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Health Bill [H.L.] - continued        House of Lords
SCHEDULE 12A, EXPENDITURE OF HEALTH AUTHORITIES AND PRIMARY CARE TRUSTS - continued
Evasion of charges, fraud etc. - continued
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Disqualification etc. of Part II practitioners.     36. - (1) For section 46 of the 1977 Act (disqualification of practitioners) there is substituted-
 
 
"The NHS tribunal.     46. - (1) The tribunal constituted in accordance with Schedule 9 to this Act shall continue under the name of "the NHS Tribunal"; and that Schedule shall continue to have effect in relation to the Tribunal.
 
    (2) If the Tribunal receive from a Health Authority representations that-
 
 
    (a) a person who is included in any list meets either of the conditions for disqualification, or
 
    (b) a person who has applied to be included in any list meets the second condition for disqualification,
  the Tribunal shall inquire into the case.
 
      (3) If the Tribunal receive such representations from any other person, they may inquire into the case.
 
      (4) Representations under this section shall be made-
 
 
    (a) in the prescribed manner, and
 
    (b) where the representations are that the second condition for disqualification is met and regulations prescribe the time within which such representations are to be made, within that time.
      (5) Subsections (6) to (11) below apply for the purposes of this group of sections.
 
      (6) The first condition for disqualification is that the continued inclusion of the person concerned in the list would be prejudicial to the efficiency of the services which those included in the list undertake to provide.
 
      (7) The second condition for disqualification is that the person concerned-
 
 
    (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 securing or trying to secure for himself or another any financial or other benefit, and
 
    (b) knew that he or (as the case may be) the other was not entitled to the benefit.
      (8) A "list" means-
 
 
    (a) a list of medical practitioners undertaking to provide general medical services,
 
    (b) a list of medical practitioners undertaking to provide general ophthalmic services,
 
    (c) a list of dental practitioners undertaking to provide general dental services,
 
    (d) a list of ophthalmic opticians undertaking to provide general ophthalmic services, or
 
    (e) a list of persons undertaking to provide pharmaceutical services,
  prepared (in each case) under this Part of this Act.
 
      (9) "Health scheme" means-
 
 
    (a) any of the health services under section 1(1) above or any corresponding enactment extending to Scotland or Northern Ireland, and
 
    (b) any prescribed scheme;
  and regulations may prescribe any scheme for the purposes of this subsection which appears to the Secretary of State to be a health or medical scheme paid for out of public funds.
 
      (10) 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.
 
      (11) Cases in which representations are made that the first condition for disqualification is met are referred to below as efficiency cases; and cases in which representations are made that the second condition for disqualification is met are referred to below as fraud cases.
 
      (12) In this section and sections 46A to 49E below-
 
 
    (a) "this group of sections" means this and those sections and Schedule 9 to this Act, and
 
    (b) the NHS Tribunal is referred to as the Tribunal.
The NHS Tribunal: supplementary.     46A. - (1) Where an ophthalmic optician is a body corporate, the body corporate is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if any director meets that condition (whether or not he first met that condition when he was a director).
 
      (2) Where a body corporate carries on a retail pharmacy business, the body corporate is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if any one of the body of persons controlling the body corporate meets that condition (whether or not he first met that condition when he was one of them).
 
      (3) A person who is included in any list ("the practitioner") is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if-
 
 
    (a) another person, because of an act or omission of his occurring in the course of providing any services mentioned in section 46(8) above on the practitioner's behalf, meets that condition, and
 
    (b) the practitioner failed to take all such steps as were reasonable to prevent acts or omissions within section 46(7)(a) above occurring in the course of the provision of those services on his behalf.
      (4) The Tribunal is not required to inquire into a fraud case if they have previously inquired into representations in respect of the person concerned and the same acts or omissions.
 
      (5) In a fraud case, regulations may make provision (including provision modifying the effect of this Part of this Act) for the purpose of securing that the person subject to the inquiry is not added to any list until proceedings in that case are finally concluded.
 
      (6) For the purposes of this group of sections, in a fraud or efficiency case proceedings are finally concluded-
 
 
    (a) if the Tribunal determine not to exercise their power under section 46B(2) below, when they make that determination,
 
    (b) if they determine to exercise that power and no appeal is brought against the determination, at the end of the period for bringing an appeal,
 
    (c) if they determine to exercise that power and an appeal is brought against the determination, when the appeal process is exhausted.
      (7) An inquiry under section 46 above is not affected by the person subject to the inquiry withdrawing from, withdrawing any application to be included in or being removed from the list to which the case relates.
 
Powers of NHS Tribunal.     46B. - (1) Subsection (2) below applies where the Tribunal are of the opinion-
 
 
    (a) on inquiring into an efficiency case, that the person meets the first condition for disqualification,
 
    (b) on inquiring into a fraud case, that the person meets the second condition for disqualification.
      (2) The Tribunal-
 
 
    (a) shall disqualify him for inclusion in the list to which the case relates, and
 
    (b) may disqualify him for inclusion in all lists within the same paragraph of section 46(8) above as that list.
      (3) If the Tribunal disqualify a person under subsection (2)(b) above they may also declare that the person is not fit to be engaged in any capacity in the provision of the services to which the lists in question relate (referred to in this group of sections as a declaration of unfitness).
 
      (4) The Tribunal shall not make any disqualification or declaration under this section if they are of the opinion that it would be unjust to do so.
 
      (5) A disqualification under this section shall have effect when proceedings in the case are finally concluded.
 
      (6) If a person is disqualified for inclusion in any list prepared by a Health Authority, the Authority must not enter him in the list and (if he is already included in the list) must remove him from the list.
 
Conditional disqualification etc.     46C. - (1) The power to disqualify under section 46B above includes power to make a conditional disqualification, that is, a disqualification which is to come into effect only if the Tribunal determine (on a review under section 47) that the person subject to the inquiry has failed to comply with any conditions imposed by them.
 
      (2) Conditions may be imposed under subsection (1) above with a view to-
 
 
    (a) removing any prejudice to the efficiency of the services in question, or
 
    (b) preventing any acts or omissions within section 46(7)(a) above,
  (as the case may be).
 
      (3) Conditions so imposed shall have effect when proceedings in the case are finally concluded.
 
      (4) Section 46B(4) above applies to a conditional disqualification as it applies to a disqualification.
 
      (5) The Tribunal may by directions-
 
 
    (a) vary the terms of service of the person subject to the inquiry (including terms imposed by regulations under this Part),
 
    (b) confer functions on any Health Authority,
  for the purpose of or in connection with the imposition of any conditions under this section.
 
      (6) References in any enactment to a disqualification by the Tribunal do not include a conditional disqualification".
 
      (2) For section 47 of the 1977 Act (removal of disqualification) there is substituted-
 
 
"Review etc. of disqualification.     47. - (1) The Tribunal may review any disqualification, conditional disqualification or declaration of unfitness-
 
    (a) if the disqualified or conditionally disqualified person requests a review, or
 
    (b) in any other circumstances in which they consider it appropriate.
      (2) On a review under subsection (1) above, the Tribunal may-
 
 
    (a) remove a disqualification or provide that a declaration of unfitness is to cease to have effect,
 
    (b) make a disqualification conditional,
 
    (c) in the case of a conditional disqualification, remove it, vary the conditions or make it unconditional,
 
    (d) in a fraud case where there is a disqualification (or conditional disqualification) under section 46B(2)(a) above, make a disqualification (or conditional disqualification) under section 46B(2)(b) above,
 
    (e) in a fraud case where there is a disqualification under section 46B(2)(b) above, or the Tribunal on the review make such a disqualification or make a conditional disqualification under section 46B(2)(b) above unconditional, make a declaration of unfitness.
      (3) If any Health Authority request a review of a conditional disqualification on the ground that-
 
 
    (a) there has been a change in the circumstances by reference to which the conditions were imposed,
 
    (b) the person concerned has failed to comply with the conditions, or
 
    (c) in a fraud case, the person concerned has since the Tribunal imposed the conditions (or made the disqualification conditional) again satisfied the second condition for disqualification,
  the Tribunal shall review the conditional disqualification.
 
      (4) In the case of a person who is providing services in Scotland or Northern Ireland, the reference in subsection (3) above to a Health Authority includes any corresponding authority under the provisions in force in Scotland or Northern Ireland corresponding to this Part of this Act.
 
      (5) On a review under subsection (3) above of a conditional disqualification, the Tribunal may-
 
 
    (a) remove it, vary the conditions or make it unconditional,
 
    (b) in a fraud case where there is a conditional disqualification under section 46B(2)(a) above, make a disqualification (or conditional disqualification) under section 46B(2)(b) above,
 
    (c) in a fraud case where the Tribunal on the review make a conditional disqualification under section 46B(2)(b) above unconditional, make a declaration of unfitness.
      (6) The Tribunal may hold an inquiry for the purposes of any review under this section".
 
 
Miscellaneous
High security psychiatric services.     37. - (1) For section 4 of the 1977 Act (special hospitals) there is substituted-
 
 
"High security psychiatric services.     4. - (1) The duty imposed on the Secretary of State by section 1 above to provide services for the purposes of the health service includes a duty to provide hospital accommodation and services for persons who are liable to be detained under the Mental Health Act 1983 and in his opinion require treatment under conditions of high security on account of their dangerous, violent or criminal propensities.
 
    (2) The hospital accommodation and services mentioned in subsection (1) above are in this Act referred to as "high security psychiatric services".
 
      (3) High security psychiatric services shall be provided only at hospital premises at which services are provided only for the persons mentioned in subsection (1) above; and for this purpose "hospital premises" means-
 
 
    (a) a hospital; or
 
    (b) any part of a hospital which is treated as a separate unit."
      (2) In section 145(1) of the Mental Health Act 1983 (interpretation), in the definition of "the managers", paragraph (b) is omitted.
 
      (3) At the end of paragraph 10 of Schedule 2 to the 1990 Act (powers of NHS trusts to enter into NHS contracts) there is inserted-
 
 
    "(2) An NHS trust may not, as the provider, enter into an NHS contract for the provision of high security psychiatric services unless the NHS trust is approved for the purpose of this paragraph by the Secretary of State.
 
      (3) Such approval-
 
 
    (a) shall be for a period specified in the approval,
 
    (b) may be given subject to conditions, and
 
    (c) may be amended or revoked at any time."
Provision of information by Registrar General.     38. After section 124 of the 1977 Act there is inserted-
 
 
"Provision of information by Registrar General.     124A. - (1) The Registrar General may provide to the Secretary of State any information to which this section applies.
 
    (2) Any information provided under subsection (1) above shall be provided in such form as appears to the Registrar General appropriate for the purpose of assisting the Secretary of State in the performance of his functions in relation to the health service.
 
      (3) This section applies to any information-
 
 
    (a) entered in any register kept under the Births and Deaths Registration Act 1953; or
 
    (b) which is kept by the Registrar General under any other enactment and relates to any birth or death.
      (4) In subsection (3) above, "enactment" includes an enactment contained in subordinate legislation."
 
 
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