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Elderly (Long-term Care)
Miss McIntosh: To ask the Secretary of State for Health what provision the Government are making for residential and nursing care for the elderly in each of the next three years. [96754]
Mr. Hutton: We do not set a specific amount aside for residential and nursing care for the elderly. This is for health authorities and local authorities to decide upon, from within their overall budgets. My right hon. Friend the Chancellor of the Exchequer announced the total amount available to the National Health Service and to local authorities for 1999-2000 to 2001-02 in July 1998 when he published the outcome of the Comprehensive Spending Review. Copies are available in the Library.
Miss McIntosh: To ask the Secretary of State for Health what plans he has to allow local authority social services to relocate elderly people in care without consulting next of kin; and if he will make a statement. [96751]
When relocation is being considered, we expect local authorities to consult with and take into account the views of the older people concerned, as well as their relatives or carers.
NHS Direct
Mr. Cohen: To ask the Secretary of State for Health what representations he has received about the possibility of advertising NHS Direct on radio; and if he will make a statement. [96535]
Ms Stuart: We have recently received a letter from the Radio Advertising Bureau about NHS Direct advertising on radio.
It is important that the public has clear information about all NHS services. Radio advertising has been used in the past to widen public access to NHS Direct in particular.
Officials are talking to the Radio Authority to ensure radio advertising remains an option for providing information about NHS Direct in the future.
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Mr. Dobbin:
To ask the Secretary of State for Health what plans he has to include (a) professional health groups and (b) pharmacists, radiographers and medical laboratory scientists on the NHS Pay Review Body. [96275]
Mr. Denham:
On 15 February 1999, the Health Departments published proposals for modernising the National Health Service pay system in "Agenda for Change." This included the possibility of moving some highly qualified health professionals into the remit of the Nurses, Midwives, Health Visitors and Professions Allied to Medicine Review Body (NPRB).
Initial discussions with NHS trade unions on pay modernisation were completed successfully on 5 October and resulted in a Joint Framework of Principles and Agreed Statement on the Way Forward which was published on 8 October, copies of which are available in the Library. Paragraph 7.2 of the Joint Framework identifies, as a starting point for more detailed discussions with trade unions, the qualifying criteria for groups of staff to come within the scope of the NPRB.
The criteria are
Staff groups which support professions added to the NPRB remit, and who have a direct connection with the transferred groups similar to that between nursing auxiliaries and registered nurses would also need to be considered for transfer.
No change will take place until all aspects of the new pay system are agreed. The joint target for agreement is summer 2000.
Radiographers are already covered by the NPRB.
Mrs. Ann Winterton:
To ask the Secretary of State for Health if he will list the differences between his policies in relation to the removal of assisted nutrition and hydration from (a) patients in persistent vegetative state and (b) other mentally incapacitated patients; what plans he has for changes to the law or practice in relation to such matters; and if he will make a statement. [96518]
Mr. Hutton:
The removal of artificial nutrition and hydration is in all cases a matter of clinical judgment which is undertaken in accordance with professional advice provided by a responsible and recognised body of medical opinion and the general law. There are no plans to change the law in this respect.
Mrs. Ann Winterton:
To ask the Secretary of State for Health if he will estimate the numbers of mentally incapable adults in (a) Scotland and (b) the rest of the United Kingdom in each of the last three years whose death could have been brought about by the removal of artificial nutrition and hydration if such removal were legally sanctioned (i) without recourse to the courts for such patients not in persistent vegetative state and
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(ii) through recourse to the courts for such patients in persistent vegetative state; and if he will estimate how many and what percentage of those patients in each year would (1) have issued an advance directive requesting such a recourse of action and (2) have such nutrition and hydration removed without their own express request. [96521]
Mr. Hutton:
The information requested is not available centrally.
Mrs. Ann Winterton:
To ask the Secretary of State for Health what the basis is for the distinction he makes between advance directives and advance refusals in respect of patients in persistent vegetative state or otherwise mentally incapacitated. [96522]
Mr. Hutton:
Advance Statements are anticipatory decisions made while a person is capable, which are intended to give effect to that person's wishes as to how he or she shall be treated or cared for after the loss of capacity. An advance statement can be concerned with the refusal of medical treatment and are then sometimes known as advance directives.
Mrs. Ann Winterton:
To ask the Secretary of State for Health what plans he has to introduce legislation defining assisted food and fluid as treatment which may be withdrawn from patients with mental incapacities other than persistent vegetative state; and if he will make a statement. [96519]
Mr. Hutton:
We have indicated that we intend to introduce a provision on Continuing Powers of Attorney (CPA) when parliamentary time allows such legislative changes.
It is a general principle of law and medical practice that all adults have the right to consent to or refuse medical treatment. The CPA is a method by which adults can continue to ensure that their views are respected in decisions concerning their welfare when they can no longer take, or communicate, those decisions themselves. A CPA therefore would allow an attorney to make decisions on behalf of the person without capacity about the withdrawal of artificial nutrition and hydration but only if the person has specifically given authority to do this in the CPA. Where decisions need to be taken in such cases, the healthcare team and attorney should do so in the best interests of the individual concerned.
Mrs. Ann Winterton:
To ask the Secretary of State for Health what definition he uses of the phrase, a patient's best interests, in relation to patients in persistent vegetative state and other mentally incapacitated patients. [96632]
Mr. Hutton:
A patient's best interests includes his physical and psychological health, well being, quality of life, relationship with family and other carers, spiritual and religious welfare.
Mrs. Ann Winterton:
To ask the Secretary of State for Health what plans he has to enshrine in statute law the judgment in Airdale NHS Trust v. Bland [1993] in relation to the definition of assisted food and fluid as treatment and the removal of tubal feeding from Mr. Tony Bland. [96631]
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Mr. Hutton:
We have no plans to enshrine this judgment in statute law.
Mr. Bercow:
To ask the Secretary of State for Health what was the total cost of commemorative (a) coins and (b) events to mark the 50th anniversary of the National Health Service. [96571]
Mr. Denham:
Events to mark the 50th anniversary of the National Health Service were organised in accordance with the principles that activities should promote the core aims of the service and that money should not be diverted from patient care.
Commemorative coins marking the anniversary were produced by the Royal Mint and involved no cost on the part of the Department.
Central support for the NHS' special activities during its anniversary year were met within the Department's publicity and communications budget. The total for activity was £1,673,000, spread across the financial years 1997-98 and 1998-99. This was offset by sponsorship support to the value of around £1 million.
Mr. Baker:
To ask the Secretary of State for Health if he will make a statement on the termination payment awarded to Clive Uren by Eastbourne Hospitals NHS Trusts. [96333]
Ms Stuart:
On 13 October 1999, Mr. Uren resigned as Chief Executive of Eastbourne Hospitals National Health Service Trust following the publication of the Review of Nursing at Eastbourne Hospitals NHS Trust.
"Professions with a minimum entry requirement of three years' educational study (or equivalent) to diploma level or higher, in a health specific area (other than medicine or dentistry) and which are state registered and have a substantial majority of members employed in healthcare."
Exceptions might be agreed for staff groups which meet the majority but not all of these conditions.
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