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HEALTH
Osteoporosis
Ms Walley: To ask the Secretary of State for Health (1) what guidelines he has issued in respect of preventive and treatment strategies for patients in high-risk groups of osteoporosis; [36332] (2) what action has been taken to consider the role of diet in the prevention of osteoporosis; and if he will make a statement. [36333]
Mr. Sackville: It is the responsibility of professional bodies to develop clinical guidelines where a need has been identified. Discussions have begun between the Department and the relevant medical royal colleges with a view to their developing clinical guidelines for
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osteoporosis. In addition, a new expert advisory group has been set up and will be considering the dietary aspects of osteoporosis prevention. Details of the group will be announced shortly.Prescriptions
Ms Walley: To ask the Secretary of State for Health what plans he has to remove the statutory requirement for a prescription charge to be paid for each drug contained in hormone replacement therapy preparations. [36334]
Mr. Malone: None. Where two, or more, prescribed drugs are dispensed, a prescription charge is payable for each one even though, for patient convenience or through manufacturers' packaging arrangements, they may be supplied together in a single combination pack or duo pack.
Mr. Morgan: To ask the Secretary of State for Health (1) if he will conduct a review of the principal factors underlying the non-redemption rate of prescriptions issued by general practitioners; and if he will make a statement; [37047]
(2) if he will undertake a comprehensive review of the prescription system; and if he will include in such a review the option of altering pharmacists' regulations to allow individual pharmacists to offer patients the option of paying the cost price where this is less than the standard per item prescription charge. [37049]
Mr. Malone: Extensive charge exemption and remission arrangements, among the most generous in Europe, ensure that only those able to afford the national health service prescription charge are asked to pay. The scheme was last reviewed in 1993 as part of the fundamental review of health expenditure. There are no current plans for a further review, either of the scheme itself or of the reasons why patients may choose not to present prescriptions for dispensing.
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Where a medicine is available only on prescription, doctors may already issue private prescriptions free of charge to NHS patients, although they are not obliged to do so. Pharmacists then set and charge patients a price for the medicine and a private dispensing fee.Temazepam
Mr. Nicholas Brown: To ask the Secretary of State for Health (1) what action his Department is taking to reduce the illegal use of Temazepam; [36624]
(2) what representations he has received concerning the illegal use of Temazepam. [36625]
Mr. Bowis: On 10 May, Official Report , columns 747 59, my right hon. Friend the Lord President of the Council announced a range of measures to help combat its misuse. This included a public consultation exercise on a proposal to ban national health service prescribing of the soft gelatin gel filled capsule formulation of the drug under schedule 10 to the NHS (General Medical Service) Regulations 1992. The Department of Health received 168 responses to the consultation exercise and these are being carefully considered. An announcement will be made shortly.
On 12 September my right hon. and learned Friend the Secretary of State for the Home Department also announced that the drug was to be moved from schedule 4 to schedule 3 to the Misuse of Drugs Regulations 1985, which would make unlawful possession an offence, require pharmacies to store the drug more securely, and impose import and export licensing controls. Manufacturers and wholesalers will also be required to store the drug securely.
GP Fundholders
Mr. Nicholas Brown: To ask the Secretary of State for Health what evidence he has that the administrative costs of GP fundholding are less than budget savings. [36634]
Mr. Malone: Information about fundholder savings and management allowances expenditure is shown in the table, which does not include start- up costs.
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Total fundholderGeneral
Practitioner
Fundholding
budgets (retained) Management
Savings allowances
|As a percentage |As a percentage
|£ million |£ million |of budgets set |£ million |of budgets set
----------------------------------------------------------------------------------------------------------------
1991-92 |400 |14.5 |3.7 |10 |2.5
1992-93 |800 |28.3 |3.5 |19 |2.4
1993-94 |1,800 |64.2 |3.5 |38 |2.1
Final figures for 1994-1995 are not yet available.
Mr. Brown: To ask the Secretary of State for Health (1) what evaluation his Department has made of general practitioner multi-funds as purchasers of secondary health care services; [36614] (2) what is the number of general practitioner multi-funds in the NHS by regional and nationally. [36613]
Mr. Malone: Information about multi-funds is not collected centrally. Multi-funds are administrative arrangements whereby one or more fundholders work together to share administration or purchasing expertise
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which can provide improved services for patients. How general practitioners choose to manage their fund, whether singly or in groups, is a matter for individual fundholders.Market Testing
Mr. Blunkett: To ask the Secretary of State for Health which sites within the NHS have been subject to market testing; and which services on those sites have been market tested. [36642]
Mr. Sackville: This information is not available centrally.
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Mr. Blunkett: To ask the Secretary of State for Health what advice his Department or the NHS executive has issued to health authorities or trusts about the market testing of physiotherapy services. [36646]
Mr. Sackville: None that is specific to physiotherapy.
Ms Jowell: To ask the Secretary of State for Health what was the value of NHS contracts by district and region placed with independent sector providers for
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(a) catering (b) cleaning and (c) other ancillary services for (i) 1992 93, (ii) 1993 94 and (iii) 1994 95. [36795]Mr. Sackville: From information recorded on the national health service executive market testing database, the aggregate value of contracts awarded by NHS trusts to another contractor, including other NHS trusts, for the baseline year 1992 93 is shown in the table by region for each service grouping requested. For later years the records are incomplete. Information is not maintained by district.
Contract value £000
|Other hotel
Region |Catering |Domestic services |ancillary services
----------------------------------------------------------------------------------------------------------
Anglia/Oxford |1,199.10 |8,563.82 |17,793.14
North West (including Mersey) |4,462.85 |18,013.65 |35,460.27
Northern and Yorkshire |13,363.11 |16,159.02 |65,212.49
North Thames |3,159.30 |31,181.71 |50,592.81
South Thames |3,587.23 |18,087.73 |36,782.08
South and West |1,407.20 |9,469.60 |29,948.07
Trent |1,483.34 |4,023.60 |9,469.44
West Midlands |4,632.55 |5,417.98 |23,329.61
Total |32,294.68 |110.917.11 |209,587.91
Ms Jowell: To ask the Secretary of State for Health what was the value of NHS clinical contracts by district and region placed with independent sector providers for (a) radiology, (b) pathology, (c) imaging and (d) other clinical services for (i) 1992 93, (ii) 1993 94 and (iii) 1994 95. [36794]
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Mr. Sackville: The table shows the information recorded on the national health service executive's market testing database, and covers market testing of the specified services by NHS trusts, where the contract was awarded to a non-NHS contractor. The analysis is by region, but not by district, for 1992 93. Information for 1993 94 and 1994 95 is still incomplete.
Figures in £000
|Other clinical
Region |Radiology |Pathology |Imaging |services
--------------------------------------------------------------------------------------------------
Anglia and Oxford |Nil |Nil |Nil |52.6
North Thames |Nil |224 |98 |280
North West |Nil |Nil |Nil |Nil
Northern and Yorkshire |Nil |Nil |Nil |305
South Thames |Nil |Nil |Nil |277
South and West |Nil |Nil |Nil |893.5
Trent |Nil |Nil |182 |Nil
West Midlands |Nil |Nil |Nil |3,181.6
Sheep Dipping
Mr. Nicholas Brown: To ask the Secretary of State for Health what assessment his Department has made of the health risk associated with long- term exposure to chemicals used for dipping sheep. [36612]
Mr. Sackville: The Department of Health's staff continually assess evidence relating to the health risks associated with long term exposure to chemicals used for dipping sheep. In particular officials provided expert input into the two meetings held by the Veterinary Products Committee in 1992 and 1993 to discuss the future licensing of organophosphorus sheep dips. The Department continues to provide expert input to the medical and scientific panel which the VPC set up to investigate the long-term health effects of exposure to these products. The panel has yet to report its final conclusions.
Cancer
Mr. Nicholas Brown: To ask the Secretary of State for Health (1) if he will list by region the proportion of NHS
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cancer patients receiving modern anti- emetics, HT3 antagonists, while on chemotherapy; [36628](2) what is the proportion of NHS cancer patients receiving modern anti- emetics, HT3 antagonists, whilst on chemotherapy in (a) England and (b) other OECD nations. [36627]
Mr. Sackville: This information is not available centrally.
Mr. Brown: To ask the Secretary of State for Health what plans he has to implement in full the recommendations of the Calman report on the commissioning of cancer services in the NHS. [36626]
Mr. Sackville: My right hon. Friend the Secretary of State has accepted the report's recommendations and welcomed the aim of delivering a uniformly high level of cancer care based on a network of expertise covering primary as well as secondary care. We support the development of designated specialist cancer units and centres and look to the national health service to make systematic progress in implementing this strategy.
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Mr. Brown: To ask the Secretary of State for Health (1) how many new patients are seen per year by NHS oncologists; and what are the comparable figures in other OECD states; [36635]
(2) if he will publish figures, by region and nationally, for the proportion of NHS cancer patients referred to a cancer
specialist. [36637]
Mr. Sackville: This information is not available centrally.
Travel Allowances
Dr. Lynne Jones: To ask the Secretary of State for Health what rates of travel allowance may be claimed by civil servants in his Department when using their own vehicles for official
business. [36369]
Mr. Sackville: The Department, with the exception of the Medicines Control Agency, has adopted a single motor mileage rate of 30p per mile for all motor cars and 15p per mile for all motor cycles. The Medicines Control Agency rates are as follows:
Engine cc:
|Up to |1501- |Over
|1500 cc|2000 cc|2000 cc
-------------------------------------------------
Up to 5000 miles |35.7p |42p |46p
Over 5000 miles |23p |27p |35p
The Agency pays 23p per mile when a car is used in preference to public transport.
Consultant Oncologists
Mr. Nicholas Brown: To ask the Secretary of State for Health if he will make it his policy to meet the recommendation of the Royal College of Radiologists that there be a minimum of 470 NHS consultant oncologists by 2000; and what progress is being made towards this target. [36638]
Mr. Malone: The Government seek to ensure an adequate supply of appropriately trained doctors in each specialty, including both medical and clinical oncology. This involves planning the number of doctors in higher specialist training on a specialty basis and including all relevant parties in the process. However, employment of consultants is a matter for local employing bodies, who make medical staffing decisions in the light of competing priorities and the health care needs of the local population.
I refer the hon. Member to the reply I gave him today for the number of consultant oncologists up to and including September 1994.
Mr. Brown: To ask the Secretary of State for Health if he will publish figures for the number of (a) consultant medical oncologists, (b) consultant clinical oncologists and (c) palliative care specialists working in the NHS for each of the last five years for which figures are available. [36636]
Mr. Malone: The information is shown in the table.
Hospital Medical Consultants at 30 September each year
England-whole-time equivalents
|1989 |1990 |1991 |1992 |1993 |1994
--------------------------------------------------------------
Palliative Medicine |12.1 |13.4 |14.1 |19.5 |22.1 |31.8
Medical Oncology |24.7 |23.7 |30.7 |32.7 |41.5 |61.5
Clinical Oncology |190.2|185.6|202.5|200.1|198.8|221.2
Mr. Brown: To ask the Secretary of State for Health what is the number of consultant oncologists per head of population in (a) England and (b) other OECD countries. [36615]
Mr. Malone: There were 282.7 hospital medical and clinical consultant oncologists--whole-time equivalents--in England as at 30 September 1994, 0.6 per 100,000 population. Data on the number of oncologists per head of population in OECD countries are not available centrally.
Intensive Care Unit Beds
Mr. Nicholas Brown: To ask the Secretary of State for Health what plans he has to set up a central telephone and computer system to provide accurate information for clinicians on the availability of ICU beds across the country. [36622]
Mr. Sackville: This is one of the points being considered by a working group of experts looking into admission to intensive care.
Bloomsbury and Islington College of Nursing and Midwifery
Mr. Nicholas Brown: To ask the Secretary of State for Health (1) if he will list the numbers and grades of those
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who will be made redundant because of the closure of the Bloomsbury and Islington college of nursing and midwifery; [36632](2) what representations he has received concerning the proposed closure of the Bloomsbury and Islington college of nursing and midwifery; and if he will make a statement. [36633]
Mr. Sackville: The closure of the Bloomsbury and Islington college of nursing and midwifery is a matter for the North Thames regional health authority. The hon. Member may wish to contact Sir William Staveley, chairman of the authority, for details.
Dental Services
Ms Coffey: To ask the Secretary of State for Health if he will publish the recommendations of the committee convened to review the provision of NHS dental services and the date on which he expects to publish the recommendations. [36443]
Mr. Malone: The Government have not convened such a committee. We have, however, been working closely with the General Dental Services Committee on the detailed development of the reform proposals that I announced to the House on 5 April, Official Report , columns 1214-15 .
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Ms Jowell: To ask the Secretary of State for Health how many salaried dental practitioner posts have been (a) approved and (b) filled since 1 January 1994. [36809]
Mr. Malone: The number of salaried dentist posts approved from 7 January 1994 to 22 September 1995 is 36. Over the same period the net increase in the number of salaried dentists was 26.
Ms Jowell: To ask the Secretary of State for Health how many referrals were received by the community dental service in (a) 1992 93, (b) 1994 95 and (c) in respect of patients unable to obtain treatment within the general dental service. [36819]
Mr. Malone: Family health services authorities in England report that between 1 August 1994 and 22 September 1995 that they suggested to 1,399 patients that treatment might be available through the community dental service. Information is not available in this form before 1 August 1994.
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Ms Jowell: To ask the Secretary of State for Health what plans he has to initiate pilot studies on purchaser-provider arrangements for the dentist service; and if he will make a statement. [36815]
Mr. Malone: The package of reforms I announced on 5 April reaffirmed the Government's aim to introduce a system of local contracts between health authorities and dental practices similar to that which operates elsewhere in the health service. Such a system will need careful piloting and evaluation before a decision is taken on nationwide introduction. To run pilot projects would require primary legislation. The Government will seek to introduce the necessary legislation when parliamentary time allows. Bids for pilot projects will then be invited.
Ms Jowell: To ask the Secretary of State for Health what is the average waiting time by region for orthodontic treatment at hospitals. [36813]
Mr. Malone: At 31 March 1995 there were 275 patients waiting for in- patient or day case orthodontic treatment. No patient had waited more than 15 months and information by region is shown in the table. Waiting times for patients being treated on an out-patient basis are not collected centrally.
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Numbers of patients waiting for orthodontic in-patient or day case
treatment, by region and monthly time band, at 31 March 1995
Region |0-2 |3-5 |6-8 |9-11 |12-14 |Total
------------------------------------------------------------------------
Northern and Yorkshire |23 |16 |1 |0 |0 |40
Trent |0 |0 |0 |0 |0 |0
Anglia and Oxford |29 |37 |23 |33 |22 |144
North Thames |0 |0 |0 |0 |0 |0
South Thames |15 |5 |0 |0 |0 |20
South and West |31 |19 |1 |0 |0 |51
West Midlands |7 |8 |0 |0 |0 |15
North West |5 |0 |0 |0 |0 |5
SHAs |0 |0 |0 |0 |0 |0
Total |110 |85 |25 |33 |22 |275
Ms Jowell: To ask the Secretary of State for Health what is the total number of children by region waiting for orthodontic treatment on the NHS for each month since January 1994. [36811]
Mr. Malone: Children are not identified separately in information collected on numbers of patients waiting for in-patient or day case treatment.
Ms Jowell: To ask the Secretary of State for Health what measures he is taking to improve dental care for elderly people in residential and nursing homes; and if he will make a statement. [36821]
Mr. Bowis: Last April the Government announced a range of reforms of national health service dentistry, including its intention to strengthen the community dental service's role in ensuring continued access to NHS dental services for all who wish to use them. This development should benefit those patients in residential and nursing homes unable to use the mainstream general dental service.
Ms Jowell: To ask the Secretary of State for Health how many dental practices in the United Kingdom are accepting children for orthodontic treatment on only a private contract basis. [36810]
Mr. Malone: This information is not available centrally.
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Ms Jowell: To ask the Secretary of State for Health what was the total budget for the community dental service in (a) 1992 93, (b) 1994 95 and (c) 1995 96; and what is the projected budget for (i) 1995 96 and (ii) 1996 97. [36820]
Mr. Malone: Expenditure on the community dental services in 1992 93 was £75,770,000. Figures are not available for later years. The level of future expenditure on the community dental service is a matter for health authorities, as the local purchasers of health care, to decide.
Ms Jowell: To ask the Secretary of State for Health what was the total amount allocated by his Department to dental schools for capital improvements in (a) 1993 94, (b) 1994 95 and (c) 1995 96; and what proportion of this amount in each year was passed on to dental schools by hospital trusts. [36816]
Mr. Sackville: The Department does not allocate capital funds direct to dental schools for capital improvements. Up to and including 1994 95 a central allocation for the re-equipment of dental hospitals was made to each regional health authority for the schools in its area. The total allocated was £4,608,000 in 1993 94 and £4,788,000 in 1994 95 which was split equally between the schools to produce £384,000 and £399,000 a year respectively. These amounts were allocated by the
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RHAs to the appropriate health authorities and national health service trusts. Records are not kept centrally of any additional capital allocated to dental schools by the health authority or trust.From 1995 96 there is no central allocation. Dental schools are required to put bids in for capital funds from the trust's capital programme. Records are not kept centrally of the capital allocated.
Ms Jowell: To ask the Secretary of State for Health what was the total number of trained orthodontists for each year since 1991; and what was the estimated requirement for orthodontists in each of those years. [36812]
Mr. Malone: Any dentist who has the necessary facilities, experience of expertise may provide orthodontic treatment.
Ms Jowell: To ask the Secretary of State for Health what was the total amount allocated by his Department for orthodontic training for each year since 1991; and what is the projected budget for orthodontic training for (a) 1995 96 and (b) 1996 97. [36818]
Mr. Malone: This information is not available centrally.
Ms Jowell: To ask the Secretary of State for Health what research his Department has carried out into the working of the capitation payment system to dentists for dental care of children; and what plans he has to change this system. [36814]
Mr. Malone: The Government have commissioned two research studies on the operation of the capitation system since it was introduced in 1990.
The reports are at different stages of readiness. That from the university of Birmingham is in its final form and I have today placed it in the House of Commons Library. The report from the university of Manchester will be available shortly. Both research teams have plans to disseminate their findings more widely.
The improvement of the capitation system was one of the package of proposals for the reform of NHS dentistry that I announced on 5 April. The Government intend to reform the capitation system by relating payments to dentists to disease levels in children. We are discussing the detailed development of this and the other elements of the package with the representatives of the dental profession.
Mrs. Beckett: To ask the Secretary of State for Health, formerly health services authority if he will list by region and in total the number of people (a) deregistered from NHS dental treatment and (b) seeking help from their local FHSA to find a NHS dentist, since July 1992. [36994]
Mr. Malone: This information will be placed in the Library. At 31 July 1995, as at 1 July 1992, there were 27.3 million patients registered with national health service dentists in England.
Redundancy Payments
Mr. Nicholas Brown: To ask the Secretary of State for Health pursuant to his answer on 27 March, Official Report, column 412 , if he will publish a breakdown of the
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grades of staff made redundant and the cost of redundancy payments, made to each grade of staff, for each of the last 10 years. [36647]Mr. Malone: Information on the cost of redundancy by grade is not collected centrally.
Nursing and Midwifery Education
Mr. Nicholas Brown: To ask the Secretary of State for Health what was the real terms NHS expenditure on nursing and midwifery education, for each of the past 15 years nationally and by region. [36621]
Mr. Sackville: This information is not available centrally.
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