Health and Care Bill (HL Bill 71)

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assistance under section 149(2) so far as they are not functions to which
subsection (3) above applies.

(5)The Secretary of State may give directions to a body about the exercise
of any functions that it is directed to exercise under any of subsections
5(1) to (4).”

(5)In section 154 (arrangements with other third parties)—

(a)in subsection (1)(a), after “section 149” insert “(1)”;

(b)after subsection (1) insert—

(1A)The Secretary of State may make arrangements for—

(a)10financial assistance under section 149(1A) to be given, or

(b)other functions relating to such assistance to be
exercised,

by a person other than a Special Health Authority (as to Special
Health Authorities, see section 153(2)).”;

(c)15in subsections (2), (3), (4) and (5) after “subsection (1)” insert “or (1A)”.

(6)In section 155 (power to form company), after “section 154(1)” insert “or (1A)”.

Professional regulation

142 Regulation of health care and associated professions

(1)The Health Act 1999 is amended as follows.

(2)20In section 60 (regulation of health professions and social care workers etc)—

(a)in subsection (1), after paragraph (b) insert—

(bza)deregulating a profession regulated by an enactment to
which subsection (2) applies if the profession does not
appear to Her to require regulation for the protection of
25the public,”;

(b)in subsection (1), after paragraph (bd) insert—

(be)deregulating any social care workers in England who do
not appear to Her to require regulation for the
protection of the public,”;

(c)30for subsection (2) substitute—

(2)The professions referred to in subsection (1)(a) and (bza) are the
professions regulated by any of the following—

(a)the Medical Act 1983;

(b)the Dentists Act 1984;

(c)35the Opticians Act 1989;

(d)the Osteopaths Act 1993;

(e)the Chiropractors Act 1994;

(f)the Nursing and Midwifery Order 2001;

(g)the Health Professions Order 2001;

(h)40the Pharmacy Order 2010 and the Pharmacy (Northern
Ireland) Order 1976;

(i)an Order in Council under this section.”;

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(d)after subsection (2) insert—

(2ZZA)For the purposes of subsection (1)(b) the reference to a
profession is to be treated as including any group of workers,
whether or not they are generally regarded as a profession (and
5references in this Part to a profession are to be read
accordingly).”;

(e)in subsection (2ZB), for “and (bd)” substitute “, (bd) and (be)”.

(3)In section 62 (regulations and orders), after subsection (10) insert—

(10A)If any provision made by an Order in Council by virtue of
10section 60(2ZZA) would, if it were included in an Act of Senedd
Cymru, be within the legislative competence of the Senedd and is not
merely incidental to, or consequential on, provision that (if so included)
would be outside that competence, no recommendation is to be made
to Her Majesty to make the Order unless the Welsh Ministers have
15consented to that provision.”

(4)In Schedule 3 (power to make provision about regulation of health care and
associated professions: supplementary)—

(a)after paragraph 1B insert—

“Power to abolish regulatory bodies

1C20An Order may abolish a regulatory body if (and only if) the
professions regulated by the body or social care workers in
England regulated by it—

(a)will continue to be regulated by one or more other
regulatory bodies, or

(b)25are deregulated by provision made under section
60(1)(bza).”;

(b)in paragraph 7 (matters outside scope of the Orders), omit sub-
paragraphs (1) and (1A);

(c)in paragraph 8 (restrictions on provision authorising regulatory body’s
30functions to be exercised by others)—

(i)in sub-paragraphs (1), (2ZA) and (2A), for the words from
“other than” to the end substitute “to exercise that function
other than—

(a)a regulatory body for—

(i)35a profession to which section 60(2)
applies, or

(ii)social care workers in England, or

(b)the committees or officers of such a body.”;

(ii)omit sub-paragraph (2B).

Health and Care BillPage 122

Medical examiners

143 Medical examiners

(1)After section 18 of the Coroners and Justice Act 2009 insert—

18A Medical examiners: England

(1)5An English NHS body may appoint persons as medical examiners to
discharge in England the functions conferred on medical examiners by
or under this Chapter.

(2)The Secretary of State must take such steps as the Secretary of State
considers appropriate for the purpose of ensuring—

(a)10that enough medical examiners are appointed under subsection
(1) to enable those functions to be discharged in England,

(b)that the funds and other resources that are made available to
such medical examiners are enough to enable those functions to
be discharged in England, and

(c)15that the performance of such medical examiners is monitored
by reference to any standards or levels of performance that they
are expected to attain.

(3)For the purposes of discharging the duty in subsection (2), the Secretary
of State may give a direction to an English NHS body—

(a)20requiring the body to appoint or arrange for the appointment of
one or more medical examiners,

(b)about the funds or other resources to be made available to a
medical examiner employed by an English NHS body,

(c)about the steps to be taken by the body to monitor the
25performance of such a medical examiner, or

(d)about the steps to be taken by the body to monitor the
performance of functions by an English NHS body in relation to
such a medical examiner.

(4)In this section “English NHS body” means—

(a)30NHS England,

(b)an integrated care board established under section 14Z25 of the
National Health Service Act 2006,

(c)a National Health Service trust established under section 25 of
that Act,

(d)35a Special Health Authority established under section 28 of that
Act, or

(e)an NHS foundation trust within the meaning of section 30 of
that Act.

18B Medical examiners: Wales

(1)40A Welsh NHS body may appoint persons as medical examiners to
discharge in Wales the functions conferred on medical examiners by or
under this Chapter.

(2)The Welsh Ministers must take such steps as the Welsh Ministers
consider appropriate for the purpose of ensuring—

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(a)that enough medical examiners are appointed under subsection
(1) to enable those functions to be discharged in Wales,

(b)that the funds and other resources that are made available to
such medical examiners are enough to enable those functions to
5be discharged in Wales, and

(c)that the performance of such medical examiners is monitored
by reference to any standards or levels of performance that they
are expected to attain.

(3)In this section “Welsh NHS body” means—

(a)10a Local Health Board,

(b)a National Health Service trust established under section 18 of
the National Health Service (Wales) Act 2006, or

(c)a Special Health Authority established under section 22 of that
Act.”

(2)15In section 19 of that Act (medical examiners)—

(a)in the heading, after “examiners” insert “: supplementary”;

(b)omit subsections (1) and (2);

(c)in subsection (5)—

(i)after “Nothing in” insert “section 18A or 18B or”;

(ii)20for “a local authority or a Local Health Board” substitute “an
English NHS body (as defined by section 18A) or a Welsh NHS
body (as defined by section 18B)”.

(3)In section 20 of that Act (medical certificate of cause of death), in subsection (5),
for “a local authority or Local Health Board” substitute “an English NHS body
25(as defined by section 18A) or a Welsh NHS body (as defined by section 18B)”.

(4)In section 48 of that Act (interpretation: general), in subsection (1), in the
definition of “medical examiner”, for “section 19” substitute “section 18A or
18B”.

(5)In section 41 of the Births and Deaths Registration Act 1953 (interpretation), in
30subsection (1), in the definition of “medical examiner”, for “means a person
appointed under section 19” substitute “has the meaning given by section
48(1)”.

(6)In the Health and Social Care Act 2012 omit section 54 (which inserted
references to local authorities into sections 19 and 20 of the Coroners and
35Justice Act 2009).

Food and drink

144 Advertising of less healthy food and drink

Schedule 17 amends the Communications Act 2003 to restrict the advertising
of certain food and drink products.

145 40Hospital food standards

In section 20 of the Health and Social Care Act 2008 (regulation of regulated
activities)—

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(a)in subsection (3), after paragraph (d), insert—

(da)impose requirements in connection with food or drink
provided or made available to any person on hospital
premises in England that are used in connection with
5the carrying on of a regulated activity;”;

(b)after subsection (4A) insert—

(4B)Regulations made under this section by virtue of subsection
(3)(da) may in particular—

(a)specify nutritional standards, or other nutritional
10requirements, which are to be complied with;

(b)require that specified descriptions of food or drink are
not to be provided or made available.”

(c)after subsection (5B) insert—

(5C)In subsection (3)(da) “hospital” has the meaning given by
15section 275 of the National Health Service Act 2006.”

146 Food information for consumers: power to amend retained EU law

(1)In section 16 of the Food Safety Act 1990 (regulations about food labelling etc),
after subsection (3) insert—

(3A)Regulations under subsection (1)(e) may amend Regulation (EU) No
201169/2011 of the European Parliament and of the Council on the
provision of food information to consumers.

(3B)The inclusion in that Regulation of savings in respect of the power to
make regulations under this Act of a particular kind is not to be taken
as in any way limiting the generality of the provision that may be made
25by virtue of subsections (1)(e) and (3A).”

(2)In section 48 (regulations and orders)—

(a)in subsection (3), after “shall” insert “, unless the instrument contains
regulations which include provision made by virtue of section 16(3A),”;

(b)after subsection (3) insert—

(3A)30A statutory instrument containing regulations which include
provision made by virtue of section 16(3A) may not be made by
the Secretary of State unless a draft of the instrument has been
laid before and approved by a resolution of each House of
Parliament.

(3B)35A statutory instrument containing regulations which include
provision made by virtue of section 16(3A) may not be made by
the Welsh Ministers unless a draft of the instrument has been
laid before and approved by a resolution of Senedd Cymru.

(3C)Regulations made by the Scottish Ministers which include
40provision made by virtue of section 16(3A) are subject to the
affirmative procedure (see Part 2 of the Interpretation and
Legislative Reform (Scotland) Act 2010 (asp 10)).”

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Fluoridation of water supplies

147 Fluoridation of water supplies

(1)The Water Industry Act 1991, as amended by the Health and Social Care Act
2012, is amended in accordance with subsections (2) to (7).

(2)5In section 87 (fluoridation of water supplies at request of relevant
authorities)—

(a)omit subsection (3A);

(b)in subsection (4), in paragraph (a), for the words from “as the Secretary
of State” to the end of that paragraph substitute “in England as the
10Secretary of State may determine”;

(c)in subsection (6), at the beginning insert “Subject to subsection (6A)”;

(d)after subsection (6) insert—

(6A)The Secretary of State may by regulations provide that, in
circumstances specified in the regulations, subsection (6)(a) is
15not to apply in relation to arrangements entered into by the
Secretary of State.

(6B)The Secretary of State may by regulations require a public body
specified in the regulations to make payments to the Secretary
of State to meet any costs incurred by the Secretary of State
20under the terms of the arrangements.”;

(e)omit subsections (7A) and (7B);

(f)after subsection (7F) insert—

(7G)Before making regulations under subsection (6A) or (6B) the
Secretary of State must consult such persons as the Secretary of
25State considers appropriate.”;

(g)in subsection (11), for “the Welsh Ministers” substitute “a relevant
authority”;

(h)after subsection (11) insert—

(12)A statutory instrument containing regulations under subsection
30(6A) is not to be made unless a draft of the instrument has been
laid before, and approved by a resolution of, each House of
Parliament.”

(3)In section 87A (target concentration of fluoride), omit subsection (3A).

(4)Omit sections 88B to 88O (procedural requirements in connection with
35fluoridation of water supplies).

(5)In section 89 (consultation)—

(a)in the heading, omit “: Wales”;

(b)in subsection (1)—

(i)in the words before paragraph (a), for “the Welsh Ministers”
40substitute “a relevant authority”;

(ii)in paragraphs (a) and (b), for “the Welsh Ministers” substitute
“that authority”;

(c)in subsection (3), in paragraph (a), for “the Welsh Ministers are”
substitute “the relevant authority is”;

(d)45in subsection (4)—

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(i)for “the Welsh Ministers”, in the first place it occurs, substitute
“a relevant authority”;

(ii)for “the Welsh Ministers so direct” substitute “that authority so
directs”.

(6)5In section 90A (review of fluoridation), omit subsection (5A).

(7)In section 213 (power to make regulations), in subsection (1), after “36A” insert
“, 87(6A)”.

(8)In consequence of the amendments made by this section, omit section 36 of the
Health and Social Care Act 2012.

(9)10The reference in section 213(1A) of the Water Industry Act 1991 to the first
exercise of the power to make regulations under section 89 is to be read as a
reference to the first exercise of the power to make regulations under that
section as amended by subsection (5).

148 Fluoridation of water supplies: transitional provision

(1)15The Water Industry Act 1991 is amended in accordance with subsections (2)
and (3).

(2)After section 90A insert—

90B Old English fluoridation arrangements: transitional provision

(1)With effect from the day on which section 148 of the Health and Care
20Act 2021 comes into force, old English fluoridation arrangements are to
be treated for the purposes of this Chapter as if they were arrangements
entered into by the water undertaker with the Secretary of State under
section 87(1).

(2)The Secretary of State may request such modifications to the
25arrangements as the Secretary of State considers necessary in order to
give effect to subsection (1) (for example to insert the terms mentioned
in section 87(6)).

(3)If the Secretary of State and the water undertaker fail to agree the
modifications requested by the Secretary of State—

(a)30subsection (2) or, as the case may be, (4) of section 87B is to
apply as if the parties had failed to agree the terms of the
arrangements under section 87(1), and

(b)following determination of the modifications—

(i)the Secretary of State is to give notice of the
35determination to the water undertaker, and

(ii)the arrangements are deemed to have been modified as
so determined with effect from the day after the date of
notice.

(4)Sections 87(11) and 89(1) (which relate to consultation) do not apply to
40the deemed entry into, and modification of, arrangements by virtue of
this section.

(5)References in this Chapter to arrangements entered into under section
87(1) include arrangements entered into by a water undertaker by
virtue of subsection (1).

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(6)In this section “old English fluoridation arrangements” means—

(a)any arrangements entered into by a water undertaker with a
Strategic Health Authority under section 87(1) of the Water
Industry Act 1991 (before section 87(3) was amended by section
535(2) of the Health and Social Care Act 2012 in relation to
England)), and

(b)any arrangements which were treated as arrangements falling
within paragraph (a) by virtue of section 91 (as that section had
effect immediately before the commencement of section 37(4) of
10the Health and Social Care Act 2012).”

(3)In section 91—

(a)for the heading substitute “Old Welsh fluoridation arrangements:
transitional provision”;

(b)in subsection (1)—

(i)15for “relevant pre-1985 arrangements” substitute “old Welsh
fluoridation arrangements”;

(ii)for “relevant authority” substitute “Welsh Ministers”;

(c)in subsection (2), for “relevant authority” substitute “Welsh Ministers”;

(d)in subsection (3)—

(i)20for “relevant authority”, in both places it occurs, substitute
“Welsh Ministers”;

(ii)in the words before paragraph (a), for “the authority” substitute
“the Welsh Ministers”;

(iii)in paragraph (a), omit “(2),”;

(e)25in subsection (6)—

(i)in the definition of “the appointed day”, after “force” insert “in
relation to Wales”;

(ii)for the definition of “relevant pre-1985 arrangements”
substitute—

  • 30““old Welsh fluoridation arrangements” means
    arrangements, other than arrangements
    mentioned in section 90B(6), in pursuance of
    which a scheme for increasing the fluoride
    content of water was being operated by a water
    35undertaker by virtue of paragraph 1 of Schedule
    7 to this Act immediately before the appointed
    day.”

(4)In consequence of the amendments made by this section, omit section 37 of the
Health and Social Care Act 2012.

40Part 7 General

149 Power to make consequential provision

(1)The Secretary of State may by regulations make provision that is consequential
on this Act.

(2)45Regulations under this section may amend, repeal or revoke provision made
by this Act or any provision made by or under primary legislation passed—

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(a)before this Act, or

(b)later in the same session of Parliament as this Act.

(3)In this section “primary legislation” means—

(a)an Act,

(b)5an Act or Measure of Senedd Cymru,

(c)an Act of the Scottish Parliament, or

(d)Northern Ireland legislation.

150 Regulations

(1)A power to make regulations under any provision of this Act includes power
10to make—

(a)consequential, supplementary, incidental, transitional or saving
provision;

(b)different provision for different purposes.

(2)Regulations under this Act are to be made by statutory instrument.

(3)15A statutory instrument containing any of the following (whether alone or with
other provision) may not be made unless a draft of the instrument has been laid
before and approved by a resolution of each House of Parliament—

(a)regulations under section 15(4);

(b)regulations under sections 89 or 90;

(c)20regulations under section 109;

(d)regulations under section 149 that amend or repeal provision made by
primary legislation (as defined by section 149(3)).

Any other statutory instrument containing regulations under section 149 is
subject to annulment in pursuance of a resolution of either House of
25Parliament.

(5)This section does not apply to regulations under section 153.

151 Financial provision

There is to be paid out of money provided by Parliament—

(a)any expenditure incurred by the Secretary of State under or by virtue of
30this Act, and

(b)any increase attributable to this Act in the sums payable under any
other Act out of money so provided.

152 Extent

(1)This Act extends to England and Wales only, subject to subsections (2) to (5).

(2)35The following extend to England and Wales, Scotland and Northern Ireland—

(a)in Part 1, paragraph 1(3) and (4) of Schedule 1 (renaming of NHS
Commissioning Board);

(b)Part 3 (Secretary of State’s powers to transfer or delegate functions);

(c)in Part 4, section 111 (restriction of statutory powers requiring
40disclosure);

(d)this Part.

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(3)Sections 126 to 129 extend to Scotland only.

(4)Sections 130 to 133 extend to Northern Ireland only.

(5)An amendment, repeal or revocation made by this Act has the same extent as
the provision amended, repealed or revoked.

153 5Commencement

(1)This Part comes into force on the day on which this Act is passed.

(2)Section 135(2) comes into force on such day as the Welsh Ministers may by
regulations appoint.

(3)Section 144 and Schedule 17 (advertising of less healthy food and drink) come
10into force on 1 January 2023.

(4)Except as mentioned in subsections (1) to (3), this Act comes into force on such
day as the Secretary of State may by regulations appoint.

(5)Different days may be appointed under subsection (2) or (4) for different
purposes.

(6)15The Secretary of State may by regulations make transitional or saving
provision in connection with the coming into force of any provision of this Act.

(7)The Welsh Ministers may by regulations make transitional or saving provision
in connection with the coming into force of section 135(2).

(8)The power to make regulations under subsection (6) or (7) includes power to
20make different provision for different purposes.

(9)Regulations under this section are to be made by statutory instrument.

154 Short title

This Act may be cited as the Health and Care Act 2021.