Legalize / United Kingdom / Public General Act

National Health Service (Wales) Act 2006

Type Public General Act

Publication 2006-11-08

Last updated 2026-03-28

State In force

Department Statute Law Database

Source legislation.gov.uk

articles Not indexed

Reform history JSON API

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

The Welsh Ministers and the health service in Wales

Suspension

1

(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

2

(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

3

(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,

(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

4

(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

5

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

6

(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

7

(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,

(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

8

(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

9

(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,

(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

10

(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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(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

11

(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

12

(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

13

(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

(3) The bodies are—

(aa) NHS England,

(ab) integrated care boards,

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

(b) NHS trusts, and

(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

14

(1) Each Local Health Board must, in accordance with regulations, perform such functions in relation to section 50 arrangements (primary medical services) and section 64 arrangements (primary dental services) as may be prescribed.

(2) The regulations may, in particular—

(a) prescribe functions in relation to training,

(b) provide for appeals to the Welsh Ministers or a prescribed body in relation to prescribed functions.

Administration and management of services

15

Each Local Health Board must, in accordance with regulations—

(a) administer the arrangements made in pursuance of this Act for the provision for its area of primary medical services, primary dental services, general ophthalmic services and pharmaceutical services, and

(b) perform such management and other functions relating to those services as may be prescribed.

Advice for Local Health Boards

16

Each Local Health Board must make arrangements with a view to securing that it receives advice appropriate for enabling it effectively to exercise the functions exercisable by it from persons with professional expertise relating to the physical or mental health of individuals.

Plans for improving health etc

17

(1) Each Local Health Board must, at such times as the Welsh Ministers may direct, prepare a plan which sets out a strategy for improving—

(a) the health of the people for whom it is responsible, and

(b) the provision of health care to such people.

(2) Each Local Health Board must keep under review any plan prepared by it under this section.

(3) Each of the bodies specified in subsection (4) must participate in the preparation or review by a Local Health Board of any plan under this section.

(4) Those bodies are—

(a) any local authority whose area falls wholly or partly within the area of the Local Health Board, and

(b) any NHS trust which provides services at or from a hospital or other establishment or facility which falls within the area of the Local Health Board.

(5) In preparing or reviewing any plan under this section, a Local Health Board—

(a) must consult, or seek the participation of, such persons as the Welsh Ministers may direct, and

(b) may consult, or seek the participation of, such other persons as it considers appropriate.

(6) The Welsh Ministers may give directions as to—

(a) the periods to be covered by plans under this section,

(b) the action to be taken by Local Health Boards, NHS trusts and local authorities in connection with the preparation or review of plans under this section,

(d) the matters to be dealt with by plans under this section,

(e) the form and content of plans under this section,

(f) the publication of plans prepared or reviewed under this section,

(g) the sharing of information between NHS England , integrated care boards, ... ... NHS trusts, Local Health Boards and local authorities in connection with the preparation or review of plans under this section or the preparation of joint local health and wellbeing strategies under section 116A of the Local Government and Public Involvement in Health Act 2007,

(h) the provision by NHS England , integrated care boards, ... ... and Local Health Boards of reports or other information to the Welsh Ministers in connection with plans under this section or joint local health and wellbeing strategies under section 116A of the Local Government and Public Involvement in Health Act 2007.

(7) In exercising its functions—

(a) a Local Health Board must have regard to any plan prepared or reviewed by it, and

(b) an NHS trust and a local authority must have regard to any plan in relation to which it has participated.

(8) For the purposes of this section, the persons for whom a Local Health Board is responsible are—

(a) the people in the area of the Local Health Board, and

(b) such of the people outside the area as may be specified in directions given by the Welsh Ministers.

(9) “Health care” means—

(a) services provided to individuals for or in connection with the prevention, diagnosis or treatment of illness, and

(b) the promotion and protection of public health.

Chapter 2 — NHS trusts

NHS trusts

18

(1) The Welsh Ministers may by order establish bodies, called National Health Service trusts (“NHS trusts”), to provide goods and services for the purposes of the health service.

(2) An order under subsection (1) is referred to in this Act as “an NHS trust order”.

(3) No NHS trust order may be made until after the completion of such consultation as may be prescribed.

(4) Schedule 3 makes further provision about NHS trusts.

Welsh Ministers' directions to NHS trusts

19

(1) The Welsh Ministers may give directions to an NHS trust about its exercise of any functions.

(2) The Welsh Ministers may not give directions under this section in respect of matters concerning xenotransplantation, surrogacy agreements, embryology or human genetics.

(3) Nothing in provision made by or under this or any other Act affects the generality of subsection (1).

General duty of NHS trusts

20

An NHS trust must exercise its functions effectively, efficiently and economically.

Financial provisions relating to NHS trusts

21

Schedule 4 makes provision about the financing of NHS trusts.

Chapter 3 — Special Health Authorities

Special Health Authorities

22

(1) The Welsh Ministers may by order establish special bodies for the purpose of exercising any functions which may be conferred on them by or under this Act.

(2) The Welsh Ministers may make such further provision relating to a body established under subsection (1) as they consider appropriate.

(3) A body established under this section is called a Special Health Authority.

(4) An order may, in particular, contain provisions as to—

(a) the membership of the body established by the order,

(b) the transfer to the body of officers, property and liabilities, and

(5) The liabilities which may be transferred by virtue of this section, section 203(10) and section 204(1) to an NHS body on the abolition of a Special Health Authority include criminal liabilities.

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

(7) The Welsh Ministers must, before they make an order under this section, consult with respect to the order such bodies as they may recognise as representing officers who in the opinion of the Welsh Ministers are likely to be transferred or affected by transfers in pursuance of the order.

(8) Schedule 5 makes further provision about Special Health Authorities.

Welsh Ministers' directions to Special Health Authorities

23

(1) The Welsh Ministers may give directions to a Special Health Authority about its exercise of any functions.

(2) The Welsh Ministers may not give directions under this section in respect of matters concerning xenotransplantation, surrogacy agreements, embryology or human genetics.

(3) Nothing in provision made by or under this or any other Act affects the generality of subsection (1).

Exercise of health service functions by Special Health Authorities

24

(1) The Welsh Ministers may direct a Special Health Authority to exercise any of the functions of the Welsh Ministers relating to the health service which are specified in the directions.

(2) Subsection (1) does not apply to the functions of the Welsh Ministers in relation to pilot schemes.

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

Exercise of Special Health Authority functions

25

(1) Regulations may provide for any functions which are exercisable by a Special Health Authority under section 24 to be exercised—

(a) by another Special Health Authority, or

(b) jointly with one or more other Special Health Authorities.

(2) Regulations may provide—

(a) for any functions which are exercisable by a Special Health Authority under section 24 or this section to be exercised on behalf of that Special Health Authority by a committee, sub-committee or officer of the Special Health Authority,

(b) for any functions exercisable jointly under subsection (1)(b) to be exercised, on behalf of the Special Health Authorities in question, by a joint committee or joint sub-committee.

Chapter 4 — Miscellaneous

Intervention orders and default powers

Intervention orders

26

(1) This section applies to NHS bodies other than NHS England , integrated care boards and NHS foundation trusts.

(2) If the Welsh Ministers—

(a) consider that a body to which this section applies is not performing one or more of its functions adequately or at all, or that there are significant failings in the way the body is being run, and

(b) are satisfied that it is appropriate for them to intervene under this section,

they may make an order under this section in respect of the body (an “intervention order”).

(3) An intervention order may make any provision authorised by section 27 (including any combination of such provisions).

Effect of intervention orders

27

(1) In this section—

(a) “member” means a member of a ... ... Special Health Authority or Local Health Board, or a member of the board of directors of an NHS trust,

(b) “employee member” means a member of a ... ... Special Health Authority or Local Health Board who is an officer of the body, or an executive director of an NHS trust.

(2) An intervention order may provide for the removal from office of—

(a) all the members, or

(b) those specified in the order,

and for their replacement with individuals specified in or determined in accordance with the order (who need not be the same in number as the removed individuals).

(3) An intervention order may provide for the suspension (either wholly, or in respect only of powers and duties specified in or determined in accordance with the order) of—

(a) all the members, or

(b) those specified in the order,

and for the powers of the suspended members to be exercised, and their duties performed, during their suspension by individuals specified in or determined in accordance with the order (who need not be the same in number as the suspended individuals).

(4) The powers and duties referred to in subsection (3) are, in the case of an employee member, only those which he has in his capacity as a member.

(5) An intervention order may contain directions to the body to which it relates to secure that a function of the body specified in the directions—

(a) is performed, to the extent specified in the directions, on behalf of the body and at its expense, by such person as is specified in the directions, and

(b) is so performed in such a way as to achieve such objectives as are so specified,

and the directions may require that any contract or other arrangement made by the body with that person contains such terms and conditions as may be so specified.

(6) If the person referred to in subsection (5)(a) is a body to which section 26 applies, the functions of that body include the performance of the functions specified in the directions under subsection (5).

(7) Subsection (8) applies in relation to any provision in this Act, or in any order or regulations made, or directions given, under this Act, relating to—

(a) the membership of the body to which an intervention order relates (or in the case of an NHS trust to the membership of its board of directors), or

(b) the procedure of the body.

(8) The intervention order may provide in relation to any provision specified in the order—

(a) that it does not apply in relation to the body while the order remains in force, or

(b) that it applies in relation to the body, while the order remains in force, with modifications specified in the order.

(9) An intervention order may contain such supplementary directions to the body to which it relates as the Welsh Ministers consider appropriate for the purpose of giving full effect to the order.

Default powers

28

(1) This section applies to NHS bodies other than NHS England , integrated care boards and NHS foundation trusts.

(2) If the Welsh Ministers consider that a body to which this section applies—

(a) has failed to carry out any functions conferred or imposed on it by or under this Act, or

(b) has in carrying out those functions failed to comply with any regulations or directions relating to those functions,

they may after such inquiry as they consider appropriate make an order declaring it to be in default.

(3) The members of the body in default must immediately vacate their office, and the order—

(a) must provide for the appointment, in accordance with the provisions of this Act, of new members of the body, and

(b) may contain such provisions as seem to the Welsh Ministers expedient for authorising any person to act in the place of the body pending the appointment of new members.

(4) An order under this section may contain such supplementary and incidental provisions as appear to the Welsh Ministers to be necessary or expedient, including—

(a) provision for the transfer to the Welsh Ministers of property and liabilities of the body in default, and

(b) where any such order is varied or revoked by a subsequent order, provision in the subsequent order for the transfer to the body in default of any property or liabilities acquired or incurred by the Welsh Ministers in discharging any of the functions transferred to them.

Transfer of residual liabilities

29

(1) If a Local Health Board, an NHS trust or a Special Health Authority ceases to exist, the Welsh Ministers must exercise their functions so as to secure that all of the body's liabilities (other than any criminal liabilities) are dealt with.

(2) A liability is dealt with by being transferred to an NHS body, the Welsh Ministers or the Secretary of State.

Losses and liabilities of certain health service bodies

Schemes for meeting losses and liabilities etc of certain health service bodies

30

(1) The Welsh Ministers may by regulations establish a scheme (a “mutual indemnity scheme”) whereby any of the bodies or other persons specified in subsection (2) may make provision to meet—

(a) expenses arising from any loss of or damage to their property, and

(b) liabilities to third parties for loss, damage or injury arising out of the carrying out of the functions of the bodies or other persons concerned.

(2) The bodies and other persons referred to in subsection (1) are—

(a) Local Health Boards,

(b) NHS trusts, ...

(d) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(e) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(f) a person who is providing, or who has provided, primary medical services in accordance with a contract or other arrangement under Part 4, and

(g) a body or other person (other than a body or other person specified under paragraphs (a) to (f)) who is providing or arranging the provision of, or who has provided or arranged the provision of, health services whose provision is the subject of a contract or other arrangements with a Local Health Board, NHS trust or Special Health Authority,

but a mutual indemnity scheme may limit the class or description of bodies which, or other persons who, are eligible to participate in it.

(3) A mutual indemnity scheme may, in particular—

(a) provide for the scheme to be administered by the Welsh Ministers or by an NHS trust or Special Health Authority specified in the scheme,

(b) require any body which, or other person who, participates in the scheme to make payments in accordance with the scheme, and

(4) If the Welsh Ministers so direct, a Local Health Board, NHS trust or Special Health Authority which is eligible to participate in a scheme must do so.

(5) Where a mutual indemnity scheme provides for the scheme to be administered by the Welsh Ministers, a Special Health Authority or NHS trust must carry out such functions in connection with the administration of the scheme as the Welsh Ministers may direct.

(6) Subsections (4) and (5) do not affect any other power of direction of the Welsh Ministers.

(7) A person or body administering a mutual indemnity scheme does not require permission under any provision of the Financial Services and Markets Act 2000 (c. 8) as respects activities carried out under the scheme.

(8) The Welsh Ministers may by regulations establish a scheme (a “direct indemnity scheme”) under which they may indemnify any of the bodies or other persons specified in subsection (2) against—

(a) expenses arising from any loss of or damage to their property, and

(b) liabilities to third parties for loss, damage or injury arising out of the carrying out of the functions of the bodies or other persons concerned.

(9) A direct indemnity scheme may, in particular–

(a) specify the persons or other bodies eligible to be indemnified (including limiting the class or description of bodies or other persons who are eligible);

(b) specify the expenses and liabilities in respect of which a body or other person may be indemnified and the extent to which they may be indemnified;

(10) Nothing in this section limits or affects the powers of the Welsh Ministers under this Act, or any other enactment, to provide an indemnity—

(a) to any person other than the bodies or other persons specified in subsection (2), or

(b) to a body or other person specified in subsection (2) in respect of any expenses or liabilities other than those mentioned in subsections (1) and (8).

(11) In this section—

(a) in subsections (1)(b) and (8)(b) “functions”, in relation to a body or other person specified in subsection (2)(g), means the body or person's functions of providing, or arranging the provision of, health services whose provision is the subject of a contract or other arrangements with a Local Health Board, NHS trust or Special Health Authority;

(b) in subsection (2) and in paragraph (a) of this subsection “health services” means services provided as part of the health service.

Directions and regulations under this Part

31

(1) This section applies to directions and regulations under any of—

(a) section 12,

(b) section 13,

(d) section 23,

(e) section 24,

(f) section 25.

(2) Except in prescribed cases, the directions and regulations must not preclude a person or body by whom the function is exercisable apart from the directions or regulations from exercising the function.

Part 3 — Local authorities and the NHS

Supply of goods and services by local authorities

32

(1) In the Local Authorities (Goods and Services) Act 1970 (c. 39) the expression “public body” includes—

(a) any Local Health Board, and

(b) so far as relates to their functions under this Act, the Welsh Ministers.

(2) Subsection (1) has effect as if made by an order under section 1(5) of the Local Authorities (Goods and Services) Act 1970 and may be varied or revoked by such an order.

(3) Each local authority must make services available to each NHS body acting in its area, so far as is reasonably necessary and practicable to enable the NHS body to discharge its functions under this Act.

(4) “services” means—

(a) in relation to a local authority in England, the services of persons employed by the authority for the purposes of its functions under the Local Authority Social Services Act 1970 (c. 42);

(b) in relation to a local authority in Wales, the services of persons employed by the authority for the purposes of functions which are social services functions for the purposes of the Social Services and Well-being (Wales) Act 2014 (anaw 4).

Arrangements between NHS bodies and local authorities

33

(1) The Welsh Ministers may by regulations make provision for or in connection with enabling prescribed NHS bodies (on the one hand) and prescribed local authorities (on the other) to enter into prescribed arrangements in relation to the exercise of—

(a) prescribed functions of the NHS bodies, and

(b) prescribed health-related functions of the local authorities,

if the arrangements are likely to lead to an improvement in the way in which those functions are exercised.

(2) The arrangements which may be prescribed include arrangements—

(a) for or in connection with the establishment and maintenance of a fund—

(i) which is made up of contributions by one or more NHS bodies and one or more local authorities, and

(ii) out of which payments may be made towards expenditure incurred in the exercise of both prescribed functions of the NHS body or bodies and prescribed health-related functions of the authority or authorities,

(b) for or in connection with the exercise by an NHS body on behalf of a local authority of prescribed health-related functions of the authority in conjunction with the exercise by the NHS body of prescribed functions of the NHS body,

(c) for or in connection with the exercise by a local authority on behalf of an NHS body of prescribed functions of the NHS body in conjunction with the exercise by the local authority of prescribed health-related functions of the local authority,

(d) as to the provision of staff, goods or services in connection with any arrangements mentioned in paragraph (a), (b) or (c),

(e) as to the making of payments by a local authority to an NHS body in connection with any arrangements mentioned in paragraph (b),

(f) as to the making of payments by an NHS body to a local authority in connection with any arrangements mentioned in paragraph (c).

(3) Regulations under this section may make provision—

(a) as to the cases in which NHS bodies and local authorities may enter into prescribed arrangements,

(b) as to the conditions which must be satisfied in relation to prescribed arrangements (including conditions in relation to consultation),

(c) for or in connection with requiring the consent of the Welsh Ministers to the operation of prescribed arrangements (including provision in relation to applications for consent, the approval or refusal of such applications and the variation or withdrawal of approval),

(d) in relation to the duration of prescribed arrangements,

(e) for or in connection with the variation or termination of prescribed arrangements,

(f) as to the responsibility for, and the operation and management of, prescribed arrangements,

(g) as to the sharing of information between NHS bodies and local authorities.

(4) The provision which may be made by virtue of subsection (3)(f) includes provision in relation to—

(a) the formation and operation of joint committees of NHS bodies and local authorities,

(b) the exercise of functions which are the subject of prescribed arrangements (including provision in relation to the exercise of such functions by joint committees or employees of NHS bodies and local authorities),

(d) the monitoring of prescribed arrangements,

(e) the provision of reports on, and information about, prescribed arrangements,

(f) complaints and disputes about prescribed arrangements,

(g) accounts and audit in respect of prescribed arrangements.

(5) Arrangements made by virtue of this section do not affect—

(a) the liability of NHS bodies for the exercise of any of their functions,

(b) the liability of local authorities for the exercise of any of their functions, or

(c) any power or duty to recover charges in respect of services provided in the exercise of any local authority functions.

(6) The Welsh Ministers may issue guidance to NHS bodies and local authorities in relation to consultation or applications for consent in respect of prescribed arrangements.

(7) The reference in subsection (1) to an improvement in the way in which functions are exercised includes an improvement in the provision to any individuals of any services to which those functions relate.

(8) In this section—

“health-related functions”, in relation to a local authority, means functions of the authority which, in the opinion of the Welsh Ministers—have an effect on the health of any individuals,have an effect on, or are affected by, any functions of NHS bodies, orare connected with any functions of NHS bodies,

“NHS body” does not include a Special Health Authority.

(9) Schedule 12 makes provision with respect to the transfer of staff in connection with arrangements made by virtue of this section.

Power of local authorities to make payments

34

(1) A local authority may make payments to NHS England , an integrated care board ... ... or a Local Health Board towards expenditure incurred or to be incurred by the body in connection with the performance by it of prescribed functions.

(2) A payment under this section may be made in respect of expenditure of a capital or of a revenue nature or in respect of both kinds of expenditure.

(3) The Welsh Ministers may by directions prescribe conditions relating to payments under this section.

(4) The power under subsection (3) may in particular be exercised so as to require, in such circumstances as may be specified—

(a) repayment of the whole or part of a payment under this section, or

(b) in respect of property acquired with payments under this section, payment of an amount representing the whole or part of an increase in the value of the property which has occurred since its acquisition.

(5) No payment may be made under this section in respect of any expenditure unless the conditions relating to it conform with the conditions prescribed for payments of that description under subsection (3).

Care Trusts

35

(1) Where—

(a) an NHS trust is, or will be, a party to any existing or proposed LA delegation arrangements, and

(b) the Welsh Ministers consider that designation of the NHS trust as a Care Trust would be likely to promote the effective exercise by the NHS trust of prescribed health-related functions of a local authority (in accordance with the arrangements) in conjunction with prescribed NHS functions of the NHS trust,

the Welsh Ministers may designate the NHS trust as a Care Trust.

(2) An NHS trust may, however, be designated only in pursuance of an application made to the Welsh Ministers jointly by each prescribed body.

(3) If the application under subsection (2) requests the Welsh Ministers to do so, they may when designating an NHS trust as a Care Trust make a direction under subsection (4).

(4) The direction is that, while it is designated, the NHS trust may (in addition to exercising health-related functions of the local authority as mentioned in subsection (1)(b)) exercise such prescribed health-related functions of the local authority as are specified in the direction in relation to persons in any area so specified, even though it does not exercise any NHS functions in relation to persons in that area.

(5) Where an NHS trust is designated as a Care Trust under this section—

(a) its designation may be revoked by the Welsh Ministers at any time—

(i) of their own motion, and

(ii) after such consultation as they consider appropriate,

(b) if an application for the revocation of its designation is made to the Welsh Ministers by one or more of the parties to the LA delegation arrangements, its designation must be revoked by the Welsh Ministers at the earliest time at which they consider it practicable to do so, having regard, in particular, to any steps that need to be taken in relation to those arrangements in connection with the revocation.

(6) The designation of an NHS trust as a Care Trust under this section must be effected by an order under section 18 which—

(a) (in the case of an existing NHS trust) amends the order establishing the NHS trust so as to change its name to one that includes the words “Care Trust”, or

(b) (in the case of a new NHS trust) establishes the NHS trust with a name that includes those words,

and any revocation of its designation must be effected by a further order under section 18 which makes such provision for changing the name of the NHS trust as the Welsh Ministers consider expedient.

(7) The power of the Welsh Ministers to dissolve an NHS trust includes power to dissolve an NHS trust where they consider that it is appropriate to do so in connection with the designation of any other NHS trust (whether existing or otherwise) as a Care Trust.

(8) Regulations may make such incidental, supplementary or consequential provision (including provision amending, repealing or revoking enactments) as the Welsh Ministers consider expedient in connection with the preceding provisions of this section.

(9) Regulations under subsection (8) may, in particular, make provision—

(a) prescribing—

(i) the manner and circumstances in which, and

(ii) any conditions which must be satisfied before,

an application may be made for an NHS trust to be designated as a Care Trust under this section, or to cease to be so designated, and the information to be supplied with such an application,

(b) enabling the Welsh Ministers to terminate appointments of persons as members of the board of directors of an NHS trust (or of a committee of such a trust) where they consider that it is appropriate to do so in connection with the designation of the NHS trust as a Care Trust,

(c) requiring the consent of the Welsh Ministers to be obtained before any prescribed change is made with respect to the governance of an NHS trust so designated,

(d) for supplementing or modifying, in connection with the operation of subsection (3), any provision made by regulations under section 33.

(10) The designation of an NHS trust as a Care Trust under this section does not affect any of the functions, rights or liabilities of that NHS trust in its capacity as an NHS trust.

(11) In connection with the exercise by an NHS trust so designated of any relevant social services functions of a local authority in England under LA delegation arrangements—

(a) section 7 of the Local Authority Social Services Act 1970 (c. 42) (authorities to exercise social services functions under guidance), and

(b) section 7A of that Act (directions as to exercise of such functions),

apply to the NHS trust as if it were a local authority within the meaning of that Act.

(11A) In connection with the exercise by a body so designated of any relevant social services functions of a local authority in Wales under LA arrangements, sections 145 to 149 of the Social Services and Well-being (Wales) Act 2014 (codes on the exercise of social services functions) apply to the body as if it were a local authority within the meaning of that Act.

(12) In this section—

“health-related functions” has the meaning given by section 33(8),

“LA delegation arrangements” means arrangements falling within section 33(2)(b), whether or not made in conjunction with any pooled fund arrangements,

“NHS functions” means functions exercisable by an NHS trust in its capacity as such,

“pooled fund arrangements” means arrangements falling within section 33(2)(a),

“relevant social services functions” means—in relation to a local authority in England, health-related functions which are social services functions within the meaning of the Local Authority Social Services Act 1970;in relation to a local authority in Wales, health-related functions which are social services functions for the purposes of the Social Services and Well-being (Wales) Act 2014 (anaw 4).

Directed partnership arrangements

36

(1) If the Welsh Ministers are of the opinion—

(a) that a body to which this section applies (“the failing body”) is not exercising any of its functions adequately, and

(b) that it would be likely to lead to an improvement in the way in which that function is exercised if it were to be exercised—

(i) by another body to which this section applies under delegation arrangements, or

(ii) in accordance with pooled fund arrangements made with another such body,

the Welsh Ministers may direct those bodies to enter into such delegation arrangements or pooled fund arrangements in relation to the exercise of the appropriate function or functions as are specified in the direction.

(2) In subsection (1) “the appropriate function or functions” means—

(a) the function of the failing body mentioned in that subsection, and

(b) such other function of that body (if any) as the Welsh Ministers consider would, if exercised under or in accordance with the arrangements in question, be likely to contribute to an improvement in the exercise of the function referred to in paragraph (a).

(3) The bodies to which this section applies are—

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

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

(d) Local Health Boards, and

(e) local authorities,

but in subsections (1) and (2) any reference to functions is, in relation to a local authority, a reference only to relevant social services functions of the authority.

(4) In this section any reference to an improvement in the way in which any function is exercised includes an improvement in the provision to any individuals of any services to which that function relates.

(5) In this section—

“delegation arrangements” means arrangements falling within section 33(2)(b) or (2)(c), whether or not made in conjunction with any pooled fund arrangements,

“health-related functions” has the meaning given by section 33(8),

“pooled fund arrangements” means arrangements falling within section 33(2)(a),

“relevant social services functions” means health-related functions of local authorities in England within the meaning of the Local Authority Social Services Act 1970 (c. 42) or of local authorities in Wales for the purposes of the Social Services and Well-being (Wales) Act 2014 (anaw 4).

Further provisions about directions and directed partnership arrangements

37

(1) A direction under section 36(1) (a “principal direction”) may make provision with respect to—

(a) any of the matters with respect to which provision is required to be made by the specified arrangements by virtue of regulations under section 33, and

(b) such other matters as the Welsh Ministers consider appropriate.

(2) The Welsh Ministers may in particular (either in a principal direction or in any subsequent direction) make provision—

(a) for the determination, whether—

(i) by agreement, or

(ii) (in default of agreement) by the Welsh Ministers or an arbitrator appointed by them,

of the amount of any payments which need to be made by one body to another for the purposes of the effective operation of the specified arrangements, and for the variation of any such determination,

(b) specifying the manner in which the amount of any such payments must be so determined (or varied),

(c) requiring a body specified in the direction to supply to the Welsh Ministers or an arbitrator, for the purpose of enabling any such amount to be so determined (or varied), such information or documents as may be so specified,

(d) requiring any amount so determined (or varied) to be paid by and to such bodies as are specified in the direction,

(e) requiring capital assets specified in the direction to be made available by and to such bodies as are so specified.

(3) The Welsh Ministers may, when giving a principal direction to any bodies to which section 36 applies, give such directions to any other such body as they consider appropriate for or in connection with securing that full effect is given to the principal direction.

(4) Before giving a principal direction to any bodies to which section 36 applies, the Welsh Ministers may—

(a) direct either or both of the bodies in question to take such steps specified in the direction, or

(b) give such other directions,

as the Welsh Ministers consider appropriate with a view to enabling them to determine whether the principal direction should be given.

(5) The revocation of a principal direction does not affect the continued operation of the specified arrangements.

(6) “The specified arrangements”, in relation to a principal direction, means the arrangements specified in the direction in pursuance of section 36(1).

Supply of goods and services by the Welsh Ministers

38

(1) The Welsh Ministers may supply to—

(a) local authorities, and

(b) such public bodies or classes of public bodies as the Welsh Ministers may determine,

any goods or materials of a kind used in the health service.

(2) In subsection (1) “public bodies” includes public bodies in Northern Ireland.

(3) The Welsh Ministers may make available to persons falling within subsection (1)—

(a) any facilities provided by them ... for any service under this Act, and

(b) the services of persons employed by the Welsh Ministers or by a Local Health Board... or a Special Health Authority.

(4) The Welsh Ministers may carry out maintenance work (including minor renewals, minor improvements and minor extensions) in connection with any land or building for the maintenance of which a local authority is responsible.

(5) The Welsh Ministers may supply or make available to persons—

(a) providing general ophthalmic services or pharmaceutical services,

(b) providing services under a general medical services contract or a general dental services contract, or

such goods, materials or other facilities as may be prescribed.

(6) The Welsh Ministers must make available to local authorities—

(a) any services (other than the services of any person) or other facilities provided under this Act,

(b) the services provided as part of the health service by any person employed by the Welsh Ministers..., a Special Health Authority or a Local Health Board, and

(c) the services of any medical practitioner, dental practitioner or nurse employed by the Welsh Ministers..., a Special Health Authority or a Local Health Board otherwise than to provide services which are part of the health service,

so far as is reasonably necessary and practicable to enable local authorities to discharge their functions relating to social services, education and public health.

(7) The Welsh Ministers may arrange to make available to local authorities the services of persons—

(a) providing general ophthalmic services or pharmaceutical services,

(b) performing services under a general medical services contract or a general dental services contract,

(d) providing Local Health Boards... or Special Health Authorities with services of a kind provided as part of the health service,

so far as is reasonably necessary and practicable to enable local authorities to discharge their functions relating to social services, education and public health.

Conditions of supply under section 38

39

(1) The Welsh Ministers must, before they make available the services of any officer under subsection (3)(b) of section 38, or subsection (6)(b) or (c) of that section—

(a) consult the officer or a body recognised by the Welsh Ministers as representing the officer, or

(b) satisfy themselves that the body who employs the officer has consulted the officer about the matter.

(2) The Welsh Ministers may disregard the provisions of subsection (1) in a case where they—

(a) consider it necessary to make the services of an officer available for the purpose of dealing temporarily with an emergency, and

(b) have previously consulted a body such as is mentioned in subsection (1)(b) about making services available in an emergency.

(3) The Welsh Ministers may, for the purposes of subsection (3)(b) of section 38, or subsection (6)(b) or (c) of that section, give such directions to ... Special Health Authorities and Local Health Boards to make the services of their officers available as the Welsh Ministers consider appropriate.

(4) Powers under this section and section 38 may be exercised on such terms as may be agreed, including terms as to the making of payments to the Welsh Ministers.

(5) The Welsh Ministers may make such charges in respect of services or facilities provided under section 38(6) as may be agreed between the Welsh Ministers and the local authority or, in default of agreement, as may be determined by arbitration.

(6) Any power to supply goods or materials under section 38 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.

Health and well-being strategies in Wales

40

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part 4 — Medical services

Duty of Local Health Boards in relation to primary medical services

Primary medical services

41

(1) Each Local Health Board must, to the extent that it considers necessary to meet all reasonable requirements, exercise its powers so as to provide primary medical services within its area, or secure their provision within its area.

(2) A Local Health Board may (in addition to any other power conferred on it)—

(a) provide primary medical services itself (whether within or outside its area),

(b) make such arrangements for their provision (whether within or outside its area) as it considers appropriate, and may in particular make contractual arrangements with any person.

(3) Each Local Health Board must publish information about such matters as may be prescribed in relation to the primary medical services provided under this Act.

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

(5) Regulations may provide that services of a prescribed description must, or must not, be regarded as primary medical services for the purposes of this Act.

(6) Regulations under this section may in particular describe services by reference to the manner or circumstances in which they are provided.

General medical services contracts

General medical services contracts: introductory

42

(1) A Local Health Board may enter into a contract under which primary medical services are provided in accordance with the following provisions of this Part.

(2) A contract under this section is called in this Act a “general medical services contract”.

(3) A general medical services contract may make such provision as may be agreed between the Local Health Board and the contractor or contractors in relation to—

(a) the services to be provided under the contract,

(b) remuneration under the contract, and

(4) The services to be provided under a general medical services contract may include—

(a) services which are not primary medical services,

(b) services to be provided outside the area of the Local Health Board.

(5) In this Part, “contractor”, in relation to a general medical services contract, means any person entering into the contract with the Local Health Board.

Requirement to provide certain primary medical services

43

(1) A general medical services contract must require the contractor or contractors to provide, for his or their patients, primary medical services of such descriptions as may be prescribed.

(2) Regulations under subsection (1) may in particular describe services by reference to the manner or circumstances in which they are provided.

Persons eligible to enter into GMS contracts

44

(1) A Local Health Board may, subject to such conditions as may be prescribed, enter into a general medical services contract with—

(a) a medical practitioner,

(b) two or more individuals practising in partnership where the conditions in subsection (2) are satisfied, or

(2) The conditions referred to in subsection (1)(b) are that—

(a) at least one partner is a medical practitioner, and

(b) any partner who is not a medical practitioner is either—

(i) an NHS employee,

(ii) a section 50 employee, section 64 employee, section 92 employee, section 107 employee, section 17C employee or Article 15B employee,

(iii) a health care professional who is engaged in the provision of services under this Act or the National Health Service Act 2006 (c. 41), or

(iv) an individual falling within section 51(1)(d).

(3) The conditions referred to in subsection (1)(c) are that—

(a) at least one share in the company is legally and beneficially owned by a medical practitioner, and

(b) any share which is not so owned is legally and beneficially owned by a person referred to in subsection (2)(b).

(4) Regulations may make provision as to the effect, in relation to a general medical services contract entered into by individuals practising in partnership, of a change in the membership of the partnership.

(5) In this section—

GMS contracts: payments

45

(1) The Welsh Ministers may give directions as to payments to be made under general medical services contracts.

(2) A general medical services contract must require payments to be made under the contract in accordance with directions under this section.

(3) Directions under subsection (1) may in particular—

(a) provide for payments to be made by reference to compliance with standards or the achievement of levels of performance,

(b) provide for payments to be made by reference to—

(i) any scheme or scale specified in the direction, or

(ii) a determination made by any person in accordance with factors specified in the direction,

(d) provide that the whole or any part of a payment is subject to conditions (and may provide that payments are payable by a Local Health Board only if it is satisfied as to certain conditions),

(e) make provision having effect from a date before the date of the direction, provided that, having regard to the direction as a whole, the provision is not detrimental to the persons to whose remuneration it relates.

(4) Before giving a direction under subsection (1), the Welsh Ministers—

(a) must consult any body appearing to them to be representative of persons to whose remuneration the direction would relate, and

(b) may consult such other persons as they consider appropriate.

(5) “Payments” includes fees, allowances, reimbursements, loans and repayments.

GMS contracts: prescription of drugs, etc

46

(1) A general medical services contract must contain provision requiring the contractor or contractors to comply with any directions given by the Welsh Ministers for the purposes of this section as to the drugs, medicines or other substances which may or may not be ordered for patients in the provision of medical services under the contract.

(2) A direction under this section must, subject to subsection (3), be given by regulations.

(3) A direction under this section may be given by an instrument in writing where it gives effect to a request made in writing to the Welsh Ministers by a person who is a holder of a UK marketing authorisation in respect of the drug, medicine or other substance to which the request relates.

(4) “UK marketing authorisation” has the meaning given by regulation 8(1) of the Human Medicines Regulations 2012 (S.I. 2012/1916).

GMS contracts: other required terms

47

(1) A general medical services contract must contain such provision as may be prescribed (in addition to the provision required by the preceding provisions of this Part).

(2) Regulations under subsection (1) may in particular make provision as to—

(a) the manner in which, and standards to which, services must be provided,

(b) the persons who perform services,

(d) the variation of contract terms (other than terms required by or under this Part),

(e) rights of entry and inspection (including inspection of clinical records and other documents),

(f) the circumstances in which, and the manner in which, the contract may be terminated,

(g) enforcement,

(h) the adjudication of disputes.

(3) Regulations making provision under subsection (2)(c) may make provision as to the circumstances in which a contractor or contractors—

(a) must or may accept a person as a patient to whom services are provided under the contract,

(b) may decline to accept a person as such a patient, or

(4) Regulations under subsection (2)(d) may—

(a) make provision as to the circumstances in which a Local Health Board may impose a variation of contract terms,

(b) make provision as to the suspension or termination of any duty under the contract to provide services of a prescribed description.

(5) Regulations making provision of the kind described in subsection (4)(b) may prescribe services by reference to the manner or circumstances in which they are provided.

(6) Regulations under subsection (1) must make provision as to the right of patients to choose the persons from whom they receive services.

GMS contracts: disputes and enforcement

48

(1) Regulations may make provision for the resolution of disputes as to the terms of a proposed general medical services contract.

(2) Regulations under subsection (1) may make provision—

(a) for the referral of the terms of the proposed contract to the Welsh Ministers, and

(b) for the Welsh Ministers, or a person appointed by them, to determine the terms on which the contract may be entered into.

(3) Regulations may make provision for a person or persons entering into a general medical services contract to be regarded as a health service body for any purposes of section 7, in circumstances where he or they so elect.

(4) Regulations under subsection (3) may include provision as to the application of section 7 in cases where—

(a) persons practising in partnership elect to become a health service body, and

(b) there is a change in the membership of the partnership.

(5) Where—

(a) by virtue of regulations under subsection (3), section 7(11) applies in relation to a general medical services contract, and

(b) a direction as to payments is made under that subsection in relation to the contract,

the direction is enforceable in a county court (if the court so orders) as if it were a judgment or order of that court.

Performance of primary medical services

Persons performing primary medical services

49

(1) Regulations may provide that a health care professional of a prescribed description may not perform any primary medical service for which a Local Health Board is responsible unless he is included in a list maintained under the regulations by a Local Health Board.

(2) For the purposes of this section—

(a) “health care professional” means a person who is a member of a profession regulated by a body mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002 (c. 17),

(b) a Local Health Board is responsible for a medical service if it provides the service, or secures its provision, by or under any enactment.

(3) Regulations under this section may make provision in relation to lists under this section and in particular as to—

(a) the preparation, maintenance and publication of a list,

(b) eligibility for inclusion in a list,

(c) applications for inclusion (including provision as to the Local Health Board to which an application must be made, and for the procedure for applications and the documents to be supplied on application),

(d) the grounds on which an application for inclusion may or must be granted or refused,

(e) requirements with which a person included in a list must comply (including the declaration of financial interests and gifts and other benefits),

(f) suspension or removal from a list (including provision for the grounds for, and consequences of, suspension or removal),

(g) circumstances in which a person included in a list may not withdraw from it,

(h) payments to be made in respect of a person suspended from a list (including provision for the amount of the payment, or the method of calculating the payment, to be determined by the Welsh Ministers or a person appointed by them),

(i) the criteria to be applied in making decisions under the regulations,

(j) appeals against decisions made by a Local Health Board under the regulations, and

(k) disclosure of information about applicants for inclusion, grants or refusals of applications or suspensions or removals,

and may make any provision corresponding to anything in sections 107 to 115.

(4) Regulations under this section may, in particular, also provide for—

(a) a person's inclusion in a list to be subject to conditions determined by a Local Health Board,

(b) a Local Health Board to vary the conditions or impose different ones,

(d) the review by a Local Health Board of decisions made by it by virtue of the regulations.

(5) The imposition of such conditions must be with a view to—

(a) preventing any prejudice to the efficiency of the services to which a list relates, or

(b) preventing fraud.

(6) Regulations making provision as to the matters referred to in subsection (3)(k) may in particular authorise the disclosure of information—

(a) by a Local Health Board to the Welsh Ministers, and

(b) by the Welsh Ministers to a Local Health Board.

Other arrangements for the provision of primary medical services

Arrangements by Local Health Boards for the provision of primary medical services

50

(1) A Local Health Board may make one or more agreements with respect to its area under which primary medical services are provided (otherwise than by the Local Health Board).

(2) An agreement must be in accordance with regulations under section 52.

(3) An agreement may not combine arrangements for the provision of primary medical services with arrangements for the provision of primary dental services.

(4) An agreement may not combine arrangements for the provision of primary medical services with arrangements for the provision of local pharmaceutical services.

(5) But an agreement may include arrangements for the provision of services which are not primary medical services but which may be provided under this Act, other than under Part 6 (general ophthalmic services) or Chapter 1 or 2 of Part 7 (pharmaceutical services and local pharmaceutical services under pilot schemes).

(6) Regulations may provide—

(a) for functions which are exercisable by a Local Health Board in relation to an agreement to be exercisable on behalf of the Local Health Board by a Health Board, and

(b) for functions which are exercisable by a Health Board in relation to an agreement made under section 17C of the National Health Service (Scotland) Act 1978 (c. 29) to be exercisable on behalf of the Board by the Local Health Board.

(7) In this Act, arrangements for the provision of services made under this section are called “section 50 arrangements”.

Persons with whom agreements may be made under section 50

51

(1) A Local Health Board may make an agreement under section 50 only with one or more of the following—

(a) an NHS trust or an NHS foundation trust,

(b) a medical practitioner who meets the prescribed conditions,

(d) an individual who is providing services—

(i) under a general medical services contract or a general dental services contract or an English general medical services contract or an English general dental services contract,

(ii) in accordance with section 50 arrangements, section 64 arrangements, section 92 arrangements, section 107 arrangements, section 17C arrangements or Article 15B arrangements, or

(iii) under section 17J or 25 of the 1978 Act or Article 57 or 61 of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)),

or has so provided them within such period as may be prescribed,

(e) an NHS employee, a section 50 employee, a section 64 employee, a section 92 employee, a section 107 employee, a section 17C employee or an Article 15B employee,

(f) a qualifying body,

(g) a ... Local Health Board.

(2) The power under subsection (1) to make an agreement with a person falling within paragraph (d) or (e) of that subsection is subject to such conditions as may be prescribed.

(3) In this section—

“the 1978 Act” means the National Health Service (Scotland) Act 1978 (c. 29),

“Article 15B arrangements” means arrangements for the provision of services made under Article 15B of the Health and Personal Social Services (Northern Ireland) Order 1972,

“Article 15B employee” means an individual who, in connection with the provision of services in accordance with Article 15B arrangements, is employed by a person providing or performing those services,

“English general dental services contract” means a contract under section 100(2) of the National Health Service Act 2006 (c. 41),

“English general medical services contract” means a contract under section 84(2) of that Act,

“health care professional” means a person who is a member of a profession regulated by a body mentioned (at the time the agreement in question is made) in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002 (c. 17),

“NHS employee” means an individual who, in connection with the provision of services in the health service, the Scottish health service or the Northern Ireland health service, is employed by—an NHS trust, an NHS foundation trust or (in Northern Ireland) a Health and Social Services Trust,a ... Local Health Board,a person who is providing services under a general medical services contract or a general dental services contract or an English general medical services contract or an English general dental services contract,an individual who is providing services as specified in subsection (1)(d)(iii),

“the Northern Ireland health service” means the health service within the meaning of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)),

“qualifying body” means a company which is limited by shares all of which are legally and beneficially owned by persons falling within paragraph (a), (b), (c), (d), (e) or (g) of subsection (1),

“the Scottish health service” means the health service within the meaning of the National Health Service (Scotland) Act 1978 (c. 29),

“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 17C arrangements, is employed by a person providing or performing those services,

“section 92 arrangements” means arrangements for the provision of services made under section 92 of the National Health Service Act 2006 (c. 41),

“section 107 arrangements” means arrangements for the provision of services made under section 107 of that Act,

“section 92 employee” means an individual who, in connection with the provision of services in accordance with section 92 arrangements, is employed by a person providing or performing those services,

“section 107 employee” means an individual who, in connection with the provision of services in accordance with section 107 arrangements, is employed by a person providing or performing those services,

“section 50 employee” means an individual who, in connection with the provision of services in accordance with section 50 arrangements, is employed by a person providing or performing those services,

“section 64 employee” means an individual who, in connection with the provision of services in accordance with section 64 arrangements, is employed by a person providing or performing those services.

Regulations about section 50 arrangements

52

(1) The Welsh Ministers may make regulations about the provision of services in accordance with section 50 arrangements.

(2) The regulations must include provision for participants other than Local Health Boards to withdraw from section 50 arrangements if they wish to do so.

(3) The regulations may, in particular—

(a) provide that section 50 arrangements may be made only in prescribed circumstances,

(b) provide that section 50 arrangements may be made only in prescribed areas,

(c) provide that only prescribed services, or prescribed categories of service, may be provided in accordance with section 50 arrangements,

(d) impose conditions (including conditions as to qualifications and experience) to be satisfied by persons performing services in accordance with section 50 arrangements,

(e) require details of section 50 arrangements to be published,

(f) make provision with respect to the variation and termination of section 50 arrangements,

(g) provide for parties to section 50 arrangements to be treated, in such circumstances and to such extent as may be prescribed, as health service bodies for the purposes of section 7,

(h) provide for directions, as to payments, made under section 7(11) (as it has effect as a result of regulations made by virtue of paragraph (g)) to be enforceable in the county court (if the court so orders) as if they were judgments or orders of that court.

(4) The regulations may also require payments to be made under the arrangements in accordance with directions given for the purpose by the Welsh Ministers.

(5) A direction may make provision having effect from a date before the date of the direction, provided that, having regard to the direction as a whole, the provision is not detrimental to the persons to whose remuneration it relates.

(6) The regulations may also include provision requiring a Local Health Board, in prescribed circumstances and subject to prescribed conditions, to enter into a general medical services contract on prescribed terms with any person who is providing services under section 50 arrangements and who so requests.

(7) The regulations may also include provision for the resolution of disputes as to to the terms of any proposed section 50 arrangements, and in particular may make provision—

(a) for the referral of the terms of the proposed arrangements to the Welsh Ministers, and

(b) for the Welsh Ministers or a person appointed by them to determine the terms on which the arrangements may be entered into.

(8) The regulations must provide for the circumstances in which a person providing primary medical services under section 50 arrangements—

(a) must or may accept a person as a patient to whom such services are so provided,

(b) may decline to accept a person as such a patient,

(9) The regulations must make provision as to the right of patients to choose the persons from whom they receive services under section 50 arrangements.

Assistance and support

Assistance and support: primary medical services

53

(1) A Local Health Board may provide assistance or support to any person providing or proposing to provide—

(a) primary medical services under a general medical services contract, or

(b) primary medical services in accordance with section 50 arrangements.

(2) Assistance or support provided by a Local Health Board under subsection (1) is provided on such terms, including terms as to payment, as the Local Health Board considers appropriate.

(3) “Assistance” includes financial assistance.

Local Medical Committees

54

(1) A Local Health Board may recognise a committee formed for its area, or for its area and that of one or more other Local Health Boards, which it is satisfied is representative of—

(a) the persons to whom subsection (2) applies, and

(b) the persons to whom subsection (3) applies.

(2) This subsection applies to—

(a) each medical practitioner who, under a general medical services contract entered into by him, is providing primary medical services in the area for which the committee is formed, and

(b) each medical practitioner who is providing general ophthalmic services in that area.

(3) This subsection applies to each other medical practitioner—

(a) who is performing primary medical services in the area for which the committee is formed—

(i) pursuant to section 41(2)(a),

(ii) in accordance with section 50 arrangements, or

(iii) under a general medical services contract, and

(b) who has notified the Local Health Board that he wishes to be represented by the committee (and has not notified it that he wishes to cease to be so represented).

(4) A committee recognised under this section is called the Local Medical Committee for the area for which it is formed.

(5) Any such committee may delegate any of its functions, with or without restrictions or conditions, to sub-committees composed of members of that committee.

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