Health and Social Care (Community Health and Standards) Act 2003 (c. 43)

Part 4 E+W Dental and medical services

Primary dental and medical services: supplementary E+W

177 Arrangements under section 28C of the 1977 Act E+W

(1) Section 28D of the 1977 Act (persons with whom arrangements under section 28C of that Act may be made) is amended as follows.

(2) In subsection (1), for paragraphs (b) and (c) substitute—

“(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;”.

(3) After subsection (1) insert—

“(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.”

(4) In subsection (2), after the definition of “the 1978 Act” insert—

““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;”.

(5) In that subsection, for the definition of “NHS employee” substitute—

““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;”.

(6) In the definitions of “section 17C employee” and “section 28C employee”, for “an individual providing” substitute “ a person providing or performing ”.

(7) In section 28E of the 1977 Act (regulations), in subsection (3), after paragraph (c) insert—

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

(8) In that section, after subsection (3) insert—

“(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.”

(9) In that section, after subsection (3B) (as inserted by subsection (8) above), insert—

“(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.”

(10) In that section, after subsection (3C) (as inserted by subsection (9) above) insert—

“(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.”

(11) In that section, after subsection (3D) (as inserted by subsection (10) above) insert—

“(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.”

(12) In that Act, sections 28F (choice of medical practitioner), 28G (choice of dental practitioner) and 28H (immunisation) shall cease to have effect.

Commencement Information

I1 S. 177 partly in force; s. 177 in force at Royal Assent for certain purposes, see s. 199(1)(4)

I2 S. 177(1)(2) in force at 3.2.2004 for specified purposes for E. by S.I. 2004/288, art. 4(1) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I3 S. 177(1) in force at 1.3.2004 for specified purposes for E. by S.I. 2004/288, art. 4(2)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I4 S. 177(1)-(11) in force at 1.12.2005 for E. so far as not already in force by S.I. 2005/2925, art. 6(1)(a)

I5 S. 177(2) in force at 1.3.2004 for specified purposes for E. by S.I. 2004/288, art. 4(2)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I6 S. 177(3)-(11) in force at 1.3.2004 for specified purposes for E. by S.I. 2004/288, art. 4(2)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I7 S. 177(12) in force at 1.4.2004 for specified purposes for E. by S.I. 2004/288, art. 4(3)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

178 Abolition of pilot schemes E+W

(1) Part 1 of the National Health Service (Primary Care) Act 1997 (c. 46) (power to make pilot schemes for the provision of personal medical and dental services) shall cease to have effect.

(2) This section extends to England and Wales only.

Commencement Information

I8 S. 178 in force at 1.4.2004 for specified purposes for E. by S.I. 2004/288, art. 4(3)(b) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

179 Persons performing primary medical and dental services E+W

(1) In the 1977 Act, after section 28W (as inserted by section 175 above) insert—

“28X Persons performing primary medical and dental services

(1) Regulations may provide that a health care professional of a prescribed description may not perform any primary medical service for which a Primary Care Trust or Local Health Board is responsible unless he is included in a list maintained under the regulations by a Primary Care Trust or Local Health Board.

(2) Regulations may provide that a health care professional of a prescribed description may not perform any primary dental service for which a Primary Care Trust or Local Health Board is responsible unless he is included in a list maintained under the regulations by a Primary Care Trust or Local Health Board.

(3) For the purposes of this section—

(a) “health care professional” means a person who is a member of a profession regulated by a body for the time being mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002;

(b) a Primary Care Trust or Local Health Board is responsible for a medical or dental service if it provides the service, or secures its provision, by or under any enactment.

(4) Regulations under this section may make provision in relation to lists under this section and in particular as to—

(a) the preparation, maintenance and publication of a list;

(b) eligibility for inclusion in a list;

(c) applications for inclusion (including provision as to the Primary Care Trust or Local Health Board to which an application must be made, and for the procedure for applications and the documents to be supplied on application);

(d) the grounds on which an application for inclusion may or must be granted or refused;

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

(f) suspension or removal from a list (including provision for the grounds for, and consequences of, suspension or removal);

(g) circumstances in which a person included in a list may not withdraw from it;

(h) payments to be made in respect of a person suspended from the list (including provision for the amount of the payment, or the method of calculating the payment, to be determined by the Secretary of State or National Assembly for Wales, or a person appointed by him or it);

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

(j) appeals against decisions made by a Primary Care Trust or Local Health Board under the regulations; and

(k) disclosure of information about applicants for inclusion, grants or refusals of applications or suspensions or removals;

and may make any provision corresponding to anything in sections 49F to 49N below.

(5) Regulations under this section may, in particular, also provide for—

(a) a person’s inclusion in a list to be subject to conditions determined by a Primary Care Trust or Local Health Board;

(b) a Trust or Board to vary the conditions or impose different ones;

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

(d) the review by a Trust or Board of decisions made by it by virtue of the regulations.

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

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

(b) preventing fraud.

(7) Regulations making provision as to the matters referred to in subsection (4)(k) may in particular authorise the disclosure of information—

(a) by a Primary Care Trust or Local Health Board to the Secretary of State or the National Assembly for Wales; and

(b) by the Secretary of State or the National Assembly for Wales to a Primary Care Trust or Local Health Board.”

(2) In section 49M(7) of that Act, at the end there is inserted “ ; and regulations under this subsection may include provision of the kind referred to in section 49I(10) ”.

Commencement Information

I9 S. 179 partly in force; s. 179 in force at Royal Assent for certain purposes, see s. 199(1)(4)

I10 S. 179(1) in force at 3.2.2004 for specified purposes for E. by S.I. 2004/288, art. 2(1)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I11 S. 179(1) in force at 28.2.2004 for specified purposes for W. by S.I. 2004/480, art. 2(1)(a) (with arts. 6, 7) (as amended by S.I. 2004/1019 and S.I. 2006/345)

I12 S. 179(1) in force at 1.12.2005 for E. so far as not already in force by S.I. 2005/2925, art. 4(1)(a)

I13 S. 179(2) in force at 3.2.2004 for E. by S.I. 2004/288, art. 2(1)(a) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I14 S. 179(2) in force at 28.2.2004 for W. by S.I. 2004/480, art. 2(1)(a) (with arts. 6, 7) (as amended by S.I. 2004/1019 and S.I. 2006/345)

180 Assistance and support E+W

In the 1977 Act, after section 28X (as inserted by section 179 above) insert—

“28Y Assistance and support

(1) A Primary Care Trust or Local Health Board may provide assistance or support to—

(a) any person providing, or proposing to provide primary medical services or primary dental services under a general medical services contract or a general dental services contract;

(b) any person providing, or proposing to provide, such services in accordance with section 28C arrangements.

(2) Assistance or support provided by a Primary Care Trust or Local Health Board under subsection (1) is to be provided on such terms, including terms as to payment, as the Trust or Board thinks fit.

(3) In this section “assistance” includes financial assistance.”

Commencement Information

I15 S. 180 in force at 28.2.2004 for specified purposes for W. by S.I. 2004/480, art. 2(1)(e) (with arts. 6, 7) (as amended by S.I. 2004/1019 and S.I. 2006/345)

I16 S. 180 in force at 1.3.2004 for specified purposes for E. by S.I. 2004/288, art. 2(2)(b) (with arts. 7, 8) (as amended by S.I. 2004/866 and S.I. 2005/2925)

I17 S. 180 in force at 1.1.2006 for E. so far as not already in force by S.I. 2005/2925, art. 4(2)(c)