PART 3BENEFITS FOR PRACTITIONERS ETC.

CHAPTER 1INTRODUCTION

Preliminary

Interpretation of Part 3: general137.

(1)

In this Part—

“the 1972 Order” means the Health and Personal Social Services (Northern Ireland) Order 197247;
“the 1993 Act” means the Pension Schemes (Northern Ireland) Act 199348;
“the 1995 Order” means the Pensions (Northern Ireland) Order 199549;
“the 1995 Regulations” means the Health and Personal Social Services (Superannuation) Regulations (Northern Ireland)199550;
“the 1997 Order” means the National Health Service (Primary Care) (Northern Ireland) Order 199751;
“the 1999 Order” means the Welfare Reform and Pensions (Northern Ireland) Order 199952;
“the 2003 Order” means the General and Specialist Medical Practice (Education, Training and Qualifications) Order 200353;
“the 2004 Order” means the General Medical Services Transitional and Consequential Provisions (No.2) (Northern Ireland) Order 200454;

“the Agency” means the Northern Ireland Central Services Agency for the Health and Social Services established under Article 26 of the 1972 Order;

“active member” has the meaning given in Article 121(1) of the 1995 Order and, except where the context otherwise requires, refers to membership of the Scheme (but see regulation 180(8));

“additional pension”, in relation to a member, except where the context otherwise requires, means so much of any pension payable to a member as is payable by virtue of contributions made under regulations 165, 167 and 168;

“additional services” with regard to a—

(a)

GMS practice has the meaning given in regulation 2 of the GMS Contracts Regulations; or

(b)

any other performer or provider of primary medical services, means services which, if provided by a GMS practice, would be additional services within the meaning given in regulation 2 of those Regulations;

“APMS contract” means arrangements under Article 56 (2)(b) of the 1972 Order between a Health and Social Services Board and an APMS contractor;

“APMS contractor” means a person—

(a)

with whom a Health and Social Services Board has made arrangements under Article 56 (2)(b) of the 1972 Order, and

(b)

who has entered into, or would be eligible to enter into, a GMS contract for the provision of primary medical services;

“appropriate proportion” means—

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“assistant medical practitioner” means a medical practitioner, employed by a principal medical practitioner, who in that employment is wholly or mainly engaged in assisting his employer in the discharge of the employer’s duties as a practitioner, and for whose employment the consent of the relevant Health and Social Services Board and the Agency is required;

“assistant dental practitioner” means a dental practitioner, employed by a principal dental practitioner, who in that employment is wholly or mainly engaged in assisting his employer in the discharge of the employer’s duties as a practitioner, and for whose employment the consent of the relevant Health and Social Services Board and the Agency is required;

“bank holiday” means any day that is specified or proclaimed as a bank holiday, pursuant to section 1 of the Banking and Financial Dealings Act 197155;

“base rate” means the Bank of England base rate—

(a)

announced from time to time by the Monetary Policy Committee of the Bank of England as the official dealing rate, being the rate at which the Bank is willing to enter into transactions for providing short term liquidity in the money markets, or

(b)

where an order under section 19 of the Bank of England Act 1998 is in force, any equivalent rate determined by the Treasury under that section;

“Board and advisory work” means—

(a)

work undertaken as a member of the Board of an employing authority which is not a GMS practice, an APMS contractor or an OOH provider; or

(b)

advisory work commissioned by and undertaken on behalf of such an authority, if it is connected to the authority’s role in performing, or securing the delivery of, primary medical services or associated management activities or similar duties,

but which is not in itself the performance of primary medical services, and payment for which is made by that authority directly to the person carrying out that work;

“buy-out policy” means a policy of insurance or annuity contract that is appropriate for the purposes of section 15 of the 1993 Act and “buy out” must be read accordingly;

“capped transferred-in service” must be read in accordance with regulation 231;

“cash equivalent” is to be construed in accordance with Chapter IV of Part IV of the 1993 Act;

“CCT” means a Certificate of Completion of Training awarded under article 8 of the 2003 Order, including any such certificate awarded in pursuance of the competent authority functions of the Postgraduate Medical Education and Training Board specified in article 20(3)(a) of that Order;

“certification services” means services related to the provision of medical certificates listed in Schedule 3 to the GMS Contracts Regulations;

“chapter” unless otherwise specified, means a chapter in this Part;

“collaborative services” means primary medical services provided by a GP performer, a GMS practice, an APMS contractor or an OOH provider under or as a result of an arrangement between—

(a)

a Health and Social Services Board; and

(b)

a person or body, under which a Health and Social Services Board is responsible for providing services for purposes related to the provision of health care in accordance with Article 56 of the 1972 Order;

“commissioned services” means medical services provided under a contract between—

(a)

a GP performer, a GMS practice, an APMS contractor or an OOH provider; and

(b)

a Health and Social Services Board under Article 56 of the 1972 Order;

“contracting-out requirements” means the requirements mentioned in section 5(2) of the 1993 Act;

“contribution option period” has the meaning given in regulation 165(8);

“corresponding health service scheme” has the meaning given in regulation 230(7);

“core hours” means the period beginning at 8am and ending at 6:30pm on any day from Monday to Friday except Good Friday, Christmas Day and a bank holiday;

“deferred member” has the meaning given in Article 121(1) of the 1995 Order and, except where the context requires otherwise, refers to membership of the Scheme (but see regulation 180(8));

“dental performers list” means a list of dental practitioners prepared by the Agency in accordance with regulations made under the Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 199356;

“dentist performer” means a dental practitioner who has undertaken to provide general dental services and whose name is included in a dental performers list;

“Department” means the Department of Health, Social Services and Public Safety;

“dependent child” is to be construed in accordance with regulation 202;

“dispensing services” means the provision of drugs, medicines or appliances that may be provided as pharmaceutical services by a registered medical practitioner in accordance with arrangements made under Part III of the Pharmaceutical Services Regulations (Northern Ireland) 199757;

“employing authority” means—

(a)

a Health and Social Services Board established under Article 16 of the 1972 Order,

(b)

a Health and Social Services Trust established under Article 10 of the Health and Personal Social Services (Northern Ireland) Order 1991 (HSS Trusts)58,

(c)

the Agency,

(d)

any other body which is constituted under an Order relating to health services and which the Department agrees to treat as an employing authority for the purposes of the Scheme,

(e)

an OOH provider,

(f)

an APMS contractor,

(g)

a GMS practice,

(h)

a PMS practice,

  1. (i)

    a host Board; and

(i)

in relation to a person who is subject to a direction made under Article 12 (5) of the Superannuation (Northern Ireland) Order 1972, and subject to such modifications to this Part as the Department may in any particular case direct, any employer of such a person whom the Department agrees to treat as an employing authority for the purposes of this Part;

“employment” includes an office or appointment (other than an honorary office or appointment) and related expressions are to be read accordingly;

“enhanced services” with regard to—

(a)

a GMS practice, has the meaning given in regulation 2 of the GMS Contracts Regulations; or

(b)

any other performer or provider of primary medical services, means services which, if provided by a GMS practice, would be enhanced services within the meaning given in regulation 2 of those Regulations;

“essential services” means the services described in regulation 15(3), (5), (6) and (8) of the GMS Contracts Regulations, whether provided by a GMS practice or an APMS contractor;

“GDS arrangements” means general dental services arrangements under Article 61 of the 1972 Order;

“GDS provider” is a person who is a party to GDS arrangements;

“GMS contract” means a contract under Articles 57 and 57A of the 1972 Order or under Article 13 of the 2004 Order;

“GMS Contracts Regulations” means the Health and Personal Social Services (General Medical Services Contracts) Regulations (Northern Ireland) 200459;

“GMS practice” means—

(a)

a registered medical practitioner; or

(b)

two or more individuals practising in partnership; or

(c)

a company limited by shares,

with whom a Health and Social Services Board has entered into a GMS contract;

“GP performer” means a registered medical practitioner, other than a GP Registrar or a locum practitioner, whose name is included in a medical performers list and who performs essential services, additional services, enhanced services, dispensing services, collaborative services, commissioned services, OOH services or certification services (or a combination of those services)—

(a)

under a GMS contract or APMS contract; or

(b)

on behalf of an OOH provider; or

(c)

under a contract of service or for services with a Health and Social Services Board which relates to arrangements under which it provides primary medical services under Article 56 of the 1972 Order;

“GP provider” means a GP performer who is—

(a)

a GMS practice or an APMS contractor;

(b)

a partner in a partnership that is a GMS practice or an APMS contractor; or

(c)

a shareholder in a company limited by shares that is a GMS practice or an APMS contractor,

and who performs medical services as or on behalf of that practice or contractor;

“GP Registrar” means a medical practitioner who is being trained in general practice by a general medical practitioner who is approved under article 4(5)(d) of the 2003 Order for the purpose of providing training under article 5(1)(c)(i) of that Order, whether as part of training leading to the award of a CCT or otherwise;

“GP trainer” means a registered medical practitioner who is approved by the Postgraduate Medical Education and Training Board under article 4(5)(d) of the 2003 Order for the purposes of providing training to a GP Registrar under article 5(1)(c)(i) of that Order;

“health services” has the meaning given in Article 2 (1) of the 1972 Order;

“the guarantee date” has the meaning given in regulation 221(2);

“guaranteed cash equivalent transfer value payment” has the meaning given in regulation 222(3);

“guaranteed minimum pension” means guaranteed minimum pension, or accrued rights to guaranteed minimum pension, under section 10 of the 1993 Act;

“host Board”—

(a)

in respect of a non-GP provider who is—

  1. (i)

    a partner in a partnership—

    1. (aa)

      that is a GMS practice; or

    2. (bb)

      is an APMS contractor that has entered into an APMS contract for the provision of primary medical services;

  2. (ii)

    a shareholder in a company limited by shares that is a GMS practice or an APMS contractor that has entered into an APMS contract for the provision of primary medical services;

  3. (iii)

    an individual who is an APMS contractor,

means the Health and Social Services Board with which that partnership (in the case of sub-paragraph (i)), company (in the case of sub-paragraph (ii)) or practice or contractor (in the case of sub-paragraph (iii)) has entered into an agreement or contract referred to in those provisions;

(b)

in respect of a registered medical practitioner, means the Health and Social Services Board on whose medical performers list his name appears;

“HSC employment” means employment with an employing authority;

“the HPSS Superannuation Scheme 1995” means the Scheme set out in the 1995 Regulations;

“lifetime allowance”, in relation to a person, has the meaning given in section 218 of the Finance Act 200460;

“locum practitioner” means a registered medical practitioner (other than a GP Registrar) whose name is included in a medical performers list and who is engaged, otherwise than in pursuance of a commercial arrangement with an agent, under a contract for services by—

(a)

a GMS practice;

(b)

an APMS contractor;

(c)

an OOH provider; or

(d)

a Health and Social Services Board,

to deputise or assist temporarily in the provision of essential services, additional services, enhanced services, dispensing services, OOH services, commissioned services, certification services or collaborative services (or any combination thereof);

“lower earnings limit” must be read in accordance with section 5 of the Social Security Contributions and Benefits (Northern Ireland) Act 199261;

“lump sum rule” has the meaning given in section 166 of the Finance Act 2004;

“lump sum death benefit rule” has the meaning given in section 168 of the Finance Act 2004;

“member”, except where the context otherwise requires, means an active member, a deferred member, a pensioner member or a pension credit member;

“medical performers list” means a list of registered medical practitioners prepared and published in accordance with the Health and Personal Social Services (Primary Medical Services Performers Lists) Regulations (Northern Ireland) 200462;

“non-GP provider” in these Regulations shall apply as if he were a whole time officer and means—

(a)

a partner in a partnership that is a GMS practice who is not a GP provider and who demonstrates to the satisfaction of the Department that he assists in the provision of health and personal social services provided by that practice;

(b)

a partner in a partnership all of whose members have entered into arrangements for the provision of primary medical services—

  1. (i)

    but who is not a GP provider; and

  2. (ii)

    who demonstrates to the satisfaction of the Department that he assists in the provision of health and personal social services provided by that partnership;

(c)

a partner in a partnership that is an APMS contractor that has entered into an APMS contract for the provision of primary medical services—

  1. (i)

    but who is not a GP provider; and

  2. (ii)

    who demonstrates to the satisfaction of the Department that he assists in the provision of health and personal social services provided by that partnership;

(d)

a shareholder in a company limited by shares that is—

  1. (i)

    a GMS practice; or

  2. (ii)

    an APMS contractor that has entered into a an APMS contract for the provision of primary medical services,

but who is not a GP provider and who demonstrates to the satisfaction of the Department that he assists in the provision of health and personal social services provided by that company;

(e)

an individual who is an APMS contractor but who is not a GP provider and who demonstrates to the satisfaction of the Department that he participates in the provision of health and personal social services;

“occupational pension scheme” means an occupational pension scheme within the meaning of section 1 of the 1993 Act which—

(a)

in the case of such a scheme established on, or after, 6th April 2006 is a registered pension scheme for the purposes of the Finance Act 2004 and which the Department agrees to recognise as a transferring scheme for the purposes of Chapter 6;

(b)

in the case of such a scheme established before that date, was—

  1. (i)

    approved by the Commissioners for Her Majesty’s Revenue and Customs for the purposes of Chapter I of Part XIV of the Income and Corporation Taxes Act 1988 (retirement benefits schemes) or whose application for approval under that Chapter was under consideration,

  2. (ii)

    a statutory scheme as defined in section 612(1) of the Income and Corporation Taxes Act 1988 (interpretation), or

  3. (iii)

    a scheme to which section 608 of the Income and Corporation Taxes Act 1988 applied (superannuation funds approved before 6th April 1980);

“officer” means a person other than a GP performer employed by an employing authority and includes a GP Registrar;

“officer service” means pensionable service as an officer under Part 2;

“OOH provider” has the meaning given by regulation 152;

“OOH services” means services which are required to be provided in the out of hours period and which, if provided during core hours by a GMS practice to patients to whom the practice is required by its GMS contract to provide essential services, would be or would be similar to essential services;

“opting-out” and related expressions are to be construed in accordance with regulation 157;

“out of hours period” means—

(a)

the period beginning at 6:30pm on any day from Monday to Thursday and ending at 8am the following day;

(b)

the period between 6:30pm on Friday and 8am the following Monday;

(c)

Good Friday, Christmas Day and a bank holiday;

“pay period” means—

(a)

in relation to a practitioner who receives regular payments for his service under a contract for services or contract of employment, means the period in respect of which each payment of salary, wages or fees is made in accordance with that contract, and

(b)

in all other cases, any period of three months ending on the last day of March, June, September or December;

“pensionable earnings” has the meaning given in regulation 143 (read with regulation 144);

“pensionable earnings ceiling” in relation to GDS arrangements, is to be construed in accordance with regulation 143(4);

“pensionable employment” means employment as a practitioner which is pensionable under this Part;

“pensionable service” has the meaning given by regulations 139 and 140 (read with regulation 141);

“pensioner member” has the meaning given in Article 121(1) of the 1995 Order and, except where the context otherwise requires, refers to membership of the Scheme (but see regulation 138 and regulation 180(8));

“pension credit” means a credit under Article 26 (1) (b) of the 1999 Order and includes a credit under section 29(1)(b) of the Welfare Reform and Pensions Act 199963;

“pension credit benefit” has the meaning given by section 97B of the 1993 Act;

“pension credit member” has the meaning given by Article 121(1) of the 1995 Order;

“pension credit rights” has the meaning given by section 97B of the 1993 Act;

“pension sharing order or provision” means such an order or provision as is mentioned in Article 25(1) of the 1999 Order;

“personal pension scheme” means a personal pension scheme which—

(a)

in the case of such a scheme established on, or after, 6th April 2006 is a registered pension scheme for the purposes of the Finance Act 2004 and which the Department agrees to recognise as a transferring scheme for the purposes of Chapter 6;

(b)

in the case of a scheme established before that date, was—

  1. (i)

    approved by the Commissioners for Her Majesty’s Revenue and Customs for the purposes of Chapter IV of Part XIV of the Income and Corporation Taxes Act 1988 (personal pension schemes); and

on the 6th April 2006 became a registered pension scheme for the purposes of the Finance Act 2004;

“practice staff” means a person who—

(a)

is not a registered medical practitioner, a GP Registrar or a non-GP provider, and

(b)

is employed by a GMS practice, an APMS contractor or an OOH provider to assist in the provision of the services it provides;

“practitioner” means—

(a)

a registered medical practitioner who—

  1. (i)

    is not a GP Registrar, and

  2. (ii)

    is a locum practitioner, a GP provider or a GP performer, or

(b)

a dentist performer;

“practitioner income” has the meaning given in regulation 143(2) to (8);

“practitioner service” means service as a practitioner which is pensionable under this Part;

“preservation requirements” means the requirements of Chapter 1 of Part IV of the 1993 Act relating to the preservation of benefits under occupational pension schemes;

“principal medical practitioner” means a practitioner on the medical performers list;

“principal dental practitioner” means a practitioner whose name is included in a list of dentists prepared by the Agency under regulation 4 of the Health and Personal Social Services General Dental Services Regulations (Northern Ireland) 199364;

“public sector transfer arrangements” means arrangements approved by the Department as providing reciprocal arrangements for the payment and receipt of transfer values between the Scheme and other occupational pension schemes;

“qualifying service” has the meaning given in regulation 141 (read with regulation 142);

“quarter” means a 3 month period ending on the last day of March, June, September or December;

“recent leaver” has the meaning given in regulation 199(3);

“registered” means registered under Chapter 2 of Part 4 of the Finance Act 2004;

“retail prices index” has the meaning given in section 989 of the Income Tax Act 200765;

“safeguarded percentage” has the meaning given by section 64A(3) of the 1993 Act;

“safeguarded rights” has the meaning given by section 64A(1) of the 1993 Act;

“the Scheme” means the scheme, the rules of which are set out in this Part;

“the Scheme actuary” means the actuary appointed by the Department for the time being to provide a consulting service on actuarial matters relevant to the Scheme;

“scheme year” means a period of one year beginning with 1st April and ending with 31st March next following;

“specialist” means a consultant, other than a nurse consultant, or a senior hospital medical officer or senior hospital dental officer;

“State pension age” means pensionable age, as defined in section 176(1) of the 1993 Act;

“tax yar” means a year of assessment for income tax purposes;

“tier 1 ill-health pension” must be read in accordance with regulation 182;

“tier 2 ill-health pension” must be read in accordance with regulation 182;

“trade dispute” has the meaning given in Article 2 (2) of the Jobseekers (Northern Ireland) Order 199566;

“uprated earnings” is to be construed in accordance with regulation 176 (4) (b);

“vocational trainee” means a dentist performer who is employed as a vocational trainee as a consequence of a placement arrangement made by a local postgraduate dental dean or a director of postgraduate dental education;