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| | New Amendments handed in are marked thus  |
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| | Health and Social Care (Re-Committed) Bill, As Amended
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| | | The Amendments have been arranged in accordance with the Health and Social |
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| | | Care Bill (Programme) ( No. 3) Motion to be proposed by Mr Secretary Lansley |
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| | New clauses and new schedules relating to, and amendments to, parts 3 |
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| | (a) new clauses, new schedules and amendments relating to transitional |
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| | arrangements for nhs foundation trusts,
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| | (B) new clauses, new schedules and amendments relating to private |
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| | (C) amendments providing for commissioning consortia to be known as |
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| | clinical commissioning groups |
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| | | Conditions relating to the continuation of the provision of services etc. |
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| | To move the following Clause:— |
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| | | ‘(1) | The things which a licence holder may be required to do by a condition under |
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| | | section 104(1)(i)(i) include, in particular— |
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| | | (a) | providing information to the commissioners of services to which the |
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| | | condition applies and to such other persons as Monitor may direct, |
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| | | (b) | allowing Monitor to enter premises owned or controlled by the licence |
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| | | holder and to inspect the premises and anything on them, and |
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| | | (c) | co-operating with such persons as Monitor may appoint to assist in the |
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| | | management of the licence holder’s affairs, business and property. |
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| | | (2) | A commissioner of services to which a condition under section 104(1)(i), (j) or |
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| | | (k) applies must co-operate with persons appointed under subsection (1)(c) in |
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| | | their provision of the assistance that they have been appointed to provide. |
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| | | (3) | Where a licence includes a condition under section 104(1)(i), (j) or (k), Monitor |
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| | | must carry out an ongoing assessment of the risks to the continued provision of |
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| | | services to which the condition applies. |
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| | | (4) | Monitor must publish guidance— |
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| | | (a) | for commissioners of a service to which a condition under section |
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| | | 104(1)(i), (j) or (k) applies about the exercise of their functions in |
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| | | connection with the licence holders who provide the service, and |
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| | | (b) | for such licence holders about the conduct of their affairs, business and |
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| | | property at a time at which such a condition applies. |
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| | | (5) | A commissioner of services to which a condition under section 104(1)(i), (j), or |
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| | | (k) applies must have regard to guidance under subsection (4)(a). |
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| | | (6) | Monitor may revise guidance under subsection (4) and, if it does so, must publish |
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| | | (7) | Before publishing guidance under subsection (4) or (6), Monitor must obtain the |
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| | | (a) | the Secretary of State, and |
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| | | (b) | the National Health Service Commissioning Board.’. |
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| | | Objective of trust special administration |
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| | To move the following Clause:— |
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| | | ‘After section 65D of the National Health Service Act 2006 insert— |
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| | | “65DA | Objective of trust special administration |
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| | | (1) | The objective of a trust special administration is to secure— |
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| | | (a) | the continued provision of such of the services provided for the |
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| | | purposes of the NHS by the NHS foundation trust that is subject |
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| | | to an order under section 65D(2), at such level, as the |
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| | | commissioners of those services determine, and |
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| | | (b) | that it becomes unnecessary for the order to remain in force for |
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| | | (2) | The commissioners may determine that the objective set out in |
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| | | subsection (1) is to apply to a service only if they are satisfied that the |
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| | | criterion in subsection (3) is met. |
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| | | (3) | The criterion is that ceasing to provide the service under this Act would, |
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| | | in the absence of alternative arrangements for its provision under this |
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| | | (a) | have a significant adverse impact on the health of persons in need |
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| | | of the service or significantly increase health inequalities, or |
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| | | (b) | cause a failure to prevent or ameliorate either a significant |
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| | | adverse impact on the health of such persons or a significant |
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| | | increase in health inequalities. |
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| | | (4) | In determining whether that criterion is met, the commissioners must (in |
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| | | so far as they would not otherwise be required to do so) have regard to— |
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| | | (a) | the current and future need for the provision of the service under |
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| | | (b) | whether ceasing to provide the service under this Act would |
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| | | significantly reduce equality between those for whom the |
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| | | commissioner arranges for the provision of services under this |
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| | | Act with respect to their ability to access services so provided, |
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| | | (c) | such other matters as may be specified in relation to NHS |
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| | | foundation trusts in guidance published by the regulator. |
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| | | (5) | Monitor may revise guidance under subsection (4)(c) and, if it does so, |
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| | | must publish the guidance as revised. |
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| | | (6) | Before publishing guidance under subsection (4)(c) or (5), the regulator |
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| | | must obtain the approval of— |
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| | | (a) | the Secretary of State; |
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| | | (7) | The Board must make arrangements for facilitating agreement between |
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| | | commissioners in determining the services provided by the trust under |
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| | | this Act to which the objective set out in subsection (1) is to apply. |
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| | | (8) | Where commissioners fail to reach agreement in pursuance of |
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| | | arrangements under subsection (7), the Board may make the |
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| | | determination (and the duty imposed by subsection (1)(a), so far as |
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| | | applying to the commissioners concerned, is to be regarded as |
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| | | “commissioners” means the persons to which the trust provides services |
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| | | “health inequalities” means the inequalities between persons with respect to |
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| | | the outcomes achieved for them by the provision of services that are |
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| | | provided as part of the health service.”’. |
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| | Page 83, line 5, leave out Part 3. |
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| | Page 83, line 13 [Clause 57], leave out ‘monitor’ and insert ‘Integrated Health |
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| | Service Regulator (elsewhere referred to in this Bill as “Monitor”)’. |
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| | Page 83, line 20 [Clause 58], at end insert ‘and |
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| | | (c) | is sufficiently integrated so as to reduce any risk to patient care and to |
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| | | provide continuity of service.’. |
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| | Page 83, line 23 [Clause 58], after ‘preventing’, insert ‘competitive or, as the case |
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| | Page 84, line 42 [Clause 59], at end insert ‘bearing in mind that it should be |
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| | balanced with ensuring the protection of health service integration.’. |
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| | Page 85, line 2 [Clause 59], at end insert— |
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| | | ‘(3A) | “Integration”, in relation to health services, means the provision or |
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| | | commissioning of health services in a manner to ensure the viability of the full |
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| | | range of health and social care facilities which a community might reasonably |
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| | | expect from the NHS, including the provision of complex and commercially less |
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| | | attractive and difficult to provide emergency and other acute services which |
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| | | require to be provided on a site or in a manner which benefits from its |
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| | | collaboration with other acute health specialities or services.’. |
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| | Page 85, line 14 [Clause 60], at end insert— |
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| | | ‘( ) | Any regulations under this section must apply in relation to England only.’. |
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| | Page 86, line 14 [Clause 61], at end insert— |
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| | | ‘(n) | the need to avoid existing NHS services, including but not restricted to, |
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| | | emergency care, intensive care, chronic and complex care, teaching, |
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| | | training and research, becoming unviable or unstable due to an unplanned |
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| | | reduction in income or case-load.’. |
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| | Page 86, line 30 [Clause 62], leave out paragraph (b). |
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| | Page 90, line 3, leave out Clause 67. |
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| | Page 90, line 23, leave out Clause 68. |
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| | Page 91, line 43, leave out Clause 70. |
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| | Page 92, line 7 [Clause 70], after ‘in’, insert ‘competitive or, as the case may be,’. |
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| | Page 92, line 8 [Clause 70], at end insert— |
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| | | ‘(d) | protect and promote the integration of health services and health and |
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| | | (e) | improve the equality of access to NHS services and healthcare outcome, |
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| | | (f) | do not undermine the stability of existing NHS services, including but not |
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| | | restricted to, emergency care, intensive care, chronic and complex care, |
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| | | teaching, training and research.’. |
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| | Page 92, line 8 [Clause 70], at end insert— |
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| | | ‘(d) | do not act in a manner which risks undermining the viability of |
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| | | maintaining essential or designated core health services or the essential |
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| | | integration between health services.’. |
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| | Page 94, line 22 [Clause 74], leave out subsections (1) to (3) and insert— |
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| | | ‘(1) | Part 3 of the Enterprise Act 2002 (mergers) applies (in so far as it would not |
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| | | otherwise) where two or more enterprises have ceased to be distinct enterprises |
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| | | and specifically the activities of one or more NHS foundation trusts and the |
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| | | activities of one or more businesses have ceased to be distinct activities.’. |
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| | Page 94, line 29 [Clause 74], leave out ‘subsections (2) and (3)’ and insert |
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| | Page 97, line 34, leave out Clause 79. |
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| | Page 97, line 36 [Clause 79], leave out ‘designation’ and insert ‘non-designation’. |
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| | Page 97, line 36 [Clause 79], at end insert— |
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| | | ‘(1A) | In the absence of an application for non-designation being granted by Monitor for |
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| | | a health care service for the purposes of the NHS, that health care service is to be |
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| | Page 97, line 39 [Clause 79], leave out ‘(3)’ and insert ‘(4)’. |
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| | Page 98, line 3 [Clause 79], after ‘purposes’, insert ‘not’. |
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| | Page 98, line 19 [Clause 79], leave out ‘(2)(a)’ and insert ‘(3)(a)’. |
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