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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

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 175   Persons performing primary medical and dental services

     (1)    In the 1977 Act, after section 28W (as inserted by section 171 above) insert—

       “28X              Persons performing primary medical and dental services

           (1)                         Regulations may provide that a health care professional of a prescribed

description may not perform any primary medical service for which a

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Primary Care Trust or Local Health Board is responsible unless he is

included in a list maintained under the regulations by a Primary Care

Trust or Local Health Board.

           (2)           Regulations may provide that a health care professional of a prescribed

description may not perform any primary dental service for which a

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Primary Care Trust or Local Health Board is responsible unless he is

included in a list maintained under the regulations by a Primary Care

Trust or Local Health Board.

           (3)           For the purposes of this section—

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

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a profession regulated by a body for the time being mentioned

in section 25(3) of the National Health Service Reform and

Health Care Professions Act 2002;

                  (b)                 a Primary Care Trust or Local Health Board is responsible for a

medical or dental service if it provides the service, or secures its

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provision, by or under any enactment.

           (4)           Regulations under this section may make provision in relation to lists

under this section and in particular as to—

                  (a)                 the preparation, maintenance and publication of a list;

                  (b)                 eligibility for inclusion in a list;

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                  (c)                 applications for inclusion (including provision as to the

Primary Care Trust or Local Health Board to which an

application must be made, and for the procedure for

applications and the documents to be supplied on application);

                  (d)                 the grounds on which an application for inclusion may or must

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be granted or refused;

                  (e)                 requirements with which a person included in a list must

comply (including the declaration of financial interests and gifts

and other benefits);

                  (f)                 suspension or removal from a list (including provision for the

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grounds for, and consequences of, suspension or removal);

                  (g)                 circumstances in which a person included in a list may not

withdraw from it;

                  (h)                 payments to be made in respect of a person suspended from the

list (including provision for the amount of the payment, or the

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method of calculating the payment, to be determined by the

Secretary of State or National Assembly for Wales, or a person

appointed by him or it);

                  (i)                 the criteria to be applied in making decisions under the

regulations;

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                  (j)                 appeals against decisions made by a Primary Care Trust or

Local Health Board under the regulations; and

                  (k)                 disclosure of information about applicants for inclusion, grants

or refusals of applications or suspensions or removals;

 

 

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

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                         and may make any provision corresponding to anything in sections 49F

to 49N below.

           (5)           Regulations under this section may, in particular, also provide for—

                  (a)                 a person’s inclusion in a list to be subject to conditions

determined by a Primary Care Trust or Local Health Board;

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                  (b)                 a Trust or Board to vary the conditions or impose different ones;

                  (c)                 the consequences of failing to comply with a condition

(including removal from the list);

                  (d)                 the review by a Trust or Board of decisions made by it by virtue

of the regulations.

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           (6)           The imposition of such conditions must be with a view to—

                  (a)                 preventing any prejudice to the efficiency of the services to

which the list relates, or

                  (b)                 preventing fraud.

           (7)           Regulations making provision as to the matters referred to in

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subsection (4)(k) may in particular authorise the disclosure of

information—

                  (a)                 by a Primary Care Trust or Local Health Board to the Secretary

of State or the National Assembly for Wales; and

                  (b)                 by the Secretary of State or the National Assembly for Wales to

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a Primary Care Trust or Local Health Board.”

     (2)    In section 49M(7) of that Act, at the end there is inserted “; and regulations

under this subsection may include provision of the kind referred to in section

49I(10)”.

 176   Assistance and support

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In the 1977 Act, after section 28X (as inserted by section 175 above) insert—

       “28Y  Assistance and support

           (1)           A Primary Care Trust or Local Health Board may provide assistance or

support to—

                  (a)                 any person providing, or proposing to provide primary medical

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services or primary dental services under a general medical

services contract or a general dental services contract;

                  (b)                 any person providing, or proposing to provide, such services in

accordance with section 28C arrangements.

           (2)           Assistance or support provided by a Primary Care Trust or Local

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Health Board under subsection (1) is to be provided on such terms,

including terms as to payment, as the Trust or Board thinks fit.

           (3)           In this section “assistance” includes financial assistance.”

Dental services: miscellaneous

 177   Abolition of Dental Practice Board

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The Dental Practice Board is abolished.

 

 

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

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 178   Special Health Authorities

     (1)    In section 16B of the 1977 Act (exercise of functions by Primary Care Trusts), at

the end insert—

           “(4)              The Secretary of State may by order make provision for the transfer to

a Special Health Authority of the rights and liabilities of a Primary Care

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Trust under a general dental services contract in a case where the

Authority exercises functions of the Trust in relation to the contract by

virtue of subsection (2)(b) above (and for their transfer back to the Trust

where the Authority ceases to exercise those functions).”.

     (2)    In section 16BC of that Act (exercise of functions by Local Health Boards), at

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the end insert—

           “(4)              The Assembly may by order make provision for the transfer to a Special

Health Authority of the rights and liabilities of a Local Health Board

under a general dental services contract in a case where the Authority

exercises functions of the Board in relation to the contract by virtue of

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subsection (2)(b) above (and for their transfer back to the Board where

the Authority ceases to exercise those functions).”.

 179   Charges for dental services

     (1)    In the 1977 Act, for sections 78A to 79A substitute—

       “79            Dental charging

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           (1)           Regulations may provide for the making and recovery, in such manner

as may be prescribed, of charges for relevant dental services.

           (2)           Regulations under subsection (1) may in particular include provision—

                  (a)                 specifying the amount, or maximum amount, of any charge (or

aggregate charge in respect of the provision for two or more

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relevant dental services);

                  (b)                 for calculating the amount of any charge;

                  (c)                 for the variation of the amount, or maximum amount, of any

charge in cases of a prescribed description;

                  (d)                 for any charge not to be payable in cases of a prescribed

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description;

                  (e)                 for power to direct that a charge is not payable in any particular

case;

                  (f)                 for the repayment of any charge (including provision as to the

persons by whom, and manner in which, repayments are to be

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made).

           (3)           Regulations under subsection (1) may provide for sums which would

otherwise be payable by a Primary Care Trust, Local Health Board or

Special Health Authority to persons providing relevant dental services

to be reduced by the amount of the charges authorised by the

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regulations.

           (4)           This section is subject to Schedule 12ZA.

           (5)           In this section and Schedule 12ZA “relevant dental services” means—

                  (a)                 dental treatment provided—

 

 

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

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                        (i)                        under section 16CA(2) above (dental services provided

by a Primary Care Trust or Local Health Board);

                        (ii)                       under a general dental services contract;

                        (iii)                      in accordance with section 28C arrangements; and

                  (b)                 the supply of dentures and other dental appliances under this

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Act.

           (6)           Any reference in this section or Schedule 12ZA to the supply of an

appliance includes a reference to its repair, adjustment, refitting or

replacement and, in the case of dentures, to their being relined or

having additions made to them.”

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     (2)    After Schedule 12 to that Act insert—

“Schedule 12za

Dental charging: exemptions

General exemptions

        1              (1)             No charge is to be made under regulations under section 79(1) in

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respect of a relevant dental service provided for any person who at

the prescribed time—

                    (a)                   was under 18;

                    (b)                   was under 19 and receiving qualifying full-time education;

                    (c)                   was pregnant; or

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                    (d)                   had given birth to a child within the previous 12 months.

                       (2)             In sub-paragraph (1)(b), “qualifying full-time education” means full-

time instruction at a recognised educational establishment or by

other means accepted as comparable by the person or body making

the regulations.

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                       (3)             For the purposes of sub-paragraph (2)—

                    (a)                   “recognised educational establishment” means an

establishment recognised by the person or body making the

regulations as being, or as comparable to, a school, college or

university; and

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                    (b)                   regulations may prescribe the circumstances in which a

person is or is not to be treated as receiving full-time

instruction.

                       (4)             In sub-paragraph (1)(d), “child” includes a still-born child (within

the meaning of the Births and Deaths Registration Act 1953).

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                       (5)             This paragraph is subject to paragraph 3.

Repair and replacement

        2              (1)             No charge is to be made under regulations under section 79(1) in

respect of the repair or replacement of any appliance.

                       (2)             This paragraph is subject to paragraph 3.

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Exceptions to paragraphs 1 and 2

        3               Paragraphs 1 and 2 do not apply in relation to—

 

 

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

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                    (a)                   the repair or replacement of any appliance of a prescribed

description; or

                    (b)                   the repair or replacement of any appliance where it is

determined in the prescribed manner—

                           (i)                          in any case, that the repair or replacement was

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necessitated by an act or omission of the person

supplied; or

                           (ii)                         in a case where the person supplied was under the

age of 16, that the repair or replacement was

necessitated by an act or omission, occurring while

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that person was under that age, of a person having

charge of him.

Hospital patients

        4               No charge is to be made under regulations under section 79(1) in

respect of any appliance supplied to a patient for the time being

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resident in a hospital.

        5               Paragraph 4 does not apply where an appliance is supplied—

                    (a)                   under section 16CA(2) above;

                    (b)                   under a general dental services contract; or

                    (c)                   in accordance with section 28C arrangements.

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Arrest of bleeding

        6               No charge is to be made under regulations under section 79(1) in

respect of the arrest of bleeding.

Declarations and evidence

        7               Regulations may provide, with respect to any exemption under this

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Schedule, that it is to be a condition of the exemption that—

                    (a)                   a declaration of the prescribed kind is made in the prescribed

form and manner; or

                    (b)                   a certificate or other evidence of the prescribed kind is

supplied in the prescribed form and manner.”

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     (3)           In respect of any period after the coming into force of this section but before the

coming into force of section 174, section 79(5)(b) of the 1977 Act (as inserted by

subsection (1) above) shall have effect as if it included a reference to the supply

of dentures and other dental appliances in accordance with a pilot scheme

under Part 1 of the National Health Service (Primary Care) Act 1997 (c. 46).

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General

 180   Minor and consequential amendments

Schedule 11 (which contains minor and consequential amendments relating to

this Part) has effect.

 

 

Health and Social Care (Community Health and Standards) Bill
Part 5 — Miscellaneous

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Part 5

Miscellaneous

Welfare Food Schemes

 181   Replacement of the Welfare Food Schemes: Great Britain

     (1)    In the Social Security Act 1988 (c. 7), for section 13 (schemes for the distribution

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etc of welfare foods), substitute—

       “13            Benefits under schemes for improving nutrition: pregnant women,

mothers and children

           (1)           Regulations may establish one or more schemes to provide benefits for

prescribed descriptions of—

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                  (a)                 pregnant women,

                  (b)                 mothers, and

                  (c)                 children,

                         with a view to helping and encouraging them to have access to, and to

incorporate in their diets, food of a prescribed description.

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           (2)           Before establishing, or varying, a scheme the Secretary of State must

consult the Scottish Ministers and the National Assembly for Wales

(“the Assembly”).

           (3)           A scheme may, in particular, specify requirements that must be

satisfied—

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                  (a)                 before a person may become entitled to a benefit;

                  (b)                 for a beneficiary to remain entitled to a continuing benefit.

           (4)           Requirements that may be specified include requiring a person

(including someone who has parental responsibility for a

beneficiary)—

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                  (a)                 to be registered under the scheme;

                  (b)                 to attend a hospital, clinic or doctor’s surgery determined in

accordance with the scheme;

                  (c)                 where the beneficiary is a child, to take the child to a hospital,

clinic or doctor’s surgery determined in accordance with the

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scheme;

                  (d)                 to allow herself, or a child of hers, to be examined by a doctor or

nurse;

                  (e)                 to allow a visit to her home by a health professional or other

prescribed description of person;

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                  (f)                 to receive advice of a prescribed description about nutrition,

diet or other matters relating to health.

           (5)           A scheme may also include provision—

                  (a)                 for a benefit to consist of food of a prescribed description being

provided by—

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                        (i)                        a person who supplies, or arranges for the supply of,

food of that description for beneficiaries under the

scheme;

 

 

Health and Social Care (Community Health and Standards) Bill
Part 5 — Miscellaneous

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                        (ii)                       a person providing a service (such as day care) for the

recipient of the benefit; or

                        (iii)                      a health service body;

                  (b)                 for the use of vouchers, or similar arrangements, in connection

with the provision of benefits;

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                  (c)                 that a person taking part in the scheme, otherwise than as a

beneficiary, must be registered under the scheme;

                  (d)                 for the payment by the Secretary of State of sums to persons

registered in accordance with a provision of a kind mentioned

in paragraph (c), in respect of things provided or done by them

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in accordance with the scheme;

                  (e)                 for the making of payments to such persons entitled to receive

benefits as may be determined by or under the scheme;

                  (f)                 for the delegation, in accordance with provisions of the scheme,

of prescribed functions under the scheme;

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                  (g)                 for the scheme, or prescribed provisions of the scheme, to be

administered on behalf of the Secretary of State by such health

service body, or other description of body, as may be

prescribed;

                  (h)                 requiring prescribed categories of persons to take reasonable

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steps to provide—

                        (i)                        to a person authorised for the purpose in accordance

with the scheme,

                        (ii)                       on production, if required, of evidence of his authority,

                                      such information or evidence as may be reasonably needed in

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connection with administering the scheme.

           (6)           Provision of a kind mentioned in subsection (5)(h) may, in particular—

                  (a)                 require information or evidence to be provided in a legible

form;

                  (b)                 authorise the taking of copies or making of extracts;

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                  (c)                 require an explanation by the information provider of anything

which he has provided;

                  (d)                 require an information provider to state, to the best of his

knowledge and belief, where information or evidence that he

has failed to provide is held.

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           (7)           The power to prescribe descriptions of food (conferred by subsection

(1)) and the power to prescribe descriptions of advice (conferred by

subsection (4)(f)) are to be exercised, in relation to the operation of a

scheme in Wales, by regulations made by the Assembly.

           (8)           The Secretary of State may give such directions—

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                  (a)                 to a body administering a scheme (or part of a scheme),

                  (b)                 in relation to matters relating to the operation of the scheme (or

that part of the scheme),

                         as he considers appropriate.

           (9)           The Assembly may, with the agreement of the Secretary of State, give

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such directions—

                  (a)                 to a body administering a scheme (or part of a scheme),

                  (b)                 in relation to matters relating to the operation of the scheme (or

that part of the scheme) in Wales,

 

 

 
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