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Mr. Byers : To ask the Minister of Agriculture, Fisheries and Food on what occasions in the last 10 years he or a Minister in his Department has given a direction to civil servants to award a contract against the advice of the civil service ; what was the subject matter of the contract and its value ; and when it was awarded.
I refer my hon. Friend to the answer I gave him yesterday at columns 267- 68.
Administration of Radioactive Substances Advisory Committee ; British Pharmacopoeia Commission ;
Clinical Standards Advisory Group ;
Committee on Dental and Surgical Materials ;
Committee on the Safety of Medicines ;
Joint Committee on Vaccination and Immunisation ;
Medicines Commission ;
Standing Dental Advisory Committee ;
Standing Medical Advisory Committee ;
Standing Nursing and Midwifery Advisory Committee ;
Standing Pharmaceutical Advisory Committee ;
Unrelated Live Transplant Regulatory Authority.
Mr. Kilfoyle : To ask the Secretary of State for Health if she will list those of his Department's advisory non-departmental public bodies which the Government are required to consult before legislation proposals ; and in respect of which bodies the Government must publish their response to advice supplied by them.
Mr. Kilfoyle : To ask the Secretary of State for Health if she will list the advisory non-departmental public bodies sponsored by her Department which are required to lay their annual reports before Parliament.
Mr. Sackville : The British Pharmacopoeia Commission, the Committee on the Safety of Medicines, the Joint Planning Advisory Committee, the National Health Service Advisory Service and the Medicines Commission.
Mr. Blunkett : To ask the Secretary of State for Health what arrangements exist to publish the national management letters on the national health service, referred to in paragraph 36 of "Accounting for Independent Audit", published jointly by her and other Departments.
Dr. Lynne Jones : To ask the Secretary of State for Health (1) what plans she has to fund research into the cause, detection and treatment of obstetric cholestasis and its epidemiology ; (2) what is the current incidence of obstetric cholestasis ; (3) if she has sought evidence from abroad as to any link between still births and obstetric cholestasis ;
(4) what the Government are doing to ensure that health professionals know about obstetric cholestasis.
Mr. Sackville : 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 council is always willing to consider for support soundly based new scientific proposals in competition with other applications.
As to the incidence of obstetric cholestasis, the medical literature suggests that one pregnancy in 1,000 is affected by the condition. Some of the material on this subject has come from abroad, in particular the United States.
I refer the hon. Member to the reply I gave her on 22 June at column 198 for information for health professionals.
Mr. Bowis : Year on year changes in the number of registered drug addicts, and of registered child drug addicts in particular, should be interpreted carefully because, while changes in the figures may indicate that there are more young addicts, they may also indicate more coming forward for treatment or a higher rate of compliance with reporting arrangements.
The Government will continue to develop prevention and publicity campaigns alerting parents and young people
Column 367to the dangers of drug misuse. Guidance issued by the Department of Health in April, EL(94)11 and subsequent letter, encouraged health authorities to review the needs of drug misusers locally and ensure that the range and choice of treatment services available included provision, where appropriate, for young people. Copies of the guidance and letter are available in the Library.
Mr. Morley : To ask the Secretary of State for Health what research her Department has conducted into the health effects of prolonged low-level consumption of (a) clenbuterol and (b) other beta-agonists.
Mr. Sackville : Clenbuterol is not a licensed medicinal product in the United Kingdom and the Department has not conducted any research specifically into the health effects of its prolonged low level consumption. A large number of beta-agonists are licensed for the treatment of asthma on the basis of evidence of quality, efficacy and safety assessed by the licensing authority. A working party of the Committee of Safety of Medicines was set up in May 1991 to review information on the safety of beta-agonists in the treatment of patients with asthma. Its findings were published in the bulletin "Current Problems no. 33" in February 1992, a copy of which is available in the Library. This concluded that beta- agonists are of value in the relief of symptoms of asthma and that the overall benefits of treatment with beta-agonists outweigh the risk of any side effects.
Ms Primarolo : To ask the Secretary of State for Health if she will make a statement on the progress by January 1994 towards implementation of the United Nations convention on the rights of children ; and if she will give it a star rating.
Mr. Bowis : This information is set out in the United Kingdom's first report to the United Nations Committee on the Rights of the Child, which was published in March. Copies are available in the Library.
Mr. Cohen : To ask the Secretary of State for Health, pursuant to her answer of 28 June, Official Report, column 534, if she will list the NHS trusts and health authorities responsible for the provision of children's wards and beds in east London ; and what arrangements are made for an overall regional perspective beyond the boundary of each unit.
Dr. Mawhinney : Two health authorities, East London and the City and Redbridge and Waltham Forest, are responsible for arranging services to meet the health needs of people in East London. In-patient services for children are provided at the Royal Hospitals national health service trust, Newham Healthcare NHS trust and Forest Healthcare NHS trust in addition to the Queen Elizabeth hospital for children, Hackney.
North Thames regional health authority is responsible for holding all its health authorities to account for the provision of appropriate services for their populations.
Mr. Cohen : To ask the Secretary of State for Health what progress her Department is making on assessment of (a) consultants and (b) general practitioners ; and what are the reasons for the differences between assessment of these two groups.
Dr. Mawhinney : Consultants and general practitioners are not at present subject to assessment. Assessment needs to be linked to a formal scheme of continuing medical education. These are issues explored in a consultation paper launched at a conference on 13 June chaired by the Government's Chief Medical Officer. The consultation period ends on 30 September. Copies of the document will be placed in the Library.
Mr. Paice : To ask the Secretary of State for Health what priority is given to ex-service men and women within the national health service ; and what steps her Department takes to ensure that this is widely known throughout the national health service.
Mr. Sackville : Ex-service men and women do not normally have priority within the national health service. However, if they are war pensioners they are entitled to receive priority examination and treatment for the condition or conditions for which they receive a pension or received a gratuity. Health service guidelines (94)28 dated 16 May, which is standing guidance, reminded the national health service about this entitlement. Copies of the guidance are available in the Library.
Mrs. Roche : To ask the Secretary of State for Health what proportion of the people living in the family health service authority covering Hornsey and Wood Green are currently registered as national health service dental patients ; and what is the figure for Britain as a whole.
Dr. Mawhinney : As patients are free to register with a dentist outside the family health services authority area where they live the information requested is not available. At 30 April 1994 the proportion of the population registered with a dentist in Great Britain was 57.8 per cent.
Mr. Alan Howarth : To ask the Secretary of State for Health what role will be played by her Department in the forthcoming consultation on disability ; and if she will publish a consultation paper on countering unfair discrimination in health provision and the health service.
The national health service provides services for everybody on the basis of their clinical need. A consultation paper on this will not therefore be necessary.
Column 369percentage savings in Supplies Authority purchasing costs was assessed by its consultants as achievable as at April 1994 for the divisions for whom benchmarking comparisons were carried out ; whether such savings have been achieved across all divisions over each of the last six months ; and if she will make a statement.
Mr. Sackville : The information is not available in the form requested. For 1993-94 the National Health Service Supplies Authority was targeted to achieve purchasing cost savings of £57 million, or four per cent. of the value of all contracts negotiated in the year. The actual saving achieved was £71.65 million, broken down as follows :
5 Division/Unit |Savings |(£ million) ----------------------------------------------------- National Purchasing Unit |36.55 Central |6.31 North East |6.50 North Thames Anglia |4.27 North West |6.45 South and West |5.96 South East |5.60
Mr. Robert Ainsworth : To ask the Secretary of State for Health (1) what advice she offers fund-holding general practitioners on how to reduce the cost of hospital treatment required by their patients ; (2) to what extent she expects a fund-holding general practitioner to follow his patient's wishes with regard to the choice of hospital to which they are sent for treatment ;
(3) what advice she has given to fund-holding general practitioner's with regard to the number of hospitals they hold contracts with.
Dr. Mawhinney : General practitioner fundholders are able to purchase services on behalf of their patients and, in consultation with them, from whichever hospital offers the best quality care and value for money.
Dr. Mawhinney : Each year a Minister from the Department attends the world health assembly, the annual meeting of the World Health Organisation, at which the operations of the organisation are discussed. We also receive reports from the Chief Medical Officer on the meetings of the executive board of the World Health Organisation and the European Regional Committee meeting, and on all other major developments.
Mrs. Peacock : To ask the Secretary of State for Health how many medical negligence claims have been made against NHS hospitals and NHS trust hospitals in each of the last eight years ; what was the cost of those claims for each year, including (a) compensation legal costs and (b) fees paid to doctors for medical opinions ; and what was the average time taken from commencement of complaint to settlement.
Mr. Bowis : It if for each health authority to assess and monitor the health needs of their population including people suffering from dementia and, together with local authorities, to provide a range of appropriate services.
Mr. Bowis : Health authorities and local authorities are required to assess the health and social care needs of their population and to make appropriate arrangements to meet those needs. Such assessments will identify additional care and support services needed by those living alone.
Mr. Burden : To ask the Secretary of State for Health if she will make it her policy to collect information from district health authorities regarding their policies on the purchase of in vitro fertilisation treatment, and the number of district health authorities who currently provide IVF treatment.
Mr. Hinchliffe : To ask the Secretary of State for Health if she will make a statement on her Department's policy on the limiting by health authorities of IVF treatment to women of 34 years and under.
Mr. Sackville : Decisions about the availability of IVF treatment are for individual health authorities. Advice is available to health authorities and clinicians in two publications drawn to the attention of the National Health Service in 1992 :
(a) The Effective Health Care Bulletin on management of subfertility, published for the NHS Management Executive by a consortium of Leeds and York universities and the research unit of the Royal College of Physicians.
(b) The Royal College of Obstetricians and Gynaecologists publication "Infertility--Guidelines For Practice".
Copies of both publications are available in the Library.
(2) what analysis has been made of the implications of childlessness upon marriage stability in infertile couples ; (3) what information she has available on the effect on mental health in couples who are unable to have children of their own.
Column 371researchers, some of which are referred to in the Effective Health Care bulletin series entitled "The Management of Subfertility". The position is summarised as follows :
"There is some evidence that subfertility causes considerable emotional stress and distress in some couples, which effects many areas of their life. Subfertility may result in social handicap preventing fulfilment of social roles and realisation of personal and societal expectations for parenthood."
The bulletin was made available to the national health service in 1992. Copies are available in the Library.
Mr. Byers : To ask the Secretary of State for Health on what occasions in the last 10 years she or a Minister in her Department has given a direction to civil servants to award a contract against the advice of the civil service ; what was the subject matter of the contract and its value ; and when it was awarded.
Mr. Blunkett : To ask the Secretary of State for Health if she will list for each national health service trust in the former Yorkshire region, those chairmen and non-executive directors who live outside the boundaries of the district health authority in which that trust is situated.
Dr. Mawhinney [holding answer 5 July 1994] : A total of 133 of the 150--89 per cent.--chairmen and non-executive directors appointed to a national health service trust within the former Yorkshire region live within the boundaries of the district health authority in which that trust is situated. The names of those who live outside the relevant district health authority boundaries are listed.
Harrogate Health Care NHS Trusts
Mrs. J. Wesson
East Yorkshire Hospitals NHS Trust
Mrs. S. Smith
Royal Hull Hospitals NHS Trust
Dr. N. Varey
Grimsby Health NHS Trust
Mrs. M. Clarke
Scunthorpe and Goole Hospitals
Mrs. E. Redfearn
Mrs. L. Stone
Scunthorpe Community Health NHS Trust
Mr. B. Beaumont
Bradford Hospitals NHS Trust
Mr. R. Walker
Mr. C. Thomas
Dr. G. Alderson
Bradford Community NHS Trust
Professor M. Schofield
Huddersfield NHS Trust
Mr. J. Dyson
Calderdale Health Care NHS Trust
Dr. I. Hughes
Leeds Community and Mental Health Services Teaching
Ms S. Tate
Professor G. Wistow