ANNEX A:: OUTLINE OF THE EXISTING LAW RELATING TO THE NHS Part 2 System: family health services Common provisions
496.Sections 43A and 43B of the 1977 Act, as substituted by section 10 of the Health Act, provide a structure for the remuneration of persons providing Part 2 services. Section 10 of the Health Act has, however, not been brought into force. Neither have the original sections 43A and 43B inserted by the Health and Social Security Act 1984 (c.48) been commenced. In effect the original sections inserted by the 1984 Act must be complied with because of section 7 of that Act, which provides that a determina­tion of remuneration made before the coming into force of those provisions is deemed to be validly made if regulations authorising it could have been made had that provision been in force at that time. It is therefore not open to the Secretary of State or anyone else to make a determination which is inconsist­ent with the provisions of sections 43A and 43B as inserted by the 1984 Act. What in fact happens is that the Secretary of State makes and publishes a determi­na­tion for each of the professions, which takes the form of the separate document referred to in each of the sets of Regula­tions governing the four professions. These determina­tions therefore have the force of law, although they are not subject to any further degree of formality or Parliamentary procedure. In the case of General Medical Services, the determination is contained in a document known as the Red Book.
497.Each profession has in each HA area a local representative committee (called the Local Medical Committee, the Local Dental Committee, and so on). These represent local practitioners and are provided for under sections 44 and 45 of the 1977 Act as amended.
498.There are detailed provisions for the removal or suspension of practitioners from the list in which their names are included (see sections 49F to 49R in the 1977 Act). There is provision for review of decisions and for appeal to a new statutory body, the Family Health Services Appeal Authority (‘the FHSAA’). The FHSAA is set up by section 49S of the 1977 Act, inserted by section 27 of the Health and Social Care Act 2001. It is constituted in accordance with new Schedule 9A. This new body may turn a local removal from a particular HA list into a national disqualification that prevents any HA from including them in their list.