The National Health Service (General Medical and Pharmaceutical Services) Amendment (No. 3) Regulations 1990

Substitution of regulations in the principal Regulations

6.  For regulations 10 and 11 of the principal Regulations (advertisement of vacancies, and procedure for the determination of applications) there shall be substituted the following regulations:—

“Advertisement of vacancies

10.— (1) Where it has been resolved that a vacancy has arisen or is about to arise in any locality, the Family Health Services Authority for that locality shall, within such period (not being less than 14 days) as the Medical Practices Committee shall direct, beginning on the date of the direction, give notice of the vacancy in accordance with paragraph (2).

(2) A notice of a vacancy—

(a) shall include—

(i) details of the nature and location of the vacancy;

(ii) where the vacancy is one in connection with which the Medical Practices Committee has indicated to the Authority the nature of any condition which it is likely to impose under section 33(4) of the National Health Service Act 1977 in relation to a successful applicant, details of that condition, and

(iii) the date by which any application to fill the vacancy must be sent or delivered to that Authority; and

(b) may include such other information about the vacancy or the locality as that Authority considers appropriate,

and shall be published in such manner as appears to that Authority to be likely to bring the vacancy to the attention of doctors within and outside its locality.

(3) In this regulation and regulation 10A, “vacancy” means a requirement for—

(a) an additional doctor to provide general medical services otherwise than in succession to another doctor, as mentioned in regulation 7(2);

(b) a doctor to succeed to a practice which has been rendered vacant, as mentioned in regulation 7(4).

Selection of applicants by Family Health Services Authority

10A.— (1) An application under regulation 7(2) in respect of a vacancy shall be an application to which the provisions of section 33(2A) of the National Health Service Act 1977 shall apply, and shall be dealt with by the Family Health Services Authority in accordance with the following provisions of this regulation.

(2) Where a Family Health Services Authority receives more than one such application in connection with any vacancy, it shall select the applicant whose application it wishes to be considered by the Medical Practices Committee.

(3) Before making its selection for the purposes of paragraph (2) the Family Health Services Authority may give to any applicant for the vacancy an opportunity of making—

(a) representations to it in writing;

(b) where that Authority sees fit, representations to it in person.

(4) When the Family Health Services Authority has selected an applicant, it shall—

(a) notify each applicant in writing whether or not he has been selected;

(b) inform any applicant who has not been selected of his right of appeal to the Secretary of State on a point of law under section 33(2A)(c) of the National Health Service Act 1977; and

(c) subject to paragraph (5), send the application of the selected applicant to the Medical Practices Committee, indicating in writing that it wishes that application to be considered by that Committee.

(5) An application shall not be sent to the Medical Practices Committee under paragraph (4)(c) until—

(a) the time has expired for bringing an appeal under section 33(2A)(c) of the National Health Service Act 1977 in connection with the non-selection of any applicant for the vacancy to which the application relates; or

(b) where such an appeal is made—

(i) the appeal has been determined adversely to the appellant, or

(ii) where the appeal is successful, the Family Health Services Authority has reconsidered the application in respect of which the appeal is made,

whichever is the latest.

(6) Where a Family Health Services Authority receives only one application in connection with any vacancy it shall—

(a) send the application to the Medical Practices Committee indicating in writing that it is the only application for that vacancy; and

(b) notify the applicant in writing that it has done so.

Determination of applications by Medical Practices Committee

11.— (1) The Medical Practices Committee shall determine applications under section 30 of the National Health Service Act 1977 in accordance with the following paragraphs of this regulation.

(2) Subject to paragraph (3), in relation to any such application, the Medical Practices Committee shall—

(a) where the application is made under regulation 7(1), consider the report made by the Family Health Services Authority with respect to the application;

(b) before granting the application, ascertain whether or not the applicant is suitably experienced as mentioned in section 31 of the National Health Service Act 1977; and

(c) where it grants the application, consider—

(i) which of the conditions mentioned in regulation 11A is appropriate in the case of the applicant, and

(ii) whether it should impose in relation to the applicant any condition mentioned in section 33(4)(b).

(3) The Medical Practices Committee shall not consider any application made under regulation 7(2) unless the Family Health Services Authority has indicated that—

(a) the application is the only one for the vacancy in question; or

(b) it has selected the application for consideration by that Committee.

(4) Subject to paragraph (5), any determination of the Medical Practices Committee shall be the decision of the majority of those members who are present and voting at a meeting of the Committee.

(5) At any such meeting, four members of the Committee shall form a quorum, and in the case of an equality of votes the chairman shall have a second or casting vote.

(6) The Medical Practices Committee shall give notice in writing to the applicant, the Family Health Services Authority and the Secretary of State of its determination of any application which it has considered, and shall inform each such applicant of his right of appeal to the Secretary of State on a point of law.

Conditions under which general medical services are to be provided

11A.   For the purposes of section 33(4)(a) of the National Health Service Act 1977, the condition by reference to which the Medical Practices Committee shall specify the provision of general medical services for which the applicant will be entitled to be remunerated is that he shall provide such services as—

(a) a full-time doctor, that is to say a doctor who is to provide general medical services during not less than 26 hours in any week in which he is, pursuant to paragraph 25 of his terms of service, normally available to provide such services; or

(b) a three-quarter-time doctor, that is to say a doctor who is to provide such services during less than 26 hours, but not less than 19 hours, in any such week; or

(c) a half-time doctor, that is to say a doctor who is to provide such services during less than 19 hours, but not less than 13 hours, in any such week; or

(d) a job-sharing doctor, that is to say a doctor—

(i) who is to practise in partnership with another doctor whose name is included in the medical list,

(ii) who is himself to provide such services during less than 26 hours in any such week, and

(iii) for whom the hours during which he is to provide such services are, when aggregated with the hours of that other doctor, to amount to not less than 26 hours in any such week; or

(e) a restricted doctor, that is to say a doctor—

(i) who is a restricted list principal or a restricted services principal, and

(ii) who is to provide general medical services during such number of hours in any week as he shall have specified in his application pursuant to regulation 7.

Variation of conditions

11B.— (1) A doctor whose name is included in a medical list may apply, in accordance with paragraph (2), for the variation of any condition—

(a) imposed in relation to him by the Medical Practices Committee—

(i) excluding the provision by that doctor of general medical services in a specified part or specified parts of the locality of the Family Health Services Authority,

(ii) on or after 1st January 1991, by reference to regulation 11A in relation to the extent to which that doctor may carry out remunerated work;

(b) specified in relation to him by the Secretary of State on the determination of any appeal from a decision of the Medical Practices Committee;

(c) treated, by virtue of regulation 12(3) of the Amendment Regulations, as having been imposed in relation to him by that Committee on 1st January 1991.

(2) An application for the purposes of paragraph (1) shall be made in writing to the Family Health Services Authority and shall include the information specified in Part IIIA of Schedule 1 to these Regulations.

(3) On receipt of an application under this regulation, the Family Health Services Authority shall forward the application to the Medical Practices Committee, together with its observations in writing on the application.

(4) The Family Health Services Authority shall send to the doctor a copy of the observations it has made on his application, and the doctor may, within 14 days of receiving the copy of the observations, send to the Medical Practices Committee his representations in writing in response to the observations.

(5) The provisions of regulation 11(4) and (5) as respects the constitution and quorum of the Medical Practices Committee shall apply in the case of the determination by that Committee of an application under this regulation as they apply to the determination of an application under that regulation.

(6) The Medical Practices Committee shall not consider an application under this regulation until it has received representations from the doctor under paragraph (4) or until the time allowed under that paragraph for the making of representations has expired, whichever is the earlier.

(7) On consideration of an application under this regulation the Medical Practices Committee—

(a) shall take account of the observations made by the Family Health Services Authority and of any representations made by the doctor in response;

(b) in determining the application, may refuse to vary the condition in question, or may—

(i) in the case of a condition mentioned in paragraph (1)(a)(i) or (b), vary the condition by specifying therein such other part or parts of the relevant locality (in which the doctor is to be excluded from providing general medical services) as that Committee considers appropriate,

(ii) in the case of a condition mentioned in paragraph (1)(a)(ii) or (c), vary the condition by imposing in relation to the doctor such other condition mentioned in regulation 11A(a) to (e) as has been requested in the application; and

(c) shall give notice of its decision in writing to the doctor and to the Family Health Services Authority.

(8) Where the Medical Practices Committee refuses under paragraph (7)(b) to vary a condition, or varies a condition in the manner mentioned in head (i) of that sub-paragraph it shall, when it gives notice to the doctor of its decision—

(a) include with the notice a statement of the reasons for its decision; and

(b) advise the doctor in writing of his right of appeal under paragraph (9).

(9) A doctor may appeal to the Secretary of State on a point of law against the refusal of the Medical Practices Committee to vary a condition under this regulation, and—

(a) paragraphs (2) to (8) of regulation 12 shall apply to the making and determination of any such appeal; and

(b) where the Secretary of State allows such an appeal, he shall remit the application to that Committee for reconsideration, and regulation 12(9) shall apply in that event.”.