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Septic Arthritis
Mr. Pope : To ask the Secretary of State for Health how many registered cases of septic arthritis there have been in the United Kingdom over the last five years broken down by district health authority ; and if she will make a statement.
Mr. Sackville : Information on registrations of this condition are not held centrally. The table shows the estimated number of cases of septic arthritis treated in national health service hospitals in each regional health authority in England for the last five available years. The numbers of treatments are too small to make reliable estimates at district level.
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|c|Septic arthritis-discharges and deaths/hospital episodes|c|
|1982 |1983 |1984 |1985 |1989-90
------------------------------------------------------------------
Northern |100 |90 |160 |100 |96
Yorkshire |90 |110 |70 |110 |96
Trent |200 |180 |160 |190 |208
East Anglia |60 |130 |100 |30 |60
North West Thames |60 |40 |80 |60 |64
North East Thames |80 |50 |30 |110 |108
South East Thames |130 |140 |100 |90 |128
South West Thames |70 |80 |30 |60 |88
Wessex |60 |80 |100 |50 |100
Oxford |70 |40 |80 |100 |64
South Western |90 |70 |140 |80 |68
West Midlands |230 |280 |230 |120 |224
Mersey |90 |90 |110 |40 |64
North Western |80 |200 |110 |130 |164
SHAs |0 |0 |20 |10 |12
|-------|-------|-------|-------|-------
Totals |1,410 |1,580 |1,520 |1,280 |1,544
Sources: 1982-85 Hospital In-Patient Enquiry (HIPE).
1989-90 Hospital Episode System (HES).
Who Cares?"
Mrs. Golding : To ask the Secretary of State for Health what contribution her Department made to the "World in Action" programme, "Who Cares?" broadcast on 30 November.
Care Leavers
Mrs. Golding : To ask the Secretary of State for Health if she will now review local authority support for young care leavers.
Mr. Yeo : We are monitoring how local authorities are exercising their powers and duties under the Children Act 1989. A report will be presented to Parliament in the new year.
Disabled Employees
Mr. Elletson : To ask the Secretary of State for Health how many (a) physically disabled and (b) sensorily disabled people are employed in her Department ; and what percentage they are of the total work force.
Mr. Sackville : At 7 December 1992, the latest figures available, the Department employed 74 people who were registered disabled, of whom 37- -0.7 per cent. of the work force--are known to have physical disabilities and 13--0.3 per cent.--to have sensory disabilities. In addition, a number of staff have a disability but are not registered disabled.
Child Care Facilities
Mr. Harvey : To ask the Secretary of State for Health what steps she will take to give further encouragement to employers to provide child care facilities for employees' children.
Mr. Yeo : It is for employers to consider the business case for providing a child care service, to help recruit, retain and support the career development of the work force.
The new review duty, introduced by the Children Act 1989, provides a legislative framework for local child care
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plans, which involve all local interests, including employers and parents, in looking at the existing child care services and identifying priorities for future expansion.The Department of Health is spending £1 million over three years starting in 1992-93 to pump prime expansion of child care services for school age children. The Employment Department is planning to spend up to£45 million over three years starting in 1993-94 through training and enterprise councils in promoting child care for school age children.
Community Care
Mr. Cox : To ask the Secretary of State for Health what steps she is taking to ensure that users of community care provisions are enabled to have a genuine choice of services after April.
Mr. Yeo : My right hon. Friend the Secretary of State intends to issue a statutory direction requiring local authorities to place someone assessed as needing residential care into the accommodation of their choice, subject to practical conditions such as cost, availability and suitability. The statutory direction will also make it clear that authorities should use their discretion in a way which respects users' wishes when arranging the provision of any community care service.
Mr. Bowden : To ask the Secretary of State for Health when her Department will issue the guidance referred to in paragraph 3.31 of the policy guidance, "Community Care in the Next Decade and Beyond", on the power of local authorities to make discretionary charges for welfare services under section 17 of the Health and Social Services and Social Security Adjudications Act 1983.
Mr. Yeo : We intend to issue guidance before April 1993.
Private Ambulance Services
Mr. Blunkett : To ask the Secretary of State for Health what representations her Department has received in the last five years on the regulation of private ambulance services ; and if she will make a statement.
Mr. Sackville : We have, from time to time, received letters from hon. Members and from the public. In each case the response has been that private ambulance services and their staff are not subject to any specific statute or regulation. It is for the prospective purchaser of private ambulance services to satisfy themselves that operators are competent to provide the required service.
Dr. Kypros Loucas
Mr. Blunkett : To ask the Secretary of State for Health (1) what plans she has to investigate allegations of professional misconduct by Dr. Kypros Loucas while he was working at Horton hospital in Epson, Surrey, and the circumstances in which he was appointed to the post ; and if she will make a statement ;
(2) what plans she has to review the powers available to the Mental Health Act Commission ; and if she will make a statement ; (3) when her Department first became aware of the Mental Health Act Commission's concerns over possible breaches of the Mental Health Act 1983 by Dr. Kypros
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Loucas while he was employed at Broadmoor hospital ; what representations her Department received from the commission on Dr. Loucas's activities at Broadmoor hospital ; and if she will make a statement ;(4) what plans she has to review the effectiveness of the Mental Health Act 1983 following reports by the Mental Health Act Commission on the treatment of patients at Broadmoor hospital.
Ms. Lynne : To ask the Secretary of State for Health (1) how many past Secretaries of State were approached through their private offices about Dr. Kypros Loucas and his treatment of psychiatric patients ;
(2) if she will now set up an independent inquiry into the activities of Dr. Kypros Loucas with a view to publishing a report ; (3) to how many internal Department of Health inquiries Dr. Kypros Loucas consultant psychiatrist has been subject ;
(4) what action has been taken against Dr. Kypros Loucas following the Mental Health Act Commission's reports to her Department.
Mr. Yeo : The Mental Health Act Commission first expressed concern to the Department about compliance by Dr. Loucas with part IV of the Mental Health Act in 1985. This and subsequent reports by the commission were followed up by the Department with local management at Broadmoor hospital and with the local hospital board. Ministers were involved as necessary and the commission was kept fully informed of the action being taken, which concluded with Dr. Loucas's early retirement from Broadmoor in 1989. In that year the commission stated in its third biennial report :
"the Department of Health has remedied the situation in a way which fully satisfied the Commission's insistent call for official action".
It is not clear that the reported events demonstrate an inadequacy in the Mental Health Act 1983 or in the powers of the Mental Health Act Commission, but we are ready to consider any proposals for changes in this area. We do not believe that a general inquiry into these matters would serve a useful purpose, but we are considering whether any steps need to be taken on particular issues raised. The decision to employ Dr. Loucas at Horton hospital was taken by the Riverside health authority. We have received a copy from the authority of the report of its internal inquiry into the death of a patient at Horton in 1990 and we are considering urgently whether this calls for any further action.
Questions relating to the professional conduct and competence of doctors are for the General Medical Council to consider. We have drawn the council's attention to the allegations about Dr. Loucas and will do all that we can to assist any investigation that it may decide to undertake.
Medical Manpower Standing Advisory Committee
Mr. Alexander : To ask the Secretary of State for Health when she expects the Medical Manpower Standing Advisory Committee to make its first report.
Dr. Mawhinney : I am pleased to announce that the Medical Manpower Standing Advisory Committee has completed its first report. It is published today and copies have been placed in the Library.
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Long-term manpower planning is an important issue for health care and it is not too soon to be thinking about the manpower requirements for the next century. We are grateful to Professor Campbell, the chairman, and to the members of the committee for their consideration of a wide range of issues. We will be studying their recommendations very carefully.Sunderland Health Authority
Mr. Mullin : To ask the Secretary of State for Health how many (a) administrative, (b) nursing and (c) other staff were employed by Sunderland health authority in 1987 and 1991.
Dr. Mawhinney : The figures, where available, are given in the table.
Whole-time
equivalent
|1987 |1991
----------------------------------------------------
Administrative and clerical |618.4 |<1>-
Nursing and midwifery |2,609.4|2,656.4
Other professional |449.5 |494.7
Other non-professional |1,103.9|<1>-
<1> Not available (for DHA).
Notes:
1. Excludes medical and dental staff.
2. Includes agency nurses.
3. Source: Non-medical Manpower Census.
4. 1991 figures for administrative and clerical and
other non-professional staff are not available
centrally for Sunderland district health authority.
Bradford Hospitals Trust
Mr. Madden : To ask the Secretary of State for Health what representations she has received from the Bradford hospitals trust to approve the closure of Bradford royal infirmary, Woodlands and Bierley hospitals ; and if she will make a statement.
Dr. Mawhinney : I have received no such representations.
Tobacco
Mr. Bowis : To ask the Secretary of State for Health what will be the dimensions of the warning notices required by section 4 of the Children and Young Persons (Protection from Tobacco) Act 1991.
Dr. Mawhinney : In the light of consultation on the draft regulations, we shall shortly be making regulations which will provide that the notice for display at premises where tobacco is sold is to be not less than 297 mm 420 mm (A3), and the lettering is to be not less than 36 mm high. The notice to be affixed to cigarette vending machines is to be not less than 60 mm 100 mm, and the lettering not less than 6 mm high.
TRANSPORT
Transport Council
Mr. Dunn : To ask the Secretary of State for Transport what was the result of the Transport Council held in Brussels on 7 and 8 December.
Mr. MacGregor : The Transport Council met in Brussels on 7 and 8 December. There was constructive
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discussion of a very full agenda on aviation, maritime and inland transport issues. On the outstanding measures needed for completion of the single market in transport, full agreement was reached on the regulation on airport slot allocation, thus completing the single market in aviation ; and good progress was made on the liberalisation of road haulage cabotage. This will be discussed further at an additional special Transport Council on 21 December. There was also unanimous agreement on a directive to ensure better information when dangerous and polluting goods are carried into and out of Community sea ports.Airport Slot Allocation
The Council agreed a regulation on airport slot allocation to come into force early in 1993. It will put into place a fair and uniform system for allocating slots at Community airports. The regulation will provide preferential treatment for new entrants on intra-Community routes, and also introduces stricter penalties on airlines that fail to use their slots. The Council will review the operation of the regulation after three years. The completion of the single market in aviation will assist air travellers across Europe by promoting competition and choice.
Aviation External Relations
Useful preliminary discussions took place on the Commission's communication on aviation external relations. There was general agreement that a case-by- case examination will be needed before the Community negotiates collectively with any third country. The forthcoming Danish presidency agreed to take this forward. Air Traffic Control Issues
The Council emphasised the importance of co-operation by the Commission with Eurocontrol and the European Civil Aviation Conference (ECAC). It called for the adoption as soon as possible of the Commission's proposal for a directive on standards for air traffic management (ATM) equipment and systems. It encouraged the Commission to ensure the continuation of the EURET research programme and to make provisions for research to support the development of the future ATM system for Europe, in close co-operation with ECAC and Eurocontrol.
State Aids Resolution
The presidency proposed a draft resolution urging tighter control of state aids in the single market for transport, to which we have attached great importance. This is a matter which lies within the Commission's competence, and the resolution was supported by the Commission. There was support from most member states. But there were objections in principle from certain member states so it was not possible to adopt the resolution. I am hopeful that the matter will be pursued by the Danish presidency.
Road haulage fiscal harmonisation and cabotage
Further discussions took place on these linked and difficult issues. Good progress was made, but without conclusion. In view of the importance and urgency of these items the Council agreed to adjourn and resume discussions at a further meeting on 21 December, in order to reach agreement before the end of the year because the current transitional scheme runs out on 1 January 1993.
Inland waterways
Agreement was reached on a Commission mandate on the opening of negotiations with Danubian countries on inland waterways.
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Transit wth SloveniaThe Commission reported on the negotiations for a Community transit agreement with Slovenia. The Council was not satisfied that an agreement could yet be initialled.
EC tranport infrastructure funding
The draft regulation to succeed the current infrastructure funding regulation had already received political agreement at the October Council. The December Council confirmed this and agreed to re-consult the European Parliament given the considerable differences between this text and the Commission's original proposal.
Dangerous goods at sea
We succeeded in getting unanimous agreement, after three years of Council deliberation, for a directive concerning the carriage of dangerous or polluting goods at sea. This will allow the Community to set in hand a practical scheme compatible with international law, to achieve a better flow of information about the carriage of dangerous and polluting goods into and out of Community ports.
Positive measures for shipping
The Council discussed ways of improving the competitiveness of Community fleets to guide the Commission's future work in this area. Three points were made in particular : state aids should not be mandatory ; and there was widespread concern that aids distort competition, especially in some countries which could not afford to grant them, and that manning arrangements should be kept as flexible as possible.
Maritime external relations
The Council agreed the presidency paper which encourages the Commission to produce a strategy and working arrangements for Community action on external relations for shipping.
Maritime safety
There was a useful general discussion on the Community's approach to maritime safety during which the United Kingdom emphasised the importance of achieving the right standards on ferry stability. Shipping liberalisation
The Commission presented a report which shows that some member states are not complying fully with their obligations under the regulation liberalising shipping between member states and third countries.
White Paper
Commissioner Van Miert presented the wide-ranging Commission White Paper "The Future Development of the Common Transport Policy". The Danish presidency will take forward discussion of the paper.
Rail Freight
Mr. Nicholls : To ask the Secretary of State for Transport if he will take the legislative or other steps necessary to place an immediate moratorium on the rates British Rail charges to its freight customers as part of the preparations for privatisation of British Rail's freight operations.
Mr. Freeman : The rates British Rail charges to freight customers are not matters that the Government can control. The Government intend to bring forward legislation under which a regulator would be appointed to supervise track charges to railway operators.
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Nuclear Material
Ms. Walley : To ask the Secretary of State for Transport what plans he has to introduce legislation to enforce the British Railways Board "List of Dangerous Goods Class 7 : radioactive material", 1977 edition.
Mr. Freeman : This issue is under consideration by the Department as part of the safety regime to be put in place following the privatisation of British Rail.
Ms. Walley : To ask the Secretary of State for Transport what recent changes have been made to the Chicago convention to cover the air freight of nuclear material.
Mr. Norris : None. Annex 18 to the convention already lays down provisions for the safe transport by air of dangerous goods, including radioactive material.
Ms. Walley : To ask the Secretary of State for Transport what information his Department has regarding accidents involving (a) air transport, (b) sea or water course transport, (c) road transport and (d) rail transport of nuclear materials in the European Community since 1979.
Mr. Norris : Details of accidents in the United Kingdom and their radiological consequences are given in National Radiological Protection Board reports M206, M230 and M310, commissioned jointly by the Department of Transport and the Health and Safety Executive. The Department does not hold details of accidents in other member states of the European Community.
Ms. Walley : To ask the Secretary of State for Transport what petitions he has received in his position as President of the European Council of Transport Ministers relating to the risks associated with the transportation of radioactive materials ; and if he will make a statement.
Mr. MacGregor : No such petitions have been received.
Ms. Walley : To ask the Secretary of State for Transport if he will list all published and unpublished reports, commissioned and retained by his Department on the safety and the security of the transport of nuclear materials, and place in the Library those not otherwise available.
Mr. Kenneth Carlisle : The following safety studies have been commissioned by the Department :
Radiation exposure from the normal movement of irradiated fuel elements by road and rail from Magnox power stations : March 1983 Review of the radiological consequence resulting from accidents and incidents during transportation in and from the United Kingdom : December 1984
Derived limits for surface contamination of transport packages : February 1987
The radiological impact of releases from a Magnox fuel flask damages by a hypothetical fire in the summit tunnel : December 1988 Review of the radiological consequences resulting from accidents and incidents involving the transport of radioactive materials in the United Kingdom from 1964 to 1988 : March 1990
Radiological impact of the normal transport of radioactive materials by air : March 1990
Transport of radioactive materials between the United Kingdom mainland and gas and oil platforms in the North sea : March 1990 Radiological consequences resulting from accidents and incidents involving the transport of radioactive materials in the United Kingdom--1989 review : July 1990
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Radiological consequences resulting from accidents and incidents involving the transport of radioactive materials in the United Kingdom--1990 review : July 1991All the above studies were carried out by the National Radiological Protection Board.
In addition, the Department of Energy commissioned a confidential security study in 1980 on the consequences of a terrorist attack on an irradiated fuel flask.
I will place in the Library copies of the listed safety reports that are not already there.
Ms. Walley : To ask the Secretary of State for Transport if he will list those United Kingdom ports which have been used for the transportation of separated plutonium since January 1989.
Mr. Norris : Radioactive material transported in approved packages may be moved through any port. Consignors are under no regulatory obligation to give this information to the Department.
Ms. Walley : To ask the Secretary of State for Transport what proportion of the research undertaken at his Department's Road Research Laboratory since its inception has been devoted to safety assessment of the transportation of nuclear materials by road.
Mr. Kenneth Carlisle : None : such research is the responsibility of the consignors.
Ms. Walley : To ask the Secretary of State for Transport what information on the import and export of plutonium port authorities are required to provide to his Department.
Ms. Walley : To ask the Secretary of State for Transport what discussions he or his officials have had with the European Transport Commissioner or his officials on the import and export of nuclear materials into (a) the European Community and (b) the United Kingdom.
Ms. Walley : To ask the Secretary of State for Transport what recent discussions he has had with his German counterparts in regard to the air freighting of plutonium fuel from Germany to Scotland ; and if he will make a statement.
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