Decisione N.1233 del Consiglio permanente
In the National Health Service and Community Care Act 1990, sections 14 to 17 (which make provision in relation to fund-holding practices) are to cease to have effect.
After section 16 of the National Health Service Act 1977 there is inserted—
Schedule 1 (which inserts the new Schedule 5A in the 1977 Act) is to have effect.
Before section 98 of the 1977 Act there is inserted—
After Schedule 12 to the 1977 Act there is inserted—
Section 97 of the 1977 Act (means of meeting expenditure of Health Authorities etc. out of public funds) is amended as follows—
subsection (2) is omitted,
in subsection (3), at the end there is inserted “in that year”,
for subsections (3A) and (3B) there is substituted—.
Section 103(3) of the 1977 Act (special arrangements as to payment of remuneration) is amended as follows—
in paragraph (a), for the words from “the Health Authority” to the end of that paragraph there is substituted “a Health Authority so determined in respect of the whole or any part of that remuneration”,
in paragraph (b), for “that” there is substituted “the whole or (as the case may be) that part of the”.
This section has effect for the financial year 1999-2000 and subsequent financial years.
After section 18 of the 1977 Act there is inserted—
After section 8 of the National Health Service (Primary Care) Act 1997, there is inserted—
After section 28E of the 1977 Act there is inserted—
After section 96A of the 1977 Act there is inserted—
Section 97 of the 1977 Act (public funding of Health Authorities and Special Health Authorities) is amended as follows.
After subsection (3BB) there is inserted—
In subsection (5)—
after “reducing” there is inserted “(subject to subsection (3F) above)”,
at the end there is inserted “and the reference to a determination in subsection (3C) above includes a determination made with a view to increasing or reducing an allotment previously so made”.
Before section 44 of the 1977 Act there is inserted—
In section 29A of the 1977 Act (medical lists), at the beginning of subsection (3) there is inserted “Subject to any provision made under section 43C below,”.
In section 36 of that Act (regulations as to arrangements for general dental services), in subsection (1)(b), after “below” there is inserted “to any provision made under section 43C below”.
In section 39 of that Act (regulations as to arrangements for general ophthalmic services), in paragraph (b), after “subject” there is inserted “to any provision made under section 43C below and”.
For sections 43A and 43B of the 1977 Act (regulations as to Part II remuneration) there is substituted—
Sections 43A and 43B of the 1977 Act, as substituted by this section, have effect in relation to— and in this subsection “determinations” means determinations under Part II of the 1977 Act of the remuneration to be paid to persons who provide services mentioned in section 43A(1).
the making of determinations on or after the commencement of this section, and
the variation or revocation on or after the commencement of this section of determinations whenever made,
Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of 1977 Act deemed to be valid) have effect in relation to England and Wales as if— there were inserted “and before the coming into force of section 10 of the Health Act 1999”.
after “inserted by this section” in section 7(4)(b) of the 1984 Act, and
after “section 7 of the Health and Social Security Act 1984” in section 15(3) of the 1988 Act,
Section 44 of the 1977 Act (recognition of local representative committees) is amended as provided in subsections (2) to (4).
Before subsection (1) there is inserted—
In subsection (1), paragraphs (a) and (b) and “the Local Medical Committee, the Local Dental Committee,” are omitted.
After subsection (2) there is inserted—
Section 45 of that Act (functions of local representative committees) is amended as provided in subsections (6) to (8).
For subsection (1) there is substituted—
In subsection (2), “(including travelling and subsistence allowances payable to its members)” is omitted.
After subsection (3) there is inserted—
For section 17 of the 1977 Act (Secretary of State’s directions) there is substituted—
Subsection (3) of section 17 of the 1977 Act applies in relation to the powers to give directions conferred by sections 4, 6 and 8 of the National Health Service (Primary Care) Act 1997 (proposals for, and making, variation and termination of, pilot schemes) as it applies in relation to the powers conferred by any of the provisions mentioned in paragraphs (a) to (c) of that subsection.
For section 18 of the 1977 Act (directions and regulations under sections 11 to 17) down to the end of subsection (1) there is substituted—
In subsection (3) of that section, for “11 to 17” there is substituted “16 to 17B above”.
Section 13 of the 1977 Act (Secretary of State’s directions) is to cease to have effect.
In section 5 of the 1990 Act (NHS trusts)—
in subsection (1), for paragraphs (a) and (b) there is substituted “to provide goods and services for the purposes of the health service”, and
for subsection (6) there is substituted—
“provide” includes manage
Any order under section 5(1) of that Act—
is to be treated as always having had effect with the omission of any obligation for the NHS trust to which the order relates to own land specified in the order, and
so far as any functions specified in it could have been specified under that provision as amended by this Act, is to be treated as having been made under that provision as so amended.
Any restriction preventing the acquisition of any land by any NHS trust (including an NHS trust dissolved before the commencement of this section) merely because the land did not comprise a hospital or other establishment or facility previously managed or provided by a Health Authority, a Special Health Authority, a Regional Health Authority or a District Health Authority is to be treated as never having had effect.
An order under section 63 may—
provide for any provision made by it for the purposes of, in consequence of or for giving full effect to this section to be treated as having had effect from a time before the commencement of this section,
make such provision about an NHS trust dissolved before that commencement.
In section 11(1) of the 1990 Act (trust funds and trustees for NHS trusts), for “which is owned and managed” there is substituted “at or from which services are provided”.
In paragraph 3(2) of Schedule 2 to that Act (establishment orders), for “assume responsibility for the ownership and management of” there is substituted “provide services at”.
In paragraph 16(2) of that Schedule (general powers of NHS trusts), for “which is owned and managed” there is substituted “at or from which services are provided”.
In paragraph 3 of Schedule 3 to that Act (borrowing limits), in sub-paragraphs (1) and (2), for the words from “established” to “manage” there is substituted “which are required to provide services at or from”.
The 1990 Act is to be treated as always having had effect subject to the amendments made by this section.
Paragraphs (aa) and (ab) of section 91(3) of the 1977 Act (private trusts for hospitals) are to be treated as always having had effect (until their replacement by paragraph 27(a) of Schedule 4 to this Act) with the omission of “owned and”.
For section 5(9) of the 1990 Act (restrictions on exercise of certain powers) there is substituted—
Section 9 of the 1990 Act (originating capital debt of, and other financial provisions relating to, NHS trusts) is amended as provided in subsections (2) to (5).
In subsections (1), (2) and (3), for “originating capital debt” there is substituted “originating capital”.
For subsection (4) there is substituted—
Subsections (5) and (6) are omitted.
In subsection (7), for the words from “the terms” to the end there is substituted—.
In Schedule 3 to that Act—
in paragraph 3 (limits on indebtedness), sub-paragraph (3) is omitted, and
in paragraph 5 (additional public dividend capital), sub-paragraph (2) is omitted.
This section applies to any NHS trust in existence immediately before commencement.
On commencement so much of the originating capital debt of the NHS trust as remains outstanding immediately before commencement is to be treated as the originating capital of the NHS trust and accordingly is public dividend capital.
Any reference in any enactment, instrument or other document to the originating capital debt of the NHS trust is to be construed (except where the context otherwise requires) as a reference to its originating capital.
The Secretary of State may with the consent of the Treasury determine the amount and time for payment of interest on the NHS trust’s initial loan in respect of the period ending with commencement.
In this section—
“commencement” means the coming into force of this section,
“confidential information” means information which is held subject to a duty of confidence, and includes information contained in a health record,
Schedule 3 to the 1990 Act is amended as follows.
In paragraph 1 (borrowing powers of NHS trusts), in sub-paragraph (1), after “Subject to” there is inserted “any direction given by the Secretary of State under section 17 of the principal Act, to”.
Sub-paragraphs (3) to (5) of that paragraph are omitted.
It shall be for the Secretary of State, with the consent of the Treasury, to determine the terms of any loan made by him to an NHS trust (including terms as to the payment of interest, if any).
It is the duty of each Health Authority, Primary Care Trust and NHS trust to put and keep in place arrangements for the purpose of monitoring and improving the quality of health care which it provides to individuals.
The reference in subsection (1) to health care which a body there mentioned provides to individuals includes health care which the body provides jointly with another person to individuals.
The Secretary of State may by regulations extend the duty in this section to Special Health Authorities of any particular description.
In this section—
“the 1990 Act” means the National Health Service and Community Care Act 1990,
“health record” has the meaning given by section 68(2) of the Data Protection Act 1998,
There is to be a body corporate known as the Commission for Health Improvement.
The Commission is to have the functions conferred on it by or under sections 20 to 22.
Schedule 2 makes further provision in relation to the Commission.
The Commission has the following functions—
the function of providing advice or information with respect to arrangements by Primary Care Trusts or NHS trusts for the purpose of monitoring and improving the quality of health care for which they have responsibility,
the function of conducting reviews of, and making reports on, arrangements by Primary Care Trusts or NHS trusts for the purpose of monitoring and improving the quality of health care for which they have responsibility,
the function of carrying out investigations into, and making reports on, the management, provision or quality of health care for which Health Authorities, Primary Care Trusts or NHS trusts have responsibility,
the function of conducting reviews of, and making reports on, the management, provision or quality of, or access to or availability of, particular types of health care for which NHS bodies or service providers have responsibility, and
such functions as may be prescribed relating to the management, provision or quality of, or access to or availability of, health care for which prescribed NHS bodies or prescribed service providers have responsibility.
The Secretary of State may by regulations make provision—
as to the times at which, the cases in which, the manner in which, the persons in relation to which or the matters with respect to which any functions of the Commission are to be exercised,
as to the matters to be considered or taken into account in connection with the exercise of any functions of the Commission,
as to the persons to whom any advice, information or reports are to be given or made,
as to the publication of reports and summaries of reports,
as to the recovery from prescribed persons of amounts in respect of the expenditure incurred by the Commission in the exercise of any of its functions, and
for or in connection with the exercise of functions of the Commission in conjunction with the exercise of statutory functions of other persons.
The Secretary of State may give directions with respect to the exercise of any functions of the Commission.
The Commission must comply with any directions under this section.
For the purposes of this section a person has responsibility for health care—
if he provides or is to provide that care to individuals, or
if another person provides or is to provide that care to individuals—
at his direction,
on his behalf, or
in accordance with an agreement or arrangements made by him with that other person.
References in subsection (5) to the provision of care include references to the provision of care jointly with another person.
In this section—
“supplier” means any person who supplies health service medicines.
“Order” means an Order in Council under section 60,
and accordingly the “or” after paragraph (b) is omitted. Subsection (7) is omitted. In subsection (9), after “paid” there is inserted “to Health Authorities or Special Health Authorities”.
Section 2. After Schedule 5 to the 1977 Act (Health Authorities and Special Health Authorities), there is inserted—
Section 19.
The Commission is not to be regarded as the servant or agent of the Crown or as enjoying any status, immunity or privilege of the Crown; and the Commissions' property is to not to be regarded as property of, or property held on behalf of, the Crown.
Subject to any directions given by the Secretary of State, the Commission may do anything which appears to it to be necessary or expedient for the purpose of, or in connection with, the exercise of its functions. That includes, in particular—
It is the duty of the Commission to carry out its functions effectively, efficiently and economically.
The Commission is to consist of—
a chairman appointed by the Secretary of State,
a member appointed by the National Assembly for Wales who appears to the Assembly to be suited to make the interests of Wales his special care, and
other members appointed by the Secretary of State.
The Secretary of State may by regulations make provision as to—
the appointment of the chairman and other members of the Commission (including the number, or limits on the number, of members who may be appointed and any conditions to be fulfilled for appointment),
the tenure of office of the chairman and other members of the Commission (including the circumstances in which they cease to hold office or may be removed or suspended from office),
the appointment of, constitution of and exercise of functions by committees and sub-committees of the Commission (including committees and sub-committees which consist of or include persons who are not members of the Commission), and
the procedure of the Commission and any committees or sub-committees of the Commission (including the validation of proceedings in the event of vacancies or defects in appointment).
The Commission may pay to its chairman, and to any other member of the Commission, such remuneration and allowances as the Secretary of State may determine. The Commission may pay to any member of a committee or sub-committee of the Commission such allowances as the Secretary of State may determine. If the Secretary of State so determines, the Commission must make provision for the payment of such pension, allowance or gratuities as the Secretary of State may determine to or in respect of a person who is or has been the chairman or any other member of the Commission. If the Secretary of State determines that there are special circumstances that make it right for a person ceasing to hold office as chairman of the Commission to receive compensation, the Commission must pay to him such compensation as the Secretary of State may determine.
There is to be a chief executive of the Commission (to be known as the Director for Health Improvement) who is to be an employee of the Commission and is to be responsible to the Commission for the general exercise of the Commission’s functions. Subject to sub-paragraph (3), the Director for Health Improvement is to be appointed by the Commission, but his appointment requires the consent of the Secretary of State. The first Director for Health Improvement is to be appointed by the Secretary of State on such terms and conditions as the Secretary of State may determine. The Commission may appoint such other employees as it considers appropriate. Employees of the Commission are to be appointed by the Commission on such terms and conditions as the Commission may determine. The Secretary of State may give directions as to— The Commission must comply with any directions under sub-paragraph (6).
The Commission may arrange for the discharge of any of its functions by a committee, sub-committee, member or employee of the Commission.
The Commission may arrange for such persons as it thinks fit to assist it in the discharge of any of its functions in relation to a particular case or class of case. Such arrangements may include provision with respect to the payment of remuneration and allowances to, or amounts in respect of, such persons.
The Secretary of State may make payments out of money provided by Parliament to the Commission of such amounts, at such times and on such conditions (if any) as he considers appropriate. The National Assembly for Wales may make payments to the Commission of such amounts, at such times and on such conditions (if any) as it considers appropriate. The Secretary of State may make loans out of money provided by Parliament to the Commission on such terms (including terms as to repayment and interest) as he may determine. The National Assembly for Wales may make loans to the Commission on such terms (including terms as to repayment and interest) as it may determine. The approval of the Treasury is required as to the amount and terms of any loan under sub-paragraph (3). Except as provided by sub-paragraphs (3) and (4), the Commission has no power to borrow money. The Secretary of State may give directions to the Commission as to the application of any sums received by the Commission under sub-paragraph (1) or (3). The National Assembly for Wales may give directions to the Commission as to the application of any sums received by the Commission under sub-paragraph (2) or (4). The Commission must comply with any directions under sub-paragraph (7) or (8).
The Commission must keep accounts in such form as the Secretary of State may determine. The Commission must prepare annual accounts in respect of each financial year in such form as the Secretary of State may determine. The Commission must send copies of the annual accounts to the Secretary of State and the Comptroller and Auditor General within such period after the end of the financial year to which the accounts relate as the Secretary of State may determine. The Comptroller and Auditor General must examine, certify and report on the annual accounts and must lay copies of the accounts and of his report before Parliament. In this paragraph “financial year” means—
As soon as possible after the end of each financial year, the Commission must make a report to the Secretary of State on the exercise of its functions during the year. The Commission must provide the Secretary of State with such reports and information relating to the exercise of its functions as he may from time to time require. In this paragraph “financial year” has the meaning given by paragraph 11(5).
The application of the seal of the Commission must be authenticated by the signature—
of any member of the Commission, or
of any other person who has been authorised by the Commission (whether generally or specially) for that purpose.
A document purporting to be duly executed under the seal of the Commission or to be signed on its behalf is to be received in evidence and, unless the contrary is proved, taken to be so executed or signed.
Commission for Health Improvement.
In the Schedule to the Public Bodies (Admission to Meetings) Act 1960 (bodies to which the Act applies), after paragraph (bb) of paragraph 1 there is inserted—.
Commission for Health Improvement.
The Commission for Health Improvement
In the Northern Ireland Assembly Disqualification Act 1975, the same entry as is set out in paragraph 18 is inserted at the appropriate place in Part II of Schedule 1.
Section 60.
An Order may make provision, in relation to any profession, for any of the following matters (among others)—
the establishment and continuance of a regulatory body,
keeping a register of members admitted to practice,
education and training before and after admission to practice,
privileges of members admitted to practice,
standards of conduct and performance,
discipline and fitness to practise,
investigation and enforcement by or on behalf of the regulatory body,
appeals,
default powers exercisable by a person other than the regulatory body.
The power to make an Order may be exercised by amending or repealing any enactment (whether or not mentioned in section 60) or prerogative instrument and any other instrument or document. But an Order may not amend the Medicines Act 1968. Sub-paragraph (2) does not prevent an Order amending—
The power may be exercised so as to make provision for the delegation of functions, including provision conferring power to make, confirm or approve subordinate legislation.
The power may be exercised so as to make provision for the charging of fees.
The power may be exercised so as to—
confer functions (including power to pay grants) on Ministers of the Crown, the Scottish Ministers or the National Assembly for Wales, or
modify their functions.
The power may not be exercised so as to create any criminal offence, except an offence punishable on summary conviction with a fine not exceeding the amount specified as level 5 on the standard scale.
An Order may not abolish the regulatory body of any profession to which section 60(2)(a) applies, any regulatory body established by an Order as the successor to the Council for Professions Supplementary to Medicine or the United Kingdom Central Council for Nursing, Midwifery and Health Visiting or any other regulatory body established by an Order. An Order may not impose any requirement which would have the effect that a majority of the members of the regulatory body of any profession would be persons not included in the register of members admitted to practice. An Order may not provide for any function conferred on the Privy Council, in relation to any profession to which section 60(2)(a) applies, to be exercised by a different person.
Where an enactment provides, in relation to any profession, for any function mentioned in sub-paragraph (2) to be exercised by the regulatory body or any of its committees or officers, an Order may not provide for any person other than that regulatory body or any of its committees or officers to exercise that function. The functions are— In sub-paragraph (1), “enactment” does not include any enactment contained in or made under the Professions Supplementary to Medicine Act 1960 or the Nurses, Midwives and Health Visitors Act 1997.
If it is proposed to lay a draft of an Order before Parliament, the Secretary of State must first— After the end of the period of three months beginning with the publication of the draft, he may lay the draft as published, or that draft with any modifications he considers appropriate, together with a report about the consultation before Parliament. If any provision of a draft would, if it were included in an Act of the Scottish Parliament, be within the legislative competence of that Parliament— After the end of the period of three months beginning with the publication of the draft, the draft as published, or that draft with any modifications which the Secretary of State and the Scottish Ministers consider appropriate, may be laid before Parliament and the Scottish Parliament together with a report made by the Secretary of State and the Scottish Ministers about the consultation.
In this Schedule— and other expressions used in this Schedule and in the 1977 Act have the same meaning in this Schedule as in that Act.
The powers conferred by section 60 may be exercised so as to regulate a profession which is not regulated by any enactment (whether established before or after the passing of this Act). References to regulation, in relation to a profession, in that section and this Schedule include— In sub-paragraph (2)(c), the reference to the provision of general medical services includes the performance of personal medical services and the reference to the 1977 Act includes arrangements under section 28C of that Act.
The powers conferred by section 60 extend to the regulation of— only in relation to the matters dealt with in sections 80 to 83 of the Medicines Act 1968. But an Order may not provide for any function conferred by any of those sections on the Statutory Committee to be exercised, in relation to Northern Ireland, otherwise than by the committee appointed under Article 19 of the Pharmacy (Northern Ireland) Order 1976.
Section 65.
In the Schedule to the Public Bodies (Admission to Meetings) Act 1960 (bodies to which the Act applies), after paragraph (g) of paragraph 1 there is inserted—.
Section 10 of the National Health Service Act 1966 (modification of prohibition of full-time salaried practitioner service) is omitted (and, accordingly, section 29(4) of the 1977 Act and section 19(3) of the 1978 Act continue to have effect).
In section 63 of the Health Services and Public Health Act 1968 (instruction of Health Authority employees and others)—
in subsection (1)(a), for “or Special Health Authority or a Health Board” there is substituted “Special Health Authority, Health Board or Primary Care Trust”,
in subsection (5A), for “or Special Health Authority” in both places there is substituted “Special Health Authority or Primary Care Trust”,
in subsection (5B), after “Special Health Authorities” there is inserted—.
The 1977 Act is amended as follows.
In section 8 (Health Authorities)—
in subsection (2), for “act” there is substituted “be established”,
in subsection (3)(a), for “act” there is substituted “be established”,
in subsection (4), after paragraph (c) there is inserted—,
in subsection (5)—
in paragraph (a), for “acting” there is substituted “established”,
in paragraph (b), for “act” there is substituted “are established”.
In section 11 (Special Health Authorities), for subsection (1) there is substituted—
In section 12 (supplementary provisions for sections 8 and 11), subsection (1) is omitted.
In section 15 (duty of Health Authority in relation to family health services), subsections (1B) to (1D) are omitted.
For section 16 (exercise of functions) there is substituted—
After section 16B there is inserted—
In section 26 (supply of goods and services by Secretary of State)—
in subsection (1)(b), after “by him” there is inserted “or by a Primary Care Trust” and for “or Special Health Authority” there is substituted “Special Health Authority or Primary Care Trust”,
in subsection (3), for “or Special Health Authority” (in both places) there is substituted “Special Health Authority or Primary Care Trust”,
in subsection (4)(b), for “or Special Health Authorities” there is substituted “Special Health Authorities or Primary Care Trusts”.
Section 27 (conditions of supply under section 26) is amended as follows. In subsection (1), for “or Special Health Authority” (in both places) there is substituted “Special Health Authority or Primary Care Trust”. In subsection (3)—
In section 28 (supply of goods and services by local authorities)—
in subsection (1), for “and any Special Health Authority” there is substituted “Special Health Authority or Primary Care Trust”,
in subsection (3), after “Special Health Authorities” (in both places) there is inserted “Primary Care Trusts”.
Section 28A (power to make payments towards expenditure on community services) is amended as follows. In subsection (2), for “An authority to whom” there is substituted “A body to which”. Subsections (4) and (8)(a) are omitted. In subsection (9)—
In section 28C(4) (personal medical or dental services), for “13” there is substituted “16D”.
In section 28D (persons who may provide personal medical or personal dental services)—
in subsection (1), after paragraph (e) there is inserted—,
in subsection (2), in paragraph (a) of the definition of “qualifying body”, for “paragraphs (a) to (d)” there is substituted “paragraph (a), (b), (c), (d) or (f)”.
In section 29A(3)(b) of the 1977 Act (medical lists), for the words from first “disqualified” to “46” there is substituted “disqualified for inclusion in the list by, or by virtue of a direction of, the NHS Tribunal”.
In section 48 (disqualification provisions in Scotland or Northern Ireland)— Where under the conditional disqualification provisions in Scotland or Northern Ireland— the Secretary of State may, by a notice in writing given to each Health Authority and to the person in question, impose those conditions in relation to the provision by that person of those services under this Part of this Act. A notice under subsection (2) above may make such modifications of the conditions as the Secretary of State considers necessary for them to have the like effect in relation to England and Wales as they have in relation to Scotland or (as the case may be) Northern Ireland, but only if the Secretary of State has previously given the person concerned written notice of the proposed modifications and an opportunity (in accordance with such requirements, if any, as may be prescribed) to make representations about them. Conditions imposed by a notice under subsection (2) above shall cease to have effect if the Secretary of State withdraws the notice by giving written notice to the person concerned. In this section, “the conditional disqualification provisions in Scotland or Northern Ireland” means any provisions in force in Scotland or Northern Ireland corresponding to sections 46C and (so far as relating to conditional disqualifications) 47 above
in paragraph (a), for the words from “services” to “above” there is substituted “any of the services mentioned in any of the paragraphs of section 46(8) above”,
in paragraph (b), at the beginning there is inserted “in relation to the services in question” and for the words from “a list” to the end there is substituted “any list and (if also the subject of a declaration under those provisions corresponding to a declaration of unfitness) be treated as if a declaration of unfitness had been made in respect of him.”
In section 49 (regulations as to sections 46 to 48)—
in paragraph (c), after “disqualifications” there is inserted “or conditions”,
at the end of that section there is inserted—
In section 49A (application for interim suspension)—
after subsection (1) there is inserted—,
in subsection (2), for the words from “it” to “patients” there is substituted “either of the conditions for doing so is satisfied” and after “in question” there is inserted “or the case to which the review in question,”,
after that subsection there is inserted—,
in subsection (3)(c), for the words from “under” to “engaged in” there is substituted “of unfitness in relation to”,
in subsection (4), after “case” there is inserted “or review”,
subsection (5) is omitted,
in subsection (6)(a), “prepared under this Part of this Act” is omitted.
In section 49B (continuation of suspension pending appeal)—
for subsection (1) and the preceding sidenote there is substituted—,
in subsection (2), in paragraph (a), for “direction under section 46(2)(b) above” there is substituted “national disqualification” and, in paragraph (b), for “that direction” there is substituted “the disqualification”,
in subsection (3), for the words from “direction” to “section 46(2)(c) above” there is substituted “disqualification which is not coupled with a declaration of unfitness”,
subsection (4) is omitted.
In section 49D (suspension provisions in Scotland or Northern Ireland), for “46(1)” there is substituted “46(8)”.
In section 51 (university clinical teaching and research)—
in subsection (2), for “or Special Health Authority” in both places there is substituted “Special Health Authority or Primary Care Trust”,
in subsection (3), after “Special Health Authorities” there is inserted—.
Section 65(3) (accommodation and services for private patients: directions) is omitted.
In section 85 (default powers), after subsection (1)(b) there is inserted—.
In section 86 (emergency powers), in paragraph (b), the words from “and it shall” to the end are omitted.
In section 91 (private trusts for hospitals)—
in subsection (3), for paragraphs (aa) to (b) there is substituted—,
in subsection (4), “to a trust for a special hospital, or” is omitted.
In section 92 (further transfers of trust property)—
in subsection (1A), after “NHS trust” (in both places) there is inserted “or a Primary Care Trust”,
after subsection (6) there is inserted—
In section 96 (trusts: supplementary provisions), after “90 to 95 above” (in both places) there is inserted “and 96B below”.
Section 96A (power of health authorities etc. to raise money) is amended as follows. In subsection (5)(b), “on behalf” is omitted. After subsection (5A) there is inserted— After subsection (10) there is inserted—
Section 97 (public funding of Health Authorities and Special Health Authorities) is amended as follows. In subsection (6), after paragraph (b) there is inserted—,
Section 97A(5) (duty to comply with directions) is omitted.
Section 98 (accounts and audit) is amended as follows. In subsection (1)— Before subsection (2A) there is inserted—
In section 99 (regulation of financial arrangements)—
in subsection (1), after paragraph (b) there is inserted—,
in subsection (3), the words from “and shall be complied with” to the end are omitted.
In section 103 (special arrangements as to payment of remuneration), in subsection (3)(a), after “trust” there is inserted “or a Primary Care Trust”.
In section 122(2) (recovery of charges), “as a simple contract debt” is omitted.
Section 126 (orders, regulations and directions) is amended as follows. In subsection (1)— In subsection (3A), after “Secretary of State” there is inserted “or by a Health Authority”. In subsection (3B), for “11 to 17” there is substituted “16D to 17B”. After subsection (3B) there is inserted— In subsection (4), for “incidental or supplemental” there is substituted “supplementary, incidental, consequential, transitory, transitional or saving”.
Section 128 (interpretation) is amended as follows. In subsection (1)— After that subsection there is inserted—
Schedule 5 (Health Authorities and Special Health Authorities) is amended as follows. In paragraph 9 (pay and allowances), in sub-paragraph (4), after “sub-committee of” there is inserted “, or joint committee or joint sub-committee including,”. In paragraph 10 (staff), in sub-paragraph (3), the words from “and it shall” to the end are omitted. In paragraph 12 (miscellaneous)— For sub-paragraph (1) of paragraph 15 (acting as principal), there is substituted—
In Schedule 7 (Community Health Councils), in paragraph 2 (regulations)—
in sub-paragraphs (d) and (e), after “Health Authorities” there is inserted “Primary Care Trusts”,
in sub-paragraphs (f) and (g), after “Health Authorities” there is inserted “and Primary Care Trusts”.
In Schedule 9 (NHS Tribunal), in paragraph 5A—
in sub-paragraph (2)(a), for “section 46” there is substituted “sections 46 to 46C”,
in sub-paragraph (2)(b), after “disqualification” there is inserted “conditional disqualification or declaration of unfitness”,
in sub-paragraph (2)(d), for the words from “the application” to the end there is substituted “section 49A(3) may be made to apply or continue to apply”.
The 1978 Act is amended as follows.
In section 9 (local consultative committees)—
in subsection (5), for “on the provision of services under this Act” there is substituted “and, where the Secretary of State so directs, an NHS trust on the provision of services under this Act or under a pilot scheme under section 1 of the National Health Service (Primary Care) Act 1997”,
in subsection (7), after “Health Boards” there is inserted “or, where the Secretary of State so directs, NHS trusts” and for “may be prescribed” there is substituted “the Secretary of State may direct”.
In section 10(4) (Common Services Agency)—
after “Health Boards” in the first place where it appears there is inserted “the NHS trusts”,
after “Health Boards” in the second place where it appears there is inserted “or of the NHS trusts”,
after “Health Boards” in the third place where it appears there is inserted “or NHS trusts”.
In section 12A(5) (NHS trusts)—
in paragraph (a), for “and directors” there is substituted “, directors and trustees”,
in paragraph (b), after “directors” there is inserted “, trustees,”,
in paragraph (c), after “directors” there is inserted “and trustees”,
in paragraph (d), for the words from “director” where it first appears to the end of the paragraph there is substituted “trustee, to be regarded as an executive director rather than as a trustee”.
In section 17A (NHS contracts)—
in subsection (2)—
after paragraph (a) there is inserted—,
after paragraph (k) there is inserted—,
paragraphs (d) and (j) are omitted,
in subsection (3), paragraph (a) and the word “and” following it are omitted.
In section 17E (personal medical and dental services: regulations), subsection (4) is omitted.
In section 19A(3)(b) (medical lists), for the words from first “disqualified” to “29” there is substituted “disqualified for inclusion in the list by, or by virtue of a direction of, the NHS Tribunal”.
Section 31 (disqualification provisions in England and Wales or Northern Ireland) is renumbered as subsection (1) of that section and—
in paragraph (a), for the words from “services” to “29(1)” there is substituted “any of the services mentioned in one of the paragraphs of section 29(8)”,
in paragraph (b), at the beginning, there is inserted “in relation to the services in question” and for the words from “a list” to the end there is substituted “any list and (if also the subject of such a declaration under those provisions corresponding to a declaration of unfitness) be treated as if a declaration of unfitness had been made in respect of him”,
after that subsection there is inserted—
Section 32 (regulations as to sections 29 to 31) is renumbered as subsection (1) of that section and—
in paragraph (c) after “disqualification” in both places where it occurs there is inserted “or condition”,
after that subsection there is inserted—
In section 32A (applications for interim suspension)—
after subsection (1) there is inserted—,
in subsection (2), for the words from “it” to “patients” there is substituted “either of the conditions for doing so is satisfied” and after “in question” there is inserted “or the case to which the review in question”,
after that subsection there is inserted—,
in subsection (3)(c), for the words from “under” to “engaged in” there is substituted “of unfitness in relation to”,
in subsection (4), after “case” there is inserted “or review”,
subsection (5) is omitted'
in subsection (6)(a), “prepared under this Part of this Act” is omitted.
In section 32B (continuation of suspension pending appeal)—
for subsection (1) and the preceding sidenote there is substituted—,
in subsection (2), in paragraph (a), for “direction under section 29(2)(b)” there is substituted “national disqualification” and, in paragraph (b), for “that direction” there is substituted “the disqualification”,
in subsection (3), for the words from “direction” to “section 29(3)(c)” there is substituted “disqualification which is not coupled with a declaration of unfitness”,
subsection (4) is omitted.
In section 32D (suspension provisions in England and Wales or Northern Ireland), for “29(1)” there is substituted “29(8)”.
After section 35 there is inserted—
In section 85A (financial duties of certain bodies)—
in subsection (1), before “85(1)” in both places where it occurs there is inserted “85AA(1) or” and for “85(2)(a)” there is substituted “85AA(3)”,
in subsection (2), for “Subsection (3) of section 85” there is substituted “Subsection (9) of section 85AA”,
in subsection (3), before “85(1)” there is inserted “85AA(1) or”,
in subsection (6), in paragraph (c) before “85(1)” there is inserted “85AA(1)” and for “85(2)(a)” there is substituted “85AA(3)”.
In section 85B(2) (bodies in respect of which schemes for meeting losses and liabilities may be made)—
the “and” after paragraph (c) is omitted,
after paragraph (d) there is insertedand.
In section 86 (accounts of Health Boards and the Agency), subsections (1A), (1C) and (5) are omitted.
Section 87D (indicative amounts for doctors' practices) is omitted.
In section 102 (state hospitals), for paragraph (b) of subsection (4) there is substituted—
In section 105(7) (orders, regulations and directions), for “incidental or supplemental” there is substituted “supplementary, incidental, consequential, transitory, transitional or saving”.
In section 108(1) (interpretation)—
“goods” includes accommodation
“state hospital” has the meaning indicated in section 102(2)
In Schedule 7A (NHS trusts)—
for any reference to a non-executive director or to non-executive directors there is substituted a reference to a trustee or, as the case may be, to trustees,
in paragraph 16(c), the words from “which purposes shall include” to the end are omitted,
in paragraph 22, in sub-paragraph (1), in paragraph (c) the words from “or is within” to the end of the paragraph, and “or Health Authority” are omitted,
paragraph 23 is omitted.
Schedule 7B (financial provisions relating to NHS trusts) is amended as follows. In paragraph 6 (surplus funds)— For paragraph 7 of that Schedule (investment) there is substituted— After that paragraph there is inserted—
In Schedule 8 (the Tribunal), in paragraph 8—
in sub-paragraph (2)(a), for “section 29” there is substituted “sections 29 to 29C”,
in sub-paragraph (2)(b), after “disqualification” there is inserted “conditional disqualification or declaration of unfitness”,
in sub-paragraph (2)(d), for the words from “the application” to the end there is substituted “section 32A(3) may be made to apply or continue to apply”.
The Mental Health Act 1983 is amended as follows.
In section 122(1) (provision of pocket money for in-patients in hospital), “special hospitals or other hospitals being” is omitted.
In section 123 (transfers to and from special hospitals)—
in subsection (1), “in a special hospital” is omitted, after “above)” there is inserted “in a hospital at which high security psychiatric services are provided” and for “other special hospital” there is substituted “other hospital at which those services are provided”,
in subsection (2), for “which is not a special hospital” there is substituted “at which those services are not provided”.
In section 134 (correspondence of patients)—
in subsection (1)(b), for “a special hospital” there is substituted “one at which high security psychiatric services are provided”,
in subsection (2), for “in a special hospital under this Act” there is substituted “under this Act in a hospital at which high security psychiatric services are provided”.
Section 145 (interpretation) is amended as follows. In subsection (1)— After that subsection there is inserted—
In section 125(1) (interpretation) of the Mental Health (Scotland) Act 1984, in the definition of “managers of a hospital”, in paragraph (c) after “Health Board” there is inserted “, to a Special Health Board, to an NHS trust” and after “that Board” there is inserted “, trust”.
In section 1 of the Hospital Complaints Procedure Act 1985 (complaints procedures for hospitals managed by health authorities and NHS trusts)—
in subsection (1), the words from “under” to “functions)” and “for the management of” are omitted and for “are responsible” there is substituted “manage”,
in subsection (1A), for “is responsible for the management of” there is substituted “manages”, “for the management of” is omitted and for “is responsible” there is substituted “manages”,
after subsection (1A) there is inserted—
If requested to do so by the Commission in any particular case, the Audit Commission may join with the Commission in exercising—
the Commission’s functions under section 20(1)(b) or (d), or
any functions of the Commission—
which are conferred under section 20(1)(e),
which correspond to its functions under section 20(1)(b), and
which relate to Health Authorities or Special Health Authorities.
If requested to do so by the Audit Commission in any particular case, the Commission may assist the Audit Commission in the exercise of its functions under section 33(1) of the Audit Commission Act 1998 so far as they relate to any body specified in section 98(1) of the 1977 Act.
For the purposes of subsection (1), the Commission’s functions under paragraph (b) or (d) of section 20(1) are to be treated as including the function of conducting and making reports on studies designed to improve—
economy, efficiency and effectiveness in the performance of any functions of the persons mentioned in that paragraph, and
the management of those persons.
For the purposes of subsection (1), the Commission’s functions mentioned in subsection (1)(b) are to be treated as including the function of conducting and making reports on studies designed to improve—
economy, efficiency and effectiveness in the performance of any functions of the bodies mentioned in subsection (1)(b)(iii) to which those functions of the Commission relate, and
the management of those bodies.
Any report prepared by virtue of subsection (1) is to be prepared by the Commission acting in conjunction with the Audit Commission.
The Audit Commission may not act as mentioned in subsection (1) unless, before it does so, the Commission has agreed to pay the Audit Commission an amount equal to the full costs incurred by the Audit Commission in so acting.
The Commission may not act as mentioned in subsection (2) unless, before it does so, the Audit Commission has agreed to pay the Commission an amount equal to the full costs incurred by the Commission in so acting.
Any reference in subsection (5) or (6) to subsection (1) is a reference to that subsection as read with subsections (3) and (4).
In this section “the Audit Commission” means the Audit Commission for Local Authorities and the National Health Service in England and Wales.
Arrangements may be made between the Commission and a Minister of the Crown—
for the Commission to perform any of its functions in relation to any prescribed health scheme for which the Minister has responsibility, or
for the Commission to provide services or facilities in so far as they are required by the Minister in connection with any such health scheme.
Arrangements may be made between the Commission and a Northern Ireland Minister—
for the Commission to perform on behalf of the Minister any functions of the Minister which—
correspond to any functions of the Commission, and
relate to the Northern Irish health service, or
for the Commission to provide services or facilities in so far as they are required by the Minister in connection with the exercise by him of any such functions.
Arrangements under this section may be made on such terms and conditions as may be agreed between the parties to the arrangements.
Those terms and conditions may include provision with respect to the making of payments to the Commission in respect of the cost to the Commission of performing or providing any functions, services or facilities under the arrangements.
Any arrangements under subsection (2)(a) are not to affect the responsibility of the Northern Ireland Minister on whose behalf any functions are exercised.
In this section—
“medicinal product” has the meaning given by section 130 of the Medicines Act 1968,
“regulatory body”, in relation to any profession, means the body (or main body) responsible for the regulation of the profession,
“Part II practitioner” means a person who provides (or, at any time since 31st March 1996, has provided) general medical services, general dental services, general ophthalmic services or pharmaceutical services in accordance with arrangements made or treated as made (or which, but for any of the relevant defects, would have been made or treated as made) under Part II of the 1977 Act,
“Scottish border area” means the area of any Health Board adjacent to England.
The Secretary of State may by regulations make provision—
conferring a right on persons authorised by the Commission to enter NHS premises at such times, in such cases, for such purposes and on such conditions as may be prescribed in order—
to inspect those premises, or
to inspect and take copies of prescribed documents held by prescribed persons on those premises,
requiring prescribed persons at such times, at such places, in such cases and for such purposes as may be prescribed to produce prescribed documents or information, or make reports, to the Commission or to persons authorised by the Commission,
requiring prescribed persons at such times, at such places, in such cases and for such purposes as may be prescribed to provide to the Commission, or to persons authorised by the Commission, an explanation of—
any matters which are the subject of the exercise of any functions of the Commission, or
any documents or information inspected, copied or produced as mentioned in paragraph (a) or (b).
Regulations under this section may not make provision with respect to the disclosure of confidential information which relates to and identifies a living individual unless one or more of the following conditions is satisfied—
the information is disclosed in a form in which the identity of the individual cannot be ascertained,
the individual consents to the information being disclosed,
the individual cannot be traced despite the taking of all reasonable steps,
in a case where the Commission is exercising its functions under section 20(1)(c)—
it is not practicable to disclose the information in a form in which the identity of the individual cannot be ascertained,
the Commission considers that there is a serious risk to the health or safety of patients arising out of the matters which are the subject of the exercise of those functions, and
having regard to that risk and the urgency of the exercise of those functions, the Commission considers that the information should be disclosed without the consent of the individual.
Regulations under this section may not make provision with respect to the disclosure of information if that disclosure would be prohibited by or under any other enactment; but where information is held in a form in which the prohibition operates by reason of the fact that the information is capable of identifying an individual, regulations under this section may make provision with respect to the disclosure of the information in a form in which the identity of the individual cannot be ascertained.
Any person who without reasonable excuse— is guilty of an offence and liable on summary conviction to a fine not exceeding level 3 on the standard scale.
obstructs a person authorised by the Commission in the exercise of any right conferred by virtue of subsection (1)(a), or
fails to comply with any requirement imposed by virtue of subsection (1)(b) or (c),
In this section any reference to documents includes a reference to information held by means of a computer or in any other electronic form; and in the case of information so held, regulations under this section may make provision for it to be made available or produced in a visible and legible form.
In this section—
A person who, without lawful authority, knowingly or recklessly discloses information which— is guilty of an offence if the disclosure is made during the lifetime of the individual to whom the information relates.
falls within section 23(2), and
has been obtained by the Commission in accordance with any condition mentioned in section 23(2),
A person who, without lawful authority, knowingly or recklessly discloses information which— is guilty of an offence if the disclosure is made during the lifetime of that individual.
relates to and identifies an individual,
has been obtained by the Commission on terms or in circumstances requiring it to be held in confidence, and
does not fall within subsection (1),
A person guilty of an offence under this section is liable—
on summary conviction, to imprisonment for a term not exceeding 6 months or to a fine not exceeding the statutory maximum or to both, or
on conviction on indictment, to imprisonment for a term not exceeding two years or to a fine or to both.
It is not an offence under this section—
to disclose information in a form in which the individual to whom the information relates is not identified, or
to disclose information which has previously been disclosed to the public with lawful authority.
It is a defence for a person charged with an offence under this section to prove that at the time of the alleged offence—
he believed that he was making the disclosure in question with lawful authority and had no reasonable cause to believe otherwise, or
he believed that the information in question had previously been disclosed to the public with lawful authority and had no reasonable cause to believe otherwise.
For the purposes of this section a disclosure of information is to be regarded as made with lawful authority if, and only if, it is made—
with the consent of the individual to whom the information relates,
for the purpose of facilitating the exercise of any functions of the Commission,
for the purpose of facilitating the conduct of any investigation under the Health Service Commissioners Act 1993,
in accordance with any enactment or order of a court,
in connection with the investigation of a serious arrestable offence,
for the purposes of criminal proceedings in any part of the United Kingdom,
in a case where the information appears to the Commission to reveal— and the person to whom the information is disclosed is a person to whom the Commission considers that it should be disclosed in order for appropriate action to be taken, or
that the performance of a health professional in his capacity as such has or may have fallen substantially below that which is expected,
that a health professional has or may have been guilty of serious professional misconduct, or
that the fitness of a health professional to practise as such is or may be seriously impaired by reason of his physical or mental condition,
in a case where—
the information reveals that a person is likely to constitute a threat to the health or safety of individuals, and
the person to whom it is disclosed is a person to whom the Commission considers that the information should be disclosed in the interests of the health and safety of individuals.
For the purposes of subsection (2), information obtained by the Commission is to be regarded as identifying an individual if the individual can be identified—
from that information, or
from that information and from other information obtained by the Commission.
For the purposes of subsection (4)(a), information disclosed by a person is not to be regarded as being in a form in which an individual is not identified if the individual can be identified—
from that information, or
from that information and from other information disclosed—
by the Commission, or
by any member or employee of the Commission.
Any reference in subsection (1), (2), (7) or (8)(b)(i) to the Commission includes a reference to any person authorised by the Commission under section 23.
In this section—
The Clinical Standards Advisory Group is to cease to exist.
It is the duty of Health Authorities, Special Health Authorities, Primary Care Trusts and NHS trusts to co-operate with each other in exercising their functions.
Section 22 of the 1977 Act (co-operation between health authorities and local authorities) is amended as follows.
For subsection (1) (co-operation between Health Authorities and Special Health Authorities on the one hand and local authorities on the other) there is substituted—
It is the duty of each Health Authority, at such times as the Secretary of State may direct, to prepare a plan which sets out a strategy for improving—
the health of the people for whom they are responsible, and
the provision of health care to such people.
It is the duty of each Health Authority to keep under review any plan prepared by them under this section.
It is the duty of the bodies specified in subsection (4) to participate in the preparation or review by a Health Authority of any plan under this section.
Those bodies are—
any Primary Care Trust whose area falls within the area of the Health Authority,
any NHS trust which provides services at or from a hospital or other establishment or facility which falls within the area of the Health Authority, and
any local authority whose area falls wholly or partly within the area of the Health Authority.
In preparing or reviewing any plan under this section, a Health Authority—
must consult, or seek the participation of, such persons as the Secretary of State may direct, and
may consult, or seek the participation of, such other persons as they consider appropriate.
The Secretary of State may give directions—
as to the periods to be covered by plans under this section,
as to the action to be taken by Health Authorities, Primary Care Trusts, NHS trusts and local authorities in connection with the preparation or review of plans under this section,
as to the matters to be taken into account in connection with the preparation or review of plans under this section,
as to the matters to be dealt with by plans under this section,
as to the form and content of plans under this section,
as to the publication of plans prepared or reviewed under this section,
as to the sharing of information between Health Authorities, Primary Care Trusts, NHS trusts and local authorities in connection with the preparation or review of plans under this section,
as to the provision by Health Authorities of reports or other information to the Secretary of State in connection with plans under this section.
In exercising their respective functions—
Health Authorities must have regard to any plan prepared or reviewed by them under this section, and
Primary Care Trusts, NHS trusts and local authorities must have regard to any plan under this section in relation to which they have participated.
For the purposes of this section, the persons for whom a Health Authority are responsible are—
the people in the Authority’s area, and
such of the people outside the Authority’s area as may be specified in directions given by the Secretary of State.
It is the duty of Health Authorities, Primary Care Trusts, NHS trusts and local authorities to comply with any directions under this section which relate to them.
In this section—
“local authority” means a county council, a county borough council, a district council, a London borough council or the Common Council of the City of London.
Section 28A of the 1977 Act (power to make payments towards expenditure on community services) is amended as follows.
In subsection (1) (authorities to which section applies)—
for “authorities” there is substituted “bodies”,
for paragraph (b) (which specifies a Special Health Authority established for a London Post-Graduate Teaching Hospital) there is substituted—.
After subsection (2) there is inserted—
After section 28B of the 1977 Act there is inserted—
The Secretary of State may by regulations make provision for or in connection with enabling prescribed NHS bodies (on the one hand) and prescribed local authorities (on the other) to enter into prescribed arrangements in relation to the exercise of— if the arrangements are likely to lead to an improvement in the way in which those functions are exercised.
prescribed functions of the NHS bodies, and
prescribed health-related functions of the local authorities,
The arrangements which may be prescribed include arrangements—
for or in connection with the establishment and maintenance of a fund—
which is made up of contributions by one or more NHS bodies and one or more local authorities, and
out of which payments may be made towards expenditure incurred in the exercise of both prescribed functions of the NHS body or bodies and prescribed health-related functions of the authority or authorities,
for or in connection with the exercise by an NHS body on behalf of a local authority of prescribed health-related functions of the authority in conjunction with the exercise by the NHS body of prescribed functions of theirs,
for or in connection with the exercise by a local authority on behalf of an NHS body of prescribed functions of the NHS body in conjunction with the exercise by the authority of prescribed health-related functions of theirs,
as to the provision of staff, goods, services or accommodation in connection with any arrangements mentioned in paragraph (a), (b) or (c),
as to the making of payments by a local authority to an NHS body in connection with any arrangements mentioned in paragraph (b),
as to the making of payments by an NHS body to a local authority in connection with any arrangements mentioned in paragraph (c).
Regulations under this section may make provision—
as to the cases in which NHS bodies and local authorities may enter into prescribed arrangements,
as to the conditions which must be satisfied in relation to prescribed arrangements (including conditions in relation to consultation),
for or in connection with requiring the consent of the Secretary of State to the operation of prescribed arrangements (including provision in relation to applications for consent, the approval or refusal of such applications and the variation or withdrawal of approval),
in relation to the duration of prescribed arrangements,
for or in connection with the variation or termination of prescribed arrangements,
as to the responsibility for, and the operation and management of, prescribed arrangements,
as to the sharing of information between NHS bodies and local authorities.
The provision which may be made by virtue of subsection (3)(f) includes provision in relation to—
the formation and operation of joint committees of NHS bodies and local authorities,
the exercise of functions which are the subject of prescribed arrangements (including provision in relation to the exercise of such functions by joint committees or employees of NHS bodies and local authorities),
the drawing up and implementation of plans in respect of prescribed arrangements,
the monitoring of prescribed arrangements,
the provision of reports on, and information about, prescribed arrangements,
complaints and disputes about prescribed arrangements,
accounts and audit in respect of prescribed arrangements.
Any arrangements made by virtue of this section shall not affect—
the liability of NHS bodies for the exercise of any of their functions,
the liability of local authorities for the exercise of any of their functions, or
any power or duty to recover charges in respect of services provided in the exercise of any local authority functions.
The Secretary of State may issue guidance to NHS bodies and local authorities in relation to consultation or applications for consent in respect of prescribed arrangements.
The reference in subsection (1) to an improvement in the way in which functions are exercised includes an improvement in the provision to any individuals of any services to which those functions relate.
In this section—
“NHS body” means a Health Authority, Primary Care Trust or NHS trust,
“prescribed” means prescribed to any extent by regulations made by the Secretary of State.
In section 22 of the 1977 Act (co-operation between health authorities and local authorities), subsections (2) to (6) (which make provision in relation to joint consultative committees) are omitted.
The powers conferred by this section may be exercised where there is in existence a scheme (referred to in this section and sections 34 and 35 as a voluntary scheme) made by the Secretary of State and the industry body for the purpose of—
limiting the prices which may be charged by any manufacturer or supplier to whom the scheme relates for the supply of any health service medicines, or
limiting the profits which may accrue to any manufacturer or supplier to whom the scheme relates in connection with the manufacture or supply of any health service medicines.
For the purposes of this section and sections 34 and 35, a voluntary scheme is to be treated as applying to a manufacturer or supplier to whom it relates if—
he has consented to the scheme being so treated (and has not withdrawn that consent), and
no notice is in force in his case under subsection (4).
For the purposes of this section a voluntary scheme has effect, in relation to a manufacturer or supplier to whom it applies, with any additions or modifications made by him and the Secretary of State.
If any acts or omissions of any manufacturer or supplier to whom a voluntary scheme applies (a “scheme member”) have shown that, in the scheme member’s case, the scheme is ineffective for either of the purposes mentioned in subsection (1), the Secretary of State may by a written notice given to the scheme member determine that the scheme is not to apply to him.
A notice under subsection (4) must give the Secretary of State’s reasons for giving the notice; and the Secretary of State may not give a notice under that subsection until he has given the scheme member an opportunity to make representations about the acts or omissions in question.
Consent under subsection (2)(a) must be given, or withdrawn, in the manner required by the Secretary of State.
The Secretary of State may after consultation with the industry body require any manufacturer or supplier to whom a voluntary scheme applies to— which the Secretary of State may require for the purpose of enabling the scheme to operate or facilitating its operation or for the purpose of giving full effect to any provision made under subsection (8).
record and keep any information, and
provide any information to the Secretary of State,
The Secretary of State may—
prohibit any manufacturer or supplier to whom a voluntary scheme applies from increasing any price charged by him for the supply of any health service medicine covered by the scheme without the approval of the Secretary of State, and
provide for any amount representing any increase in contravention of that prohibition in the sums charged by that person for that medicine, so far as the increase is attributable to supplies to the health service, to be paid to the Secretary of State within a specified period.
The Secretary of State may, after consultation with the industry body—
limit any price which may be charged by any manufacturer or supplier for the supply of any health service medicine, and
provide for any amount representing sums charged by that person for that medicine in excess of the limit to be paid to the Secretary of State within a specified period.
The powers conferred by this section are not exercisable at any time in relation to a manufacturer or supplier to whom at that time a voluntary scheme applies.
The Secretary of State may, after consultation with the industry body, make a scheme (referred to in this section and section 36 as a statutory scheme) for the purpose of—
limiting the prices which may be charged by any manufacturer or supplier for the supply of any health service medicines, or
limiting the profits which may accrue to any manufacturer or supplier in connection with the manufacture or supply of any health service medicines.
A statutory scheme may, in particular, make any provision mentioned in subsections (3) to (6).
The scheme may require any manufacturer or supplier to whom it applies to—
record and keep information, and
provide information to the Secretary of State.
The scheme may provide for any amount representing sums charged by any manufacturer or supplier to whom the scheme applies, in excess of the limits determined under the scheme, for health service medicines covered by the scheme to be paid by that person to the Secretary of State within a specified period.
The scheme may provide for any amount representing the profits, in excess of the limits determined under the scheme, accruing to any manufacturer or supplier to whom the scheme applies in connection with the manufacture or supply of health service medicines covered by the scheme to be paid by that person to the Secretary of State within a specified period.
The scheme may—
prohibit any manufacturer or supplier to whom the scheme applies from increasing, without the approval of the Secretary of State, any price charged by him for the supply of any health service medicine covered by the scheme, and
provide for any amount representing any increase in contravention of that prohibition in the sums charged by that person for that medicine, so far as the increase is attributable to supplies to the health service, to be paid to the Secretary of State within a specified period.
A statutory scheme may not apply to a manufacturer or supplier to whom a voluntary scheme applies.
The Secretary of State may, after consultation with the industry body, make any provision he considers necessary or expedient for the purpose of enabling or facilitating—
the introduction of a statutory scheme or of a limit under section 34, or
the determination of the provision to be made in a proposed statutory scheme.
The provision may, in particular, require any person to whom such a scheme or limit may apply to—
record and keep information,
provide information to the Secretary of State.
Where the Secretary of State is preparing to make or vary a statutory scheme, he may make any provision he considers necessary or expedient for transitional or transitory purposes which could be made by such a scheme.
Regulations may provide for a person who contravenes any provision of regulations or directions under sections 33 to 36 to be liable to pay a penalty to the Secretary of State.
The penalty may be—
a single penalty not exceeding £100,000, or
a daily penalty not exceeding £10,000 for every day on which the contravention occurs or continues.
Regulations may provide for any amount required to be paid to the Secretary of State by virtue of section 33(8)(b), 34(1)(b) or 35(4) or (6)(b) to be increased by an amount not exceeding 50 per cent.
Regulations may provide for any amount payable to the Secretary of State by virtue of provision made under section 33(8)(b), 34(1)(b) or 35(4), (5) or (6)(b) (including such an amount as increased under subsection (3)) to carry interest at a rate specified or referred to in the regulations.
Provision may be made by regulations for conferring on manufacturers and suppliers a right of appeal against enforcement decisions taken in respect of them in pursuance of sections 33 to 36 and this section.
The provision which may be made by virtue of subsection (5) includes any provision which may be made by model provisions with respect to appeals under section 6 of the Deregulation and Contracting Out Act 1994, reading—
the references in subsections (4) and (5) of that section to enforcement action as references to action taken to implement an enforcement decision,
in subsection (5) of that section, the references to interested persons as references to any persons and the reference to any decision to take enforcement action as a reference to any enforcement decision.
In subsections (5) and (6), “enforcement decision” means a decision of the Secretary of State or any other person to— and in this subsection “specific” means specified in the decision.
require a specific manufacturer or supplier to provide information to him,
limit, in respect of any specific manufacturer or supplier, any price or profit,
refuse to give his approval to a price increase made by a specific manufacturer or supplier,
require a specific manufacturer or supplier to pay any amount (including an amount by way of penalty) to him,
A requirement or prohibition, or a limit, under sections 33 to 36 may only be enforced under this section and may not be relied on in any proceedings other than proceedings under this section.
In this section “regulations” means regulations made by the Secretary of State, and the Secretary of State must consult the industry body before making any regulations under this section.
The Secretary of State may by order increase (or further increase) either of the sums mentioned in subsection (2).
Any power conferred on the Secretary of State by sections 33(6) to (8) and 34 to 36 may be exercised by— and the regulations may themselves confer power for the Secretary of State to give directions to a specific manufacturer or supplier; and in this subsection “specific” means specified in the direction concerned.
making regulations, or
giving directions to a specific manufacturer or supplier,
Any power to make regulations under any of those provisions or section 37 may be exercised generally in relation to manufacturers or suppliers of health service medicines or be exercised in relation to any class of manufacturers or suppliers.
The powers to refuse approval under section 33(8)(a) or 35(6)(a) or to impose a limit under section 34(1)(a) or 35(1) are exercisable only with a view to limiting by reference to the prices or profits which would be reasonable in all the circumstances— the manufacture or supply for the purposes of the health service of health service medicines.
the prices which may be charged for, or
the profits which may accrue to any manufacturer or supplier in connection with,
In so exercising those powers (in the case of sections 34(1)(a) and 35(1) and (6)(a)) the Secretary of State and any other person must bear in mind, in particular, the need for medicinal products to be available for the health service on reasonable terms and the costs of research and development.
Section 57 of, and Schedule 11 to, the 1977 Act and section 49 of, and Schedule 10 to, the 1978 Act (maximum prices of medical supplies) are to cease to have effect in relation to health service medicines; but the powers conferred by sections 33 to 36 do not affect any other powers of the Secretary of State to control prices or profits.
This subsection and subsections (7) and (8) apply for the interpretation of sections 33 to 37 and this section—
References to contravention of a provision include failure to comply with it.
References to supplying medicines include selling them.
After section 122 of the 1977 Act there is inserted—
Any power conferred by section 37 of the 1977 Act or section 17 of the National Health Service (Primary Care) Act 1997 to confer functions on the Dental Practice Board includes, in particular, power to confer functions relating to the prosecution of offences concerning charges for the provision of dental treatment and appliances.
Sections 122A to 122C of the 1977 Act apply to charges which may be made and recovered under section 20 of the National Health Service (Primary Care) Act 1997 as they apply to charges under the 1977 Act which may be recovered under section 122(1) of that Act; and the reference in section 122A(7)(a) to the 1977 Act includes a reference to a pilot scheme (within the meaning of the 1997 Act).
For section 46 of the 1977 Act (disqualification of practitioners) there is substituted—
For section 47 of the 1977 Act (removal of disqualification) there is substituted—
For section 4 of the 1977 Act (special hospitals) there is substituted—
In section 145(1) of the Mental Health Act 1983 (interpretation), in the definition of “the managers”, paragraph (b) is omitted.
An NHS trust may not, as the provider, enter into an NHS contract for the provision of high security psychiatric services unless the NHS trust is approved for the purpose of this paragraph by the Secretary of State. Such approval—
After section 124 of the 1977 Act there is inserted—
Section 15 of the Health Service Commissioners Act 1993 (confidentiality of information) is amended as follows.
In subsection (1), at the beginning of paragraph (e) there is inserted “where the information is to the effect that any person is likely to constitute a threat to the health or safety of patients”.
Subsection (1A) is omitted.
In subsection (1B)—
for “such a case” there is substituted “a case within subsection (1)(e)”,
the words following “patients” are omitted.
In subsection (1C), for paragraphs (a) and (b) there is substituted—.
The Secretary of State may by order make such provision as he considers appropriate in consequence of the matters mentioned in subsection (2) (the “relevant defects”).
Those matters are—
the omission from Part III of Schedule 2 to the Health Authorities Act 1995 (Transitional Provisions) Order 1996 (which determined the relevant Health Authority in relation to any Family Health Services Authority in England whose locality comprised or formed part of the area of more than one Health Authority) of an entry for Bromley Family Health Services Authority,
the inclusion in Part III or IV of Schedule 1 to that order (which determined the relevant Health Authority in relation to any Family Health Services Authority whose locality comprised or formed part of the area of only one Health Authority) of an entry for any Family Health Services Authority in England or Wales whose locality comprised or formed part of the area of more than one Health Authority (and an entry for which should accordingly have been included in Part III or IV of Schedule 2 to that order),
the omission from column 2 of the entry for any Family Health Services Authority in Part III or IV of Schedule 2 to that order (which together with column 3 of that entry specified the relevant Health Authorities in relation to that Family Health Services Authority) of any Health Authority whose area or any part of whose area forms part of the locality of the Family Health Services Authority and which was not included in column 3 of that entry,
where— the treatment, incorrectly, by a Health Authority of a person included in that list as residing, or as not residing, in their area.
the locality of a Family Health Services Authority and the area of a Health Authority overlap but do not coincide, and
the Family Health Services Authority had compiled a list of persons residing in its locality,
Provision that may be made under subsection (1) includes, in particular—
provision amending the Health Authorities Act 1995 (Transitional Provisions) Order 1996,
provision transferring, or adding, the name of any Part II practitioner to any Part II list in which he is (or, at the material time, was) not included because of any of the relevant defects,
provision for treating anything done by or in relation to an acting authority or a person of any description identified by reference to an acting authority as having been done by or in relation to the proper authority or a person of that description identified by reference to the proper authority,
provision for treating anything done by or in relation to an acting authority or a person of any description identified by reference to an acting authority as having been so done in the exercise by them or him of functions on behalf of the proper authority or a person of that description identified by reference to the proper authority.
Any provision made by an order under this section may be made with effect from any date after 31st March 1996 specified in the order.
Provision contained in an order under this section by virtue of section 62(4) may include provision conferring functions on the Secretary of State.
In subsection (3)(b)—
in Part I of this Act as in the 1977 Act,
In subsection (3)(c) and (d), in relation to anything done by or in relation to a Health Authority or a person identified by reference to a Health Authority—
In the National Health Service (Scotland) Act 1978, sections 87A to 87C (which make provision in relation to fund-holding practices in Scotland) are to cease to have effect.
In section 12A of the 1978 Act (NHS trusts)—
in subsection (1), for paragraphs (a) and (b) there is substituted “to provide goods and services for the purposes of the health service”,
for subsection (4) there is substituted—
“provide” includes manage
Any order under section 12A(1) of that Act—
is to be treated as always having had effect with the omission of any obligation for the NHS trust to which the order relates to own land specified in the order, and
so far as any functions specified in it could have been specified under that provision as amended by this Act, is to be treated as having been made under that provision as so amended.
Any restriction preventing the acquisition by any NHS trust (including any NHS trust dissolved before the commencement of this section) of land merely because the land did not comprise a hospital or other establishment or facility previously managed or provided by a Health Board or the Agency is to be treated as never having had effect.
An order under section 63 of this Act may—
provide for any provision made by it for the purposes of, in consequence of, or for giving full effect to, this section to be treated as having had effect from a time before the commencement of this section,
make such provision about an NHS trust dissolved before that commencement.
In paragraph 3(2) of Schedule 7A to the 1978 Act (establishment orders), for “assume responsibility for the ownership and management of” there is substituted “provide services at”.
In paragraph 3 of Schedule 7B to that Act (borrowing limits), in sub-paragraph (1), for the words from “established” to “manage” there is substituted “which are required to provide services at or from”.
The 1978 Act is to be treated as always having had effect subject to the amendments made by this section.
After section 12A of the 1978 Act there is inserted—
In section 12A of the 1978 Act (NHS trusts), in subsection (3), for paragraph (a) there is substituted—.
Paragraph 6 of Schedule 7A to the 1978 Act is amended as follows.
In carrying out the functions for the time being conferred on it an NHS trust shall comply with any directions given to it by the Secretary of State, whether of a general or of a particular nature.
Sub-paragraph (2) is omitted.
After section 12C of the 1978 Act there is inserted—
After section 12G of the 1978 Act there is inserted—
For section 85 of the 1978 Act there is substituted—
Section 12E of the 1978 Act (originating capital debt of, and other financial provisions relating to, NHS trusts) is amended as provided in subsections (2) to (5).
In subsections (1), (2) and (3), for “originating capital debt” there is substituted “originating capital”.
For subsection (4) there is substituted—
Subsections (5) and (6) are omitted.
In subsection (7), for the words from “the terms” to the end there is substituted—.
In Schedule 7B to that Act—
in paragraph 3 (limits on indebtedness), sub-paragraph (2) is omitted,
in paragraph 5 (additional public dividend capital), sub-paragraph (2) is omitted.
This section applies to any NHS trust in existence immediately before commencement.
On commencement so much of the originating capital debt of the NHS trust as remains outstanding immediately before commencement is to be treated as the originating capital of the NHS trust and accordingly is public dividend capital.
Any reference in any enactment, instrument or other document to the originating capital debt of the NHS trust is to be construed (except where the context otherwise requires) as a reference to its originating capital.
The Secretary of State may with the consent of the Treasury determine the amount and time for payment of interest on the NHS trust’s initial loan in respect of the period ending with commencement.
In this section—
Schedule 7B to the 1978 Act is amended as follows.
In paragraph 1 (borrowing powers of NHS trusts), in sub-paragraph (1), after “Subject to” there is inserted “any direction given by the Secretary of State, to”.
Sub-paragraphs (3) to (5) of that paragraph are omitted.
It shall be for the Secretary of State, with the consent of the Treasury, to determine the terms of any loan made by him to an NHS trust (including terms as to the payment of interest, if any).
After section 28B of the 1978 Act there is inserted—
In section 19A of the 1978 Act (medical lists), at the beginning of subsection (3) there is inserted “Subject to any provision made under section 28C,”.
In section 25 of that Act (arrangements for provision of general dental services), in subsection (2)(b), the word “and” before sub-paragraph (iii) is omitted and after that sub-paragraph there is inserted; and.
In section 26 of that Act (arrangements for provision of general ophthalmic services), in subsection (2)(b), after “practitioners” there is inserted “and any provision made under section 28C”.
For sections 28A and 28B of the 1978 Act (regulations as to remuneration) there is substituted—
Sections 28A and 28B of the 1978 Act as substituted by this section have effect in relation to— and in this subsection “determinations” means determinations under Part II of the 1978 Act of the remuneration to be paid to persons who provide services mentioned in section 28A(1).
the making of determinations on or after the commencement of this section; and
the variation or revocation on or after the commencement of this section of determinations whenever made,
Section 7(4) of the Health and Social Security Act 1984 and section 15(3) of the Health and Medicines Act 1988 (determinations of remuneration for services under Part II of the 1978 Act deemed to be valid) have effect in relation to Scotland as if— there were inserted “and before the coming into force of section 57 of the Health Act 1999”.
after “inserted by this section” in section 7(4)(b) of the 1984 Act; and
after “section 7 of the Health and Social Security Act 1984” in section 15(3) of the 1988 Act,
For section 29 of the 1978 Act (disqualification of persons providing services) there is substituted—
For section 30 of the 1978 Act (removal of disqualification) there is substituted—
After section 99 of the 1978 Act there is inserted—
In section 105(3) of the 1978 Act (Parliamentary procedure for certain regulations) after “endowments)” there is inserted “or orders under section 99ZB(3)”.
Her Majesty may by Order in Council make provision—
modifying the regulation of any profession to which subsection (2) applies, so far as appears to Her to be necessary or expedient for the purpose of securing or improving the regulation of the profession or the services which the profession provides or to which it contributes,
regulating any other profession which appears to Her to be concerned (wholly or partly) with the physical or mental health of individuals and to require regulation in pursuance of this section.
The professions referred to in subsection (1)(a) are—
the professions regulated by the Pharmacy Act 1954, the Medical Act 1983, the Dentists Act 1984, the Opticians Act 1989, the Osteopaths Act 1993 and the Chiropractors Act 1994,
the professions regulated by the Nurses, Midwives and Health Visitors Act 1997,
the professions regulated by the Professions Supplementary to Medicine Act 1960,
any other profession regulated by an Order in Council under this section.
The Professions Supplementary to Medicine Act 1960 and the Nurses, Midwives and Health Visitors Act 1997 are to cease to have effect.
Schedule 3 (which makes further provision about Orders under this section) is to have effect.
Her Majesty may by Order in Council provide for any functions to which subsection (2) applies which are specified in the Order, so far as exercisable in respect of the provision of services to persons in English border areas, to be exercisable (instead of any corresponding function to which subsection (4) applies) in respect of the provision of the services in question to persons in Scottish border areas who are specified in the Order.
This subsection applies to any functions under the 1977 Act, or Part I of the National Health Service (Primary Care) Act 1997, which are exercisable by the Secretary of State or any Health Authority or Primary Care Trust.
Her Majesty may by Order in Council provide for any functions to which subsection (4) applies which are specified in the Order, so far as exercisable in respect of the provision of services to persons in Scottish border areas, to be exercisable (instead of any corresponding function to which subsection (2) applies) in respect of the provision of the services in question to persons in English border areas who are specified in the Order.
This subsection applies to any functions under the 1978 Act, or Part I of the National Health Service (Primary Care) Act 1997, which are exercisable by the Scottish Ministers or any Health Board or NHS trust established under the 1978 Act.
In this section—
in Part II of this Act as in the 1978 Act.
Any power to make regulations or an order under this Act is exercisable by statutory instrument.
Directions under section 20 or 28 or Schedule 2, or by virtue of section 38(1)(b), are to be given by an instrument in writing.
Any such directions may be varied or revoked by subsequent directions under, or by virtue of, the same provision.
Subsections (4) and (5) of section 126 of the 1977 Act (supplementary provisions about subordinate legislation) apply in relation to any power conferred by this Act to make Orders in Council, orders or regulations, or to give directions mentioned in subsection (2), as they apply in relation to the powers which may be exercised as mentioned in subsection (4)(a) and (b) of that section.
The provision which may be made by virtue of subsection (4) of that section in regulations under section 20 or 31 or an Order in Council under section 61 includes provision amending or repealing any enactment, instrument or document.
Subject to the following subsections, a statutory instrument containing subordinate legislation under this Act is to be subject to annulment in pursuance of a resolution of either House of Parliament.
Subsection (6) does not apply to—
an order under section 63 which contains only provision for or in connection with the transfer of any property, rights or liabilities, or
an order under section 67.
No order is to be made under section 37(10) unless a draft has been laid before, and approved by resolution of, each House of Parliament.
No recommendation is to be made to Her Majesty to make an Order in Council under section 60 unless a draft has been laid before, and approved by resolution of, each House of Parliament.
But if any provision made by an Order in Council under that section would, if it were included in an Act of the Scottish Parliament, be within the legislative competence of that Parliament, no recommendation is to be made to Her Majesty to make the Order unless a draft—
has been laid before, and approved by resolution of, each House of Parliament, and
has been laid before, and approved by resolution of, the Scottish Parliament.
No recommendation is to be made to Her Majesty to make an Order in Council under section 61 unless a draft—
has been laid before, and approved by resolution of, each House of Parliament, and
has been laid before, and approved by resolution of, the Scottish Parliament.
The Secretary of State may by order make— as he considers necessary or expedient for the purposes of, in consequence of or for giving full effect to any provision of this Act.
such supplementary, incidental or consequential provision, or
such transitory, transitional or saving provision,
The provision which may be made under subsection (1) includes provision amending or repealing any enactment, instrument or document.
In this Act—
Schedule 4 (amendments of enactments) is to have effect.
The repeals set out in Schedule 5 (which include the repeal of an enactment which is spent) are to have effect.
For the purposes of the Scotland Act 1998, any provision of this Act which extends to Scotland is to be taken to be a pre-commencement enactment within the meaning of that Act; but this subsection does not apply to section 22.
The power of a Minister of the Crown under section 67 to appoint a day for any of the following provisions to come into force in relation to Wales— is exercisable instead by the National Assembly for Wales.
sections 1 to 8 and 10 to 18 and Schedule 1,
sections 26 to 32,
section 65(1) and Schedule 4, so far as concerns the following provisions of that Schedule: paragraphs 1 to 16, 23 to 26, 27(a), 28 to 35, 37, 38 (except sub-paragraph (2)(b) and (d)), 39, 40, 71, 72, 74, 75, 76(b), 77 to 80, 81 (except sub-paragraph (2)(b)), 83, 84, 85 (except sub-paragraph (2)(a)) and 87 to 90,
In Schedule 5 to the Government of Wales Act 1998 (bodies and offices covered by section 74), after paragraph 12 there is inserted—
The National Assembly for Wales (Transfer of Functions) Order 1999 is amended as follows; and those amendments are to have effect as if made by an Order in Council under section 22 of the Government of Wales Act 1998 (transfer of Ministerial functions).
In Schedule 1—
in the entry for the 1977 Act, after paragraph (c) there is inserted—,
The references above to paragraph 1 of Schedule 3 are references to that paragraph before the amendments made by section 17 of the Health Act 1999. The Treasury consent requirement under paragraph 8 of that Schedule (inserted by Schedule 4 to the Health Act 1999), so far as relating to the matters referred to in paragraph (b) of that paragraph, shall continue in effect.
after the entry for the National Minimum Wage Act 1998 there is inserted—In the Health Act 1999—.
Health Act 1999 (c. 8) The functions of the Secretary of State under section 20(1) shall be exercisable only with the agreement of the Assembly. The functions of the Secretary of State under paragraphs 4 to 7 of Schedule 2 shall be exercisable only after consultation with the Assembly.
The preceding provisions of this Act (including the Schedules) are to come into force on such day as the Secretary of State may by order appoint.
Different days may be appointed under this section for different purposes.
Subsection (1) does not apply to the repeal of section 10 of the Professions Supplementary to Medicine Act 1960 (power to extend or restrict application of Act), which comes into force on 1st July 1999 or, if later, on the day on which this Act is passed.
Subsection (1) does not apply to section 66, of which—
subsections (1) and (3) to (6) come into force on the day on which this Act is passed,
subsection (2) comes into force on 1st July 1999 or, if later, the day on which this Act is passed.
Subject to the following provisions—
Part I extends only to England and Wales,
Part II extends only to Scotland, and
this Part extends to Northern Ireland (as well as to England and Wales and Scotland).
The amendment or repeal of an enactment, or a power to amend or repeal an enactment, which extends to any part of the United Kingdom extends also to that part.
Sections 22 and 25 extend to Scotland and Northern Ireland.
Sections 33 to 38 extend to Scotland and Northern Ireland.
The Secretary of State may by order provide that so much of this Act as extends to England and Wales is to apply to the Isles of Scilly with such modifications (if any) as are specified in the order; but otherwise this Act does not extend there.
This Act may be cited as the Health Act 1999.