National Health Service (Wales) Act 2006

Part 1 — Promotion and provision of the health service in Wales

The Welsh Ministers and the health service in Wales

Suspension

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• (1) The Welsh Ministers must continue the promotion in Wales of a comprehensive health service designed to secure improvement—

• (a) in the physical and mental health of the people of Wales, and

• (b) in the prevention, diagnosis and treatment of illness.

• (2) The Welsh Ministers must for that purpose provide or secure the provision of services in accordance with this Act.

• (3) The services so provided must 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.

General power to provide services

Welsh Ministers' general power

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• (1) The Welsh Ministers may—

• (a) provide such services as they consider appropriate for the purpose of discharging any duty imposed on them by this Act, and

• (b) do anything else which is calculated to facilitate, or is conducive or incidental to, the discharge of such a duty.

• (2) Subsection (1) does not affect—

• (a) the powers of the Welsh Ministers apart from this section,

• (b) Part 6 and Chapter 1 of Part 7 (ophthalmic and pharmaceutical services).

Provision of particular services

Welsh Ministers' duty as to provision of certain services

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• (1) The Welsh Ministers must provide throughout Wales, to such extent as they consider necessary to meet all reasonable requirements—

• (a) hospital accommodation,

• (b) other accommodation for the purpose of any service provided under this Act,

• (c) medical, dental, ophthalmic, nursing and ambulance services,

• (d) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as they consider are appropriate as part of the health service,

• (e) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as they consider are appropriate as part of the health service,

• (f) such other services or facilities as are required for the diagnosis and treatment of illness.

• (2) For the purposes of the duty in subsection (1), services provided under—

• (a) section 41(2) (primary medical services) or 56(2) (primary dental services), or

• (b) a general medical services contract or a general dental services contract,

must be regarded as provided by the Welsh Ministers.

• (3) This section does not affect Part 6 and Chapter 1 of Part 7 (ophthalmic and pharmaceutical services).

High security psychiatric services

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• (1) The Welsh Ministers' duty under section 1 includes a duty to provide hospital accommodation and services for persons who—

• (a) are liable to be detained under the Mental Health Act 1983 (c. 20), and

• (b) in the opinion of the Welsh Ministers require treatment under conditions of high security on account of their dangerous, violent or criminal propensities.

• (2) The hospital accommodation and services mentioned in subsection (1) are referred to in this section and paragraph 15 of Schedule 3 as “high security psychiatric services”.

• (3) High security psychiatric services may be provided only at hospital premises at which services are provided only for the persons mentioned in subsection (1).

• (4) “Hospital premises” means—

• (a) a hospital, or

• (b) any part of a hospital which is treated as a separate unit.

Other services

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Schedule 1 makes further provision about the Welsh Ministers and services under this Act.

Provision of services otherwise than in Wales

Performance of functions outside Wales

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• (1) The Welsh Ministers may provide or secure the provision of anything mentioned in section 3(1) outside Wales.

• (2) The Welsh Ministers' functions may be performed outside England and Wales, in so far as they relate to—

• (a) holidays for patients,

• (b) the transfer of patients to or from Scotland, Northern Ireland, the Isle of Man or the Channel Islands, or

• (c) the return of patients who have received treatment in England and Wales, to countries or territories outside the British Islands (including for this purpose the Republic of Ireland).

NHS contracts

NHS contracts

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• (1) In this Act, an NHS contract is an arrangement under which one health service body (“the commissioner”) arranges for the provision to it by another health service body (“the provider”) of goods or services which it reasonably requires for the purposes of its functions.

• (2) Section 97(6) (NHS contracts and the provision of local pharmaceutical services under pilot schemes) makes further provision about acting as commissioner for the purposes of subsection (1).

• (3) Paragraph 15 of Schedule 3 (NHS trusts and NHS contracts) makes further provision about an NHS trust acting as provider for the purposes of subsection (1).

• (4) “Health service body” means any of the following—

• (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (ba) NHS England,

• (bb) an integrated care board,

• (c) an NHS trust,

• (d) a Special Health Authority,

• (e) a Local Health Board,

• (f) a Health Board constituted under section 2 of the National Health Service (Scotland) Act 1978 (c. 29),

• (fa) a Special Health Board constituted under that section,

• (g) the Regional Agency for Public Health and Social Well-being,

• (h) the Common Services Agency for the Scottish Health Service,

• (i) the Wales Centre for Health,

• (j) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (k) the Care Quality Commission,

• (ka) the National Institute for Health and Care Excellence,

• (kb) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (l) the Scottish Dental Practice Board,

• (m) the Secretary of State,

• (n) the Welsh Ministers,

• (na) the Scottish Ministers,

• (nb) Healthcare Improvement Scotland,

• (o) the Regional Business Services Organisation,

• (p) a special health and social services agency established under the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990 (S.I. 1990/247 (N.I.3)),

• (q) a Health and Social Care trust established under the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)),

• (r) the Department of Health, Social Services and Public Safety.

• (5) Whether or not an arrangement which constitutes an NHS contract would apart from this subsection be a contract in law, it must not to be regarded for any purpose as giving rise to contractual rights or liabilities.

• (6) But if any dispute arises with respect to such an arrangement, either party may refer the matter to the Welsh Ministers for determination under this section.

• (7) If, in the course of negotiations intending to lead to an arrangement which will be an NHS contract, it appears to a health service body—

• (a) that the terms proposed by another health service body are unfair by reason that the other is seeking to take advantage of its position as the only, or the only practicable, provider of the goods or services concerned or by reason of any other unequal bargaining position as between the prospective parties to the proposed arrangement, or

• (b) that for any other reason arising out of the relative bargaining position of the prospective parties any of the terms of the proposed arrangement cannot be agreed,

that health service body may refer the terms of the proposed arrangement to the Welsh Ministers for determination under this section.

• (8) Where a reference is made to the Welsh Ministers under subsection (6) or (7), they may determine the matter themselves or appoint a person to consider and determine it in accordance with regulations.

• (9) “The appropriate person” means the Welsh Ministers or the person appointed under subsection (8).

• (10) By the determination of a reference under subsection (7), the appropriate person may specify terms to be included in the proposed arrangement and may direct that it be proceeded with.

• (11) A determination of a reference under subsection (6) may contain such directions (including directions as to payment) as the appropriate person considers appropriate to resolve the matter in dispute.

• (12) The appropriate person may by the determination in relation to an NHS contract vary the terms of the arrangement or bring it to an end (but this does not affect the generality of the power of determination under subsection (6)).

• (13) Where an arrangement is so varied or brought to an end—

• (a) subject to paragraph (b), the variation or termination must be treated as being effected by agreement between the parties, and

• (b) the directions included in the determination by virtue of subsection (11) may contain such provisions as the appropriate person considers appropriate in order to give effect to the variation or to bring the arrangement to an end.

Provision for bodies in Northern Ireland

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• (1) Subsection (2) applies where the Regional Agency for Public Health and Social Well-being or a body mentioned in paragraph (o), (p), (q) or (r) of section 7(4) is a party or prospective party to an arrangement or proposed arrangement which—

• (a) falls within the definition of NHS contract in section 7(1), and

• (b) also falls within the definition of HSS contract in Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)).

• (2) Subsections (5) to (13) of section 7 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Welsh Ministers of references to the Welsh Ministers and the Department of Health, Social Services and Public Safety acting jointly.

Arrangements to be treated as NHS contracts

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• (1) This section applies to any arrangement under which a Local Health Board or such other health service body as may be prescribed arranges for the provision to it—

• (a) by a contractor under a general ophthalmic services contract,

• (b) by a person on an ophthalmic list,

• (c) by a person on a pharmaceutical list, or

• (d) by a person who has entered into a pharmaceutical care services contract under section 17Q of the National Health Service (Scotland) Act 1978 (c. 29),

of the goods or services mentioned in subsection (2).

• (2) The goods or services are those that the body reasonably requires for the purposes of its functions, other than functions under—

• (a) Part 6 (general ophthalmic services),

• (b) Chapter 1 or 2 of Part 7 (pharmaceutical services and local pharmaceutical services under pilot schemes), or

• (c) section 115 of, or Chapter 1 or 2 of Part 7 of, the National Health Service Act 2006 (c. 41) (primary ophthalmic services and pharmaceutical services and local pharmaceutical services under pilot schemes).

• (3) Any such arrangement is to be treated as an NHS contract for the purposes of section 7 (other than subsections (7) and (10)).

• (4) In this section—

• “general ophthalmic services contract” and “contractor” under such a contract have the meanings given by section 117 of the National Health Service Act 2006,

• “health service body” means a body which is a health service body for the purposes of section 7,

• “ophthalmic list” includes a list published in accordance with regulations made under—section 26(2)(a) of the National Health Service (Scotland) Act 1978 (c. 29), orArticle 62(2)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)), and

• “pharmaceutical list” includes a list published in accordance with regulations made under—section 129(2)(a) of the National Health Service Act 2006, orArticle 63(2A)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972.

• (5) The reference to a list published in accordance with regulations made under paragraph (a) of section 26(2) of the National Health Service (Scotland) Act 1978 is a reference to the first part of the list (referred to in sub-paragraph (i) of that paragraph) which is published in accordance with regulations under that paragraph.

Provision of services otherwise than by the Welsh Ministers

Welsh Ministers' arrangements with other bodies

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• (1) The Welsh Ministers may arrange with any person or body to provide, or assist in providing, any service under this Act.

• (2) Arrangements may be made under subsection (1) with voluntary organisations.

• (3) The Welsh Ministers may make available any facilities provided by them for any service under this Act—

• (a) to any person or body carrying out any arrangements under subsection (1), or

• (b) to any voluntary organisation eligible for assistance under section 64 or section 65 of the Health Services and Public Health Act 1968 (c. 46).

• (4) Where facilities are made available under subsection (3) the Welsh Ministers may make available the services of any person employed in connection with the facilities by—

• (a) the Welsh Ministers,

• (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (c) a Special Health Authority, or

• (d) a Local Health Board.

• (5) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Welsh Ministers.

• (6) Goods or materials may be made available either temporarily or permanently.

• (7) Any power to supply goods or materials under this section includes—

• (a) a power to purchase and store them, and

• (b) a power to arrange with third parties for the supply of goods or materials by those third parties.

Part 2 — Health service bodies

Chapter 1 — Local Health Boards

Local Health Boards

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• (1) The Welsh Ministers may establish bodies to be known as Local Health Boards.

• (2) Each Local Health Board is established by order made by the Welsh Ministers (referred to in this Act as an LHB order), and an order may establish more than one Local Health Board.

• (3) A Local Health Board is established for the area of Wales specified in its LHB order.

• (4) If any consultation requirements apply, they must be complied with before an LHB order is varied or revoked.

• (5) “Consultation requirements” means requirements about consultation contained in regulations.

• (6) Schedule 2 makes further provision about Local Health Boards.

Functions of Local Health Boards

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• (1) The Welsh Ministers may direct a Local Health Board to exercise in relation to its area—

• (a) functions which were transferred to the National Assembly for Wales by the Health Authorities (Transfer of Functions, Staff, Property, Rights and Liabilities and Abolition) (Wales) Order 2003 (S.I. 2003/813 (W.98)),

• (b) such other of their functions relating to the health service as are specified in the direction.

• (2) The functions which may be specified in directions under subsection (1) include functions under enactments relating to mental health and care homes.

• (3) The Welsh Ministers may give directions to a Local Health Board about its exercise of any functions.

Exercise of Local Health Board functions

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• (1) This section applies to functions exercisable by a Local Health Board under or by virtue of this Act (including this section) or any prescribed provision of any other Act.

• (2) The Welsh Ministers may give directions providing for any functions to which this section applies to be exercised—

• (a) by another Local Health Board,

• (b) by a Special Health Authority, or

• (c) jointly with any one or more of the bodies mentioned in subsection (3).

• (3) The bodies are—

• (aa) NHS England,

• (ab) integrated care boards,

• (a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

• (b) NHS trusts, and

• (c) other Local Health Boards.

• (4) Directions given by the Welsh Ministers may provide—

• (a) for any functions to which this section applies to be exercised, on behalf of the Local Health Board by whom they are exercisable, by a committee, sub-committee or officer of the Local Health Board,

• (b) for any functions which, under this section, are exercisable by a Special Health Authority to be exercised, on behalf of that Special Health Authority, by a committee, sub-committee or officer of the Special Health Authority,

• (c) for any functions which, under this section, are exercisable by a Local Health Board jointly with one or more other Local Health Boards (but not with any NHS trusts) to be exercised, on behalf of the Local Health Boards in question, by a joint committee or joint sub-committee.

• (5) Subsection (6) applies where, by virtue of subsection (2)(b), a Special Health Authority exercises functions of a Local Health Board in relation to a general dental services contract.

• (6) The Welsh Ministers may by order make provision for the transfer to the Special Health Authority of the rights and liabilities of the Local Health Board under the contract (and for their transfer back to the Local Health Board where the Special Health Authority ceases to exercise the functions).

Section 50 arrangements and section 64 arrangements

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