Written Answers
Wednesday, 3rd December 1997.
Museum Visits
asked Her Majesty's Government:How many people visited (a) the Science Museum in London; (b) the Victoria and Albert Museum; (c) the National Maritime Museum; (d) the Natural History Museum; and (e) the Imperial War Museum at Lambeth Road in the year 1996–97.
The number of visitors to each museum is given in the following table.
| Visitors in 1996–97 | |
| Museum | Millions |
| Science Museum (South Kensington site only) | 1.47 |
| Victoria and Albert Museum (South Kensington site only) | 1.20 |
| National Maritime Museum (including Queen's House and Old Royal Observatory) | 0.47 |
| Natural History Museum (South Kensington site only) | 1.75 |
| Imperial War Museum (Lambeth site only) | 0.49 |
The Barnett Formula
asked Her Majesty's Government:What is the needs element for healthcare in (a) the Barnett formula; and (b) the formula which will replace the Barnett formula; andHow the Barnett formula was used to determine health care expenditure in the constituent parts of the United Kingdom; and how recent changes to the formula will impact on the resourcing of health care in each of the four countries over the next three years.
The Government set out their view on the Barnett Formula in the Scottish and Welsh White Papers.There is no healthcare allowance in the formula.The Secretaries of State for Scotland, Wales and Northern Ireland have discretion to deploy resources between programmes in the light of local priorities within the block budgets, including changes to spending plans determined by applying the Barnett formula. Details of current and planned spending on health in Scotland, Wales and Northern Ireland are published in the relevant departmental reports.
Inheritance Tax
asked Her Majesty's Government:Whether they will consider replacing the present 40 per cent. rate of tax on inherited wealth by a greater number of tax bands related to the amount of the inheritance; and, if not, why not.
The Chancellor of the Exchequer continues to review all aspects of the tax system.
House Of Commons Medals Cabinet: Gulf War Medal
asked the Chairman of Committees:Whether he will write to the authorities in the House of Commons to ask them when they expect the medals cabinet to be updated by the addition of the Gulf War medal.
I understand from the House of Commons authorities that they have received a specimen of the Gulf medal 1990–91 from the Army Medal Office, and that this will be placed in the medals cabinet shortly.
Scotland: Religious Observance In Non-Denominational Schools
asked Her Majesty's Government:Further to the Written Answer by Lord Sewel on 20 November
(WA 90), what is their policy on religious observance in non-denominational schools in Scotland.
Government policy for religious observance in non-denominational schools in Scotland is set out in the Scottish Office Education Department Circular 6/91. The circular states that religious observance complements religious education and is an important part of a pupil's spiritual development. In non-denominational schools religious observance should be of a broadly Christian character. Where appropriate, schools may wish to organise special acts of observance for particular religions. In primary schools all pupils should take part in religious observance not less than once a week. In secondary school all pupils should take part in religious observance at least once a month and preferably with greater frequency.
Mgn Plc: Flotation
asked Her Majesty's Government:When the Inspectors appointed to investigate the flotation of MGN plc expect to conclude their investigation and what is holding up their report.
It is not possible to forecast the timing of the completion of an investigation of this kind. It would not be helpful to the Inspectors and it is not our policy to comment on an Inspection during its progress.
Lambeth Firearms Amnesty
asked Her Majesty's Government:The number of:
surrendered for:
during the London Borough of Lambeth amnesty.
During the firearms amnesty held in Lambeth last month, the Metropolitan Police received 24 firearms in total, consisting of 16 handguns, four shotguns, two rifles, and two air weapons. Four imitation firearms and a canister of pepper spray were also surrendered. A large amount and range of ammunition was surrendered, including shotgun cartridges, large and small bore rounds, primers and blank rounds. It is not practicable to provide this information on a daily and weekly basis.
"Grand Theft Auto" Computer Game
asked Her Majesty's Government:With reference to the Answers given by Lord Williams of Mostyn on 20 May (H.L. Deb., col. 258), what action they will take in relation to the classification of the computer game "Grand Theft Auto" by the British Board of Film Classification and the likelihood of the game being played by young people.
All computer games which are likely to any significant extent to stimulate or encourage crime (or which depict human sexual activity or acts of gross violence) must be submitted to the British Board of Film Classification (BBFC) for classification. The game "Grand Theft Auto" was submitted and was recently given an 18 certificate by the board. It is, therefore, considered suitable for supply only to adults. Its supply to anyone under the age of 18 is an illegal act subject to criminal penalties. The maximum penalty for supplying a computer game in breach of its classification is six months' imprisonment, a £5,000 fine, or both.The classification decisions of the BBFC are a matter for the board. However, the Government fully share public concern about violent computer games and are keeping the situation under review.
Youth Justice: Responses To Consultation
asked Her Majesty's Government:Whether they will publish the advice they received from the Task Force on Youth Justice and the responses to the consultation paper on youth justice.
Yes. Copies of the two reports submitted by the Task Force on Youth Justice, in August and October, have been placed in the Library.Several hundred responses have been received to our consultation paper on youth justice and these are currently being assessed. We will provide Parliament with a report as soon as practicable.
Terminally Ill Patients
asked Her Majesty's Government:Further to the Answer by Lord Williams of Mostyn on 20 November 1997 (H.L. Deb., cols. 742–744) whether they consider that it is clear under the criminal law of homicide as currently declared by the courts that a doctor treating a terminally ill patient has a defence to a prima facie case of murder based on foresight of consequences, where the jury is satisfied (i) that the doctor administered the treatment in good faith for the purpose of relieving his patient's pain, suffering and severe distress; (ii) the treatment was given with the patient's inferred consent; and (iii) the treatment given accorded with good medical practice.
The Government consider that the law is clear. The intentional killing of another person can be prosecuted as murder. Treatment intended to cause death rather than alleviate pain and distress is, and should remain, unlawful. However, it is lawful to provide treatment which is intended to reduce pain and suffering, but which may shorten life, subject to the usual requirements regarding patient consent.
Terminally Ill Patients: Care
asked Her Majesty's Government:Further to the Answer by Lord Williams of Mostyn on 20 November 1997 (H.L. Deb., cols. 742–44), what authoritative guidance is given to the medical and nursing professions about the treatment of terminally ill patients; andFurther to the Answer by Lord William of Mostyn on 20 November 1997 (H.L. Deb., cols. 742–44), what initial and in-practice training is given for doctors and nurses about the treatment of terminally ill patients, and about the ethical and legal implications of such treatment.
A number of guidance documents are available to help professionals caring for terminally ill patients. The Standing Medical Advisory Committee and Standing Nursing and Midwifery Advisory Committee published a report in 1992 on the Principles and Provision of Palliative Care. The National Council for Hospices and Specialist Palliative Care Services, working with the then Clinical Outcomes Group in the Department of Health's NHS Executive, has produced a document entitled Managing Cancer Pain in Adults. A further document, Changing Gear—care of people in the last few days of life, is to be published shortly. In addition, as part of the implementation of the policy framework for improved cancer services, a series of guidance documents on site specific cancers is being produced by a group chaired by Professor Bob Howard and disseminated by the NHS Executive. Each of these will include guidance on care for the terminally ill. Improving Outcomes in Breast Cancer and Improving Outcomes in Colorectal Cancer have already been published. Copies of these documents will be placed in the Library.All doctors training at undergraduate and postgraduate level learn about the principles of caring for the dying as part of their medical training and also about the legal and ethical implications.Doctors training for a career in hospitals will be in contact with terminally ill patients to a greater or lesser degree depending upon the specialties in which they train and some doctors choose to receive specialty training in palliative care.Those doctors intending to enter general practice will, during their year of general practice training, regularly see patients with terminal illnesses and will learn about their treatment. Trainee general practitioners may well also see patients with terminal illnesses during their two-year hospital rotation. Additionally, doctors are expected to continue with their medical education after qualification and they will spend some of this time learning about the illnesses and conditions they most commonly encounter.The medical education curriculum is a matter for the medical schools in collaboration with the General Medical Council's Education Committee, which has a statutory responsibility to determine the extent of the knowledge and skill required for the granting of primary medical qualifications in the UK, and the relevant Medical Royal Colleges and, in the case of general practice, the Joint Committee on Postgraduate Training for General Practice. All of these have an interest in ensuring that doctors are equipped to deal with the problems they will encounter in practice—both in hospital and in general practice. It is not however practicable or desirable for the Government to prescribe the exact training that any individual doctor will receive.Nurses also receive training at pre-and post-registration levels about the principles of caring for the dying as part of their medical training and also about the ethical implications. Within pre-registration nursing programmes, the Common Foundation element addresses issues of nursing patients with terminal illnesses and associated ethical and moral implications. Many pre-registration nurses will have the opportunity to experience a clinical placement within settings offering this type of specialist care. This may be with a hospital palliative care team, community team or a local hospice.There are also a number of post-registration packages available to qualified nurses who wish to pursue this particular area of specialist care. Ethical and moral issues are integral components in all courses for qualified nurses focusing on care for people with any life threatening illness. There are also specific, specialist courses on palliative and terminal care for those qualified nurses who wish to pursue this particular area of specialist care.
Drug Prescription By Dentists
asked Her Majesty's Government:Whether their proposed review of the use of prescriptive drugs by the medical and dental professions will change the anomaly in The Medicines (Product other than Veterinary Drugs) (Prescription Only) Order 1983, Section 6, which prevents dentists from making telephoned requests to a convenient and accessible pharmacist for the provision of emergency drugs for a patient; and what is the justification for the different rules as between doctors and dentists.
The Review of Prescribing, Supply and Administration of Medicines is currently under way, chaired by Dr. June Crown, and is considering a wide range of issues regarding the prescribing, supply and administration of medicines. The review is due to report to Ministers next year.There is no provision in current legislation for pharmacists to supply prescription only medicines to a patient following a telephoned request from a dentist. We are not aware that this is a widespread problem.
Service Personnel And Nhs Waiting Lists
asked Her Majesty's Government:What steps they are taking to improve co-operation between the Ministry of Defence and the Department of Health to ensure that servicemen and their families who require in-patient treatment in hospital do not revert to the bottom of hospital waiting lists due to the servicemen's postings to different parts of the United Kingdom.
The priority individual patients are given once on a waiting list is a clinical matter.However, hospitals accepting patients who have moved into their area have been asked to consider what account they are able to take of the time patients have already spent on waiting lists at other hospitals.Officials of the Ministry of Defence and the Department of Health have jointly recognised that service personnel and their dependents may be concerned about transferring to a new waiting list for hospital treatment as a result of a posting within the United Kingdom, or when returning from overseas. Officials will examine individual cases of extended delay in receiving treatment.
Smoking-Related Disease: Treatment Costs
asked Her Majesty's Government:Following the recent assertion by the Health Minister that the bill for treating people with smoking-related diseases was now estimated to be between £1.4 and £1.7 billion per annum, what proportion of those so treated were smokers.
The estimate of £l.4–£1.7 billion is the expenditure incurred by smokers because they smoke. Hence all those whose treatment incurred this expenditure are smokers.Expenditure on diseases to which smoking makes some contribution ("smoking related diseases") is necessarily higher.
asked Her Majesty's Government:Whether, following the publication of revised estimated costs to the NHS of smoking, they will publish the costs to the NHS of other lifestyle activities, including the costs of illness, injury, deaths and adverse social consequences (including murder and assault) from the effects of alcohol and diseases (especially respiratory diseases) and accidents arising from the use of motor vehicles.
The information is not available in the form requested.
Compulsory Competitive Tendering
asked Her Majesty's Government:When they expect to issue new guidance on the conduct of compulsory competitive tendering.
We have today published a new Departmental Circular No. 16/97 (Welsh Office 62/97) which gives local authorities guidance on the conduct of compulsory competitive tendering (CCT).The guidance reflects the new regulations on CCT laid before Parliament on 21 November. These amended the existing framework for CCT in England and Wales to make it more flexible and encourage local authorities to move to a Best Value-based approach to service delivery. The new guidance will alow authorities to pursue the principles of Best Value in a manner consistent with the purpose of the CCT legislation (that is, that local authorities only carry out work if they do so competitively) and provide more flexibility to tendering.A draft of the guidance formed part of a package of proposed changes to CCT which went out to consultation on 25 July. The new circular takes account of the views of 112 local authorities and related organisations, professional bodies and private sector interests who responded specifically to the draft. A further 19 responses were received by the Welsh Office. Copies of the responses are held in the DETR's library.The guidance sets out the Government's views on how CCT should be carried out in the period before Best Value is implemented. It emphasises the importance of ensuring that competition is undertaken in an open and transparent manner and that service users and service providers are consulted on the level and standard of services to be provided. Local authorities should secure services which are economic, effective and efficient and in which considerations of price and quality are properly balanced. Competing bids need to be evaluated objectively and authorities need to deal fairly with potential contractors to ensure that tendering practice does not advantage any one potential supplier or suppliers.The new guidance applies immediately to those services currently subject to CCT. My right honourable friend the Secretary of State will take into account the extent to which there has been a contravention of the guidance in determining whether or not authorities have acted anti-competitively.
Best Value Duty
asked Her Majesty's Government:When they will announce the decision about which local authorities will pilot the duty of Best Value.
My honourable friend the Minister for Local Government and Housing will announce these decisions later this week. The Department of the Environment, Transport and the Regions will write to all local authorities and other organisations who submitted proposals to pilot Best Value. We shall place a list of proposals, together with a record of the decision taken on each proposal, in the Library on the day of the announcement.