This is the original text of the Act except inso far as it relates to Community Health Councils, in respect of which an attempt has been made to incorporate the relevant amendments.
CHAPTER 49
ARRANGEMENT OF SECTIONS
Section
1. Secretary of State's duty as to health service.
2. Secretary of State's general power as to services.
3. Services generally.
4. Special hospitals.
5. Other services.
6. Central Health Services Council, and standing advisory committees.
7. Medical Practices Committee.
8. Regional and Area Health Authorities.
9. Special provisions for Area Health Authorities (Teaching).
10. Family Practitioner Committees.
11. Special health authorities.
12. Supplementary provisions for ss. 8 to 11.
13. Secretary of State's directions.
14. Regional Health Authority's directions.
15. Duty of Family Practitioner Committee.
16. Exercise of functions.
17. Directions as to exercise of functions.
18. Directions under ss. 13 to 17 generally.
19. Local advisory committees.
20. Community Health Councils.
21. Local social services authorities.
22. Co-operation between health authorities and local authorities.
23. Voluntary organisations and other bodies.
24. Overseas aid.
25. Supplies not readily obtainable.
26. Supply of goods and services by Secretary of State.
27. Conditions of supply under s. 26.
28. Supply of goods and services by local authorities.
29. Arrangements and regulations for general medical services.
30. Applications to provide general medical services.
31. Requirement of suitable experience.
32. Regulations as to s. 31.
33. Distribution of general medical services.
34. Regulations for Medical Practices Committee.
35. Arrangements for general dental services.
36. Regulations as to s. 35.
37. Dental Estimates Board.
38. Arrangements for general ophthalmic services.
39. Regulations as to s. 38.
40. Medical practitioners with qualifications prescribed under s. 38.
41. Arrangements for pharmaceutical services.
42. Regulations as to s. 41.
43. Persons authorised to provide pharmaceutical services.
44. Recognition of local representative committees.
45. Functions of local representative committees.
46. Disqualification of practitioners.
47. Removal of disqualification.
48. Disqualification provisions in Scotland or Northern Ireland.
49. Regulations as to ss. 46 to 48.
50. Exercise of choice of practitioner in certain cases.
51. University clinical teaching and research.
52. Use of accommodation.
53. Immunisation.
54. Prohibition of sale of medical practices.
55. Decision of disputes.
56. Inadequate services.
57. Maximum price of medical supplies may be controlled.
58. Additional powers as to accommodation and services.
59. S. 58 power in relation to private patients.
60. Additional provision as to charges under s. 58.
61. Additional powers as to disposal and production of goods.
62. Restriction of powers under ss. 25, 58 and 61.
63. Hospital accommodation on part payment.
64. Expenses payable by remuneratively employed resident patients.
65. Accommodation and services for private resident patients.
66. Accommodation and services for private non-resident patients.
67. Withdrawal of facilities available for private patients.
68. Revocation of authorisations under s. 65 or s. 66.
69. Further provisions as to revocation of s. 66 authorisations.
70. Principles as to proposals under s. 68 or s. 69.
71. Restrictions on authorisations under s. 65 or s. 66.
72. Permission for use of facilities in private practice.
73. Information for Health Services Board.
74. Publication of matters under ss. 68 and 71.
75. Reports on extent of facilities for -private patients.
76. "Common waiting-lists".
77. Charges for drugs, medicines or appliances, or pharmaceutical services.
78. Charges for dental or optical appliances.
79. Charges for dental treatment.
80. Charges for designated facilities.
81. Charges for more expensive supplies.
82. Charges for repairs and replacements in certain cases.
83. Sums otherwise payable to those providing services.
84. Inquiries.
85. Default powers.
86. Emergency powers.
87. Acquisition, use and maintenance of property.
88. Transferred property free of trusts.
89. Power of voluntary organisations to transfer property.
90. Gifts on trust.
91. Private trusts for hospitals.
92. Further transfers of trust property.
93. Trust property previously held for general hospital purposes.
94. Application of trust property: further provisions.
95. Special trustees for a university or teaching hospital.
96. Trusts: supplementary provisions.
97. Expenses of health authorities.
98. Accounts and audit.
99. Regulation of financial arrangements.
100. Other payments.
101. Secretary of State's receipts.
102. Allowances and remuneration for members of certain bodies.
103. Special arrangement as to payment of remuneration.
104. Superannuation of officers of certain hospitals.
105. Payments for certain medical examinations.
106. Appointment and tenure of office of Commissioners.
107. Salaries and pensions of Commissioners.
108. Administrative provisions.
109. Bodies subject to investigation. .
110. Investigations for England, and for Wales.
111. Who may complain.
112. Reply.
113. Commissioner's discretion.
114. Procedure, and additional procedural provisions.
115. Matters subject to investigation.
116. Matters not subject to investigation.
117. Reference to Commissioner by relevant body.
1] 8. Consultations between Commissioners and Local Commissioners.
119. Reports by Commissioners.
120. Interpretation of Part. V.
121. Charges in respect of non-residents.
122. Recovery of charges.
123. Persons displaced by health service development.
124. Special notices of births and deaths.
125. Protection of members and officers of authorities.
126. Orders and regulations, and directions.
127. Supplementary regulatory powers..
128. Interpretation and construction.
129. Transitional provisions and savings, consequential amendments, and repeals.
130. Short title, extent and commencement.
Schedule 1-Additional provisions as to the medical and dental inspection and
treatment of pupils.
Schedule 2-Additional provisions as to vehicles for those suffering disability.
Schedule 3-PubIic Health Laboratory Service Board.
Schedule 4-Central Health Services Council and advisory committees.
Schedule 5-Regional and Area Health Authorities, Family Practitioner Committees,
and special health authorities.
Schedule 6-Additional provisions as to local advisory committees.
Schedule 7-Additional provisions as to Community Health Councils.
Schedule 8-Local social services authorities.
Schedule 9- Tribunal for purposes of section 46.
Schedule 10-Additional provisions as to prohibition of sale of medical practices.
Schedule 11-Additional provisions as to the control of maximum prices for medical
supplies.
Schedule 12-Additional provisions as to regulations for the making and recovery
of charges.
Schedule Schedule 13-Additional provisions as to the Health Service Commissioner
for England and the Health Service Commissioner for Wales.
Schedule 14-Transitional provisions and savings.
Schedule 15-Consequential amendments.
Schedule 16-Repeals.
An Act to consolidate certain provisions relating to the health service for England and Wales; and to repeal certain enactments relating to the health service which have ceased to have any effect. [29th July 1977]
BE IT ENACTED by the Queen's most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:
1.-(1) It is the Secretary of State's duty to continue the promotion in England
and Wales of a comprehensive health service designed to secure improvement-
(a) in the physical and mental health of the people of those countries, and
(b) in the prevention, diagnosis and treatment of illness,
and for that purpose to provide or secure the effective provision of services
in accordance with this Act.
(2) The services so provided shall be free of charge except in so far as the
making and recovery of charges is expressly provided for by or under any enactment,
whenever passed.
2. Without prejudice to the Secretary of State's powers apart from this section,
he has power
(a) to provide such services as he considers appropriate for the purpose of
discharging any duty imposed on him by this Act; and .
(b) to do any other thing whatsoever which is calculated to facilitate, or is
conducive or incidental to, the
discharge of such a duty.
This section is subject to section 3(3) below.
3.-(1) It is the Secretary of State's duty to provide throughout England and
Wales, to such extent as he considers necessary to meet all reasonable requirements
(a) hospital accommodation;
(b) other accommodation for the purpose of any service provided under this Act;
(c) medical, dental, nursing and ambulance services ;
(d) such other facilities for the care of expectant and nursing mothers and
young children as he considers are appropriate as part of the health service;
(e) such facilities for the prevention of illness, the care of persons suffering
from illness and the after-care of persons who have suffered from illness as
he considers are appropriate as part of the health service;
(f) such other services as are required for the diagnosis and treatment of illness.
(2) Where any hospital provided by the Secretary of State in accordance with
this Act was a voluntary hospital transferred by virtue of the National Health
Service Act 1946, and
(a) the character and associations of that hospital before its transfer were
such as to link it with a particular religious denomination, then
(b) regard shall be had in the general administration of the hospital to the
preservation of that character and those associations.
(3) Nothing in section 2 above or in this section affects the provisions of
Part 11 of this Act (which relates to arrangements with practitioners for the
provision of medical, dental, ophthalmic and pharmaceutical services).
4. The duty imposed on the Secretary of State by section 1 above to provide services for the purposes of the health service includes a duty to provide and maintain establishments (in this Act referred to as "special hospitals") for persons subject to detention under the Mental Health Act 1959 who in his opinion require treatment under conditions of special security on account of their dangerous, violent or criminal propensities
5.-( 1) It is the Secretary of State's duty-
(a) to provide for the medical and dental inspection at appropriate intervals
of pupils in attendance at schools maintained by local education authorities
and for the medical and dental treatment of such pupils (and the additional
provisions set out in Schedule 1 to this Act have effect in relation to this
paragraph) ;
(b) to arrange, to such extent as he considers necessary to meet all reasonable
requirements in England and Wales, for the giving of advice on contraception,
the medical examination of persons seeking advice on contraception, the treatment
of such persons and the supply of contraceptive substances and appliances.
(2) The Secretary of State may
(a) provide invalid carriages for persons appearing to him to be suffering from
severe physical defect or disability and, at the request of such a person, may
provide for him a vehicle other than an invalid carriage (and the additional
provisions set out in Schedule 2 to this Act have effect in relation to this
paragraph) ;
(b) arrange to provide accommodation and treatment outside Great Britain for
persons suffering from respiratory tuberculosis;
(c) provide a microbiological service, which may include the provision of laboratories,
for the control of the spread of infectious diseases (and the Secretary of State
may allow persons to use services provided at such laboratories on such terms,
including terms as to charges, as he thinks fit) ;
(d) conduct, or assist by grants or otherwise (without prejudice to the general
powers and duties conferred on him under the Ministry of Health Act 1919) any
person to conduct, research into any matters relating to the causation, prevention,
diagnosis or treatment of illness, and into any such other matters connected
with any service provided under this Act as he considers appropriate.
(3) Regulations may provide for the payment by the Secretary of State in such
cases .as may be prescribed of travelling expenses (including the travelling
expenses of a companion) incurred or to be incurred by persons for the purpose
of availing themselves of any services provided under this Act.
(4) The Public Health Laboratory Service Board continues in being for the purpose
of exercising such functions with respect to the administration of the public
health laboratory service (the service referred to in paragraph (c) of subsection
(2) above) as the Secretary of State may determine.
(5) The Board shall continue to be constituted in accordance with Part I of
Schedule 3 to this Act, and the additional provisions set out in Part 11 of
that Schedule have effect in relation to the Board.
6.-(1) The Central Health Services Council (in this Act referred to as "the
Central Council") shall have the duty of advising the Secretary of State
upon such general matters relating to the services provided under this Act as
the Council think fit, and upon any questions relating to those services which
he may refer to them.
(2) The Central Council shall be constituted in accordance with Schedule 4 to
this Act, but the Secretary of State may by order vary that constitution after
consultation with the Council; and the supplementary provisions of that Schedule
have effect in relation to the Central Council and any standing advisory committee
constituted under subsection (3) below.
(3) The Secretary of State may, after consultation with the Central Council,
by order constitute standing advisory committees for the purpose of advising
him and the Council on such of the services provided under this Act as may be
specified in the order.
(4) Any committee so constituted shall consist partly of members of the Central
Council appointed by the Secretary of State, and partly of persons (whether
or not members of the Council) appointed by the Secretary of State after consultation
with such representative organisations as he may recognise for the purpose.
(5) It shall be the duty of a committee so constituted to advise the Secretary
of State and the Central Council
(a) upon such matters relating to the services with which the committee are
concerned as they think fit, and
(b) upon any questions referred to them by the Secretary of State or the Council
relating to those services,
and, if the committee advise the Secretary of State upon any matter, they shall
inform the Council, who may express their views on the matter to the Secretary
of State.
(6) The Central Council shall make an annual report to the Secretary of State
on their proceedings, and on the proceedings of any standing advisory committee
constituted under subsection (3) above, and, subject to subsection (7) below
the Secretary of State shall lay that report before Parliament with such comments
(if any) as he thinks fit.
(7) If the Secretary of State, after consultation with the Central Council, is satisfied that it would be contrary to the public interest to lay any such report, or a part of any such report before Parliament, he may refrain from so laying that report or that part.
7.-(1) The Medical Practices Committee--
(a) shall consist of a chairman and eight other members appointed by the Secretary
of State after consultation with such organisations as he may recognise as representative
of the medical profession; and
(b) the chairman and six of the other members shall be medical practitioners,
and five at least of those six shall be actively engaged in medical practice.
(2) The Secretary of State may
(a) make regulations as to the appointment, tenure of office and vacation of
office of the members of the Committee ; and
(b) provide the services of such officers as the Committee may require.
(3) The Committee's proceedings shall not be invalidated by any vacancy in its
membership or by any defect in a member's appointment or qualification.
8.(1) It is the Secretary of State's duty to establish by order in accordance
with Part I of Schedule 5 to this Act-
(a) authorities, to be called Regional Health Authorities, for such regions
in England as he may by order
determine, and
(b) authorities, to be called either Area Health Authorities
or (in accordance with section 9 below) Area Health Authorities (Teaching),
for such areas in Wales and those regions as he may by order determine,
and orders determining regions or areas in pursuance of this subsection shall
be separate from orders establishing authorities for the regions or areas.
Any reference in the following provisions of this Act to an Area Health Authority
includes a reference to an Area. Health Authority (Teaching) unless the context
otherwise requires.
(2) The Secretary of State may by order vary the region of a Regional Health
Authority or the area of an Area Health Authority whether or not the variation
entails the determination of a new or the abolition of an existing region or
area.
(3) It is the .Secretary of State's duty to exercise the powers conferred on
him by the preceding provisions of this section so as to secure-
(a) that the regions determined in pursuance of those provisions together comprise
the whole of England, that the areas so determined together comprise the whole
of Wales and those regions and that no region includes part only of any area;
and
(b) that the provision of health services in each region can conveniently be
associated with a university which has a school of medicine or with two or more
such universities.
(4) An order made by virtue of subsection (2) above may (without prejudice to
the generality of section 126(4) below) contain such provisions for the transfer
of officers, property, rights and liabilities as the Secretary of State thinks
fit.
(5) It is the Secretary of State's duty before he makes an order under subsection
(2) to consult with respect to the order
(a) such bodies as he may recognise as representing officers who in his opinion
are likely to be transferred ,or affected by transfers in pursuance of the order;
and
(b) such other bodies as he considers are concerned with the order.
9.-( 1) An order establishing an Authority in pursuance of paragraph (b) of
section 8(1) above may provide for it to be called an Area Health Authority
(Teaching) if and only if the Secretary of State is satisfied that the Authority
is to provide for a university or universities substantial facilities for undergraduate
or post-graduate clinical teaching.
(2) Where the Secretary of State is satisfied that an Area Health Authority
is to provide, or is providing such facilities, he may provide by order for
the Authority to be called an Area Health Authority (Teaching), and, where he
is satisfied that an Area Health Authority (Teaching) no longer provides such
facilities, he may provide by order for the Authority to be called an Area Health
Authority.
(3) It is the Secretary of State's duty, before providing that an Authority
shall be called or cease to be called an Area Health Authority (Teaching), to
consult the university or universities concerned with the facilities in question.
10. It is the duty of each Area Health Authority to establish for its area, in accordance with Part 11 of Schedule 5 to this Act, a body called a Family Practitioner Committee, and each Family Practitioner Committee has the duty described in section 15
11.-(1) If the Secretary of State considers that a special body should be established
for the purpose of performing any functions which he may direct the body to
perform on his behalf, authorities.
or on behalf of an Area Health Authority or a Family Practitioner Committee,
he may by order establish a body for that purpose.
(2) The Secretary of State may, subject to the provisions of Part III of Schedule
5 to this Act, make such further provision relating to that body as he thinks
fit
(3) A body established in pursuance of this section shall (without prejudice
to the power conferred by subsection (4) below to allocate a particular name
to the body) be called a special health authority.
(4) Without prejudice to the generality of the power conferred by this section
to make an order (or of section 126(4) below), that order may in particular
contain provisions as to
(a) the membership of the body established by the order;
(b) the transfer to the body of officers, property, rights and liabilities;
and
(c) the name by which the body is to be known.
(5) It is the Secretary of State's duty before he makes such an order to consult
with respect to the order such bodies as he may recognise as representing officers
who in his opinion are likely to be transferred or affected by transfers in
pursuance of the order.
12. The provisions of Part III of Schedule 5 to this Act have effect, so far
as applicable, in relation to-
(a) Regional Health Authorities and Area Health Authorities established under
section 8 above;
(b) Family Practitioner Committees established under section 10 above;
(c) any special health authority established under section 11 above.
13.-(1) The Secretary of State may direct a Regional Health Authority, an Area Health Authority of which the area is in Wales or a special health authority to exercise on his behalf such of his functions relating to the health service as are specified in the directions, and (subject to section 14 below) it shall be the duty of the body in question to comply with the directions.
(2) The Secretary of State's functions under subsection (1) above-
(a) include any of his functions under enactments relating to mental health
and nursing homes, but
(b) exclude the duty imposed on him by section 1(1) above to secure the effective
provision of the services mentioned in section 15 below.
14.-( 1) A Regional Health Authority may direct any Area Health Authority of
which the area is included in its region to exercise such of the functions exercisable
by the Regional Health Authority by virtue of section 13 above as are specified
in the directions, and it is the Area Health Authority's duty to comply with
the directions.
(2) If the Secretary of State directs a Regional Health Authority to secure
that any of its functions specified in his directions are or are not exercisable
by an Area Health Authority it is the Regional Health Authority's duty to comply
with his directions.
15.-( 1) It is the duty of each Family Practitioner Committee, in accordance
with regulations
(a) to administer, on behalf of the Area Health Authority by which the Committee
was established, the arrangements made in pursuance of this Act for the provision
of general medical services, general dental services, general ophthalmic services
and pharmaceutical services for the area of the Authority, and
(b) to perform such other functions relating to those services as may be prescribed.
(2) If it appears to the Secretary of State that, in consequence of regulations
made by virtue of the preceding provisions of this section, references to an
Area Health Authority in particular provisions of this Act should be construed
as references to a Family Practitioner Committee, he may by regulations provide
accordingly.
16.-( 1) Regulations may provide for functions exercisable by virtue of the
provisions of sections 13 to 15 above by a body other than an Area Health Authority,
or exercisable by virtue of any provision of this Act by an Area Health Authority,
to be exercisable on behalf of the body in question
(a) by an equivalent body or by another body of which the members consist only
of the body and equivalent bodies;
(b) by a committee, sub-committee or officer of the body or an equivalent body
or such another body as afore said;
(c) in the case of functions exercisable by an Area Health Authority, by a special
health authority, an officer of such an authority or a Family Practitioner Committee;
(d) in the case of functions exercisable by a Family Practitioner Committee,
by a special health authority,
an officer of such an authority or an officer of an Area Health Authority.
(2) For the purposes of subsection (1) above, a Regional or Area Health Authority
or a Family Practitioner Committee is equivalent to another body of the same
name and a special health authority is equivalent to another such authority.
(3) Nothing in this section shall be construed as precluding any body from acting
by an agent where it is entitled so to act apart from this section.
17. The Secretary of State may give directions with respect to Directions as
the exercise of any functions exercisable by virtue of sections 13 to 16 above,
or by an Area Health Authority by virtue of Part 11 of this Act; and, subject
to any directions given by the Secretary of State by virtue of this section
(a) a Regional Health Authority may give directions with respect to the exercise
by an Area Health Authority of which the area is included in its region, of
any functions exercisable by the Area Health Authority by virtue of section
14 above,
(b) an Area Health Authority may give directions with respect to the exercise
by the Family Practitioner Committee established by it of any functions which
are exercisable by the Committee by virtue of section 15 above and are prescribed
for the purposes of this paragraph, and it shall be the duty of the body in
question to comply with the directions.
18.-( 1) Any directions given by the Secretary of State in pursuance of sections
13 to 17 above shall be given either by regulations or by an Instrument In writing,
except that-
(a) any such directions in pursuance of section 13 above in respect of functions
relating to special hospitals, and
(b) any such directions in respect of functions conferred on the Secretary of
State by section 20(1) or (2) below,
shall only be given by regulations
(2) Any directions given by an Authority in pursuance of sections 13 to 17
shall be given by an instrument in writing.
(3) Directions given and regulations made under sections 13 to 17 in respect
of any function
(a) shall not, except in prescribed cases, preclude a body or person by whom
the function is exercisable apart from the directions or regulations from exercising
the function, and
(b) may in the case of directions given by an instrument in writing be varied
or revoked by subsequent directions given in pursuance of those sections and
this section (without prejudice to the operation of section 32(3) of the Interpretation
Act 1889 in the case of directions given by regulations), so, however, that
an Area Health Authority shall not be entitled to exercise any functions which,
by virtue of section 15 above, are exercisable by the Family Practitioner Committee
established by the Authority.
19.-( 1) Where the Secretary of State is satisfied that a committee formed
for Wales, or for the region of a Regional Health Authority, is representative
of persons of any of the following categories
(a) the medical practitioners, or
(b) the dental practitioners, or
(c) the nurses and midwives, or
(d) the registered pharmacists, or
(e) the ophthalmic and dispensing opticians,
of Wales or of the region, then it shall be his duty to recognise the committee.
(2) A committee recognised in pursuance of subsection (1) above shall be called
(a) the Welsh Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical
Committee, as the case may be;
(b) the Regional Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical
Committee, as the case may be, for the region in question.
(3) Where the Secretary of State is satisfied that a committee formed for the
area of an Area Health Authority is representative of persons of any of the
categories mentioned in paragraphs
(a) to (e) in subsection (1) it shall be his duty to recognise the committee.
A committee recognised in pursuance of this subsection shall be called the Area
Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical Committee,
as the case may be, for the area in question.
(4) The Secretary of State's duty under subsections (1) and (3) above is subject
to paragraph 1 of Schedule 6 to this Act, and that Schedule has effect in relation
to a committee recognised
in pursuance of this section.
20.-(1) It is the Secretary of State's duty to establish in accordance with
this section a council for the area of each Area Health Authority, or separate
councils for such separate parts of the areas of those Authorities as he thinks
fit, and such a council shall be caned a Community Health Council.
(2) The Secretary of State
(a) may if he thinks fit discharge this duty by establishing a Community Health
Council for a district which includes the areas or parts of the areas of two
or more Area Health Authorities, but
(b) shall be treated as not having discharged that duty unless he secures that
there is no part of the area of
an Area Health Authority which is not included in some Community Health Council's
district.
(3) The additional provisions of Schedule 7 to this Act have effect in relation
to Community Health Councils.
This section has been amended by the Health Authorities Act 1995. CHCs were originally established by section 9 of the NHS (Reorganisation) Act 1973, which was replaced by this provision. This section makes it clear that there is no necessity for the area of the CHC to match that of a health authority. The area of each Council is established by the Secretary of State.
Section 20A (inserted by the Health (Wales) Act 2003)
1 It is the duty of a Council-
(a) to represent the interests in the health service of the public in its district;
and
(b) to perform such other functions as may be conferred on it by regulations
under paragraph 2.
2 The National Assembly for Wales may by regulations make provision about-
(a) the membership of Councils (including the election by members of a Council
of a member to chair the Council);
(b) the proceedings of Councils;
(c) the staff, premises and expenses of Councils;
(d) the discharge of any function of a Council by a committee of the Council
or by a joint committee appointed with another Council;
(e) the appointment, as members of a committee or joint committee, of persons
who are not members of the Council or Councils concerned;
(f) the consultation of Councils by Health Authorities, Local Health Boards,
Strategic Health Authorities, Primary Care Trusts and NHS trusts with respect
to such matters, and on such occasions, as may be prescribed;
(g) the consideration by Councils of matters relating to the operation of the
health service within their districts, and the giving of advice by Councils
to Health Authorities, Local Health Boards and NHS trusts on such matters;
(h) the preparation and publication of reports by Councils;
(i) matters to be included in any such report;
(j) the furnishing and publication by Health Authorities, Local Health Boards
and NHS trusts of comments on reports of Councils;
(k) the provision of information (including descriptions of information which
are or are not to be provided) to Councils by Health Authorities, Local Health
Boards, Strategic Health Authorities, Primary Care Trusts or NHS trusts;
(l) the provision of information (including descriptions of information which
are or are not to be provided) by Councils to other persons (including other
Councils);
(m) the provision by Councils on behalf of the Assembly of the independent advocacy
services required to be provided under section 19A of this Act;
(n) the functions to be exercised by Councils in addition to those exercisable
otherwise by virtue of this Schedule.
3 (1) The Assembly may make regulations requiring-
(a) Health Authorities;
(b) Local Health Boards;
(c) Strategic Health Authorities;
(d) Primary Care Trusts;
(e) local authorities;
(f) NHS trusts;
(g) persons providing services under Part 2 of this Act or under arrangements
under section 28C of this Act; or
(h) persons providing piloted services under pilot schemes established under
section 28 of the Health and Social Care Act 2001 (c. 15), or providing LP services
under an LPS scheme established under Schedule 8A to this Act,
to allow members of a Council authorised by or under the regulations to enter
and inspect, for the purposes of any of the Council's functions, premises owned
or controlled by those referred to in paragraphs (a) to (h).
(2) The Assembly may also make regulations requiring any other person who owns
or controls premises where services are provided as mentioned in sub-paragraph
(1)(g) or (h) to allow members of a Council authorised by or under the regulations
to enter and inspect the premises for the purposes of any of the Council's functions.
(3) The regulations may in particular make provision as to-
(a) cases and circumstances in which access is to be permitted;
(b) limitations or conditions to which access is to be subject.
4 The Assembly may by regulations-
(a) provide for the establishment of a body-
(i) to advise Councils with respect to the performance of their functions, and
to assist Councils in the performance of their functions; and
(ii) to perform such other functions as may be prescribed; and
(b) provide for the membership, proceedings, staff, premises and expenses of
that body.
5 The Assembly may pay to members of Councils and any body established under
paragraph 4 such travelling and other allowances (including compensation for
loss of remunerative time) as it may determine.
21.-( 1) Subject to paragraphs (d) and (e) of section 3 (1) above, the services
described in Schedule 8 to this Act in relation to-
(a) care of mothers and young children,
(b) prevention, care and after-care,
(c) home help and laundry facilities,
are functions exercisable by local social services authorities, and that Schedule
has effect accordingly.
(2) A local social services authority who provide premises, furniture or equipment
for any of the purposes of this Act may permit the use of the premises, furniture
or equipment
(a) by any other local social services authority, or
(b) by any of the bodies constituted under this Act, or
(c) by a local education authority.
This permission may be on such terms (including terms with respect to the services
of any staff employed by the authority giving permission as may be agreed.
(3) A local social services authority may provide (or improve or furnish) residential
accommodation
(a) for officers employed by them for the purposes of any of their functions
as a local social services authority, or
(b) for officers employed by a voluntary organisation for the purposes of any
services provided under this section and Schedule 8.
22.-(1) In exercising their respective functions health and local authorities
shall co-operate with one
another in order to secure and advance the health and welfare of the people
of England and Wales.
(2) There shall be committees, to be called joint consultative committees, who shall advise Area Health Authorities and the authorities in column 2 of the Table below on the performance of their duties under subsection (1) above, and on the planning and operation of services of common concern to those authorities.
TABLE
| 1 Area Health Authority | 2 Associated authorities |
| An Area Health Authority in a metropolitan county in England. | The local authority for each district wholly or partly in the area of the Authority. |
| An Area Health Authority in a non-metropolitan county in England,
or an Area Health Authority in Wales. |
The local authority for each county, and also for each district, wholly or partly in the area of the Authority. |
| An Area Health Authority in Greater London. | The local authority for each London borough wholly or partly in the area of the Authority. |
| Also the Inner London Education Authority, if wholly or partly
in the area of the Authority . Also the Common Council of the City of London, if in the area of the Authority. |
(3) Except as provided by an order under the following provisions of this section,
each joint consultative committee shall represent one or more Area Health Authorities
together with one or more of the authorities in column 2 of the Table above,
and an Area Health Authority shall be represented together with each of the
authorities associated with that Authority in column 2 of the said Table in
one or other of the committees (but not necessarily the same committee).
(4) The Secretary of State shall have power by order to provide for any matter
relating to joint consultative committees, and such an order may in particular
(a) provide for the way in which the previsions of subsections (2) and (3) above
are to be carried out, or provide for varying the arrangements set out in these
subsections;
(b) provide, where it appears to the Secretary of State appropriate, for an
Area Health Authority to be represented on a joint consultative committee together
with a local or ether authority whose area is not within the area of the Area
Health Authority ;
(c) afford a choice to any authorities as to the number of joint consultative
committees on which they are to be represented, and provide for the case where
the authorities cannot agree on the choice ;
(d) authorise or require a joint consultative committee to appoint any sub-committee
or to join with another joint consultative committee or other joint consultative
committees in appointing a joint sub-committee ;
(e) authorise or require the appointment to a joint consultative committee,
or to any sub-committee, of persons who are not members of the authorities represented
by the joint consultative committee;
(f) require the authorities represented on a joint consultative committee to
defray the expenses of the committee, and of any sub-committee, in such shares
as may be determined by or under the order, and provide for the way in which
any dispute between these authorities concerning the expenses is to be resolved;
and
(g) require these authorities to make reports to the Secretary of State on the
work of the joint consultative Committee and of any sub-committee.
(5) Before making an order under this section the Secretary of State shall consult
with such associations of local authorities as appear to him to be concerned,
and with any local authority with whom consultation appears to him to be desirable.
23.-(l) The Secretary of State may, where be considers it appropriate, arrange with any person or body (including a voluntary organisation) for that person or body to provide, or assist in providing, any service under this Act.
In this section" voluntary organisation" means a body the activities
of which are carried on otherwise than for profit, but does not include any
public or local authority.
(2) The Secretary of State may make available
(a) to any person or body (including a voluntary organisation) carrying out
any arrangements under subsection (1) above, or
(b) to any voluntary organisation eligible for assistance under section 64 or
section 65 of the Health Services and Public Health Act 1968 (assistance made
available by the Secretary of State or local authorities),
any facilities (including goods or materials, or the use of any premises and
the use of any vehicle, plant or apparatus) provided by him for any service
under this Act; and, where anything is so made available, the services of persons
employed by the Secretary of State or by a health authority in connection with
it.
(3) The powers conferred by this section may be exercised on such terms as may
be agreed, including terms as to the making of payments by or to the Secretary
of State, and any goods or materials may be made available either temporarily
or permanently.
(4) The Secretary of State may by order provide that, in relation to a vehicle
which is made available by him in pursuance of this section and is used in accordance
with the terms on which it is so made available, the Vehicles (Excise) Act 1971
and Part VI of the Road Traffic Act 1972 shall have effect with such modifications
as are specified in the order.
(5) Any power to supply goods or n1aterials conferred by this section includes
a power to purchase and store them and includes a power to arrange with third
parties for the supply of goods or materials by those third parties.
24. Each health authority and the Public Health Laboratory Service Board has
power
(a) with the Secretary of State's consent, to enter into and carry out agreements
with the relevant Minister under which, at the expense of that Minister, the
authority or board acts as the instrument by means of which he furnishes technical
assistance in the exercise of the power conferred on him by section 1 (1) of
the Overseas Aid Act 1966;
(b) with the consent of the Secretary of State and the relevant Minister, to
enter into and carry out agreements which under the authority or board furnishes,
for any purpose specified in that section 1 (1), technical assistance (excluding
financial assistance) in any country or territory outside the United Kingdom
against reimbursement to the authority or board of the cost of furnishing the
assistance.
In this section" the relevant Minister" means the Minister of the
Crown by whom is exercisable the power conferred on the Minister of Overseas
Development by that section 1 (1) as originally enacted.
25. Where the Secretary of State has acquired-
(a) supplies of human blood for the purposes of any service under this Act,
or .
(b) any part of a human body for the purpose of, or in the course of providing,
any such service, or
(c) supplies of any other substances or preparations not readily obtainable,
he may arrange to make such supplies or that part available (on such terms,
including terms as to charges, as he thinks fit) to any person.
This section is subject to section 62 below (restriction of powers under sections
25, 58 and 61).
26.-(1) The Secretary of State may-
(a) supply to local authorities, and to such public bodies or classes of public
bodies as he may determine, any goods or materials of a kind used in the health
service;
(b) make available to local authorities, and to those bodies or classes of bodies,
any facilities (including the use of any premises and the use of any vehicle,
plant or apparatus) provided by him for any service under this Act, and the
services of persons employed by the Secretary of State or by a health authority;
(c) carry out maintenance work in connection with any land or building for the
maintenance of which a local authority is responsible.
In this subsection
"maintenance work" includes minor renewals, minor improvements and
minor extensions; and
"public bodies" includes public bodies in Northern Ireland.
(2) The Secretary of State may supply or make available to persons providing
general medical services, general dental services, general ophthalmic services
or pharmaceutical services such goods, materials or other facilities as may
be prescribed.
(3) The Secretary of State shall make available to local authorities
(a) any services or other facilities (excluding the services of any person but
including goods or materials, the use of any premises and the use of any vehicle,
plant or apparatus) provided under this Act,
(b) the services provided as part of the health service by any person employed
by the Secretary of State or a health authority, and
(c) the services of any medical practitioner, dental practitioner or nurse employed
by the Secretary of State or a health authority otherwise than to provide services
which are part of the health service,
so far as is reasonably necessary and practicable to enable local authorities
to discharge their functions relating to social services, education and public
health.
27.-(1) It is the Secretary of State's duty, before he makes the services of
any officer of a health authority available in pursuance of subsection (1)(b)
or subsection (3)(b) or (c) of section 26 above, to consult the officer or a
body recognised by the Secretary of State as representing the officer about
the matter, or to satisfy himself that the health authority has consulted the
officer about the matter.
(2) The Secretary of State shall be entitled to disregard the provisions of
subsection (1) above in a case where he considers it necessary to make the services
of an officer available as mentioned in that subsection for the purpose of dealing
temporarily with an emergency, and has previously consulted such a body about
the making available of services in an emergency.
(3) For the purposes of subsection (1)(b) or subsection (3)(b) or (c) of section
26 the Secretary of State may give such directions to health authorities to
make the services of their officers available as he considers appropriate; and
it shall be the health authority's duty to comply with any such directions.
(4) The powers conferred by this section and section 26 may be exercised on
such terms as may be agreed, including terms as to the making of payments to
the Secretary of State, and such charges may be made by the Secretary of State
in respect of services or facilities provided under subsection (3) of section
26 as may be agreed between the Secretary of State and the local authority or,
in default of agreement, as may be determined by arbitration.
(5) The Secretary of State may by order provide that, in relation to a vehicle
which is made available by him in pursuance of section 26 and is used in accordance
with the terms on which it is so made available, the Vehicles (Excise) Act 19711971
c. 10. and Part VI of the Road Traffic Act 1972 shall have effect with 1972
c. 20. such modifications as are specified in the order.
(6) Any power to supply goods or materials conferred by section 26 includes
a power to purchase and store them, and a power to arrange with third parties
for the supply of goods or materials by those third parties.
28.-(1) In the Local Authorities (Goods and Services) Act 1970 the expression"
public. body". includes any health authority and so far as relates to his
functions under this Act includes the Secretary of State.
(2) The provisions of subsection (1) above have effect as if made by an order
under section 1 (5) of that Act of 1970, and accordingly may be varied or revoked
by such an order.
(3) Every local authority shall make available to health authorities acting
in the area of the local authority the services of persons employed by the local
authority for the purposes of the local authority's functions under the Local
Authorities Social Services Act 1970 so far as is reasonably necessary and practicable
to enable health authorities to discharge their functions under this Act.
(4) Such charges may be made by a local authority for acting under subsection
(3) above as may be agreed between the local authority and the Secretary of
State or, in default of agreement, as may be determined by arbitration.
29.-(1) It is every Area Health Authority's duty, in accordance with regulations,
to arrange as respects their area with medical practitioners to provide personal
medical services for all persons in the area who wish to take advantage of the
arrangements. The services so provided are in this Act referred to as "
general
medical services".
(2) Regulations may provide for the definition of the personal medical services
to be provided and for securing that the arrangements will be such that all
persons availing themselves of those services will receive adequate personal
care and attendance, and the regulations shall include provision
(a) for the preparation and publication of lists of medical practitioners who
undertake to provide general medical services;
(b) for conferring a right on any person to choose, in accordance with the prescribed
procedure, the medical practitioner by whom he is to be attended, subject to
the consent of the practitioner so chosen and to any prescribed limit on the
number of patients to be accepted by any practitioner;
(c) for the distribution among medical practitioners whose names are on the
lists of any persons who have indicated a wish to obtain general medical services
but who have not made any choice of medical practitioner or have been refused
by the practitioner chosen;
(d) for the issue to patients or their personal representatives by medical practitioners
providing those services of such certificates as may be prescribed being certificates
reasonably required by them under or for the purposes of any enactment;
(e) for the removal from the list of medical practitioners undertaking to provide
general medical services for persons in any area of the name of anyone in whose
case it has been determined in such manner as may be prescribed that he has
never provided, or has ceased to provide, such general medical services for
persons in that area.
(3) Regulations under subsection (2) above may provide for the personal medical
services there mentioned to include the provision of, and services connected
with, any such advice, examination and treatment as are mentioned in paragraph
(b) of section 5(1) above.
(4) The remuneration to be paid under the arrangements mentioned in subsection (1) above to a practitioner who provides general medical services shall not, except in special circumstances, consist wholly or mainly of a fixed salary which has no reference to the number of patients for whom he has undertaken to provide such services.
30.-(1) All applications made in the prescribed manner to an Area Health Authority
for inclusion in a list kept by that Authority of the names of medical practitioners
undertaking to provide general medical services for persons in the Authority's
area shall be referred by the Authority to the Medical Practices Committee and
(except as mentioned in subsection (2) below any medical practitioner whose
application is granted by that Committee shall be entitled to the inclusion
of his name in the list.
(2) That entitlement is subject to
(a) if the Secretary of State should so prescribe, section 31 below;
(b) section 33 below (distribution of general medical services) ;
(c) section 46 below (disqualification of practitioners).
31.-(1) Where the Secretary of State so prescribes, and after a day so prescribed-
(a) the Medical Practices Committee shall refuse any application under section
30 above if the medical practitioner is not suitably experienced; and
(b) an Area Health Authority shall not arrange under section 29 above with a
medical practitioner for him to provide general medical services for persons
in its area unless the Medical Practices Committee have granted an application
by him for the inclusion of his name in the list kept by the Authority of medical
practitioners undertaking to provide general medical services for persons in
that area.
(2) For the purposes of this section a medical practitioner is "suitably
experienced" if, but only if, he either
(a) has acquired the prescribed medical experience, or
(b) is by virtue of regulations made under section 32 below exempt from the
need to have acquired that experience,
and" medical experience" includes hospital experience in any specialty
.
32.-(1) Regulations may for the purposes of section 31 above provide-
(a) for prescribing the medical experience needed to satisfy paragraph (a) of
section 31 (2) ;
(b) as to the documents which an applicant may or must produce as evidence
that he is suitably experienced or has acquired medical experience of any particular
kind;
(c) for requiring an applicant who claims to have acquired the prescribed experience
to submit particulars of his experience to a prescribed body, and for requiring
that body, if satisfied that he has acquired the prescribed experience, to issue
him a certificate (a "certificate of prescribed experience") to that
effect;
(d) for enabling an applicant without the prescribed experience who considers
that the medical experience which he has acquired is, or ought to be regarded
as, equivalent to the prescribed experience to submit particulars of that experience
to a prescribed body, and for requiring or enabling that body, if satisfied
that the applicant's medical experience is so equivalent, to issue him a certificate
(a "certificate of equivalent experience ") to that effect;
(e) for treating an applicant who holds a certificate of equivalent experience
as satisfying paragraph (a) of section 31 (2) ;
(f) as to the circumstances or conditions in or subject to which a medical practitioner
is exempt from the need to have acquired the prescribed experience;
(g) for conferring on an applicant who is refused a certificate of prescribed
experience or a certificate of equivalent experience a right of appeal to a
body constituted by the Secretary of State, and for any matter for which it
appears to the Secretary of State to be requisite or expedient to provide in
consequence of the conferring of that right;
(h) for anything authorised or required by section 31 to be prescribed or otherwise
provided for by regulations.
In this section-
" applicant" means a medical practitioner who has made or proposes
to make an application to which paragraph (a) of section 31 (1) applies;
"the prescribed experience" means the medical experience for the time
being prescribed for the purposes of paragraph (a) of section 31 (2).
(2) Regulations under this section shall be framed so as to allow the prescribed
experience to be acquired without undertaking whole-time employment.
(3) Any power under this section to make regulations-
(a) may be exercised so as to make different provision for different areas
or different periods of time or in relation to different cases or different
circumstances ;
(b) includes power to make such incidental or supplemental provision in the
regulations as the Secretary of State considers appropriate.
33.-(1) The Medical Practices Committee may refuse any application under section
30 above on the ground that the number of medical practitioners undertaking
to provide general medical services in the area of the Area Health Authority
concerned or in part of that area is already adequate.
(2) If in the opinion of the Medical Practices Committee additional practitioners
are required for any area or part, but the number of applications exceeds the
number required, the Committee shall select the persons. whose applications
are to be granted and shall refuse the other applications.
(3) Before selecting any persons under subsection (2) above the Medical Practices
Committee shall consult the Area Health Authority concerned, and that Authority
shall. if a local medical committee has been formed for that Authority's area
and recognised under section 44 below, consult that local medical committee
before expressing their views on the persons to be selected.
(4) Except as provided in subsections (1) to (3) above, or as required by section
31 above, the Medical Practices Committee shall not refuse any application under
section 30, but the Committee may grant an application subject to conditions
excluding the provision of general medical services by the applicant in such
part or parts of the area of the Area Health Authority as the Committee may
specify.
(5) A medical practitioner who has made an application under section 30 which
has been refused or has been granted subject to such conditions may appeal to
the Secretary of State; and the Secretary of State may, on any such appeal,
direct the Medical Practices Committee to grant the application either unconditionally
or subject to such conditions as the Secretary of State may specify.
This subsection does not apply where an application has been refused under paragraph
(a) of section 31(1).
(6) Where the Medical Practices Committee select persons from a number of applicants,
the persons selected shall not be included In the list in question during the
period for bringing an appeal to the Secretary of State or pending the determination
of any such appeal.
(7) If the Secretary of State grants an appeal to which subsection (6) above
relates, he may direct either that the application
(a) shall be granted in addition to those already granted;
or
(b) shall be granted instead of such one of those applications as he may specify.
In the latter case, he shall make the other applicant a party to the appeal,
and no further appeal shall be brought by that applicant in respect of the application
in question.
(8) The Medical Practices Committee shall, in a case where persons have to be
selected from a number of applicants, and the Secretary of State shall on an
appeal in any such case
(a) have regard to any desire expressed by any applicant to practise with other
medical practitioners already providing general medical services in the area
or part of an area concerned and of any desire expressed by such other practitioners
to take any applicant into practice with them ;
(b) have special regard to such matters in cases where an applicant is related
to any other such practitioner.
34. Regulations may make provisions for conferring or imposing on the Medical
Practices Committee such additional functions in relation to arrangements for
the provision of general medical services as may be prescribed; and regulations
shall provide
(a) for requiring Area Health Authorities to make to the Medical Practices Committee,
at such times and in such manner as may be prescribed, reports as to
(i) the number of medical practitioners required to meet the reasonable needs
of their areas and the different parts of those areas;
(ii) the occurrence of any vacancies on the lists of medical practitioners kept
by them under this Part of this Act; and
(iii) the need for filling such vacancies; and
(b) for prescribing the procedure for
(i) the determination of applications by the Medical Practices Committee;
(ii) the making and determination of appeals to the Secretary of State under
section 33 above; and
(iii) requiring Area Health Authorities and applicants to be informed of the
decisions of the Committee and the Secretary of State.
35.-(1) It is every Area Health Authority's duty, in accordance with regulations,
to make as respects their area arrangements with dental practitioners under
which any person in the area for whom a dental practitioner undertakes in accordance
with the arrangements to provide dental treatment and appliances shall receive
such treatment and appliances.
The services so provided are in this Act referred to as "general dental
services".
(2) The remuneration to be paid under such arrangements to a dental practitioner
who provides general dental services elsewhere than at a health centre shall
not consist wholly or mainly of a fixed salary unless either
(a) the remuneration is paid in pursuance of arrangements made under section
56 below, or
(b) the services are provided in prescribed circumstances and the practitioner
consents,
and it shall be the Secretary of State's duty, before he prescribes any circumstances
for the purposes of paragraph (b), to consult such organisations as appear to
him to be representative of the dental profession.
36. Regulations may provide as to the arrangements to be made under section
35 above, and shall include provision-
(a) for the preparation and publication of lists of dental practitioners who
undertake to provide general dental services;
(b) for conferring a right, subject to the provisions of this Part of this Act
relating to the disqualification of practitioners, on any dental practitioner,
who wishes to be included in any such list, to be so included;
(c) for conferring on any person a right to choose, in accordance with the prescribed
procedure, the dental practitioner from whom he is to receive general dental
services, subject to the consent of the practitioner so chosen;
(d) for the removal from the list of dental practitioners undertaking to provide
general dental services for persons in any area of the name of anyone in whose
case it has been determined in such manner as may be prescribed that he has
never provided, or has ceased to provide, such general dental services for persons
in that area.
37. Regulations providing as to the arrangements to be made under section 35
above shall include provision-
(a) for constituting a Board, to be called the Dental Estimates Board, of whom
the chairman and a majority of
the members shall be dental practitioners for the purpose of carrying out such
duties as may be prescribed with respect to the approval of estimates of dental
treatment and appliances. and to the remuneration of dental practitioners providing
general dental services ;
(b) for providing in relation to that Board for any of the matters for which.
in relation to an Area Health Authority. provision is or may be made by or under
Part III of Schedule 5 to this Act.
38. It is every Area Health Authority's duty, in accordance with regulations
to arrange as respects their area with medical practitioners having the prescribed
qualifications, ophthalmic opticians, and dispensing opticians for securing
the testing of sight by such medical practitioners and ophthalmic opticians,
and the supply by ophthalmic opticians and dispensing opticians of optical appliances.
The services so provided' are in this Act referred to as "general ophthalmic
services".
39. Regulations may provide as to the arrangements to be made under section
38 above, and shall include provision
(a) for the preparation and publication of lists of medical practitioners, ophthalmic
opticians and dispensing opticians, respectively, who undertake to provide general
ophthalmic services;
(b) for conferring a right, subject to the provisions of this Act relating to
the disqualification of practitioners, on any medical practitioner having the
prescribed qualifications. ophthalmic optician or dispensing optician who wishes
to be included in the appropriate list, to be so included;
(c) for conferring on any person a right to choose in accordance with the prescribed
procedure the medical practitioner or ophthalmic optician by whom his sight
is to be tested, or from whom any prescription for the supply of optical appliances
is to be obtained and the ophthalmic or dispensing optician who wishes to supply
the appliances;
(d) for the removal from the list of medical practitioners, ophthalmic opticians
or dispensing opticians undertaking to provide general ophthalmic services for
persons in any area of the name of anyone in whose case it has been determined
in such manner as may be prescribed that he has never provided. or has ceased
to provide such general ophthalmic services for persons in that area.
40. The power conferred by section 38 above (in relation to general ophthalmic
services) to prescribe the qualifications to be possessed by any medical practitioner
includes a power -
(a) to prescribe a requirement that the. practitioner shall show to the satisfaction
of a committee recognised by the Secretary of State for the purpose that he
possesses such qualifications, including qualifications as to experience. as
may be mentioned in the regulations;
and
(b) to confer on a person who is dissatisfied with the determination of such
a committee. a right of appeal to a committee appointed by the Secretary of
State. and to provide for any matter for which it appears to the Secretary of
State to be requisite or expedient to provide in consequence of the conferring
of that right.
41. It is every Area Health Authority's duty. in accordance with regulations.
to arrange as respects their area for the supply to persons who are in that
area of-
(a) proper and sufficient drugs and medicines and listed appliances which are
ordered for those persons by a medical practitioner in pursuance of his functions
in the health service, the Scottish health service, the Northern Ireland health
service or the armed forces of the Crown (excluding forces of a Commonwealth
country and forces raised in a colony) ; and
(b) listed drugs and medicines which are ordered for those persons by a dental
practitioner in pursuance of such functions.
The services so provided are in this Act referred to as "pharmaceutical
services".
In this section
"listed" means included in a list for the time being approved by the
Secretary of State for the purposes of this
section; and
"the Scottish health service" and" the Northern Ireland health
service" mean respectively the health service established in pursuance
of section 1 of the National Health Service (Scotland) Act 1947 or any service
provided in pursuance of Article 4 (a) of the Health and Personal Social Services
(Northern Ireland) Order 1972.
42. Regulations may provide for securing that arrangements made under section
41 above will be such as to enable any person for whom they are ordered as mentioned
in that section to receive the drugs, medicines and appliances there mentioned
from any person with whom such arrangements have been made; and the regulations
shall include provision
(a) for the preparation and publication of lists of persons who undertake to
provide pharmaceutical services ;
(b) for conferring a right, subject to this Part of this Act relating to the
disqualification of practitioners, on any person who wishes to be included in
any such list to be so included for the purpose of supplying such drugs, medicines
and appliances as that person is entitled by law to sell; and
(c) for the removal from the list of persons undertaking to provide pharmaceutical
services for persons in any area of the name of anyone in whose case it has
been determined in such manner as may be prescribed that he has never provided,
or has ceased to provide, such pharmaceutical services for persons in that area.
43.-(1) No arrangements shall be made by an Area Health Authority (except as
may be provided by regulations) with a. medical practitioner or dental practitioner
under which he is required or agrees to provide pharmaceutical services to any
person to whom he is rendering general medical services or general dental services.
(2) No arrangements for the dispensing of medicines shall be made (except as
may be provided by regulations) with persons other than persons who are registered
pharmacists, or are persons lawfully conducting a retail pharmacy business in
accordance with section 69 of the Medicines Act 1968 and who undertake that
all medicines supplied by them under the arrangements made under this Part of
this Act shall be dispensed either by or under the direct supervision of a registered
pharmacist.
44.-(1) Where the Secretary of State is satisfied that a committee formed for
the area of any Area Health Authority is representative-
(a) of the medical practitioners providing general medical services or general
ophthalmic services in that area, or
(b) of the dental practitioners providing general dental services in that area,
or
(c) of the ophthalmic opticians and dispensing opticians providing general ophthalmic
services in that area, or
(d) of the persons providing pharmaceutical services in that area,
he may recognise that committee; and any committee so recognised shall be called
the Local Medical Committee, the Local Dental. Committee, the Local Optical
Committee or the Local Pharmaceutical Committee, as the case may be, for the
area concerned.
(2) Any such committee may with the Secretary of State's approval delegate any
of their functions, with or without restrictions or conditions, to sub-committees
composed of members of that committee.
45.-(1) The Family Practitioner Committee for the area of an Area Health Authority
in respect of which committees are recognised under section 44 above shall,
in exercising their functions under this Part of this Act, consult with those
committees on such occasions and to such extent as may be prescribed; and those
committees shall exercise such other functions as may be prescribed.
(2) The Family Practitioner Committee may, on the request of any committee recognised
under section 44 for their area, allot to that committee such sums for defraying
the committee's administrative expenses (including travelling and subsistence
allowances payable to its members) as may be determined by the Family Practitioner
Committee with the Secretary of State's approval.
(3) Any sums so allotted shall be out of the moneys available to the Family
Practitioner Committee for the remuneration of persons of whom the committee
so recognised is representative and who provide general medical services, general
dental services, general ophthalmic services or pharmaceutical services, as
the case may be, under this Part of this Act.
The amount of any such sums shall be deducted from the remuneration of those
persons in such manner as may be determined by the Family Practitioner Committee
with the Secretary of State's approval.
46.-( 1) There shall be a tribunal (in this section and sections 47 to 49 below
referred to as "the Tribunal ") which shall be constituted in accordance
with Schedule 9 to this Act to inquire into cases where representations are
made in the prescribed manner to the Tribunal by an Area Health Authority or
any
other person that the continued inclusion of a person's name in a list prepared
under this Part of this Act
(a) of medical practitioners undertaking to provide general medical services,
(b) of medical practitioners undertaking to provide general ophthalmic services,
(c) of dental practitioners undertaking to provide general dental services,
(d) of ophthalmic opticians undertaking to provide general ophthalmic services,
(e) of dispensing opticians undertaking to provide general ophthalmic services,
or
(f) of persons undertaking to provide pharmaceutical services,
would be prejudicial to the efficiency of the services in question.
The supplementary provisions contained in Schedule 9 apply in relation to the
Tribunal.
(2) The Tribunal, on receiving representations from an Area Health Authority
shall, and in any other case may, inquire into the case, and, if they are of
opinion that the continued inclusion of that person's name in any list to which
the representations relate would be prejudicial to the efficiency of those services
(a) shall direct that his name be removed from that list;
and
(b) may also, if they think fit, direct that his name be removed from, or not
be included in, any corresponding
list kept by any other Area Health Authority under this Part.
(3) An appeal shall lie to the Secretary of State from any direction of the
Tribunal under subsection (2) above, and the Secretary of State may confirm
or revoke that direction.
(4) Where the Tribunal direct that the name of any person be removed from or
not included in any list or lists the Area Health Authority or Authorities concerned
shall
(a) if no appeal is brought, at the end of the period for bringing an appeal,
or
(b) if an appeal is brought and the decision of the Tribunal is confirmed by
the Secretary of State, on receiving notice of the Secretary of State's decision,
remove the name of the person concerned from the list or lists in question.
47.-(1) Any person whose name has been removed by a direction under section
46 above from any list or lists shall be disqualified for inclusion in any list
to which that direction relates until the Tribunal or the Secretary of State
direct under this section to the contrary.
(2) For the purpose of deciding whether or not to issue a direction under this
section (or under paragraph 8 of Schedule 14 to this Act), the Tribunal or the
Secretary of State, as the case may be, may hold an inquiry.
48. Where-
(a) under any provision in force in Scotland or Northern Ireland corresponding
to the provisions of this Part. of this Act a person is for the time being disqualified
for inclusion in all lists prepared under those provisions of persons undertaking
to provide services of one or more of the kinds specified in section 46(1) above,
then
(b) that person shall, so long as that disqualification is in force, be disqualified
for inclusion in a list prepared under this Part of persons undertaking to provide
services of those kinds, and the name of that person shall be removed from every
such list in which his name is included.
49. Regulations shall provide-
(a) for prescribing the procedure for the holding of inquiries by the Tribunal
or the Secretary of State under sections 46 to 48 above, and for the making
and determining of appeals to the Secretary of State under that procedure, and,
in particular for securing that any person who is the subject of such an inquiry
shall have an opportunity
(i) of appearing, either in person or by counsel or solicitor or such other
representative as may be prescribed, before the Tribunal and, in the case of
an inquiry by, or appeal to, the Secretary of State before a person appointed
by the Secretary of State, and
(ii) of being heard by the Tribunal or the person so appointed and of calling
witnesses and producing other evidence on his behalf,
and that the hearing, whether by the Tribunal or the person so appointed shall
be in public if the person who is the subject of the inquiry so requests ;
(b) for conferring on the Tribunal and on any person so appointed such powers
as the Secretary of State considers necessary, and for that purpose to apply,
with any necessary modifications, any of the provisions of section 250 of the
Local Government Act 1972 ; and
(c) for the publication of the decisions of the Tribunal and the Secretary of
State under this section and the imposition and removal of any disqualifications
imposed under section 48 above.
50. Regulations may provide that, where a right to choose the person by whom services are to be provided under this Part of this Act is conferred by or under this Part, that right shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.
51. It is the Secretary of State's duty to make available, in premises provided by him by virtue of this Act, such facilities as he considers are reasonably required by any university which has a medical or dental school, in connection with clinical teaching and with research connected with clinical medicine or, as the case may be, clinical dentistry.
52. If the Secretary of State considers that any accommodation provided by
him by virtue of this Act is suitable for use in connection with the provision
of general medical services, general dental services, general ophthalmic services
or pharmaceutical services he may make the accommodation available on such terms
as he thinks fit to persons providing any of those services.
53. Where the Secretary of State arranges with medical practitioners for the vaccination or immunisation of persons against disease, he shall so far as reasonably practicable give every medical practitioner providing general medical services an opportunity to participate in the arrangements.
54.-(1) Where the name of any medical practitioner is or has been at any time
entered on any list of medical practitioners undertaking to provide general
medical services, it shall be unlawful subsequently to sell the goodwill or
any part of the goodwill of the medical practice of that medical practitioner.
This subsection is subject to subsections (2) and (3) below and the additional
provisions contained in Schedule 10 to this Act have effect for the purposes
of this section.
(2) Where a medical practitioner, whose name has ceased to be entered on any
list of medical practitioners undertaking to provide general medical services,
practises in the area of an Area Health Authority (or of an Executive Council,
before its abolition under section 14 of the National Health Service Reorganisation
Act 1973) on whose list his name has never been entered, subsection (1) above
does not render unlawful the sale of the goodwill or any part of the goodwill
of his practice in that area.
(3) Subsection (1) does not prevent the sale of the goodwill or any part of
the goodwill of a medical practice carried on in any area, being a sale by a
medical practitioner whose name has never been entered on a list of an Area
Health Authority (or of an Executive Council, before its abolition) for that
area of medical practitioners undertaking to provide general medical services,
notwithstanding that any part of the goodwill to be sold is attributable to
a practice previously carried on by a person whose name was entered on such
a list.
55. Any dispute arising under this Part of this Act or any regulation made under this Part between an Area Health Authority and a person receiving, or claiming that he is entitled to receive, any services under this Part shall be referred to and decided by the Secretary of State.
56. If the Secretary of State is satisfied, after such inquiry as he may think
fit, as respects any area or part of an area of an Area Health Authority that
the persons whose names are included in any list prepared under this Part of
this Act
(a) of medical practitioners undertaking to provide general medical services,
(b) of dental practitioners undertaking to provide general dental services,
(c) of persons undertaking to provide general ophthalmic services, or
(d) of persons undertaking to provide pharmaceutical services,
are not such as to secure the adequate provision of the services in question
in that area or part, or that for any other reason any considerable number of
persons in any such area or part are not receiving satisfactory services under
the arrangements in force under this Part, then
(i) he may authorise the Area Health Authority to make such other arrangements
as he may approve, or may himself make other arrangements, and
(ii) he may dispense with any of the requirements of regulations made under
this Part so far as appears to him necessary to meet exceptional circumstances
and enable such arrangements to be made.
57.-(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 &et 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.
58. 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.-(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 nonresident 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.-(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 far
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 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 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.-(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. 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.
63.-(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. 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.-(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 provision 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, it 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 cost appearing to him to be properly attributable to capita 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 a appear to him fit, such
amounts as appear to be 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 a undertaking given under this section
by or in respect of an 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.-(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.
67.-(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.
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.-(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 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 650)
or section 660) 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.-(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,
ultra sonics 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 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 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. 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 nonresident 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.-(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 nonresident
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) far 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.
72.-( 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 wham 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 11 ; 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 11.
73. 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. 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.-(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-fists
referred to in section 6 of the Health Services Act 1976. and in section 76
below.
76.-(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 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.
77.-(1) Regulations may provide for the making and recovery in such manner
as may be prescribed of such charges as may be for
(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
eligible 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.-(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.-(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. 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. 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. Regulations may provide for the making and recovery 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. Regulations made--
(a) under sections 77 to 79 and under sections 81 and 82 above providing for
the making and recovery of charges to those 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 11 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.
84.-(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.-( 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 i