Amendments proposed to the Health and Social Care (Community Health and Standards) Bill, As Amended - continued	House of Commons
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As Amendments to Mr Secretary Reid's proposed new Clause (General Medical Services contracts) (NC27):

   

Dr Evan Harris
Mrs Patsy Calton
Mr Paul Burstow

(a)

*Line     97,     after 'appropriate', insert—

    '(4A)   No direction issued under subsection (1) shall involve payment based on rewarding contractors for reaching a target number or target proportion of treatments given.'.

   

Dr Evan Harris
Mrs Patsy Calton
Mr Paul Burton

(b)

*Line     110,     leave out 'may' and insert 'must'.

   

Dr Evan Harris
Mrs Patsy Calton
Mr Paul Burstow

(c)

*Line     131,     after 'patient', insert—

    '(3A)   Regulations making provision of the kind described in subsections 3(b) and 3(c) must provide for a process whereby such patients or their representatives are informed of the reason or reasons for such a decision.

    (3B)   Regulations making provision in subsection 2(i) must make provisions as to the circumstances in which such persons or patients as referred to in subsections 3(b) or 3(c) may have access to appeal procedure.'.

   

Dr Evan Harris
Mrs Patsy Calton
Mr Paul Burstow

(d)

*Line     145,     after 'contract', insert—

    '(6A)   Such provisions, as described in subsection (6) must also require the appropriate authority to—

(a)	publish a statement of the evidence on efficacy, cost-effectiveness, and/or affordability which underlies any directions as to drugs, medicines and other substances which may or may not be ordered for patients in the provision of medical services; and

(b)	consult the Overview and Scrutiny Committee of such local authorities in whose area such contractor(s) operate before issuing such directions.

    (6B)   Subsection 6A(b) shall apply only to England.'.

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General medical services: transitional

   

Mr Secretary Reid

NC28

To move the following Clause:—

    '(1)   The appropriate authority shall by order make transitional provision in respect of persons who, immediately before the coming into force of section (general medical services contracts), are providing services under section 29 of the 1977 Act (general medical services).

    (2)   An order under this section may provide that, in such circumstances as the order may prescribe, a Primary Care Trust or Local Health Board must, if any such person so wishes, enter into a general medical services contract with him; and the order may make provision as to the terms of any such contract.

    (3)   An order under this section may provide that, in such circumstances as the order may prescribe, a Primary Care Trust or Local Health Board must, if any such person so wishes, enter into a contract with him, containing such terms as the order may specify, for the provision of medical services.

    (4)   An order under this section may make provision for the resolution of disputes in relation to any contract entered into, or proposed to be entered into, under subsection (2) or (3), including provision for the determination of disputes by the appropriate authority or a person appointed by the authority.

    (5)   An order under this section may make provision in respect of a period beginning before the coming into force of the provision (or of section (general medical services contracts)), provided that the provision is not as a whole detrimental to the remuneration of the persons to whom it relates.

    (6)   In this section—

"appropriate authority" means—

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

(b)	the Assembly, in relation to Wales;

"general medical services contract" means a contract under section 28Q of the 1977 Act (as inserted by section (general medical services contracts))'.

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Abolition of pilot schemes

   

Mr Secretary Reid

NC29

To move the following Clause:—

    '(1)   Part 1 of the National Health Service (Primary Care) Act 1997 (c.46) (power to make pilot schemes for the provision of personal medical and dental services) shall cease to have effect.

    (2)   This section extends to England and Wales only.'.

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Definition of personal medical services

   

Dr Evan Harris
Sandra Gidley
Mrs Patsy Calton
Paul Burstow

NC40

To move the following Clause:—

       'In the 1977 Act, in section 29(2), leave out "adequate" and, after "attendance", insert "to meet their clinical needs".'.

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Mr Secretary Reid

270

Page     78,     line     26     [Clause     161],     leave out 'it reasonable to do so,' and insert 'necessary to meet all reasonable requirements, exercise its powers so as to'.

   

Mr Secretary Reid

271

Page     78,     line     28     [Clause     161],     leave out 'For the purposes of this section'.

   

Mr Secretary Reid

272

Page     78,     line     30     [Clause     161],     at end insert '(whether within or outside its area)'.

   

Mr Secretary Reid

273

Page     78,     line     33     [Clause     161],     leave out 'section' and insert 'Part'.

   

Mr Secretary Reid

274

Page     78,     line     36     [Clause     161],     leave out 'under this section' and insert 'relating to the provision of primary dental services under this Part'.

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Mr Secretary Reid

275

Page     80,     line     29     [Clause     163],     after 'contract', insert 'or a general medical services contract'.

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Mr Secretary Reid

276

Page     81,     line     1     [Clause     163],     leave out from 'employee"' to end of line 3.

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Mr Secretary Reid

277

Page     82,     line     10     [Clause     163],     at end insert—

'( )	the right of patients to choose the persons from whom they are to receive services;'.

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Mr Secretary Reid

278

Page     83,     line     32     [Clause     165],     leave out from 'for' to end of line 43 and insert 'paragraphs (b) and (c) substitute—

"(b)	a medical practitioner who meets the prescribed conditions;

(ba)	a dental practitioner who meets the prescribed conditions;

(bb)	a health care professional who meets the prescribed conditions;

(bc)	an individual who is providing services—

(i)	under a general medical services contract or general dental services contract;

(ii)	in accordance with section 28C arrangements or section 17C arrangements;

or has so provided them within such period as may be prescribed;".'.

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Mr Secretary Reid

279

Page     84,     line     3     [Clause     165],     leave out '(c)(iii)' and insert '(bc)'.

   

Mr Secretary Reid

280

Page     84,     line     10     [Clause     165],     leave out from 'subsection,' to end of line 23 and insert 'for the definition of "NHS employee" substitute—

""NHS employee" means an individual who, in connection with the provision of services in the health service in England and Wales, Scotland or Northern Ireland, is employed by—

(a)	an NHS trust, an NHS foundation trust or (in Northern Ireland) a Health and Social Services Trust;

(b)	a Primary Care Trust or Local Health Board;

(c)	an individual who is providing services under a general medical services contract or a general dental services contract;

(d)	a medical practitioner whose name is included in a list kept under the 1978 Act which is equivalent to a list maintained under section 28W below;

(e)	a dental practitioner whose name is included in a list prepared in accordance with regulations made under section 25(2)(a) of the 1978 Act;

(f)	a medical practitioner whose name is included in a list kept under article 56 of the Health and Personal Social Services (Northern Ireland) Order 1972 (1972 No. 1256 (N.I.14));

(g)	a dental practitioner whose name is included in a list kept under article 61 of that Order;".'.

   

Mr Secretary Reid

281

Page     84,     line     30     [Clause     165],     after 'arrangements;', insert—

'(cb)

provide for the circumstances in which a person providing primary medical services under section 28C arrangements—

(i)	must or may accept a person as a patient to whom such services are so provided;

(ii)	may decline to accept a person as such a patient;

(iii)

may terminate his responsibility for a patient;

(cc)	make provision as to the right of patients to choose the persons from whom they are to receive services;".'.

   

Mr Secretary Reid

282

Page     84,     line     39     [Clause     165],     at end insert—

    '( )   In that section, after subsection (3B) (as inserted by subsection (8) above), insert—

    "(3C)   The regulations may also include provision requiring a Primary Care Trust or Local Health Board, in prescribed circumstances and subject to prescribed conditions, to enter into a general medical services contract or general dental services contract on prescribed terms with any person providing services under section 28C arrangements who so requests.".'.

   

Mr Secretary Reid

283

Page     84,     line     39     [Clause     165],     at end insert—

    '( )   In that Act, sections 28F (choice of medical practitioner), 28G (choice of dental practitioner) and 28H (immunisation) shall cease to have effect.'

Prepared 8 Jul 2003