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Agency was unable to trace the absent parent, and these cases may be re-opened if new information becomes available. Overall, the Agency has contacted 381,300 absent parents.During the same period there were 37,400 cases where it was either accepted that the parent with care had "good cause" not to identify the absent parent, or where they declined to do so, and "good cause" was not accepted.
You also asked about enforcement. Activity in this area is at a relatively early stage, and the process can prove time consuming. However, so far out of 2,700 cases in which enforcement action had commenced, payment had been re-established in 280 cases.
I hope this reply is helpful.
Permanent Health Insurance Policies
Mr. Bradley : To ask the Secretary of State for Social Security what was the estimated cost to his Department of extra-statutory concessions on benefits paid under permanent health insurance policies during 1991-92 and 1992-93.
Mr. Dorrell : I have been asked to reply.
Precise figures are not available centrally, but the estimated cost of the concession which exempted benefits from tax for the remainder of the tax year in which they commenced and the subsequent tax year was £10 million in 1991-92 and £15 million in 1992-93. The revenue cost of this concession will be lower in future years as a result of the changes in its operation which were announced on 30 November 1993.
War Pensions
Mr. Alfred Morris : To ask the Secretary of State for Social Security if he will publish in the Official Report the correspondence between the then Parliamentary Under-Secretary of State, Lord Henley, and the President of the war pensions appeal tribunal on the proposed changes in legislation for noise-induced hearing loss entitlement which were announced by the Government in 1992.
Mr. Hague : Lord Henley consulted the Central Advisory Committee on War Pensions on the proposals to amend the war pensions legislation on noise-induced hearing loss. He did not consult the then president of the war pensions appeal tribunal on the proposed changes.
HEALTH
Health Service Administration
Mr. Redmond : To ask the Secretary of State for Health how much the administration of each regional health authority cost in the last four years and in 1978, adjusted to 1993 prices.
Dr. Mawhinney : The information available is shown in the table. The figures for 1989-90 and 1990-91 are not directly comparable with the figures for 1991-92 and 1992-93 because of the introduction of capital charges and other changes to accounting procedures. Simple comparisons between authorities are misleading because regional health authorities devolved their non-core functions at varying times and bore different costs on their regional budgets. Administration expenditure figures are not held for individual health authorities in 1978.
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Administration costs for Regional Health Authorities
1989-90-1992-93 at 1993 prices
Region |1989-90|1990-91|1991-92|1992-93
|£000s |£000s |£000s |£000s
----------------------------------------------------------
Northern |8,919 |10,300 |19,433 |21,517
Yorkshire |12,774 |14,528 |67,010 |44,751
Trent |13,718 |13,026 |18,867 |21,227
East Anglian |9,712 |12,614 |8,310 |9,595
North West Thames |10,880 |13,371 |20,334 |32,126
North East Thames |15,588 |16,931 |33,096 |21,720
South East Thames |17,949 |18,235 |17,153 |19,142
South West Thames |16,370 |16,820 |13,638 |16,625
Wessex |7,450 |9,472 |20,741 |23,493
Oxford |5,612 |6,918 |27,768 |29,210
South Western |9,545 |11,655 |16,143 |16,773
West Midlands |21,499 |30,201 |23,196 |26,306
Mersey |7,211 |6,996 |24,881 |28,409
North Western |14,742 |15,054 |13,450 |16,454
Source Annual accounts of regional health authorities.
Notes:
1. The table shows expenditure adjusted to 1992-93 prices
by use of the Gross Domestic Product deflator.
2. The figures represent expenditure on pay and
accommodation costs of the staff at Regional Health
Authority headquarters and exclude costs of emergency bed
service, planning and setting up NHS Trusts, grants not
related to purchase of health care, education and
training, expenditure on Community Health Councils. They
do not include the costs of purchasing healthcare.
3. The figures for the years vary between RHAs as regions
were managed in an integrated way and the balance of
management between RHAs and their respective district
health authorities (DHAs) differed between regions. The
figures were also affected by other factors including
differences in the geographical size of regions and in
the extent to which RHAs directly managed operational
services. Following implementation of the NHS Reforms
from April 1991, the role of RHAs changed. There were
significant variations in the extent to which RHAs
retained or devolved management, support and operational
services functions and in the extent to which their costs
are borne or recharged to users directly involved in the
purchaser function.
4. The figures for 1992-93 are provisional.
Complaints Review
Mr. Rooker : To ask the Secretary of State for Health if her review of national health service complaints procedures includes a right for patients to lodge complaints against employees of general practitioners.
Ms Primarolo : To ask the Secretary of State for Health when she expects the publication of the review of national health service procedures.
Dr. Mawhinney : The committee set up to review national health service complaints procedures has now made its report with a number of recommendations and we are considering our response to these.
Ms Primarolo : To ask the Secretary of State for Health what advice the review of national health service complaints took from the social service inspectorate.
Severance Payments
Mr. Spellar : To ask the Secretary of State for Health, pursuant to her answer of 11 March, Official Report , column 438 , on irregular severance payments, what action she has taken to recover the irregular payment of £78,000.
Dr. Mawhinney : Any ultra vires payment by a health authority is recoverable in principle, and it is obligatory for the authority in question to consider the feasibility of recovery and to take prompt action as appropriate. The Department of Health and Her Majesty's Treasury will be looking to ensure that this happens in the instance referred to.
DNase
Mr. McAllion : To ask the Secretary of State for Health if she will list the hospitals which took part or are taking part in trials of the drug DNase ; on whose behalf these
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trials were conducted ; when the results of the trial will be published ; and if she will be issuing guidance to health boards on the use of the drug if the trials are successful.Mr. Sackville : Medicinal products for use in clinical trials are regulated under the Medicines Act 1968 and subsidiary legislation. The Medicines Control Agency acting on behalf of the licensing authority keeps confidential records of all applications to conduct clinical trials. Information from these records cannot be disclosed in accordance with section 118 of the Medicines Act. The question of guidance to health boards is a matter for my right hon. Friend the Secretary of State for Scotland. In England, it is for a local district health authority to decide priorities in the light of competing demands on finite resources. The Department of Health encourages the national health service to study the results of research into drugs.
Accident and Emergency Units
Mrs. Bridget Prentice : To ask the Secretary of State for Health what is the current ratio of accident and emergency units to district general hospitals in London ; and what the ratio was (a) two, (b) five and (c) 10 years ago.
Mr. Sackville : I refer the hon. Member to the reply I gave my hon. Friend the Member for Romford (Sir M. Neubert) on 22 February at columns 210-11.
General Practitioner Prescribing
Dr. Marek : To ask the Secretary of State for Health what plans she has to commission a medical audit of the quality of treatment being received by patients of general practitioner practices whose annual prescribing costs are 20 per cent. below the average for practices in their family health service authority areas.
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Dr. Mawhinney : Family health services authorities are responsible for working with general practitioner practices to make sure that their prescribing is both cost-effective and meets all the clinical needs of their patients.
Pre-school Child Care
Mrs. Golding : To ask the Secretary of State for Health how many (a) nursery places and (b) child minding places there were in England and Wales, (i) in total and (ii) in the private sector for 1987 and the last year that figures were available.
Mr. Bowis : Information on day nursery and child minder places in England for 1987 and the latest available year is contained in the publication "Children's day care facilities at 31 March 1992, England", copies of which are available in the Library.
Information about nursery schools is a matter for my right hon. Friend the Secretary of State for Education.
The number of nursery and child minding places in Wales is a matter for my right hon. Friend the Secretary of State for Wales.
Sheffield Community Health Trust
Mr. Blunkett : To ask the Secretary of State for Health how much has been spent by Sheffield health authority in consultative fees for research, design or establishment costs for the logo to be adopted by the proposed Sheffield Community Health Trust operational from 1 April.
Dr. Mawhinney : This is a matter for Sheffield health authority. The hon. Member may wish to contact the chairman, Mr. J. Neill, for details.
Pain Clinics
Mr. Redmond : To ask the Secretary of State for Health how many pain clinics are available in the Doncaster area ; on what sites ; and how many people were treated at each in 1992, 1993, and 1994 to date.
Mr. Sackville : This is a matter for the Doncaster health authority. The hon. Member may wish to contact the chairman, Mr. J. G. Smith, for details.
Dental Services
Mr. Tyler : To ask the Secretary of State for Health what is the total number of patients being deregistered for NHS dentistry treatment in each of the health authority areas within the south-west region, and what is the proportion per head of population in each of those areas, for the latest available period.
Dr. Mawhinney : Information for the latest available period is shown in the table. At 31 January 1994, there were 2,178,566 patients registered in South Western region. Based on June 1992 estimates, this represents 62.2 per cent. of the population of the region. In England since July 1992 there has been a net increase of over 600,000 patients registered and a net increase of 264 dentists in contract with family health services authorities.
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Number of patients and percentage of population deregistered, week
ending 18 March 1994, by FHSA
FHSA |Number of |Percentage of
|patients |population
|deregistered |deregistered
|during week
|ending 18 March
|1994
-----------------------------------------------------------------------------
Avon |36 |0.004
Cornwall and Isles of Scilly |22 |0.005
Devon |79 |0.008
Gloucestershire |206 |0.038
Somerset |129 |0.027
Mr. Blunkett : To ask the Secretary of State for Health how much additional revenue would be raised in a full year by increasing the contributions to NHS dental treatment fees for patients not exempt from charges to 100 per cent.
Dr. Mawhinney : We estimate that an increase in contributions for patients liable to pay dental charges to 100 per cent. of the national health service dental fee would raise £90 million £100 million additional revenue in a full year. This estimate is made on the assumption that there is no change in the demand for or supply of dental treatment under the general dental services. It also takes into account the maximum patient charge from 1 April 1994 of £275 for a course of NHS dental treatment.
Mr. Blunkett : To ask the Secretary of State for Health how many NHS dentists in England are offering private dental insurance schemes to their patients.
Dr. Mawhinney : This is a matter for individual dentists who are independent contractors, who themselves decide whether, and to what extent, to provide private treatment.
Press Conference Suite
Mr. Blunkett : To ask the Secretary of State for Health what are the planned uses for the new Department of Health press conference suite ; and if she will make a statement.
Mr. Sackville : The new conference room in Richmond house will be used for conferences, meetings, training seminars and workshops by the Departments of Health and Social Security. The room has also been equipped for press conferences and interviews.
The conference facility is also being made available for other Government Departments.
NHS Trusts
Ms Primarolo : To ask the Secretary of State for Health what freedom NHS trusts have to vary the terms and conditions for service for hospital medical and dental staff in relation to the freedom of practitioners to publish articles or to speak on any issue without the prior consent of their employer.
Dr. Mawhinney : Trusts have freedom to recruit staff on new terms and conditions and can negotiate new terms with existing staff.
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NHS Employees
Mr. Nicholas Winterton : To ask the Secretary of State for Health what information she has concerning the number of employees aged over 70 years who are currently allowed to continue to work within the national health service.
Dr. Mawhinney : Information available centrally suggests that there were about 200 direct care staff aged over 70 years as at 30 September 1992.
Complaints
Ms Primarolo : To ask the Secretary of State for Health whether it is her policy to apply different standards in relation to complaints by social service clients and NHS patients.
Dr. Mawhinney : There are separate procedures for complaints by social service clients and national health service patients.
GP Fundholders
Ms Primarolo : To ask the Secretary of State for Health what was (a) the budget, (b) the outturn and (c) the amount retained by general practitioner fundholders in each family health service authority area for each of the last four years.
Dr. Mawhinney : Information about general practitioner fundholder budgets is available centrally only at regional health authority level.
Ms Primarolo : To ask the Secretary of State for Health how many (a) administrative staff, (b) practice nurses, (c) other nurses, (d) social workers or counsellors and (e) other staff are directly employed by general practitioners' fundholding practices.
Dr. Mawhinney : Information collected centrally covers all general practitioner-employed staff. It does not distinguish between fundholding and other GP practices.
Call-out Fees
Ms Primarolo : To ask the Secretary of State for Health on what basis general practitioners may charge a call-out fee to (a) an individual patient, (b) a voluntary organisation providing a community care service, (c) a family health service authority and (d) a district health authority.
Dr. Mawhinney : Under their terms of service general practitioners receive a fee from their family health services authority for making a visit to a patient between 10 pm and 8 am. GPs may not charge any call-out fee to patients.
Family Health Services Authorities
Ms Primarolo : To ask the Secretary of State for Health (1) how much was paid over to family health services authorities by district health authorities in each of the last five years ;
(2) what was the total amount of money paid over by family health services authorities to (a) district health authorities and (b) local authorities for services provided and joint projects for each of the last five years for which figures are available.
Mr. Sackville : The annual accounts and financial returns of family health services authorities and district
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health authorities do not analyse income and expenditure in a way which would permit the identification of all such payments to DHAs or local authorities by FHSAs or to FHSAs by DHAs.Ms Primarolo : To ask the Secretary of State for Health what is the responsibility for a family health services authority to ensure that adequate general practitioner cover is available to respite centres for carers and day centres for elderly or disabled people.
Dr. Mawhinney : A family health services authority may require a general practitioner included in its medical list to provide treatment at any place in his practice area, provided that there is no other doctor who, at the time of the request, is under an obligation to give treatment to that person.
Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she will publish in the Official Report details of the administrative costs of administering the family health service authorities for England for each year since 1989-90 ; and what has been the percentage change since then for the latest possible year.
Dr. Mawhinney [holding answer 16 March 1994] : The revenue expenditure on family health services authorities--in 1989-90, family practitioner committees--in England on administration was £67 million in 1989-90, £104 million in 1990-91, £136 million in 1991-92 and £162 million in 1992-93. The percentage change from 1989-90 to 1992-93 was 142 per cent. FHSAs manage the introduction of general practitioner fundholding, the monitoring of prescribing and the development of clinical audit in primary care--all initiatives aimed at improving the effectiveness of patient care and value for money the national health service receives from its investment in primary care services. In 1992-93, FHSA administrative expenditure represented only 2.5 per cent. of the £6.5 billion of taxpayers' money spent on the family health service.
Community Care
Ms Primarolo : To ask the Secretary of State for Health, pursuant to her answer of 24 February, Official Report , column 356 , what steps a member of community care staff with concerns about fraud or client abuse by their employer can take.
Mr. Bowis : It is the responsibility of social care staff to raise such issues with their line managers and with any other authority as appropriate.
Ms Primarolo : To ask the Secretary of State for Health what measures her Department takes to ensure that voluntary organisations and private providers of commu-nity care services have suitable complaints procedures in place.
Mr. Bowis : Voluntary and private providers of community care services are responsible for their own complaints procedures. If the service is being provided under a contract from the local authority, the local authority's own complaints procedures are available.
Regional Health Authorities
Mr. Blunkett : To ask the Secretary of State for Health when she intends to bring forward legislation to replace regional health authorities.
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Dr. Mawhinney : As soon as parliamentary time allows.
Mr. Blunkett : To ask the Secretary of State for Health what will be the names of the regional health authorities after 1 April.
Dr. Mawhinney : The following is the information :
Northern and Yorkshire
Anglia and Oxford
South Thames
North West
Trent
North Thames
West Midlands
South and West
St. Bartholomew's Hospital
Mr. Sedgemore : To ask the Secretary of State for Health if she intends to transfer the freehold of St. Bartholomew's hospital at Smithfield to the new Royal Hospital of St. Bartholomew, the Royal London hospital and the London Chest hospital national health service trust.
Dr. Mawhinney : This is a matter which is currently being discussed by the trust project team and the North Thames Outpost.
Midwifery Supervision
Mrs. Gillan : To ask the Secretary of State for Health what is her policy on which is the appropriate body or person to make local decisions on midwifery supervision ; what guidance or circulars have been issued in relation to this question ; and if she will make a statement.
Mr. Sackville : The policy for local supervision of midwifery practice is set out in the Nurses, Midwives and Health Visitors Act 1979. In section 16(1) (a) it is specified that in England the local supervising authorities shall be the regional health authorities. Guidance on supervision of midwives has been issued by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting and the English National Board for Nursing, Midwifery and Health Visiting to the regional health authorities, and by them to the supervisors of midwives in their areas of supervision.
Hospital Staff
Ms Primarolo : To ask the Secretary of State for Health when paragraph 330 of the terms and conditions for service for hospital medical and dental staff was last revised ; and what was the effect of that revision.
Dr. Mawhinney : In 1981, when a reference to "an administrative medical officer of a regional hospital board" was deleted as no longer relevant.
Water Births
Mrs. Gillan : To ask the Secretary of State for Health if she will take further steps to draw the attention of all NHS providers of maternity services, in relation to water births, to the recommendations of her expert maternity group that where there are no proven risks in any procedure, priority should be given to the expressed wishes of the mother-to-be.
Mr. Sackville : Circular EL(94)9 already sets out action required by national health service purchasers and
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providers to implement the recommendations of the expert maternity group within the next five years. Copies of this circular are available in the Library.Adoption Registration Data
Mr. Blunkett : To ask the Secretary of State for Health what action she plans to take to increase the confidentiality of adoption registration data and to guarantee a standard, controlled procedure through which birth relatives may seek to re-establish contact with adopted adults ; and if she will make a statement.
Mr. Bowis : The means already exist for adopted adults and their birth parents or relatives to make contact by using the Adoption Contact Register, established in May 1991 and operated by the registrar general. I am studying the judgment of the Court of Appeal of 21 March concerning disclosure of information from the index to the Adopted Children's Register and will consider with the registrar general how best to reconcile access to the register with the need to protect confidentiality.
Mersey Regional Health Authority
Mr. Nicholas Winterton : To ask the Secretary of State for Health, pursuant to her answer of 18 March, Official Report, column 890, if she will indicate the number of full days per week, month and year which Sir Donald Wilson is expected to commit to his responsibilities as chairman of the Mersey regional health authority ; where information about Sir Donald's attendance record is held ; if she will request copies of that attendance record, and those of all chairmen of regional health authorities ; and if she will make it her policy in future to hold centrally such information.
Dr. Mawhinney : Sir Donald Wilson was recently appointed as chairman of North West regional health authority and non-executive regional policy board member for that region. We have every confidence that he will fulfil these responsibilities with distinction and we have no intention of requiring him, or other non-executive members of the policy board, to report their daily involvement upon national health service business.
Dental Services
Mr. Blunkett : To ask the Secretary of State for Health how many dental patients have been de-registered in each family health services authority since July 1992.
Dr. Mawhinney [pursuant to his reply, 17 March, c. 836-38] : I regret that there was an omission in the second sentence of my previous reply. It should read "Since July 1992 there has been a net increase of over 600,000 patients registered and an increase of 264 dentists in contract with family health services authorities".
TRADE AND INDUSTRY
Post Offices
Mr. Cousins : To ask the President of the Board of Trade how many proposals there are in each English region, Wales and Northern Ireland for conversion of Crown to agency status post offices ; and if he will list the affected offices in each case.
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Mr. McLoughlin : I understand from the Post Office that consultation on a proposal to convert the following Crown post offices had (a) been completed but the conversion had not taken place by 21 March 1994 or (b) is currently in progress. The information is provided on the basis of Post Office Counters regions, except in the case of data for Wales and Northern Ireland which has been produced separately.
North Thames and Anglia Region
(a) Completed
Woodbridge
Borehamwood
Cannon St. London
Chief Office London
Ware
Hatfield
Maida Vale
Rayleigh
Bush Fair Harlow
Staple Tye Harlow
Leytonstone
Epping
Beaconsfield
Bicester
Prestwick Road Watford
West Ealing
Maida Hill
Cricklewood
(b) In Progress
Forest Gate
Wolverton
Sheringham
Brandon
Turners Hill Cheshunt
Bruce Grover Tottenham
Wanstead
Midlands Region
(a) Completed
Corporation Street Coventry
Warstone Lane Birmingham
(b) In Progress
Nantwich
North West Region
(a) Completed
Buxton
Barnes Green Manchester
Farnworth
Tarporley
Birkenhead
Nelson
Morecambe
Darwen
High Town Manchester
Radcliffe
(b) In Progress
Stockport Road Manchester
Cheadle (Cheshire)
Bury
North East Region
(a) Completed
Peterlee
Heaton Newcastle upon Tyne
Shipley
Worksop
Otley
Hexham
(b) In Progress
Hessle
Cleethorpes
South East Region
(a Completed Bexleyheath
Godalming
Hythe
Blackheath
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