National Health Service (Wales) Bill [HL]

House of Commons

Session 2005 - 06
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Other Bills before Parliament

National Health Service (Wales) Bill [HL]

National Health Service (Wales) Bill [HL]
Part 4 — Medical services
29

(2)
For the purposes of this section—
(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),
5
(b)
a Local Health Board is responsible for a medical service if it 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—
(a)
the preparation, maintenance and publication of a list,
10
(b)
eligibility for inclusion in a list,
(c)
applications for inclusion (including provision as to the Local Health
Board to which an application must be made, and for the procedure for
applications and the documents to be supplied on application),
(d)
the grounds on which an application for inclusion may or must be
15
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
benefits),
(f)
suspension or removal from a list (including provision for the
20
grounds for, and consequences of, suspension or removal),
(g)
circumstances in which a person included in a list may not withdraw
from it,
(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
25
calculating the payment, to be determined by the Welsh Ministers or a
person appointed by them),
(i)
the criteria to be applied in making decisions under the regulations,
(j)
appeals against decisions made by a Local Health Board under the
regulations, and
30
(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 107 to 115.
(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
35
a Local Health Board,
(b)
a Local Health Board to vary the conditions or impose different ones,
(c)
the consequences of failing to comply with a condition (including
removal from a list),
(d)
the review by a Local Health Board of decisions made by it by virtue of
40
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
relates, or
(b)
preventing fraud.
45
(6)
Regulations making provision as to the matters referred to in subsection (3)(k)
may in particular authorise the disclosure of information—
(a)
by a Local Health Board to the Welsh Ministers, and
(b)
by the Welsh Ministers to a Local Health Board.

National Health Service (Wales) Bill [HL]
Part 4 — Medical services
30

Other arrangements for the provision of primary medical services
50
Arrangements by Local Health Boards for the provision of primary medical
services
(1)
A Local Health Board may make one or more agreements with respect to its
area under which primary medical services are provided (otherwise than by
5
the Local Health Board).
(2)
An agreement must be in accordance with regulations under section 52.
(3)
An agreement may not combine arrangements for the provision of primary
medical services with arrangements for the provision of primary dental
services.
10
(4)
An agreement may not combine arrangements for the provision of primary
medical services with arrangements for the provision of local pharmaceutical
services.
(5)
But an agreement may include arrangements for the provision of services
which are not primary medical services but which may be provided under this
15
Act, other than under Part 6 (general ophthalmic services) or Chapter 1 or 2 of
Part 7 (pharmaceutical services and local pharmaceutical services under pilot
schemes).
(6)
Regulations may provide—
(a)
for functions which are exercisable by a Local Health Board in relation
20
to an agreement to be exercisable on behalf of the Local Health Board
by a Health Board, and
(b)
for functions which are exercisable by a Health Board in relation to
an agreement made under section 17C of the National Health Service
(Scotland) Act 1978 (c. 29) to be exercisable on behalf of the Board by
25
the Local Health Board.
(7)
In this Act, arrangements for the provision of services made under this section
are called “section 50 arrangements”.
51
Persons with whom agreements may be made under section 50
(1)
A Local Health Board may make an agreement under section 50 only with one
30
or more of the following—
(a)
an NHS trust or an NHS foundation trust,
(b)
a medical practitioner who meets the prescribed conditions,
(c)
a health care professional who meets the prescribed conditions,
(d)
an individual who is providing services—
35
(i)
under a general medical services contract or a general dental
services contract or an English general medical services contract
or an English general dental services contract,
(ii)
in accordance with section 50 arrangements, section 64
arrangements, section 92 arrangements, section 107
40
arrangements, section 17C arrangements or Article 15B
arrangements, or
(iii)
under section 17J or 25 of the 1978 Act or Article 57 or 61 of the
Health and Personal Social Services (Northern Ireland) Order
1972 (S.I. 1972/1265 (N.I.14)),
45

National Health Service (Wales) Bill [HL]
Part 4 — Medical services
31


or has so provided them within such period as may be prescribed,
(e)
an NHS employee, a section 50 employee, a section 64 employee, a
section 92 employee, a section 107 employee, a section 17C employee or
an Article 15B employee,
(f)
a qualifying body,
5
(g)
a Primary Care Trust or Local Health Board.
(2)
The power under subsection (1) to make an agreement with a person falling
within paragraph (d) or (e) of that subsection is subject to such conditions as
may be prescribed.
(3)
In this section—
10
“the 1978 Act” means the National Health Service (Scotland) Act 1978
(c. 29),
“Article 15B arrangements” means arrangements for the provision of
services made under Article 15B of the Health and Personal Social
Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)),
15
“Article 15B employee” means an individual who, in connection with the
provision of services in accordance with Article 15B arrangements, is
employed by a person providing or performing those services,
“English general dental services contract” means a contract under section
100(2) of the National Health Service Act 2006 (c. 00),
20
“English general medical services contract” means a contract under
section 84(2) of that Act,
“health care professional” means a person who is a member of a
profession regulated by a body mentioned (at the time the agreement
in question is made) in section 25(3) of the National Health Service
25
Reform and Health Care Professions Act 2002 (c. 17),
“NHS employee” means an individual who, in connection with the
provision of services in the health service, the Scottish health service or
the Northern Ireland health service, is employed by—
(a)
an NHS trust, an NHS foundation trust or (in Northern Ireland)
30
a Health and Social Services Trust,
(b)
a Primary Care Trust or Local Health Board,
(c)
a person who is providing services under a general medical
services contract or a general dental services contract or an
English general medical services contract or an English general
35
dental services contract,
(d)
an individual who is providing services as specified in
subsection (1)(d)(iii),
“the Northern Ireland health service” means the health service within the
meaning of the Health and Personal Social Services (Northern Ireland)
40
Order 1972,
“qualifying body” means a company which is limited by shares all of
which are legally and beneficially owned by persons falling within
paragraph (a), (b), (c), (d), (e) or (g) of subsection (1),
“the Scottish health service” means the health service within the meaning
45
of the National Health Service (Scotland) Act 1978,
“section 17C arrangements” means arrangements for the provision of
services made under section 17C of the 1978 Act,
“section 17C employee” means an individual who, in connection with the
provision of services in accordance with section 17C arrangements, is
50
employed by a person providing or performing those services,

National Health Service (Wales) Bill [HL]
Part 4 — Medical services
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“section 92 arrangements” means arrangements for the provision of
services made under section 92 of the National Health Service Act 2006
(c. 00),
“section 107 arrangements” means arrangements for the provision of
services made under section 107 of that Act,
5
“section 92 employee” means an individual who, in connection with the
provision of services in accordance with section 92 arrangements, is
employed by a person providing or performing those services,
“section 107 employee” means an individual who, in connection with the
provision of services in accordance with section 107 arrangements, is
10
employed by a person providing or performing those services,
“section 50 employee” means an individual who, in connection with the
provision of services in accordance with section 50 arrangements, is
employed by a person providing or performing those services,
“section 64 employee” means an individual who, in connection with the
15
provision of services in accordance with section 64 arrangements, is
employed by a person providing or performing those services.
52
Regulations about section 50 arrangements
(1)
The Welsh Ministers may make regulations about the provision of services in
accordance with section 50 arrangements.
20
(2)
The regulations must include provision for participants other than Local
Health Boards to withdraw from section 50 arrangements if they wish to do so.
(3)
The regulations may, in particular—
(a)
provide that section 50 arrangements may be made only in prescribed
circumstances,
25
(b)
provide that section 50 arrangements may be made only in prescribed
areas,
(c)
provide that only prescribed services, or prescribed categories of
service, may be provided in accordance with section 50 arrangements,
(d)
impose conditions (including conditions as to qualifications and
30
experience) to be satisfied by persons performing services in
accordance with section 50 arrangements,
(e)
require details of section 50 arrangements to be published,
(f)
make provision with respect to the variation and termination of
section 50 arrangements,
35
(g)
provide for parties to section 50 arrangements to be treated, in such
circumstances and to such extent as may be prescribed, as health
service bodies for the purposes of section 7,
(h)
provide for directions, as to payments, made under section 7(11) (as it
has effect as a result of regulations made by virtue of paragraph (g)) to
40
be enforceable in a county court (if the court so orders) as if they were
judgments or orders of that court.
(4)
The regulations may also require payments to be made under the
arrangements in accordance with directions given for the purpose by the
Welsh Ministers.
45
(5)
A direction may 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.

National Health Service (Wales) Bill [HL]
Part 4 — Medical services
33

(6)
The regulations may also include provision requiring a Local Health Board, in
prescribed circumstances and subject to prescribed conditions, to enter into a
general medical services contract on prescribed terms with any person who is
providing services under section 50 arrangements and who so requests.
(7)
The regulations may also include provision for the resolution of disputes as to
5
to the terms of any proposed section 50 arrangements, and in particular may
make provision—
(a)
for the referral of the terms of the proposed arrangements to the Welsh
Ministers, and
(b)
for the Welsh Ministers or a person appointed by them to determine the
10
terms on which the arrangements may be entered into.
(8)
The regulations must provide for the circumstances in which a person
providing primary medical services under section 50 arrangements—
(a)
must or may accept a person as a patient to whom such services are so
provided,
15
(b)
may decline to accept a person as such a patient,
(c)
may terminate his responsibility for a patient.
(9)
The regulations must make provision as to the right of patients to choose the
persons from whom they receive services under section 50 arrangements.
Assistance and support
20
53
Assistance and support: primary medical services
(1)
A Local Health Board may provide assistance or support to any person
providing or proposing to provide—
(a)
primary medical services under a general medical services contract, or
(b)
primary medical services in accordance with section 50 arrangements.
25
(2)
Assistance or support provided by a Local Health Board under subsection (1)
is provided on such terms, including terms as to payment, as the Local Health
Board considers appropriate.
(3)
“Assistance” includes financial assistance.
Local Medical Committees
30
54
Local Medical Committees
(1)
A Local Health Board may recognise a committee formed for its area, or for its
area and that of one or more other Local Health Boards, which it is satisfied is
representative of—
(a)
the persons to whom subsection (2) applies, and
35
(b)
the persons to whom subsection (3) applies.
(2)
This subsection applies to—
(a)
each medical practitioner who, under a general medical services
contract entered into by him, is providing primary medical services in
the area for which the committee is formed, and
40
(b)
each medical practitioner who is providing general ophthalmic services
in that area.

National Health Service (Wales) Bill [HL]
Part 4 — Medical services
34

(3)
This subsection applies to each other medical practitioner—
(a)
who is performing primary medical services in the area for which the
committee is formed—
(i)
pursuant to section 41(2)(a),
(ii)
in accordance with section 50 arrangements, or
5
(iii)
under a general medical services contract, and
(b)
who has notified the Local Health Board that he wishes to be
represented by the committee (and has not notified it that he wishes to
cease to be so represented).
(4)
A committee recognised under this section is called the Local Medical
10
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.
(6)
Regulations may require a Local Health Board, in the exercise of its functions
15
relating to primary medical services, to consult any committee recognised by it
under this section on such occasions and to such extent as may be prescribed.
(7)
A committee recognised under this section has such other functions as may be
prescribed.
(8)
A committee recognised under this section must in respect of each year
20
determine—
(a)
the amount of its administrative expenses for that year attributable to
persons of whom it is representative under subsection (1)(a), and
(b)
the amount of its administrative expenses for that year attributable to
persons of whom it is representative under subsection (1)(b).
25
(9)
A Local Health Board may—
(a)
on the request of a committee recognised by it, allot to that committee
such sums for defraying the expenses referred to in subsection (8)(a) as
the Local Health Board may determine, and
(b)
deduct the amount of such sums from the remuneration of persons of
30
whom the committee is representative under subsection (1)(a) under
the general medical services contracts, or arrangements under section
71, entered into by those persons with the Local Health Board.
(10)
A committee recognised under this section must apportion the amount
determined by it under subsection (8)(b) among the persons of whom it is
35
representative under subsection (1)(b); and each such person must pay in
accordance with the committee’s directions the amount so apportioned to him.
(11)
The administrative expenses of a committee include the travelling and
subsistence allowances payable to its members.
Provision of accommodation by the Welsh Ministers
40
55
Use of accommodation: provision of primary medical services
If the Welsh Ministers consider that any accommodation provided by them by
virtue of this Act is suitable for use in connection with the provision of primary
medical services, they may make the accommodation available on such terms
as they consider appropriate to persons providing those services.
45

National Health Service (Wales) Bill [HL]
Part 5 — Dental services
35

Part 5
Dental services
Duty of Local Health Boards in relation to primary dental services
56
Primary dental services
(1)
Each Local Health Board must, to the extent that it considers necessary to meet
5
all reasonable requirements, exercise its powers so as to provide primary
dental services within its area, or secure their provision within its area.
(2)
A Local Health Board may (in addition to any other power conferred on it)
provide primary dental services itself (whether within or outside its area).
(3)
Each Local Health Board must publish information about such matters as may
10
be prescribed in relation to the primary dental services for which it makes
provision under this Act.
(4)
Each Local Health Board must co-operate with each other Local Health Board
and each Primary Care Trust in the discharge of their respective functions
relating to the provision of primary dental services under this Act and the
15
National Health Service Act 2006 (c. 00).
(5)
Regulations may provide that services of a prescribed description must, or
must not, be regarded as primary dental services for the purposes of this Act.
(6)
Regulations under subsection (5) may in particular describe services by
reference to the manner or circumstances in which they are provided.
20
General dental services contracts
57
General dental services contracts: introductory
(1)
A Local Health Board may enter into a contract under which primary dental
services are provided in accordance with the following provisions of this Part.
(2)
A contract under this section is called in this Act a “general dental services
25
contract”.
(3)
A general dental services contract may make such provision as may be agreed
between the Local Health Board and the contractor in relation to—
(a)
the services to be provided under the contract (which may include
services which are not primary dental services),
30
(b)
remuneration under the contract, and
(c)
any other matters.
(4)
In this Part, “contractor”, in relation to a general dental services contract,
means any person entering into the contract with the Local Health Board.
58
Requirement to provide certain primary dental services
35
(1)
A general dental services contract must require the contractor or contractors to
provide, for his or their patients, primary dental services of such descriptions
as may be prescribed.