Health and Social Care Bill (HL Bill 119)

subsection (6), after paragraph (zb) insert—

“(zc) an order under section 28 which varies such an order as
mentioned in section 28A(5),”.

48 Primary care services: directions as to exercise of functions

(1) 5After section 98 of the National Health Service Act 2006 insert—

“Directions

98A 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
10medical services.

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

(3) 15The Board may direct a clinical commissioning group to exercise any of
the Board’s functions relating to the provision of primary medical
services.

(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
20medical services (including functions which the group 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 under subsection (3) or (4), it may
25disclose to the clinical commissioning group information it has about
the provision of the primary medical services in question, if the Board
considers 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
30direction under subsection (3) or (4) must report to the Board on
matters arising out of the group’s exercise of the function.

(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
35the primary medical services in question, have regard to a report under
subsection (7).”

(2) After 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
5Secretary of State’s functions relating to the provision of primary dental
services.

(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
10exercise under subsection (1)).”

(3) After 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
15Secretary of State’s functions relating to the provision of primary
ophthalmic 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
20directed 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
the Board’s functions relating to the provision of primary ophthalmic
services.

(4) 25The 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
of primary ophthalmic services (including functions which it has been
directed to exercise under subsection (3)).

(5) 30Subsection (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),
it may disclose to the body the information it has about the provision of
the primary ophthalmic services in question, if the Board considers it
35necessary 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
report to the Board on matters arising out of the exercise of the function
to which the direction relates.

(8) 40A 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 ophthalmic services in question, have regard to a report
under subsection (7).”

(4) After section 168 of that Act insert—

5“Directions

168A Exercise of functions

(1) The 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
10this Part.

(2) The Secretary of State may give directions to the Board about its
exercise 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)).”

49 15Charges in respect of certain public health functions

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

“186A 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) 20The 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) Charges under subsection (1) may be calculated on such basis as the
25Secretary 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
2A (by virtue of regulations under section 6C(1)), and

(b) 30the 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
provision prescribing the amount or the maximum amount that may be
35charged.

(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
subsection (6) after paragraph (zc) insert—

“(zd) 40regulations under section 186A(4),”.

50 Pharmaceutical services expenditure

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

“165A Pharmaceutical remuneration: further provision

(1) The Board must provide the Secretary of State with such information
5relating 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
within such period, as the Secretary of State may require.

(3) 10Schedule 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.

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

15In Part 13 of the National Health Service Act 2006, after section 247B (as
inserted by section 59) insert—

“Duty to keep under review

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

(1) 20The Secretary of State must keep under review the effectiveness of the
exercise by the bodies mentioned in subsection (2) of functions in
relation to the health service in England.

(2) The bodies mentioned in this subsection are—

(a) the Board;

(b) 25Monitor;

(c) the Care Quality Commission;

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

(e) the Health and Social Care Information Centre;

(f) Special Health Authorities.

(3) 30The Secretary of State may include in an annual report under section
247D the Secretary of State’s views on the effectiveness of the exercise
by the bodies mentioned in subsection (2) of functions in relation to the
health service.”

52 Secretary of State’s annual report

After section 247C of the National Health Service Act 2006 insert—

“Annual report

247D Secretary of State’s annual report

(1) 5The 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
before Parliament.”

53 Certification of death

(1) 10Chapter 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) in subsection (1) for “Primary Care Trusts” substitute “Local
authorities”,

(b) 15in 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
authority”.

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

54 Amendments related to Part 1 and transitional provision

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

(2) Schedule 5 (which makes amendments of other enactments in consequence of
25the provision made by this Part) has effect.

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

Part 2 Further provision about public health

55 30Abolition of Health Protection Agency

(1) The Health Protection Agency is abolished.

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

(3) Subsection (2) does not apply to—

(a) paragraph 3 of Schedule 3 to that Act (which amends Schedule 2 to the
35Immigration 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
the provision made by this section) has effect.

56 Functions in relation to biological substances

(1) The appropriate authority must—

(a) 5devise standards for the purity and potency of biological substances,

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

(c) design appropriate procedures for testing biological substances,

(d) provide or arrange for the provision of laboratory facilities for testing
10biological substances,

(e) carry out tests on biological substances,

(f) examine 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
15of paragraph (e) or (f), and

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

(2) 20The appropriate authority may do anything which it considers is appropriate
for facilitating, or incidental or conducive to, the exercise of any of its functions
under 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
25to the United Kingdom).

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

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

(6) 30The appropriate authority may make charges (whether or not on a commercial
basis) in respect of anything done by it under this section.

(7) Any function conferred on the appropriate authority by this section may be
performed by either the Secretary of State or the Department of Health, Social
Services and Public Safety in Northern Ireland acting alone or both of them
35acting jointly (and references in this section to the appropriate authority are to
be construed accordingly).

(8) In this section “biological substance” means a substance whose purity or
potency cannot, in the opinion of the Secretary of State, be adequately tested by
chemical means.

57 40Radiation 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
considers 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
5arising from exposure to radiation;

(d) providing training;

(e) providing 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
10facilitating, or incidental or conducive to, the exercise of any of its functions
under this section.

(4) The 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
15respect of which a Health and Safety body has a function, the appropriate
authority must—

(a) consult the body, and

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

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

(a) 20the Health and Safety Executive;

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

(7) In 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) 25the Scottish Ministers to the extent that the functions are exercisable
within devolved competence (within the meaning of the Scotland Act
1998);

(b) the Department of Health, Social Services and Public Safety in
Northern Ireland to the extent that the functions relate to a transferred
30matter (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) 35where the appropriate authority is the Scottish Ministers, the public in
Scotland, 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) 40This section does not apply in relation to England.

58 Repeal 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.

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

(1) In 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

247B 5Co-operation in relation to public health functions

(1) This section applies to any body or other person that exercises functions
similar 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
10the exercise by it of those functions.

(3) If the Secretary of State acts under subsection (2) at the request of the
body 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
15the 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
the 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
20(3) after paragraph (d) insert—

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

Part 3 Regulation of health and adult social care services

CHAPTER 1 25Monitor

60 Monitor

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

(a) is to continue to exist, and

(b) 30is to be known as Monitor.

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

61 General 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
35health care services which—

(a) is economic, efficient and effective, and

(b) maintains 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
5which 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
10achieved 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) 15Monitor 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
20outcomes 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
25achieved 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) 30clinical 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
35about 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
40the 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) 45Monitor 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)
private sector, or

(b) some other aspect of their status.

(11) In this section—

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

• “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).

62 10General duties: supplementary

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

(2) “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
15effects (or potential effects) of the behaviour.

(3) “Health care” means all forms of health care provided for individuals, whether
relating 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,
20see section 63).

(4) “The NHS” means the comprehensive health service continued under section
1(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) 25A 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) Nothing in section 61 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.

63 30Power to give Monitor functions relating to adult social care services

(1) Regulations may provide for specified functions of Monitor also to be
exercisable 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) 35“Adult social care”—

(a) includes all forms of personal care and other practical assistance
provided 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) 40does not include anything provided by an establishment or agency for
which Her Majesty’s Chief Inspector of Education, Children’s Services
and Skills is the registration authority under section 5 of the Care
Standards Act 2000.