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Mr. Ainger : To ask the Secretary of State for Wales how many meetings his officials have had with officers of Pembrokeshire NHS trust, Pembrokeshire health authority, Clwyd health authority and Marlow hospital trust to discuss the service review report.

Mr. Gwilym Jones : None. The director of the NHS in Wales has been sent a draft copy of the report in the light of his responsibilities as the accounting officer.

Mr. Ainger : To ask the Secretary of State for Wales if the Pembrokeshire NHS trust achieved its target rate of return on capital in 1992-93.

Mr. Gwilym Jones : In 1992-93 Pembrokeshire NHS trust achieved a pre -interest return of 4.7 per cent. against the initial planned target of 6 per cent.

Mr. Ainger : To ask the Secretary of State for Wales if he expects the service review report on the health service in Pembrokeshire to be published.

Mr. Gwilym Jones : As the service review was commissioned jointly by Pembrokeshire NHS trust and Pembrokeshire health authority, this will be a matter for those two bodies.

Mr. Ainger : To ask the Secretary of State for Wales when he expects the report jointly commissioned by the Pembrokeshire health authority and the Pembrokeshire NHS trust and the Welsh Office on the service review will be presented to the commissioning bodies.

Mr. Gwilym Jones : This is a matter for Pembrokeshire NHS trust and Pembrokeshire health authority as the joint commissioning bodies for the service review.

Welsh Development Agency

Mr. Richards : To ask the Secretary of State for Wales what guidance he has given to the Welsh Development Agency in the preparation of its 1994 corporate plan ; and whether he will set targets for the agency.

Mr. Redwood : I have today written to the chairman of the agency setting out the ways in which I expect the agency to contribute to the wider objectives of economic development in Wales. I have included targets for inward investment, the development of industrial and commercial floorspace, leverage for private sector investment, and the clearance of derelict land.


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There are changes to some of the targets following discussions with the chairman and the WDA board. I have also given the WDA a specific target for inward investment within its overall inward investment plans. I have arranged for a copy of the letter to be placed in the Library of the House.

NHS Trusts

Mr. Ainger : To ask the Secretary of State for Wales what action he will take to assist those national health service trusts that do not achieve their target rate of return on capital.

Mr. Gwilym Jones : NHS trusts are currently required to achieve a 6 per cent. pre-interest return on their assets ; break even, taking one year with another, and stay within the external financing limit set on an annual basis. Failure to meet any of those obligations will require appropriate action by the trust concerned, the extent of which will depend on the underlying causes of the variances from planned targets.

Patient Treatment Numbers

Mr. Ainger : To ask the Secretary of State for Wales if it is his policy to limit the numbers of patients treated by health providers to that contained in the contracts with health purchasers.

Mr. Gwilym Jones : These arrangements are intended to ensure that all patients meant to be treated within the currency of a contract are treated within that time and, additionally, all urgent patients are to be treated without any delay.

HEALTH

Long-stay Hospital Beds

Mr. Frank Field : To ask the Secretary of State for Health how many long-stay hospital ward beds have been closed nationally and in the Wirral since the introduction of the National Health Service and Community Care Act 1990.

Mr. Bowis : The first full year of data following the introduction of the national health service aspects of the Act was 1991-92. These data exclude long-stay places provided by the NHS in the community or purchased from independent providers. It shows that between 1991-92 and 1992-93 there was at net increase of four long-stay hospital ward beds in the NHS in the Wirral and a net decrease of 6,832 in England.

Asthma

Mrs. Bridget Prentice : To ask the Secretary of State for Health what is her assessment of the effect upon asthma sufferers of air pollution in London.

Mr. Sackville : On the few occasions when levels are high, those who suffer from respiratory disease such as asthma may experience some effects including respiratory irritation, some coughing and possible pain on deep inspiration when taking exercise out of doors. Advice and information is provided on the freephone helpline : 0800 556677.


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Minor Injuries Unit

Ms Primarolo : To ask the Secretary of State for Health what is the cost of (a) a full-time general practitioner and (b) an accident and emergency specialist in a minor injuries unit.

Dr. Mawhinney : In 1992-93, general practitioners in Great Britain received an intended average net income of £40,010 for the provision of general medical services. The average earnings of a consultant, whose pay is agreed nationally, were £53,450 in the same year. Accident and emergency consultants may have their pay negotiated locally if they work in a national health service trust.

Public Health

Mr. Steinberg : To ask the Secretary of State for Health what evidence she has on which groups of people have experienced (a) an improvement and (b) a deterioration of health since 1979 ; and if she will make a statement.

Mr. Sackville : The available data indicate that there have been improvements since 1979 for almost all groups. Examples are life expectancy, which has increased from 70 to 74 in males and from 76 to 79 for females, between 1979 and 1992 in England and Wales ; and infant mortality rates which have almost halved in this period, falling from 12.8 to 6.5 per 1,000 live births in England. There are, however, some instances of negative trends : for example, the general household survey shows an increasing percentage of people reporting longstanding illness--from 27 per cent. of persons questioned in 1979 to 32 per cent. in 1992--although slightly fewer said that their activities were restricted by illness in the previous two weeks--13 per cent. compared with 12 per cent. in 1979. Such trends are reported in the first chapter of the chief medical officer's annual report "On the State of the Public Health", copies of which are available in the Library.

The strategy for health launched by the Government in July 1992 has the overall aim of further continuing improvement in the health of the nation. This requires better monitoring of the health of the population, and we have initiated a major new health survey for England. Its expansion to 17,000 subjects in 1993 will, when the results are available, greatly increase the information about groups within the population, including regional variations and trends over time.

Dentistry

Mr. Ronnie Campbell : To ask the Secretary of State for Health how many dentists in practice in south-east Northumberland (a) take NHS patients and (b) took private patients only but took NHS patients until 1990.

Dr. Mawhinney : At 30 September 1993 the number of dentists in the general dental service in the Northumberland family health services authority area, which includes south-east Northumberland, was 101. The comparable number at 30 September 1990 was 103. Dentists are independent contractors who make their own decisions about whether to accept patients under national health service arrangements.

Ms Corston : To ask the Secretary of State for Health (1) how many dental surgeons in the Bristol area provide treatment under Denplan and other dental care schemes, for the last three years for which figures are available ;


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(2) how many dental surgeons were operating exclusively within the NHS in the Bristol area for the last three years for which figures are available ;

(3) what percentage of dental costs in the Bristol area have been met (a) privately and (b) publicly for the years 1979, 1984, 1989 and each year since.

Dr. Mawhinney : This information is not available centrally. Dentists are independent contractors and free to choose whether or not to accept an individual patient, or category of patients, for national health service treatment and to review their decisions at any time.

Mr. Redmond : To ask the Secretary of State for Health how many of the deregistered dental patients failed to get reregistered in the last year for which figures are available.

Dr. Mawhinney : It is not possible to identify whether particular patients have sought reregistration but overall the number of adult patients registered has increased significantly since July 1992. All family health services authorities report that patients approaching them for help in obtaining national health service treatment can be assisted.

Wansbeck Hospital

Mr. Ronnie Campbell : To ask the Secretary of State for Health what assessment she has made of the number of job losses in Wansbeck hospital in south-east Northumberland.

Dr. Mawhinney : None. This is a matter for the local health authority. The hon. Member may wish to contact Mr. J. R. Baker, chairman of Northumberland health authority, for details.

Prescribed List

Mr. Redmond : To ask the Secretary of State for Health what assessment she has made of the value to the NHS of the savings made in 1992 -93 from the removal of drugs from the NHS prescribable list.

Dr. Mawhinney : None.

National Neurological Hospital

Mr. Barry Jones : To ask the Secretary of State for Health what representations she has received concerning the national neurological hospital, Queens square, London and its proposed closure.

Dr. Mawhinney : Up to 3 March 1994 there have been 28 representations from hon. Members and 49 from members of the public.

Mr. Barry Jones : To ask the Secretary of State for Health how many staff are employed at the national neurological hospital, London.

Dr. Mawhinney : As at 30 September 1992, the latest date for centrally held data, there were 950 whole-time equivalent staff employed by the National Hospital for Neurology and Neurosurgery.

NHS Supplies Authority

Mr. Redmond : To ask the Secretary of State for Health if she will place in the Library a copy of the PE Consultancy report on the NHS Supplies Authority.


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Mr. Sackville : I refer the hon. Member to the reply I gave my hon. Friend the Member for Hendon, South (Mr. Marshall) on 10 February, at column 423.

Mr. Redmond : To ask the Secretary of State for Health what proportion of hospital supplies are purchased through the NHS Supplies Authority.

Mr. Sackville : About half, on the basis that the total full-year value of National Health Service Supplies contracts on behalf of NHS hospital and community health services in 1992-93 was about £1.7 billion and the outturn total NHS HCHS spend on supplies in 1991-92, the latest year for which a figure is available, was about £3.5 billion.

Glasses and Lenses

Dame Jill Knight : To ask the Secretary of State for Health what she estimates is the total number of people eligible for receiving assistance towards the purchase of glasses or lenses through the NHS low-income scheme in each year from 1991-92 to 1996-97.

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


Estimated total number of     

national health service       

low-income scheme             

beneficiaries in Great        

Britain entitled to help with 

the cost                      

of glasses or lenses 1991-92  

to 1995-96                    

Year      |Number<1>          

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

1991-92   |5,992,060          

1992-93   |6,738,032          

1993-94   |7,242,933          

1994-95   |7,610,330          

1995-96   |7,872,347          

<1> Figures are families (    

individuals or couples)       

receiving income              

support or family credit,     

holders of AG2 and AG3        

certificates and the          

members of their families     

named on the certificates.    

Figures for                   

1995-96 include recipients of 

disability working allowance  

with                          

capital of £8,000 or less and 

their partners.               

Manchester University Health ServicesManagement Unit

Mr. Redmond : To ask the Secretary of State for Health what funds were provided for the health services management unit at Manchester university in the last three years ; and if she will make a statement.

Mr. Sackville : The health services management unit at Manchester university is not funded by the Department of Health. It is known that the unit received £211,330 in 1993-94 for specific projects carried out for the Department, and may have received such funding on other occasions. However, information on this is not separately identifiable.

Cortico-steroids

Mr. Blunkett : To ask the Secretary of State for Health what guidelines exist for doctors prescribing cortico-steroids to pregnant women ; and what research has been undertaken into the health effects of cortico- steroids on pregnant women and their babies.

Mr. Sackville : The Department of Health has not issued specific guidelines on the prescribing of cortico-steroids to pregnant women. The Department is aware that both the Royal College of Obstetricians and


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Gynecologists and a joint working group of the British Association of Perinatal Medicine and the research unit of the Royal College of Physicians have published guidelines about prescribing

corticosteroids to pregnant women for the prevention of neonatal respiratory distress syndrome. The Department has also funded a review of research into this matter which was published in "Effective Care in Pregnancy and Childbirth". Attention has been drawn to these guidelines through EL(93)115 which was sent to all national health service managers and directors of public health. Extensive clinical trials have shown that administration of corticosteroids, to women who are about to deliver prematurely, reduces the risk of respiratory distress syndrome in the infant. Copies of "Effective Care in Pregnancy and Childbirth" and EL(93)115 are available in the Library.

Travellers

Mr. Frank Field : To ask the Secretary of State for Health whether she was consulted in the drafting of sections 58 to 61 of the Criminal Justice and Public Order Bill on the effect of providing health care to the children of travellers following any repeal of the Caravan Sites Act 1968.

Mr. Bowis : Yes.

Head Injuries

Mr. Gareth Wardell : To ask the Secretary of State for Health if she will list hospitals in England which employ multidisciplinary rehabilitation teams for treating local patients who have suffered severe head injuries.

Mr. Bowis : The Department is providing funding of over £1 million per year to the following hospitals and units to develop rehabilitation services for people with head injuries :

Regional rehabilitation centre, Hunters Moor hospital, Newcastle-upon-Tyne

Leeds head injury team, St. Mary's hospital, Leeds

Derbyshire royal infirmary and Derby City hospital, Derby City hospital, Nottingham

Central Sheffield university hospitals

Regional neurological rehabilitation unit, Homerton hospital, London

Rivermead rehabilitation centre, Oxford

Rayners Hedge physical rehabilitation service, Aylesbury Stroke and rehabilitation unit, Royal Cornwall hospital (City), Truro

Frenchay healthcare trust, Bristol

Neurobehavioural rehabilitation unit, St. Edward's hospital, Cheddleton, and Neurorological rehabilitation unit, Haywood hospital, Burslem

Community unit, Worcester district health authority

Other national health service trusts and health authority units are also developing services.

Multiple Sclerosis

Mr. Barry Jones : To ask the Secretary of State for Health (1) if she will make a statement concerning the initiatives her Department has taken to assist those in the medical profession who are pioneering treatment for those suffering from multiple sclerosis ; (2) if she will make a statement concerning her future policy development as it affects neurological matters.

Mr. Bowis : The Department is providing funding for a study being carried out at the university of Cardiff entitled


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"Walking and Mobility in Patients with Multiple Sclerosis--Is Modification by Physiotherapy Effective". The study is due to finish in June 1995. Research is primarily a matter for 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. In addition to research directly on multiple sclerosis, the Medical Research Council also supports research on a number of related topics, in particular muscle and neuroscience research, which may shed light on the causes and mechanisms and potential therapies.

The treatment and management of multiple sclerosis, as for other neurological conditions which result in physical disability, are primarily a matter for the medical practitioners concerned. It is for the district health authority or general practitioner fundholder to enter into arrangements with hospital and community units to ensure that the necessary range of services is available. The National Health Service Management Executive priorities and planning guidelines--EL(93)54--for 1994-95, copies of which are available in the Library, require regional health authorities to ensure that services for people with physical disabilities meet local standards in all districts based on the assessment of need and consultation with disabled people and carers.

Research Units

Mr. Blunkett : To ask the Secretary of State for Health, pursuant to her answer of 2 February 1993, Official Report, columns 721-22, what decisions have been taken about the renewal of contracts of research units whose site visit reports have been completed ; and, for each the decisions which have been taken, whether new contracts are being offered and their nature and period of time for which they will apply.

Dr. Mawhinney : I refer the hon. Member to the reply I gave him on 26 November 1993 at columns 242-44. We have not yet completed the series of site visits.

Health Authorities and Trusts

Mr. Donohoe : To ask the Secretary of State for Health (1) if she will list the names of the chief executives and general managers of each of the regional and district health authorities in England with the correspondence addresses of each of the authorities and the parliamentary constituencies covered by each of the health authorities;

(2) if she will list the NHS trusts currently operating in England and the parliamentary constituencies within which each trust lies; and if she will list the names of the chief executives of each of these NHS trusts and the correspondence addresses of each of the trusts.

Dr. Mawhinney : Information on the address of each health authority and trust in England and the name of each chief executive and general manager is published annually in the national health service yearbook. Information on the relevant constituencies can be obtained from the House of Commons Public Information Office.

Pharmaceutical Drugs

Mr. Gale : To ask the Secretary of State for Health what percentage of pharmaceutical drugs returned for destruction were (a) over-the-counter products, (b) time expired pharmacists' stock and (c) prescription medicines in each of the last five years for which figures are available.


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Dr. Mawhinney : No data about medicines returned to pharmacies for destruction have been collected to date.

Transport, London

Mr. Keen : To ask the Secretary of State for Health what was (a) in 1981 and (b) in 1991 (i) the mode of travel to work of residents by London borough, (ii) the mode of travel to work of employees by London borough of employment, (iii) the location of employment of residents by London borough and (iv) the level of car ownership by London borough.

Mr. Sackville : This information has been, or is soon to be, published in census reports to Parliament, copies of which are in the Library. The following list gives references for the figures requested.

Means of travel to work by London borough of residence 1981--Census 1981, workplace and transport to work, England and Wales (Table 6).

1991--1991 census county report, inner London, Part 2 (Table 82) ; and 1991 census county report, outer London, Part 2 (Table 82). Means of travel to work by London borough of employment 1981--Census 1981, workplace and transport to work, England and Wales (Table 6).

1991--1991 census, workplace and transport to work, Great Britain (Table 6).

Area of employment by London borough of residence

1981--Census 1981, workplace and transport to work, England and Wales (Table 2A).

1991--1991 census, workplace and transport to work, Great Britain (Table 2).

Cars in households by London borough

1981--Census 1981, county report, Greater London, Part 1 (Table 31).

1991--1991 census county report, inner London, Part 1 (Table 21), and 1991 census county report, outer London, Part 1 (Table 21). 1991 census, workplace and transport to work, Great Britain is due for publication in May 1994. A copy will be placed in the Library.

NHS Trusts

Mr. Ainger : To ask the Secretary of State for Health which NHS trusts in England failed to meet their target return on capital in 1992-93.

Mr. Sackville : The trusts that recorded a return of less than 6 per cent. in their accounts for 1992-93 were :

Airedale NHS Trust

Allington NHS Trust

Anglian Harbours Health Trust

Barnsley Community and Priority Services NHS Trust

Bedford Hospital NHS Trust

Bradford Community Health NHS Trust

Bradford Hospitals NHS Trust

Central Manchester Healthcare NHS Trust

Chester and Halton Community NHS Trust

Christie Hospital NHS Trust

Devon Ambulance Service NHS Trust

Ealing Hospital NHS Trust

East Hertfordshire Health NHS Trust

Eastbourne Hospitals NHS Trust

Hinchingbrooke Health Care NHS Trust

Liverpool Obstetrics and Gynaecological NHS Trust

Mersey Regional Ambulance Service NHS Trust

Mid Cheshire Hospitals NHS Trust

Milton Keynes General Hospital NHS Trust

Mount Vernon Hospital NHS Trust

North East Essex Mental Health NHS Trust

Newcastle Mental Health Services NHS Trust

Norfolk Ambulance Services NHS Trust


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