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(i) Specialist skills required that do not exist in the Department,
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(ii) Specialist skills exist but they are needed for higher priority objectives,(iii) Where management have taken a decision to contract out the work,
(iv) Where impartiality is fundamental to the success of the project.
Mr. Blunkett : To ask the Secretary of State for Health on which occasions since 1990 her Department has employed the services of external consultants ; and if she will give details of the purposes for which they were employed and the cost of employing them.
Mr. Sackville : There have been numerous occasions since 1990 that the Department has found the need to employ the assistance of external consultants. Detailed information could be provided only at disproportionate cost.
Birth Defects
Mr. Cummings : To ask the Secretary of State for Health (1) if she will investigate the number of children in the Northern region who have been born with missing or defective limbs over the last 10 years ;
(2) how many children have been born with missing or defective limbs in the Northern region in each year since 1989 ; and if she will list the village or town of each child.
Mr. Sackville : The information is shown in the table.
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Number of children born with missing or deformed limbs<1>-ICDs 775.0-755.9-notified to office of population of
censuses and surveys in each year 1983 to 1992 for the Northern RHA and individual DHAs
Residence |1983 |1984 |1985 |1986 |1987 |1988 |1989 |1990 |1991 |1992
--------------------------------------------------------------------------------------------------------------------------------
Northern RHA |96 |128 |109 |118 |105 |112 |95 |65 |87 |56
Hartlepool |4 |5 |6 |0 |2 |4 |5 |1 |2 |3
North Tees |6 |10 |4 |6 |6 |8 |5 |2 |1 |2
South Tees |10 |8 |12 |10 |9 |13 |6 |7 |7 |7
East Cumbria |4 |1 |3 |5 |6 |6 |3 |1 |5 |3
South Cumbria |5 |10 |4 |5 |6 |9 |8 |0 |6 |10
West Cumbria |5 |8 |6 |6 |6 |6 |1 |5 |3 |5
Darlington |2 |4 |7 |11 |2 |2 |4 |1 |6 |0
Durham |9 |9 |11 |14 |14 |14 |13 |7 |2 |0
North West Durham |0 |1 |6 |4 |3 |3 |2 |2 |0 |0
South West Durham |0 |3 |4 |6 |4 |7 |11 |4 |8 |4
Northumberland |9 |17 |11 |8 |7 |15 |8 |6 |17 |5
Gateshead |2 |10 |8 |5 |7 |4 |5 |7 |6 |6
Newcastle |4 |5 |5 |6 |3 |4 |4 |7 |8 |4
North Tyneside |2 |4 |2 |9 |7 |7 |7 |5 |3 |2
South Tyneside |8 |13 |8 |9 |6 |2 |3 |4 |5 |1
Sunderland |26 |20 |14 |14 |15 |8 |10 |6 |8 |2
North Durham |0 |0 |0 |0 |0 |0 |0 |0 |0 |2
<1> ICD (International Classification of Disease) ninth revision.
Note: Prior to 1990 all malformations, however minor, were reportable to OPCS. In January 1990 an exclusion list was
introduced. As a result minor malformations of the toe, coded to ICD 755.6 were no longer notifiable.
To protect the confidentiality of individuals we are unable to provide information on a single village or town.
Grantham and Kesteven Hospital
Ms Primarolo : To ask the Secretary of State for Health what information she has received relating to nursing and medical staffing levels at Grantham and Kesteven hospital in each of the last five years.
Dr. Mawhinney : Data on staffing levels at this level of detail are not available centrally.
Mr. Blunkett : To ask the Secretary of State for Health how many full-time consultant paediatricians are currently
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employed at the Grantham and Kesteven hospital ; and how many were employed at the time of the Beverley Allitt case.Dr. Mawhinney : Data on medical staff at local level are not available centrally.
Clinical Complaints Procedure
Mr. Gordon Prentice : To ask the Secretary of State for Health if he will list for each year since 1990 for each hospital in England, by department, how many complaints have been pursued and have succeeded under the clinical complaints procedure.
Dr. Mawhinney : The information held centrally about complaints is categorised as follows :
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--by region.--whether a complaint is about a hospital or community service. --whether wholly or partly clinical or other.
--whether the complaint was investigated by health authority officers or referred for further investigation.
The information is available in the booklet "Written complaints by or on behalf of patients, England", copies of which will be placed in the Library.
Prostate Cancer
Ms Primarolo : To ask the Secretary of State for Health how many men died from cancer of the prostate in each of the last five years.
Mr. Sackville : The information is shown in the table.
Numbers of deaths
from cancer of the
prostate-ICD 185-for
England and Wales,
1988-1992
|Number
---------------------
1988 |7,458
1989 |7,861
1990 |8,098
1991 |8,570
1992 |8,735
<1>International
Classification of
Disease, Ninth
Revision.
Private Patients
Ms Primarolo : To ask the Secretary of State for Health what has been the private patient income of trust hospitals in each year since 1990- 91.
Mr. Sackville : Information on private patient income of National Health Service trust hospitals for 1991-92 and 1992-93 will be placed in the Library. There are no figures for 1990-91 as NHS trusts did not exist in that year. The overall increase in private patient income for trusts is partially due to the increased number of trusts in 1992-93. The income raised is used to improve services for all patients.
GP Fundholders
Ms Primarolo : To ask the Secretary of State for Health how many (a) general practitioner fundholders, (b) general practitioner fundholding practitioners and (c) general practitioners were involved in fundholdings in the first, second, third and fourth wave by (i) region and (ii) FHSA.
Dr. Mawhinney : Information given in the tables is the number of fundholding units, and numbers of the practices and general practitioners who make up these units in the first, second and third waves by region. Fourth wave figures are not yet available and information at family health services authority level is not collected centrally.
First wave
Region |Fundholding|Practices |GPs
|units
------------------------------------------------------------------
Northern |27 |29 |168
Yorkshire |34 |39 |208
Trent |28 |28 |115
East Anglia |9 |9 |57
North West Thames |22 |23 |123
North East Thames |13 |13 |73
South East Thames |15 |15 |85
South West Thames |21 |21 |125
Wessex |17 |18 |98
Oxford |25 |25 |155
South Western |20 |21 |127
West Midlands |26 |26 |144
Mersey |20 |21 |107
North Western |16 |17 |88
|---- |---- |----
Totals |293 |305 |1,713
Second Wave
Region |Fundholding |Practices |General
|units |Practitioners
--------------------------------------------------------------------------
Northern |11 |11 |63
Yorkshire |25 |27 |154
Trent |28 |32 |157
East Anglia |4 |4 |27
North West Thames |21 |26 |110
North East Thames |8 |8 |43
South East Thames |15 |15 |77
South West Thames |17 |18 |100
Wessex |17 |18 |109
Oxford |21 |23 |124
South Western |18 |20 |108
West Midlands |31 |33 |178
Mersey |24 |30 |121
North Western |13 |15 |72
|---- |---- |----
Totals |253 |280 |1,443
Third Wave
Region |Fundholding |Practices |General
|units |Practitioners
--------------------------------------------------------------------------
Northern |31 |34 |161
Yorkshire |54 |57 |249
Trent |84 |102 |420
East Anglia |35 |38 |193
North West Thames |45 |46 |223
North East Thames |25 |29 |122
South East Thames |48 |59 |227
South West Thames |28 |30 |135
Wessex |22 |23 |128
Oxford |28 |28 |152
South Western |31 |33 |170
West Midlands |73 |80 |357
Mersey |40 |51 |196
North Western |37 |49 |168
|---- |---- |----
Totals |581 |659 |2,901
Source: Regional Health Authorities.
Market Testing
Ms Walley : To ask the Secretary of State for Health (1) what advice she has issued in respect of what comprises acceptable levels of detail in any specification issued in respect of national health service contracts subject to market testing ; and if she will make a statement ;
(2) what guidance she has issued in respect of market testing in the national health service ;
(3) if she will list her criteria for ensuring that procedures used in respect of the contract tendering procedure for market testing are of an acceptable standard ;
(4) to whom she has delegated responsibility to ensure compliance of contracts let under national health service market testing guidance ; and in what circumstances she may intervene.
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Mr. Sackville : Guidance to the national health service was first issued in June 1993 under cover of executive letter EL(93)55. This document "Market Testing in the NHS Revised Guidance" sets out the standards expected. Additional guidance was issued in November 1993 as an attachment to a letter to all chief executives who are responsible for market testing. Both documents are available in the Library.
Ms Walley : To ask the Secretary of State for Health (1) if she will publish full details of the arbitration procedure to be used in respect of disputed contracts let under the national health service market testing guidance ;
(2) what action she has taken to ensure the justice of the arbitration procedure in respect of national health service market testing contract procedures.
Mr. Sackville : "Market Testing in the National Health Service Revised Guidance" issued in June 1993 provides a disputes and complaints procedure. In addition, the National Health Service and Community Care Act 1990 section 4(3) provides for the determination of any dispute in an NHS contract by my right hon. Friend the Secretary of State.
Bjork-Shiley Heart Valve
Mrs. Bridget Prentice : To ask the Secretary of State for Health when her Department became aware of the United States Food and Drug Administration's (a) suspension and (b) withdrawal of the export licence for the Bjork-Shiley 70 deg convexo-concave valve.
Mr. Sackville : The first departmental record indicating the suspension and subsequent withdrawal of export permission is dated 15 January 1985.
Mrs. Bridget Prentice : To ask the Secretary of State for Health how many patients have been fitted with (a) a 60 deg
convexo-concave heart valve and (b) a 70 deg convexo-concave heart valve since 1980.
Mr. Sackville : Approximately 5,000 60 deg Bjork-Shiley convexo- concave heart valves and 42 70 deg Bjork-Shiley convexo-concave heart valves.
Mrs. Bridget Prentice : To ask the Secretary of State for Health how many patients fitted with (a) 60 deg convexo-concave valves and (b) 70 deg convexo-concave valves have had them replaced.
Mr. Sackville : Information on the replacement of Bjork-Shiley heart valves is not held centrally. However, a Bjork-Shiley convexo-concave heart valve registry has recently been established and it will be possible to obtain data on future valve replacements.
Mrs. Bridget Prentice : To ask the Secretary of State for Health when she first became aware of faults in the Bjork-Shiley heart valve ; and what action was taken.
Mr. Sackville : The Department was informed of the possibility of the failure of a small proportion of Bjork-Shiley convexo-concave heart valves in May 1982. The Department reviewed the information provided by the manufacturer and ensured that the action taken in identifying and withdrawing this group of valves was consistent with the extent of the problem as perceived at the time.
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Pacemaker Leads
Mrs. Bridget Prentice : To ask the Secretary of State for Health (1) what was the source of the information in her answer of 4 November, Official Report, column 452, that 235 pacemaker leads have been replaced ;
(2) who runs the national pacemaker database and register ; (3) pursuant to her answer of 2 December, Official Report, column 700, what is the explanation for the different figures for the number of pacemaker leads fitted in that answer and in the answer given on 4 November 1993, Official Report, column 452.
Mr. Sackville : The figure of 235 replacement pacemaker leads was obtained from the national pacemaker database--NPD--which is managed by Dr. A. F. Rickards, consultant cardiologist, at the Royal Brompton heart and lung hospital.
The NPD is continually being updated and the figures referred to on 2 December 1993 reflect the updated situation.
Pacemakers and Heart Valves
Mrs. Bridget Prentice : To ask the Secretary of State for Health which companies manufacture (a) pacemakers and (b) artificial heart valves currently in use in the United Kingdom.
Mr. Sackville : According to information held by the national pacemaker database, pacemaker manufacturers with products currently in use in the United Kingdom are : Biotec ; Biotronik GmbH & Co ; Cardiac Pacemakers Inc. ; ELA Medical ; Intermedics Inc. ; Medico Italia SRL ; Medtronic Inc. ; Osypka ; Siemens ; Sorin Biomedica SPA ; Telectronics Inc. ; Vitatron Medical BV.
According to information held by the United Kingdom heart valve registry, the following companies currently supply heart valves to the United Kingdom :
Aortech Ltd.
ATS Medical Ltd.
Baxter Healthcare
Carbomedics Inc.
Manley Western Ltd.
Medtronic Inc.
Cambridge Biomedical Ltd.
Sorin Biomedica
St. Jude Medical
Tissuemed Ltd.
Anophthalmia
Mr. Cousins : To ask the Secretary of State for Health if she will publish the conclusions of the research into the distribution of anophthalmia referred to in her answer to the hon. Member for Sheffield, Brightside (Mr. Blunkett) of 20 May 1993, Official Report, column 259.
Dr. Mawhinney : The study commissioned by the Department into the incidence of anophthalmia began on 1 January 1994 and is due to be completed by 30 September 1995. The Department of Health would usually expect the results of research it has commissioned to be published either as a separate scientific report or in a scientific journal.
Clothier Inquiry
Mr. Blunkett : To ask the Secretary of State for Health (1) when she intends to publish the report of the Clothier inquiry ; and if she will make a statement ;
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(2) if she has received the report of the Clothier inquiry.Dr. Mawhinney : I refer the hon. Member to the reply I gave the hon. Member for Bristol, South (Ms Primarolo) on 2 February, Official Report, columns 718-19.
NHS Contracts
Ms Walley : To ask the Secretary of State for Health in what circumstances she is able to call in cases of national health service contracts subjected to arbitration for her further consideration.
Mr. Sackville : There is provision within the National Health Service and Community Care Act 1990 section 4(3) for my right hon. Friend the Secretary of State to act to determine cases where a dispute arises within a national health service contract.
Ms Walley : To ask the Secretary of State for Health if she will list those national health service contracts worth over £140,000, where the arbitration procedure has been invoked.
Mr. Sackville : This information is not required centrally to monitor market testing in the national health service and is therefore not collected.
Smoking
Mr. Janner : To ask the Secretary of State for Health what percentage of (a) men and (b) women in the United Kingdom aged (i) 15 to 20 years, (ii) 20 to 25 years, (iii) 25 to 30 years, (iv) 30 to 35 years, (v) 35 to 40 years, (vi) 40 to 45 years, (vii) 45 to 50 years, (viii) 50 to 55 years and (ix) 55 years and over smoke.
Mr. Sackville : The available information is shown in the table.
Cigarette smoking among adults aged 16 and over Great Britain 1992 Age |Men |Women ------------------------------ 16-19 |29 |25 20-24 |39 |37 25-34 |34 |34 35-49 |32 |30 50-59 |28 |29 60 and over |21 |19 Notes: 1. Data published in General Household Survey 1992-OPCS. 2. Cigarette smokers are those respondents who affirmed that "they smoked cigarettes at all nowadays".
Information relating to Northern Ireland is a matter for my right hon. and learned Friend the Secretary of State for Northern Ireland.
Mr. Clifton-Brown : To ask the Secretary of State for Health what action is being taken to achieve the targets on smoking set out in "The Health of the Nation" White Paper ; and if she will make a statement.
Dr. Mawhinney : We are publishing today "Smoke-Free for Health--An Action Plan to achieve the Health of the Nation targets on Smoking". Copies are available in the Library.
The action plan sets out the Government's comprehensive approach to reducing smoking, involving a range of inter-related measures, including action on price, health education, tackling parental influence and controls on
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tobacco advertising and promotion. As part of this wide-ranging programme, the Government will open negotiations with the tobacco industry to strengthen the existing voluntary agreement on tobacco advertising and promotion.NHS Procurement
Ms Walley : To ask the Secretary of State for Health what steps she has taken to incorporate the EC services directive in respect of public procurement of national health service-related services.
Mr. Sackville : The Management Executive has incorporated advice on the EC services directive in their advice "Market Testing in the NHS Revised Guidance" published in June 1993, copies of which are available in the Library.
Medical Devices (Faults)
Mrs. Bridget Prentice : To ask the Secretary of State for Health how her Department, through the medical devices directorate, assesses the effects of faults in medical devices.
Mr. Sackville : Adverse incidents related to medical devices are reported to the national reporting and investigation centre. Scientific and technical experts fro the medical devices directorate investigate these incidents, taking advice from medical and nursing advisors and, where necessary, from relevant specialists in academia and the Health Service.
Mrs. Bridget Prentice : To ask the Secretary of State for Health what discussions she has had with the United States Food and Drug Administration regarding faulty medical devices.
Mr. Sackville : Officers of the medical devices directorate are in frequent contact with their counterparts in the United States Food and Drug Administration. This includes discussion of faulty medical devices where necessary.
Pacemakers
Mrs. Bridget Prentice : To ask the Secretary of State for Health, pursuant to her answer of 6 December, Official Report, columns 59-60, which of the 17 pacemaker technical notes and one hazard circular issued by the medical devices directorate relate to specific manufacturers ; and what are the names of the manufacturers.
Mr. Sackville : One hazard circular and 16 of the 17 pacemaker technical notes issued by the medical devices directorate relate to specific manufacturers. The names of these manufacturers are : Cardiac Pacemakers Inc ; Intermedics Inc ; Medtronic Inc ; Siemens ; Sorin Biomedica SPA ; Telectronics Inc ; and Vitatron Medical BV.
Deregulation
Mr. Heppell : To ask the Secretary of State for Health which organisations were consulted by her Department, on each of the recommendations of the business deregulation task forces before they were agreed and action proposed in the DTI document "Deregulation : Cutting the Red Tape".
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Mr. Sackville : Each of the task force recommendations agreed or agreed in principle by the Government have been or will be the subject of appropriate consultation with interested parties.
Cash Limits
Mr. Bates : To ask the Secretary of State for Health what changes are proposed to the cash limits and the running costs of her Department for 1993-94.
Mrs. Virginia Bottomley : Subject to parliamentary approval of the necessary supplementary estimate the cash limit for class XII, vote 3-- Department of Health, administration, miscellaneous health services and personal social services, England--will be reduced by £1,255,000, from £1,437,247,000 to £1,435,992,000. This reduction allows for transfers of £493,000--£484,000 running costs--to class XIII, vote 4--Department of Social Security, administration and miscellaneous services--for accommodation and word processing ; £886,000 to class XII, vote 1--Hospital, community health, family health services (part) and related services, England--£318,000 to class XIV, vote 14--Hospital, community health, family health (part) and other services, Scotland-- £148,000 to class XV, vote 8--Hospital, community health, family health services (part) and related services, Wales--and £80,000 for the Department of Health and Social Services, Northern Ireland for work of the national health service estate management and health building agency ; and £10,000 to class III, vote 5--Ministry of Agriculture, Fisheries and Food : departmental research, advisory services and administration--for the Advisory Committee on Novel Foods and Processes. The overall decrease is partially offset by transfers of £348,000 from class XIII, vote 4-- Department of Social Security, administration and miscellaneous services-- for security functions and £332,000--£326,000 running costs--from class VII, vote 6--Department of the Environment : property holdings and other services to Government--for maintenance charges.
The Department's gross running cost limit will be increased by £180,000 from £253,084,000 to £253,264,000. This reflects the transfers mentioned above.
All increases will either be offset by savings, increased receipts or transfers to or from other votes and will not therefore add to the planned total of public expenditure.
Public Appointments
Dr. Wright : To ask the Secretary of State for Health which appointments since 1979 to public bodies or posts for which she is responsible have included candidates nominated by the Chief Whip's Office ; if any nominees by this source have been appointed ; and if she will give details.
Mr. Sackville : I refer the hon. Member to the reply I gave him on 3 February at column 852.
NHS Trusts
Mr. Hicks : To ask the Secretary of State for Health what guidance her Department have given to regional health authorities as to the selection procedures that should be followed, for considering possible names for consideration as non-executive directors of NHS trusts ; what assessment she has made of the procedures adopted by the South West regional health authority ; and if she will make a statement.
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Dr. Mawhinney : In the past, regional health authority chairmen have adopted selection procedures they considered appropriate in order to identify the best candidates to meet Ministers' aim of appointing people from a variety of backgrounds and with a range of skills and experience.
Ministers will be discussing with the recently announced regional chairmen the procedures for identifying and selecting candidates for national health service appointments, with a view to adopting a common process in all regions which continues to identify the most able people available for appointment.
We have no reason to believe that the selection processes adopted by South Western regional health authority have been unsatisfactory.
Mr. Hicks : To ask the Secretary of State for Health what are the guidance and terms of reference provided by her Department to regional health authorities for prospective appointments as non-executive directors of NHS trusts ; and if she will make a statement.
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