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Review Bodies: Terms of Reference
Lord Tomlinson asked Her Majesty's Government:
- Whether they will announce the terms of reference of the doctors' and dentists' and the nurses' review bodies.[HL3814]
The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman): Earlier this year, my right honourable friend the Minister of State for Health set out proposed terms of reference for the Doctors' and Dentists' Review Body (DDRB) and the Nurses', Midwives' and Professions' Allied to Medicine Review Body (NPRB). The Government have listened very carefully to the points made in consultation. As a result, we have been able to finalise the terms of reference. These are set out as follows. Doctors' and Dentists' Review Body: Terms of Reference
The Review Body on Doctors' and Dentists' remuneration is independent. Its role is to make recommendations to the Prime Minister, the Secretary
of State for Health, the Secretary of State for Scotland and the Secretary of State for Wales on the remuneration of doctors and dentists taking any part in the NHS.In reaching its recommendations, the Review Body is to have regard to the following considerations:
- the need to recruit, retain and motivate doctors and dentists;
- the Health Departments' output targets for the delivery of services, as set out by the Government;
- the funds available to the Health Departments as set out in the Government's departmental expenditure limits;
- the Government's inflation target.
The Review Body is also required to take careful account of the economic and other evidence submitted by the Government, staff and professional representatives and others.
Reports and recommendations should be submitted jointly to the Secretary of State for Health, the Secretary of State for Scotland, and the Secretary of State for Wales and the Prime Minister. Nurses', Midwives', Health Visitors' and Professions' Allied to Medicine Review Bodies: Terms of Reference
The Review Body on Nursing Staff, Midwives, Health Visitors and Professions Allied to Medicine (NPRB) remuneration is independent. Its role is to make recommendations to the Prime Minister, the Secretary of State for Health, the Secretary of State for Scotland and the Secretary of State for Wales on the remuneration of: (i) Nurses, Midwives and Health Visitors employed in the NHS; (ii) Physiotherapists, Radiographers, Remedial Gymnasts, Occupational Therapists, Orthoptists, Chiropodists, Dietitians and related grades employed in the NHS.
In reaching its recommendations, the Review Body is to have regard to the following considerations:
- the need to recruit, retain and motivate nurses, midwives, health visitors and staff in the Professions Allied to Medicine;
- the Health Departments' output targets for the delivery of services, as set out by the Government;
- the funds available to the Health Departments as set out in the Government's departmental expenditure limits;
- the Government's inflation target.
The Review Body is also required to take careful account of the economic and other evidence submitted by the Government, staff and professional representatives and others.
Reports and recommendations should be submitted jointly to the Secretary of State for Health, the Secretary of State for Scotland, and the Secretary of State for Wales and the Prime Minister.
Fluoride and Skeletal Fluorosis
Earl Baldwin of Bewdley asked Her Majesty's Government:
- Further to the Written Answers by Baroness Jay of Paddington on 23 March (WA 234) and Baroness Hayman on 3 September (WA 26), whether they can show, or arrange for the Committee on Medical Aspects of Food Policy to show, that they have adequately addressed the scientific evidence on the continuing discrepancy in advice about excessive intakes of fluoride, and give their reasons for preferring a guideline figure of 20-80mg/d rather than 10-20mg/d over 10 to 20 years as cited by other authorities, since this information is not apparent in either of the references they have hitherto quoted. (COMA Panel on Dietary Reference Values for Food Energy and Nutrients for the UK, 1996: Environmental Health Criteria 36; Fluorine and Fluorides, WHO 1984).[HL3703]
Baroness Hayman: The Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy was not asked to provide, and did not provide, any "guideline figure" for skeletal fluorosis. It was asked "to review the Recommended Daily Amounts for food energy and nutrients for groups of people in the United Kingdom". For fluoride, the panel decided to derive "safe intakes" as defined in paragraph 1.3.18 of the Report on Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. The report explains that the "safe intakes" are calculated on the basis of the average intakes in the UK in areas whose drinking water supply contains 1 ppm fluoride. There is no evidence that such exposures in the UK have caused, or will cause, clinical skeletal fluorosis.
Earl Baldwin of Bewdley asked Her Majesty's Government:
- Further to the Written Answer by the Baroness Hayman on 3 September (WA 24) whether they will cite the "continuing studies of the effects of fluoride in drinking-water on humans" referred to therein.[HL3704]
Baroness Hayman: Studies are regularly published in relevant scientific and medical journals. There is a significant programme of work in progress in the United States of America. In the United Kingdom, the Medical Research Council Environmental Epidemiology Unit at Southampton will shortly be completing a report on Water Fluoridation and the Fracture of the Proximal Femur and the British Association for the Study of Community Dentistry co-ordinates regular surveys of dental decay in children.
Earl Baldwin of Bewdley asked Her Majesty's Government:
- What advice is given to doctors to be aware of the possibility of incipient skeletal fluorosis in patients who present with skeletal problems.[HL3705]
Baroness Hayman: No specific advice is required. As with other diseases, skeletal fluorosis should be considered where indicated by the clinical history and physical findings, and confirmed or excluded as appropriate by further radiological, biochemical and histological investigation.
Earl Baldwin of Bewdley asked Her Majesty's Government:
- Further to the Written Answer by the Baroness Hayman on 3 September (WA 24) on the lack of any direct measurement of total fluoride consumption in humans, whether they will now consider making individual fluoride monitoring available within the NHS.[HL3706]
Baroness Hayman: Measurement of fluoride levels in an individual is available through the National Health Service when clinically indicated.
Mobile Phones: Health Risks
The Earl of Denbigh asked Her Majesty's Government:
- Whether they are aware of any potential health risk associated with the operation of mobile phones; and, if so, what action they propose to take.[HL3738]
Baroness Hayman: The Government obtain advice from the National Radiological Protection Board (NRPB) on the risks to health from exposure to electromagnetic fields, including those emitted by mobile phones. The NRPB's advice is that mobile phones currently used in the United Kingdom comply with their exposure guidelines (Restrictions on human exposure to static and time varying electromagnetic fields and radiation. Documents of the NRPB 4, No. 5, 7-63 (1993)). These guidelines are intended to prevent acute adverse responses to increased heat load and elevated body temperature. Copies of the guidelines have been placed in the Library.
Research into the possible long-term health effects of electromagnetic fields in general is being undertaken on a worldwide basis. The Department of Health and the Health and Safety Executive are currently supporting the World Health Organisation's project on electromagnetic fields and health.
Health Authority Revenue Allocations1999-2000
Lord Clinton-Davis asked Her Majesty's Government:
- When they will announce the 1999-2000 revenue allocations for health authorities.[HL3815]
Baroness Hayman: The 1999-2000 unified revenue allocations for health authorities are given in the following table. Unified allocations cover spending on hospital and community health services, general medical services (cash limited) and prescribing.
| £000s | % cash increase | |
| Avon | 582.510 | 6.69 |
| Barking and Havering | 256,500 | 6.60 |
| Barnet | 209,057 | 6.58 |
| Barnsley | 156,588 | 7.85 |
| Bedfordshire | 312,909 | 7.47 |
| Berkshire | 431,001 | 7.38 |
| Bexley and Greenwich | 289,039 | 5.45 |
| Birmingham | 681,946 | 6.50 |
| Bradford | 312,469 | 7.25 |
| Brent and Harrow | 310,879 | 5.79 |
| Bromley | 183,609 | 6.49 |
| Buckinghamshire | 368,084 | 7.15 |
| Bury and Rochdale | 249,286 | 7.09 |
| Calderdale and Kirklees | 369,439 | 6.67 |
| Cambridge and Huntingdon | 233,706 | 6.70 |
| Camden and Islington | 320,971 | 7.04 |
| Cornwall and Isles of Scilly | 317,079 | 5.80 |
| County Durham | 411,001 | 7.09 |
| Coventry | 200,882 | 7.28 |
| Croydon | 202,682 | 6.72 |
| Doncaster | 198,465 | 7.04 |
| Dorset | 446,631 | 5.49 |
| Dudley | 183,018 | 6.66 |
| Ealing, Hammersmith and Hounslow | 475,900 | 6.67 |
| East and North Hertfordshire | 290,037 | 6.59 |
| East Kent | 395,915 | 6.36 |
| East Lancashire | 349,892 | 6.57 |
| East London and the City | 491,634 | 8.12 |
| East Norfolk | 380,037 | 6.41 |
| East Riding | 360,233 | 6.92 |
| East Surrey | 244,052 | 5.49 |
| East Sussex, Brighton and Hove | 505,366 | 6.35 |
| Enfield and Haringey | 323,495 | 6.72 |
| Gateshead and South Tyneside | 255,537 | 6.95 |
| Gloucestershire | 334,591 | 5.47 |
| Herefordshire | 98,713 | 6.45 |
| Hillingdon | 154,353 | 6.46 |
| Isle of Wight | 92,390 | 5.96 |
| Kensington, Chelsea and Westminster | 286,339 | 8.71 |
| Kingston and Richmond | 208,380 | 5.51 |
| Lambeth, Southwark and Lewisham | 573,116 | 7.11 |
| Leeds | 469,356 | 6.80 |
| Leicestershire | 517,887 | 7.15 |
| Lincolnshire | 394,990 | 6.42 |
| Liverpool | 350,296 | 6.87 |
| Manchester | 349,914 | 6.00 |
| Merton, Sutton and Wandsworth | 422,995 | 6.35 |
| Morecambe Bay | 205,730 | 5.46 |
| Newcastle and North Tyneside | 333,829 | 6.92 |
| North and East Devon | 300,720 | 5.50 |
| North and Mid Hampshire | 291,934 | 6.39 |
| North Cheshire | 201,585 | 5.49 |
| North Cumbria | 198,917 | 6.78 |
| North Derbyshire | 228,364 | 6.47 |
| North Essex | 503,561 | 6.57 |
| North Nottinghamshire | 236,475 | 6.71 |
| North Staffordshire | 304,458 | 7.32 |
| North West Anglia | 250,526 | 6.86 |
| North West Lancashire | 321,635 | 6.51 |
| North Yorkshire | 434,879 | 6.51 |
| Northamptonshire | 326,245 | 6.40 |
| Northumberland | 196,638 | 6.81 |
| Nottingham | 391,712 | 7.40 |
| Oxfordshire | 327,812 | 7.39 |
| Portsmouth and South East Hampshire | 330,353 | 6.65 |
| Redbridge and Waltham Forest | 296,944 | 5.46 |
| Rotherham | 159,696 | 7.27 |
| Salford and Trafford | 310,166 | 6.72 |
| Sandwell | 205,838 | 7.35 |
| Sefton | 192,610 | 6.73 |
| Sheffield | 367,283 | 6.88 |
| Shropshire | 247,650 | 6.51 |
| Solihull | 122,698 | 6.82 |
| Somerset | 290,097 | 6.40 |
| South and West Devon | 383,565 | 5.63 |
| South Cheshire | 405,696 | 6.42 |
| South Derbyshire | 340,745 | 6.90 |
| South Essex | 417,802 | 7.24 |
| South Humber | 199,138 | 5.47 |
| South Lancashire | 185,797 | 5.49 |
| South Staffordshire | 322,868 | 6.41 |
| Southampton and South West Hampshire | 327,774 | 6.58 |
| St. Helen's and Knowsley | 237,210 | 6.88 |
| Stockport | 176,374 | 6.68 |
| Suffolk | 397,601 | 5.49 |
| Sunderland | 201,223 | 6.97 |
| Tees | 370,553 | 7.02 |
| Wakefield | 211,891 | 6.81 |
| Walsall | 163,794 | 7.37 |
| Warwickshire | 293,422 | 5.49 |
| West Hertfordshire | 317,538 | 6.38 |
| West Kent | 582,935 | 6.41 |
| West Pennine | 297,286 | 6.80 |
| West Surrey | 371,000 | 5.48 |
| West Sussex | 467,090 | 6.59 |
| Wigan and Bolton | 373,322 | 7.18 |
| Wiltshire | 345,684 | 6.37 |
| Wirral | 226,913 | 6.70 |
| Wolverhampton | 160,766 | 7.15 |
| Worcestershire | 303,405 | 6.37 |
| England | 31,192,915 | 6.60 |
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