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Notices of Amendments: 23 June 2011

28

Health and Social Care (Re-committed) Bill, continued

(b)	by virtue of section 7A or 12;

“relevant inequalities” means inequalities between the persons for whose

benefit relevant services are at any time provided with respect to—

(a)	their ability to access the services, or

(b)	the outcomes achieved for them by their provision.’.

Mr Simon Burns

146

Clause  23,  page  42,  line  16,  leave out from beginning to end of line 3 on page 43.

Mr Simon Burns

147

Schedule  3,  page  262,  line  4,  leave out ‘223J and 223K(2)’ and insert ‘and

223J(3)’.

Mr Simon Burns

148

Clause  56,  page   74,  line  37,  leave out from ‘services’ to end of line 2 on page 75

and insert ‘by promoting provision of health care services which—

(a)	is economic, efficient and effective, and

(b)	maintains or improves the quality of the services.’.

Mr Simon Burns

149

Clause  56,  page   75,  line  4,  at end insert—

‘(2A)

Monitor must exercise its functions with a view to preventing anti-competitive

behaviour in the provision of health care services for the purposes of the NHS

which is against the interests of people who use such services.

(2B)	Monitor must exercise its functions with a view to enabling health care services

provided for the purposes of the NHS to be provided in an integrated way where

it considers that this would—

(a)	improve the quality of those services (including the outcomes that are

achieved from their provision) or the efficiency of their provision,

(b)	reduce inequalities between persons with respect to their ability to access

those services, or

(c)	reduce inequalities between persons with respect to the outcomes

achieved for them by the provision of those services.

(2C)	Monitor must exercise its functions with a view to enabling the provision of

health care services provided for the purposes of the NHS to be integrated with

the provision of health-related services or social care services where it considers

that this would—

(a)	improve the quality of those health care services (including the outcomes

that are achieved from their provision) or the efficiency of their

provision,

(b)	reduce inequalities between persons with respect to their ability to access

those health care services, or

(c)	reduce inequalities between persons with respect to the outcomes

achieved for them by the provision of those health care services.

(2D)	Monitor must, in carrying out its duties under subsections (2B) and (2C), have

regard to the way in which—

(a)	the National Health Service Commissioning Board carries out its duties

under section 13J of the National Health Service Act 2006, and

Notices of Amendments: 23 June 2011

29

Health and Social Care (Re-committed) Bill, continued

(b)	commissioning consortia carry out their duties under section 14OC of

that Act.’.

Mr Simon Burns

150

Clause  56,  page  75,  line  4,  at end insert—

‘( )	Monitor must secure that people who use health care services, and other members

of the public, are involved to an appropriate degree in decisions that Monitor

makes about the exercise of its functions (other than decisions it makes about the

exercise of its functions in a particular case).’.

Mr Simon Burns

151

Clause  56,  page   75,  line  5,  leave out subsection (3).

Mr Simon Burns

152

Clause  56,  page  75,  line  6,  at end insert—

‘( )	Monitor must obtain advice appropriate for enabling it effectively to discharge its

functions from persons who (taken together) have a broad range of professional

expertise in—

(a)	the prevention, diagnosis or treatment of illness (within the meaning of

the National Health Service Act 2006), and

(b)	the protection or improvement of public health.’.

Mr Simon Burns

153

Clause  56,  page  75,  line  9,  at end insert—

‘( )	Monitor must not exercise its functions for the purpose of causing a variation in

the proportion of health care services provided for the purposes of the NHS that

is provided by persons of a particular description if that description is by

reference to—

(a)	whether the persons in question are in the public or (as the case may be)

private sector, or

(b)	some other aspect of their status.’.

Mr Simon Burns

154

Clause  56,  page   75,  line  9,  at end insert—

‘( )	In this section—

“health-related services” means services that may have an effect on people’s

health but are not health care services or social care services;

“social care services” means services that are provided in pursuance of the

social services functions of local authorities (within the  meaning of the

Local Authority Social Services Act 1970).’.

Mr Simon Burns

155

Clause  56,  page   75,  line  10,  leave out subsections (5) to (8).

Notices of Amendments: 23 June 2011

30

Health and Social Care (Re-committed) Bill, continued

Mr Simon Burns

156

Clause  58,  page  76,  line  11,  at end insert—

‘( )	the desirability of persons who provide health care services for the

purposes of the NHS co-operating with each other in order to improve the

quality of health care services provided for those purposes,’.

Mr Simon Burns

157

Clause  63,  page  79,  line  29,  leave out ‘a function’ and insert ‘any function of its’.

Mr Simon Burns

158

Clause  67,  page  82,  line  7,  leave out paragraph (c) and insert—

‘(c)	do not engage in anti-competitive behaviour which is against the interests

of people who use such services.’.

Mr Simon Burns

159

Clause  100,  page  100,  line  41,  leave out from first ‘of’ to end of line 42 and insert

‘preventing anti-competitive behaviour in the provision of health care services for those

purposes which is against the interests of people who use such services;’.

Mr Simon Burns

160

Clause  100,  page  101,  line  19,  leave out ‘public or (as the case may be) private

ownership’ and insert ‘the public or (as the case may be) private sector’.

Mr Simon Burns

161

Clause  101,  page  101,  line  33,  leave out from ‘to’ to end of line 34 and insert

‘prevent anti-competitive behaviour in the provision of health care services for the

purposes of the NHS which is against the interests of people who use such services,’.

Mr Simon Burns

162

Clause  101,  page  102,  line  14,  at end insert—

‘( )	Monitor must not include a condition under subsection (1)(c) that requires the

licence holder (A) to provide another licence holder with access to facilities of

A.’.

Mr Simon Burns

163

Clause  101,  page  102,  line  15,  leave out subsections (3) and (4).

Mr Simon Burns

164

Clause  115,  page  112,  line  23,  leave out paragraphs (d) and (e).

Mr Simon Burns

165

Clause  115,  page  112,  line  29,  leave out ‘must also’ and insert ‘may’.

Notices of Amendments: 23 June 2011

31

Health and Social Care (Re-committed) Bill, continued

Mr Simon Burns

166

Clause  115,  page  112,  line  33,  at end insert—

‘(2A)

Where a variation is agreed in accordance with rules provided for under

subsection (2), the commissioner of the service in question must maintain and

publish a written statement of—

(a)	the variation, and

(b)	such other variations as have already been agreed in accordance with

rules provided for under that subsection in the case of that service.’.

Mr Simon Burns

167

Clause  115,  page  112,  line  34,  after ‘also’, insert ‘—

(a)	specify variations to the national price for a service by reference to

circumstances in which the service is provided or other factors relevant

to the provision of the service,

(b)	provide for rules for determining the price payable for the provision for

the purposes of the NHS of health care services which are not specified

under subsection (1)(a), and

(c)

’.

Mr Simon Burns

168

Clause  115,  page  112,  line  36,  at end insert—

‘(3A)

Rules provided for under subsection (3)(b) may specify health care services

which are not specified under subsection (1)(a).

(3B)	The national tariff may also provide for rules for determining, where a health care

service is specified in more than one way under subsection (1)(a) or in more than

one way in rules provided for under subsection (3)(b), which specification of the

service is to apply in any particular case or cases of any particular description.’.

Mr Simon Burns

169

Clause  115,  page  112,  line  37,  leave out subsection (4) and insert—

‘(4)	The national tariff may include guidance as to—

(a)	the application of rules provided for under subsection (2), (3)(b) or (3B),

(b)	the application of variations specified under subsection (3)(a), or

(c)	the discharge of the duty imposed by subsection (2A),

and a commissioner of a health care service for the purposes of the NHS must

have regard to guidance under this subsection.’.

Mr Simon Burns

170

Clause  115,  page  112,  line  43,  leave out ‘provide for different rules under

subsection (1)(d)’ and insert ‘different variations under subsection (3)(a)’.

Mr Simon Burns

171

Clause  115,  page  113,  line  5,  leave out ‘public or private ownership’ and insert ‘the

public or (as the case may be) private sector’.

Notices of Amendments: 23 June 2011

32

Health and Social Care (Re-committed) Bill, continued

Mr Simon Burns

172

Clause  116,  page  113,  line  19,  after ‘115(1)(a)’, insert ‘, or in rules provided for in

the national tariff under section 115(3)(b),’.

Mr Simon Burns

173

Clause  116,  page  113,  line  24,  leave out subsections (2) to (4) and insert—

‘( )	In the case of a service specified in the national tariff under section 115(1)(a), the

national tariff must—

(a)	if the service is specified in accordance with subsection (1)(a), specify a

national price for each component of the service;

(b)	if it is specified in accordance with subsection (1)(b), specify a national

price for the bundle;

(c)	if it is specified in accordance with subsection (1)(c), specify a single

price as the national price for each service in the group.

( )	In the case of a service specified in rules provided for in the national tariff under

section 115(3)(b), the rules may—

(a)	if the service is specified in accordance with subsection (1)(a), make

provision for determining the price payable for each component of the

service;

(b)	if it is specified in accordance with subsection (1)(b), make provision for

determining the price payable for the bundle;

(c)	if it is specified in accordance with subsection (1)(c), make provision for

determining the price payable for each service in the group.’.

Mr Simon Burns

174

Clause  116,  page  113,  line  36,  after ‘115’, insert ‘or (as the case may be) in rules

provided for under subsection (3)(b) of that section’.

Mr Simon Burns

175

Clause  116,  page  113,  line  37,  at end insert—

‘( )	Where the commissioner of a health care service for the purposes of the NHS

agrees to pay a price for the provision of the service other than the price that is

payable by virtue of this Chapter, Monitor may direct the commissioner to take

such steps within such period as Monitor may specify to secure that the position

is, so far as practicable, restored to what it would have been if the commissioner

had agreed to pay the price payable by virtue of this Chapter.

( )	Where the commissioner of a health care service fails to comply with rules

provided for under section 115(2), (3) or (3B), Monitor may direct the

commissioner to take such steps within such period as Monitor may specify—

(a)	to secure that the failure does not continue or recur;

(b)	to secure that the position is, so far as practicable, restored to what it

would have been if the failure was not occurring or had not occurred.’.

Mr Simon Burns

176

Clause  117,  page  114,  line  6,  leave out paragraph (c) and insert—

‘(c)	the prices, determined in each case by using the applicable method

specified under paragraph (b), that Monitor proposes as the national

prices of those services,’.

Notices of Amendments: 23 June 2011

33

Health and Social Care (Re-committed) Bill, continued

Mr Simon Burns

177

Clause  117,  page  114,  line  8,  leave out paragraph (d).

Mr Simon Burns

178

Clause  117,  page  114,  line  11,  leave out from ‘must also specify the rules for which

Monitor proposes to provide’ and insert ‘may specify such rules as Monitor proposes to

provide for’.

Mr Simon Burns

179

Clause  117,  page  114,  line  15,  at end insert—

‘(4A)

The notice may also specify—

(a)	such variations (by reference to circumstances in which a service is

provided or other factors relevant to its provision) as Monitor proposes

to specify to the prices that it proposes as the national prices,

(b)	such rules as Monitor proposes to provide for in the national tariff for

determining the price payable for the provision for the purposes of the

NHS of health care services not specified for the purposes of subsection

(3)(a), and

(c)	such rules as Monitor proposes to provide for in the national tariff for

determining, where a health care service is specified in more than one

way for the purposes of subsection (3)(a) or in more than one way in rules

specified for the purposes of paragraph (b), which specification of the

service is to apply in any particular case or cases of any particular

description.’.

Mr Simon Burns

180

Clause  117,  page  114,  line  15,  at end insert—

‘(4B)

The notice may include guidance as to the application of rules specified for the

purposes of subsection (4) or (4A)(b) or (c) or the application of variations

specified for the purposes of subsection (4A)(a).’.

Mr Simon Burns

181

Clause  117,  page  114,  line  22,  leave out subsection (6).

Mr Simon Burns

182

Clause  117,  page  114,  line  35,  at end insert—

‘( )	Such variations as are specified for the purposes of subsection (4A)(a), and such

guidance on the application of those variations as is included for the purposes of

subsection (4B), are only such variations and such guidance as Monitor considers

should be so specified and included and—

(a)	as Monitor and the Board agree will be so specified and included, or

(b)	in default of agreement, as are determined by arbitration as being the

variations that will be so specified and the guidance that will be so

included.’.

Notices of Amendments: 23 June 2011

34

Health and Social Care (Re-committed) Bill, continued

Mr Simon Burns

183

Clause  117,  page  114,  line  36,  leave out subsection (9).

Mr Simon Burns

184

Clause  117,  page  114,  line  41,  leave out ‘The rules specified for the purposes of

subsection (4) are only such rules’ and insert ‘Such rules as are specified for the purposes

of subsection (4) or (4A)(c), and such guidance on those rules as is included for the

purposes of subsection (4B), are only such rules and such guidance’.

Mr Simon Burns

185

Clause  117,  page  114,  line  43,  after ‘specified’, insert ‘and included’.

Mr Simon Burns

186

Clause  117,  page  114,  line  44,  after ‘specified’, insert ‘and included’.

Mr Simon Burns

187

Clause  117,  page  114,  line  46,  after ‘specified’, insert ‘and the guidance that will

be so included’.

Mr Simon Burns

188

Clause  117,  page  114,  line  46,  at end insert—

‘(10A)

Such rules as are specified for the purposes of subsection (4A)(b), and such

guidance on those rules as is included for the purposes of subsection (4B), are

only such rules and such guidance as Monitor considers should be so specified

and included and—

(a)	as Monitor and the Board agree will be so specified and included, or

(b)	in default of agreement, as are determined by arbitration as being the

rules that will be so specified and the guidance that will be so included.’.

Mr Simon Burns

189

Clause  147,  page  135,  line  7,  at end insert—

‘“anti-competitive behaviour” has the meaning given in section [General

duties: supplementary] and references to preventing anti-competitive

behaviour are to be read in accordance with subsection (2) of that

section;’.

Mr Simon Burns

190

Clause  147,  page  135,  line  13,  at end insert—

‘“facilities” has the same meaning as in the National Health Service Act

2006 (see section 275 of that Act);’.

Mr Simon Burns

191

Clause  147,  page  135,  line  16,  leave out ‘56’ and insert ‘[General duties:

supplementary]’.

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