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Ritodrine
Mr. Blunkett : To ask the Secretary of State for Health what assessment her Department has made of the drug ritodrine ; what guidance she has issued on its use ; and what plans she has to review its usage.
Dr. Mawhinney : The Committee on Safety of Medicines has recently conducted a full investigation into the safety and efficacy of ritodrine. This review was prompted by a publication in the medical literature which expressed concern about the risks and benefits of ritodrine and by two recent deaths in the United Kingdom following treatment with the drug. The committee concluded that the drug was effective and safe when administered correctly. They recommended a number of changes to the prescribing information which are currently being implemented. The manufacturer of ritodrine has written to all doctors emphasising the measures which should be adopted to ensure that the drug is administered safely. As with all medicines licensed for use in the United Kingdom, the safety of ritodrine is being kept under constant review by the Medicines Control Agency.
Intensive Therapy Units
Sir Patrick McNair-Wilson : To ask the Secretary of State for Health if she will list the number and location of the intensive therapy units in England and Wales ; and how many organ donors have arisen in each during the past 12 months.
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Mr. Sackville : Not all intensive therapy units in England and Wales can be identified from information collected centrally. According to information provided by the United Kingdom Transplant Support Service Authority (UKTSSA) organs were retrieved from 732 donors in 216 units in England and Wales in 1992. The table gives the regional distribution :
Region |Number of Units |Number of Donors ------------------------------------------------------------------------------------ Northern |15 |51 Yorkshire |9 |59 Trent |16 |67 East Anglian |10 |33 North West Thames |13 |32 North East Thames |20 |55 South East and South West Thames |34 |110 Wessex |10 |34 Oxford |10 |38 South Western |12 |48 West Midlands |22 |70 Mersey |14 |37 North Western |18 |61 Wales |13 |37 Reports from UKTSSA showing the names of all these units, the number of donors in each of them and the names of all hospitals that have retrieved organs during the past ten years have been placed in the Library.
West Midlands Regional Health Authority
Mr. Blunkett : To ask the Secretary of State for Health if she will make a statement on the findings of Sir Roy Griffiths in relation to the operation of the West Midlands regional health authority.
Mr. Burden : To ask the Secretary of State for Health if she will make public the reports she has received from Sir Roy Griffiths in respect of the West Midlands regional health authority.
Dr. Mawhinney : Sir Roy Griffiths was asked to work with West Midlands regional health authority in looking at its management systems to enable the authority to discharge its functions more effectively in the future. Sir Roy has been keeping the Department and region in touch with progress and a number of changes have now been made. As indicated at the outset there are no plans for a formal report on his work to be published.
Mr. Purchase : To ask the Secretary of State for Health if she will make a statement on the actions of Sir James Ackers, former chair of the West Midlands regional health authority, in respect of financial losses to the health services in the west midlands ; and when she proposes to make good these losses.
Dr. Mawhinney : Sir James Ackers was chairman of West Midlands regional health authority for over 10 years, during which time many excellent developments in health care took place. Recently, the region has faced a number of difficulties arising from management of its regionally managed services. When Sir James became aware of the problems he instigated remedial action, including changes in managerial structures, lines of accountability, the limits of authority and the standing and financial orders together with a number of senior management changes. Management of the West Midlands regional health authority and the provision of health services for the
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people of the west midlands is the responsibility of the regional health authority. Allocation and use of resources to meet these objectives are therefore matters for them.Mr. Burden : To ask the Secretary of State for Health if she will order the publication of the report by the district auditor into the West Midlands regional health authority currently in the hands of senior management of that authority.
Dr. Mawhinney : The district auditor's report on the West Midlands supplies division was published on 10 September 1992. No other reports are currently complete.
Mr. Burden : To ask the Secretary of State for Health what financial settlement was made in respect of the resignation of Sir James Ackers as chair of the West Midlands regional health authority.
Dr. Mawhinney : No decision has been made.
Family Health Service Authorities
Mr. Colvin : To ask the Secretary of State for Health what plans she has for reorganising the family health service authorities ; and if she will make a statement.
Dr. Mawhinney : Circular EL(92)47, priorities and planning guidance 1993/94, copies of which are available in the Library, sets out the Government's position on the organisation of family health service authorities. It states that
"the full benefits of current arrangements have yet to be realised".
We believe that FHSAs have a major role to play in the further development of primary care.
Doncaster Health Services
Mr. Redmond : To ask the Secretary of State for Health if she will dismiss those of her appointees to the Doncaster healthcare trust who neither reside nor work in south Yorkshire.
Health Authority Appointments
Mr. Redmond : To ask the Secretary of State for Health who is consulted when candidates for appointment as chairman or non-executive directors of health authorities are selected ; and if she will make a statement.
Mr. Mawhinney : Nominations for appointment as chairmen of district health authorities are made by regional health authority chairmen, and I make the appointments on behalf of the Secretary of State. The appointment of non-executive members of district health authorities is the responsibility of the regional health authority chairmen. There is no requirement to consult anyone in making such appointments. However, in making these public appointments I take into account local views, including those of hon. Members.
European Year of the Elderly
Mrs. Gorman : To ask the Secretary of State for Health what measures she is taking in connection with the European year of the elderly.
Mr. Yeo : The Department, in co-operation with the Department of Social Security, has overall co-ordinating
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responsibility for the European Year of Older People and Solidarity between Generations in the United Kingdom and we are now well advanced with our plans. My right hon. Friend the Secretary of State for Health launched the Year in the United Kingdom at the age resource awards, which were presented in London on 17 December 1992 by HRH The Prince of Wales.Following consultation with a wide range of national voluntary and professional bodies, statutory authorities and other relevant Government Departments, we have set up a group to advise on the conduct, promotion and evaluation of the programme of events to celebrate the year. The group involves representatives of organisations reflecting the interests of older people, including the National Pensioners' Convention, and will take direct account wherever possible of the views and preferences of older people themselves. The programme in the United Kingdom will focus on four major themes :
Combating "ageism" and promoting positive images of ageing ; Volunteering ;
Health promotion and active leisure, including remaining mentally active ;
Social integration, including problems of isolation and loneliness, information needs, housing, transport and community care issues. Four task groups have also been set up to examine each of these themes and put forward specific proposals.
There will be two elements to the year in the United Kingdom : a core programme involving national events focusing on the four themes, including cultural and sporting events, exhibitions and conferences ; and a general programme, consisting of activities organised by individual groups and voluntary bodies.
The Department has committed £81,000 in the current financial year for the costs of a secretariat--based at Age Concern England headquarters--to co-ordinate the core programme and to disseminate news and information.
Midwives
Mr. Kirkwood : To ask the Secretary of State for Health (1) what plans she has to review the current clinical grading system for midwives ; and if she will make a statement ;
(2) if she will establish an expert committee to review the pay conditions and grading structures for midwives in the NHS ; and if she will make a statement.
Mr. Sackville : We have no plans to review the current clinical grading system for midwives. These are matters for the Nursing and Midwifery Staffs Negotiating Council.
Mr. Kirkwood : To ask the Secretary of State for Health what representations she has had recently regarding the pay and conditions of midwives working within the NHS.
Mr. Sackville : We receive representations periodically about pay and conditions from a variety of sources including midwives and their representative organisations.
Mr. Kirkwood : To ask the Secretary of State for Health what response the Government made to the recommendations by the House of Commons Select Committee on the changes needed in the clinical grading and pay structure for midwives.
Mr. Sackville : The Health Committee did not make any specific recommendations about clinical grading and the pay structure of midwives.
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Alcohol and Drugs
Mr. Michael : To ask the Secretary of State for Health if he will list the establishments in England which provide residential facilities for (a) those with alcohol problems and (b) those with drug problems ; if he will show for each establishment (i) the capital grant and (ii) the total revenue grant provided by his Department in each of the last five years ; and if he will provide estimated figures for 1992-93 and 1993-94.
Mr. Yeo : Information on residential and non residential facilities for drug misusers is available in the SCODA directory and for alcohol misusers in the Alcohol Concern directory, copies of which are in the Library. Funding for drug and alcohol projects are provided directly and indirectly by the Department from a number of sources. In part grants are from small centrally administered budgets such as the specific grant for alcohol and drug misusers. Other funds are provided locally by health authorities, either from money specifically allocated to them for drug misuse services, which totals £20 million in 1992-93, or from their general allocations. Details of projects funded from all these sources could be provided only at disproportionate cost.
Killingbeck Hospital
Mr. Fatchett : To ask the Secretary of State for Health (1) if she will make a statement on the discussions between her Department and Yorkshire regional health authority about the decision to transfer the management of Killingbeck hospital to the United Leeds Teaching hospital trust ;
(2) what assessment she made of the process of consultation between the Yorkshire regional health authority and (a) Leeds community health council, (b) employees of Killingbeck hospital and (c) local hon. Members before the decision was announced to transfer the management of Killingbeck hospital to the United Leeds Teaching hospital trust ; and if she will make a statement ;
(3) if she will make a statement on the future management of Killingbeck hospital in Leeds.
Dr. Mawhinney : I will write to the hon. Member with full details.
Interleukin-6
Mr. Fatchett : To ask the Secretary of State for Health (1) whether she will set out the cost to the United Leeds Teaching Hospital Trust of the further investigation currently being undertaken by Coopers and Lybrand into the Interleukin-6 research project ; and if she will make a statement.
(2) whether her Department will instruct the United Leeds Teaching Hospital Trust to publish the Coopers and Lybrand report on the cost of the Interleukin-6 research project ; and if she will make a statement.
Dr. Mawhinney : I understand that the investigations by Coopers and Lybrand into the Interleukin-6 research project on behalf of the United Leeds teaching hospitals national health service trust are not yet complete. The costs of any investigation and decisions about publication of any report will be matters for the trust.
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Civil Servants (Bicycles)
Mr. Simon Hughes : To ask the Secretary of State for Health if she will make a statement on the current conditions on which civil servants in her Department are granted salary advances to enable the purchase of bicycles for home-to-office travel ; if she will make a statement on the current conditions in each agency of her Department ; what plans she has to change the conditions ; and if she will make a statement.
Mr. Sackville : All permanent staff with at least two months' service in the Department of Health and its agencies are able to apply for an advance of salary to enable the purchase of bicycles for home-to-office travel. The maximum advance for purchase of a bicycle is £100. This provision was introduced in the Department in June 1992. We have no immediate plans to change these conditions.
Birth Defects
Mrs. Ann Winterton : To ask the Secretary of State for Health, (1) pursuant to her answer of 17 December 1992, Official Report , column 420 , what steps she is taking to ensure that women at risk of bearing children with neural tube defects are aware of the benefits which would accrue from taking a daily dietary supplement of folic acid ;
(2) when the potential benefits of dietary supplementation with folic acid by women at risk of bearing children with neural tube defects were first drawn to her or her predecessor's attention.
Mr. Sackville : It was not until July 1991, when the first results of a Medical Research Council study were published, that it was concluded that a daily dietary supplement of folic acid could significantly reduce the risk of recurrence of neural tube defects. Guidance was issued at once to doctors, senior nurses, midwives and health visitors. The subsequent 1992 report of the Chief Medical Officer's Expert Advisory Group endorsed the earlier guidance and extended it to include also women with no history of neural tube defects. There has been widespread publicity and action is in hand to ensure the public are fully aware of this important advice.
Mrs. Ann Winterton : To ask the Secretary of State for Health, pursuant to her answer of 17 December 1992, Official Report , column 420 , whether she will consider claims for ex gratia payments from those women who may have delivered or who have had aborted babies suffering from neural tube defects, and who had been given placebos in earlier studies involving folic acid supplementation.
Mr. Sackville : We do not consider that it would be appropriate to make payments to women for not being given a treatment which at the time was unproven.
Abortion
Mrs. Ann Winterton : To ask the Secretary of State for Health what information she has concerning the average cost of a national health service abortion performed (a) in a national health service hospital and (b) in a private clinic under agency arrangements.
Mr. Sackville : The estimated average cost of a surgical abortion in a national health service hospital is £270 for a
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straightforward in-patient case and £140 for a day case (at 1990-91 figures). Some two thirds of abortions performed in national health service hospitals are carried out on a day case basis (i.e. the patient does not stay overnight). No information is held centrally about the cost of abortions performed in the private sector under agency arrangements.Mrs. Ann Winterton : To ask the Secretary of State for Health (1) what has been the total number of abortions performed under the terms of the Abortion Act 1967 ; how many of these were performed in national health service hospitals ; and what was the total estimated cost at current prices ;
(2) how many of the total number of abortions so far performed under the Abortion Act 1967 were performed in private clinics under national health service agency arrangements ; and what was the total cost of those abortions at current prices.
Mr. Sackville : Of the 3,546,681 abortions performed in England and Wales since the Abortion Act 1967 came into effect, and up to 31 December 1991, 1,387,829 were performed in national health service hospitals. Since 1981, when information was first collected about agency arrangements between NHS authorities and the private sector, a total of 74,680 abortions have been so provided. The total cost of these is not known centrally. Information is not available centrally to enable the total cost of all abortions to be estimated.
Mrs. Ann Winterton : To ask the Secretary of State for Health what information she has concerning the average cost to patients of abortions performed in private abortion clinics ; and how many such abortions in total have now been performed under the provisions of the Abortion Act 1967.
Mr. Sackville : The total number of abortions performed in private abortion clinics and hospitals under the Abortion Act 1967 since it came into effect, and up to 31 December 1991, is 2,158,852. We do not collect centrally information about fees charged by all private clinics.
Mrs. Ann Winterton : To ask the Secretary of State for Health if she will indicate, without revealing the names of the doctors concerned, how many and what percentage of all abortions on babies of 18 or more weeks gestation in the latest year for which figures are available were carried out by each of the 10 doctors who have performed the greatest number of such abortions.
Mr. Sackville : This information is available only from the abortion notification forms submitted to the Chief Medical Officer under regulation 4 of the Abortion Regulations 1991, and cannot be disclosed because of restrictions set out in regulation 5.
Hospitals, Birmingham
Mr. Burden : To ask the Secretary of State for Health on what dates in the last six months she visited hospitals in Birmingham ; and if she will give details of her visits.
Dr. Mawhinney : My right hon. Friend the Secretary of State has not visited any hospitals in Birmingham in the last six months. However, the Parliamentary Under-Secretary of State--my hon. Friend the Member for
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Bolton, West (Mr. Sackville)--and I have visited hospitals in and around Birmingham on a number of occasions since July.Mr. Burden : To ask the Secretary of State for Health when she expects to make a decision regarding the proposal from the West Midlands regional health authority to close the accident and royal orthopaedic hospitals in Birmingham.
Dr. Mawhinney : My right hon. Friend has received proposals from the regional health authority to close the Accident and Royal Orthopaedic hospitals and transfer the services to the Birmingham general hospital. An announcement will be made once the consideration of the proposal is complete.
Philip Lyndon
Mrs. Ann Taylor : To ask the Secretary of State for Health what has been the total cost so far to the Yorkshire health authority of the Philip Lyndon inquiry including the costs of his suspension.
Dr. Mawhinney : This information is not available centrally. The hon. Member may wish to contact Sir Bryan Askew, the chairman of Yorkshire regional health authority for details.
Medical Treatment Abroad
Mrs. Jane Kennedy : To ask the Secretary of State for Health what assistance is available for parents whose children contract a medical condition, treatment for which cannot be obtained in the United Kingdom, to receive treatment in (a) another EC country, (b) the United States of America, (c) Japan and (d) any other country.
Dr. Mawhinney : There are no general powers under national health service legislation allowing purchase of treatment outside the EC for patients resident in England. There are powers under EC legislation for individual patients to be referred elsewhere in the Community for treatment with the prior authorisation of my right hon. Friend the Secretary of State.
Capital Programmes
Mr. Cousins : To ask the Secretary of State for Health whether, in granting approvals in to the capital programmes of NHS trusts, it is her policy to act in accordance with the previous outline capital programmes of regional health authorities or any undertakings regional health authorities may have given relating thereto.
Dr. Mawhinney : With the introduction of capital charges all capital developments, whether in trusts or directly managed units, have revenue consequences for purchasers. The national health service management executive requires all new capital developments to be supported by a business case which demonstrates that the scheme meets purchaser requirements, has their support, and can be afforded by them. Schemes in regional health authorities previous outline programmes are subject to these criteria in the same way that any new proposals are. The NHS management executive's outposts are responsible for recommending major capital schemes for inclusion in trust capital programmes and work closely with regional health authorities in drawing up their proposals.
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Merseyside Regional Health Authority
Mr. Burden : To ask the Secretary of State for Health if she will establish an independent inquiry into the Merseyside regional health authority.
Dr. Mawhinney : We have no plans to do so.
Ambulance Service
Mr. McCartney : To ask the Secretary of State for Health what was the percentage of ambulances in each service in England that responded within (a) eight minutes and (b) 14 to 20 minutes to emergency calls in 1991-92.
Mr. Sackville : The available information is in the table. In 1991- 92 ambulance authorities had the option to return information on either the basis of emergency telephone calls received or of emergency patient journeys, with consequent variation in the basis of calculation. It is not considered that this has any significant impact on comparisons. The data are provisional.
Emergency calls: Non-metropolitan authorities 1991-92
Ambulance authority |Response within 8 |Response within 19
|minutes |minutes
|per cent. |per cent.
--------------------------------------------------------------------------------------
Cleveland<1> |70 |94
Cumbria<1> |53 |87
Durham |<2>54 |<3>96
Humberside<1> |73 |99
North Yorkshire<1> |61 |96
Derbyshire |50 |<3>97
Leicestershire<1> |52 |96
Lincolnshire NHS Trust |65 |<3>96
Nottinghamshire |<2>58 |<3>97
Cambridgeshire<1> |38 |84
Norfolk NHS Trust |55 |91
Suffolk |<2>53 |<3>91
Bedfordshire<1> |57 |95
Hertfordshire<1> |62 |96
Essex |55 |96
East Sussex<1> |67 |98
Kent<1> |59 |96
Surrey |<2>50 |<3>91
West Sussex<1> |64 |97
Dorset<1> |61 |97
Hampshire<1> |55 |97
Wiltshire<1> |62 |96
Isle of Wight<1> |58 |99
Berkshire<1> |51 |93
Buckinghamshire |<2>58 |<3>96
Northamptonshire |<2>67 |<3>98
Oxfordshire |<2>51 |<3>92
Avon<1> |59 |99
Cornwall NHS Trust |<2>44 |<3>92
Devon<1> |57 |94
Gloucestershire<1> |55 |94
Somerset<1> |55 |91
Hereford and Worcester<1> |56 |97
Shropshire |49 |<3>93
Staffordshire |<2>57 |<3>99
Warwickshire<1> |54 |94
Cheshire<1> |57 |90
Lancashire |67 |<3>99
<1> Return based on number of emergency patient journeys.
<2> Response within 7 minutes.
<3> Response within 20 minutes.
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Emergency calls: Metropolitan authorities 1991-92
Ambulance authority |Response within |Response within 14
|eight minutes |minutes
|Percentage |Percentage
--------------------------------------------------------------------------------------------
Northumbria Metropolitan NHS
trust<1> |59 |97
West Yorkshire Metropolitan |34 |83
South Yorkshire Metropolitan<1> |<2>29 |76
London Ambulance Service<1> |15 |64
West Midlands Metropolitan<1> |72 |92
Mersey Metropolitan<1> |66 |94
Greater Manchester Metropolitan |<2>59 |97
<1> Return based on number of emergency patient journeys.
<2> Response within seven minutes.
Mr. McCartney : To ask the Secretary of State for Health what was the number of ambulance staff in England employed by the NHS in 991, using whole-time equivalents.
Mr. Sackville : As at 30 September 1991, there were some 18,190 whole-time equivalent ambulance staff employed by the national health service (including those in NHS trusts).
Engagements
Mr. Burden : To ask the Secretary of State for Health if she will list her engagements for 4, 5 and 6 December 1992.
Mrs. Virginia Bottomley : My official engagements were as follows :
Friday 4 December : Meeting with Departmental officials and attendance at the Service for the Citizen Conference at the QEII conference centre.
Saturday 5 December : Meeting with the Guildford and Godalming Branch of National Asthma Campaign.
Domiciliary Services
Mr. Terry Davis : To ask the Secretary of State for Health how many health visitors and district nurses providing domiciliary services to elderly people were employed in England on the most recent date for which this information is available.
Mr. Sackville : The Department collects information about the numbers of health visitors and district nurses, but data on their type of work (e.g. domiciliary services to elderly people) is not separately identifiable.
Community Care
Mr. Tony Banks : To ask the Secretary of State for Health what arrangements are being made to monitor the community care policy from April.
Mr. Yeo : We are currently considering how best to do this.
Mr. Tony Banks : To ask the Secretary of State for Health what is the assessment of the community care needs of London boroughs in 1993-94.
Mr. Yeo : Standard spending assessments provide the Government's view of appropriate expenditure. Within each SSA there are components for adult social services. Authorities also have available the special transitional grant for community care and other relevant specific
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grants. However, it is for each authority to decide within its available resources how much it is appropriate to spend in the light of their own judgments.Varicose Veins
Mr. Hinchliffe : To ask the Secretary of State for Health how many varicose vein surgical operations are undertaken by the national health service annually for males under 40 years of age.
Mr. Sackville : The number of hospital episodes in England 1989-90, the latest year for which figures are available, involving surgical operations under the national health service for varicose veins on males under 40 years of age, are estimated to be 4,200.
Residential Care
Mr. Tony Banks : To ask the Secretary of State for Health what action is being taken to improve the provision of residential care places in the London area.
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