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|Millions
------------------------------------------------
1989-90 |<1> <3>10.8
1990-91 |<1> <3>12.41
1991-92 |<2> <3>12.8
1992-93 |<2> <3>14.3
1993-94 |<3> <4>13.2
1994-95 |<3> <4> <5>12.7
<1> Figures estimated using Federation of
Ophthalmic and Dispensing Opticians data.
<2> Figures estimated by FODO.
<3> These estimates may not be comparable
because of different sampling methodologies
used.
<4> Figures estimated by the joint-Department
of Health and profession-Technical
Sub-Committee.
<5> There is no statistically significant
change in the estimated volume since 1993-94,
which indicates that the volume has remained
much the same.
Mr. Nicholas Brown: To ask the Secretary of State for Health what steps she has taken for the early prevention, detection and treatment of eye problems in the population aged over 65 years. [17987]
Mr. Malone: A sight test must by law include a comprehensive eye examination to check for any disease, injury or abnormality which may be present. People aged over 65 are not, as a group, automatically eligible for free national health service sight tests, but provision has been made for people especially at risk from eye disease and those in receipt of income support, family credit and disability working allowance to continue to be entitled to them.
Clinical Outcome Indicators
Mr. Bayley: To ask the Secretary of State for Health, pursuant to her answer 28 March, Official Report, column 563, when she intends to publish clinical outcome indicators for NHS trusts in England similar to those published by the Secretary of State for Scotland in December 1994. [17961]
Mr. Sackville: The clinical outcome indicators for national health service trusts which were published in Scotland were based on linked patient records. Such linkage is not yet available in England and there are therefore no plans at present to publish such indicators. The programme of developing new outcome indicators is longer term and until the work progresses it will not be possible to give publication dates.
Hepatitis C
Mr. Burden : To ask the Secretary of State for Health if she will make a statement on the policy of her Department regarding compensation for haemophiliacs infected with hepatitis C through contaminated blood concentrates. [18039]
Mr. Sackville: The Government have no plans to make payments to haemophilia patients who have been infected with hepatitis C through blood products.
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Mr. Merchant: To ask the Secretary of State for Health, pursuant to her answer of 11 January, Official Report , column 145 , when she expects the ad hoc working party of experts to produce guidance on procedures for the look-back exercise for identifying those at risk of hepatitis C. [18581]
Mr. Sackville: The guidance, including counselling guidelines and treatment options, is being issued to the national health service under cover of a letter from the Chief Medical Officer. Copies will be placed in the Library.
This phase of the exercise is to trace, counsel and, where appropriate, treat those identified as being at risk. It will primarily concern hospital consultants in a number of specialties, those working in blood transfusion centres, and general practitioners. We shall do all that we can by way of counselling and, where appropriate, treatment to care for those who may have been infected.
NHS Low Income Scheme
Mr. Gordon Prentice: To ask the Secretary of State for Health how many people get full charge remission under the NHS low income scheme. [18232]
Mr. Malone: The information requested is not available. In 1994 95, 694,135 claims to the national health service low income scheme resulted in entitlement to full charge remission for the claimant and his dependants. In addition, receipt of income support, family credit and, from 1 April 1995, disability working allowance--and capital was £8,000 or less when this benefit was claimed--provides automatic entitlement to full charge remission under the low income scheme.
Parliamentary Questions
Mrs. Ann Taylor: To ask the Secretary of State for Health how many times in each year since 1979 80 her Department has written to an hon. or right hon. Member correcting an answer to a parliamentary question. [18520]
Mr. Sackville: This information could be provided only at disproportionate cost.
Mrs. Ann Taylor: To ask the Secretary of State for Health (1) how many parliamentary questions to her Department in each year since 1979 80 requesting a priority written answer or answer on a named day, were answered within three days; how many received a holding reply; and how many of those which received a holding reply then received a substantive answer within a further five, 10, 15, 20 days or longer; [18518]
(2) how many times in each year since 1979 80 her Department has given a reply to a parliamentary question which has resulted in the information requested being placed in the Library and not printed in the Official Report; [18519]
(3) how many parliamentary questions requesting an ordinary written answer were received by her Department in each year since 1979 80; and how many such questions received a substantive answer within 10, 15, 20 days or longer. [18517]
Mr. Sackville: The information requested is a matter of public record but it could be extracted in the form requested only at disproportionate cost.
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Patient Complaints Procedure
Mr. Llwyd: To ask the Secretary of State for Health what recourse is open to a patient who is aggrieved after the responsible medical officer for complaints has agreed to provide an independent professional review; and if she will make a statement. [18231]
Mr. Malone: The independent professional review is carried out by two consultants independent of the hospital involved and the result of their report is final in issues concerning clinical judgement, unless new evidence is brought to light in which case it is for the regional director of public health--or the medical officer for complaints in Wales--to consider what action to take which may include reconvening the IPR. Once the IPR process has reported, the chief executive of the hospital will write to the complainant.
If the complainant remains dissatisfied then he or she may refer their case to the Health Service Commissioner. However, the HSC may only investigate the process of the handling of the complaint. Under the present system complaints about clinical judgement are outside his jurisdiction. The complainant can also consider approaching the appropriate professional representative body, the General Medical Council, and/or taking legal advice.
The Department of Health recently published in the document "Acting on Complaints", copies of which have been placed in the Library, proposals for a simpler, speedier and more effective complaints procedure which will cover complaints about clinical judgement. The Government will introduce legislation as soon as the parliamentary timetable allows, to extend the jurisdiction of the HSC to cover all national health service complaints including complaints about the exercise of clinical judgement. These plans will be developed in more detail in consultation with the NHS, professional representative bodies and other interested parties in the coming months. The new NHS complaints procedure will be implemented from April 1996.
Access to Information
Mr. David Porter: To ask the Secretary of State for Health what steps she is taking to increase access to information about the national health service. [18762]
Mrs. Virginia Bottomley: I shall be publishing a code of practice on openness in the national health service on Wednesday 5 April. This fulfils the Government's commitment in the White Paper on Open Government, published in 1993, to increase public access to information about the NHS. This code is the first of its kind in the NHS and, following the codes of conduct and accountability which I published last year, represents a further step towards making the NHS more responsive and accountable to the public it serves. It builds on the success of the patients charter and performance league tables in increasing and improving the information available to members of the public about the NHS.
The governing principle of this code of practice on openness is that the NHS should respond positively to requests for information. The code sets out clearly for the public what information is available and from whom. It explains how to complain about a refusal to provide information, including referral of such a complaint to the Health Service Commissioner. It also describes good practice in publishing information and in responding to
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requests for information which is not routinely published. One of the key aims of the code of practice on openness is to foster mutual trust and confidence between the public and the NHS.The code of practice is to be implemented by all NHS trusts and authorities on 1 June 1995. My Department will be issuing detailed guidance to assist NHS organisations in the operation of the code. Copies of the code will be placed in the Library.
NHS Superannuation Scheme
Mr. Clappison: To ask the Secretary of State for Health if she will make a statement on the report by the Government Actuary on his valuation of the national health service superannuation scheme in England and Wales 1984 to 1989. [18763]
Mr. Malone: I have today placed copies of the report in the Library.
The report concludes that the rate of contribution required from employers to meet the scheme's future liabilities, after taking account of employees' contributions, should remain at 4 per cent. The scheme's liabilities do not include the cost of pensions increase, most of which is currently met by the Exchequer.
I have decided to accept the Government Actuary's recommendation.
Waiting Lists, London
Mr. Corbyn: To ask the Secretary of State for Health what is her latest estimate of the waiting list for elective surgery at each London district health authority; and what are the available beds in each London district health authority. [18290]
Mr. Malone: Information on waiting lists and times at each national health service trust and district health authority is given in "Hospital Waiting List Statistics: England", published twice yearly. Copies are available in the Library.
The latest information on the average daily number of available beds is for NHS trusts and directly managed units and is published in "Bed availability for England: Financial Year 1993 94", copies of which are also available in the Library.
Health Service Development, London
Mrs. Roe: To ask the Secretary of State for Health how it is proposed to develop London's health services following the recent public consultations conducted by health authorities in north and south London. [18858]
Mrs. Virginia Bottomley: I have today written to the chairmen of the North and South Thames regional health authorities advising them of my decisions on a number of proposals from health authorities to develop local services. These proposals have all been subject to extensive public consultation and I have given most careful consideration to the comments made. Copies of my letters to the regional chairmen will be placed in the Library.
Lambeth, Southwark and Lewisham
I have decided to accept the proposals for the concentration of acute services provided by the Guy's and St. Thomas' NHS Trust by developing St. Thomas' as the main site for acute in-patient and emergency services, and
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developing Guy's as a hospital for local people providing a range of services including a minor injuries unit, out- patient clinics, day surgery facilities and in-patient beds for planned, non-emergency treatment for people on waiting lists. Guy's would also retain the dental hospital and school, and would provide mental health services including in-patient beds. I have made it clear that the Guy's accident and emergency department and supporting beds are not to close until alternative facilities are in place and operating satisfactorily, which I understand will not be before the end of 1998.I have also decided to accept the proposal to transfer kidney transplant operations from King's College hospital, Dulwich to the Guy's and St. Thomas' NHS Trust.
Bexley and Greenwich
I have decided to accept the proposals to develop the Queen Elizabeth military hospital as the main new NHS district general hospital for the Greenwich area by transferring acute services from Greenwich district hospital and the Brook hospital to QEMH. This will lead to the closure of the Brook hospital and change of use of the Greenwich district hospital. I have also decided to agree to the transfer of specialist neurosurgery and cardiothoracic services from the Brook hospital to King's and Guy's and St. Thomas', respectively.
East London and The City
I have decided to accept the proposals to improve the general and specialist services managed by the Royal Hospitals NHS Trust by bringing them together on the Royal London Whitechapel site. This will mean, over time, transferring services from the London chest hospital site and most of the St. Bartholomew's site.
I am determined that the St. Bartholomew's ethos and culture should be preserved, albeit on a different site. In making my decision, I have paid particular attention to the views which have been expressed about the historical significance of St. Bartholomew's and its national and international importance as a centre of excellence in medical teaching and research. I am setting up a project team to explore the options for using the invaluable asset of the Smithfield site. This will build on the work carried out by the trust and the "City Initiative".
I also welcome the proposals to develop the Homerton hospital as a modern district general hospital for the growing population of Hackney.
Barnet
I have decided to accept the proposals to develop the Edgware site as a new local hospital. The Edgware accident and emergency department will be replaced by a minor injuries unit, and in-patient services transferred from Edgware general hospital to Barnet General, following completion of its redevelopment, Northwick Park and the Royal Free hospitals. I have made it clear that the Edgware accident and emergency department is to remain open until phase 1a of the development at the Barnet general hospital, which includes a new accident and emergency department, has been completed, which I understand is not expected to be before 1997, and satisfactory arrangements are in place for ambulance transport and for patient and visitor transport between the two sites.
The changes which I have agreed will strengthen specialist services by concentrating them in fewer, better,
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centres of excellence and provide modern acute hospitals closer to major centres of population. Together with major planned investment in primary and community health services, they will take forward our aim of improving health care for Londoners.Exhaust Fumes (Leukaemia)
Mr. Alan W. Williams: To ask the Secretary of State for Health what assessment her Department has made of whether exposure to benzene from motor exhaust fumes is a causative factor in leukaemia and lymphoma; and if she will make a statement. [17701]
Mr. Sackville: Benzene is known to have both carcinogenic and toxic effects, and studies of workers exposed to high concentrations of benzene-- up to 100 parts per million--throughout their working life have demonstrated increased risks of leukaemia. Because benzene is a genotoxic carcinogen, no absolutely safe level of exposure can be defined. However, no adverse effect on blood formation has been confirmed in humans following regular repeated exposure to benzene in air at concentrations below 25 30 ppm.
The Department is advised on the health effects of benzene by the Committee on Carcinogenicity and the Committee on the Medical Effects of Air Pollutants. Their views were taken into account by the joint Department of the Environment/Department of Health expert panel on air quality standards when it recommended a United Kingdom air quality standard for benzene of 5ppb as a running annual average. The urban annual average concentrations is generally at or below 5ppb; at these concentrations there is only an exceedingly small risk to health. The overall effect of policies now in place or agreed means that by the year 2000 exceedances of 5ppb standard should be virtually eliminated.
Staphylococcus Aureus
Mr. Alan W. Williams: To ask the Secretary of State for Health how many cases of methicillin-resistant staphylococcus aureus occurred in Britain in each year since 1990 and in each month since January 1994. [17770]
Mr. Sackville: This information is not available centrally in England. Details relating to Wales and Scotland are matters for my right hon. Friends the Secretaries of State for Wales and Scotland.
Foster Placements
Ms Coffey: To ask the Secretary of State for Health(1) what proposals she is considering to alter the Foster Placement (Children) Regulations 1991 with respect to the duties of local authorities and the delegation of those duties to profit-making independent fostering agencies; [17553]
(2) what consultations she has undertaken or plans to undertake about any proposed changes in the Foster Placement Regulations 1991. [17554]
Mr. Bowis: The Government propose to amend the Foster Placement (Children) Regulations 1991 to allow local authorities to delegate to profit-making bodies, certain of their fostering duties.
In August 1994 the Department of Health advised authorities, through circular LAC(94)20, copies of which are available in the Library, of an intention to amend these
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regulations in this way. I shall shortly be consulting on the draft regulations and associated guidance.Lynfield Mount Hospital
Mr. Madden: To ask the Secretary of State for Health what disciplinary action has been taken following the internal and external inquiries into the circumstances in which Raymond Pemberton escaped from the secure unit at Lynfield Mount hospital in Bradford; and if she will make a statement. [18156]
Mr. Bowis: This is a matter for Bradford Community Health National Health Service Trust. The hon. Member may wish to contact the chairman of the trust for details.
Job Losses
Mr. Flynn: To ask the Secretary of State for Health if she will list the jobs that have been lost to agencies in her Department in the past two years that have (a) been taken over by contractors and (b) disappeared. [18326]
Mr. Sackville: The numbers of staff in post in the Department's agencies for the period 1 April 1993 to 1 February 1995--the latest date for which information is held--and the numbers of posts in agencies which have been contractorised in the last two years, are shown in the tables.
Agency staff in post<1>
|1 April |1 April |1 February
|1993 |1994 |1995
---------------------------------------------------------------------
Medicines Control Agency |327 |379 |372
National Health Service
Estates |98 |99 |109
National Health Service
Pensions Agency |531 |530 |498.6
Medical Devices Agency |- |<2>160.5 |158
<1>Vacancies and unfilled posts not included.
<2> The Medical Devices Agency was established on 27 September 1994.
Staff in post figures are given for that date.
Contractorised posts
|1993-94|1994-95
---------------------------------------------------------
Medicines Control Agency |2 |-
National Health Service Estates |23 |-
National Health Service Pensions
Agency |- |16.4
Medical Devices Agency |- |4.35
Royal Northern Hospital
Mr. Corbyn: To ask the Secretary of State for Health what representations or considerations were received either by her Department or the regional health authority concerning the future of the Royal Northern hospital in Islington. [18417]
Mr. Malone: The future of the Royal Northern hospital is a matter for the North Thames regional health authority. The hon. Member may wish to contact Sir William Stavely, chairman of the authority, for information concerning the representations the authority has received. The Department of Health has received few expressions of interest in the future of the hospital.
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Accident and Emergency Services, London
Mr. Corbyn: To ask the Secretary of State for Health if she will make it her policy that the accident and emergency departments of (a) the Royal Free hospital, (b) University College hospital, (c) Whittingdon hospital, (d) the Royal London hospital, (e) Homerton hospital, (f) North Middlesex and (g) Chase Farm will remain open permanently. [18310]
Mr. Sackville: The provision of accident and emergency services is the responsibility of local health authorities, and is determined in the light of local needs, priorities and resources. The hon. Member may wish to contact New River health authority for details of any plans concerning North Middlesex and Chase Farm hospitals; Camden and Islington health authority about the Royal Free, Whittington and University College hospitals; and East London and The City health authority about Homerton and the Royal London hospitals.
Mr. Corbyn: To ask the Secretary of State for Health what is the latest estimate of the operating capacity and operating level of each of London's accident and emergency units; and if she will make a statement. [18289]
Mr. Sackville: It is for local health authorities to determine the extent of their needs for accident and emergency services, and to ensure that these are met.
Mr. Chidgey: To ask the Secretary of State for Health what consideration her Department has given to the effect that the closure of London hospitals will have on the time that emergency ambulances will take to reach a suitable hospital. [18269]
Mr. Malone: When proposing major service changes, local heath authorites take into account the effect on ambulance journey times to ensure that arrangements will be adequate.
Dental Services
Mr. Wigley: To ask the Secretary of State for Health what was the increase or decrease in the number of dentists between 1985 and 1995 in the areas of (a) Kent, (b) Surrey, (c) Bedfordshire and (d) Buckinghamshire. [18273]
Mr. Malone: The information is shown in the table.
General Dental Service: numbers of dentists<2> in Kent, Surrey, Bedfordshire and Buckinghamshire family health services authorities at 30 September 1995 and 30 September 1994. FHSA |1985 |1994 |Increase ---------------------------------------------------- Kent |458 |540 |82 Surrey |431 |443 |12 Bedfordshire |128 |149 |21 Buckinghamshire |189 |240 |51 Source: Dental Practice Board. Notes: <1> Includes principals, assistants and vocational trainees. Excludes hospital, community and salaried dentists. <2> Some dentists have contracts with more than one family health services authority. These dentists have been counted only once, in the family health services authority in which they hold their main contracts.
Contagious Diseases (Health Workers)
Mrs. Beckett: To ask the Secretary of State for Health how many nurses and how many doctors have died from
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contagious diseases originating at their work place in each of the last 15 years; what information is given to nursing and other staff of the risks of disease from specific patients; and if she will make a statement. [16946]Mr. Sackville [holding answer 28 March 1995]: The information requested from the national health service industrial injuries scheme records would require extensive manual investigations and could be provided only at disproportionate cost. Information from other sources is as shown.
Employers are required by the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1985 to report specified diseases suffered by a person currently at work where the work involves an activity mentioned in the schedule. There is no requirement to report deaths resulting from these diseases. The specified diseases relevant to health care workers most likely to be fatal are hepatitis, tuberculosis and illnesses caused by a pathogen which presents a hazard to human health. The latter would include HIV. The table gives details of reports received since April 1986 where the occupation was given as nurse or doctor. Not all of these will have been occupationally acquired.
N Year |Hepatitis |Tuberculosis|Pathogen |Total ------------------------------------------------------------------------------ 1986-87 |11 |6 |4 |21 1987-88 |9 |3 |- |12 1988-89 |7 |1 |- |8 1989-90 |8 |2 |- |10 1990-91 |5 |3 |2 |10 1991-92 |4 |5 |12 |21 1992-93 |1 |2 |2 |5 1993-94 |- |2 |2 |4
The Public Health Laboratory Service keep records of how HIV infection and hepatitis B were probably acquired. No deaths from AIDS are known to have occurred in health care workers who acquired HIV infection occupationally. No fatal cases of acute hepatitis B are known to have occurred in a health care worker infected at work in the United Kingdom during the past 10 years.
The number of deaths from tuberculosis in health care workers infected at work is not known. However, a survey in 1988 revealed fewer than 50 health care workers with tuberculosis and the majority of those will not have acquired the disease through their work. Based on the known fatality rate for TB in this age group, only one or two of these cases will be expected to have died.
In 1990 The Department of Health issued a booklet "Guidance for Clinical Health Care Workers--Protection Against Infection With HIV and Hepatitis Viruses". Advice is also contained in guidelines by the Advisory Committee on Dangerous Pathogens; "HIV--the Causative agent of AIDS" also issued in 1990. Advice on protection of health workers was given in the British Thoracic Society guidelines in 1994. Copies of these documents are available in the Library.
Food labelling (Peanut Products)
Rev. Ian Paisley: To ask the Secretary of State for Health what plans her Department has to introduce food safety regulations to enforce the indication of peanut extract contents on food labelling. [17014]
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Mrs. Browning: I have been asked to reply.
The European Community's scientific committee for food is currently considering recommendations concerning which allergens occurring in food have sufficiently serious consequences for consumer health to justify their always being listed on a food label. We expect the EC Commission to make proposals for revised rules following receipt of the scientific opinion and we expect that peanuts will be included. In the meantime, my officials have held discussions with industry and consumer representatives and have established awareness of the problem across all sectors of the industry. As a result, many food manufacturers are now labelling their products voluntarily and some have examined the reformulation of products. We have also sponsored research to determine whether and how far groundnut oils may be contributing to the problems.
ENVIRONMENT
Homelessness
Mr. Raynsford: To ask the Secretary of State for the Environment if he will list in England the total number of homeless households accepted for each local authority in each year between 1979 and 1994. [17045]
Mr. Curry: I have today placed in the Library a table giving the numbers of homeless households which each local authority in England reported as having accepted responsibility to secure permanent accommodation, under the homelessness provisions of the Housing (Homeless Persons) Act 1977 and the Housing Act 1985 in the years 1979 to 1994.
Council House Sales
Mr. Raynsford: To ask the Secretary of State for the Environment if he will list the total number of council homes sold (a) under the right to buy, and (b) otherwise, by each local authority in England in each year from 1980 to 1994. [17044]
Mr. Curry: Tables showing the available information on total right- to-buy sales for each English local authority for every financial year from 1979 80 to March 1994 are in the Library. In addition, the tables also give data on total sales and on the number of flats sold.
Local Government Finance
Mr. Clifton-Brown: To ask the Secretary of State for the Environment if he will list those local authorities which are considered to be debt free; and what are the Government guidelines on the debt to equity ratio for local authorities. [17372]
Mr. Robert B. Jones: A local authority is debt free if it has a nil or negative credit ceiling at the beginning of the current financial year and has no outstanding borrowing, other than short-term borrowing repayable within not more than 12 months or borrowing under the City of London (Various Powers) Act 1924. The following local authorities declared themselves to be debt free as at 30 September 1994:
Dorset
Bedford
Bracknell
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BrecklandBroadland
Chiltern
Christchurch
Corby
Dacorum
Daventry
East Cambridgeshire
East Devon
East Dorset
Epsom and Ewell
Hambleton
Hertsmere
Leominster
Medina
Mid Bedfordshire
Mid Sussex
Newbury
Rochester upon Medway
Ryedale
St. Edmundsbury
South Bucks
South Northampton
South Shropshire
South Wight
South Coastal
Surrey Heath
Swale
Tonbridge and Malling
Tunbridge Wells
West Sussex
Barking and Dagenham
City of London
There is no real equivalent to shareholders' equity in local authorities, and therefore no guidelines on the ratio of debt to equity. But the local government capital finance system effectively regulates authorities' new borrowing and requires provision to be made for debt redemption. We will continue to encourage local authorities to reduce their outstanding debt using sums which they have set aside for this purpose.
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