The Health and Personal Social Services(Northern Ireland) Order 1991

Payments to recognised fund-holding practices

18.—(1) In respect of each financial year, the Department shall be liable to pay to the members of each recognised fund-holding practice a sum calculated in such manner and by reference to such factors as the Department may determine (in this Article referred to as an “allotted sum”).

(2) The liability to pay an allotted sum under paragraph (1) may be discharged, in whole or in part, in either of the following ways—

(a) by making payments on account of the allotted sum at such times and in such manner as the Department may determine; and

(b) by discharging liabilities of the members of the practice to any other person (including, in particular, liabilities under HSS contracts);

and any reference in the following provisions of this Part to payment of or of a part of an allotted sum includes a reference to the discharge, in accordance with this paragraph, of the whole or part of the liability to pay that sum.

(3) The members of a recognised fund-holding practice may apply an allotted sum only for purposes specified in regulations under paragraph (4).

(4) Regulations shall make provision with respect to the purposes for which allotted sums are to be or may be applied and may make provision generally with respect to the operation of recognised fund-holding practices in relation to allotted sums; and the regulations may, in particular,—

(a) require the members of a practice to pay to the Department out of allotted sums paid to them an amount determined in accordance with the regulations as the basic cost of the drugs, medicines and listed appliances supplied pursuant to orders given by or on behalf of members of the practice;

(b) provide that the goods and services, other than general medical services, which may be purchased by or on behalf of the members of a practice out of allotted sums for the individuals on the lists of patients of the members of the practice shall be such as may be specified in a list approved for the purpose under the regulations; and

(c) impose a limit on the amount which may be spent out of an allotted sum on the provision of goods and services for any one individual, being a limit above which the cost of any goods and services for that individual in the financial year in question will fall to be met by the Health and Social Services Board whose primary functions (as defined in Article 9(5)) include the provision of goods and services (not necessarily the goods and services in question) to the individual concerned.

(5) In accordance with directions under Article 17 of the principal Order, the relevant Health and Social Services Board shall monitor the expenditure of the members of a recognised fund-holding practice and may institute an audit and review in any case where the Board considers it necessary to do so.

(6) In paragraph (4)(a) “listed” has the same meaning as in Article 63 of the principal Order.

(7) In paragraph (5) “the relevant Health and Social Services Board” in relation to a recognised fund-holding practice means—

(a) where all the members in that practice have entered into arrangements under Article 56 of the principal Order with the same Board and none of those members has entered into such arrangements with any other Board, the Board with which all the members have entered into such arrangements;

(b) in any other case, the Board in whose area resides the largest number of individuals who are on the lists of patients of the members of the practice.