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Mr. Sackville: According to figures supplied by the London ambulance service there are: 306 accident and emergency ambulances, average age of six years; and 376 patient transport service vehicles, with an average age of six years. In the current year 180 new vehicles will be delivered and put into service.

Information on average time out of service is not currently available.

Breathing Difficulties

Mr. Matthew Taylor: To ask the Secretary of State for Health how many people received hospital treatment for acute breathing difficulties during (a) March, (b) April, (c) May, (d) June, (e) July and (f) August.

Mr. Sackville: Acute breathing difficulties occur as a symptom of a wide range of medical conditions. Central returns do not include numbers of hospital admissions classified by symptom. The number of hospital admissions for asthma recorded for the months requested in 1991, the latest figures available, is shown in the table.


1

Finished consultant episodes, ordinary           

admissions and day cases, England:               

March  |April |May   |June  |July  |August       

-------------------------------------------------

6,086  |6,346 |6,791 |6,695 |6,782 |6,197        

Source                                           

Hospital Episode Statistics (estimated from 25   

per cent. sample). The figures do not include    

numbers of attendances at out-patient or         

accident and emergency facilities.               

Disabled People

Mr. John Marshall: To ask the Secretary of State for Health if she will give a breakdown of the 6.5 million disabled people between those (a) who suffer from impaired hearing, (b) who have defective sight, (c) who suffer from immobility and (d) those with other difficulties.

Mr. Bowis: The four Office of Population Censuses and Surveys surveys of disability in Great Britain, which were carried out between 1985 and 1988, found that over


Column 308

6.2 million adults and 360,000 children under 16 had at least one disability. Full details are contained in report 1: "The Prevalence of Disability among Adults", and report 3: "The Prevalence of Disability among Children", copies of which are available in the Library.

Health Care

Mr. Morgan: To ask the Secretary of State for Health if she will list those areas which have developed joint commissioning operations for the planning and purchasing of primary and secondary health care in their area; and what are the principal organisational models used.

Mr. Malone: Every district health authority and family health services authority is required to develop effective joint working arrangements for the management of the health care services within their area. It is for the statutory authorities concerned to determine the exact management arrangements to promote joint working, within the current legislation governing the composition and functions of those authorities, and guidance issued by the Department.

Blood Supply

Mr. Wareing: To ask the Secretary of State for Health what representations she has received concerning the proposals of the National Blood Authority which include the closure of Liverpool's blood transfusion unit; what her response has been; if she will as a matter of urgency study the proposals; and if she will make a statement.

Mr. Sackville: We have received representations from Members of both Houses, and from other interested parties. The National Blood Authority is undertaking a detailed consultation about its proposals. The results of the consultation will be carefully considered before decisions are made.

Community Health Services

Mr. Spearing: To ask the Secretary of State for Health what (a) communications and (b) recommendations she has received from the North Thames regional health authority concerning the future structure and organisation of community health services in the City and east London; and on what basis and on what occasions any such conclusions were reached.

Mr. Malone: My right hon. Friend the Secretary of State has received no such communication or recommendation. Prior to 1 April 1994, representations were received from North East Thames regional health authority expressing support for a combined community and primary care trust. We have yet to reach a decision.

Mr. Tom Pindar

Mr. Blunkett: To ask the Secretary of State for Health what discussions she or her Department has had with Mr. Tom Pindar, chairman of the Scarborough and North East Yorkshire Health Care NHS Trust, following his remarks in the course of a mental health review meeting in January; and what plans she has to seek his resignation.

Mr. Sackville: Discussions have taken place between Mr. Pindar and the chairman of Northern and Yorkshire regional health authority. I understand that Mr Pindar has apologised unreservedly for his remarks and this has been accepted by all parties. I am satisfied that he should


Column 309

continue as chairman of the Scarborough and East Yorkshire Health Care National Health Service Trust.

Prescriptions

Mr. Morgan: To ask the Secretary of State for Health if she will list those regions, areas and general practitioner practices which are participating in an incentive prescribing scheme; when the schemes started; for how long they are intended to run; and what arrangements she is making to set up an independent review of the results.

Mr. Malone: Prescribing incentive schemes were introduced on a pilot basis for non-fundholding general


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practitioner practices in 11 of the former 14 regions during 1993 94. Around 2,000 practices participated in nationally approved schemes. The regions and family health services authorities which participated in these schemes are shown in the table. There were also a number of locally approved schemes about which information is not available centrally.

The schemes are subject to annual review. Those for 1993 94 were effective in encouraging cost-effective prescribing and further nationally approved schemes are running this year in all new regions. Figures are not yet available centrally on the numbers of practices participating in this year's schemes.


List of FHSAs Participating in the 1993-94 Nationally Approved Practice based Prescribing Incentive Scheme                                                                                            

Northern                         |Yorkshire                       |Trent                           |East Anglia                     |North East Thames                                                

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Cleveland                        |Humberside                      |Lincolnshire                    |Cambridgeshire                  |Essex                                                            

Cumbria                          |North Yorkshire                 |Doncaster                       |Norfolk                         |Camden and Islington                                             

Durham                           |Bradford                        |Sheffield                       |Suffolk                         |Enfield and Haringey                                             

Gateshead                        |Calderdale                                                                                        |Barking and Havering                                             

South Tyneside                   |Kirklees                                                                                          |City and East London                                             

Sunderland                       |Leeds                                                                                             |Redbridge and Waltham Forest                                     

Newcastle                        |Wakefield                                                                                                                                                           

North Tyneside                                                                                                                                                                                        

Northumberland                                                                                                                                                                                        


Column 309


List of FHSAs participating in the 1993-94 nationally approved practice based prescribing incentive    

scheme                                                                                                 

Oxford            |South Western   |West Midlands   |Mersey          |North Western                    

-------------------------------------------------------------------------------------------------------

Berkshire         |Avon            |Coventry        |Cheshire        |Lancashire                       

Buckinghamshire   |Cornwall        |Solihull        |Liverpool       |Bolton                           

Northamptonshire  |Devon           |Staffordshire   |Sefton          |Bury                             

Oxfordshire       |Gloucestershire |Walsall         |St. Helens      |Manchester                       

                  |Somerset                         |Wirral          |Oldham                           

                                                                     |Rochdale                         

                                                                     |Salford                          

                                                                     |Stockport                        

                                                                     |Tameside                         

                                                                     |Trafford                         

                                                                     |Wigan                            


Column 309

WALES

Parliamentary Questions

Mr. Hanson: To ask the Secretary of State for Wales how many times during the 1993 94 session information requested in parliamentary questions has been refused on the grounds of commercial confidentiality.

Mr. Redwood: Information requested has been refused 11 times on the grounds of commercial confidentiality during the 1993 94 Session.

Morriston Open Heart Surgery Unit

Mr. Morgan: To ask the Secretary of State for Wales what arrangements he has made for the management and ownership of the Morriston open heart surgery unit at the completion of the first five-year period, in the event of contractors being appointed for the second five year


Column 310

contract different from the owners of the facility for the duration of the first five years.

Mr. Redwood: Arrangements for the operation of the new unit following the first five years will be a matter for the Morriston Hospital NHS Trust and the commissioners of the service in negotiation with the successful contractor, whether public or private. The services provided by the unit will be free at the point of delivery to NHS patients as it will remain an NHS-controlled facility meeting NHS needs whoever is the manager.

Medical Genetic Services

Mr. Morgan: To ask the Secretary of State for Wales what consultations he has had with purchasing health authorities in Wales with respect to the funding of a consortium to purchase medical genetic services.

Mr. Redwood: None. Advice on contracting mechanisms, including consortium purchasing, for specialised services was set out in Welsh Office circular


Column 311

DGM(94)65. These are matters for health authorities and providers to decide.

Hospital Services

Mr. Morgan: To ask the Secretary of State for Wales if he will list those hospital services classified as regional services which he proposes to de-designate from 1 April 1995; what representations he has had from the chairmen of Welsh health authorities concerning the de-designation of these services; and if he will publish his assessment of the effect of de- designation subregionally; and if he will make a statement.

Mr. Redwood: The following protected former regional services are to be de-designated from 1 April 1995:

Bone Marrow Transplantation Service

Medical Genetics Service

Pharmaceutical Service:

Drugs Information Service

Pharmaceutical Quality Assurance Service

Surgical Dressings Quality Control Service

Poisons Information Service

Renal Transplantation Service

Spinal Injuries Rehabilitation Service

Transplant Tissue Typing Service

Welsh Hearing Institute

It is open to any service provider or commissioner to argue against de- designation until April 1996. No such representations have been received to date from health authorities in Wales.

Health Authorities and Trusts

Mr. Morgan: To ask the Secretary of State for Wales what consultations he has had with the chairmen of the Welsh health authorities and trusts in relation to expenditure by trusts and units within the national health service in Wales on public relations consultants; under which powers such expenditure is approved by his Department; and if he will make a statement.

Mr. Redwood: None. Health authorities and trusts have discretion to make their own judgments within delegated powers. I do not myself favour expenditure on such consultancy.

Abattoirs

Mr. Morley: To ask the Secretary of State for Wales if he will make a statement on the prevalence and use of mobile abattoirs.

Mr. Redwood: At present there are no mobile abattoirs in use in Wales. All abattoirs, including mobile abattoirs, need to meet the structural and hygiene standards set out in regulations and require licensing by the appropriate Agriculture Department.

General Practitioners Training

Mr. Morgan: To ask the Secretary of State for Wales what representations he has received concerning the funding of flexible training for qualification as general practitioners; how many places are currently funded by the grants from his Department; how many people are on the waiting list who have already completed their pre-registration year; how many women returners have entered their names on to the waiting list; what proposals


Column 312

he has to increase funding for the training; and if he will make a statement.

Mr. Redwood: The Welsh Office has received one representation. The only scheme for training in general practice is the vocational training scheme, within which there is scope for trainees to work part-time. No figures are held centrally on the numbers undertaking vocational training for general practice whether on a full or part-time basis. There is no central waiting list. The general practice component of the vocational training scheme for full-time and part-time trainees is funded from the non cash-limited general medical services budget and paid by the family health services authority. Expenditure on trainee practitioner salaries in 1993 94 was in the order of £3.4 million.

Part-time hospital training posts are funded from the postgraduate dean's flexible training scheme budget, which funds all part-time junior grade hospital doctors' posts. The current annual budget is £235,000 which supports 14 posts.

At present there are no vocational training scheme trainees undertaking part-time hospital training. There are 13 women doctors waiting for placements under the flexible training scheme, three of whom are GP vocational trainees.

I will be considering the extension of this scheme in the context of this year's public expenditure review.

Neighbourhood Hospital

Mr. Morgan: To ask the Secretary of State for Wales what consultations he has had with the chairman of the South Glamorgan health authority in relation to the planning and consultation exercise for a neighbourhood hospital on the site of St. David's hospital, Cowbridge Road, East Cardiff; on what date the approval in principle letter was sent to the health authority; on what date the detailed application has been requested from the authority; and on what date he expects the start of construction.

Mr. Redwood: These are matters for the South Glamorgan health authority. My Department advised the authority on a draft proposal for a local hospital on the site on 14 February 1994. No formal application has been submitted.

Mr. Morgan: To ask the Secretary of State for Wales what consultations he has had with the west Wales cardiac care purchasing consortium in relation to the tendering procedure for the open heart surgery unit to be opened at Morriston hospital; what arrangements he has made for the treatment of non-standard open heart surgery cases; what departmental representation there is on the purchasing consortium; and what guarantees have been given regarding the overall activity at the centre in the initial two years.

Mr. Redwood: The South Wales Consortium is represented on the project board managing the competitive tendering process. The board's report and recommendations will be submitted shortly. The purchasing consortium has been operating successfully since 1993 and will work with the Morriston unit to determine overall activity. The unit will treat emergency and elective cases in line with the service specification.


Column 313

Cardiff East Sewage Works

Mr. Morgan: To ask the Secretary of State for Wales on what date he received the application for a derogation from the 2000 deadline under the European municipal waste water treatment directive for the completion of the Cardiff East sewage treatment works; what consultations he had with the chairman of the Wales area of the National Rivers Authority about it; and on what date he approved the derogation order.

Mr. Redwood: The Government made clear in "Paying For Quality" that they intended to take advantage of opportunities for derogations which EC directives accord to member states. Dwr Cymru Cyf has been in discussion with my officials about the possibility of a derogation under article 8.1 of the urban waste water treatment directive to extend the period during which the Cardiff East scheme is to be completed, but no application has as yet been made to the Commission.

Consultants (Merit Awards)

Mr. Morgan: To ask the Secretary of State for Wales if he will list the numbers of consultants with merit awards for each of the three categories of award, employed by each Welsh health authority or trust at the latest conveniently available date.

Mr. Redwood: The numbers of consultants with merit awards for each Welsh health authority are as follows:


                  Category of award                                                                   

                                                                                                      

Health authority |A+              |A               |B               |C                                

------------------------------------------------------------------------------------------------------

Clwyd                             |2               |10              |20                               

East Dyfed                                         |4               |10                               

Gwent            |1               |3               |5               |24                               

Gwynedd                           |1               |4               |17                               

Mid Glamorgan                     |1               |7               |23                               

Pembrokeshire                                                       |4                                

Powys                             |1               |1               |6                                

South Glamorgan  |11              |24              |47              |57                               

West Glamorgan                    |1               |13              |29                               

Mr. Morgan: To ask the Secretary of State for Wales what are the names of the members of the Merit Awards Assessment Committee for Wales; on what date they each commenced their period of service on the committee; and for how long a period.

Mr. Redwood: The membership of both the C awards committee and the higher awards committee together with their term of appointment are as follows:


`C' Regional Awards Committee                      

                                     Term of       

                                     Appointment   

Name                                |From|To       

---------------------------------------------------

Mr. P. R. Gregory                                  

Dr. Patricia Steane FRCA            |1992|1994     

D. Harding Jones Esq. FRCS          |1992|1994     

R. T. Maxwell Esq. FRCP             |1992|1994     

Dr. Molly Hall FRCP                 |1992|1994     

Professor W. I. Fraser FRCPsych DPM |1992|1994     

C. W. Rouse Esq. FDSRCS             |1992|1994     

Dr. G. J. Arthurs FRCA              |1993|1995     

Dr. J. N. Horton FRCA               |1993|1995     

Mr. W. I. Jones FRCS                |1993|1995     

Mr. J. P. Williams FRCOG            |1993|1995     

Dr. M. Adams FRCOG FRCR             |1993|1995     

Dr. C. P. Williams MRCPath          |1993|1995     

Dr. D. J. C. Davies FFCM            |1993|1995     

Dr. G. Hughes FRCP                  |1993|1995     

Mr. R. F. Rintoul FRCS              |1993|1995     

Dr. J. E. Cawdery FRCP              |1994|1997     

Dr. J. Gough FRCPath                |1994|1997     

Dr. Gareth H. Jones FRCPsych        |1994|1997     

Dr. M. S. T. Ruttley FRCR           |1994|1997     

Mr. J. W. R. Hombal FRCS            |1994|1997     

Dr. G. Melville Jones FRCPath       |1994|1997     

Dr. John H. Williams FRCR           |1994|1997     

Dr. B. Ll. Griffiths FRCP           |1994|1997     

Dr. Neil S. Davies FRCPsych         |1994|1997     

Mr. C. J. Davies                    |1994|1997     

Dr. Deidre Hine FFCM DPH                           

Mr. K. Thomson                      |1994|1997     

Mr. A. J. Beddow                    |1993|1994     

Mr. R. Hudson                       |1993|1995     

Mr. E. M. W. Griffith CBE           |1993|1996     


Higher Awards Committee                                                                           

                                      |Term of Appointment                                        

Name                                  |From               |To                                     

--------------------------------------------------------------------------------------------------

Professor G. M. Roberts FRCR DMRD     |1992               |1994                                   

H. Bevan-Jones Esq FRCPsych DPM       |1991               |1993                                   

D. D. R. Williams Esq MD MRCPsych DPM |1991               |1993                                   

D. Seel Esq FDSRCS D'ORTH             |1991               |1993                                   

J. F. Pearson Esq FRCOG               |1991               |1993                                   

Professor G. H. Elder FRCPath         |1992               |1994                                   

Professor G. Crompton                 |1992               |1994                                   

Professor J. Rhodes FRCP              |1992               |1994                                   

Dr. A. E. Edwards FRCA                |1993               |1995                                   

Mr. K. H. Cromplin FRCS               |1993               |1995                                   

Dr. D. M. Wayte FRCPath               |1993               |1995                                   

Mr. M. H. Wheeler FRCS                |1993               |1995                                   

Dr. R. S. Vaughan FRCA                |1993               |1995                                   

Dr. Patricia Steane                   |1993               |1995                                   

Health Care

Mr. Morgan: To ask the Secretary of State for Wales if he will list those areas of Wales which have developed joint commissioning operations for the planning and purchasing of primary and secondary health care in their area; and if he will list the principal organisational models used.

Mr. Redwood: Every health authority and family health services authority is required to develop effective joint working arrangements for the management of the health care services within their area. It is for the statutory authorities concerned to determine the exact management arrangements to promote joint working, within the current legislation governing the composition and functions of those authorities, and guidance issued centrally.

At present all authorities in Wales apart from Clwyd and Powys have formal joint commissioning arrangements. Details of the arrangements in each area are available from the authorities concerned.


Column 315

National Health Service Trusts

Mr. Morgan: To ask the Secretary of State for Wales if he will list the total cost of preparing each NHS trust's application in each of the financial years since the passing of the National Health Service and Community Care Act 1990.

Mr. Redwood: This information is not held centrally.

Welsh Development Agency

Mr. Morgan: To ask the Secretary of State for Wales what are the terms of reference and reporting chain of command of (a) the Welsh Office departmental member seconded to the Grant Thornton inquiry team set up pursuant to his statement to the House of 7 July, Official Report, columns 463-67, and (b) the Grant Thornton members of that team; and if he will make a statement.

Mr. Redwood: The Welsh Office secondee works direct to Mr. Geraint Davies, partner at Grant Thornton, and has no terms of reference and no remit distinct from those of the inquiry in which she is assisting. The arrangements for the inquiry are a matter for the agency.

Mr. Morgan: To ask the Secretary of State for Wales what requests his legal department has received from the Grant Thornton inquiry team set up, pursuant to his statement to the House of 7 July, in relation to the status and structure of the Welsh Development Agency's joint ventures in urban regeneration with local authorities as (a) boards with executive powers and (b) consultative forums.

Mr. Redwood: None.

Prescribing

Mr. Morgan: To ask the Secretary of State for Wales if he will list those family health services authorities where computerised recording of average proportions of generic and non-generic prescribing for each practice is carried out.

Mr. Redwood: Levels of generic prescribing are recorded for each practice by the prescription pricing services division of the Welsh Health Common Services Authority. This information is made available to every family health services authority in Wales.

Wales Energy Project

Mr. Morgan: To ask the Secretary of State for Wales what consultations he has had with the chairman of the Welsh Development Agency in relation to the follow-up action appropriate for the Wales Energy Project completed in March 1993.

Mr. Redwood: None.

Child Care

Mr. Morgan: To ask the Secretary of State for Wales what funding has been allocated to each training and enterprise council in Wales from the out-of-school child care network; how much has been committed already; and if he will list the projects to which funds have already been committed.

Mr. Redwood: The budget for 1994 95 for the out-of-school child care grant initiative in Wales has been allocated to training and enterprise councils as follows:


Column 316


                                   

-----------------------------------

Gwent            |£135,054         

Mid Glamorgan    |£135,054         

South Glamorgan  |£135,054         

West Wales       |£133,395         

Powys            |£ 93,350         

North West Wales |£ 84,150         

North East Wales |£ 84,150         

TECs have committed funding to the following projects beginning in 1994-95:

Gwent

Magor and Undy After School Club

Monmouth Holiday Club

Northern Telecom Holiday Club

Mid Glamorgan

Hendredenny After School Club

Creigau After School Club

Bridgend College

Menter Taf Elai (Rhydyfelin)

Menter Taf Elai (Llanhari)

Bridgend & District NHS Trust

Ogmore Valley Childcare Club

South Glamorgan

Allensbank Primary School

South Glamorgan Community Education Services

Penarth Community Education Service (Before-school)

Penarth Community Education Service (After-school)

Barry Holiday Playcare Scheme

Llanrumney East End Kids Club

Whitchurch "Out of School" Association

West Wales

The Kid Care Club

Llangumor School

St. Pauls

Melthrinfa Mair - Aberystwyth

Powys

School's Out - Talgarth

Maldwyn Nursery and Family Centre - Newtown

Kool for Kids - Llanidloes

N W Wales

Beach Play Club - Barmouth

Kidz Klub - Colwyn Bay

Bangor University Students Union

N E Wales

Hawarden Infants

Clych Meithrin

Lilliput Denbigh

Clwyd County Council

The total committed to these projects and other supporting development work as at 18 October 1994 is £592,490. The balance provides cover for other projects which will begin during the remainder of the financial year.


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