The Minister for Health, in exercise of the powers conferred on him by the Health Acts, 1947 and 1953, with the consent of the Minister for Finance to Article 15, hereby makes the following Regulations :—

PART I —PRELIMINARY AND GENERAL

1 Citation.

1. These Regulations may be cited as the General Institutional and Specialist Services Regulations, 1954.

2 Definitions.

2. In these Regulations—

" the Act " means the Health Act, 1953 (No. 26 of 1953) ;

" the Act of 1947 " means the Health Act, 1947 (No. 28 of 1947) ;

" institutional services " means—

(a) diagnosis, advice and treatment,

(b) appliances and medicines and other preparations,

(c) the use of special apparatus made available for a person who is maintained for the purpose of obtaining such services in a hospital, convalescent home or home for persons suffering from physical or mental disability ;

" mental hospital authority " has the meaning given to it in the Mental Treatment Act, 1945 (No. 19 of 1945) ;

" specialist services " does not include—

(a) services given to persons while they are maintained in an institution, or

(b) the giving of any drug, medicine or other preparation, except where it is administered to the patient direct by a person providing the service, or

3 Commencement.

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

4 Records and confidential nature of documents.

4.—(1) A health authority and their officers shall keep such records as may be specified by the Minister or, in the absence of any such specification, as may be determined by the health authority from time to time in relation to the services made available in accordance with these Regulations.

(2) Any records kept in pursuance of this Article shall be treated in a confidential manner and shall be available for inspection by persons authorised by the health authority or by the Minister and by no other persons.

(3) When any record, claim, application, report or other communication relating to the giving of services under section 15 of the act to an individual person is sent by post, it shall be enclosed in a sealed envelope.

(4) A document which is obtained or compiled under these Regulations (or a part of, or an extract from, such a document) which contains the name of an individual shall not be published save with the consent in writing of such individual.

PART II —INSTITUTIONAL SERVICES

5 Exclusions.

5. Save to such extent as may be approved by the Minister, a health authority shall not make available under section 15 of the Act institutional services which such health authority or a mental hospital authority are authorised to provide by or under any other section of the Act or by regulations made under section 31 of the Act of 1947 or by the Mental Treatment Act, 1945 (No. 19 of 1945).

6 Scope of institutional services.

6. Subject to the provisions of Article 5 of these Regulations, institutional services shall be made available under section 15 of the act in respect of any ailment, injury, infirmity, defect or disability for which institutional services are necessary, having regard to normal medical practice.

7 Manner of making services available.

7.—(1) Institutional services under section 15 of the act may be made available by a health authority by providing such services in the health institutions maintained by that authority, or by making arrangements under section 10 of the act for the provision of such services in other institutions.

(2) Except in a case of urgent necessity, institutional services shall not be made available under section 15 of the act save where the person to obtain the services is referred for such services by a registered medical practitioner who certifies that the person needs such services.

8 Applications for institutional services.

8.—(1) There shall be completed by or on behalf of a person desiring to avail himself of institutional services under section 15 of the act an application for such services in the form (Form ISA) set out in the Schedule to these regulations or in a form substantially to the like effect.

(2) An application completed under this Article shall be sent to the health authority responsible for making the services available to the applicant and, if the application is refused, that authority shall notify the applicant of the refusal.

(3) Where a decision by a health authority on an application made under this Article is to the effect that the yearly means of an adult person are not less than six hundred pounds, they shall notify the applicant of his right of appeal under subsection (9) of section 15 of the act giving particulars of the person to whom and the time within which the appeal may be made.

(4) Where a person by or on behalf of whom an application has been made under this Article is to be or, since making the application, has been maintained in an institution not managed by the health authority, the health authority shall, where the application is refused, notify the authority or person managing that institution of the refusal.

(5) This Article shall not apply to persons availing themselves of institutional services under subsection (7) of section 15 of the act.

(6) A health authority may, if they are otherwise satisfied in relation to his or their entitlement to institutional services under section 15 of the act, dispense with the requirements of this Article in respect of a particular person or a particular class of persons.

9 Admission to health institutions.

9.—(1) A person entitled to institutional services under section 15 of the act may be admitted to an appropriate health institution by the appropriate medical officer, matron or head nurse of the institution-

(a) on the statement of a registered medical practitioner that the person is in need of institutional services, or

(b) in a case of urgent necessity, without such statement.

(2) If an application under Article 8 of these Regulations in respect of the person has not been completed by or on behalf of the person before his admission to the institution, such an application shall, if it is required under that Article, be completed and transmitted to the appropriate health authority as soon as may be after the person is admitted to the institution.

(3) This Article shall not apply in relation to a person sent to a health institution from another health institution in which he has received institutional services under section 15 of the act.

10 Notification of admissions to extern institution.

10. Where, under an arrangement made under section 10 of the act, a person is admitted to an institution for the provision of institutional services under section 15 of the act and his admission has not been arranged by the health authority, the authority or person managing the institution shall, within three days or such longer period as may be agreed to, notify the health authority of his admission in the form (Form ISB) in the Schedule to these Regulations or in a form substantially to the like effect.

11 Payments under section 25 of the act.

11.—(1) The making of a payment by a health authority to an institution under section 25 of the act in respect of a person entitled to avail himself of institutional services under section 15 of the act shall be subject to the following conditions :—

(a) the person in charge of the institution shall, within three days of the admission of the person to the institution or within such longer period as may be agreed upon with the health authority, notify the health authority of hisadmission in the form (Form ISB) in the Schedule to these Regulations or in a form substantially to the like effect ;

(b) except in the case of services for defects discovered at schoo health examinations, the person in charge of the institution shall ensure that an application in the form (Form ISA) in the Schedule to these Regulations, or in a form substantially to the like effect, completed by or on behalf of the person shall be sent to the health authority on the admission of the person to the institution ;

(c) the claim for payment shall be made to the health authority in the form (Form ISC) in the Schedule to these Regulations, or in a form substantially to the like effect at such intervals as may be determined by the health authority.

(2) A health authority shall, as soon as may be after receiving a notification and application under sub-article (1) of this Article, notify the institution and the person of the refusal of any application.

(3) Where a decision by a health authority on an application made under this Article is to the effect that the yearly means of a person are not less than six hundred pounds, they shall notify the applicant of his right of appeal under subsection (9) of section 15 of the act giving particulars of the person to whom and the time within which an appeal may be made.

PART III —SPECIALIST SERVICES

12 Exclusions.

12. Save to such extent as may be approved by the Minister, a health authority shall not make available under section 15 of the Act specialist services which such health authority or a mental hospital authority are authorised to provide by or under any other section of the Act or by regulations made under section 31 of the Act of 1947 or by the Mental Treatment Act, 1945 .

13 Manner of making specialist services available.

13.—(1) Specialist services may be made available by a health authority through their own officers, or by making arrangements with an institution or person for the giving of such services.

(2) Specialist services shall not be made available under section 15 of the act save where the person to obtain the services is referred for such services by a registered medical practitioner who certifies that the person needs such services.

14 Applications for specialist services.

14.—(1) There shall be completed by or on behalf of a person desiring to avail himself of specialist services under section 15 of the act an application for such services in the form (Form ISA) set out in the Schedule to these Regulations or in a form substantially to the like effect.

(a) notify the applicant of the refusal and

(b) if the applicant has availed himself of any service, notify him of the charge for the service under section 30 of the act.

(3) Where a decision by a health authority on an application made under this Article is to the effect that the yearly means of an adult person are not less than six hundred pounds, they shall notify the applicant of his right of appeal under subsection (9) of section 15 of the act, giving particulars of the person to whom and the time within which an appeal may be made.

(4) This Article shall not apply to persons availing themselves of specialist services under subsection (7) of section 15 of the act.

(5) A health authority may, if they are otherwise satisfied in relation to his or their entitlement to specialist services under section 15 of the act, dispense with the requirements of this Article in respect of a particular person or a particular class of persons.

PART IV —SPECIFICATION OF CASES UNDER SECTION 15(4) OF THE ACT

15 Cases where charges approved or directed by the Minister are to be made.

15.—(1) Where institutional services are made available under subsection (1) of section 15 of the act in cases not governed by subsection (3) of the said section (not being cases of persons insured under the Social Welfare Act, 1952 ), the charges approved or directed by the Minister towards the cost of such services shall be charged in the following cases instead of such charges as may, in pursuance of subsection (4) of the said section, be determined by the health authority :—

(a) persons (other than farmers) without any dependants or with only one dependant whose yearly means are six hundred pounds or more and dependants (if any) of such persons ;

(b) persons who are farmers without any dependants or with only one dependant, the rateable valuation of the farm or farms (including the buildings thereon) being more than fifty pounds, and dependants (if any) of such persons ;

(c) persons (other than farmers) who have only two dependants and whose yearly means are seven hundred pounds or more, and dependants of such persons ;

(d) persons who are farmers with only two dependants, the rateable valuation of the farm or farms (including the buildings thereon) being more than fifty-five pounds, and dependants of such persons ;

(e) persons (other than farmers) who have only three dependants and whose yearly means are eight hundred pounds or more, and dependants of such persons ;

(f) persons who are farmers with only three dependants, the rateable valuation of the farm or farms (including the buildings thereon) being more than sixty pounds, and dependants of such persons ;

(g) persons (other than farmers) whose yearly means are nine hundred pounds or more, and dependants of such persons ;

(h) persons who are farmers, the rateable valuation of the farm or farms (including the buildings thereon) being more than sixty-five pounds, and dependants of such persons.

(2) In this Article, " farmer " means a person whose yearly means are, in the opinion of the health authority, derived wholly or mainly from farming.

PART V —APPEALS IN RELATION TO YEARLY MEANS

16 Definitions for Part V.

16. In this Part of these Regulations —

" an appeal " means an appeal under subsection (9) of section 15 of the act ;

" the appeals officer " means a person appointed by the Minister to determine appeals under subsection (9) of section 15 of the act ;

" hearing " means an oral hearing.

17 Appeals.

17.—(1) A person appealing pursuant to subsection (9) of section 15 of the act shall give notice of his appeal in writing to the Appeals Officer, Department of Health, Custom House, Dublin.

(2) Every appeal shall be made within twenty-one days from the notification by the health authority of the decision against which the appeal is made or within such longer period as the appeals officer may, in any particular case, allow.

(3) A notice of appeal shall contain a statement of the facts and contentions upon which the appellant intends to rely.

(4) The appellant shall send to the appeals officer with the notice such documentary evidence as the appellant desires to adduce in support of his appeal, and the notice shall contain a list of any such documents.

(5) An appeal may be withdrawn at any time by sending to the appeals officer a written notice of withdrawal.

18 Further particulars relating to appeals.

18. The appeals officer shall request the observations of the health authority on the appeal and may at any time require the appellant or the health authority to furnish to him, in writing, further particulars with respect to the appeal, and may, at any stage of the proceedings, allow the amendment of any notice of appeal, statement, or particulars and may fix the time for furnishing any statement or particulars upon such terms as he may think just.

19 Summary determination.

19. If the appeals officer is of opinion that the appeal is of such a nature that it can properly be determined without a hearing, he may dispense with a hearing and may determine the appeal summarily.

20 Hearings.

20.—(1) If, in the opinion of the appeals officer, a hearing is required he shall, as soon as may be, fix a date and place for the hearing, and reasonable notice thereof shall be given to the appellant and the health authority and any other person appearing to be concerned in the appeal.

(2) The procedure at the hearing shall be such as the appeals officer may determine.

(3) The appellant may appear at the hearing in person or may be represented at the hearing by any member of his family or, with the consent of the appeals officer, by any other person.

(4) The manager for the health authority, or any other officer of that authority authorised in that behalf, may appear at the hearing.

(5) There may also appear at the hearing any other person who is concerned in the appeal or who, in the opinion of the appeals officer, should be heard.

(6) The appeals officer may postpone or adjourn the hearing from time to time as he may think fit.

(7) The appeals officer may, if he thinks fit, admit any duly authenticated written statement or other material as prima facie evidence of any fact or facts in any case in which he thinks it just and proper so to do.

(8) The appellant and the health authority shall not, without the leave of the appeals officer, be entitled to rely upon any facts or contentions other than those set out in the notice of appeal and in statements supplied in accordance with these Regulations.

21 Decisions.

21.—(1) If, after notice of a hearing has been duly given, either of the parties fails to appear at the hearing, such order or decision may be made, and such steps may be taken with a view to the determination of, or in reference to, the appeal as the appeals officer may think just.

(2) The appeals officer may consider and decide any question duly referred to him for consideration and determination, notwithstanding the failure or neglect of any person to comply with any requirement of these Regulations.

(3) The decision of the appeals officer shall be in writing signed by him and shall be sent, as soon as may be, to the health authority, to the appellant and to any other person concerned.

22 Sending of notices etc.

22. Any notice or other document required or authorised to be sent to any person for the purpose of these Regulations shall be deemed to be duly sent if sent by post addressed to him, in the case of the appeals officer, at the Department of Health, Custom House, Dublin and, in any other case, at the ordinary address of such person.

SCHEDULE.

PRESCRIBED FORMS.

Form ISA HEALTH ACT, 1953 . Confidential.

INSTITUTIONAL AND SPECIALIST SERVICES.

APPLICATION.

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

I hereby apply for institutional or specialist services under the Health Act, 1953 , for myself or for a person dependent on me and submit the following particulars in relation to my entitlement to those services:—

Note to Applicant: Only Part I and one other Part need be completed.

Part I—To be Completed in all Cases.

Applicant's full name:............................................................ ............................................................ ..................
Ordinary address:............................................................ ............................................................ ...........................
............................................................ ............................................................ ......................................................
Present address (if different):............................................................ ............................................................ .........
	............................................................ .................................
If the patient is Not the applicant, but a dependant of the applicant :—
Patient's name:............................................................ ............................................................ ....................................
Full address :............................................................ ............................................................ ....................................
Is patient under 16 years ?..........	Relationship to applicant..............................................

Part II—TO BE COMPLETED WHERE THE APPLICANT IS THE HOLDER OF A CARD ENTITLING HIM TO THE DISPENSARY MEDICAL SERVICE UNDER section 14 of the act.

Number of Card:............................................................ ............................................................ .........................

If you have completed Parts I and II, Parts, IV and V of the form may be ignored.

Part III—TO BE COMPLETED ONLY WHERE THE APPLICANT IS AN INSURED PERSON UNDER THE SOCIAL WELFARE ACT, 1952 .

Insurance Number:..................................................	Employer:..................................................
Occupation:............................................................ ..	................................................
Salary or wages:.....................................................

If you have completed Parts I and III, Parts II, IV and V of the form may be ignored.

Part IV—TO BE COMPLETED ONLY WHERE THE APPLICANT'S MEANS ARE DERIVED WHOLLY OR MAINLY FROM FARMING.

Address (or addresses) of the farm or farms (including land held on an agreement of letting) :

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

Rateable valuation (including buildings): ............................................................ ...............................................

Specify any other source of income.* (Further particulars about this may be required later): ............................................................ ............................................................ .........................................................

*The income of the spouse and of any unmarried son, daughter, stepson or stepdaugther normally resident with the applicant should be included.

If you have completed Parts I and IV, Parts II, III and V of the form may be ignored.

Part V—TO BE COMPLETED ONLY WHERE THE APPLICANT IS NOT A PERSON COVERED BY PART II, III or IV ABOVE.

Note—Further particulars as to the means of an applicant completing this Part of the Form may be required later.

1. What is the precise occupation of
(a) the applicant ?	............................................................ ....................
(b) the wife or husband of the applicant ?	............................................................ .................
(c) any other member of the family ?*	............................................................ .........
2. Does the applicant, or any other member of the family,* own
(a) the dwelling house in which the family resides	.........................................
(b) any other premises	.........................................
(c) any land or
(d) any property other than buildings or land (e.g. investments, cash in bank, etc.) value more than £25	.........................................
3. Is the applicant in receipt of
(a) an old age pension	.........................................
(b) a widow's (non-contributory) pension	.........................................
(c) unemployment assistance ?	.............................................
If so state the pension number
or
The qualification certificate number

*" Family " for the purpose of this form includes the applicant, his or her wife or husband and any unmarried son, daughter, stepson or stepdaughter normally resident in the home.

I hereby declare that the above particulars are, to the best of my knowledge, correct and complete, and I hereby undertake to pay the charge approved of or directed by the Minister for Health for any service of which I avail myself to which I am not entitled.

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

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

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.

CONFIDENTIAL

Ref. No................

Form ISB

HEALTH ACT, 1953 .

GENERAL INSTITUTIONAL SERVICES.

NOTIFICATION OF ADMISSION OF PATIENT.

INSTITUTION....................................

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

The following are particulars of a patient admitted to the above-mentioned institution in respect of which it is proposed to claim payment from your authority for the provision of services under /images/./en.si.1954.0100/si100y54p0547.jpg of the Health Act, 1953 :—

Name of Patient : ............................................................ ............................................................ ...............................

Ordinary Address : ............................................................ ............................................................ ...............................

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

Name and address of medical practitioner who certified the need for institutional treatment............................................................ .........................................................

Date of admission of Patient :............................................................ ............................................................ ...............

Expected duration of stay in institution :............................................................ .......................................................

Signed :...................................................

Office :....................................................

Date :...............................................

To the Secretary

............................................................ County Council.

To the City Manager and Town Clerk

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

*Strike out inapplicable words

CONFIDENTIAL

Form ISC

Ref. No...................

HEALTH ACT, 1953 .

INSTITUTIONAL AND SPECIALIST SERVICES.

CLAIM FOR PAYMENT UNDER section 25 of the act.

Note—This Form should be completed in duplicate. A copy will be returned to the institution when payment is being made.

Name of Institution :............................................................ ............................................................ ...............................

Address :............................................................ ............................................................ ...................................................

The above institution claims from your health authority payments under section 25 of the Health Act, 1953 , as set out below in respect of persons maintained in the institution during the period from......................................... to...................................................

Name of Patient and ordinary address

Date of Admission

Date (or expected date) of Discharge

Whether in private or semi-private ward or not

Number of days' maintenance in respect of which this claim is made

Total days' maintenance ........

I certify that the above claim is accurate.

Signed :....................................................

Office : ....................................................

Date :..........................................

To the Secretary,

............................................................ County Council.

To the City Manager and Town Clerk

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

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

SÉAMAS Ó RIAIN,

Minister for Health.