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District Health Authorities
Mr. Redmond : To ask the Secretary of State for Health if she will list in rank order the district health authorities which are currently running at (a) a deficit and (b) a surplus.
Mr. Sackville : The information requested is collected only by regional health authorities. The hon. Member may wish to contact the chairmen of the regional health authorities for details.
Hospital Parking
Mr. Blunkett : To ask the Secretary of State for Health what guidance she intends to issue to hospitals on charging (a) visitors and patients and (b) staff, for parking within hospital grounds.
Mr. Sackville : The question of charging for parking within hospitals grounds is for local determination in the light of local circumstances. We have no plans to issue guidance.
Royal Sussex County Hospital
Mr. Blunkett : To ask the Secretary of State for Health if she will publish details of the review which enabled the Brighton health commissioners to determine a zero growth rate in health care demands for the Royal Sussex county hospital when redevelopment is completed.
Mr. Sackville : The allocation of funds to East Sussex health authority is a matter for South East Thames regional health authority. The hon. Member may wish to contact Mr. Peter Barker, chairman of the regional health authority for details.
Mr. Blunkett : To ask the Secretary of State for Health if she will provide current staffing figures for the Brighton Health Care NHS trust and projected staffing figures at the Royal Sussex County hospital when reconstruction is complete.
Dr. Mawhinney : Brighton health care national health service trust currently employs approximately 4,500 staff. Future employment plans at the trust is a matter for the board, the chairman of which is Mr. John Spiers.
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Mr. Blunkett : To ask the Secretary of State for Health what part the planned expansion of the Nuffield Sussex trust hospital has played in the revision of bed space demands at the Royal Sussex county hospital.
Mr. Sackville : The planned provision of health services from the Royal Sussex county hospital is a matter for Brighton health care national health service trust and East Sussex health authority. The hon. Member may wish to contact Mr. John Spiers, chairman of the trust for details.
Mr. Blunkett : To ask the Secretary of State for Health if she will provide details of the present pattern of bed usage within the Brighton health care NHS trust and the proposed pattern of use when the reconstruction of the Royal Sussex county hospital is complete.
Mr. Sackville : This information is not available centrally.
Dental Charges
Mr. Blunkett : To ask the Secretary of State for Health what is the total amount raised from all charges on NHS dental services.
Dr. Mawhinney : In 1992-93 patient charge income from the general dental services was £394.8 million, net of refunds to patients. Information is not available centrally on the small amount of income raised by the limited range of patient charges applicable in the community and hospital dental services.
Mr. Blunkett : To ask the Secretary of State for Health how much would be raised if the amount paid for a course of NHS dental treatment by a patient not exempt from charges was raised from 80 per cent. of the cost of treatment to (a) 85 per cent., (b) 90 per cent., (c) 95 per cent. and (d) 100 per cent.
Dr. Mawhinney : Each additional 5 per cent. increase in the rate of the proportional charge would raise between £20 million and £25 million. This estimate is made on the assumption that there is no change in the demand for or supply of dental treatment under the general dental services.
Mr. Blunkett : To ask the Secretary of State for Health what would be the total annual saving to the Exchequer of removing the exemption for pregnant women and nursing mothers from dental examination and treatment charges.
Dr. Mawhinney : Some £23 million in 1992-93.
Abortions
Ms Primarolo : To ask the Secretary of State for Health how many women having terminations of pregnancies in non-NHS hospitals were charged for the procedure in the last year for which figures are available ; and what was the average charge levied.
Mr. Sackville : Of the total 179,522 abortions in 1991, 84,442--47 per cent--were carried out under the national health service, either directly in NHS hospitals or under arrangements between certain NHS authorities and the private sector. A total of 95,080 were performed on a private fee paying basis.
Information on fees charged by private clinics is supplied to the Department on an in confidence basis. The hon. Member may wish to approach individual approved places direct about the level of their fees.
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Prescriptions
Mr. Redmond : To ask the Secretary of State for Health if she will give for each year since 1988 the change in numbers of items prescribed resulting from changes to the limited list.
Dr. Mawhinney : The total number of prescriptions dispensed in each of the years from 1988 is shown in the table. It is not possible to isolate the effect of the selected list scheme from the other factors which have an influence on the number of national health service prescriptions dispensed each year.
Number of prescriptions-England Year |Number (million) --------------------------------------------------- 1988 |375.5 1989 |383.5 1990 |394.8 <1>1991 |413.9 <2>1991 |406.5 1992 |425.1 <1>1988 to 1991 (a) are based on fees. They cover prescriptions dispensed by community pharmacists and appliance contractors, dispensing doctors and personal administration. <2>1991 (b) to 1992 data are from the new prescription cost analysis system based on items and have the same coverage as above.
Health Service Reform
Mr. Sims : To ask the Secretary of State for Health what role was played by the Royal College of Nursing and other royal colleges in establishing the clinical standards advisory group ; and what assessment he has made of the contribution of this group to the debate on health service reform.
Mr. Sackville : The medical and nursing royal colleges were consulted on and fully supported the establishment of the clinical standards advisory group--CSAG--in 1991. All of the group's appointed members are nominated by the medical and nursing royal colleges in the manner prescribed by the CSAG Regulations (1991 No. 578). The group's first reports, on access to and availability of specialist services published in July, copies of which are available in the Library, made a positive and constructive contribution to discussions on how best to maintain and raise standards of clinical care for national health service patients. The group has just submitted its second report, on services for people with diabetes, which the United Kingdom Health Ministers will consider carefully and publish with their response early next year.
Child Prostitution
Mr. Allen : To ask the Secretary of State for Health (1) what are the latest estimated figures of her Department for the numbers of children involved in child prostitution ;
(2) what measures are being taken by her Department to deal with the problems of child prostitution.
Mr. Bowis : My Department does not have central figures to estimate the numbers of children involved in child prostitution. I understand that my right hon. and learned Friend the Secretary of State for the Home Department collects figures on the number of children cautioned or proceeded against for soliciting offences.
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Local authorities social services have a duty under section 47 of the Children Act 1989 to investigate where they have reasonable cause to suspect that a child in their area is suffering from or is likely to suffer significant harm and this would include information received suggesting a child may need protection from child prostitution. The Government's guidance, "Working Together", emphasises that the investigative process should involve gathering information from other key professionals and liaising with other investigating agencies such as the police. Any action taken to protect the child should be taken in collaboration with all the other agencies involved.Royal Free Hospital
Mr. John Marshall : To ask the Secretary of State for Health when she expects to make a decision about the future of the renal transplant unit at the Royal Free hospital.
Dr. Mawhinney : The Government are taking the important advice of the specialty reviews into account in their review of hospital services in London.
The issues are complex but it is our intention to make some initial announcements shortly.
Surgery Costs
Mr. Blunkett : To ask the Secretary of State for Health what is the average cost of NHS procedures for (a) total hip replacement, (b) total knee replacement, (c) coronary artery bypass grafting, (d) mitral-aortic valve replacement, (e) hernia repair, (f) stripping of varicose veins, (g) hysterectomy, (h) tonsillectomy, (i) cataract extraction and lens implant, (j) knee replacement, (k) heart transplant, (l) heart/lung transplant and (m) surgery for an enlarged prostate.
Mr. Sackville : The information available is shown in the table. All estimates of average cost are at 1991-92 prices and inclusive of an allowance for capital charges. Estimates are not available for total knee replacement, stripping of varicose veins, knee replacement, heart/lung transplant and surgery for an enlarged prostate.
NHS procedure |Estimated average
|cost in £s (1991-92
|prices)
----------------------------------------------------------------
Total hip replacement |3,810
Coronary artery bypass grafting 5,870
Heart valve replacement |8,800
Inguinal hernia |1,140
Hysterectomy |2,050
Tonsillectomy |590
Cataract extraction |1,230
Heart transplant |26,400
General Practitioners
Mr. Redmond : To ask the Secretary of State for Health how many general practitioners in England received gross payments in excess of £200,000 in each year since 1991-92.
Dr. Mawhinney : This information is not available centrally.
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NHS Trusts
Mr. Blunkett : To ask the Secretary of State for Health whether travel expenses for employees of national health service trusts, incurred through attending training sessions, should be paid by the employing trust.
Dr. Mawhinney : This is a matter for the employing trust.
Ms Primarolo : To ask the Secretary of State for Health what are the total accumulated receipts of the NHS trusts that have achieved a 6 per cent. return on assets.
Dr. Mawhinney : National health service trusts do not have accumulated receipts. They do, however, have accumulated reserves which represent the surpluses retained in the trusts after interest and dividends. The total net accumulated income and expenditure reserves of all NHS trusts at 31 March 1993 was £134,510,000.
Ms Primarolo : To ask the Secretary of State for Health (1) what connections the outgoing chairman of the Royal Cornwall hospital trust had with any political party ;
(2) what are the party political affiliations of chairs of trusts and regional health authorities and district health authorities at present.
Dr. Mawhinney : We do not seek details on political affiliation. People are appointed for their personal qualities, and for the skills they bring to the leadership and strategic direction of the national health service.
Mr. Redmond : To ask the Secretary of State for Health what plans she has to dismiss the chairman and chief executives of (a) health authorities and (b) NHS trusts whose authorities fail regularly to meet the standards of the patients charter.
We expect the corporate governance task force to set out new definitions of the functions of chairmen and non-executive directors and it will be against these definitions that their performance will be judged. The performance of chief executives of national health service authorities and trusts is a matter for the chairman and non-executive directors working together.
Ms Primarolo : To ask the Secretary of State for Health what is the salary of the chairman of the Royal Cornwall hospital trust.
Dr. Mawhinney : The remuneration of the chairman of the Royal Cornwall hospital trust is £19,285 per year.
Ms Primarolo : To ask the Secretary of State for Health what were the grounds for not renewing the contract from 30 November of the chairman of the Royal Cornwall hospital trust ; when he was informed that his contract would not be renewed ; and on what basis he was appointed as chairman of the trust two years ago.
Dr. Mawhinney : The chairman of the Royal Cornwall hospital trust was appointed for a two year term of office which expired on 30 November 1993.
In considering whether to offer a further term, we sought advice from the national health service management executive outpost director and the regional health authority chairman. We decided, after very careful consideration of a variety of factors which govern these matters, that a change in the leadership of the trust was necessary.
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I wrote to the chairman of the Royal Cornwall hospital trust on 5 November informing him of my decision.Mr. Redmond : To ask the Secretary of State for Health if she will list the current official listed business addresses of each (a) NHS hospital trust and (b) general practitioner fund holding practice within (i) the Trent regional health authority and (ii) Yorkshire regional health authority.
Dr. Mawhinney : A list of addresses of national health service trusts in Trent and Yorkshire regions will be placed in the Library. The information on general practitioner fundholding practices is not available centrally. The hon. Member may wish to contact Sir Michael Carlisle and Sir Bryan Askew, the chairmen of the Trent and Yorkshire regional health authorities for details.
Mr. Redmond : To ask the Secretary of State for Health if she will ask all existing chairmen and non-executive directors of health authorities and NHS trusts if they would be willing to continue in office without payment other than loss of earnings and expenses.
Ms Primarolo : To ask the Secretary of State for Health what reasons were given for the chief executive of the Royal Corors of the Royal Cornwall hospital trust. The hon. Member may wish to contact Mr. John Williams, vice chairman of the trust and acting chairman, for details.
Mr. Redmond : To ask the Secretary of State for Health what plans she has to issue advice to NHS trusts to prevent trusts seeking contracts by offering faster treatment for patients covered by these contracts.
Dr. Mawhinney : Guidance has already been issued jointly by the Department and the Joint Consultants Committee which clearly states that provider units should not offer contracts to one purchaser which would disadvantage the patients of another purchaser.
West Midlands Regional Health Authority
Mr. Redmond : To ask the Secretary of State for Health (1) if Sir James Ackers (a) resigned, (b) was asked to resign or (c) was dismissed from the chairmanship of West Midlands regional health authority ;
(2) what were her reasons for paying Sir James Ackers £10,000 under paragraph 9(3) of schedule 5 to the National Health Service Act 1977.
Dr. Mawhinney : Sir James Ackers resigned from the position of chairman of West Midlands regional health authority on 8 January 1993.
The decision to offer a compensation payment took account of the fact that Sir James Ackers resigned from the position of chairman of the West Midlands regional health authority 18 months before his term of office was due to expire ; and that in his 10 years of service considerable progress was made, particularly in carrying out many major hospital developments ; waiting lists had fallen dramatically and a record number of patients had been treated.
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Ambulances
Ms Primarolo : To ask the Secretary of State for Health (1) how many patients were recorded as dead on arrival by each ambulance trust in each of the last five years ;
(2) how many patients were recorded as dead on arrival by ambulance by region in each of the last five years.
Mr. Sackville : This information is not available centrally.
Bomb-proofing
Mr. Redmond : To ask the Secretary of State for Health what has been the cost, by location, of bomb-proofing the Department's premises.
Mr. Sackville : On security grounds, I do not propose to give this information.
Referrals
Mr. Redmond : To ask the Secretary of State for Health if she will make it her policy to hold centrally records in respect of (a) regional health authorities and (b) district health authorities on the number of extra-contractual referrals that they have refused ; and if she will make a statement.
Mr. Sackville : There are no plans to collect this information centrally.
Cancer
Ms Primarolo : To ask the Secretary of State for Health (1) what percentage of male and female adult cancer patients have been included in clinical treatment trials in the NHS in the last available year ;
(2) if she will give the percentage of male and female child cancer patients who have been included in clinical treatment trials in the NHS in the last available year.
Mr. Sackville : This information is not available centrally.
Coronary Care
Ms Primarolo : To ask the Secretary of State for Health how many patients were turned away from coronary care units, in the last recorded year, through lack of space.
Mr. Sackville : This information is not available centrally. Any hospital that takes acute admissions will have coronary care facilities, and if a patient needing those facilities cannot be accommodated in a coronary care unit for any reason they will normally be accommodated in an acute medical ward where they will receive the same treatment and care as they would in a coronary care unit.
Ms Primarolo : To ask the Secretary of State for Health how many coronary care unit beds there were in each of the last five years.
Mr. Sackville : This information is not routinely collected centrally. Figures based on the latest information available indicated that in 1991 there were at least 879 coronary care beds and 356 high dependency beds in England.
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GPs (Night Visits)
Mr. Redmond : To ask the Secretary of State for Health what is the current fee payable to a general practitioner when making a night visit between the hours of 10 pm and 8 am.
Dr. Mawhinney : The higher night visit fee, payable where a visit is made by the patient's own general practitioner, a GP from the patient's practice, or by a GP from a small rota of not more than 10 GPs, is £46.65 ; the lower night visit fee, payable for all other visits, is £15.55.
Smoking
Ms Primarolo : To ask the Secretary of State for Health what estimate she has made of the effect on the level of cigarette consumption of the price of cigarettes.
Mr. Sackville : Increases in price have been shown to decrease consumption, though by a proportionately smaller amount. A 10 per cent. increase in price, for example, would be expected to lead to a reduction in consumption in the range of 3 per cent. to 6 per cent.
General Practitioner Fundholders
Mr. Blunkett : To ask the Secretary of State for Health what guidance she has given to regions concerning their plans for the funding allocations for general practitioner fundholders.
Dr. Mawhinney : Guidance on setting general practitioner fundholder budgets is given in EL(93)93, copies of which are available in the Library.
Mr. Blunkett : To ask the Secretary of State for Health what discussions she has had with North West Thames regional health authority over its proposed adjustment to the funding allocation for fundholding general practitioners ; and if he will make a statement.
Dr. Mawhinney : All regional health authorities set general practitioner fund-holder budgets within the framework set out in EL(93)93, which requires them to take account of significant local factors. Copies of EL(93)93 are available in the Library.
Private Ambulance Operators
Mr. Ian Taylor : To ask the Secretary of State for Health what plans she has to issue a code of practice for private ambulance operators.
Mr. Sackville : A code of practice for private ambulance operators has been published today. Copies will be placed in the Library. The code sets out minimum standards in a range of important operational areas including staff selection and training, vehicles, equipment and telecommunications. It will provide valuable guidance for purchasers in judging the quality of potential providers against the high standards set by national health service ambulance services, as well as giving private providers clear indicators of the standard of service acceptable to the national health service.
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National Health Service andCommunity Care Act 1990
Sir Michael Grylls : To ask the Secretary of State for Health if she will establish a task force of senior civil servants to consider the workings of the National Health Service and Community Care Act 1990 ; and if she will make a statement.
Hospital Patients
Mr. Alex Carlile : To ask the Secretary of State for Health what is the average cost per day for each patient in (a) health authority-run hospitals and (b) national health service trust hospitals ; and if she will make a statement.
Mr. Sackville : The cost per day for each patient in directy managed units and national health service trust hospitals in 1991-92 was £149.87 and £168.89 respectively. The figures are based on patients using a bed and include day cases. Direct comparisons are not meaningful since a large proportion of first wave trust hospitals were acute units whose costs would be greater than directly managed units with long-stay facilities.
Pensioners
Mr. Alex Carlile : To ask the Secretary of State for Health what is the cost to public funds of each person of pensionable age cared for in (a) a NHS hospital, (b) a registered nursing home and (c) a registered residential care home ; and if she will make a statement.
Mr. Bowis : Information relating to the costs of hospital care is not available by age group. Information concerning financial support for residents who entered registered nursing and residential care homes prior to April 1993 is a matter for my right hon. Friend the Secretary of State for Social Security. No information is as yet available centrally on the situation since April 1993 under the new community care arrangements.
Asthma (Pollution)
Mr. Miller : To ask the Secretary of State for Health if she will make a statement on the Government's assessment of the relationship between air pollution and asthma.
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