---

Gibraltar

Mr. Hoyle: To ask the Secretary of State for Defence if he will make a statement on the location of the new NATO headquarters for GIBMED. [30809]

Dr. Reid: As part of the implementation of NATO's new command structure GIBMED, the NATO headquarters based in Gibraltar is due to close. Gibraltar will be located in Regional Command South. In the new structure, NATO command of Gibraltar will be the responsibility of Commander-in-Chief Allied Forces South Europe, based at Naples. The Commanders of Allied Naval and Air Forces South, also based at Naples, will exercise region-wide air and maritime responsibilities on behalf of the Commander-in-Chief. Regional Commanders will also be able to propose the establishment of areas of responsibility for particular Joint Sub-Regional Commanders in specific contingencies or missions. Such proposals will require the approval of all NATO nations. NATO's Joint Sub-Regional Commands, once implemented, would have no permanently established boundaries or areas of responsibility.

25 Feb 1998 : Column: 262

Torpedo Testing Facilities

Mr. Charles Kennedy: To ask the Secretary of State for Defence what assessment he has made of the medium to long-term need for United Kingdom torpedo testing facilities; and if he will make a statement. [30028]

Dr. Reid: Current plans for in-water testing of United Kingdom new production torpedoes assume the continuing use over the next ten years of the British Underwater Test and Evaluation Centre (BUTEC). This facility is situated in North West Scotland and is managed by the Defence Evaluation and Research Agency on behalf of the Secretary of State for Defence. In addition to testing of new production torpedoes, the BUTEC facilities are used for in-service trials and exercise firings, which are expected to continue for the foreseeable future.

HEALTH

Secure Mental Health Units

Mr. Vaz: To ask the Secretary of State for Health how many secure mental health units there are in the United Kingdom; and how many patients are in each. [29541]

Mr. Boateng: There are 33 secure units in England with 1,504 places. This does not include the high security hospitals. Information on the number of places occupied is not kept, but anecdotal evidence suggests that most medium secure units are running at capacity most of the time.

Tuberculosis

Mr. Nicholls: To ask the Secretary of State for Health what trends he has identified in the incidence of TB in the United Kingdom in the last 10 years; if he will make extra resources available for the detection and treatment of TB; and if he will make a statement. [30466]

Ms Jowell: The numbers of notifications of tuberculosis (TB) in the United Kingdom are published in the Annual Abstract of Statistics. Information for the years 1987 to 1997 are given in the table:

Year	Number of notifications of tuberculosis in the UK(5)
1987	5,745
1988	5,778
1989	6,059
1990	5,897
1991	6,078
1992	6,441
1993	6,564
1994	6,228
1995	6,174
1996	6,238
1997	(6)6,430

(5) Annual Abstract of Statistics.

(6) Provisional.

Sources:

Scottish Health Service Common Services Agency; Department of Health and Social Services (Northern Ireland); and Office of Population Censuses and Surveys.

There was a 90 per cent. decrease in notifications of TB in the UK between 1948 and 1987. There was a small increase in cases after the late 1980s, but figures have

25 Feb 1998 : Column: 263

now levelled out and the latest full year provisional figure is 6,430. This success is against a worldwide resurgence in TB in recent years which is having a small but important impact on trends in the UK. Data suggest that certain parts of the community--older white people who were exposed to TB when they were younger, homeless people, HIV infected individuals and certain ethnic minority populations--are at an increased risk from TB. Many of these groups are harder to reach, and inner city areas--London, in particular--do see a disproportionate amount of TB due to a concentration of risk groups in those areas.

No resources have been specifically identified for TB detection and treatment. Health authorities are given general allocations for hospital and community health services to commission health care services for their resident population. All 100 health authorities in England will receive a real terms cash boost in 1998-99. The 1.9 per cent. real terms increase in general allocations is the largest for five years. It is for individual health authorities to decide the level and type of services purchased, taking account of local circumstances and national policies and priorities. TB is an important public health concern and purchasers of health care need to ensure that adequate resources are provided to meet this in their contracting for TB services. While the details of local TB policies depend on local factors, local policies must be considered within a national context (especially for Bacille-Calmette-Guerin (BCG) immunisation) and national policy should prevail. The importance of this has been brought to the attention of health authorities. The Department continues to purchase the BCG vaccine and make it available free to the National Health Service. The Department is also funding the Public Health Laboratory Service, with around £400,000, to conduct a detailed Survey of Notifications of TB in 1998. The survey will provide important information on trends and incidence.

The UK has an excellent record of TB control and we are determined that this should remain the case. The BCG immunisation programme, treatment of identified cases and screening of their close contacts, screening and treatment for immigrants from countries with a high prevalence of TB and active surveillance of TB continue. We are responding positively to new adverse developments in other countries and strengthening policies to protect the health of the nation against TB.

Tinnitus

Dr. Vis: To ask the Secretary of State for Health what research his Department has commissioned, and at what cost, into the alleviation of tinnitus. [30738]

Mr. Milburn: The main agency through which the Government support medical and clinical research is the Medical Research Council (MRC). The MRC and Trent Regional Office were supporting research specifically into tinnitus at the MRC Institute of Hearing Research in Nottingham at an annual level of approximately £100,000 per year until the end of 1992.

Since then, there have been two studies on the quality of life of those who report tinnitus and there is continued work in this area. In addition, a study of young people's lifestyles has shown an association between those reporting tinnitus and those who have experienced high levels of leisure noise from, for example, discos and

25 Feb 1998 : Column: 264

personal cassette players. This work is currently being prepared for publication, although it has been presented at several conferences during 1996-97. It is expected that future clinical and epidemiological studies at the Institute of Hearing Research will continue to incorporate a tinnitus aspect.

The MRC also currently funds a number of researchers to investigate at a basic level the mechanisms through which the ear analyses, and the brain interprets and attends to, sound. New approaches to tinnitus, including treatments for the sensory neural hearing losses that underlie most cases, are expected to result from such work. The cost of this research is unavailable at the current time.

Consultant Episode Costs

Mr. McDonnell: To ask the Secretary of State for Health if he will list the annual average cost for completed NHS consultant episodes since 1987-88 in real terms. [31226]

Mr. Milburn: The average costs per finished consultant episode for acute care, for each year since 1987-88, are listed in the table. Costs prior to 1990-91 are not comparable to later years owing to a discontinuity in accounting practice.

Average cost per acute finished consultant episode (FCE) in real terms (at 1995-96 prices)

Year	Cost per acute FCE (£)
1987-88	1,091
1988-89	1,134
1989-90	1,111
1990-91	1,093
1991-92	1,087
1992-93	1,087
1993-94	1,033
1994-95	1,022
1995-96	995

Trust and Authority Boards

Mr. Gordon Prentice: To ask the Secretary of State for Health (1) how many (a) chairpersons and (b) other board members on (i) NHS trusts, (ii) Ambulance NHS trusts and (iii) health authorities previously served on a community health council in a volunteer capacity; [31043]

(2) how many chairpersons of (a) NHS trusts, (b) Ambulance NHS trusts and (c) health authorities were, prior to their appointment, chair of a community health council. [31044]

Mr. Milburn: This information is not collated centrally and could be provided only at disproportionate cost.

Abortion

Mr. Austin: To ask the Secretary of State for Health how many residents of England who met the requirements for an abortion as specified by the Abortion Act 1967 were unable to obtain an abortion paid for by the NHS in (a) 1996 and (b) 1997. [31110]

25 Feb 1998 : Column: 265

Ms Jowell: This information is not collected centrally. Information on whether an abortion was purchased by the National Health Service or privately is collected. In 1996, 72 per cent. of abortions in England were purchased by the NHS. Statistics for 1997 are not yet available.

---