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“the CHAI” means the Commission for Healthcare Audit and Inspection; | |
“cross-border SHA” means a Special Health Authority performing | |
functions in respect of England and Wales equally; | |
“the CSCI” means the Commission for Social Care Inspection; | |
“English local authority social service” means— | 5 |
(a) a service which is provided, in any place, by a local authority in | |
England in the exercise of any of its social services functions; | |
(b) a service which is provided, in any place, by another person | |
pursuant to arrangements made by a local authority in England | |
in the exercise of its social services functions; | 10 |
(c) a service which— | |
(i) is provided, in any place, by a local authority in England, | |
or by another person pursuant to arrangements made by a | |
local authority in England, under section 2(1)(b) of the | |
Local Government Act 2000 (c. 22); and | 15 |
(ii) is similar in nature to a service which could be provided by | |
the authority in the exercise of any of its social services | |
functions. | |
“English NHS body” means— | |
(a) a Primary Care Trust; | 20 |
(b) a Strategic Health Authority; | |
(c) an NHS trust all or most of whose hospitals, establishments and | |
facilities are situated in England; | |
(d) an NHS foundation trust; | |
(e) a Special Health Authority performing functions only or mainly | 25 |
in respect of England; | |
“financial year”, in relation to the CHAI or the CSCI, means— | |
(a) the period beginning with the date on which that body is | |
established and ending with the next 31st March following that | |
date; and | 30 |
(b) each successive period of twelve months ending with 31st | |
March; | |
“health care” has the meaning given by section 40(2); | |
“local authority” has the same meaning as in the Local Authority Social | |
Services Act 1970 (c. 42) (see section 1 of that Act); | 35 |
“Minister of the Crown” has the same meaning as in the Ministers of the | |
Crown Act 1975 (c. 26); | |
“NHS body” means— | |
(a) an English NHS body; | |
(b) a Welsh NHS body; | 40 |
(c) a cross-border SHA; | |
“NHS trust” has the same meaning as in Part 1 of the 1977 Act; | |
“personal records” includes medical records; | |
“prescribed” means prescribed by regulations made by— | |
(a) the Secretary of State; | 45 |
(b) in the case of sections 58, 69, 95, 108 and 110, the Assembly; | |
“regulator” means the Independent Regulator of NHS Foundation Trusts; | |
“social services functions” has the same meaning as in the Local Authority | |
Social Services Act 1970; | |
“Welsh local authority social service” means— | 50 |
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(a) a service provided, in any place, by a local authority in Wales in | |
the exercise of any of its social services functions; | |
(b) a service provided, in any place, by another person pursuant to | |
arrangements made by a local authority in Wales in the exercise | |
of its social services functions; | 5 |
(c) a service which— | |
(i) is provided, in any place, by a local authority in Wales, or | |
by another person pursuant to arrangements made by a | |
local authority in Wales, under section 2(1)(b) of the Local | |
Government Act 2000 (c. 22); and | 10 |
(ii) is similar in nature to a service which could be provided by | |
the authority in the exercise of any of its social services | |
functions; | |
“Welsh NHS body” means— | |
(a) a Local Health Board; | 15 |
(b) an NHS trust all or most of whose hospitals, establishments and | |
facilities are situated in Wales; | |
(c) a Special Health Authority performing functions only or mainly | |
in respect of Wales. | |
140 References to the provision of health care | 20 |
(1) For the purposes of this Part, a person provides health care for another person | |
if he provides it— | |
(a) at the direction of the other person; | |
(b) in accordance with, or by virtue of, an agreement or arrangements | |
made by the other person (whether or not with the person providing | 25 |
the health care); or | |
(c) otherwise on behalf of the other person. | |
(2) References in this section to the provision of health care include references to | |
its provision jointly with another person. | |
Part 3 | 30 |
Recovery of NHS charges | |
NHS charges | |
141 Liability to pay NHS charges | |
(1) This section applies if— | |
(a) a person makes a compensation payment to or in respect of any other | 35 |
person (the “injured person”) in consequence of any injury suffered by | |
the injured person, and | |
(b) the injured person has— | |
(i) received NHS treatment at a health service hospital in respect of | |
the injury, | 40 |
(ii) been provided with NHS ambulance services as a result of the | |
injury for the purpose of taking him to a health service hospital | |
for NHS treatment (unless he was dead on arrival at that | |
hospital), or | |
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| |
(iii) received treatment as mentioned in sub-paragraph (i) and been | |
provided with ambulance services as mentioned in sub- | |
paragraph (ii). | |
(2) The person making the compensation payment is liable to pay the relevant | |
NHS charges— | 5 |
(a) in respect of— | |
(i) the treatment, in so far as received at a hospital in England or | |
Wales, | |
(ii) the ambulance services, in so far as provided to take the injured | |
person to such a hospital, | 10 |
to the Secretary of State, | |
(b) in respect of— | |
(i) the treatment, in so far as received at a hospital in Scotland, | |
(ii) the ambulance services, in so far as provided to take the injured | |
person to such a hospital, | 15 |
to the Scottish Ministers. | |
(3) “Compensation payment” means a payment, including a payment in money’s | |
worth, made— | |
(a) by or on behalf of a person who is, or is alleged to be, liable to any extent | |
in respect of the injury, or | 20 |
(b) in pursuance of a compensation scheme for motor accidents, | |
but does not include a payment mentioned in Schedule 9. | |
(4) Subsection (1)(a) applies— | |
(a) to a payment made— | |
(i) voluntarily, or in pursuance of a court order or an agreement, or | 25 |
otherwise, and | |
(ii) in the United Kingdom or elsewhere, and | |
(b) if more than one payment is made, to each payment. | |
(5) “NHS treatment” means any treatment (including any examination of the | |
injured person) other than— | 30 |
(a) treatment provided by virtue of section 18A(4) or 65 of the 1977 Act, | |
section 57 of, or paragraph 14 of Schedule 7A to, the 1978 Act or | |
paragraph 14 of Schedule 2 to the National Health Service and | |
Community Care Act 1990 (c. 19) (accommodation and services for | |
private patients), | 35 |
(b) treatment provided at a hospital of an NHS foundation trust in | |
pursuance of an undertaking to pay in respect of the treatment given by | |
or on behalf of the injured person, | |
(c) treatment provided at a health service hospital by virtue of section 72 | |
of the 1977 Act or section 64 of the 1978 Act (permission for use of | 40 |
national health service accommodation or facilities in private practice), | |
or | |
(d) treatment provided by virtue of— | |
(i) section 16CA, 28C, 28K or 29 of the 1977 Act (primary dental | |
services and personal or general medical or dental services), or | 45 |
(ii) section 17C, 19 or 25 of the 1978 Act (personal or general | |
medical or dental services). | |
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(6) In relation to any time before sections 161 and 163 come into force, the | |
references in subsection (5)(d)(i) to sections 16CA and 28K of the 1977 Act are | |
to be taken as a reference to section 35 of that Act (arrangements for general | |
dental services). | |
(7) “Relevant NHS charges” means the amount (or amounts) specified in a | 5 |
certificate of NHS charges— | |
(a) issued under this Part, in respect of the injured person, to the person | |
making the compensation payment, and | |
(b) in force. | |
(8) “Compensation scheme for motor accidents” means any scheme or | 10 |
arrangement under which funds are available for the payment of | |
compensation in respect of motor accidents caused, or alleged to have been | |
caused, by uninsured or unidentified persons. | |
(9) Regulations may amend Schedule 9 by omitting or modifying any payment for | |
the time being specified in that Schedule. | 15 |
(10) This section applies in relation to any injury which occurs after the date on | |
which this section comes into force. | |
(11) For the purposes of this Part, it is irrelevant whether a compensation payment | |
is made with or without an admission of liability. | |
Certificates of NHS charges | 20 |
142 Applications for certificates of NHS charges | |
(1) Before a person makes a compensation payment in consequence of any injury | |
suffered by an injured person, he may apply for a certificate to the Secretary of | |
State, the Scottish Ministers or both, according to whether he believes the | |
relevant NHS charges payable by him (if any) would be due to the Secretary of | 25 |
State, the Scottish Ministers or both. | |
(2) If the Secretary of State receives or the Scottish Ministers receive an application | |
under subsection (1), he or they must arrange for a certificate to be issued as | |
soon as is reasonably practicable (subject to section 143). | |
(3) A certificate may provide that it is to remain in force— | 30 |
(a) until a specified date, | |
(b) until the occurrence of a specified event, or | |
(c) indefinitely. | |
(4) A person may apply under subsection (1) for a fresh certificate from time to | |
time. | 35 |
(5) Subsection (2) does not require the Secretary of State or the Scottish Ministers | |
to arrange for a fresh certificate to be issued to a person applying under | |
subsection (4) if, when the application is received, a certificate issued to the | |
applicant in respect of the injured person is still in force; but the Secretary of | |
State or the Scottish Ministers (as the case may be) may arrange for a fresh | 40 |
certificate to be issued so as to have effect on the expiry of the current | |
certificate. | |
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(6) If a certificate expires, the Secretary of State or the Scottish Ministers (as the | |
case may be) may arrange for a fresh certificate to be issued without an | |
application having to be made. | |
(7) In the circumstances mentioned in subsection (8), a person who has made a | |
compensation payment in consequence of an injury suffered by an injured | 5 |
person must apply for a certificate to the Secretary of State, the Scottish | |
Ministers or both, according to whether he believes the relevant NHS charges | |
payable by him (if any) would be due to the Secretary of State, the Scottish | |
Ministers or both. | |
(8) The circumstances are that— | 10 |
(a) at the time the payment is made by the person— | |
(i) no certificate has been issued to him in respect of the injured | |
person, or | |
(ii) if such a certificate has been issued to him, it is no longer in | |
force, and | 15 |
(b) no application for a certificate has been made by him during the | |
prescribed period ending immediately before the day on which the | |
compensation payment is made. | |
(9) An application for a certificate must be made in the prescribed manner and, in | |
the case of an application under subsection (7), within the prescribed period. | 20 |
(10) On receiving an application under subsection (7), the Secretary of State or the | |
Scottish Ministers must arrange for a certificate to be issued as soon as is | |
reasonably practicable (subject to section 143). | |
(11) In this section and section 143, “relevant NHS charges” has the meaning given | |
in section 141(7). | 25 |
143 Section 142: supplementary | |
(1) Subsection (2) applies if— | |
(a) an application is made under subsection (1) or (7) of section 142 to the | |
Secretary of State or the Scottish Ministers, and | |
(b) it appears to the Secretary of State or the Scottish Ministers that the | 30 |
relevant NHS charges payable by the applicant (if any) would be due | |
to the Scottish Ministers or the Secretary of State (respectively) instead. | |
(2) The Secretary of State or the Scottish Ministers (as the case may be) must refer | |
the application to the Scottish Ministers or the Secretary of State (respectively), | |
and the application is to be treated, for the purposes of this Part, as having been | 35 |
made to the Scottish Ministers or the Secretary of State (as the case may be). | |
(3) Subsection (4) applies if— | |
(a) an application is made under subsection (1) or (7) of section 142 to the | |
Secretary of State or the Scottish Ministers, and | |
(b) it appears to the Secretary of State or the Scottish Ministers that the | 40 |
relevant NHS charges payable by the applicant (if any) would be due | |
in part to him or them and in part to the Scottish Ministers or the | |
Secretary of State (respectively). | |
(4) The Secretary of State or the Scottish Ministers (as the case may be) must refer | |
the application to the Scottish Ministers or the Secretary of State (respectively) | 45 |
in so far as the application relates to relevant NHS charges due to them or him, | |
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and the application is to be treated, for the purposes of this Part, as having been | |
made to the Secretary of State in so far as it relates to relevant NHS charges due | |
to him under subsection (2) of section 141 and to the Scottish Ministers in so far | |
as it relates to relevant NHS charges due to them under that subsection. | |
(5) A certificate may be issued under section 142 jointly by the Secretary of State | 5 |
and the Scottish Ministers specifying— | |
(a) an amount (or amounts) for which a person is liable under subsection | |
(2) of section 141 to the Secretary of State, and | |
(b) an amount (or amounts) for which that person is liable under that | |
subsection to the Scottish Ministers, | 10 |
in respect of the same injured person in consequence of the same injury. | |
(6) In the case of a certificate issued under section 142 specifying an amount (or | |
amounts) as mentioned in paragraphs (a) and (b) of subsection (5), references | |
in the following provisions of this Part to a certificate are to be taken as being | |
to the certificate in so far as it relates to the liability to the Secretary of State or | 15 |
in so far as it relates to the liability to the Scottish Ministers (as the case may | |
require). | |
144 Information contained in certificates | |
(1) A certificate must specify the amount (or amounts) for which the person to | |
whom it is issued is liable under section 141(2). | 20 |
(2) The amount (or amounts) to be specified is (or are) to be that (or those) set out | |
in, or determined in accordance with, regulations, reduced if applicable in | |
accordance with subsection (3). | |
(3) If a certificate relates to a claim made by or on behalf of an injured person— | |
(a) in respect of which a court in England and Wales or Scotland has | 25 |
ordered a reduction of damages in accordance with section 1 of the Law | |
Reform (Contributory Negligence) Act 1945 (c. 28), | |
(b) in respect of which a court in Northern Ireland has ordered a reduction | |
of damages in accordance with section 2 of the Law Reform | |
(Miscellaneous Provisions) Act (Northern Ireland) 1948 (c. 23), | 30 |
(c) in respect of which a court in a country other than England and Wales, | |
Scotland or Northern Ireland has ordered a reduction of damages | |
under any provision of the law of that country which appears to the | |
Secretary of State or the Scottish Ministers (as the case may be) to | |
correspond to section 1 of the Law Reform (Contributory Negligence) | 35 |
Act 1945, | |
(d) in respect of which an officer of a court in England and Wales or | |
Northern Ireland has entered or sealed an agreed judgement or order | |
which specifies— | |
(i) that the damages are to be reduced to reflect the injured | 40 |
person’s share in the responsibility for the injury in question, | |
and | |
(ii) the amount or proportion by which they are to be so reduced, | |
(e) in the case of which the parties to any resulting action before a court in | |
Scotland have executed a joint minute which specifies— | 45 |
(i) that the action has been settled extra-judicially, and | |
(ii) the matters mentioned in paragraph (d)(i) and (ii), | |
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(f) in respect of which a document has been made under any provision of | |
the law of a country other than England and Wales, Scotland or | |
Northern Ireland— | |
(i) which appears to the Secretary of State to correspond to an | |
agreed judgement or order entered or sealed by an officer of a | 5 |
court in England and Wales, and | |
(ii) which specifies the matters mentioned in paragraph (d)(i) and | |
(ii), or | |
(g) in the case of which a document has been made under any provision of | |
the law of a country other than England and Wales, Scotland or | 10 |
Northern Ireland— | |
(i) which appears to the Scottish Ministers to correspond to a joint | |
minute executed by the parties to a resulting action before a | |
court in Scotland specifying that the action has been settled | |
extra-judicially, and | 15 |
(ii) which specifies the matters mentioned in paragraph (d)(i) and | |
(ii), | |
the amount (or amounts) specified in the certificate is (or are) to be that (or | |
those) which would be so specified apart from this subsection, reduced by the | |
same proportion as the reduction of damages. | 20 |
(4) If a certificate relates to an injured person who has not received NHS treatment | |
at a health service hospital or been provided with NHS ambulance services in | |
respect, or as a result, of the injury, it must indicate that no amount is payable | |
to the Secretary of State or the Scottish Ministers (as the case may be) by | |
reference to that certificate. | 25 |
(5) Regulations under subsection (2) may, in particular, provide— | |
(a) that the amount, or the aggregate amount, specified in a certificate is | |
not to exceed a prescribed sum, | |
(b) for different amounts to be specified in respect of different | |
circumstances or areas, | 30 |
(c) for cases in which an injured person receives treatment at two or more | |
health service hospitals, | |
(d) for cases in which an injured person receives treatment at one or more | |
health service hospitals and is provided with NHS ambulance services, | |
(e) for cases in which liability under section 141(2) is to be apportioned | 35 |
between two or more persons making compensation payments to or in | |
respect of the same injured person in consequence of the same injury, | |
(f) for cases in which a fresh certificate is issued or a certificate is revoked | |
as a result of a review under section 147 or an appeal under section 148 | |
or 150, | 40 |
(g) for the amount specified in a certificate issued by the Secretary of State | |
or the Scottish Ministers to be adjusted to take into account any amount | |
for which the person to whom the certificate is issued is liable under | |
section 141(2), in respect of the same injured person in consequence of | |
the same injury, in accordance with a certificate issued by the Scottish | 45 |
Ministers or the Secretary of State (respectively), | |
(h) for any matter requiring determination under or in consequence of the | |
regulations to be determined by the Secretary of State or the Scottish | |
Ministers (as the case may require), | |
and in the case of paragraph (e) may make such provision by modifying this | 50 |
Part. | |
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