Health and Social Care (Wales) Act 2025

PART 2 HEALTH CARE

23 Overview of Part 2

(1) Sections 24 and 25 make provision for and in connection with allowing payments to be made directly to a patient or a person nominated by the patients for the purpose of the patient securing services or goods that otherwise must or may be provided under the National Health Service (Wales) Act 2006 (c. 42) (“the 2006 Act”) or under section 117 of the Mental Health Act 1983 (c. 20).

(2) Section 26 amends section 47 of the 2014 Act so as to provide that a local authority may only provide or arrange the provision of services or facilities that are required to be provided under certain health enactments if—

(a) providing the services or facilities would be incidental or ancillary to certain care and support services that the local authority may or must provide under the 2014 Act, and

(b) they are of a nature that the local authority can be expected to provide.

24 Direct payments for health care

(1) The 2006 Act is amended as follows.

(2) After section 10A insert—

“Direct payments for health care

10B Direct payments for health care

(1) The Welsh Ministers may, for the purpose of securing the provision to a patient of anything to which subsection (3) applies, make payments to the patient or to a person nominated by the patient.

(2) Subsection (1) is subject to any provision made by regulations under section 10C.

(3) This subsection applies to—

(a) anything that the Welsh Ministers may or must provide under section 2(1) or 3(1);

(b) anything for which the Welsh Ministers must arrange under paragraph 8 of Schedule 1;

(c) any vehicles that the Welsh Ministers may provide under paragraph 9 of Schedule 1;

(d) anything the Welsh Ministers may provide under paragraph 10 of Schedule 1 (including anything for which a grant may be made under paragraph 10(3) of Schedule 1).

(4) Payments may not be made under subsection (1) unless the patient consents to the making of the payments, subject to any provision made by regulations under section 10C in respect of a patient who lacks capacity or is a child.

(5) Where the Welsh Ministers make payments under subsection (1), they must, having regard to the purposes for which the payments are made, make arrangements for the provision to the patient, payee or their representative of such information, advice or other support, as the Welsh Ministers consider appropriate.

(6) Regulations may provide that a Local Health Board may, for the purpose of securing the provision to a patient of after-care services that a Local Health Board must provide under section 117 of the Mental Health Act 1983 (c. 20), make payments to the patient or to a person nominated by the patient.

(7) Regulations under subsection (6) must—

(a) provide that payments under the regulations cannot be made unless the patient consents to the making of the payments, subject to any provision made by regulations under section 10C in respect of a patient who lacks capacity or is a child;

(b) make provision in respect of information, advice or other support to be provided by a Local Health Board to patients, payees or their representatives in connection with the payments.

(8) In section 10C and section 10D, “direct payments” means payments made under subsection (1) or under regulations made under subsection (6).

(9) In this section and section 10C—

(a) “child” means a person who has not attained the age of 16;

(b) references to a person lacking capacity are references to a person lacking capacity within the meaning of the Mental Capacity Act 2005 (c. 9).

10C Regulations about direct payments

(1) Regulations may make provision about direct payments.

(2) The regulations may, in particular, make provision about—

(a) the circumstances in which, and descriptions of persons and services in respect of which, direct payments may, must or must not be made;

(b) the circumstances in which direct payments may, must or must not be made to a person nominated by the patient;

(c) the making of direct payments (and, in particular, as to persons to whom payments may or must be made) if the patient lacks capacity to consent to the making of the payments or is a child;

(d) matters to which the Welsh Ministers or a Local Health Board may or must have regard when making a decision about direct payments;

(e) conditions that the Welsh Ministers or a Local Health Board may, must or must not attach in relation to direct payments;

(f) the steps that the Welsh Ministers or a Local Health Board may or must take before, or after, making a decision about direct payments;

(g) the conditions that the patient or (if different) the payee may or must be required to comply with before, after, or at the time when a direct payment is made;

(h) the amount of any direct payment or how it is to be calculated;

(i) the circumstances in which the Welsh Ministers or a Local Health Board may or must stop making direct payments;

(j) the circumstances in which the Welsh Ministers or a Local Health Board may or must require all or part of a direct payment to be repaid by the patient or (if different) the payee, or otherwise;

(k) the monitoring of the making of direct payments, of their use by the patient or (if different) the payee, or of services which they are used to secure;

(l) the review of decisions as to whether a direct payment should be made;

(m) the arrangements to be made by the Welsh Ministers or Local Health Board for providing patients, payees or their representatives with information, advice or other support in connection with direct payments;

(n) the extent to which such support is to be treated as a service in respect of which direct payments may be made.

(3) If the regulations make provision about persons who lack capacity to consent to the making of direct payments, the regulations may also make provision about the cases or circumstances where a person who has lacked that capacity but no longer does so (whether because of fluctuating capacity or regaining or gaining capacity).

(4) The regulations may provide for a sum that must be repaid to the Welsh Ministers or Local Health Board (as the case may be) by virtue of a condition or other requirement imposed by or under the regulations to be recoverable as a debt due to the Welsh Ministers or Local Health Board (as the case may be).

(5) The regulations may make provision—

(a) for a service in respect of which a direct payment has been made under section 10B(1) to be regarded as provided or arranged for by the Welsh Ministers under an enactment mentioned in section 10B(3), only to such extent and subject to such conditions as the regulations may specify;

(b) displacing functions or obligations of a Local Health Board with respect to the provision of after-care services under section 117 of the Mental Health Act 1983 (c. 20), only to such extent and subject to such conditions as the regulations may prescribe.

(6) In this section, “service” includes anything in respect of which direct payments may be made.

10D Arrangements with other bodies relating to direct payments

(1) The Welsh Ministers or a Local Health Board may arrange with any person or body to provide assistance in connection with direct payments.

(2) Arrangements may be made under subsection (1) with voluntary organisations.

(3) Powers under this section may be exercised on such terms as may be agreed, including terms as to the making of payments by or to the Welsh Ministers or the Local Health Board.”

(3) In section 203—

(a) in subsection (6), after “section 10A(1),” insert “section 10C(1) (direct payments),”;

(b) in subsection (6A), after “section 82A (pharmaceutical needs assessments)” insert “or the first regulations under section 10B(6) (direct payments by Local Health Boards)”.

25 Direct payments for health care: minor and consequential amendments

Schedule 2 makes minor and consequential amendments relating to direct payments for health care.

26 Provision of health services by local authorities

(1) The 2014 Act is amended as follows.

(2) In section 47(1)—

(a) the words from “doing so would be incidental” to the end become paragraph (a);

(b) at the end of that paragraph, insert “, and

(b) the service or the facility in question would be of a nature that the local authority could be expected to provide.”

(3) In section 47(2)—

(a) the words from “doing so would be incidental” to the end become paragraph (a);

(b) at the end of that paragraph insert “, and

(b) the service or the facility in question would be of a nature that the local authority could be expected to provide.”