asked the Minister for Health if it is obligatory on a local health authority to pay for health services provided in extern institutions to people who have not been referred to such institutions by local authority medical officers.
Ceisteanna—Questions. Oral Answers. - Health Services in Extern Institutions.
15.
The obligation on health authorities to pay the full approved charge for eligible patients receiving treatment in extern institutions is limited to patients sent in by them or with their prior approval, although in certain areas, e.g., in Dublin where, because of the special circumstances that the health authority is in a position to provide facilities in its own institutions for only a minority of the patients requiring hospital treatment, patients who enter extern hospitals are deemed for payment purposes to have been sent in by the health authority.
Save in the areas where the special arrangement mentioned applies, eligible patients who enter extern hospitals without the prior consent of their health authority are covered by Section 25 of the Health Act, 1953.
In such cases, where an eligible patient accepts treatment in a public ward in an approved extern hospital, his personal liability to the hospital is 10/- a day in respect of all treatment given, including doctors' fees; the health authority being obliged to pay a subvention to the hospital covering the balance of the cost of the patient's maintenance and treatment and the fees of the hospital's medical staff concerned. Where, however, the patient, instead of availing of treatment in a public ward, opts to be treated in private or semi-private accommodation —and this applies also to approved nursing homes—the health authority pays a subvention of 8/- a day to the hospital or home plus, in cases where they arise, a part contribution towards the cost of expensive drugs and medicines and of blood transfusions, and the patient is liable for the balance of the charge levied by the hospital or home and for any medical fees in addition.
I understand that all health authorities have taken reasonable steps by means of advertisements in the public press; by leaflets; and by circular letters to medical practitioners practising in their areas to explain what health services are available; how they may be obtained and the financial implications of exercising a choice of institution or of accommodation.
Will the Minister say if the regulation which he has read out applies to those who are sent in to extern institutions by doctors other than dispensary doctors or local authority doctors in emergency cases?
I think so, provided they go into a public ward and do not seek private or semi-private accommodation.
In that case, they do not have to pay.
The local authority is responsible but the patient has to pay 10/-.
A maximum of 10/-.
It all depends on whether the institution is one approved by the medical authority in accordance with Sections 14 and 15.