Statutory Rules of Northern Ireland
1997 No. 190

HEALTH AND PERSONAL SOCIAL SERVICES
General Medical and Pharmaceutical Services (Amendment) Regulations (Northern Ireland) 1997

Made
28th March 1997

Coming into operation
1st April 1997

The Department of Health and Social Services, in exercise of the powers conferred on it by Articles 26(2), 56, 106, and 107(6) of, and paragraph 7(5) of Schedule 3 to, the Health and Personal Social Services (Northern Ireland) Order 1972(1) and of all other powers enabling it in that behalf, and in conjunction with the Department of Finance and Personnel and after consultation with such organisations as appeared to the Department to be representative of the Medical profession, as required by Article 56(5) of that Order, hereby makes the following Regulations:

Citation, commencement and interpretation

1.—(1) These Regulations may be cited as the General Medical and Pharmaceutical Services (Amendment) Regulations (Northern Ireland) 1997 and shall come into operation on 1st April 1997.

(2) In these Regulations, the “principal Regulations” means the Health and Personal Social Services (General Medical and Pharmaceutical Services) Regulations (Northern Ireland) 1973(2).

Amendment to regulation 4A of the principal Regulations

2.  In regulation 4A(3) of the principal Regulations (local directory of family doctors) for paragraph (1)(h) there shall be substituted—

“(h)any arrangements for the provision of any deputy notified to the Board under paragraph 14(4)(d) of Schedule 1; and”.

Amendment of regulation 32 of the principal Regulations

3.  In regulation 32 of the principal Regulations after sub-paragraph (f) there shall be inserted—

“(ff)allowances to maintain practice viability for essential medical practices in isolated rural areas;”.

Arrangements for the provision of deputies

4.—(1) Schedule 1 to the principal Regulations (terms of service for doctors) shall be amended as provided by paragraphs (2) to (5).

(2) In paragraph 14 (deputies, assistants and partners), in sub-paragraph (4)—

(a)in head (a)(iv) for “a deputising service” there shall be substituted “an organisation providing deputy doctors”;

(b)for heads (b) to (k) there shall be substituted—

“(b)in this sub-paragraph “organisation providing deputy doctors” means a person who provides deputies to doctors and includes a body which—

(i)consists only of doctors who are included in the medical list and who arrange to act as deputies to each other; and

(ii)which keeps separate accounts in relation to such arrangements;

(c)before entering into arrangements with an organisation providing deputy doctors for the provision of any deputy, a doctor shall obtain the written agreement of the organisation that any doctor it provides to him—

(i)will not be subject to a declaration either under paragraph 3(c) of Schedule 11 to the Order or under any corresponding provision in force in England and Wales or Scotland that he is not fit to be engaged in any capacity in the provision of general medical services;

(ii)will not be suspended by direction of the Tribunal, other than in a case falling within paragraph 8B(3) of Schedule 11 to the Order; and

(iii)will (unless he is a trainee general practitioner acting in the place of and under the supervision of the doctor responsible for his training) be suitably experienced within the meaning of Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1978 (other than by virtue of being a restricted services principal) or will have the acquired right specified in regulation 5(1)(d) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994(4); and

take all reasonable steps to satisfy himself that the service provided by the organisation (including its monitoring arrangements) will be adequate and appropriate having regard in particular to the interests of the doctor’s patients;

(d)a doctor shall notify the Board of any arrangements he makes with an organisation providing deputy doctors;

(e)a doctor shall from time to time and at any time when there are grounds for doing so, take reasonable steps to satisfy himself that an organisation providing deputy doctors with which he has entered into arrangements for the provision of any deputy—

(i)continues to comply with the agreement referred to in head (c) and;

(ii)continues to provide a service which is adequate and appropriate as mentioned in that head;

(f)subject to head (g), if the Board so requests, a doctor shall furnish it with evidence that such an organisation is continuing—

(i)to comply with the agreement mentioned in head (c) or, as the case may be;

(ii)to provide a service which is adequate and appropriate as mentioned in that head;

(g)a Board shall not make a request for evidence under head (f) unless—

(i)it has reasonable grounds for believing that the organisation providing deputy doctors is not providing a service which is adequate and appropriate as mentioned in head (c), and

(ii)it has consulted the Local Medical Committee;

(h)subject to head (i), where in response to a request for evidence under head (f)(ii), the Board continues to have reasonable grounds for believing that the organisation providing deputy doctors is not providing a service which is adequate and appropriate as mentioned in head (c), it shall give notice (in this paragraph referred to as a “remedial notice”) to the doctor specifying—

(i)the grounds for its concern;

(ii)the remedial action which it considers necessary; and

(iii)the time within which such action must be taken;

(i)a Board shall not issue a remedial notice under head (h) without first consulting the Local Medical Committee;

(j)where a Board issues a remedial notice under head (h), it shall also send a copy of that notice to any other doctor who has made arrangements with the same organisation;

(k)where it appears to the Board that an organisation providing deputy doctors with which a doctor has made arrangements for the provision of a deputy—

(i)is not complying with the agreement referred to in head (c); or

(ii)has not taken the action specified in a remedial notice issued under head (h) within the time specified in that notice,

or that a doctor’s arrangement with such an organisation is putting the doctor’s patients at risk, it may give notice to the doctor requiring him to bring his arrangement with that organisation to an end either immediately or within such time as is stated in the notice.”.

(3) In paragraph 14(10) (which relates to the responsibility of doctors for their deputies)—

(a)for “deputising service” where it first occurs, there shall be substituted “organisation of the type mentioned in sub-paragraph (4)(b) with which he has entered into an arrangement in accordance with that sub-paragraph”; and

(b)for “deputising service” in the second place it occurs there shall be substituted “that organisation”.

(4) For paragraph 14A (Employees)(5) there shall be substituted the following paragraph—

“14A.—(1) A doctor shall not engage another doctor as a deputy, or employ one as an assistant unless the other doctor—

(a)is suitably experienced within the meaning of Article 8 of the Health and Personal Social Services (Northern Ireland) Order 1978 (other than by virtue of being a restricted services principal); or

(b)has the acquired right specified in regulation 5(1)(d) of the Vocational Training for General Medical Practice (European Requirements) Regulations 1994; or

(c)is a trainee general practitioner acting in the place of and under the supervision of the doctor responsible for his training.”.

(5) In paragraph 20 (annual reports), in sub-paragraph (2)(c) the words “health promotion or” shall be omitted.

5.  In Schedule 1I to the principal Regulations (information to be provided in annual reports)(6), in paragraph 4—

(a)at the end of the sub-paragraph (a) the word “and” shall be inserted;

(b)at the end of sub-paragraph (b) the word “and” shall be omitted;

(c)sub-paragraph (c) shall be omitted.

Substitution of Schedule 5 to the principal Regulations

6.  For Schedule 5 to the principal Regulations (constitution of the medical and pharmaceutical committees) there shall be substituted the new Schedule 5 set out in the Schedule.

Sealed with the Official Seal of the Department of Health and Social Services on

L.S.
J. R. Kearney
Assistant Secretary
28th March 1997.

Sealed with the Official Seal of the Department of Finance and Personnel on

L.S.
V. N. Hewitt
Assistant Secretary
28th March 1997.

Regulation 6

SCHEDULESchedule 5 to the Principal Regulations as substituted

Regulations 5 and 35

“SCHEDULE 5Constitution of the Medical and Pharmaceutical Committees

Medical Committee

Membership

1.  The Medical Committee shall be constituted by the Agency and shall consist of a chairperson and 6 other members.

2.  The chairperson shall be a doctor on the medical list and shall be appointed by the Department.

3.  Four of the other members shall be doctors on the medical list and shall be appointed by the Agency, in consultation with the Department, from nominations submitted in accordance with paragraph 5.

4.  Two of the other members shall be lay persons and shall be appointed by the Agency, in consultation with the Department, from nominations submitted in accordance with paragraph 5.

5.  The nominations referred to in paragraphs 3 and 4 shall be obtained by the Agency in accordance with this paragraph:—

(a)each Board, after consultation with its Local Medical Committee, shall nominate at least 2 doctors on the medical list and, after consultation with its Health and Social Services Council, shall nominate at least 2 lay persons;

(b)the General Medical Services Committee of the British Medical Association (Northern Ireland) shall nominate at least 3 doctors on the medical list;

(c)the Northern Ireland Faculty of the Royal College of General Practitioners shall nominate at least 3 doctors on the medical list.

6.  To ensure that a quorum is present at meetings of the Medical Committee, the Agency, when constituting the Committee, shall appoint, in consultation with the Department, an additional 4 doctors and 2 lay persons from the nominations submitted under paragraph 5 to deputise, as necessary, for absent members.

7.  The term of office of members and deputies shall be 3 years and a member may be re-appointed on the expiration of his term of office.

8.  Where the place of a member or deputy becomes vacant before the expiration of his term of office whether by death, resignation or otherwise, the vacancy shall be filled by the Agency, after consultation with the Department, from the list of nominations submitted under paragraph 5 and any person so appointed shall hold office for the remainder of the term of office of the former member.

9.  A member of the Medical Committee may resign his membership by giving notice in writing to the Agency, and a member who is appointed as being a doctor on the medical list shall be deemed to have resigned if he ceases to be included in the medical list.

Procedure at meetings

10.  Subject to paragraphs 11 and 12, any recommendation of the Medical Committee shall be that of the majority of those members who are present and voting at a meeting of the Committee.

11.  At any such meeting, 4 members of the Medical Committee shall form a quorum and, in the case of an equality of votes, the chairperson shall have a second or casting vote.

12.  A member may vote upon any matter which touches the interests of members of his profession (himself included) but shall not vote upon any matter touching only his individual professional interests.

13.  The proceedings of the Medical Committee shall not be invalidated by any vacancy in the membership of the Committee or by any defect in the appointment of its members.

14.  The Medical Adviser of the relevant Board shall have the right to attend a meeting of the Medical Committee to provide members with additional background information on any application made by a doctor in accordance with regulation 4(3), 8 or 10 in relation to that Board’s area and shall attend if the Chairperson so requests.

Pharmaceutical Committee

Membership

15.  The Pharmaceutical Committee constituted by the Agency after consultation with the Boards and such organisation which is, in the opinion of the Agency, representative of the general body of chemists and such other persons as it considers appropriate, shall consist of a chairman and such number of other members as the Agency thinks fit.

16.  The chairman shall be a pharmacist appointed by the Department.

17.  The term of office of members shall be determined by the Agency.

18.  Where the place of a member becomes vacant before the expiration of his term of office whether by death, resignation or otherwise, the vacancy shall be filled by the Agency after consultation in accordance with paragraph 15 and if necessary with the Pharmaceutical Committee and any other person so appointed shall hold office for the remainder of the term of office of the member who died, resigned or otherwise vacated his office as the case may be.

19.  A member of the Pharmaceutical Committee may resign his membership by giving to the Agency notice in writing.

20.  Where any member of the Pharmaceutical Committee—

(a)is absent from the meetings of the Committee for more than 6 months consecutively (except for a reason approved by the Agency);

(b)has become bankrupt or has made a composition with his creditors; or

(c)is convicted of an indictable offence;

the Agency shall forthwith by resolution, declare the office to be vacant and shall notify that fact in such manner as it thinks fit and thereupon the office shall become vacant.

21.  A member of the Pharmaceutical Committee who is a member of a Board shall cease to be a member of that Committee if he ceases to be a member of that Board.

Procedure at meetings

22.  A member of the Pharmaceutical Committee may vote upon any matter which touches the interests of members of his profession (himself included) but shall not vote upon any matters touching only his individual professional interests.

23.  The proceedings of the Pharmaceutical Committee shall not be invalidated by any vacancy in the membership of the Committee or by any defect in the appointment of its members.”

Explanatory Note

(This note is not part of the Regulations.)
These Regulations further amend the Health and Personal Social Services (General Medical and Pharmaceutical Services) Regulations (Northern Ireland) 1973 (“the principal Regulations”).
The amendment to the principal Regulations contained in regulation 2 is consequential upon regulation 4.
Regulation 3 amends the principal Regulations to provide for a scheme to protect the viability of essential medical practices in isolated rural areas.
Regulation 4 amends the doctors' terms of service in relation to a doctor’s obligations where he uses the services of an organisation providing deputy doctors. While a doctor has to notify the Board of any arrangements he may make with such an organisation, he no longer has to obtain the prior consent of the Board. The Regulations require a doctor himself to ensure that the services provided by an organisation providing deputy doctors are adequate and appropriate and that its doctors are suitably qualified and trained and have not been either disqualified or suspended from practice by the Tribunal. There is provision enabling the Board to ask a doctor for evidence that he is complying with this obligation, to alert the doctor to any concerns it may have and, if need be, to require the doctor to bring his arrangement with an organisation providing deputy doctors to an end.
Regulation 5 removes information about a doctor’s health promotion activities from the list of information which doctors are required to include in their annual reports to Boards.
Regulation 6 substitutes a new Schedule 5 in the principal Regulations to provide for a re-constitution of the Medical Committee.


(1)
S.I. 1972/1265 (N.I. 14) as amended by S.I. 1978/1907 (N.I. 26) S.I. 1981/432, and S.I. 1991/194 (N.I. 1)

(2)
S.R. & O. (N.I.) 1973 No. 421; relevant amending Regulations are S.R. 1989 Nos. 198 and 454, S.R. 1994 No. 500 and S.R. 1995 No. 487

(3)
Regulation 4A was inserted by S.R. 1989 No. 454

(4)
S.I. 1994/3030

(5)
Paragraph 14A was inserted by S.R. 1989 No. 454

(6)
Schedule 1I was inserted by S.R. 1989 No. 454 and substituted by S.R. 1993 No. 158