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Ms Primarolo : To answer the Secretary of State for Health, pursuant to her answer of 23 June, Official Report, column 177 if she will make a statement outlining the existing advocacy role of hospital doctors.
Dr. Mawhinney : The hospital doctor's role is to provide effective health care for each of the patients entrusted to his or her care taking account of available resources.
Mr. Chris Smith : To ask the Secretary of State for Health (1) what information is available to her Department about the numbers and circumstances of children who are indirectly affected by HIV and AIDS because their parents or carers are infected with the virus ; and what assessment her Department has made of the extent of support likely to be required for the children if they cannot be cared for by their parent or parents ;
(2) what guidance she has issued as to the information on which social services departments should base their plans for the support or provision of care for children who are indirectly affected by HIV or AIDS because of the illness of their parents or carers.
Mr. Sackville : So far as numbers of children indirectly affected by HIV are concerned, I refer the hon. Member to the reply I gave him on 12 July 1993, at column 378.
The Children Act 1989 and the guidance and regulations associated with it set out local authorities' duties towards children in need. For services for children both infected and affected by HIV or AIDS this is supplemented by "Children and HIV" which gives detailed guidance to local authorities to assist them in planning and providing services. The guidance encourages HIV awareness amongst service providers, and describes good practice.
The Children Act and associated guidance and regulations provide a policy framework through which local authorities, in collaboration with other agencies, can develop comprehensive plans for all children in need in their locality.
Copies of these documents will be placed in the Library.
Mr. Kevin Hughes : To ask the Secretary of State for Health what was the number of emergency admissions to hospitals in each health authority in England in 1990-91.
Mr. Sackville : The information from the hospital episodes statistics is not yet available. The collection of the management information on non-elective admissions in the general and acute specialties given in my reply to the hon. Member on 28 June at col. 352, did not begin until April 1991.
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Mr. Redmond : To ask the Secretary of State for Health if she will review the procedure where general practitioner fund holders extend their role by undertaking services such as physiotherapy currently provided by community hospitals so that these services are not put in jeopardy for the majority of service users leading to a knock on adverse effect on the other services provided at the local hospital ; and if he will make a statement.
Dr. Mawhinney : General practitioner fundholders, like district health authorities, are responsible for obtaining high quality health care for their patients in the most effective way. The challenge for provider units is to develop services which meet the needs of purchasers and patients.
Mr. Fraser : To ask the Secretary of State for Health what supplementary inquiries and research and other work was carried out by the Office of Population Censuses and Surveys to supplement the census return in Lambeth and to obtain additional information about numbers and details of persons whose details ought to appear as part of the census.
Mr. Sackville : Census enumerators had the task of locating, contacting, and delivering census forms to all households and communal establishments in their areas. Census statistics have been derived principally from the completed forms. Where enumerators located households they believed to be present on census night, but were not able to contact people in them, the numbers and details of the people and households concerned have been estimated and included in the census statistics. Households identified by enumerators as absent on census night were asked to fill in a census form voluntarily on their return. For those who did not complete a form, numbers and details have been estimated and included in the census statistics.
A census validation survey was carried out shortly after the census to check on its quality and coverage. This survey compared information given on census forms with that obtained by experienced interviewers who re- visited a sample of addresses. The sample was not large enough, however, to provide information directly about individual authorities. A report on the survey's findings on coverage will be published later this year.
In preparing the Registrar General's mid-1991 population estimates, allowances were made for under-enumeration in the census, using results from the census validation survey and all other relevant sources. For individual local authorities these adjustments are inevitably less precise than at the national level.
Mr. Redmond : To ask the Secretary of State for Health what steps she is taking to issue clear advice to people requiring dental treatment of their entitlement to free treatment under the NHS ; if she will instruct family health services authorities to provide up-to-date information about the dental services available locally ; and if she will make a statement.
Dr. Mawhinney : Under their terms of service, dentists are required to display prominently at their practices a
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notice supplied by the family health servicesauthority--FHSA--indicating entitlement to exemption from and remission of national health service dental charges. Leaflets are available from family doctors and dentists and Benefits Agency offices explaining NHS dental treatment and how people may be entitled to free treatment or help with the cost. Copies of these leaflets will be placed in the Library.
FHSAs are responsible for maintaining up-to-date lists of the dentists providing NHS treatment in their localities. The list contains information about the days and hours the dentist is available at the practice, as well as the services offered.
Mr. McCartney : To ask the Secretary of State for Health by whom the review, proposed in The "The Health of the Nation" White Paper, of the possible legal control of the use of additives and emission of toxic substances from cigarettes was instituted ; who is conducting the review ; and which organisations and individuals have been invited to submit their views.
Mr. Sackville : The review will be established in due course.
Mr. Pickthall : To ask the Secretary of State for Health what progress has been made towards achieving the targets for reducing smoking prevalence to 20 per cent. of adults by 2000, and by 33 per cent. of 11 to 15-year-olds by 1994.
Mr. Sackville : The results of the biennial survey of adult smoking in 1990 gave levels of 31 per cent. for men and 29 per cent. for women and these were taken as the base for "The Health of the Nation" target. The results of the 1992 survey are not yet available. The base figure for children's smoking--8 per cent.--is that reported in the 1988 Office of Population Censuses and Surveys biennial survey of smoking among secondary schoolchildren. The 1990 survey showed a level of 10 per cent. but the general trend will not be known until the results of the 1992 survey are available late this year.
Mrs. Currie : To ask the Secretary of State for Health what estimate she has made of the expected reduction in the consumption of cigarettes as a result of the increase in excise duty announced in the Chancellor's last Budget ; and what would be the expected aggregated reduction in consumption were the same increase in real terms to be repeated at each successive Budget up to and including 2000.
Mr. Sackville : The consumption of cigarettes would be expected to reduce by between 1 per cent. and 2 per cent. as a result of the March 1993 Budget increase in tobacco taxation, assuming no change in other factors. The aggregated reduction in consumption if the same increase were repeated in each Budget up to and including the year 2000 would be expected to be in the range 9 per cent. to 18 per cent.
Mr. Redmond : To ask the Secretary of State for Health if she will issue guidelines to require that draft health care commissioning plans on which consultation with
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community health councils are held include (a) the present state of the service, (b) the proposed changes and (c) the effect of the proposed changes on the existing service and to require that all plans should be in plain English and in other languages where appropriate ; and if she will make a statement.Dr. Mawhinney : Current guidance, EL(93)10, a copy of which is available in the Library, already requires health authorities to undertake formal consultation when local health services are under review and it is recommended that they should ensure that black, Asian and other minority groups are enabled to play a full part in that process.
Ms Jowell : To ask the Secretary of State for Health what plans she has for collecting gender-specific information about use of mental health services for her review of information requirements in mental health services.
Mr. Bowis : Data collected on the use of services include information by gender when appropriate.
Sir David Steel : To ask the Secretary of State for Health if she has a proposed timetable for the extension of the limited list to include contraceptives.
Mr. Sackville : The Advisory Committee on National Health Service Drugs has started to look at contraceptives and will be approaching manufacturers for information about individual products. We expect that they will complete this review by the end of this year.
Mr. David Shaw : To ask the Secretary of State for Health what is the annual cost to the health service of (1) cosmetic treatment and surgery and (2) operations to remove tattoos ; and how much is received from patients towards the cost of such treatments and surgery.
Mr. Sackville : This information is not available centrally.
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she has any plans to revise the guidelines given to local authority social services departments concerning the escalation of unmet need resulting from the implementation of community care.
Mr. Bowis : No such guidlines have been issued.
Mrs. Lait : To ask the Secretary of State for Health what plans she has to improve consultation between her Department and the pharmaceutical industry.
Mr. Sackville : We established earlier this year a pharmaceutical industry strategy working group consisting of representatives of the Association of the British Pharmaceutical Industry (ABPI) and senior officials from
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the Department of Health, the Treasury and the Department of Trade and Industry with the terms of reference :"To consider jointly the future development of the pharmaceutical industry in the UK, its contribution to the UK economy and its role in the provision of health care ; and in particular to consider issues of common interest such as the provision of affordable health care and the encouragement of a strong pharmaceutical industry." In addition, officials consult regularly with the ABPI and individual companies on specific issues of mutual interest.
Ms Primarolo : To ask the Secretary of State for Health what is the estimated percentage of female patients who have access to a female general practitioner ; and what percentage of general practitioner partnerships have a female general practitioner.
Dr. Mawhinney : At 1 April 1992--the latest date for which the figures are available--approximately 68 per cent. of female patients in England were registered with general practitioners in partnerships which included a female general practitioner ; 53 per cent. of general practitioner partnerships had at least one female partner.
Mr. Alfred Morris : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Wakefield (Mr. Hinchliffe) of 26 April, Official Report, column 278, if Her Majesty's Government will now make it their policy to provide additional funding for the Child Migrants Trust ; and if she will make a statement.
Mr. Bowis : Funds for the year 1993-94 are fully allocated and include a grant for the Child Migrants Trust. Decisions about funding for future years will be taken when the Department knows what resources are available and what the competing demands for funds are.
Ms Primarolo : To ask the Secretary of State for Health if she will list the units that provide training for paediatric nurses.
Mr. Sackville : This information is not available centrally.
Miss Emma Nicholson : To ask the Secretary of State for Health how she intends to secure the continued value and effectiveness of the Health Education Authority ; and if she will make a statement.
Dr. Mawhinney : The White Paper "The Health of the Nation"--Cm 1986- -makes clear the important part to be played by the Health Education Authority (HEA) in achieving the targets for improvements in people's health set in that health strategy. It also emphasises that, complementing the HEA's national role, health authorities throughout England have a key responsibility for health promotion among their local populations. Last December, we approved the HEA's strategy for 1993 to 1998 to carry forward its role in "The Health of the Nation", which includes closer co-ordination with health authorities and other local agencies.
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To help achieve these aims, and to ensure the continued effectiveness of the HEA, we have decided--with the agreement of its chairman, Sir Donald Maitland--to carry out a review with the following terms of reference :"To consider the future role, responsibilities and functioning of the Health Education Authority, taking account of developments since it was established in 1987, notably :
the new structure of the NHS ;
the 1992 White Paper "The Health of the Nation" and its programme for a long term health strategy ;
the development of Government policy on market testing and contracting out ;
the need for cost-effectiveness ;
and to report to the Secretary of State for Health."
The review team will be led by Mr. John Lee--chairman, The Christie NHS Trust, Manchester and formerly a Minister in the Department of Employment.
The other members will be :
Mrs. Terry Banks--former director of the Office of Population Censuses and Surveys ;
Mr. Tonie Gibson--former newspaper editor and chairman of the Peterborough district health authority 1982 to 1992 ;
Dr. Bob Haward--regional director of public health, Yorkshire regional health authority.
We expect the review to be completed in November.
Mr. Pickthall : To ask the Secretary of State for Health what measures she is taking to protect from closure small pharmacies in rural and suburban areas which deal with many fewer than 2,000 prescriptions per month.
Dr. Mawhinney : Discussions are continuing with the pharmacists' representatives about how best to restructure fees to encourage better services for patients and improve value for money. In these discussions we have made it clear that we remain committed to ensuring that patients in rural and suburban areas continue to enjoy reasonable access to a local pharmacy.
Mr. Milburn : To ask the Secretary of State for Health how many homicides involved (a) shotguns and (b) other firearms in each year since 1979 ; and how many involved people under 16 years.
Mr. Sackville [holding answer 7 July 1993] : The information relating to registered deaths is shown in table 1.
For further information, the Coroners (Amendment) Rules 1977 now allow for death registration in cases where an inquest is adjourned because a person has been charged with an offence in connection with the death ; these cases are known as accelerated registrations. The correct external cause of injury, for example, "Assault by firearms and explosives" cannot, however, except in those cases relating to transport accidents, be determined until any criminal proceedings are concluded. Consequently, all non-transport accelerated registrations are assigned to the external cause of injury code E988.8--injury by other specified means, undetermined whether accidentally or purposely inflicted--until results of proceedings are known and the death can be reassigned to the correct external cause code--E code.
Homicides are one of the categories most affected by this legislation. Accordingly, for each of the years 1979-92 there are a number of deaths that are the result of the use
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of a firearm but which as a consequence of the rules do not appear in table 1. Table 2 shows the number of deaths assigned--at the outcome of criminal proceedings--to a broad group of causes which includes "Assault by firearms and explosives". It is not, however, possible to specifically identify those deaths which were the consequence of the use of a firearm, or those deaths where the person was a child under the age of 16 years without incurring disproportionate cost.Column 411
Table 1 Numbers of registered deaths from homicides involving firearms (ICD E965) in England and Wales, 1979 to 1992 -------------------------------------------------- 1979 |19|2 |0 |0 |0 |0 |0 |0 |18|3 |18|3 |37|5 1980 |6 |0 |1 |0 |0 |0 |0 |0 |12|0 |13|0 |19|0 1981 |3 |0 |0 |0 |0 |0 |5 |0 |5 |0 |10|0 |13|0 1982 |10|0 |0 |0 |0 |0 |0 |0 |16|2 |16|2 |26|2 1983 |21|2 |0 |0 |0 |0 |0 |0 |13|1 |13|1 |34|3 1984 |12|0 |0 |0 |0 |0 |0 |0 |31|4 |31|4 |43|4 1985 |8 |2 |0 |0 |0 |0 |0 |0 |15|0 |15|0 |23|2 1986 |17|0 |1 |0 |0 |0 |0 |0 |28|7 |29|7 |46|7 1987 |9 |0 |2 |0 |0 |0 |0 |0 |30|2 |32|2 |41|2 1988 |12|0 |0 |0 |0 |0 |0 |0 |16|0 |16|0 |28|0 1989 |8 |0 |0 |0 |0 |0 |0 |0 |10|0 |10|0 |18|0 1990 |10|0 |0 |0 |0 |0 |0 |0 |17|2 |17|2 |27|2 1991 |12|0 |0 |0 |0 |0 |0 |0 |15|0 |15|0 |27|0 1992 |10|0 |0 |0 |0 |0 |0 |0 |24|5 |24|5 |34|5
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Table 2. Causes to which accelerated registrations in injury by other specified means, undetermined whether accidentally or purposely inflicted (ICD E988.8) were eventually assigned, 1980-90 England and Wales Year |Other accidental |Suicide and |Assault by firearms|Injury undetermined |deaths E880 to E928|self-inflicted |and explosives E965|whether |injury E950 to E959 |accidentally or |purposely inflicted |E980 to E989 ------------------------------------------------------------------------------------------------------------------------ 1980 |1 |- |1 |2 1981 |1 |- |10 |- 1982 |3 |- |12 |- 1983 |3 |- |9 |- 1984 |1 |- |14 |- 1985 |- |- |12 |- 1986 |1 |- |9 |- 1987 |2 |1 |19 |- 1988 |3 |- |14 |- 1989 |- |- |8 |1 1990 |1 |- |9 |- Figures for 1979, 1991 and 1992 are not readily available.
Mr. Elletson : To ask the Secretary of State for Health how many NHS patients had waited for treatment for over a year in the North Western region (a) in March 1991 and (b) in the latest month for which figures are available ; and if she will make a statement.
Mr. Sackville [pursuant to his reply, 4 May 1993, c. 41] : I regret that there was an error in my previous reply. The last sentence should read
"in England over the same period, the number waiting over a year fell by 55 per cent. to 72,446--the lowest figure ever recorded".
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Ms Gordon : To ask the Secretary of State for the Environment who funded the dance which took place in celebration of the opening of the Limehouse link road on 17 May in the Canary Wharf tower ; and what was the full cost of this event.
Sir George Young : The London Docklands development corporation provided a reception in the Canary Wharf tower for staff involved in the Limehouse link project who were not able to attend the opening ceremony. The total cost of the reception was approximately £3,500.
Ms Gordon : To ask the Secretary of State for the Environment what was the full cost, including security arrangements, of the opening ceremony for the Limehouse link road on 17 May.
Sir George Young : A total of £64,000. The main costs were for the hire of a marquee, catering, toilets, stands, the parade, plaques and presentation plates.
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Mr. Cox : To ask the Secretary of State for the Environment what information he is providing to the task force on deregulation in the construction industry ; and what assessment he has made of the effect of removing building regulations on reducing carbon dioxide emissions, improving energy conservation and ensuring health and safety in buildings.
Mr. Baldry : Officials in my Department have met members of the task force on deregulation in the construction industry, and have provided them with details of the Building Regulations 1991 and the proposals to amend parts L and F. All proposed changes to the Building Regulations are fully assessed before implementation.
Mr. Kilfoyle : To ask the Secretary of State for the Environment what assessments urban development corporations are required to make of the competence of the companies to which they give grants.
Mr. Baldry : Urban development corporations are required to assess the ability of companies to carry through the project concerned ; their financial viability ; and their track record in undertaking similar projects.
Mr. Kilfoyle : To ask the Secretary of State for the Environment what guidelines are issued to board members of urban development corporations governing conflict of interest.
Mr. Baldry : Board members are issued with a code of conduct on appointment, which includes guidance on how to deal with conflicts of interest and what interests should be declared and recorded in the corporation's register of interests.
Mr. Kilfoyle : To ask the Secretary of State for the Environment what rules or guidelines are applied to the tendering process of urban development corporations.
Mr. Baldry : Urban development corporations are required to follow best public sector practice, which is that contracts should be placed on a competitive basis and the lowest tender accepted, subject only to certain clearly defined exceptions where this would not secure best value for money.
Mr. Kilfoyle : To ask the Secretary of State for the Environment what plans he has to review the operation of the Merseyside development corporation.
Mr. Baldry : I refer the hon. Gentleman to the answer given by my hon. Friend the Member for Hornchurch (Mr. Squire) to his previous question on Thursday 13 May 1993 at column 529.
Mr. Byers : To ask the Secretary of State for the Environment how much each urban development corporation has spent, since its inception, on consultations.
Mr. Baldry [holding answer 5 July 1993] : I refer the hon. Member to the answer given on 16 November 1992 at column 48. Updated expenditure on consultants' reports to 31 March 1993, where available, is in the table :
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UDC |£ million ------------------------------------------ Birmingham Heartlands |0.1 Black Country |<1>2.9 Bristol |0.7 Central Manchester |<2>- Leeds |<2>- London Docklands |<2>- Merseyside |3.2 Plymouth |Nil Sheffield |0.6 Teesside |4.9 Trafford Park |<2>- Tyne and Wear |4.0 <1> To 31 March 1992. <2> Not available.
Mr. Salmond : To ask the Secretary of State for the Environment, pursuant to his answer to the hon. Member for Blaenau Gwent (Mr. Smith) of 15 June, Official Report, column 538, how many of the submissions he received on the discussion document "Climate Change" were from (a) Scotland, (b) organisations and (c) members of the public ; and if he will make a statement.
Mr. Yeo : Out of the 254 responses now received to our discussion document, 31 were from Scotland. Twenty-four of these were from organisations and seven from members of the public.
Mr. Kilfoyle : To ask the Secretary of State for the Environment what income has accrued to the Merseyside development corporation from the Albert Dock Company.
Mr. Baldry : In the period covering 1987-88 to 1992-93 a total income of £2,022,659 has accrued to the development corporation from the Albert Dock Company in respect of rents, service charges and sales of flats.
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