Health and Social Care Bill (HL Bill 119)

Health and Social Care BillPage 10

(c) in sub-paragraph (2) —

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

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

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

(a) 5in sub-paragraph (1)(b) for “by the Secretary of State” substitute “by a
local authority”, and

(b) in sub-paragraph (1)(d)—

(i) for “by the Secretary of State” substitute “by a local authority”,
and

(ii) 10after “paragraph 7A” insert “and of any other prescribed
information relating to the children concerned”, and

(c) in sub-paragraph (2) after “such weighing or measuring” insert “or in
relation to information prescribed under sub-paragraph (1)”.

(9) After paragraph 7B insert—

15Supply 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
blood or other tissues,

(b) 20preparing blood components and reagents, and

(c) facilitating tissue and organ transplantation.

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

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

(b) in that sub-paragraph—

(i) 25for “The Secretary of State may provide” substitute “A clinical
commissioning group may make arrangements for the
provision of”, and

(ii) for “persons appearing to him to be persons who have a
physical impairment” substitute “persons for whom the group
30has responsibility and who appear to it to have a physical
impairment”, and

(c) after that sub-paragraph insert—

(2) Subsections (1A), (1B) and (1D) of section 3 apply for the
purposes of sub-paragraph (1) as they apply for the purposes
35of that section.

(11) In paragraph 10—

(a) in sub-paragraph (1)(a) after “provided” insert “in pursuance of
arrangements made”,

(b) in sub-paragraph (2) —

(i) 40for “The Secretary of State may” substitute “The clinical
commissioning group may make arrangements for”,

(ii) in paragraph (a) for “adapt” substitute “the adaptation of”,

(iii) in paragraph (b) for “maintain and repair” substitute “the
maintenance and repair of”,

(iv) 45in paragraph (c) for “take out” substitute “the taking out of”,

(v) in that paragraph for “pay” substitute “the payment of”,

Health and Social Care BillPage 11

(vi) in paragraph (d) for “provide” (in each place it occurs)
substitute “the provision of”, and

(vii) in that paragraph for “execute” substitute “the execution of”,

(c) in sub-paragraph (3) for “The Secretary of State” substitute “A clinical
5commissioning group”, and

(d) in sub-paragraph (5) for “the Secretary of State” substitute “the clinical
commissioning group”.

(12) In paragraph 12 (provision of a microbiological service)—

(a) in sub-paragraph (1)—

(i) 10omit paragraph (a) and the word “and” immediately following
it,

(ii) in paragraph (b) omit “other”, and

(iii) in that paragraph for “that service” substitute “a
microbiological service provided under section 2A”, and

(b) 15omit sub-paragraph (2).

(13) For paragraph 13 and the cross-heading preceding it substitute—

Powers in relation to research etc.

13 (1) The Secretary of State, the Board or a clinical commissioning group
may conduct, commission or assist the conduct of research into—

(a) 20any matters relating to the causation, prevention, diagnosis
or treatment of illness, and

(b) any such other matters connected with any service provided
under this Act as the Secretary of State, the Board or the
clinical commissioning group (as the case may be) considers
25appropriate.

(2) A local authority may conduct, commission or assist the conduct of
research for any purpose connected with the exercise of its functions
in relation to the health service.

(3) The Secretary of State, the Board, a clinical commissioning group or
30a local authority may for any purpose connected with the exercise of
its functions in relation to the health service—

(a) obtain and analyse data or other information;

(b) obtain advice from persons with appropriate professional
expertise.

(4) 35The power under sub-paragraph (1) or (2) to assist any person to
conduct research includes power to do so by providing financial
assistance or making the services of any person or other resources
available.

(5) In this paragraph, “local authority” has the same meaning as in
40section 2B.

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17 Regulations as to the exercise by local authorities of certain public health
functions

(1) After section 6B of the National Health Service Act 2006 insert—

Regulations as to the exercise of functions
6C 5Regulations as to the exercise by local authorities of certain public
health functions

(1) Regulations may require a local authority to exercise any of the public
health functions of the Secretary of State (so far as relating to the health
of the public in the authority’s area) by taking such steps as may be
10prescribed.

(2) Regulations may require a local authority to exercise its public health
functions by taking such steps as may be prescribed.

(3) Where regulations under subsection (1) require a local authority to
exercise any of the public health functions of the Secretary of State, the
15regulations may also authorise or require the local authority to exercise
any prescribed functions of the Secretary of State that are exercisable in
connection with those functions (including the powers conferred by
section 12).

(4) The making of regulations under subsection (1) does not prevent the
20Secretary of State from taking any step that a local authority is required
to take under the regulations.

(5) Any rights acquired, or liabilities (including liabilities in tort) incurred,
in respect of the exercise by a local authority of any of its functions
under regulations under subsection (1) are enforceable by or against the
25local authority (and no other person).

(6) In this section, “local authority” has the same meaning as in section 2B.

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

(zza) regulations under section 6C(1) or (2),.

18 30Regulations relating to EU obligations

After section 6C of the National Health Service Act 2006 insert—

6D Regulations relating to EU obligations

(1) Regulations may require the Board or a clinical commissioning group
to exercise a specified EU health function.

(2) 35In subsection (1)—

(a) EU health function” means any function exercisable by the
Secretary of State for the purpose of implementing EU
obligations that concern, or are connected to, the health service,
other than a function of making subordinate legislation (within
40the meaning of the Interpretation Act 1978), and

(b) “specified” means specified in the regulations.

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(3) The Secretary of State may give directions to the Board or a clinical
commissioning group about its exercise of any of its functions under
regulations under subsection (1).

(4) The making of regulations under subsection (1) does not prevent the
5Secretary of State from exercising the specified EU health function.

(5) Any rights acquired, or liabilities (including liabilities in tort) incurred,
in respect of the exercise by the Board or a clinical commissioning
group of any of its functions under regulations under subsection (1) are
enforceable by or against the Board or (as the case may be) the group
10(and no other person).

(6) The Secretary of State may, for the purpose of securing compliance by
the United Kingdom with EU obligations, give directions to the Board
or a clinical commissioning group about the exercise of any of its
functions.

19 15Regulations as to the exercise of functions by the Board or clinical
commissioning groups

(1) After section 6D of the National Health Service Act 2006 insert—

6E Regulations as to the exercise of functions by the Board or clinical
commissioning groups

(1) 20Regulations may impose requirements (to be known as “standing
rules”) in accordance with this section on the Board or on clinical
commissioning groups.

(2) The regulations may, in relation to the commissioning functions of the
Board or clinical commissioning groups, make provision—

(a) 25requiring the Board or clinical commissioning groups to
arrange for specified treatments or other specified services to be
provided or to be provided in a specified manner or within a
specified period;

(b) as to the arrangements that the Board or clinical commissioning
30groups must make for the purpose of making decisions as to—

(i) the treatments or other services that are to be provided;

(ii) the manner in which or period within which specified
treatments or other specified services are to be provided;

(iii) the persons to whom specified treatments or other
35specified services are to be provided;

(c) as to the arrangements that the Board or clinical commissioning
groups must make for enabling persons to whom specified
treatments or other specified services are to be provided to
make choices with respect to specified aspects of them.

(3) 40Regulations by virtue of paragraph (b) of subsection (2) may, in
particular, make provision—

(a) requiring the Board or a clinical commissioning group to take
specified steps before making decisions as to the matters
mentioned in that paragraph;

(b) 45as to reviews of, or appeals from, such decisions.

(4) The regulations may—

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(a) specify matters for which provision must be made in
commissioning contracts entered into by the Board or clinical
commissioning groups;

(b) require the Board to draft terms and conditions making
5provision for those matters;

(c) require the Board or clinical commissioning groups to
incorporate the terms and conditions drafted by virtue of
paragraph (b) in commissioning contracts entered into by the
Board or (as the case may be) clinical commissioning groups.

(5) 10The regulations must—

(a) require the Board to draft such terms and conditions as the
Board considers are, or might be, appropriate for inclusion in
commissioning contracts entered into by the Board or clinical
commissioning groups (other than terms and conditions that
15the Board is required to draft by virtue of subsection (4)(a));

(b) authorise the Board to require clinical commissioning groups to
incorporate terms and conditions prepared by virtue of
paragraph (a) in their commissioning contracts;

(c) authorise the Board to draft model commissioning contracts.

(6) 20The regulations may require the Board to consult prescribed persons
before exercising any of its functions by virtue of subsection (4)(b) or
(5).

(7) The regulations may require the Board or clinical commissioning
groups in the exercise of any of its or their functions—

(a) 25to provide information of a specified description to specified
persons in a specified manner;

(b) to act in a specified manner for the purpose of securing
compliance with EU obligations;

(c) to do such other things as the Secretary of State considers
30necessary for the purposes of the health service.

(8) The regulations may not impose a requirement on only one clinical
commissioning group.

(9) If regulations under this section are made so as to come into force on a
day other than 1 April, the Secretary of State must—

(a) 35publish a statement explaining the reasons for making the
regulations so as to come into force on such a day, and

(b) lay the statement before Parliament.

(10) In this section—

(a) “commissioning contracts”, in relation to the Board or clinical
40commissioning groups, means contracts entered into by the
Board or (as the case may be) clinical commissioning groups in
the exercise of its or their commissioning functions;

(b) “commissioning functions”, in relation to the Board or clinical
commissioning groups, means the functions of the Board or (as
45the case may be) clinical commissioning groups in arranging for
the provision of services as part of the health service;

(c) “specified” means specified in the regulations.

(2) In section 272 of that Act (orders, regulations, rules and directions), in

Health and Social Care BillPage 15

subsection (6) after paragraph (zza) insert—

(zzb) regulations under section 6E, except where they do not include
provision by virtue of subsection (7)(c) of that section,.

20 Functions of Special Health Authorities

(1) 5Section 7 of the National Health Service Act 2006 (distribution of health service
functions) is amended as follows.

(2) For subsection (1) substitute—

(1) The Secretary of State may direct a Special Health Authority to exercise
any functions of the Secretary of State or any other person which relate
10to the health service in England and are specified in the direction.

(1A) Before exercising the power in subsection (1) in relation to a function of
a person other than the Secretary of State, the Secretary of State must
consult that person.

(1B) Regulations may provide that a Special Health Authority specified in
15the regulations is to have such additional functions in relation to the
health service in England as may be so specified.

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

(4) For the heading to that section, and for the cross-heading preceding it,
substitute “Functions of Special Health Authorities”.

(5) 20In section 272 of that Act (orders, regulations, rules and directions), in
subsection (6) after paragraph (zzb) insert—

(zzc) regulations under section 7(1B),.

21 Exercise of public health functions of the Secretary of State

After section 7 of the National Health Service Act 2006 insert—

25Exercise of Secretary of State’s public health functions
7A Exercise of Secretary of State’s public health functions

(1) The Secretary of State may arrange for a body mentioned in subsection
(2) to exercise any of the public health functions of the Secretary of
State.

(2) 30Those bodies are—

(a) the Board;

(b) a clinical commissioning group;

(c) a local authority (within the meaning of section 2B).

(3) The power conferred by subsection (1) includes power to arrange for
35such a body to exercise any functions of the Secretary of State that are
exercisable in connection with those functions (including the powers
conferred by section 12).

(4) Where the Secretary of State arranges (under subsection (1)) for the
Board to exercise a function, the Board may arrange for a clinical
40commissioning group to exercise that function.

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(5) Any rights acquired, or liabilities (including liabilities in tort) incurred,
in respect of the exercise by a body mentioned in subsection (2) of any
function exercisable by it by virtue of this section are enforceable by or
against that body (and no other person).

(6) 5Powers under this section may be exercised on such terms as may be
agreed, including terms as to payment.

Further provision about the Board

22 The NHS Commissioning Board: further provision

(1) In Part 2 of the National Health Service Act 2006 (health service bodies), before
10Chapter 1 insert—

CHAPTER A1 The National Health Service Commissioning Board
Secretary of State’s mandate to the Board
13A Mandate to Board

(1) Before the start of each financial year, the Secretary of State must
15publish and lay before Parliament a document to be known as “the
mandate”.

(2) The Secretary of State must specify in the mandate—

(a) the objectives that the Secretary of State considers the Board
should seek to achieve in the exercise of its functions during
20that financial year and such subsequent financial years as the
Secretary of State considers appropriate, and

(b) any requirements that the Secretary of State considers it
necessary to impose on the Board for the purpose of ensuring
that it achieves those objectives.

(3) 25The Secretary of State must also specify in the mandate the amounts
that the Secretary of State has decided to specify in relation to the
financial year for the purposes of section 223D(2) and (3) (limits on
capital and revenue resource use).

(4) The Secretary of State may specify in the mandate any proposals that
30the Secretary of State has as to the amounts that the Secretary of State
will specify in relation to subsequent financial years for the purposes of
section 223D(2) and (3).

(5) The Secretary of State may also specify in the mandate the matters by
reference to which the Secretary of State proposes to assess the Board’s
35performance in relation to the first financial year to which the mandate
relates.

(6) The Secretary of State may not specify in the mandate an objective or
requirement about the exercise of the Board’s functions in relation to
only one clinical commissioning group.

(7) 40The Board must—

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(a) seek to achieve the objectives specified in the mandate, and

(b) comply with any requirements so specified.

(8) Before specifying any objectives or requirements in the mandate, the
Secretary of State must consult—

(a) 5the Board,

(b) the Healthwatch England committee of the Care Quality
Commission, and

(c) such other persons as the Secretary of State considers
appropriate.

13B 10The mandate: supplemental provision

(1) The Secretary of State must keep the Board’s performance in achieving
any objectives or requirements specified in the mandate under review.

(2) If the Secretary of State varies the amount specified for the purposes of
section 223D(2) or (3), the Secretary of State must revise the mandate
15accordingly.

(3) The Secretary of State may make any other revision to the mandate only
if—

(a) the Board agrees to the revision,

(b) a parliamentary general election takes place, or

(c) 20the Secretary of State considers that there are exceptional
circumstances that make the revision necessary.

(4) If the Secretary of State revises the mandate, the Secretary of State
must—

(a) publish the mandate (as so revised), and

(b) 25lay it before Parliament, together with an explanation of the
reasons for making the revision.

General duties of the Board
13C Duty to promote NHS Constitution

(1) The Board must, in the exercise of its functions—

(a) 30act with a view to securing that health services are provided in
a way which promotes the NHS Constitution, and

(b) promote awareness of the NHS Constitution among patients,
staff and members of the public.

(2) In this section, “patients” and “staff” have the same meanings as in
35Chapter 1 of Part 1 of the Health Act 2009 (see section 3(7) of that Act).

13D Duty as to effectiveness, efficiency etc.

The Board must exercise its functions effectively, efficiently and
economically.

13E Duty as to improvement in quality of services

(1) 40The Board must exercise its functions with a view to securing
continuous improvement in the quality of services provided to
individuals for or in connection with—

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

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(b) the protection or improvement of public health.

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

(3) 5The 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) the quality of the experience undergone by patients.

(4) 10In discharging its duty under subsection (1), the Board must have
regard to—

(a) any document published by the Secretary of State for the
purposes of this section, and

(b) the quality standards prepared by NICE under section 233 of
15the Health and Social Care Act 2012.

13F Duty as to promoting autonomy

In exercising its functions, the Board 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
20health service or providing services for its purposes is free to
exercise those functions or provide those services in the manner
it considers most appropriate, and

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

13G Duty as to reducing inequalities

25The Board must, in the exercise of its functions, have regard to the need
to—

(a) reduce inequalities between patients with respect to their ability
to access health services, and

(b) reduce inequalities between patients with respect to the
30outcomes achieved for them by the provision of health services.

13H Duty to promote involvement of each patient

The Board must, in the exercise of its functions, promote the
involvement of patients, and their carers and representatives (if any), in
decisions about the provision of health services to the patients.

13I 35Duty as to patient choice

The Board must, in the exercise of its functions, act with a view to
enabling patients to make choices with respect to aspects of health
services provided to them.

13J Duty to obtain appropriate advice

40The Board 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, and

(b) the protection or improvement of public health.

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13K Duty to promote innovation

(1) The Board must, in the exercise of its functions, promote innovation in
the provision of health services (including innovation in the
arrangements made for their provision).

(2) 5The Board may make payments as prizes to promote innovation in the
provision of health services.

(3) A prize may relate to—

(a) work at any stage of innovation (including research);

(b) work done at any time (including work before the
10commencement of section 22 of the Health and Social Care Act
2012).

13L Duty in respect of research

The Board must, in the exercise of its functions, have regard to the need
to promote—

(a) 15research on matters relevant to the health service, and

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

13M Duty as to promoting integration

(1) The Board must exercise its functions with a view to securing that
health services are provided in an integrated way where it considers
20that this would—

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

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

(c) 25reduce inequalities between persons with respect to the
outcomes achieved for them by the provision of those services.

(2) The Board must exercise its functions with a view to securing that the
provision of health services is integrated with the provision of health-
related services or social care services where it considers that this
30would—

(a) improve the quality of the health services (including the
outcomes that are achieved from the provision of those
services),

(b) reduce inequalities between persons with respect to their ability
35to access those services, or

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

(3) The Board must encourage clinical commissioning groups to enter into
arrangements with local authorities in pursuance of regulations under
40section 75 where it considers that this would secure—

(a) that health services are provided in an integrated way and that
this would have any of the effects mentioned in subsection
(1)(a) to (c), or

(b) that the provision of health services is integrated with the
45provision of health-related services or social care services and
that this would have any of the effects mentioned in subsection
(2)(a) to (c).