National Health Service Bill [HL]

House of Commons

Session 2005 - 06
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Other Bills before Parliament

National Health Service Bill [HL]

National Health Service Bill [HL]
Part 6 — Ophthalmic services
65

(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 after it to
fall within any of paragraphs (a) to (d) of subsection (2),

must be taken for the purposes of the testing to have so fallen immediately
5
before his sight was tested.
(10)
In the case mentioned in subsection (9), the testing of his sight must (unless it
took place in circumstances prescribed under subsection (2)) 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
10
(b)
for any such other purpose as may be prescribed.
116
Regulations under section 115: supplementary
(1)
Regulations under section 115 which refer to an Act of Parliament or an
instrument made under an Act of Parliament may direct that the reference
must be construed as a reference to that Act or instrument—
15
(a)
as it has effect at the time when the regulations are made, or
(b)
both as it has effect at that time and as amended subsequently.
(2)
Descriptions of persons may be prescribed under section 115(2)(e) by reference
to any criterion, including the following—
(a)
their age,
20
(b)
the fact that a prescribed person or a prescribed body accepts 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,
25
(d)
their receipt of benefit in money or kind under any enactment 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.
30
(3)
Regulations under section 115(3)(b) may direct that a person’s 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
35
section or in an instrument made under an Act of 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
40
(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.

National Health Service Bill [HL]
Part 6 — Ophthalmic services
66

General ophthalmic services contracts
117
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.
5
(2)
A contract under this section is called in this Act a “general ophthalmic services
contract”.
(3)
A general ophthalmic services contract may make such provision as may be
agreed between the Primary Care Trust and the contractor or contractors in
relation to—
10
(a)
the services to be provided under the contract,
(b)
remuneration under the contract, and
(c)
any other matters.
(4)
The services to be provided under a general ophthalmic services contract may
include—
15
(a)
services which are not primary ophthalmic services,
(b)
services to be provided outside the area of the Primary Care Trust.
(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.
118
Persons eligible to enter into GOS contracts
20
(1)
A Primary Care Trust may, subject to such conditions and exceptions 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
25
regulations under section 119.
119
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
30
entering into a general ophthalmic services contract.
(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 will happen in relation to general ophthalmic services contracts to
35
which P is a party when the order is made.
120
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
40
under the contract in accordance with directions under this section.

National Health Service Bill [HL]
Part 6 — Ophthalmic services
67

(3)
A direction under subsection (1) may in particular—
(a)
provide for payments to be made by reference to compliance with
standards or the achievement of levels of performance,
(b)
provide for payments to be made by reference to—
(i)
any scheme or scale specified in the direction, or
5
(ii)
a determination made by any person in accordance with factors
specified in the direction,
(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
10
(and may provide that payments are payable by a Primary Care Trust
only if it is satisfied as to certain conditions),
(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
15
relates.
(4)
Before giving a direction under subsection (1), the Secretary of State—
(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 considers appropriate.
20
(5)
“Payments” includes fees, allowances, reimbursements, loans and repayments.
121
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 preceding provisions
of this Part).
25
(2)
Regulations under subsection (1) may in particular make provision as to—
(a)
the manner in which, and standards to which, services must be
provided,
(b)
the persons who perform services,
(c)
the persons to whom services will be provided,
30
(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 records
and other documents),
(f)
the circumstances in which, and the manner in which, the contract may
35
be terminated,
(g)
enforcement,
(h)
the adjudication of disputes.
(3)
Regulations under subsection (2)(d) may—
(a)
make provision as to the circumstances in which a Primary Care Trust
40
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 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
45
are provided.

National Health Service Bill [HL]
Part 6 — Ophthalmic services
68

(5)
Regulations under subsection (1) must make provision as to the right of
persons to whom services are provided to choose the persons from whom they
receive them.
122
GOS contracts: disputes and enforcement
(1)
Regulations may make provision for the resolution of disputes as to the terms
5
of a proposed general ophthalmic services contract.
(2)
Regulations under subsection (1) may make provision—
(a)
for the referral of the terms of the proposed contract to the Secretary of
State, and
(b)
for the Secretary of State, or a person appointed by him, to determine
10
the terms on which the contract may be entered into.
(3)
Regulations may make provision for a person or persons entering into a
general ophthalmic services contract to be regarded, in circumstances where he
or they so elect, as a health service body for the purposes of section 9, but only
so far as concerns the general ophthalmic services contract (and not for any
15
other purpose).
(4)
Regulations under subsection (3) may include provision as to the application
of section 9 in cases where—
(a)
persons practising in partnership elect to become a health service body,
and
20
(b)
there is a change in the membership of the partnership.
(5)
Where—
(a)
by virtue of regulations under subsection (3), subsection section 9(11)
applies in relation to a general ophthalmic services contract, and
(b)
a direction as to payments is made under that provision in relation to
25
the contract,

the direction is enforceable in a county court (if the court so orders) as if it were
a judgment or order of that court.
Performance of primary ophthalmic services
123
Persons performing primary ophthalmic services
30
(1)
Regulations may provide that a health care professional of a prescribed
description may not perform any primary ophthalmic service for which a
Primary Care Trust is responsible unless he is included in a list maintained
under the regulations by a Primary Care Trust.
(2)
For the purposes of this section—
35
(a)
“health care professional” means a person who is a member of a
profession regulated by a body mentioned in section 25(3) of the
National Health Service Reform and Health Care Professions Act 2002
(c. 17),
(b)
a Primary Care Trust is responsible for an ophthalmic service if it
40
provides the service, or secures its provision, by or under any
enactment.
(3)
Regulations under this section may make provision in relation to lists under
this section and in particular as to—

National Health Service Bill [HL]
Part 6 — Ophthalmic services
69

(a)
the preparation, maintenance and publication of a list,
(b)
eligibility for inclusion in a list,
(c)
applications for inclusion (including provision as to the Primary
Care Trust to which an application must be made, and for the
procedure for applications and the documents to be supplied on
5
application),
(d)
the grounds on which an application for inclusion may or must be
granted or refused,
(e)
requirements with which a person included in a list must comply
(including the declaration of financial interests and gifts and other
10
benefits),
(f)
suspension or removal from a list (including provision for the
grounds for, and consequences of, suspension or removal),
(g)
circumstances in which a person included in a list may not withdraw
from it,
15
(h)
payments to be made in respect of a person suspended from a list
(including provision for the amount of the payment, or the method of
calculating the payment, to be determined by the Secretary of State or a
person appointed by him),
(i)
the criteria to be applied in making decisions under the regulations,
20
(j)
appeals against decisions made by a Primary Care Trust under the
regulations, and
(k)
disclosure of information about applicants for inclusion, grants or
refusals of applications or suspensions or removals,

and may make any provision corresponding to anything in sections 151 to 159.
25
(4)
Regulations under this section may, in particular, also provide for—
(a)
a person’s inclusion in a list to be subject to conditions determined by
a Primary Care Trust,
(b)
a Primary Care Trust to vary the conditions or impose different ones,
(c)
the consequences of failing to comply with a condition (including
30
removal from a list),
(d)
the review by a Primary Care Trust of decisions made by it by virtue of
the regulations.
(5)
The imposition of such conditions must be with a view to—
(a)
preventing any prejudice to the efficiency of the services to which a list
35
relates, or
(b)
preventing fraud.
(6)
Regulations under this section may, in particular, also prescribe the
qualifications and experience which a medical practitioner who applies for
inclusion in a list under this section must have, and may—
40
(a)
provide for the practitioner to show to the satisfaction of a committee
recognised by the Secretary of State for the purpose that he possesses
such qualifications and experience,
(b)
confer on a person who is dissatisfied with the determination of such a
committee a right of appeal to a committee appointed by the Secretary
45
of State, and
(c)
provide for anything which appears to the Secretary of State to be
appropriate in connection with that right of appeal.

National Health Service Bill [HL]
Part 6 — Ophthalmic services
70

(7)
Regulations making provision as to the matters referred to in subsection (3)(k)
may in particular authorise the disclosure of information—
(a)
by a Primary Care Trust to the Secretary of State, and
(b)
by the Secretary of State to a Primary Care Trust.
Assistance and support
5
124
Assistance and support: primary ophthalmic services
(1)
A Primary Care Trust may provide assistance or support to any person
providing or proposing to provide primary ophthalmic services under a
general ophthalmic services contract.
(2)
Assistance or support provided by a Primary Care Trust under subsection (1)
10
is provided on such terms, including terms as to payment, as the Primary Care
Trust considers appropriate.
(3)
“Assistance” includes financial assistance.
Local Optical Committees
125
Local Optical Committees
15
(1)
A Primary Care Trust may recognise a committee formed for its area, or for its
area and that of one or more other Primary Care Trusts, which it is satisfied is
representative of—
(a)
the persons to whom subsection (2) applies, and
(b)
the persons to whom subsection (3) applies.
20
(2)
This subsection applies to each person who, under a general ophthalmic
services contract entered into by him, is providing primary ophthalmic
services in the area for which the committee is formed.
(3)
This subsection applies to each optometrist not falling within subsection (2)—
(a)
who is performing primary ophthalmic services in the area for which
25
the committee is formed, whether under section 115(4)(a), or under a
general ophthalmic services contract, and
(b)
who has notified the Primary Care Trust that he wishes to be
represented by the committee (and has not notified it that he wishes to
cease to be so represented).
30
(4)
A committee recognised under this section is called the Local Optical
Committee for the area for which it is formed.
(5)
Any such committee may delegate any of its functions, with or without
restrictions or conditions, to sub-committees composed of members of that
committee.
35
(6)
Any such committee may co-opt persons not falling within subsection (2) or (3)
on such terms as it considers appropriate.
(7)
Regulations may require a Primary Care Trust, in the exercise of its functions
relating to primary ophthalmic services, to consult any committee recognised
by it under this section on such occasions and to such extent as may be
40
prescribed.

National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 1 — Provision of pharmaceutical services
71

(8)
A committee recognised under this section has such other functions as may be
prescribed.
(9)
A committee recognised under this section must in respect of each year
determine the amount of its administrative expenses for that year.
(10)
A Primary Care Trust may—
5
(a)
on the request of a committee recognised by it, allot to that committee
such sums as the Primary Care Trust may determine for defraying the
committee’s administrative expenses, and
(b)
deduct the amount of such sums from the remuneration of persons of
whom the committee is representative under subsection (1)(a) under
10
the general ophthalmic services contracts entered into by those persons
with the Primary Care Trust.
(11)
The administrative expenses of a committee include the travelling and
subsistence allowances payable to its members.
Part 7
15
Pharmaceutical services and local pharmaceutical services
Chapter 1
Provision of pharmaceutical services
126
Arrangements for pharmaceutical services
(1)
Each Primary Care Trust must, in accordance with regulations, make the
20
arrangements mentioned in subsection (3).
(2)
The Secretary of State must make regulations for the purpose of subsection (1).
(3)
The arrangements are arrangements as respects the area of the Primary Care
Trust for the provision to persons who are in that area of—
(a)
proper and sufficient drugs and medicines and listed appliances
25
which are ordered for those persons by a medical practitioner in
pursuance of his functions in the health service, the Scottish health
service, the Northern Ireland health service or the armed forces of the
Crown,
(b)
proper and sufficient drugs and medicines and listed appliances which
30
are ordered for those persons by a dental practitioner in pursuance of—
(i)
his functions in the health service, the Scottish health service
or the Northern Ireland health service (other than functions
exercised in pursuance of the provision of services mentioned in
paragraph (c)), or
35
(ii)
his functions in the armed forces of the Crown,
(c)
listed drugs and medicines and listed appliances which are ordered for
those persons by a dental practitioner in pursuance of the provision of
primary dental services or equivalent services in the Scottish health
service or the Northern Ireland health service,
40
(d)
such drugs and medicines and such listed appliances as may be
determined by the Secretary of State for the purposes of this paragraph
and which are ordered for those persons by a prescribed description of
person in accordance with such conditions, if any, as may be