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Written Answers to Questions

Tuesday 13 June 1995


GP Fundholding, Warwickshire

Mr. Mike O'Brien: To ask the Secretary of State for Health what percentage of fundholding practices have exceeded their allocated budget in each of the last three years in the county of Warwickshire and have had to seek new resources from the health authority.     [27302]

Mr. Malone: The numbers of fundholders in Warwickshire who have exceeded their allocated budgets over the last three years are shown in the table.

                                                |Number of                      

                                |Number of      |fundholding                    

                                |fundholding    |practices                      

                |Total number of|practices      |exceeding their                

                |fundholding    |exceeding their|budgets by over                

                |practices      |budgets        |5 per cent.                    


1992-93         |9              |1              |0                              

1993-94         |21             |4              |2                              

1994-95<1>      |26             |<2>13          |5                              


<1>Provisional information.                                                     

<2 >Eight have an overspend of less than 1 per cent. and the highest overspend  

is around 7.4 per cent. A number of practices have made savings of over 10 per  



West Midlands Regional Health Authority.                                        


Mr. Battle: To ask the Secretary of State for Health (1) what plans she has to ensure that people aged over 60 years with epilepsy receive treatment from specialists in neurology rather than from geriatricians;     [27766]

(2) if she will provide details of her Department's planned expenditure on the provision of epilepsy services in the current financial year, in cash terms and as (a) a percentage of its total budget and (b) equivalent figures for each of the last five years, adjusted for inflation;     [27762]

(3) what plans she has to include epilepsy as a condition for special attention in "The Health of the Nation";     [27572]

(4) how many specialist centres and clinics for epilepsy are currently operating in the United Kingdom; and what plans she has to increase the number;     [27691]

(5) if she will instruct NHS providers to introducea maximum waiting time for consultants to seepeople diagnosed as having epilepsy by a general practitioner.     [27763]

Mr. Bowis: The treatment of epilepsy is a matter for clinicians, who decide on specific treatment for each individual patient based on that patient's medical history.

Information on expenditure on the provision of epilepsy services is not available centrally.

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Currently, there are no plans to include epilepsy as a condition for special attention in "The Health of the Nation". The Chief Medical Officer's working group on "The Health of the Nation", however, regularly reviews and considers various conditions for such attention.

Information on the numbers of specialist centres and clinics for specific conditions is not available centrally. There are no central plans to increase the number of these for epilepsy, as this a matter for local determination.

The revised patients charter has introduced standard waiting times to first -patient out-patient consultation. This standard applies to all specialties and requires that all patients should be seen within 26 weeks of being referred to a consultant by their general practitioner, and that nine out of 10 patients should be seen within 13 weeks.

These are maximum waiting times and we would expect that patients whose clinical need was urgent should be seen much more quickly.

Disabled Living Centres

Mr. Battle: To ask the Secretary of State for Health if she will list all disabled living centres in England and Wales; and how much her Department contributes to each of their budgets.     [27768]

Mr. Bowis: A list of all the disabled living centres is not available centrally. The Government support the work of the disabled living centres by providing funding to their representative national organisation, the Disabled Living Centres Council--£108,000 in the current financial year.

National Blood Authority

Mr. Spearing: To ask the Secretary of State for Health if she will publish the findings of the National Blood Authority consequent to its consultations on proposals it has made for changes in the organisation of its service.     [27876]

Mr. Sackville: The National Blood Authority will make its final recommendations shortly. A copy of the authority's proposals will be placed in the Library when published.

Emergency Admissions

Mr. Congdon: To ask the Secretary of State for Health what has been (a) the total number of admissions, (b) the number of emergency and urgent admissions and (c) (b) as a percentage of (a) for each year since 1988 89.     [27537]

Mr. Sackville: The information is shown in the table:

Emergency admissions as a total of waiting list, booked,              

planned and emergency admissions                                      

Finished consultant episodes  Thousands                               

                            |(b) Episodes,|(b) as                     

              |(a) Total    |emergency    |percentage of              

              |episodes     |admission    |(a)                        


1988-89       |6,830        |3,302        |48                         

1989-90       |7,085        |3,423        |47                         

1990-91       |7,082        |3,452        |49                         

1991-92       |7,504        |3,457        |46                         

1992-93       |7,873        |3,641        |46                         

1993-94       |8,287        |3,833        |46                         

Source: Hospital Episode Statistics.                                  


Mr. Battle: To ask the Secretary of State for Health how many reports of adverse reactions have been referred to the Committee on Safety of Medicines in respect of products containing phenobarbitone in each of the last five years for which figures are

available.     [27573]

Mr. Sackville: The tables shows the number of reports of adverse reactions received by the Committee on Safety of Medicines in respect of products containing phenobarbitone for each of the last five years. A report of a suspected adverse reaction does not necessarily mean that it was caused by the drug. Other factors, including the underlying disease of the patient or other drugs taken by the patient, may be contributing.

Year              |Number of reports                  


1990              |4                                  

1991              |0                                  

1992              |2                                  

1993              |1                                  

1994              |2                                  

Mr. Battle: To ask the Secretary of State for Health, how many prescriptions for products containing phenobarbitone have been written for people with epilepsy in each of the last five years for which figures are available.     [27574]

Mr. Malone: Information about the use of phenobarbitone products is contained in the table. It is not possible, however, from central data to identify the clinical conditions for which the drug has been prescribed.

Prescription items dispensed containing phenobarbitone,                                                               

England, 1990 to 1994                                                                                                 


Chemical entity       |1990           |1991           |1992           |1993           |1994                           


Phenobarbitone        |547.8          |543.9          |513.0          |480.5          |453.0                          

Phenobarbitone and                                                                                                    

  Phenytoin           |0.2            |0.0            |0.0            |0.0            |0.0                            

Phenobarbitone Sodium |0.6            |2.6            |2.1            |0.5            |1.2                            


Total                 |548.6          |546.5          |515.1          |481.0          |454.2                          


1. The data are from the prescription costs analysis system.                                                          

2. The data for 1990 are not consistent with data from 1991 onwards. Figures for 1990 are based on fees and on a      

sample of one in 200 prescriptions dispensed by community pharmacists and appliance contractors only. Figures from    

1991 are based on items and cover all prescriptions dispensed by community pharmacists, appliance contractors,        

dispensing doctors and prescriptions submitted by prescribing doctors for items personally administered.              

3. Prescriptions dispensed in hospitals and private prescriptions are not included.                                   

DNA Analysis

Mr. MacShane: To ask the Secretary of State for Health what were the results of the DNA analysis undertaken by the Forensic Science Service of tissue samples allegedly taken from a patient who died in Manchester allegedly of AIDS in 1959, which were provided to it by Central Manchester Healthcare Trust and Professor David Ho of New York.     [27816]

Mr. Sackville: Tests are under way on the tissue samples at the Home Office laboratory at Wetherby. It is hoped that the results will be available shortly. The hon.

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Member may wish to contact Professor S. A. Moore, chairman of the trust, for more information.

Intensive Care Units, Yorkshire

Mr. Battle: To ask the Secretary of State for Health how many beds there are in intensive care units in Leeds infirmary, St. James' hospital, Leeds, Pinderfields hospital, Wakefield.     [27819]

Mr. Sackville: This is a matter for the Northern and Yorkshire regional health authority. The hon. Member may wish to contact Mr. John Greetham, chairman of Northern and Yorkshire regional health authority, for details.

Infant Feeding

Mr. Martyn Jones: To ask the Secretary of State for Health what is the estimated expenditure for 1995 for producing information on infant and young child feeding (a) for families and (b) those involved in the field of infant and young nutrition.     [27928]

Mr. Sackville: As a wide range of organisations may produce such materials, I am unable to estimate expenditure.

The Department of Health spent £53,000 in producing materials in support of this year's National Breastfeeding Awareness Week held last month. We contributed £50,000 towards the costs of the "Invest in Breast" training programme produced jointly by the Royal College of Midwives and Health Visitors Association which was launched on 25 May. We provided some £55,000 in 1994 95, under the section 64 grant aid programme, to the three voluntary groups concerned with informing and supporting mothers about breastfeeding.

The Health Education Authority expended £475,000 in 1994 95 on materials--leaflets and such popular books as "Birth to Five" and "The Pregnancy Book"--which provide information on breastfeeding and other aspects of infant and young child feeding.

Bounty Packs

Mr. Martyn Jones: To ask the Secretary of State for Health what regulations are in place covering the distribution of bounty packs to nursing mothers in hospital.     [27929]

Mr. Sackville: I refer the hon. Member to the reply I gave him on 5 April at columns 1211 12 . National health service units decide locally whether they wish to permit the distribution of bounty packs and similar packs to new mothers in their care. The packs and their contents must comply with the relevant provisions on advertising and promotion of baby milks in the Infant Formula and Follow-on Formula Regulations 1995.

Homeless Mentally Ill Initiative

Mr. Rowe: To ask the Secretary of State for Health when she expects to publish the evaluation of the homeless mentally ill initiative's clinical teams.     [28848]

Mr. Bowis: The report, "The Homeless Mentally Ill Initiative--An Evaluation of Four Clinical Teams", is being published today and copies are available in the Library. I am grateful to Professor Craig and his colleagues for their work.

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The homeless mentally ill initiative, organised by the Department of Health in collaboration with the Mental Health Foundation, was launched in 1990. It provides multidisciplinary community mental health teams to identify homeless mentally ill people in London who are not already in touch with statutory services. The teams assess clients' needs, provide medical and social support, and refer them to appropriate statutory services. The initiative also provides specialist hostels with a high level of care which meets immediate housing needs and offers rehabilitation before clients move on to more permanent accommodation. There is also provision of supported move-on accommodation with capital funding from the Housing Corporation.

The Government have invested over £20 million in this initiative. The five outreach teams, the eight hostels with two more to come and the move- on supported accommodation that is beginning to come on stream have begun to transform lives. It is estimated that between October 1994 and March 1995 about 115 people were rehoused, either into the specialist high care hostels or into permanent accommodation.

The report acknowledges the need for multidisciplinary outreach teams and comments favourably on the high level of direct client interaction that they have been able to attain. It also comments on the positive view taken of the teams by the majority of agencies with which they work.

Professor Craig's report contains a number of recommendations. We shall be studying these in detail and considering what action can be taken to build on the successes that he has identified.

Hyperactive Disorder

Mr. Ieuan Wyn Jones: To ask the Secretary of State for Health if she will list the amount of grant aid given by her Department to (a) the hyperactive children's support group and (b) other voluntary organisations concerned with the treatment of attention deficit and hyperactivity disorder for each of the last five years for which figures are available; and if she will make a statement.     [26581]

Mr. Bowis: The hyperactive children's support group received grant aid from the Department of £7,000 each

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year from 1 April 1992 to 31 March 1995. The grant has been renewed at an amount totalling £19,000 over three years beginning on 1 April 1995. We make no other grants to organisations dealing exclusively with the treatment of attention deficit and hyperactivity disorder.

GP Fundholding, Cumbria

Mr. Campbell-Savours: To ask the Secretary of State for Health how many fundholders there are in the county of Cumbria.     [27797]

Mr. Malone: From April 1995, there have been 16 fundholding practices in Cumbria.

Mr. Campbell-Savours: To ask the Secretary of State for Health what is her estimate of the cost in cash to health authorities in Cumbria with particular reference to the budget of the West Cumbria Health Trust arising out of individual general practices acquiring fundholding status.     [27798]

Mr. Malone: Fundholding general practitioners, like health authority purchasers, are allocated their patients' fair share of national health service resources based on need. It is for NHS trusts to respond to the requirements of purchasers so that services for patients are improved.

Hospital League Tables

Ms Lynne: To ask the Secretary of State for Health how much is being spent promoting the current year's hospital league tables to the editors of regional newspapers.     [28000]

Mr. Sackville: Money is not being spent on promoting the league tables. Regional editors are being given the option of receiving the material in hard copy or disk format. They have also been invited to a briefing on the arrangements for publishing the tables.

Mental Health

Mr. Hinchliffe: To ask the Secretary of State for Health how many people were discharged from mental hospitals in each region in each of the last 10 years.     [27966]

Mr. Bowis: The number of finished consultant episodes--ordinary admissions and day cases combined--from national health service hospitals in England by main diagnosis of mental disorder and by region of treatment is shown in the table. Data prior to April 1988 are not on a comparable basis.

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Finished consultant episodes (ordinary admissions and day cases combined) 

1988-89 to 1993-94                                                        

Mental Disorders                                                          

RHAs              |1988-89|1989-90|1990-91|1991-92|1992-93|1993-94        


England           |294,327|306,077|302,042|302,378|313,186|315,378        

Northern          |22,841 |22,228 |22,852 |22,017 |22,814 |22,877         

Yorkshire         |21,628 |22,152 |24,095 |20,391 |24,342 |24,985         

Trent             |28,415 |28,369 |31,183 |32,032 |32,268 |31,602         

East Anglian      |11,454 |11,936 |11,890 |10,452 |12,471 |11,525         

North West Thames |19,484 |24,206 |17,461 |17,568 |18,482 |19,373         

North East Thames |21,294 |20,451 |20,581 |20,807 |21,792 |22,436         

South East Thames |21,033 |19,447 |19,540 |18,501 |19,394 |19,463         

South West Thames |20,063 |19,858 |20,218 |20,929 |20,680 |21,313         

Wessex            |18,445 |18,788 |19,607 |21,829 |18,348 |19,324         

Oxford            |10,860 |11,122 |11,718 |11,156 |12,711 |12,383         

South Western     |24,871 |25,627 |24,182 |23,306 |25,548 |26,340         

West Midlands     |30,800 |34,801 |31,562 |36,539 |35,824 |35,447         

Mersey            |15,768 |17,795 |17,935 |17,770 |18,369 |17,541         

North Western     |25,474 |27,204 |26,391 |26,136 |26,608 |27,171         

SHAs              |1,897  |2,093  |2,827  |2,945  |3,535  |3,598          

Special Transitional Grants

Mr. Hinchliffe: To ask the Secretary of State for Health which district auditors have yet to submit audited returns of expenditure by local authorities of the 1993 94 special transitional grant.     [27967]

Mr. Bowis: None. All the audited returns detailing community care spending in 1993 94 have now been received.

Home Care Services

Mr. Hinchliffe: To ask the Secretary of State for Health how much was spent on home care services by each authority in each of the last 10 years, expressed in 1995 prices.     [28026]

Mr. Bowis: The information, expressed in 1994 95 prices, will be placed in the Library. These figures should be treated with caution as local authorities differ from year to year in their treatment of administrative and other overhead costs. Year-on-year variations may also reflect changes in types of home care service and changes of contract. New guidelines for future social services accounting have been drawn up by the Chartered Institute of Public Finance and Accountancy and the local authorities, which should result in greater consistency of reporting. Estimates have had to be made for some years for Greenwich, Hackney, Lambeth, Newham, Berkshire, Ealing, Harringey, Sheffield, Manchester and Wakefield.

Kirklees Metropolitan Council

Mrs. Peacock: To ask the Secretary of State for Health how much money has been made available to Kirklees metropolitan council for alteration and adaptations for 1995 96 to residents' homes to allow them to stay longer in their own homes rather than in residential care; and what were the figures in each of the last 10 years.     [27856]

Mr. Bowis: Expenditure by Kirklees metropolitan council up to 1993 94, the latest year available, is shown in the table.

Personal social     

services gross      

expenditure on      

adaptations to      




Year    |£000s      


1986-87 |100        

1987-88 |107        

1988-89 |100        

1989-90 |150        

1990-91 |393        

1991-92 |210        

1992-93 |82         

1993-94 |502        

Information from    

annual revenue      

outturn forms (RO3) 

completed by the    

local authority.    

Contract Sanctions

Mrs. Jane Kennedy: To ask the Secretary of State for Health what sanctions can be applied against a contractor for failing to comply fully with the specifications of a contract awarded to it by an NHS trust hospital following the market testing process.     [28383]

Mr. Sackville: This depends on the terms of the contract, and on the nature of the failure to meet specified requirements. Minor or occasional failures would normally be resolved in discussion. In more serious and continuing cases sanctions might include premature

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termination of contract, withholding of payments pending satisfactory meeting of work requirements, or legal action for breach of contract.

Royal Liverpool University Hospital

Mrs. Jane Kennedy: To ask the Secretary of State for Health if the Transfer of Undertakings (Protection of Employment) Regulations 1981 applied to the contracting out and sub-contracting out of the estates department by the Royal Liverpool University hospital; and what stipulation the contract awarded made in respect of the provision of a pension scheme for those employees transferred.     [28385]

Mr. Sackville: I understand that the award of the contract was on the basis that staff would transfer to the new contractor under the provisions of the Transfer of Undertakings (Protection of Employment) Regulations 1981. Pension scheme benefits for old age, invalidity and widowhood are explicitly excluded from the transfer arrangements, but the two parties to the contract have ensured accrued pension rights are fully protected and that the new employer's pension arrangements are based on the same employers contribution as the previous national health service scheme. The Royal Liverpool University hospital took legal advice that the transfer accorded fully with all statutory responsibilities under United Kingdom and European law.

Mrs. Jane Kennedy: To ask the Secretary of State for Health what representations she has received concerning the guidelines and procedures followed by the Royal Liverpool University hospital NHS trust in contracting out its estates department to Mowlem and the subsequent sub- contracting out of the department of Lorne Stewart.     [28382]

Mr. Sackville: I have received representations from two hon. Members on behalf of individual constituents whose employment transferred as a result of the award of contract in this case. I am satisfied that the parties concerned have made every effort to meet all liabilities arising under United Kingdom and European law.

NHS Staff, Southwark

Ms Harman: To ask the Secretary of State for Health how many (a) men and (b) women have been employed within the national health service in the London borough of Southwark as part of the South East London health authority in each of the last five years.     [28352]

Mr. Malone: The information is not available centrally in the form requested.

NHS Trust, London

Mr. Spearing: To ask the Secretary of State for Health if she will state the defined interest or repayment terms on the interest bearing debt and public dividend capital of (a) Newham Healthcare NHS Trust and (b) the Royal Hospitals of St. Bartholomew's, Royal London, and London Chest Hospital Trust together with their respective payments for the years 1975 76 in respect of (i) 6 per cent. of their origination capital debt, (ii) interest and repayment of their interest-bearing debt and (iii) public dividend capital, stating the purpose of each type of payment.     [28380]

Mr. Sackville: The two national health service trusts in question were established as at 1 April 1994. Information is therefore only available for 1994 95.

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An NHS trust's originating capital debt is divided between a loan--on which interest shall be paid--and public dividend capital. The debt is divided on a 50:50 basis and the interest- bearing element is repayable in equal instalments over 25 years at a fixed rate of interest. The interest rate applicable to NHS trusts established on 1 April 1994 is 8.125 per cent. The actual value of the originating debt of the trusts in question is given in Statutory Instrument 1995 No. 407, dated 20 February 1995.

My right hon. Friend the Secretary of State may determine the dividend which is to be payable at any time on the public dividend capital element of the trust's originating debt.

The NHS executive's records show that the following payments were made in 1994 95.

                          |Royal London             

             |Newham      |hospitals                

             |£           |£                        


Principal    |377,773     |1,649,000                

Interest     |1,469,530   |6,409,556                

Dividend     |720,472     |2,842,485                

These figures are provisional and subject to audit. 

Contract income received by a trust will include a 6 per cent. return on its relevant net assets from which the trust remunerates its debt. The actual return achieved by trusts in 1994 95 will be reported in their annual accounts which will be available following audit no later than 30 September.

Veterinary Medicines

Mr. Martyn Jones: To ask the Secretary of State for Health what research her Department has (a) commissioned and (b) evaluated into the use of Baytril in farm animals and the incidence of bacterial resistance in humans; and if she will make a statement on the subject.     [26783]

Mrs. Browning: I have been asked to reply.

No specific research has been commissioned into the use of Baytril in farm animals. The Veterinary Products Committee keeps the development of antibiotic resistance in humans and animals under close review. It has recently confirmed, in the light of the latest information, that no change in current licensing policy is required: new antibiotics should not necessarily be precluded from therapeutic use in animals, but their prophylactic use should be discouraged. The committee will continue to consider each case on its merits.



Mr. Dalyell: To ask the Chancellor of the Duchy of Lancaster what action Her Majesty's Government are taking to train sufficient scientists in methods relating to the identification of species to enable the United Kingdom to fulfil obligations under the biodiversity convention; and what assessment has been made of the shortage of taxonomists.     [26328]

Mr. Horam: In line with the convention, the Darwin initiative is funding about 30 projects relating to

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taxonomy costing over £3 million. Those projects involve the training of over 400 developing country scientists.

Responsibility for assessing and meeting the UK's needs more generally rests primarily with the scientific community in universities, institutions such as the natural history museum, and the research councils. The Natural Environment Research Council launched an initiative in 1992 to revitalise taxonomic research and training relevant to the environmental sciences, and currently supports students, fellows, and projects in the field. I understand that Edinburgh university and the Royal Botanic Garden, Edinburgh have introduced an MSc "Biodiversity and Taxonomy in Plants" which has proved successful in attracting students from home and abroad as well as research council support. The UK Systematics Forum, funded by the Office of Science and Technology, now brings together members from across the country to investigate, among other things, ways of increasing the opportunities for training systematists.

Mr. Dalyell: To ask the Chancellor of the Duchy of Lancaster what measures Her Majesty's Government have taken to implement the recommendations of Lord Dainton's report on biological

taxonomy.     [26331]

Mr. Horam: The Government's response Cm 2243 to the House of Lords Science and Technology Select Committee report on systematic biology research was published in June 1993. Since then, the Office of Science and Technology has set up the UK Systematics Forum and commissioned an independent review of the UK's microbial culture collections.

The Natural Environment Research Council, through its initiative in taxonomy research and training, is currently funding six research fellowships over a five-year period at a total cost of just over £1 million. These fellowships are eligible for associated research grants, for which a further £665,000 has been committed over the same period.

Oral Scientific Histories

Mr. Dalyell: To ask the Chancellor of the Duchy of Lancaster, pursuant to his letter DH/94/M/1078 to the hon. Member for Linlithgow of 7 December 1994, what is the outcome of his investigation into the desirability of oral scientific histories.     [26327]

Mr. David Hunt: I agree that the history of science can be enriched by oral scientific histories.

Investigations have established that a number of bodies are engaged in making such histories, including the Royal College of Physicians, the British Library, the Physiological Society and the Biochemical Society. BBC television has some recorded interviews with Nobel Laureates and other scientists who have made a significant contribution across many fields. I have asked the Office of Science and Technology to pursue the issue of oral scientific histories further with the national sound archive of the British Library.


Summer Economic Forecast

Mr. Andrew Smith: To ask the Chancellor of the Exchequer what is the expected publication date for the Treasury's summer economic forecast.     [24495]

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Mr. Aitken [pursuant to his answer, 18 May 1995, c. 307]: The Treasury's summer economic forecast will be published on 28 June 1995. Copies will be available from the Vote Office at 11 am on that day.

Public Sector Investment

Mr. Milburn: To ask the Chancellor of the Exchequer what estimate he has made as to how much public sector investment will change over the next three years, as measured by public sector asset creation; and if he will estimate by how much public sector investment has changed in real terms since 1989 90.     [27882]

Mr. Aitken: The latest available public sector investment figures are published in table 1.7 of the statistical supplement to the "Financial Statement and Budget Report 1995 96". These cover outturn and plans from 1989 90 to 1997 98 in real and cash terms. In addition, the private finance initiative will harness private sector resources leading to more and better infrastructure projects and improved services.

Income Tax

Mr. Flynn: To ask the Chancellor of the Exchequer how many new income tax payers recorded in the past two years were previously non-income tax payers of pension age.     [27589]

Sir George Young [holding answer 9 June 1995]: There are about 200,000 fewer taxpayers aged over 65 in 1995 96 than there would have been if the 1993 94 tax regime had been indexed.

Value Added Tax

Mr. Malcolm Bruce: To ask the Chancellor of the Exchequer if he will list the categories of goods and services which currently bear value added tax at the rate of 17.5 per cent. together with the annual revenue yield from each of the listed categories.     [28142]

Mr. Heathcoat-Amory [holding answer 12 June 1995]: VAT legislation does not identify separate categories of goods and services on which VAT is chargeable at 17.5 per cent. but specifies that it should be charged on any supply of goods or services in the United Kingdom made by a taxable person in the course or furtherance of a business, except for supplies of fuel and power for domestic or charity use which are chargeable at 8 per cent., and the zero rates and exemptions listed in schedules 8 and 9 to the Value Added Tax Act 1994.

It is not possible to provide figures for the revenue yield from each individual category of expenditure.

Incapacitated Spouses

Mrs. Maddock: To ask the Chancellor of the Exchequer what plans he has to review the operation of the additional personal allowance for married men with an incapacitated wife.     [28344]

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