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Climate Change Conference

Mr. Chris Smith : To ask the Prime Minister if he plans to attend the first conference of the parties to the Framework convention on climate change to be held in Berlin from 27 March to 7 April 1995 ; and what will be his targets for the conference.

The Prime Minister : No decisions have yet been taken on attendance at the conference of parties in 1995. The

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convention requires that meeting to resolve a number of issues relating to the operation of the convention and the implementation of parties' commitments. The United Kingdom will be looking for a successful resolution of those issues.

Civil Servants (Outside Appointments)

Mr. Milburn : To ask the Prime Minister how many job offers were reported by staff in his Department under the requirements of the rules on the acceptance of outside appointments in each of the last 10 years by (a) staff of

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grade 3 and above, (b) staff below grade 3, (c) staff in sections concerned with procurement or contract work, under section 15 of the rules of 1 February 1993 and (d) staff in other sections, under section 14 ; and how many of these reports were followed by an application to join the company concerned.

The Prime Minister : Information about job offers is not held centrally. For the areas covered by the Cabinet Office and Office of Public Service and Science votes, the number of applications to join companies is as follows :

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Job applications under the business appointment rules                                                                      



By Grade                                                                                                                   

Grade 3 and above                                                   |1   |1   |1   |3   |6   |3   |4   |7   |-   |1        

Below Grade 3                                                       |-   |-   |1   |-   |-   |-   |1   |-   |2   |4        

By Function                                                                                                                

People in contract/procurement sections (under section 15 of rules) |-   |-   |-   |-   |-   |-   |-   |-   |-   |3        

People in other sections (under section 14 of rules)                |1   |1   |2   |3   |6   |3   |5   |7   |2   |2        

Civil Rights (Disabled Persons) Bill

Mr. Madden : To ask the Prime Minister what considerations underlay the Government's decision not to seek to amend the Civil Rights (Disabled Persons) Bill at Committee stage ; and if he will make a statement.

The Prime Minister : Although the Government share the aim of eliminating discrimination against disabled people, we favour specific legislation. Despite concerns about the Bill's clarity, affordability and practicality, we examined it in detail, in a considered way, at Committe stage to see whether any parts of it were appropriate and acceptable. Having decided that the Bill could not be accepted, the Government subsequently announced their intention to consult within six months on proposals for action in five key areas : employment, access to goods and services, financial services, access to buildings and the establishment of a new advisory body on disability.


Mr. Austin Mitchell : To ask the Prime Minister how many letters he has received on the subject of beggars in the last three months.

The Prime Minister : I have received numerous representations.

Third-party Claims

Mr. Dalyell : To ask the Prime Minister, pursuant to his letter to the hon. Member for Linlithgow of 15 March, what success Her Majesty's Government have had in persuading eastern European countries, which are not yet members of the third-party liability regime, to join the convention system, and implement its provisions in their national law ; and what agreements have been reached with recipent states on the indemnification of western countries for third-party claims in the event of an accident at a plant that they have assisted.

The Prime Minister : Several eastern European countries, among them Lithuania, Hungary, Poland and

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Romania, already belong to the Vienna convention. The Czech Republic acceded to it in March. Estonia acceded in May.

A number of other countries in eastern Europe and the former Soviet Union have still to accede. This is a matter of concern to all those interested in helping them to improve nuclear safety. Every opportunity, both bilaterally and multilaterally, is being taken to persuade them of the importance of acceding to the Vienna convention and implementing its provisions in their national legislation. The Government of the United States have concluded interim indemnity agreements with Russia and Ukraine. These cover material provided under the United States bilateral nuclear safety assistance programmes to those two countries. As an interim measure, the European Commission is continuing to negotiate an appropriate indemnity from the Governments of Russia and Ukraine for European companies involved in the European Union nuclear safety assistance programme.


Per Capita Expenditure

Mr. Cousins : To ask the Secretary of State for Health what was the expenditure per head in cash and standard prices, for each region and nationally, on (a) hospital and community health services, (b) general practitioner services, excluding prescriptions, (c) general dental services, gross and net of charges and (d) general practitioners prescribed prescriptions for each year since 1991-92 and 1992-93.

Dr. Mawhinney : Expenditure on hospital and community health services, general practitioners' services, general dental services and general practitioner prescribed prescriptions in 1991-92 and 1992-93 will be placed in the Library.

Comparisons of per capita spend figures on hospital and community health services need to be treated with caution. First, not all the expenditure covered arises from population related activities. Secondly, crude populations do not reflect differences in age structure or relative health

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care need. These differences feature in the formulae used to inform the main allocations made to regional health authorities.

Primary Care

Ms Primarolo : To ask the Secretary of State for Health what was the expenditure per head of population on primary care by family health service authority, including fundholders' budgets, in the last available year.

Dr. Mawhinney : I refer the hon. Member to the reply I gave the hon. Member for Darlington (Mr. Milburn) on 26 May at column 305.

Administration Costs

Ms Primarolo : To ask the Secretary of State for Health what percentage of health care spending is absorbed by administration (a) in the United Kingdom and (b) in the United States of America.

Dr. Mawhinney : Comparable figures are not available. There are no internationally accepted definitions of either health spending or of spending on administration of health services.


Mr. Gareth Wardell : To ask the Secretary of State for Health what evidence she has as to a causal link between the consumption of dairy products and the incidence of diabetes in children.

Mr. Sackville : While there have been suggestions of a relationship between the onset of insulin-dependent diabetes mellitus and the early introduction of cow's milk in the diet of infants, there is as yet no firm evidence of a causal link. This possibility will be examined in a study to be mounted in the south-west of England.

Coxsackie Virus

Mr. Tom Clarke : To ask the Secretary of State for Health what was the incidence of the coxsackie virus in England in the last two years ; and in what geographical areas the problem has been identified.

Mr. Sackville : The incidence of coxsackie virus infection varies considerably between years, as in the case with many infectious diseases ; the reported incidence of coxsackie virus infection was particularly low in 1993. Estimates of the incidence of coxsackie virus infection are based on voluntary reports made to the public health laboratory service communicable disease surveillance centre by microbiology laboratories throughout England and Wales. Inter-regional variation in reported incidence reflects both true variations in incidence and variations in diagnostic and reporting practice.

Coxsackie Virus Infection, 1992-93                                

Laboratory Reports to PHLS Communicable Disease                   

Surveillance Centre                                               

Regional Health   |1992           |<1>1993                        



Northern          |78             |88                             

Yorkshire         |56             |28                             

Trent             |83             |51                             

East Anglian      |32             |12                             

North West Thames |37             |11                             

North East Thames |13             |12                             

South East Thames |28             |17                             

South West Thames |36             |10                             

Wessex            |77             |49                             

Oxford            |33             |14                             

South Western     |126            |94                             

West Midlands     |81             |21                             

Mersey            |40             |29                             

North Western     |51             |17                             

England           |771            |453                            

<1> 1993 data provisional                                         

Mr. Tom Clarke : To ask the Secretary of State for Health what research is being undertaken into the coxsackie virus in England.

Mr. Sackville : The public health laboratory service is developing new diagnostic tests for coxsackie virus infections ; these new tests should overcome many of the problems currently associated with the diagnosis of coxsackie infections.

The PHLS is also undertaking a retrospective analysis of the epidemiology of coxsackie virus infections in England and Wales over the last 20 years.

Research into dilated cardiomyopathies and persistent myopericarditis due to coxsackie viruses is being conducted by a teaching hospital in London.

There is a multicentre study of myalgic encephalomyelitis that is investigating whether there is an association between ME and, among other infections, coxsackie virus infection.

The Medical Research Council, which receives its grant in aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster, is supporting research at the university of Essex concerning the molecular analysis of receptors specifically in coxsackie virus A9.

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 list for each NHS trust in the Trent region, those chairmen and non-executive directors who live outside the boundaries of the district health authority area within which that trust is situated.

Dr. Mawhinney : I refer the hon. Member to the reply I gave him on 16 May at column 324 and to the reply I gave the hon. Member for Sherwood (Mr. Tipping) on 25 May at columns 214-15. The information for national health service trusts which lie within the boundaries of the remaining health authorities in Trent region is given. Barnsley District Health Authority--

Barnsley Community and Priority Services NHS Trust

Mr. R. Kefford

Mrs. M. Michaels

Barnsley District General Hospital NHS Trust

Mr. A. Sherriff

Mr. R. Cave

Mrs. M. Young

Doncaster District Health Authority--

Doncaster Healthcare NHS Trust

Mr. J. Lucas

Miss C. Fleming

Mrs. M. Spencer

Leicestershire District Health Authority--

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West Lindsey NHS Trust

Mr. S. Buchanan-Parker

Mr. A. Roberts

Mr. D. Weir

Fosse Health NHS Trust

Mrs. G. Parker

North Derbyshire District Health Authority--

Chesterfield & North Derbyshire Royal Hospital NHS Trust Mr. P. Lindley

Community Healthcare Services (North Derbyshire) NHS Trust Mrs. P. Spencer

Rotherham District Health Authority--

Rotherham General Hospitals NHS Trust

Mr. I. Stephen

Mr. M. Colbear

Mrs. G. Brooke

Rotherham Priority Services NHS Trust

Mr. J. Salmon

Mr. T. Palmer

Mr. J. Hyde

South Yorkshire Metropolitan Ambulance & Paramedic Service NHS Trust

Mr. J. Chambers

Mr. P. Threlfall

Mr. S. Mahon

Mrs. P. Battersby

Southern Derbyshire District Health Authority--

Community Health Services, Southern Derbyshire NHS Trust Mr. C. Marsland

Mr. B. Billings

Southern Derbyshire Mental Health Unit NHS Trust

Miss K. Johnson

Derby City General Hospital NHS Trust

Mr. N. Woods


Mr. Mullin : To ask the Secretary of State for Health (1) how much money was spent in each health region on merit awards for consultants ;

(2) how many consultants received merit awards in 1993-94 in each health region.

Dr. Mawhinney : Information on the numbers of consultants who received distinction awards in 1993-94 in each health region is shown in the table. Information on money spent by region is not available centrally.

Distinction awards-analysis by  


England at 31 December 1993     

Region            |Number       


Northern          |371          

Yorkshire         |396          

Trent             |499          

East Anglia       |251          

North West Thames |475          

North East Thames |670          

South East Thames |531          

South West Thames |357          

London SHAs       |402          

Wessex            |294          

Oxford            |300          

South Western     |325          

West Midlands     |528          

Mersey            |264          

North Western     |459          


Total             |5,893        

Note: Where a consultant works  

in more than one region he or   

she has been included in the    

total for each.                 

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GP Co-operatives

Dr. Goodson-Wickes : To ask the Secretary of State for Health if, where general medical practitioners have formed co-operatives to provide out-of-hours cover for patients and those co-operatives are being provided with financial support by their local family health service authorities, that financial support is paid to the corporate body or other organisation operating the co-operative or personally to the individual general practitioners who make up the co-operative.

Dr. Mawhinney : Reimbursements under the statement of fees and allowances are made by family health services authorities to general practitioners.

Myalgic Encephalomyelitis

Mr. Watson : To ask the Secretary of State for Health what assessment she has made as to whether the NHS Pensions Agency policy in respect of myalgic encephalomyelitis sufferers is in line with her Department's position on the likelihood of recovery from myalgic encephalomyelitis ; and what action she plans to take.

Mr. Sackville : The prognosis for any illness is a matter of clinical judgment in individual cases. The statutory requirement for the early payment of national health service pension benefits is that a person must be permanently incapable of discharging efficiently the duties of his or her employment.

Myasthenia Gravis

Mr. Gordon Prentice : To ask the Secretary of State for Health (1) what research the Government have commissioned into the causes and treatment of myasthenia gravis ;

(2) how many people in each health region have been diagnosed as suffering from myasthenia gravis :

(3) what help and advice she has given to the Myasthenia Gravis Association.

Mr. Bowis : Figures for the numbers of people diagnosed as having myasthenia gravis who have been admitted to hospital are published in volume 1 of the "Hospital Episode Statistics", copies of which are available in the Library. The main agency through which the Government support biomedical and clinical research is the Medical Research Council which receives its grant in aid from the office of my right hon. Friend the Chancellor of the Duchy of Lancaster. The MRC is always willing to consider scientifically sound proposals for research. At present, the council funds two groups specifically to investigate myasthenia gravis : one at Oxford to investigate immune mechanisms and immunotherapy in myasthenia ; the second at Newcastle upon Tyne investigates altering a T cell epitope in experimental autoimmune myasthenia gravis. The Myasthenia Gravis Association has not approached the Department for help or advice.


Dr. Marek : To ask the Secretary of State for Health what advice she is to receive regarding osteoporosis ; and when she intends to publish it.

Mr. Sackville : An expert group was set up last November to provide advice on the current state of

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knowledge and research about osteoporosis, and what further work needs to be done. We have yet to receive the group's advice, and will need to consider in the light of it any further action that is indicated.

Private Care Homes

Mr. Hardy : To ask the Secretary of State for Health if the guidance issued by her Department in 1989 in regard to the placing of national health service patients in private nursing or residential homes still stands ; and if she will make it her policy that no such patient will be placed in a home if this compels that patient to take personal responsibility for the charges made by the home.

Mr. Bowis : Where a person is assessed as requiring long-term care secured by the national health service and is placed in a private nursing or residential care home, the national health service will be responsible for meeting the full costs of care.

NHS Property and Land

Mr. Gordon Prentice : To ask the Secretary of State for Health if she will make it her policy for valuation reports on surplus national health service land and property prepared for regional health authorities by district valuers to be made available for public inspection after the sale has been concluded.

Mr. Sackville : It would be inappropriate for valuation reports to be publicly available, whether made by the district valuer or the private sector. Those reports are commercially confidential, and the release of price-sensitive information could disadvantage future land and property transactions.

Equal Opportunities

Mr. Watson : To ask the Secretary of State for Health what steps she intends to take to ensure that NHS trusts and health authorities detail in their business plans arrangements to ensure that all staff involved in recruitment and selection receive training in fair procedures and that records are kept, as set out in the Goal One instruction contained in the document, "Ethnic Minority Staff in the NHS : A Programme for Action" ; and what steps she intends to take to ensure that this requirement is drawn to the attention of general practitioners.

Dr. Mawhinney : We expect all national health service health authorities and trusts to comply with each of the relevant goals in the programme of action, and family health services authorities to ensure that general practitioners are made aware of the programme's principles of good employment practice which it contains.

Mr. Watson : To ask the Secretary of State for Health how many GPs have refused to comply with the Goal One instruction contained in the document, "Ethnic Minority Staff in the NHS : A Programme for Action".

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