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Column 790the adult population is of the order of 1 per cent. In 1989, latest available figures, there were 190,590 registrations of newly diagnosed cases of cancer in England, excluding non- melanoma skin cancers. Projections for 2015 are not available and could be provided only at disproportionate cost.
Information relating to Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales and for Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland.
Mr. Redmond: To ask the Secretary of State for Health if she will instruct the NHS executive to change its purchasing system so that all patients are treated equally according to clinical need by (a) having a separate budget for accident and emergency costs, to ensure that unexpected increases do not have to be absorbed by the district health authority, (b) allocating the cost of more expensive and long-term treatments so that general practitioner fundholders pay an appropriate amount, (c) investigation the merits of bringing all general practitioners into the purchasing system as equal partners with district health authorities and (d) investigating the merits of providing all general practitioners with funds for routine treatments; and if she will make a statement.
Mr. Malone: The aim of budget setting in the national health service is to give both health authorities and fundholding general practitioners a fair share of NHS resources to meet their patients' needs. In the case of health authorities, this includes funding to secure accident and emergency services for the whole of their local population. EL(94)79 recently announced a significant expansion of fundholding options to enable all GPs to become directly involved in purchasing and managing funds on their patients' behalf.
Copies of EL(94)79, "Developing NHS purchasing and GP fundholding", EL(94)84, "General Practice Fundholding: guidance on setting budgets for 1995 96" and FDL (94)68, "Revenue allocations 1995 96" are available in the Library.
Mr. Redmond: To ask the Secretary of State for Health if she will consider making changes to general practitioners' contracts so as to ensure that if a parent chooses to deregister their child for health surveillance with their general practitioner, the money is then transferred to the health authority to provide an alternative community service; and if she will make a statement.
Mr. Malone: In purchasing community child health surveillance, district health authorities take account of the needs of all children who are not registered for child health surveillance with general practitioners. No transfer of money is required to ensure this.
Mr. Redmond: To ask the Secretary of State for Health (1) if she will set up a working party to examine and report to the House within the next 12 months on the feasibility of introducing a properly funded and independent advocacy service for all national health service complainants; and if she will make a statement;
Column 791(2) if she will ensure (a) that a full range of appropriate independent advocacy services based on existing local interest groups are available to all national health service patients who require such a service with support from joint finance and (b) that it is a statutory duty of regional and district health authorities to have strategies supporting independent advocacy initiatives and financially support advocacy services; and if she will make a statement.
Mr. Malone: The Government welcome the initiative of those national health service authorities and trusts which have already set up their own patient advocacy and patient friend schemes to encourage and support patients including those who are not able to represent themselves in pursuing complaints, making suggestions about and seeking NHS services. "Being Heard", copies of which are available in the Library, the report of the Wilson committee on NHS complaints procedures, recognised the importance of providing support to complainants and the role of community health councils in doing so. We are currently considering the responses to the consultation exercise on the report and will make an announcement on our decisions in due course.
Mr. Redmond: To ask the Secretary of State for Health if her Department will undertake a review of the national health services (Pharmaceutical Services) Regulations 1992 to take account of patients' needs; and if she will make a statement.
Mr. Cohen: To ask the Secretary of State for Health what surveys her Department has commissioned which indicate that vegetarians tend to be more healthy than meat-eaters; and if she will make a statement.
Mr. Sackville: The Department has not commissioned any surveys specifically of the diet, nutritional status and health of vegetarians. A variety of studies have shown that vegetarians as a group tend to be healthier than non-vegetarians, but the many other differences in their diet and in other aspects of their lifestyle may be just as important as the avoidance of meat.
Mrs. Bridget Prentice: To ask the Secretary of State for Health what are the total costs of redundancy and early retirement payments to (a) midwife teachers, (b) nurse teachers and (c) senior midwife managers for each of the last three years including 1994 to date.
Column 792Member may wish to contact Bernard Williams, chairman of the trust, for details.
Mrs. Bridget Prentice: To ask the Secretary of State for Health what is her policy in respect of marketing testing or selling national health service computer centres; and if she will make a statement.
Mr. Sackville: A number of regional computer centres serving the national health service have been sold off or contracted out for a number of years. Others, which remain in-house, have been reviewing their options in the light of the planned abolition of the parent regional health authorities in 1996. The aim is to secure best long-term value for money for the NHS and to maximise the use of existing management and financial resources on the core statutory function of improved health care. Options, which are for local determination, include;
Closure without replacement
Market testing to identify a new supplier or suppliers
Transfer to another owner within the NHS at manageable risk Sale by competition to an owner outside the NHS (which might include a bid from a Management buy-out)
Guidelines to assist health authorities and trusts in their consideration of future arrangements for NHS trading agencies generally will be issued shortly.
Mr. Sackville: Trent regional health authority received a report from the district auditor at the public meeting of the authority held on 11 July 1994. This related to the transfer of services to the private sector between 1988 and 1992. Copies of the report are available on request from the RHA.
Mr. Redmond: To ask the Secretary of State for Health if she will amend legislation on general practitioner fundholding to require any savings generated by fundholding practices to be paid to the local district health authority to be used for the development of health care against identified needs within a broad and publicly accountable health strategy; and if she will make a statement.
Mr. Malone: The report of the Wilson committee on national health service complaints procedures recommended that the Government should consider a number of options put forward for reviewing complaints in the NHS, including a national complaints commission. We are currently considering the responses to the consultation exercise on the report and will make an announcement of our decisions in due course.
In training population-England. Years ended 31 March 1988 and 31 March 1992. |1988 |1992 ----------------------------------------------------- Pre-registration |58,901|51,901 Post-registration |6,485 |4,049 Total pre and post registration |65,386|55,950 Source: English National Board for nursing, midwifery and health visiting.
The level of qualified nursing and midwifery staff in post has remained virtually static over this period, thus reducing the overall demand for newly qualified staff.
Mr. Alfred Morris: To ask the Secretary of State for Health what consideration her Department has given to the research report, commissioned by the British Council of Organisations of Disabled People, entitled "Cashing in on Independence".
Mr. Alfred Morris: To ask the Secretary of State for Health when she now expects direct cash payments by local authorities to disabled people to become legally available; and if she will make a statement.
Mr. Bowis: My right hon. Friend the Secretary of State for Health made an announcement about direct payments on 24 November and I refer the hon. Member to the reply that my right hon. Friend gave my hon. Friend the Member for Stratford-on-Avon (Mr. Howarth) on 24 November, Official Report, columns 332 33.
Mr. Alfred Morris: To ask the Secretary of State for Health what steps she is taking to ensure full compliance by local authorities with the legal duties imposed by section 2 of the Chronically Sick and Disabled Persons Act 1970; and if she will make a statement on cases known to her Department of failure to comply with these duties.
Mr. Bowis: Local authorities are aware of their duties under section 2 of the Chronically Sick and Disabled Persons Act 1970. Most cases of alleged breach of statutory duties are resolved by means of local authority complaints procedures, established for this purpose. The Department, of course, follows up any cases brought to its attention and issues guidance as necessary.
Column 794revised protective markings were introduced earlier this year, and are therefore not in active use. Since October 1992, no top secret, and only 13 secret, files have been created.
Mr. Sackville: We understand that the Royal Devon and Exeter trust ceased elective ventilation following receipt of legal advice. The Department has recently issued guidance--HSG(94)41--copies of which are available in the Library, setting out the legal position on ventilation of potential organ donors. Where clinicians believe there may be some benefit, however slight, to the patient, ventilation remains lawful.
Mr. Corbyn: To ask the Secretary of State for Health what analysis she has undertaken of the effectiveness of health care in Camden and Islington and the adequacy of the funding of the Camden and Islington health authority.
Mr. Sackville: It is the responsibility of the Camden and Islington health authority to obtain effective health care using available resources. The hon. member may wish to contact Roland Everington, chairman of Camden and Islington health authority, for further information.
Mr. Nicholas Brown: To ask the Secretary of State for Health what is the total budget for mobile telephones in the national health service; and how many are held by (a) medical staff and (b) administrators.
Mr. Sackville: Financial responsibility for mobile telephones rests with individual users or their employers. From a limited expenditure survey of users, as part of a national initiative to minimise expenditure on telecommunications, total expenditure is estimated to be of the order of £24 million per year. Estimates of the number of mobile telephones held by various national health service groups are shown in the table.
Group |Number --------------------------------------- Clinical Staff |30,000 Other Hospital Staff |<1>9,500 Ambulance Services |500 <1> Includes a variety of technical, clinical and non-clinical staff; administrators were not identified separately. The NHS Executive have recently negotiated substantial discounts with a number of suppliers. These offer individual user savings of between 8 per cent. and 19 per cent. and should provide an overall reduction in the NHS bill of 10 per cent. by 1997.
Mrs. Ewing: To ask the Secretary of State for Health how many hospital admissions there were for each month in 1991, 1992 and 1993 for (a) acute respiratory complaints and (b) bronchitis; and if she will provide a breakdown by (i) United Kingdom nation and region and (ii) local health authority or trust.
Column 795episodes for respiratory infections including acute bronchitis and bronchiolitis--ICD 460-466--and acute bronchitis--ICD 466--by month of admission, in England, for each national health service region, will be placed in the Library. Information for individual health authorities and NHS trusts is not available. Information relating to Scotland, Wales and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Scotland and for Wales and my right hon. and learned Friend the Secretary of State for Northern Ireland.