House of Lords Amendments - Health Bill [H.L.]

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Session 1998-99
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Health Bill [H.L.] -
Amendments to be debated in the House of Lords
Here you can browse the Amendments to the Health Bill [H.L.] to be moved on Third Reading in the House of Lords.

Clause 1

BY THE BARONESS HAYMAN

     Page 1, line 9, leave out from beginning to ("sections")

Clause 2

BY THE BARONESS HAYMAN

     Page 1, line 12, leave out from ("1977") to ("there") in line 13

BY THE LORD CLEMENT-JONES
THE BARONESS SHARP OF GUILDFORD
THE BARONESS THOMAS OF WALLISWOOD

     Page 2, line 19, at end insert--

    ("(  )  No regulations are to be made under subsection (5) unless a draft has been laid before and approved by resolution of each House of Parliament.")

     Page 2, line 38, at end insert--

    ("(  )  Appropriate arrangements shall be made with a view to securing that a Primary Care Trust's functions are exercised with due regard to the principle that every individual has a right to treatment according to individual need free of discrimination as to access to or the quality of service.")

After Clause 8

BY THE BARONESS HAYMAN

     Insert the following new Clause--

    (".--(1) For sections 43A and 43B of the 1977 Act (regulations as to Part II remuneration) there is substituted-- Remuneration for Part II services.

Remuneration for Part II services.      43A.--(1) The remuneration to be paid to persons who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services).

    (2)  For the purposes of this section and section 43B below determining authorities are--
(a)  the Secretary of State, and

(b)  so far as authorised by him to exercise the functions of determining authorities, any Health Authority or other person appointed by him in an instrument (referred to in this section and section 43B below as an instrument of appointment).
    (3)  An instrument of appointment--
(a)  may contain requirements with which a determining authority appointed by that instrument must comply in making determinations, and

(b)  may be contained in regulations.
    (4)  Subject to this section and section 43B below, regulations may make provision about determining remuneration under subsection (1) above and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication).

    (5)  Regulations may provide--
(a)  that determinations may be made by reference to any of the following--

    (i)  rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1) above,

    (ii)  scales, indices or other data of any description specified in the regulations,

(b)  that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) above falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause.
    (6)  Regulations may--
(a)  provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates,

(b)  provide that any determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning--

    (i)  if it is required to be published, on the date of publication,

    (ii)  if it is not so required, on the date on which it is made.
    (7)  A reference in this section or section 43B below to a determination is to a determination of remuneration under subsection (1) of this section.

Part II remuneration: supplementary.      43B.--(1) Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 43A(1) above, he shall consult at least one of the following bodies--
(a)  a body one of whose functions is to provide advice in connection with the matters to be determined,

(b)  a body appearing to him to be representative of persons to whose remuneration the determination would relate.
    (2)  Determinations may make different provision for different cases including different provision for any particular case, class of case or area.

    (3)  Determinations may--
(a)  be made in more than one stage,

(b)  be made by more than one determining authority,

(c)  be varied or revoked by subsequent determinations.
    (4)  A determination may be revised--
(a)  to correct an error, or

(b)  where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact.
    (5)  Determinations may, in particular, provide that the whole or any part of the remuneration--
(a)  is payable only if the determining authority is satisfied as to certain conditions, or

(b)  is to be applied for certain purposes or is otherwise subject to certain conditions.
    (6)  Subject to sections 29(4) and 35(2) above, remuneration under section 43A above may consist of payments by way of--
(a)  salary,

(b)  fees,

(c)  allowances,

(d)  reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction,
and may be determined from time to time.

    (7)  At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later time.

    (8)  The matters which may be reserved include in particular--
(a)  the amount of remuneration to be paid in particular cases,

(b)  whether any remuneration is to be paid in particular cases.
    (9)  Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular--
(a)  the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 43A(1) above to which the determination will relate or of any category falling within that description,

(b)  the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services,

(c)  the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons,

(d)  the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate,

(e)  the desirability of promoting services which are--

    (i)  economic and efficient, and

    (ii)  of an appropriate standard.
    (10)  If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 43A(1) above, the reference in subsection (9)(a) above to a category of services is a reference to the same category of services or to any other category of services falling within the same description".

    (2)  Sections 43A and 43B of the 1977 Act, as substituted by this section, have effect in relation to--
(a)  the making of determinations on or after the commencement of this section, and

(b)  the variation, revocation or revision on or after the commencement of this section of determinations whenever made,
and in this subsection "determinations" means determinations under Part II of the 1977 Act of the remuneration to be paid to persons who provide services mentioned in section 43A(1).

    (3)  Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of 1977 Act deemed to be valid) have effect in relation to England and Wales as if--
(a)  after "inserted by this section" in section 7(4)(b) of the 1984 Act, and

(b)  after "section 7 of the Health and Social Security Act 1984" in section 15(3) of the 1988 Act,
there were inserted "and before the coming into force of section (Remuneration for Part II services) of the Health Act 1999".

    (4)  The reference in section 43B(6) of the 1977 Act, as substituted by this section, to section 29(4) of that Act is to be read on and after the commencement of section 10 of the National Health Service Act 1966 as a reference to that section.") 1984 c. 48.
1988 c. 49.

Clause 9

BY THE BARONESS HAYMAN

     Page 12, line 10, leave out ("16C") and insert ("16D")

     Page 12, line 28, after ("28A") insert ("41A")

     Page 13, line 24, at end insert--

    ("(  ) Subsection (3) of section 17 of the 1977 Act applies in relation to the powers to give directions conferred by sections 4, 6 and 8 of the National Health Service (Primary Care) Act 1997 (proposals for, and making, variation and termination of, pilot schemes) as it applies in relation to the powers conferred by any of the provisions mentioned in paragraphs (a) to (c) of that subsection.") 1997 c. 46.

     Page 13, line 29, leave out ("16C") and insert ("16D")

     Page 13, line 32, leave out ("16C") and insert ("16D")

     Page 13, line 36, leave out ("16C") and insert ("16D")

Clause 15

BY THE LORD CLEMENT-JONES
THE BARONESS SHARP OF GUILDFORD
THE BARONESS THOMAS OF WALLISWOOD

     Page 16, line 30, at end insert ("including, without prejudice to the generality of this section, general clinical care as well as medical treatment, and the promotion of health,")

Clause 16

BY THE BARONESS HAYMAN

     Page 16, line 33, leave out from ("Improvement") to end of line

Clause 17

BY THE LORD CLEMENT-JONES
THE BARONESS SHARP OF GUILDFORD
THE BARONESS THOMAS OF WALLISWOOD

     Page 17, line 16, at end insert--

    ("(  )  In exercising its functions under this section the Commission shall act in accordance with the principle that every individual has a right to treatment according to individual need free of discrimination as to access to or the quality of service.")

Clause 19

BY THE BARONESS HAYMAN

     Page 20, line 30, leave out from ("of") to end of line 31 and insert ("a serious arrestable offence,")

     Page 20, line 45, at end insert--
(""serious arrestable offence"--

    (a)  in relation to England and Wales, is to be construed in accordance with section 116 of the Police and Criminal Evidence Act 1984,

    (b)  in relation to Scotland, means an offence which is triable on indictment,
1984 c. 60.

    (c)  in relation to Northern Ireland, is to be construed in accordance with Article 87 of the Police and Criminal Evidence (Northern Ireland) Order 1989.")
S.I. 1989/1341 (N.I.12).

Clause 34

BY THE BARONESS HAYMAN

     Page 30, line 37, leave out (" 29(2)(a), (7) and") and insert (" 29(6) to")

     Page 31, line 10, leave out ("and") and insert--

    ("(4A)")

     Page 31, line 15, after ("Act") insert ("and section 49 of, and Schedule 10 to, the 1978 Act")

     Page 31, line 22, at end insert ("or, as the case may be, the 1978 Act")

Clause 36

BY THE BARONESS HAYMAN

     Page 37, line 40, leave out from ("to") to ("when") in line 41 and insert ("disqualify, or conditionally disqualify, him")

     Page 37, line 43, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him")

     Page 37, line 46, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him")

     Page 38, line 12, after ("shall") insert ("make a local disqualification, that is")

     Page 38, line 14, after ("may") insert ("also make a national disqualification, that is")

     Page 38, line 17, leave out from ("Tribunal") to ("they") in line 18 and insert ("make a national disqualification")

     Page 38, line 31, leave out ("power to disqualify") and insert ("functions of making disqualifications")

     Page 38, line 32, leave out ("includes power to make") and insert ("include making")

     Page 38, line 37, leave out ("under") and insert ("by virtue of")

     Page 39, line 7, leave out ("under") and insert ("by virtue of")

     Page 39, leave out lines 25 to 35 and insert--

("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.")

     Page 40, leave out lines 10 to 17 and insert--

("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.

    (  )  If, on a review under this section of a fraud case--
(a)  there is a national disqualification which the Tribunal do not remove or make conditional,

(b)  there is a national disqualification which is conditional and which the Tribunal make unconditional, or

(c)  the Tribunal make a national disqualification,
they may also make a declaration of unfitness.

    (  )  The Tribunal shall not under this section--
(a)  in the case of a conditional disqualification, make it unconditional or vary the conditions,

(b)  make any further disqualification or conditional disqualification, or

(c)  make a declaration of unfitness,
if they are of the opinion that it would be unjust to do so.

    (  )  A determination of the Tribunal under this section shall have effect--
(a)  if no appeal is brought against it, at the end of the period for bringing an appeal,

(b)  if an appeal is brought against it, when the appeal process is exhausted.")

© Parliamentary copyright 1999
Prepared 24 March 1999

Clause 1
BY THE BARONESS HAYMAN
Page 1, line 9, leave out from beginning to ("sections")
Clause 2
BY THE BARONESS HAYMAN
Page 1, line 12, leave out from ("1977") to ("there") in line 13
BY THE LORD CLEMENT-JONES THE BARONESS SHARP OF GUILDFORD THE BARONESS THOMAS OF WALLISWOOD
Page 2, line 19, at end insert-- ("( ) No regulations are to be made under subsection (5) unless a draft has been laid before and approved by resolution of each House of Parliament.")
Page 2, line 38, at end insert-- ("( ) Appropriate arrangements shall be made with a view to securing that a Primary Care Trust's functions are exercised with due regard to the principle that every individual has a right to treatment according to individual need free of discrimination as to access to or the quality of service.")
After Clause 8
BY THE BARONESS HAYMAN
Insert the following new Clause--
(".--(1) For sections 43A and 43B of the 1977 Act (regulations as to Part II remuneration) there is substituted--		Remuneration for Part II services.
Remuneration for Part II services.	43A.--(1) The remuneration to be paid to persons who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services). (2) For the purposes of this section and section 43B below determining authorities are-- (a) the Secretary of State, and (b) so far as authorised by him to exercise the functions of determining authorities, any Health Authority or other person appointed by him in an instrument (referred to in this section and section 43B below as an instrument of appointment). (3) An instrument of appointment-- (a) may contain requirements with which a determining authority appointed by that instrument must comply in making determinations, and (b) may be contained in regulations. (4) Subject to this section and section 43B below, regulations may make provision about determining remuneration under subsection (1) above and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication). (5) Regulations may provide-- (a) that determinations may be made by reference to any of the following-- (i) rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1) above, (ii) scales, indices or other data of any description specified in the regulations, (b) that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) above falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause. (6) Regulations may-- (a) provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates, (b) provide that any determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning-- (i) if it is required to be published, on the date of publication, (ii) if it is not so required, on the date on which it is made. (7) A reference in this section or section 43B below to a determination is to a determination of remuneration under subsection (1) of this section.
Part II remuneration: supplementary.	43B.--(1) Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 43A(1) above, he shall consult at least one of the following bodies-- (a) a body one of whose functions is to provide advice in connection with the matters to be determined, (b) a body appearing to him to be representative of persons to whose remuneration the determination would relate. (2) Determinations may make different provision for different cases including different provision for any particular case, class of case or area. (3) Determinations may-- (a) be made in more than one stage, (b) be made by more than one determining authority, (c) be varied or revoked by subsequent determinations. (4) A determination may be revised-- (a) to correct an error, or (b) where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact. (5) Determinations may, in particular, provide that the whole or any part of the remuneration-- (a) is payable only if the determining authority is satisfied as to certain conditions, or (b) is to be applied for certain purposes or is otherwise subject to certain conditions. (6) Subject to sections 29(4) and 35(2) above, remuneration under section 43A above may consist of payments by way of-- (a) salary, (b) fees, (c) allowances, (d) reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction, and may be determined from time to time. (7) At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later time. (8) The matters which may be reserved include in particular-- (a) the amount of remuneration to be paid in particular cases, (b) whether any remuneration is to be paid in particular cases. (9) Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular-- (a) the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 43A(1) above to which the determination will relate or of any category falling within that description, (b) the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services, (c) the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons, (d) the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate, (e) the desirability of promoting services which are-- (i) economic and efficient, and (ii) of an appropriate standard. (10) If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 43A(1) above, the reference in subsection (9)(a) above to a category of services is a reference to the same category of services or to any other category of services falling within the same description".
(2) Sections 43A and 43B of the 1977 Act, as substituted by this section, have effect in relation to-- (a) the making of determinations on or after the commencement of this section, and (b) the variation, revocation or revision on or after the commencement of this section of determinations whenever made, and in this subsection "determinations" means determinations under Part II of the 1977 Act of the remuneration to be paid to persons who provide services mentioned in section 43A(1).
(3) Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of 1977 Act deemed to be valid) have effect in relation to England and Wales as if-- (a) after "inserted by this section" in section 7(4)(b) of the 1984 Act, and (b) after "section 7 of the Health and Social Security Act 1984" in section 15(3) of the 1988 Act, there were inserted "and before the coming into force of section (Remuneration for Part II services) of the Health Act 1999". (4) The reference in section 43B(6) of the 1977 Act, as substituted by this section, to section 29(4) of that Act is to be read on and after the commencement of section 10 of the National Health Service Act 1966 as a reference to that section.")		1984 c. 48. 1988 c. 49.
Clause 9
BY THE BARONESS HAYMAN
Page 12, line 10, leave out ("16C") and insert ("16D")
Page 12, line 28, after ("28A") insert ("41A")
Page 13, line 24, at end insert--
("( ) Subsection (3) of section 17 of the 1977 Act applies in relation to the powers to give directions conferred by sections 4, 6 and 8 of the National Health Service (Primary Care) Act 1997 (proposals for, and making, variation and termination of, pilot schemes) as it applies in relation to the powers conferred by any of the provisions mentioned in paragraphs (a) to (c) of that subsection.")		1997 c. 46.
Page 13, line 29, leave out ("16C") and insert ("16D")
Page 13, line 32, leave out ("16C") and insert ("16D")
Page 13, line 36, leave out ("16C") and insert ("16D")
Clause 15
BY THE LORD CLEMENT-JONES THE BARONESS SHARP OF GUILDFORD THE BARONESS THOMAS OF WALLISWOOD
Page 16, line 30, at end insert ("including, without prejudice to the generality of this section, general clinical care as well as medical treatment, and the promotion of health,")
Clause 16
BY THE BARONESS HAYMAN
Page 16, line 33, leave out from ("Improvement") to end of line
Clause 17
BY THE LORD CLEMENT-JONES THE BARONESS SHARP OF GUILDFORD THE BARONESS THOMAS OF WALLISWOOD
Page 17, line 16, at end insert-- ("( ) In exercising its functions under this section the Commission shall act in accordance with the principle that every individual has a right to treatment according to individual need free of discrimination as to access to or the quality of service.")
Clause 19
BY THE BARONESS HAYMAN
Page 20, line 30, leave out from ("of") to end of line 31 and insert ("a serious arrestable offence,")
Page 20, line 45, at end insert-- (""serious arrestable offence"--
(a) in relation to England and Wales, is to be construed in accordance with section 116 of the Police and Criminal Evidence Act 1984, (b) in relation to Scotland, means an offence which is triable on indictment,		1984 c. 60.
(c) in relation to Northern Ireland, is to be construed in accordance with Article 87 of the Police and Criminal Evidence (Northern Ireland) Order 1989.")		S.I. 1989/1341 (N.I.12).
Clause 34
BY THE BARONESS HAYMAN
Page 30, line 37, leave out (" 29(2)(a), (7) and") and insert (" 29(6) to")
Page 31, line 10, leave out ("and") and insert-- ("(4A)")
Page 31, line 15, after ("Act") insert ("and section 49 of, and Schedule 10 to, the 1978 Act")
Page 31, line 22, at end insert ("or, as the case may be, the 1978 Act")
Clause 36
BY THE BARONESS HAYMAN
Page 37, line 40, leave out from ("to") to ("when") in line 41 and insert ("disqualify, or conditionally disqualify, him")
Page 37, line 43, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him")
Page 37, line 46, leave out ("exercise that power") and insert ("disqualify, or conditionally disqualify, him")
Page 38, line 12, after ("shall") insert ("make a local disqualification, that is")
Page 38, line 14, after ("may") insert ("also make a national disqualification, that is")
Page 38, line 17, leave out from ("Tribunal") to ("they") in line 18 and insert ("make a national disqualification")
Page 38, line 31, leave out ("power to disqualify") and insert ("functions of making disqualifications")
Page 38, line 32, leave out ("includes power to make") and insert ("include making")
Page 38, line 37, leave out ("under") and insert ("by virtue of")
Page 39, line 7, leave out ("under") and insert ("by virtue of")
Page 39, leave out lines 25 to 35 and insert-- ("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate.")
Page 40, leave out lines 10 to 17 and insert-- ("and, on a review of a fraud case, may make any further disqualification or conditional disqualification which they consider appropriate. ( ) If, on a review under this section of a fraud case-- (a) there is a national disqualification which the Tribunal do not remove or make conditional, (b) there is a national disqualification which is conditional and which the Tribunal make unconditional, or (c) the Tribunal make a national disqualification, they may also make a declaration of unfitness. ( ) The Tribunal shall not under this section-- (a) in the case of a conditional disqualification, make it unconditional or vary the conditions, (b) make any further disqualification or conditional disqualification, or (c) make a declaration of unfitness, if they are of the opinion that it would be unjust to do so. ( ) A determination of the Tribunal under this section shall have effect-- (a) if no appeal is brought against it, at the end of the period for bringing an appeal, (b) if an appeal is brought against it, when the appeal process is exhausted.")