(1)For sections 43A and 43B of the 1977 Act (regulations as to Part II remuneration) there is substituted—
(1)The remuneration to be paid to persons who provide general medical services, general dental services, general ophthalmic services or pharmaceutical services under this Part of this Act shall be determined by determining authorities (and they may also determine the remuneration to be paid to persons providing those services in respect of the instruction of any person in matters relating to those services).
(2)For the purposes of this section and section 43B below determining authorities are—
(a)the Secretary of State, and
(b)so far as authorised by him to exercise the functions of determining authorities, any Health Authority or other person appointed by him in an instrument (referred to in this section and section 43B below as an instrument of appointment).
(3)An instrument of appointment—
(a)may contain requirements with which a determining authority appointed by that instrument must comply in making determinations, and
(b)may be contained in regulations.
(4)Subject to this section and section 43B below, regulations may make provision about determining remuneration under subsection (1) above and may in particular impose requirements with which determining authorities must comply in making, or in connection with, determinations (including requirements as to consultation and publication).
(5)Regulations may provide—
(a)that determinations may be made by reference to any of the following—
(i)rates or conditions of remuneration of any persons or any descriptions of persons which are fixed or determined, or to be fixed or determined, otherwise than by way of a determination under subsection (1) above,
(ii)scales, indices or other data of any description specified in the regulations,
(b)that any determination which in accordance with regulations made by virtue of paragraph (a)(ii) above falls to be made by reference to a scale or an index or to any other data may be made not only by reference to that scale or index or those data in the form current at the time of the determination but also by reference to the scale, index or data in any subsequent form attributable to amendment or revision taking effect after that time or to any other cause.
(6)Regulations may—
(a)provide that determining authorities may make determinations which have effect in relation to remuneration in respect of a period beginning on or after a date specified in the determination, which may be the date of the determination or an earlier or later date, but may be an earlier date only if, taking the determination as a whole, it is not detrimental to the persons to whose remuneration it relates,
(b)provide that any determination which does not specify such a date shall have effect in relation to remuneration in respect of a period beginning—
(i)if it is required to be published, on the date of publication,
(ii)if it is not so required, on the date on which it is made.
(7)A reference in this section or section 43B below to a determination is to a determination of remuneration under subsection (1) of this section.
(1)Before a determination is made by the Secretary of State which relates to all persons who provide services of, or of a category falling within, one of the descriptions of services mentioned in section 43A(1) above, he—
(a)shall consult a body appearing to him to be representative of persons to whose remuneration the determination would relate, and
(b)may consult such other persons as he considers appropriate.
(2)Determinations may make different provision for different cases including different provision for any particular case, class of case or area.
(3)Determinations may—
(a)be made in more than one stage,
(b)be made by more than one determining authority,
(c)be varied or revoked by subsequent determinations.
(4)A determination may be varied—
(a)to correct an error, or
(b)where it appears to the determining authority that it was made in ignorance of or under a mistake as to a relevant fact.
(5)Determinations may, in particular, provide that the whole or any part of the remuneration—
(a)is payable only if the determining authority is satisfied as to certain conditions, or
(b)is to be applied for certain purposes or is otherwise subject to certain conditions.
(6)Subject to sections 29(4) and 35(2) above, remuneration under section 43A above may consist of payments by way of—
(a)salary,
(b)fees,
(c)allowances,
(d)reimbursement (in full or in part) of expenses incurred or expected to be incurred in connection with the provision of the services or instruction,
and may be determined from time to time.
(7)At the time a determination is made or varied, certain matters which require determining may be reserved to be decided at a later time.
(8)The matters which may be reserved include in particular—
(a)the amount of remuneration to be paid in particular cases,
(b)whether any remuneration is to be paid in particular cases.
(9)Any determination shall be made after taking into account all the matters which are considered to be relevant by the determining authority and such matters may include in particular—
(a)the amount or estimated amount of expenses (taking into account any discounts) incurred in the past or likely to be incurred in the future (whether or not by persons to whose remuneration the determination will relate) in connection with the provision of services of the description in section 43A(1) above to which the determination will relate or of any category falling within that description,
(b)the amount or estimated amount of any remuneration paid or likely to be paid to persons providing such services,
(c)the amount or estimated amount of any other payments or repayments or other benefits received or likely to be received by any such persons,
(d)the extent to which it is desirable to encourage the provision, either generally or in particular places, of the description or category of services to which the determination will relate,
(e)the desirability of promoting services which are—
(i)economic and efficient, and
(ii)of an appropriate standard.
(10)If the determination is of remuneration for a category of services falling within one of the descriptions of services mentioned in section 43A(1) above, the reference in subsection (9)(a) above to a category of services is a reference to the same category of services or to any other category of services falling within the same description.”
(2)Sections 43A and 43B of the 1977 Act, as substituted by this section, have effect in relation to—
(a)the making of determinations on or after the commencement of this section, and
(b)the variation or revocation on or after the commencement of this section of determinations whenever made,
and in this subsection “determinations” means determinations under Part II of the 1977 Act of the remuneration to be paid to persons who provide services mentioned in section 43A(1).
(3)Section 7(4) of the [1984 c. 48.] Health and Social Security Act 1984 and section 15(3) of the [1988 c. 49.] Health and Medicines Act 1988 (determinations of remuneration for services under Part II of 1977 Act deemed to be valid) have effect in relation to England and Wales as if—
(a)after “inserted by this section” in section 7(4)(b) of the 1984 Act, and
(b)after “section 7 of the Health and Social Security Act 1984” in section 15(3) of the 1988 Act,
there were inserted “and before the coming into force of section 10 of the [1999 c. 8.] Health Act 1999”.