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Column 680
CLASS 4Lower Profits Limit
£6,640
Upper Profits Limit
£22,880
Contribution rate
7.3 per cent.
Notes
Revised in light of the decision not to proceed with the second phase of VAT.
Not contracted-out rates shown. A contracted-out rebate of 3 per cent. for employers and 1.8 per cent. for employees applies to earnings between the lower earnings limit and the upper earnings limit.
HEALTH
Hospitals
Mr. Bayley: To ask the Secretary of State for Health if she will publish a table which breaks down the data in table 16 of the Department of Health statistical bulletin 12/94, "NHS Hospital Activity Statistics: England 1983 to 1993 94", by regional health authority; and if she will also show the results in terms of number of each type of operation per 100,000 population in each age group in each region.
Mr. Sackville: Tables giving the available information will be placed in the Library. Information on finished consultant episodes broken down by region and by age is not available centrally.
Mr. Bayley: To ask the Secretary of State for Health if she will publish a table which breaks down the data in table 18 of the Department of Health statistical bulletin 12/94, "NHS Hospital Activity Statistics: England 1983 to 1993 94", by regional health authority; and if she will also show the results in terms of number discharged dead per 100,000 population in each age group in each region.
Mr. Sackville: The available information is shown in the table. Information on the numbers discharged dead, broken down by age group in each region, is not available centrally.
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Percentage discharged dead, by region, ordinary admissions, acute
sector NHS Hospitals, England
|1988-89|1989-90|1990-91|1991-92|1992-93
------------------------------------------------------------------
Northern |3.1 |3.4 |3.0 |3.3 |2.8
Yorkshire |2.4 |2.3 |2.2 |2.5 |2.2
Trent |3.3 |3.6 |3.7 |3.5 |3.1
East Anglian |2.6 |2.8 |2.7 |3.2 |2.6
North West Thames |3.0 |3.0 |3.0 |2.9 |2.5
North East Thames |3.6 |3.8 |3.7 |3.3 |3.5
South East Thames |2.7 |3.0 |3.1 |3.0 |2.8
South West Thames |3.0 |3.1 |3.1 |2.8 |2.8
Wessex |3.3 |3.1 |3.1 |3.0 |2.8
Oxford |3.0 |3.2 |2.9 |2.9 |2.8
South Western |3.2 |3.0 |2.8 |3.0 |2.8
West Midlands |2.8 |2.9 |3.8 |3.5 |2.9
Mersey |2.9 |2.9 |2.7 |3.1 |2.5
North Western |2.6 |2.7 |2.6 |2.5 |2.5
SHAs |2.2 |2.1 |2.2 |1.9 |1.8
Source:
Hospital Episode Statistics
NHS Trusts
Mr. Milburn: To ask the Secretary of State for Health if she will list by name the start-up costs for each national health service trust hospital, by region.
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Mr. Sackville: The information will be place in the Library.
Mr. Denham: To ask the Secretary of State for Health what was the total sum paid in the most recent year for which figures are available in (a) fees and salaries and (b)
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expenses to members of (i) NHS trust boards located in and (ii) health commissions serving Hampshire; and how many people serve on these bodies.Mr. Malone: There are currently nine trusts in Hampshire. They each have a chairman and five non-executive directors with the exception of the Hampshire Ambulance and Andover District Community Trusts which each have a chairman and four non-executive directors. There are three district health authorities which each have a chairman and five non-executive members.
In 1993 94 the remuneration of chairmen and non-executive directors of the six trusts then established totalled £230,000. Members expenses and the remuneration of district health authority executive and non-executive members is not available centrally.
Secure Hospital Accommodation
Mr. John Morris: To ask the Secretary of State for Health what representations she has received from the judiciary about the availability of secure hospital accommodation for mentally affected defendants; and if she will make a statement.
Mr. Bowis: There have been occasions where judges have expressed concern about the availability of hospital places for defendants requiring admission under the Mental Health Act 1983. These have been resolved through local action.
The difficulties have centred mainly on the availability of medium secure psychiatric places. Up to 1979, following the 1975 Glancy report, no medium secure places had been developed. There are now more than 700 purpose-built medium secure places in national health service hospitals in England and a further 600 places in interim NHS units and the private sector. We have allocated more than £45 million from central funds over the period 1991 95 to increase the number of NHS places to nearly 1,200 by the end of 1996.
Winter Warmth Campaign
Sir Andrew Bowden: To ask the Secretary of State for Health how many inquiries have been made to the winter warmth campaign information line since its launch.
European Year of Older People
Sir Andrew Bowden: To ask the Secretary of State for Health what contributions her Department has made in 1994 to follow up the European Year of Older People and Solidarity between Generations in 1993.
Mr. Bowis: The Department funded an evaluation seminar and will shortly be publishing a report on the Year. This will include the results of an evaluation by an independent consultant whose recommendations we shall consider carefully.
We have provided £20,000 towards a new voluntary sector team--the United Kingdom European resource unit--to take forward the work of the year.
Hospice Expenditure
Mr. Beggs: To ask the Secretary of State for Health what percentage of hospice expenditure in England and Wales is publicly provided.
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Mr. Sackville: The information for England is not available centrally. Information relating to Wales is a matter for my right hon. Friend the Secretary of State for Wales.
Toxocariasis
Sir Graham Bright: To ask the Secretary of State for Health how many cases for toxocariasis there are each year; and what assessment she has made of the main available source of the disease.
Mr. Sackville: The main source of toxocara infection is dog faeces. The Public Health Laboratory Service's communicable disease surveillance centre receives an average of about 50 laboratory reports of toxocariasis per year--not all caused by toxocara infection in dogs--the vast majority of these positives being reported because there has been some eye infection or disease. It is, however, acknowledged that there is probably a degree of under-reporting of this condition because the infection is self-limiting, and the infection may be either asymptomatic or very mild. The centre believes that it is not unreasonable to accept that there are between 100 and 200 new cases of toxocaral eye infection or disease--not necessarily causing severe damage to eyes--each year in the United Kingdom. Toxocariasis is not a notifiable disease.
Sir Graham Bright: To ask the Secretary of State for Health what information she has about the proportion of infants carrying antibodies to the parasitic worm, toxicara; and what action she plans to take to reduce the problem.
Mr. Sackville: It is estimated that between 2 and 3 per cent. of the general population possess antibodies to toxocara species, suggesting that about 1 million people in the United Kingdom have been infected at some time. No antibody surveys have been undertaken specifically among children aged less than 12 months. However a survey in Bedford, conducted among children aged three to seven years in 1981, found that 14.6 per cent. possessed antibody. These data suggest that the majority of infections are acquired in childhood. Toxocariasis is an avoidable illness which can easily be prevented by dog owners worming their dogs regularly and by cleaning up their dog's faeces. Basic hygiene procedures, such as wearing gloves when gardening and washing hands after gardening or, with children, when they have been playing in the garden or parks should be followed. The Department of Health provides a grant to the charity Community Hygiene Concern which produces information for the public on toxocariasis and also supports the work of the Department of the Environment to encourage responsible dog ownership.
Complementary Medicine
Mr. Gordon Prentice: To ask the Secretary of State for Health if she will list those health authorities that purchase complementary medicine.
Mr. Sackville: Lists of services purchased by health authorities are not available centrally.
Powick Hospital, Worcestershire
Mr. Purchase: To ask the Secretary of State for Health how many patients were treated at Powick hospital, Worcestershire, with lysergic acid diethymide during the period 1964 to 1975; and if she will make a statement.
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Mr. Bowis: I refer the hon. Member to the Worcester and District health authority.
Excimer Laser Keratectomy
Mr. Cousins: To ask the Secretary of State for Health what information she has as to the incidence of side-effects on complications following excimer laser keratectomy.
Mr. Sackville: The College of Ophthalmologists has established a sub -committee to look at all aspects of laser treatment, including such side- effects of excimer laser treatment as haziness of the cornea, irritation of the eye, glare, subsequent long sight or persistent short sight.
The long-term side effects associated with laser treatment are not yet known.
Schizophrenia
Dr. Lynne Jones: To ask the Secretary of State for Health what approaches were made by the inquiry into the care of Michael Buchanan to, (a) local members of the National Schizophrenia Fellowship and (b) other local organisations about the issues raised by this case.
Mr. Bowis: The independent inquiry was established by the North West London Mental Health National Health Service Trust. The hon. Member may wish to contact the trust for information about the conduct of the inquiry.
Supervision Register
Mr. Hinchliffe: To ask the Secretary of State for Health what additional services are available to someone placed on a supervision register.
Mr. Bowis: Supervision registers are designed to help local services identify those patients who should receive the greatest priority for care and treatment. Whether an individual placed on a register requires additional services is a matter for clinical or professional judgment in each case.
Mr. Hinchliffe: To ask the Secretary of State for Health what provision exists for advising individuals (a) of their inclusion on a supervision register and (b) that information from the supervision register has been given to a third party.
Mr. Bowis: The guidelines on the introduction of registers make clear that patients who are placed on the supervision register should be informed orally and in writing at the time. They should be told why they are on the register, how the information on the register will be used and to whom that information may be disclosed.
Mr. Hinchliffe: To ask the Secretary of State for Health what organisations have made representations regarding supervision registers for the mentally ill; and if she will list those which are in favour and those against.
Mr. Bowis: The Department consulted a number of organisations and individuals in the statutory and voluntary sector on the draft guidelines on the introduction of supervision registers and received a number of very helpful comments. Those who were consulted officially are shown in the table. Of those consulted only two organisations were against registers in principle, namely MIND and the Association of Metropolitan Authorities.
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Organisations and individuals consulted over the draft guidelineson the introduction of supervision registers
Afro-Caribbean Mental Health Association
National Schizophrenia Fellowship
MIND
MINDLINK
Mental Health Foundation
Manic Depression Fellowship
SANE
Survivors Speak Out
United Kingdom Advocacy Network
Richmond Fellowship
Good Practices in Mental Health
Mental Health Act Commission
Royal College of General Practitioners
Royal College of Psychiatrists
Community Psychiatric Nurses Association
Royal College of Nurses
British Psychological Society
College of Occupational Therapists
Association of Metropolitan Authorities
Association of County Councils
Association of District Councils
Association of Directors of Social Services
London Boroughs Association
British Association of Social Workers
Special Hospitals SHSA
Association of Chief Officers of Probation
Data Protection Registrar
National Association of Health Authorities and Trusts
Institute of Health Services Management
Mr. Hinchliffe: To ask the Secretary of State for Health what monitoring is being carried out on the operation of supervision registers for the mentally ill.
Mr. Bowis: It is the responsibility of health authorities to ensure that mental health service providers with which they contract establish and maintain supervision registers. Progress on the implementation of supervision registers is being monitored closely by the National Health Service Executive.
Mr. Hinchliffe: To ask the Secretary of State for Health what external advice she has received on the legality of supervision registers for the mentally ill.
Mr. Bowis: None. We are satisfied as to their legality.
Mr. Hinchliffe: To ask the Secretary of State for Health what has been the cost of setting up the supervision registers; and what the sources of funding have been.
Mr. Bowis: Supervision registers are an integral part of the care programme approach which was introduced in April 1991. The additional administrative costs involved in the introduction of supervision registers should be minimal and will be met from existing resources.
Mr. Hinchliffe: To ask the Secretary of State for Health in what circumstances the contents of a supervision register can be passed to the police.
Mr. Bowis: Supervision registers are health records. As with other health records, information should be disclosed to a third party such as the police without the patient's consent only if that disclosure can be justified in the public interest.
Mr. Hinchliffe: To ask the Secretary of State for Health what provisions exist for the review of or appeal against placement on a supervision register for the mentally ill.
Mr. Bowis: Patients who are placed on a supervision register can request a review to consider their withdrawal
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from the register. If the patient remains dissatisfied with the outcome of that review the normal channels of complaint and the right to a clinical second opinion apply.Mr. Hinchliffe: To ask the Secretary of State for Health how many people she expects to be placed on supervision registers for the mentally ill.
Mr. Bowis: Before the deadline for full implementation of registers it was estimated that between 5,000 and 10,000 people nationally were likely to be placed on registers. Early indications are that the estimate was correct.
Children (Nutrition)
Mr. Jim Cunningham: To ask the Secretary of State for Health (1) whether she has discussed with the Secretary of State for Social Security measures to combat malnutrition in children of poor families;
(2) what recent representations she has received about the diet of children of low-income families; and if she will make a statement; (3) what plans she has to assist children of poor families suffering from malnutrition.
Mr. Sackville: A small number of the responses to the 1993 consultation on the nutrition task force's draft action programme referred to the potential difficulties of eating healthily on a low income. I refer the hon. Member to the replies I gave the hon. Member for Bristol, East (Ms Corston) on 27 June, Official Report column 413 4 and 19 July at column 143 5 for more recent representations about diet and nutrition of children in different socio-economic circumstances.
Malnutrition is a term which covers a wide variety of single or combined deficiencies of nutrients and/or energy. Although there is some evidence that iron intakes are low in children there is no evidence that this is particularly a problem in low-income families. There is no other evidence of public health problems from inadequate nutrient intakes.
The welfare food scheme continues to provide a nutritional safeguard for children aged under five in families on income support.
The nutrition task force has set up a project team to consider ways of assisting people on a low income to choose a healthy diet. In establishing the team, my right hon. Friend the Secretary of State for Social Security was consulted.
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