National Health Service Act 1977

[F1 Provision of personal medical or dental services] E+W+S

Textual Amendments

F1 Cross-heading inserted (prosp.) by 1997 c. 46, ss. 21(1), 41(3)

Prospective

F2 28C Personal medical or dental services. E+W+S

(1) A [Strategic Health Authority or a] Health Authority may make one or more agreements with respect to their area, in accordance with the provisions of regulations under section 28E, under which—

(a) personal medical services are provided (otherwise than by the Authority); or

(b) personal dental services are provided (otherwise than by the Authority).

(2) An agreement made under this section—

(a) may not combine arrangements for the provision of personal medical services with arrangements for the provision of personal dental services [F3 , and may not combine arrangements for the provision of personal medical services or personal dental services with arrangements for the provision of local pharmaceutical services under LPS schemes (within the meaning of paragraph 1(3) of Schedule 8A to this Act) or under pilot schemes made under section 28 of the Health and Social Care Act 2001]; but

(b) may include arrangements for the provision of services—

(i) which are not personal medical services or personal dental services; but

(ii) which may be provided under this Part.

(3) Except to such extent as may be prescribed—

(a) a patient for whom personal medical services are provided in accordance with an agreement made under this section is not to count as a person for whom arrangements must be made by the [Primary Care Trust or] Health Authority concerned under section 29;

(b) a patient for whom personal dental services are provided under an agreement made under this section is not to count as a person for whom arrangements must be made by the [Primary Care Trust or] Health Authority concerned under section 35.

(4) This Act (and in particular section 17) has effect, in relation to personal medical services or personal dental services provided under an agreement made under this section, as if those services were provided as a result of the delegation by the Secretary of State (by directions given under section [F4 16D]) of functions of his under this Part.

(5) The functions of a Health Authority in relation to an agreement made under this section are primary functions of the Authority for the purposes of the M1 National Health Service and Community Care Act 1990.

(6) Regulations may provide—

(a) for functions which are exercisable by a [Strategic Health Authority or a] Health Authority in relation to an agreement made under this section to be exercisable on behalf of the Authority by a Health Board; and

(b) for functions which are exercisable by a Health Board in relation to an agreement made under section 17C of the M2 National Health Service (Scotland) Act 1978 to be exercisable on behalf of the Board by a [Strategic Health Authority or a] Health Authority.

(7) For the purposes of this section—

• “personal medical services” means medical services of a kind that may be provided by a general medical practitioner in accordance with arrangements made under Part II; and

• “personal dental services” means dental services of a kind that may be provided by a general dental practitioner in accordance with arrangements made under Part II.

Textual Amendments

F2 SS. 28C-28D inserted (prosp.) by 1997 c. 46, ss. 21(1), 41(3)

F3 Words in s. 28C(2)(a) inserted (1.7.2002 for W. and otherwise prosp.) by 2001 c. 15, ss. 67(1), 70(2), Sch. 5 para. 11(4) (with ss. 64(9), 65(4))); S.I. 2002/1475, art. 2, Sch. Pt. 1

F4 Word in s. 28C(4) substituted (1.10.1999 for E. and 1.12.1999 for W.) by 1999 c. 8, ss. 65(1), Sch. 4 para. 15; S.I. 1999/2540, art. 2(1)(a), Sch. 1; S.I. 1999/3184, art. 2(2), Sch. 2

Marginal Citations

M1 1990 c. 19.

M2 1978 c. 29.

Prospective

[F5 28D Persons with whom agreements may be made. E+W+S

(1) A [F6 Strategic Health Authority or a] Health Authority may make an agreement under section 28C only with one or more of the following—

(a) an NHS trust;

[F7 (b) a medical practitioner who meets the prescribed conditions;

(ba) a dental practitioner who meets the prescribed conditions;

(bb) a health care professional who meets the prescribed conditions;

(bc) an individual who is providing services—

(i) under a general medical services contract or general dental services contract;

(ii) in accordance with section 28C arrangements, section 17C arrangements or Article 15B arrangements; or

(iii) under section 19 or 25 of the 1978 Act or Article 56 or 61 of the Health and Personal Social Services (Northern Ireland) Order 1972 (1972 No. 1256 (N.I. 14));

or has so provided them within such period as may be prescribed;]

(d) an NHS employee, a section 28C employee or a section 17C employee;

(e) a qualifying body.

[F8 (f) a Primary Care Trust]

[F9 (1A) The power under subsection (1) to make an agreement with a person falling within paragraph (bc) or (d) of that subsection is subject to such conditions as may be prescribed.]

(2) In this section—

• “the 1978 Act” means the M3 National Health Service (Scotland) Act 1978;

• “NHS employee” means an individual who, in connection with the provision of services in the health service in England and Wales or Scotland, is employed by—

  (a)

  an NHS trust;

  (b)

  in the case of an agreement under which personal medical services are provided—

  (i)

  a medical practitioner whose name is included in a medical list kept under this Act or in a corresponding list kept under the 1978 Act; or

  (ii)

  a medical practitioner who is providing personal medical services in accordance with section 28C arrangements or section 17C arrangements;

  (c)

  in the case of an agreement under which personal dental services are provided—

  (i)

  a dental practitioner whose name is included in a list prepared in accordance with regulations made under section 36(1)(a) of this Act or section 25(2)(a) of the 1978 Act; or

  (ii)

  a dental practitioner who is providing personal dental services in accordance with section 28C arrangements or section 17C arrangements;

• “qualifying body” means—

  (a)

  a company which is limited by shares all of which are legally and beneficially owned by persons falling within [F10 paragraph (a), (b), (c), (d) or (f)] of subsection (1); and also

  (b)

  in the case of an agreement under which personal dental services are provided, a body corporate which, in accordance with the provisions of Part IV of the M4 Dentists Act 1984, is entitled to carry on the business of dentistry;

• “qualifying dental practitioner” means a dental practitioner who satisfies the conditions imposed by regulations made under section 28E(2)(b) of this Act or section 17E(2)(b) of the 1978 Act;

• “qualifying medical practitioner” means a medical practitioner who satisfies the conditions imposed by regulations made under section 28E(2)(b) of this Act or section 17E(2)(b) of the 1978 Act;

• “section 17C arrangements” means arrangements for the provision of services made under section 17C of the 1978 Act;

• “section 17C employee” means an individual who, in connection with the provision of services in accordance with section 17C arrangements, is employed by an individual providing those services;

• “section 28C arrangements” means arrangements for the provision of services made under section 28C; and

• “section 28C employee” means an individual who, in connection with the provision of services in accordance with section 28C arrangements, is employed by an individual providing those services.]

Textual Amendments

F5 SS. 28C-28D inserted (prosp.) by 1997 c. 46, ss. 21(1), 41(3)

F6 Words in s. 28D(1) inserted (1.10.2002) by National Health Service Reform and Health Care Professions Act 2002 (c. 17), ss. 4(3), 42(3), Sch. 3 Pt. 1 para. 7(3); S.I. 2002/2478, art. 3(1)(c)

F7 S. 28D(1)(b)-(bc) substituted for s. 28D(1)(b) (20.11.2003) by Health and Social Care (Community Health and Standards) Act 2003 (c. 43), ss. 177(2), 199(1)(4)

F8 S. 28D(1)(f) inserted (4.1.2000 for E. and otherwise prosp.) by 1999 c. 8, ss. 65(1), 67(2), Sch. 4 para. 16(a); S.I. 1999/2540, art. 2(2)

F9 S. 28D(1A) inserted (20.11.2003) by Health and Social Care (Community Health and Standards) Act 2003 (c. 43), ss. 177(3), 199(1)(4)

F10 S. 28D(2); words in para. (a) of the definition of “qualifiying body” substituted (4.1.2000 for E. and otherwise prosp.) by 1999 c. 8, ss. 65(1), 67(2), Sch. 4 para. 16(b); S.I. 1999/2540, art. 2(2)

Marginal Citations

M3 1978 c. 29.

M4 1984 c. 24.

Yn ddilys o 01/07/2002

[F11 28DA Lists of persons who may perform personal medical services or personal dental services E+W

(1) The Secretary of State may make regulations providing for the preparation and publication by each Health Authority of one or more lists of—

(a) medical practitioners who may perform personal medical services in accordance with section 28C arrangements,

(b) dental practitioners who may perform personal dental services in accordance with section 28C arrangements.

(2) Such a list is referred to in this section as a “services list”.

(3) The regulations may, in particular, include provision as to—

(a) the Health Authority to which an application for inclusion in a services list is to be made,

(b) the procedure for applying for inclusion, including any information to be supplied to the Health Authority (whether by the applicant or by arrangement with him),

(c) grounds on which the Health Authority may, or must, refuse a person’s application for inclusion in a services list (including his unsuitability for inclusion in such a list), or on which they may defer their decision on the application,

(d) requirements with which a person included in a services list must comply (including the declaration of financial interests and of gifts and other benefits),

(e) grounds on which a Health Authority may, or must, suspend or remove a person from a services list, the procedure for doing so, and the consequences of doing so,

(f) payments to or in respect of persons who are suspended from a services list (including provision for the amount of the payments, or the method of calculating the amount, to be determined by the Secretary of State or by another person appointed for the purpose by the Secretary of State),

(g) the supply to the Health Authority by an applicant for inclusion in a services list, or by a person included in one, of a criminal conviction certificate under section 112 of the Police Act 1997 (c. 50), a criminal record certificate under section 113 of that Act or an enhanced criminal record certificate under section 115 of that Act,

(h) circumstances in which a person included in a services list may not withdraw from it,

(i) criteria to be applied in making decisions under the regulations,

(j) appeals against decisions of Health Authorities under the regulations,

(k) the disclosure by a Health Authority, to prescribed persons or persons of prescribed descriptions, of information of a prescribed description about applicants for inclusion in a services list, refusals of such applications, and suspensions and removals from that list.

(4) The regulations may, in particular, also provide for—

(a) a person’s inclusion in a services list to be subject to conditions determined by the Health Authority,

(b) the Health Authority to vary the conditions or impose different ones,

(c) the consequences of failing to comply with a condition (including removal from the list), and

(d) the review by the Health Authority of their decisions made by virtue of regulations under this subsection.

(5) The imposition of such conditions must be with a view to—

(a) preventing any prejudice to the efficiency of the services to which the services list relates; or

(b) preventing any acts or omissions of the type described in section 49F(3)(a) below.

(6) Regulations may provide—

(a) that no person may perform personal medical services in accordance with section 28C arrangements unless he is included in a medical list, a supplementary list under section 43D or a services list,

(b) that no person may perform personal dental services in accordance with section 28C arrangements unless he is included in a list referred to in section 36(1)(a), a supplementary list under section 43D or a services list.

(7) Regulations made by virtue of subsection (3)(e) may (but need not) make provision corresponding to anything in sections 49F to 49N below.

(8) If the regulations provide under subsection (3)(e) or (4) that a Health Authority may suspend or remove a person from a services list, they must include provision—

(a) requiring him to be given notice of any allegation against him;

(b) giving him the opportunity of putting his case at a hearing before the Health Authority make any decision as to his suspension or removal; and

(c) requiring him to be given notice of the Health Authority’s decision and the reasons for it and of any right of appeal under subsection (9) or (10).

(9) If the regulations provide under subsection (3)(c) or (e) that a Health Authority may refuse a person’s application for inclusion in a services list, or remove a person from one, the regulations must provide for an appeal (by way of redetermination) to the FHSAA against the Health Authority’s decision.

(10) If the regulations make provision under subsection (4), they must provide for an appeal (by way of redetermination) by the person in question to the FHSAA against the Health Authority’s decision—

(a) to impose conditions, or any particular condition,

(b) to vary a condition,

(c) to remove him from the services list for breach of condition,

(d) on any review of an earlier such decision of theirs.]

Textual Amendments

F11 S. 28DA inserted (1.7.2002 for W., otherwise prosp.) by 2001 c. 15, ss. 26(1), 70(2) (with ss. 64(9), 65(4)); S.I. 2002/1475, art. 2

Prospective

[F12 28E Personal medical or dental services: regulations. E+W+S

(1) The Secretary of State may make regulations with respect to the provision of services in accordance with section 28C arrangements.

(2) The regulations must—

(a) include provision for participants other than [Strategic Health Authorities and] Health Authorities to withdraw from section 28C arrangements if they wish to do so;

(b) impose conditions (including conditions as to qualifications and experience) to be satisfied by medical practitioners performing personal medical services, and dental practitioners performing personal dental services, in accordance with section 28C arrangements.

In paragraph (b) “practitioner” does not include a practitioner who is undergoing training of a prescribed description.

(3) The regulations may, in particular—

(a) provide that section 28C arrangements may be made only in prescribed circumstances;

(b) provide that section 28C arrangements may be made only in prescribed areas;

(c) provide that only prescribed services, or prescribed categories of service, may be provided in accordance with section 28C arrangements;

(d) require details of section 28C arrangements to be published;

(e) make provision with respect to the variation and termination of section 28C arrangements;

(f) prevent (except in such circumstances and to such extent as may be prescribed) a medical practitioner who performs personal medical services in accordance with section 28C arrangements from providing general medical services;

(g) make provision with respect to medical lists, including provision for preferential treatment for medical practitioners;

(h) provide for parties to section 28C arrangements to be treated, in such circumstances and to such extent as may be prescribed, as health service bodies for the purposes of section 4 of the M5 National Health Service and Community Care Act 1990;

(i) provide for directions, as to payments, made under section 4(7) of the Act of 1990 (as it has effect as a result of regulations made by virtue of paragraph (h)) to be enforceable in a county court (if the court so orders) as if they were judgments or orders of that court;

(j) confer powers or impose duties on the Dental Practice Board in relation to agreements made by virtue of section 28C(1) under which personal dental services are provided;

(k) authorise [Strategic Health Authorities and] Health Authorities to make payments of financial assistance for prescribed categories of preparatory work undertaken—

(i) in connection with preparing proposals for section 28C arrangements; or

(ii) in preparation for the provision of services under proposed section 28C arrangements.

[F13 (4) The regulations must include provision for a medical practitioner who—

(a) has provided or performed personal medical services in accordance with section 28C arrangements, and

(b) in contemplation of doing so, gave up fund-holding status,

to be allowed to return immediately to fund-holding status on satisfying the Secretary of State that, if he were granted that status, he would be able to fulfil the conditions for the time being in force for continuing to have it.

For the purposes of this subsection “fund-holding status” has such meaning as may be prescribed.]

(5) The Secretary of State must—

(a) consider whether section 28C arrangements are likely to have an adverse effect on the distribution of medical practitioners providing general medical services or performing personal medical services in England or in Wales;

(b) if he thinks that the arrangements are likely to have that effect, consider whether it is necessary to include in the regulations provisions designed to secure that, so far as is possible, the arrangements do not have that effect; and

(c) if he thinks that it is necessary, include such provisions in the regulations.

(6) Regulations which impose conditions on persons performing personal medical services or persons performing personal dental services (whether made by virtue of subsection (2)(b) or otherwise) may, in particular, include provision of a kind that may be made by regulations under section 32.

(7) Regulations made by virtue of subsection (3)(g) may, in particular, include provision—

(a) requiring (except in prescribed circumstances) [Primary Care Trusts and] Health Authorities to remove from their medical lists persons who are performing personal medical services in accordance with section 28C arrangements or corresponding services under section 17C of the M6 National Health Service (Scotland) Act 1978;

(b) conferring a right to transfer to a medical list on persons who have ceased to perform such services;

(c) that any provision in relation to medical lists made by or under any enactment is not to apply;

(d) as to conditions to be attached to entries in medical lists;

(e) conferring powers of disqualification on the [F14 Family Health Services Appeal Authority constituted under section 49S].

(8) The power to make provision under this section of the kind mentioned in subsection (3)(j) includes power—

(a) to authorise or require the Dental Practice Board to perform on behalf of a [Strategic Health Authority or] Health Authority functions of a prescribed description (including functions relating to remuneration) which have been delegated to the Board by the [Strategic Health Authority or] Health Authority in accordance with a power conferred by the regulations;

(b) to provide that functions conferred by the regulations are only to be exercised by the Board in accordance with directions of the Secretary of State;

(c) to require information for the purpose of performing any functions conferred or imposed on the Board under this section.]

Textual Amendments

F12 S. 28E inserted (prosp.) by 1997 c. 46, ss. 22(1), 41(3)

F13 S. 28E(4) repealed (1.10.1999 for E. and 1.4.2000 for W.) by 1999 c. 8, ss. 65(2), Sch. 5; S.I. 1999/2540, art. 2(1), Sch. 1; S.I. 2000/1041, art. 2(d), Sch.

F14 Words in s. 28E(7)(e) substituted ((E.) 1.10.2001 for specified purposes otherwise 1.12.2001 and (W.) 26.8.2002) by 2001 c. 15, ss. 27(5)(a), 70(2) (with ss. 64(9), 65(4)); S.I. 2001/3294, art. 4(1), Sch. Pt. I (subject to art. 4(2), Sch. Pt. II); S.I. 2002/1919, art. 3(1), Sch. Pt. ll (subject to art. 3(2))

Marginal Citations

M5 1990 c. 19.

M6 1978 c. 29.

Prospective

[F15 28EE Delegation of Health Authority functions relating to section 28C arrangements. E+W

(1) No commentary item could be found for this reference c18059541. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2) The Secretary of State may by order make provision for any rights and liabilities arising under an agreement to provide personal medical services under section 28C above to be transferred from [Strategic Health Authorities] to Primary Care Trusts and from Primary Care Trusts to [Strategic Health Authorities] .

(3) Subsection (2) above is without prejudice to any other power of the Secretary of State to transfer rights and liabilities under this Act.]

Textual Amendments

F15 S. 28EE inserted (prosp.) by 1999 c. 8, ss. 6(2), 67(2)

[F16 28F Right to choose medical practitioner. E+W+S

(1) Provision shall be made in regulations for conferring a right on any person to choose the medical practitioner from whom he is to receive primary medical services, subject to—

(a) the consent of the practitioner concerned; and

(b) any limit on the number of patients to be accepted by any practitioner.

(2) In particular, the regulations—

(a) shall prescribe the procedure for choosing a practitioner;

(b) may prescribe a limit on the number of patients to be accepted by a medical practitioner who undertakes to provide general medical services under Part II; and

(c) shall provide for the distribution among medical practitioners of persons who have indicated a wish to obtain primary medical services but—

(i) have been refused by the medical practitioner of their choice; or

(ii) have not chosen a medical practitioner.

(3) The Secretary of State may give directions imposing a limit on the number of patients to be accepted by a medical practitioner who performs personal medical services in accordance with section 28C arrangements.

(4) Any such directions may make different provision for different cases or descriptions of case.

(5) Regulations under this section may also provide that the right to choose a medical practitioner conferred by the regulations shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.

(6) In this section “primary medical services” means medical services which are—

(a) provided, in accordance with section 28C arrangements, as personal medical services; or

(b) provided under Part II as general medical services.]

Textual Amendments

F16 S. 28F inserted (1.4.1998) by 1997 c. 46, s. 23(1); S.I. 1997/631, art. 2(1)(a), Sch. 1 (subject to arts. 3-5)

[F17 28G Right to choose dental practitioner. E+W+S

(1) Provision shall be made in regulations for conferring a right on any person to choose the dental practitioner from whom he is to receive primary dental services, subject to the consent of the practitioner concerned.

(2) The regulations shall, in particular, prescribe the procedure for choosing a practitioner.

(3) The regulations may, in particular, provide that the right to choose a dental practitioner conferred by the regulations shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.

(4) In this section “primary dental services” means dental services which are—

(a) provided, in accordance with section 28C arrangements, as personal dental services; or

(b) provided under Part II as general dental services.]

Textual Amendments

F17 S. 28G inserted (1.10.1998) by 1997 c. 46, s. 24(1); S.I. 1998/1998, art. 2(2)(a), Sch. 1

[F18 28H Immunisation. E+W+S

Where the Secretary of State arranges with medical practitioners for the vaccination or immunisation of persons against disease, he shall so far as reasonably practicable give every person providing, and every medical practitioner performing, personal medical services in accordance with section 28C arrangements an opportunity to participate in the arrangements for vaccination or immunisation.]

Textual Amendments

F18 S. 28H inserted (1.4.1998) by 1997 c. 46, s. 41(10), Sch. 2 Pt. I para. 6; S.I. 1998/631, art. 2(1), Schs. 1, 2 (subject to arts. 3-5)

[F19 28I Use of accommodation. E+W+S

If the Secretary of State considers that any accommodation provided by him by virtue of this Act is suitable for use in connection with the provision of personal medical services or personal dental services in accordance with section 28C arrangements, he may make the accommodation available on such terms as he thinks fit to persons providing those services.]

Textual Amendments

F19 S. 28I inserted (1.4.1998) by 1997 c. 46, s. 41(10), Sch. 2 Pt. I para. 7; S.I. 1998/631, art. 2(1), Schs. 1, 2 (subject to arts. 3-5)

Prospective

[F20 28J Local pharmaceutical services schemes E+W

(1) Schedule 8A makes provision with respect to the provision of local pharmaceutical services in accordance with schemes made by [Primary Care Trusts and] Health Authorities.]

Textual Amendments

F20 S. 28J inserted (prosp.) by 2001 c. 15, ss. 40(1), 70(2) (with ss. 64(9), 65(4))