NATIONAL HEALTH SERVICE, SCOTLAND PART I INTRODUCTORY Citation, commencement and interpretation 1 1 These Regulations may be cited as the National Health Service (Fund-Holding Practices) (Scotland) Amendment Regulations 1999. 2 Part I and regulation 26 shall come into force on 18th February 1999, Parts II and IV, except regulation 26, shall come into force on 10th March 1999 and Part III shall come into force on 1st April 1999. 3 In these Regulations, “the principal Regulations ” means the National Health Service (Fund-Holding Practices) (Scotland) Regulations 1997 . PART II AMENDMENTS TO TAKE EFFECT ON 10TH MARCH 1999 Amendment of regulation 1 of the principal Regulations 2 In regulation 1 of the principal Regulations (citation, commencement and interpretation) in paragraph (2) after the definition of “relevant Health Board” there is inserted the following definition:– “residual fund-holding practice” means a fund-holding practice recognised as from 1st April 1999. . Amendment of regulation 2 of the principal Regulations 3 In regulation 2 of the principal Regulations (application for recognition as a fund-holding practice), paragraph (4) is omitted. Amendment of regulation 12 of the principal Regulations 4 In regulation 12 of the principal Regulations (grounds for removal of recognition), in paragraph (1)– a after “the next 1st April” insert “or, if 1st April has passed, for the current financial year (beginning on 1st April immediately past),”; and b for “that 1st April” substitute “midnight on 31st March immediately preceding that 1st April, or, if that date has passed, forthwith”. Amendment of regulation 13 of the principal Regulations 5 1 Regulation 13 of the principal Regulations (procedure for removal of recognition) is amended as follows. 2 In paragraph (1)– a in sub-paragraph (a)(ii), for “three months” substitute “three weeks”; and b in sub-paragraph (b), omit “either orally or”. 3 In paragraph (2), for “two months” substitute “two weeks”. 4 Omit paragraph (3). Amendment of regulation 22 of the principal Regulations 6 1 Regulation 22 of the principal Regulations (savings from the allotted sum) is amended as follows. 2 In paragraph (1)– a for “regulations 17 and 18” substitute “regulation 18”; b omit “17”. 3 For paragraph (2) substitute– 2 Subject to paragraph (3), where the accounts for a financial year of members of a fund-holding practice have been audited in accordance with section 86(1A) of the Act, the members of a fund-holding practice may, within the period of two years after the end of that financial year, with the consent of the Health Board apply any part of the allotted sum paid to them in respect of that financial year for the purposes specified in regulations 18 and 19 or any one or more of the following purposes– a the purchase of material or equipment which– i can be used for the treatment of patients; or ii enhances the comfort or convenience of patients; or b the purchase of material or equipment relating to health education; or c in relation to any premises from which general medical services are provided– i improvements to the premises, including alterations to or decoration of the premises and the purchase of furniture and furnishings; or ii building an extension provided that no acquisition of land is involved; provided that the improvements or extensions as the case may be are in accordance with the premises strategy of the relevant Health Board; or d the purchase of goods and services as part of an initiative to improve prescribing practices; or e training for members or employees of the practice which in the case of members is required in connection with their membership of the practice, or in the case of employees is required in connection with duties arising in the course of their employment; or f the cost of employing temporary staff. . 4 In paragraph (3) omit “(a) to (e)”. Revocations 7 Regulation 9 of the principal Regulations is hereby revoked. PART III AMENDMENTS EFFECTING RESIDUAL FUND-HOLDING PRACTICES AS FROM 1ST APRIL 1999 Amendment of regulation 1 of the principal Regulations 8 In regulation 1 (citation, commencement and interpretation) in paragraph (2) omit the definitions of “primary care purchasing practice”, “purchasing co-operative” and “standard fund-holding practice”. Amendment of regulation 2 of the principal Regulations 9 In regulation 2 of the principal Regulations (application for recognition as a fund-holding practice) omit paragraph (2). Amendment of regulation 3 of the principal Regulations 10 In regulation 3 of the principal Regulations (grant of recognition as a fund-holding practice) in paragraph (1), for “as a standard fund-holding practice, primary care purchasing practice or a purchasing co-operative (as the case may be)”, substitute “as a residual fund-holding practice”. Amendment of regulation 6 of the principal Regulations 11 In regulation 6 of the principal Regulations (conditions for continuing recognition) in paragraph (1), for “of a standard fund-holding practice, a primary care purchasing practice or a purchasing co-operative (as the case may be)”, substitute “of a residual fund-holding practice”. Amendment of regulation 8 of the principal Regulations 12 In regulation 8 of the principal Regulations (withdrawal or death of a member of a fund-holding practice)– a in paragraph (1), omit “in relation to the kind of practice in question”; and b omit paragraphs (2) to (6). Amendment of regulation 11 of the principal Regulations 13 In regulation 11 of the principal Regulations (consequences of renunciation of recognition) in paragraph (3), for “ending on that date”, substitute “in which that date falls”. Amendment of regulation 12 of the principal Regulations 14 In regulation 12 of the principal Regulations (grounds for removal of recognition), in paragraph (2), for the words “a standard fund-holding practice, a primary care purchasing practice or a purchasing co-operative (as the case may be)” substitute “a fund-holding practice”. Amendment of regulation 18 of the principal Regulations 15 1 Regulation 18 of the principal Regulations (payment for goods and services) is amended as follows. 2 Omit paragraphs (3) to (6) and (11)(a). 3 In paragraph (1), for “Subject to paragraphs (3) to (9)” substitute “Subject to paragraphs (7) to (10) and to regulation 19A”. 4 For paragraph (2) substitute– 2 The goods and services referred to in paragraph (1) are the goods and services specified in the list set out in Schedule 4 to these Regulations. . 5 After paragraph (2), insert– 2A Except where goods and services are purchased pursuant to an agreement entered into before 1st April 1999, fund-holding practices shall purchase goods and services only from providers which are health service bodies. . Amendment of regulation 19 of the principal Regulations 16 1 Regulation 19 of the principal Regulations (payments to members of the practice) is amended as follows. 2 In paragraph (1)– a at the beginning insert “Subject to regulation 19A,”; b at the end of sub-paragraph (a) insert “or”; c omit sub-paragraph (b). Limit on period of agreements 17 After regulation 19 insert– Limit on period of agreements 19A 1 Any agreement entered into on or after 1st April 1999 by the members of a fund-holding practice whereby the allotted sum would be applied as provided for in regulation 18, 19, 20 or 21, must comply with the requirements of paragraph (2). 2 The agreement shall contain terms the effect of which shall be that– a it shall come to an end not later than the end of the period of 6 months beginning with the date the agreement was made and that the duration of the agreement may not be extended; and b without prejudice to the availability of any remedy for breach of the agreement, no rights, liabilities or obligations are imposed beyond the end of that period. . Amendment of regulation 21 of the principal Regulations 18 1 Regulation 21 of the principal Regulations (payment for management expenses) is amended as follows. 2 In paragraph (1), at the beginning insert “Subject to regulation 19A”. 3 Omit paragraph (7). 4 In paragraph (8) omit sub-paragraph (c). Amendment of regulation 23 of the principal Regulations 19 In regulation 23 of the principal Regulations (recovery of mis-applied amounts), in paragraph (1) omit “17”. Amendment of Schedule 1 to the principal Regulations 20 In Schedule 1 to the principal Regulations (conditions for obtaining recognition as a fund-holding practice)– a omit paragraph 1; and b in paragraph 5(c) , for “, in the case of standard fund-holding practices in Part I, and in the case of primary care purchasing practices in Part II, of” substitute “in”. Amendment of Schedule 2 to the principal Regulations 21 1 Schedule 2 to the principal Regulations (conditions for continuing recognition as a fund-holding practice) is amended as follows. 2 Omit paragraph 1. 3 In paragraph 3, for “17 to 22” substitute “18 to 22”. 4 In paragraph 14(c) , for “, in the case of standard fund-holding practices in Part I, and in the case of primary care purchasing practices in Part II, of” substitute “in”. 5 After paragraph 14 insert the following– 15 There shall be no changes to the membership of the fund-holding practice, either by addition of new members or withdrawal of existing members, except in circumstances of death or retirement of a member. 16 The members of the practice shall not let the fund-holding account become overdrawn. . New Schedule 4 to the principal Regulations 22 After Schedule 3 to the principal Regulations, insert the new Schedule 4 set out in the Schedule to these Regulations. Revocations 23 Regulations 7 and 17 of the principal Regulations are hereby revoked. Saving 24 1 The amendments made by regulation 12 do not affect the members of any fund-holding practice from which a member has withdrawn before 1st April 1999 in circumstances other than death or retirement provided that the notice required in accordance with regulation 8(2) of the principal Regulations has been sent before 1st April 1999 and in such cases regulation 8 of the principal Regulations shall continue to apply in relation to members and former members of such practices as if the amendment referred to above had not been made. 2 In respect of any part of an allotted sum applied before 1st April 1999, regulation 23 of the principal Regulations shall continue to have effect as though the amendments made by regulations 19 and 23 of these Regulations had not been made, notwithstanding that the Secretary of State does not make his determination until on or after that date. PART IV TRANSITION TO RESIDUAL FUND-HOLDING SCHEME Applications for recognition as a residual fund-holding practice 25 1 Where the relevant Health Board has granted recognition in accordance with regulation 3(1) as a standard fund-holding practice, a primary care purchasing practice or a purchasing co-operative, but the recognition has not taken effect before 1st April 1999, such recognition shall lapse. 2 Where, by midnight on 31st March 1999, the relevant Health Board has neither granted nor refused recognition in respect of any outstanding application for recognition as a standard fund-holding practice, or as a primary care purchasing practice or as a purchasing co-operative that application shall lapse. 3 In this regulation, “residual fund-holding practice” means a fund-holding practice recognised as from 1st April 1999, in accordance with the principal Regulations as amended by these Regulations. Change in status of recognised fund-holding practices 26 Where the members of a standard fund-holding practice, a primary care purchasing practice or a purchasing co-operative wish the practice to continue to be recognised as a fund-holding practice on and after 1st April 1999, they shall send a written notice of their intention to remain a fund-holding practice to the relevant Health Board to be received no later than 11th March 1999. Removal of recognition 27 1 Subject to paragraph (4) where the notice referred to in regulation 26 has not been received on or before 11th March 1999 from the members of any fund-holding practice, recognition shall be removed from them with effect from midnight on 31st March 1999. 2 Where recognition is to be removed in circumstances specified in this regulation the relevant Health Board shall– a send to each member of the practice notice of removal of recognition; b include in the notice a statement of the reason for removal of recognition and that the removal takes effect from midnight on 31st March 1999; c inform the members of the practice that they may, subject to paragraphs (3) and (4), make representations in writing to the Secretary of State concerning the matter; and d inform each member of the practice of the consequences of removal of recognition. 3 Where the members of the practice wish to make representations in writing against the removal of recognition, the representations may be sent to the Secretary of State within the period of three weeks beginning with the date on which the notice referred to in paragraph (2) was sent. 4 Where the Secretary of State decides, having taken into account the representations of the members of the fund-holding practice, not to remove recognition he shall– a write to each member of the fund-holding practice withdrawing the notice referred to in paragraph (2); and b inform them of a new date by which the notice referred to in regulation 26, must be received by the relevant Health Board. 5 Where the Secretary of State informs the members of a fund-holding practice that their notice or application must be received by a new date in accordance with paragraph (4)(b), and the notice or application is not received by that new date the relevant Health Board shall remove recognition from them forthwith and paragraph 2(a), (b) and (d) shall apply, save that paragraph (b) shall apply as if “forthwith” were substituted for “from midnight on 31st March 1999”. Consequences of removal of recognition 28 Where recognition is removed from a practice in accordance with regulation 27(1) the consequences shall be the same as the consequences of the practice’s having renounced recognition and– a regulation 11(2) to (6) of the principal Regulations shall apply as if the references in those paragraphs to renunciation of recognition were references to removal of recognition; and b regulation 14 of the principal Regulations shall not apply. Sam Galbraith Minister for Health, Scottish Office St Andrew’s House, Edinburgh 15th February 1999