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(ii) may decline to accept a person as such a patient; | |
(iii) may terminate his responsibility for a patient; | |
(cc) make provision as to the right of patients to choose the persons | |
from whom they are to receive services;”. | |
(8) In that section, after subsection (3) insert— | 5 |
“(3A) The regulations may also require payments to be made under the | |
arrangements in accordance with directions given for the purpose by | |
the Secretary of State; and section 18(1) and (3)(b) apply in relation to | |
any such directions. | |
(3B) A direction under subsection (3A) may make provision having effect | 10 |
from a date before the date of the direction, provided that, having | |
regard to the direction as a whole, the provision is not detrimental to | |
the persons to whose remuneration it relates.” | |
(9) In that section, after subsection (3B) (as inserted by subsection (8) above), | |
insert— | 15 |
“(3C) The regulations may also include provision requiring a Primary Care | |
Trust or Local Health Board, in prescribed circumstances and subject to | |
prescribed conditions, to enter into a general medical services contract | |
or general dental services contract on prescribed terms with any person | |
providing services under section 28C arrangements who so requests.” | 20 |
(10) In that Act, sections 28F (choice of medical practitioner), 28G (choice of dental | |
practitioner) and 28H (immunisation) shall cease to have effect. | |
174 Abolition of pilot schemes | |
(1) Part 1 of the National Health Service (Primary Care) Act 1997 (c. 46) (power to | |
make pilot schemes for the provision of personal medical and dental services) | 25 |
shall cease to have effect. | |
(2) This section extends to England and Wales only. | |
175 Persons performing primary medical and dental services | |
(1) In the 1977 Act, after section 28V (as inserted by section 171 above) insert— | |
“28W Persons performing primary medical and dental services | 30 |
(1) Regulations may provide that a health care professional of a prescribed | |
description may not perform any primary medical service for which a | |
Primary Care Trust or Local Health Board is responsible unless he is | |
included in a list maintained under the regulations by a Primary Care | |
Trust or Local Health Board. | 35 |
(2) Regulations may provide that a health care professional of a prescribed | |
description may not perform any primary dental service for which a | |
Primary Care Trust or Local Health Board is responsible unless he is | |
included in a list maintained under the regulations by a Primary Care | |
Trust or Local Health Board. | 40 |
(3) For the purposes of this section— | |
(a) “health care professional” means a person who is a member of | |
a profession regulated by a body for the time being mentioned | |
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in section 25(3) of the National Health Service Reform and | |
Health Care Professions Act 2002; | |
(b) a Primary Care Trust or Local Health Board is responsible for a | |
medical or dental service if it provides the service, or secures its | |
provision, by or under any enactment. | 5 |
(4) Regulations under this section may make provision in relation to lists | |
under this section and in particular as to— | |
(a) the preparation, maintenance and publication of a list; | |
(b) eligibility for inclusion in a list; | |
(c) applications for inclusion (including provision as to the | 10 |
Primary Care Trust or Local Health Board to which an | |
application must be made, and for the procedure for | |
applications and the documents to be supplied on application); | |
(d) the grounds on which an application for inclusion may or must | |
be granted or refused; | 15 |
(e) requirements with which a person included in a list must | |
comply (including the declaration of financial interests and gifts | |
and other benefits); | |
(f) suspension or removal from a list (including provision for the | |
grounds for, and consequences of, suspension or removal); | 20 |
(g) circumstances in which a person included in a list may not | |
withdraw from it; | |
(h) payments to be made by a Primary Care Trust or Local Health | |
Board in respect of a person suspended from the list (including | |
provision for the amount of the payment, or the method of | 25 |
calculating the payment, to be determined by the Secretary of | |
State or National Assembly for Wales, or a person appointed by | |
him or it); | |
(i) the criteria to be applied in making decisions under the | |
regulations; | 30 |
(j) appeals against decisions made by a Primary Care Trust or | |
Local Health Board under the regulations; and | |
(k) disclosure of information about applicants for inclusion, grants | |
or refusals of applications or suspensions or removals; | |
and may make any provision corresponding to anything in sections 49F | 35 |
to 49N below. | |
(5) Regulations under this section may, in particular, also provide for— | |
(a) a person’s inclusion in a list to be subject to conditions | |
determined by a Primary Care Trust or Local Health Board; | |
(b) a Trust or Board to vary the conditions or impose different ones; | 40 |
(c) the consequences of failing to comply with a condition | |
(including removal from the list); | |
(d) the review by a Trust or Board of decisions made by it by virtue | |
of the regulations. | |
(6) The imposition of such conditions must be with a view to— | 45 |
(a) preventing any prejudice to the efficiency of the services to | |
which the list relates, or | |
(b) preventing fraud. | |
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(7) Regulations making provision as to the matters referred to in | |
subsection (4)(k) may in particular authorise the disclosure of | |
information— | |
(a) by a Primary Care Trust or Local Health Board to the Secretary | |
of State or the National Assembly for Wales; and | 5 |
(b) by the Secretary of State or the National Assembly for Wales to | |
a Primary Care Trust or Local Health Board.” | |
(2) In section 49M(7) of that Act, at the end there is inserted “; and regulations | |
under this subsection may include provision of the kind referred to in section | |
49I(10)”. | 10 |
176 Assistance and support | |
In the 1977 Act, after section 28W (as inserted by section 175 above) insert— | |
“28X Assistance and support | |
(1) A Primary Care Trust or Local Health Board may provide assistance or | |
support to— | 15 |
(a) any person providing, or proposing to provide primary medical | |
services or primary dental services under a general medical | |
services contract or a general dental services contract; | |
(b) any person providing, or proposing to provide, such services in | |
accordance with section 28C arrangements. | 20 |
(2) Assistance or support provided by a Primary Care Trust or Local | |
Health Board under subsection (1) is to be provided on such terms, | |
including terms as to payment, as the Trust or Board thinks fit. | |
(3) In this section “assistance” includes financial assistance.” | |
Dental services: miscellaneous | 25 |
177 Abolition of Dental Practice Board | |
The Dental Practice Board is abolished. | |
178 Special Health Authorities | |
(1) In section 16B of the 1977 Act (exercise of functions by Primary Care Trusts), at | |
the end insert— | 30 |
“(4) The Secretary of State may by order make provision for the transfer to | |
a Special Health Authority of the rights and liabilities of a Primary Care | |
Trust under a general dental services contract in a case where the | |
Authority exercises functions of the Trust in relation to the contract by | |
virtue of subsection (2)(b) above (and for their transfer back to the Trust | 35 |
where the Authority ceases to exercise those functions).”. | |
(2) In section 16BC of that Act (exercise of functions by Local Health Boards), at | |
the end insert— | |
“(4) The Assembly may by order make provision for the transfer to a Special | |
Health Authority of the rights and liabilities of a Local Health Board | 40 |
under a general dental services contract in a case where the Authority | |
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exercises functions of the Board in relation to the contract by virtue of | |
subsection (2)(b) above (and for their transfer back to the Board where | |
the Authority ceases to exercise those functions).”. | |
179 Charges for dental services | |
(1) In the 1977 Act, for sections 78A to 79A substitute— | 5 |
“79 Dental charging | |
(1) Regulations may provide for the making and recovery, in such manner | |
as may be prescribed, of charges for relevant dental services. | |
(2) Regulations under subsection (1) may in particular include provision— | |
(a) specifying the amount, or maximum amount, of any charge (or | 10 |
aggregate charge in respect of the provision for two or more | |
relevant dental services); | |
(b) for calculating the amount of any charge; | |
(c) for the variation of the amount, or maximum amount, of any | |
charge in cases of a prescribed description; | 15 |
(d) for any charge not to be payable in cases of a prescribed | |
description; | |
(e) for power to direct that a charge is not payable in any particular | |
case; | |
(f) for the repayment of any charge (including provision as to the | 20 |
persons by whom, and manner in which, repayments are to be | |
made). | |
(3) Regulations under subsection (1) may provide for sums which would | |
otherwise be payable by a Primary Care Trust, Local Health Board or | |
Special Health Authority to persons providing relevant dental services | 25 |
to be reduced by the amount of the charges authorised by the | |
regulations. | |
(4) This section is subject to Schedule 12ZA. | |
(5) In this section and Schedule 12ZA “relevant dental services” means— | |
(a) dental treatment provided— | 30 |
(i) under section 16CA(2) above (dental services provided | |
by a Primary Care Trust or Local Health Board); | |
(ii) under a general dental services contract; | |
(iii) in accordance with section 28C arrangements; and | |
(b) the supply of dentures and other dental appliances under this | 35 |
Act. | |
(6) Any reference in this section or Schedule 12ZA to the supply of an | |
appliance includes a reference to its repair, adjustment, refitting or | |
replacement and, in the case of dentures, to their being relined or | |
having additions made to them.” | 40 |
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(2) After Schedule 12 to that Act insert— | |
“Schedule 12za | |
Dental charging: exemptions | |
General exemptions | |
1 (1) No charge is to be made under regulations under section 79(1) in | 5 |
respect of a relevant dental service provided for any person who at | |
the prescribed time— | |
(a) was under 18; | |
(b) was under 19 and receiving qualifying full-time education; | |
(c) was pregnant; or | 10 |
(d) had given birth to a child within the previous 12 months. | |
(2) In sub-paragraph (1)(b), “qualifying full-time education” means full- | |
time instruction at a recognised educational establishment or by | |
other means accepted as comparable by the person or body making | |
the regulations. | 15 |
(3) For the purposes of sub-paragraph (2)— | |
(a) “recognised educational establishment” means an | |
establishment recognised by the person or body making the | |
regulations as being, or as comparable to, a school, college or | |
university; and | 20 |
(b) regulations may prescribe the circumstances in which a | |
person is or is not to be treated as receiving full-time | |
instruction. | |
(4) In sub-paragraph (1)(d), “child” includes a still-born child (within | |
the meaning of the Births and Deaths Registration Act 1953). | 25 |
(5) This paragraph is subject to paragraph 3. | |
Repair and replacement | |
2 (1) No charge is to be made under regulations under section 79(1) in | |
respect of the repair or replacement of any appliance. | |
(2) This paragraph is subject to paragraph 3. | 30 |
Exceptions to paragraphs 1 and 2 | |
3 Paragraphs 1 and 2 do not apply in relation to— | |
(a) the repair or replacement of any appliance of a prescribed | |
description; or | |
(b) the repair or replacement of any appliance where it is | 35 |
determined in the prescribed manner— | |
(i) in any case, that the repair or replacement was | |
necessitated by an act or omission of the person | |
supplied; or | |
(ii) in a case where the person supplied was under the | 40 |
age of 16, that the repair or replacement was | |
necessitated by an act or omission, occurring while | |
that person was under that age, of a person having | |
charge of him. | |
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Hospital patients | |
4 No charge is to be made under regulations under section 79(1) in | |
respect of any appliance supplied to a patient for the time being | |
resident in a hospital. | |
5 Paragraph 4 does not apply where an appliance is supplied— | 5 |
(a) under section 16CA(2) above; | |
(b) under a general dental services contract; or | |
(c) in accordance with section 28C arrangements. | |
Arrest of bleeding | |
6 No charge is to be made under regulations under section 79(1) in | 10 |
respect of the arrest of bleeding. | |
Declarations and evidence | |
7 Regulations may provide, with respect to any exemption under this | |
Schedule, that it is to be a condition of the exemption that— | |
(a) a declaration of the prescribed kind is made in the prescribed | 15 |
form and manner; or | |
(b) a certificate or other evidence of the prescribed kind is | |
supplied in the prescribed form and manner.” | |
(3) In respect of any period after the coming into force of this section but before the | |
coming into force of section 174, section 79(5)(b) of the 1977 Act (as inserted by | 20 |
subsection (1) above) shall have effect as if it included a reference to the supply | |
of dentures and other dental appliances in accordance with a pilot scheme | |
under Part 1 of the National Health Service (Primary Care) Act 1997 (c. 46). | |
General | |
180 Minor and consequential amendments | 25 |
Schedule 11 (which contains minor and consequential amendments relating to | |
this Part) has effect. | |
Part 5 | |
Miscellaneous | |
Welfare Food Schemes | 30 |
181 Replacement of the Welfare Food Schemes: Great Britain | |
(1) In the Social Security Act 1988 (c. 7), for section 13 (schemes for the distribution | |
etc of welfare foods), substitute— | |
“13 Benefits under schemes for improving nutrition: pregnant women, | |
mothers and children | 35 |
(1) Regulations may establish one or more schemes to provide benefits for | |
prescribed descriptions of— | |
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(a) pregnant women, | |
(b) mothers, and | |
(c) children, | |
with a view to helping and encouraging them to have access to, and to | |
incorporate in their diets, food of a prescribed description. | 5 |
(2) Before establishing, or varying, a scheme the Secretary of State must | |
consult the Scottish Ministers and the National Assembly for Wales | |
(“the Assembly”). | |
(3) A scheme may, in particular, specify requirements that must be | |
satisfied— | 10 |
(a) before a person may become entitled to a benefit; | |
(b) for a beneficiary to remain entitled to a continuing benefit. | |
(4) Requirements that may be specified include requiring a person | |
(including someone who has parental responsibility for a | |
beneficiary)— | 15 |
(a) to be registered under the scheme; | |
(b) to attend a hospital, clinic or doctor’s surgery determined in | |
accordance with the scheme; | |
(c) where the beneficiary is a child, to take the child to a hospital, | |
clinic or doctor’s surgery determined in accordance with the | 20 |
scheme; | |
(d) to allow herself, or a child of hers, to be examined by a doctor or | |
nurse; | |
(e) to allow a visit to her home by a health professional or other | |
prescribed description of person; | 25 |
(f) to receive advice of a prescribed description about nutrition, | |
diet or other matters relating to health. | |
(5) A scheme may also include provision— | |
(a) for a benefit to consist of food of a prescribed description being | |
provided by— | 30 |
(i) a person who supplies, or arranges for the supply of, | |
food of that description for beneficiaries under the | |
scheme; | |
(ii) a person providing a service (such as day care) for the | |
recipient of the benefit; or | 35 |
(iii) a health service body; | |
(b) for the use of vouchers, or similar arrangements, in connection | |
with the provision of benefits; | |
(c) that a person taking part in the scheme, otherwise than as a | |
beneficiary, must be registered under the scheme; | 40 |
(d) for the payment by the Secretary of State of sums to persons | |
registered in accordance with a provision of a kind mentioned | |
in paragraph (c), in respect of things provided or done by them | |
in accordance with the scheme; | |
(e) for the making of payments to such persons entitled to receive | 45 |
benefits as may be determined by or under the scheme; | |
(f) for the delegation, in accordance with provisions of the scheme, | |
of prescribed functions under the scheme; | |
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