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Written Answers to Questions
Wednesday 7 December 1994
HEALTH
Ward Funds
Mr. Redmond: To ask the Secretary of State for Health what assessment she has made of the effect of separate registration of individual ward funds on the income of NHS hospitals.
Mr. Sackville: Individual ward funds are required to be registered only where they constitute separate charities. We have no information on any link between registration and income.
Community Care
Mr. Pickthall: To ask the Secretary of State for Health what evidence she has to demonstrate that the transfer of funding to local authorities for care in the community is keeping pace with the transfer of responsibilities.
Mr. Bowis: Since 1990 91, total resources for community care have risen by 121 per cent. to £5,122.6 million for 1995 96, including an increase of 12.4 per cent. for 1995 96 over 1994 95. In addition, specific grants have been increased for drugs and alcohol, AIDS/HIV and social work training for 1995 96 in line with inflation and increased by some 30 per cent. for mental illness.
Mr. Pickthall: To ask the Secretary of State for Health when she plans to meet representatives of Lancashire county council to discuss the resourcing of care in the community.
Mr. Bowis: I have on various occasions met members and officers of Lancashire county council and Members of Parliament from the area. I have no current plans for further meetings.
Maternity Services
Mrs. Wise: To ask the Secretary of State for Health if she will list the organisations who will be consulted about the applicability of the data set to maternity care.
Mr. Sackville: The development of the maternity contract minimum data set will require consultation with all organisations who have an interest in the data set. These will include representatives of the organisations involved in the delivery of maternity services, those involved in the purchasing of maternity services, and of organisations representing the health professionals involved.
Mrs. Wise: To ask the Secretary of State for Health if she will publish the criteria for assessment of the data set for maternity services to be used during the piloting programme.
Mr. Sackville: The criteria for the assessment of the maternity data set will be agreed during the initial stages of its development.
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Mrs. Wise: To ask the Secretary of State for Health what information in respect of the professional group of main care giver the minimum data set for maternity services will record.
Mr. Sackville: The draft contract minimum data set published in October 1993 recommended the inclusion of a data item to record the key professional with overall responsibility for the care programme. The proposed classifications were consultant, general practitioner and midwife.
NHS Trusts
Mr. Gordon Prentice: To ask the Secretary of State for Health if she will now make it her policy to keep a record centrally of the resignations or dismissals of chief executives of NHS trusts, together with the reasons for the resignation or dismissal and details of the settlement agreed on termination.
NHS Managers
Mr. Gordon Prentice: To ask the Secretary of State for Health what is the definition of proper public scrutiny in respect of confidentiality clauses in employment contracts of general and senior managers in the NHS.
Mr. Malone: Proper public scrutiny in this context means parliamentary scrutiny and judgment about propriety.
Asthma
Mr. Cousins: To ask the Secretary of State for Health if she will make it her policy to include targets relating to asthma in the "The Health of the Nation" targets programme under review; and when she expects to conclude that review.
Mr. Sackville: "The Health of the Nation" programme is continuously under review. The chief medical officer's working group is considering what further work is necessary on interventions and possible targets, before asthma can be reconsidered for key area status.
Quality (NHS)
Mrs. Beckett: To ask the Secretary of State for Health what evidence she has on the extent to which the quality of care provided by the NHS differs from what it was four years ago.
Mr. Malone: The changes we have introduced, including the introduction of a managed market, national health service trusts, the general practitioner fundholding scheme and the patients charter have all contributed to marked improvements in the quality of patient care, by focusing on the development of locally determined services which reflect the needs and wishes of the individuals who use those services. Tangible benefits in terms of patients care include: significant reductions in waiting-times, the development of quality services which effectively reflect local needs and priorities and a greater role for patients in decisions concerning their own health care and treatment.
These improvements have been borne out by the results of the recently published British Social Attitudes Survey, which suggests that, since 1990, the number of people satisfied with the NHS has increased by 10 per cent.
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Hypothermia
Mr. Wicks: To ask the Secretary of State for Health how many deaths have been caused by, or were associated with, hypothermia among people over (a) 65 years, (b) 75 years and (c) 85 years old in each year since 1979.
Mr. Sackville: The information for England and Wales will be placed in the Library.
Cot Mattresses
Mr. Pike: To ask the Secretary of State for Health if she plans a full investigation of the safety of cot and baby mattresses; and if he will make a statement.
Mr. Sackville: Dr. Kenneth Calman, the chief medical officer, has set up an expert group to steer further work by the Department on cot deaths. The group will be chaired by Lady Limerick.
Its terms of reference are:
To review the findings of the report on "Sudden Infant Death Syndrome" (the "Turner Report", 1991) and any subsequent data on hypotheses linking antimony with unexplained deaths in infants; and to advise the CMO on what further studies should be undertaken to investigate postulated causal relationships between chemicals and cot deaths.
The group has been asked to review the available material and to provide the Department with advice as quickly as possible. It will meet shortly.
Waiting Lists
Mrs. Beckett: To ask the Secretary of State for Health (1) how many patients were waiting for hospital treatment (a) in total and (b) over 12 months, for each year since 1979;
(2) how many patients had been waiting for hospital treatment for more than a year in March 1991.
Mr. Malone: Information on the numbers of people waiting over 12 months and in total for hospital treatment is shown in the table. There has been a reduction of 66.7 per cent. in the numbers waiting over one year since March 1979.
|Number waiting over|Total waiting
|one year
----------------------------------------------------------------------------------------------------
1979 |March |185,195 |752,422
|September |197,532 |695,726
1980 |March |196,983 |664,919
|September |187,993 |635,881
1981 |March |180,774 |628,333
|September |180,905 |619,393
1982 |March |175,554 |622,480
|September |192,902 |725,865
1983 |March |198,546 |726,186
|September |205,920 |703,755
1984 |March |194,614 |692,945
|September |189,546 |682,599
1985 |March |171,197 |674,453
|September |160,227 |661,249
1986 |March |161,326 |673,107
|September |164,682 |681,901
1987 |March |162,273 |687,945
|September |209,440 |848,022
1988 |March |207,925 |876,246
|September |219,929 |900,051
1989 |March |223,311 |922,676
|September |218,116 |929,056
1990 |March |207,860 |958,976
|September |202,740 |957,533
1991 |March |169,761 |948,243
|September |155,419 |947,842
1992 |March |80,585 |917,717
|September |80,581 |939,740
1993 |March |56,877 |994,974
|September |71,022 |1,032,038
1994 |March |64,508 |1,065,369
|September<1> |61,693 |1,063,302
Note:
<1> Provisional Figures from September 1987 figures include numbers waiting for day case treatment.
Chlamydia Trachomatis Infection
Mr. Alton: To ask the Secretary of State for Health when the review of the Public Health Laboratory Service into the epidemiology and control of chlamydia trachomatis infection will be complete; what representations she has received about this matter; and if she will made a statement.
Mr. Sackville: The paper being prepared by the Public Health Laboratory Service for the Department of Health is a compilation of published and unpublished epidemiologic data concerning:
the levels of genital chlamydia infection in various population groups in the United Kingdom and abroad;
what is known concerning the health burden resulting from chlamydia;
information that has been gathered in the United Kingdom and elsewhere relating to control strategies and the outcome of those measures.
This paper is a background document. Given the lack of information in this field, it is likely to make recommendations as to the areas of further study which could be undertaken. The paper is in a late stage of development and will be delivered to the Department in the new year.
Covert Video Surveillance
Mr. Morgan: To ask the Secretary of State for Health, pursuant to her answer of 25 November, Official Report , columns 412-3 , if the use of covert video surveillance at the North Staffordshire hospital is classified as a research experiment.
Mr. Bowis: No; it is one of the range of services available to individual children and like other innovative developments, it is regularly evaluated.
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Empty Property
Mr. Pike: To ask the Secretary of State for Health what plans she has to make use of her Department's empty residential property.
Mr. Sackville: The Department and the national health service follow Government guidelines on the management of their residential estate whereby only property which is required for operational purposes should be retained, and that surplus property should be disposed of as quickly as possible. This may be in the open market, or to housing associations or local authorities. Consideration should be given to short-term or temporary lettings of vacant residential property which is either not surplus, or which cannot be disposed of immediately.
Smoking
Mr. Speller: To ask the Secretary of State for Health what studies her Department has undertaken to ascertain whether higher taxes are the most effective and fair means of reducing smoking.
Mr. Sackville: The Government's assessment of the effectiveness of interventions to reduce smoking is based on critical evaluation of the available research evidence. Studies show that an increase of 10 per cent. in the price of tobacco products can be expected to lead to a drop of between 3 and 6 per cent. in tobacco consumption. There is a significant relationship between price and consumption across the range of income groups. This supports the view that raising tobacco taxation is one of the most important parts of any strategy to reduce smoking.
Mental Hospitals (Sales)
Ms Jowell: To ask the Secretary of State for Health what were the capital receipts on the sale of mental hospitals over the past six years by region; and what were the consequent current revenue savings by region.
Mr. Sackville: The information requested is not separately identifiable in the information available centrally.
Tapeworm Infection
Dr. Strang: To ask the Secretary of State for Health for each of the years 1990, 1991, 1992 and 1993, how many people in the United Kingdom (a) became infected with the tapeworm echinococcus granulosus and (b) died from infection with the tapeworm echinococcus granulosus caught in the United Kingdom.
Mr. Sackville: The number of laboratory reports of human echinococcus infection received by the Public Health Laboratory Service communicable disease surveillance centre in 1990 93 are shown in the table. Place of acquisition of the infection is not reported.
|1990 |1991 |1992 |<1>1993
----------------------------------------------------------
England and Wales |14 |5 |16 |13
Northern Ireland |0 |0 |0 |0
Scotland |0 |0 |0 |1
United Kingdom |14 |5 |16 |14
<1> Data for 1993 are provisional.
There have been no deaths certified as being due to echinococcus granulosus -- ICD 122.0, 122.1, 122.2, 122.3, 122.4 in 1990 92. The table below gives the
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number of deaths in each of the three years due to echinococcus unspecified-- ICD 122.8, 122.9--in England and Wales, Scotland and Northern Ireland. Information on whether the infections were acquired in the United Kingdom or abroad is not available. Data for 1993 are not yet available.
|1990|1991|1992
--------------------------------------
England and Wales |5 |3 |3
Scotland |0 |0 |0
Northern Ireland |0 |0 |0
United Kingdom |5 |3 |3
<1> International Classification of
Diseases, 9th Revision.
Dr. Strang: To ask the Secretary of State for Health for each of the years 1990, 1991, 1992 and 1993, what has been the cost to public funds of treatment of infection with the tapeworm echinococcus granulosus.
Mr. Sackville: Echinococcus granulosus--hydatid disease--can be treated either medically or with a combination of anti-helminthic drugs and surgery. It is not possible to estimate the cost to public funds of this treatment.
Dr. Strang: To ask the Secretary of State for Health what have been the main focuses in the United Kingdom of infection with the tapeworm echinococcus since 1990.
Mr. Sackville: Information on the focuses of infection with echinococcus granulosus--hydatid disease--is not available. Data on the number of cases are available from laboratory reports made to the Public Health Laboratory Service communicable disease surveillance centre. A total of 34 laboratory reports were made from 19 different laboratories in England and Wales during the period 1991 to 1993. However, as data are provided by reporting laboratory it is not possible to assume focuses of infection from these figures because some laboratories--for example, Cardiff public health laboratory and the London tropical diseases hospital- -have particular interest and expertise in this field and cases are referred to them from all over the country. It is also not possible to tell from these reports whether these are new cases or fresh investigations on previously diagnosed cases or what duplication might exist in them.
NHS Probity
Mr. Alex Carlile: To ask the Secretary of State for Health if she will make a statement concerning the Audit Commission's report, "Ensuring Probity in the NHS"; and if she will make a statement.
Mr. Malone: We welcome the report's comments that the majority of national health service employees and contractors are honest and diligent. The level of losses through fraud are small compared with the huge amount spent on the health service. We have already taken a number of steps to safeguard NHS funds but have asked the NHS executive to scrutinise the report to see whether any further action is necessary.
Hearing Aids
Mr. Alex Carlile: To ask the Secretary of State for Health what is her policy in relation to the provision of non-NHS hearing aids to adults for whom they have been prescribed by medical practitioners on the basis that they
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are more suitable than NHS hearing aids; and if she will make a statement.Mr. Bowis: Where no standard range hearing aid meets the medical needs of a patient, an alternative model may be supplied.
Hillingdon Hospital Health Trust
Mr. Alex Carlile: To ask the Secretary of State for Health if she will call for a report on the suitability of Professor Neil Merritt, vice- chancellor of Portsmouth university, as chairman of the Hillingdon Hospital Health trust; and if she will make a statement.
Mr. Malone: No. Hillingdon Hospital National Health Service trust has been very successful, meeting all its financial objectives and achieving eight five star awards in the patients charter league tables.
Organ Donation
Mr. Alex Carlile: To ask the Secretary of State for Health if she will make it her policy to replace organ donor cards by an opting-out system; and if she will make a statement.
Mr. Sackville: The Government believe that giving organs should be a positive, altruistic choice made by individuals or their surviving relatives and not a presumed right on the part of the state. "Opting-out" does not have the support of the majority of the British people and there is no clear evidence that it would improve donation rates. On 6 October this year, we launched the national health service organ donor register; all those wishing to signal their intention to be a donor can now record their names on this central computerised register. The volume of applications is already encouraging.
ENVIRONMENT
Housing Corporation
Mrs. Maddock: To ask the Secretary of State for the Environment (1) how many jobs the Government estimate are created annually by the approved development programme budget;
(2) what was the average cost to a housing association of compiling a bid for the Housing Corporation's approved development programme for the most recent year for which figures are available.
Mr. Robert B. Jones: Neither my Department nor the Housing Corporation can provide the cost to housing associations of compiling bids for the Housing Corporation's approved programme or the total number of jobs created by the approved development programme.
Mrs. Maddock: To ask the Secretary of State for the Environment what proportion of the budget of the Housing Corporation is spent on administration.
Mr. Robert B. Jones: The Housing Corporation's administration costs for 1994 95 represent 1.4 per cent. of its total grant in aid.
Sound Insulation
Mr. Matthew Taylor: To ask the Secretary of State for the Environment (1) how the sound insulation provisions of the building regulations are enforced
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currently; what plans he has to introduce post-construction testing of building; and what plans he has to introduce standards for impact sound transmission into the regulations;(2) what is his estimate of the proportion of post-1985 buildings which have sound insulation below the standard generally regarded as reasonable for building regulations purposes.
Mr. Robert B. Jones: Reasonable standards of sound insulation between new dwellings were required by the 1985 building regulations, which applied in England and Wales outside London. In 1986, these were extended to cover new dwellings built in London where previously there was no requirement for sound insulation in the London Building Acts. The requirements were further extended in the 1991 building regulations to cover reasonable standards of sound insulation between converted flats. We have no information on the proportion of dwellings built since 1985 where reasonable provision for sound insulation was not required.
The approved document to part E of the building regulations provides guidance on ways of demonstrating compliance, including recommending forms of construction which have been shown to provide a reasonable standard of sound insulation in practice. As with other parts of the building regulations, they are administered by local authorities or approved inspectors who normally assess plans and carry out site visits.
My Department funds a programme of research at the Building Research Establishment to assess how the regulations are operating in practice. As noted above, the provisions for sound insulation were last strengthened in 1991, and they are kept under review. The need for, and the costs, benefits and practical implications of, post-construction testing, and any further provisions for impact sound transmission beyond those already covered by the regulations which might be considered necessary for the purpose of achieving a reasonable standard of health, are included in such reviews.
Rough Sleepers
Mr. Pike: To ask the Secretary of State for the Environment what information he has received regarding the numbers of rough sleepers (a) in London and (b) outside London; and what representations he has received regarding accommodation provision for them outside London.
Mr. Robert B. Jones: The 1991 census is the only national count of people sleeping rough. It found 2,650 people sleeping out in England, of whom 1,197 were in London, with most concentrated in the central London boroughs. Since 1990, the Government's £182 million rough sleepers initiative has been successful in reducing the number of people sleeping rough in central London by around three-quarters; 268 were found in a count undertaken by voluntary sector organisations in May 1994.
My Department receives occasional representations to extend the RSI outside central London. however, the initiative remains targeted on central London because the greatest concentrations of people sleeping rough remain there. Outside central London, it is the responsibility of each local authority to consider the housing needs of all people living in its area, including people sleeping rough, when drawing up its housing strategy. I commend to local
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authorities the RSI model of co-operation between statutory and voluntary organisations in meeting the needs of people sleeping rough.Housing Stock
Mrs. Maddock: To ask the Secretary of State for the Environment what is the total asset value of local authority owned housing stock.
Mr. Robert B. Jones: The Department has no direct data on the value of dwellings owned by local housing authorities.
However, for the purpose of setting guideline rents for housing revenue account subsidy, the value of each authority's stock is estimated, based on the pre-discount prices of recent right-to-buy purchases. For the year 1994 95, the total of these estimates for all English housing authorities was £151.43 billion.
Homelessness
Mr. Pike: To ask the Secretary of State for the Environment what guidelines are issued to local authorities regarding their statutory duty to house homeless 16 and 17-year-olds; and if he will make a statement.
Mr. Robert B. Jones: I refer the hon. Member to chapter 6 of the "Homelessness Code of Guidance to Local Authorities", third edition, 1991, issued under section 71 of the Housing Act 1985, a copy of which is in the Library.
Building Control Fees
Mr. Bill Michie: To ask the Secretary of State for the Environment what change has been made to building control fees for (a) local authority building control and (b) the National Housebuilding Council; and if he will make a statement.
Mr. Robert B. Jones: Changes to the fees local authorities charge for their building control work were made in the Building (Prescribed Fees) Regulations 1994, which came into force on 1 October 1994. The fees chargeable by the National House Building Council as an approved inspector are a matter for it.
Radioactive Waste
Mr. Betts: To ask the Secretary of State for the Environment (1) if local authorities will be allowed to refuse authority for the disposing of radioactive waste from the nuclear industry under the proposals contained in the consultation paper, "Review of Radioactive Waste Management Policy: Preliminary Conclusions";
(2) if the proposals in the consultation document, "Review of Radioactive Waste Management Policy: Preliminary Conclusions" will allow radioactive waste to be deposited in tips owned privately or by the Local Authorities Waste Disposal Companies Association.
Mr. Atkins: I refer the hon. Member to the reply I gave him on 6 December at column 132.
Mr. Betts: To ask the Secretary of State for the Environment what means he intends to take to ensure the ability of private owners of tips to comply with all necessary requirements before allowing the depositing of radioactive waste on such tips under proposals contained in the consultation document, "Review of Radioactive Waste Management Policy: Preliminary Conclusions".
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Mr. Atkins: The Government's consultation document "Review of Radioactive Waste Management Policy: Preliminary Conclusions" proposed that there might be advantage in encouraging waste producers to make greater use of the burial of low-level radioactive waste at landfill sites. This remains only a proposal, however, and there are no plans in relation to specific sites. The Government are considering the responses to the consultation document and will make a statement of future policy in due course.
Pollution Prosecutions
Ms Ruddock: To ask the Secretary of State for the Environment if he will list all prosecutions, and their outcome, initiated over the past three years in England and Wales by (a) Her Majesty's Inspectorate of Pollution, (b) the National Rivers Authority, (c) the London Waste Regulation Authority and (d) local waste authorities.
Mr. Atkins: I will write to the hon. Member.
Scrap Metal
Mr. Peter Ainsworth: To ask the Secretary of State for the Environment what plans he has to provide exemptions from waste management licensing for the recovery of scrap metal; and if he will make a statement.
Mr. Atkins: On 8 November I published a consultation paper setting out our proposals for exemptions from waste management licensing under part II of the Environmental Protection Act 1990 for the recovery of scrap metal and the dismantling of waste motor vehicles. The consultation paper invited comments by 5 December and proposed that waste management licensing should apply to these activities from 1 January 1995.
It is clear from the responses I have received that the period of transition to the new system is a matter of concern to both the industry and waste regulation authorities. There are two main reasons for this concern. The first arises from section 77(2) of the 1990 Act. Under the terms of this provision, licences issued under part I of the Control of Pollution Act 1974, which are in force when the new system is implemented, will be treated as site licences under part II of the 1990 Act. The second is the need for the industry and waste regulation authorities to have time to consider any regulations which are laid before Parliament, and the related statutory guidance on licensing, before the new system comes into force.
I recognise the importance of both these issues to the industry and waste regulation authorities. I have decided, therefore, that waste management licensing under part II of the 1990 Act should apply to the recovery of scrap metal and the dismantling of waste motor vehicles from 1 April 1995. I have made the necessary amendment to the commencement order to give effect to this decision.
I will now conclude my consideration of the responses to the consultation paper with the aim of laying the regulations providing any exemptions, and publishing the related statutory guidance on licensing, as early as possible in the new year.
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