Health and Social Care Bill

Session 2010 - 11
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Other Bills before Parliament

Health and Social Care Bill

Health and Social Care Bill
Part 1 — The health service in England
41

attributable to the performance by it of its functions in that year does
not exceed the aggregate of—
(a)
the amount allotted to it for that year under section 223H,
(b)
any sums received by it in that year under any provision of this
Act (other than sums received by it under section 223H), and
5
(c)
any sums received by it in that year otherwise than under this
Act for the purpose of enabling it to defray such expenditure.
(2)
The Board may by directions determine—
(a)
whether specified sums must, or must not, be treated for the
purposes of this section as received by a specified consortium,
10
(b)
whether specified expenditure must, or must not, be treated for
those purposes as expenditure within subsection (1) of a
specified consortium, or
(c)
the extent to which, and the circumstances in which, sums
received by a consortium under section 223H but not yet spent
15
must be treated for the purposes of this section as part of the
expenditure of the consortium, and to which financial year’s
expenditure they must be attributed.
(3)
The Secretary of State may by directions require a commissioning
consortium to use specified banking facilities for any specified
20
purposes.
(4)
In this section, “specified” means specified in the directions.
223J
Financial duties of commissioning consortia: use of resources
(1)
A commissioning consortium must ensure that the use of its resources
in a financial year does not exceed the amount specified for it in relation
25
to that year by the Board.
(2)
The Board may vary the amount specified by it under this section.
(3)
For the purposes of subsection (1) the Board may give directions—
(a)
specifying uses of resources which must, or must not, be taken
into account;
30
(b)
making provision for determining to which consortium certain
uses of resources must be attributed;
(c)
specifying descriptions of resources which must, or must not,
be taken into account.
(4)
In this section, a reference to the use of resources is a reference to their
35
expenditure, consumption or reduction in value.
223K
Financial duties of commissioning consortia: restriction on certain
types of expenditure
(1)
A commissioning consortium must ensure that its capital expenditure
in respect of a financial year does not exceed such sum as the Board
40
may specify in relation to that year.
(2)
A commissioning consortium must ensure that its revenue expenditure
in respect of a financial year does not exceed such sum as the Board
may specify in relation to that year.
(3)
A commissioning consortium must ensure that its expenditure in
45
respect of a financial year on prescribed matters relating to

Health and Social Care Bill
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administration does not (in total) exceed such sum as the Board may
specify in relation to that year.
(4)
The Board may vary any sum specified for the purposes of this section.
(5)
The Board may by directions determine whether expenditure by a
consortium of a description specified in the directions must, or must
5
not, be treated for the purposes of this section as expenditure within
subsection (1) or (2).
(6)
For the purposes of this section, expenditure is to be disregarded if it is
met otherwise than from sums paid to the consortium under section
223H.
10
223L
Payments in respect of performance
(1)
The Board may, after the end of a financial year, make a payment to a
commissioning consortium if, in the light of an assessment carried out
under section 14Z1, it considers that the consortium has performed
well during that year.
15
(2)
The Board may make one or more payments (“advance payments”) to
a commissioning consortium before the end of a financial year if it
considers that the consortium is likely to perform well during that year.
(3)
The amount of a payment under subsection (1) is to be—
(a)
the amount that the Board considers to be appropriate in the
20
light of the consortium’s performance during the financial year,
less
(b)
the amount of any advance payments made to the consortium
during that year.
(4)
Subsection (5) applies if—
25
(a)
any advance payments are made to a commissioning
consortium during a financial year, but
(b)
no payment is made to the consortium under subsection (1) in
respect of that year (whether because the Board decided not to
make such a payment or because the amount of any advance
30
payments was equal to or exceeded the amount determined by
the Board under subsection (3)(a)).
(5)
The Board may—
(a)
make a deduction from a payment that the Board decides to
make under subsection (1) in respect of a subsequent financial
35
year, or
(b)
make deductions from more than one such payment.
(6)
The maximum amount that may (in total) be deducted under
subsection (5) is—
(a)
in a case where the Board decided not to make a payment to the
40
consortium under subsection (1), the amount of any advance
payments, and
(b)
in any other case, the difference between the amount of any
advance payments and the amount determined by the Board
under subsection (3)(a).
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Part 1 — The health service in England
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(7)
A commissioning consortium may distribute any payments received
by it under this section among its members in such proportions as it
considers appropriate.”
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Requirement for primary medical services provider to belong to consortium
(1)
In section 89 of the National Health Service Act 2006 (general medical services
5
contracts: required terms), after subsection (1) insert—
“(1A)
Regulations under subsection (1) may in particular make provision—
(a)
for requiring a contractor who provides services of a prescribed
description (a “relevant contractor”) to be a member of a
commissioning consortium;
10
(b)
as to arrangements for securing that a relevant contractor
appoints one individual to act on its behalf in the dealings
between it and the consortium to which it belongs;
(c)
for imposing requirements with respect to those dealings on the
individual appointed for the purposes of paragraph (b);
15
(d)
for requiring a relevant contractor, in doing anything pursuant
to the contract, to act with a view to enabling the consortium to
which it belongs to discharge its functions (including its
obligation to act in accordance with its constitution).
(1B)
Provision by virtue of subsection (1A)(a) may in particular describe
20
services by reference to the manner or circumstances in which they are
performed.
(1C)
In the case of a contract entered into by two or more individuals
practising in partnership—
(a)
regulations making provision under subsection (1A)(a) may
25
make provision for requiring each partner to secure that the
partnership is a member of the consortium;
(b)
regulations making provision under subsection (1A)(b) may
make provision as to arrangements for securing that the
partners make the appointment;
30
(c)
regulations making provision under subsection (1A)(d) may
make provision for requiring each partner to act as mentioned
there.
(1D)
Regulations making provision under subsection (1A) for the case of a
contract entered into by two or more individuals practising in
35
partnership may make provision as to the effect of a change in the
membership of the partnership.
(1E)
The regulations may require an individual appointed for the purposes
of subsection (1A)(b)—
(a)
to be a member of a profession regulated by a body mentioned
40
in section 25(3) of the National Health Service Reform and
Health Care Professions Act 2002, and
(b)
to meet such other conditions as may be prescribed.”
(2)
In section 94 of that Act (regulations about arrangements under section 92 of
that Act for provision of primary medical services), after subsection (3) insert—
45
“(3A)
Regulations under subsection (3)(d) may—

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(a)
require a person who provides services of a prescribed
description in accordance with section 92 arrangements (a
“relevant provider”) to be a member of a commissioning
consortium;
(b)
make provision as to arrangements for securing that a relevant
5
provider appoints one individual to act on its behalf in dealings
between it and the consortium to which it belongs;
(c)
impose requirements with respect to those dealings on the
individual appointed for the purposes of paragraph (b);
(d)
require a relevant provider, in doing anything pursuant to
10
section 92 arrangements, to act with a view to enabling the
consortium to which it belongs to discharge its functions
(including its obligation to act in accordance with its
constitution).
(3B)
Provision by virtue of subsection (3A)(a) may in particular describe
15
services by reference to the manner or circumstances in which they are
performed.
(3C)
In the case of an agreement made with two or more persons—
(a)
regulations making provision under subsection (3A)(a) may
require each person to secure that the persons collectively are a
20
member of the consortium;
(b)
regulations making provision under subsection (3A)(b) may
make provision as to arrangements for securing that the
persons collectively make the appointment;
(c)
regulations making provision under subsection (3A)(d) may
25
require each person to act as mentioned there.
(3D)
Regulations making provision under subsection (3A) for the case of an
agreement made with two or more persons may make provision as to
the effect of a change in the composition of the group of persons
involved.
30
(3E)
The regulations may require an individual appointed for the purposes
of subsection (3A)(b)—
(a)
to be 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, and
35
(b)
to meet such other conditions as may be prescribed.”
Further provision about local authorities’ role in the health service
25
Other health service functions of local authorities under the 2006 Act
(1)
The National Health Service Act 2006 (c. 41) is amended as follows.
(2)
In section 111 (dental public health)—
40
(a)
in subsection (1) for “A Primary Care Trust” substitute “A local
authority”,
(b)
in subsection (2)—
(i)
for “Primary Care Trust” (in each place where it occurs)
substitute “local authority”, and
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(ii)
in paragraph (b) for “other Primary Care Trusts” substitute
“other local authorities”, and
(c)
after subsection (2) insert—
“(3)
In this section, “local authority” has the same meaning as in
section 2B.”
5
(3)
In section 249 (joint working with the prison service) after subsection (4)
insert—
“(4A)
For the purposes of this section, each local authority (within the
meaning of section 2B) is to be treated as an NHS body.”
26
Appointment of directors of public health
10
In Part 3 of the National Health Service Act 2006 (local authorities and the
NHS) before section 74 insert—
“73A
Appointment of directors of public health
(1)
Each local authority must, acting jointly with the Secretary of State,
appoint an individual to have responsibility for —
15
(a)
the exercise by the authority of its functions under section 2B,
111 or 249 or Schedule 1,
(b)
the exercise by the authority of its functions by virtue of section
6C,
(c)
anything done by the authority in pursuance of arrangements
20
under section 7A,
(d)
the exercise by the authority of any of its functions that relate to
planning for, or responding to, emergencies involving a risk to
public health,
(e)
the functions of the authority under section 325 of the Criminal
25
Justice Act 2003, and
(f)
such other functions relating to public health as may be
prescribed.
(2)
The individual so appointed is to be an officer of the local authority and
is to be known as its director of public health.
30
(3)
Subsection (4) applies if the Secretary of State—
(a)
considers that the director has failed or might have failed to
discharge (or to discharge properly) the responsibilities of the
director under—
(i)
subsection (1)(b), or
35
(ii)
subsection (1)(c) where the arrangements relate to the
Secretary of State’s functions under section 2A, and
(b)
has consulted the local authority.
(4)
The Secretary of State may direct the local authority to—
(a)
review how the director has discharged the responsibilities
40
mentioned in subsection (3)(a);
(b)
investigate whether the director has failed to discharge (or to
discharge properly) those responsibilities;
(c)
consider taking any steps specified in the direction;

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(d)
report to the Secretary of State on the action it has taken in
pursuance of a direction given under any of the preceding
paragraphs.
(5)
A local authority may terminate the appointment of its director of
public health.
5
(6)
Before terminating the appointment of its director of public health, a
local authority must consult the Secretary of State.
(7)
In this section, “local authority” has the same meaning as in section 2B.”
27
Exercise of public health functions of local authorities
In Part 3 of the National Health Service Act 2006 after section 73A insert—
10
“73B
Exercise of public health functions of local authorities: further
provision
(1)
A local authority must, in the exercise of any functions mentioned in
subsection (2), have regard to any document published by the Secretary
of State for the purposes of this section.
15
(2)
The functions mentioned in this subsection are—
(a)
the exercise by the authority of its functions under section 2B,
111 or 249 or Schedule 1,
(b)
the exercise by the authority of its functions by virtue of section
6C,
20
(c)
anything done by the authority in pursuance of arrangements
under section 7A,
(d)
the functions of the authority under section 325 of the Criminal
Justice Act 2003, and
(e)
such other functions relating to public health as may be
25
prescribed.
(3)
The Secretary of State may give guidance to local authorities as to the
exercise of any functions mentioned in subsection (2).
(4)
The director of public health for a local authority must prepare an
annual report on the health of the people in the area of the local
30
authority.
(5)
The local authority must publish the report.
(6)
In this section, “local authority” has the same meaning as in section 2B.”
Abolition of Strategic Health Authorities and Primary Care Trusts
28
Abolition of Strategic Health Authorities
35
(1)
The Strategic Health Authorities continued in existence or established under
section 13 of the National Health Service Act 2006 are abolished.
(2)
Chapter 1 of Part 2 of that Act (Strategic Health Authorities) is repealed.