Office of Public Sector Information
PART 4 continued
(1) Section 28D of the 1977 Act (persons with whom arrangements under section 28C of that Act may be made) is amended as follows.
(2) In subsection (1), for paragraphs (b) and (c) substitute—
“(b) a medical practitioner who meets the prescribed conditions;
(ba) a dental practitioner who meets the prescribed conditions;
(bb) a health care professional who meets the prescribed conditions;
(bc) an individual who is providing services—
(i) under a general medical services contract or general dental services contract;
(ii) in accordance with section 28C arrangements, section 17C arrangements or Article 15B arrangements; or
(iii) under section 19 or 25 of the 1978 Act or Article 56 or 61 of the Health and Personal Social Services (Northern Ireland) Order 1972 (1972 No. 1256 (N.I. 14));
or has so provided them within such period as may be prescribed;”.
(3) After subsection (1) insert—
“(1A) The power under subsection (1) to make an agreement with a person falling within paragraph (bc) or (d) of that subsection is subject to such conditions as may be prescribed.”
(4) In subsection (2), after the definition of “the 1978 Act” insert—
““health care professional” means a person who is a member of a profession regulated by a body mentioned (at the time the agreement in question is made) in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002;”.
(5) In that subsection, for the definition of “NHS employee” substitute—
““NHS employee” means an individual who, in connection with the provision of services in the health service in England and Wales, Scotland or Northern Ireland, is employed by—
(a) an NHS trust, an NHS foundation trust or (in Northern Ireland) a Health and Social Services Trust;
(b) a Primary Care Trust or Local Health Board;
(c) a person who is providing services under a general medical services contract or a general dental services contract;
(d) an individual who is providing services as specified in subsection (1)(bc)(iii) above;”.
(6) In the definitions of “section 17C employee” and “section 28C employee”, for “an individual providing” substitute “a person providing or performing”.
(7) In section 28E of the 1977 Act (regulations), in subsection (3), after paragraph (c) insert—
“(ca) impose conditions (including conditions as to qualifications and experience) to be satisfied by persons performing services in accordance with section 28C arrangements;”.
(8) In that section, after subsection (3) insert—
“(3A) The regulations may also require payments to be made under the arrangements in accordance with directions given for the purpose by the Secretary of State; and section 18(1) and (3)(b) apply in relation to any such directions.
(3B) A direction under subsection (3A) may make provision having effect from a date before the date of the direction, provided that, having regard to the direction as a whole, the provision is not detrimental to the persons to whose remuneration it relates.”
(9) In that section, after subsection (3B) (as inserted by subsection (8) above), insert—
“(3C) The regulations may also include provision requiring a Primary Care Trust or Local Health Board, in prescribed circumstances and subject to prescribed conditions, to enter into a general medical services contract or general dental services contract on prescribed terms with any person providing services under section 28C arrangements who so requests.”
(10) In that section, after subsection (3C) (as inserted by subsection (9) above) insert—
“(3D) The regulations may also include provision for the resolution of disputes as to the terms of any proposed section 28C arrangements, and in particular may make provision—
(a) for the referral of the terms of the proposed arrangements to the Secretary of State or National Assembly for Wales; and
(b) for the Secretary of State, or Assembly, or a person appointed by him or it, to determine the terms on which the arrangements may be entered into.”
(11) In that section, after subsection (3D) (as inserted by subsection (10) above) insert—
“(3E) The regulations must provide for the circumstances in which a person providing primary medical services under section 28C arrangements—
(a) must or may accept a person as a patient to whom such services are so provided;
(b) may decline to accept a person as such a patient;
(c) may terminate his responsibility for a patient.
(3F) The regulations must make provision as to the right of patients to choose the persons from whom they are to receive services under section 28C arrangements.”
(12) In that Act, sections 28F (choice of medical practitioner), 28G (choice of dental practitioner) and 28H (immunisation) shall cease to have effect.
(1) Part 1 of the National Health Service (Primary Care) Act 1997 (c. 46) (power to make pilot schemes for the provision of personal medical and dental services) shall cease to have effect.
(2) This section extends to England and Wales only.
(1) In the 1977 Act, after section 28W (as inserted by section 175 above) insert—
(1) Regulations may provide that a health care professional of a prescribed description may not perform any primary medical service for which a Primary Care Trust or Local Health Board is responsible unless he is included in a list maintained under the regulations by a Primary Care Trust or Local Health Board.
(2) Regulations may provide that a health care professional of a prescribed description may not perform any primary dental service for which a Primary Care Trust or Local Health Board is responsible unless he is included in a list maintained under the regulations by a Primary Care Trust or Local Health Board.
(3) For the purposes of this section—
(a) “health care professional” means a person who is a member of a profession regulated by a body for the time being mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002;
(b) a Primary Care Trust or Local Health Board is responsible for a medical or dental service if it provides the service, or secures its provision, by or under any enactment.
(4) Regulations under this section may make provision in relation to lists under this section and in particular as to—
(a) the preparation, maintenance and publication of a list;
(b) eligibility for inclusion in a list;
(c) applications for inclusion (including provision as to the Primary Care Trust or Local Health Board to which an application must be made, and for the procedure for applications and the documents to be supplied on application);
(d) the grounds on which an application for inclusion may or must be granted or refused;
(e) requirements with which a person included in a list must comply (including the declaration of financial interests and gifts and other benefits);
(f) suspension or removal from a list (including provision for the grounds for, and consequences of, suspension or removal);
(g) circumstances in which a person included in a list may not withdraw from it;
(h) payments to be made in respect of a person suspended from the list (including provision for the amount of the payment, or the method of calculating the payment, to be determined by the Secretary of State or National Assembly for Wales, or a person appointed by him or it);
(i) the criteria to be applied in making decisions under the regulations;
(j) appeals against decisions made by a Primary Care Trust or Local Health Board under the regulations; and
(k) disclosure of information about applicants for inclusion, grants or refusals of applications or suspensions or removals;
and may make any provision corresponding to anything in sections 49F to 49N below.
(5) Regulations under this section may, in particular, also provide for—
(a) a person’s inclusion in a list to be subject to conditions determined by a Primary Care Trust or Local Health Board;
(b) a Trust or Board to vary the conditions or impose different ones;
(c) the consequences of failing to comply with a condition (including removal from the list);
(d) the review by a Trust or Board of decisions made by it by virtue of the regulations.
(6) The imposition of such conditions must be with a view to—
(a) preventing any prejudice to the efficiency of the services to which the list relates, or
(b) preventing fraud.
(7) Regulations making provision as to the matters referred to in subsection (4)(k) may in particular authorise the disclosure of information—
(a) by a Primary Care Trust or Local Health Board to the Secretary of State or the National Assembly for Wales; and
(b) by the Secretary of State or the National Assembly for Wales to a Primary Care Trust or Local Health Board.”
(2) In section 49M(7) of that Act, at the end there is inserted “; and regulations under this subsection may include provision of the kind referred to in section 49I(10)”.
In the 1977 Act, after section 28X (as inserted by section 179 above) insert—
(1) A Primary Care Trust or Local Health Board may provide assistance or support to—
(a) any person providing, or proposing to provide primary medical services or primary dental services under a general medical services contract or a general dental services contract;
(b) any person providing, or proposing to provide, such services in accordance with section 28C arrangements.
(2) Assistance or support provided by a Primary Care Trust or Local Health Board under subsection (1) is to be provided on such terms, including terms as to payment, as the Trust or Board thinks fit.
(3) In this section “assistance” includes financial assistance.”
The Dental Practice Board is abolished.
(1) In section 16B of the 1977 Act (exercise of functions by Primary Care Trusts), at the end insert—
“(4) The Secretary of State may by order make provision for the transfer to a Special Health Authority of the rights and liabilities of a Primary Care Trust under a general dental services contract in a case where the Authority exercises functions of the Trust in relation to the contract by virtue of subsection (2)(b) above (and for their transfer back to the Trust where the Authority ceases to exercise those functions).”.
(2) In section 16BC of that Act (exercise of functions by Local Health Boards), at the end insert—
“(4) The Assembly may by order make provision for the transfer to a Special Health Authority of the rights and liabilities of a Local Health Board under a general dental services contract in a case where the Authority exercises functions of the Board in relation to the contract by virtue of subsection (2)(b) above (and for their transfer back to the Board where the Authority ceases to exercise those functions).”.
(1) In the 1977 Act, for sections 78A to 79A substitute—
(1) Regulations may provide for the making and recovery, in such manner as may be prescribed, of charges for relevant dental services.
(2) Regulations under subsection (1) may in particular include provision—
(a) specifying the amount, or maximum amount, of any charge (or aggregate charge in respect of the provision for two or more relevant dental services);
(b) for calculating the amount of any charge;
(c) for the variation of the amount, or maximum amount, of any charge in cases of a prescribed description;
(d) for any charge not to be payable in cases of a prescribed description;
(e) for power to direct that a charge is not payable in any particular case;
(f) for the repayment of any charge (including provision as to the persons by whom, and manner in which, repayments are to be made).
(3) Regulations under subsection (1) may provide for sums which would otherwise be payable by a Primary Care Trust, Local Health Board or Special Health Authority to persons providing relevant dental services to be reduced by the amount of the charges authorised by the regulations.
(4) This section is subject to Schedule 12ZA.
(5) In this section and Schedule 12ZA “relevant dental services” means—
(a) dental treatment provided—
(i) under section 16CA(2) above (dental services provided by a Primary Care Trust or Local Health Board);
(ii) under a general dental services contract;
(iii) in accordance with section 28C arrangements; and
(b) the supply of dentures and other dental appliances under this Act.
(6) Any reference in this section or Schedule 12ZA to the supply of an appliance includes a reference to its repair, adjustment, refitting or replacement and, in the case of dentures, to their being relined or having additions made to them.”
(2) After Schedule 12 to that Act insert—
1 (1) No charge is to be made under regulations under section 79(1) in respect of a relevant dental service provided for any person who at the prescribed time—
(a) was under 18;
(b) was under 19 and receiving qualifying full-time education;
(c) was pregnant; or
(d) had given birth to a child within the previous 12 months.
(2) In sub-paragraph (1)(b), “qualifying full-time education” means full-time instruction at a recognised educational establishment or by other means accepted as comparable by the person or body making the regulations.
(3) For the purposes of sub-paragraph (2)—
(a) “recognised educational establishment” means an establishment recognised by the person or body making the regulations as being, or as comparable to, a school, college or university; and
(b) regulations may prescribe the circumstances in which a person is or is not to be treated as receiving full-time instruction.
(4) In sub-paragraph (1)(d), “child” includes a still-born child (within the meaning of the Births and Deaths Registration Act 1953).
(5) This paragraph is subject to paragraph 3.
2 (1) No charge is to be made under regulations under section 79(1) in respect of the repair or replacement of any appliance.
(2) This paragraph is subject to paragraph 3.
3 Paragraphs 1 and 2 do not apply in relation to—
(a) the repair or replacement of any appliance of a prescribed description; or
(b) the repair or replacement of any appliance where it is determined in the prescribed manner—
(i) in any case, that the repair or replacement was necessitated by an act or omission of the person supplied; or
(ii) in a case where the person supplied was under the age of 16, that the repair or replacement was necessitated by an act or omission, occurring while that person was under that age, of a person having charge of him.
4 No charge is to be made under regulations under section 79(1) in respect of any appliance supplied to a patient for the time being resident in a hospital.
5 Paragraph 4 does not apply where an appliance is supplied—
(a) under section 16CA(2) above;
(b) under a general dental services contract; or
(c) in accordance with section 28C arrangements.
6 No charge is to be made under regulations under section 79(1) in respect of the arrest of bleeding.
7 Regulations may provide, with respect to any exemption under this Schedule, that it is to be a condition of the exemption that—
(a) a declaration of the prescribed kind is made in the prescribed form and manner; or
(b) a certificate or other evidence of the prescribed kind is supplied in the prescribed form and manner.”
(3) In section 126 of that Act—
(a) in subsection (1), after “PCT order” insert “or an instrument to which subsection (1A) applies”;
(b) after subsection (1) insert—
“(1A) The Secretary of State may not make a statutory instrument containing the first regulations made under section 79(1) above (as substituted by the Health and Social Care (Community Health and Standards) Act 2003) unless a draft of the instrument has been laid before, and approved by resolution of, each House of Parliament.”
(4) In respect of any period after the coming into force of this section but before the coming into force of section 178, section 79(5)(b) of the 1977 Act (as inserted by subsection (1) above) shall have effect as if it included a reference to the supply of dentures and other dental appliances in accordance with a pilot scheme under Part 1 of the National Health Service (Primary Care) Act 1997 (c. 46).
Schedule 11 (which contains minor and consequential amendments relating to this Part) has effect.
Health and Social Care (Community Health and Standards) Act 2003