HL Deb 20 March 1997 vol 579 cc1077-81

20 Clause 19, page 11, line 23, at end insert—

("Persons with whom agreements may be made.

28CA.—(1) A Health Authority may make an agreement under section 28C only with one or more of the following—

  1. (a) an NHS trust;
  2. (b) in the case of an agreement under which personal medical services are provided—
    1. (i) a qualifying medical practitioner;
    2. (ii) an individual who is providing personal medical services in accordance with section 28C arrangements or section 17C arrangements;
  3. (c) in the case of an agreement under which personal dental services are provided—
    1. (i) a qualifying dental practitioner;
    2. (ii) an individual who is providing personal dental services in accordance with section 28C arrangements or section I7C arrangements;
  4. (d) an NHS employee, a section 28C employee or a section 17C employee;
  5. (e) a qualifying body.

(2) In this section—

"the 1978 Act" means the National Health Service (Scotland) Act 1978;

"NHS employee" means an individual who, in connection with the provision of services in the health service in England and Wales or Scotland, is employed by—

  1. (a) an NHS trust;
  2. (b) in the case of an agreement under which personal medical services are provided—
    1. (i) a medical practitioner whose name is included in a medical list kept under this Act or in a corresponding list kept under the 1978 Act; or
    2. (ii) a medical practitioner who is providing personal medical services in accordance with section 28C arrangements or section 17C arrangements;
  3. (c) in the case of an agreement under which personal dental services are provided—
    1. (i) a dental practitioner whose name is included in a list prepared in accordance with regulations made under section 36(1)(a) of this Act or section 25(2)(a) of the 1978 Act; or
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    2. (ii) a dental practitioner who is providing personal dental services in accordance with section 28C arrangements or section 17C arrangements;

"qualifying body" means—

  1. (a) a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraphs (a) to (d) of subsection (1); and also
  2. (b) in the case of an agreement under which personal dental services are provided, a body corporate which, in accordance with the provisions of Part IV of the Dentists Act 1984, is entitled to carry on the business of dentistry;

"qualifying dental practitioner" means a dental practitioner who satisfies the conditions imposed by regulations made under section 28D(2)(b) of this Act or section 17D(2)(b) of the 1978 Act;

"qualifying medical practitioner" means a medical practitioner who satisfies the conditions imposed by regulations made under section 28D(2)(b) of this Act or section 17D(2)(b) of the 1978 Act;

"section 17C arrangements" means arrangements for the provision of services made under section 17C of the 1978 Act;

"section 17C employee" means an individual who, in connection with the provision of services in accordance with section I7C arrangements, is employed by an individual providing those services;

"section 28C arrangements" means arrangements for the provision of services made under section 28C; and

"section 28C employee" means an individual who, in connection with the provision of services in accordance with section 28C arrangements, is employed by an individual providing those services.").

21 Page 12, line 22, leave out ("and section I7D").

22 Page 12, line 22, at end insert—

(""Health Authority" has the same meaning as in the National Health Service Act 1977;").

23 Page 12, line 30, at end insert—

("Persons with whom agreements may be made.

17CA.—(1). A Health Board may make an agreement under section 17C only with one or more of the following—

  1. (a) an NHS trust;
  2. (b) in the case of an agreement under which personal medical services are provided—.
    1. (i) a qualifying medical practitioner;
    2. (ii) an individual who is providing personal medical services in accordance with section 17C arrangements or section 28C arrangements;
  3. (c) in the case of an agreement under which personal dental services are provided—
    1. (i) a qualifying dental practitioner;
    2. (ii) an individual who is providing personal dental services in accordance with section 17C arrangements or section 28C arrangements;
  4. (d) an NHS employee, a section 17C employee or a section 28C employee;
  5. (e) a qualifying body.

(2) In this section—

"the 1977 Act" means the National Health Service Act 1977;

"NHS employee" means an individual who, in connection with the provision of services in the health service in Scotland or England and Wales, is employed by—

(a) an NHS trust;

(b) in the case of an agreement under which personal medical services are provided—

  1. (i) a medical practitioner whose name is included in a medical list kept under this Act or in a corresponding list kept under the 1977 Act; or
  2. (ii) a medical practitioner who is providing personal medical services in accordance with section 17C arrangements or section 28C arrangements;

(c) in the case of an agreement under which personal dental services are provided—

  1. (i) a dental practitioner whose name is included in a list prepared in accordance with regulations made under section 25(2)(a) of this Act or section 36(1)(a) of the 1977 Act; or
  2. (ii) a dental practitioner who is providing personal dental services in accordance with section 17C arrangements or section 28C arrangements;

"qualifying body" means—

  1. (a) a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraphs (a) to (d) of subsection (1); and also
  2. (b) in the case of an agreement under which personal dental services are provided, a body corporate which, in accordance with the provisions of Part IV of the Dentists Act 1984, is entitled to carry on the business of dentistry;

"qualifying dental practitioner" means a dental practitioner who satisfies the conditions imposed by regulations made under section 17D(2)(b) of this Act or section 28D(2)(b) of the 1977 Act;

"qualifying medical practitioner" means a medical practitioner who satisfies the conditions imposed by regulations made under section 17D(2)(b) of this Act or section 28D(2)(b) of the 1977 Act;

"section 17C employee" means an individual who, in connection with the provision of services in accordance with section 17C arrangements, is employed by an individual providing those services;

"section 28C arrangements" means arrangements for the provision of services made under section 28C of the 1977 Act; and

"section 28C employee" means an individual who, in connection with the provision of services in accordance with section 28C arrangements, is employed by an individual providing those services.").

24 Clause 20, page 12, line 46, leave out from beginning to end of line 48 and insert—

("medical practitioners performing personal medical services, and dental practitioners performing personal dental services, in accordance with section 28C arrangements.

In paragraph (b) "practitioner" does not include a practitioner who is undergoing training of a prescribed description.").

25 Page 14, line 4, at end insert—

("() The Secretary of State must—

  1. (a) consider whether section 28C arrangements are likely to have an adverse effect on the distribution of medical practitioners providing general medical services or performing personal medical services in England or in Wales;
  2. (b) if he thinks that the arrangements are likely to have that effect, consider whether it is necessary to include in the regulations provisions designed to secure that, so far as is possible, the arrangements do not have that effect; and
  3. (c) if he thinks that it is necessary, include such provisions in the regulations.").

26 Page 14, line 4, at end insert—

("() Regulations which impose conditions on persons performing personal medical services or persons performing personal dental services (whether made by virtue of subsection (2)(b) or otherwise) may, in particular, include provision of a kind that may be made by regulations under section 32.").

27 Page 14, line 11, after ("arrangements") insert ("or corresponding services under section 17C of the National Health Service (Scotland) Act 1978").

28 Page 14, line 36, leave out from beginning to end of line 38.

29 Page 15, line 3, leave out from beginning to end of line 5 and insert—

("medical practitioners performing personal medical services, and dental practitioners performing personal dental services, in accordance with section 17C arrangements.

In paragraph (b) "practitioner" does not include a practitioner who is undergoing training of a prescribed description.").

30 Page 15, leave out lines 14 to 16 and insert—

("(d) require details of section 17C arrangements to be published.").

31 Page 15, line 34, leave out from ("enforceable") to end of line 37 and insert ("in like manner as extract registered decrees arbitral bearing warrant for execution issued by the sheriff court of any sheriffdom in Scotland.").

32 Page 16, line 12, at end insert—

("() The Secretary of State must—

  1. (a) consider whether section 17C arrangements are likely to have an adverse effect on the distribution of medical practitioners providing general medical services or performing personal medical services in Scotland;
  2. (b) if he thinks that the arrangements are likely to have that effect, consider whether it is necessary to include in the regulations provisions designed to secure that, so far as is possible, the arrangements do not have that effect; and
  3. (c) if he thinks that it is necessary, include such provisions in the regulations.").

33 Page 16, line 12, at end insert—

("() Regulations which impose conditions on persons performing personal medical services or persons performing personal dental services (whether made by virtue of subsection (2)(b) or otherwise) may, in particular, include provision of a kind that may be made by regulations under section 22.").

34 Page 16, line 19, after ("arrangements") insert ("or corresponding services under section 28C of the National Health Service Act 1977").

35 Clause 21, page 17, line 9, at beginning insert ("In particular,").

36 Page 17, line 10, leave out (", in particular,").

37 Page 17, line 27. at end insert—

("() Regulations under this section may also provide that the right to choose a medical practitioner conferred by the regulations shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.").

38 Page 17, line 41, at beginning insert ("In particular,").

39 Page 17, line 42, leave out (", in particular,").

40 Page 18, line 12. at end insert—

("() Regulations under this section may also provide that the right to choose a medical practitioner conferred by the regulations shall, in the case of such persons as may he specified in the regulations, be exercised on their behalf by other persons so specified.").

41 Clause 22, page 18, line 24, at end insert—

("() The regulations may, in particular, provide that the right to choose a dental practitioner conferred by the regulations shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.").

42 Page 18, line 36, at end insert—

("() The regulations may, in particular, provide that the right to choose a dental practitioner conferred by the regulations shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified.").

43 Clause 23, page 19, line 31, leave out ("medical") and insert ("Part II").

Baroness Cumberlege

My Lords, I spoke to Amendments Nos. 20 to 43 when I spoke to Amendments Nos. 1 to 7, 12 and 19. I beg to move.

Moved, That the House do agree with the Commons in their Amendments Nos. 20 to 43.—(Baroness Cumberlege.)

On Question, Motion agreed to.