The Minister for Health, in exercise of the powers conferred on him by section 5 of the Health Act, 1947 (No. 28 of 1947), and section 22 of the Health Act, 1953 (No. 26 of 1953) (as amended by section 2 of the Health Act, 1954 ) (No. 23 of 1954), hereby makes the following Regulations :

PART I. PRELIMINARY AND GENERAL.

1 Citation

1. (1) These Regulations may be cited as the Maternity and Child Health Services (Amendment) Regulations, 1964.

(2) The Maternity and Child Health Services Regulations, 1954, ( S.I. No. 98 of 1954 ) and these Regulations shall be construed together and may be cited together as the Maternity and Child Health Services Regulations, 1954 and 1964.

2 Definitions

2. In these Regulations :

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

" the Minister " means the Minister for Health;

" hospital services " does not include a service given by a member of the staff of a hospital under an arrangement made under article 9 or article 10 of these Regulations;

" midwife ", " nurse " and " nursing " have the same meanings as in the Nurses Act, 1950 (No. 27 of 1950);

" specialist services " does not include the giving of any drug, medicine or other preparation which is not administered to the patient direct by a person giving such service.

3 Commencement

3. These Regulations shall come into operation on 1st day of July, 1964.

4 Revocations

4. 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 are hereby revoked :—

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 ).

5 Giving of information to medical practitioners of institution

5. A registered medical practitioner who sends a person for hospital services or for specialist services under section 16 or section 17 of the act shall give to the medical practitioners of any institution in which such person receives such services all information in his possession relating to the medical history and condition of the person.

6 Records and confidential nature of documents

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

(2) Any clinical records compiled or any document obtained under these Regulations shall be treated in a confidential manner and, save as provided in subarticle (5) of this article, shall not, without the consent in writing of the patient, be disclosed in such a manner as to make identification of the patient possible.

(3) When any record, claim, application, report or other communication relating to the giving of services to a person in accordance with these Regulations is sent by post, it shall be enclosed in a sealed envelope.

(4) Nothing in this article shall be construed as preventing the inspection by a registered medical practitioner authorised by the health authority or by the Minister of the clinical records kept in pursuance of these Regulations where the written consent of the patient has been obtained.

(5) Where the Minister certifies in respect of clinical records compiled under these Regulations and held by any particular medical practitioner or in relation to any particular patient that it would not in his opinion be in the interests of the common good to seek the consent referred to in subarticles (2) and (4) of this article a registered medical practitioner authorised by the Minister may inspect such records.

(6) Where a certificate under subarticle (5) of this article has been given in respect of any particular clinical records by the Minister and the medical practitioner holding such records is of opinion that the patient to whom the records relate should be informed of the giving of the certificate such medical practitioner may so inform such patient.

(7) The consent referred to in subarticles (2) and (4) of this article may, in the case of a minor, be given by a parent or guardian and, in the case of a deceased person, may be given by the spouse of such person, or if there is no spouse, by any of the next of kin of such person or by his personal representative.

7 Class of woman entitled to services under section 16 of the Act

7. The women for whom services under section 16 of the act shall be made available shall be women who are entitled to avail themselves of the institutional and specialist services made available under subsection (1) of section 15 of the act.

8 Application of Article 16 of the General Medical Services Regulations 1954

8. Article 16 of the General Medical Services Regulations, 1954, ( S.I. No. 102 of 1954 ) shall apply in relation to the giving by district medical officers and midwives who are officers of health authorities of services under section 16 of the act, to women entitled to services under section 14 of the act in the same way as that article applies in relation to the giving of services by district medical officers under section 14 of the act.

PART II. MEDICAL CARE FOR MOTHERS AND INFANTS.

CHAPTER I. General Medical Services.

9 Medical care for mothers

9. (1) A health authority shall make available medical services under section 16 of the act for women in respect of motherhood—

(a) by making agreements, in Form MCD set out in the Schedule to these Regulations or in a form substantially to the like effect, with registered medical practitioners for the provision of such services,

(b) where the health authority think fit, by—

(i) arranging, with the consent of the Minister, for the provision of such services through medical officers of any health institution in which instruction is given to persons being trained to become registered medical practitioners or nurses, or

(ii) making arrangements, with the consent of the Minister, with other hospitals for the provision of such services, and

(2) Any woman entitled to receive the services referred to in this article may receive them, at her choice, from any medical practitioner or hospital authority having an agreement with the health authority for the provision of those services and willing to accept her as a patient.

10 Infant welfare services

10. (1) A health authority shall make available medical and surgical services under section 17 of the act for children up to the age of six weeks whose mothers are entitled to avail themselves of the services under section 16 of the act—

(b) where the health authority think fit, by—

(ii) making arrangements, with the consent of the Minister, with other hospitals for the provision of such services, and

(2) The services referred to in this article shall be made available for a child at the choice of the parent by any medical practitioner or hospital authority having an agreement with the health authority for the provision of those services and willing to accept the child as a patient.

11 Making of agreements

11. (1) A health authority shall, on application being made to them, enter into an agreement in Form MCD set out in the Schedule to these Regulations or in a form substantially to the like effect with any registered medical practitioner (whether resident in the functional area of the health authority or not) for the provision of services under section 16 or section 17 or sections 16 and 17 (as may be appropriate) of the Act, 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 any agreement relating to the provision of maternity medical services under sections 16 or 17 of the Act 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.

12 Lists of participating medical practitioners

12. 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.

13 Applications for services

13. (1) There shall be completed by or on behalf of a woman desiring to avail herself of the service referred to in article 9 of these Regulations in respect of a pregnancy or on behalf of a child for whom it is desired that there be available the services referred to in article 10 of these Regulations, an application for such services in Form MCA in the Schedule to these Regulations or in a form substantially to the like effect.

(2) Only one application under this article (whether to a medical practitioner or to a hospital) may be made in respect of a particular pregnancy except where the health authority otherwise agree.

(3) Only one application under this article (whether to a medical practitioner or to a hospital) may be made in respect of a particular child, except where the health authority otherwise agree.

(4) An application completed under this article shall be sent to the medical practitioner or hospital authority selected to provide the service and such practitioner or authority, if willing to accept the woman or child as a patient, shall, within two weeks of its receipt send the application to the health authority responsible for making the service available for the applicant, together with an undertaking to provide the service.

(5) The health authority shall, as soon as may be, notify the applicant and the medical practitioner or hospital authority of their decision on an application under this article.

(6) Where a decision by a health authority on an application under this article is to the effect that the yearly means of an adult person are not less than eight hundred pounds, the health authority 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.

(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.

14 Extra professional assistance

14. (1) Whenever in the course of attendance by a medical practitioner on a woman or child in pursuance of an agreement made by him with a health authority for the purposes of section 16 or section 17 of the act or in pursuance of his duty as an officer of the health authority, circumstances arise which, in his opinion, necessitate his obtaining the assistance of another registered medical practitioner, he may, on his own authority, summon the assistance of such other practitioner and shall thereupon report the circumstances in writing to the health authority.

(2) If the health authority, on consideration of a report made under subarticle (1) of this article, are satisfied that the summoning of the second medical practitioner was necessary, the health authority shall pay to such medical practitioner such fee as may be permitted under arrangements approved of by the Minister.

(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.

15 Claims for payment

15. (1) When the giving of services in any particular case has been completed under this Chapter of this Part of these Regulations by a medical practitioner or by the authority of a hospital which is not a health institution, such practitioner or authority shall furnish to the chief medical officer of the health authority a claim for payment in respect of the services and the completed record card relating to the case.

(2) The claim and completed record card shall be furnished to the chief medical officer of the health authority within one year of the completion of services in each case. Payment shall not be made by the health authority in respect of claims submitted after the expiration of the said year, save in exceptional circumstances with the approval of the Minister.

(3) This article 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.

16 Obstetrical requisites

16. (1) The obstetrical requisites which a health authority shall make available to a woman entitled to such requisites under subsection (5) of section 16 of the act shall be—

(a) (i) twenty-four ounces of gauze and cotton tissues,

(ii) eight ounces of absorbent cotton wool,

(iii) one ounce of absorbent lint,

(iv) one four-ounce bottle of antiseptic fluid of a suitable type, and

(b) such other obstetrical requisites as may be specified by the Minister from time to time and as may be certified to be necessary for the woman by the appropriate registered medical practitioner providing services under article 9 of these Regulations in respect of the period commencing at the onset of labour and ending fourteen days after its termination.

CHAPTER II. Midwifery and Nursing Services.

17 Midwifery services

17. A health authority shall make available midwifery services under section 16 of the act—

(a) through midwives who are officers of the health authority;

(b) by making, with the consent of the Minister, arrangements for the provision of such services by other midwives.

18 Nursing services for infants

18. A health authority shall make available nursing services under section 17 of the act—

(a) through nurses who are officers of the health authority;

(b) by making, with the consent of the Minister, arrangements for the provision of such services by other nurses.

CHAPTER III. Institutional and Specialist Services.

19 Manner of makign hospital services available

19. (1) Hospital services under section 16 or section 17 of the act may be made available by a health authority—

(a) by providing such services in the health institutions maintained by that authority ;

(b) 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, hospital services shall not be made available under section 16 or section 17 of the Act, save where the person, requiring the services, is referred for such services by a registered medical practitioner.

20 Applications for hospital services

20. (1) There shall be completed by or on behalf of a woman desiring to avail herself of, or on behalf of a child for whom it is desired that there be available, hospital services under section 16 or section 17 of the act and who is not being attended at the time by a medical practitioner or midwife under an agreement made in accordance with article 11 or article 17 of these Regulations, an application for such services in Form MCB in the Schedule to these Regulations or in a form substantially to the like effect.

(2) A health authority may, if otherwise satisfied in relation to the entitlement of a person or persons to such services, dispense with the requirement in subarticle (1) of this article in respect of a particular person or a particular class of persons.

(3) An application completed under this article shall be sent to the health authority responsible for making the services available to the woman or child and, if the application is refused, that authority shall, as soon as may be, notify the applicant of the refusal.

(4) 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 eight hundred pounds, the health authority 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.

(5) Where an application under this article is refused and the person by or on behalf of whom the application was made is to be or, since making the application, has been maintained in an institution not managed by the health authority, the health authority shall, as soon as may be, notify the authority or person managing the institution of the refusal.

21 Admissions to health institutions

21. (1) A woman entitled to hospital services under section 16 of the act, may be admitted to an appropriate health institution by the appropriate medical officer, matron or head nurse—

(a) where she is referred for hospital services by a registered medical practitioner, or

(b) in a case of urgent necessity, where she is not so referred.

(2) A child who is entitled to hospital services under section 17 of the act, may be admitted to an appropriate health institution by the appropriate medical officer, matron or head nurse—

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

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

(3) Where a person is admitted to a health institution in accordance with this article and an application under article 20 of these Regulations has not already been completed on behalf of the person, such an application, if it is required under article 20 of these Regulations, shall be completed and transmitted to the appropriate health authority as soon as may be after the person is admitted to the institution.

(4) This article shall not apply in relation to a woman or a child sent to a health institution from another health institution in which such woman or child has received institutional services.

22 Notificaiton of admission to extern institution

22. Where under an arrangement made under section 10 of the act, a person is admitted to an institution for the provision of hospital services under section 16 or section 17 of the act and the admission of that person has not been arranged by the health authority or by a medical practitioner providing services in accordance with article 9 or article 10 of these Regulations, the person in charge of the institution shall within three days, or such longer period as may be agreed to, notify the health authority of his admission in Form MCC in the Schedule to these Regulations or in a form substantially to the like effect.

23 Payments under Section 25 of the Act

23. (1) The making of a payment by a health authority under section 25 of the act, in respect of a woman or child entitled to institutional services under section 16 or section 17 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 his admission in Form MCC in the Schedule to these Regulations, or in a form substantially to the like effect,

(b) the person in charge of the institution shall ensure that in a case where it is required under article 20 of these Regulations, an application in Form MCB 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, if such an application has not already been sent to that authority by or on behalf of that person,

(c) the claim for payment shall be made to the health authority in Form ISC in the Schedule to the General Institutional and Specialist Services Regulations, 1954 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 subarticle (1) of this article notify the institution and the applicant of the refusal of any application.

(3) Where a decision by a health authority on an application under this article is to the effect that the yearly means of a person are not less than eight hundred pounds, the health authority 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.

24 Manner of making specialist services available

24. (1) Specialist services under sections 16 and 17 of the Act may be made available by a health authority through their own officers or by making arrangements, with the consent of the Minister, with an institution or person for the giving of such services.

(2) Specialist services shall not be made available in accordance with this article save where the person to obtain the services is recommended for such services by a registered medical practitioner.

(3) Specialist services under this article shall not include the supply of appliances, drugs, medicines or other preparations save to such extent as may be approved of or directed by the Minister.

25 Applicaiton for specialist services

25. (1) There shall be completed by or on behalf of a woman desiring to avail herself of, or on behalf of a child for whom it is desired that there should be available, specialist services under section 16 or section 17 of the act and who is not being attended at the time by a medical practitioner or midwife under an agreement made in accordance with article 11 or article 17 of these Regulations, an application for such services in Form MCB in the Schedule to these Regulations or in a form substantially to the like effect.

(2) A health authority may, if otherwise satisfied in relation to the entitlement of a person or persons to specialist services under these Regulations, dispense with the requirement in subarticle (1) of this article in respect of a particular person or a particular class of persons.

(3) 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,

(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.

SCHEDULE.

Form MCA HEALTH ACT, 1953 . Confidential.

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.

Particulars in relation to my entitlement are overleaf.

I certify that these particulars are, to the best of my knowledge, accurate and complete 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.

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

To the Secretary, Cork, Dublin, Limerick or Waterford Health Authority (as appropriate).

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

PARTICULARS AS TO ENTITLEMENT.

PART I.—TO BE COMPLETED WHERE THE APPLICANT (OR HER HUSBAND) IS THE HOLDER OF A MEDICAL CARD ENTITLING HER TO THE DISPENSARY MEDICAL SERVICE UNDER SECTION 14 OF THE ACT OR OF A LETTER NOTIFYING HER (OR HIM) THAT SHE IS ENTITLED TO OTHER SERVICES UNDER SECTION 14.

To whom was the card or letter issued ?............................................................ .............................................

Number of card or reference number and date of letter............................................................ ....................

If you have completed Part I, the remaining Parts may be ignored.

PART II.—TO BE COMPLETED WHERE THE APPLICANT OR HER HUSBAND IS INSURED UNDER THE SOCIAL WELFARE ACT, 1952 (AS AMENDED).

If the applicant is herself insured under the Social Welfare Act, 1952 (as amended)—

her insurance number............................................................ ............................................................ .................

Name and address of her employer............................................................ .......................................................

If the applicant is not insured but her husband is—

his name............................................................ ............................................................ .......................................

his insurance number............................................................ ............................................................ ..................

name and address of his employer............................................................ ........................................................

If you have completed Part II, the remaining Parts may be ignored.

PART III.—TO BE COMPLETED WHERE THE APPLICANT'S (OR HER HUSBAND'S) MEANS ARE DERIVED WHOLLY OR MAINLY FROM FARMING.

Address (or addresses) of the farm or farms (including any held on an agreement for letting)............................................................ ............................................................ ...........................................

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

Total rateable valuation (including buildings)............................................................ ........................................

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

*The incomes of the husband and wife and of any unmarried son, daughter, stepson or stepdaughter normally resident with the applicant should be included.

If you have completed Part III, the remaining Part may be ignored.

PART IV.—TO BE COMPLETED ONLY WHERE THE APPLICANT IS NOT A PERSON COVERED BY PART I, II OR III 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) a widow's (non-contributory) pension ?	............................................................ ...
(b) 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.

Form MCB. Confidential

HEALTH ACT, 1953 .

MEDICAL CARE FOR MOTHERS AND INFANTS.

APPLICATION FOR INSTITUTIONAL OR SPECIALIST SERVICES.

I*................................................... of*........................in the County/County Borough of......................................................hereby apply for institutional and specialist services—

(a)† for myself in respect of motherhood, or

(b)† for my child who is under six weeks old.

Particulars in relation to my entitlement are overleaf.

I certify that these particulars are, to the best of my knowledge, accurate and complete.

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

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

To the............................................. County Council, or Cork, Dublin, Limerick or Waterford Health Authority (as appropriate).

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.

PARTICULARS AS TO ENTITLEMENT.

To whom was the card or letter issued ? ............................................................ ..................................................

Number of card or reference number and date of letter............................................................ ..........................

If you have completed Part I, the remaining Parts may be ignored.

PART II.—TO BE COMPLETED WHERE THE APPLICANT OR HER HUSBAND IS INSURED UNDER THE SOCIAL WELFARE ACT, 1952 (AS AMENDED).

If the applicant is herself insured under the Social Welfare Act, 1952 (as amended)—

her insurance number............................................................ ............................................................ ...................

name and address of her employer............................................................ ..........................................................

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

If the applicant is not insured but her husband is—

his name............................................................ ............................................................ .........................................

his insurance number............................................................ ............................................................ ....................

name and address of his employer............................................................ ..........................................................

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

If you have completed Part II, the remaining Parts may be ignored.

*Name and address in block letters.

†Delete if not applicable.

PART III.—TO BE COMPLETED WHERE THE APPLICANT'S (OR HER HUSBAND'S) MEANS ARE DERIVED WHOLLY OR MAINLY FROM FARMING.

Address (or addresses) of the farm or farms (including any held on an agreement for letting)....................

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

Total rateable valuation (including buildings)............................................................ ........................................

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

*The incomes of the husband and wife and of any unmarried son, daughter, stepson or stepdaughter normally resident with the applicant should be included.

If you have completed Part III, the remaining Part may be ignored.

PART IV.—TO BE COMPLETED ONLY WHERE THE APPLICANT IS NOT A PERSON COVERED BY PART I, II OR III 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) a widow's (non-contributory) pension ?	............................................................ ...............................
(b) 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.

Form MCC. Confidential.

HEALTH ACT, 1953 .

FORM OF NOTIFICATION OF ADMISSION TO INSTITUTION.

INSTITUTIONAL SERVICES FOR MOTHERS AND INFANTS.

Institution.............................

*Delete whichever is not applicable.

The following are particulars of a patient admitted to the above-mentioned institution in respect of whom it is proposed to claim payment from your authority under section 16, or section 17 or section 25* of the Health Act, 1953 :—

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

Ordinary Address............................................................ ............................................................ ..............

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

Name and address of medical practitioner who referred the patient for institutional treatment............................................................ ............................................................ ....................

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

Date of admission of patient............................................................ ........................................................

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

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

Office............................................................ ............................................

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

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

To : the Secretary, Cork, Dublin, Limerick or Waterford Health Authority (as appropriate).

Form MCD.

PART I.

FORM OF AGREEMENT WITH REGISTERED MEDICAL PRACTITIONER.

HEALTH ACT, 1953 .

Form of Agreement with General Medical Practitioner under Article 9, 10 or 11 of the Maternity and Child Health Services (Amendment) Regulations, 1964.

I*.........................................................of* .......................................(hereinafter called the registered medical practitioner) propose to provide services in accordance with the terms and conditions in Part II of Form MCD in the Schedule to the Maternity and Child Health Services (Amendment) Regulations, 1964, for persons for whom the *............................................................ (hereinafter called the Authority) are obliged to make such services available.

Part II of Form MCD in the Schedule to the Maternity and Child Health Services (Amendment) Regulations, 1964, shall be taken and construed as part of this agreement and 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 (Amendment) Regulations, 1964 ( S.I. No. 158 of 1964 ).

Signed this.................day of............... 19......, by the registered medical practitioner :—............................... in the presence of :—............................................................ ............................................................ .......................

The Authority hereby accepts the above proposal of the medical practitioner for the provision by him of services in accordance with the terms and conditions aforesaid.

Signed this............................................................ ... day of............................................................ .......... 19...............

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

Manager.

PART II.

TERMS AND CONDITIONS OF AGREEMENT WITH REGISTERED MEDICAL PRACTITIONER.

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

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

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.