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Mr. Galloway : To ask the Secretary of State for Health how many (a) civil servants within her Department, (b) consultants sitting upon any of the advisory committees since 1977 or (c) other individuals involved organisationally in the Concorde trials have received money in royalties or grants, or had career positions, or directorships or consultancies, with the Wellcome Foundation, the Wellcome Trust or any of the Wellcome Foundation's subsidiary companies.
Dr Mawhinney : No civil servants within the Department have received money in any form from the Wellcome Foundation or the Wellcome Trust. Membership of the Committee on Safety of Medicines is published in the Medicines Commission annual report, which includes a comprehensive list of members' interests in the pharmaceutical industry. Information is not available for outside experts who sit on other Departmental advisory committees. The Concorde trial
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was organised by the Medical Research Council, which receives its grant-in-aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster.Mr. Galloway : To ask the Secretary of State for Health if she will place in the Library the full results of the Concorde trials ; and if she will make a statement on the results.
Mr. Jackson : I have been asked to reply.
The full report of the trial is still in preparation and is due to be published within the next few months. A copy of the letter to The Lancet summarising the preliminary results is available in the Library.
Mr. Galloway : To ask the Secretary of State for Health is she will place in the Library all the relevant research data prior to the start of the Concorde trials in 1988, which showed that AZT was of benefit to HIV antibody positive asymptomatic individuals.
Mr. Robert Jackson : I have been asked to reply.
Prior to the start of the Concorde trial one paper had been published which indicated a potential benefit of AZT treatment in asymptomatic HIV-infected individuals, and this reported data on a very small number of subjects. A copy is available in the Library. (Lancet (i) 1988 : pages373-376).
Mr. Galloway : To ask the Secretary of State for Health what arrangements are being made for those Concorde trial subjects who were given the drug AZT : how many are still being prescribed the drug ; and who is bearing the cost.
Mr. Robert Jackson : I have been asked to reply.
All patients in the Concorde trial will have the opportunity to discuss their future treatment with their doctors in the light of the results of the trial and their own clinical status and will be told whether they received AZT or placebo during the blinded phase of the trial, if they wish to know. For those deciding to continue treatment with AZT and who fall within the currently licensed indications, the cost of the drug will be met by the national health service. There is no information available on the number of patients still being prescribed the drug.
Mr. Galloway : To ask the Secretary of State for Health when the Concorde trials relating to AZT were completed ; when the results were announced ; and if she will make a statement about the way in which the preliminary results were announced.
Mr. Robert Jackson : I have been asked to reply.
Analysis of the data from the Concorde trial collected up to 31 December 1992 was completed in March 1993 ; limited follow-up information will continue to be collected on the patients, in an unblinded fashion, so the trial is not completely finished. Preliminary results were published in a letter to The Lancet on 2 April 1993, having been announced to doctors and other staff involved with the trials at partie to an international readership in a preliminary report through the scientific press as soon as possible, to avoid the spread of inaccurate rumours among patients and their doctors.
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Pegasus Drug Abuse Project
Mr. Gapes : To ask the Secretary of State for Health what is the current state of plans for the Pegasus drug abuse project proposed by the North East Thames regional health authority.
Dr. Mawhinney : An application for funding for the Pegasus project proposal was considered recently by North East Thames regional health authority and the hon. Member may wish to contact the chairman, Sir William Staveley, for details. An application was also made to the Department of Health by the Association for the Prevention of Addiction under section 64 of the Health Services and Public Health Act 1968. This was unsuccessful.
Children in Care
Lady Olga Maitland : To ask the Secretary of State for Health what plans she has to ensure that children who might abscond while in care are properly escorted while outside the home.
Mr. Yeo : Advice on physical intervention to prevent a detained child from running away from an open children's home, or while being escorted outside a secure accommodation care unit, is included in the guidance on permissible forms of control in children's residential care published by the Department on 28 April 1993. It is the responsibility of management to interpret this guidance and develop policies and procedures within which to operate. A copy of the guidance is available in the Library.
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Back Pain
Mr. David Atkinson : To ask the Secretary of State for Health when she expects to receive the report from her Department's clinical standards advisory committee inquiry into back pain; and if she will make a statement.
Mr. Sackville : The group expects to report in the summer of 1994 to my right hon. Friend the Secretary of State, my right hon. Friends the Secretaries of State for Wales and Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland. Clinical standards advisory group reports are normally published along with a Government response within three months of receipt.
Male Circumcision
Mr. Bennett : To ask the Secretary of State for Health what was the cost to the NHS of male circumcision operations in the last 15 years for which figures are available; and what was the cost of comparable operations in the private sector.
Mr. Sackville : This information is not available centrally.
GP Fund Holders
Mrs. Jane Kennedy : To ask the Secretary of State for Health if she will list for each district health authority within the Mersey region the total number of (a) general practitioners and medical practices and (b) general practitioners and medical practices that are fund holders.
Dr. Mawhinney : The information available is shown in the table.
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FHSA |Number of GPs |Number of medical|Number of |Number of
|practices |fundholding |fundholding GPs
|practices
------------------------------------------------------------------------------------------------------------------
Cheshire |512 |143 |47 |236
Liverpool |240 |104 |18 |54
St. Helens and Knowsley |176 |76 |12 |40
Sefton |141 |55 |13 |52
Wirral |178 |68 |11 |41
|------- |------- |------- |-------
Total for Mersey RHA |1,247 |446 |101 |423
Information on GP numbers is collected by family health services authorities; the data are for 1 October 1992.
Fundholding figures are for 30April 1993.
Complaints (Evidence)
Mr. Boyce : To ask the Secretary of State for Health, pursuant to her answer of 22 April, Official Report, column 169, what action she takes to ensure that evidence presented to her by the Medical Advisory Committee is complete ; and by what process a complainant may raise objections to the material before the committee.
Dr. Mawhinney : The Medical Advisory Committee gives advice to my right hon. Friend the Secretary of State on any penalty which should be imposed on a general practitioner who has been found in breach of his terms of service. There is no provision under the regulations for the involvement of the complainant in this consideration.
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Drugs
Mrs. Lait : To ask the Secretary of State for Health, pursuant to her answer of 22 April, Official Report, column 169, how many of the preparations listed as drugs acting on the skin (a) do not require a product licence under the Medicines Act 1968, (b) are available for purchase without a doctor's prescription at pharmacies and other retail outlets and (c) attracted fewer than 20prescriptions a year met by the NHS in each of the years 1990, 1991 and 1992.
Dr. Mawhinney : The number of products within this list which attracted fewer than 20 prescriptions was 788 in 1991 and 822 in 1992 ; figures for 1990 are not available. The remaining information could be provided only at disproportionate cost.
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Health Centres
Mr. Stern : To ask the Secretary of State for Health when she expects to announce the results of the working group on the financing of health centres.
Dr. Mawhinney : We intend to announce the results, and our proposals, shortly.
Dementia
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health whether dementia is included within the ambit of the specific grant for mental illness.
Home Care Services
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she will make it her policy to bring forward legislation to enforce the registration and inspection of private individual home care services.
Mr. Yeo : We have no plans to do so.
Junior Doctors
Ms Primarolo : To ask the Secretary of State for Health if she will give average figures for (a) hours contracted, (b) duty hours and (c) hours on feet of junior hospital doctors in each year since 1971.
Dr. Mawhinney : Information on the average contracted hours of junior hospital doctors and dentists, at 30September for each year, is as follows :
|Hours
------------------------------------------------------
1971-1975 |Not available
1976 |92
1977 |91
1978 |90
1979 |90
1980 |89
1981 |89
1982 |88
1983 |87
1984 |86
1985 |85
1986 |85
1987 |82
1988 |81
1989 |81
1990 |79
1991 |79
1992 |Not yet available
Information on duty hours and on "hours on feet" is
not available centrally.
NHS Management Review
Mr. Congdon : To ask the Secretary of State for Health if she will announce the terms of reference and membership of the NHS management functions and manpower review ; and if she will make a statement.
Mrs. Virginia Bottomley : The continuing development of the national health service reforms requires the structure of the NHS above the level of local purchasers and providers to be examined. I have set up a review to
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consider what management processes and organisational structures will best deliver measurable improvements in health and effective and efficient services, through the operation of the NHS internal market, while minimising management costs and ensuring proper public accountability. I have asked the review team to complete its work in July.The review team's terms of reference are as follows :
1. To carry out an organisational analysis of the main work and functions required to :
Ensure that the Government's reforms of the NHS are fully effected.
Ensure effective oversight of purchasers and providers operating in the NHS internal market.
Ensure that the Secretary of State is able to discharge her statutory responsibilities for the management of the NHS. Ensure that the proportion of NHS expenditure devoted to direct patient care is maximised.
2. In the light of the above :
To determine the statutory responsibilities and the core functions which must continue to be discharged by bodies which are part of, or directly accountable to, central Government.
To make recommendations on the organisational structure required for this.
To consider possible future changes to the configuration of NHS purchasers- -including DHA mergers, joint DHA/FHSA working and the development of the GP Fundholding scheme.
To make recommendations on the discharge of other essential functions, e.g., Estates Management and Information Management and Technology.
To determine the financial and manpower consequences, for the NHS and the Department of Health (including the NHSME), of conclusions reached.
3. The review team should take particular account of :
The need to achieve a balance between the benefits of decentralisation and the essential requirements of public accountability.
The need for an internally consistent regulatory framework to support the operation and development of the internal market. The need for the development of effective purchasing in the NHS. The conclusions of the Cadbury Report on corporate governance. Ms Kate Jenkins, a member of the NHS policy board, will chair the review's steering group and lead the review team itself. The other members of the review team are :
Mr. Alan Langlands --(Deputy Chief Executive, NHS Management Executive)
Mr. Peter Griffiths --(Formerly Chief Executive, Guy's NHS Trust) Mr. Ian Carruthers --(Chief Executive, Dorset Health Commission) Mr. John Sherring --(Regional Director--West Midlands, Audit Commission)
Dr. Carol Propper --(NHS Management Executive on secondment from University of Bristol)
Members of the review team providing professional advice on specific areas are :
Professor Andrew Pettigrew --(Centre for Corporate Strategy and Change, Warwick Business School, University of Warwick)
Dr. Graham Winyard --(Medical Director, NHS Management Executive) Mrs. Sue Williams --(Deputy Director of Nursing, NHS Management Executive)
Other sources of professional advice will be identified as necessary.
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Clinical Services
Mr. Nigel Evans : To ask the Secretary of State for Health what is her Department's policy on the use, by health authorities or trusts, when all other clinical indicators are equal, of age as a criterion for access to clinical services.
Dr. Mawhinney : It is the responsibility of clinicians to establish the need for and priority of medical treatment.
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SCOTLAND
Piers
Mrs. Ray Michie : To ask the Secretary of State for Scotland, pursuant to his answer of 29 April, Official Report, columns 538-39, if he will give a full breakdown of the cost of adapting the piers at Kennacraig, Port Ellen and Port Askaig per agency involved in the project.
Lord James Douglas-Hamilton : The breakdown of the estimated cost of adapting the piers at Kennacraig, Port Ellen and Port Askaig by source of funding is as follows :
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|Caledonian MacBrayne|Scottish Office |European Regional
|Ltd. |Development Fund
---------------------------------------------------------------------------------------------------------
Kennacraig |299,000 |161,000 |120,000
Port Ellen |10,000 |- |-
Port Askaig |70,000 |- |-
|------- |------- |-------
|379,000 |161,000 |120,000
Council House Sales
Mr. Home Robertson : To ask the Secretary of State for Scotland, pursuant to his answer of 18 March, Official Report, column 383, if he will now make a statement on the evidence that he has received from East Lothian district council on 18 February, and also on 26 April, about abuses of the right to buy council houses with discounts ; and if he will introduce amendments to the Housing (Scotland) Act 1987 to prevent such abuses.
Lord James Douglas-Hamilton : My right hon. Friend has considered the information provided by East Lothian district council about certain right-to-buy sales in East Lothian. Our conclusion on the basis of this information is that it does not appear that anything has happened which is contrary to the right-to-buy provisions in the Housing (Scotland) Act 1987.
Tenants who are buying their homes should be free to make whatever financial arrangements they think desirable to suit their particular circumstances. A tenant who has bought a house is also free to dispose of it as he or she wishes, subject to the provisions for the repayment of discount if the disposal takes place within three years. We do not propose to amend the legislation to constrain these freedoms.
It is important that tenants should understand the financial implications of any agreement they might enter into. It is advisable for tenants to take independent legal advice before entering into any agreement, and we will emphasise this in revising the leaflet "Buy Your Home" later this year.
Forestry
Mr. Chris Smith : To ask the Secretary of State for Scotland, pursuant to his answer of 20 April, Official Report, columns 89-90, if he will give biographical details of the members of the forestry review group.
Sir Hector Monro : All the members of the forestry review group are serving civil servants and have responsibilities, knowledge and experience, relevant to its remit and work. I see no benefit in publishing further biographical details.
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Mr. Chris Smith : To ask the Secretary of State for Scotland what steps he is taking to ensure that the work of the forestry review group does not jeopardise the Forestry Commission's existing policy and practice of allowing free public access to its land.
Sir Hector Monro : The remit of the forestry review group expressly includes the request that it should make proposals for changes which would improve the effectiveness of the delivery of the Government's forestry policy objectives, having regard to the Government's other economic and environmental policies.
Such objectives and policies clearly include the Forestry Commission's practice of encouraging public access to woodlands as stated in its "Forestry Policy for Great Britain", copies of which are in the Library.
Mr. Chris Smith : To ask the Secretary of State for Scotland how many individual Forestry Commission land holdings there are.
Sir Hector Monro : It is estimated that there are about 5,000 individual Forestry Commission land holdings, excluding individual housing plots and other small areas.
Mr. Chris Smith : To ask the Secretary of State for Scotland if he will estimate the total amount of public expenditure generated since 1981 by former Forestry Commission land passing into the private sector and becoming eligible for agricultural grants and subsidies.
Sir Hector Monro : The amount of public expenditure generated in these circumstances has been negligible.
Woodlands sold by the commission are rarely converted to agricultural use as, under the felling licensing procedures, there is a general presumption against this. Existing agricultural land sold by the commission will normally have been attracting agricultural grants and subsidies before sale.
Mr. Chris Smith : To ask the Secretary of State for Scotland if he will list (a) the total area of land disposed of, (b) the number of individual sales, (c) the income generated by the sales, (d) the total area of land disposed of over which public access has been formally protected and (e) the number of individual access agreements made on land disposed of, regarding land disposed of by the Forestry Commission since 1981.
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Sir Hector Monro [holding answer 11 May 1993] : Between 27 July 1981 and 31 March 1993, the Forestry Commission sold 173,000 hectares of land, including woodlands and other land such as agricultural land and residential properties.
The sales included over 2,000 individual areas of forest land which are identified in lists held in the Library of the House ; no central record is kept of the number of sales of agricultural land and residential properties.
The total income from all sales was £174 million.
The arrangements for securing continued public access to commission woodlands after sale, by way of prior agreements entered into between the Commission and local authorities, were introduced in October 1991. Most of the sales concluded since then were too far advanced in October 1991 to be considered for an access agreement, while most of the areas brought forward for disposal since that date have still to be sold. Access agreements have now been made with local authorities for five areas of commission land, one of which, covering 21 hectares, has been sold.
Mr. Chris Smith : To ask the Secretary of State for Scotland, pursuant to his answer of 20 April, Official Report, columns 89-90 , what steps he has taken, or proposes to take, to publicise the name and address of the secretary to the forestry review group ; and if he intends to encourage or invite the submission of expert evidence to the group from outside.
Sir Hector Monro [holding answer 11 May 1993] : Many individuals and organisations have already submitted useful comments and thoughts to the secretary to the forestry review group, whose name and address have been given coverage in the Official Report and the media. Further submissions will continue to be welcomed and, as the work of the group progresses, there may be issues on which specific comment is invited ; publicity will be arranged for these, as appropriate.
Mr. Chris Smith : To ask the Secretary of State for Scotland, pursuant to his answer of 17 March, Official Report, columns 276-78, to the hon. Member for Glanford and Scunthorpe (Mr. Morley), if he will place in the Library a list by county and region of Forestry Commission land holdings greater than 1,000 hectares, giving the name, location and area.
Sir Hector Monro [holding answer 21 April 1993] : The Forestry Commission is preparing a list of its landholdings greater than 1,000 hectares and I shall arrange for the hon. Member to receive a copy as soon as possible and for further copies to be placed in the Library.
Cockburnspath Bypass
Mr. Kirkwood : To ask the Secretary of State for Scotland when he expects to receive the Strathclyde university study monitoring the wind levels over the newly
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constructed Cockburnspath bypass ; and if he will make it his policy to publish the results when they are known in full.Lord James Douglas-Hamilton [holding answer 10 May 1993] : The report of the Strathclyde university study of wind speeds on the new Cockburnspath bypass is expected to be submitted by the end of this year. The results will be made public.
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