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Cervical Smear Tests

Ms Primarolo : To ask the Secretary of State for Health if she will issue guidance on the time before a repeat cervical smear test is needed after a result which shows no endocervical cells.

Mr. Sackville : An absence of columnar glandular endocervical cells per se does not in itself constitute an indication for a repeat smear as the smear could be adequate in other respects. Where a patient's smear is shown by the laboratory to be unsatisfactory, she is invited to have a smear as soon as possible.


Mr. Blunkett : To ask the Secretary of State for Health, (1) pursuant to her answer of 1 March, Official Report, columns 680-81, to what extent the AIDS (Control) Act 1987 reports for the past year revealed gaps in the area of HIV-AIDS-related services for those with a physical disability ;

(2) what assessment her Department has made of the physical accessibility of those locations in which HIV-AIDS-related services for the physically disabled are based.

Mr. Sackville : The AIDS (Control) Act 1987 requires regional and district health authorities to report on :

the known number of HIV seropositive people and people with AIDS in the area of the authority ;

a report of facilities and services ;

the number of staff employed ;

expenditure on HIV and AIDS-related services.

Gaps in the area of HIV-related services for those with a physical disability have not been specifically identified. We would, however, expect authorities to provide services which are sensitive to the needs of and accessible by people with a physical disability since many people with AIDS would fall within this category.

Profit Margins

Mr. Blunkett : To ask the Secretary of State for Health if her Department has collected data, or issued guidance, regarding the levels of profit margin placed on equipment and goods sold to national health service authorities or bodies.

Mr. Sackville : No, apart from the pharmaceutical price regulation scheme.

Health Promotion Clinics

Ms Primarolo : To ask the Secretary of State for Health if she will assess value for money in regard to health promotion clinics in general practice.

Dr. Mawhinney : Practice-based health promotion programmes are a good use of national health service resources to improve people's health.

Proton Cars

Mr. Redmond : To ask the Secretary of State for Health how many Proton cars were purchased by her Department and its predecessor in each of the last 10 years for which information is available ; and at what cost.

Mr. Sackville : None.

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Ritual Abuse

Mr. Alton : To ask the Secretary of State for Health when Professor Jean La Fontaine's report on ritual abuse will be completed ; and if the result will be made public.

Mr. Bowis : Professor La Fontaine's survey into the extent and nature of organised and ritual abuse will be completed later this year. No decision on publication has yet been made.

Suicides (Paracetamol)

Ms Primarolo : To ask the Secretary of State for Health what plans she has to deal with suicides from paracetamol.

Mr. Bowis : We are considering a number of measures designed to reduce the risk of deliberate or accidental paracetamol overdoses.

Cancer Treatment

Ms Primarolo : To ask the Secretary of State for Health how much in real terms was spent in each of the last three years in the NHS on (a) the treatment of cancer and (b) the prevention of cancer.

Mr. Sackville : Information on the amount spent on treatment and prevention of cancer is not identified separately.

Tobacco Advertising

Mr. Barron : To ask the Secretary of State for Health what is the total number of billboard sites currently covered by the voluntary agreement with the tobacco manufacturing companies ; and how many she estimates are within (a) three miles, (b) two miles, (c) one mile, (d) three quarters of a mile, (e) half a mile and (f) one quarter of a mile of school premises.

Mr. Sackville : Under the voluntary agreement, billboard advertising of cigarettes and hand-rolling tobacco is not allowed which is in close proximity to and clearly visible from schools, places of education for young people and children's playgrounds. Information on the number of billboard sites covered by the voluntary agreement, and on the proportion within different distances of school premises is not held by the Department. However, the voluntary agreement limits expenditure on cigarette brand poster advertising by companies represented by the Tobacco Manufacturers Association to 50 per cent. of the 1980 level, allowing for inflation.

NHS Supplies Authority

Mr. Redmond : To ask the Secretary of State for Health whether the National Health Service Supplies Authority, either centrally or through its divisions, employs independent consultants to undertake comparisons between the prices it pays or negotiates and the best available market price.

Mr. Sackville : The National Health Service Supplies Authority currently contracts with three independent consultants to obtain regular price comparisons.

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Trent RHA

Mr. Redmond : To ask the Secretary of State for Health how much money was allocated to Trent regional health authority purchasers in each year since 1990 ; and what percentage this represents of all revenue funding for hospital 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 Trent in 1991-92 and 1992-93 is shown in the table ; it excludes expenditure by general practitioner fundholders. 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.

Trent district health authorities' expenditure accounted for 8.7 per cent. of the total expenditure by district health authorities in England in 1991- 92 and 9.2 per cent. in 1992-93.

Revenue expenditure by district health authorities in England               

District health             |1991-92        |1992-93                        


                            |£              |£                              


North Derbyshire DHA        |105,670,742    |113,114,609                    

Southern Derbyshire DHA     |167,981,567    |185,166,596                    

Leicestershire DHA          |261,702,208    |297,169,389                    

North Lincolnshire DHA      |91,668,517     |100,708,900                    

South Lincolnshire DHA      |102,072,066    |109,472,637                    

Bassetlaw DHA               |31,107,515     |n/a                            

Central Nottinghamshire DHA |87,214,069     |n/a                            

North Nottinghamshire DHA   |n/a            |131,696,612                    

Nottingham DHA              |201,912,223    |224,553,446                    

Barnsley DHA                |70,930,301     |79,006,026                     

Doncaster DHA               |88,483,141     |99,681,002                     

Rotherham DHA               |75,355,705     |84,222,003                     

Sheffield DHA               |212,577,749    |241,697,006                    

                            |-------        |-------                        

Total DHAs, Trent           |1,496,675,803  |1,666,488,226                  

                            |-------        |-------                        

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

Source: Annual accounts of health authorities (England).                    


1. Figures shown are for total revenue expenditure.                         

2. Figures for 1992-93 are provisional.                                     

3. Bassetlaw and Central Nottinghamshire DHAs merged to form North          

Nottinghamshire DHA in 1992-93.                                             

Hospital Beds

Ms Primarolo : To ask the Secretary of State for Health how many hospital beds there were in each year between 1978-79 and 1988-89 in England excluding inner and outer London district health authorities and regional health authorities.

Mr. Sackville : The available information on the average daily number of available beds has been published and copies of the national and regional summaries placed in the Library. The data for the years 1978 to 1986 are contained in the publication "Hospital Statistics-Form SH3". Summary tables for the years from 1982 to 1992-93 are set out in "Bed availability for England : Financial Year 1992-93".

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Breast Lump Clinics

Ms Primarolo : To ask the Secretary of State for Health what percentage of hospitals have specific breast lump clinics.

Mr. Sackville : This information is not available centrally. It is for local provider units in consultation with their purchasers to decide what provision is required.

Cash Limits

Mr. Luff : To ask the Secretary of State for Health what changes will be made to the cash limits of her Department in 1993-94.

Mrs. Virginia Bottomley : The cash limit for class XII vote 1-- hospital, community health, family health services (part) and related services, England--will be increased by £5,794,000, from £19, 880,171,000 to £19,885,965,000. This increase covers transfers of £5, 000,000 for enabling work for phase IV development of Derriford Hospital, from class I, vote 1, Ministry of Defence ; £763,000 for payments to the National Health Service Estate Management and Health Building Agency and £123,000 in respect of Public Health Laboratory Service Board, from class XII, vote 3, Department of Health, administration, miscellaneous health services and personal social services, England ; £93,000 for the cost of clinical placements in England in respect of Glasgow Caledonian university students, to class XIV, vote 18, student awards, Scotland ; and an increase of £1, 000 offset by receipts from members of the public towards the cost of medical treatment for Bosnian evacuees.

The non-voted cash limit for supplementary credit approvals for personal social services--DOH/LACAP--in England is to be increased by £1,183,500, from £23,700,000 to £24,883,500 in respect of the take up of entitlement to carry forward of underspends from the 1992-93 financial year under the end-year flexibility arrangements as announced by the Chief Secretary to the Treasury on 14 July 1993 at columns 512-17.

All increases will either be offset by increased receipts, transfers to or from other votes, or from the reserve and will not therefore add to the planned total of public expenditure.


Mr. Garnier : To ask the Secretary of State for Health if she will make a statement about the future of the centre for applied microbiology and research.

Mr. Sackville : I announced on 15 January 1993 that the Centre for Applied Microbiology and Research was to become independent of the Public Health Laboratory Service and would be separately accountable to Health Ministers. I can now announce that the centre will, from 1 April, be administered by a new authority called the Microbiological Research Authority under the chairmanship of Mr. J. E. Everitt, outgoing chairman and chief executive of Vickers Medical. I have also agreed to the appointment of Dr. J. Melling as chief executive and director of the centre. The greater independence and more appropriate management expertise provided by these measures should enable the centre to develop its full scientific and commercial potential.

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Breast Cancer Treatment

Ms Lynne : To ask the Secretary of State for Health what is her policy on the encouragement of randomised controlled trails for the treatment of breast cancer.

Mr. Sackville : The Government are committed to encouraging research into breast cancer. Randomised controlled trials are regarded as the scientific method for determining and evaluating new developments in health care, and are funded by the Department when they represent the most appropriate method of research for answering specific questions relevant to health care policy and practice. The United Kingdom Health Departments, along with 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, and the major cancer research charities--the Imperial Cancer Research Fund and the Cancer Research Campaign--are currently funding four studies into breast screening at an estimated cost of £5 million over five years. Three of these trials involve RCTs. The trials are being co- ordinated by the United Kingdom Co-ordinating Committee on Cancer Research.

General Practitioner Fundholders

Ms Jowell : To ask the Secretary of State for Health how much money was allocated in Greater London to general practitioner fundholders in 1991 -92 and 1992-93 ; and what percentage this represented of the total allocation for general practitioner fundholders in England for each year.

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Dr. Mawhinney : Regional health authorities manage the general practitioner fundholding scheme in their areas. The hon. Member may wish to contact the chairmen of the Thames regional health authorities for local information in London.

Ms Jowell : To ask the Secretary of State for Health how many fundholding practices there were in Greater London for each year since 1991 -92 ; and what percentage of the total figure for fundholders in England those figures represent in each year.

Dr. Mawhinney : Information about general practitioner fundholder numbers is only available centrally at regional health authority level. I refer the hon. Member to the reply that I gave the hon. Member for Bristol, South (Ms Primarolo) on 7 February at columns 43-44.

Patient Stays (Average Length)

Ms Jowell : To ask the Secretary of State for Health what is the average length of in patient stay for patients who receive (a) hysterectomy, (b) gall bladder removal, (c) hernia repair, (d) kidney transplant and (e) angioplasty in hospitals in (i) Birmingham, (ii) Leeds, (iii) London, (iv) Manchester, (v) Newcastle and (vi) Bristol.

Mr. Sackville : This information is not available centrally. The available information by regional health authority is shown in the table.

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In-patients in NHS hospitals in England 1990-91                                                                                             

Average duration of stay (days)                                                                                                             

Region of treatment |Hysterectomy       |Gall bladder       |Hernia repair<2>   |Kidney             |Angioplasty<3>                         

                                        |excision<1>                            |transplant                                                 


Northern            |8.4                |9.5                |4.4                |16.6               |4.8                                    

Yorkshire           |9.0                |9.2                |4.3                |11.0               |3.8                                    

Trent               |8.4                |8.4                |3.5                |17.2               |3.7                                    

East Anglia         |8.0                |9.3                |3.9                |14.1               |3.6                                    

North West Thames   |9.2                |9.7                |3.7                |18.0               |4.4                                    

North East Thames   |8.4                |9.3                |3.8                |11.4               |4.7                                    

South East Thames   |8.6                |9.3                |3.9                |25.2               |4.7                                    

South West Thames   |8.8                |8.9                |3.8                |0.6<4>             |3.8                                    

Wessex              |8.1                |8.5                |3.2                |15.8               |3.5                                    

Oxford              |7.9                |8.2                |3.4                |8.1                |2.9                                    

South Western       |9.0                |10.0               |3.9                |19.7               |4.9                                    

West Midlands       |8.4                |8.8                |3.5                |15.4               |4.6                                    

Mersey              |8.7                |9.8                |4.3                |16.3               |6.6                                    

North Western       |8.2                |9.8                |4.7                |16.2               |4.4                                    

ENGLAND             |8.5                |9.2                |3.9                |16.0               |4.3                                    

<1> May exclude some laparoscopic cholecystectomies, not otherwise identifiable.                                                            

<2> Figures represent repairs of groin hernias. They exclude those of other less common hernias in other parts of the body.                 

<3> Covers coronary artery angioplasty. The term "angioplasty" covers a very large range of operative procedures on blood vessels in        

different parts of the body.                                                                                                                

<4> It is believed that this extremely low figure reflects mis-coding at source.                                                            

District Health Authority Mergers

Mr. Milburn : To ask the Secretary of State for Health if she will list all proposed district health authority mergers and the timetable for each.

Dr. Mawhinney : I refer the hon. Member to the reply I gave him on 15 March at column 566 concerning district health authority mergers from 1 April 1994. Proposals to merge Wigan DHA with Bolton DHA and Newcastle DHA

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with North Tyneside DHA have been received by the Department. Decisions on these proposals, which will include a timetable, will be made in due course.

Disability Equipment

Mr. Alex Carlile : To ask the Secretary of State for Health if she will list the average weekly cost of powering (a) a powered wheelchair, (b) a bed/bath hoist, (c) an automatic door opener, (d) a stair lift, (e) a respirator, (f) an automatic toilet-bidet unit and (g) a self-lift chair ; and if she will make a statement.

Mr. Bowis : This information is not available centrally.

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Mr. Alex Carlile : To ask the Secretary of State for Health what amount of public funding is granted each year to help disabled people not on benefits pay the costs of running disability equipment ; and if she will make a statement.

Mr. Bowis : A wide range of disability equipment is supplied and, where appropriate, maintained by the national health service, social services departments, and other public bodies.

Health Authorities (Ethnic Minority Members)

Mr. Alex Carlile : To ask the Secretary of State for Health what specific measures her Department plans to take to increase the percentages of ethnic minority members of health authorities, national health service trusts and working parties formed by her Department ; and if she will make a statement.

Dr. Mawhinney : Our aim is to appoint the best people we can to the boards of national health service authorities and trusts and to ensure that good candidates from ethnic minorities are given every encouragement to come forward. To this end, regional health authority chairmen are specifically encouraged to seek people from ethnic minorities when identifying candidates for chairman and non-executive positions.

Urgent Cases

Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health if she will make a statement on the implications for patients of the letter by Sir Duncan Nichol, chief executive of the national health service, to district health authorities on the treatment of urgent cases within available resources.

Dr. Mawhinney : Sir Duncan Nichol wrote to all hospitals and health authorities on 24 February reminding those concerned with the purchasing and provision of hospital treatment of the need to ensure that appropriate clinical priority is given to patients on waiting lists. Copies of the letter, EL(94)19, are available in the Library.

Continuing Care Provision

Mr. Alfred Morris : To ask the Secretary of State for Health when she expects the NHS Management Executive to complete its inquiry into NHS continuing care provision by those district health authorities identified in the recent Alzheimer's Disease Society report as supplying no NHS continuing care beds ; whether the NHS Management Executive's findings will be made public ; and if she will make a statement.

Mr. Bowis : I expect to receive a report from the National Health Service Management Executive shortly. Such advice is normally internal for the Department.

Birth Deformities

Mr. Ieuan Wyn Jones : To ask the Secretary of State for Health what research her Department has carried out on the link between sea pollution and deformities of children at birth ; and if she will make a statement.

Mr. Sackville : The Department itself has undertaken no such research. I refer the hon. Member to the reply that I gave to the hon. Member for Hartlepool (Mr. Mandelson) on 25 March at columns 462-63.

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Your Pocket Guide to Sex"

Mr. Blunkett : To ask the Secretary of State for Health what has been the cost of (a) commissioning, (b) printing, (c) distributing, (d) promoting and (e) recalling "Your Pocket Guide to Sex", written by Nick Fisher for the Health Education Authority, which was withdrawn on 23 March.

Dr. Mawhinney : I shall let the hon. Member have a reply as soon as possible.

Waiting Times

Mr. Morgan : To ask the Secretary of State for Health what proposals she has to issue patients charter maximum waiting times inclusive of the wait for the first time out-patient appointment ; and if she will make a statement.

Dr. Mawhinney : New initiatives to reduce hospital waiting times are constantly being considered. An announcement will be made in due course if it is decided to add to the successful standards contained in the patients charter.

Farmers (Suicide)

Mr. Alex Carlile : To ask the Secretary of State for Health if she will commission a report into the rate of suicide for farmers ; and if she will make a statement.

Mr. Bowis : We have commissioned Dr. K. Hawton of the University of Oxford to carry out a study of individuals in high-risk groups, including farmers, for whom verdicts of suicide or undetermined death were returned. His report is expected in December 1995.


Supported Employment

Mr. Merchant : To ask the Secretary of State for Employment if he will make a statement on provision for supported employment in 1994-95.

Mr. David Hunt : The maximum grant payable in 1994-95 per contracted place in the supported employment programme will be £4,420 for both voluntary body and local authority providers. Under the arrangements I announced on the 10 March 1994, Official Report, column 338, coming into force on 1 April, the number of places in the programme will be for negotiation between the Employment Service and both local authorities and voluntary bodies. Payments to local authorities will continue, as previously, to be limited to at most 75 per cent. of their costs.

Ministerial Offices

Mr. Boyes : To ask the Secretary of State for Employment what was the cost of new furniture for his private office during the year 1993-94.

Mr. Michael Forsyth : The cost of new furniture for the Secretary of State's private office was £911.88.

Work Experience Schemes

Sir Ralph Howell : To ask the Secretary of State for Employment what percentage of participants in (a) North Norfolk Action, (b) job clubs, (c) workstart and

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(d) Government-organised or funded work experience schemes found subsequent employment as a result of joining the scheme, after the first six months of the scheme starting.

Mr. Michael Forsyth : The information is as follows : North Norfolk Action 12.8 per cent. from the work experience element and 2.3 per cent. from attendance at a series of caseload interviews ; job clubs 63 per cent.

Figures for workstart are as yet unavailable ; the scheme, which began in July 1993, provides subsidies for 12 months to employers who recruit eligible long-term people. Figures are also unavailable for community action, through which work experience is currently provided. This scheme also began in July 1993, and information on the number of leavers who obtain jobs is collected three months after the date of leaving.

Labour Statistics

Mr. Harvey : To ask the Secretary of State for Employment if he will estimate the proportion of the United Kingdom work force which is employed under terms and conditions which do not fulfil the terms of the European Community social chapter.

Mr. Michael Forsyth : The draft social chapter proposed at Maastricht did not set out any terms and conditions of employment.

Aerospace Apprenticeships

Mr. Gordon Prentice : To ask the Secretary of State for Employment how many engineering apprenticeships in the aerospace industry there were in each year since 1979.

Miss Widdecombe : Data on apprentices have been collected on a consistent basis through the labour force survey since 1984. However, the sample size does not allow reliable estimates at this level of industrial detail.

Labour Flexibility

Mr. Austin Mitchell : To ask the Secretary of State for Employment what assumption the Government make about the cost of their policy of labour flexibility for those affected : if he will list the evidence available to him about the relative costs and benefits ; and if he will publish his estimate of the losses and gains and those who have lost and those who have gained.

Mr. Michael Forsyth : A more flexible and efficient labour market leads overall to more jobs and less unemployment. It is not possible to disentangle the effect of flexibility on individuals.

Mr. Austin Mitchell : To ask the Secretary of State for Employment (1) what is the objective of the Government policy of labour flexibility ; and what benchmarks the Government used for judging its success ;

(2) pursuant to his answer of 11 March, Official Report, column 433, concerning rewards for productivity, by what means he assesses the effectiveness of the Government's policy of labour flexibility.

Mr. Michael Forsyth : The objective of labour flexibility is to support economic growth, create jobs and reduce unemployment. Increased labour flexibility has contributed to unemployment falling earlier in the cycle

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than previously--a fall of 220,000 since December 1992, and to a relatively early upturn in the work force in employment--an increase of 136,000 in the nine months to December 1993.

Mr. Austin Mitchell : To ask the Secretary of State for Employment if he will publish a list of the measures which the Government include under the heading of labour flexibility ; and which of these were commended to the Group of Seven.

Mr. Michael Forsyth : Flexibility requires measures to improve the efficient working of the labour market, to increase the ability of unemployed people to get jobs and compete effectively, and to encourage investment in skills by individuals and their employers. My right hon. Friend, the Secretary of State commended each of these to the G7 jobs conference, which agreed that flexible labour markets support economic growth and deliver higher employment and lower unemployment.

Mr. Austin Mitchell : To ask the Secretary of State for Employment what assessment he has made of the effect of the policy of labour flexibility on full-time adult male employment since 1979.

Mr. Michael Forsyth : No such assessment has been made. Labour market flexibility should support economic growth, reduce unemployment and increase all types of jobs.

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