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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

47

 

29      

Abolition of Primary Care Trusts

(1)   

The Primary Care Trusts continued in existence or established under section 18

of the National Health Service Act 2006 are abolished.

(2)   

Chapter 2 of Part 2 of that Act (Primary Care Trusts) is repealed.

Functions relating to fluoridation of water

5

30      

Fluoridation of water supplies

(1)   

Chapter 4 of Part 3 of the Water Industry Act 1991 (fluoridation), as amended

by the Water Act 2003, is amended as follows.

(2)   

In section 87 (fluoridation of water supplies at request of relevant authorities),

in subsection (3)(a) for sub-paragraph (i) substitute—

10

“(i)   

in relation to areas in England, are to the Secretary of

State;”.

(3)   

After subsection (3) of that section insert—

“(3A)   

The Secretary of State may make a request under subsection (1) only if

the Secretary of State is required to do so by section 88G(2) (following

15

the making of a fluoridation proposal in accordance with section 88B).”

(4)   

In subsection (4) of that section, for paragraph (a) substitute—

“(a)   

in relation to England, such area as the Secretary of State

considers appropriate for the purpose of complying with

section 88G(2);”.

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(5)   

After subsection (7) of that section insert—

“(7A)   

The Secretary of State must, in relation to the terms to be included in

any arrangements under this section, consult any local authority whose

area includes, coincides with or is wholly or partly within the specified

area.

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(7B)   

In this section and the following provisions of this Chapter “local

authority” means—

(a)   

a county council in England;

(b)   

a district council in England, other than a council for a district

in a county for which there is a county council;

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(c)   

a London borough council;

(d)   

the Common Council of the City of London.”

(6)   

After subsection (7B) of that section (as inserted by subsection (5) above)

insert—

“(7C)   

If the Secretary of State and the Welsh Ministers request a particular

35

water undertaker to enter into arrangements in respect of adjoining

areas—

(a)   

they must co-operate with each other so as to secure that the

arrangements (taken together) are operable and efficient; and

(b)   

if suitable terms are not agreed for all the arrangements, a

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combined reference may be made by them under section 87B

below to enable the terms of each set of arrangements to be

determined so that they are consistent.

 
 

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

48

 

(7D)   

If the Secretary of State requests a water undertaker to vary

arrangements for an area which adjoins an area in respect of which the

Welsh Ministers have made arrangements with the same water

undertaker, the Secretary of State must co-operate with the Welsh

Ministers so as to secure that following the variation the arrangements

5

(taken together) will be operable and efficient.

(7E)   

If the Welsh Ministers request a water undertaker to vary arrangements

for an area which adjoins an area in respect of which the Secretary of

State has made arrangements with the same water undertaker, the

Welsh Ministers must co-operate with the Secretary of State so as to

10

secure that following the variation the arrangements (taken together)

will be operable and efficient.

(7F)   

If suitable terms are not agreed for a variation to which subsection (7D)

or (7E) applies, a combined reference may be made by the Secretary of

State and the Welsh Ministers under section 87B below so that

15

(following the variation) both sets of arrangements are consistent.”

(7)   

Omit subsections (8) to (10) of that section.

(8)   

In subsection (11) of that section for “a relevant authority” substitute “the

Welsh Ministers”.

(9)   

In section 87A (target concentration of fluoridation), after subsection (3)

20

insert—

“(3A)   

If the Secretary of State proposes to—

(a)   

make arrangements which provide for the concentration in the

specified area (or any part of it) to be lower than the general

target concentration, or

25

(b)   

vary existing arrangements so that they so provide,

   

the Secretary of State shall consult any local authority whose area

includes, coincides with or is wholly or partly within the specified

area.”

(10)   

In section 87B (fluoridation arrangements: determination of terms), in

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subsection (2) —

(a)   

for paragraph (a) substitute—

“(a)   

the Secretary of State may—

(i)   

determine the terms of the arrangements as the

Secretary of State sees fit; or

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(ii)   

refer the matter for determination by such other person

as the Secretary of State considers appropriate; and”,

and

(b)   

omit paragraph (b).

(11)   

In that section, in subsection (4) for the words from the beginning to “section

40

87(8)(b) or (10)” substitute “Where a combined reference is made under section

87(7C)(b) or 87(7F)”.

(12)   

In section 87C (fluoridation arrangements: compliance), omit subsection (8).

(13)   

In section 89—

(a)   

in the heading, after “Consultation” insert “:Wales”,

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(b)   

in subsections (1) and (4) for “a relevant authority” substitute “the

Welsh Ministers”,

 
 

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

49

 

(c)   

in subsection (1) for “the appropriate authority” (in each place where it

occurs) substitute “the Welsh Ministers”,

(d)   

in subsection (3), in paragraph (a) for “relevant authorities” substitute

“the Welsh Ministers”,

(e)   

in subsection (4) for “the appropriate authority so directs” substitute

5

“the Welsh Ministers so direct”, and

(f)   

omit subsection (5).

(14)   

In section 90A (review of fluoridation) after subsection (5) insert—

“(5A)   

The relevant authority must, in exercising its functions under

subsection (1)—

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(a)   

consult any local authority affected by the arrangements at such

times as the relevant authority considers appropriate, and

(b)   

in particular, consult any such local authority before it

publishes a report under paragraph (b) of that subsection.”

31      

Procedural requirements in connection with fluoridation of water supplies

15

After section 88A of the Water Industry Act 1991 insert—

“88B    

Requirement for fluoridation proposal: England

(1)   

The Secretary of State may not request a water undertaker to enter into

arrangements under section 87(1) unless a fluoridation proposal is

made to the Secretary of State.

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(2)   

A fluoridation proposal is a proposal that the Secretary of State enter

into arrangements with one or more water undertakers to increase the

fluoride content of the water supplied by the undertaker or undertakers

to premises within such area or areas in England as may be specified in

the proposal.

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(3)   

A fluoridation proposal may be made by one or more local authorities

in England.

(4)   

A local authority may not make a fluoridation proposal unless its area

includes, coincides with or is wholly or partly within the area, or at least

one of the areas, specified in the proposal.

30

(5)   

In the following provisions of this Chapter, “proposer”, in relation to a

fluoridation proposal, means the local authority or authorities which

made the proposal.

(6)   

Any reference in the following provisions of this Chapter to a local

authority affected by a fluoridation proposal is a reference to a local

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authority whose area includes, coincides with or is wholly or partly

within the area, or at least one of the areas, specified in the proposal.

88C     

Initial consultation etc. on fluoridation proposal

(1)   

This section applies if a fluoridation proposal is made.

(2)   

The proposer must consult the Secretary of State as to whether the

40

arrangements which would result from implementing the proposal

would be operable and efficient.

 
 

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

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(3)   

The proposer must consult each water undertaker who supplies water

to premises within the area or areas specified in the proposal as to

whether the arrangements which would result from implementing the

proposal, insofar as they might affect the undertaker, would be

operable and efficient.

5

(4)   

Each person consulted under subsection (2) or (3) must give the

proposer its opinion on the matter mentioned in that subsection.

(5)   

The proposer must notify the Secretary of State of the opinion of each

water undertaker consulted under subsection (3).

(6)   

If the Secretary of State informs the proposer that the Secretary of State

10

is of the opinion that the arrangements would not be operable and

efficient, no further steps may be taken in relation to the proposal.

88D     

Additional requirements where other local authorities affected

(1)   

This section applies where—

(a)   

a fluoridation proposal is made,

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(b)   

the Secretary of State is of the opinion that the arrangements

which would result from implementing the proposal would be

operable and efficient,

(c)   

one or more local authorities other than the proposer are

affected by the proposal, and

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(d)   

the proposer wishes to take further steps in relation to the

proposal.

(2)   

The proposer must notify any other local authority which is affected by

the proposal.

(3)   

The proposer must make arrangements for enabling the authorities

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affected by the proposal to decide whether further steps should be

taken in relation to the proposal.

(4)   

The Secretary of State must by regulations—

(a)   

make provision as to the arrangements which must be made for

the purposes of subsection (3), and

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(b)   

prescribe conditions, with respect to the outcome of the

arrangements, which must be satisfied before any further steps

may be taken in relation to the proposal.

88E     

Decision on fluoridation proposal

(1)   

This section applies where—

35

(a)   

a fluoridation proposal is made,

(b)   

the Secretary of State is of the opinion that the arrangements

which would result from implementing the proposal would be

operable and efficient,

(c)   

in a case where section 88D applies, the conditions prescribed

40

under subsection (4)(b) of that section are satisfied, and

(d)   

the proposer wishes to take further steps in relation to the

proposal.

(2)   

The proposer must comply with such requirements as may be

prescribed in regulations made by the Secretary of State as to the steps

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

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to be taken for the purposes of consulting and ascertaining opinion in

relation to the proposal.

(3)   

The proposer may (after any requirements imposed by regulations

under subsection (2) have been complied with) modify the proposal.

(4)   

But the proposal may not be modified so as to extend the boundary of

5

any area to which it relates, or to add another area, except in

circumstances prescribed in regulations by the Secretary of State.

(5)   

The proposer must (after any requirements imposed by regulations

under subsection (2) have been complied with) decide whether to

request the Secretary of State to make such requests under section 87(1)

10

as are necessary to implement the proposal.

(6)   

The Secretary of State may by regulations make provision—

(a)   

as to factors which the proposer must or may take into account

in making the decision mentioned in subsection (5);

(b)   

as to the procedure to be followed by the proposer in exercising

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functions under or by virtue of subsection (2) or (5).

88F     

Decision-making procedure: exercise of functions by committee

(1)   

This section applies in relation to the exercise of functions under or by

virtue of section 88E(2) to (5) (“the fluoridation functions”) except

where the proposer is a single local authority and either—

20

(a)   

no other local authorities are affected by the proposal, or

(b)   

no other local authority which is affected by the proposal

informs the proposer that it wishes to participate in the exercise

of the fluoridation functions.

(2)   

The local authorities affected by the proposal must—

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(a)   

arrange for an existing joint committee of the authorities to

exercise the fluoridation functions,

(b)   

establish a joint committee of the authorities for that purpose, or

(c)   

arrange for the Health and Wellbeing Boards established by

them under section 191 of the Health and Social Care Act 2011

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to exercise the fluoridation functions.

(3)   

Where arrangements are made under subsection (2)(c) the Health and

Wellbeing Boards in question must exercise the power conferred by

section 195(b) of the Health and Social Care Act 2011 to establish a joint

sub-committee of the Boards to exercise the fluoridation functions.

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(4)   

The Secretary of State may by regulations make provision—

(a)   

for subsection (2)(a) to apply only in relation to a joint

committee which meets prescribed conditions as to its

membership;

(b)   

as to the membership of a joint committee established under

40

subsection (2)(b) (including provision as to qualification and

disqualification for membership and the holding and vacating

of office as a member);

(c)   

as to the membership of a joint sub-committee of Health and

Wellbeing Boards established in accordance with subsection (3);

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

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(d)   

as to the procedure to be followed by any joint committee, or

any joint sub-committee of Health and Wellbeing Boards, in

exercising the fluoridation functions.

88G     

Secretary of State’s duty in relation to fluoridation proposal

(1)   

This section applies if the Secretary of State is requested to make such

5

requests under section 87(1) as are necessary to implement a

fluoridation proposal.

(2)   

The Secretary of State must comply with the request if the Secretary of

State is satisfied that the requirements imposed by sections 88B to 88F

have been met in relation to the proposal.

10

(3)   

Subsection (2) does not require the Secretary of State to consider the

adequacy of any steps taken for the purposes of complying with any

requirement to consult or to ascertain opinion which is imposed under

or by virtue of section 88C(2) or (3), 88D(3) or 88E(2).

88H     

Payments by local authorities towards fluoridation costs

15

(1)   

This section applies where a water undertaker enters into

arrangements with the Secretary of State under section 87(1).

(2)   

The Secretary of State may require all local authorities affected by the

arrangements to make payments to the Secretary of State to meet any

costs incurred by the Secretary of State under the terms of the

20

arrangements.

(3)   

The amount to be paid by each of the affected local authorities is to be

determined—

(a)   

where a joint committee, or a joint sub-committee of Health and

Wellbeing Boards, has exercised the fluoridation functions of

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the authorities in relation to the proposal which resulted in the

arrangements being made and the committee or sub-committee

continues to exist at the time when the Secretary of State

exercises the power conferred by subsection (2), by that

committee or sub-committee;

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(b)   

in any other case, by agreement between the local authorities.

(4)   

If the amount to be paid by the affected local authorities is not

determined as mentioned in subsection (3), the Secretary of State

may—

(a)   

determine the amount to be paid, or

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(b)   

refer the matter for determination by such other person as the

Secretary of State considers appropriate.

(5)   

The amount determined in accordance with subsection (3) may, at the

request of one or more of the affected local authorities, be varied with

the agreement of all of them.

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(6)   

If the affected local authorities fail to reach agreement for the purposes

of subsection (5), the Secretary of State may—

(a)   

determine whether to vary the amount (and, if so, how), or

(b)   

refer the matter for determination by such other person as the

Secretary of State considers appropriate.

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Part 1 — The health service in England

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(7)   

Any reference in this section to a local authority affected by

arrangements under section 87(1) is a reference to a local authority

whose area includes, coincides with or is wholly or partly within the

area specified in the arrangements.

88I     

Variation or termination of arrangements under section 87(1)

5

(1)   

The Secretary of State may not request a water undertaker to vary

arrangements entered into by the water undertaker under section 87(1)

unless a proposal (“a variation proposal”) is made to the Secretary of

State for a variation in the arrangements.

(2)   

The Secretary of State may not give notice to a water undertaker under

10

section 87C(7) to terminate arrangements entered into by the water

undertaker under section 87(1) unless a proposal (“a termination

proposal”) is made to the Secretary of State for the termination of the

arrangements.

(3)   

Subsection (1) does not apply in relation to a variation to provide for the

15

concentration of fluoride in the area specified in the arrangements (or

any part of it) to be lower than the general target concentration.

(4)   

The Secretary of State may by regulations provide that subsection (1) or

(2) does not apply in prescribed circumstances.

(5)   

A variation or termination proposal may be made by one or more of the

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local authorities affected by the arrangements.

(6)   

The Secretary of State may by regulations provide that, where a

termination proposal is made in relation to arrangements under section

87(1), no further termination proposal may be made in relation to the

arrangements until the end of such period as may be specified in the

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regulations.

(7)   

In the following provisions of this Chapter, “proposer”, in relation to a

variation or termination proposal, means the local authority or

authorities which made the proposal.

(8)   

Any reference in this section and in the following provisions of this

30

Chapter to a local authority affected by a variation or termination

proposal is a reference to a local authority whose area includes,

coincides with or is wholly or partly within the area specified in the

arrangements.

(9)   

In relation to a proposal for the variation of the area specified in

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arrangements under section 87(1), any reference in this section and in

the following provisions of this Chapter to a local authority affected by

the proposal also includes a reference to a local authority whose area

would include, coincide with or be wholly or partly within the area

specified in the arrangements if the variation were made.

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88J     

Initial consultation etc. on variation or termination proposal

(1)   

This section applies if a variation or termination proposal is made.

(2)   

In the case of a variation proposal, the proposer must consult the

Secretary of State and the water undertaker who entered into the

arrangements as to whether the arrangements as varied in accordance

45

with the proposal would be operable and efficient.

 
 

 
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Revised 1 April 2011