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National Health Service Act 1977

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Changes over time for: Cross Heading: Provision of personal medical or dental services

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Version Superseded: 01/04/1998

Status:

Point in time view as at 01/10/1993. This version of this cross heading contains provisions that are not valid for this point in time. Help about Status

Changes to legislation:

There are outstanding changes not yet made by the legislation.gov.uk editorial team to National Health Service Act 1977. Any changes that have already been made by the team appear in the content and are referenced with annotations. Help about Changes to Legislation

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

Textual Amendments

F1Cross-heading inserted (1.3.2004 for E. for specified purposes and 1.7.2002 for W.) by 1997 c. 46, ss. 21(1), 41(3); S.I. 2004/287, art. 2(1); S.I. 2002/1475, art. 2(1), Sch. Pt. 1

F228C Personal medical or dental services.E+W+S

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

(a)[F3primary] medical services are provided (otherwise than by the Authority); or

(b)[F3primary] dental services are provided (otherwise than by the Authority).

(2)An agreement made under this section—

(a)may not combine arrangements for the provision of personal medical services with arrangements for the provision of [F4primary] dental services [F5, and may not combine arrangements for the provision of [F4primary] medical services or [F4primary] dental services with arrangements for the provision of local pharmaceutical services under LPS schemes (within the meaning of paragraph 1(3) of Schedule 8A to this Act) or under pilot schemes made under section 28 of the Health and Social Care Act 2001]; but

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

(i)which are not [F4primary] medical services or [F4primary] dental services; but

(ii)which may be provided under this Part.

F6(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(4)This Act (and in particular section 17) has effect, in relation to [F7primary] medical services or [F7primary] dental services provided under an agreement made under this section, as if those services were provided as a result of the delegation by the Secretary of State (by directions given under section [F816D]) of functions of his under this Part.

(5)The functions of a Health Authority in relation to an agreement made under this section are primary functions of the Authority for the purposes of the M1National Health Service and Community Care Act 1990.

(6)Regulations may provide—

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

(b)for functions which are exercisable by a Health Board in relation to an agreement made under section 17C of the M2National Health Service (Scotland) Act 1978 to be exercisable on behalf of the Board by a [Strategic Health Authority or a] Health Authority.

F9(7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F2SS. 28C-28D inserted (1.7.2002 for W. and 1.3.2004 for E. for specified purposes) by 1997 c. 46, ss. 21(1), 41(3); S.I. 2002/1475, art. 2(1), Sch. Pt. 1 S.I. 2004/287, art. 2(1);

F5Words in s. 28C(2)(a) inserted (1.7.2002 for W. and otherwise prosp.) by 2001 c. 15, ss. 67(1), 70(2), Sch. 5 para. 11(4) (with ss. 64(9), 65(4))); S.I. 2002/1475, art. 2, Sch. Pt. 1

F8Word in s. 28C(4) substituted (1.10.1999 for E. and 1.12.1999 for W.) by 1999 c. 8, ss. 65(1), Sch. 4 para. 15; S.I. 1999/2540, art. 2(1)(a), Sch. 1; S.I. 1999/3184, art. 2(2), Sch. 2

Marginal Citations

F1028D Persons with whom agreements may be made.E+W+S

(1)A [F11Strategic Health Authority or a] Health Authority may make an agreement under section 28C only with one or more of the following—

(a)an NHS trust; [F12or NHS foundation trust]

[F13(b)a medical practitioner who meets the prescribed conditions;

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

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

(bc)an individual who is providing services—

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

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

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

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

(d)an NHS employee, a section 28C employee [F14, a section 17C employee or an Article 15B employee] ;

(e)a qualifying body.

[F15(f)a Primary Care Trust] [F16or Local Health Board]

[F17(1A)The power under subsection (1) to make an agreement with a person falling within paragraph (bc) or (d) of that subsection is subject to such conditions as may be prescribed.]

(2)In this section—

  • “the 1978 Act” means the M3National Health Service (Scotland) Act 1978;

  • [F18“Article 15B arrangements” means arrangements for the provision of services made under Article 15B of the Health and Personal Social Services (Northern Ireland) Order 1972 (1972 No. 1256 (N.I. 14));

    “Article 15B employee” means an individual who, in connection with the provision of services in accordance with Article 15B arrangements, is employed by a person providing or performing those services;]

  • [F19“health care professional” means a person who is a member of a profession regulated by a body mentioned (at the time the agreement in question is made) in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002;]

  • [F20“ NHS employee ” means an individual who, in connection with the provision of services in the health service in England and Wales, Scotland or Northern Ireland, is employed by—

    (a)

    an NHS trust, an NHS foundation trust or (in Northern Ireland) a Health and Social Services Trust;

    (b)

    a Primary Care Trust or Local Health Board;

    (c)

    a person who is providing services under a general medical services contract or a general dental services contract;

  • (d)

    an individual who is providing services as specified in subsection (1)(bc)(iii) above;]

  • “qualifying body” means—

    (a)

    a company which is limited by shares all of which are legally and beneficially owned by persons falling within [F21paragraph (a), (b), [F22(ba), (bb), (bc)] , (d) or (f)] of subsection (1); and also

    (b)

    in the case of an agreement under which [F23primary] dental services are provided, a body corporate which, in accordance with the provisions of Part IV of the M4Dentists Act 1984, is entitled to carry on the business of dentistry;

  • F24...

  • F24...

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

  • “section 17C employee” means an individual who, in connection with the provision of services in accordance with section 17C arrangements, is employed by [F25a person providing or performing] those services;

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

  • “section 28C employee” means an individual who, in connection with the provision of services in accordance with section 28C arrangements, is employed by [F25a person providing or performing] those services.

Textual Amendments

F10SS. 28C-28D inserted (1.7.2002 for W. and 1.3.2004 for E. for specified purposes) by 1997 c. 46, ss. 21(1), 41(3); S.I. 2002/1475, art. 2(1), Sch. Pt. 1; S.I. 2004/287, art. 2(1)

F15S. 28D(1)(f) inserted (4.1.2000 for E. and otherwise prosp.) by 1999 c. 8, ss. 65(1), 67(2), Sch. 4 para. 16(a); S.I. 1999/2540, art. 2(2)

F21S. 28D(2); words in para. (a) of the definition of “qualifiying body” substituted (4.1.2000 for E. and otherwise prosp.) by 1999 c. 8, ss. 65(1), 67(2), Sch. 4 para. 16(b); S.I. 1999/2540, art. 2(2)

F25Words in s. 28D substituted (1.3.2004 for E.W. for specified purposes) by Health and Social Care (Community Health and Standards) Act 2003 (c. 43), ss. 177(6), 199(1)(4); S.I. 2004/288, art. 4(2)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

Marginal Citations

[F2628DA Lists of persons who may perform personal medical services or personal dental servicesE+W

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(6)Regulations may provide—

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

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

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

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

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

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

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

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

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

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

(b)to vary a condition,

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

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

Textual Amendments

F26S. 28DA inserted (1.7.2002 for W., otherwise prosp.) by 2001 c. 15, ss. 26(1), 70(2) (with ss. 64(9), 65(4)); S.I. 2002/1475, art. 2

Prospective

[F2728E Personal medical or dental services: regulations.E+W+S

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

(2)The regulations must—

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

F28(b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

(3)The regulations may, in particular—

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

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

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

[F29(ca)impose conditions (including conditions as to qualifications and experience) to be satisfied by persons performing services in accordance with section 28C arrangements;]

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

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

F30(f). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F30(g). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(h)provide for parties to section 28C arrangements to be treated, in such circumstances and to such extent as may be prescribed, as health service bodies for the purposes of section 4 of the M5National Health Service and Community Care Act 1990;

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

F31(j). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F31(k). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F32(3A)The regulations may also require payments to be made under the arrangements in accordance with directions given for the purpose by the Secretary of State; and section 18(1) and (3)(b) apply in relation to any such directions.

(3B)A direction under subsection (3A) may make provision having effect from a date before the date of the direction, provided that, having regard to the direction as a whole, the provision is not detrimental to the persons to whose remuneration it relates.]

[F33(3C)The regulations may also include provision requiring a Primary Care Trust or Local Health Board, in prescribed circumstances and subject to prescribed conditions, to enter into a general medical services contract or general dental services contract on prescribed terms with any person providing services under section 28C arrangements who so requests.]

[F34(3D)The regulations may also include provision for the resolution of disputes as to the terms of any proposed section 28C arrangements, and in particular may make provision—

(a)for the referral of the terms of the proposed arrangements to the Secretary of State or National Assembly for Wales; and

(b)for the Secretary of State, or Assembly, or a person appointed by him or it, to determine the terms on which the arrangements may be entered into.]

[F35(3E)The regulations must provide for the circumstances in which a person providing primary medical services under section 28C arrangements—

(a)must or may accept a person as a patient to whom such services are so provided;

(b)may decline to accept a person as such a patient;

(c)may terminate his responsibility for a patient.

(3F)The regulations must make provision as to the right of patients to choose the persons from whom they are to receive services under section 28C arrangements.]

[F36(4)The regulations must include provision for a medical practitioner who—

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

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

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

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

F37F37(...). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F37. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F37. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .]

F37. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Textual Amendments

F27S. 28E inserted (1.7.2002 for W. and 1.3.2004 for E. for specified purposes) by 1997 c. 46, ss. 22(1), 41(3); S.I. 2004/287, art. 2(1); S.I. 2002/1475, art. 2(1), Sch. Pt. 1

F36S. 28E(4) repealed (1.10.1999 for E. and 1.4.2000 for W.) by 1999 c. 8, ss. 65(2), Sch. 5; S.I. 1999/2540, art. 2(1), Sch. 1; S.I. 2000/1041, art. 2(d), Sch.

Marginal Citations

Prospective

[F3828EE Delegation of Health Authority functions relating to section 28C arrangements.E+W

(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2)The Secretary of State may by order make provision for any rights and liabilities arising under an agreement to provide [F39primary] medical services under section 28C above to be transferred from [Strategic Health Authorities] to Primary Care Trusts and from Primary Care Trusts to [Strategic Health Authorities] .

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

Textual Amendments

F38S. 28EE inserted (prosp.) by 1999 c. 8, ss. 6(2), 67(2)

[F4028F Right to choose medical practitioner.E+W+S

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

(a)the consent of the practitioner concerned; and

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

(2)In particular, the regulations—

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

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

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

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

(ii)have not chosen a medical practitioner.

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

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

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

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

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

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

Textual Amendments

F40S. 28F inserted (1.4.1998) by 1997 c. 46, s. 23(1); S.I. 1997/631, art. 2(1)(a), Sch. 1 (subject to arts. 3-5)

[F4128G Right to choose dental practitioner.E+W+S

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

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

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

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

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

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

Textual Amendments

[F4228H Immunisation.E+W+S

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

Textual Amendments

[F4328I Use of accommodation.E+W+S

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

Textual Amendments

Prospective

[F4428J Local pharmaceutical services schemesE+W

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

Textual Amendments

F44S. 28J inserted (prosp.) by 2001 c. 15, ss. 40(1), 70(2) (with ss. 64(9), 65(4))

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