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Numbers employed in Greater London in banking, finance, insurance and their business services (SIC 8) (includes employees and self employed only) Thousands Quarter |Numbers in |employment ---------------------------------- Spring 1989 |595 Spring 1990 |637 Spring 1991 |586 Spring 1992 |523 Summer 1992 |554 Spring 1993 |603 Summer 1993 |600 Source: Labour force survey-not seasonally adjusted.
Mr. Bowis : The national health service has a responsibility to provide long-term care for people who need it for reasons of ill-health. In implementing the new arrangements for community care we have required health and local authorities to clarify their respective responsibilities for long-term care.
Mr. Cousins : To ask the Secretary of State for Health what information she has about differences in prescribing practices of general practitioner fundholders and other general practitioners ; and from what sources that information has been derived.
Dr. Mawhinney : Prescribing analysis and cost and budget monitoring information provided by the Prescription Pricing Authority shows that fundholders prescribe drugs in generic form more often than non-fundholders --figures for 1992-93 are shown in the
Column 204table--that the rate of growth of drug expenditure is about 4 per cent. below that of non-fundholders and that fundholders came in at around their budget levels in each of the last two years. Preliminary results from a research study being undertaken by Keele university suggest that there is no evidence that fundholding leads to any reduction in the quality of prescribing and it may lead to improvements.
Percentage generic prescribing rate 1992-93 |Per cent. ------------------------------------ GP Fundholders |49 Non-fundholders |43
Dr. Mawhinney : The Government have a statutory duty to consult representatives of the dental profession when it proposes changes to their remuneration. Officials of the Department of Health also meet representatives of the dental profession informally, frequently and as the need arises.
16. Sir Fergus Montgomery : To ask the Secretary of State for Health what was the average annual change in the number of patients treated between (a) 1974 and 1979 and (b) 1979 and the latest year for which figures are available.
Mr. Sackville : The national health service is treating record numbers of patients. The average annual increase between 1974 and 1979 was 1.3 per cent. The corresponding figure for the period 1979 to 1992-93 was 2.9 per cent.
17. Mr. Dalyell : To ask the Secretary of State for Health when she expects to respond to the report of the Nuffield Council on Bioethics in relation to the insurance consequences of genetic screening.
Mr. Sackville : The scope of the report's findings go beyond the interest of the Department of Health. Ministers in this and other Government Departments will want to consider the reaction of public and professional interests before deciding whether action by the Government is needed and I will write to the hon. Member.
Mr. Bowis : We have received representations from a variety of organisations. We have no current plans to introduce compulsory registration of home care agencies, but we will review the position in 1995.
Mr. Sackville : Three and a half million in 1992-93 compared with 2.5 million in 1979. Although not directly comparable, the figures are indicative of the marked increase in national health service activity over the period, and in particular the more efficient use of hospital operating theatres.
Mr. Sackville : No. We believe that further development and research is necessary before national targets in respect of asthma can be set. In 1992-93 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, spent over £1.5 million on research into asthma and areas which may be relevant to the condition.
Mr. Raynsford : To ask the Secretary of State for Health what evidence has been presented to her Department about the incidence of asthma and other respiratory illnesses in the London borough of Greenwich.
21. Mrs. Lait : To ask the Secretary of State for Health how much was, or will be, available to councils for spending on personal social services (a) in 1979 and (b) in 1994-95 ; and if she will make a statement.
Mr. Bowis : Net expenditure by local authorities on personal social services in 1978-79 was £1,062 million. In 1994-95 total standard spending for personal social services, including the community care special transitional grant, will be £6,403.2 million, more than twice 1978-79 expenditure in real terms.
23. Ms Janet Anderson : To ask the Secretary of State for Health what discussions she has had with UNI Clinical Laboratories, UCL, about the privatisation of NHS pathology services ; and if she will make a statement.
Mr. Sackville : In accordance with the Government's market-testing policy and private finance initiative trusts and health authorities are encouraged to contract with private health care providers where it can be shown that there are real benefits to patients in terms of quality and cost -effectiveness. In October 1993, I held a meeting with UNI Clinical Laboratories at the company's request, at which these principles were discussed, as part of a series of meetings with national health service and private sector providers regarding the PFI and market testing.
24. Mr. Simon Hughes : To ask the Secretary of State for Health when she will make public all the documents relating to the future of the Guy's and St. Thomas's hospital trust ; and if she will make a statement.
Dr. Mawhinney : We have already indicated that, following careful consideration of the advice received we made the judgment that proposals to concentrate patient services, over time, at the St. Thomas's site should be pursued by the trust. All information which is necessary for statutory public consultation will be made available before a final decision is made.
25. Sir David Madel : To ask the Secretary of State for Health whether her Department is now in a position to offer any additional advice for people suffering from multiple sclerosis ; and if she will make a statement.
Dr. Mawhinney : The separation of the purchasing and provider functions is now virtually complete. Four hundred and nineteen national health service trusts will be operational by 1 April 1994 and over 6,000 general practitioners are now fundholders. Overall these changes have produced dramatic changes in patient activity which is now growing at 5 per cent. per annum. Average waiting times have been reduced from nine months to five. The recent changes announced as part of the functions and manpower review will build on the success of the reforms by streamlining the central management of the NHS to create a simplified, sharper structure.
93 per cent. of children had received diphtheria, tetanus and polio immunisations ;
91 per cent. had received pertussis--whooping cough--and, 90 per cent. had received Hib immunisation all at age 12 months, while
92 per cent. had received measles, mumps and rubella at age 24 months.
We are now well within reach of our target of 95 per cent. immunisation uptake by 1995. Doctors and nurses in general practice and in the community health service are to be congratulated on their achievements.
Dr. Mawhinney : On 7 February 1994 the Government launched "Smoke- Free for Health", an action plan to achieve "The Health of the Nation" targets on smoking. The action plan sets out the full range of measures being taken to reduce smoking, including smoking by young people.
Copies are available in the Library.
Mr. Sackville : Health authorities in Birmingham and Solihull have chosen Dudley Road general hospital to provide inpatient and day case ophthalmology services for Greater Birmingham. In support of these services, West Midlands health authority has approved a £7 million development for the hospital. The new development will replace the service currently provided at the Birmingham Midland eye hospital and is expected to open in spring 1996.
Mr. Robert Ainsworth : To ask the Secretary of State for Health what representations she has received from family health services authorities seeking additional powers to enable them to prevent fraud by general practitioners.
Mr. Robert Ainsworth : To ask the Secretary of State for Health what mechanisms exist within the national health service to deal with general practitioners who are suspected of fraud ; and if she will make a statement.
Mr. Illsley : To ask the Secretary of State for Health (1) what inquiries she has made into the level of awareness among general practitioners as to the availability of infertility provision in their area ;
(2) if she will list the centres throughout the United Kingdom which provide treatment for infertility, together with the type of treatment provided, the number of centres which provide infertility treatment for men and the number of centres which provide infertility treatment on the national health service ;
(3) if she will list the district health authorities which provide infertility treatment under the national health service, together with the treatment centre with which they are contracted for such treatment ;
(4) what statistics are collected on the level of provision of infertility treatment ; and what plans she has to increase the amount of data collected.
Mr. Sackville : Information on centres which provide regulated treatment services under the Human Fertilisation and Embryology Act 1990 is collected by the Human Fertilisation and Embryology Authority. This covers both private and national health service provision. Details of centres licensed by the HFEA are included in their annual reports, copies of which have been placed in the Library. In addition, limited information on in- patient and day case episodes in NHS hospitals is available centrally from the hospital episodes statistics, copies of which are available in the Library. District health authorities and general practitioner fundholders are responsible for identifying the health needs of their local population and for commissioning the appropriate services.
Dr. Mawhinney : Infertility treatments on an out-patient basis are already included within the scope of the fundholding scheme. High cost in- patient procedures are not included, as fundholding covers only treatments up to £5,000.
Mr. Hawkins : To ask the Secretary of State for Health what evidence she has on the changes in the workload of general medical practitioners since the introduction of the new general practitioner contract in 1990.
Dr. Mawhinney : A year-long survey of general practitioners' workload began in November 1992, carried out jointly by the Health Departments and the British Medical Association. A report of the final results will be presented to the Review Body on Doctors and Dentists Remuneration later in the year. An interim report, based on the first seven months' results, was made to the DDRB in October 1993, to inform its 23rd report--Cm 2460.
Dr. Lynne Jones : To ask the Secretary of State for health whether arrangements have now been made for a national conference to establish an agreed approach to the training of key workers for mentally ill people accepted by the specialist psychiatric services.
(2) what is the tenure of the Merseyside regional health authority headquarters premises, Hamilton house, Pall Mall, Liverpool.
Mrs. Bridget Prentice : To ask the Secretary of State for Health if she will list the amount, recipient and date of all the grants made by Lewisham and Southwark family health services authority since 1990.
Dr. Lynne Jones : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Sheffield, Brightside (Mr. Blunkett), of 8 December, Official Report, columns 249-50, whether homeless mentally ill people in London not moved into potentially permanent accommodation by community psychiatric teams are (a) sleeping rough or (b) what accommodation they are living in ; and if she will specify the accommodation.
Mr. Bowis : The table, based on active clients of the community psychiatric teams established under the homeless mentally ill initiative, indicates the proportion of that group who are sleeping rough and in a variety of types of temporary accommodation. It also specifies the types of accommodation.
Percentage of unresettled clients (sample = 369) |Percentage ----------------------------------------------------------------- (a) Sleeping rough |16 (b) Temporary accommodation |84 |------- Total |100 Type of accommodation Direct access hostel |33 HMI specialist hostel |15 Other hostel-providing care |2 Other hostel-not providing care |9 Hospital |8 Staying with friends/family or Squatting |3 Adult fostering |less than 1 Bed and breakfast |8 Prison |1 Not known |4 |------- Total per cent. |84 Notes: 1. This information is based on data about active clients with whom the five community psychiatric teams set up under the homeless mentally ill initiative were working at a particular date. 2. The category "direct access hostel" includes the Department of the Environment's cold weather shelters.
Miss Lestor : To ask the Secretary of State for Health what her Department is doing to ensure that local authorities have the time and the resources to publicise their services to children in need and fulfil their obligations to compile a register of children with disabilities ; and if she will make a statement.
Mr. Bowis : Time is, alas, not in my gift. The level of resources needed to implement the Children Act 1989 was taken into account in the local government settlements for 1991-92 and 1992-93, the first full year of the Act. In 1992-93 standard spending for children's services was 15 per cent. above the level for 1990-91 in real terms. It is, however, for local authorities to decide on the allocation of resources of the various services for which they are responsible.
Mr. Henderson : To ask the Secretary of State for Health what guidance he has issued about the effect of the Employment Protection (Consolidation) Act 1978 and the Transfer of Undertakings (Protection of Employment) Regulations 1981 on the transfer of pension rights in services in his Department which are subject to contracting out.
Prescription charge increases from 16 July 1979 to 1 April 1994 Date |Prescription|Increase |charge |(£) |(£) -------------------------------------------------------- 16 July 1979 |0.45 |0.25 1 April 1980 |0.70 |0.25 1 December 1980 |1.00 |0.30 1 April 1982 |1.30 |0.30 1 April 1983 |1.40 |0.10 1 April 1984 |1.60 |0.20 1 April 1985 |2.00 |0.40 1 April 1986 |2.20 |0.20 1 April 1987 |2.40 |0.20 1 April 1988 |2.60 |0.20 1 April 1989 |2.80 |0.20 1 April 1990 |3.05 |0.25 1 April 1991 |3.40 |0.35 1 April 1992 |3.75 |0.35 1 April 1993 |4.25 |0.50 1 April 1994 |4.75 |0.50
Mr. Congdon : To ask the Secretary of State for Health what is the total amount she expects to award in grants to voluntary organisations in 1994-95 under the section 64 general scheme ; and if she will make a statement.
Mr. Bowis : We expect to make grants totalling £19,525 million, an increase of £765,000 over the corresponding figure for 1993-94. This increase, despite current financial pressures, underlines the Government's commitment to the
Column 212important role of the voluntary sector. It represents a rise of £1.675 million--or well above 9 per cent. between 1992-93 and 1994-95.
General scheme grants go to voluntary organisations working with a wide range of people and coinciding with involving the policy responsibilities of several Department of Health Ministers. These include children, elderly people, carers, and people from ethnic minorities, as well as those having to cope with mental illness, physical disabilities, learning difficulties, or the effects of HIV/AIDS or of the misuse of alcohol or drugs.
To provide some stability in funding and to help voluntary organisations to plan ahead, most departmental grants are for three years. So for many, 1994 -95 will be the second or third year of their grant. Others will be having their grant renewed for a further term. But there will be new grants, too.
We are determined to provide room for core and project grants for organisations which have not previously benefited from departmental funding. Among the new grants beginning in April will be £15,000 a year to Changing Faces, a project at Frenchay hospital, Bristol, concerned with remedying facial disfigurement ; a core grant of £15, 000 a year to invalid children aid network ; and a core grant of £25, 000 a year to action on elder abuse.