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School nursing staff (excluding
agency), England 1989-1993 as at
30 September each year
|Whole-time
|equivalents
------------------------------------
1989 |2,440
1990 |2,510
1991 |2,460
1992 |2,440
1993 |2,470
Source:
PD(STATS)B Non-Medical Workforce
Census.
Note:
Figures are rounded to the nearest
ten whole-time equivalent.
GP Fundholding
Mrs. Beckett: To ask the Secretary of State for Health what has been the average expenditure per fundholding practice on purchasing care from the private sector in each year since 1990 91. [30436]
Mr. Malone: The first wave of fundholders took responsibility for their own budgets on 1 April 1991. The average expenditure per fundholding practice on purchasing care from non-national health service providers is shown in the table.
|Expenditure on
|health-care
|Number of |from non-NHS
|providers per
|fundholding |GP fundholding
|practice
|practices |£000s
------------------------------------------------------------
1991-92 |306 |12
1992-93 |587 |22
1993-94 |1,235 |24
Notes:
The figures for 1993-94 are provisional: the summarised
accounts for 1993-94 are subject to audit by the National
Audit Office.
Prescriptions
Mr. Miller: To ask the Secretary of State for Health, pursuant to her answer of 20 June, Official Report , columns 209 10 , in respect of discrepancies in answers on prescriptions if she will make a statement on the steps she has taken to eliminate such errors; what are the implications that the corrected information will have on her assessment of the level of fraud in the NHS; and what are the differences between the data she placed in the Library on 15 June and the information provided to the Chester and Ellesmere Port community health council which make the latter commercial-in -confidence. [31049]
Mr. Malone: The Department is reviewing internal procedures and use of the database package to minimise the risk of such errors reoccurring. The data supplied to the Chester and Ellesmere Port community health council
Column 685
have not been used within the Department and so have no implications for any other analyses.The information provided to the community health council included details of the numbers of prescription items and net ingredient cost for each preparation, which are considered to be
commercial-in-confidence. The data placed in the Library on 15 June included only the names of the preparations, in alphabetical order.
Mr. Ieuan Wyn Jones: To ask the Secretary of State for Health what is her estimate for the cost of administering the present prescription and exemption charges system in the United Kingdom; and if she will make a statement. [29584]
Mr. Malone: The available information for England is shown in the table.
Administration cost of the National Health Service prescription
system<1> and the prescription charge exemption and remission
arrangements in England in 1994-95
|Cost £
Item |Million
---------------------------------------------------------------------
Purchase of prescription forms for supply to doctors
and dentists<2> |1.3
Pricing of prescriptions dispensed by community
pharmacists, appliance contractors and doctors<3> |28.0
Operation of the NHS Low Income Scheme in England
and Wales<3> |5.2
Total |34.5
Notes:
<1>Excludes fees paid to doctors, dentists and pharmacists for
professional services and expenditure on the drugs bill.
<2>Expenditure by Family Health Services Authorities. Other FHSA
administration costs associated with the NHS prescription system and
the charge exemption and remission arrangements are not separately
identified.
<3>Expenditure by the Prescription Pricing Authority. The costs of
operating the NHS Low Income Scheme in England and Wales are not
separately identified. The scheme provides remission of prescription
charges and help with other NHS costs to eligible claimants and
their dependents.
Information relating to Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales and for Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland.
Mr. Jones: To ask the Secretary of State for Health what was the revenue raised through prescription charges in the United Kingdom in (i) 1992 93, (ii) 1993 94 and (iii) 1994 95; and if she will make statement. [29586]
Mr. Malone: I refer the hon. Member to the reply I gave the right hon. Member for Derby, South (Mrs. Beckett) on 9 December 1994 at column 397. Figures for 1994 95 are not yet available. Information relating to Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales and for Scotland and my right hon. and learned Friend the Secretary of State for Northern Ireland.
Mrs. Ewing: To ask the Secretary of State for Health if she will list the cost of prescription charges since 1965 indicating the figure as a percentage of (a) average earnings, (b) the cost of living, (c) basic state pensions and (d) taxable pensions. [30501]
Column 686
Mr. Malone: Prescription charges since 1965 are shown in the table. Details of average gross weekly earnings are contained in the "New Earnings Survey", a copy of which is in the Library. Everyone of state retirement pension age is entitled to free prescriptions, as are people of working age on low incomes who qualify for full remission of charges under the national health service low income scheme. In 1994, about 83 per cent. of prescribed items were dispensed free of charge compared with some 42 per cent. in 1968 when prescription charges were reinstated.
Prescription charges at 1 April
1965-1995
|Prescription
|charges
Year |£
---------------------------------------
1965 |0.00
1966 |0.00
1967 |0.00
1968 |0.00
1969 |0.13
1970 |0.13
1971 |0.20
1972 |0.20
1973 |0.20
1974 |0.20
1975 |0.20
1976 |0.20
1977 |0.20
1978 |0.20
1979 |0.20
1980 |0.70
1981 |1.00
1982 |1.30
1983 |1.40
1984 |1.60
1985 |2.00
1986 |2.20
1987 |2.40
1988 |2.60
1989 |2.80
1990 |3.05
1991 |3.40
1992 |3.75
1993 |4.25
1994 |4.75
1995 |5.25
Waiting Times Fund
Mrs. Beckett: To ask the Secretary of State for Health how much has been spent on the waiting list initiative in total, by region, in the NHS sector and the private sector in each of the last five years; and how many patients have been treated in the NHS and private sectors under the waiting list initiative, by region and in total. [30767]
Mr. Malone: The central waiting times fund operated from 1987 88 to 1993 94 during which time the number of patients waiting more than one year for treatment fell from 209,440 to 64,508, and has since fallen further to 31,635. The table shows allocations from the fund to regional health authorities. Information is not available centrally on spending of these funds between the national health service and the private sector, or on the number of patients treated in the NHS and the private sector under the waiting times initiative.
£ thousands
Allocations
|1989-90|1990-91|1991-92|1992-93|1993-94|Total
--------------------------------------------------------------------------
Northern |1,737 |1,798 |1,665 |2,216 |3,002 |10,418
Yorkshire |2,538 |2,017 |2,178 |2,659 |3,562 |12,954
Trent |2,489 |2,923 |2,779 |3,307 |3,988 |15,486
East Anglian |1,327 |1,135 |2,099 |1,846 |1,939 |8,346
North West Thames |2,428 |1,690 |2,768 |3,549 |5,230 |15,665
North East Thames |3,400 |3,808 |4,769 |3,169 |4,083 |19,229
South East Thames |2,653 |2,738 |3,909 |3,562 |5,220 |18,082
South West Thames |1,674 |2,138 |2,938 |2,332 |3,172 |12,254
Wessex |1,518 |2,024 |2,217 |2,317 |2,875 |10,951
Oxford |992 |1,638 |1,733 |2,056 |2,604 |9,023
South Western |1,665 |1,546 |2,137 |2,773 |3,537 |11,658
West Midlands |3,250 |4,472 |4,440 |3,424 |4,780 |20,366
Mersey |1,925 |1,515 |2,300 |2,272 |2,579 |10,591
North Western |2,407 |2,860 |2,735 |3,344 |4,311 |15,657
Total |30,003 |32,302 |38,667 |38,826 |50,882 |190,680
Column 687
North West Regional Health Authority
Mrs. Beckett: To ask the Secretary of State for Health what representations she has received from the British Medical Association relating to the impact of the waiting list initiative on clinical care in the North West regional health authority; and if she will make a statement. [30768]
Press and Public Relations Officers
Mrs. Beckett: To ask the Secretary of State for Health how much was spent on press and public relations by (a) the NHS Executive, (b) regional offices, (c) regional health authorities, (d) district health authorities, (e) family health service authorities and (f) trusts in each of the last five years; and how many press and public relations officers were employed by (a) to (f) . [30783]
Mr. Sackville: I refer the right hon. Member to the reply I gave her on 3 May, Official Report , column 241 . Information about the costs of press and public relations in the national health services is not available centrally.
NHS Communications
Mr. Trend: To ask the Secretary of State for Health what action is being taken to improve the standard of communications in the NHS; and if she will make a statement. [31821]
Mr. Malone: The National Health Service Executive's business plan for 1995 96, copies of which are available in the Library, reflects the priority now given to improving communications in the NHS. Improved communications will assist the accountability of the NHS to those it serves. It will now also enhance responsiveness to patients and ensure that the NHS is better able to promote good health. The NHS Executive is taking action both to improve its own communications and to encourage best practice within the service.
The executive has taken steps to improve the quality of information it supplies to both the NHS and the public. The volume of publications issued is being reduced and printed communications are being targeted more precisely to ensure resources are used to best effect. Information is now supplied through:
Column 688
regular briefings on service developments for NHS staff; a guide to the NHS for the public;quarterly reviews of the most up to date performance data; annual reports; and
more clearly targeted newsletters including "NHS Magazine". The NHS Executive has ceased production of six NHS newsletters and is seeking a more cost-effective approach. The new quarterly "NHS Magazine" replaced an old monthly publication and its production costs are met in part by advertising. The magazine is projected to cost £130,000 in its first year, against an estimated annual saving of £227,000 from discontinued publications.
The executive is working with the NHS to develop measurable standards for communication to improve the clarity and accessibility of information for the public. Such standards would ensure a consistent approach to communication throughout the NHS. It is also working on training and development packages opportunities covering NHS communications. These explain the benefits to be gained from promoting open communications with staff and include material on the importance of clear, jargon-free communication. The executive is working closely, where appropriate, with other health organisations, such as the National Association of Health Authorities and Trusts, on projects to develop higher standards in NHS communications.
Health Service Expenditure
Mr. Ieuan Wyn Jones: To ask the Secretary of State for Health if she will express health service expenditure in the United Kingdom as a proportion of United Kingdom gross domestic product for (i) 1990 91, 1993 94 and (iii) 1994 95; and if she will make a statement. [29587]
Mr. Sackville: National health service expenditure in the United Kingdom as a whole has increased from the equivalent of 4.7 per cent. of gross domestic product in 1978 79 to 5.3 per cent. in 1990 91, 5.9 per cent. in 1993 94 and an estiamted 5.8 per cent. in 1994 95.
Column 689
Medical Cost Inflation
Mr. Malcolm Bruce: To ask the Secretary of State for Health, pursuant to her answer of 20 June, Official Report , column 206 , on medical cost inflation, what are her estimates of the inflation rate for the hospital and community health services for each year from 1979 80 to 1992 93; and what components of national health service spending are covered by this inflation measure. [31056]
Mr. Sackville: Estimates for hospital and community health services inflation are shown in the table. The inflation measure covers HCHS expenditure on staffing and the purchase of goods and services.
HCHS inflation 1979-80 to 1992-93
Year |HCHS inflation
|estimate
---------------------------------------------
1979-80 |20.5
1980-81 |28.0
1981-82 |8.2
1982-83 |6.5
1983-84 |5.1
1984-85 |5.8
1985-86 |4.9
1986-87 |7.0
1987-88 |8.5
1988-89 |10.6
1989-90 |6.3
1990-91 |8.7
1991-92 |10.1
1992-93 |6.9
Capital Spending
Mr. Betts: To ask the Secretary of State for Health what is the expected capital spending figure for her Department for 1994 95; and what is the latest budget figure. [30881]
Mr. Sackville: The information is shown in the table.
Capital expenditure<1> <2>
£ million
|1994-95 estimated
|outturn |1995-96 plan
-----------------------------------------------------------------------------
Public Corporations<3> |1,582 |1,702
Central Government's
own expenditure<4> |318 |120
Total |1,900 |1,822
Notes:
<1>These figures are consistent with the Statistical Supplement to the
Financial Statement and Budget Report 1995-96, Cm 2821.
<2>Figures are not available for local authority capital expenditure in
1995-96. Estimated outturn for 1994-95 is £165 million.
<3>NHS trusts and the Medicines Control Agency.
<4>Includes health authorities.
Private Finance Initiative
Mr. Betts: To ask the Secretary of State for Health by how much Government spending has changed in 1994 95 as a result of the private finance initiative; what is the estimated effect in 1995 96; how many jobs are to be created by schemes approved to date under the initiative and how many have lost as a consequence in the public sector; and what is the forecast of transfer of employment from public to private sector over the last five years because of the initiative. [30843]
Column 690
Mr. Sackville: Capital made available as a result of the private finance initiative is additional to publicly-funded capital. I refer the hon. Member is to the reply I have the right hon. Member for Derby, South (Mrs. Beckett) on 2 May at cols 175 76 for information on spending in 1994 95 and 1995 96 on the National Health Service Executive private finance unit.
Information on numbers of public and private sector jobs affected by the private finance initiative in the NHS is not available centrally.
Mr. Betts: To ask the Secretary of State for Health how many schemes and to what value have been approved in 1994 95 under the private finance initiative; what are the estimates for the current financial year; how many schemes are currently being considered and at what value; for how long they have been considered and how many have been in the assessment process for over (a) six months and (b) 12 months; and what was the average length of time taken to assess schemes so far approved. [30842]
Mr. Sackville: I refer the hon. Member to the reply I gave the hon. Member for Newcastle upon Tyne, East (Mr. Brown) on 24 May at column 594 , for the available information.
Health Expenditure
Mr. Malcolm Bruce: To ask the Secretary of State for Health, pursuant to her answer of 20 June, Official Report , column 205 , on health expenditure, if she will specify the monetary sum relating to local authorities' new community care responsibilities for 1996 97, which is at present held in the Department of the Environment's local government programme. [31057]
Mr. Bowis: A sum of £2,256 million is at present held in the Department of Environment's local government programme for local authorities' new community care responsibilities for 1996 97. Part of this sum will form the special transitional grant for 1996 97 and will be transferred to this Department's programme. The amount is not yet decided.
Health and Housing Policy
Mr. Alex Carlile: To ask the Secretary of State for Health on which dates in the last three years she has met her ministerial colleagues responsible for housing to discuss the co-ordination of the Government's health and housing policies; and if she will make a statement. [31027]
Mr. Sackville: Ministers in the Department of Health hold frequent meetings with Ministers in other Government Departments to discuss a variety of matters, which will sometimes include health and housing.
AGRICULTURE, FISHERIES AND FOOD
Phytoestrogens
Mr. Martyn Jones: To ask the Minister of Agriculture, Fisheries and Food what are the approved levels of oestrogen and phytoestrogen in food and drinks given to babies and toddlers. [29990]
Column 691
Mrs. Browning: There are no United Kingdom advisory limits or regulations controlling levels of phytoestrogens in foods specially prepared for infants and toddlers.
Mr. Jones: To ask the Minister of Agriculture, Fisheries and Food what research has been (a) started and (b) completed on phytoestrogen in soya milk following the 1992 recommendations of the Committee of Toxicity on Foodstuffs. [29993]
Mrs. Browning: Two MAFF-funded studies are currently in progress. These studies include an analysis of soya milk and infant formula. In addition, a surveillance project measuring levels of oestrogens in the diets of infants, toddlers and young children will start shortly. None of these projects has been completed.
Mr. Jones: To ask the Minister of Agriculture, Fisheries and Food what levels of oestrogen or phytoestrogen are normally found in soya-based cooking oil and spread. [29997]
Mrs. Browning: Information available to the Ministry indicates that phytoestrogens are not present in soya-based cooking oil and spread.
Mr. Jones: To ask the Minister of Agriculture, Fisheries and Food what monitoring his Department undertakes on the levels of oestrogenic chemicals in food; and what is the budget and total full-time staff for this study. [30541]
Mrs. Browning: Several chemicals claimed to have oestrogenic properties are included in MAFF's food chemical surveillance programme. It is not possible to separate out the costs and staff allocated to this group of chemicals.
Sheep Dips
Mr. David Nicholson: To ask the Minister of Agriculture, Fisheries and Food (1) what representations were made to him or to farming organisations by the French authorities before benzene hectochlorine sheep dip was banned in the United Kingdom; and if such dip is currently used in France; [30273]
(2) if he will make a statement on the circumstances which led him to ban the sheep dip containing benzene hectochlorine. [30274]
Mrs. Browning: Following expressions of concern from the French authorities in the 1980s, about levels of lindane residues in sheep meat, United Kingdom manufacturers ceased to use benzene hexachloride in treatments for sheep scab. The decision to make this change was taken by the manufacturers; there has not been a ban. I am not aware if benzene hexachloride is still used in France.
Mr. Nicholson: To ask the Minister of Agriculture, Fisheries and Food what advice, in view of the report entitled "CULS 50/93, Diazinon: post-Dipping Exposure in Humans", he gives to those handling sheep which have been dipped with this compound; for how long after dipping this advice applies; and when this advice was issued. [30269]
Mrs. Browning: Advice on various aspects of using sheep dips, including the handling of sheep that have been dipped with diazinon, or with any other organophosphorus
Column 692
product, is contained in the free leaflet AS29, available from the Health and Safety Executive. This leaflet, which was sent to sheep farmers in 1994, includes advice to observe the label withdrawal periods for the product used. It also advises that it is good practice not to shear sheep for three months after dipping.Mr. Nicholson: To ask the Minister of Agriculture, Fisheries and Food what measures he takes to ensure that sheep are effectively dipped against scab, with particular reference to a repeat treatment at a specific time after the first dipping. [30275]
Mrs. Browning: All treatments for sheep scab must be approved by the Veterinary Medicines Directorate under the provisions of the Marketing Authorisations for Veterinary Medicinal Products Regulations 1994, S.I. 1994/3142. As part of the authorisation process, consideration is given to the safety quality and efficacy of the product. The instructions, including any necessity for repeat applications, are clearly printed on the containers and should always be carefully followed. Most sheep scab treatments do not require repeat applications.
General advice on dealing with sheep scab is given in the Ministry's current publicity leaflet--PB 1927--which advises consulting a veterinary surgeon if farmers are in doubt about treatments. Advice on dipping procedures is given in the leaflet "Sheep
Dipping"--AS29--available from the Health and Safety Executive.
Mr. Nicholson: To ask the Minister of Agriculture, Fisheries and Food what evidence he has that particular working conditions, weather conditions, and existing medical conditions among those handling sheep which are, or have been, dipped with organophosphorus compounds, exacerbate reactions to exposure to the compounds; and if he will make as statement on the particular advice he gives in these circumstances. [30268]
Mrs. Browning: Information on reported suspected adverse reactions is collected by the Veterinary Medicines Directorate but details provided on individual reports vary inequality and would be very unlikely to lead to any meaningful conclusions. Extracting the specific information requested could not in any case be done readily.
Leaflet AS 29 (rev), "Sheep dipping", issued by the Health and Safety Executive includes the joint advice of the HSE, the Veterinary Medicines Directorate and the Department of the Environment to those involved in sheep dipping on protecting their health.
Mr. Nicholson: To ask the Minister of Agriculture, Fisheries and Food what advice he has issued to those shearing sheep, regarding shearing within (a) one week (b) two weeks and (c) up to five weeks after dipping. [30276]
Mrs. Browning: The leaflet "Sheep Dipping"--(AS29)--which was sent to sheep farmers in 1994, includes the advice that
"It is good practice not to shear sheep for three months after dipping."
The leaflet, which is available from the Health and Safety Executive, gives advice on various aspects of sheep dipping. It was prepared jointly by the Health and Safety Executive, the Veterinary Medicines Directorate and the Department of the Environment.
Column 693
Mr. Nicholson: To ask the Minister of Agriculture, Fisheries and Food what research he has evaluated, and what (a) representations or (b) claims he has received suggesting that there is a link between the numbers of suicides among farmers and the mental and physical effects of reactions to exposure to organophosphate sheep dips. [30272]
Mrs. Browning: I am aware that a recent report by the Office of Population Censuses and Surveys on suicide deaths in England and Wales, 1982 92 indicates that farmers are among the occupational groups with the highest rate of suicide. The reasons for this are not clear, but factors such as access to the means of suicide, firearms for example, and physical and social isolation are likely to play a part.
Anti-androgens
Mr. Martyn Jones: To ask the Minister of Agriculture, Fisheries and Food what research his Department is undertaking on anti-androgens in food. [30538]
Mrs. Browning: The Department is not carrying out any specific research on anti-androgens in food.
Nutritional Labelling
Mr. Martyn Jones: To ask the Minister of Agriculture, Fisheries and Food what additional nutritional labelling regulations have been made since 1991. [30544]
Mrs. Browning: The Food Labelling (Amendment) Regulations 1994, S.I. 1994 No. 804, implemented EC directive 90/496 on nutritional labelling for foodstuffs. These regulations set out the format for nutrition labelling when given and require it to be given if a claim is made on the label about a particular nutrient.
DDT
Mr. Martyn Jones: To ask the Minister of Agriculture, Fisheries and Food what is the approved level of DDT in food; and what checks are undertaken on the levels of DDT in imported foods. [30540]
Mrs. Browning: Maximum residue levels for DDT in a wide range of foodstuffs are included in schedule 2, part 2, to the Pesticides (Maximum Residues Levels in Crops, Food and Feeding Stuffs) Regulations 1994. Generally, the MRL is 0.05 mg/kg. As part of the Govenment's food surveillance programme for pesticide residues, imported foodstuffs are checked selectively for residues of DDT. The results of this programme are published annually in reports of the working party on pesticide residues, copies of which are available from HMSO.
Organic-based Fertilisers
Mr. Martyn Jones: To ask the Minister of Agriculture, Fisheries and Food what research is being funded into organic based fertilisers. [30543]
Mrs. Browning: The Ministry of Agriculture, Fisheries and Food will be spending around £1 million in 1995 96 on research on organic-based fertilisers. The main emphasis of this work is to improve our understanding of the behaviour of the nitrogen and phosphorus in animal manures and to develop practical methods and improved
Column 694
recommendations to enable farmers better to utilise the fertiliser value of manures.The project titles, contractors and estimated costs for 1995 96 are as follows:
On-farm monitoring of nitrate leaching from organic rotations Elm Farm Research Centre
£54,000
Phosphorous losses to surface water following organic manure applications to agricultural land
ADAS
£36,000
Phosphate loss from drained clay soils receiving organic manures ADAS
£65,000
Use of injectors and low trajectory spreaders
ADAS/Institute of Grassland and Environmental Research
£47,000
To improve guidelines on waste management practices which will minimise the short and long term risk of nitrate leaching from animal manures applied to land
ADAS
£103,000
Improving the conservation of nitrogen during storage of slurries and manures
Silsoe Research Institute
£65,000
Grassland manuring: Nitrogen loss and efficiency from use of organic manures
ADAS
£124,000
Nitrogen losses from organic manures
ADAS
£66,000
Nitrogen losses from drained clay soils receiving organic manures ADAS
£19,000
Effective utilisation of animal manures in fertilising forage Levington Agriculture
£44,000
Development of user-friendly systems for on-farm estimation of the available nitrogen content in solid manures and slurries
ADAS/Institute of Grassland and Environmental Research
£26,000
Utilisation of slurry on grazed and silage areas during the growing season
Institute of Grassland and Environmental Research
£51,000
Nitrate leaching from livestock manures
Harper Adams Agricultural College
£54,000
Improved prediction of nitrogen availability and losses following land application of organic manures
ADAS
£20,000
Development and evaluation of a rapid paper test strip method for determining the nitrogen supplying power of slurries and manures Institute of Grassland and Environmental Research
£25,000
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