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Column 521


Number of cases notified for     

selected diseases in England and 

Wales                            

1992                             

               |Number           

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

Cholera        |25               

Dysentery      |16,960           

Tuberculosis   |<1>5,798         

Diphtheria     |8                

Whooping Cough |2,309            

Scarlet Fever  |4,645            

Measles        |10,268           

<1> Excluding chemoprophylaxis.  

Mr. Blunkett : To ask the Secretary of State for Health if she will list for each year since 1990 the rate per 100,000 population of diagnosed episodes of (a) whooping cough, (b) scarlet fever, (c) measles, (d) scabies, (e) pneumonia and pneumonitis and (f) pleurisy.

Mr. Sackville : The notification rates of selected diseases in 1990 and 1991 are listed in the Office of Population Censuses and Surveys publication, "Communicable Disease Statistics" series MB2, Nos. 17 and 18 respectively, copies of which are available in the Library. The information for 1992 is shown in the table. The figures have been checked as correct and will be the figures that are given in the published volume in April.


Notification rates (per 100,   

000 population) of selected    

diseases in                    

England and Wales, 1992        

ICD<1>           |1992         

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

033                            

  Whooping cough |10.3         

034                            

  Scarlet fever  |101.7        

055                            

  Measles        |34.5         

133.0                          

  Scabies        |310.9        

480-486                        

  Pneumonia and pneumonitis 173

511                            

  Pleurisy       |152.8        

<1>ICD (International          

Classification of Diseases)    

9th revision.                  

Private Health Insurance

Mr. Blunkett : To ask the Secretary of State for Health if she will list the number of persons with private health insurance for each year since 1990.

Mr. Sackville : The available information is shown in the table :


United Kingdom                

Year      |Number             

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

1991      |7,432,703          

1992      |6,976,870          

Source: Figures compiled by   

the Association of British    

Insurers to which             

figures for the Post Office   

and Civil Service Sanitorium  

Society have                  

been added.                   

Toxoplasmosis

Ms Lynne : To ask the Secretary of State for Health what action her Department is taking to promote awareness of the dangers of toxoplasmosis in pregnancy and the preventative measures available.


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Mr. Sackville : Advice on the risks from toxoplasmosis is included in the Health Education Authority's "Pregnancy Book"--which is provided for women who attend antenatal clinics--and, together with other conditions, in the Department of Health's leaflet "While you are pregnant : Safe eating and how to avoid infection from food and animals", copies of which are available in the Library. Women should be given copies of the leaflet as soon as their pregnancy is confirmed and it is available from antenatal clinics, maternity units and general practitioners practices. Doctors and midwives may also give the leaflet to women who are planning to become mothers. The Department also gives a grant of £10,000 per year to the Toxoplasmosis Trust under section 64 of the Health Services and Public Health Act 1968.

Help us to Help You" Initiative

Ms Lynne : To ask the Secretary of State for Health how much has been spent on the "Help Us to Help You" initiative ; and what savings have so far been made as a result of this campaign.

Dr. Mawhinney : I refer the hon. Member to the reply I gave to her on 18 June 1993, at column 744. There have been no further costs since that date.

Freedom of Speech

Ms Lynne : To ask the Secretary of State for Health what representations she has received from the United Kingdom Central Council for Nursing, Midwifery and Health Visitors regarding freedom of speech in the NHS.

Dr. Mawhinney : We received a comprehensive and generally supportive submission from the United Kingdom Central Council during the consultation period on the management executive's "Guidance for staff on relations with the public and the media". Two further representations were received after the publication of the guidance addressing particular points of detail.

Private Practices

Ms Lynne : To ask the Secretary of State for Health what figures her Department collects related to private practice in the NHS.

Mr. Sackville : The Department collects the following data on private patients in the national health service :

(i) for in-patients, details of hospital episodes for all specialties.

(ii) for out-patients, numbers of attendances at clinics for all specialties.

(iii) income from private in-patients.

(iv) income from private out-patients.

NHS Finance

Mr. Andrew Smith : To ask the Secretary of State for Health if she will list for each year since 1979, at 1993 prices (a) total NHS expenditure and (b) proceeds from prescription charges.

Dr. Mawhinney : The information is shown in the table.


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                 |NHS gross       |Proceeds from                    

                 |expenditure     |prescription                     

                 |adjusted        |charges adjusted                 

                 |by the GDP      |by the GDP                       

                 |1993-94 prices  |1993-94 prices                   

                 |£ million       |£ million                        

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

1978-79          |18,717          |69                               

1979-80          |19,061          |95                               

1980-81          |20,987          |147                              

1981-82          |21,458          |164                              

1982-83          |21,841          |182                              

1983-84          |22,159          |186                              

1984-85          |22,689          |194                              

1985-86          |22,748          |195                              

1986-87          |23,761          |219                              

1987-88          |24,821          |222                              

1988-89          |25,862          |233                              

1989-90          |26,049          |233                              

1990-91          |26,982          |235                              

1991-92          |28,743          |231                              

1992-93          |30,342          |250                              

1993-94          |<2>30,732       |<2>267                           

<1>Information on income from the very limited number of items      

which                                                               

attract a hospital prescription charge is not available centrally.  

<2>Figures for the current financial year are estimates.            

Private Patient Income

Mr. Milburn : To ask the Secretary of State for Health, pursuant to her answer of 18 February, Official Report, column 1037, if she will itemise, by district, the amount of private patient income received by NHS trusts in each of the last five years.

Mr. Sackville : Information is not available in the form requested. For private patient income received by national health service trusts I refer the hon. Member to the reply I gave the hon. Member for Bristol, South (Ms Primarolo) on 7 February at column 43.

Merit Awards

Ms Primarolo : To ask the Secretry of State for Health what criteria are used in in the award of merit awards.

Dr. Mawhinney : The criteria for awards are set out in the leaflet "Consultants' Distinction Awards", copies of which are available in the Library.

Stanley Royd Hospital

Mr. Hinchliffe : To ask the Secretary of State for Health, pursuant to her answer of 17 February, Official Report, columns 932-33, how many official meetings have taken place between Wakefield metropolitan district council social services department and (a) the Wakefield health authority and (b) the Pontefract and Wakefield community trust to discuss the closure of Stanley Royd hospital between the original announcement of the closure and 22 February.

Mr. Bowis : This is a matter for Wakefield health authority and the Wakefield and Pontefract community trust.

Functions Analysis Groups

Mr. Blunkett : To ask the Secretary of State for Health (1) when the functions analysis groups will report ; and whether their findings will be made public ;


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(2) if she will list the role and the membership of each of the functions analysis groups established as part of the national health service functions and manpower review.

Dr. Mawhinney : Twelve functions groups have been set up to look in detail at the future functions of national health service central management, as part of the implementation of the "Managing the New NHS" changes announced by my right hon. Friend the Secretary of State on 21 October 1993. Information about the membership and terms of reference of the groups has been placed in the Library.

The functions groups have been asked to produce final reports by 1 April 1994 and a summary of their findings will be made available.

Overseas Visitor Charges

Ms Primarolo : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Bradford, North (Mr. Rooney) of 31 January, Official Report, column 539, what was the total private income of the national health service from overseas visitors under section 121 of the National Health Service Act 1977 in 1991-92 and 1992-93 in each region, special health authority and individual trust.

Mr. Sackville : Overseas visitors charged under section 121 of the National Health Service Act 1977 are charged as national health service patients and not private patients. The available information is shown in the tables. Figures for trusts are not available centrally.


£ thousands                               

Region            |1991-92|1992-93        

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

Northern          |168    |100            

Yorkshire         |106    |67             

Trent             |143    |45             

East Anglian      |130    |180            

North West Thames |722    |963            

North East Thames |178    |141            

South East Thames |312    |416            

South West Thames |180    |248            

Wessex            |113    |145            

Oxford            |319    |334            

South Western     |148    |42             

West Midlands     |189    |153            

Mersey            |74     |8              

North Western     |74     |121            

Source: Receipts and Payments returns of  

health authorities (England).             

Notes: Figures for 1992-93 are            

provisional.                              


£000s                                                                                                            

Special health authority              |1991-92                 |1992-93                                          

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

Hospitals for Sick Children           |0                       |0                                                

National Hospital for Neurology and                                                                              

 Neurosurgery                         |0                       |0                                                

Moorfields Eye Hospital               |0                       |0                                                

The Bethlem Royal and Maudsley                                                                                   

 Hospital                             |0                       |24                                               

The Royal Brompton National Heart and                                                                            

 Lung Hospitals                       |0                       |0                                                

The Royal Marsden Hospital            |1                       |0.7                                              

Hammersmith and Queen Charlotte's                                                                                

 Hospitals                            |25                      |26                                               

The Eastman Dental Hospital           |0                       |0                                                

Source: Receipts and Payments returns of health authorities (England).                                           

Note: Figures for 1992-93 are provisional.                                                                       


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Drug Misuse

Mr. Blunkett : To ask the Secretary of State for Health (1) what plans she has to provide a co-ordinated strategic lead from her Department on building community partnerships to tackle drug misuse ;

(2) what is her response to the recommendation concerning investment in infrastructure to co-ordinate drug misuse policy made in the report commissioned by her Department from Roger Howard Associates ;

(3) when she plans to publish the report "Across the Divide : Building Community Partnerships to Tackle Drug Misuse" ;

(4) whether the report "Across the Divide : Building Community Partnerships to Tackle Drug Misuse", was amended between January and April 1993 ; and whether she will make a statement.

Mr. Bowis : The United Kingdom Government are committed to tackling every aspect of the drugs problem. On 16 December, 0fficial Report, column 780, my right hon. and learned Friend the Home Secretary announced the setting up of a central drugs co-ordination unit which will review our strategy across Government to help to ensure policies are well co-ordinated both at national and local level.

The report by Roger Howard Associates--"Across The Divide--Building Community Partnerships to Tackle Drug Misuse"--was published on 23 February. It is being distributed to health and local authorities and other interested agencies. It contains advice and recommendations for improving collaboration among local agencies to tackle the serious problem of drugs misuse. Copies of the report have been placed in the Library.


Column 526

The report touches on questions of national co-ordination which, together with its recommendations on local action, will be considered by the central drugs co-ordination unit. The remit of the study was, however, local and regional collaboration and the early draft of the report was revised to reflect this.

Amenity Beds

Ms Primarolo : To ask the Secretary of State for Health, pursuant to her answer of 4 February, Official Report, column 976, what percentage of hospitals for each region, special health authority and trust charge for amenity beds ; and what price variations exist regionally.

Mr. Sackville : The availability and charges made for amenity beds are matters for local decision. Charges should represent the notional cost of the additional privacy of a single room or small ward.

Merit Awards

Ms Primarolo : To ask the Secretary of State for Health what was the value and number of the merit awards given to men and to women in each of the regional health authority areas in England.

Dr. Mawhinney : Information on the numbers of distinction awards for male and female national health service consultants by region and by level of award is shown in the tables. The value of each level of award payable to a whole time consultant, as at 1 April 1993, is A , £47,200 ; A, £34,775 ; B, £19,875 ; C, £9,935.


Column 525


Analysis by numbers and level of awards within regions                     

                           |A+     |A      |B      |C      |Total          

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

Female at 31 December 1993                                                 

Northern                   |-      |1      |2      |29     |32             

Yorkshire                  |-      |3      |3      |18     |24             

Trent                      |1      |2      |8      |24     |35             

East Anglia                |-      |-      |5      |13     |18             

North West Thames          |1      |10     |13     |44     |68             

North East Thames          |2      |6      |19     |76     |103            

South East Thames          |1      |6      |10     |41     |58             

South West Thames          |-      |2      |8      |46     |56             

SHAs                       |3      |6      |13     |26     |48             

Wessex                     |-      |-      |4      |17     |21             

Oxford                     |-      |5      |5      |17     |27             

South Western              |-      |2      |4      |12     |18             

West Midlands              |-      |4      |9      |30     |43             

Mersey                     |-      |1      |6      |12     |19             

North Western              |-      |1      |9      |24     |34             

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

Totals                     |8      |44     |118    |421    |591            

                                                                           

Male at 31 December 1993                                                   

Northern                   |8      |31     |100    |201    |340            

Yorkshire                  |10     |36     |103    |224    |373            

Trent                      |15     |46     |118    |285    |464            

East Anglia                |12     |27     |65     |129    |233            

North West Thames          |17     |62     |103    |225    |407            

North East Thames          |23     |85     |147    |313    |568            

South East Thames          |21     |53     |117    |285    |476            

South West Thames          |9      |30     |96     |166    |301            

SHAs                       |33     |84     |106    |130    |353            

Wessex                     |3      |30     |70     |171    |274            

Oxford                     |14     |43     |62     |154    |273            

South Western              |6      |26     |98     |177    |307            

West Midlands              |6      |63     |111    |305    |485            

Mersey                     |9      |32     |62     |143    |246            

North Western              |12     |38     |109    |266    |425            

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

Totals                     |190    |645    |1,395  |3,074  |5,304          

Note: Where a consultant holds a contract in more than one region he or    

she may be counted under each but only once in the total.                  

Staff Guidance

Ms Primarolo : To ask the Secretary of State for Health whether the guidance for staff on relations with the public and media will cover private sector health providers operating under contracts from GP fundholders or health authorities ; and whether staff employed by national health service contractors are covered by the guidance.

Dr. Mawhinney : The guidance is directed at national health service staff but anyone working in the national health service is expected to comply with national health service standards of conduct particularly the obligation to safeguard patient confidentiality at all times.

CHURCH COMMISSIONERS

Gilt Stripping

Mr. Frank Field : To ask the right hon. Member for Selby, as representing the Church Commissioners, to what extent in money terms gilt stripping activity is currently being undertaken by the commissioners ; and if the commissioners will make it their policy that money from these sales is used to replenish the capital account to prevent further capital erosion of the commissioners' assets.

Mr. Alison : The income from coupon trading--or "gilt stripping"--in 1993 was £13.6 million. The amount to be generated in 1994 and ensuing years is still to be determined in the light of income requirements. Until these are brought in line with expenditure, the capital cannot be replenished. The commissioners have accepted the


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recommendations of the Lambeth Group concerning the need to preserve their capital in real terms, and coupon trading will be phased out as soon as possible.

Mr. Frank Field : To ask the right hon. Member for Selby, as representing the Church Commissioners, what agreement the commissioners have reached with their auditors on how they should treat for book-keeping purposes their gilt stripping activities, following the evidence given to the Social Security Committee.

Mr. Alison : The commissoners have recently obtained counsel's opinion on their methods of accounting for capital and income. They have been advised that coupon trading--or "gilt stripping"--does not constitute a breach of trust if it is carried out with a view to balancing the investment strategy as a whole and compensating for a low yield on other investments with a greater potential for capital growth. In those circumstances, the whole of the income thus generated may correctly rank as income in their accounts. The coupon trading activities are part of the policy recently given publicity in the press, namely that the cuts in the commissioners' allocations shall not be at so fast a rate that they will risk short-term, but irreversible, damage to the Church, while at the same time maintaining, so far as is possible, the integrity of the commissioners' portfolio.

The commissioners are discussing this matter with their auditors, whose opinion will be given in the context of the annual report and accounts taken as a whole. The commissioners cannot anticipate that opinion before the accounts and audit have been completed. The amount of income generated by coupon trading will continue to be disclosed in the commissioners' annual report and accounts.


 

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