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Community Treatment Orders
24. Mr. Fabricant : To ask the Secretary of State for Health what recent representations she has received regarding the possibility of introducing community treatment orders.
Mr. Yeo : We have received views from many organisations and individuals. They will be taken fully into account by the departmental team which, as my right hon. Friend the Secretary of State stated in her reply to my hon. Friend the Member for Canterbury (Mr. Brazier) on 13 January at column 731, is reviewing the legal powers in this field. The team will be seeking further views as its work proceeds.
Ambulance Service
25. Mr. Nigel Jones : To ask the Secretary of State for Health what studies her Department has made of the effect of the closure of Leyland-DAF on the ambulance service.
Mr. Sackville : Leyland-DAF has entered into administrative receivership with a view to operating the business as a going concern. National Health Service Supplies is currently in daily contact with the company to monitor the situation in respect of the placement of future orders for vehicles for the ambulance service.
Community Care
26. Mr. William O'Brien : To ask the Secretary of State for Health what provisions are being made for the new community care programme to ensure that improvements are introduced into the care of the elderly and the disabled ; and if she will make a statement.
Mr. Yeo : The introduction of assessment of individuals' care needs will ensure that services are increasingly tailored to need rather than need to services. Improved responsiveness to need will lead to a wider choice of services being delivered by an increasing variety of
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providers. A total of £565 million is being made available to local authorities in 1993-94 through a ring-fenced special transitional grant to enable them to implement the new arrangements.27. Mrs. Helen Jackson : To ask the Secretary of State for Health when she last met representatives of the British Association of Social Workers to discuss the implementation of the community care proposals.
Mr. Yeo : I met representatives of the British Association of Social Workers on 11 November 1992. A number of issues were discussed including the implementation of community care.
Mr. Harry Greenway : To ask the Secretary of State for Health how many people have been released into the community from psychiatric institutions in each of the past three years ; and if she will make a statement.
Mr. Yeo : The table shows the estimated number of discharges into the community from national health service hospitals in England from 1987- 88 to 1989-90. The figures do not reflect the number of patients leaving hospitals, as a person can be discharged more than once during the year.
Discharges from national health service hospitals and units in England Year |Number ------------------------ 1987-88 |175,910 1988-89 |182,903 1989-90 |177,752
Mr. Nicholas Winterton : To ask the Secretary of State for Health what recent representations she has received about the continuing closure of psychiatric hospitals and the finding of community care.
Mr. Yeo : We have received seven representations from interested organisations and 57 from individuals since 1 January 1993 about the closure of psychiatric hospitals and the funding of community care.
28. Mr. Heppell : To ask the Secretary of State for Health, pursuant to her answer of 8 February, Official Report, column 474, what information she has on the number of times permission was granted by the Secretary of State for the emigration of a child in care between 1967 and 14 October 1991.
Mr. Yeo : Archive papers are stored under the name of the individual child. As I explained in my answer of 8 February at column 474, information regarding the numbers involved could be produced only at disproportionate cost.
Hospital Beds (London)
29. Ms. Abbott : To ask the Secretary of State for Health what assessment she has made of the need to increase or reduce the supply of hospital beds in London.
Dr. Mawhinney : The demand for hospital beds in London in the future will depend both on improvements in efficiency and primary services, and on how many patients are treated locally rather than being referred to London. While it is impossible to predict precisely the speed of these
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changes, in our policy document "Making London Better" we made a cautious estimate of 2,000 to 2,500 fewer acute beds in four to five years' time.Mental Health Services (Ethnic Minorities)
Mrs. Fyfe : To ask the Secretary of State for Health what research is being funded by her Department into the provision of mental health services to meet the needs of ethnic minority communities.
Mr. Yeo : The Department is currently funding two research projects in respect of black and ethnic minorities. Both relate to aspects of psychosis in Afro-Caribbean people. The Medical Research Council is, however, the main route for funding research in psychiatry.
Folic Acid
Mrs. Ann Winterton : To ask the Secretary of State for Health if the folic acid supplements recommended for women intending to have children in the recent report of the Chief Medical Officer's expert advisory group will be available without a prescription ; and what charge will be made.
Mr. Sackville : The report recommended that to prevent a recurrence of neural tube defects women should be prescribed folic acid supplements until the 12th week of pregnancy at a dose of 5mg per day. As there are rare but potentially serious hazards of folic acid therapy at these levels in particular groups of people there are no plans to make this dose available without a prescription. To prevent a first occurrence of neural tube defect women planning a pregnancy are advised to take a supplement of 0.4mg folic acid from the start of trying to conceive until the 12th week of pregnancy. These supplements are available over the counter at many health food stores and chemists at a cost of around £1 for a month's supply.
Consultants
Ms. Mowlam : To ask the Secretary of State for Health (1) if she will list the contracts awarded by her Department to (a) Coopers and Lybrand management consultants, (b) Touche Ross management consultants, (c) Price Waterhouse management consultants, (d) Ernst and Young management consultants, (e) Chrichton Roberts Ltd., (f) KPMG management consultants and (g) Leopold Joseph management consultants, with the total cost of the contracts with each contractor, for (i) the past 12 months and (ii) 1991-92 ; (2) how many contracts for consultancies were awarded by his Department over (a) the last 12 months and (b) 1991-92.
Mr. Sackville : The information has been placed in the Library.
Hartley Hospital, Colne
Mr. Gordon Prentice : To ask the Secretary of State for Health when the Hartley hospital in Colne ceased to be used as an NHS hospital ; what amount has since been spent on its maintenance ; what valuation has been made of it ; and what plans there are for an open market sale.
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Mr. Sackville : Hartley hospital was vacated in December 1989. The hon. Member may wish to contact Sir Bruce Martin, chairman of North Western regional health authority, for further details.
Publicity
Mr. Morgan : To ask the Secretary of State for Health, pursuant to her answer of 2 June 1992 to the hon. Member for Holborn and St. Pancras (Mr. Dobson), Official Report, column 463, what is her Department's (a) current outturn estimate for publicity expenditure for 1992-93 and (b) budgeted publicity expenditure for 1993-94.
Mr. Sackville : Estimated expenditure on communications and publicity for 1992-93 is £22 million.
The budget for 1993-94 is £23.7 million.
Caring for People"
Mr. Thomason : To ask the Secretary of State for Health when she intends to issue further guidance to local authorities on charges to users of social services provided under "Caring for People".
Mr. Yeo : As envisaged in "Caring for People" we have issued guidance and made regulations about charges to people in residential and nursing homes from April 1993. Local social services authorities also have powers to charge users of day and domiciliary services where this is reasonable. The Government's long-established policy on the use of these powers is well known. we consider that further guidance will be more useful if it can reflect early experience of implementing "Caring for People". We plan to issue such guidance once that has been assessed.
Disabled People
Mr. Alfred Morris : To ask the Secretary of State for Health what further consideration she has given to calls from disability organisations for the implementation of sections 1, 2 and 3 of the Disabled Persons (Services, Consultation and Representation) Act 1986 ; and if she will make a statement.
Mr. Yeo : Most of the major provisions of the Act have now been implemented, bringing substantial benefits to disabled people and their carers. The requirements of the non-implemented sections of the Act are now, to a very large extent, reflected in the new and wide-ranging reforms of community care, which demonstrate our commitment to high-quality care responsive to the needs and wishes of service users and carers. The need to implement these sections will therefore be reviewed in the light of several years' experience of the community care arrangements.
Mr. Alfred Morris : To ask the Secretary of state for Health what representations she has received on the need to empower local authorities to enable them to make direct cash payments to disabled people to make their own personal assistance arrangements.
Mr. Yeo : I have received a number of representations. I have, however, no plans to amend long-standing legislation in this way.
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District Health Authorities (Funding)
Mr. Clapham : To ask the Secretary of state for Health how many district health authorities will receive less funding through the transfer to weighted capitation in 1993-94.
Mr. Sackville : In 1993-94 the following 24 district health authorities, all of which are currently receiving more than their share of their region's resources, will receive less funding, at constant prices, than in 1992-93.
DHA's which will have their funding reduced in 1993-94 Regional health |Amount £'s authority and district health authority -------------------------------------------------------------------- Northern RHA Newcastle |1,000,000 Yorkshire RHA None |n/a Trent RHA None |n/a East Anglian RHA None |n/a North West Thames RHA Kensington, Chelsea and Westminster |500,000 Brent |500,000 Barnet |1,500,000 North East Thames RHA Hampstead |400,000 Bloomsbury and Islington |900,000 Haringey |750,000 Redbridge |350,000 Waltham Forest |600,000 South East Thames RHA Dartford and Gravesham |463,000 Tunbridge Wells |59,000 Greenwich |452,000 Bromley |722,000 South East London<1> |6,000,000 South West Thames RHA Wandsworth |1,032,000 East Surrey |85,000 Kingston and Esher |50,000 Wessex RHA None |n/a Oxford RHA Aylesbury Vale |1,069,000 Wycombe |499,000 Oxfordshire |44,000 South Western RHA None |n/a West Midlands RHA West Birmingham |250,000 South Warwickshire |250,000 Mersey RHA Liverpool |2,000,000 Macclesfield |500,000 North Western RHA None |n/a <1> New authority containing Camberwell, Lewisham/north Southwark and west Lambeth DHAs.
Fluoridation
Ms. Lynne : To ask the Secretary of State for Health which health authorities in England and Wales have requested fluoridation of water supplies in their region ; and in which health authorities water is currently fluoridated.
Dr. Mawhinney : This information is not held centrally.
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Patients (Protection)
Mr. Hinchliffe : To ask the Secretary of State for Health what quality assurance mechanisms she is considering to protect vulnerable groups of patients ; and what assessment she has made of the appropriateness of BS5750 accreditation.
Mr. Yeo : Purchasers are required to set standards of quality in the contracts they place with providers.
The Department is funding an evaluation of major accreditation and organisational audit schemes, including BS5750, to establish the benefits relevant to the national health service.
Mental Illness
Mr. Madden : To ask the Secretary of State for Health what policy advice or guidelines she has issued concerning the treatment of those suffering from mental illness in secure units ; and if she will make a statement.
Mr. Yeo : The treatment of mental illness is the responsibility of the professionals involved. The code of practice issued under the Mental Health Act 1983 provides guidance on the operation of that Act. Current needs for treatment in secure conditions are among the issues considered in the reports of the joint Department of Health/Home Office review of services for mentally disordered offenders (Cm. 2088, 1992). In the light of the review's recommendations we have increased capital funding for medium secure services from £3 million in 1991-92 to £17 million in 1992-93 and £22.4 million in 1993-94.
Health Advisory Service
Mr. Hinchliffe : To ask the Secretary of State for Health what recent changes there have been in the strategic brief, method of operation and independence of the health advisory service ; and what announcements she has made of them.
Mr Yeo : Following a ministerial review in 1991, the national health service health advisory service now has a new remit compatible with the NHS reforms and the Government's new policies for care in the community. The HAS will continue to undertake reviews of local services, but a proportion of its resources will be allocated to examinations of particular aspects of the management of care and quality standards. These changes were announced in January 1992. The HAS remains independent and it retains the status of a
non-departmental public body.
Mr. Hinchliffe : To ask the Secretary of State for Health what arrangements are made for the publication of annual reports by the health advisory service.
Mr. Yeo : Following the review of the national health service health advisory service and the appointment of the new director, all future annual reports will be published as soon as possible after receipt.
Mr. Hinchliffe : To ask the Secretary of State for Health what progress has been made in discussions between the health advisory service and other monitoring bodies concerned with health and social services care.
Mr. Yeo : During his first months in office, the present director met many other monitoring bodies whose views
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have been taken into account in the formulation of the national health service health advisory service's forward programme.Mr. Hinchliffe : To ask the Secretary of State for Health how many visits were completed by the health advisory service other than in respect of drug services ; how many reports were published in each quarter since 1991 ; how many person/days were employed on these visits and subsequent report writing, for each quarter, in respect of (a) psychiatrists, psychogeriatricians and geriatricians, (b) nurses, (c) therapists representing the professions allied to medicine, (d) managers and (e) social service inspectors ; how many visits are planned for the period 1 January to 31 March ; and how many person/days of each of the professional groups it is planned to employ.
Mr. Yeo : No visits to review services for mentally ill and elderly people have taken place since 1991. Twelve reports were published during January-March 1992 and six during April-May 1992, relating to the final 18 of the 40 visits undertaken during 1991. No visits have been planned for the period January-March 1993.
Nurses
Mr. Blunkett : To ask the Secretary of State for Health how many enrolled nurses, working within the national health service, underwent professional development training (a) prior to and (b) following the implementation of the National Health Service and Community Care Act 1990.
Mr. Sackville : This information is not held centrally.
Mr. Blunkett : To ask the Secretary of State for Health what guidance has been issued to (a) directly managed hospitals and (b) national health service trusts with regard to funding for conversion courses for enrolled nurses ; and if she will make a statement.
Mr. Sackville : Regional health authorities and employing authorities are aware of their responsibilities regarding enrolled nurse conversion.
Mr. Blunkett : To ask the Secretary of State for Health what steps her Department is taking to ensure that opportunities for professional development are open to all enrolled nurses irrespective of ethnic origin.
Mr. Sackville : We are committed to a policy of equal opportunity for all staff in the national health service. It is an employer responsibility to ensure that professional development opportunities are made available irrespective of ethnic origin.
Mr. Blunkett : To ask the Secretary of State for Health what steps her Department is taking to encourage enrolled nurses who are not in employment back into the nursing profession ; and if she will make a statement.
Mr. Sackville : Responsibility for the recruitment of qualified nurses rests with employers.
Mr. Blunkett : To ask the Secretary of State for Health what plans her Department has (a) to increase and (b) to standardise professional development opportunities for enrolled nurses working within the national health service ; and if she will make a statement.
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Mr. Sackville : We are committed to increasing the number of places available for level two to level one conversion as part of the Project 2000 reforms. Central funding has been made available to facilitate this and on 12 February we announced additional funding for Project 2000 in 1993-94. However, it is for regional health authorities, in consultation with employers, to plan for enrolled nurse conversion.
Chemists
Mr. Hawksley : To ask the Secretary of State for Health if she will arrange a meeting with the pharmaceutical industry to discuss whether chemists will check, in return for a small fee, the eligibility of those claiming free prescriptions.
Dr. Mawhinney : Mechanisms already exist to check eligibility for prescription charge exemption and charge remission under the national health service low income scheme. The adequacy and operation of these arrangements is kept under review.
Making London Better"
Ms. Primarolo : To ask the Secretary of State for Health what estimate she has of the cost of implementation of "Making London Better" for 1993-94.
Dr. Mawhinney : As my right hon. Friend the Secretary of State announced in the House on 16 February, there will be some £158.5 million funding for changes in London in 1993-94. An additional £43.5 million will be available for investment on improving primary and community health services, together with £105 million for changes in secondary care. We will also provide £10 million to ease waiting times in London.
Thames Regional Health Authority
Ms. Primarolo : To ask the Secretary of State for Health what are the total activity levels in the Thames regional health authority for 1991- 92 and 1992-93.
Mr. Sackville : The number of finished consultant episodes in the general and acute specialties purchased in the four Thames regions in 1991- 92 was 1,958,681. The corresponding number forecast for 1992-93 is 2,025,474.
NHS Trusts
Mr. Milburn : To ask the Secretary of State for Health, pursuant to her answer of 2 February, Official Report , column 153, if she will show for each trust into which band the chairman's salary falls.
Dr. Mawhinney [holding answer 12 February 1993] : This information is not held centrally for national health service trusts in the first wave. These details can be obtained from the individual trusts. Remuneration bands for the second and third wave are as follows :
SECOND WAVE TRUSTS
Northern Region
Band-- 1
South Tees Acute Hospitals NHS Trust
The RVI Infirmary and Associated Hospitals Trust
Band 2--
North Tees Health NHS Trust
Band-- 3
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Cleveland Ambulance NHS TrustGateshead Community Health NHS Trust
Northgate NHS Trust
Yorkshire Region
Band-- 1
York Hospitals and Community Services
Band-- 2
Airedale NHS Trust
Harrogate Health Care NHS Trust
Bradford Community Health NHS Trust
Scarborough and North East Yorkshire Healthcare NHS Trust Northallerton Health Services NHS Trust
Trent Region
Band-- 1
Central Sheffield University Hospitals NHS Trust
Nottingham City Hospital NHS Trust
Band-- 2
Bassetlaw Hospital and Community Health Services
Doncaster Healthcare NHS Trust
Band-- 3
Mulberry South Lincolnshire Mental Handicap
Nottingham Community Unit
Weston Park Hospital NHS Trust
Sheffield Children's Hospital NHS Trust
South Yorkshire Metropolitan Ambulance Service
Barnsley Community and Priority Services NHS Trust
East Anglian Region
Band-- 2
Hinchingbrooke Health Care NHS Trust
Kings Lynn and Wisbech Hospitals NHS Trust
Band-- 3
Allington
North West Thames Region
Band-- 1
Parkside Health NHS Trust
Wellhouse NHS Trust (Barnet and Edgware)
St. Mary's NHS Trust
East Hertfordshire Health NHS Trust
Band-- 2
Ashford Hospital NHS Trust
Ealing Hospital NHS Trust
South Bedfordshire Community Healthcare NHS Trust
Bedford Hospital NHS Trust (Formerly North Bedfordshire General Hospital)
Luton and Dunstable Hospital NHS Trust
Dacorum and St. Albans Community NHS Trust (Formerly North West Hertfordshire Priority)
Horizon NHS Trust (Formerly North West Hertfordshire Mental Health)
Barnet Community Healthcare NHS Trust
Band 3--
Harrow Community Health Services NHS Trust
Hillingdon Community Health NHS Trust
Harefield Hospital NHS Trust
North East Thames Region
Band 1--
The Bart's NHS Trust
Forest Healthcare NHS Trust
Essex Rivers Healthcare NHS Trust (North East Essex Acute) Band 2--
Mid Essex Hospital Services NHS Trust
Southend Community Care NHS Trust
Basildon and Thurrock General Hospitals NHS Trust
Band 3--
Essex Ambulance Service NHS Trust
North East Essex Mental Health NHS Trust
New Possibilities NHS Trust (formerly Turner Village)
South East Thames Region
Band 2--
South Downs Health NHS Trust (Brighton Community)
Hastings and Rother NHS Trust
West Lambeth Community Care NHS Trust
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