Health and Social Care Bill

Session 2010 - 12
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Other Bills before Parliament

Health and Social Care Bill

Health and Social Care Bill
Part 1 — The health service in England
1

A
Bill
[AS AMENDED ON REPORT]
To
Establish and make provision about a National Health Service Commissioning
Board and clinical commissioning groups and to make other provision about
the National Health Service in England; to make provision about public health
in the United Kingdom; to make provision about regulating health and adult
social care services; to make provision about public involvement in health and
social care matters, scrutiny of health matters by local authorities and co-
operation between local authorities and commissioners of health care services;
to make provision about regulating health and social care workers; to establish
and make provision about a National Institute for Health and Care Excellence;
to establish and make provision about a Health and Social Care Information
Centre and to make other provision about information relating to health or
social care matters; to abolish certain public bodies involved in health or social
care; to make other provision about health care; and for connected purposes.
Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and
consent of the Lords Spiritual and Temporal, and Commons, in this present
Parliament assembled, and by the authority of the same, as follows:—
Part 1
The health service in England
The health service: overview
1
Secretary of State’s duty to promote comprehensive health service
For section 1 of the National Health Service Act 2006 (Secretary of State’s duty
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HL Bill 132
55/1

Health and Social Care Bill
Part 1 — The health service in England
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to promote health service) substitute—
“1
Secretary of State’s duty to promote comprehensive health service
(1)
The Secretary of State must continue the promotion in England of a
comprehensive health service designed to secure improvement—
(a)
in the physical and mental health of the people of England, and
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(b)
in the prevention, diagnosis and treatment of physical and
mental illness.
(2)
For that purpose, the Secretary of State must exercise the functions
conferred by this Act so as to secure that services are provided in
accordance with this Act.
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(3)
The Secretary of State retains ministerial responsibility to Parliament
for the provision of the health service in England.
(4)
The services provided as part of the health service in England must be
free of charge except in so far as the making and recovery of charges is
expressly provided for by or under any enactment, whenever passed.”
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2
The Secretary of State’s duty as to improvement in quality of services
After section 1 of the National Health Service Act 2006 insert—
“1A
Duty as to improvement in quality of services
(1)
The Secretary of State must exercise the functions of the Secretary of
State in relation to the health service with a view to securing continuous
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improvement in the quality of services provided to individuals for or in
connection with—
(a)
the prevention, diagnosis or treatment of illness, or
(b)
the protection or improvement of public health.
(2)
In discharging the duty under subsection (1) the Secretary of State
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must, in particular, act with a view to securing continuous
improvement in the outcomes that are achieved from the provision of
the services.
(3)
The outcomes relevant for the purposes of subsection (2) include, in
particular, outcomes which show—
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(a)
the effectiveness of the services,
(b)
the safety of the services, and
(c)
the quality of the experience undergone by patients.
(4)
In discharging the duty under subsection (1), the Secretary of State
must have regard to the quality standards prepared by NICE under
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section 234 of the Health and Social Care Act 2012.”
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The Secretary of State’s duty as to the NHS Constitution
After section 1A of the National Health Service Act 2006 insert—
“1B
Duty as to the NHS Constitution
(1)
In exercising functions in relation to the health service, the Secretary of
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State must have regard to the NHS Constitution.

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Part 1 — The health service in England
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(2)
In this Act, “NHS Constitution” has the same meaning as in Chapter 1
of Part 1 of the Health Act 2009 (see section 1 of that Act).”
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The Secretary of State’s duty as to reducing inequalities
After section 1B of the National Health Service Act 2006 insert—
“1C
Duty as to reducing inequalities
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In exercising functions in relation to the health service, the Secretary of
State must have regard to the need to reduce inequalities between the
people of England with respect to the benefits that they can obtain from
the health service.”
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The Secretary of State’s duty as to promoting autonomy
10
After section 1C of the National Health Service Act 2006 insert—
“1D
Duty as to promoting autonomy
(1)
In exercising functions in relation to the health service, the Secretary of
State must have regard to the desirability of securing, so far as
consistent with the interests of the health service—
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(a)
that any other person exercising functions in relation to the
health service or providing services for its purposes is free to
exercise those functions or provide those services in the manner
that it considers most appropriate, and
(b)
that unnecessary burdens are not imposed on any such person.
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(2)
If, in the case of any exercise of functions, the Secretary of State
considers that there is a conflict between the matters mentioned in
subsection (1) and the discharge by the Secretary of State of the duties
under section 1, the Secretary of State must give priority to the duties
under that section.”
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6
The Secretary of State’s duty as to research
After section 1D of the National Health Service Act 2006 insert—
“1E
Duty as to research
In exercising functions in relation to the health service, the Secretary of
State must promote—
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(a)
research on matters relevant to the health service, and
(b)
the use in the health service of evidence obtained from
research.”
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The Secretary of State’s duty as to education and training
After section 1E of the National Health Service Act 2006 insert—
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“1F
Duty as to education and training
(1)
The Secretary of State must exercise the functions of the Secretary of
State under any relevant enactment so as to secure that there is an
effective system for the planning and delivery of education and
training to persons who are employed, or who are considering
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becoming employed, in an activity which involves or is connected with
the provision of services as part of the health service in England.
(2)
Any arrangements made with a person under this Act for the provision
of services as part of that health service must include arrangements for
securing that the person co-operates with the Secretary of State in the
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discharge of the duty under subsection (1) (or, where a Special Health
Authority is discharging that duty by virtue of a direction under section
7, with the Special Health Authority).
(3)
In subsection (1), “relevant enactment” means—
(a)
section 63 of the Health Services and Public Health Act 1968,
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(b)
this Act,
(c)
the Health and Social Care Act 2008,
(d)
the Health Act 2009, and
(e)
the Health and Social Care Act 2012.”
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Secretary of State’s duty as to promoting equality of provision
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After section 1F of the National Health Service Act 2006 insert—
“1G
Duty as to promoting equality of provision
In exercising functions in relation to the Health Service, the Secretary of
State must have regard to the need to promote equality for those
providing services on behalf of the health service and shall within one
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year of passing this Act, lay a report before Parliament on the treatment
for Value Added Tax of supplies by charities to bodies exercising
functions on behalf of a Minister of the Crown of healthcare services or
associated goods.”
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The NHS Commissioning Board
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(1)
After section 1G of the National Health Service Act 2006 insert—
“Role of the Board in the health service in England
1H
The National Health Service Commissioning Board and its general
functions
(1)
There is to be a body corporate known as the National Health Service
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Commissioning Board (“the Board”).
(2)
The Board is subject to the duty under section 1(1) concurrently with
the Secretary of State except in relation to the part of the health service
that is provided in pursuance of the public health functions of the
Secretary of State or local authorities.
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(3)
For the purpose of discharging that duty, the Board—
(a)
has the function of arranging for the provision of services for the
purposes of the health service in England in accordance with
this Act, and
(b)
must exercise the functions conferred on it by this Act in
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relation to clinical commissioning groups so as to secure that
services are provided for those purposes in accordance with this
Act.

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(4)
Schedule A1 makes further provision about the Board.
(5)
In this Act—
(a)
any reference to the public health functions of the Secretary of
State is a reference to the functions of the Secretary of State
under sections 2A and 2B and paragraphs 7C, 8 and 12 of
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Schedule 1, and
(b)
any reference to the public health functions of local authorities
is a reference to the functions of local authorities under sections
2B and 111 and paragraphs 1 to 7B and 13 of Schedule 1.”
(2)
Before Schedule 1 to that Act, insert the Schedule set out in Schedule 1 to this
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Act.
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Clinical commissioning groups
After section 1H of the National Health Service Act 2006 insert—
“Role of clinical commissioning groups in the health service in England
1I
Clinical commissioning groups and their general functions
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(1)
There are to be bodies corporate known as clinical commissioning
groups established in accordance with Chapter A2 of Part 2.
(2)
Each clinical commissioning group has the function of arranging for the
provision of services for the purposes of the health service in England
in accordance with this Act.”
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Arrangements for provision of health services
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The Secretary of State’s duty as to protection of public health
After section 2 of the National Health Service Act 2006 insert—
“Provision for protection or improvement of public health
2A
Secretary of State’s duty as to protection of public health
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(1)
The Secretary of State must take such steps as the Secretary of State
considers appropriate for the purpose of protecting the public in
England from disease or other dangers to health.
(2)
The steps that may be taken under subsection (1) include—
(a)
the conduct of research or such other steps as the Secretary of
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State considers appropriate for advancing knowledge and
understanding;
(b)
providing microbiological or other technical services (whether
in laboratories or otherwise);
(c)
providing vaccination, immunisation or screening services;
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(d)
providing other services or facilities for the prevention,
diagnosis or treatment of illness;
(e)
providing training;
(f)
providing information and advice;

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(g)
making available the services of any person or any facilities.
(3)
Subsection (4) applies in relation to any function under this section
which relates to—
(a)
the protection of the public from ionising or non-ionising
radiation, and
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(b)
a matter in respect of which the Health and Safety Executive has
a function.
(4)
In exercising the function, the Secretary of State must—
(a)
consult the Health and Safety Executive, and
(b)
have regard to its policies.”
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Duties as to improvement of public health
After section 2A of the National Health Service Act 2006 insert—
“2B
Functions of local authorities and Secretary of State as to improvement
of public health
(1)
Each local authority must take such steps as it considers appropriate for
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improving the health of the people in its area.
(2)
The Secretary of State may take such steps as the Secretary of State
considers appropriate for improving the health of the people of
England.
(3)
The steps that may be taken under subsection (1) or (2) include—
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(a)
providing information and advice;
(b)
providing services or facilities designed to promote healthy
living (whether by helping individuals to address behaviour
that is detrimental to health or in any other way);
(c)
providing services or facilities for the prevention, diagnosis or
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treatment of illness;
(d)
providing financial incentives to encourage individuals to
adopt healthier lifestyles;
(e)
providing assistance (including financial assistance) to help
individuals to minimise any risks to health arising from their
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accommodation or environment;
(f)
providing or participating in the provision of training for
persons working or seeking to work in the field of health
improvement;
(g)
making available the services of any person or any facilities.
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(4)
The steps that may be taken under subsection (1) also include
providing grants or loans (on such terms as the local authority
considers appropriate).
(5)
In this section, “local authority” means—
(a)
a county council in England;
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(b)
a district council in England, other than a council for a district
in a county for which there is a county council;
(c)
a London borough council;
(d)
the Council of the Isles of Scilly;
(e)
the Common Council of the City of London.”
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