Welsh Statutory Instruments
NATIONAL HEALTH SERVICE, WALES
Made
28 March 2002
Coming into force
1 April 2002
1.—(1) These Regulations may be cited as the National Health Service (General Medical Services) (Amendment) (Wales) Regulations 2002 and shall come into force on 1st April 2002.
(2) These Regulations apply to Wales only.
(3) In these Regulations “the principal Regulations” (“y prif Reoliadau”) means the National Health Service (General Medical Services ) Regulations 1992 (3).
(4) The principal Regulations shall be amended in accordance with the following provisions of these Regulations.
2. In regulation 2(1) (interpretation), omit the definition of “Medical Practices Committee”.
3. In regulation 4 (medical list), in paragraphs (3) and (5)(f), for “by the Medical Practices Committee” in each place where those words occur substitute “by the Health Authority”.
4.—(1) Regulation 5A (preferential right to be included in medical list) shall be amended in accordance with the following paragraphs—
(2) in paragraph (2)(a) for “the Medical Practices Committee” substitute “the Health Authority”;
(3) in paragraph (2)(b), for “under section 33(4)(b) of the Act” substitute “under regulation 13(1)(c)”;
(4) omit paragraph (4).
5. In regulation 6 (amendment of or withdrawal from the medical list), in paragraph (5) from “Where a Health Authority” to “ and the Medical Practices Committee grants such variation,” substitute “Where the Health Authority grants an application for the variation of a condition imposed pursuant to regulation 13(1)(b), ”.
6. Omit regulations 10 (Medical Practices Committee - appointment of members and tenure of office) and 11 (references and reports to the Medical Practices Committee by a Health Authority).
7. For regulation 12 (decisions of the Medical Practices Committee) substitute—
12.—(1) A Health Authority may consider at any time whether there is, or will be a vacancy for a doctor to provide general medical services in their area.
(2) A Health Authority must consider whether there is, or will be a vacancy for a doctor in their area if—
(a)it has been asked to do so by a doctor who provides general medical services in their area , or
(b)a doctor has died, or has withdrawn from, or been removed from the Health Authority’s medical list.
(3) Where paragraph (2) applies and where a doctor’s prospective patients are situated in the area of more than one Health Authority, any of those Health Authorities may—
(a)elect to consider separately whether there is a vacancy in respect of the prospective patients residing in their area, or
(b)agree to deal jointly with one or more other Health Authorities with prospective patients residing in their areas.
(4) In a case falling within paragraph (3)(b), the Health Authority in whose area reside the largest number of the prospective patients shall decide whether to declare a vacancy, and, if it does so, it shall proceed in accordance with regulation 13 .
(5) If a Health Authority is considering whether or not there is, or will be a vacancy, the Health Authority shall before reaching a decision—
(a)consider the matters set out in Part I of Schedule 3;
(b)obtain from any other Health Authority in whose area prospective patients reside, such information as it thinks necessary.
(6) In reaching their decision a Health Authority shall, in particular, take account of—
(a)the needs of persons in their area for personal medical services;
(b)any relevant financial considerations;
(c)the effect of creating a vacancy on any other Health Authority in whose area prospective patients reside;
(d)any services outside general medical services and personal medical services already provided by doctors in the area.
8.—(1) Regulation 13 (declaration of vacancies) shall be amended in accordance with the following paragraphs.
(2) In paragraph (1) for “If the Medical Practices Committee” to “in a locality” substitute “If a Health Authority decides that the number of doctors undertaking to provide general medical services in an area”.
(3) For paragraph (1)(c) substitute—
“(c)may impose the condition that any doctor who is to fill a particular vacancy may provide general medical services only in such part of the area as the Health Authority may specify.”.
(4) In paragraph (2)(e)(ii) from “ as shall have been specified in” to the end, substitute “as the Health Authority may specify.”.
(5) Omit paragraphs (3) and (4).
(6) After paragraph (4) add—
“(5) In a case to which regulation 12(3)(b) applies, before deciding which of the conditions set out in paragraph (2) it is appropriate to specify, the Health Authority declaring the vacancy shall consult any Health Authority in whose area prospective patients reside.
(6) When a Health Authority declares a vacancy to which regulation 18A or 18B applies, the vacancy will automatically lapse by effluxion of time after a period of 12 months beginning with the date of the declaration of the vacancy.
(7) When a Health Authority declares a vacancy for a sole practitioner, it shall advertise the vacancy within three months of the declaration of the vacancy or such further period as may be agreed by the National Assembly for Wales.
(8) The Health Authority shall notify its decision in writing, giving reasons, to—
(a)the Local Medical Committee;
(b)any doctor who made a request under regulation 12(2)(a);
(c)any Health Authority or Health Board in whose area prospective patients reside.
(9) In this Part of these Regulations, where the prospective patients of a doctor reside in the area of more than one Health Authority, any reference to “area” shall be construed as a reference to those areas in which prospective patients reside.”.
9. Omit regulation 14 (report by Health Authority to Medical Practices Committee).
10.—(1) For regulation 15 (variation and revocation of decisions of the Medical Practices Committee) substitute—
15.—(1) Subject to paragraph (2), the Health Authority which declared a vacancy may—
(a)except in cases where an additional doctor has already been nominated or approved pursuant to regulation 18A, 18B or 18C, revoke a decision made pursuant to regulation 13(1) to declare a vacancy for an additional doctor in an area;
(b)in the case of a condition imposed pursuant to regulation 13(1)(b) (or such a condition as varied pursuant to this regulation), vary the condition by imposing in relation to any doctor who fills or would fill that particular vacancy another condition set out in regulation 13(2);
(c)in the case of a condition imposed pursuant to regulation 13(1)(c) (or such condition as varied pursuant to this regulation), revoke the condition or vary it by specifying such other part of the area in which the doctor is to be excluded from providing general medical services as the Health Authority considers appropriate; or
(d)refuse to vary or revoke the decision in question.
(2) The Health Authority may not vary or revoke any decision referred to in paragraph (1)(b) or (c) without the written consent of any doctor to whom the existing condition applies.
(3) Before making a decision to vary or revoke a decision under this regulation, the Health Authority shall consult—
(a)the Local Medical Committee for its area;
(b)any Health Authority in whose area prospective patients reside.
(4) In cases where the Health Authority has, at the request or with the consent of a particular doctor considered whether to vary a condition imposed pursuant to regulation 13(1)(b) or vary or revoke a condition imposed pursuant to regulation 13(1)(c) then the Health Authority shall give to that doctor a written statement of the reasons for its decision.”.
11. For regulation 16 (effect of variation or revocation) substitute—
“16. A decision of a Health Authority under regulations 13 or 15 has effect until it is varied or revoked, or expires by effluxion of time pursuant to regulation 13 (6).”
12.—(1) Regulation 17 (decision by Health Authority as to type of vacancy) shall be amended in accordance with the following paragraphs.
(2) For paragraph (1) substitute—
“(1) This regulation applies where a Health Authority decides that there is a vacancy for an additional doctor in an area.”;
(3) In paragraphs (2) and (3) for “If the Health Authority made a reference pursuant to regulation 11(1)” in each place where those words occur substitute “Where the Health Authority considered in accordance with regulation 12(2)(a) whether to declare a vacancy”.
(4) For paragraph (5) substitute—
“(5) In making their decision the Health Authority must—
(a)in a case to which regulation 12(3)(b) applies, consult any Health Authority in whose area the prospective patients reside; and
(b)take account, in particular, of the needs of the patients in the area.”.
13. In regulation 18 ( consultation with Local Medical Committee)—
(a)for sub- paragraphs (a) to (c) substitute—
“(a)declares a vacancy under regulation 13(1)(a),
(b)imposes conditions on a doctor under regulation 13(1)(b),
(c)decides under regulation 15 to vary or revoke a decision,”;
(b)after sub-paragraph (f), for “where regulation 11(2)(a)” substitute “where regulation 12 (1)”.
14. In regulation 18A(4) (particular partnership vacancies), after “agreed” add “(after consultation with any other Health Authority in whose area prospective patients reside).”.
15.—(1) Regulation 18B (general partnership vacancies) shall be amended in accordance with the following paragraphs.
(2) In paragraph (2) for “in the locality” in each place where those words occur substitute “in the area”;
(3) After paragraph (2) insert—
“(2A) Before setting the criteria referred to in paragraph (2)(a), the Health Authority must consult any other Health Authority in whose area prospective patients reside.”;
(4) In paragraph (7), after “agreed between the Health Authority” insert “(after consultation with any other Health Authority in whose area prospective patients reside)”.
16.—(1) Regulation 18C(vacancies for sole practitioners) shall be amended in accordance with the following paragraphs.
(2) In paragraph (6) omit “to the Secretary of State ”.
(3) In paragraph (7)—
(a)for “regulation 12(4)(d)” substitute “regulation 13(7)”;
(b)for “must make a further reference” to the end, substitute “must consider again in accordance with regulation 12 whether there is, or will be, a vacancy in the area.”.
(4) For paragraph (8) substitute—
“(8) No vacancy may be re-advertised until the expiry of the period for appeal, or, if an appeal is lodged under regulation 18G, until that appeal is dismissed .”.
17.—(1) Regulation 18D (advertisement of vacancies for sole practitioners) shall be amended in accordance with the following paragraphs.
(2) For paragraph (1)(a) substitute—
“(a)the Health Authority has declared a vacancy, pursuant to regulation 13(1)(a), for an additional doctor in an area; and”.
(3) In paragraph (2) for “within such period as the Medical Practices Committee has specified pursuant to regulation 12 (4)(d),” substitute “within the period specified in regulation 13(7),”.
(4) In paragraph (3)—
(a)in sub-paragraph (b) for “by the Medical Practices Committee ” substitute “by the Health Authority ”;
(b)for “the locality” substitute “the area”.
(5) In paragraph (6) for “the locality” substitute “the area, and shall be set after consultation with any other Health Authority in whose area prospective patients reside.”
18. In regulation 18E(criteria for approval and nomination), in paragraph (3) omit “to the Secretary of State ”.
19.—(1) Regulation 18F (entry on to medical list) shall be amended in accordance with the following paragraphs.
(2) In paragraph (1), omit “,and shall inform the Medical Practices Committee that it has done so.”;
(3) After paragraph (1) insert—
“(2A) The other Authorities are those whose areas include any part of the area in respect of which the vacancy was declared or, where the Health Authority has imposed a condition pursuant to regulation 13(1)(c), those whose areas include any part of the specified area.”
(4) In paragraph (3) omit “to the Secretary of State”.
20. In regulation 18G (appeal to the Secretary of State )—
(a)in paragraphs (1) and (3)(a) for “the Secretary of State” in each place where those words occur, substitute “National Assembly for Wales”;
(b)omit paragraphs (4) and (5) and ( 7) to (14).
21. Omit regulations 18H (cases not requiring a reference to the Medical Practices Committee) and 18I (procedure in cases to which regulation 18H applies).
22.—(1) For regulation 18J (cross-border vacancies) substitute—
18J.—(1) This regulation applies where—
(a)a Health Authority is considering under regulation 12(1) or (2) whether there is, or will be, a vacancy; and
(b)a doctor’s prospective patients are situated in the area of one or more Health Authorities in Wales and of one or more Health Authorities in England.
(2) A Health Authority may elect to consider separately whether there is a vacancy in respect of prospective patients residing in their area.
(3) Where two or more have agreed to deal jointly with prospective patients residing in their areas, the Health Authority in whose area reside the largest number of the prospective patients of the additional doctor shall decide whether there is a vacancy and deal with it in accordance with the provisions contained in this Part of these Regulations.
(4) Any Health Authority in whose area will reside any patient who is expected to be on the doctor’s list of patients (other than the Health Authority which is responsible for making the decision as to whether there is a vacancy) shall provide whatever information the Health Authority making the decision requires.
(5) Before—
(a)declaring a vacancy under regulation 13(1)(a);
(b)imposing conditions on a doctor under regulation 13(1)(b);
(c)making a decision as to whether an additional doctor should be a member of a partnership or a sole practitioner pursuant to regulation 17(4);
(d)setting or agreeing criteria pursuant to regulation 18D(5);
(e)nominating or approving an additional or replacement doctor pursuant to regulation18A, 18B or 18C,
the Health Authority must consult the Local Medical Committee and any other Health Authority in whose area reside individuals who are, or are expected to be, on the doctor’s list of patients.”.
23.—(1) Regulation 18K (practice vacancies where patients are subject to pilot scheme proposals) shall be amended in accordance with the following paragraphs.
(2) In paragraph (1)—
(a)for sub-paragraph (a) substitute—
“(a)a Health Authority is considering under regulation 12(1) or (2) whether to declare a vacancy, or has declared a vacancy pursuant to regulation 13(1)(a); and”;
(b)for sub-paragraph (d) substitute—
“(d)either—
(i)the Health Authority is considering under regulation 12(1) or (2) whether to declare a vacancy but has not yet reached a decision, or
(ii)the Health Authority has declared a vacancy for an additional doctor in the vacancy area but the Health Authority has not yet nominated or approved a doctor pursuant to regulation 18A, 18B or 18C.”.
(3) For paragraph (2) substitute—
“(2) In a case referred to in paragraph (1), without prejudice to any steps that may already have been taken, a Health Authority shall not—
(a)consider under regulation 12(1) or (2) whether to declare a vacancy; or
(b)declare a vacancy pursuant to regulation 13(1)(a); or
(c)decide whether an additional doctor should be a member of a partnership or a sole practitioner pursuant to regulation 17(4), or
(d)nominate or approve an additional doctor pursuant to regulation 18A, 18B or 18C; or
(e)give notice or further notice of the vacancy in accordance with regulation 18D,
until such time as one of the events set out in paragraph (3) has occurred.”.
(4) Omit paragraph (4).
24.—(1) For Regulation 18L (transitional provision) substitute—
18L—(1) Any decision of the Medical Practices Committee taken before 1st April 2002 under the provisions of these Regulations as they are in force, shall on or after that date have effect as though the decision had been made by the Health Authority which made the reference to the Medical Practices Committee as a result of which that decision was made .
(2) Any condition of practice imposed before 1st April 2002 by the Medical Practices Committee under regulation 13(1)(b) or (1)(c) (or such a condition as varied by the Medical Practices Committee pursuant to regulation 15(1) as then in force shall on or after that date have effect as though the condition had been imposed by the Health Authority which made the reference to the Medical Practices Committee as a result of which the condition was imposed .
(3) Subject to paragraph (4), where before 1st April 2002—
(a)a reference had been made to the Medical Practices Committee under regulation 11(1) as then in force, but the Medical Practices Committee had not made a decision by that date; or
(b)an application had been made to the Medical Practices Committee under regulation 15 as then in force, but the Medical Practices Committee had not determined the application by that date,
the decision, or as the case may be, the determination shall be made by the Health Authority which made that reference or application.
(4) Where the reference to the Medical Practices Committee was made at the request of a doctor providing general medical services in that area, that doctor may, on or after the 1st April 2002, choose to withdraw the request and make a new request for consideration of the vacancy instead.”
25. In regulation 37(publication of particulars), in paragraph (3)(a) omit “the Medical Practices Committee, ”.
26. In regulation 40 (certificate that transaction does not involve sale of goodwill), for “the Medical Practices Committee” substitute “the Secretary of State”.
27.—(1) Schedule 2 (terms of service) shall be amended in accordance with the following provisions.
(2) In paragraph 24 (3), for “to the Medical Practices Committee” substitute “to the National Assembly for Wales ”.
(3) In paragraph 24(4)—
(a)for the reference to “the Medical Practices Committee” in each place it occurs substitute “the National Assembly for Wales”;
(b)for the reference to “the Committee” substitute “the National Assembly for Wales”.
(4) In paragraphs 29(8)(b) for “pursuant to section 33(4)(b) or (5) of the Act” and in paragraph 29A(3)(b) for “pursuant to section 33(4)(b) of the Act” substitute “under regulation 13(1)(c).”.
(5) In paragraph 32—
(a)in paragraph (1), for the reference to “the Medical Practices Committee” in each place it occurs substitute “the National Assembly for Wales ”;
(b)in paragraph (2)—
(i)for “regulation 18A, 18B, 18C or 18I,” substitute “regulation 18A, 18B or 18C”,
(ii)for “the Secretary of State” in each place it occurs substitute “the National Assembly for Wales”.
(6) In paragraph 33(1), for “the Medical Practices Committee” substitute “the National Assembly for Wales”.
(7) In paragraph 34 (practice area), in sub-paragraph (2) substitute—
“(2) A doctor shall not, contrary to any condition imposed by the Health authority, or on appeal the National Assembly for Wales, under regulation 13(1)(c ), open practice premises in any area or part of an area where, at the time of his application to open such promises, the Health Authority is of the opinion that the number of medical practitioners undertaking to provide General Medical Services in that area or part of that area is already adequate.”.
28.—(1) Schedule 3, shall be amended in accordance with the following provisions.
(2) For the heading to Part I (information to be included in a report by a Health Authority when making a reference to the Medical Practices Committee) substitute—
(3) Omit paragraphs 9 and 10.
(4) For the heading to Part IB (additional information to be included where the reference is being made to the Medical Practices Committee on the death of a doctor, or the withdrawal or removal of a doctor from a medical list) substitute—
“B. Additional information to be considered where the Health Authority is deciding whether or not to declare a vacancy on the death of a doctor, or on the withdrawal or removal of a doctor from a medical list”.
(5) In paragraph 13, for “If the Medical Practices Committee so requests,” substitute “Where the Health Authority considers it necessary,”.
(6) Omit Part II (information to be included in a report by a Health Authority to the Medical Practices Committee concerning adequacy of services).
29. In Schedule 7 (form of certificate to be issued by Medical Practices Committee under paragraph 1(3) of Schedule 10 to the National Health Service Act 1977)—
(a)for the heading substitute “Form of Certificate to be issued by the Secretary of State under paragraph 1(3) of Schedule 10 to the National Health Service Act 1977”;
(b)for “the Medical Practices Committee” in each place where those words occur, substitute “the Secretary of State”;
(c)for the “Signature of the chairman or other member authorised by the Medical Practices Committee.” substitute “Signed by Authority of the Secretary of State.”.
30. In Schedule 8 (doctors' hours)—
(a)in Part I (information to be included with any application under paragraph 29 of Schedule 2), for paragraph 8 substitute—
“8. The terms of any condition imposed by the Health Authority under regulation 13(1)(c).”;
(b)in Part IV (illustrative list of health-related activities), in the last entry omit “or the Medical Practices Committee”.
31. Where before these Regulations come into force—
(a)a medical practitioner or his personal representative has applied to the Medical Practices Committee for an opinion under paragraph 1(2) of Schedule 10 (prohibition, and certificate of Medical Practices Committee); or
(b)a person proposing to be a party to a transaction or series of transactions has applied to the Medical Practices Committee for a certificate under paragraph 1(3) of that Schedule,
that application shall be treated as an application to the Secretary of State.
Signed on behalf of the National Assembly for Wales under section 66(1) of the Government of Wales Act 1998(4)
Rhodri Morgan
The First Secretary
Date 28 March 2002
(This note is not part of the Regulations)
These Regulations further amend the National Health Service (General Medical Services) Regulations 1992 (“the principal Regulations”), which regulate the selection of general practitioners (“GPs”) to fill practice vacancies.
Following the abolition of the Medical Practices Committee by section 14 of the Health and Social Care Act 2001, these Regulations provide for a new system for the identification of vacancies by Health Authorities and the imposition of conditions of practice on GPs filling those vacancies and makes consequential amendments to the principal Regulations.
Section 14 of the Health and Social Care Act 2001 also transferred the function of issuing a certificate to GPs that a transaction does not involve the sale of goodwill to the Secretary of State and regulations 24 and 27 make consequential amendments to the principal Regulations. Regulation 29 makes transitional provisions for outstanding applications to the Medical Practices Committee for certificates or opinions as to whether certain transactions amount to the sale or purchase of goodwill of a medical practice when these Regulations come into force to be treated as applications to the Secretary of State .
Regulation 24 amends regulation 18L to provide new transitional provisions to reflect the changes made to Part III of the principal Regulations by these Regulations.
1977 c. 49; see section 128(1) as amended by the National Health Service and Community Care Act 1990 (c. 19) (“the 1990 Act”), section 26(2)(g) and (i), for the definitions of “prescribed” and “regulations”. Section 29 was extended by the Health and Medicines Act 1988 (c. 49), section 17; and amended by the Health Services Act 1980 (c. 53), sections 1 and 7 and Schedule 1, paragraph 42(b); by the Health and Social Services and Social Security Adjudications Act 1983 (c. 41), Schedule 6, paragraph 2; by the Medical Act 1983 (c. 54), section 56(1) and Schedule 5, paragraph 16(a); by S.I. 1985/39, article 7(3); by the Health Authorities Act 1995 (c. 17), Schedule 1, paragraph 18; and by the National Health Service (Primary Care) Act 1997 (c. 46) (“the 1997 Act”), Schedule 2, paragraph 8. Section 29A was inserted by the 1997 Act , section 32, and amended by the Health and Social Care Act 2001(c. 15) (“the 2001 Act”), section 20. Section 29B was inserted by the 1997 Act , section 32, and amended by the 2001 Act, sections 15 and 20. Section 126(4) was amended by the 1990 Act, section 65(2); by the Health Act 999 (c.8), Schedule 4, paragraph 37(6) and by the 2001 Act, Schedule 5, paragraph 5(13)(b).
As regards Wales, the functions of the Secretary of State under section 29, 29A, 29B and 126(4) of the 1977 Act are transferred to the National Assembly for Wales under article 2 of, and Schedule 1 to, the National Assembly for Wales (Transfer of Functions) Order 1999, S.I. 1999/672; section 68 of the 2001 Act provides that Sch 1 shall be construed so as to include the amendments made by that Act to the 1977 Act; these Regulations therefore apply only to Wales.
S.I. 1992/635; relevant amending instruments are S.I. 1998/682, 1998/2838 and 2000/220 (the amendments made by these Regulations have effect in Wales by virtue of SI. 2000/1707, W114).