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Myalgic Encephalomyelitis
Mr. Harry Greenway: To ask the Secretary of State for Health what guidance she gives to local health authorities for the treatment of myalgic encephalomyelitis; and if she will make a statement.
Mr. Sackville: The production of guidance on the treatment of what is increasingly being referred to as chronic-fatigue syndrome is a matter for the health care professions and not for the Department. The Department may however commend to purchasers guidelines which have been accepted by all the professional bodies.
The national task force on CFS/PVFS--post-viral fatigue syndrome--ME which is autonomous of the Department of Health, has produced a report. With a view to securing progress and promoting the development of a professional consensus, the chief medical officer has invited the conference of colleges to consider the report. A response from the conference is not expected until spring.
Maternity Wards
Mr. Milburn: To ask the Secretary of State for Health how many maternity wards have been provided in hospitals in each of the last five years.
Mr. Sackville: Information about the number of maternity wards is not available centrally. However, data on the number of available beds in maternity units are contained in the publication "Bed Availability for England--Financial Year 1993 94", copies of which are available in the Library.
GP Fundholders
Mr. Milburn: To ask the Secretary of State for Health how many general practitioner fundholders have overrun their budgets; and by what level.
Mr. Malone: In 1992 93, the latest year for which audited information is available, 147 general practitioner fundholders overspent their budgets. The overspend was £9.8 million or 1.2 per cent. of total fundholder budgets.
Mrs. Beckett: To ask the Secretary of State for Health what is the number of general practitioner fundholding practices and the total number of general practitioners who are fundholders.
Mr. Malone: There are currently 2,040 general practitioner fundholding practices and 8,760 general practitioner fundholders in England.
Mrs. Beckett: To ask the Secretary of State for Health what was the average budget for fundholders in 1991 92, 1992 93 and 1993 94 and the comparable budget held by district health authorities for non-fundholders in those years.
Mr. Malone: I refer the right hon. Member to the reply the then Minister for Health, my right hon. Friend the Member for Peterborough (Dr. Mawhinney), gave the hon. Member for Bristol, South (Ms Primarolo) on 20 June 1994, columns 26 27.
Mrs. Beckett: To ask the Secretary of State for Health what are the average waiting times for fundholders and
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non-fundholding general practitioners' patients; and if she will make a statement.Mr. Malone: It is not possible to calculate separate average waiting times for patients from general practitioners fundholders and non- fundholding GPs from centrally held data.
Ambulance Response Times
Mr. Cohen: To ask the Secretary of State for Health what is the average time taken for the London ambulance service to arrive at the scene following an emergency 999 call.
Mr. Sackville: London ambulance service figures show that following an emergency call the average time taken for an ambulance to arrive at the scene is 14.5 minutes.
Rules and Regulations
Mr. Steen: To ask the Secretary of State for Health if she will list the rules and regulations in her Department which have been withdrawn in the last 12 months, or which her Department plans to withdraw in the next 12 months; and what impact this will have on her Department's manpower.
Mr. Sackville: We withdrew three sets of regulations in 1994 relating to medicines control. A good deal of deregulatory activity consists of amending or replacement regulation, or new and better guidance, rather than withdrawal. For example, we have amended regulations to allow more medicines to be sold over the counter without the need for a prescription; issued new guidance on welfare inspections of independent boarding schools and on regulation of day care for young children, reduced the number of boarding schools required to register as children's homes; and widened choice of venue for people getting married. The Department is continuing to consider rules and regulations for possible withdrawal or simplification. Details will be announced as and when consultations are completed. There are no manpower effects for the Department, but we are committed to reducing staffing in the central Department by 21 per cent. by April 1997.
NHS Trusts (Borrowing)
Mr. Milburn: To ask the Secretary of State for Health if she will list those trusts that have received either (a) a loan from her Department or (b) an overdraft guarantee in each year since their inception, indicating (i) the amount concerned and (ii) the reason for its allocation.
Mr. Sackville: Information on loans and guarantees will be placed in the Library. No information is available on the reasons why loans are drawn. Trusts borrow principally to support their capital investment activities, but may also borrow to cover working capital requirements. All the borrowing detailed was within agreed limits. Trusts use overdrafts to cover very short-term working capital requirements. The purpose of overdraft guarantees is to reduce the cost of this borrowing from the trusts' bankers.
Health Care, East Anglia
Mr. David Porter: To ask the Secretary of State for Health what savings she expects to result from the
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abolition of the Anglia and Oxford regional health authority; and how many of those savings will be put into health care in East Anglia.Mr. Malone: By 1997 98, total annual savings from the abolition of regional health authorities are expected to be around £100 million. These substantial savings will be retained by the national health service and thus will be available to be reinvested in patient care.
Dental Services
Mr. Burden: To ask the Secretary of State for Health what are the regulations concerning the provision by the NHS of out-of-hours dental cover for (a) patients registered with an NHS dentist and (b) patients not registered with an NHS dentist; and if she will make a statement on the content of those regulations.
Mr. Malone: The regulations concerning the provision of out-of-hours emergency dental cover, for both registered and unregistered patients, are contained in the National Health Service (General Dental Services) Regulations 1992.
The terms of service for general dental practitioners contained in these regulations require dentists to make reasonable arrangements to ensure that patients registered with them for capitation or continuing care can get treatment in an emergency.
Regulation 14 of these regulations enables family health services authorities to make arrangements for treatment in urgent cases of patients who have difficulty obtaining treatment. FHSAs organise emergency sessions at health centres at weekends and bank holidays, mainly for unregistered patients.
Mr. Burden: To ask the Secretary of State for Health if she will list by family health services authority the arrangements which exist for emergency dental cover out of hours; and what procedures are in place to monitor the extent and quality of these arrangements.
Mr. Malone: Emergency dental services for registered patients are the responsibility of their dentists. For non-registered patients, information about emergency dental services is obtained in an annual survey of family health services authorities in England and Wales. The results for 1993 94 are available in the Library. It is for each FHSA to manage the general dental service locally, and this will include monitoring the extent and quality of such emergency arrangements.
Cervical Smears
Mrs. Beckett: To ask the Secretary of State for Health what estimate she has made of the percentage of United Kingdom women being offered cervical smears three-yearly or less.
Mr. Sackville: This information is not available centrally for England. Information relating to Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales and for Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland.
Mrs. Beckett: To ask the Secretary of State for Health what guidance is issued to hospitals in respect of charging for cervical smears if done more frequently than every five years; and what is the recommended charge.
Mr. Sackville: None. It is for individual health authorities to negotiate contracts with hospitals to provide
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a cervical screening service for their resident population, in accordance with national guidelines.Computerisation
Mrs. Beckett: To ask the Secretary of State for Health what was the expenditure on computerisation in primary care in each of the last five years.
Mr. Sackville: Reimbursement of the costs for computerisation in general practice are shown in the table. The amount reimbursed in 1990 91, when the scheme was introduced, includes claims for the years 1989 90 and 1990 91.
Year |£ million ------------------------------ 1990-91 |17.5 1991-92 |34.0 1992-93 |40.2 1993-94 |38.4
Drug Dispensing (Qualifications)
Mrs. Beckett: To ask the Secretary of State for Health what qualifications are required for staff dispensing drugs in a general practitioner's dispensing practice.
Mr. Malone: The responsibility for ensuring the competence of staff dispensing drugs in general practitioners' practices lies with the doctor who is subject to the enforcement provisions of the Medicines Act 1968.
General Practitioners (Administrative Costs)
Mrs. Beckett: To ask the Secretary of State for Health what are the administrative costs of all general practice per general practitioner.
Mr. Malone: This information is not available centrally.
Waiting Times
Mrs. Beckett: To ask the Secretary of State for Health what guidance she has on the maximum waiting time for repair of an aortic aneurysm.
Mr. Malone: It is not appropriate to have a maximum waiting time for repair of an aortic aneurism. Each case is different and it must be for the clinician to decide whether surgical treatment is appropriate and when surgery should be performed. Patients are placed on a waiting list only if, in the opinion of a clinician at the time of assessment, their condition is judged to be stable.
Mrs. Beckett: To ask the Secretary of State for Health what was the total of days patients have waited in each of the last five years for treatment in NHS hospitals.
Mr. Malone: The information requested cannot be derived from waiting time data available centrally.
Resuscitation Facilities
Mrs. Beckett: To ask the Secretary of State for Health if she will make a statement on the availability of resuscitation facilities at (a) King's College hospital and (b) other hospitals while invasive cardiac investigations and treatments are being undertaken.
Mr. Sackville: Full resuscitation facilities are available at King's College hospital, Denmark Hill, in all areas
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where invasive cardiac investigations are undertaken. Full resuscitation facilities are also available on the King's College hospital, Dulwich, site although no invasive cardiac procedures are carried out there. Resuscitation facilities are generally available in other specialist hospital departments where risk of cardiac arrest is high.Infectious Material (Postal Services)
Mrs. Beckett: To ask the Secretary of State for Health (1) what evidence she has that human tissue and infectious material sent through the post has posed a health hazard; how many cases arose in the last year; and what the hazardous material was;
(2) what guidance she has on the packaging of human tissue samples and infectious material when sent through the post; and what status this guidance has.
Mr. Sackville: No such cases were reported last year. There is a range of measures to safeguard against infection as a result of the postal transport of pathology specimens. There is no evidence that these measures are inadequate. The Post Office guide sets out the requirements under the Post Office Telecommunications Act, 1969--revised 1981--for sending specimens through the post, and carriage by rail or road is covered by new Health and Safety Executive regulations on the classification, packaging and labelling of dangerous goods for carriage by road and rail, 1994. The transportation of certain pathogens listed in the Health and Safety (Dangerous Pathogens) Regulations 1981, all the provisions of which have been subsumed into the new Control of Substances Hazardous to Health Regulations 1994, requires prior notification to the Health and Safety Executive which will notify the appropriate Health Minister. The Health and Safety Commission's health service advisory committee guidance on safe working and the prevention of infection in clinical laboratories 1991 refers to the procedures which laboratories should observe in dispatching material. In all work situations, the potential for exposure to infection from material either in transit or under examination has to be assessed under COSHH and the appropriate safe working procedures adopted.
Prescribing Costs
Mrs. Beckett: To ask the Secretary of State for Health what assessment she has made of the prescribing costs of (a) a dispensing general practitioner and (b) non-dispensing general practitioner.
Mr. Malone: Information is contained in the annual report of the Prescription Pricing Authority for the period 1 April 1993 to 31 March 1994, copies of which are available in the Library.
Accumulated Assets
Mrs. Beckett: To ask the Secretary of State for Health what is the total amount of accumulated assets of trust hospitals and directly managed units in each year since 1989.
Mr. Sackville: District health authorities did not account for fixed assets, and there were no trusts, prior to 1991 92. Information for 1991 92 to 1993 94 is shown in the table.
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Accumulated assets
|DMUs<1> |NHS trusts
|£ |£
------------------------------------------------------------
1991-92 |15,028,465,000|2,651,111,000
1992-93 |12,268,968,000|6,465,354,000
1993-94 |Note 1 refers |12,464,800,000
Source:NHS Summarised accounts.
<1> Directly Managed Units.
Notes:
1. In 1993-94 district health authorities were not required
to provide a separate figure for DMUs.
2. The 1993-94 figures are provisional.
3. The figures represent the total assets employed by DMUs
and NHS trusts-fixed assets plus net current assets.
Care in the Community
Mr. Hinchliffe: To ask the Secretary of State for Health what distinction she makes between (a) community care and (b) care in the community; and if she will make a statement.
Mr. Bowis: Community care, as used in the National Health Service and Community Care Act 1990, refers to the provision of services and support which people who are affected by problems of aging, illness or disability need to be able to live as independently as possible in their own homes, or in residential care. Care in the community is a term used specifically to refer to policies for mentally ill people and people with learning disabilities which enable them to live as full, independent and normal lives in or as near to the community as possible.
Bereaved Relatives
Mrs. Beckett: To ask the Secretary of State for Health what guidance is available for the treatment of relatives of patients who die within (a) King's College hospital and (b) other hospitals; and if she will make a statement.
Mr. Sackville: Guidance, which applies to all hospitals, is contained in HSG(92)8, copies of which are available in the Library.
Departmental Staff
Mr. Byers: To ask the Secretary of State for Health how many staff her Department employs on a regional basis in each standard English region; what is the cost of running these regional operations; what was the total budget for each region in the latest available year; and what are the main purposes for which the budget is used.
Mr. Sackville: The information requested on staff employed in each of the standard English regions is shown in the table. Information about departmental running costs by region is not available. Details of the Departments' gross running costs are provided in the Department's annual report for 1994 95, Cm 2512.
Region ----------------------------------- Scotland |- Northern |14 Yorks and Humberside |896 North West |679 East Midlands |55 West Midlands |120 Wales |- East Anglia |- South East |2,894 South West |19 Northern Ireland |- Overseas |- Source: MANDATE returns to Treasury from Chessington Computer Centre. Notes: 1. Figures include inward loans and secondments, fixed term appointments and staff in Agencies. 2. Figures exclude casual and industrial staff and outward loans and secondments.
Closures
Mrs. Beckett: To ask the Secretary of State for Health (1) if she will list the hospitals or trusts in respect of which she has been formally consulted about partial or complete closure in the last three years;
(2) pursuant to her answer of 19 December, Official Report, column 983, what information is held regarding the number of accident and emergency departments currently threatened with closure or that have closed since April 1991;
(3) what information is provided to her Department by district health authorities, trusts, regional health authorities and NHS Executive on (a) hospital closures, (b) ward closures, (c) accident and emergency department closures, (d) reducing NHS beds and (e) increasing private beds and bed units;
(4) pursuant to her answer of 19 December, Official Report, column 983 , how many hospital closures in England since April 1991 are known to her Department following objection to a proposed closure from a community health council;
(5) pursuant to her answer of 19 December, Official Report, column 983, what information her Department does not collected which is collected by the Scottish, Welsh and Northern Ireland offices on the number of hospitals closed since April 1991 or the number of accident and emergency departments currently threatened with closure.
Mr. Sackville [holding answer 13 January 1995]: The Department does not routinely collect information on hospital, ward or accident and emergency department closures. Information is available centrally on proposals to close, or change the use of, health service facilities which are referred to Ministers for decision following objections from a community health council. A list of such proposed closures referred to Ministers in the period 1992 94 is available in the Library.
The Department collects information on the number of national health service beds which is published annually in the booklet "Bed Availability for England", copies of which are available in the Library. Information on private beds in NHS hospitals is not collected centrally. However, information on the number of private non-NHS beds is collected and published annually in "Private Hospitals, Homes and Clinics Registered Under Section 23 of the Registered Homes Act 1994", copies of which are also available in the Library.
Information collected by the Scottish, Welsh and Northern Ireland offices on hospital closures and accident and emergency departments threatened with closure is a matter for my right hon. Friends the Secretaries of State
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for Scotland and for Wales and my right hon. and learned Friend the Secretary of State for Northern Ireland.DEFENCE
Operation Granby
Mr. Clifton-Brown: To ask the Secretary of State for Defence what indications there were that (a) chemical and (b) biological weapons were used by the Iraqi forces, or anyone under their command, during Operation Granby.
Mr. Soames: This is a matter for the Chemical and Biological Defence Establishment, Porton Down, under its framework document. I have asked the chief executive CBDE to write to the hon. Member. Letter from Graham Pearson to Mr. Geoffrey Clifton-Brown, dated 6 February 1995:
1. Your Parliamentary Question to the Secretary of State for Defence asking him what indictions there were that (a) chemical and (b) biological weapons were used by the Iraqi forces, or anyone under their command, during Operation GRANBY has been passed to me to answer as Chief Executive of the Chemical and Biological Defence Establishment.
2. There are no indications or evidence to suggest that the Iraqi forces or anyone under their command used chemical or biological weapons against the British Armed Forces during Operation GRANBY.
Correspondence
Mr. Wilson: To ask the Secretary of State for Defence when he intends to reply to the letter of 7 December 1994, from the hon. Member for Cunninghame, North, concerning the death of Fusilier G. Riley; and if he will make a statement.
Mr. Soames: My noble friend the Parliamentary Under-Secretary of State will reply shortly.
Land, Scotland
Dr. Godman: To ask the Secretary of State for Defence how many acres of land are currently occupied by (a) the Army, (b) the Royal Air Force and (c) the Royal Navy in Scotland; what proposals he has to acquire more land, in Scotland; for any of the armed forces; and if he will make a statement.
Mr. Soames: At 31 March 1994, the latest date for which records are available, the land occupied by the Armed Forces in Scotland was (a) the Army--20,883 acres (b) the Royal Air Forces--9,482 acres and (c) the Royal Navy--16,116 acres. There are no proposals to acquire more land in Scotland at this time.
HMS Andromeda
Dr. David Clark: To ask the Secretary of State for Defence what plans he has for HMS Andromeda; and if he will make a statement.
Mr. Freeman: It is planned to sell HMS Andromeda and initial negotiations, by the Disposal Sales Agency with a friendly overseas navy, are in train. It is not our practice to discuss details of such negotiations in the interests of customer confidentiality.
Dr. David Clark: To ask the Secretary of State for Defence when the last refit of HMS Andromeda took place; and what was its cots.
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Mr. Freeman: The last refit of HMS Andromeda was undertaken between August 1990 and December 1991 at a total cost of some £27 million.
Dr. David Clark: To ask the Secretary of State for Defence what recent valuations have been placed on HMS Andromeda.
Mr. Freeman: Valuations of HMS Andromeda form part of the negotiations being considered on her sale. It is not our practice to discuss details of such negotiations in the interests of customer confidentiality.
Rules and Regulations
Mr. Steen: To ask the Secretary of State for Defence if he will list the rules and regulations in his Department which have been withdrawn in the last 12 months, or which his Department plans to withdraw in the next 12 months; and what impact this will have on his Department's manpower.
Mr. Freeman: My Department is playing a full part in the deregulation initiative. As a non-regulatory Department, the Ministry of Defence has focused its efforts on relieving unnecessary administrative burdens on its suppliers; streamlining contracts procedures; and improving communications with industry.
Whitehall Expenditure
Mr. Malcolm Bruce: To ask the Secretary of State for Defence what has been the total annual expenditure on Whitehall organisations included in the Defence budget,
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for each year since 1979, expressed in 1994 prices and broken down by organisation.Mr. Soames: The information is not available in the form requested and could not be compiled without disproportionate cost.
Trident
Mr. Malcolm Bruce: To ask the Secretary of State for Defence what estimate he has made of the potential savings which would be made by reducing the number of warheads developed, purchased and maintained for the Trident nuclear weapons programme, to the average of the number of Polaris- based nuclear warheads deployed between 1984 and 1990.
Mr. Freeman: None. Our plans are based on sustaining through the life of Trident, the minimum deterrent capability required for the security of the United kingdom.
Army Reserve
Mr. Malcolm Bruce: To ask the Secretary of State for Defence what was the (a) total manpower and (b) the cost of supporting the United Kingdom Army Reserve for each year since 1979 in 1994 prices.
Mr. Soames: The total manpower of the United Kingdom Army Reserve for each year since 1979 is as follows.
The costs of supporting the United Kingdom Army Reserve are spread out among a wide variety of budgets and cannot therefore be identified in the form requested.
Strength of the Army Regular Reserves (Male and Female)
Thousands
|1979 |1980 |1981 |1982 |1983 |1984 |1985 |1986
---------------------------------------------------------------------------------
Regular Reserves |126.9|133.1|137.4|140.1|138.2|143.2|150.2|153.9
Territorial Army<1> |59.4 |63.3 |69.6 |69.1 |72.8 |71.4 |73.7 |77.7
Ulster Defence Regiment<2> |7.6 |7.4 |7.4 |7.2 |7.1 |6.7 |6.4 |6.5
Home Service Force<3> |- |- |- |- |0.3 |0.3 |0.9 |3.0
Thousands
|1987 |1988 |1989 |1990 |1991 |1992 |1993 |1994
---------------------------------------------------------------------------------
Regular Reserves |160.4|167.7|175.3|183.5|187.7|188.6|190.1|192.5
Territorial Army<1> |78.5 |74.7 |72.5 |72.5 |73.3 |71.3 |68.5 |65.0
Ulster Defence Regiment<2> |6.6 |6.3 |6.3 |6.2 |6.1 |6.0 |- |-
Home Service Force<3> |3.3 |3.1 |3.0 |3.2 |3.3 |2.9 |0.2 |-
Falkland Islands
Mr. Malcolm Bruce: To ask the Secretary of State for Defence what is his estimate of the annual level of defence expenditure relating to the protection of the Falkland islands for each year since 1983; and what is his estimate of the current annual level of defence expenditure per household for (a) the Falkland islands and (b) the United Kingdom.
Mr. Soames: The annual cost of defence expenditure relating to the protection of the Falkland islands is as follows:
|£ million
------------------------------
1983-84 |637
1984-85 |644
1985-86 |572
1986-87 |402
1987-88 |229
1988-89 |102
1989-90 |68
1990-91 |66
1991-92 |72
1992-93 |58
1993-94 |67
The cost to each United Kingdom household of defence expenditure in the Falkland islands was approximately £2.90 in 1993 94, the latest year for which figures are available.
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The total defence cash limit for the United Kingdom in 1994 95, is £22,735,585,000 representing a cost to each United Kingdom household of approximately £981 this financial year.No statistics are held by the Ministry of Defence that would enable the calculation of Defence Expenditure per household in the Falkland islands.
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