Mr. Sackville : Newham health authority is responsible for commissioning services for local residents. The hon. Member may wish to contact Mrs. Rosemary Walters, chairman of Newham district health authority, for details.
Mr. Sheerman : To ask the Secretary of State for Health what is the average length of time taken by her Department to respond after an appeal is lodged following a Dental Practice Board recommendation.
Dr. Mawhinney : Appeals to the Secretary of State, following complaints made under the National Health Service (Service Committees and Tribunal) Regulations 1992, are now handled by the family health services appeal unit at Yorkshire regional health authority under devolved powers. Appeals are given very careful consideration and the time taken to process them varies from case to case. Information about average times is not available centrally and could be obtained only at disproportionate cost.
NHS trust |Allocated 1992-93 |Proposed allocation |1993-94 |£000 |£000 --------------------------------------------------------------------------------------------- The Freeman Group of Hospitals |2,154 |3,505 Newcastle Mental Health Services |252 |288 Northumbrian Ambulance |2,210 |1,695 Cleveland Ambulance |496 |300 North Tees Health |2,508 |1,498 Northgate |2,172 |252 The RVI Group of Hospitals |15,081 |7,627 Gateshead Community Health |356 |1,084 South Tees Acute Hospitals |9,149 |5,730
Mrs. Roe : To ask the Secretary of State for Health when she expects to respond to the first report from the Health Committee of Session 1992- 93, "NHS Trusts : Interim Conclusions and Proposals for Future Inquiries"-- House of Commons Paper No. 321.
Mr. Yeo : It is the responsibility of district health authorities and local authority social services departments to contract for or provide a comprehensive range of mental health services to meet the level of psychiatric need in their areas.
Mr. McAllion : To ask the Secretary of State for Health if she will provide figures for the reduction in numbers of posts as a result of contracting out since 1979 in her Department and agencies for which she has responsibility.
Mr. Sackville : The Department of Health became a separate Government Department in 1989. Since then, the number of posts in the Department has been reduced by just under 30 as a result of contracting out.
Mr. Yeo : There is no requirement to register patients suffering from schizophrenia. The table gives the number of admissions to hospitals in England in 1986 and 1989-90, the latest year for which the quality of information permits publication, where a diagnosis of schizophrenia was made.
Number of hospital admissions in England for patients with schizophrenia 1986 ( Mental Health Enquiry) and 1989-90 (Hospital Episode Statistics) ---------------------- 1986 |29,419 1989-90 |38,180
Ms. Lynne : To ask the Secretary of State for Health what guidelines her Department has issued to local authorities with regard to specific provision for the care of those in the 16 to 25 years age group suffering from mental illness.
Mr. Yeo : No guidance has been issued which specifically focuses on this age group. Services for disturbed adolescents--generally 12 to 19 years--were the subject of a report "Bridges over Troubled Waters" from the national health service health advisory service which the Department issued to health and local authorities in 1986. A copy will be placed in the Library.
|Number -------------------------------- Under one year |25,500 One year and over |19,700 Note: These figures are estimates based on data obtained directly from regional health authorities.
Mr. Yeo : Information about the numbers waiting by specialty is given in the publication "Hospital Waiting List, In-Patients and Day Cases" --ISBN 1 85839 003 6--a copy of which is available in the Library.
Mr. Milburn : To ask the Secretary of State for Health how many GP non-fund-holding practices there are in each region ; what percentage this represents of the regional total of GP practices ; and what percentage of the regional population they serve.
Region |Number of GP |Percentage of GP |Percentage of |practices |practices |population served |by GP |Non-fundholding |Non-fundholding |Non-fundholding |April 1992 |April 1992 |practice April 1992 ---------------------------------------------------------------------------------------------------- Northern |479 |92.3 |84 Yorkshire |605 |90.2 |79 Trent |785 |92.9 |86 East Anglia |283 |95.6 |92 North West Thames |760 |93.9 |86 North East Thames |890 |97.7 |93 South East Thames |757 |96.2 |91 South West Thames |494 |92.7 |85 Wessex |405 |91.8 |85 Oxford |345 |87.8 |77 South Western |537 |92.9 |86 West Midlands |997 |94.4 |87 Mersey |396 |88.6 |81 North Western |847 |96.4 |91 Note: 1. The number of GP practices given above relates to the number of GP partnerships at 1 April 1992, including single handed partnerships.
Ms. Primarolo : To ask the Secretary of State for Health if she will extend to non-fund-holding GPs the facility to hold two sessions a week to perform a range of diagnostic tests and extra minor surgery procedures to be paid at the clinical assistant rate.
GP |List Size|GP |List Size|GP |List Size ---------------------------------------------------------------------- 1 |4,291 |17 |2,395 |33 |1,782 2 |3,617 |18 |2,356 |34 |1,729 3 |3,158 |19 |2,339 |35 |1,682 4 |3,158 |20 |2,300 |36 |1,624 5 |2,981 |21 |2,293 |37 |1,621 6 |2,945 |22 |2,259 |38 |1,588 7 |2,910 |23 |2,241 |39 |1,526 8 |2,871 |24 |2,214 |40 |1,415 9 |2,796 |25 |2,204 |41 |1,346 10 |2,769 |26 |2,194 |42 |1,323 11 |2,740 |27 |2,135 |43 |1,046 12 |2,673 |28 |1,990 |44 |694 13 |2,557 |29 |1,980 |45 |628 14 |2,433 |30 |1,907 |46 |619 15 |2,418 |31 |1,898 |47 |258 16 |2,401 |32 |1,853 |48 |1 This includes one unfilled vacancy.
Dr. Lynne Jones : To ask the Secretary of State for Health (1) what instructions the national health service management executive has given to hospitals in respect of telling patients how long they will have to wait for their operations ; and if she will make a statement.
(2) what action she is taking to reduce hospital waiting lists and to keep patients informed about the length of time they will have to wait for operations.
Column 201treatment. In addition, a national telephone health helpline has been established under the patients charter so that patients can inquire about local waiting times as well as a wide variety of other health matters.
Since 1987 we have provided a waiting time fund of nearly £200 million to enable hundreds of thousands of additional patients to be treated from waiting lists. Waiting times for hospital treatment have improved dramatically and we are determined to build on this success.
Mrs. Mahon : To ask the Secretary of State for Health what percentage of enrolled nurses have the opportunity for training or professional development on conversion courses to achieve first level registration ; what information she has on the different levels of opportunity in different health authority areas ; and which health authorities provide (a) the best and (b) the worst training opportunities for enrolled nurses.
Mrs. Mahon : To ask the Secretary of State for Health if she will introduce a national policy on training for enrolled nurses to ensure a consistent approach between regions ; and if she will refund the costs of undertaking open and distance learning incurred by enrolled nurses.
Mr. Blunkett : To ask the Secretary of State for Health what is her policy on the rights of access to NHS facilities of patients with guide dogs ; and what guidance she has issued or intends to issue on this matter.
Mr. Yeo : The patients charter sets a national standard requiring arrangements to be made to ensure that everyone, including people with special needs, can use the services. This includes patients with guide dogs.
Dr. Mawhinney : I understand that, as part of its continuing programme of value-for money studies, the Audit Commission is undertaking a study of unit management in the national health service. I look forward to considering its report.
Mr. Blunkett : To ask the Secretary of State for Health what progress has been made on the consultations on her draft guidance on the protection of the position of NHS employees who draw attention to malpractice and fraud ; and when she expects to issue formal guidance.
Dr. Mawhinney : Following the recent consultation exercise on the draft guidance on freedom of speech for national health service staff, we are currently considering the large number of comments received. We expect to be able to issue the final version shortly.
Mr. Morgan : To ask the Secretary of State for Health what guidelines she has given to purchasers and providers of health care concerning the use of marginal cost pricing for waiting list initiative expenditure ; in what circumstances purchaser-provider arrangements for operations can be based on marginal cost pricing ; and if she will make a statement.
Mr. Sackville : Allocations to regional health authorities from the waiting time fund are tied to the achievement of waiting time targets and, in particular, national policy objectives. Standard pricing guidelines apply to the health care that these funds purchase. As marginal cost pricing should only be applied, in year, for unplanned spare capacity in excess of the assumed volume of service, waiting list initiative expenditure need not result in marginal cost pricing. It is therefore not appropriate to issue separate guidelines on marginal cost pricing of waiting list expenditure.
Mr. Yeo : The latest year for which figures are held is 1989-90. In that year there were 725 admissions to national health service hospitals of patients whose diagnosis was Huntington's chorea. There is no known cure for this disease ; the full range of NHS treatment and nursing and social care is available to people suffering from it. Because it is an inherited condition, genetic counselling is available to help with decisions about having children.
Mr. Yeo : The Department of Health has not commissioned any research into Huntington's chorea. The Medical Research Council, which receives its grant in aid through the Office of Science and Technology, is the main Government agency for the promotion of medical and related biological research in this country. I understand that in the financial year 1991-92, the council's expenditure on research relevant to Huntington's chorea was £99,000. Other basic research funded by the council may, in part, have some relevance to Huntington's chorea. Universities and medical schools may also be funding relevant research.
Mr. Blunkett : To ask the Secretary of State for Health if she will publish details of the formula used to calculate the moneys (a) paid to GP fund holders, (b) the data collection methods used to inform the actual distribution of moneys and (c) any changes to either (a) or (b) she plans.
Dr. Mawhinney : The methodology for setting general practitioner fund holders' 1993-94 budgets was published in EL 92(83) "General Practice Fundholding : Guidance on setting budgets for 1993-94", a copy of which is in the Library.
The responsibility for setting budgets rests with regional health authorities who organise data collection locally. We have no immediate plans to change the way budgets are set but will keep this under review.
Mr. Ainger : To ask the Secretary of State for Health how many qualified nurses were employed in (a) private hospitals, (b) private nursing homes and (c) private nursing agencies in each year since 1985.
Qualified staff employed in private hospitals and nursing homes Hospitals Nursing homes |Number|W.T.E |Number|W.T.E ------------------------------------------- 1985 |7,746 |6,660 |17,259|11,693 1986 |8,210 |7,001 |21,825|14,682 1987-88 |8,252 |6,967 |27,801|18,869 1988-89 |8,907 |7,579 |32,044|21,487 1989-90 |9,103 |7,707 |36,678|24,719 1990-91 |9,048 |7,581 |43,865|29,730 Source: SBH 212. 1985-86. K036 1987-88-1990-91. W.T.E: Whole time equivalent number of staff based on contracted hours of employment in individual establishments.
Mr. Mackinlay : To ask the Prime Minister, pursuant to his statement on 11 February, Official Report, column 1111, if Sandringham will be treated as a royal palace or as a private residence of Her Majesty the Queen.
Mr. Hardy : To ask the Parliamentary Secretary, Lord Chancellor's Department how many magistrates have resigned before reaching retirement age in the last five years ; and how many have offered as the reason for their decision the changes in the law and practice restricting their freedom of decision taking.
Year |Number --------------------- 1992 |1,034 1991 |820 1990 |794 1989 |799 1988 |659
No information is collected centrally on how many magistrates have resigned with the reason offered being changes in the law and practice restricting their freedom of decision taking. Over the period the number of magistrates has grown from 24,112 to 25,340.
Mr. Channon : To ask the Parliamentary Secretary, Lord Chancellor's Department when he proposes to arrange for county courts' judgments under £5,000 to carry interest ; if he will authorise such interest to apply retrospectively ; and if he will make a statement.
Mr. John M. Taylor : My Department has recently conducted a wide- ranging public consultation to evaluate the scheme introduced in July 1991 which provides for interest on county court judgments over £5,000. Responses to this consultation are currently being evaluated. While it would not therefore be appropriate to make a statement about any extension of the scheme at this time, my officials will be writing to interested parties to inform them of the outcome of the evaluation during the spring. I can, however, confirm that any extension of the scheme would not provide for interest to apply retrospectively.
Mr. John M. Taylor : My Department's evaluation of the changes introduced in July 1991, which included a provision for interest on judgment debts over £5,000, will be completed by the end of this month.
Mr. Llew Smith : To ask the Chancellor of the Exchequer what discount rate was adopted by Her Majesty's Government for public sector spending in the periods (a) 1979 to 1989 and (b) 1989 to the present ; what considerations underpinned the change made in 1989 ; and if he will make a statement on Her Majesty's Government's future plans for the discount rate.
The 1978 White Paper, "The Nationalised Industries", Cm 7131, introduced the concept of the required rate of return--RRR--a real return on the whole of each enterprise's investment programme. No discount rate was centrally specified for the enterprises, but in practice a rate
Column 205of 5 per cent. in real terms--the same as the RRR--or sometimes a higher rate, was used as a discount rate for investment appraisal. At the same time as Cm 7131 an announcement was made about the discount rates to be used in the public services-- Official Report, 5 April 1978, columns 147-48. A discount rate of 5 per cent. in real terms was specified for appraisals of choice of techniques, and a rate of 7 per cent. for other appraisals. In practice 7 per cent. was used only for the appraisal of roads.
A new regime was announced on 5 April 1989-- Official Report, column 187. The RRR for public enterprises was raised from 5 to 8 per cent., and the discount rate for the public services from 5 to 6 per cent. However for central Government trading activities selling commercially into private markets the discount rate should usually be at least 8 per cent. Other special cases are listed in "Economic Appraisal in Central Government : A Technical Guide for Government Departments"--the "Green Book"--annex G, paragraph 12.
The 1989 changes were a consequence of the long-term trend in the real rate of return on private sector assets between the late 1970s and late 1980s. The increase in the discount rate for the public sector services was more modest, reflecting the smaller increase in the cost of capital to a private sector company raising funds for low-risk purposes.
The discount rate is intended to reflect long-term conditions, rather than cyclical factors.
My Department's investment in energy technology projects is for research or regulatory purposes, for which assessment on a discounting basis is not appropriate. All the programmes are, however, subject to regular review. The public sector energy industries, which operate in a commercial environment, assess their investment programmes according to the appropriate Treasury guidelines.
Sir John Cope : The importation of obscene material and indecent material featuring children into the United Kingdom from any country remains illegal. Routine frontier Customs controls on goods from EC countries ceased on 1 January 1993, but anti-smuggling checks better targeted in response to the known risks continue to prevent the importation of illegal goods. Routine checks also continue on goods from non-EC countries.
Mr. David Nicholson : To ask the Chancellor of the Exchequer what would be the annual cost of introducing a 35 per cent. income tax rate for all income (a) between £23,700 and £26,000, (b) between £23,700 and £30,000, and (c) between £23,700 and £35,000 ; and what would be
Column 206the annual revenue from introducing a 50 per cent. rate on (i) all income over £50,000, (ii) all income over £60,000 and (iii) all income over £70,000.
Band of taxable |Revenue cost in full income over which |year at 1992-93 35 per cent. rate |income levels would be charged £ |£ million --------------------------------------------------------------- 23,700 to 26,000 |170 23,700 to 30,000 |400 23,700 to 35,000 |600
Level of taxable |Revenue yield in a income above which |full year at 50 per cent. rate |1992-93 income would be charged |levels £ |£ million --------------------------------------------------------- 50,000 |1,360 60,000 |1,120 70,000 |950
The estimates do not allow for any behavioural effect that might result from such changes to the tax system and do not include capital gains tax.
Mr. Alfred Morris : To ask the Chancellor of the Exchequer what representations he has had from the Charities Tax Reform Group in regard to taxation on charities ; what reply he is sending ; what action he will be taking ; and if he will make a statement.
Sir John Cope : The Charities' Tax Reform Group--CTRG--has suggested that charities could be compensated by grant in aid for their irrecoverable VAT on non-business expenditure incurred in carrying out their charitable objectives.
I cannot anticipate my right hon. Friend's Budget speech. I have replied to the CTRG along those lines. However, I am also expecting to meet the group shortly to receive further representations.
Mr. Portillo : The Government can best assist traders by keeping inflation and interest rates low. Inflation is now at its lowest level for 25 years and below the European Community average. Interest rates are the lowest for 15 years, and are the lowest in the European Community. The extra support for the Export Credits Guarantee Department announced in the autumn statement will also benefit many exporters.
The success of this approach is demonstrated by the number of overseas investors choosing to locate here. In 1991 the United Kingdom had over 40 per cent. of the stock of Japanese inward investment to the EC.
Mr. Nelson : The balance of trade in manufactured goods for December 1992 was published by the Central Statistical Office in the "UK Balance of Payments--Current Account in December" press notice which was published on 28 January 1993, copies of which are available in the House of Commons Library. The information is also available on the Central Statistical Office database which may be accessed by the House of Commons Library.