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 7 — Pharmaceutical services and local pharmaceutical services
Chapter 5 — Conditional inclusion in pharmaceutical lists, and supplementary lists
86

(a)
the regulations may provide that he may not withdraw from the list
while the Primary Care Trust is investigating whether there are
grounds for exercising their power to remove him, or after the Primary
Care Trust has decided to remove him but before it has given effect to
that decision, and
5
(b)
the regulations must include provision—
(i)
requiring the practitioner to be given notice of any allegation
against him,
(ii)
giving him the opportunity of putting his case at a hearing
before the Primary Care Trust makes any decision as to his
10
removal from the list, and
(iii)
requiring him to be given notice of the decision of the
Primary Care Trust and the reasons for it and of his right of
appeal under subsection (4).
(4)
If regulations provide as mentioned in subsection (1), they must also provide
15
for an appeal by the person in question to the FHSAA against the decision of
the Primary Care Trust—
(a)
to impose conditions, or any particular condition,
(b)
to vary a condition,
(c)
to vary his terms of service,
20
(d)
on any review of an earlier such decision of the Primary Care Trust,
(e)
to remove him from the list for breach of condition,

and the appeal must be by way of redetermination of the decision of the
Primary Care Trust.
(5)
The regulations may provide for any such decision not to have effect until the
25
determination by the FHSAA of any appeal against it, and must so provide in
relation to a decision referred to in subsection (4)(e).
(6)
Regulations under this section may provide for the disclosure by a Primary
Care Trust, to prescribed persons or persons of prescribed descriptions, of
information of a prescribed description—
30
(a)
about persons whose inclusion in a pharmaceutical list is subject to
conditions imposed under this section, and
(b)
about the removal of such persons from a pharmaceutical list for breach
of condition.
(7)
In this Part, “terms of service” means the terms upon which, by virtue of
35
regulations, a person undertakes to provide pharmaceutical services.
149
Supplementary lists
(1)
The Secretary of State may make regulations providing for the preparation and
publication by each Primary Care Trust of one or more lists of persons
approved by the Primary Care Trust for the purpose of assisting in the
40
provision of pharmaceutical services.
(2)
Such a list is referred to in this section, section 150 and section 159 as a
“supplementary list”.
(3)
The regulations may, in particular, include provision as to—
(a)
the Primary Care Trust to which an application for inclusion in a
45
supplementary list must be made,

National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 5 — Conditional inclusion in pharmaceutical lists, and supplementary lists
87

(b)
the procedure for applying for inclusion, including any information
to be supplied to the Primary Care Trust (whether by the applicant or
by arrangement with him),
(c)
grounds on which the Primary Care Trust may, or must, refuse a
person’s application for inclusion in a supplementary list (including his
5
unsuitability for inclusion in such a list), or on which it may defer its
decision on the application,
(d)
requirements with which a person included in a supplementary list
must comply (including the declaration of financial interests and of
gifts and other benefits),
10
(e)
grounds on which a Primary Care Trust may, or must, suspend or
remove a person from a supplementary list, the procedure for doing so,
and the consequences of doing so,
(f)
payments to or in respect of persons who are suspended from a
supplementary list (including provision for the amount of the
15
payments, or the method of calculating the amount, to be determined
by the Secretary of State or by another person appointed for the
purpose by the Secretary of State),
(g)
the supply to the Primary Care Trust by an applicant for inclusion in a
supplementary list, or by a person included in one, of a criminal
20
conviction certificate under section 112 of the Police Act 1997 (c. 50), a
criminal record certificate under section 113 of that Act or an enhanced
criminal record certificate under section 115 of that Act,
(h)
circumstances in which a person included in a supplementary list may
not withdraw from it,
25
(i)
criteria to be applied in making decisions under the regulations,
(j)
appeals against decisions of Primary Care Trusts under the regulations,
(k)
the disclosure by a Primary Care Trust, to prescribed persons or
persons of prescribed descriptions, of information of a prescribed
description about applicants for inclusion in a supplementary list,
30
refusals of such applications, and suspensions and removals from that
list.
(4)
The regulations may, in particular, also provide for—
(a)
a person’s inclusion in a supplementary list to be subject to
conditions determined by the Primary Care Trust,
35
(b)
the Primary Care Trust to vary the conditions or impose different ones,
(c)
the consequences of failing to comply with a condition (including
removal from the list), and
(d)
the review by the Primary Care Trust of its decisions made by virtue of
regulations under this subsection.
40
(5)
The imposition of such conditions must be with a view to—
(a)
preventing any prejudice to the efficiency of the services to which the
supplementary list relates, or
(b)
preventing any acts or omissions of the type described in section
151(3)(a).
45
(6)
Regulations made by virtue of subsection (3)(e) may (but need not) make
provision corresponding to anything in sections 151 to 159.
(7)
If the regulations provide under subsection (3)(e) or (4) that a Primary Care
Trust may suspend or remove a person from a supplementary list, they must
include provision—
50

National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 5 — Conditional inclusion in pharmaceutical lists, and supplementary lists
88

(a)
requiring him to be given notice of any allegation against him,
(b)
giving him the opportunity of putting his case at a hearing before the
Primary Care Trust makes any decision as to his suspension or
removal, and
(c)
requiring him to be given notice of the decision of the Primary Care
5
Trust and the reasons for it and of any right of appeal under subsection
(8) or (9).
(8)
If the regulations provide under subsection (3)(c) or (e) that a Primary Care
Trust may refuse a person’s application for inclusion in a supplementary list,
or remove a person from one, the regulations must provide for an appeal (by
10
way of redetermination) to the FHSAA against the decision of the Primary
Care Trust.
(9)
If the regulations make provision under subsection (4), they must provide for
an appeal (by way of redetermination) by the person in question to the FHSAA
against the decision of the Primary Care Trust—
15
(a)
to impose conditions, or any particular condition,
(b)
to vary a condition,
(c)
to remove him from the supplementary list for breach of condition,
(d)
on any review of an earlier such decision of the Primary Care Trust.
150
Further provision about regulations under section 149
20
(1)
Regulations under section 149 may require a person (“A”) included in—
(a)
a pharmaceutical list, or
(b)
a list under section 132(3) (provision of drugs, medicines or listed
appliances),

not to employ or engage a person (“B”) to assist him in the provision of the
25
service to which the list relates unless B is included in a list mentioned in
subsection (2).
(2)
The lists are—
(a)
a list referred to in subsection (1),
(b)
a supplementary list,
30
(c)
a list under section 91, 106 or 123,
(d)
a list under section 146 or a list corresponding to a list under section 91
prepared by a Primary Care Trust by virtue of regulations made under
section 145,
(e)
a list corresponding to a list mentioned in any of paragraphs (a) to (d)
35
prepared by a Local Health Board under or by virtue of the National
Health Service (Wales) Act 2006 (c. 00),

or, in any of the cases in paragraphs (a) to (e), such a list of a prescribed
description.
(3)
If regulations do so require, they—
40
(a)
need not require both A and B to be included in lists prepared by the
same Primary Care Trust, but
(b)
may, in particular, require that both A and B be included in lists
prepared by Primary Care Trusts.

National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 6 — Disqualification
89

Chapter 6
Disqualification
151
Disqualification of practitioners
(1)
If it appears to a Primary Care Trust that any of the conditions set out in
subsections (2) to (4) is established in relation to a person included in a
5
pharmaceutical list it may (or, in cases falling within subsection (5), must)
decide to remove him from that list.
(2)
The first condition is that the continued inclusion of the practitioner in the list
would be prejudicial to the efficiency of the services which those included in
the list undertake to provide (and such a case is referred to in this Chapter as
10
an “efficiency case”).
(3)
The second condition is that the practitioner—
(a)
has (whether on his own or together with another) by an act or
omission caused, or risked causing, detriment to any health scheme by
securing or trying to secure for himself or another any financial or other
15
benefit, and
(b)
knew that he or the other was not entitled to the benefit,

(and such a case is referred to in this Chapter as a “fraud case”).
(4)
The third condition is that the practitioner is unsuitable to be included in the
list (and such a case is referred to in this Chapter as an “unsuitability case”).
20
(5)
In unsuitability cases, the Primary Care Trust must remove the practitioner
from the list in prescribed circumstances.
(6)
The Primary Care Trust must state which condition (or conditions) it is relying
on when removing a practitioner from a list.
(7)
“Health scheme” means—
25
(a)
any of the health services under section 1(1) of this Act, section 1(1) of
the National Health Service (Wales) Act 2006 (c. 00), or any enactment
corresponding to section 1(1) of this Act and extending to Scotland or
Northern Ireland, and
(b)
any prescribed scheme,
30

and regulations may prescribe any scheme for the purposes of this subsection
which appears to the Secretary of State to be a health or medical scheme paid
for out of public funds.
(8)
Detriment to a health scheme includes detriment to any patient of, or person
working in, that scheme or any person liable to pay charges for services
35
provided under that scheme.
(9)
In this Chapter a “practitioner” means a person included in a pharmaceutical
list.
152
Contingent removal
(1)
In an efficiency case or a fraud case, the Primary Care Trust may, instead of
40
deciding to remove a practitioner from its list, decide to remove him
contingently.

National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 6 — Disqualification
90

(2)
If it so decides, it must impose such conditions as it may decide on his inclusion
in the list with a view to—
(a)
removing any prejudice to the efficiency of the services in question
(in an efficiency case), or
(b)
preventing further acts or omissions within section 151(3)(a) (in a fraud
5
case).
(3)
If the Primary Care Trust determines that the practitioner has failed to comply
with a condition, it may decide to—
(a)
vary the conditions, or impose different conditions, or
(b)
remove him from its list.
10
(4)
The Primary Care Trust may decide to vary the terms of service of the person
concerned for the purpose of or in connection with the imposition of any
conditions by virtue of this section.
153
Fraud and unsuitability cases: supplementary
(1)
Where the practitioner is a body corporate providing pharmaceutical services,
15
the body corporate must be treated for the purposes of this Chapter as meeting
a condition referred to in section 151(3) or (4) if any one of the body of persons
controlling the body meets that condition (whether or not he first did so when
he was such a person).
(2)
A practitioner must be treated for the purposes of this Chapter as meeting the
20
condition referred to in section 151(3) if—
(a)
another person, because of an act or omission of his occurring in the
course of providing any services mentioned in section 151(1) on the
practitioner’s behalf, meets that condition, and
(b)
the practitioner failed to take all such steps as were reasonable to
25
prevent acts or omissions within section 151(3)(a) occurring in the
course of the provision of those services on his behalf.
154
Suspension
(1)
If the Primary Care Trust is satisfied that it is necessary to do so for the
protection of members of the public or is otherwise in the public interest, it may
30
suspend a practitioner from its list—
(a)
while it decides whether or not to exercise its powers under section 151
or 152 (other than in circumstances falling within paragraph (b)), or
(b)
while it waits for a decision affecting the practitioner of a court or of a
body which regulates—
35
(i)
the practitioner’s profession,
(ii)
the profession of a person providing any of the services
mentioned in section 151(1) on the practitioner’s behalf, or
(iii)
if the practitioner is a body corporate, the profession of one of
its directors, or one of the body of persons controlling it or (if it
40
is a limited liability partnership) one of its members,

or one of that regulatory body’s committees.
(2)
The references in subsection (1)(b) to a court or regulatory body are to a court
or such a body anywhere in the world.

National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 6 — Disqualification
91

(3)
In a case falling within subsection (1)(a), the Primary Care Trust must specify
the length of the period of suspension.
(4)
In a case falling within subsection (1)(b), the Primary Care Trust may specify
that the practitioner remains suspended after the decision referred to there for
an additional period which the Primary Care Trust must specify.
5
(5)
In either case—
(a)
before that period expires it may extend, or further extend, the
suspension for a further specified period, or
(b)
if that period has expired, it may impose a further suspension, for a
period which it must specify.
10
(6)
The period of suspension (in a subsection (1)(a) case) or the additional period
(in a subsection (1)(b) case), including in both cases the period of any further
suspension imposed under subsection (5)(b), may not exceed six months in
aggregate, except—
(a)
in prescribed circumstances, when it may not extend beyond any
15
prescribed event (which may be the expiry of a prescribed period),
(b)
if, on the application of the Primary Care Trust, the FHSAA orders
accordingly before the expiry of the period of suspension, or
(c)
if the Primary Care Trust has applied under paragraph (b) before the
expiry of the period of suspension, but the FHSAA has not made an
20
order by the time it expires, in which case it continues until the FHSAA
has made an order.
(7)
If the FHSAA does so order, it must specify—
(a)
the date on which the period of suspension will end, or
(b)
an event beyond which it will not continue.
25
(8)
The FHSAA may, on the application of the Primary Care Trust, make a further
order (complying with subsection (7)) at any time while the period of
suspension pursuant to the earlier order is still continuing.
(9)
The Secretary of State may make regulations providing for payments to
practitioners who are suspended.
30
(10)
Those regulations may include provision for the amount of the payments, or
the method of calculating the amount, to be determined by the Secretary of
State or by another person appointed for the purpose by the Secretary of State.
155
Suspension pending appeal
(1)
This section applies if the Primary Care Trust decides to remove a practitioner
35
from a list under section 151.
(2)
In such a case it may also decide to suspend the practitioner from the list
pending any appeal by him, if it is satisfied that it is necessary to do so for the
protection of members of the public or is otherwise in the public interest.
(3)
If it does suspend the practitioner under this section, the suspension has effect
40
from the date when the Primary Care Trust gave him notice of the suspension.
(4)
The suspension has effect until its revocation under subsection (5) or (6) or, if
later, until the expiry of the period of 28 days referred to in section 158(1), or,
if the practitioner appeals under section 158, until the FHSAA has disposed of
the appeal.
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National Health Service Bill [HL]
Part 7 — Pharmaceutical services and local pharmaceutical services
Chapter 6 — Disqualification
92

(5)
The Primary Care Trust may revoke a suspension imposed under this section.
(6)
If the practitioner appeals under section 158 against the decision of the Primary
Care Trust to remove him from the list, the FHSAA may also revoke a
suspension imposed on him under this section.
(7)
Subsections (9) and (10) of section 154 apply for the purposes of this section as
5
they apply for the purposes of that.
156
Effect of suspension
While a practitioner is suspended (whether under section 154 or under section
155) he must be treated as not being included in the list from which he has been
suspended even though his name appears in it.
10
157
Review of decisions
(1)
The Primary Care Trust may, and (except in prescribed cases) if requested in
writing to do so by the practitioner must, review a contingent removal or a
suspension (other than a contingent removal or a suspension imposed by, or a
suspension continuing pursuant to, an order of the FHSAA, or a suspension
15
imposed under section 155).
(2)
The practitioner may not request a review before the expiry of the period of—
(a)
three months beginning with the date of the decision of the Primary
Care Trust to suspend or contingently remove him, or (as appropriate),
(b)
six months beginning with the date of its decision on the previous
20
review.
(3)
On such a review, the Primary Care Trust may—
(a)
confirm the contingent removal or the suspension,
(b)
in the case of a suspension, terminate it,
(c)
in the case of a contingent removal, vary the conditions, impose
25
different conditions, revoke the contingent removal, or remove the
practitioner from the list.
158
Appeals
(1)
A practitioner may appeal to the FHSAA against a decision of a Primary Care
Trust mentioned in subsection (2) by giving notice in writing to the FHSAA
30
within the period of 28 days beginning with the date on which the Primary
Care Trust gave him notice of the decision.
(2)
The Primary Care Trust decisions in question are—
(a)
to remove the practitioner from a list (under section 151 or 152(3) or
under subsection (5)(b) of this section),
35
(b)
to remove him contingently (under section 152),
(c)
to impose any particular condition under section 152, or to vary any
condition or to impose any different condition under that section,
(d)
to vary his terms of service (under section 152(4)),
(e)
any decision on a review of a contingent removal under section 157.
40
(3)
The appeal must be way of redetermination of the decision of the Primary Care
Trust.