National Health Service (Wales) Bill [HL]

House of Commons

Session 2005 - 06
Internet Publications
Other Bills before Parliament

National Health Service (Wales) Bill [HL]

National Health Service (Wales) Bill [HL]
Part 5 — Dental services
42

66
Regulations about section 64 arrangements
(1)
The Welsh Ministers may make regulations about the provision of services in
accordance with section 64 arrangements.
(2)
The regulations must include provision for participants other than Local
Health Boards to withdraw from section 64 arrangements if they wish to do so.
5
(3)
The regulations may, in particular—
(a)
provide that section 64 arrangements may be made only in prescribed
circumstances,
(b)
provide that section 64 arrangements may be made only in prescribed
areas,
10
(c)
provide that only prescribed services, or prescribed categories of
service, may be provided in accordance with section 64 arrangements,
(d)
impose conditions (including conditions as to qualifications and
experience) to be satisfied by persons performing services in
accordance with section 64 arrangements,
15
(e)
require details of section 64 arrangements to be published,
(f)
make provision with respect to the variation and termination of
section 64 arrangements,
(g)
provide for parties to section 64 arrangements to be treated, in such
circumstances and to such extent as may be prescribed, as health
20
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
be enforceable in a county court (if the court so orders) as if they were
judgments or orders of that court.
25
(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.
(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
30
provision is not detrimental to the persons to whose remuneration it relates.
(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 dental services contract on prescribed terms with any person who is
providing services under section 64 arrangements and who so requests.
35
(7)
The regulations may also include provision for the resolution of disputes as to
to the terms of any proposed section 64 arrangements, and in particular may
make provision—
(a)
for the referral of the terms of the proposed arrangements to the Welsh
Ministers, and
40
(b)
for the Welsh Ministers or a person appointed by them to determine the
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 64 arrangements—
(a)
must or may accept a person as a patient to whom such services are so
45
provided,
(b)
may decline to accept a person as such a patient,
(c)
may terminate his responsibility for a patient.

National Health Service (Wales) Bill [HL]
Part 5 — Dental services
43

(9)
The regulations must make provision as to the right of patients to choose the
persons from whom they receive services under section 64 arrangements.
Dental public health
67
Dental public health
(1)
A Local Health Board has such functions in relation to dental public health in
5
Wales as may be prescribed.
(2)
The Welsh Ministers have such functions in relation to dental public health in
Wales as may be prescribed.
(3)
The functions of a Local Health Board under this section may be discharged—
(a)
by the Local Health Board itself,
10
(b)
by the Local Health Board and one or more other Local Health Boards
acting jointly, or
(c)
by any other person or body in accordance with arrangements made by
the Local Health Board.
Assistance and support
15
68
Assistance and support: primary dental services
(1)
A Local Health Board may provide assistance or support to any person
providing or proposing to provide—
(a)
primary dental services under a general dental services contract, or
(b)
primary dental services in accordance with section 64 arrangements.
20
(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 Dental Committees
25
69
Local Dental 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
30
(b)
the persons to whom subsection (3) applies.
(2)
This subsection applies to each dental practitioner who, under a general dental
services contract entered into by him, is providing primary dental services in
the area for which the committee is formed.
(3)
This subsection applies to each other dental practitioner—
35
(a)
who is performing primary dental services in the area for which the
committee is formed—
(i)
pursuant to section 56(2),

National Health Service (Wales) Bill [HL]
Part 5 — Dental services
44

(ii)
in accordance with section 64 arrangements, or
(iii)
under a general dental 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).
5
(4)
A committee recognised under this section is called the Local Dental
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.
10
(6)
Regulations may require a Local Health Board, in the exercise of its functions
relating to primary dental 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.
15
(8)
A committee recognised under this section must in respect of each year
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
20
persons of whom it is representative under subsection (1)(b).
(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
25
(b)
deduct the amount of such sums from the remuneration of persons of
whom it is representative under subsection (1)(a) under the general
dental services contracts entered into by them with the 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
30
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
35
70
Use of accommodation: provision of primary dental 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
dental services, they may make the accommodation available on such terms as
they consider appropriate to persons providing those services.
40

National Health Service (Wales) Bill [HL]
Part 6 — Ophthalmic services
45

Part 6
Ophthalmic services
General ophthalmic services
71
Arrangements for general ophthalmic services
(1)
Each Local Health Board must, in accordance with regulations, arrange as
5
respects its area—
(a)
with medical practitioners having the prescribed qualifications, and
(b)
with optometrists,

for securing sight tests by them of the persons mentioned in subsection (2).
(2)
The persons are—
10
(a)
a child,
(b)
a person whose resources fall to be treated under the regulations as
being less than or equal to his requirements, or
(c)
a person of such other description as may be prescribed.
(3)
In subsection (2)—
15
“child” means—
(a)
a person who is under the age of 16 years, or
(b)
a person who is under the age of 19 years and receiving
qualifying full-time education, and
“qualifying full-time education” means full-time instruction at a
20
recognised educational establishment or by other means accepted as
comparable by the Welsh Ministers.
(4)
For the purposes of subsection (3)—
(a)
“recognised educational establishment” means an establishment
recognised by the Welsh Ministers as being, or as comparable to, a
25
school, college or university, and
(b)
regulations may prescribe the circumstances in which a person must, or
must not, be treated as receiving full-time instruction.
(5)
Regulations under this section may direct how a person’s resources and
requirements must be calculated and may, in particular, direct that they must
30
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
section or in an instrument made under an Act of Parliament or by
35
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
(d)
by reference to the person’s being or having been entitled to
40
payment under an Act of Parliament or an instrument made under an
Act of Parliament.

National Health Service (Wales) Bill [HL]
Part 6 — Ophthalmic services
46

(6)
Descriptions of persons may be prescribed for the purposes of subsection (1)
by reference to any criterion and, in particular, by reference to any of the
following criteria—
(a)
their age,
(b)
the fact that a prescribed person or a prescribed body accepts them as
5
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,
(d)
their receipt of benefit in money or in kind under any enactment or
10
their entitlement to receive any such benefit, and
(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.
(7)
Regulations which refer to an Act of Parliament or an instrument made under
15
an Act of Parliament may direct that the reference is to be construed as a
reference to that Act or instrument—
(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.
(8)
Regulations may provide that a person—
20
(a)
whose sight is tested by a person who provides general ophthalmic
services, and
(b)
who is shown during the test or within a prescribed time after it to fall
within subsection (1),

must be taken for the purposes of the test to have fallen within subsection (1)
25
immediately before the test.
(9)
For the purposes of subsection (8), the test must be treated as a sight test under
this Act—
(a)
for the purposes of any arrangements under this section,
(b)
for the purposes of remuneration in respect of the test, and
30
(c)
for any such other purpose as may be prescribed.
(10)
Regulations must define the services for the provision of which arrangements
under this section must be made, and the services so defined are in this Act
referred to as “general ophthalmic services”.
72
Regulations as to general ophthalmic services
35
(1)
Regulations may provide as to the arrangements to be made under section 71,
and must include provision—
(a)
for the preparation and publication by each Local Health Board of a list
of medical practitioners and a list of optometrists who undertake to
provide general ophthalmic services for persons in the area of the Local
40
Health Board,
(b)
for conferring a right on any medical practitioner having the prescribed
qualifications, and on any optometrist, who wishes to be included in an
ophthalmic list, to be included,
(c)
for conferring on any person a right to choose in accordance with the
45
prescribed procedure the medical practitioner or optometrist by whom
his sight will be tested, or from whom any prescription for the supply
of optical appliances will be obtained,

National Health Service (Wales) Bill [HL]
Part 6 — Ophthalmic services
47

(d)
for the removal from an ophthalmic list for any area of the name of any
person in whose case it has been determined in such manner as may be
prescribed that he has never provided, or has ceased to provide,
general ophthalmic services for persons in that area.
(2)
Subsection (1)(b) is subject to subsections (3) and (4) and Part 8.
5
(3)
The regulations may, in particular, make provision in relation to—
(a)
grounds on which a Local Health Board may, or must, refuse to include
a medical practitioner or an optometrist in an ophthalmic list
(including grounds corresponding to the conditions referred to in
section 107(2), (3) and (4) as read with section 109),
10
(b)
information which must be supplied to a Local Health Board by a
person included or seeking inclusion in an ophthalmic list (or by
arrangement with him),
(c)
the supply to a Local Health Board by an individual—
(i)
who is included, or seeking inclusion, in an ophthalmic list, or
15
(ii)
who is a director of a body corporate or who is a member of a
limited liability partnership included, or seeking inclusion, in
such a list,

of a criminal conviction certificate under section 112 of the Police Act
1997 (c. 50), a criminal record certificate under section 113 of that Act or
20
an enhanced criminal record certificate under section 115 of that Act,
(d)
grounds on which a Local Health Board may defer a decision whether
or not to include a person in an ophthalmic list,
(e)
the disclosure by a Local Health Board, to prescribed persons or
persons of prescribed descriptions, of information of a prescribed
25
description about applicants for inclusion in an ophthalmic list, and
refusals by the Local Health Board to include them, and
(f)
criteria to be applied in making decisions under the regulations.
(4)
If regulations made by virtue of subsection (3)(a) provide that a Local Health
Board may refuse to include a person in an ophthalmic list, they must also
30
provide for an appeal (by way of redetermination) to the FHSAA against the
decision of the Local Health Board.
(5)
The regulations may include provision as to the making of declarations
about—
(a)
financial interests,
35
(b)
gifts above a prescribed value, and
(c)
other benefits received.
(6)
Before making regulations by virtue of subsection (5), the Welsh Ministers
must consult such organisations as they consider appropriate appearing to
them to represent persons providing general ophthalmic services.
40
(7)
In this Act an “ophthalmic list” means a list published in accordance with
regulations made under subsection (1)(a).
73
Medical practitioners with qualifications prescribed under section 71
The power conferred by section 71 to prescribe the qualifications to be
possessed by any medical practitioner includes a power to—
45
(a)
prescribe a requirement that the practitioner must show to the
satisfaction of a committee recognised by the Welsh Ministers for the

National Health Service (Wales) Bill [HL]
Part 6 — Ophthalmic services
48

purpose that he possesses such qualifications, including qualifications
as to experience, as may be mentioned in the regulations, and
(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 Welsh
Ministers, and to provide for any matter for which it appears to the
5
Welsh Ministers to be requisite or expedient to provide in consequence
of the conferring of that right.
74
Exercise of choice of practitioner
Regulations may provide that, where a right is conferred to choose the person
by whom general ophthalmic services will be provided under this Part, that
10
right must, in the case of prescribed persons, be exercised on their behalf by
other prescribed persons.
75
Inadequate provision of ophthalmic services
(1)
Subsection (2) applies if the Welsh Ministers are satisfied, after such inquiry as
they consider appropriate, that—
15
(a)
as respects the area, or part of the area, of a Local Health Board, the
persons whose names are included in any ophthalmic list are not such
as to secure the adequate provision of general ophthalmic services in
that area or part, or
(b)
for any other reason any considerable number of persons in any such
20
area or part are not receiving satisfactory services under the
arrangements in force under this Part.
(2)
Where this subsection applies, the Welsh Ministers—
(a)
may authorise the Local Health Board to make such other
arrangements as the Welsh Ministers may approve, or may themselves
25
make such other arrangements, and
(b)
may dispense with any of the requirements of regulations made under
this Part or Part 8 so far as appears to the Welsh Ministers necessary to
meet exceptional circumstances and enable such arrangements to be
made.
30
Remuneration
76
Remuneration for persons providing general ophthalmic services
(1)
The remuneration to be paid to persons who provide general ophthalmic
services under this Part must be determined by determining authorities.
(2)
Determining authorities may also determine the remuneration to be paid to
35
persons who provide those services in respect of the instruction of any person
in matters relating to those services.
(3)
For the purposes of this section and section 77 determining authorities are—
(a)
the Welsh Ministers, and
(b)
so far as authorised by the Welsh Ministers to exercise the functions of
40
determining authorities, any Local Health Board or other person
appointed by them in an instrument.