National Health Service Act 1977

General medical servicesE+W+S

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

[F1(1)It is the duty of every [F2Health Authority], in accordance with regulations, to arrange as respects their [F3area] with medical practitioners to provide personal medical services for all persons in the [F3area] 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;

F4(b). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F4(c). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(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 [F5area] 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 [F5area].

[F6(f)for the making of arrangements for the temporary provision of general medical services [F7in the area of a Health Authority];

(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.

[F8(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.]

[F9(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.]

[F10(6)The persons with whom arrangements for the temporary provision of general medical services in [F11an area] 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 [F12the area], 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 [F13section 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 [F13section 38(1)] of that Act (order for immediate suspension); or

(c)by an interim order [F14under section 42]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.]

[F15(9)Where the registration of a medical practitioner in the register of medical practitioners is suspended by a direction of the Committee on Professional Performance of the General Medical Council—

(a)under section 36A of the Medical Act 1983 (professional performance),

(b)under section 38(1) of that Act (order for immediate suspension), or

(c)under rules made by virtue of paragraph 5A(3) of Schedule 4 to that Act (procedure of committees),

the suspension shall not, except in so far as is provided by or determined in accordance with regulations under subsection (2) above, 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.]

[F1629A Medical lists.E+W+S

(1)A Health Authority may not, under section 29, arrange with a medical practitioner for him to provide general medical services for persons in the Authority’s area unless his name is included in the Authority’s medical list.

(2)A medical practitioner is entitled to be included in a Health Authority’s medical list only if—

(a)he is eligible for inclusion in the list; and

(b)he is nominated or approved, in accordance with regulations under section 29B, for appointment to fill a vacancy which relates (whether wholly or in part) to the area of the Authority.

(3)A medical practitioner is eligible for inclusion in a medical list if—

(a)he has not attained the age specified in regulations under section 8 of the M2Health and Medicines Act 1988 (retirement age for practitioners); and

(b)he is not disqualified, or treated as disqualified, from inclusion in the list by virtue of a direction of the Tribunal constituted under section 46 or any corresponding tribunal in Scotland or Northern Ireland.

(4)Regulations may make provision in relation to delaying a person’s inclusion in a medical list in prescribed circumstances.

(5)This section is subject to section 29(6) (temporary provision of general medical services) and any provision of, or made under, an enactment relating to the right of a medical practitioner to transfer to a medical list.

(6)In this Act “medical list”, in relation to a Health Authority, means the list of medical practitioners undertaking to provide general medical services for persons in their area, kept by the Authority under regulations made under section 29(2)(a).]

[F1729B Vacancies for medical practitioners.E+W+S

(1)Regulations may make provision in relation to the filling of vacancies for medical practitioners to provide general medical services.

(2)The regulations may, in particular, include provision for—

(a)references by a Health Authority to the Medical Practices Committee as to whether there is, or will be, a vacancy for a medical practitioner in a locality;

(b)the determination of such references by the Medical Practices Committee;

(c)the determination by the Medical Practices Committee of conditions of practice to be imposed on any medical practitioner who fills a particular vacancy;

(d)the determination by a Health Authority of whether a vacancy is to be filled by a member of a partnership or by a sole practitioner;

(e)the nomination by a Health Authority of a medical practitioner for appointment to fill a vacancy as a sole practitioner;

(f)the approval by a Health Authority of a medical practitioner for appointment to fill a vacancy as a member of a partnership.

(3)The regulations may also make provision in relation to—

(a)criteria to be applied in making decisions under the regulations,

(b)the variation or revocation of such decisions (including appeals to the Secretary of State on points of law), or

(c)vacancies relating to the area of one Health Authority which also relate to the area of another Health Authority or a Health Board,

and may contain such transitional provisions as the Secretary of State considers appropriate.

(4)Regulations which make provision about vacancies which relate partly to the area of a Health Board may, in particular, provide that section 29A(2)(b) is to have effect in prescribed circumstances as if the reference to regulations under this section were a reference to regulations under section 19B of the M3National Health Service (Scotland) Act 1978.

(5)In this section—

• “conditions of practice” means conditions—

  (a)

  specifying, by reference to one or more prescribed conditions relating to hours or the sharing of work, the provision of general medical services for which a person is entitled to be remunerated; and

  (b)

  specifying the locality in which a person is entitled to provide general medical services;

• “Health Board” has the same meaning as in the National Health Service (Scotland) Act 1978;

• “locality”, in relation to a Health Authority, means the Authority’s area or a particular part of their area; and

• “sole practitioner” means a medical practitioner providing general medical services otherwise than in partnership with one or more other medical practitioners.

(6)This section does not affect the power to make regulations under section 29.]

F1830. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .E+W+S

31 Requirement of suitable experience.E+W+S

[F19(1)Regulations under section 29B must secure that a medical practitioner is not nominated or approved by a Health Authority for appointment to fill a vacancy unless he is suitably experienced.]

(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—

• [F20“applicant” means a medical practitioner who is seeking to be nominated or approved by a Health Authority in accordance with regulations under section 29B for appointment to fill a vacancy;]

• “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 [F21areas] 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

F22(1). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F23(1A)The Secretary of State may by order specify—

(a)the maximum number of medical practitioners with whom, in any year, all the [F24Health Authorities for areas] 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 [F25Health Authorities for areas] 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 [F26or any regulations made under 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 [F27references under regulations made under section 29B are to be determined] in order to secure that any maximum number specified in the order is not exceeded.]

[F28(1C)An order under subsection (1A) may, in particular, 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 of practice which relate to remuneration and are determined under regulations made under section 29B.]

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

F29(2A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F29(3). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F29(4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F29(5). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

F29(6). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(7). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F30

F29(8). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

34 Regulations for Medical Practices Committee.E+W+S

[F31(1)] 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—

[F32(a)for requiring [F33Health Authorities] 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 [F34areas] and the different parts of those [F34areas];]