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3
|Notifications of
|tuberculosis
---------------------------------------------------
Birmingham |319
Bradford |164
Leicester |162
Newham |137
Brent |129
Data for district health authorities are not
available.
c) The five district health authorities with the highest conception rates to women under 20 in England, 1991, were:
|Conception
|rates<1>
---------------------------------------
North Manchester |139.2
City and Hackney |113.9
West Lambeth |112.4
Tower Hamlets |111.4
East Birmingham |105.5
England |64.8
<1> All conceptions to women under 20
per 1,000 females aged 15-19.
d) Residents of three health districts accounted for 35 per cent. of all AIDS notifications in England and Wales in 1993. The districts were:
Kensington, Chelsea and Westminster
Camden and Islington
Ealing, Hammersmith and Hounslow
e) The six district health authorities in England with the highest rates of perinatal mortality in 1993 were:
?
|Perinatal mortality
|rates
---------------------------------------------------------------
West Birmingham |14.9
South Birmingham |14.1
Central Manchester |13.8
Gateshead |13.3
South Manchester |13.2
Worcester and District |13.2
<1> Per 1,000 live and still births
Clinical Services
Mrs. Beckett: To ask the Secretary of State for Health which clinical and clinical support services which have been market tested are now (a) viewed as suitable for privatisation in the future or (b) available for tender to private contractors in 1994 95.
Mr. Sackville: None--contracts for clinical and clinical support services awarded as a result of a market testing exercise remain national health service contracts whether they are won in-house or by another public or private contractor. At the end of the relevant contract period, they will again be subject to fresh market testing under NHS arrangements.
We have been advised of local plans to market test some 20 clinical and clinical support services for1994 95.
Long-Term Care
Mrs. Beckett: To ask the Secretary of State for Health how many letters were received from individuals and from organisations concerning the draft guidance on long term care of the elderly; and how many were opposed to the Department's proposals.
Mr. Bowis: A total of 182 responses were received from both individuals and organisations in response to our invitation for comments on the draft guidance on NHS responsibilities for meeting continuing health care needs. We considered very carefully the range of views expressed on the draft guidance in finalising
HSG(95)8/LAC(95)5, which was issued on 23 February 1995. Copies are available in the Library. The guidance has been widely welcomed.
Hospital Staff (Recruitment)
Mrs. Beckett: To ask the Secretary of State for Health how much money was spent by her Department, NHSE, district health authorities and trusts on recruiting hospital staff from overseas in each of the last three years.
Mr. Malone: This information is not available centrally.
Market Testing
Mrs. Beckett: To ask the Secretary of State for Health what has been the cost to her Department and the NHS
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of management consultants advising on market testing of (a) clinical and clinical support services and (b) other NHS services.Mr. Sackville: The Department of Health and national health service summary accounts do not separately record expenditure on management consultancy advice for market testing issues.
Consultancy
Mrs. Beckett: To ask the Secretary of State for Health what has been the total cost estimated by the Audit Commission or her Department on management consultants by her Department, NHSE, regional Health authorities, district health authorities, family health service authorities, trusts and general practitioner fundholders in the last three years.
Mr. Sackville: The Department of Health and the national health service executive, however, have spent the following amounts from running costs on consultancy in the last three years;
1991 92: £24,258,000
1992 93: £18,399,000
1993 94: £15,933,037
Information is not available centrally about expenditure on management consultants by regional health authorities, district health authorities, family health services authorities, trust and general practitioner fundholders.
Operation Cancellations
Mrs. Beckett: To ask the Secretary of State for Health, how many operations were cancelled on the day of or after the date the patient was due to be admitted to hospital by regional health authority, district health authority and in total; and how many were not re-admitted with one month during each quarter since March 1993.
Mr. Malone: This information was not collected in the form requested until April 1994 when the national patients charter standard on cancelled operations was improved so that a patient whose operation is cancelled for non-medical reasons on the day of, or after, admission is admitted for treatment within one month of the first cancellation. The information from 1 April 1994 will be placed in the Library. Performance against this patients charter standard is being kept under review.
Waiting Times
Mr. Hinchcliffe: To ask the Secretary of State for Health if she will list for each regional office the latest waiting times for each fundholder procedure for (a) patients funded by health authorities and (b) patients funded by general practitioner fundholders.
Mr. Malone: This information is not available centrally.
GP Fundholding
Mrs. Beckett: To ask the Secretary of State for Health, what was the total amount of savings made by fundholders in the last three years.
Mr. Malone: I refer the right hon. Member to the replies I gave the hon. Member for Darlington (Mr. Milburn) on 24 November 1994, columns 321 - 22 and on 14 March, column 545 .
Column 704
Mr. Morgan: To ask the Secretary of State for Health, if she will give the aggregate level of savings by fundholding general practitioners in each family health service authority for the years 1991 92, 1992 93 and 1993 94.
Mrs. Beckett: To ask the Secretary of State for Health, what was the number of general practitioner fundholding practices and the amount of savings (a) by family health service authority and (b) in total for (i) 1991 92, (ii) 1992 93 and (iii) 1993 94.
Mr. Malone [holding answer 24 February 1995]: I refer the right hon. Member to the reply I gave the hon. Member for Cardiff, West (Mr. Morgan) on 15 March for information on the number of general practitioner fundholding practices.
I refer the right hon. and hon. Members, to the reply I gave the hon. Member for Darlington (Mr. Milburn) on 24 November 1994, columns 321-22 which provides information on fundholder savings at regional health authority level in 1991 92 and 1992 93. Information on fundholder savings at family health services authority level for these years is not available centrally.
The requested information on fundholder savings for 1993 94 will be placed in the Library. Nationally, retained savings in 1993 94 equalled £64.2 million, about 3.5 per cent. of budgets set--similar to the levels of efficiency savings made by fundholders in the first two years of the scheme.
Savings may be spent only after external audit of the fundholding account by the Audit Commission. Fundholder savings are held by FHSAs on behalf of the patients of fundholders and may be retained for up to four years. With the agreement of the regional health authority, savings may be used for the benefit of patients of the practice as outlined in the practice's annual business plan.
Special Hospitals
Mr. Alex Carlile: To ask the Secretary of State for Health (1) what difficulties she has identified in integrating special hospitals into the internal market; and if she will make a statement; (2) what are her plans regarding the status of special hospitals; what is the timescale for changes; and if she will make a statement.
Mr. Bowis: I refer the hon. and learned Member to the reply I gave the hon. Member for Barnsley, Central (Mr. Illsley) on 3 February, column 872.
Edgware
Sir John Gorst: To ask the Secretary of State for Health on what basis the present capitation formula for Edgware is calculated; and what evidence she has on whether the census figures for 1991 still represent the true picture in the case of the London borough of Barnet.
Mr. Sackville: For 1995 96, the modified national weighted capitation formula has been used to set targets for regional health authorities. It is for North Thames RHA to determine both its own sub- regional formula and how much funding is to be made available to its district health authorities. The hon. Member may wish to contact Sir William Staveley, the chairman of North Thames regional health authority.
The population base used for revenue resource allocation is the mid-year sub-national population
Column 705
projections, that is mid-1995 for 1995 96. These are currently based on the 1991 census, however, they do take account of assumed rates of births, deaths and migration since 1991.Minor Accident Treatment Service Units
Sir John Gorst: To ask the Secretary of State for Health what is the minimum number of staff at any one time at a minor accident treatment service unit: what is the level of qualification of those staff; and whether it is part of their responsibility to diagnose acute medical conditions.
Mr. Sackville: These aspects are determined by individual hospital trusts according to local needs.
Grading Appeals
Mrs. Beckett: To ask the Secretary of State for Health (1) if she will estimate how long it will take until all the outstanding nurses' grading appeals have been heard; and what steps she is taking to speed up the waiting times;
(2) how many nurses' grading appeals have not been heard; and if she will make a statement.
Mr. Sackville: At 1 March 1995, there were just over 2,500 nurse grading appeals in England which were still unresolved. This is about half of the number outstanding a year ago. The Nursing and Midwifery Staffs Negotiating Council is operating an agreed appeals mechanism for clearing all outstanding appeals. The aim is for all appeals to be cleared by 31 December 1995.
Mrs. Beckett: To ask the Secretary of State for Health how many nurses' grading appeals have been conducted since 1988; and how many were outstanding in each year since 1990.
Mr. Sackville: Since 1988, approximately 98,000 nurse clinical grading appeals have been heard. Information on the number of appeals outstanding at the end of the last three years is shown in the table. Comparable information is not available for 1990 and 1991.
)
Outstanding nurses and midwives clinical
grading appeals
(England)
|Number of
|appeals
Year ending |outstanding
-----------------------------------------
31 December 1992 |21,326
31 December 1993 |4,819
31 December 1994 |2,964
The aim is for all appeals to be cleared by 31 December 1995.
NHS Trusts
Mr. Alex Carlile: To ask the Secretary of State for Health what proposals she has to secure the financial future of NHS trusts against medical negligence claims; and if she will make a statement.
Mr. Malone: The management of medical negligence claims is a matter for individual trusts. At present, where
Column 706
a trust has, in any financial year, to pay claims with a total value in excess of 0.5 per cent. of its turnover, the trust may apply to the national health service executive for a loan in order to spread the cost of meeting the claims. A scheme is being developed under section 21 of the National Health Service and Community Care Act 1990 for trusts to pool the financial liabilities arising out of clinical negligence. Discussions are continuing on the details of the proposals and if trusts are sufficiently supportive, the scheme is likely to be introduced in 1995 96 on a voluntary basis.Mr. Alex Carlile: To ask the Secretary of State for Health how much was paid out in damages by each NHS trust in England in (a) 1992, (b) 1993 and (c) 1994.
Mr. Malone: The information will be placed in the Library.
Mr. Alex Carlile: To ask the Secretary of State for Health how many civil actions for damages arising from alleged medical negligence were started against each NHS trust in England in (a) 1992, (b) 1993 and (c) 1994.
Mr. Malone: This information is not available centrally.
Mr. Milburn: To ask the Secretary of State for Health if she will list all the current (a) chairs and (b) non-executive directors of each trust board by region, indicating the gender and occupation of each individual.
Mr. Malone [holding answer 23 February 1995]: The latest information available centrally will be placed in the Library.
Mr. Milburn: To ask the Secretary of State for Health if she will list those trust boards that currently have vacancies for chairs and non- executive directors; and whether the posts will be filled under the new appointments regime.
Mr. Malone: I refer the hon. Member to the reply I gave him earlier, for details of vacancies on the boards of national health service trusts. All appointments made after 1 April will be in accordance with new guidelines on appointments procedures.
Mr. Milburn: To ask the Secretary of State for Health if she will list all the current (a) chairs and (b) non-executive directors of each trust board by region, indicating the gender and occupation of each individual.
Mr. Malone [holding answer 23 February 1995]: The latest information available centrally will be placed in the Library.
Immunisation and Cancer Screening
Mrs. Peacock: To ask the Secretary of State for Health what assessment has been made of the effect of the GP contract on immunisation and cancer screening services.
Mr. Malone: When the new general practitioner contract was introduced in 1990, 89 per cent. of GPs met targets for childhood immunisation and 86 per cent. for cancer screening. By April 1993, this had increased to 96 per cent. of GPs meeting childhood immunisation targets and 98 per cent. cancer screening targets. This shows clearly the positive impact of the GP contract on these services.
Column 707
Chemotherapy
Mr. Morgan: To ask the Secretary of State for Health what NHS trials are being conducted of treatment for breast cancer involving the removal and replacement of stem cells after high dose chemotherapy analogous to recent trials in the United States of America; and what plans she has to make this treatment available under the national health service.
Mr. Sackville: I refer the hon. Member to the reply I gave my hon. Friend the Member for Rugby and Kenilworth (Mr. Pawsey) on 15 March, Official Report, column 549.
NHS Accountants
Mrs. Beckett: To ask the Secretary of State for Health how many accountants were employed within all sections of the NHS in each of the last 15 years.
Mr. Malone: In the years 1991 to 1994, the years for which information is available, some 1,463, 1,701, 2,176 and 2,174 staff in the national health service were recorded as holding qualifications recognised by the consultative committee of the accounting bodies.
GP Lists
Mr. Milburn: To ask the Secretary of State for Health, pursuant to her answer of 9 December, Official Report, column 400 , when she will publish data for 1993 on patients removed from general practitioners' lists.
Mr. Malone: Information for all family health services authorities for 1993 94 is not yet available.
Pinderfields Hospital
Mr. Hinchliffe: To ask the Secretary of State for Health if she will seek reports regarding the future of Pinderfields hospital, Wakefield from (a) the chair of the Yorkshire and Northern health region, (b) the chair of the Wakefield health authority and (c) the chair of the Pinderfields trust; and if she will make a statement.
Mr. Sackville: This is a matter for Wakefield Healthcare. The hon. Member may wish to contact Mr. Brian Hayward, chairman of Wakefield Healthcare, for details.
Column 708
Form FP10
Mr. Madden: To ask the Secretary of State for Health what is the total estimated cost of printing and distributing the amended form FP10 required to be available as from 1 April next; what was the total cost of printing and distributing the forms that the amended FP10 will replace; and what representations she has received from professional bodies about the lack of consultation over the design and content of amended FP10 prior to printing.
Mr. Malone: No new costs have been incurred by introducing a revised print of form FP10. At about £1.38 million, the costs of printing and distributing the forms for 1995 96 are expected to be some 11 per cent. higher than in 1994 95 because of a rise in the cost of paper.
Representations have been received from the General Medical Services Committee of the British Medical Association and the Pharmaceutical Services Negotiating Committee with whom there are on-going consultations about the new arrangements.
NHS Supplies Contracts
Mrs. Beckett: To ask the Secretary of State for Health what was the total value of contracts placed by the NHS Supplies Authority for cash registers and other accounting devices in each of the last 15 years.
Mr. Sackville: The National Health Service Supplies Authority was set up in October 1991, and has no specific contracts for cash registers or accounting devices.
Emergency Admissions
Mrs. Beckett: To ask the Secretary of State for Health what is the change in emergency admissions to hospital by regional health authority and in total for each quarter of 1993 and 1994.
Mr. Sackville [holding answer 13 March 1995]: The table shows numbers of non-elective admissions in the general and acute specialties for each regional health authority in England and in total, using information collected by the national health service executive.
For England as a whole, the national proportion of non-elective admissions in relation to total admissions has remained at about 47 per cent. for all the period.
Column 707
Non-elective admissions (general and acute) by region and quarter 1993-94 to 1994-95: England finished
consultant episodes
Thousand
1993-94 1994-95
Region<1> |Q1 |Q2 |Q3 |Q4 |Q1 |Q2 |Q3
-------------------------------------------------------------------------------------------------------
Northern and Yorkshire |144 |149 |158 |154 |145 |145 |153
Trent |93 |89 |98 |96 |97 |96 |102
Anglia and Oxford |88 |91 |96 |95 |95 |93 |95
North Thames |113 |123 |127 |128 |128 |134 |136
South Thames |116 |116 |125 |116 |119 |118 |123
South and West |118 |125 |124 |126 |124 |125 |130
West Midlands |104 |100 |109 |106 |102 |106 |111
North West |144 |144 |158 |150 |150 |154 |161
England |918 |937 |994 |971 |961 |972 |1,010
<1> The table shows admissions in each region not including data from the special health authorities.
Column 709
DEFENCE
Nerve Agents
Mr. Livingstone: To ask the Secretary of State for Defence what was the purpose of research on the nerve agent GB at the nerve agent plant at Nancekuke, Cornwall; what quantities of nerve agent GB were used at this research; when the results of this research were shared with other countries; and under which defence agreements these results were exchanged.
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 to write to the hon. Member. Letter from Graham Pearson to Mr. Ken Livingstone, dated 16 March 1995:
1.
Your Parliamentary Question to the Secretary of State for Defence asking what was the purpose of research on the nerve agent GB at the nerve agent plant at Nancekuke, Cornwall; what quantities of nerve agent GB were used at this research; when the results of this research were shared with other countries; and under which Defence Agreements these results were exchanged, has been passed to me to answer as Chief Executive of the Chemical and Biological Defence Establishment.
2.
The role of the Chemical and Biological Defence Establishment is to carry out work to ensure that the UK Armed Forces are provided with effective protective measures against the threat that chemical and biological weapons may be used against them.
3.
The research work carried out at the Chemical and Biological Defence Establishment at Nancekuke involving the nerve agent GB focused on the following:
(a) Developing a specification for the materials used in the preparation process.
(b) To study the impurities and by-products found in the GB product.
(c) To examine alternative preparation processes and to compare the differences in the GB product.
(d) To study the amount of GB in the by-products from the preparations.
(e) To investigate the storage of GB.
(f) To study the corrosion properties of materials used in the construction of the GB preparation facility.
4.
During the period 1951 1956 some 20 tonnes of GB were produced. Most of this was used in the storage studies and then subsequently destroyed.
5.
After 1956 some research on the stability of GB continued until 1979 when the Chemical Defence Establishment at Nancekuke closed. The results of the research and studies into GB were part of the chemical and biological defence programme and would have formed part of the technical database drawn upon in collaboration with the United States, Australia and Canada under the Technical Cooperation Programme and its predecessors and with the United States and Canada under the Memorandum of Understanding on Chemical and Biological Defence.
Mr. Livingstone: To ask the Secretary of State for Defence, pursuant to his answer of 3 February, Official Report , column 888 , what was the conclusion of the studies to find out if it was easier to produce the nerve agent GE than the nerve agent GB; in which years these studies were carried out; and when the results of these studies were exchanged with Canada and the United States of America under the tripartite conferences on toxicological warfare.
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