Previous Section Home Page


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.              

HEALTH

Long-term Care

12. Ms Coffey : To ask the Secretary of State for Health what is the responsibility of the national health service for people requiring long -term care.

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.

General Practitioner Fundholding

13. Mr. Clapham : To ask the Secretary of State for Health what is the administrative cost of general practitioner fundholding ; and if she will make a statement.

Dr. Mawhinney : The management allowance is about 2 per cent. of the budgets set. This is more than offset by the improvements fundholders are achieving in waiting times and quality of 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 204

table--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                 

Oral Health

14. Mr. Clifton-Brown : To ask the Secretary of State for Health if she will make a statement on her Department's negotiations with representatives of the dental profession.

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.

Mr. Loyden : To ask the Secretary of State for Health if she will publish the response to the Bloomfield report on oral health strategy.

Mrs. Jane Kennedy : To ask the Secretary of State for Health if she intends to publish her response to the Bloomfield report on oral health strategy.

Dr. Mawhinney : I refer the hon. Members to the reply I gave the hon. Member for Gower (Mr. Wardell) on 18 February, at column 1042.

Old People's Homes

15. Ms Corston : To ask the Secretary of State for Health how many local authority elderly persons homes have (a) opened and (b) closed within the last 12 months ; and if she will make a statement.

Mr. Bowis : We do not yet have national information for the period from 1 April 1993 as the main statistics are collected on a financial year basis.

Patients

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.

22. Mr. Nigel Evans : To ask the Secretary of State for Health how many in-patients were treated in (a) the latest year for which figures are available and (b) 1979.

Mr. Sackville : There were 7,829,403 episodes of care in 1992-93 compared with 5,400,120 in-patients in 1979. This represents an increase of 30 per cent.


Column 205

Genetic Screening

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.

Home Care

18. Mr. Chisholm : To ask the Secretary of State for Health if she will make a statement on the representations she has received regarding the registration and inspection of home care.

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.

Surgical Operations

19. Mr. Jacques Arnold : To ask the Secretary of State for Health how many surgical operations were completed (a) in 1993 and (b) in 1979.

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.

Asthma

20. Dr. Howells : To ask the Secretary of State for Health if she intends to modify "The Health of the Nation" to include asthma as a key medical condition to be tackled by the NHS.

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.

Mr. Sackville : A copy of the report "Health on the Waterfront" has been forwarded to the Department of Health and is receiving careful attention.

Personal Social Services

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.


Column 206

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.

Pathology Services

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.

Guy's and St. Thomas's Hospital Trust

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.

Multiple Sclerosis

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.

Mr. Bowis : Advice to people suffering from multiple sclerosis will vary according to individual needs and is a professional matter for the doctors and consultants looking after them.

Health Service Reforms

26. Sir Thomas Arnold : To ask the Secretary of State for Health if she will make a further statement about the progress of the health service reforms.

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.


Column 207

Hospital Day Cases

27. Mr. Thurnham : To ask the Secretary of State for Health how the proportion of hospital day cases has changed since 1991-92 ; and if she will make a statement.

Mr. Sackville : In 1991-92 day cases represented 20 per cent. of the total number of finished consultant episodes. The corresponding figure for 1992-93 is 23 per cent.

Immunisation

28. Mrs. Gillan : To ask the Secretary of State for Health what proportion of children are now immunised against childhood diseases ; and if she will make a statement.

Mr. Sackville : At November 1993, according to figures provided by the public health laboratory service's "Cover of Vaccination Evaluated Rapidly" programme :

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.

Tobacco

29. Ms Quin : To ask the Secretary of State for Health what new proposals she has to discourage young people from using tobacco.

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.

Birmingham Midland Eye Hospital

30. Mr. Rooker : To ask the Secretary of State for Health if she will make a statement on the proposed replacement for the Birmingham Midland eye hospital.

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.

Doctors (Fraud)

Mr. Robert Ainsworth : To ask the Secretary of State for Health what plans she has to give family health service authorities the power to suspend doctors where there are strong suspicions of fraud.

Dr. Mawhinney : We are considering the need for legislation to provide, in extreme cases, for a power of suspension of general practitioners from provision of national health service services.


Column 208

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.

Dr. Mawhinney : None.

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.

Dr. Mawhinney : I refer the hon. Member to the reply I gave the hon. Member for Coventry, South-East (Mr. Cunningham) on 18 February, at column 1046.

Infertility Treatment

Ms Corston : To ask the Secretary of State for Health what steps her Department has taken to ensure adequate central monitoring of the level of infertility treatment provision in England.

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.

Ms Corston : To ask the Secretary of State for Health what were the reasons for the decision to exclude provision of infertility treatments from the coverage of the local GP fundholding contracts.

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.


Column 209

Mr. Illsley : To ask the Secretary of State for Health what guidance is given by her Department to district health authorities with regard to the provision of infertility treatments.

Mr. Sackville : I refer the hon. Member to the reply I gave the hon. Member for Cheltenham (Mr. Jones) on 14 January, at column 315.

General Practitioners

Ms Corston : To ask the Secretary of State for Health what studies have been commissioned into the different (a) prescribing and (b) referring practices of female as opposed to male GPs.

Dr. Mawhinney : The Department is not aware of any specific studies on this issue.

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.

Mentally Ill People

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.

Mr. Bowis : The conference will be held on 3 March.

Regional Health Authority Headquarters

Mr. Lewis : To ask the Secretary of State for Health (1) what is the tenure of the North West regional health authority headquarters premises, Gateway house, Piccadilly, Manchester ;

(2) what is the tenure of the Merseyside regional health authority headquarters premises, Hamilton house, Pall Mall, Liverpool.

Mr. Sackville : Gateway house is the freehold property of my right hon. Friend the Secretary of State for Health. Hamilton house is held on lease until February 2010.

Lewisham and Southwark FHSA

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.

Mr. Sackville : This is a matter for Lambeth, Southwark and Lewisham family health services authority. The hon. Member may wish to contact Mr. Jeremy Fraser, the chairman, for details.


Column 210

Homelessness

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.                             

Children

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.

Epilepsy

Mrs. Lait : To ask the Secretary of State for Health whether epilepsy is regarded by the NHS as a chronic ailment.


Column 211

Mr. Bowis : The national health service does not categorise any illness or condition as being a chronic ailment. This is because of the degree of variation in individual cases.

Munchhausen's Syndrome by Proxy

Ms Corston : To ask the Secretary of State for Health what research she has commissioned or undertaken into diagnosis and treatment of Munchhausen's syndrome by proxy.

Mr. Bowis : None directly, but I would refer the hon. Member to the research undertaken at the St. James's hospital, university of Leeds, by Professor Roy Meadow.

Contracting Out (Pension Rights)

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.

Mr. Sackville : I refer the hon. Member to the reply my right hon. Friend the Chancellor of the Duchy of Lancaster gave him on 18 February, at column 1010.

Prescription Charges

Mr. Cox : To ask the Secretary of State for Health if she will list the dates and amounts of each increase that has been made in prescription charges since 1979.

Dr. Mawhinney : The information is in the table.


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                     

Voluntary Organisations

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 212

important 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.


Next Section

  Home Page