The National Health Service (General Medical Services) Amendment (No. 4) Regulations 2001

Insertion of new regulations

5.  After regulation 7 ( removal from the medical list) insert the following regulations—

“Supplementary matters relating to removal

7A.   In addition to the services covered by the definition of “health scheme” in section 49F(8) of the Act, the following shall also be health schemes—

(a) health services, including medical and surgical treatment, provided by Her Majesty’s Forces;

(b) services provided by Port Health Authorities constituted under the Public Health (Control of Disease) Act 1984(1);

(c) health services provided to a prisoner in the care of the medical officer or other such officer of a prison appointed for the purposes of section 7 of the Prison Act 1952(2);

(d) publicly-funded health services provided by or on behalf of any organisation anywhere in the world.

Criteria for decisions on removal

7B.— (1) Where a Health Authority is considering removal of a doctor under section 49F(4) of the Act (an unsuitability case), it shall consider the information from the doctor supplied under paragraph 36A(1), (2), (4) and (5) of Schedule 2 and must apply the criteria set out in paragraph (2).

(2) The criteria referred to in paragraph (1) are—

(a) the nature of any criminal offence, investigation or incident;

(b) the length of time since any such offence or incident was committed, and since any criminal conviction or investigation;

(c) whether there are other criminal offences to be considered;

(d) the penalty imposed on any criminal conviction or the outcome of any investigation;

(e) the relevance of any criminal offence, or investigation into professional conduct, on the provision by the doctor of general medical services and the likely risk to patients;

(f) whether any criminal offence was a sexual offence to which Part I of the Sexual Offences Act 1997(3) applies;

(g) whether the doctor has been refused admittance to, conditionally included, removed, contingently removed or is currently suspended from other Health Authority lists or equivalent lists, and if so, what the facts were in those cases and what were the reasons given by the Health Authority or equivalent body in the case; and

(h) whether he was at the time, has in the preceding six months been, or was at the time of the originating events, a director of a body corporate which was refused admittance to, conditionally included, removed or contingently removed from other Health Authority lists or equivalent lists, or is currently suspended from such lists, and if so, what the facts were in those cases and what were the reasons given by the Health Authority or equivalent body in the case.

(3) Where a Health Authority is considering removal of a doctor under section 49F(3) of the Act (a fraud case), it shall consider the information from the doctor supplied under paragraph 36A(1), (2), (4) and (5) of Schedule 2, and must apply the criteria set out in paragraph (4).

(4) The criteria referred to in paragraph (3) are—

(a) the nature of any incidents of fraud;

(b) the length of time since any incident occurred, and since the investigation was concluded;

(c) whether there are other incidents of fraud or other criminal offences to be considered;

(d) any action taken by any licensing, regulatory or other body, the police or the courts as a result of any such incident;

(e) the relevance of the investigation to the provision by him of general medical services and the likely risk to patients or to public finances;

(f) whether the doctor has been refused admittance to, conditionally included, removed, contingently removed or is currently suspended from other Health Authority lists or equivalent lists, and if so, what the facts were in those cases and what were the reasons given by the Health Authority or equivalent body in the case;

(g) whether he was at the time, has in the preceding six months been, or was at the time of the originating events a director of a body corporate which was refused admittance to, conditionally included, removed or contingently removed from other Health Authority lists or equivalent lists, or is currently suspended from such lists, and if so, what the facts were in those cases and what were the reasons given by the Health Authority or equivalent body in the case.

(5) Where a Health Authority is considering removal of a doctor under section 49F(2) of the Act (an efficiency case), it shall consider the information from the doctor supplied under paragraph 36A(1), (2), (4) and (5) of Schedule 2, and must apply the criteria set out in paragraph (6).

(6) The criteria referred to in paragraph (5) are—

(a) whether it was prejudicial to the efficiency of the general medical services provided by the doctor;

(b) the length of time since any incident occurred, and since the investigation was concluded;

(c) any action taken by any licensing, regulatory or other body, the police or the courts as a result of any such incident;

(d) the nature of the incident and whether there is a likely risk to patients;

(e) whether the doctor has ever failed to comply with a request by the Health Authority to undertake an assessment by the NCAA;

(f) whether the doctor has previously failed to make a declaration or comply with an undertaking required by these Regulations;

(g) whether the doctor has been refused admittance to, conditionally included, removed, contingently removed or is currently suspended from other Health Authority lists or equivalent lists, and if so, what the facts were in those cases and what were the reasons given by the Health Authority or equivalent body in the case;

(h) whether he was at the time, has in the preceding six months been, or was at the time of the originating events a director of a body corporate which was refused admittance to, conditionally included, removed or contingently removed from other Health Authority lists or equivalent lists, or is currently suspended from such lists, and if so, what the facts were in those cases and what were the reasons given by the Health Authority or equivalent body in the case.

(7) In making any decision under section 49F of the Act, the Health Authority shall take into account the effect of all relevant incidents and offences relating to the doctor of which it is aware, whichever condition it relies on.

(8) When making a decision on any condition in section 49F of the Act, the Health Authority shall state in its decision on which condition (or conditions) in section 49F of the Act it relies.

Cases where the Health Authority must remove a doctor

7C.— (1) The Health Authority must remove the doctor from the medical list where it becomes aware that the doctor—

(a) has been convicted in the United Kingdom of murder;

(b) has been convicted in the United Kingdom since 13th December 2001 of a criminal offence and has been sentenced to a term of imprisonment of over six months.

(2) The Health Authority shall notify the doctor immediately that he has been removed from the list.

Notifications by Health Authorities

7D.— (1) Where a Health Authority—

(a) refuses to approve or nominate a doctor under regulation 18EE;

(b) removes a doctor under section 49F of the Act;

(c) contingently removes a doctor under section 49G of the Act; or

(d) suspends a doctor,

it shall notify the persons and bodies specified in paragraph (2), and shall notify those specified in paragraph (3) if so requested by those persons or bodies, of the matters set out in paragraph (4).

(2) Where paragraph (1) applies, a Health Authority shall notify—

(a) the Secretary of State;

(b) any Health Authority in England that has the doctor, or a body corporate of which the doctor is director, on any of its lists, or is considering an application for inclusion in any of its lists by such a doctor or body corporate;

(c) the Scottish Executive;

(d) the National Assembly for Wales;

(e) the Northern Ireland Executive;

(f) the General Medical Council or any other appropriate regulatory body;

(g) the local medical committee for its area;

(h) any other organisation that, to the knowledge of the Health Authority, employs or uses the services of the doctor in a professional capacity;

(i) where it is a fraud case, the National Health Service Counter Fraud Service.

(3) Where paragraph (1) applies, the Health Authority shall notify any person or body that can establish that it is considering employing the doctor in a professional capacity if the Health Authority receives a written request (including an electronic request) to do so.

(4) The matters referred to in paragraph (1) are—

(a) identifying details of the doctor;

(b) professional registration number;

(c) date and copy of the decision of the Health Authority;

(d) a contact name of a person in the Health Authority for further enquiries.

(5) The Health Authority shall send to the doctor concerned a copy of any information about him provided to the persons or bodies specified in paragraphs (2) and (3) and any correspondence with those persons or bodies.

(6) Where the Health Authority has notified any of the persons or bodies specified in paragraph (2) or (3) of the matters set out in paragraph (4), it may in addition, if so requested by that person or body, notify that person or body of any evidence that was considered, including representations made by the doctor.

(7) Where a Health Authority is notified by the FHSAA that it has imposed a national disqualification on a doctor whom the Health Authority had removed from its list, it shall notify the persons or bodies listed in paragraph (2)(b), (g), (h) and (i) and paragraph (3).

(8) Where a decision is changed on review or appeal, or a suspension lapses, the Health Authority shall notify any person or body that was notified of the original decision of the later decision.

Procedure on removal

7E.— (1) Where a Health Authority is considering—

(a) removing a doctor under section 49F of the Act (other than in cases specified in regulation 7C);

(b) contingently removing a doctor under section 49G of the Act;

(c) removing a doctor for a breach of a condition imposed under regulation 49G of the Act; or

(d) removing a doctor for breach of a condition imposed under regulation 18M,

it shall follow the procedure set out in paragraphs (3) to (8) below.

(2) Where a Health Authority is notified by the FHSAA that it has considered—

(a) an appeal by a doctor against a contingent removal by the Health Authority and has decided to remove him instead; or

(b) an appeal by a doctor against a conditional inclusion, where the doctor has been conditionally included in the list until the appeal has been decided, and has decided not to include him,

the Health Authority shall remove the doctor and shall notify the doctor immediately that it has done so.

(3) Before reaching a decision of the kind mentioned in paragraph (1), the Health Authority shall—

(a) give the doctor notice in writing of any allegation against him;

(b) give the doctor notice of what action the Health Authority is considering and on what grounds;

(c) give him the opportunity to make written representations to the Health Authority within 28 calendar days of the date of the notification under sub-paragraph (b);

(d) give him the opportunity to put his case at an oral hearing before the Health Authority, if he so requests within the 28 day period mentioned in sub-paragraph (c).

(4) If there are no representations within the period specified in paragraph (3)(c), the Health Authority shall inform the doctor of its decision, the reasons for it (including any facts relied upon), and of any right of appeal.

(5) If there are representations, the Health Authority must take them into account before reaching its decision, and notifying the doctor of its decision, the reasons for it (including any facts relied upon), and of any right of appeal.

(6) If the doctor requests an oral hearing, this must take place before the Health Authority reaches its decision, and the Health Authority must then notify the doctor of its decision, the reasons for it (including any facts relied upon), and of any right of appeal.

(7) When the Health Authority notifies the doctor of any decision, it shall inform him that if he wishes to exercise a right of appeal, he has 28 days from the date of the decision to do so, and shall tell him how to do so.

(8) The Health Authority shall also notify the doctor of his right to have the decision reviewed in accordance with section 49L of the Act.

Procedure on suspension

7F.— (1) Before reaching a decision to suspend a doctor under section 49I or 49J of the Act, the Health Authority shall—

(a) give the doctor notice in writing of any allegation against him;

(b) give the doctor notice of what action the Health Authority is considering and on what grounds;

(c) give him the opportunity to put his case at an oral hearing before the Health Authority on a specified day, provided that at least 24 hours' notice of the hearing is given;

(d) give the doctor notice of his right of review under section 49L of the Act.

(2) If the doctor does not wish to have an oral hearing or does not attend the oral hearing, the Health Authority shall inform him of its decision and the reasons for it (including any facts relied upon).

(3) If an oral hearing takes place, the Health Authority shall take into account any representations made before it reaches its decision.

(4) The Health Authority may suspend the doctor with immediate effect following the hearing.

(5) The Health Authority shall notify the doctor of its decision and the reasons for it (including any facts relied upon).

Procedure on review of Health Authority decision

7G.— (1) If a Health Authority decides to review its decision to conditionally include, contingently remove or suspend a doctor under section 49I of the Act, it shall—

(a) notify the doctor in writing that it intends to review its decision;

(b) notify him of what action it has in mind and the reasons for it;

(c) give him the opportunity to make written representations to the Health Authority within 28 calendar days of the date of the notification under sub-paragraph (b);

(d) give him the opportunity to put his case at an oral hearing before the Health Authority if he requests one within the 28 day period mentioned above;

(e) after any hearing or on completion of the review, notify him of its decision and the reasons for it (including any facts relied upon).

(2) If there are representations, the Health Authority must take them into account before reaching its decision.

(3) The Health Authority shall notify the doctor of its decision and the reasons for it (including any facts relied upon).

(4) If the doctor requests an oral hearing, this must take place before the Health Authority reaches its decision.

(5) The Health Authority shall notify the doctor of its decision and the reasons for it (including any facts relied upon).

(6) When the Health Authority notifies the doctor of any decision, it shall inform him of any right of appeal, that he has 28 days from the date of the decision to exercise that right if he wishes to do so, and tell him how to do so.

(7) The Health Authority shall also notify the doctor of his right to have the decision further reviewed in accordance with section 49L of the Act.

National Disqualification

7H.   The period for review shall be the different period specified below instead of that in section 49N(8) of the Act where the circumstances are that—

(a) on making a decision to impose a national disqualification, the FHSAA states that it is of the opinion that the criminal or professional conduct of the doctor is such that there is no realistic prospect of a further review being successful if held within the period specified in section 49N(8)(a) of the Act, in which case the reference to “two years” in that provision shall be a reference to five years;

(b) on the last review by the FHSAA of a national disqualification the doctor was unsuccessful and the FHSAA states that it is of the opinion that there is no realistic prospect of a further review being successful if held within a period of three years beginning with the date of its decision on that review, in which case the reference to “one year” in section 49N(8)(b) of the Act shall be a reference to three years;

(c) the FHSAA states that it is of the opinion that because a criminal conviction considered by the FHSAA in reaching its decision has been quashed or the penalty reduced on appeal, there is a need for an immediate review, in which case the reference to “two years” or “one year” in section 49N(8) of the Act shall be a reference to the period that has already elapsed;

(d) the FHSAA is of the opinion that because the decision of a licensing, regulatory or other body has been quashed or the penalty reduced on appeal, there is a need for an immediate review, in which case the reference to “two years” or “one year” in section 49N(8) of the Act shall be a reference to the period that has already elapsed.”.

(1)

1984 c. 22.

(2)

1952 c. 52.

(3)

1997 c. 51.