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Mr. Tredinnick : To ask the Secretary of State for Health what effects the proposed changes in health promotion clinic fee structure will have on counselling services in primary health care and on the availability of complementary therapies.
Mr. Sackville : It will remain open to practices, as now, to offer these services to patients if they so wish.
The arrangements for health promotion programmes, to be introduced from July 1993, will concentrate on action to address smoking, coronary heart disease and stroke. But there will also be transitional arrangements to help protect existing activity outside the scope of the main scheme, and we intend from 1994-95 to establish funding arrangements for action to address additional local priorities.
Community Care
Mr. Hinchliffe : To ask the Secretary of State for Health if, pursuant to her answer of 30 November, Official Report, column 82, what is her Department's latest estimate of the annual shortfall between benefits and charges for residential or nursing care ; and what account was taken of this in the announcement she made on 2 October concerning the funding of community care with effect from April 1993.
Mr. Yeo : As I said in my reply to the hon. Member on 30 November at column 82, the £140 million additional finance for community care above the £399 million transfer from social security will ensure that all authorities will be able to purchase appropriate care for people under their new responsibilities. Any difference that exists
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currently between the level of benefits and charges should be substantially reduced after April 1993 when authorities negotiate fee levels with care homes or provide non-residential services for people who could be better cared for at home.Magnetic Resonance Imaging
Ms. Walley : To ask the Secretary of State for Health if she will make it her policy to ensure Magnetic Resonance Imaging provision in all health authorities the size of North-Staffordshire.
Mr. Sackville : Magnetic resonance imaging (MRI) is a powerful imaging technique with the advantage that it does not involve ionising radiation. It has advantages over computerised tomography scanning in particular clinical situations but is expensive in terms of capital and running costs. Case-mix, amongst other things, will influence whether or not a provider unit will wish to have MRI facilities.
The national health service reforms as set out in the White Paper "Working for Patients" provide that hospitals and other units will be responsible for providing efficient and effective health services to meet the needs identified by health authorities. In this context, provider units will inevitably reach different decisions on whether MRI should form part of the services they provide.
Hospitals
Ms. Primarolo : To ask the Secretary of State for Health what was the total number of hospitals in England in 1979, 1991 and 1992.
Mr. Sackville : In 1979 there were 2,023 hospitals in England making activity returns, and in 1990-91 there were 1,578. Over the same period the number of hospital in-patient cases treated rose by an estimated 25 per cent. to 7.5 million finished consultant episodes in 1990-91. From 1991-92 returns refer to national health service trusts (which may comprise more than one unit) and district health authorities (covering all directly managed units) and data on the number of individual units are not available.
Care in the Community
Mr. Pope : To ask the Secretary of State for Health what is her estimate of expenditure required in Hyndburn during the first year of the transfer of funds for care in the community from the Department of Social Security to Lancashire county council's social services department.
Mr. Yeo : It is the responsibility of Lancashire county council to estimate the expenditure required in Lancashire for the first year of the community care reforms. The indicative special transitional grant allocation for Lancashire for 1993-94 is £20.07 million.
Pharmaceuticals (Cost)
Rev. Martin Smyth : To ask the Secretary of State for Health what was the cost of pharmaceuticals to hospitals, prescribing doctors and normal general practitioner prescription costs for the past five years ; and if she will make a statement.
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Dr. Mawhinney : Expenditure on drugs by the family health services (FHS) and health authorities in England is shown in the table. The FHS figures include the cost of prescriptions written by all family doctors.
£ million
|Family health |Hospital and |Total
|services |community health
|services
-------------------------------------------------------------------------------------
1987-88 |1,536 |352 |1,888
1988-89 |1,744 |380 |2,124
1989-90 |1,942 |414 |2,356
1990-91 |2,080 |460 |2,540
1991-92 |2,317 |<1>- |-
<1> An equivalent figure for 1991-92 is not yet available.
Regional Health Authorities
Mr. Redmond : To ask the Secretary of State for Health how many visits her Department officials have made to each regional health authority during the last 12 months ; and how many visits each regional health authority chairman has made in that period to her Department.
Mr. Sackville : This information is not collected centrally.
Ambulance Services
Mr. Adley : To ask the Secretary of State for Health if she will list the ambulance services which have applied for or have been granted status as self-governing trusts.
Dr. Mawhinney : Twenty four ambulance service units have been established as national health service trusts. They are as follows : First wave
1. Northumbria Ambulance NHS Trust.
2. Lincolnshire Ambulance NHS Trust.
3. Norfolk Ambulance NHS Trust.
4. Cornwall Ambulance Service (part of Cornwall Community Healthcare Trust)
Second wave
5. Cleveland Ambulance NHS Trust.
6. South Yorkshire Metropolitan Ambulance and Paramedic Service NHS Trust.
7. Essex Ambulance Service NHS Trust.
8. Avon Ambulance Service NHS Trust.
9. Gloucestershire Ambulance Service NHS Trust.
10. Devon Ambulance Service NHS Trust.
11. Staffordshire Ambulance Service NHS Trust.
12. Mersey Regional Ambulance Service NHS Trust.
Third wave
13. Cumbria Ambulance Service NHS Trust.
14. Durham County Ambulance Service NHS Trust.
15. West Yorkshire Metropolitan Ambulance Service NHS Trust. 16. North Yorkshire Ambulance Service NHS Trust.
17. Humberside Ambulance Service NHS Trust.
18. Nottinghamshire Ambulance Service NHS Trust.
19. Bedfordshire and Hertfordshire Ambulance Service NHS Trust. 20. The Two Shires--Northampton and
Buckinghamshire Ambulance NHS Trust.
21. Royal Berkshire Ambulance NHS Trust.
22. Dorset Ambulance Service NHS Trust.
23. Hampshire Ambulance Service NHS Trust.
24. Wiltshire Ambulance Service NHS Trust.
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Limited List Prescribing
Mr. Renton : To ask the Secretary of State for Health how much money has been saved annually by the national health service by the original selected list scheme on drugs ; and what was the effect on the level of prescriptions in those catergories which were not on the selected list.
Dr. Mawhinney : In 1985-86 the selected list scheme saved £75 million on the drugs bill. It is not possible to make meaningful estimates for subsequent years, or to measure changes in the level of prescriptions which can be directly attributed to the scheme. We believe however that significant savings continue to be made.
Market Testing
Mr. Wilshire : To ask the Secretary of State for Health if she will publish a timetable showing when she plans to market-test those activities listed for testing before 30 September 1993.
Mr. Sackville : The activities to be market tested in the Department were listed in Cmd 2101. A timetable for market-testing these activities has been drawn up with the aim of making a recommendation on the outcome of each tender by 30 September 1993. The Department has already awarded contracts for office and building services at the Department's new building in London.
Mr. Wilshire : To ask the Secretary of State for Health to which of those of her Department's activities due to be market tested by 30 September 1993, the Transfer of Undertakings (Protection of Employment) Regulations 1981 and the EC acquired rights directive 77/189/EEC will apply.
Mr. Sackville : We will consider the application of the Transfer of Undertakings (Protection of Employment) Regulations 1981 and the EC Acquired Rights Directive 77/189/EEC to the Department's market-testing programme on a case-by-case basis.
Asbestos
Mr. Milburn : To ask the Secretary of State for Health if she will publish a table showing (a) asbestos-related deaths and (b) asbestos- related disorders, by region for each year since 1979.
Mr. Sackville : I shall let the hon. Member have such information as is available without incurring disproportionate cost as soon as possible.
NHS Trusts
Mr. Milburn : To ask the Secretary of State for Health (1) if she will list the chief executives of shadow trusts who have failed to become the chief executive in the subsequent self-governing trust ; (2) if she will list the chief executives of directly managed national health service units that have failed to be appointed to the post of chief executives in the subsequent shadow trust unit.
Dr. Mawhinney : The information is not held centrally. Chief executive appointments in shadow and operational national health service trusts are a matter for the chairman and non-executive directors of the trust concerned.
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London Health Services
Ms. Primarolo : To ask the Secretary of State for Health (1) if she will make a statement on the age structure, gender breakdown and specialty mix of the 680 consultants who are identified in the Tomlinson report as surplus to requirements ;
(2) if she will make a statement on the current merit award allocation to the 680 consultants identified by the Tomlinson report as surplus to requirements ; what is the total amount of these awards ; and how much of this sum will be transferred to primary care provision.
Dr. Mawhinney : The figure of 680 consultants mentioned in the report is Sir Bernard Tomlinson's estimate of the number of surplus consultant posts, if patient inflows to inner London hospitals reduce to the maximum extent projected. We are still considering the proposals in the report, and will announce our response, including the staffing implications, in the new year.
Ms. Primarolo : To ask the Secretary of State for Health if she will make a statement on the funds allocated in the autumn statement for the implementation of the Tomlinson report proposals.
Dr. Mawhinney : We shall put forward our proposals for the future direction of London's health services, including the financial implications, in the new year.
GP Drug Budgets
Ms. Primarolo : To ask the Secretary of State for Health if she will make a statement on the total GP drug budget for 1989-90, 1990-91, 1991-92 and projected figure for 1992-93 and the proportion of that budget spent for all patients in relation to patient age by five-year intervals.
Dr. Mawhinney : Expenditure on drugs by the family health services in England amounted to £1,942 million in 1989-90, £2,080 million in 1990-91 and £2,317 million in 1991-92. The latest estimate for 1992 -93 is £2,584 million. Information on the proportion of expenditure spent on patients in particular age groups is not available centrally.
Running Costs
Mr. Sproat : To ask the Secretary of State for Health what progress she has made in achieving the target of a reduction of 1.5 per cent. in her 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 her responsibility.
Mr. Sackville [holding answer 1 December 1992] : All parts of the Department are required to contribute towards the target for increased efficiency through measures aimed at cash-releasing savings or improved productivity. These are taken into account at the outset when budget allocations are made at the start of each year. For 1992-93 the Department plans to achieve efficiency gains totalling 1.4 per cent. Taken with the 1.7 per cent. gains achieved last year this more than meets the average target of 1.5 per cent. each year. The planned savings this year are made up of £1.2 million on manpower, £1.8 million on non-manpower costs and £0.6 million on the London paybill as a result of the first phase of the relocation to Leeds of the National Health Service
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Management Executive. Further savings of £1.9 million are expected to be realised in 1992-93 (including on capital expenditure) through improved purchasing policies.The Department's agencies (NHS Estates and the Medicines Control Agency) work to separate targets. These are monitored through the respective departmental boards and the latest quarterly reports for the agencies show that they are both on course to achieve their targets by the end of the year. The NHS Estates Agency is working to an efficiency target of 4 per cent. in 1992-93 through reductions in manpower costs, improvements in procurement and increased use of video-conferencing. The target for the Medicines Control Agency is to achieve increased productivity of 3 per cent.
SCOTLAND
Market-Testing
Mr. Wilshire : To ask the Secretary of State for Scotland if he will publish a timetable showing when he plans to market-test those activities listed for testing before 30 September 1993.
Mr. Lang : I announced the 1992-93 market-testing programme for my Departments on 28 August 1992. The market-testing of all 26 activities is due to be complete by 30 September 1993. The time taken to complete the market test will vary depending on the value of and complexity of the activity under consideration. Testing is now under way on several activities, including pay, leave and superannuation functions and the Scottish prison service works and store.
Mr. Wilshire : To ask the Secretary of State for Scotland to which of those of his Department's activities due to be market-tested by 30 September 1993, the Transfer of Undertakings (Protection of Employment) Regulations 1981 and the EC acquired knights directive 77/189/EEC will apply.
Mr. Lang : This will be determined for each activity in the light of the facts of the case and after considering legal advice.
Waivers of Disqualification
Mr. Darling : To ask the Secretary of State for Scotland how many waivers of disqualification have been granted ; and how many have been refused, for employees and trustees of charities since part I of the Law Reform (Miscellaneous Provisions) (Scotland) Act 1990 came into force on 27 July.
Lord James Douglas-Hamilton : No waivers of disqualification have been granted and no waivers have been refused for employees and trustees of charities since the coming into force of the Act on 27 July.
EDUCATION
Market Testing
Mr. Wilshire : To ask the Secretary of State for Education if he will publish a timetable showing when he plans to market-test those activities listed for testing before 30 September 1993.
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Mr. Forman : Work has already begun on each of the Department's areas for market testing listed in Cmnd 2101, with a view to completing the programme by 30 September 1993. In the largest test, that of support services in the Department's headquarters, the work of developing specifications and shortlisting potential contractors is well advanced.
Mr. Wilshire : To ask the Secretary of State for Education to which of those of his Department's activities due to be market-tested by 30 September 1993 the Transfer of Undertakings (Protection of Employment) Regulations 1981 and the EC Acquired Rights Directive 77/189/EEC will apply.
Mr. Forman : The relevance of the Transfer of Undertakings (Protection of Employment) Regulations and the Acquired Rights Directive to an area of work being market tested depends upon the facts of each case, since there are a number of factors to be taken into account. The Department will be taking legal advice on the application of the regulations for each of the areas to be market tested by 30 September 1993.
School Examination Results
Mr. Dunn : To ask the Secretary of State for Education how many secondary schools were entered in the recently published schools' examinations results tables ; how many entries were incorrect and for what reason ; and if he will make a statement.
Mr. Forth : A total of 4,622 schools were included in the school performance tables published on 18 November. All complaints of incorrect figures are being investigated on a case by case basis. To date, the entries for some 16 schools have been found to be incorrect due to error on the part of the Department or its contractor. In all these cases, erratum slips are being issued and letters of apology sent to the schools concerned.
Administration Costs
Mr. Nigel Jones : To ask the Secretary of State for Education how much in real terms his Department spent centrally on general administration in the last three years for which figures are available ; what proportion of the total budget these figures represented ; and if he will make a statement.
Mr. Forth : The figures are based on those set in table 1 of the departmental report, published in February this year (Cm 1911), and revalued to 1991-92 financial year prices. The figures are rounded to the nearest £1 million.
£ million
|1989-90 |1990-91 |1991-92
----------------------------------------------------------------------
Administration, research and
miscellaneous services |87 |91 |107
Total Department of Education
and Science |6,659 |7,102 |7,345
|Per cent.|Per cent.|Per cent.
Administration expressed as a
percentage of total |1.3 |1.3 |1.4
The figures include expenditure on civil science ; responsibility for this work was transferred to the Office of Science and Technology on 6 July 1992.
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Disabled Employees
Mr. Elletson : To ask the Secretary of State for Education how many (a) physically disabled and (b) sensorily disabled people are employed in his Department ; and what percentage they are of the total work force.
Mr. Forman : The Department, including the Teachers Pensions Agency, has 69 staff (3 per cent. of the work force) who are registered disabled. This includes 19 (0.8 per cent.) with sensory disabilities and 30 (1.3 per cent.) with physical disabilities. There are other staff in the Department with disabilities who have chosen not to register and who are not included in the above figures.
Grant-maintained Schools
Mr. Simon Coombs : To ask the Secretary of State for Education how many schools have declined to opt for grant-maintained status following ballots.
Mr. Forth : Of the 779 ballots for grant-maintained status which have been held to date, 172 (22 per cent.) have resulted in a vote against applying for grant-maintained status. Once a school has balloted in favour of applying for grant-maintained status, the governors have a statutory duty to proceed with the application by publishing proposals.
Education Courses (London)
Mr. Dowd : To ask the Secretary of State for Education how many courses of adult education were provided by the Inner London education authority at the time of its abolition ; and what are the current corresponding figures for its successor authorities.
Mr. Forman : Information on the number of adult education courses is not collected by the Department, which collects only enrolment data from adult education centres.
Natural Medicines
Mr. Tredinnick : To ask the Secretary of State for Health what provision there is in the curricula of Government-funded medical establishments for the teaching and theory and practice of the schools of natural medicine.
Mr. Forman : I have been asked to reply.
It is for universities to determine the curriculum for medical education in the light of recommendations from the General Medical Council. The GMC is considering changes to its current
recommendations. Its intention is that medical students should in future have a range of options from which to choose for part of their course. It will be for institutions to decide their own curricula taking account of the GMC's revised criteria.
Grant-maintained Schools
Mrs. Angela Knight : To ask the Secretary of State for Education if he will make a statement on the recent survey into the operation of of grant-maintained schools undertaken by the grant-maintained schools centre.
Mr. Patten : A survey of 103 grant-maintained schools, undertaken by the grant-maintained schools centre, was
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published on 27 November 1992. The survey demonstrated clearly the benefits of grant-maintained status, which enables schools to manage their own affairs and gives them the flexibility to target funding at classroom level.The main findings of the survey were as follows :
more than 80 per cent. of the schools that responded reported increased pupil numbers at the beginning of the school year 1992-93 ;
more than three-quarters of schools reported an increase in teaching staff ;
more than 90 per cent. of schools experienced no difficulty in recruiting or retaining governors ;
57 per cent. of secondary comprehensive schools and 40 per cent. of primary schools reported an increase in their provision for Special Needs.
Copies of the survey are available in the Library.
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