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Written Answers to Questions

Wednesday 17 February 1993


Orthodontic Facilities

Mr. Leighton : To ask the Secretary of State for Health what orthodontic facilities exist in the London borough of Newham.

Mr. Sackville : Newham health authority is responsible for commissioning services for local residents. The hon. Member may wish to contact Mrs. Rosemary Walters, chairman of Newham district health authority, for details.


Mr. Sheerman : To ask the Secretary of State for Health what is the average length of time taken by her Department to respond after an appeal is lodged following a Dental Practice Board recommendation.

Dr. Mawhinney : Appeals to the Secretary of State, following complaints made under the National Health Service (Service Committees and Tribunal) Regulations 1992, are now handled by the family health services appeal unit at Yorkshire regional health authority under devolved powers. Appeals are given very careful consideration and the time taken to process them varies from case to case. Information about average times is not available centrally and could be obtained only at disproportionate cost.

NHS Trusts

Mr. Cousins : To ask the Secretary of State for Health what was the capital allocation granted to each NHS trust in the northern region in 1992 -93 : and what allocation is proposed for 1993-94.

Dr. Mawhinney : The information requested is set out in the table.

NHS trust                        |Allocated 1992-93  |Proposed allocation                    


                                 |£000               |£000                                   


The Freeman Group of Hospitals   |2,154              |3,505                                  

Newcastle Mental Health Services |252                |288                                    

Northumbrian Ambulance           |2,210              |1,695                                  

Cleveland Ambulance              |496                |300                                    

North Tees Health                |2,508              |1,498                                  

Northgate                        |2,172              |252                                    

The RVI Group of Hospitals       |15,081             |7,627                                  

Gateshead Community Health       |356                |1,084                                  

South Tees Acute Hospitals       |9,149              |5,730                                  

NHS Trusts

Mrs. Roe : To ask the Secretary of State for Health when she expects to respond to the first report from the Health Committee of Session 1992- 93, "NHS Trusts : Interim Conclusions and Proposals for Future Inquiries"-- House of Commons Paper No. 321.

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Dr. Mawhinney [pursuant to his reply, 16 February 1993] : We are publishing our response to the report today. Copies are available in the Library.

Mentally Ill People

Mr. Fraser : To ask the Secretary of State for Health what plans there are to provide day care centres for the mentally ill in Lambeth.

Mr. Yeo : It is the responsibility of district health authorities and local authority social services departments to contract for or provide a comprehensive range of mental health services to meet the level of psychiatric need in their areas.

Contracting Out

Mr. McAllion : To ask the Secretary of State for Health if she will provide figures for the reduction in numbers of posts as a result of contracting out since 1979 in her Department and agencies for which she has responsibility.

Mr. Sackville : The Department of Health became a separate Government Department in 1989. Since then, the number of posts in the Department has been reduced by just under 30 as a result of contracting out.


Lady Olga Maitland : To ask the Secretary of State for Health how many patients were registered as suffering from schizophrenia in (a) 1986 and (b) 1991-92.

Mr. Yeo : There is no requirement to register patients suffering from schizophrenia. The table gives the number of admissions to hospitals in England in 1986 and 1989-90, the latest year for which the quality of information permits publication, where a diagnosis of schizophrenia was made.

Number of hospital    

admissions in England 

for patients with     

schizophrenia 1986 (  

Mental Health         

Enquiry) and 1989-90  

(Hospital Episode     



1986    |29,419       

1989-90 |38,180       

Mental Illness

Ms. Lynne : To ask the Secretary of State for Health what guidelines her Department has issued to local authorities with regard to specific provision for the care of those in the 16 to 25 years age group suffering from mental illness.

Mr. Yeo : No guidance has been issued which specifically focuses on this age group. Services for disturbed adolescents--generally 12 to 19 years--were the subject of a report "Bridges over Troubled Waters" from the national health service health advisory service which the Department issued to health and local authorities in 1986. A copy will be placed in the Library.

Psychiatric Patients

Lady Olga Maitland : To ask the Secretary of State for Health how many psychiatric patients are (a) long-term and (b) acute.

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Mr. Yeo : The table gives the total number of residents in the mental illness specialty in England for (a) long-term--one year and over-- and (b) acute--under one year--at 31 March 1992.



Under one year    |25,500       

One year and over |19,700       

Note: These figures are         

estimates based on data         

obtained directly from regional 

health authorities.             

Lady Olga Maitland : To ask the Secretary of State for Health how many psychiatric patients are waiting for a bed.

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Mr. Yeo : Information about the numbers waiting by specialty is given in the publication "Hospital Waiting List, In-Patients and Day Cases" --ISBN 1 85839 003 6--a copy of which is available in the Library.

Fund-holding Practices

Mr. Milburn : To ask the Secretary of State for Health how many GP non-fund-holding practices there are in each region ; what percentage this represents of the regional total of GP practices ; and what percentage of the regional population they serve.

Dr. Mawhinney : The information is given in the table :

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Region              |Number of GP       |Percentage of GP   |Percentage of                          

                    |practices          |practices          |population served                      

                                                            |by GP                                  

                    |Non-fundholding    |Non-fundholding    |Non-fundholding                        

                    |April 1992         |April 1992         |practice April 1992                    


Northern            |479                |92.3               |84                                     

Yorkshire           |605                |90.2               |79                                     

Trent               |785                |92.9               |86                                     

East Anglia         |283                |95.6               |92                                     

North West Thames   |760                |93.9               |86                                     

North East Thames   |890                |97.7               |93                                     

South East Thames   |757                |96.2               |91                                     

South West Thames   |494                |92.7               |85                                     

Wessex              |405                |91.8               |85                                     

Oxford              |345                |87.8               |77                                     

South Western       |537                |92.9               |86                                     

West Midlands       |997                |94.4               |87                                     

Mersey              |396                |88.6               |81                                     

North Western       |847                |96.4               |91                                     


1. The number of GP practices given above relates to the number of GP partnerships at 1 April 1992, 

including single handed partnerships.                                                               

Community Care

Mr. Battle : To ask the Secretary of State for Health when she will publish the guidance note "Housing and Community Care Planning : The First Steps : A Review of Good Practice."

Mr. Yeo : The community care support force is aiming to complete and issue practical guidance on a range of issues concerned with housing and community care, by the end of March.

General Practitioners

Ms. Primarolo : To ask the Secretary of State for Health if she will extend to non-fund-holding GPs the facility to hold two sessions a week to perform a range of diagnostic tests and extra minor surgery procedures to be paid at the clinical assistant rate.

Dr. Mawhinney : Non-fund holding general practitioners may already provide these services under contract to district health authorities.

Walthamstow GPs

Mr. Gerrard : To ask the Secretary of State for Health if she will list the number of patients per general practitioner in Walthamstow.

Mr. Sackville : The information requested is shown in the table.

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GP        |List Size|GP       |List Size|GP       |List Size          


1         |4,291    |17       |2,395    |33       |1,782              

2         |3,617    |18       |2,356    |34       |1,729              

3         |3,158    |19       |2,339    |35       |1,682              

4         |3,158    |20       |2,300    |36       |1,624              

5         |2,981    |21       |2,293    |37       |1,621              

6         |2,945    |22       |2,259    |38       |1,588              

7         |2,910    |23       |2,241    |39       |1,526              

8         |2,871    |24       |2,214    |40       |1,415              

9         |2,796    |25       |2,204    |41       |1,346              

10        |2,769    |26       |2,194    |42       |1,323              

11        |2,740    |27       |2,135    |43       |1,046              

12        |2,673    |28       |1,990    |44       |694                

13        |2,557    |29       |1,980    |45       |628                

14        |2,433    |30       |1,907    |46       |619                

15        |2,418    |31       |1,898    |47       |258                

16        |2,401    |32       |1,853    |48       |1                  

This includes one unfilled vacancy.                                   

Operations (Waiting Times)

Dr. Lynne Jones : To ask the Secretary of State for Health (1) what instructions the national health service management executive has given to hospitals in respect of telling patients how long they will have to wait for their operations ; and if she will make a statement.

(2) what action she is taking to reduce hospital waiting lists and to keep patients informed about the length of time they will have to wait for operations.

Mr. Sackville : We have made it a requirement under the patients charter that all hospitals must inform patients of the guaranteed date by which they will be admitted for

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treatment. In addition, a national telephone health helpline has been established under the patients charter so that patients can inquire about local waiting times as well as a wide variety of other health matters.

Since 1987 we have provided a waiting time fund of nearly £200 million to enable hundreds of thousands of additional patients to be treated from waiting lists. Waiting times for hospital treatment have improved dramatically and we are determined to build on this success.

Nurse Training

Mrs. Mahon : To ask the Secretary of State for Health what percentage of enrolled nurses have the opportunity for training or professional development on conversion courses to achieve first level registration ; what information she has on the different levels of opportunity in different health authority areas ; and which health authorities provide (a) the best and (b) the worst training opportunities for enrolled nurses.

Mr. Sackville : This information is not held centrally.

Mrs. Mahon : To ask the Secretary of State for Health if she will introduce a national policy on training for enrolled nurses to ensure a consistent approach between regions ; and if she will refund the costs of undertaking open and distance learning incurred by enrolled nurses.

Mr. Sackville : It is for regional health authorities, in consultation with employers, to plan for enrolled nurse conversion.

Mrs. Mahon : To ask the Secretary of State for Health what percentage of enrolled nurses are from an ethnic minority ; and what policies there are to increase training opportunities for this group.

Mr. Sackville : Data on the ethnic background of enrolled nurses are not held centrally. They will benefit from recent measures which have increased opportunities for conversion.

NHS Facilities (Access)

Mr. Blunkett : To ask the Secretary of State for Health what is her policy on the rights of access to NHS facilities of patients with guide dogs ; and what guidance she has issued or intends to issue on this matter.

Mr. Yeo : The patients charter sets a national standard requiring arrangements to be made to ensure that everyone, including people with special needs, can use the services. This includes patients with guide dogs.

NHS Management Audit

Mr. Blunkett : To ask the Secretary of State for Health what plans she has to conduct an audit of management within the NHS ; and if she will make a statement.

Dr. Mawhinney : I understand that, as part of its continuing programme of value-for money studies, the Audit Commission is undertaking a study of unit management in the national health service. I look forward to considering its report.

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Whistle Blowers

Mr. Blunkett : To ask the Secretary of State for Health what progress has been made on the consultations on her draft guidance on the protection of the position of NHS employees who draw attention to malpractice and fraud ; and when she expects to issue formal guidance.

Dr. Mawhinney : Following the recent consultation exercise on the draft guidance on freedom of speech for national health service staff, we are currently considering the large number of comments received. We expect to be able to issue the final version shortly.

Waiting List Initiative

Mr. Morgan : To ask the Secretary of State for Health what guidelines she has given to purchasers and providers of health care concerning the use of marginal cost pricing for waiting list initiative expenditure ; in what circumstances purchaser-provider arrangements for operations can be based on marginal cost pricing ; and if she will make a statement.

Mr. Sackville : Allocations to regional health authorities from the waiting time fund are tied to the achievement of waiting time targets and, in particular, national policy objectives. Standard pricing guidelines apply to the health care that these funds purchase. As marginal cost pricing should only be applied, in year, for unplanned spare capacity in excess of the assumed volume of service, waiting list initiative expenditure need not result in marginal cost pricing. It is therefore not appropriate to issue separate guidelines on marginal cost pricing of waiting list expenditure.

Huntington's Chorea

Mr. Blunkett : To ask the Secretary of State for Health how many people were diagnosed with Huntington's chorea for each year since 1990 ; and what facilities for treatment are available.

Mr. Yeo : The latest year for which figures are held is 1989-90. In that year there were 725 admissions to national health service hospitals of patients whose diagnosis was Huntington's chorea. There is no known cure for this disease ; the full range of NHS treatment and nursing and social care is available to people suffering from it. Because it is an inherited condition, genetic counselling is available to help with decisions about having children.

Mr. Blunkett : To ask the Secretary of State for Health what research has been commissioned into Huntington's chorea.

Mr. Yeo : The Department of Health has not commissioned any research into Huntington's chorea. The Medical Research Council, which receives its grant in aid through the Office of Science and Technology, is the main Government agency for the promotion of medical and related biological research in this country. I understand that in the financial year 1991-92, the council's expenditure on research relevant to Huntington's chorea was £99,000. Other basic research funded by the council may, in part, have some relevance to Huntington's chorea. Universities and medical schools may also be funding relevant research.

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GP Fund Holders

Mr. Blunkett : To ask the Secretary of State for Health if she will publish details of the formula used to calculate the moneys (a) paid to GP fund holders, (b) the data collection methods used to inform the actual distribution of moneys and (c) any changes to either (a) or (b) she plans.

Dr. Mawhinney : The methodology for setting general practitioner fund holders' 1993-94 budgets was published in EL 92(83) "General Practice Fundholding : Guidance on setting budgets for 1993-94", a copy of which is in the Library.

The responsibility for setting budgets rests with regional health authorities who organise data collection locally. We have no immediate plans to change the way budgets are set but will keep this under review.

Private Nurses

Mr. Ainger : To ask the Secretary of State for Health how many qualified nurses were employed in (a) private hospitals, (b) private nursing homes and (c) private nursing agencies in each year since 1985.

Mr. Sackville [holding answer 8 February 1993] : The available information is given in the table. The Department does not collect information about the staffing levels in private nursing agencies.

Qualified staff employed in private        

hospitals and nursing homes                

         Hospitals     Nursing homes       

        |Number|W.T.E |Number|W.T.E        


1985    |7,746 |6,660 |17,259|11,693       

1986    |8,210 |7,001 |21,825|14,682       

1987-88 |8,252 |6,967 |27,801|18,869       

1988-89 |8,907 |7,579 |32,044|21,487       

1989-90 |9,103 |7,707 |36,678|24,719       

1990-91 |9,048 |7,581 |43,865|29,730       

Source: SBH 212. 1985-86.                  

K036 1987-88-1990-91.                      

W.T.E: Whole time equivalent number of     

staff based on contracted hours of         

employment in individual establishments.   



Mr. Mackinlay : To ask the Prime Minister, pursuant to his statement on 11 February, Official Report, column 1111, if Sandringham will be treated as a royal palace or as a private residence of Her Majesty the Queen.

The Prime Minister : Sandringham, which has official as well as private use, is a private asset of Her Majesty the Queen.



Mr. Hardy : To ask the Parliamentary Secretary, Lord Chancellor's Department how many magistrates have resigned before reaching retirement age in the last five years ; and how many have offered as the reason for their decision the changes in the law and practice restricting their freedom of decision taking.

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Mr. John M. Taylor : The number of resignations, other than on grounds of age, for the Lord Chancellor's area of responsibility in each of the last five years were :

Year   |Number       


1992   |1,034        

1991   |820          

1990   |794          

1989   |799          

1988   |659          

No information is collected centrally on how many magistrates have resigned with the reason offered being changes in the law and practice restricting their freedom of decision taking. Over the period the number of magistrates has grown from 24,112 to 25,340.

County Court Judgments

Mr. Channon : To ask the Parliamentary Secretary, Lord Chancellor's Department when he proposes to arrange for county courts' judgments under £5,000 to carry interest ; if he will authorise such interest to apply retrospectively ; and if he will make a statement.

Mr. John M. Taylor : My Department has recently conducted a wide- ranging public consultation to evaluate the scheme introduced in July 1991 which provides for interest on county court judgments over £5,000. Responses to this consultation are currently being evaluated. While it would not therefore be appropriate to make a statement about any extension of the scheme at this time, my officials will be writing to interested parties to inform them of the outcome of the evaluation during the spring. I can, however, confirm that any extension of the scheme would not provide for interest to apply retrospectively.

Mr. Channon : To ask the Parliamentary Secretary, Lord Chancellor's Department when his evaluation of the question of county court judgments carrying interest will be concluded.

Mr. John M. Taylor : My Department's evaluation of the changes introduced in July 1991, which included a provision for interest on judgment debts over £5,000, will be completed by the end of this month.


Public Sector Spending

Mr. Llew Smith : To ask the Chancellor of the Exchequer what discount rate was adopted by Her Majesty's Government for public sector spending in the periods (a) 1979 to 1989 and (b) 1989 to the present ; what considerations underpinned the change made in 1989 ; and if he will make a statement on Her Majesty's Government's future plans for the discount rate.

Mr. Portillo : The Government specify a standard rate of discount for the public services. It is set on the basis of long-term factors, and is changed infrequently.

The 1978 White Paper, "The Nationalised Industries", Cm 7131, introduced the concept of the required rate of return--RRR--a real return on the whole of each enterprise's investment programme. No discount rate was centrally specified for the enterprises, but in practice a rate

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of 5 per cent. in real terms--the same as the RRR--or sometimes a higher rate, was used as a discount rate for investment appraisal. At the same time as Cm 7131 an announcement was made about the discount rates to be used in the public services-- Official Report, 5 April 1978, columns 147-48. A discount rate of 5 per cent. in real terms was specified for appraisals of choice of techniques, and a rate of 7 per cent. for other appraisals. In practice 7 per cent. was used only for the appraisal of roads.

A new regime was announced on 5 April 1989-- Official Report, column 187. The RRR for public enterprises was raised from 5 to 8 per cent., and the discount rate for the public services from 5 to 6 per cent. However for central Government trading activities selling commercially into private markets the discount rate should usually be at least 8 per cent. Other special cases are listed in "Economic Appraisal in Central Government : A Technical Guide for Government Departments"--the "Green Book"--annex G, paragraph 12.

The 1989 changes were a consequence of the long-term trend in the real rate of return on private sector assets between the late 1970s and late 1980s. The increase in the discount rate for the public sector services was more modest, reflecting the smaller increase in the cost of capital to a private sector company raising funds for low-risk purposes.

The discount rate is intended to reflect long-term conditions, rather than cyclical factors.

Mr. Llew Smith : To ask the Chancellor of the Exchequer what assessment he has made on the effect on public sector investment in energy technology projects of the current level of discount rates.

Mr. Eggar : I have been asked to reply.

My Department's investment in energy technology projects is for research or regulatory purposes, for which assessment on a discounting basis is not appropriate. All the programmes are, however, subject to regular review. The public sector energy industries, which operate in a commercial environment, assess their investment programmes according to the appropriate Treasury guidelines.


Mr. Richards : To ask the Chancellor of the Exchequer what measures are being taken to stop the flow of illegal pornography from other European countries into the United Kingdom.

Sir John Cope : The importation of obscene material and indecent material featuring children into the United Kingdom from any country remains illegal. Routine frontier Customs controls on goods from EC countries ceased on 1 January 1993, but anti-smuggling checks better targeted in response to the known risks continue to prevent the importation of illegal goods. Routine checks also continue on goods from non-EC countries.

Income Tax

Mr. David Nicholson : To ask the Chancellor of the Exchequer what would be the annual cost of introducing a 35 per cent. income tax rate for all income (a) between £23,700 and £26,000, (b) between £23,700 and £30,000, and (c) between £23,700 and £35,000 ; and what would be

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the annual revenue from introducing a 50 per cent. rate on (i) all income over £50,000, (ii) all income over £60,000 and (iii) all income over £70,000.

Mr. Dorrell : The latest estimates are as follows :

Band of taxable      |Revenue cost in full                     

income over which    |year at 1992-93                          

35 per cent. rate    |income levels                            

would be charged                                               

£                    |£ million                                


23,700 to 26,000     |170                                      

23,700 to 30,000     |400                                      

23,700 to 35,000     |600                                      

Level of taxable   |Revenue yield in a                   

income above which |full year at                         

50 per cent. rate  |1992-93 income                       

would be charged   |levels                               

£                  |£ million                            


50,000             |1,360                                

60,000             |1,120                                

70,000             |950                                  

The estimates do not allow for any behavioural effect that might result from such changes to the tax system and do not include capital gains tax.

Charities (Taxation)

Mr. Alfred Morris : To ask the Chancellor of the Exchequer what representations he has had from the Charities Tax Reform Group in regard to taxation on charities ; what reply he is sending ; what action he will be taking ; and if he will make a statement.

Sir John Cope : The Charities' Tax Reform Group--CTRG--has suggested that charities could be compensated by grant in aid for their irrecoverable VAT on non-business expenditure incurred in carrying out their charitable objectives.

I cannot anticipate my right hon. Friend's Budget speech. I have replied to the CTRG along those lines. However, I am also expecting to meet the group shortly to receive further representations.

Balance of Payments

Mr. David Nicholson : To ask the Chancellor of the Exchequer if he will make a statement on the measures he is taking to endeavour to reduce the United Kingdom balance of payments deficit.

Mr. Portillo : The Government can best assist traders by keeping inflation and interest rates low. Inflation is now at its lowest level for 25 years and below the European Community average. Interest rates are the lowest for 15 years, and are the lowest in the European Community. The extra support for the Export Credits Guarantee Department announced in the autumn statement will also benefit many exporters.

The success of this approach is demonstrated by the number of overseas investors choosing to locate here. In 1991 the United Kingdom had over 40 per cent. of the stock of Japanese inward investment to the EC.

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Mr. Nicholas Winterton : To ask the Chancellor of the Exchequer what was the net balance of trade in manufactured goods in the last month for which figures are available.

Mr. Nelson : The balance of trade in manufactured goods for December 1992 was published by the Central Statistical Office in the "UK Balance of Payments--Current Account in December" press notice which was published on 28 January 1993, copies of which are available in the House of Commons Library. The information is also available on the Central Statistical Office database which may be accessed by the House of Commons Library.

European Co-operative Statute

Mr. Turner : To ask the Chancellor of the Exchequer what is the Government's policy on the European co-operative statute, passed by the European Parliament on 22 January.

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