Health Services Act 1976

PART I — The Health Services Board and its Committees

The Health Services Board and its committees

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• (1) There shall be a body, to be called the Health Services Board (in this Act referred to as " the Board "), which shall have the functions assigned to it by this Act.

• (2) The Board shall consist of five members appointed by the Secretary of State in accordance with Part I of Schedule 1 to this Act,

• (3) Without prejudice to the power of the Board to set up any other committees, there shall be constituted in accordance with Part II of the said Schedule 1—

• (a) a Scottish Committee of the Board (" the Scottish Committee ") having the general duty of advising the Board on the performance of its functions in relation to matters affecting Scotland ; and

• (b) a Welsh Committee of the Board (" the Welsh Committee ") having the general duty of advising the Board on the performance of its functions in relation to matters affecting Wales.

• (4) At any meeting of the Board or of the Scottish or Welsh Committee for the purpose of considering or dealing with any application for an authorisation under section 12 below or any proposed alteration of the terms of any such authorisation, the Board or Committee shall be assisted by four assessors selected in accordance with Part III of the said Schedule 1.

• (5) In deciding how to perform any of its functions in relation to any matter affecting Scotland or Wales the Board shall obtain and consider the advice of the Scottish Committee or the Welsh Committee, as the case may be.

• (6) The supplementary provisions contained in Parts IV to VI of the said Schedule 1 shall have effect with respect to the Board and its committees and assessors.

PART II — Use of National Health Service Facilities by Private Patients, etc.

Withdrawal of NHS pay beds and services from private patients

Purpose of ss. 3 to 5

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• (1) Sections 3 to 5 below shall have effect for the purpose of—

• (a) securing the separation of the facilities available in Great Britain for the prevention, diagnosis and treatment of illness under private arrangements from the facilities available for those purposes at premises vested in the Secretary of State ; and

• (b) to that end securing the progressive withdrawal of accommodation and services at NHS hospitals from use in connection with the treatment of persons at such hospitals as resident or non-resident private patients.

• (2) Nothing in this Act shall prejudice the operation of paragraph 10(5) of Schedule 1 to the National Health Service Reorganisation Act 1973 or paragraph 10 of Part I of Schedule 1 to the National Health Service (Scotland) Act 1972 (by virtue of which regulations governing the terms of employment of officers employed by an authority within the meaning of the said paragraph 10(5) or, in Scotland, by a Health Board must not contain a requirement that all consultants so employed shall be so employed whole-time).

Immediate duty of Secretary of State as regards withdrawal of NHS beds from resident private patients

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• (1) Within six months after the passing of this Act the Secretary of State shall reduce by one thousand the total number of beds authorised under section 1(1) of the 1968 Act to be made available to resident private patients.

• (2) That overall reduction shall be effected by reducing, in the case of each authority, and the group of preserved Boards, mentioned in column 1 of Schedule 2 to this Act, the number of beds at NHS hospitals administered by that authority, or by Boards within that group, which were so authorised at the passing of this Act (being the number stated for that authority or group in column 2 of that Schedule) by the number specified for that authority or group in column 3 of that Schedule.

• (3) The Area Health Authorities and Health Boards, and the group of preserved Boards, mentioned in the said Schedule 2, and the numbers specified for them respectively in column 3 of that Schedule, are those the mention and specification of which will best secure that the overall reduction required by subsection (1) above is effected with due regard to the following matters, namely—

• (a) the extent to which the accommodation and services authorised under section 1 of the 1968 Act at each of the NHS hospitals in Great Britain were, in the period of two years which ended on the relevant date, used in connection with the treatment of resident private patients; and

• (b) the extent to which, in the case of each NHS hospital in Great Britain, alternative accommodation and facilities for the private practice of medicine and dentistry are reasonably available (whether privately or at NHS hospitals) in the area served by that hospital.

• (4) The Secretary of State shall so far as is practicable ensure that the beds released by the reduction made under this section are made available for the use of patients other than private patients.

• (5) In subsection (3) above " the relevant date " means—

• (a) in relation to an NHS hospital in England or Wales, 31st December 1973 ;

• (b) in relation to an NHS hospital in Scotland, 31st March 1974.

Functions of Board as regards withdrawal of NHS facilities from private patients

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• (1) It shall be the duty of the Board to submit to the Secretary of State from time to time in accordance with this section proposals for the progressive revocation of—

• (a) the authorisations under section 1(1) of the 1968 Act (use of accommodation and services at NHS hospitals for resident private patients) which are in force at the end of the initial period or are by virtue of section 5(4) below granted thereafter ; and

• (b) the authorisations under section 2(1) of that Act (use of such accommodation and services for non-resident private patients) which are in force at the passing of this Act or are by virtue of section 5(4) below granted thereafter ;

and it shall be the duty of the Secretary of State to give effect to all proposals so submitted.

• (2) The Board—

• (a) shall submit its first proposals under this section within the initial period or such longer period as the Secretary of State may allow ; and

• (b) shall in the six months beginning with the date on which the first proposals are submitted, and in each successive period of six 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 six months is unnecessary, shall instead prepare and submit to the Secretary of State a report explaining the Board's reasons for that decision.

• (3) In formulating proposals under this section the Board shall—

• (a) have regard to the principles set out in subsection (8) below; and

• (b) consider any representations made to the Board by—

• (i) the Secretary of State ;

• (ii) any body which is representative of medical practitioners or dental practitioners or of persons employed in one or other of the national health services or concerned with the interests of patients at NHS hospitals;

• (iii) any other person having a substantial interest in the proposals ;

and in deciding what advice to give the Board in connection with the formulation of any such proposals the Scottish Committee and the Welsh Committee shall likewise have regard to the principles set out in the said subsection (8) and shall consider any representations made to the Committee by any of the persons or bodies above mentioned.

• (4) Without prejudice to subsection (3) above, the Board in formulating proposals under this section for the revocation of authorisations given under section 2(1) of the 1968 Act in respect of accommodation or services at any particular NHS hospital or hospitals, and the Scottish or Welsh Committee in deciding what advice to give the Board in connection with the formulation of any such proposals—

• (a) shall have regard to the purposes and specialties for which the accommodation or services in question are available for use in connection with the treatment of non-resident private patients ; and

• (b) shall apply the principles set out in subsection (8) below separately in respect of different purposes and specialties;

and the Board may formulate separate proposals in respect of different purposes or specialties accordingly.

• (5) As regards the revocation of authorisations under section 2(1) of the 1968 Act, any proposals under this section relating to—

• (a) accommodation available to consultants for the purpose of affording consultations to their private patients, or

• (b) accommodation and services available for the following specialties, namely radiotherapy, diagnostic pathology and diagnostic radiology (including scanning, ultrasonics and methods involving the use of radio-isotopes),

shall be formulated by the Board as separate proposals; and without prejudice to the preceding provisions of this section, the Board's first proposals thereunder shall include separate proposals relating to accommodation available to consultants as mentioned in paragraph (a) above.

• (6) Without prejudice to the preceding provisions of this section, the Board shall, as regards the revocation of authorisations under section 2(1) of the 1968 Act, submit separate proposals under this section relating to—

• (a) accommodation and services available for the specialties other than radiotherapy mentioned in subsection (5)(b) above; and

• (b) other accommodation and services available for diagnostic purposes,

and shall do so not later than the end of the twelve months following the initial period (or, if a period longer than the initial period is allowed under subsection (2)(a) above for the submission of the Board's first proposals under this section, the twelve months following that longer period).

• (7) Each set of proposals under this section shall specify—

• (a) the accommodation and services authorisation of which under the said section 1(1) or 2(1) should be revoked ; and

• (b) the date before which the necessary revocations should take effect,

and may specify different dates for different accommodation or services so specified.

• (8) The principles referred to above are—

• (a) that accommodation or services at any particular NHS hospital or hospitals should remain authorised under section 1(1) or 2(1) of the 1968 Act for use in connection with the treatment of resident or non-resident private patients only while there is a reasonable demand for accommodation and facilities for the private practice of medicine and dentistry in the area or areas served by the hospital or hospitals in question;

• (b) that the authorisation of any such accommodation or services under those provisions for use in that connection should be revoked only if sufficient accommodation and facilities for the private practice of medicine and dentistry are otherwise reasonably available (whether privately or at NHS hospitals) to meet the reasonable demand for them in the area or areas served by the hospital or hospitals in question;

• (c) that the continued authorisation of any such accommodation or services under those provisions for use in that connection should depend on there having been or being taken all reasonable steps to provide, otherwise than at NHS hospitals, sufficient reasonable accommodation and facilities for the private practice of medicine and dentistry to meet the reasonable demand for them in the area or areas served by the hospital or hospitals in question ;

• (d) that failure, in the circumstances mentioned in paragraph (c) above, to take all reasonable steps that could be taken to provide as mentioned in that paragraph would itself be grounds for the Board, after giving due warning to persons likely to be affected thereby of the likely consequences of such failure, to propose the revocation of the authorisations under those provisions relating to accommodation or services at the hospital or hospitals in question.

• (9) It shall be the duty of the Secretary of State to furnish the Board with such information as it may reasonably require for the proper discharge of its functions under this and the following section.

Restrictions on Secretary of State's powers under ss. 1 and 2 of 1968 Act

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• (1) Except as provided by section 3 above, the Secretary of State's powers under section 1(1) of the 1968 Act shall not be exercised at any time in the initial period so as to alter the total number of beds for the time being authorised under the said section 1(1) to be made available to resident private patients.

• (2) After the passing of this Act—

• (a) no authorisation under section 2(1) of the 1968 Act shall be granted, except by virtue of subsection (4) or (5) below; and

• (b) no such authorisation (other than one granted on a temporary basis by virtue of subsection (5) below) shall be to any extent revoked otherwise than in accordance with proposals submitted to the Secretary of State by the Board under section 4 above.

• (3) After the end of the initial period—

• (a) no authorisation under section 1(1) of the 1968 Act shall be granted, except by virtue of subsection (4) or (5) below; and

• (b) no such authorisation (other than one granted on a temporary basis as aforesaid) shall be to any extent revoked otherwise than as mentioned in subsection (2)(b) above.

• (4) The Board may submit to the Secretary of State—

• (a) proposals for securing that in any case where, after the end of the initial period, one or more beds authorised under section 1(1) of the 1968 Act cease to be available to resident private patients in consequence of the permanent closure of any hospital accommodation in England, Wales or Scotland independently of any proposals submitted by the Board under section 4 above, the total number of effective beds so authorised in England, Wales or Scotland (as the case may be) is not thereby reduced below what it would be if—

• (i) the closed accommodation had remained in use; but

• (ii) effect had been given by the Secretary of State to all proposals under section 4 above which were received by him before the submission of the proposals in question under this paragraph ;

• (b) proposals for securing that in any case where, after the passing of this Act, any accommodation or services authorised under section 2(1) of the 1968 Act cease to be available to non-resident private patients in consequence of the permanent closure of any hospital accommodation in England, Wales or Scotland independently of any proposals submitted by the Board under section 4 above, the total amount of effective accommodation and services so authorised in England, Wales or Scotland (as the case may be) is not thereby reduced below what it would be if—

• (i) the closed accommodation had remained in use; but

• (ii) effect had been given by the Secretary of State to all proposals under section 4 above received by him before the submission of the proposals in question under this paragraph ;

and it shall be the duty of the Secretary of State to grant such authorisations under the said section 1(1) or 2(1), as the case may be, as are needed to give effect to any proposals submitted to him under this subsection.

• (5) Where any hospital accommodation in England, Wales or Scotland 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 1(1) or 2(1) of the 1968 Act as he would have been able to grant by virtue of paragraph (a) or (b) of subsection (4) above if—

• (a) the closure had been permanent; and

• (b) the Board had submitted to him any proposals which it could in that case have submitted to him under the paragraph in question.

• (6) Subject to the restrictions imposed by the preceding provisions of this section, the provisions of section 1 or, as the case may be, section 2 of the 1968 Act shall continue to have effect in relation to any accommodation or services to which an authorisation under section 1(1) or section 2(1) of that Act relates.

Common waiting-lists

Recommendations on arrangements for securing use of NHS facilities on basis of medical priority

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• (1) The Board shall within the initial period make recommendations to the Secretary of State as to what arrangements for affording persons admission or access as resident or non-resident private patients to authorised accommodation and services are, in the opinion of the Board, best suited for securing that all persons admitted or afforded access to accommodation or services at NHS hospitals as resident or non-resident patients are, so far as is practicable, admitted or afforded access thereto on the basis of medical priority alone, whether they come as private patients or not.

• (2) In subsection (1) above " authorised accommodation and services" means such accommodation and services at NHS hospitals as for the time being remain authorised under section 1(1) or 2(1) of the 1968 Act for use in connection with the treatment of resident or non-resident private patients.

• (3) In deciding what recommendations to make under this section the Board shall take into account all relevant considerations and shall, in particular, have regard to the advice of the Scottish and Welsh Committees and to any representations made to the Board by any body representing persons of any of the following descriptions who are likely to be affected by the recommendations, namely—

• (a) medical practitioners;

• (b) dental practitioners ; and

• (c) persons (other than medical and dental practitioners) employed in one or other of the national health services,

or by any body concerned with the interests of patients at NHS hospitals likely to be so affected.

Use of NHS facilities and supplies otherwise than for purposes of services under National Health Service Acts

Secretary of State's powers to provide services etc. otherwise than for purposes of services under National Health Service Acts

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• (1) in the following provisions (which confer power on the Secretary of State to make certain supplies and services available to persons on such terms, including terms as to the payment of charges, as he thinks fit), namely—

• (a) section 18 of the 1946 Act and section 19 of the 1947 Act (supplies of blood and other substances and preparations not readily available); and