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Dr. Mawhinney : More than 350 small practices have expressed an interest in joining the fund-holding scheme from April 1994 by joining together as groups to hold a fund. This is the largest cohort of small practices coming forward so far.
22. Dr. Twinn : To ask the Secretary of State for Health how many general practitioners have expressed an interest in joining the fund- holding scheme in April 1994 ; and if she will make a statement.
Dr. Mawhinney : More than 800 practices are preparing to join the scheme from April 1994. From that date about one in three of the population will be covered by a general practitioner fund holder.
26. Mr. Ian Taylor : To ask the Secretary of State for Health what progress has been made in extending the range of services which can be provided by general practitioner fund holders.
Dr. Mawhinney : From 1 April 1993 fund holders have been able to purchase community health services from their patients, and can receive payment from the fund for performing secondary care procedures at practice level. We keep the range of services for which fund holders can contract under constant review.
Mr. Bayley : To ask the Secretary of State for Health what provision exists (a) to assess whether a fund-holding general practitioner practice was over-funded in its initial year of operation and (b) to recover funds from a fund-holding practice that has been overfunded.
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Dr. Mawhinney : Regional health authorities are responsible for setting fair budgets for general practitioner fundholders. If budgets are set incorrectly, for example because of data problems, regions agree with fund holders how to resolve the problem. Excessive surpluses can be returned at the end of the year and regions hold contingency reserves for cases where budgets are set too low.
Occupational Health
17. Mr. Roy Hughes : To ask the Secretary of State for Health how many patients the national health service treated in 1990-91 and 1991-92 for (a) occupational health related diseases and (b) industrial accidents.
Mr. Sackville : This information is not available centrally.
Barnet Health Authority
18. Mr. John Marshall : To ask the Secretary of State for Health if she will make a statement about the number of patients treated by the Barnet health authority in 1992-93 and 1982-83.
Mr. Sackville : Between 1982-83 and 1992-93 in-patient and out- patient activity both went up by approximately 5 per cent. to 42, 906 and 226,317 respectively. Over the same period daycase activity trebled to 9,627.
Treatment in Barnet from April 1992 is provided by the Wellhouse Trust, comprising Barnet and Edgware hospitals. Previously the hospitals were managed by Barnet health authority.
Residential Care
19. Mr. Illsley : To ask the Secretary of State for Health what representations she has received from representatives of residential care homes regarding assessments by local authorities.
Mr. Bowis : I have regular meetings with care home representatives at which we discuss various issues including local authority assessments.
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she will make it her policy to monitor the effect of the deregistration of residential care homes for vulnerable people upon service provision to their inhabitants.
Mr. Bowis : I am aware of a few homes in the drug and alcohol field which have been deregistered. These services have been and are continuing to be monitored by Goldsmith's college, whose first report was published on 28 July and a copy of which is available in the Library.
Domiciliary Care Agencies
20. Ms Glenda Jackson : To ask the Secretary of State for Health if she will introduce legislation to require the registration and inspection of domiciliary care agencies.
Mr. Bowis : We have no plans to introduce such legislation.
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National Health Service
21. Mr. Kynoch : To ask the Secretary of State for Health what plans she has to make the public aware of how they can help the national health service to provide a better service.
Dr. Mawhinney : Every opportunity is used to emphasise how important the public's help is to the national health service in providing a better service. When the patient's charter was launched two years ago it included a section on how patients could help the NHS. More recently the Department of Health has developed and issued throughout the NHS a "Help Us to Help You" information pack. This initiative will stimulate and encourage local campaigns.
23. Sir David Knox : To ask the Secretary of State for Health what percentage of the gross domestic product was spent on the national health service in the most recent year for which figures are available; and what was the percentage in 1978.
Mr. Sackville : Total national health service expenditure in the United Kingdom was equivalent to 6.1 per cent. of gross domestic product in 1992-93, compared with 4.7 per cent. in 1978-79.
Harlow Wood Hospital
24. Mr. Tipping : To ask the Secretary of State for Health what are the future plans for the Harlow Wood hospital, Nottinghamshire.
Mr. Sackville : No final decision has been made on the long-term future of the hospital. I understand that the North Nottinghamshire health authority is considering various options to secure orthopaedic services for local people.
Patients Charter
25. Ms Eagle : To ask the Secretary of State for Health if she will make a statement on the patients charter.
Dr. Mawhinney : Since the patients charter came into effect in April 1992, patients throughout the national health service have seen the benefits in terms of better services. The patients charter has stimulated many innovative ideas and much good practice at local level and the efforts of the national health service should be applauded.
Health Information
27. Mr. Couchman : To ask the Secretary of State for Health what steps have been taken to improve the provision of information on health matters for patients.
Dr. Mawhinney : The Government are committed to improving the information available to patients and the public about the national health service and health matters. The patients charter emphasises that patients have a right to be given detailed information on local health services. The national freephone health information service was launched in January this year, providing a free and confidential service to patients on a wide range of health issues, including information on diseases, treatments, self-help groups and local services. The freephone number of HIS is 0800 66 55 44.
The Government provide £36 million per year for the funding of the Health Education Authority, which
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promotes a wide range of health education and advice, both directly to the public and through others. The Department also produces information on such areas as help with charges for prescriptions, optical and dental treatment and the costs of travel to hospital.Care in the Community
28. Mr. Thurnham : To ask the Secretary of State for Health what representations she has received about the role of voluntary groups in care in the community.
Mr. Bowis : We have received a variety of representations from different voluntary organisations. We meet regularly with many of them and we greatly value the contribution they make to the care of individuals whether in their own homes or in community-based residential establishments.
Mental Health Facilities
Mr. Hoyle : To ask the Secretary of State for Health how many patients in 1991-92 were retained in the hospital system under sections 2 or 3 of the Mental Health Act 1983 because (a) suitable accommodation outside the hospital was not available or (b) an alternative but less restrictive mental health facility was not available.
Mr. Bowis : This information is not collected centrally.
Child Care, Lambeth
Mr. Fraser : To ask the Secretary of State for Health what assessment she has made of the delivery of child care services in the London borough of Lambeth ; and if she will make a statement.
Mr. Bowis : Following the social services inspectorate report of April 1992 into child protection services, Lambeth has been asked to provide regular reports on these services in the borough. The latest report covers the period up to 1 October 1993 and shows that, despite some work towards achieving improved standards in management and quality of services, there are continuing causes for concern, including an unacceptably high level of unallocated casework. Lambeth will be asked to send a further report by 1 March 1994. In addition, Lambeth is addressing recommendations in a recent social services inspectorate report on three of its children's homes.
Charitable Trusts
Mr. Redmond : To ask the Secretary of State for Health what advice she has offered or will offer district health authorities who now no longer manage patient services regarding the transfer of district charitable trust funds to hospitals for the benefit of patients.
Mr. Sackville : The administration of charitable funds is the responsibility of the trustees. We have given advice on the legal process required when trustees' responsibilities are transferred from health authorities to national health service trusts. The latest such advice (FDL(93)24) was issued in March 1993, and will be placed in the Library.
Offenders (Mental Disorders)
Mr. Redmond : To ask the Secretary of State for Health when she will reply to Dr. John Reed, principal medical officer at her Department to his recommendations made
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last November in respect of improvements to the treatment of offenders with mental disorders ; and if she will make a statement.Mr. Bowis : I refer the hon. Member to the reply that my hon. Friend the Member for Suffolk, South (Mr. Yeo) gave my hon. Friend the Member for Teignbridge (Mr. Nicholls) on 27 November 1992 at cols. 873-74.
We have endorsed the guiding principles of the joint Department of Health/Home Office review, which point in particular to services being provided, as far as is compatible with public safety, in more local and less institutional settings. In addition we have reaffirmed the policy that, wherever possible, mentally disordered offenders should be cared for and treated by health and social services rather than in the criminal justice system.
The implementation of these recommendations falls largely to the agencies concerned at local level. We have made services for mentally disordered offenders a first order priority for the national health service in 1994- 95. This means that health authorities are required to work with personal social services and criminal justice agencies to develop strategic and purchasing plans for services for mentally disordered offenders, based on the recommendations of the interdepartmental review. Regional health authorities are currently carrying out an assessment of the need for these services which builds on an initial assessment last year.
We have increased central capital funding for medium secure psychiatric services from £3 million in 1991-92 to £17 million in 1992-93, and have made available a further £22 million in 1993-94. We have also made a total of £422,000 available in 1992-93 and 1993-94 for pump- priming of local multi-agency initiatives to help mentally disordered offenders. We have received many imaginative proposals and have so far allocated funds to 61 schemes. The Home Office has provided funds to assist the development of Court assessment and diversion schemes. At least 60 of these schemes are now operating in England, of which 26 are receiving central funding this year. The committee which we set up to advise the Department of Health and the Home Office on action to follow up the review has been appointed and has held its first meeting. We fully recognise the importance of sustaining the development of these services and will take full account of the committee's advice in taking this forward.
Warner Report
Mr. Redmond : To ask the Secretary of State for Health what is the current situation in respect of the Warner report.
Mr. Bowis : Following publication of the report in December 1992, local authorities were asked to improve methods of recruitment and vetting of staff responsible for children in residential care. On 1 July this year, local authorities were asked to address other recommendations in the report and to submit progress returns to the Department. On 22 July I announced the membership and the terms of reference for the children's residential care support force in a reply to my hon. Friend the Member for Canterbury (Mr. Brazier) at columns 291-92.
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Life Expectancy
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she will make it her policy to institute standard and objective means to monitor healthy life expectancy among the population aged over 50 years.
Mr. Bowis : We have recently commissioned research to help us to measure healthy life expectancy more accurately and to identify the factors we need to target to increase healthy life expectancy among older people. The results will be available early next year.
Peripheral Nerve Damage
Mr. Redmond : To ask the Secretary of State for Health if she will consider holding centrally information on the number of patients treated for peripheral nerve damage by (a) regional health authorities and (b) district health authorities ; and if she will make a statement.
Mr. Sackville : Information is collected centrally in the hospital episode system on the number of episodes of in-patient treatment for peripheral nerve damage, as well as those where operations are carried out. The latest England and regional data are published in "Hospital Episode Statistics. Volume 1 : Finished Consultant Episodes by diagnosis, operation and specialty, England : Financial year 1989-90", a copy of which is available in the Library.
Drug and Alcohol Services
Mr. Dafis : To ask the Secretary of State for Health if she will make a statement outlining the outcome of her departmental review of drug and alcohol rehabilitation services.
Mr. Bowis : The report carried out for the Department by Goldsmith's college was published on 28 July. I issued a press statement at the time of publication and my hon. Friend the Minister for Health wrote to local authorities to draw their attention to matters raised in the report which required their further action. Copies of the press release (H93/896) and the report are available in the Library.
Tinnitus
Mr. Hanson : To ask the Secretary of State for Health if she will list the current Government financial support to voluntary organisations dealing with tinnitus for the year 1993-94.
Mr. Sackville : Under section 64 of the Health Services and Public Health Act 1968 the Government are providing £22,500 this year and for the next two financial years to the British Tinnitus Association.
Mr. Hanson : To ask the Secretary of State for Health if she will list central Government's financial initiatives with regard to the treatment of tinnitus for the year 1992-93.
Mr. Sackville : People suffering from tinnitus may receive treatment under normal service funding arrangements.
Child Immunisation
Mr. Thurnham : To ask the Secretary of State for Health if she can provide a league table of childhood immunisation take-up rates in regional health authorities and local health authorities.
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Mr. Sackville : The information can be found in table 7 of "Vaccination and immunisation 1991-92 Summary Information from Forms KC50, KC50A and KC51" produced by the Government Statistical Service. Copies of which are available in the Library.
Optometrists
Dame Jill Knight : To ask the Secretary of State for Health if an agreement has been reached with optometrists providing general ophthalmic services on their remuneration for the year beginning 1 April.
Dr. Mawhinney : Representatives of optometrists have been consulted about the national health service sight test fee and the fee for domiciliary visits. As yet no agreement has been reached about the level of fees for 1993-94.
medical practitioners in respect of general ophthalmic services ; and to what extent they are subject to the same terms of service.
Dr. Mawhinney : Optometrists and ophthalmic medical practitioners may be registered with a family health service authority to provide national health service sight tests under the general ophthalmic services. In this respect they are subject to the same terms of service.
Schizophrenics
Mr. John Marshall : To ask the Secretary of State for Health what research her Department has undertaken into the number of schizophrenics killing (a) themselves and (b) others.
Mr. Bowis : In 1991 the Department established the confidential inquiry into homicides and suicides by mentally ill people being conducted by the Royal College of Psychiatrists. This aims to cover all homicides and suicides by people who are currently in contact with the mental health services or who have been in contact within the last 12 months. Information is collected in respect of the various diagnostic groups, including schizophrenia.
Long-term Medication
Mr. Gareth Wardell : To ask the Secretary of State for Health if she will list the chronic medical disorders requiring long-term medication for which there is no exemption from the payment of prescription charges.
Dr. Mawhinney : Medical conditions which attract exemption from national health service prescription charges are listed in leaflet P11, copies of which are available in the Library. No other medical conditions confer this entitlement.
Myalgic Encephalomyelitis
Mr. Pike : To ask the Secretary of State for Health what provision has been made in the current financial year and each of the last four financial years for research into myalgic encephalomyelitis ; and if she will make a statement.
Mr. Sackville : The main agency through which the Government support biomedical and clinical research is
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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. The MRC has been funding a study at the Institute of Psychiatry for four years where researchers are attempting to find ways to help myalgic encephalomyelitis sufferers cope with their disease and regain their health. The estimated cost of this project is £91,000. The Department and the MRC are always willing to receive and consider soundly-based research proposals in competition with other applications. The Department also keeps in touch with research being funded by bodies such as the Linbury Trust.Mr. Pike : To ask the Secretary of State for Health what is the current assessment of the number of people in England suffering from myalgic encephalomyelitis ; and how that figure is obtained.
Mr. Sackville : We are currently awaiting an evaluation of data from existing studies which is being undertaken by the myalgic encephalomyelitis task force with funding from the Department. A draft report is being prepared for discussion in early 1994.
Diabetics
Mr. Gareth Wardell : To ask the Secretary of State for Health how many people are diabetics dependent on insulin injections ; and in what form and at what level of disaggregation the information is held by her Department.
Mr. Sackville : This information is not available centrally.
Creutzfeldt-Jakob Syndrome
Mr. Gareth Wardell : To ask the Secretary of State for Health what evidence she has linking the incidence of Creutzfeldt-Jakob syndrome with transmission of a virus at dental surgeries.
Dentistry
Mr. Gareth Wardell : To ask the Secretary of State for Health if she will investigate the consideration underlying the decision not to invite the General Dental Practitioners Association to attend the working group of the Dental Practice Board which prepared the publication, "Access to Information" held by the Dental Practice Board.
Dr. Mawhinney : Membership of the working group which considered access to information held by the Dental Practice Board was kept to a minimum to enable it to work effectively. The dental profession was represented by members from the General Dental Services Committee.
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Child Supervision Orders
Ms Corston : To ask the Secretary of State for Health how many supervision orders with restriction requirements were made under provisions of the Children Act 1989 during each of the last two years for which figures are available.
Mr. Bowis : The Children Act 1989 came into force on 14 October 1991. Information is not yet available about the number of supervision orders with restriction requirements.
Ophthalmic Services
Dame Jill Knight : To ask the Secretary of State for Health what criteria govern the settlement of the remuneration of contractors who provide general ophthalmic services ; and what changes there have been in the criteria in 1993-94 relative to previous years.
Dr. Mawhinney : National health service sight test fees are determined by my right hon. Friend the Secretary of State, following consultation with the profession, in such a way as to ensure that there are adequate general ophthalmic services, of the right calibre. In doing this, regard is had to recruitment, retention and motivation factors, within the amount that can be afforded. These criteria have been used consistently for several years, including 1993-94.
Dame Jill Knight : To ask the Secretary of State for Health by what amount (a) optometrists and (b) ophthalmic medical practitioners providing general ophthalmic services are remunerated for their practice expenses.
Dr. Mawhinney : Optometrists are currently paid a fee of £12.75 for each national health service sight test they carry out, which covers both pay and expenses. These elements are not considered separately. Ophthalmic medical practitioners are paid a fee of £10.15. This contains a pay element of £7.53 and an expenses element of £2.62.
NHS Management Executive
Ms Primarolo : To ask the Secretary of State for Health what was the expenditure of the NHS Management Executive in each of the last five years.
Mr. Sackville : Expenditure figures for the National Health Service Management Executive from 1990-91 onwards are as shown--figures are not available prior to 1990-91. Figures have not been adjusted for inflation and are not directly comparable from year to year because of organisational changes between the NHSME and the rest of the Department.
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Year |1990-91 |1991-92 |1992-93 |1993-94
|(Current allocation)
------------------------------------------------------------------------------------------------------------------------------
Running costs (£) |29,933,505 |29,402,541 |42,883,317 |33,922,969
Capital (£) |339,000 |483,712 |511,745 |6,415
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Emergency Contraception Pill
Ms Primarolo : To ask the Secretary of State for Health what plans she has to investigate the deregulation and over-the-counter provision of the emergency contraception pill.
Mr. Sackville : The suggestion that emergency contraception should be available from pharmacies without a prescription was made in a recent article in the British Medical Journal on 18 September. The article and reactions to it are being studied in the Department.
Junior Doctors
Ms Primarolo : To ask the Secretary of State for Health how many junior doctors have been working over the new deal target of 83 hours after 1 April in each trust or directly managed unit and by region.
Dr. Mawhinney : The number of junior doctors and dentists in each region contracted for more than an average of 83 hours a week at 1 April 1993 is shown in the table :
|Number
----------------------------------
Northern |0
Yorkshire |18
Trent |0
East Anglian |3
North West Thames |89
North East Thames |101
South East Thames |9
South West Thames |21
Wessex |4
Oxford |31
South Western |2
West Midlands |33
Mersey |0
North Western |59
|-------
Total |370
Information for trusts and directly managed units is not available centrally.
Mr. Cox : To ask the Secretary of State for Health what was the average number of hours being worked by junior hospital doctors in the week of 18 October 1992.
Dr. Mawhinney : This information is not available centrally.
Prempak C
Mrs. Helen Jackson : To ask the Secretary of State for Health if Prempak C hormone replacement therapy treatment will be treated as a single prescription for charging purposes in the future.
Dr. Mawhinney : A prescription charge is payable in respect of each quantity of a drug or appliance dispensed, unless the patient is entitled to charge exemption or remission. Prempak C contains two separate preparations differentiated by colour and two prescription charges are, therefore, due when these items are dispensed. The fact that for convenience and, as an aid to patient compliance, the two preparations are supplied in one pack does not alter the patient's liability for prescription charges. We have no plans to change these arrangements.
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