Health Act 1999

Part I — The National Health Service

Fund-holding practices

Disqualification etc. of Part II practitioners.

1

In the National Health Service and Community Care Act 1990, sections 14 to 17 (which make provision in relation to fund-holding practices) are to cease to have effect.

Local administration

Statutory schemes: supplementary.

2

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Primary Care Trusts: finance

3

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Expenditure of Health Authorities and Primary Care Trusts

4

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Primary Care Trusts: provision of services etc

5

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Delegation of Health Authority functions relating to pilot schemes and section 28C arrangements

6

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Primary Care Trusts: trust-funds and trustees

7

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Payments relating to past performance

8

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Indemnity cover for Part II services

9

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Remuneration for Part II services

10

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Local representative committees

11

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Directions

12

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NHS trusts

Establishment orders

13

• (1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (5) An order under section 63 may—

• (a) provide for any provision made by it for the purposes of, in consequence of or for giving full effect to this section to be treated as having had effect from a time before the commencement of this section,

• (b) make such provision about an NHS trust dissolved before that commencement.

• (6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (9) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Exercise of powers

14

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Public dividend capital

15

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Existing NHS trusts: conversion of initial loan

16

• (1) This section applies to any NHS trust in existence immediately before commencement.

• (2) On commencement so much of the originating capital debt of the NHS trust as remains outstanding immediately before commencement is to be treated as the originating capital of the NHS trust and accordingly is public dividend capital.

• (3) Any reference in any enactment, instrument or other document to the originating capital debt of the NHS trust is to be construed (except where the context otherwise requires) as a reference to its originating capital.

• (4) The Secretary of State may with the consent of the Treasury determine the amount and time for payment of interest on the NHS trust’s initial loan in respect of the period ending with commencement.

• (5) In this section—

• “commencement” means the coming into force of this section,

• “initial loan” has the meaning given by section 9(5) of the National Health Service and Community Care Act 1990, prior to the repeal of that section by the National Health Service (Consequential Provisions) Act 2006

Borrowing

17

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Quality etc

Duty of quality

18

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The Commission for Health Improvement

19

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Functions of the Commission

20

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Arrangements with the Audit Commission.

21

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Arrangements with Ministers

22

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Obtaining information etc

23

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Restrictions on disclosure of information

24

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Abolition of Clinical Standards Advisory Group

25

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Partnership

Co-operation between NHS bodies

26

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Co-operation between NHS bodies and local authorities

27

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Plans for improving health etc

28

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Payments by NHS bodies to local authorities

29

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Payments by local authorities to NHS bodies

30

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Arrangements between NHS bodies and local authorities

31

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Joint consultative committees

32

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Control of prices of medicines and profits

Powers relating to voluntary schemes

33

• (1) The powers conferred by this section may be exercised where there is in existence a scheme (referred to in this section and sections 34 and 35 as a voluntary scheme) made by the Secretary of State and the industry body for the purpose of—

• (a) limiting the prices which may be charged by any manufacturer or supplier to whom the scheme relates for the supply of any health service medicines, or

• (b) limiting the profits which may accrue to any manufacturer or supplier to whom the scheme relates in connection with the manufacture or supply of any health service medicines.

• (2) For the purposes of this section and sections 34 and 35, a voluntary scheme is to be treated as applying to a manufacturer or supplier to whom it relates if—

• (a) he has consented to the scheme being so treated (and has not withdrawn that consent), and

• (b) no notice is in force in his case under subsection (4).

• (3) For the purposes of this section a voluntary scheme has effect, in relation to a manufacturer or supplier to whom it applies, with any additions or modifications made by him and the Secretary of State.

• (4) If any acts or omissions of any manufacturer or supplier to whom a voluntary scheme applies (a “scheme member”) have shown that, in the scheme member’s case, the scheme is ineffective for either of the purposes mentioned in subsection (1), the Secretary of State may by a written notice given to the scheme member determine that the scheme is not to apply to him.

• (5) A notice under subsection (4) must give the Secretary of State’s reasons for giving the notice; and the Secretary of State may not give a notice under that subsection until he has given the scheme member an opportunity to make representations about the acts or omissions in question.

• (6) Consent under subsection (2)(a) must be given, or withdrawn, in the manner required by the Secretary of State.

• (7) The Secretary of State may after consultation with the industry body require any manufacturer or supplier to whom a voluntary scheme applies to—

• (a) record and keep any information, and

• (b) provide any information to the Secretary of State,

which the Secretary of State may require for the purpose of enabling the scheme to operate or facilitating its operation or for the purpose of giving full effect to any provision made under subsection (8).

• (8) The Secretary of State may—

• (a) prohibit any manufacturer or supplier to whom a voluntary scheme applies from increasing any price charged by him for the supply of any health service medicine covered by the scheme without the approval of the Secretary of State, and

• (b) provide for any amount representing any increase in contravention of that prohibition in the sums charged by that person for that medicine, so far as the increase is attributable to supplies to the health service, to be paid to the Secretary of State within a specified period.

Power to control prices

34

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Statutory schemes

35

• (1) The Secretary of State may, after consultation with the industry body, make a scheme (referred to in this section and section 36 as a statutory scheme) for the purpose of—

• (a) limiting the prices which may be charged by any manufacturer or supplier for the supply of any health service medicines, or

• (b) limiting the profits which may accrue to any manufacturer or supplier in connection with the manufacture or supply of any health service medicines.

• (2) A statutory scheme may, in particular, make any provision mentioned in subsections (3) to (6).

• (3) The scheme may require any manufacturer or supplier to whom it applies to—

• (a) record and keep information, and

• (b) provide information to the Secretary of State.

• (4) The scheme may provide for any amount representing sums charged by any manufacturer or supplier to whom the scheme applies, in excess of the limits determined under the scheme, for health service medicines covered by the scheme to be paid by that person to the Secretary of State within a specified period.

• (5) The scheme may provide for any amount representing the profits, in excess of the limits determined under the scheme, accruing to any manufacturer or supplier to whom the scheme applies in connection with the manufacture or supply of health service medicines covered by the scheme to be paid by that person to the Secretary of State within a specified period.

• (6) The scheme may—

• (a) prohibit any manufacturer or supplier to whom the scheme applies from increasing, without the approval of the Secretary of State, any price charged by him for the supply of any health service medicine covered by the scheme, and

• (b) provide for any amount representing any increase in contravention of that prohibition in the sums charged by that person for that medicine, so far as the increase is attributable to supplies to the health service, to be paid to the Secretary of State within a specified period.

• (7) A statutory scheme may not apply to a manufacturer or supplier to whom a voluntary scheme applies.

Statutory schemes: supplementary

36

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Enforcement

37

• (1) Regulations may provide for a person who contravenes any provision of regulations or directions under sections 33 to 36 to be liable to pay a penalty to the Secretary of State.

• (2) The penalty may be—

• (a) a single penalty not exceeding £100,000, or

• (b) a daily penalty not exceeding £10,000 for every day on which the contravention occurs or continues.

• (3) Regulations may provide for any amount required to be paid to the Secretary of State by virtue of section 33(8)(b), 34(1)(b) or 35(4) or (6)(b) to be increased by an amount not exceeding 50 per cent.

• (4) Regulations may provide for any amount payable to the Secretary of State by virtue of provision made under section 33(8)(b), 34(1)(b) or 35(4), (5) or (6)(b) (including such an amount as increased under subsection (3)) to carry interest at a rate specified or referred to in the regulations.

• (5) Provision may be made by regulations for conferring on manufacturers and suppliers a right of appeal against enforcement decisions taken in respect of them in pursuance of sections 33 to 36 and this section.

• (6) The provision which may be made by virtue of subsection (5) includes any provision which may be made by model provisions with respect to appeals under section 6 of the Deregulation and Contracting Out Act 1994, reading—

• (a) the references in subsections (4) and (5) of that section to enforcement action as references to action taken to implement an enforcement decision,

• (b) in subsection (5) of that section, the references to interested persons as references to any persons and the reference to any decision to take enforcement action as a reference to any enforcement decision.

• (7) In subsections (5) and (6), “enforcement decision” means a decision of the Secretary of State or any other person to—

• (a) require a specific manufacturer or supplier to provide information to him,

• (b) limit, in respect of any specific manufacturer or supplier, any price or profit,

• (c) refuse to give his approval to a price increase made by a specific manufacturer or supplier,

• (d) require a specific manufacturer or supplier to pay any amount (including an amount by way of penalty) to him,

and in this subsection “specific” means specified in the decision.

• (8) A requirement or prohibition, or a limit, under sections 33 to 36 may only be enforced under this section and may not be relied on in any proceedings other than proceedings under this section.

• (9) In this section “regulations” means regulations made by the Secretary of State, and the Secretary of State must consult the industry body before making any regulations under this section.

• (10) The Secretary of State may by order increase (or further increase) either of the sums mentioned in subsection (2).

Controls: supplementary

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• (1) Any power conferred on the Secretary of State by sections 33(6) to (8) and 34 to 36 may be exercised by—

• (a) making regulations, or

• (b) giving directions to a specific manufacturer or supplier,

and the regulations may themselves confer power for the Secretary of State to give directions to a specific manufacturer or supplier; and in this subsection “specific” means specified in the direction concerned.

• (2) Any power to make regulations under any of those provisions or section 37 may be exercised generally in relation to manufacturers or suppliers of health service medicines or be exercised in relation to any class of manufacturers or suppliers.

• (3) The powers to refuse approval under section 33(8)(a) or 35(6)(a) or to impose a limit under section 34(1)(a) or 35(1) are exercisable only with a view to limiting by reference to the prices or profits which would be reasonable in all the circumstances—

• (a) the prices which may be charged for, or

• (b) the profits which may accrue to any manufacturer or supplier in connection with,

the manufacture or supply for the purposes of the health service of health service medicines.

• (4) In so exercising those powers (in the case of sections 34(1)(a) and 35(1) and (6)(a)) the Secretary of State and any other person must bear in mind, in particular, the need for medicinal products to be available for the health service on reasonable terms and the costs of research and development.

• (5) Section 57 of, and Schedule 11 to, the 1977 Act and section 49 of, and Schedule 10 to, the 1978 Act (maximum prices of medical supplies) are to cease to have effect in relation to health service medicines; but the powers conferred by sections 33 to 36 do not affect any other powers of the Secretary of State to control prices or profits.

• (6) This subsection and subsections (7) and (8) apply for the interpretation of sections 33 to 37 and this section—

• “health service” means any of the health services within the meaning of the 1977 Act, the 1978 Act or the Health and Personal Social Services (Northern Ireland) Order 1972,

• “health service medicine” means a medicinal product used to any extent for the purposes of the health service,

• “the industry body” means any body which appears to the Secretary of State appropriate to represent manufacturers and suppliers,

• “manufacture” includes assemble and “manufacturer” means any person who manufactures health service medicines,

• “medicinal product” has the meaning given by section 130 of the Medicines Act 1968,

• “supplier” means any person who supplies health service medicines.

• (7) References to contravention of a provision include failure to comply with it.

• (8) References to supplying medicines include selling them.

Evasion of charges, fraud etc.

Evasion of charges etc

39

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Disqualification etc. of Part II practitioners

40

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Miscellaneous

High security psychiatric services

41

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Provision of information by Registrar General

42

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Health Service Commissioners

43

• (1) Section 15 of the Health Service Commissioners Act 1993 (confidentiality of information) is amended as follows.

• (2) In subsection (1), at the beginning of paragraph (e) there is inserted “ where the information is to the effect that any person is likely to constitute a threat to the health or safety of patients ”.

• (3) Subsection (1A) is omitted.

• (4) In subsection (1B)—

• (a) for “such a case” there is substituted “ a case within subsection (1)(e) ”,