The General Medical Services Transitional and Consequential Provisions (Wales) Order 2004

Entitlement to a contract under section 176(3) of the Act

13.—(1) For the purposes of section 176(3) of the Act, the circumstances in which a Local Health Board must enter into a contract for the provision of medical services (in this Order referred to as a default contract) are those set out in this article.

(2) Subject to paragraphs (5) and (6), a Local Health Board must, if a person so wishes, enter into a default contract with that person as an individual medical practitioner if that person—

(a) is, on 31st March 2004, entitled to enter into a general medical services contract under article 3(1); and

(b) on or before 31st March 2004—

(i) has not entered into a general medical services contract with that Local Health Board as an individual medical practitioner or as one of two or more individuals practising in partnership, or

(ii) is not a legal and beneficial shareholder in a company which has entered into such a contract with that Local Health Board.

(3) A Local Health Board must, if a person so wishes, enter into a default contract with him or her as one of two or more individuals practising in partnership if that person—

(a) is, on 31st March 2004, entitled to enter into a general medical services contract under article 5; and

(b) on or before 31st March 2004—

(i) has not entered into a general medical services contract with that Local Health Board as an individual medical practitioner or one of two or more individuals practising in partnership, or

(ii) is not a legal and beneficial shareholder in a company which has entered into such a contract with that Local Health Board.

(4) A contract entered into pursuant to paragraph (2) or (3) must—

(a) commence on 1st April 2004 or within 14 days of determination of an appeal under paragraph (9); and

(b) be on the terms set out, or agreed in accordance with any options set out, in the Default Contract 2004(1).

(5) A Local Health Board shall only be required to enter into a default contract under paragraph (2) with a person for whom, on 31st March 2004 (or on the date on which the contract is to be signed if earlier) it has in place temporary arrangements under regulation 25(6) of the 1992 Regulations(2), if it is satisfied, on the date that the contract is to be signed, that he or she is able to provide (but not perform) services under the contract.

(6) A Local Health Board shall only be required to enter into a default contract under paragraph (2) with a person who is, on 31st March 2004 (or on the date on which the contract is to be signed if earlier) suspended from the Medical Register in the circumstances specified in article 3(4) or suspended from its medical list, if it is satisfied, on the date that the contract is to be signed, that —

(a) in the case of a suspension on grounds relating to the practitioner’s physical or mental health, he or she is able to provide (but not perform) services under the contract;

(b) having regard to the grounds of suspension, the letting of the contract would not—

(i) put at risk the safety of the contractor’s patients, or

(ii) be prejudicial to the efficiency of the provision of primary medical services in the area of the Local Health Board; and

(c) the practitioner has in place adequate arrangements for the provision of services under the contract during the period of his suspension.

(7) Whenever a Local Health Board is considering refusing to enter into a default contract under paragraph (5) or (6) it shall consult the Local Medical Committee (if any) for its area before making its decision.

(8) Where a Local Health Board is refusing to enter into a default contract pursuant to paragraph (5) or (6) it shall notify the prospective contractor in writing of its decision, its reasons for that decision and of the practitioner’s right of appeal.

(9) Article 4 (appeal against refusal of a contract) shall apply to a refusal of a default contract by a Local Health Board under this article subject to the modifications that—

(a) the references to notification under article 3(8) in paragraphs (1) and (2) shall be read as references to notification under paragraph (8) of this article; and

(b) the reference to a general medical services contract in paragraph (12) shall be read as a reference to a default contract.

(1)

The Default Contract 2004 is published by the Department of Health. It is available on their web site at www.dh.gov.uk or a copy can be obtained by writing to the Department of Health, P.O. Box 777, London SE1 6XH.

(2)

Regulation 25(6) was amended by S.I. 2002/2469.