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Mrs. Beckett: To ask the Secretary of State for Health (1) what information she has about the number of hours general practitioners spent on paperwork in March 1991 and currently;
(2) what information she has about differences in time spent on paperwork between general practitioners in fundholding and in non-fundholding practices.
Mr. Malone: Information in the form requested is not available.
Special Advisers
Mr. Vaz: To ask the Secretary of State for Health, pursuant to her answer to the hon. Member for Darlington (Mr. Milburn) of 1 December, Official Report, column 832 , if she will make a statement regarding her Department's expenditure on special advisers in each of the last three financial years and for the financial year 1979 80.
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Mr. Sackville: I refer the hon. Member to the reply that my right hon. Friend the Chief Secretary gave on 19 December 1994, Official Report, column 937.
Alcoholism
Dr. Lynne Jones: To ask the Secretary of State for Health what plans she has for the co-ordination of alcohol services and other functions carried out by regional alcohol co-ordination following the intended demise of the regional health authorities; and what is to become of the funds made available to regional health authority's following circular HN(89)4 to provide for regional alcohol co-ordinators.
Mr. Bowis: The report, "Public Health in England: Roles and Responsibilities of the Department of Health and the NHS", copies of which are available in the Library, makes it clear that health authorities will be expected to continue alcohol-related work. There will be a gradual process of devolution of specialist advice from regional offices as the recommendations of the functions and manpower review take effect and it will be for health authorities to decide the form this should take. Regional offices will be responsible for ensuring that robust and appropriate arrangements are in place. Finance for alcohol co-ordination work was made available to regional health authorities in 1989 90 and added into their general funding in 1990 91.
Health Authority Staff
Mr. Redmond: To ask the Secretary of State for Health how many staff were employed by each health region in 1993 94; and how many were administrative.
Mr. Malone: The information is shown in the table. At 30 September 1993, administrative and clerical staff made up 17.3 per cent. of the total national health service work force in England. Over a quarter of administrative staff work in direct support of clinicians, allowing them to concentrate their skills and experience on direct patient care.
Total national health service staff and administrative staff
employed in each region as at 30 September 1993
Whole-time equivalents
|Administration and
|clerical |Total
----------------------------------------------------------------------------
Northern |7,030 |48,560
Yorkshire |9,140 |57,810
Trent |10,980 |73,790
East Anglia |4,660 |31,050
NW Thames |8,590 |44,900
NE Thames |10,420 |60,060
SE Thames |9,760 |53,410
SW Thames |7,070 |42,440
Wessex |6,800 |45,540
Oxford |6,040 |34,810
South Western |7,880 |52,010
West Midlands |13,020 |81,720
Mersey |5,970 |37,350
North Western |11,060 |68,680
SHA's and Others |14,230 |34,570
England Total |132,650 |766,710
Source:
Department of Health Medical and Non-Medical Workforce Censuses.
Note:
All figures are independently rounded to the nearest ten whole-time
equivalents.
Family Health Services
Mr. Campbell-Savours: To ask the Secretary of State for Health what is the level of spending per head of population on family health service services in England; and if her answer of 1 December, Official Report , column 830 , included such expenditure.
Mr. Malone: Gross expenditure on family health services per head of population in England in 1993 94 was £157.
The reply that I gave the hon. Member for Darlington (Mr. Milburn) on 26 May 1994 at column 305 gave per head of population spending figures for each family health services authority in England for 1992 93.
The information is not directly comparable because the figures relate to different years, and the earlier answer recorded expenditure by FHSAs on an accruals basis whereas the national figure of £157 specifically reflects spending in cash terms on family health services. Key differences are that the FHSA data include GP fundholders' purchases of hospital services and FHSA administration costs, and exclude dental services administered centrally by the dental practices board and the income from prescription and dental charges collected by FHS contractors.
Sudden Infant Death Syndrome
Sir David Steel: To ask the Secretary of State for Health what plans she has to increase funding for research into sudden infant death syndrome.
Mr. Sackville: The main agency for Government funding of research into sudden infant death syndrome and respiratory distress syndrome is 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. Between 1991 92 and 1992 93, the last two years for which figures are available, spending on this area of research rose by almost 117 per cent., from £747,000 to £1.62 million.
The Department is currently funding two research projects through its central research programme which are both examining changes in infant care practice following the "Back to Sleep" campaign. Estimated expenditure on these totals £408,257 between 1993 and 1996.
In 1995, the Department will be continuing with a further £200,000 special in-depth study using the mechanism of the confidential inquiry into stillbirths and deaths in infancy to examine possible new, avoidable factors leading to sudden and unexplained deaths in infancy. This is in addition to £200,000 which has been spent on the project already this year.
The need for further research into sudden infant death syndrome is kept under regular review. New research is commissioned as soon as the need arises, as exemplified by the chief medical officer's recent announcement of the formation of an expert group to steer further work on cot death and to examine the likelihood of a causal link between chemicals and cot death.
Maternity Contracts
Mrs. Wise: To ask the Secretary of State for Health what arrangements she has made for piloting the maternity contract minimum data set; and if she will list the sites where it will be piloted, who will be responsible,
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the duration and costs of the piloting exercise and when a report of the piloting is expected to be available.Mr. Sackville: No arrangements are in place for piloting the maternity contract minimum data set. These will be made following consultation on the content of the proposed data set.
Mrs. Wise: To ask the Secretary of State for Health what discussions her Department has had with the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners and the British Paediatric Association about the content of the maternity contract minimum data set; and when she proposes to place a copy of the consultation document in the Library.
Mr. Sackville: The Department of Health consulted widely on the content of the maternity, community and mental health contract minimum data set during 1993, and held meetings to gain the views of representatives of the healthcare professional bodies.
The outcome of the consultations is included in five documents which will be placed in the Library:-- "CMDS Volume 1 Overview"; "CMDS Volume 2 Community Health Services"; "CMDS Volume 3 Maternity Services"; "CMDS Volume 4 Mental Health Services" and "CMDS Volume 5 Data Models".
Subsequent work during 1994 concentrated on the community contract minimum data set. As work on the maternity contract minimum data set has resumed, further discussions will be held with the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners and the British Paediatric Association.
Breast Screening
Mrs. Wise: To ask the Secretary of State for Health for what reasons no information was available for the former North West Thames region in the tables of data from the maternity hospital episode system for 1991 92 which she placed in the Library following her answer of 27 October, Official Report, column 820.
Mr. Sackville: During 1991 92, changes were undertaken to the hospital information systems in North West Thames region. Problems were encountered in re-establishing links to collate some centrally required maternity data, and the region was unable to provide full data. These difficulties have been resolved and maternity information for the former North West Thames region is available for subsequent years.
Recycled Paper
Mr. Redmond: To ask the Secretary of State for Health if she will make it her policy that all Government Departments NHS and NHS trust authorities and other non-departmental public bodies should publish all reports on recycled paper.
Mr. Sackville: Departments are encouraged to purchase paper and board containing as much recycled fibre as possible without impairing performance. National health service and NHS trust authorities, along with other non-departmental public bodies, make their own purchasing decisions, but we would expect them to consider the environmental issue.
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Road Accident Victims
Mr. Redmond: To ask the Secretary of State for Health under what statutory authority hospitals may request payment for treatment from road accident victims; and if she will make a statement.
Mr. Sackville: Hospitals are empowered to collect an emergency treatment fee of £20.65 under section 158 of the Road Traffic Act 1988. The fee must be covered by motor vehicle insurance policies and is payable by vehicle users in respect of each person given immediate treatment or examination arising from a road traffic accident. Charges may also be made, under section 157, for subsequent in-patient or out-patient hospital treatment, up to ceilings of £2, 856 and £286 respectively. These charges are levied directly on insurance companies, but only in cases where companies make third party payments.
Diabetes
Mr. Battle: To ask the Secretary of State for Health what is her Department's current policy on the provision of supplies for the treatment of diabetes.
Mr. Sackville: Human and animal insulin and disposable syringes to dispense it are available on prescription where necessary for the treatment of diabetes.
Mr. Battle: To ask the Secretary of State for Health if novo pen (a) cartridges and (b) needles used by diabetics are available on prescription.
Mr. Malone: The cartridges of insulin for the novo pen II injection device are available on national health service prescription; the needles that fit them are not.
Disabled Children
Mr. Alan Howarth: To ask the Secretary of State for Health how many families with children with disabilities have been provided with respite care for each year since 1990; and what proportion has been provided to them in their own homes.
Mr. Bowis: The available information, which relates only to children accommodated by local authorities under section 20 of the Children Act 1989, is shown in the table. This does not include families whose children are not accommodated by local authorities, but may receive respite care under section 17 of the Act within their own homes or elsewhere.
Children accommodated by local authorities under section 20
of
the Children Act 1989 because parents need relief from
problems
or stresses of caring for children with disabilities,
England.
Period<1> ending
31 March
|1992 |1993
-------------------------------------------------------------
Series of short term placements covered by
one agreement<2> |1,600|3,600
Single placement<2><3> |900 |1,400
<1> Periods 14 October 1991 to 31 March 1992 and 1 April
1992 to 31 March 1993. No comparable information is
available prior to implementation of the Act on 14 October
1991.
<2> Some children may be counted in both categories if their
type of care changed during the period.
<3> Most children in single placements were receiving long
term
care.
Mr. Alan Howarth: To ask the Secretary of State for Health what action her Department has taken since the publication of the Children Act report 1993 and the social services inspectorate report on the national inspection of services to disabled children and their families in 1994 to improve implementation of the Children Act 1989 with respect to these children and their families.
Mr. Bowis: Following the publication of "Services to Disabled Children and their Families" and other information about the implementation of the family support provisions of the Children Act the SSI organised six workshops across England to disseminate the findings and discuss with local authorities how improvements can be achieved.
Ninety two local authorities attended the workshops, and there was widespread commitment to seeking ways to improve services. A report of the workshop discussions is being prepared.
Our continuing interest in services for disabled children and their families is demonstrated by the inclusion of a further inspection in the SSI work programme for 1995 96. The findings will be published in due course.
NHS Guidelines
Mr. Battle: To ask the Secretary of State for Health (1) if she has issued guidance giving further clarification on the issues of (a) setting eligibility criteria, (b) assessment of patients and (c) service provisions;
(2) if her Department has issued guidance on the NHS responsibility for meeting long-term health care needs following the consultation exercise carried out over the summer.
Mr. Bowis: We are considering the results of the consultation exercise. A final version of the guidance will be issued in due course.
Health Authorities
Mr. Redmond: To ask the Secretary of State for Health what was the cash allocation for health authorities' discretionary use in each year since 1988 89 and in 1994 95; and what was the percentage change in each year.
Mr. Sackville: The allocations for resident population for hospital and community health services for 1991 92 to 1994 95, including capital charges, are shown in the table. Figures for earlier years are not available on a comparable basis.
|Allocation for
Year |resident population|per cent. change
--------------------------------------------------------------------------------
1991-92 |£17,283,812,000
1992-93 |£18,909,977,000 |9.41
1993-94 |£19,731,477,000 |4.34
1994-95 |£20,569,646,000 |4.25
Medicines
Mr. Trotter: To ask the Secretary of State for Health if she will make it her policy that the system of regulation imposed by the Medicines Act 1968 will be maintained to ensure that medicines are not marketed without a product licence.
Mr. Sackville: From 12 January this year, no medicinal product for human use, unless specifically exempt from
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licensing, may be placed on the market in the United Kingdom except in accordance with a licence issued by the United Kingdom Licensing Authority under the Medicines for Human Use (Marketing Authorisations Etc.) Regulations 1994 or the Medicines Act 1968, or, in a small number of cases, an authorisation issued by the European Commission.Children Act 1989
Mr. Alan Howarth: To ask the Secretary of State for Health if her Department has completed work on the pilot questionnaire to produce regular statistics on the Children Act 1989; and in what areas information will be collected.
Mr. Bowis: No general questionnaire is planned as regular statistics are already collected and published to monitor local authority implementation of many of the key aspects of the Act. The most recent figures were presented to Parliament in the Children Act report 1993, copies of which are available in the Library. Information is not regularly collected centrally at present on local authority support for children and families under section 17 of the Act. A questionnaire was sent to local authorities in September 1994 to identify the information they collect for their own use in implementing this section of the Act. Response to this questionnaire is not yet complete.
Mr. Alan Howarth: To ask the Secretary of State for Health what funding her Department has made available to local authorities to assist with the implementation of the Children Act 1989.
Mr. Bowis: In general, central Government support to local authorities is not allocated to individual services; it is for local authorities to decide on the allocation of resources between particular services in the light of local needs and priorities. Implementation of the Children Act 1989 was, however, one of the factors which influenced the relevant revenue support grant settlements. Standard spending for children's services in the current year is 17 per cent. in real terms above 1990 91.
Leather Preservatives
Mr. Battle: To ask the Secretary of State for Health if she will commission research into the carcinogenic properties of leather preservatives; and if she will make a statement.
Mr. Sackville: We are not aware of any particular concern regarding the carcinogenic potential of leather preservatives, and have no plans for commissioning work in this area.
The International Agency for Research into Cancer reviewed the data in leather tanning and processing industries, and in the manufacture of leather goods, in 1987 and concluded that there is no evidence to warrant classification of these processes in causing cancer.
Creuzfeldt-Jakob Disease
Mr. Battle: To ask the Secretary of State for Health how many cases of Creuzfeldt-Jakob disease were diagnosed in the United Kingdom in each year since 1990; and if she will break down cases by occupation.
Mr. Sackville: There have been 166 definite and probable cases of Creutzfeldt-Jacob disease since 1990. Details are shown in the table.
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Year |Total
---------------------------------
1990 |31
1991 |36
1992 |51
1993 |40
1994 (to April) |8
Total for the period |166
A breakdown of these cases by occupation is not available centrally and could be provided only at disproportionate cost. A demonstration of the broad range of lifetime occupations of 50 definite and probable cases is at table 7 of the third annual report of the Creutzfeldt Jakob Surveillance Unit. Copies of the report are available in the Library.
AIDS
Dr. Goodson-Wickes: To ask the Secretary of State for Health what funds have been made available for the treatment of AIDS in 1993 94 and 1994 95 in (a) absolute terms and (b) as a percentage of the NHS budget.
Mr. Sackville: The amount of funding made available specifically for the treatment of HIV and AIDS services was £148 million in 1993 94 and £164 million in 1994 95. As a percentage of the total NHS budget, we estimate this to be approximately 0.5 per cent. in each year.
Electronic Mail
Mrs. Anne Campbell: To ask the Secretary of State for Health when she expects to be able to receive and respond to communications via electronic mail.
Mr. Sackville: Electronic mail is used throughout the Department of Health and its agencies. However, there are no immediate plans for my right hon. Friend the Secretary of State to receive or respond to external communications by electronic mail.
The Department of Health is consulting widely to determine how best to develop electronic mail links with other Government Departments, organisations and electronic networks. These discussions are part of a wider study on external communications.
The Department will consider establishing electronic mail links with external contacts only when it is sure that it can receive and respond to electronic mail communications effectively without risking the security of confidential or personal information.
Hospitals, Manchester
Mr. Alfred Morris: To ask the Secretary of State for Health what progress has been made in the version of the Wythenshawe hospital development scheme and the clinical review of hospital services in south Manchester since her answer of 21 June, Official Report , column 119 ; and if she will make a statement.
Mr. Sackville: Professor Sir Herbert Duthie's review of clinical services in south Manchester was received by North West regional health authority at its meeting in November 1994. The review broadly endorsed the proposals for Wythenshawe hospital. Manchester district health authority has been asked to draw up a new public consultation document outlining those needs of the local population that can be met on the site of Withington hospital. Consultation is planned to begin in February.
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The RHA has set up a steering group to ensure that there are no further unnecessary delays in developing services in south Manchester. In the meantime, the South Manchester university hospital national health service trust continues to develop its plans for major capital investment at Wythenshawe hospital.Doctor's Letters
Mr. Battle: To ask the Secretary of State for Health how many general practitioners make a charge for doctor's letters required to assist a patient's application for social housing; and if she will make a statement.
Mr. Malone: General practitioners provide a range of services outside the national health service which are considered as private matters between patient and doctor. Such services, of which no record is held, include the writing of letters to provide medical information to a third party, such as a local authority housing department. Doctors are free to charge for such services, as they wish.
Tobacco
Mr. Lewis: To ask the Secretary of State for Health what is the status of the proposed voluntary agreement on tobacco promotion between herself and the industry; and when she expects the agreement to be concluded.
Mr. Sackville: The new voluntary agreement on tobacco products advertising and promotion was published on 21 December, copies of which are available in the Library.
Heart Disease
Sir Russell Johnston: To ask the Secretary of State for Health what assessment she has made of research at Harvard medical school on the practice of hydrogenating vegetable oils to produce solid fats and the effect on coronary heart disease.
Mr. Sackville: The committee on medical aspects of food policy has considered the issue of hydrogenation and has examined a wide range of research evidence, including that of Harvard medical school, for its report "Nutritional Aspects of Cardiovascular Disease", copies of which will be placed in the Library. COMA has recommended that the intake of transfatty acids in the population should not increase beyond the current average and that consideration should be given to ways of decreasing the amount present in the diet.
Smoking
Mr. Peter Bottomley: To ask the Secretary of State for Health what is her estimate of the proportion of smokers among lone mothers on income support.
Mr. Sackville: Data on the proportion of smokers amongst lone mothers on income support are not available centrally. Surveys indicate that the levels of smoking amongst lone parents and amongst low-income families are significantly higher than in the population as a whole.
Mr. Peter Bottomley: To ask the Secretary of State for Health what is her estimate of the proportion of smokers among doctors.
Mr. Sackville: The available information from a 1989 survey by the Commission of the European Communities showed that 10 per cent., of general medical practitioners in the United Kingdom were smokers. There is no
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information collected concerning the smoking habits of doctors working in other fields.Telephone Dialling Codes
Mr. Donohoe: To ask the Secretary of State for Health what assessment has been made as to the additional costs which will be incurred by her Department as a result of the changes in national telephone dialling codes next year; and how much this change will cost her Department in additional expenditure.
Mr. Sackville: The Department will not incur additional costs as a result of changes to national telephone dialling codes. Changes to the Department's telephone exchanges will be done as part of our standing maintenance arrangements and the printing of stationery with the new codes will be contained within our existing financial allocations.
Health Authorities
Mr. Chidgey: To ask the Secretary of State for Health (1) what is the total budget for Hampshire family health services authority in the financial year 1994 95;
(2) what was the total annual budget of (a) Winchester, (b) Basingstoke and north Hampshire and (c) Portsmouth and south-east Hampshire district health authorities in the financial year 1994 95.
Mr. Sackville: This is a matter for the South and West regional health authority. The hon. Member may wish to contact the chairman, Rennie Fritchie, for details.
Mr. Chidgey: To ask the Secretary of State for Health what is the total annual budget for the Wessex regional health authority for 1994 95.
Mr. Sackville: The initial cash limit for hospital and community health services for Wessex regional health authority for 1994 95 was set at £1,345,359,000 in December 1993. This figure does not include demand- led spending on family health services or money allocated since then. Wessex regional health authority ceased to exist on 1 April 1994 when it was replaced by the new South and West regional health authority.
Hypertrophic Cardiomyopathy
Mr. Mackinlay: To ask the Secretary of State for Health if she will make available a screening programme for athletes, sports people and young people in order to reduce hypertrophic cardiomyopathy deaths.
Mr. Sackville: A genetic screening test is currently being investigated. An effective screening programme would probably need to be focused on affected families since the disease is inherited.
Stomach Ulcers
Mr. Nicholas Winterton: To ask the Secretary of State for Health what has been the total expenditure by the national health service in each of the last five years for which figures are available on (a) Zantac, (b) Cimetidine and (c) Tagamet.
Mr. Sackville: The data for Zantac and Tagamet are commercially confidential. Information in respect of Cimetidine is shown in the table.
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>
Prescribing information for the chemical entity cimetidine
|1991 |1992 |1993
--------------------------------------------------------------
Prescriptions (thousands) |2,617.4 |2,635.4 |2,608.9
Net Ingredient Cost
(£ thousands) |48,333.9|45,860.7|33,816.0
Figures are based on items and cover all prescriptions
dispensed by community pharmacists, appliance contractors,
dispensing doctors and also include prescriptions submitted
by prescribing doctors for items personally administered.
Mr. Nicholas Winterton: To ask the Secretary of State for health (1) in what percentage of cases of stomach ulcers (a) Zantac, (b) Cimetidine, (c) Tagamet or (d) other acid blockers are prescribed;
(2) what information she has concerning the percentage of cases of stomach cancer in which (a) Zantac, (b) Cimetidine, (c) Tagamet or (d) other acid blockers are prescribed.
Mr. Sackville: This information is not available centrally.
Mr. Nicholas Winterton: To ask the Secretary of State for Health what information she has concerning the comparative typical costs of a full course of treatment for stomach ulcers involving (a) antibiotics for helicobacter whether or not in conjunction with acid blockers and (b) a course of acid blockers not in association with antibiotics for helicobacter; and if she will make a statement.
Mr. Sackville: The medicines resource centre has published data on comparative costs on the treatment of duodenal ulcers, copies of which have been placed in the Library.
Mr. Nicholas Winterton: To ask the Secretary of State for Health what consideration she has given to the implementation of a screening programme involving a short course of antibiotics for helicobacter as a means of substantially reducing the incidence of (a) stomach ulcers and (b) stomach cancer; how the costs of such a programme might compare to a typical course of treatment involving acid blockers over a period of several years and surgery to remove all or part of the stomach; and if she will make a statement.
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