Health and Social Care Bill (HL Bill 92)

subsection (2) —

(a) for paragraph (a) substitute—

“(a) the Secretary of State may—

(i) determine the terms of the arrangements as the
5Secretary of State sees fit; or

(ii) refer the matter for determination by such other person
as the Secretary of State considers appropriate; and”,
and”

(b) omit paragraph (b).

(11) 10In that section, in subsection (4) for the words from the beginning to “section
87(8)(b) or (10)” substitute “Where a combined reference is made under section
87(7C)(b) or 87(7F)”.

(12) In section 87C (fluoridation arrangements: compliance), omit subsection (8).

(13) In section 89—

(a) 15in the heading, after “Consultation” insert “:Wales”,

(b) in subsections (1) and (4) for “a relevant authority” substitute “the
Welsh Ministers”,

(c) in subsection (1) for “the appropriate authority” (in each place where it
occurs) substitute “the Welsh Ministers”,

(d) 20in subsection (3), in paragraph (a) for “relevant authorities” substitute
“the Welsh Ministers”,

(e) in subsection (4) for “the appropriate authority so directs” substitute
“the Welsh Ministers so direct”, and

(f) omit subsection (5).

(14) 25In section 90A (review of fluoridation) after subsection (5) insert—

“(5A) The relevant authority must, in exercising its functions under
subsection (1)—

(a) consult any local authority affected by the arrangements at such
times as the relevant authority considers appropriate, and

(b) 30in particular, consult any such local authority before it
publishes a report under paragraph (b) of that subsection.”

33 Procedural requirements in connection with fluoridation of water supplies

After section 88A of the Water Industry Act 1991 insert—

“88B Requirement for fluoridation proposal: England

(1) 35The Secretary of State may not request a water undertaker to enter into
arrangements under section 87(1) unless a fluoridation proposal is
made to the Secretary of State.

(2) A fluoridation proposal is a proposal that the Secretary of State enter
into arrangements with one or more water undertakers to increase the
40fluoride content of the water supplied by the undertaker or undertakers
to premises within such area or areas in England as may be specified in
the proposal.

(3) A fluoridation proposal may be made by one or more local authorities
in England.

(4) A local authority may not make a fluoridation proposal unless its area
includes, coincides with or is wholly or partly within the area, or at least
one of the areas, specified in the proposal.

(5) In the following provisions of this Chapter, “proposer”, in relation to a
5fluoridation proposal, means the local authority or authorities which
made the proposal.

(6) Any reference in the following provisions of this Chapter to a local
authority affected by a fluoridation proposal is a reference to a local
authority whose area includes, coincides with or is wholly or partly
10within the area, or at least one of the areas, specified in the proposal.

88C Initial consultation etc. on fluoridation proposal

(1) This section applies if a fluoridation proposal is made.

(2) The proposer must consult the Secretary of State as to whether the
arrangements which would result from implementing the proposal
15would be operable and efficient.

(3) The proposer must consult each water undertaker who supplies water
to premises within the area or areas specified in the proposal as to
whether the arrangements which would result from implementing the
proposal, insofar as they might affect the undertaker, would be
20operable and efficient.

(4) Each person consulted under subsection (2) or (3) must give the
proposer its opinion on the matter mentioned in that subsection.

(5) The proposer must notify the Secretary of State of the opinion of each
water undertaker consulted under subsection (3).

(6) 25If the Secretary of State informs the proposer that the Secretary of State
is of the opinion that the arrangements would not be operable and
efficient, no further steps may be taken in relation to the proposal.

88D Additional requirements where other local authorities affected

(1) This section applies where—

(a) 30a fluoridation proposal is made,

(b) the Secretary of State is of the opinion that the arrangements
which would result from implementing the proposal would be
operable and efficient,

(c) one or more local authorities other than the proposer are
35affected by the proposal, and

(d) the proposer wishes to take further steps in relation to the
proposal.

(2) The proposer must notify any other local authority which is affected by
the proposal.

(3) 40The proposer must make arrangements for enabling the authorities
affected by the proposal to decide whether further steps should be
taken in relation to the proposal.

(4) The Secretary of State must by regulations—

(a) make provision as to the arrangements which must be made for
45the purposes of subsection (3), and

(b) prescribe conditions, with respect to the outcome of the
arrangements, which must be satisfied before any further steps
may be taken in relation to the proposal.

88E Decision on fluoridation proposal

(1) 5This section applies where—

(a) a fluoridation proposal is made,

(b) the Secretary of State is of the opinion that the arrangements
which would result from implementing the proposal would be
operable and efficient,

(c) 10in a case where section 88D applies, the conditions prescribed
under subsection (4)(b) of that section are satisfied, and

(d) the proposer wishes to take further steps in relation to the
proposal.

(2) The proposer must comply with such requirements as may be
15prescribed in regulations made by the Secretary of State as to the steps
to be taken for the purposes of consulting and ascertaining opinion in
relation to the proposal.

(3) The proposer may (after any requirements imposed by regulations
under subsection (2) have been complied with) modify the proposal.

(4) 20But the proposal may not be modified so as to extend the boundary of
any area to which it relates, or to add another area, except in
circumstances prescribed in regulations by the Secretary of State.

(5) The proposer must (after any requirements imposed by regulations
under subsection (2) have been complied with) decide whether to
25request the Secretary of State to make such requests under section 87(1)
as are necessary to implement the proposal.

(6) The Secretary of State may by regulations make provision—

(a) as to factors which the proposer must or may take into account
in making the decision mentioned in subsection (5);

(b) 30as to the procedure to be followed by the proposer in exercising
functions under or by virtue of subsection (2) or (5).

88F Decision-making procedure: exercise of functions by committee

(1) This section applies in relation to the exercise of functions under or by
virtue of section 88E(2) to (5) (“the fluoridation functions”) except
35where the proposer is a single local authority and either—

(a) no other local authorities are affected by the proposal, or

(b) no other local authority which is affected by the proposal
informs the proposer that it wishes to participate in the exercise
of the fluoridation functions.

(2) 40The local authorities affected by the proposal must—

(a) arrange for an existing joint committee of the authorities to
exercise the fluoridation functions,

(b) establish a joint committee of the authorities for that purpose, or

(c) arrange for the Health and Wellbeing Boards established by
45them under section 191 of the Health and Social Care Act 2011
to exercise the fluoridation functions.

(a)(a)arrange for an existing joint committee of the authorities to
exercise the fluoridation functions,

(b) establish a joint committee of the authorities for that purpose, or

(c) 50arrange for the Health and Wellbeing Boards established by
them under section 191 of the Health and Social Care Act 2011
to exercise the fluoridation functions.

(3) Where arrangements are made under subsection (2)(c) the Health and
Wellbeing Boards in question must exercise the power conferred by
section 195(b) of the Health and Social Care Act 2011 to establish a joint
sub-committee of the Boards to exercise the fluoridation functions.

(4) 5The Secretary of State may by regulations make provision—

(a) for subsection (2)(a) to apply only in relation to a joint
committee which meets prescribed conditions as to its
membership;

(b) as to the membership of a joint committee established under
10subsection (2)(b) (including provision as to qualification and
disqualification for membership and the holding and vacating
of office as a member);

(c) as to the membership of a joint sub-committee of Health and
Wellbeing Boards established in accordance with subsection (3);

(d) 15as to the procedure to be followed by any joint committee, or
any joint sub-committee of Health and Wellbeing Boards, in
exercising the fluoridation functions.

88G Secretary of State’s duty in relation to fluoridation proposal

(1) This section applies if the Secretary of State is requested to make such
20requests under section 87(1) as are necessary to implement a
fluoridation proposal.

(2) The Secretary of State must comply with the request if the Secretary of
State is satisfied that the requirements imposed by sections 88B to 88F
have been met in relation to the proposal.

(3) 25Subsection (2) does not require the Secretary of State to consider the
adequacy of any steps taken for the purposes of complying with any
requirement to consult or to ascertain opinion which is imposed under
or by virtue of section 88C(2) or (3), 88D(3) or 88E(2).

88H Payments by local authorities towards fluoridation costs

(1) 30This section applies where a water undertaker enters into
arrangements with the Secretary of State under section 87(1).

(2) The Secretary of State may require all local authorities affected by the
arrangements to make payments to the Secretary of State to meet any
costs incurred by the Secretary of State under the terms of the
35arrangements.

(3) The amount to be paid by each of the affected local authorities is to be
determined—

(a) where a joint committee, or a joint sub-committee of Health and
Wellbeing Boards, has exercised the fluoridation functions of
40the authorities in relation to the proposal which resulted in the
arrangements being made and the committee or sub-committee
continues to exist at the time when the Secretary of State
exercises the power conferred by subsection (2), by that
committee or sub-committee;

(b) 45in any other case, by agreement between the local authorities.

(4) If the amount to be paid by the affected local authorities is not
determined as mentioned in subsection (3), the Secretary of State
may—

(a) determine the amount to be paid, or

(b) 5refer the matter for determination by such other person as the
Secretary of State considers appropriate.

(5) The amount determined in accordance with subsection (3) may, at the
request of one or more of the affected local authorities, be varied with
the agreement of all of them.

(6) 10If the affected local authorities fail to reach agreement for the purposes
of subsection (5), the Secretary of State may—

(a) determine whether to vary the amount (and, if so, how), or

(b) refer the matter for determination by such other person as the
Secretary of State considers appropriate.

(7) 15Any reference in this section to a local authority affected by
arrangements under section 87(1) is a reference to a local authority
whose area includes, coincides with or is wholly or partly within the
area specified in the arrangements.

88I Variation or termination of arrangements under section 87(1)

(1) 20The Secretary of State may not request a water undertaker to vary
arrangements entered into by the water undertaker under section 87(1)
unless a proposal (“a variation proposal”) is made to the Secretary of
State for a variation in the arrangements.

(2) The Secretary of State may not give notice to a water undertaker under
25section 87C(7) to terminate arrangements entered into by the water
undertaker under section 87(1) unless a proposal (“a termination
proposal”) is made to the Secretary of State for the termination of the
arrangements.

(3) Subsection (1) does not apply in relation to a variation to provide for the
30concentration of fluoride in the area specified in the arrangements (or
any part of it) to be lower than the general target concentration.

(4) The Secretary of State may by regulations provide that subsection (1) or
(2) does not apply in prescribed circumstances.

(5) A variation or termination proposal may be made by one or more of the
35local authorities affected by the arrangements.

(6) The Secretary of State may by regulations provide that, where a
termination proposal is made in relation to arrangements under section
87(1), no further termination proposal may be made in relation to the
arrangements until the end of such period as may be specified in the
40regulations.

(7) In the following provisions of this Chapter, “proposer”, in relation to a
variation or termination proposal, means the local authority or
authorities which made the proposal.

(8) Any reference in this section and in the following provisions of this
45Chapter to a local authority affected by a variation or termination
proposal is a reference to a local authority whose area includes,

coincides with or is wholly or partly within the area specified in the
arrangements.

(9) In relation to a proposal for the variation of the area specified in
arrangements under section 87(1), any reference in this section and in
5the following provisions of this Chapter to a local authority affected by
the proposal also includes a reference to a local authority whose area
would include, coincide with or be wholly or partly within the area
specified in the arrangements if the variation were made.

88J Initial consultation etc. on variation or termination proposal

(1) 10This section applies if a variation or termination proposal is made.

(2) In the case of a variation proposal, the proposer must consult the
Secretary of State and the water undertaker who entered into the
arrangements as to whether the arrangements as varied in accordance
with the proposal would be operable and efficient.

(3) 15In the case of a termination proposal, the proposer must consult the
Secretary of State and the water undertaker who entered into the
arrangements as to whether it would be reasonably practicable to
terminate the arrangements.

(4) Each person consulted under subsection (2) or (3) must give the
20proposer its opinion on the matter mentioned in that subsection.

(5) The proposer must notify the Secretary of State of the opinion of each
water undertaker consulted under subsection (2) or (3).

(6) If the Secretary of State informs the proposer that the Secretary of State
is of the opinion that the arrangements as varied would not be operable
25and efficient or (as the case may be) that it would not be reasonably
practicable to terminate the arrangements, no further steps may be
taken in relation to the proposal.

88K Additional requirements where other local authorities affected

(1) This section applies where—

(a) 30a variation or termination proposal is made,

(b) the Secretary of State is of the opinion that the arrangements as
varied would be operable and efficient or (as the case may be)
that it would be reasonably practicable to terminate the
arrangements,

(c) 35one or more local authorities other than the proposer are
affected by the proposal, and

(d) the proposer wishes to take further steps in relation to the
proposal.

(2) The proposer must notify any other local authority which is affected by
40the proposal.

(3) The proposer must make arrangements for enabling the authorities
affected by the proposal to decide whether further steps should be
taken in relation to the proposal.

(4) The Secretary of State may by regulations provide that the duty in
45subsection (3) does not apply in prescribed circumstances.

(5) The duty in subsection (3) does not apply in relation to a termination
proposal if the Secretary of State so directs by an instrument in writing
(and such a direction may apply generally or in relation to a particular
proposal).

(6) 5The Secretary of State must by regulations—

(a) make provision as to the arrangements which must be made for
the purposes of subsection (3), and

(b) prescribe conditions, with respect to the outcome of the
arrangements, which must be satisfied before any further steps
10may be taken in relation to the proposal.

88L Decision on variation or termination proposal

(1) This section applies where—

(a) a variation or termination proposal is made,

(b) the Secretary of State is of the opinion that the arrangements
15which would result from implementing the proposal would be
operable and efficient or (as the case may be) that it would be
reasonably practicable to terminate the arrangements,

(c) in a case where the duty in section 88K(3) applies, the
conditions prescribed under subsection (6)(b) of that section are
20satisfied, and

(d) the proposer wishes to take further steps in relation to the
proposal.

(2) The proposer must comply with such requirements as may be
prescribed in regulations made by the Secretary of State as to the steps
25to be taken for the purposes of consulting and ascertaining opinion in
relation to the proposal.

(3) The Secretary of State may by regulations provide that the duty in
subsection (2) does not apply in prescribed circumstances.

(4) The duty in subsection (2) does not apply in relation to a termination
30proposal if the Secretary of State so directs by an instrument in writing
(and such a direction may apply generally or in relation to a particular
termination proposal).

(5) The proposer of a variation proposal may (after any requirements
imposed by regulations under subsection (2) have been complied with)
35modify the proposal.

(6) But, except in circumstances prescribed in regulations by the Secretary
of State, the proposal may not be modified so as to propose the
extension of the boundary of the area specified in the arrangements or,
if the proposal is that the arrangements be varied so as to extend the
40boundary, may not be modified so as to propose a further extension of
it.

(7) The proposer must (after any requirements imposed by regulations
under subsection (2) have been complied with) decide whether to
request the Secretary of State to request the water undertaker to vary
45the arrangements or (as the case may be) to give notice under section
87C(7) to the water undertaker to terminate the arrangements.

(8) The Secretary of State may by regulations may make provision—

(a) as to factors which the proposer must or may take into account
in making the decision mentioned in subsection (7);

(b) as to the procedure to be followed by the proposer in exercising
functions under or by virtue of subsection (2) or (7).

88M 5Decision-making procedure: exercise of functions by committee

(1) This section applies in relation to the exercise of functions under or by
virtue of section 88L(2) to (7) (“the relevant functions”) except where
the proposer is a single local authority and either—

(a) no other local authorities are affected by the proposal, or

(b) 10no other local authority which is affected by the proposal
informs the proposer that it wishes to participate in the exercise
of the functions.

(2) The local authorities affected by the proposal must—

(a) arrange for an existing joint committee of the authorities to
15exercise the relevant functions,

(b) establish a joint committee of the authorities for that purpose, or

(c) arrange for the Health and Wellbeing Boards established by
them under section 191 of the Health and Social Care Act 2011
to exercise the relevant functions.

(a)(a)20arrange for an existing joint committee of the authorities to
exercise the relevant functions,

(b) establish a joint committee of the authorities for that purpose, or

(c) arrange for the Health and Wellbeing Boards established by
them under section 191 of the Health and Social Care Act 2011
25to exercise the relevant functions.

(3) The Secretary of State may by regulations provide that the duty in
subsection (2) does not apply in prescribed circumstances.

(4) The duty in subsection (2) does not apply in relation to a termination
proposal if the Secretary of State so directs by an instrument in writing
30(and such a direction may apply generally or in relation to a particular
termination proposal).

(5) Where arrangements are made under subsection (2)(c) the Health and
Wellbeing Boards in question must exercise the power conferred by
section 195(b) of the Health and Social Care Act 2011 to establish a joint
35sub-committee of the Boards to exercise the relevant functions.

(6) The Secretary of State may by regulations make provision—

(a) for subsection (2)(a) to apply only in relation to a joint
committee which meets prescribed conditions as to its
membership;

(b) 40as to the membership of a joint committee established under
subsection (2)(b) (including provision as to qualification and
disqualification for membership and the holding and vacating
of office as a member);

(c) as to the membership of a joint sub-committee of Health and
45Wellbeing Boards established in accordance with subsection (5);

(d) as to the procedure to be followed by any joint committee, or
any joint sub-committee of Health and Wellbeing Boards, in
exercising the relevant functions.

88N Secretary of State’s duty in relation to requests for variation or
50termination

(1) This section applies if (following the making of a variation or
termination proposal) the Secretary of State is requested—

(a) to request a variation of arrangements entered into under
section 87(1), or

(b) (as the case may be) to give notice under section 87C(7) to a
water undertaker to terminate such arrangements.

(2) 5The Secretary of State must comply with the request if satisfied that the
requirements imposed by sections 88I to 88M have been met in relation
to the proposal.

(3) Subsection (2) does not require the Secretary of State to consider the
adequacy of any steps taken for the purposes of complying with any
10requirement to consult or to ascertain opinion which is imposed under
or by virtue of section 88J(2) or (3), 88K(3) or 88L(2).

88O Power to make regulations as to maintenance of section 87
arrangements

(1) The Secretary of State may by regulations prescribe circumstances in
15which arrangements must be made in accordance with the
regulations—

(a) for consulting and ascertaining opinion on whether
arrangements under section 87(1) (“section 87(1)
arrangements”) should be maintained, and

(b) 20for enabling authorities affected by section 87(1) arrangements
to decide whether to propose to the Secretary of State that they
be maintained.

(2) The regulations must make provision requiring the Secretary of State to
give notice under section 87C(7) to a water undertaker to terminate
25section 87(1) arrangements entered into by the undertaker if—

(a) the outcome of arrangements made by virtue of subsection
(1)(b) is that the affected authorities decide not to propose that
the section 87(1) arrangements be maintained, and

(b) the Secretary of State is satisfied that any requirements imposed
30by regulations under subsection (1), as to the arrangements to
be made for the purposes mentioned in that subsection, have
been met.

(3) Subsection (2)(b) does not require the Secretary of State to consider the
adequacy of any steps taken for the purposes of complying with any
35requirement to consult or to ascertain opinion which is imposed by
regulations made under subsection (1).

(4) The provision that may be made by regulations under subsection (1) (as
to the arrangements to be made for the purposes mentioned in that
subsection) includes provision corresponding, or similar, to any
40requirements imposed by or under sections 88K to 88M.”

34 Fluoridation of water supplies: transitional provision

(1) In relation to any time on or after the commencement of section 32, any
relevant arrangements which have effect immediately before its
commencement are to be treated for the purposes of Chapter 4 of Part 3 of the
45Water Industry Act 1991 as if they were arrangements entered into by the
water undertaker with the Secretary of State under section 87(1) of that Act.

(2) In subsection (1) “relevant arrangements” means—

(a) any arrangements entered into by a water undertaker with a Strategic
Health Authority under section 87(1) of the Water Industry Act 1991,
and

(b) any arrangements which are treated as arrangements falling within
5paragraph (a) by virtue of section 91 of that Act (as it had effect
immediately before the commencement of this section).

(3) In its application to arrangements which are treated by virtue of subsection (1)
as arrangements entered into by a water undertaker with the Secretary of State
under section 87(1) of the Water Industry Act 1991, section 88H of that Act
10applies as if for subsection (3) there were substituted—

“(3) The amount to be paid by each of the affected local authorities is to be
determined by agreement between the local authorities.”.

(4) Section 91 of the Water Industry Act 1991 (pre-1985 fluoridation schemes)
ceases to have effect in relation to arrangements which are (by virtue of
15subsection (1)) treated as if they were arrangements entered into by a water
undertaker with the Secretary of State under section 87(1) of that Act.

Functions relating to mental health matters

35 Approval functions

(1) After section 12 of the Mental Health Act 1983 insert—

“12ZA 20 Agreement for exercise of approval function: England

(1) The Secretary of State may enter into an agreement with another person
for an approval function of the Secretary of State to be exercisable by
the Secretary of State concurrently—

(a) with that other person, and

(b) 25if a requirement under section 12ZB has effect, with the other
person by whom the function is exercisable under that
requirement.

(2) In this section and sections 12ZB and 12ZC, “approval function”
means—

(a) 30the function under section 12(2), or

(b) the function of approving persons as approved clinicians.

(3) An agreement under this section may, in particular, provide for an
approval function to be exercisable by the other party—

(a) in all circumstances or only in specified circumstances;

(b) 35in all areas or only in specified areas.

(4) An agreement under this section may provide for an approval function
to be exercisable by the other party—

(a) for a period specified in the agreement, or

(b) for a period determined in accordance with the agreement.

(5) 40The other party to an agreement under this section must comply with
such instructions as the Secretary of State may give with respect to the
exercise of the approval function.