Health and Social Care Bill (HL Bill 132)

(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 5Complaints about exercise of public health functions by local
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
10functions;

(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) 15the exercise by a local authority of any of its other functions—

(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
20function mentioned in paragraphs (a) to (d).

(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) 25an independent panel established under the regulations;

(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
30Government Act 1974 for the Commissioner to consider
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) 35Where the regulations make provision under subsection (3)(a) they
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
40regulations: supplementary) applies in relation to regulations under
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.”

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) 5Chapter 1 of Part 2 of that Act (Strategic Health Authorities) is repealed.

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.

10Functions relating to fluoridation of water

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),
15in subsection (3)(a) for sub-paragraph (i) substitute—

“(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
20the Secretary of State is required to do so by section 88G(2) (following
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
25section 88G(2);”.

(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
30area.

(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
35in a county for which there is a county council;

(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)

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) 5they must co-operate with each other so as to secure that the
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
10determined so that they are consistent.

(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
15Ministers so as to secure that following the variation the arrangements
(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
20Welsh Ministers must co-operate with the Secretary of State so as to
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
25State and the Welsh Ministers under section 87B below so that
(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) 30In section 87A (target concentration of fluoridation), after subsection (3)
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
35target concentration, or

(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) 40In section 87B (fluoridation arrangements: determination of terms), in
subsection (2) —

(a) for paragraph (a) substitute—

“(a) the Secretary of State may—

(i) determine the terms of the arrangements as the
45Secretary of State sees fit; or

(ii) refer the matter for determination by such other person
as the Secretary of State considers appropriate; and”,
and”

(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) 5In section 87C (fluoridation arrangements: compliance), omit subsection (8).

(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) 10in subsection (1) for “the appropriate authority” (in each place where it
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
15“the Welsh Ministers so direct”, and

(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) 20consult any local authority affected by the arrangements at such
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

25After section 88A of the Water Industry Act 1991 insert—

“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) 30A fluoridation proposal is a proposal that the Secretary of State enter
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) 35A fluoridation proposal may be made by one or more local authorities
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) 40In the following provisions of this Chapter, “proposer”, in relation to a
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

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) 5The proposer must consult the Secretary of State as to whether the
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
10whether the arrangements which would result from implementing the
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) 15The proposer must notify the Secretary of State of the opinion of each
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 20Additional requirements where other local authorities affected

(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
25operable and efficient,

(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) 30The proposer must notify any other local authority which is affected by
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) 35The Secretary of State must by regulations—

(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
40may be taken in relation to the proposal.

88E Decision on fluoridation proposal

(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,

(c) in a case where section 88D applies, the conditions prescribed
5under subsection (4)(b) of that section are satisfied, and

(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
10to be taken for the purposes of consulting and ascertaining opinion in
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
15any area to which it relates, or to add another area, except in
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)
20as are necessary to implement the proposal.

(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
25functions under or by virtue of subsection (2) or (5).

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) 30no other local authorities are affected by the proposal, or

(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) 35arrange for an existing joint committee of the authorities to
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
40to exercise the fluoridation functions.

(a)(a)arrange for an existing joint committee of the authorities to
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
45them under section 194 of the Health and Social Care Act 2012
to exercise the fluoridation functions.

(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
50sub-committee of the Boards to exercise the fluoridation functions.

(4) The Secretary of State may by regulations make provision—

(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
5subsection (2)(b) (including provision as to qualification and
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) 10as to the procedure to be followed by any joint committee, or
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
15requests under section 87(1) as are necessary to implement a
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) 20Subsection (2) does not require the Secretary of State to consider the
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) 25This section applies where a water undertaker enters into
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
30arrangements.

(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
35the authorities in relation to the proposal which resulted in the
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) 40in any other case, by agreement between the local authorities.

(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) 45refer the matter for determination by such other person as the
Secretary of State considers appropriate.

(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
5of subsection (5), the Secretary of State may—

(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
10arrangements under section 87(1) is a reference to a local authority
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
15arrangements entered into by the water undertaker under section 87(1)
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
20undertaker under section 87(1) unless a proposal (“a termination
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
25any part of it) to be lower than the general target concentration.

(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) 30The Secretary of State may by regulations provide that, where a
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) 35In the following provisions of this Chapter, “proposer”, in relation to a
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
40proposal is a reference to a local authority whose area includes,
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
45the following provisions of this Chapter to a local authority affected by
the proposal also includes a reference to a local authority whose area

would include, coincide with or be wholly or partly within the area
specified in the arrangements if the variation were made.

88J Initial consultation etc. on variation or termination proposal

(1) This section applies if a variation or termination proposal is made.

(2) 5In the case of a variation proposal, the proposer must consult the
Secretary of State and the water undertaker who entered into the
arrangements as to whether the arrangements as varied in accordance
with the proposal would be operable and efficient.

(3) In the case of a termination proposal, the proposer must consult the
10Secretary of State and the water undertaker who entered into the
arrangements as to whether it would be reasonably practicable to
terminate the arrangements.

(4) Each person consulted under subsection (2) or (3) must give the
proposer its opinion on the matter mentioned in that subsection.

(5) 15The proposer must notify the Secretary of State of the opinion of each
water undertaker consulted under subsection (2) or (3).

(6) If the Secretary of State informs the proposer that the Secretary of State
is of the opinion that the arrangements as varied would not be operable
and efficient or (as the case may be) that it would not be reasonably
20practicable to terminate the arrangements, no further steps may be
taken in relation to the proposal.

88K Additional requirements where other local authorities affected

(1) This section applies where—

(a) a variation or termination proposal is made,

(b) 25the Secretary of State is of the opinion that the arrangements as
varied would be operable and efficient or (as the case may be)
that it would be reasonably practicable to terminate the
arrangements,

(c) one or more local authorities other than the proposer are
30affected 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
the proposal.

(3) 35The 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 duty in subsection (3) does not apply in relation to the proposal if
the Secretary of State so directs by an instrument in writing.

(5) 40The Secretary of State may by regulations provide that the duty in
subsection (3) does not apply in prescribed circumstances.

(6) The Secretary of State must by regulations—

(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.

88L Decision on variation or termination proposal

(1) 5This section applies where—

(a) a variation or termination 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 or (as the case may be) that it would be
10reasonably practicable to terminate the arrangements,

(c) in a case where the duty in section 88K(3) applies, the
conditions prescribed under subsection (6)(b) of that section are
satisfied, and

(d) the proposer wishes to take further steps in relation to the
15proposal.

(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
relation to the proposal.

(3) 20The duty in subsection (2) does not apply in relation to the proposal if
the Secretary of State so directs by an instrument in writing.

(4) The Secretary of State may by regulations provide that the duty in
subsection (2) does not apply in prescribed circumstances.

(5) The proposer of a variation proposal may (after any requirements
25imposed by regulations under subsection (2) have been complied with)
modify the proposal.

(6) But, except in circumstances prescribed in regulations by the Secretary
of State, the proposal may not be modified so as to propose the
extension of the boundary of the area specified in the arrangements or,
30if the proposal is that the arrangements be varied so as to extend the
boundary, may not be modified so as to propose a further extension of
it.

(7) The proposer must (after any requirements imposed by regulations
under subsection (2) have been complied with) decide whether to
35request the Secretary of State to request the water undertaker to vary
the arrangements or (as the case may be) to give notice under section
87C(7) to the water undertaker to terminate the arrangements.

(8) The Secretary of State may by regulations may make provision—

(a) as to factors which the proposer must or may take into account
40in making the decision mentioned in subsection (7);

(b) as to the procedure to be followed by the proposer in exercising
functions under or by virtue of subsection (2) or (7).

88M Decision-making procedure: exercise of functions by committee

(1) This section applies in relation to the exercise of functions under or by
45virtue of section 88L(2) to (7) (“the relevant functions”) except where
the proposer is a single local authority and either—

(a) no other local authorities are affected by the proposal, or