asked the Minister for Health whether there has been any change in the maternal mortality or infant mortality rates since the introduction of the Maternity Benefit Scheme; what are the required qualifications and experience for doctors who give service under the Scheme; what are the regulations regarding ante-natal visiting and examination by the doctors; how many visits by the doctor are necessary; and when they should be carried out.
Ceisteanna—Questions. Oral Answers. - Maternity Benefit Scheme.
7.
I presume that the Deputy is referring to the general medical care service for mothers and infants provided for the lower income group under the Maternity and Child Health Services Regulations, 1954, which came into operation on 1st August, 1954, and which was extended to the middle income group under amending Regulations which came into operation on 31st March, 1956.
The maternal mortality rate, that is the number of maternal deaths expressed as a proportion of every 100,000 births registered, from 1956 to 1960 has been as follows:
|
Year |
1956 |
1957 |
1958 |
1959 |
1960 |
|
Maternal Death Rate |
86 |
132 |
103 |
66 |
58 |
The infant mortality rate (that is the deaths of infants in the 0-1 year age group expressed as a proportion of every 1,000 births registered in the same year) from 1956 to 1960 has been as follows:
|
Year |
1956 |
1957 |
1958 |
1959 |
1960 |
|
Infant Mortality Rate |
36 |
33 |
35 |
32 |
29 |
Under the Regulations, a health authority is empowered to enter into an agreement for the provision of medical care for mothers and infants with any registered medical practitioner (whether resident in the functional area of the health authority or not) unless:
(a) the medical practitioner is employed in a wholetime capacity in the service of the State or of a local authority, or
(b) by reason of previous breaches by him of an agreement with the health authority or any other health authority, the health authority consider that it is not desirable to enter into an agreement with the medical practitioner.
The terms and conditions of agreement between a registered medical practitioner and a health authority require that the doctor shall, in respect of each eligible woman accepted by him for maternity care, provide such services as can appropriately be given by him and as he considers desirable in respect of motherhood; and in particular that he shall provide such of the following services as are appropriate in respect of each such woman:
Initial examination (to be carried out, where possible, not later than the sixth month of pregnancy); an examination where possible in each of the last three months of pregnancy; such other examinations and ante-natal care as the medical practitioner considers necessary; attendance at the confinement (if the medical practitioner considers it necessary or if his services are called for by a midwife attending on the patient); attendance on at least one occasion in the week following the delivery; an examination (including a pelvic examination if thought necessary) at or about the end of the sixth week after the delivery; such other examinations and post-natal care within the period of six weeks after the delivery as the medical practitioner considers necessary; the taking of any specimens required for investigation.
A doctor providing domiciliary attendance is empowered by the regulations to summon, on his own authority, the assistance of another registered medical practitioner. A doctor may also, if he deems it necessary, recommend a patient for specialist services and may refer a patient for institutional treatment.