National Health Service Act 1977

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

[F1(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 [F2locality] 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 [F2locality].

[F3(f)for the making of arrangements for the temporary provision of general medical services [F4in 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.

[F5(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.]

[F6(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.]

[F7(6)The persons with whom arrangements for the temporary provision of general medical services in a [F8locality] 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 [F8locality], 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 [F9section 37(1) or (2) of the M1Medical Act 1983] (unfitness to practice by reason of physical or mental condition);

(b)by an order of that Committee under [F9section 38(1)] of that Act (order for immediate suspension); or

(c)by an interim order of the Preliminary Proceedings Committee of the Council under [F9section 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)[F15Subject to subsection (1A) below] all applications made [F16by 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 . . . F17 any medical practitioner whose application is granted by that Committee shall [F18subject 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.

[F19(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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F20

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

[F21(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 [F22localities] 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

[F23(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.]

[F24(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)[F25Subject to subsection (2A) below] if in the opinion of the Medical Practices Committee additional practitioners are required for any [F26locality 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.

[F27(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.]

[F28(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

[F29(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]

[F29(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][F30and 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 [F31by the Medical Practices Committee] or has been granted [F31by that Committee] subject to [F32conditions under paragraph (a) or paragraph (b) of subsection (4) above] may appeal to the Secretary of State; [F33on 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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F34

(8)[F35In 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 [F36locality 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—

[F37(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 [F38and where such an appeal is allowed, the reconsideration of any application]; and

[F39(iii)requiring Family Practitioner Committees and applicants to be informed of the decisions of the Medical Practices Committee and the Secretary of State.]

[F40(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

[F41(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.

[F42(3)Where the registration of a dental practitioner in the dentists register is suspended—

(a)by an order under [F43section 32 of the M4Dentists Act 1984] (interim suspension); or

(b)by a direction or [F44an 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

[F45(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 [F46[F47subsections (2) and (3)] below and to] the provisions of this Part of this Act relating to the disqualification of practitioners [F48and 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 [F49locality] 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 [F49locality].

[F50(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.]

[F51(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

[F52(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 . . . F53 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 [F54or District] Health Authority, provision is or may be made by or under Part III of Schedule 5 to this Act.

[F55(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

[F56(1)][F57It 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, [F58and ophthalmic opticians for securing the testing][F59by 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, [F60and ophthalmic] opticians, respectively, who undertake to provide general ophthalmic services;

(b)for conferring a right, subject to the provisions of this [F61Part of this] Act relating to the disqualification of practitioners, on any medical practitioner having the prescribed qualifications, [F62or 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 . . . F63;

(d)for the removal from the list of medical practitioners, [F64or ophthalmic] opticians undertaking to provide general ophthalmic services for persons in any [F65locality] 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 [F65locality].

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

[F66It is the duty of every Family Practitioner Committee, in accordance with regulations, to arrange as respects their locality for the [F67provision to persons who are in that locality of]]

(a)proper and sufficient drugs and medicines and listed appliances which are ordered for those persons by a medical practitioner in pursuance of his functions in the health service, the Scottish health service, the Northern Ireland health service or the armed forces of the Crown (excluding forces of a Commonwealth country and forces raised in a colony; . . . F68

[F69(b)proper and sufficient drugs and medicines which are ordered for those persons by a dental practitioner in pursuance of the provision by [F70a health authority][F71or an NHS trust] of dental services; . . . F72

(c)listed drugs and medicines which are ordered for those persons by a dental practitioner in pursuance of the provision by him of general dental services.][F73and

(d)such other services as may be prescribed.]

The services so provided are in this Act referred to as “pharmaceutical services”.

In this section—

• “listed” means included in a list for the time being approved by the Secretary for the purposes of this section; and

• “the Scottish health service” and “the Northern Ireland health service” mean respectively the health service established in pursuance of section 1 of the M5National Health Service (Scotland) Act 1947 or any service provided in pursuance of Article 4(a) of the M6Health and Personal Social Services (Northern Ireland) Order 1972.

[F7642Regulations as to pharmaceutical services.E+W+S

(1)Regulations shall provide for securing that arrangements made by a Family Practitioner Committee under section 41 above will enable persons in the Committee’s locality for whom drugs, medicines or appliances mentioned in that section are ordered as there mentioned to receive them from persons with whom such arrangements have been made.

(2)The regulations shall include provision—

(a)for the preparation and publication by a Committee of one or more lists of persons, other than medical practitioners and dental practitioners, who undertake to provide pharmaceutical services from premises in the Committee’s locality;

(b)that an application to a Committee for inclusion in such a list shall be made in the prescribed manner and shall state—

(i)the services which the applicant will undertake to provide and, if they consist of or include the supply of appliances, which appliances he will undertake to supply; and

(ii)the premises from which he will undertake to provide those services;

(c)that, except in prescribed cases—

(i)an application for inclusion in such a list by a person not already included; and

(ii)an application by a person already included in such a list for inclusion also in respect of services or premises other than those already listed in relation to him,

(d)for the removal of an entry in respect of premises from a list if it has been determined in the prescribed manner that the person to whom the entry relates—

(i)has never provided from those premises; or

(ii)has ceased to provide from them, the services, or any of the services, which he is listed as undertaken to provide from them.

(3)The regulations may include provision—

(a)that an application to a Committee may be granted in respect of some only of the services specified in it;

(b)that an application to a Committee relating to services of a prescribed description shall be granted only if it appears to the Committee that the applicant has satisfied such conditions with regard to the provision of those services as may be prescribed;

[F77(ba)that an application to a Committee by a person who qualified to have his name registered under the Pharmacy Act 1954 by virtue of section 4A of that Act (qualification by European diploma) shall not be granted unless the applicant satisfies the Committee that he has the knowledge of English which, in the interests of himself and persons making use of the services to which the application relates, is necessary for the provision of pharmaceutical services in the Committee’s locality.]

(c)that the inclusion of a person in a list in pursuance of such an application may be for a fixed period;

(d)that, where the premises from which an application states that the applicant will undertake to provide services are in an area of a prescribed description, the applicant shall not be included in the list unless his inclusion is approved by [F78reference to prescribed criteria by the Family Health Services Authority in whose locality those premises are situated; and]

(e)that [F79that Family Health Services Authority] may give its approval subject to conditions.

(4)The regulations shall include provision conferring on such persons as may be prescribed rights of appeal from decisions made by virtue of this section.

(5)The regulations shall be so framed as to preclude—

(a)a person included in a list published under subsection (2)(a) above ;and (b) an employee of such a person; from taking part in the decision whether an application such as is mentioned in subsection (2)(c) above should be granted or an appeal against such a decision brought by virtue of subsection (4) above should be allowed.]

43 Persons authorised to provide pharmaceutical services.E+W+S

(1)No arrangements shall be made by [F80a Family Practitioner Committee] (except as may be provided by [F81or under] regulations) with a medical practitioner or dental practitioner under which he is required or agrees to provide pharmaceutical services to any person to whom he is rendering general medical services or general dental services.

(2)No arrangements for the dispensing of medicines shall be made (except as may be provided by [F81or under] regulations) with persons other than persons who are registered pharmacists, or are persons lawfully conducting a retail pharmacy business in accordance with section 69 of the M10Medicines Act 1968 and who undertake that all medicines supplied by them under the arrangements made under this Part of this Act shall be dispensed either by or under the direct supervision of a registered pharmacist.

[F82(3)No arrangements for the provision of pharmaceutical services falling within section 41(d) above shall be made with persons other than those who are registered pharmacists or are of a prescribed description.]

Local representative committeesE+W+S

44 Recognition of local representative committees.E+W+S

(1)Where the Secretary of State is satisfied that a committee formed for the [F87locality of any Family Practitioner Committee] is representative —

(a)of the medical practitioners providing general medical services or general ophthalmic services in that [F88locality], or

(b)of the dental practitioners providing general dental services in that [F88locality], or

(c)of the ophthalmic opticians . . . F89 providing general ophthalmic services in that [F88locality], or

(d)of the persons providing pharmaceutical services in that [F88locality],

he may recognise that committee; and any committee so recognised shall be called the Local Medical Committee, the Local Dental Committee, the Local Optical Committee or the Local Pharmaceutical Committee, as the case may be, for the [F88locality] concerned.

(2)Any such committee may with the Secretary of State’s approval delegate any of their functions, with or without restrictions or conditions, to sub-committees composed of members of that committee.

45 Functions of local representative committees.E+W+S

(1)The Family Practitioner Committee for [F90a locality] in respect of which committees are recognised under section 44 above shall, in exercising their functions under this Part of this Act, consult with those committees on such occassions and to such extent as may be prescribed; and those committees shall exercise such other functions as may be prescribed.

(2)The Family Practitioner Committee may, on the request of any committee recognised under section 44 for their [F91locality], allot to that committee such sums for defraying the committee’s administrative expenses (including travelling and subsistence allowances payable to its members) as may be determined by the Family Practitioner Committee . . . F92

(3)Any sums so allotted shall be out of the moneys available to the Family Practitioner Committee for the remuneration of persons of whom the committee so recognised is representative and who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services, as the case may be, under this Part of this Act.

The amount of any such sums shall be deducted from the remuneration of those persons in such manner as may be determined by the Family Practitioner Committee . . . F92

Provisions as to disqualification of practitionersE+W+S

46 Disqualification of practitioners.E+W+S

(1)There shall be a tribunal (in this section and sections 47 to 49 below referred to as “the Tribunal”) which shall be constituted in accordance with Schedule 9 to this Act to inquire into cases where representations are made in the prescribed manner to the Tribunal by [F93a Family Practitioner Committee] or any other person that the continued inclusion of a person’s name in a list prepared under this Part of this Act—

(a)of medical practitioners undertaking to provide general medical services,

(b)of medical practitioners undertaking to provide general ophthalmic services,

(c)of dental practitioners undertaking to provide general dental services,

(d)of ophthalmic opticians undertaking to provide general ophthalmic services,

(e). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F94

(f)of persons undertaking to provide pharmaceutical services,

would be prejudicial to the efficiency of the services in question.

The supplementary provisions contained in Schedule 9 apply in relation to the Tribunal.

(2)The Tribunal, on receiving representations from [F95a family Practitioner Committee] shall, and in any other case may, inquire into the case, and, if they are of opinion that the continued inclusion of that person’s name in any list to which the representations relate would be prejudicial to the efficiency of those services—

(a)shall direct that his name be removed from that list; and

(b)may also, if they think fit, direct that his name be removed from, or not be included in, any corresponding list kept by any other [F96Family Practitioner Committee] under this Part.

(3)An appeal shall lie to the Secretary of State from any direction of the Tribunal under subsection (2) above, and the Secretary of State may confirm or revoke that direction.

(4)Where the Tribunal direct that the name of any person be removed from or not included in any list or lists the [F97Family Practitioner Committee or Committees] concerned shall—

(a)if no appeal is brought, at the end of the period for bringing an appeal, or

(b)if an appeal is brought and the decision of the Tribunal is confirmed by the Secretary of State, on receiving notice of the Secretary of State’s decision,

remove the name of the person concerned from the list or lists in question.

47 Removal of disqualification.E+W+S

(1)Any person whose name has been removed by a direction under section 46 above from any list or lists shall be disqualified for inclusion in any list to which that direction relates until the Tribunal or the Secretary of State direct under this section to the contrary.

(2)For the purpose of deciding whether or not to issue a direction under this section (or under paragraph 8 of Schedule 14 to this Act), the Tribunal or the Secretary of State, as the case may be, may hold an inquiry.

48 Disqualification provisions in Scotland or Northern Ireland.E+W+S

Where—

(a)under any provisions in force in Scotland or Northern Ireland corresponding to the provisions of this Part of this Act a person is for the time being disqualified for inclusion in all lists prepared under those provisions of persons undertaking to provide services of one or more of the kinds specified in section 46(1) above, then

(b)that person shall, so long as that disqualifiction is in force, be disqualified for inclusion in a list prepared under this Part of persons undertaking to provide services of those kinds, and the name of that person shall be removed from every such list in which his name is included.

49 Regulations as to ss. 46 to 48.E+W+S

Regulations shall provide—

(a)for prescribing the procedure for the holding of inquiries by the Tribunal or the Secretary of State under sections 46 to 48 above, and for the making and determining of appeals to the Secretary of State under that procedure, and, in particular for securing that any person who is the subject of such an inquiry shall have an opportunity—

(i)of appearing, either in person or by counsel or solicitor or such other representative as may be prescribed, before the Tribunal and, in the case of an inquiry by, or appeal to, the Secretary of State before a person appointed by the Secretary of State, and

(ii)of being heard by the Tribunal or the person so appointed and of calling witnesses and producing other evidence on his behalf,

(b)for conferring on the Tribunal and on any person so appointed such powers as the Secretary of State considers necessary, and for that purpose to apply, with any necessary modifications, any of the provisions of section 250 of the M11Local Government Act 1972; and

(c)for the publication of the decisions of the Tribunal and the Secretary of State under this section and of the imposition and removal of any disqualifications imposed under section 48 above.

Other provisions supplementary to Part IIE+W+S

50 Exercise of choice of practitioner in certain cases.E+W+S

Regulations may provide that, where a right to choose the person by whom services are to be provided under this Part of this Act is conferred by or under this Part, that right shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.

51 University clinical teaching and research.E+W+S

It is the Secretary of State’s duty to make available, in premises provided by him by virtue of this Act, such facilities as he considers are reasonably required by any university which has a medical or dental school, in connection with clinical teaching and with research connected with clinical medicine or, as the case may be, clinical dentistry.

52 Use of accommodation.E+W+S

If the Secretary of State considers that any accommodation provided by him by virtue of this Act is suitable for use in connection with the provision of general medical services, general dental services, general ophthalmic services or pharmaceutical services he may make the accommodation available on such terms as he thinks fit to persons providing any of those services.

53 Immunisation.E+W+S

Where the Secretary of State arranges with medical practitioners for the vaccination or immunisation of persons against disease, he shall so far as reasonably practicable give every medical practitioner providing general medical services an opportunity to participate in the arrangements.

54 Prohibition of sale of medical practices.E+W+S

(1)Where the name of any medical practitioner is or has been at any time entered on any list of medical practitioners undertaking to provide general medical services, it shall be unlawful subsequently to sell the goodwill or any part of the goodwill of the medical practice of that medical practitioner.

This subsection is subject to subsections (2) and (3) below; and the additional provisions contained in Schedule 10 to this Act have effect for the purposes of this section.

[F131(2)Where a medical practitioner whose name has ceased to be entered on any list of medical practitioners undertaking to provide general medical services practices in the locality of a Family Practitioner Committee without his name ever having been entered on a list of medical practitioners undertaking to provide general medical services there, subsection (1) above does not render unlawful the sale of the goodwill or any part of the goodwill of his practice in that locality.

(3)Subsection (1) above does not prevent the sale of the goodwill or any part of the goodwill of a medical practice carried on in any such locality, being a sale by a medical practitioner whose name has never been entered on a list of medical practitioners undertaking to provide general medical services there, notwithstanding that any part of the goodwill to be sold is attributable to such a practice previously carried on by a person whose name was entered on such a list.

(4)In this section “general medical services” includes the services so described provided pursuant to the provisions of the National Health Service Act 1946 by arrangement with an Executive Council or pursuant to the provisions of the M12National Health Service Reorganisation Act 1973 by arrangement with a Family Practitioner Committee.]

55. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F132E+W+S

56 Inadequate services.E+W+S

If the Secretary of State is satisfied, after such inquiry as he may think fit, as respects [F133the locality of a Family Practitoner Committee or part of the locality of such a Committee] that the persons whose names are included in any list prepared under this Part of this Act—

(a)of medical practitioners undertaking to provide general medical services,

(b)of dental practitioners undertaking to provide general dental services,

(c)of persons undertaking to provide general ophthalmic services, or

(d)of persons undertaking to provide pharmaceutical services,

are not such as to secure the adequate provision of the services in question in [F134that][F135locality or part], or that for any other reason any considerable number of persons in any such [F136locality or part] are not receiving satisfactory services under the arrangements in force under this Part, then—

[F137(i)he may authorise the Family Practitioner Committee to make such other arrangements as he may approve, or may himself make such other arrangements, and]

(ii)he may dispense with any of the requirements of regulations made under this Part so far as appears to him necessary to meet exceptional circumstances and enable such arrangements to be made.