S.I. No. 158/1964 - Maternity and Child Health Services (Amendment) Regulations, 1964.

1. The medical practitioner agrees to provide under the terms of the agreement services for any eligible woman or child by or on whose behalf an application is made to him and whom he is willing to accept as a patient. Subject to paragraph 25, nothing in this paragraph shall be construed as requiring a medical practitioner to provide services under the agreement for any woman or child whom he is unwilling to accept as a patient, but, within two weeks of receiving an application to accept a woman or child as a patient, he shall, if he is unwilling to accept that woman or child as a patient, notify the applicant and the health authority.

2. The medical practitioner shall comply with the provisions of the Regulations 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 24 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 28th week of pregnancy and as soon as possible following the 16th week 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 bi-manual 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.

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 withold 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, subject to the provisions of the Regulations, 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 to any woman or child being attended by him in accordance with the terms of the agreement by whom or on whose behalf there is produced to him—

(a) a card issued in accordance with Article II of the General Medical Services Regulations, 1954, and for the time being in force,

(b) a direction issued in accordance with Article 16 of the said Regulations, and for the time being in force, or

(c) a direction issued by the health authority,

such drugs, medicines and surgical dressings and such minor appliances for use by the patient in connection with the administration of the said drugsand medicines as he considers necessary. In the case of any other patient being attended by him in accordance with the terms of the agreement, he shall prescribe for the patient such drugs, medicines and surgical dressings and such minor appliances as he considers necessary for use by the patient in connection with the administration of the said drugs and medicines.

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, medicines and surgical dressings and such minor appliances for use by the patient in connection with the administration of the said drugs and medicines as he considers necessary. The medical practitioner shall use for this purpose a form supplied by the health authority provided there is produced by or on behalf of the woman or child a card issued in accordance with article 11 of the General Medical Services Regulations, 1954, and for the time being in force, or a direction issued in accordance with article 16 of the said Regulations and for the time being in force, or a direction issued by the health authority. The medical practitioner may also use the form supplied by the health authority to prescribe for his own use such items, approved by the Minister from time to time, as may be required by him in the course of his domiciliary attendance on patients to whom he is affording services in accordance with the provisions of the agreement.

The forms issued by the health authority shall not be used by the medical practitioner for any person other than a woman or a child by whom or on whose behalf a card or direction as aforesaid is produced, or for ordering items for his own use, except such of the approved items as are required by him in the course of his domiciliary attendance on patients to whom he is affording services in accordance with the provisions of the agreement, or for ordering for his own use items other than those which he is hereby authorised to order, or for prescribing for any woman or child being attended by him items other than drugs, medicines and surgical dressings and minor appliances for use by the patient in connection with the administration of the said drugs and medicines.

11. The medical practitioner shall, without charge, furnish any certificate to the woman 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

(as amended), or for milk under

section 24

of the

Health Act, 1953

, or for obtaining any other benefit under the Health Acts, 1947 to 1960.

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 twenty-eight 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. Nothing in this paragraph, however, shall be construed as preventing the acceptance by a medical officer of—

(a) his salary as a medical officer of a local authority hospital ;

(b) a payment from any fund which may be established for the remuneration of specialist staff in voluntary or proprietary hospitals.

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. Where a health authority has reason to believe that a medical practitioner has failed to comply with any of the terms of the agreement they shall notify the medical practitioner of the reasons for such belief by registered post and inform him that they will consider any representations in regard to the matter which may be received by them from him within fourteen days of the issue of the notification to him. The health authority, if they are satisfied, after consideration of any representations which the medical practitioner may make in regard to the matter, that the medical practitioner has not complied with the terms of the agreement may if they think fit—

(a) issue a warning to the medical practitioner ;

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

(c) terminate the agreement on one month's notice or such longer notice as the health authority considers adequate.

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 twenty-eight 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 inclusion of the terms and conditions set out in paragraphs 16 to 19 of the agreement shall not be construed as affecting any right of action in the Courts which either of the parties to the agreement may have.

21. 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.

22. Where a fine due by a medical practitioner under paragraph 18 or 19 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.

23. The medical practitioner agrees, subject to the provisions of the Regulations, 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 any matter arising under paragraph 18 of these terms and conditions.

24. 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 11 of the Regulations are in operation, as can, in the opinion of the chief medical officer, most conveniently make the relevant services available.

25. The medical practitioner agrees to accept any patient assigned to him under paragraph 24 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 twenty-ninth day of June, One thousand nine hundred and sixty-four.

SEÁN MAC ENTEE,

Minister for Health.

EXPLANATORY NOTE.

These Regulations revoke articles 6 to 8 inclusive, and articles 10 to 22, inclusive, of the Maternity and Child Health Services Regulations, 1954 (

S.I. No. 98 of 1954

) and the following Regulations

The Maternity and Child Health Services (Amendment) Regulations, 1954, (

S.I. No. 158 of 1954

).

The Maternity and Child Health Services (Amendment) Regulations, 1955, (

S.I. No. 48 of 1955

).

The Maternity and Child Health Services (Amendment) Regulations, 1956, (

S.I. No. 44 of 1956

).

The Maternity and Child Health Services (Amendment) (No. 2) Regulations, 1956, (

S.I. No. 142 of 1956

).

The Maternity and Child Health Services (Amendment) Regulations, 1958, (

S.I. No. 265 of 1958

).

which provide for maternity and infant care services under

sections 16

and

17

of the

Health Act, 1953

.

The provisions of the regulations which have been revoked are replaced by these Regulations which also provide for minor adjustments in the services provided by participating medical practitioners under the Maternity and Infant Care Scheme.

S.I. No. 158 of 1964.

MATERNITY AND CHILD HEALTH SERVICES (AMENDMENT) REGULATIONS, 1964.

TABLE OF CONTENTS.

PART I.—PRELIMINARY AND GENERAL.

Article