Health Insurance
(Amendment No. 15) (Jersey) Law 2016
A LAW to amend further the Health
Insurance (Jersey) Law 1967
Adopted by the
States 12th July 2016
Sanctioned by
Order of Her Majesty in Council 16th November 2016
Registered by the
Royal Court 25th
November 2016
THE STATES, subject to the sanction of Her Most Excellent Majesty in Council, have
adopted the following Law –
1 Interpretation
In this Law (except Article 18) a
reference to an Article or a Part, or to a Schedule, is a reference to the
Article or Part of that number in, or the Schedule of that number to, the
Health Insurance (Jersey) Law 1967[1].
2 Article 1
amended
In Article 1(1) –
(a) after
the definition “approved optician” there shall be inserted the
following definition –
“ ‘approved
prescribing practitioner’ means a prescribing practitioner for the time
being approved under Article 26;”;
(b) for
the definition “dentist” there shall be substituted the following
definition –
“ ‘dentist’
has the same meaning as ‘registered dentist’ in the Dentistry
(Jersey) Law 2015[2];”;
(c) in
the definition “Health Services Disciplinary Tribunal” for the
words “Schedule 2 to this Law” there shall be substituted the
words “Article 27AA”;
(d) in
the definition “Pharmaceutical Benefit Advisory Committee”, for the
words “Schedule 1” there shall be substituted the words
“Article 15A”;
(e) after
the definition “prescribed” there shall be inserted the following
definition –
“ ‘prescribing
practitioner’ means a person of a class specified by Order made under Article 57(1)
of the Medicines (Jersey) Law 1995[3], but does not include a
veterinary surgeon;”.
3 Article 10
amended
In Article 10(2) the words “and Article 20A”
shall be deleted.
4 Article 15
amended
In Article 15 –
(a) for
paragraph (1) there shall be substituted the following paragraph –
“(1) For the purposes of this Law
‘pharmaceutical benefit’ means, in relation to an approved medical
practitioner, an approved dentist or an approved prescribing practitioner, any
medicine, drug, appliance or material for the time being approved under this
Article.”;
(b) in paragraph (2)
for the words “an approved medical practitioner, an approved dentist or a
registered dentist.” there shall be substituted the words “an
approved medical practitioner, an approved dentist or an approved prescribing
practitioner.”;
(c) after
paragraph (2) there shall be inserted the following paragraph –
“(2A) A prescription for pharmaceutical benefit must
only be given for treatment that is proper and necessary.”;
(d) in paragraph (3)
for the words “An approved medical practitioner, an approved dentist or a
registered dentist” there shall be substituted the words “An
approved medical practitioner, an approved dentist or an approved prescribing
practitioner”;
(e) paragraph (4)
shall be deleted;
(f) for
paragraph (9) there shall be substituted the following paragraph –
“(9) The Minister shall by Order
make provision for the remuneration of approved suppliers in respect of
pharmaceutical benefit supplied by them in accordance with this Law and any
such Order may –
(a) specify the terms and conditions subject to
which pharmaceutical benefit shall be supplied;
(b) specify the terms and conditions subject to
which payment for pharmaceutical benefit supplied by approved suppliers will be
made; and
(c) without prejudice to the generality of the
power to prescribe terms and conditions under Article 26(2) and (3), require
an approved supplier to make returns of information to the Minister, for the
purposes of the administration of this Law, regarding the supply of
pharmaceutical benefit.”;
(g) for
paragraph (11)(b) there shall be substituted the following sub-paragraph –
“(b) in so approving them, may
make different provision for the medicines, drugs, appliances and materials
that may be prescribed by, respectively, approved medical practitioners,
approved dentists and approved prescribing practitioners as items of
pharmaceutical benefit; and”;
(h) for
paragraphs (13) and (14) there shall be substituted the following
paragraphs –
“(13) The Minister shall keep a list of items
of pharmaceutical benefit.
(14) The Minister shall –
(a) keep the list of items of pharmaceutical
benefit open, at all reasonable times, to the inspection of any person, without
fee; and
(b) publish that list in such manner as makes it
generally accessible to the public.”;
(i) paragraph (15)
shall be deleted.
5 Article 15A
inserted
After Article 15 there shall be inserted the following Article –
“15A Pharmaceutical
Benefit Advisory Committee
(1) The Minister shall, by Order, establish a
Pharmaceutical Benefit Advisory Committee.
(2) An Order made under this Article shall
provide for –
(a) the constitution of the Committee;
(b) the appointment, term of office, retirement
and removal of its members, including its chairman and any deputy chairmen;
(c) the eligibility of persons for appointment
as a member;
(d) the circumstances in which persons are
disqualified for being a member.
(3) An Order made under this Article may provide
for the conduct of proceedings of the Committee.
(4) An Order made under this Article may contain
savings and transitional provisions.
(5) Subject to the requirements of an Order made
under this Article and the requirements of any other enactment, the Committee
shall determine its own proceedings.
(6) The Minister shall provide secretarial
support to the Committee.”.
6 Article 16
amended
(1) In
the heading to Article 16 for the words “or approved dentists”
there shall be substituted the words “approved dentists or approved
prescribing practitioners”.
(2) In Article 16
for the words “and approved dentists” there shall be substituted
the words “, approved dentists and approved prescribing
practitioners”.
7 Article 20A
amended
In Article 20A(a) after the words “a general medical
practice” there shall be inserted the words “or of a person
lawfully conducting a retail pharmacy business”.
8 Article 20B
amended
After Article 20B(3)(d) there shall be inserted the following
sub-paragraph –
“(da) require the contractor to use vaccines
supplied under a contract entered into under Article 20C, where a medical
service to which the contract applies is the administration of
vaccines;”.
9 Articles 20C
and 20D inserted
After Article 20B there shall be inserted the following
Articles –
“20C Supply
of vaccines – contracts
The Minister may enter into
contracts for the supply of vaccines.
The States may, by
Regulations, amend this Part.”.
10 Article 21
amended
In Article 21(1A)(a) for the words “Article 20B”
there shall be substituted the words “Part 3A”.
11 Heading
to Part 5 amended
In the heading to Part 5 after the word “OPTICIANS”
there shall be inserted the words “, PRESCRIBING PRACTITIONERS”.
12 Article 26
amended
(1) In
the heading to Article 26 after the word “opticians” there
shall be inserted the words “, prescribing practitioners”.
(2) In Article 26 –
(a) paragraph (1)
shall be deleted;
(b) after
paragraph (1D) there shall be inserted the following paragraphs –
“(1E) The Minister shall approve, for the
purposes of this Law, every dentist, every optician and every prescribing
practitioner who –
(a) applies for such approval in the prescribed
manner; and
(b) satisfies the prescribed conditions for such
approval.
(1F) The conditions for approval prescribed under paragraph (1E)(b)
may relate to any matter including (by way of example and not by way of
limitation) –
(a) the terms on which the dentist, optician or
prescribing practitioner is working;
(b) the nature of the entity in which or for
which he or she is working;
(c) the nature of the work being undertaken, or
service provided, by him or her; and
(d) whether he or she is approved for the
purposes of this Law in another capacity.
(1G) The Minister may further prescribe –
(a) conditions with which any dentist, optician
or prescribing practitioner must comply whilst approved for the purposes of
this Law;
(b) circumstances in which such approval shall
be restricted, suspended, withdrawn or restored.
(1H) An Order made under paragraph (1G)(b) prescribing mandatory
grounds for restricting, suspending, withdrawing or restoring approval does not
derogate from the discretionary powers conferred by Article 27.”;
(c) in paragraph (4)
for the words “dentists, opticians and suppliers” there shall be
substituted the words “approved dentists, approved opticians, approved
prescribing practitioners and approved suppliers”.
13 Article 27
amended
In Article 27 –
(a) in paragraph (1) –
(i) after
the words “approved optician” there shall be inserted the words
“, approved prescribing practitioner”,
(ii) for
the words beginning “if of the opinion that the representation is
well-founded,” and ending “the conduct aforesaid.” there
shall be substituted the words “if of the opinion that the representation
is well founded, shall make a recommendation to the Minister.”;
(b) after
paragraph (1) there shall be inserted the following paragraph –
“(1A) The Health Services Disciplinary Tribunal may
make a recommendation –
(a) in every case, that the approval of the
practitioner is withdrawn, restricted or made subject to conditions in addition
to any imposed under or by virtue of Article 26; and
(b) in the case of a representation that the
conduct of the practitioner has been such as to create an unreasonable charge
on the Health Insurance Fund, that the practitioner be required to pay into the
Fund an amount not exceeding the amount estimated by the said Tribunal to be
that of the additional charges imposed on the Fund by reason of the conduct
aforesaid.”;
(c) for
paragraph (2) there shall be substituted the following paragraphs –
“(2) Where the Health Services
Disciplinary Tribunal recommends to the Minister that the approval of a
practitioner should be withdrawn, restricted or made subject to additional
conditions, the Minister may withdraw or restrict such approval, or make it
subject to additional conditions, either for a definite or an indefinite
period.
(2A) The Minister may, at any time, if of the opinion that it
is proper and equitable to do so –
(a) restore an approval withdrawn under paragraph (2);
(b) remove a restriction imposed on an approval
under paragraph (2);
(c) remove any additional condition imposed
under paragraph (2).”;
(d) in paragraph (4)
for the word “withdrawn” there shall be substituted the words
“withdrawn, restricted or made subject to additional conditions”.
14 Article 27AA
inserted
After Article 27 there shall be inserted the following Article –
“27AA Health
Services Disciplinary Tribunal
(1) The Minister shall, by Order, establish a Health
Services Disciplinary Tribunal.
(2) An Order made under this Article shall
provide for –
(a) the constitution of the Tribunal;
(b) the appointment, term of office, retirement
and removal of its members, including its chairman and any deputy chairmen;
(c) the eligibility of persons for appointment
as a member;
(d) the circumstances in which persons are
disqualified for being a member.
(3) Subject to the requirements of an Order made
under Article 27(7) and the requirements of any other enactment, the
Tribunal shall determine its own proceedings.
(4) An Order made under this Article may contain
savings and transitional provisions.
(5) The Minister shall provide secretarial
support to the Tribunal.”.
15 Article 27B
amended
In Article 27B –
(a) in paragraph (1)
after the word “pharmacists,” there shall be inserted the words “prescribing
practitioners,”;
(b) in paragraph (2)
after the words “Dentists (Registration) (Jersey) Law 1961[4],” there shall be inserted
the words “the Medical Practitioners (Registration) (Jersey) Law 1960[5],”.
16 Schedules 1
and 2 repealed
(1) Schedule 1
is repealed.
(2) Schedule 2
is repealed.
17 Long
title amended – governance
In the long title to the Health Insurance (Jersey) Law 1967[6], after the words
“providing a service” there shall be inserted the words “or
writing a prescription for pharmaceutical supplies”.
18 Citation,
commencement and transitional arrangement
(1) This
Law may be cited as the Health Insurance (Amendment No. 15) (Jersey) Law 2016.
(2) Article 16(1)
shall come into force on the same day as the first Order made under Article 15A
of the Health Insurance (Jersey) Law 1967.
(3) Article 16(2)
shall come into force on the same day as the first Order made under Article 27AA
of the Health Insurance (Jersey) Law 1967.
(4) The
remaining provisions of this Law shall come into force 7 days after this
Law is registered.
(5) Notwithstanding
the amendments made by this Law removing provision from the Health Insurance
(Jersey) Law 1967 for the payment of pharmaceutical benefit for a
prescription given by a dentist who is registered, but not approved, under that
Law –
(a) pharmaceutical
benefit shall continue to be paid for such a prescription; and
(b) such
a dentist who gives such a prescription shall continue to be liable to
disciplinary proceedings, in accordance with Article 15(4) of the Health
Insurance (Jersey) Law 1967 as it was in force immediately before the
commencement of Article 4 of this Law,
until the expiry of 3 months following the commencement of an
Order made under Article 26 of the Health Insurance (Jersey) Law 1967
in respect of the approval of dentists.
l.-m. hart
Deputy Greffier of the States