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Mr. Maclean : I would refer my hon. Friend the to reply given to a question from the hon. Member for Southampton, Itchen (Mr. Denham) on 16 May 1994, Official Report, column 337.
HEALTH
Nurses and Midwives
Mr. Redmond : To ask the Secretary of State for Health if she will give details of the number of national health service nursing and midwifery staff by pay grades within the groups of (a) senior nursing and midwifery staff, (b) education staff, (c) clinical nursing and midwifery staff, (d) learner, (e) other staff ; and (f) Project 2000 nursing students, in each year since 1989 ; and if she will give the percentage change each year.
Mr. Sackville : The information available will be placed in the Library. The figures requested do not include practice nurses who contribute significantly to community nursing work. The number of practice nurses increased by 96.98 per cent. from 4,630 in 1989 to 9, 120 in 1992.
Paracetamol
Ms Primarolo : To ask the Secretary of State for Health in how many instances paracetamol has been mentioned on death records as a cause of death in each EEC country in each of the last five years.
Mr. Sackville : The available information for England and Wales is shown in the table.
Number of instances
where paracetamol
has been mentioned
on death
records as a cause
of death, England
and Wales, 1988-1992
|Number
---------------------
1988 |491
1989 |458
1990 |512
1991 |544
1992 |585
Information is not
available centrally
for European
Economic Community
countries.
Patients Charter
Ms Primarolo : To ask the Secretary of State for Health what has been the cost of the patients charter in each of the last three years.
Dr. Mawhinney : Implementation of patients charter rights and standards by the NHS has been at negligible cost ; the charter is about doing things differently and does not need extra resources to implement.
GP Trainees
Ms Primarolo : To ask the Secretary of State for Health how many doctors applied for general practitioner trainee posts in each of the last 10 years.
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Dr. Mawhinney : This information is not available centrally.
Civil Servants, London
Ms Primarolo : To ask the Secretary of State for Health how many civil servants were employed in London in each year since 1991-92.
Mr. Sackville : The information is shown in the table.
Department of Health
staff in London 1991-94
Wholetime equivalents
as at 1 April
|Numbers
------------------------
1991 |3,016
1992 |3,677
1993 |3,719
1994 |2,892
1. Numbers include
inward loans and
secondments, fixed term
appointments and Agency
staff in London.
2. Numbers exclude
outward loans and
secondments and casual
staff.
Post-mortem Reports
Ms Primarolo : To ask the Secretary of State for Health what plans she has to ensure that general practitioners and hospital doctors receive post-mortem reports on their patients.
Mr. Sackville : Post mortems may be requested for clinical purposes, if relatives' permission is obtained, or by the coroner. Guidelines issued in August 1993 by the Royal College of Pathologists drew attention to the desirability of sending post mortem reports to general practitioners and hospital consultants, but noted the particular considerations where the post mortem has been requested by the coroner. The report is his property but the Coroners Rules 1984 provide for it to be supplied to those with a proper interest. Further consideration is being given to means of facilitating access to reports.
Contraceptive Services
Ms Primarolo : To ask the Secretary of State for Health if she will give the number of patients in each year since 1983 for whom payment was due to general medical practitioners for the provision of contraceptive services.
Dr. Mawhinney : This information is not available centrally.
Family Planning Clinics
Ms Primarolo : To ask the Secretary of State for Health how many family planning clinics there were, and how many women were seen by them, in each year since 1983.
Mr. Sackville : Information on the number of family planning clinics for the years 1983-87 is as follows :
Year |Number ---------------------- 1983 |1,755 1984 |1,768 1985 |1,746 1986 |1,756 1987-88 |1,754
These statistics were not collected after 1987-88. I refer the hon. Member to the reply I gave her on 5 May, Official Report, column 627-28, for information on the number of women seen in family planning clinics.
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Child Vaccinations
Ms Primarolo : To ask the Secretary of State for Health what is the current take-up of child vaccinations ; and what assessment she has made of the factors which lead some parents not to have children vaccinated.
Mr. Sackville : The Public Health Laboratory Service's latest "Cover of Vaccination Evaluated Rapidly" figures are :
93 per cent. of children have received diphtheria, tetanus and polio immunisations ;
92 per cent. of children have received pertussis immunisation ; 92 per cent. of children have received Hib immunisation(all at 12 months) ;
92 per cent. of children have received measles, mumps and rubella immunisation (at 24 months).
The figures show that there are not many children who remain unimmunised. The Health Education Authority has commissioned research with parents of very young children to find out why immunisations were not completed. The main reasons why parents decided not to complete immunisations are :
(i) loss of commitment after first born child ;
(ii) perception that diseases are no longer serious ;
(iii) perceived difficulty over access to services ; and (
(iv) vaccine safety.
Water Quality
Ms Primarolo : To ask the Secretary of State for Health what assessment she has made of the benefits to health of a continuous high quality water supply.
Mr. Sackville : None. It is recognised that the availability of a supply of good quality drinking water is important for health and well- being.
Staff Statistics
Ms Primarolo : To ask the Secretary of State for Health how many people were employed in her Department and the NHS management executive in each year since 1989.
Mr. Sackville : The information requested is shown in the table.
Department of Health and NHS Executive 1989-94 Whole-time Equivalents as at 1 April Year |DH |NHS ---------------------------------------------------- 1989 |8,799 |666 1990 |5,388 |797 1991 |4,651 |677 1992 |4,803 |776 1993 |4,846 |931 1994 |4,690 |838 <1> Figures are included in overall Department of Health numbers. Notes: 1. Figures include inward loans and secondments, fixed term appointments and staff in Agencies. 2. Figures exclude casual staff and outward loans and secondments.
Poverty
Ms Primarolo : To ask the Secretary of State for Health what plans she has to investigate the relationship between poverty and ill health.
Mr. Sackville : "The Health of the Nation" White Paper noted that variations in health exist between different
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groups of the population and that these are associated with a wide range of factors--socio-economic, geographical, age, gender and others. The Chief Medical Officer has recently established a sub -group of his "Health of the Nation" working group to consider health variations in relation to the five key areas in the health strategy. I refer the hon. Member to the reply I gave the hon. Member for Sheffield, Brightside (Mr. Blunkett) on 12 May, Official Report, columns 217-18, which gives the terms of reference of the sub-group.GP Fundholders
Ms Primarolo : To ask the Secretary of State for Health (1) what plans she has to review the use of general practitioner fundholders' savings ;
(2) what plans she has to introduce new regulations for general practitioner fundholders.
Dr. Mawhinney : Ministers will be reviewing options for expanding and developing the fundholding scheme during the summer.
Travel and Subsistence Costs
Mr. Blunkett : To ask the Secretary of State for Health if he will list for 1993-94 the expenditure on travelling and subsistence for each (a) health authority and (b) national health service trust in England.
Dr. Mawhinney : The information is not yet available.
Mobile Telephones
Mr. Vaz : To ask the Secretary of State for Health, pursuant to his answer of 6 May, Official Report, column 664, what was the cost of calls made on mobile telephones in 1993-94 ; how much this equipment cost to buy or hire ; and what were the maintenance costs.
Mr. Sackville : The standing charges for mobile telephones in 1993- 94 was £150,000 and the cost of calls made in the year was £152, 000. All mobile telephones have been purchased over a period of several years ; the average price paid in 1993-94 was £232, including value added tax. In view of the warranties provided and long-term reliability of this equipment, the Department has not entered into any maintenance contracts.
Health Trusts
Mr. Cox : To ask the Secretary of State for Health to whom those wishing to be considered for appointment to a health trust should apply ; and if she will make a statement on the procedures to be followed.
Dr. Mawhinney : Those wishing to nominate themselves, or be nominated by others, should contact their regional health authority, which may also advertise for candidates from time to time. Regional health authorities are responsible for appraising and selecting candidates for recommendation to Ministers.
Tuberculosis
Mr. Kevin Hughes : To ask the Secretary of State for Health how many tuberculosis tracing nurses are currently employed in the national health service, listed by district ; and what has been the change in the number of such appointments in each year since 1982-83.
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Mr. Sackville : It is not possible, from the data collected centrally, to identify those nurses specifically involved with tuberculosis tracing.
Mr. Kevin Hughes : To ask the Secretary of State for Health what is the unit cost of a single BCG vaccination to her Department.
Mr. Sackville : The cost is subject to commercial confidence.
Mr. Kevin Hughes : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Bristol, South (Ms Primarolo) of 30 March, Official Report, column 890, if she will list by region those district health authorities which routinely offer BCG vaccinations to all new-born babies.
Mr. Sackville : I refer the hon. Member to the reply, I gave the hon. Member for Bristol, South (Ms Primarolo) on 29 April, Official Report, column 370.
Mr. Kevin Hughes : To ask the Secretary of State for Health (1) what advice the joint committee on vaccination and immunisation recommended in 1985 and 1990 on the continuation of the BCG schools immunisation programmes ;
(2) what written instruction she has circulated to health authorities on restarting the school BCG vaccination programme.
Mr. Sackville : Following consideration by the Joint Committee on Vaccination and Immunisation, DA(85)27 was issued on 17 December 1985 recommending continuation of the schools' BCG programme. On 21 August 1990, EL(90)166 was issued following further consideration by the Joint Committee on Vaccination and immunisation recommending continuation of the programme at least until 1995-96 when a further review would take place. Copies of both letters are available in the Library.
In addition to the above, a reminder of the importance of the BCG immunisation programme has been brought to the attention of regional health authorities through the regional review process ; regions have been asked to consider carefully whether their arrangements to protect against tuberculosis are adequate.
Mr. Kevin Hughes : To ask the Secretary of State for Health if she will list members of the departmental task force for tuberculosis ; and when the task force will submit a final report to her.
Mr. Sackville : The inter-departmental working group on tuberculosis will include officials from the Departments of Health, of Social Security, of Transport, of the Environment, the Home Department, the Department of Health and Social Security Northern Ireland Office, the Welsh Office and the Scottish Office Home and Health Department. There will also be a representative from the Public Health Laboratory Service and experts representing health care professionals.
The working group will oversee a number of sub-groups who will address the following issues :
the need for guidance on local control procedures ;
screening of immigrants and refugees ;
the impact of tuberculosis on the homeless ;
the need to review prevention and control measures in prisons ; the need to review monitoring and surveillance mechanisms. These groups will consist of officials from the interested Departments and others with expertise in the prevention
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and control of tuberculosis in each of these areas. Each sub-group will provide a paper for ministerial consideration with a final report giving key outcomes and recommendations. At this stage it is not possible to give a date for the final report.Mr. Kevin Hughes : To ask the Secretary of State for Health how many cases of respiratory and non-respiratory tuberculosis have been notified via the Home Office to her Department in each year since 1985.
Mr. Sackville : It is not part of the notification procedures for the Home Department to provide the Department of Health with data on cases of tuberculosis.
Statutory notifications of tuberculosis are made by registered medical practitioners to the proper officer of the local authority or port health district. Reports of these notifications are sent to the Registrar General at the Office of Population, Censuses and Surveys. Immigration Service officials have the power to refer for medical examination persons covered by the Immigration Act 1971 seeking to enter the United Kingdom. If any of these were found to have tuberculosis, notification would then be made to the proper officer of the relevant local authority or port health district.
The number of notifications of tuberculosis reported to the Office of Population, Censuses and Surveys for England and Wales during the years 1985-92 are shown in the table.
Notification of tuberculosis 1985-92, England and Wales
Tuberculosis (excluding chemoprophylaxis)
|Respiratory|Non- |Total
|respiratory
------------------------------------------------------------
1985 |4,660 |1,197 |5,857
1986 |4,759 |1,234 |5,993
1987 |4,010 |1,076 |5,086
1988 |4,022 |1,142 |5,164
1989 |4,146 |1,286 |5,432
1990 |3,942 |1,262 |5,204
1991 |3,950 |1,486 |5,436
1992 |4,205 |1,593 |5,798
Mr. Kevin Hughes : To ask the Secretary of State for Health what has been the specific level of research funding allocated by her Department via the Medical Research Council into the prevention and cure of tuberculosis in each year since 1979.
Mr. Sackville : The Medical Research Council is already funding a considerable amount of basic research into tuberculosis. The Department has not allocated any specific research funds via the MRC, which receives its grant in aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster, into the prevention and cure of tuberculosis since 1979.
Public Expenditure
Ms Harman : To ask the Secretary of State for Health, pursuant to the answer of 12 May, Official Report, columns 232-34, what were the principal causes of the difference between the figure for expenditure by the Department of Health of £29,950 million in 1993-94 and the equivalent figure of £30,090 million published in table 5B.3 of the "Financial Statement and Budget Report" 1994-95 ; and if she will make a statement.
Mr. Sackville : The main differences are an addition of £111 million, net, provided to meet a forecast increase in
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demand on the family health services and for hospital and community health services expenditure an underspend of £257 million. Subject to parliamentary approval of the necessary supplementary estimates, the underspends of health authorities are eligible for carry forward into 1994-95.Final outturn figures will be published in the appropriation accounts in the autumn.
Nursing Students
Mr. Blunkett : To ask the Secretary of State for Health how many nursing students took up places in each region in England in each year since 1990 ; and if she will make a statement on the likely level for 1994- 95 assuming both volume and percentage changes.
Mr. Sackville : I shall let the hon. Member have such information as is available as soon as possible.
Research Projects
Mr. Blunkett : To ask the Secretary of State for Health what was the total cost of the research projects her Department has commissioned for the past five years ; and what was the total cost of projects undertaken by staff employed by (a) universities and polytechnics, (b) independent research institutes, (c) health authorities, (d) management consultants and (e) other organisations, in each of those years.
Dr. Mawhinney : I shall let the hon. Member have such information as is available as soon as possible.
Hospital and Community Health Service Expenditure
Mr. Blunkett : To ask the Secretary of State for Health what was the level of current spending on the hospital and community health services for each national health service region and for the special health authorities, in each year since 1974-75 (a) in cash terms, (b) adjusted using the gross domestic product deflator and (c) adjusted using the national health service pay and prices index.
Mr. Sackville : This information is not held in this form and could be provided only at disproportionate cost.
Surgical Procedures (Cost)
Mr. Blunkett : To ask the Secretary of State for Health what is the average cost of national health service procedures for (a) total hip replacement, (b) total knee replacement, (c) coronary artery bypass grafting, (d) mitral/aortic valve replacement, (e) hernia repair, (f) stripping of varicose veins, (g) hysterectomy, (h) tonsillectomy, (i) cataract extraction and lens implant, (j) heart transplant, (l) heart/lung transplant and (m) surgery for an enlarged prostate.
Mr. Sackville : The information is not available. The costing systems used are currently under review to enable the methodologies used to be standardised in all hospitals.
Repairs and Maintenance
Mr. Blunkett : To ask the Secretary of State for Health what is the estimated expenditure required to clear the backlog of repairs and maintenance in each district health authority and national health service trust in England.
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Mr. Sackville : I refer the hon. Member to the reply I gave him on 1 November 1993, Official Report , column 64 , for the latest available information.
Ambulance Service
Mr. Cousins : To ask the Secretary of State for Health what guidance has been issued to ambulance service providers on the length of regular work shifts by (a) paramedic emergency services and (b) patient transport services ; when this guidance was issued ; whether it is under current review ; and if copies of such guidance can be placed in the Library.
Mr. Sackville : No such guidance has been issued.
NHS Trusts
Mr. Blunkett : To ask the Secretary of State for Health, pursuant to her answer of 16 May, Official Report, column 324, if she will show for each NHS trust by district health authority, those chairmen and non- executive directors who live outside the boundaries of the district health authority within which that trust is situated.
Dr. Mawhinney : This information could be provided only at disproportionate cost.
TRANSPORT
Traffic Generation
Mr. Dunn : To ask the Secretary of State for Transport if the Standing Advisory Committee on Trunk Road Assessment has submitted its report on traffic generation ; and what action he is planning to take.
Mr. Key : I received SACTRA's report on Wednesday 18 May. The issues covered are extremely complex, and a full response will be published in due course.
Seat Belts
Mr. Flynn : To ask the Secretary of State for Transport what assessment he has made of the benefits of the compulsory fitting of seat belts in (a) school coaches and (b) minibuses.
Mr. Key : I have now received the report of the review of the technical and cost implications of seat belt fitment in these vehicles. I hope to be able to announce the conclusions shortly.
Coach Safety
Mr. Flynn : To ask the Secretary of State for Transport what assessment he has made of the safety benefits of anti-crush zones in place of the rear seats of coaches.
Motorways
Mr. Flynn : To ask the Secretary of State for Transport what assessment he has made of the implications in terms of traffic volume of road pricing motorways for A and B roads.
Mr. Key : Research described in the Green Paper "Paying for Better Motorways" (Cm 2200) shows that
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substantial revenue could be raised at toll levels which would cause relatively little diversion to other roads. For example, charges of 1.5p per mile for cars and light goods vehicles and 4.5p per mile for other vehicles would raise some £700 million and might cause diversion of some 10 per cent. in terms of vehicle miles at peak periods. Further traffic modelling conducted since the Green Paper was published has broadly confirmed these estimates. Rising congestion on a motorway network which was not improved quickly enough would of itself cause increasing diversion to other roads. Motorway charging offers the key to accelerating expansion of inter-urban road capacity, thereby reducing the diversion which would otherwise occur.Accidents (Fatalities)
Mr. Flynn : To ask the Secretary of State for Transport how many child passengers have died in accidents involving (a) school coaches or (b) minibuses in each of the last 10 years.
Mr. Key : It is not possible to identify school coaches or minibuses in the road injury accident data collection system. However, it is possible to identify school children in coaches and minibuses, during journeys to and from school, and also in other types of journey. Both these categories are included in the table along with children of school age, classified as school pupils, but not necessarily travelling in a school minibus on a school activity. The information requested is shown in the attached table.
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