services (including functions which the Board has been directed to
exercise under subsection (1)).

(3) The Board may direct a clinical commissioning group to exercise any of
the Board’s functions relating to the provision of primary medical
5services.

(4) The Board may give directions to a clinical commissioning group about
the exercise by it of any functions relating to the provision of primary
medical services (including functions which the group has been
directed to exercise under subsection (3)).

(5) 10Subsection (3) does not apply to such functions, or functions of such
descriptions, as may be prescribed.

(6) Where the Board gives a direction under subsection (3) or (4), it may
disclose to the clinical commissioning group information it has about
the provision of the primary medical services in question, if the Board
15considers it necessary or appropriate to do so in order to enable or assist
the group to exercise the function specified in the direction.

(7) A clinical commissioning group exercising a function specified in a
direction under subsection (3) or (4) must report to the Board on
matters arising out of the group’s exercise of the function.

(8) 20A report under subsection (7) must be made in such form and manner
as the Board may specify.

(9) The Board may, in exercising its functions relating to the provision of
the primary medical services in question, have regard to a report under
subsection (7).”

(2) 25After section 114 of that Act insert—

“Directions

114A Exercise of functions

(1) The Secretary of State may direct the Board to exercise any of the
Secretary of State’s functions relating to the provision of primary dental
30services.

(2) The Secretary of State may give directions to the Board about its
exercise of any functions relating to the provision of primary dental
services (including functions which the Board has been directed to
exercise under subsection (1)).”

(3) 35After section 125 of that Act insert—

“Directions

125A Exercise of functions

(1) The Secretary of State may direct the Board to exercise any of the
Secretary of State’s functions relating to the provision of primary
40ophthalmic services.

(2) The Secretary of State may give directions to the Board about its
exercise of any functions relating to the provision of primary

ophthalmic services (including functions which the Board has been
directed to exercise under subsection (1)).

(3) The Board may direct a clinical commissioning group, a Special Health
Authority or such other body as may be prescribed to exercise any of
5the Board’s functions relating to the provision of primary ophthalmic
services.

(4) The Board may give directions to a clinical commissioning group, a
Special Health Authority or such other body as may be prescribed
about the exercise by the body of any functions relating to the provision
10of primary ophthalmic services (including functions which it has been
directed to exercise under subsection (3)).

(5) Subsection (3) does not apply to such functions, or functions of such
descriptions, as may be prescribed.

(6) Where the Board gives a direction to a body under subsection (3) or (4),
15it may disclose to the body the information it has about the provision of
the primary ophthalmic services in question, if the Board considers it
necessary or appropriate to do so in order to enable or assist the body
to exercise the function specified in the direction.

(7) A body which is given a direction under subsection (3) or (4) must
20report to the Board on matters arising out of the exercise of the function
to which the direction relates.

(8) A report under subsection (7) must be made in such form and manner
as the Board may specify.

(9) The Board may, in exercising its functions relating to the provision of
25the primary ophthalmic services in question, have regard to a report
under subsection (7).”

(4) After section 168 of that Act insert—

“Directions

168A Exercise of functions

(1) 30The Secretary of State may direct the Board to exercise any of the
Secretary of State’s functions relating to services that may be provided
as pharmaceutical services, or as local pharmaceutical services, under
this Part.

(2) The Secretary of State may give directions to the Board about its
35exercise of any functions relating to pharmaceutical services or to local
pharmaceutical services (including functions which the Board has been
directed to exercise under subsection (1)).”

47 Charges in respect of certain public health functions

(1) After section 186 of the National Health Service Act 2006 insert—

“186A 40 Charges in respect of public health functions

(1) The Secretary of State may make charges under this subsection in
respect of any step taken under section 2A.

(2) The power conferred by subsection (1) does not apply in respect of the
provision of a service or facility to an individual, or the taking of any
other step in relation to an individual, for the purpose of protecting the
individual’s health.

(3) 5Charges under subsection (1) may be calculated on such basis as the
Secretary of State considers appropriate.

(4) Regulations may provide for the making and recovery of charges in
respect of—

(a) the taking of prescribed steps by a local authority under section
102A (by virtue of regulations under section 6C(1)), and

(b) the taking of prescribed steps by a local authority under section
2B.

(5) Regulations under subsection (4) may make provision as to the
calculation of charges authorised by the regulations, including
15provision prescribing the amount or the maximum amount that may be
charged.

(6) Nothing in this section affects any other power conferred by or under
this Act to make charges.”

(2) In section 272 of that Act (orders, regulations, rules and directions), in
20subsection (6) after paragraph (zc) insert—

“(zd) regulations under section 186A(4),”.

48 Pharmaceutical services expenditure

(1) After section 165 of the National Health Service Act 2006 insert—

“165A Pharmaceutical remuneration: further provision

(1) 25The Board must provide the Secretary of State with such information
relating to the remuneration paid by the Board to persons providing
pharmaceutical services or local pharmaceutical services as the
Secretary of State may require.

(2) The information must be provided in such form, and at such time or
30within such period, as the Secretary of State may require.

(3) Schedule 12A makes further provision about pharmaceutical
remuneration.”

(2) After Schedule 12 to that Act insert the Schedule set out in Schedule 3 to this
Act.

49 35Secretary of State’s duty to keep health service functions under review

In Part 13 of the National Health Service Act 2006, before section 248 (and the
cross-heading preceding it) insert—

“Duty to keep under review

247B Secretary of State’s duty to keep health service functions under review

(1) The Secretary of State must keep under review the effectiveness of the
exercise by the bodies mentioned in subsection (2) of functions in
5relation to the health service in England.

(2) The bodies mentioned in this subsection are—

(a) the Board;

(b) Monitor;

(c) the Care Quality Commission;

(d) 10the National Institute for Health and Care Excellence;

(e) the Health and Social Care Information Centre;

(f) Special Health Authorities.

(3) The Secretary of State may include in an annual report under section
247C the Secretary of State’s views on the effectiveness of the exercise
15by the bodies mentioned in subsection (2) of functions in relation to the
health service.”

50 Secretary of State’s annual report

In Part 13 of the National Health Service Act 2006 before section 248 (and the
cross-heading preceding it) insert—

20“Annual report

247C Secretary of State’s annual report

(1) The Secretary of State must publish an annual report on the
performance of the health service in England.

(2) The Secretary of State must lay any report prepared under this section
25before Parliament.”

51 Certification of death

(1) Chapter 2 of Part 1 of the Coroners and Justice Act 2009 (notification,
certification and registration of deaths) is amended as follows.

(2) In section 19 (medical examiners)—

(a) 30in subsection (1) for “Primary Care Trusts” substitute “Local
authorities”,

(b) in subsection (2) for “Trust” (in each place where it occurs) substitute
“local authority”, and

(c) in subsection (5) for “a Primary Care Trust” substitute “a local
35authority”.

(3) In section 20 (medical certificate of cause of death), in subsection (5) for
“Primary Care Trust” substitute “local authority”.

52 Amendments related to Part 1 and transitional provision

(1) Schedule 4 (which makes further amendments of the National Health Service
40Act 2006 in consequence of the provision made by this Part) has effect.

(2) Schedule 5 (which makes amendments of other enactments in consequence of
the provision made by this Part) has effect.

(3) Schedule 6 (which makes transitional provision in connection with this Part)
has effect.

5Part 2 Further provision about public health

53 Abolition of Health Protection Agency

(1) The Health Protection Agency is abolished.

(2) The Health Protection Agency Act 2004 is repealed.

(3) 10Subsection (2) does not apply to—

(a) paragraph 3 of Schedule 3 to that Act (which amends Schedule 2 to the
Immigration Act 1971), and

(b) section 11(1) of that Act so far as it gives effect to that paragraph.

(4) Schedule 7 (which makes amendments of other enactments in consequence of
15the provision made by this section) has effect.

54 Functions in relation to biological substances

(1) The appropriate authority must—

(a) devise standards for the purity and potency of biological substances,

(b) prepare, approve, hold and distribute standard preparations of
20biological substances,

(c) design appropriate procedures for testing biological substances,

(d) provide or arrange for the provision of laboratory facilities for testing
biological substances,

(e) carry out tests on biological substances,

(f) 25examine records kept in connection with the manufacture and quality
control of biological substances,

(g) report on the results of tests or examinations conducted in pursuance
of paragraph (e) or (f), and

(h) carry out or arrange for the carrying out of such research, or provide or
30arrange for the provision of such information or training, as it considers
appropriate in connection with the functions mentioned in paragraphs
(a) to (g).

(2) The appropriate authority may do anything which it considers is appropriate
for facilitating, or incidental or conducive to, the exercise of any of its functions
35under this section.

(3) Subsections (4) and (5) apply to any person that exercises functions similar to
those of the appropriate authority under this section (whether or not in relation
to the United Kingdom).

(4) The appropriate authority must co-operate with the person in the exercise of
40those functions.

(5) The person must co-operate with the appropriate authority in the exercise of
the authority’s functions under this section.

(6) The appropriate authority may make charges (whether or not on a commercial
basis) in respect of anything done by it under this section.

(7) In this section—

• “appropriate authority” means the Secretary of State and the Department
  5of Health, Social Services and Public Safety in Northern Ireland acting
  jointly;

• “biological substance” means a substance whose purity or potency
  cannot, in the opinion of the Secretary of State, be adequately tested by
  chemical means.

55 10Radiation protection functions

(1) The appropriate authority must take such steps as it considers appropriate for
the purposes of protecting the public from radiation (whether ionising or not).

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

(a) the conduct of research or such other steps as the appropriate authority
15considers appropriate for advancing knowledge and understanding;

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

(c) providing services for the prevention, diagnosis or treatment of illness
arising from exposure to radiation;

(d) providing training;

(e) 20providing information and advice;

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

(3) The appropriate authority may do anything which it considers appropriate for
facilitating, or incidental or conducive to, the exercise of any of its functions
under this section.

(4) 25The appropriate authority may make charges (whether or not on a commercial
basis) in respect of anything done by it under this section.

(5) In the exercise of any function under this section which relates to a matter in
respect of which a Health and Safety body has a function, the appropriate
authority must—

(a) 30consult the body, and

(b) have regard to the body’s policies.

(6) Each of the following is a Health and Safety body—

(a) the Health and Safety Executive;

(b) the Health and Safety Executive for Northern Ireland.

(7) 35In subsection (2)(f), “facilities” has the same meaning as in the National Health
Service Act 2006.

(8) In this section, “the appropriate authority” means—

(a) the Scottish Ministers to the extent that the functions are exercisable
within devolved competence (within the meaning of the Scotland Act
401998);

(b) the Department of Health, Social Services and Public Safety in
Northern Ireland to the extent that the functions relate to a transferred
matter (within the meaning of the Northern Ireland Act 1998);

(c) the Secretary of State in any other case.

(9) In this section, “the public” means—

(a) where the appropriate authority is the Secretary of State, the public in
Wales, Scotland and Northern Ireland,

(b) where the appropriate authority is the Scottish Ministers, the public in
5Scotland, and

(c) where the appropriate authority is the Department of Health, Social
Services and Public Safety in Northern Ireland, the public in Northern
Ireland.

(10) This section does not apply in relation to England.

56 10Repeal of AIDS (Control) Act 1987

(1) The AIDS (Control) Act 1987 is repealed.

(2) The AIDS (Control) (Northern Ireland) Order 1987 (S.I. 1987/1832 (N.I. 18)S.I. 1987/1832 (N.I. 18)) is
revoked.

57 Co-operation with bodies exercising functions in relation to public health

(1) 15In Part 13 of the National Health Service Act 2006, before section 248 (and the
cross-heading preceding it) insert—

“Co-operation in relation to public health functions

247A Co-operation in relation to public health functions

(1) This section applies to any body or other person that exercises functions
20similar to those of the Secretary of State under section 2A (whether or
not in relation to the United Kingdom).

(2) The Secretary of State must co-operate with the body or other person in
the exercise by it of those functions.

(3) If the Secretary of State acts under subsection (2) at the request of the
25body or other person, the Secretary of State may impose charges in
respect of any costs incurred by the Secretary of State in doing so.

(4) The body or other person must co-operate with the Secretary of State in
the exercise by the Secretary of State of functions under section 2A.

(5) If the body or other person acts under subsection (4) at the request of
30the Secretary of State, it may impose charges in respect of any costs
incurred by it in doing so.”

(2) In section 271 of that Act (territorial limit of exercise of functions), in subsection
(3) after paragraph (d) insert—

“(da) section 247A (co-operation in relation to public health
35functions),”.

Part 3 Regulation of health and adult social care services

CHAPTER 1 Monitor

58 Monitor

(1) 5The body corporate known as the Independent Regulator of NHS Foundation
Trusts—

(a) is to continue to exist, and

(b) is to be known as Monitor.

(2) Schedule 8 (which makes further provision about Monitor) has effect.

59 10General duties

(1) The main duty of Monitor in exercising its functions is to protect and promote
the interests of people who use health care services by promoting provision of
health care services which—

(a) is economic, efficient and effective, and

(b) 15maintains or improves the quality of the services.

(2) In carrying out its main duty, Monitor must have regard to the likely future
demand for health care services.

(3) Monitor must exercise its functions with a view to preventing anti-competitive
behaviour in the provision of health care services for the purposes of the NHS
20which is against the interests of people who use such services.

(4) Monitor must exercise its functions with a view to enabling health care services
provided for the purposes of the NHS to be provided in an integrated way
where it considers that this would—

(a) improve the quality of those services (including the outcomes that are
25achieved from their provision) or the efficiency of their provision,

(b) reduce inequalities between persons with respect to their ability to
access those services, or

(c) reduce inequalities between persons with respect to the outcomes
achieved for them by the provision of those services.

(5) 30Monitor must exercise its functions with a view to enabling the provision of
health care services provided for the purposes of the NHS to be integrated with
the provision of health-related services or social care services where it
considers that this would—

(a) improve the quality of those health care services (including the
35outcomes that are achieved from their provision) or the efficiency of
their provision,

(b) reduce inequalities between persons with respect to their ability to
access those health care services, or

(c) reduce inequalities between persons with respect to the outcomes
40achieved for them by the provision of those health care services.

(6) Monitor must, in carrying out its duties under subsections (4) and (5), have
regard to the way in which—

(a) the National Health Service Commissioning Board carries out its duties
under section 13M of the National Health Service Act 2006, and

(b) 5clinical commissioning groups carry out their duties under section 14Y
of that Act.

(7) Monitor must secure that people who use health care services, and other
members of the public, are involved to an appropriate degree in decisions that
Monitor makes about the exercise of its functions (other than decisions it makes
10about the exercise of its functions in a particular case).

(8) Monitor must obtain advice appropriate for enabling it effectively to discharge
its functions from persons who (taken together) have a broad range of
professional expertise in—

(a) the prevention, diagnosis or treatment of illness (within the meaning of
15the National Health Service Act 2006), and

(b) the protection or improvement of public health.

(9) Monitor must exercise its functions in a manner consistent with the
performance by the Secretary of State of the duty under section 1(1) of the
National Health Service Act 2006 (promotion of comprehensive health service).

(10) 20Monitor must not exercise its functions for the purpose of causing a variation
in the proportion of health care services provided for the purposes of the NHS
that is provided by persons of a particular description if that description is by
reference to—

(a) whether the persons in question are in the public or (as the case may be)
25private sector, or

(b) some other aspect of their status.

(11) In this section—

• “health-related services” means services that may have an effect on
  people’s health but are not health care services or social care services;

• 30“social care services” means services that are provided in pursuance of the
  social services functions of local authorities (within the meaning of the
  Local Authority Social Services Act 1970).

60 General duties: supplementary

(1) This section applies for the purposes of this Part.

(2) 35“Anti-competitive behaviour” means behaviour which would (or would be
likely to) prevent, restrict or distort competition and a reference to preventing
anti-competitive behaviour includes a reference to eliminating or reducing the
effects (or potential effects) of the behaviour.

(3) “Health care” means all forms of health care provided for individuals, whether
40relating to physical or mental health, with a reference in this Part to health care
services being read accordingly; and for the purposes of this Part it does not
matter if a health care service is also an adult social care service (as to which,
see section 61).

(4) “The NHS” means the comprehensive health service continued under section
451(1) of the National Health Service Act 2006, except the part of it that is

provided in pursuance of the public health functions (within the meaning of
that Act) of the Secretary of State or local authorities.

(5) A reference to the provision of health care services for the purposes of the NHS
is a reference to their provision for those purposes in accordance with that Act.

(6) 5Nothing in section 59 requires Monitor to do anything in relation to the supply
to persons who provide health care services of goods that are to be provided as
part of those services.

61 Power to give Monitor functions relating to adult social care services

(1) Regulations may provide for specified functions of Monitor also to be
10exercisable in relation to adult social care services.

(2) Any regulations under this section must apply in relation to England only.

(3) The regulations may amend this Part.

(4) “Adult social care”—

(a) includes all forms of personal care and other practical assistance
15provided for individuals who by reason of age, illness, disability,
pregnancy, childbirth, dependence on alcohol or drugs, or any other
similar circumstances, are in need of such care or other assistance, but

(b) does not include anything provided by an establishment or agency for
which Her Majesty’s Chief Inspector of Education, Children’s Services
20and Skills is the registration authority under section 5 of the Care
Standards Act 2000.

62 Matters to have regard to in exercise of functions

In exercising its functions, Monitor must have regard to—

(a) the need to maintain the safety of people who use health care services,

(b) 25the desirability of securing continuous improvement in the quality of
health care services for the purposes of the NHS,

(c) the desirability of securing continuous improvement in the efficiency
with which health care services are provided for the purposes of the
NHS,

(d) 30the need for commissioners of health care services for the purposes of
the NHS to ensure that the provision of access to the services for those
purposes operates fairly,

(e) the need for commissioners of health care services for the purposes of
the NHS to ensure that people who require health care services for
35those purposes are provided with access to them,

(f) the need for commissioners of health care services for the purposes of
the NHS to make the best use of resources when doing so,

(g) the desirability of persons who provide health care services for the
purposes of the NHS co-operating with each other in order to improve
40the quality of health care services provided for those purposes,

(h) the desirability of promoting investment by persons who provide
health care services for the purposes of the NHS in the provision of
health care services for those purposes,

(i) the need to promote research into matters relevant to the NHS by
45persons who provide health care services for the purposes of the NHS,