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Chronic Fatigue Syndrome

Mr. Sawford: To ask the Secretary of State for Health if he will list those NHS trusts in Britain which offer specialist treatment to patients suffering from chronic fatigue syndrome. [67008]

Ms Jowell: The information is not available in the form requested. The organisation of health services, including services for people suffering from chronic fatigue syndrome/myalgic encephalomyelitis, and the manner in which they are delivered, are matters for National Health Service trusts and health authorities, taking account of the needs of the local population and the priorities set for the use of the available resources.

Orthopaedic Consultants

Mr. Webb: To ask the Secretary of State for Health if he will estimate the ratio of orthopaedic consultants to (a) adults and (b) pensioners in each health authority. [67000]

Mr. Denham: Copies of a table showing the latest available information on the ratio of orthopaedic consultants to (a) adults and (b) pensioners in each health authority will be placed in the Library.

Ongar War Memorial Hospital

Mr. Pickles: To ask the Secretary of State for Health when he will announce his decision on the proposed closure of Ongar War Memorial Hospital. [67640]

Mr. Denham: A decision on the proposed closure of Ongar War Memorial Hospital will be announced shortly.

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Winter Pressures Money

Mr. Syms: To ask the Secretary of State for Health how much extra money was put into the NHS to help deal with the 1998-99 winter pressures; when this money was made available; and what it was spent on. [67375]

Mr. Denham: An extra £250 million (£209 million for England) was announced in November to help the National Health Service and social services manage this winter's pressures, £159 million of which was made available immediately in England. £50 million was held as a central contingency fund, £44 million of which has been allocated in January to relieve particular pressure points.

The additional moneys have funded well over 2,000 projects to manage emergency admissions and maximise bed availability, including many joint NHS/social service schemes aimed at providing appropriate support for patients in the community.

Aricept

Mr. Kidney: To ask the Secretary of State for Health what evaluation he has made of the clinical trials regarding the use of Aricept in treating patients suffering from Alzheimer's disease. [67993]

Mr. Hutton: Information regarding the use of Aricept in patients suffering from Alzheimer's disease from clinical trials has been considered by the Medicines Control Agency.

The Standing Medical Advisory Committee, which advises health ministers, also considered available evidence from clinical trials and has reflected these in the clinical statement issued in April 1998.

Mr. Kidney: To ask the Secretary of State for Health under what circumstances the drug Aricept is currently available by prescription for the treatment of Alzheimer's disease. [67992]

Mr. Denham: Aricept (donepezil) is licensed in the United Kingdom for the treatment of mild to moderate Alzheimer's disease, and can be prescribed by doctors on the National Health Service. The Standing Medical Advisory Committee has recommended that this treatment should be initiated only following a specialist assessment.

Practice Dispensing

Mr. Peter Bradley: To ask the Secretary of State for Health when arrangements were introduced through which general practitioners may earn additional income related to the volume and costs of drugs they dispense. [68448]

Mr. Denham: Payments to general practitioners in respect of practice dispensing have included arrangements to reflect the volume and cost of the drugs since the inception of the National Health Service.

The level of fees and allowances payable to GPs are set by the independent pay review body to deliver and distribute their recommended level of net incomes for GPs, taking account of the costs, pressures and workload of practice in different areas. Earnings from practice dispensing are an integral part of the overall recommendations of the review body.

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Mr. Peter Bradley: To ask the Secretary of State for Health what proportion of GPs dispense drugs. [68443]

Mr. Denham: Based on October 1997 data, some 16 per cent. of general practitioners in England are dispensing doctors.

Dental Services

Dr. Harris: To ask the Secretary of State for Health (1) how much was spent on NHS general dental services in each health authority in each year since 1995-96; [67260]

Mr. Denham [holding answer 28 January 1999]: Copies of the information requested have been placed in the Library. Data are not directly comparable from year to year because of health authority boundary changes.

Residential Care

Sir Geoffrey Johnson Smith: To ask the Secretary of State for Health when he will respond to the report of the Centre for Policy on Ageing on National Required Standards for Residential Care and Nursing Homes; and if he will provide an estimate of the costs of compliance. [68222]

Mr. Hutton: The Centre for Policy on Ageing submitted their report on national standards for older people in residential care only very recently. We intend to publish the proposed standards for consultation shortly. Following consultation, we will consider the cost implications of introducing the standards prior to taking any decision about their implementation.

Beta-interferon

Mr. Burstow: To ask the Secretary of State for Health if he will specify the unanswered questions about the appropriate use of beta-interferon referred to in his answer of 17 November, Official Report, columns 566-67, on which his Department is commissioning new research. [68429]

Mr. Hutton: I refer the hon. Member to the reply I gave my hon. Friend the Member for Birmingham, Erdington (Mr. Corbett) on 26 January 1999, Official Report, column 211.

A range of research questions are under consideration, broadly relating to the long-term clinical effectiveness of beta-interferon and its cost effectiveness relative to other treatments for multiple sclerosis.

Nurses' Uniforms

Mr. Hoyle: To ask the Secretary of State for Health if he will make a statement on the charging of nurses for their uniforms by colleges. [68465]

1 Feb 1999 : Column: 524

Mr. Denham: Uniforms are provided free of charge to nursing students. They are provided either by the local National Health Service trust or by the higher education institution; in the latter case, the costs are met through NHS contracts. A case came to our attention last week where a university was seeking to charge for nurses' uniforms, in a way not sanctioned by their contract. As soon as we heard about the proposal we asked officials to investigate and the university concerned has now withdrawn its proposal. NHS education commissioners have been reminded of the policy in this area.

Pay Review Body Recommendations

Dr. Iddon: To ask the Secretary of State for Health if he will make a statement on the reports and recommendations of the Health Pay Review bodies. [68859]

Mr. Dobson: I am responding on behalf of my right hon. Friends the Prime Minister, the Secretary of State for Wales and the Secretary of State for Scotland to the reports of the Review Body on Doctors' and Dentists' Remuneration (DDRB) and the Review Body on Nursing Staff, Midwives, Health Visitors and Professions Allied to Medicine (NPRB), which have been published today. Copies are available in the Vote Office and the Library. I am grateful to the chairmen and members of these Review Bodies for their hard work.

Nurses are to get their biggest real terms increase for 10 years, and for the first time in 5 years the award is being paid nationally in full with no staging. The NPRB have recommended an across the board increase of 4.7 per cent. for nurses, midwives and health visitors. Around 70,000 D grade staff nurses will receive 8.2 per cent.-8.4 per cent., worth an extra £1,100-£1,200 a year. In addition, minimum starting pay for newly qualified nurses will rise to £14,400, an increase of 12 per cent. In inner London starting pay for a newly qualified nurse will be at least £17,325 including London Allowance. The guaranteed London Allowance affecting 50,000 nurses will increase by 15.4 per cent. On top of these pay increases, almost half of all nurses will receive pay increments worth at least a further 3.4 per cent. With these increases, more than two thirds of qualified nurses will earn £20,000 or more per year.

The NPRB have also recommended an across the board increase of 4.7 per cent. for physiotherapists, radiographers and other professions allied to medicine (PAMs). Starting pay for basic grade PAMs with a degree after four years' training will increase on 1 April from £14,180 to £15,405, a rise of 8.6 per cent., with similar rises for other basic grade PAMs. The maximum of scale for highly skilled Senior 1 grade PAMs will increase from £21,485 to £23,130 from 1 April, a rise of 7.7 per cent.

The Government have decided to accept all the NPRB pay recommendations for 1999-2000, with no staging. The headline settlement of 4.7 per cent. for nurses and other NPRB staff groups is significantly higher than for any of the other Review Body groups announced today, and more than we would expect for pay settlements in the public sector generally or elsewhere in the National Health Service. However, this is justified by the exceptional problems of nurse recruitment and retention which result from the failure of the last Government to put in place an adequate training and pay system for the

1 Feb 1999 : Column: 525

profession. We are pleased that the NPRB have recommended an exceptional increase for an exceptional problem.

The Doctors' and Dentists' Review Body (DDRB) has recommended a general pay increase of 3.5 per cent. for salaried doctors and dentists and for the pay element of fees for general medical practitioners. General practitioners will also receive the £60 million additional income recommended by DDRB last year for payment from 1999-2000. General dental practitioners' fees will also increase by 3.5 per cent. once the 0.9 per cent. addition to the feescale, awarded in 1998-99 only, has been removed. The DDRB has also recommended an additional £500 per year on the consultant scale maximum. The Government have accepted these recommendations for the coming year in full, with no staging.

The DDRB also recommended an extra £50 million a year from 2000-2001 to reward individual consultants for increases in workload and intensity of work. Our negotiations with the profession on a new consultant contract are covering these issues. We will consider this recommendation very carefully in the context of the negotiations, and are willing to make an investment in rewards and incentives if the negotiations deliver a better service for patients. We will, therefore, decide on the level of any extra funding for future years, and how such funding might be allocated, when the negotiations are complete.

Health authorities and NHS trusts can now use these opportunities to support a modern approach to recruiting, retaining and motivating key staff. I can announce today we are backing this with an allocation from the Modernisation Fund of £100m already earmarked for staff, which will go to all health authorities in England. This is in addition to the 6.5 per cent. increase in allocations to health authorities; and it will not affect the sums already announced within the Modernisation Fund for waiting lists, capital, mental health, primary care and information technology which already come to almost £1 billion for the coming year. The pay increases are therefore affordable both nationally and locally.

This extra funding will help us get the nurses and other staff in place to take forward effectively the Government's programme for modernising the NHS. My right hon. Friend the Secretary of State for Scotland will be releasing an additional £20m to Health Boards from his Modernisation Programme. My right hon. Friend the Secretary of State for Wales is making £6m available as a contribution to modernising the service including recruitment and retention initiatives.

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In its evidence to the Nursing Pay Review Body, the Department drew attention to recruitment and retention concerns and asked for changes to address this by starting to modernise the nursing pay scales. The Review Body has responded by improving starting pay for nurses, as well as continuing the discretionary points for staff at the top of pay scales.

We are supporting local recruitment plans with a high-profile, recruitment campaign for nurses which starts tonight on television. The aim is to attract more people into nursing and encourage qualified nurses and midwives to come back to work in the NHS. The focus of the campaign is on the value and rewards of a career in nursing and is intended to help recruit the extra nurses and midwives the NHS needs. The TV campaign will run for a month, backed by activity through to March in the national and regional press, in magazines and on radio.

These settlements are fair and are being paid in full. They provide a platform for us to move forward on pay modernisation. We will publish detailed proposals for modernising the NHS pay system shortly. The kind of pay system needed in a modern NHS will:



    get away from the rigid and outdated grading structures which restrict career progression for experienced staff


    pay fairly and equitably for work done, with career progression based on responsibility, competence and satisfactory performance


    simplify and modernise conditions of service, with national core conditions and appropriate local flexibility.

These changes are crucial to the modernisation of the NHS. They respond directly to concerns expressed by the Review Bodies, and are the only realistic way to satisfy nurses' aspirations for fewer pay ceilings and better reward for the job done. They provide the essential background for future investment in pay and staff development.


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