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Executive Agencies

Mr. Bayley : To ask the Prime Minister what proportion of civil servants were operating in agencies run along "next steps" lines as at July 1993.

The Prime Minister : Around 60 per cent. of civil servants were working in agencies and other organisations operating on "next steps" lines as at July 1993.

Cash Limits

Mr. David Atkinson : To ask the Prime Minister what proposals he has to change the 1993-94 cash limit or running costs limit for the Cabinet Office ; other services vote.

The Prime Minister : Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XIX, vote 1-- Cabinet Office : other services--will be increased by £166,000 from £21,634,000 to £21,800,000 and the running costs limit increased by £166,000 from £24,414,000 to £24,580,000. The increase will be offset by the following inter-departmental transfers and will not therefore add to the planned total of public expenditure :

(a) a reduction on Her Majesty's Treasury : administration--class XVII, vote 1--in respect of the transfer of provision for central services-- £116,000 ;

(b) the transfer of provision for Property Holdings maintenance charges-- £56,000 ;

(c) a transfer to Department of Social Security administration and miscellaneous services--class XIII, vote 4--for central services--£6, 000.

Angela Heylin

Mr. Cryer : To ask the Prime Minister if he will make a statement on the appointment of Angela Heylin to the citizens charter advisory group.

The Prime Minister : Members of the panel of advisers on the citizens charter are appointed in a personal capacity and bring independent, professional expertise from the private sector. Angela Heylin was appointed on that basis.


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Lockerbie

Mr. Dalyell : To ask the Prime Minister whether he will discuss Lockerbie when he next meets President Clinton.

The Prime Minister [holding answer 3 February 1994] : The agenda for my meeting with President Clinton on 28 February has not yet been fixed.

Accounting Officers

Mr. Alan Williams : To ask the Prime Minister what were the two most recent occasions on which the Prime Minister decided that a written ministerial direction should be issued to an accounting officer overruling the accounting officer's advice.

The Prime Minister [holding answer 3 February 1994] : None, so far as I am aware.

HEALTH

NHS Hospital Admissions

Dr. Marek : To ask the Secretary of State for Health (1) how many admissions to NHS hospitals for each of the last three years for which figures are available were elective admissions ; and how many were emergency admissions ;

(2) how many admissions to NHS hospitals there were in each of the last three years for which figures are available ; and how many of these admissions were readmissions within a month of hospital discharge.

Mr. Sackville : The table shows the number of elective, day case and non-elective admissions in the general and acute sector. It is estimated that over 80 per cent. of all non-elective admissions are emergencies. Information on readmissions is not collected centrally.


General and Acute                                           |Thousands                          

                        |1991-92          |1992-93          |1993-94                            

                                                            |(forecast)                         

------------------------------------------------------------------------------------------------

Elective Admissions     |2,416            |2,323            |2,263                              

Day Cases Admissions    |1,536            |1,784            |1,958                              

Non-elective Admissions |3,505            |3,644            |3,753                              

                        |---              |---              |---                                

Total General and Acute |7,457            |7,770            |7,974                              

Sources: Ordinary admissions, day cases and total admissions:                                   

1991-92-1992-93: KP70                                                                           

1993-94: Quarterly monitoring (Q2)                                                              

Elective, non-electives                                                                         

1991-92-1992-93: Quarterly monitoring (Q4) rescaled by KP70                                     

1993-94: Quarterly monitoring (Q2).                                                             

GP Surgeries

Mr. Milburn : To ask the Secretary of State for Health how much has been spent on rebuilding general practitioners' surgeries in each of the last three years ; and what percentage has been accounted for by general practitioner fundholders.


Column 974

Mr. Sackville : The information is shown in the table. Information held centrally does not differentiate between fundholding and non- fundholding practices.


1990-91   |1991-92  |1992-93            

£ million |£ million|£ million          

----------------------------------------

79.6      |97.9     |104.9              

Dementia

Mr. Barry Jones : To ask the Secretary of State for Health what steps her Department is taking to encourage the joint commissioning by local authorities and district health authorities of generic home care for people with dementia and their carers.

Dr. Mawhinney : The Department sees joint commissioning between local authorities and health authority purchasers of community care services as important in further strengthening the effectiveness and efficiency of community care provision. To this end, copies of the report "Joint Commissioning--A Slice Through Time", prepared for the Department, were distributed to social services departments and health authorities in March 1993. Copies of the report will be placed in the Library. In addition, the Department is currently undertaking a development project aimed at spreading good practice in joint commissioning of community services in general. This should increase authorities' expertise in joint commissioning for specific client groups.

Public Bodies

Dr. Wright : To ask the Secretary of State for Health which non- departmental public bodies for which she is responsible have been (a) abolished or (b) created since 1979.

Mr. Sackville : I refer the hon. Member to the reply my right hon. Friend the Prime Minister gave on 1 February, at column 611.

Land and Building (Sales)

Mr. Blunkett : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Sheffield, Hillsborough (Ms Jackson) on 24 January, Official Report, column 116, if she will publish a table showing what total levels of capital receipts have been realised from the sale of health authority land and buildings for each of the last five financial years in each of the regional health authority areas other than Trent regional health authority.

Mr. Sackville : The table shows the total capital receipts of each region. No breakdown of these figures into land, buildings and other assets is available centrally.


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Total capital receipts for regions 1988-89 to 1992-93                         

Region            |1988-89  |1989-90  |1990-91  |1991-92  |1992-93            

                  |£ million|£ million|£ million|£ million|£ million          

------------------------------------------------------------------------------

Northern          |4.8      |3.8      |2.8      |4.8      |4.3                

Yorkshire         |10.3     |11.8     |5.3      |4.8      |2.3                

Trent             |13.9     |18.7     |25.9     |4.8      |2.9                

East Anglian      |11.1     |5.5      |3.2      |5.1      |2.6                

North West Thames |44.7     |47.1     |20.7     |40.0     |13.1               

North East Thames |51.6     |22.3     |14.3     |23.7     |18.5               

South East Thames |30.5     |21.4     |8.3      |16.1     |8.2                

South West Thames |24.8     |9.4      |15.7     |20.5     |5.9                

Wessex            |17.8     |15.5     |6.4      |5.6      |9.3                

Oxford            |17.1     |5.4      |9.6      |6.9      |5.7                

South Western     |17.3     |17.7     |23.7     |12.5     |10.6               

West Midlands     |9.5      |10.0     |4.2      |9.3      |7.0                

Mersey            |7.3      |15.9     |16.0     |6.0      |7.5                

North Western     |8.7      |8.3      |17.1     |3.1      |7.5                

Source: Receipts and payment returns for regional and district health         

authorities-England-1989 to 1992-93.                                          

Note: Figures for 1992-93 are provisional. All figures are cash.              

Ethnic Communities

Mr. Cousins : To ask the Secretary of State for Health what changes her Department has made to the health service provision for elderly members of ethnic communities in (a) London and (b) England, following her recent survey.

Dr. Mawhinney : The final reports of studies carried out by the Age Concern institute of gerontology of health and social services provision for elderly people from ethnic minorities have been carefully assessed, and executive summaries of each have been commissioned as a prelude to determining how best the research findings might be disseminated.

The 1993 Royal College of Physicians publication "Access to health care for people from black and ethnic minorities", copies of which will be placed in the Library,


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includes a paper by the Department's adviser in ethnic minority health which draws on the institute of gerontology's work. This sets out, for the use of health service purchasers and professionals in the field, the principles which should underline the provision of health care for black and ethnic minority elderly people. It is of course the responsibility of district health authorities to assess the health needs of their resident populations, including the ethnic communities, and to ensure that appropriate services are made available.

Ms Primarolo : To ask the Secretary of State for Health what has been private patient income of directly managed units in each year since 1990-91 nationally and by region.

Mr. Sackville : The total income figures shown in the table have decreased due to the decreasing number of directly managed units in 1991-92 and 1992-93.


Column 975


Directly Managed Unit Private Patient Income by Region                     

Region/SHA                 |1990-91    |1991-92    |1992-93                

---------------------------------------------------------------------------

Northern                   |2,071,309  |1,877,310  |1,332,230              

Yorkshire                  |5,044,191  |4,541,752  |2,551,178              

Trent                      |2,877,057  |3,464,673  |2,615,399              

East Anglia                |5,278,653  |7,318,941  |6,068,307              

North West Thames          |13,377,772 |13,984,258 |11,082,874             

North East Thames          |16,267,305 |11,158,170 |9,893,003              

South East Thames          |11,023,826 |11,692,162 |12,558,427             

South West Thames          |4,150,714  |3,527,592  |2,966,909              

Wessex                     |3,322,716  |4,383,335  |3,530,475              

Oxford                     |9,510,480  |9,724,622  |10,803,281             

South Western              |4,821,114  |2,111,512  |1,484,225              

West Midlands              |5,612,685  |6,326,507  |5,525,374              

Mersey                     |2,051,833  |2,006,183  |312,253                

North Western              |6,644,907  |4,949,840  |4,127,700              

Special Health Authorities |16,677,193 |21,512,694 |23,942,774             

Total Income               |108,731,755|108,579,551|98,794,409             

Source: Annual accounts for regional health authorities, district health   

authorities and London postgraduate special health authorities.            

Notes:                                                                     

1. The figures in the table include money received from NHS patients       

paying for accommodation in single rooms or small wards-section 63, NHS    

Act 1977-private in-patients-section 65-and private non-resident           

patients-section 66.                                                       

2. Overseas visitors-section 121-have been excluded as these are not       

separately identifiable for all the years requested.                       

3. The 1992-93 figures are provisional and subject to National Audit       

Office audit amendment.                                                    

Mr. Milburn : To ask the Secretary of State for Health how much income by region has been generated by private patient facilities in national health service hospitals in each year since 1987-88.

Mr. Sackville : I refer the hon. Member to the reply I gave the hon. Member for Bristol, South (Ms Primarolo) on 31 January at columns 531-32.


Column 976

Counselling and Condoms

Miss Lestor : To ask the Secretary of State for Health what information she has received from the health districts which are running evaluation projects looking at the provision of counselling and condoms on a starter basis by general practices ; and if she will make a statement.

Mr. Sackville : Since 1992 the Department has suggested that health authorities consider developing the role of general practitioners in safer sexual counselling and the provision of information and condoms on a "starter"


Column 977

basis. Results from these projects are generally favourable. In particular, offering sexual health advice during family planning and smear test consultations is an efficient and effective way of reaching sexually active women. On the basis of their own evaluation, some regions have decided to expand their schemes to include more GP practices. It is, however, a matter for health authorities how they choose to develop the initiative.

Voluntary Bodies

Miss Lestor : To ask the Secretary of State for Health (1) if she will list the organisations which are to receive section 64 funding from April 1994 and the amount each organisation will receive ; (2) if she will list the organisations, which will receive section 64 funding from April 1994, which are based outside London and indicate separately those based in the north-west.

Dr. Mawhinney : Ministers are curently considering all applications received for possible funding under the section 64 general scheme during 1994-95. Some organisations have already been notified of the outcome and the remainder will be notified as soon as decisions are taken. In addition further notifications will be issued at a later stage, where, for example, work on a project has yet to start or to accommodate slippage during the year on approved proposals. To qualify for section 64 support, an organisation must generally operate on a national basis ; where its headquarters may be located is not a relevant criterion. Information on where it may be based is, therefore, not separately identified.

Miss Lestor : To ask the Secretary of State for Health if she will give the reasons why the application for section 64 funding, from April 1994, by the George House trust in Manchester was unsuccessful.

Dr. Mawhinney : Bids from HIV/AIDS voluntary organisations exceeded the section 64 funding available for 1994-95 by over 100 per cent. Our priority was to continue grants to those organisations to which financial commitments had already been made.

NHS Capital Schemes

Mr. Willetts : To ask the Secretary of State for Health what steps have been taken by her Department to notify NHS directors of finance that all NHS capital schemes will in the future need to demonstrate that private sector alternatives have been fully considered before a case is made for public finance.

Mr. Sackville : In a letter dated 14 January 1993, FDL(93)03, the National Health Service Management Executive director of finance and corporate information urged NHS directors of finance to make full and appropriate use of the new scope for private capital in the NHS, so that NHS money would be used most productively on patient care, and major improvements to the environment for patients and NHS staff, and to health care services, would be possible. Many examples of private finance options were included in the information pack "Public Service, Private Finance putting private capital to work for the NHS", sent with the executive letter EL(93)101 to all NHS general managers on 18 November 1993. In this executive letter the director of finance and corporate information said :


Column 978

"I expect private finance to become a standard option that is considered in planning any NHS capital scheme".

Further instructions on considering private finance options are to be included in the forthcoming NHS capital investment manual. Copies of both letters are available in the Library.

GPs (Deputising Services)

Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the contractual relationship between the NHS and GP deputising services.

Dr. Mawhinney : It is for individual general practitioners to choose whether to enter into an arrangement with a deputising service, to obtain their family health services authority's consent, and to agree any contractual arrangement with the deputising service.

Accident and Emergency Units

Ms Primarolo : To ask the Secretary of State for Health how many accident and emergency units there were in London in each of the last five years.

Mr. Sackville : The information available is shown in the table. From 1991-92 the numbers of national health service accident and emergency services have been recorded by management units which may provide services on more than one site. In February 1994, the London ambulance service advised that it serves accident and emergency units on 48 sites.


                                 |Inner |Outer |Total        

                                 |London|London              

-------------------------------------------------------------

Number of hospitals providing                                

A and E services                                             

1988-89                          |27    |31    |58           

1989-90                          |27    |31    |58           

1990-91                          |29    |31    |60           

                                                             

Number of NHS management                                     

units providing A and E services                             

1991-92                          |18    |25    |43           

1992-93                          |18    |18    |36           

Source: SD2A KH03 return.                                    

Adoption (Smokers)

Mr. Janner : To ask the Secretary of State for Health what plans she has to encourage local authorities to ban male or female smokers from adopting children of (a) under three years or (b) over three years of age.

Dr. Mawhinney : We have no plans to encourage local authorities to ban smokers from adopting children of any age. However, the effects of passive smoking are well known and local authorities cannot ignore the information when assessing prospective adopters of young children.

Hearing Aids

Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she will make a statement on her Department's policy concerning the provision of free hearing aids on the national health service.

Dr. Mawhinney : Hearing aids continue to be available free of charge through the national health service.


Column 979

Disabled Persons

Mr. McMaster : To ask the Secretary of State for Health if she will take steps to implement the remaining sections of the Disabled Persons (Services, Consultation and Representation) Act 1986 ; and if she will make a statement.

Dr. Mawhinney : We have no plans at present to implement the remaining sections of the Disabled Persons (Services, Consultation and Representation) Act 1986. However, the Department is committed to reviewing the situation in the light of a few years' experience of community care.

AIDS

Mr. Blunkett : To ask the Secretary of State for Health if she will publish a table showing details of AIDS support grant allocations to local authorities for 1993-94 and 1994-95.

Mr. Sackville : 1993-94 allocations to local authorities for HIV/AIDS related services are shown in the table. Final allocations for 1994-95 have not yet been determined.


                 |1993-94                

                 |allocations            

Authority        |£                      

-----------------------------------------

Camden                                   

Hammersmith                              

Kensington                               

Lambeth                                  

Westminster                              

Avon                                     

Barnet                                   

Birmingham                               

Brent                                    

Bromley                                  

Croydon                                  

Ealing                                   

East Sussex                              

Enfield                                  

Greenwich                                

Hackney                                  

Hampshire                                

Haringey                                 

Hillingdon                               

Hounslow                                 

Islington                                

Leeds                                    

Leicestershire                           

Lewisham                                 

Liverpool                                

City of London                           

Manchester                               

Merton                                   

Newcastle                                

Newham                                   

Oxfordshire                              

Richmond                                 

Southwark                                

Sutton                                   

Tower Hamlets                            

Wandsworth                               

Waltham Forest                           

Barking                                  

Barnsley                                 

Bedfordshire                             

Berkshire                                

Bexley                                   

Bolton                                   

Bradford                                 

Buckinghamshire                          

Bury                                     

Calderdale                               

Cambridgeshire                           

Cheshire                                 

Cleveland        |56,000                 

Cornwall         |31,000                 

Coventry         |54,000                 

Cumbria          |31,000                 

Derbyshire       |31,000                 

Devon            |40,000                 

Doncaster        |31,000                 

Dorset           |21,000                 

Dudley           |31,000                 

Durham           |44,000                 

Essex            |48,000                 

Gateshead        |30,000                 

Gloucestershire  |34,000                 

Harrow           |42,000                 

Havering         |16,000                 

Hereford         |34,000                 

Hertfordshire    |29,000                 

Humberside       |62,000                 

Isle of Wight    |22,000                 

Kent             |74,000                 

Kingston         |43,000                 

Kirklees         |39,000                 

Lancashire       |22,000                 

Lincolnshire     |31,000                 

Norfolk          |25,000                 

Northamptonshire |36,000                 

Northumberland   |25,000                 

North Tyneside   |54,000                 

North Yorkshire  |31,000                 

Nottinghamshire  |48,000                 

Oldham           |31,000                 

Redbridge        |30,000                 

Rochdale         |17,000                 

Rotherham        |31,000                 

Salford          |26,000                 

Sandwell         |26,000                 

Sefton           |31,000                 

Sheffield        |86,000                 

Shropshire       |93,000                 

Somerset         |24,000                 

South Tyneside   |45,000                 

St. Helens       |26,000                 

Staffordshire    |31,000                 

Stockport        |31,000                 

Suffolk          |20,000                 

Sunderland       |48,000                 

Surrey           |31,000                 

Tameside         |31,000                 

Trafford         |31,000                 

Wakefield        |40,000                 

Walsall          |40,000                 

Warwickshire     |26,000                 

West Sussex      |23,000                 

Wigan            |21,000                 

Wiltshire        |31,000                 

Wirral           |31,000                 

Wolverhampton    |15,000                 

Infertility Services

Ms Jowell : To ask the Secretary of State for Health if she will list the national health service purchasing authorities which purchase infertility services according to their purchasing strategies submitted to her Department ; how much each authority spends on infertility services ; which national health service purchasing authorities provide each of (a) advanced reproductive technologies generally (b) in vitro fertilisation (c) gamete intrafallopian


Column 981

transfer and (d) infertility counselling within their infertility service purchasing plans ; and how much they spend on each service.

Mr. Sackville : Individual health authority purchasing plans are monitored by the regional health authorities. The hon. Member may wish to contact the chairmen of the regional health authorities for details.

Data Protection

Mr. Cohen : To ask the Secretary of State for Health whether the draft of the code of practice with respect to the confidentiality of medical records has been shown to the Data Protection Registrar.

Mr. Sackville : The Data Protection Registrar will be among those consulted on draft guidance on the confidentiality, use and disclosure of personal health information which we will issue shortly.

Cash Limits

Mrs. Gillan : To ask the Secretary of State for Health what changes she proposes to make to the cash limits and running costs limits for the Office of Population Censuses and Surveys for 1993-94.

Mr. Sackville : Subject to parliamentary approval of the necessary supplementary estimate, the cash limit for class XII, vote 6--Office of Population Censuses and Surveys--will be increased by £149,000 to £33,809,000 and the running costs limit for OPCS will be increased by £149,000 to £48,288,000. This increase will be offset by transfers of £142,000 from Property Holdings and £7,000 from the Employment Department and will not therefore add to the planned total of public expenditure.

Community Care

Mr. Garnier : To ask the Secretary of State for Health what conditions she intends to attach to the community care special transitional grant for 1994-95.

Mr. Bowis : We intend that local authorities will again be required to spend the entire grant on community care services and directly associated costs. They will also be required to spend 85 per cent. of the social security transfer element of the grant on community care services provided by the independent sector.

Changing Childbirth"

Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the implementation of the report of the expert maternity group "Changing Childbirth".

Mr. Sackville : My right hon. Friend the Secretary of State for Health announced on 24 January the Government's intention to implement in full the recommendations in the report of the expert maternity group. The report was previously the subject of extensive consultation with consumers, national health service and professional bodies, and its recommendations for establishing a woman-centred service were widely welcomed.

EL(94)9 set out action required in the NHS, and copies are available in the Library.


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Pregnant Women

Ms Primarolo : To ask the Secretary of State for Health if she will list by region for the last five years the number of pregnant women who (a) gave birth in a hospital, (b) gave birth in the mother's home, (c) booked a midwife as their lead professional and (d) hold their own medical notes.

Mr. Sackville : Information on the number of pregnancies resulting in births at hospital and births at home can be found in table 8.2 of the annual reference volume "Birth Statistics", series FM1. Volumes for 1987 to 1991--series FM1, Nos. 16 to 20--are available in the Library. Information on women booking with a midwife as a lead professional and those holding their own medical notes are not available centrally.

Abortions

Ms Primarolo : To ask the Secretary of State for Health how many abortions in 1992 were carried out under national health service agency agreements by district health authority of usual residence.

Mr. Sackville : This information will be placed in the Library.

Hospital Closures

Mr. Cryer : To ask the Secretary of State for Health if she will list the national health service hospitals closed for each year since 1980 ; to what subsequent use the sites have been put ; and what revenue was gained from these.

Mr. Sackville : Since 1980-81 some £1,540 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. Information on individual hospital closures is not available.

Breast Cancer

Ms Primarolo : To ask the Secretary of State for Health what percentage of women in the eligible target group have been screened for breast cancer in the last three years for each health region in England ; how many women have breast cancer in each region ; and how many women died from breast cancer in each health region.

Mr. Sackville : The information is not available in the form requested. Table A shows the uptake figures for breast cancer screening by region for 1990-91 and table B for 1991-92. Table C give regional incidence data for the latest available year of 1987. Table D gives mortality data for the years 1990 to 1992.


Table A                                            

Breast cancer-Uptake of screening invitation by    

region for 1990-91                                 

Region            |Screened  |Compliance           

                             |Per cent.            

---------------------------------------------------

England           |625,615   |71                   

Northern          |46,855    |75                   

Yorkshire         |39,956    |68                   

Trent             |67,074    |76                   

East Anglia       |29,725    |74                   

North West Thames |34,792    |60                   

North East Thames |57,583    |60                   

South East Thames |53,213    |70                   

South West Thames |21,076    |70                   

Wessex            |48,902    |76                   

Oxford            |27,837    |81                   

South Western     |53,527    |69                   

West Midlands     |73,757    |69                   

Mersey            |38,422    |73                   

North Western     |32,896    |74                   


Table B                                            

Breast cancer-uptake of screening invitation by    

region for 1991-92                                 

Region            |Screened  |Compliance           

                             |Per cent.            

---------------------------------------------------

England           |922,726   |71                   

                                                   

Northern          |70,214    |75                   

Yorkshire         |64,598    |74                   

Trent             |92,257    |77                   

East Anglia       |41,939    |81                   

North West Thames |50,484    |58                   

North East Thames |73,439    |61                   

South East Thames |70,868    |71                   

South West Thames |49,176    |67                   

Wessex            |54,027    |78                   

Oxford            |60,050    |77                   

South Western     |73,001    |74                   

West Midlands     |102,011   |72                   

Mersey            |46,786    |69                   

North Western     |73,876    |73                   


Table C                         

Breast cancer registrations by  

Regional Health Authority 1987  

malignant neoplasm of female    

breast                          

                  |Number       

--------------------------------

England           |22,026       

Northern          |1,352        

Yorkshire         |1,658        

Trent             |2,193        

East Anglian      |1,084        

North West Thames |1,354        

North East Thames |1,621        

South East Thames |1,351        

South West Thames |1,168        

Wessex            |1,682        

Oxford            |1,208        

South Western     |1,789        

West Midlands     |2,649        

Mersey            |1,104        

North Western     |1,813        


Table D                                       

Deaths-Cancer of the breast by region         

Region            |1990  |1991  |1992         

----------------------------------------------

England           |12,824|12,980|12,804       

Northern          |757   |801   |796          

Yorkshire         |927   |888   |888          

Trent             |1,250 |1,260 |1,287        

East Anglian      |585   |576   |593          

North West Thames |840   |886   |819          

North East Thames |1,009 |1,020 |938          

South East Thames |1,042 |1,087 |1,061        

South West Thames |860   |877   |885          

Wessex            |856   |871   |871          

Oxford            |629   |623   |648          

South Western     |952   |1,019 |989          

West Midlands     |1,401 |1,437 |1,402        

Mersey            |674   |590   |646          

North Western     |1,042 |1,045 |981          

Consultant Episodes

Ms Primarolo : To ask the Secretary of State for Health, pursuant to her answer of 31 January, Official Report , columns 531-33 , when she intends to publish the number of finished consultant episodes by region for private patients in national health service hospitals in 1992-93, in- patients plus day cases ; and for what reasons the revenue generated is known for 1992-93 but not the activity level.

Mr. Sackville : Information about revenue and activity comes from different information systems. Private patient treatment numbers are part of the hospital episode statistics system which are not submitted to the Department until clinical information has been added to the patient record. We expect the information on the number of private patients treated in the national health service to be available by the end of March.

Cervical Cancer

Ms Primarolo : To ask the Secretary of State for Health what percentage of women in the eligible target group have had a cervical cancer smear test within the last five years for each health region in England ; how many women have cervical cancer in each region ; and how many women died of cervical cancer in each health region.

Mr. Sackville : The information required is not available in the form requested. Table A gives latest available Korner data from 1991-92 on the number of women tested for cervical cancer in the last 5.5 years by region. Table B gives the latest available incident data. Table C gives the latest available mortality data for 1989 to 1992.


Table A                                                           

Cervical cancer test                                              

Status of residents aged 20 to 64 by regional health authority    

                  |Number of      |Coverage                       

                  |women tested in                                

                  |last 5.5 years |Per cent.                      

------------------------------------------------------------------

England           |11,048,444     |79.9                           

Northern          |737,788        |83.5                           

Yorkshire         |844,486        |84.8                           

Trent             |1,147,980      |87.5                           

East Anglia       |477,109        |85.8                           

North West Thames |714,127        |65.0                           

North East Thames |805,961        |64.4                           

South East Thames |794,951        |70.3                           

South West Thames |707,827        |78.0                           

Wessex            |699,260        |87.6                           

Oxford            |613,479        |85.1                           

South Western     |766,994        |86.5                           

West Midlands     |1,240,756      |84.1                           

Mersey            |556,856        |82.0                           

North Western     |940,870        |83.5                           


Table B                         

Cervical cancer registrations   

by regional health authority    

1987                            

Malignant neoplasm of cervix    

uteri                           

                  |Number       

--------------------------------

England           |3,636        

Northern          |248          

Yorkshire         |397          

Trent             |405          

East Anglian      |150          

North West Thames |161          

North East Thames |164          

South East Thames |210          

South West Thames |144          

Wessex            |282          

Oxford            |152          

South Western     |270          

West Midlands     |415          

Mersey            |263          

North Western     |375          


Table C                                                     

Deaths cancer of the cervix by region                       

Region            |1988  |1989  |1990  |1991  |1992         

------------------------------------------------------------

England           |1,809 |1,692 |1,653 |1,531 |1,532        

Northern          |148   |117   |119   |114   |102          

Yorkshire         |144   |151   |135   |133   |131          

Trent             |196   |177   |160   |175   |148          

East Anglian      |68    |63    |72    |62    |56           

North West Thames |101   |109   |97    |83    |103          

North East Thames |124   |123   |97    |103   |120          

South East Thames |131   |146   |117   |107   |133          

South West Thames |89    |80    |81    |76    |66           

Wessex            |107   |99    |99    |95    |71           

Oxford            |81    |52    |56    |76    |57           

South Western     |122   |121   |114   |76    |133          

West Midlands     |206   |172   |186   |152   |179          

Mersey            |105   |111   |123   |109   |92           

North Western     |187   |171   |197   |170   |141          

GP Fundholders

Mr. Blunkett : To ask the Secretary of State for Health what powers health authorities have to impose financial penalties on general practitioner fundholders who have patients waiting over 18 months for surgery.

Dr. Mawhinney : None. Fundholders are expected to comply with patients charter standards in the same way as district health authorities, and are providing extremely effective in improving waiting times.

Mrs. Ann Winterton : To ask the Secretary of State for Health whether the case identified by a general practitioner in a letter to the hon. Member for Congleton, a copy of which has been drawn to her attention in a letter of 11 January, about priority used by the North Staffordshire infirmary in the allocation of treatment to the patients of fundholding and non-fundholding general practices is consistent with her policies ; what action she has taken in that case ; and if she will make a statement.

Dr. Mawhinney [holding answer 17 January 1994] : This was an issue about magnetic resonance imaging scanning. Patients are referred for a scan on the basis of urgent clinical need and there is no preference for the patients of either fundholders or non-fundholding general practitioners.

Accommodation Costs

Ms Primarolo : To ask the Secretary of State for Health how much money was received in total by the NHS from NHS patients paying for accommodation in single rooms or small wards in 1988-89, 1990-91 and 1992- 93 ; what was the estimated average charge for such accommodation ; and how many people paid such a charge in each of those years.


Column 986

Mr. Sackville : The figures requested on income are shown in the table. Information on the number of people paying such charges are held locally. Therefore, estimated average charges are not known. Income of this sort enables hospitals to improve services for all patients.


Income from amenity beds               

Year         |Sum received             

             |£                        

---------------------------------------

1988-89      |764,276                  

1990-91      |1,260,313                

1992-93      |1,776,185                

Source: Annual accounts and receipts   

and payments returns for regional      

health authorities, district health    

authorities and London postgraduate    

special health authorities.            

Notes:                                 

1. Figures for 1988-89 and 1990-91     

were obtained from the annual          

accounts of health authorities. The    

figures for 1992-93 were only          

separately identifiable in the         

receipts and payments returns. The     

figures                                

for 1992-93 are not, therefore,        

directly comparable with those for the 

earlier years.                         

2. Amenity bed income received by      

national health service trusts has     

been omitted as it is not separately   

identified from private patient in     

annual accounts.                       

GP Retraining

Mr. Blunkett : To ask the Secretary of State for Health what was the total cost to the NHS, for each of the last five financial years of allowances to general practitioners for retraining courses.

Dr. Mawhinney : Expenditure on the postgraduate education allowance for general practitioners, introduced in April 1990, has been :


          |£ million          

------------------------------

1990-91   |44.4               

1991-92   |47.6               

1992-93   |49.1               

These sums were not identified separately within GPs' remuneration prior to 1990-91. Payments made through the more limited postgraduate training allowance scheme totalled £1.3 million in 1988-89 and £2.5 million in 1989-90.

Mr. Blunkett : To ask the Secretary of State for Health if she will make a statement of the criteria to be satisfied by retraining courses in order for general practitioners to qualify for reimbursement of the costs of attending those courses ; and what was the date on which current department guidelines were introduced.

Dr. Mawhinney : Criteria for the approval of courses held in England which qualify for the postgraduate education allowance are not promulgated centrally. The responsibility for the accreditation of such courses is exercised centrally by the regional advisers in general practice.

Mr. Blunkett : To ask the Secretary of State for Health what was the total number of retraining courses undertaken by general practitioners for each of the last five years.

Dr. Mawhinney : Locally based data are collected and held by the regional advisers in general practice.


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