Medical Cards General

HEALTH ACT 1970

Chapter III

General Medical Services

Section 58
F95[

General practitioner medical and surgical service.

58.—(1) F96[Subject to subsection (4), the Health Service Executive] shall make available without charge a general practitioner medical and surgical service for a person in any of the following categories—

(a) persons with full eligibility,

(b) adult persons with limited eligibility for whom, in the opinion of the Health Service Executive, and notwithstanding that they do not come within the category mentioned in section 45(1)(a), it would be unduly burdensome to arrange general practitioner medical and surgical services for themselves and their dependants, and

(2) In deciding whether or not a person comes within the category mentioned in subsection (1)(b), the Health Service Executive shall have regard to the person’s overall financial situation (including the means of the spouse F97[or civil partner within the meaning of the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010], if any, of that person in addition to the person’s own means) in view of the person’s reasonable expenditure in relation to himself or herself and his or her dependants, if any.

(3) Insofar as it is considered practicable by the Health Service Executive, a choice of medical practitioner shall be offered under the general practitioner medical and surgical service made available under this section.]

F98[(4) For the purposes of this section, a person shall be deemed not to come within a category mentioned in paragraph (a) or (c) of subsection (1) for so long as that person has not attained the age of F99[eight years].]

Annotations

Amendments:

F95
Substituted (11.03.2005) by Health (Amendment) Act 2005 (3/2005), s. 5, commenced on enactment.

F96
Substituted (1.07.2015) by Health (General Practitioner Service) Act 2014 (28/2014), s. 4(a), S.I. No. 267 of 2015.

F97
Inserted (1.01.2011) by Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010 (24/2010), s. 170 and sch. part 5 item 5, S.I. No. 648 of 2010.

F98
Inserted (1.07.2015) by Health (General Practitioner Service) Act 2014 (28/2014), s. 4(a), S.I. No. 267 of 2015.

F99
Substituted (11.08.2023) by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 4(a), S.I. No. 401 of 2023.

F100
Substituted by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 5(a), not commenced as of date of revision.

F101
Substituted by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 6(a), not commenced as of date of revision.

F102
Substituted by Health (General Practitioner Service) Act 2015 (19/2015), s. 2(a), not commenced as of date of revision.

F103
Inserted by Health (General Practitioner Service) Act 2015 (19/2015), s. 2(b), not commenced as of date of revision.

Modifications (not altering text):

C24
Prospective affecting provision: subs. (4) amended by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 5(a), not commenced as of date of revision.

C25
Prospective affecting provision: subs. (4) amended by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 6(a), not commenced as of date of revision.

C26
Prospective affecting provision: subs. (1) amended and subs. (5) inserted by Health (General Practitioner Service) Act 2015 (19/2015), s. 2, not commenced as of date of revision.

58.—(1) F96[F102[Subject to subsections (4) and (5),] the Health Service Executive] shall make available without charge a general practitioner medical and surgical service for a person in any of the following categories—

…

F103[(5) For the purposes of this section, a person shall be deemed not to come within a category mentioned in paragraph (a), (b) or (c) of subsection (1) where that person has attained the age of 70 years.]

Editorial Notes:

E222
Power pursuant to section exercised (1.04.1972) by Health Services Regulations 1972 (S.I. No. 88 of 1972), in effect as per reg. 3.

Section 58A
F104[

General practitioner medical and surgical service for certain persons over 70 years of age.

58A.—(1) The Health Service Executive shall make available without charge a general practitioner medical and surgical service for a person who is ordinarily resident in the State in one of the following categories—

(a) persons—

(i) who on or after 5 April 2013, attain or have attained the age of 70 years,

(ii) who have limited eligibility,

(iii) whose gross income does not exceed the relevant gross income limit, and

(iv) who—

(I) make an application to the Health Service Executive in such form as it may consider appropriate, and

(II) receive confirmation from the Health Service Executive that they have qualified for services under this section because they have attained the age of 70 years, are ordinarily resident in the State and their gross income does not exceed the relevant gross income limit,

so long as their gross income does not exceed that relevant limit,

and

(b) dependants of persons referred to in paragraph (a).

(2) The gross income limits for the purposes of this section are the following:

(a) if a person—

(i) is not married, and is not living together with another person as husband and wife, or

(ii) does not have a civil partner,

his or her gross income limit is €700 per week, not including the income from the portion of the person’s savings or similar investments whose capital value does not exceed €36,000, and

(b) if persons—

(i) are married or live together as husband and wife, or

(ii) are civil partners as respects each other,

their combined gross income limit is €1,400 per week, not including the income from the portion of their savings or similar investments whose capital value does not exceed €72,000.

(3) Where—

(a) a person—

(i) was married to another person until that other person’s death,

(ii) was living with another person as husband and wife until that other person’s death, or

(iii) was a civil partner as respects another person until that other person’s death,

and

(b) the death of the other person occurred on or after 5 April 2013, and

the gross income limit applicable to the surviving person in the 3 years following the death of that other person shall be that specified in paragraph (b) of subsection (2) for such part of that period as the surviving person is not married, living together with another person as husband and wife, or does not have a civil partner.

(4) The Health Service Executive shall provide any necessary supports to any person in the making of an application under subsection (1) where, by reason of any incapacity, such person requests such assistance.

(5) The Minister shall, on 1 September of every year, review the most recent information on the consumer price index made available by the Central Statistics Office, and may, with the consent of the Minister for Public Expenditure and Reform, by regulations to take effect on 1 January next following that review, increase or decrease the gross income limits specified for the purposes of this section to reflect any increase or decrease in that index.

(6) In the calculation of gross income for the purposes of this section, all gross income from all sources is to be included except for the gross income arising from the following sources of income, and any subsequent income from the investment of the monies arising from those sources:

(a) compensation awards to persons under the Hepatitis C Compensation Tribunal Acts 1997 to 2006;

(b) compensation awards by way of the Residential Institutions Redress Board established under section 3 of the Residential Institutions Redress Act 2002;

(i) to a living relevant person,

(ii) to the spouse or former spouse of a living or deceased relevant person,

(iii) directly to a living child of a relevant person by virtue of section 9(8) of that Act;

(d) ex-gratia awards approved by the Lourdes Hospital Redress Board under the terms of the Lourdes Hospital Redress Scheme 2007;

(e) similar awards and payments set out in regulations made under subsection (8).

(7) In the calculation of gross income for the purposes of this section, income will not be imputed from property comprising an interest in land (whether a family home, a holiday home or any other property), other than the net rental income (calculated as gross rental income, less any cost necessarily incurred and associated with the rental of the property).

(8) The Minister may make regulations prescribing a class or classes of payments not coming within paragraphs (a) to (d) of subsection (6) but which the Minister considers to be made for a similar purpose as those made under those paragraphs.

(9) Insofar as it is considered practicable by the Health Service Executive, a choice of medical practitioner shall be offered under the general practitioner medical and surgical service made available under this section.

(10) In this section “civil partner” has the same meaning as it has in the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010.]

Annotations

Amendments:

F104
Inserted (19.04.2013) by Health (Alteration of Criteria for Eligibility) Act 2013 (10/2013), s. 7, S.I. No. 133 of 2013.

F105
Substituted (5.08.2015) by Health (General Practitioner Service) Act 2015 (19/2015), s. 3, partially commenced by S.I. No. 348 of 2015 insofar as it applies to persons other than persons who come within a category mentioned in s. 58(1)(a), (b) or (c).

Modifications (not altering text):

C27
Prospective affecting provision: section substituted (5.08.2015) by Health (General Practitioner Service) Act 2015 (19/2015), s. 3, partially commenced by S.I. No. 348 of 2015 insofar as it applies to persons other than persons who come within a category mentioned in s. 58(1)(a), (b), or (c).

F105[58A. (1) The Health Service Executive shall make available without charge a general practitioner medical and surgical service for a person who is ordinarily resident in the State in one of the following categories:

(a) persons who have attained the age of 70 years;

(b) dependants of qualifying persons where the Health Service Executive has, in accordance with subsection (5)(a), confirmed that a condition specified in subsection (2) is met by the qualifying person concerned, for so long as that condition is met.

(2) A qualifying person meets a condition referred to in subsection (1)(b) where—

(a) in the case of a qualifying person who is not married, is not living together with another person as husband and wife and does not have a civil partner, his or her gross income does not exceed the gross income limit specified in subsection (3)(a),

(b) in the case of a qualifying person who is married, the combined gross income of the person and his or her spouse does not exceed the gross income limit specified in subsection (3)(b),

(c) in the case of a qualifying person who is living together with another person as husband and wife, the combined gross income of the person and that other person does not exceed the gross income limit specified in subsection (3)(b), or

(d) in the case of a qualifying person who has a civil partner, the combined gross income of the person and his or her civil partner does not exceed the gross income limit specified in subsection (3)(b).

(3) Subject to subsection (9)—

(a) for the purposes of subsection (2)(a), the gross income limit shall be €700 per week, not including the income from the portion of the person’s savings or similar investments whose capital value does not exceed €36,000, and

(b) for the purposes of subsection (2)(b), (c) and (d), the gross income limit shall be €1,400 per week, not including the income from the portion of the persons’ savings or similar investments whose capital value does not exceed €72,000.

(4) A qualifying person may, for the purposes of subsection (1)(b), make an application to the Health Service Executive, in such form as it considers appropriate, for confirmation that a condition specified in subsection (2) is met by him or her.

(5) The Health Service Executive shall, on receipt of an application under subsection (4), consider the application, together with any information furnished to it pursuant to a request under subsection (6), and—

(a) if it is satisfied that a condition specified in subsection (2) is met by the qualifying person concerned, provide the qualifying person with confirmation in writing that the condition is met by him or her, or

(b) if it is not so satisfied, provide the qualifying person with a notice in writing stating that the application has been refused and the reasons for such refusal.

(6) A person shall, when requested to do so by the Health Service Executive, furnish to the Health Service Executive such information as the Health Service Executive considers necessary for it to establish that the person, or his or her dependant, as the case may be, is, or continues to be, entitled under subsection (1) to the service referred to in that subsection.

(7) Where a person fails or refuses to furnish the information requested by the Health Service Executive under subsection (6) within such reasonable period as is specified in the request, the Health Service Executive may—

(a) if the information requested relates to the person’s entitlement under subsection (1)(a) to the service referred to in that subsection, treat the person concerned as if he or she was not entitled under subsection (1)(a) to the service referred to in that subsection, and

(b) if the information requested relates to the entitlement of the person’s dependant under subsection (1)(b) to the service referred to in that subsection, treat the dependant concerned as if he or she was not entitled under subsection (1)(b) to the service referred to in that subsection.

(8) The Health Service Executive shall provide any necessary assistance to any person in the making of an application under subsection (4) or the furnishing of information requested under subsection (6), as the case may be, where, by reason of any incapacity, such person requests such assistance.

(9) The Minister shall, on 1 September of every year, review the most recent information on the consumer price index made available by the Central Statistics Office and may, with the consent of the Minister for Public Expenditure and Reform, by regulations to take effect on 1 January next following that review, increase or decrease the gross income limits specified in subsection (3) to reflect any increase or decrease in that index.

(10) In the calculation of gross income for the purposes of this section, all gross income from all sources shall be included other than the gross income arising from the following sources of income, and any subsequent income from the investment of the monies arising from those sources:

(a) compensation awarded under the Hepatitis C Compensation Tribunal Acts 1997 to 2006;

(b) compensation awarded by the Residential Institutions Redress Board;

(d) ex-gratia awards approved by the Lourdes Hospital Redress Board under the terms of the Lourdes Hospital Redress Scheme 2007;

(e) such other awards and payments prescribed in regulations made under subsection (12).

(11) In the calculation of gross income for the purposes of this section, income shall not be imputed from property comprising an interest in land (whether a family home, a holiday home or any other property) other than any net rental income (calculated as gross rental income less any cost necessarily incurred and associated with the rental of the property).

(12) The Minister may make regulations prescribing a class or classes of awards or payments not coming within paragraphs (a) to (d) of subsection (10) but which the Minister considers to be made for a similar purpose as those made under those paragraphs.

(13) Insofar as considered practicable by the Health Service Executive, a choice of medical practitioner shall be offered under the general practitioner medical and surgical service made available under this section.

(14) In this section—

“civil partner” has the same meaning as it has in the Civil Partnership and Certain Rights and Obligations of Cohabitants Act 2010;

“dependants” means dependants who have not attained the age of 70 years;

“qualifying person” means a person who is entitled under subsection (1)(a) to the service referred to in that subsection.]

Editorial Notes:

E223
Power pursuant to subs. (8) exercised (2.08.2019) by Health Act 1970 (Section 58A(8)) (Classes of Payments) Regulations 2019 (S.I. No. 416 of 2019).

E224
Previous affecting provision: power pursuant to subs. (8) exercised (1.07.2015) by Health Act 1970 (Section 58A(8)) (Classes of Payments) Regulations 2015 (S.I. No. 278 of 2015), in effect as per reg. 1(2); revoked (2.08.2019) by Health Act 1970 (Section 58A(8)) (Classes of Payments) Regulations 2019 (S.I. No. 416 of 2019), reg. 3.

Section 58B
F106[

General practitioner medical and surgical service for persons under 6 years of age.

58B.—(1) The Health Service Executive shall make available without charge a general practitioner medical and surgical service for a person who is ordinarily resident in the State and has not attained the age of F107[eight years].

(2) The parent or guardian of a person shall, when requested to do so by the Health Service Executive, furnish to the Health Service Executive such information as the Health Service Executive considers necessary for it to establish that the person is, or continues to be, entitled under subsection (1) to the service referred to in that subsection.

(3) Where a parent or guardian fails or refuses to furnish the information requested by the Health Service Executive under subsection (2) within such reasonable period as is specified in the request, the Health Service Executive may treat the person concerned as if he or she was not entitled under subsection (1) to the service referred to in that subsection.

(4) Insofar as considered practicable by the Health Service Executive, a choice of medical practitioner shall be offered under the general practitioner medical and surgical service made available under this section.]

Annotations

Amendments:

F106
Inserted (1.07.2015) by Health (General Practitioner Service) Act 2014 (28/2014), s. 5, S.I. No. 267 of 2015.

F107
Substituted (11.08.2023) by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 4(b), S.I. No. 401 of 2023.

F108
Substituted by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 5(b), not commenced as of date of revision.

F109
Substituted by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 6(b), not commenced as of date of revision.

Modifications (not altering text):

C28
Prospective affecting provision: subs. (1) amended by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 5(b), not commenced as of date of revision.

58B. (1) The Health Service Executive shall make available without charge a general practitioner medical and surgical service for a person who is ordinarily resident in the State and has not attained the age of F108[ten years].

C29
Prospective affecting provision: subs. (1) amended by Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 (11/2020), s. 6(b), not commenced as of date of revision.

Section 58C
F110[

Agreement for provision of service under section 58B.

58C.—(1) The Health Service Executive may, subject to this section, enter, on such terms and conditions as it considers appropriate, into an agreement with a relevant medical practitioner for the provision by him or her of relevant services to eligible persons.

(2) Without prejudice to the generality of the power of the Health Service Executive under subsection (1), an agreement referred to in that subsection shall—

(a) specify the services referred to in subsection (1) that are to be provided by the relevant medical practitioner, and

(b) provide that the payment to be made to the relevant medical practitioner for the provision of those services shall be the payment prescribed in respect of those services by regulations under this section in force at the time the services are provided.

(3) The Minister may, with the consent of the Minister for Public Expenditure and Reform and in accordance with this section, by regulation prescribe the amount or the rate of payment to be made to relevant medical practitioners in respect of the services provided by them under agreements referred to in subsection (1).

(4) Regulations made under subsection (3) may prescribe different amounts or rates in respect of different services or in respect of the provision of services to different classes of eligible person.

(5) Prior to making regulations under subsection (3), the Minister or, at the Minister’s direction, the Health Service Executive, shall engage in such consultations as the Minister considers appropriate.

(6) Consultations under subsection (5) shall be completed no later than 60 days after the Minister gives notice of the commencement of the consultations.

(7) Regulations made under subsection (3) shall prescribe amounts or rates that the Minister considers to be fair and reasonable having regard to the matters the Minister considers appropriate, including either or both of the following:

(a) any submissions made and views expressed during the consultations under subsection (5);

(b) the nature of the services concerned and the general nature of expenses and commitments of the relevant medical practitioners providing those services.

(8) (a) The Minister may define the manner in which consultations under subsection (5) are to be conducted and, in doing so, shall have regard to any agreement entered into between the Minister and representatives of relevant medical practitioners relating to the conduct of consultations under that subsection.

(b) The Minister or, as the case may be, the Health Service Executive shall conduct consultations under subsection (5) in the manner defined under paragraph (a) and with such representatives of relevant medical practitioners or otherwise as the Minister or, as the case may be, the Health Service Executive considers appropriate, and nothing in the Competition Act 2002 shall prevent participation by the Minister, the Health Service Executive or any such representative in such consultations, or the communication and discussion of the outcome of such consultations by the representatives with the relevant medical practitioners they represent.

(9) Without prejudice to any other provision in such an agreement relating to its termination, an agreement referred to in subsection (1) shall provide that, where an amount or rate of payment prescribed by a regulation under subsection (3) is varied by a subsequent regulation made under that subsection, the relevant medical practitioner concerned may terminate the agreement by giving the Health Service Executive 3 months’ notice of the termination.

(10) An agreement referred to in subsection (1) shall apply between its parties notwithstanding any other contract, arrangement, understanding, expectation, circular or instrument or other document that exists at the time the contract is entered into.

(11) (a) Notwithstanding subsection (1), the Health Service Executive may, during the period that begins on the date on which this section comes into operation and ends six months after that date, enter into an agreement referred to in that subsection with a registered medical practitioner who is not a relevant medical practitioner, where that registered medical practitioner, at the time the agreement is entered into, is party to an agreement with the Health Service Executive to provide one or more services which may be provided, under the General Medical Services Scheme, to a person entitled under section 58 to have those services made available to him or her.

(b) A reference in this section (other than in paragraph (a)) to a relevant medical practitioner shall be deemed to include a reference to a registered medical practitioner who has, in accordance with paragraph (a), entered into an agreement referred to in subsection (1).

(12) In this section—

“eligible persons” means persons who are entitled under section 58B (inserted by section 5 of the Health (General Practitioner Service) Act 2014) to have relevant services made available to them;

“General Medical Services Scheme” has the meaning it has under section 1 of the Health (Provision of General Practitioner Services) Act 2012;

“registered medical practitioner” has the same meaning as it has in section 2 of the Medical Practitioners Act 2007;

“relevant medical practitioner”, subject to subsection (11), means a registered medical practitioner—

(a) whose name is included in the Specialist Division of the register of medical practitioners established under section 43(2)(b) of the Medical Practitioners Act 2007, and

(b) who holds a current certificate of registration within the meaning of section 2 of that Act in respect of the medical speciality “General Practice” recognised under section 89(1) of that Act;

“relevant services” means the services that constitute the general practitioner medical and surgical service referred to in section 58B(1).]

F111[(13) Notwithstanding any other part of this section, the agreement, referred to in subsection (1) shall not:

(a) include any provision to restrict the criticism of the Health Service Executive, or the Department of Health;

(b) impose an obligation upon any general practitioner to limit criticism of the Health Service Executive, or the Department of Health;

(c) require any general practitioner to notify the Health Service Executive, or the Department of Health in advance of making a public statement;

(d) require any general practitioner to receive prior approval from the Health Service Executive, or the Department of Health, for any public statement they wish to make;

(e) require any general practitioner to dilute their natural rights to freedom of expression implicit in article 40.3.1º of Bunreacht na hÉireann and explicit in article 10.1 in the European Convention on Human Rights.]

Annotations

Amendments:

F110
Inserted (1.07.2015) by Health (General Practitioner Service) Act 2014 (28/2014), s. 5, S.I. No. 267 of 2015.

F111
Inserted (1.07.2015) by Health (General Practitioner Service) Act 2014 (28/2014), s. 6, S.I. No. 267 of 2015.

Editorial Notes:

E225
Power pursuant to subss. (3), (4) exercised (1.08.2023, deemed) by Health Act 1970 (Section 58C) (Payments to Relevant Medical Practitioners) (Amendment) Regulations 2023 (S.I. No. 459 of 2023), in effect as per reg. 2.

E226
Power pursuant to subss. (3), (4) exercised (1.07.2015) by Health Act 1970 (Section 58C) (Payments to Relevant Medical Practitioners) Regulations 2015 (S.I. No. 284 of 2015), in effect as per reg. 1(2).

Section 58D
F112[

General practitioner medical and surgical service for persons in receipt of carer’s allowance or carer’s benefit.

58D.—(1) The Health Service Executive shall make available without charge a general practitioner medical and surgical service for a person who is in receipt of—

(a) carer’s benefit within the meaning of Chapter 14 of Part 2 of the Act of 2005,

(b) carer’s allowance within the meaning of Chapter 8 of Part 3 of the Act of 2005, or

(2) A person shall, when requested to do so by the Health Service Executive, furnish to the Health Service Executive such information as the Health Service Executive considers necessary for it to establish that the person is, or continues to be, entitled under subsection (1) to the service referred to in that subsection.

(3) Where a person fails or refuses to furnish the information requested by the Health Service Executive under subsection (2) within such reasonable period as is specified in the request, the Health Service Executive may treat the person concerned as if he or she was not entitled under subsection (1) to the service referred to in that subsection.

(5) In this section “Act of 2005” means the Social Welfare Consolidation Act 2005.]

Annotations

Amendments:

F112
Inserted (1.09.2018) by Health (General Practitioner Service) Act 2018 (13/2018), s. 4, S.I. No. 320 of 2018.

Editorial Notes:

E227
The section heading is taken from the amending section in the absence of one included in the amendment.

Section 59

Drugs, medicines and appliances.

59.—(1) F113[Subject to sections 20 and 23 of the Health (Pricing and Supply of Medical Goods) Act 2013, a] health board shall make arrangements for the supply without charge of drugs, medicines and medical and surgical appliances F114[, for the time being on the Reimbursement List within the meaning of section 2(1) of that Act,] to persons with full eligibility.

F115[(1A) Notwithstanding subsection (1) but subject to F116[subsections (1B) and (1C) and section 59A], a person with full eligibility who avails himself or herself of the service under subsection (1) shall be charged, by a community pharmacy contractor, an amount of F117[€1.50], or such other amount as may be determined by regulations made by the Minister under this section, per item supplied to that person on the prescription of a registered medical practitioner or registered dentist, or on the prescription of a registered nurse (being a person whose name is entered in the register of nurses maintained under section 27 of the Nurses Act 1985) who is entitled pursuant to any enactment to prescribe the drugs, medicines or medical or surgical appliances so supplied.

(1B) (a) F118[Subject to paragraphs (b) and (c) and subsection (3) of section 59A], the maximum aggregate amount payable in respect of items referred to in subsection (1A) supplied in a month to an adult person and his or her dependants shall be F117[€15.00] or such other amount as may be determined by regulations made by the Minister under this section.

(b) The Health Service Executive shall make arrangements for the refunding, crediting or otherwise relieving persons from the payment of amounts charged that exceed F118[the maximum aggregate amount referred to in paragraph (a) or subsection (3) of section 59A] and where, for any reason, such an excess amount is charged in respect of an adult person and his or her dependants, that excess amount shall be refunded or credited, or relief shall otherwise be granted, as the case may be, in relation to any such excess amount in accordance with such arrangements and subject to any regulations that the Minister may make under this section.

F119[(c) Where a child referred to in subsection (5B) of section 45 has full eligibility solely by reason of that subsection, the maximum aggregate amount referred to in paragraph (a) shall apply in respect of items referred to in subsection (1A) supplied in a month—

(i) to that child, or

(ii) in the case where an allowance referred to in subsection (5B) of section 45 is being paid to the same person in respect of more than one such child, to those children.]

(1C) A person who falls within any of the following classes shall not be charged an amount under subsection (1A):

(a) children who are in the care of the Health Service Executive under the Child Care Acts 1991 to 2007;

(b) persons to whom are supplied specified controlled drugs, within the meaning of the Misuse of Drugs (Supervision of Prescription and Supply of Methadone) Regulations 1998 or such other regulations as may be made by the Minister under section 5 of the Misuse of Drugs Act 1977 for the purpose of preventing the misuse of controlled drugs, in respect of those specified controlled drugs;

(1D) Notwithstanding any other enactment, contract, arrangement, understanding, expectation, circular or other document, the payment that shall be made to a community pharmacy contractor in respect of services rendered by the community pharmacy contractor to or on behalf of the Health Service Executive in respect of the drugs, medicines and medical and surgical appliances dispensed by a registered pharmacist to persons and their dependants under this section shall be reduced by an amount equal to the amounts collectable by that community pharmacy contractor under subsection (1A), irrespective of whether those amounts are actually collected.

(1E) In subsections (1A) to (1D)—

“community pharmacy contractor” means a registered pharmacist, company or other body corporate that provides services to the Health Service Executive under an agreement made in accordance with conditions specified by the Minister in 1971 or 1996, as amended from time to time, for the provision of community pharmacy services to eligible persons under subsection (1);

“dependant”, in relation to a person with full eligibility, includes an adult person with full eligibility, so long as that adult person is under the age of 21 years and receiving full time education and is wholly or mainly maintained by the first-mentioned person.]

(2) When a person with limited eligibility, or a person with full eligibility who does not avail himself of the service under subsection (1), satisfies the chief effective officer of the health board that, F120[in respect of a prescribed period and to a prescribed amount], he has incurred expenditure on drugs, medicines and medical and surgical appliances F114[, for the time being on the Reimbursement List within the meaning of section 2(1) of the Health (Pricing and Supply of Medical Goods) Act 2013,] which were obtained on the prescription of a registered medical practitioner F121[, or on the prescription of a registered nurse (being a person whose name is entered in the register of nurses maintained under section 27 of the Nurses Act 1985) entitled pursuant to any enactment to prescribe the drugs, medicines or medical or surgical appliances so obtained,] and were for the treatment of that person or his dependants, the health board shall make arrangements to meet the balance of the cost, or a proportion thereof (as may be prescribed) of the person’s being supplied in respect of that period with such drugs, medicines and medical and surgical appliances.

(3) A health board may make arrangements for the supply without charge of drugs, medicines or medical and surgical appliances F114[, for the time being on the Reimbursement List within the meaning of section 2(1) of the Health (Pricing and Supply of Medical Goods) Act 2013,] to persons suffering from a prescribed disease or disability of a permanent or long-term nature.

F120[(4) (a) The Minister may make regulations—

(i) subject to paragraph (b), varying either or both of the amounts referred to in subsections (1A) and (1B)(a),

(ii) subject to paragraph (c), specifying other classes of persons who shall not be charged the amount referred to in subsection (1A) either in respect of all items supplied to persons of that class or specified categories of such items, and

(iii) where the Minister considers it necessary to do so, in relation to the refund, credit or other relief of amounts in excess of the maximum aggregate amount referred to in subsection (1B).

(b) The Minister shall make regulations under paragraph (a)(i) only where he or she is of opinion that such a variation is desirable, having regard to such of the following as he or she considers appropriate:

(i) information on the consumer price index made available by the Central Statistics Office from time to time;

(ii) recent information on the aggregate of the amounts expended, and the number of items in respect of which those amounts were expended, by the Health Service Executive in providing the service under subsection (1);

(iii) the medical needs of, and the financial burden on, persons who avail themselves of the service under subsection (1);

(iv) the necessity of controlling expenditure in relation to the provision by the State of health services.

(c) The Minister shall make regulations under paragraph (a)(ii) only where he or she is of opinion that not to charge the amount referred to in subsection (1A) to such a class is just and equitable in the circumstances, having regard to such of the following as he or she considers appropriate:

(i) the particular medical condition, disability or medical needs of persons of that class;

(ii) the number of prescription items required in respect of the condition, disability or medical needs referred to in subparagraph (i);

(iii) recent information on the aggregate of the amounts expended, and the number of items in respect of which those amounts were expended, by the Health Service Executive in providing the service under subsection (1), either generally or in respect of persons of that class;

(iv) the necessity of controlling expenditure in relation to the provision by the State of health services;

(v) whether the overall financial situation of all, or substantially all, of the persons of that class is significantly worse than that of other persons who are charged amounts under subsection (1A).

(d) Regulations under this section shall be made with the consent of the Minister for Finance.]

F114[(5) Nothing in this section shall be construed to affect the operation of section 26 of the Health (Pricing and Supply of Medical Goods) Act 2013.]

Annotations

Amendments:

F113
Substituted (24.06.2013) by Health (Pricing and Supply of Medical Goods) Act 2013 (14/2013), s. 30(a)(i), S.I. No. 202 of 2013.

F114
Inserted (24.06.2013) by Health (Pricing and Supply of Medical Goods) Act 2013 (14/2013), s. 30(a)(ii)-(d), S.I. No. 202 of 2013.

F115
Inserted (1.10.2010) by Health (Amendment) (No. 2) Act 2010 (20/2010), s. 1(a), S.I. No. 415 of 2010.

F116
Substituted (14.04.2017) by Health (Amendment) Act 2017 (5/2017), s. 3(a), (b)(i), (ii), S.I. No. 155 of 2017.

F117
Substituted (1.11.2020) by Health Services (Prescription Charges) Regulations 2020 (S.I. No. 464 of 2020), regs. 3, 4, in effect as per reg. 2.

F118
Substituted (14.04.2017) by Health (Amendment) Act 2017 (5/2017), s. 3(a), (b)(i), (ii), S.I. No. 155 of 2017.

F119
Inserted (1.06.2017) by Health (Amendment) Act 2017 (5/2017), s. 3(b)(iii), S.I. No. 155 of 2017.

F120
Substituted (1.10.2010) by Health (Amendment) (No. 2) Act 2010 (20/2010), s. 1(b), (c), S.I. No. 415 of 2010.

F121
Inserted (27.02.2009) by Irish Medicines Board (Miscellaneous Provisions) Act 2006 (3/2006), s. 26, S.I. No. 67 of 2009.

Modifications (not altering text):

C30
Application of section affected (24.06.2013) by Health (Pricing and Supply of Medical Goods) Act 2013 (14/2013), s. 20, S.I. No. 202 of 2013.

Conditional supply of listed items.

20.— (1) The Executive may attach conditions to the supply or reimbursement, under section 59 of the Act of 1970, of listed items (including classes of listed items) in the interests of one or more of the following:

(a) patient safety;

(b) cost-effectiveness;

(d) appropriately applying the resources available to the Executive.

…

C31
Application of subs. (2) restricted (24.06.2013) by Health (Pricing and Supply of Medical Goods) Act 2013 (14/2013), s. 24(7), S.I. No. 202 of 2013.

Reference price for listed items which fall within group of interchangeable medicinal products.

24.— …

(7) Section 59(2) of the Act of 1970 applies to the following expenditure:

(a) expenditure on a relevant listed item if, and only if, the relevant listed item is priced at or below the reference price;

(b) expenditure on a relevant listed item which is priced above the reference price if, and only if, the medicinal product is the subject of a clinical exemption; and

C32
Functions transferred and references to “Department of Finance” and “Minister for Finance” construed (29.07.2011) by Finance (Transfer of Departmental Administration and Ministerial Functions) Order 2011 (S.I. No. 418 of 2011), arts. 2, 3, 5 and sch. 1 part 2, in effect as per art. 1(2), subject to transitional provisions in arts. 6-9.

2. (1) The administration and business in connection with the performance of any functions transferred by this Order are transferred to the Department of Public Expenditure and Reform.

(2) References to the Department of Finance contained in any Act or instrument made thereunder and relating to the administration and business transferred by paragraph (1) shall, on and after the commencement of this Order, be construed as references to the Department of Public Expenditure and Reform.

3. The functions conferred on the Minister for Finance by or under the provisions of —

(a) the enactments specified in Schedule 1, and

(b) the statutory instruments specified in Schedule 2,

are transferred to the Minister for Public Expenditure and Reform.

…

5. References to the Minister for Finance contained in any Act or instrument under an Act and relating to any functions transferred by this Order shall, from the commencement of this Order, be construed as references to the Minister for Public Expenditure and Reform.

…

Schedule 1

Enactments

…

Part 2

1922 to 2011 Enactments

Number and Year

Short Title

Provision

(1)

(2)

(3)

…

No. 1 of 1970

Health Act 1970

Sections 44, 45, 52, 53, 56 and 59

…

C33
Term “registered medical practitioner” construed (3.07.2008) by Medical Practitioners Act 2007 (25/2007), s. 108(1), S.I. No. 231 of 2008.

Construction of references to registered medical practitioner and Medical Council, etc.

108.— (1) Every reference to a registered medical practitioner contained in any enactment or any statutory instrument shall be construed as a reference to a registered medical practitioner within the meaning of section 2.

…

C34
References to “health board” construed as references to Health Service Executive (1.01.2005) by Health Act 2004 (42/2004), ss. 56(a), 66, S.I. No. 887 of 2004.

Definitions (Part 10).

56.—In this Part “specified body” means—

(a) the health boards,

…

References to specified bodies.

66.—Subject to this Act, references (however expressed) to a specified body in any Act passed before the establishment day, or in any instrument made before that day under an Act, are to be read as references to the Executive, unless the context otherwise requires.

Editorial Notes:

E228
Power pursuant to section exercised (1.03.2022) by Health Services (Amendment) Regulations 2022 (S.I. No. 77 of 2022), in effect as per reg. 2.

E229
Power pursuant to section exercised (1.11.2020) by Health Services (Prescription Charges) Regulations 2020 (S.I. No. 464 of 2020), in effect as per reg. 2.

E230
Power pursuant to section exercised (1.01.2018) by Health Services (Drug Payment Scheme) Regulations 2017 (S.I. No. 577 of 2017), in effect as per reg. 2.

E231
Power pursuant to subs. (4)(a)(ii) exercised (16.12.2016) by Health Act 1970 (Section 59(4)) Regulations 2016 (S.I. No. 635 of 2016).

E232
Power pursuant to subs. (4)(a)(ii) exercised (8.09.2015) by Health Act 1970 (Section 59(4)) Regulations 2015 (S.I. No. 382 of 2015).

E233
Power pursuant to section exercised (31.01.2002) by Health (Community Pharmacy Contractor Agreement) Regulations, 1996 (Revocation) Regulations 2002 (S.I. No. 28 of 2002).

E234
Power pursuant to section exercised (1.04.1975) by Health Services (Amendment) Regulations 1975 (S.I. No. 64 of 1975), in effect as per reg. 2.

E235
Power pursuant to section exercised (5.07.1973) by Health Services Regulations 1973 (S.I. No. 184 of 1973).

E236
Power pursuant to section exercised (1.04.1972) by Health Services Regulations 1972 (S.I. No. 88 of 1972), in effect as per reg. 3.

E237
Power pursuant to section exercised (1.10.1971) by Health Services (Amendment) Regulations 1971 (S.I. No. 277 of 1971), in effect as per reg. 3.

E238
Previous affecting provision: power pursuant to section exercised (1.01.2022) by Health Services (Amendment) Regulations 2021 (S.I. No. 595 of 2021), in effect as per reg. 2; revoked (1.03.2022) by Health Services (Amendment) Regulations 2022 (S.I. No. 77 of 2022), reg. 5, in effect as per reg. 2.

E239
Previous affecting provision: power pursuant to section exercised (1.11.2020) by Health Services (Amendment) Regulations 2020 (S.I. No. 463 of 2020), in effect as per reg. 2; revoked (1.01.2022) by Health Services (Amendment) Regulations 2021 (S.I. No. 595 of 2021), reg. 5, in effect as per reg. 2.

E240
Previous affecting provision: power pursuant to section exercised (1.04.2019) by Health Services (Amendment ) Regulations 2019 (S.I. No. 59 of 2019), in effect as per reg. 2; revoked (1.11.2020) by Health Services (Amendment) Regulations 2020 (S.I. No. 463 of 2020), reg. 5, in effect as per reg. 2.

E241
Previous affecting provision: power pursuant to section exercised (1.01.2018) by Health Services (Prescription Charges) Regulations 2017 (S.I. No. 553 of 2017), in effect as per reg. 2; revoked (1.11.2020) by Health Services (Prescription Charges) Regulations 2020 (S.I. No. 464 of 2020), reg. 5, in effect as per reg. 2 .

E242
Previous affecting provision: power pursuant to section exercised (1.12.2013) by Health Services (Prescription Charges) Regulations 2013 (S.I. No. 437 of 2013), in effect as per reg. 2; revoked (1.01.2018) by Health Services (Prescription Charges) Regulations 2017 (S.I. No. 553 of 2017), reg. 5, in effect as per reg. 2.

E243
Previous affecting provision: power pursuant to section exercised (1.01.2013) by Health Services (Prescription Charges) Regulations 2012 (S.I. No. 545 of 2012), in effect as per reg. 2; revoked (1.12.2013) by Health Services (Prescription Charges) Regulations 2013 (S.I. No. 437 of 2013), reg. 5, in effect as per reg. 2.

E244
Previous affecting provision: power pursuant to section exercised (1.01.2013) by Health Services (Drug Payment Scheme) Regulations 2012 (S.I. No. 526 of 2012), in effect as per reg. 2; revoked (1.01.2017) by Health Services (Drug Payment Scheme) Regulations 2017 (S.I. No. 577 of 2017), reg. 3, in effect as per reg. 2.

E245
Previous affecting provision: power pursuant to section exercised (1.01.2012) by Health Services (Drug Payment Scheme) Regulations 2011 (S.I. No. 648 of 2011), in effect as per reg. 2; revoked (1.01.2013) by Health Services (Drug Payment Scheme) Regulations 2012 (S.I. No. 526 of 2012), reg. 3, in effect as per reg. 2.

E246
Previous affecting provision: power pursuant to section exercised (1.01.2010) by Health Services (Drugs Payment Scheme) Regulations 2009 (S.I. No. 536 of 2009), in effect as per reg. 2; revoked (1.01.2012) by Health Services (Drug Payment Scheme) Regulations 2011 (S.I. No. 648 of 2011), reg. 3, in effect as per reg. 2.

E247
Previous affecting provision: power pursuant to section exercised (1.01.2009) by Health Services Regulations 2008 (S.I. No. 519 of 2008), in effect as per reg. 2; revoked (1.01.2010) by Health Services (Drugs Payment Scheme) Regulations 2009 (S.I. No. 536 of 2009), reg. 3, in effect as per reg. 2.

E248
Previous affecting provision: power pursuant to section exercised (1.01.2008) by Health Services Regulations 2007 (S.I. No. 837 of 2007), in effect as per reg. 2; revoked (1.01.2009) by Health Services Regulations 2008 (S.I. No. 519 of 2008), reg. 3, in effect as per reg. 2.

E249
Previous affecting provision: power pursuant to section exercised (1.01.2005) by Health Services Regulations 2005 (S.I. No. 832 of 2004), in effect as per reg. 2; revoked (1.01.2008) by Health Services Regulations 2007 (S.I. No. 837 of 2007), reg. 3, in effect as per reg. 2.

E250
Previous affecting provision: power pursuant to section exercised (1.01.2004) by Health Services Regulations 2004 (S.I. No. 658 of 2003), in effect as per reg. 2; revoked (1.01.2005) by Health Services Regulations 2005 (S.I. No. 832 of 2004), reg. 3, in effect as per reg. 2.

E251
Previous affecting provision: power pursuant to section exercised (1.01.2003) by Health Services Regulations 2003 (S.I. No. 603 of 2002), in effect as per reg. 2; revoked (1.01.2004) by Health Services Regulations 2004 (S.I. No. 658 of 2003), reg. 3, in effect as per reg. 2.

E252
Previous affecting provision: power pursuant to section exercised (1.08.2002) by Health Services Regulations 2002 (S.I. No. 368 of 2002), in effect as per reg. 2; revoked (1.01.2003) by Health Services Regulations 2003 (S.I. No. 603 of 2002), reg. 3, in effect as per reg. 2.

E253
Previous affecting provision: power pursuant to section exercised (1.03.2001) by Health Services Regulations 2001 (S.I. No. 66 of 2001), in effect as per reg. 2; revoked (1.08.2002) by Health Services Regulations 2002 (S.I. No. 368 of 2002), reg. 3, in effect as per reg. 2.

E254
Previous affecting provision: section substituted by Health (Miscellaneous Provisions) Act 2001 (14/2001), s. 1(1)(b), not commenced; s. 1(1)(b) (24.06.2013) by Health (Pricing and Supply of Medical Goods) Act 2013 (14/2013), s. 31, S.I. No. 202 of 2013.

E255
Previous affecting provision: power pursuant to subs. (4) exercised (31.05.1996) by Health (Community Pharmacy Contractor Agreement) Regulations 1996 (S.I. No. 152 of 1996), in effect as per reg. 13; revoked (31.01.2002) by Health (Community Pharmacy Contractor Agreement) Regulations, 1996 (Revocation) Regulations 2002 (S.I. No. 28 of 2002), reg. 2.

E256
Previous affecting provision: power pursuant to section exercised (1.08.1991) by Health Services Regulations 1991 (S.I. No. 203 of 1991), in effect as per reg. 2; revoked (1.03.2001) by Health Services Regulations 2001 (S.I. No. 66 of 2001), reg. 3, in effect as per reg. 2.

E257
Previous affecting provision: power pursuant to section exercised (1.01.1991) by Health Services Regulations 1990 (S.I. No. 334 of 1990), in effect as per reg. 2; revoked (1.08.1991) by Health Services Regulations 1991 (S.I. No. 203 of 1991), reg. 4, in effect as per reg. 2.

E258
Previous affecting provision: power pursuant to section exercised (1.01.1984) by Health Services (No. 4) Regulations 1983 (S.I. No. 389 of 1983), in effect as per reg. 2; revoked (1.08.1991) by Health Services Regulations 1991 (S.I. No. 203 of 1991), reg. 4, in effect as per reg. 2.

E259
Previous affecting provision: power pursuant to section exercised (1.03.1983) by Health Services Regulations 1983 (S.I. No. 54 of 1983), in effect as per reg. 2; revoked (1.08.1991) by Health Services Regulations 1991 (S.I. No. 203 of 1991), reg. 4, in effect as per reg. 2.

E260
Previous affecting provision: power pursuant to section exercised (1.09.1982) by Health Services Regulations 1982 (S.I. No. 283 of 1982), in effect as per reg. 2; revoked (1.03.1983) by Health Services Regulations 1983 (S.I. No. 54 of 1983), reg. 3, in effect as per reg. 2.

E261
Previous affecting provision: power pursuant to section exercised (1.08.1981) by Health Services Regulations 1981 (S.I. No. 267 of 1981), in effect as per reg. 2; revoked (1.09.1982) by Health Services Regulations 1982 (S.I. No. 283 of 1982), reg. 3, in effect as per reg. 2.

E262
Previous affecting provision: power pursuant to section exercised (1.03.1980) by Health Services Regulations 1980 (S.I. No. 61 of 1980), in effect as per reg. 2; revoked (1.08.1981) by Health Services Regulations 1981 (S.I. No. 267 of 1981), reg. 3, in effect as per reg. 2.

E263
Previous affecting provision: power pursuant to section exercised (1.05.1976) by Health Services Regulations 1976 (S.I. No. 97 of 1976), in effect as per reg. 2; revoked (1.03.1980) by Health Services Regulations 1980 (S.I. No. 61 of 1980), reg. 3, in effect as per reg. 2.

E264
Previous affecting provision: power pursuant to section exercised (5.08.1975) by Health Services Regulations, 1972 (Amendment) Regulations 1975 (S.I. No. 181 of 1975); revoked (1.04.2019) by Health Services (Amendment ) Regulations 2019 (S.I. No. 59 of 2019), reg. 5, in effect as per reg. 2.

Section 59A
F122[

Prescription charges for persons who have attained age of 70 years and their dependants.

59A.—(1) This section applies to persons with full eligibility who avail of the service under subsection (1) of section 59 and who fall within any of the following classes:

(a) persons who have attained the age of 70 years;

(b) dependants of the persons referred to in paragraph (a).

(2) Subject to subsection (3), the amount of charge under subsection (1A) of section 59 per item supplied to a person to whom this section applies shall be F123[€1.00] or such other amount as may be determined by regulations made by the Minister under this section.

(3) Subject to subsection (1B)(b) of section 59, the maximum aggregate amount payable in respect of items referred to in subsection (1A) of that section supplied in a month to a person who has attained the age of 70 years and his or her dependants shall be F123[€10.00] or such other amount as may be determined by regulations made by the Minister under this section.

(4) The Minister may, with the consent of the Minister for Public Expenditure and Reform, make regulations varying either or both of the amounts referred to in subsections (2) and (3), where he or she is of the opinion that such a variation is desirable, having regard to such of the following as he or she considers appropriate:

(a) information on the consumer price index made available by the Central Statistics Office from time to time;

(b) recent information on the aggregate of the amounts expended, and the number of items in respect of which those amounts were expended, by the Health Service Executive in providing the service under subsection (1) of section 59 either generally or to persons to whom this section applies;

(d) the necessity of controlling expenditure in relation to the provision by the State of health services;

(e) either or both of the amounts for the time being referred to in subsections (1A) and (1B)(a) of section 59.]

Annotations

Amendments:

F122
Inserted (14.04.2017) by Health (Amendment) Act 2017 (5/2017), s. 4, S.I. No. 155 of 2017.

F123
Substituted (1.11.2020) by Health Services (Prescription Charges) (Over 70s) Regulations 2020 (S.I. No. 465 of 2020), regs. 3, 4, in effect as per reg. 2.

Editorial Notes:

E265
Power pursuant to subs. (4) exercised (1.11.2020) by Health Services (Prescription Charges) (Over 70s) Regulations 2020 (S.I. No. 465 of 2020), in effect as per reg. 2.

E266
The section heading is taken from the amending section in the absence of one included in the amendment.

E267
Previous affecting provision: power pursuant to section exercised (1.04.2019) by Health Services (Prescription Charges) (Over 70s) Regulations 2018 (S.I. No. 639 of 2018), in effect as per reg. 2; revoked (1.11.2020) by Health Services (Prescription Charges) (Over 70s) Regulations 2020 (S.I. No. 465 of 2020), reg. 5, in effect as per reg. 2.

Medical Cards General

HEALTH ACT 1970

General Medical Services

General practitioner medical and surgical service.

General practitioner medical and surgical service for certain persons over 70 years of age.

General practitioner medical and surgical service for persons under 6 years of age.

Agreement for provision of service under section 58B.

General practitioner medical and surgical service for persons in receipt of carer’s allowance or carer’s benefit.

Drugs, medicines and appliances.

Prescription charges for persons who have attained age of 70 years and their dependants.

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