National Health Service Act 1977

Part IE+W+S Services and Administration

Functions of the Secretary of StateE+W+S

1 Secretary of State’s duty as to health service.E+W+S

(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 Secretary of State’s general power as to services.E+W+S

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 Services generally.E+W+S

(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 M1National 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 II of this Act (which relates to arrangements with practitioners for the provision of medical, dental, ophthalmic and pharmaceutical services).

4 Special hospitals.E+W+S

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 [F1the M2Mental Health Act 1983] who in his opinion require treatment under conditions of special security on account of their dangerous, violent or criminal propensities.

5 Other services.E+W+S

(1)It is the Secretary of State’s duty—

(a)to provide for the medical . . . F2 inspection at appropriate intervals of pupils in attendance at schools maintained by local education authorities [F3or at grant–maintained schools] and for the medical . . . F2 treatment of such pupils . . . F4;

(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.

[F5(1A)It is also the Secretary of State’s duty to provide, to such extent as he considers necessary to meet all reasonable requirements—

(a)for the dental inspection of pupils in attendance at schools maintained by local education authorities or at grant-maintained schools;

(b)for the dental treatment of such pupils; and

(c)for the education of such pupils in dental health.

(1B)Schedule 1 to this Act shall have effect.]

(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 [F6and carry on such other activities as in his opinion can conveniently be carried on in conjunction with that service];

(d)conduct, or assist by grants or otherwise (without prejudice to the general powers and duties conferred on him under the M3Ministry 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.

[F7(2A)Charges may be made for service or materials supplied by virtue of paragraph (c) of subsection (2) above; and the powers conferred by that paragraph may be exercised both for the purposes of the health service and for other purposes.]

[F8(2B)The Secretary of State’s functions may be performed outside England and Wales, in so far as they relate—

(a)to holidays for patients;

(b)to the transfer of patients to or from Scotland, Northern Ireland, the Isle of Man or the Channel Islands; or

(c)to the return of patients who have received treatment in England and Wales to countries or territories outside the British Islands.]

(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F9

(4)The Public Health Laboratory Service Board continues in being for the purpose of exercising such functions with respect to the [F10powers conferred by 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 II of that Schedule have effect in relation to the Board.

Central Health Services Council and Medical Practices CommitteeE+W+S

6X1Central Health Services Council, and standing advisory committees.E+W+S

(1), (2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F11

(3)The Secretary of State may, . . . F12 by order constitute standing advisory committees for the purpose of advising him . . . F12 on such of the services provided under this Act as may be specified in the order [F13and the provisions of Schedule 4 to this Act shall have effect in relation to such committees].

[F14(4)Any committee so constituted shall consist of persons appointed by the Secretary of State after consultation with such representative organisations as he recognises for the purpose.]

(5)It shall be the duty of a committee so constituted to advise the Secretary of State and . . . F12—

(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 . . . F12 relating to those services,

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F12

(6), (7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F11

7 Medical Practices Committee.E+W+S

(1)[F15Subject to subsection (1A) below] 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)[F16five of the] members shall be medical practitioners, and [F17four] at least of those [F17five] shall be actively engaged in medical practice.

[F18(1A)The Secretary of State may by order make such modifications as he considers appropriate of paragraphs (a) and (b) of subsection (1) above.]

(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.

[F19(4)After consulting the Medical Practices Committee, the Secretary of State may give the Committee directions with respect to the exercise of its functions; and it shall be the duty of the Committee to comply with any such directions.]

Local administrationE+W+S

8Regional and Area Health Authorities.E+W+S

[F20F21(1)It is the Secretary of State’s duty to establish by order in accordance with Part I of [F22Schedule 1 to the National Health Service and Community Care Act 1990]]—

(a)authorities for such regions in England as he may by order determine; and

(b)authorities for such . . . F23 . . . F24 districts in Wales or those regions in England as he may by order determine,

and orders determining regions, . . . F23 or districts in pursuance of this subsection shall be separate from orders establishing authorities for the regions, . . . F23 or districts.

(1A)The authorities established by order under subsection (1) above shall be named as follows—

(a)an authority established for a region shall be called a Regional Health Authority;

(b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F25

(c)an authority for a district shall, . . . F26 be called either a District Health Authority . . . F26 or by a special name indicating the authority’s connection with the district or a place in the district, . . . F26;

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F26

(2)The Secretary of State may by order vary the region of a Regional Health Authority or the . . . F27[F28 . . . F27district] of an . . . F27[F28 . . . F27District] Health Authority whether or not the variation entails the determination of a new or the abolition of an existing region or . . . F27[F28 . . . F27 district].

(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 . . . F29[F30 . . . F29 districts] so determined together comprise the whole of Wales and those regions and that no region includes part only of any . . . F29[F30 . . . F29 district]; 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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .F20

9. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F31E+W+S

[F3210 Family Practitioner Committees.E+W+S

(1)It is the duty of the Secretary of State by order to establish, in accordance with Part II of [F33Schedule 1 to the National Health Service and Community Care Act 1990], authorities to be called Family Practitioner Committees.

(2)Family Practitioner Committees shall be known by such names, in addition to that title, as the order may specify.

(3)When the Secretary of State makes an order under subsection (1) above establishing a Family Practitioner Committee, he shall also (either in the same or another instrument) make an order in relation to that Committee specifying a locality for which the Committee is to act.

(4)The Secretary of State may by order—

(a)vary a Committee’s locality;

(b)abolish a Committee;

(c)establish a new one.

(5)The Secretary of State shall so exercise his powers under subsections (3) and (4) above as to secure—

(a)that the localities for which Family Practitioner Committees are at any time acting together comprise the whole of England and Wales; but

(b)that none of them extends both into England and into Wales.

(6)Without prejudice to the generality of section 126(4) below, the power to make incidental or supplemental provision conferred by that subsection includes, in its application to orders under this section, power to make provision for the transfer of staff, property, rights and liabilities.

(7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F34]

11 Special health authorities.E+W+S

(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, or on behalf of an . . . F35[F36 . . . F35 District] 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 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 Supplementary provisions for ss. 8 to 11.E+W+S

The provisions of Part III of Schedule 5 to this Act have effect, so far as applicable, in relation to—

(a)Regional Health Authorities . . . F37 . . . F38[F39and District Health Authorities] established under section 8 above;

(b)Family Practitioner Committees established under section 10 above . . . F40;

(c)any special health authority established under section 11 above.

13 Secretary of State’s directions.E+W+S

(1)The Secretary of State may direct a Regional Health Authority, . . . F41, [F42a District Health Authority of which the district 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 Regional Health Authority’s directions.E+W+S

(1)A Regional Health Authority may direct any . . . F43[F44 . . . F43 District] Health Authority of which the . . . F43[F44 . . . F43 district] 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 . . . F43[F44 . . . F43 District] 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 . . . F43[F44 . . . F43 District] Health Authority it is the Regional Health Authority’s duty to comply with his directions.

15 Duty of Family Practitioner Committee.E+W+S

(1)It is the duty of each Family Practitioner Committee, in accordance with regulations [F45and subject to any directions from the relevant Regional Health Authority]—

[F46(a)to administer 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 their locality;]

(b)to perform such [F47management and] other functions relating to those services as may be prescribed.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F48

[F49(1A)In relation to a Family Health Services Authority for a locality in England, any reference in this Act or the National Health Service and Community Care Act 1990 to the relevant Regional Health Authority is a reference to that Authority in whose region lies the whole or the greater part of the Authority’s locality.

(1B)In relation to a medical practitioner, any reference in this Act or the National Health Service and Community Care Act 1990 to the relevant Family Health Services Authority shall be construed as follows,—

(a)if he practices in partnership with other medical practitioners, the relevant Authority is that Authority on whose medical list the members of the practice are included and, if some are included on one Authority’s medical list and some on another’s or if any of the members is included in the medical lists of two or more Authorities, the relevant Authority is that Authority in whose locality resides the largest number of individuals who are on the lists of patients of the members of the practice; and

(b)in any other case, the relevant Authority is that Authority on whose medical list he is included and, if there is more than one, that one of them in whose locality resides the largest number of individuals who are on his list of patients.]

(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F50

16 Exercise of functions.E+W+S

(1)Regulations may provide for functions exercisable by virtue of the provisions of sections 13 to 15 above by a body other than [F51a Regional or District Health Authority, or exercisable by a Regional or District Health Authority by virtue of any prescribed provision of this or any other Act, or exercisable by a Family Health Services Authority under Part I of the National Health Service and Community Care Act 1990], 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 aforesaid;

(c)in the case of functions exercisable by an . . . F52[F53 . . . F52 District] 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 . . . F52[F53 . . . F52 District] Health Authority.

(2)For the purposes of subsection (1) above, a Regional [F54Health Authority, . . . F55, a District] Health Authority or a Family Practitioner Committee is equivalent to another body of the same name . . . F56 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.

[F61 Directions as to distribution and exercise of functions]E+W+S

[F6317Directions as to exercise of functions.E+W+S

(1)The Secretary of State may give directions with respect to the exercise of any functions exercisable by virtue of sections 13 to 16 above [F64and may also give directions with respect to the exercise by health authorities or Family Health Services Authorities of functions under the National Health Service and Community Care Act 1990]; and, subject to any directions given by the Secretary of State by virtue of this section, a Regional Health Authority may give directions with respect to the exercise

[F65(a)]by a District Health Authority of which the district is included in its region, of any functions exercisable by the District Health Authority by virtue of section 14 above. [F66and

(b)by a Family Health Services Authority in relation to which it is the relevant Regional Health Authority, of any functions exercisable by the Family Health Services Authority by virtue of section 15 above or the National Health Service and Community Care Act 1990.]

(2)It shall be the duty of a body to whom directions are given under subsection (1) above to comply with the directions.]

[F69 Directions and regulations: general]E+W+S

18 Directions under ss. 13 to 17 generally.E+W+S

(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 [F70section 14 of the M5Interpretation Act 1978] in the case of directions given by regulations),

so, however, that an . . . F71[F72 . . . F71 District] Health Authority shall not be entitled to exercise any functions which, by virtue of section 15 above, are exercisable by the Family Practitioner Committee . . . F73

Local advisory committees andCommunity Health CouncilsE+W+S

19 Local advisory committees.E+W+S

(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 [F76and 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 [F77or for the district of a District 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 [F77or the District] Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical Committee, as the case may be, for the area [F77or district] 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 Community Health Councils.E+W+S

(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 [F79and a council for the district of each District Health Authority], or separate councils for such separate parts of the areas [F79or districts] of those Authorities as he thinks fit, and such a council shall be called 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 [F79or for a district which includes the districts or parts of the districts of two or more District 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 [F79or of the district of a District 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.

Co-operation and assistanceE+W+S

21 Local social services authorities.E+W+S

(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 F80. . .,

(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 Co-operation between health authorities and local authorities.E+W+S

(1)In exercising their respective functions health authorities [F81, Family Practitioner Committees] 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 [F82bodies represented on them] on the performance of their duties under subsection (1) above, and on the planning and operation of services of common concern to those authorities.

(3)Except as provided by an order under the following provisions of this section, each joint consultative committee shall represent one or more Area [F83or District] Health Authorities together with one or more of the authorities in column 2 of the Table above, and an Area [F83or District] 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).

[F86(3A)It is the Secretary of State’s duty by order to secure as respects each joint consultative committee that it includes additional members appointed in a manner specified in the order by voluntary organisations.]

(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 provisions of subsections (2) and (3) above are to be carried out, or provide for varying the arrangements set out in those subsections;

(b)provide, where it appears to the Secretary of State appropriate, for an Area [F83or District] Health Authority [F87or a Family Practitioner Committee] to be represented on a joint consultative committee together with a local or other authority whose area is not within the area [F83or district] of the Area [F83or District] Health Authority [F88or the locality of the Family Practitioner Committee];

(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 [F89neither—

(i)members of the authorities represented by the joint consultative committee; nor

(ii)appointed by virtue of an order under subsection (3A) above];

(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 those authorities concerning the expenses is to be resolved; and

(g)require those 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.

[F90(6)Without prejudice to the generality of section 126(4) below, the power to make an order conferred by subsection (3A) above may be exercised so as to make different provision for England and Wales and different provision for different communities in either.]

23 Voluntary organisations and other bodies.E+W+S

(1)The Secretary of State may, where he 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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F91

(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 [F92Part VI of the Road Traffic Act 1988] shall have effect with such modifications as are specified in the order.

(5)Any power to supply goods or materials 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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F93E+W+S

25 Supplies not readily obtainable.E+W+S

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.

26 Supply of goods and services by Secretary of State.E+W+S

(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.

[F95(4)The Secretary of State may arrange to make available to local authorities the services of persons of the following descriptions, that is to say—

(a)persons providing general medical services, general dental services, general ophthalmic services or pharmaceutical services, and

(b)persons providing health authorities with services of a kind provided as 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 Conditions of supply under s. 26.E+W+S

(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 M7Vehicles (Excise) Act 1971 and [F96Part VI of the M8Road Traffic Act 1988] shall have effect with 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 Supply of goods and services by local authorities.E+W+S

(1)In the M9Local 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 [F97and NHS trusts] 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 M10Local Authorities Social Services Act 1970 so far as is reasonably necessary and practicable to enable health authorities [F97and NHS trusts] to discharge their functions under this Act [F98and the National Health Service and Community Care Act 1990].

(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F99

[F10028A Power to make payments towards expenditure on community services.E+W+S

(1)This section applies to the following authorities—

(a)a District Health Authority; and

(b)a special health authority established for a London Post-Graduate Teaching Hospital.

(2)An authority to whom this section applies may, if they think fit, make payments—

(a)to a local social services authority towards expenditure incurred or to be incurred by them in connection with any function which, by virtue of section 2(1) or (2) of the M11Local Authority Social Services Act 1970, is to be performed through their social services committee, other than functions under section 3 of the M12Disabled Persons (Employment) Act 1958;

(b)to a district council, towards expenditure incurred or to be incurred by them in connection with their functions under section 8 of the M13Residential Homes Act 1980 or Part II of Schedule 9 to the M14Health and Social Services and Social Security Adjudications Act 1983 (meals and recreation for old people);

(c)to an authority who are a local education authority for the purposes of the Education Acts 1944 to [F1011993], towards expenditure incurred or to be incurred by them in connection with their functions under those Acts, in so far as they perform those functions for the benefit of disabled persons;

[F102(d)to a local housing authority within the meaning of the M15Housing Act 1985, towards expenditure incurred or to be incurred by them in connection with their functions under Part II of that Act (provision of housing); and]

(e)to the following bodies, in respect of expenditure incurred or to be incurred by them in connection with the provision of housing accommodation,—

[F103(i)a registered housing association within the meaning of the M16Housing Associations Act 1985;]

(ii)the Commission for the New Towns;

(iii)a new town development corporation;

(iv)an urban development corporation established under the M17Local Government, Planning and Land Act 1980;

(v)the Housing Corporation; and

(vi)the Development Board for Rural Wales [F104and

(vii)Housing for Wales.]

(3)A payment under this section may be made in respect of expenditure of a capital or of a revenue nature or in respect of both kinds of expenditure.

(4)No payment shall be made under this section in respect of any expenditure unless the expenditure has been recommended for a payment under this section by a joint consultative committee on which the authority proposing to make the payment are represented.

(5)The Secretary of State may by directions prescribe conditions relating to payments under this section.

(6)The power to give such directions may be exercised so as to make, as respects the cases in relation to which it is exercised, the same provision for all cases, or different provision for different cases or different classes of case, or different provision as respects the same case or class of case for different purposes.

(7)Without prejudice to the generality of subsection (5) above, the power may be exercised—

(a)so as to make different provision for England and Wales and different provision for different districts in either; and

(b)so as to require, in such circumstances as may be specified,—

(i)repayment of the whole or any part of a payment under this section;

(ii)payment, in respect of property acquired with money paid under this section, of an amount representing the whole or part of an increase in the value of the property which has occurred since its acquisition.

(8)No payment shall be made under this section in respect of any expenditure unless the conditions relating to it—

(a)accord with the advice given by the joint consultative committee in making the recommendation for a payment under this section in respect of the expenditure in question; and

(b)conform with the conditions prescribed for payments of that description under subsection (5) above.

(9)Where expenditure which has been recommended by a joint consultative committee for a payment under this section is expenditure in connection with services to be provided by a voluntary organisation—

(a)the authority who are to make the payment may make payments to the voluntary organisation towards the expenditure incurred or to be incurred by the organisation in connection with the provision of those services, instead of or in addition to making payments under subsection (2) above; and

(b)an authority of one of the descriptions specified in paragraph (a), (b), (c) or (d) of subsection (2) above and who have received payments under that subsection may make out of the sums paid to them payments to the voluntary organisation towards expenditure incurred or to be incurred by the organisation in connection with the provision of those services,

but no payment shall be made under this subsection except subject to conditions—

(i)which conform with the conditions prescribed for payments of that description under subsection (5) above; and

(ii)which accord with the advice given by the joint consultative committee in recommending the expenditure for a payment under this section.]

[F10528B Power of Secretary of State to make payments towards expenditure on community services in Wales.E+W+S

(1)The Secretary of State may, if he thinks fit, make payments—

(a)to authorities in Wales of any of the descriptions mentioned in paragraphs (a), (b), (c) and (d) of sectopm 28A(2) above, for the purposes respectively mentioned in those paragraphs;

(b)to the following bodies, in respect of expenditure incurred or to be incurred by them in connection with the provision of housing accommodation in Wales,—

[F106(i)a registered housing association within the meaning of the M18Housing Associations Act 1985;]

(ii)the Commission for the New Towns;

(iii)a new town development corporation;

(iv)an urban development corporation established under the M19Local Government, Planning and Land Act 1980;

(v)[F107Housing for Wales]; and

(vi)the Development Board for Rural Wales.

(2)The Secretary of State may, if he thinks fit, make payments to a voluntary organisation towards expenditure incurred or to be incurred by the organisation in connection with the provision of services for which he could make payments under subsection (1) above.

(3)A payment under this section may be made in respect of expenditure of a capital or of a revenue nature or in respect of both kinds of expenditure.

(4)Conditions may be attached to a payment under this section.

(5)Without prejudice to the generality of subsection (4) above, the conditions that may be attached include conditions requiring, in such circumstances as may be specified,—

(a)repayment of the whole or any part of a payment under this section;

(b)payment, in respect of property acquired with money paid under this section, of an amount representing the whole or part of an increase in the value of the property which has occurred since its acquisition.]

Part IIE+W+S General Medical, General Dental, General Ophthalmic, and Pharmaceutical Services

General medical servicesE+W+S

29Arrangements and regulations for general medical services.E+W+S

[F127(1)It is the duty of every Family Practitioner Committee, in accordance with regulations, to arrange as respects their locality with medical practitioners to provide personal medical services for all persons in the locality who wish to take advantage of the arrangements.

(1A)The services so provided are referred to in this Act 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 [F128locality] of the name of any one 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 [F128locality].

[F129(f)for the making of arrangements for the temporary provision of general medical services [F130in the locality of a Family Practitioner Committee];

(g)for the circumstances in which a name added to the list by virtue of subsection (6) below may be removed from it.]

(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.

[F131(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.]

[F132(5)Regulations shall—

(a)include provision for the making to a medical practitioner providing general medical services of payments in respect of qualifying services provided by a spouse or other relative of his; and

(b)provide that the rates and conditions of payment and the qualifying services in respect of which the payments may be made shall be such as may be determined by the Secretary of State after consultation with such bodies as he may recognise as representing such medical practitioners.]

[F133(6)The persons with whom arrangements for the temporary provision of general medical services in a [F134locality] may be made by virtue of regulations under subsection (2) above include medical practitioners who are not on the list of medical practitioners providing such services in the [F134locality], and the power to prepare and publish lists of medical practitioners conferred by paragraph (a) of that subsection accordingly includes power to add the names of medical practitioners with whom such arrangements are made to the list.

(7)Regulations may provide that this Act and any regulations made under it shall apply in relation—

(a)to the making of arrangements for the temporary provision of general medical services; and

(b)to the provision of general medical services in pursuance of any such arrangements,

subject to such modifications as may be specified in the regulations.

(8)Where the registration of a medical practitioner in the register of medical practitioners is suspended—

(a)by a direction of the Health Committee of the General Medical Council under [F135section 37(1) or (2) of the M26Medical Act 1983] (unfitness to practice by reason of physical or mental condition);

(b)by an order of that Committee under [F135section 38(1)] of that Act (order for immediate suspension); or

(c)by an interim order of the Preliminary Proceedings Committee of the Council under [F135section 42(3)(b)] of that Act,

the suspension shall not terminate any arrangements made with him for the provision of general medical services, but he shall not provide such services in person during the suspension.]

30 Applications to provide general medical services.E+W+S

(1)[F141Subject to subsection (1A) below] all applications made [F142by medical practitioners in the prescribed manner to a Family Practitioner Committee for inclusion in a list kept by that Committee of the names of medical practitioners undertaking to provide general medical services for persons in the Committee’s locality shall be referred by the Committee] to the Medical Practices Committee and . . . F143 any medical practitioner whose application is granted by that Committee shall [F144subject to the provisions of this Part of this Act relating to disqualification of practitioners] be entitled to the inclusion of his name in the list.

[F145(1A)No medical practitioner who is a national of a member State and is registered by virtue of a qualification granted in a member State shall be entitled to have his application for the inclusion of his name in the list kept by any Family Practitioner Committee referred to the Medical Practices Committee unless he satisfies the Family Practitioner Committee that he has that knowledge of English which, in the interests of himself and his patients, is necessary for the provision of general medical services in the Committee’s locality; and where a Family Practitioner Committee is not so satisfied with respect to any applicant the Family Practitioner Committee shall not refer his application to the Medical Practices Committee.]

(2). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F146

31 Requirement of suitable experience.E+W+S

(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

[F147(b)a Family Practitioner Committee shall not arrange under section 29 above with a medical practitioner for him to provide general medical services for persons in the Committee’s locality unless the Medical Practices Committee have granted an application by him for the inclusion of his name in the list kept by the Family Practitioner Committee of medical practitioners undertaking to provide general medical services for persons in their locality.]

(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 Regulations as to s. 31.E+W+S

(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 [F148localities] 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 Distribution of general medical services.E+W+S

[F149(1)The Medical Practices Committee may refuse any applications under section 30 above on the grounds that the number of medical practitioners undertaking to provide general medical services in the locality of the Family Practitioner Committee concerned or in the relevant part of that locality is already adequate.]

[F150(1A)The Secretary of State may by order specify—

(a)the maximum number of medical practitioners with whom, in any year, all the Family Health Services Authorities for localities in England, taken as a whole, may enter into arrangements under section 29 above for the provision of general medical services; and

(b)the maximum number of medical practitioners with whom, in any year, all the Family Health Services Authorities for localities in Wales, taken as a whole, may enter into such arrangements.

(1B)An order under subsection (1A) above may contain such incidental and consequential provisions (including provisions amending this Part of this Act) as appear to the Secretary of State to be appropriate including, in particular, provisions as to the basis on which the Medical Practices Committee are to refuse applications under section 30 above in order to secure that any maximum number specified in the order is not exceeded.]

(2)[F151Subject to subsection (2A) below] if in the opinion of the Medical Practices Committee additional practitioners are required for any [F152locality or part of a locality], 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.

[F153(2A)If, in the opinion of the Medical Practices Committee, a medical practitioner is required for a particular part of the locality of a Family Health Services Authority, then, in such circumstances as may be prescribed,—

(a)the Authority (instead of the Committee) shall, in accordance with regulations, select the medical practitioner whose application they wish to be considered by the Committee; and

(b)the Committee shall not consider any application from a medical practitioner who is not so selected; and

(c)any medical practitioner who has made an application but is not so selected may appeal to the Secretary of State on a point of law;

and if the Secretary of State allows an appeal under paragraph (c) above he shall remit the application to the Authority for reconsideration.]

[F154(3)Before selecting any persons under subsection (2) above the Medical Practices Committee shall consult the Family Practitioner Committee concerned, and the Family Practitioner Committee shall, if a Local Medical Committee has been formed for their locality 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

[F155(a)in granting an application shall specify, by reference to one or more prescribed conditions relating to hours or the sharing of work, the provision of general medical services for which the applicant will be entitled to be remunerated; and]

[F155(b)]may grant an application subject to conditions excluding the provision of general medical services by the applicant in such part or parts of the Family Practitioner Committee’s locality as the Medical Practices Committee may specify][F156and an order under subsection (1A) above may make provision as to the extent to which account is to be taken under the order of medical practitioners whose ability to carry out remunerated work is limited by virtue of conditions imposed under paragraph (a) above].

(5)A medical practitioner who has made an application under section 30 which has been refused [F157by the Medical Practices Committee] or has been granted [F157by that Committee] subject to [F158conditions under paragraph (a) or paragraph (b) of subsection (4) above] may appeal to the Secretary of State; [F159on a point of law; and, if the Secretary of State allows such an appeal, he shall remit the application to the Medical Practices Committee for reconsideration].

(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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F160

(8)[F161In any case where medical practitioners have to be selected from a number of applicants, the Medical Practices Committee or, where subsection (2A) above applies, the Family Health Services Authority shall]—

(a)have regard to any desire expressed by any applicant to practise with other medical practitioners already providing general medical services in the [F162locality concerned or part of it] 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 for Medical Practices Committee.E+W+S

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—

[F163(a)for requiring Family Practitioner Committees 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 localities and the different parts of those localities;]

(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 [F164and where such an appeal is allowed, the reconsideration of any application]; and

[F165(iii)requiring Family Practitioner Committees and applicants to be informed of the decisions of the Medical Practices Committee and the Secretary of State.]

[F166(2)Regulations under this section may make provision for, and in connection with, the variation of any condition imposed under subsection (4) or subsection (5) of section 33 above, including provision for appeals to the Secretary of State on a point of law]

General dental servicesE+W+S

35 Arrangements for general dental services.E+W+S

[F167(1)It is the duty of every Family Practitioner Committee, in accordance with regulations, to make as respects their locality arrangements with dental practitioners under which any person in the locality for whom a dental practitioner undertakes in accordance with the arrangements to provide dental treatment and appliances shall receive such treatment and appliances.

(1A)The services so provided are referred to in this Act 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.

[F168(3)Where the registration of a dental practitioner in the dentists register is suspended—

(a)by an order under [F169section 32 of the M29Dentists Act 1984] (interim suspension); or

(b)by a direction or [F170an order of the Health Committee under] that Act (health cases),

the suspension shall not terminate any arrangements made with him for the provision of general dental services, but he shall not provide such services in person during the suspension.

(4)Regulations may provide for the making of payments in consequence of suspension to a dental practitioner whose registration is so suspended.]

36Regulations as to s. 35.E+W+S

[F171(1)]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 [F172[F173subsections (2) and (3)] below and to] the provisions of this Part of this Act relating to the disqualification of practitioners [F174and to section 8 of the Health and Medicines Act 1988 and regulations under that section], 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 [F175locality] of the name of any one 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 [F175locality].

[F176(2)No dental practitioner who is a national of a member State and is registered by virtue of a qualification granted in a member State shall be entitled to have his name included in the list kept by any Family Practitioner Committee unless he satisfies the Committee that he has that knowledge of English which, in the interests of himself and his patients, is necessary for the provision of general dental services in the Committee’s locality.]

[F177(3)Regulations may make the exercise of the right conferred by virtue of paragraph (b) of subsection (1) above subject to any provision made by or under the regulations, and, in such cases as may be prescribed, may confer a right of appeal to a prescribed body in respect of a refusal to include a dental practitioner on such a list as is referred to in paragraph (a) of that subsection.]

37 Dental Estimates Board.E+W+S

[F178(1)]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 . . . F179 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 [F180or District] Health Authority, provision is or may be made by or under Part III of Schedule 5 to this Act.

[F181(1A)Regulations may empower the Dental Practice Board—

(a)to direct a dental practitioner to submit to the Board, in relation to treatment which he has carried out or contemplates carrying out or to a description of such treatment specified in the direction, such estimates and information and such radiographs, models or other items as may be prescribed; and

(b)to direct a dental practitioner not to carry out treatment, or a description of treatment specified in the direction, without first obtaining approval of an estimate from the Board.

(1B)If regulations include any such provision as is mentioned in subsection (1A)(b) above, regulations shall confer on a dental practitioner in whose case a direction such as is mentioned in that pargraph has been given a right of appeal against the direction to a prescribed person or body, but before making regulations conferring such a right the Secretary of State shall consult such organisations as appear to him to be representative of persons providing general dental services.

(1C)Regulations may be made authorising or requiring the Dental Practice Board to carry on any such additional activity relating to the provision of general dental services as may be prescribed and, without prejudice to the generality of this subsection, to conduct or commission surveys or other research relating to the provision of such services.]

General ophthalmic servicesE+W+S

38 Arrangements for general ophthalmic services.E+W+S

[F182(1)][F183It is the duty of every Family Practitioner Committee, in accordance with regulations, to arrange as respects their locality] with medical practitioners having the prescribed qualifications, [F184and ophthalmic opticians for securing the testing][F185by them of the sight—

(a)of a child;

(b)of a person whose resources fall to be treated under the regulations as being less than his requirements or as being equal to his requirements; or

(c)of a person of such other description as may be prescribed.

(2)In this section—

• “child” means—

(a)a person who is under the age of 16 years; or

(b)a person who is under the age of 19 years and receiving qualifying full-time education; and

• “qualifying full-time education” means full-time instruction at a recognised educational establishment or by other means accepted as comparable by the Secretary of State, and for the purpose of this definition—

(a)“recognised educational establishment” means an establishment recognised by the Secretary of State as being, or as comparable to, a school, college or university; and

(b)regulations may prescribe the circumstances in which a person is or is not to be treated as receiving full-time instruction.

(3)Regulations under this section may direct how a person’s resources and requirements are to be calculated and, without prejudice to the generality of this subsection, may direct that they shall be calculated—

(a)by a method set out in the regulations;

(b)by a method described by reference to a method of calculating or estimating income or capital specified in an enactment other than this section or in an instrument made under an Act of Parliament or by reference to such a method but subject to prescribed modifications;

(c)by reference to an amount applicable for the purposes of a payment under an Act of Parliament or an instrument made under an Act of Parliament; or

(d)by reference to the person’s being or having been entitled to payment under an Act of Parliament or an instrument made under an Act of Parliament.

(4)Descriptions of persons may be prescribed for the purposes of subsection (1) above by reference to any criterion and, without prejudice to the generality of this subsection, by reference to any of the following criteria—

(a)their age;

(b)the fact that a prescribed person or a prescribed body accepts them as suffering from a prescribed medical condition;

(c)the fact that a prescribed person or a prescribed body accepts that a prescribed medical condition from which they suffer arose in prescribed circumstances;

(d)their receipt of benefit in money or in kind under any enactment or their entitlement to receive any such benefit; and

(e)the receipt of any such benefit by other persons satisfying prescribed conditions or the entitlement of other persons satisfying prescribed conditions to receive such benefits.

(5)Regulations which refer to an Act of Parliament or an instrument made under an Act of Parliament may direct that the reference is to be construed as a reference to that Act or instrument—

(a)as it has effect at the time when the regulations are made; or

(b)both as it has effect at that time and as amended subsequently.

(6)Regulations may provide that a person—

(a)whose sight is tested by a person who provides general ophthalmic services; and

(b)who is shown during the testing or within a prescribed time after it to fall within subsection (1) above,

shall be taken for the purposes of the testing to have so fallen immediately before his sight was tested; and the testing shall be treated—

(i)for the purposes of any arrangements under this section;

(ii)for the purposes of remuneration in respect of the testing; and

(iii)for any such other purpose as may be prescribed,

as a testing of sight under this Act.

(7)Regulations shall define the services for the provision of which arrangements under this section are to be made and the services so defined are in this Act referred to as “general ophthalmic services”.]

39Regulations as to s. 38.E+W+S

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, [F186and ophthalmic] opticians, respectively, who undertake to provide general ophthalmic services;

(b)for conferring a right, subject to the provisions of this [F187Part of this] Act relating to the disqualification of practitioners, on any medical practitioner having the prescribed qualifications, [F188or ophthalmic] 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 . . . F189;

(d)for the removal from the list of medical practitioners, [F190or ophthalmic] opticians undertaking to provide general ophthalmic services for persons in any [F191locality] of the name of any one 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 [F191locality].

40 Medical practitioners with qualifications prescribed under s. 38.E+W+S

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.

Pharmaceutical servicesE+W+S

41 Arrangements for pharmaceutical services.E+W+S

[F192It is the duty of every Family Practitioner Committee, in accordance with regulations, to arrange as respects their locality for the [F193provision to persons who are in that locality of]]