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Mr. Norris : The setting of air fares is essentially a matter for the commercial judgment of airlines. United Kingdom airlines had considerable freedom to compete by setting their own air fares on domestic routes for a number of years even before free pricing was introduced by the EC single market.

We believe that airlines should be free to set their own fares with a minimum of regulatory intervention. This is consistent with an open and competitive market and is in the best overall interests of users. Safeguards are, however, available under EC regulation 2409/92 to combat the exploitation of consumers by airlines charging excessively high fares.

Unlicensed Airfields

Mr. Ingram : To ask the Secretary of State for Transport how many complaints he has received in each of the last five years about alleged breaches of the regulations applying to unlicensed airfields.

Mr. Norris [holding answer 20 April 1994] : My Department does not keep a record of complaints about unlicensed airfields. This information could be obtained only at disproportionate cost.

Mr. Ingram : To ask the Secretary of State for Transport which body has the responsibility for ensuring regulatory compliance by the operators and users of unlicensed airfields.

Mr. Norris [holding answer 20 April 1994] : I refer to the answer that I gave to the hon. Member earlier today. The appropriate bodies will have responsibility for enforcement of any relevant legislation. The commander of an aircraft using an unlicensed aerodrome is responsible for his own safe operation, including satisfying himself that the aerodrome is suitable in all respects.

Mr. Ingram : To ask the Secretary of State for Transport what plans he has to change the regulations applying to unlicensed airfields.

Mr. Norris [holding answer 20 April 1994] : None.

Mr. Ingram : To ask the Secretary of State for Transport if he will give details of the regulations which apply to unlicensed airfields.

Mr. Norris [holding answer 20 April 1994] : No regulations specifically apply to unlicensed airfields. The


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CAA has published guidance material : CAP 428 "Safety Standards at Unlicensed Aerodromes". Article number 87 of the Air Navigation order "Aviation Fuel at Aerodromes" would also apply. Other legislation applies to unlicensed airfields as appropriate.

Mr. Ingram : To ask the Secretary of State for Transport if he will list all unlicensed airfields in the United Kingdom and the operators.

Mr. Norris [holding answer 20 April 1994] : There are no special registration procedures for unlicensed airfields and it is not therefore possible for me to provide a list of all such airfields and their operators.

Public Service Vehicles

Mr. Gareth Wardell : To ask the Secretary of State for Transport what information his Department now holds on the failure rates of public service vehicles at the annual roadworthiness test ; and if he will specify the level of disaggregation available to him.

Mr. Key : I have asked the Vehicle Inspectorate chief executive to write to the hon. Member with this detailed information.

Letter from Ron Oliver to Mr. Gareth Wardell, dated 4 March 1994 :

The Secretary of State for Transport has asked me to reply to your question about the information his Department holds on failure rates for public service vehicles (PSVs) at annual roadworthiness tests, and the amount of detail available to him.

The Vehicle Inspectorate (VI) is responsible for the annual testing of HGVs and PSVs. VI maintains a database detailing the test record of each vehicle it tests. At its lowest level the database can provide basic information about whether a particular vehicle has passed or failed its annual roadworthiness test and the reason for failure. This detailed information is not made available to the general public for data protection reasons.

The database also provides regular management information on first annual tests and retests at a regional, national and test station level. It can be programmed to aggregate the results in different ways at additional cost. It no longer records operator types and does not yet produce information automatically about particular PSV operators. This is because vehicle information is not cross referenced with operator details. VI is working on solutions aimed at creating a full vehicle and operator database in the medium term. In view of your interest I have enclosed a copy of VI's annual report for 1992-93. This gives details of national PSV test failure rates for the financial years 1988-89 to 1992-93, and provides a breakdown of the reasons for failure over the same period.

HEALTH

Hospital Information Support Systems

Mr. Milburn : To ask the Secretary of State for Health (1) what has been the cost of the Hospital Information Support Systems project in each year since its inception ;

(2) what level of financial support her Department intends to make available to hospitals that have become trusts to continue the development of HISS.

Mr. Sackville : Integrated hospital systems were seen as a key feature of the future information management and technology in the acute sector and, when the national health service reforms were being formulated, were seen as important for the development of contracting. As soon as the NHS reforms were announced a team was set up to run projects to explore these matters.


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Until recently the team dispersed sums to support projects of varying sizes, the amounts of which are shown in the table.


Year       |£                               

                                            

1989-90    |5,000,000                       

1990-91    |7,500,000                       

1991-92    |12,750,000                      

1992-93    |21,215,000                      

1993-94    |6,690,000                       

This phase is virtually complete and the team is involved primarily in tracking benefits realisation, disseminating results, assisting those considering a hospital information support system, supporting activities like consortia to get better value for money and vetting £1 million plus projects under the new approval process.

To complete the hospital information support system programme, a total of £1.668 million is being allocated to trusts for specific purposes in 1994-95. The further funding of HISS systems is a local responsibility.

Parliamentary Questions

Mr. McMaster : To ask the Secretary of State for Health how many parliamentary questions to her Department have not been answered because of disproportionate costs or because the information requested was not held centrally over the last five years ; how many could be answered now due to computerisation and/or more effective operational systems ; and if she will list each such question along with the name and constituency of the hon. Member who tabled it.

Mr. Sackville : The number of answers given to parliamentary questions by the Department of Health between January 1989 and December 1993, recorded on the POLIS database as including a reference to part or all of the information not being available or involving disproportionate cost was 1,223. Details of each of these questions can be obtained from the POLIS database, access to which is available in the Library. The further information requested could be provided only at disproportionate cost.

We are anxious to reduce the number of forms which currently have to be filled in by national health service units and returned to the Department. There is a limit to the amount of information required by the Department and the NHS executive on a national service which is regionally and locally administered. Release from the burden of filling in forms will give NHS units more time for activities with a greater bearing on direct patient care.

Junior Doctors

Mr. Jim Cunningham : To ask the Secretary of State for Health how many junior doctors are employed (a) by the West Midlands health authority and (b) in the Coventry area ; and what were the figures for 1991-92 and 1992-93.

Dr. Mawhinney : There were 2,029 whole-time equivalent registrars, senior house officers and house officers employed in the west midlands region in 1991 and 2,056 in 1992. In 1991,

142--estimated--were employed in the Coventry area ; in 1992 the figure had risen to 166.

There were 272 whole-time equivalent senior registrars in the west midlands region in 1991 and 277 in 1992. The number working in the Coventry area is not available.


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Figures for 1993 are not yet available.

British Pharmaceutical Industry

Mr. Sheerman : To ask the Secretary of State for Health what steps she is taking to ensure that the British pharmaceutical industry remains competitive with foreign rivals.

Dr. Mawhinney : The British pharmaceutical industry is outstandingly competitive ; it directly employs about 80,000 people in the United Kingdom and had a positive balance of trade of about £1.5 billion in 1993. This results from a wide range of factors. So far as my responsibilities are concerned, we have negotiated a new pharmaceutical price regulation scheme for a period of five years from October 1993. This provides continued stability to the pharmaceutical industry in the United Kingdom, recognises research and development through the prices paid by the national health service for its medicines and encourages the efficient and competitive development and supply of medicines to pharmaceutical markets in this and other countries.

Private Security Firms

Mr. George : To ask the Secretary of State for Health how many private security firms have been employed by her Department for each of the last 10 years ; what has been the annual value of the contracts ; and if she will estimate how many guards have been employed for each of those years.

Mr. Sackville : The Department employed four private security firms in 1993-94. The estimated total expenditure for these contracts is £700,000 and the estimated total of guards employed was 30. To provide information prior to 1993-94 would incur disproportionate cost.

Breast Cancer

Mr. Sheerman : To ask the Secretary of State for Health what steps she is taking to improve the quality of procedures for the identification and treatment of breast cancer ; and if she will make a statement.

Mr. Sackville : The chief medical officer's expert advisory group on cancer is currently preparing advice for health authorities on the organisation of cancer services. These recommendations will be put to my right hon. Friend the Secretary of State later this year.

Mr. Sheerman : To ask the Secretary of State for Health if she will establish a target of reducing levels of death from breast cancer to the OECD average.

Mr. Sackville : Reducing deaths from breast cancer among women invited for screening by at least 25 per cent. from 1990 by the year 2000 is a target in the Government's "The Health of the Nation" initiative.

Premature Mortality

Ms Corston : To ask the Secretary of State for Health if she will list the latest studies funded by her Department of causes of premature mortality related to (a) environmental pollution, (b) deprived material conditions of work and (c) other forms of material deprivation.

Mr. Sackville : The small area health statistics unit at the London School of Hygiene and Tropical Medicine is


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funded by the Department of Health, Department of Environment, Health and Safety Executive, Scottish Office, Welsh Office and Northern Ireland Office. The unit is conducting a number of studies to determine whether cancers are associated with environmental pollution associated with local sources of pollution.

These are as follows :

1. Cancer incidence and mortality around PBI Ltd., Waltham Abbey. 2. TV and Radio Transmitters : the initial local concern was around Sutton Coldfield, but there are others which are included in the study.

3. Municipal Incinerators : the study covered 72 incinerators around Great Britain, being all those licensed sites which burn household, commercial and/or industrial waste and for which the relevant information was available.

4. BP Petrochemical Works, Baglan Bay.

5. Vinyl Chloride Works.

The Department is also funding the following :

1. A research project which will examine the health effects of the December 1991 air pollution episode in London and is due to be completed later this year.

2. The Social Medicine and Health Services Research Unit which is currently undertaking two research projects, due to be completed later this year, into the incidence of asthma in the United Kingdom and the European Community.

The Department also supports the newly formed Medical Research Council Institute for Environment and Health at the University of Leicester. This will act as a focus to co-ordinate work on chemical environmental pollutants.

The Department has not funded any studies into causes of premature mortality related to conditions of work or "other forms of deprivation".

Health Expenditure, London

Mr. Congdon : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Dulwich (Ms Jowell) of 12 April, Official Report, column 72, if she will give the figures for expenditure per capita for London for (a) district health authorities and (b) family health services authorities, including expenditure by the London postgraduate hospitals and special health authorities.

Mr. Luff : To ask the Secretary of State for Health how much is spent per capita by London district health authorities and special health authorities on health services for residents of (i) inner London and (ii) outer London ; and what is the national average expenditure per capita by district health authorities.

Dr. Mawhinney : Expenditure per capita by district health authorities in inner London, at £553, is higher than that of all the other major cities included in my reply to the hon. Member for Dulwich (Ms Jowell) on 12 April at column 72, with the exception of Manchester. When special health authorities' spending is added to DHA spending, inner London per capita spend is 56 per cent. above the national average.

1992-93 per capita spend by inner and outer London district health authorities and the national average spend by DHAs in England are given in the table. The table also shows the effects of including expenditure by the London postgraduate SHAs which were funded centrally in 1992-93. The family health services authority figures given in my reply to the hon. Member for Dulwich are unchanged.


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               DHA spend               DHA spend                          

                           including SHAs                                 

              |Expenditure|Percentage |Expenditure|Percentage             

              |per capita |above      |per capita |above                  

              |£          |national   |£          |national               

                          |average                |average                

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

Inner         |553        |46         |603        |56                     

Outer         |398        |5          |415        |8                      

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

Total London  |460        |22         |490        |27                     

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

Total England |378        |-          |368        |-                      

Notes:                                                                    

1. Inner London defined as in the Report of the Enquiry into London's     

Health Services, Medical Education and Research (Tomlinson Report).       

2. SHA 1992-93 expenditure apportioned to DHAs based on analysis of       

district of residence of 1993-94 referrals.                               

Road Traffic Act 1988

Mr. Amess : To ask the Secretary of State for Health (1) if she will estimate how much money (a) her Department and (b) NHS trusts expect to recover under section 157 of the Road Traffic Act 1988 for the provisions of treatment to road accident victims for the years 1994 and 1995 ;

(2) if she will list the total amount of money recovered by (a) her Department and (b) NHS trusts under section 157 of the Road Traffic Act for the provisions of treatment to road accident victims for each year since 1991.

Mr. Sackville : Income from Road Traffic Act charges as a whole-- sections 157 and 158--was £9.1 million in 1990-91, the last year in which these data were collected centrally.

Carers

Mr. Cox : To ask the Secretary of State for Health what research has been undertaken as to the impact of the community care changes on carers ; and if she will make a statement.

Mr. Bowis : Research is currently being funded by the Department into the extent to which carers are benefiting from the community care reforms.

Youth Treatment Service

Mr. Quentin Davies : To ask the Secretary of State for Health when she will publish the annual report of the chief executive of the youth treatment service for 1992-93 ; and if she will make a statement.

Mr. Bowis : Copies of the report have been placed in the Library today. The report contains, at annex 14, the youth treatment service's receipts and payments account for the year ended 31 March 1993. These accounts, which are unaudited and have no form of endorsement by the National Audit Office, represent the service's view of the financial outcome for the year.

Drugs

Mr. Clappison : To ask the Secretary of State for Health what plans she has to examine the effectiveness of treatment services for drug misuers ; and if she will make a statement.

Dr. Mawhinney : I am concerned to ensure that services for drug misusers work to clear objectives and that we are


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able to assess how effective these services are in terms of delivering reductions in drug misuse, and the harm associated with it. I have decided therefore to establish a task force to undertake a wide-ranging review of the effectiveness of treatment services for drug misusers. Membership of the task force, which will be chaired by the Reverend Dr. John Polkinghorne, president of Queen's college, Cambridge, comprises experts from the drugs field and people from different backgrounds who will bring a fresh perspective to issues in this important area. They are :

Mr. Denis O'Connor (Deputy Chief Constable of Kent).

Dr. Michael Farrell (Consultant Psychiatrist in drug dependence at Maudsley Hospital).

Dame Margaret Fry (non-executive member of South and West Regional Health Authority).

Dr. Silvain Edouard Josse (General Practitioner).

Mr. James Kay (Director of Healthwise, Liverpool and member of the Advisory Council on the Misuse of Drugs).

Ms Rosemary Ramsay (Lawyer, and Vice Chairman of Brixton Drugs Project).

Miss Esther Rantzen (Member of the Health Education Authority). Mr. Tony Shaw (Chief Executive of Southampton and South West Hampshire Health Commission).

Mr. Tony Sheehan (Nurse).

Mr. David Taylor (Audit Commission).

Mr. Rodney Walker (Chairman of the NHS Trust Federation). The Rt. Reverend William John Westwood (Bishop of Peterborough). The chief medical officer's consultant adviser on drug misuse, Dr. John Strang, will be medical adviser to the task force.

The terms of reference of the review are :

"To conduct a comprehensive survey of clinical, operational and cost effectiveness of existing services for drug misusers ; to review current policy in relation to the principal objective of assisting drug misusers to achieve and maintain a drug-free state, and the secondary objective of reducing harm caused to themselves and others by those who continue to use drugs ; to make recommendations where appropriate and to report to Ministers."

The Advisory Council on the Misuse of Drugs will also be represented on the task force, and the central drugs co-ordination unit will take a close interest in their work.

The work of the task force will complement the role of the central drugs co -ordination unit, which has been established to ensure that, through the development of a comprehensive and co-ordinated strategy, we get best possible value for the significant resources invested by the Government in the fight against drugs. To ensure that close links are maintained, the director of the central co-ordination unit will have observer status on the task force.

Ophthalmics

Mr. Gunnell : To ask the Secretary of State for Health how many Leeds general practitioner practices were sent letters from consultant ophthalmic surgeons at the Leeds general infirmary explaining that their patients could not be admitted for elective surgery until the start of the 1994-95 financial year.

Mr. Sackville : This is a matter for the United Leeds Teaching Hospitals national health service trust. The hon. Member may wish to contact Mr. Tony Clegg, chairman of the trust, for details.


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South West Thames Health Authority

Sir Cranley Onslow : To ask the Secretary of State for Health what reports she has received from the South West Thames health authority concerning the extent to which the accident and emergency departments at (a) Ashford hospital, (b) St. Peter's hospital and (c) Frimley Park hospital met patients charter standards during the quarter ended 31 December 1993.

Mr. Sackville : The report from South West Thames regional health authority for the quarter ending 31 December 1993 on the accident and emergency standard--initial assessment in accident and emergency within five minutes--shows :


                                |Per cent.          

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

Ashford Hospital NHS Trust      |37                 

St. Peter's Hospital NHS Trust  |100                

Frimley Park Hospital NHS Trust |71                 

North West Surrey health authority was told that action must be taken to ensure improved performance.

Provisional figures for the quarter ended 31 March are as follows :


                                |Per cent.          

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

Ashford Hospital NHS Trust      |93                 

St. Peter's Hospital NHS Trust  |98                 

Frimley Park Hospital NHS Trust |90                 

Allergies

Sir Cranley Onslow : To ask the Secretary of State for Health what assessment she has made of whether adequate advice is being provided to general practitioners in England and Wales about the treatment of choice in cases of severe allergic reactions ; and what steps she is taking to ensure that the necessary equipment is readily available and easy to use.

Mr. Sackville : The next edition of the chief medical officer's update, which goes to all doctors, will include advice on the management of anaphylaxis, particularly in respect of peanuts. The British National Formulary, which is distributed twice a year free of charge to all prescribers, contains a section on anaphylaxis and the treatment available.

NHS Changes in London"

Ms Primarolo : To ask the Secretary of State for Health (1) if she will halt further distribution of the "NHS Changes in London" leaflet pending an inquiry by the Committee of Public Accounts ;

(2) which company is employed by her Department to distribute the leaflet "NHS Changes in London" ; how much they have been paid ; and when they are distributing the leaflet to each London borough ; (3) to which areas the leaflet "NHS Changes in London" has already been distributed ; and to which London areas it is not planned to distribute it.

Dr. Mawhinney : The leaflet "NHS Changes in London" was targeted at households within the area bounded by the M25 and aims to address key questions


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about health services in London which have been and continue to be put to the Department. The Central Office of Information was employed to arrange distribution of the leaflet. The estimated total cost is £150,000 of which distribution costs are estimated to be £86,500. Distribution was completed by 9 April and there are no further distribution plans.

Ms Bridget O'Connell

Mr. Blunkett : To ask the Secretary of State for Health what discussions her Department has had with North Thames health authority and the former North East Thames health authority about the case of the consultant Ms Bridget O'Connell.

Dr. Mawhinney : This is a complex case, which I hope will be resolved soon. Suspensions are a contractual matter between employer and employee and neither the Department nor Ministers are directly involved in such matters.

Out-patients

Ms Primarolo : To ask the Secretary of State for Health what is the average cost of an out-patient appointment.

Mr. Sackville : The average cost of an out-patient attendance during 1992-93 was £59.21--provisional.


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