National Health Service (Amended Duties and Powers) Bill (HL Bill 26)

A

BILL

TO

Re-establish the Secretary of State’s legal duty as to the National Health
Service in England, Quangos and related bodies.

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:—

1 Secretary of State’s duties to promote and provide a comprehensive and
integrated health service

For section 1 of the National Health Service Act 2006 (Secretary of State’s duty
to promote comprehensive health service) substitute—

1 5Secretary of State’s duty as to the health service

(1) It shall be the duty of the Secretary of State to promote in England a
comprehensive and integrated health service designed to secure
improvement—

(a) in the physical and mental health of the people of England, and

(b) 10in the prevention, diagnosis and treatment of illness, and for
that purpose to provide or secure the effective provision of
services in accordance with this Act.

(2) The services so provided must be free of charge except in so far as the
making and recovery of charges is expressly provided for, by or under
15any enactment, whenever passed.

(3) The services provided pursuant to this Act and to the Health and Social
Care Act 2012, howsoever or by whom so ever provided, secured or
arranged, shall be deemed to be provided in furtherance of the duty to
provide or secure effective provision of services under subsection (1).

2 20Abolition of the duties of autonomy

Sections 1D and 13F of the National Health Service Act 2006 (duties as to
promoting autonomy) are repealed.

National Health Service (Amended Duties and Powers) BillPage 2

3 Concurrent duty of and commissioning by the NHS Commissioning Board

(1) Section 1H(2) of the National Health Service Act 2006 is repealed.

(2) In section 1H(3) of that Act, for “For the purpose of discharging that duty”,
substitute “For the purpose of furthering the duty of the Secretary of State
5under section 1(1).”

4 Secretary of State’s duty as to provision of certain services

(1) Section 3 of the National Health Service Act 2006 is amended as follows.

(2) Before subsection (1) insert—

(A1) The Secretary of State must provide, or secure the effective provision of,
10throughout England, to such extent as he considers necessary to meet
all reasonable requirements, the accommodation, services and facilities
set out in subsection (1)(a) to (f).

(3) In subsection (1), before “A” insert “For that purpose,”.

5 Powers of directions to Quangos and other bodies

(1) 15The Secretary of State may direct any of the bodies mentioned in subsection (2)
to exercise any functions relating to the health service which are specified in
the directions, and may also give directions to any such body about its exercise
of any functions or about its provision of services under arrangements referred
to in subsection (2)(h).

(2) 20These bodies are—

(a) the National Health Service Commissioning Board,

(b) a clinical commissioning group,

(c) a Special Health Authority,

(d) an NHS trust,

(e) 25an NHS foundation trust,

(f) the National Institute for Health and Care Excellence,

(g) the Health and Social Care Information Centre, and

(h) any other body or person providing services in pursuance of
arrangements made—

(i) 30by the Secretary of State under section 12 of,

(ii) by the Board or a clinical commissioning group under section 3,
3A, 3B, 4 of or Schedule 1 to,

(iii) by a local authority for the purpose of the exercise of its
functions under or by virtue of section 2B or 6C(1) of or
35Schedule 1 to, or

(iv) by the Board, a clinical commissioning group or a local
authority by virtue of section 7A of,

the National Health Service Act 2006.

(3) In exercising his power under subsection (1), the Secretary of State must have
40regard to the desirability, so far as consistent with the interests of the health
service and relevant to the exercise of the power in all circumstances—

(a) of protecting and promoting the health of patients and the public;

(b) of any bodies mentioned in subsection (2) being free, in exercising its
functions or providing services in accordance with its duties and

National Health Service (Amended Duties and Powers) BillPage 3

powers, to do so in the manner that it considers best calculated to
promote the comprehensive and integrated service referred to in
section 1(1) of the National Health Service Act 2006; and

(c) of ensuring co-operation between the bodies mentioned in subsection
5(2) in the exercise of their functions or provision of services.

(4) If, in having regard to the desirability of the matters referred to in subsection
(3) the Secretary of State considers that there is a conflict between those matters
and the discharge of his duties under section 1 of the National Health Service
Act 2006, he must give priority to the duties under that section.

6 10Monitor

(1) The Health and Social Care Act 2012 is amended as follows.

(2) After section 61 insert—

61A Monitor’s objective

(1) The objective of Monitor is to contribute to the achievement of a
15comprehensive and integrated health service in England through the
exercise of its functions.

(2) In exercising its main duty and other functions Monitor must act in
accordance with that objective and in a manner consistent with the
performance by the Secretary of State of his duties contained in sections
201 and 3 of the National Health Service Act 2006.

(3) Section 62(9) is repealed.

7 Amendment to competition requirements

(1) Section 75 of the Health and Social Care Act 2012 (requirements as to
procurement, patient choice and competition) is amended as follows.

(2) 25For paragraph (c) of subsection (1) substitute—

(c) are free so to commission such services which best serve
patients’ interests and with no impediments to beneficial co-
operation to increase integration, improve quality or reduce
inequalities;.

(3) 30After paragraph (c) of subsection (1), insert—

(d) will have a full range of options and will be under no legal
obligation to foster markets, particularly where competition
would not be effective in driving high standards and value for
patients.

(4) 35The National Health Service (Procurement, Patient Choice and Competition)
(No. 2) Regulations 2013 are repealed.

8 Public register of NHS contracts

(1) Each NHS body shall establish and maintain a public register of contracts
entered into by it in relation to the provision of health services.

National Health Service (Amended Duties and Powers) BillPage 4

(2) The register shall be available electronically and for inspection by the public at
all reasonable hours and copies of the documents on the register shall be
provided on request at reasonable cost.

(3) The Secretary of State shall make regulations to make further provision
5regarding the public register.

(4) In subsection (1) “contracts” includes documents presented in relation to the
contracts, and sub-contracts.

9 Treaty requirements

(1) No treaty which requires the United Kingdom—

(a) 10to change; or

(b) to limit the powers of the United Kingdom in respect of,

NHS legislation shall be signed or agreed unless any such changes or limits
have been approved by—

(i) in relation to England, an Act of Parliament;

(ii) 15in relation to Scotland, an Act of the Scottish Parliament;

(iii) in relation to Wales, an Act of the National Assembly for
Wales; and

(iv) in relation to Northern Ireland, an Act of the Northern
Ireland Assembly.

(2) 20In subsection (1)

  • “to change” means to amend, repeal, introduce or otherwise to change;

  • NHS legislation” means any primary legislation passed by Parliament,
    the Scottish Parliament, the National Assembly for Wales or the
    Northern Ireland Assembly, and any secondary legislation enacted by
    25the Secretary of State or any of the devolved administrations, relating
    to—

    (a)

    as regards England, the comprehensive health service which
    must be continued under section 1(1) of the National Health
    Service Act 2006;

    (b)

    30as regards Scotland, the comprehensive and integrated health
    service that must be continued under section 1(1) of the
    National Health Service (Scotland) Act 1978;

    (c)

    as regards Wales, the comprehensive health service that must
    be continued under section 1(1) of the National Health Service
    35(Wales) Act 2006; and

    (d)

    as regards Northern Ireland, the integrated health services and
    personal social services that must be provided or secured under
    Article 4 of the Health and Personal Social Services (Northern
    Ireland) Order 1972;

  • 40“treaty” means a written agreement between States or between States and
    international organisations which is binding under international law
    and includes any protocol, annex or schedule to or an amendment or
    replacement of such an agreement and includes a regulation, rule,
    measure, decision or similar instrument made under a treaty, which
    45has the effect mentioned in subsection (1).

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10 Interpretation

Expressions used in this Act which are also in the National Health Service Act
2006 and in the Health and Social Care Act 2012 shall have the same meanings
as the meanings given to those expressions under those Acts.

11 5Short title, commencement and extent

(1) This Act may be cited as the National Health Service (Amended Duties and
Powers) Act 2013.

(2) This Act shall come into force on the day on which it is passed.

(3) This Act extends to England, except section 9 which extends to England and
10Wales, Northern Ireland and Scotland.