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Quangos

Mr. Steen : To ask the Secretary of State for Employment if he will list the number of quangos for which he is responsible ; how much in public funds has been given to each quango in each of the last three years ; what is the current staffing establishment of each quango ; and what it was five years ago.

Mr. Michael Forsyth : Such information is contained in the publication "Public Bodies 1993" and earlier editions of the same publication. Copies of all editions are available in the Library.

Outdoor Education Centres

Mr. Win Griffiths : To ask the Secretary of State for Employment if he will list all outdoor education centres, giving their location and the frequency of visits made by the Health and Safety Executive over the last five years.

Mr. Michael Forsyth : The information is not collected in the form requested and could be obtained only at disproportionate cost.

HEALTH

Ambulance Services

Mr. Pike : To ask the Secretary of State for Health what has been the percentage response by each ambulance service in England meeting the minimum standard within the patients charter ; what are the comparable figures for meeting the ORCON standard ; what were the comparative figures for the previous two years ; and if he will make a statement.

Mr. Sackville : The information available is included in "Patient Transport Services 1992-93", copies of which are available in the Library.

Ambulance emergency response time standards, commonly referred to as ORCON standards, were first introduced in 1974. Revised standards, introduced following a 1990 review, are in the patients charter.

Health Visitors

Ms Jowell : To ask the Secretary of State for Health how many health visitors are now being trained ; and how many in 1984.

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


Year Ending |Entries to             

31 March    |Training               

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

1984        |848                    

1992        |694                    

Source: English National Board for  

Nursing, Midwifery and Health       

Visiting Annual Report Table 5.3.   

The number of whole-time equivalent health visitors in 1994 was 9, 700 and in 1992 was 10,250--an increase of 5.6 per cent. over the last eight years.

Counterfeit Medicines

Mr. David Nicholson : To ask the Secretary of State for Health how many manufacturers of counterfeit medicines have been detected in the United Kingdom this year ; and


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what steps are being taken by the Medicines Control Agency to protect NHS patients from counterfeit medicines, particularly in respect of those that are entering the country under the guise of parallel imports.

Mr. Sackville : Two. All reports of possible counterfeits are immediately investigated by the enforcement unit of the Medicines Control Agency, MCA, and any subsequent investigation given a high priority. The MCA also assesses the degree of hazard to the public and if necessary alerts relevant organisations and the public accordingly.

Mr. David Nicholson : To ask the Secretary of State for Health how many reports her Department has received of counterfeit medicines being (a) detected and (b) distributed in the United Kingdom in each year since 1990 and to date in 1994 ; and if she will name the products involved and the source of the products.

Mr. Sackville : Information in this detail could be provided only at disproportionate cost.

The Department of Health receives between 20 and 30 such reports each year, the products involved are usually major brand leaders or--more recently-- anabolic steroids. Eighty per cent. of the reports are related to "diverted" products. These products are legally manufactured within product specification but diverted to the United Kingdom from other markets.

Greater London Health Authority

Ms Jowell : To ask the Secretary of State for Health how much money was allocated to Greater London health authority purchasers in each year since 1990 ; and what percentage this represents of all revenue funding for hospitals and community health services in each year.

Mr. Sackville : Allocations to district health authorities as purchasers of health care were made for the first time in the 1991-92 financial year. It is the responsibility of regional health authorities to allocate resources to districts and this information is not separately identifiable in the information collected by the Department.

Expenditure by district health authorities in Greater London in 1991-92 and 1992-93 is shown in the table ; it excludes expenditure by general practitioner fund holders. The figures for individual authorities over the two years are not directly comparable in every case because of boundary changes.

Figures for 1993-94 are not yet available.

Greater London district health authorities' expenditure accounted for 18.1 per cent. of total expenditure by district health authorities in England in 1991-92 and 18.0 per cent. in 1992-93.


                                |1991-92       |1992-93                      

                                |(£)           |(£)                          

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

Barnet DHA                      |130,730,177   |132,241,755                  

Harrow DHA                      |88,397,307    |90,006,782                   

Hillingdon DHA                  |83,518,302    |86,111,744                   

Hounslow and Spelthorne DHA     |107,625,179   |112,230,351                  

Ealing DHA                      |103,110,478   |109,108,576                  

Riverside DHA                   |186,629,392   |194,018,538                  

Parkside DHA                    |238,303,679   |247,777,479                  

Barking, Havering and Brentwood                                              

   DHA                          |153,568,011   |159,857,405                  

Hampstead DHA                   |60,483,821    |62,510,951                   

City and Hackney DHA            |107,363,560   |99,429,552                   

Newham DHA                      |99,756,200    |103,351,059                  

Tower Hamlets DHA               |80,426,175    |78,932,970                   

Enfield DHA                     |96,196,452    |101,677,262                  

Haringey DHA                    |92,736,373    |99,423,594                   

Redbridge DHA                   |88,194,556    |92,187,298                   

Waltham Forest DHA              |96,763,754    |100,435,238                  

Bloomsbury and Islington DHA    |178,471,140   |191,942,037                  

Bexley DHA                      |71,303,254    |77,543,500                   

Greenwich DHA                   |91,659,692    |99,359,709                   

Bromley DHA                     |110,819,831   |119,819,385                  

West Lambeth DHA                |88,371,499    |471,547                      

Camberwell DHA                  |84,269,767    |482,703                      

Lewisham and North Southwark                                                 

   DHA                          |145,155,564   |365,351,088                  

Croydon DHA                     |109,082,512   |116,944,624                  

Kingston and Esher DHA          |68,653,248    |75,032,766                   

Richmond, Twickenham and                                                     

Roehampton DHA                  |96,517,808    |99,424,758                   

Wandsworth DHA                  |104,631,717   |111,878,599                  

Merton and Sutton DHA           |132,302,204   |141,250,768                  

                                                                             

Total, DHAs Greater London      |3,095,041,652 |3,268,802,038                

                                                                             

Total, DHAs England             |17,114,662,189|18,182,143,979               

Source: Annual accounts of health authorities (England).                     

Notes:                                                                       

1. Figures shown are for total revenue expenditure.                          

2. Figures for 1992-93 are provisional.                                      

Private Beds

Mr. Redmond : To ask the Secretary of State for Health if she will list for each district health authority in the Trent regional health authority the private bed income for each financial year since 1988-89 and for the current year to date.

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


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Authority name                 |1992-93<1>    |1991-92       |1990-91       |1989-90       |1988-89                      

                               |£             |£             |£             |£             |£                            

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

North Derbyshire DHA           |1,174         |364           |65,691        |133,139       |86,340                       

South Derbyshire DHA           |300,615       |272,887       |332,618       |260,008       |206,840                      

Leicestershire DHA             |132,907       |343,566       |199,517       |486,702       |550,638                      

North Lincolnshire DHA         |33,106        |63,260        |67,243        |116,566       |58,369                       

South Lincolnshire DHA         |505,789       |400,036       |275,659       |238,824       |280,774                      

Bassetlaw DHA<2>               |-             |122,903       |52,677        |49,560        |46,758                       

Central Nottinghamshire DHA<2> |-             |61,576        |30,522        |25,842        |27,395                       

Nottingham DHA                 |256,491       |315,829       |202,942       |252,601       |172,033                      

Barnsley DHA                   |96,461        |51,293        |46,239        |51,051        |35,182                       

Doncaster DHA                  |0             |0             |43,246        |44,584        |41,742                       

Rotherham DHA                  |0             |0             |0             |0             |0                            

Sheffield DHA                  |0             |204,081       |453,053       |412,272       |295,469                      

North Nottinghamshire DHA<2>   |67,282        |-             |-             |-             |-                            

Source: Receipts and payments returns for district health authorities.                                                   

<1>Latest figures available are for 1992-93 and are provisional.                                                         

<2>Bassetlaw and Central Notts merged to form North Nottinghamshire in 1992-93.                                          

Powered Wheelchairs

Mr. Redmond : To ask the Secretary of State for Health what is the estimated cost of including powered wheelchairs for occupant control out of doors in the artificial limb and appliance centre service ; and what plans she has to provide this service.

Mr. Bowis : Decisions about the issue of wheelchairs, including powered indoor-outdoor wheelchairs, are matters for arrangement between district health authorities and national health service trusts. No estimate of the cost of providing these wheelchairs on a national basis has been made. In 1991-92 total expenditure on the wheelchair service was £46.93 million.


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Nursing and Residential Homes

Mr. Redmond : To ask the Secretary of State for Health what information she has on the changes in the number of places in staffed residential care homes catering primarily for people who are mentally ill or have learning difficulties in (a) the Doncaster health authority area and (b) Trent regional health authority in each of the last four years, divided into (i) publicly owned, (ii) privately owned and (iii) voluntary sector owned.

Mr. Bowis : The information requested is shown in the table.


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Number of places in staffed residential care homes for people who are mentally  

ill or have learning disabilities<1>                                            

           Doncaster DHA                 Trent RHA                              

          |Local    |Private  |Voluntary|Local    |Private  |Voluntary          

          |authority                    |authority                              

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

1989      |168      |0        |73       |1,530    |1,440    |470                

1990      |168      |0        |73       |1,550    |1,640    |580                

1991      |183      |0        |75       |1,520    |1,780    |880                

1992      |220      |0        |93       |1,550    |1,940    |910                

<1>Includes places in homes primarily for elderly mentally infirm people.       


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Cornwall Health Trust

Mr. Redmond : To ask the Secretary of State for Health on what date the non-executive directors of the Cornwall health trust requested assistance towards the cost of their defence on charges of libel ; and what is her Department's response.

Dr. Mawhinney : Officials of the National Health Service Management Executive received a letter dated 26 January from the chief executive of the Cornwall Healthcare NHS trust asking that consideration be given to meeting the cost of the legal action against the trust's non-executive directors from central funds. Mr. J. H. Askham has recently been appointed as chairman of the Cornwall Healthcare NHS trust : officials will shortly be discussing with him the way forward for the trust.

Limb Defects

Mr. Redmond : To ask the Secretary of State for Health what investigations or research her Department is carrying out in respect of children who have been born in England and Wales during the last 10 years with missing or defective limbs ; and if she will make a statement.

Mr. Sackville : I refer the hon. Member to the reply I gave the hon. Member for Hartlepool (Mr. Mandelson) on 1 March at column 678.

Disciplinary Procedures

Mr. Matthew Taylor : To ask the Secretary of State for Health what procedures her Department has to collect information from NHS trusts in regard to disciplinary action taken under the new procedure HC(90)9.

Dr. Mawhinney : We do not collect such information.

Mr. Matthew Taylor : To ask the Secretary of State for Health how many doctors accused of personal misconduct under the new procedure have appealed to the Secretary of State under paragraph 190(d) procedures, for each year since 1990 ; and of these how many cases were (a) dismissed, (b) settled through premature retirement and (c) reinstated.

Dr. Mawhinney : My right hon. Friend the Secretary of State has received representations from two doctors under paragraph 190(d) of the "Terms and Conditions for Hospital Medical and Dental Staff (England and Wales)" to refer to a panel the question whether their appointment was terminated on the sole ground of personal misconduct. These representations were made in 1993 and the cases are still under consideration.

Mr. Matthew Taylor : To ask the Secretary of State for Health (1) how many doctors suspended from duty under the new procedure HC(90)9 for each year since 1990 have been suspended for (a) personal misconduct, (b) professional misconduct, (c) professional incompetence or (d) some other substantial reason ;

(2) how many doctors suspended from duty under the new procedure HC(90)9, for each year since 1990, have had (a) internal hearings only and (b) full independent professional hearings under annex B HC(90)9 procedures ; how many cases were dismissed ; in how many cases settlements were made out of court involving premature retirement of the doctor ; and how many were reinstated ;


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(3) how many doctors were suspended from duty under the new procedure HC(90)9 for each year since 1990 in each region.

Dr. Mawhinney : This information is not available centrally. Decisions on disciplinary action for hospital doctors or dentists rest with the employing authority or trust. This includes the decision as to whether to suspend a practitioner.

Mr. Matthew Taylor : To ask the Secretary of State for Health how many doctors suspended from duty under the new procedure HC(90)9 have been refused a request for a paragraph 190 hearing because the original ground for dismissal was personal misconduct.

Dr. Mawhinney : Doctors who are suspended from duty cannot request a paragraph 190 hearing unless they are subsequently dismissed.

Mr. Matthew Taylor : To ask the Secretary of State for Health how many doctors dismissed under the new procedures HC(90)9, for each year since 1990, have appealed to the Secretary of State under paragraph 190 procedures ; and of these how many cases were (a) dismissed, (b) settled through premature retirement and (c) reinstated.

Dr. Mawhinney : A total of 11 appeals have been lodged by doctors eligible to appeal under paragraph 190 of the terms and conditions of service since the new procedures set out in HC(90)9 were introduced in March 1990. None of these appeals arose from the application of the procedures in HC(90)9.

Of these 11 appeals two were upheld, two were dismissed and one was withdrawn. The outcome of the remaining six appeals is not yet known.

Rheumatoid Arthritis

Mr. William Ross : To ask the Secretary of State for Health what sums she has expended in each of the last five years for research into (a) the causes and (b) the treatment of rheumatoid arthritis ; and if he will make a statement.

Dr. Mawhinney : The Department is funding a research project to investigate long-term progression in rheumatoid arthritis and to study aetiology and prognostic factors. Departmental funding for this ongoing project began in 1980 at the clinical operational research unit--CORU--at University college London. The project is being funded in collaboration with pharmaceutical companies. The central funding is approximately £15,000 per year although this forms only part of the £327,975 allocated to CORU in 1993-94 to undertake its remit of studying applications of operational research and information technology to clinical aspects of health care.

The main agency through which the Government support biomedical and clinical research is the Medical Research Council--MRC--which receives its grant-in-aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster. The MRC is an independent body deciding what research to support on its own expert judgment.


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Psychiatric Care (Women's Wards)

Ms Jowell : To ask the Secretary of State for Health whether she will direct that health authority purchasers must ensure that women who are admitted to psychiatric hospitals are guaranteed care on a women-only ward if they request it.

Mr. Bowis : Our advice to health authorities contained in the "Mental Illness Key Area Handbook", copies of which are available in the Library, is that one of women's particular concerns is the choice of a single sex ward or single sex area. In addition the patients charter requires health authorities to provide services which respect patients' privacy, dignity and religious and cultural beliefs.

Mentally Ill People

Mr. Alton : To ask the Secretary of State for Health if she will ask the Mental Health Act Commission to monitor arrangements made for the aftercare of patients covered by section 117 of the Mental Health Act 1983, as recommended in the Ritchie report.

Mr. Bowis : We will consider this in consultation with the Mental Health Act Commission.

Abortions

Mrs. Bridget Prentice : To ask the Secretary of State for Health how many abortions were performed on women who were less than 13 weeks pregnant (a) in each regional health authority and (b) in each district health authority, in England and Wales in 1992 and 1993 ; and how many of these operations involved admission and discharge of the patient on the same day.

Mr. Sackville : The information for 1992 will be placed in the Library. For reasons of confidentiality, statistics for district health authorities are presented by DHA of woman's usual residence, not by DHA of termination. Information for 1993 is not yet available.

Mrs. Bridget Prentice : To ask the Secretary of State for Health how many fee-paying private bed abortions were performed in NHS hospitals in each regional health authority in England and Wales in 1992 and 1993.

Mr. Sackville : Information on private abortions carried out in national health service hospitals is collected as part of the hospital episode statistics system. The quality and completeness of this data is at present inadequate to provide regional level data but analysis conducted so far indicates that in both 1991-92 and 1992-93 the proportion of all abortions carried out in NHS hospitals that were performed privately was approximately 1.5 per cent.

Osteoporosis

Mrs. Bridget Prentice : To ask the Secretary of State for Health what funding has been made available in each of the past five years to regional health authorities in London for screening osteoporosis ; how many women in London have been screened for osteoporosis in each of the past five years ; how many clinics exist in London for the specific purpose of screening for osteoporosis ; and how many women in London have been diagnosed as suffering from osteoporosis in each of the past five years.

Mr. Sackville : There is no national population screening programme for osteoporosis and therefore no


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central funding as there is not yet evidence to show that such a programme would be effective. District health authorities are responsible for assessing need and for ensuring that suitable diagnostic services for individual women are made available.

Medical Product Licences

Mr. David Nicholson : To ask the Secretary of State for Health if the licensing authority responsible for granting product licences for parallel imports of medicines is currently subject to a legal challenge in the courts.

Mr. Sackville : On 26 January a pharmaceutical company in the United Kingdom was granted leave for a judical review of a decision by the Medicines Control Agency, on behalf of the licensing authority, to grant a parallel import product licence to a company to market a product imported from Belgium. The hearing is expected in April.

Blue-green Algae

Mr. Gordon Prentice : To ask the Secretary of State for Health what information she has concerning the number of people in the North West Water region who are allergic to blue-green algae.

Mr. Sackville : None. The numbers of people with allergies are not available centrally.

Illnesses including skin rashes, eye irritation, vomiting, diarrhoea, fever and pains in muscles and joints have occurred in people who swam through or swallowed water with an algal scum. Very few reports of such occurrences have come from the United Kingdom. There have been no reports of long term effects or deaths in humans from such exposures.

In 1990, the Department advised that although algal scum is not always harmful, it is a sensible precaution to avoid contact with the scum and the water close to it.

Accommodation

Mr. Redmond : To ask the Secretary of State for Health (1) what is the tenure of the Trent regional health authority headquarters' premises ;

(2) what is the tenure of the Doncaster health authority headquarters' premises.

Mr. Sackville : Trent regional health authority headquarters is freehold. Doncaster health authority headquarters is leasehold for 125 years from 4 December 1992.

GP Fundholding

Mr. Clapham : To ask the Secretary of State for Health what were the average savings made by each fundholding practice in 1992-93.

Dr. Mawhinney : I refer the hon. Member to the reply I gave the hon. Member for Darlington (Mr. Milburn) on 17 January at column 387.

Mr. Hinchliffe : To ask the Secretary of State for Health what proportion of the resources of fundholding general practice is being used to purchase health provision from the private sector ; what is her policy in respect of such purchasing ; and if she will make a statement.


Column 727

Dr. Mawhinney : I refer the hon. Member to the reply I gave the hon. Member for Bristol, South (Ms Primarolo) on 7 February at column 52.

Mr. Hinchliffe : To ask the Secretary of State for Health if she will list those health authorities which have indicated to general practitioners an inability to fund extra-contractual referrals during the current financial year.

Dr. Mawhinney : This is a matter for individual district health authorities. The National Health Service Management Executive has issued guidance to district health authorities who are expected to work closely with general practitioners in managing their budget for extra contractual referrals. Copies of the guidance contained in FDL(93)07 are available in the Library.

NHS Information

Mr. Duncan Smith : To ask the Secretary of State for Health if she will announce the results of the review of her Department's requirements for information from the NHS.

Mr. Sackville : We are anxious to do all we can to reduce further the number of forms which currently have to be filled in by national health service units and returned to the Department, as part of our statistical database.

We have already reduced and rationalised the contents of 21 different forms. A further five returns are being abolished, because the information they contain is now available from other sources. In addition, I am pleased to announce that from 1 April this year the Department will no longer require returns giving the following information :

Form KH10--Radiotherapy Machine Activity ;

Form KH13--Diagnostic Departments--Physiological Measurements ; Form KO39-- Hospital Eye Services.

There is clearly a limit to the amount of information required by the Department and the NHS Management Executive on a national service regionally and locally administered. Moreover, release from the burden of filling in forms will give NHS units more time for activities which have a greater bearing on direct patient care. All statistical returns from the NHS are being continually reviewed.

Michael Buchanan

Dr. Lynne Jones : To ask the Secretary of State for Health who are the members of the inquiry team set up by the North West London mental health trust to investigate the care and treatment of Michael Buchanan, convicted of manslaughter after discharge from Shenley psychiatric hospital ; and whether the report will be published.

Mr. Bowis : The membership of the independent inquiry panel is : Mr. C. Heginbotham, Chief Executive, Riverside Mental Health Trust (Chairman) ;

Dr. R. Hale, Consultant Psychiatrist, Tavistock Clinic ; Mrs. L. Warren, Non-Executive Member, Brent and Harrow Health Authority ;

Mr. T. Walsh, Assistant Director of Commissioning, Brent and Harrow Health Authority ;

Mrs. J. Carr, Non-Executive Director, Parkside Health NHS Trust. The report of this panel will be made public.


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Food Poisoning

Mr. Martyn Jones : To ask the Secretary of State for Health how many cases of food poisoning of all types were recorded monthly in each year since 1988, by health authority.

Mr. Sackville : This information is not available in the form requested. Data are published weekly, quarterly and annually by regional health authority, standard regions and local authority areas in the Office of Population Censuses and Surveys MB2

series--Communicable disease statistics, copies of which are available in the Library.

Rules and Regulations

Mr. Steen : To ask the Secretary of State for Health how many rules and regulations her Department has passed in each of the last three years.

Mr. Sackville : The information is shown in the tables.


Statutory            

Instruments Made     

       |Number       

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

1991   |122          

1992   |147          

1993   |141          


Government Bills     

which became Acts    

       |Number       

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

1991   |1            

1992   |0            

1993   |0            

Quangos

Mr. Steen : To ask the Secretary of State for Health if she will list the number of quangos for which she is responsible ; how much in public funds has been given to each quango in each of the last three years ; what is the current staffing establishment of each quango ; and what it was five years ago.

Mr. Sackville : This information is contained in the publication "Public Bodies 1993" and earlier editions of the same publication. Copies of all editions are available in the Library.

Peto Institute

Mr. Jim Cunningham : To ask the Secretary of State for Health, (1) pursuant to her answer of 1 February, Official Report, column 597-98, what study her Department has made of the extent to which families and institutions in the United Kingdom now require the services of the proposed International Peto Institute in Budapest ; will issue new briefing on conductive education ;

(4) what assessment she has made of whether the Government's policy that conductive education should be


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