HC Deb 20 January 1992 vol 202 cc86-8W
Ms. Harman

To ask the Secretary of State for Health if he will make a statement about progress towards implementing the proposals of the committee on child health services in 1976 (Cmnd. 6684).

Mrs. Virginia Bottomley

We continue to subscribe to the general principles of the Court report, particularly the emphasis it gave to the integration of child health services. This was a central theme of our guide on the welfare of children and young people in hospital, which will be developed further in the complementary guidance that we plan to issue on community child health services.

Ms. Harman

To ask the Secretary of State for Health if he will make a statement about the effect of the internal market on cross-boundary flows for paediatric cases.

Mrs. Virginia Bottomley

Contractual arrangements introduced by health authorities for children's services provide for the great majority of referrals. There have been few difficulties in arranging extra-contractual referrals.

Ms. Harman

To ask the Secretary of State for Health if he will consider making immunisation against certain diseases a precondition of children attending school.

Mr. Dorrell

No. We recommend that all children should be immunised against diphtheria, tetanus, polio and whooping cough by three doses of vaccine at age two, three and four months, and against measles, mumps and rubella by one dose at age 12 to 15 months. It is essential that these immunisations are completed at an early age to achieve the most effective levels of protection for the community. Under the present system that objective is being achieved. The latest estimates available show the following rates of immunisation nationallyDiphteria, tetanus, polio—92 per cent. by 12 months of age Whooping cough—88 per cent by 12 months of age Measles, mumps, rubella—90 per cent. by 24 months of age

Ms. Harman

To ask the Secretary of State for Health (1) for each district health authority, how many extra-contractual referrals for paediatric cases have been(a) made, (b) funded and (c) not been funded since the introduction of the internal market in April 1991;

(2) how many district health authorities have negotiated contracts for paediatric care outside their authority boundaries; and if he will list them.

Mrs. Virginia Bottomley

This information is not collected centrally.

Ms. Harman

To ask the Secretary of State for Health if he will instruct all district health authorities to report annually on arrangements for child health service.

Mrs. Virginia Bottomley

We monitor the quality of child health services—in the same way as other health services—through a continuous review of NHS authority preformance. In addition, the patients charter introduces a new right to information which will ensure health authorities and hospitals make available much more information about local services and performance, including child health services.

Ms. Harman

To ask the Secretary of State for Health if he will make a statement on the implementation of Government circular, "The welfare of children and young people in hospital" HSG(91)1.

Mrs. Virginia Bottomley

The guide has been very well received both within the national health service and among voluntary organisations and special interest groups concerned with the welfare of children. Last autumn the Royal College of Nursing held four regional conferences on implementation of the guidance in which the Department participated. It is already in general use as a reference document in the negotiation and agreement of contracts for child health services.

Ms. Harman

To ask the Secretary of State for Health what steps he is taking to ensure that parents throughout the United Kingdom possess a standardised health record for each of their children; and if he will make a statement.

Mrs. Virginia Bottomley

We have supported the introduction nationally of a model parent-held child health record produced by a working party led by the British Paediatric Association. The Department will shortly be writing to all health authorities, family health services authorities and NHS trusts in England, commending the use of these records. We shall also be issuing guidance on how copies of the record can be obtained, together with notes on implementation.

The introduction of parent-held records in Wales, Scotland and Northern Ireland are matters for my right hon. Friends the Secretaries of State for Wales, for Scotland and for Northern Ireland.