Law

National Health Service (Scotland) Act 1978

United Kingdom · statute

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In force since 2026-07-22, as the publisher states.

Copy read on 2026-11-08. The page it was read from

Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.

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Contents: 286 provisions

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286 provisions

17EB Application for inclusion in services list

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17G Right to choose dental practitioner.

(1) Provision shall be made in regulations for conferring a right on any person to choose the dental practitioner from whom he is to receive primary dental services, subject to the consent of the practitioner concerned. (2) The regulations shall, in particular, prescribe the procedure for choosing a practitioner. (3) The regulations may, in particular, provide that the right to choose a dental practitioner conferred by the regulations shall, in the case of such persons as may be specified in the regulations, be exercised on their behalf by other persons so specified. (4) In this section “ primary dental services ” means dental services which are— (a) provided, in accordance with section 17C arrangements, as personal dental services; or (b) provided under Part II as general dental services.

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17H Immunisation.

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17I Use of accommodation.

If the Secretary of State considers that any accommodation provided by him by virtue of this Act is suitable for use in connection with the provision of primary medical services or personal dental services in accordance with section 17C arrangements, he may make the accommodation available on such terms as he thinks fit to persons providing those services.

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17J Health Boards' power to enter into general medical services contracts

(1) A Health Board may enter into a contract under which primary medical services are provided (whether directly or indirectly) by a contractor in accordance with the provisions of this Part. (2) A contract under this section is referred to in this Act as a “ general medical services contract ”. (3) Subject to any provision made by or under this Part, a general medical services contract may make such provision as may be agreed between the Health Board and the contractor as respects— (a) the services to be provided under the contract; (b) the remuneration to be paid under the contract; and (c) any other matters. (4) The services to be provided under a general medical services contract may include services which are not primary medical services; and the contract may provide for such other services to be performed in any place where, by virtue of section 2C, primary medical services may be performed. (5) In this Part, “ contractor ”, in relation to a general medical services contract with a Health Board, means the other party to the contract.

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17K Mandatory contract term: provision of prescribed primary medical services

(1) A general medical services contract must require the contractor to provide for the contractor’s patients primary medical services of such descriptions as may be prescribed. (2) Regulations under subsection (1) may in particular describe the primary medical services by reference to the manner or circumstances in which they are provided.

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17L Eligibility to be contractor under general medical services contract

(1) A Health Board may, subject to such conditions as may be prescribed, enter into a general medical services contract with— (a) a medical practitioner, (b) such other health care professional as may be prescribed, (c) a qualifying partnership, (d) a qualifying limited liability partnership, or (e) a qualifying company. (2) For the purposes of subsection (1)— (a) a qualifying partnership is a partnership that satisfies both of the following conditions— (i) at least one partner is a medical practitioner or other health care professional prescribed under subsection (1)(b), (ii) all other partners are individuals, (b) a qualifying limited liability partnership is a limited liability partnership that satisfies both of the following conditions— (i) at least one member is a medical practitioner or other health care professional prescribed under subsection (1)(b), (ii) all other members are individuals, (c) a qualifying company is a company which satisfies both of the following conditions— (i) at least one member of the company is a medical practitioner or other health care professional prescribed under subsection (1)(b), (ii) all other members are individuals. (3) A Health Board may only enter into a general medical services contract if the Board is satisfied that the contractor has sufficient involvement in patient care. (4) The contractor has sufficient involvement in patient care if— (a) where the contractor is a medical practitioner or other health care professional prescribed under subsection (1)(b), the contractor, or (b) where the contractor is a partnership, limited liability partnership or a company, each partner or, as the case may be, member of the contractor, regularly performs, or is engaged in the day to day provision of, primary medical services in accordance with a general medical services contract, section 17C arrangements or any other arrangement made in pursuance of section 2C(2) (or will so perform or be so engaged by virtue of the contract in question). (5) Regulations may— (a) make provision as to what constitutes the regular performance of, or being engaged in the day to day provision of, primary medical services for the purposes of subsection (4), (b) provide that references in subsection (4) to a person who is performing or is engaged in the provision of services include a person who has performed or been engaged in providing the services within such period as may be prescribed. (6) Regulations under subsection (5)(a) may, in particular, provide that a period of time in which a person is not performing or is not engaged in the provision of primary medical services is, in prescribed circumstances, to be disregarded for the purposes of determining whether the person regularly performs or is engaged in the day to day provision of those services. (7) In relation to a general medical services contract under which primary medical services are provided which is entered into with a partnership, regulations may make provision as to the effect on the contract of a change in membership of the partnership. (8) In this section, “ health care professional ” means a member of a profession which is regulated by a body mentioned (at the time the contract in question is made) in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002.

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17M Payments by Health Boards under general medical services contracts

(1) The Scottish Ministers may give directions as to payments to be made under general medical services contracts. (2) A general medical services contract must require payments to be made under it in accordance with directions for the time being in force under this section. (3) A direction under subsection (1) may in particular— (a) provide for payments to be made by reference to compliance with standards or the achievement of levels of performance; (b) provide for payments to be made by reference to— (i) any scheme or scale specified in the direction; (ii) a determination made by any person in accordance with factors specified in the direction; (c) provide for the making of payments in respect of individual practitioners; (d) provide that the whole or any part of a payment is subject to conditions (including a condition that the whole or any part of a payment is liable to be paid by a Health Board only if they are satisfied as to such conditions as may be specified in the direction); (e) make provision having effect from a date before the date of the direction, provided that, having regard to the direction as a whole, the provision is not detrimental to the persons to whose remuneration it relates. (4) Before giving a direction under subsection (1), the Scottish Ministers— (a) must consult any body appearing to them to be representative of persons to whose remuneration the direction would relate; and (b) may consult such other persons as they think appropriate. (5) References in this section to payments include fees, allowances, reimbursements, loans and repayments.

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17N Other mandatory contract terms

(1) A general medical services contract must include (in addition to provisions required by or under other provisions of this Part) such provision as may be prescribed. (2) Regulations under subsection (1) may in particular make provision as to— (a) the manner in which, and the standards to which, services must be provided; (b) the persons who are to perform services; (c) the persons to whom services are to be provided; (d) the right of patients to choose the persons from whom they are to receive services; (e) the variation of terms of the contract (except terms required by or under this Part); (f) rights of entry and inspection (including inspection of clinical records and other documents); (g) the circumstances in which, and the manner in which, the contract may be terminated; (h) enforcement; (i) the adjudication of disputes. (3) Regulations making provision in pursuance of subsection (2)(c) may make provision as to the circumstances in which a contractor— (a) must, or may, accept a person as a patient to whom services are provided under the contract; (b) may decline to accept a person as such a patient; or (c) may terminate the contractor’s responsibility for a patient. (4) Regulations making provision in pursuance of subsection (2)(e) may— (a) make provision as to the circumstances in which a Health Board may unilaterally vary the terms of a contract; (b) make provision suspending or terminating any duty under the contract to provide services of a prescribed description. (5) Regulations making provision of the kind described in subsection (4)(b) may prescribe services by reference to the manner or circumstances in which they are provided. (6) A general medical services contract must contain provision requiring the contractor to comply with any directions given by the Scottish Ministers for the purposes of this section as to the drugs, medicines or other substances which may, or may not, be ordered for patients in the provision of primary medical services under the contract.

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17O Resolution of disputes and entry into NHS contracts

(1) Regulations may make provision for the resolution of disputes as to the terms of a proposed general medical services contract, including, without prejudice to that generality, provision for— (a) the referral of the terms of the proposed contract to the Scottish Ministers; and (b) the Scottish Ministers, or a person or panel of persons appointed by them, to determine the terms on which the contract may be entered into. (2) Regulations may make provision for any person entering, or who has entered, into a general medical services contract to be regarded as a health service body for any purposes of section 17A, in circumstances where the person so elects. (3) Where a person is to be regarded as a health service body for any purposes of section 17A by reason only of an election by virtue of subsection (2) of this section, that section has effect in relation to that person with the omission of the words “under any enactment” in subsection (1) and with such other modifications (if any) as may be prescribed. (4) Regulations under subsection (2) may include provision as to the application of section 17A in cases where— (a) a partnership is to be regarded as a health service body; and (b) there is a change in the membership of the partnership.

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17P Persons performing primary medical services

(1) Regulations may provide that a health care professional of a prescribed description may not perform any primary medical service which a Health Board is, under section 2C(1), under a duty to provide or secure the provision of unless that professional is included in a list maintained under the regulations by the Health Board. (2) For the purposes of this section, “ health care professional ” means a member of a profession regulated by a body for the time being mentioned in section 25(3) of the National Health Service Reform and Health Care Professions Act 2002 (c. 17). (3) Regulations under subsection (1) may make provision in relation to such lists and in particular as to— (a) the preparation, maintenance and publication of a list; (b) eligibility for inclusion in a list; (c) applications for inclusion (including provision for the procedure for applications to be made and dealt with and the documents to be supplied on application); (d) the grounds on which an application for inclusion may or must be granted or refused; (e) requirements with which a person included in a list must comply (including requirements as to standards of performance and patient care and as to declarations, consents or undertakings); (f) suspension or removal from a list (including the grounds for and consequences of suspension or removal); (g) circumstances in which a person included in a list may not withdraw from it; (h) payments to be made by a Health Board in respect of a person suspended from the list (including provision for the amount of, or the method of calculating, the payment to be determined by the Scottish Ministers); (i) the criteria to be applied in making decisions under the regulations; (j) appeals against decisions made by a Health Board under the regulations; (k) disclosure of information about applicants for inclusion, refusals of applications, or suspensions, removals or references to the Tribunal. (4) Regulations making provision as to the matters referred to in subsection (3)(k) may in particular authorise the disclosure of information— (a) by a Health Board to the Scottish Ministers; and (b) by the Scottish Ministers to a Health Board.

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17Q Assistance and support

(1) A Health Board may provide assistance and support to— (a) any person providing, or proposing to provide, primary medical services under a general medical services contract; (b) any person providing, or proposing to provide, such services in accordance with section 17C arrangements. (2) Assistance and support provided by a Health Board under subsection (1) is to be provided on such terms, including terms as to payment, as the Board think fit. (3) In this section, “ assistance ” includes financial assistance.

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18 Duty of Secretary of State.

It shall be the duty of the Secretary of State to secure the provision of . . . general dental and general ophthalmic services, and of pharmaceutical services, in accordance with the provisions of this Part.

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19 Arrangements and regulations for general medical services.

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19A Medical lists.

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19B Vacancies for medical practitioners.

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20 Applications to provide general medical services.

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21 Requirement of suitable experience.

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22 Regulations as to section 21.

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23 Distribution of general medical services.

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24 Regulations for Medical Practices Committee.

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24A Liabilities and obligations in relation to deputies.

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24B Supplementary lists

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24C Application for inclusion in supplementary list

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25 Arrangements for provision of general dental services.

(1) It shall be the duty of every Health Board, in accordance with regulations, to make as respects their area arrangements with dental practitioners or bodies corporate entitled, by virtue of section 43 of the Dentists Act 1984 (c. 24), to carry on the business of dentistry under which any person for whom a dental practitioner or body corporate undertakes in accordance with the arrangements to provide dental treatment and appliances shall receive such treatment and appliances; and the services provided in accordance with those arrangements are in this Act referred to as “general dental services”. (2) Regulations may make provision as to the arrangements to be made under subsection (1), and shall include provision as to the preparation, maintenance and publication by every Health Board of a list— (a) the first part of which shall be of dental practitioners who, and bodies corporate referred to in that subsection which, undertake to provide general dental services under arrangements with the Board; (b) the second part of which shall be of persons who do not undertake to provide such services under such arrangements but who are approved by the Board to assist in the provision of such services provided under such arrangements. (2A) In making provision as to the preparation, maintenance and publication of a list referred to in subsection (2), the regulations may include in particular provision as to— (a) the division of either part (or both parts) of a list into further sub-parts; (b) eligibility for inclusion in a list; (c) applications for inclusion (including provision for the procedure for applications to be made and dealt with and the documents to be supplied on application); (d) the grounds on which an application for inclusion must be granted or refused; (e) requirements with which a person included in a list must comply (including requirements as to standards of performance and patient care and as to declarations, consents or undertakings); (f) suspension or removal from a list (including the grounds for and consequences of suspension or removal); (g) circumstances in which a person included in a list may not withdraw from it; (h) payments to be made by a Health Board in respect of a person suspended from a list (including provision for the amount of, or the method of calculating, the payment to be determined by the Scottish Ministers); (i) criteria to be applied in making decisions under the regulations; (j) disclosure of information about applicants for inclusion, refusals of applications, or suspensions, removals or references to the Tribunal, including in particular the disclosure of information about any such matter by a Health Board to the Scottish Ministers and by the Scottish Ministers to a Health Board. (2B) Regulations may provide that— (a) a dental practitioner who, and a body corporate referred to in subsection (1) which, undertakes to provide general dental services under arrangements with a Health Board may not provide such services unless his name or, as the case may be, the body corporate's name is included in the first part of the Board's list referred to in subsection (2)(a); (b) a person who does not undertake to provide general dental services under arrangements with a Health Board may not assist in the provision of such services provided under arrangements with the Board unless his name is included in the second part of the Board's list referred to in subsection (2)(b). (3) The remuneration to be paid under arrangements made under this section to a dental practitioner who provides general dental services elsewhere than at a health centre shall not, , consist wholly or mainly of a fixed salary unless either— (a) the remuneration is paid in pursuance of arrangements made under section 33, or (b) the services are provided in prescribed circumstances and the practitioner consents, and it shall be the Secretary of State’s duty, before he prescribes any circumstances for the purposes of paragraph (b), to consult such organisations as appear to him to be representative of the dental profession. (4) Subsection (4B) applies where the registration of a dental practitioner in the dentists register is suspended— (a) by an interim suspension order under section 32 of the Dentists Act 1984 (interim orders); or (b) by a direction or order of the Health Committee, the Professional Performance Committee or the Professional Conduct Committee of the General Dental Council under any of sections 27B, 27C or 30 of that Act following a relevant determination that that practitioner's fitness to practise is impaired. (4A) For the purposes of subsection (4), a “relevant determination” that a practitioner's fitness to practise is impaired is a determination which is based solely on— (a) the ground mentioned in paragraph (b) of subsection (2) of section 27 of the Dentists Act 1984 (deficient professional performance); (b) the ground mentioned in paragraph (c) of that subsection (adverse physical or mental health); or (c) both those grounds. (4B) Where this subsection applies, the suspension shall not terminate any arrangements made with the dental practitioner for the provision of general dental services, but he shall not provide such services in person during the suspension. (5) Regulations may provide for the making of payments in consequence of suspension to a dental practitioner whose registration is suspended as described in subsection (4).

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26 Arrangements for provision of general ophthalmic services.

(1) It shall be the duty of every Health Board to make as respects their area, in accordance with regulations, arrangements with medical practitioners having the prescribed qualifications, and with ophthalmic opticians, for securing the carrying out of eye examinations including where clinically necessary testing of sight. (1A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1E) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (1F) Regulations shall define the services for the provision of which arrangements under this section are to be made and the services so defined are in this Act referred to as “general ophthalmic services”. (2) Regulations may make provision as to the arrangements to be made under subsection (1), and shall include provision— (a) as to the preparation, maintenance and publication by every Health Board of a list— (i) the first part of which shall be of medical practitioners and ophthalmic opticians who undertake to provide general ophthalmic services under arrangements with the Board; (ii) the second part of which shall be of persons who do not undertake to provide such services under such arrangements but who are approved by the Board to assist in the provision of such services provided under such arrangements; (b) conferring on any person a right to choose in accordance with the prescribed procedure the medical practitioner or ophthalmic optician by whom his eyes are to be examined, his sight is to be tested or from whom any prescription for the supply of optical appliances is to be obtained. (2A) In making provision as to the matters referred to in subsection (2)(a), the regulations may include in particular provision as to— (a) the division of either part (or both parts) of a list into further sub-parts; (b) eligibility for inclusion in a list; (c) applications for inclusion (including provision for the procedure for applications to be made and dealt with and the documents to be supplied on application); (d) the grounds on which an application for inclusion must be granted or refused; (e) requirements with which a person included in a list must comply (including requirements as to standards of performance and patient care and as to declarations, consents or undertakings); (f) suspension or removal from a list (including the grounds for and consequences of suspension or removal); (g) circumstances in which a person included in a list may not withdraw from it; (h) payments to be made by a Health Board in respect of a person suspended from a list (including provision for the amount of, or the method of calculating, the payment to be determined by the Scottish Ministers); (i) criteria to be applied in making decisions under the regulations; (j) disclosure of information about applicants for inclusion, refusals of applications, or suspensions, removals or references to the Tribunal, including in particular the disclosure of information about any such matter by a Health Board to the Scottish Ministers and by the Scottish Ministers to a Health Board. (2B) Regulations may provide that— (a) a medical practitioner or ophthalmic optician who undertakes to provide general ophthalmic services under arrangements with a Health Board may not provide such services unless his name is included in the first part of the Board's list referred to in subsection (2)(a)(i); (b) a person who does not undertake to provide general ophthalmic services under arrangements with a Health Board may not assist in the provision of such services provided under arrangements with the Board unless his name is included in the second part of the Board's list referred to in subsection (2)(a)(ii). (3) The power conferred by this section to prescribe the qualifications to be possessed by any medical practitioner includes— (a) power to prescribe a requirement that the practitioner shall show, to the satisfaction of a committee recognised by the Secretary of State for the purpose, that he possesses such qualifications (including qualifications as to experience) as may be mentioned in the regulations, and (b) power to confer on a person who is dissatisfied with the determination of such a committee, a right of appeal to a committee appointed by the Secretary of State, and to make provision for any matter for which it appears to the Secretary of State to be requisite or expedient to make provision in consequence of the conferring of that right.

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27 Arrangements for provision of pharmaceutical services.

(1) It shall be the duty of every Health Board to make, in accordance with regulations, arrangements as respects its area for the provision to persons who are in that area of— (a) proper and sufficient drugs and medicines and listed appliances which are ordered for those persons by a medical practitioner in pursuance of his functions in the health service, the health service for England and Wales, the Northern Ireland health service or the armed forces of the Crown (excluding forces of a Commonwealth country and forces raised in a colony), and (b) proper and sufficient drugs and medicines which are ordered for those persons by a dental practitioner in pursuance of the provision by that Board or by an NHS trust of dental services; and (c) listed drugs and medicines which are ordered for those persons by a dental practitioner in pursuance of the provision by him of general dental services; . . . (cc) such drugs and medicines and such listed appliances as may be determined by the Scottish Ministers for the purposes of this paragraph which are ordered for those persons by a prescribed description of person in accordance with such conditions, if any, as may be prescribed, in pursuance of functions in the health service, the health service for England and Wales, the Northern Ireland health service or the armed forces of the Crown (excluding forces of a Commonwealth country and forces raised in a colony); and (d) such services as may be prescribed, and the provision of drugs, medicines, appliances and services in accordance with the arrangements istogether with additional pharmaceutical services provided in accordance with a direction under section 27A, referred to in this Act as “pharmaceutical services”. In this subsection— “listed” means included in a list for the time being approved by the Secretary of State for the purposes of this subsection; “the health service for England and Wales” and “the Northern Ireland health service” mean respectively the health service established in pursuance of section 1 of the National Health Service Act 1946 or any service provided in pursuance of Article 4(a) of the Health and Personal Social Services (Northern Ireland) Order 1972. (1A) The descriptions of persons which may be prescribed for the purposes of subsection (1)(cc) are the following, or any sub-category of such a description— (a) persons who are registered in the register maintained under article 5 of the Health and Social Work Professions Order 2001; (b) persons who are registered pharmacists; (c) persons who are registered in the dental care professionals register established under section 36B of the Dentists Act 1984; (d) persons who are ophthalmic opticians; (e) persons who are registered osteopaths within the meaning of the Osteopaths Act 1993 (c. 21); (f) persons who are registered chiropractors within the meaning of the Chiropractors Act 1994 (c. 17); (g) persons who are registered nurses or registered midwives; (h) persons not mentioned above who are registered in any register established, continued or maintained under an Order in Council under section 60(1) of the Health Act 1999 (c. 8); (i) any other description of persons which appears to the Scottish Ministers to be a description of persons whose profession is regulated by or under a provision of, or made under, Northern Ireland legislation and which the Scottish Ministers consider it appropriate to specify. (1B) A determination under subsection (1)(cc) may— (a) make different provision for different cases; (b) provide for the circumstances or cases in which a drug, medicine or appliance may be ordered; (c) provide that persons falling within a description specified in the determination may exercise discretion in accordance with any provision made by the determination in ordering drugs, medicines and listed appliances. (1C) Paragraphs (a) and (h) of subsection (1A) do not apply to persons in so far as they are registered as members of the social work profession in England or social care workers in England (each of those expressions having the same meaning as in section 60 of the Health Act 1999). (2) Regulations shall provide for securing that arrangements made by a Health Board under subsection (1) will enable persons in the Board’s area for whom drugs, medicines or appliances mentioned in that subsection are ordered as there mentioned , or to whom services mentioned in subsection (1)(d) are to be provided, to receive them from persons with whom such arrangements have been made. (3) The regulations shall include provision— (a) for the preparation and publication by a Health Board of one or more lists of persons, other than medical practitioners and dental practitioners, who undertake to provide pharmaceutical services from premises in the Board’s area; (b) that an application to a Health Board for inclusion in such a list shall be made in the prescribed manner and shall state— (i) the pharmaceutical services which the applicant will undertake to provide and, if they consist of or include the supply of appliances, which appliances he will undertake to supply; and (ii) the premises from which he will undertake to provide those services; (c) that, except in prescribed cases— (i) an application for inclusion in such a list by a person not already included; and (ii) an application by a person already included in such a list for inclusion also in respect of pharmaceutical services or premises other than those already listed in relation to him, shall be granted only if the Health Board is satisfied, in accordance with the regulations, that it is necessary or desirable to grant it in order to secure in the neighbourhood in which the premises are located the adequate provision by persons included in the list of the services, or some of the services, specified in the application; and (d) for the removal of an entry in respect of premises from a list if it has been determined in the prescribed manner that the person to whom the entry relates— (i) has never provided from those premises; or (ii) has ceased to provide from them, the pharmaceutical services, or any of the services, which he is listed as undertaking to provide from them. (4) The regulations may include provision— (a) that an application to a Health Board may be granted in respect of some only of the pharmaceutical services specified in it; (b) that an application to a Health Board relating to pharmaceutical services of a prescribed description shall be granted only if it appears to the Board that the applicant has satisfied such conditions with regard to the provision of those pharmaceutical services as may be prescribed; (ba) that an application to a Health Board by a person who qualified to have his name registered in Part 1 or 4 of the register maintained under article 19 of the Pharmacy Order 2010 by virtue of a qualification in pharmacy awarded in an EEA State other than the United Kingdom, or in Switzerland shall not be granted unless the applicant satisfies the Board that he has the knowledge of English which, in the interests of himself and the persons making use of the services to which the application relates, is necessary for the provision of pharmaceutical services in the Board’s area. (c) that the inclusion of a person in a list in pursuance of such an application may be for a fixed period; (d) that, where the premises from which an application states that the applicant will undertake to provide pharmaceutical services are in an area of a prescribed description, the applicant shall not be included in the list unless his inclusion is approved by a prescribed body and by reference to prescribed criteria; and (e) that the prescribed body may give its approval subject to conditions. (5) The regulations shall include provision conferring on such persons as may be prescribed rights of appeal from decisions made by virtue of subsection (3) or (4). (6) The regulations shall be so framed as to preclude— (a) a person included in a list published under subsection (3)( a ) above; and (b) an employee of such a person; from taking part in the decision whether an application such as is mentioned in subsection (3)( c ) above should be granted or an appeal against such a decision brought by virtue of subsection (5) above should be allowed.

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27A Arrangements for providing additional pharmaceutical services.

(1) The Secretary of State may— (a) give directions to a Health Board requiring them to arrange for the provision to persons in their area of additional pharmaceutical services; or (b) by giving directions to a Health Board authorise them to arrange for such provision if they wish to do so. (2) Directions under this section may make different provision in relation to different services specified in the directions. (3) The Secretary of State must publish any directions under this section in the Drug Tariff or in such other manner as he thinks appropriate. (4) In this section— “additional pharmaceutical services”, in relation to directions, means such services (of a kind that do not fall within section 27) as may be specified in the directions; and “Drug Tariff” means the Drug Tariff published under regulation 9 of the National Health Service (Pharmaceutical Services) (Scotland) Regulations 1995 or under any corresponding provision replacing, or otherwise derived from, that regulation.

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27B Terms and conditions etc.

(1) Directions under section 27A may require the Health Authority to whom they apply, when making arrangements— (a) to include, in the terms on which the arrangements are made, such terms as may be specified in the directions; (b) to impose, on any person providing a service in accordance with the arrangements, such conditions as may be so specified. (2) The arrangements must secure that any service to which they apply is provided only by a person whose name is included in a pharmaceutical list. (3) Different arrangements may be made with respect to— (a) the provision of the same service by the same person but in different circumstances; or (b) the provision of the same service by different persons. (4) A Health Authority must provide details of proposed arrangements (including the remuneration to be offered for the provision of services) to any person who asks for them. (5) After making any arrangements, a Health Authority must publish, in such manner as the Secretary of State may direct, such details of the arrangements as he may direct. (6) In this section, “pharmaceutical list” means, subject to any provision of the directions in question, a list— (a) published by the Health Authority concerned, or by any other Health Authority, in accordance with regulations made under section 27(2)(a) of this Act; or (b) published by any body in accordance with regulations made under section 42(2)(a) of the National Health Service Act 1977or Article 63(2A)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972.

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28 Persons authorised to provide pharmaceutical services.

(1) Except as may be provided by or under regulations, no arrangements shall be made by a Health Board with a medical practitioner or dental practitioner under which he is required or agrees to provide pharmaceutical services to any person to whom he is rendering primary medical services under Part 1 or general dental services. (2) Except as may be provided by or under regulations, no arrangements for the dispensing of medicines or the provision of pharmaceutical services shall be made with persons other than persons who are registered pharmacists or are persons lawfully conducting a retail pharmacy business in accordance with section 69 of the Medicines Act 1968, and who undertake (a) that all medicines provided by them under the arrangements made under this Part shall be dispensed , and (b) that (i) all services mentioned in section 27(1)(d) provided by them under those arrangements (ii) all additional pharmaceutical services provided in accordance with a direction under section 27A, shall be provided either by, or under the direct supervision of, a registered pharmacist. (2A) Regulations shall provide for the preparation and publication by a Health Board of one or more lists of medical practitioners who undertake to supply drugs and appliances in the Board’s area. (2B) The regulations shall include provision for the removal of an entry from a list in prescribed circumstances. (2C) Where— (a) arrangements have been made under this Part with a registered pharmacist; and (b) the registration of that pharmacist is suspended by virtue of any direction or order under the Pharmacy Order 2010,

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28A Remuneration for Part II services.

(1) The remuneration to be paid to persons who provide . . . , general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services). (2) For the purposes of this section and section 28B, determining authorities are— (a) the Secretary of State; and (b) so far as authorised by him to exercise the functions of determining authorities, any Health Board or other person appointed by him in an instrument (referred to in this section and section 28B as an instrument of appointment). (3) An instrument of appointment— (a) may contain requirements with which a determining authority appointed by that instrument must comply in making determinations; and (b) may be contained in regulations. (4) Subject to this section and section 28B, regulations may make provision about determining remuneration under subsection (1) and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication). (5) Regulations may provide— (a) that determinations may be made by reference to any of the following— (i) rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1); (ii) scales, indices or other data of any description specified in the regulations; (b) that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause. (6) Regulations may— (a) provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates; (b) provide that any such determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning— (i) if it is required to be published, on the date of publication; (ii) if it is not so required, on the date on which it is made. (7) A reference in this section or section 28B to a determination is a reference to a determination of remuneration under subsection (1) of this section.

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28B Part II remuneration: supplementary.

(1) Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 28A(1), he— (a) shall consult a body appearing to him to be representative of persons to whose remuneration the determination would relate, and (b) may consult such other persons as he considers appropriate. (2) Determinations may make different provision for different cases including different provision for any particular case, class of case or area. (3) Determinations may— (a) be made in more than one stage; (b) be made by more than one determining authority; (c) be varied or revoked by subsequent determinations. (4) A determination may be varied— (a) to correct an error; or (b) where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact. (5) Determinations may, in particular, provide that the whole or any part of the remuneration— (a) is payable only if the determining authority is satisfied as to certain conditions; or (b) is to be applied for certain purposes or is otherwise subject to certain conditions. (6) Subject to section 25(3), remuneration under section 28A may consist of payments by way of— (a) salary; (b) fees; (c) allowances; (d) reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction, and may be determined from time to time. (7) At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later date. (8) The matters which may be reserved include in particular— (a) the amount of remuneration to be paid in particular cases; (b) whether any remuneration is to be paid in particular cases. (9) Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular— (a) the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 28A(1) to which the determination will relate or of any category falling within that description; (b) the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services; (c) the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons; (d) the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate; (e) the desirability of promoting services which are— (i) economic and efficient; and (ii) of an appropriate standard. (10) If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 28A(1), the reference in subsection (9)(a) to a category of services is a reference to the same category of services or to any other category of services falling within the same description.

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28C Indemnity cover.

(1) Regulations may make provision for the purpose of securing that, in prescribed circumstances, prescribed Part II practitioners hold approved indemnity cover. (2) The regulations may, in particular, make provision as to the consequences of a failure to hold approved indemnity cover, including provision— (a) for securing that a person is not be added to any list unless he holds approved indemnity cover; (b) for the removal from a list prepared by a Health Board of a Part II practitioner who does not within a prescribed period after the making of a request by the Health Board in the prescribed manner satisfy the Health Board that he holds approved indemnity cover. (3) For the purposes of this section— “approved body” means a person or persons approved in relation to indemnity cover of any description, after such consultation as may be prescribed, by the Secretary of State or by such other person as may be prescribed; “approved indemnity cover” means indemnity cover made— on prescribed terms; and with an approved body; “indemnity cover”, in relation to a Part II practitioner (or person who proposes to provide Part II services), means a contract of insurance or other arrangement made for the purpose of indemnifying him and any person prescribed in relation to him to any prescribed extent against any liability which— arises out of the provision of Part II services in accordance with arrangements made by him with a Health Board under this Part of this Act; and is incurred by him or any such person in respect of the death or personal injury of a person; “list” has the same meaning as in section 29(8)(b) to (e); “Part II practitioner” means a person whose name is on a list; “Part II services” means . . . general dental services, general ophthalmic services or pharmaceutical services; “personal injury” means any disease or impairment of a person’s physical or mental condition and includes the prolongation of any disease or such impairment; and a person holds approved indemnity cover if he has entered into a contract or arrangement which constitutes approved indemnity cover. (4) The regulations may provide that a person of any description who has entered into a contract or arrangement which is— (a) in a form identified in accordance with the regulations in relation to persons of that description; and (b) made with a person or persons so identified, is to be treated as holding approved indemnity cover for the purposes of the regulations.

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28D Assistance and support: general dental services

(1) A Health Board may provide assistance and support to any person providing, or proposing to provide, general dental services. (2) Assistance and support provided by a Health Board under subsection (1) is to be provided on such terms, including terms as to payment, as the Board think fit. (3) In this section, “assistance” includes financial assistance.

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29 The NHS tribunal.

(1) The tribunal constituted in accordance with Schedule 8 shall continue under the name of “the NHS Tribunal” and that Schedule shall continue to have effect in relation to the Tribunal. (2) If the Tribunal receive from a Health Board representations that a person— (a) who has applied to be included; or (b) who is included, in any list meets any of the conditions for disqualification, the Tribunal shall inquire into the case. (3) If the Tribunal receive such representations from any other person, they may inquire into the case. (4) Representations under this section shall be made— (a) in the prescribed manner; and (b) where . . . regulations prescribe the time within which such representations are to be made, within that time. (5) Subsections (6) to (11) apply for the purposes of this group of sections. (6) The first condition for disqualification is that the inclusion or continued inclusion of the person concerned in the list would be prejudicial to the efficiency of the services which those included in the list— (a) in relation to a list referred to in subsection (8)(a), (cc) or (e), perform; (b) in relation to a list referred to in subsection (8)(c) or (d), undertake to provide or are approved to assist in providing; . undertake to provide . . . . (7) The second condition for disqualification is that the person concerned— (a) has (whether on his own or together with another) by an act or omission caused, or risked causing, detriment to any health scheme by securing or trying to secure for himself or another any financial or other benefit; and (b) knew that he or (as the case may be) the other was not entitled to the benefit. (7A) The third condition for disqualification is that the person concerned is unsuitable (by virtue of professional or personal conduct) to be included, or to continue to be included, in the list. (8) A “list” means— (a) a list of health care professionals of a prescribed description performing primary medical services or approved to assist in the provision of such services; (aa) a list of medical practitioners approved to perform personal medical services— (i) in accordance with section 17C arrangements; or (ii) in connection with the provision of such services under a pilot scheme; (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) a list of dental practitioners and bodies corporate referred to in section 25(1) undertaking to provide, and of persons who are approved to assist in providing, general dental services; (cc) a list of persons performing personal dental services; (d) a list of medical practitioners and ophthalmic opticians undertaking to provide, and of persons who are approved to assist in providing, general ophthalmic services; or (e) a list of registered pharmacists performing pharmaceutical care services, prepared (in each case) under or by virtue of this Part or Part I of this Act. (8A) In subsection (8)(a), “health care professional” has the same meaning as in section 17P. (9) “Health scheme” means— (a) any of the health services under section 1(1) or any corresponding enactment extending to England and Wales or Northern Ireland; and (b) any prescribed scheme, and regulations may prescribe any scheme for the purposes of this subsection which appears to the Secretary of State to be a health or medical scheme paid for out of public funds. (10) Detriment to a health scheme includes detriment to any patient of, or person working in, that scheme or any person liable to pay charges for services provided under that scheme. (11) Cases in which representations are made that the first condition for disqualification is met are referred to below as efficiency cases; . . . cases in which representations are made that the second condition for disqualification is met are referred to below as fraud cases ; and cases in which representations are made that the third condition for disqualification is met are referred to below as unsuitability cases. (12) In this section and sections 29A to 29C— (a) “this group of sections” means this and those sections and Schedule 8; and (b) the NHS Tribunal is referred to as the Tribunal.

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29A The NHS Tribunal: supplementary.

(1) Where an ophthalmic optician is a body corporate, the body corporate is to be treated for the purposes of this group of sections as meeting the second condition for disqualification or, as the case may be, the third condition for disqualification if any director meets that condition (whether or not he first met that condition when he was a director). (1A) A body corporate entitled, by virtue of section 43 of the Dentists Act 1984 (c. 24), to carry on the business of dentistry is to be treated for the purposes of this group of sections as meeting the second condition for disqualification or, as the case may be, the third condition for disqualification if any director meets that condition (whether or not he first met that condition when he was a director). (2) Where a body corporate carries on a retail pharmacy business, the body corporate is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if any one of the body of persons controlling the body corporate meets that condition (whether or not he first met that condition when he was one of them). (3) A person who is included in any list (“the practitioner”) is to be treated for the purposes of this group of sections as meeting the second condition for disqualification if— (a) another person, because of an act or omission of his occurring in the course of providing assisting in providing,, or as the case may be performing, any services mentioned in section 29(8) on the practitioner’s behalf, meets that condition; and (b) the practitioner failed to take all such steps as were reasonable to prevent acts or omissions within section 29(7)(a) occurring in the course of the provision , assistance in provision, or performance, of those services on his behalf. (3A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (4) The Tribunal is not required to inquire into a fraud case if they have previously inquired into representations in respect of the person concerned and the same acts or omissions. (5) In an unsuitability case, a fraud case or an efficiency case, regulations may make provision . . . for the purpose of securing that the person subject to the inquiry is not added to any list until proceedings in that case are finally concluded. (6) For the purposes of this group of sections, in an unsuitability, a fraud or efficiency case proceedings are finally concluded— (a) if the Tribunal determine not to disqualify or conditionally disqualify him when they make that determination; (b) if they determine to disqualify or conditionally disqualify him and no appeal is brought against the determination, at the end of the period for bringing an appeal; (c) if they determine to disqualify or conditionally disqualify him and an appeal is brought against the determination, when the appeal process is exhausted. (7) An inquiry under section 29 is not affected by the person subject to the inquiry withdrawing from, withdrawing any application to be included in or being removed from the list to which the case relates.

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29B Powers of NHS Tribunal.

(1) Subsection (2) applies where the Tribunal are of the opinion— (a) on inquiring into an efficiency case, that the person meets the first condition for disqualification; (b) on inquiring into a fraud case, that the person meets the second condition for disqualification; (c) on inquiring into an unsuitability case, that the person meets the third condition for disqualification. (2) The Tribunal shall disqualify him for inclusion in— (a) the list to which the case relates; (b) all lists within the same paragraph of subsection (8) of section 29 as that list; and (c) where the list to which the case relates is a list referred to in— (i) paragraph (c) of that subsection, all lists within paragraph (cc) of that subsection; (ii) that paragraph (cc), all lists within that paragraph (c). (3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (4) The Tribunal shall not make a disqualification . . . under this section if they are of the opinion that it would be unjust to do so. (5) A disqualification under this section shall have effect when the case is finally concluded. (6) If a person is disqualified for inclusion in any list prepared by a Health Board, the Board must not enter him in the list and (if he is already included in the list) must remove him from the list.

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29C Conditional disqualification etc.

(1) The functions of making disqualifications under section 29B include making a conditional disqualification, that is, a disqualification which is to come into effect only if the Tribunal determine (on a review under section 30) that the person subject to the inquiry has failed to comply with any conditions imposed by them. (2) Conditions may be imposed by virtue of subsection (1) with a view to— (a) removing any prejudice to the efficiency of the services in question; . . . (b) preventing any acts or omissions within section 29(7)(a); (c) ensuring that the person— (i) performs, undertakes to provide or assists in providing only services specified (or of a description specified) in the condition; (ii) undertakes an activity (or course of activity) of a personal or professional nature, or refrains from conduct of a personal or professional nature, so specified (or of a description so specified), (as the case may be). (3) Conditions so imposed shall have effect when proceedings in the case are finally concluded. (4) Section 29B(4) applies to a conditional disqualification as it applies to a disqualification. (5) The Tribunal may by directions— (a) vary the terms of service of the person subject to the inquiry (including terms imposed by regulations under this Part); (aa) vary any requirements to which the person subject to the inquiry is subject under or by virtue of section 17F, 17P or 17X or this Part; (b) confer functions on any Health Board, for the purpose of or in connection with the imposition of any conditions by virtue of this section. (6) References in any enactment to a disqualification by the Tribunal do not include a conditional disqualification.

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30 Review etc. of disqualification.

(1) The Tribunal may review a disqualification or conditional disqualification— (a) if the disqualified or conditionally disqualified person requests a review; or (b) in any other circumstances in which they consider it appropriate. (2) On a review under subsection (1), the Tribunal may— (a) remove a disqualification; . . . (b) make a disqualification conditional; (c) in the case of a conditional disqualification, remove it, vary the conditions or make it unconditional. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (3) If any Health Board request a review of a conditional disqualification on the ground that— (a) there has been a change in the circumstances by reference to which the conditions were imposed; (b) the person concerned has failed to comply with the conditions; or (c) in a fraud case, the person concerned has since the Tribunal imposed the conditions (or made the disqualification conditional) again satisfied the second condition for disqualification, the Tribunal shall review the conditional disqualification. (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5) On a review under subsection (3) of a conditional disqualification, the Tribunal may remove it, vary the conditions or make it unconditional . . . (6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (7) The Tribunal shall not under this section— (a) in the case of a conditional disqualification, make it unconditional or vary the conditions; . . . (b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (c) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . if they are of the opinion that it would be unjust to do so. (8) A determination by the Tribunal under this section shall have effect— (a) if no appeal is brought against it, at the end of the period for bringing an appeal; (b) if an appeal is brought against it, when the appeal process is exhausted. (9) The Tribunal may hold an inquiry for the purposes of any review under this section.

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31 Disqualification provisions in England or Wales or Northern Ireland.

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