Health and Social Care Bill

Session 2010 - 12
Internet Publications
Other Bills before Parliament

Health and Social Care Bill

Health and Social Care Bill
Part 1 — The health service in England
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Abolition of Strategic Health Authorities and Primary Care Trusts
33
Abolition of Strategic Health Authorities
(1)
The Strategic Health Authorities continued in existence or established under
section 13 of the National Health Service Act 2006 are abolished.
(2)
Chapter 1 of Part 2 of that Act (Strategic Health Authorities) is repealed.
5
34
Abolition of Primary Care Trusts
(1)
The Primary Care Trusts continued in existence or established under section 18
of the National Health Service Act 2006 are abolished.
(2)
Chapter 2 of Part 2 of that Act (Primary Care Trusts) is repealed.
Functions relating to fluoridation of water
10
35
Fluoridation of water supplies
(1)
Chapter 4 of Part 3 of the Water Industry Act 1991 (fluoridation), as amended
by the Water Act 2003, is amended as follows.
(2)
In section 87 (fluoridation of water supplies at request of relevant authorities),
in subsection (3)(a) for sub-paragraph (i) substitute—
15
“(i)
in relation to areas in England, are to the Secretary of
State;”.
(3)
After subsection (3) of that section insert—
“(3A)
The Secretary of State may make a request under subsection (1) only if
the Secretary of State is required to do so by section 88G(2) (following
20
the making of a fluoridation proposal in accordance with section 88B).”
(4)
In subsection (4) of that section, for paragraph (a) substitute—
“(a)
in relation to England, such area as the Secretary of State
considers appropriate for the purpose of complying with
section 88G(2);”.
25
(5)
After subsection (7) of that section insert—
“(7A)
The Secretary of State must, in relation to the terms to be included in
any arrangements under this section, consult any local authority whose
area includes, coincides with or is wholly or partly within the specified
area.
30
(7B)
In this section and the following provisions of this Chapter “local
authority” means—
(a)
a county council in England;
(b)
a district council in England, other than a council for a district
in a county for which there is a county council;
35
(c)
a London borough council;
(d)
the Common Council of the City of London.”
(6)
After subsection (7B) of that section (as inserted by subsection (5) above)

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insert—
“(7C)
If the Secretary of State and the Welsh Ministers request a particular
water undertaker to enter into arrangements in respect of adjoining
areas—
(a)
they must co-operate with each other so as to secure that the
5
arrangements (taken together) are operable and efficient; and
(b)
if suitable terms are not agreed for all the arrangements, a
combined reference may be made by them under section 87B
below to enable the terms of each set of arrangements to be
determined so that they are consistent.
10
(7D)
If the Secretary of State requests a water undertaker to vary
arrangements for an area which adjoins an area in respect of which the
Welsh Ministers have made arrangements with the same water
undertaker, the Secretary of State must co-operate with the Welsh
Ministers so as to secure that following the variation the arrangements
15
(taken together) will be operable and efficient.
(7E)
If the Welsh Ministers request a water undertaker to vary arrangements
for an area which adjoins an area in respect of which the Secretary of
State has made arrangements with the same water undertaker, the
Welsh Ministers must co-operate with the Secretary of State so as to
20
secure that following the variation the arrangements (taken together)
will be operable and efficient.
(7F)
If suitable terms are not agreed for a variation to which subsection (7D)
or (7E) applies, a combined reference may be made by the Secretary of
State and the Welsh Ministers under section 87B below so that
25
(following the variation) both sets of arrangements are consistent.”
(7)
Omit subsections (8) to (10) of that section.
(8)
In subsection (11) of that section for “a relevant authority” substitute “the
Welsh Ministers”.
(9)
In section 87A (target concentration of fluoridation), after subsection (3)
30
insert—
“(3A)
If the Secretary of State proposes to—
(a)
make arrangements which provide for the concentration in the
specified area (or any part of it) to be lower than the general
target concentration, or
35
(b)
vary existing arrangements so that they so provide,

the Secretary of State shall consult any local authority whose area
includes, coincides with or is wholly or partly within the specified
area.”
(10)
In section 87B (fluoridation arrangements: determination of terms), in
40
subsection (2) —
(a)
for paragraph (a) substitute—
“(a)
the Secretary of State may—
(i)
determine the terms of the arrangements as the
Secretary of State sees fit; or
45
(ii)
refer the matter for determination by such other person
as the Secretary of State considers appropriate; and”,
and

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(b)
omit paragraph (b).
(11)
In 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).
5
(13)
In section 89—
(a)
in 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
10
occurs) substitute “the Welsh Ministers”,
(d)
in 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
15
(f)
omit subsection (5).
(14)
In 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
20
times as the relevant authority considers appropriate, and
(b)
in particular, consult any such local authority before it
publishes a report under paragraph (b) of that subsection.”
36
Procedural requirements in connection with fluoridation of water supplies
After section 88A of the Water Industry Act 1991 insert—
25
“88B
Requirement for fluoridation proposal: England
(1)
The 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
30
into arrangements with one or more water undertakers to increase the
fluoride 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
35
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
40
fluoridation 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

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authority whose area includes, coincides with or is wholly or partly
within 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
5
arrangements which would result from implementing the proposal
would 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
10
proposal, insofar as they might affect the undertaker, would be
operable 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
15
water undertaker consulted under subsection (3).
(6)
If 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
20
(1)
This 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,
25
(c)
one 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
30
the 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 must by regulations—
35
(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
may be taken in relation to the proposal.
40
88E
Decision on fluoridation proposal
(1)
This section applies where—
(a)
a fluoridation proposal is made,

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(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)
in a case where section 88D applies, the conditions prescribed
under subsection (4)(b) of that section are satisfied, and
5
(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
to be taken for the purposes of consulting and ascertaining opinion in
10
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)
But 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
15
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
request the Secretary of State to make such requests under section 87(1)
as are necessary to implement the proposal.
20
(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)
as to the procedure to be followed by the proposer in exercising
functions under or by virtue of subsection (2) or (5).
25
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
where the proposer is a single local authority and either—
(a)
no other local authorities are affected by the proposal, or
30
(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)
The local authorities affected by the proposal must—
(a)
arrange for an existing joint committee of the authorities to
35
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
them under section 194 of the Health and Social Care Act 2012
to exercise the fluoridation functions.
40
(3)
Where arrangements are made under subsection (2)(c) the Health and
Wellbeing Boards in question must exercise the power conferred by
section 198(b) of the Health and Social Care Act 2012 to establish a joint
sub-committee of the Boards to exercise the fluoridation functions.
(4)
The Secretary of State may by regulations make provision—
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(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
subsection (2)(b) (including provision as to qualification and
5
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)
as to the procedure to be followed by any joint committee, or
10
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
requests under section 87(1) as are necessary to implement a
15
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)
Subsection (2) does not require the Secretary of State to consider the
20
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(4) or 88E(2).
88H
Payments by local authorities towards fluoridation costs
(1)
This section applies where a water undertaker enters into
25
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
arrangements.
30
(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
the authorities in relation to the proposal which resulted in the
35
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)
in any other case, by agreement between the local authorities.
40
(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)
refer the matter for determination by such other person as the
45
Secretary of State considers appropriate.

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(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)
If the affected local authorities fail to reach agreement for the purposes
of subsection (5), the Secretary of State may—
5
(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)
Any reference in this section to a local authority affected by
arrangements under section 87(1) is a reference to a local authority
10
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)
The Secretary of State may not request a water undertaker to vary
arrangements entered into by the water undertaker under section 87(1)
15
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
section 87C(7) to terminate arrangements entered into by the water
undertaker under section 87(1) unless a proposal (“a termination
20
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
concentration of fluoride in the area specified in the arrangements (or
any part of it) to be lower than the general target concentration.
25
(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
local authorities affected by the arrangements.
(6)
The Secretary of State may by regulations provide that, where a
30
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
regulations.
(7)
In the following provisions of this Chapter, “proposer”, in relation to a
35
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
Chapter to a local authority affected by a variation or termination
proposal is a reference to a local authority whose area includes,
40
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
the following provisions of this Chapter to a local authority affected by
45
the proposal also includes a reference to a local authority whose area