National Health Service Act 1977

General medical services E+W+S

29 Arrangements and regulations for general medical services. E+W+S

[F1 (1) It is the duty of every Family Practitioner Committee, in accordance with regulations, to arrange as respects their locality with medical practitioners to provide personal medical services for all persons in the locality who wish to take advantage of the arrangements.

(1A) The services so provided are referred to in this Act 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 [F2 locality] 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 [F2 locality].

[F3 (f) for the making of arrangements for the temporary provision of general medical services [F4 in the locality of a Family Practitioner Committee];

(g) for the circumstances in which a name added to the list by virtue of subsection (6) below may be removed from it.]

(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.

[F5 (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.]

[F6 (5) Regulations shall—

(a) include provision for the making to a medical practitioner providing general medical services of payments in respect of qualifying services provided by a spouse or other relative of his; and

(b) provide that the rates and conditions of payment and the qualifying services in respect of which the payments may be made shall be such as may be determined by the Secretary of State after consultation with such bodies as he may recognise as representing such medical practitioners.]

[F7 (6) The persons with whom arrangements for the temporary provision of general medical services in a [F8 locality] may be made by virtue of regulations under subsection (2) above include medical practitioners who are not on the list of medical practitioners providing such services in the [F8 locality], and the power to prepare and publish lists of medical practitioners conferred by paragraph (a) of that subsection accordingly includes power to add the names of medical practitioners with whom such arrangements are made to the list.

(7) Regulations may provide that this Act and any regulations made under it shall apply in relation—

(a) to the making of arrangements for the temporary provision of general medical services; and

(b) to the provision of general medical services in pursuance of any such arrangements,

subject to such modifications as may be specified in the regulations.

(8) Where the registration of a medical practitioner in the register of medical practitioners is suspended—

(a) by a direction of the Health Committee of the General Medical Council under [F9 section 37(1) or (2) of the M1 Medical Act 1983] (unfitness to practice by reason of physical or mental condition);

(b) by an order of that Committee under [F9 section 38(1)] of that Act (order for immediate suspension); or

(c) by an interim order of the Preliminary Proceedings Committee of the Council under [F9 section 42(3)(b)] of that Act,

the suspension shall not terminate any arrangements made with him for the provision of general medical services, but he shall not provide such services in person during the suspension.]

Textual Amendments

F1 S. 29(1)(1A) substituted for s. 29(1) by S.I. 1985/39, art. 7(3)(a)

F2 Word substituted by S.I. 1985/39, art. 7(3)(b)(i)

F3 S. 29(2)(f)(g) added by Health and Social Security Adjudications Act 1983 (c. 41, SIF 113:3), s. 14, Sch. 6 para. 2(1)

F4 Words added by S.I. 1985/39, art. 7(3)(b)(ii)

F5 S. 29(4) ceased to have effect (prosp.) by National Health Service Act 1966 (c. 8, SIF 113:2), s. 10(3), (as substituted (29.8.1977) by Sch. 15 para. 37(b) of this Act)

F6 S. 29(5) added by Health Services Act 1980 (c. 53, SIF 113:2), s. 7

F7 S. 29(6)–(8) inserted by Health and Social Security Adjudications Act 1983 (c. 41, SIF 113:3), s. 14, Sch. 6 para. 2(2)

F8 Word substituted by S.I. 1985/39, art. 7(3)(c)

F9 Words substituted by Medical Act 1983 (c. 54, SIF 83:1), s. 56(1), Sch. 5 para. 16(a)

Modifications etc. (not altering text)

C1 S. 29 extended by Health and Medicines Act 1988 (c. 49, SIF 113:2), s. 17(1)

C2 S. 29(4) modified by S.I. 1974/160, reg. 19(16)(a) (as substituted by S.I. 1985/1053, reg. 3(5)

Marginal Citations

M1 1983 c. 54(83:1).

Prospective

[F10 29A Medical lists. E+W+S

(1) A Health Authority may not, under section 29, arrange with a medical practitioner for him to provide general medical services for persons in the Authority’s area unless his name is included in the Authority’s medical list.

(2) A medical practitioner is entitled to be included in a Health Authority’s medical list only if—

(a) he is eligible for inclusion in the list; and

(b) he is nominated or approved, in accordance with regulations under section 29B, for appointment to fill a vacancy which relates (whether wholly or in part) to the area of the Authority.

(3) [F11 Subject to any provision made under section 43C] a medical practitioner is eligible for inclusion in a medical list if—

(a) he has not attained the age specified in regulations under section 8 of the M2 Health and Medicines Act 1988 (retirement age for practitioners); and

(b) he is not disqualified, or treated as [F12 disqualified for inclusion in the list by, or by virtue of a direction of, the NHS Tribunal]or any corresponding tribunal in Scotland or Northern Ireland.

(4) Regulations may make provision in relation to delaying a person’s inclusion in a medical list in prescribed circumstances.

[F13 (4A) Regulations may make provision in relation to the supply to a Health Authority, by a medical practitioner who is included in their medical list (or, as respects paragraph (a), by arrangement with him), of—

(a) information of a prescribed description; and

(b) 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.]

(5) This section is subject to section 29(6) (temporary provision of general medical services) and any provision of, or made under, an enactment relating to the right of a medical practitioner to transfer to a medical list.

(6) In this Act “medical list”, in relation to a Health Authority, means the list of medical practitioners undertaking to provide general medical services for persons in their area, kept by the Authority under regulations made under section 29(2)(a).]

Textual Amendments

F10 S. 29A inserted (10.12.1998) by 1997 c. 46, s. 32(1); S.I. 1998/2840, art. 2(3), Sch.

F11 Words in s. 29A inserted (1.4.2000) by 1999 c. 8, ss. 9(2), 67; S.I. 1999/2793, art. 2 (3)(b); S.I. 2000/1041, art. 2(a)

F12 Words in s. 29A(3)(b) substituted (prosp.) by 1999 c. 8, ss. 65, 67, Sch. 4 para. 17 (which substitution repealed (prosp.) by 2001 c. 15, ss. 67(2), 70(2), sch. 6 Pt. I) (with ss. 64(9), 65(4))

F13 S. 29A(4A) inserted (22.11.2001 for certain purposes (E.) 14.12.2001 for all other purposes (except those relating to the provision of pharmaceutical services under the 1977 Act) (E.) and otherwise prosp.) by 2001 c. 15, ss. 20(2), 70(2) (with ss. 64(9), 65(4)); S.I. 2001/3738, art. 2(2), Sch. 1 Pt. II

Modifications etc. (not altering text)

C3 S. 29A(2)(b) excluded (1.4.1998: subject to transitional provisions) by 1997 c. 46, s. 13(9), Sch. 1 para. 2(2); S.I. 1998/631, art. 2(1)(a), Sch. 1

Marginal Citations

M2 1988 c. 49.

Valid from 10/12/1998

[F14 29B Vacancies for medical practitioners. E+W+S

(1) Regulations may make provision in relation to the filling of vacancies for medical practitioners to provide general medical services.

(2) The regulations may, in particular, include provision for—

(a) references by a Health Authority to the Medical Practices Committee as to whether there is, or will be, a vacancy for a medical practitioner in a locality;

(b) the determination of such references by the Medical Practices Committee;

(c) the determination by the Medical Practices Committee of conditions of practice to be imposed on any medical practitioner who fills a particular vacancy;

(d) the determination by a Health Authority of whether a vacancy is to be filled by a member of a partnership or by a sole practitioner;

(e) the nomination by a Health Authority of a medical practitioner for appointment to fill a vacancy as a sole practitioner;

(f) the approval by a Health Authority of a medical practitioner for appointment to fill a vacancy as a member of a partnership.

(3) The regulations may also make provision in relation to—

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

(b) the variation or revocation of such decisions (including appeals to the Secretary of State on points of law), or

(c) vacancies relating to the area of one Health Authority which also relate to the area of another Health Authority or a Health Board,

and may contain such transitional provisions as the Secretary of State considers appropriate.

(4) Regulations which make provision about vacancies which relate partly to the area of a Health Board may, in particular, provide that section 29A(2)(b) is to have effect in prescribed circumstances as if the reference to regulations under this section were a reference to regulations under section 19B of the M3 National Health Service (Scotland) Act 1978.

(5) In this section—

• “conditions of practice” means conditions—

  (a)

  specifying, by reference to one or more prescribed conditions relating to hours or the sharing of work, the provision of general medical services for which a person is entitled to be remunerated; and

  (b)

  specifying the locality in which a person is entitled to provide general medical services;

• “Health Board” has the same meaning as in the National Health Service (Scotland) Act 1978;

• “locality”, in relation to a Health Authority, means the Authority’s area or a particular part of their area; and

• “sole practitioner” means a medical practitioner providing general medical services otherwise than in partnership with one or more other medical practitioners.

(6) This section does not affect the power to make regulations under section 29.]

Textual Amendments

F14 S. 29B inserted (10.12.1998) by 1997 c. 46, s. 32(1); S.I. 1998/2840, art. 2(3), Sch.

Marginal Citations

M3 1978 c. 29.

30 Applications to provide general medical services. E+W+S

(1) [F15 Subject to subsection (1A) below] all applications made [F16 by medical practitioners in the prescribed manner to a Family Practitioner Committee for inclusion in a list kept by that Committee of the names of medical practitioners undertaking to provide general medical services for persons in the Committee’s locality shall be referred by the Committee] to the Medical Practices Committee and . . . F17 any medical practitioner whose application is granted by that Committee shall [F18 subject to the provisions of this Part of this Act relating to disqualification of practitioners] be entitled to the inclusion of his name in the list.

[F19 (1A) No medical practitioner who is a national of a member State and is registered by virtue of a qualification granted in a member State shall be entitled to have his application for the inclusion of his name in the list kept by any Family Practitioner Committee referred to the Medical Practices Committee unless he satisfies the Family Practitioner Committee that he has that knowledge of English which, in the interests of himself and his patients, is necessary for the provision of general medical services in the Committee’s locality; and where a Family Practitioner Committee is not so satisfied with respect to any applicant the Family Practitioner Committee shall not refer his application to the Medical Practices Committee.]

(2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F20

Textual Amendments

F15 Words inserted by S.I. 1981/432, art. 3(1)(a)

F16 Words substituted by S.I. 1985/39, art. 7(4)

F17 Words repealed by Health Services Act 1980 (c. 53, SIF 113:2), Sch. 7

F18 Words inserted by Health Services Act 1980 (c. 53, SIF 113:2), Sch. 1 para. 43(a)

F19 S. 30(1A) inserted by Health and Social Security Act 1984 (c. 48, SIF 113:1), s. 5(4), Sch. 3 para. 4

F20 Ss. 6(1)(2)(6)(7), 30(2), 59, 60, 67–71, 73–76, Sch. 4 para. 1, Sch. 15 paras. 11, 41, 68—70 repealed by Health Services Act 1980 (c. 53, SIF 113:2), Sch. 7

Modifications etc. (not altering text)

C4 S. 30(1A) modified by S.I. 1987/160, reg. 19(16)(b) (as substituted by S.I. 1985/1053, reg. 3(5)

31 Requirement of suitable experience. E+W+S

(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

[F21 (b) a Family Practitioner Committee shall not arrange under section 29 above with a medical practitioner for him to provide general medical services for persons in the Committee’s locality unless the Medical Practices Committee have granted an application by him for the inclusion of his name in the list kept by the Family Practitioner Committee of medical practitioners undertaking to provide general medical services for persons in their locality.]

(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.

Textual Amendments

F21 S. 31(1)(b) substituted by S.I. 1985/39, art. 7(5)

32 Regulations as to s. 31. E+W+S

(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 [F22 localities] 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.

Textual Amendments

F22 Word substituted by S.I. 1985/39, art. 7(6)

33 Distribution of general medical services. E+W+S

[F23 (1) The Medical Practices Committee may refuse any applications under section 30 above on the grounds that the number of medical practitioners undertaking to provide general medical services in the locality of the Family Practitioner Committee concerned or in the relevant part of that locality is already adequate.]

[F24 (1A) The Secretary of State may by order specify—

(a) the maximum number of medical practitioners with whom, in any year, all the Family Health Services Authorities for localities in England, taken as a whole, may enter into arrangements under section 29 above for the provision of general medical services; and

(b) the maximum number of medical practitioners with whom, in any year, all the Family Health Services Authorities for localities in Wales, taken as a whole, may enter into such arrangements.

(1B) An order under subsection (1A) above may contain such incidental and consequential provisions (including provisions amending this Part of this Act) as appear to the Secretary of State to be appropriate including, in particular, provisions as to the basis on which the Medical Practices Committee are to refuse applications under section 30 above in order to secure that any maximum number specified in the order is not exceeded.]

(2) [F25 Subject to subsection (2A) below] if in the opinion of the Medical Practices Committee additional practitioners are required for any [F26 locality or part of a locality], 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.

[F27 (2A) If, in the opinion of the Medical Practices Committee, a medical practitioner is required for a particular part of the locality of a Family Health Services Authority, then, in such circumstances as may be prescribed,—

(a) the Authority (instead of the Committee) shall, in accordance with regulations, select the medical practitioner whose application they wish to be considered by the Committee; and

(b) the Committee shall not consider any application from a medical practitioner who is not so selected; and

(c) any medical practitioner who has made an application but is not so selected may appeal to the Secretary of State on a point of law;

and if the Secretary of State allows an appeal under paragraph (c) above he shall remit the application to the Authority for reconsideration.]

[F28 (3) Before selecting any persons under subsection (2) above the Medical Practices Committee shall consult the Family Practitioner Committee concerned, and the Family Practitioner Committee shall, if a Local Medical Committee has been formed for their locality 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

[F29 (a) in granting an application shall specify, by reference to one or more prescribed conditions relating to hours or the sharing of work, the provision of general medical services for which the applicant will be entitled to be remunerated; and]

[F29 (b)] may grant an application subject to conditions excluding the provision of general medical services by the applicant in such part or parts of the Family Practitioner Committee’s locality as the Medical Practices Committee may specify][F30 and an order under subsection (1A) above may make provision as to the extent to which account is to be taken under the order of medical practitioners whose ability to carry out remunerated work is limited by virtue of conditions imposed under paragraph (a) above].

(5) A medical practitioner who has made an application under section 30 which has been refused [F31 by the Medical Practices Committee] or has been granted [F31 by that Committee] subject to [F32 conditions under paragraph (a) or paragraph (b) of subsection (4) above] may appeal to the Secretary of State; [F33 on a point of law; and, if the Secretary of State allows such an appeal, he shall remit the application to the Medical Practices Committee for reconsideration].

[F33 This subsection does not apply where an application has been refused under paragraph (a) of section 31(1)][F33 or under section 8 of the Health and Medicines Act 1988 (persons over retiring age)].

(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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F34

(8) [F35 In any case where medical practitioners have to be selected from a number of applicants, the Medical Practices Committee or, where subsection (2A) above applies, the Family Health Services Authority shall]—

(a) have regard to any desire expressed by any applicant to practise with other medical practitioners already providing general medical services in the [F36 locality concerned or part of it] 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.

Textual Amendments

F23 S. 33(1) substituted by S.I. 1985/39, art. 7(7)(a)

F24 S. 33(1A)(1B) inserted by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(1)

F25 Words inserted (subject to transitional provisions in S.I. 1990/2511, art. 4(1)) (E.W.) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(2)

F26 Words substituted by S.I. 1985/39, art. 7(7)(b)

F27 S. 33(2A) inserted (subject to transitional provisions in S.I. 1990/2511, art. 4(1)) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(2)

F28 S. 33(3)(4) substituted by S.I. 1985/39, art. 7(7)(c)

F29 Words inserted by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(3)

F30 Words inserted by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(3)

F31 Words inserted by S.I. 1981/432, art. 3(2)

F32 Words substituted (subject to transitional provisions in S.I. 1990/2511, art. 4(2)(3) ) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(4)

F33 Words from “on a point of law” to “reconsideration” substituted for the words following “Secretary of State” up to “retiring age)” by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), S. 23(4) (the substitution being in force 1.1.1991 by S.I. 1990/1329, art. 2(7)(c) as amended by S.I. 1990/2511, art. 2(b), by virtue of which art. 2(b) section 23(4) is excepted from the coming into force on 1.1.1991 so far as it repeals the second paragraph of s. 33(5) of the 1977 Act) (subject to transitional provisions in S.I. 1990/2511, art. 4(2)(3) ). New words were added at the end of the second paragraph of s. 33(5) by Health and Medicines Act 1988 (c. 49, SIF 113:2), s. 25(1), Sch. 2 para. 3

F34 S. 33(7) repealed (subject to transitional provisions in S.I. 1990/2511, art. 4(2) ) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), ss. 23(5), 66(2), Sch. 10

F35 Words substituted (subject to transitional provisions in S.I. 1990/2511, art. 4(2) ) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(6)

F36 Words substituted by S.I. 1985/39, art. 7(7)(d)

Modifications etc. (not altering text)

C5 S. 33(2A) applied by S.I. 1974/160, reg. 10A (as substituted by S.I. 1990/2513, reg. 6)

C6 S. 33(2A) extended (1.4.1992) by S.I. 1992/635, reg. 13(1).

34 Regulations for Medical Practices Committee. E+W+S

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—

[F37 (a) for requiring Family Practitioner Committees 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 localities and the different parts of those localities;]

(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 [F38 and where such an appeal is allowed, the reconsideration of any application]; and

[F39 (iii) requiring Family Practitioner Committees and applicants to be informed of the decisions of the Medical Practices Committee and the Secretary of State.]

[F40 (2) Regulations under this section may make provision for, and in connection with, the variation of any condition imposed under subsection (4) or subsection (5) of section 33 above, including provision for appeals to the Secretary of State on a point of law]

Textual Amendments

F37 Words substituted by S.I. 1985/39, art. 7(8)(a)

F38 Words inserted (subject to transitional provisions in S.I. 1990/2511, art. 4(2) ) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(7)(a)

F39 S. 34(b)(iii) substituted by S.I. 1985/39, art. 7(8)(b)

F40 S. 34(2) added (subject to transitional provisions in S.I. 1990/2511, art 4(2) ) by National Health Service and Community Care Act 1990 (c. 19, SIF 113:2), s. 23(7)(b)