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Hospital Consultant Vacancies

Mr. Simon Hughes: To ask the Secretary of State for Health if he will list, by region, the number of hospital consultant positions currently vacant and the equivalent number for this time in each of the last five years. [10414]

Mr. Milburn: The latest available information is shown in the table.

Whole-time equivalent of vacant hospital medical consultant posts by region
England at 30 September each year

199019911992199319941995
England (Totals)700470540480570690
Northern701030304050
Yorkshire402050304040
Trent705080507050
East Anglian202020103020
North-west Thames202020304040
North-east Thames707050805070
South-east Thames403010304050
South-west Thames704030303040
Wessex40010101020
Oxford20200201020
South Western601040303040
West Midlands1109011070100100
Mersey202020304060
North Western605060505080
Special health authorities201010000

Notes:

1. Figures are rounded to the nearest 10; 0 indicates a figure less than five.

2. Data for 1996 are not yet available. We expect to have information available in September/October.

3. The census is a snapshot at 30 September each year. Some vacancies will be wholly or partly filled by locums. For others, national health service trusts may find alternative ways to provide the service rather than re-advertising. The numbers give no indication of how long the post has been empty; some of these will be in the process of being filled.

Source:

The medical and dental work force census 30 September 1990 to 1995.


Mental Health Services

Mr. Simon Hughes: To ask the Secretary of State for Health what proportion of the community health budget has been spent on mental health services in each year since 1988. [10418]

Mr. Boateng: Information on the proportion of the community health budget spent on mental health services in each year since 1988 is in the table.

YearProportion of expenditure (per cent.)
1988-897.5
1989-908.6
1990-919.2
1991-927.4
1992-938.7
1993-948.4
1994-959.5
1995-9610.2

Figures from 1991 onwards are not directly comparable with earlier years owing to revised NHS accounting practices.


28 Jul 1997 : Column: 82

Mr. Hughes: To ask the Secretary of State for Health what has been the level of spending on mental health services in each health authority and as a percentage of total expenditure in each health authority in each of the last three years. [10409]

Mr. Boateng: The information requested has been placed in the Library.

Homeopathy

Dr. Starkey: To ask the Secretary of State for Health (1) what research his Department has (a) commissioned and (b) evaluated into the cost-effectiveness of homoeopathic treatments of food allergies; [10350]

Ms Jowell: National health service doctors are able to arrange for their patients to receive homoeopathic treatment for their problems, including food allergy, if there is a clinical need and such treatment is considered the most appropriate and cost-effective way of meeting the need.

We have not commissioned or evaluated research into the cost-effectiveness of homoeopathy in relation to treatment of food allergies. We have no plans to issue guidance to the NHS on the cost-effectiveness of homoeopathy generally, or in relation to treatment of food allergies.

Property Sales

Mr. Simon Hughes: To ask the Secretary of State for Health what has been the (a) estimated and (b) actual value of NHS property sales in each of the last five years.[10417]

Mr. Milburn: Figures providing planned and outturn values of national health service capital receipts are shown in the table.

NHS Capital Receipts £ million (Cash)

YearPlanned(19)Outturn(20)
1992-93200115
1993-94200213
1994-95234208
1995-96220282
1996-97310369

(19) Planned figures are taken from the Department of Health annual report printed prior to the start of each financial year. For example, the 1992-93 planned figure is taken from the February 1992 annual report and the 1993-94 figure is taken from the February 1993 annual report.

(20) Outturn figures are taken from the March 1997 annual report. The 1996-97 figure is the estimated outturn.


28 Jul 1997 : Column: 83

Attention Deficit Hyperactivity Disorder

Mr. Ieuan Wyn Jones: To ask the Secretary of State for Health what research his Department has evaluated into links between long-term addictive tendencies and attention deficit hyperactivity disorder; and if he will make a statement. [10541]

Mr. Boateng: Research suggests that children with attention deficit hyperactivity disorder have an increased risk of developing further problems later in childhood and in adolescence, including substance abuse in some. The nature of any such linkage is, however, not yet clear.

28 Jul 1997 : Column: 84

Mr. Jones: To ask the Secretary of State for Health if he will list for each of the last three years (a) the total amount estimated to have been spent on mental health treatment and (b) the total amount estimated to have been spent on treating children diagnosed as suffering from attention deficit hyperactivity disorder, indicating in each case the percentage of each item as a proportion of the total health budget; and if he will make a statement. [10545]

Mr. Boateng: Total amounts estimated to have been spent on mental health treatment for the last three years are shown in the table. The information requested on treatment of children diagnosed as suffering from attention deficit hyperactivity disorder is not collected centrally.

1993-941994-951995-96
Total expenditure23,016.8 million23,354.3 million23,804.6 million
Expenditure on people with mental illness2,508.0 million2,472.3 million2,511.4 million
Percentage of total expenditure10.9 per cent.10.6 per cent.10.65 per cent.

Source:

Health Select Committee and RO3 return.

Note:

All figures are adjusted to 1995-96 prices using hospital and community health services expenditure.


28 Jul 1997 : Column: 83

28 Jul 1997 : Column: 83

Mr. Jones: To ask the Secretary of State for Health what assessment his Department has made of (a) the connection between attention deficit hyperactivity disorder and behaviour problems and aggression among school pupils, (b) the number and percentage of pupils affected by attention deficit disorder and (c) the degree to which attention deficit hyperactivity disorder may be inherited; and if he will make a statement. [10581]

Mr. Boateng: Attention deficit hyperactivity disorder is one of several possible causes of behaviour problems, including aggression, in school pupils.

This information is not collected centrally. Recent research suggests that severe hyperkinetic disorder, which is one form of attention deficit hyperactivity disorder, is found in about one in 200 children.

It is accepted that there is an inherited contribution to the development of attention deficit hyperactivity disorder but the mode of inheritance is complex.

Mr. Jones: To ask the Secretary of State for Health if he will list the amount of grant aid given by his Department to (a) the hyperactive children's support group and (b) other voluntary organisations concerned with the treatment of attention deficit hyperactivity disorder for each of the last five years for which figures are available; and if he will make a statement. [10500]

Mr. Boateng: Departmental grant aid to the hyperactive children's support group for 1997-98 and the previous four years is as follows:






The Department grant-aids a number of other voluntary organisations that give information and support over a range of child and adolescent mental health disorders and do not focus exclusively on attention deficit hyperactivity disorder.

28 Jul 1997 : Column: 84

Mr. Jones: To ask the Secretary of State for Health what plans he has to improve the detection rate of children suffering from attention deficit hyperactivity disorder by child psychiatrists and paediatricians; and if he will make a statement. [10504]

Mr. Boateng: Matters concerning clinical performance and effectiveness are for the bodies, including the royal colleges, responsible for professional training, accreditation and development programmes and for clinical audit at local level. The Department has funded and supported a number of initiatives aimed at highlighting the importance of identifying and treating attention deficit hyperactivity disorder.

Mr. Jones: To ask the Secretary of State for Health (1) what recent evidence he has evaluated in respect of the number of times children in care are moved; if he will make it his policy to require all social service departments to incorporate a full assessment for attention deficit hyperactivity disorder by a specially qualified medical practitioner into the social services' own assessment as to whether a child should enter care; and if he will make a statement; [10508]

Mr. Boateng: No information is currently available centrally from routinely collected data about the number of times children in care are moved.

The criteria for taking children into care are set out in sections 20 and 31 of the Children Act 1989. Before each placement, local authorities are required to undertake a full assessment of a child's needs, including health needs, and match them to an appropriate placement. The assessment should, where appropriate, be made in collaboration with other agencies.

Children are moved from placement to placement for a wide variety of reasons. It is for local authorities to monitor the number of times a child is moved because of

28 Jul 1997 : Column: 85

placement breakdown. The Department of Health "Looking After Children: Good Parenting, Good Outcomes" system of planning, assessment and review is designed to improve the care of looked after children and to help all those involved in a child's care to ensure more effective outcomes for the child, including health and education.

Mr. Jones: To ask the Secretary of State for Health what guidance his Department gives to adoptive parents who discover that their adopted child is affected by attention deficit disorder or similar conditions; and if he will make a statement. [10510]

Mr. Boateng: Adopted children and their parents have access to the same level of medical care and attention as any other children.

Mr. Jones: To ask the Secretary of State for Health if he will issue guidelines to assist head teachers and social workers in providing for the medical problems of hyperactive children; and if he will make a statement[10539]

Mr. Boateng: The Young Minds publication "Mental Health in Your School--A Guide for Teachers and Others Working In Schools" was funded by the Department of Health and published in 1996. It includes a section on attention deficit hyperactivity disorder. The looking after children assessment and action records, which are completed by social workers who are participating in the looking after children study, includes questions that focus on children's concentration and behaviour. Subsequent questions address the services that have been or are being sought to meet the needs of the child.

Mr. Jones: To ask the Secretary of State for Health what representations he has received in respect of his Department's advice to child psychiatrists on the treatment of hyperactivity; what plans he has to review the advice; and if he will make a statement. [10543]

Mr. Boateng: None. It is for the relevant professional and academic bodies to review and evaluate evidence for the treatment of attention deficit hyperactivity disorder and to disseminate such information through training and through publications in professional journals and texts.

Mr. Jones: To ask the Secretary of State for Health if he will assess the advantages of promoting a national awareness week focusing on attention deficit disorder and similar conditions; and if he will make a statement. [10547]

Mr. Boateng: We are advised that it is unlikely that attention deficit hyperactivity disorder would benefit from presentation in this way.

Mr. Jones: To ask the Secretary of State for Health if he will make a statement on his Department's latest assessment of the prevalence of attention deficit hyperactivity disorder; and what plans he has to allow treatment of the disorder within the national health service. [10494]

Mr. Boateng: Information on the current prevalence of attention deficit hyperactivity disorder is not collected centrally. A recent review of research suggests that severe hyperkinetic disorder, which is one form of attention deficit hyperactivity disorder, is found in about one in 200

28 Jul 1997 : Column: 86

children. Attention deficit hyperactivity disorder is one of many child mental health disorders that is available for treatment in the national health service.

Mr. Jones: To ask the Secretary of State for Health if he will ensure that health professionals are informed of the methods of recognising and treating attention deficit hyperactivity disorder employed in the United States of America; and if he will make a statement. [10542]

Mr. Boateng: It is the responsibility of professional and academic bodies to assess the evidence for the best approaches in the recognition and treatment of attention deficit hyperactivity disorder. This evidence is available in literature from around the world, including the United States, and is widely available in professional journals within this country.

Mr. Jones: To ask the Secretary of State for Health what assessment he has made of the appropriateness of conventional family therapy in the case of families where one or more child is affected by attention deficit hyperactivity disorder. [10546]

Mr. Boateng: Family therapy may play a part in a comprehensive treatment programme which may also include medication and other interventions. With young children and in milder forms of attention deficit hyperactivity disorder, family therapy may be an appropriate and effective approach on its own, for example if focused on enhancing parenting skills and helping the child learn strategies to improve concentration.

Mr. Jones: To ask the Secretary of State for Health what plans he has in association with the Department for Education and Employment to promote (a) awareness of attention deficit hyperactivity disorder and (b) appropriate training for the disorder among child psychiatrists and paediatricians. [10501]

Mr. Boateng: The handbook on "Child and Adolescent Mental Health Services", which was published jointly with the Department for Education and Employment, raises awareness of attention deficit hyperactivity disorder and includes references to training of professional groups involved in the treatment of young people with emotional and behavioural disorders. Copies of the handbook are available in the Library.

Mr. Jones: To ask the Secretary of State for Health what research his Department has (a) commissioned and (b) evaluated into the relationship between attention deficit disorder and learning difficulties; and if he will make a statement. [10509]

Mr. Boateng: It has been shown that children with learning difficulties have an increased risk of a wide range of conditions, including hyperactivity. Attention deficit and hyperactivity disorder in children may also impair the capacity of a child to learn.

Mr. Jones: To ask the Secretary of State for Health if he will list those university teaching hospitals, medical colleges and other institutions involved in the training of medical doctors, indicating which of them include in their courses training in attention deficit disorder. [10511]

Mr. Boateng: A list of United Kingdom university teaching hospitals, UK medical schools and medical royal colleges and their faculties is attached. The detailed

28 Jul 1997 : Column: 87

content of curricula is set by individual medical schools within the parameters laid down by the General Medical Council which has responsibility for determining the extent of knowledge and skill required for the granting of UK primary medical qualifications. The standard and content of postgraduate medical training is the responsibility of the appropriate royal college or faculty, which will be fully aware of the importance of attention deficit disorder in training programmes.

Specialist training of child psychiatrists includes training in the diagnosis and treatment of attention deficit hyperactivity disorder. The training rotations are regularly inspected and accredited by the Royal College of Psychiatrists.



































    Central Sheffield University Hospital NHS trust


    The Addenbrooke's NHS trust


    Southampton University Hospital NHS trust


    Oxford Radcliffe Hospital NHS trust


    United Bristol Healthcare NHS trust


    Queen Elizabeth II Hospital


    Royal Liverpool University NHS trust


    Central Manchester Healthcare NHS trust


    London Hospitals:


28 Jul 1997 : Column: 88

































Mr. Jones: To ask the Secretary of State for Health if he will examine the practice among medical practitioners of giving up the use of ritalin among children suffering from attention deficit hyperactivity disorder after 12 months' use; and if he will make a statement. [10544]

Mr. Boateng: The use of ritalin to treat children suffering from attention deficit hyperactivity disorder is a matter for professional and clinical judgment and we have no plans to examine it.


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