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Planning Forums (Representation)
Mr. Wigley : To ask the Secretary of State for Health what representation there is of disabled people, carers of disabled people, parents of disabled children and disabled children on the planning forums of each local authority in England.
Mr. Bowis : Local authorities are obliged by law to consult service users and carers on their community care plans. It is for each authority to determine how best to consult and involve people.
Mental Health Services
Mr. Peter Bottomley : To ask the Secretary of State for Health what are the targets for improvements in mental health services which she has asked the national health service executive to monitor with regard to the care of patients in the special supervision group identified by the Ritchie report.
Mr. Bowis : From April 1 1994, providers of mental health services will be required to establish supervision registers of those patients with a severe mental illness, who may pose a significant risk to themselves or others. The national health service executive will monitor the introduction of the registers to ensure that all patients in contact with the specialist psychiatric services have been assessed for inclusion on local registers by October 1994. The executive will also be monitoring provider units to ensure that all patients in contact with the specialist psychiatric services are subject to the care programme approach.
Child Guidance Clinics
Miss Lestor : To ask the Secretary of State for Health how many child guidance clinics were operating in 1985 and in each year since 1990.
Mr. Bowis : This information is not available centrally.
Children's In-patient Units
Miss Lestor : To ask the Secretary of State for Health how many children's in-patient units were operating in 1985 and in each year since 1990.
Mr. Bowis : The information available is shown in the table.
|Number of|Number of
|units |beds
----------------------------------------
1990-91 |427 |14,458
1991-92 |<1>306 |14,436
1992-93 |295 |14,152
<1>Before 1991-92 information was
collected by hospital site. Thereafter,
as a result of National Health Service
re-organisation, some individual
hospital sites were aggregated under
larger hospital and community units.
The overall number of beds is therefore
shown for comparative purposes.
Figures for 1985 are not comparable as they were then collected by consultant speciality--not by numbers of designated children's beds and units.
Junior Doctors
Ms Primarolo : To ask the Secretary of State for Health if she will list the average hours contracted for junior doctors in each EU country.
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Dr. Mawhinney : This information is not available.
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the results of her new deal initiative for junior doctors.
Dr. Mawhinney : We receive regular reports on junior doctors' hours from regional task forces. Between September 1990 and September 1993 the number of junior doctors and dentists contracted for more than an average of 83 hours a week fell from over 13,300 to 91, a reduction of 99 per cent. This is a remarkable achievement. The remaining few posts are being tackled as a priority.
From August 1992 to September 1993 the number of those working in hard- pressed on-call posts contracted on average for between 73 and 83 hours a week fell from over 10,200 to 7,800, a 24 per cent. reduction. We announced in December last year that eliminating the remaining posts in this category is a priority in 1994.
Ms Primarolo : To ask the Secretary of State for Health what plans she has to ensure that hospital trusts abide by her new deal for junior doctors.
Dr. Mawhinney : Our regional task forces work very closely with trusts and authorities to monitor progress and support local action to reach the new deal targets. Task forces receive regular detailed reports from all units and, in turn, submit returns to the ministerial group on junior doctors' hours.
I and the chief executive of the national health service have also written respectively to chairmen and chief executives of trusts and authorities to re-affirm the Government's commitment to eliminating hard-pressed on-call posts contracted for more than 72 hours a week. This is a priority for 1994 and we have issued a detailed action plan to all regions, trusts and authorities.
Ms Primarolo : To ask the Secretary of State for Health what plans she has to issue guidelines on minimum sleep for junior doctors within 24 hour and seven day periods.
Dr. Mawhinney : The guidance on the new deal for junior doctors issued in June 1991, copies of which are available in the Library, advises that those working on on-call rotas should have a reasonable expectation of eight hours rest during a period of 32 hours on duty, principally within the on-call period. Where possible the greater part of this rest period should be continuous. For junior doctors working on partial shifts there should be a reasonable expectation of four hours rest during a duty period of 16 hours. Those on full shifts should also be allowed reasonable time for natural breaks during their working time. The implementation of this guidance forms part of our overall policy of reducing junior doctors' hours of work as part of the new deal. No further guidance is necessary.
Ms Primarolo : To ask the Secretary of State for Health how many junior doctors in each region are working more than 72 hours per week ; and what plans she has to ensure that no doctor works more than 72 hours by her target date of 1 January 1995.
Dr. Mawhinney : Information on the number of hours worked by junior doctors is not available centrally. The number of junior doctors and dentists contracted for more than an average of 72 hours a week in England, by region, is :
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Posts contracted for over 72
hours per week at 30 September
1993
(England)
Region |Number
----------------------------------
Northern |780
Yorkshire |1,381
Trent |550
East Anglian |517
North West Thames |729
North East Thames |1,229
South East Thames |762
South West Thames |801
Wessex |520
Oxford |532
South Western |327
West Midlands |925
Mersey |783
North Western |1,369
|-------
England |11,205
Notes:
(i) Figures derived from the
reports of the 14 English
Regional Task Forces.
(ii) SHAs included in the figures
for the Thames Regions.
Our priority is to eliminate all hard-pressed on-call posts contracted for an average of more than 72 hours a week by 31 December 1994. To this end I and the chief executive of the national health service have written respectively to chairmen and chief executives of trusts and authorities to re-affirm the Government's commitment to this target. Detailed guidance-- EL(94)17--has also been sent to regions, authorities and trusts which provides a plan for action for the remainder of 1994. Copies of the guidance are available in the Library.
We are also providing in 1994-95 an extra £11.6 million from central funds to create at least 125 new consultant posts and for local initiatives to help the new deal. This will bring the total number of new posts for senior doctors created to reduce hours since the new deal was launched in 1991 to 750.
Orthopaedics
Mr. Shersby : To ask the Secretary of State for Health what difficulties are being experienced in hospitals in the Hillingdon area in appointing suitable candidates to fill consultant posts in orthopaedics ; what steps she is taking to increase the number of doctors qualifying in this specialty ; and if she will make a statement.
Dr. Mawhinney : At the last review of trauma and orthopaedics by the joint planning advisory committee--JPAC--in February 1993, the senior registrar national target was increased from 181 to 210 posts, and the career registrar national target from 153 to 202 posts. We are confident that all these posts will be funded within the target timescales. This should increase the number of suitable candidates to fill consultant vacancies.
My hon. Friend may wish to consult the chairmen of national health service trusts in Hillingdon for local details.
Fostering Respite Care
Ms Primarolo : To ask the Secretary of State for Health how many and what percentage of authorities offer fostering respite care.
Mr. Bowis : Information available centrally relates to local authorities who have provided children with a series of short term placements with foster carers under one
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agreement. Such placements generally relate to respite care if parents need relief, either from caring for a disabled child or for other reasons, or because a child is at risk of harm from their own behaviour.In the period 14 October 1991 to 31 March 1992, 76 authorities--78 per cent. of those submitting returns--looked after children in this way.
Redundant Health Facilities
Mr. Gordon Prentice : To ask the Secretary of State for Health what assessment she has made of the amount spent by health authorities in keeping redundant hospital and other redundant health facilities wind and water tight and safe from vandalism and theft.
Mr. Sackville : This information is not available centrally. Regional health authorities, and national health service trusts, are responsible for property management.
Asthma
Mr. Martyn Jones : To ask the Secretary of State for Health how many children aged five to 11 years have died following acute asthma attacks in each health region in England since 1990.
Mr. Sackville : The information is shown in the table.
Number of deaths from asthma (ICD<1> 493) in each health region of England for the grouped ages of 5 to 11, 1990-92 Regional health |1990 |1991 |1992 authority ---------------------------------------------------------------------------------- Northern |1 |1 |- Yorkshire |- |1 |1 Trent |- |- |- East Anglian |1 |- |- North West Thames |- |3 |- North East Thames |1 |1 |- South East Thames |- |- |1 South West Thames |- |1 |- Wessex |1 |- |1 Oxford |2 |- |- South Western |- |1 |- West Midlands |- |2 |- Mersey |3 |- |1 North Western |3 |1 |- <1> International Classification of Disease, 9th Revision.
Mr. Martyn Jones : To ask the Secretary of State for Health how many asthma-related deaths of children aged
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five to 11 years there have been on school premises in the current academic year in (a) England, (b) Wales, (c) Scotland and (d) Northern Ireland ; and if he will make a statement.Mr. Sackville : Figures for the current academic year are not available. There were four deaths recorded for this age group in 1992 in England and Wales but none occurred on school premises. Information relating to Scotland and Northern Ireland is a matter for my right hon. Friend the Secretary of State for Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland.
Mr. Martyn Jones : To ask the Secretary of State for Health if she will make a statement on her policy on the immediate availability of ventilators for children suffering from asthma aged (a) under 5, (b) 5 to 11 and (c) 11 to 18 years.
Mr. Sackville : I understand that the hon. Member is referring to the immediate availability of portable inhalers which are prescribed for asthma sufferers to help control their condition. Our advice is that children should have immediate access to the medication they require, and that in consultation with parents and with appropriate medical advice, children should be encouraged to manage their own medical condition as early as is consistent with their development.
Mr. George Howarth : To ask the Secretary of State for Health how many cases of asthma were reported in each health region for each year since 1979.
Mr. Sackville : The information available, which derives from hospital in-patient data and which does not cover all cases of asthma, is shown in the table. The 1979 to 1985 data are based on a survey of discharges and deaths in hospital, and the figures for 1989-90 and 1990-91 are based on finished consultant episodes. The first year of published data from the hospital episode statistics is 1989-90. The reason for the increase over the period 1979 to 1990-91 is not known, but some proportion of the increase can be attributed to a change in diagnostic practice.
Figures were not collected in 1986. As 1987-88 was the first year of changing to the, then, new Ko"rner system there was considerable under reporting and the resultant data are incomplete in certain important areas.
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Hospital episodes with a main diagnosis of asthma (ICD9 493)
In-patients by region of treatment
Discharges and Finished consultant
deaths
episodes
|1979 |1980 |1981 |1982 |1983 |1984 |1985 |<1>1989-90|<1>1990-91
--------------------------------------------------------------------------------------------------------------------------------
Northern |2,190 |2,550 |2,660 |3,180 |3,090 |4,000 |3,950 |7,686 |5,699
Yorkshire |3,230 |3,630 |3,960 |4,220 |4,230 |4,650 |5,610 |7,189 |7,928
Trent |3,710 |3,710 |4,970 |5,150 |5,790 |6,300 |7,300 |8,722 |8,490
East Anglian |1,240 |1,520 |2,060 |1,770 |1,950 |2,480 |2,700 |3,198 |2,914
North West Thames |2,740 |3,320 |3,880 |4,480 |4,840 |5,560 |6,460 |8,922 |7,378
North East Thames |3,650 |4,140 |4,950 |5,550 |5,650 |6,920 |7,090 |9,538 |8,341
South East Thames |2,690 |3,490 |4,040 |4,150 |5,080 |5,690 |5,910 |7,817 |7,053
South West Thames |2,090 |2,400 |3,140 |3,390 |3,560 |4,190 |3,890 |5,548 |5,511
Wessex |1,740 |1,350 |3,020 |2,500 |3,600 |3,050 |3,180 |4,143 |4,317
Oxford |1,780 |2,280 |2,390 |3,020 |3,240 |3,440 |3,660 |5,161 |3,691
South Western |1,960 |2,310 |2,570 |3,000 |2,950 |3,460 |3,820 |5,683 |5,455
West Midlands |3,510 |4,090 |5,080 |6,050 |6,900 |7,140 |8,320 |10,130 |10,034
Mersey |2,010 |2,610 |2,670 |3,430 |3,360 |3,730 |3,950 |4,968 |5,047
North Western |5,090 |4,900 |5,880 |6,700 |7,370 |8,300 |8,900 |10,232 |10,550
SHA's |1,020 |1,310 |1,510 |1,710 |1,500 |1,450 |1,390 |1,251 |869
England |38,650 |43,610 |52,780 |58,310 |63,100 |70,360 |76,130 |100,188 |93,277
Sources: Hospital In-Patient Enquiry (HIPE) 1979 to 1985.
Hospital Episode Statistics (HES) 1989-90 onwards.
<1>Provisional figures.
Emergency Contraception
Ms Primarolo : To ask the Secretary of State for Health what is the total annual cost to the national health service of prescriptions for emergency contraception.
Mr. Sackville : There is only one product under this category of drug. The information requested is therefore commercially confidential to the manufacturer and cannot be disclosed.
Care Orders
Ms Primarolo : To ask the Secretary of State for Health what percentage of homeless people aged under 16, 16 to 18 and 18 years or more have had care orders at some time in the past ; and what is the national average percentage of children who have care orders.
Mr. Bowis : The Department does not collect information about the whereabouts of children once they have ceased to be looked after by a local authority. The number of children subject to care orders at 31 March 1992 in England, as a percentage of the estimated total number of children aged under 18 years, was 0.33 per cent.
Ms Corston : To ask the Secretary of State for Health how many children were received into care because of homelessness in each of the 10 years preceding the implementation of the Housing (Homeless Persons) Act 1977.
Mr. Bowis : The information available centrally relates to the number of children in England taken into care on a voluntary basis because their families were made homeless. Figures for the 10 years preceding 1977 are in the table.
Children admitted to
care due to
homelessness
England 1968-77
|England
------------------------
1968 |-
1969 |-
1970 |-
1971 |2,829
1972 |2,811
1973 |2,619
1974 |2,204
1975 |1,503
1976 |1,194
1977 |946
BCG Vaccination
Ms Primarolo : To ask the Secretary of State for Health what is her Department's target for coverage of BCG vaccination ; and if she will list those district health authorities and regional health authorities not reaching those targets.
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Mr. Sackville : There is no target for coverage of BCG immunisation. The Government recommend that BCG be offered to all school children between the ages of 10 and 14 years and also to new immigrants from countries with a high prevalence of the disease ; to their newly born children ; and to certain other higher risk groups which are listed in "Immunisation against infectious disease", copies of which are available in the Library. About 75 per cent. of school children are immunised each year whilst a further 5 to 7 per cent. are already tuberculin positive and, therefore, do not require immunisation.
Ms Primarolo : To ask the Secretary of State for Health what plans she has to include the BCG vaccination in the targets for general practitioners.
Mr. Sackville : I refer the hon. Member to the reply I gave her on 5 November 1993 at column 536.
Ms Primarolo : To ask the Secretary of State for Health which districts no longer carry out routine school programmes for BCG vaccination ; how many children were vaccinated for BCG in each of the last five years ; and what percentage of children have had BCG vaccination by the target date in each of the last five years.
Mr. Sackville : We understand that 15 health authorities have discontinued the school's BCG immunisation programme but details are not available centrally.
The number of children immunised with BCG in the last five years is shown in the table :
Children given BCG vaccination by age in the years 1988-89
to 1992-93
Number of
vaccinations
(thousands)
|Total |Under 1|1-9 |10-13 |14-15
-----------------------------------------------------------
1988-89 |404.0 |31.3 |4.6 |269.1 |99.0
<1>1989-90 |194.5 |31.4 |4.6 |120.8 |37.7
1990-91 |472.5 |36.7 |5.5 |300.0 |130.3
1991-92 |453.6 |34.5 |6.7 |294.5 |117.9
1992-93 |393.6 |43.9 |4.1 |262.8 |82.8
<1>The school BCG programme was suspended in 1989 as there
were insufficient supplies of BCG vaccine.
The percentage of children which have had BCG immunisation in each of the last five years is not available.
Ms Primarolo : To ask the Secretary of State for Health what is her Department's policy on BCG immunisation of neonates ; how many district health authorities and regional health authorities are without policies in BCG immunisation of neonates ; and how many offer BCG immunisation of neonates.
Mr. Sackville : The Government's policy on the
BCG--Bacille-Calmette-Gue rin-- immunisation of neonates is as set out in the memorandum, "Immunisation against infectious disease" copies of which are available in the Library. It is recommended that all babies born to immigrants to the United Kingdom who have come from
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countries with a high prevalence of tuberculosis are immunised with BCG. Eighty per cent. of districts, including 14 of the 15 of those who have stopped the schools immunisation programme, offer BCG to neonates. Thirty-one districts do not offer BCG to neonates.Commissioning Agencies
Mr. Milburn : To ask the Secretary of State for Health if she will provide a list of commissioning agencies and the health authorities that they cover.
Dr. Mawhinney : This information is currently being collected.
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Vaccination Methods
Ms Primarolo : To ask the Secretary of State for Health what evidence she has on the extent to which pre-filling syringes to be used in vaccinations reduces anxiety in patients.
Departmental Staff
Mr. Janner : To ask the Secretary of State for Health how many, and what percentage of officers in each of grades 1 to 7 and overall in her Department are (a) women, (b) from ethnic minorities and (c) disabled, respectively.
Mr. Sackville : The information shows the position on 23 March 1994.
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Col 1 |Col 2 |Col 3 |Col 4 |Col 5 |Col 6 |Col 7 |Col 8
Grade |Total staff|Women |Per cent. |Ethnic |Per cent. |Disabled |Per cent.
|(Numbers) |Number |Minorities |people
|Number |Number
---------------------------------------------------------------------------------------------------------------------------
1 |3 |0 |0.0 |0 |0.0 |0 |0.0
2 |8 |0 |0.0 |0 |0.0 |0 |0.0
3 |25 |5 |20.0 |0 |0.0 |0 |0.0
4 |28 |11 |39.2 |0 |0.0 |2 |7.1
5 |204 |78 |38.2 |11 |5.3 |0 |0.0
6 |136 |44 |32.3 |7 |6.3 |0 |0.0
7 |575 |150 |26.0 |21 |3.7 |3 |0.5
All Grades (including 1-7) |5,110 |2,653 |51.9 |648 |13.2 |67 |1.4
Notes:
1. Cols 2-4 exclude staff on loan to other government departments, on maternity leave of more than three months, on unpaid
career/study breaks and casual staff.
2. Cols 5-8 exclude Youth Treatment Service, staff on loan, secondees into the Department and casual staff and the
percentages shown relate to the numbers of staff in this definition, rather than the definition in note 1.
3. Numbers of staff from ethnic minorities relate to those responding to the Department's ethnic origin questionnaire.
4. The figures for disabled people are for Registered Disabled People only.
Family Centres
Miss Lestor : To ask the Secretary of State for Health what plans she has to develop the network of family-based centres to help families in crisis.
Mr. Bowis : The Government fund local authorities, through the revenue support grant, to safeguard and promote the welfare of children in need by providing a range of appropriate services, including family centres.
They make their own decisions on the allocation of resources available to them. Local authorities have a duty to provide family centres as they consider appropriate, either themselves or through working jointly with other organisations including voluntary bodies. The Department has funded the family centre network for a number of years with the aim of promoting the family centre approach. It also funds other voluntary organisations which run family centres with the support of local authorities and, in some cases of health authorities.
Behavioural Difficulties
Miss Lestor : To ask the Secretary of State for Health what plans she has to establish an inter-departmental agency to co-ordinate responses to children with behavioural difficulties.
Column 888
Young People (Support)
Miss Lestor : To ask the Secretary of State for Health what plans she has to increase funding for aftercare support for young people leaving residential care.
Mr. Bowis : It is for local authorities to determine their priorities and the level of funding to be allocated from within their overall budget.
Passive Smoking
Ms Primarolo : To ask the Secretary of State for Health what are the findings of the most recent research she has commissioned on the health risks in terms of morbidity and mortality of passive smoking.
Mr. Sackville : The available evidence on the health effects of passive smoking is summarised in paragraph 2.13 of "Smoke Free For Health" which was published in February 1994. Copies of the report are available in the Library.
The Scientific Committee on Tobacco and Health will be reviewing the available research findings on this issue at the earliest opportunity.
Adoption
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the length of time a child is fostered prior to adoption.
Mr. Bowis : No definitive timescale can be given about the length of time a child might spend in foster care prior
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to adoption. A placement can be made only when all the important factors of the child's circumstances and needs have been carefully considered as well as the availability of prospective adopters to meet those needs.Nurses (Smoking)
Ms Primarolo : To ask the Secretary of State for Health what estimate she has of the percentage of nurses who smoke.
Mr. Sackville : This information is not available centrally. The Government are committed to ensuring that the whole of the health service works towards a virtually smoke-free environment for staff, patients and visitors.
Immunisation
Ms Primarolo : To ask the Secretary of State for Health what are the relative costs of delivering immunisation by prefilled syringe and by the traditional method of vial, syringe and needle.
Mr. Sackville : Some vaccines are supplied in pre-filled syringes ; the costs are matters of commercial confidence.
Vaccinations
Ms Primarolo : To ask the Secretary of State for Health what are the latest average national targets being achieved by general practitioners for measles, mumps and rubella--MMR--polio, diphtheria, tetanus and pertussis vaccinations.
Dr. Mawhinney : At 1 October 1992, 88 per cent. of general practitioners had achieved the higher target and 7 per cent. had achieved the lower target.
Drug Companies
Ms Primarolo : To ask the Secretary of State for Health what plans she has to issue further guidelines on the relationship between general practitioners and drug company representatives.
Mr. Sackville : We have no plans to issue guidelines on the relationship between general practitioners and drug
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company representatives. Advice on professional conduct is a matter for the General Medical Council Ethical committee.Care
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on children aged 16 to 18 years and young adults and after care within families.
Mr. Bowis : The Children Act provides a flexible framework of powers which enable local authorities to tailor support to the needs of the individual child leaving care.
Care Orders
Ms Primarolo : To ask the Secretary of State for Health what plans or guidelines she has for ensuring that children, subject to care orders, return to a family environment as soon as possible.
Mr. Bowis : Part III of the Children Act 1989 emphasises the duty on local authorities to provide services to support parents in bringing up children in need in their own home and to work in partnership with parents in looking after children away from home. The Children Act "Guidance and Regulations Volume 3", on family placements, contains guidance on the planned return of a child to his family after a placement with another carer under a care order. This takes into account the views of parents along with the views of the child--where he is of sufficient understanding- -so far as this is practicable and in the best interests of the child.
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