asked the Minister for Health if he will state what qualifications are stipulated in regulations or draft regulations to local authorities so that a mother may obtain the maternity grant of £4.
Ceisteanna—Questions. Oral Answers. - Qualifications for Maternity Grant.
Since the coming into operation of Section 23 of the Health Act, 1953, on the 1st January, 1954, and the Maternity Cash Grant Regulations, 1953, made thereunder, a cash grant of £4 in respect of each confinement is payable to a woman in the lower income group, i.e., broadly speaking, persons who are entitled to be attended free of charge by a dispensary doctor during illness. The grant is payable irrespective of whether the woman is attended by any doctor during confinement. The woman must apply in writing for the grant within three months after her confinement to the appropriate local authority and produce evidence that the confinement took place.
The grant is not payable to a woman who is maintained in an institution after confinement (otherwise than for the purpose of medical or surgical treatment) at the expense of the local authority.
The maternity cash grant is distinct from, and additional to, any maternity benefit to which an insured woman or wife of an insured man may be entitled under the Social Welfare Act, 1952.
Do I understand from the Minister's reply that those persons will only qualify who would be in the same category as those formerly known as red ticket cases?
Yes, that is correct.
Would the Minister say to whom application should be made by the woman?
To the secretary of the local authority.
Is it the function of the local authority, therefore, to inquire into the woman's circumstances before making the grant?
She will write to the secretary for a form of application which she will fill in and send back. I presume that if the local authority had any doubts they would make inquiries.
May I take it that this grant is only paid to people in the lower income groups——
Yes.
——and will not apply to those who would be in the insured persons' category or the middle income group?
Not all insured people. Many insured people belong to the lower income group. They have always claimed to belong to it and they still belong to it.
Do I understand, the grant would not be payable in the case of any woman in an institution?
If she is being treated in the institution for confinement or subsequently for surgical or medical treatment she will get it. Exception is only where a person is kept in an institution all the time.
Are all those in the middle income group included or can the grant be applied to all people who would ordinarily be eligible for dispensary treatment?
That is right. That is the lower income group.
People in the middle income group would be eligible?
No, there is a lower income group in that case. There are insured people in the lower income group.
Could I ask the Minister if the mother can make application before her confinement?
If she wishes she may apply for the application form.
Further there is a certain amount of confusion in some mothers' minds in regard to the £4— this is the mother and child scheme— that the £4 is to be paid to the midwife or to the doctor. Could the Minister make the position clear in this connection?
The woman who receives this is entitled absolutely to free medical and midwife treatment; therefore, the doctor or midwife has no right to ask for this money.
Is it possible for the Minister, in order to clarify the situation surrounding the issue of this circular, to set out the definite categories of persons who are entitled to this benefit and those who are not? I am quite sure that Deputies on the Minister's benches are getting as many letters on this subject as Deputies on other benches.
Yes.
This implies a kind of means test. Could the Minister tell us who will determine when a particular patient qualifies? Who will determine on the patient's means?
On the means test?
Yes.
The local authority. If we were in a position to proceed with the new cards we have in mind, then a person could apply for the card and in that way his case would be determined whether he was in the lower income group or not. But in the meantime the local authority decides.
The home assistance officer?
It would be on his report.
Would the Minister say whether it is possible for him to issue a statement to explain the particular categories who would be entitled to this maternity benefit under the Health Act?
That would be possible but what the Deputy has asked me for in this question is a booklet giving precise information and it will not be possible to do that until all the regulations are agreed and issued. It is only then we will know the precise information for which the Deputy asks. Deputy Norton puts the point as to how you would define a person in the lower income group. That can only be decided when the cards are issued and the people apply for them.
In the meantime and pending that further clarification when the card is available would the Minister now indicate particularly those who will be entitled to the maternity benefit?
Legally where a person declares that he cannot, out of his own resources, pay for his medical expenses and where the local authority agrees with that, that is the lower income group.
Would it be a good rule to say those people who would ordinarily be eligible for dispensary treatment whether in the lower or the middle income group?
Exactly. Those who are entitled to free dispensary treatment— and that is the definition I have just given—those who are not out of their own means able to defray medical expenses.
It is not whether the person himself thinks he is in a position to pay; it is the local authority who will say who is in a position to pay. It is what the local authority says he should pay.
You could not leave it altogether to the person to decide.
We have the means test here with a vengeance.
Will the Minister say whether he has issued a series of circular instructions to the various authorities who would normally have the administration of the Health Act and, if so, whether he would place a set of these instructions in the Library so that Deputies might consult them and find out some of the information for which they have been asking?
The Department of Health has issued tentative regulations to all people concerned such as voluntary hospitals, medical officers, nursing organisations, and so on, for their comments. When these comments are received the regulations will be framed.
Would the Minister see any serious objection to putting copies of these tentative instructions, in so far as they are addressed to public authorities, in the Library?
I do not know.
Will the Minister say if he has issued definite instructions or if he has circularised the responsible public authorities?
Yes.
And could the Minister put these instructions in the Library?
I would have to consider that.