Health and Social Care Bill (HL Bill 132)

(4) In paragraph 2—

(a) in sub-paragraph (1)—

(i) for “The Secretary of State” substitute “A local authority”, and

(ii) omit “, by arrangement with any local authority,”,

(b) 5in sub-paragraph (2)—

(i) for “The Secretary of State” substitute “A local authority”,

(ii) after “educational establishment” insert “in its area”, and

(iii) for “a local authority” substitute “the local authority”, and

(c) omit sub-paragraph (3).

(5) 10In paragraph 4—

(a) for “A local authority may not make an arrangement” substitute “A
local authority may not provide for any medical inspection or
treatment”, and

(b) for “the arrangement” substitute “the inspection or (as the case may be)
15treatment”.

(6) In paragraph 5—

(a) omit sub-paragraph (1)(a) and the word “and” immediately following
it,

(b) in sub-paragraph (2) omit “local authority or”,

(c) 20for “the Secretary of State” substitute “a local authority”, and

(d) for “him” substitute “it”.

(7) In paragraph 7A (weighing and measuring of children)—

(a) for “The Secretary of State” (in each place it occurs) substitute “A local
authority”,

(b) 25in sub-paragraph (1) omit “, by arrangement with any local authority,”,
and

(c) in sub-paragraph (2) —

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

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

(8) 30In paragraph 7B (regulations as to weighing and measuring of children)—

(a) in 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”,
35and

(ii) after “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) 40After paragraph 7B insert—

“Supply 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
45blood or other tissues,

(b) preparing 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) 5in that sub-paragraph—

(i) for “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
10physical impairment” substitute “persons for whom the group
has 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
15purposes of sub-paragraph (1) as they apply for the purposes
of that section.”

(11) In paragraph 10—

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

(b) 20in sub-paragraph (2) —

(i) for “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
25maintenance and repair of”,

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

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

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

(vii) 30in that paragraph for “execute” substitute “the execution of”,

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

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

(12) 35In paragraph 12 (provision of a microbiological service)—

(a) in sub-paragraph (1)—

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

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

(iii) 40in that paragraph for “that service” substitute “a
microbiological service provided under section 2A”, and

(b) omit sub-paragraph (2).

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

“Powers in relation to research etc.

13 (1) 45The Secretary of State, the Board or a clinical commissioning group
may conduct, commission or assist the conduct of research into—

(a) any 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
5clinical commissioning group (as the case may be) considers
appropriate.

(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) 10The Secretary of State, the Board, a clinical commissioning group or
a 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
15expertise.

(4) The 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) 20In this paragraph, “local authority” has the same meaning as in
section 2B.”

18 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—

25“Regulations as to the exercise of functions

6C Regulations 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
30of the public in the authority’s area) by taking such steps as may be
prescribed.

(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
35exercise any of the public health functions of the Secretary of State, the
regulations 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) 40The making of regulations under subsection (1) does not prevent the
Secretary 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
local 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
5subsection (6) after paragraph (zza) insert—

“(zzb) regulations under section 6C(1) or (2),”.

19 Regulations relating to EU obligations

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

“6D Regulations relating to EU obligations

(1) 10Regulations may require the Board or a clinical commissioning group
to exercise a specified EU health function.

(2) In subsection (1)—

(a) “EU health function” means any function exercisable by the
Secretary of State for the purpose of implementing EU
15obligations that concern, or are connected to, the health service,
other than a function of making subordinate legislation (within
the meaning of the Interpretation Act 1978), and

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

(3) The Secretary of State may give directions to the Board or a clinical
20commissioning 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
Secretary of State from exercising the specified EU health function.

(5) Any rights acquired, or liabilities (including liabilities in tort) incurred,
25in 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
(and no other person).

(6) The Secretary of State may, for the purpose of securing compliance by
30the United Kingdom with EU obligations, give directions to the Board
or a clinical commissioning group about the exercise of any of its
functions.”

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

(1) 35After 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) Regulations may impose requirements (to be known as “standing
rules”) in accordance with this section on the Board or on clinical
40commissioning groups.

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

(a) requiring 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) 5as to the arrangements that the Board or clinical commissioning
groups 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) 10the persons to whom specified treatments or other
specified 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
15make choices with respect to specified aspects of them.

(3) Regulations 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
20mentioned in that paragraph;

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

(4) The regulations may—

(a) specify matters for which provision must be made in
commissioning contracts entered into by the Board or clinical
25commissioning groups;

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

(c) require the Board or clinical commissioning groups to
incorporate the terms and conditions drafted by virtue of
30paragraph (b) in commissioning contracts entered into by the
Board or (as the case may be) clinical commissioning groups.

(5) The regulations must—

(a) require the Board to draft such terms and conditions as the
Board considers are, or might be, appropriate for inclusion in
35commissioning contracts entered into by the Board or clinical
commissioning groups (other than terms and conditions that
the 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
40paragraph (a) in their commissioning contracts;

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

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

(7) 45The regulations may require the Board or clinical commissioning
groups in the exercise of any of its or their functions—

(a) to 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
necessary for the purposes of the health service.

(8) 5The 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) publish a statement explaining the reasons for making the
10regulations 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
commissioning groups, means contracts entered into by the
15Board 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
the case may be) clinical commissioning groups in arranging for
20the 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
subsection (6) after paragraph (zzb) insert—

“(zzc) regulations under section 6E, except where they do not include
25provision by virtue of subsection (7)(c) of that section,”.

21 Functions of Special Health Authorities

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

(2) For subsection (1) substitute—

“(1) 30The Secretary of State may direct a Special Health Authority to exercise
any functions of the Secretary of State or any other person which relate
to the health service in England and are specified in the direction.

(1A) Subsection (1) does not apply to any function of the Secretary of State
of making an order or regulations.

(1B) 35Before 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.

(1C) Regulations may provide that a Special Health Authority specified in
the regulations is to have such additional functions in relation to the
40health 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) In section 272 of that Act (orders, regulations, rules and directions), in

subsection (6) after paragraph (zzc) insert—

“(zzd) regulations under section 7(1C),”.

(6) In section 273 of that Act (further provision about orders and directions), in
subsection (4)(b)—

(a) 5before paragraph (i) insert—

“(zi) section 7 about a function of a person other than the
Secretary of State,” and

(b) in paragraph (i) after “a function” insert “of the Secretary of State”.

22 Exercise of public health functions of the Secretary of State

10After section 7 of the National Health Service Act 2006 insert—

“Exercise 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
15State.

(2) Those bodies are—

(a) the Board;

(b) a clinical commissioning group;

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

(3) 20The power conferred by subsection (1) includes power to arrange for
such 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
25Board to exercise a function, the Board may arrange for a clinical
commissioning group to exercise that function.

(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
30against that body (and no other person).

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

Further provision about the Board

23 The NHS Commissioning Board: further provision

(1) 35In Part 2 of the National Health Service Act 2006 (health service bodies), before

Chapter 1 insert—

“CHAPTER A1 The National Health Service Commissioning Board

Secretary of State’s mandate to the Board

13A Mandate to Board

(1) 5Before the start of each financial year, the Secretary of State must
publish 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
10should seek to achieve in the exercise of its functions during
that 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
15that it achieves those objectives.

(3) The 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) 20The Secretary of State may specify in the mandate any proposals that
the 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
25reference to which the Secretary of State proposes to assess the Board’s
performance 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
30only one clinical commissioning group.

(7) The Board must—

(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
35Secretary of State must consult—

(a) the Board,

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

(c) such other persons as the Secretary of State considers
40appropriate.

(9) Requirements included in the mandate have effect only if regulations
so provide.

13B The 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
5section 223D(2) or (3), the Secretary of State must revise the mandate
accordingly.

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

(a) the Board agrees to the revision,

(b) 10a parliamentary general election takes place, or

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

(4) Revisions to the mandate which consist of adding, omitting or
modifying requirements have effect only if regulations so provide.

(5) 15If the Secretary of State revises the mandate, the Secretary of State
must—

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

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

20General duties of the Board

13C Duty to promote NHS Constitution

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

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

(b) 25promote 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
Chapter 1 of Part 1 of the Health Act 2009 (see section 3(7) of that Act).

13D Duty as to effectiveness, efficiency etc.

30The Board must exercise its functions effectively, efficiently and
economically.

13E Duty as to improvement in quality of services

(1) The Board must exercise its functions with a view to securing
continuous improvement in the quality of services provided to
35individuals 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 its duty under subsection (1), the Board must, in
particular, act with a view to securing continuous improvement in the
40outcomes 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—

(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 its duty under subsection (1), the Board must have
regard to—

(a) 5any document published by the Secretary of State for the
purposes of this section, and

(b) the quality standards prepared by NICE under section 234 of
the Health and Social Care Act 2012.

13F Duty as to promoting autonomy

(1) 10In exercising its functions, the Board must have regard to the
desirability of securing, so far as consistent with the interests of the
health service—

(a) that any other person exercising functions in relation to the
health service or providing services for its purposes is free to
15exercise 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.

(2) If, in the case of any exercise of functions, the Board considers that there
is a conflict between the matters mentioned in subsection (1) and the
20discharge by the Board of its duties under sections 1(1) and 1H(3)(b),
the Board must give priority to those duties.

13G Duty as to reducing inequalities

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

(a) 25reduce inequalities between patients with respect to their ability
to access health services, and

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

13H Duty to promote involvement of each patient

30The Board must, in the exercise of its functions, promote the
involvement of patients, and their carers and representatives (if any), in
decisions which relate to—

(a) the prevention or diagnosis of illness in the patients, or

(b) their care or treatment.

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.