asked the Minister for Health if he will state the precise steps to be staken by an insured worker who contemplates entering the public ward of an approved hospital to ensure that he will obtain the maximum benefit at the lowest outlay; whether such worker can engage his own private doctor where the latter has beds available in the approved hospital; whether the services of such doctor are provided free; what steps the worker should take to ensure that he will not be charged fees by such doctor; whether he is aware that fees have been charged by doctors to insured workers; and whether he will make an Order for a refund of such fees in cases brought to his notice.
Ceisteanna—Questions. Oral Answers. - Treatment of Insured Workers.
An insured worker who desires to obtain institutional services is required to complete a form of application for such services, and, except in a case of urgency, to furnish medical evidence of the need for the services. The forms are available at the office of health authorities and at hospitals in which the services are provided, and detailed information on the services available in any particular area should be obtained from the appropriate health authority.
If the patient, or some other person on his behalf, makes it clear to the hospital authority that he desires to be accommodated in a public ward, no question of payment of a fee to any member of the medical staff of the hospital for his services as such can arise. Neither is the hospital entitled to make any charge in excess of 10/- per day in respect of maintenance and treatment. The hospital authority, or any other authority, is not entitled to make any charge if the patient is regarded as entitled to services under Section 14 of the Health Act, 1953, as a person in the lower income group.
So far as I am aware a patient in a public ward of a voluntary hospital is attended by such members of the medical staff as are assigned to him by the hospital authorities in the normal course of administration of the hospital. A patient receiving treatment in a public ward of a local authority hospital under the provisions of the Health Acts is attended by the appropriate members of the medical staff of the health authority. In neither case is the hospital doctor acting as the private doctor of the patient. He is acting as a doctor of the hospital, receiving payment by way of salary or under other arrangements, for his services in the hospital and is not entitled to charge the patient any fee for such services.
As I indicated on 15th instant in reply to a question by the Deputy, I am not aware that, in general, the medical staffs of hospitals have charged and are charging fees to patients who are not properly liable for such charges, but, if the Deputy will furnish me with particulars of specific cases in which it is contended that fees have been charged irregularly, I shall have them investigated.
There are no statutory provisions under which an Order could be made by the Minister for Health regarding the refund of fees irregularly obtained by medical practitioners in the circumstances mentioned, but in the case of an irregular charge by a medical officer in a local authority hospital, the local authority can require the medical officer to refund the amount of the fee and, in the case of an irregular charge by a medical officer in a voluntary hospital, that hospital has the duty, in accordance with its agreement with the health authority, to secure the refund to the patient of the fee.
If there is a patient who wishes to go into a public ward and there is no bed available in a public ward, is it right to charge that patient the fee which a private patient would be charged?
That is a very general question; it would depend entirely on the circumstances. There are in public authority hospitals what are regarded as private beds under the control of the county surgeon or county physician as the case may be, but these beds are provided only on the understanding that no public patient is excluded when a bed has to be found.