asked the Minister for Health whether he is aware that insured workers, their wives and dependents are being charged fees in certain cases by private doctors attending them in private or semi-private hospital wards; if he will make a statement in order to clarify the position; and if he will state the procedure necessary to ensure that an insured worker will not leave himself open to such charges.
Ceisteanna—Questions. Oral Answers. - Medical Treatment of Insured Workers.
8.
Where a patient (including) an insured person or his dependent) eligible to receive institutional services under the Health Acts, 1953 to 1957, elects to enter private or semi-private accommodation in an approved voluntary hospital the liability of the health authority concerned is limited to a subvention towards the cost of his maintenance in the hospital. The subvention does not include any payment in respect of the services of the visiting medical staff of the hospital, and the patient is liable for the payment of fees to the medical staff for their services. In addition the hospital authorities may recover from the patient the difference between the amount of the subvention and the amount of what would normally be the hospital bill excluding any fees chargeable by the visiting medical staff.
If a patient receiving services under the Acts elects to enter private or semi-private accommodation, where available, in a hospital conducted by a health authority he would be liable to the health authority for certain charges, namely, the charge he would have to bear if he were in a public ward plus an addition because he was in private or semi-private accommodation. In addition he would be liable for fees to a member of the medical staff if that member had the right to private beds in the hospital and he entered the hospital as the private patient of that member.
All that an eligible person has to do to ensure that he will not leave himself open to charges by the medical staff is to make it clear to the hospital authority when entering the hospital that the accommodation he wants is public ward accommodation or that he is not entering the hospital as the private patient of any member of the medical staff.
9.
asked the Minister for Health whether an insured worker, his wife and dependents are entitled to hospital treatment (subject to a maximum charge of 10/- per day), free X-ray service and free specialist treatment on payment of a fee of 2/6 at an approved clinic; if he will state the necessary steps to be taken by an insured worker in Limerick City to obtain such benefits; and whether in such cases all medical fees are covered, including those of the private doctor and specialist.
An insured worker, his wife and any other dependent in Limerick City who is eligible for services under Section 14 of the Health Act, 1953 (broadly, any person, who is covered by a medical card), is entitled as an in-patient to free hospital services in a public ward of any hospital in Limerick City or in the Limerick Regional Hospital, and as an out-patient to free X-ray services or other specialist services, as defined, at any of the clinics approved by the Limerick Corporation for such purposes. He must be referred for such services by a doctor, and, if that doctor in the local district medical officer, no fee is chargeable by the doctor, but if the doctor is not the local district medical officer, he may charge a fee. Otherwise no fee is payable by the insured person to any doctor.
Any other insured worker, his wife and any other dependent in Limerick City is entitled as an in-patient to hospital services in a public ward in any hospital to which he is sent by the health authority at a charge not exceeding 10/- a day or in a public ward of any other hospital of his choice at a charge of 10/- a day. As an out-patient, he is entitled to X-ray service at a charge of 7/6 and to other specialist services as defined at a charge of 2/6 at any of the clinics approved by Limerick Corporation for such purposes. As in the case of the insured worker who is covered by a medical card, he must be referred for any such services by a doctor who in this case may charge a fee. Again, as in the case of the insured worker covered by a medical card, he is not liable for payment of any fee to any other doctor.
The first step to be taken by a patient wishing to avail himself of these services is, therefore, to consult his family doctor and if institutional or specialist services are necessary he should obtain a reference to the appropriate hospital or clinic, where coincident with the commencement of investigation or treatment as appropriate, the necessary form of application for services under the Health Acts can be completed for submission by the institution concerned to the health authority. Any question of doubt or difficulty should be taken up with the Limerick Corporation.