Explanatory Memorandum

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1 IN THE KEYS NATIONAL HEALTH AND CARE SERVICE BILL 06 Explanatory Memorandum. This Bill is promoted by Minister Quayle M.H.K. on behalf of the Department of Health and Soial Care.. Clauses - deal with the short title and ommenement of the resulting At, as well as the interpretation of ertain terms used in it. Of partiular importane is the definition of are.. Clause provides that a Sheme or Shemes established under the resulting At and the are provided under those Shemes are to be olletively referred to and ited as the Isle of Man National Health and Care Servie ( NHCS ).. Clause requires the Department to publish a Charter is respet of the NHCS.. Clause 6 stipulates that the Charter must set out the Department s general ommitments in respet of the NHCS and requires the Department to have regard to the Charter in the provision of are. 6. Clause 7 requires the Department to review and, if appropriate, revise the Charter at least one every years. Also, lause 7 authorises the Department to amend the Charter at any time. 7. Clause 8 requires the Department to ensure that are is provided to individuals to the extent and in the manner set out in one or more Shemes made by the Department. Suh Shemes, whih are publi douments within the meaning of setion () of the Interpretation At 976, must be laid before Tynwald. Tynwald will thereby be given the opportunity to resolve that the Sheme be annulled. Tynwald an do so at the sitting at whih the Sheme is laid before it or at the subsequent sitting. One annulled, the Sheme eases to have effet. It follows that, in aordane with the Interpretation At 976, the Shemes ome into operation upon being made and will ontinue to be in operation unless and until Tynwald annuls them, should it hoose to do so. 8. Clause 9 set out standards to whih are provided under Shemes must onform. 9. Clause 0 stipulates what the Department must determine when making a Sheme. 0. Clause permits the Department to harge for are provided under Shemes and for the use of its failities. The Department is given disretion as to the irumstanes in whih it may harge. Also, lause stipulates that, when setting any harge it may see fit to impose, the Department must take aount of the funds available to it. The Department is speifially given the latitude to provide that ertain individuals or ategories of individuals are either exempt from harge or are subjet to a redued harge. Charges so imposed are

2 Explanatory Memorandum National Health and Care Servie Bill 06 speifially stipulated to be debts due to the Department or any other person that provides are, unless a Sheme provides otherwise. The lause ends by mandating that the proeeds of all suh harges are to be paid by the Department into the general revenue of the Island.. Clause authorises the Department to make ontributions towards the meeting of speified are-related osts of individuals to whom are is provided. Again, the Department is required to take into aount the funds available to it before making a deision to ontribute.. Clause provides that persons other than the Department may provide are and speifies the arrangements in aordane with whih are may be provided by suh other persons (either instead of or in ollaboration with the Department).. Clause requires the Department to keep and maintain one or more lists of qualified are providers whom it may permit to provide are either in onjuntion with or in plae of the Department. The Department is authorised to keep the lists in any form it hooses and to publish, to the extent that it onsiders appropriate, suh details from any list so maintained. The Department is also required to publish the detailed requirements to be met by appliants who wish to be listed, and to publish the proedure to be followed by appliants for listing. Clause further stipulates that listed persons whose names have been removed, or appliants whose names have been exluded, from any of the lists may appeal to a ommittee or body to be identified in regulations made under the resulting At. The Department must omply with the deisions of that ommittee or body in respet of an appeal.. Clause undersores the point that persons other than the Department may provide are and provides that the Department s failities may be used by others for the provision of are that is not governed by a Sheme. Clause expressly gives the Department freedom to determine the terms and onditions subjet to whih it may allow other persons to provide are outside of a Sheme and to use its failities for the provision of suh are.. Clause 6 provides that harges an be made in respet of persons who refuse to vaate the Department s failities when offiially asked to do so. The Department is authorised to set the level of suh harges on a ase by ase basis, having regard (as may be appropriate) to the means of the individual oupying the faility or of any other person who has aepted finanial responsibility for the individual. The harge set should make defiant, ontinued oupation finanially unfeasible for whoever is responsible for meeting the ost. A person who has taken responsibility for deision-making need not have also aepted personal finanial responsibility, and it is only where the person has aepted personal finanial responsibility that the Department may have regard to that person s resoures in setting the harge for defiant, ontinued oupation of the faility. It is stipulated that the harges imposed in aordane with lause 6 are a debt due to the Department, may be reovered by way of legal proeedings Page ii

3 National Health and Care Servie Bill 06 Explanatory Memorandum and, when reovered (by whatever means), must be paid over by the Department into the general revenue of the Island. 6. Clause 7 authorises the Department to establish ommittees to srutinise and advise on the arrying out by the Department of its funtions, or to assist it with the arrying out of any of those funtions. The Department may only establish suh ommittees by means of regulations made under the resulting At. 7. Clause 8 provides that the Department may onsult any of the ommittees it establishes under lause 7. However, lause 8 also provides that the Department, whilst being required to onsider any advie it reeives (whether gratuitously or in response to onsultation), is not bound to follow the advie. 8. Clause 9 sets out the sope of Part, whih lause 9 ommenes. It stipulates the irumstanes in whih individuals may omplain about are they have reeived. 9. Clause 0 requires the Department to publish details of the proedure to be followed by omplainants and those hearing the omplaints, and also requires that the rules of natural justie be followed when omplaints are being onsidered. 0. Clause provides that if omplaints referred to in the preeding lause are not resolved, either party may refer the omplaint in question to the Independent Review Body, whih is presently in existene and will be saved by the resulting At by virtue of lause ()(i). Clause provides that speified provisions of lause 0 apply to the Independent Review Body. It also speifially provides that no attempt is being made in the Bill to prevent an aggrieved person from seeking another remedy in respet of his or her omplaint.. Clause gives the Department the power to enter into ontrats for the use by another person or other persons of its failities for any purpose whatsoever, and requires that the Department pay into the general revenue of the Island all proeeds it reeives from ontrats under this or any other provision in the resulting At. Clause also requires the Department to ensure the regular and independent monitoring and review of speified aspets of the administration of Shemes. A report of the findings of eah independent review is to be presented to the Department and the Department is required to publish any suh report.. Clause gives the Department regulation-making powers additional to those given in lause 7. It also provides that any regulations made under the resulting At are required to be approved by Tynwald before they ome into operation.. Clause saves several speified regulations made under the National Health Servie At 00 ( the 00 At ), as if they were made under the resulting At. Two of those regulations are saved subjet to speified amendments. Further, lause provides that referenes in any of the saved regulations to provisions of the 00 At are to be onstrued as referenes to the equivalent provisions of Page iii

4 Explanatory Memorandum National Health and Care Servie Bill 06 the resulting At, and authorises the use of Shemes to amend or repeal any of the saved regulations.. Clause makes transitional provisions in respet of existing ontrats.. Clause 6 gives effet to the Shedule to the resulting At. 6. Clause 7 repeals the 00 At. 7. The Bill is not expeted to have any human or finanial resoure impliations. 8. In the opinion of the member moving the Bill its provisions are ompatible with the Convention rights within the meaning of the Human Rights At 00. Page iv

5 National Health and Care Servie Bill 06 Index e NATIONAL HEALTH AND CARE SERVICE BILL 06 Index Setion Page PART INTRODUCTORY 7 Short title... 7 Commenement... 7 Interpretation... 7 Citation of the Isle of Man National Health and Care Servie... 8 PART - THE NHCS CHARTER 8 Department to prepare and maintain a Charter Charater of the Charter Revision and amendment of the Charter... 8 PART SCHEMES 8 8 Department to provide are Standards of are Contents of a Sheme... 9 Charges under a Sheme... 9 Contributions under a Sheme... 0 Care may be provided by others... 0 Department to maintain list of qualified are providers... 0 Private failities and are... 6 Misuse of the Department s failities... PART COMMITTEES 7 Establishment of ommittees... 8 Advie of ommittees... PART COMPLAINTS UNDER A SCHEME 9 Appliation of Part... 0 Proedure for making omplaints... Independent Review Body to onsider omplaints... Page

6 Index National Health and Care Servie Bill 06 PART 6 FINAL AND SUPPLEMENTAL PROVISIONS Powers and duties of the Department... Regulations... Saving... Transitional provision existing ontrats Legislation amended Repeal... 7 SCHEDULE 9 LEGISLATION AMENDED 9 Page 6

7 National Health and Care Servie Bill 06 Setion e NATIONAL HEALTH AND CARE SERVICE BILL 06 A BILL to provide for national health and are servies; to make provision for private are; and for onneted purposes. BE IT ENACTED by the Queen s Most Exellent Majesty, by and with the advie and onsent of the Counil and Keys in Tynwald assembled, and by the authority of the same, as follows: PART INTRODUCTORY Short title The short title of this At is the National Health and Care Servie At 06. Commenement () This At omes into operation on suh day or days as the Department may by order appoint, and different days may be appointed for different purposes of this At. () An order under subsetion () may make suh transitional and saving provisions as the Department onsiders neessary or expedient. Interpretation In this At Appointments Commission means the Commission established by setion of the Tribunals At 006; are means health are and servies and inludes are and servies that the Department may or is required to provide under other legislation; Charter means the Charter for the time being in operation under Part ; Department means the Department of Health and Soial Care; Independent Review Body has the meaning given in setion ()(a); NHCS means the Isle of Man National Health and Care Servie; Page 7

8 Setion National Health and Care Servie Bill 06 publish, in respet of information required to be published under this At, means publish in a manner that gives the publi free and onvenient aess to a opy of the information; Sheme means a Sheme established under setion Citation of the Isle of Man National Health and Care Servie A Sheme or Shemes and the are provided to individuals under the Sheme or Shemes may olletively be referred to and ited as the Isle of Man National Health and Care Servie PART - THE NHCS CHARTER Department to prepare and maintain a Charter The Department must publish and maintain a Charter in respet of the NHCS. 6 Charater of the Charter () The Charter must set out the Department s general ommitments in respet of the NHCS. () The Department must have regard to the Charter in the provision of are. 7 Revision and amendment of the Charter The Department must review and, if appropriate, revise the Charter at least one every years and may amend it at any time PART SCHEMES 8 Department to provide are () Subjet to setion 9, the Department must ensure that are is provided to individuals to the extent and in the manner set out in one or more Shemes made by the Department. () Shemes must be laid before Tynwald. () If Tynwald at the sitting at whih a Sheme is laid or at the subsequent sitting resolves that it is to be annulled, the Sheme eases to have effet. 9 Standards of are The Department must ensure that are provided under a Sheme (a) is in aordane with generally aepted standards; Page 8

9 National Health and Care Servie Bill 06 Setion (b) () (d) (e) (f) (g) provides, subjet to available resoures, the highest levels of human knowledge and skill neessary to save lives and improve health; is administered with ompassion and onern for the wellbeing of the individuals to whom it is provided; is omprehensive and available to all; is designed to improve, prevent, diagnose and treat both physial and mental health onditions with equal regard; supports individuals to promote and manage their own health; and provides best value for money by using in the most effetive, fair and sustainable manner the resoures alloated to the Sheme Contents of a Sheme When making a Sheme the Department must determine (a) the are that will be provided to individuals under the Sheme; (b) the way in whih that are will be provided; () the terms and onditions on whih that are will be provided to individuals; and (d) the manner in whih the Sheme is to be administered. Charges under a Sheme () The terms and onditions of a Sheme must provide for (a) the harges (if any) to be paid for the provision of are and for the use of the Department s failities under the Sheme; and (b) the manner in whih those harges are to be alulated. () Nothing in subsetion () is to be taken as implying that a harge must be made for the provision of are or for the use of the Department s failities under a Sheme. () In setting a harge for are or for the use of the Department s failities under a Sheme, the Department must have due regard to the funds and other resoures available to it. () A Sheme may provide that individuals speified in the Sheme are exempt from a harge for are or for the use of the Department s failities provided under the Sheme or are only liable to a redued harge. () Exept as may otherwise be provided by a Sheme, a harge for are provided under a Sheme or for the use of a faility of the Department under a Sheme is a debt due to the Department or, in the ase of are provided by another person under a Sheme, that person. Page 9

10 Setion National Health and Care Servie Bill 06 (6) The Department must pay any amount it reeives for are it provides under a Sheme or for the use of its failities under a Sheme into the general revenue of the Island Contributions under a Sheme () The terms and onditions of a Sheme may provide for the Department to make payments to meet or to ontribute towards speified are-related osts inurred or to be inurred in respet of individuals who have reeived or who are to reeive are under the Sheme. () In setting those payments, the Department must have due regard to the funds and other resoures available to it. Care may be provided by others () The obligation on the Department to establish one or more Shemes is not to be taken as implying that the are to be provided under a Sheme must be provided by the Department. () A Sheme may provide that all or any part of the are to be provided under the Sheme may be provided by a person who (a) has been ommissioned by, or on behalf of, the Department; or (b) has entered into a ontrat with the Department, to provide the are or that part of it. Department to maintain list of qualified are providers () The Department must maintain a list of the names of persons that it is satisfied are qualified to provide are in aordane with setion (). () The list may inlude the name of a person pratising on the Island who is providing are under a Sheme, whether the are is provided by the Department or by the person in aordane with setion (). () The Department may publish the list either in full or to suh extent as the Department onsiders appropriate in any partiular ase. () The Department must publish details setting out (a) how a person may apply to have his or her name inluded on the list; and (b) the proedure it will follow to determine an appliation by a person to have his or her name inluded on the list. () The Department may keep the list in any form it onsiders appropriate. (6) If the Department determines that the name of a person should not be inluded on the list or should be removed from it, the person may appeal to the ommittee or body to whih responsibility is given for this purpose by regulations made under setion ()(j). Page 0

11 National Health and Care Servie Bill 06 Setion (7) Where the ommittee or body referred to in subsetion (6) hears an appeal under this setion, the Department must omply with the deision of the ommittee or body in respet of the appeal Private failities and are () Nothing in this Part is to be taken as implying (a) that only the Department may provide are under a Sheme; or (b) that the Department s failities an be used only by the Department for the provision of are under a Sheme. () If otherwise than under a Sheme the Department (a) allows are to be provided; or (b) makes its failities available for the provision of are, it may do so on terms and onditions it determines. 6 Misuse of the Department s failities () Subsetion () applies where (a) an individual oupies any of the Department s failities for the purpose of reeiving are; (b) the individual or the individual s representative, having been informed by an appropriate person that it is no longer neessary for the individual to oupy the faility for the purpose of reeiving suh are, is asked to vaate the faility or to remove the individual from the faility; and () the individual refuses to vaate the faility, or the individual s representative refuses to remove the individual from the faility. () As an alternative to eviting the individual, the Department may harge the individual in respet of the period for whih the individual ontinues to oupy the faility after having been asked to vaate. () The harge must be (a) determined by the Department on a ase by ase basis; and (b) set at suh a level, having regard to the individual s means or the means of the individual s representative, as to disourage (i) the individual from ontinuing to oupy the faility; or (ii) the individual s representative from refusing to remove the individual from the faility, after an appropriate person has advised that the individual is required to vaate the faility. () Any harge under this setion (a) is a debt due to the Department; Page

12 Setion 7 National Health and Care Servie Bill (b) may be reovered by way of legal proeedings; and () when reovered, whether by way of legal proeedings or otherwise, must be paid by the Department into the general revenue of the Island. () In this setion appropriate person means a person who has atual or ostensible authority, derived from the Department, to ommuniate to the individual or to the individual s representative the deision of the Department regarding whether the individual is required to vaate the faility; individual s representative means any person satisfatory to the Department that, in respet of an individual who (a) is reeiving are; (b) is oupying any of the Department s failities for the purpose of reeiving suh are; and () is personally unable to make deisions in respet of the are the individual is reeiving or any matter assoiated with suh are, has formally indiated to the Department that the person is responsible for making on the individual s behalf deisions referred to in paragraph (), regardless of whether that person has also ommitted to meeting from the person s own resoures any osts assoiated with the are being provided PART COMMITTEES 7 Establishment of ommittees The Department may by regulations (a) subjet to paragraphs (h) and (i) of setion (), establish a onsultative ommittee to provide the Department with srutiny and advie on the provision by the Department of servies in furtherane of its funtions; (b) establish ommittees to exerise on behalf of the Department and in its name any of its funtions; or () establish ommittees to o-ordinate the provision and delivery of are under Shemes. 8 Advie of ommittees () The Department may seek advie from a ommittee established under setion 7 in respet of any ation the Department has taken or intends to take in respet of are. Page

13 National Health and Care Servie Bill 06 Setion 9 () The Department must take aount of any advie it reeives from a ommittee, whether or not the advie was sought under subsetion (), but is not bound to follow the advie PART COMPLAINTS UNDER A SCHEME 9 Appliation of Part () This Part applies to omplaints made by individuals about are provided under a Sheme, whether by the Department or by a person ating in aordane with setion (). () A omplaint under this Part may, in partiular, be made in respet of (a) a failure to provide are; (b) a delay in the provision of are; () the quality or effiay of are that was provided; or (d) the manner in whih are was provided. 0 Proedure for making omplaints () The Department must publish details setting out (a) the proedure to be followed by an individual who wishes to make a omplaint; and (b) the proedure to be followed by those onsidering suh a omplaint. () The proedure to be followed in onsidering a omplaint must ensure that the rules of natural justie are followed. Independent Review Body to onsider omplaints () If a omplaint is not resolved in aordane with the proedure published in aordane with setion 0()(b), either party to the omplaint may for the purpose of having the omplaint resolved refer it to the Independent Review Body provided for in regulations made under paragraphs (a) to (g) of setion (). () The Independent Review Body must onsider the omplaint and report its deision to the parties to the omplaint. () Setions 0()(b) and () apply to the Independent Review Body. () Nothing in this setion is to be taken as prohibiting a person from seeking any other remedy in respet of a omplaint. Page

14 Setion National Health and Care Servie Bill PART 6 FINAL AND SUPPLEMENTAL PROVISIONS Powers and duties of the Department () The Department may enter into a ontrat with any person for the use of its failities for any purpose whatsoever, and must pay into the general revenue of the Island all proeeds it reeives from a ontrat under this or any other provision of this At. () The Department must ensure that the following provisions of a Sheme are regularly and independently monitored and reviewed (a) the are provided to individuals under the Sheme; (b) the way in whih that are is provided; () any failities, equipment and other resoures made available in respet of the Sheme; and (d) the way in whih the Sheme is being administered. () The Department must (a) ensure that a report of the findings of eah independent monitoring and review under subsetion () is provided to it; and (b) publish or see to the publishing of the report so provided. Regulations () In addition to the power to make regulations under setion 7, the Department may make regulations neessary or onvenient for its administration of this At. () Without limiting subsetion (), the Department may make regulations (a) providing for the appointment by the Appointments Commission of members of a body to be alled the Independent Review Body, the purpose of whih is to review omplaints onerning the provision by the Department of servies in furtherane of its funtions; (b) providing for the membership of the Independent Review Body; () providing for the ondut of business of the Independent Review Body; (d) providing for the appointment of panels by the Independent Review Body, to any of whih panels the Independent Review Body may delegate any of its funtions; (e) providing for the expenses of the Independent Review Body; (f) providing for the submission of annual reports by the Independent Review Body; Page

15 National Health and Care Servie Bill 06 Setion (g) providing for suh other details in respet of the Independent Review Body as the Department onsiders neessary or onvenient, inluding giving the Independent Review Body funtions additional to that required by paragraph (a); (h) providing for the appointment by the Appointments Commission of members of a body to be alled the Health Servies Consultative Committee (i) that the Department may onsult on general matters relating to the servies provided by the Department; (ii) that the Department must respond to on suh questions as the Health Servies Consultative Committee may refer to it; (iii) that may tender to the Department its views on any general matter relating to the servies provided by the Department; (iv) to the members of whih payments may be made in respet of expenses; and (v) the views of whih the Department must have regard to in exerising its funtions, provided those views are given under any of subparagraphs (i) to (iii); (i) providing for the onstitution, and for additional funtions, of the Health Servies Consultative Committee; or (j) stipulating that a ommittee or body, (i) whether established by regulations made under this At or by any other enatment; and (ii) subjet to the requirements of setion 0, is responsible for hearing and determining appeals by persons aggrieved by the exlusion or removal of their names from the list provided for in setion. () Regulations made under this At must not ome into operation unless approved by Tynwald Saving () Despite the repeal of the National Health Servie At 00, the following regulations made under that At ontinue in operation, with any neessary amendments, as if made under the provision of this At speified below and approved by Tynwald (a) the National Health Servies (Appointment of Consultants) Regulations 00, as if made under setion ; SD 086/0 Page

16 Setion National Health and Care Servie Bill (b) the National Health Servie (Complaints) Regulations 00, as if made under setion ; () the National Health Servie (Expenses in Attending Hospitals) Regulations 00, as if made under setion ; (d) the National Health Servie (General Ophthalmi Servies) Regulations 00, as if made under setion ; (e) the National Health Servie (Optial Payments) Regulations 00, as if made under setion ; (f) the National Health Servie (Charges for Drugs and Applianes) Regulations 00, 6 as if made under setion ; (g) the National Health Servie (Pharmaeutial Servies) Regulations 00, 7 as if made under setion ; (h) the National Health Servie (Dental Charges) Regulations 006, 8 as if made under setion ; (i) subjet to subsetion (), the National Health Servie (Independent Review Body) Regulations 00, 9 as if made under paragraphs (a) to (g) of setion (); (j) the National Health Servie (Overseas Visitors) Regulations 0, 0 as if made under setion ; and (k) subjet to subsetion (), the Health Servie Consultative Committee Constitution Regulations 0, as if made under setion 7(a) and in aordane with paragraphs (h) and (i) of setion (). () The National Health Servie (Independent Review Body) Regulations 00 are amended as follows (a) by repealing regulation ; and (b) in regulation, by deleting the Counil of Ministers wherever it appears and substituting in eah ase the Appointments Commission. () Regulation of the Health Servies Consultative Committee Constitution Regulations 0 is repealed. SD 06/0 SD 08/0 SD 008/0 SD 009/0, as amended by SD 066/0. 6 SD 00/0, as amended by SD 078/0, SD 0/0 and SD 009/. 7 SD 077/0 8 SD 000/06, as amended by SD 00/0, SD 000/ and SD 07/. 9 SD 0679/0 0 SD 00/ SD 0/ Page 6

17 National Health and Care Servie Bill 06 Setion () In all regulations saved under this setion, any referene to a provision of the National Health Servie At 00 is to be onstrued as a referene to the equivalent provision in this At. () A Sheme may amend or repeal any of the regulations listed in subsetion () Transitional provision existing ontrats () This setion applies to a ontrat that (a) was entered into pursuant to the National Health Servie At 00 that provided for a person to provide servies; and (b) was in fore immediately before setion 7 was brought into fore. () The ontrat ontinues in fore, with the neessary amendments, as if it had been entered into in aordane with setion () of this At. 6 Legislation amended The Shedule has effet. 7 Repeal The National Health Servie At 00 is repealed. Page 7

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19 National Health and Care Servie Bill 06 SCHEDULE SCHEDULE LEGISLATION AMENDED In a provision mentioned in olumn of the following table, the expression in olumn is omitted and if there is an expression in olumn that expression is substituted. Table Column Column Column Provision Expression to be omitted Expression to be substituted Law Reform (Personal Injuries) At 99 Setion () Health Servie At 00 National Health and Care Servie At 06 Children and Young Persons At 966 Setion 8() (definition of hospital ) hospital has the same meaning as in the National Health Servie At 00; Dental At 98 Setion ()(a) (a) by an authority providing national health servies, or Setion () () Referenes in this At to national health servies are referenes to (a) hospital servies and speialist servies under Part of the National Health Servie At 00; or (b) servies at health entres under setion of that At; or () shool medial servies under setion 6 of that At; or (d) servies for mothers and young hildren under setion 7 of that At; Design Right At 99 Setion 6() for the purpose of providing (a) general pharmaeutial servies, (a) by the Department of Health and Soial Care in respet of the provision of are under the National Health and Care Servie At 06, or for the purpose of providing are under the Isle of Man National Health and Care Servie Page 9

20 SCHEDULE National Health and Care Servie Bill 06 Setion 6()(b) (b) general medial servies, or () general dental servies, that is, servies of those kinds under the National Health Servie At 00 Sexual Offenes At 99 National Health Servie At 00 National Health and Care Servie At 06 Aess to Health Reords and Reports At 99 Setion ()(b) National Health Servie At 00 National Health and Care Servie At 06 Setion 0 general pratitioner general pratitioner means a means a medial person who is a registered pratitioner who is medial pratitioner, is providing general medial servies in aordane with arrangements made under setion 7 of the National Health Servie (Isle of Man) At 98; registered on the register of general medial pratitioners in aordane with the Health Care Professionals At 0, and is providing are in aordane with the National Health and Care Servie At 06; Termination of Pregnany(Medial Defenes) At 99 Setion 6()(b) Setion 6()(a) Setion 6()(b) the pregnany is terminated in a national health hospital is not employed on the staff of, or otherwise ontrated to provide medial servies in, a national health hospital in a post or offie whih is junior to the hospital surgeon who terminates the pregnany; or (b) if there is no live birth, the foetus shall be disposed of (i) in aordane with the wishes of the pregnant woman; or (ii) in the absene of any diretion by the pregnant woman, in aordane with the the pregnany is terminated under the Isle of Man National Health and Care Servie in a national health servie hospital is not employed by the Department or otherwise ontrated or ommissioned by the Department to provide medial servies in a post or offie that is junior to the hospital surgeon who terminates the pregnany; or (b) if there is no live birth, the foetus must be disposed of (i) in aordane with the wishes of the mother; or (ii) in the absene of a diretion by the mother, in aordane with the normal pratie of the Department, Page 0

21 National Health and Care Servie Bill 06 SCHEDULE Setion 8() (definition of onsultant ) Setion 8() (definition of national health hospital ) Setion 8(0)(b) Setion () Setion 9() Setion () normal pratie of the hospital, but the foetus or any part of the foetus shall not be used or made available for any medial or other experiment or proedure or for any purpose whatsoever without the express written onsent of the mother at a hospital provided by the Department under setion 8 of the National Health Servie At 00; national health hospital means a hospital vested in the Department for the purposes of the National Health Servie At 00. but the foetus or any part of it must not be used or made available for any medial or other experiment or proedure or for any purpose whatsoever without the express written onsent of the mother at a national health servie hospital; national health servie hospital means a hospital provided by the Department for the purposes of the Isle of Man National Health and Care Servie. Video Reordings At 99 for the purpose of servies for the purpose of are provided in pursuane of provided in pursuane of the the Health Servie At 00 National Health and Care Servie At 06 Mental Health At 998 setion 6 (aommodation setion of the National for private patients) of the Health and Care Servie At 06 National Health Servie (Isle of Man) At 98 in a hospital vested in the Department for the purposes of its funtions under the NHS At or any aommodation used under Part I of that At by the managers of suh a hospital, For the purposes of the NHS At the making of payments under this setion to persons for whom hospital and speialist servies are provided under that At shall be treated as inluded among those in a hospital provided by the Department for the purposes of the Isle of Man National Health and Care Servie or any other aommodation provided for that purpose and used by the managers of suh a hospital, The making of payments under this setion to persons for whom are is provided under the Isle of Man National Health and Care Servie is to be treated as inluded in that are. Page

22 SCHEDULE National Health and Care Servie Bill 06 Setion 8() (definition of the NHS At ) Setion 0() (definition of health servie hospital ) Setion (6) Setion 9() (definition of shool buildings Shedule 8, para (b) servies. the NHS At means the Health Servie At 00; the NHS At means the National Health and Care Servie At 06; Children and Young Persons At 00 health servie hospital health servie hospital means a hospital provided means a hospital provided by by the Department under the Department for the Part of the National Health purposes of the Isle of Man Servie At 00; National Health and Care Servie; Eduation At 00 The Department shall make arrangements for enouraging and assisting pupils to take advantage of servies provided by the Department of Health under setion 6 of the National Health Servie At 00. for affording failities for enabling the Health Department to arry out its funtions under setion 6 of the National Health Servie At 00; or a hospital trust within the meaning of Shedule to the National Health Servie At 00 Mediines At 00 Setion 6() and setion of the National Health Servie At 00 applies to onsultations under paragraph (a) as it applies to onsultations for the purposes of that At Setion () For the purposes of this setion the provision of servies by or on behalf of the Department under the National Health Servie At 00 shall be treated as the arrying on of a business by The Department must make arrangements to enourage and assist pupils to take advantage of are provided for them under the Isle of Man National Health and Care Servie. for affording failities to enable the Department of Health and Soial Care to arry out any of its funtions under the National Health and Care Servie At 06; or a hospital trust, being a trust of property for purposes relating to hospital servies For the purposes of this setion the provision of are by or on behalf of the Department under the National Health and Care Servie At 06 is to be treated as the arrying on of a business by that Department Page

23 National Health and Care Servie Bill 06 SCHEDULE Shedule (definition of health entre ) Setion 8()() Setion ()(a) Setion 0() (definition of hospital ) 6()(b) Shedule (definition of hospital ) Shedule (definition of NHS hospital ) that Department means a health entre maintained under setion of the National Health Servie At 00 means premises provided, equipped and maintained by the Department of Health and Soial Care for the provision of are under the Isle of Man National Health and Care Servie Employment At 006 works or worked as a works or worked as an person providing general individual providing are medial servies, general under setion () of the dental servies, general National Health and Care Servie ophthalmi servies or At 06. pharmaeutial servies in aordane with arrangements made by the Department of Health under setion, 6, 8 or 0 of the Health Servie At 00, Publi Setor Pensions At 0 any persons engaged in any of the servies mentioned in setion of the National Health Servie At 00 any person providing are as defined under the Isle of Man National Health and Care Servie Soial Servies At 0 hospital has the same meaning as in setion of the National Health Servie At 00; Regulation of Care At 0 National Health Servie At National Health and Care Servie 00 At 06 hospital see setion of the NHS At. NHS hospital means a NHS hospital means a hospital provided under hospital provide by the Part (hospital and Department for the purposes speialist servies) of the of the Isle of Man National NHS At. Health and Care Servie. Page

24 IN THE KEYS NATIONAL HEALTH AND CARE SERVICE BILL 06 A BILL to provide for national health and are servies; to make provision for private are; and for onneted purposes. Approved by the Counil of Ministers for introdution in the House of Keys. MR QUAYLE MARCH 06 Published by Authority

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