S.I. No. 158/1954:

MATERNITY AND CHILD HEALTH SERVICES (AMENDMENT) REGULATIONS, 1954.

MATERNITY AND CHILD HEALTH SERVICES (AMENDMENT) REGULATIONS, 1954.

The Minister for Health, in exercise of the powers conferred on him by the Health Acts, 1947 to 1954, hereby makes the following Regulations :--

1. These Regulations may be cited as the Maternity and Child Health Services (Amendment) Regulations, 1954.

2. These Regulations shall come into operation on 1st day of August, 1954.

3. Until this Article is revoked, services under section 16 of the Health Act, 1953 (No. 26 of 1953) shall be made available for women (being women specified in sub-section (2) of that section) who are themselves unable, or who are dependants of persons who are unable, to provide by their own industry or other lawful means the services mentioned in subsection (1) of that section which are necessary for them in respect of motherhood, and to no other persons.

4. Sub-article (2) of Article 5 of the Maternity and Child Health Services Regulations, 1954 ( S.I. No. 98 of 1954 ) (hereinafter referred to as the Principal Regulations) shall be amended by the insertion after " persons " where it first occurs of " (being registered medical practitioners) ".

5. Sub-article (1) of Article 6 and sub-article (1) of Article 7 of the Principal Regulations shall be amended by the addition to each of the following :--

" and

(c) where the Minister so approves or directs, through medical practitioners who are officers of the health authority."

6. An agreement between a health authority and a registered medical practitioner under Article 6, Article 7 or Article 8 of the Principal Regulations shall be in the form (Form MCD) set out in the Schedule to these Regulations or in a form substantially to the like effect.

7. Article 9 of the Principal Regulations shall be deleted and the following substituted therefor :--

" 9. A health authority shall from time to time prepare a list of the medical practitioners with whom they have agreements and of the hospitals (if any) with which they have arrangements in operation under this Chapter of this Part of these Regulations and shall make a copy of the list available to any person entitled to receive the Services under section 16 or section 17 of the Act on the request of that person ".

8. Article 10 of the Principal Regulations shall be amended as follows :--

(a) by the deletion of sub-article (5) and the substitution therefor of the following :--

" (5) Where a health authority, on examination of an application under this Article, decides that the applicant is not entitled to the service they shall forthwith notify the applicant and the medical practitioner or hospital authority of their decision ".

(b) by the addition thereto of a new sub-article as follows :

" (7) This Article shall not apply in respect of a service given to a woman or child by a district medical officer in pursuance of his duty as an officer of a health authority ".

9. Article II of the Principal Regulations shall be amended as follows :

(a) by the insertion in sub-article (1), after " Act " of " or in pursuance of his duty as an officer of the health authority ".

(b) by the addition thereto of a new sub-article as follows :

" (3) A medical practitioner aggrieved by a decision of a health authority that the summoning of another medical practitioner under this Article was not necessary may appeal to the Minister and the Minister, after consideration of such appeal and of the representations (if any) of such health authority in relation thereto, shall either (as he thinks proper) refuse such appeal or give to such health authority such direction as he considers will remedy the grievance of such medical practitioner ".

10. Article 12 of the Principal Regulations shall not apply where a medical officer of a health authority provides a service under these Regulations in pursuance of his duty as an officer of the health authority.

11. The Schedule to the Principal Regulations shall be amended by the deletion therefrom of the Form MCA and the substitution therefor of the Form MCA in the Schedule to these Regulations.

SCHEDULE

Form MCA                            Confidential

HEALTH ACT, 1953 .

MEDICAL AND SURGICAL SERVICES FOR MOTHERS AND INFANTS. APPLICATION FOR MEDICAL SERVICES.

To be completed by the Applicant

I*.................................... of*.....................................in the County/County Borough of............................................................ ............hereby apply to you to

(a)† accept me for medical and surgical services in respect of motherhood

(b)† provide medical and surgical services for my infant under and in accordance with the provisions of the Health Act, 1953 , and the Regulations made under that Act.

I herewith produce for inspection as evidence of my entitlement--

(a) Medical Card No......................issued in the name of............................................................ .....

............................................................ ............................................

or

(b) a notification from the health authority

or

(c) other document, as follows :--

............................................................ ............................................................ ................................................

............................................................ ............................................................ ................................................

I certify that these particulars are, to the best of my knowledge, accurate and that I have not made arrangements for these services with another medical practitioner.

Signature of applicant...........................................

Date...........................................

To Dr...........................................

N.B.--Knowingly to make any false statement or conceal any material fact in making this application is an offence punishable by a fine of £50 or by three months imprisonment, or both.

______________________________________________________________________

To be completed by the Doctor.

I undertake to provide medical and surgical services

(a) ‡for the person named above

(b) ‡for the infant

in accordance with the conditions laid down in the agreement made between me and the health authority for the provision of such services.

The expected date of confinement is............................................................ ........ 19....

To the Secretary............................................................ ............................................................ .....County Council

" " City Manager and Town Clerk............................................................ .........................................................

Signed............................................................ ........

Address............................................................ .......

Date............................................................ .......

_______________________________________________________________________

For Use in the Health Authority's Office.

*Name and address in BLOCK LETTERS

†Delete if not applicable.

‡Delete if not applicable.

SCHEDULE

Form MCD

PART I.

FORM OF AGREEMENT WITH REGISTERED MEDICAL PRACTITIONER HEALTH ACT, 1953 .

FORM OF AGREEMENT WITH GENERAL MEDICAL PRACTITIONER. UNDER ARTICLE 6, 7 OR 8 OF THE MATERNITY AND CHILD HEALTH SERVICES REGULATIONS, 1954.

I*............................................................ ....... of*............................................. (hereinafter called the registered medical practitioner) agree to provide services in accordance with the terms and conditions in Part II of the Schedule to the Maternity and Child Health Services (Amendment) Regulations, 1954 for persons for whom

the†............................................(hereinafter called the Authority) are obliged to make such services available.

The Authority hereby agrees with the registered medical practitioner for the provision by him of such services in accordance with the terms and conditions mentioned.

It is hereby agreed between the registered medical practitioner and the Authority that Part II of the Schedule to the Maternity and Child Health Services (Amendment) Regulations, 1954, shall be taken and construed as part of this agreement and that references in the said Part II to the agreement, the medical practitioner, the health authority and the Regulations shall be construed as referring respectively to this agreement, the registered medical practitioner, the Authority and the Maternity and Child Health Services Regulations, 1954 ( S.I. No. 98 of 1954 ).

Signed this        day of

  19 , by

the registered medical practitioner in the presence of :--

Present when the Common Seal of

the†    was affixed

hereto this    day of

19 .

PART II.

TERMS AND CONDITIONS OF AGREEMENT WITH REGISTERED MEDICAL PRACTITIONER.

1. Subject to paragraph 24 of these terms and conditions the medical practitioner shall not be required to provide under the agreement services for any woman or child whom he is not willing to accept as a patient, but, within two weeks of receiving an application for a woman or child to become his patient he shall, if he is unwilling to accept that woman or child as a patient, notify the applicant. (Note : It is desirable that in such a case the medical practitioner should also notify the health authority).

2. The medical practitioner shall comply with the provisions of Articles 10 and 12 of the Maternity and Child Health Services Regulations, 1954, in relation to the completion of forms of application and claim and their transmission, with the appropriate record cards, to the health authority or the chief medical officer of such authority, as may be appropriate.

*Name and full address in BLOCK LETTERS.

†Insert name of health authority

3. The medical practitioner shall, in respect of each woman entitled to avail herself of the service under section 16 of the Health Act, 1953 , whom he has accepted as a patient under this agreement or who has been assigned to him under paragraph 23 of these terms and conditions, provide such services as can appropriately be given by him and as he considers desirable in respect of motherhood : in particular, 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 sixteenth week of pregnancy); an examination 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) ; 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 postnatal care within the period of six weeks after the delivery as the medical practitioner considers necessary ; the taking of any specimens required for investigation.

4. The medical practitioner shall, in respect of each child whom he has agreed to accept as a patient, provide up to the age of six weeks, such medical and surgical services (including at least one examination of the child) as can appropriately be given by him.

5. The medical practitioner shall provide the services in person except where he is unable for a good reason to do so. In such a case he shall, with the agreement (except in case of urgency) of the woman or a parent of the child, as the case may be, arrange for another registered medical practitioner to attend to provide the services. The health authority will not be responsible for any payment to the latter practitioner.

6. The medical practitioner shall make services under the agreement available, as may be agreed with the woman or a parent of the child, as the case may be, either in the patient's place of residence, in the medical practitioner's surgery or in a maternity home or other institution to which he has access. Where the medical practitioner is a district medical officer he shall not withhold or refuse to provide services which he has undertaken to provide in accordance with this agreement by reason of the refusal of the patient to attend for such services at the dispensary. If the medical practitioner is a district medical officer, attendance at the dispensary may, if the woman or a parent of the child (as the case may be) agrees, be arranged, subject to the approval of the health authority at such time as may be convenient to the medical practitioner and the patient.

7. The medical practitioner shall keep a record in a form approved of or directed by the Minister in relation to his attendance on a woman under the agreement and shall make any such record available, where required, for inspection by a medical officer of the health authority or of the Minister authorised in that behalf.

8. Where a woman to whom a record card compiled under paragraph 7 of these terms and conditions relates attends or is admitted to a hospital for services in respect of her pregnancy, the medical practitioner shall make the record card available on loan, or a summary of the information thereon, to the medical staff of the hospital.

9. Where the medical practitioner is a district medical officer, he shall make available from dispensary stocks for any woman or child being attended by him under the agreement such drugs, dressings and medical requisites as he considers necessary.

10. Where the medical practitioner is not a district medical officer, he shall prescribe for any woman or child being attended by him under the agreement such drugs, dressings and medical requisites as he considers necessary. The medical practitioner shall use for this purpose a form supplied by the health authority. The forms so supplied shall not be used by the medical practitioner for persons other than women or children being treated by him under the agreement.

11. The medical practitioner shall, without charge, furnish to the woman any certificate in relation to the pregnancy or to the parent of the child in relation to the health of the child which she or he may require for the purpose of obtaining admission to an institution, applying for a maternity benefit under section 23 of the Health Act, 1953 , or under the Social Welfare Act, 1952 , or for milk un der section 24 of the Health Act, 1953 or for obtaining any other benefit under the Health Acts, 1947 to 1954.

12. If the medical practitioner considers that any woman or child being attended by him under the agreement needs hospital or specialist services or any other service which may be made available by the health authority and which cannot appropriately be given by him, he shall inform the woman or a parent of the child (as the case may be) of the availability of such service and shall, if it is desired by the woman or parent, take appropriate steps to enable the woman or child to avail herself or himself of such service.

13. The health authority, in consideration of services provided by a medical practitioner in accordance with these terms and conditions, shall make payments to him in accordance with such scale as may be approved of or directed by the Minister from time to time. The health authority may, if they so think fit, refuse to make a payment in respect of a service given more than fourteen days before the appropriate application on Form MCA has been received by them.

14. The medical practitioner shall not demand or accept any payment or consideration whatsoever other than the payment under paragraph 13 of these terms and conditions in reward for services provided by him under the agreement or of travelling or other expenses incurred by him or of the use of any premises, equipment or instruments in making the services available.

15. The agreement shall be terminated forthwith where the medical practitioner's name is erased from the register of medical practitioners under the Medical Practitioners Act, 1927 (No. 25 of 1927).

16. The agreement shall be terminated, on such notice not exceeding three months as may be agreed to by the health authority, upon the medical practitioner being offered employment in a wholetime capacity in the service of the State or of a local authority.

17. The agreement may be terminated at any time by the medical practitioner giving notice to the health authority. Notice under this clause shall be given three months (or such shorter period as may be agreed to by the health authority) before such termination.

18. The health authority, if they are satisfied after investigating a complaint, made by a woman or by the parent of a child, who has been accepted as a patient by a medical practitioner under the agreement, that the medical practitioner has not complied with the agreement may, if they so think fit--

(a) issue a warning to the medical practitioner

(b) require the medical practitioner to pay to them a fine not exceeding ten pounds or

(c) terminate the agreement without notice.

19. If a medical practitioner is aggrieved by a decision of a health authority in regard to any of the matters dealt with in Paragraphs 16, 17 or 18, he may appeal to the Minister for Health within 14 days of the date on which the decision of the health authority is conveyed to him and the Minister, after consideration of such appeal and of the representations (if any) of such health authority in relation thereto shall either (as he thinks proper) refuse such appeal or give to such health authority such direction as he considers appropriate to the case.

20. The medical practitioner agrees to pay to the health authority any fine required to be paid by him in accordance with paragraph 18 or 19 of these terms and conditions.

21. Where a fine due by a medical practitioner under paragraph 18 of these terms and conditions has not been paid, the amount thereof may be deducted by the health authority from moneys payable by that authority to the practitioner.

22. The medical practitioner agrees to make available to a medical officer of the health authority or of the Minister authorised in that behalf any relevant information requested by such officer for the purpose of the investigation of a complaint under paragraph 18 of this Schedule.

23. Where the woman, or a parent of a child (as the case may be) having made reasonable efforts in that behalf, has failed to come to an arrangement for the provision of services under section 16 or Section 17 of the Health Act, 1953 , for herself or the child and notifies the chief medical officer of the health authority accordingly, he may assign such woman or child to such one of the registered medical practitioners, between whom and the health authority agreements under Article 8 of the Regulations are in operation, as can, in the opinion of the chief medical officer, most conveniently make the relevant services available.

24. The medical practitioner agrees to accept any patient assigned to him under paragraph 23 of these terms and conditions and to make services available for such patient as if she or he had been accepted by the medical practitioner under these terms and conditions.

GIVEN under the Official Seal of the Minister for Health this thirty-first day of July, One Thousand, Nine Hundred and Fifty-four.

THOMAS F. O'HIGGINS

Minister for Health.