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Mr. J. Provan--Secretary of State for Scotland
Mr. M. Mackie, Jnr--Secretary of State for Scotland
Professor A. Trichopoulou--Secretary of State for Scotland Mr. W. J. Ferguson--The Scottish Agricultural College
Professor H. M. Keir--University of Aberdeen
Principal J. M. Irvine--University of Aberdeen
Professor C. Kidd--University of Aberdeen
Dr. R. W. Brimblecombe--Confederation of British Industry Mr. F. G. Perry-- Confederation of British Industry
Professor P. Cohen--Learned Societies The Royal Society Professor A. J. F. Webster--Nutrition Society
Mr. C. S. MacPhie--Co-opted by the Rowett Research Institute Mr. D. S. C. Levie--Co-opted by the Rowett Research Institute Professor C. H. MacMurray- -Co-opted by the Rowett Research Institute
(2) how much was spent on hospital general managers and senior managers in England in the last year for which figures are available and the previous year.
Dr. Mawhinney : General and senior management posts were introduced in phases from 1986 before which the national health service was clearly undermanaged. In the hospital and community health services in 1986 and 1991 there were respectively 510 and 12,420 whole-time equivalent staff paid on general and senior managers' terms. HCHS salary costs for this group of staff were £25.7 million in 1986-87, £383.8 million in 1991-92 and £494.1 million (provisional) in 1992-93. Comparisons over the years are meaningless because the growth in numbers and costs is mainly due to the reclassification of staff
Column 604previously included in other administrative and professional categories, including many senior nurses. General and senior managers account for only 2 per cent. of the total NHS work force and 3 per cent. of total NHS expenditure on salaries and wages, but the proposals set out by my right hon. Friend on 21 October 1993 contained a commitment to streamline the structure of the NHS, to slim down its management and to make it simpler and sharper.
Dr. Marek : To ask the Secretary of State for Health what was the total cost of employing managers, advisers, administrators and clerical staff in the NHS management executive, the NHS Supplies Authority, the Prescription Pricing Authority, the medical advisers support group and the medicines research centre in each of the last three years for which figures are available.
Dr. Mawhinney : Disaggregated costs for managers, advisers, administrative and clerical staff in these five organisations are not available centrally. The total manpower costs for the national health service management executive in 1990-91, 1991-92 and 1992-93 were £24 million, £20 million and £29 million respectively. These figures are not directly comparable because of organisational changes between the NHSME and the rest of the Department of Health. The total manpower costs for the national health service supplies authority were £640, 000 for the six-month period from 1 October 1991, when the authority was formally established, and £32.2 million in 1992-93 when 4,500 staff were transferred from NHS regional and district health authorities. The total manpower costs for the Prescription Pricing Authority were £20.19 million, £22.17 million and £24.13 million in 1990-91, 1991-92 and 1992-93 respectively. The total manpower costs for the medical advisers support group were £71.11 million in 1990-91--part year in which the MASG was set up--£157.96 million and £175.94 million in 1991-92 and 1992-93 respectively. The total manpower costs for the medicines research centre were £83 million in 1990-91--part year in which the MRC was set up--£114.25 million and £111.83 million in 1991-92 and 1992-93 respectively.
Ms Primarolo : To ask the Secretary of State for Health how many babies born in each of the last five years were found at birth to be HIV positive ; what percentage remained HIV positive one and a half years later ; and if she will make a statement on HIV in the new-born.
Mr. Sackville : Between the beginning of 1989 and October 1993, 235 children born in England have been recognised at or after their birth as born to an HIV-infected woman. HIV infection has been confirmed in 76 of these and 49 are known to be uninfected. The infection status of the remaining 110 has not yet been resolved. However, the figures do not provide a reliable guide to the transmission rate as they do not cover all women who are HIV positive, but only those who were already known to be so, or whose status was recognised
retrospectively as a result of the child developing symptoms. It is generally accepted that the proportion of infants born to HIV-infected women who are infected themselves is best estimated from prospective studies such as the European collaborative study, which estimates the transmission rate at 14 per cent.
Mr. Burden : To ask the Secretary of State for Health what response she has made to the letters sent to her by the Save Highfield Hospital Campaign on 20 November 1993 and 31 January 1994 and to the petition on Highfield hospital which was handed to her on 20 November 1993 ; and if she will make a statement.
Mr. Sackville : The Save Highfield Hospital campaign has been informed that the proposal to close Highfield hospital and transfer services to Worcester royal infirmy was dealt with in accordance with laid- down procedures. As agreement was reached locally with the two community health councils involved and followed a full public consultation exercise, North Worcester health authority was able to implement the proposal without recourse to my right hon. Friend the Secretary of State.
Miss Lestor : To ask the Secretary of State for Health what plans she has for carrying forward the work of the children's rights development unit in connection with the United Nations convention on the rights of the child following the decision to cease its funding ; and if she will make a statement.
Mr. Matthew Taylor : To ask the Secretary of State for Health if she will list the schemes her Department operates to assist staff facing financial hardship following a transfer, showing (a) the particular criteria and rules applying to each one, including the circumstances under which any loans can be written off, (b) the total amount loaned or granted under the schemes in 1992-93 and so far in 1993-94 and (c) the number of staff assisted in 1992-93 and so far in 1993-94.
1. Bridging Loans
The Department may assist a member of staff transferred at the public expense who is in severe and immediate financial difficulties as a result of taking out a bridging loan which subsequently exceeds the selling price of property. Provided the member of staff cannot make good the shortfall of funds from his or her own resources and, that a value for money case can be clearly established, the Department can offer :
an interest free advance of up to 12 months salary repayable over 15 years ; and/or
an additional housing cost allowance to cover the interest charges on extra mortgage borrowing ; and/or
as a last resort where other options are not possible, to write off up to £15,000 of the bridging loan. Amounts in excess of this require Treasury approval.
2. Mortgage Redemption (negative Equity)
Where staff transferred at the public expense face genuine financial hardship an advance of up to 12 months salary may be made, repayable over 15 years.
In 1992-93 eight members of staff received advances of salary averaging £7,860 under these provisions. To date the comparable figures for 1993 -94 are two and £16,500.
Mr. Rendel : To ask the Secretary of State for Health what assessment she has made of the level of competence and skills of the nursing staff at (a) Broadmoor hospital and (b) other mental hospitals ; and if she will make a statement.
Mr. Bowis : Those who manage hospitals are responsible for ensuring that the nursing staff they employ have the required competence and skills. The management of Broadmoor hospital and the other special hospitals is the responsibility of the Special Hospitals Service Authority.
The review of mental health nursing which my right hon. Friend the Secretary of State announced in 1992 has now been completed and the report will be published shortly.
Dr. Mawhinney : The names of the members and their areas of medical expertise are listed. Dr. Grattan is a consultant dermatologist with a specialist knowledge in the treatment of skin conditions. The committee can also seek advice from external experts if it wishes to do so.
Advisory Committee on NHS Drugs Membership Name |Areas of Medical Expertise --------------------------------------------------------------------------------------------------------------------- Chairman Dr. J. S. Metters |Deputy Chief Medical Officer, |Department of Health Members Professor A. M. Breckenridge |Professor of Clinical Pharmacology, |University of Liverpool Professor C. M. Castleden |Professor of Medicine for the Elderly, |University of Leicester Mr. D. L. Coleman |Community Pharmacist, Norfolk Professor H. D. Edmondson |Professor of Oral Surgery and Oral |Medicine, Dental School, |University of Birmingham Dr. P. R. Fellows |General practitioner, Gloucestershire |Chairman of Gloucester Local Medical |Committee Professor D. Ganderton |Visiting Professor in pharmacy, King's |College, London. Chairman of the |British Pharmacopoeia Commission Miss A. F. Glasier |Consultant gynaecologist, Director of |Family Planning, Lothian Health |Board Dr. C. Grattan |Consultant dermatologist, Norfolk and |Norwich Hospital Dr. A. Greenhough |Professor of Clinical Respiratory |Physiology, King's College School of |Medicine and Dentistry Dr. G. Hargreaves |Former GP with experience of the |Pharmaceutical Industry Professor S. Holgate |Specialist in allergic disorders, |Southampton Hospital Dr. D. F. Jones |General practitioner, South Wales Professor R. M. Jones |Professor of Anaesthetics, St. Mary's |Hospital Medical School, London Mr. A. G. Kerr |Consultant ENT Surgeon, Royal |Victoria Hospital, Belfast Mrs. S. Noyce |Pharmacist adviser to Sefton FHSA Dr. S. J. Richards |General practitioner, Exeter Dr. C. H. Swan |Consultant physician (gastro- |enterology) City General Hospital, |Stoke-on-Trent Professor P. J. Tyrer |Professor of Community Psychiatry, |St. Mary's Hospital Medical School, |London Dr. D. M. B. Ward |General practitioner, Glasgow
Mr. Foulkes : To ask the Secretary of State for Health what representations she has received concerning the referral to the Advisory Committee on NHS Drugs of treatments for skin diseases ; what action she has taken as a result ; when she expects the report of the committee ; and if she will make a statement.
Dr. Mawhinney : A number of representations have been received about drugs acting on the skin. These have been drawn to the attention of the independent advisory committee, which will be reporting as soon as its review is complete. Any recommendations resulting from the work of the committee will be published for consultation before final decisions are taken.
Mr. Gale : To ask the Secretary of State for Health what steps she takes to ensure that animal tests currently used for the safety assessment of food products are effective for identifying constituents of diet that are potentially toxic or harmful to humans.
Mr. Sackville : The use of toxicity studies in laboratory animals for the safety testing of food and other products is of proven value and has gained acceptance by the scientific community worldwide. Most chemically-induced toxic effects seen in humans are also seen in appropriate animal studies. Animal studies are assessed by expert toxicologists experienced in extrapolating the information to predict likely effects in humans. Allowances are made for the uncertainties involved, particularly any differences between species.
Mr. Gale : To ask the Secretary of State for Health what progress has been made towards the introduction of validated alternatives to the use of animals in the toxicity and safety testing of food products.
Mr. Sackville : Validated alternatives to laboratory animals are available for assessing mutagenic potential of chemicals in food and other products. These data are also of value in screening compounds for their carcinogenic potential.
Much effort is being put into the development of alternatives in other areas, particularly for screening for local irritant effects, where it is hoped to have validated alternatives within a few years. However, the replacement of animals for general toxicity testing is much more difficult because of the need to reproduce the very complex
Column 608biochemical and pharmacological interactions that occur in animals. There has been some progress in reducing the number of animals used in certain tests and reducing the distress that may be caused, for example by the use of the fixed dose procedure as an alternative method for investigating acute toxicity. This was validated in a large international study sponsored by United Kingdom Government Departments and the European Community. The new procedure obviates the need for calculating LD50 values.
Mr. Milburn : To ask the Secretary of State for Health, pursuant to her answer of 17 January, Official Report, column 385, if she will list for each trust chair and non-executive director in the Northern region the name of the organisation by which they are employed.
Mr. Milburn : To ask the Secretary of State for Health, pursuant to her answer of 17 January, Official Report, column 385, if she will list for each trust chair and non-executive director in the Northern region their known party political affiliation.
Dr. Mawhinney : The political affiliation of chairmen and non- executive directors of national health service trusts plays no part in the appointment by my right hon. Friend the Secretary of State and would be known only where an appointee is actively pursuing a political career at the time of the appointment. No attempt is made to check on whether that activity is continued after appointment, so current political affiliations are not known.
Dr. Wright : To ask the Secretary of State for Health what age limits her Department (a) recommends and (b) requires for appointment to community health councils, health authorities, health service trusts, family health service authorities and any other bodies for which age limits are recommended or required ; and if in each case she will state the reasons why limits have been set.
Dr. Mawhinney : There are no statutory age limits for members of national health service authorities and trusts, nor for community health council members. Regional health authorities have been recommended not to appoint members to community health councils older than 70 years except in special circumstances.
Mr. Sackville : In 1993, 35 per cent. of members of national health service bodies and health non-departmental public bodies were women. This includes 40 per cent. of appointees to fourth-wave NHS trusts.
Ms Ruddock : To ask the Secretary of State for Health (1) how many females aged (a) 12, (b) 13, (c) 14, (d) 15, (e) 16, (f) 17 and (g) 18 years were detained in secure accommodation on the last day of each month of 1992 and 1993 ; and what were the reasons for their detention in secure accommodation ;
(2) how many males aged (a) 12, (b) 13, (c) 14, (d) 15, (e) 16, (f) 17 and (g) 18 years were detained in secure accommodation on the last day of each month of 1992 and 1993 ; and what were the reasons for their detention in secure accommodation ; (3) how many females aged (a) 12, (b) 13, (c) 14, (d) 15, (e) 16, (f) 17 and (g) 18 years were admitted to secure accommodation during (i) 1992 and (ii) 1993 ; and what were the reasons for their detention in secure accommodation ;
(4) how many males aged (a) 12, (b) 13, (c) 14, (d) 15, (e) 16, (f) 17 and (g) 18 years were admitted to secure accommodation during (i) 1992 and (ii) 1993 ; and what were the reasons for their detention in secure accommodation.
Mr. Bowis : The latest available information on the numbers of children and young people admitted to secure accommodation and resident in secure accommodation during the year by legal status and age on admission relates to the year ending 31 March 1992 and has been placed in the Library.
Dr. Mawhinney : National health service bodies are not required to take out insurance cover for possible negligence by the health care professionals that they employ, but both health authorities and NHS trusts are responsible for the negligent acts and omissions of their midwife employees acting in the course of their employment. Insurance is desirable for any work done outside the NHS contract of employment, such as Good Samaritan acts in emergencies and providing midwifery services to friends and relatives.
Ms Lynne : To ask the Secretary of State for Health what response she has made to the decision by insurance companies to regard self-employed midwives as a high financial risk ; and if she will make a statement.
Dr. Mawhinney : My noble Friend the Parliamentary Under-Secretary of State, Baroness Cumberlege, has had discussions with the Royal College of Midwives about this matter ; they arrange for their self-employed members to be provided with professional indemnity insurance and are actively seeking to resolve the concerns raised.
Mr. Blunkett : To ask the Secretary of State for Health if she will list for September 1989, September 1990 and September 1992, for each regional health authority, the number of nurses, midwives and health visitors by clinical grade and specialty.
Dr. Mawhinney : The available information is shown in the table. Child registrations increased in each month until 31 December when, on that day, child registrations which had not previously been extended for a further term were automatically deleted from the dental register. Children whose registrations have lapsed will be able to re-register.
Month ending |Child registra- |tions ------------------------------------------------ July |7,156,512 August |7,273,977 September |7,396,329 October |7,488,760 November |7,604,594 December |6,196,058
Mr. Hinchliffe : To ask the Secretary of State for Health, [pursuant to the answer of the Secretary of State for the Environment of 21 February, Official Report, column 7] : What is the percentage of the implicit element within the standard spending assessment calculation for personal social services relating to charges for services other than residential care ; and if she will make a statement.
Mr. Bowis : Within the calculations of the standard spending assessments for personal social services other than residential care for the elderly, it is uniformity between authorities in the rate of recovery of gross expenditure through income from charges which is implicitly assumed, not any specific rate of recovery.
Mr. Blunkett : To ask the Secretary of State for Health (1) if she will publish a table showing administrative expenditure by family practitioner committees in 1989 (a) in total and (b) by region ; (2) what was the total administrative expenditure of family health services authorities for each year since their creation (a) for England as a whole and (b) by region.
Dr. Mawhinney [holding answer 24 February 1994] : The information is shown in the table. Family health services authorities manage the introduction of general practitioner fundholding, the monitoring of GP prescribing, and the development of clinical audit in primary care-- all initiatives aimed at improving the effectiveness of patient care and value for money. In 1992-1993 FHSA administrative expenditure represented only 2.5 per cent. of the £6.5 billion of taxpayers' money spent on the FHS.
£000s Region FPC (1989-90) and FHSA (1990-91 to 1992 Revenue Expenditure in England |1989-90|1990-91|1991-92|1992-93 ---------------------------------------------------------- Northern |6,159 |9,684 |9,438 |10,824 Yorkshire |6,304 |9,769 |9,265 |10,973 Trent |5,175 |7,811 |12,689 |14,638 East Anglian |3,021 |4,640 |5,083 |5,663 North West Thames |5,429 |9,983 |12,964 |15,160 North East Thames |4,588 |7,677 |12,297 |14,772 South East Thames |2,903 |6,689 |10,975 |14,604 South West Thames |4,693 |6,423 |9,711 |11,533 Wessex |2,979 |6,285 |6,417 |7,701 Oxford |1,810 |5,641 |6,403 |8,528 South Western |4,168 |4,997 |7,210 |8,151 West Midlands |6,855 |9,956 |14,314 |16,700 Mersey |3,432 |3,499 |7,146 |7,899 North Western |8,993 |10,863 |12,779 |14,735 Total |66,509 |103,917|136,331|161,881 Source: Family Practitioner Committee annual accounts for 1989-90 and Family Health Services Authorities' annual accounts for 1990-91 to 1992-93; net revenue expenditure.
Mr. Lilley : I am determined to step up the fight against fraud and abuse. A wide variety of initiatives are being introduced including making more use of information technology, more secure payment methods, a one-stop service and tightening the rules to prevent abuse.
21. Ms Corston : To ask the Secretary of State for Social Security what precentage of households have an income which is less than half the average national household income ; and what was the comparable figure for 1979.
Mr. Burt : In 1979, half average national household income was £86 before housing costs and £73 after housing costs, in 1991 prices. The percentage of households with income less than this was 8 per cent. and 10 per cent. respectively. In 1990-91, the latest date for which information is available, half average national household income was £118 before housing costs and £101 after housing costs. The percentage of households with income less than this was 23 per cent. and 27 per cent. respectively. The percentage of households below half of the 1979 average household income held constant was lower in 1990-91 than in 1979.
Mr. Burt : From 20 January to 16 January the Department of Social Security and the Child Support Agency headquarters have received 2, 954 written representations covering a range of views about child support policy and Child Support Agency operations.
The cost of establishing the number of written representations made to the Child Support Agency centres and field offices would be disproportionately high. The number of representations made in person or by telephone is not recorded.
Mr. Burt : The child support system will continue to be kept under close scrutiny, as it has been since its introduction. The recent changes are testament to that fact. This is a continual process and therefore not one which should be subject to a specific timetable.
Mr. Jon Owen Jones : To ask the Secretary of State for Social Security if he intends to charge the collection fee for child support maintenance to the absent parent when the Child Support Agency takes on all maintenance agreements in 1996 where the parent with care is not on income support and where the parents are not using the collection service.
Column 613Agency's collection service, which includes enforcement, the fee will be payable by both parents. Otherwise, no fee will be charged where payments are made direct.
Mr. Jim Cunningham : To ask the Secretary of State for Social Security what proposals he has for the protection of mothers who may know the whereabouts of the absentee father, but may be reluctant to divulge it.