General Medical Services Regulations (Northern Ireland) 1997

Temporary provision of services

24.—(1) This regulation applies to the making of arrangements for the temporary provision of general medical services.

(2) Where a doctor’s name ceases to be included in the medical list or his registration is suspended under sections 37(1) or (2), 38(1) and 42(3)(b) of the Medical Act 1983(1), the Board may, after consultation with the Local Medical Committee—

(a) make arrangements for the temporary provision of general medical services for that doctor’s patients, which may consist of or include the appointment of one or more doctors to undertake the treatment of such persons; and

(b) where—

(i) the doctor whose name was included in the medical list by virtue of regulation 4(1)(a) dies; and

(ii) within 7 days of the date of death, any person applies to the Board in writing on behalf of the estate of that doctor for the appointment of one or more named doctors,

appoint one or more of the named doctors to undertake the treatment of the deceased doctor’s patients,

and where a doctor is suspended by direction of the Tribunal the Board shall, after consultation with the Local Medical Committee, make arrangements for the temporary provision of general medical services for the suspended doctor’s patients with one or more doctors whose names are included in the medical list (one or more of whom may be partners of the suspended doctor) or with one or more doctors appointed for the purpose, or both.

(3) The Board may make such arrangements as it thinks fit (including arrangements in relation to accommodation) to enable any doctor appointed in accordance with paragraph (2) to undertake the treatment of the deceased doctor’s patients and, in the case of any doctor appointed under paragraph (2)(b), shall, where practicable, first consult the person who applied to it for the appointment of that doctor.

(4) Subject to paragraphs (10), (16) and (17), arrangements under paragraph (2) shall subsist for such period as the Board may determine but not beyond the date on which the vacancy is filled or the suspension referred to in that paragraph ceases to have effect.

(5) Where it appears to a Board, after consultation with the Local Medical Committee, that a doctor is incapable of carrying out his obligations under the terms of service because of his physical or mental condition, it may require him to be medically examined.

(6) Where a Board is satisfied—

(a) after receiving from the Local Medical Committee a report of a medical examination under paragraph (9) that, because of his physical or mental condition; or

(b) that because of his continued absence,

a doctor’s obligations under the terms of service are not being carried out adequately, it may, after consultation with the Local Medical Committee and with the consent of the Department, make arrangements for the temporary provision of general medical services for that doctor’s patients which may consist of or include the appointment of one or more doctors to undertake the treatment of such persons, and may vary such arrangements as necessary.

(7) A doctor shall not be appointed under paragraph (2) or (6) unless he is suitably experienced (other than by virtue of being a restricted services principal) within the meaning of Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1978(2).

(8) Subject to paragraph (11), arrangements under paragraph (6) shall subsist for such period as the Board may determine but not, in a case to which paragraph (6)(a) applies, beyond the date on which the Board is satisfied, after consulting the Local Medical Committee, that the doctor is fit to resume his practice.

(9) Where under paragraph (5) or (10) a doctor is required to be medically examined—

(a) he shall submit himself for medical examination by a doctor appointed by the Local Medical Committee; and

(b) the Local Medical Committee, having considered the report of that medical examination, shall make a report in writing to the Board as to the doctor’s capability to carry out his obligations under the terms of service.

(10) Before varying or terminating any arrangements made under paragraph (6), but after consulting the Local Medical Committee, the Board may require the doctor to be medically examined.

(11) Where the Board proposes that the arrangements under paragraph (2) or (6) shall continue—

(a) for longer than one year;

(b) for such shorter period as the Department may specify in any particular case; or

(c) beyond any period specified in sub-paragraph (a) or (b),

it shall so notify the Department in writing not less than 30 days, or as soon as is practicable, before the expiry of that period or further period and shall, in each case, obtain the consent of the Department to the continuance of the arrangements.

(12) The Board shall—

(a) give reasonable notice, in writing, of the termination of arrangements under paragraph (2) or (6) to the doctor with whom they were made; and

(b) as soon as is practicable, notify the Department in writing that such termination has taken place.

(13) Where the Board makes any arrangements under this regulation in relation to the treatment of the patients of any doctor it shall, where practicable, notify in writing that doctor of such arrangements and of their variation or termination.

(14) A doctor appointed under this regulation shall agree in writing to be bound throughout his appointment by the terms of service which were applicable to the doctor, the treatment of whose patients he is appointed (with or without the other doctors) to undertake, except that nothing in this regulation shall require him to provide child health surveillance services, contraceptive services, maternity medical services or minor surgery services which he has not undertaken to provide.

(15) Where paragraph (16) does not apply, any person on the list of the doctor for the treatment of whose patients arrangements are made under this regulation shall be deemed to remain on that list while those arrangements subsist, unless that person is transferred to the list of another doctor, and any person who applies to the doctor appointed under this regulation for acceptance for inclusion in his list shall, if so accepted, be recorded by the Agency as being—

(a) where that doctor’s name is included in the medical list by virtue of regulation 4(1)(a), on his list; and

(b) in any other case, on the list of the doctor for the treatment of whose patients arrangements are made under this regulation.

(16) In the case of a doctor who has been suspended by direction of the Tribunal—

(a) the Agency shall temporarily assign each of that doctor’s patients to the list of one of the doctors with whom arrangements for the temporary provision of general medical services are made for the duration of those arrangements; and

(b) to the extent necessary to accommodate any additional patients temporarily assigned under sub-paragraph (a), the limitation contained in regulation 23 on the number of persons who may be on a doctor’s list shall not apply for the duration of those arrangements.

(17) Where arrangements such as are referred to in paragraph (16) are in operation when a suspension by direction of the Tribunal ceases to have effect—

(a) in the case where the suspended doctor’s name continues to be included in the medical list, the Agency shall reassign to him all those patients temporarily assigned under paragraph (16) who are still on the list of the doctor to whom they were so assigned; and

(b) in the case where his name ceases to be included in the medical list, the arrangements referred to in paragraph (16) shall cease to have effect (without prejudice to any new arrangements which may be made under this regulation).

(18) The Agency—

(a) may deduct from the remuneration of a doctor—

(i) for the treatment of whose patients arrangements are made under paragraph (6); or

(ii) consequent upon whose suspension by direction of the Tribunal arrangements are made for the temporary provision of general medical services for that doctor’s patients,

the cost, in whole or in part, of any such arrangements; and

(b) in the case of a doctor performing relevant service, shall deduct from his remuneration the cost of any such arrangements.

(19) In the application of the Order to the making of arrangements for the temporary provision of general medical services and the provision of such services in pursuance of those arrangements—

(a) Article 57(1) (which prohibits, with exceptions, payment of a fixed salary) shall have effect as if the words “otherwise than temporarily” were inserted after the words “general medical services”; and

(b) Article 56(2A)(3) (which contains requirements as to knowledge of English) shall apply to a doctor appointed under this regulation and, in respect of any such doctor, Article 56(2A) shall have effect as if for the words from “shall” to “paragraph (2)(a)” there were substituted the words “shall be appointed to provide general medical services temporarily”.

(1)

1983 c. 54

(2)

S.I. 1978/1907 (N.I. 26)

(3)

Article 56(2A) was inserted by Article 5(1)(b) of S.I. 1981/432 and amended by Article 29 of S.I. 1991/194 (N.I. 1)