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Mr. Waldegrave : I refer the hon. Gentleman to the 2 February debate in the House on the research council orders, during which I set out my immediate plans for encouraging private sector partnerships with the science and engineering base, Official Report , column 895, through, for example, the "realising our potential" awards--ROPA--grants scheme and the industry-led CASE postgraduate studentship awards.
At my request, the Director General of the Research Councils is embarking on a fundamental examination of the research council programmes in order to advise on the overall health of the science and engineering base, and on the action required to take forward the policies set out in the White Paper "Realising our Potential : A Strategy for Science and Technology"--Cm 2250, May 1993.
Human Gene Technology
Mr. Harry Greenway : To ask the Chancellor of the Duchy of Lancaster if he will make a statement about Government control of human gene technology.
Mr. Waldegrave : Certain aspects of human gene technology are controlled under the Genetically Modified Organisms (Contained Use) Regulations 1992, which are designed to protect human health and safety and the environment from genetically modified organisms used in contained conditions such as laboratories or industrial facilities. Under these regulations, all persons undertaking such work must conduct a risk assessment of the activity. This assessment will determine the risk classification of, and the safety precautions required for, the work. The independent Advisory Committee on Genetic Modification is regularly consulted on higher risk projects. All premises where work with genetically modified organisms takes place must be registered with the Health and Safety Executive. The regulations also contain provisions for inspection and enforcement under the Health and Safety at Work, etc. Act 1974.
All proposals for gene therapy research on human subjects are considered by the Gene Therapy Advisory
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Committee, established in 1993 by United Kingdom Health Ministers in response to the recommendation of the Committee on the Ethics of Gene Therapy. It advises on the acceptability of such proposals on ethical grounds, taking account of the scientific merits of proposals and potential benefits and risks.Subsidiarity
Mr. Jenkin : To ask the Chancellor of the Duchy of Lancaster, pursuant to the answer by the Prime Minister on 13 December, Official Report, column 700, what assessment he has made of the effects of subsidiarity on the EC acquired rights directive and the Government's market-testing and competitive tendering programme.
Mr. David Davis : The Government welcome the European Commission's review of the directive, under subsidiarity, and hope that this will remove the damaging effects it can have on competitiveness and jobs--in particular where it has been inappropriately applied to contracting out.
However, the Transfer of Undertakings (Protection of Employment) Regulations 1981 which implement the directive in United Kingdom law have not prevented Departments from market testing or otherwise examining around £1.1 billion-worth of services to the end of December 1993.
Agencies (Management)
Mr. Morgan : To ask the Chancellor of the Duchy of Lancaster if he will place a copy of the Trosa report into the setting up of executive agencies and the evaluation of the civil service reforms in the Library ; and if he will make a statement.
Mr. Waldegrave : I did so on 1 March and I refer the hon. Member to the answer I gave to my hon. Friend the Member for Wyre (Mr. Mans), Official Report, columns 671-72.
HEALTH
Public Appointments
Dr. Wright : To ask the Secretary of State for Health if she will give details of the public appointments she is responsible for making in addition to those identified in "Public Bodies 1993", including non- executive agency and other departmental management boards.
Mr. Sackville : In addition to those listed in "Public Bodies 1993", my right hon. Friend the Secretary of State, or Ministers acting on her behalf, appoints the chairman and members of the following bodies :
Central Research and Development Committee for the NHS ; Research and Development Strategy ;
Dental Vocational Training Authority ;
National Advisory Body (which guides and co-ordinates the Confidential Enquiry into Stillbirths and Deaths in Infancy in England, Wales and Northern Ireland) ;
NHS Supplies Authority ;
National Breastfeeding Working Group ;
Nutrition Task Force ;
Pharmacists' Review Panel ;
Vocational Training Appeal Body.
My right hon. Friend appoints chairmen of the London implementation group, the joint supervisory board of the NHS centre for coding and classification and the national case mix office.
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In addition, my right hon. Friend the Secretary of State is responsible for appointing the expert members of the steering group on the microbiological safety of food. Some appointments to the Council for Professions Supplementary to Medicine and the General Dental Council's dental auxiliaries committee are made jointly with my right hon. Friends the Secretaries of State for Scotland and Wales and my right hon. and learned Friend the Secretary of State for Northern Ireland.Appointments are also made to the three main "Health of the Nation" advisory groups. These are the wider health working group, The Chief Medical Officer's "Health of the Nation" working group and the chief executive's NHS implementation group.
My right hon. Friend the Secretary of State also appoints 26 bodies of special trustees to administer the trust funds of various pre-1974 boards of governors and university hospitals which chose to keep their individual funds.
Pacemaker Leads
Mrs. Bridget Prentice : To ask the Secretary of State for Health how many patients with (a) Siemens and (b) Medtronic pacing leads which have been subject to warnings have had the leads replaced or inactivated.
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Mr. Sackville : According to information sent to the national pacemaker database, 224 Siemens pacing leads, and 39 Medtronic pacing leads subject to warnings, have been replaced or inactivated in the United Kingdom.
Mr. Bridget Prentice : To ask the Secretary of State for Health how many patients have been implanted with (a) Sorin 580T silicone pacemaker leads, (b) Talectronics 330258158 pacemaker leads, (c) Talectronics 033301 pacemaker leads, (d) Medtronic 4004 pacing leads, (e) Medtronic 4004M pacing leads, (f) Medtronic 4082 pacing leads, (g) Siemens 1010T pacing leads, (h) Siemens 1050T pacing leads and (i) Siemens prototype T93 since 1987 ; and how many have died in each category, in each year since 1987.
Mr. Sackville : There is no 580T pacemaker lead made by Sorin Biomedica, and no records exist of pacemaker leads with the model numbers 330258158 and 033301.
Information requested for the Medtronic and Siemens pacemaker leads, based upon data returned to the national pacemaker database, is shown in the table.
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Information based upon data returned to the national pacemaker database
Pacemaker lead |1987 |1988 |1989 |1990 |1991 |1992 |1993 |1994
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Number of pacemaker lead implants
Medtronic 4004 |0 |0 |18 |60 |32 |3 |0 |0
Medtronic 4004M |0 |2 |19 |7 |192 |196 |30 |0
Medtronic 4082 |0 |0 |0 |142 |619 |515 |1 |0
Siemens 1010T |84 |332 |591 |989 |679 |19 |7 |0
Siemens 1050T |3 |2 |56 |745 |1,235 |13 |0 |0
Siemens T93 |0 |0 |0 |0 |0 |0 |0 |0
Number of deaths of patients treated with pacemaker lead
Medtronic 4004 |0 |0 |7 |11 |5 |0 |0 |0
Medtronic 4004M |0 |0 |0 |5 |14 |21 |1 |0
Medtronic 4082 |0 |0 |0 |12 |35 |16 |0 |0
Siemens 1010T |7 |34 |62 |74 |68 |0 |0 |0
Siemens 1050T |0 |0 |0 |11 |68 |64 |1 |0
Siemens T93 |0 |0 |0 |0 |0 |0 |0 |0
Note: None of the deaths given above for either the Siemens or Medtronic pacemaker leads was lead-related. (Information based upon data returned
to the National Pacemaker Database).
Mrs. Bridget Prentice : To ask the Secretary of State for Health what recommendations her Department has made to pacing centres and follow- up centres about the incidence of failures in polyurethane leads.
Mr. Sackville : Advice issued is contained in pacemaker technical notes Nos. 48, and 49, copies of which are available in the Library.
Mrs. Bridget Prentice : To ask the Secretary of State for Health what guidance has been given regarding the purchase of polyurethane leads by (a) her Department and (b) the medical devices directorate.
Mr. Sackville : The medical devices directorate, a division of the Department of Health, gives no specific advice on the purchase of polyurethane leads. However, purchasers are strongly recommended to buy medical devices only from companies registered under the Department's manufacturer registration scheme.
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Mrs. Bridget Prentice : To ask the Secretary of State for Health what review her Department has conducted of the use of polyurethane in pacing leads ; and if she will make a statement.
Mr. Sackville : No formal review has been conducted. The Department is continually up-dated by the national pacemaker database which analyses statistics on the use of all types of implantable pacemaker leads.
Faulty Medical Devices
Mrs. Bridget Prentice : To ask the Secretary of State for Health when she last had discussions with the Food and Drug Administration in the United States of America on the subject of faulty medical devices ; and which devices were discussed.
Mr. Sackville : No formal discussions have been held with the Food and Drug Administration in the United States of America on the subject of faulty medical devices. No central record is kept of the frequent informal contacts which are made about a variety of subjects associated with a wide range of medical devices.
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Pacemaker Database
Mrs. Bridget Prentice : To ask the Secretary of State for Health what estimation she has made of the accuracy of the national pacemaker database.
Mr. Sackville : Overall data capture was last estimated by the national pacemaker database to be 88.8 per cent. in 1992, based upon an annual nation-wide audit. Data accuracy is dependent upon that supplied, on a voluntary basis, by the implanting and follow-up centres. The database has a system for data validation, which has recently led to a re- classification of some of the data.
Mrs. Bridget Prentice : To ask the Secretary of State for Health, pursuant to her answer of 14 February, Official Report, column 618, listing pacing and pacing follow-up centres, what information she has on hospitals not on the pacemaker database, carrying out pacing or pacing follow-up.
Mr. Sackville : Hospitals are encouraged to inform both the national pacemaker database and the Department of Health, when either pacing or follow-up activities are initiated. Information held relies upon this notification.
Hammersmith and Charing Cross Hospitals
Mr. Gareth Wardell : To ask the Secretary of State for Health what plans she has to move or relocate the Hammersmith hospital.
Mr. Alex Carlile : To ask the Secretary of State for Health if she will make it her policy to discourage a merger between Hammersmith hospital and Charing Cross hospital ; and if she will make a statement.
Dr. Mawhinney : I refer the hon. Members to the statement my right hon. Friend the Secretary of State made on 10 February.
Oncology
Mrs. Dunwoody : To ask the Secretary of State for Health (1) how many hospitals comply with the target of radical radiotherapy involving complex treatment planning within two weeks laid down in the guidelines of the Joint Council for Clinical Oncology ; (2) how many hospitals comply with the target of urgent palliative radiotherapy within 48 hours laid down in the guidelines of the Joint Council for Clinical Oncology ;
(3) how many hospitals comply with the target of urgent radiotherapy or chemotherapy within 24 hours laid down in the guidelines of the Joint Council for Clinical Oncology ;
(4) how many hospitals comply with the target of intensive chemotherapy within one week laid down in the guidelines of the Joint Council for Clinical Oncology.
Mr. Sackville : This information is not held centrally.
Private Prescriptions
Ms Primarolo : To ask the Secretary of State for Health when she will publish guidance on private prescriptions.
Dr. Mawhinney : The rules governing the issue of private prescriptions by general practitioners are set out in the NHS (General Medical Services) Regulations 1992.
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Staff Sickness
Mr. Milburn : To ask the Secretary of State for Health what has been the number of days lost to the NHS through staff sickness in each region in each of the last five years.
Dr. Mawhinney : This information is not available centrally. The control of absenteeism is a local management responsibility.
General Psychiatric Wards
Mr. Harry Greenway : To ask the Secretary of State for Health if she will ensure that the number of beds on general psychiatric wards in London is increased as a matter of urgency.
Mr. Bowis : The number of beds on general psychiatric wards in London is a matter for each local district health authority. They are responsible for assessing the needs of their local populations and ensuring that a range of services are in place to meet those needs.
Mentally Ill People
Mr. Horam : To ask the Secretary of State for Health whether she will consult with the Home Office and the police about the need for further development of proper training about mental health for police officers ; and if she will provide additional funding for the course already run for police officers by the National Schizophrenic Fellowship.
Mr. Bowis : These are matters for my right hon. and learned Friend the Secretary of State for the Home Department. Our Departments work closely together on the co-ordination of services in this area.
Market Testing
Mr. Redmond : To ask the Secretary of State for Health if she will publish details of contracts market tested (a) by health authorities and (b) by health trusts in 1992-93.
Mr. Sackville : I refer the hon. Member to the reply I gave the hon. Member for Darlington (Mr. Milburn) on 21 January at column 887.
Secure Units
Mrs. Golding : To ask the Secretary of State for Health what is the average cost of providing a place on a secure unit for a child per week.
Mr. Bowis : This information is not available centrally, but may be obtained from the local authority providing the secure accommodation.
Mrs. Golding : To ask the Secretary of State for Health what is the average length of time spent by a child on remand in a secure unit.
Mr. Bowis : Table 11 of the annual publication "Children Accommodated in Secure Units During the Year Ending 31 March 1993 England" provides information on the number of young people discharged from secure accommodation, by legal status, sex and length of stay. Copies of this publication are held in the Library.
Engagements
Mr. Spellar : To ask the Secretary of State for Health if she will list her engagements for Tuesday 22 February and Tuesday 15 February.
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Mrs. Virginia Bottomley : On Tuesday 15 February, I had a regular meeting with Ministers ; addressed the National Asthma Campaign conference ; attended a meeting chaired by the President of the Board of Trade on the White Paper on competitiveness, had meetings with officials on proposed legislation for the next session and mental health services ; met officers of the Back-Bench health committee and then the hon. Member for Sheffield, Brightside (Mr. Blunkett). On Tuesday 22 February, I had a regular meeting with Ministers ; officially launched the Sainsbury centre for mental health ; attended first order questions ; had separate meetings with Claire Rayner and the Conservative party chairman ; met a delegation of hon. Members for Birmingham and attended a dinner being held in honour of the Egyptian Minister of Populations and Family Welfare.
WRVS
Mr. Lidington : To ask the Secretary of State for Health what plans she has to meet representatives of the Women's Royal Volunteer Service to discuss the impact of food hygiene regulations on WRVS pensioners' lunch clubs ; and if she will make a statement.
Mr. Sackville : My noble Friend the Under-Secretary of State, the Baroness Cumberlege, who has ministerial responsibility for food safety, will be meeting my hon. Friend the Member for Aylesbury (Mr. Lidington) and the Women's Royal Voluntary Service on 14 March. We will be happy to discuss the sensible application of the regulations.
Nuffield Report
Mr. Dalyell : To ask the Secretary of State for Health what discussions are taking place with the Association of British Insurers on the Nuffield report on genetic screening ; and if he will make a statement on progress.
Mr. Sackville : The report was raised during a meeting in December 1993 between officials of the Department of Health and the Department of Trade and Industry and representatives of the Association of British Insurers. I also wrote to the hon. Member on 25 February ; a copy of my letter is available in the Library.
Health Management Trust Ltd.
Mr. Jim Cunningham : To ask the Secretary of State for Health if she will make a statement concerning the establishment by West Midlands regional health authority of the Health Management Trust Ltd., with particular reference to the transfer to the trust of Crown copyright software and the licence fee paid for this.
Dr. Mawhinney : The financial information project--FIP--was set up in 1979 and was jointly funded initially by the Department and West Midlands regional health authority and later by an association of regions. The association was subsequently disbanded. In order to ensure the further development of the software, a charitable trust called the health management trust was set up and a licence was granted to it by the Department to use, develop and distribute the software for the benefit of the national health service. As the trust is a non-profit-making charity and the software is made available to NHS users at beneficial rates, there was no licence fee.
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Mr. Jim Cunningham : To ask the Secretary of State for Health (1) what amount was granted by the West Midlands health authority to Health Management Trust Ltd. ; what were the reasons for this ; how much of this amount the company has repaid ; and what representations her Department has made to West Midlands health authority on this matter ;
(2) what amount was lent by the West Midlands health authority to Health Management Trust Ltd. ; what were the reasons for this ; what were the repayment terms of the loan ; and what representations her Department have made to the West Midlands regional health authority on this matter.
Dr. Mawhinney : The amount granted by West Midlands regional health authority to Health Management Trust Ltd. is £101,700 : in addition loans amounting to £930,000 have been made by West Midlands regional health authority to Health Management Trust Ltd. The grant was not repayable and was made as part of a total package of financial assistance to enable the trust, on behalf of the regional health authority, to research and develop computer-based systems to improve organisation and management within the NHS. The loan was made to enable the trust to continue development of the financial information project--FIP--software products, consisting of software systems on ward nursing, paramedic and theatre systems and community nursing and is repayable, with interest, by quarterly instalments beginning on 28 February 1994. The Department has been in contact with West Midlands regional health authority about this matter on a number of occasions.
Mr. Jim Cunningham : To ask the Secretary of State for Health by what authority the West Midlands regional health authority was able to establish the Health Management Trust Ltd. as a separate company with charitable status ; and if she will make a statement.
Dr. Mawhinney : Health Management Trust Ltd. was established by a number of individuals, some of whom were national health service employees, acting in a personal capacity, with assistance from the West Midlands regional health authority.
Mr. Jim Cunningham : To ask the Secretary of State for Health what has been the change in the level of charges levied by Health Management Trust Ltd. on the users of software, including other health authorities, for which it has the Crown copyright.
Dr. Mawhinney : The level of charges is a matter for Health Management Trust Ltd. to determine.
Mr. Jim Cunningham : To ask the Secretary of State for Health what representations she has received from other national health service bodies about the conduct of Health Management Trust Ltd. in pursuing legal action against the users of the software for which it has the Crown copyright.
Dr. Mawhinney : The Department is not aware that Health Management Trust Ltd. has taken legal action against any national health service users.
Mr. Jim Cunningham : To ask the Secretary of State for Health what settlements have recently been concluded between (a) the South Western regional health authority and (b) North West Thames regional authority and Health Management Trust Ltd.
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Dr. Mawhinney : In 1992, the Department mediated successfully in a dispute between South Western regional health authority and Health Management Trust Ltd. In 1993, the Department was similarly successful in mediating between North West Thames regional health authority and the Health Management Trust. The terms of the respective settlements are confidential between the parties concerned.
Mr. Jim Cunningham : To ask the Secretary of State for Health what representations she has made to West Midlands health authority or Health Management Trust Ltd. about these settlements.
Dr. Mawhinney : None, as settlement was reached by all the parties concerned.
Mr. Jim Cunningham : To ask the Secretary of State for Health (1) what is the relationship between the West Midlands health authority and Health Management Trust Ltd. and FIP Ltd. ;
(2) what is the status of Health Management Trust Ltd. and FIP Ltd. within the NHS.
Dr. Mawhinney : Financial information project--FIP--was set up in the mid 1980s as a consortium of district health authorities to develop and use a series of financial information systems. In July 1989 the West Midlands regional health authority agreed a proposal to transfer the activities of FIP to an independent trust--Health Management Trust--which was registered as a charity. Focus Information Systems, the new name for the company previously known as FIP, is a wholly owned subsidiary of Health Management Trust Ltd.
Dental Health
Mr. Hinchliffe : To ask the Secretary of State for Health if she will make a statement on the potential dental risks associated with the use of soya-based baby milk.
Mr. Sackville : Soya-based infant formulas have been developed for the particular needs of infants who are allergic to cow milk protein or who are lactose intolerant or who are being reared on a vegan diet. In order to meet all of these needs in one product they are formulated with carbohydrates which are more cariogenic than lactose. Parents feeding their infants with soya-based formulas should therefore pay particular attention to good weaning practices. Oral hygiene procedures should be started as soon as teeth emerge and parents may wish to seek medical and dental advice on the provision of fluoride supplements.
Abortions
Mrs. Ann Winterton : To ask the Secretary of State for Health if she will give a breakdown by regional health authority of the numbers of abortions performed in the latest year for which figures are available in pregnancies of more than 24 weeks' gestation ; if she will indicate the grounds upon which those abortions were performed ; and, specifically, if she will indicate where appropriate the nature of any possible handicap from which the baby might have been suffering.
Mr. Sackville : I refer my hon. Friend to the reply I gave my hon. Friend the Member for Isle of Wight (Mr. Field) on 29 June 1992 at columns 437-38.
Mrs. Ann Winterton : To ask the Secretary of State for Health what guidance has been issued by her Department
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