National Health Service Act 1977

Part I — Services and Administration

Functions of the Secretary of State

Appointment of acting Commissioners.

1

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Secretary of State's general power as to services

2

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Services generally

3

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Special hospitals

4

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Other services

5

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Central Health Services Council and Medical Practices Committee

Central Health Services Council, and standing advisory committees

6

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Medical Practices Committee

7

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Local administration

Regional and Area Health Authorities

8

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Special provisions for Area Health Authorities (Teaching)

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Membership

10

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Special health authorities

11

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Supplementary provisions for ss. 8 to 11

12

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Secretary of State's directions

13

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Regional Health Authority's directions

14

Duty of Family Practitioner Committee

15

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Exercise of functions

16

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17

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Directions under ss. 13 to 17 generally

18

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Local advisory committees and Community Health Councils

Local advisory committees

19

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Community Health Councils

20

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Co-operation and assistance

Local social services authorities

21

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Co-operation between health authorities and local authorities

22

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Voluntary organisations and other bodies

23

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Overseas aid

24

Exercise of functions by Local Health Boards

25

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Supply of goods and services by Secretary of State

26

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Conditions of supply under s. 26

27

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Supply of goods and services by local authorities

28

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Part II — General Medical, General Dental, General Ophthalmic, and Pharmaceutical Services

General medical services

Secretary of State’s directions: distribution of functions.

29

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Applications to provide general medical services

30

Health Authority’s directions: exercise of functions.

31

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Independent advocacy services

32

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Distribution of general medical services

33

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Regulations for Medical Practices Committee

34

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General dental services

Arrangements for general dental services

35

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Regulations as to s. 35

36

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Dental Estimates Board

37

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General ophthalmic services

Arrangements for general ophthalmic services

38

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39

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Medical practitioners with qualifications prescribed under s. 38

40

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Pharmaceutical services

Arrangements for pharmaceutical services

41

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Regulations as to s. 41

42

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Persons authorised to provide pharmaceutical services

43

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Local representative committees

Recognition of local representative committees

44

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Functions of local representative committees

45

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Provisions as to disqualification of practitioners

Disqualification of practitioners

46

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Removal of disqualification

47

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Disqualification provisions in Scotland or Northern Ireland

48

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Regulations as to ss. 46 to 48

49

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Other provisions supplementary to Part II

Exercise of choice of practitioner in certain cases

50

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University clinical teaching and research

51

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Use of accommodation

52

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Immunisation

53

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Prohibition of sale of medical practices

54

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Decision of disputes

55

Inadequate services

56

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Part III — Other Powers of the Secretary of State as to theHealth Service

Control of maximum prices for medical supplies

Maximum price of medical supplies may be controlled

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• (1) 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.

• (2) 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—

• (a) to keep such books, accounts and records relating to the undertaking as may be prescribed by the direction or, as the case may be, by the order or a notice served under the order;

• (b) to furnish at such times, in such manner and in such form as may be so prescribed such estimates, returns or information relating to the undertaking as may be so prescribed.

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

• “medical supplies” in this section includes surgical, dental and optical materials and equipment; and

• “undertaking” in this section and that Schedule means any public utility undertaking or any undertaking by way of trade or business.

Additional powers as to services and supplies; and the use of those services and supplies for private patients

Power of Secretary of State to make payments towards expenditure on community services in Wales.

58

S. 58 power in relation to private patients

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Additional provision as to charges under s. 58

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• (1) 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.

• (2) 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—

• (a) for different accommodation or services at different health service hospitals or different classes of such hospitals;

• (b) for different forms or classes of treatment;

• (c) in relation to patients who are, and patients who are not, ordinarily resident in Great Britain ;

• (d) generally for different accommodation and for different services and in relation to different circumstances.

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

• (a) shall be such as will ensure, so far as is practicable, that no increase in the expenses incurred by the Secretary of State under this Act results from any exercise of the section 58 power ;

• (b) shall include such amounts as appear to the Secretary of State proper and reasonable in respect of costs appearing to him to be properly attributable to capital account; and

• (c) in the case of charges for services provided to a private patient at a health service hospital by a whole-time consultant, shall be not less than would be charged by a part-time consultant for providing similar services in similar circumstances to a private patient of his.

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

• (a) the authority shall retain that sum and use it for the purposes of research and development in medicine or dentistry, but

• (b) if the services in question were provided by a consultant employed by a medical or dental school or university, the authority shall, if so directed by the Secretary of State, pay the sum to that school or university to use for those purposes.

• (5) 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.

• (6) In this section—

• " health authority " includes a preserved Board ;

• " preserved Board " has the meaning given by section 15(6) of the National Health Service Reorganisation Act 1973;

• " whole-time consultant " and " part-time consultant " mean respectively a consultant employed whole-time or part-time by a health authority, medical or dental school or university.

Additional powers as to disposal and production of goods

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Restriction of powers under ss. 25, 58 and 61

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Further provisions as to payments by patients for health service accommodation and services

Hospital accommodation on part payment

63

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Personal medical or dental services.

64

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Accommodation and services for private resident patients

65

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Accommodation and services for private non-resident patients

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• (1) 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—

• (a) he may, subject to section 71 below, authorise accommodation and services at the hospital or hospitals in question to be made available to such extent as he may determine, and

• (b) that accommodation and those services shall be 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 any such hospital, of private patients of that practitioner otherwise than as resident patients.

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.

• (2) 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.

• (3) 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.

Withdrawal of health service pay beds and services from private patients

Withdrawal of facilities available for private patients

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Revocation of authorisations under s. 65 or s. 66

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• (1) 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—

• (a) the authorisations under section 65(1) above or those granted by virtue of section 71(3) below, and

• (b) the authorisations under section 66(1) above or those granted by virtue of section 71(3) below,

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

• (2) 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.

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

• (a) have regard to the principles set out in section 70 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 the health service or concerned with the interests of patients at health service hospitals ;

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

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.

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

• (a) the accommodation and services authorisation of which under section 65(1) or section 66(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.

Further provisions as to revocation of s. 66 authorisations

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• (1) 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—

• (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 section 70 below separately in respect of different purposes and specialties,

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

• (2) As regards the revocation of authorisations under section 66(1), any proposals under section 68 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 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.

• (3) 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—

• (a) accommodation and services available for the specialties other than radiotherapy mentioned in subsection (2)(b) above, and

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