Health Bill [H.L.]

Health Bill [H.L.] - continued	House of Lords
SCHEDULE 12A, EXPENDITURE OF HEALTH AUTHORITIES AND PRIMARY CARE TRUSTS - continued
Primary Care Trusts: further functions - continued

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Primary Care Trusts: trust-funds and trustees.

6. - (1) After section 96A of the 1977 Act there is inserted-

"Trust-funds and trustees for Primary Care Trusts.	96B. - (1) The Secretary of State may by order provide for the appointment of trustees for any Primary Care Trust.
	(2) Trustees for a Primary Care Trust may accept, hold and administer any property on trust-
	(a) for the general or any specific purposes of the Primary Care Trust (including the purposes of any specific hospital or other establishment or facility which is managed by the trust), or
	(b) for all or any purposes relating to the health service.
	(3) An order under subsection (1) above may-
	(a) make provision as to the persons by whom trustees are to be appointed and generally as to the method of their appointment,
	(b) provide for any appointment to be subject to any conditions specified in the order (including conditions requiring the consent of the Secretary of State),
	(c) make provision as to the number of trustees to be appointed, including provision under which that number may from time to time be determined by the Secretary of State after consultation with any persons he considers appropriate, and
	(d) make provision about the term of office of any trustee and his removal from office.
	(4) Where trustees have been appointed for a Primary Care Trust under subsection (1) above, the Secretary of State may by order provide for the transfer of any trust property from the Primary Care Trust to the trustees so appointed."

Payments relating to past performance.

7. - (1) Section 97 of the 1977 Act (means of meeting expenditure of Health Authorities etc. out of public funds) is amended as follows.

(2) After subsection (3BB) there is inserted-

	"(3C) Where the Secretary of State has made an initial determination of the amount ("the initial amount") to be allotted for any year to a Health Authority under subsection (3) above, he may, if it appears to him that the authority satisfied in any preceding year any objectives notified as objectives to be met by Health Authorities for the purposes of this subsection in performing their functions, increase the initial amount by a further sum.
	(3D) In subsection (3C) above, "notified" means specified or referred to in a notice given to Health Authorities by the Secretary of State.
	(3E) In making any increase under subsection (3C) above, the Secretary of State may (whether by directions under subsection (6) below or otherwise) impose any conditions he thinks fit on the application or retention by the authority of the sum in question.
	(3F) Where the Secretary of State has, under subsection (3C) above, increased by any sum the amount to be allotted for any year to a Health Authority and notified the authority of the allotment and it subsequently appears to him that the authority have failed (wholly or in part) to satisfy any conditions imposed in making that increase, he may-
	(a) reduce the allotment made to that authority for that year, or
	(b) when he has made an initial determination of the amount ("the initial amount") to be allotted for any subsequent year to the authority under subsection (3) above, reduce the initial amount,
	by an amount not exceeding that sum".

(3) In subsection (5)-

(a) after "reducing" there is inserted "(subject to subsection (3F) above)",

(b) at the end there is inserted "and the reference to a determination in subsection (3C) above includes a determination made with a view to increasing or reducing an allotment previously so made".

Indemnity cover for Part II services.

8. - (1) Before section 44 of the 1977 Act there is inserted-

	"Indemnity cover
Indemnity cover.	43C. - (1) Regulations may make provision for the purpose of securing that, in prescribed circumstances, prescribed Part II practitioners hold approved indemnity cover.
	(2) The regulations may, in particular, make provision as to the consequences of a failure to hold approved indemnity cover, including provision-
	(a) for securing that a person is not to be added to any list unless he holds approved indemnity cover;
	(b) for the removal from a list prepared by a Health Authority of a Part II practitioner who does not within a prescribed period after the making of a request by the Health Authority in the prescribed manner satisfy the Health Authority that he holds approved indemnity cover.
	(3) For the purposes of this section-
	"approved body" means a person or persons approved in relation to indemnity cover of any description, after such consultation as may be prescribed, by the Secretary of State or by such other person as may be prescribed;
	"approved indemnity cover" means indemnity cover made-
	(a) on prescribed terms; and
	(b) with an approved body;
	"indemnity cover", in relation to a Part II practitioner (or person who proposes to provide Part II services), means a contract of insurance or other arrangement made for the purpose of indemnifying him and any person prescribed in relation to him to any prescribed extent against any liability which-
	(a) arises out of the provision of Part II services in accordance with arrangements made by him with a Health Authority under this Part of this Act; and
	(b) is incurred by him or any such person in respect of the death or personal injury of a person;
	"list" has the same meaning as in section 46 below;
	"Part II practitioner" means a person whose name is on a list;
	"Part II services" means general medical services, general dental services, general ophthalmic services or pharmaceutical services;
	"personal injury" means any disease or impairment of a person's physical or mental condition and includes the prolongation of any disease or such impairment;
	and a person holds approved indemnity cover if he has entered into a contract or arrangement which constitutes approved indemnity cover.
	(4) The regulations may provide that a person of any description who has entered into a contract or arrangement which is-
	(a) in a form identified in accordance with the regulations in relation to persons of that description; and
	(b) made with a person or persons so identified,
	is to be treated as holding approved indemnity cover for the purposes of the regulations."

(2) In section 29A of the 1977 Act (medical lists), at the beginning of subsection (3) there is inserted "Subject to any provision made under section 43C below,".

(3) In section 36 of that Act (regulations as to arrangements for general dental services), in subsection (1)(b), after "below" there is inserted "to any provision made under section 43C below".

(4) In section 39 of that Act (regulations as to arrangements for general ophthalmic services), in subsection (1)(b), after "subject" there is inserted "to any provision made under section 43C below".

Directions.

9. - (1) For section 17 of the 1977 Act (Secretary of State's directions) there is substituted-

	"Directions as to distribution and exercise of functions
Secretary of State's directions: distribution of functions.	16C. - (1) The Secretary of State may direct a Health Authority or Special Health Authority to exercise any of his functions relating to the health service which are specified in the directions.
	(2) The functions which may be specified include functions under enactments relating to mental health and nursing homes.
Secretary of State's directions: exercise of functions.	17. - (1) The Secretary of State may give directions to any of the bodies mentioned in subsection (2) below about their exercise of any functions.
	(2) The bodies are-
	(a) Health Authorities;
	(b) Special Health Authorities;
	(c) Primary Care Trusts;
	(d) NHS trusts.
	(3) The power conferred by subsection (1) above shall not be exercised so as to give any directions which may be given under-
	(a) section 27, 28A, 97, 97A or 99 of or paragraph 10 of Schedule 5, or paragraph 9 of Schedule 5A, to this Act;
	(b) section 7(3)(ii) of the Health and Medicines Act 1988 (directions about the exercise of powers for financing the health service); or
	(c) section 24 of the Health Act 1999 (plans for improving health etc.).
Health Authority's directions: distribution of functions.	17A. - (1) A Health Authority may direct a Primary Care Trust whose area falls within their area to exercise any specified delegable functions.
	(2) A function is a delegable function for the purposes of this section if it is a function exercisable by the Health Authority which is not an excepted function.
	(3) In subsection (2) above "excepted function" means a function under-
	(a) section 4 above;
	(b) section 15 above (except in so far as it relates to general medical services);
	(c) section 44 or 45(2) or (3) below; or
	(d) any of the other provisions of Part II of this Act-
	(i) unless it is a function under section 51, 52 or 53; or
	(ii) in relation to the remaining provisions of Part II, except in so far as the function relates to general medical services.
	(4) The Secretary of State may direct Health Authorities that specified delegable functions-
	(a) are to be exercisable, or exercisable to (or only to) any specified extent, by Primary Care Trusts; or
	(b) are not to be exercisable by Primary Care Trusts,
	and that the power under subsection (1) above is to be exercised accordingly.
	(5) In this section "specified" means specified in directions.
Health Authority's directions: exercise of functions.	17B. - (1) A Health Authority may give directions to a Primary Care Trust about its exercise of any functions which the authority have directed the trust to exercise under section 17A above.
	(2) Directions under this section have effect subject to any directions given under section 17 above".

(2) For section 18 of the 1977 Act down to the end of subsection (1) there is substituted-

	"Directions and regulations: general
Directions and regulations under preceding provisions.	18. - (1) Any directions given by the Secretary of State under section 11, 16C, 17 or 17A above shall be given by regulations or by an instrument in writing.
	(1A) But any directions given by him-
	(a) under section 16C above about functions under section 4 above;
	(b) under section 17A(4) above about functions relating to general medical services; or
	(c) under section 11, 16C, 17 or 17A above about functions conferred on the Secretary of State by section 20(1) or (2) below,
	shall be given by regulations.
	(1B) Directions given by a Health Authority under section 17A or 17B above shall be given by an instrument in writing".

(3) In subsection (3) of that section, for "17" there is substituted "17B above".

(4) Section 13 of the 1977 Act (Secretary of State's directions) is to cease to have effect.

NHS trusts

Establishment orders.

10. - (1) In section 5 of the 1990 Act (NHS trusts)-

(a) in subsection (1), for paragraphs (a) and (b) there is substituted "to provide goods and services for the purposes of the health service", and

(b) for subsection (6) there is substituted-

"(6) The functions which may be specified in an order under subsection (1) above include a duty to provide goods or services so specified at or from a hospital or other establishment or facility so specified".

(2) In section 26(3) of that Act (interpretation of Part I), after the definition of "health board" there is inserted-

""provide" includes manage;".

(3) Any order under section 5(1) of that Act-

(a) is to be treated as always having had effect with the omission of any obligation for the NHS trust to which the order relates to own land specified in the order, and

(b) so far as any functions specified in it could have been specified under that provision as amended by this Act, is to be treated as having been made under that provision as so amended.

(4) Any restriction preventing the acquisition of any land by any NHS trust (including an NHS trust dissolved before the commencement of this section) merely because the land did not comprise a hospital or other establishment or facility previously managed or provided by a Health Authority, a Special Health Authority, a Regional Health Authority or a District Health Authority is to be treated as never having had effect.

(5) An order under section 54 may-

(a) provide for any provision made by it for the purposes of, in consequence of or for giving full effect to this section to be treated as having had effect from a time before the commencement of this section,

(b) make such provision about an NHS trust dissolved before that commencement.

(6) In section 11(1) of the 1990 Act (trust funds and trustees for NHS trusts), for "which is owned and managed" there is substituted "at or from which services are provided".

(7) In paragraph 3(2) of Schedule 2 to that Act (establishment orders), for "assume responsibility for the ownership and management of" there is substituted "provide services at".

(8) In paragraph 3 of Schedule 3 to that Act (borrowing limits), in sub-paragraphs (1) and (2), for the words from "established" to "manage" there is substituted "which are required to provide services at or from".

(9) The 1990 Act is to be treated as always having had effect subject to the amendments made by this section.

(10) Paragraphs (aa) and (ab) of section 91(3) of the 1977 Act (private trusts for hospitals) are to be treated as always having had effect (until their replacement by paragraph 22(a) of Schedule 4 to this Act) with the omission of "owned and".

Exercise of powers.

11. - (1) Section 5 of the 1990 Act (NHS trusts) is amended as follows.

(2) In subsection (9), for the words following "may" there is substituted"only be exercised-

	(a) to the extent that its exercise does not to any significant extent interfere with the performance by the NHS trust of its functions or of its obligations under NHS contracts, and
	(b) in circumstances specified in directions under section 17 of the principal Act, with the consent of the Secretary of State."

Prepared 22 March 1999