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Lord Falconer of Thoroton: As with previous reports, the Social Exclusion Unit's report on teenage pregnancy was informed by a very wide range of research, data and consultation. The studies mentioned are included in a number of reviews of effectiveness which draw together evidence from here and abroad. The need to improve evaluation for future programmes will be taken into account in developing the research and evaluation programme announced in the report.
Lord Falconer of Thoroton: The Social Exclusion Unit is aware of the work of Professor Oakley and the Social Science Research Unit and refers to the 1994 Review of Effectiveness in Annex 3 of the report on teenage pregnancy. Unfortunately, the 1996 review, unlike its predecessor, was not published in the peer review journals or disseminated through the usual channels. However, I will ensure that the teenage pregnancy unit in the Department of Health, who are taking forward the action in the report, have access to a copy of the 1996 review.
The Lord Chancellor (Lord Irvine of Lairg): There have been no payments beyond those I described to Parliament on 24 May 1999 (Official Report, cols. 66 and 67). Detailed assessment of the bill of the firm of solicitors under contract to the Legal Aid Board is to begin on 18 October 1999. We do not expect to know
The Lord Chancellor: Although there are no such cases listed for trial in the period specified, in respect of the noble Lord's previous Question answered on 24 May 1999 (WA66), of the four cases then outstanding, two have settled, and in the remaining two a judicial decision was made to fix both cases to be heard between 1 March and 1 June 2000.
The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): Priority-setting is a necessary part of decision-making in the National Health Service. This Government are committed to increasing access to the NHS. An extra 450,000 waiting list cases were treated last year, and waiting lists for elective surgery have fallen to over 60,000 below the level inherited from the last government.
Lord Hunt of Kings Heath: 4,793 juniors--that is 15.9 per cent or one in six of all posts--were working, on average, more than 56 hours a week in September 1998. Compliance had improved every six months
The numbers working over 56 hours are likely to have fallen further since then, given the continuing action to improve working hours. The regional task force chairmen--who are responsible for providing support and advice to the National Health Service on reducing junior doctor's hours--have confirmed that, keeping to a consistent definition of hours worked, they would have expected the numbers of junior doctors working more than 56 hours to have fallen further since September 1998, continuing the trend after March 1997.
However, in December 1998, with the support and agreement of the British Medical Association's Junior Doctors' Committee, we introduced in England new and tougher compliance criteria in order to safeguard the quality of rest periods for junior doctors. Although they would not in fact represent a change in actual hours worked, any compliance figures calculated on this new basis could well be higher. As expected, 8,508 posts, or 28.6 per cent of all juniors' posts, were found at 31 March 1999 not to be complying with this different and tougher measure which, for the first time, included, for example, criteria on the length of continuous rest periods at weekends. The Scottish Health Department issued similar guidance to their trusts under NHS Circular MEL(1998)40 in April this year.
Lord Hunt of Kings Heath: Her Majesty's Government attach great importance to continuing to make progress in reducing junior doctors' hours. We certainly have no intention of lifting the 56-hour limit which is a central part of the current United Kingdom New Deal agreement. We have reaffirmed our commitment to the New Deal task forces and we issued, in England last December and in Scotland in April, new guidance on the quality of rest for juniors, especially when working out of hours. There remains, however, a significant number of posts outside full compliance and our first step must be to tackle these posts.
Over time, the European Community Working Time Directive will require the implementation of a 48-hour week. We need to do so over a reasonable period and in such a way that does not jeopardise patient care, the training needs of juniors or our plans to modernise the National Health Service into the next century. The current situation where too many doctors are working over 56 hours means, for example, that we could not move immediately to the legal enforcement of the current 56-hour limit.
At a European level it has been necessary to agree, with other countries, an approach which we and our European partners feel is fair and deliverable. It was necessary to take into account the differing needs of all our European partners in setting realistic minimum standards for the outset, standards which will apply and can be enforced in all member states.
The period and staging proposed by the German Presidency and agreed unanimously by the Social Affairs Council on 25 May 1999 achieves such a framework. The proposed Europe-wide ceiling is not about the average number of hours junior doctors must work but the maximum average above which they cannot be made to work.
This proposal means that in the UK we can continue to make progress at a realistic rate. We believe that we will continue to see progress made on reducing junior doctors' hours and that the route to 48 hours will be marked with clear goals which will mean that junior doctors will see benefits from our actions well before the final implementation date.
Lord Hunt of Kings Heath: The following table contains data outlining the expenditure by health authorities on artificial limb and wheelchair services in England for 1991-92 to 1995-96. From 1995-96 we are not able to disaggregate artificial limb and wheelchair services costs from a broader data set on appliances. We are unable to provide data prior to 1991-92.
|Year||Artificial Limb Services||Wheel Chair Services||Total £|
1. Annual financial returns of district and regional health authorities and the special health authorities for the London postgraduate teaching hospitals, 1991-92 to 1995-96.