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Health and Social Care (Community Health and Standards) Bill


Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

    82

 

 167   Dental public health

     (1)    In the 1977 Act, after section 16CA (as inserted by section 166 above) insert—

       “16CB   Dental public health

           (1)           A Primary Care Trust shall have such functions in relation to dental

public health in England as may be prescribed.

5

           (2)           A Local Health Board shall have such functions in relation to dental

public health in Wales as may be prescribed.

           (3)           The National Assembly for Wales shall have such functions in relation

to dental public health in Wales as may be prescribed.

           (4)           The functions of a Primary Care Trust under this section may be

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discharged—

                  (a)                 by the Trust itself;

                  (b)                 by the Trust and one or more other Primary Care Trusts acting

jointly; or

                  (c)                 by any other person or body in accordance with arrangements

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made by the Trust.

           (5)           The functions of a Local Health Board under this section may be

discharged—

                  (a)                 by the Board itself;

                  (b)                 by the Board and one or more other Local Health Boards acting

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jointly; or

                  (c)                 by any other person or body in accordance with arrangements

made by the Board.”

     (2)    Section 5(1A) of the 1977 Act shall cease to have effect.

 168   General dental services contracts

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     (1)    In the 1977 Act, after section 28J insert—

“General dental services contracts

       28K      General dental services contracts: introductory

           (1)           A Primary Care Trust or Local Health Board may enter into a contract

under which primary dental services are provided in accordance with

30

the following provisions of this Part.

           (2)           A contract under this section is called in this Act a “general dental

services contract”.

           (3)           Subject to any provision made by or under this Part, a general dental

services contract may make such provision as may be agreed between

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the Primary Care Trust or Local Health Board and the contractor in

relation to—

                  (a)                 the services to be provided under the contract (which may

include services which are not primary dental services),

                  (b)                 remuneration under the contract, and

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                  (c)                 any other matters.

 

 

Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

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           (4)           In this Part, “contractor”, in relation to a general dental services

contract, means any person entering into the contract with the Primary

Care Trust or Local Health Board.

       28L       Requirement to provide certain primary dental services

           (1)           A general dental services contract must require the contractor or

5

contractors to provide, for his or their patients, primary dental services

of such descriptions as may be prescribed.

           (2)           Regulations under subsection (1) may in particular describe services by

reference to the manner or circumstances in which they are provided.

       28M       Persons eligible to enter into GDS contracts

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           (1)           A Primary Care Trust or Local Health Board may, subject to such

conditions as may be prescribed, enter into a general dental services

contract with—

                  (a)                 a dental practitioner;

                  (b)                 a dental corporation;

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                  (c)                 two or more individuals practising in partnership where the

conditions in subsection (2) are satisfied.

           (2)           The conditions referred to in subsection (1)(c) in relation to a

partnership are that—

                  (a)                 at least one partner is a dental practitioner, and

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                  (b)                 any partner who is not a dental practitioner is either—

                        (i)                        an NHS employee,

                        (ii)                       a section 28C employee, section 17C employee or Article

15B employee,

                        (iii)                      a health care professional who is engaged in the

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provision of services under this Act, or

                        (iv)                       an individual falling within section 28D(1)(bc) above.

           (3)           Regulations may make provision as to the effect, in relation to a general

dental services contract entered into by individuals practising in

partnership, of a change in the membership of the partnership.

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           (4)           In this section—

                                  “dental corporation” means a body corporate which, in

accordance with the provisions of Part 4 of the Dentists Act

1984, is entitled to carry on the business of dentistry;

                                  “health care professional” means a person who is a member of a

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profession regulated by a body mentioned (at the time the

contract in question is entered into) in section 25(3) of the

National Health Service Reform and Health Care Professions

Act 2002; and

                                  “NHS employee”, “section 28C employee”, “section 17C

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employee” and “Article 15B employee” have the same

meanings as in section 28D above.

       28N       GDS contracts: payments

           (1)           The appropriate authority may give directions as to payments to be

made under general dental services contracts.

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Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

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           (2)           A general dental services contract must require payments to be made

under the contract in accordance with directions for the time being in

force under this section.

           (3)           Without prejudice to the generality of the power under subsection (1),

a direction under that subsection may—

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                  (a)                 provide for payments to be made by reference to compliance

with standards or the achievement of levels of performance;

                  (b)                 provide for payments to be made by reference to—

                        (i)                        any scheme or scale specified in the direction, or

                        (ii)                       a determination made by any person in accordance with

10

factors specified in the direction;

                  (c)                 provide for the making of payments in respect of individual

practitioners;

                  (d)                 provide that the whole or any part of a payment is subject to

conditions (and may provide that payments are payable by a

15

Primary Care Trust or Local Health Board only if it is satisfied

as to certain conditions);

                  (e)                 make provision having effect from a date before the date of the

direction, provided that, having regard to the direction as a

whole, the provision is not detrimental to the persons to whose

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remuneration it relates.

           (4)           Before giving a direction under subsection (1), the appropriate

authority—

                  (a)                 must consult any body appearing to the authority to be

representative of persons to whose remuneration the direction

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would relate, and

                  (b)                 may consult such other persons as the authority thinks

appropriate.

           (5)           Section 18(1) and (3)(b) above apply in relation to directions under this

section.

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           (6)           References in this section to payments include fees, allowances,

reimbursements, loans and repayments.

           (7)           In this section “appropriate authority” means—

                  (a)                 the Secretary of State, in relation to a contract made by a

Primary Care Trust;

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                  (b)                 the National Assembly for Wales, in relation to a contract made

by a Local Health Board.

       28O      GDS contracts: other required terms

           (1)           A general dental services contract must contain such provision as may

be prescribed (in addition to the provision required by the preceding

40

provisions of this Part).

           (2)           Regulations under subsection (1) may in particular make provision as

to—

                  (a)                 the manner in which, and standards to which, services are to be

provided;

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                  (b)                 the persons who perform services;

                  (c)                 the persons to whom services are to be provided;

 

 

Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

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                  (d)                                     the right of patients to choose the persons from whom they are

to receive services;

                  (e)                 the variation of contract terms (other than terms required by or

under this Part);

                  (f)                 rights of entry and inspection (including inspection of clinical

5

records and other documents);

                  (g)                 the circumstances in which, and the manner in which, the

contract may be terminated;

                  (h)                 enforcement;

                  (i)                 the adjudication of disputes.

10

           (3)           Regulations under subsection (2)(e) may make provision as to the

circumstances in which a Primary Care Trust or Local Health Board

may impose a variation of contract terms.

       28P       GDS contracts: disputes and enforcement

           (1)           Regulations may make provision for the resolution of disputes as to the

15

terms of a proposed general dental services contract.

           (2)           Regulations under subsection (1) may make provision—

                  (a)                 for the referral of the terms of the proposed contract to the

Secretary of State or National Assembly for Wales; and

                  (b)                 for the Secretary of State or Assembly, or a person appointed by

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him or it, to determine the terms on which the contract may be

entered into.

           (3)           Regulations may make provision for a person or persons entering into

a general dental services contract to be regarded as a health service

body for any purposes of section 4 of the National Health Service and

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Community Care Act 1990, in circumstances where he or they so elect.

           (4)           Regulations under subsection (3) may include provision as to the

application of section 4 of that Act in cases where—

                  (a)                 persons practising in partnership elect to become a health

service body; and

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                  (b)                 there is a change in the membership of the partnership.

           (5)           Where—

                  (a)                 by virtue of regulations under subsection (3), subsection (7) of

section 4 of that Act applies in relation to a general dental

services contract, and

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                  (b)                 a direction as to payments is made under that provision in

relation to the contract,

                         the direction is to be enforceable in a county court (if the court so

orders) as if it were a judgment or order of that court.”

     (2)    Sections 35 and 36 of the 1977 Act (arrangements for general dental services)

40

shall cease to have effect.

 169   General dental services: transitional

     (1)    The appropriate authority shall by order make transitional provision in respect

of persons who, immediately before the coming into force of section 168, are

providing services under section 35 of the 1977 Act (general dental services).

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Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

    86

 

     (2)    An order under this section may provide that, in such circumstances as the

order may prescribe, a Primary Care Trust or Local Health Board must, if any

such person so wishes, enter into a general dental services contract with him;

and the order may make provision as to the terms of any such contract.

     (3)    An order under this section may provide that, in such circumstances as the

5

order may prescribe, a Primary Care Trust or Local Health Board must, if any

such person so wishes, enter into a contract with him, containing such terms as

the order may specify, for the provision of dental services.

     (4)    An order under this section may make provision for the resolution of disputes

in relation to any contract entered into, or proposed to be entered into, under

10

subsection (2) or (3), including provision for the determination of disputes by

the appropriate authority or a person appointed by the authority.

     (5)    An order under this section may make provision in respect of a period

beginning before the coming into force of the provision (or of section 168),

provided that the provision is not as a whole detrimental to the remuneration

15

of the persons to whom it relates.

     (6)    In this section—

                     “appropriate authority” means—

                  (a)                 the Secretary of State, in relation to England; and

                  (b)                 the Assembly, in relation to Wales;

20

                      “general dental services contract” means a contract under section 28K of

the 1977 Act (as inserted by section 168(1)).

Primary medical services

 170   Provision of primary medical services

In the 1977 Act, after section 16CB (as inserted by section 167 above) insert—

25

       “16CC                           Primary medical services

           (1)           Each Primary Care Trust and Local Health Board must, to the extent

that it considers necessary to meet all reasonable requirements, exercise

its powers so as to provide primary medical services within its area, or

secure their provision within its area.

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           (2)           A Primary Care Trust or Local Health Board may (in addition to any

other power conferred on it)—

                  (a)                 provide primary medical services itself (whether within or

outside its area);

                  (b)                 make such arrangements for their provision (whether within or

35

outside its area) as it thinks fit, and may in particular make

contractual arrangements with any person.

           (3)           Each Primary Care Trust and Local Health Board must publish

information about such matters as may be prescribed in relation to the

primary medical services provided under this Part.

40

           (4)           A body on which functions are conferred under this section must co-

operate with any other such body in the discharge of their respective

functions relating to the provision of primary medical services under

this Part.

 

 

Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

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           (5)           Regulations may provide that services of a prescribed description are,

or are not, to be regarded as primary medical services for the purposes

of this Part.

           (6)           Regulations under this section may in particular describe services by

reference to the manner or circumstances in which they are provided.”

5

 171   General medical services contracts

     (1)    In the 1977 Act, after section 28P (as inserted by section 168 above) insert—

“General medical services contracts

       28Q      General medical services contracts: introductory

           (1)           A Primary Care Trust or Local Health Board may enter into a contract

10

under which primary medical services are provided in accordance with

the following provisions of this Part.

           (2)           A contract under this section is called in this Act a “general medical

services contract”.

           (3)           Subject to any provision made by or under this Part, a general medical

15

services contract may make such provision as may be agreed between

the Primary Care Trust or Local Health Board and the contractor or

contractors in relation to—

                  (a)                 the services to be provided under the contract,

                  (b)                 remuneration under the contract, and

20

                  (c)                 any other matters.

           (4)           The services to be provided under a general medical services contract

may include—

                  (a)                 services which are not primary medical services;

                  (b)                 services to be provided outside the area of the Primary Care

25

Trust or Local Health Board.

           (5)           In this Part, “contractor”, in relation to a general medical services

contract, means any person entering into the contract with the Primary

Care Trust or Local Health Board.

       28R     Requirement to provide certain primary medical services

30

           (1)           A general medical services contract must require the contractor or

contractors to provide, for his or their patients, primary medical

services of such descriptions as may be prescribed.

           (2)           Regulations under subsection (1) may in particular describe services by

reference to the manner or circumstances in which they are provided.

35

       28S              Persons eligible to enter into GMS contracts            

           (1)           A Primary Care Trust or Local Health Board may, subject to such

conditions as may be prescribed, enter into a general medical services

contract with—

                  (a)                 a medical practitioner;

40

                  (b)                 two or more individuals practising in partnership where the

conditions in subsection (2) are satisfied; or

 

 

Health and Social Care (Community Health and Standards) Bill
Part 4 — Dental and medical services

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                  (c)                 a company limited by shares where the conditions in subsection

(3) are satisfied.

           (2)           The conditions referred to in subsection (1)(b) in relation to a

partnership are that—

                  (a)                 at least one partner is a medical practitioner; and

5

                  (b)                 any partner who is not a medical practitioner is either—

                        (i)                        an NHS employee;

                        (ii)                       a section 28C employee, section 17C employee or Article

15B employee;

                        (iii)                      a health care professional who is engaged in the

10

provision of services under this Act; or

                        (iv)                       an individual falling within section 28D(1)(bc) above.

           (3)           The conditions referred to in subsection (1)(c) in relation to a company

are that—

                  (a)                 at least one share in the company is legally and beneficially

15

owned by a medical practitioner; and

                  (b)                 any share which is not so owned is legally and beneficially

owned by a person referred to in subsection (2)(b)(i) to (iv).

           (4)           Regulations may make provision as to the effect, in relation to a general

medical services contract entered into by individuals practising in

20

partnership, of a change in the membership of the partnership.

           (5)           In this section—

                                  “health care professional” has the same meaning as in section 28M

above;

                                  “NHS employee”, “section 28C employee”, “section 17C

25

employee” and “Article 15B employee” have the same

meanings as in section 28D above.

       28T     GMS contracts: payments

           (1)           The appropriate authority may give directions as to payments to be

made under general medical services contracts.

30

           (2)           A general medical services contract must require payments to be made

under the contract in accordance with directions for the time being in

force under this section.

           (3)           Without prejudice to the generality of the power under subsection (1),

directions under that subsection may—

35

                  (a)                 provide for payments to be made by reference to compliance

with standards or the achievement of levels of performance;

                  (b)                 provide for payments to be made by reference to—

                        (i)                        any scheme or scale specified in the direction; or

                        (ii)                       a determination made by any person in accordance with

40

factors specified in the direction;

                  (c)                 provide for the making of payments in respect of individual

practitioners;

                  (d)                 provide that the whole or any part of a payment is subject to

conditions (and may provide that payments are payable by a

45

Primary Care Trust or Local Health Board only if it is satisfied

as to certain conditions);

 

 

 
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