asked the Minister for Health if the wife of an insured worker or of a person self-employed whose income is under £800 per annum is entitled to free treatment ante- and post-natal from a doctor on the panel of the local authority and to free hospital treatment in an approved local authority hospital whether or not she possesses a medical card; what procedure is adopted for an applicant for such treatment; if he is is aware that many qualified persons have been charged fees by a doctor on the local authority panel and, also, in certain instances have had to pay hospital charges; and whether such persons are entitled to recover such payments.
Ceisteanna—Questions. Oral Answers. - Health Services: Wives of Qualified Persons.
10.
The answer to the first part of the question is in the affirmative, subject to the qualification that, where the patient is confined in hospital, maintenance and treatment is provided free of charge only in a public ward whether in a local authority hospital or in a voluntary hospital with which the local authority has made an arrangement.
In order to establish entitlement to these services, an expectant mother should apply to her local health authority either direct or through a doctor who has entered into an agreement with the health authority to provide maternity medical care for eligible women.
I am not aware that many qualified persons have been charged fees by a doctor on the local authority panel. Such doctors are precluded by the terms of their agreements from demanding or accepting fees for maternity care provided for eligible patients whom they have accepted for treatment under the scheme. Every expectant mother who wishes to obtain the services of a doctor under the scheme, should attend a doctor chosen by her from the local authority panel and should inform him that she wishes to become his patient, under the scheme. She should apply for the service on the appropriate form, form MCA, obtainable either from the doctor or the health authority. On this form she will state the grounds on which she claims entitlement to the service. Briefly these grounds are:
(a) that she is a person currently or until recently insured under the Social Welfare Acts or is a dependant of such a person; or
(b) that the family income is less than £800; or
(c) that she derives her livelihood wholly or mainly from farming, the rateable valuation of the farm not exceeding £50, or is a dependant of such a person; or
(d) that she is a person who, in the opinion of the health authority, would be unable without undue hardship to provide the service for herself.
These categories include, of course, persons who hold, or are covered by, medical cards.
On receipt of the application form, the local authority will decide whether or not she is eligible for the service and will notify her of its decision.
If the doctor accepts her as his patient, and if she is deemed eligible for the service by the health authority, the doctor cannot demand or accept any fee from her. Women seeking maternity services under the Health Acts should, therefore, in order to avoid misunderstandings, submit the completed application form, which gives the grounds for her entitlement to the service, to the doctor before forwarding it to the local authority and should obtain his endorsement on it that he is prepared to accept her as his patient. If the doctor is willing to accept her but the health authority does not regard her as eligible, the doctor can charge for his services. If the Deputy is aware of cases in which doctors on the panel demanded or accepted fees from women entitled to the service whom they had accepted for treatment, he should report the matter to the local authority concerned who, I am confident, will investigate the matter fully and take appropriate action.
As regards the position where an eligible patient is confined in hospital, I have already explained that entirely free maintenance and treatment is provided only in public ward accommodation. Where the patient elects for semi-private or private accommodation she becomes liable for payment of part of the cost of her maintenance in hospital, but is not liable for any payment to the doctor who has accepted her as his patient under the Health Authority Scheme. The question of the recovery of sums paid for services which should properly have been provided free of charge is, of course, a matter between the patient and the doctor in the first instance. Any reported case of wrongful charging would be investigated fully by the health authority, who have power to warn the doctor, or fine him, or to terminate their agreement with him.
Would the Minister indicate for how long that service has been in operation, apart from the change in the income level from £600 to £800?
I should require some notice of that question. I think the Deputy brought it in. I have not the exact date, but, at any rate, from the beginning.
Since April, 1956?
Yes.
Deputy O'Malley is only learning of it now.
Oh, no. That, I gather, is not the purpose of the question.