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

54

 

223I    

Financial duties of clinical commissioning groups: use of resources

(1)   

For the purposes of this section and section 223J—

(a)   

a clinical commissioning group’s capital resource use, in

relation to a financial year, means the group’s use of capital

resources in that year, and

5

(b)   

a clinical commissioning group’s revenue resource use, in

relation to a financial year, means the group’s use of revenue

resources in that year.

(2)   

A clinical commissioning group must ensure that its capital resource

use in a financial year does not exceed the amount specified by

10

direction of the Board.

(3)   

A clinical commissioning group must ensure that its revenue resource

use in a financial year does not exceed the amount specified by

direction of the Board.

(4)   

Any directions given in relation to a financial year under subsection (6)

15

of section 223D apply (in relation to that year) for the purposes of this

section as they apply for the purposes of that section.

(5)   

The Board may by directions make provision for determining to which

clinical commissioning group a use of capital resources or revenue

resources is to be attributed for the purposes of this section or section

20

223J.

(6)   

Where the Board gives a direction under subsection (2) or (3), it must

notify the Secretary of State.

223J    

Financial duties of clinical commissioning groups: additional controls

on resource use

25

(1)   

The Board may direct a clinical commissioning group to ensure that its

capital resource use in a financial year which is attributable to matters

specified in the direction does not exceed an amount so specified.

(2)   

The Board may direct a clinical commissioning group to ensure that its

revenue resource use in a financial year which is attributable to matters

30

specified in the direction does not exceed an amount so specified.

(3)   

The Board may direct a clinical commissioning group to ensure that its

revenue resource use in a financial year which is attributable to

prescribed matters relating to administration does not exceed an

amount specified in the direction.

35

(4)   

The Board may give directions, in relation to a financial year, specifying

uses of capital resources or revenue resources which must, or must not,

be taken into account for the purposes of subsection (1) or (as the case

may be) subsection (2) or (3).

(5)   

The Board may not exercise the power conferred by subsection (1) or (2)

40

in relation to particular matters unless the Secretary of State has given

a direction in relation to those matters under subsection (1) of section

223E or (as the case may be) subsection (2) of that section.

(6)   

The Board may not exercise the power conferred by subsection (3) in

relation to prescribed matters relating to administration unless the

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

55

 

Secretary of State has given a direction in relation to those matters

under subsection (3)(a) of section 223E.

223K    

Payments in respect of quality

(1)   

The Board may, after the end of a financial year, make a payment to a

clinical commissioning group.

5

(2)   

For the purpose of determining whether to make a payment under

subsection (1) and (if so) the amount of the payment, the Board must

take into account at least one of the following factors—

(a)   

the quality of relevant services provided during the financial

year;

10

(b)   

any improvement in the quality of relevant services provided

during that year (in comparison to the quality of relevant

services provided during previous financial years);

(c)   

the outcomes identified during the financial year as having

been achieved from the provision at any time of relevant

15

services;

(d)   

any improvement in the outcomes identified during that

financial year as having been so achieved (in comparison to the

outcomes identified during previous financial years as having

been so achieved).

20

(3)   

For that purpose, the Board may also take into account either or both of

the following factors—

(a)   

relevant inequalities identified during that year;

(b)   

any reduction in relevant inequalities identified during that

year (in comparison to relevant inequalities identified during

25

previous financial years).

(4)   

Regulations may make provision as to the principles or other matters

that the Board must or may take into account in assessing any factor

mentioned in subsection (2) or (3).

(5)   

Regulations may provide that, in prescribed circumstances, the Board

30

may, if it considers it appropriate to do so—

(a)   

not make a payment that would otherwise be made to a clinical

commissioning group under subsection (1), or

(b)   

reduce the amount of such a payment.

(6)   

Regulations may make provision as to how payments under subsection

35

(1) may be spent (which may include provision as to circumstances in

which the whole or part of any such payments may be distributed to

members of the clinical commissioning group).

(7)   

A clinical commissioning group must publish an explanation of how

the group has spent any payment made to it under subsection (1).

40

(8)   

In this section—

“relevant services” means services provided in pursuance of

arrangements made by the clinical commissioning group—

(a)   

under section 3 or 3A or Schedule 1, or

(b)   

by virtue of section 7A;

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

56

 

“relevant inequalities” means inequalities between the persons for

whose benefit relevant services are at any time provided with

respect to—

(a)   

their ability to access the services, or

(b)   

the outcomes achieved for them by their provision.”

5

28      

Requirement for primary medical services provider to belong to clinical

commissioning group

(1)   

In section 89 of the National Health Service Act 2006 (general medical services

contracts: required terms), after subsection (1) insert—

“(1A)   

Regulations under subsection (1) may, in particular, make provision—

10

(a)   

for requiring a contractor who provides services of a prescribed

description (a “relevant contractor”) to be a member of a clinical

commissioning group;

(b)   

as to arrangements for securing that a relevant contractor

appoints one individual to act on its behalf in the dealings

15

between it and the clinical commissioning group to which it

belongs;

(c)   

for imposing requirements with respect to those dealings on the

individual appointed for the purposes of paragraph (b);

(d)   

for requiring a relevant contractor, in doing anything pursuant

20

to the contract, to act with a view to enabling the clinical

commissioning group to which it belongs to discharge its

functions (including its obligation to act in accordance with its

constitution).

(1B)   

Provision by virtue of subsection (1A)(a) may, in particular, describe

25

services by reference to the manner or circumstances in which they are

performed.

(1C)   

In the case of a contract entered into by two or more individuals

practising in partnership—

(a)   

regulations making provision under subsection (1A)(a) may

30

make provision for requiring each partner to secure that the

partnership is a member of the clinical commissioning group;

(b)   

regulations making provision under subsection (1A)(b) may

make provision as to arrangements for securing that the

partners make the appointment;

35

(c)   

regulations making provision under subsection (1A)(d) may

make provision for requiring each partner to act as mentioned

there.

(1D)   

Regulations making provision under subsection (1A) for the case of a

contract entered into by two or more individuals practising in

40

partnership may make provision as to the effect of a change in the

membership of the partnership.

(1E)   

The regulations may require an individual appointed for the purposes

of subsection (1A)(b)—

(a)   

to be a member of a profession regulated by a body mentioned

45

in section 25(3) of the National Health Service Reform and

Health Care Professions Act 2002, and

(b)   

to meet such other conditions as may be prescribed.”

 
 

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

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(2)   

In section 94 of that Act (regulations about arrangements under section 92 of

that Act for provision of primary medical services), after subsection (3) insert—

“(3A)   

Regulations under subsection (3)(d) may—

(a)   

require a person who provides services of a prescribed

description in accordance with section 92 arrangements (a

5

“relevant provider”) to be a member of a clinical commissioning

group;

(b)   

make provision as to arrangements for securing that a relevant

provider appoints one individual to act on its behalf in dealings

between it and the clinical commissioning group to which it

10

belongs;

(c)   

impose requirements with respect to those dealings on the

individual appointed for the purposes of paragraph (b);

(d)   

require a relevant provider, in doing anything pursuant to

section 92 arrangements, to act with a view to enabling the

15

clinical commissioning group to which it belongs to discharge

its functions (including its obligation to act in accordance with

its constitution).

(3B)   

Provision by virtue of subsection (3A)(a) may, in particular, describe

services by reference to the manner or circumstances in which they are

20

performed.

(3C)   

In the case of an agreement made with two or more persons—

(a)   

regulations making provision under subsection (3A)(a) may

require each person to secure that the persons collectively are a

member of the clinical commissioning group;

25

(b)   

regulations making provision under subsection (3A)(b) may

make provision as to arrangements for securing that the

persons collectively make the appointment;

(c)   

regulations making provision under subsection (3A)(d) may

require each person to act as mentioned there.

30

(3D)   

Regulations making provision under subsection (3A) for the case of an

agreement made with two or more persons may make provision as to

the effect of a change in the composition of the group of persons

involved.

(3E)   

The regulations may require an individual appointed for the purposes

35

of subsection (3A)(b)—

(a)   

to be a member of a profession regulated by a body mentioned

in section 25(3) of the National Health Service Reform and

Health Care Professions Act 2002, and

(b)   

to meet such other conditions as may be prescribed.”

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Further provision about local authorities’ role in the health service

29      

Other health service functions of local authorities under the 2006 Act

(1)   

The National Health Service Act 2006 (c. 41) is amended as follows.

(2)   

In section 111 (dental public health)—

(a)   

in subsection (1) for “A Primary Care Trust” substitute “A local

45

authority”,

 
 

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

58

 

(b)   

in subsection (2)—

(i)   

for “Primary Care Trust” (in each place where it occurs)

substitute “local authority”, and

(ii)   

in paragraph (b) for “other Primary Care Trusts” substitute

“other local authorities”, and

5

(c)   

after subsection (2) insert—

“(3)   

In this section, “local authority” has the same meaning as in

section 2B.”

(3)   

In section 249 (joint working with the prison service) after subsection (4)

insert—

10

“(4A)   

For the purposes of this section, each local authority (within the

meaning of section 2B) is to be treated as an NHS body.”

30      

Appointment of directors of public health

In Part 3 of the National Health Service Act 2006 (local authorities and the

NHS) before section 74 insert—

15

“73A    

Appointment of directors of public health

(1)   

Each local authority must, acting jointly with the Secretary of State,

appoint an individual to have responsibility for —

(a)   

the exercise by the authority of its functions under section 2B,

111 or 249 or Schedule 1,

20

(b)   

the exercise by the authority of its functions by virtue of section

6C(1) or (3),

(c)   

anything done by the authority in pursuance of arrangements

under section 7A,

(d)   

the exercise by the authority of any of its functions that relate to

25

planning for, or responding to, emergencies involving a risk to

public health,

(e)   

the functions of the authority under section 325 of the Criminal

Justice Act 2003, and

(f)   

such other functions relating to public health as may be

30

prescribed.

(2)   

The individual so appointed is to be an officer of the local authority and

is to be known as its director of public health.

(3)   

Subsection (4) applies if the Secretary of State—

(a)   

considers that the director has failed or might have failed to

35

discharge (or to discharge properly) the responsibilities of the

director under—

(i)   

subsection (1)(b), or

(ii)   

subsection (1)(c) where the arrangements relate to the

Secretary of State’s functions under section 2A, and

40

(b)   

has consulted the local authority.

(4)   

The Secretary of State may direct the local authority to—

(a)   

review how the director has discharged the responsibilities

mentioned in subsection (3)(a);

 
 

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Part 1 — The health service in England

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(b)   

investigate whether the director has failed to discharge (or to

discharge properly) those responsibilities;

(c)   

consider taking any steps specified in the direction;

(d)   

report to the Secretary of State on the action it has taken in

pursuance of a direction given under any of the preceding

5

paragraphs.

(5)   

A local authority may terminate the appointment of its director of

public health.

(6)   

Before terminating the appointment of its director of public health, a

local authority must consult the Secretary of State.

10

(7)   

A local authority must have regard to any guidance given by the

Secretary of State in relation to its director of public health, including

guidance as to appointment and termination of appointment, terms

and conditions and management.

(8)   

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

15

31      

Exercise of public health functions of local authorities

In Part 3 of the National Health Service Act 2006 after section 73A insert—

“73B    

Exercise of public health functions of local authorities: further

provision

(1)   

A local authority must, in the exercise of any functions mentioned in

20

subsection (2), have regard to any document published by the Secretary

of State for the purposes of this section.

(2)   

The functions mentioned in this subsection are—

(a)   

the exercise by the authority of its functions under section 2B,

111 or 249 or Schedule 1,

25

(b)   

the exercise by the authority of its functions by virtue of section

6C(1) or (3),

(c)   

anything done by the authority in pursuance of arrangements

under section 7A,

(d)   

the functions of the authority under section 325 of the Criminal

30

Justice Act 2003, and

(e)   

such other functions relating to public health as may be

prescribed.

(3)   

The Secretary of State may give guidance to local authorities as to the

exercise of any functions mentioned in subsection (2).

35

(4)   

A document published under subsection (1), and guidance given under

subsection (3), may include guidance as to the appointment of officers

of the local authority to discharge any functions mentioned in

subsection (2), and as to their terms and conditions, management and

dismissal.

40

(5)   

The director of public health for a local authority must prepare an

annual report on the health of the people in the area of the local

authority.

(6)   

The local authority must publish the report.

 
 

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

60

 

(7)   

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

32      

Complaints about exercise of public health functions by local authorities

In Part 3 of the National Health Service Act 2006 (local authorities and the

NHS) after section 73B insert—

“73C    

Complaints about exercise of public health functions by local

5

authorities

(1)   

Regulations may make provision about the handling and consideration

of complaints made under the regulations about —

(a)   

the exercise by a local authority of any of its public health

functions;

10

(b)   

the exercise by a local authority of its functions by virtue of

section 6C(1) or (3);

(c)   

anything done by a local authority in pursuance of

arrangements made under section 7A;

(d)   

the exercise by a local authority of any of its other functions—

15

(i)   

which relate to public health, and

(ii)   

for which its director of public health has responsibility;

(e)   

the provision of services by another person in pursuance of

arrangements made by a local authority in the exercise of any

function mentioned in paragraphs (a) to (d).

20

(2)   

The regulations may provide for a complaint to be considered by one

or more of the following—

(a)   

the local authority in respect of whose functions the complaint

is made;

(b)   

an independent panel established under the regulations;

25

(c)   

any other person or body.

(3)   

The regulations may provide for a complaint or any matter raised by a

complaint—

(a)   

to be referred to a Local Commissioner under Part 3 of the Local

Government Act 1974 for the Commissioner to consider

30

whether to investigate the complaint or matter under that Part;

(b)   

to be referred to any other person or body for that person or

body to consider whether to take any action otherwise than

under the regulations.

(4)   

Where the regulations make provision under subsection (3)(a) they

35

may also provide for the complaint to be treated as satisfying sections

26A and 26B of the Act of 1974.

(5)   

Section 115 of the Health and Social Care (Community Health and

Standards) Act 2003 (health care and social services complaints

regulations: supplementary) applies in relation to regulations under

40

this section as it applies in relation to regulations under subsection (1)

of section 113 of that Act.

(6)   

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

 
 

 
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