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Mr. Bowis: Some local authorities have cited the popularity of the policy as a reason for increased demand for community care as a factor which is placing their services under pressure. It is for authorities to manage such factors within the context of the increased resources which we have made available for community care.
Mr. Jim Cunningham: To ask the Secretary of State for Health (1) what consultation takes place between the NHS and local authorities to determine the needs of particular areas for community care; (2) how much has been saved in the NHS by the recent allocation of community care responsibility to local authorities.
Mr. Bowis: I refer the hon. Member to the reply that I gave him on 13 December 1994 at columns 615-16 .
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Smoking
Mrs. Lait: To ask the Secretary of State for Health when smoking was last discussed at the EU Health Minsters' Council.
Mr. Sackville: On 22 December 1994.
Patients (Deaths)
Mr. Illsley: To ask the Secretary of State for Health if she intends to hold an investigation into the recent deaths of patients at Kneesworth psychiatric hospital.
Mr. Bowis: No. I refer the hon. Member to the reply that I gave him on 8 February at column 271.
Mr. Illsley: To ask the Secretary of State for Health what action she intends to take to reduce the number of deaths of patients undergoing psychiatric care.
Mr. Bowis: In the White Paper, "The Health of the Nation" we set a target to reduce the suicide rate of severely mentally ill people. A number of central initiatives designed to improve existing mental health services will complement local action to reduce the suicide rate among severely mentally ill people. These include the various measures in the ten point plan that we announced in August 1993 and the issue of the "Mental Illness Key Area Handbook" to all managers of national health service and local authority mental health services. The revised edition of the handbook provides a number of examples of interventions which may help to reduce suicide rates. Many of the measures being taken to reduce deaths from suicide among severely mentally ill people should also help to reduce the number of other premature and preventable deaths of patients undergoing psychiatric care.
Medical Negligence
Mr. Illsley: To ask the Secretary of State for Health (1) how many actions for medical negligence have been issued against the Fallodon hospital in Leeds, and Leeds Private Hospitals Ltd.
(2) what action she is taking in response to claims for medical negligence against the Fallodon hospital in Leeds and Leeds Private Hospitals Ltd.
Mr. Sackville: In the private sector, any question of medical negligence is a matter between the parties concerned.
Mr. Illsley: To ask the Secretary of State for Health if she will make it a condition of any licence given to a private hospital that adequate insurance against medical negligence claims is obtained by that hospital;
(2) what requirements are placed on private hospitals to insure themselves against claims for medical negligence.
Mr. Sackville: Any question of medical negligence is a matter between the parties concerned.
Waiting Lists, West Midlands
Dr. Lynne Jones: To ask the Secretary of State for Health for what reasons additional resources made available in the present and forthcoming financial years for the West Midlands waiting list initiative are not being incorporated into district health authority budgets; and if she will make a statement on the impact of this on the
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scale of the redundancy programme in South Birmingham health authority.Mr. Malone: The allocation of resources for the West Midlands waiting times initiative is a matter for West Midlands regional health authority and I refer the hon. Member to Mr. Bryan Baker, chairman of West Midlands RHA, for this information. The redundancy programme in South Birmingham, and any possible impact that the waiting times initiative may have on this, is a matter for South Birmingham health authority and the hon. Member may wish to contact Mr. Bryan Stoten, chairman of the authority, for further details.
Dr. Lynne Jones: To ask the Secretary of State for Health if she will make a statement on the future of the West Midlands waiting list initiative in 1996 97.
Mr. Malone: West Midlands are to be congratulated on the excellent progress that they have made in reducing waiting times for in-patient and day case treatment for their residents. I look to local purchasers and providers to build on this success in the future.
Fallodon Hospital, Leeds
Mr. Illsley: To ask the Secretary of State for Health how many complaints have been submitted to Leeds Healthcare regarding the Fallodon hospital and Leeds Hospitals Ltd.
Mr. Malone: This is a matter for Leeds Healthcare. The hon. Member may wish to contact Mrs. Pam Smith, chairman of Leeds Healthcare, for details.
Mr. Illsley: To ask the Secretary of State for Health (1) if she will order an inquiry into the standards of health care provision at the Fallodon hospital and Leeds Private Hospitals Ltd.
(2) what representations she has received regarding the Fallodon hospital in Leeds.
Mr. Sackville: Responsibility for the Fallodon's registration under the Registered Homes Act 1984 rests with the health authority. A number of concerns have been raised with the Department in relation to the Fallodon's approval by my right hon. Friend the Secretary of State under section 1(3) of the Abortion Act 1967 to provide treatment for termination of pregnancy. All were fully investigated. Improvements were required and implemented and the Fallodon continues to be approved under the Act.
Osteoporosis
Mr. Elletson: To ask the Secretary of State for Health what measures she is taking to encourage bone density scanning for osteoporosis.
Mr. Sackville: My noble Friend the Parliamentary Under-Secretary of State, Baroness Cumberlege, announced on 31 January that she had accepted the recommendations contained in the report of the Advisory Group on Osteoporosis, copies of which are available in the Library. She wrote to the chairmen of all national health service bodies drawing their attention to the recommendation that bone densitometry should be available to assist clinical decision-making for certain patients identified as being at high risk. My noble Friend will also be discussing this aspect, and the report more generally, with regional chairmen.
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Domiciliary Care
Mr. Jim Cunningham: To ask the Secretary of State for Health what assessment she has made of the extent to which the current NHS system meets the Government's objective to promote the development of the domiciliary day and respite care services to enable people to live in their own home wherever feasible and sensible.
Mr. Bowis: Recent guidance, HSG(95)8, on national health service responsibilities for meeting continuing health care needs reiterated the important responsibilities of the NHS to arrange and fund a full range of services to meet people's continuing health care needs. As well as continuing in-patient care the guidance included important responsibilities for rehabilitation, respite health care and community health and primary care services for people at home or in residential care homes. Copies of the guidance are available in the Library.
Mr. Jim Cunningham: To ask the Secretary of State for Health how many elderly people are currently under domiciliary day and respite care; and how many are in full nursing home facilities.
Mr. Bowis: The centrally available information on day and domiciliary services arranged by social services authorities shows that in a sample week in September 1993 there were estimated totals of 435,000 households in England receiving home help or home care where the oldest resident was aged 65 or over, 123,000 attendances at day centres by people aged 65 or over, and 287,000 people--nearly all aged 65 or over--had meals either delivered to their homes or served at luncheon clubs. Information is not available centrally about how many individuals were receiving services arranged by social services authorities.
The number of local authority supported residents aged 65 and over in short -term placements in either residential care or nursing homes, many of which will be for respite purposes, was 11,000 on 31 March 1994.
Information on all registered nursing homes is that there were 132, 200 nursing home beds occupied by people aged 65 or over in 1993 94.
Dental Practitioners
Mr. Illsley: To ask the Secretary of State for Health (1) when she expects to recover the average overpayment from each general dental practitioner;
(2) what proposals she has to require general dental practitioners to repay the average overpayment to the Government.
Mr. Malone: The Green Paper, "Improving NHS Dentistry", states that the issue of past overpayments to dentists is one that needs to be addressed. The Government have been reviewing the issue as part of their consideration of the way forward following the Green Paper.
Maternal Mortality
Mrs. Ann Taylor: To ask the Secretary of State for Health how many cases of maternal mortality there have been following births in the Dewsbury area for (a) home confinements and (b) hospital births in each of the last 10 years.
Mr. Sackville: The information is shown in the table.
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Maternal deaths of women (ICD 630-676<1> aged 16-50 for Dewsbury district health authority, 1983-1992 Year |Number --------------------- 1983 |1 1984 |0 1985 |0 1986 |0 1987 |1 1988 |0 1989 |1 1990 |0 1991 |1 1992 |1 <1> ICD 9 codes 630-676 refer to complications of pregnancy, childbirth and the puerperium. Of these, codes 647 and 648 may be considered indirect causes of the pregnancy as they cover conditions in the mother classifiable elsewhere in the ICD 9 but which complicate pregnancy, childbirth and the puerperium. The remaining conditions may be considered direct causes relating to pregnancy, childbirth and the puerperium. Notes 1. There may have been other deaths among women who were pregnant or had recently given birth where this information was not given on the death certificate or was not selected as the underlying cause of death. 2. Information collected on the death certificate gives the place where the woman died. This may be different from where her child was born. Therefore it is not possible to separate deaths following births from home confinements and hospital births.
Mental Health Act 1983
Mr. Illsley: To ask the Secretary of State for Health if she will list those services which an authority (a) can be required to provide and (b) can make available under section 117 of the Mental Health Act 1983; and if she will list the services actually available under that section.
Mr. Bowis: The specific services provided by health and local authorities under section 117 will vary according to individual needs and local arrangements. General guidance on the provision of after-care services for patients who have been detained in hospital is given in chapter 27 of the Mental Health Act code of practice, copies of which are available in the Library.
Mr. Illsley: To ask the Secretary of State for Health, pursuant to her answer of 8 February, Official Report, columns 270 17, when she expects to publish the numbers of patients detained under the Mental Health Act 1983 in (a) NHS units and (b) private units.
Mr. Bowis: The Statistical Bulletin, "In-patients Formally Detained in Hospitals Under The Mental Health Act 1983 and Other Legislation, England: 1987 88 to 1992 93", is to be published shortly. A copy will be placed in the Library.
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Neuroleptic Drugs
Mr. Illsley: To ask the Secretary of State for Health, what proposals she has to hold an inquiry into the use of neuroleptic drugs.
Mr. Bowis: I refer the hon. Member to the reply that I gave him on 8 February at column 273.
Refugees
Mr. Bernie Grant: To ask the Secretary of State for Health what reports she has received of NHS trust hospitals denying treatment to refugees properly referred by their general practitioners; and what mechanisms are in place to ensure that the rules as regards eligibility for free NHS hospital care are correctly applied.
Mr. Sackville: None. It is for national health service trusts to establish whether patients are eligible for exemption from charges for NHS hospital treatment, using the Department's Manual of Guidance on the NHS Treatment of Overseas Visitors.
Private Hospitals
Mr. Illsley: To ask the Secretary of State for Health what plans she has to review the licensing procedures of private hospitals.
Mr. Sackville: The registration of private hospitals is subject to part II of the Registered Homes Act 1984. A review of registration and inspection procedures will commence this year.
Human Rights
Sir Andrew Bowden: To ask the Secretary of State for Health if she will arrange for the draft convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine to be amended in response to opinion No. 184 of the Parliamentary Assembly of the Council of Europe; when she expects the draft convention to be opened for signature; and if she will make a statement.
Mr. Bowis: The United Kingdom Government will take account of the Parliamentary Assembly's opinion in considering the current draft convention. No date has as yet been agreed for the convention to be signed.
The Government share with the Governments of other member states a commitment to the protection of human rights and dignity.
Mr. Battle: To ask the Secretary of State for Health what is her Department's policy towards the draft convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine; and if she will make a statement.
Mr. Bowis: My Department will continue its involvement in the Council of Europe's Steering Committee on Bioethics, which is drawing up a draft convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine for consideration by the Council of Ministers. This involvement will reflect the United Kingdom Government's firm commitment to the protection of human rights.
Prescribing Incentive Schemes
Mr. Clappison: To ask the Secretary of State for Health if she will make a statement about payments to
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general medical practitioners under the 1993 94 national practice based prescribing incentive schemes.Mr. Malone: The schemes have been successful in encouraging cost- effective prescribing. Payments due to those who qualified under the 1993 94 schemes have been authorised on an extra statutory basis. Similar arrangements will apply to payments in respect of1994 95 schemes. The total amount paid on this basis--estimated at £1.7 million in 1994 95--will be included in family health services authorities summarised accounts.
Continuing Care
Mr. Hinchliffe: To ask the Secretary of State for Health (1) what is her estimate of the cost to the National Health Service of providing continuing care for each year from 1979 to 1996; (2) what is her estimate of the number of people in need of continuing care as provided by the national health service in each year from 1979 to 1996.
Mr. Bowis: I refer the hon. Member to the reply that I gave to the hon. Member for Alyn and Deeside(Mr. Jones) on 19 December 1994 at column 1147. The number of people in need of continuing care is not available centrally.
Mr. Hinchliffe: To ask the Secretary of State for Health, what steps she will take to monitor health authorities investment in continuing care provision; and how she will ascertain which health authorities are under- providing.
Mr. Bowis: The National Health Service Executive and social services inspectorate will work closely with authorities to ensure that the guidance is fully implemented. As part of this process, health authorities will be required to include managing any re-investment in their timed and costed plans which will be in place by 1 April 1996.
Mr. Hinchliffe: To ask the Secretary of State for Health in what circumstances patients will be able to challenge the criteria applied by the health authority to decide their entitlement to national health service continuing care.
Mr. Bowis: Health authorities must consult and fully involve local authorities, all general practitioners, national health service and independent providers and representatives of users and carers in drawing up local eligibility criteria.
From April 1996, a patient or his or her family and any carer can ask the health authority to review the decision on entitlement to national health service funded continuing health care if they do not believe that the health authority's eligibility criteria have been applied correctly.
Mr. Hinchliffe: To ask the Secretary of State for Health in what circumstances a patient in need of continuing care as provided by the national health service can be placed in a nursing home.
Mr. Bowis: It is for health authorities to arrange and fund a full range of services to meet the continuing health care needs of their local population. They may purchase such care from national health service hospitals or other facilities, including nursing homes. If a patient meets the
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eligibility criteria for continuing NHS in- patient care but a bed is not available within the health authority's contracted provision, agreement for an extra-contractual referral to another hospital or nursing home should be sought.Home Helps
Mr. Hinchliffe: To ask the Secretary of State for Health how many local authority home helps there have been per 1,000 population in each year since 1979.
Mr. Bowis: The information requested is shown in the table.
Table: Whole time equivalent (WTE) home helps employed
by
local authorities, 1979-1993 England
At 30 September |WTE home helps per
|1,000
|population<1>
---------------------------------------------------------
1979 |0.96
1980 |1.00
1981 |0.99
1982 |1.01
1983 |1.05
1984 |1.08
1985 |1.10
1986 |1.13
1987 |1.19
1988 |1.20
1989 |1.18
1990 |1.16
1991 |1.13
1992 |1.12
1993<2> |1.05
<2> The statistical return collecting details of local
authority staffing was very substantially revised in
1993 and this may have affected comparability with
earlier years.
Permanent Secretaries
Mr. Milburn: To ask the Secretary of State for Health which permanent secretaries have left her Department's employment in the past five years; and which public positions they have been appointed to subsequently.
Mr. Sackville: Sir Donald Acheson and Sir Duncan Nichol have retired as permanent secretaries in this Department in the five years from 1 March 1990. Ministers appointed Sir Donald Acheson to chair the Home Office Health Advisory Committee to the Prison Service in 1992. Ministers have not offered Sir Duncan Nichol any public appointments.
Operations
Mr. Shersby: To ask the Secretary of State for Health what representations she has received from the health services management centre of the University of Birmingham questioning the value of a number of operations commonly performed on patients; and if she will make a statement.
Mr. Sackville: No such representations have been received.
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Staff Relocation Expenses
Mr. Milburn: To ask the Secretary of State for Health how much has been spent on staff relocation expenses in each year since 1990 91 by region.
Mr. Malone: This information is not separately identifiable within the annual accounts or annual financial returns of health authorities and national health service trusts.
TRADE AND INDUSTRY
Women Directors
21. Mr. Khabra: To ask the President of the Board of Trade what initiatives his Department is taking to increase the number of female directors in Britain's industrial companies.
Mr. Jonathan Evans: It is for the board and shareholders of companies to choose directors, not Government.
Company Assistance (Midlands)
22. Mr. Mike O'Brien: To ask the President of the Board of Trade what concerns have been raised by companies and firms in the midlands about the provision of assistance to them by his Department.
Mr. Eggar: The Department deals with a large number of companies in the midlands on a daily basis on a wide variety of issues.
Telecommunications
23. Mr. Jacques Arnold: To ask the President of the Board of Trade what studies his Department has conducted on the relative costs of telecommunications services in the United Kingdom and other European Union countries.
Mr. Ian Taylor: My Department has studied the overall competitiveness of United Kingdom telecommunications infrastructure, including costs. We also monitor studies by outside bodies. These studies show that UK telecom costs are amongst the lowest in Europe.
Jaguar X200
24. Mr. Robert Ainsworth: To ask the President of the Board of Trade what discussions he has had with Jaguar concerning financial assistance for the X200 project.
Mr. Heseltine: I have been keeping in very close touch with the top management in Ford and Jaguar as their plans for the X200 project have developed.
The company has not yet decided whether to go ahead with the project or, if it does, where the car would be manufactured. I am of course keen to maximise the prospects of the project being located in the United Kingdom.
Internet
25. Mr. Streeter: To ask the President of the Board of Trade what use his Department is making of the Internet super-highway.
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Mr. Ian Taylor: My Department recognises the value of the Internet as a means to share information and develop contacts at a national and international level. We are already making use of its facilities for electronic mail, and to obtain and provide information, and I have instigated a programme to consider and develop the Department's usage from a strategic perspective.
My E-Mail address is Taylor@mintech.demon.co.uk
Private Mines
26. Mr. Hanson: To ask the President of the Board of Trade what discussions he has had with private mine owners regarding terms and conditions of service for miners since privatisation.
Mr. Page: None. These are matters for the employers and their employees.
Electricity Companies
27. Mr. Eric Clarke: To ask the President of the Board of Trade what advice his Department has given to the Director General of Electricity Supply concerning the consequences on prices of the high remuneration of directors.
Mr. Eggar: My Department has given no advice to the Director General of Electricity Supply regarding these matters.
Trade Deficit
28. Mr. Spring: To ask the President of the Board of Trade by how much the United Kingdom deficit with countries outside the EU changed in 1994; and to what factors he attributes this.
Mr. Ian Taylor: In 1994, the value of the visible trade deficit of the United Kingdom with countries outside the European Union was reduced by £2.7 billion, reaching its lowest level since 1987. UK exports to these countries increased in value by 10 per cent. in 1994 while imports increased by 5 per cent. UK exports are now at record levels both in terms of value and volume. This has been achieved by UK companies manufacturing goods that are competitive in quality and price in international markets.
Steel
29. Mr. MacShane: To ask the President of the Board of Trade what support he is giving to the Iron and Steel Trades
Confederation's campaign in favour of British-made steel.
Mr. Eggar: The Government share the ISTC's concerns about continuing subsidies to the United Kingdom steel industry's competitors in Europe. We have consistently made it clear to the Commission and other member states the importance we attach to the strict application of the ECSC rules on state aid. To assist us in this task, I have recently set up a steel subsidies monitoring committee--consisting of Government and steel industry
representatives--to help gather evidence of illegal state aid and to pass it on to the Commission for action. We are also working with the UK constructional steelwork industry to improve the transparency and rigour with which sub-contracts for steelwork are awarded for public sector projects.
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