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Health and Social Care (Community Health and Standards) Bill


Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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           (g)           in the case of which a document has been made under any provision of

the law of a country other than England and Wales, Scotland or

Northern Ireland—

                  (i)                 which appears to the Scottish Ministers to correspond to a joint

minute executed by the parties to a resulting action before a

5

court in Scotland specifying that the action has been settled

extra-judicially, and

                  (ii)                which specifies the matters mentioned in paragraph (d)(i) and

(ii),

            the amount (or amounts) specified in the certificate is (or are) to be that (or

10

those) which would be so specified apart from this subsection, reduced by the

same proportion as the reduction of damages.

     (4)    If a certificate relates to an injured person who has not received NHS treatment

at a health service hospital or been provided with NHS ambulance services as

a result of the injury, it must indicate that no amount is payable to the Secretary

15

of State or the Scottish Ministers (as the case may be) by reference to that

certificate.

     (5)    Regulations under subsection (2) may, in particular, provide—

           (a)           that the amount, or the aggregate amount, specified in a certificate is

not to exceed a prescribed sum,

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           (b)           for different amounts to be specified in respect of different

circumstances or areas,

           (c)           for cases in which an injured person receives treatment at two or more

health service hospitals,

           (d)           for cases in which an injured person receives treatment at one or more

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health service hospitals and is provided with NHS ambulance services,

           (e)           for cases in which liability under section 146(2) is to be apportioned

between two or more persons making compensation payments to or in

respect of the same injured person in consequence of the same injury,

           (f)           for cases in which a fresh certificate is issued or a certificate is revoked

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as a result of a review under section 152 or an appeal under section 153

or 155,

           (g)           for the amount specified in a certificate issued by the Secretary of State

or the Scottish Ministers to be adjusted to take into account any amount

for which the person to whom the certificate is issued is liable under

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section 146(2), in respect of the same injured person in consequence of

the same injury, in accordance with a certificate issued by the Scottish

Ministers or the Secretary of State (respectively),

           (h)           for any matter requiring determination under or in consequence of the

regulations to be determined by the Secretary of State or the Scottish

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Ministers (as the case may require),

            and in the case of paragraph (e) may make such provision by modifying this

Part.

     (6)    Any reference in subsection (5)(a) or (b) to any amount (or amounts) specified

in a certificate are to the amount (or amounts) which would be so specified

45

apart from subsection (3).

     (7)    Regulations under subsection (2) which provide for cases mentioned in

subsection (5)(e) may (among other things) provide in the case of each

compensator for—

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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           (a)           determining, or re-determining, the amount for which he is liable

under section 146(2),

           (b)           giving credit for amounts already paid, and

           (c)           the payment by any person of any balance or the recovery from any

person of any excess.

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     (8)    Regulations under subsection (2) which provide for cases mentioned in

subsection (5)(f) may (among other things) provide in the case of any

compensator for the matters mentioned in paragraphs (b) and (c) of subsection

(7).

     (9)    A person to whom a certificate is issued is entitled to such particulars of the

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manner in which any amount (or amounts) specified in the certificate has (or

have) been determined as may be prescribed, if he applies to the Secretary of

State or the Scottish Ministers (as the case may require) for those particulars.

     (10)   Regulations under subsection (2) may be made so as to apply to any certificate

issued after the time the regulations come into force, other than one relating to

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a compensation payment made before that time.

Recovery of NHS charges

 150   Payment of NHS charges

     (1)    If the certificate by reference to which an amount payable under section 146(2)

is determined is issued before the settlement date, that amount must be paid

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before the end of the period of 14 days beginning with the settlement date.

     (2)    If the certificate by reference to which an amount payable under section 146(2)

is determined is issued on or after the settlement date, that amount must be

paid before the end of the period of 14 days beginning with the day on which

the certificate is issued.

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     (3)    “Settlement date” means the date on which the compensation payment is

made.

     (4)    This section is subject to section 151(2).

 151   Recovery of NHS charges

     (1)    This section applies if a person has made a compensation payment and

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either—

           (a)           subsection (7) of section 147 applies but he has not applied for a

certificate as required by that subsection, or

           (b)           he has not made payment, in full, of any amount due under section

146(2) by the end of the period allowed under section 150.

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     (2)    The Secretary of State, the Scottish Ministers or both, according to the

circumstances of the case, may—

           (a)           in a case within subsection (1)(a), issue the person who made the

compensation payment with a certificate, and

           (b)           in a case within subsection (1)(b), issue him with a copy of the certificate

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or (if more than one has been issued) the most recent one,

            and, in either case, issue him with a demand that payment of any amount due

under section 146(2) be made immediately.

 

 

Health and Social Care (Community Health and Standards) Bill
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     (3)    Subsections (5) and (6) of section 148 apply to certificates issued under

subsection (2) above as they apply to certificates issued under section 147.

     (4)    A demand issued under subsection (2) may be issued jointly by the Secretary

of State and the Scottish Ministers specifying—

           (a)           an amount due under subsection (2) of section 146 to the Secretary of

5

State, and

           (b)           an amount due under that subsection to the Scottish Ministers,

            in respect of the same injured person in consequence of the same injury.

     (5)    In the case of a demand specifying amounts as mentioned in subsection (4)(a)

and (b), references in the following provisions of this section to a demand are

10

to be taken as being (as the case may require) to—

           (a)           the demand in so far as it relates to any amount due to the Secretary of

State, or

           (b)           the demand in so far as it relates to any amount due to the Scottish

Ministers,

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            and related expressions are to be read accordingly.

     (6)    The Secretary of State or the Scottish Ministers may recover the amount for

which a demand for payment is made under subsection (2) from the person

who made the compensation payment.

     (7)    If the person who made the compensation payment resides or carries on

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business in England or Wales and a county court so orders, the amount

demanded is recoverable by execution issued from the county court or

otherwise as if it were payable under an order of that court.

     (8)    If the person who made the compensation payment resides or carries on

business in Scotland, the demand may be enforced as if it were an extract

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registered decree arbitral bearing a warrant for execution issued by the sheriff

court of any sheriffdom in Scotland.

     (9)    A document which states that it is a record of the amount recoverable under

subsection (6) is conclusive evidence that the amount is so recoverable if it is

signed by a person authorised to do so by the Secretary of State or the Scottish

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Ministers (as the case may be).

     (10)   For the purposes of subsection (9), a document purporting to be signed by a

person authorised to do so by the Secretary of State or the Scottish Ministers (as

the case may be) is to be treated as so signed unless the contrary is proved.

Review and appeal

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 152   Review of certificates

     (1)    The Secretary of State or the Scottish Ministers must review a certificate issued

by him or them if the certificate relates to a claim made by or on behalf of an

injured person—

           (a)                         in respect of which, after the certificate is issued, a court in England and

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Wales or Scotland orders a reduction of damages in accordance with

section 1 of the Law Reform (Contributory Negligence) Act 1945 (c. 28),

           (b)                         in respect of which, after the certificate is issued, a court in Northern

Ireland orders a reduction of damages in accordance with section 2 of

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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the Law Reform (Miscellaneous Provisions) Act (Northern Ireland)

1948 (c. 23),

           (c)                         in respect of which, after the certificate is issued, a court in a country

other than England and Wales, Scotland or Northern Ireland orders a

reduction of damages under any provision of the law of that country

5

which appears to the Secretary of State or the Scottish Ministers (as the

case may be) to correspond to section 1 of the Law Reform

(Contributory Negligence) Act 1945 (c. 28),

           (d)                         in respect of which, after the certificate is issued, an officer of a court in

England and Wales or Northern Ireland enters or seals an agreed

10

judgement or order which specifies—

                  (i)                 that the damages are to be reduced to reflect the injured

person’s share in the responsibility for the injury in question,

and

                  (ii)                the amount or proportion by which they are to be so reduced,

15

           (e)           in the case of which, after the certificate is issued, the parties to any

resulting action before a court in Scotland execute a joint minute which

specifies—

                  (i)                 that the action has been settled extra-judicially, and

                  (ii)                the matters mentioned in paragraph (d)(i) and (ii),

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           (f)                         in respect of which, after the certificate is issued, a document is made

under any provision of the law of a country other than England and

Wales, Scotland or Northern Ireland—

                  (i)                 which appears to the Secretary of State to correspond to an

agreed judgement or order entered or sealed by an officer of a

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court in England and Wales, and

                  (ii)                which specifies the matters mentioned in paragraph (d)(i) and

(ii), or

           (g)                         in the case of which, after the certificate is issued, a document is made

under any provision of the law of a country other than England and

30

Wales, Scotland or Northern Ireland—

                  (i)                 which appears to the Scottish Ministers to correspond to a joint

minute executed by the parties to a resulting action before a

court in Scotland, specifying that the action has been settled

extra-judicially, and

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                  (ii)                which specifies the matters mentioned in paragraph (d)(i) and

(ii),

                   and notification of the order, judgement, minute or document has been given

to the Secretary of State or the Scottish Ministers (as the case may be) in the

prescribed manner.

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     (2)    If—

           (a)           the Secretary of State and the Scottish Ministers have issued certificates

to a person specifying an amount (or amounts) for which that person is

liable under section 146(2) in respect of the same injured person in

consequence of the same injury, and

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           (b)           either the Secretary of State or the Scottish Ministers subsequently

adjusts or adjust the amount (or amounts) specified in the certificate

issued by him or them on a review of, or an appeal against, that

certificate,

            the other must review the certificate issued by him or them (as the case may be)

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if he is or they are satisfied that it is necessary or expedient to make

consequential adjustments to that certificate.

 

 

Health and Social Care (Community Health and Standards) Bill
Part 3 — Recovery of NHS charges

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     (3)    The Secretary of State or the Scottish Ministers may review a certificate issued

by him or them—

           (a)           either within the prescribed period or in prescribed cases or

circumstances, and

           (b)           either on application made for the purpose or on his or their initiative.

5

     (4)    On a review under this section, the Secretary of State or the Scottish Ministers

may—

           (a)           confirm the certificate,

           (b)           issue a fresh certificate containing such variations as he considers or

they consider appropriate, or

10

           (c)           revoke the certificate.

     (5)    Subsections (5) and (6) of section 148 apply to certificates issued under

subsection (4)(b) above as they apply to certificates issued under section 147.

 153   Appeal against a certificate or a waiver decision

     (1)    An appeal against a certificate may be made by the person to whom the

15

certificate was issued on one or more of the following grounds—

           (a)           that an amount (or amounts) specified in the certificate is (or are)

incorrect,

           (b)           that an amount (or amounts) so specified takes (or take) into account—

                  (i)                 treatment which is not NHS treatment received by the injured

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person, as a result of his injury, at a health service hospital,

                  (ii)                ambulance services which are not NHS ambulance services

provided to the injured person as a result of his injury, or

                  (iii)               treatment as mentioned in sub-paragraph (i) and ambulance

services as mentioned in sub-paragraph (ii),

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           (c)           that the payment on the basis of which the certificate was issued is not

a compensation payment.

     (2)    No appeal may be made until—

           (a)           the claim against the person to whom the certificate was issued, which

gives rise to the compensation payment, has been finally disposed of,

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and

           (b)           payment of the amount (or amounts) specified in the certificate has

been made to the Secretary of State or the Scottish Ministers (as the case

may be), subject to subsection (4) and sections 154(6) and 155(5).

     (3)    For the purposes of subsection (2)(a), if an award of damages in respect of a

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claim has been made under or by virtue of—

           (a)           section 32A(2)(a) of the Supreme Court Act 1981 (c. 54),

           (b)           section 12(2)(a) of, or paragraph 10(2)(a) of Schedule 6 to, the

Administration of Justice Act 1982 (c. 53), or

           (c)           section 51(2)(a) of the County Courts Act 1984 (c. 28),

40

            (orders for provisional damages in personal injury cases), the claim is to be

treated as having been finally disposed of.

     (4)           The Secretary of State or the Scottish Ministers may, on an application by the

person to whom the certificate was issued, waive the requirement in

subsection (2)(b) that payment of the amount (or amounts) specified in the

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certificate be made before making an appeal.

 

 

Health and Social Care (Community Health and Standards) Bill
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     (5)           The Secretary of State or the Scottish Ministers may only grant a waiver if it

appears to him or them that payment of the amount (or amounts) specified in

the certificate would cause exceptional financial hardship.

     (6)           An appeal against a decision of the Secretary of State or the Scottish Ministers

on an application under subsection (4) (referred to in this section and sections

5

154 and 155 as a “waiver decision”) may be made by the person to whom the

certificate was issued.

     (7)    Regulations may make provision—

           (a)           as to the manner in which, and the time within which, an appeal against

a certificate or waiver decision may be made,

10

           (b)           as to the procedure to be followed if an appeal against a certificate or

waiver decision is made,

           (c)           as to the circumstances in which appeals may be consolidated

(including the consolidation of an appeal against a certificate issued by

the Secretary of State with an appeal against a certificate issued by the

15

the Scottish Ministers), and

           (d)           for the purpose of enabling an appeal against a certificate to be treated

as an application for a review under section 152.

 154   Appeal tribunals

     (1)    The Secretary of State or the Scottish Ministers must refer to an appeal tribunal

20

constituted under Chapter 1 of Part 1 of the Social Security Act 1998 (c. 14) an

appeal against—

           (a)           a certificate, or

           (b)                         a waiver decision.

     (2)    In determining an appeal against a certificate, the tribunal must take into

25

account any decision of a court relating to the same, or any similar, issue

arising in connection with the injury in question.

     (3)    On an appeal against a certificate, the tribunal may—

           (a)           confirm the amount or amounts specified in the certificate,

           (b)           specify any variations which are to be made on the issue of a fresh

30

certificate under subsection (4), or

           (c)           declare that the certificate is to be revoked.

     (4)    When the Secretary of State or the Scottish Ministers (as the case may be) has

or have received the decision of the tribunal on an appeal against a certificate,

he or they must in accordance with that decision—

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           (a)           confirm the certificate,

           (b)           issue a fresh certificate, or

           (c)           revoke the certificate.

     (5)    Subsections (5) and (6) of section 148 apply to certificates issued under

subsection (4)(b) above as they apply to certificates issued under section 147.

40

     (6)           On an appeal against a waiver decision, the tribunal may—

           (a)           confirm the decision, or

           (b)           waive the requirement in question.

 

 

Health and Social Care (Community Health and Standards) Bill
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     (7)    Regulations under section 153 may (among other things) provide for the non-

disclosure of medical advice or medical evidence given or submitted following

a reference under subsection (1).

 155   Appeal to Social Security Commissioner

     (1)    An appeal may be made to a Commissioner against any decision of an appeal

5

tribunal under section 154 on the ground that the decision was erroneous in

point of law.

     (2)    An appeal under this section may be made by—

           (a)           the Secretary of State or the Scottish Ministers (as the case may be), or

           (b)           the person to whom the certificate was issued.

10

     (3)    If an appeal is made under this section, subsections (7) to (12) of section 14 of

the 1998 Act apply to the appeal as they apply to an appeal under that section

(reading references to a tribunal as references to an appeal tribunal constituted

as mentioned in section 154(1)).

     (4)    In a case in which subsection (7) or (8)(b) of section 14 of the 1998 Act applies

15

by virtue of subsection (3) above to an appeal against a decision of an appeal

tribunal under subsection (3) of section 154, subsections (2) to (4) of that section

apply as they apply to an appeal determined on a reference under subsection

(1)(a) of that section.

     (5)           In a case in which subsection (7) or (8)(b) of section 14 of the 1998 Act applies

20

by virtue of subsection (3) above to an appeal against a decision of an appeal

tribunal under subsection (6) of section 154, the appeal tribunal may—

           (a)           confirm the waiver decision, or

           (b)           waive the requirement in question.

     (6)    In a case in which subsection (8)(a) of section 14 of the 1998 Act applies by

25

virtue of subsection (3) above to an appeal against a decision of an appeal

tribunal under subsection (3) of section 154, subsection (4) of that section

applies as if the references to the decision of the tribunal on an appeal against

a certificate were references to the decision of the Commissioner on an appeal

under this section.

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     (7)    In this section—

                    “Commissioner” has the same meaning as in Chapter 2 of Part 1 of the

1998 Act, and

                    “the 1998 Act” means the Social Security Act 1998 (c. 14).

Information

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 156   Provision of information

     (1)    If compensation is sought in consequence of any injury suffered by an injured

person, such information with respect to the circumstances of the case as may

be prescribed must be given by the following persons to the Secretary of State

or the Scottish Ministers (as the case may require)—

40

           (a)           the person against whom the claim is made and anyone acting on

behalf of that person, whether or not proceedings have been

commenced,

 

 

 
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