NATIONAL HEALTH SERVICE, ENGLAND AND WALES PART I GENERAL Citation and commencement 1 These Regulations may be cited as the National Health Service (Service Committees and Tribunal) Regulations 1992 and shall come into force on 1st April 1992. Interpretation 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PART II PROVISIONS RELATING TO INVESTIGATIONS, DISPUTES, APPEALS, ETC. Establishment of committees 3 1 Subject to paragraph (2) every Health Authority or Primary Care Trust shall have— a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c an ophthalmic discipline committee; d a pharmaceutical discipline committee; and e a joint discipline committee, and may, where it sees fit, have two or more of any of those committees. 2 The committees mentioned in paragraph (1) shall be known as discipline committees. 3 Three or more Health Authorities or Primary Care Trusts may appoint discipline committees jointly and in these Regulations a reference to a discipline committee of a Health Authority or Primary Care Trust includes a reference to a discipline committee jointly appointed by three or more Health Authorities or Primary Care Trusts . 4 A Health Authority or Primary Care Trust may have a reference committee which shall include one member who is both an officer and a member of that Health Authority or Primary Care Trust and which may exercise the Health Authority’s or Primary Care Trust's functions under these Regulations with respect to the referral of disciplinary matters. 5 Schedule 2 shall have effect with respect to the committees mentioned in paragraph (1). Provisions relating to the start of disciplinary proceedings 4 1 Where an appropriate Health Authority or Primary Care Trust receives information which it considers could amount to an allegation that a practitioner has failed to comply with his terms of service it shall decide either to take no action or to take one or both of the courses of action set out in paragraph (2). 2 The courses of action referred to in paragraph (1) are— a to refer the matter to another Health Authority or Primary Care Trust for investigation in accordance with regulation 5(1); b to refer the information to, as it considers appropriate, the Tribunal, the relevant professional body or the local police authority. 3 The appropriate Health Authority or Primary Care Trust shall not proceed under paragraph 2(a) in any case where the allegation and information on which it is based is the subject of a complaint which is being investigated. 4 For the purposes of these Regulations an allegation remains the subject of a complaint which is being investigated until— a the procedure for investigating the complaint is completed by the delivery of a report of the investigation to a Health Authority or Primary Care Trust by a panel appointed in accordance with directions given under section 17 of the Act; or b the complaint is withdrawn or abandoned by the person bringing it. 5 In these Regulations “appropriate Health Authority or Primary Care Trust ” in relation to a practitioner is the Health Authority or Primary Care Trust — a in whose ... ... ophthalmic or pharmaceutical list the name of the practitioner was included; or b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at the relevant time or, where the practitioner referred to in sub-paragraph (a) ... was at that time on more than one such list, the Health Authority or Primary Care Trust by arrangement with which the relevant services giving rise to the allegation were provided. 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Where a Health Authority or Primary Care Trust considers that a payment has been made to a practitioner which was not due and the practitioner does not admit that overpayment, the Health Authority or Primary Care Trust may refer the overpayment under regulation 5(1). 8 In this regulation “the relevant time” means the time of the event, treatment, or other matter giving rise to the allegation. Referral to investigating discipline committee 5 1 Where an appropriate Health Authority or Primary Care Trust decides to proceed under regulation 4(2)(a) or (7) it shall, subject to paragraph (2), refer the matter to another Health Authority or Primary Care Trust , for investigation by that Health Authority’s or Primary Care Trust's appropriate discipline committee. 2 The appropriate Health Authority or Primary Care Trust shall not refer the matter to another Health Authority or Primary Care Trust which has appointed any discipline committee jointly with the appropriate Health Authority or Primary Care Trust . 3 Subject to paragraph (6) the appropriate discipline committee referred to in paragraph (1) is— a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c where the matter relates to an ophthalmic medical practitioner or optician, an ophthalmic discipline committee; d where the matter relates to a chemist, a pharmaceutical discipline committee. 4 A matter which, under paragraph (1), is required to be investigated by two discipline committees, may instead be referred for investigation by a joint discipline committee. 5 If, in the opinion of a discipline committee, a matter referred to it includes allegations which are required, by virtue of paragraph (1), to be investigated also by another discipline committee, it shall refer the matter to the joint discipline committee instead of dealing with the matter itself. 6 Where a matter is referred for investigation by a joint discipline committee under paragraph (4) or paragraph (5), that committee shall be the appropriate discipline committee instead of any other committee. Time limits 6 1 Where the disciplinary matter concerns an allegation which has been the subject of a complaint the appropriate Health Authority or Primary Care Trust shall refer it under regulation 5(1) within 28 days of the allegation having ceased to be the subject of a complaint which is being investigated. 2 Where the disciplinary matter does not concern an allegation which has been the subject of a complaint the appropriate Health Authority or Primary Care Trust shall refer it under regulation 5(1) within the time limits specified in paragraph (3). 3 The time limits referred to in paragraph (2) are— a in the case of a ... ophthalmic medical practitioner, optician or chemist, 13 weeks after the event or matter which is the subject of the allegation; b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Investigations by discipline committees 7 1 A discipline committee shall investigate any matter which is referred to it. 2 Schedule 4 shall have effect with respect to the procedure for investigating disciplinary matters under this Part. 3 Where the disciplinary matter concerns an alleged overpayment made to a practitioner pursuant to regulation 4(7) the appropriate Health Authority or Primary Care Trust may refer it under regulation 5(1) at any time. Determination of appropriate Health Authority or Primary Care Trust 8 1 The appropriate Health Authority or Primary Care Trust , after due consideration of a report presented to it by the discipline committee pursuant to paragraph 7(1) of Schedule 4, shall— a accept as conclusive the findings of fact made by that committee; b accept as conclusive the inferences from those findings of fact which that committee considered could properly be drawn from those findings as to whether the practitioner has failed to comply with any of the terms of service detailed in the appropriate Health Authority’s or Primary Care Trust's statement of case; c determine, having regard to any recommendation made by the discipline committee pursuant to paragraph 7(1)(e) of Schedule 4 either— i that no further action should be taken in relation to the report, or ii that action should be taken in relation to the practitioner, in accordance with any one or more of the provisions of paragraphs (3) and (5). 2 If the appropriate Health Authority or Primary Care Trust decides either not to adopt the recommendation of the discipline committee or to take any action not recommended by that committee it shall record in writing its reasons for that decision. 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Where it has been determined that a practitioner to whom the report of the discipline committee relates has failed to comply with any of his terms of service the appropriate Health Authority or Primary Care Trust may— a determine that an amount shall be recovered from the practitioner, whether by way of deduction from his remuneration or otherwise; b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c determine that the practitioner should be warned to comply more closely with his terms of service in future. 6 In acting under sub-paragraphs (a) to (c) the appropriate Health Authority or Primary Care Trust may take into consideration any determination made by any FHSA before 1st April 1996 under these Regulations as they were in force prior to that date, or any determination, finding or inference under paragraph (1) since 1st April 1996, so long as such a determination, finding or inference has not been overturned on appeal and was not made more than 6 years prior to the date of the referral under regulation 5(1), that the practitioner had, on some other occasion, failed to comply with his terms of service. 7 The appropriate Health Authority or Primary Care Trust shall give notice in writing of its determination under paragraph (1) and any determination under paragraph (5), to the practitioner, any person who is treated as a party pursuant to paragraph 2(3) of Schedule 4, the discipline committee and the Secretary of State, and shall include with the notice— a a copy of the report of the discipline committee; b a statement of any reasons recorded by the Health Authority or Primary Care Trust under paragraph (2); and c a statement as to the rights of appeal to the Secretary of State under regulation 9. 8 Subject to paragraph (9), where an appropriate Health Authority or Primary Care Trust determines under this regulation that action should be taken in accordance with any of the provisions of paragraph (5)(a) ... or (c) that action shall be taken by the appropriate Health Authority or Primary Care Trust except that where, at the time when such action falls to be taken, the practitioner’s name is no longer included in that Health Authority’s or Primary Care Trust's list but is included in the list of some other Health Authority or Primary Care Trust , that action shall be taken by that other Health Authority or Primary Care Trust . 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Any amount determined under paragraph (5)(a) as being recoverable shall, to the extent that it is not recovered from the practitioner’s remuneration, be a debt owed by the practitioner to the Health Authority or Primary Care Trust by which it is recoverable. 11 Where the appropriate Health Authority or Primary Care Trust makes a determination under the provisions of paragraph (5)(a) ... or (c) no action shall be taken in consequence of that determination— a if no appeal is brought, before the end of the period specified in regulation 9(2) for bringing an appeal; or b if an appeal is brought, before it has received notice— i that the appeal has been withdrawn, or ii of the Secretary of State’s determination of the appeal. Appeal to the Secretary of State 9 1 An appeal may be made to the Secretary of State by a practitioner— a against a finding of fact, or an inference drawn from a finding of fact which (in either case) is adverse to him pursuant to regulation 8(1)(a) or (b); b against any determination by a Health Authority or Primary Care Trust under regulation 8(1)(c)(ii) to take action in accordance with any one or more of paragraphs ..., (5)(a) ... and (c) of that regulation; c in respect of a determination by a Health Authority or Primary Care Trust that an overpayment has or has not been made in respect of his remuneration; by giving notice of appeal in accordance with paragraph (2). 2 A notice of an appeal under this regulation shall be in writing and sent to the Secretary of State within 30 days beginning on the date on which notice of the appropriate Health Authority’s or Primary Care Trust's decision was given to the practitioner under regulation 8(7), and shall contain a concise statement of the grounds of appeal upon which the practitioner intends to rely in respect of each ground of appeal. 3 Subject to paragraph (6), on an appeal to which paragraph (1)(a) or (c) applies, the Secretary of State shall consider the appeal on the basis of such evidence as was available to the discipline committee and of such further evidence as shall have been adduced on the appeal, and shall— a make such findings of fact as he sees fit; and b draw such inferences from those findings as he sees fit; and c in the case of an appeal to which paragraph (1)(a) applies— i determine whether or not the practitioner has failed to comply with any one or more of the terms of service detailed in the appropriate Health Authority’s or Primary Care Trust's statement of case, and ii determine in accordance with any one or more of the following provisions that is, paragraph (5)(a) ... and (c), (as modified in accordance with paragraph (5) of this regulation) of regulation 8 or regulation 11 whether any, and if so what, action should be taken in relation to that practitioner; or d in the case of an appeal to which paragraph (1)(c) applies, determine whether there has been an overpayment and, if so, of what amount. 4 On an appeal to which paragraph (1)(b) alone applies, the Secretary of State shall— a accept as conclusive— i those findings of fact made by the discipline committee which were necessary for the purpose of the Health Authority’s or Primary Care Trust's determination under regulation 8(1)(c)(ii), and ii the inferences specified in the discipline committee’s report pursuant to paragraph 7(1)(c) of Schedule 4; b determine in accordance with any one or more of the following provisions, that is, paragraph (5)(a) ... and (c), (as modified in accordance with paragraph (5) of this regulation) of regulation 8, or regulation 11 , whether any, and if so what, action should be taken in relation to the practitioner. 5 For the purposes of paragraphs (3)(c)(ii) and (4)(b) of this regulation, paragraphs ... (5)(a) and (c) and (6), of regulation 8 shall have effect as if for any reference to “the appropriate Health Authority or Primary Care Trust ” there were substituted a reference to “the Secretary of State”. 6 The practitioner may withdraw his appeal, at any time before it is determined— a by giving written notice to the Secretary of State of his intention to do so; and b with the consent of the Secretary of State. Procedure on appeal 10 1 Subject to paragraph (5), if the Secretary of State, after considering a notice of appeal and any further particulars furnished by the practitioner, is of the opinion that the notice and particulars disclose no reasonable grounds of appeal or that the appeal is otherwise vexatious or frivolous, he may determine the appeal by dismissing it forthwith. 2 The Secretary of State shall, unless he dismisses the appeal under paragraph (1), send a copy of the notice of appeal and of any further particulars furnished by the practitioner to the appropriate Health Authority or Primary Care Trust , and shall invite that Authority or Trust to submit its observations on the appeal within 28 days of being sent the copy of the notice of appeal. 3 Where observations are made under paragraph (2), the Secretary of State shall send a copy of those observations to the practitioner and shall invite him to submit his comments on the observations within 21 days of his being sent that copy. 4 The Secretary of State shall hold an oral hearing to determine the appeal except in the circumstances described in paragraph (5). 5 Where a practitioner who is not appealing under regulation 9(1)(a), appeals under regulation 9(1)(b) against a decision in which the appropriate Health Authority or Primary Care Trust has determined to take action under paragraph ..., (5)(a) or (c) of regulation 8 his appeal may be dismissed without an oral hearing if the practitioner has stated in writing that he does not want such a hearing. 6 Where there is to be an oral hearing the Secretary of State shall appoint three persons to hear the appeal, of whom— a one shall be a barrister or a solicitor, and shall act as chairman; and b two shall be selected in accordance with paragraph (7) . 7 The persons appointed under paragraph (6)(b) shall be— a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c where the practitioner is an ophthalmic medical practitioner, two ophthalmic medical practitioners; d where the practitioner is an optician, two opticians; e where the practitioner is a chemist, two registered pharmacists. 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 The Secretary of State shall appoint a day for the hearing and shall give the practitioner and the appropriate Health Authority or Primary Care Trust not less than 21 days' notice in writing of the day, time and place of the hearing. 10 ... No person shall, without the consent of the practitioner, and the persons appointed under paragraph (6), be admitted to a hearing before those persons unless he is— a the practitioner; b a representative of the appropriate Health Authority or Primary Care Trust who is an officer or a member of it; c a person (who may be a barrister, a solicitor or any other person) engaged by a person or body mentioned in sub-paragraph (a) or (b) of this paragraph to represent them before the persons appointed under paragraph (6); or d a person whose attendance is required for the purpose of giving evidence to the persons so appointed. 11 The practitioner and the appropriate Health Authority or Primary Care Trust shall not rely on any facts or contentions which do not appear to the Secretary of State or the persons hearing the appeal to have been raised in the course of the proceedings before the discipline committee unless— a not less than seven days before the hearing, notice in writing was given to the Secretary of State of such facts or contentions; and b the Secretary of State or the persons hearing the appeal give their consent. 12 The persons hearing the appeal shall draw up a report and present it to the Secretary of State who shall take it into consideration and determine the appeal. 13 Where a Health Authority or Primary Care Trust has made representations to the Tribunal following its consideration of a report of a discipline committee, the Secretary of State may, for the purpose of any appeal under regulation 9(1)(a), treat as conclusive any relevant findings of fact of the Tribunal. 14 The Secretary of State shall give notice in writing to the practitioner and the Health Authority or Primary Care Trust of his determination under paragraph (1) or (12) of the matters mentioned in paragraphs (3)(c), (3)(d) or (4)(b) of regulation 9 and shall include with the notice a statement of his reasons for the determination. 15 The provisions of subsections (2) and (3) of section 250 of the Local Government Act 1972 (which relate to the summoning of witnesses and other matters) shall apply to an appeal held under this regulation as if in that subsection (3) for the words the “person appointed to hold the inquiry” there were substituted the words “persons hearing the appeal”. Recovery of amounts from practitioners following appeal 11 1 Where— a in the case of an appeal under regulation 9(1)(a), the Secretary of State determines that a practitioner has failed to comply with one or more of his terms of service; or b an appeal is made under regulation 9(1)(b) or (c), the Secretary of State shall, subject to the following provisions of this regulation, determine whether any, and if so what, amount shall be recovered from the practitioner, whether by way of deduction from his remuneration or otherwise. 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 The Secretary of State shall give notice in writing of his determination under paragraph (1) to the practitioner and the appropriate Health Authority or Primary Care Trust , and shall include with the notice a statement of the reasons for his determination. 6 Where the Secretary of State has determined under paragraph (1) that an amount shall be recovered from a practitioner, he shall direct the appropriate Health Authority or Primary Care Trust to recover that amount either by deduction from the practitioner’s remuneration or otherwise and, subject to regulation 8(8) (as modified by paragraph (7) of this regulation), that Health Authority or Primary Care Trust shall comply with that direction. 7 For the purposes of paragraph (6) regulation 8(8) shall have effect as if for the words “an appropriate Health Authority or Primary Care Trust determines under this regulation that action should taken in accordance with any of the provisions of paragraph (5)(a) ... or (c) that action shall be taken” there were substituted the words “the Secretary of State determines under regulation 11(1) that an amount should be recovered that amount shall be recovered”. 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Any sum which falls by virtue of paragraph (6) to be recovered by an Health Authority or Primary Care Trust shall, to the extent that it is not recovered by deduction from the practitioner’s remuneration, be a debt owed by the practitioner to that Health Authority or Primary Care Trust . Prior approval in dental cases 12 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Death of practitioner 13 Where, at any time after a disciplinary matter has been referred under regulation 5(1) but before the appropriate Health Authority or Primary Care Trust makes a determination under regulation 8 in relation to that matter, the practitioner to whom the matter relates dies, no further action shall be taken under these Regulations in relation to that practitioner. Prior approval in dental cases 14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Excessive prescribing by doctors 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Investigation of certification 16 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Investigation of record keeping 17 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Decision as to treatment for which fees may be charged by doctors 18 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appeals from decisions of the Board 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Power of Local Representative Committees to consider complaints 20 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 A Local Optical Committee may consider any complaint made to it by any optician against an optician providing primary ophthalmic services or other ophthalmic services pursuant to arrangements with Local Health Boards under the National Health Service (Wales) Act 2006 in the relevant locality involving any question of the efficiency of such services in that locality. 4 A Local Pharmaceutical Committee may consider any complaint made to it by any chemist against a chemist providing pharmaceutical services in the relevant locality involving any question of the efficiency of such services in that locality. 5 In this regulation “the relevant locality” means the locality in respect of which the Local Representative Committee in question is recognised under section 44 of the Act . PART III INQUIRIES BY, AND APPEALS FROM, THE TRIBUNAL Interpretation and forms 21 1 In this Part— ... “applicant” means a person who has made an application; “application” means an application for a direction under section 47 of the Act or paragraph 5 of Schedule 1 to the 1997 Act ; “complainant” means a person who, or a body which, has made representations; “inquiry” means an inquiry held under the provisions of this Part; “representations” means representations made to the Tribunal under section 46(1) of the Act or paragraph 3(1) or (2) of Schedule 1 to the 1997 Act ; “respondent” means— in relation to representations, the doctor, dentist, ophthalmic medical practitioner, optician or chemist in relation to whom the respresentations are made; in relation to an application, the Health Authority or Primary Care Trust from whose list the name of the applicant was removed pursuant to a direction under section 46(2)(a) of the Act or not included pursuant to a direction under paragraph 4(1) of Schedule 1 to the 1997 Act . 1A In this Part, references to “proceedings” before the Tribunal are to any such proceedings, whether relating to representations, applications, or suspension, and include inquiries, hearings and preliminary matters. 2 Any reference in this Part to a form prescribed in Schedule 8 includes a form substantially to like effect. Tenure of office of chairman and member of the Tribunal 22 1 The chairman and deputy chairmen of the Tribunal shall hold office during the pleasure of the Lord Chancellor. 2 The other members of the Tribunal shall hold office during the pleasure of the Secretary of State. Officers of the Tribunal 23 The chairman of the Tribunal shall appoint the following persons, who shall hold office during the pleasure of the chairman — a a person approved by the Secretary of State to act as Clerk of the Tribunal; and b such other officers as may be necessary. Procedure of the Tribunal 23A The chairman of the Tribunal may give practice directions applying generally to any Tribunal proceedings, and subject to any such directions, the person (being the chairman or a deputy chairman) presiding over any such proceedings may give procedural directions, order pre-hearing reviews, and generally determine the procedure to be followed. Making of representations and preliminary matters 24 1 Representations to the Tribunal— a under section 46(1) of the Act that the continued inclusion of a person’s name in a medical list, dental list, ophthalmic list or list of persons providing pharmaceutical services would be prejudicial to the efficiency of the services in question; or b under paragraph 3 of Schedule 1 to the 1997 Act that the inclusion of a person’s name in a medical list would be prejudicial to the efficiency of general medical services, shall be made in accordance with this regulation. 1A Subject to paragraph (1B), the representations referred to in paragraph (1) shall— a be made in writing; b be signed by the complainant or on his behalf by some person authorised by him; and c include a preliminary statement of the alleged facts and the grounds upon which he intends to rely, and shall be sent to the Tribunal. 1B The representations referred to in paragraph (1)(b) shall be sent to the Tribunal before the end of the period of two weeks beginning with the date on which the Health Authority or Primary Care Trust received the person’s application for his name to be included in the medical list. 2 The complainant shall, if so required by the Tribunal, send to it, before the end of such period (being not less than 14 nor more than 28 days), beginning with the day on which the Tribunal sent him notice of its requirement, as the Tribunal shall specify in the notice , a further statement setting out— a the alleged facts; b the grounds on which the representations are made; c where a fact is not within the personal knowledge of the person signing the representations, the source of the information and why it is considered to be true; and d such further particulars as the Tribunal may require, and shall, if so required by the Tribunal, verify the preliminary statement provided under paragraph (1A)(c) by statutory declaration. 3 Where the complainant is not a Health Authority or Primary Care Trust the Tribunal shall consider the representations and any statement furnished under paragraph (2) and if it declines to inquire into the case, it shall so inform the complainant in writing. 4 Where an inquiry is to be held, the Tribunal shall give— a to the respondent notice in writing in the form set out in Part I of Schedule 8 that the Tribunal intends to hold an inquiry as to the representations made by the complainant; b to the complainant notice in writing in the form set out in Part II of Schedule 8 that the Tribunal intends to hold an inquiry as to his representations and requiring him, within a time specified in the notice, to send to the Tribunal a copy of any document which he proposes to put in evidence. 5 The complainant shall comply with any requirement of a notice given to him under paragraph (4)(b) within the time stated in it. 6 The Tribunal shall send to the respondent— a a copy of the preliminary statement provided by the complainant under paragraph (1A)(c) ; b a copy of any further statement furnished under paragraph (2); c copies of documents which have been provided by the complainant under paragraph (5); and d a notice informing him that he may, by a statement in writing to be sent to the Tribunal within a time specified in the notice, admit or dispute the truth of all or any of the allegations appearing in a statement sent to him under sub-paragraph (a) or (b) of this paragraph. 7 The Tribunal may at any time before the conclusion of the inquiry allow the statement of complaint to be amended, upon such conditions as it may think just, on the application of the complainant. Applications for interim suspension 24A 1 An application for interim suspension under section 49A of the Act shall— a be made in writing; b be signed by some person authorised by the Health Authority or Primary Care Trust ; c include a statement of the alleged facts and the grounds upon which the Health Authority or Primary Care Trust intends to rely; and d include a copy of each document which the Health Authority or Primary Care Trust proposes to put in evidence, and shall be sent to the Tribunal. 2 The statement mentioned in paragraph (1)(c) may be made by reference to any other document already before the Tribunal. 3 The application shall be dealt with by way of oral hearing, and Schedule 9 shall apply with respect to that hearing. 4 The Tribunal shall give the respondent notice in writing of the application and of its intention to hold an oral hearing on a date to be fixed, and shall include a copy of— a the Health Authority's or Primary Care Trust's application; b any document provided under paragraph (1)(d); and c where paragraph (2) applies, any document which is referred to in the statement. 5 The Tribunal may at any time before the conclusion of the proceedings relating to the application allow it to be amended, upon such conditions as it may think just, on the application of the Health Authority or Primary Care Trust . 6 At the conclusion of proceedings relating to the application, the Tribunal shall, as soon as practicable, issue a decision in writing, signed by the person (being the chairman or a deputy chairman) who presided over the proceedings, containing— a any directions it decides to give under section 49A(2) of the Act; b a statement of reasons for its decision; and c any order it decides to make as to costs. 7 The Tribunal shall send a copy of its decision to the respondent, the Health Authority or Primary Care Trust , and the Secretary of State; and the Secretary of State shall send a copy of the decision to any other Health Authority or Primary Care Trust which appears to him to be concerned. 8 Where the decision includes a direction under section 49A(2) of the Act, the Tribunal shall include with the decision a notice to the respondent of his right to appeal under section 11(1) of the Tribunals and Inquiries Act 1992. Withdrawal of representations and suspension of procedures 25 1 The complainant may at any time before the inquiry, with the consent of the Tribunal and on such terms as the Tribunal thinks fit, withdraw his representations by giving notice of withdrawal in writing to the Tribunal. 2 If the complainant fails to comply, within the time allowed by the Tribunal for such compliance, with any requirement imposed under regulation 24 or 26, or fails, without having previously offered a reasonable excuse, to appear at an inquiry of which due notice was given under paragraph 1 of Schedule 9, the Tribunal may treat the representations as having been withdrawn. 3 Subject to paragraph (3A), where representations are withdrawn or treated as withdrawn the Tribunal shall immediately so inform the respondent in writing (without prejudice to its power to determine any question as to costs under regulation 31A ). 3A Where representations are withdrawn or treated as withdrawn after the Tribunal has given a direction under section 49A(2) of the Act, that direction shall cease to have effect; and— a the Tribunal shall include this information also when informing the respondent under paragraph (3); b the Tribunal shall immediately also so inform the Secretary of State in writing that the direction has ceased to have effect; and b the Secretary of State shall so inform anyone to whom he sent a copy of the Tribunal’s decision pursuant to regulation 24A(7). 4 Except where the Tribunal has made a direction under section 49A(2) of the Act, where it appears to the Tribunal that the alleged facts on which any representations are based are being or may be investigated by some other tribunal, body or person, it may direct that no further steps shall be taken under this Part pending the result of the other investigation. 5 The Tribunal may also direct that no further steps shall be taken for the time being under this Part in any other circumstances where it appears to the Tribunal that it would be appropriate so to direct. Inquiry as to representations 26 1 Subject to paragraph (2), the inquiry shall be held by way of an oral hearing, and Schedule 9 shall apply with respect to that hearing. 2 Subject to paragraph (2A), where the grounds on which representations are based are solely that the respondent has been convicted of a criminal offence and the respondent states in writing that— a he admits the conviction; and b he does not want an oral hearing, the Tribunal may decide the case on such documentary evidence as may be submitted to it. 2A Where the Tribunal has determined to decide the case on documentary evidence pursuant to paragraph (2), but proposes to give a direction under section 49B(1) of the Act, it shall before doing so give notice to the Health Authority or Primary Care Trust and the respondent of its intention to hold an oral hearing relating to that proposal, and shall then hold an oral hearing to which Schedule 9 shall apply. 3 At the conclusion of the inquiry the Tribunal shall, as soon as practicable, issue a decision in writing, signed by the person (being the chairman or a deputy chairman) who presided over the inquiry , containing— a its findings of fact; b its conclusions; c any directions it decides to give under section 46(2) or 49B(1) of the Act or under paragraph 4(1) of Schedule 1 to the 1997 Act ; d a statement of the reasons for its decision; and e any order it decides to make as to costs. 4 The Tribunal shall send a copy of its decision to the respondent, the complainant and the Secretary of State; and the Secretary of State shall send a copy of the decision to any Health Authority or Primary Care Trust which appears to him to be concerned. 5 Where the decision contains a direction under section 46(2) of the Act or under paragraph 4(1) of Schedule 1 to the 1997 Act , or directions under both sections 46(2) and 49B(1) of the Act, the Tribunal shall include with the decision a notice to the respondent of his right of appeal under section 11(1) of the Tribunals and Inquiries Act 1992 in respect of any direction under section 49B(1) of the Act or a direction under section 46(2) of the Act, or both or a direction under paragraph 4(1) of Schedule 1 to the 1997 Act . Discharge of suspension functions by chairman or deputy chairman 26A The functions of the Tribunal under section 49A or 49B of the Act may be carried out by the chairman or a deputy chairman of the Tribunal; and where the chairman or a deputy chairman does carry them out, any reference to the Tribunal in this Part or in Schedule 9 shall be construed as a reference to that person. Appeals to Secretary of State as to representations 27 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Applications for removal of disqualification 28 1 An application for a direction— a under section 47 of the Act that a person shall no longer be disqualified for inclusion in any list to which a direction under section 46 of the Act relates; or b under paragraph 5 of Schedule 1 to the 1997 Act that a person shall no longer be disqualified for inclusion in any medical list to which a direction under paragraph 4 of that Schedule relates, may be made to the Tribunal and shall be made in accordance with this regulation. 2 An application made under paragraph (1) shall— a be made in writing; b be signed by or on behalf of the applicant; c contain a statement of the grounds on which it is made; and d include a copy of each document which the applicant proposes to put in evidence. Applications to the Tribunal 29 1 An application made to the Tribunal shall be sent to the Tribunal. 2 The Tribunal shall send to the respondent a copy of the application, together with a copy of any document included with it under regulation 28(2)(d) . 3 The Tribunal shall consider the application and— a if it considers that no good cause has been shown for an inquiry, it may decline to hold an inquiry and to make a direction under section 47 of the Act or (as the case may be) under paragraph 5 of Schedule 1 to the 1997 Act and shall give notice in writing to the applicant and the respondent accordingly; b if it considers that an inquiry should be held, it shall give notice in writing to the applicant and the respondent accordingly. 4 The applicant may at any time before the inquiry, with the consent of the Tribunal and on such terms as it thinks fit, withdraw his application by giving notice of withdrawal in writing to the Tribunal; and where an application is withdrawn the Tribunal shall so inform the respondent in writing. 5 Where an inquiry is to be held by way of an oral hearing, the provisions of Schedule 9 shall apply with respect to that hearing. 6 At the conclusion of the inquiry the Tribunal shall, as soon as practicable, issue a decision in writing, signed by the person (being the chairman or a deputy chairman) who presided over the inquiry , containing— a its findings of fact; b its conclusions; c any direction it decides to give under section 47 of the Act or (as the case may be) under paragraph 5 of Schedule 1 to the 1997 Act ; and d any order it decides to make as to costs. 7 The Tribunal shall send a copy of the Tribunal’s decision to the applicant, the respondent and the Secretary of State; and the Secretary of State shall send a copy of the decision to any other Health Authority or Primary Care Trust which appears to him to be concerned. Applications to the Secretary of State 30 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Publication of decisions 31 The Secretary of State shall publish in such manner as he thinks fit— a any direction of the Tribunal under section 46(2) of the Act; b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c any direction of the Tribunal ... under section 47 of the Act; d any imposition or removal of a disqualification referred to in section 48 of the Act (corresponding provisions for Scotland and Northern Ireland); e any direction of the Tribunal under section 49A(2) or 49B(1) of the Act ; f any direction of the Tribunal under paragraph 4(1) or 5 of Schedule 1 to the 1997 Act; g any imposition or removal of a disqualification referred to in paragraph 6 of Schedule 1 to the 1997 Act (direction in Northern Ireland). Costs 31A Section 250(5) of the Local Government Act 1972 (costs) shall apply to Tribunal proceedings as though the reference there to the Minister causing an inquiry to be held under section 250 were to the Tribunal, and as if the reference to the parties at the inquiry were to the parties to Tribunal proceedings. Publication of information about applications involving preferential treatment 31B The Secretary of State shall publish in such a manner as he thinks fit information about— a applications made to Health Authorities or Primary Care Trusts for inclusion in their medical list of the names of medical practitioners in respect of whom Schedule 1 to the 1997 Act applies; and b the right of persons to make representations against such applications. PART IV MISCELLANEOUS PROVISIONS Service of documents 32 1 Any notice or other document required or authorised by any provision of these Regulations to be served on any person or to be given or sent to any person may be served, given or sent— a by delivering it or sending it by post to him at his usual or last-known address, which in the case of a ... dentist, ophthalmic medical practitioner, optician or chemist may be the address given in the ... dental, ophthalmic or pharmaceutical list in which his name is included; b in the case of the Tribunal, a Health Authority or Primary Care Trust , a Local Representative Committee or a committee mentioned in regulation 3, by delivering it or sending it by post to their Clerk, chief officer or secretary at its principal office; c in the case of the Secretary of State, by delivering it or sending it by post to his principal office; d in the case of a person represented by— i a solicitor, by delivering it or sending it by post to that solicitor at his professional address, ii the Citizen Voice Body for Health and Social Care, Wales (“the Body”) established under section 12(1) of the Health and Social Care (Quality and Engagement) (Wales) Act 2020 or any person acting on its behalf, by delivering it or sending it by post to the Body’s chief executive or board secretary at its principal office, iii any other person, by delivering it or sending it by post to that other person at his usual or last-known address. 2 Where a notice or document is delivered to a person under paragraph (1)(a) to (d) it shall be treated as served on the day on which it was so delivered and where a notice or document is sent by post to a person under paragraph (1) (a) to (d) it shall be treated as served on the second day after that on which it was posted. Attendance by member of Administrative Justice and Tribunals Council 33 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Power to dispense with requirements as to notices 34 The Secretary of State or the Tribunal may dispense with any requirements of these Regulations respecting notices, applications, documents or otherwise in any case where it appears to the Secretary of State or the Tribunal just and proper to do so. Power to extend time limits 35 1 Where, by virtue of a provision of these Regulations mentioned in paragraph (3)— a a person or body is required— i to give notice of an appeal or ... to signify any wish or intention, ii to provide documents or reasons, iii to submit observations or comments, iv to make any statement or representations, or v to admit or dispute the truth of an allegation, within a time specified in or under that provision; and b that person applies (whether before or after the expiry of the time so specified) to the relevant authority in accordance with paragraph (2) for that time to be extended, the relevant authority may, where it is satisfied that it is in all the circumstances reasonable to do so, extend that time by such further period as it shall specify. 2 An application under paragraph (1) shall— a where it seeks the extension of the time allowed for the giving of a notice of appeal, be made in writing; b in any other case, be made either orally or in writing, and shall include a statement of the grounds for the application. 3 For the purposes of this regulation, the relevant authority is, in relation to any application in connection with a time specified in— a regulation 15(5) or 19(3) or (5), or ..., the Health Authority or Primary Care Trust ; b regulation 24(1B), (2) , (4)(b) or (6)(d), the Tribunal; c ..., 15(19) or (21)(a) or (b), 16(7), or 17(10) , or paragraph 4(1) of Schedule 3, the Secretary of State. Fresh appointments 36 1 Where a person appointed by the Secretary of State for any purpose of any provision of regulation 10, 11, 12 or of Schedule 5— a dies or resigns before the completion of that purpose; or b is unable or refuses to complete that purpose, the Secretary of State may rescind that appointment together with that of any other person so appointed in relation to the same matter, and appoint different persons in accordance with the provision in question. 2 Where different persons are appointed pursuant to paragraph (1), any matter referred to them shall be considered afresh. 3 For the purposes of this regulation a person has completed the purpose for which he was appointed if he has indicated to any other person also appointed for that purpose the decision to be given or recommendation to be made, even if he has not signed a report embodying the decision or recommendation. Referral of matters to professional bodies 37 1 Where, in relation to any disciplinary matter— a an appropriate Health Authority or Primary Care Trust receives a report of a discipline committee; and b having regard to the facts found by the discipline committee in relation to that matter, that Health Authority or Primary Care Trust considers that the matter should be brought to the attention of the relevant professional body, it may refer to that body any documents in its possession connected with that disciplinary matter. 2 Where, in relation to any such disciplinary matter— a the Secretary of State— i receives, pursuant to regulation 8(7) a copy of the report of a discipline committee and the consequent determination of the appropriate Health Authority or Primary Care Trust , or ii makes a determination of an appeal under regulation 9; b that matter has not been the subject of a referral by the health authority or Primary Care Trust under paragraph (1); and c the Secretary of State considers that the matter should be brought to the attention of the relevant professional body, he may refer to that body any documents in his possession connected with that disciplinary matter and any appeal. 3 Where the Secretary of State receives a copy of a decision of the Tribunal pursuant to regulation 24A(7) or 26(4), and considers that the matter should be brought to the attention of the relevant professional body, he may refer to that body any documents in his possession connected with the representations or the application for interim suspension to which the Tribunal’s decision relates. 4 In this regulation, “the relevant professional body” means— a in relation to ... an ophthalmic medical practitioner, the General Medical Council; b in relation to a dentist, the General Dental Council; c in relation to an optician, the General Optical Council; d in relation to a pharmacist, the General Pharmaceutical Council . Transitional provisions 38 Where, before 1st April 1992— a a complaint has been made under regulation 4, or a matter has been referred under regulation 6(6), of the National Health Service (Service Committees and Tribunal) Regulations 1974 ; b an application has been made to the Secretary of State under regulation 15(3) of those Regulations; c a matter has been referred to a Local Representative Committee, or to a joint committee of Local Medical Committees, under regulation 16(1)(a), 17, 18 or 19 of those Regulations; d an appeal has been made under regulation 21 of those Regulations; e a matter has been referred to an ophthalmic service committee under regulation 23(1) of those Regulations; or f representations have been made to the Tribunal under regulation 28, or an application has been made to the Tribunal or the Secretary of State under regulation 43, of those Regulations, the provisions of those Regulations shall, notwithstanding regulation 39, continue to apply on and after that date, as respects any investigation, consideration, hearing, referral, report or determination which, by virtue of any provision of those Regulations, falls to be undertaken, held or made in relation to any such application, reference, appeal or representations, or in relation to any appeal under those Regulations from any determination of such application, reference or representations. Revocations 39 The Regulations specified in column (1) of Schedule 10 are hereby revoked to the extent specified in column (3) of that Schedule. William Waldegrave One of Her Majesty’s Principal Secretaries of State 10th March 1992