asked the Minister for Health if he is satisfied that the Cork Health Authority interpreted the health regulations correctly in asserting that it is optional for medical officers to visit medical card holders at their homes when so requested; and, if so, if he will make a detailed statement clarifying the position.
Ceisteanna—Questions. Oral Answers. - Visits to Medical Card Holders.
21.
I am informed by the Cork Health Authority that their interpretation of the Health (Duties of District Medical Officers) Order, 1954, was not as stated by the Deputy. I am also informed that the obligations of a district medical officer in regard to the provision of medical care for an eligible person were correctly explained at the meeting of the Western Committee of the Authority held on 10th May, 1966.
A district medical officer is obliged to provide adequate medical care and advice to an eligible person at a dispensary or elsewhere as the case may require. While it is mandatory on a district medical officer to provide adequate medical care it is for the medical officer, by exercising his professional judgement, to decide in individual cases the manner in which such care should be provided.
Thus, a district medical officer is obliged to visit a case at home, when requested, unless he is satisfied from his knowledge of the circumstances, that a domiciliary visit is not warranted.
Will the Minister not agree that in this particular case of an elderly lady, the medical officer visited her early in March and some five weeks later was requested to do so again and refused to do so? Is it in order for the medical officer so to refuse and will the Minister further state if in such cases it is mandatory on the medical officer to attend at the patient's home?
I said in the final paragraph of the reply that the medical officer is obliged to visit the patient at home, unless he is satisfied from his knowledge of the circumstances that a domiciliary visit is not warranted. There may have been circumstances which satisfied him.
Am I to assume that the health authority was correct in asserting that it is only optional for the medical officer to visit medical card holders at their homes? Is the Minister satisfied that the medical officer, having seen this woman five weeks earlier than the second request, could say that she needed no further treatment at her home?
From the reply given, it would appear that it is not correct to say it is optional. The doctor must have professional reasons for refusing.
Is the Minister satisfied that the reasons are valid in this particular case? There is a big principle involved here, as the Minister will agree, that would change the whole conception of these regulations. Will the Minister not agree that it is the belief of all the people in the State that dispensary doctors must visit medical card holders on request at their homes when obliged to do so? If the Minister agrees in this case that the medical officer was correct, then the Minister is agreeing that it is only optional. That is the point I want to get out by this question.
The duties of the medical officer are clearly set out in paragraph 2 (b) of the Health (Duties of District Medical Officers) Order, 1954 as "to afford adequate medical care and advice at a dispensary or elsewhere as the case may require to any person resident in the dispensary district whose name is entered in the General Medical Services Register and to the dependants of such person and to any person by whom or on whose behalf there is presented to him a direction given pursuant to Article 16 of the General Medical Services Regulations, 1954." I understand there is also a warning or instruction on the medical card that it is not to be abused, that people should not use it otherwise than if they were paying for the service. It is a matter of reason.
Will the Minister say whether the doctor was justified or otherwise in refusing this particular case? The circumstances were that after a period of five weeks he was requested to visit this woman of 86 who was bedridden. How did he assert that there was no medical reason to visit this woman having regard to the fact that he had not seen her for five weeks?
I would not reply to that——
Is the Minister saying this was adequate medical care? If the Minister says she got adequate medical care, I think it is time to change the regulations. That is the purpose of putting down this question. If this old woman got adequate medical care, we must review the regulations and change the position.
The question addressed to the Minister merely asked what the doctor is obliged to do and in what circumstances he may do other things.
Seeing that the Minister is not here, I do not think I shall raise this on the Adjournment but will the Minister say from the brief he has with him whether it is optional and whether the local authority are correct in saying it is optional for the medical officer to refuse?
The Deputy asked that question before.
I want to know if it is optional. I want a "yes" or "no" answer to that.
There is no "yes" or "no" answer to that question. I am not giving a "yes" or "no" answer to that on behalf of the Minister.
(Interruptions.)
The reply very adequately set out the circumstances in which the medical officer may refuse, if he is for professional reasons satisfied that the case does not warrant a domiciliary visit. The question whether this case did or did not is a different question.
(Interruptions.)
Does the doctor have to justify himself to the Minister for Health?
He is immediately responsible to the local authority.
Does he have to justify himself to the Minister for Health? Is that not what Deputy Murphy is asking?
No; what Deputy Murphy is asking is whether it is optional or not and he infers, or the question conveys, that the health authority held that it was optional. The reply denies that was conveyed.
(Interruptions.)