confusing reports concerning an amendment to the Transfer of Undertakings (Protection of Employment) Regulations (1981) proposed in the employment legislation now before Parliament.
These regulations provide for the transfer of employees' contracts where an undertaking has transferred to a new employer. It is not true, as reports have suggested, that the amendment which is being made applies the regulations to the public sector for the first time. Nor is it correct to suggest this cuts across the Government's policy to open central and local government services to competition. The Government have always accepted that the regulations cover both the public and private sectors.
However, in every case the crucial consideration in deciding whether the regulations require that existing terms and conditions of employment should be preserved, is whether or not an undertaking is actually being transferred. This test has always applied and will continue to apply.
In the NHS there is a wide spectrum of work and contracting scenarios. Health authorities, trusts and would-be contractors need to consider in each case, whether there is likely to be a transfer of undertaking involved and if in any doubt to take legal advice.
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The Bill makes no difference to the likely outcome of such consideration. The only relevant changes that are being made in the Bill are that it will no longer be necessary to show that the undertaking is in the nature of a commercial venture and that it is made clear that property does not have to be transferred for there to be a transfer of an undertaking.These changes are required to bring the wording into line with the EC acquired rights directive and to clarify its interpretation. The changes in the Bill do not imply that past cases should have been decided differently because other criteria may have been relevant to those decisions, nor can it be assumed that future cases will be decided differently.
Market testing in the NHS has led to both improvements in quality of service and financial savings thus releasing resources for direct patient care. The NHS is committed to pressing ahead with the challenging programme of market testing for the future.
Hospital Waiting Times
Mr. Blunkett : To ask the Secretary of State for Health if she will publish a table showing for each regional health authority the latest figures on (a) the percentage of patients receiving an immediate assessment in casualty, (b) the percentage of patients whose waiting time has been limited to 30 minutes and (c) the percentage of patients who have experienced the cancellation of a booked operation.
Mr. Sackville : Health authorities, as purchasers of services, are required to publish annual reports giving details of the performance against all relevant patients charter rights and standards achieved by their providers. A commentary on overall performance will be included in the chief executive's annual report for 1992-93.
NATIONAL HERITAGE
Loan Objects
Mr. Wolfson : To ask the Secretary of State for National Heritage what was the number of indemnity undertakings given by Departments under section 16 of the National Heritage Act 1980 for the six-month period ended 30 September ; and what was the value of contingent liabilities in respect of such undertakings given at any time and which remain outstanding as at 30 September.
Mr. Brooke : The information my hon. Friend requests is as follows :
In the six-month period ended 30 September 1992 the following undertakings to indemnify were given by the relevant Departments for items on loan to national and non-national institutions.
|Number
-----------------------------------------------------------
Department of National Heritage |535
Scottish Office Education Department |93
Welsh Office Education Department |38
Department of Education for Northern Ireland |8
The value of contingent liabilities in respect of such undertakings given at any time and outstanding at 30 September 1992 are :
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|£
-------------------------------------------------------------------------
Department of National Heritage |1,303,095,363
Scottish Office Education Department |284,743,138
Welsh Office Education Department |56,733,397
Department of Education for Northern Ireland |2,899,587
Items in Lieu of Tax
Mr. Wolfson : To ask the Secretary of State for National Heritage what allocations of items accepted in lieu of tax there have been since his last announcement on 6 November.
Mr. Brooke : Since my last announcement, on 6 November at column 429, I am pleased to inform the House of an allocation of an offer in lieu of tax. The offer is of minutes and accounts relating to the Hambledon cricket club. These documents will be allocated to the Hampshire record office.
Children's Play
Mr. Wolfson : To ask the Secretary of State for National Heritage what support he intends to give to children's play after 31 March 1993.
Mr. Brooke : My Department's current funding of the national children's play and recreation unit, through the Sports Council, comes to an end on 31 March 1993, Discussions have now been opened with the Sports Council with a view to its taking over direct responsibility for a number of the play unit's functions.
National Lottery
Mr. Ashton : To ask the Secretary of State for National Heritage (1) what advice he has received on the impact of the proposed national lottery on the football pools if the total percentage taken out in tax and in payments to good causes were identical for pools and national lottery ;
(2) what advice he has received on the impact of the proposed national lottery on football pools assuming no changes are made in the current rules governing the pools operation and promotion ; (3) what advice he has received on the impact of the proposed national lottery on football pools if pools were permitted (a) to be promoted to potential clients who want to use lucky numbers rather than skill and judgment in placing their bets, (b) to run roll-over jackpots, (c) to be advertised on television or (d) to have pools coupons collected from shops ;
(4) what advice he has received on the consequences for the proposed national lottery's turnover if the lottery were not to offer instant games ;
(5) what advice he has received on the number of jobs lost in the football pools industry if the national lottery is introduced and no changes are permitted in the regime governing footbal pools operation and promotion ;
(6) what advice he has received on the consequence for the proposed national lottery's turnover if (a) the number of types of retailer handling lottery tickets were restricted to one, (b) if it were not advertised on television or (c) limits were imposed on prizes and jackpots ;
(7) what advice he has received on the impact of the proposed national lottery on retail sales of newspapers and sweets.
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Mr. Brooke : The Department commissioned a firm of consultants to advise on a number of aspects of the national lottery. This advice was intended to identify the key determinants for a successful lottery. Among the matters covered was advice on the issues the hon. Member raises in his questions. This advice contained a number of illustrative scenarios based on ranges of assumptions. Much of the information in the report is commercially sensitive to those who provided it, and I do not intend to publish the report.
Mr. Ashton : To ask the Secretary of State for National Heritage what advice he has received on the impact of the proposed national lottery on funding for football, assuming no changes in the rules governing pools operation and promotion.
Mr. Brooke : I have received a number of letters from chairmen of football clubs and the Football Trust, which refer to the concerns expressed by the pools companies.
Mr. Ashton : To ask the Secretary of State for National Heritage if he will allow representatives of the GAH consulting group to meet representatives of the pools promoters to discuss its report on the impact of the proposed national lottery on football pools.
Mr. Brooke : GAH is bound by normal Government contract conditions not to disclose details of its report.
Mr. Ashton : To ask the Secretary of State for National Heritage what advice he has received on the impact of the proposed national lottery on the sale of premium bonds.
Mr. Brooke : Internal advice suggests that the products offered by these two schemes are very different. Premium bonds are a savings instrument. We expect both schemes to be viable.
Mr. Ashton : To ask the Secretary of State for National Heritage when he last met the Pools Promoters Association members to discuss the proposed national lottery.
Mr. Brooke : My officials have met the Pools Promoters Association to discuss the national lottery on a number of occasions, most recently on 4 November. I am due to meet the chairman and representatives of the pools companies on 9 December.
Mr. Ashton : To ask the Secretary of State for National Heritage what is his latest forecast of the projected annual income of the national lottery.
Mr. Brooke : All forecasts at this stage must be speculative. I hope that the national lottery will generate substantial sums for good causes.
Mr. Ashton : To ask the Secretary of State for National Heritage how many reports have been commissioned on the impact of the national lottery on football pools.
Mr. Brooke : The GAH group was commissioned to undertake a report to help the Department shape its legislation on the national lottery. Part of this report looked at the possible effects of the national lottery on the pools industry.
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