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Mental Health Budget

Ms Primarolo: To ask the Secretary of State for Health what is the current mental health budget (a) per head of population and (b) in total (i) in each region and (ii) for the London implementation zone.

Mr. Bowis: Decisions about spending on hospital and community health services for mentally ill people are taken locally by district health authorities and general practitioner fundholders based on their assessment of the needs of mentally ill people living in the district or on the practice's list. Information on this expenditure is not available centrally. It is not possible to identify separately the element of family health services expenditure which relates to mentally ill people.

General Practitioner Fundholders

Ms Primarolo: To ask the Secretary of State for Health what conditions are attached to general practitioner fundholder savings used to improve or build surgeries owned by the general practitioners.

Mr. Malone: Fundholding general practitioners' savings are to be used for the benefit of patients of the practice. In approving proposals for the use of savings, family health services authorities are expected to consider carefully any plans to extend surgery premises for the benefit of patients.

Ms Primarolo: To ask the Secretary of State for Health whether general practitioner fundholders can use their savings to employ a general practitioner assistant.

Mr. Malone: A medical practitioner may be employed from fundholder savings only to provide approved fundholding procedures and may not be employed to provide general medical services.

Asthma

Ms Primarolo: To ask the Secretary of State for Health how many children (a) had asthma and (b) were admitted to hospital with asthma in each of the last 15 years.

Mr. Sackville: It is estimated that between 4 and 6 per cent. of children suffer from asthma sufficiently seriously to require medical supervision. Numbers of hospital in-patient cases of children suffering from asthma are available from hospital episode statistics for the years shown in the table. Figures for earlier years are not available.


Finished Consultant Episodes-England                   

Thousands                                              

               |1988-89|1989-90|1990-91|1991-92        

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

0-14 age group |61.7   |51.5   |49.1   |50.7           

Source:                                                

Hospital episode statistics                            


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Refugee Children

Mr. Fishburn: To ask the Secretary of State for Health if she will list those local authorities that provide care and support for 50 or more unaccompanied refugee children under the provisions of the Children Act 1989; and what financial assistance has been given by central Government to those local authorities since 1990.

Mr. Bowis: Information about whether children looked after by local authorities have refugee status is not available centrally. Financial assistance totalling £4,197,698 has been given through a Department of the Environment special grant to local authorities caring for unaccompanied refugee children in respect of 1993 94.

Mr. Fishburn: To ask the Secretary of State for Health how many unaccompanied refugee children were being supported by the royal borough of Kensington and Chelsea (a) on 1 April 1991 and (b) at the latest available date; and by how much the children's services block in the standard spending assessment has increased in the same period.

Mr. Bowis: Information about whether children looked after by local authorities have refugee status is not available centrally. In 1990 91, the children's services sub-block of the personal social services standard spending assessment for Kensington and Chelsea was £11.945 million. In 1994 95, following a comprehensive review of the standard spending assessment formulae, and the first full use of data from the 1991 census, the equivalent figure is £11.926 million.

Private Patients

Ms Primarolo: To ask the Secretary of State for Health what was the total income generated from private patients in 1993 94, and for each trust.

Mr. Sackville: This information will not be available until December 1994.

Ms Primarolo: To ask the Secretary of State for Health how many NHS hospital trusts have dedicated private bed units.

Mr. Sackville: I refer the hon. Member to the reply I gave her on 26 May, Official Report, column 303.

Ms Primarolo: To ask the Secretary of State for Health what was the NHS activity figure for private patients by region in 1992 93 and 1993 94.

Mr. Sackville: Figures for 1992 93 will be published shortly in "Hospital Episodes Statistics, Volume 1, England 1992 93", copies of which will be placed in the Library. The 1993-94 figures are not yet available.

Ms Primarolo: To ask the Secretary of State for Health what limits there are on the number of private beds as percent private work that NHS trusts can do.

Mr. Sackville: None, providing there is no significant interference with the performance of the trust of its obligations under national health service contracts. That statutory requirement prevents NHS patients from being disadvantaged by private practice within the health service.

Alcohol (Women)

Ms Primarolo: To ask the Secretary of State for Health what percentage of women drank more than 14 units of alcohol per week in each year since 1986.


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Mr. Bowis: The available information, derived from the general household survey, is shown in the table.


Percentage of women aged 18+     

drinking over                    

14 units of alcohol weekly (     

England)                         

Year       |Percentage           

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

1986       |10                   

1988       |11                   

1990       |11                   

1992       |12                   

Notes:                           

1. Percentages rounded to the    

nearest whole figure.            

2. The General Household Survey  

collects data on alcohol         

consumption in alternate years   

only.                            

Community Care

Ms Primarolo: To ask the Secretary of State for Health what evidence she has that the objectives of the community care policies are being met.

Mr. Bowis: We have an extensive monitoring programme in place. This has shown that local authorities have made a good start with the implementation of community care in the first year. This view has also been confirmed by reports from the Audit Commission and the Association of Directors of Social Services.

Pain

Ms Primarolo: To ask the Secretary of State for Health what percentage of medical schools offer tuition in pain control.

Mr. Malone: A total of 100 per cent.

Ms Primarolo: To ask the Secretary of State for Health if she will estimate the number of people suffering from chronic pain.

Mr. Sackville: The prevalence of chronic pain is not known.

Ms Primarolo: To ask the Secretary of State for Health what research she has commissioned on the chief causes of chronic pain; and with what results.

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 MRC is an independent body deciding what research to support on its own expert judgment.

In 1992 93, the latest year for which figures are available, the MRC spent £237,000 on research into pain.

Ms Primarolo: To ask the Secretary of State for Health to what extent pain relief is included in undergraduate medical training.

Mr. Malone: Knowledge and understanding of the relief of pain is taught in all university medical schools. They determine the extent of this teaching in the light of recommendations from the education committee of the General Medical Council, which has the statutory authority to determine the extent of the knowledge and skill required for the granting of primary medical qualifications in the United Kingdom.

Ms Primarolo: To ask the Secretary of State for Health what percentage of district health authorities have pain relief clinics.


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Mr. Sackville: The information is not available centrally. It is for individual health authorities to commission hospital services that meet local needs including services for people with acute or chronic pain.

Ms Primarolo: To ask the Secretary of State for Health if pain relief is recognised as a specialty by her Department.

Mr. Sackville: No. This is primarily a matter for the medical profession in discussion with the Department.

Blood Transfusion

Ms. Primarolo: To ask the Secretary of State for Health what plans she has to develop autologous blood transfusion.

Mr. Sackville: We are aware of the value of autologous transfusion for those patients where the procedures are applicable. In appropriate cases it can provide a useful supplement to the supply of blood from voluntary donors which the National Blood Service supplies to our hospitals. The medical profession is aware of autologous transfusion and advice is available from medical staff of the National Blood Service and hospital consultant haematologists. Selection of patients for this procedure has to be undertaken with extreme care to avoid any possible clinical risk to that patient.

Help us to Help You Campaign

Ms Primarolo: To ask the Secretary of State for Health how much has been spent on the help us to help you campaign; and how effective the campaign has been.

Mr. Malone: The total cost of the help us to help you initiative has been £91,870. Monitoring to assess the effectiveness of local campaigns is a local responsibility. The national health service executive has found that help us help you messages are now widely featured in national health service information literature.

Adoption

Ms Primarolo: To ask the Secretary of State for Health what plans she has to set up an international adoption agency in the United Kingdom.

Mr. Bowis: Our role is to receive applications from voluntary organisations for approval under section 3 of the Adoption Act 1976. We have not yet received any such application.

Performance-related Pay

Ms Primarolo: To ask the Secretary of State for Health (1) what is the annual administrative cost of performance-related pay for consultants;

(2) what savings on the total consultant staff budget will come from performance-related pay.

Mr. Malone: Our proposals are for the introduction of local pay arrangements in the national health service, not performance-related pay. The size of the consultants' pay bill depends on a number of factors including consultant expansion. It is for trusts to determine the cost of local schemes.

Mental Illness

Ms Primarolo: To ask the Secretary of State for Health how many people (a) in the London implementation zone and (b) in each region suffer from mental illness.


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Mr. Bowis: The information is not currently available centrally. A national survey assessing the extent of psychiatric morbidity in Great Britain is being carried out for the Department of Health by the Office of Population Censuses and Surveys. The results of the first part of the survey, covering the private household population, are due to be published later this year and will provide information both nationally and regionally on the nature and extent of mental illness among adults.

Hospitality Budgets

Ms Primarolo: To ask the Secretary of State for Health what was the hospitality budget for her Department, the national health service executive and regional health authorities, district health authorities, family health services authorities and trusts in (a) 1993 94 (b) 1991 92 and (c) 1979 1980.

Mr. Sackville: Information on hospitality expenditure for regional health authorities, district health authorities, family health services authorities and trusts is not available centrally. Figures for the Department of Health are shown in the table.


                                             |1993-94|1991-92        

                                             |£      |£              

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

Department of Health                         |218,995|168,151        

                                                                     

National Health Service Management Executive |88,846 |35,803         

Notes:                                                               

<1> Figures are not available prior to 1990-91.                      

<2> Figures have not been adjusted for inflation.                    

<3> Departmental figures include the Management Executive figures.   

<4> Management Executive figures are not directly comparable from    

year to year because of organisational changes.                      

Cleveden Services

Ms Primarolo: To ask the Secretary of State for Health what contracts her Department, the national health service executive, regional health authorities, district health authorities, family health services authorities or trusts had with Cleveden Services.

Mr. Sackville: We have no records of any contracts between the Department of Health or the national health service executive and Cleveden Services.

Information on contracts held with individual contractors by regional health authorities, district health authorities, family health services authorities or trusts is not available centrally.

Sandwell General Practitioner Consortium

Ms Primarolo: To ask the Secretary of State for Health what plans she has to investigate Sandwell family health services authority, the general practitioner consortium and the limited company that ran it.

Mr. Malone: West Midlands regional health authority published the results of an investigation into the setting up of the Sandwell general practitioner consortium in May this year. Sandwell family health services authority is currently investigating the decision by general practitioners to leave the consortium.


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Consultants

Ms Primarolo: To ask the Secretary of State for Health what plans she has for ethnic monitoring of the merit award system for consultants.

Mr. Malone: Ethnic monitoring is one of the issues to be addressed in the review of distinction awards.

Patient Records

Ms Primarolo: To ask the Secretary of State for Health when the guidance on confidentiality on patient records is to be published; and when guidance was initially drafted.

Mr. Sackville: Draft guidance on the confidentiality, use and disclosure of personal health information was issued for consultation on 10 August 1994, and copies of it are available in the Library. The consultation period ends on 9 December, and a final version will be published when we have considered the comments received. Work on drafting guidance on confidentiality first began in 1989.

Footwear

Ms Primarolo: To ask the Secretary of State for Health if she will estimate the number of hospital referrals each year directly related to use of poor footwear.

Mr. Sackville: There is no information available on which to base such an estimate.

EU Doctors

Ms Primarolo: To ask the Secretary of State for Health how many doctors from other EU countries have practised in the United Kingdom in each of the last five years.

Mr. Malone: The available information is shown in the table. Information relating to Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales and Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland. Comparable information is not available for general practitioners.


Hospital and         

community health     

service medical      

staff from           

European Union       

countries (by        

countries of birth)  

other than UK        

who were practising  

in England as at 30  

September 1989-1993  

(whole time          

equivalents)         

       |Number       

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

1989   |1,830        

1990   |1,740        

1991   |1,870        

1992   |1,900        

1993   |2,010        

Figures are rounded  

to nearest 10.       

Opportunity 2000

Ms Primarolo: To ask the Secretary of State for Health when she expects to have the monitoring data for the Opportunity 2000 targets to be achieved by the end of the current year.

Mr. Sackville: Monitoring arrangements are in hand. The main findings will be published in 1995.

Ethnic Minority Health Unit

Ms Primarolo: To ask the Secretary of State for Health if she will make a statement on the planned closure of the regional ethnic minority health unit.


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Mr. Sackville: The closure of any regional unit would be the responsibility of the relevant regional health authority. The national health service ethnic health unit was established this year for a three- year period; it is located in Leeds and will cover ethnic health issues across the whole of the NHS in England.

Passive Smoking

Ms Primarolo: To ask the Secretary of State for Health what plans she has to limit the dangers of passive smoking.

Mr. Sackville: The Government will continue to publicise the dangers of passive smoking and to encourage the introduction of smoking policies in public places, public transport and the workplace. Good progress is being made in all those areas.

Ms Primarolo: To ask the Secretary of State for Health how many deaths were caused by passive smoking in each of the last five years; and what research findings she has on the illnesses caused by passive smoking.

Mr. Sackville: On the available data it is not possible to estimate a figure for all deaths attributable to passive smoking. The available evidence on the health effects of passive smoking is summarised in paragraph 2.13 of "Smoke Free for Health" which was published in February 1994, copies of which are available in the Library.

The Scientific Committee on Tobacco and Health is reviewing the available research findings on this issue.

Hospital Patient Statistics

Ms Primarolo: To ask the Secretary of State for Health what plans she has to collect data on the patient readmission rates of each hospital.

Mr. Sackville: None.

Ambulance Service, London

Ms Primarolo: To ask the Secretary of State for Health what plans she has to improve the London ambulance service.

Mr. Sackville: Mr right hon. Friend the Secretary of State announced in December 1993 an additional £14.8 million investment in the London ambulance service for 1994 95, which the LAS is using to purchase new accident and emergency vehicles, to increase ambulance staff, provide additional paramedic training and make other improvements to services. This additional funding was linked to firm targets for improved response times-- 80 per cent. of emergency calls to be responded to within 14 minutes by September 1994 and 85 per cent. by April 1995 as interim stages to meeting the national standard of responding to 95 per cent. of calls within 14 minutes. My right hon. Friend the Secretary of State has asked Mr William Wells, the chairman of South Thames regional health authority, to produce a report into the LAS. The report will look into what changes need to be made in terms of:

working practices, including staff deployment and rostering systems

the use of resources

management/staff relation

management and staff training


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The report will be made to Ministers before Christmas and will be made public.

Home Visits

Ms Primarolo: To ask the Secretary of State for Health if she will make a statement on the opportunities for patients to speak to a doctor prior to a home visit by that doctor.

Mr. Malone: In general, there should be no difficulty in speaking to a doctor before a home visit. However, it is for individual general practitioners to decide how to organise their patient contacts.

Caesarean Sections

Ms Primarolo: To ask the Secretary of State for Health what was the rate of caesarean sections in each of the last 10 years.

Mr. Sackville: I refer to the hon. Member to the reply I gave the hon. Member for Eccles (Miss Lestor) on 18 May, Official Report , column 519 .

Figures for 1992 93 are not yet available.

Junior Doctors

Ms Primarolo: To ask the Secretary of State for Health what plans she has to discipline consultants who continue to allow their junior doctors to work longer hours than those targets in her new deal for junior doctors.

Mr. Malone: None. I expect consultants to work with managers and junior doctors to help achieve the new deal targets.

Toxoplasmosis

Ms Primarolo: To ask the Secretary of State for Health what has been the incidence of (a) toxoplasmosis and (b) congenital toxoplasmosis in each of the last 10 years.


Column 832

Mr. Sackville: The number of laboratory reports of toxoplasmosis in England and Wales during the past10 years is shown in the table. It should be noted that those reports are not necessarily of new infections; some may be of chronic infection or represent results from repeat test on the same patient.

Information on the incidence of congenital toxoplasmosis each year is not routinely available.


Laboratory reports to the Public Health Laboratory Service,    

England and Wales, 1984-1993                                   

Year                     |Laboratory reports                   

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

1984                     |759                                  

1985                     |842                                  

1986                     |762                                  

1987                     |849                                  

1988                     |825                                  

1989                     |852                                  

1990                     |704                                  

1991                     |636                                  

1992                     |580                                  

1993<1>                  |454                                  

1993<1> data provisional                                       

Mental Health

Ms Primarolo: To ask the Secretary of State for Health what are the mental health activity figures for each of the last five years for (a) the London implementation zone and (b) by region, per head of population.

Mr. Bowis: Information on in-patient activity is given in the "Ordinary and day case admissions for England, Financial Year 1992 93" copies of which are available in the Library.

Information available on rates per head of population is shown in the tables. The numbers are based on ordinary admissions and day cases. It should be noted that the figures relate to finished consultant episodes and not individual patients, as an individual may be admitted and discharged more than once.


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