National Health Service Act 1977

Prospective

F228C Personal medical or dental services.E+W+S

(1)A [F3Strategic Health Authority or a] Health Authority may make one or more agreements with respect to their area, in accordance with the provisions of regulations under section 28E, under which—

(a)personal medical services are provided (otherwise than by the Authority); or

(b)personal dental services are provided (otherwise than by the Authority).

(2)An agreement made under this section—

(a)may not combine arrangements for the provision of personal medical services with arrangements for the provision of personal dental services [F4, and may not combine arrangements for the provision of personal medical services or personal dental services with arrangements for the provision of local pharmaceutical services under LPS schemes (within the meaning of paragraph 1(3) of Schedule 8A to this Act) or under pilot schemes made under section 28 of the Health and Social Care Act 2001]; but

(b)may include arrangements for the provision of services—

(i)which are not personal medical services or personal dental services; but

(ii)which may be provided under this Part.

(3)Except to such extent as may be prescribed—

(a)a patient for whom personal medical services are provided in accordance with an agreement made under this section is not to count as a person for whom arrangements must be made by the [F5Primary Care Trust or] Health Authority concerned under section 29;

(b)a patient for whom personal dental services are provided under an agreement made under this section is not to count as a person for whom arrangements must be made by the [F6Primary Care Trust or] Health Authority concerned under section 35.

(4)This Act (and in particular section 17) has effect, in relation to personal medical services or personal dental services provided under an agreement made under this section, as if those services were provided as a result of the delegation by the Secretary of State (by directions given under section [F716D]) of functions of his under this Part.

(5)The functions of a Health Authority in relation to an agreement made under this section are primary functions of the Authority for the purposes of the M1National Health Service and Community Care Act 1990.

(6)Regulations may provide—

(a)for functions which are exercisable by a [F8Strategic Health Authority or a] Health Authority in relation to an agreement made under this section to be exercisable on behalf of the Authority by a Health Board; and

(b)for functions which are exercisable by a Health Board in relation to an agreement made under section 17C of the M2National Health Service (Scotland) Act 1978 to be exercisable on behalf of the Board by a [F8Strategic Health Authority or a] Health Authority.

(7)For the purposes of this section—

• “personal medical services” means medical services of a kind that may be provided by a general medical practitioner in accordance with arrangements made under Part II; and

• “personal dental services” means dental services of a kind that may be provided by a general dental practitioner in accordance with arrangements made under Part II.

Prospective

[F928D Persons with whom agreements may be made.E+W+S

(1)A [F10Strategic Health Authority or a] Health Authority may make an agreement under section 28C only with one or more of the following—

(a)an NHS trust;

(b)in the case of an agreement under which personal medical services are provided—

(i)a qualifying medical practitioner;

(ii)an individual who is providing personal medical services in accordance with section 28C arrangements or section 17C arrangements;

(c)in the case of an agreement under which personal dental services are provided—

(i)a qualifying dental practitioner;

(ii)an individual who is providing personal dental services in accordance with section 28C arrangements or section 17C arrangements;

(d)an NHS employee, a section 28C employee or a section 17C employee;

(e)a qualifying body.

[F11(f)a Primary Care Trust]

(2)In this section—

• “the 1978 Act” means the M3National Health Service (Scotland) Act 1978;

• “NHS employee” means an individual who, in connection with the provision of services in the health service in England and Wales or Scotland, is employed by—

  (a)

  an NHS trust;

  (b)

  in the case of an agreement under which personal medical services are provided—

  (i)

  a medical practitioner whose name is included in a medical list kept under this Act or in a corresponding list kept under the 1978 Act; or

  (ii)

  a medical practitioner who is providing personal medical services in accordance with section 28C arrangements or section 17C arrangements;

  (c)

  in the case of an agreement under which personal dental services are provided—

  (i)

  a dental practitioner whose name is included in a list prepared in accordance with regulations made under section 36(1)(a) of this Act or section 25(2)(a) of the 1978 Act; or

  (ii)

  a dental practitioner who is providing personal dental services in accordance with section 28C arrangements or section 17C arrangements;

• “qualifying body” means—

  (a)

  a company which is limited by shares all of which are legally and beneficially owned by persons falling within [F12paragraph (a), (b), (c), (d) or (f)] of subsection (1); and also

  (b)

  in the case of an agreement under which personal dental services are provided, a body corporate which, in accordance with the provisions of Part IV of the M4Dentists Act 1984, is entitled to carry on the business of dentistry;

• “qualifying dental practitioner” means a dental practitioner who satisfies the conditions imposed by regulations made under section 28E(2)(b) of this Act or section 17E(2)(b) of the 1978 Act;

• “qualifying medical practitioner” means a medical practitioner who satisfies the conditions imposed by regulations made under section 28E(2)(b) of this Act or section 17E(2)(b) of the 1978 Act;

• “section 17C arrangements” means arrangements for the provision of services made under section 17C of the 1978 Act;

• “section 17C employee” means an individual who, in connection with the provision of services in accordance with section 17C arrangements, is employed by an individual providing those services;

• “section 28C arrangements” means arrangements for the provision of services made under section 28C; and

• “section 28C employee” means an individual who, in connection with the provision of services in accordance with section 28C arrangements, is employed by an individual providing those services.]

Prospective

[F3028E Personal medical or dental services: regulations.E+W+S

(1)The Secretary of State may make regulations with respect to the provision of services in accordance with section 28C arrangements.

(2)The regulations must—

(a)include provision for participants other than [F31Strategic Health Authorities and] Health Authorities to withdraw from section 28C arrangements if they wish to do so;

(b)impose conditions (including conditions as to qualifications and experience) to be satisfied by medical practitioners performing personal medical services, and dental practitioners performing personal dental services, in accordance with section 28C arrangements.

In paragraph (b) “practitioner” does not include a practitioner who is undergoing training of a prescribed description.

(3)The regulations may, in particular—

(a)provide that section 28C arrangements may be made only in prescribed circumstances;

(b)provide that section 28C arrangements may be made only in prescribed areas;

(c)provide that only prescribed services, or prescribed categories of service, may be provided in accordance with section 28C arrangements;

(d)require details of section 28C arrangements to be published;

(e)make provision with respect to the variation and termination of section 28C arrangements;

(f)prevent (except in such circumstances and to such extent as may be prescribed) a medical practitioner who performs personal medical services in accordance with section 28C arrangements from providing general medical services;

(g)make provision with respect to medical lists, including provision for preferential treatment for medical practitioners;

(h)provide for parties to section 28C arrangements to be treated, in such circumstances and to such extent as may be prescribed, as health service bodies for the purposes of section 4 of the M5National Health Service and Community Care Act 1990;

(i)provide for directions, as to payments, made under section 4(7) of the Act of 1990 (as it has effect as a result of regulations made by virtue of paragraph (h)) to be enforceable in a county court (if the court so orders) as if they were judgments or orders of that court;

(j)confer powers or impose duties on the Dental Practice Board in relation to agreements made by virtue of section 28C(1) under which personal dental services are provided;

(k)authorise [F32Strategic Health Authorities and] Health Authorities to make payments of financial assistance for prescribed categories of preparatory work undertaken—

(i)in connection with preparing proposals for section 28C arrangements; or

(ii)in preparation for the provision of services under proposed section 28C arrangements.

[F33(4)The regulations must include provision for a medical practitioner who—

(a)has provided or performed personal medical services in accordance with section 28C arrangements, and

(b)in contemplation of doing so, gave up fund-holding status,

to be allowed to return immediately to fund-holding status on satisfying the Secretary of State that, if he were granted that status, he would be able to fulfil the conditions for the time being in force for continuing to have it.

For the purposes of this subsection “fund-holding status” has such meaning as may be prescribed.]

(5)The Secretary of State must—

(a)consider whether section 28C arrangements are likely to have an adverse effect on the distribution of medical practitioners providing general medical services or performing personal medical services in England or in Wales;

(b)if he thinks that the arrangements are likely to have that effect, consider whether it is necessary to include in the regulations provisions designed to secure that, so far as is possible, the arrangements do not have that effect; and

(c)if he thinks that it is necessary, include such provisions in the regulations.

(6)Regulations which impose conditions on persons performing personal medical services or persons performing personal dental services (whether made by virtue of subsection (2)(b) or otherwise) may, in particular, include provision of a kind that may be made by regulations under section 32.

(7)Regulations made by virtue of subsection (3)(g) may, in particular, include provision—

(a)requiring (except in prescribed circumstances) [F34Primary Care Trusts and] Health Authorities to remove from their medical lists persons who are performing personal medical services in accordance with section 28C arrangements or corresponding services under section 17C of the M6National Health Service (Scotland) Act 1978;

(b)conferring a right to transfer to a medical list on persons who have ceased to perform such services;

(c)that any provision in relation to medical lists made by or under any enactment is not to apply;

(d)as to conditions to be attached to entries in medical lists;

(e)conferring powers of disqualification on the [F35Family Health Services Appeal Authority constituted under section 49S].

(8)The power to make provision under this section of the kind mentioned in subsection (3)(j) includes power—

(a)to authorise or require the Dental Practice Board to perform on behalf of a [F36Strategic Health Authority or] Health Authority functions of a prescribed description (including functions relating to remuneration) which have been delegated to the Board by the [F37Strategic Health Authority or] Health Authority in accordance with a power conferred by the regulations;

(b)to provide that functions conferred by the regulations are only to be exercised by the Board in accordance with directions of the Secretary of State;

(c)to require information for the purpose of performing any functions conferred or imposed on the Board under this section.]

Prospective

[F3828EE Delegation of Health Authority functions relating to section 28C arrangements.E+W

(1)F39. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2)The Secretary of State may by order make provision for any rights and liabilities arising under an agreement to provide personal medical services under section 28C above to be transferred from [F40Strategic Health Authorities] to Primary Care Trusts and from Primary Care Trusts to [F41Strategic Health Authorities] .

(3)Subsection (2) above is without prejudice to any other power of the Secretary of State to transfer rights and liabilities under this Act.]

Prospective

[F4728J Local pharmaceutical services schemesE+W

(1)Schedule 8A makes provision with respect to the provision of local pharmaceutical services in accordance with schemes made by [F48Primary Care Trusts and] Health Authorities.]