The National Health Service (General Medical and Pharmaceutical Services) (Scotland) Amendment (No.2) Regulations 1989

(13A) (1) Any doctor whose name is included in a medical list shall, after 31st March 1990— (a) be available normally at such times and places as, following an application by the doctor, the Board shall approve after consultation with the Area Medical Committee, or, on appeal the Secretary of State shall determine in his case, in accordance with the requirements of the following provisions of this paragraph; and (b) inform his patients about his availability in such manner as the Board may require in accordance with sub-paragraph (14). (2) Subject to sub-paragraphs (3) and (4), a Board shall not approve any application submitted by a doctor in relation to the times at which he is to be available unless it is satisfied that the times proposed are such that— (a) the doctor will be available normally— (i) in 42 weeks in any period of twelve months, (ii) during not less than 26 hours in any such week, and (iii) on 5 days in any such week; and (b) the hours for which the doctor will be available normally in any week are to be allocated between the days on which he will be available normally in that week in such a manner as is likely to be convenient to his patients. (3) On any application made pursuant to sub-paragraph (1) by a doctor who is a restricted services principal or a restricted list principal— (a) sub-paragraph (2) shall not apply; and (b) the Board shall approve the application provided that it is satisfied that the times at which the doctor proposes to be available normally are likely to be convenient to his patients. (4) The Board may, in relation to the application of any doctor— (a) who seeks to be available normally on only 4 days in any week referred to in sub-paragraph (2)(a), excuse the doctor from the requirement of head (a)(iii) of that sub-paragraph and approve the application to the extent allowed by paragraph 13B; (b) who seeks to be available normally for either— (i) less than 26 hours but not less than 19 hours, or (ii) less than 19 hours but not less than 13 hours, in any week referred to in sub-paragraph (2)(a), excuse the doctor from the requirement of head (a)(ii) and (iii) of that sub-paragraph and approve the application to the extent allowed by paragraph 13C; (c) to whom either paragraph 13D or 13E applies, may excuse the doctor from the requirement of head (a)(ii) and (iii) of sub-paragraph (2) to the extent allowed by paragraph 13D or, as the case may be, paragraph 13E. (5) In this paragraph and in paragraphs 13B to 13E, “available” means, in relation to a doctor, available to provide general medical services to his patients, and for the purposes of calculating the times at which a doctor is to be regarded as available— (a) account may be taken of any period when the doctor is attending at his practice premises or at any clinic provided by him for his own patients, and of any time spent when he is making a domiciliary visit; but (b) no account shall be taken of time spent by the doctor when he is holding himself in readiness to make a domiciliary visit if required by any patient; and “availability” shall be construed accordingly. (6) An application by a doctor in relation to any place at which he is to be available shall not be approved by the Board unless it is satisfied that the place at which the doctor proposes to be available normally is likely to be convenient to his patients. (7) An application for approval pursuant to sub-paragraph (1) shall be made in writing to the Board and shall— (a) include the information specified in paragraph 1 of Part ID of this Schedule; and (b) where appropriate, also include— (i) in the case of a doctor to whom sub-paragraph (3) applies, the additional information specified in paragraph 2 of that Part, (ii) in the case of a doctor to whom sub-paragraph (4)(a) applies, the additional information specified in paragraph 3 of that Part, (iii) in the case of a doctor to whom sub-paragraph (4)(b) applies, the additional information specified in paragraph 4 of that Part, (iv) in the case of a doctor to whom paragraph 13D(1) applies, the additional information specified in paragraph 5 of that Part, and (v) in the case of a doctor to whom paragraph 13E(1) applies, the additional information specified in paragraph 6 of that Part, (c) be made— (i) in the case of a doctor whose name is in the medical list on 1st January 1990, not later than 1st February 1990, (ii) in the case of a doctor who is notified after 1st January 1990 that his name has been included in a medical list, within 28 days of his receiving such notification. (8) The Board shall decide an application under sub-paragraph (1) within 28 days of receiving it. (9) In deciding upon any application, the Board shall either— (a) grant approval; (b) grant approval subject to such conditions as the Board sees fit to impose for the purpose of securing that the doctor is available at such times and places as are convenient to his patients; or (c) refuse approval. (10) The Board shall notify the doctor in writing of its decision, and, where it refuses an application or grants an application subject to conditions, it shall send the doctor a statement in writing of the reasons for its decision and of the doctor’s right of appeal under sub-paragraph (11). (11) A doctor may within 28 days of receiving a notification pursuant to sub-paragraph (10) appeal in writing to the Secretary of State against any refusal of approval or against any condition imposed pursuant to sub-paragraph (9)(b). (12) The Secretary of State may, when determining the appeal, either confirm the decision of the Board or substitute his own determination for the decision of the Board. (13) The Secretary of State shall give written notice to the doctor of his determination and of his reasons therefor. (14) The Board may, as it considers appropriate, require a doctor to inform his patients, either by displaying a notice in his waiting room or by sending notices to them, about the times and places at which he is available. (13B) (1) Subject to sub-paragraph (3), where the Board is satisfied that, by reason of a doctor’s participation in health-related activities (other than the provision of general medical services to his patients) he would be likely to suffer an unreasonable degree of inconvenience if paragraph 13A(2)(a)(iii) applied in his case, it may give its approval for the doctor to be available normally on only 4 days in any week referred to in sub-paragraph (2)(a) of that paragraph. (2) For the purposes of sub-paragraph (1), “health-related activities” means activities connected with— (a) the organisation of the medical profession or the training of its members; (b) the provision of medical care or treatment; (c) the improvement of the quality of such care or treatment; or (d) the administration of services under Part I of the National Health Service (Scotland) Act 1978, or of arrangements pursuant to section 19 of that Act for the provision of general medical services, and in reaching a decision as to whether any activity is a health-related activity, the Board shall have regard to the illustrative list in paragraph 7 of Part 1D of this Schedule. (3) The Board shall not give its approval in accordance with sub-paragraph (1) if, in its opinion— (a) the effectiveness of the doctor’s services to his patients is likely to be significantly reduced; or (b) his patients are likely to suffer significant inconvenience, by reason of the doctor’s having been relieved from the requirements of paragraph 13A(2)(a)(iii). (13C) (1) Subject to sub-paragraph (2) the Board may, in the case of a doctor— (a) who practises in partnership with another doctor (i) whose name is included in the medical list, and (ii) who is available normally for not less than 26 hours in each of the weeks referred to in paragraph 13(A)(2)(a); and (b) who seeks to be available normally for either— (i) less than 26 hours but not less than 19 hours, or (ii) less than 19 hours but not less than 13 hours, decide the application as if for the reference to 26 hours in paragraph 13A(2)(a)(ii) there were substituted a reference to 19 hours or 13 hours, as the case may be, and as if the provisions of paragraph 13A(2)(a)(iii) did not apply. (2) Any approval of an application which has been decided in accordance with sub-paragraph (1) shall be subject to the condition that the approval shall lapse after the expiry of a period of 6 months from the date on which the doctor ceases to satisfy head (a) of that sub-paragraph. (13D) (1) Subject to sub-paragraph (2), where a doctor applies for the approval of the Board pursuant to paragraph 13A(1) jointly with another doctor— (a) with whom he practises in partnership; (b) whose name is included in the medical list; (c) with whom he proposes to operate an arrangement whereby— (i) each doctor will be available normally for less than 26 hours in any week referred to in paragraph 13A(2)(a), but (ii) the hours for which both doctors will be available normally will be in aggregate not less than 26 hours in any such week, the Board may approve the application, notwithstanding that neither doctor can himself satisfy the requirement specifi ed in paragraph 13A(2)(a)(ii). (2) Any approval of an application to which sub-paragraph (1) applies shall be subject to the condition that the approval shall lapse after the expiry of six months after the date on which the arrangement referred to in head (c) of that sub-paragraph comes to an end. (13E) (1) Subject to sub-paragraph (3), where a doctor— (a) does not practise in partnership with any other doctor; (b) has no more than 599 patients on his list on 31st January 1990; (c) during the period of 12 months immediately preceding that date— (i) was available normally for an average of less than 20 hours each week, and (ii) in consequence, had his remuneration abated by the Board, in accordance with the Statement published pursuant to regulation 31(1); and (d) seeks to be available normally, in each week referred to in regulation 13A(2)(a), for not less than the number of hours for which he had, on average, been available in each week during the period mentioned in head (c)(i) above, the Board may approve the application notwithstanding that the doctor will not be available normally in accordance with paragraph 13A(2)(a)(ii). (2) When calculating the average hours for the purposes of sub-paragraph (1)(c)(i), account shall be taken of the aggregate number of hours for which the doctor was available normally to patients in the areas of all Boards on whose medical lists his name was included. (3) Any approval by the Board in relation to a doctor to whom sub-paragraph (1) applies shall be subject to the condition that it shall lapse on 1st April 1991.

New paragraph (annual reports)

14

After paragraph 19 (reports to the medical officer) there shall be inserted the following new paragraph:—

(19A) (1) A doctor whose name is included in the medical list shall, in accordance with the provisions of this paragraph, provide annually to each Board in whose medical list his name is included, a report relating to the provision by him of personal medical services (in this paragraph called an “annual report”). (2) An annual report shall contain the information specified in Part IE of this Schedule. (3) Each annual report shall be compiled in respect of a period of 12 months ending on 31st March of the year in which it is provided and shall be sent to the Board not later than 30th June of that year. (4) The first annual report shall be sent to the Board not later than 30th June 1991 and shall be compiled in respect of the period of twelve months ending on 31st March 1991. (5) In the case of a doctor who practises in partnership with other doctors whose names are included in the medical list the information referred to in sub-paragraph (2) may alternatively be provided in the form of an annual report in respect of the partnership as a whole instead of by each doctor in the partnership individually and in such a case a doctor may, if he so wishes, also provide his own annual report. (6) When a Board requires that the information referred to in sub-paragraph (2) be provided in a Form supplied by the Board the doctor shall provide that information on that Form. (7) A Board shall not disclose any annual report to any person unless empowered or required in accordance with any provision or rule of law to do so.

Amendment to paragraph 20 (acceptance of fees)

15

In paragraph 20(1) (acceptance of fees) after sub-paragraph (n) there shall be added the following sub-paragraph:—

(o) where the person is not one to whom any of paragraphs (a), (b) or (c) of section 26(1) of the National Health Service (Scotland) Act 1978[^f00007] applies, including any person to whom any of those paragraphs do not apply by virtue of regulations made under section 26(1E) of that Act, for testing the sight of that person.

PART II — NEW PARTS TO BE INSERTED AFTER PART I OF SCHEDULE 1 TO THE PRINCIPAL REGULATIONS

(1) The services referred to in paragraph 6C(a) of Part I of this Schedule shall comprise— (a) the monitoring— (i) by the consideration of information concerning the child received by or on behalf of the doctor, and (ii) on any occasion when the child is examined or observed by or on behalf of the doctor (whether pursuant to sub-paragraph (b) or otherwise) of the health, well-being and physical, mental and social development (all of which characteristics for the purpose of child health surveillance shall be referred to as “development”) of the child while under the age of 5 years with a view to detecting any deviations from normal development; (b) the examination of the child by or on behalf of the doctor on so many occasions and at such intervals as shall be determined by the Board in whose area the child resides for the purposes of the provision of child health surveillance services generally in that area. (2) The records mentioned in paragraph 6C(b) of Part I of this Schedule shall comprise an accurate record of— (a) the development of the child while under the age of 5 years, compiled as soon as is reasonably practicable following the first examination mentioned in paragraph 1(a) of this Part and, where appropriate, amended following each subsequent examination mentioned in that sub-paragraph; and (b) the responses if any to offers made to an appropriate person for the child to undergo any examination referred to in paragraph 1(b) of this Part. (3) The information mentioned in paragraph 6C(c) of Part I of this Schedule shall comprise— (a) a statement, to be prepared and dispatched to the Board referred to in paragraph 1(b) of this Part as soon as is reasonably practicable following any examination referred to in paragraph 1(a) of this Part, of the procedures undertaken in the course of that examination and of the doctor’s findings in relation to each such procedure; (b) such further information regarding the development of the child while under the age of 5 years as that Board may request.

(1) Full name. (2) Sex. (3) Medical qualifications registered by the General Medical Council. (4) Date and place of first registration as medical practitioner. (5) The times approved by the Board during which the doctor is personally available for consultation by his patients at his practice premises. (6) Whether an appointments system is operated by the doctor for surgery consultations at his practice premises. (7) If there is an appointments system, the method of obtaining a non-urgent appointment and the method of obtaining an urgent appointment. (8) The method of obtaining a non-urgent domiciliary visit and the method of obtaining an urgent domiciliary visit. (9) The doctor’s arrangements for providing personal medical services when he is not personally available. (10) The method by which patients may obtain repeat prescriptions from the doctor. (11) Whether the doctor’s practice is a dispensing practice, and, if so, the arrangements for dispensing prescriptions. (12) Whether the doctor provides clinics for his patients, and if so, their frequency, duration and purpose. (13) The numbers of staff, other than doctors, assisting the doctor in his practice, and a description of their roles. (14) Whether the doctor provides (1) maternity medical services, (2) contraceptive services, (3) child health surveillance services, or (4) minor surgery services. (15) Whether the doctor works single-handed, in partnership, part-time or on a job share basis, or within a group practice. (16) Details of any arrangements whereby the doctor or his staff receive comments by patients on the provision by him of general medical services. (17) The geographical boundary of his practice area by reference to a map of an appropriate scale. (18) Whether the doctor’s practice premises have suitable access for all disabled patients and, if not, the limitations on access for particular types of disability. (19) Personal and professional details as in paragraphs 1 to 4 in relation to any assistant or associate general practitioner who is employed. (20) If the practice either— (a) is a general practitioner training practice for the purposes of the National Health Service (Vocational Training) (Scotland) Regulations 1980[^f00008], or (b) undertakes the teaching of undergraduate medical students, details of any arrangements for drawing this to the attention of patients. (1) Information to be included with any application under paragraph 13A of Part I (1) The address of the proposed practice premises. (2) The days in each week during which the doctor will be in attendance normally at the practice premises and available for consultation by his patients. (3) The hours of each such attendance by the doctor. (4) The hours of any attendance by the doctor on those occasions when he is not usually available to provide the full range of services specified in paragraph 9 of the terms of service (for example, for providing emergency treatment only). (5) The frequency, duration and purpose of any clinic provided by the doctor. (6) The estimated total time to be spent each week making any domiciliary visits. (7) The doctor’s proposals for notifying patients of the times and places approved by the Board at which he will be available to patients for consultation. (8) In the case of a doctor to whom paragraph 11(2) of the terms of service does not apply, his proposals for discharging his continuous responsibility for his patients. (2) Additional information to be included in any application by a doctor who is a restricted services principal or a restricted list principal (1) In the case of a res tricted services principal— (a) the proposed allocation, between each category of services provided, of the total number of hours for which he is to be available normally in any week; and (b) where different services are to be provided at different places, the place at which each category of services is to be provided. (2) In the case of a restricted list principal, the name, address and nature of the establishment(s) or organisation(s) with which his patients are connected. (3) Additional information to be included in any application by a doctor who seeks to be available normally on only 4 days in each week (1) A brief description of each health-related activity with reference to which the application is made. (2) The days in each week during which the doctor will be undertaking that activity. (3) The number of hours in each week which are likely to be occupied in the course of such activity. (4) Additional information to be included in any application by a doctor who seeks to be available normally for less than 26 hours in each week (1) The level of reduced availability sought: either— - not less than 19 hours; or - not less than 13 hours. (2) The proposed allocation of those hours among the days on which the doctor is to be available normally. (3) The name(s) of the doctor’s partner(s). (4) Whether such reduced availability is sought permanently or for only a temporary period. (5) Additional information to be included in any application made jointly by doctors to whom paragraph 13D(1) of Part I applies (1) The name of the doctor’s partner with whom the joint application is made. (2) The nature of the proposed arrangement, including— (a) the hours for which each doctor will be available normally in each week; and (b) the days on which each doctor will be available normally in each week. (6) Additional information to be included in any application made by a doctor to whom paragraph 13E(1) of Part I applies (1) Details of the doctor’s practice(s) in the area of any other Board(s) in whose medical list his name is included. (2) The number of hours occupied in each week in the course of such practice(s). (7) Illustrative list of health-related activities (1) Appointments concerning medical education or training. (2) Medical appointments within the health service other than in relation to the provision of general medical services. (3) Medical appointments under the Crown, with Government Departments or Agencies, or public or local authorities. (4) Appointments concerning the regulation of the medical profession or the Medical Practices Committee.

(1) The number of staff, other than doctors, who assist the doctor in his practice giving details of— (i) the total number of such staff (without specifying their names); (ii) the principal duties of the members of staff and the hours each week during which each assists the doctor; (iii) the qualifications of each member of staff; (iv) in relation to such staff the training undertaken by each member, during the preceding 5 years, which is relevant to their role in the practice. (2) Information in relation to the practice premises, as follows:— (i) any variations in the size of the floor space or, in general, in the design or quality of the premises since the last annual report; (ii) any such variations anticipated in the course of the forthcoming period of 12 months. (3) The following information in relation to the referral of patients to other services under the National Health Service (Scotland) Act 1978 during the period of the Report:— (a) referrals by the doctor to a specialist specifying— (i) the total number of patients referred as in-patients; (ii) the total number of patients referred as out-patients; giving details, in each case, of the hospital to which each patient was referred and, in respect of which of the clinical specialities on the following list, each referral was made:— - General Surgery - General Medicine - Orthopaedics - Rheumatology (physical medicine) - Ear, Nose and Throat - Gynaecology - Obstetrics - Paediatrics - Ophthalmology - Psychiatry - Geriatrics - Dermatology - Neurology - Genito-urinary - X-Ray - Pathology - Others (including plastic surgery, accident & emergency, endocrinology) (b) the total number of patients who, so far as the doctor is aware, referred themselves for services under that Act. (4) The doctor’s other commitments as a medical practitioner with reference to— (i) a description of any posts held; and (ii) a description of all work undertaken, including in each case the annual hourly commitment. (5) Details of any arrangements whereby the doctor or his staff receive comments by patients on the provision by him of general medical services. (6) Information in relation to orders for drugs and appliances as follows:— (a) whether the doctor’s practice has its own dispensary; (b) whether the doctor uses a separate dispensary, and, if so, its location; and (c) the doctor’s arrangements for the issue of repeat prescriptions to patients.

SCHEDULE 2 — NEW PART II TO BE SUBSTITUTED IN SCHEDULE 1 TO THE PRINCIPAL REGULATIONS

(1) Full name. (2) Sex. (3) Date of birth. (4) Private address. (5) Medical qualifications and where obtained. (6) Registration number in the Medical Register and date of first registration. (7) Information about general medical services to be provided for persons in the Board’s area, and in particular whether—

(8) Present or most recent appointment. (9) (a) Names and addresses of intended partner(s) and whether or not they are on the Board’s Medical List; (b) Names and addresses of members of group (other than those already specified in (a)) with whom doctor intends to practise. (10) Whether applied/intending to apply for inclusion on minor surgery list/child health surveillance list. (11) Notification of proposed practice area (including appropriate map). (12) Notification of proposed practice premises. (13) Notification of proposed days and hours of attendance. (14) Proposed place of residence (including telephone number and distance from main surgery) and an undertaking to inform the Board whenever changing permanent residence. (15) Telephone number(s) at which prepared to receive messages. (16) Undertaking that if accepting as a patient a person who at the time of acceptance is residing at a place outside the practice area that he will visit him at that address.

SCHEDULE 3 — (NEW PARTS IV AND V TO BE ADDED TO SCHEDULE 1 TO THE PRINCIPAL REGULATIONS)

(1) Name. (2) Address of practice premises. (3) Registration number in the Medical Register and date of first registration. (4) Details of relevant medical experience (if appropriate before and) after the date of first registration (3) and during the 5 years prior to the application, together with any references. (5) Title of postgraduate qualifications held and date awarded. (1) Name. (2) Address of practice premises. (3) Registration number in the Medical Register and date of first registration. (4) Details of relevant medical experience (if appropriate before and) after the date of first registration during the 5 years prior to the application, together with any references. (5) Details of premises and equipment to be used. (6) Title of postgraduate qualifications held and date awarded.

Signed

Michael B Forsyth — Parliamentary Under Secretary of State, Scottish Office — 31st October 1989

Explanatory note

(This note is not part of the Regulations)

These Regulations further amend the National Health Service (General Medical and Pharmaceutical Services) (Scotland) Regulations 1974 (“the principal Regulations”) which regulate the terms on which general medical and pharmaceutical services are provided under the National Health Service (Scotland) Act 1978 (“the 1978 Act”).

Regulations 3 and 4 of the principal Regulations is amended to include child health surveillance services (set out in a new Part 1A of Schedule I to the principal Regulations) and minor surgery services (set out in a new Part 1B) among the services provided by medical practitioners (“doctors”) in pursuance of arrangements made by a Health Board (“the Board”) (regulations 3 and 4), and new regulation 4A is inserted to make provision for each Board to compile and maintain lists of the doctors providing child health surveillance services and minor surgery services in its locality (regulation 5). New Parts IV and V are inserted into Schedule 1 to the principal Regulations (by Schedule 3 to these Regulations) to specify the information to be provided by a doctor applying for the inclusion of his name in, respectively, the child health surveillance list or the minor surgery list.

Amendments are made to require a Board to record additional information on the list (“the medical list”) it maintains of the names of doctors providing general medical services (regulations 4 and 5). A new regulation 4C is inserted in the principal Regulations to require each Board to compile and maintain a Local Directory of Family Doctors (“the Local Directory”) in relation to those doctors whose names are included in its medical list, and to oblige doctors to supply certain information to the Board for the purpose of the Local Directory. A new regulation 5A is also inserted to make provision for the removal of a doctor’s name from any medical list when attains the age of 70 (regulation 6). The form to be used by doctors when applying to have their names included in a medical list is replaced by a specified list of particulars and undertakings to be included in an application (Schedule 2 to these Regulations).

Regulation 8 amends regulation 15 of the principal Regulations to make provision for a patient’s application to a doctor for the provision of child health surveillance services or minor surgery services and consequential amendments are made to govern the provision of such services, in circumstances where, respectively, a patient is assigned by a Board to a doctor’s list or where a doctor is providing temporary medical services to a patient (regulations 8 and 10). Regulations 9 and 11 of these Regulations simplify the procedure whereby a patient may change the doctor who is providing, respectively, any general medical services or only maternity medical services. Regulation 12 of these Regulations amends the provision for the remuneration of doctors providing general medical services, and amendments made by regulation 13 provide for the publication by a Board of its Local Directory and of doctors' practice leaflets. Regulation 14 inserts a new regulation 33A in the principal Regulations to provide for the issue by Health Boards of guidance to assist doctors in assessing the competence of actual or prospective employees. Transitional provision is made (in regulation 17) in respect of any doctor whose claim for fees or allowances earned before the date from which the amendments relating to doctor’s remuneration come into force is not determined until after that date and in respect of any doctor whose appeal against a decision of a Board under new paragraph 13A of Part I of Schedule I to the principal Regulations (availability to patients) is not determined by 1st April 1990.

Schedule 1 to these Regulations amends Part I of Schedule 1 to the principal Regulations which contains the “terms of service” under which doctors provide general medical services to their patients. A new paragraph 3A is inserted into those terms of service to make provision for the standard of skill, knowledge and care to be expected from doctors providing child health surveillance services and minor surgery services, and an amendment is made to the definition of a doctor’s patients in paragraph 4 to include those persons to whom he provides such services. New paragraphs 6A, 6B, 6C, 6D, and 6E of the terms of service and new Parts IA and IB of Schedule 1 to the principal Regulations are inserted to make detailed provision for the nature and application of child health surveillance services and minor surgery services.

Paragraph 9 (service to patients) is amended to specify the nature of the services to be provided by a doctor, including the giving of general advice in relation to the health of his patients and the provision of consultations, vaccinations and referrals. A new paragraph 9A is inserted to oblige a doctor to produce annually, and to make available to the Board, to his patients and to certain other persons, a practice leaflet which must include certain information (specified in a new Part IC of Schedule 1 to the principal Regulations) about the personal medical services he provides.

New paragraphs 10A, 10B and 10C of the terms of service are inserted to provide that a doctor is, in addition to his general obligations, required to offer a consultation to newly registered patients (new paragraph 10A), to patients whom he has not seen within the preceding 3 years (new paragraph 10B) and to patients who have attained the age of 75 (new paragraph 10C).

An amendment is made also in paragraph 10 in connection with the employment of assistants and deputies by doctors when providing child health surveillance services or minor surgery services.

Paragraph 11 of the terms of service is amended to provide that a doctor is at all times responsible for the provision of general medical services to his patients, while enabling those doctors who have before 1st April 1990 been relieved by the Board of such responsibility at certain times to continue to enjoy such relief after that date.

A new paragraph 12A is inserted in the terms of service to require a doctor to satisfy himself as to the suitability and competence of prospective employees, having regard in particular to any guidance to doctors by the Board under the new regulation 33A in the principal Regulations (inserted by regulation 14) Paragraph 13 is amended to require a doctor to notify the Board of any change in his place of residence.

A new paragraph 13A is inserted in the terms of service to require a doctor to obtain the approval of the Board for the times and places at which he proposes to be available for consultation by his patients, and new paragraphs 13B, 13C, 13D and 13E are also inserted to make provision for the circumstances in which, and the extent to which, a Board may approve a proposal by a doctor to be available for fewer hours, or on fewer days, in each week than are specified in the new paragraph 13A. A new Part ID is inserted in Schedule 1 to the principal Regulations to specify the information to be included in applications by doctors for the purposes of paragraph 13A.

New paragraph 19A obliges a doctor to provide annually to the Board a report which must include certain information (specified in a new Part IE of Schedule 1 to the principal Regulations) about his practice and paragraph 20 is amended to enable an ophthalmic doctor to demand or accept a fee or remuneration for testing the sight of a patient.

These Regulations also effect consequential amendments in the principal Regulations arising out of and in connection with the changes mentioned above.

The Regulations come into effect, in terms of regulation 2(2), for certain purposes on 22nd November 1989, for certain other purposes on 1st January 1990, and for all remaining purposes on 1st April 1990.

Footnotes

[^f00001]: 1978 c. 29; section 19 was amended by the Health Services Act 1980 (c. 53) (“the 1980 Act”), section 7, the Health and Social Services and Social Security Adjudications Act 1983 (c. 41) (“the 1983 Act”), Schedule 7, paragraph 2, and the Medical Act 1983 (c. 54), Schedule 5, paragraph 17(a); the provisions of section 19 are subject to the Health and Medicines Act 1988 (c. 49), section 17; section 105(7), which was amended by the 1983 Act, Schedule 9, paragraph 24, contains provisions, and section 108(1) contains definitions of “prescribed” and “regulations”, relevant to the exercise of the statutory powers under which these Regulations are made.

[^f00002]: 1988 c. 49; the relevant commencement provision is contained in S.I. 1989/1984; the provisions relevant to which this power is exercised came into force on 31st October 1989.

[^f00003]: 1971 c. 62

[^f00004]: S.I. 1974/506; relevant amending instruments are S.I. 1975/696, 1978/1762, 1981/56, 1982/1279, 1985/296, 804, 1625 and 1987/385

[^f00005]: 1983 c. 54

[^f00006]: 1978 c. 29

[^f00007]: 1978 c. 29; section 26 was amended by the Health and Social Security Act 1984 (c. 48), Schedules 1 and 8 and by the Health and Medicines Act 1988, section 13(4).

[^f00008]: S.I. 1980/30, amended by S.I. 1986/1657