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National Insurance

Mr. Chaytor: To ask the Secretary of State for Health if he will estimate the revenue effect of reducing national insurance charges by 0.5 per cent. for those employed by the NHS. [82750]

Mr. Denham: The rate of employers national insurance will be reduced by 0.5 per cent. from April 2000. This will have the effect of reducing the national insurance bill for hospital and community health services by approximately £38 million. The reduction in employers national insurance rates is intended to compensate for the climate change levy announced in the budget. The overall effect of these two policies on the National Health Service is expected to be broadly cost neutral.

Health Authorities (Expenditure)

Mr. Ruffley: To ask the Secretary of State for Health if he will publish the expenditure plans for each health authority in the Eastern Region, indicating those authorities that are making reductions in service and by how much. [83012]

Mr. Denham: The expenditure plans of health authorities for the financial year 1999-2000 have not yet been finalised.

Competitive Bidding

Mr. Opik: To ask the Secretary of State for Health how many bids by each local health trust were (a) received and (b) successful in each of the competitive bidding processes launched and managed by his Department since May 1997. [82461]

Mr. Denham [holding answer 28 April 1999]: National Health Service trusts were asked to submit bids for two elements of the capital modernisation fund direct to the Department. Details of the numbers of bids to the waiting lists modernisation fund and accident and emergency modernisation fund are contained in the table. NHS trusts are also benefiting from a wide range of bidding exercises, handled through health authorities and the regional offices of the NHS Executive, to fund specially targeted initiatives as part of the Government's commitment to improve services and modernise the NHS.

11 May 1999 : Column: 133

	Waiting lists modernisation fund		Accident and emergency modernisation fund
Regional Office	Number of bids submitted to ROs	Number of bids approved by Ministers	Number of bids submitted to ROs	Number of bids approved by Ministers
Northern and	86	18	34	15
Trent	56	19	31	6
Eastern(8)	19	21	12	7
London	109	33	44	9
South East	28	28	16	9
South West	19	19	18	7
West Midlands	2	2	21	7
North West	145	25	42	10
Total	464	165	218	70

(8) Having reviewed the criteria, Eastern Regional decided to focus on schemes that would deliver extra capacity. It was expected that the equipment would be bought via an increase in allocations to all waiting lists trusts, hence the increase from 19 bids to 21 approved schemes.

Note:

East Regional Office had flexibility to decide how to manage the bidding process within its region. There were differences in the way ROs invited and assessed bids.

11 May 1999 : Column: 133

Human Insulin

Mr. Flynn: To ask the Secretary of State for Health what assessment his Department has made of the Posner report on genetically engineered human insulin commissioned by the British Diabetic Association in 1993. [83336]

Ms Jowell: The Department and the Medicines Control Agency have evaluated the Posner Report together with all available evidence on the safety of human insulin. The independent advisory body to Government, the Committee on Safety of Medicines, has also fully reviewed the safety of human insulin on several occasions since its introduction, taking into account patient experiences of the effects of human insulin. The Committee has concluded that although some patients have experienced problems on transferring to human insulins and are better suited to animal insulins, there is no evidence of a safety problem specific to human insulin.

Loughborough General Hospital

Mr. Reed: To ask the Secretary of State for Health when he expects to announce the completion of the private finance initiative project to replace Loughborough's general hospital. [83167]

Mr. Denham: The National Health Service Executive has received a revised Full Business Case from Fosse Health NHS Trust for the scheme to replace Loughborough's General Hospital. The NHS Executive has agreed a deadline for an initial response to the trust of 30 May 1999.

The revised Full Business Case is based on the best and final offer which was received from the preferred bidder on 3 November 1998.

Fosse Health NHS Trust was merged with Leicestershire Mental Health Services NHS Trust on 1 April 1999. The new trust is named Leicestershire and Rutland Healthcare NHS Trust. The merger will not affect the submitted proposals for the scheme.

11 May 1999 : Column: 134

Fluoridisation (Leicestershire)

Mr. Reed: To ask the Secretary of State for Health what representations he has received about fluoridisation of water in Leicestershire; and if he will make a statement. [83165]

Mr. Denham: The Green Paper Our Healthier Nation invited comments on the contribution which fluoridation can make to improved oral health. Of the 258 comments received from the Trent region, in which Leicestershire is located, 241 were in favour of fluoridation and 17 opposed. We will be announcing our policy on fluoridation in a White Paper on public health, which will be published shortly.

Domestic Violence

Mr. Cohen: To ask the Secretary of State for Health in what types of location copies of the leaflet associated with the Breaking the Chain campaign on domestic violence have been placed, and in what numbers. [83566]

Ms Jowell: Distribution agreed by the Department included a broad range of health settings and all social services departments and other voluntary child care organisations. One copy each of the leaflet and poster was sent to all general practitioner practices in England (around 9,500) in the GP pack at the end of March 1999, with the opportunity to request as many more copies as they require.

Ten copies of the leaflet and one of the poster are shortly to be sent to all trust nurse directors in England (402) to be placed in hospital patient information racks, again with a form for ordering additional copies to meet local requirements.

Additional supplies of both leaflets and posters are available from Departmental stores as and when needed within local areas.

NHS Appointments

Mr. Brady: To ask the Secretary of State for Health if he will list the NHS trust and health authority appointments which were not made by the due date and which remained outstanding on 1 May. [83395]

Mr. Denham: All health authority appointments due on 1 April 1999 were completed on time. A small number of appointments to National Health Service trusts and health authorities which expired in 1998 remain vacant. Details are given in the table.

11 May 1999 : Column: 135

List of health authority and national health service trust appointments which expired in 1998 and for which no appointment had been made by 1 May 1999

Region	Body	Number of Chairs	Number of Non-executives
Eastern	Essex Rivers Healthcare NHS Trust	0	1
North West	Chester and Halton Community NHS Trust	1	0
	Liverpool Women's Hospital NHS Trust	0	1
	Wirral Hospital NHS Trust	0	1
Northern and Yorkshire	Calderdale and Kirklees Health Authority	0	1
London	BHB Community Healthcare NHS Trust	0	1
	City and Hackney Community Services NHS Trust	0	1
	Croydon Community Health NHS Trust	0	1
	Enfield Community Care NHS Trust	0	1
Trent	Central Nottinghamshire Healthcare NHS Trust	0	1
	Grantham and District Hospital NHS Trust	0	1
South East	East Surrey Health Authority	0	2
South West	Gloucestershire Ambulance Service NHS Trust	0	1
	Royal United Hospital Bath NHS Trust	0	1
West Midlands	Birmingham Heartlands and Solihull (Teaching) Hospitals NHS Trust	0	1
	Walsall Community Health NHS Trust	0	1
	Total	1	16

11 May 1999 : Column: 135

Medical Treatment (Hastened Death)

Dr. Iddon: To ask the Secretary of State for Health what data he has collated on cases in which medical treatment has been given to a patient with the deliberate intention of hastening death. [83394]

Ms Jowell: Medical treatment given to a patient with the primary purpose of hastening death is illegal. Anyone alleged to have undertaken such action would be open to a charge of murder or manslaughter.

It is the responsibility of the police to decide whether to bring charges in individual cases and for the Crown Prosecution Service to decide whether a prosecution should proceed.

Information on such cases is not available centrally.

Junior Doctors

Miss McIntosh: To ask the Secretary of State for Health what plans he has to extend the scope of the EU Working Time Directive to include junior hospital doctors. [83776]

Mr. Denham: The European Commission has proposed an extension of Council Directive 93/104/EC, of 23 November 1993, to encompass the previously excluded sectors, which include junior doctors. This proposal is now being considered by the Council of Member States and the European Parliament. When this extension is agreed, it will be adopted into United Kingdom legislation.

11 May 1999 : Column: 136

Miss McIntosh: To ask the Secretary of State for Health what plans he has to increase overtime rates for junior hospital doctors. [83775]

Mr. Denham: Pay rates for junior doctors, including rates for out of hours work, known as additional duty hours, are decided by the independent Doctors' and Dentists' Pay Review Body. Their 28th report, published on 1 February 1999, concluded that

"there was no need for changes to the existing working patterns of junior doctors and against that background the existing rates of additional duty hours remain appropriate".

Copies of this report are available in the Library.

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