National Health Service Bill [HL]

House of Commons

Session 2005 - 06
Internet Publications
Other Bills before Parliament

National Health Service Bill [HL]

National Health Service Bill [HL]
Part 3 — Local authorities and the NHS
37

with the arrangements) in conjunction with prescribed NHS functions
of the body,

the Secretary of State may designate the body as a Care Trust.
(2)
A Primary Care Trust or NHS trust may, however, be designated only in
pursuance of an application made to the Secretary of State jointly by each
5
prescribed body.
(3)
If the application under subsection (2) requests the Secretary of State to do so,
he may when designating a body as a Care Trust make a direction under
subsection (4).
(4)
The direction is that while the body is designated it may (in addition to
10
exercising health-related functions of the local authority as mentioned in
subsection (1)(b)) exercise such prescribed health-related functions of the local
authority as are specified in the direction in relation to persons in any area so
specified, even though it does not exercise any NHS functions in relation to
persons in that area.
15
(5)
Where a body is designated as a Care Trust under this section—
(a)
its designation may be revoked by the Secretary of State at any time—
(i)
of the Secretary of State’s own motion, and
(ii)
after such consultation as he considers appropriate,
(b)
if an application for the revocation of its designation is made to the
20
Secretary of State by one or more of the parties to the LA delegation
arrangements, its designation must be revoked by the Secretary of State
at the earliest time at which he considers it practicable to do so, having
regard, in particular, to any steps that need to be taken in relation to
those arrangements in connection with the revocation.
25
(6)
The designation of a body as a Care Trust under this section must be effected
by an order under section 18 or 25 which—
(a)
(in the case of an existing body) amends the order establishing the body
so as to change its name to one that includes the words “Care Trust”, or
(b)
(in the case of a new body) establishes the body with a name that
30
includes those words,

and any revocation of its designation must be effected by a further order under
section 18 or 25 which makes such provision for changing the name of the body
as the Secretary of State considers expedient.
(7)
The power of the Secretary of State to dissolve a Primary Care Trust or an NHS
35
trust includes power to dissolve such a Primary Care Trust or NHS trust where
he considers that it is appropriate to do so in connection with the designation
of any other such body (whether existing or otherwise) as a Care Trust.
(8)
Regulations may make such incidental, supplementary or consequential
provision (including provision amending, repealing or revoking enactments)
40
as the Secretary of State considers expedient in connection with the preceding
provisions of this section.
(9)
Regulations under subsection (8) may, in particular, make provision—
(a)
prescribing—
(i)
the manner and circumstances in which, and
45
(ii)
any conditions which must be satisfied before,

National Health Service Bill [HL]
Part 3 — Local authorities and the NHS
38


an application may be made for a body to be designated as a Care Trust
under this section, or to cease to be so designated, and the information
to be supplied with such an application,
(b)
enabling the Secretary of State to terminate appointments of persons as
members of a Primary Care Trust or of the board of directors of an NHS
5
trust (or of a committee of such a Primary Care Trust or NHS trust)
where he considers that it is appropriate to do so in connection with the
designation of the Primary Care Trust or NHS trust as a Care Trust,
(c)
requiring the consent of the Secretary of State to be obtained before any
prescribed change is made with respect to the governance of a body so
10
designated,
(d)
for supplementing or modifying, in connection with the operation of
subsection (3), any provision made by regulations under section 75.
(10)
The designation of a body as a Care Trust under this section does not affect any
of the functions, rights or liabilities of that body in its capacity as a Primary
15
Care Trust or NHS trust.
(11)
In connection with the exercise by a body so designated of any relevant social
services functions under LA delegation arrangements—
(a)
section 7 of the Local Authority Social Services Act 1970 (c. 42)
(authorities to exercise social services functions under guidance), and
20
(b)
section 7A of that Act (directions as to exercise of such functions),

apply to the body as if it were a local authority within the meaning of that Act.
(12)
In this section—
“health-related functions” has the meaning given by section 75(8),
“LA delegation arrangements” means arrangements falling within section
25
75(2)(b), whether or not made in conjunction with any pooled fund
arrangements,
“NHS functions” means functions exercisable by a Primary Care Trust or
NHS trust in its capacity as such,
“pooled fund arrangements” means arrangements falling within section
30
75(2)(a),
“relevant social services functions” means health-related functions which
are social services functions within the meaning of the Local Authority
Social Services Act 1970.
78
Directed partnership arrangements
35
(1)
If the Secretary of State is of the opinion—
(a)
that a body to which this section applies (“the failing body”) is not
exercising any of its functions adequately, and
(b)
that it would be likely to lead to an improvement in the way in which
that function is exercised if it were to be exercised—
40
(i)
by another body to which this section applies under delegation
arrangements, or
(ii)
in accordance with pooled fund arrangements made with
another such body,

the Secretary of State may direct those bodies to enter into such delegation
45
arrangements or pooled fund arrangements in relation to the exercise of the
appropriate function or functions as are specified in the direction.
(2)
In subsection (1) “the appropriate function or functions” means—

National Health Service Bill [HL]
Part 3 — Local authorities and the NHS
39

(a)
the function of the failing body mentioned in that subsection, and
(b)
such other function of that body (if any) as the Secretary of State
considers would, if exercised under or in accordance with the
arrangements in question, be likely to contribute to an improvement in
the exercise of the function referred to in paragraph (a).
5
(3)
The bodies to which this section applies are—
(a)
Strategic Health Authorities,
(b)
Primary Care Trusts,
(c)
NHS trusts,
(d)
Local Health Boards, and
10
(e)
local authorities,

but in subsections (1) and (2) any reference to functions is, in relation to a local
authority, a reference only to relevant social services functions of the authority.
(4)
In this section any reference to an improvement in the way in which any
function is exercised includes an improvement in the provision to any
15
individuals of any services to which that function relates.
(5)
In this section—
“delegation arrangements” means arrangements falling within section
75(2)(b) or (c), whether or not made in conjunction with any pooled
fund arrangements,
20
“health-related functions” has the meaning given by section 75(8),
“pooled fund arrangements” means arrangements falling within section
75(2)(a),
“relevant social services functions” means health-related functions which
are social services functions within the meaning of the Local Authority
25
Social Services Act 1970 (c. 42).
79
Further provision about directions and directed partnership arrangements
(1)
A direction under section 78(1) (a “principal direction”) may make provision
with respect to—
(a)
any of the matters with respect to which provision is required to be
30
made by the specified arrangements by virtue of regulations under
section 75, and
(b)
such other matters as the Secretary of State considers appropriate.
(2)
The Secretary of State may in particular (either in a principal direction or in any
subsequent direction) make provision—
35
(a)
for the determination, whether—
(i)
by agreement, or
(ii)
(in default of agreement) by the Secretary of State or an
arbitrator appointed by him,

of the amount of any payments which need to be made by one body to
40
another for the purposes of the effective operation of the specified
arrangements, and for the variation of any such determination,
(b)
specifying the manner in which the amount of any such payments must
be so determined (or varied),
(c)
requiring a body specified in the direction to supply to the Secretary of
45
State or an arbitrator, for the purpose of enabling any such amount to

National Health Service Bill [HL]
Part 3 — Local authorities and the NHS
40

be so determined (or varied), such information or documents as may be
so specified,
(d)
requiring any amount so determined (or varied) to be paid by and to
such bodies as are specified in the direction,
(e)
requiring capital assets specified in the direction to be made
5
available by and to such bodies as are so specified.
(3)
The Secretary of State may, when giving a principal direction to any bodies to
which section 78 applies, give such directions to any other such body as he
considers appropriate for or in connection with securing that full effect is given
to the principal direction.
10
(4)
Before giving a principal direction to any bodies to which section 78 applies,
the Secretary of State may—
(a)
direct either or both of the bodies in question to take such steps
specified in the direction, or
(b)
give such other directions,
15

as he considers appropriate with a view to enabling him to determine whether
the principal direction should be given.
(5)
The revocation of a principal direction does not affect the continued operation
of the specified arrangements.
(6)
“The specified arrangements”, in relation to a principal direction, means the
20
arrangements specified in the direction in pursuance of section 78(1).
80
Supply of goods and services by the Secretary of State
(1)
The Secretary of State may supply to—
(a)
local authorities, and
(b)
such public bodies or classes of public bodies as he may determine,
25

any goods or materials of a kind used in the health service.
(2)
In subsection (1) “public bodies” includes public bodies in Northern Ireland.
(3)
The Secretary of State may make available to persons falling within subsection
(1)—
(a)
any facilities provided by him or by a Primary Care Trust for any
30
service under this Act, and
(b)
the services of persons employed by the Secretary of State or by a
Strategic Health Authority, a Primary Care Trust, a Special Health
Authority or a Local Health Board.
(4)
The Secretary of State may carry out maintenance work (including minor
35
renewals, minor improvements and minor extensions) in connection with any
land or building for the maintenance of which a local authority is responsible.
(5)
The Secretary of State may supply or make available to persons—
(a)
providing pharmaceutical services,
(b)
providing services under a general medical services contract, a general
40
dental services contract or a general ophthalmic services contract,
(c)
providing services in accordance with section 92 arrangements or
section 107 arrangements, or
(d)
providing services under a pilot scheme or an LPS scheme,

such goods, materials or other facilities as may be prescribed.
45

National Health Service Bill [HL]
Part 3 — Local authorities and the NHS
41

(6)
The Secretary of State must make available to local authorities—
(a)
any services (other than the services of any person) or other facilities
provided under this Act,
(b)
the services provided as part of the health service by any person
employed by the Secretary of State, a Strategic Health Authority, a
5
Primary Care Trust, a Special Health Authority or a Local Health
Board, and
(c)
the services of any medical practitioner, dental practitioner or nurse
employed by the Secretary of State, a Strategic Health Authority, a
Primary Care Trust, a Special Health Authority or a Local Health Board
10
otherwise than to provide services which are part of the health service,

so far as is reasonably necessary and practicable to enable local authorities to
discharge their functions relating to social services, education and public
health.
(7)
The Secretary of State may arrange to make available to local authorities the
15
services of persons—
(a)
providing pharmaceutical services,
(b)
performing services under a general medical services contract, a
general dental services contract or a general ophthalmic services
contract,
20
(c)
providing services in accordance with section 92 arrangements or
section 107 arrangements,
(d)
performing services under a pilot scheme or an LPS scheme, or
(e)
providing Strategic Health Authorities, Primary Care Trusts, Special
Health Authorities or Local Health Boards with services of a kind
25
provided as part of the health service,

so far as is reasonably necessary and practicable to enable local authorities to
discharge their functions relating to social services, education and public
health.
81
Conditions of supply under section 80
30
(1)
The Secretary of State must, before he makes available the services of any
officer under subsection (3)(b) of section 80, or subsection (6)(b) or (c) of that
section—
(a)
consult the officer or a body recognised by the Secretary of State as
representing the officer, or
35
(b)
satisfy himself that the body who employs the officer has consulted the
officer about the matter.
(2)
The Secretary of State may disregard the provisions of subsection (1) in a case
where he—
(a)
considers it necessary to make the services of an officer available for the
40
purpose of dealing temporarily with an emergency, and
(b)
has previously consulted a body such as is mentioned in subsection
(1)(b) about making services available in an emergency.
(3)
The Secretary of State may, for the purposes of subsection (3)(b) of section 80,
or subsection (6)(b) or (c) of that section, give such directions to Strategic
45
Health Authorities, Primary Care Trusts, Special Health Authorities and Local
Health Boards to make the services of their officers available as he considers
appropriate.

National Health Service Bill [HL]
Part 4 — Medical services
42

(4)
Powers under this section and section 80 may be exercised on such terms as
may be agreed, including terms as to the making of payments to the Secretary
of State.
(5)
The Secretary of State may make such charges in respect of services or facilities
provided under section 80(6) as may be agreed between the Secretary of State
5
and the local authority or, in default of agreement, as may be determined by
arbitration.
(6)
Any power to supply goods or materials under section 80 includes—
(a)
a power to purchase and store them, and
(b)
a power to arrange with third parties for the supply of goods or
10
materials by those third parties.
82
Co-operation between NHS bodies and local authorities
In exercising their respective functions NHS bodies (on the one hand) and local
authorities (on the other) must co-operate with one another in order to secure
and advance the health and welfare of the people of England and Wales.
15
Part 4
Medical services
Duty of Primary Care Trusts in relation to primary medical services
83
Primary medical services
(1)
Each Primary Care Trust must, to the extent that it considers necessary to meet
20
all reasonable requirements, exercise its powers so as to provide primary
medical services within its area, or secure their provision within its area.
(2)
A Primary Care Trust may (in addition to any other power conferred on it)—
(a)
provide primary medical services itself (whether within or outside its
area),
25
(b)
make such arrangements for their provision (whether within or outside
its area) as it considers appropriate, and may in particular make
contractual arrangements with any person.
(3)
Each Primary Care Trust must publish information about such matters as may
be prescribed in relation to the primary medical services provided under this
30
Act.
(4)
Each Primary Care Trust must co-operate with each other Primary Care Trust
and each Local Health Board in the discharge of their respective functions
relating to the provision of primary medical services under this Act and the
National Health Service (Wales) Act 2006 (c. 00).
35
(5)
Regulations may provide that services of a prescribed description must, or
must not, be regarded as primary medical services for the purposes of this Act.
(6)
Regulations under this section may in particular describe services by reference
to the manner or circumstances in which they are provided.