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Trends over time indicate that the proportion of energy intake derived from total fats has remained comparatively steady while that from saturated fatty acids has been declining.In 1994 the Government published "Smoke Free for Health" and "Eat Well!" setting out action plans for achieving the smoking and diet targets respectively. Each document sets out the range of measures being taken.
General Practitioners
19. Mr. Brandreth: To ask the Secretary of State for Health what changes there have been in the number of general practitioners in the past decade; and if she will make a statement.
Mr. Malone: The number of general medical practitioners in England rose from 23,640 at 1 October 1984 to 26,387 at 1 April 1994, an increase of 12 per cent.
Community Care
20. Mr. Gordon Prentice: To ask the Secretary of State for Health when she next expects to meet disability organisations to discuss the implications for disabled persons of the Government's community care policy.
Mr. Bowis: I meet disability organisations on a regular basis and discuss a range of issues including community care. I also meet the national user and carer group every six months. The group is made up of users from a wide range of community care client groups and carers and provides information on the progress being made with the community care reforms by local and health authorities from a user's and carer's perspective.
Mr. Thurnham: To ask the Secretary of State for Health which local authorities have not submitted audited returns detailing community care spending in 1993 94.
Mr. Bowis: Audited returns detailing community care spending in 1993 94 for 29 local authorities have not yet been received by the Department. The outstanding returns are being followed up through the Audit Commission. A list of the relevant authorities is as shown. List of local authorities whose audited returns have not yet been received by the Department of Health.
Metropolitan Authorities
Birmingham
Bolton
Bury
Coventry
Manchester
Rochdale
Sheffield
Wirral
County Councils
Berkshire
Cheshire
Gloucestershire
Hampshire
Hereford and Worcester
Hertfordshire
North Yorkshire
Northamptonshire
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NorthumberlandNottinghamshire
London Boroughs
Bexley
Brent
Ealing
Greenwich
Hackney
Haringey
Hillingdon
Islington
Kensington
Richmond Upon Thames
Sutton
Winter Illnesses
21. Mr. Cohen: To ask the Secretary of State for Health what estimate she has made of the adequacy of NHS resources to cope with flu and flu-type illnesses this winter.
Mr. Sackville: Every year the Department runs an immunisation campaign aimed at people who are at particular risk of serious illness or death.
At the first sign of an impending epidemic, the Department alerts health authorities and trusts so that local contingency plans can be made.
The national health service reimburses general practitioners for the purchase of influenza vaccine. The cost of vaccine purchased during 1993 94 was about £27 to £28 million. Year-on-year increases in uptake are expected.
GP Fundholders
22. Mr. Jenkin: To ask the Secretary of State for Health what proportion of the population is currently served by a GP fundholder; and what proportion she expects this to be from April.
Mr. Malone: Some 35 per cent. of the population in England is currently served by a fundholding general practitioner. Final figures for 1995 96 are not yet available.
Mr. MacShane: To ask the Secretary of State for Health what assessment she has made of the amount of general practitioner fundholders' budgets which is being spent on medical services outside the NHS in the last 12 months.
Mr. Malone: I refer the hon. Member to the reply my hon. Friend the Under-Secretary gave the hon. member for Darlington (Mr. Milburn) on 9 December 1994 Official Report, column 401.
Mr. MacShane: To ask the Secretary of State for Health what guidance she has given the health commissions in respect of those general practitioner fundholders who have overspent their budget.
Mr. Malone: Guidance on financial matters relevant to the general practice funding scheme was issued to health authorities in EL(91)36 and covered by the general practitioner fundholders' manual of accounts, 1993, copies of which are in the Library.
West Midlands Regional Health Authority
23. Mr. Thomason: To ask the Secretary of State for Health what savings she expects to result from the abolition of the West Midlands regional health authority.
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Mr. Malone: I refer my hon. Friend to the reply my hon. Friend the Under-Secretary of State gave my hon. Friend the Member for Harborough (Mr. Garnier) earlier today.
Community Care
24. Mr. Kirkwood: To ask the Secretary of State for Health when she next expects to meet the Association of Directors of Social Services to discuss resources available for the implementation of community care.
Mr. Bowis: We have regular contacts with the association and discuss a wide range of issues, including community care.
Accident and Emergency Departments
25. Mr. Eastham: To ask the Secretary of State for Health how many hospital accident and emergency departments have closed since 1979, and since April 1991.
Mr. Sackville: The information is not available centrally.
27. Mr. Simon Hughes: To ask the Secretary of State for Health what is her estimate of the number of (a) beds and (b) accident and emergency departments needed in London.
Mr. Sackville: District health authorities are responsible for purchasing hospital and other services for their resident populations, with general practitioner fundholders also purchasing some care for patients on their lists. In addition, districts are responsible for purchasing accident and emergency services for all-comers in their area, and for ensuring that, where major changes to the pattern of local services are proposed, full public consultation takes place.
Consultant Episodes (Private Patients)
26. Mr. Bryan Davies: To ask the Secretary of State for Health what is the percentage increase in finished consultant episodes on private patients on NHS premises between 1990 91 and the latest available date.
Mr. Sackville: Between 1990 91 and 1992 93 there was an increase in private patient finished consultant episodes in the national health service in England of 21.8 per cent. Private patient episodes in the NHS are about one per cent. of total episodes.
Waiting Times, Essex
28. Dr. Spink: To ask the Secretary of State for Health what assessment she has made of the impact of Essex county council's budgetary overspend on social services on waiting times in Essex hospitals.
Mr. Malone: We have made no comprehensive assessment of this impact but recent visits to two otherwise well-run national health service trusts in Essex have made it clear to me that the county council's failure to make arrangements for discharge of patients is having a direct impact on hospitals' ability to admit new patients for elective surgery.
Teenage Pregnancies
Dr. Lynne Jones: To ask the Secretary of State for Health if she will make a statement on progress in meeting
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"The Health of the Nation" targets for teenage pregnancies.Mr. Sackville: The year 1991 saw the first fall in 10 years in the under-16 conception rate. Provisional figures for 1992 are broadly in line with 1991. Concerted effort is necessary if a downward trend is to be maintained.
Minimal Access Surgery
Mr. Illsley: To ask the Secretary of State for Health what representations she has received regarding the dangers of minimal access surgery; and how many hospital re-admissions occurred in the last year as a result of the failure of that type of surgery.
Mr. Sackville: We have received a number of letters about the risks and benefits of minimal access surgery. Information on readmissions following minimal access surgery, or for any other reason, is not available centrally.
Public Bodies
Mr. Patten: To ask the Secretary of State for Health if she will list those public bodies for which she retains departmental responsibility; which of these bodies have been identified as suitable for placing in the private sector; and by when it is expected each of these bodies will enter the private sector.
Mr. Sackville: The public bodies for which the Department has responsibility are listed in "Public Bodies 1994". None have been identified as suitable for privatisation. As part of the usual quinquennial review process, the Department critically examines both the need for its public bodies and whether control of their business should reside in the private sector.
NHS Trusts
Mr. Redmond: To ask the Secretary of State for Health what plans she has to order NHS trusts to stop the practice of NHS trusts soliciting voluntary contributions from persons treated for road accident injuries.
Mr. Sackville: We have no evidence of national health service trusts seeking voluntary contributions. All health service hospitals, including those managed by NHS trusts, are empowered to collect the emergency treatment fee under section 158 of the Road Traffic Act 1988. The fee, which must be covered by motor vehicle insurance policies, is payable by vehicle users in respect of each person given immediate treatment or examination arising from a road traffic accident.
Mr. Redmond: To ask the Secretary of State for Health if she will advise all NHS trusts to finance a patients' friend and arrange that the postholder is accountable only to the appropriate community health council.
Mr. Sackville: This is a matter for individual trusts.
Professions Supplementary to Medicine Act 1960
Mr. Alfred Morris: To ask the Secretary of State for Health if she will make a statement on the Government's intentions in regard to the future of the Professions Supplementary to Medicine Act 1960.
Mr. Sackville: The Government accept the case for examining how far this legislation provides an adequate framework for professional self- regulation. We intend to commission an independent review of the current operations of the statutory bodies concerned. We shall
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bring forward for consultation specific proposals for change in the light of the outcome of that review.Convictions (Disclosure)
Mr. Redmond: To ask the Secretary of State for Health what plans she has to require all organisations tendering for NHS authority or trust business to declare convictions for fraud or professional misconduct.
Care Fees
Sir Andrew Bowden: To ask the Secretary of State for Health what estimate she has made of the number of people who have had to sell their homes to pay for fees in a residential or nursing home since 1990.
Mr. Bowis: The value of a resident's interest in a property can be taken into account only if he or she has moved permanently to residential accommodation. It must be ignored in certain circumstances, for example if the resident's spouse still lives in it. If it does have to be taken into account, the local authority may put a charge on the property which is not recovered until the property is eventually sold.
Information about the number of properties actually sold in order to meet charges for residential accommodation is not available centrally.
Directors
Mr. Redmond: To ask the Secretary of State for Health if chairmen and non-executive directors of health authorities and trusts are informed on appointment of the number of hours per week or month that they would normally be expected to devote to their duties.
Mr. Malone: The matter of the number of hours per week or month which chairmen and non-executive directors of health authorities and national health service trusts will be expected to devote to their duties forms part of a comprehensive discussion between the appropriate regional health authority and prospective nominees before their names are submitted to Ministers, or, in the case of appointments made by regional health authorities, before formal appointment is made.
Club 18-30
Dr. Lynne Jones: To ask the Secretary of State for Health what assessment she has made of the effect of the current poster advertising campaign of Club 18-30 on "The Health of the Nation" targets for teenage pregnancies and sexual health; and what plans she has to make representations to those responsible for these posters.
Mr. Sackville: None. Club 18-30 is a commercial enterprise. It would not be appropriate for the Government to intervene in the company's choice of advertising material. Complaints about the nature or content are a matter for the Advertising Standards Authority.
Consultants
Mr. Cousins: To ask the Secretary of State for Health what guidance she has issued since the National Health Service and Community Care Act 1990 on the limitation of NHS consultants' private work sessions, or private
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work income; and on what occasions such guidance has later been withdrawn or amended.Mrs. Beckett: To ask the Secretary of State for Health what guidance she has issued to NHS consultants on doing private work at the same time as their NHS (a) out-patients work, (a) surgeries, (c) ward rounds and (d) other clinical sessions.
Mr. Malone: I refer the right hon. Member to the reply I gave to the hon. Member for Cynon Valley (Mrs. Clwyd) on 2 February, columns 837-38 .
Mrs. Beckett: To ask the Secretary of State for Health what guidance her Department has issued on the maximum time NHS consultants with maximum part-time contracts can spend working in the private sector during their normal working week.
Mr. Malone: Guidance is contained in the national terms and conditions of service for national health service consultants.
Specialties
Mr. Sheerman: To ask the Secretary of State for Health what action she is taking to increase the numbers of doctors specialising in neurology and anaesthesiology.
Mr. Malone: Considerable attention is given to medical work force planning. The aim is to provide an adequate supply of
appropriately-trained doctors in each specialty. The agreed policy of achieving a balance, introduced in 1987, is overseen by the Advisory Group on Medical Education, Training and Staffing. This policy encourages consultant expansion of at least 2 per cent. per year. Consultant posts are also funded under the new deal and the part-time consultant scheme.
However, the establishment of new consultant posts is a matter for local employing authorities and they should have regard to competing priorities and available resources.
For doctors in higher specialist training, senior registrar and career registrar quotas set by the Joint Planning Advisory Committee are still in operation. It is necessary to ensure an appropriate supply of doctors, and numbers of higher specialist trainees in any specialty must therefore depend on the best available predictions of future consultant opportunities in that specialty.
Liquid Fuels
Mrs. Anne Campbell: To ask the Secretary of State for Health what health risks have been identified from the emissions from burning secondary liquid fuel.
Mr. Sackville: The likely health effects of emissions from the burning of fuel cannot be determined unless the specific components of the fuel, and the method and temperature of its combustion, are known.
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