asked the Minister for Health whether the Cork Health Authority is empowered to refuse applications for hearing aids from persons who are holders of medical cards and are certified in accordance with the regulations set out in the Health Acts.
Ceisteanna—Questions. Oral Answers. - Cork Health Authorities: Applications for Hearing Aids and Dental Services.
2.
As indicated in my replies to previous questions regarding the provisions of hearing aids for persons in the lower income group, an approved scheme, applying generally, for the supply of these appliances by health authorities, free of charge, to persons in this group has not yet been introduced.
The Cork Health Authority have, however, with my consent, supplied a limited number of hearing aids for children maintained in, or referred to, recognised institutions for the deaf where they are fitted with a suitable aid and are properly instructed in its use.
Pending the introduction of a properly organised general scheme for the supply and maintenance of hearing aids to persons in the lower income group, the provision of an aid for a person in that group would be approved in exceptional circumstances, for example where it was clear that the appliance was required by the applicant to enable him to obtain, or continue in, employment.
The organisation of a scheme for the supply of hearing aids, which will ensure that approved applicants will be provided at reasonable cost to health authorities not only with suitable aids but, scarcely less important, with the necessary maintenance service for these appliances, is a matter of some difficulty and requires very careful consideration before being approved for general adoption by health authorities. I am not yet in a position to say when such a scheme will be introduced.
Qualified insured persons, including such persons in the lower income group, may obtain financial assistance towards the cost of hearing aids under the Department of Social Welfare's scheme of treatment benefits.
Would the Minister indicate clearly who is responsible for making a decision as to whether an application for a hearing aid, certified by a medical officer, is in order or otherwise? Who actually makes the decision?
The country manager, or the city manager in this case.
That is not so.
The Minister then asserts that a layman, a county manager, is entitled to determine whether a medical certification is in order or otherwise?
The Deputy is starting a debate on the Minister's reply.
I am putting a question. Is it the law that a layman decides whether or not something prescribed by a medical officer is necessary for the applicant?
No. I think the position is that the medical officer certifies that a person needs a hearing aid but the county manager decides whether he should pay for it.
Am I to assume that a layman determines what is actually a medical question?
No, the financial question.
That is the Minister's answer.
No, it is not.
The Minister will hear more about it.
3.
asked the Minister for Health whether he is aware that applications made to the Cork Health Authority for dental services from persons who are properly certified and are holders of medical cards have been deferred for a number of years; and, if so, if he will indicate what action he proposes to take to ensure that the Authority in question will provide these services without undue delay.
I understand that, because of the limited funds available to it, the Cork Health Authority is not in a position to provide dental services for persons in the lower income group otherwise than on a restricted scale. In these circumstances, a waiting list is inevitable, but I am informed that the health authority intends to increase somewhat its expenditure on dental services for adults in the current financial year.
In fairness to the Cork Health Authority, I should point out that in accordance with the policy recommended to health authorities generally; because of the limited funds and dental personnel available, they are concentrating mainly on providing dental services for those who stand to benefit most from such services, namely children.
Will the Minister agree that it is mandatory on the Cork Health Authority to provide dental services for all people who are holders of medical cards?
I do not think so.
Does the Minister assert that the provisions of the Health Act do not warrant the provision of dental services for holders of medical cards who have the necessary certification? If that is the Minister's assertion, will he indicate more clearly where the division lies? Will he indicate what cases are to be approved and what cases, in his opinion, should not be approved?
The Health Act can be applied fully or not fully, as the case may be. The county manager must decide as between the classes if he has not either enough money or enough professional men at his disposal.
Does the Minister assert that the Health Act can be applied or not applied as the health authority decides? Does he assert that it is optional on the health authority?
The Deputy is starting an argument.
No; I am asking the Minister a question arising out of his reply.
No matter in what form the Deputy may phrase it, he is making an argument.
It is not an argument. I am entitled to ask the Supplementary Question.
I am the authority on that matter. The Deputy is debating the Minister's reply.
Is it correct to assume that it is optional for the health authority to provide dental services for applicants?
No.
If it is not, it is mandatory on the health authority to provide these services? Is that correct?
It is purely an argument.
It is a question.
The Minister for Social Welfare—Question No. 4.
You cannot lightly pass over these important questions, with all respect to your office.
I am the authority on how many Supplementary Question are to be allowed.
The possibility is that you may be abusing your authority.
That is for the House to decide.
As certain county managers have taken it upon themselves not to provide these services in full, would the Minister indicate the section in the Health Act which enables the county manager to exercise this alleged option?
When the Health Act was passed, many of the services were made mandatory immediately, while others were postponed. Some of them have, I understand, been brought in since. That is the position.
Is it not a fact that it is mandatory on all county managers to implement and operate the service to which Deputy M.P. Murphy refers?
I shall not answer that question now.
Is it correct that the dental benefits under the Health Act have not been in force except in so far as holders of medical cards are concerned?
That is true.