Presentation by Prof. Stephen Stec, Visiting Professor, Department of Environmental Science and Policy

It is the Secretary of State's duty to continue the promotion in England and Wales of a comprehensive health service designed to secure improvement— and for that purpose to provide or secure the effective provision of services in accordance with this Act.

The services so provided shall be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.

It is the Secretary of State's duty to provide throughout England and Wales, to such extent as he considers necessary to meet all reasonable requirements—

Where any hospital provided by the Secretary of State in accordance with this Act was a voluntary hospital transferred by virtue of the National Health Service Act 1946, and—

Nothing in section 2 above or in this section affects the provisions of Part II of this Act (which relates to arrangements with practitioners for the provision of medical, dental, ophthalmic and pharmaceutical services).

It is the Secretary of State's duty—

The Secretary of State may—

Regulations may provide for the payment by the Secretary of State in such cases as may be prescribed of travelling expenses (including the travelling expenses of a companion) incurred or to be incurred by persons for the purpose of availing themselves of any services provided under this Act.

The Public Health Laboratory Service Board continues in being for the purpose of exercising such functions with respect to the administration of the public health laboratory service (the service referred to in paragraph (c) of subsection (2) above) as the Secretary of State may determine.

The Board shall continue to be constituted in accordance with Part I of Schedule 3 to this Act, and the additional provisions set out in Part II of that Schedule have effect in relation to the Board.

The Central Health Services Council (in this Act referred to as " the Central Council") shall have the duty of advising the Secretary of State upon such general matters relating to the services provided under this Act as the Council think fit, and upon any questions relating to those services which he may refer to them.

The Central Council shall be constituted in accordance with Schedule 4 to this Act, but the Secretary of State may by order vary that constitution after consultation with the Council; and the supplementary provisions of that Schedule have effect in relation to the Central Council and any standing advisory committee constituted under subsection (3) below.

The Secretary of State may, after consultation with the Central Council, by order constitute standing advisory committees for the purpose of advising him and the Council on such of the services provided under this Act as may be specified in the order.

Any committee so constituted shall consist partly of members of the Central Council appointed by the Secretary of State, and partly of persons (whether or not members of the Council) appointed by the Secretary of State after consultation with such representative organisations as he may recognise for the purpose.

It shall be the duty of a committee so constituted to advise the Secretary of State and the Central Council— and, if the committee advise the Secretary of State upon any matter, they shall inform the Council, who may express their views on the matter to the Secretary of State.

The Central Council shall make an annual report to the Secretary of State on their proceedings, and on the proceedings of any standing advisory committee constituted under subsection (3) above, and, subject to subsection (7) below, the Secretary of State shall lay that report before Parliament with such comments (if any) as he thinks fit.

If the Secretary of State, after consultation with the Central Council, is satisfied that it would be contrary to the public interest to lay any such report, or a part of any such report before Parliament, he may refrain from so laying that report or that part.

The Medical Practices Committee—

The Secretary of State may—

The Committee's proceedings shall not be invalidated by any vacancy in its membership or by any defect in a member's appointment or qualification.

It is the Secretary of State's duty to establish by order in accordance with Part I of Schedule 5 to this Act— and orders determining regions or areas in pursuance of this subsection shall be separate from orders establishing authorities for the regions or areas. Any reference in the following provisions of this Act to an Area Health Authority includes a reference to an Area Health Authority (Teaching) unless the context otherwise requires.

The Secretary of State may by order vary the region of a Regional Health Authority or the area of an Area Health Authority whether or not the variation entails the determination of a new or the abolition of an existing region or area.

It is the Secretary of State's duty to exercise the powers conferred on him by the preceding provisions of this section so as to secure—

An order made by virtue of subsection (2) above may (without prejudice to the generality of section 126(4) below) contain such provisions for the transfer of officers, property, rights and liabilities as the Secretary of State thinks fit.

It is the Secretary of State's duty before he makes an order under subsection (2) to consult with respect to the order—

An order establishing an Authority in pursuance of paragraph (b) of section 8(1) above may provide for it to be called an Area Health Authority (Teaching) if and only if the Secretary of State is satisfied that the Authority is to provide for a university or universities substantial facilities for undergraduate or post-graduate clinical teaching.

Where the Secretary of State is satisfied that an Area Health Authority is to provide, or is providing such facilities, he may provide by order for the Authority to be called an Area Health Authority (Teaching), and, where he is satisfied that an Area Health Authority (Teaching) no longer provides such facilities, he may provide by order for the Authority to be called an Area Health Authority.

It is the Secretary of State's duty, before providing that an Authority shall be called or cease to be called an Area Health Authority (Teaching), to consult the university or universities concerned with the facilities in question.

If the Secretary of State considers that a special body should be established for the purpose of performing any functions which he may direct the body to perform on his behalf, or on behalf of an Area Health Authority or a Family Practitioner Committee, he may by order establish a body for that purpose.

The Secretary of State may, subject to the provisions of Part III of Schedule 5 to this Act, make such further provision relating to that body as he thinks fit.

A body established in pursuance of this section shall (without prejudice to the power conferred by subsection (4) below to allocate a particular name to the body) be called a special health authority.

Without prejudice to the generality of the power conferred by this section to make an order (or of section 126(4) below), that order may in particular contain provisions as to—

It is the Secretary of State's duty before he makes such an order to consult with respect to the order such bodies as he may recognise as representing officers who in his opinion are likely to be transferred or affected by transfers in pursuance of the order.

The Secretary of State may direct a Regional Health Authority, an Area Health Authority of which the area is in Wales or a special health authority to exercise on his behalf such of his functions relating to the health service as are specified in the directions, and (subject to section 14 below) it shall be the duty of the body in question to comply with the directions.

The Secretary of State's functions under subsection (1) above—

A Regional Health Authority may direct any Area Health Authority of which the area is included in its region to exercise such of the functions exercisable by the Regional Health Authority by virtue of section 13 above as are specified in the directions, and it is the Area Health Authority's duty to comply with the directions.

If the Secretary of State directs a Regional Health Authority to secure that any of its functions specified in his directions are or are not exercisable by an Area Health Authority it is the Regional Health Authority's duty to comply with his directions.

It is the duty of each Family Practitioner Committee, in accordance with regulations—

If it appears to the Secretary of State that, in consequence of regulations made by virtue of the preceding provisions of this section, references to an Area Health Authority in particular provisions of this Act should be construed as references to a Family Practitioner Committee, he may by regulations provide accordingly.

Regulations may provide for functions exercisable by virtue of the provisions of sections 13 to 15 above by a body other than an Area Health Authority, or exercisable by virtue of any provision of this Act by an Area Health Authority, to be exercisable on behalf of the body in question—

For the purposes of subsection (1) above, a Regional or Area Health Authority or a Family Practitioner Committee is equivalent to another body of the same name and a special health authority is equivalent to another such authority.

Nothing in this section shall be construed as precluding any body from acting by an agent where it is entitled so to act apart from this section.

Any directions given by the Secretary of State in pursuance of sections 13 to 17 above shall be given either by regulations or by an instrument in writing, except that— shall only be given by regulations.

Any directions given by an Authority in pursuance of sections 13 to 17 shall be given by an instrument in writing.

Directions given and regulations made under sections 13 to 17 in respect of any function— so, however, that an Area Health Authority shall not be entitled to exercise any functions which, by virtue of section 15 above, are exercisable by the Family Practitioner Committee established by the Authority.

Where the Secretary of State is satisfied that a committee formed for Wales, or for the region of a Regional Health Authority, is representative of persons of any of the following categories— of Wales or of the region, then it shall be his duty to recognise the committee.

A committee recognised in pursuance of subsection (1) above shall be called—

Where the Secretary of State is satisfied that a committee formed for the area of an Area Health Authority is representative of persons of any of the categories mentioned in paragraphs (a) to (e) in subsection (1) it shall be his duty to recognise the committee. A committee recognised in pursuance of this subsection shall be called the Area Medical, Dental, Nursing and Midwifery, Pharmaceutical or Optical Committee, as the case may be, for the area in question.

The Secretary of State's duty under subsections (1) and (3) above is subject to paragraph 1 of Schedule 6 to this Act, and that Schedule has effect in relation to a committee recognised in pursuance of this section.

It is the Secretary of State's duty to establish in accordance with this section a council for the area of each Area Health Authority, or separate councils for such separate parts of the areas of those Authorities as he thinks fit, and such a council shall be called a Community Health Council.

The Secretary of State—

The additional provisions of Schedule 7 to this Act have effect in relation to Community Health Councils.

Subject to paragraphs (d) and (e) of section 3(1) above, the services described in Schedule 8 to this Act in relation to— are functions exercisable by local social services authorities, and that Schedule has effect accordingly.

A local social services authority who provide premises, furniture or equipment for any of the purposes of this Act may permit the use of the premises, furniture or equipment— This permission may be on such terms (including terms with respect to the services of any staff employed by the authority giving permission) as may be agreed.

A local social services authority may provide (or improve or furnish) residential accommodation—

In exercising their respective functions health authorities and local authorities shall co-operate with one another in order to secure and advance the health and welfare of the people of England and Wales.

There shall be committees, to be called joint consultative committees, who shall advise Area Health Authorities and the authorities in column 2 of the Table below on the performance of their duties under subsection (1) above, and on the planning and operation of services of common concern to those authorities. 1 2 Area Health Authority Associated authorities An Area Health Authority in a metropolitan county in England. The local authority for each district wholly or partly in the area of the Authority. An Area Health Authority in a non-metropolitan county in England, or an Area Health Authority in Wales. The local authority for each county, and also for each district, wholly or partly in the area of the Authority. An Area Health Authority in Greater London. The local authority for each London borough wholly or partly in the area of the Authority. Also the Inner London Education Authority, if wholly or partly in the area of the Authority. Also the Common Council of the City of London, if in the area of the Authority.

Except as provided by an order under the following provisions of this section, each joint consultative committee shall represent one or more Area Health Authorities together with one or more of the authorities in column 2 of the Table above, and an Area Health Authority shall be represented together with each of the authorities associated with that Authority in column 2 of the said Table in one or other of the committees (but not necessarily the same committee).

The Secretary of State shall have power by order to provide for any matter relating to joint consultative committees, and such an order may in particular—

Before making an order under this section the Secretary of State shall consult with such associations of local authorities as appear to him to be concerned, and with any local authority with whom consultation appears to him to be desirable.

The Secretary of State may, where he considers it appropriate, arrange with any person or body (including a voluntary organisation) for that person or body to provide, or assist in providing, any service under this Act. In this section " voluntary organisation " means a body the activities of which are carried on otherwise than for profit, but does not include any public or local authority.

The Secretary of State may make available— any facilities (including goods or materials, or the use of any premises and the use of any vehicle, plant or apparatus) provided by him for any service under this Act; and, where anything is so made available, the services of persons employed by the Secretary of State or by a health authority in connection with it.

The powers conferred by this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Secretary of State, and any goods or materials may be made available either temporarily or permanently.

The Secretary of State may by order provide that, in relation to a vehicle which is made available by him in pursuance of this section and is used in accordance with the terms on which it is so made available, the Vehicles (Excise) Act 1971 and Part VI of the Road Traffic Act 1972 shall have effect with such modifications as are specified in the order.

Any power to supply goods or materials conferred by this section includes a power to purchase and store them and includes a power to arrange with third parties for the supply of goods or materials by those third parties.

The Secretary of State may supply or make available to persons providing general medical services, general dental services, general ophthalmic services or pharmaceutical services such goods, materials or other facilities as may be prescribed.

The Secretary of State shall make available to local authorities— so far as is reasonably necessary and practicable to enable local authorities to discharge their functions relating to social services, education and public health.

It is the Secretary of State's duty, before he makes the services of any officer of a health authority available in pursuance of subsection (1)(b) or subsection (3)(b) or (c) of section 26 above, to consult the officer or a body recognised by the Secretary of State as representing the officer about the matter, or to satisfy himself that the health authority has consulted the officer about the matter.

The Secretary of State shall be entitled to disregard the provisions of subsection (1) above in a case where he considers it necessary to make the services of an officer available as mentioned in that subsection for the purpose of dealing temporarily with an emergency, and has previously consulted such a body about the making available of services in an emergency.

For the purposes of subsection (1)(b) or subsection (3)(b) or (c) of section 26 the Secretary of State may give such directions to health authorities to make the services of their officers available as he considers appropriate; and it shall be the health authority's duty to comply with any such directions.

The powers conferred by this section and section 26 may be exercised on such terms as may be agreed, including terms as to the making of payments to the Secretary of State, and such charges may be made by the Secretary of State in respect of services or facilities provided under subsection (3) of section 26 as may be agreed between the Secretary of State and the local authority or, in default of agreement, as may be determined by arbitration.

The Secretary of State may by order provide that, in relation to a vehicle which is made available by him in pursuance of section 26 and is used in accordance with the terms on which it is so made available, the Vehicles (Excise) Act 1971 and Part VI of the Road Traffic Act 1972 shall have effect with such modifications as are specified in the order.

Any power to supply goods or materials conferred by section 26 includes a power to purchase and store them, and a power to arrange with third parties for the supply of goods or materials by those third parties.

In the Local Authorities (Goods and Services) Act 1970 the expression " public body " includes any health authority and so far as relates to his functions under this Act includes the Secretary of State.

The provisions of subsection (1) above have effect as if made by an order under section 1(5) of that Act of 1970, and accordingly may be varied or revoked by such an order.

Every local authority shall make available to health authorities acting in the area of the local authority the services of persons employed by the local authority for the purposes of the local authority's functions under the Local Authorities Social Services Act 1970 so far as is reasonably necessary and practicable to enable health authorities to discharge their functions under this Act.

Such charges may be made by a local authority for acting under subsection (3) above as may be agreed between the local authority and the Secretary of State or, in default of agreement, as may be determined by arbitration.

It is every Area Health Authority's duty, in accordance with regulations, to arrange as respects their area with medical practitioners to provide personal medical services for all persons in the area who wish to take advantage of the arrangements. The services so provided are in this Act referred to as " general medical services ".

Regulations may provide for the definition of the personal medical services to be provided and for securing that the arrangements will be such that all persons availing themselves of those services will receive adequate personal care and attendance, and the regulations shall include provision—

Regulations under subsection (2) above may provide for the personal medical services there mentioned to include the provision of, and services connected with, any such advice, examination and treatment as are mentioned in paragraph (b) of section 5(1) above.

The remuneration to be paid under the arrangements mentioned in subsection (1) above to a practitioner who provides general medical services shall not, except in special circumstances, consist wholly or mainly of a fixed salary which has no reference to the number of patients for whom he has undertaken to provide such services.

All applications made in the prescribed manner to an Area Health Authority for inclusion in a list kept by that Authority of the names of medical practitioners undertaking to provide general medical services for persons in the Authority's area shall be referred by the Authority to the Medical Practices Committee and (except as mentioned in subsection (2) below) any medical practitioner whose application is granted by that Committee shall be entitled to the inclusion of his name in the list.

That entitlement is subject to—

Where the Secretary of State so prescribes, and after a day so prescribed—

For the purposes of this section a medical practitioner is " suitably experienced " if, but only if, he either— and " medical experience " includes hospital experience in any specialty.

Regulations under this section shall be framed so as to allow the prescribed experience to be acquired without undertaking whole-time employment.

Any power under this section to make regulations—

The Medical Practices Committee may refuse any application under section 30 above on the ground that the number of medical practitioners undertaking to provide general medical services in the area of the Area Health Authority concerned or in part of that area is already adequate.

If in the opinion of the Medical Practices Committee additional practitioners are required for any area or part, but the number of applications exceeds the number required, the Committee shall select the persons whose applications are to be granted and shall refuse the other applications.

Before selecting any persons under subsection (2) above the Medical Practices Committee shall consult the Area Health Authority concerned, and that Authority shall, if a local medical committee has been formed for that Authority's area and recognised under section 44 below, consult that local medical committee before expressing their views on the persons to be selected.

Except as provided in subsections (1) to (3) above, or as required by section 31 above, the Medical Practices Committee shall not refuse any application under section 30, but the Committee may grant an application subject to conditions excluding the provision of general medical services by the applicant in such part or parts of the area of the Area Health Authority as the Committee may specify.

A medical practitioner who has made an application under section 30 which has been refused or has been granted subject to such conditions may appeal to the Secretary of State ; and the Secretary of State may, on any such appeal, direct the Medical Practices Committee to grant the application either unconditionally or subject to such conditions as the Secretary of State may specify. This subsection does not apply where an application has been refused under paragraph (a) of section 31(1).

Where the Medical Practices Committee select persons from a number of applicants, the persons selected shall not be included in the list in question during the period for bringing an appeal to the Secretary of State or pending the determination of any such appeal.

If the Secretary of State grants an appeal to which subsection (6) above relates, he may direct either that the application— In the latter case, he shall make the other applicant a party to the appeal, and no further appeal shall be brought by that applicant in respect of the application in question.

The Medical Practices Committee shall, in a case where persons have to be selected from a number of applicants, and the Secretary of State shall on an appeal in any such case—

It is every Area Health Authority's duty, in accordance with regulations, to make as respects their area arrangements with dental practitioners under which any person in the area for whom a dental practitioner undertakes in accordance with the arrangements to provide dental treatment and appliances shall receive such treatment and appliances. The services so provided are in this Act referred to as " general dental services ".

The remuneration to be paid under such arrangements to a dental practitioner who provides general dental services elsewhere than at a health centre shall not consist wholly or mainly of a fixed salary unless either— and it shall be the Secretary of State's duty, before he prescribes any circumstances for the purposes of paragraph (b), to consult such organisations as appear to him to be representative of the dental profession.

No arrangements shall be made by an Area Health Authority (except as may be provided by regulations) with a medical practitioner or dental practitioner under which he is required or agrees to provide pharmaceutical services to any person to whom he is rendering general medical services or general dental services.

No arrangements for the dispensing of medicines shall be made (except as may be provided by regulations) with persons other than persons who are registered pharmacists, or are persons lawfully conducting a retail pharmacy business in accordance with section 69 of the Medicines Act 1968 and who undertake that all medicines supplied by them under the arrangements made under this Part of this Act shall be dispensed either by or under the direct supervision of a registered pharmacist.

Where the Secretary of State is satisfied that a committee formed for the area of any Area Health Authority is representative— he may recognise that committee; and any committee so recognised shall be called the Local Medical Committee, the Local Dental Committee, the Local Optical Committee or the Local Pharmaceutical Committee, as the case may be for the area concerned.

Any such committee may with the Secretary of State's approval delegate any of their functions, with or without restrictions or conditions, to sub-committees composed of members of that committee.

The Family Practitioner Committee for the area of an Area Health Authority in respect of which committees are recognised under section 44 above shall, in exercising their functions under this Part of this Act, consult with those committees on such occasions and to such extent as may be prescribed; and those committees shall exercise such other functions as may be prescribed.

The Family Practitioner Committee may, on the request of any committee recognised under section 44 for their area, allot to that committee such sums for defraying the committee's administrative expenses (including travelling and subsistence allowances payable to its members) as may be determined by the Family Practitioner Committee with the Secretary of State's approval.

Any sums so allotted shall be out of the moneys available to the Family Practitioner Committee for the remuneration of persons of whom the committee so recognised is representative and who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services, as the case may be, under this Part of this Act. The amount of any such sums shall be deducted from the remuneration of those persons in such manner as may be determined by the Family Practitioner Committee with the Secretary of State's approval.

There shall be a tribunal (in this section and sections 47 to 49 below referred to as " the Tribunal") which shall be constituted in accordance with Schedule 9 to this Act to inquire into cases where representations are made in the prescribed manner to the Tribunal by an Area Health Authority or any other person that the continued inclusion of a person's name in a list prepared under this Part of this Act— would be prejudicial to the efficiency of the services in question. The supplementary provisions contained in Schedule 9 apply in relation to the Tribunal.

The Tribunal, on receiving representations from an Area Health Authority shall, and in any other case may, inquire into the case, and, if they are of opinion that the continued inclusion of that person's name in any list to which the representations relate would be prejudicial to the efficiency of those services—

An appeal shall lie to the Secretary of State from any direction of the Tribunal under subsection (2) above, and the Secretary of State may confirm or revoke that direction.

Where the Tribunal direct that the name of any person be removed from or not included in any list or lists the Area Health Authority or Authorities concerned shall— remove the name of the person concerned from the list or lists in question.

Any person whose name has been removed by a direction under section 46 above from any list or lists shall be disqualified for inclusion in any list to which that direction relates until the Tribunal or the Secretary of State direct under this section to the contrary.

For the purpose of deciding whether or not to issue a direction under this section (or under paragraph 8 of Schedule 14 to this Act), the Tribunal or the Secretary of State, as the case may be, may hold an inquiry.

Where the name of any medical practitioner is or has been at any time entered on any list of medical practitioners undertaking to provide general medical services, it shall be unlawful subsequently to sell the goodwill or any part of the goodwill of the medical practice of that medical practitioner. This subsection is subject to subsections (2) and (3) below ; and the additional provisions contained in Schedule 10 to this Act have effect for the purposes of this section.

Where a medical practitioner, whose name has ceased to be entered on any list of medical practitioners undertaking to provide general medical services, practises in the area of an Area Health Authority (or of an Executive Council, before its abolition under section 14 of the National Health Service Reorganisation Act 1973) on whose list his name has never been entered, subsection (1) above does not render unlawful the sale of the goodwill or any part of the goodwill of his practice in that area.

Subsection (1) does not prevent the sale of the goodwill or any part of the goodwill of a medical practice carried on in any area, being a sale by a medical practitioner whose name has never been entered on a list of an Area Health Authority (or of an Executive Council, before its abolition) for that area of medical practitioners undertaking to provide general medical services, notwithstanding that any part of the goodwill to be sold is attributable to a practice previously carried on by a person whose name was entered on such a list.

The Secretary of State may by order provide for controlling maximum prices to be charged for any medical supplies required for the purposes of this Act.

The Secretary of State may by direction given with respect to any undertaking, or by order made with respect to any class or description of undertakings, being an undertaking or class or description of undertakings concerned with medical supplies required for the purposes of this Act, require persons carrying on the undertaking or undertakings of that class or description—

The additional provisions set out in Schedule 11 to this Act have effect in relation to this section; and

In this section and section 60 below " the section 58 power " means the Secretary of State's power under section 58 above to afford persons (subject to section 62 below) admission or access to accommodation or services as resident or non-resident private patients at health service hospitals.

The Secretary of State shall not in the exercise of his section 58 power afford a person admission or access to accommodation or services at such a hospital as a private patient unless satisfied that the accommodation or services are required for the purposes of investigation, diagnosis or treatment which— In this subsection " privately available " means available at a satisfactory standard otherwise than at a health service hospital.

The Secretary of State shall not exercise his section 58 power in such a way as to afford persons admission or access to accommodation or services at health service hospitals otherwise than in accordance with the following arrangements. Those arrangements are such as in his opinion are best suited for securing that all persons admitted or afforded access to accommodation or services at health service hospitals as resident or non-resident patients for the purposes of investigation, diagnosis or treatment of a specialised nature, or involving the use of specialised equipment or skills, are, so far as is practicable, admitted or afforded such access on the basis of medical priority alone, whether they come as private patients or not.

The Secretary of State shall not exercise his section 58 power in such a way as to allow any particular accommodation or facilities at a health service hospital to be reserved or set aside for regular or repeated use in connection with the treatment of persons as private patients. This subsection is without prejudice to his power to allow such use in connection with the treatment of any particular person afforded admission or access to that accommodation or those facilities.

There shall be made in respect of any exercise of the section 58 power such charges as the Secretary of State may in accordance with subsections (2) and (3) below determine.

Without prejudice to the generality of the Secretary of State's section 58 power to make and recover charges for any use which he may under that section allow to be made of any accommodation or services provided under this Act, the Secretary of State may in pursuance of subsection (1) above determine different rates or scales of charges—

The charges determined in pursuance of subsection (1) above—

Where a health authority receives any sum charged under section 58 for services provided to a private patient by a whole-time consultant—

Nothing in this section or in section 59 above prevents the Secretary of State from allowing any medical or dental practitioner employed by a health authority to make use of any accommodation or services provided by virtue of this Act to the extent to which the practitioner would be entitled to make such use under the terms of that employment if those terms were as they were or would have been at the passing of the Health Services Act 1976.

In this section—

The Secretary of State may sell or give away, or otherwise dispose of, goods the production or manufacture of which by him is involved in the provision of services under this Act.

He may, in the case of goods referred to in subsection (1) above which are prescribed for the purposes of this section, produce or manufacture them to an extent greater than that necessitated by the provision of such services in order that they may be supplied to persons other than those to whom they are supplied by way of the provision of such services whether or not the first-mentioned persons are engaged in the provision of other services provided under this Act.

This section is subject to section 62 below.

The Secretary of State may authorise the accommodation described in this section to be made available, to such extent as he may determine, for patients who give an undertaking (or for whom one is given) to pay such charges for part of the cost as the Secretary of State may determine, and he may recover those charges. The accommodation mentioned above is—

The Secretary of State may allow such deductions as he thinks fit from the amount of a charge due by virtue of an undertaking given under this section to be paid for accommodation in respect of any period during which the accommodation is temporarily vacated by the person for whom it is made available.

Subject to section 71 below, if the Secretary of State is satisfied, in the case of a health service hospital or group of such hospitals or of the health service hospitals in a particular area, that it is reasonable to do so—

The Secretary of State may allow accommodation and services to which an authorisation under subsection (1) above relates to be made available in connection with treatment, in pursuance of arrangements made by a medical practitioner or dental practitioner serving (whether in an honorary or paid capacity) on the staff of a health service hospital, of private patients of that practitioner as resident patients.

The Secretary of State, for the purpose of determining charges to be paid under subsection (1) above—

The Secretary of State may under subsection (3) above determine different charges for different accommodation and for different services and in relation to different circumstances.

The Secretary of State may allow such deduction as he thinks proper from the amount of a charge due by virtue of an undertaking given under this section by or in respect of any patient—

Nothing in this section prevents accommodation from being made available for a patient other than one mentioned in subsection (1) above if the use of that accommodation is needed more urgently for him on medical grounds than for a patient so mentioned, and no other suitable accommodation is available.

If the Secretary of State is satisfied, in the case of a health service hospital or group of such hospitals or of the health service hospitals in a particular area, that it is reasonable to do so— Those patients shall be patients who give an undertaking (or for whom one is given) to pay, in respect of the accommodation and services, such charges as the Secretary of State may determine, and he may recover those charges.

The Secretary of State may under subsection (1) above determine different charges for different accommodation and for different services, and in relation to different circumstances.

No accommodation and no services shall be so made available under subsection (1) above as to prejudice persons availing themselves of services at a hospital otherwise than as private patients.

Sections 68 to 71 below have effect for the purpose of—

Nothing in this Part of this Act prejudices the operation of paragraph 10(4) of Schedule 5 to this Act (by virtue of which regulations governing the terms of employment of officers employed by an authority within the meaning of sub-paragraph (4) of that paragraph must not contain a requirement that all consultants so employed shall be so employed whole-time).

It continues to be the duty of the Health Services Board to submit to the Secretary of State from time to time in accordance with this section proposals for the progressive revocation of— and it shall be the Secretary of State's duty to give effect to all proposals so submitted.

The Health Services Board shall in the 6 months beginning with the date on which its first proposals were submitted under section 4(2) of the Health Services Act 1976, and in each successive period of 6 months thereafter, submit further proposals under this section or, if in all the circumstances it decides that the submission of further proposals in any particular period of 6 months is unnecessary, shall instead prepare and submit to the Secretary of State a report explaining the Board's reasons for that decision.

In formulating proposals under this section the Board shall— In deciding what advice to give the Board in connection with the formulation of any such proposals the Board's Welsh Committee shall likewise have regard to the principles set out in section 70 and shall consider any representations made to the Committee by any of the persons or bodies above mentioned.

Each set of proposals under this section shall specify— and may specify different dates for different accommodation or services so specified.

Without prejudice to subsection (3) of section 68 above, the Health Services Board, in formulating proposals under that section for the revocation of authorisations given under section 66(1) above in respect of accommodation or services at any particular health service hospital or hospitals, and the Welsh Committee in deciding what advice to give the Board in connection with the formulation of any such proposals— and the Board may formulate separate proposals in respect of different purposes or specialties accordingly.

As regards the revocation of authorisations under section 66(1), any proposals under section 68 relating to— shall be formulated by the Board as separate proposals; and (without prejudice to section 68(1) to (3) above and subsection (1) above) the Board's first proposals under section 4(2) of the Health Services Act 1976 (submitted within 6 months of the passing of that Act or such longer period as the Secretary of State may allow) shall include separate proposals relating to accommodation available to consultants as mentioned in paragraph (a) above.

Without prejudice to section 68 and the preceding provisions of this section, the Health Services Board shall, as regards the revocation of authorisations under section 66(1), submit separate proposals under section 68 relating to— and shall do so not later than the end of the 12 months following the initial period defined by the Health Services Act 1976 (that is the period of 6 months beginning with the date on which that Act was passed), or, if a period longer than the initial period has been allowed under that Act for the submission of the Board's first proposals under this section, the 12 months following that longer period.

No authorisation—

The Health Services Board may submit to the Secretary of State proposals for securing that in any case where one or more beds authorised under section 65(1) cease to be available to resident private patients, or any accommodation or services authorised under section 66(1) cease to be available to non-resident private patients, in consequence of the permanent closure of any health service hospital accommodation in England or Wales independently of any proposals submitted by the Board under section 68, the total number of effective beds, or the total amount of effective accommodation or services, as the case may be, so authorised in England or Wales is not thereby reduced below what it would be if—

It shall be the Secretary of State's duty to grant such authorisations under section 65(1) or section 66(1), as the case may be, as are needed to give effect to any proposals submitted to him under subsection (2) above.

Where any health service hospital accommodation in England or Wales is temporarily closed (whether at the instance of the Secretary of State or not) for physical or other reasons outside his control, the Secretary of State shall, without the need for any proposals by the Board, grant on a temporary basis such authorisations under section 65(1) or section 66(1) as he would have been able to grant by virtue of subsections (2) and (3) above if—

Subject to the restrictions imposed by this section, section 65 or, as the case may be, section 66 continue to have effect in relation to any accommodation or services to which an authorisation under section 65(1) or section 66(1) relates.

A person to whom this section applies who wishes to use any relevant health service accommodation or facilities for the purpose of providing medical, dental, pharmaceutical, ophthalmic or chiropody services to non-resident private patients may apply in writing to the Secretary of State for permission under this section.

Any application for permission under this section must specify—

On receiving an application under this section the Secretary of State—

Any grant of permission under this section shall be on such terms (including terms as to the payment of charges for the use of the relevant health service accommodation or facilities pursuant to the permission) as the Secretary of State may from time to time determine.

The persons to whom this section applies are—

In this section—

There shall be prepared by the Secretary of State on the matters mentioned in subsection (2) below an annual report relating to England and one relating to Wales, and he shall lay a copy of every report under this section before each House of Parliament.

The matters referred to under subsection (1) above are—

The reference in paragraph (d) of section 75(2) above to common waiting-lists is to the recommendations made to the Secretary of State by the Health Services Board under section 6(1) of the Health Services Act 1976.

Those recommendations—

Regulations may provide for the making and recovery in such manner as may be prescribed of such charges as may be prescribed in respect of— and paragraphs (a) and (b) of this subsection may include the supply of substances and appliances mentioned in paragraph (b) of section 5(1) above.

Regulations under subsection (1) above may provide for the grant, on payment of such sums as may be prescribed by those regulations, of certificates conferring on the persons to whom the certificates are granted exemption from charges otherwise exigible under the regulations in respect of drugs, medicines and appliances supplied during such period as may be prescribed, and different sums may be so prescribed in relation to different periods.

The additional provisions of paragraphs 1 and 4 of Schedule 12 to this Act have effect in relation to this section.

Regulations may provide for the making and recovery in such manner as may be prescribed of charges of such amounts as are mentioned in sub-paragraph (1) of paragraph 2 of Schedule 12 to this Act, in respect of the supply under the Act of such dental or optical appliances as are mentioned in that sub-paragraph.

If the Secretary of State, after consultation with the university associated with any hospital providing facilities for clinical dental teaching, is satisfied that it is expedient in the interests of dental training or education that the charges imposed by subsection (1) above should be remitted in the case of dental services provided at that hospital, either generally or subject to limitations or conditions, he may by order provide for that purpose. Any order made under this subsection may be revoked or varied by a subsequent order made by the Secretary of State after such consultation as is mentioned above.

The additional provisions of paragraphs 2 and 5 of Schedule 12 have effect in relation to this section.

A charge of the amount authorised by this section may be made and recovered, in such manner as may be prescribed, in respect of any services provided as part of the general dental services under Part II of this Act, not being— The additional provisions of paragraphs 3 and 5 of Schedule 12 have effect in relation to this subsection.

Regulations may provide that, in the case of such special dental treatment as may be prescribed, being treatment provided as part of the general dental services, such charges as may be prescribed may be made and recovered by the person providing the services.

The Secretary of State may cause an inquiry to be held in any case where he deems it advisable to do so in connection with any matter arising under this Act.

For the purpose of any such inquiry (but subject to subsection (3) below) the person appointed to hold the inquiry—

Nothing in this section—

Any person who refuses or deliberately fails to attend in obedience to a summons under this section, or to give evidence, or who deliberately alters, suppresses, conceals, destroys, or refuses to produce any book or other document which he is required or is liable to be required to produce for the purposes of this section, shall be liable on summary conviction to a fine not exceeding £100 or to imprisonment for a term not exceeding 6 months, or to both.

Where the Secretary of State causes an inquiry to be held under this section— No local authority shall be ordered to pay costs under this subsection in the case of any inquiry unless it is a party to that inquiry.

Where the Secretary of State causes an inquiry to be held under this section he may make orders— and every such order may be made a rule of the High Court on the application of any party named in the order.

Where the Secretary of State is of opinion, on complaint or otherwise, that— have failed to carry out any functions conferred or imposed on them by or under this Act, or have in carrying out those functions failed to comply with any regulations or directions relating to those functions, he may after such inquiry as he may think fit make an order declaring them to be in default.

Except where the body in default is a local social services authority, the members of the body shall forthwith vacate their office, and the order—

If the body in default is a local social services authority—

Any expenses certified by the Secretary of State to have been incurred by him in discharging functions transferred to him under this section from a local social services authority shall on demand be paid to him by that authority and shall be recoverable by him from them as a debt due to the Crown; and

An order made under this section may contain such supplementary and incidental provisions as appear to the Secretary of State to be necessary or expedient, including—

The Secretary of State may acquire— required by him for the purposes of this Act; and (without prejudice to the generality of paragraph (a) above) land may be so acquired to provide residential accommodation for persons employed for any of those purposes.

The Secretary of State may use for the purposes of any of the functions conferred on him by this Act any property belonging to him by virtue of this Act, and he has power to maintain all such property.

A local social services authority may be authorised to purchase land compulsorily for the purposes of this Act by means of an order made by the authority and confirmed by the Secretary of State.

The Acquisition of Land (Authorisation Procedure) Act 1946 shall apply to the compulsory purchase of land by the Secretary of State under this section, and accordingly shall have effect—

Section 120(3) of the Local Government Act 1972 (which relates to the application of Part I of the Compulsory Purchase Act 1965 where a council are authorised to acquire land by agreement) applies to the acquisition of land by the Secretary of State under this section in like manner as it applies to such acquisition by a council under that section.

Section 128 of the Town and Country Planning Act 1971 (use and development of consecrated land and burial grounds) applies to consecrated land and land comprised in a burial ground within the meaning of that section which— as if that land had been so acquired for those purposes.

All property vested in the Secretary of State in consequence of the transfer of that property under section 6 of the National Health Service Act 1946 (transfer of hospitals) so vests free of any trust existing immediately before that transfer.

The Secretary of State may use any such property for the purpose of any of his functions under this Act, but he shall so far as practicable secure that the objects for which any such property was used immediately before that transfer are not prejudiced by section 6 of that Act of 1946.

Where—

Any sum so paid to the appropriate hospital authority shall, so far as practicable, be applied by them for the purpose specified in the trust instrument.

In this section " the appropriate hospital authority" means—

Nothing in this section applies to a trust for a special hospital, or to property transferred under section 24 of the National Health Service Reorganisation Act 1973.

The Secretary of State may, having regard to any change or proposed change in the arrangements for the administration of a hospital or in the area or functions of any health authority, by order provide for the transfer of any trust property from any health authority or special trustees to any other health authority or special trustees.

If it appears to the Secretary of State at any time that all the functions of any special trustees should be discharged by one or more health authorities then, whether or not there has been any such change as is mentioned in subsection (1) above, he may by order provide for the transfer of all trust property from the special trustees to the health authority, or, in such proportions as he may specify in the order, to those health authorities.

Before so acting the Secretary of State shall consult the health authorities and special trustees concerned.

Where by an order under this section, property is transferred to two or more authorities, it shall be apportioned by them in such proportions as they may agree or as may in default of agreement be determined by the Secretary of State, and the order may provide for the way in which the property is to be apportioned.

Where property is so apportioned, the Secretary of State may by order make any consequential amendments of the trust instrument relating to the property.

This section applies— and this section continues to apply to the property after any further transfer under section 92 above.

The person holding the property after the transfer or last transfer shall secure, so far as is reasonably practicable, that the objects of any original endowment and the observance of any conditions attached to that endowment, including in particular conditions intended to preserve the memory of any person or class of persons, are not prejudiced by this Part of this Act, or Part II of that Act of 1973. In this subsection " original endowment" means a hospital endowment which was transferred under section 7 of that Act of 1946 and from which the property in question is derived.

Subject to subsection (2) above, the property shall be held on trust for such purposes relating to hospital services (including research), or to any other part of the health service associated with any hospital, as the person holding the property thinks fit.

Where the person holding the property is a body of special trustees, the power conferred by subsection (3) above shall be exercised as respects the hospitals for which they are appointed.

Any discretion given by a trust instrument to the trustees of property transferred under— shall be exercisable by the person to whom the property is so transferred and, subject to section 93 above and the following provisions of this section, the transfer shall not affect the trusts on which the property is held.

Where— the discretion shall be enlarged so as to allow the application of the property or (as the case may be) of the income arising from the property, to such extent as the trustees think fit, for any other part of the health service associated with any hospital.

Subsection (2) above shall apply on any subsequent transfer of the property under section 92 above.

The bodies of trustees (in this Act referred to as special trustees) appointed by the Secretary of State under section 29 of the National Health Service Reorganisation Act 1973 and this section shall (subject to section 92 above) hold and administer the property transferred to them under that Act of 1973. The special trustees so appointed are bodies of trustees appointed for the hospital or hospitals which, immediately before the day appointed for the purposes of section 29 of that Act of 1973, were controlled and managed by a University Hospital Management Committee or a Board of Governors, but excluding—

Special trustees have power to accept, hold and administer any property on trust for all or any purposes relating to hospital services (including research), or to any other part of the health service associated with hospitals, being a trust which is wholly or mainly for hospitals for which the special trustees are appointed.

The number of trustees for any hospital or hospitals shall be such as the Secretary of State may from time to time determine after consultation with such persons as he considers appropriate.

The term of office of any special trustee shall be fixed by the Secretary of State but a special trustee may be removed by the Secretary of State at any time during the special trustee's term of office.

Any provision in sections 90 to 95 above for the transfer of any property includes provision for the transfer of any rights and liabilities arising from that property.

Nothing in those sections shall affect any power of Her Majesty, the court (as defined in the Charities Act 1960) or any other person to alter the trusts of any charity.

Nothing in section 12 of the Finance Act 1895 (which requires certain Acts and certain instruments relating to the vesting of property by virtue of an Act to be stamped as conveyances on sale) applies to sections 90 to 95 above or to an order made in pursuance of any of those sections; and stamp duty shall not be payable on such an order.

It is the Secretary of State's duty to pay—

It is the duty of each Regional Health Authority to pay to each Area Health Authority of which the area is included in the region of the Regional Health Authority the sums needed to defray such expenses of the Area Health Authority as the Regional Health Authority approves in the prescribed manner.

Where an order establishing a special health authority provides for any expenses of the authority to be defrayed by a Regional or Area Health Authority or by two or more such Authorities in portions determined by or in accordance with the order, it is the duty of each Authority in question to pay to the special health authority sums equal to, or to the appropriate portion of, those expenses.

Sums falling to be paid under this section shall be payable subject to compliance with such conditions as to records, certificates or otherwise as the Secretary of State may determine.

Accounts, in such form as the Secretary of State may with the approval of the Treasury direct, shall be kept by— Those accounts shall be audited by auditors appointed by the Secretary of State, and the Comptroller and Auditor General may examine all such accounts and any records relating to them, and any report of the auditor on them.

Every such body shall prepare and transmit to the Secretary of State in respect of each financial year annual accounts in such form as the Secretary of State may with the approval of the Treasury direct. The accounts prepared and transmitted by an Area Health Authority in pursuance of this subsection shall include annual accounts of the Family Practitioner Committees established by the Authority and of any Community Health Council of which the district includes any part of the Authority's area.

The Secretary of State may by regulations provide generally with respect to the audit under subsection (1) above of accounts of bodies to which that subsection applies; and in particular for conferring on the auditor of any of those accounts—

The Secretary of State shall prepare in respect of each financial year— and shall transmit them on or before 30th November in each year to the Comptroller and Auditor General, who shall examine and certify them, and lay copies of them together with his report on them before both Houses of Parliament.

The Secretary of State may by regulations provide, in the case of all or any of the following bodies— for restricting the making of payments by or on behalf of the body otherwise than on such authorisation and subject to such conditions as may be specified in the regulations.

Such provision may be made subject to such exceptions as may be so specified, and those regulations may contain such other provisions as to the making and carrying out by all or any of those bodies of such arrangements with respect to financial matters as the Secretary of State thinks necessary for the purpose of securing that the affairs of such bodies are conducted, so far as reasonably practicable, in such manner as to prevent financial loss and to ensure and maintain efficiency.

The Secretary of State may give directions to any of those bodies as to any matter with respect to which those regulations may be made; and those directions may be specific in character and shall be— and shall be complied with by the body to whom they are given.

There shall be paid out of moneys provided by Parliament such expenses incurred by— as may be determined by the Secretary of State with the approval of the Treasury.

Payments made under this section shall be in accordance with regulations made by the Secretary of State and approved by the Treasury, and shall be made at such times and in such manner as the Treasury may direct, and subject to such conditions as to records, certificates, or otherwise as the Secretary of State may with the approval of the Treasury determine.

The Secretary of State may pay such travelling and other allowances, including compensation for loss of remunerative time, as he may, with the approval of the Minister for the Civil Service, determine—

The Secretary of State may pay to members of any of the following bodies such remuneration as he may, with the approval of the Minister for the Civil Service, determine—

Allowances shall not be paid under subsection (1) above except in connection with the exercise or performance of such powers or duties, in such circumstances, as may, with the approval of the Minister for the Civil Service, be determined by the Secretary of State.

Any payments under this section shall be made at such times and in such manner, and subject to such conditions as to records, certificates or otherwise, as the Secretary of State may, with the approval of the Minister for the Civil Service, determine.

If the Secretary of State— the Secretary of State may by order confer that function on the body.

Any sums required to enable any body having that function to pay remuneration in respect of such services shall, if apart from this section there is no provision authorising the payment of the sums by the Secretary of State or out of money provided by Parliament, be paid by him.

The Secretary of State may enter into an agreement with the governing body of any hospital to which this section applies—

The governing body of any hospital to which this section applies shall have all such powers as may be necessary for the purpose of giving effect to any terms and conditions on which their officers are admitted to participate in those superannuation benefits.

This section applies to any hospital (not vested in the Secretary of State) which is used, in pursuance of arrangements made by the governing body of the hospital with the Secretary of State, for the provision of services under this Act.

Where a medical practitioner carries out a medical examination of any person with a view to an application for his admission to hospital for observation or treatment being made under Part IV of the Mental Health Act 1959 the council which is the local authority for the purposes of the Local Authority Social Services Act 1970 for the area where the person examined resides shall, subject to the following provisions of this section, pay to that medical practitioner—

No payment shall be made under this section to a medical practitioner—

This section shall only apply in a case where it is intended, when the medical examination of the person in question is carried out, that if he is admitted to hospital in pursuance of any such application as mentioned in subsection (1) above, the whole cost of his maintenance and treatment will be defrayed out of moneys provided by Parliament under this Act or the Mental Health Act 1959.

All charges recoverable under this Act by the Secretary of State, a local social services authority, or any body constituted under this Act, may, without prejudice to any other method of recovery, be recovered summarily as a civil debt.

If any person, for the purpose of evading the payment of any charge under this Act, or of reducing the amount of any such charge— the charge, or as the case may be the balance of the charge, may be recovered from him as a simple contract debt by the person by whom the cost of the service in question was defrayed.

Where the carrying out of a scheme for the provision by the Secretary of State in pursuance of this Act of hospital accommodation or other facilities will involve the displacement from any premises of persons residing in them, the Secretary of State may make arrangements with one or more of the following bodies— for securing, in so far as it appears to him that there is no other residential accommodation suitable for the reasonable requirements of those persons available on reasonable terms, the provision of residential accommodation in advance of the displacement from time to time becoming necessary as the carrying out of the scheme proceeds.

Arrangements under subsection (1) above may include provision for the making by the Secretary of State to the body with whom the arrangements are made of payments of such amounts and for such purposes as may be approved by the Treasury.

The requirements of this section with respect to the notification of births and deaths are in addition to, and not in substitution for, the requirements of any Act relating to the registration of births and deaths.

It is the duty of each registrar of births and deaths to furnish, to the prescribed medical officer of the Area Health Authority of which the area includes the whole or part of the registrar's sub-district, such particulars of each birth and death which occurred in the Authority's area as are entered (on and after 1st April 1974) in a register of births or deaths kept for that sub-district.

Regulations may provide as to the manner in which and the times at which particulars are to be furnished in pursuance of subsection (2) above.

In the case of every child born, it is the duty— to give notice of the birth (as provided in subsection (5) below) to the prescribed medical officer of the Area Health Authority for the area in which the birth takes place. This subsection applies to any child which has issued forth from its mother after the expiry of the twenty-eighth week of pregnancy whether alive or dead.

Notice under subsection (4) above shall be given either— and an Area Health Authority shall, upon application to them, supply without charge to any medical practitioner or midwife residing or practising within their area prepaid addressed envelopes together with the forms of notice.

Any person who fails to give notice of a birth in accordance with subsection (4) above is liable on summary conviction to a fine not exceeding £1, unless he satisfies the court that he believed, and had reasonable grounds for believing, that notice had been duly given by some other person. Proceedings in respect of this offence shall not, without the Attorney-General's written consent, be taken by any person other than a party aggrieved or the Area Health Authority concerned.

A registrar of births and deaths shall, for the purpose of obtaining information concerning births which have occurred in his sub-district, have access at all reasonable times to notices of births received by a medical officer under this section, or to any book in which those notices may be recorded.

Any power to make orders , rules or regulations conferred by this Act shall be exercisable by statutory instrument, and a statutory instrument made by virtue of this Act shall , unless it is a PCT order or an instrument to which subsection (1A) applies or an instrument made by the National Assembly for Wales, be subject to annulment in pursuance of a resolution of either House of Parliament. This subsection—

Any power to make regulations conferred on the Secretary of State by this Act or Part I of the National Health Service and Community Care Act 1990 is, if the Treasury so directs, exercisable by the Treasury and the Secretary of state acting jointly, except in the case of—

The Secretary of State may not make a statutory instrument containing the first regulations made under section 79(1) above (as substituted by the Health and Social Care (Community Health and Standards) Act 2003) unless a draft of the instrument has been laid before, and approved by resolution of, each House of Parliament.

Where under or by virtue of any provision of this Act or Part I of the National Health Service and Community Care Act 1990— that provision includes power to vary or revoke the order or direction, as the case may be, by subsequent order or by subsequent directions.

Any power conferred by this Act or Part I of the National Health Service and Community Care Act 1990 to make orders , rules, regulations or schemes, and any power conferred by section 16BB, 18 or 19A(7) above , or by section 28E(3A), 28N, 28T , 28U or 28WD above, or by section 42A or 42B above, to give directions by an instrument in writing, may unless the contrary intention appears, be exercised— and includes power to make such supplementary, incidental, consequential, transitory, transitional or saving provision in the orders , rules, regulations, schemes or directions as the persons making or giving them consider appropriate. This subsection does not only apply to ... an order made under section 57 above (but without prejudice to paragraph 1(1) of Schedule 11 to this Act or Part I of the National Health Service and Community Care Act 1990)

Directions given by the Secretary of State or by a Strategic Health Authority or Health Authority in pursuance of any provision of this Act or Part I of the National Health Service and Community Care Act 1990 shall be given by an instrument in writing.

In relation to directions given in pursuance of section 16BB or sections 16D to 17B above section 18 above applies in place of subsections (3) and (3A) above.

Any person or body to whom directions are given in pursuance of any provision of this Act or Part I of the National Health Service and Community Care Act 1990 shall comply with the directions.

Supplementary, incidental, consequential, transitory, transitional or saving provision made by virtue of subsection (4) above in connection with an order under section 20A above, or regulations under Schedule 7A to this Act, may include provision amending or repealing any provision made by or under an enactment.

Without prejudice to the generality of subsection (4) above, any power which may be exercised as mentioned in paragraphs (a) and (b) of that subsection (other than a power to make rules) may make different provision for different areas.

In this Act and Part I of the National Health Service and Community Care Act 1990, unless the contrary intention appears— . . . . . . . . . ... “dental practitioner” means a person registered in the dentists register under the Dentists Act 1984; “disabled persons” means persons who are blind, deaf or dumb or who suffer from mental disorder of any description and other persons who are substantially and permanently handicapped by illness, injury or congenital deformity or such other disability as may be prescribed; “dispensing optician” means a person who is registered in the register kept under section 2 of the Opticians Act 1958 of dispensing opticians or a body corporate enrolled in the list kept under section 4 of that Act of such bodies carrying on business as dispensing opticians; “equipment” includes any machinery, apparatus or appliance, whether fixed or not, and any vehicle; “the FHSAA” means the Family Health Services Appeal Authority; “financial year” means a period of 12 months ending with 31st March in any year; “functions” included powers and duties; . . . . . . “general dental services contract” has the meaning given by section 28K above; “general medical services contract” has the meaning given by section 28Q above; “the health service” means the health service established in pursuance of section 1 of the National Health Service Act 1946 and continued under section 1(1) above; “health service body” has the same meaning as in section 4 of the National Health Service and Community Care Act 1990; “health service hospital” means a hospital vested in the Secretary of State for the purposes of his functions under this Act or vested in a Primary Care Trust , an NHS trust or an NHS foundation trust; “high security psychiatric services” has the meaning given by section 4 above . . . “hospital” means— any institution for the reception and treatment of persons suffering from illness, any maternity home, and any institution for the reception and treatment of persons during convalescence or persons requiring medical rehabilitation, and includes clinics, dispensaries and out-patient departments maintained in connection with any such home or institution, and hospital accommodation shall be construed accordingly; “illness” includes mental disorder within the meaning of the Mental Health Act 1983 and any injury or disability requiring medical or dental treatment or nursing; “local authority” means a county council, . . . a district council, a county borough council, a London borough council, and the Common Council of the City of London; . . . “local education authority” has the same meaning as in the the Education Act 1996; “local pharmaceutical services” means such services of a kind which may be provided under section 41 or by virtue of section 41A (except the provision of drugs, medicines or listed appliances by a medical practitioner or dental practitioner to a patient of his pursuant to arrangements made by virtue of section 43(1)) as are prescribed by regulations under section 28 of the Health and Social Care Act 2001; “LPS arrangements” means arrangements made under a pilot scheme established under section 28 of the Health and Social Care Act 2001; “local social services authority” means the council of a non-metropolitan county, of a county boroughor of a metropolitan district or London borough, or the Common Council of the City of London; “medical” includes surgical; ... “medical practitioner” means a registered medical practitioner within the meaning of Schedule 1 to the Interpretation Act 1978 “medicine” includes such chemical re-agents as are included in a list for the time being approved by the Secretary of State for the purposes of section 41 above; “modifications” includes additions, omissions and amendments; “NHS contract” has the meaning assigned by section 4(1) of the National Health Service and Community Care Act 1990; “National Health Service trust” has the meaning assigned by section 5 of the National Health Service and Community Care Act 1990 and “NHS trust” shall be construed accordingly “officer” includes servant; “operational date”, in relation to an NHS trust, shall be construed in accordance with paragraph 3(1)(e) of Schedule 2 to the National Health Service and Community Care Act 1990 “optometrist” means a person registered in the register of optometrists maintained under section 7 of the Opticians Act 1989 , or in the register of visiting optometrists from relevant European States maintained under section 8B(1)(a) of that Act , or a body corporate registered in the register of bodies corporate maintained under section 9 of that Act carrying on business as an optometrist; “patient” includes an expectant or nursing mother and a lying-in woman; ... ... “pharmaceutical services” has the meaning assigned by section 41 of this Act “prescribed” means prescribed by regulations made by the Secretary of State under this Act or Part I of the National Health Service and Community Care Act 1990; “PCT order” has the meaning given by section 16A above “primary dental services” means services which are primary dental services for the purposes of Part 1 (see section 16CA); “primary functions” shall be construed in accordance with section 3 of the National Health Service and Community Care Act 1990 “primary medical services” means services which are primary medical services for the purposes of Part 1 (see section 16CC). “property” includes rights; . . . “registered pharmacist” means a pharmacist registered in the register of pharmaceutical chemists; “regulations” means regulations made by the Secretary of State under this Act or Part I of the National Health Service and Community Care Act 1990; “section 28C arrangements” means arrangements made under section 28C; . . . “superannuation benefits” means annual superannuation allowances, gratuities and periodical payments payable on retirement, death or incapacity, and similar benefits; “terms of service” means the terms upon which by virtue of regulations a person undertakes to provide ... general ophthalmic services or pharmaceutical services. “university” includes a university college; “voluntary organisation” means a body the activities of which are carried on otherwise than for profit, but does not include any public or local authority;

References in this Act to the purposes of a hospital shall be construed as referring both to the general purposes of the hospital and to any specific purpose of the hospital.

Any reference in this Act to any enactment is a reference to it as amended or applied by or under any other enactment including this Act.

This Act may be cited as the National Health Service Act 1977.

This Act does not extend to Scotland, except as is mentioned in paragraph 3 of Schedule 11 to this Act.

The following provisions only of this Act apply to Northern Ireland—

The Secretary of State may by order provide that this Act shall extend to the Isles of Scilly with such modifications, if any, as are specified in the order, and except as provided in pursuance of this subsection this Act does not extend to the Isles of Scilly. The Secretary of State may by any such order amend or repeal any provisions contained in the Isles of Scilly Orders 1927 to 1943.

This Act shall come into force on the expiry of the period of one month beginning on the date of its passing.