Previous Next

Contents page 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-109 Last page

A

BILL

TO

Establish and make provision about a National Health Service Commissioning
Board and commissioning consortia and to make other provision about the
National Health Service in England; to make provision about public health in
the United Kingdom; to make provision about regulating health and adult
social care services; to make provision about public involvement in health and
social care matters, scrutiny of health matters by local authorities and co-
operation between local authorities and commissioners of health care services;
to make provision about regulating health and social care workers; to establish
and make provision about a National Institute for Health and Care Excellence;
to establish and make provision about a Health and Social Care Information
Centre and to make other provision about information relating to health or
social care matters; to abolish certain public bodies involved in health or social
care; to make other provision about health care; and for connected purposes.

Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and
consent of the Lords Spiritual and Temporal, and Commons, in this present
Parliament assembled, and by the authority of the same, as follows:—

Part 1 The health service in England

The health service: overview

1 Secretary of State’s duty to promote comprehensive health service

5For section 1 of the National Health Service Act 2006 (Secretary of State’s duty

Health and Social Care BillPage 2

to promote health service) substitute—

1 Secretary of State’s duty to promote comprehensive health service

(1) The Secretary of State must continue the promotion in England of a
comprehensive health service designed to secure improvement—

(a) 5in the physical and mental health of the people of England, and

(b) in the prevention, diagnosis and treatment of illness.

(2) For that purpose, the Secretary of State must exercise the functions
conferred by this Act so as to secure that services are provided in
accordance with this Act.

(3) 10The services provided as part of the health service in England must be
free of charge except in so far as the making and recovery of charges is
expressly provided for by or under any enactment, whenever passed.

2 The Secretary of State’s duty as to improvement in quality of services

After section 1 of the National Health Service Act 2006 insert—

1A 15Duty as to improvement in quality of services

(1) The Secretary of State must exercise the functions of the Secretary of
State in relation to the health service with a view to securing continuous
improvement in the quality of services provided to individuals for or in
connection with—

(a) 20the prevention, diagnosis or treatment of illness, or

(b) the protection or improvement of public health.

(2) In discharging the duty under subsection (1) the Secretary of State
must, in particular, act with a view to securing continuous
improvement in the outcomes that are achieved from the provision of
25the services.

(3) The outcomes relevant for the purposes of subsection (2) include, in
particular, outcomes which show—

(a) the effectiveness of the services,

(b) the safety of the services, and

(c) 30the quality of the experience undergone by patients.

(4) In discharging the duty under subsection (1), the Secretary of State
must have regard to the quality standards prepared by NICE under
section 237 of the Health and Social Care Act 2011.

3 The Secretary of State’s duty as to reducing inequalities

35After section 1A of the National Health Service Act 2006 insert—

1B Duty as to reducing inequalities

In exercising functions in relation to the health service, the Secretary of
State must have regard to the need to reduce inequalities between the
people of England with respect to the benefits that they can obtain from
40the health service.

Health and Social Care BillPage 3

4 The Secretary of State’s duty as to promoting autonomy

After section 1B of the National Health Service Act 2006 insert—

1C Duty as to promoting autonomy

In exercising functions in relation to the health service, the Secretary of
5State must, so far as is consistent with the interests of the health service,
act with a view to securing—

(a) that any other person exercising functions in relation to the
health service or providing services for its purposes is free to
exercise those functions or provide those services in the manner
10that it considers most appropriate, and

(b) that unnecessary burdens are not imposed on any such person.

5 The Secretary of State’s duty as to research

After section 1C of the National Health Service Act 2006, insert—

1D Duty as to research

15“In exercising functions in relation to the health service, the Secretary
of State must have regard to the need to promote—

(a) research on matters relevant to the health service, and

(b) the use in the health service of evidence obtained from
research.

6 20The NHS Commissioning Board

(1) After section 1D of the National Health Service Act 2006 insert—

Role of the Board in the health service in England
1E The National Health Service Commissioning Board and its general
functions

(1) 25There is to be a body corporate known as the National Health Service
Commissioning Board (“the Board”).

(2) The Board is subject to the duty under section 1(1) concurrently with
the Secretary of State except in relation to the part of the health service
that is provided in pursuance of the public health functions of the
30Secretary of State or local authorities.

(3) For the purpose of discharging that duty, the Board—

(a) has the function of arranging for the provision of services for the
purposes of the health service in England in accordance with
this Act, and

(b) 35must exercise the functions conferred on it by this Act in
relation to commissioning consortia so as to secure that services
are provided for those purposes in accordance with this Act.

(4) Schedule A1 makes further provision about the Board.

(5) In this Act—

(a) 40any reference to the public health functions of the Secretary of
State is a reference to the functions of the Secretary of State

Health and Social Care BillPage 4

under sections 2A and 2B and paragraphs 7C, 8 and 12 of
Schedule 1, and

(b) any reference to the public health functions of local authorities
is a reference to the functions of local authorities under sections
52B and 111 and paragraphs 1 to 7B and 13 of Schedule 1.

(2) Before Schedule 1 to that Act, insert the Schedule set out in Schedule 1 to this
Act.

7 Commissioning consortia

After section 1E of the National Health Service Act 2006 insert—

10Role of commissioning consortia in the health service in England
1F Commissioning consortia and their general functions

(1) There are to be bodies corporate known as commissioning consortia
established in accordance with Chapter A2 of Part 2.

(2) Each commissioning consortium has the function of arranging for the
15provision of services for the purposes of the health service in England
in accordance with this Act.

Arrangements for provision of health services

8 The Secretary of State’s duty as to protection of public health

After section 2 of the National Health Service Act 2006 insert—

20Provision for protection or improvement of public health
2A Secretary of State’s duty as to protection of public health

(1) The Secretary of State must take such steps as the Secretary of State
considers appropriate for the purpose of protecting the public in
England from disease or other dangers to health.

(2) 25The steps that may be taken under subsection (1) include—

(a) the conduct of research or such other steps as the Secretary of
State considers appropriate for advancing knowledge and
understanding;

(b) providing microbiological or other technical services (whether
30in laboratories or otherwise);

(c) providing vaccination, immunisation or screening services;

(d) providing other services or facilities for the prevention,
diagnosis or treatment of illness;

(e) providing training;

(f) 35providing information and advice;

(g) making available the services of any person or any facilities.

(3) Subsection (4) applies in relation to any function under this section
which relates to—

Health and Social Care BillPage 5

(a) the protection of the public from ionising or non-ionising
radiation, and

(b) a matter in respect of which the Health and Safety Executive has
a function.

(4) 5In exercising the function, the Secretary of State must—

(a) consult the Health and Safety Executive, and

(b) have regard to its policies.

9 Duties as to improvement of public health

After section 2A of the National Health Service Act 2006 insert—

2B 10Functions of local authorities and Secretary of State as to improvement
of public health

(1) Each local authority must take such steps as it considers appropriate for
improving the health of the people in its area.

(2) The Secretary of State may take such steps as the Secretary of State
15considers appropriate for improving the health of the people of
England.

(3) The steps that may be taken under subsection (1) or (2) include—

(a) providing information and advice;

(b) providing services or facilities designed to promote healthy
20living (whether by helping individuals to address behaviour
that is detrimental to health or in any other way);

(c) providing services or facilities for the prevention, diagnosis or
treatment of illness;

(d) providing financial incentives to encourage individuals to
25adopt healthier lifestyles;

(e) providing assistance (including financial assistance) to help
individuals to minimise any risks to health arising from their
accommodation or environment;

(f) providing or participating in the provision of training for
30persons working or seeking to work in the field of health
improvement;

(g) making available the services of any person or any facilities.

(4) The steps that may be taken under subsection (1) also include
providing grants or loans (on such terms as the local authority
35considers appropriate).

(5) In this section, “local authority” means—

(a) a county council in England;

(b) a district council in England, other than a council for a district
in a county for which there is a county council;

(c) 40a London borough council;

(d) the Council of the Isles of Scilly;

(e) the Common Council of the City of London.

10 Duties of consortia as to commissioning certain health services

(1) Section 3 of the National Health Service Act 2006 is amended as follows.

Health and Social Care BillPage 6

(2) In subsection (1)—

(a) for the words from the beginning to “reasonable requirements”
substitute “A commissioning consortium must arrange for the
provision of the following to such extent as it considers necessary to
5meet the reasonable requirements of the persons for whom it has
responsibility”, and

(b) in each of paragraphs (d) and (e) for the words “as he considers”
substitute “as the consortium considers”.

(3) After that subsection insert—

(1A) 10For the purposes of this section, a commissioning consortium has
responsibility for—

(a) persons who are provided with primary medical services by a
member of the consortium, and

(b) persons who usually reside in the consortium’s area and are not
15provided with primary medical services by a member of any
consortium.

(1B) Regulations may provide that for the purposes of this section a
commissioning consortium also has responsibility (whether generally
or in relation to a prescribed service or facility) for persons who—

(a) 20were provided with primary medical services by a person who
is or was a member of the consortium, or

(b) have a prescribed connection with the consortium’s area.

(1C) The power conferred by subsection (1B)(b) must be exercised so as to
provide that, in relation to the provision of services or facilities for
25emergency care, a commissioning consortium has responsibility for
every person present in its area.

(1D) Regulations may provide that subsection (1A) does not apply—

(a) in relation to persons of a prescribed description (which may
include a description framed by reference to the primary
30medical services with which the persons are provided);

(b) in prescribed circumstances.

(1E) The duty in subsection (1) does not apply in relation to a service or
facility if the Board has a duty to arrange for its provision.

(4) Omit subsections (2) and (3).

(5) 35For the heading to section 3 substitute “Duties of consortia as to commissioning
certain health services”.

(6) For the cross-heading preceding section 3 substitute “Arrangements for the
provision of certain health services”.

Health and Social Care BillPage 7

11 Power of consortia as to commissioning certain health services

After section 3 of the National Health Service Act 2006 insert—

3A Power of commissioning consortia to commission certain health
services

(1) 5Each commissioning consortium may arrange for the provision of such
services or facilities as it considers appropriate for the purposes of the
health service that relate to securing improvement—

(a) in the physical and mental health of the persons for whom it has
responsibility, or

(b) 10in the prevention, diagnosis and treatment of illness in those
persons.

(2) A commissioning consortium may not arrange for the provision of a
service or facility under subsection (1) if the Board has a duty to arrange
for its provision by virtue of section 3B or 4.

(3) 15Subsections (1A), (1B) and (1D) of section 3 apply for the purposes of
this section as they apply for the purposes of that section.

12 Power to require Board to commission certain health services

After section 3A of the National Health Service Act 2006 insert—

3B Secretary of State’s power to require Board to commission services

(1) 20Regulations may require the Board to arrange, to such extent as it
considers necessary to meet all reasonable requirements, for the
provision as part of the health service of—

(a) dental services of a prescribed description;

(b) services or facilities for members of the armed forces or their
25families;

(c) services or facilities for persons who are detained in a prison or
in other accommodation of a prescribed description;

(d) such other services or facilities as may be prescribed.

(2) A service or facility may be prescribed under subsection (1)(d) only if
30the Secretary of State considers that it would be appropriate for the
Board (rather than consortia) to arrange for its provision as part of the
health service.

(3) In deciding whether it would be so appropriate, the Secretary of State
must have regard to—

(a) 35the number of individuals who require the provision of the
service or facility;

(b) the cost of providing the service or facility;

(c) the number of persons able to provide the service or facility;

(d) the financial implications for commissioning consortia if they
40were required to arrange for the provision of the service or
facility.

(4) Before deciding whether to make regulations under this section, the
Secretary of State must—

(a) obtain advice appropriate for that purpose, and

Health and Social Care BillPage 8

(b) consult the Board.

(5) The reference in subsection (1)(b) to members of the armed forces is a
reference to persons who are members of—

(a) the regular forces within the meaning of the Armed Forces Act
52006, or

(b) the reserve forces within the meaning of that Act.

13 Secure psychiatric services

(1) Section 4 of the National Health Service Act 2006 (high security psychiatric
services) is amended as follows.

(2) 10In subsection (1) for the words from the beginning to “duty to provide”
substitute “The Board must arrange for the provision of”.

(3) In subsection (3)—

(a) after “may be provided” insert

(a), and

(b) 15after paragraph (a) insert , and

(b) only by a person approved by the Secretary of State for
the purposes of this subsection.

(4) After subsection (3) insert—

(3A) The Secretary of State may—

(a) 20give directions to a person who provides high security
psychiatric services about the provision by that person of those
services;

(b) give directions to the Board about the exercise of its functions in
relation to high security psychiatric services.

14 25Other services etc. provided as part of the health service

(1) In section 5 of the National Health Service Act 2006 (other services) for “about
the Secretary of State and services under this Act” substitute “about the
provision of services for the purposes of the health service in England”.

(2) Schedule 1 to that Act is amended as follows.

(3) 30In paragraph 1 (medical inspection of pupils)—

(a) for “The Secretary of State” substitute “A local authority”, and

(b) for “local authorities” substitute “the local authority”.

(4) In paragraph 2—

(a) in sub-paragraph (1)—

(i) 35for “The Secretary of State” substitute “A local authority”, and

(ii) omit “, by arrangement with any local authority,”,

(b) in sub-paragraph (2)—

(i) for “The Secretary of State” substitute “A local authority”,

(ii) after “educational establishment” insert “in its area”, and

(iii) 40for “a local authority” substitute “the local authority”, and

(c) omit sub-paragraph (3).

(5) In paragraph 4—

Health and Social Care BillPage 9

(a) for “A local authority may not make an arrangement” substitute “A
local authority may not provide for any medical inspection or
treatment”, and

(b) for “the arrangement” substitute “the inspection or (as the case may be)
5treatment”.

(6) In paragraph 5—

(a) omit sub-paragraph (1)(a) and the word “and” immediately following
it,

(b) in sub-paragraph (2) omit “local authority or”,

(c) 10for “the Secretary of State” substitute “a local authority”, and

(d) for “him” substitute “it”.

(7) In paragraph 6 after “to 5” insert

(a) any reference to medical inspection or medical treatment
includes dental inspection or (as the case may be) dental
15treatment; and

(b).

(8) In paragraph 7A (weighing and measuring of children)—

(a) for “The Secretary of State” (in each place it occurs) substitute “A local
authority”,

(b) 20in sub-paragraph (1) omit “, by arrangement with any local authority,”,
and

(c) in sub-paragraph (2) —

(i) after “any school” insert “in its area”, and

(ii) for “a local authority” substitute “the local authority”.

(9) 25In paragraph 7B (regulations as to weighing and measuring of children)—

(a) in sub-paragraph (1)(b) for “by the Secretary of State” substitute “by a
local authority”, and

(b) in sub-paragraph (1)(d) for “by the Secretary of State” substitute “by a
local authority”.

(10) 30After paragraph 7B insert—

Supply of blood and other human tissues

7C The Secretary of State must for the purposes of the health service
make arrangements for—

(a) collecting, screening, analysing, processing and supplying
35blood or other tissues,

(b) preparing blood components and reagents, and

(c) facilitating tissue and organ transplantation.

(11) In paragraph 9 (provision of vehicles for disabled persons)—

(a) the existing text becomes sub-paragraph (1),

(b) 40in that sub-paragraph—

(i) for “The Secretary of State may provide” substitute “A
commissioning consortium may make arrangements for the
provision of”, and

(ii) for “persons appearing to him to be persons who have a
45physical impairment” substitute “persons for whom the

Previous Next

Contents page 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100-109 Last page