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Market Testing
Ms Ruddock : To ask the Secretary of State for the Home Department what criteria are used to select a Home Office function for market testing.
Mr. Charles Wardle : The Home Office approach to market testing accords with Government policy as set out in the White Paper "Competing for Quality : Buying Better Public Services", Cm 1730. Priority is being given to market-testing activities where the costs are substantial and it seems likely that comparable services could be provided satisfactorily by external suppliers under contract.
Prison Visits
Ms Ruddock : To ask the Secretary of State for the Home Department (1) how many queries from the police and probation service were processed by the prisoner location unit in Birmingham during the last four weeks for which figures are available ; and what was the average time taken to process each application ;
(2) how many complaints were received from members of the public about the processing of prison visit applications in the year prior to the establishment of the assisted prison visits unit ; (3) what additional resources will be made available in the next financial year to investigate possible fraudulent claims at the assisted prison visits unit ;
(4) how many staff wsits unit records will be computerised ; (7) how many applications were dealt with last year by the assisted prison visits unit ; and what is the average time taken to process each application ;
(8) how many complaints were received from the public about the processing of the assisted prison visits unit applications last year ;
(9) what checks are currently made to detect fraudulent claims at the assisted prison visits unit.
Mr. Peter Lloyd : Responsibility for these matters has been delegated to the Director General of the Prison Service, who has been asked to arrange for a reply to be given.
Letter from Derek Lewis to Ms Joan Ruddock, dated December 1993 :
The Home Secretary has asked me to reply to your recent Questions about the operation of the Assisted Prison Visits Unit, including the Prisoner Location Unit.
The Assisted Prison Visits Unit (APVU) currently operates with 37 members of staff, five of whom are dedicated to work arising on the Prisoner Location Unit. The APVU processed 79,370 applications last year with an average turn round time of seven working days. The Prisoner Location Unit received 4,263 calls from the police and the probation service during November 1993. On average the Unit took 24 hours to process each claim, although the vast majority were dealt with on the same day.
Current administrative procedures provide that there should be systematic checks with prison establishments to confirm that visits have been made, and with the Benefits Agency to ensure that applicants qualify on low income. Where evidence of any fraudulent claim comes to light these are referred to the police for investigation. The advent of computerisation within the APVU, the first phase of which is scheduled to come on line in March 1994, will enhance the detection of fraudulent claims and their investigation. You also ask about the proposed extension of the Assisted Visits scheme to cover the second statutory monthly payment. The White Paper "Custody, Care and Justice" includes a commitment to consider extensions of the scheme as resources allow. We have also indicated in the Prison Service Business plan that the extension should take place this financial year. No final decision on this matter has been taken. It will be necessary to do so in the light of the resources available to the Prison Service and it is not possible to say when payment of the second monthly visit will be initiated.
Lastly, you also ask about the number of complaints which were received from members of the public in the year prior to this function being transferred from the then DHSS to the Prison Service and similarly, the number of complaints from the public about processing of applications which the APVU received last year. I am afraid that we do not have any records relating to the performance of the DHSS. Statistics on the number of complaints received by the APVU are not held in the form requested and could be obtained only by inspecting individual case files.
Ms Ruddock : To ask the Secretary of State for the Home Department whether the Transfer of Undertakings (Protection of Employment) Regulations 1981 will apply to the market testing of the assisted prison visits unit.
Mr. Peter Lloyd : Responsibility for this matter has been delegated to the Director General of the Prison Service, who has been asked to arrange for a reply to be given.
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Letter from Derek Lewis to Ms Joan Ruddock, dated December 1993 :The Home Secretory has asked me to reply to your recent Question about whether the Transfer of Undertakings (Protection of Employment) Regulations 1981 will apply to the market testing of the Assisted Prisons Visits Unit.
We have identified the Unit as one of our candidates for market testing. Work on a scoping study, which is the first stage in the process, will start in the new year. This will examine in detail the suitability or otherwise of the Assisted Prisons Visits Unit for competitive tendering against the private sector. If competitive tendering follows we will expect bidders to consider the implications of the Regulations.
As in all market tests, whether the Regulations apply will depend on the circumstances of the particular case and the way that bidders respond to the invitation to tender. To assist in this the Chancellor of the Duchy of Lancaster issued advice on the application of the Transfer of Undertakings (Protection of Employment) Regulations 1981 on 11 March 1993 (HWA col. 648).
Ms Ruddock : To ask the Secretary of State for the Home Department what criteria were used to select the assisted prison visits unit and the prisoner location unit for market testing.
Mr. Peter Lloyd : Responsibility for this matter has been delegated to the Director General of the Prison Service, who has been asked to arrange for a reply to be given.
Letter from Derek Lewis to Ms Joan Ruddock, dated December 1993 :
The Home Secretary has asked me to reply to your recent Question about the criteria used to select the Assisted Prisons Visits Unit and the Prisoner Location Unit for market testing.
The White Paper Competing for Quality' identified promising areas for market testing. These included such functions as payment of grants, grant administration and advisory services. APVU, which at present subsumes the Prisoner Location Unit, carries out these functions.
A scoping study due to start in the new year will examine the suitability or otherwise of the Unit for competitive tendering.
Ms Ruddock : To ask the Secretary of State for the Home Department whether the scoping report into the proposed market test of the assisted prison visits unit will be made available to staff.
Mr. Peter Lloyd : Responsibility for this matter has been delegated to the Director General of the Prison Service, who has been asked to arrange for a reply to be given.
Letter from Derek Lewis to Ms Joan Ruddock, dated December 1993 :
The Home Secretary has asked me to reply to your recent Question about whether the Scoping Report into the proposed market test of the Assisted Prisons Visits Unit will be made available to staff. Staff in the Unit will be consulted fully throughout the scoping study and a copy of the scoping study report will be made available to them.
Ms Ruddock : To ask the Secretary of State for the Home Department when the decision was made to market test the assisted prison visits unit ; and when the staff association was informed.
Mr. Peter Lloyd : Responsibility for this matter has been delegated to the Director General of the Prison Service, who has been asked to arrange for a reply to be given.
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Letter from Derek Lewis to Ms Joan Ruddock, dated December 1993 :The Home Secretary has asked me to reply to your recent Question about when the decision was made to market test the Assisted Prisons Visits Unit ; and when the Staff Association was informed. The Prisons Board Executive Committee decided on 26 July 1993 to include the Assisted Prisons Visits Unit as one of our candidates for market testing. Staff in the Unit were told by their Head of Division on 6 August 1993. Prison Service Trades Unions and Staff Associations were advised at the same time. This has been followed up with briefing by senior line management and our Market Testing Section. Work on the first stage of the process will start in the new year. This will examine in detail the suitability, or otherwise, of APVU for competitive tendering against the private sector.
Primates
Mrs. Roche : To ask the Secretary of State for the Home Department (1) if he will list the areas of research or categories of product involving the use of primates in (a) toxicity and (b) non-toxicity tests for the intention of registration of medical or dental products under the Medicines Act 1968 and equivalent international legislation in 1992 ;
(2) what assessment he has made of the increase in the number of primates used in scientific procedures required by the Medicines Act 1968 and the equivalent international legislation during 1992.
Mr. Charles Wardle [holding answers 7 December 1993] : The increase in the number of primates used in scientific procedures in 1992 was attributable principally to a general increase in the number of pharmaceutical products submitted for chronic toxicity testing. Total numbers of primates used increased from 4,518 in 1991 to 5, 018 in 1992, as shown in table 14 of the "Statistics of Scientific Procedures on Living Animals in Great Britain 1992", Cm 2356. Table 7 provides information on procedures for toxicity tests on the basis of broad areas and relates to the use of animals in the final stages of regulatory testing when the purpose is to identify any unexpected or adverse effects in body systems immediately prior to use of medicine by humans.
Table 4 relates to information presented to regulatory authorities and derived from animal testing at an earlier stage of product development.
To list individual areas of research or categories of product would be in breach of the requirement of section 24(1) of the Animals (Scientific Procedures) Act 1986 which provides for the protection of confidential information.
Citizenship Applications
Mr. Madden : To ask the Secretary of State for the Home Department what are the current duties of police detective officers in the processing of British citizenship applications ; what is his estimate of the total police time devoted to these duties in the current year to date ; and what plans he has to transfer these duties to other staff.
Mr. Charles Wardle [holding answer 7 December 1993] : The duties of police officers are to interview where necessary on behalf of the Home Office applicants for
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naturalisation and their referees in order to help determine whether the statutory requirements for citizenship are met and whether discretion should be exercised to grant it. The amount of police time spent on these duties is currently being collated and I shall write to the hon. Member. Consideration is currently being given to the feasibility of the nationality division conducting a proportion of these interviews itself.Column 321
HEALTH
Management Costs
Mr. Redmond : To ask the Secretary of State for Health what plans she has to reduce the management costs of health authorities and trusts.
Dr. Mawhinney : My right hon. Friend the Secretary of State has announced proposals for streamlining the structure and slimming down the management of the national health service outside hospital provider units. NHS trusts are free to determine the mix of staff required to deliver services but must do so within what they can afford from health care contracts.
Primary Care
Ms Primarolo : To ask the Secretary of State for Health what plans she has for developing equal opportunities in primary care ; and if she will make a statement.
Mr. Sackville : Family health services authorities continue to make good progress with the Opportunity 2000 initiative. Their action plans are submitted to regional health authorities and have concerned their own directly employed staff. We believe that the principles of Opportunity 2000 can be pursued to good effect within general medical practice. Although general practitioners are independent contractors and responsible for their own staff, they may look to FHSAs for support and expertise.
Steroids
Ms Primarolo : To ask the Secretary of State for Health how many deaths of children were caused or partially caused by steroids in each of the last five years.
Mr. Sackville : In the last five years one report of a fatality in a child has been received by the Committee on Safety of Medicines, through the United Kingdom's voluntary spontaneous adverse drug reaction reporting scheme, in association with corticosteroid therapy. The receipt of a report does not necessarily indicate that a specific drug caused the reaction, as many other factors may have contributed.
Smear Tests
Mr. Cohen : To ask the Secretary of State for Health what percentage of women currently receive the results of a smear test within one month ; and what is (a) the average and (b) the longest time for receiving the results for those cases outside of one month.
Mr. Sackville : Information is not available centrally in the form requested. Health authorities must aim to return the results of cervical smear tests to the doctor who undertook them within one month. The most recent review indicates that, in most cases, health authorities are meeting the one-month target time for cervical smear reporting.
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General Practitioners
Ms Primarolo : To ask the Secretary of State for Health (1) if she will make a statement on the creation of incentives for general practitioners to work in the inner city ;
(2) what plans she has to encourage (a) women general practitioners and (b) general practitioners generally into working in the inner city.
Dr. Mawhinney : The 1990 general practitioner contract introduced the deprivation payments scheme in recognition of the potential higher work load faced by GPs in urban areas. The contract also introduced explicit recognition for part-time working and job-sharing arrangements to assist doctors, including women, who wish to combine a career in general practice with other commitments.
As outlined in "Making London Better", we are currently exploring the scope for more flexible approaches to general medical services within the London initiative zone, including arrangements to strengthen the recruitment of GPs. We will assess subsequently the potential for wider application of any new arrangements which are introduced.
Ms Primarolo : To ask the Secretary of State for Health what plans she has to adjust allocation of budgets given to general practitioner budget holders to take into account census and household survey data.
Dr. Mawhinney : General practitioner fundholder budget setting guidance for 1994-95 is given in EL(93) 93, a copy of which is available in the Library. Work is being undertaken to identify any new data which may usefully be taken account of in future guidance.
Abortions
Ms Primarolo : To ask the Secretary of State for Health (1) how many abortions were performed on a private fee- paying basis in 1991 in each region ;
(2) how many abortions were performed on a private fee-paying basis by regional health authority in each year from 1985 to 1990.
Mr. Sackville : The information requested is published in "Abortion Statistics", Office of Population Censuses and Surveys, AB Nos. 12-18, table 20, copies of which are available in the Library.
Carbon Monoxide Poisoning
Ms Primarolo : To ask the Secretary of State for Health how many deaths per year are caused by carbon monoxide poisoning.
Mr. Sackville : This information is shown in the table.
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Number of deaths from carbon monoxide poisoning
England and Wales
1988 to 1992
International |1988 |1989 |1990 |1991 |1992
classification
diseases number
-------------------------------------------------------------------------------------------------------------------------------------------
|E868.1
(Accidental poisoning by other and
unspecified utility gas) |9 |5 |5 |4 |16
E868.2
(Accidental poisoning by motor vehicle
exhaust gas) |35 |33 |26 |29 |25
E868.3
(Accidental poisoning by carbon
monoxide from incomplete combustion
of other domestic fuels) |22 |10 |11 |25 |20
E868.8
(Accidental poisoning by carbon
monoxide from other sources) |1 |2 |1 |0 |2
E868.9
(Accidental poisoning by unspecified
carbon monoxide) |0 |3 |5 |3 |3
E982.0
(Poisoning by motor vehicle exhaust gas) |102 |80 |94 |90 |93
E982.1
(Poisoning by other carbon monoxide) |7 |9 |5 |7 |3
Total |176 |142 |147 |158 |162
NHS Charges
Ms Primarolo : To ask the Secretary of State for Health what were national health service items for which a charge was made ; and what was the revenue from charges in England in each of the last five years.
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Dr. Mawhinney : The available information is shown in the table.
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Charged national health service items and revenue from charges (£ million) in England
between 1988 and 1993
|1988-89|1989-90|1990-91|1991-92|1992-93
---------------------------------------------------------------------------------------
Family health services prescriptions |176.9 |189.3 |205.9 |215.2 |242.0
Family health service dental treatment |290.6 |366.2 |379.7 |404.0 |394.8
Road traffic accidents |8.7 |9.3 |9.1 |<1>- |<1>-
<1> Information about revenue from road traffic accident charges has not been
available centrally since 1990-91.
All national health service sight tests are free of charge. People who are entitled to
help with the cost of spectacles receive this in the form of a spectacle voucher; the
sale of spectacles is always a private transaction between patient and practitioner,
even when an NHS voucher is used. Information about hospital prescriptions, the
hospital eye service, and hospital orthotic services is not available centrally.
Mr. Blunkett : To ask the Secretary of State for Health if she will provide details of estimates of receipts from NHS charges broken down by category of charge for 1994-95.
Dr. Mawhinney : Information for 1994-95 will be published in the Department of Health's main Supply estimates in March 1994.
Incontinence Pads
Ms Primarolo : To ask the Secretary of State for Health if she will give the number of purchasers that are restricting either the number of incontinence pads per patient or the total number of incontinence pads.
Mr. Bowis : This information is not available centrally.
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NHS Chairmen
Ms Primarolo : To ask the Secretary of State for Health what has been the range of remuneration of the chairmen of boards of NHS health authorities and trusts for each of the last three years ; and what is their projected income for the next year.
Dr. Mawhinney : The range of remuneration for chairmen of boards of national health service health authorities and trusts from April 1990 is shown in the table.
Chairmen volunteered to forgo any increase during the period when public sector pay settlements were restricted to the range of zero to 1.5 per cent. No decision has yet been made on future increases.
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Date |Regional Health|District Health|Family Health |Trusts
|Authorities |Authorities |Services
|Authorities
|£ |£ |£ |£
------------------------------------------------------------------------------------------------
1 December 1991 |20,925 |15,125-19,285 |10,845-12,605 |15,125-19,285
1 April 1991 |20,545 |14,850-18,935 |10,645-12,375 |14,850-18,935
1 January 1991 |19,110 |13,812-17,610 |9,903-11,510 |13,812-17,610
1 April 1990 |18,921 |13,674-17,437 |9,805-11,395 |13,674-17,437
NHS Numbers
Mr. Cohen : To ask the Secretary of State for Health what plans she has to issue patients with NHS numbers.
Mr. Sackville : Every United Kingdom resident is issued with a national health service number. This happens either when the birth of a child is registered or when someone who comes to live here seeks to register with a general practitioner.
From July 1995 the NHS number will be issued in a new format suited to its wider use to identify patients within the NHS. This replacement number will continue to appear on the medical card patients receive when they register with a GP.
Junior Doctors
Ms Primarolo : To ask the Secretary of State for Health what changes she plans to the new deal for junior doctors following publication of the Winyard report.
Dr. Mawhinney : We remain committed to implementing the "New Deal on Junior Doctors' Hours", copies of which are available in the Library.
Out-patients
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the changes in levels of out-patient attendance nationally in 1991-92 and 1992-93 ; and what assessment she has made of the connections between this and the development of primary care.
Mr. Sackville : There was a 1.7 per cent. increase in the number of out-patient attendances in England between 1991-92 and 1992-93. The Government have identified a number of national health service priorities for research relating to the relationship between primary and secondary care. One of these priority areas is the
appropriateness of out-patient follow-up, which accounts for the majority of all out-patient attendances. The role of primary care in reducing unnecessary out-patient attendances is among these areas to be explored.
Insulin Cartridges
Mr. Gareth Wardell : To ask the Secretary of State for Health what is the cost of cartridges for use with insulin pens ; and what action she is taking to ensure that general practitioner fundholders are able equally with non-fundholders to continue to prescribe insulin cartridges for use with pen devices.
Dr. Mawhinney : The cost of a pack of five insulin cartridges ranges from £6.44 to £27. All cartridges are available on national health service prescription and, therefore, all general practitioners including fundholders are able to prescribe them.
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Terminal Care
Ms Primarolo : To ask the Secretary of State for Health what was the number of doctors specialising in terminal care in each of the last five years.
Mr. Sackville : The available information is shown in the table.
Doctors specialising in palliative medicine (terminal care)
by whole-time equivalents
England-at 30 September
Year |All doctors in
|palliative medicine
------------------------------------------------------------
1989 |22.2
1990 |26.3
1991 |31.2
1992 |55.5
Notes:
Statistics on the number of doctors specialising in
palliative medicine were collected for the first time in
1989.
In addition, doctors in anaesthetics, radiology and the
surgical specialties will also have a role in terminal care
in terms of pain relief and life-prolonging surgery.
Ms Primarolo : To ask the Secretary of State for Health what was the number of nurses specialising in terminal care in each of the last five years.
Mr. Sackville : This information is not available centrally.
Coronary Care
Ms Primarolo : To ask the Secretary of State for Health how many coronary care beds and high-dependency beds there were in England in each of the last 14 years.
Mr. Sackville : This information is not available centrally. A study into intensive care provision showed that in 1991-92 there were at least 356 high-dependency beds and at least 879 coronary care unit beds in England ; this is the only year for which such information is held centrally.
Ms Primarolo : To ask the Secretary of State for Health what is the difference between an acute ward and a coronary care unit ; and what research has been undertaken in relation to outcome for patients with the same heart condition placed on these two types of wards.
Mr. Sackville : An acute ward is a medical ward taking the range of medical admissions. A coronary care unit is a small ward specially staffed and equipped for the care of acutely ill patients who have suffered or are suspected of having suffered a heart attack. Any hospital that takes acute admissions will have coronary care facilities, and if a patient needing those facilities cannot be accommodated in a coronary care unit for any reason they will normally be accommodated in an acute medical ward where they will
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receive the same treatment and care as they would in a coronary care unit. No information is available centrally of any study into outcomes for patients with the same heart condition placed on these two types of wards.Cancer Patients
Ms Primarolo : To ask the Secretary of State for Health what plans she has to ensure that cancer patients are included in clinical trials in the national health service ; and if she will make a statement.
Mr. Sackville : The national health service supports cancer research funded by a number of bodies including 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, and cancer charities. The recruitment of patients to clinical trials is a matter for those conducting and funding individual studies. The funding and support of research and development in the NHS are currently under review.
NHS Registers
Mr. Cohen : To ask the Secretary of State for Health what items of personal data will be contained in NHS registers ; whether the computers containing such registers will be linked ; what statutory protection will be afforded to the registers ; and if she will make a statement.
Mr. Sackville : The national health service administrative register will consolidate information held today by the NHS in England and Wales, to facilitate seamless health care provision and support the business needs of health service bodies.
The register will comprise a number of networked, locally managed databases and will contain basic administrative details only such as name, age, address, sex, NHS number and name of the family doctor. There will be no statutory regulations governing the register ; access to and use of the register is being determined in consultation with the clinical professions and in conformance with the Data Protection Act 1988.
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