asked the Minister for Health if health boards are entitled to request or demand contributions towards the cost of orthopaedic appliances from persons with full eligibility under the Health Acts, when such appliances or aids have been recommended by a physician.
Ceisteanna—Questions. Oral Answers. - Orthopaedic Appliances.
9.
In the normal course, medical and surgical appliances are provided free to medical card holders. Requests are sometimes received for items which cannot readily be classed as medical or surgical appliances. In such cases health boards may seek a contribution towards the cost.
Would the Minister state if an orthopaedic bed or orthopaedic mattress is regarded as a surgical appliance? If it is recommended by a GP would the Eastern Health Board be required to provide it free of charge?
I am only aware of two incidents. One case is where a couple, who are medical card holders, sought an orthopaedic bed. It is open to question, in terms of definition under the Health Act whether an orthopaedic bed is an applicance, which is what we are obliged to supply free of charge — we are obliged to supply medical and surgical appliances — or whether it can be classified as furniture. In this instance the health board supplied the bed, which was an orthopaedic bed, at a cost of £400 and asked for a nominal contribution of £20 from the couple. The only other case I know of is that of a person in his twenties who made an application for an orthopaedic bed and, likewise, a contribution of £20 was sought. I am assured that in cases where major equipment, such as furniture items are supplied and there is no prospect of a nominal contribution the beds and all other such equipment are supplied free of charge.
Would the Minister agree that doctors are not in the habit of prescribing furniture for patients and if a doctor wants a patient to have a particular applicance he does so for particular medical reasons? Under the Health Act appliances of this kind are supplied free to persons with full eligibility. Therefore, the health boards who are looking for contributions of this kind are in breach of the Health Act.
I do not accept that. Orthopaedic beds are advertised in all furniture advertisements as furniture. Any person can buy an orthopaedic bed. Section 59 of the Health Act requires the health boards to supply drugs, medicines and medical and surgical appliances. In this instance the health board felt they should supply an orthopaedic bed. Only in two instances within the operation of the health board in the past 12 months were beds to the value of £400 each supplied. The question arose as to whether they were covered by the Health Act and the health board asked for a nominal contribution. I do not know if in fact the £20 was paid but I know they got the beds in both cases.
Does the Minister not consider that doctors are entitled to prescribe appliances of this kind in the medical interest of the patient and where a patient has full eligibility that the health board are obliged under the Act to supply such equipment free of charge? They have an obligation to do this.
There are many items which doctors would wish to prescribe, for example, a commode. A doctor may wish to see a patient supplied with one but this is not covered under the Health Act in terms of a medical or surgical appliance. Because a doctor issues a prescription under the GMS for such an item to be supplied it does not automatically mean that the health board are obliged on a statutory basis to supply it. I would make the point very strongly to the Deputy that the health boards, to my knowledge, supply a very wide range of appliances and equipment above and beyond what they might normally be expected to supply.