§ Mr. DuncanTo ask the Secretary of State for Northern Ireland if he will make a statement on the work of the Department of Health and Social Security (Northern Ireland) since 1979.
§ Mr. HanleySince 1978–79, expenditure on health and personal social services in Northern Ireland has increased by 38 per cent. after allowing for general inflation. Cost improvement programmes have also generated savings of nearly £83 million for investment in services to patients and clients.
Over the same period, levels of activity have increased by 33 per cent. Since 1981 the number of hospital in-patients has risen by 12 per cent. from 249,198 to 278,960; the number of day cases has increased sixfold, from 9,853 to 60,094; the number of operations has risen by 29 per cent.; and the number of out-patient attendances has risen by 17 per cent., from 1.7 million to 2.0 million. Considerable investment has been made in key regional services including cardiac surgery, orthopaedics and the treatment of end stage renal failure.
There have also been substantial increases in the numbers of professional staff; there are now 19 per cent. more doctors and dentists; 53 per cent. more general dental practitioners; 17 per cent. more hospital doctors; 28 per cent. more general practitioners; 5 per cent. more nurses and midwives; and 111 per cent. more qualified social workers. Particular emphasis has been placed on the training and development of professional staff. The training budget currently stands at £15 million a year.
Since 1979, perinatal and infant mortality rates in Northern Ireland have been reduced from 16.6 and 14.8 to 8.4 and 7.3 respectively. A confidential inquiry into 365W stillbirths and deaths in infancy to reduce further the numbers of stillbirths and deaths in infancy was launched in January 1993.
Through the emphasis on developing community services, there has been a reduction of 37 per cent. and 38 per cent. respectively in the number of patients in psychiatric and mental handicap hospitals.
A code of practice under the Mental Health (NI) Order 1986 was published in 1992. This gives guidance in relation to the admission of patients to hospitals and the reception of patients into guardianship under the order and in relation to the medical treatment of patients suffering from mental disorder.
A major study was commissioned to evaluate the outcome of community care for long stay patients discharged from psychiatric and mental handicap care since 1987.
Implementation of the major reforms flowing from "Promoting Better Health", "Working for Patients" and "People First" will lead to better management of the resources available and better services to patients and clients.
Six health and social services trusts will become operational from 1 April 1993 and four more have been approved but must await a change in legislation before they can be set up. A further three units have been invited to develop applications for a third round.
Twenty GP fund holders will begin to manage their own budgets from 1 April 1993 and a further 34 have expressed an interest in a second wave.
The charter for patients and clients published in March 1992 provides a framework for action to raise the quality of health and personal social services and to make these more responsive to the needs of patients and clients.
The social security benefits system has been maintained and reformed on the same basis as in the rest of the United Kingdom. The cash value of pensions and other long-term benefits have been secured in real terms.
In July 1991 a Social Security Agency was established as part of the next steps initiative, and in 1992 it published a customer charter setting out the standard of service the public has a right to expect. The agency attracted around 850 jobs to Northern Ireland provided services to the benefit network in Great Britain.
Programmes operating only in urban priority areas (£ million) Year Urban Development Corporations Urban Programme1 City Grant (inc UDG and URG) Programmes City Challenge Housing Action Trusts Task Forces City Action Teams A B A B A B A B A B A B A B 1981–82 36 67 94 175 — — — — — — — — — — 1982–83 62 108 160 278 — — — — — — — — — — 1983–84 95 158 156 259 8 13 — — — — — — — — 1984–85 88 139 278 439 15 24 — — — — — — — — 1985–86 86 129 254 381 24 36 — — — — — — — — 1986–87 89 129 237 344 24 35 — — — — — — — — 1987–88 160 220 246 338 28 39 — — — — 5 7 — — 1988–89 255 327 224 287 28 36 — — — — 23 29 — — 1989–90 477 574 223 268 39 47 — — — — 20 24 4 5 1990–91 607 677 226 252 45 50 — — — — 21 23 8 9 1991–92 602 628 238 248 41 43 — — 10 10 21 22 8 8 1992–93 515 515 243 243 60 60 642 642 27 27 23 23 4 4 A Year-on-year.
B Current prices.
1Includes for 1984–85 onwards other Government Departments' contributions to Urban Programme.
2Programme also supported by £19 million per year from the Housing Corporation.
366WA child support agency for Northern Ireland is being established from 5 April 1993. Also, a regional child support agency centre is being established to provide back office services to Great Britain in relation to the assessment and collection of child maintenance.
Adoption law and practice were brought broadly into line with the rest of the United Kingdom. A major new guide on the management of child abuse was issued to health and social services boards in 1989.
Since 1979 aid to the voluntary sector has been increased by 228 per cent. in real terms. The Department has taken responsibility for the community volunteering scheme since April 1992. It was previously administered by the Department of Economic Development.
In 1992 the Registered Homes (NI) Order set out new legislation on the registration and inspection of private and voluntary sector residential care homes and nursing homes.