National Health Service Act 1977

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.