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GP Fund Holders
13. Mr. Callaghan : To ask the Secretary of State for Health what alternatives to general practice fund-holding her Department has costed.
Dr. Mawhinney : All general practitioner practices should be involved in purchasing decisions through their district health authorities, but this is no substitute for fundholding which enables GPs to improve services for their patients by directly managing resources. That is why ever-increasing numbers of GPs are joining the scheme.
26. Mr. Hendry : To ask the Secretary of State for Health what proportion of the population of Derbyshire is covered by fund-holding doctors' practices.
Dr. Mawhinney : The information requested is not available centrally. My hon. Friend may wish to contact Sir Michael Carlisle, chairman of Trent regional health authority, for details.
Nurses
27. Mr. Alton : To ask the Secretary of State for Health how many nurses are employed in NHS hospitals within the Liverpool area health authority.
Mr. Sackville : There were 5,030 whole-time equivalent nursing and midwifery staff, excluding agency staff, employed by the national health service within the Liverpool district health authority area at 30 September 1992, the latest figures available.
Transitional Community Care Grant
28. Mr. McKelvey : To ask the Secretary of State for Health what representations she has received regarding the requirement for local authorities to spend 85 per cent. of special transitional community care grant in the independent sector.
Mr. Bowis : I refer the hon. Member to the reply I gave the hon. Member for Blyth Valley (Mr. Campbell) on 6 December.
London NHS (Debts)
29. Mr. Cohen : To ask the Secretary of State for Health what assistance she is giving to London NHS trust and district health authorities to help them resolve their debt problems.
Dr. Mawhinney : As part of the overall resources required for the implementation of "Making London Better", transitional funds have been made available to support London hospitals who have lost contract income from purchasers and to meet the costs of staff redeployment or unavoidable redundancies.
Health Care (North West Thames)
30. Mr. Shersby : To ask the Secretary of State for Health what progress has been made in improving primary and community health care in the North West Thames region.
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Dr. Mawhinney : North West Thames regional health authority has committed £9 million this year to developing primary care and community services. In addition, £5 million has been provided from central sources to fund new primary care developments in their part of the London initiative zone. The regional health authority has also recently agreed a comprehensive programme to close all its large mental illness and learning disability hospitals by the year 2000, and to replace them with a full range of local community-based services.
The Health of the Nation"
Mr. Olner : To ask the Secretary of State for Health what plans she has to revise "The Health of the Nation" targets.
Mr. Sackville : "The Health of the Nation" is a long-term strategy, with targets up to 17 years ahead, and we have made good progress in the first year. There is no need to revise the targets ; they remain the right ones.
NHS Complaints Procedures
Mr. McAvoy : To ask the Secretary of State for Health when she expects to publish the report of the review committee into NHS complaints procedures.
Dr. Mawhinney : I understand that Professor Wilson and his colleagues plan to submit their recommendations to my right hon. Friend the Secretary of State at the beginning of February. Decisions on publication will be made at that time.
Prescriptions
Mr. Cousins : To ask the Secretary of State for Health if he will publish a table showing (a) the number of prescriptions, (b) total expenditure and (c) expenditure per head of population served for (i) sunscreens and similar protection and (ii) vitamins and dietary supplements for 1992.
Dr. Mawhinney : This information is shown in the table.
England 1992 figures |Prescriptions |Net ingredient cost |Net ingredient cost
|(thousands) |per head of
|population
|(£ thousands) |(£)
---------------------------------------------------------------------------------------------------------
Sunscreening
preparations |81.1 |395.0 |8.16
Vitamins and
dietary
supplements |5,833.3 |51,009.2 |1.05
Notes:
1. The data cover all prescriptions dispensed by community pharmacists and appliance contractors,
dispensing doctors, and prescriptions submitted by prescribing doctors for items personally
administered.
2. The data are based on September 1991 British National Formulary section 13.8.1.
3. For net ingredient cost per head Office Population of Censuses and Surveys 1991 mid year resident
population projections for 1992 have been used.
Medical Cards
Mr. Blunkett : To ask the Secretary of State for Health what plans she has to change the numbers of any NHS medical cards ; and what will be the cost of the changes.
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Mr. Sackville : By July 1995, we will have started to replace the present national health service number where it is currently in use with one with a more suitable format. Medical cards will record the replacement number when they are reissued after this date. The number is being replaced as part of a wider programme to make the new format number the common patient identifier for the NHS. The costs of this programme are estimated at £22 million at today's prices, over the period 1992 to 1995.
Information Security
Mr. Cohen : To ask the Secretary of State for Health whether she has incorporated the code of practice for information security management, published by the British Standards Institution, into relevant contracts with information technology suppliers.
Mr. Sackville : The security requirements for information technology systems and services used by central Government Departments are stated in the HMG IT security policy document. This document is supported by use of the CCTA risk analysis and management method and baseline security for IT systems risk analysis methods, by the communications electronic security group memorandum No. 10 where appropriate and by supporting advice and guidance published by the HMG IT security authorities. These are regularly reviewed to ensure best practice, have been developed specifically for use within Government and have been in operation for some time. The code of practice for information security management was developed by and established for use by commercial organisations and does not specifically address the requirements for the protection of official information.
District Health Authorities
Mr. Milburn : To ask the Secretary of State for Health, pursuant to her answer of 29 November 1993, Official Report , column 307 , if she will list those district health authorities that (a) gain and (b) lose under the mortality weighted population projections for 1991 to 1996.
Dr. Mawhinney : The district health authority weighted capitation shares were obtained from the regional health authorities. Each region has its own weighted capitation formula for determining the shares of its districts. We do not hold centrally all of the information which would be required to model the effects of population changes on individual DHA shares.
Women's Refuges
Mr. Cohen : To ask the Secretary of State for Health what progress she is making towards achieving a comprehensive network of women's refuge provision ; in which borough areas such a provision currently does not exist ; and if she will make a statement.
Mr. Sackville : Earlier this year, the Government published their response--HC 245--to the Home Affairs Select Committee's report on domestic violence. The Select Committee did not recommend that central Government should make more funds available to local refuges. Funding at a local level is a consideration for local authorities and other agencies who are best placed to make decisions on local need and provision.
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The need for improved co-ordination of refuge provision is an area which will be given early consideration by members of the ministerial group on domestic violence at its forthcoming inaugural meeting. Information relating to local refuge provision is not available centrally.Herbs
Ms Primarolo : To ask the Secretary of State for Health what response she has made to the publication by the European Community Committee for Proprietary Medicinal Products of a list of herbs which have been banned in other European countries ; if she will make it her policy to oppose any such ban on products containing these common herbs in this country ; and to ensure that right hon. and hon. Members are kept informed of such proposals emanating from the different agencies of the European Community.
Mr. Sackville : No response was called for, and none has been made. The list is simply a factual record, for information, of herbs that have already been withdrawn from medicinal products for safety reasons in one or more member states. We are not aware of any current proposals for further action in the European Community.
The Government's policy on the licensing of medicinal products is that they must demonstrate acceptable standards of safety, quality and efficacy. This will continue to be applied.
Private Medical Insurance
Ms Primarolo : To ask the Secretary of State for Health how many people (a) have and (b) do not have private medical insurance by age group, social class and gender.
Mr. Sackville : This information is not available centrally.
Changing Childbirth"
Mrs. Gillan : To ask the Secretary of State for Health what research and audit projects her Department has commissioned, and from whom, to evaluate the recommendations made by the expert maternity group in its report "Changing Childbirth" ; and what role the national perinatal epidemiology unit will take in the evaluation.
Mr. Sackville : The consultation period for "Changing Childbirth", the report of the expert maternity group, ended on 29 October. Ministers are currently considering the comments received before deciding on future action. Decisions on any evaluation projects to be undertaken will be made as part of this process.
Copies of "Changing Childbirth" are available in the Library.
Sensitive Documents Unit
Mr. Cohen : To ask the Secretary of State for Health if she will make a statement about the operation of her Department's sensitive documents unit ; how many staff are employed in its operation ; and approximately how many documents per annum come within its purview.
Mr. Sackville : The Department of Health does not operate a sensitive documents unit. All documents raised
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within the Department are public records under the terms of the Public Record Acts 1958 and 1967, and have varying degrees of sensitivity.The Department has a departmental records officer who is responsible for systems for the control of all documents from the time of their creation to final disposal.
In the course of the Department's business, hundreds of thousands of records come within the departmental records officer's purview each year.
Extra-contractual Referrals
Ms Primarolo : To ask the Secretary of State for Health how many extra-contractual referrals were refused by each health authority in 1990- 91 and 1992-93.
Mr. Sackville : This information is not available centrally.
Mental Health Care
Mr. McCartney : To ask the Secretary of State for Health (1) in relation to each regional health authority area in England how many mentally ill patients from that region were in low security places on 30 June ; how many of those patients were in private sector facilities ; how many patients were waiting for a community place ; and how many of the patients were, in the opinion of their responsible medical officer, fit to move to a community place ; (2) in relation to each regional health authority area in England how many people with learning disabilities are assessed as (a) requiring treatment or care in high security, (b) requiring treatment or care in medium security and (c) requiring treatment or care in low security ; how many such people are currently detained in (d) high security, (e) medium security and (f) low security, in relation to those currently detained in secure facilities ; how many are currently considered to be in unsuitable facilities ; and how many are being cared for in secure private facilities ;
(3) in relation to each regional health authority area in England what is the estimated number of people in the region assessed as needing treatment for psychopathic disorder ; how many of these detained in secure NHS psychiatric facilities, or in other NHS psychiatric facilities as in- patients, are in touch with other NHS psychiatric facilities as outpatients, or are in local social services authority facilities ; how many are in prison ; and how many are in private sector health care or other facilities ;
(4) in relation to each regional health authority area in England how many mentally ill patients from each region were in medium secure provision on 30 June ; how many were in private sector facilities ; how many were waiting for admission to less secure accommodation and how many waiting to be discharged to a community place ; and how many were, in the opinion of their responsible medical officer, fit to move to less secure accommodation ;
(5) in relation to each regional health authority area in England, how many mentally ill patients from each region were in special hospitals on 30 June and which special hospitals they were in ; how many of the patients detained in special hospitals were, in the opinion of their responsible medical officer, ready to move to less secure accommodation ; how many patients from each region were authorised for discharge but remained in the special hospital ; how long each of these patients had been waiting for discharge ; what had prevented discharge in each case ; what
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arrangements are in place to ensure that patients in special hospitals are able to be discharged within a year of discharge being authorised ; and how these arrangements will be developed to meet the six month maximum waiting time referred to in the NHS planning guidance for 1994-95.Mr. Bowis : This information is not collected on a routine basis but regional directors of public health were asked in the Department of Health's letter, EL(93)68, to undertake an assessment of needs in their regions, including the numbers of patients needing mental health care at the different levels of security. We are awaiting the full results of this exercise. Copies of the letter (EL(93)68) are available in the Library.
Prescription Charges
Mr. Blunkett : To ask the Secretary of State for Health when she will announce (a) changes to prescription charges and (b) changes in the proportion of costs paid by dental patients for 1994-95.
Dr. Mawhinney : I refer the hon. Member to the reply I gave him on 3 December at column 805.
Hospices
Ms Primarolo : To ask the Secretary of State for Health what was the number of hospice beds in each of the last five years.
Mr. Sackville : Information on 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<2>
------------------------------------------------------
1989 |1,863
1990 |2,093
1991 |2,171
1992 |2,321
1993 |2,409
<1> Figures collected in January of each year.
<2> In-patient, England.
Source: St. Christopher's Hospice Information
Service.
NHS Trusts
Ms Primarolo : To ask the Secretary of State for Health, pursuant to her answer of 1 December, Official Report, columns 583-84, if she will list the remuneration of the chairman of each NHS trust in England.
Dr. Mawhinney : The information requested is not available centrally.
National health service trust chairmen's remuneration is paid on the basis of the following bands :
Unit turnover |Band |Rates per annum (£) 1988-89 ------------------------------------------------------------------------------------------------ In excess of £50 million |Band 1 |19,285 Between £20 million and £50 million |Band 2 |17,145 Less than £20 million |Band 3 |15,125
Administrators
Mr. Clapham : To ask the Secretary of State for Health how many new management posts have been created since the NHS reforms ; and what they cost.
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Dr. Mawhinney : This information is not available centrally.
Surgical Operations
Mr. Clapham : To ask the Secretary of State for Health how many patients have now been waiting for more than a year for their operation.
Dr. Mawhinney : Information on waiting times for in-patient and day case treatment is given in "Hospital Waiting List Statistics : England", which is published twice yearly. The latest published figures are for March 1993. In addition provisional figures for the quarter ending 30 September 1993 were published on 1 November, in press release H93/1036. Copies of both documents are available in the Library.
Mr. Clapham : To ask the Secretary of State for Health how many routine operations have now been suspended until the next financial year.
Mr. Sackville : This information is not available centrally.
Cervical Smear Tests
Mr. Clelland : To ask the Secretary of State for Health (1) what advice her Department issues on methods to be adopted in carrying out cervical smear tests ;
(2) what action she proposes to take 88 the Department of Health circulated to all health authorities the report of an intercollegiate working party on cervical cytology screening which includes guidance on the taking of cervical smears. HSG(93)41 issued in August 1993 updates earlier guidance on the cervical cancer screening programme. This refers both to accepted clinical guidance issued by the British Society for Clinical Cytology on the taking of cervical smears and fail-safe mechanisms for their follow-up. Copies of both documents are available in the Library. All women should have access to the same high standard of service regardless of socio- economic group. It is unacceptable to use an inferior method on such grounds. Variations from the standard method for taking cervical smears are acceptable only on clinical grounds, or where the patient makes an informed choice, in full possession of the clinical facts.
Mr. Clelland : To ask the Secretary of State for Health what action she proposes to take following the publication of the report of the Northern regional health authority on the recall of Dr. Lustman's patients for repeat cervical smears ; and if she will make a statement.
Mr. Sackville : This is a matter for the Northern regional health authority and Gateshead family health services authority. The hon. Member may wish to contact the chairmen for details.
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General Practitioners
Mr. Clelland : To ask the Secretary of State for Health what advice she intends to issue to consultants on the importance of absolute accuracy and clarity in their advice and/or comments relating to methods adopted by general practitioners.
Mr. Clelland : To ask the Secretary of State for Health what advice she intends to issue to family health services authorities on the importance of verifying verbal assurances from general practitioners that their methods are supported by consultants.
Family Health Services Authorities (Training)
Mr. Clelland : To ask the Secretary of State for Health (1) what training provision in techniques for thoroughness she intends to provide for family health services authority members engaged in practice visits ;
(2) what advice she intends to issue to family health services authorities on the importance of keeping accurate records of findings following FHSA practice visits.
Immunisation
Mrs. Roche : To ask the Secretary of State for Health what immunisations her Department recommends for children under five travelling to Nigeria.
Mr. Sackville : A United Kingdom resident child should have been immunised routinely against diphtheria, tetanus, polio, whooping cough, measles, mumps, rubella and haemophilus influenzae b. Recommendations for travel, in addition to the above immunisations, will depend on factors such as purpose of visit--holiday or parents' occupation--length of stay, area to be visited and season of the year. They include, for Nigeria, hepatitis A human normal immunoglobulin, or hepatitis A vaccine where prolonged protection is required, typhoid--but not for infants under 12 months of age --yellow fever--but not for infants under nine months of age--and meningococcal meningitis. Advice in specific cases should be sought from a general practitioner or travel clinic.
Regional Health Authorities
Sir Donald Thompson : To ask the Secretary of State for Health what financial allocations each regional health authority will receive in 1994- 95.
Mrs. Virginia Bottomley : I am today sending each regional health authority details of their main revenue allocations for resident population. These are set out in table 1. They are provisional until Parliament approves the relevant supply estimate.
Regions are to receive an average cash increase of 5.4 per cent., and I have decided that all regions should get a minimum increase of 0.7 per cent. above forecast inflation.
This will enable all regions to make faster progress towards equalisation of resources at district health authority level. Table 2 sets out the main capital planning totals for each region. Regional health authorities and National Health
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Service Management Executive outposts will be giving me agreed proposals for how much of these planning totals should be spent by trusts and how much by health authorities. These will form the basis of external financing limits for trusts and capital cash limits for regional health authorities.Table 3 sets out the cash-limited resources being made available to fund general practice expenditure. This will fund practice staff in fund-holding and non-fund-holding practices, premises improvements costs, and non-fund- holding computer costs. This represents a cash increase of 5.9 per cent.
Table 1
Regional health authority allocations
1994-95
Revenue allocations for resident populations
|Allocation for |Percentage cash
|resident |increase
|populations
|£'000s |Per cent.
------------------------------------------------------------------
Northern |1,219,112 |5.10
Yorkshire |1,406,336 |5.32
Trent |1,767,925 |5.65
East Anglian |748,471 |6.17
North West Thames |1,352,165 |4.74
North East Thames |1,561,379 |4.74
South East Thames |1,519,821 |5.58
South West Thames |1,163,130 |4.74
Wessex |1,136,485 |6.43
Oxford |843,071 |6.05
South Western |1,253,144 |5.67
West Midlands |1,960,156 |5.64
Mersey |932,826 |4.87
North Western |1,583,160 |5.14
England |18,447,181 |5.38
Table 2
NHS regional main capital planning totals for 1994-95
Region (both trusts |Capital planning
and RHAs) |Total £000s
------------------------------------------------------------
Northern |100,462
Yorkshire |117,127
Trent |147,872
East Anglian |64,514
North West Thames |97,719
North East Thames |111,800
South East Thames |115,243
South West Thames |86,069
Wessex |96,881
Oxford |73,650
South Western |106,657
West Midlands |162,940
Mersey |76,509
North Western |129,970
England |1,487,413
Table 3
General medical services cash limited allocations for 1994-95
Regions |Allocation at |Increase over
|1994-95 prices|1993-94 cash
|(£000s) |Percentage
---------------------------------------------------------------
Northern |39,415 |7.4
Yorkshire |49,372 |4.4
Trent |63,125 |6.2
East Anglian |36,558 |4.0
North West Thames |51,342 |4.0
North East Thames |53,862 |7.3
South East Thames |55,404 |5.9
South West Thames |43,632 |7.0
Wessex |43,478 |4.0
Oxford |38,215 |4.0
South Western |55,385 |4.0
West Midlands |64,533 |7.3
Mersey |31,814 |5.9
North Western |48,261 |10.2
England |674,396 |5.9
SOCIAL SECURITY
Pensioner Incomes
Mr. Bowden : To ask the Secretary of State for Social Security what has been (a) the mean and (b) the median increase each year from 1979 to 1990-91 in the incomes of (i) single male pensioners aged 65-74, (ii) single female pensioners aged 60-74, (iii) all single pensioners under 75, (iv) pensioner couples under 75, (v) single male pensioners aged 75 and over, (vi) single female pensioners aged 75 and over, (vii) all single pensioners aged 75 and over and (viii) pensioner couples aged 75 years and over ; and in each case for which the figures are available if he will break the figures down by quintile groups.
Mr. Hague : The answer is in the tables.
Change in pensioner incomes from 1979 to 1990-1
|Per cent. increase|Per cent. increase
|in median per year|in mean per year
-------------------------------------------------------------------------------
Single men aged 65-74 |2.4 |2.9
Single men over 75 |2.1 |3.0
Single women over 75 |1.6 |2.2
Couples over 75<1> |2.5 |3.8
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|Q1 |Q2 |Q3 |Q4 |Q5 |All
------------------------------------------------------------------
All singles over 75
Per cent. increase in median per year |1.0|1.7|2.1|2.8|5.1|2.1
Per cent. increase in mean per year |0.2|1.2|1.9|2.4|3.9|3.0
Couples<1> under 75
Per cent. increase in median per year |1.1|1.8|2.6|3.2|3.6|2.6
Per cent. increase in mean per year |2.4|1.5|2.2|2.9|2.9|3.0
All singles under 75
Per cent. increase in median per year |1.2|2.0|2.2|3.0|4.6|2.2
Per cent. increase in mean per year |0.2|1.8|2.1|2.5|3.7|3.3
Single women aged 60-74
Per cent. increase in median per year |1.1|2.0|2.1|2.7|4.3|2.1
Per cent. increase in mean per year |1.0|1.8|2.1|2.4|3.6|3.2
Note: Income is net before housing costs income. Because of small
sample size, it has not been possible to provide all of the
information in the form requested. Such information as is
provided is liable to error due to small sample groups.
<1>Husband's age specified
Source: Family Expenditure Surveys 1979 and 1990-91
Benefit Statistics
Sir David Knox : To ask the Secretary of State for Social Security if he will disaggregate the total expenditure figures in table 1 of "The Growth of Social Security," in order to show the different growth rates of (a) national insurance basic retirement pension, (b) national insurance unemployment benefit, (c) naational insurance invalidity benefit, (d) family allowance/child benefit, (e) national assistance/supplementary benefit/income support, (f) one-parent benefit, (g) housing benefits and (h) rate rebates/community charge benefit.
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Mr. Scott : The information requested in relation to national insurance basic retirement pension, national insurance unemployment benefit and family allowance/child benefit is in the table. Invalidity benefit and one-parent benefit were introduced in 1971 and 1980 respectively and information about growth in expenditure on these is in table 9a of "The Growth of Social Security." Meaningful comparisons of the growth rates since 1949 in national
assistance/supplementary benefit/income support, housing benefit and rate rebates/community charge benefit are not possible because of changes in the structure of provision in the benefit system.
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|Television|Radio |Press
|£ |£ |£
-------------------------------------------------------
1989-90 |4,911,000 |402,000 |1,486,000
1991-92 |4,396,000 |626,000 |772,000
1992-93 |1,792,000 |429,000 |2,296,000
Notes:
1. The total spend in 1990-91 was 4,360,000 but a
breakdown is not immediately available.
2. The Department did not exist independently prior to
August 1988.
Nursing Homes
Mr. Bradley : To ask the Secretary of State for Social Security what representations he has received regarding financial difficulties facing people who have been in private care or nursing homes since before 1 April.
Mr. Burt : I refer the hon. Member to the reply to the hon. Member for Wakefield (Mr. Hinchliffe) on 6 December.
Information Security
Mr. Cohen : To ask the Secretary of State for Social Security whether he has incorporated the code of practice for information security management, published by the British Standards Institution, into relevant contracts with information technology suppliers.
Mr. Hague : The security requirements for IT systems and services used by central Government departments are
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stated in the Government IT security policy document. This document is supported by use of the CCTA risk analysis and management method (CRAMM) and baseline security for IT systems (BSITS) risk analysis methods and by supporting advice and guidance published by the Government IT security authorities. These are regularly reviewed to ensure best practice and have been developed specifically for use within Government and have been in operation for some time. The Department of Social Security's IT security standards have been devised in accordance with the above, and the need for compliance with them is being referenced in relevant contracts.The code of practice for information security management was developed by and established for use by commercial organisations and does not specifically address the requirements for the protection of official information.
Mr. Cohen : To ask the Secretary of State for Social Security if he will make a statement about the operation of his Department's sensitive documents unit ; how many staff are employed in its operation ; and approximately how many documents per annum come within its purview.
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Mr. Hague : The Department of Social Security does not operate a sensitive documents unit. However, all documents raised within the Department are public records under the terms of the Public Records Acts 1958 and 1967, and have varying degrees of sensitivity. The Department has a departmental records officer, who is responsible for systems for the control of all documents from the time of their creation to final disposal. In the course of the Department's business, millions of records come within the departmental records officer's purview each year.
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