Section 65 and Schedules 4 and 5: Amendments and repeals
356.Section 65 introduces Schedule 4, which makes amendments to various Acts, and Schedule 5, which sets out the various repeals made by the Act.
357.Many of the amendments in Schedule 4 are consequent upon the provisions of the Act relating to Primary Care Trusts. Some of the other amendments have been referred to above in the context of the sections to which they relate. The following amendments are of particular note.
358.Paragraph 5 amends section 8 of the 1977 Act, which provides for the establishment of Health Authorities. In particular the amendment provides that Health Authorities are to “be established for” their area, rather than “act for” their area. This is to make it clearer that Health Authorities may exercise certain functions in respect of patients who are not resident or present in their area. In addition, section 8 is amended so that the Secretary of State is able to change the name of a Health Authority without changing its boundaries.
359.Paragraphs 6 and 10 have the effect of replacing the existing section 12(1) of the 1977 Act (duty on Health Authorities to make arrangements to secure advice from persons with professional expertise in and experience of health care) with a new provision (section 16C) which places a duty on both Health Authorities and Primary Care Trusts to make arrangements with a view to securing appropriate advice from health care professionals in order to exercise their functions effectively.
360.Paragraph 84(6) repeals the provisions in Schedule 2 to the 1990 Act which provide for the re-imbursement of NHS trusts in respect of the provision of goods and services otherwise than under NHS contract. These arrangements became known as extra-contractual referrals (or ECRs). The term extra-contractual referral is also used to describe one-off contracts that arise where an NHS trust provides care for someone which is not covered by an NHS contract with the patient's Health Authority. The system of extra-contractual referrals has been abolished. From April 1999 patients will always be treated under NHS contracts. A new system of comprehensive contract coverage, to be known as Out of Area Treatments, has been established through secondary legislation.