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26 1953

HEALTH ACT, 1953

PART III.

Health Services.

General medical services.

14. —(1) A health authority shall, in accordance with regulations, make available, without charge, for the persons specified in subsection (2) of this section, and their dependants, a general practitioner medical and surgical service, medicines, ophthalmic, dental and aural treatment and medical, surgical and dental appliances.

(2) The persons referred to in subsection (1) of this section are persons who are unable to provide by their own industry or other lawful means the medical, surgical, ophthalmic, dental or aural treatment, or medicines, or medical, surgical or dental appliances necessary for themselves or their dependants.

Institutional and specialist services.

15. —(1) A health authority shall, in accordance with regulations, make available institutional and specialist services for the persons specified in subsection (2) of this section.

(2) The persons referred to in subsection (1) of this section are the following persons and their dependants:

(a) persons insured under the Social Welfare Act, 1952 (No. 11 of 1952),

(b) adult persons whose yearly means are less than six hundred pounds,

(c) adult persons whose yearly means are, in the opinion of the health authority, derived wholly or mainly from farming, the rateable valuation of the farm or farms (including the buildings thereon) being fifty pounds or less,

(d) persons not specified in the foregoing paragraphs who, in the opinion of the health authority, would be unable, without undue hardship, to provide institutional and specialist services for themselves or their dependants.

(3) Institutional services under subsection (1) of this section shall be made available without charge for the persons specified in subsection (2) of section 14 of this Act and to such other persons specified in subsection (2) of this section as may be determined by the health authority.

(4) Where institutional services are made available under subsection (1) of this section, in cases not governed by subsection (3) of this section, there shall be charged such charges, not exceeding six shillings for each day during which institutional services are availed of, as may be determined by the health authority, save in such cases (being cases of persons specified in paragraph (d) of subsection (2) of this section or dependants of such persons) as may be specified by regulations made by the Minister with the consent of the Minister for Finance and, in those cases, there shall be charged the charges approved of or directed by the Minister towards the cost of the services.

(5) Specialist services under subsection (1) of this section shall be made available without charge.

(6) In paragraph (b) and paragraph (c) of subsection (2) of this section, the reference to yearly means includes, in addition to the yearly means of the person in question—

(a) the yearly means of the spouse (if any) of such person, where the spouse is resident with such person, and

(b) the yearly means of any unmarried son or daughter of

(i) such person, or

(ii) the spouse (if any) of such person, or

(iii) any deceased spouse of such person,

where the son or daughter is normally resident with such person.

(7) A health authority shall, in accordance with regulations, make available, without charge, institutional and specialist services for pupils of national schools in respect of defects discovered at school health examinations.

(8) Yearly means shall be calculated for the purposes of this section in accordance with Rule 1 of the Rules contained in the Seventh Schedule to the Social Welfare Act, 1952 .

(9) Where a decision taken in pursuance of paragraph (b) of subsection (2) of this section is a decision that the yearly means of the adult person are not less than six hundred pounds, an appeal shall lie from the decision to a person appointed by the Minister, and regulations may make provision with respect to the making and determination of appeals under this subsection.

(10) For the purposes of this section, specialist services shall not include ophthalmic or aural services and services provided otherwise than in a hospital, convalescent home or home for persons suffering from physical or mental disability shall not be institutional services.

Medical care for mothers.

16. —(1) A health authority shall, in accordance with regulations, make available, without charge, medical, surgical, midwifery, hospital and specialist services for attendance to the health of women (being women specified in subsection (2) of this section) in respect of motherhood.

(2) The women referred to in subsection (1) of this section are:

(a) women who are in, or who are dependants of persons in, any of the classes mentioned in subsection (2) of section 15 of this Act,

(b) women by or on behalf of whom such contributions as may be required by regulations have been made towards the cost of the services under this section.

(3) The regulations referred to in paragraph (b) of subsection (2) of this section—

(a) shall provide that contributions shall be at the rate of the appropriate amount for each year (not being a year before marriage) in respect of which a contribution is payable, and

(b) may require the making of different numbers of contributions in different circumstances, provided that advance payments of contributions (other than current contributions) shall not be required, and

(c) shall provide that, subject to the provisions pursuant to paragraph (d) of this subsection, the appropriate amount referred to in paragraph (a) of this subsection shall be one pound, and

(d) shall provide that the appropriate amount referred to in paragraph (a) of this subsection shall, for each successive period of five years (the first of such periods being the period of five years beginning on the day after the expiration of three years from the commencement of this section or such later day as the Minister may determine to be the earliest practicable day for the beginning of the first of such periods), be—

(i) for persons other than persons who had paid a contribution in respect of the year immediately preceding such period, either—

(I) such amount as may be fixed by the Minister for that period as the amount which will result in obtaining by contributions approximately one-half of the estimated cost, as determined by the Minister, during such period of the provision of the services for women by or on behalf of whom contributions at the rate fixed under this clause of this subparagraph are paid, or

(II) two pounds,

whichever is the less, and

(ii) for persons who had paid a contribution in respect of the year immediately preceding such period, the amount payable by that person for that year or the amount fixed by the Minister as aforesaid, whichever is the less.

(4) Regulations shall provide that any woman entitled to receive medical services under this section may receive them from such registered medical practitioner who has entered into an agreement with the health authority for the provision of those services and who is willing to accept her as a patient as she may choose.

(5) Where a woman avails of services under this section for a confinement taking place otherwise than in a hospital or maternity home, the health authority shall make available, without charge, obstetrical requisites to such extent as may be specified by regulations.

Infant welfare services.

17. —(1) A health authority shall, in accordance with regulations, make available, without charge, medical, surgical, hospital, specialist and nursing services for children up to the age of six weeks whose mothers are entitled to avail themselves of the services under section 16 of this Act.

(2) Regulations shall provide that medical services under this section shall be made available for a child by such registered medical practitioner who has entered into an agreement with the health authority for the provision of those services and who is willing to accept the child as a patient as the parent of the child may choose.

Child welfare services.

18. —A health authority shall, in accordance with regulations, make available, without charge, at clinics, health centres or similar institutions, medical, surgical and nursing services for children under the age of six years.

School health examination and treatment service.

19. —(1) A health authority shall, in accordance with regulations, make available, without charge, a health examination and treatment service for the pupils attending schools to which this section applies.

(2) This section applies to every school which is—

(a) a national school or

(b) a school to which an order under subsection (3) of this section applies.

(3) Where a health authority are not satisfied that an adequate health examination service is available for the pupils attending a school in their functional area which provides elementary education and is not a national school, the health authority may by order direct that this section shall apply to the school.

(4) Nothing in this section shall be construed as authorising a health authority to provide any general domiciliary service or any services such as are mentioned in section 15 or section 20 of this Act.

Dental, ophthalmic and aural services, for children.

20. —A health authority shall, in accordance with regulations, make available dental, ophthalmic and aural treatment and dental, optical and aural appliances—

(a) for pupils of national schools, in respect of defects discovered at school health examinations, and

(b) for children under six years of age attending clinics, health centres or similar institutions, in respect of defects discovered at such clinics, centres or institutions,

and the treatment and appliances shall be made available without charge, save that where any dental, optical or aural appliance is supplied as a replacement and the health authority are not satisfied that the replacement has become necessary otherwise than as a result of negligence, such charge may be made for the appliance as may be approved of or directed by the Minister.

Dental, ophthalmic and aural services for middle income group.

21. —A health authority shall, in accordance with regulations, make available, either, as may be specified in the regulations, without charge or at charges approved of or directed by the Minister, dental, ophthalmic and aural treatment and dental, optical and aural appliances for the persons (including dependants) specified in paragraphs (a), (b) and (c) of subsection (2) of section 15 of this Act (exclusive of the persons specified in sections 14 and 20 of this Act).

Regulations in relation to services.

22. —(1) The Minister may make regulations applicable to every health authority, every health authority of a particular class or a particular health authority as to the manner in which and the extent to which they are to make available the services specified in sections 14 to 21 of this Act and generally in relation to the administration of such services.

(2) References in sections 14 to 21 of this Act to regulations are to regulations under this section.

Maternity cash grants.

23. —(1) A health authority shall pay to a woman—

(a) who is entitled to the services made available by the health authority under section 14 of this Act, and

(b) whom it is not proposed to maintain in an institution after confinement (otherwise than for the purposes of medical or surgical treatment) by or at the expense of the health authority, and

(c) who fulfils the prescribed conditions,

a cash grant of four pounds in respect of each confinement.

(2) In this section “confinement” means labour resulting in the issue of a living child, or labour after twenty-eight weeks of pregnancy resulting in the issue of a child whether alive or dead.

(3) In deciding whether or not he shall make an order under the Illegitimate Children (Affiliation Orders) Act, 1930 (No. 17 of 1930), for the payment of the expenses incidental to the birth of a child, the Justice shall not take into consideration the fact that the mother of the child is entitled to a cash grant under this section.

Milk for mothers and children.

24. —(1) A health authority may, subject to the prescribed conditions, make arrangements for the supply of milk to expectant and nursing mothers who are entitled to the services made available by the health authority under section 14 of this Act and to children to whom this section applies.

(2) In this section “children to whom this section applies” means children under five years of age whose parents are unable from their own resources to provide such children with an adequate supply of milk.

(3) The references in subsections (1) and (2) of this section to milk shall be construed as including references to such foods derived wholly or mainly from milk as may from time to time be approved of by the Minister.

Institutional services at choice of patient, etc.

25. —(1) A person entitled, having regard to regulations under section 22 of this Act, to avail himself of institutional services under section 15 or section 16 of this Act, or the parent of a child entitled, having regard to regulations under section 22 of this Act, to allow the child to avail of the services under section 15 or section 17 of this Act, may, if he so desires, in lieu of accepting services made available by the health authority, arrange for the like services being made available for him or for the child (as the case may be)—

(a) in any hospital approved of by the Minister for the purposes of this section, or

(b) in any nursing home or maternity home approved of by the Minister for the purposes of this section,

and where a person so arranges, the health authority shall, in accordance with such regulations as may be made by the Minister, make, in respect of the services made available, a payment as provided for in this section.

(2) Where institutional services are made available in pursuance of subsection (1) of this section otherwise than in a private or semi-private ward in any institution (not being a health institution) with which the health authority have made an arrangement under section 10 of this Act, the payment to be made by the health authority to the institution in respect of the institutional services shall be equivalent to the payment which would be made to the institution pursuant to the said arrangement, less a sum of six shillings for each day during which the services are availed of.

(3) Where institutional services are made available in pursuance of subsection (1) of this section, otherwise than in a private or semi-private ward in any institution (not being a health institution) with which the health authority have not made an arrangement under section 10 of this Act, the payment to be made by the health authority to the institution in respect of the institutional services shall be equivalent to the payment normally made by the health authority for similar services made available in an institution (otherwise than in a private or semi-private ward) with which the health authority have made an arrangement under section 10 of this Act, less a sum of six shillings for each day during which the services are availed of.

(4) Where institutional services are made available in pursuance of subsection (1) of this section in a private or semi-private ward in any institution (not being a health institution) with which the health authority have made an arrangement under section 10 of this Act, the following provisions shall have effect:

(a) the payment to be made by the health authority to the institution in respect of the institutional services shall be equivalent to the payment which would be made to the institution in accordance with the said arrangement for services otherwise than in private or semi-private wards, less a sum of six shillings for each day during which the services are availed of,

(b) nothing in this Act or any regulations made thereunder shall be construed as restricting the amount of any charge which the institution may make on the person availing of the services.

(5) Where institutional services are made available in pursuance of subsection (1) of this section in a private or semi-private ward in any institution (not being a health institution) with which the health authority have not made an arrangement under section 10 of this Act, the following provisions shall have effect:

(a) the payment to be made by the health authority to the institution in respect of the institutional services shall be equivalent to the payment normally made by the health authority for similar services made available (otherwise than in a private or semi-private ward) in an institution with which the health authority have made an arrangement under section 10 of this Act, less a sum of six shillings for each day during which the services are availed of,

(b) nothing in this Act or any regulations made thereunder shall be construed as restricting the amount of any charge which the institution may make on the person availing of the services.

(6) Where institutional services are made available in pursuance of subsection (1) of this section in a nursing home or a maternity home, the following provisions shall have effect:

(a) the payment to be made by the health authority to the home in respect of the institutional services shall be equivalent to the payment normally made by the health authority for similar services made available (otherwise than in a private or semi-private ward) in a hospital with which the health authority have made an arrangement under section 10 of this Act, less a sum of six shillings for each day during which the services are availed of, and unless the health authority otherwise determine, shall be limited to payment in respect of a period of six weeks in the case of a nursing home or two weeks in the case of a maternity home,

(b) nothing in this Act or any regulations made thereunder shall be construed as restricting the amount of any charge which the institution may make on the person availing of the services.

(7) Where institutional services are made available under section 15 , section 16 or section 17 of this Act in a private or semi-private ward in a health institution on request made by or on behalf of the patient, there shall be charged therefor, in addition to any charge under subsection (4) of section 15 of this Act, a sum equivalent to the difference between—

(a) the charge approved of or directed by the Minister under section 26 of this Act for such services in a private or semi-private ward (as the case may be) in that institution, and

(b) the charge approved of or directed by the Minister under section 26 of this Act for such services in that institution otherwise than in a private or semi-private ward.

Institutional services for persons not entitled to services under section 15.

26. —(1) A health authority may make available institutional services for such persons as are not entitled to services under section 15 of this Act and they shall charge for any institutional services so made available the charges approved of or directed by the Minister.

(2) Except in cases of urgent necessity, institutional services (other than institutional services in special accommodation designated by the health authority with the consent of the Minister) shall not be provided under this section for a person unless there is accommodation available which, at the time of such person's admission, is not required for a person entitled to services under section 15 of this Act.

(3) A health authority may, with the consent of the Minister, make rules governing the provision of institutional services under this section and such rules may, in particular, contain provisions governing the making and amounts of payments to officers of the health authority in respect of any service or treatment given by them to persons who avail themselves of the institutional services.

(4) An officer of a health authority providing institutional services shall not demand or take from any person availing himself of such services (or from any other person on behalf of such person) any payment in respect of the services given to such person, not being a payment demanded or taken on behalf of the health authority, unless the taking of the payment by the officer is expressly authorised by rules made under this section or by the terms of his appointment.

(5) Regulations made under section 37 of the Public Assistance Act, 1939 , and in force immediately before the commencement of this section shall be deemed to be rules made under this section.

(6) Nothing in this section shall affect the operation of section 14 or sections 16 to 21 of this Act or of section 31 of the Principal Act or any regulations under that section.

Declaration as to means.

27. —For the purpose of determining whether a person is or is not entitled to any service provided by them under this Part of this Act, a health authority may require that person to make a declaration in such form as they consider appropriate in relation to his means and may take such steps as they think fit to verify the declaration.

Notification of change of circumstances.

28. —(1) Where a person is recorded for the purposes of this section by a health authority as entitled on account of specified circumstances to a service provided by the health authority under this Part of this Act, he shall notify the health authority of any change in those circumstances such as renders him no longer entitled to the service.

(2) Where a person knowingly contravenes subsection (1) of this section, he shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding twenty pounds.

Determination of doubt as to responsible health authority.

29. —The Minister shall decide, in any case of doubt or dispute with respect to a particular person or persons of a particular class, which health authority is to be responsible for the provision for such person or persons of such class (where appropriate) of any service under the Principal Act or this Act.

Charge where person not entitled obtains service.

30. —Where—

(a) a person has availed himself of a service provided under this Part of this Act, and

(b) it is ascertained that he was not entitled to the service,

the health authority may charge for the service the charge approved of or directed by the Minister.

Recovery of charges.

31. —Any charge which may be made by a health authority pursuant to this Part of this Act or the regulations thereunder may, in default of payment, be recovered as a simple contract debt in any court of competent jurisdiction from—

(a) the person in respect of whom the charge is made or, in case such person has died, his legal personal representative, or

(b) any other person liable to maintain such person for the purposes of the Public Assistance Act, 1939 , by virtue of section 27 of that Act or, in case such other person has died, his legal personal representative.

Affording of facilities for health examination of children at schools.

32. —(1) A health authority intending to arrange for a health examination of children at a school, under this Act, may give to the school manager of the school notice in writing of such intention stating the day or days (not being earlier than seven days after the giving of the notice) on which and the time at which the examination will be held and requiring the school manager to afford all reasonable facilities for the examination.

(2) A notice under subsection (1) of this section may be addressed to “the school manager” and may be given by delivering it to the school manager of the school to which it relates or by sending it by post to the address at which he ordinarily resides.

(3) A copy of every notice under subsection (1) of this section in respect of a health examination to be held in a school of which the school manager is not the principal teacher shall be either delivered to the principal teacher of such school or sent by post to such teacher at the school.

(4) The school manager of a school to which a notice given under subsection (1) of this section relates shall cause all reasonable facilities to be given for the holding of a health examination in accordance with the notice and on the day or days and at the time mentioned therein and, if he fails to do so, he shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding ten pounds.

(5) Without prejudice to the foregoing subsections of this section, a health authority shall consult the school manager of a school before determining the day or days on which and the time at which a health examination of children in the school will be held and shall, so far as may be practicable, comply with the wishes of the school manager.

(6) An offence under this section may be prosecuted by the health authority who gave the relevant notice under this section.

False statements, etc.

33. —If any person, for the purpose of obtaining any service provided under this Part of this Act, whether for himself or some other person, or for any purpose connected with this Part of this Act—

(a) knowingly makes any false statement or false representation or knowingly conceals any material fact, or

(b) produces or furnishes, or causes or knowingly allows to be produced or furnished, any document or information which he knows to be false in a material particular,

he shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding fifty pounds or, at the discretion of the Court, to imprisonment for any term not exceeding three months or to both such fine and such imprisonment.