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Rail Safety

Mrs. Dunwoody: To ask the Secretary of State for the Environment, Transport and the Regions if he will publish the cost benefit analysis of (a) ATP and (b) other alternative systems of train protection presently available. [107860]

Mr. Hill: The cost benefit analysis of Automatic Train Protection (ATP) will depend on a number of factors including the precise system chosen, the timing of its introduction, and the level of safety risk which it addresses. A British rail report on ATP including estimates of costs and benefits was placed in the Library of the House in July 1994, but those estimates would need to be recalculated in the light of specific proposals.

A regulatory impact assessment for the Railway Safety Regulations 1999, including a cost benefit assessment of the Train Protection and Warning System (TPWS), was placed in the Library of each House when the Regulations were laid on 10 August 1999. Following the tragic accident at Ladbroke Grove, we asked Sir David Davies to make an assessment of train protection systems and we expect his report shortly. We will also look to the Health and Safety Commission for advice before any further decisions on train protection are taken.

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Rail Passengers (Delays)

Mr. Steinberg: To ask the Secretary of State for the Environment, Transport and the Regions how much compensation was paid to rail passengers for delays under passenger charters in each of the last five years. [108440]

Mr. Hill: Passenger's Charter payment records are maintained separately by each of the 25 franchised passenger train operators. This information is not held centrally.


Hip Replacement Revisions

Mr. Dalyell: To ask the Secretary of State for Health how many revision total hip replacement operations in the National Health Service were performed in (a) 1995, (b) 1996, (c) 1997, (d) 1998 and (e) from January to June 1999 expressed as a percentage of total hip operations. [101206]

Mr. Denham: The information for England is set out in the table. This is routinely presented in financial years rather than calendar years.

YearRevision operations as a percentage of all hip replacements
1999-2000 Q1(6)9.4
1998-99 Q3(6)9.6
1998-99 Q2(6)10.1
1998-99 Q1(6)10.5

(6) Data for 1999-2000, 1998-99 and 1997-98 are provisional. No adjustments have been made for coverage and the figures are not directly comparable with earlier years.


1. Data for 1995-96 and 1996-97 are grossed for coverage (but not for unknown/invalid clinical data). Information for Quarter 4 of 1998-99 is not yet available.

2. OPCS4R codes W37-W39, W46-W48, excluding emergency admissions and episodes with a primary diagnosis of ICD 10 codes S72.0, S72.1 and S72.2.

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Heart Transplants

Mr. O'Hara: To ask the Secretary of State for Health if he will make a statement on the Government's policy on heart transplants for patients over 60 years. [103957]

Mr. Denham: There is no specific policy on heart transplants for patients over 60. Every patient should be assessed according to his or her individual needs, and there should be no bar to transplantation other than a clear medical contraindication.

Nursing Vacancies

Mrs. Virginia Bottomley: To ask the Secretary of State for Health if he will list those health authorities which have nursing vacancies in excess of 300. [107065]

Mr. Denham: The available information is given in the table.

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Vacancies (nursing and midwifery staff) in health authorities with over 300 posts vacant at 31 March 1999
Whole-time equivalents

Health AuthorityTotal vacancies (7)Percentage (8)3 month vacancies (9)Percentage (8)
Camden and Islington78011.13905.5
North Essex3305.2----
East London and City70012.95009.1
Kensington, Chelsea and Westminster5608.3----
Merton, Sutton and Wandsworth5609.7----
West Kent3005.3----
West Surrey3508.2----
Lambeth, Southwark and Lewisham81011.4----

(7) Posts that Trusts were actively trying to fill at 31 March 1999.

(8) Vacancies as a percentage of total posts (staff in post plus vacancies.)

(9) Posts that had been vacant for three months or more at 31 March 1999.


Figures are rounded to the nearest 10.


Department of Health Recruitment, Retention and Vacancies Survey 1999

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Thyroid Disorder

Mr. Maclean: To ask the Secretary of State for Health what methods are used by health authorities to test for thyroid disorder; and what plans he has to prescribe a standard test. [107488]

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Mr. Denham: There are a number of thyroid disorders and diseases. The results of initial testing may indicate further tests are needed to diagnose the patient's condition.

The initial thyroid function tests have improved greatly in recent years as a result of medical research, and

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up-to-date tests are available in National Health Service laboratories. The most common are the measurement of serum thyroid stimulating hormone, and free thyroxine (T4). Others commonly used include isotope uptake studies, thyroid antibody assays, ultrasound scans and needle biopsies. All NHS laboratories participate in quality assurance schemes.

The Department has no plans to issue guidance in this area.

Rural Ambulance Services

Mr. Maclean: To ask the Secretary of State for Health what plans he has to increase resources to rural ambulance services in (a) Cumbria and (b) elsewhere. [107486]

Ms Stuart: Since 1997, an extra £15 million has been included in the general allocation to health authorities to support implementation of the new ambulance service targets across England; those allocations are weighted to take account of rurality. Furthermore, we have carried out research recently to support ambulance services in delivering the national targets in both urban and rural areas such as Cumbria.

Mr. Maclean: To ask the Secretary of State for Health what plans he has to improve the (a) effectiveness and (b) response times for ambulance services in sparsely populated rural counties. [107490]

Ms Stuart: We recognise the practical constraints on ambulance services that have to cope with extremes of geography. In emergency situations the effectiveness of ambulance services is largely dependent on speed of response and the clinical training of their crews. The new response time targets will benefit rural areas as they are based on clinical need rather than geography. However rural services will need to develop alternative approaches to achieving the response times for people with immediately life-threatening conditions including paramedics using fast response vehicles, co-responder programmes (using the fire service and police) and community first responder schemes (local trained volunteers). We have commissioned research on the cost effectiveness of these alternative responses to help local health economies, including those in rural areas, plan specific service improvements.

Radiological Facilities

Mr. Norman: To ask the Secretary of State for Health how many acute hospitals in the NHS do not have full radiological facilities, including scanning equipment, on site. [107415]

Ms Stuart: Information on radiological facilities, including scanning equipment, on individual acute hospital sites is not collected centrally. However, information on the number of imaging and radiodiagnostic examinations or tests undertaken in National Health Service trusts is available and is published annually in "Imaging and radiodiagnostics, England". The latest data are for 1998-99 and have been placed in the Library.

Neurology Treatment

Mr. Bob Russell: To ask the Secretary of State for Health, pursuant to his answer of 24 January 2000, Official

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Report, column 100W, on waiting times, for how many weeks in excess of 26 weeks each of the 36 patients referred to are waiting to see the neurology consultant. [108093]

Mr. Denham: The information requested is not collected.

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