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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

 
 

 
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