Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694251011021.pdf (Guyana)
323 No.

35 of 1969.

NATIONAL INSURANCE AND SOCIAL SECURITY ACT, 1969.

THE NATIONAL INSURANCE AND SOCIAL SECURITY (INDUSTRIAL BENEFIT MEDICAL CARE) REGULATIONS, 1969.
In exercise of the powers conferred upon the Minister by sections 19, 20, 21, 24 and 51 of the National Insurance and Social Security Act, 1969, and by virtue and in exercise of all other powers enabling him in that behalf the following Regulations are her~by made :- .1. and Social Security (Industrial Benefit Medical Care) Regulations, :=ence- These Regulations may be cited as the National Insurance Otation and 1969, and shall come into operation on the day declared pursuant to section 19(3) of the Act.
2.

In these Regulations, unless the context otherwise Interpretation.

requires - "the Act" means the National Insurance and Social No .
1s ot 1969 · Security Act, 1969; "employment injuty" has the same meaning as in para graph (h) of sub-section ( 1) of section 19 of the Act; "hospital" means any institution fo r the reception and treatment of persons suffering from illness or mental defectiveness, any maternity home, and any institu tion for the reception and treatment of persons dur ing convalesence or persons requiring medical re habilitation, and includes clinics, dispensaries and out-patient departments maintained in connection with any such institution or home as aforesaid; "injured person" means a person suffe ring from a morbid condition due to employment injury arising out of .and in the course of insurable employment on or after the declared day and shall ·mclude a person suffering from any sequela to that condition; "medical adviser" means such medical officer as may be designated by the Board; "medical care" includes - (i) general medical practitioner oore including medical examinations, diagnosis and treatment and in areas where general medical practitioner care is not available, shall include such para medical care and treatment as may be approved by the Board; specialist care and treatment at hospitals and ,such specialist care and treatment a s may be the out-patient departments of available at hospitals; (ii) 324 (iii ) (iv) (v) the supply of essential pharmaceutical products and dressings prescribed by a registered medi- cal practitioner in accordance with any form ulary laid down by the Board; medical care in hospitals
 including free board, lodging, treatment and nursing in cases where, owing to the nature of the employment injury, medical care cannot be provided otherwise; the provision, rep air and renewal within_ limits laid down by the Board, of orthopaedic and prosthetic appliances necessary for the rehabil i- tation, or th e reduction of the incapacity for work, of the injured person arising as a direct consequence of the employment injury; but shall not include first aid treatment given by any person other th an a registered medical practi tioner; "registered medical practitioner" means a person duly registered as a medical practitioner under the laws for the time being in force relating to the registration of medical practitioners.
3.

(1) Where an injured person requires medical care for any Entitlement to medical morbid condition due to an accident or prescribed disease arising out d h bl care for em· rst ay in- o or m t e course o msura e emp oyment on or a ter t e ploymer>t of Ja nuary, 1970 he shall be e ntitled to medical care from the date of that accident or the date of development of that prescribed disease for as long as the need for such car:e continues or recurs .

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(2) There shall be no qualifying contribution condition for the provision of med ical care in accordance with thi s regulation .

(3) Medical care shall be provided with a view to maintain ing, restoring or improving the health , and ability to work, of the injured person.

(4) Medical care shall be given in such a manner as to secure maximu m effici ency within the scope of the benefit at the minimum reason able cost.

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(5) The Board may make such arrangements as it thinks fit with registered medical practitioners for general medical practitioner care.

Supply of p harmace u,ti cal products.

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(1) The Board may specify a formulary of pharmaceutical products and dressi ngs which may be prescribed by a registered medi cal practitioner for an inju red person; and in areas where there is no registered med ical practitioner, such formulary may be applied by the Board in whole or in part to prescriptions by any para-medical person approved by the Board to give medical praotiitioner care .
325 (2) The Board may make arrangements to supply such pro ducts and dressings itself or may arrange for their supply through pharmacies, drug stores, dispensaries, hospitals, registered medical practitioners or other agencies, or in more than one of those ways, as to the Board may seem convenient for providing an efficient service in any area.
(3) Such products and dressings shall be prescribed as economically as possible and only as far as they are necessary for the proper treatment of the person for whom they are prescribed.

(4) If in the opinion of the medical adviser equally good results can be obtained by the use of either of two pharmaceutical products, preference shall be given to the less expensiw of the two.
(5) The quantity of pharmaceutical products and dressings presqibed for each injured person shall b_e determined in accordance with the presumptive period du/ring which treatment will be needed and further quantities shall be given only if considered necessary.
( 6) Instructions for the use of the pharmaceutical products and dressings prescribed shall be given by the registered medical practi_tioner to the injured person : Provided that in areas where there is no registe-red medical prac titioner such instructions shall be given by such para-medical person as may be approved by the Board.

5.

(1) The Board may make arrangements with the owners of Arrangements hospitals, whether public or private, for the medical care of injured ~~th p~°v;si;/~~Is persons.
~re'.11edi<:al (2) In making arrangements for medical care with hospitals unde-r paragraph (1) of this regulation, the Board shall have power to make these arrangements on the basis of refunding the agreed cost of medical care for each injured person or of making a grant, periodical or otherwise, for the medical care of all injured persons or partly in one method and partly in the other, as may be desirable having regard to the interests of injured persons.
( 3) If the Board is of the opinion that further public provision of facilities for hospital medical care is necessary for injured per,sons, it sh~ll consider with the appropriate public authorities the extension of existing public services before deciding to set up its own services.
(4) Subject to the provisions of paragraph (3) of this regula tion, the Board, if it is satisfied that public provision has not been, and i~ unlikely to be, made for further hospital medical care for injured persons and is of opinion that such provision is essential, may make such provision either itself or by arrangement under paragraph ( 1) of this regulation with hospitals other than pubJic hospitals.
(5) Nothing in this regulation shall be construed as prevent ing the Board, if it so thinks fit, from entering into agreements to reserve for injured persons a specified number of beds in a hospital in return for a payment by the Board of a contru'bution towards the 326 operation of that hospi tal or for extension of the available facilities for the exclusive use of injured persons .

in- ,res to medical 6 · Du tics of jured per- 111:>n• lation medical care.
to !in care - (a) An injured person who has applied for and is entitled to whom he the care and treatment of the shall remain under first registered medical practitioner applied for general practitioner care unless in the opinion of the Board the general practitioner care should be ~ontinued by another registered medical practitioner or a hospital; the shall comply with registered medical practitioner in charge of his case; shall not, while under medical care, do anything which might retard or prejudice his recovery; the instructions given by , b) (c) ( d ) shall submit himself to be medically examined by any medical referee approved by the Board to under take such an examination; and ·shall not refuse to receive medical care in hospital if such care is considered essential in his case.
(e) !vledica l case histories.

7.

Where &rrnngernents are made lby the Board with regis- tered medical practitioners for the medical care of injured persons, the medical adviser may requ ire them to submit a medical case history for any case in which he is of the opinion that such a case history is necessary to ascertain whether the charges made (if any) or the pharmaceutical products and dressings prescribed are reasonable.
f h Reimburse- d d ment of cost of ~ edicaI been ma e un er t e oregomg proV1s1ons 'J1o~ .. i1° c~xs:_: Board shall not be empowered 8.
( 1) If arr:mgem(.lllts for medical care of injured persons havr th e ese to re-imburse other medical care · expenses incurred by an injured person except in cases of extreme emergency in which the medical care arrangements made by the Board are not immediately available and delay in attending immediately to the person may have caused serious risk to his life or grave detriment to his health.

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(2) In any case of emergency in which medical care expenses may be re-imbursed under paragraph (1) of this regulation, the re imbursement shall be made within such limits as may be determined by the Board.

·Toansitional provisions.

Cap.

111 9.
Pending the mak ing of arrangements for medical care under these Regulations, either generally or for a particular area, the Board may re-im.burse to an employer such expenses as may be in curred by hi.m after the declared day in continuation of any arrange ments for the medical care of employment injury cases made by the employer under the Workmen's Compensation Ordinance : Provided that the Board shall not be liable under this regulation for medical care expenses of any case of employment injury arising out of and in the course of employment ,before the declared day.
327 10.

All information regarding the health of any person to ~~=~ whom medical care is being or has been given shall be strictly con- care fidential and no other person, apart from officers of the Board, the National Insurance Commissioner, tribunals and medical boards appointed or constituted under Regulations made under the Act, shall have access to any medical case history or any other medical document or record in connection with the case.

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outside Guyana at the cost of the Board unless in the opinion of the ~:a.na.

· An injured person shall not be entitled to medical care Medica!ittside Board the care is justified by the circumstances of tne case and the necessary medical care cannot be provided in Guyana: Provided that the Board shall before deciding that the necessary medical care cannot be obtained in Guyana, obtain a certificate to that effect from the Chief Medical Officer of the Ministry of Health.

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The Board may re-irnburse to an injllired pe rson or to TraveWna his employer any reasonable costs ~ecessarily incurred in the con- EJlll)IM8eS.
veyance of the injured person and any necessary escort to or from any place at which he is required to attend for medical care under these Regulations : Provided that - (a) (b) the Board shall not refund any expenses which for an individual journey amount to less than twenty-five cents; and except in a case of emergency, no reimbursement of any expenses whatsoever shall be made for the conveyance of an injured person to a place for medical care if he could reasonably have obtained the necessary medical care at a place ne.arer to his own home or to the place of employment where the accident occurred.
Made this 15th day of December, 1969.

Minister of Labour and Social Security.

W. CARRINGTON