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Mr. Blunkett : To ask the Secretary of State for Health what were the total costs of her Department's research and development programme in each year from 1991-92 to 1993-94, what are the estimated costs for 1994-95 and the projected costs for each of the next five years ; and if she will show, in each case, the funds allocated to (i) the centrally-funded research programme, (ii) the national health service research and development programme, (iii) running costs in the Department of Health, (iv) running costs in the NHS executive and (v) other costs, listing all significant areas of expenditure.
Dr. Mawhinney [holding answer 15 July 1994] : Details on the Department's central research and development expenditure, including the National Health
Column 208Service executive, are collected annually in the "Forward Look of Government Funded Science, Engineering and Technology".
The total costs of the Department's research and development programme, including the NHS executive research and development programme for 1991-92 to 1993-94, as quoted in the 1994 forward look are set out below. These costs are based on the Organisation for Economic Co-operation and Development Frascati definition of research which excludes running costs. Details on the running costs of the Department's research and development division, which oversees the centrally commissioned and NHS executive R and D programmes, are given in the second column of the table. The running costs include all manpower and non-manpower expenditure.
|£ million |£ million Actual |Research cost |running costs Year |Total |Total -------------------------------------------------------------------- 1991-92<1> |27.4 |1.77 1992-93<1> |31.3 |2.27 1993-94<1><2> |33.9 |<3>2.55 The estimated costs for 1994-95 are as follows: 1994-95<1> |41.2 |2.58 <1> Forward Look of Government Funded Science, Engineering and Technology 1994, Statistical Supplement (HMSO) for details of total R and D spend. The information on running costs is drawn from the Departmental sources. <2> Estimated outturn for 1993-94. <3> Actual running costs, 1993-94.
The R and D costs of the Department of Health sponsored non-departmental public bodies are not included in the table. All future spending and running costs of these programmes, including the NHS executive R and D programme, are subject to departmental discussions and to the decisions arising out of public expenditure rounds.
A copy of the 1994 forward look is available in the Library.
Mr. Bayley : To ask the Secretary of State for Health what proportion of people resident in each family health services authority area were registered with a general practitioner in 1993-94 and in the first three months of 1994-95.
Dr. Mawhinney : The latest available information is published in the health service indicators set, a copy of which is available in the Library.
Mrs. Fyfe : To ask the Secretary of State for Health what was the total public expenditure on child care services for pre-school children under the age of five years, by sector, including all local authority provision and grants to the voluntary sector, for each year from 1989-90 to 1993-94 ; and what was the total public expenditure on these services as a percentage of the gross domestic product for England in each of these years.
Mr. Bowis : Information is not available in the form requested.
Mrs. Fyfe : To ask the Secretary of State for Health what was the average cost per annum in 1993-94 of a place in (a) a local authority day nursery, (b) a local authority family centre and (c) a local authority playgroup.
Mr. Bowis : Figures are not yet available for 1993-94.
Mr. Boyes : To ask the Secretary of State for Health how many registered child minders there are in each local authority area ; and what is the average weekly payment in each area.
Mr. Bowis : The number of registered child minders in each local authority area is published in "Children's Day Care Facilities at 31 March 1993, England", a copy of which is available in the Library. Information on payments is not recorded centrally.
Mr. Blunkett : To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Derbyshire, North-East (Mr. Barnes) of 23 June, Official Report , column 305 , what research she has undertaken into the link between growth hormone treatment, fertility treatment and Creutzfeldt-Jakob disease.
Mr. Sackville : So far, research supported by the Department has concentrated on tracing the patients treated with pituitary derived hormones and monitoring their health status. The researchers also keep in close touch with developments in other countries where these treatments were used. It is hoped that biomedical research on spongiform encephalopathies will eventually lead to the identification of the agent by which Creutzfeldt-Jakob disease is transmitted.
Mr. Blunkett : To ask the Secretary of State for Health what correspondence she has had with Dr. Bangham, former director of the National Institute for Biological Standards and Control, on the investigation into Creutzfeldt-Jakob disease undertaken in Australia.
Mr. Blunkett : To ask the Secretary of State for Health when her Department was first alerted to evidence linking Creutzfeldt-Jakob disease with growth hormone treatment and fertility treatment.
Mr. Sackville : On 11 April 1985.
Mr. Cohen : To ask the Secretary of State for Health if she will make a statement concerning the reason for the delay in publishing a code of practice or guidance in relation to the confidentiality of medical information.
Dr. Mawhinney : The handling of personal health information raises complex legal and ethical issues. When we have concluded our consideration of these, we will issue the draft guidance.
Mr. Cohen : To ask the Secretary of State for Health what consideration she has given to the view expressed in the 10 report of the Data Protection Registrar on whether
Column 210Crown copyright will be readily enforceable as a remedy to counter possible extraneous uses of the new NHS number ; and if she will make a statement.
Mr. Sackville : The Department is seeking further legal advice on the opinion expressed in the Data Protection Registrar's report.
Mr. Cox : To ask the Secretary of State for Health what was the number of written patient complaints received by her Department in 1993.
Dr. Mawhinney : The Department receives huge amounts of correspondence in the course of a year covering the full range of its responsibilities. No separate statistics are kept of written patient complaints or letters of appreciation.
Mr. Bayley : To ask the Secretary of State for Health, pursuant to her answer of 13 July, Official Report, column 605, when the information about the number of official complaints received from NHS patients by each NHS hospital or trust between January and March 1994 will be available ; and if she will provide the information for the most recent quarter for which figures are available.
Dr. Mawhinney : Statistics on written complaints are collected centrally on an annual basis. The latest data available are for the financial year 1992-93--"Written Complaints by or on behalf of Patients, England" and copies are available in the Library.
Mr. Bayley : To ask the Secretary of State for Health if she will list all the NHS major capital schemes costing£1 million or more that have been approved since 1 April 1991 ; and if in each case (a) whether the scheme is managed by an NHS trust or an NHS directly managed unit and (b) what is the parliamentary constituency in which the development took place.
Mr. Sackville : A list of all major national health service capital schemes costing £1 million or more approved since 1 April 1991 will be placed in the Library. To identify whether each scheme is managed by a NHS trust or directly managed unit, and the parliamentary constituency in which the development took place, could be done only at disproportionate cost.
The earlier schemes were usually initiated by directly managed units and nearly all schemes currently in progress are managed by trusts.
Mr. David Shaw : To ask the Secretary of State for Health if she will make a statement on the achievements of (a) her policies and (b) her Department in helping small businesses over the last 12 months as against the previous 12 months ; if she will publish the performance indicators by which her Department monitors those achievements and the statistical results of such monitoring ; and if she will set out her targets to help small businesses in the next year.
Mr. Sackville : The Government recognise the crucial role played by small firms in the United Kingdom economy. The Government help small firms by keeping
Column 211inflation and interest rates low and by reducing legislation and administrative burdens. They also provide direct assistance where appropriate and is currently establishing a network of business links to provide high-quality business support around the country. The Department of Health helps small businesses through effective and proportionate regulation which takes account of the interests of small businesses, by encouraging sensible enforcement, through deregulation and by specific support and assistance.
The Department and the national health service provide equal opportunities to all potential suppliers, of whatever size, to trade on a value for money basis. Some 75 to 80 per cent. of national health service suppliers are small businesses.
On deregulation, the removal of unnecessary burdens on small business is an important consideration in the Department's review of regulations which we aim to complete by December 1994. The Department is active in promoting exports of health care goods and services, many of which are produced by small businesses. The prompt payment of bills, especially important to small businesses, is also taken seriously. In 1993-94, this Department paid 87.1 per cent. of its bills within an agreed credit period, or within 30 days. Prompt payment of creditors is also vigorously pursued in the national health service.
As it is not practicable to monitor centrally the precise extent to which the national health service or the Department makes use of small businesses, no performance indicators are maintained.
Mr. Redmond : To ask the Secretary of State for Health what action she is taking to ensure there will continue to be adequate numbers of qualified nurses to maintain the national health service.
Mr. Sackville : Regions commission training places for non-medical staff, including nurses, based on provider unit forecasts.
Mr. Redmond : To ask the Secretary of State for Health what were (a) the design and publication costs, (b) the numbers printed, (c) the printing costs and (d) the distribution costs of the "National Health Service News" issued of 3 June.
Mr. Sackville : The information requested is as follows :
|£ --------------------------------- Design |376 Number printed |17,000 Printing costs |5,436 Distribution costs |3,809
Mr. Redmond : To ask the Secretary of State for Health what were (a) the design and publication costs, (b) the numbers printed, (c) the printing costs and (d) the distribution costs of the publication "Women Managers in the National Health Service".
Mr. Sackville : Some 5,000 copies of "Women Managers in the NHS--A Celebration of Success" were produced. The costs were :
|£ ------------------------------------------------- Design and publication costs |11,350.73 Printing costs |20,570.00
Distribution of the publication was carried out by the Department's in- house distribution unit and these costs cannot be separately identified.
Mr. Redmond : To ask the Secretary of State for Health what were (a) the numbers printed, (b) the printing costs and (c) the distribution costs of the publication, "Code of Conduct--Code of Accountability".
Mr. Sackville : The information requested for printing and distribution of "Code of Conduct--Code of Accountability" is shown in the table.
|Cost --------------------------------- Number printed |20,000 Printing costs |£7,509 Distribution costs |£1,922
Mr. Redmond : To ask the Secretary of State for Health what were (a) the design and publication costs, (b) the numbers printed, (c) the printing costs and (d) the distribution costs of the publication "Opportunity 2000 : The Challenge in General Practice".
Mr. Sackville : Some 5,000 copies of "Opportunity 2000 : The Challenge in General Practice" were produced. In addition, 500 copies of ancillary reports are expected to be produced in this financial year at no extra cost. The photographs taken for this publication will be used in other publications.
Costs are as follows :
|£ ----------------------------------------- Writing/Design/Photography |13,342 Print |5,638
Distribution of the publication was carried out by the Department's in- house distribution unit and these costs cannot be separately identified.
Mr. Bayley : To ask the Secretary of State for Health, pursuant to her answer of 21 February, Official Report, column 35-6, on family health services expenditure, if she will update the information to include figures for 1993-94 and estimates for 1994-95 ; and if she will recalculate the appropriate figures in the new table on the basis of current prices.
Mr. Sackville : The latest available information has been incorporated in the table.
Family health services net expenditure England £ million Year |<1><5>FHS |<2><5>Drugs bill|<3>Drugs bill |<4><5>Other FHS |<3>Other FHS |<5>FHSA |<3>FHSA |expenditure |expenditure |expenditure at |expenditure |expenditure at |administration |administration |1994-95 prices |1994-95 prices |expenditure |expenditure at |1994-95 prices --------------------------------------------------------------------------------------------------------------------------------------------------------- 1973-74 |522 |n/a |n/a |n/a |n/a |13 |83 1974-75 |630 |n/a |n/a |n/a |n/a |n/a |n/a 1975-76 |854 |277 |1,176 |577 |2,444 |n/a |n/a 1976-77 |993 |361 |1,348 |632 |2,361 |n/a |n/a 1977-78 |1,123 |461 |1,515 |662 |2,175 |n/a |n/a 1978-79 |1,329 |554 |1,638 |775 |2,292 |n/a |n/a 1979-80 |1,549 |633 |1,603 |916 |2,320 |n/a |n/a 1980-81 |1,923 |766 |1,641 |1,157 |2,477 |n/a |n/a 1981-82 |2,208 |876 |1,711 |1,331 |2,599 |n/a |n/a 1982-83 |2,547 |1,009 |1,838 |1,538 |2,803 |n/a |n/a 1983-84 |2,730 |1,130 |1,968 |1,600 |2,786 |n/a |n/a 1984-85 |3,010 |1,192 |1,976 |1,818 |3,014 |n/a |n/a 1985-86 |3,188 |1,275 |2,002 |1,914 |3,006 |45 |71 1986-87 |3,419 |1,378 |2,103 |2,041 |3,115 |47 |72 1987-88 |3,802 |1,536 |2,226 |2,265 |3,282 |49 |71 1988-89 |4,293 |1,744 |2,368 |2,549 |3,460 |55 |75 1989-90 |4,531 |1,942 |2,466 |2,589 |3,287 |67 |85 1990-91 |5,156 |2,080 |2,443 |3,076 |3,614 |104 |122 1991-92 |5,944 |2,317 |2,561 |3,627 |4,009 |136 |150 1992-93 |6,593 |2,641 |2,809 |3,952 |4,203 |162 |172 1993-94 |6,976 |2,951 |3,040 |4,025 |4,146 |n/a |n/a 1994-95 |7,401 |3,177 |3,177 |4,224 |4,224 |n/a |n/a <1>Net expenditure, after taking account of patient charges and other receipts, on the General Medical, General Dental, General Ophthalmic and Pharmaceutical Services. Excludes administrative costs of FHSAs and other bodies and GP Fundholders budgets for purchasing secondary care services. Information is based on the relevant year's Appropriation Account unless otherwise indicated. <2>Represents the cost of items prescribed by GPs. Dispensing fees are not included. Costs are not separately identifiable in 1973-74 and 1974-75. <3>Converted to 1994-95 prices using GDP deflator. <4>Balance of net FHS expenditure minus the cost of the drugs bill. Consists mainly of the cost of remuneration and practice expenses of FHS contractors. <5>1993-94 outturn figures are provisional; 1994-95 figures are estimates. Note: Net administrative expenditure of Family Health Services Authorities (known as Family Practitioner Committees before September 1990, and as Executive Councils before April 1974). The administrative functions of FHSAs and their precedessors have changed over time as their management responsibilities have been developed. Expenditure was not separately identifiable in the period 1974-75 to 1984-85. Excludes expenditure on national administrative bodies such as the Prescription Pricing Authority and the Dental Practice Board. Information is based on FHSA's income and expenditure accounts. 1993-94 information is not yet available on a comparable basis with previous year's figures. No forecast is available centrally for 1994-95 as FHSA administrative budgets are determined locally by Regional Health Authorities from within their overall cash limit.
Mr. Llew Smith : To ask the Secretary of State for Health what considerations underpinned her decision not to provide a Minister or civil servant to be interviewed for the BBC "Panorama" programme on the health risks of mercuric amalgam used in tooth fillings, broadcast on 11 July.
Dr. Mawhinney : The Department gave the programme makers a statement on the safety of dental amalgam.
Mr. Llew Smith : To ask the Secretary of State for Health what research has been commissioned by her Department into the potential threats posed from mercury vapours leaking from amalgam used as tooth fillings.
Mr. Blunkett : To ask the Secretary of State for Health what research her Department has undertaken into mercury contamination arising from fillings.
Dr. Mawhinney : I refer the hon. Members to the reply that I gave to my hon. Friend the Member for Gloucester (Mr. French) on 14 July, Official Report , column 702 .
Mrs. Fyfe : To ask the Secretary of State for Health what was the total public expenditure on out-of-school services for children from the age of five for each year since 1989-90 ; and what was the total public expenditure on these services as a percentage of the gross domestic product for England for each of these years.
Mr. Bowis : Information is not available centrally in this Department for all the services provided locally and nationally, directly and indirectly.
Mrs. Roche : To ask the Secretary of State for Health what recent discussions she has had with the National Association of Community Health Councils ; and what plans she has to meet representatives of the National Association of Community Health Councils in the near future.
Dr. Mawhinney : I addressed the Association of Community Health Councils for England and Wales' conference on complaints on 14 June and spoke at the association's annual general meeting both last year and on 12 July this year. I also met the chairman and director of ACHCEW on 4 July. We will continue to have regular contact with representatives of ACHCEW.
Mr. Hunter : To ask the Secretary of State for Health if she will take measures to ensure that a percentage of the special transitional grant to local authorities for community care spending is ring fenced for spending in the independent health care sector.
Mr. Bowis : We have already required local authorities to spend 85 per cent. of the social security transfer element of their special transitional grant in 1993-94 and 1994-95 on services provided by the independent sector.
Miss Lestor : To ask the Secretary of State for Health if she will issue guidance as to the age of a child to which a child minder may administer corporal punishment with parental consent.
Mr. Bowis : We have studied the recent High Court judgment. I have already met representatives of Families for Discipline and voluntary sector organisations representing day care providers and I shall shortly be meeting local authority representatives. In due course we shall consider whether any clarification of the Department's guidance is necessary.
Mr. Bayley : To ask the Secretary of State for Health, pursuant to her answer of 13 July, Official Report, column 605, when the information about the average time that patients in (a) England, (b) each English regional health authority and (c) each hospital or trust waited from the date that their general practitioner referred them to a consultant until the date of their first out-patient appointment in the period January to March 1994 will be available ; and if she will provide the information for the most recent quarter for which figures are available.
Dr. Mawhinney : I refer the hon. Member to the reply that I gave him on 13 July, Official Report, column 605.
Mr. Sims : To ask the Secretary of State for Health what steps she is taking to provide for the retraining and redeployment of nurse teachers who are displaced as a result of the proposed reduction in the number of nursing students.
Mr. Sackville : This is a matter for individual employers.
Mr. Sims : To ask the Secretary of State for Health what is the total cost of the changes in nurse education since 1989 which result from the introduction of Project 2000.
Mr. Sackville : Between 1989-90 and 1994-95, the Government have invested £431 million to introduce Project 2000 in England.
Mr. Sims : To ask the Secretary of State for Health if she will provide a breakdown of the spending on nurse education and training for the years 1990-91 to 1993-94 identifying the spending allocated to (a) pre- registration education ; (b) post-registration education and (c) nurse teacher training and support.
Mr. Sackville : Figures for the total expenditure by regional health authorities on nurse education and training for 1991-92 and 1992-93 are shown in the table. A breakdown in the requested categories was not available centrally in those years. Information for 1990-91 was not collected centrally, figures for 1993-94 are currently being collected.
£ million |1991-92|1992-93 ------------------------------------------------------------ Total Annual Expenditure by RHAs on Nurse Education and training |476.837|521.637
Mr. Sims : To ask the Secretary of State for Health what provision was made in allocations for regional health authorities for nurse education in each of the last three financial years ; how much was spent by regional health authorities in each of those years ; and how she treats funds so allocated but not spent for the purpose of nurse education.
Mr. Sackville : For 1991-92 and 1992-93, the following allocations towards the cost of pre-registration nurse education and nurse teacher training were made to the English National Board for Nursing, Midwifery and Health Visiting ; and to regional health authorities in respect of Project 2000 costs. For 1993-94, funds for
pre-registration nurse education were transferred to regional health authorities. Funds allocated to the board are returnable to the Department to the extent that they are not used for the purposes specified. Those allocated to regions may be used for other education and training purposes if the demand for pre-registration nurse education and training has been met in full.
£ million Allocations |1991-92 |1992-93 |1993-94 ---------------------------------------------------------------------------- National Board |132 |138 |10 Regional Health Authorities |62 |87 |238
Mr. Jon Owen Jones : To ask the Secretary of State for Health how many complaints have been received about alternative therapists in each of the last 10 years.
Mr. Sackville : These figures are not available centrally.
Mr. Jon Owen Jones : To ask the Secretary of State for Health (1) what plans she has to regulate alternative therapists and subject them to codes of practice ;
(2) if she will consider the regulation of psychic healers and hypnotherapists ; and if she will make a statement.
Mr. Sackville : The Department of Health has no plans to impose regulation on alternative therapists such as psychic healers and hypnotherapists. We do, however, encourage voluntary regulation schemes that have an enforceable code of practice.
Mr. Alton : To ask the Secretary of State for Health what caused the North Mersey national health service trust to close the homoeopathic ward at Mossley Hill hospital ;
Column 217for how long the ward will be closed ; what resources are provided for homoeopathy in the north-west of England ; what other homoeopathic wards exist in the region ; and if she will make a statement.
Mr. Sackville : These are matters for North Mersey community national health service trust and for North West regional health authority. The hon. Member may wish to contact Mr. R. James, chairman of North Mersey community NHS trust, and Sir Donald Wilson, chairman of North West regional health authority, for details.
Mr. Raymond S. Robertson : To ask the Secretary of State for Health if she will make a statement on progress towards establishing her Department's medical devices directorate as an executive agency.
Mr. Sackville : I am pleased to be able to announce that the medical devices directorate will be established as the Medical Devices Agency from September.
The primary purpose of the MDA is to protect the public health and safeguard the interests of patients and users by ensuring that medical devices and equipment meet appropriate standards of safety, quality and performance. The agency will be the competent authority for the United Kingdom under European Community directives for medical devices. The MDA's aim, objectives and functions are set out in a framework document, copies of which will be placed in the Library.
The chief executive has been set a number of performance targets for 1994- 95, copies of which will be placed in the Library.
Mr. Raymond S. Robertson : To ask the Secretary of State for Health what plans she has for reviewing the NHS Pensions Agency.
Mr. Sackville : The NHS Pensions Agency is responsible for the administration of the national health service pensions scheme. As part of its already announced programme of market testing, the agency was intending this year to carry out a scoping study to identify which of the agency's core functions might be suitable for market testing in some form. This study would, by its nature, have looked at most of the questions which would be addressed in the prior options exercise which forms part of the normal three-year agency review process.
In the case of the NHS Pensions Agency, the three-year review is due to be completed by the end of 1995. I have therefore decided to formalise the agency's market-testing scoping study and subsume it within the first, prior options, stage of the agency's review, which will be publicised in the usual way. This part of the review will take place in the autumn of 1994. The other elements of the full review of the agency--evaluation of its performance and revision of the framework document--will then be carried out in late-1995 to the usual timetable. This two-stage process will avoid what would otherwise have been an unnecessary duplication of effort next year. I would welcome contributions to the prior options review from those with an interest in the work of the agency. The review will have the usual terms of reference
Column 218--viz, to look again at the prior options questions for the NHS Pensions Agency by re-examining the feasibility of abolition, privatisation, sub-contracting, or market-testing, of any of the agency's functions. Comments should be sent by 30 September 1994 to :
Ms Ann Gross
NHS Pensions Review Team
80 London Road
Elephant and Castle
London SE1 6LW.