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Mr. Sackville : We understand that Sunderland district health authority has conducted formal consultation on a proposal affecting child health services in Sunderland. It is reviewing this proposal, as a result of the consultation. The proposal may be referred to the Northern and Yorkshire regional health authority and my right hon. Friend the Secretary of State for Health in due course for a final decision.
Details of the consultation and tendering process are a matter for Sunderland district health authority. The hon. Member may wish to contact Mr. George Bedell, chairman of the DHA for details.
Mr. Sackville : The disclosure of patient data outside the national health service, whether computerised or manually held and whether for a fee or not, is subject to the common law of confidentiality. Computerised data are also subject to the Data Protection Act 1984. Patient data should not be released outside the NHS without the patient's consent unless disclosure can be justified in the public interest. Data may also be disclosed if required by court order or statute.
Ms Primarolo : To ask the Secretary of State for Health what plans she has to enable patients' notes to be used in the interests of the national health service where it conflicts with interests of patients.
Mr. Sackville : We have no such plans. Patients' notes are compiled primarily for the care and treatment of the individual patient. However, the information in them may be used to help with planning and managing the national health service, and monitoring and maintaining the public health to benefit individual patients and the population as a whole. Most of these wider functions require only anonymised data, and confidentiality is strictly maintained throughout.
Ms Primarolo : To ask the Secretary of State for Health what plans she has to define the need to know in relation to access by non-clinicians to patients' notes in the national health service ; and to what parts of the patients' notes managers should have access.
Mr. Sackville : Advice on this will be included in the draft guidance on the confidentiality, use and disclosure of personal health information which we plan to issue for consultation shortly. Patient information is used only on a strict need-to-know basis within the national health service, including bodies acting on behalf of the NHS, for care and treatment and for other NHS purposes. Only that part of the information which a recipient needs to know to fulfil his responsibilities may be disclosed, and the information should be anonymised unless it is essential for the recipient to know the patient's identity.
Mr. Sackville : National Health Service bodies have been asked to encourage informal, voluntary arrangements for patients to see their records at the discretion of the health professional principally responsible for their clinical care. Under the Data Protection Act 1984 patients have a right of access to all personal information held on computer, subject to safeguards to protect themselves from
Column 308serious harm and prevent the identification of third parties. They also have the right of access to their manual health records subject to similar safeguards under the Access to Health Records Act 1990, which applies to records compiled on or after its operative date of 1 November 1991. Access to manual records compiled before that date is at the discretion of the record-holder.
Mr. Sackville : Patient information may not be disclosed to any agencies outside the national health service unless the patient consents, or unless disclosure can be justified in the public interest or is required by court order or statute.
Mr. Sackville : Communications between computers in primary care with computers in hospitals are by predetermined messages which comply with strict standards ensuring security. Such messages do not involve access by one computer to records held in another. If access of that type is proposed in future, strict security guidance will be issued to control it.
Mr. Sackville : National health service bodies and staff have a legal duty of confidence towards patients. Decisions on the use or disclosure of information in patients' notes are the responsibility of the health service body but are usually taken by, or after consultation with, the health professional principally responsible for a patient's care and treatment.
Dr. Mawhinney : Under the terms of their cost-plus contract, practice expenses, including necessary motoring expenses, incurred in the delivery of general medical services are fully reimbursed to the profession.
Column 309health service, including the movement of the national health service executive to Leeds and internal changes within the regions ; and which buildings are currently unoccupied.
Mr. Sackville : Prior to their move to Leeds, the national health service management executive staff occupied parts of 10 buildings in London. These were State house, Portland court, Richmond house, Russell square, Eileen house, Friars house, Market towers, Euston towers, Milbank tower and Hannibal house. Of those, two have been disposed of and seven remain occupied by Government Departments. Hannibal house is currently empty but is to be partly reoccupied by the Department of Health to allow another building to be disposed of. The move of the NHS management executive to Leeds is saving some £10 million a year on the cost of office space in London and on higher London salaries.
Information is not available centrally in the form requested on accommodation changes in the NHS more widely. These are a matter for the health authority or NHS trust concerned.
Mr. Sackville : The upper age limit for routine screening for cervical cancer is 64 years. Women aged 65 and over who have not had two consecutive negative smear tests in the previous 10 years should also be screened, otherwise smears are available at least every five years on request. The upper age limit for routine screening for breast cancer is 64. Women aged 65 and over may continue to be screened at least every three years on request.
Ms Primarolo : To ask the Secretary of State for Health how many women (a) were diagnosed as having and (b) died from (i) cervical cancer and (ii) breast cancer by five yearly age groups in each of the last five years ; and what is the total number of women in each of those age groups.
Mr. Sackville : Figures for the incidence of cervical and breast cancer are given in "Cancer Statistics Registrations" Series MB1 nos. 16, 18, 19, 20 and 21 (1988 the latest available) ; and for deaths in "Mortality Statistics : cause" series DH2 nos. 11-19, copies of which are available in the Library.
Mr. Hoon : To ask the Secretary of State for Health what was the total number of prescriptions issued to asthmatics in (a) 1992-93 and (b) 1993-94 ; and how many were (i) free of charge, (ii) covered by a pre- payment certificate, (iii) paid for a
straightforward commercial transaction and (iv) paid for in some other way.
Dr. Mawhinney The available information is shown in the table.
Number of prescription items for drugs used in the treatment of asthma (Bronchodilators, Corticosteroids, and Cromoglycate and related therapy<1>) dispensed by community pharmacists and appliance contractors in England in 1992 and 1993 Year |Free of charge |Charge at point of|Pre-payment |Total |dispensing |certificate ------------------------------------------------------------------------------------------------------------------ 1992 |21,088,000 |3,879,000 |2,396,000 |27,363,000 1993 |22,912,000 |3,817,000 |2,496,000 |29,225,000 Note: <1>Drugs used in the treatment of asthma are contained in the British National Formulary sections 3.1 ( Bronchodilators), 3.2 (Corticosteroids), and 3.3 (Cromoglycate and related therapy). The therapeutic classifications are based on the September 1992 issue. The drugs for Bronchodilators may be used for other conditions. Patients with asthma may also be prescribed drugs which are not specifically for the treatment of asthma.
Mr. Sackville : The information requested is shown in the table. Information for 1993-94 will not be available until the accounts of trusts are audited. The majority of trusts had technical issues which affected their ability to meet their financial duties. This does not imply any failure in financial control. In a number of cases the difference between actual financial performance and statutory target is deemed to be immaterial.
|1991-92|1992-93 ---------------------------------- London<1> |4 |9 England |18 |73 <1> Trusts located in London boroughs.
K Date 1 October |Number of |Date 1 October|Number of |unrestricted |unrestricted |principals |principals --------------------------------------------------------------------------- 1984 |536 |1989 |574 1985 |547 |1990 |579 1986 |556 |1991 |564 1987 |570 |1992 |563 1988 |574 |<1>1993 |560 <1> Average list size 1,909; England average list size 1,902.
The Medical Practices Committee has advised that since 1990 there have been a number of single-handed general practitioners leaving the medical list and because they had small list sizes their lists were dispersed. There have also been a number of GPs leaving partnerships where the partnerships have succeeded to the outgoing doctor's list but no replacement was required.
Mr. Blunkett : To ask the Secretary of State for Health what plans she has to subsidise or reimburse the cost to patients of making essential calls to general practitioners where the latter are using mobile phones in the course of their duties.
Mr. Alex Carlile : To ask the Secretary of State for Health if she plans to publish the report concerning the alleged connection between anophthalmia and the use of the pesticide Benomyl ; when this report was originally due ; and if she will make a statement.
Mr. Sackville : The Department has commissioned a comprehensive epidemiological study of cases of anophthalmia and microphthalmia from the environmental epidemiology unit at the London School of Hygiene and Tropical Medicine. This is projected to run from January 1994 until November 1995.
Mr. Bowis : We recognise the importance of child and adolescent mental health services and are currently involved in a number of initiatives aimed at promoting their development. These include research and other service-based studies and preparation of a purchasing guide for the relevant health, social services and education authorities.
Mr. Bowis : The social services inspectorate undertook a study of the prevalence and use made of these homes by local authorities in the north-west of England. "Small Unregistered Children's Homes", the report of a study by the social services inspectorate, was published in March and copies are available in the Library. Further studies will be made in due course.
Mr. Blunkett : 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, how much is spent per capita in health services for residents in Sheffield as a whole ; and what proportion is spent in treatment by (a) district health authorities and (b) family health services authorities.
|£ |Per cent. --------------------------------------------- Sheffield DHA |455 |77 Sheffield FHSA |135 |23
Dr. Reid : To ask the Secretary of State for Health what responsibilities agencies and bodies accountable to her Department are required to assume in the event of an accident or incident involving United States nuclear weapons in the United Kingdom.
Mr. Sackville : The arrangements for the response to radiation incidents are essentially the same regardless of the source of the incident. The national health service is responsible for the treatment of any casualties, for monitoring for radiation of anyone who may have been exposed to radiation and for the provision of information and advice to the public.
The National Radiological Protection Board is required to specify emergency reference levels of radiation dose for members of the public in the event of any radiation incident and will provide advice to the operational bodies in the event of an incident.
Sir Gerard Vaughan : To ask the Secretary of State for Health (1) what plans she has to commission a medical audit of the quality of treatment being received by patients of the general practitioner practices whose annual prescribing costs are 20 per cent. or below the average for practices in their family health service authority areas ;
(2) what plans she has to commission a medical audit of the quality of treatment being received by patients of the four general practitioner practices cited in the Audit Commission's recent report on rational prescribing.
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 real clinical needs of patients.
Mr. Lang : I have agreed that the new agency established to administer student awards in Scotland should be known as the Student Awards Agency for Scotland ; it commenced operations on 5 April. I am arranging for copies of the framework document to be placed in the Vote Office and in the Libraries of the House. I shall remain accountable to Parliament for the activities of the agency, but I am delegating to the chief executive full managerial authority for its day to day operation. For the future, I envisage that the agency will use its greater flexibilities to help meet increasingly demanding targets and to improve further its standards of service.
I will arrange for copies of the executive summary of the agency's corporate plan, which will detail the key performance targets I have set, to be made available shortly.
Mr. Lang : I have reviewed the Registers of Scotland at the end of its first three years as an executive agency and have concluded that agency status should continue. ROS's performance has been evaluated, and the following main conclusions reached :
Column 314despite some difficulties in 1990-91, ROS has had a successful first three years ;
substantial improvements in quality of service to customers have been achieved in line with the principles of the citizens charter ; backlogs of work have been largely eliminated ;
the extension of the Land Register is now proceeding to an agreed timetable ; and
a major information systems strategy is being successfully implemented.
the satisfactory introduction of accrual accounts for the year 1992-93 will allow consideration of ROS moving to trading fund status in the near future.
ROS's framework document has been revised and I have placed a copy in the Libraries of both Houses.
I have set ROS the following key targets for 1994-95 :
to reduce turnround times for recording writs on the Sasines register from eight to seven weeks.
to reduce turnround times for dealings on the Land Register not attached to a first registration or Transfer of part from 12 to 11.5 weeks.
to implement the agreed Land Register extension programme. to contain any increase in unit costs in real terms for each of its main categories of work to 1 per cent.
Mr. Wilson : To ask the Secretary of State for Scotland if he will list, by estate, those occasions on which birds belonging to protected species have been found (a) shot, (b) poisoned or (c) otherwise illegally killed in each of the past five years ; and if he will state the number of (i) prosecutions and (ii) convictions which have resulted.
Sir Hector Monro [holding answer 28 March 1994] : The information relates to incidents reported to the Scottish Office Agriculture and Fisheries Department's wildlife incident investigation service. The estate or other location listed is that recorded when each incident was reported. The location of a find has in itself no bearing on the responsibility for the incident.
Reports are made to the procurator fiscal where sufficient evidence is available. In respect of these cases, one prosecution in 1989, three in 1990 and one in 1993 all resulted in convictions. One case is pending.
Location |Region |Species |Cause of death ----------------------------------------------------------------------------------------------------------------------------------------------------------- 1989 Roxburghe Estate |Borders |Buzzard |Mevinphos Carbeth Estate |Central |Buzzard |Chloralose Campsie Fells |Central |Peregrine Falcon |Mevinphos Campsie Fells |Central |Buzzard |Chloralose Langholm |Dumfries and Galloway |Peregrine Falcon |Mevinphos Creochs of Balmaghig Castle Douglas |Dumfries and Galloway |Buzzard |Chloralose Lossiemouth |Grampian |Buzzard |Chloralose New Pitsligo |Grampian |Buzzard |Mevinphos Old Meldrum |Grampian |Buzzard |Chloralose Gordon Bush Est Brora |Highland |Peregrine Falcon |Chloralose Corntown |Highland |Buzzard |Chloralose Dalwhinnie |Highland |Hen Harrier |Shot Lochcarron |Highland |Eagle |Shot Golspie |Highland |Merlin |Shot Drumochter Estate |Highland |Eagle |Chloralose Black Isle |Highland |Red Kite |Chloralose Islay Estate |Strathclyde |Raven |Mevinphos Islay Estate |Strathclyde |Buzzard |Mevinphos Kilbirnie |Strathclyde |Peregrine Falcon |Shot Monzie Estate, Crieff |Tayside |Buzzard |Chloralose Fincastle |Tayside |Tawny Owl |Shot Caenlochan NR |Tayside |Eagle |Shot Blair Atholl |Tayside |Buzzard |Shot South Uist |Western Isles |Raven/Crow |Chloralose 1990 Cromlix Estate |Central |Buzzard/Hen Harrier |Chloralose Flanders Moss |Central |Buzzard |Chloralose Aberdeenshire |Grampian |Sparrowhawk |Shot Den of Pitlurg |Grampian |Buzzard |Chloralose Rosehaugh Estate, Black Isle |Highland |Buzzard |Chloralose Ledmore Estate, Lairg |Highland |Buzzard |Chloralose Edderton, Tain |Highland |Buzzard |Chloralose Ledmore Estate, Lairg |Highland |Eagle and Gull |Chloralose Alness |Highland |Buzzard |Chloralose Strathpeffer |Highland |Buzzard |Chloralose Edinburgh |Lothian |Buzzard |Chloralose Hopetoun Estate, Abington |Strathclyde |Buzzard |Chloralose Forfar |Tayside |Sparrowhawk |Shot Glenfernate Estate Enochdu, Blairgowrie |Tayside |Buzzard |Chloralose Loch Earn |Tayside |Buzzard |Chloralose Grimersta Estate, Lewis |Western Isles |Eagle chick |Chloralose 1991 Hawkhill |Fife |Buzzard |Strychnine Forres |Grampian |Buzzards/Crows |Chloralose Lybster |Highland |Buzzard |Chloralose Seafield Estate |Highland |Buzzard |Chloralose Rosehaugh Estate, Black Isle |Highland |Buzzards |Mevinphos Abington |Strathclyde |Hen harrier |Shot Sorn |Strathclyde |Buzzard/crows |Chloralose Dougarie Estate, Arran |Strathclyde |Eagle |Chloralose Glean Eason Biorach, Arran |Strathclyde |Eagle |Shot Kelburn Country Park, Renfrew |Strathclyde |Buzzard |Chloralose Blairgowrie |Tayside |Crossbills |Shot 1992 Endrickmouth NNR |Central |Buzzard |Chloralose Dalswinton Estate Auldgirth |Dumfermline and Gall |Buzzard |Chloralose Invercauld Estate Crathie |Grampian |Buzzard |Chloralose Huntly |Grampian |Sparrowhawk |Chloralose Tomatin |Highland |Eagle |Chloralose Dochfour Estate |Highland |Buzzard |Chloralose Unknown |Highland |Swan |Shot Cawdor Estate |Highland |Buzzard and magpie |Strychnine Balival Farm, Conon Bridge |Highland |Hen harrier |Strychnine Kincraig |Highland |Buzzard |Shot Careston Estate, Brechin |Tayside |Buzzard |Chloralose Over Cardney Estate, Dunkeld |Tayside |Buzzard |Chloralose Fortingall |Tayside |Buzzard |Chloralose Glenbeich and Ardveich Farms near Loch Tay |Tayside |Buzzard |Chloralose Straloch Farm, Blairgowrie |Tayside |Buzzard |Chloralose 1993 Galashiels |Border |Red Kite |Chloralose Lothian Estate, Monteviot |Border |Osprey |Shot Stracathro |Grampian |Buzzard |Chloralose Stracathro Hill |Grampian |Buzzard |Chloralose Alness |Highland |Buzzard |Difenacoum Aberarder Estate |Highland |Eagle |Carbofuran Gledfield Estate, Ardgay |Highland |Buzzard |Chloralose South Balkeith Farm, Tain |Highland |Buzzards, rook and jackdaws|Carbofuran Glenberg Estate, Grantown/Spey |Highland |Buzzard |Chloralose Ralia Estate |Highland |Buzzard |Chloralose Assich Forest Nairn |Highland |Buzzard |Chloralose Woodall Estate, Calderbank |Strathclyde |Buzzard |Chloralose Carruth Estate |Strathclyde |Buzzard |Chloralose Bougilie, Arran |Strathclyde |Eagle |Shot Mauchline |Strathclyde |Buzzard |Chloralose Farleyer Estate, Aberfeldy |Tayside |Buzzard |Carbofuran Loansfold Farm and Blindswell Farm, Perth |Tayside |Buzzard |Chloralose
Mrs. Bridget Prentice : To ask the Secretary of State for Scotland how many NHS abortions were performed on women who were under 13 weeks pregnant and resident in each health board area in Scotland in each year since 1990 ; and how many of these operations involved admission and discharge of the patient on the same day.
Under 13 weeks-Total |1990 |1991 |1992 -------------------------------------------------- Scotland |8,904|9,814|9,624 Argyll and Clyde |617 |640 |511 Ayrshire and Arran |555 |590 |625 Borders |118 |160 |146 Dumfries and Galloway |204 |214 |216 Fife |675 |708 |678 Forth Valley |427 |460 |487 Grampian |1,009|1,131|1,088 Greater Glasgow |1,486|1,689|1,778 Highland |386 |377 |376 Island Boards<1> |73 |69 |92 Lanarkshire |747 |837 |836 Lothian |1,602|1,882|1,792 Tayside |993 |1,046|981 Resident Outwith Scotland |12 |11 |18
Under 13 weeks-Admission and discharge same day |1990 |1991 |1992 -------------------------------------------------- Scotland |5,498|7,286|8,008 Argyll and Clyde |421 |488 |396 Ayrshire and Arran |372 |556 |588 Borders |91 |151 |137 Dumfries and Galloway |3 |19 |17 Fife |492 |547 |535 Forth Valley |126 |316 |419 Grampian |658 |829 |818 Greater Glasgow |571 |1,023|1,547 Highland |275 |293 |302 Island Boards<1> |12 |10 |15 Lanarkshire |139 |267 |570 Lothian |1,429|1,798|1,722 Tayside |904 |983 |926 Resident Outwith Scotland |5 |6 |16 <1> Orkney, Shetland and Western Isles Health Boards.
Mr. Galbraith : To ask the Secretary of State for Scotland what was the success rate for the Scottish ambulance service, Greater Glasgow area, in percentage terms of achieving its ORCON standards for (a) reaction to a 999 call and (b) reaching the site.
The information is as follows :
Target |Achieved 1992-93|Achieved 1993-94 |Per cent. |Per cent. ------------------------------------------------------------------------------ Activation time 95 per cent. in 3 minutes |83 |92 Response times 50 per cent. in 7 minutes |32 |38 95 per cent. in 14 minutes |80 |89
Mr. Lang [holding answer 27 April 1994] : Responsibility for the subject of the question has been delegated to the Scottish Prison Service under its chief executive, Mr. E. W. Frizzell. I have asked him to arrange for a reply to be given.
Letter from E. W. Frizzell to Mr. John McFall, dated 3 May 1994 :
The Secretary of State has asked me to reply to your Question about days work lost by prison officers, due to illness, in Scotland, in each of the last five years.
Information held centrally relates to all days covered by sick certificates and does not necessarily equate to working days lost. It also includes all prison service grades, not just prison officers. The information is as follows :
Year |Number --------------------- 1989 |80,496 1990 |73,980 1991 |75,602 1992 |80,781 1993 |97,403
Mr. Lang : There were 66 regular publications published and sold by the Scottish Office in 1993-94. All are available by subscription or standing order. There are 707 addresses on the subscription file.
Mr. Home Robertson : To ask the Secretary of State for Scotland if he will give an estimate of the total cost to his Department of all aspects of (a) the consultation paper on the structure of local government of June 1991 and subsequent consideration, (b) the White Paper of July 1993 and (c) all correspondence, meetings and briefings before and during the second reading debate and the committee stage of the Local Government etc. (Scotland) Bill.
Mr. Stewart : The total cost of the consultation paper "The Case for Change", which was published in June 1991, of the consultation paper "Shaping the New Councils", published in October 1992 and of associated material, including leaflets, a video and so on, was approximately £148,800. The cost of the White Paper "Shaping the Future--The New Councils" and related material was £58,200. It is not possible to identify or quantify administrative costs incurred by the Scottish Office which are related specifically to correspondence, meetings and briefings about the Local Government etc. (Scotland) Bill.