The Welsh Ministers and the health service in Wales
Welsh Ministers' duty to promote health service
(1) The Welsh Ministers must continue the promotion in Wales of a comprehensive health service designed to secure improvement—
(a) in the physical and mental health of the people of Wales, and
(b) in the prevention, diagnosis and treatment of illness.
(2) The Welsh Ministers must for that purpose provide or secure the provision of services in accordance with this Act.
(3) The services so provided must be free of charge except in so far as the making and recovery of charges is expressly provided for by or under any enactment, whenever passed.
Welsh Ministers' duty to secure quality in health services
(1) The Welsh Ministers must exercise their functions in relation to the health service with a view to securing improvement in the quality of health services.
(2) For the purposes of this section—
“ health services ” means any services provided or secured in accordance with this Act;
“ quality ” includes, but is not limited to, quality in terms of—
the effectiveness of health services,
the safety of health services, and
the experience of individuals to whom health services are provided.
(3) The Welsh Ministers must publish an annual report on the steps they have taken to comply with the duty in subsection (1).
(4) The report must include an assessment of the extent of any improvement in outcomes achieved by virtue of those steps.
(5) The Welsh Ministers must lay a copy of the report before the National Assembly for Wales.
General power to provide services
Welsh Ministers' general power
(1) The Welsh Ministers may—
(a) provide such services as they consider appropriate for the purpose of discharging any duty imposed on them by this Act, and
(b) do anything else which is calculated to facilitate, or is conducive or incidental to, the discharge of such a duty.
(2) Subsection (1) does not affect—
(a) the powers of the Welsh Ministers apart from this section,
(b) Part 6 and Chapter 1 of Part 7 (ophthalmic and pharmaceutical services).
Provision of particular services
Welsh Ministers' duty as to provision of certain services
(1) The Welsh Ministers must provide throughout Wales, to such extent as they consider necessary to meet all reasonable requirements—
(a) hospital accommodation,
(b) other accommodation for the purpose of any service provided under this Act,
(c) medical, dental, ophthalmic, nursing and ambulance services,
(d) such other services or facilities for the care of pregnant women, women who are breastfeeding and young children as they consider are appropriate as part of the health service,
(e) such other services or facilities for the prevention of illness, the care of persons suffering from illness and the after-care of persons who have suffered from illness as they consider are appropriate as part of the health service,
(f) such other services or facilities as are required for the diagnosis and treatment of illness.
(2) For the purposes of the duty in subsection (1), services provided under—
(a) section 41(2) (primary medical services) or 56(2) (primary dental services), or
(b) a general medical services contract or a general dental services contract,
must be regarded as provided by the Welsh Ministers.
(3) This section does not affect Part 6 and Chapter 1 of Part 7 (ophthalmic and pharmaceutical services).
High security psychiatric services
(1) The Welsh Ministers' duty under section 1 includes a duty to provide hospital accommodation and services for persons who—
(a) are liable to be detained under the Mental Health Act 1983 (c. 20), and
(b) in the opinion of the Welsh Ministers require treatment under conditions of high security on account of their dangerous, violent or criminal propensities.
(2) The hospital accommodation and services mentioned in subsection (1) are referred to in this section and paragraph 15 of Schedule 3 as “high security psychiatric services”.
(3) High security psychiatric services may be provided only at hospital premises at which services are provided only for the persons mentioned in subsection (1).
(4) “ Hospital premises ” means—
(a) a hospital, or
(b) any part of a hospital which is treated as a separate unit.
Other services
Schedule 1 makes further provision about the Welsh Ministers and services under this Act.
Provision of services otherwise than in Wales
Performance of functions outside Wales
(1) The Welsh Ministers may provide or secure the provision of anything mentioned in section 3(1) outside Wales.
(2) The Welsh Ministers' functions may be performed outside England and Wales, in so far as they relate to—
(a) holidays for patients,
(b) the transfer of patients to or from Scotland, Northern Ireland, the Isle of Man or the Channel Islands, or
(c) the return of patients who have received treatment in England and Wales, to countries or territories outside the British Islands (including for this purpose the Republic of Ireland).
Reimbursement of cost of services provided in another EEA state
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Prior authorisation for the purposes of section 6A
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Reimbursement of cost of services provided in another EEA state where expenditure incurred on or after 25 October 2013
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Prior authorisation for the purposes of section 6BA
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NHS contracts
(1) In this Act, an NHS contract is an arrangement under which one health service body (“the commissioner”) arranges for the provision to it by another health service body (“ the provider ”) of goods or services which it reasonably requires for the purposes of its functions.
(2) Section 97(6) (NHS contracts and the provision of local pharmaceutical services under pilot schemes) makes further provision about acting as commissioner for the purposes of subsection (1).
(3) Paragraph 15 of Schedule 3 (NHS trusts and NHS contracts) makes further provision about an NHS trust acting as provider for the purposes of subsection (1).
(4) “ Health service body ” means any of the following—
(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(ba) NHS England ,
(bb) an integrated care board,
(c) an NHS trust,
(d) a Special Health Authority,
(e) a Local Health Board,
(f) a Health Board constituted under section 2 of the National Health Service (Scotland) Act 1978 (c. 29),
(fa) a Special Health Board constituted under that section,
(g) the Regional Agency for Public Health and Social Well-being,
(h) the Common Services Agency for the Scottish Health Service,
(i) the Wales Centre for Health,
(j) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(k) the Care Quality Commission,
(ka) the National Institute for Health and Care Excellence,
(kb) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(l) the Scottish Dental Practice Board,
(m) the Secretary of State,
(n) the Welsh Ministers,
(na) the Scottish Ministers,
(nb) Healthcare Improvement Scotland,
(o) the Regional Business Services Organisation,
(p) a special health and social services agency established under the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990 ( S.I. 1990/247 (N.I.3)),
(q) a Health and Social Care trust established under the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)),
(r) the Department of Health, Social Services and Public Safety.
(5) Whether or not an arrangement which constitutes an NHS contract would apart from this subsection be a contract in law, it must not to be regarded for any purpose as giving rise to contractual rights or liabilities.
(6) But if any dispute arises with respect to such an arrangement, either party may refer the matter to the Welsh Ministers for determination under this section.
(7) If, in the course of negotiations intending to lead to an arrangement which will be an NHS contract, it appears to a health service body—
(a) that the terms proposed by another health service body are unfair by reason that the other is seeking to take advantage of its position as the only, or the only practicable, provider of the goods or services concerned or by reason of any other unequal bargaining position as between the prospective parties to the proposed arrangement, or
(b) that for any other reason arising out of the relative bargaining position of the prospective parties any of the terms of the proposed arrangement cannot be agreed,
that health service body may refer the terms of the proposed arrangement to the Welsh Ministers for determination under this section.
(8) Where a reference is made to the Welsh Ministers under subsection (6) or (7), they may determine the matter themselves or appoint a person to consider and determine it in accordance with regulations.
(9) “ The appropriate person ” means the Welsh Ministers or the person appointed under subsection (8).
(10) By the determination of a reference under subsection (7), the appropriate person may specify terms to be included in the proposed arrangement and may direct that it be proceeded with.
(11) A determination of a reference under subsection (6) may contain such directions (including directions as to payment) as the appropriate person considers appropriate to resolve the matter in dispute.
(12) The appropriate person may by the determination in relation to an NHS contract vary the terms of the arrangement or bring it to an end (but this does not affect the generality of the power of determination under subsection (6)).
(13) Where an arrangement is so varied or brought to an end—
(a) subject to paragraph (b), the variation or termination must be treated as being effected by agreement between the parties, and
(b) the directions included in the determination by virtue of subsection (11) may contain such provisions as the appropriate person considers appropriate in order to give effect to the variation or to bring the arrangement to an end.
Provision for bodies in Northern Ireland
(1) Subsection (2) applies where the Regional Agency for Public Health and Social Well-being or a body mentioned in paragraph (o), (p), (q) or (r) of section 7(4) is a party or prospective party to an arrangement or proposed arrangement which—
(a) falls within the definition of NHS contract in section 7(1), and
(b) also falls within the definition of HSS contract in Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1991 (S.I. 1991/194 (N.I.1)).
(2) Subsections (5) to (13) of section 7 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Welsh Ministers of references to the Welsh Ministers and the Department of Health, Social Services and Public Safety acting jointly.
Provision for bodies in Scotland
(1) Subsection (2) applies where the Scottish Ministers are, or a body mentioned in paragraph (f), (fa), (h), (l) or (nb) of section 7(4) is, a party or prospective party to an arrangement or proposed arrangement which—
(a) falls within the definition of NHS contract in section 7(1), and
(b) also falls within the definition of NHS contract in section 17A of the National Health Service (Scotland) Act 1978.
(2) Subsections (5) to (13) of section 7 apply in relation to the arrangement or proposed arrangement with the substitution for references to the Welsh Ministers—
(a) in so far as the arrangement or proposed arrangement relates to reserved matters within the meaning of the Scotland Act 1998, of references to the Welsh Ministers and the Secretary of State acting jointly, and
(b) for all other purposes, of references to the Welsh Ministers and the Scottish Ministers acting jointly.
(3) Subsection (4) applies (and subsection (2) does not apply) where a cross-border Special Health Authority is a party or prospective party to an arrangement or proposed arrangement which—
(a) falls within the definition of NHS contract in section 7(1), and
(b) also falls within the definition of NHS contract in section 17A of the National Health Service (Scotland) Act 1978 and the definition of NHS contract in section 9(1) of the National Health Service Act 2006.
(4) Subsections (5) to (13) of section 7 apply in relation to the arrangement or proposed arrangement (except in so far as it relates to reserved matters within the meaning of the Scotland Act 1998) with the substitution for references to the Welsh Ministers—
(a) where the cross-border Special Health Authority is exercising functions in relation to Wales only, of references to the Welsh Ministers and the Scottish Ministers acting jointly, and
(b) where the Authority is exercising functions in relation to England and Wales, of references to the Welsh Ministers and the Secretary of State acting concurrently with each other and jointly with the Scottish Ministers.
(5) In subsections (3) and (4), “ cross-border Special Health Authority ” means a Special Health Authority which is established under the National Health Service Act 2006 and the National Health Service (Wales) Act 2006 by virtue of—
(a) paragraph 1(2) of Schedule 2 to the National Health Service (Consequential Provisions) Act 2006, or
(b) the power under section 28 of the National Health Service Act 2006 and the power under section 22 of the National Health Service (Wales) Act 2006 being exercised together.
Arrangements to be treated as NHS contracts
(1) This section applies to any arrangement under which a Local Health Board or such other health service body as may be prescribed arranges for the provision to it—
(a) by a contractor under a general ophthalmic services contract,
(b) by a person on an ophthalmic list,
(c) by a person on a pharmaceutical list, or
(d) by a person who has entered into a pharmaceutical care services contract under section 17Q of the National Health Service (Scotland) Act 1978 (c. 29),
of the goods or services mentioned in subsection (2).
(2) The goods or services are those that the body reasonably requires for the purposes of its functions, other than functions under—
(a) Part 6 (general ophthalmic services),
(b) Chapter 1 or 2 of Part 7 (pharmaceutical services and local pharmaceutical services under pilot schemes), or
(c) section 115 of, or Chapter 1 or 2 of Part 7 of, the National Health Service Act 2006 (c. 41) (primary ophthalmic services and pharmaceutical services and local pharmaceutical services under pilot schemes).
(3) Any such arrangement is to be treated as an NHS contract for the purposes of section 7 (other than subsections (7) and (10)).
(4) In this section—
“general ophthalmic services contract” and “contractor” under such a contract have the meanings given by section 117 of the National Health Service Act 2006,
“ health service body ” means a body which is a health service body for the purposes of section 7,
“ ophthalmic list ” includes a list published in accordance with regulations made under—
section 26(2)(a) of the National Health Service (Scotland) Act 1978 (c. 29), or
Article 62(2)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972 (S.I. 1972/1265 (N.I.14)), and
“ pharmaceutical list ” includes a list published in accordance with regulations made under—
section 129(2)(a) of the National Health Service Act 2006, or
Article 63(2A)(a) of the Health and Personal Social Services (Northern Ireland) Order 1972.
(5) The reference to a list published in accordance with regulations made under paragraph (a) of section 26(2) of the National Health Service (Scotland) Act 1978 is a reference to the first part of the list (referred to in sub-paragraph (i) of that paragraph) which is published in accordance with regulations under that paragraph.
Provision of services otherwise than by the Welsh Ministers
Welsh Ministers' arrangements with other bodies
(1) The Welsh Ministers may arrange with any person or body to provide, or assist in providing, any service under this Act.
(2) Arrangements may be made under subsection (1) with voluntary organisations.
(3) The Welsh Ministers may make available any facilities provided by them for any service under this Act—
(a) to any person or body carrying out any arrangements under subsection (1), or
(b) to any voluntary organisation eligible for assistance under section 64 or section 65 of the Health Services and Public Health Act 1968 (c. 46).
(4) Where facilities are made available under subsection (3) the Welsh Ministers may make available the services of any person employed in connection with the facilities by—
(a) the Welsh Ministers,
(b) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(c) a Special Health Authority, or
(d) a Local Health Board.
(5) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Welsh Ministers.
(6) Goods or materials may be made available either temporarily or permanently.
(7) Any power to supply goods or materials under this section includes—
(a) a power to purchase and store them, and
(b) a power to arrange with third parties for the supply of goods or materials by those third parties.
Procurement of services etc. as part of the NHS in Wales
(1) The Welsh Ministers may, by regulations, make provision in relation to the processes to be followed and objectives to be pursued by relevant authorities in the procurement of—
(a) services provided as part of the health service in Wales (“health services”), and
(b) goods or other services that are connected to those health services.
(2) Regulations under subsection (1) must include provision specifying steps to be taken when following a competitive tendering process.
(3) Regulations under subsection (1) must, in relation to the procurement of the services or goods to which they apply, make provision for the purposes of—
(a) ensuring transparency;
(b) ensuring fairness;
(c) ensuring that compliance can be verified;
(d) managing conflicts of interest.
(4) Before making regulations under subsection (1), the Welsh Ministers must carry out such consultation as they consider appropriate and publish a summary of the responses they receive.
(5) Explanatory material accompanying regulations made under subsection (1) must set out how the regulations make provision for the purposes of subsection (3).
(6) The Welsh Ministers must publish such guidance as they consider appropriate about compliance with the regulations.
(7) A relevant authority must have regard to guidance published under this section.
(8) The Welsh Ministers must—
(a) review the operation of the regulations, and
(b) publish the conclusions of the review before the end of the period of 5 years beginning with the day on which the regulations come into force.
(9) In this section “ relevant authority ” means—
(a) a county council or county borough council in Wales;
(b) a local health board established under section 11;
(c) a National Health Service trust established under section 18;
(d) a special health authority established under section 22.
Direct payments for health care
Direct payments for health care
(1) The Welsh Ministers may, for the purpose of securing the provision to a patient of anything to which subsection (3) applies, make payments to the patient or to a person nominated by the patient.
(2) Subsection (1) is subject to any provision made by regulations under section 10C.
(3) This subsection applies to—
(a) anything that the Welsh Ministers may or must provide under section 2(1) or 3(1);
(b) anything for which the Welsh Ministers must arrange under paragraph 8 of Schedule 1;
(c) any vehicles that the Welsh Ministers may provide under paragraph 9 of Schedule 1;
(d) anything the Welsh Ministers may provide under paragraph 10 of Schedule 1 (including anything for which a grant may be made under paragraph 10(3) of Schedule 1).
(4) Payments may not be made under subsection (1) unless the patient consents to the making of the payments, subject to any provision made by regulations under section 10C in respect of a patient who lacks capacity or is a child.
(5) Where the Welsh Ministers make payments under subsection (1), they must, having regard to the purposes for which the payments are made, make arrangements for the provision to the patient, payee or their representative of such information, advice or other support, as the Welsh Ministers consider appropriate.
(6) Regulations may provide that a Local Health Board may, for the purpose of securing the provision to a patient of after-care services that a Local Health Board must provide under section 117 of the Mental Health Act 1983 (c. 20) , make payments to the patient or to a person nominated by the patient.
(7) Regulations under subsection (6) must—
(a) provide that payments under the regulations cannot be made unless the patient consents to the making of the payments, subject to any provision made by regulations under section 10C in respect of a patient who lacks capacity or is a child;
(b) make provision in respect of information, advice or other support to be provided by a Local Health Board to patients, payees or their representatives in connection with the payments.
(8) In section 10C and section 10D, “ direct payments ” means payments made under subsection (1) or under regulations made under subsection (6).
(9) In this section and section 10C—
(a) “ child ” means a person who has not attained the age of 16;
(b) references to a person lacking capacity are references to a person lacking capacity within the meaning of the Mental Capacity Act 2005 (c. 9) .
Regulations about direct payments
(1) Regulations may make provision about direct payments.
(2) The regulations may, in particular, make provision about—
(a) the circumstances in which, and descriptions of persons and services in respect of which, direct payments may, must or must not be made;
(b) the circumstances in which direct payments may, must or must not be made to a person nominated by the patient;
(c) the making of direct payments (and, in particular, as to persons to whom payments may or must be made) if the patient lacks capacity to consent to the making of the payments or is a child;
(d) matters to which the Welsh Ministers or a Local Health Board may or must have regard when making a decision about direct payments;
(e) conditions that the Welsh Ministers or a Local Health Board may, must or must not attach in relation to direct payments;
(f) the steps that the Welsh Ministers or a Local Health Board may or must take before, or after, making a decision about direct payments;
(g) the conditions that the patient or (if different) the payee may or must be required to comply with before, after, or at the time when a direct payment is made;
(h) the amount of any direct payment or how it is to be calculated;
(i) the circumstances in which the Welsh Ministers or a Local Health Board may or must stop making direct payments;
(j) the circumstances in which the Welsh Ministers or a Local Health Board may or must require all or part of a direct payment to be repaid by the patient or (if different) the payee, or otherwise;
(k) the monitoring of the making of direct payments, of their use by the patient or (if different) the payee, or of services which they are used to secure;
(l) the review of decisions as to whether a direct payment should be made;
(m) the arrangements to be made by the Welsh Ministers or Local Health Board for providing patients, payees or their representatives with information, advice or other support in connection with direct payments;
(n) the extent to which such support is to be treated as a service in respect of which direct payments may be made.
(3) If the regulations make provision about persons who lack capacity to consent to the making of direct payments, the regulations may also make provision about the cases or circumstances where a person who has lacked that capacity but no longer does so (whether because of fluctuating capacity or regaining or gaining capacity) .
(4) The regulations may provide for a sum that must be repaid to the Welsh Ministers or Local Health Board (as the case may be) by virtue of a condition or other requirement imposed by or under the regulations to be recoverable as a debt due to the Welsh Ministers or Local Health Board (as the case may be).
(5) The regulations may make provision—
(a) for a service in respect of which a direct payment has been made under section 10B(1) to be regarded as provided or arranged for by the Welsh Ministers under an enactment mentioned in section 10B(3), only to such extent and subject to such conditions as the regulations may specify;
(b) displacing functions or obligations of a Local Health Board with respect to the provision of after-care services under section 117 of the Mental Health Act 1983 (c. 20) , only to such extent and subject to such conditions as the regulations may prescribe.
(6) In this section, “ service ” includes anything in respect of which direct payments may be made.
Arrangements with other bodies relating to direct payments
(1) The Welsh Ministers or a Local Health Board may arrange with any person or body to provide assistance in connection with direct payments.
(2) Arrangements may be made under subsection (1) with voluntary organisations.
(3) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Welsh Ministers or the Local Health Board.
Contains public sector information licensed under the Open Government Licence v3.0 (legislation.gov.uk).
