|
| |
|
106 | Further provision about regulations under section 105 |
| |
(1) | Regulations under section 105 may require a person (“A”) included in— |
| |
| |
(b) | a pharmaceutical list, or |
| |
(c) | a list under section 86(3) (provision of drugs, medicines or listed |
| 5 |
| |
| not to employ or engage a person (“B”) to assist him in the provision of the |
| |
service to which the list relates unless B is included in a list mentioned in |
| |
| |
| 10 |
(a) | a list referred to in subsection (1), |
| |
(b) | a supplementary list, |
| |
(c) | a list under section 49 or 63, |
| |
(d) | a list corresponding to a list under section 49 or section 63 and prepared |
| |
by a Local Health Board by virtue of regulations made under section |
| 15 |
| |
(e) | a list corresponding to a list mentioned in any of paragraphs (a) to (d) |
| |
prepared by a Primary Care Trust under or by virtue of the National |
| |
Health Service Act 2006 (c. 00), |
| |
| or, in any of the cases in paragraphs (a) to (e), such a list of a prescribed |
| 20 |
| |
(3) | If regulations do so require, they— |
| |
(a) | need not require both A and B to be included in lists prepared by the |
| |
same Local Health Board, but |
| |
(b) | may, in particular, require that both A and B be included in lists |
| 25 |
prepared by Local Health Boards. |
| |
| |
| |
107 | Disqualification of practitioners |
| |
(1) | If it appears to a Local Health Board that any of the conditions set out in |
| 30 |
subsections (2) to (4) is established in relation to a person included in an |
| |
ophthalmic list or a 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 |
| 35 |
the list undertake to provide (and such a case is referred to in this Chapter as |
| |
| |
(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 |
| 40 |
securing or trying to secure for himself or another any financial or other |
| |
| |
(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”). |
| |
(5) | In unsuitability cases, the Local Health Board must remove the practitioner |
| |
from the list in prescribed circumstances. |
| |
(6) | The Local Health Board must state which condition (or conditions) it is relying |
| 5 |
on when removing a practitioner from a list. |
| |
(7) | “Health scheme” means— |
| |
(a) | any of the health services under section 1(1) of this Act, section 1(1) of |
| |
the National Health Service Act 2006 (c. 00) or any enactment |
| |
corresponding to section 1(1) of this Act and extending to Scotland or |
| 10 |
| |
(b) | any prescribed scheme, |
| |
| and regulations may prescribe any scheme for the purposes of this subsection |
| |
which appears to the Welsh Ministers to be a health or medical scheme paid for |
| |
| 15 |
(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 |
| |
provided under that scheme. |
| |
(9) | In this Chapter a “practitioner” means a person included in a pharmaceutical |
| |
| 20 |
| |
(1) | In an efficiency case or a fraud case, the Local Health Board may, instead of |
| |
deciding to remove a practitioner from its list, decide to remove him |
| |
| |
(2) | If it so decides, it must impose such conditions as it may decide on his inclusion |
| 25 |
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 107(3)(a) (in a fraud |
| |
| 30 |
(3) | If the Local Health Board 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. |
| |
(4) | The Local Health Board may decide to vary the terms of service of the person |
| 35 |
concerned for the purpose of or in connection with the imposition of any |
| |
conditions by virtue of this section. |
| |
109 | Fraud and unsuitability cases: supplementary |
| |
(1) | Where the practitioner is a body corporate, the body corporate must be treated |
| |
for the purposes of this Chapter as meeting a condition referred to in section |
| 40 |
| |
(a) | in the case of an optometrist not referred to in paragraph (b), if any |
| |
director meets that condition (whether or not he first did so when he |
| |
| |
|
| |
|
| |
|
(b) | in the case of a body corporate providing pharmaceutical services or an |
| |
optometrist which is a limited liability partnership, 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 |
| 5 |
condition referred to in section 107(3) if— |
| |
(a) | another person, because of an act or omission of his occurring in the |
| |
course of providing any services mentioned in section 107(1) on the |
| |
practitioner’s behalf, meets that condition, and |
| |
(b) | the practitioner failed to take all such steps as were reasonable to |
| 10 |
prevent acts or omissions within section 107(3)(a) occurring in the |
| |
course of the provision of those services on his behalf. |
| |
| |
(1) | If the Local Health Board 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 |
| 15 |
suspend a practitioner from its list— |
| |
(a) | while it decides whether or not to exercise its powers under section 107 |
| |
or 108 (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 |
| |
| 20 |
(i) | the practitioner’s profession, |
| |
(ii) | the profession of a person providing any of the services |
| |
mentioned in section 107(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 |
| 25 |
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. |
| |
(3) | In a case falling within subsection (1)(a), the Local Health Board must specify |
| 30 |
the length of the period of suspension. |
| |
(4) | In a case falling within subsection (1)(b), the Local Health Board may specify |
| |
that the practitioner remains suspended after the decision referred to there for |
| |
an additional period which the Local Health Board must specify. |
| |
| 35 |
(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. |
| |
(6) | The period of suspension (in a subsection (1)(a) case) or the additional period |
| 40 |
(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 |
| |
| |
(a) | in prescribed circumstances, when it may not extend beyond any |
| |
prescribed event (which may be the expiry of a prescribed period), |
| 45 |
(b) | if, on the application of the Local Health Board, the FHSAA orders |
| |
accordingly before the expiry of the period of suspension, or |
| |
|
| |
|
| |
|
(c) | if the Local Health Board has applied under paragraph (b) before the |
| |
expiry of the period of suspension, but the FHSAA has not made an |
| |
order by the time it expires, in which case it continues until the FHSAA |
| |
| |
(7) | If the FHSAA does so order, it must specify— |
| 5 |
(a) | the date on which the period of suspension will end, or |
| |
(b) | an event beyond which it will not continue. |
| |
(8) | The FHSAA may, on the application of the Local Health Board, make a further |
| |
order (complying with subsection (7)) at any time while the period of |
| |
suspension pursuant to the earlier order is still continuing. |
| 10 |
(9) | The Welsh Ministers may make regulations providing for payments to |
| |
practitioners who are suspended. |
| |
(10) | Those regulations may include provision for the amount of the payments, or |
| |
the method of calculating the amount, to be determined by the Welsh Ministers |
| |
or by another person appointed for the purpose by them. |
| 15 |
111 | Suspension pending appeal |
| |
(1) | This section applies if the Local Health Board decides to remove a practitioner |
| |
from a list under section 107. |
| |
(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 |
| 20 |
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 |
| |
from the date when the Local Health Board 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 114(1), or, |
| 25 |
if the practitioner appeals under section 114, until the FHSAA has disposed of |
| |
| |
(5) | The Local Health Board may revoke a suspension imposed under this section. |
| |
(6) | If the practitioner appeals under section 114 against the decision of the Local |
| |
Health Board to remove him from the list, the FHSAA may also revoke a |
| 30 |
suspension imposed on him under this section. |
| |
(7) | Subsections (9) and (10) of section 110 apply for the purposes of this section as |
| |
they apply for the purposes of that. |
| |
| |
While a practitioner is suspended (whether under section 110 or under section |
| 35 |
111) he must be treated as not being included in the list from which he has been |
| |
suspended even though his name appears in it. |
| |
| |
(1) | The Local Health Board may, and (except in prescribed cases) if requested in |
| |
writing to do so by the practitioner must, review a contingent removal or a |
| 40 |
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 |
| |
imposed under section 111). |
| |
(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 Local |
| |
Health Board to suspend or contingently remove him, or (as |
| 5 |
| |
(b) | six months beginning with the date of its decision on the previous |
| |
| |
(3) | On such a review, the Local Health Board may— |
| |
(a) | confirm the contingent removal or the suspension, |
| 10 |
(b) | in the case of a suspension, terminate it, |
| |
(c) | in the case of a contingent removal, vary the conditions, impose |
| |
different conditions, revoke the contingent removal, or remove the |
| |
practitioner from the list. |
| |
| 15 |
(1) | A practitioner may appeal to the FHSAA against a decision of a Local Health |
| |
Board mentioned in subsection (2) by giving notice in writing to the FHSAA |
| |
within the period of 28 days beginning with the date on which the Local Health |
| |
Board gave him notice of the decision. |
| |
(2) | The Local Health Board decisions in question are— |
| 20 |
(a) | to remove the practitioner from a list (under section 107 or 108(3) or |
| |
under subsection (5)(b) of this section), |
| |
(b) | to remove him contingently (under section 108), |
| |
(c) | to impose any particular condition under section 108, or to vary any |
| |
condition or to impose any different condition under that section, |
| 25 |
(d) | to vary his terms of service (under section 108(4)), |
| |
(e) | any decision on a review of a contingent removal under section 113. |
| |
(3) | The appeal must be by way of redetermination of the decision of the Local |
| |
| |
(4) | On an appeal, the FHSAA may make any decision which the Local Health |
| 30 |
| |
(5) | If the FHSAA decides to remove the practitioner contingently— |
| |
(a) | the Local Health Board and the practitioner may each apply to the |
| |
FHSAA for the conditions imposed on the practitioner to be varied, for |
| |
different conditions to be imposed, or for the contingent removal to be |
| 35 |
| |
(b) | the Local Health Board may remove him from its list if it determines |
| |
that he has failed to comply with a condition. |
| |
(6) | The Local Health Board may not remove a person from a list, or impose a |
| |
| 40 |
(a) | until the expiry of the period of 28 days referred to in subsection (1), or |
| |
(b) | if the practitioner appeals within that period, until the FHSAA has |
| |
| |
|
| |
|
| |
|
(7) | Regulations may provide for payments by Local Health Boards to practitioners |
| |
who are removed from lists pursuant to decisions of the FHSAA under this |
| |
section, but whose appeals against those decisions are successful. |
| |
(8) | Regulations under subsection (7) may include provision for the amount of the |
| |
payments, or the method of calculating the amount, to be determined by the |
| 5 |
Welsh Ministers or by another person appointed for the purpose by them. |
| |
115 | National disqualification |
| |
(1) | If the FHSAA removes the practitioner from a list, it may also decide to |
| |
disqualify him from inclusion in— |
| |
(a) | the pharmaceutical lists and ophthalmic lists prepared by each Local |
| 10 |
| |
(b) | the supplementary lists prepared by each Local Health Board, |
| |
(c) | the lists under section 49 or 63 prepared by each Local Health Board, |
| |
(d) | the lists corresponding to the lists under section 49 prepared by each |
| |
Local Health Board by virtue of regulations made under section 103, |
| 15 |
(e) | the lists corresponding to the lists mentioned in paragraphs (a) to (d) |
| |
prepared by each Primary Care Trust under or by virtue of the National |
| |
Health Service Act 2006 (c. 00), |
| |
| or only from inclusion in one or more descriptions of such lists prepared by |
| |
each Local Health Board and each Primary Care Trust, the description being |
| 20 |
specified by the FHSAA in its decision. |
| |
(2) | A decision by the FHSAA to do what is mentioned in subsection (1) is referred |
| |
to in this section as the imposition of a national disqualification. |
| |
(3) | The FHSAA may also impose a national disqualification on a practitioner if it |
| |
dismisses an appeal by him against the refusal by a Local Health Board to |
| 25 |
include him in such a list. |
| |
(4) | The Local Health Board may apply to the FHSAA for a national |
| |
disqualification to be imposed on a person after the Local Health Board has— |
| |
(a) | removed him from a list prepared by it of any of the kinds referred to |
| |
in subsection (1)(a) to (d), or |
| 30 |
(b) | refused to include him in such a list. |
| |
(5) | Any such application must be made before the end of the period of three |
| |
months beginning with the date of the removal or of the Local Health Board’s |
| |
| |
(6) | If the FHSAA imposes a national disqualification on a person— |
| 35 |
(a) | no Local Health Board or Primary Care Trust may include him in a list |
| |
of any of the kinds prepared by it from which he has been disqualified |
| |
| |
(b) | if he is included in such a list, each Local Health Board and each |
| |
Primary Care Trust in whose list he is included must remove him from |
| 40 |
| |
(7) | The FHSAA may at the request of the person upon whom it has been imposed |
| |
review a national disqualification, and on a review may confirm it or revoke it. |
| |
(8) | Subject to subsection (9), the person may not request such a review before the |
| |
| 45 |
|
| |
|
| |
|
(a) | two years beginning with the date on which the national |
| |
disqualification was imposed, or |
| |
(b) | one year beginning with the date of the FHSAA’s decision on the last |
| |
| |
(9) | The Welsh Ministers may provide in regulations for subsection (8) to have |
| 5 |
effect in prescribed circumstances as if the reference there to “two years” or |
| |
“one year” were a reference to a different period specified in the regulations. |
| |
116 | Notification of decisions |
| |
Regulations may require a Local Health Board to notify prescribed persons, or |
| |
persons of prescribed descriptions, of any decision it makes under this |
| 10 |
Chapter, and of any information relevant to the decision which it considers |
| |
appropriate to include in the notification. |
| |
117 | Withdrawal from lists |
| |
Regulations may provide for circumstances in which a practitioner— |
| |
(a) | whom a Local Health Board is investigating in order to see whether |
| 15 |
there are grounds for exercising its powers under section 107, 108 or |
| |
| |
(b) | whom a Local Health Board has decided to remove from a list under |
| |
section 107 or 108, or contingently remove under section 108, but who |
| |
has not yet been removed or contingently removed, or |
| 20 |
(c) | who has been suspended under section 110, |
| |
may not withdraw from a list in which he is included. |
| |
118 | Regulations about decisions under this Chapter |
| |
(1) | Any decision by a Local Health Board referred to in this Chapter must be |
| |
reached in accordance with regulations about such decisions. |
| 25 |
(2) | The regulations must include provision— |
| |
(a) | requiring the practitioner to be given notice of any allegation against |
| |
| |
(b) | giving him the opportunity of putting his case at a hearing before a |
| |
Local Health Board makes any decision affecting him under this |
| 30 |
| |
(c) | requiring him to be given notice of the decision of the Local Health |
| |
Board and the reasons for it and of any right of appeal which he may |
| |
| |
(3) | The regulations may, in particular, make provision as to criteria which the |
| 35 |
Local Health Board must apply when making decisions in unsuitability cases. |
| |
119 | Corresponding provisions in Scotland and Northern Ireland |
| |
(1) | This section applies where it appears to the Welsh Ministers that there is |
| |
provision in Scotland or Northern Ireland under which a person may be dealt |
| |
with in any way which corresponds (whether or not exactly) with a way in |
| 40 |
which a person may be dealt with under this Chapter. |
| |
|
| |
|