Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what improvements are planned for the system of selecting solicitors and counsel to act for the Legal Aid Board in the future ; and what consideration has been given to providing an opportunity for all suitably qualified firms of solicitors and counsel to benefit from the available work which the Legal Aid Board is able to provide.
Mr. John M. Taylor : No changes are planned. Suitably qualified solicitors and counsel are instructed by the board as required. Any suitably qualified firm of solicitors or counsel have the opportunity to be instructed just as they have the opportunity to be instructed by any other client choosing a legal representative.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what directions and other guidance are given to solicitors and counsel acting for the legal aid fund to ensure that costs from unsuccessful non-legally aided litigants are recovered for the benefit of the legal aid fund.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what rates of remuneration have been claimed since the creation of the Legal Aid Board by firms of solicitors acting for the Legal Aid Board in litigation ; if he will specify the expense rates and mark-up claimed by such firms of solicitors in their bills and the period or periods to which such charges relate ; and what are the comparable rates allowed upon taxation and the proposed civil legal aid rates.
Mr. John M. Taylor : Information on the rates of remuneration since the creation of the board claimed by firms of solicitors acting for the board and on the expense rates and mark-up rates claimed by those firms is not available. A prescribed hourly rate for civil non-matrimonial cases came into force on 25 February 1994. Details of the rates and their application are given in the following statutory instruments which are available from HMSO :
SI 1994/228 Legal Aid in Civil Proceedings (Remuneration) Regulations 1994
Column 554SI 1994/229 Civil Legal Aid (General) (Amendment) Regulations 1994
SI 1994/230 Legal Aid in Family Proceedings (Remuneration) (Amendment) Regulations 1994
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how many bills submitted by firms of solicitors acting for the Legal Aid Board have been reduced by negotiation or taxation ; and what amounts have been saved in real and percentage terms.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how many firms of solicitors have been instructed by the Legal Aid Board's head office legal department to conduct litigation on behalf of the Legal Aid Board.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how much has been paid by the Legal Aid Board since its creation to (a) firms of solicitors instructed by the Legal Aid Board to represent the Legal Aid Board in litigation, (b) the firm of Messrs. Collyer-Bristow when instructed to act for the Legal Aid Board in litigation and (c) counsel instructed to act for the Legal Aid Board in litigation.
Mr. John M. Taylor : (a) The information requested is not available. (b) It is not the Legal Aid Board's policy to disclose details of a commercially confidential nature between itself and its suppliers. (c) The information requested is not available.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what redundancies are being made at the Liverpool area office of the Legal Aid Board ; who is being made redundant ; what are their qualifications and experience ; how many years service they have had in being employed in dealing with legal aid matters by (a) the Legal Aid Board and (b) the Law Society when it was responsible for administering legal aid.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how many staff have been, are and will be engaged in the Liverpool area office of the Legal Aid Board on franchising ; and how much time has been, is being and will be spent on franchising.
Mr. John M. Taylor : Up to now, three senior staff at the Liverpool area office have been engaged on a part-time basis carrying out preliminary audits. Over the next four to six months an additional six quality auditors will be engaged at that office on a part-time basis on the pre-contract audits. Excluding training in the current financial year, the equivalent of one full-time member of staff has been engaged on franchising. In the next financial year, with the commencement of pre-contract audits this figure will increase to approximately four full-time equivalents. This figure will increase if a higher than predicted number of applications is received in this office.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what the staff levels, taking account of qualifications and experience to be employed by the Liverpool area office of the Legal Aid Board will be after the redundancies which are to take place ; and what were the comparable staff levels employed prior to (a) the creation of the Legal Aid Board and (b) the redundancies.
Mr. John M. Taylor : Seventy-three staff will be employed in the Liverpool area office post the redundancy programme ; 80 staff were employed in the office in 1988 prior to the board's creation. The number of staff employed in March 1994 prior to any staff leaving under the voluntary redundancy programme is 90.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what criteria are used to select solicitors firms and counsel to be instructed by the Legal Aid Board ; what are the costs considerations involved ; and who is responsible for the selection.
Mr. John M. Taylor : The criteria used for these purposes are value for money, fitness for purpose and delivery against price. The costs considerations are value for money given the nature, complexity and importance of the matter. A number of individual staff are responsible for the selection of solicitors' firms and counsel, depending on the nature of the particular matter.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how many court actions have been brought by and against the Legal Aid Board since its creation ; in how many cases the Legal Aid Board has conducted such litigation by solicitors (a) employed at the Legal Aid Board area offices, (b) employed by at the legal aid head office and (c) in private practice.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what volumes of work have been received by the legal aid area office in Liverpool immediately prior to its creation and in each year thereafter ; and how the volume of work is calculated and recorded.
Mr. John M. Taylor : In 1988-89, immediately prior to the Legal Aid Board's creation, the Liverpool area office handled 51,041.9 units of work. The table shows work volumes for each full year since then.
|Units --------------------------- 1989-90 |53,199.2 1990-91 |51,975.4 1991-92 |57,485.8 1992-93 |65,706.2
Units of work are calculated using a series of weighted calculations derived from the standard times necessary to complete specific transactions. The volume of work is calculated and recorded by computer.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how much the Legal Aid Board's administration and the legal aid fund, respectively, has had to pay by way of (a) damages and (b) costs in respect of litigation in which the Legal Aid Board has been unsuccessful.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how quickly bills submitted to the Legal Aid Board by firms of solicitors acting on its behalf have been paid ; and what scrutiny, including referring the matter for taxation, takes place before such bills are paid.
Mr. John M. Taylor : The information requested on the speed with which the board pays firms of solicitors which have acted for it is not available. Bills received from solicitors instructed to act for the board are scrutinised by the Department which has been responsible for issuing the instructions. If necessary, the board would apply for a solicitor and own client taxation in respect of a bill submitted by a solicitor instructed to act for it.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department how many sets of counsels' chambers and individual counsel have been instructed to represent the Legal Aid Board in litigation.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what fees have been paid directly by the Legal Aid Board to counsel who have been instructed by firms of solicitors acting for the Legal Aid Board.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what staff will be left in the Liverpool legal aid area office following the redundancies ; and what are the qualifications and experience of the remaining staff.
Mr. John M. Taylor : Seventy-three staff will be employed in the Liverpool area office after the redundancy programme. It is not possible to say what the mix of staff will be after the redundancy exercise. The redundancy exercise is a voluntary arrangement and the Legal Aid Board cannot predict with any certainty which staff will volunteer.
Mr. Alton : To ask the Parliamentary Secretary, Lord Chancellor's Department what cost has been involved in franchising at the Liverpool area office of the Legal Aid Board to date ; what further costs are envisaged ; what savings have been made as a result of franchising in real terms ; and how such savings have been calculated.
Mr. John M. Taylor : The cost of establishing franchising in the Liverpool area office has been the cost of training four existing staff and of recruiting and training five additional staff. Excluding salaries this is estimated to be £42,500. The cost of running franchising in the Liverpool office on an on-going basis is £100,000 per annum.
Column 557Franchising has been introduced to ensure the delivery of a quality assured, value for money legal aid service from the board's suppliers, mainly solicitors. Franchising has not been introduced to achieve savings in the administration costs of legal aid.
Mr. Llwyd : To ask the Parliamentary Secretary, Lord Chancellor's Department on how many occasions in each year since 1987 his Department has written to individual judges regarding their interpretation of the workings of the legal system ; if he will list each such occasion ; and if he will make a statement.
Mr. John M. Taylor : My Department conducts a great deal of correspondence with the judiciary on a wide variety of topics which is usually conducted on a confidential basis. Information on the precise volume and nature of correspondence is not held centrally and could be obtained only at disproportionate cost.
Mr. Peter Bottomley : To ask the Secretary of State for Health what assessment she has made of the contribution of prescribing practice and limitation to the change of life expectancy and infant mortality.
Dr. Mawhinney : Life expectancy has improved steadily and the rate of infant mortality has improved markedly over the past 10 years. Prescribing is only one part of clinical care ; increased health screening, promotion and vaccination and the availability of new medicines will all have contributed to these improvements.
Ms Jowell : To ask the Secretary of State for Health what plans she has to publish information from the Public Health Laboratory Service showing the number with toxoplasmosis in pregnancy ; and if she will give the results why testing for toxoplasmosis is not a standard procedure in the United Kingdom.
Mr. Sackville : The Public Health Laboratory Service communicable disease surveillance centre is currently reviewing laboratory reports of human toxoplasma infections in England and Wales from 1981 to 1992. Submission for scientific publication of this analysis is expected later this year. This review will contain information on laboratory reported human infections in pregnant women, although the incidence of toxoplasmosis in pregnant women is unknown due to unrecognised or undiagnosed asymptomatic infections or individuals with non-specific symptoms that may go undetected.
Screening for toxoplasmosis in pregnancy is not a standard procedure in the United Kingdom because the significance of the test, the natural history of the disease and the efficacy of the treatment are all surrounded by uncertainty. For any screening programme, the benefits conferred by screening must clearly outweigh the risks.
Mr. Sackville : The Department makes no recommendations as to local staffing levels in the groups listed. Decisions concerning staffing are the responsibility of local managers who, with advice from professional colleagues, are in the best position to consider the amount and type of work to be done, and therefore the work force they require.
Mr. Redmond : To ask the Secretary of State for Health what is the system of inspection in respect of the suitability and adequacy of premises from which NHS services are provided by (a) medical general practitioners, (b) dental general practitioners, (c) pharmacists and (d) opticians.
Dr. Mawhinney : Through their management responsibility for primary health care services, family health services authorities are required to be satisfied that premises used by doctors, dentists and opticians are suitable and adequate. In the case of pharmacists, responsibility rests with the Royal Pharmaceutical Society inspectorate. On-site inspection of the premises used by each type of practitioner can be made to ensure that the appropriate standards are met.
Mr. Clifton-Brown : To ask the Secretary of State for Health how many times the hospital complaints procedure for the John Radcliffe hospital, Headington, Oxfordshire, has been invoked in the last two years.
Mr. Alton : To ask the Secretary of State for Health what steps she is taking to review surrogacy arrangements ; what inquiries she makes as to the expenses paid for surrogate pregnancies ; how many children were born to surrogate parents in 1993 ; what counselling and information is given to surrogate and natural parents prior to insemination ; whether the surrogacy parenting centre was approved by her Department ; and if she will make a statement.
Column 559commercial basis and advertising of or for surrogacy services. The Human Fertilisation and Embryology Act 1990 amended the Surrogacy Arrangements Act 1985 so as to make clear that surrogacy arrangements are unenforceable by or against any persons making them.
There is no requirement for voluntary organisations concerned with surrogacy to be approved by the Department. Where treatment is being undertaken by a centre licensed under by the Human Fertilisation and Embryology Authority surrogates and couples will be assessed and offered counselling in accordance with the HFEA's code of practice. Copies of the code of practice are available in the Library. Information on the number of children born to surrogate parents in 1993 is not available.
Mr. Redmond : To ask the Secretary of State for Health what plans she has to bring within the regulations governing inspection of nursing and residential homes with three or fewer residents (a) in all cases or (b) in all cases where the funding of a resident is from public funds.
Mr. Bowis : Health authorities are required to inspect all nursing homes, whatever their size, at least twice a year. Since April 1993 local authorities have had powers to inspect independent residential care homes for three or fewer residents.
Mr. David Nicholson : To ask the Secretary of State for Health if it is her Department's policy to encourage the parallel importation of medicines in order to save money for the NHS ; and if she will make a statement.
Dr. Mawhinney : Parallel imports are a consequence of substantial price differentials for pharmaceuticals created by a wide variety of national pricing mechanisms across the European Union within a single European market with common licensing criteria. We consider that the parallel importing scheme which has operated since 1984 neither encourages nor discourages parallel imports, but strikes the right balance between ensuring that imported medicines comply with EU standards of safety, quality and efficacy and avoiding placing undue obstacles in the way of importers.
Mr. Soley : To ask the Secretary of State for Health if she will initiate a study in Hammersmith in respect of any correlation between heavy traffic use on major roads and asthma, eczema and other related diseases.
Mr. Sackville : No. A causal link between air pollutants from traffic and the induction of eczema, asthma and other diseases has not been proven. However, high levels of air pollutants may exacerbate pre-existing respiratory illness.
The Department is advised on these matters by the Committee on the Medical Effects of Air Pollutants and by the Advisory Group on the Medical Aspects of Air Pollution Episodes. The latter's three reports are available in the Library ; they are on ozone ; on sulphur dioxide, acid aerosols and particulates ; and on oxides of nitrogen. The Committee on the Medical Effects of Air Pollutants has formed a sub-group specifically to consider the relationship between air pollution and asthma.
Column 560Advice and information for the public is provided on the freephone helpline : 0800 556677.
Dr. Mawhinney : No. In accordance with the National Health Service and Community Care Act 1990, NHS trusts are required to have one public meeting per year. Many NHS trusts have developed substantial programmes of public meetings and regular meetings with community health councils.
Mr. Ainger : To ask the Secretary of State for Health if she will list those English national health service trusts which in 1992-93 exceeded their external financing limit ; and by how much in each case.
Mr. Sackville : The NHS trusts which exceeded their external financing limit in 1992-93, and the amount by which they did so, are shown in the table. These trusts have had their 1993-94 EFL reduced by the amount of the 1992-93 excess.
Trust |Amountby |which EFL |exceeded |£'000 --------------------------------------------------------------------- Airedale NHS Trust |4 Bath Mental Health Care NHS Trust |1 Central Manchester Healthcare NHS Trust |6 Dacorum and St. Albans Community NHS Trust |141 Devon Ambulance Service NHS Trust |4 Doncaster Healthcare NHS Trust |2 Eastbourne Hospitals NHS Trust |3 East Hertfordshire Health NHS Trust |2 Epsom Health Care NHS Trust |2 First Community NHS Trust |1 Guy's and Lewisham NHS Trust |37 Homewood NHS Trust |3 Milton Keynes Community Health NHS Trust |47 Mulberry NHS Trust |4 Northern General Hospital NHS Trust |4 North Hertfordshire NHS Trust |4 North Middlesex Hospital NHS Trust |1 Optimum Health Services NHS Trust |161 Ravensbourne Priority Health NHS Trust |30 Royal United Hospital, Bath NHS Trust |27 South Downs Health NHS Trust |35 The Cardiothoracic Centre Liverpool NHS Trust |1 The Walton Centre for Neurology and Neurosurgery NHSTrust |1 Walsall Hospitals NHS Trust |4 Walsgrave Hospital NHS Trust |5 Wellhouse NHS Trust |22 West Dorset General Hospitals NHS Trust |20 Weston Area Health NHS Trust |2 Weybourne Community NHS Trust |2 Source: NHS Trust Annual Accounts.
Mr. Ainger : To ask the Secretary of State for Health if she will list those English national health service trusts which in 1992-93 failed to achieve a 6 per cent. return on capital in (a) percentage terms and (b) cash terms.
Return on capital employed Trust |Amount |Percentage |£ thousands ------------------------------------------------------------------------------ Airedale NHS Trust |2,128 |4.00 Allington NHS Trust |127 |2.40 Anglian Harbours Health NHS Trust |979 |5.90 Barnsley Community and Priority Services NHS Trust |1,512 |5.70 Bedford Hospitals NHS Trust |1,633 |5.80 Bradford Community Health NHS Trust |1,635 |5.20 Bradford Hospitals NHS Trust |2,392 |5.67 Broadgreen Hospital NHS Trust<1> |-3,783 |-6.20 Central Manchester Healthcare NHS Trust |7,723 |5.80 Chester and Halton Community NHS Trust |205 |5.70 Christie Hospital NHS Trust |531 |3.00 Devon Ambulance Service NHS Trust |77 |1.50 Ealing Hospital NHS Trust |914 |2.80 East Hertfordshire Health NHS Trust |2,319 |5.10 Eastbourne Hospitals NHS Trust |3,025 |4.80 Hinchingbrooke Health Care NHS Trust |1,601 |5.85 Liverpool Obstetrics and Gynaecology Services NHS Trust |-925 |-14.40 Mersey Regional Ambulance Service NHS Trust |482 |3.30 Mid Cheshire Hospitals NHS Trust |881 |2.80 Milton Keynes General Hospital NHS Trust |2,846 |5.75 Mount Vernon Hospital NHS Trust |1,594 |4.60 North East Essex Mental Health NHS Trust |1,059 |5.60 Newcastle Mental Health Services NHS Trust |1,369 |4.70 Norfolk Ambulance NHS Trust |224 |4.50 Northern Devon Healthcare NHS Trust |1,817 |5.00 North Hertfordshire NHS Trust |2,572 |4.40 North Tees Health NHS Trust |2,493 |5.60 Northumbria Ambulance Service NHS Trust |555 |5.30 Nottingham City Hospital NHS Trust |4,620 |4.80 Nottingham Community Health NHS Trust |563 |4.40 Royal National Throat, Nose and Ear Hospital NHS Trust |630 |5.10 Royal United Hospital, Bath NHS Trust |2,864 |4.00 South Yorkshire Metropolitan Ambulance and Paramedic Service NHS Trust |333 |5.00 Scarborough and North East Yorkshire Healthcare NHS Trust |1,641 |3.70 South Bedfordshire Community Healthcare NHS Trust |46 |0.50 Southend Health Care NHS Trust |2,744 |5.10 Southport and Formby NHS Trust |2,107 |4.60 St. Helen's and Knowsley Hospital NHS Trust |332 |5.20 St. James's University Hospital NHS Trust |2,778 |4.60 St. Peter's Hospital NHS Trust |2,053 |4.80 The Poole Hospital NHS Trust |2,245 |5.80 The Royal Cornwall Hospitals and West Cornwall Hospital NHS Trust |3,322 |5.68 The Royal Liverpool University Hospital NHS Trust |2,100 |2.20 The Royal Surrey County and St.Luke's NHS Trust |806 |1.78 The United Leeds Teaching Hospitals NHS Trust |5,870 |5.50 United Bristol Healthcare NHS Trust |6,673 |4.40 Walsgrave Hospital NHS Trust |2,615 |4.50 Wellhouse NHS Trust |2,089 |2.47 West Dorset Community Health NHS Trust |691 |4.60 West Dorset General Hospitals NHS Trust |2,042 |5.60 West Dorset Mental Health NHS Trust |407 |5.00 <1>I regret that this trust was omitted in error from the list supplied in the reply that I gave the hon. Member on 8 March at columns 163-64. Source: NHS trust annual accounts.
£000 Trust |Amount |of deficit ------------------------------------------------------------------------------ Airedale NHS Trust |577 Allington NHS Trust |82 Anglian Harbours Health NHS Trust |165 Bradford Hospitals NHS Trust |1,312 Broadgreen Hospital NHS Trust |3,783 Christie Hospital NHS Trust |321 Cornwall and Isles of Scilly Mental Handicap NHS Trust |186 Cleveland Ambulance NHS Trust |141 Devon Ambulance Service NHS Trust |134 Ealing Hospital NHS Trust |594 Hillingdon Community Health NHS Trust |32 Liverpool Obstetrics and Gynaecology Services NHS Trust |1,006 Mersey Regional Ambulance Service NHS Trust |153 North East Essex Mental Health NHS Trust |264 Royal National Throat, Nose and Ear Hospital NHS Trust |113 Royal United Hospital, Bath NHS Trust |767 Scarborough and North East Yorkshire Healthcare NHS Trust |528 South Bedfordshire Community Healthcare NHS Trust |18 Southport and Formby NHS Trust |347 St. James's University Hospital NHS Trust |521 St. Peters Hospital NHS Trust |119 The Royal Liverpool University Hospital NHS Trust |2,097 The Royal Surrey County and St. Lukes NHS Trust |1,215 Wellhouse NHS Trust |1,735 West Dorset Mental Health NHS Trust |22 Source: NHS trust annual accounts.
Dr. Mawhinney [pursuant to his reply, 29 November 1993, c. 305] : I regret that my previous reply contained an error. The number of trusts which have made a pre-interest rate of return of less than 6 per cent. is 51.
Mr. Mackinlay : To ask the Secretary of State for Health (1) what funding is available for health authorities to supply artificial larynx equipment to those under the NHS to all laryngectomy patients.
Mr. Sackville : Funding for health authorities to supply artificial larynx equipment to those who have undergone a laryngectomy operation is provided through resources made available to the national health service.
It is for individual health authorities to determine the level of service provision required to meet the needs of people needing these operations in their area. Priorities are determined in the light of local circumstances.
Column 563National health service consultants may prescribe artificial larynx equipment as part of NHS treatment and when they do so no charge is made. As for all other services, supply is dependent on resources, with decisions being made on the basis of clinical priorities and local needs.
Mr. Mackinlay : To ask the Secretary of State for Health if sterile tracheostomy dressings are available on prescription to patients who have undergone laryngectomy surgery, once discharged from hospital ; and if she will make a statement.
Mr. Bayley : To ask the Secretary of State for Health what was her Department's response to the request from the Home Office to provide NHS hospital beds for nine Algerian and one Indian political asylum seekers who were on hunger strike at Campsfield detention centre in Oxfordshire in the first week in March ; and for what reasons that response was given.
Dr. Mawhinney : Officials in the immigration department were advised that assessment of patient health care needs and appropriate hospital placement were matters for the local health authorities. Officials in the National Health Service Management Executive approached Oxford regional health authority to help identify suitable facilities in the region.
Dr. Marek : To ask the Secretary of State for Health what information she has on the incidence of side-effects on patients, as a result of allergies or other reasons, when taking more than one brand or form of a particular medicine for a specific ailment.
Mr. Sackville : A product licence in the United Kingdom for a generic medicine is granted on provision of evidence to demonstrate that the product is equivalent to the branded form. Since formulation and manufacturing methods may vary among all the different proprietary and generic forms of a particular medicine, it must be demonstrated that any differences do not produce untoward effects. The yellow card system for monitoring adverse reactions to drugs is a voluntary system whereby doctors send reports of suspected adverse reactions to the Medicines Control Agency. There have been occasional reports of adverse reactions apparently associated with generic substitution. However, a report of an adverse reaction in association with a drug does not necessarily mean that the drug caused the reaction.