Jersey R&O 48/2002

 

Health Insurance (Jersey) Law 1967

____________

 

HEALTH INSURANCE (PHARMACEUTICAL BENEFIT) (GENERAL PROVISIONS) (No. 2) (JERSEY) ORDER 2002

____________

 

1.       Interpretation

2.       Approval of suppliers

3.       Terms and conditions of supply of pharmaceutical benefit

4.       Schemes for securing proper pharmaceutical services

5.       Prescribed form for the supply of pharmaceutical benefit

6.       Period of supply

7.       Supply

8.       Offences

9.       Prescription costs payable by the Committee

10.     Revocation

11.     Citation and commencement

 

SCHEDULES

 

Schedule 1     -       Approval of suppliers of pharmaceutical benefit

Schedule 2     -       Part 1      Terms and conditions to be observed by an approved supplier

                                Part 2      Form of notice to be displayed by an approved supplier who is a person lawfully conducting a retail pharmacy business

                                Part 3      Form of notice to be displayed by an approved supplier other than a person lawfully conducting a retail pharmacy business

                                Part 4      Form of notice to be displayed by an approved supplier who is a person lawfully conducting a retail pharmacy business at times when his premises are closed

Schedule 3     -       Form of prescription

Schedule 4     -       Pharmaceutical benefit which may be supplied for 90 days on any one prescription signed by an approved medical practitioner

Schedule 5     -       Dispensing fees

Schedule 6     -       Reduction of amount payable to approved suppliers

Health Insurance (Jersey) Law 1967

____________

 

HEALTH INSURANCE (PHARMACEUTICAL BENEFIT) (GENERAL PROVISIONS) (No. 2) (JERSEY) ORDER 2002

____________

 

                THE EMPLOYMENT AND SOCIAL SECURITY COMMITTEE, in pursuance of Articles 24, 26 and 46 of the Health Insurance (Jersey) Law 1967,[1] as amended,[2] orders as follows -

 

Interpretation

 

                1.-(1)  In this Order, unless the context otherwise requires -

 

“Drug Tariff” means the statement compiled and published by the Secretary of State for Health of the United Kingdom pursuant to Regulation 18(1) of the National Health Service (Pharmaceutical Services) Regulations 1992, as that statement is for the time being in force;

 

“Health Card” means an Identity Card issued in accordance with the Health Insurance (Evidence) (Jersey) Order 1967;[3]

 

“Law” means the Health Insurance (Jersey) Law 1967,[4] as amended;[5]

 

“prescription” has the same meaning as given to the expression “prescribed form” by Article 5.

 

                (2)     In this Order, unless the context otherwise requires -

 

                (a)     a reference to an enactment (including an instrument made under any enactment of the Parliament of the United Kingdom) shall be taken to be a reference to -

 

                          (i)      that enactment as from time to time amended or extended or applied by or under another enactment, and

 

                          (ii)     any other enactment repealing and re-enacting that enactment with or without any further amendment;

 

                (b)     a reference to an Article or Schedule by number only is a reference to the Article or Schedule of that number contained in this Order;

 

                (c)     a reference in an Article or other division of this Order to a paragraph, sub-paragraph, clause or item by number or letter only is a reference to the paragraph, sub-paragraph, clause or item of that number or letter contained in the Article or other division of this Order in which it appears.

 

Approval of suppliers

 

                2.-(1)  An application by a person conducting a retail pharmacy business for approval under Article 35(2) of the Law[6] as a supplier of pharmaceutical benefit must be substantially in the form set out in Part 1 of Schedule 1.

 

                (2)     An application by any other person for that approval must be substantially in the form set out in Part 2 of Schedule 1.

 

Terms and conditions of supply of pharmaceutical benefit

 

                3.      For the purpose of Article 35(2) and (3) of the Law⁶ the terms and conditions a person in an application for approval as an approved supplier must undertake to supply pharmaceutical benefit on are those set out in Part 1 of Schedule 2.

 

Schemes for securing proper pharmaceutical services

 

                4.-(1)  The Committee may act in accordance with paragraph (2) if at any time it is satisfied that there is an insufficient number of places of business of approved suppliers open outside normal business hours.

 

                (2)     The Committee may after consulting the Pharmaceutical Benefit Advisory Committee prepare a scheme designed to ensure that a sufficient number of places of business of approved suppliers are open at reasonable times outside normal business hours.

 

                (3)     The scheme must -

 

                (a)     specify the days and hours during which places of business of approved suppliers are to be open; and

 

                (b)     provide for payments to be made to those suppliers in respect of periods during which their premises are open under the scheme.

 

Prescribed form for the supply of pharmaceutical benefit

 

                5.-(1)  For the purposes of Article 24(1A) of the Law[7] “prescribed form” means a form substantially in the form set out in Schedule 3 that -

 

                (a)     contains the particulars required to complete the form;

 

                (b)     is dated with the date on which it is to become effective;

 

                (c)     is signed by the approved medical practitioner or dentist that gave the form;

 

                (d)     is printed on white paper if signed by a medical practitioner and on yellow paper if signed by a dentist; and

 

                (e)     is watermarked with a design designated by the Committee.

 

                (2)     A form is not in the prescribed form if it authorizes the supply of pharmaceutical benefit for more than one person.

 

Period of supply

 

                6.-(1)  An approved medical practitioner or dentist must not give a prescription that orders the supply of pharmaceutical benefit necessary to provide treatment for a person for a period exceeding 30 days.

 

                (2)     Despite paragraph (1) an approved medical practitioner may give a prescription that orders the supply of pharmaceutical benefit necessary to provide treatment for a person for a period exceeding 30 days but not exceeding 90 days if the pharmaceutical benefit is of a type specified in Schedule 4.

 

                (3)     An approved medical practitioner or dentist must not give more than one prescription in respect of the same pharmaceutical benefit at any one time.

 

                (4)     Despite paragraph (3) an approved medical practitioner or dentist may give more than one but not more than four prescriptions in respect of the same pharmaceutical benefit at any one time if the prescriptions authorize consecutive periods of supply of pharmaceutical benefit to a person.

 

                (5)     Where an approved medical practitioner or dentist has given a prescription or prescriptions in respect of a period of treatment of a person the practitioner or dentist must not during that period of treatment give a further prescription in respect of that person for the same pharmaceutical benefit unless the practitioner or dentist is satisfied that it is necessary or desirable to do so for the purpose of the treatment and -

 

                (a)     the pharmaceutical benefit is intended for the continuation of the treatment after the expiry of the present period of treatment and the prescription bears a date not earlier than 21 days before the end of that period;

 

                (b)     the prescription is for an increase in dosage; or

 

                (c)     the prescription is to replace pharmaceutical benefit previously supplied on prescription and accidentally lost or destroyed.

 

                (6)     An approved supplier must not supply pharmaceutical benefit ordered on a prescription before the effective date of the prescription.

 

Supply

 

                7.-(1)  This Article applies where in accordance with a prescription pharmaceutical benefit is supplied by an approved supplier in respect of an insured person or a dependant of an insured person.

 

                (2)     The person to whom the pharmaceutical benefit is supplied must produce and show to the approved supplier the insured person’s Health Card.

 

                (3)     Subject to paragraph (4) -

 

                (a)     the person to whom the pharmaceutical benefit is supplied must surrender the prescription to the approved supplier; and

 

                (b)     the approved supplier must mark on the prescription the health insurance number specified on the insured person’s Health Card.

 

                (4)     The person taking delivery of pharmaceutical benefit is not required to surrender the prescription if by an electronic means the approved medical practitioner or dentist that signed the prescription -

 

                (a)     notifies the approved supplier of the particulars contained in the prescription and its effective date;

 

                (b)     confirms that the prescription is signed by the doctor or dentist; and

 

                (c)     undertakes to surrender the prescription to the approved supplier within 72 hours of the notification,

 

and the approved supplier is satisfied that, by reason of an emergency, the practitioner or dentist has been unable to furnish the person taking delivery of the pharmaceutical benefit with the prescription so that it is available for surrender at the time of delivery.

 

                (5)     Except as provided in paragraphs (6) and (7), the person taking delivery of the pharmaceutical benefit must pay the approved supplier a prescription charge of £1.95 for each item of pharmaceutical benefit supplied.

 

                (6)     The person taking delivery of the pharmaceutical benefit must pay the approved supplier a prescription charge of 65p for each item of pharmaceutical benefit supplied if -

 

                (a)     the pharmaceutical benefit is of a type described in Part 1 of Schedule 4;

 

                (b)     the prescription is signed by an authorized medical practitioner; and

 

                (c)     the supply ordered by any one prescription is only sufficient to provide treatment for a person for a period not exceeding 30 days.

 

                (7)     The approved supplier shall not require the person taking delivery of the pharmaceutical benefit to pay a prescription charge if the person produces and shows to the approved supplier a current Health Insurance Exception card issued by the Employment and Social Security Department to the insured person.

 

                (8)     Where paragraph (7) applies the approved supplier must endorse the prescription with the notation “HIE”.

 

Offences

 

                8.-(1)  Except as provided by paragraph (2), a person who fails to comply with a provision of this Order shall be guilty of an offence and liable to a fine not exceeding level 2 on the standard scale.[8]

 

                (2)     A person who fails to surrender a prescription as required under Article 7(3)(a) is liable to a fine not exceeding level 1 on the standard scale.[9]

 

Prescription costs payable by the Committee

 

                9.-(1)  Except as otherwise provided by this Article, the amount to be paid by the Committee to an approved supplier for each item of pharmaceutical benefit supplied on a prescription in respect of an insured person or a dependant of an insured person is the sum of the following -

 

                (a)     the basic price of the ingredients; and

 

                (b)     the appropriate dispensing fee or fees as set out in Schedule 5.

 

                (2)     The aggregate amount payable to an approved supplier under paragraph (1)(a) in respect of pharmaceutical benefit supplied in any month shall be reduced in accordance with the scale set out in the Schedule 6.

 

                (3)     Despite paragraph (2) a reduction shall not be made in respect of any item supplied by an approved suppler that is specified in the “ZD List” in the Drug Tariff if the approved supplier -

 

                (a)     purchased the item at a price not less than its basic price as calculated in accordance with the Drug Tariff; and

 

                (b)     has endorsed the prescription with the notation “ZD”.

 

                (4)     In the circumstances specified in paragraph (5) the amount to be paid to the approved supplier under paragraph (1) shall be the amount that would be payable under that paragraph if each instalment referred to in paragraph (5) had been supplied on a separate prescription.

 

                (5)     The circumstances referred to in paragraph (4) are where an approved supplier supplies by way of pharmaceutical benefit a substance or product in accordance with a prescription signed by a approved medical practitioner that specifies that it is to be supplied in instalments at stipulated intervals or on given dates, and -

 

                (a)     the substance or product at the time of supply is specified in Part I, II or III of the Second Schedule to the Misuse of Drugs (Jersey) Law 1978;[10] and

 

                (b)     the person for whom the supply is ordered has been the subject of notification to the Medical Officer of Health pursuant to the Misuse of Drugs (Addicts) (Jersey) Order 1980.[11]

 

                (6)     Where an approved supplier supplies pharmaceutical benefit on a prescription any amount that the supplier receives or should have received under Article 7(5) or (6) is to be deducted from the amount payable to the supplier in respect of the pharmaceutical benefit.

 

                (7)     For the purposes of this Article the basic price of an ingredient is its basic price calculated in accordance with the Drug Tariff as at the date of its supply.

 

                (8)     If the term “aqua” is used in a prescription without qualification the approved supplier shall -

 

                (a)     interpret it to mean wholesome drinking water; and

 

                (b)     not charge for it.

 

                (9)     An approved supplier shall not charge for distilled water unless -

 

                (a)     its use is specified on the prescription; or

 

                (b)     it is necessary to use distilled water to conform with standard dispensing practice.

 

Revocation

 

                10.    The Health Insurance (Pharmaceutical Benefit) (General Provisions) (Jersey) Order 2002 is revoked.[12]

 

Citation and commencement

 

                11.    This Order may be cited as the Health Insurance (Pharmaceutical Benefit) (General Provisions) (No. 2) (Jersey) Order 2002 and comes into force on 1st October 2002.

 

                By Order of the Employment and Social Security Committee,

 

                                                                                            C.M. NEWCOMBE

 

Greffier of the States.

 

6th June 2002.

SCHEDULE 1

 

(Article 2)

 

APPROVAL OF SUPPLIERS OF PHARMACEUTICAL BENEFIT

 

PART 1

 

Health Insurance (Jersey) Law 1967

 

Form of application for approval as supplier of pharmaceutical benefit of person(s) lawfully conducting a retail pharmacy business

 

To: The Employment and Social Security Committee

 

I/We, .......................................................................................................

 

of ..............................................................................................................................

 

being a person or persons lawfully conducting a retail pharmacy business within the meaning of the Medicines (Jersey) Law 1995, apply for approval in accordance with Article 35(2) of the Health Insurance (Jersey) Law 1967. I/we undertake to dispense medicines and supply drugs at the prices fixed and in accordance with the terms and conditions prescribed under the Health Insurance (Jersey) Law 1967. I/we understand that those prices, terms and conditions are subject to variation in the manner provided by that Law.

 

The address(es) of my/our business premises registered in accordance with the Medicines (Jersey) Law 1995 and the pharmacist(s) in charge of those premises will be as follows -

 

 

                                    Signed: ................................................................................

 

                                    Date: ....................................................................................

PART 2

 

Health Insurance (Jersey) Law 1967

 

Form of application for approval as supplier of pharmaceutical benefit of person(s) other than person(s) lawfully conducting a retail pharmacy business

 

To: The Social Security Committee

 

I/We ........................................................................................................

 

of ..............................................................................................................................

 

apply for approval in accordance with Article 35(3) of the Health Insurance (Jersey) Law 1967. I/we hereby undertake to supply drugs (except poisons in Part I of the Poisons List set out in the Schedule to the Poisons List (Jersey) Order 1986) at the prices fixed and in accordance with the terms and conditions prescribed under the Health Insurance (Jersey) Law 1967. I/we understand that the those prices, terms and conditions are subject to variation in the manner provided by that Law.

 

The address(es) of my/our business premises for this purpose will be     

 

                                                Signed: ....................................................................

 

                                                Date: ........................................................................

SCHEDULE 2

 

(Article 3)

 

PART 1

 

TERMS AND CONDITIONS TO BE OBSERVED BY AN APPROVED SUPPLIER

 

Supplier to supply pharmaceutical benefit

 

                1.-(1)  The supplier must supply pharmaceutical benefit with reasonable promptness to a person who presents a prescription for them.

 

                (2)     Sub-paragraph (1) does not require a supplier to supply a pharmaceutical benefit that the supplier does not ordinarily supply.

 

                (3)     If under this paragraph a supplier is required to supply a medicine or drug the supplier must supply the medicine or drug in a suitable container being -

 

                (a)     in relation to capsules, tablets, pills or any other medicine or drug in solid form (other than those prepacked in foil or paper-board or strip card containers by the manufacturer) - an airtight container of glass, aluminium or rigid plastic;

 

                (b)     in relation to ointments, creams or pastes (other than those prepacked by the manufacturer) - a container of glass, aluminium or rigid plastic;

 

                (c)     in relation to eye, ear or nasal drops (other than those prepacked by the manufacturer) - a container of glass either incorporating or having a separate dropper attachment;

 

                (d)     in relation to liquid medicines (other than those prepacked by the manufacturer) - a container of glass or rigid plastic, including, in the case of an oral liquid medicine, a 5 ml. plastic measuring spoon (unless the patient already has one or the manufacturer’s pack includes one).

 

                (4)     The supplier must not give, promise or offer a gift or a reward as an inducement to or in consideration of a person presenting a prescription to the supplier.

 

Place and hours of business

 

                2.-(1)  The supplier must supply pharmaceutical benefit at the place or places of business specified in the supplier’s application for approval under Article 35 of the Law.

 

                (2)     The supplier must keep that place or those places open for the supply of pharmaceutical benefit -

 

                (a)     during normal business hours; and

 

                (b)     on the days and during the hours specified in any scheme made by the Committee under Article 4.

 

                (3)     At each such place of business the supplier must display a notice to be provided by the Committee in the form set out in Part 2 or Part 3 of this Schedule.

 

                (4)     If the supplier is a person lawfully conducting a retail pharmacy business the supplier must also display a notice to be provided by the Committee in the form set out in Part 4 of this Schedule when the supplier’s place of business is closed.

 

                (5)     The notice must indicate -

 

                (a)     the addresses of other people lawfully conducting a retail pharmacy business where medicines and drugs may be obtained; and

 

                (b)     the times when they may be obtained at those premises.

 

                (6)     Each notice must be displayed in a manner that makes it easily visible to members of the public.

 

Dispensing medicines

 

                3.      The supplier must ensure that the supply of medicines on prescriptions is performed by or under the direct supervision of a pharmacist.

 

Names of pharmaceutical chemists

 

                4.      Whenever required to do so by the Committee the supplier must furnish to the Committee the name of each pharmacist employed by the supplier in dispensing medicines on prescription.

 

Charges

 

                5.      Except for charges that are required or authorized to be made by this or any other Order made under the Law the supplier must supply a pharmaceutical benefit and any container free of charge.

 

Advertising

 

                6.-(1)  The supplier must not advertise either directly or by implication that the supplier is an approved supplier or that the supplier provides or is authorized to provide pharmaceutical benefit.

 

                (2)     Despite sub-paragraph (1) the supplier may -

 

                (a)     display a notice required by paragraph 2;

 

                (b)     include in an advertisement a statement of the days and hours at which pharmaceutical benefit is supplied.

 

Information to be provided

 

                7.-(1)  This paragraph does not apply except where the Committee requires information to determine the amount payable under Article 10 to the supplier for pharmaceutical benefit supplied by the supplier.

 

                (2)     The supplier must furnish to the Committee or to such person or body as the Committee directs information that the Committee requires concerning so much of the supplier’s business that relates to the supply of pharmaceutical benefit.

 

                (3)     The supplier must permit a person authorized in writing to do so by the Committee to conduct surveys at each place of business at or from which the supplier supplies pharmaceutical benefit.

 

Payment

 

                8.-(1)  On dates specified by the Committee the supplier must furnish to the Committee or to such person or body as the Committee directs the prescriptions on which pharmaceutical benefit has been supplied by the supplier.

 

                (2)     The prescriptions must be arranged in the manner the Committee directs and must be accompanied by a declaration.

 

                (3)     The declaration must contain such particulars relating to the supply by the supplier of pharmaceutical benefit and the receipt of prescription charges as the Committee specifies.

 

Withdrawal

 

                9.      If the supplier wishes to cease to be an approved supplier the supplier must give at least 3 months written notice to the Committee (or such shorter notice as the Committee may agree) that the supplier no longer wishes to supply pharmaceutical benefit.

 

 

PART 2

 

FORM OF NOTICE TO BE DISPLAYED BY AN APPROVED SUPPLIER WHO IS A PERSON LAWFULLY CONDUCTING

A RETAIL PHARMACY BUSINESS

 

Health Insurance Scheme

 

(Name of approved supplier)

 

                Approved under the Health Insurance (Jersey) Law 1967 to dispense medicines and supply drugs.

 

                These premises are open at the following times -

 

 

PART 3

 

FORM OF NOTICE TO BE DISPLAYED BY AN APPROVED SUPPLIER OTHER THAN A PERSON LAWFULLY

CONDUCTING A RETAIL PHARMACY BUSINESS

 

Health Insurance Scheme

 

(Name of approved supplier)

 

                Approved under the Health Insurance (Jersey) Law 1967 to supply drugs (except poisons in Part I of the Poisons List set out in the Schedule to the Poisons List (Jersey) Order 1986).

 

                These premises are open at the following times -

 

 

 

 

 

PART 4

 

FORM OF NOTICE TO BE DISPLAYED BY AN APPROVED SUPPLIER WHO IS A PERSON LAWFULLY CONDUCTING

A RETAIL PHARMACY BUSINESS AT TIMES WHEN HIS PREMISES ARE CLOSED

 

Health Insurance Scheme

 

                When these premises are closed, medicines and drugs may be obtained at the addresses and times shown below -

SCHEDULE 3

 

(Article 5)

 

Form of prescription

 

Front

 

 

 

 

Back

 

 

SCHEDULE 4

 

(Articles 6(2))

 

Pharmaceutical benefit which may be supplied for 90 days on any one prescription signed by an approved medical practitioner

 

PART 1

 

 

 

PART 2

 

SCHEDULE 5

 

(Article 9(1)(b))

 

Dispensing fees

 

SCHEDULE 6

 

(Article 9(2))

 

Reduction of amount payable to approved suppliers