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Mr. Yeo : We required all district health authorities to implement fully the care programme approach from 1 April 1991 and we have received assurances from regional health authorities that this has been done. The Department and the regional health authorities are monitoring progress.
The introduction of the care programme approach in itself imposed no new costs on either health or local authorities as it embodied existing good professional practice.
Ms. Jowell : To ask the Secretary of State for Health (1) what steps she is taking to monitor the application of section 117 of the Mental Health Act 1983 ;
(2) how many people are subject to the provisions of section 117 of the Mental Health Act 1983 ; and what is the current cost of its implementation for each regional health authority.
Mr. Yeo : The implementation of section 117 of the Act is reviewed by the Mental Health Act Commission as part of its programme of visits to health and social services. In its fourth biennial report, published in December 1991, the commission reported that most health authorities and social services departments had completed their policies and procedures for the implementation of section 117.
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The services which this section of the Act requries authorities to provide for formerly detained patients form part of the general provision of services for mentally ill people in the community and we do not collect separate figures about them. Under the care programme approach introduced in April 1991 all patients using these services, whether or not they have been detained in hospitals, are required to have an individual care programme and a named key worker.Blyth Valley (Patient Numbers)
Mr. Ronnie Campbell : To ask the Secretary of State for Health if she will list the number of patients per general practice in Blyth Valley.
Dr. Mawhinney : The information requested is shown in the table.
Practice |List size ------------------------------ 1 |12,656 2 |12,645 3 |12,356 4 |8,822 5 |6,867 6 |5,677 7 |4,664 8 |4,264 9 |4,208 10 |4,168 11 |924 12 |633
Creutzfeldt Jakob Disease
Mr. Hinchliffe : To ask the Secretary of State for Health what assessments have been undertaken of the number of patients potentially contaminated with Creutzfeldt Jakob disease as a result of surgery within the NHS.
Mr. Yeo : I refer the hon. Member to the reply I gave him on 23 November 1992 at column 504.
Mental Health Task Force
Ms. Jowell : To ask the Secretary of State for Health what are the names, qualifications and experience of the members of the mental health task force.
Mr. Yeo : The membership of the mental health task force and its support group is in the process of being finalised. A copy of the full list of members of the group will be placed in the Library when it has been completed.
NHS Trusts
Ms. Jowell : To ask the Secretary of State for Health which hospital trusts had by 31 December 1992 completed their contracts for the period to 31 March for elective treatments in (a) orthopaedic surgery, (b) ENT, (c) general medicine and (d) general surgery.
Dr. Mawhinney : The information requested is not available centrally and could be provided only at disproportionate cost.
Drug Prescribing
Mr. Jon Owen Jones : To ask the Secretary of State for Health how much money will be saved by expanding the selected list of drugs that cannot be prescribed under the national health service to her proposed new categories.
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Dr. Mawhinney : The savings from extending the selected list scheme will depend on the specific changes made to the list of drugs which cannot be prescribed under the national health service. These will be made only on the recommendation of the independent Advisory Committee on NHS Drugs and cannot be predicted in advance.
Supported Lodgings
Mr. Allen : To ask the Secretary of State for Health how many people (a) in Nottinghamshire and (b) nationally were classified as being looked after in supported lodgings by reason of being cared for by the carer in the carer's own home on (i) 1 January 1991 and (ii) the latest date for which figures are available.
Mr. Yeo : This information is not available centrally.
Community Care
Mr. Cummings : To ask the Secretary of State for Health how many patients are expected to be discharged into the community from Winterton and Kyhope Cherry Knowle hospitals in the coming year ; how many were discharged in 1990, 1991 and 1992 ; and if she will make a statement.
Mr. Yeo : This information is not available centrally. The hon. Member may wish to contact the Northern Regional health authority, for details.
Doncaster Health Services
Mr. Redmond : To ask the Secretary of State for Health if she will list the chairmen and non-executive directors of health authorities and trusts in Doncaster in 1991-92 ; how much each received as salary and expenses ; and if she will make a statement.
Dr. Mawhinney : The chairmen of health authorities and national health service trusts and the non-executive directors of NHS trusts in Doncaster are as follows :
Body |Chairman |Non-executive
|directors
---------------------------------------------------------------------------------
Doncaster DHA |Mr. J. G. Smith
Doncaster FHSA |Mr. K. Jones
Doncaster Royal |Mr. C. Bryant |Mr. G. A. Brown
Infirmary and |Mr. M. A. Mitchell
Montagu Hospital |Mr. J. H. Pickup
Trust |Mrs. R. M. Cottrell
|Mrs. E. Sparrow
Doncaster Healthcare |Mr. P. Horsburgh |Mr. L. Lucas
Trust |Mr. J. Millar
|Miss C. Fleming
|Mrs. M. Spencer
|Mr. J. Liversedge
District health authority and family health service authority members are appointed by regional health authority chairmen. All health authority members and NHS trust non-executive directors receive remuneration of £5,000 per annum.
DHA, FHSA and trust chairmen are remunerated annually according to a banding system as follows :
1 April 1991 :
Band 1--£18,935
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Band 2--£16,835Band 3--£14,850
1 December 1991 :
Band 1--£19,285
Band 2--£17,145
Band 3--£15,125
Health authority chairmen and members and trust chairmen and non-executive directors are entitled to have, where appropriate, expenses refunded, but details are not held centrally.
Unemployment and Ill Health
Dr. Goodson-Wickes : To ask the Secretary of State for Health what studies she has made on the association between unemployment and ill health.
Dr. Mawhinney : We are fully aware of the extensive research literature about the association between unemployment and ill-health. This literature includes analysis of the respective contributions of unemployment itself and of the related variables of social class, poverty, age and pre-existing ill-health. Studies also indicate the value of preventive health care and of social support of unemployed people and their families.
Anabolic Steroids
Mr. Menzies Campbell : To ask the Secretary of State for Health what research she has commissioned into the risks to the health of persons under the age of 18 years of the indiscriminate use of anabolic steroids.
Dr. Mawhinney : The Department has commissioned no research specifically into the risks to the health of persons under the age of 18 years of the use of anabolic steriods. However, in October 1991 we commissioned Professor G. V. Stimson, Director of the Centre for Research on Drugs and Health Behaviour, to undertake a study into the extent of misuse of anabolic steriods. The report of this study has just been received by this Department and is currently being considered.
Weight Training
Mr. Menzies Campbell : To ask the Secretary of State for Health what research she has commissioned into the risks to the health of persons under the age of 18 years of (a) weight lifting and (b) weight training ; and if she will make a statement.
Health Centres
Ms. Coffey : To ask the Secretary of State for Health when the report of the Hambros bank into the funding of health centres is to be published.
Dr. Mawhinney : The report has been received by the Department and its recommendations are now being considered. We shall announce our proposals for action in due course.
Azapropazone
Mr. Cousins : To ask the Secretary of State for Health what assessment has been made of the side effects of azapropazone ; how many cases of such side effects have
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come to her attention ; what consideration the Committee on Safety of Medicines is giving to this matter ; and what central guidance on the side effects has been given to general practitioners.Dr. Mawhinney : The safety of all licensed medicines, including azapropazone, is constantly monitored by the Medicines Control Agency. As part of this process, the Committee on Safety of Medicines (CSM) operates a yellow card scheme for physicians to report suspected adverse reactions to drugs. Under this scheme, CSM has received 2,041 reports of adverse reactions which may be associated with azapropazone. A report of a suspected reaction in association with a drug does not necessarily mean that the drug caused the effect reported. Azapropazone belongs to a group of non-steroidal anti-inflammatory drugs (NSAIDs) used in the treatment of rheumatic disease and other musculoskeletal disorders. More reports of suspected adverse reactions are received in association with this group of drugs than any others, reflecting their wide usage. A number of studies are being conducted comparing the relative safety of different NSAIDs. CSM will be reviewing these studies when the results become available and, if necessary, will issue advice to prescribers. It has been recognised for some years that NSAIDs can cause serious gastrointestinal reactions such as bleeding and perforation of ulcers. This problem was drawn to the attention of doctors by the CSM in articles in the British Medical Journal in March and May 1986 and in its bulletin "Current Problems No. 16" issued in 1986. No specific guidance has been issued by CSM regarding the side effects of azapropazone. Information is available to physicians in the British National Formulary, which the Department issues free of charge to all prescribers, and in the data sheet for products, which are produced by the manufacturers and authorised by the licensing authority.
Mr. Cousins : To ask the Secretary of State for Health what has been the expenditure on azapropazone in cash terms, and as expenditure per 1,000 population in each NHS region and health district in 1991-92.
Dr. Mawhinney : I shall let the hon. Member have such information as is available as soon as possible.
Special Hospitals
Mr. Michael : To ask the Secretary of State for Health for what percentage of patients currently residing in special hospitals in England and Wales an assessment has shown that they could more appropriately be dealt with in gaols or other forms of accommodation.
Mr. Yeo : Information is not readily available in the form requested. One hundred and fourteen special hospital patients, or 7.5 per cent. of the total, were awaiting transfer to other facilities on 31 December 1992. Six of these were awaiting transfer to prison.
Mentally Disordered Offenders
Mr. Michael : To ask the Secretary of State for Health what provision under the National Health Service and Community Care Act 1990 she requires to be made by local authorities and health departments for mentally disordered offenders.
Mr. Yeo : Section 46 of the National Health Service and Community Care Act 1990 requires local authorities, in
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consultation with health authorities, to prepare and publish plans for the provision of community care. Section 47 of the Act requires local authorities to involve district health authorities in the assessment of need for those people in their areas who are identified as requiring community care services. These would include services for mentally disordered offenders who require them.Disabled People
Mr. Hinchliffe : To ask the Secretary of State for Health what maximum figure she intends to set for the combined total public funding available after April to individual disabled people to live in their own homes.
Mr. Yeo : I do not intend to set a maximum figure for the amount that health and local authorities may spend in helping people live in their own homes.
Dentists
Mr. Wigley : To ask the Secretary of State for Health how many dentists went bankrupt during 1992 ; and if she will make a statement.
Dr. Mawhinney : This information is not held centrally. However, the Dental Practice Board has confirmed that during 1992 it received notices of bankruptcy in respect of nine dentists.
Health Authority Meetings
Mr. Redmond : To ask the Secretary of State for Health if she will require health authorities to publish the agenda for matters to be considered in private ; and if she will make a statement.
Dr. Mawhinney : No. Whether and when to exclude the press and general public is a matter for the authorities themselves to decide. However, authorities are expected to conduct their business in as open a manner as possible.
SCOTLAND
Prison Transfers
Mr. McNamara : To ask the Secretary of State for Scotland how many applications have been received for transfers from prisons in Scotland to Northern Ireland, from (a) loyalist prisoners, (b) republican prisoners, (c) men and (d) women ; and how many of each of these applications have been accepted.
Lord James Douglas-Hamilton : The information available is as follows :
|Number of requests|Agreed
|(no women applied)
----------------------------------------------------------------------------
1985 |3 |2
1986 |1 |1
1987 |3 |-
1988 |2 |1
1989 |1 |-
1990 |<1>5 |2
1991 |<2>4 |1
1992 |5 |<3>3
<1> One withdrawn.
<2> Two withdrawn.
<3> One still under consideration.
Prisoners in Scotland are not classified by reference to the political or other motivation of their offences.
Revised criteria for interjurisdiction transfers were announced in the Official Report, 23 November 1992, columns 476-77.
Legal Aid
Mr. Watson : To ask the Secretary of State for Scotland what amount he expects to be saved from the current civil legal aid budget resulting from the Government's proposals for each of the next five financial years.
Lord James Douglas-Hamilton : The purpose of the proposed changes announced on 16 November is to ensure the continuation of reasonable access to legal aid for the most needy, while at the same time taking action to control the rate of growth in legal aid expenditure. The proposed changes are expected to reduce forecast expenditure on civil legal aid by between £2 million and £3 million in 1993-94 rising to around £5 million in 1997-98. Total expenditure on legal aid will, however, continue to increase and in financial year 1995-96 it is expected to be 40 per cent. higher than the planned expenditure for the current year.
Mr. Watson : To ask the Secretary of State for Scotland if, under the Government's new legal aid proposals, applicants will be required to make continuous contributions over the full life of the case.
Lord James Douglas-Hamilton : Under the Government's proposals a person granted civil legal aid in Scotland after 1 April 1993 will not be required to make continuous contributions over the full life of the case.
Mr. Watson : To ask the Secretary of State for Scotland when he will publish detailed proposals regarding changes in civil legal aid and civil advice and assistance schemes in Scotland.
Lord James Douglas-Hamilton : Draft regulations will be laid before the House in the spring.
Mr. Watson : To ask the Secretary of State for Scotland what level of contributions will be required in civil legal aid cases under the Government's new legal aid proposals.
Lord James Douglas-Hamilton : Under the Government's proposals a person receiving civil legal aid will be required to make a maximum contribution of up to one third of the amount by which his disposable income exceeds the lower free limit for civil legal aid.
Mr. Watson : To ask the Secretary of State for Scotland what will be the maximum income level for obtaining free advice and assistance for legal aid applicants from April 1993.
Lord James Douglas-Hamilton : The maximum disposable income level for obtaining free advice and assistance has yet to be determined.
Mr. Menzies Campbell : To ask the Secretary of State for Scotland (1) what is his estimate of the proportion of the adult population of Scotland which after 1 April will be eligible for (a) legal advice and assistance and (b) legal aid, for civil purposes on a nil contribution ;
(2) what is his estimate of the proportion of the adult population of Scotland which after 1 April will be eligible for (a) legal advice and assistance and (b) legal aid for civil purposes irrespective of the level of contribution ;
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(3) what is the proportion of the adult population of Scotland currently eligible for (a) legal advice and assistance and (b) legal aid for civil purposes on a nil contribution ;(4) what proportion of the adult population of scotland is currently eligible for (a) legal advice and assistance and (b) legal aid, for civil purposes irrespective of the level of contribution.
Lord James Douglas-Hamilton [holding answer 18 January 1993] : Given the variations over time in individuals' circumstances it is not possible to estimate with any precision the proportion of the adult population eligible for legal aid.
Analyses of data from the family expenditure survey suggest that in Scotland the percentage of households which would be eligible for civil legal aid under the proposed changes to eligibility criteria would be in the range of 45 to 55 per cent. with between 20 and 30 per cent. free of contributions. Similar figures would apply to advice and assistance. This represents a reduction of between 5 and 10 per cent. of the households currently eligible in financial terms.
Mr. Kirkwood : To ask the Secretary of State for Scotland what consultations he had with relevant parties and bodies prior to his announcement of 16 November 1992 of reduced access to civil legal aid and legal advice and assistance in Scotland ; and how many legal applicants are likely to be affected by the announced changes after1 April.
Lord James Douglas-Hamilton [holding answer 18 January 1993] : No detailed consultations were held before the announcement on 16 November 1992, but discussions have since taken place with the Scottish Legal Aid Board and the Law Society of Scotland. Given the variations over time in individuals' circumstances it is not possible to estimate with any accuracy how many legal aid applicants are likely to be affected after 1 April by the proposed changes but I refer the hon. Member to my reply today to the questions by the hon. and learned Member for Fife, North-East (Mr. Campbell).
Mr. Kirkwood : To ask the Secretary of State for Scotland if he will list for each of the last five years for which figures are available the number of civil legal cases which occurred in sheriff courts in Scotland by category of case, indicating the percentage increase over the period for each category.
Lord James Douglas-Hamilton [holding answer 18 January 1993] : Figures for the number of ordinary cause, summary cause and small claim actions disposed of in sheriff courts in Scotland are set out in the table. The percentage increase or decrease between 1987 and 1991 is also shown except for small claims where the figure relates to the period 1989 to 1991.
|Ordinary cause|Summary cause |Small claims |Total
--------------------------------------------------------------------------------------------
1987 |47,555 |121,996 |- |169,551
1988 |47,735 |109,745 |- |157,480
1989 |46,232 |51,881 |62,520 |160,633
1990 |49,308 |41,941 |83,119 |174,368
1991 |54,512 |44,758 |87,769 |187,039
Percentage |+14.6 |-63.3 |+40.4 |+9.7
Increase/
Decrease
1987-1991
(1989-1991 for
Small Claims)
Mr. Kirkwood : To ask the Secretary of State for Scotland what has been the average cost per case to the civil legal aid budget in each category of civil legal actions occurring in sheriff courts in Scotland over the past five years for which figures are available.
Lord James Douglas-Hamilton [holding answer 18 January 1993] : The information is as follows :
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Civil Legal Actions in Sheriff Courts
Subject Matter Average Cost Per
Case to Scottish
Legal Aid Fund
|1987-88 |1988-89 |1989-90 |1990-91 |1991-92
-------------------------------------------------------------------------------------
Divorce
2 year separation
(Pursuer) |452.80 |450.99 |459.59 |490.13 |573.71
Divorce
2 year separation
(Defender) |443.22 |481.89 |478.10 |461.12 |641.20
Divorce
5 year separation
(Pursuer) |460.08 |481.90 |488.15 |512.80 |600.38
Divorce
5 year separation
552.34 |784.43 |711.73 |717.31 |770.64
Divorce
Other Grounds
(Pursuer) |644.13 |638.36 |698.93 |749.27 |814.21
Divorce
Other Grounds
(Defender) |607.42 |620.85 |714.81 |724.24 |831.41
Separation |536.30 |661.24 |703.21 |781.59 |789.94
Aliment |475.46 |464.17 |472.27 |486.48 |476.98
Husband and Wife
Miscellaneous |491.26 |459.54 |513.84 |551.07 |622.15
Affiliation/Aliment |501.41 |561.13 |627.91 |635.51 |664.75
Custody |529.35 |481.81 |606.60 |635.49 |683.25
Adoption |305.85 |272.64 |267.62 |354.04 |563.55
Parent and Child Miscellaneous |478.10 |526.26 |635.11 |575.14 |711.56
Reparation |673.71 |890.29 |1,058.76|1,011.98|1,405.83
Diligence |- |102.25 |213.25 |3,010.33|686.44
Other |- |348.59 |408.50 |450.68 |502.10
Total |560.22 |534.50 |603.55 |636.59 |699.11
Mr. Kirkwood : To ask the Secretary of State for Scotland how much Her Majesty's Government expects to save in civil legal aid expenditure in Scotland from 1 April as a result of the changes announced on 16 November 1992 in financial eligibility ; and if he will make a statement.
Lord James Douglas-Hamilton [holding answer 18 January 1993] : The purpose of the proposed changes announced on 16 November 1992 is to ensure the continuation of reasonable access to legal aid for the most needy, while at the same time taking action to control the rate of growth in legal aid expenditure. Depending on the detailed circumstances of the individual cases involved, the proposed changes are expected to reduce forecast expenditure on civil legal aid in future years by between£2 million and £3 million. Total expenditure on legal aid will, however, continue to increase and in financial year 1995-96 is expected to be 40 per cent. higher than the planned expenditure for the current financial year.
Mr. Kirkwood : To ask the Secretary of State for Scotland what has been the average contribution paid by legal aid recipients in each category of civil legal action over the past five years for which figures are available.
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Lord James Douglas-Hamilton [holding answer 18 January 1993] : The information is not readily available in the form requested. Over 80 per cent. of those receiving civil legal aid are not required to pay any contribution. The average contribution paid by recipients of civil legal aid falling within the contributory band in the financial years 1987-88 to 1991-92 is set out in the following table :
--------------------------------------------------------------------------------
Skye Bridge
Mr. Charles Kennedy : To ask the Secretary of State for Scotland what steps he intends to take in the light of the absence of the lodging of the geographical survey, relevant to the Skye bridge contract, with the British Geological Survey ; what legal force is ascribed to the relevant section
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of his Department's "Road's Directorate Invitation to Tender" document in this respect ; and if he will make a statement.Lord James Douglas-Hamilton : The arrangments for the various tenderers to undertake a joint geological investigation and ultimately to lodge the factual results of their survey with the British Geological Survey is a roads directorate contractual requirement not a legal requirement. This practice is undertaken on trunk road projects whereby the information provided by public expenditure is made available for general use. There is no prescribed time limit for the lodging of such information and it is done at an appropriate time, often at the conclusion of the construction works.
Mr. Charles Kennedy : To ask the Secretary of State for Scotland what allowance he has made for the extent of public subsidy to Caledonian Macbrayne Ltd. after the loss of Kyle of Lochalsh-Kyleakin ferry fares income to the company when the Skye bridge opens ; and if he will make a statement.
Lord James Douglas-Hamilton : The company's corporate plan for 1992- 95 contains assumptions on cost savings and loss of revenue which are likely to occur upon the discontinuation of the Kyle of Lochalsh-Kyleakin ferry service. My right hon. Friend has taken these assumptions into account in making provision for deficit subsidy for the company within the planning period. My right hon. Friend does not consider it desirable to make public such commercially-sensitive information.
Caledonian Macbrayne Ltd.
Mr. Charles Kennedy : To ask the Secretary of State for Scotland what has been the public subsidy given in each of the last 10 financial years to Caledonian Macbrayne Ltd. ; what proportion this subsidy represented of the total income of the company ; and if he will make a statement.
Lord James Douglas-Hamilton : The information requested is set out in the table :
Year |Deficit subsidy |Turnover |Deficit subsidy as
|percentage of
|turnover
-----------------------------------------------------------------------------------------------
1981-82 |5.800 |17.5 |33.1
1982-83 |6.115 |17.6 |34.7
1983-84 |6.650 |19.2 |34.6
1984-85 |6.987 |21.0 |33.3
1985-86 |7.500 |22.3 |33.6
1986-87 |7.400 |23.1 |32.0
1987-88 |6.900 |23.8 |29.0
1988-89 |6.540 |25.4 |25.8
1989-90 |6.280 |26.9 |23.3
1990-91 |5.722 |28.6 |20.0
1991-92 |5.800 |31.7 |18.3
Mr. Charles Kennedy : To ask the Secretary of State for Scotland what information is made available to him by Caledonian Macbrayne Ltd as to (a) the profitability of individual ferry routes and (b) the extent to which there is cross subsidisation of fares within the network ; and if he will make a statement.
Lord James Douglas-Hamilton : The scale fare system which has been operated by Caledonian MacBrayne since
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1975 generalises costs across the network as a whole and produces network-based information about costs, fares income and deficit subsidy requirements. The new CFARES fares setting system which the company is in process of introducing will be based upon route-specific infomation about costs, surpluses and deficits. As a consequence of this change from network-based information to route-specific information, Caledonian MacBrayne makes available to my right hon. Friend an increasing amount of information about costs, surpluses and deficits incurred on individual routes. Since deficit subsidy is paid to meet the operating loss incurred by the company in providing a network of approved services, there is some cross subsidisation of services within this arrangement.However, the overall deficit of £6,050,000 likely to be incurred by the company this year in operating the network indicates that the majority of the company's routes are unprofitable. My right hon. Friend does not consider it desirable to make public
commercially-sensitive information about operating costs, surpluses or deficits incurred on individual routes.
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