The National Health Service (General Dental Services) Regulations 1992

PART V PAYMENTS IN CONSEQUENCE OF SUSPENSION

Interpretation

23.  In this Part of these Regulations, unless the context otherwise requires—

(a) “claimant” means a person claiming to be entitled to, or receiving, payments;

“erasure” means the erasure of a person’s name from the register;

“fees” does not include remuneration by way of salary;

“immediate suspension” means suspension by virtue of an order under section 30(3) of the Dentists Act 1984(1) except suspension which is terminated by the court under section 30(6) of that Act;

“interim suspension order” means an order under section 32 of the Dentists Act 1984(1);

“payment” means a payment under this Part of these Regulations;

“register” means the register kept under section 14 of the Dentists Act 1984(2) and “registration” means registration in that register;

“suspension date” means the date on which suspension of a person’s registration takes effect;

(b)

a reference to a direction or an order of the Health Committee is to a direction or an order of that Committee under the Dentists Act 1984(2).

Entitlement to payments

24.—(1) Payments shall be made as provided for by this Part of these Regulations to a person whose registration is suspended by an interim suspension order or by a direction or an order of the Health Committee.

(2) Subject to paragraph (3), no payment shall be made to a person—

(a) whose registration has been suspended by a direction or an order of the Health Committee once he has received payments in respect of twelve months' such suspension, whether in respect of the same or a previous period of such suspension and whether or not those twelve months formed a continuous period;

(b) in respect of any part of a period of suspension where in the period of two years immediately preceding the suspension date he received no fees for the provision of general dental services.

(3) In calculating whether a person has received payments in respect of twelve months, suspension under paragraph (2)(a), no account shall be taken of any payment made in consequence of the suspension of his registration by a direction or order of the Health Committee more than five years previously.

(4) No payment shall be made to a person for a period (whether the whole or part of a period of suspension)—

(a) earlier than eight weeks before the date on which an application for payments is received by the FHSA, unless the FHSA is satisfied that the lateness of the application is due to illness or some other reasonable cause;

(b) during which his name is not included in the dental list of an FHSA;

(c) during which he is absent from the United Kingdom;

(d) for which he is entitled to any benefit under a contract of insurance against the risk of the suspension of his registration or of the circumstances which led to it or for which the FHSA is satisfied he could have been so entitled but for his failure to enter into such a contract or to pay any premium due under such a contract;

(e) during which he is serving a term of imprisonment;

(f) during which he is remanded in custody in connection with a criminal offence for which he is (then or later) convicted; or

(g) during which he is in breach of any condition of bail in connection with a criminal offence for which he is (then or later) convicted.

Application for payments

25.—(1) An application for payments shall be made to the FHSA in whose dental list the claimant’s name was included immediately before the suspension date; and where his name was then included in the list of more than one FHSA, the application shall be made to the FHSA by whom the larger or largest amount of remuneration was payable to him in the two years immediately preceding that date.

(2) An application for payments shall—

(a) be made in writing;

(b) be made by the claimant or, where he is incapable of applying, on his behalf; and

(c) contain or be supported by such information as the FHSA may reasonably require for the purpose of establishing the claimant’s entitlement to payments.

Amount and time of payments

26.—(1) An FHSA to whom an application for payments is made in accordance with regulation 25 shall, having made such enquiries as it considers relevant, if satisfied that the claimant is entitled to payments by virtue of regulation 24, determine that he shall, in respect of any period for which he is so entitled, receive payments which, subject to paragraphs (2) to (6), shall be of the following amounts—

(a) where his registration is suspended by a direction or an order of the Health Committee—

(i) £2,984 per month for each of the first six months for which payments are made to him, whether in respect of that or a previous period of such suspension and whether or not those six months form a continuous period, and

(ii) £1,492 per month thereafter;

(b) where his registration is suspended by an interim suspension order—

(i) where the period of interim suspension ends with an order for erasure or immediate suspension, £1,492 per month, and

(ii) in any other case, £2,984 per month.

(2) Where in the period of two years immediately preceding the suspension date the total amount of a claimant’s gross fees received for the provision of general dental services was less than £142,242, the amount of payments made to him shall (subject to any further reduction under paragraph (3)) be the same proportion of the amount otherwise payable in accordance with paragraph (1) as that total amount of fees is of £142,242.

(3) Where a claimant’s name was included in the dental list of an FHSA for a period of less than two years immediately preceding the suspension date the amount of payments made to him shall be the same proportion of the amount otherwise payable in accordance with paragraph (1) or paragraph (2) as the number of complete months in that lesser period is of 24.

(4) Where a claimant’s registration has been suspended by an interim suspension order or by a direction or an order of the Health Committee within a period of two years after the expiry of a previous period of any such suspension, the references in paragraphs (2) and (3) to the suspension date shall be taken as references to the suspension date as respects that previous period.

(5) Where the FHSA has to make a determination as to payments at a time when it does not know whether or not the period of a person’s interim suspension will end with an order for erasure or immediate suspension, or whether or not he will be convicted of a criminal offence, it shall make that determination as though his period of interim suspension did so end or he was convicted of the offence; but it shall review that determination and determine that a claimant is entitled to an appropriate payment of any arrears if subsequently that period does not so end or he is not convicted of the offence.

(6) Where the FHSA determines that a claimant is entitled to a payment, it shall inform the Board of the amount of that payment and authorise the Board to make the payment to the claimant.

(7) The Board shall make to the claimant any payments authorised by the FHSA.

(8) Payments under paragraph (7) shall be made monthly in arrears, and an appropriate proportion of the amount for a full month shall be paid where the claimant is entitled to a payment for part only of a month.

Changes of circumstances

27.—(1) A claimant shall notify the FHSA in writing immediately of any changes in his circumstances which he might reasonably be expected to know might affect his entitlement to, or the amount of, any payment made or to be made to him, and in particular of any erasure, immediate suspension, or termination of suspension, of his registration.

(2) Where the FHSA considers, whether or not following a notification under paragraph (1), that there has been a change of circumstances affecting a claimant’s payments it shall determine the adjustment as respects those payments which is appropriate to take account of that change and notify the Board accordingly.

Overpayments

28.  Where the Board considers that a payment has been made to a person owing to an error or in circumstances where it was not due it shall, except to the extent that the Secretary of State on the Board’s application directs otherwise, draw the overpayment to the attention of that person and—

(a) where he admits the overpayment; or

(b) where he does not admit the overpayment but, the matter having been referred under regulation 7 of the National Health Service (Service Committees and Tribunal) Regulations 1992(3) for investigation, the FHSA, or the Secretary of State on appeal, decides that there has been an overpayment,

the overpayment shall be recoverable either by deduction from that person’s remuneration or payments or in some other manner.

(1)

1984 c. 24.

(2)

1984 c. 24.

(3)

S.I. 1992/664.