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Mr. McLoughlin: To ask the Secretary of State for Health what plans there are to reconsider the present level of prescription charges; and if she will make a statement.

Mr. Malone: Judgments are made each year about how finite health resources can be best targeted for maximum health gain. Perscription charges are one aspect of these considerations. An announcement will be made at the appropriate time.

Burnley Healthcare NHS Trust

Mr. Gordon Prentice: To ask the Secretary of State for Health if the former chairman of Burnley Healthcare NHS Trust is disqualified from serving as the chairman or non-executive director of an NHS trust.

Mr. Malone: No.

Wheelchairs

Mr. Berry: To ask the Secretary of State for Health what plans she has to ensure that people who need indoor or outdoor wheelchairs can obtain then through the national health service.

Mr. Bowis: I refer the hon. Member to the reply I gave him on 24 November at column 321.

Mr. Berry: To ask the Secretary of State for Health if she will list all health authority wheelchair centres.

Mr. Bowis: A list of addresses of national health service wheelchair services will be placed in the Library.

Mr. Berry: To ask the Secretary of State for Health if she will make a statement on the statutory basis for the wheelchair service.

Mr. Bowis: I refer the hon. Member to the reply I gave him on 24 November at column 321 .

Birth Statistics

Mrs. Wise: To ask the Secretary of State for Health how many births took place in England and Wales in 1993; and how many took place in (a) NHS hospitals with consultation obstetric units, (b) other NHS hospitals, (c) other hospitals, (d) at home and (e) elsewhere.

Mr. Sackville: The available information is shown in the table.


Live and still births in England and Wales 1993              

             |Live births|Stillbirths|All births             

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

Total        |673,497    |3,855      |677,322                

Institutions |662,423    |3,781      |666,204                

At Home      |10,528     |60         |10,588                 

Elsewhere    |516        |14         |530                    

Note:                                                        

The "Institutions" total includes national health service    

hospitals-those with obstetrics and those without-other      

hospitals and other institutions. Information for 1993 is    

not available separately for types of institution.           

Parental Accommodation

Mr. Gordon Prentice: To ask the Secretary of State for Health how many general hospitals (a) provide and (b) do not provide overnight accommodation for parents visiting their sick children.

Mr. Etherington: To ask the Secretary of State for Health (1) if she will list by district health authority all children's hospitals giving (a) the total number of beds,


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(b) the total number and percentage of beds available for overnight parental accommodation and (c) the average annual number of overnight stays by parents;

(2) if she will list by district health authority all hospitals with children's wards giving (a) the total number of beds, (b) the total number and percentage of beds available for overnight parental accommodation and (c) the average annual number of overnight stays by parents.

Mr. Sackville: Information on parental overnight accommodation is not collected centrally. However, the Audit Commission report "Children First, A Study of Hospital Services" published in 1993, noted that most hospitals provide facilities for parents to stay overnight and indicated that in recent years there has been a considerable increase in the number of parents staying overnight. Information on numbers of children's hospital beds is available in "Bed Availability for England, Financial Year 1993 94", copies of which are available in the Library.

NHS Centre for Information Technology

Dr. Lynne Jones: To ask the Secretary of State for Health what legislation was invoked to establish the NHS Centre for Information Technology in 1985; to whom the NHS Centre for Information Technology is directly accountable; and what was the employment status of the staff at its establishment.

Mr. Sackville: In 1985, Ministers agreed to set up the National Health Service Centre for Information Technology through an agency agreement with the West Midlands regional health authority. It ceased to operate in March 1988. The centre was directly accountable for its work programme to the then NHS management board's director for information and planning. The staff were NHS employees and their contracts of employment were held by the regional health authority.

Ambulance Services

Sir Irvine Patnick: To ask the Secretary of State for Health (1) what is the total number of ambulances which contain trained paramedics operated by Trent regional health authority and the total number serving (a) the city of Sheffield, (b) south Yorkshire, (c) Greater Manchester and (d) the west midlands; and if she will make a statement;

(2) what is the total number of ambulances per head of population of the city of Sheffield operated by Trent regional health authority and the total number serving (a) the city of Sheffield, (b) south Yorkshire, (c) Greater Manchester and (d) the west midlands; and if she will make a statement;

(3) what is the total number of ambulances per head of population of the city of Sheffield which contain trained paramedics operated by Trent regional health authority; what is the total number serving (a) the city of Sheffield, (b) south Yorkshire, (c) Greater Manchester and (d) the west midlands; and if she will make a statement;

(4) if she will list the total number of ambulances operated by Trent regional health authority and the total number serving (a) the city of Sheffield, (b) south Yorkshire, (c) Greater Manchester and (d) the west midlands; and if she will make a statement.


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Mr. Sackville: Information on numbers of ambulances is available from national health service trusts. The information available on paramedics listed shows the unconfirmed results of an informal survey of numbers of paramedics and other front-line staff in each ambulance service in England at the end of 1993.


                                                                         |Total front-line                                                                                                                            

                                                                         |staff (including                                                                                                                            

Ambulance service                                                        |paramdeics)                                   |Paramedics                                                                                   

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

Ambulance service                                                        |Total front-line staff (including paramedics) |Paramedics                                                                                   

 Cumbria Ambulance NHS Trust                                             |180                                           |96                                                                                           

Durham County Ambulance Service NHS Trust                                |159                                           |54                                                                                           

Northumbria Ambulance Service NHS Trust                                  |357                                           |188                                                                                          

Humberside Ambulance Service NHS Trust                                   |285                                           |85                                                                                           

North Yorkshire Ambulance Service NHS Trust                              |183                                           |61                                                                                           

Derbyshire Ambulance Service                                             |232                                           |73                                                                                           

Leicestershire Ambulance and Paramedic Service                           |214                                           |60                                                                                           

Lincolnshire Ambulance and Health Transport NHS Trust                    |200                                           |80                                                                                           

Nottinghamshire Ambulance Service NHS Trust                              |250                                           |84                                                                                           

Cambridge Ambulance Service                                              |166                                           |62                                                                                           

Norfolk Ambulance NHS Trust                                              |246                                           |89                                                                                           

Suffolk Ambulances Service                                               |145                                           |36                                                                                           

Bedfordshire and Hertfordshire Ambulance and Paramedic Service NHS Trust |278                                           |133                                                                                          

Essex Ambulance Service NHS Trust                                        |377                                           |174                                                                                          

East Sussex Ambulance Service                                            |235                                           |90                                                                                           

Kent Ambulance Service                                                   |375                                           |138                                                                                          

West Sussex Ambulance Service                                            |175                                           |68                                                                                           

Dorset Ambulance Service NHS Trust                                       |178                                           |134                                                                                          

Hampshire Ambulance Service NHS Trust                                    |321                                           |134                                                                                          

Wiltshire Ambulance Service NHS Trust                                    |156                                           |77                                                                                           

Isle of Wight Ambulance Service                                          |48                                            |31                                                                                           

Royal Berkshire Ambulance NHS Trust                                      |168                                           |61                                                                                           

Two Shires Ambulance NHS Trust                                           |290                                           |101                                                                                          

Oxfordshire Ambulance Service                                            |134                                           |62                                                                                           

West Country Ambulance Services NHS Trust                                |752                                           |206                                                                                          

Gloucestershire Ambulance Service NHS Trust                              |165                                           |84                                                                                           

Hereford and Worcester Ambulance Service                                 |182                                           |108                                                                                          

Shropshire Ambulance Service                                             |125                                           |45                                                                                           

Staffordshire Service NHS Trust                                          |276                                           |98                                                                                           

Warwickshire Ambulance Service                                           |113                                           |63                                                                                           

Lancashire Ambulance Service                                             |368                                           |142                                                                                          

Cleveland Ambulance Service NHS Trust                                    |134                                           |69                                                                                           

West Yorkshire Metropolitan Ambulance Service NHS Trust                  |450                                           |122                                                                                          

South Yorkshire Metropolitan Ambulance and Paramedic Service NHS Trust   |250                                           |101                                                                                          

Surrey Ambulance Service                                                 |288                                           |124                                                                                          

London Ambulance Service                                                 |1,485                                         |394                                                                                          

Avon Ambulance Service NHS Trust                                         |190                                           |84                                                                                           

West Midlands Ambulance Service NHS Trust                                |523                                           |181                                                                                          

Mersey Regional Ambulance Service NHS Trust                              |552                                           |183                                                                                          

Greater Manchester Ambulance Service                                     |585                                           |204                                                                                          

Care Costs

Mr. Barry Jones: To ask the Secretary of State for Health what was the cost to the national health service of providing long-term care for the chronically sick and terminally ill for each of the last five years.

Mr. Bowis: Information on the cost of different services provided for the chronically sick and terminally ill is not aggregated centrally. People with long-term health care needs are supported by a wide range of professionals and services within the national health service including in- patient hospital care, general practitioner and primary care support, continuing care in hospital or an alternative facility and NHS contributions towards social services led packages of care.

I refer the hon. Member to the reply the Parliamentary Under-Secretary of State for Health, my hon. Friend the Member for Bolton, West (Mr. Sackville), gave the hon. Member for Wakefield (Mr. Hinchliffe) on 5 December at columns 89 90 , for information on palliative care.

Mr. Barry Jones: To ask the Secretary of State for Health what is the projected cost to the national health service of providing long-term care for the chronically sick and terminally ill in (a) 1995 96 and (b) 1996 97.

Mr. Bowis: Financial allocations are made to district health authorities and general practitioner fundholders. They will determine the specific levels of service required to meet local priorities and the needs of their local population.

Home Births

Mrs. Wise: To ask the Secretary of State for Health how many of the births which took place at home in 1993 were actually planned as home births.

Mr. Sackville: There were 10,588 home births in England and Wales in 1993, of which 10,528 were live births and 60 stillbirths. Information on how many of these births were planned as home births is not available.

Health Statistics

Mrs. Wise: To ask the Secretary of State for Health if she will now provide the tabulations corresponding to those mentioned in her answer of 27 October, Official Report , column 820 , from the maternity hospital episode system for 1992 93; and what plans her Department has to publish these tables in a statistical bulletin.

Mr. Sackville: The information requested will be placed in the Library. Future publication plans for


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information from the maternity hospital episode statistics system are currently under consideration.

Dementia

Mr. Barry Jones: To ask the Secretary of State for Health how many people with dementia there are in (a) each district health authority area and (b) each regional health authority area in England, Wales and Northern Ireland.

Mr. Bowis: We do not collect this information centrally but it is estimated that some 5 per cent. of the population aged 65 and over suffer from dementia. Information relating to Wales and Northern Ireland are matters for my right hon. Friend the Secretary of State for Wales and my right hon. and learned Friend the Secretary of State for Northern Ireland respectively.

Health Care International

Mr. McAllion: To ask the Secretary of State for Health which health authorities have contracted with the Health Care International hospital at Clydebank to treat patients from their area; how many patients were treated from each health board area; and what was the cost of the contract to the health authority concerned.

Mr. Sackville: North West regional health authority placed individual contracts with Health Care International for the treatment of some 57 patients at a total cost of £260,000.

Psychiatry and Human Rights

Sir Andrew Bowden: To ask the Secretary of State for Health what action she proposes to take in response to recommendation 1235 of 1994 of the parliamentary assembly of the Council of Europe relating to psychiatry and human rights; and if she will make a statement.

Mr. Bowis: The recommendation of the parliamentary assembly of the Council of Europe on psychiatry and human rights has yet to be formally adopted by the Council.

NHS Estate

Mr. Gordon Prentice: To ask the Secretary of State for Health what is the total value of the NHS estate in the current year; and what it was in 1979 in constant prices.

Mr. Sackville: The total value of the estate in the national health service, as at 1 April 1992, the last year in which it was valued, was £21,447,463,000. No valuation figures are available centrally for 1979.

Blood Transfusion Centres

Mr. Alton: To ask the Secretary of State for Health if she will make available copies of the representations received by the National Blood Authority about the closure of the five blood transfusion centres; and what has been the total number of letters, for and against.

Mr. Sackville: These are matters for the National Blood Authority, which has undertaken a thorough and widespread consultation. The results will be carefully considered before decisions are made.


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Hypertrophic Cardiomyopathy

Mr. Mackinlay: To ask the Secretary of State for Health how many deaths due to hypertrophic cardiomyopathy were recorded over the past 10 years; and if she will break down the figures by age group.

Mr. Sackville: A table showing the number of deaths for which hypertrophic obstructive cardiomyopathy-- CD*425.1--was stated as the cause will be placed in the Library, as will a table showing the number of deaths for which other primary

cardiomyopathies--ICD*425.4--were stated as the cause. Some of the latter include cases of hypertrophic non-obstructive cardiomyopathy, but it is not possible to make a count of such cases without disproportionate cost.

Mr. Mackinlay: To ask the Secretary of State for Health what research has been done, and what findings have been made, about the causes of the fatal hypertrophic cardiomyopathy condition and which groups are vulnerable; and if she will make a statement.

Mr. Sackville: It is believed that the majority of patients with hypertrophic cardiomyopathy have an inherited disorder. Therefore the families of those with the disorder are at risk of having the disease.

Ambulatory Care

Mr. Deva: To ask the Secretary of State for Health what experience has been gained elsewhere on the successful operation of an ambulatory care centre of the size of which is proposed for Guy's hospital which is separated from an in-patient service on another site; and what is her assessment of the practicability of the scheme.

Mr. Sackville: Patient care throughout the national health service is increasingly being delivered on a day case and out-patient basis and the proposals for an ambulatory care centre at Guy's would put it at the forefront of such developments.

Guy's and St. Thomas' NHS Trust has carried out considerable and detailed work on the proposals which are currently the subject of public consultation. My hon. Friend may wish to contact Lord Hayhoe, the chairman of the Guy's and St. Thomas's Hospital Trust, for further details of the proposals.

A copy of the consultation document "Looking to the Future" is available in the Library.

Chest Diseases

Mr. Redmond: To ask the Secretary of State for Health if she will initiate a study into the level of chest diseases of those who live close to opencast coal mining operations; and if she will make a statement.

Mr. Sackville: The expert Advisory Committee on the Medical Effects of Air Pollutants has considered the results of a study in 1992 and concluded that there was no clear evidence that it is injurious to health to live in an area where opencast coal mining is carried out.

In October the Departments of the Environment and of Health, together with 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, announced a £5 million research programme into the effects of air pollution on health, and invited research proposals. The closing date for proposals to be received is 30 December. Proposals for research into the health


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effect of opencast coal mining fall within the scope of this programme and, if submitted, will be considered for commissioning as part of the programme.

Sudden Infant Death Syndrome

Rev. Martin Smyth: To ask the Secretary of State for Health when she expects the recently appointed committee to investigate sudden infant deaths to report.

Mr. Sackville: The recently appointed expert group to investigate sudden infant death syndrome has been asked to report as soon as possible.

Mr. Tom Pinders

Mr. Redmond: To ask the Secretary of State for Health what steps were taken to ascertain the political views of Mr. Tom Pinders before his appointment.

Mr. Malone: None.

Private Health Care

Mr. Redmond: To ask the Secretary of State for Health is she will state the total payments made in respect of private health care provisions for the treatment of NHS patients in each of the last three years.

Mr. Sackville: The level of expenditure by the national health service on health care services from non-NHS providers over the last three years is as follows:

1991 92: £208.5 million

1992 93: £267.3 million

1993 94: £357.4 million (provisional)

Source:

Annual accounts of FHSAs, regional and district health authorities.

Financial returns of NHS trusts.

These figures include other non-NHS providers such as charitable and religious hospitals, hospices, MENCAP and, MOD hospitals. No figure is held for the level of expenditure with the private sector alone.

Accident and Emergency Departments

Mr. Deva: To ask the Secretary of State for Health what previous experience there is of closing an accident and emergency department the size of that at Guy's hospital.

Mr. Sackville: There have been a number of accident and emergency departments which have been replaced successfully with minor injuries units. In developing these plans, careful account has been taken to ensure that adequate alternatives would be available for those patients requiring full accident and emergency services.

The Lambeth, Southwark and Lewisham health commission is currently consulting widely on proposals for future services at Guy's hospital.

National Blood Authority

Ms Eagle: To ask the Secretary of State for Health (1) what steps she intends to take to make public a summary of the comments received by the National Blood Authority on its consultation document "The Future of the National Blood Service";

(2) if she will give a detailed timetable for the remaining stages of the consultation process on the


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National Blood Authority's document "The Future of the National Blood Service".

Mr. Sackville: These are matters for the National Blood Authority. The authority has undertaken a thorough and widespread consultation on its proposals. The results will be carefully considered before decisions are made.

Ms Eagle: To ask the Secretary of State for Health what steps she intends to take to bring the recommendations of the National Blood Authority before Parliament.

Mr. Sackville: The National Blood Authority has undertaken a thorough and widespread consultation. the results will be carefully considered before decisions are made.

Ms Eagle: To ask the Secretary of State for Health if she will make a statement on the appointment of zonal directors by the National Blood Authority, prior to the conclusion of the consultation process on the authority's document "The Future of the National Blood Service".

Mr. Sackville: When the National Blood Authority took over management control of the regional transfusion centres on 1 April 1994, the regional transfusion directors became directly accountable to the chief executive of the authority. The National Blood Authority decided that this change gave rise to the need for a new management structure based on three zones, notwithstanding the authority's proposals for reorganising the blood service.

Autism

Mr. Soley: To ask the Secretary of State for Health what assessment has been made of the auditory integration training for the treatment of autism; if she will make it available on the national health service; and if she will make a statement.

Mr. Bowis: Practitioners are free, within available resources, to offer desensitisation techniques such as auditory integration therapy if they consider it to be in the best interests of their patients.

Drugs (Poisoning)

Mr. Flynn: To ask the Secretary of State for Health what new proposals she has to improve the danger warning on labels of products on those medicinal drugs that have been involved in the fatal poisoning of more than five people in the most recent year for which figures are available.

Mr. Sackville: None at present. All medicines are labelled to show the recommended dose and any appropriate warnings. Consideration has been given to putting explicit warnings on the labels of medicines known to be implicated in accidental or deliberate poisonings but it is felt that such warnings may actually encourage misuse and overdose. The European Commission is currently considering the whole question of warnings on medicines labels and we will participate in finalising guidance as soon as proposals are available.

Clinical Waste

Mr. Parry: To ask the Secretary of State for Health what methods are now being considered for the disposal of clinical waste by the Royal Liverpool University hospital; and if she will make a statement.


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Mr. Sackville: This is a matter for the Royal Liverpool University Hospital National Health Service Trust, which has a duty to comply with all relevant statutory requirements.

Weighted Capitation

Mr. Bayley: To ask the Secretary of State for Health if she will supplement the information which she provided to the Health Select Committee, which was published as table 8.3 to the Committee's first special report in the 1993 94 Session, by specifying (a) the cash allocation and (b) the weighted capitation target figure in cash terms for each district health authority in 1994 95; and if she will also specify a notional weighted capitation target figure for 1994 95 for each English district health authority calculated on the basis of the modified formula described in annex 1 to the NHS executive's recent publication "HCHS Revenue Resource Allocation: Weighted Capitation Formula".

Mr. Sackville: Some figures have changed from those provided in table 8.3 following the receipt of amended data from regional health authorities. A revised table including the information requested will be placed in the Library.

There are no operational reasons for calculating notional 1994 95 capitation targets for district health authorities on the basis sought.

Mr. Bayley: To ask the Secretary of State for Health (1) if she will specify the HCHS weighted capitation target figure in cash terms for each English district health authority in 1995 96 on the basis of the capitation formula described as (a) current and (b) modified in annex 1 to NHS executive booklet "HCHS Revenue Resource Allocation: Weighted Capitation Formula", published this autumn;

(2) what cash allocation would be made to each English district health authority, including allocations to general practitioners fundholding practices in its area, in 1995 96 on the assumption that regional health authorities disburse their 1995 96 HCHS revenue allocations on the basis of the same percentage increase for each district health authority.

Mr. Sackville: For 1995 96 it is for regional health authorities to determine weighted capitation targets, including the formula used, and allocations for each of their districts. Similarly, the hypothetical figures sought on cash allocations can be calculated only by regional health authorities.

When the regional health authorities have determined hospital and community health services revenue allocations and capitation targets for their districts in 1995 96, we will undertake an exercise to collect this information in a comparable format.

Mr. Bayley: To ask the Secretary of State for Health if she will specify in cash terms the 1995 96 HCHS weighted capitation targets for each health region calculated on the capitation formula described as (a) current and (b) modified in annex 1 to the NHS executive's recent publication "HCHS Revenue Resource Allocation: Weighted Capitation Formula", in a form that is compatible with the 1995 96 HCHS revenue allocations to regions announced on 6 December.

Mr. Sackville: The modified targets referred to are shown in the table.


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