Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—
Pilot Schemes for Primary Care
Preparation and making of pilot schemes
In this Act “pilot scheme” means one or more agreements made by an authority with respect to their area and in accordance with this Part under which—
personal medical services are provided (otherwise than by the authority); or
personal dental services are provided (otherwise than by the authority).
A pilot scheme may not combine arrangements for the provision of personal medical services with arrangements for the provision of personal dental services, 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 the National Health Service Act 1997 or under pilot schemes made under section 28 of the Health and Social Care Act 2001.
A pilot scheme may include arrangements for the provision of services—
which are not personal medical services or personal dental services; but
which(not being primary medical services) may be provided under Part I of the National Health Service Act 1977 or (as the case may be) Part I or III of the National Health Service (Scotland) Act 1978.
In this Act “piloted services” means services provided in accordance with a pilot scheme (including any services to which the scheme applies by virtue of subsection (3)).
Except to such extent as may be prescribed—
Regulations may provide—
for functions which are exercisable by a Strategic Health Authority or a Health Authority in relation to a pilot scheme to be exercisable on behalf of the Authority by a Health Board; and
for functions which are exercisable by a Strategic Health Authority or a Health Board in relation to a pilot scheme to be exercisable on behalf of the Board by a Health Authority.
For the purposes of this Part—“authority” means—“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 of the 1977 Act or (as the case may be) Part II of the 1978 Act; and“personal dental services” means dental services of a kind that may be provided by a general dental practitioner(or, in England and Wales, a dental corporation) in accordance with arrangements made under Part II of the 1977 Act or (as the case may be) Part II of the 1978 Act.
in relation to England, a Strategic Health Authority;
in relation to Wales, a Health Authority; and
in relation to Scotland, a Health Board;
This section applies to any pilot scheme under which personal medical services are provided.
An agreement which constitutes, or is one of the agreements which together constitute, a pilot scheme may be made by an authority only with one or more of the following—
an NHS trust;
a suitably experienced medical practitioner;
an NHS employee or a pilot scheme employee;
a qualifying body;
an individual who is providing personal medical services under that or another pilot scheme.
a Primary Care Trust
In this section—“NHS employee” means an individual who, in connection with the provision of services in the health service, is employed by—an NHS trust; a medical practitioner whose name is included in a medical list; or a medical practitioner who is providing personal medical services in accordance with a pilot scheme;“pilot scheme employee” means an individual who, in connection with the provision of personal medical services in accordance with a pilot scheme, is employed by an individual providing those services;“qualifying body” means a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraph (a), (b), (c)(e) or (f) of subsection (2).
In this Part, “medical list” means—
in relation to England and Wales, a list prepared in accordance with regulations made under section 29(2)(a) of the 1977 Act;
in relation to Scotland, a list prepared in accordance with regulations made under section 19(2)(a) of the 1978 Act.
This section applies to any pilot scheme under which personal dental services are provided.
An agreement which constitutes, or is one of the agreements which together constitute, a pilot scheme may be made by an authority only with one or more of the following—
an NHS trust;
a dental practitioner whose name is included in a dental list;
an NHS employee or a pilot scheme employee;
a qualifying body;
an individual who is providing personal dental services under that or another pilot scheme.
a Primary Care Trust
In this section—“dental list” means—in relation to England and Wales, a list prepared in accordance with regulations made under section 36(1)(a) of the 1977 Act; in relation to Scotland, a list prepared in accordance with regulations made under section 25(2)(a) of the 1978 Act;“NHS employee” means an individual who, in connection with the provision of services in the health service, is employed by—an NHS trust; a dental practitioner whose name is included in a dental list; or a dental practitioner who is providing personal dental services in accordance with a pilot scheme;“pilot scheme employee” means an individual who, in connection with the provision of personal dental services in accordance with a pilot scheme, is employed by an individual providing those services;“qualifying body” means—a body corporate which, in accordance with the provisions of Part IV of the Dentists Act 1984, is entitled to carry on the business of dentistry; or a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraph (a), (b), (c)(e) or (f) of subsection (2).
Before any pilot scheme may be made, the authority concerned must prepare proposals for the scheme and submit them to the Secretary of State.
An authority must prepare and submit such proposals if they are asked to do so by a person—but otherwise they may not do so.
who wishes to provide piloted services, and
with whom an agreement which constitutes, or is part of, a pilot scheme may be made;
A request to an authority under subsection (2) must—
be made in writing; and
comply with such requirements (if any) as may be prescribed.
In preparing proposals for a pilot scheme, an authority must comply with any directions given to them by the Secretary of State as to the matters to be dealt with, and information to be included, in the proposals.
Before submitting proposals for a pilot scheme, an authority must (in addition to complying with any requirements about consultation imposed by or under any other enactment) comply with any directions given to them by the Secretary of State about the extent to which, and manner in which, they are to consult on the proposals.
The Secretary of State may give directions as to—
the matters to which an authority must have regard in making any recommendation to the Secretary of State when submitting proposals for a pilot scheme; and
the form in which any such recommendation is to be made.
If proposals for a pilot scheme are submitted to the Secretary of State under section 4, he must—
approve them as submitted;
make such modifications as he considers appropriate and approve them as modified; or
reject them.
The Secretary of State may not approve proposals for a pilot scheme unless he is satisfied that they include satisfactory provision for any participant other than the authority to withdraw from the scheme if he wishes to do so.
Subsection (4) applies if—
the Secretary of State intends to approve proposals for a pilot scheme; and
it appears to him that the effect of implementing the proposals would be to increase or reduce the number of general practitioners in the area of the authority concerned.
The Secretary of State must have regard to the effect that the proposals, as he intends to approve them, are likely to have on—
the distribution of general practitioners in England, in the case of proposals submitted by an authority in England;
the distribution of general practitioners in Scotland, in the case of proposals submitted by an authority in Scotland;
the distribution of general practitioners in Wales, in the case of proposals submitted by an authority in Wales.
In carrying out his functions under subsection (4) in relation to the distribution of general practitioners in Scotland, the Secretary of State must consult the Scottish Medical Practices Committee.
The Secretary of State must notify the authority concerned, in writing, of any decision made under this section.
In this section “general practitioner” means any medical practitioner who is providing general medical services or performing personal medical services.
If the Secretary of State approves proposals for a pilot scheme and notifies the authority concerned in accordance with section 5, the authority must implement the proposals in accordance with directions given by the Secretary of State.
A proposed participant in a pilot scheme (other than the authority concerned) may withdraw at any time before the proposals relating to him are implemented.
A pilot scheme, as implemented, may differ from the proposals for the scheme approved by the Secretary of State only if the Secretary of State agrees to the variation or—
directions given by the Secretary of State (either under subsection (1) or generally) authorise variations that satisfy specified requirements; and
the variation satisfies those requirements.
As soon as is reasonably practicable after implementing proposals for a pilot scheme, the authority concerned must (in accordance with any directions given to them by the Secretary of State) publish details of the scheme.
Reviews of pilot schemes
At least one review of the operation of each pilot scheme must be conducted by the Secretary of State.
Each pilot scheme must be reviewed under this section before the end of the period of three years beginning with the date on which piloted services are first performed under the scheme.
When conducting a review of a pilot scheme, the Secretary of State must give—an opportunity to comment on any matter relevant to the review.
the authority concerned, and
any person providing services under the scheme,
Otherwise, the procedure on any review is to be determined by the Secretary of State.
Variation and termination of pilot schemes
The Secretary of State may by directions require a pilot scheme to be varied by the authority concerned in accordance with the directions.
Directions under subsection (1) may be given—
in response to a request made by the authority or by any other participant in the scheme; or
on the Secretary of State’s own initiative.
The Secretary of State may give directions authorising authorities to vary pilot schemes (otherwise than in response to directions given under subsection (1)) in such circumstances, and subject to such conditions, as may be specified in the directions.
If the Secretary of State is satisfied that a pilot scheme is (for any reason) unsatisfactory, he may give directions to the authority concerned requiring them to bring the scheme to an end in accordance with the terms of the directions.
Services Lists
The Secretary of State may make regulations providing for the preparation and publication by each Primary Care Trust and by each Health Authority of one or more lists of—
medical practitioners who may perform personal medical services in connection with the provision of such services under a pilot scheme,
dental practitioners who may perform personal dental services in connection with the provision of such services under a pilot scheme.
Such a list is referred to in this section as a “services list”.
The regulations may, in particular, include provision as to—
the Primary Care Trust or Health Authority to which an application for inclusion in a services list is to be made,
the procedure for applying for inclusion, including any information to be supplied to the Primary Care Trust or Health Authority (whether by the applicant or by arrangement with him),
grounds on which the Primary Care Trust or Health Authority may, or must, refuse a person’s application for inclusion in a services list (including his unsuitability for inclusion in such a list), or on which they may defer their decision on the application,
requirements with which a person included in a services list must comply (including the declaration of financial interests and of gifts and other benefits),
grounds on which a Primary Care Trust or Health Authority may, or must, suspend or remove a person from a services list, the procedure for doing so, and the consequences of doing so,
payments to or in respect of persons who are suspended from a services list (including provision for the amount of the payments, or the method of calculating the amount, to be determined by the Secretary of State or by another person appointed for the purpose by the Secretary of State),
the supply to the Primary Care Trust or Health Authority by an applicant for inclusion in a services list, or by a person included in one, of a criminal conviction certificate under section 112 of the Police Act 1997 (c. 50), a criminal record certificate under section 113 of that Act or an enhanced criminal record certificate under section 115 of that Act,
circumstances in which a person included in a services list may not withdraw from it,
criteria to be applied in making decisions under the regulations,
appeals against decisions of Primary Care Trusts and Health Authorities under the regulations,
the disclosure by a Primary Care Trust or Health Authority, to prescribed persons or persons of prescribed descriptions, of information of a prescribed description about applicants for inclusion in a services list, refusals of such applications, and suspensions and removals from that list.
The regulations may, in particular, also provide for—
a person’s inclusion in a services list to be subject to conditions determined by the Primary Care Trust or Health Authority,
the Primary Care Trust or Health Authority to vary the conditions or impose different ones,
the consequences of failing to comply with a condition (including removal from the list), and
the review by the Primary Care Trust or Health Authority of their decisions made by virtue of regulations under this subsection.
The imposition of such conditions must be with a view to—
preventing any prejudice to the efficiency of the services to which the services list relates; or
preventing any acts or omissions of the type described in section 49F(3)(a) of the 1977 Act.
Regulations may provide—
that no person may perform personal medical services unless he is included in a medical list, a supplementary list under section 43D of the 1977 Act or a services list,
that no person may perform personal dental services unless he is included in a list referred to in section 36(1)(a) of the 1977 Act, a supplementary list under section 43D of that Act or a services list.
Regulations made by virtue of subsection (3)(e) may (but need not) make provision corresponding to anything in sections 49F to 49N of the 1977 Act.
If the regulations provide under subsection (3)(e) or (4) that a Primary Care Trust or Health Authority may suspend or remove a person from a services list, they must include provision—
requiring him to be given notice of any allegation against him;
giving him the opportunity of putting his case at a hearing before the Primary Care Trust or Health Authority make any decision as to his suspension or removal; and
requiring him to be given notice of the decision of the Primary Care Trust or of the Health Authority and the reasons for it and of any right of appeal under subsection (9) or (10).
If the regulations provide under subsection (3)(c) or (e) that a Primary Care Trust or Health Authority may refuse a person’s application for inclusion in a services list, or remove a person from one, the regulations must provide for an appeal (by way of redetermination) to the Family Health Services Appeal Authority (“FHSAA”) against the decision of the Primary Care Trust or of the Health Authority.
If the regulations make provision under subsection (4), they must provide for an appeal (by way of redetermination) by the person in question to the FHSAA against the decision of the Primary Care Trust or of the Health Authority—
to impose conditions, or any particular condition,
to vary a condition,
to remove him from the services list for breach of condition,
on any review of an earlier such decision of theirs.
A Strategic Health Authority may not, under section 17A of the 1977 Act, direct a Primary Care Trust to exercise any functions of the Strategic Health Authority arising under a pilot scheme if the Primary Care Trust is providing any services under the pilot scheme.
The Secretary of State may by order make provision for any rights and liabilities arising under pilot schemes under which personal medical services are provided to be transferred from Strategic Health Authorities to Primary Care Trusts and from Primary Care Trusts to Strategic Health Authorities.
Subsection (2) is without prejudice to any other power of the Secretary of State to transfer rights and liabilities under the 1977 Act.
General
The provisions of the 1977 Act, apart from section 16D(power of Secretary of State to direct a Health Authority to exercise his functions), apply in relation to functions of the Secretary of State under this Part (exercisable in relation to England and Wales) as if they were functions of his under Part I of the 1977 Act.
In subsection (1), the words from “, apart from” to “functions),” have effect only in relation to Wales.
The 1977 Act (and in particular section 17) has effect in relation to piloted services—
subject to any provision of, or made under, this Part; but
otherwise as if those services were provided as a result of the delegation by the Secretary of State (by directions given under section 16D of the 1977 Act) of functions of his under Part I of that Act.
The functions of a Health Authority in relation to piloted services are primary functions of the Authority for the purposes of the National Health Service and Community Care Act 1990.
The provisions of the 1978 Act apply in relation to functions of the Secretary of State under this Part (exercisable in relation to Scotland) as if they were functions of his under Part I of the 1978 Act.
The 1978 Act (and in particular section 2) has effect in relation to piloted services—
subject to any provision of, or made under, this Part; but
otherwise as if those services were provided as a result of the delegation by the Secretary of State (by regulations made or directions given under section 2 of the 1978 Act) of functions of his under that Act.
Any medical practitioner who performs personal medical services in connection with the provision of such services under a pilot scheme must be suitably experienced.
Subsection (1) does not prevent the performance of personal medical services by—
a person who is provisionally registered under section 15 or 21 of the Medical Act 1983, acting in the course of his employment in a resident medical capacity in an approved medical practice (within the meaning of section 11(4) of that Act); or
such other category of person as may be prescribed.
In its application by virtue of subsection (3), section 32 of the 1977 Act is to be read as if references to the applicant were references to a medical practitioner who is proposing to perform personal medical services in connection with the provision of such services under a pilot scheme.
In its application by virtue of subsection (5), section 22(2) of the 1978 Act is to be read as if references to the applicant were references to a medical practitioner who is proposing to perform personal medical services in connection with the provision of such services under a pilot scheme.
Except in such circumstances and to such extent as may be prescribed, a medical practitioner who performs personal medical services in connection with the provision of such services under a pilot scheme may not provide general medical services under Part II of the 1977 Act or Part II of the 1978 Act.
Except in such circumstances as may be prescribed, a Primary Care Trust, Health Authority or Health Board must remove from their medical list the name of any medical practitioner who is performing personal medical services in connection with the provision of such services under a pilot scheme made by any authority.
Before the Secretary of State approves a pilot scheme, he must determine whether a participating medical practitioner is to be given preferential treatment under Schedule 1 if he makes an application for his name to be included in the medical list of the relevant body after ceasing to perform personal medical services under the scheme.
For the purposes of this section—
where the authority concerned is a Health Authority or a Health Board, the relevant body is that Authority or Board;
where the authority concerned is a Strategic Health Authority, the relevant body is the Primary Care Trust designated in relation to the pilot scheme by the Secretary of State.
Before a pilot scheme is varied so as to permit a new medical practitioner to perform personal medical services under the scheme, the Secretary of State must make a determination under this section in relation to the new practitioner.
The Secretary of State may at any time make a determination under this section varying a determination about a medical practitioner if he is asked to do so by the practitioner concerned.
Before making any determination under this section, the Secretary of State must publish the criteria by reference to which he will make it.
Those criteria may be—
criteria applying generally to all determinations;
criteria applying only to the pilot scheme in question; or
a mixture of both.
The Secretary of State must notify the relevant body and the medical practitioner or practitioners concerned in writing of any determination made by him under this section.
Different determinations may be made with respect to different medical practitioners performing personal medical services under the same pilot scheme.
A determination may identify the medical practitioner or practitioners to which it applies by name or in any other way.
Schedule 1 has effect in relation to preferential treatment for medical practitioners who wish to transfer to medical lists.
Regulations may make provision with respect to the liabilities and obligations of—
a Part II practitioner who, in connection with any obligation of his to provide general medical services, enters into arrangements under which a pilot scheme practitioner deputises, or is engaged to deputise, for him; or
a Part II practitioner who enters into arrangements under which he deputises, or is engaged to deputise, for a pilot scheme practitioner, in connection with that practitioner’s obligation to perform personal medical services under a pilot scheme.
The regulations may, in particular—
modify any liabilities or obligations which would otherwise be applicable by virtue of Part II of the 1977 Act or Part II of the 1978 Act;
apply (with or without modifications) any provision made by or under Part II of the 1977 Act or Part II of the 1978 Act (including any provision so made by virtue of section 17 of the Health and Medicines Act 1988).
In this section—“Part II practitioner” means a medical practitioner who provides general medical services; and“pilot scheme practitioner” means a medical practitioner who performs personal medical services under a pilot scheme.
In the case of a pilot scheme entered into, or to be entered into, by a single individual or body corporate, that individual or body may make an application under this section to become a health service body.
In the case of any other pilot scheme, all of those providing, or proposing to provide, piloted services under the scheme may together make an application under this section to become a single health service body.
An application must—
be made to the Secretary of State in accordance with such provisions as may be prescribed; and
specify the pilot scheme in relation to which it is made.
Except in such cases as may be prescribed, the Secretary of State may grant an application.
If an application is granted, the Secretary of State must specify when it is to come into effect and, as from that time—a health service body for the purposes of section 4 of the National Health Service and Community Care Act 1990 and section 17A of the 1978 Act (NHS contracts).
in the case of an application under subsection (1), the applicant is, and
in the case of an application under subsection (2), the applicants together are,
Those sections have effect in relation to such a health service body (“a pilot scheme health service body”), acting as acquirer, as if the functions referred to in subsection (1) of those sections were the provision of piloted services.
Except in such circumstances as may be prescribed, a pilot scheme health service body resulting from an application under subsection (2) is to be treated, at any time, as consisting of those providing piloted services under the scheme.
A direction as to payment made under section 4(7) of the Act of 1990 or section 17A(8) of the 1978 Act against, or in favour of, a pilot scheme health service body is enforceable—
in England and Wales, in a county court (if the court so orders) as if it were a judgment or order of that court; and
in Scotland, in like manner as an extract registered decree arbitral bearing warrant for execution issued by the sheriff court of any sheriffdom in Scotland.
Regulations may provide for a pilot scheme health service body to cease to be such a body in prescribed circumstances.
The Secretary of State must—
maintain and publish a list of pilot scheme health service bodies;
publish a revised copy of the list as soon as is reasonably practicable after any change is made to it.
The list is to be published in such manner as the Secretary of State considers appropriate.
Regulations may confer such powers or impose such duties on the Board, in relation to pilot schemes under which personal dental services are provided, as may be prescribed.
The regulations may, in particular, make any of the following kinds of provision.
They may authorise or require the Board—
to perform on behalf of an authority functions of a prescribed description (including functions relating to remuneration) which have been delegated to the Board by the authority in accordance with a power conferred by the regulations;
to conduct or commission surveys or other research;
to carry on such other activities as may be prescribed.
They may provide that functions conferred by the regulations are only to be exercised by the Board in accordance with directions of the Secretary of State.
They may enable the Board to direct a dental practitioner to submit to the Board, in relation to treatment or a description of treatment that he has carried out or contemplates carrying out, such information (including estimates, radiographs, models and other items) as may be prescribed.
In this section “the Board” means—
in relation to England and Wales, the Dental Practice Board; and
in relation to Scotland, the Scottish Dental Practice Board.
Financial provisions
Provision may be made by regulations for authorities to make payments of financial assistance for preparatory work.
“Preparatory work” means work which it is reasonable for a person to undertake—
in connection with preparing proposals for a pilot scheme; or
in preparing for the provision by him of any piloted services.
Regulations under this section may, in particular, include provision—
prescribing the circumstances in which payments of financial assistance may be made;
imposing a limit on the amount of any payment of financial assistance which an authority may make in any prescribed period in respect of any one person or any one pilot scheme;
imposing a limit on the aggregate amount which an authority may pay by way of financial assistance in any one financial year;
requiring a person to whom assistance is given under this section to comply with such conditions as may be imposed in accordance with prescribed requirements; and
for repayment in the case of a failure to comply with any condition so imposed.
Regulations may provide for the making and recovery, in such manner as may be prescribed, of charges for dental treatment provided in accordance with pilot schemes. personal dental services provided in accordance with pilot schemes except—
those services to which section 78(1A) of the 1977 Act or (as the case may be) section 70(1A) of the 1978 Act applies; and
oral health assessments and dental examinations carried out on or after 1st April 2006.
“Dental treatment” means personal dental services other than those to which section 78(1A) of the 1977 Act or (as the case may be) section 70(1A) of the 1978 Act applies.
The regulations must secure that the amount charged for a particular treatment (or course of treatment) is the same as the amount that would be charged for that treatment (or course of treatment) if it were provided under Part II of the 1977 Act or (as the case may be) Part II of the 1978 Act.
The regulations may—
provide for the amount or the maximum amount of any charge authorised by the regulations to be varied in prescribed circumstances; or
give power to direct that the charge is not to be payable.
If, under a contract or arrangement, a patient receives—the total charge for those services and that treatment is not to exceed such sum as may be prescribed.
services for which a charge is payable under section 78 of the 1977 Act or (as the case may be) section 70 of the 1978 Act, and
treatment for which a charge is payable under the regulations,
No charge is to be made under the regulations in respect of treatment provided for any person who, at the time of the making of the contract or arrangement under which the treatment is provided—
was under 18;
was under 19 and receiving qualifying full-time education;
was pregnant; or
had given birth within the previous twelve months.
In subsection (6)(b) “qualifying full-time education” has the same meaning as in Schedule 12 to the 1977 Act or (as the case may be) in Schedule 11 to the 1978 Act.
The regulations may provide, with respect to any exemption under subsection (6), that it is to be a condition of the exemption that—
a declaration of the prescribed kind is made in the prescribed form or manner; or
a certificate of the prescribed kind is supplied in the prescribed form or manner.
Primary Care
Personal medical or dental services
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In the 1978 Act, after section 17B, insert—
The Secretary of State may not make an order under section 41(3) bringing this section into force unless he is satisfied, having regard in particular to reviews of pilot schemes which have been conducted under section 7, that it would be in the interests of any part of the health service to bring this section into force.
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In the 1978 Act, after section 17D, insert—
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In the 1978 Act, after section 17F, insert—
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In the 1978 Act, after section 24, insert—
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In the 1978 Act, after section 70, insert—
Pharmaceutical services
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In the 1978 Act, after section 27, insert—
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In the 1978 Act, after section 27A, insert—
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In section 28 of the 1978 Act, after subsection (2), insert—
Ophthalmic services
Section 31 of the Opticians Act 1989 (matters with respect to which the General Optical Council may make rules) is amended as follows.
In subsection (5) (power to make rules requiring registered optician to refer persons to registered medical practitioners except in certain circumstances), for the words from “except” to “take the prescribed steps” substitute.
After subsection (5), insert—
NHS contracts
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In the 1978 Act, after section 17, insert—
Medical lists and vacancies
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Medical practices
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In the 1978 Act, for section 35 (sale of medical practices), substitute—
The Medical Act 1983 is amended as follows.
In subsection (2) of section 10 (experience required for full registration as a medical practitioner), for “approved hospitals or approved institutions,” substitute.
In subsection (4) of section 11—
insert in the appropriate place—;
in the definition of “prescribed”, after “means” insert.
After subsection (4) of section 11 insert—
After subsection (6) of section 11 insert—
Miscellaneous and Supplemental
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In section 85 of the 1978 Act (expenses of certain bodies), after subsection (1) insert—
In subsection (2) at the beginning insert “ Subject to subsection (1AA), ”.
An Order in Council under paragraph 1(1)(b) of Schedule 1 to the Northern Ireland Act 1974 (legislation for Northern Ireland in the interim period) which contains a statement that it is made only for purposes corresponding to purposes of any of the provisions of this Act—
shall not be subject to paragraph 1(4) and (5) of that Schedule (affirmative resolution of both Houses of Parliament); but
shall be subject to annulment in pursuance of a resolution of either House of Parliament.
Any power under this Act to make regulations is exercisable by the Secretary of State.
Any such power—
may be exercised to make different provision for different cases or descriptions of case, including different provision for different areas; and
includes power to make such incidental, supplemental, consequential or transitional provision as appears to the Secretary of State to be appropriate.
Regulations under this Act must be made by statutory instrument.
Such a statutory instrument shall be subject to annulment in pursuance of a resolution of either House of Parliament.
Any power under or by virtue of this Act to give directions—
is to be exercised by an instrument in writing; and
includes power to vary or revoke the directions by subsequent directions.
Subsection (2) applies in relation to any power of the Secretary of State under or by virtue of this Act to give directions as it applies in relation to any power of his to make regulations.
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In this Act—...“the 1978 Act” means the National Health Service (Scotland) Act 1978;“authority” has the meaning given by section 1(8), except in Schedule 1;“health service” means the health service in England and Wales and the health service in Scotland;“medical list” has the meaning given by section 2(5);“personal medical services” and “personal dental services” have the meaning given in section 1(8);“pilot scheme” and “piloted services” have the meaning given in section 1;“prescribed” means prescribed by regulations; and“regulations” means regulations under this Act.
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This Act may be referred to as the National Health Service (Primary Care) Act 1997.
Otherwise, this Act comes into force on such date as may be appointed by order made by the Secretary of State; but different dates may be appointed for different provisions and for different purposes.
Any such order may include such transitional provisions or savings as the Secretary of State considers appropriate.
A Health Authority, Health Board or NHS trust is to be taken as having, at any time before the commencement of any provision of this Act, power to prepare for that commencement.
Any amendment, repeal or revocation made by or under this Act has the same extent as the enactment or other instrument amended, repealed or revoked.
Subject to subsection (6), only section 38 and this section (except subsections (5) and (8)) extend to Northern Ireland.
The Secretary of State may by order provide that this Act extends to the Isles of Scilly with such modifications (if any) as are specified in the order; but otherwise this Act does not extend there.
Orders under subsections (3), (8) and (13) must be made by statutory instrument.
Part I of Schedule 2 makes minor and consequential amendments.
Part II of Schedule 2 makes amendments to facilitate, or which are otherwise desirable in connection with, the consolidation of certain enactments relating to the health service.
The repeals and revocations set out in Schedule 3 are to have effect.
The Secretary of State may by order make such amendments or repeals of any enactment passed before, or in the same Session as, this Act as appear to him necessary or expedient in consequence of any provision of this Act.
An order under subsection (13)—
may contain such supplemental, incidental, consequential or transitional provisions and savings as the Secretary of State considers appropriate; and
shall be subject to annulment in pursuance of a resolution of either House of Parliament.
Preferential Treatment on Transferring to Medical Lists
Cases where preference is given
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The preferential treatment
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Representations against preferential treatment
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Power of Tribunal to give directions
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Termination of directions
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Directions in Northern Ireland
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Regulations
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Interpretation
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Amendments
Minor and Consequential Amendments
The Health Services and Public Health Act 1968 (c. 46)
The Health Services and Public Health Act 1968 is amended as follows.
In section 59(1), for “general medical services or general dental services” substitute “ general medical services, personal medical services, general dental services or personal dental services ”.
After section 59(2) insert—
After section 63(2)(b) insert—.
The Patents Act 1977 (c. 37)
In section 56(4)(a) of the Patents Act 1977, for the words from “provision of” to “Isle of Man” substitute.
The National Health Service Act 1977 (c. 49)
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After section 28H insert—
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In section 85(1), references to functions conferred or imposed by or under the 1977 Act are to be construed as including references to functions conferred or imposed in relation to pilot schemes by or under this Act; and references to regulations and directions are accordingly to be construed as including regulations or directions under this Act.
In section 86, the reference to a function conferred by virtue of the 1977 Act is to be construed as including a reference to a function conferred in relation to pilot schemes by virtue of this Act.
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In section 105(2)(a) after “examined” insert “ or as part of his duty to perform personal medical services for that person in accordance with section 28C arrangements ”.
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The National Health Service (Scotland) Act 1978 (c. 29)
The 1978 Act is amended in accordance with paragraphs 33 to 60.
In section 3(1), omit from “, for the purpose of” to the end.
In section 12A, after subsection (4) insert—
In section 15(1)(a)—
after “persons” insert; and
after “Part II” insert.
In section 17A(2), at the end insert “ and in this Act “health service body” means any of those persons or bodies ”.
After section 17G insert—
After section 17H insert—
Section 19 is amended as follows.
In subsection (2), omit paragraphs (b) and (c).
For subsection (8) substitute—
In section 22(1) for the definition of “applicant” substitute—.
Section 23 is amended as follows.
Omit subsection (1).
In subsection (1B)—
after “Act” insert“ or any regulations made under this Part of this Act ”; and
for “the Medical Practices Committee are to refuse applications under section 20” substitute“ references under regulations made under section 19B are to be determined ”.
After subsection (1B) insert—
Omit subsections (2) to (6) and (8).
In section 24(1)(a), omit from “(ii) the occurrence” to the end of the section.
Omit section 25(2)(c).
In section 27(1), for “in this Act referred to” substitute “ , together with additional pharmaceutical services provided in accordance with a direction under section 27A, referred to in this Act ”.
In section 28(2)(b), after “that” insert “ (i) ”, and after “arrangements” insert.
In section 34, after “whom” insert “ general ophthalmic ”.
In section 73(b), after “providing” insert “ personal dental services in accordance with section 17C arrangements or ”.
In section 74(b), after “providing” insert “ personal dental services in accordance with section 17C arrangements or ”.
In section 75, for paragraph (b) substitute—
In section 75A(1)(a), after “section 70(1) or (1A) above” insert “ , section 70A(1) above ”.
In section 77(1), references to functions conferred or imposed by or under the 1978 Act are to be construed as including references to functions conferred or imposed in relation to pilot schemes by or under this Act; and references to regulations, schemes, proposals and directions are accordingly to be construed as including regulations, schemes, proposals or directions under this Act.
In section 78, the reference to a function conferred by or under the 1978 Act is to be construed as including a reference to a function conferred in relation to pilot schemes by or under this Act.
Section 87A is amended as follows.
In subsection (1), after “section 19”, insert “ , or (in the case of practitioners who are not employed by another person) personal medical services in accordance with section 17C arrangements, ”.
In subsection (4), for paragraph (g) substitute—.
Section 87B is amended as follows.
In subsection (3)(b), for “individuals on the lists of patients of any of the members of the practice” substitute “ practice patients ”.
In subsection (5)(b)—
after “general medical services” insert “ or personal medical services provided in accordance with section 17C arrangements ”; and
for “individuals on the lists of patients of the members of the practice” substitute “ practice patients ”.
After subsection (6) insert—
Section 87D is amended as follows.
In subsection (1), for “subsection (2)” substitute“ subsections (2) and (8) ”.
In subsection (3)—
in paragraph (a), after “who” insert“ is on the medical list of a Health Board and ”; and
for paragraph (b) substitute—.
After subsection (7) insert—
In section 88(1)(d) and (2)(e), after “section 22” insert “ or by regulations which make provision in relation to section 17C arrangements of a kind that may be made by regulations under section 22 ”.
In section 108, insert at the appropriate places—;;;;.
In Schedule 8, paragraph 8 is amended as follows.
In sub-paragraph (2), after “sub-paragraph (1)(c) above” insert “ as it has effect in relation to the functions mentioned below ”.
After sub-paragraph (2) insert—
Schedule 9 is amended as follows.
In paragraph 1(1) and (3), omit “, or any part of the goodwill,”.
In paragraph 1, for sub-paragraph (2) substitute—
In paragraph 1, omit sub-paragraph (8).
In paragraph 2, for sub-paragraph (1) substitute—
In paragraph 2(2)—
omit “between medical practitioners”; and
omit “, or part of the goodwill,”.
In paragraph 2, for sub-paragraph (3) substitute—
In paragraph 2, for sub-paragraphs (4) and (5) substitute—
In paragraph 2, for sub-paragraph (7) substitute—
At the end insert—
In Schedule 11, in paragraph 1(1)(b), after “drug or medicine” insert “ (otherwise than in accordance with section 17C arrangements) ”.
The Medical Act 1983 (c. 54)
The Medical Act 1983 is amended as follows.
In section 11(4), in the definition of “approved”, for “, in relation to a hospital or institution,” substitute “ (except in subsection (5) ”.
In section 13—
in subsection (1), for “approved hospital or approved institution” substitute “ approved hospital, approved institution or approved medical practice ”;
in subsection (2), for “hospital or institution” substitute “ hospital, institution or medical practice ”;
in subsection (3)(a), for “an approved hospital or an approved institution” substitute “ an approved hospital, an approved institution or an approved medical practice ”.
In section 15(3), for “approved hospitals or approved institutions” substitute “ approved hospitals, approved institutions or approved medical practices ”.
In section 21(3), for “approved hospitals or approved institutions” substitute “ approved hospitals, approved institutions or approved medical practices ”.
The Dentists Act 1984 (c. 24)
In section 53(3)(a) of the Dentists Act 1984, for the words from “services under” to “1978 or” substitute—.
The Copyright, Designs and Patents Act 1988 (c. 48)
In section 240(4) of the Copyright, Designs and Patents Act 1988, for the words from “(a) pharmaceutical services” to the end of the subsection substitute—
The Health and Medicines Act 1988 (c. 49)
The Health and Medicines Act 1988 is amended as follows.
In section 2(1)(a), for the words from “provision of general medical services” to “Act 1978” substitute.
In section 8(2) omit “(a) or”.
In section 17, at the end insert—
The National Health Service and Community Care Act 1990 (c. 19)
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The Access to Health Records Act 1990 (c. 23)
The Access to Health Records Act 1990 is amended as follows.
In section 1(2), for paragraph (a) substitute—.
In section 11, in the definition of “general practitioner”, for the words from “providing” to “Act 1978” substitute.
The Trade Union and Labour Relations (Consolidation) Act 1992 (c. 52)
In section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992—
after “as a person” insert “ performing personal medical services or personal dental services or ”;
before “29” insert “ 28C, ”; and
before “19” insert “ 17C, ”.
The Health Service Commissioners Act 1993 (c. 46)
The Health Service Commissioners Act 1993 is amended as follows.
In section 2A(1), for the words from “if they are” to “Act 1977” substitute.
In section 2A(2), for the words from “if they are” to “Act 1977” substitute.
In section 2A(3), for the words from “if they are” to “Act 1978” substitute.
In section 3, after subsection (1) insert—
Pre-consolidation Amendments
The National Health Service Act 1966 (c. 8)
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The National Health Service Act 1977 (c. 49)
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In section 36(1)(a), for “of lists” substitute“ by each Health Authority of a list ”and after “services” insert“ for persons in the Health Authority’s area ”
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Transitional provisions for amendments to 1977 Act
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The Health and Medicines Act 1988 (c. 49)
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The Health Service Commissioners Act 1993 (c. 46)
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Repeals and Revocations
Repeals
Pre-consolidation Repeals
Revocations