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Health and Social Care (Community Health and Standards) Bill


Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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     (4)    When the Secretary of State or the Scottish Ministers (as the case may be) has

or have received the decision of the tribunal on an appeal, he or they must in

accordance with that decision—

           (a)           confirm the certificate,

           (b)           issue a fresh certificate, or

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           (c)           revoke the certificate.

     (5)    Subsections (5) and (6) of section 139 apply to certificates issued under

subsection (4)(b) above as they apply to certificates issued under section 138.

     (6)    Regulations under section 144 may (among other things) provide for the non-

disclosure of medical advice or medical evidence given or submitted following

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a reference under subsection (1).

 146   Appeal to Social Security Commissioner

     (1)    An appeal may be made to a Commissioner against any decision of an appeal

tribunal under section 145 on the ground that the decision was erroneous in

point of law.

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     (2)    An appeal under this section may be made by—

           (a)           the Secretary of State or the Scottish Ministers (as the case may be), or

           (b)           the person to whom the certificate was issued.

     (3)    If an appeal is made under this section, subsections (7) to (12) of section 14 of

the 1998 Act apply to the appeal as they apply to an appeal under that section

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(reading references to a tribunal as references to an appeal tribunal constituted

as mentioned in section 145(1)).

     (4)    In a case in which subsection (7) or (8)(b) of section 14 of the 1998 Act applies

by virtue of subsection (3) above, subsections (2) to (4) of section 145 apply as

they apply to an appeal determined on a reference under subsection (1) of that

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section.

     (5)    In a case in which subsection (8)(a) of section 14 of the 1998 Act applies by

virtue of subsection (3) above, section 145(4) applies as if the references to the

decision of the tribunal on an appeal were references to the decision of the

Commissioner on an appeal under this section.

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     (6)    In this section—

                    “Commissioner” has the same meaning as in Chapter 2 of Part 1 of the

1998 Act, and

                    “the 1998 Act” means the Social Security Act 1998 (c. 14).

Information

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 147   Provision of information

     (1)    If compensation is sought in consequence of any injury suffered by an injured

person, such information with respect to the circumstances of the case as may

be prescribed must be given by the following persons to the Secretary of State

or the Scottish Ministers (as the case may require)—

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           (a)           the person against whom the claim is made and anyone acting on

behalf of that person, whether or not proceedings have been

commenced,

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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           (b)           the injured person or, if the injured person has died, his personal

representative,

           (c)           anyone not within paragraph (a) who is, or is alleged to be, liable to any

extent in respect of the injury,

           (d)           if the claim is not made by the injured person, the person by whom it is

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made,

           (e)           anyone acting on behalf of the person within any of paragraphs (b) to

(d),

           (f)           the responsible body of each health service hospital at which the

injured person has received NHS treatment in respect of his injury,

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           (g)           any ambulance trust which provided NHS ambulance services as a

result of his injury.

     (2)    A person who is required to give information under this section must do so—

           (a)           in the prescribed manner, and

           (b)           within the prescribed period.

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     (3)    Regulations under this section may, in particular, require the provision of

information about any NHS treatment which an injured person has received at

a health service hospital and any NHS ambulance services provided to the

injured person.

     (4)    In this section—

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                     “ambulance trust”—

                  (a)                 in relation to England or Wales, means—

                      (i)                     a National Health Service trust established under section 5

of the National Health Service and Community Care Act

1990 (c. 19), or

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                      (ii)                    an NHS foundation trust,

                  (b)                 in relation to Scotland, means a Special Health Board

established under section 2(1)(b) of the 1978 Act;

                    “responsible body”, in relation to a health service hospital, means—

                  (a)                 in the case of a hospital vested in—

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                      (i)                     a National Health Service trust established under section 5

of the National Health Service and Community Care Act

1990 or section 12A of the 1978 Act, or

                      (ii)                    a Primary Care Trust,

                                      the trust, and

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                  (b)                 in any other case, the body responsible for the management of

the hospital.

 148   Use of information held by the Secretary of State or the Scottish Ministers etc.

     (1)    Subsection (2) applies to information which is held—

           (a)           by the Secretary of State, or

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           (b)           by a person providing services to the Secretary of State in connection

with the provision of those services,

            for the purposes of, or for any purpose connected with, the exercise of

functions under the Social Security (Recovery of Benefits) Act 1997 (c. 27).

     (2)    The information may—

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           (a)           be used for the purposes of, or for any purpose connected with, the

exercise of functions under this Part, and

 

 

Health and Social Care (Community Health and Standards) Bill
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           (b)           be supplied to a qualifying person for use for those purposes.

     (3)    In subsection (2), “qualifying person” means—

           (a)           in the case of information held by the Secretary of State—

                  (i)                 a person providing services to the Secretary of State, or

                  (ii)                the Scottish Ministers or a person providing services to the

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Scottish Ministers, or

           (b)           in the case of information held by a person providing services to the

Secretary of State—

                  (i)                 the Secretary of State or another person providing services to

the Secretary of State, or

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                  (ii)                the Scottish Ministers or a person providing services to the

Scottish Ministers.

     (4)    Subsection (5) applies to information which is held—

           (a)           by the Secretary of State or the Scottish Ministers, or

           (b)           by a person providing services to the Secretary of State or the Scottish

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Ministers in connection with provision of those services,

            for the purposes of, or for any purpose connected with, the exercise of

functions under this Part.

     (5)    The information may—

           (a)           be used for the purposes of, or for any purpose connected with, the

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exercise of functions under the Social Security (Recovery of Benefits)

Act 1997 (c. 27), and

           (b)           be supplied to a qualifying person for use for those purposes.

     (6)    In subsection (5), “qualifying person” means—

           (a)           in the case of information held by the Secretary of State, a person

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providing services to the Secretary of State,

           (b)           in the case of information held by the Scottish Ministers, the Secretary

of State or a person providing services to the Secretary of State,

           (c)           in the case of information held by a person providing services to the

Secretary of State, the Secretary of State or another person providing

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services to the Secretary of State,

           (d)           in the case of information held by a person providing services to the

Scottish Ministers, the Secretary of State or a person providing services

to the Secretary of State.

Payments to hospitals or ambulance trusts

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 149   Payment of NHS charges to hospitals or ambulance trusts

     (1)    If the Secretary of State receives or the Scottish Ministers receive a payment of

relevant NHS charges under section 137(2)—

           (a)           if the payment relates only to NHS treatment received at a health

service hospital, he or they must pay the amount received to the

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responsible body of the health service hospital,

           (b)           if the payment relates only to the provision of NHS ambulance services,

he or they must pay the amount received to the relevant ambulance

trust,

           (c)           if the payment relates to NHS treatment received at more than one

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health service hospital, he or they must divide the amount received

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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           (c)           among the responsible bodies of the hospitals concerned in such

manner as he considers or they consider appropriate,

           (d)           if the payment relates to NHS treatment received at one or more health

services hospitals and the provision of NHS ambulance services, he or

they must divide the amount received among the responsible body or

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bodies of the hospital or hospitals and any relevant ambulance trusts

concerned in such manner as he considers or they consider appropriate.

     (2)    Subsection (1) does not apply to any amount received by the Secretary of State

or the Scottish Ministers under section 137(2) which he is or they are required

to repay in accordance with regulations under section 140(2).

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     (3)    Regulations under this section may—

           (a)           make provision for the manner in which and intervals at which any

payments due under this section are to be made,

           (b)           make provision for cases where the responsible body of the health

service hospital or relevant ambulance trust concerned has ceased to

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exist (including provision modifying this Part).

     (4)    Any amounts received under this section by the responsible bodies of the

health service hospitals concerned must be used for the purposes of providing

goods and services for the benefit of patients receiving NHS treatment at those

hospitals.

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     (5)    Any amounts received under this section by the relevant ambulance trusts

concerned must be used for the purposes of NHS ambulance services.

     (6)    In this section—

                     “relevant ambulance trust”—

                  (a)                 in relation to England or Wales, means—

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                      (i)                     the National Health Service trust established under section

5 of the National Health Service and Community Care Act

1990 (c. 19), or

                      (ii)                    the NHS foundation trust,

                                      which is designated by the Secretary of State for the purposes of

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this section in relation to the health service hospital to which the

injured person was taken for treatment,

                  (b)                 in relation to Scotland, means the Special Health Board,

established under section 2(1)(b) of the 1978 Act, which is

designated by the Scottish Ministers for the purposes of this

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section in relation to the health service hospital to which the

injured person was taken for treatment;

                    “responsible body” has the meaning given in section 147(4).

Miscellaneous and general

 150   Regulations governing lump sums, periodical payments etc

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     (1)    Regulations may make provision (including provision modifying this Part)—

           (a)           for cases to which section 137(2) applies in which two or more

compensation payments in the form of lump sums are made by the

same person in respect of the same injury,

           (b)           for cases to which section 137(2) applies in which an agreement is

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entered into for the making of—

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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                  (i)                 periodical compensation payments (whether of an income or

capital nature), or

                  (ii)                periodical compensation payments and lump sum

compensation payments,

           (c)           for cases in which the compensation payment to which section 137(2)

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applies is an interim payment of damages which a court orders to be

repaid.

     (2)    Regulations made by virtue of subsection (1)(a) may (among other things)

provide—

           (a)           for giving credit for amounts already paid, and

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           (b)           for the payment by any person of any balance or the recovery from any

person of any excess.

     (3)    Regulations may make provision modifying the application of this Part in

relation to cases in which a payment into court is made and, in particular, may

provide—

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           (a)           for the making of a payment into court to be treated in prescribed

circumstances as the making of a compensation payment,

           (b)           for application for, and issue of, certificates.

 151   Liability of insurers

     (1)    If a compensation payment is made in a case where—

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           (a)           a person is liable to any extent in respect of the injury, and

           (b)           the liability is covered to any extent by a policy of insurance,

            the policy is also to be treated as covering any liability of that person under

section 137(2).

     (2)    Liability imposed on the insurer by subsection (1) cannot be excluded or

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restricted.

     (3)    For that purpose excluding or restricting liability includes—

           (a)           making the liability or its enforcement subject to restrictive or onerous

conditions,

           (b)           excluding or restricting any right or remedy in respect of the liability,

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or subjecting a person to any prejudice in consequence of his pursuing

any such right or remedy, or

           (c)           excluding or restricting rules of evidence or procedure.

     (4)    Regulations may in prescribed cases limit the amount of the liability imposed

on the insurer by subsection (1).

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     (5)    This section applies in relation to policies of insurance issued before (as well as

those issued after) the date on which it comes into force.

     (6)    References in this section to policies of insurance and their issue include

references to contracts of insurance and their making.

 152   Power to apply Part 3 to treatment at non-health service hospitals

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     (1)    Regulations may make provision for this Part to apply, with such

modifications as may be prescribed, if—

           (a)           a person makes a compensation payment as mentioned in section

137(1)(a), but

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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           (b)           the person to or in respect of whom the payment is made has—

                  (i)                 received treatment in respect of the injury at a qualifying

hospital under an NHS arrangement,

                  (ii)                been provided with NHS ambulance services as a result of the

injury for the purpose of taking him to a qualifying hospital for

5

treatment under an NHS arrangement (unless he was dead on

arrival at that hospital), or

                  (iii)               received treatment as mentioned in sub-paragraph (i) and been

provided with NHS ambulance services as mentioned in sub-

paragraph (ii),

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                         (subject to subsection (2)).

     (2)    Subsection (1)(b) does not apply where the person to or in respect of whom the

payment is made receives, or is taken to a hospital for, treatment which would

be provided as mentioned in paragraph (a), (b) or (d) of section 137(5) if it were

provided at a health service hospital.

15

     (3)    In subsection (1), “NHS arrangement” means an arrangement or agreement

between—

           (a)           the hospital in question or a body responsible for it, and

           (b)           any of the following—

                  (i)                 a Primary Care Trust,

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                  (ii)                a National Health Service trust established under section 5 of

the National Health Service and Community Care Act 1990

(c. 19) or section 12A of the 1978 Act,

                  (iii)               a Local Health Board,

                  (iv)                a Health Board or Special Health Board established under

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section 2 of the 1978 Act, or

                  (v)                 an NHS foundation trust.

     (4)    Regulations under subsection (1) may include provision excluding the

application of sections 157 to 159 of the Road Traffic Act 1988 (c. 52) in such

description of case as may be prescribed.

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     (5)    In this section “qualifying hospital” means a hospital (within the meaning of

section 128(1) of the 1977 Act or section 108(1) of the 1978 Act) which is not a

health service hospital.

 153   The Crown

This Part binds the Crown.

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 154   Regulations

     (1)    Any power to make regulations conferred by this Part is exercisable—

           (a)           in relation to England and Wales, by the Secretary of State; and

           (b)           in relation to Scotland, by the Scottish Ministers.

     (2)    Regulations under section 144(4) may only be made by the Scottish Ministers

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with the consent of the Secretary of State.

 155   Interpretation of Part 3

In this Part—

 

 

Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental Services

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                      “the 1978 Act” means the National Health Service (Scotland) Act 1978

(c. 29);

                      “compensation payment” has the meaning given in section 137;

                      “health service hospital” means a health service hospital within the

meaning of the 1977 Act or the 1978 Act;

5

                      “injured person” has the meaning given in section 137(1);

                      “NHS ambulance services” means ambulance services provided under

section 3(1)(c) of the 1977 Act or section 45 of the 1978 Act;

                      “NHS treatment” has the meaning given in section 137(5);

                      “prescribed” means prescribed by regulations.

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 156   Consequential and minor repeals

     (1)    The Road Traffic (NHS Charges) Act 1999 (c. 3) shall cease to have effect.

     (2)    In the Road Traffic Act 1988 (c. 52), in section 161(1), in the definition of

“hospital”, paragraph (b) is omitted.

Part 4

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Dental Services

 157   Provision of primary dental services

In the 1977 Act, after section 16C insert—

“Functions of Primary Care Trusts and Local Health Boards

       16CA               Primary dental services

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           (1)           Each Primary Care Trust and Local Health Board must, to the extent

that it considers it reasonable to do so, provide primary dental services

within its area, or secure their provision within its area.

           (2)           For the purposes of this section, a Primary Care Trust or Local Health

Board may (in addition to any other power conferred on it) provide

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primary dental services itself.

           (3)           Each Primary Care Trust and Local Health Board must publish

information about such matters as may be prescribed in relation to the

primary dental services for which it makes provision under this section.

           (4)           A body on which functions are conferred under this section must co-

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operate with any other such body in the discharge of their respective

functions under this section.

           (5)           Regulations may provide that services of a prescribed description are,

or are not, to be regarded as primary dental services for the purposes of

this Part.

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           (6)           Regulations under subsection (5) may in particular describe services by

reference to the manner or circumstances in which they are provided.”

 

 

 
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