The National Health Service (General Medical Services) (Amendment) (Wales) (No. 2) Regulations 2002

Insertion of new regulation 18EE and 18EF

7.  After regulation 18E insert—

“Grounds for refusal

18EE.— (1) The grounds on which a Health Authority may refuse to approve a doctor are—

(a) that the Health Authority having considered the declaration required by paragraph 6A of Part III of Schedule 3 and any other information in their possession in relation to this application considers the doctor is unsuitable to be included in the list;

(b) that having checked the information provided by the doctor in paragraphs 5 and 6 of Part III of Schedule 3 consider the practitioner is unsuitable to be included in the list;

(c) that having contacted referees, the Health Authority is not satisfied with the references given in accordance with paragraph 18 of that Part;

(d) that having checked with the National Health Service Counter Fraud Service for any facts that it considers relevant relating to past or current investigations into a fraud case, involving the doctor, and any fraud case involving the doctor, the Health Authority considers these justify such refusal;

(e) that there are any grounds for the Health Authority to consider that admitting the doctor to the list would be prejudicial to the efficiency of the service which the doctor would undertake;

(2) The grounds on which a Health Authority must refuse to approve or nominate an additional doctor are—

(a) where the doctor has been convicted in the United Kingdom of murder;

(b) where, after 30th July 2002, the doctor has been convicted in the United Kingdom of a criminal offence and sentenced to a term of imprisonment of over six months;

(c) where the doctor has been the subject of a national disqualification;

(d) where the doctor has not updated his or her application in accordance with regulation 18EF(4);

(e) where the doctor does not notify the Health Authority under regulation 18M(11) that the doctor wishes to be included in the list subject to the specified conditions.

(3) Where the Health Authority is considering refusal of a doctor under paragraph (1), it shall consider all facts which appear to it to be relevant and shall in particular take into consideration in relation to paragraph (1)(a), (b), or (d) above—

(a) the nature of any offence, investigation or incident;

(b) the length of time since such offence, or incident, conviction or investigation;

(c) whether there are other offences, incidents or investigations to be considered;

(d) any action or penalty imposed by any licensing, regulatory or other body, the police or the courts as a result of the offence, incident or investigation;

(e) the relevance of any offence, investigation or incident to the provision by him of general medical services and any likely risk to his patients or to public finances;

(f) whether any offence was a sexual offence to which Part I of the Sexual Offences Act 1997(1) applies; and

(g) whether the doctor has been refused admission to or conditionally included in, removed, contingently removed, or suspended from any of a Health Authority’s lists or equivalent lists, and if so, the facts relating to the matter which led to such action and the reasons given by the Health Authority or equivalent body for such action; and

(h) whether the doctor is at the time, has in the preceding six months been, or was at the time of the originating events a director of a body corporate which was refused admittance to, conditionally included, removed or contingently removed from other Health Authority lists or equivalent lists, and if so, the facts relating to the matter which led to such action and the reasons given by the Health Authority or equivalent body for such action;

(i) whether the doctor is at the time, has in the preceding six months been, or was at the time of the originating events, a director of a body corporate which is currently suspended from such a list, and if so, the facts relating to the matter which led to the suspension and the reasons given by the Health Authority or equivalent body for the suspension.

(4) When the Health Authority takes into consideration the matters set out in paragraph (3), it shall consider the overall effect of all the matters being considered.

(5) When refusing to nominate or approve an additional doctor, the Health Authority shall notify the doctor of its decision and the reasons for it (including any facts relied upon) and of any right of appeal under regulation 18GG against the Health Authority’s decision.

Deferment of Decision

18EF— (1) A Health Authority may defer a decision whether to approve an additional doctor under regulation 18A or 18B, or nominate the doctor under regulation 18C, or approve a replacement doctor under regulation 18I—

(a) where there are legal proceedings that are criminal proceedings in the United Kingdom, or where there are legal proceedings in respect of conduct which, if it had occurred in the United Kingdom would constitute a criminal offence, and that if successful would be likely to lead to the removal of the doctor from the Health Authority list if the doctor had been included;

(b) where there are legal proceedings that are criminal proceedings in the United Kingdom against a body corporate of which the doctor is, has in the preceding six months been, or was at the time of the originating events a director, or where there are legal proceedings in respect of conduct which, if it had occurred in the United Kingdom would constitute a criminal offence, and that if successful would be likely to lead to the removal of the doctor from the Health Authority list if the doctor had been included;

(c) where there is an investigation anywhere in the world by the doctor’s regulatory or licensing body or any other investigation (including one by another Health Authority ) relating to the doctor in the doctor’s professional capacity that if adverse would be likely to lead to the removal of the doctor from the Health Authority list if the doctor were to be included;

(d) where the doctor is suspended from any of the lists or equivalent lists;

(e) where a body corporate of which the doctor is, has in the preceding six months been, or was at the time of the originating events a director, is suspended from any of the lists or equivalent lists;

(f) where the FHSAA is considering an appeal by the doctor against a decision of a Health Authority to refuse to approve or nominate or admit a doctor to its list, or to conditionally include in or to contingently remove from, or to remove from any list kept by a Health Authority and if that appeal is unsuccessful the Health Authority would be likely to remove the doctor from the Health Authority list if the doctor had been included;

(g) where the FHSAA is considering an appeal by a body corporate of which the doctor is, had in the preceding six months been, or was at the time of the originating events a director, against a decision of a Health Authority to refuse to approve, nominate or admit the body corporate to its list, or to conditionally include in or to contingently remove from, or to remove from any list kept by a Health Authority and if that appeal is unsuccessful the Health Authority would be likely to remove the doctor from the Health Authority list if the doctor had been included;

(h) where the doctor is being investigated by the National Health Service Counter Fraud Services in relation to any fraud case, where the result if adverse would be likely to lead to the removal of the doctor from the Health Authority list if the doctor had been included;

(i) where a body corporate of which the doctor is, has been in the preceding six months been, or was at the time of the originating events a director, is being investigated by the National Health Service Counter Fraud Service in relation to any fraud case, where the result if adverse would be likely to lead to the removal of the doctor from the Health Authority list if the doctor were to be included;

(j) where the FHSAA is considering an application from a Health Authority for a national disqualification of the doctor;

(k) where the FHSAA is considering an application from a Health Authority for a national disqualification of the body corporate of which the doctor is, has been in the preceding six months been, or was at the time of the originating events a director.

(2) A Health Authority may only defer consideration under paragraph (1) above until the outcome of the relevant event mentioned in sub-paragraph (a), (b), (c), (f), (g), (h), (i), (j) or (k) is known or whilst the doctor or body corporate is suspended under sub-paragraph (d) or (e).

(3) A Health Authority must notify the doctor of a decision to defer a decision of an application and the reasons for this.

(4) Once the outcome of the relevant event mentioned in sub-paragraphs (a), (b), (c), (f), (g), (h), (i), (j) or (k) of paragraph (1) is known or the suspension referred to in sub-paragraph (d) or (e) comes to an end, the Health Authority shall notify the doctor in writing that the doctor must—

(a) update his or her application within 28 days of the date of the notification (or such longer period as the Health Authority may agree);

(b) confirm in writing within the period mentioned in sub-paragraph (a) that the doctor wishes to proceed with the application.

(5) Provided any additional information has been received within the 28 days the time agreed, the Health Authority shall notify the doctor as soon as possible—

(a) that the doctor’s application to be approved or nominated has been successful; or

(b) that the Health Authority has decided to refuse the application or impose conditions on the doctor’s inclusion, and the reasons for it (including any facts relied upon), and of any right of appeal under regulation 18GG or 18M(8).”.

(1)

1997 c. 51.