Mr. Redmond: To ask the Secretary of State for Health if she will ensure that all NHS patients, with the exception of young children and patients in intensive care units, should be offered the choice of accommodation in a single-sex area with segregated toilets and bathroom facilities without delaying their treatment or otherwise reducing its quality; and if she will make a statement.
Mr. Sackville: This is a matter for local decision, but we do expect all patients to be treated with dignity and respect for their religious and cultural beliefs. A new standard in the revised and expanded patients charter to be issued in the new year will expect patients to be told in advance if they are to be treated in mixed-sex wards. This will allow them to raise any objections with the hospital which will, where possible, take account of their views.
Mr. Malone: Information on the number of people waiting for treatment in England is collected by specialty and published in "Hospital Waiting List Statistics: England", copies of which are available in the Library. Data on the number waiting by individual procedure are not available centrally.
Information relating to Wales and Scotland are matters for my right hon. Friends the Secretaries of State for Wales and for Scotland.
Mr. Redmond: To ask the Secretary of State for Health what research her Department has carried out on the effect on the reduction of junior hospital doctors' hours on accessibility to patient services; and if she will make a statement.
Mr. Malone: A number of research projects have been supported, fully or in part, by central funds. The main studies include: Description and preliminary evaluation of Department of Health initiatives to reduce junior doctors' hours--Dr. Irene
Column 590Higginson, health services research unit, London School of Hygiene and Tropical Medicine, 1992;
The interface between junior doctors and nurses: a research study for the Department of Health--Greenhalgh and Company, September 1994; Medical support worker policy--Northern general hospital, Sheffield, on-going;
The patient's progress --Department of Health, on-going
Evaluation of processes for creating successful roles for nurse practitioners--Sheffield Centre for Health and Related Research, on-going;
Evaluation project on parasurgical assistants--University of Sheffield, Department of Surgical Sciences, on-going.
Much of the research in this area has concentrated on how best various disciplines can work together to deliver good quality patient care. The evidence suggests that an effective use of skill mix can help maintain continuity of care, improve services to patients, help reduce junior doctors' hours and provide a range of staff with opportunities to develop their skills further.
As well as projects supported directly by central funds, our regional task forces have been able to develop a range of local schemes to examine how best to reduce juniors' hours. They also evaluate the effect on patient care and juniors' hours of the extra senior medical posts, over 800 in all, which we have funded since 1991.
Mr. Wigley: To ask the Secretary of State for Health when she plans to publish the counselling guide on multiple pregnancies for patients attending infertility treatment centres; and if she will place a copy in the Library.
Mr. Sackville: A guide for patients entitled "The Prospect of Triplets and Quads", written by Dr. Frances Price, was published in July 1993. Copies were sent to all assisted conception centres licensed under the Human Fertilisation and Embryology Act 1990. Copies will be placed in the Library.
Mr. Malone: The employment of consultants is a matter for local rather than national decision. To assist health authorities and trusts to achieve best value for money, the Department published comprehensive
guidance--EL(94)78--this on the use of consultants, entitled "The Procurement and Management of Consultants within the NHS". This guidance included an indication of the range of fee rates that might be reasonable depending on the skill levels required. Copies of guidance will be placed in the Library.
Mr. Milburn: To ask the Secretary of State for Health if she will list all the current (a) chairs and (b) non-executive directors of each trust board, indicating the gender and occupation of each individual.
Mr. Tim Smith: To ask the Secretary of State for Health what guidance or instructions have been given to national health service trusts about the timely payment of suppliers' bills; and what evidence she has about the performance of national health service trusts in this regard.
Mr. Sackville: The national health service has been routinely monitored against a payment target of eight weeks from receipt of goods and services. Monitoring in the 1994 95 financial year shows that trusts are generally meeting this target.
New guidance was issued to the national health service in October 1994 on the timely payment of suppliers. The guidance includes the expectation that all trusts will abide by the Confederation of British Industry prompt payment code and with Government accounting regulations. A copy of the guidance, FDL(94)67, is available in the Library.
(2) what plans she has to allocate extra money to GPs in order to help fund the practice reception programme.
Mr. Redmond: To ask the Secretary of State for Health if she will (a) increase the resources available to family health service authorities to ensure that more frequent inspections are carried out of general practitioner premises, (b) introduce measures to enforce standards and
Column 592(c) ensure that public money spent by general practitioners is used for the maximum benefit of patients; and if she will make a statement.
Mr. Malone: Under their terms of service, general practitioners are responsible for the provision of adequate practice premises from which to see their patients and it is for family health services authorities to decide the frequency of practice visits needed in the light of local circumstances. Minimum standards are set out in the statement of fees and allowances which are payable for premises and measures already exist to enforce them.
Mr. Alex Carlile: To ask the Secretary of State for Health if general practitioners in the South Thames region will remain free to accept or reject secondary care contracts; and if she will make a statement.
Mr. Malone: Health authority decisions about contracts should be reached in close co-operation with general practitioners. However, GPs remain free to refer their patients in line with their clinical judgment to a service or hospital with which the health authority has no contract.
Mr. Alex Carlile: To ask the Secretary of State for Health if she will make it her policy that general practitioners in the South Thames region will remain able to choose fundholding, locality purchasing or neither; and if she will make a statement.
Mr. Malone: The recent executive letter "Developing NHS Purchasing and GP Fundholding"--EL(94)79--copies of which are available in the Library, emphasised that health authorities should work with all general practitioners to develop local health and purchasing strategies. The experience of the past four years has shown that patients receive more appropriate services when general practitioners take on direct responsibility for purchasing through fundholding. This remains voluntary.
Mr. Bowis: The number of suicides, including undetermined deaths, in each standard region for the years 1979 to 1992 will be placed in the Library. Information on employment status at the time of death is not generally available.
Mr. Alex Carlile: To ask the Secretary of State for Health if she will name the health authorities which are unwilling to fund referrals to gender identity or dysphoria clinics; and if she will make a statement.
Mr. Alex Carlile: To ask the Secretary of State for Health if she will introduce national criteria and protocols for gender reassignment therapy in England and Wales; and if she will make a statement.
Mr. Alex Carlile: To ask the Secretary of State for Health (1) if waiting times for out-patient consultant appointments at Hereford are subject to the same criteria for patients from Powys as for patients from Hereford and Worcester; and if she will make a statement; (2) if waiting times for out-patient consultant appointments at the Royal Shrewbury hospital are subject to the same criteria for patients from Powys as for patients from Shropshire; and if she will make a statement.
Mr. Malone: Health authorities and general practitioner fundholders must purchase services for their patients according to the appropriate national and local standards applicable to their residents taking account of available resources.
Mr. Alex Carlile: To ask the Secretary of State for Health if she will make a statement concerning the location of the new headquarters of the Northern health authority, the cost of relocation and the cost of using existing premises.
The business case estimated that relocating to Durham would be cheaper than retaining the existing headquarters by around £225,000 a year.
Mr. Madden: To ask the Secretary of State for Health what representations she has received concerning the need to amend reporting procedures when patients, whether referred under the Mental Health Acts or voluntary, abscond from a secure unit; if she will describe current reporting procedures; and if she will make a statement.
The current procedures are given in chapter 21 of the code of practice to the Mental Health Act 1983 and paragraphs 76 to 80 and 288 and 289 of the memorandum to the Mental Health Act 1983, copies of which are available in the Library. My right hon. and learned Friend the Secretary of State for the Home Department is notified if a patient subject to restrictions under sections 41 or 49
Column 594of the Mental Health Act 1983 absents himself without leave.
Mr. Madden: To ask the Secretary of State for Health what legal advice she has received or sought to clarify on whether those referred to secure units under the Mental Health Acts have a mandatory or discretionary right to exercise outside such units; and if she will make a statement.
Mr. Bowis: The decisions as to whether a patient is allowed to exercise outside a secure unit, whether within or outside the secure perimeter, is one for the clinical staff responsible for his or her care. In the case of a patient subject to restriction under sections 41 or 49 of the Mental Health Act 1983, any proposal to grant leave outside the perimeter of the unit has to be approved by my right hon. and learned Friend the Secretary of State for the Home Department.
Mr. Alex Carlile: To ask the Secretary of State for Health what proposals she has to alter the arrangements whereby donor blood is obtained by voluntary and unpaid donation; and if she will make a statement.
Mr. Alex Carlile: To ask the Secretary of State for Health if she will institute an inquiry into the lodging of NHS funds with the Durham business school for the purpose of payment for MBA studies; and if she will make a statement.
Ms Armstrong: To ask the Secretary of State for Health how much has been spent to date on the preparation of the business plan and planning for the refurbishment of Bishop Auckland hospital by the Bishop Auckland hospitals trust.
Column 595may wish to contact Mrs. Barbara Gill, chairman of Bishop Auckland hospitals NHS trust, for details.
(2) if she will make a statement concerning the future of the operation theatre and associated facilities at Newton Abbot community hospital.
Mr. Sackville: It is the responsibility of individual purchasers, in discussion with their hospital providers, to ensure that high standards of quality and safety are maintained for all surgical procedures. The hon. Member may wish to contact Mrs. Leverton, chairman of Plymouth and Torbay district health authority, about the future of the operating theatre at Newton Abbot hospital.
Mr. Austin-Walker: To ask the Secretary of State for Health (1) what estimate she has made of the number of people with tinnitus in England and Wales; and how many tinnitus-only clinics there are; (2) what guidance she has issued to health authorities regarding special provision for the relief of tinnitus; what assessment she has made of the adequacy of resources available for it; and if she will make a statement;
(3) what plans she has to review the provision of NHS services for people with tinnitus; and if she will make a statement.
Mr. Sackville: It is not known how many people suffer from tinnitus. The numbers of tinnitus-only clinics are not available centrally. However, there are facilities for the treatment of tinnitus at all national health service ear, nose and throat departments.
As with all patient groups, responsibility for the provision of services for people with tinnitus rests with health authorities who have to assess needs and priorities against their resources. We have no plans to review these provisions.
Ms Armstrong: To ask the Secretary of State for Health how much has been spent to date on the preparation of the business plan, and planning for the new general hospital by the North Durham hospital trust.
Mr. Hain: To ask the Secretary of State for Health, pursuant to her answer of 22 November 1994, Official Report, column 86 , what steps she took to obtain counsel's opinion about possible court interpretations of the term "industrially produced", prior to formulating her policy on such matters in relation to the availability of herbal remedies; and if she will make available in the Library a copy of all legal opinions received.
Mr. Hain: To ask the Secretary of State for Health, pursuant to her answer of 22 November, Official Report, column 86 , how she is able to safeguard the position of herbal remedies in possible future legal cases; and if she will make a statement.
The effects of insulin-like growth factor-1, IGF-1, being a naturally occurring substance in humans, have been studied extensively and the Medical Research Council is currently funding a project on the effect of IGF-1 on binding protein in implantation and pregnancy. There are a large number of reports on research into IGF-1 on human beings which have been published in the international scientific literature. The MRC is always willing to consider soundly based proposals in competition with other applications for council's support, and funding decisions are dependent upon a peer review process.
Mr. Hain: To ask the Secretary of State for Health if she will now make it her policy to decline to introduce the Medicines for Human Use (Marketing Authorisations, Pharmacovigilance and Related Matters) Regulations; and if she will make a statement.
Mr. Tyler: To ask the Secretary of State for Health if she will revise the guidance given to general practitioners on the diagnosis, treatment and benefit implications of conditions caused by exposure to organophosphorous sheep dips; and if she will make a statement.
Mr. Sackville: Training in diagnosis and treatment is principally a matter for the medical profession rather than the Government. All general practitioners and accident and emergency departments were sent the Department's book "Pesticide Poisoning" when it was published, copies of which are available in the Library, and the chief medical officer wrote to all doctors in England in 1991 and again with the chief executive of the Veterinary Medicines Directorate in June 1993 to alert general practitioners to the possibility of exposure to pesticides and certain veterinary medicines including organophosphorus sheep dips and to remind them of the reporting schemes operated by Employment Medical Advisory Service and the Ministry of Agriculture, Fisheries and Food's veterinary medicines directive. The chief medical officers in Scotland, Wales and Northern Ireland also wrote to doctors in those countries. All doctors therefore should be aware of the possibility of poisoning if over exposure to any of these products occurs and the symptoms to be expected.
Column 597This guidance is still valid.
Any benefit implications are a matter for my right hon. Friend the Secretary of State for Social Security.
Mr. Redwood: I propose to set total standard spending in Wales for 1995 96 at £2,767 million. This figure includes £124.4 million for care in the community. It represents an increase of £72 million, 2.7 per cent. on the comparable level of funding for 1994 95. I propose to set central Government support for TSS through aggregate external finance at £2,450.8 million.
Within AEF I propose to make available £1,711.1 million in revenue support grant, £520 million in distributable non-domestic rates and £219.7 million in specific and supplementary grants.
My Department has today written to the local authority associations to consult them on my proposals for revenue support grant in 1995 96.
I shall announce provisional standard assessments and provisional capping principles for police authorities in Wales later this week. I shall announce provisional standard spending assessments and provisional capping principles for county and district councils in mid December. I shall announce final details of the settlement early in the new year.