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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: 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.
(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. 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.
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
Column 235scale 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.
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.
(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.
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.
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. 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.
(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.
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.
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.
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.
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.
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.
Column 240general 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.
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. 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
Column 241eligibility 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.
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.
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.
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.
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.
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.
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
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. 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.
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.