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Written Answers to Questions

Thursday 4 March 1993

FOREIGN AND COMMONWEALTH AFFAIRS

Somalia

Mr. Llew Smith : To ask the Secretary of State for Foreign and Commonwealth Affairs what assessment Her Majesty's Government have made of whether the Serbian Government breached United Nations Security Council resolutions by secretly selling arms to Somalia via the federal directorate of supply and procurement.

Mr. Douglas Hogg : Any sale of arms by Serbia to Somalia would breach United Nations Security Council resolutions 757 and 733. We are aware of press reports of such deals, but we have no evidence to substantiate these.

Hong Kong

Mr. Lidington : To ask the Secretary of State for Foreign and Commonwealth Affairs if he will make a statement about the position reached in discussions with the Chinese Government on Hong Kong electoral issues.


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Mr. Goodlad : The Governor of Hong Kong plans to make a full statement to the Legislative Council in Hong Kong on 5 March of the position reached with the Chinese side over electoral arrangements in Hong Kong. I will write to my hon. Friend as soon as possible.

HEALTH

NHS Staff

Mr. William Powell : To ask the Secretary of State for Health how many full-time equivalent (a) nursing, (b) midwifery, (c) management and (d) clerical and administrative staff were employed by the national health service in each district health authority of the Oxford regional health authority in each year since 1983.

Dr. Mawhinney : The figures are shown in the table. Many of the functions undertaken by senior nursing and professional staff are now reflected in the national health service management figures. This means it is unreliable to compare numbers within groups between the years shown in the table. Management still accounts for less than 1.8 per cent. of the NHS work force and the ratio of clinical to support staff has never been higher.


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Whole-time equivalent staff in each district health         

authority of Oxford regional health authority               

September 1983                                              

------------------------------------------------------------

Oxford HQ and units |70     |0      |-      |570            

East Berkshire      |1,970  |160    |-      |470            

West Berkshire      |2,760  |210    |-      |560            

Aylesbury Vale      |1,600  |50     |-      |420            

Wycombe             |1,110  |140    |-      |290            

Milton Keynes       |300    |40     |-      |170            

Kettering           |1,330  |120    |-      |290            

Northampton         |2,410  |170    |-      |640            

Oxfordshire         |3,910  |230    |-      |1,120          

Ex-AHA staff        |20     |0      |-      |160            

                    |-------|-------|-------|-------        

Regional total      |15,480 |1,110  |-      |4,700          


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September 1984                                                                                                     

                    |Nursing           |Midwifery         |Management        |Administration and                   

                                                                             |clerical                             

-------------------------------------------------------------------------------------------------------------------

Oxford HQ and units |70                |0                 |-                 |580                                  

East Berkshire      |2,000             |160               |-                 |500                                  

West Berkshire      |2,710             |210               |-                 |650                                  

Aylesbury Vale      |1,670             |40                |-                 |420                                  

Wycombe             |1,140             |140               |-                 |310                                  

Milton Keynes       |570               |70                |-                 |260                                  

Kettering           |1,390             |130               |-                 |320                                  

Northampton         |2,390             |170               |-                 |640                                  

Oxfordshire         |3,880             |230               |-                 |1,140                                

Ex-AHA staff        |20                |0                 |-                 |70                                   

                    |-------           |-------           |-------           |-------                              

Regional total      |15,830            |1,150             |-                 |4,890                                


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September 1985                                                                                                     

                    |Nursing           |Midwifery         |Management        |Administration and                   

                                                                             |clerical                             

-------------------------------------------------------------------------------------------------------------------

Oxford HQ and units |70                |0                 |0                 |570                                  

East Berkshire      |2,000             |190               |0                 |490                                  

West Berkshire      |2,700             |210               |0                 |670                                  

Aylesbury Vale      |1,620             |50                |0                 |360                                  

Wycombe             |1,140             |140               |0                 |310                                  

Milton Keynes       |610               |80                |0                 |280                                  

Kettering           |1,350             |120               |-                 |330                                  

Northampton         |2,350             |170               |0                 |580                                  

Oxfordshire         |3,790             |240               |0                 |1,090                                

                    |-------           |-------           |-------           |-------                              

Regional total      |15,630            |1,200             |-                 |4,690                                


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September 1986                                                                                                     

                    |Nursing           |Midwifery         |Management        |Administration and                   

                                                                             |clerical                             

-------------------------------------------------------------------------------------------------------------------

Oxford HQ and units |70                |0                 |-                 |530                                  

East Berkshire      |1,970             |190               |10                |500                                  

West Berkshire      |2,720             |210               |10                |680                                  

Aylesbury Vale      |1,630             |60                |-                 |370                                  

Wycombe             |1,180             |140               |-                 |310                                  

Milton Keynes       |630               |80                |-                 |240                                  

Kettering           |1,350             |120               |-                 |330                                  

Northampton         |2,250             |160               |-                 |560                                  

Oxfordshire         |3,840             |250               |10                |1,120                                

                    |-------           |-------           |-------           |-------                              

Regional total      |15,640            |1,220             |20                |4,640                                


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September 1987                                                                                                     

                    |Nursing           |Midwifery         |Management        |Administration and                   

                                                                             |clerical                             

-------------------------------------------------------------------------------------------------------------------

Oxford HQ and units |70                |0                 |-                 |550                                  

East Berkshire      |1,980             |190               |10                |500                                  

West Berkshire      |2,730             |210               |10                |710                                  

Aylesbury Vale      |1,630             |60                |-                 |360                                  

Wycombe             |1,150             |150               |-                 |310                                  

Milton Keynes       |670               |90                |-                 |270                                  

Kettering           |1,370             |110               |-                 |340                                  

Northampton         |2,270             |160               |-                 |570                                  

Oxfordshire         |3,980             |250               |10                |1,130                                

                    |-------           |-------           |-------           |-------                              

Regional total      |15,860            |1,230             |30                |4,730                                


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September 1988                                                                                                     

                    |Nursing           |Midwifery         |Management        |Administration and                   

                                                                             |clerical                             

-------------------------------------------------------------------------------------------------------------------

Oxford HQ and units |70                |0                 |-                 |530                                  

East Berkshire      |2,100             |180               |10                |480                                  

West Berkshire      |2,640             |200               |10                |710                                  

Aylesbury Vale      |1,620             |60                |-                 |350                                  

Wycombe             |1,130             |120               |-                 |340                                  

Milton Keynes       |640               |90                |-                 |290                                  

Kettering           |1,380             |120               |-                 |360                                  

Northampton         |2,250             |160               |10                |570                                  

Oxfordshire         |3,900             |250               |10                |1,140                                

                    |-------           |-------           |-------           |-------                              

Regional total      |15,740            |1,190             |40                |4,760                                


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September 1989                                              

------------------------------------------------------------

Oxford HQ and units |70     |0      |10     |550            

East Berkshire      |2,020  |180    |30     |470            

West Berkshire      |2,740  |210    |10     |710            

Aylesbury Vale      |1,520  |60     |20     |340            

Wycombe             |1,190  |120    |10     |360            

Milton Keynes       |730    |90     |20     |300            

Kettering           |1,430  |120    |20     |360            

Northampton         |2,210  |160    |30     |570            

Oxfordshire         |3,850  |240    |50     |1,200          

                    |-------|-------|-------|-------        

Regional total      |15,760 |1,200  |200    |4,860          


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September 1990                                              

------------------------------------------------------------

Oxford HQ and units |70     |0      |50     |570            

East Berkshire      |2,040  |190    |40     |560            

West Berkshire      |2,670  |220    |30     |770            

Aylesbury Vale      |1,600  |60     |30     |370            

Wycombe             |1,180  |130    |30     |380            

Milton Keynes       |730    |100    |30     |320            

Kettering           |1,450  |140    |50     |350            

Northampton         |2,110  |150    |60     |580            

Oxfordshire         |3,990  |240    |110    |1,240          

                    |-------|-------|-------|-------        

Regional total      |15,850 |1,230  |420    |6,150          


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September 1991                                                                                                     

                    |Nursing           |Midwifery         |Management        |Administration and                   

                                                                             |clerical                             

-------------------------------------------------------------------------------------------------------------------

Oxford HQ and units |70                |0                 |-                 |-                                    

East Berkshire      |2,290             |220               |-                 |-                                    

West Berkshire      |2,310             |170               |-                 |-                                    

Aylesbury Vale      |1,480             |70                |-                 |-                                    

Wycombe             |1,270             |130               |-                 |-                                    

Milton Keynes       |800               |90                |-                 |-                                    

Kettering           |1,460             |140               |-                 |-                                    

Northampton         |2,000             |130               |-                 |-                                    

Oxfordshire         |3,950             |260               |-                 |-                                    

                    |-------           |-------           |-------           |-------                              

Regional total      |15,620            |1,200             |520               |4,930                                

Note: In 1991 there has been a shift of Nursing and Midwifery staff from West Berkshire district health authority  

to East Berkshire district health authority due to the reallocation of Berkshire College of Nursing and Midwifery, 

Wexham park hospital from West to East Berkshire.                                                                  

Environmental Health Prosecutions

Mr. Clifton-Brown : To ask the Secretary of State for Health how many prosecutions were brought by environmental health officers in each of the last five years ; and what percentage of (a) cases and (b) contested cases resulted in convictions.

Mr. Sackville : Information prior to 1991 is not held centrally. During 1991, environmental health officers brought 1,143 prosecutions in connection with hygiene and microbiological contamination. In addition, there were 691 prosecutions relating to chemical contamination and extraneous matter, some of which related to food safety and some to quality. The available information does not show whether cases were successful or contested.

Tobacco Advertising

Mr. Llwyd : To ask the Secretary of State for Health how many representations she has received on the subject of continued tobacco advertising ; and if she will make a statement.


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Dr. Mawhinney : I have received a number of representations. The Government will consider all representations received in keeping under review the need for further action to achieve the ambitious targets for reducing smoking set out in the "Health of the Nation".

HIV (Therapy)

Mr. Chris Smith : To ask the Secretary of State for Health what monitoring her Department is undertaking on the use of combination therapy of AXT, DDI and Pyridinone for the treatment of HIV infection, as currently being tested in the United States ; whether she envisages any trial use being made available in the United Kingdom ; and if she will make a statement.

Mr. Sackville : We do not ourselves carry out clinical trials for HIV infection. This is the responsibility of the Medical Research Council. The Department does have an influence on the research programme through a concordat with the MRC.

Recently, there have been reports from the United States that resistance developed to the drugs AZT, DDI and pyridinones renders HIV non-viable. It has been suggested that combination therapy with these three drugs


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may be an effective treatment for HIV disease. The MRC AIDS therapeutic trials committee, on which the Department of Health is represented, has identified combination therapy as one of a number of priority areas for further research.

So far all the evidence supporting use of this combination of drugs comes from laboratory studies. We do not know what the clinical significance will be. Unfortunately many therapies which are promising in the test tube do not give the hoped-for benefits to patients.

Surgery (Waiting Times)

Sir Thomas Arnold : To ask the Secretary of State for Health what is the current average waiting period for (a) all operations, (b) cataract surgery, or the specialty within which such surgery falls and (c) hip replacement surgery, or the specialty within which such surgery falls ; and what information is available as to the proportion of all people waiting for operations who are aged over 65 years.

Mr. Sackville : Waiting time information by specialty is published in "Hospital Waiting Lists, In-Patients and Day cases", a copy of which is in the Library. Waiting time information on individual conditions and by age of patients is not held centrally.

Out-patient Appointments

Dr. Lynne Jones : To ask the Secretary of State for Health if she will introduce a system to limit waiting times for out-patient appointments.

Mr. Sackville : Under the patients charter, health authorities already set and publish local charter standards for first out-patient appointments, and from 1993-94 regional health authorities will set targets in their corporate contracts for local improvements.

Children (State Care)

Ms. Mowlam : To ask the Secretary of State for Health if she will calculate the cost to the Exchequer of a child placed in the care of the state, from birth to the age of majority, at current prices.

Mr. Yeo : The information available represents the average weekly unit costs to local authorities for children of all ages for various placements. The latest average figures for English authorities, published in "Children in Care ; England and Wales ; year ending 31 March 1991", are £102 per week for a foster placement, £536 per week for a community home placement and £943 for a registered voluntary homes placement. These averages represent the gross "direct costs". The costs of field social work support are excluded as are the charges which local authorities may recover for children accommodated by them. Information is not currently available about the placement histories of children looked after since birth.

Salmonellosis

Mrs. Currie : To ask the Secretary of State for Health if she will list the number of death certificates on which salmonellosis is shown (a) as the main cause of death and (b) as a subsidiary cause of death, for the last five years.

Mr. Sackville : The number of deaths, main cause and subsidiary, from salmonella infections, other than typhoid


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and paratyphoid fevers, ICD 003 in England and Wales, for the last five years for which figures are available are shown in the table.


           |Main cause|Subsidiary           

--------------------------------------------

1987       |52        |23                   

1988       |58        |36                   

1989       |61        |23                   

1990       |68        |28                   

1991       |62        |26                   

<1> Excluding neonatal deaths (0 to 27      

days).                                      

Heart Disease

Mr. Llwyd : To ask the Secretary of State for Health what is the latest estimate of the annual cost of treatment for coronary heart disease ; and if she will make a statement.

Mr. Sackville : This information is not routinely collected centrally. The latest year for which figures are held is 1989-90. We estimate that in that year £540 million was spent on all forms of treatment of coronary heart disease in the national health service.

Homoeopathic Hospitals

Ms. Primarolo : To ask the Secretary of State for Health how much money was spent on each of the five homoeopathic hospitals in each year since 1990-91; and what changes in funding are planned following EC directive 92/73/EEC of 22 September 1992.

Mr. Sackville : This information is not held centrally.

Northwick Park Hospital

Dr. Lynne Jones : To ask the Secretary of State for Health, pursuant to her answer of 17 February, Official Report, columns 204-5, what instructions she has given to doctors at Northwick Park Hospital Trust about involving patients or their general practitioners in discussions about contractual issues.

Dr. Mawhinney : The national health service executive has issued further guidance to the NHS about involving general practitioners and other clinicians in the contracting process under cover of EL(93)10 "Managing activity and change through contracting", copies of which are available in the Library.

Green Agenda

Ms. Primarolo : To ask the Secretary of State for Health if she will make a statement on the guidelines and targets set for the implementation of the May 1991 DOH green agenda in respect of (a) exploiting the NHS's purchasing power by specifying environmentally friendly products, (b) using contracting to create healthier environments, (c) producing a smoking policy manual, (d) saving 15 per cent. on energy over five years and (e) changing to unleaded fuel throughout the national health service by 1992- 93.

Mr. Sackville : The National Health Service Supplies

Authority--NHSSA--is responsible for procurement matters for the NHS. It is a customer-driven organisation and responds to its customers' requirements, which are


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increasingly for environmentally friendly products. This is taken into account when procuring products and NHSSA is in the process of developing a policy, in partnership with customers and suppliers, to encourage wider usage of "green" products throughout the NHS. In October 1992, guidance was issued to ensure that all sales of tobacco on NHS premises were stopped by the end of 1992, except to long-stay patients who are smokers, and to ensure that, by 31 May 1993, the NHS is smoke-free except for limited necessary provision of separate smoking rooms. A booklet of good practice in implementing smoking policies was issued jointly by the Department and the Health Education Authority. A copy is available in the Library.

In line with the Government-wide target, health authorities are set an overall target for reducing energy consumption by 15 per cent. over the five years from 1991-92. Guidance and advice has been issued to the NHS on options for attaining this reduction. The NHS management executive is monitoring progress towards its achievement. Ambulance services, the main users of petrol within the NHS, are phasing out the use of leaded petrol in their fleets as part of their vehicle replacement programmes. This allows resources to be managed effectively and provides for the further option of diesel-powered vehicles.

Regional Health Authority Staff

Mr. Gill : To ask the Secretary of State for Health if she will list the number of staff employed in each of the regional health authority offices.

Dr. Mawhinney : The numbers of staff employed by regional health authorities--RHAs--are not directly comparable as some centrally manage NHS Supplies, blood transfusion, and ambulance services, as well as directly employing consultants and registrars for the health service in their region. Excluding these centrally maintained functions, we estimate a total of some 7,850 whole-time equivalent staff were employed by RHAs on 1 July 1992 or an average of 560 staff each. The number of each RHA is in the table :


                  |Number       

--------------------------------

Northern          |656          

Yorkshire         |518          

Trent             |509          

East Anglian      |292          

North West Thames |361          

North East Thames |580          

South East Thames |604          

South West Thames |611          

Wessex            |331          

Oxford            |567          

South Western     |559          

West Midlands     |1,168        

Mersey            |313          

North Western     |785          

                                

                  |---          

Total             |7,854        

                  |---          


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Home Helps

Mrs. Anne Campbell : To ask the Secretary of State for Health (1) what were the costs per hour of the home help or home care service in Cambridgeshire in each year since 1984, expressed both in actual prices and 1987 prices ;

(2) what were the total numbers of home help or home care hours provided in Cambridgeshire in each year since 1984 ; and, for each year and what were the average numbers of hours per user and per pensioner resident in the county for each year.

Mr. Yeo : The information is not held centrally. The numbers of clients, hours of service received by them and costs per hour of service are included in "Personal Social Services Statistics--Actuals" published annually by the Chartered Institute of Public Finance and Accountancy. Several items of the CIPFA data, including hourly costs, are reproduced in "Key Indicators of Local Authority Services" published by the Department of Health. Copies of these publications covering the years up to 1990-91 are in the Library.

Fluoridation

Sir Ivan Lawrence : To ask the Secretary of State for Health what representations she has received from local authorities about the proposed addition of fluoride to the North Yorkshire drinking water supply ; and whether she will make a statement.

Dr. Mawhinney : None.

Human Tissue Tests

Mr. Cohen : To ask the Secretary of State for Health what requirements there are for pharmaceutical companies to carry out human tissue tests in vitro prior to marketing their products.

Dr. Mawhinney : None. The requirement is for adequate and appropriate pharmacological and toxicological testing of proposed medicinal products before trials of such products in human subjects and before eventual marketing.

Certain accepted safety tests that are performed routinely on potential new medicines do use human cells in vitro to achieve their results. Other tests necessitate the use of animal models to reassure on safety issues, but research continues in order to ascertain whether in vitro tests could become valid substitutes.

Care Homes

Mrs. Anne Campbell : To ask the Secretary of State for Health what were the numbers of places in local authority residential homes for the elderly in Cambridgeshire in each year since 1984.

Mr. Yeo : The table shows the total number of places in local authority staffed homes in Cambridgeshire reported as being primarily for elderly people form 1987 onwards. Similar information is not available for earlier years or unstaffed homes.


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Number of places in local authority staffed homes  

for elderly people                                 

Cambridgeshire                                     

1987-92                                            

As at 31 March   |Number of places                 

---------------------------------------------------

1987             |1,358                            

1988             |1,344                            

1989             |1,297                            

1990             |1,249                            

1991             |1,259                            

1992             |1,150                            

Mrs. Anne Campbell : To ask the Secretary of State for Health what was the average age of people admitted to local authority residential homes for the elderly in Cambridgeshire in each year since 1984.

Mr. Yeo : Information is collected centrally in age bands. The table shows the number of admissions, by age band, to local authority staffed homes in Cambridgeshire reported as being primarily for elderly people, from 1987 onwards. Similar information is not available for earlier years or unstaffed homes.


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Number of admissions to local authority staffed homes for elderly                                                      

people by age-band                                                                                                     

Cambridgeshire 1987-92                                                                                                 

                  Age-band on                                                                                          

                  admission                                                                                            

Year to 31 March |Under 65        |65-74           |75-84           |85 and over     |Total                            

-----------------------------------------------------------------------------------------------------------------------

1987             |23              |160             |517             |576             |1,276                            

1988             |45              |255             |992             |797             |2,089                            

1989             |55              |257             |808             |814             |1,934                            

1990             |32              |221             |1,021           |875             |2,149                            

1991             |43              |311             |929             |1,176           |2,459                            

1992             |51              |284             |1,027           |1,077           |2,439                            

Children (Unnatural Deaths)

Mr. Peter Bottomley : To ask the Secretary of State for Health if she will estimate the number and main causes of unnatural deaths of two- year-olds each year since 1981.

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


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Unnatural deaths of two year olds in England and Wales from 1981 to 1990                                                                                                                                                                                                                                                                                                                                                                                                            

ICD number                                                               Year                                                                                                                                                                                                                                                                                                                                                                                                       

                                                                        |1981                               |1982                               |1983                               |1984                               |1985                               |1986                               |1987                               |1988                               |1989                               |1990                                                                   

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

001-E999                            |All causes                         |299                                |289                                |284                                |243                                |278                                |259                                |274                                |272                                |268                                |239                                                                    

E800-E999                           |External causes of injury and                                                                                                                                                                                                                                                                                                                                                                                                                  

                                    |poisoning                          |81                                 |81                                 |75                                 |75                                 |69                                 |56                                 |70                                 |64                                 |73                                 |64                                                                     

E800-E807                           |Railway accidents                  |1                                  |0                                  |0                                  |1                                  |1                                  |0                                  |0                                  |0                                  |0                                  |1                                                                      

E810-E819                           |Motor vehicle traffic accidents    |10                                 |29                                 |21                                 |20                                 |11                                 |14                                 |26                                 |20                                 |20                                 |19                                                                     

E820-E829                           |Other vehicle accidents            |0                                  |1                                  |2                                  |0                                  |1                                  |0                                  |0                                  |0                                  |2                                  |1                                                                      

E830-E848                           |Water, air and space transport                                                                                                                                                                                                                                                                                                                                                                                                                 

                                    |accidents and vehicle accidents                                                                                                                                                                                                                                                                                                                                                                                                                

                                    |not elsewhere classifiable         |1                                  |0                                  |0                                  |0                                  |0                                  |0                                  |1                                  |0                                  |1                                  |0                                                                      

E850-E869                           |Accidental poisoning by drugs,                                                                                                                                                                                                                                                                                                                                                                                                                 

                                    |medicaments, biologicals, other                                                                                                                                                                                                                                                                                                                                                                                                                

                                    |solid and liquid substances, gases                                                                                                                                                                                                                                                                                                                                                                                                             

                                    |and vapours                        |3                                  |1                                  |2                                  |1                                  |0                                  |1                                  |2                                  |1                                  |1                                  |0                                                                      

E870-E879                           |Misadventure during medical                                                                                                                                                                                                                                                                                                                                                                                                                    

                                    |care, abnormal reactions, late                                                                                                                                                                                                                                                                                                                                                                                                                 

                                    |complications                      |0                                  |0                                  |1                                  |0                                  |1                                  |0                                  |0                                  |0                                  |0                                  |0                                                                      

E880-E888                           |Accidental falls                   |10                                 |4                                  |6                                  |8                                  |1                                  |4                                  |4                                  |1                                  |0                                  |2                                                                      

E890-E899                           |Accidents caused by fire and                                                                                                                                                                                                                                                                                                                                                                                                                   

                                    |flames                             |18                                 |8                                  |17                                 |19                                 |17                                 |20                                 |9                                  |15                                 |20                                 |15                                                                     

E900-E929                           |Other accidents including late                                                                                                                                                                                                                                                                                                                                                                                                                 

                                    |effects                            |30                                 |27                                 |13                                 |13                                 |28                                 |13                                 |18                                 |14                                 |17                                 |16                                                                     

E960-E969                           |Homicide and injury purposely                                                                                                                                                                                                                                                                                                                                                                                                                  

                                    |inflicted by other person          |1                                  |6                                  |7                                  |7                                  |5                                  |3                                  |7                                  |4                                  |2                                  |6                                                                      

E980-E989                           |Injury undetermined whether                                                                                                                                                                                                                                                                                                                                                                                                                    

                                    |accidentally or purposely inflicted|7                                  |5                                  |6                                  |6                                  |4                                  |1                                  |3                                  |9                                  |10                                 |4                                                                      

Myelograms

Mr. Barry Field : To ask the Secretary of State for Health what plans she has to issue new guidelines about myelograms.

Mr. Sackville : I have no plans to issue guidelines.


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Hospital Shops (Cigarettes)

Ms. Primarolo : To ask the Secretary of State for Health what surveys have been conducted as to the number or estimated percentage of hospital shops that sell cigarettes.

Mr. Sackville : Guidance was issued to all national health service authorities and provider units in October


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1992 requiring them to stop the sale of all tobacco on NHS premises, except to long-stay patients who are smokers, by 31 December 1992. No surveys have been conducted and implementation is being monitored through normal management arrangements.

Primary Health Care Forum

Mr. Paice : To ask the Secretary of State for Health, pursuant to her oral statement on 16 February, Official Report, columns 133-37, on the national health service in London, if she will list the membership of the Primary Health Care Forum ; and if she will make a statement.

Dr. Mawhinney : The Primary Health Care Forum will be the engine for change and improvement for primary care in London. Its members come from a variety of backgrounds, but common to all is their work in helping to stimulate and develop high quality primary and community services. This blend of experience will provide a sharp focus on the problems in the capital. Their task is crucial if the health care of Londoners is to improve as they and we would wish. The Primary Health Care Forum members are :

Mr. Tim Chessells (Chairman), Chairman of the London Implementation Group.

Mr. Gerry Green, Regional General Manager, South East Thames and regional general manager lead on primary care.

Mrs. Ainna Fawcett-Henesy, Regional Nursing Oficer, South East Thames on secondment to LIG.

Professor Lesley Southgate, Professor of General Practice and Primary Care, St. Bartholomew's Hospital.

Ms. Hilary Scott, General Manager, Enfield and Haringey FHSA. Dr. Peter Skolar, an inner London GP and Chairman of Camden and Islington Local Medical Committee.

Ms. Jean Rowe, Nurse Manager, Hillingdon Community Health Trust. Mr. Geoff Shepherd, Chief Executive, Redbridge and Waltham Forrest DHA.

Dr. Rod Smith, GP fundholder, Caversham, Berkshire.

Dr. Sian Griffiths, Regional Director of Public Health, South West Thames RHA.

Mr. Terry Bamford, Director of Social Services, Kensington and Chelsea.

Dr. Jo Ivey Boufford, Director, King's Fund College.

Ms. Rosemary Glanville, Director of Medical Architecture Research Unit, University of North London and Non-Executive Director, West Lambeth Community Health Care Trust.

Mr. Jack Barnes, Health Care Directorate, NHS Management Executive.

Drug and Alcohol Abuse

Mr. Andrew Smith : To ask the Secretary of State for Health what statutory directions have been issued to local authorities to ensure that the needs of those with drug and alcohol problems are fairly considered under care in the community.

Mr. Yeo : The whole of the community care special transitional grant, which will be made available to local authorities, has been ring fenced to protect the funding of the entire range of community care services, including those for drug and alcohol misusers. The grant will reflect existing levels of provision in the alcohol and drug field. We have not, therefore, issued separate statutory directions on the distribution of these funds in respect of alcohol and drug misuse services. Statutory directions have, however, been issued to support payment of £3.3 million to enable local authorities to further develop


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voluntary sector services for those with alcohol and drug problems. We have also issued special guidance to local authorities in recognition of the particular challenge they face in meeting the needs of alcohol and drug misusers from 1 April 1993.

Teleconference Costs

Mr. Blunkett : To ask the Secretary of State for Health what was the cost of the primary care charter teleconference she held on Monday 22 February.

Dr. Mawhinney : A total of £53,217.92 including VAT.

Juvenile Offenders

Mr. Tipping : To ask the Secretary of State for Health what research her Department has commissioned into the effectiveness of residential care and secure residential care for juvenile offenders.

Mr. Yeo [holding answer 2 March 1993] : The following research projects commissioned by the Department include examination of the effectiveness of residential care for all children including juvenile offenders.

1. Dartington Social Research Unit--Locking up chil-dren : secure provision within the child care system

1978

2. Professor Timms/Professor Harris, University of

Leicester--Between hospital and prison or thereabouts : a study of the implementation of the secure accommodation regulations

1987

3. Dartington Social Research Unit--The experiences and careers of young people leaving youth treatment centres

1989

4. Dartington Social Research Unit--Alternative care careers : the experience of very difficult adolescents outside youth treatment centre provision

1989

5. Dartington Social Research Unit--Follow-up of young people from youth treatment centres

1993

6. Professor Bottoms/Professor Knapp, University of Cambridge and University of Kent--Evaluation of the effectiveness of intermediate treatment

1993

7. Professor Whitaker, University of York--culture and staff dynamics in children's homes

Commissioned : 1992

8. Professor Sinclair--The role and quality of residential care Commissioned : 1993

9. Dartington Social Research Unit--Factors and processes associated with positive outcomes for troubled adolescents

Commissioned : 1993

Copies of projects 1 to 4 are available in the Library. Copies of projects 5 to 9 are not yet available. Copies will be placed in the Library.


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