Legalize / United Kingdom / Wales / Welsh-Statutory-Instrument

The General Medical Services Transitional and Consequential Provisions (Wales) (No. 2) Order 2004

Type Welsh-Statutory-Instrument

Publication 2004-03-31

Last updated 2023-04-01

State In force

Jurisdiction Wales

Department King's Printer of Acts of Parliament

Source legislation.gov.uk

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(a) any references to the patients of the medical practitioner were references to the patients of the general medical services contractor or the default contractor;

(b) any references to the whole of the out of hours period were references to—

(i) the period beginning at 6.30pm on any day from Monday to Thursday and ending at 8am on the following day,

(ii) the period between 6.30pm on Friday and 8am the following Monday, and

(iii) Good Friday, Christmas Day and bank holidays;

(i) any reference to 7pm on Monday to Friday were a reference to 6.30pm, and

(ii) any reference to 1pm on Saturday were a reference to 6.30pm on Friday; and

(d) any references to a particular transferee doctor were references to—

(i) that person as a general medical services contractor, a default contractor or a party to contractual arrangements made under article 15 of the Transitional Order;

(ii) that person and any other medical practitioner with whom he or she is practising in partnership who have entered in to a general medical services contract or a default contract or are a party to contractual arrangements made under article 15 of the Transitional Order; or

(iii) the company in which he or she is a legal and beneficial shareholder and which has entered into a general medical services contract.

Review of approval of out of hours arrangements under general medical services contracts and default contracts

61

(1) Where—

(a) an approval of an out of hours arrangement granted under paragraph 18A of Schedule 2 to the 1992 Regulations is to be treated, pursuant to article 59, as an approval granted under the term of a general medical services contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or under the equivalent term of a default contract); and

(b) on or before 31st March 2004, the Local Health Board had commenced a review of its approval of that arrangement under paragraph 18B of Schedule 2 to the 1992 Regulations but had not yet made its determination,

that review shall continue as if it were a review under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract), subject to the modification that the 30 days referred to in the term giving effect to paragraph 4(2) of that Schedule (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Local Health Board sent its notice under paragraph 18B(1) of Schedule 2 to the 1992 Regulations.

Review of approval of out of hours arrangements under general medical services contracts which follow default contracts

62

(1) Where—

(a) an approval of an out of hours arrangement granted under a default contract is to be treated, pursuant to article 41, as an approval granted under the term of a general medical services contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations; and

(b) on or before the date on which the default contract ceases to have effect, the Local Health Board has commenced a review of its approval of that arrangement under the term of the default contract which is equivalent to paragraph 4 of Schedule 7 to the 2004 Regulations but has not yet made its determination,

that review shall continue as if it were a review under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations, subject to the modification that the 30 days referred to in the term giving effect to paragraph 4(2) of that Schedule shall be treated as beginning with the day on which the Local Health Board sent its notice under the equivalent term of the default contract.

Withdrawal of approval of out of hours arrangements under general medical services contracts and default contracts

63

(1) Where—

(a) an approval of an out of hours arrangement granted under paragraph 18A of Schedule 2 to the 1992 Regulations is to be treated, pursuant to article 59, as an approval granted under the term of a general medical services contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or under the equivalent term of a default contract); and

(b) on or before 31st March 2004, a Local Health Board had notified a medical practitioner of its withdrawal of approval of that arrangement under paragraph 18B of Schedule 2 to the 1992 Regulations but that withdrawal had not yet taken effect,

paragraphs (2) to (4) shall apply.

(2) In a case where, on 31st March 2004—

(a) the time for appealing under paragraph 18B(6) of Schedule 2 to the 1992 Regulations had expired without any appeal being made; or

(b) an appeal had been made under that paragraph but had been determined or withdrawn before the end of the period of two months beginning with the date on which the notice of withdrawal was sent by the Local Health Board under paragraph 18B(4) of that Schedule,

the withdrawal shall take effect as a withdrawal of approval under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract) on the date on which it would have taken effect had paragraph 18B(7) of Schedule 2 to the 1992 Regulations not been revoked.

(3) In a case where the time for appealing under paragraph 18B(6) of Schedule 2 to the 1992 Regulations had not expired on or before 31st March 2004, the notice of determination of withdrawal shall be deemed to be a notice of determination of withdrawal of approval on notice under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract), subject to the modifications that—

(a) the 30 days referred to in the term of the general medical services contract giving effect to paragraph 4(8) (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Local Health Board sent the notice under paragraph 18B, and

(b) the date referred to in the term of the general medical services contract giving effect to sub-paragraph 4(9)(a) (or in the equivalent term of the default contract) shall be treated as being the date on which the Local Health Board sent the notice under paragraph 18B.

(4) In a case where, on 31st March 2004, an appeal had already been made under paragraph 18B(6) of Schedule 2 to the 1992 Regulations but not yet been determined or withdrawn, the appeal shall continue to be dealt with as if paragraphs 18A and 18B of that Schedule had not been revoked and, if the appeal is dismissed, the withdrawal of approval shall take effect as a withdrawal of approval under the term of the general medical services contract which gives effect to paragraph 4 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract) on the date on which the general medical services contractor or the default contractor received notice of the dismissal of the appeal.

Appeal against immediate withdrawal of approval of out of hours arrangements under general medical services and default contracts

64

Where—

(a) on or before 31st March 2004, a Local Health Board had notified a medical practitioner of its immediate withdrawal of approval of an out of hours arrangement under paragraph 18C of Schedule 2 to the 1992 Regulations; and

(b) on or before 1st April 2004, that medical practitioner—

(i) has entered as an individual medical practitioner into a general medical services contract, or a default contract, which requires the provision of out of hours services;

(ii) is one of two or more individuals practising in partnership who have entered into such a contract; or

(iii) is a legal and beneficial shareholder in a company which has entered into such a general medical services contract,

paragraphs (2) and (3) shall apply.

(2) In a case where the time for appealing under paragraph 18C(4) had not expired on or before 31st March 2004, that withdrawal shall be treated as if it were a withdrawal of approval under the term of the general medical services contract which gives effect to paragraph 4(3)(c) of Schedule 7 to the 2004 Regulations (or under the equivalent term of a default contract) subject to the modification that the 30 days referred to in the term giving effect to paragraph 4(8) of that Schedule (or in the equivalent term of the default contract) shall be treated as beginning with the day on which the Local Health Board’s notification under paragraph 18C(2) of Schedule 2 to the 1992 Regulations was sent.

(3) In a case where, on 31st March 2004, an appeal had already been made under paragraph 18C(4) but not yet been determined or withdrawn, that appeal shall, except in the circumstances specified in paragraph (4), continue to be dealt with as if paragraphs 18A and 18C of Schedule 2 to the 1992 Regulations had not been revoked and, if the appeal is successful, the approval of the arrangement shall be treated as an approval given under the term of the general medical services contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations (or under the equivalent term of the default contract).

(4) The circumstances referred to in paragraph (3) are that the appeal related to an arrangement with a transferee doctor as defined in paragraph 18A(1)(c) of Schedule 2 to the 1992 Regulations and that doctor—

(a) has not entered as an individual medical practitioner into a general medical services contract, or a default contract, which includes the provision of out of hours services;

(b) is not one of two or more individuals practising in partnership who have entered into such a contract;

(c) is not a legal and beneficial shareholder in a company which has entered into such a general medical services contract; or

(d) is not a party to contractual arrangements under article 15 of the Transitional Order which include the provision of out of hours services.

(5) The terms of an approval granted pursuant to paragraph (2) or (3) shall be the same as those of the approval previously granted under paragraph 18A of Schedule 2 to the 1992 Regulations except that—

(a) any references to the patients of the medical practitioner shall be amended to be references to the patients of the general medical services contractor or the default contractor;

(b) any references to the whole of the out of hours period shall be amended to be references to—

(i) the period beginning at 6.30pm on any day from Monday to Thursday and ending at 8am on the following day,

(ii) the period between 6.30pm on Friday and 8am the following Monday, and

(iii) Good Friday, Christmas Day and bank holidays;

(i) any reference to 7pm on Monday to Friday shall be amended to be a reference to 6.30pm, and

(ii) any reference to 1pm on Saturday shall be amended to be a reference to 6.30pm on Friday; and

(d) any references to a particular transferee doctor shall be amended to be references to—

(i) that person as a general medical services contractor, a default contractor or a party to contractual arrangements made under article 15 of the Transitional Order,

(ii) that person and any other medical practitioner with whom he or she is practising in partnership who have entered in to a general medical services contract or a default contract or are a party to contractual arrangements made under article 15 of the Transitional Order, or

(iii) the company in which he or she is a legal and beneficial shareholder and which has entered into a general medical services contract.

References to the NHS dispute resolution procedure in general medical services contracts which follow default contracts

65

Where—

(a) on or before the date on which a default contract ceases to have effect, a default contractor has received notice of—

(i) the refusal of an application for approval of an out of hours arrangement under the term of its contract equivalent to paragraph 2(4) of Schedule 7 to the 2004 Regulations,

(ii) a determination of a Local Health Board under the term of its contract equivalent to paragraph 4(6) of Schedule 7 to the 2004 Regulations which gives notice of immediate withdrawal of approval, or

(iii) immediate withdrawal of approval under the term of its contract equivalent to paragraph 5(1)(b) of that Schedule;

(b) on the date on which the default contract ceases to have effect—

(i) the 30 days for referring that matter in accordance with the NHS dispute resolution procedure has not expired, and

(ii) no referral under that procedure has yet been made; and

(c) the default contractor has entered into a general medical services contract which takes effect immediately after the default contract ceases to have effect,

the refusal or notice shall be treated, for the purposes of referring the matter in accordance with the NHS dispute resolution procedure contained in the general medical services contract, as if it were a refusal or notice of withdrawal given under the equivalent terms of the general medical services contract and the general medical services contractor may refer the matter in accordance with that dispute resolution procedure before the end of the period of 30 days beginning with the day on which the Local Health Board sent the notice of refusal, determination, or, as the case may be, withdrawal, to the default contractor.

Carry over of disputes relating to out of hours arrangements between default contracts and general medical services contracts

66

(1) Where—

(a) on or before the date on which a default contract ceases to have effect, a default contractor has referred a dispute to be determined in accordance with the NHS dispute resolution procedure under the terms of its default contract equivalent to paragraphs 2(5), or 4(8) of Schedule 7 to the 2004 Regulations;

(b) on the date on which the default contract ceases to have effect, that dispute has not been determined or withdrawn; and

(c) the default contractor has entered into a general medical services contract which takes effect immediately after the default contract ceases to have effect,

paragraph (2) shall apply.

(2) The dispute shall continue to be dealt with as if it were a dispute referred under the NHS dispute resolution procedure contained in the general medical services contract relating to—

(a) a refusal of an application under the term of the general medical services contract giving effect to paragraph 2 of Schedule 7 to the 2004 Regulations;

(b) a determination of the Local Health Board under the term of the general medical services contract giving effect to paragraph 4 of that Schedule; or

(c) an immediate withdrawal of approval under the term of the general medical services contract giving effect to paragraph 6 of that Schedule.

Sub-contracting of out of hours services under general medical services contracts

67

(1) Where, prior to 1st January 2005, a general medical services contractor wishes to sub-contract all or part of its out of hours services in circumstances which would require the written approval of the Local Health Board in accordance with the term of the general medical services contract which gives effect to paragraph 69 of Schedule 6 to the 2004 Regulations, it shall be deemed to have such written approval if, at the date on which it enters into the sub-contract—

(a) it has, or, pursuant to articles 59, 60, and 64 is deemed to have, approval of an out of hours arrangement under the term of the general medical services contract which gives effect to paragraph 2 of Schedule 7 to the 2004 Regulations whose terms are, in all material respects, identical to those of the proposed sub-contract;

(b) that approval has not been suspended or withdrawn; and

(c) it has not previously entered into a sub-contract for its out of hours services in reliance on the approval referred to in sub-paragraph (a).

(2) The general medical services contractor shall notify the Local Health Board in writing as soon as reasonably practicable of any sub-contract which it proposes to enter into or has entered into pursuant to paragraph (1).

(3) An approval deemed to have been granted pursuant to paragraph (1) shall be regarded, for all purposes, as an approval granted under the term of the general medical services contract which gives effect to paragraph 69 of Schedule 6 of the 2004 Regulations.

Out of hours services to patients not registered with general medical services contractors or default contractors

68

(1) Where a general medical services contractor or a default contractor is required under article 24 or 25 of the Transitional Order to provide any of the additional services to patients who are not included on its list of patients, it shall, for so long as that requirement continues, and subject to paragraphs (2) and (4), also be required to provide that service to those patients throughout the out of hours period.

(2) In the case of a general medical services contract, the requirement referred to in paragraph (1) shall cease on the date on which any opt out of out of hours services commences pursuant to the terms of the general medical services contract which gives effect to paragraphs 4 or 5 of Schedule 3 to the 2004 Regulations.

(3) Where paragraph (2) applies, the requirement to inform patients of opt outs in the term of the general medical services contract which gives effect to paragraph 6 of Schedule 3 to the 2004 Regulations shall apply to the patients to whom services are provided pursuant to this article as it applies to the general medical services contractor’s own registered patients.

(4) Nothing in this article shall require a general medical services contractor or a default contractor to provide services under this article if, in the reasonable opinion of the default contractor or the general medical services contractor in the light of the patient’s medical condition it would be reasonable in all the circumstances for the patient to wait for the services required until the next time at which he or she could obtain such services during core hours.

(5) Services included in a general medical services contract or a default contract pursuant to this article shall be deemed to fall within the definition of out of hours services for the purposes of—

(a) the terms of the general medical services contract which give effect to paragraphs 11, 13 and 69 to 71 of Schedule 6 to the 2004 Regulations and Schedule 7 to those Regulations; or

(b) any equivalent terms of the default contract.

Application of regulation 30 of the 2004 Regulations to general medical services contracts entered into under Part 2 of the Transitional Order

69

Where a person enters into a general medical services contract pursuant to an entitlement under Part 2 of the Transitional Order under which services are not to be provided until on or after 1st January 2005, regulation 30 of the 2004 Regulations (out of hours services) shall apply to that general medical services contract as it applies to general medical services contracts under which services are to be provided before that date.

PART 6 — TRANSITIONAL ARRANGEMENTS: THE NATIONAL HEALTH SERVICE (SERVICE COMMITTEES AND TRIBUNAL) REGULATIONS 1992

Interpretation

70

(1) In this Part—

“the Service Committees Regulations” means the National Health Service (Service Committees and Tribunal) Regulations 1992[^f00050];

“amendments” in respect of any regulation or regulations in the Service Committees Regulations means amendments made to that regulation or those regulations by paragraph 10 of Schedule 1 to this Order;

“appropriate Local Health Board” has the same meaning as “appropriate Health authority” in the Service Committees Regulations;

“contracting LHB” means a Local Health Board that has entered into a default contract or a general medical services contract (as the case may be) with— a doctor who is the subject of the allegation, a partnership, where a doctor who is the subject of the allegation is a partner, a limited company, where a doctor who is the subject of the allegation is a legal and beneficial shareholder of shares in that company;

“doctor” has the same meaning as in the Service Committees Regulations;

“the Performers List LHB” means the Local Health Board in whose medical performers list the doctor’s name appears on 1st April 2004;

“relevant contractor” means a party to a general medical services contract or default contract with a contracting LHB, where that contractor is— a doctor who is the subject of the allegation, a partnership, and a doctor who is or was the subject of the allegation is a partner in that partnership, a limited company, where a doctor who is or was the subject of the allegation is a legal and beneficial shareholder of shares in that company; and

“relevant date” means 1st April 2004.

(2) Unless the contract otherwise requires, any reference in this Part to—

(a) A numbered regulation is to the regulation bearing that number in the Service Committees Regulations; and

(b) A numbered Schedule is to the Schedule to the Service Committees Regulations bearing that number.

Cases where no decision has been made before the relevant date as to whether disciplinary action should be taken (regulation 4 of the Service Committees Regulations)

71

(1) Where, before the relevant date, or on or after the relevant date in respect of a matter that occurred before the relevant date, a Local Health Board receives, or has received information that could amount to an allegation that a doctor had failed to comply with his or her terms of service and—

(a) that Local Health Board, or its reference committee (as the case may be), has not taken a final decision pursuant to regulation 4(1) of the Service Committees Regulations before the relevant date as to whether it will take no action or take one or both of the courses of action set out in regulation 4(2) of the Service Committees Regulations; and

(b) any time limit specified in regulation 6 of the Service Committees Regulations has not expired,

paragraph (2) shall apply.

(2) Where this paragraph applies, the Local Health Board shall—

(a) if it is the appropriate Local Health Board, continue to be the appropriate Local Health Board for the purposes of the Service Committees Regulations, and consider and take such action as it sees fit pursuant to the Service Committees Regulations, subject to article 74, as if the amendments to regulations 2 to 8 and Schedules 2 and 4 had not taken effect; or

(b) if it is not the appropriate Local Health Board, forward the information to that Trust as soon as is reasonably practicable, and that Trust shall consider the information received and take such action as it sees fit pursuant to the Service Committees Regulations, subject to the time limits specified in the Service Committees Regulations, and article 74, as if the amendments to regulations 2 to 8 and Schedules 2 and 4 had not taken effect.

(3) If the appropriate Local Health Board, or its reference committee, decides, pursuant to paragraph (2)(a) or (b), to refer the matter to the discipline committee of another Local Health Board (B) in accordance with regulation 4(2)(a) or (7)—

(a) that Local Health Board (B) shall investigate the matter and report to the appropriate Local Health Board as if the amendments to regulations 2 to 8 and Schedules 2 and 4 had not taken effect; and

(b) the appropriate Local Health Board shall be entitled, subject to article 74, to take any action it could have taken pursuant to the Service Committees Regulations as if those amendments had not taken effect.

Referrals to investigating discipline committees before the relevant date (regulation 5 of the Service Committees Regulations)

72

Where a Local Health Board (A) has, before the relevant date, referred a matter in respect of a doctor to another Local Health Board (B) in accordance with regulation 4(2)(a) or (7)—

(a) that matter has not been finally determined by the discipline committee of that Local Health Board (B) before the relevant date—

(i) the discipline committee of that Local Health Board (B) shall investigate the matter and report to the Local Health Board (A) as if the amendments to regulations 2 to 8 and Schedules 2 and 4 had not taken effect, and

(ii) the Local Health Board (A) shall be entitled to take any action it could have taken pursuant to the Service Committees Regulations as if those amendments had not taken effect, subject to article 74; or

(b) that Local Health Board (A) has received the report of the discipline committee of the Local Health Board (B) but has not yet determined what (if any) action to take as a result of the report, the Local Health Board (A) shall be entitled to take any action it could have taken pursuant to the Service Committees Regulations as if the amendments to regulations 2 to 8 had not taken effect, subject to article 74.

Determination of a Local Health Board or the Assembly made before the relevant date (regulation 8, 9, 10 and 11 of the Service Committees Regulations)

73

(1) Where, before the relevant date, a Local Health Board (or where relevant, the Assembly) has determined pursuant to regulation 8(5)(a) and 9(3) or regulation 11 (as the case may be) that an amount should be recovered from the doctor, insofar as any of that amount has not been recovered before the relevant date, it shall continue to be recoverable by the Local Health Board that was the appropriate Local Health Board for the purposes of the Service Committees Regulations in respect of that matter, and it shall be treated as a debt owed by that doctor to that Trust.

(2) Where a contracting LHB has record of, or receives notification of, an adverse determination made before the relevant date pursuant to regulation 8, 9, 10 or 11 in respect of a doctor (where, in the case of a determination under regulation 8, such a determination was not overturned on appeal), paragraph (3) shall apply without prejudice to any other rights the contracting LHB may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(3) Where this paragraph applies, the contracting LHB—

(a) may take into account that adverse determination in relation to a relevant contractor if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 113(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract; but

(b) shall not, pursuant to sub-paragraph (a), take into account any adverse determination that was made that occurred more than 6 years prior to the date upon which the contracting LHB is considering terminating the general medical services contract or the default contract (as the case may be).

(4) Where a Performers List LHB has record of, or receives notification of, an adverse determination pursuant to regulation 8, 9, 10 or 11 made before the relevant date in respect of a doctor (where, in the case of a determination under regulation 8, such a determination was not overturned on appeal) it may take that determination into account in determining what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.

Determination of a Local Health Board made on or after the relevant date (regulation 8 of the Service Committees Regulations)

74

(1) Where, on or after the relevant date, an appropriate Local Health Board is determining what (if any) action to take pursuant to regulation 8 in accordance with provision made in this Part, it shall make such a determination in accordance with such limitations and modifications to that regulation as are specified in this article.

(2) The appropriate Local Health Board may—

(a) pursuant to regulation 8(1)(c)(i), determine that no further action should be taken;

(b) pursuant to regulation 8(3), determine after consultation with the Local Medical Committee that it would have considered it appropriate to impose a special limit on the number of persons for whom a doctor may undertake to provide treatment;

(d) pursuant to regulation 8(5)(c), determine that it would have warned the doctor to comply more closely with his or her terms of service in future, if those terms of service were still applicable,

and if it makes any one or more of the decisions specified in sub-paragraphs (b) to (d), it shall, after the period specified in regulation 8(11)(a) or (b) (as applicable) has expired, notify in writing the contracting LHB and the Performers List LHB (if any) of its decision and the reasons for it, if either one is a different Local Health Board to the appropriate Local Health Board.

(3) Where, pursuant to paragraph (2)(c), the appropriate Local Health Board determines that an amount should be recovered from the doctor, regulation 8(8) shall not apply and that amount shall be recoverable by the appropriate Local Health Board and it shall be treated as a debt owed by that doctor to that appropriate Local Health Board.

(4) Where the appropriate Local Health Board has notified the contracting LHB that it has made any of the determinations specified in paragraph (2)(b) to (d), or where the appropriate Local Health Board is the contracting LHB, paragraph (5) shall apply without prejudice to any other rights the contracting LHB may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(5) Where this paragraph applies, the contracting LHB—

(a) may, in relation to a relevant contractor, take into account the determination of the appropriate Local Health Board if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 113(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract; but

(b) shall not, pursuant to sub-paragraph (a), take into account any determination of an appropriate Local Health Board that was made more than 6 years prior to the date upon which the contracting LHB is considering terminating the general medical services contract or the default contract (as the case may be).

(6) Where—

(a) a Performers List LHB has received notification from an appropriate Local Health Board pursuant to paragraph (2); or

(b) where an appropriate Local Health Board that has taken a decision pursuant to paragraph (2) is also the Performers List LHB,

it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.

Appeals to the Assembly against determinations of Local Health Boards (regulations 9, 10 and 11 of the Service Committees Regulations)

75

(1) Where a doctor has—

(a) appealed against a determination of a Local Health Board in accordance with regulation 9 before the relevant date, but that appeal has not been finally determined before that date; or

(b) in respect of a determination made by a Local Health Board in accordance with regulation 8 before the relevant date, the time limit specified in regulation 9(2) for appealing that determination has not expired before the relevant date, and the doctor serves a notice of appeal on or after the relevant date but within the time limit specified in regulation 9(2),

that appeal shall be determined pursuant to regulations 9, 10 and 11, as if the amendments to those regulations and Schedule 5 had not taken effect.

(2) Where an appropriate Local Health Board has made a determination in respect of a doctor on or after the relevant date pursuant to this Part—

(a) the doctor shall be entitled to appeal against that determination in accordance with regulation 9; and

(b) that appeal shall be determined pursuant to regulations 9, 10 and 11,

as if the amendments to those regulations and to Schedule 5 had not taken effect.

(3) Where, on or after the relevant date, the Assembly is determining pursuant to regulation 9, 10 or 11 (as the case may be) what (if any) action to take in respect of a doctor, it shall make a determination pursuant to those regulations as if the amendments to those regulations and to Schedule 5 had not taken effect and that determination shall have effect in accordance with this article.

(4) If, in accordance with paragraph (3), the Assembly determines pursuant to—

(a) regulation 8(3), that it would have considered it appropriate to impose a special limit on the number of persons for whom a doctor may undertake to provide treatment;

(b) pursuant to regulation 9(3)(d), that there has been an overpayment and, if so, what amount;

(d) pursuant to regulation 8(5)(c), that it would have warned the practitioner to comply more closely with his or her terms of service in future, if those terms of service were still applicable,

it shall, in addition to the persons specified in regulation 10(14), notify the Local Health Boards specified in paragraph (5).

(5) The Assembly shall, pursuant to paragraph (4)(a) to (d), notify the contracting LHB and the Performers List LHB (if any) of its determination if those Local Health Boards are different to the Local Health Board referred to in regulation 10(14).

(6) Where, pursuant to regulation 8(5)(a) and 9(3) or 11, the Assembly has determined that an amount shall be recovered from a doctor it shall direct the appropriate Local Health Board, to recover that amount from the doctor and that amount shall be a debt owed to that appropriate Local Health Board.

(7) Where, pursuant to paragraph (5), the Assembly has notified the contracting LHB that it has taken any of the decisions specified in paragraph (4)(a) to (d), whether or not the contracting LHB is also the appropriate Local Health Board, paragraph (8) shall apply without prejudice to any other right the contracting LHB may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(8) Where this paragraph applies, the contracting LHB may, in relation to a relevant contractor, take into account the determination of the Assembly if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 113(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.

(9) The contracting LHB shall not, pursuant to paragraph (8), take into account any notification received that relates to a determination that was made by the Assembly that occurred more than 6 years prior to the date upon which the contracting LHB is considering the matter pursuant to paragraph (8).

(10) Where a Performers List LHB has received notification from the Assembly pursuant to paragraph (4) or (5), whether or not the Performers List LHB is also the appropriate Local Health Board, it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.

Excessive prescribing (regulation 15 of the Service Committees Regulations)

76

(1) Where, on 31st March 2004, a Local Health Board had—

(a) referred a question of excessive prescribing for investigation and determination by a professional committee under regulation 15 of the Service Committees Regulations[^f00051]; and

(b) that committee had not yet made its determination,

the investigation by the committee shall continue and its determination be made as if that regulation were still in force.

(2) Where, on 31st March 2004, a professional committee had given notice of its determination to a medical practitioner under paragraph (18) of regulation 15 but—

(a) the medical practitioner had not given notice of appeal in accordance with paragraph (20) of that regulation; and

(b) the time for appealing in paragraph (19) of that regulation had not yet expired,

the time for appealing shall continue as if regulation 15 were still in force.

(3) Where—

(a) on 31st March 2004, a medical practitioner had given notice of appeal against the determination of a professional committee in accordance with paragraph (20) of regulation 15 but that appeal had not been determined or withdrawn; or

(b) a medical practitioner has given notice of such an appeal after 31st March 2004, pursuant to paragraph (2),

that appeal shall continue to be dealt with as if regulation 15 were still in force.

(4) In this article “professional committee” has the same meaning as in regulation 15.

Investigation of certification (regulation 16 of the Service Committees Regulations)

77

(1) Where the Assembly has—

(a) before the relevant date, or on or after the relevant date in respect of an investigation that took place before the relevant date, received information in relation to an investigation of medical certificates issued under and for the purposes of the Social Security Act 1975 by a doctor, but he or she has not yet determined whether to refer the matter for consideration pursuant to regulation 16(1); or

(b) before the relevant date, pursuant to regulation 16(1), referred a matter to a Local Medical Committee, or to a joint committee of two or more Local Medical Committees and the Local Medical Committee has not yet finally determined the matter pursuant to regulation 16(6),

the Assembly may, in a case falling within sub-paragraph (a), refer the matter as if the amendments to regulation 16 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee or joint committee of Local Medical Committees shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 16, subject to the provisions in this article.

(2) Where, pursuant to paragraph (1), the Local Medical Committee makes a determination pursuant to regulation 16(6), it shall forward its report to the contracting LHB and the Performers List LHB (if any), in addition to the persons specified in regulation 16(6), unless the doctor exercises his or her right of appeal pursuant to regulation 16.

(3) Where—

(a) a doctor—

(i) has appealed against a finding of a Local Medical Committee made before the relevant date pursuant to regulation 16(7), and within the time limit specified in that paragraph, and that appeal has not been determined before the relevant date, or

(ii) appeals against a finding of a Local Medical Committee on or after the relevant date in respect of a finding of a Local Medical Committee made pursuant to paragraph (1) within the time limit specified in regulation 16(7); or

(b) the Assembly —

(i) has referred a finding of a Local Medical Committee made before the relevant date pursuant to regulation 16(10), and that referral has not been determined before the relevant date, or

(ii) referred a finding of a Local Medical Committee on or after the relevant date in respect of a finding of a Local Medical Committee made pursuant to paragraph (1),

that appeal or referral shall be determined in accordance with regulation 16 as if the amendments to that regulation had not taken effect, save that written notification of the determination made by the referee or referees shall be given to the contracting LHB and the Performers List LHB (if any).

(4) The Assembly may, on or after the relevant date, determine that, pursuant to regulation 16(12), an amount should be recovered from a doctor, and shall, in determining whether an amount should be recovered, act as if the amendments to regulations 11(3), (4) and (5) and 16 and Schedule 5 had not taken effect.

(5) Where pursuant to regulation 16(12), the Assembly has determined that an amount should be recovered from a doctor—

(a) before the relevant date, where that amount has not been fully recovered before the relevant date; or

(b) on or after the relevant date pursuant to this article,

that amount shall be recoverable by the appropriate Local Health Board, insofar as it has not already been recovered before the relevant date in respect of an amount falling within sub-paragraph (a), and that amount shall be a debt owed to that Local Health Board.

(6) Where the contracting LHB has received notification pursuant to this article of an adverse determination in respect of the doctor pursuant to regulation 16, paragraph (7) shall apply without prejudice to any other right the contracting LHB may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(7) Where this paragraph applies, the contracting LHB may, in relation to a relevant contractor, take into account the adverse determination of the Assembly if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 113(7) of Schedule 6 to the Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.

(8) The contracting LHB shall not, pursuant to paragraph (7), take into account any notification that relates to a determination that was made more than 6 years prior to the date upon which the contracting LHB is considering the matter pursuant to paragraph (7).

(9) Where a Performers List LHB has received notification of an adverse determination pursuant to regulation 16, it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.

Investigation of record keeping (regulation 17 of the Service Committees Regulations)

78

(1) Where the Assembly has—

(a) before the relevant date, or on or after the relevant date in respect of an examination of record cards by a medical officer that took place before the relevant date, received information in relation to an examination of record cards held by a doctor, but he or she has not yet determined whether to refer the matter for consideration pursuant to regulation 17(1); or

(b) before the relevant date, pursuant to regulation 17(1), referred a matter to a Local Medical Committee and the Local Medical Committee has not yet finally determined the matter pursuant to regulation 17(8),

the Assembly may, in a case falling within sub-paragraph (a), refer the matter as if the amendments to regulation 17 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 17, subject to the provisions in this article.

(2) Where, pursuant to paragraph (1), the Local Medical Committee makes a determination pursuant to regulation 17(8), it shall forward its report to the contracting LHB and the Performers List LHB, in addition to the persons specified in regulation 17(8), unless the doctor exercises his or her right of appeal pursuant to regulation 17(10).

(3) Where—

(a) a doctor—

(i) has appealed against a finding of a Local Medical Committee made before the relevant date pursuant to regulation 17(10), and within the time limit specified in that paragraph, and that appeal has not been determined before the relevant date, or

(ii) appeals against a finding of a Local Medical Committee on or after the relevant date in respect of a finding of a Local Medical Committee made pursuant to paragraph (1) within the time limit specified in regulation 17(10); or

(b) the Assembly —

(i) has referred a finding of a Local Medical Committee made before the relevant date pursuant to regulation 17(12), and that referral has not been determined before the relevant date, or

(ii) referred a finding of a Local Medical Committee on or after the relevant date in respect of a finding of a Local Medical Committee made pursuant to paragraph (1),

that appeal or referral shall be determined in accordance with regulation 17 as if the amendments to that regulation (and regulation 16(8) and (9) where applicable) had not taken effect, save that written notification of the determination made by the referee or referees shall be given to the contracting LHB and the Performers List LHB (if any).

(4) The Assembly may, on or after the relevant date, determine that, pursuant to regulation 17(14), an amount should be recovered from a doctor and shall, in determining whether an amount should be recovered, act as if the amendments to regulations 11(3), (4) and (5) and 17 and Schedule 5 had not taken effect.

(5) Where pursuant to regulation 17(14), the Assembly has determined that an amount should be recovered from a doctor—

(a) before the relevant date, where that amount has not been fully recovered before the relevant date; or

(b) on or after the relevant date pursuant to this article,

(6) Where the contracting LHB has received notification pursuant to this article of an adverse determination in respect of the doctor pursuant to regulation 17, paragraph (7) shall apply without prejudice to any other right the contracting LHB may have to take action against the relevant contractor pursuant to any term of the general medical services contract or default contract.

(7) Where this paragraph applies, the contracting LHB may, in relation to a relevant contractor, take into account the adverse determination of the Assembly if it is considering, pursuant to a term of the general medical services contract that gives effect to paragraph 113(7) of Schedule 6 to the 2004 Regulations, or an equivalent term in the default contract, whether the cumulative effect of breaches under that contract is such that to allow the contract to continue would be prejudicial to the efficiency of the services provided under that contract.

(8) The contracting LHB shall not, pursuant to paragraph (7), take into account any notification that relates to a determination that was made more than 6 years prior to the date upon which the contracting LHB is considering the matter pursuant to paragraph (7).

(9) Where a Performers List LHB has received notification of an adverse determination pursuant to regulation 17, it shall consider what (if any) action it should take in respect of that doctor pursuant to its powers under the Performers Lists Regulations.

Decision as to treatment for which fees may be charged by doctors (regulation 18 of the Service Committees Regulations)

79

(1) Where a question has arisen as to whether any treatment given by a doctor to a patient is treatment for which he or she may demand or accept a fee from a patient within the meaning of regulation 18(1), and that question has arisen before the relevant date, or on or after the relevant date in respect of any fee charged by a doctor before the relevant date, and that question—

(a) has not been referred for consideration by the Local Medical Committee; or

(b) has been referred to the Local Medical Committee and the Local Medical Committee has not yet finally determined the matter pursuant to regulation 18,

the question may, in a case falling within sub-paragraph (a), be referred as if the amendments to that regulation and Schedule 7 had not taken effect and, in relation to both sub-paragraphs, the Local Medical Committee shall consider or continue to consider (as the case may be) and determine the matter in accordance with regulation 18 and Schedule 7, subject to the provisions in this article.

(2) Where a Local Medical Committee makes a determination pursuant to paragraph (1), regulation 18(6) shall apply to the Local Health Board.

(3) Where a Local Health Board—

(a) has referred a finding of a Local Medical Committee made before the relevant date to the Assembly pursuant to regulation 18(2), and that referral has not been determined before the relevant date; or

(b) refers a finding of a Local Medical Committee on or after the relevant date,

that referral shall be determined in accordance with regulation 18 and Schedule 7 as if the amendments to that regulation and Schedule had not taken effect.

(4) Where the Assembly—

(a) has referred a finding of a Local Medical Committee made before the relevant date pursuant to regulation 18(6), and that referral has not been determined before the relevant date; or

(b) refers a finding of a Local Medical Committee on or after the relevant date,

that referral shall be determined in accordance with regulation 18 and Schedule 7 as if the amendments to that regulation and Schedule had not taken effect.

Functions of Local Medical Committees

80

Where—

(a) a Local Medical Committee has, before the relevant date had any matter referred to it for its consideration that it had not finally determined before the relevant date; and

(b) pursuant to this Part, that matter is to be determined by the Local Medical Committee on or after the relevant date,

the Local Medical Committee that had had the matter referred to it shall be deemed to be a Local Medical Committee that is recognised by a Local Health Board pursuant to section 45A of the 1977 Act for the purpose of exercising the continuing functions conferred on it in relation to the matter by this Part.

PART 7 — MISCELLANEOUS

Details to be included on prescription forms

81

(1) Notwithstanding—

(a) the terms of a general medical services contract which give effect to Schedule 1 to and paragraph 65(2)(b) of Schedule 6 to the 2004 Regulations; or

(b) the equivalent terms of a default contract,

prescription forms, issued for the purposes of a default contract, a general medical services contract or a personal medical services agreement before 31st March 2005 need not include the name of the contractor.

(2) In paragraph (1), “prescription form”, has the same meaning as in the 2004 Regulations.

Transitional provision in cases where preferential treatment on transferring to medical lists was given

82

(1) This article applies to any case to which, on or before 31st March 2004, paragraph 1 of Schedule 1 (cases where preferential treatment on transferring to medical lists is given) to the Primary Care Act 1997[^f00052] (“the Schedule”) applies.

(2) If —

(a) a medical practitioner had made an application to a Local Health Board, pursuant to paragraph 1 of the Schedule, for his or her name to be included in its medical list; and

(b) the matter had not been determined on or before 31st March 2004,

paragraph 7 of Schedule 1 (transitional and consequential provisions) to the Performers Lists Regulations shall apply.

(3) In a case where—

(a) paragraph (2) applies; and

(b) the Local Health Board determines to add that medical practitioner’s name to its medical performers list,

that medical practitioner shall be treated as though his or her name had been included in the medical list of that Local Health Board on 31st March 2004.

(4) In any case where representations under paragraph 3 of the Schedule have been made and the FHSAA (“the Authority”) has not determined that matter on or before 31st March 2004, the matter shall be treated by the Authority as though it were an appeal against the refusal of the Local Health Board to include that medical practitioner’s name in its medical performers list.

(5) If the Authority decides that appeal in favour of that medical practitioner—

(a) his or her name shall be included in that Local Health Board’s medical performers list; and

(b) he or she shall be treated as though his or her name had been included in the medical list of that Local Health Board on 31st March 2004.

(6) In a case to which paragraph (4) applies (“paragraph 4 case”), if that medical practitioner had applied to be included in the medical performers list of any Local Health Board or, by virtue of paragraph 7 of Schedule 1 to the Performers Lists Regulations, is treated as so applying, any appeal to the Authority in respect of that application shall be heard with the paragraph 4 case.

Continuing validity of forms

83

Notwithstanding the amendments made by paragraphs 1 and 5 of Schedule 1 to the form of certificates set out in Part 2 of Schedule 2 to the Social Security (Medical Evidence) Regulations 1976[^f00053] and in Part 2 of the Schedule to the Statutory Maternity Pay (Medical Evidence) Regulations 1987[^f00054], a form which complies with those regulations as in force on 31st March 2004 shall continue to be valid.

Transitory interpretation of references in enactments to primary medical services

84

For so long as default contracts entered into pursuant to section 176(3) of the 2003 Act (general medical services: transitional) exist, a reference in any enactment to primary medical services under the 1977 Act shall be deemed to include a reference to services provided under such contracts.

Transitory interpretation of references to general medical services contracts

85

(1) For as long as default contracts entered into pursuant to section 176(3) of the 2003 Act (general medical services: transitional) exist, any reference to a general medical services contract or to a contract under section 28Q of the 1977 Act in the enactments listed in paragraph (2) shall be deemed to include a reference to a default contract.

(2) The enactments referred to in paragraph (1) are—

(a) the 1977 Act, sections 3(4)(b)[^f00055], 26(2)[^f00056] and (4)(aa)(b)[^f00056], 28D(1)(bc)(i)[^f00057], 45A(3), (4) and (11)[^f00058], 54(1)(c)[^f00059], 72(5)(d)[^f00060];

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

(d) the Trade Union and Labour Relations (Consolidation) Act 1992[^f00064], section 279(2);

(e) the Health Service Commissioners Act 1993, section 2A(1)(a) and (2)(a)[^f00065];

(f) the Employment Rights Act 1996, section 43K(1)(ba)[^f00066];

(g) the Health and Social Care Act 2001, Schedule 1, paragraph 11(a)[^f00067].

PART 8 — SAVINGS, MODIFICATIONS, AMENDMENTS AND REVOCATIONS

Meaning of suitable experience

86

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

Savings of certain provisions of the Medical Act 1983

87

Notwithstanding the coming into force of the amendments to sections 11 and 12 of the Medical Act 1983[^f00071] made by paragraphs 47 to 49 of Schedule 11 to the 2003 Act[^f00072], in relation to any employment before 1st April 2004 in—

(a) an approved medical practice; or

(b) a health centre,

sections 11(4) and 12(2)(a) of the Medical Act 1983 shall have effect as if those amendments had not been brought into force.

Saving of section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992

88

Notwithstanding the coming into force of the amendments to the definition of worker in section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992[^f00073] (health service practitioners) made by paragraph 59 of Schedule 11 to the 2003 Act[^f00074], in relation to any complaint arising in respect of a matter which occurred before 1st April 2004, section 279 shall have effect as if those amendments had not been brought into force.

Saving of sections 2A and 6(5) of the Health Service Commissioners Act 1993

89

Notwithstanding the coming into force of the amendments to sections 2A and 6(5) of the Health Service Commissioners Act 1993[^f00075] made by paragraphs 62 and 63 of Schedule 11 to the 2003 Act[^f00076], in relation to any complaint arising in respect of a matter which occurred before 1st April 2004, sections 2A and 6(5) shall have effect as if those amendments had not been brought into force.

Transitional provision in relation to the National Health Service (Injury Benefits) Regulations 1995

90

Notwithstanding the amendments made to the National Health Service (Injury Benefits) Regulations 1995 by paragraph 13 of Schedule 1, those regulations shall, in relation to any employment before 1st April 2004, continue to apply as if those amendments had not been made.

Transitory modification of section 18 of the 1990 Act

91

For as long as default contracts entered into pursuant to section 176(3) of the 2003 Act (general medical services: transitional) exist, section 18 of the 1990 Act[^f00077] (indicative amounts for doctors' practices) shall be read as if—

(a) the reference in subsection (3)(a) to a contract under section 28Q of the Act included a reference to a default contract entered into pursuant to section 176(3) of the 2003 Act; and

(b) after subsection (3), there were inserted—

(3A) Where, in the same financial year, a practice enters into— (a) a contract pursuant to section 176(3) of the Health and Social Care (Community Health and Standards) Act 2003; and (b) a contract with the same Local Health Board under section 28Q of the Act which takes effect immediately after the contract referred to in paragraph (a) ceases to have effect, that practice will, for that financial year, count as a single practice for the purposes of this section.

Modification of section 115 of the Police Act 1997

92

(1) Until the coming into force of paragraph 4(4) of Schedule 35 to the Criminal Justice Act 2003[^f00078], section 115 of the Police Act 1997[^f00079] shall be read as if—

(a) in subsection (6C)—

(i) the words “Part 2 of” were omitted, and

(ii) for paragraph (a) there were substituted—

(a) medical practitioners performing primary medical services,

; and

(b) in subsection (6E)—

(i) in paragraph (a) the words “section 28DA of the National Health Service Act 1977 or” were omitted, and

(ii) in paragraph (b), for “the 1977 Act” there were substituted “the National Health Service Act 1977”.

(2) The modifications made by this article do not extend to Scotland or Northern Ireland.

Transitory modification of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994

93

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

Transitory modification of the National Health Service (Vocational Training for General Medical Practice) Regulations 1997

94

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

Minor and consequential amendments

95

The enactments listed in Schedule 1 are amended as there specified.

Revocations

96

The enactments listed in Schedule 2 are revoked to the extent there specified.

SCHEDULE 1 — MINOR AND CONSEQUENTIAL AMENDMENTS

1

(1) The Social Security (Medical Evidence) Regulations 1976[^f00084] shall be amended as provided in this paragraph.

(2) In Part 1 of Schedule 1 (rules), for paragraph 3 substitute—

(3) Where the claimant— (a) is on the list of a person providing primary medical services under the National Health Service Act 1977 or the National Health Service (Scotland) Act 1978 and is being attended by a doctor performing such services; or (b) is on the list of a doctor, or list held jointly by two or more doctors performing personal medical services in connection with a pilot scheme under the National Health Service (Primary Care) Act 1997 and is being attended by such a doctor, the doctor’s statement shall be on the form provided by the Secretary of State for the purpose and shall be signed by the attending doctor.

(3) In Part 2 of Schedule 2, (form of certificate) for “Health Authority or Primary Care Trust in whose medical list you are included” substitute “Primary Care Trust or Local Health Board in whose medical performers list you are included (or, in Scotland, by the Health Board in whose primary medical performers list you are included)”.

Medicines (Pharmacy and General Sale – Exemption) Order 1980

2

(1) The Medicines (Pharmacy and General Sale – Exemption) Order 1980[^f00085] shall be amended as provided in this paragraph.

(2) In article 4B (exemption for health professionals who supply medicinal products under a Patient Group Direction in order to assist doctors or dentists in providing national health services)[^f00086]—

(a) in paragraph (2)(d) (ii)—

(i) after “health authority” insert “or Local Health Board”,

(ii) before sub-paragraph (a), insert—

(aa) in the case of the provision of primary medical services, with which a contract or agreement for the provision of those services has been made or which provides the services itself;

, and

(iii) in sub-paragraph (a), omit “general medical services”, and

and

(b) in paragraph (3), for sub-paragraph (b)(i) substitute—

(i) in relation to England and Wales, the provision of primary medical services under Part I of the National Health Service Act 1977;

The Statutory Sick Pay (Medical Evidence) Regulations 1985

3

In the Statutory Sick Pay (Medical Evidence) Regulations 1985[^f00087], in Part 1 of Schedule 1 (rules)[^f00088], for paragraph 3 substitute—

(3) Where the patient is on the list of a person providing primary medical services under the National Health Service Act 1977 or the National Health Service (Scotland) Act 1978 and is being attended by a doctor performing such services, the doctor’s statement shall be on the form provided by the Secretary of State for the purpose and shall be signed by the attending doctor.

The National Health Service (General Ophthalmic Services) Regulations 1986

4

(1) The National Health Service (General Ophthalmic Services) Regulations 1986[^f00089] shall be amended as provided in this paragraph.

(2) In regulation 2(1) (interpretation), for the definition of “lists”, substitute—

“list” means— a list referred to in section 49N(1)(a) to (c) of the Act; a list of persons undertaking to provide general medical services prepared in accordance with regulations under section 29 of that Act as the list existed on or before 31st March 2004; or a list of persons approved by a Local Health Board for the purpose of assisting in the provision of general medical services prepared in accordance with regulations under section 43D(i) of that Act as the list existed on or before 31st March 2004.

(3) In Schedule 1, for paragraph 8C (complaints against ophthalmic medical practitioners) substitute—

(1) Where a contractor who, being an ophthalmic medical practitioner, also performs primary medical services under a GMS contract for any person to whom he or she provides general ophthalmic services, the complaints procedure established and operated in accordance with the terms of that GMS contract shall apply in relation to any matter reasonably connected with his provision of general ophthalmic services as it applies as respects the provision of services under the GMS contract. (2) Accordingly, any requirement as to co-operation with investigations of complaints by other bodies imposed on a GMS contractor under the term of its contract which gives effect to paragraph 95 of Schedule 6 to the National Health Service (General Medical Services Contracts) (Wales) Regulations 2004[^f00090] also applies in relation to complaints about such matters.

(3) In this paragraph “GMS contract” means a general medical services contract under section 28Q of the Act and “general medical services contractor” shall be construed accordingly.

(4) For as long as there are in existence contracts entered into under article 13 of the General Medical Services Transitional and Consequential Provisions (Wales) Order 2004[^f00091] (“default contracts”) any reference in this paragraph to a GMS contract shall be read as including a reference to a contract entered into under that article and any reference to a term of a GMS contract shall be read as including a reference to the equivalent term of the default contract.

(5) In paragraph 10 of Schedule 1A (information and undertakings to be given), for “whose dental, medical, pharmaceutical, supplementary or services list”, substitute “any of whose lists”.

The Statutory Maternity Pay (Medical Evidence) Regulations 1987

5

In the Statutory Maternity Pay (Medical Evidence) Regulations 1987[^f00092], in Part 2 of the Schedule (form of certificate) for “Health Authority or Primary Care Trust in whose medical list you are included” substitute “Primary Care Trust or Local Health Board in whose medical performers list you are included (or, in Scotland, by the Health Board in whose primary medical services performers list you are included)”.

Prescription Pricing Authority Constitution Order 1990

6

In the Prescription Pricing Authority Constitution Order 1990[^f00093], in article 5 (constitution of the pricing authority)[^f00094] for “providing general medical services or personal medical services” substitute “performing primary medical services”.

National Health Service Trusts (Membership and Procedure) Regulations 1990

7

The National Health Service Trusts (Membership and Procedure) Regulations 1990[^f00095] shall be amended as provided in this paragraph.

(1) In regulation 1 (citation, commencement and interpretation)[^f00096], omit the definition of “general medical practitioner”.

(2) In regulation 11 (disqualification for appointment of chairman and non-executive directors)[^f00097], in paragraph (1)—

(a) for sub-paragraph (f), substitute—

(f) he— (i) is a dental practitioner (ii) performs or provides primary medical services under Part I of the National Health Service Act 1977, (iii) is a partner in a partnership that, or is the legal and beneficial owner of shares in a company that, provides primary medical services under Part I of that Act, or (iv) is an employee of any of those;

(b) in sub-paragraph (h), insert at the end “or a list prepared pursuant to section 28X[^f00098] of that Act”.

The Children (Private Arrangements for Fostering) Regulations 1991

8

(1) The Children (Private Arrangements for Fostering) Regulations 1991[^f00099] shall be amended as provided in this paragraph.

(2) In regulation 2 (general welfare of children), in paragraph (2)(f) for the words “general medical practitioner” to the end, substitute “person who provides primary medical services pursuant to Part I of the National Health Service Act 1977;”.

The National Health Service (General Dental Services) Regulations 1992

9

In the National Health Service (General Dental Services) Regulations 1992[^f00100], in regulation 2 (interpretation)[^f00101]—

(a) in the definition of “Local Dental Committee” omit “Local Medical Committee”; and

(b) after the definition of “locality” insert—

“Local Medical Committee” means a committee recognised by the Primary Care Trust under section 45A of the Act[^f00102];

The National Health Service (Service Committees and Tribunal) Regulations 1992

10

(1) Subject to articles 70 to 80, the National Health Service (Service Committees and Tribunal) Regulations 1992[^f00103] shall be amended as follows—

(a) in regulation 2 (interpretation)[^f00104]—

(i) in paragraph (1)—

(aa) omit the definitions of “doctors' panel”, “Local Medical Committee”, “Medical Advisory Committee”, “medical discipline committee”, “medical list”, “medical officer”, “Medical Regulations”, “personal medical services”, “pilot scheme” and “pilot scheme practitioner”;

(bb) in the definition of “deputy”, omit paragraph (a);

(cc) in the definition of “Part II service”, omit the words “general medical services”;

(dd) in the definition of “practitioner”, omit the words “doctor,”;

(ee) in the definition of “relevant local representative committee”, omit paragraph (a);

(ff) in the definition of “terms of service”, omit paragraph (a); and

(gg) in the definition of “treatment”, omit the words “in relation to general medical services, has the same meaning as in the Medical Regulations, and,”, and

(ii) in paragraph (4), omit sub-paragraph (b);

(b) in regulation 3 (establishment of committees)[^f00105], omit paragraph (1)(a);

(i) omit paragraph (5)(b) and (c) and (6); and

(ii) in paragraph (5)(a), omit the word “medical,” and in the full out text in paragraph (5), omit the words “or other doctor referred to in sub-paragraph (b)”;

(d) in regulation 5 (referral to investigating committee)[^f00107], omit paragraph (3)(a);

(e) in regulation 6 (time limits)[^f00108], in paragraph (3)(a), omit the word “doctor,”;

(f) in regulation 8 (determination of appropriate Health Authority or Primary Care Trust)[^f00109]—

(i) omit paragraphs (3) and (4), and

(ii) in paragraph (8), for the words “paragraphs (3), or”, substitute “paragraph”;

(g) in regulation 9 (appeal to the Secretary of State)[^f00110]—

(i) in paragraph (1)(b), omit (3),

(ii) in paragraphs (3)(c)(ii) and (4)(b) for the words “paragraphs (3), or” in each place where it appears, substitute “paragraph”, and

(iii) in paragraph (5), omit “(3),” in the second place it appears;

(h) in regulation 10 (procedure on appeal)[^f00111]—

(i) in paragraph (5), omit “(3)”,

(ii) in paragraph (7), omit sub-paragraph (a), and

(iii) in paragraph (8), omit sub-paragraph (a);

(i) in regulation 11 (recovery of amounts from practitioners following appeal)[^f00112]—

(i) in paragraph (2) and (3)(a), omit the words “doctor or” in both places it appears,

(ii) in paragraph (4), omit sub-paragraph (a), and

(iii) in paragraph (7), for the words “paragraphs (3), or”, substitute “paragraph”;

(j) omit regulations 15 (excessive prescribing by doctors), 16 (investigation of certification), 17 (investigation of record keeping) and 18 (decision as to treatment for which fees may be charged by doctors);

(k) in regulation 20 (power of Local Representative Committees to consider complaints)[^f00113], omit paragraph (1);

(l) in regulation 32 (service of documents)[^f00114], in paragraph (1)(a), omit the word “doctor,” and “medical,”;

(m) in regulation 37 (referral of matters to professional bodies)[^f00115], in paragraph (4)(a), omit the words “a doctor or”;

(n) in Schedule 2 (constitution of discipline committees)[^f00116]—

(i) omit paragraph 2(1)(b)(ii),

(ii) in paragraph 2(2), for “(ii)”, substitute “(iii)”,

(iii) in paragraph 2(4), omit sub-paragraph (a), and

(iv) in paragraph 8, omit sub-paragraph (c)(i);

(o) in Schedule 4 (procedure for investigation by discipline committees)[^f00117]—

(i) in paragraph 2, omit sub-paragraph (1)(a), and

(ii) in paragraph 9, omit sub-paragraph (b)(i) and (c);

(p) in Schedule 5 (advisory committees)[^f00118], omit paragraph 1 and Part 2; and

(q) omit Schedule 7 (rules of procedure under regulation 18).

The Dental Vocational Training Authority Regulations 1993

11

In the Dental Vocational Training Authority Regulations 1993[^f00119], in regulation 5 (application of regulations relating to membership and procedure)[^f00120], in paragraph (1)(b)(iii), in the sub-paragraph (d) added by that paragraph, for “general” substitute “or performing primary”.

The Medicines for Human Use (Marketing Authorisations etc.) Regulations 1994

12

In the Medicines for Human Use (Marketing Authorisations etc.) Regulations 1994[^f00121], in Schedule 1 (exemptions and exceptions from the provisions of regulation 3), in paragraph 3(1)(a) for “general medical or dental services” substitute “primary medical services or general dental services”.

The National Health Service (Injury Benefits) Regulations 1995

13

(1) The National Health Service (Injury Benefits) Regulations 1995[^f00122] shall be amended as provided in this paragraph.

(2) In regulation 2 (interpretation)[^f00123]—

(a) for the definition of “assistant practitioner” substitute—

“assistant practitioner” means— a person on the medical performers list who is employed (other than by a Primary Care Trust or a Local Health Board) to perform primary medical services under a GMS contract, a default contract or a PMS agreement; or an employee of a dental practitioner on the list of a Strategic Health Authority, Primary Care Trust or Local Health Board, being himself a dental practitioner who, in such employment, is engaged in assisting his employer in the actual discharge of his duties as such practitioner and for whose employment the consent of the Strategic Health Authority, Primary Care Trust or Local Health Board is required;

(b) for the definition of “medical list” substitute—

“medical performers list” means a list prepared by a Primary Care Trust pursuant to regulation 3(1) of the National Health Service (Performers Lists) Regulations 2004[^f00124];

(i) in paragraph (a) for “a registered medical practitioner or a registered dentist whose name is included on the medical list or, as the case may be,” substitute “a registered dentist whose name is included”,

(ii) in paragraph (c), omit “a registered medical practitioner or”,

(iii) omit “and” after paragraph (d),

(iv) in paragraph (e)—

(aa) for “a registered medical practitioner or a registered dentist who is a medical pilot scheme employee or a dental pilot scheme employee, as the case may be,” substitute “a registered dentist who is a dental pilot scheme employee”;

(bb) in sub-paragraph (i), omit “the medical list or, as the case may be,”;

(cc) in the full out words at the end, omit “medical or”; and

(dd) at the end, insert “and”, and

(v) at the end, add paragraph (f)—

(f) a registered medical practitioner who is included in a medical performers list and who is providing services under— (i) a GMS contract or a default contract, or (ii) a PMS agreement;

(d) omit the definitions of “medical pilot scheme employee” and “personal medical services”; and

(e) insert, in the appropriate alphabetical position—

“default contract” means a contract under article 13 of the General Medical Services Transitional and Consequential Provisions (Wales) Order 2004[^f00125];

“GMS contract” means a contract under section 28Q of the National Health Service Act 1977[^f00126];

(3) In regulation 3 (persons to whom the regulations apply)[^f00127], omit paragraph (1)(f).

(4) In regulation 4A (recovery of costs)[^f00128], in paragraph (6)(c), for

to— a person providing piloted services, or a registered medical practitioner who is a medical pilot scheme employee,

substitute “to a person providing piloted services”.

The National Health Service Contracts (Dispute Resolution) Regulations 1996

14

In the National Health Service Contracts (Dispute Resolution) Regulations 1996[^f00129], after regulation 1 (citation, commencement and interpretation), insert—

(1A) (1) These Regulations do not apply in the case of a dispute concerning a term of — (a) a GMS contract; or (b) a contract entered into pursuant to section 176(3) of the Health and Social Care (Community Health and Standards) Act 2003[^f00130]. (2) These Regulations do not apply in the case of a dispute concerning a proposed term of arrangement which is intended to be a GMS contract. (3) In this regulation— - “GMS contract” means a general medical services contract under section 28Q of the National Health Service Act 1977[^f00131].

The National Health Service (Functions of Health Authorities) (Complaints) Regulations 1996

15

In the National Health Service (Functions of Health Authorities) (Complaints) Regulations 1996[^f00132], in regulation 1 (citation, commencement and interpretation), in paragraph (2), for the definition of “family health service practitioner” substitute—

“family health service practitioner” means a person who— provides or performs primary medical services under Part 1 of the Act; provides any of the services to be provided under Part 2 of the Act, that is to say, general dental services, general ophthalmic services or pharmaceutical services; or before 1st April 2004, provided general medical services under Part 2 of the Act.

The Health Authorities (Membership and Procedure) Regulations 1996

16

(1) The Health Authorities (Membership and Procedure) Regulations 1996[^f00133] shall be amended as provided in this paragraph.

(2) In regulation 1 (citation, commencement and interpretation)—

(a) in the definition of “discipline committee” omit “medical”;

(b) in the definition of “Part II services” omit “general medical services,”;

(3) In regulation 10 (disqualification for appointment)—

(a) in paragraph (1)(d), insert at the end “or a list prepared pursuant to section 28X of that Act”;

(b) in paragraph (4)(b), for the words from “general medical services” to the end substitute “or performing primary medical services under Part 1 of the 1977 Act”;

(c) in paragraph (5)(b), for “or performing personal medical services in connection with a pilot scheme under the National Health Service (Primary Care) Act 1997” substitute “or providing or performing primary medical services under Part 1 of the 1977 Act”.

(4) In regulation 14 (appointment of committees and sub-committees), in paragraph (3), at the end add “or provide or perform primary medical services under Part 1 of the 1977 Act”.

(5) In regulation 16 (disability of chairman and members in proceedings on account of pecuniary interest), for “or performing personal medical services in connection with a pilot scheme under the National Health Service (Primary Care) Act 1997” substitute “or providing or performing primary medical services under Part 1 of the 1977 Act”.

The National Health Service (Indicative Amounts) Regulations 1997

17

In the National Health Service (Indicative Amounts) Regulations 1997[^f00134], in regulation 3 (application of section 18 of the 1990 Act to practices with members on the list of a Health Board)—

(a) for “medical list” in both places it occurs, substitute “medical performers list”; and

(b) for “Health Authority” in both places it occurs, substitute “Local Health Board”.

The Prescription Only Medicines (Human Use) Order 1997

18

(1) The Prescription Only Medicines (Human Use) Order 1997[^f00135] shall be amended as provided in this paragraph.

(2) In article 12B (exemption for health professionals who supply or administer prescription only medicines under a Patient Group Direction in order to assist doctors or dentists in providing national health services)[^f00136], for paragraph 3(b)(i) substitute—

(i) in relation to England and Wales, the provision of primary medical services under Part I of the National Health Service Act 1977;

The National Health Service (Proposals for Pilot Schemes) and (Miscellaneous Amendments) Regulations 1997

19

(1) In the National Health Service (Proposals for Pilot Schemes) and (Miscellaneous Amendments) Regulations 1997[^f00137]—

(a) in regulation 2 (requests to authorities for preparation of proposals), in paragraph (5)(b), omit paragraph (i); and

(b) in regulation 3 (consultation on proposals), omit paragraph (2).

(2) The amendment made by sub-paragraph (1) does not extend to Scotland.

The National Health Service (Pilot Schemes – Health Service Bodies) Regulations 1997

20

(1) In the National Health Service (Pilot Schemes – Health Service Bodies) Regulations 1997[^f00138], in regulation 1(2) (citation, commencement and application), in the definition of “application” omit “personal medical services or”.

(2) The amendment made by sub-paragraph (1) does not extend to Scotland.

The Medical Act 1983 (Approved Medical Practices and Conditions of Residence) and National Health Service (General Medical Services) (Amendment) Regulations 1998

21

(1) The Medical Act 1983 (Approved Medical Practices and Conditions of Residence) and National Health Service (General Medical Services) (Amendment) Regulations 1998[^f00139] shall be amended as provided in this paragraph.

(2) In regulation 2 (medical practices qualifying for approval)[^f00140]—

(a) in paragraph (1), for sub-paragraph (a) substitute—

(a) “GP Registrar” has the meaning assigned to it in regulation 2(1) of the National Health Service (General Medical Services Contracts) Regulations (Wales) 2004[^f00141]; and

; and

(b) in paragraph (2)(d), for “General Practice (GP) Registrar” substitute “GP Registrar”.

(3) In regulation 3 (conditions as to residence), in paragraph (1) for the words “the National Health Service (General Medical Services) Regulations 1992” substitute “the National Health Service (General Medical Services Contracts) (Wales) Regulations 2004”.

(4) Omit regulation 4 (amendment of the National Health Service (General Medical Services) Regulations 1992).

The Health Service Medicines (Control of Prices of Branded Medicines) Regulations 2000

22

In the Health Service Medicines (Control of Prices of Branded Medicines) Regulations 2000[^f00142], in regulation 5 (application of regulations), in paragraph (b), for “Schedule 10 to the National Health Service (General Medical Services) Regulations 1992” substitute “Schedule 1 to the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004[^f00143]”.

The National Health Service (Payments by Local Authorities to NHS Bodies) (Prescribed Functions) (Wales) Regulations 2001

23

In the National Health Service (Payments by Local Authorities to NHS Bodies) (Prescribed Functions) (Wales) Regulations 2001[^f00144], in regulation 2(2), in paragraph (c)—

(a) for “Schedule 10 to the National Health Service (General Medical Services) Regulations 1992” substitute “Schedule 1 to the National Health Service (General Medical Services Contracts) (Prescription of Drugs etc.) (Wales) Regulations 2004”; and

(b) for “Schedule 11” substitute “Schedule 2”.

The National Health Service (Charges for Drugs and Appliances) (Wales) Regulations 2001

24

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

The Family Health Services Appeal Authority (Procedure) Rules 2001

25

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

The Care Homes (Wales) Regulations 2002

26

(1) The Care Homes (Wales) Regulations 2002[^f00151] shall be amended as provided in this paragraph.

(2) In regulation 2 (interpretation)[^f00152], paragraph (1), for the definition of “general practitioner”, substitute—

“general practitioner” means a person who— provides primary medical services pursuant to Part I of the National Health Service Act 1977; or provides services which correspond to primary medical services provided under Part I of that Act, otherwise than in pursuance of that Act;

The Children’s Homes Regulations 2001

27

(1) The Children’s Homes Regulations 2001[^f00153] shall be amended as provided in this paragraph.

(2) In regulation 2 (interpretation)[^f00154], in paragraph (1), for the definition of “general practitioner”, substitute—

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The General Medical Services Transitional and Consequential Provisions (Wales) (No. 2) Order 2004

Review of approval of out of hours arrangements under general medical services contracts and default contracts

61

Review of approval of out of hours arrangements under general medical services contracts which follow default contracts

62

Withdrawal of approval of out of hours arrangements under general medical services contracts and default contracts

63

Appeal against immediate withdrawal of approval of out of hours arrangements under general medical services and default contracts

64

References to the NHS dispute resolution procedure in general medical services contracts which follow default contracts

65

Carry over of disputes relating to out of hours arrangements between default contracts and general medical services contracts

66

Sub-contracting of out of hours services under general medical services contracts

67

Out of hours services to patients not registered with general medical services contractors or default contractors

68

Application of regulation 30 of the 2004 Regulations to general medical services contracts entered into under Part 2 of the Transitional Order

69

PART 6 — TRANSITIONAL ARRANGEMENTS: THE NATIONAL HEALTH SERVICE (SERVICE COMMITTEES AND TRIBUNAL) REGULATIONS 1992

Interpretation

70

Cases where no decision has been made before the relevant date as to whether disciplinary action should be taken (regulation 4 of the Service Committees Regulations)

71

Referrals to investigating discipline committees before the relevant date (regulation 5 of the Service Committees Regulations)

72

Determination of a Local Health Board or the Assembly made before the relevant date (regulation 8, 9, 10 and 11 of the Service Committees Regulations)

73

Determination of a Local Health Board made on or after the relevant date (regulation 8 of the Service Committees Regulations)

74

Appeals to the Assembly against determinations of Local Health Boards (regulations 9, 10 and 11 of the Service Committees Regulations)

75

Excessive prescribing (regulation 15 of the Service Committees Regulations)

76

Investigation of certification (regulation 16 of the Service Committees Regulations)

77

Investigation of record keeping (regulation 17 of the Service Committees Regulations)

78

Decision as to treatment for which fees may be charged by doctors (regulation 18 of the Service Committees Regulations)

79

Functions of Local Medical Committees

80

PART 7 — MISCELLANEOUS

Details to be included on prescription forms

81

Transitional provision in cases where preferential treatment on transferring to medical lists was given

82

Continuing validity of forms

83

Transitory interpretation of references in enactments to primary medical services

84

Transitory interpretation of references to general medical services contracts

85

PART 8 — SAVINGS, MODIFICATIONS, AMENDMENTS AND REVOCATIONS

Meaning of suitable experience

86

Savings of certain provisions of the Medical Act 1983

87

Saving of section 279 of the Trade Union and Labour Relations (Consolidation) Act 1992

88

Saving of sections 2A and 6(5) of the Health Service Commissioners Act 1993

89

Transitional provision in relation to the National Health Service (Injury Benefits) Regulations 1995

90

Transitory modification of section 18 of the 1990 Act

91

Modification of section 115 of the Police Act 1997

92

Transitory modification of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994

93

Transitory modification of the National Health Service (Vocational Training for General Medical Practice) Regulations 1997

94

Minor and consequential amendments

95

Revocations

96

SCHEDULE 1 — MINOR AND CONSEQUENTIAL AMENDMENTS

The Social Security (Medical Evidence) Regulations 1976

1

Medicines (Pharmacy and General Sale – Exemption) Order 1980