National Health Service Act 1977

PART I Services and Administration

Functions of the Secretary of State

1 Secretary of State's duty as to health service

(1) It is the Secretary of State's duty to continue the promotion in England and Wales of a comprehensive health service designed to secure improvement—

(a) in the physical and mental health of the people of those countries, and

(b) in the prevention, diagnosis and treatment of illness,

and for that purpose to provide or secure the effective provision of services in accordance with this Act.

(2) The services so provided shall be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.

2 Secretary of State's general power as to services

Without prejudice to the Secretary of State's powers apart from this section, he has power—

(a) to provide such services as he considers appropriate for the purpose of discharging any duty imposed on him by this Act; and

(b) to do any other thing whatsoever which is calculated to facilitate, or is conducive or incidental to, the discharge of such a duty.

This section is subject to section 3(3) below.

3 Services generally

(1) It is the Secretary of State's duty to provide throughout England and Wales, to such extent as he considers necessary to meet all reasonable requirements—

(a) hospital accommodation;

(b) other accommodation for the purpose of any service provided under this Act;

(c) medical, dental, nursing and ambulance services;

(d) such other facilities for the care of expectant and nursing mothers and young children as he considers are appropriate as part of the health service;

(e) such facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as he considers are appropriate as part of the health service;

(f) such other services as are required for the diagnosis and treatment of illness.

(2) Where any hospital provided by the Secretary of State in accordance with this Act was a voluntary hospital transferred by virtue of the [1946 c. 81.] National Health Service Act 1946, and—

(a) the character and associations of that hospital before its transfer were such as to link it with a particular religious denomination, then

(b) regard shall be had in the general administration of the hospital to the preservation of that character and those associations.

(3) Nothing in section 2 above or in this section affects the provisions of Part II of this Act (which relates to arrangements with practitioners for the provision of medical, dental, ophthalmic and pharmaceutical services).

4 Special hospitals

The duty imposed on the Secretary of State by section 1 above to provide services for the purposes of the health service includes a duty to provide and maintain establishments (in this Act referred to as " special hospitals ") for persons subject to detention under the [1959 c. 72.] Mental Health Act 1959 who in his opinion require treatment under conditions of special security on account of their dangerous, violent or criminal propensities.

5 Other services

(1) It is the Secretary of State's duty—

(a) to provide for the medical and dental inspection at appropriate intervals of pupils in attendance at schools maintained by local education authorities and for the medical and dental treatment of such pupils (and the additional provisions set out in Schedule 1 to this Act have effect in relation to this paragraph);

(b) to arrange, to such extent as he considers necessary to meet all reasonable requirements in England and Wales, for the giving of advice on contraception, the medical examination of persons seeking advice on contraception, the treatment of such persons and the supply of contraceptive substances and appliances.

(2) The Secretary of State may—

(a) provide invalid carriages for persons appearing to him to be suffering from severe physical defect or disability and, at the request of such a person, may provide for him a vehicle other than an invalid carriage (and the additional provisions set out in Schedule 2 to this Act have effect in relation to this paragraph);

(b) arrange to provide accommodation and treatment outside Great Britain for persons suffering from respiratory tuberculosis;

(c) provide a microbiological service, which may include the provision of laboratories, for the control of the spread of infectious diseases (and the Secretary of State may allow persons to use services provided at such laboratories on such terms, including terms as to charges, as he thinks fit);

(d) conduct, or assist by grants or otherwise (without prejudice to the general powers and duties conferred on him under the [1919 c. 21.] Ministry of Health Act 1919) any person to conduct, research into any matters relating to the causation, prevention, diagnosis or treatment of illness, and into any such other matters connected with any service provided under this Act as he considers appropriate.

(3) Regulations may provide for the payment by the Secretary of State in such cases as may be prescribed of travelling expenses (including the travelling expenses of a companion) incurred or to be incurred by persons for the purpose of availing themselves of any services provided under this Act.

(4) The Public Health Laboratory Service Board continues in being for the purpose of exercising such functions with respect to the administration of the public health laboratory service (the service referred to in paragraph (c) of subsection (2) above) as the Secretary of State may determine.

(5) The Board shall continue to be constituted in accordance with Part I of Schedule 3 to this Act, and the additional provisions set out in Part II of that Schedule have effect in relation to the Board.

Central Health Services Council and Medical Practices Committee

6 Central Health Services Council, and standing advisory committees

(1) The Central Health Services Council (in this Act referred to as " the Central Council") shall have the duty of advising the Secretary of State upon such general matters relating to the services provided under this Act as the Council think fit, and upon any questions relating to those services which he may refer to them.

(2) The Central Council shall be constituted in accordance with Schedule 4 to this Act, but the Secretary of State may by order vary that constitution after consultation with the Council; and the supplementary provisions of that Schedule have effect in relation to the Central Council and any standing advisory committee constituted under subsection (3) below.

(3) The Secretary of State may, after consultation with the Central Council, by order constitute standing advisory committees for the purpose of advising him and the Council on such of the services provided under this Act as may be specified in the order.

(4) Any committee so constituted shall consist partly of members of the Central Council appointed by the Secretary of State, and partly of persons (whether or not members of the Council) appointed by the Secretary of State after consultation with such representative organisations as he may recognise for the purpose.

(5) It shall be the duty of a committee so constituted to advise the Secretary of State and the Central Council—

(a) upon such matters relating to the services with which the committee are concerned as they think fit, and

(b) upon any questions referred to them by the Secretary of State or the Council relating to those services,

and, if the committee advise the Secretary of State upon any matter, they shall inform the Council, who may express their views on the matter to the Secretary of State.

(6) The Central Council shall make an annual report to the Secretary of State on their proceedings, and on the proceedings of any standing advisory committee constituted under subsection (3) above, and, subject to subsection (7) below, the Secretary of State shall lay that report before Parliament with such comments (if any) as he thinks fit.

(7) If the Secretary of State, after consultation with the Central Council, is satisfied that it would be contrary to the public interest to lay any such report, or a part of any such report before Parliament, he may refrain from so laying that report or that part.

7 Medical Practices Committee

(1) The Medical Practices Committee—

(a) shall consist of a chairman and eight other members appointed by the Secretary of State after consultation with such organisations as he may recognise as representative of the medical profession; and

(b) the chairman and six of the other members shall be medical practitioners, and five at least of those six shall be actively engaged in medical practice.

(2) The Secretary of State may—

(a) make regulations as to the appointment, tenure of office and vacation of office of the members of the Committee ; and

(b) provide the services of such officers as the Committee may require.

(3) The Committee's proceedings shall not be invalidated by any vacancy in its membership or by any defect in a member's appointment or qualification.

Local administration

8 Regional and Area Health Authorities

(1) It is the Secretary of State's duty to establish by order in accordance with Part I of Schedule 5 to this Act—

(a) authorities, to be called Regional Health Authorities, for such regions in England as he may by order determine, and

(b) authorities, to be called either Area Health Authorities or (in accordance with section 9 below) Area Health Authorities (Teaching), for such areas in Wales and those regions as he may by order determine,

and orders determining regions or areas in pursuance of this subsection shall be separate from orders establishing authorities for the regions or areas.

Any reference in the following provisions of this Act to an Area Health Authority includes a reference to an Area Health Authority (Teaching) unless the context otherwise requires.

(2) The Secretary of State may by order vary the region of a Regional Health Authority or the area of an Area Health Authority whether or not the variation entails the determination of a new or the abolition of an existing region or area.

(3) It is the Secretary of State's duty to exercise the powers conferred on him by the preceding provisions of this section so as to secure—

(a) that the regions determined in pursuance of those provisions together comprise the whole of England, that the areas so determined together comprise the whole of Wales and those regions and that no region includes part only of any area ; and

(b) that the provision of health services in each region can conveniently be associated with a university which has a school of medicine or with two or more such universities.

(4) An order made by virtue of subsection (2) above may (without prejudice to the generality of section 126(4) below) contain such provisions for the transfer of officers, property, rights and liabilities as the Secretary of State thinks fit.

(5) It is the Secretary of State's duty before he makes an order under subsection (2) to consult with respect to the order—

(a) such bodies as he may recognise as representing officers who in his opinion are likely to be transferred or affected by transfers in pursuance of the order; and

(b) such other bodies as he considers are concerned with the order.

9 Special provisions for Area Health Authorities (Teaching)

(1) An order establishing an Authority in pursuance of paragraph (b) of section 8(1) above may provide for it to be called an Area Health Authority (Teaching) if and only if the Secretary of State is satisfied that the Authority is to provide for a university or universities substantial facilities for undergraduate or post-graduate clinical teaching.

(2) Where the Secretary of State is satisfied that an Area Health Authority is to provide, or is providing such facilities, he may provide by order for the Authority to be called an Area Health Authority (Teaching), and, where he is satisfied that an Area Health Authority (Teaching) no longer provides such facilities, he may provide by order for the Authority to be called an Area Health Authority.

(3) It is the Secretary of State's duty, before providing that an Authority shall be called or cease to be called an Area Health Authority (Teaching), to consult the university or universities concerned with the facilities in question.

10 Family Practitioner Committees

It is the duty of each Area Health Authority to establish for its area, in accordance with Part II of Schedule 5 to this Act, a body called a Family Practitioner Committee, and each Family Practitioner Committee has the duty described in section 15 below.

11 Special health authorities

(1) If the Secretary of State considers that a special body should be established for the purpose of performing any functions which he may direct the body to perform on his behalf, or on behalf of an Area Health Authority or a Family Practitioner Committee, he may by order establish a body for that purpose.

(2) The Secretary of State may, subject to the provisions of Part III of Schedule 5 to this Act, make such further provision relating to that body as he thinks fit.

(3) A body established in pursuance of this section shall (without prejudice to the power conferred by subsection (4) below to allocate a particular name to the body) be called a special health authority.

(4) Without prejudice to the generality of the power conferred by this section to make an order (or of section 126(4) below), that order may in particular contain provisions as to—

(a) the membership of the body established by the order;

(b) the transfer to the body of officers, property, rights and liabilities; and

(c) the name by which the body is to be known.

(5) It is the Secretary of State's duty before he makes such an order to consult with respect to the order such bodies as he may recognise as representing officers who in his opinion are likely to be transferred or affected by transfers in pursuance of the order.

12 Supplementary provisions for ss. 8 to 11

The provisions of Part III of Schedule 5 to this Act have effect, so far as applicable, in relation to—

(a) Regional Health Authorities and Area Health Authorities established under section 8 above ;

(b) Family Practitioner Committees established under section 10 above;

(c) any special health authority established under section 11 above.

13 Secretary of State's directions

(1) The Secretary of State may direct a Regional Health Authority, an Area Health Authority of which the area is in Wales or a special health authority to exercise on his behalf such of his functions relating to the health service as are specified in the directions, and (subject to section 14 below) it shall be the duty of the body in question to comply with the directions.

(2) The Secretary of State's functions under subsection (1) above—

(a) include any of his functions under enactments relating to mental health and nursing homes, but

(b) exclude the duty imposed on him by section 1(1) above to secure the effective provision of the services mentioned in section 15 below.

14 Regional Health Authority's directions

(1) A Regional Health Authority may direct any Area Health Authority of which the area is included in its region to exercise such of the functions exercisable by the Regional Health Authority by virtue of section 13 above as are specified in the directions, and it is the Area Health Authority's duty to comply with the directions.

(2) If the Secretary of State directs a Regional Health Authority to secure that any of its functions specified in his directions are or are not exercisable by an Area Health Authority it is the Regional Health Authority's duty to comply with his directions.

15 Duty of Family Practitioner Committee

(1) It is the duty of each Family Practitioner Committee, in accordance with regulations—

(a) to administer, on behalf of the Area Health Authority by which the Committee was established, the arrangements made in pursuance of this Act for the provision of general medical services, general dental services, general ophthalmic services and pharmaceutical services for the area of the Authority, and

(b) to perform such other functions relating to those services as may be prescribed.

(2) If it appears to the Secretary of State that, in consequence of regulations made by virtue of the preceding provisions of this section, references to an Area Health Authority in particular provisions of this Act should be construed as references to a Family Practitioner Committee, he may by regulations provide accordingly.

16 Exercise of functions

(1) Regulations may provide for functions exercisable by virtue of the provisions of sections 13 to 15 above by a body other than an Area Health Authority, or exercisable by virtue of any provision of this Act by an Area Health Authority, to be exercisable on behalf of the body in question—

(a) by an equivalent body or by another body of which the members consist only of the body and equivalent bodies;

(b) by a committee, sub-committee or officer of the body or an equivalent body or such another body as aforesaid ;

(c) in the case of functions exercisable by an Area Health Authority, by a special health authority, an officer of such an authority or a Family Practitioner Committee ;

(d) in the case of functions exercisable by a Family Practitioner Committee, by a special health authority, an officer of such an authority or an officer of an Area Health Authority.

(2) For the purposes of subsection (1) above, a Regional or Area Health Authority or a Family Practitioner Committee is equivalent to another body of the same name and a special health authority is equivalent to another such authority.

(3) Nothing in this section shall be construed as precluding any body from acting by an agent where it is entitled so to act apart from this section.

17 Directions as to exercise of functions

The Secretary of State may give directions with respect to the exercise of any functions exercisable by virtue of sections 13 to 16 above, or by an Area Health Authority by virtue of Part II of this Act; and, subject to any directions given by the Secretary of State by virtue of this section—

(a) a Regional Health Authority may give directions with respect to the exercise by an Area Health Authority of which the area is included in its region, of any functions exercisable by the Area Health Authority by virtue of section 14 above,

(b) an Area Health Authority may give directions with respect to the exercise by the Family Practitioner Committee established by it of any functions which are exercisable by the Committee by virtue of section 15 above and are prescribed for the purposes of this paragraph,

and it shall be the duty of the body in question to comply with the directions.

18 Directions under ss. 13 to 17 generally

(1) Any directions given by the Secretary of State in pursuance of sections 13 to 17 above shall be given either by regulations or by an instrument in writing, except that—

(a) any such directions in pursuance of section 13 above in respect of functions relating to special hospitals, and

(b) any such directions in respect of functions conferred on the Secretary of State by section 20(1) or (2) below,

shall only be given by regulations.

(2) Any directions given by an Authority in pursuance of sections 13 to 17 shall be given by an instrument in writing.

(3) Directions given and regulations made under sections 13 to 17 in respect of any function—

(a) shall not, except in prescribed cases, preclude a body or person by whom the function is exercisable apart from the directions or regulations from exercising the function, and

(b) may in the case of directions given by an instrument in writing be varied or revoked by subsequent directions given in pursuance of those sections and this section (without prejudice to the operation of section 32(3) of the [1889 c. 63.] Interpretation Act 1889 in the case of directions given by regulations),

so, however, that an Area Health Authority shall not be entitled to exercise any functions which, by virtue of section 15 above, are exercisable by the Family Practitioner Committee established by the Authority.

Local advisory committees and Community Health Councils

19 Local advisory committees

(1) Where the Secretary of State is satisfied that a committee formed for Wales, or for the region of a Regional Health Authority, is representative of persons of any of the following categories—

(a) the medical practitioners, or

(b) the dental practitioners, or

(c) the nurses and midwives, or

(d) the registered pharmacists, or

(e) the ophthalmic and dispensing opticians,

of Wales or of the region, then it shall be his duty to recognise the committee.

(2) A committee recognised in pursuance of subsection (1) above shall be called—

(a) the Welsh Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical Committee, as the case may be;

(b) the Regional Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical Committee, as the case may be, for the region in question.

(3) Where the Secretary of State is satisfied that a committee formed for the area of an Area Health Authority is representative of persons of any of the categories mentioned in paragraphs (a) to (e) in subsection (1) it shall be his duty to recognise the committee.

A committee recognised in pursuance of this subsection shall be called the Area Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical Committee, as the case may be, for the area in question.

(4) The Secretary of State's duty under subsections (1) and (3) above is subject to paragraph 1 of Schedule 6 to this Act, and that Schedule has effect in relation to a committee recognised in pursuance of this section.

20 Community Health Councils

(1) It is the Secretary of State's duty to establish in accordance with this section a council for the area of each Area Health Authority, or separate councils for such separate parts of the areas of those Authorities as he thinks fit, and such a council shall be called a Community Health Council.

(2) The Secretary of State—

(a) may if he thinks fit discharge this duty by establishing a Community Health Council for a district which includes the areas or parts of the areas of two or more Area Health Authorities, but

(b) shall be treated as not having discharged that duty unless he secures that there is no part of the area of an Area Health Authority which is not included in some Community Health Council's district.

(3) The additional provisions of Schedule 7 to this Act have effect in relation to Community Health Councils.

Co-operation and assistance

21 Local social services authorities

(1) Subject to paragraphs (d) and (e) of section 3(1) above, the services described in Schedule 8 to this Act in relation to—

(a) care of mothers and young children,

(b) prevention, care and after-care,

(c) home help and laundry facilities,

are functions exercisable by local social services authorities, and that Schedule has effect accordingly.

(2) A local social services authority who provide premises, furniture or equipment for any of the purposes of this Act may permit the use of the premises, furniture or equipment—

(a) by any other local social services authority, or

(b) by any of the bodies constituted under this Act, or

(c) by a local education authority.

This permission may be on such terms (including terms with respect to the services of any staff employed by the authority giving permission) as may be agreed.

(3) A local social services authority may provide (or improve or furnish) residential accommodation—

(a) for officers employed by them for the purposes of any of their functions as a local social services authority, or

(b) for officers employed by a voluntary organisation for the purposes of any services provided under this section and Schedule 8.

22 Co-operation between health authorities and local authorities

(1) In exercising their respective functions health authorities and local authorities shall co-operate with one another in order to secure and advance the health and welfare of the people of England and Wales.

(2) There shall be committees, to be called joint consultative committees, who shall advise Area Health Authorities and the authorities in column 2 of the Table below on the performance of their duties under subsection (1) above, and on the planning and operation of services of common concern to those authorities.

TABLE

1	2
Area Health Authority	Associated authorities
An Area Health Authority in a metropolitan county in England.	The local authority for each district wholly or partly in the area of the Authority.
An Area Health Authority in a non-metropolitan county in England, or an Area Health Authority in Wales.	The local authority for each county, and also for each district, wholly or partly in the area of the Authority.
An Area Health Authority in Greater London.	The local authority for each London borough wholly or partly in the area of the Authority.
	Also the Inner London Education Authority, if wholly or partly in the area of the Authority.
	Also the Common Council of the City of London, if in the area of the Authority.

(3) Except as provided by an order under the following provisions of this section, each joint consultative committee shall represent one or more Area Health Authorities together with one or more of the authorities in column 2 of the Table above, and an Area Health Authority shall be represented together with each of the authorities associated with that Authority in column 2 of the said Table in one or other of the committees (but not necessarily the same committee).

(4) The Secretary of State shall have power by order to provide for any matter relating to joint consultative committees, and such an order may in particular—

(a) provide for the way in which the provisions of subsections (2) and (3) above are to be carried out, or provide for varying the arrangements set out in those subsections;

(b) provide, where it appears to the Secretary of State appropriate, for an Area Health Authority to be represented on a joint consultative committee together with a local or other authority whose area is not within the area of the Area Health Authority ;

(c) afford a choice to any authorities as to the number of joint consultative committees on which they are to be represented, and provide for the case where the authorities cannot agree on the choice ;

(d) authorise or require a joint consultative committee to appoint any sub-committee or to join with another joint consultative committee or other joint consultative committees in appointing a joint sub-committee ;

(e) authorise or require the appointment to a joint consultative committee, or to any sub-committee, of persons who are not members of the authorities represented by the joint consultative committee;

(f) require the authorities represented on a joint consultative committee to defray the expenses of the committee, and of any sub-committee, in such shares as may be determined by or under the order, and provide for the way in which any dispute between those authorities concerning the expenses is to be resolved ; and

(g) require those authorities to make reports to the Secretary of State on the work of the joint consultative committee and of any sub-committee.

(5) Before making an order under this section the Secretary of State shall consult with such associations of local authorities as appear to him to be concerned, and with any local authority with whom consultation appears to him to be desirable.

23 Voluntary organisations and other bodies

(1) The Secretary of State may, where he considers it appropriate, arrange with any person or body (including a voluntary organisation) for that person or body to provide, or assist in providing, any service under this Act.

In this section " voluntary organisation " means a body the activities of which are carried on otherwise than for profit, but does not include any public or local authority.

(2) The Secretary of State may make available—

(a) to any person or body (including a voluntary organisation) carrying out any arrangements under subsection (1) above, or

(b) to any voluntary organisation eligible for assistance under section 64 or section 65 of the [1968 c. 46.] Health Services and Public Health Act 1968 (assistance made available by the Secretary of State or local authorities),

any facilities (including goods or materials, or the use of any premises and the use of any vehicle, plant or apparatus) provided by him for any service under this Act; and, where anything is so made available, the services of persons employed by the Secretary of State or by a health authority in connection with it.

(3) The powers conferred by this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Secretary of State, and any goods or materials may be made available either temporarily or permanently.

(4) The Secretary of State may by order provide that, in relation to a vehicle which is made available by him in pursuance of this section and is used in accordance with the terms on which it is so made available, the [1971 c. 10.] Vehicles (Excise) Act 1971 and Part VI of the [1972 c. 20.] Road Traffic Act 1972 shall have effect with such modifications as are specified in the order.

(5) Any power to supply goods or materials conferred by this section includes a power to purchase and store them and includes a power to arrange with third parties for the supply of goods or materials by those third parties.

24 Overseas aid

Each health authority and the Public Health Laboratory Service Board has power—

(a) with the Secretary of State's consent, to enter into and carry out agreements with the relevant Minister under which, at the expense of that Minister, the authority or board acts as the instrument by means of which he furnishes technical assistance in the exercise of the power conferred on him by section 1(1) of the [1966 c. 21.] Overseas Aid Act 1966;

(b) with the consent of the Secretary of State and the relevant Minister, to enter into and carry out agreements which under the authority or board furnishes, for any purpose specified in that section 1(1), technical assistance (excluding financial assistance) in any country or territory outside the United Kingdom against reimbursement to the authority or board of the cost of furnishing the assistance.

In this section " the relevant Minister " means the Minister of the Crown by whom is exercisable the power conferred on the Minister of Overseas Development by that section 1(1) as originally enacted.

25 Supplies not readily obtainable

Where the Secretary of State has acquired—

(a) supplies of human blood for the purposes of any service under this Act, or

(b) any part of a human body for the purpose of, or in the course of providing, any such service, or

(c) supplies of any other substances or preparations not readily obtainable,

he may arrange to make such supplies or that part available (on such terms, including terms as to charges, as he thinks fit) to any person.

This section is subject to section 62 below (restriction of powers under sections 25, 58 and 61).

26 Supply of goods and services by Secretary of State

(1) The Secretary of State may—

(a) supply to local authorities, and to such public bodies or classes of public bodies as he may determine, any goods or materials of a kind used in the health service ;

(b) make available to local authorities, and to those bodies or classes of bodies, any facilities (including the use of any premises and the use of any vehicle, plant or apparatus) provided by him for any service under this Act, and the services of persons employed by the Secretary of State or by a health authority ;

(c) carry out maintenance work in connection with any land or building for the maintenance of which a local authority is responsible.

In this subsection—

• " maintenance work " includes minor renewals, minor improvements and minor extensions; and

• " public bodies " includes public bodies in Northern Ireland.

(2) The Secretary of State may supply or make available to persons providing general medical services, general dental services, general ophthalmic services or pharmaceutical services such goods, materials or other facilities as may be prescribed.

(3) The Secretary of State shall make available to local authorities—

(a) any services or other facilities (excluding the services of any person but including goods or materials, the use of any premises and the use of any vehicle, plant or apparatus) provided under this Act,

(b) the services provided as part of the health service by any person employed by the Secretary of State or a health authority, and

(c) the services of any medical practitioner, dental practitioner or nurse employed by the Secretary of State or a health authority otherwise than to provide services which are part of the health service,

so far as is reasonably necessary and practicable to enable local authorities to discharge their functions relating to social services, education and public health.

27 Conditions of supply under s. 26

(1) It is the Secretary of State's duty, before he makes the services of any officer of a health authority available in pursuance of subsection (1)(b) or subsection (3)(b) or (c) of section 26 above, to consult the officer or a body recognised by the Secretary of State as representing the officer about the matter, or to satisfy himself that the health authority has consulted the officer about the matter.

(2) The Secretary of State shall be entitled to disregard the provisions of subsection (1) above in a case where he considers it necessary to make the services of an officer available as mentioned in that subsection for the purpose of dealing temporarily with an emergency, and has previously consulted such a body about the making available of services in an emergency.

(3) For the purposes of subsection (1)(b) or subsection (3)(b) or (c) of section 26 the Secretary of State may give such directions to health authorities to make the services of their officers available as he considers appropriate; and it shall be the health authority's duty to comply with any such directions.

(4) The powers conferred by this section and section 26 may be exercised on such terms as may be agreed, including terms as to the making of payments to the Secretary of State, and such charges may be made by the Secretary of State in respect of services or facilities provided under subsection (3) of section 26 as may be agreed between the Secretary of State and the local authority or, in default of agreement, as may be determined by arbitration.

(5) The Secretary of State may by order provide that, in relation to a vehicle which is made available by him in pursuance of section 26 and is used in accordance with the terms on which it is so made available, the [1971 c. 10.] Vehicles (Excise) Act 1971 and Part VI of the [1972 c. 20.] Road Traffic Act 1972 shall have effect with such modifications as are specified in the order.

(6) Any power to supply goods or materials conferred by section 26 includes a power to purchase and store them, and a power to arrange with third parties for the supply of goods or materials by those third parties.

28 Supply of goods and services by local authorities

(1) In the [1970 c. 39.] Local Authorities (Goods and Services) Act 1970 the expression " public body " includes any health authority and so far as relates to his functions under this Act includes the Secretary of State.

(2) The provisions of subsection (1) above have effect as if made by an order under section 1(5) of that Act of 1970, and accordingly may be varied or revoked by such an order.

(3) Every local authority shall make available to health authorities acting in the area of the local authority the services of persons employed by the local authority for the purposes of the local authority's functions under the [1970 c. 42.] Local Authorities Social Services Act 1970 so far as is reasonably necessary and practicable to enable health authorities to discharge their functions under this Act.

(4) Such charges may be made by a local authority for acting under subsection (3) above as may be agreed between the local authority and the Secretary of State or, in default of agreement, as may be determined by arbitration.

PART II General Medical, General Dental, General Ophthalmic, and Pharmaceutical Services

General medical services

29 Arrangements and regulations for general medical services

(1) It is every Area Health Authority's duty, in accordance with regulations, to arrange as respects their area with medical practitioners to provide personal medical services for all persons in the area who wish to take advantage of the arrangements.

The services so provided are in this Act referred to as " general medical services ".

(2) Regulations may provide for the definition of the personal medical services to be provided and for securing that the arrangements will be such that all persons availing themselves of those services will receive adequate personal care and attendance, and the regulations shall include provision—

(a) for the preparation and publication of lists of medical practitioners who undertake to provide general medical services;

(b) for conferring a right on any person to choose, in accordance with the prescribed procedure, the medical practitioner by whom he is to be attended, subject to the consent of the practitioner so chosen and to any prescribed limit on the number of patients to be accepted by any practitioner;

(c) for the distribution among medical practitioners whose names are on the lists of any persons who have indicated a wish to obtain general medical services but who have not made any choice of medical practitioner or have been refused by the practitioner chosen ;

(d) for the issue to patients or their personal representatives by medical practitioners providing those services of such certificates as may be prescribed being certificates reasonably required by them under or for the purposes of any enactment;

(e) for the removal from the list of medical practitioners undertaking to provide general medical services for persons in any area of the name of any one in whose case it has been determined in such manner as may be prescribed that he has never provided, or has ceased to provide, such general medical services for persons in that area.

(3) Regulations under subsection (2) above may provide for the personal medical services there mentioned to include the provision of, and services connected with, any such advice, examination and treatment as are mentioned in paragraph (b) of section 5(1) above.

(4) The remuneration to be paid under the arrangements mentioned in subsection (1) above to a practitioner who provides general medical services shall not, except in special circumstances, consist wholly or mainly of a fixed salary which has no reference to the number of patients for whom he has undertaken to provide such services.

30 Applications to provide general medical services

(1) All applications made in the prescribed manner to an Area Health Authority for inclusion in a list kept by that Authority of the names of medical practitioners undertaking to provide general medical services for persons in the Authority's area shall be referred by the Authority to the Medical Practices Committee and (except as mentioned in subsection (2) below) any medical practitioner whose application is granted by that Committee shall be entitled to the inclusion of his name in the list.

(2) That entitlement is subject to—

(a) if the Secretary of State should so prescribe, section 31 below ;

(b) section 33 below (distribution of general medical services);

(c) section 46 below (disqualification of practitioners).

31 Requirement of suitable experience

(1) Where the Secretary of State so prescribes, and after a day so prescribed—

(a) the Medical Practices Committee shall refuse any application under section 30 above if the medical practitioner is not suitably experienced; and

(b) an Area Health Authority shall not arrange under section 29 above with a medical practitioner for him to provide general medical services for persons in its area unless the Medical Practices Committee have granted an application by him for the inclusion of his name in the list kept by the Authority of medical practitioners undertaking to provide general medical services for persons in that area.

(2) For the purposes of this section a medical practitioner is " suitably experienced " if, but only if, he either—

(a) has acquired the prescribed medical experience, or

(b) is by virtue of regulations made under section 32 below exempt from the need to have acquired that experience,

and " medical experience " includes hospital experience in any specialty.

32 Regulations as to s. 31

(1) Regulations may for the purposes of section 31 above provide—

(a) for prescribing the medical experience needed to satisfy paragraph (a) of section 31(2);

(b) as to the documents which an applicant may or must produce as evidence that he is suitably experienced or has acquired medical experience of any particular kind;

(c) for requiring an applicant who claims to have acquired the prescribed experience to submit particulars of his experience to a prescribed body, and for requiring that body, if satisfied that he has acquired the prescribed experience, to issue him a certificate (a " certificate of prescribed experience ") to that effect;

(d) for enabling an applicant without the prescribed experience who considers that the medical experience which he has acquired is, or ought to be regarded as, equivalent to the prescribed experience to submit particulars of that experience to a prescribed body, and for requiring or enabling that body, if satisfied that the applicant's medical experience is so equivalent, to issue him a certificate (a "certificate of equivalent experience ") to that effect;

(e) for treating an applicant who holds a certificate of equivalent experience as satisfying paragraph (a) of section 31(2);

(f) as to the circumstances or conditions in or subject to which a medical practitioner is exempt from the need to have acquired the prescribed experience;

(g) for conferring on an applicant who is refused a certificate of prescribed experience or a certificate of equivalent experience a right of appeal to a body constituted by the Secretary of State, and for any matter for which it appears to the Secretary of State to be requisite or expedient to provide in consequence of the conferring of that right;

(h) for anything authorised or required by section 31 to be prescribed or otherwise provided for by regulations.

In this section—

• " applicant " means a medical practitioner who has made or proposes to make an application to which paragraph (a) of section 31(1) applies ;

• " the prescribed experience " means the medical experience for the time being prescribed for the purposes of paragraph (a) of section 31 (2).

(2) Regulations under this section shall be framed so as to allow the prescribed experience to be acquired without undertaking whole-time employment.

(3) Any power under this section to make regulations—

(a) may be exercised so as to make different provision for different areas or different periods of time or in relation to different cases or different circumstances;

(b) includes power to make such incidental or supplemental provision in the regulations as the Secretary of State considers appropriate.

33 Distribution of general medical services

(1) The Medical Practices Committee may refuse any application under section 30 above on the ground that the number of medical practitioners undertaking to provide general medical services in the area of the Area Health Authority concerned or in part of that area is already adequate.

(2) If in the opinion of the Medical Practices Committee additional practitioners are required for any area or part, but the number of applications exceeds the number required, the Committee shall select the persons whose applications are to be granted and shall refuse the other applications.

(3) Before selecting any persons under subsection (2) above the Medical Practices Committee shall consult the Area Health Authority concerned, and that Authority shall, if a local medical committee has been formed for that Authority's area and recognised under section 44 below, consult that local medical committee before expressing their views on the persons to be selected.

(4) Except as provided in subsections (1) to (3) above, or as required by section 31 above, the Medical Practices Committee shall not refuse any application under section 30, but the Committee may grant an application subject to conditions excluding the provision of general medical services by the applicant in such part or parts of the area of the Area Health Authority as the Committee may specify.

(5) A medical practitioner who has made an application under section 30 which has been refused or has been granted subject to such conditions may appeal to the Secretary of State ; and the Secretary of State may, on any such appeal, direct the Medical Practices Committee to grant the application either unconditionally or subject to such conditions as the Secretary of State may specify.

This subsection does not apply where an application has been refused under paragraph (a) of section 31(1).

(6) Where the Medical Practices Committee select persons from a number of applicants, the persons selected shall not be included in the list in question during the period for bringing an appeal to the Secretary of State or pending the determination of any such appeal.

(7) If the Secretary of State grants an appeal to which subsection (6) above relates, he may direct either that the application—

(a) shall be granted in addition to those already granted; or

(b) shall be granted instead of such one of those applications as he may specify.

In the latter case, he shall make the other applicant a party to the appeal, and no further appeal shall be brought by that applicant in respect of the application in question.

(8) The Medical Practices Committee shall, in a case where persons have to be selected from a number of applicants, and the Secretary of State shall on an appeal in any such case—

(a) have regard to any desire expressed by any applicant to practise with other medical practitioners already providing general medical services in the area or part of an area concerned and of any desire expressed by such other practitioners to take any applicant into practice with them;

(b) have special regard to such matters in cases where an applicant is related to any other such practitioner.

34 Regulations for Medical Practices Committee

Regulations may make provisions for conferring or imposing on the Medical Practices Committee such additional functions in relation to arrangements for the provision of general medical services as may be prescribed; and regulations shall provide—

(a) for requiring Area Health Authorities to make to the Medical Practices Committee, at such times and in such manner as may be prescribed, reports as to—

(i) the number of medical practitioners required to meet the reasonable needs of their areas and the different parts of those areas ;

(ii) the occurrence of any vacancies on the lists of medical practitioners kept by them under this Part of this Act; and

(iii) the need for filling such vacancies ; and

(b) for prescribing the procedure for—

(i) the determination of applications by the Medical Practices Committee;

(ii) the making and determination of appeals to the Secretary of State under section 33 above ; and

(iii) requiring Area Health Authorities and applicants to be informed of the decisions of the Committee and the Secretary of State.

General dental services

35 Arrangements for general dental services

(1) It is every Area Health Authority's duty, in accordance with regulations, to make as respects their area arrangements with dental practitioners under which any person in the area for whom a dental practitioner undertakes in accordance with the arrangements to provide dental treatment and appliances shall receive such treatment and appliances.

The services so provided are in this Act referred to as " general dental services ".

(2) The remuneration to be paid under such arrangements to a dental practitioner who provides general dental services elsewhere than at a health centre shall not consist wholly or mainly of a fixed salary unless either—

(a) the remuneration is paid in pursuance of arrangements made under section 56 below, or

(b) the services are provided in prescribed circumstances and the practitioner consents,

and it shall be the Secretary of State's duty, before he prescribes any circumstances for the purposes of paragraph (b), to consult such organisations as appear to him to be representative of the dental profession.

36 Regulations as to s. 35

Regulations may provide as to the arrangements to be made under section 35 above, and shall include provision—

(a) for the preparation and publication of lists of dental practitioners who undertake to provide general dental services;

(b) for conferring a right, subject to the provisions of this Part of this Act relating to the disqualification of practitioners, on any dental practitioner, who wishes to be included in any such list, to be so included;

(c) for conferring on any person a right to choose, in accordance with the prescribed procedure, the dental practitioner from whom he is to receive general dental services, subject to the consent of the practitioner so chosen;

(d) for the removal from the list of dental practitioners undertaking to provide general dental services for persons in any area of the name of any one in whose case it has been determined in such manner as may be prescribed that he has never provided, or has ceased to provide, such general dental services for persons in that area.

37 Dental Estimates Board

Regulations providing as to the arrangements to be made under section 35 above shall include provision—

(a) for constituting a Board, to be called the Dental Estimates Board, of whom the chairman and a majority of the members shall be dental practitioners, for the purpose of carrying out such duties as may be prescribed with respect to the approval of estimates of dental treatment and appliances, and to the remuneration of dental practitioners providing general dental services;

(b) for providing in relation to that Board for any of the matters for which, in relation to an Area Health Authority, provision is or may be made by or under Part III of Schedule 5 to this Act.

General ophthalmic services

38 Arrangements for general ophthalmic services

It is every Area Health Authority's duty, in accordance with regulations, to arrange as respects their area with medical practitioners having the prescribed qualifications, ophthalmic opticians, and dispensing opticians for securing the testing of sight by such medical practitioners and ophthalmic opticians, and the supply by ophthalmic opticians and dispensing opticians of optical appliances.

The services so provided are in this Act referred to as " general ophthalmic services ".

39 Regulations as to s. 38

Regulations may provide as to the arrangements to be made under section 38 above, and shall include provision—

(a) for the preparation and publication of lists of medical practitioners, ophthalmic opticians and dispensing opticians, respectively, who undertake to provide general ophthalmic services;

(b) for conferring a right, subject to the provisions of this Act relating to the disqualification of practitioners, on any medical practitioner having the prescribed qualifications, ophthalmic optician or dispensing optician who wishes to be included in the appropriate list, to be so included;

(c) for conferring on any person a right to choose in accordance with the prescribed procedure the medical practitioner or ophthalmic optician by whom his sight is to be tested, or from whom any prescription for the supply of optical appliances is to be obtained and the ophthalmic or dispensing optician who wishes to supply the appliances;

(d) for the removal from the list of medical practitioners, ophthalmic opticians or dispensing opticians undertake-to provide general ophthalmic services for persons in any area of the name of any one in whose case it has been determined in such manner as may be prescribed that he has never provided, or has ceased to provide, such general ophthalmic services for persons in that area.

40 Medical practitioners with qualifications prescribed under s. 38

The power conferred by section 38 above (in relation to general ophthalmic services) to prescribe the qualifications to be possessed by any medical practitioner includes a power—

(a) to prescribe a requirement that the practitioner shall show to the satisfaction of a committee recognised by the Secretary of State for the purpose that he possesses such qualifications, including qualifications as to experience, as may be mentioned in the regulations; and

(b) to confer on a person who is dissatisfied with the determination of such a committee, a right of appeal to a committee appointed by the Secretary of State, and to provide for any matter for which it appears to the Secretary of State to be requisite or expedient to provide in consequence of the conferring of that right.

Pharmaceutical services

41 Arrangements for pharmaceutical services

It is every Area Health Authority's duty, in accordance with regulations, to arrange as respects their area for the supply to persons who are in that area of—

(a) proper and sufficient drugs and medicines and listed appliances which are ordered for those persons by a medical practitioner in pursuance of his functions in the health service, the Scottish health service, the Northern Ireland health service or the armed forces of the Crown (excluding forces of a Commonwealth country and forces raised in a colony); and

(b) listed drugs and medicines which are ordered for those persons by a dental practitioner in pursuance of such functions. The services so provided are in this Act referred to as " pharmaceutical services ".

In this section—

• " listed " means included in a list for the time being approved by the Secretary of State for the purposes of this section; and

• " the Scottish health service " and " the Northern Ireland health service " mean respectively the health service established in pursuance of section 1 of the [1947 c. 27.] National Health Service (Scotland) Act 1947 or any service provided in pursuance of Article 4(a) of the [1972 S.I. 1972/1265 (N.I. 14).] Health and Personal Social Services (Northern Ireland) Order 1972.

42 Regulations as to s. 41

Regulations may provide for securing that arrangements made under section 41 above will be such as to enable any person for whom they are ordered as mentioned in that section to receive the drugs, medicines and appliances there mentioned from any person with whom such arrangements have been made ; and the regulations shall include provision—

(a) for the preparation and publication of lists of persons who undertake to provide pharmaceutical services ;

(b) for conferring a right, subject to this Part of this Act relating to the disqualification of practitioners, on any person who wishes to be included in any such list to be so included for the purpose of supplying such drugs, medicines and appliances as that person is entitled by law to sell; and

(c) for the removal from the list of persons undertaking to provide pharmaceutical services for persons in any area of the name of any one in whose case it has been determined in such manner as may be prescribed that he has never provided, or has ceased to provide, such pharmaceutical services for persons in that area.

43 Persons authorised to provide pharmaceutical services

(1) No arrangements shall be made by an Area Health Authority (except as may be provided by regulations) with a medical practitioner or dental practitioner under which he is required or agrees to provide pharmaceutical services to any person to whom he is rendering general medical services or general dental services.

(2) No arrangements for the dispensing of medicines shall be made (except as may be provided by regulations) with persons other than persons who are registered pharmacists, or are persons lawfully conducting a retail pharmacy business in accordance with section 69 of the [1968 c. 67.] Medicines Act 1968 and who undertake that all medicines supplied by them under the arrangements made under this Part of this Act shall be dispensed either by or under the direct supervision of a registered pharmacist.

Local representative committees

44 Recognition of local representative committees

(1) Where the Secretary of State is satisfied that a committee formed for the area of any Area Health Authority is representative—

(a) of the medical practitioners providing general medical services or general ophthalmic services in that area, or

(b) of the dental practitioners providing general dental services in that area, or

(c) of the ophthalmic opticians and dispensing opticians providing general ophthalmic services in that area, or

(d) of the persons providing pharmaceutical services in that area,

he may recognise that committee; and any committee so recognised shall be called the Local Medical Committee, the Local Dental Committee, the Local Optical Committee or the Local Pharmaceutical Committee, as the case may be for the area concerned.

(2) Any such committee may with the Secretary of State's approval delegate any of their functions, with or without restrictions or conditions, to sub-committees composed of members of that committee.

45 Functions of local representative committees

(1) The Family Practitioner Committee for the area of an Area Health Authority in respect of which committees are recognised under section 44 above shall, in exercising their functions under this Part of this Act, consult with those committees on such occasions and to such extent as may be prescribed; and those committees shall exercise such other functions as may be prescribed.

(2) The Family Practitioner Committee may, on the request of any committee recognised under section 44 for their area, allot to that committee such sums for defraying the committee's administrative expenses (including travelling and subsistence allowances payable to its members) as may be determined by the Family Practitioner Committee with the Secretary of State's approval.

(3) Any sums so allotted shall be out of the moneys available to the Family Practitioner Committee for the remuneration of persons of whom the committee so recognised is representative and who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services, as the case may be, under this Part of this Act.

The amount of any such sums shall be deducted from the remuneration of those persons in such manner as may be determined by the Family Practitioner Committee with the Secretary of State's approval.

Provisions as to disqualification of practitioners

46 Disqualification of practitioners

(1) There shall be a tribunal (in this section and sections 47 to 49 below referred to as " the Tribunal") which shall be constituted in accordance with Schedule 9 to this Act to inquire into cases where representations are made in the prescribed manner to the Tribunal by an Area Health Authority or any other person that the continued inclusion of a person's name in a list prepared under this Part of this Act—

(a) of medical practitioners undertaking to provide general medical services,

(b) of medical practitioners undertaking to provide general ophthalmic services,

(c) of dental practitioners undertaking to provide general dental services,

(d) of ophthalmic opticians undertaking to provide general ophthalmic services,

(e) of dispensing opticians undertaking to provide general ophthalmic services, or

(f) of persons undertaking to provide pharmaceutical services,

would be prejudicial to the efficiency of the services in question.

The supplementary provisions contained in Schedule 9 apply in relation to the Tribunal.

(2) The Tribunal, on receiving representations from an Area Health Authority shall, and in any other case may, inquire into the case, and, if they are of opinion that the continued inclusion of that person's name in any list to which the representations relate would be prejudicial to the efficiency of those services—

(a) shall direct that his name be removed from that list; and

(b) may also, if they think fit, direct that his name be removed from, or not be included in, any corresponding list kept by any other Area Health Authority under this Part.

(3) An appeal shall lie to the Secretary of State from any direction of the Tribunal under subsection (2) above, and the Secretary of State may confirm or revoke that direction.

(4) Where the Tribunal direct that the name of any person be removed from or not included in any list or lists the Area Health Authority or Authorities concerned shall—

(a) if no appeal is brought, at the end of the period for bringing an appeal, or

(b) if an appeal is brought and the decision of the Tribunal is confirmed by the Secretary of State, on receiving notice of the Secretary of State's decision,

remove the name of the person concerned from the list or lists in question.

47 Removal of disqualification

(1) Any person whose name has been removed by a direction under section 46 above from any list or lists shall be disqualified for inclusion in any list to which that direction relates until the Tribunal or the Secretary of State direct under this section to the contrary.

(2) For the purpose of deciding whether or not to issue a direction under this section (or under paragraph 8 of Schedule 14 to this Act), the Tribunal or the Secretary of State, as the case may be, may hold an inquiry.

48 Disqualification provisions in Scotland or Northern Ireland

Where—

(a) under any provisions in force in Scotland or Northern Ireland corresponding to the provisions of this Part of this Act a person is for the time being disqualified for inclusion in all lists prepared under those provisions of persons undertaking to provide services of one or more of the kinds specified in section 46(1) above, then

(b) that person shall, so long as that disqualification is in force, be disqualified for inclusion in a list prepared under this Part of persons undertaking to provide services of those kinds, and the name of that person shall be removed from every such list in which his name is included.

49 Regulations as to ss. 46 to 48

Regulations shall provide—

(a) for prescribing the procedure for the holding of inquiries by the Tribunal or the Secretary of State under sections 46 to 48 above, and for the making and determining of appeals to the Secretary of State under that procedure, and, in particular for securing that any person who is the subject of such an inquiry shall have an opportunity—

(i) of appearing, either in person or by counsel or solicitor or such other representative as may be prescribed, before the Tribunal and, in the case of an inquiry by, or appeal to, the Secretary of State before a person appointed by the Secretary of State, and

(ii) of being heard by the Tribunal or the person so appointed and of calling witnesses and producing other evidence on his behalf,

and that the hearing, whether by the Tribunal or the person so appointed shall be in public if the person who is the subject of the inquiry so requests ;

(b) for conferring on the Tribunal and on any person so appointed such powers as the Secretary of State considers necessary, and for that purpose to apply, with any necessary modifications, any of the provisions of section 250 of the [1972 c. 70.] Local Government Act 1972 ; and

(c) for the publication of the decisions of the Tribunal and the Secretary of State under this section and of the imposition and removal of any disqualifications imposed under section 48 above.

Other provisions supplementary to Part II

50 Exercise of choice of practitioner in certain cases

Regulations may provide that, where a right to choose the person by whom services are to be provided under this Part of this Act is conferred by or under this Part, that right shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.

51 University clinical teaching and research

It is the Secretary of State's duty to make available, in premises provided by him by virtue of this Act, such facilities as he considers are reasonably required by any university which has a medical or dental school, in connection with clinical teaching and with research connected with clinical medicine or, as the case may be, clinical dentistry.

52 Use of accommodation

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 general medical services, general dental services, general ophthalmic services or pharmaceutical services he may make the accommodation available on such terms as he thinks fit to persons providing any of those services.

53 Immunisation

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 medical practitioner providing general medical services an opportunity to participate in the arrangements.

54 Prohibition of sale of medical practices

(1) Where the name of any medical practitioner is or has been at any time entered on any list of medical practitioners undertaking to provide general medical services, it shall be unlawful subsequently to sell the goodwill or any part of the goodwill of the medical practice of that medical practitioner.

This subsection is subject to subsections (2) and (3) below ; and the additional provisions contained in Schedule 10 to this Act have effect for the purposes of this section.

(2) Where a medical practitioner, whose name has ceased to be entered on any list of medical practitioners undertaking to provide general medical services, practises in the area of an Area Health Authority (or of an Executive Council, before its abolition under section 14 of the [1973 c. 32.] National Health Service Reorganisation Act 1973) on whose list his name has never been entered, subsection (1) above does not render unlawful the sale of the goodwill or any part of the goodwill of his practice in that area.

(3) Subsection (1) does not prevent the sale of the goodwill or any part of the goodwill of a medical practice carried on in any area, being a sale by a medical practitioner whose name has never been entered on a list of an Area Health Authority (or of an Executive Council, before its abolition) for that area of medical practitioners undertaking to provide general medical services, notwithstanding that any part of the goodwill to be sold is attributable to a practice previously carried on by a person whose name was entered on such a list.

55 Decision of disputes

Any dispute arising under this Part of this Act or any regulation made under this Part between an Area Health Authority and a person receiving, or claiming that he is entitled to receive, any services under this Part shall be referred to and decided by the Secretary of State.

56 Inadequate services

If the Secretary of State is satisfied, after such inquiry as he may think fit, as respects any area or part of an area of an Area Health Authority that the persons whose names are included in any list prepared under this Part of this Act—

(a) of medical practitioners undertaking to provide general medical services,

(b) of dental practitioners undertaking to provide general dental services,

(c) of persons undertaking to provide general ophthalmic services, or

(d) of persons undertaking to provide pharmaceutical services,

are not such as to secure the adequate provision of the services in question in that area or part, or that for any other reason any considerable number of persons in any such area or part are not receiving satisfactory services under the arrangements in force under this Part, then—

(i) he may authorise the Area Health Authority to make such other arrangements as he may approve, or may himself make other arrangements, and

(ii) he may dispense with any of the requirements of regulations made under this Part so far as appears to him necessary to meet exceptional circumstances and enable such arrangements to be made.

PART III Other Powers of the Secretary of State as to the Health Service

Control of maximum prices for medical supplies

57 Maximum price of medical supplies may be controlled

(1) The Secretary of State may by order provide for controlling maximum prices to be charged for any medical supplies required for the purposes of this Act.

(2) The Secretary of State may by direction given with respect to any undertaking, or by order made with respect to any class or description of undertakings, being an undertaking or class or description of undertakings concerned with medical supplies required for the purposes of this Act, require persons carrying on the undertaking or undertakings of that class or description—

(a) to keep such books, accounts and records relating to the undertaking as may be prescribed by the direction or, as the case may be, by the order or a notice served under the order;

(b) to furnish at such times, in such manner and in such form as may be so prescribed such estimates, returns or information relating to the undertaking as may be so prescribed.

(3) The additional provisions set out in Schedule 11 to this Act have effect in relation to this section ; and

• " medical supplies " in this section includes surgical, dental and optical materials and equipment; and

• " undertaking " in this section and that Schedule means any public utility undertaking or any undertaking by way of trade or business.

Additional powers as to services and supplies; and the use of those services and supplies for private patients

58 Additional powers as to accommodation and services

The Secretary of State may allow persons to make use (on such terms, including terms as to the payment of charges, as he thinks fit) of any accommodation or services provided under this Act and may provide the accommodation or services in question to an extent greater than that necessary apart from this section if he thinks it expedient so to do in order to allow persons to make use of them.

This section is subject to sections 59, 60 and 62 below.

59 S. 58 power in relation to private patients

(1) In this section and section 60 below " the section 58 power " means the Secretary of State's power under section 58 above to afford persons (subject to section 62 below) admission or access to accommodation or services as resident or non-resident private patients at health service hospitals.

(2) The Secretary of State shall not in the exercise of his section 58 power afford a person admission or access to accommodation or services at such a hospital as a private patient unless satisfied that the accommodation or services are required for the purposes of investigation, diagnosis or treatment which—

(a) is of a specialised nature or involves the use of specialised equipment or skills ; and

(b) is not privately available in Great Britain or, if it is so available, either—

(i) is not privately available there at a place which is reasonably accessible to the patient; or

(ii) is such that it is in the interests of the health service or of the Scottish health service or of both for it to be carried out on that occasion at that hospital.

In this subsection " privately available " means available at a satisfactory standard otherwise than at a health service hospital.

(3) The Secretary of State shall not exercise his section 58 power in such a way as to afford persons admission or access to accommodation or services at health service hospitals otherwise than in accordance with the following arrangements.

Those arrangements are such as in his opinion are best suited for securing that all persons admitted or afforded access to accommodation or services at health service hospitals as resident or non-resident patients for the purposes of investigation, diagnosis or treatment of a specialised nature, or involving the use of specialised equipment or skills, are, so far as is practicable, admitted or afforded such access on the basis of medical priority alone, whether they come as private patients or not.

(4) The Secretary of State shall not exercise his section 58 power in such a way as to allow any particular accommodation or facilities at a health service hospital to be reserved or set aside for regular or repeated use in connection with the treatment of persons as private patients.

This subsection is without prejudice to his power to allow such use in connection with the treatment of any particular person afforded admission or access to that accommodation or those facilities.

60 Additional provision as to charges under s. 58

(1) There shall be made in respect of any exercise of the section 58 power such charges as the Secretary of State may in accordance with subsections (2) and (3) below determine.

(2) Without prejudice to the generality of the Secretary of State's section 58 power to make and recover charges for any use which he may under that section allow to be made of any accommodation or services provided under this Act, the Secretary of State may in pursuance of subsection (1) above determine different rates or scales of charges—

(a) for different accommodation or services at different health service hospitals or different classes of such hospitals;

(b) for different forms or classes of treatment;

(c) in relation to patients who are, and patients who are not, ordinarily resident in Great Britain ;

(d) generally for different accommodation and for different services and in relation to different circumstances.

(3) The charges determined in pursuance of subsection (1) above—

(a) shall be such as will ensure, so far as is practicable, that no increase in the expenses incurred by the Secretary of State under this Act results from any exercise of the section 58 power ;

(b) shall include such amounts as appear to the Secretary of State proper and reasonable in respect of costs appearing to him to be properly attributable to capital account; and

(c) in the case of charges for services provided to a private patient at a health service hospital by a whole-time consultant, shall be not less than would be charged by a part-time consultant for providing similar services in similar circumstances to a private patient of his.

(4) Where a health authority receives any sum charged under section 58 for services provided to a private patient by a whole-time consultant—

(a) the authority shall retain that sum and use it for the purposes of research and development in medicine or dentistry, but

(b) if the services in question were provided by a consultant employed by a medical or dental school or university, the authority shall, if so directed by the Secretary of State, pay the sum to that school or university to use for those purposes.

(5) Nothing in this section or in section 59 above prevents the Secretary of State from allowing any medical or dental practitioner employed by a health authority to make use of any accommodation or services provided by virtue of this Act to the extent to which the practitioner would be entitled to make such use under the terms of that employment if those terms were as they were or would have been at the passing of the [1976 c. 83.] Health Services Act 1976.

(6) In this section—

• " health authority " includes a preserved Board ;

• " preserved Board " has the meaning given by section 15(6) of the [1973 c. 32.] National Health Service Reorganisation Act 1973;

• " whole-time consultant " and " part-time consultant " mean respectively a consultant employed whole-time or part-time by a health authority, medical or dental school or university.

61 Additional powers as to disposal and production of goods

(1) The Secretary of State may sell or give away, or otherwise dispose of, goods the production or manufacture of which by him is involved in the provision of services under this Act.

(2) He may, in the case of goods referred to in subsection (1) above which are prescribed for the purposes of this section, produce or manufacture them to an extent greater than that necessitated by the provision of such services in order that they may be supplied to persons other than those to whom they are supplied by way of the provision of such services whether or not the first-mentioned persons are engaged in the provision of other services provided under this Act.

(3) This section is subject to section 62 below.

62 Restriction of powers under ss. 25, 58 and 61

The Secretary of State shall exercise the powers conferred on him by the provisions of section 25 above (supplies not readily obtainable) and sections 58 and 61 above only if and to the extent that he is satisfied that anything which he proposes to do or allow under those powers—

(a) will not to a significant extent interfere with the performance by him of any duty imposed on him by this Act to provide accommodation or services of any kind; and

(b) will not to a significant extent operate to the disadvantage of persons seeking or afforded admission or access to accommodation or services at health service hospitals (whether as resident or non-resident patients) otherwise than as private patients.

Further provisions as to payments by patients for health service accommodation and services

63 Hospital accommodation on part payment

(1) The Secretary of State may authorise the accommodation described in this section to be made available, to such extent as he may determine, for patients who give an undertaking (or for whom one is given) to pay such charges for part of the cost as the Secretary of State may determine, and he may recover those charges.

The accommodation mentioned above is—

(a) in single rooms or small wards which is not for the time being needed by any patient on medical grounds;

(b) at any health service hospital or group of hospitals, or a hospital in which patients are treated under arrangements made by virtue of section 23 above, or at the health service hospitals in a particular area or a hospital in which patients are so treated.

(2) The Secretary of State may allow such deductions as he thinks fit from the amount of a charge due by virtue of an undertaking given under this section to be paid for accommodation in respect of any period during which the accommodation is temporarily vacated by the person for whom it is made available.

64 Expenses payable by remuneratively employed resident patients

The Secretary of State may require any person—

(a) who is a resident patient for whom the Secretary of State provides services under this Act; and

(b) who is absent during the day for the purpose of engaging in remunerative employment from the hospital where he is a patient,

to pay such part of the cost of his maintenance in the hospital and any incidental cost as may seem reasonable to the Secretary of State having regard to the amount of that person's remuneration, and the Secretary of State may recover the amount so required.

65 Accommodation and services for private resident patients

(1) Subject to section 71 below, if the Secretary of State is satisfied, in the case of a health service hospital or group of such hospitals or of the health service hospitals in a particular area, that it is reasonable to do so—

(a) he may, subject to this section, authorise accommodation and services at the hospital or hospitals in question to be made available to such extent as he may determine; and

(b) that accommodation and those services shall be available for resident patients who give an undertaking (or for whom one is given) to pay such charges as he may determine in accordance with the following provisions of this section, and the Secretary of State may recover those charges.

(2) The Secretary of State may allow accommodation and services to which an authorisation under subsection (1) above relates to be made available in connection with treatment, in pursuance of arrangements made by a medical practitioner or dental practitioner serving (whether in an honorary or paid capacity) on the staff of a health service hospital, of private patients of that practitioner as resident patients.

(3) The Secretary of State, for the purpose of determining charges to be paid under subsection (1) above—

(a) may classify the health service hospitals, and may, in the case of each class, determine in respect of each period of 12 months beginning with 1st April first falling after the date on which the determination is made the charges to be paid under that subsection in respect of accommodation and services provided during that period at a hospital falling within that class;

(b) in determining such charges in respect of a period the Secretary of State shall have regard, so far as is reasonably practicable, to the total cost (exclusive of costs appearing to him to be properly attributable to capital account) which, by reference to facts known to him at the time of the determination, it is estimated will be incurred during that period in the provision for resident patients of services at hospitals falling within that class; and

(c) may include in any such charges, in such cases as appear to him fit, such amounts as appear to him proper and reasonable to be included by way of contribution to expenditure appearing to him to be properly attributable to capital account.

(4) The Secretary of State may under subsection (3) above determine different charges for different accommodation and for different services and in relation to different circumstances.

(5) The Secretary of State may allow such deduction as he thinks proper from the amount of a charge due by virtue of an undertaking given under this section by or in respect of any patient—

(a) in respect of treatment given to the patient under subsection (2) above; and

(b) in respect of any period during which the accommodation to which the undertaking relates is temporarily vacated by the patient.

(6) Nothing in this section prevents accommodation from being made available for a patient other than one mentioned in subsection (1) above if the use of that accommodation is needed more urgently for him on medical grounds than for a patient so mentioned, and no other suitable accommodation is available.

66 Accommodation and services for private non-resident patients

(1) If the Secretary of State is satisfied, in the case of a health service hospital or group of such hospitals or of the health service hospitals in a particular area, that it is reasonable to do so—

(a) he may, subject to section 71 below, authorise accommodation and services at the hospital or hospitals in question to be made available to such extent as he may determine, and

(b) that accommodation and those services shall be available in connection with treatment, in pursuance of arrangements made by a medical practitioner or dental practitioner serving (whether in an honorary or paid capacity) on the staff of any such hospital, of private patients of that practitioner otherwise than as resident patients.

Those patients shall be patients who give an undertaking (or for whom one is given) to pay, in respect of the accommodation and services, such charges as the Secretary of State may determine, and he may recover those charges.

(2) The Secretary of State may under subsection (1) above determine different charges for different accommodation and for different services, and in relation to different circumstances.

(3) No accommodation and no services shall be so made available under subsection (1) above as to prejudice persons availing themselves of services at a hospital otherwise than as private patients.

Withdrawal of health service pay beds and services from private patients

67 Withdrawal of facilities available for private patients

(1) Sections 68 to 71 below have effect for the purpose of—

(a) securing the separation of the facilities available in England and Wales for the prevention, diagnosis and treatment of illness under private arrangements from the facilities available for those purposes at premises vested in the Secretary of State ; and

(b) to that end securing the progressive withdrawal of accommodation and services at health service hospitals from use in connection with the treatment of persons at such hospitals as resident or non-resident private patients.

(2) Nothing in this Part of this Act prejudices the operation of paragraph 10(4) of Schedule 5 to this Act (by virtue of which regulations governing the terms of employment of officers employed by an authority within the meaning of sub-paragraph (4) of that paragraph must not contain a requirement that all consultants so employed shall be so employed whole-time).

68 Revocation of authorisations under s. 65 or s. 66

(1) It continues to be the duty of the Health Services Board to submit to the Secretary of State from time to time in accordance with this section proposals for the progressive revocation of—

(a) the authorisations under section 65(1) above or those granted by virtue of section 71(3) below, and

(b) the authorisations under section 66(1) above or those granted by virtue of section 71(3) below,

and it shall be the Secretary of State's duty to give effect to all proposals so submitted.

(2) The Health Services Board shall in the 6 months beginning with the date on which its first proposals were submitted under section 4(2) of the [1976 c. 83.] Health Services Act 1976, and in each successive period of 6 months thereafter, submit further proposals under this section or, if in all the circumstances it decides that the submission of further proposals in any particular period of 6 months is unnecessary, shall instead prepare and submit to the Secretary of State a report explaining the Board's reasons for that decision.

(3) In formulating proposals under this section the Board shall—

(a) have regard to the principles set out in section 70 below; and

(b) consider any representations made to the Board by—

(i) the Secretary of State ;

(ii) any body which is representative of medical practitioners or dental practitioners or of persons employed in the health service or concerned with the interests of patients at health service hospitals ;

(iii) any other person having a substantial interest in the proposals.

In deciding what advice to give the Board in connection with the formulation of any such proposals the Board's Welsh Committee shall likewise have regard to the principles set out in section 70 and shall consider any representations made to the Committee by any of the persons or bodies above mentioned.

(4) Each set of proposals under this section shall specify—

(a) the accommodation and services authorisation of which under section 65(1) or section 66(1) should be revoked, and

(b) the date before which the necessary revocations should take effect,

and may specify different dates for different accommodation or services so specified.

69 Further provisions as to revocation of s. 66 authorisations

(1) Without prejudice to subsection (3) of section 68 above, the Health Services Board, in formulating proposals under that section for the revocation of authorisations given under section 66(1) above in respect of accommodation or services at any particular health service hospital or hospitals, and the Welsh Committee in deciding what advice to give the Board in connection with the formulation of any such proposals—

(a) shall have regard to the purposes and specialties for which the accommodation or services in question are available for use in connection with the treatment of non-resident private patients, and

(b) shall apply the principles set out in section 70 below separately in respect of different purposes and specialties,

and the Board may formulate separate proposals in respect of different purposes or specialties accordingly.

(2) As regards the revocation of authorisations under section 66(1), any proposals under section 68 relating to—

(a) accommodation available to consultants for the purpose of affording consultations to their private patients, or

(b) accommodation and services available for the following specialties, namely, radiotherapy, diagnostic pathology and diagnostic radiology (including scanning, ultrasonics and methods involving the use of radio-isotopes),

shall be formulated by the Board as separate proposals; and (without prejudice to section 68(1) to (3) above and subsection (1) above) the Board's first proposals under section 4(2) of the [1976 c. 83.] Health Services Act 1976 (submitted within 6 months of the passing of that Act or such longer period as the Secretary of State may allow) shall include separate proposals relating to accommodation available to consultants as mentioned in paragraph (a) above.

(3) Without prejudice to section 68 and the preceding provisions of this section, the Health Services Board shall, as regards the revocation of authorisations under section 66(1), submit separate proposals under section 68 relating to—

(a) accommodation and services available for the specialties other than radiotherapy mentioned in subsection (2)(b) above, and

(b) other accommodation and services available for diagnostic purposes,

and shall do so not later than the end of the 12 months following the initial period defined by the [1976 c. 83.] Health Services Act 1976 (that is the period of 6 months beginning with the date on which that Act was passed), or, if a period longer than the initial period has been allowed under that Act for the submission of the Board's first proposals under this section, the 12 months following that longer period.

70 Principles as to proposals under s. 68 or s. 69

The principles referred to in sections 68 and 69 above are—

(a) that accommodation or services at any particular health service hospital or hospitals should remain authorised under section 65(1) or section 66(1) above for use in connection with the treatment of resident or non-resident private patients only while there is a reasonable demand for accommodation and facilities for the private practice of medicine and dentistry in the area or areas served by the hospital or hospitals in question;

(b) that the authorisation of any such accommodation or services under those provisions for use in that connection should be revoked only if sufficient accommodation and facilities for the private practice of medicine and dentistry are otherwise reasonably available (whether privately or at health service hospitals) to meet the reasonable demand for them in the area or areas served by the hospital or hospitals in question;

(c) that the continued authorisation of any such accommodation or services under those provisions for use in that connection should depend on there having been or being taken all reasonable steps to provide, otherwise than at health service hospitals, sufficient reasonable accommodation and facilities for the private practice of medicine and dentistry to meet the reasonable demand for them in the area or areas served by the hospital or hospitals in question ;

(d) that failure, in the circumstances mentioned in paragraph (c) above, to take all reasonable steps that could be taken to provide as mentioned in that paragraph would itself be grounds for the Health Services Board, after giving due warning to persons likely to be affected thereby of the likely consequences of such failure, to propose the revocation of the authorisations under those provisions relating to accommodation or services at the hospital or hospitals in question.

71 Restrictions on authorisations under s. 65 or s. 66

(1) No authorisation—

(a) under section 65(1) or section 66(1) above shall be granted, except by virtue of subsection (2) or subsection (4) below ; and

(b) shall be, other than one granted on a temporary basis as mentioned in subsection (4), to any extent revoked otherwise than in accordance with proposals submitted to the Secretary of State by the Health Services Board under section 68 above.

(2) The Health Services Board may submit to the Secretary of State proposals for securing that in any case where one or more beds authorised under section 65(1) cease to be available to resident private patients, or any accommodation or services authorised under section 66(1) cease to be available to non-resident private patients, in consequence of the permanent closure of any health service hospital accommodation in England or Wales independently of any proposals submitted by the Board under section 68, the total number of effective beds, or the total amount of effective accommodation or services, as the case may be, so authorised in England or Wales is not thereby reduced below what it would be if—

(a) the closed accommodation had remained in use, but

(b) effect had been given by the Secretary of State to all proposals under section 68 received by him before the submission of the proposals in question under this subsection.

(3) It shall be the Secretary of State's duty to grant such authorisations under section 65(1) or section 66(1), as the case may be, as are needed to give effect to any proposals submitted to him under subsection (2) above.

(4) Where any health service hospital accommodation in England or Wales is temporarily closed (whether at the instance of the Secretary of State or not) for physical or other reasons outside his control, the Secretary of State shall, without the need for any proposals by the Board, grant on a temporary basis such authorisations under section 65(1) or section 66(1) as he would have been able to grant by virtue of subsections (2) and (3) above if—

(a) the closure had been permanent; and

(b) the Board had submitted to him any proposals which it could in that case have submitted to him under subsection (2).

(5) Subject to the restrictions imposed by this section, section 65 or, as the case may be, section 66 continue to have effect in relation to any accommodation or services to which an authorisation under section 65(1) or section 66(1) relates.

Use by practitioners of health service facilities for private practice

72 Permission for use of facilities in private practice

(1) A person to whom this section applies who wishes to use any relevant health service accommodation or facilities for the purpose of providing medical, dental, pharmaceutical, ophthalmic or chiropody services to non-resident private patients may apply in writing to the Secretary of State for permission under this section.

(2) Any application for permission under this section must specify—

(a) which of the relevant health service accommodation or facilities the applicant wishes to use for the purpose of providing services to such patients; and

(b) which of the kinds of services mentioned in subsection (1) above he wishes the permission to cover.

(3) On receiving an application under this section the Secretary of State—

(a) shall consider whether anything for which permission is sought would interfere with the giving of full and proper attention to persons seeking or afforded access otherwise than as private patients to any services provided under this Act; and

(b) shall grant the permission applied for unless in his opinion anything for which permission is sought would so interfere.

(4) Any grant of permission under this section shall be on such terms (including terms as to the payment of charges for the use of the relevant health service accommodation or facilities pursuant to the permission) as the Secretary of State may from time to time determine.

(5) The persons to whom this section applies are—

(a) persons of any of the following descriptions who provide services under Part II of this Act, namely, medical practitioners, dental practitioners, registered pharmacists, and ophthalmic or dispensing opticians; and

(b) other persons who provide pharmaceutical or ophthalmic services under Part II; and

(c) chiropodists who provide services under this Act at premises where services are provided under Part II.

(6) In this section—

(a) " relevant health service accommodation or facilities ", in relation to a person to whom this section applies, means any accommodation or facilities available at premises provided by the Secretary of State by virtue of this Act, being accommodation or facilities which that person is for the time being authorised to use for purposes of Part II; or

(b) in the case of a person to whom this section applies by virtue of paragraph (c) of subsection (5) above, accommodation or facilities which that person is for the time being authorised to use for purposes of this Act at premises where services are provided under Part II.

Information and reports

73 Information for Health Services Board

It is the Secretary of State's duty to furnish the Health Services Board with such information as it may reasonably require for the proper discharge of its functions under sections 68 to 71 above.

74 Publication of matters under ss. 68 and 71

The Secretary of State shall cause every set of proposals submitted to him under sections 68 and 71 above, and every report submitted to him under section 68(2), to be published as soon as practicable after its submission, and shall lay a copy of every such set of proposals or report before each House of Parliament.

75 Reports on extent of facilities for private patients

(1) There shall be prepared by the Secretary of State on the matters mentioned in subsection (2) below an annual report relating to England and one relating to Wales, and he shall lay a copy of every report under this section before each House of Parliament.

(2) The matters referred to under subsection (1) above are—

(a) the accommodation and services at health service hospitals which in the period covered by the report were available for use in connection with the treatment of private patients by virtue of authorisations under sections 65(1) and 66(1) above;

(b) the extent to which " the section 58 power " (as defined in section 59(1) above) was exercised in that period;

(c) the extent to which the powers to which section 62 above applies were exercised in that period otherwise than by way of affording persons admission or access to accommodation or services at health service hospitals as resident or non-resident private patients; and

(d) the extent to which progress has been made in implementing the common waiting-lists referred to in section 6 of the [1976 c. 83.] Health Services Act 1976, and in section 76 below.

76 " Common waiting-lists "

(1) The reference in paragraph (d) of section 75(2) above to common waiting-lists is to the recommendations made to the Secretary of State by the Health Services Board under section 6(1) of the [1976 c. 83.] Health Services Act 1976.

(2) Those recommendations—

(a) related to arrangements for affording persons admission or access as resident patients (authorised under section 65 above) or non-resident patients (authorised under section 66 above) to accommodation and services; and

(b) were in the Board's opinion the ones best suited for securing that all persons admitted or afforded access to accommodation or services at health service hospitals as resident or non-resident patients are, so far as practicable, admitted or afforded access thereto on the basis of medical priority alone, whether coming as private patients or not.

Regulations as to certain charges

77 Charges for drugs, medicines or appliances, or pharmaceutical services

(1) Regulations may provide for the making and recovery in such manner as may be prescribed of such charges as may be prescribed in respect of—

(a) the supply under this Act (otherwise than under Part II) of drugs, medicines or appliances (including the replacement and repair of those appliances),

(b) such of the pharmaceutical services referred to in Part II as may be prescribed,

and paragraphs (a) and (b) of this subsection may include the supply of substances and appliances mentioned in paragraph (b) of section 5(1) above.

(2) Regulations under subsection (1) above may provide for the grant, on payment of such sums as may be prescribed by those regulations, of certificates conferring on the persons to whom the certificates are granted exemption from charges otherwise exigible under the regulations in respect of drugs, medicines and appliances supplied during such period as may be prescribed, and different sums may be so prescribed in relation to different periods.

(3) The additional provisions of paragraphs 1 and 4 of Schedule 12 to this Act have effect in relation to this section.

78 Charges for dental or optical appliances

(1) Regulations may provide for the making and recovery in such manner as may be prescribed of charges of such amounts as are mentioned in sub-paragraph (1) of paragraph 2 of Schedule 12 to this Act, in respect of the supply under the Act of such dental or optical appliances as are mentioned in that sub-paragraph.

(2) If the Secretary of State, after consultation with the university associated with any hospital providing facilities for clinical dental teaching, is satisfied that it is expedient in the interests of dental training or education that the charges imposed by subsection (1) above should be remitted in the case of dental services provided at that hospital, either generally or subject to limitations or conditions, he may by order provide for that purpose.

Any order made under this subsection may be revoked or varied by a subsequent order made by the Secretary of State after such consultation as is mentioned above.

(3) The additional provisions of paragraphs 2 and 5 of Schedule 12 have effect in relation to this section.

79 Charges for dental treatment

(1) A charge of the amount authorised by this section may be made and recovered, in such manner as may be prescribed, in respect of any services provided as part of the general dental services under Part II of this Act, not being—

(a) the supply or replacement of appliances mentioned in paragraph 2(1) of Schedule 12 to this Act;

(b) the repair of appliances other than prescribed appliances;

(c) the arrest of bleeding ; or

(d) the clinical examination of a patient and any report on that examination.

The additional provisions of paragraphs 3 and 5 of Schedule 12 have effect in relation to this subsection.

(2) Regulations may provide that, in the case of such special dental treatment as may be prescribed, being treatment provided as part of the general dental services, such charges as may be prescribed may be made and recovered by the person providing the services.

80 Charges for designated facilities

Regulations may provide for the making and recovery of charges in respect of facilities designated by the regulations as facilities provided in pursuance of paragraph (d) or paragraph (e) of section 3(1) above.

81 Charges for more expensive supplies

Regulations may provide for the making and recovery of such charges as may be prescribed—

(a) by the Secretary of State in respect of the supply by him of any appliance or vehicle which is, at the request of the person supplied, of a more expensive type than the prescribed type, or in respect of the replacement or repair of any such appliance, or the replacement of any such vehicle, or the taking of any such action in relation to the vehicle as is mentioned in paragraph 1 of Schedule 2 to this Act;

(b) by persons providing general dental services or general ophthalmic services in respect of the supply, as part of those services, of any dental or optical appliance which is, at the request of the person supplied, of a more expensive type than the prescribed type or in respect of the replacement or repair of any such appliance.

82 Charges for repairs and replacements in certain cases

Regulations may provide for the making and recovery of such charges as may be prescribed—

(a) by the Secretary of State in respect of the replacement or repair of any appliance or vehicle supplied by him, or

(b) by persons providing general dental services or general ophthalmic services in respect of the replacement or repair of any dental or optical appliance supplied as part of those services,

if it is determined in the prescribed manner that the replacement or repair is necessitated by an act or omission of the person supplied or (if the act or omission occurred when the person supplied was under 16 years of age) of the person supplied or of the person having charge of him when the act or omission occurred.

83 Sums otherwise payable to those providing services

Regulations made—

(a) under sections 77 to 79 and under sections 81 and 82 above providing for the making and recovery of charges in respect of any services, may provide for the reduction of the sums which would otherwise be payable by a Regional Health Authority, an Area Health Authority or a Family Practitioner Committee to the persons by whom those services are provided by the amount of the charges authorised by the regulations in respect of those services ;

(b) for the purposes of section 78(1) in relation to appliances provided as part of the general dental services or the general ophthalmic services under Part II of this Act, may provide for the reduction of the sums which would otherwise be payable by an Area Health Authority or a Family Practitioner Committee to the persons by whom those services are provided by the amount of the charges authorised by section 78(1) in respect of those appliances.

Inquiries, and default and emergency powers

84 Inquiries

(1) The Secretary of State may cause an inquiry to be held in any case where he deems it advisable to do so in connection with any matter arising under this Act.

(2) For the purpose of any such inquiry (but subject to subsection (3) below) the person appointed to hold the inquiry—

(a) may by summons require any person to attend, at a time and place stated in the summons, to give evidence or to produce any documents in his custody or under his control which relate to any matter in question at the inquiry; and

(b) may take evidence on oath, and for that purpose administer oaths, or may, instead of administering an oath, require the person examined to make a solemn affirmation.

(3) Nothing in this section—

(a) requires a person, in obedience to a summons under the section, to attend to give evidence or to produce any documents unless the necessary expenses of his attendance are paid or tendered to him ; or

(b) empowers the person holding the inquiry to require the production of the title, or of any instrument relating to the title, of any land not being the property of a local authority.

(4) Any person who refuses or deliberately fails to attend in obedience to a summons under this section, or to give evidence, or who deliberately alters, suppresses, conceals, destroys, or refuses to produce any book or other document which he is required or is liable to be required to produce for the purposes of this section, shall be liable on summary conviction to a fine not exceeding £100 or to imprisonment for a term not exceeding 6 months, or to both.

(5) Where the Secretary of State causes an inquiry to be held under this section—

(a) the costs incurred by him in relation to the inquiry (including such reasonable sum not exceeding £30 a day as he may determine for the services of any officer engaged in the inquiry) shall be paid by such local authority or party to the inquiry as he may direct, and

(b) he may cause the amount of the costs so incurred to be certified, and any amount so certified and directed to be paid by any authority or person shall be recoverable from that authority or person by the Secretary of State summarily as a civil debt.

No local authority shall be ordered to pay costs under this subsection in the case of any inquiry unless it is a party to that inquiry.

(6) Where the Secretary of State causes an inquiry to be held under this section he may make orders—

(a) as to the costs of the parties at the inquiry, and

(b) as to the parties by whom the costs are to be paid,

and every such order may be made a rule of the High Court on the application of any party named in the order.

85 Default powers

(1) Where the Secretary of State is of opinion, on complaint or otherwise, that—

(a) any Regional Health Authority ;

(b) any Area Health Authority;

(c) any special health authority;

(d) any Family Practitioner Committee ;

(e) any local social services authority;

(f) the Medical Practices Committee ; or

(g) the Dental Estimates Board ;

have failed to carry out any functions conferred or imposed on them by or under this Act, or have in carrying out those functions failed to comply with any regulations or directions relating to those functions, he may after such inquiry as he may think fit make an order declaring them to be in default.

(2) Except where the body in default is a local social services authority, the members of the body shall forthwith vacate their office, and the order—

(a) shall provide for the appointment, in accordance with the provisions of this Act, of new members of the body; and

(b) may contain such provisions as seem to the Secretary of State expedient for authorising any person to act in the place of the body in question pending the appointment of new members.

(3) If the body in default is a local social services authority—

(a) the order shall direct them, for the purpose of remedying the default, to discharge such of their functions, in such manner and within such time or times, as may be specified in the order; and

(b) if the authority fail to comply with any direction given under this subsection within the time so limited, the Secretary of State, instead of enforcing the order by mandamus or otherwise, may make an order transferring to himself such of the functions of the authority as he thinks fit.

(4) Any expenses certified by the Secretary of State to have been incurred by him in discharging functions transferred to him under this section from a local social services authority shall on demand be paid to him by that authority and shall be recoverable by him from them as a debt due to the Crown; and

(a) the authority or (in the case of a joint board) any constituent local authority thereof shall have the like power of raising the money required as they have of raising money for paying expenses incurred directly by them ; and

(b) the payment of any such expenses so incurred by the Secretary of State shall, to such extent as he may sanction, be a purpose for which the authority may borrow money in accordance with the statutory provisions relating to borrowing by that authority.

(5) An order made under this section may contain such supplementary and incidental provisions as appear to the Secretary of State to be necessary or expedient, including—

(a) provision for the transfer to the Secretary of State of property and liabilities of the body in default; and

(b) where any such order is varied or revoked by a subsequent order, provision in the revoking order or a subsequent order for the transfer to the body in default of any property or liabilities acquired or incurred by the Secretary of State in discharging any of the functions transferred to him.

86 Emergency powers

If the Secretary of State—

(a) considers that by reason of an emergency it is necessary, in order to ensure that a service falling to be provided in pursuance of this Act is provided, to direct that during the period specified by the directions a function conferred on any body or person by virtue of this Act shall to the exclusion of or concurrently with that body or person be performed by another body or person, then

(b) he may give directions accordingly and it shall be the duty of the bodies or persons in question to comply with the directions.

The powers conferred on the Secretary of State by this section are in addition to any other powers exercisable by him.

PART IV Property and Finance

Land and other Property

87 Acquisition, use and maintenance of property

(1) The Secretary of State may acquire—

(a) any land, either by agreement or compulsorily,

(b) any other property,

required by him for the purposes of this Act; and (without prejudice to the generality of paragraph (a) above) land may be so acquired to provide residential accommodation for persons employed for any of those purposes.

(2) The Secretary of State may use for the purposes of any of the functions conferred on him by this Act any property belonging to him by virtue of this Act, and he has power to maintain all such property.

(3) A local social services authority may be authorised to purchase land compulsorily for the purposes of this Act by means of an order made by the authority and confirmed by the Secretary of State.

(4) The [1946 c. 49.] Acquisition of Land (Authorisation Procedure) Act 1946 shall apply to the compulsory purchase of land by the Secretary of State under this section, and accordingly shall have effect—

(a) as if section 1(1) of that Act (which refers to the compulsory purchase of land by local authorities under public general Acts in force immediately before the commencement of that Act and by the Minister of Transport under certain enactments) included a reference to any compulsory purchase of land by the Secretary of State under this section; and

(b) as if this section had been in force immediately before the commencement of that Act.

(5) Section 120(3) of the [1972 c. 70.] Local Government Act 1972 (which relates to the application of Part I of the [1965 c. 56.] Compulsory Purchase Act 1965 where a council are authorised to acquire land by agreement) applies to the acquisition of land by the Secretary of State under this section in like manner as it applies to such acquisition by a council under that section.

(6) Section 128 of the [1971 c. 78.] Town and Country Planning Act 1971 (use and development of consecrated land and burial grounds) applies to consecrated land and land comprised in a burial ground within the meaning of that section which—

(a) the Secretary of State holds for any of the purposes of the health service, and

(b) has not been acquired by him as mentioned in subsection (1) of that section,

as if that land had been so acquired for those purposes.

88 Transferred property free of trusts

(1) All property vested in the Secretary of State in consequence of the transfer of that property under section 6 of the [1946 c. 81.] National Health Service Act 1946 (transfer of hospitals) so vests free of any trust existing immediately before that transfer.

(2) The Secretary of State may use any such property for the purpose of any of his functions under this Act, but he shall so far as practicable secure that the objects for which any such property was used immediately before that transfer are not prejudiced by section 6 of that Act of 1946.

89 Power of voluntary organisations to transfer property

Notwithstanding anything contained—

(a) in the constitution or rules of any voluntary organisation formed for the purpose of providing a service of nurses for attendance on the sick in their own homes, or of midwives, or

(b) in any trust deed or other instrument relating to such organisation or service,

any property vested in the organisation or held by any persons on trust for the organisation or service or for any specific purposes connected with the organisation or service may be transferred to the Secretary of State, on such terms as may be agreed between him and the organisation or trustees, with a view to the property being used or held by him for purposes similar to the purposes for which it was previously used or held.

Trusts

90 Gifts on trust

A health authority has power to accept, hold and administer any property on trust for all or any purposes relating to the health service.

91 Private trusts for hospitals

(1) Where—

(a) the terms of a trust instrument authorise or require the trustees, whether immediately or in the future, to apply any part of the capital or income of the trust property for the purposes of any health service hospital, then

(b) the trust instrument shall be construed as authorising or (as the case may be) requiring the trustees to apply the trust property to the like extent, and at the like times, for the purpose of making payments, whether of capital or income, to the appropriate hospital authority.

(2) Any sum so paid to the appropriate hospital authority shall, so far as practicable, be applied by them for the purpose specified in the trust instrument.

(3) In this section " the appropriate hospital authority" means—

(a) where special trustees are appointed for the hospital, those trustees;

(b) in any other case, the Area Health Authority exercising functions on behalf of the Secretary of State in respect of the hospital.

(4) Nothing in this section applies to a trust for a special hospital, or to property transferred under section 24 of the [1973 c. 32.] National Health Service Reorganisation Act 1973.

92 Further transfers of trust property

(1) The Secretary of State may, having regard to any change or proposed change in the arrangements for the administration of a hospital or in the area or functions of any health authority, by order provide for the transfer of any trust property from any health authority or special trustees to any other health authority or special trustees.

(2) If it appears to the Secretary of State at any time that all the functions of any special trustees should be discharged by one or more health authorities then, whether or not there has been any such change as is mentioned in subsection (1) above, he may by order provide for the transfer of all trust property from the special trustees to the health authority, or, in such proportions as he may specify in the order, to those health authorities.

(3) Before so acting the Secretary of State shall consult the health authorities and special trustees concerned.

(4) Where by an order under this section, property is transferred to two or more authorities, it shall be apportioned by them in such proportions as they may agree or as may in default of agreement be determined by the Secretary of State, and the order may provide for the way in which the property is to be apportioned.

(5) Where property is so apportioned, the Secretary of State may by order make any consequential amendments of the trust instrument relating to the property.

93 Trust property previously held for general hospital purposes

(1) This section applies—

(a) to property transferred under section 23 of the [1973 c. 32.] National Health Service Reorganisation Act 1973 (winding-up of hospital endowments funds), and

(b) to property transferred under section 24 of that Act (transfer of trust property from abolished authorities) which immediately before the day appointed for the purposes of that section was, in accordance with any provision contained in or made under section 7 of the [1946 c. 81.] National Health Service Act 1946, applicable for purposes relating to hospital services or relating to some form of research,

and this section continues to apply to the property after any further transfer under section 92 above.

(2) The person holding the property after the transfer or last transfer shall secure, so far as is reasonably practicable, that the objects of any original endowment and the observance of any conditions attached to that endowment, including in particular conditions intended to preserve the memory of any person or class of persons, are not prejudiced by this Part of this Act, or Part II of that Act of 1973.

In this subsection " original endowment" means a hospital endowment which was transferred under section 7 of that Act of 1946 and from which the property in question is derived.

(3) Subject to subsection (2) above, the property shall be held on trust for such purposes relating to hospital services (including research), or to any other part of the health service associated with any hospital, as the person holding the property thinks fit.

(4) Where the person holding the property is a body of special trustees, the power conferred by subsection (3) above shall be exercised as respects the hospitals for which they are appointed.

94 Application of trust property: further provisions

(1) Any discretion given by a trust instrument to the trustees of property transferred under—

(a) section 24 of the National Health Service Reorganisation Act 1973 (transfer of trust property from abolished authorities),

(b) section 25 of that Act (transfer of trust property held for health services by local health authorities),

(c) section 92 above,

shall be exercisable by the person to whom the property is so transferred and, subject to section 93 above and the following provisions of this section, the transfer shall not affect the trusts on which the property is held.

(2) Where—

(a) property has been transferred under section 24 of that Act of 1973, and

(b) any discretion is given by a trust instrument to the trustees to apply the property, or income arising from the property, to such hospital services (including research) as the trustees think fit without any restriction on the kinds of hospital services and without any restriction to one or more specified hospitals,

the discretion shall be enlarged so as to allow the application of the property or (as the case may be) of the income arising from the property, to such extent as the trustees think fit, for any other part of the health service associated with any hospital.

(3) Subsection (2) above shall apply on any subsequent transfer of the property under section 92 above.

95 Special trustees for a university or teaching hospital

(1) The bodies of trustees (in this Act referred to as special trustees) appointed by the Secretary of State under section 29 of the [1973 c. 32.] National Health Service Reorganisation Act 1973 and this section shall (subject to section 92 above) hold and administer the property transferred to them under that Act of 1973.

The special trustees so appointed are bodies of trustees appointed for the hospital or hospitals which, immediately before the day appointed for the purposes of section 29 of that Act of 1973, were controlled and managed by a University Hospital Management Committee or a Board of Governors, but excluding—

(a) a body on whose request an order was made under section 24(2) of that Act of 1973 ;

(b) a preserved Board within the meaning of section 15(6) of that Act of 1973.

(2) Special trustees have power to accept, hold and administer any property on trust for all or any purposes relating to hospital services (including research), or to any other part of the health service associated with hospitals, being a trust which is wholly or mainly for hospitals for which the special trustees are appointed.

(3) The number of trustees for any hospital or hospitals shall be such as the Secretary of State may from time to time determine after consultation with such persons as he considers appropriate.

(4) The term of office of any special trustee shall be fixed by the Secretary of State but a special trustee may be removed by the Secretary of State at any time during the special trustee's term of office.

96 Trusts: supplementary provisions

(1) Any provision in sections 90 to 95 above for the transfer of any property includes provision for the transfer of any rights and liabilities arising from that property.

(2) Nothing in those sections shall affect any power of Her Majesty, the court (as defined in the [1960 c. 58.] Charities Act 1960) or any other person to alter the trusts of any charity.

(3) Nothing in section 12 of the [1895 c. 16.] Finance Act 1895 (which requires certain Acts and certain instruments relating to the vesting of property by virtue of an Act to be stamped as conveyances on sale) applies to sections 90 to 95 above or to an order made in pursuance of any of those sections; and stamp duty shall not be payable on such an order.

Finance and Accounts

97 Expenses of health authorities

(1) It is the Secretary of State's duty to pay—

(a) to each Area Health Authority in Wales and each Regional Health Authority the sums needed to defray such expenditure of the Authority as the Secretary of State approves in the prescribed manner;

(b) to each Family Practitioner Committee sums equal to the expenses which the Secretary of State determines are incurred by the Committee for the purpose of performing the functions conferred on the Committee by virtue of this Act; and

(c) to each special health authority sums equal to such of the expenses of the authority as are not defrayed by payments made to the authority in pursuance of subsection (3) below.

(2) It is the duty of each Regional Health Authority to pay to each Area Health Authority of which the area is included in the region of the Regional Health Authority the sums needed to defray such expenses of the Area Health Authority as the Regional Health Authority approves in the prescribed manner.

(3) Where an order establishing a special health authority provides for any expenses of the authority to be defrayed by a Regional or Area Health Authority or by two or more such Authorities in portions determined by or in accordance with the order, it is the duty of each Authority in question to pay to the special health authority sums equal to, or to the appropriate portion of, those expenses.

(4) Sums falling to be paid under this section shall be payable subject to compliance with such conditions as to records, certificates or otherwise as the Secretary of State may determine.

98 Accounts and audit

(1) Accounts, in such form as the Secretary of State may with the approval of the Treasury direct, shall be kept by—

(a) every Regional Health Authority ;

(b) every Area Health Authority;

(c) every special health authority;

(d) all special trustees appointed in pursuance of section 29(1) of the [1973 c. 32.] National Health Service Reorganisation Act 1973 and section 95(1) above ;

(e) the Dental Estimates Board.

Those accounts shall be audited by auditors appointed by the Secretary of State, and the Comptroller and Auditor General may examine all such accounts and any records relating to them, and any report of the auditor on them.

(2) Every such body shall prepare and transmit to the Secretary of State in respect of each financial year annual accounts in such form as the Secretary of State may with the approval of the Treasury direct.

The accounts prepared and transmitted by an Area Health Authority in pursuance of this subsection shall include annual accounts of the Family Practitioner Committees established by the Authority and of any Community Health Council of which the district includes any part of the Authority's area.

(3) The Secretary of State may by regulations provide generally with respect to the audit under subsection (1) above of accounts of bodies to which that subsection applies; and in particular for conferring on the auditor of any of those accounts—

(a) such rights of access to, and production of, books, accounts, vouchers or other documents as may be specified in the regulations ; and

(b) such right, in such conditions as may be so specified, to require from any member or officer, or former member or officer, of any such body, such information relating to the affairs of the body as the Secretary of State may think necessary for the proper performance of the auditor's duty under this section.

(4) The Secretary of State shall prepare in respect of each financial year—

(a) in such form as the Treasury may direct, summarised accounts of those Authorities, special authorities and special trustees:

(b) in such form and containing such information as the Treasury may direct, a statement of the accounts of the Dental Estimates Board ;

and shall transmit them on or before 30th November in each year to the Comptroller and Auditor General, who shall examine and certify them, and lay copies of them together with his report on them before both Houses of Parliament.

99 Regulation of financial arrangements

(1) The Secretary of State may by regulations provide, in the case of all or any of the following bodies—

(a) Regional Health Authorities,

(b) Area Health Authorities,

(c) special health authorities,

(d) Family Practitioner Committees,

(e) Community Health Councils, and

(f) the Dental Estimates Board,

for restricting the making of payments by or on behalf of the body otherwise than on such authorisation and subject to such conditions as may be specified in the regulations.

(2) Such provision may be made subject to such exceptions as may be so specified, and those regulations may contain such other provisions as to the making and carrying out by all or any of those bodies of such arrangements with respect to financial matters as the Secretary of State thinks necessary for the purpose of securing that the affairs of such bodies are conducted, so far as reasonably practicable, in such manner as to prevent financial loss and to ensure and maintain efficiency.

(3) The Secretary of State may give directions to any of those bodies as to any matter with respect to which those regulations may be made; and those directions may be specific in character and shall be—

(a) such as appear to him requisite to secure that the affairs of the body are conducted in such a manner as is mentioned in subsection (2) above,

(b) without prejudice to the operation of any such regulations,

and shall be complied with by the body to whom they are given.

100 Other payments

(1) There shall be paid out of moneys provided by Parliament such expenses incurred by—

(a) the Central Council,

(b) any standing advisory committee constituted under section 6 above,

(c) the Medical Practices Committee,

(d) the Tribunal constituted under section 46 above, and

(e) the Dental Estimates Board,

as may be determined by the Secretary of State with the approval of the Treasury.

(2) Payments made under this section shall be in accordance with regulations made by the Secretary of State and approved by the Treasury, and shall be made at such times and in such manner as the Treasury may direct, and subject to such conditions as to records, certificates, or otherwise as the Secretary of State may with the approval of the Treasury determine.

101 Secretary of State's receipts

Any sums received by the Secretary of State under this Act shall be paid into the Consolidated Fund, but this section is without prejudice to section 60(4) above.

Miscellaneous provisions as to remuneration, allowances and superannuation

102 Allowances and remuneration for members of certain bodies

(1) The Secretary of State may pay such travelling and other allowances, including compensation for loss of remunerative time, as he may, with the approval of the Minister for the Civil Service, determine—

(a) to members of any of the following bodies constituted under this Act—

(i) the Central Council, any standing advisory committee constituted under section 6 above to advise the Secretary of State and that Council, any committee appointed by that Council under paragraph 4 of Schedule 4 to this Act and any sub-committee appointed by any such standing advisory committee under that paragraph;

(ii) the Medical Practices Committee;

(iii) any body on which functions are conferred by regulations under section 32 above;

(iv) the Dental Estimates Board ;

(v) the Tribunal constituted under section 46 above;

(b) to members of any other body being a body specified in an order made by the Secretary of State as being a body recognised by him to have been formed for the purpose of performing a function connected with the provision of services under this Act.

(2) The Secretary of State may pay to members of any of the following bodies such remuneration as he may, with the approval of the Minister for the Civil Service, determine—

(a) the Medical Practices Committee;

(b) any body on which functions are conferred by regulations under section 32 above;

(c) the Dental Estimates Board ;

(d) the Tribunal constituted under section 46 above;

(e) any other body constituted under Part II of this Act, being a body specified in an order made for the purposes of this subsection, with the approval of the Minister for the Civil Service, by the Secretary of State.

(3) Allowances shall not be paid under subsection (1) above except in connection with the exercise or performance of such powers or duties, in such circumstances, as may, with the approval of the Minister for the Civil Service, be determined by the Secretary of State.

(4) Any payments under this section shall be made at such times and in such manner, and subject to such conditions as to records, certificates or otherwise, as the Secretary of State may, with the approval of the Minister for the Civil Service, determine.

103 Special arrangement as to payment of remuneration

(1) If the Secretary of State—

(a) considers it appropriate for remuneration in respect of services provided by any person in pursuance of Part II of this Act to be paid by a particular body, and

(b) apart from this section the functions of the body do not include the function of paying the remuneration,

the Secretary of State may by order confer that function on the body.

(2) Any sums required to enable any body having that function to pay remuneration in respect of such services shall, if apart from this section there is no provision authorising the payment of the sums by the Secretary of State or out of money provided by Parliament, be paid by him.

104 Superannuation of officers of certain hospitals

(1) The Secretary of State may enter into an agreement with the governing body of any hospital to which this section applies—

(a) for admitting officers of the hospital of such classes as may be provided in the agreement to participate, on such terms and conditions as may be so provided, in the superannuation benefits provided under regulations made under section 10 of the [1972 c. 11.] Superannuation Act 1972 in like manner as officers of Area Health Authorities ; and

(b) those regulations shall apply accordingly in relation to the officers so admitted subject to such modifications as may be provided in the agreement.

(2) The governing body of any hospital to which this section applies shall have all such powers as may be necessary for the purpose of giving effect to any terms and conditions on which their officers are admitted to participate in those superannuation benefits.

(3) This section applies to any hospital (not vested in the Secretary of State) which is used, in pursuance of arrangements made by the governing body of the hospital with the Secretary of State, for the provision of services under this Act.

105 Payments for certain medical examinations

(1) Where a medical practitioner carries out a medical examination of any person with a view to an application for his admission to hospital for observation or treatment being made under Part IV of the [1959 c. 72.] Mental Health Act 1959 the council which is the local authority for the purposes of the [1970 c. 42.] Local Authority Social Services Act 1970 for the area where the person examined resides shall, subject to the following provisions of this section, pay to that medical practitioner—

(a) reasonable remuneration in respect of that examination and in respect of any recommendation or report made by him with regard to the person examined; and

(b) the amount of any expenses reasonably incurred by him in connection with the examination or the making of any such recommendation or report.

(2) No payment shall be made under this section to a medical practitioner—

(a) in respect of an examination carried out as part of his duty to provide general medical services for the person examined; or

(b) in respect of an examination carried out or any recommendation or report made as part of his duty as an officer of a health authority.

(3) This section shall only apply in a case where it is intended, when the medical examination of the person in question is carried out, that if he is admitted to hospital in pursuance of any such application as mentioned in subsection (1) above, the whole cost of his maintenance and treatment will be defrayed out of moneys provided by Parliament under this Act or the Mental Health Act 1959.

PART V Health Service Commissioner for England and Health Service Commissioner for Wales

106 Appointment and tenure of office of Commissioners

(1) For the purpose of conducting investigations in accordance with this Part of this Act, there shall be appointed—

(a) a Commissioner to be known as the Health Service Commissioner for England ; and

(b) a Commissioner to be known as the Health Service Commissioner for Wales.

(2) Her Majesty may by Letters Patent from time to time appoint a person to be a Commissioner; and a person so appointed shall, subject to subsection (3) below, hold office during good behaviour.

(3) A person appointed to be a Commissioner may be relieved of office by Her Majesty at his own request, or may be removed from office by Her Majesty in consequence of Addresses from both Houses of Parliament, and shall in any case vacate office on completing the year of service in which he attains the age of sixty-five.

(4) A person who is a member of a relevant body (within the meaning of section 109 below) shall not be appointed to be a Commissioner; and a Commissioner shall not become a member of a relevant body.

107 Salaries and pensions of Commissioners

(1) Subject to subsections (3) and (5) below, there shall be paid to the holder of the office of a Commissioner the same salary as if he were employed in the civil service of the State in such appointment as the House of Commons may by resolution from time to time determine ; and any such resolution may take effect from the date on which it is passed, or from such other date as it may specify.

(2) Subject to subsections (6) and (7) below, Schedule 1 to the [1967 c. 13.] Parliamentary Commissioner Act 1967 (which relates to pensions and other benefits) has effect with respect to persons who have held office as a Commissioner as it has effect with respect to persons who have held office as the Parliamentary Commissioner for Administration.

(3) The salary payable to a holder of the office of a Commissioner shall be abated by the amount of any pension payable to him in respect of any public office in the United Kingdom or elsewhere to which he has previously been appointed or elected.

(4) In computing the salary of a former holder of the office of Commissioner for the purposes of Schedule 1 to that Act of 1967 there shall be disregarded—

(a) any abatement of that salary under subsection (3) above;

(b) any temporary abatement of that salary in the national interest; and

(c) any voluntary surrender of that salary in whole or in part.

(5) Where—

(a) a person holds the office of Parliamentary Commissioner for Administration and one or more of the offices of Health Service Commissioner for England, Health Service Commissioner for Scotland and Health Service Commissioner for Wales he shall, so long as he does so, be entitled only to the salary pertaining to the first-mentioned office ; and

(b) a person holds two or more of those offices other than that of Parliamentary Commissioner for Administration he shall, so long as he does so, be entitled only to the salary pertaining to such one of those offices as he selects.

(6) A person—

(a) shall not be entitled to make simultaneously different elections in pursuance of paragraph 1 of Schedule 1 to that Act of 1967 in respect of different offices mentioned in subsection (5) above, and

(b) shall, if he has made or is treated as having made an election in pursuance of that paragraph in respect of such an office, be deemed to have made the same election in respect of all such other offices to which he is, or is subsequently, appointed,

and no account shall be taken for the purposes of that Schedule of a period of service in such an office if salary in respect of the office was not paid for that period.

(7) The Minister for the Civil Service may—

(a) by regulations provide that Schedule 1 to that Act of 1967 shall have effect in relation to persons who have held more than one of the offices mentioned in subsection (5) above, and

(b) by those regulations modify that Schedule as he considers necessary in consequence of those persons having held more than one of those offices,

and different regulations may be made in pursuance of paragraph 4 of that Schedule in relation to different offices as mentioned.

This subsection is subject to subsection (6) above.

(8) Any salary, pension or other benefit payable by virtue of this section shall be charged on and issued out of the Consolidated Fund.

108 Administrative provisions

(1) A Commissioner may appoint such officers as he may determine with the approval of the Minister for the Civil Service as to numbers and conditions of service; and it is the duty of the Health Service Commissioner for Wales to include among his officers such persons having a command of the Welsh language as he considers are needed to enable him to investigate complaints in Welsh.

(2) Any functions of a Commissioner under this Part of this Act may be performed by any officer of the Commissioner authorised by him for that purpose, or by any officer so authorised of another Commissioner mentioned in section 107(5) above.

(3) To assist him in any investigation, a Commissioner may obtain advice from any person who, in his opinion, is qualified to give it, and may pay such fees or allowances to any such person as he may determine with the approval of the Minister for the Civil Service.

(4) The expenses of a Commissioner under this Part of this Act, to such amount as may be sanctioned by the Minister for the Civil Service, shall be defrayed out of money provided by Parliament.

109 Bodies subject to investigation

In this Part of this Act " relevant body " means any of the following bodies—

(a) Regional Health Authorities;

(b) Area Health Authorities;

(c) any special health authority established on or before 1st April 1974;

(d) any special health authority established after that 1st April and designated by Order in Council as an authority to which this section applies ;

(e) Family Practitioner Committees ;

(f) the Public Health Laboratory Service Board ; and

(g) the Health Services Board and its Welsh Committee.

Except where the context otherwise requires, any reference in this Part of this Act to a relevant body includes a reference to an officer of the body.

110 Investigations for England, and for Wales

The Health Service Commissioner for England shall not conduct an investigation under this Part of this Act in respect of—

(a) an Area Health Authority of which the area is in Wales,

(b) the Family Practitioner Committee established by such an Authority,

(c) a special health authority exercising functions only or mainly in Wales, or

(d) the Welsh Committee of the Health Services Board,

and the Health Service Commissioner for Wales shall not conduct such an investigation in respect of a relevant body other than one of those bodies.

111 Who may complain

(1) A complaint under this Part of this Act may be made by any individual, or by any body of persons whether incorporated or not, not being—

(a) a local authority or other authority or body constituted for purposes of the public service or of local government, or for the purposes of carrying on under national ownership any industry or undertaking or part of an industry or undertaking;

(b) any other authority or body whose members are appointed by Her Majesty or any Minister of the Crown or government department, or whose revenues consist wholly or mainly of money provided by Parliament.

(2) Where the person by whom a complaint might have been made under the preceding provisions of this Part has died, or is for any reason unable to act for himself, the complaint may be made—

(a) by his personal representative, or

(b) by a member of his family, or

(c) by some body or individual suitable to represent him,

but, except as aforesaid and as provided by section 117 below, a complaint shall not be entertained under this Part unless made by the person aggrieved himself.

112 Reply

Before proceeding to investigate a complaint—

(a) a Commissioner shall satisfy himself that the complaint has been brought by or on behalf of the person aggrieved to the notice of the relevant body in question, and that that body had been afforded a reasonable opportunity to investigate and reply to the complaint, but

(b) a Commissioner shall disregard the provisions of paragraph (a) in relation to a complaint made by an officer of the relevant body in question on behalf of the person aggrieved if the officer is authorised by virtue of section 111(2) above to make the complaint and the Commissioner is satisfied that in the particular circumstances those provisions ought to be disregarded.

113 Commissioner's discretion

(1) In determining whether to initiate, continue or discontinue an investigation under this Part of this Act, a Commissioner shall, subject to section 110 above and sections 115 and 116 below, act in accordance with his own discretion.

(2) Any question whether a complaint is duly made to a Commissioner under this Part shall be determined by the Commissioner.

114 Procedure, and additional procedural provisions

(1) A Commissioner—

(a) shall not entertain a complaint under this Part of this Act unless it is made in writing to him by or on behalf of the person aggrieved not later than one year from the day on which the person aggrieved first had notice of the matters alleged in the complaint, but

(b) may conduct an investigation pursuant to a complaint not made within that period if he considers it reasonable to do so.

(2) The additional provisions contained in Part I of Schedule 13 to this Act, which relate to procedure and other matters, have effect for the purposes of this Part.

115 Matters subject to investigation

A Commissioner may investigate—

(a) an alleged failure in a service provided by a relevant body, or

(b) an alleged failure of such a body to provide a service which it was a function of the body to provide, or

(c) any other action taken by or on behalf of such a body,

in a case where a complaint is duly made by or on behalf of any person that he has sustained injustice or hardship in consequence of the failure or in consequence of maladministration connected with the other action.

This section is subject to sections 110 and 113 above and section 116 below.

116 Matters not subject to investigation

(1) Except as hereafter provided, a Commissioner shall not conduct an investigation under this Part of this Act in respect of any of the following matters—

(a) any action in respect of which the person aggrieved has or had a right of appeal, reference or review to or before a tribunal constituted by or under any enactment or by virtue of Her Majesty's prerogative, or

(b) any action in respect of which the person aggrieved has or had a remedy by way of proceedings in any court of law,

but a Commissioner may conduct an investigation notwithstanding that the person aggrieved has or had such a right or remedy, if satisfied that in the particular circumstances it is not reasonable to expect him to resort or have resorted to it.

(2) Without prejudice to subsection (1) above—

(a) a Commissioner shall not conduct an investigation under this Part in respect of any such action as is described in Part II of Schedule 13 to this Act; and

(b) nothing in sections 110, 113 and 115 above shall be construed as authorising such an investigation in respect of action taken in connection with any general medical services, general dental services, general ophthalmic services or pharmaceutical services by a person providing the services.

(3) Her Majesty may by Order in Council amend Part II of Schedule 13 so as to exclude from it action described in sub-paragraph (3) or (4) of paragraph 19 of that Schedule.

117 Reference to Commissioner by relevant body

Notwithstanding anything in sections 111 and 112 and section 114(1) above, a relevant body—

(a) may itself (excluding its officers) refer to a Commissioner a complaint that a person has, in consequence of a failure or maladministration for which the body is responsible, sustained such injustice or hardship as is mentioned in section 115 above if the complaint—

(i) is made in writing to the relevant body by that person, or by a person authorised by virtue of section 111(2) above to make the complaint to the Commissioner on his behalf, and

(ii) is so made not later than one year from the day mentioned in section 114(1) above, or within such other period as the Commissioner considers appropriate in any particular case, but

(b) shall not be entitled to refer a complaint in pursuance of paragraph (a) after the expiry of three months beginning with the day on which the body received the complaint.

A complaint referred to a Commissioner in pursuance of this section shall, subject to section 113 above, be deemed to be duly made to him under this Part of this Act.

118 Consultations between Commissioners and Local Commissioners

(1) Where, at any stage in the course of conducting an investigation under this Part of this Act, the Commissioner conducting the investigation—

(a) forms the opinion that the complaint relates partly to a matter which could be the subject of an investigation under Part III of the [1974 c. 7.] Local Government Act 1974, then

(b) he shall consult about the complaint with the appropriate Local Commissioner within the meaning of Part III of that Act of 1974, and

(c) if he considers it necessary, inform the person initiating the complaint under this Part of the steps necessary to initiate a complaint under Part III of that Act of 1974.

(2) Where under subsection (1) above a Commissioner consults with a Local Commissioner in relation to a complaint under this Part of this Act, he may consult that Commissioner about any matter relating to the complaint, including—

(a) the conduct of any investigation into the complaint; and

(b) the form, content and publication of any report of the results of such an investigation.

(3) Nothing in paragraph 16 of Schedule 13 to this Act applies in relation to the disclosure of information by a Commissioner or his officers in the course of consultations held in accordance with this section.

119 Reports by Commissioners

(1) In any case where a Commissioner conducts an investigation under this Part of this Act, he shall send a report of the results of his investigation—

(a) to the person who made the complaint,

(b) to the relevant body in question,

(c) to any person who is alleged in the complaint to have taken or authorised the action complained of,

(d) if the relevant body in question is not an Area Health Authority for an area in England or a Family Practitioner Committee, to the Secretary of State,

(e) if that body is an Area Health Authority for an area in England, to the Regional Health Authority of which the region includes that area, and

(f) if that body is a Family Practitioner Committee, to the Area Health Authority by which the Committee was established,

but paragraph (d) does not apply in the case of an investigation conducted in respect of the Health Services Board or the Welsh Committee unless the Commissioner thinks fit to publish his report under this subsection.

(2) In any case where a Commissioner decides not to conduct an investigation under this Part, he shall send a statement of his reasons for doing so to the person who made the complaint and to the relevant body in question.

(3) If, after conducting an investigation under this Part, it appears to a Commissioner that the person aggrieved has sustained such injustice or hardship as is mentioned in section 115 above, and that the injustice or hardship has not been and will not be remedied, he may if he thinks fit—

(a) in relation to an investigation conducted in respect of the Health Services Board or the Welsh Committee, lay before each House of Parliament a special report;

(b) in relation to any other investigation, make a special report to the Secretary of State who shall, as soon as is reasonably practicable, lay a copy of the report before each House of Parliament.

(4) Each of the Commissioners shall—

(a) annually lay before each House of Parliament a general report on the performance of his functions under this Part in respect of the Health Services Board and the Welsh Committee, and may from time to time lay before each House of Parliament such other reports with respect to those functions as he thinks fit;

(b) annually make to the Secretary of State a report on the performance of his other functions under this Part, and may from time to time make to the Secretary of State such other reports with respect to those functions as the Commissioner thinks fit, and the Secretary of State shall lay a copy of every such report before each House of Parliament.

(5) For the purposes of the law of defamation, the publication of any matter by a Commissioner in sending or making a report in pursuance of subsection (1), (3) or (4) above, or in sending a statement in pursuance of subsection (2) above, shall be absolutely privileged.

120 Interpretation of Part V

(1) In this Part of this Act and in Schedule 13 to this Act—

• " action " includes failure to act, and other expressions connoting action shall be construed accordingly ;

• " Commissioner " means the Health Service Commissioner for England or the Health Service Commissioner for Wales, and " Commissioners" means both those persons;

• " person aggrieved " means the person who claims or is alleged to have sustained such injustice or hardship as is mentioned in section 115 above ; and

• " relevant body " has the meaning given by section 109 above, and (except where the context otherwise requires) includes a reference to an officer of the body.

(2) Nothing in this Part of this Act authorises or requires a Commissioner to question the merits of a decision taken without maladministration by a relevant body in the exercise of a discretion vested in that body.

PART VI Miscellaneous and Supplementary

General provisions as to charges

121 Charges in respect of non-residents

Regulations may provide for the making and recovery, in such manner as may be prescribed, of such charges—

(a) in respect of such services provided under this Act as may be prescribed, being

(b) services provided in respect of such persons not ordinarily resident in Great Britain as may be prescribed.

Such regulations may provide that the charges are only to be made in such cases as may be determined in accordance with the regulations.

122 Recovery of charges

(1) All charges recoverable under this Act by the Secretary of State, a local social services authority, or any body constituted under this Act, may, without prejudice to any other method of recovery, be recovered summarily as a civil debt.

(2) If any person, for the purpose of evading the payment of any charge under this Act, or of reducing the amount of any such charge—

(a) knowingly makes any false statement or false representation, or

(b) produces or furnishes, or causes or knowingly allows to be produced or furnished, any document or information which he knows to be false in a material particular,

the charge, or as the case may be the balance of the charge, may be recovered from him as a simple contract debt by the person by whom the cost of the service in question was defrayed.

Miscellaneous

123 Persons displaced by health service development

(1) Where the carrying out of a scheme for the provision by the Secretary of State in pursuance of this Act of hospital accommodation or other facilities will involve the displacement from any premises of persons residing in them, the Secretary of State may make arrangements with one or more of the following bodies—

(a) an authority who are a local authority for the purposes of the [1957 c. 56.] Housing Act 1957,

(b) a housing association within the meaning of that Act of 1957,

(c) a housing trust within the meaning of that Act of 1957.

(d) a development corporation established under the [1965 c. 59.] New Towns Act 1965, and

(e) the Commission for the New Towns,

for securing, in so far as it appears to him that there is no other residential accommodation suitable for the reasonable requirements of those persons available on reasonable terms, the provision of residential accommodation in advance of the displacement from time to time becoming necessary as the carrying out of the scheme proceeds.

(2) Arrangements under subsection (1) above may include provision for the making by the Secretary of State to the body with whom the arrangements are made of payments of such amounts and for such purposes as may be approved by the Treasury.

124 Special notices of births and deaths

(1) The requirements of this section with respect to the notification of births and deaths are in addition to, and not in substitution for, the requirements of any Act relating to the registration of births and deaths.

(2) It is the duty of each registrar of births and deaths to furnish, to the prescribed medical officer of the Area Health Authority of which the area includes the whole or part of the registrar's sub-district, such particulars of each birth and death which occurred in the Authority's area as are entered (on and after 1st April 1974) in a register of births or deaths kept for that sub-district.

(3) Regulations may provide as to the manner in which and the times at which particulars are to be furnished in pursuance of subsection (2) above.

(4) In the case of every child born, it is the duty—

(a) of the child's father, if at the time of the birth he is actually residing on the premises where the birth takes place, and

(b) of any person in attendance upon the mother at the time of, or within six hours after, the birth,

to give notice of the birth (as provided in subsection (5) below) to the prescribed medical officer of the Area Health Authority for the area in which the birth takes place.

This subsection applies to any child which has issued forth from its mother after the expiry of the twenty-eighth week of pregnancy whether alive or dead.

(5) Notice under subsection (4) above shall be given either—

(a) by posting within 36 hours after the birth a prepaid letter or postcard addressed to the prescribed medical officer of the Area Health Authority at his office and containing the required information, or

(b) by delivering within that period at that officer's office a written notice containing the required information,

and an Area Health Authority shall, upon application to them, supply without charge to any medical practitioner or midwife residing or practising within their area prepaid addressed envelopes together with the forms of notice.

(6) Any person who fails to give notice of a birth in accordance with subsection (4) above is liable on summary conviction to a fine not exceeding £1, unless he satisfies the court that he believed, and had reasonable grounds for believing, that notice had been duly given by some other person.

Proceedings in respect of this offence shall not, without the Attorney-General's written consent, be taken by any person other than a party aggrieved or the Area Health Authority concerned.

(7) A registrar of births and deaths shall, for the purpose of obtaining information concerning births which have occurred in his sub-district, have access at all reasonable times to notices of births received by a medical officer under this section, or to any book in which those notices may be recorded.

125 Protection of members and officers of authorities

Section 265 of the [1875 c. 55.] Public Health Act 1875 (which relates to the protection of members and officers of certain authorities) has effect as if there were included in the authorities referred to in that section—

(a) a Regional Health Authority,

(b) an Area Health Authority,

(c) a special health authority, and

(d) a Family Practitioner Committee,

and as if any reference in that section to the Public Health Act 1875 included a reference to this Act.

Supplementary

126 Orders and regulations, and directions

(1) Any power to make orders or regulations conferred by this Act shall be exercisable by statutory instrument, and a statutory instrument made by virtue of this Act shall be subject to annulment in pursuance of a resolution of either House of Parliament.

This subsection—

(a) is subject to paragraph 15(3) of Schedule 5 to this Act;

(b) does not apply to paragraph 10 of Schedule 11 to this Act.

(2) Any power to make regulations conferred on the Secretary of State by this Act is, if the Treasury so directs, exercisable by the Treasury and the Secretary of State acting jointly, except in the case of—

(a) regulations made under section 32 above ;

(b) regulations made under section 77(1) above in respect of charges for the drugs, medicines or appliances referred to in paragraph (a) of that subsection, or under paragraph 1(1) of Schedule 12 to this Act in respect of the remission or repayment of any charge payable under that section in the cases provided for in paragraph 1(1) of that Schedule ;

(c) regulations made under paragraph 2(2) of that Schedule ;

(d) regulations made under paragraph 2(6) of that Schedule.

(3) Where under any provision of this Act—

(a) power to make an order may be exercisable, or

(b) directions may be given,

that provision includes power to vary or revoke the order or direction, as the case may be, by subsequent order or by subsequent directions.

In relation to directions given by the Secretary of State in pursuance of sections 13 to 17 above this subsection is subject to section 18 above.

(4) Any power conferred by this Act to make orders, regulations or schemes, and any power conferred by section 18 above to give directions by an instrument in writing, may, unless the contrary intention appears, be exercised—

(a) either in relation to all cases to which the power extends, or in relation to all those cases subject to specified exceptions, or in relation to any specified cases or classes of case, and

(b) so as to make, as respects the cases in relation to which it is exercised—

(i) the full provision to which the power extends or any less provision (whether by way of exception or otherwise),

(ii) the same provision for all cases in relation to which the power is exercised, or different provision for different cases or different classes of case, or different provision as respects the same case or class of case for different purposes of this Act or that section,

(iii) any such provision either unconditionally, or subject to any specified condition,

and includes power to make such incidental or supplemental provision in the orders, regulations, schemes or directions as the persons making or giving them consider appropriate.

This subsection does not apply to regulations made under section 32 above (but without prejudice to subsection (3) of that section) or to an order made under section 57 above (but without prejudice to paragraph 1(1) of Schedule 11 to this Act).

127 Supplementary regulatory powers

Regulations may provide for all or any of the following matters—

(a) for prescribing the forms and manner of service of notices and other documents ;

(b) for prescribing the manner in which documents may be executed or proved;

(c) for prescribing the manner in which resolutions of any bodies (except the Public Health Laboratory Service Board) continued in being by this Act are to be proved ;

(d) for exempting judges and justices of the peace from disqualification by their liability to rates.

128 Interpretation and construction

(1) In this Act, unless the contrary intention appears—

• " the Central Council " means the Central Health Services Council referred to in section 6 above;

• " certified midwife " means a person who is for the time being certified under the [1951 c. 53.] Midwives Act 1951;

• "dental practitioner " means a person registered in the dentists register under the [1957 c. 28.] Dentists Act 1957;

• " dispensing optician " means a person who is registered in the register kept under section 2 of the [1958 c. 32.] Opticians Act 1958 of dispensing opticians or a body corporate enrolled in the list kept under section 4 of that Act of such bodies carrying on business as dispensing opticians;

• " equipment " includes any machinery, apparatus or appliance, whether fixed or not, and any vehicle ;

• " functions " includes powers and duties ;

• " health authority " means a Regional or Area Health Authority or a special health authority ;

• " the health service " means the health service established in pursuance of section 1(1) above;

• "health service hospital " means a hospital vested in the Secretary of State under this Act;

• " Health Services Board " means the body established by section 1 of the [1976 c. 83.] Health Services Act 1976 ;

• " hospital " means—

  (a)

  any institution for the reception and treatment of persons suffering from illness,

  (b)

  any maternity home, and

  (c)

  any institution for the reception and treatment of persons during convalescence or persons requiring medical rehabilitation, and includes clinics, dispensaries and out-patient departments maintained in connection with any such home or institution, and " hospital accommodation " shall be construed accordingly ;

• " illness " includes mental disorder within the meaning of the [1959 c. 72.] Mental Health Act 1959 and any injury or disability requiring medical or dental treatment or nursing;

• " local authority " means a county council, the Greater London Council, a district council, a London borough council, and the Common Council of the City of London; and includes the King Edward VII Welsh National Memorial Association;

• " local education authority " has the same meaning as in the [1944 c. 31.] Education Act 1944;

• " local social services authority " means the council of a non-metropolitan county, or of a metropolitan district or London borough, or the Common Council of the City of London;

• " medical " includes surgical;

• " medical practitioner " means a fully registered person within the meaning of the [1956 c. 76.] Medical Act 1956 ;

• " medicine " includes such chemical re-agents as are included in a list for the time being approved by the Secretary of State for the purposes of section 41 above ;

• " modifications " includes additions, omissions and amendments;

• " officer " includes servant;

• " ophthalmic optician " means a person registered in either of the registers kept under section 2 of the [1958 c. 32.] Opticians Act 1958 of ophthalmic opticians or a body corporate enrolled in the list kept under section 4 of that Act of such bodies carrying on business as ophthalmic opticians;

• " patient " includes an expectant or nursing mother and a lying-in woman;

• " prescribed " means prescribed by regulations made by the Secretary of State under this Act;

• " property " includes rights ;

• " registered nurse " means a nurse registered in the register of nurses established under the [1919 c. 94.] Nurses Registration Act 1919 and maintained in pursuance of section 2(1) of the [1957 c. 15.] Nurses Act 1957;

• " registered pharmacist " means a pharmacist registered in the register of pharmaceutical chemists;

• " regulations " means regulations made by the Secretary of State under this Act;

• " special hospital " has the meaning given by section 4 above;

• " superannuation benefits " means annual superannuation allowances, gratuities and periodical payments payable on retirement, death or incapacity, and similar benefits;

• " university " includes a university college ;

• " voluntary " means not carried on for profit and not provided by a local or public authority ;

• " Welsh Committee " means the committee constituted under section 1(3) of the [1976 c. 83.] Health Services Act 1976.

(2) References in this Act to the purposes of a hospital shall be construed as referring both to the general purposes of the hospital and to any specific purpose of the hospital.

(3) Any reference in this Act to any enactment is a reference to it as amended or applied by or under any other enactment including this Act.

129 Transitional provisions and savings, consequential amend­ ments, and repeals

Schedule 14 to this Act is hereby given effect, and subject to the transitional provisions and savings contained in that Schedule—

(a) the enactments and the Order specified in Schedule 15 to this Act have effect subject to the amendments (being amendments consequent on this Act) specified in that Schedule, and

(b) the enactments specified in Schedule 16 to this Act (which include enactments which were spent before the passing of this Act) are hereby repealed to the extent specified in the third column of that Schedule,

but nothing in this Act shall be taken as prejudicing the operation of section 38 of the [1889 c. 63.] Interpretation Act 1889 (which relates to the operation of repeals).

130 Short title, extent and commencement

(1) This Act may be cited as the National Health Service Act 1977.

(2) This Act does not extend to Scotland, except as is mentioned in paragraph 3 of Schedule 11 to this Act.

(3) The following provisions only of this Act apply to Northern Ireland—

(a) this subsection and subsections (1) above and (5) below ;

(b) section 57 above and Schedule 11 to this Act;

(c) section 114(2) above and Part I of Schedule 13 to this Act, section 119(5) above, and section 120(1) above so far as it relates to the provisions mentioned in this paragraph;

(d) paragraph 13 of Schedule 14 to this Act so far as it relates to any enactment which extends to Northern Ireland;

(e) paragraph (a) of section 129 above and Schedule 15 to this Act so far as they amend any enactment and order which extends to Northern Ireland ;

(f) paragraph (b) of section 129 and Schedule 16 to this Act so far as they repeal any enactment which extends to Northern Ireland.

(4) The Secretary of State may by order provide that this Act shall extend to the Isles of Scilly with such modifications, if any, as are specified in the order, and except as provided in pursuance of this subsection this Act does not extend to the Isles of Scilly.

The Secretary of State may by any such order amend or repeal any provisions contained in the Isles of Scilly Orders 1927 to 1943.

(5) This Act shall come into force on the expiry of the period of one month beginning on the date of its passing.