Health Bill

House of Commons

Session 2005 - 06
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Other Bills before Parliament

Health Bill

Health Bill
Part 4 — The National Health Service
Chapter 1 — Pharmaceutical services
27

42B
Power to charge: Wales
(1)
The National Assembly for Wales may charge a fee to persons who
make an application referred to in section 42(2)(c)(i) or (ii) to the
Assembly.
(2)
The Assembly may determine the amount of the fee as it thinks fit, and
5
may in particular charge a flat fee or charge different fees in different
cases or descriptions of case.
(3)
Subsections (4) and (5) apply if the Assembly directs a Local Health
Board under section 16BB to exercise its functions of receiving and
determining applications referred to in section 42(2)(c)(i) or (ii).
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(4)
The Assembly may give directions to the Local Health Board requiring
it to charge a fee in cases or descriptions of case specified in the
directions to persons who make an application referred to in section
42(2)(c)(i) or (ii) to the Local Health Board.
(5)
The Assembly may in the directions—
15
(a)
specify the fee itself, or
(b)
require the Local Health Board to determine the amount of the
fee in accordance with any requirements set out in the
directions.
(6)
Before determining the amount of the fee—
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(a)
in a subsection (1) case, the Assembly must consult such
organisations as it thinks fit that appear to it to represent
persons providing pharmaceutical services,
(b)
in a subsection (5)(a) case, the Assembly must consult such
organisations as it thinks fit that appear to it to represent
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persons providing pharmaceutical services and such
organisations as it thinks fit that appear to it to represent Local
Health Boards,
(c)
in a subsection (5)(b) case, the Local Health Board must
undertake any consultation required by the directions.
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(7)
The Assembly must publish in such manner as it thinks fit any fee it
determines and any directions it gives under this section.
(8)
In a subsection (5)(b) case, the Local Health Board must publish in such
manner as it thinks fit the fee which it determines.”
(2)
In section 126 of that Act (orders and regulations, and directions), in subsection
35
(4), before “to give directions” insert “or by section 42A or 42B above,”.
32
Applications for provision of pharmaceutical services
In section 42 of the 1977 Act (regulations as to pharmaceutical services), after
subsection (2A) insert—
“(2B)
The regulations may include the provision mentioned in subsection
40
(2C) for the case where—
(a)
two or more applications referred to in subsection (2)(c)(i) or (ii)
relate to the same neighbourhood,
(b)
they are considered together by the Primary Care Trust or the
National Assembly for Wales, and
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Health Bill
Part 4 — The National Health Service
Chapter 2 — Ophthalmic services
28

(c)
the Primary Care Trust or the Assembly would be satisfied as
mentioned in subsection (2)(c) in relation to each application
taken on its own, but are not so satisfied in relation to all of them
taken together.
(2C)
The provision mentioned in subsection (2B) is provision for the
5
Primary Care Trust or the Assembly, in determining which application
(or applications) to grant, to take into account any proposals specified
in the applications in relation to the sale or supply at the premises in
question, otherwise than by way of pharmaceutical services or in
accordance with a private prescription, of—
10
(a)
drugs and medicines, and
(b)
other products for, or advice in relation to, the prevention,
diagnosis, monitoring or treatment of illness or handicap, or the
promotion or protection of health.”
33
Arrangements for dispensing of medicines
15
In section 43 of the 1977 Act (persons authorised to provide pharmaceutical
services), for subsection (2) substitute—
“(2)
Except as may be provided for by or under regulations, no
arrangements for the dispensing of medicines shall be made under this
Part of this Act with persons other than persons who—
20
(a)
are registered pharmacists or persons lawfully conducting a
retail pharmacy business in accordance with section 69 of the
Medicines Act 1968; and
(b)
undertake that all medicines supplied by them under the
arrangements will be dispensed either by or under the
25
supervision of a registered pharmacist.”
Chapter 2
Ophthalmic services
34
Provision of primary ophthalmic services
After section 16CC of the 1977 Act insert—
30
“16CD
   Primary ophthalmic services
(1)
Each Primary Care Trust must exercise its powers so as to provide or
secure the provision, within its area, of the following primary
ophthalmic services—
(a)
the sight-testing service mentioned in subsection (2),
35
(b)
such other primary ophthalmic services as may be prescribed,
and
(c)
to the extent that it considers necessary to meet all reasonable
requirements, any further primary ophthalmic services.
(2)
The sight-testing service mentioned in subsection (1)(a) is a service for
40
testing the sight of all of the following persons (except any such testing
which takes place in prescribed circumstances)—
(a)
those aged under 16,

Health Bill
Part 4 — The National Health Service
Chapter 2 — Ophthalmic services
29

(b)
those aged 16, 17 or 18 who are receiving qualifying full-time
education,
(c)
those whose resources are to be treated in accordance with
regulations as being less than or equal to their requirements,
(d)
those aged 60 or over,
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(e)
those of such other description as may be prescribed.
(3)
Regulations may—
(a)
prescribe what “qualifying full-time education” is for the
purposes of subsection (2)(b),
(b)
make provision for the purposes of subsection (2)(c) about how
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a person’s resources and requirements are to be calculated.
(4)
A Primary Care Trust may (in addition to any other power conferred
on it)—
(a)
provide primary ophthalmic services itself (whether within or
outside its area);
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(b)
make such arrangements for their provision (whether within or
outside its area) as it thinks fit, and may in particular make
contractual arrangements with any person.
(5)
Each Primary Care Trust must publish information about such matters
as may be prescribed in relation to the primary ophthalmic services
20
provided under this Part.
(6)
A body on which functions are conferred under this section must co-
operate with any other such body in the discharge of their respective
functions relating to the provision of primary ophthalmic services
under this Part.
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(7)
Regulations may provide that services of a prescribed description are,
or are not, to be regarded as primary ophthalmic services for the
purposes of this Part (but these regulations may not affect the duty in
subsection (1)(a)).
(8)
Regulations under subsection (7) may in particular describe services by
30
reference to the manner or circumstances in which they are provided.
(9)
Regulations may provide that a person—
(a)
whose sight is tested by a person who is a party to a general
ophthalmic services contract; and
(b)
who is shown during the testing or within a prescribed time
35
after it to fall within any of paragraphs (a) to (d) of subsection
(2),

is to be taken for the purposes of the testing to have so fallen
immediately before his sight was tested.
(10)
In the case mentioned in subsection (9), the testing of his sight is (unless
40
it took place in circumstances prescribed under subsection (2)) to be
treated as a testing under the sight-testing service mentioned in
subsection (1)(a)—
(a)
for the purposes of remuneration in respect of the testing; and
(b)
for any such other purpose as may be prescribed.
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Health Bill
Part 4 — The National Health Service
Chapter 2 — Ophthalmic services
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16CE
Regulations under section 16CD: supplementary
(1)
Regulations under section 16CD which refer to an Act of Parliament or
an instrument made under an Act of Parliament may direct that the
reference is to be construed as a reference to that Act or instrument—
(a)
as it has effect at the time when the regulations are made; or
5
(b)
both as it has effect at that time and as amended subsequently.
(2)
Descriptions of persons may be prescribed under section 16CD(2)(e) by
reference to any criterion, including the following—
(a)
their age;
(b)
the fact that a prescribed person or a prescribed body accepts
10
them as suffering from a prescribed medical condition;
(c)
the fact that a prescribed person or a prescribed body accepts
that a prescribed medical condition from which they suffer
arose in prescribed circumstances;
(d)
their receipt of benefit in money or kind under any enactment
15
or their entitlement to receive any such benefit;
(e)
the receipt of any such benefit by other persons satisfying
prescribed conditions or the entitlement of other persons
satisfying prescribed conditions to receive such benefits.
(3)
Regulations under section 16CD(3)(b) may direct that a person’s
20
resources and requirements be calculated—
(a)
by a method set out in the regulations;
(b)
by a method described by reference to a method of calculating
or estimating income or capital specified in an enactment other
than this section or in an instrument made under an Act of
25
Parliament or by reference to such a method but subject to
prescribed modifications;
(c)
by reference to an amount applicable for the purposes of a
payment under an Act of Parliament or an instrument made
under an Act of Parliament; or
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(d)
by reference to the person’s being or having been entitled to
payment under an Act of Parliament or an instrument made
under an Act of Parliament.”
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General ophthalmic services contracts
After section 28W of the 1977 Act insert—
35
“General ophthalmic services contracts
28WA
  General ophthalmic services contracts: introductory
(1)
A Primary Care Trust may enter into a contract under which primary
ophthalmic services are provided in accordance with the following
provisions of this Part.
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(2)
A contract under this section is called in this Act a “general ophthalmic
services contract”.
(3)
Subject to any provision made by or under this Part, a general
ophthalmic services contract may make such provision as may be

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Part 4 — The National Health Service
Chapter 2 — Ophthalmic services
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agreed between the Primary Care Trust and the contractor or
contractors in relation to—
(a)
the services to be provided under the contract,
(b)
remuneration under the contract, and
(c)
any other matters.
5
(4)
The services to be provided under a general ophthalmic services
contract may include—
(a)
services which are not primary ophthalmic services;
(b)
services to be provided outside the area of the Primary Care
Trust.
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(5)
In this Part, “contractor”, in relation to a general ophthalmic services
contract, means any person entering into the contract with the Primary
Care Trust.
28WB
  Persons eligible to enter into GOS contracts
(1)
A Primary Care Trust may, subject to such conditions and exceptions
15
as may be prescribed, enter into a general ophthalmic services contract
with any person.
(2)
But it may not enter into such a contract with a person who has been
disqualified from doing so by an order of disqualification made by
virtue of regulations under section 28WC.
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28WC
  Exclusion of contractors
(1)
The Secretary of State may make regulations conferring on a Primary
Care Trust, or another prescribed person, a right to apply to the FHSAA
in prescribed circumstances for an order that a person (“P”) be
disqualified from entering into a general ophthalmic services contract.
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(2)
The regulations may in particular provide for—
(a)
the review by the FHSAA of an order of disqualification made
by virtue of regulations under this section;
(b)
what is to happen in relation to general ophthalmic services
contracts to which P is a party when the order is made.
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28WD
  GOS contracts: payments
(1)
The Secretary of State may give directions as to payments to be made
under general ophthalmic services contracts.
(2)
A general ophthalmic services contract must require payments to be
made under the contract in accordance with directions for the time
35
being in force under this section.
(3)
Without prejudice to the generality of the power under subsection (1),
a direction under that subsection may—
(a)
provide for payments to be made by reference to compliance
with standards or the achievement of levels of performance;
40
(b)
provide for payments to be made by reference to—
(i)
any scheme or scale specified in the direction; or
(ii)
a determination made by any person in accordance with
factors specified in the direction;

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Part 4 — The National Health Service
Chapter 2 — Ophthalmic services
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(c)
provide for the making of payments in respect of individual
practitioners;
(d)
provide that the whole or any part of a payment is subject to
conditions (and may provide that payments are payable by a
Primary Care Trust only if it is satisfied as to certain conditions);
5
(e)
make provision having effect from a date before the date of the
direction, provided that, having regard to the direction as a
whole, the provision is not detrimental to the persons to whose
remuneration it relates.
(4)
Before giving a direction under subsection (1), the Secretary of State—
10
(a)
must consult any body appearing to him to be representative of
persons to whose remuneration the direction would relate, and
(b)
may consult such other persons as he thinks appropriate.
(5)
Section 18(1) and (3)(b) apply in relation to directions under this
section.
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(6)
References in this section to payments include fees, allowances,
reimbursements, loans and repayments.
28WE
  GOS contracts: other required terms
(1)
A general ophthalmic services contract must contain such provision as
may be prescribed (in addition to the provision required by the
20
preceding provisions of this Part).
(2)
Regulations under subsection (1) may in particular make provision as
to—
(a)
the manner in which, and standards to which, services are to be
provided;
25
(b)
the persons who perform services;
(c)
the persons to whom services are to be provided;
(d)
the variation of contract terms (other than terms required by or
under this Part);
(e)
rights of entry and inspection (including inspection of clinical
30
records and other documents);
(f)
the circumstances in which, and the manner in which, the
contract may be terminated;
(g)
enforcement;
(h)
the adjudication of disputes.
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(3)
Regulations under subsection (2)(d) may—
(a)
make provision as to the circumstances in which a Primary Care
Trust may impose a variation of contract terms;
(b)
make provision as to the suspension or termination of any duty
under the contract to provide services of a prescribed
40
description.
(4)
Regulations making provision of the kind described in subsection (3)(b)
may prescribe services by reference to the manner or circumstances in
which they are provided.
(5)
Regulations under subsection (1) must make provision as to the right of
45
persons to whom services are to be provided to choose the persons
from whom they are to receive them.