A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

ProportionalityMonitor will ensure the action we take is proportionate and reasonable in the circumstances athand, and that we balance the need to deter harmful conduct with the need to ensure thecontinued provision of health care services to health care service users.Before imposing a requirement, Monitor therefore proposes to consider:the specific circumstances of the relevant provider;how any requirement is likely to affect the provider’s delivery of health care services; andIn particular, Monitor will consider the impact of a particular requirement on the provider’s futurefinancial viability. We propose to consider factors such as:the cost of the requirement to the provider;the provider’s current financial position;how much the provider has gained from the relevant breach;whether a requirement is likely to cause the provider financial hardship or distress thatcould:ooothreaten service continuity; orcause further harm to health care service users by reducing competition andchoice in the market; orany wider harm to health care service users that might arise from reducing theresources available to the provider in line with our main duty.3.4 Variable monetary penaltiesThis section sets out the factors which Monitor will consider when deciding on the appropriateamount of a variable monetary penalty.Variable monetary penalties may require a provider to pay a monetary penalty to Monitor whichMonitor must pay into the Government Consolidated Fund. The variable monetary penalty mustnot exceed 10% of the provider’s turnover in England. The Department of Health has publishedits intended definition of ‘turnover’ for these purposes, which is available here.Page 22 of 50