2003 No. 975 (W.134)

NATIONAL HEALTH SERVICE, WALES

The National Health Service (Travelling Expenses and Remission of Charges) (Amendment) (Wales) Regulations 2003
Made
1st April 2003
Coming into force —
except for regulation 12
6th April 2003
regulation 12
7th April 2003
The National Assembly for Wales, in exercise of the powers conferred upon it by sections 83A, 126(4) and 128(1) of the National Health Service Act 1977 hereby makes the following Regulations:

Citation, commencement, interpretation and application
1
1
These Regulations may be cited as the National Health Service (Travelling Expenses and Remission of Charges) (Amendment) (Wales) Regulations 2003 and will come into force —
a
except for regulation 12, on 6th April 2003, and
b
regulation 12, on 7th April 2003.
2
In these Regulations, “the principal Regulations” (“y prif Reoliadau”) means the National Health Service (Travelling Expenses and Remission of Charges) Regulations 1988 .
3
These Regulations apply to Wales only.

Amendment of regulation 2 of the principal Regulations
2
1
Regulation 2(1) of the principal Regulations (interpretation) is amended in accordance with the following provisions of this regulation.
2
Omit the definitions of —
- amount withdrawn;
- disabled person’s tax credit;
- working families' tax credit;
.
3
In the appropriate position in alphabetical order, insert the following definitions—
- “child tax credit” (“credyd treth i blant”) means child tax credit under section 8 of the Tax Credits Act 2002 ;
- “disability element” means the disability element of working tax credit as specified in section 11(3) of the Tax Credits Act 2002;
- “gross annual income” means income that is calculated for a tax year for the purposes of Part I of the Tax Credits Act 2002 in accordance with regulations made under section 7 of that Act;
- “local health board” has the meaning assigned to it by section 16BA of the Act ;
- “port” includes an airport, ferry port or international train station in Great Britain from which an international journey begins;
- “working tax credit” (“credyd treth i bobl sy'n gweithio”) means working tax credit under section 10 of the Tax Credits Act 2002;
.
4
For the definition of “family” substitute—
- “family” has the meaning assigned to it by section 137(1) of the Social Security Contributions and Benefits Act 1992 as it applies to income support, except that—
  1. in regulation (4)(2)(q) it has the meaning assigned to it by regulation 2(2) of the Tax Credits (Definition and Calculation of Income) Regulations 2002 ;
  2. in regulation 4(2) (j) and (l) it has the meaning assigned to it by section 35 of the Jobseekers Act 1995 ;
  3. in regulation 4(2)(o) it means any dependant, as defined in section 94 of the Immigration and Asylum Act 1999 who has been included in a claim by an asylum-seeker under Part VI of that Act.
.

Amendment of regulation 3 of the principal Regulations
3
1
Regulation 3 of the principal Regulations (entitlement to full remission and payment) is amended in accordance with the following provisions of this regulation.
2
In paragraph (3)(a), after the words “in attending a hospital” insert “or any other place”.
3
In paragraph (3)(b), for the words “health authority” substitute “local health board”.
4
After paragraph 3(b), insert the following sub-paragraphs—
c
in attending an establishment managed by a local health board for the purpose of availing himself of services provided under the care of a consultant in pursuance of the Act,
d
in travelling to a port in Great Britain for the purpose of travelling to a destination outside the United Kingdom in order to receive treatment provided pursuant to arrangements made under section 23 of the Act or paragraph 13 of Schedule 2 to the National Health Service and Community Care Act 1990 ,
.

Insertion of regulation 3A into the principal Regulations
4
After regulation 3 of the principal Regulations insert the following regulation—

Entitlement to payment for travel abroad
3A
1
Where a person receives services provided outside the United Kingdom pursuant to arrangements made under section 23 of the Act or paragraph 13 of Schedule 2 to the National Health Service and Community Care Act 1990, that person is entitled, subject to paragraph (2), to payment or repayment of the whole amount of the travelling expenses incurred by him in travelling from a port in Great Britain to a destination outside the United Kingdom in order to receive treatment there (including the travelling expenses of a companion in a case where it is necessary on medical grounds that the person should be accompanied).
2
The entitlement to payment in paragraph (1) is dependent upon the health service body which has made the arrangements agreeing the mode and cost of the travel before costs are incurred.
3
For the purposes of this regulation and regulations 3(3)(d), 5A, 7B and 8 “health service body” means a local health board, an NHS Trust or the National Assembly for Wales.
.

Amendment of regulation 4 of the principal Regulations
5
1
Regulation 4 of the principal Regulations (description of persons entitled to full remission and payment) is amended in accordance with the following provisions of this regulation.
2
For the opening words of regulation 4 substitute the following —
1
Regulation 3(1) applies —
a
in the case of the charges for dental appliances and dental treatment mentioned in regulation 3(2)(b)—
i
to any person who either, at the time the arrangements for the treatment are made, or at the time the relevant charges are made, is a person described in paragraph (2), and
ii
as respects the course of treatment to which the relevant charges relate;
b
in any other case to any person mentioned in paragraph (2) who, at the time when the relevant charges are made or when the relevant travelling expenses are incurred, is a person described in paragraph (2).
2
The persons described in this paragraph are—
.
3
In regulation 4(2)—
a
for sub-paragraph (n) substitute the following sub-paragraph—
n
an asylum-seeker for whom support is provided under Part VI of the Immigration and Asylum Act 1999; or
;
b
after sub-paragraph (n) insert the following sub-paragraphs—
o
a member of the same family as a person described in paragraph (n) of this regulation; or
p
a relevant child within the meaning of section 23A of the Children Act 1989 whom a responsible local authority is supporting under section 23B(8) of that Act.
q
a person who is a member of a family—
i
that has a gross annual income of £14,200; and
ii
one member of which is receiving—
aa
working tax credit and child tax credit, or
bb
working tax credit which includes a disability element, or
cc
child tax credit, but is not eligible to receive working tax credit.
;
c
sub-paragraphs (c), (d), (g) and (h) are omitted.

Amendment of regulation 5A of the principal Regulations
6
1
Regulation 5A of the principal Regulations (payment of travelling expenses) is amended in accordance with the following provisions of this regulation.
2
In the opening words of regulation 5A after the words “made under regulation 3(1)” insert “, 3A”.
3
For paragraph (a) substitute the following paragraph—
a
in a case where the travelling expenses are incurred or to be incurred by a person in attending a hospital or any other place which is managed by an NHS trust or a local health board, by that NHS trust or that local health board;
.
4
After paragraph (a) insert the following paragraph—
aa
in a case falling within regulations 3(3)(d) or 3A, by the health service body which made the arrangements referred to in those provisions;
.

Amendment of regulation 7 of the principal Regulations
7
1
Regulation 7(1) of the principal Regulations (claims for remission or payment) is amended in accordance with the following provisions of this regulations.
2
In sub-paragraph (a)(ii) of the principal Regulations for “(m) or (n)” substitute “(m), (n), (o) (p) or (q)”.
3
For sub-paragraph (b) substitute the following sub-paragraph—
b
provide any declaration of entitlement required under regulation 3(3) or 4(3) or any declaration or evidence of entitlement required under regulation 5(3) or 6(3) of the National Health Service (Charges for Drugs and Appliances) (Wales) Regulations 2001
.

Insertion of regulation 7A into the principal Regulations
8
After regulation 7 of the principal Regulations (claims for remission or payment) insert the following regulation—

Notices of entitlement
7A
1
If a person is entitled to full remission and payment because he or she is a member of a family described in regulation 4(2)(q), the National Assembly will issue a notice of entitlement.
2
A notice of entitlement issued under paragraph (1) will be effective in respect of —
a
the person to whom it is issued and who is named on the notice of entitlement, and
b
any other members of his or her family.
3
A notice of entitlement issued under paragraph (1) will be effective—
a
from such date, and
b
for such period,
as the National Assembly may determine.
4
Any change in the financial or other circumstances of a person who is a member of a family, in respect of which a notice of entitlement has been issued under paragraph (1), during the period for which the notice of entitlement has been issued, will not affect the validity of the notice of entitlement in respect of that period.
.

Insertion of regulation 7B in to the principal Regulations
9
After regulation 7A (notices of entitlement) insert the following regulation—

Claims for payment or repayment for travel abroad
7B
1
A person who wishes to claim entitlement under regulation 3A for payment or repayment of any travelling expenses shall apply in writing to the health service body which has arranged the services referred to in that regulation within 3 months of the expenses having been incurred or such further period as that body may for good cause allow.
2
Paragraphs (1A), (1B) and (2) or regulation 7 shall apply to claims (whether for payment or repayment) made under this regulation with the modification that references to the “Secretary of State” in paragraphs (1B) and (2) are to be read as references to the health service body which arranged the services referred to in regulation 3A.
.

Amendment of regulation 8 of the principal Regulations
10
1
Regulation 8 of the principal Regulations (repayment) is amended in accordance with the following provisions of this regulation.
2
In paragraph (4)(a)(i)—
a
after the words “by an NHS trust” insert “or a local health board”,
b
after “5(1)” insert “or in regulation 6(1)”,
c
for “National Health Service (Charges for Drugs and Appliances) 1989” substitute “National Health Service (Charges for Drugs and Appliances) (Wales) Regulations 2001” .
3
For paragraph (4)(a)(ii) substitute the following paragraph—
ii
in respect of relevant travelling expenses incurred by a person in attending a hospital or any other place managed by an NHS trust or a local health board,
.
4
In the fall out words of paragraph (4)(a) after the words “by the NHS trust” insert “or the local health board”.
5
After paragraph (4)(a) insert the following sub-paragraph—
aa
in a case falling within regulation 3(3)(d) authorise in writing the repayment of the amount in question to the claimant by the health service body which made the arrangements referred to in that provision; or
.
6
In paragraph (5) after the words “by the NHS trust” insert “or the local health board”.

Amendment of regulation 8A of the principal Regulations
11
1
Regulation 8A of the principal Regulations (reimbursement of payments made in respect of relevant travelling expenses) is amended in accordance with the following provisions of this regulation.
2
For the opening words “Where a District Health Authority” substitute “Where a local health board”.
3
For the words “District Health Authority in whose district that person resides” substitute “local health board in whose area that person resides”.

Amendment of Schedule 1 to the principal Regulations
12
1
In Table A of Part I of Schedule 1 to the principal Regulations (modifications of provisions of the Income Support (General Regulations) 1987 for the purposes of Part I of this Schedule) in the entry relating to regulation 53 for “£11,500” substitute “£12,000” and for “£18,500” substitute “£19,500”.

Amendment of Schedule 1A to the principal Regulations
13
1
In paragraphs 5, 6 and 7 of Schedule 1A to the principal Regulations (periods of validity of entitlement) for the word “student” on each occasion it appears substitute “full-time student”.
2
In the Note to Schedule 1A after the definition of “remunerative work” add—
- “full-time student” has the meaning assigned to it by regulation 61 of the Income Support (General) Regulations 1987
.

Transitional Provision
14
Any person who, immediately before these Regulations came into force, was entitled to remission of relevant charges or payment of relevant expenses in accordance with regulation 4(c), (d), (g) or (h) of the principal Regulations will continue to be so entitled until 31st July 2003, despite the coming into force of these Regulations.
Signed on behalf of the National Assembly for Wales under section 66(1) of the Government of Wales Act 1998
D. Elis-Thomas
The Presiding Officer of the National Assembly
1st April 2003
(This note is not part of the Regulations)
These Regulations further amend the National Health Service (Travelling Expenses and Remission of Charges) Regulations 1988 (“the principal Regulations”) which provide for the remission of National Health Service charges and for the payment of travelling expenses in certain cases.
Regulation 3 of these Regulations amends the principal Regulations to provide that the same rules which govern payment of travelling expenses to hospitals in Wales will apply to travelling expenses to a port in Great Britain for a person who travels to a country outside the United Kingdom to receive NHS services. Regulation 4 inserts a new 3A into the principal Regulations to provide that all NHS patients receiving services outside the United Kingdom will be entitled to payment of all travel expenses (including in some cases, those of a companion) from a port in Great Britain to the place where they are to receive those services.
Regulations 6-8 make consequential amendments providing for claims for payment under the new provisions.
The amendments made to regulations 2, 4 and 7 of the principal Regulations add asylum-seekers and their dependants to the description of persons entitled to receive full remission and payment of travelling expenses. (regulations 2, 5 and 7 of these Regulations).
The amendments to regulations 2, 5A, 8 and 8A of the principal Regulations provide for payment of expenses incurred in attending establishments managed by Local Health Boards (regulations 2, 6, 9 and 10 of these Regulations).
Amendments made to regulation 2 omit the definitions of “amount withdrawn”, “disabled person’s tax credit” and “working families' tax credit”, substitute a new definition for “family” and insert definitions for “child tax credit”, “disability element”, “gross annual income” and “working tax credit” into the principal Regulations.
The amendments reflect the changes made by the Tax Credits Act 2002 and introduce into the categories of persons entitled to full remission and payment within regulation 4 of the principal Regulations persons who are members of a family that gets working tax credit and child tax credit or working tax credit with a disability addition and whose income falls below a specified income limit. In addition, a family that is entitled to child tax credit but not to working tax credit is also included within the new regulation 4(2)(q) of the principal Regulations provided its income is below the same income limit.
The income limit is based on the gross annual income (i.e. income before the deduction of tax and national insurance contributions) of the family and is currently “£14,200” or less (regulations 2 and 5 of these Regulations).
The changes made by these amendments replace entitlement to remission and payment of charges that was based on working families' tax credit and disabled person’s tax credit.
These Regulations also make amendments to regulations 7(1)(b) and 8(4)(a)(i) of the principal Regulations to reflect the changes in the principal Regulations governing charges for NHS drugs and appliances which are now set out in the National Health Service (Charges for Drugs and Appliances) (Wales) Regulations 2001 (regulations 7 and 10 of these Regulations).
Regulation 12 amends Table A of Schedule 1 to the principal Regulations to uprate the capital limits used in remission and repayment calculations relating to people living permanently in residential care or nursing homes.
Regulation 13 of these Regulations amends Schedule 1A to the principal Regulations is amended so that the provisions governing the period of validity of a notice of entitlement to remission or payment of charges held by a student will relate only to full-time students.
Regulation 14 contains a transitional provision that provides that where entitlement to remission or payment existed immediately before these Regulations came into force, on the basis of a person being in receipt of working families' tax credit or disabled person’s tax credit or being a member of such a person’s family, that entitlement will continue until 31st July 2003.
1977 c. 49 (“the 1977 Act”); section 83A was inserted by section 14(1) of the Social Security Act 1988 (c. 7) and amended by paragraph 6 of Schedule 2 to the Health and Medicines Act 1988 (c. 49), by paragraph 18(5) of Schedule 9 to the National Health Service and Community Care Act 1990 (c. 19) (“the 1990 Act”) and by paragraph 40 of Schedule 1 to the Health Authorities Act 1995 (c. 17).
Section 126(4) was amended by section 65(2) of the 1990 Act and by Schedule 4, paragraph 37(6) to the Health Act 1999 (c. 8).
See section 128(1), as amended by section 26(2)(g) and (i) of the 1990 Act, for the definitions of “prescribed” and “regulations”.
The functions of the Secretary of State under sections 83A, 126(4) and 128(1) of the 1977 Act were transferred to the National Assembly for Wales by the National Assembly for Wales (Transfer of Functions) Order 1999, S.I.1999/672, article 2 and Schedule 1, as amended by the 1999 Act, section 66(5).
S.I.1988/551 as amended by S.I.1989/394, 517 and 614, 1990/548, 918 and 661, 1991/557, 1992/1104, 1993/608, 1995/642 and 2352, 1996/410, 1346 and 2362, 1997/748 and 2393, 1998/417, 1999/767 and 2840 and 2001/1397 and 3322.
2002 c. 21.
Section 16BA was inserted by the Health Service Reform and Health Care Professions Act 2002.
1992 c. 24.
S.I. 2002/2006.
1995 c. 18.
1999 c. 33.
1990 c. 19.
1989 c. 41. In force as from 1 October 2001 (S.I.2001/2878).
S.I.2001/1358 (W.86).
S.I.2001/1358 (W.86).
S.I.1987/1967.
1998 c. 38.