Statutory Rules of Northern Ireland

"application" means an application for a review;

"Board" means a Health and Social Services Board;

"chairman" includes a deputy chairman acting in the chairman's place;

"Chief Executive" means a chief officer of a Board or officer of a Board duly authorised to act on behalf of the chief officer;

"complainant" means a Board or any other person who makes representations to the Tribunal;

"conditional disqualification" shall be construed in accordance with paragraph 4 of Schedule 11 to the Order;

"dentist" means dental practitioner;

(a) be as set out in Form 1 and shall -


(i) contain a concise statement of the alleged facts and grounds upon which the complainant intends to rely;

(ii) be signed by the complainant or on the complainant's behalf by some person authorised by the complainant;



(b) be accompanied by 2 copies of each document which the complainant proposes to put in evidence; and

(c) be sent together with the copies of the documents relevant to it to the Tribunal.

    (2) Subject to paragraph (4), where representations are made that the second condition of disqualification is met and relate to a practitioner who has applied to join a list but whose name is not yet on such a list, they shall be sent to the Tribunal within 30 days of receipt of the application for the practitioner's name to be included.

    (3) If a document which the complainant proposes to put in evidence is of a nature which renders it difficult to make or obtain a copy of it, the complainant shall not be required to submit copies of it.

    (4) Where a complainant is required to make representations within a time specified in paragraph (2) and the complainant -

(a) makes an application (whether before or after the expiry of the time so specified) to the Tribunal for an extension of that time; and

(b) includes in that application a statement of the grounds for making it,

(a) be signed by a person authorised by the Board;

(b) include a statement of the alleged facts and the grounds on which the Board intends to rely; and

(c) include 2 copies of any document which the Board proposes to put in evidence,

and shall be sent to the Tribunal.

    (2) The statement mentioned in paragraph (1)(b) may make reference to any other document already sent to the Tribunal.

    (3) Subject to paragraph (7), the Tribunal shall send to the respondent -

(a) notice informing the respondent of the application, of the intention to hold an inquiry on a date to be fixed and that the respondent may, within 2 weeks from and including the date of receipt of the notice, submit a written statement-in-answer;

(b) a copy of the application made by the complainant and of each document, if any, which accompanied it; and

(c) where paragraph (2) applies, any document which is referred to in the statement.

    (4) The Tribunal may, if it thinks fit, accept a statement-in-answer by the respondent after the period within which it is required to be submitted under paragraph (3)(a).

    (5) Where a respondent submits a statement-in-answer the respondent shall send to the Tribunal 2 copies of the statement-in-answer and of each document which the respondent proposes to put in evidence, and the Tribunal shall send to the complainant a copy of each of any such statement or document.

    (6) Subject to paragraph (7), after the expiry of the period within which a respondent may submit a statement-in-answer the Tribunal shall fix a date and time at which the inquiry shall commence and the place where it will be held, and not less than 2 weeks before the date fixed shall inform the complainant and respondent of the date, time and place of the inquiry.

    (7) At any time before the inquiry commences, notwithstanding the provisions of paragraphs (3) or (6), the Tribunal may, on the application of the complainant, including a statement of grounds for the application, if it is satisfied that there are exceptional reasons to do so -

(a) fix a date and time at which an inquiry shall commence, and place where it will be heard, as soon as may be practicable; and

(b) give such opportunity to the respondent to submit a statement-in-answer and give such notice to the complainant and the respondent of the date, time and place of the inquiry as it considers just and proper to give the respondent an opportunity to appear before the Tribunal either -


(i) in person;

(ii) by counsel or solicitor; or

(iii) by such other representative referred to in regulation 16(1)(b)(iii) to (v), and



to be heard and to call witnesses and produce other evidence.

    (8) The Tribunal may, at any time before the conclusion of any inquiry, allow the complainant to amend the terms of the application upon such conditions as it may think fit.

    (9) The provisions of regulations 11 (power to postpone inquiry), 14 (failure to appear at inquiry), 16 (representations and evidence at inquiry), 17 (procedure at and provisions as to inquiry) and 18 (power to dispense with oral inquiry) shall have effect with respect to an inquiry held in relation to an application for interim suspension as they apply in relation to representations, as if -

(a) in regulation 14 "regulation 10 (notice of inquiry)" read "regulation 20(6) or (7); and

(b) in regulation 18 -


(i) in paragraph (1) -


(aa) "Subject to paragraph (2)," were omitted;

(bb) "representations are" read "an application for interim suspension is"; and

(cc) "representations" in the second place where it occurs read "application for interim suspension"; and



(ii) paragraph (2) were omitted.

(a) be made as set out in Form 5 and shall -


(i) contain a concise statement of the alleged facts and grounds upon which the applicant intends to rely; and

(ii) be signed by the applicant or on the applicant's behalf by some person authorised by the applicant;



(b) subject to paragraph (2), be accompanied by 2 copies of each document which the applicant proposes to put in evidence; and

(c) be sent together with the copies of each document relevant to it to the clerk to the Tribunal.

    (2) If a document which the applicant proposes to put in evidence is of a nature which renders it difficult to make or obtain a copy of it, the applicant shall not be required to submit copies of it.

    (3) If it appears to the Tribunal, after due consideration of an application, that no good cause has been shown why an inquiry should be held for the purposes of any review, it may refuse to hold an inquiry and shall inform the applicant of its refusal to hold an inquiry, and its reasons for that refusal in writing.

    (4) Where the Tribunal considers that an inquiry should be held, the clerk to the Tribunal shall send to the respondent and to any Board (not being the applicant or the respondent) which was represented at the inquiry following which the decision, in respect of which the application relates, was made -

(a) a notice as set out in Form 6 informing the respondent or the Board that an application has been made by the applicant and that the Tribunal considers that an inquiry should be held;

(b) one copy of the application and of each document, if any, which accompanied it; and

(c) information as to arrangements by which any document which the applicant proposes to put in evidence, but which the applicant is not required to submit copies of in accordance with paragraph (2), may be examined by the respondent and any such Board.

    (5) As soon as may be practicable after sending a copy of the application as referred to in paragraph (4), the Tribunal shall -

(a) fix a date and time at which an inquiry shall commence and the place where it will be held; and

(b) not less than 2 weeks before the date fixed for the inquiry to commence, send to -


(i) the applicant;

(ii) the respondent; and

(iii) any Board to whom a notice as set out in Form 6 has been sent pursuant to paragraph (4),



a notice as set out in Form 7 containing the information referred to in sub-paragraph (a).

    (6) Except where the application is made by a Board under paragraph 5(3)(b) or (c) of Schedule 11 to the Order, an applicant may at any time before the inquiry commences, with the consent of the Tribunal and on such terms as it thinks fit, withdraw the application by giving notice of withdrawal to the Tribunal and the Tribunal shall so inform the rest of the parties in writing.

    (7) Where the application is made by a Board under paragraph 5(3)(b) or (c) of the Schedu1e 11 to the Order the provisions of regulations 5 (power of the Tribunal to require further statement), 12 (power to treat representations as withdrawn in certain cases), 13 (withdrawal of representations), 18 (power to dispense with oral inquiry), 20 (applications for interim suspension) and 21 (statement by the Tribunal following an inquiry on interim suspension) shall have effect with respect to an application as they apply to representations as if -

(a) in regulation 5 -


(i) "complainant" read "applicant" in both places where it appears;

(ii) in paragraph (a) "representations are" read "application is";

(iii) in paragraph (b) "complainant's" read "applicant's" in both places where it appears; and

(iv) in paragraph (c) "representations" read "application";



(b) in regulation 12 -



(i) "complainant" read "applicant" in both places where it appears;

(ii) in paragraph (a) "regulation 10 (notice of inquiry)" read "regulation 22(5)"; and

(iii) "representations" read "application";



(c) in regulation 13 -



(i) in paragraph (1) "complainant" read "applicant";

(ii) in paragraphs (1) and (2) "representations" read "application";

(iii) in paragraph (3) -


(aa) "representations have" read "application has";

(bb) sub-paragraph (c) were omitted; and



(iv) paragraph (4) were omitted;



(d) in regulation 18 -



(i) in paragraph (1) -


(aa) "Subject to paragraph (2)," were omitted;

(bb) "representations are" read "an application is"; and

(cc) "representations" in the second place where it occurs read "application"; and



(ii) paragraph (2) were omitted;



(e) in regulation 20 -



(i) "complainant" read "applicant" at every place where it appears; and

(ii) the provisions referred to in paragraph (9) shall have effect as indicated but, additionally, as if "complainant" read "applicant"; and



(f) in regulation 21(2) "complainant" read "applicant".

    (8) The provisions of regulations 11 (power to postpone inquiry), 14 (failure to appear at inquiry), 16 (representation and evidence at inquiry) and 17 (procedure at and provisions as to inquiry) shall have effect with respect to an inquiry held in relation to an application as they apply to an inquiry held in relation to a representation as if -

(a) in regulation 11 "complainant" read "applicant";

(b) in regulation 14(1) "regulation 10 (notice of inquiry)" read "regulation 22(5)"; and

(c) in regulation 16 -


(i) in paragraph (1)(b), "complainant (not being a Board ) and the respondent" read "applicant and the respondent (other than an applicant or respondent which is a Board )"; and

(ii) in paragraphs (1)(b)(iii),(iv) and (2) "complainant" read "applicant".

(a) to attend at the time and place set forth in the notice, to give evidence or to produce any books or documents in that person's custody or under that person's control which relate to any matter in question at the inquiry; or

(b) to furnish within such reasonable period as is specified in the notice such information relating to any matter in question at the inquiry as the chairman of the Tribunal who presides over the inquiry may think fit, and as the person so required is able to furnish.

     5. The chairman of the Tribunal who presides over the inquiry may administer oaths and examine witnesses on oath, and may accept in lieu of evidence on oath by any person, a statement in writing by that person.

     6. Subject to the provisions of these Regulations, the Tribunal may adjourn from time to time as it thinks fit and hold adjourned sittings at such time and place as may appear to it to be suitable.

     7. A Board to whom notices as set out in Forms 3 and 4 are sent pursuant to regulations 7(2) and 10 (notice of inquiry), or to whom notice is sent pursuant to regulation 22(4) shall be entitled to take such part in the proceedings of the inquiry as the Tribunal shall think proper.

     8. The Tribunal may make orders as to the costs incurred by the parties appearing at any such inquiry and as to the parties by whom such costs shall be paid.

(a) the continued inclusion of the respondent in the list referred to would be prejudicial to the efficiency of services which those included in the list undertake to provide or are approved to assist in providing.

(b) the respondent has (whether on the respondent's own or together with another) by an act or omission caused, or risked causing, detriment to a health scheme by securing or trying to secure for the respondent or another a financial or other benefit, and knew that the respondent or (as the case may be) the other was not entitled to the benefit.

     2. The facts and grounds upon which the representations are based are as follows -

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (5)

     3. The documents of which 2 copies of each accompany this representation shall be produced in evidence in support of the representation (6).

Signed . . . . . . . . . . . . . . . . . Complainant

Dated . . . . . . . . . . . . . . . . .

Notes

    (1) State whether the respondent is a general medical practitioner, dentist, ophthalmic medical practitioner, optician, pharmacist or pharmacist contractor.

    (2) Delete whichever is inapplicable.

    (3) State whether the list is the medical, dental, ophthalmic or pharmaceutical.

    (4) Delete whichever of (a) or (b) is inapplicable (if either).

    (5) Paragraph 2 of the representation must contain a concise statement of the alleged facts and grounds upon which the complainer intends to rely.

    (6) If any document to be put in evidence is of a nature which renders it difficult to make or obtain a copy of it, you are not required to submit copies of any such document.

(a) a copy of representations that (5)


(i) your continued inclusion in the list referred to would be prejudicial to the efficiency of services which those included in the list undertake to provide or are approved to assist in providing;

(ii) you have (whether on your own or together with another) by an act or omission caused, or risked causing, detriment to a health scheme by securing or trying to secure for yourself or another a financial or other benefit and knew that you or (as the case may be) the other was not entitled to the benefit



which representation was submitted to the Tribunal by the complainant on . . . . . . . . . . . . . . . . . (6);

(b) a copy of each document which accompanied the representation (7).

     2. The Tribunal intends to hold an inquiry in relation to the representation and notice will be sent to you not less than 2 weeks before the date on which the inquiry will commence.

     3. You may, if you so desire, submit to me within 4 weeks from the date of receipt of this notice a written statement-in-answer and 2 copies of each document which you propose to put in evidence (8).

Signed . . . . . . . . . . . . . . . . .

Dated . . . . . . . . . . . . . . . . .

Notes

    (1) The full name of the respondent should be inserted.

    (2) State whether the respondent is a general medical practitioner, dentist, ophthalmic medical practitioner, optician, pharmacist or pharmacist contractor.

    (3) Delete whichever is inapplicable.

    (4) State whether the list is the medical, dental, ophthalmic or pharmaceutical.

    (5) Delete whichever of (i) or (ii) is inapplicable (if either).

    (6) State the date on which the representation was submitted.

    (7) The complainant may intend to put in evidence documents or material which it is difficult to make or obtain a copy of. If this is the case, the Tribunal will inform you accordingly.

    (8) If any document to be put in evidence is of a nature which renders it difficult to make or obtain a copy of it, you are not required to submit copies of any such document.

(a) the inclusion of the respondent in the list referred to would be prejudicial to the efficiency of services which those included in the list undertake to provide or are approved to assist in providing;

(b) the respondent has (whether on the respondent's own or together with another) by an act or omission caused, or risked causing, detriment to a health scheme by securing or trying to secure for the respondent or another a financial or other benefit, and knew that the respondent or (as the case may be) the other was not entitled to the benefit.

I enclose a copy of the representations and a copy of each document which accompanied them.

     2. The Tribunal intends to hold an inquiry in relation to the representations and notice will be sent to you not less than 2 weeks before the date on which the inquiry will commence.

     3. . . . . . . . . . . . . . . . . . Board, if they so desire, submit to me within 4 weeks from the date of receipt of this notice a written statement.

     4. If any documents are to be put in evidence in support of the statement, 2 copies of each such document must accompany the statement (6).

     5. . . . . . . . . . . . . . . . . . Board are entitled to be represented and take part in the proceedings at the inquiry as the Tribunal shall think proper.

Signed . . . . . . . . . . . . . . . . .

Dated . . . . . . . . . . . . . . . . .

Notes

    (1) State the name of the Board to which the notice is being sent.

    (2) State whether the respondent is a general medical practitioner, dentist, ophthalmic medical practitioner, optician, pharmacist or pharmacist contractor.

    (3) State whether the list is the medical, dental, ophthalmic or pharmaceutical.

    (4) State the name of each Board in whose list the respondent's name is included.

    (5) Delete whichever of (a) or (b) is inapplicable (if either).

    (6) If any document to be put in evidence is of a nature which renders it difficult to make or obtain a copy of it, the Board is not required to submit copies of any such document.

(2) State whether the respondent is a general medical practitioner, dentist, ophthalmic medical practitioner, optician, pharmacist or pharmacist contractor.

    (3) Delete whichever is inapplicable.

    (4) State whether the list is the medical, dental, ophthalmic or pharmaceutical.

    (5) Delete these words in a notice being sent to the respondent or, where applicable, any other Board.

    (6) Delete these words in a notice being sent to the complainant, or where applicable, any other Board.

    (7) Delete these words in notices being sent to the complainant and respondent.

(a) a copy of an application for a review under paragraph 5 (review etc. of disqualification) of Schedule 11 to the said Order of the decision of the Tribunal made on . . . . . . . . . . . . . . . . . (2) in respect of . . . . . . . . . . . . . . . . . (3).

(b) a copy of each document which accompanied the application(4).

     2. The Tribunal intends to hold an inquiry in relation to the application. A notice will be sent to you not less than 2 weeks before the date on which the inquiry will commence.

Signed . . . . . . . . . . . . . . . . .

Dated . . . . . . . . . . . . . . . . .

Notes

    (1) The full name of the respondent or, as the case may be, the appropriate Board should be inserted.

    (2) State the date on which the Tribunal made the relevant direction.

    (3) State the full name of the practitioner in respect of which the application relates.

    (4) The applicant may intend to put in evidence documents or material which it is difficult to make or obtain a copy of. If this is the case, the clerk to the Tribunal will inform you accordingly.

(a) regulation 4(2) prescribes the time within which representations that the second condition for disqualification is met and which relate to a practitioner who has applied to join a list, must be made;

(b) regulations 7(3) and 13(3)(c) make provision for notifying Health and Social Services Boards when a person is subject to an inquiry in a fraud case and when those representations are withdrawn; and

(c) regulation 15(1) provides that where it would be the duty of the Tribunal to inquire into both an efficiency case and a fraud case in respect of the same person it may inquire into one case before the other.

The other principal changes in Part III from the provisions of the 1995 Regulations are -

(a) regulation 4(4) prescribes that the time limit for submitting representations may be extended by the Tribunal, and confers on the Tribunal power to do so;

(b) regulations 7(1) and (2) and 9(4) and (6) require the Tribunal to give additional information to all parties about documents submitted to the Tribunal;

(c) regulation 14 makes provision for where any party which has received notice of an inquiry fails to appear at the inquiry;

(d) regulation 15(2) makes provision that inquiries before the Tribunal may not be adjourned solely because of an investigation into the same facts by the respondent's professional body;

(e) regulation 19(4) makes additional provision for the Department to publish decisions of the Tribunal by sending them to respondents' professional bodies.

Part IV of these Regulations make provision for, and for the determination of, procedure in relation to determining applications for interim suspension under the 1972 Order. The principal change from the 1995 Regulations is to make provision, in regulation 20(7), for the time limits for submitting a statement-in-answer and for notice of the date and time of an inquiry to be varied, provided that the respondent still has an opportunity to appear before the Tribunal and to be heard and call witnesses and produce other evidence.

Part V of these Regulations makes provision for inquiries for the purposes of a review under the 1972 Order. The principal change from the 1995 Regulations is to make provision, in regulation 22(7), for certain applications for review under the 1972 Order of a conditional disqualification by a Board.

Part VI of these Regulations consolidates various miscellaneous provisions in the 1995 Regulations. The principal change to those provisions as a result of the coming into operation of amendments made by the 2001 Act is provision, in regulation 24, for the purpose of securing that a person subject to an inquiry in a fraud case is not added to any list until proceedings in that case are finally concluded.

The other principal change in Part VI from the 1995 Regulations is to make provision for the Department, in certain circumstances, after notifying the practitioner and giving them an opportunity to make representations, to direct Boards to recover amounts from practitioners where there has been a decision of the Tribunal against that practitioner.

In Part VI also, regulation 30 makes transitional provisions and regulation 31 and Schedule 3 repeal the provisions of the 1995 Regulations and consequential amendments of those regulations.

Schedule 1 makes provisions for procedure at all inquires before the Tribunal.

Schedule 2 sets out the prescribed forms for use in proceedings in connection with representations and applications to the Tribunal.