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SCHEDULES

[F1SCHEDULE 11N.I.DISQUALIFICATION OF PERSONS PROVIDING PART VI SERVICES

PART IN.I.THE TRIBUNAL

The Tribunal: general provisionsN.I.

1.—(1) There shall continue to be a tribunal ( “the Tribunal”) constituted in accordance with Part II for the purposes set out in this Part.N.I.

[F2(2) Subject to the provisions of this paragraph, if the Tribunal receives from [F3the Department] representations that a person who has applied to be included in any list, or who is included in any list, meets any of the conditions for disqualification which may apply in that person's case, the Tribunal must inquire into the case.]

(3) If the Tribunal receives such representations from any other person, it may inquire into the case.

(4) Representations under this paragraph shall be made—

(a)in the prescribed manner; and

(b)where F4. . . regulations prescribe the time within which such representations are to be made, within that time.

(5) Sub-paragraphs (6) to (11) apply for the purposes of this Schedule.

[F5(6) The first condition for disqualification is that—

(a)in relation to a list referred to in sub-paragraph (8)(a) or (c), 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 perform; or

(b)in relation to a list referred to in sub-paragraph (8)(d) or (e), the continued inclusion of the person concerned in the list would be prejudicial to the efficiency of the services which those included in the list 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.

[F6(7A) [F7Subject to sub-paragraph (7B), ] 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.]

[F8(7B) The third condition for disqualification only applies to cases where a person is included in, or has applied to be included in, a list referred to in paragraph (8)(a) or (c).]

(8) A “list” means—

[F9(a)][F9a list of health care professionals of a prescribed description performing primary medical services;]

(b)F10. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

[F11(c)a list of health care professionals of a prescribed description F12... performing primary dental services;

[F13(d)a list of medical practitioners and ophthalmic opticians undertaking to provide general ophthalmic services;] or

[F14(e)a list of persons undertaking to provide pharmaceutical services;]]

prepared (in each case) under Part VI of this Order.

[F9(8A) In [F15sub-paragraph (8)] , “health care professional” has the same meaning as in Article 15C.]

(9) “Health scheme” means—

(a)any of the [F16health care] under Article 4(a) or any corresponding statutory provision extending to Scotland or England and Wales; and

(b)any prescribed scheme,

and regulations may prescribe any scheme for the purposes of this sub-paragraph which appears to the Department 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 as efficiency cases; F17. . . cases in which representations are made that the second condition for disqualification is met are referred to as fraud cases [F18; and cases in which representations are made that the third condition for disqualification is met are referred to below as unsuitability cases].]

F4Words in Sch. 11 para. 1(4)(b) repealed (26.3.2008) by virtue of Health (Miscellaneous Provisions) Act (Northern Ireland) 2008 (c. 2), ss. 11, 17, 18(1), Sch. 1 para. 1(3), Sch. 2 Pt. 1

F15Words in Sch. 11 para. 1(8A) substituted (13.6.2016) by Health (Miscellaneous Provisions) Act (Northern Ireland) 2016 (c. 26), ss. 12(1)(h), 20(2)

Modifications etc. (not altering text)

C1Sch. 11 para. 1(6)(a) applied (with modifications) (temp.) (13.6.2016) by Health (Miscellaneous Provisions) Act (Northern Ireland) 2016 (c. 26), ss. 12(2)(a), 20(2)

C2Sch. 11 para. 1(6)(b) applied (with modifications) (temp.) (13.6.2016) by Health (Miscellaneous Provisions) Act (Northern Ireland) 2016 (c. 26), ss. 12(2)(b), 20(2)

C3Sch. 11 para. 1(7B) applied (with modifications) (temp.) (13.6.2016) by Health (Miscellaneous Provisions) Act (Northern Ireland) 2016 (c. 26), ss. 12(2)(c), 20(2)

C4Sch. 11 para. 1(8)(c) applied (with modifications) (temp.) (13.6.2016) by Health (Miscellaneous Provisions) Act (Northern Ireland) 2016 (c. 26), ss. 12(2)(d), 20(2)