The General Medical Services Transitional and Consequential Provisions (No. 2) (Northern Ireland) Order 2004

Investigation of certification (regulation 15 of the Disciplinary Procedures Regulations)

81.—(1) Where the Department has –

(a)before the relevant date, or on or after the relevant date in respect of an investigation that took place before the relevant date, received information in relation to an investigation of medical certificates issued under and for the purposes of the Social Security (Medical Evidence) Regulations (Northern Ireland) 1976(1) by a doctor, but he has not yet determined whether to refer the matter for consideration pursuant to regulation 15(1); or

(b)before the relevant date, pursuant to regulation 15(1), referred a matter to a Local Medical Committee, or to a joint committee of two or more Local Medical Committees and the Local Medical Committee has not yet finally determined the matter pursuant to regulation 15(6),

the Department may, in a case falling within sub-paragraph (a), refer the matter as if the amendments to regulation 15 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee or joint committee of Local Medical Committees shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 15, subject to the provisions in this Article.

(2) Where, pursuant to paragraph (1), the Local Medical Committee makes a determination pursuant to regulation 15(6), it shall forward its report to the contracting Board, in addition to the persons specified in regulation 15(6), unless the doctor exercises his right of appeal pursuant to regulation 15.

(3) Where –

(a)a doctor –

(i)has appealed against a finding of a Local Medical Committee made before the relevant date pursuant to regulation 15(7), and within the time limit specified in that paragraph, and that appeal has not been determined before the relevant date, or

(ii)appeals against a finding of a Local Medical Committee on or after the relevant date in respect of a finding of a Local Medical Committee made pursuant to paragraph (1) within the time limit specified in regulation 15(7); or

(b)the Department –

(i)has referred a finding of a Local Medical Committee made before the relevant date pursuant to regulation 15(10), and that referral has not been determined before the relevant date, or

(ii)referred a finding of a Local Medical Committee on or after the relevant date in respect of a finding of a Local Medical Committee made pursuant to paragraph (1),

that appeal or referral shall be determined in accordance with regulation 15 as if the amendments to that regulation had not taken effect, save that written notification of the determination made by the referee shall be given to the contracting Board.

(4) The Department may, on or after the relevant date, determine that, pursuant to regulation 16(12), an amount should be recovered from a doctor, and shall, in determining whether an amount should be recovered, act as if the amendments to regulations 11(3), (4) and (5) and 15 had not taken effect.

(5) Where pursuant to regulation 15(12), the Department has determined that an amount should be recovered from a doctor –

(a)before the relevant date, where that amount has not been fully recovered before the relevant date; or

(b)on or after the relevant date pursuant to this Article,

that amount shall be recoverable by the appropriate Board, insofar as it has not already been recovered before the relevant date in respect of an amount falling within sub-paragraph (a), and that amount shall be a debt owed to that Board.

(6) Where the contracting Board has received notification pursuant to this Article of an adverse determination in respect of the doctor pursuant to regulation 15, paragraph (7) shall apply without prejudice to any other right the contracting Board may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(7) Where this paragraph applies, the contracting Board may, in relation to a relevant contractor, take into account the adverse determination of the Department if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 107(7) of Schedule 5 to the Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.

(8) The contracting Board shall not, pursuant to paragraph (7), take into account any notification that relates to a determination that was made more than 6 years prior to the date upon which the contracting Board is considering the matter pursuant to paragraph (7).