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Mr. William O'Brien : To ask the Secretary of State for Health what research is being undertaken by her Department into the use of lasers to offer treatment under the NHS to myopia suffers ; and if she will make a statement.
Dr. Mawhinney : I refer the hon. Member to the reply I gave him on 23 June 1993 at columns 177-78.
Mental Health Patients
Mr. Robert Ainsworth : To ask the Secretary of State for Health what basic standards have been set under the citizens charter for rights for mental health patients to adequate care and staffing levels.
Mr. Bowis : All the patients charter rights and standards apply to all those who use the national health service. In particular, the charter standard No. 2 sets out that
" health authorities should ensure that the services they arrange can be used by everyone, including people with special needs such as those with mental disabilities "
Proposed Hospital, Liverpool
Mr. Loyden : To ask the Secretary of State for Health (1) what is the nature of the contracts with SAS Service Partner, Compass and other companies involved in the planned patient hotel on the site of the Royal Liverpool
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university hospital ; when the contracts will commence ; and what comparison she has made between the proposals and those made in 1990 in connection with the same site ;(2) what is the status of the document "Making a Difference to Patient Care -Proposed Short Stay Facility at the Liverpool Royal University Hospital" ; and to what consultative procedures its proposals will be subject ;
(3) what proportion of the staff employed at the proposed patient hotel on the site of the Royal Liverpool university hospital will be qualified nursing or medical staff ; what qualifications the stewards and stewardesses will have ; and what company will control the staff ;
(4) if she will make a statement on the proposals for management and staffing in paragraph 5 of the proposal for a short-stay facility at the Royal Liverpool university hospital.
Mr. Sackville : The information requested by the hon. Member is not available centrally and he may wish to contact the trust chairman, Mr. J. Fitzpatrick, for details.
We understand the proposed short-stay, low dependency facility at the Royal Liverpool university hospital national health service trust will provide more appropriate care to low-dependency patients, improving their mobility and choice while providing a more cost-effective service.
Community Care Ombudsman
Dr. Lynne Jones : To ask the Secretary of State for Health if she will bring forward proposals to introduce a community care ombudsman.
Mr. Bowis : Services provided under the new community care arrangements are already covered by the existing local government ombudsman and the health service commissioner.
Thames Region Staff
Ms Primarolo : To ask the Secretary of State for Health what was the total number of (a) hospital nurses, (b) midwives, (c) health visitors and (d) district nurses for each Thames region for each of the last five years.
Mr. Sackville : I will write to the hon. Member.
Racism
Ms Primarolo : To ask the Secretary of State for Health what plans she has to counteract racism in the NHS.
Dr. Mawhinney : We are fully committed to ensuring equality of opportunity in the national health service both for patients and for staff. We shall shortly be launching a programme of action on employment opportunities in the NHS for our ethnic minority staff and we are also setting up an ethnic health unit to address the ethnic minority community's need for equal access to provision of health services.
Prescriptions
Mr. Pike : To ask the Secretary of State for Health how many items are prescribed in multi-pack or course treatments and charged at the rate of two or more prescription items.
Dr. Mawhinney : This information is not available. A prescription charge is payable in respect of each quantity of
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a drug or appliance dispensed, unless the patient is entitled to charge exemption or remission. The fact that two or more separate preparations may be dispensed together does not alter the patient's liability for prescription charges. Examples of items for which more than one charge is payable are contained in part XVI of "Drug Tariff", copies of which are available in the Library.Mr. Pike : To ask the Secretary of State for Health what information she has on the number or percentage of prescriptions that are undispensed.
Ms Primarolo : To ask the Secretary of State for Health what percentage of prescriptions cost the NHS less than (a) £5.00, (b) £5.25 and (c) £5.50.
Dr. Mawhinney : Based on the net ingredient cost of prescriptions dispensed in 1992 the percentages costing less than £5, £5.25 and £5.50 were 61.6 per cent., 64.1 per cent. and 65.6 per cent. respectively.
Ms Primarolo : To ask the Secretary of State for Health what was the average expenditure on prescription charges by a person who is not exempt from such charges in the last year.
Dr. Mawhinney : About £10 in 1992-93.
Pharmacies, Lancashire
Mr. Pike : To ask the Secretary of State for Health how many pharmacies there are in Lancashire ; and what representations she has received as to the viability of such pharmacies arising from the new payment formula.
Dr. Mawhinney : There were 301 pharmacies in Lancashire on 30 September 1993. Since April 1993, the Department has received a number of representations about community pharmacies, 13 of which have been from hon. Members and other interests in Lancashire.
GP Fund Holders
Ms Primarolo : To ask the Secretary of State for Health if she will estimate the percentage of general practitioner fund holders over budget in 1991-92 and 1992-93.
Dr. Mawhinney : Information about individual general practitioner fund holder over or underspends is not held centrally. Regional health authorities are responsible for managing fund holder spending within overall cash limits.
Ms Primarolo : To ask the Secretary of State for Health if she will list the quality achievements that general practitioner fund holders have achieved as a result of their status.
Dr. Mawhinney : Fund holders have been at the forefront of achieving quality improvements for patients, for example, shorter waiting times ; more convenient services in general practitioner surgeries such as physiotherapy and outpatient clinics ; by providing a wider range of services themselves such as minor operations ; and by speeding up diagnostic tests and discharge arrangements. In many areas hospitals have implemented these improvements for all patients.
Ms Primarolo : To ask the Secretary of State for Health what evidence she has on the practice of fund-holding
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general practitioners in the extent to which they refer patients to specialists, including those visiting general practices.Dr. Mawhinney : There are now over 1,200 fund-holding practices in England and it would not be practicable to hold referral information about them all centrally. However, regions report that fund holders are improving services for patients locally in a variety of ways including providing a wider range of services themselves and contracting for hospital clinicians to hold out-patient clinics in their surgeries.
NHS Trusts
Ms Primarolo : To ask the Secretary of State for Health if she will publish the guidance issued on the salary of chief executives of NHS trusts.
Dr. Mawhinney : Guidance on determining rates of pay for executives in national health service trusts was set out in my right hon. Friend the Secretary of State's letter of 22 January 1991 to all NHS trust chairmen. That is the standing advice and copies have been placed in the Library. The chief executive of the NHS Management Executive also wrote to chairmen of all third wave trusts on 20 January 1993 explaining how the 1992 public sector pay restraint affected executive pay appointments at that time. Copies of that letter have also been placed in the Library.
Terminal Illness
Ms Primarolo : To ask the Secretary of State for Health how many (a) terminal cases and (b) hospice beds there were in each of the last five years.
Mr. Sackville : Information on the number of terminal cases is not available. The number of hospice in-patient beds in each of the last five years in England is shown in the table.
Year<1> |Number of hospice
|beds (in-patient)
|England
------------------------------------------------------
1989 |1,863
1990 |2,093
1991 |2,171
1992 |2,321
1993 |2,409
<1> Figures collected in January of each year.
Source: St. Christopher's Hospice Information
Service.
Ms Primarolo : To ask the Secretary of State for Health how many hospice beds for children there were in each of the last five years.
Mr. Bowis : This information is not available centrally.
Pharmacy Sales to Children
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the operation of rules and regulations in relation to the sale of (a) condoms and (b) medicines in pharmacies to children.
Dr. Mawhinney : There are no legislative restrictions on the sale of condoms.
There are no regulations covering the sale of medicines to children outside the general controls imposed by part III
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of the Medicines Act 1968. However, the code of ethics of the Royal Pharmaceutical Society, which governs the conduct of all pharmacists, states that"a pharmacist must not supply any medicinal product to a child, unless satisfied that the product will be used safely. Where the supply is for another person, the pharmacist must take steps to ensure that the product will be delivered safely to an adult and that appropriate information will be conveyed to the patient or the responsible adult."
Sellafield (Radioactive Discharges)
Mr. Simon Hughes : To ask the Secretary of State for Health if she will request COMARE to review the National Radiological Protection Board report on "Collective Doses from Proposed Sellafield Discharges".
Mr. Sackville : The Committee on Medical Aspects of Radiation in the Environment has seen and welcomed this report.
Tuberculosis
Ms Primarolo : To ask the Secretary of State for Health what plan she has to include the BCG vaccination in the target for general practitioners.
Mr. Sackville : BCG vaccination is recommended for schoolchildren aged between 10 and 13 years. The majority of such vaccinations are given in schools as part of the school health service. Therefore, it would not be appropriate to include the BCG vaccinlo : To ask the Secretary of State for Health what plans she has to convert the consultant merit award system to performance-related pay.
Dr. Mawhinney : The scheme is kept constantly under review and we would consider carefully any possible interaction between the scheme and any proposals made for the extension of performance pay throughout the national health service.
Ms Primarolo : To ask the Secretary of State for Health what was the cost of the consultants' merit award system in 1990-91 in England.
Dr. Mawhinney : I refer the hon. Member to the reply I gave her on 27 October 1993 at column 694.
Public Attendance at Meetings
Dr. Wright : To ask the Secretary of State for Health if she will publish a table showing for (i) regional health authorities, (ii) district health authorities, (iii) family health service authorities and (iv) NHS trusts, whether the public has a statutory right to attend all board or committee meetings, and to inspect (a) the minutes of meetings, (b) the annual reports and (c) the annual accounts.
Dr. Mawhinney : The meetings of regional health authorities, district health authorities and family health services authorities are governed by the Public Bodies (Admission to Meetings) Act 1960. This requires any full meeting of the authority, at which approval for a specific action is required, to be open to the public. The public may be excluded from the whole or part of a meeting when confidential business is to be discussed.
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National health service trusts are required to have one public meeting per year, in accordance with the National Health Service and Community Care Act 1990, but many more meetings are open than they are legally required to be.NHS trusts are required to publish annual reports, business plans and accounts. Regional health authorities, district health authorities and family health services authorities are not required to do so, but most publish annual reports, and their audited accounts are publicly available on request.
Cancer Specialists
Ms Primarolo : To ask the Secretary of State for Health how many cancer specialists there are per head of population in each EC country.
Dr. Mawhinney : Information for England is shown in the table. Information relating to Wales, Scotland and Northern Ireland are matters for 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. Equivalent information for other EC countries is not available.
Y
Numbers of cancer specialists per million population
England-30 September 1992
|Medical oncology |Clinical oncology
-----------------------------------------------------------------------------------------
Consultants |47 |220
All staff<1> |96 |365
Consultants per million population |1.0 |4.6
All staff per million population |2.0 |7.6
<1> Grades included are consultants, staff grades, associate specialists, senior
registrars and registrars.
Professors of General Practice
Ms Primarolo : To ask the Secretary of State for Health if she will list the London teaching hospitals that have professors of general practice.
Dr. Mawhinney : This information is not available centrally.
Zemaphyte
Ms Primarolo : To ask the Secretary of State for Health what plans she has to enable Zemaphyte to be prescribable on an NHS prescription.
Dr. Mawhinney : Zemaphyte was added to the list of products which cannot be supplied on national health service prescriptions on 1 November 1993. There are no plans to change this decision.
Hospital Closures
Mr. Alfred Morris : To ask the Secretary of State for Health if she will list for each region (a) named hospital closures from May 1979 to July 1993 and (b) the number and type of beds closed.
Mr. Sackville : This information is not available centrally.
Ms Primarolo : To ask the Secretary of State for Health if she will list the hospitals in London closed each year since 1989.
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Dr. Mawhinney : This information is not available centrally.
Ms Primarolo : To ask the Secretary of State for Health if she will list the hospitals closed in each of the last 10 years ; and how much capital was generated from each sale.
Mr. Sackville : Detailed information is not available centrally. However, in the last 10 years £1,500 million has been generated by health authorities from the sales of surplus land and property. This money has been reinvested in hospital building contributing to the largest capital programme in the history of the national health service.
Private Health Insurance
Ms Primarolo : To ask the Secretary of State for Health what plans she has to move the health service to a more private insurance-based system.
Ms Primarolo : To ask the Secretary of State for Health if she has investigated the possibility of fund-holding general practitioners selling private health insurance in the future.
Breast Cancer
Ms Primarolo : To ask the Secretary of State for Health what was the average waiting time for mastectomy in each of the last five years ; and if she will make a statement on the waiting time between diagnosis of breast cancer and surgery.
Dr. Mawhinney : Information requested on waiting times for mastectomies is not available centrally.
We are aware that the period between diagnosis of breast cancer and surgery is a worrying time for women. The national health service breast screening programme, endorsed by the Breast Cancer Screening Advisory Committee, suggests the following targets for the follow-up of abnormalities :
first stage screening to subsequent assessment : less than two weeks ;
surgical assessment : less than one week ;
completion of assessment to biopsy : 90 per cent. admitted within two weeks ;
diagnosis to treatment of screen detected lesions : 90 per cent. admitted within three weeks.
Fuel Costs
Ms Primarolo : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Sheffield, Brightside (Mr. Blunkett) of 30 March 1993, Official Report, column 189, whether she has now assessed the effect of increases in the price of fuel on the health of the elderly.
Mr. Bowis : My right hon. Friend the Secretary of State for Social Security has announced that poorer pensioners and others on a low income will receive extra financial help before value added tax appears in their fuel bills.
Hospitals (Hotel Charges)
Ms Primarolo : To ask the Secretary of State for Health whether she has investigated the possibility of hotel charges.
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Mr. Sackville : We have made clear that we have no plans to introduce hotel charges for national health service patients. Patients will continue to be treated on the basis of their clincal need, regardless of ability to pay.
Fertility Treatment
Ms Primarolo : To ask the Secretary of State for Health what plans she has to publish guidelines on eligibility for fertility treatment.
Mr. Sackville : I refer the hon. Member to the reply I gave to my hon. Friend the Member for Hendon, South (Mr. Marshall) on 27 May 1993 at column 670.
Health Service Demand
Ms Primarolo : To ask the Secretary of State for Health what estimates she has made of the cost of the increase in demand in health services in the coming years.
Mr. Sackville : My right hon. Friend the Chancellor of the Exchequer will announce the Government's spending plans for 1994-95 to 1996-97 in his Budget statement on 30 November.
Unhealthy Footwear
Ms Primarolo : To ask the Secretary of State for Health what estimates she has made of morbidity related to the wearing of unhealthy footwear.
Morning-after Pill
Ms Primarolo : To ask the Secretary of State for Health how many prescriptions for the emergency pill have been given in each of the last five years.
Mr. Sackville : As there is only one product under this category of drug, the data requested are commercially confidential to the manufacturer and cannot be disclosed.
Family Planning
Ms Primarolo : To ask the Secretary of State for Health what plans she has to encourage general practitioners to develop family planning services for men.
Mr. Sackville : Under their terms of service general practitioners are required to provide patients with all the services they need including, where appropriate, family planning advice. One of the objectives set in the Government's "Health of the Nation" White Paper is to ensure the provision of the full range of family planning services for men and women who want to use them.
Cancer
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the training of doctors and medical students on cancer.
Dr. Mawhinney : Our aim is to ensure that patients receive high quality treatment from properly trained doctors. Cancer is a major cause of mortality and morbidity. The diagnosis and treatment of the many forms of cancer figure prominently at all stages of the education and training of our doctors, and will continue to do so.
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