Statutory Instruments
NATIONAL HEALTH SERVICE, ENGLAND AND WALES
Made
21st March 1988
Laid before Parliament
21st March 1988
Coming into force
11th April 1988
The Secretary of State for Social Services, in exercise of powers conferred on him by section 83A of the National Health Service Act 1977(1) and of all other powers enabling him in that behalf, hereby makes the following Regulations:
1. These Regulations may be cited as the National Health Service (Travelling Expenses and Remission of Charges) Regulations 1988 and shall come into force on 11th April 1988.
2.—(1) In these Regulations, unless the context otherwise requires—
“the Act” means the National Health Service Act 1977;
“appropriate office” means an office of the Department of Health and Social Security;
“capital limit” means the amount prescribed for the purposes of section 22(6) of the Social Security Act 1986(2) as it applies to income support;
“claimant” means a person who makes a claim for remission, payment or repayment in accordance with regulation 7 or 8;
“date of claim” means the date on which a claim is received in an appropriate office;
“family” has the meaning assigned to it by section 20(11) of the Social Security Act 1986 as it applies to income support(3) except in regulation 4(d) where it has the meaning assigned to it by section 20(11) of that Act as it applies to family credit(4);
“family credit” means family credit under Part II of the Social Security Act 1986;
“income support” means income support under Part II of the Social Security Act 1986 and includes personal expenses addition, special transition addition and transitional addition as defined in regulation 2(1) of the Income Support (Transitional) Regulations 1987(5);
“relevant charges” and “relevant travelling expenses” have the meanings prescribed by regulation 3(1);
“trade dispute” has the same meaning as in the Social Security Act 1975(6);
“week” means a period of 7 days beginning with midnight between Saturday and Sunday.
(2) In these Regulations any reference to an instrument made under the Social Security Act 1986 is to be construed as a reference to that instrument as it has effect on the making of these Regulations and as amended subsequently.
(3) In these Regulations, unless the context otherwise requires, a reference to a numbered regulation or Schedule is a reference to the regulation in, or Schedule to, these Regulations bearing that number and a reference in a regulation or Schedule to a numbered paragraph is a reference to the paragraph in that regulation or Schedule bearing that number.
3.—(1) Any person of a description prescribed by regulation 4 is entitled, in accordance with the following provisions of these Regulations, to the remission of the whole amount of any charges referred to in paragraph (2) which would otherwise be payable by him (“relevant charges”) and payment of the whole amount of the travelling expenses referred to in paragraphs (3) and (4) (“relevant travelling expenses”).
(2) Paragraph (1) applies to the following charges—
(a)charges for drugs, medicines, appliances and pharmaceutical services payable in pursuance of section 77(1) of the Act;
(b)charges for dental appliances and dental treatment payable in pursuance of section 78(1) or section 79(1) of the Act.
(3) Paragraph (1) applies in the case of travelling expenses necessarily incurred or to be incurred by a person—
(a)in attending a hospital for the purpose of availing himself of services provided under the care of a hospital consultant in pursuance of the Act,
(b)in attending a disablement services centre for the purpose of availing himself of services provided by the Disablement Services Authority(7) in pursuance of the Act,
including the travelling expenses of a companion in a case where it is necessary on medical grounds that that person should be accompanied.
(4) The travelling expenses to be taken into account for the purposes of paragraph (3) are to be the cost of travelling by the cheapest means of transport available.
4. Regulation 3(1) applies to any person who, at the time when the relevant charge is made or when the relevant travelling expenses are incurred, is—
(a)a person who is in receipt of income support, or
(b)a member of the same family as a person who is in receipt of income support, or
(c)a person who is in receipt of family credit, or
(d)a member of the same family as a person who is in receipt of family credit, or
(e)a person whose requirements equal or exceed his income resources and whose capital resources do not exceed the capital limit, or
(f)a member of the same family as a person described in paragraph (e) of this regulation.
5.—(1) A person who is not of a description prescribed by regulation 4 and whose capital resources do not exceed the capital limit is entitled, in accordance with the following provisions of these Regulations, to the remission of part of any relevant charges or, as the case may be, payment of part of any relevant travelling expenses if at the time when the relevant charge is made or when the travelling expenses are incurred he is—
(a)a person whose income resources exceed his requirements by less than a third of the relevant charge or, as the case may be, by less than the relevant travelling expenses, or
(b)a member of the same family as a person described in sub-paragraph (a) of this paragraph.
(2) This regulation applies only in respect of charges for wigs, fabric supports and surgical brassieres payable in pursuance of section 77(1)(a) of the Act (supplied otherwise than under Part II of the Act), charges for dental appliances and dental treatment payable in pursuance of section 78(1) or section 79(1) of the Act, and any relevant travelling expenses.
(3) The amount of any relevant charge which a person is entitled by paragraph (1) to have remitted is the difference between the relevant charge and 3 times the amount by which his income resources exceed his requirements.
(4) The amount of the relevant charge for the purposes of paragraph (3) is—
(a)in the case of a charge under section 77(1)(a) of the Act for the supply of an appliance, the charge made for that appliance;
(b)in the case of a charge for dental treatment or for the supply of a dental appliance under Part II of the Act (general dental services), the charge made for one course of treatment, including any charge made for a dental appliance supplied in that course of treatment;
(c)in the case of a charge for the supply of a dental appliance supplied otherwise than under Part II of the Act, the charge made for that appliance.
(5) The amount of the relevant travelling expenses which a person is entitled by paragraph (1) to be paid is the difference between the relevant travelling expenses incurred in any week and the amount by which his income resources exceed his requirements.
6.—(1) Where it is necessary that the resources and requirements of a person, and the relationship between them, should be calculated for the purposes of these Regulations, they shall be calculated by the Secretary of State according to the provisions of this regulation and Schedule 1.
(2) For the purposes of paragraph (1), the resources and requirements of a person shall be calculated—
(a)in the case of a claim made under regulation 7(1), by reference to his resources and requirements at the date of claim;
(b)in the case of a claim made under regulation 8(2), by reference to his resources and requirements at the date when he paid the relevant charge or travelling expenses.his resources and requirements at the date of claim;
(b)in the case of a claim made under regulation 8(2), by reference to his resources and requirements at the date when he paid the relevant charge or travelling expenses.
(3) Unless any provision referred to in Schedule 1 specifies to the contrary, where a claimant is a member of a family, the resources of the other members of his family shall be calculated or estimated in the same manner as those of the claimant and shall be taken into account as if they were his resources; and in calculating his requirements, the requirements of the other members of his family shall be taken into account according to the provisions of Schedule 1.
(4) In a case to which paragraph (3) applies, unless the context otherwise requires, any reference to a “claimant” in Schedule 1 or in the provisions referred to in that Schedule shall be construed as including the other members of his family.
(5) In a case where the earnings of any person are to be calculated for the purpose of this regulation and those earnings have been affected by a trade dispute, the earnings to be taken into account shall be the earnings which that person would have received if there had been no trade dispute.
7.—(1) A person who is within a description prescribed by regulation 4(e) or (f) or 5(l) and who wishes to claim his entitlement under regulation 3(1) or 5(1) (full or partial remission of relevant charges or payment of relevant travelling expenses) shall make a claim to the Secretary of State on a form provided by or on behalf of the Secretary of State for that purpose and shall send or deliver that form to an appropriate office.
(2) A claimant shall produce in support of his claim such evidence as the Secretary of State may reasonably require.
(3) The Secretary of State may treat any claim under paragraph (1) as a claim to entitlement in respect of all of the relevant charges and relevant travelling expenses and shall calculate the resources and requirements of the claimant according to the provisions of regulation 6 and Schedule 1.
(4) If the Secretary of State determines that the claimant and any member of his family are entitled to any remission of the relevant charges or any payment of the relevant travelling expenses, he shall issue a notice of entitlement to the claimant which shall be effective in respect of the claimant and any member of his family for the purposes of any remission of those charges, and any payment of those travelling expenses, to which they are entitled.
(5) A notice of entitlement issued under paragraph (4) shall indicate whether the claimant and any member of his family are entitled to full or partial remission or payment and in the case of partial remission or payment shall specify the amount of any relevant charge or relevant travelling expenses for which there is no entitlement to remission or payment.
(6) A notice of entitlement issued under paragraph (4) shall be effective for a period of 6 months from the date of claim, subject to its being superseded by any further notice issued as a result of a claim made in accordance with paragraph (8), and shall specify the dates of commencement and expiry of that period.
(7) Subject to paragraph (8), any change in the financial or other circumstances of a claimant, or of any member of his family, during the period for which a notice of entitlement has been issued shall not affect the validity of the notice of entitlement in respect of that period or, in the case of partial remission or payment, the amounts referred to in paragraph (5).
(8) A claimant who is issued with a notice of entitlement in a case of partial remission may make a further claim in accordance with paragraph (1) at any time during the period for which the notice of entitlement has been issued, if he considers that by reason of a change in his financial circumstances or those of any member of his family the amounts referred to in paragraph (5) should be reduced.
8.—(1) Subject to the following provisions of these Regulations, a person of a description prescribed by regulation 4 or 5(1) who pays any relevant charge or relevant travelling expenses without exercising his right under regulation 3(1) or 5(1) to remission or payment is entitled to be repaid whatever amount would otherwise have been remitted or paid.
(2) It is a condition of the entitlement to repayment under paragraph (1) of a person of any description that he makes a claim to the Secretary of State for repayment within one month after payment of the relevant charge or relevant travelling expenses and that he makes that claim on a form provided by or on behalf of the Secretary of State for that purpose for persons of that description.
(3) It is a further condition of entitlement to repayment under paragraph (1) that the claimant produces in support of his claim such evidence as the Secretary of State may reasonably require.
(4) If the Secretary of State is satisfied that a claimant is entitled to any repayment under paragraph (1) he shall cause a repayment to be made to him in such manner as appears to the Secretary of State to be appropriate in the circumstances of the particular case.
9.—(1) Where before 11th April 1988 a person has made a claim—
(a)for the remission or repayment of any relevant charge in pursuance of the provisions of the National Health Service (Remission of Charges) Regulations 1974(8) or the National Health Service (Charges for Drugs and Appliances) Regulations 1980(9), or
(b)for the payment of any relevant travelling expenses in pursuance of the National Health Service (Expenses in attending Hospitals) Regulations 1950(10),
and his claim has not been determined before that date, his claim shall be determined in accordance with the provisions of those Regulations as though they remained in force.
(2) Where before 11th April 1988 a person has paid any relevant charge or relevant travelling expenses but has not made a claim for the repayment of that charge or those expenses before that date, he may make a claim for repayment in accordance with the provisions of the Regulations referred to in paragraph (1) within the time allowed by those provisions and his claim shall be determined in accordance with the provisions of those Regulations as though they remained in force.
(3) Where before 11th April 1988 a person has been issued with any document by or on behalf of the Secretary of State which was effective for the purposes of the remission of any of the relevant charges in accordance with the Regulations referred to in paragraph (1)(a), in respect of a period or course of treatment which continues until a date after 11th April 1988, he shall continue to be entitled to remission in respect of that period or course of treatment as though those Regulations remained in force.
10. The Regulations specified in column 1 of Schedule 2 are revoked to the extent specified in column 3 of that Schedule.
Signed by authority of the Secretary of State for Social Services.
Tony Newton
Minister of State,
Department of Health and Social Security
21st March 1988ecified in column 3 of that Schedule.
Signed by authority of the Secretary of State for Social Services.
Tony Newton
Minister of State,
Department of Health and Social Security
21st March 1988
Regulation 6
1. A claimant’s resources shall be calculated in terms of income and capital and shall be calculated as follows—
(a)income shall be calculated on a weekly basis according to the method of calculating or estimating income under section 22(8) of the Social Security Act 1986 as prescribed by the provisions of Part V of, and Schedules 8 and 9 to, the Income Support (General) Regulations 1987(11) subject to the modifications referred to in paragraph 2;
(b)capital shall be calculated according to the method of calculating or estimating capital under section 22(7), (8) and (9) of the Social Security Act 1986 as prescribed by the provisions of Chapter VI in Part V of, and Schedule 10 to, the Income Support (General) Regulations 1987 subject to the modifications referred to in paragraph 2.
2. The provisions of the Income Support (General) Regulations 1987 shall be applied as follows—
(a)as respects the provisions specified in column 1 of Table A in this Schedule, in accordance with the modifications specified in the corresponding entries in column 2;
(b)as if—
(i)references to income support were to the remission of any relevant charges and the payment of any relevant travelling expenses,
(ii)references to an adjudication officer were to the Secretary of State, and
(iii)references in any of those provisions to any other of those provisions were to that other provision as modified in accordance with this paragraph;
(c)according to the provisions of regulation 2 of those Regulations (interpretation) but as if there were inserted after the definition of “relative” the following definition—
““relevant date” means—
in the case of a claim made under regulation 7(1) of the National Health Service (Travelling Expenses and Remission of Charges) Regulations 1988, the date of claim;
in the case of a claim made under regulation 8(2) of those Regulations, the date when the claimant paid the relevant charge or travelling expenses;”.
| (1) | (2) |
|---|---|
| Regulation or Schedule | Modification |
| regulation 23 | As if in paragraph (1) for “section 22(5) of the Act” there were substituted “regulation 6(3) of the National Health Service (Travelling Expenses and Remission of Charges) Regulations 1988”. |
| regulation 24 | As if for the whole of regulation 24 (treatment of charitable or voluntary payments) there were substituted— “24. Any charitable or voluntary payment, other than one which is, or is due to be, made at regular intervals, or which is made under the Macfarlane Trust, shall be treated as capital.” |
| regulation 25 | As if for the whole of regulation 25 (liable relative payments) there were substituted— “25.—(1) Where a claimant’s income consists of any payments made by a person, whether under a court order or not, for the maintenance of himself or any member of his family, and those payments are made or due to be made at regular intervals, his normal weekly income shall be determined— (a)if before the relevant date those payments are made at regular intervals and in regular amounts, by reference to the normal weekly amount; (b)if they are not so made, by reference to the average of such payments received in the 13 weeks immediately preceding the week which includes the relevant date. (2) Any maintenance payment other than one to which paragraph (1) of this regulation applies shall be treated as capital.” |
| regulation 28 | As if in paragraph (1) the words from “For the purposes” to “income support)” were omitted; in paragraph (1)(a) for “the weekly amount of his income” there were substituted “the normal weekly amount of his income at the relevant date”; and for “and 41 to 43” there were substituted “, 41 and 42”. |
| regulation 29 | As if this regulation were omitted. |
| regulation 30 | As if in paragraph (1) the words “Except where paragraph (2) applies” were omitted; and paragraph (2) were omitted. |
| regulation 31 | As if this regulation were omitted. |
| regulation 32 | As if in paragraph (1) for the words from “regulation 29” to “paragraphs (2) to (5),” there were substituted “regulation 28 (calculation of income)”; and paragraphs (2) to (6) were omitted. |
| regulation 33 | As if this regulation were omitted. |
| regulation 35 | As if in paragraph 1(d) the words after “employment” were omitted. |
| regulation 36 | As if in paragraph (1) for “regulation 29 (calculation of earnings of employed earners)” there were substituted “regulation 28 (calculation of income)”. |
| regulation 37 | As if in paragraph (2) the words after “such a charge” were omitted. |
| regulation 40 | As if in paragraph (1) for “regulation 29 (calculation of income other than earnings)” there were substituted “regulation 28 (calculation of income)”. |
| regulation 41 | As if in paragraph (1) for the words from “on the first day” to “subsequent review” there were substituted “at the relevant date”; and paragraph (3) were omitted. |
| regulation 42 | As if in paragraph (4) the words from “and in the case” to “(trade disputes) applies” were omitted. |
| regulation 43 | As if this regulation were omitted. |
| regulation 44 | As if in paragraph (1) for the words from “on the first day” to “subsequent review” there were substituted “at the relevant date”; and paragraphs (2), (3) and (8) were omitted. |
| regulation 45 | As if this regulation were omitted. |
| regulation 46 | As if in paragraph (1) the words from “For the purposes” to “income support” were omitted. |
| regulation 48 | As if in paragraph (2) the words from “Except” to “applies” were omitted; and paragraph (6) were omitted. |
| regulation 49 | As if in sub-paragraph (b)(i) for the words from “first day” to “subsequent review” there were substituted “relevant date”. |
| regulation 53 | As if in paragraph (3) the reference to regulation 60 were a reference to regulation 25. |
| regulations 54 to 60 | As if these regulations were omitted. |
| Schedule 8 | As if paragraph 6 were omitted.As if there were inserted after paragraph 8 the following paragraph— “8A. In a case in which none of paragraphs 4 to 8 applies to the claimant and he is one of a married or unmarried couple and a member of that couple is engaged in employment, £10; but if this paragraph applies to a claimant it shall not apply to his partner except where, and to the extent that, the earnings of the claimant which are to be disregarded under this paragraph are less than £10.”. As if in paragraph 9 for “8” there were substituted “8A”. As if paragraphs 10 and 13 were omitted. |
| Schedule 9 | As if paragraph 12 were omitted. As if in paragraphs 15, 21 and 28 the exceptions relating to persons to whom section 23 of the Act (trade disputes) applies were omitted. As if paragraphs 30 and 37 were omitted. |
3. A claimant’s requirements shall be calculated as being the amount referred to in sub-paragraph (a), less any amount referred to in sub-paragraph (b), as follows—
(a)the applicable amounts which would apply to him, including those in respect of any other member of his family, in connection with a claim for income support as specified by the provisions of regulations 17 to 21 of, and Schedules 2, 3, 4, 5 and 7 to, the Income Support (General) Regulations 1987, but subject to the modifications referred to in paragraph 2(b) and (c), and paragraph 4;
(b)less any amount of housing benefit received by him or by any member of his family under the provisions of Part II of the Social Security Act 1986.
4. The provisions of the Income Support (General) Regulations 1987 specified in column 1 of Table B in this Schedule shall be applied in accordance with the modifications specified in the corresponding entries in column 2.
| (1) | (2) |
|---|---|
| Regulation or Schedule | Modification |
| regulation 17 | As if for the words from “18 to 22” to “urgent cases)” there were substituted “18 to 21”. |
| regulation 18 | As if for the words from “19 to 22” to “urgent cases)” there were substituted “19 to 21”. |
| regulations 19 to 21 | As if in paragraph (1) in these regulations the references to regulation 22 were omitted. |
| Schedule 3 | As if in paragraph 1 after sub-paragraph (h) there were added— “(i)mortgage capital payments; (j)payments in respect of an endowment policy in connection with the purchase of the dwelling occupied as the home; (k)payments by way of rent which do not otherwise fall within sub-paragraph (c) or (e) of this paragraph; (l)80 per cent of the general rates payable in respect of the dwelling occupied as the home.”. As if paragraphs 7, 8 and 10 were omitted. |
| Schedule 4 | As if in paragraph 1(1)(a) the words from “but, except” to “paragraph 5” were omitted. As if paragraphs 4 to 12 were omitted. |
| Schedule 5 | As if in paragraph 1(1)(a) the words from “but, except” to “paragraph 5” were omitted. As if paragraphs 4 to 10 were omitted. |
| Schedule 7 | As if paragraphs 7 and 17 were omitted. |
Regulation 10
| (1) | (2) | (3) |
|---|---|---|
| Regulations revoked | References | Extent of revocation |
| The National Health Service (Expenses in attending Hospitals) Regulations 1950 | S.I. 1950/1222 | The whole Regulations |
| The National Health Service (Remission of Charges) Regulations 1974 | S.I. 1974/1377 | The whole Regulations |
| The National Health Service (Remission of Charges) Amendment Regulations 1975 | S.I. 1975/1687 | The whole Regulations |
| The National Health Service (Remission of Charges) Amendment (No. 2) Regulations 1975 | S.I. 1975/1946 | The whole Regulations |
| The National Health Service (Remission of Charges) Amendment Regulations 1976 | S.I. 1976/1823 | The whole Regulations |
| The National Health Service (Charges and Remission) Amendment Regulations 1977 | S.I. 1977/434 | The whole Regulations |
| The National Health Service (Charges for Drugs and Appliances) Regulations 1980 | S.I. 1980/1503 | In regulation 2(1) the definitions of “dependant”, “family” and “partner”; regulation 7(1)(g), (h) and (i); and regulation 8 |
| The National Health Service (Remission of Charges) Amendment Regulations 1980 | S.I. 1980/1659 | The whole Regulations |
| The National Health Service (Remission of Charges) Amendment Regulations 1981 | S.I. 1981/1345 | The whole Regulations |
| The National Health Service (Charges for Drugs and Appliances) Amendment Regulations 1983 | S.I. 1983/306 | Regulation 2(c) |
| The National Health Service (Dental and Optical Charges and Remission of Charges) Amendment Regulations 1983 | S.I. 1983/309 | The whole Regulations |
(This note is not part of the Regulations)
These Regulations provide for the remission and repayment of certain charges which would otherwise be payable under the National Health Service Act 1977 and for the payment by the Secretary of State of travelling expenses incurred by a person attending a hospital or disablement services centre for treatment under the National Health Service.
Regulations 3 to 5 provide entitlement to full remission of charges and full payment of travelling expenses for persons who are in receipt of income support or family credit under the Social Security Act 1986. They also provide entitlement to full or partial remission, and full or part payment of travelling expenses, depending on the result of a calculation of a person’s resources and requirements, and those of his immediate family, in accordance with regulation 6 of these Regulations and Schedule 1.
Regulation 3 provides that the relevant charges for entitlement to full remission are those made for pharmaceutical services under Part II of the Act, for the supply of drugs, medicines or appliances (such as wigs, fabric supports, surgical brassieres and elastic hosiery), and for dental treatment and dental appliances. It provides that the relevant travelling expenses are those incurred by a person attending a hospital or disablement services centre for treatment, and by a companion where it is necessary on medical grounds for that person to be accompanied.
Regulation 5 provides for partial remission of certain of the relevant charges (excluding, in particular, prescription charges for pharmaceutical services) and part payment of travelling expenses even though the person’s weekly income resources, including those of his family, exceed his requirements, so long as his capital resources do not exceed the capital limit (£6,000). Under this regulation a person is entitled to the remission of any amount by which the charge exceeds 3 times his net resources (after deducting the amount of his requirements), and payment of the amount by which the travelling expenses incurred in any week exceed his net resources.
Regulation 6 provides for the calculation of resources and requirements to be made in accordance with Schedule 1, which applies, with specified modifications, the provisions of the Income Support (General) Regulations 1987 relating to income and capital and to applicable amounts in respect of a claimant and any member of his family.
Regulation 7 provides for a claim to be made to the Secretary of State, and for the Secretary of State to determine entitlement and to issue a notice of entitlement. It provides that the notice of entitlement is effective in respect of the claimant and any member of his family, for any remission of the relevant charges and any payment of travelling expenses to which they are entitled during the period of validity of the notice (6 months).
Regulation 8 makes provision for a person to claim the repayment of any relevant charge or travelling expenses which he has already paid, by applying for repayment within one month after making that payment.
Regulation 9 makes transitional provisions relating to applications and remissions under previous Regulations.
Regulation 10 provides for the revocation, in accordance with Schedule 2, of Regulations which are superseded by these Regulations.
1977 c. 49;see section 128 for the definitions of “prescribed” and “regulations”; section 83A was inserted by section 14(1) of the Social Security Act 1988 (c. 7).
1986 c. 50; regulation 45 of the Income Support (General) Regulations 1987 (S.I. 1987/1967) has prescribed the amount of £6,000 as the capital limit.
See S.I. 1987/1967, regulations 14 to 16.
See S.I. 1987/1973, regulations 6 to 9.
S.I. 1987/1969.
1975 c. 14;see section 19(2)(b).
See the Disablement Services Authority (Establishment and Constitution) Order 1987 (S.I. 1987/808).
S.I. 1974/1377. The relevant instruments amending the Regulations referred to in this sub-paragraph are specified in Schedule 2 to these Regulations.
S.I. 1980/1503.
S.I. 1950/1222.
S.I. 1987/1967; the relevant amending instrument is S.I. 1988/.