1999 No. 54
NATIONAL HEALTH SERVICE
The National Health Service (General Medical Services) (Scotland) Amendment (No.4) Regulations 1999
Made 7th September 1999
Laid before the Scottish Parliament 10th September 1999
Coming into force 1st October 1999

The Scottish Ministers, in exercise of the powers conferred on them by sections 2(5), 19, 24, 28(1), 34, 105(7) and 108(1) of the National Health Service (Scotland) Act 1978 and of all other powers enabling them in that behalf, hereby make the following Regulations:
1978 c. 29; section 19 was amended by the Health Services Act 1980 (c. 53) (“the 1980 Act”), section 7, by the Health and Social Services and Social Security Adjudications Act 1983 (c. 41) (“the 1983 Act”), Schedule 7, paragraph 2, by the Medical Act 1983 (c. 54), Schedule 5, paragraph 17(a), by the National Health Service and Community Care Act 1990 (c. 19), section 37 and by the Medical (Professional Performance) Act 1995 (c. 51), Schedule, paragraph 29(a) and is to be read with the Health and Medicines Act 1988 (c. 49), section 17; section 105(7) which contains provisions relevant to the making of Regulations, was amended by the 1980 Act, Schedule 6, paragraph 5 and Schedule 7, by the 1983 Act, Schedule 9, paragraph 24 and by the Health Act 1999 (c. 8), Schedule 4, paragraph 60; section 108(1) contains definitions of “prescribed” and “regulations” relevant to the exercise of the statutory powers under which these Regulations are made. The functions of the Secretary of State were transferred to the Scottish Ministers by virtue of section 53 of the Scotland Act 1998 (c. 46).

1 Citation, commencement and interpretation
1 These Regulations may be cited as the National Health Service (General Medical Services) (Scotland) Amendment (No.4) Regulations 1999 and shall come into force on 1st October 1999.
2 In these Regulations “the principal Regulations” means the National Health Service (General Medical Services) (Scotland) Regulations 1995.
S.I.1995/416; relevant amending instruments are 1995/3199, 1996/842 and 1504, 1997/943, 1998/660 and 1600 and 1999/1057 and 1620.

2 General amendment of the principal Regulations
In the following regulations, after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”–
regulation 5 (amendment of or withdrawal from the medical list);
regulation 7 (removal from the medical list of names of doctors not providing services);
regulation 8 (removal from the medical list on grounds of age);
regulation 9 (application for inclusion in the medical list);
regulation 14 (determination of applications);
regulation 17 (appeal to Scottish Ministers);
regulation 23 (change of doctor);
regulation 24 (temporary provision of general medical services);
regulation 27 (doctor’s lists);
regulation 29 (obtaining child health surveillance services);
regulation 30 (contraceptive services);
regulation 31 (obtaining maternity medical services);
regulation 33 (obtaining minor surgery services);
regulation 34 (arrangements for supply by doctors of drugs and appliances);
regulation 36 (claims and overpayments);
regulation 37 (publication of particulars);
regulation 38 (guidance to doctors).
Regulation 7 was amended by S.I.1995/3199.
Regulation 24 was amended by S.I.1995/3199 and 1998/660.
Regulation 27 was amended by S.I.1998/660.
Regulation 31 was substituted by S.I.1997/943.

3 Amendment of regulation 2 of the principal Regulations
In regulation 2 of the principal Regulations (interpretation), after the definition of “practice premises” there is inserted–

““primary care NHS trust” means an NHS trust to which certain functions referred to in section 12AA of the Act are delegated by the Board;”

.
Section 12AA was inserted into the National Health Service (Scotland) Act 1978 (c. 29) by the Health Act 1999 (c. 8), section 47.

4 Amendment of regulation 4 of the principal Regulations
1 Regulation 4 of the principal Regulations (medical list) is amended in accordance with this regulation.
2 In paragraphs (1), (3) and 5(d) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”.
3 In paragraph (6)(h)–
(a) after the word “Board” there is inserted “or primary care NHS trust”;
(b) for the words “that part of its area” there is substituted “the appropriate part of the Board’s area”.

5 Amendment of regulation 6 of the principal Regulations
In regulation 6 of the principal Regulations (local directory of family doctors)–
(a) in paragraphs (1), (2), (3), (4), (8) and (9) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (7) after the word “Board” in the first and third places where that word occurs there is inserted “or primary care NHS trust”.
Regulation 6 was amended by S.I.1997/943.

6 Amendment of regulation 10 of the principal Regulations
In regulation 10 of the principal Regulations (reports by Board to Medical Practices Committee)–
(a) in the heading after the word “Board” there is inserted “or primary care NHS trust”;
(b) in paragraph (1) after the word “Board” in the first place where it occurs there is inserted “or primary care NHS trust”;
(c) in paragraphs (2) and (3) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”.

7 Amendment of regulation 11 of the principal Regulations
In regulation 11 of the principal Regulations (succession to vacant medical practices)–
(a) in paragraphs (1), (2), (3), (4), (5), (6) and (7) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (8) after the word “Board” in the first place where it occurs there is inserted “or primary care NHS trust”.

8 Amendment of regulation 12 of the principal Regulations
In regulation 12 of the principal Regulations (exchange of practices)–
(a) in paragraph (1) after the word “Board” in the first, second and fourth places where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraphs (2), (3), (5) and (6) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”.

9 Amendment of regulation 16 of the principal Regulations
In regulation 16 of the principal Regulations (variation of conditions) in paragraphs (2), (3), (4), (7)(a) and 7(c) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”.

10 Amendment of regulation 21 of the principal Regulations
In regulation 21 of the principal Regulations (limitation of number of persons in doctor’s list)–
(a) in paragraphs (1), (2), (4), (5), (7), (8), (9), (10) and (12) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (11)–
(i) after the word “Board” in the first and second places where it occurs there is inserted “or primary care NHS trust”;
(ii) after the word “Boards” there is inserted “or primary care NHS trusts”;
(iii) the words “of any adjoining area” are omitted.

11 Amendment of regulation 22 of the principal Regulations
In regulation 22 of the principal Regulations (change of doctor)–
(a) in paragraphs (8) and (9) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (8) after the word “Board's” there is inserted “or primary care NHS trust's”.
Regulation 22 was amended by S.I.1998/660.

12 Amendment of regulation 25 of the principal Regulations
In regulation 25 of the principal Regulations (removal of person from doctor’s list)–
(a) in paragraphs (1), (3), (4), (5) and (6) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (2) after the word “Board” in the second, fourth and fifth places where it occurs there is inserted “or primary care NHS trust”.

13 Amendment of regulation 26 of the principal Regulations
In regulation 26 of the principal Regulations (temporary residents)–
(a) in paragraph (1) for the words “Health Board for the area in which the doctor practises” there is substituted “the Health Board or primary care NHS trust in whose medical list the name of the doctor appears”;
(b) in paragraph (2) for the words “Health Board for that area” there is substituted “appropriate Health Board or primary care NHS trust”.
Regulation 26 was substituted by S.I.1998/660.

14 Amendment of regulation 28 of the principal Regulations
In regulation 28 of the principal Regulations (child health surveillance list)–
(a) in paragraphs (1), (2), (4), (5), (6), (7), (8), (9), (11), (12), (13), (15), (16) and (17) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (10) after the word “Board's” there is inserted “or primary care NHS trust's”;
(c) in paragraph (14)–
(i) after the word “Board” in the first and second places where it occurs there is inserted “or primary care NHS trust”;
(ii) after the word “Board's” there is inserted “or primary care NHS trust's”.

15 Amendment of regulation 32 of the principal Regulations
In regulation 32 of the principal Regulations (minor survey list)–
(a) in paragraphs (1), (2), (4), (5), (6), (7), (8), (9), (11), (12), (13), (15), (16), and (17) after the word “Board” there is inserted “or primary care NHS trust”;
(b) in paragraph (10) after the word “Board's” there is inserted “or primary care NHS trust's”;
(c) in paragraph 14)–
(i) after the word “Board” in the first and second places where it occurs there is inserted “or primary care NHS trust”;
(ii) after the word “Board's” there is inserted “or primary care NHS trust's”.

16 Amendment of regulation 35 of the principal Regulations
In regulation 35 of the principal Regulations (payments), in paragraph (1)(l) and (m) after the word “Board” there is inserted “or primary care NHS trust”.
Regulation 35 was amended by S.I.1998/1600.

17 Amendment of regulation 35B of the principal Regulations
In regulation 35B of the principal Regulations (GMS local development schemes)–
(a) in paragraphs (1) and (3) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”;
(b) in paragraph (4)–
(i) after the word “Board” in the first place where it occurs there is inserted “or primary care NHS trust”;
(ii) in sub-paragraphs (a) and (c) after the word “Board's” there is inserted “or primary care NHS trust's”.
Regulation 35B was inserted by S.I.1998/1600 and was amended by S.I.1999/749.

18 Amendment of Schedule 1 to the principal Regulations
1 Schedule 1 to the principal Regulations (terms of service for doctors) is amended in accordance with this regulation.
Relevant amending instruments are S.I.1995/3199, 1996/842, and 1504, 1997/943, 1998/660, 1999/1057 and 1620.
2 For the words “Board” and “Board's” in each place in the Schedule where they occur there is substituted “Board or primary care NHS trust” and “Board’s or primary care NHS trust's” respectively.
3 In paragraph 29B after the words “National Health Service (Travelling Expenses and Remission of Charges) (Scotland) Regulations 1988” there is inserted “to provide evidence of the patient’s entitlement to such exemption or remission.”.
Paragraph 29B was amended by S.I.1999/1620.
S.I.1988/546.

19 Amendment of Schedule 2 to the principal Regulations
1 Schedule 2 to the principal Regulations is amended in accordance with this regulation.
2 In Part I of the Schedule (information and undertaking to be included in an application for inclusion in the medical list)–
(a) in paragraph 9 after the word “Board's” there is inserted “or primary care NHS trust's”;
(b) in paragraph 11 after the word “Board” there is inserted “or primary care NHS trust”.
3 In Part II (information to be included in an application for the variation of a condition imposed in connection with inclusion in a medical list)–
(a) in paragraph 4 after the word “Board's” there is inserted “or primary care NHS trust's”;
(b) in paragraph 5 after the word “Board” there is inserted “or primary care NHS trust”.
4 In Part III (form of application to provide contraceptive services) after the words “Health Board” there is inserted “or primary care NHS trust”.

20 Amendment of Schedule 3 to the principal Regulations
1 Schedule 3 to the principal Regulations (child health surveillance services) is amended in accordance with this regulation.
2 In paragraph (1)(b)–
(a) for the words “the Board in whose area the child resides” there is substituted “the appropriate Board or primary care NHS trust”;
(b) the words “in that area” are omitted.
3 In paragraph 3 after the word “Board” there is inserted “or primary care NHS trust”.

21 Amendment of Schedule 6 to the principal Regulations
In Schedule 6 to the principal Regulations (doctor’s hours), in paragraph 7 after the word “Board” there is inserted “or primary care NHS trust”.

22 Amendment of Schedule 7 to the principle Regulations
In Schedule 7 to the principal Regulations (information to be provided in annual reports), in paragraph 1 after the word “Board” there is inserted “or primary care NHS trust”.

23 Amendment of Schedule 8A to the principal Regulations
In Schedule 8A to the principal Regulations (GMS local development schemes) after the word “Board” in each place where it occurs there is inserted “or primary care NHS trust”.
Schedule 8A was inserted by S.I.1998/1600.

24 Amendment of Schedule 11 to the principal Regulations
In Schedule 11 to the principal Regulations (drugs to be supplied by general medical practitioners or prescribed for supply under pharmaceutical services only in certain circumstances).
(a) in column 2 for paragraphs (a) to (d) there is substituted–

	“(a) a man with erectile dysfunction who on 14th September 1998 was receiving a course of treatment under the Act, the National Health Service Act 1977 or the Health and Personal Social Services (Northern Ireland) Order 1972 for this condition with any of the following drugs– Alprostadil (Caverject), (MUSE), (Viridal) Moxisylyte Hydrochloride (Erecnos) Thymoxamine Hydrochloride (Erecnos) Sildenafil (Viagra); or 1977 c. 49. S.I.1972/1265 (N.I.14). (b) a man who is a national of an EEA State who is entitled to treatment by virtue of Article 7(2) of Council Regulation 1612/68 as extended by the EEA Agreement or by virtue of any other enforceable Community right who has erectile dysfunction and was on 14th September 1998 receiving a course of treatment under a national health insurance system of an EEA State for this condition with any of the drugs listed in sub-paragraph (a); or OJNo. L257, 19.10.68, p.22 (OJ/SE 1968 (II) p. 475). (c) a man who is not a national of an EEA State but who is the member of the family of such a national who has an enforceable Community right to be treated no less favourably than the national in the provision of medical treatment and has erectile dysfunction and was being treated for that condition on 14th September 1998 with any of the drugs listed in sub-paragraph (a); or (d) a man who is suffering from any of the following– diabetes multiple sclerosis Parkinson’s disease poliomyelitis prostate cancer severe pelvic injury single gene neurological disease spina bifida spinal cord injury; or (e) a man who is receiving treatment for renal failure by dialysis; or (f) a man who has had the following surgery– prostatectomy radical pelvic surgery renal failure treated by transplant.”

;
(b) at the end there is inserted the following:–

“In this Schedule–
“EEA Agreement” means the Agreement on the European Economic Area signed at Oporto on 2nd May 1992 as adjusted by the Protocol signed at Brussels on 17th March 1993;
“EEA State” means a state which is a contracting party to the EEA Agreement”

.
Relevant amending instrument is 1999/1620.
SUSAN C DEACON A member of the Scottish Executive St Andrew’s House, Edinburgh 7th September 1999

(This note is not part of the Regulations)
These Regulations further amend the National Health Service (General Medical Services) (Scotland) Regulations 1995 (S.I.1995/416) (“the principal Regulations”).
These Regulations amend the principal Regulations to include reference, where appropriate, to primary care NHS Trusts to which responsibility for certain functions relating to the provision of services mentioned in Part II of the National Health Service (Scotland) Act 1978 (c. 29) are delegated by the Health Boards. They insert a new definition of “primary care NHS Trust” (regulation 2).
The principal Regulations are amended to make clear the action which doctors are required to take to establish a patient’s eligibility for exemption from or remission of charges when drugs or appliances are supplied (regulation 18). Schedule 11 to the principal Regulations is also amended so that the prescription of specified drugs for the treatment for erectile dysfunction is extended to certain categories of patient (regulation 24).