Three of the amendments in the paper, amendments 9, 20 and 21, are ruled out as contrary to the terms of the Money Resolution. That is the point that has just been discussed. A number of other amendments on the paper are not relevant to anything already in the Bill, and could by no stretch be connected with anything in the Bill. They cannot therefore be moved.
Public Business. - National Health Insurance Bill, 1929—Committee Stage.
What is the principle?
The Ceann Comhairle, as I have frequently said, is not subject to cross-examination. It is not a question of the principle.
SECTION 1.
(1) In this Act—
the expression "the Insurance Commissioners" means the Irish Insurance Commissioners;
the expression "the Acts" means the National Health Insurance Acts, 1911 to 1928;
the word "prescribed" means prescribed by regulations made under Section 65 of the Act of 1911 as extended by this Act.
(2) In this Act the National Insurance Act, 1911, the National Insurance Act, 1913, the National Health Insurance Act, 1918, the National Health Insurance Act, 1919, the National Health Insurance Act, 1920, and the National Health Insurance Act, 1923 (No. 20 of 1923) are respectively referred to as the Act of 1911, the Act of 1913, the Act of 1918, the Act of 1919, the Act of 1920, and the Act of 1923, and references to any particular provisions of those Acts shall be construed as references to those provisions as amended by any subsequent enactment.
May I ask the Minister whether he has considered the question of co-ordinating the laws with regard to National Health Insurance dealt with in this section? Quite a number of Acts are there mentioned, and, as Deputy Hogan said here to-day, this whole question of National Health Insurance and the laws relating to it are very intricate and technical, and it would facilitate everybody who has any business dealing with National Health Insurance if there was some kind of co-ordination and some simplification of these laws. People who have to look up these Acts have to make so many references that it is very hard to understand them. I think if the Minister would undertake, when this Bill is passed, to ask his legal advisers to go into that matter, it would be a very useful work.
There are quite a number of lines in the Department's working in connection with which I am arranging a codification of the laws. I have not given any consideration to this, but I do not think it would serve any useful purpose to do it at the present moment. Reference back to the ideas current here as to changes required in the laws, on the Second Reading, would show that we might spend a lot of time codifying Acts that are very intricate, but which, from the point of view of the people administering the Acts, are not so intricate at all, that we might waste a lot of time of the Oireachtas in doing this, and then it would not be worth while. If we were to go in for the codifying of the whole National Health Insurance Acts, in the light of the discussion that took place here, it would not serve us at all. I may take some of the ideas discussed here on the Second Reading, and see how they may be moulded into an improved National Health scheme; but if we were to labour in any particular direction, I would prefer to do it in that way than in codifying the present Acts.
Section 1 agreed to.
SECTION 2.
(1) No certificate (in this Act referred to as a certificate of exemption) under Section 2 of the Act of 1911 as extended by sub-section (3) of Section 81 of the Act of 1911 or under Section 2 of the Act of 1911 as extended by Section 5 of the Act of 1913, Section 8 of the Act of 1918, and the proviso to sub-section (1) of Section 1 of the Act of 1919 exempting a person employed within the meaning of Part I. of the Act of 1911 from liability to become or continue to be insured under the said Part I. shall be granted (by way of renewal or otherwise) to any person after the passing of this Act, and if any such certificate is granted after the passing of this Act it shall be void and of no effect.
(2) Every certificate of exemption granted before and in force at the passing of this Act shall remain in force until the date on which it would ordinarily expire, or until the 5th day of January, 1930, whichever of the said dates is the earlier, and shall then cease to be in force.
Mr. Hogan (Clare):
I do not want to be raising any conundrums for the Minister, but I would like some information with regard to people who are exempt from insurance payments, and who automatically come into insurance benefit at the present time. In the ordinary course of the administration of the Act it is well known that one must have a certain number of contributions to credit before one can get treatment. Am I to understand that these people will get full credit right from the time that the Insurance Act came into operation—from the time they were employed—up to the present? I want to have it made clear if the minimum number of contributions to entitle one to treatment is 104. People who are exempt from insurance automatically come into insurance now. What is the position regarding ordinary benefit? I do not know if I am right in raising the matter at this point. It is a matter of administration.
While no persons, because of the passing of this Bill, will lose the benefits that they would be otherwise entitled to, on the other hand it is not proposed to put people into benefit under the new circumstances until they have equivalent contributions that would ordinarily entitle them to benefit.
Mr. Hogan (Clare):
Suppose I was exempt from insurance in 1912, and have been exempt up to the present time, and certain contributions have been paid in respect of me, am I credited with the 104 contributions that would entitle me to ordinary benefit the same as the persons who would be ordinarily insured since 1912?
If the Deputy will refer to Section 3 (2) he will see that regulations have to be made by the Insurance Commissioners to deal with these cases.
Mr. Hogan (Clare):
I will accept that, but I hope that the Minister will look into the regulations when they are being drafted.
I would like at this stage to raise the matter of the obligation on small farmers in the country to pay National Health Insurance contributions because they do occasional work on the roads. It is, I understand, a matter of considerable hardship upon numbers of such individuals throughout the country. Occasionally they do road work, but they are never engaged on that work for a sufficiently long period to acquire the certain number of stamps necessary to entitle them to benefit. These people look upon the obligation to pay as merely a form of tax out of which it is impossible for them to receive anything in return. If the exemption clause is to be abolished altogether it would seem that all their hopes of finding any avenue of escape from the present imposition will be removed. It seems to me that some of the provisions of the National Health Insurance Acts could have been extended so as to include the class of person that I have in mind. In the 1918 Act there was a clause that had reference to persons intermittently employed. With regard to certificates of exemption, as far as I know, no certificates have been issued in this country. I think that if the section were extended so as to make it workable it would be possible to include in it persons of the class that I have described. These unfortunate people are also subject to the payment of unemployment insurance contributions from which they get no benefit.
As far as I know none of that class of person has applied to be treated as an exempted person. I do not see that we can take a particular type of person like that and discriminate as between him and the ordinary worker on the roads. I do not see what solution there is for a problem like that.
The Act of 1918 provided that a person employed intermittently could claim a certificate of exemption. That section never operated in this country. As far as I know, no one ever got a certificate of exemption. It is possible that the persons who could claim were ignorant of its existence and were not aware of the fact that they could be relieved from paying contributions. It would not interfere with the Minister's scheme if that particular section were not repealed. It would then be still possible to grant certificates of exemption to those who were not working a sufficiently long time to enable them to receive benefit. Considerable hardship is imposed upon the people in rural districts. The small farmers who occasionally do road work have to pay National Health Insurance contributions as well as Unemployment Insurance contributions.
The case for doing away with exempted persons has been very fully gone into. In the past such a person was a privileged person, because, without paying anything himself, he was entitled to receive benefit. I do not think that we should be driven away from our position, a position that was fully concurred in by the Committee that went into this matter. If there was anything like the serious grievance that the Deputy suggests, I think that we would have heard something about it.
I am sure that most Deputies have already heard about that grievance. I am thoroughly in favour of the abolition of certificates of exemption on the whole, but it seems to me that there was one particular class of the community disregarded when these Acts were being enacted by the British Parliament. Such a class does not exist at all in England. I refer to the small farmer who has to supplement the livelihood he earns from his land by working occasionally on the roads. While working on the roads he has to pay contributions under the National Health Insurance and the Unemployment Insurance Acts, and yet he does not get any benefit. I ask the Minister to consider the possibility of devising some means by which such persons would be exempt from obligation to pay.
We can consider the matter at a later stage perhaps, but I notice that it has been overlooked even to the extent of having an amendment down.
Sections 2 and 3 agreed to.
SECTION 4.
Any moneys standing to the credit of the account known as the Irish Migratory Labourers Exemption Fund established under sub-section (3) of Section 81 of the Act of 1911 as at the 5th day of January, 1930, shall be carried to the Reserve Suspense Fund.
Will the Minister give us some information concerning Section 4? If this section is enacted, will Irish migratory labourers be compulsorily insured?
No, they will not. The position with regard to migratory labourers generally is that application for exemption has completely gone. There were only two last year. The circumstances under which some years ago in England the dole was given on the production of a National Health Insurance card brought about the situation that Irish migratory labourers did not apply for exemption, and they entered into National Health Insurance in England. They will be liable for National Health Insurance in England as labourers; they will not be here.
Will there be any possibility of their getting insurance benefit?
Here?
Yes.
They never got it.
Well, the effect of the passing of this section will be that those, even the two who applied for certificates of exemption, will now be obliged to pay contributions which they had not to pay before and for which they will get no benefits in return.
No, they are insured under the National Health Insurance in England. I expect to hear that there will be no obligation to enter into National Health Insurance, because they are Irish migratory labourers. They got no benefits in the past. Any money that was collected in this way was used for nursing institutions in the area from which the Irish migratory labourers came.
Will they be members of Irish approved societies?
No.
There are three amendments for the insertion of three new sections concerning three matters which are nowhere mentioned in the Bill. On that ground they are irrelevant to the Bill and cannot be moved.
Section 5 takes away the right from approved societies to reject an applicant for membership, and that being so, the societies ask that they should have some new section inserted before Section 5 which would increase fines for offences from 10/- to 20/- and from 20/- to 40/-. The fact that these amendments are ruled out of order is an argument for the Minister to withdraw the Bill and to introduce a comprehensive Bill incorporating all these amendments.
Sections 5, 6, 7, 8, and 9 put and agreed to.
SECTION 10 (2).
Where an insured person in respect of whom an account has been opened in the Deposit Contributors Fund has not within the period prescribed in relation to the foregoing sub-section become a member of an approved society such person shall at the prescribed time and in the prescribed manner be transferred by the Insurance Commissioners to membership of an approved society selected in accordance with this section by the Insurance Commissioners, and upon such transfer being made such person shall be admitted to membership and become a member of such society.
I move:
In sub-section (2), lines 44-45, to delete the words, "at the prescribed time" and substitute therefor the words "within one week from the date of the coming into operation of this Act."
In taking over these deposit contributors and apportioning them to societies, it might happen, if a long interval were allowed, that the healthy lives would join up, perhaps at an early stage and perhaps by consent, with different societies, leaving a balance of unhealthy lives which some societies are inclined to fear might be dumped in on one of them. Their idea is that it would be better—in fact even better than my proposal—if it were made the law that on the passing of the Bill all those people who do not at present belong to approved societies and who are to be allotted to societies by the Commissioners, should be there and then allotted to different societies in whatever manner they desire, but that there should not be a long interval during which people with healthy lives might select one society, or one set of societies, and the unhealthy lives might afterwards be dumped on to one or other of the approved societies. Such societies would feel a grievance if that method were adopted. They are of opinion that the sooner these people are dealt with the better, either by being obliged themselves to join up at once with some approved society that they themselves will select, or by the Commissioners fixing right away on societies for them. They have had long enough to decide upon it themselves. The Commissioners could divide them as they thought proper among all the approved societies, or in whatever way the approved societies thought right.
It is the intention of the Commissioners to allow a period of three months inside of which a deposit contributor can select his own society. Then such deposit contributors as have not joined societies will be prevented from electing to join any particular society, and the Commissioners will take the whole list of the residue and assign them to societies. At the moment, a deposit contributor has the right to join any particular society that he desires, and we consider, in the first place, that it might be undesirable to take away from the individual his right to join any particular society. It would be, perhaps, even more satisfactory from the Commissioners' point of view if they had not actually to allot deposit contributors but if these joined societies of their own selection. However, the Commissioners will allow three months, and after that the question will arise as to allotting deposit contributors to particular societies.
Another amendment suggests that the Commissioners should be able to take the bad lives, separate them from the good lives, and then divide up the bad lives in reasonable proportions amongst some of the societies. The Commissioners could have no information upon which to do that, and what the Commissioners will probably do will be to take the deposit contributors over in alphabetical order, or in some way like that, and allot them to societies that they know to be of reasonable strength and capable of supporting them. But I would suggest to the Deputy that there are good reasons why deposit contributors, between this and the passing of the Bill, and between the passing of the Bill and a reasonable period, say two or three months, should be allowed to join any society they wish.
Amendment, by leave, withdrawn.
Sections 10, 11, 12 and 13 put and agreed to.
took the Chair.
I move:—
To insert before Section 14 a new section as follows:—
"Section 12 of the Act of 1918 shall be construed and have effect as if the following sub-section were inserted at the end thereof, that is to say:—
(3) Where an insured person who has given notice of illness within the prescribed time fails for a period of twelve months to submit or continue to submit medical or other satisfactory evidence of incapacity he shall be treated as if he had not given notice of illness since he last received benefit or ceased to submit such evidence of incapacity."
This amendment is intended to remedy a very serious defect which has come to light in the administration of benefits under the Acts. It has been held that an insured person fulfils the statutory conditions for benefit if he becomes ill and gives notice of illness. There is, however, no obligation on him to submit evidence of incapacity within any specified time, and the consequences are that he can wait for an indefinite period—for five or ten years—then lodge a medical certificate with his society, and demand payments for the whole of the intervening period. During that time he has avoided supervision, although the Act normally contemplates that he should be subject to the society's supervision from week to week. Consequently the society is at a great disadvantage in deciding whether benefit should be paid or not. The amendment stipulates that a period of twelve months should be given, and if the member has not prosecuted his claim during that period that he shall become disentitled to any benefit whatsoever.
As far as I understand this particular amendment, it might provide a very serious grievance for a number of people. I understood the Deputy to say that medical certification was not required, and that benefit only became payable on disclosing evidence of incapacity. I think the Commissioners insist on evidence of incapacity being disclosed by means of a medical certificate. As far as I can understand the amendment, it is intended to apply to cases like this: An insured person becomes ill, and is ill for six months, when the agent of the approved society comes along and says: "Your benefit is finished now." In ignorance, the person accepts that statement. Thirteen or fourteen months pass, and then someone tells him: "You have been disabled; you have been sick all this time; you were entitled to disablement benefit after six months' sickness benefit." The person then goes to the approved society and makes a claim for disablement benefit. If in any particular case like that it could be shown that it was through the action of the approved society's officer the person was deprived of disablement benefit, not understanding that he was entitled to it, and did not submit the necessary certificate, it would be wrong that a person who was really disabled over that period should be statute-barred from getting the benefit. If the amendment is intended to cover any other case than the type of case I suggest, I would like to have a clearer explanation of it. But, in order to be entitled to be paid benefit, a person must bring forward evidence of incapacity, and in normal cases we would not contemplate that a person would not make a claim or would not send in a medical certificate for a period of twelve months.
There is no obligation on him.
I am told that there have been cases of that kind where men who for many years had not prosecuted their claims came along after five, six or ten years. I have been told that that is so. It is a hardship on approved societies to have claims of that kind thrown upon them for which, according to the rules, they have made no arrangement. The difficulty of certifying that a man had been ill all that time then arises. The man may have been ill, but may not have known his rights in the matter. At any rate, some approved societies suggest that there ought to be some limit of time during which a man can prosecute his claim, and that they should not be liable where a man had been ill—even if it were for four or five years—if he came along with the claim unexpectedly when they had no opportunity of supervising or of knowing whether he was really ill or incapacitated. There ought to be some safeguard for the funds of the society by limiting the amount of the claim. There have been cases of the kind. I heard of one case where an ex-soldier who went through the war, got benefit out of the British Army Pensions Scheme, and who, as soon as he had exhausted his rights there, went along to the insurance people. There was no limit to the amount he could claim. It is suggested that there should be some limit in order to prevent extortionate demands being made on the societies.
I would like to look further into the matter, and perhaps the Deputy would withdraw the amendment and put it down on the Report Stage.
There have been cases such as Deputy O'Kelly referred to.
I will have the matter further looked into, and see if we can safeguard the person I spoke of.
Amendment, by leave, withdrawn.
Mr. Hogan (Clare):
I have read the section several times, and as I cannot convince myself, I hope the Minister will be able to convince me that the present arrangement regarding married women stands, that is to say, that the insured wife of an insured worker is entitled to double maternity benefit. Under the section as altered I cannot convince myself that that arrangement will continue, and I would like to know if that right is withdrawn, suspended or altered.
I presume that the Minister has got, as other Deputies have got, a long statement from the Association of Trade Union Approved Societies. A considerable part of the statement deals with this section. The document is signed on behalf of the Trade Union Approved Societies by Mr. L.J. Duffy and Mr. T. Waldron. With their knowledge of the working of the Act they claim that as the section stands it is not clear. If the Minister has got a copy of the document, I need not refer to it any further. He will probably look into it, and if the opportunity arises he will probably clarify the passages referred to.
I received a long statement from the Trade Union Insurance Societies this morning, which I have not had an opportunity of fully going through. I will do so and on the Report Stage see what matters have to be made clear, and in what way we can meet any points that have been raised.
Section put and agreed to.
SECTION 15.
(1) Notwithstanding anything contained in the Acts the Minister for Education shall, for the purposes of the provisions of the said Acts relating to the payment and collection of contributions, be deemed to be the employer of junior assistant mistresses employed in National Schools.
(2) This section shall be deemed to have come into force on and shall have effect as on and from the 8th day of July, 1929.
I move:
In sub-section (2), lines 31 and 32, page 7, to delete the words and figures "shall be deemed to have come into force on and shall have effect as on and from the 8th day of July, 1929" and substitute the words "shall come into force on the 6th day of January, 1930."
There is just a change of date from 8th July, 1929, to 6th January, 1930. Owing to the fact that the Bill was not passed before the 8th July, the 6th January is the first day on which we can deal with junior assistant mistresses in the way in which we are going to deal with them.
Amendment put and agreed to.
Question—"That Section 15, as amended, stand part of the Bill"— put and agreed to.
Sections 16, 17 and 18 agreed to.
Ordered: That Sections 19 and 20 stand part of the Bill.
SECTION 21.
Part IV. of the Act of 1923 shall, subject to such adaptations and modifications as may be prescribed, apply to men belonging to the Reserve when called out on service otherwise than under section 220 of the Defence Forces (Temporary Provisions) Act, 1923 (No. 30 of 1923), and also to officers of the Reserve specially called out or commissioned for such service, but save as aforesaid shall not apply to such men or officers.
There is a long part of the statement again in this trade union document that concerns Section 21. Perhaps the Minister will look into that section also when he is going through the document to see what can be done.
Very good.
Section 21 ordered to stand part of the Bill.
SECTION 22.
(1) On and from the 1st day of January, 1930, sanatorium benefit shall cease to be included among the benefits conferred by Part I. of the Act of 1911.
(2) On and from the 1st day of January, 1930, insurance committees shall cease to exist and the provisions of the Acts in relation to such committees shall cease to apply.
(3) On the 1st day of January, 1930, all property, assets and liabilities of insurance committees shall vest in the Insurance Commissioners and the said Commissioners shall take such action as may be necessary for winding up the affairs of such committees.
(4) The Insurance Commissioners may, with the consent of the Minister for Finance, make regulations in relation to all or any of the following matters, that is to say:—
(a) the manner in which any surplus standing to the credit of the Sanatorium Benefit Fund or the administration fund of any insurance committee after all liabilities have been met is to be disposed of,
(b) the manner in which any deficit in the Sanatorium Benefit Fund or the administration fund of any insurance committee is to be met,
(c) the making of such other financial adjustments as in the opinion of the Insurance Commissioners are necessary for carrying this section into effect,
(d) the determination of any agreements entered into by insurance committees under any enactment which ceased to apply to such committees by virtue of this section or for transferring to other persons on such conditions as may be prescribed by such regulations any rights or liabilities under any such agreements.
Mr. Hogan (Clare):
I move, on behalf of Deputy Corish, amendment 10:
To delete sub-section (1).
I am afraid I will have to repeat what I said on the Money Resolution in this matter, and I am afraid I will have to ask the Minister to give us more definite reasons for this alteration. In replying to the criticism that was advanced on the Money Resolution, he juggled somewhat the figures. He gave us lists of thousands of pounds which were being paid in tuberculosis treatment more than were paid in previous years, and told us, notwithstanding the provisions made in the Insurance Acts of 1911 and 1918, etc., that a good many people affected with tuberculosis had to go without treatment. These things in themselves were very interesting, but he did not tell us how the present Bill improves the situation. He did not tell us why the administration of sanatorium treatment should be taken out of the hands of people who had years of practice and experience, and who to a great extent are very well known for social work, and did that social work very well, and handed over to a body who have no experience whatsoever in the administration of sanatorium treatment. I do not say that with any intention of disparaging the integrity of the boards of health. I do not say for a moment that they are not good, useful bodies to administer certain services, but I do say that for the administration of sanatorium treatment they are not at all adapted.
It was on this consideration that I asked the Minister to refer this matter to a special committee of the Dáil, because there are so many intricacies in it, so many things which Deputies would like to know before they would come to a conclusion or make up their minds as to what they would do in respect to this section of the Bill. The Minister told us that there is nothing technical in it. I submit to the Minister that there are many things technical in it, and I submit to him that the taking away of the money for sanatorium treatment and handing it over for medical certification is one of the worst uses that could be made of the money. I know that in ordinary circumstances I would be speaking with doctors to right of me and doctors to left of me, and I suppose I would be in a dangerous position in doing that. £45,000 is to be given for medical certification alone, and not one ounce of medicine or attention is given, simply a patient is suffering from T.B. or something of that kind. That is all that is in the certificate and the money is diverted from where it is useful and doing good work in sanatorium treatment and is to be handed over to make up that fund. £60,000 given by the British Administration was dropped somewhere in 1922 or 1923. We took fivepence per insured member as well as an amount of money out of the Unclaimed Stamps Fund to make up the medical certification fund. The only reason adduced by the Minister for robbing the sanatorium fund is that he wants to make up the medical certification fund. He has endeavoured to evade the point of questions. He has not said that the taking of that money from the administration of the sanatorium benefit is going to be any good to the insured persons; he has not said that it is going to give any additional sanatorium treatment. He has simply said that he wants to replenish the medical certification fund and that is all.
It will sound something like a platitude to repeat this, but it must be repeated on this occasion. Those of us who have some experience of local bodies, those of us who know the amount of work they have to go through, those of us who know the large correspondence, the administrative details and the local considerations that press upon them will know perfectly well that to tack on this administration of sanatorium benefit to county boards of health is not the best way, and that is putting it mildly, to administer sanatorium treatment. I submit that the Minister ought in all sincerity to take the opinion of the representatives of the various boards of health in this matter. He ought to take the opinion of the various county councils in this matter and ought to take the consensus of opinion in this matter of Deputies who have some experience of local administration. I think if he takes all that he will convince himself that administration of sanatorium benefit by the county boards of health is not at all suitable. There is no use in juggling with thousands of pounds, telling us that we are getting £59,000 and £100,000. They simply reduce what we were getting before. We were getting fifty-fifty in the matter of sanatorium treatment. You are going to get that now. £27,000 is going to be given as a grant from State funds to the boards of health. But you are taking from the funds of the societies and the funds of the members 1/7 in order to make up the deficiency that you have already in the medical certification fund. What is the good of your saying you are giving with your right hand when you are taking away with your left? What is the use of saying that because boards of health administered sanatorium treatment in the past they are capable of administering all kinds of sanatorium treatment? The Minister ought to know perfectly well that the boards of health, under the present conditions, are not the proper bodies to administer this. He ought also, before he says the boards of health could be used for this purpose, to tell us how the old county committees maladministered, what charges of maladministration he has against them. Has he any cases of where they did not give sanatorium treatment when they had the funds to do it? I submit these things to the Minister and ask him in all sincerity and in consideration of the large volume of opinion that is expressed by the various public bodies to leave the committees as they are and not put the administration of sanatorium treatment on the county boards of health.
The Deputy spoke of the maladministration of the sanatorium committees. There is no question of maladministration by a sanatorium committee. None has been brought forward. But what has happened, say, in Clare, where the local committee has a sum of something over £600 a year to administer? In the first place they have to hand over that money to the board of health to do this work, and in the second place, in administering it in that particular way, I suppose they paid £136 a year in salaries. With the exception of five or six local bodies throughout the country the insurance committees have taken their funds and handed them to the local boards of health with the names of the people who were to get sanatorium treatment. If the Deputy suggests that the boards of health are incapable of carrying on the work of the sanatorium committees I do not know why the committees did that.
Mr. Hogan
I did not suggest that they were not capable. I did suggest that they were overloaded with work and that they could not possibly do this effectively.
I have also pointed out that you have £118,000 out of tuberculosis schemes, and you add to that four-fifths of the £27,000 that the insurance committees had to handle. All that money was directly administered by the boards of health. So that what you are passing over to them now is the extra five or six thousand pounds that the committees that have not had agreements with the local bodies have been spending directly. And this is throwing an untold and unwarranted burden on the boards of health. Our tuberculosis schemes are part of our general public health schemes and must be carried out by the boards of health. I have no representation from the boards of health that they have not suitable machinery at their disposal to do the work. If I had any such representations I would be able to show them how they might be able to make use of the powers given to them to set up the proper machinery to carry it out. The Deputy talked of juggling with figures. I explained fully on the Money Resolution and on the Second Reading that there was no complete statutory right existing by which an insured person would get sanatorium treatment, that he simply took his chance when funds were available.
Mr. Hogan
Is the Minister giving us that statutory right now?
The Deputy thinks nothing of figures—that it is only fifty-fifty, fifty from the State and fifty from the local bodies, that it is only the same as in 1922 and 1923. I say now that we are spending £76,000 more of ordinary public moneys in dealing with tuberculosis throughout the country. It is at the time at which we have come to that we have taken away sanatorium benefit from the insured persons. The money that they were receiving from the insurance committees up to the present will be handed over to these local bodies subject to such conditions as the Minister for Local Government and the Minister for Finance shall appoint when they are being handed over, because we are expecting them to deal in future with not only the insurance people with whom they dealt with out of their own funds, but with people that the insurance committees dealt with out of insurance committee funds.
Mr. Hogan
You are handing over the funds with definite instructions to give sanatorium treatment. Is that it?
We are not handing over these funds for anything but treatment under the tuberculosis schemes. These funds cannot be applied to any other purpose.
Would the Minister make that explicit in the Act?
I would like to know what the Deputy wishes to make explicit in the Act.
That these funds that are handed over to local bodies will be devoted exclusively to tuberculosis treatment.
I certainly will consider that, but the intention is that they shall be so paid over.
And so used?
Would not this discussion be more appropriate on the second amendment?
There are a number of these amendments all dove-tailed into one another. Where I think it would be more appropriate would be on Section 23.
On amendment No. 11.
Section 23 deals with the handing over of £27,750 to the local bodies. If any explicit assignment of that £27,750 for tuberculosis purposes is desirable or required I will see whether it cannot come under that particular section. But it is the intention that it shall be applied.
Question—"That the words proposed to be deleted stand"—put.
The Committee divided: Tá, 103; Níl, 12.
Tá
- Aiken, Frank.
- Allen, Denis.
- Bennett, George Cecil.
- Blaney, Neal.
- Blythe, Ernest.
- Boland, Gerald.
- Boland, Patrick.
- Bourke, Daniel.
- Bourke, Séamus A.
- Brady, Seán,
- Brennan, Michael.
- Briscoe, Robert.
- Brodrick, Seán.
- Buckley, Daniel.
- Byrne, John Joseph.
- Carey, Edmund.
- Carney, Frank.
- Colbert, James.
- Collins-O'Driscoll, Mrs. Margt.
- Conlon, Martin.
- Cooney, Eamon.
- Cooper, Bryan, Ricco.
- Corkery, Dan.
- Cosgrave, William T.
- Craig, Sir James.
- Crowley, Fred. Hugh.
- Crowley, James.
- Crowley, Tadhg.
- Davis, Michael.
- De Loughrey, Peter.
- Derrig, Thomas.
- De Valera, Eamon.
- Doherty, Eugene.
- Doyle, Peadar Seán.
- Duggan, Edmund John.
- Egan, Barry M.
- Fahy, Frank.
- Fitzgerald-Kenney, James.
- Flinn, Hugo.
- Fogarty, Andrew.
- French, Seán.
- Gorey, Denis J.
- Gorry, Patrick J.
- Goulding, John.
- Haslett, Alexander.
- Hassett, John J.
- Heffernan, Michael R.
- Hennessy, Thomas.
- Hennigan, John.
- Henry, Mark.
- Hogan, Patrick (Galway).
- Holohan, Richard.
- Houlihan, Patrick.
- Jordan, Stephen.
- Kelly, Patrick Michael.
- Kent, William R.
- Keogh, Myles.
- Killilea, Mark.
- Kilroy, Michael.
- Lemass, Seán F.
- Little, Patrick John.
- Maguire, Ben.
- Mathews, Arthur Patrick.
- McDonogh, Martin.
- MacEntee, Seán.
- McFadden, Michael Og.
- Mongan, Joseph W.
- Moore, Séamus.
- Mulcahy, Richard.
- Mullins, Thomas.
- Murphy, James E.
- Murphy, Joseph Xavier.
- Myles, James Sproule.
- Nally, Martin Michael.
- Nolan, John Thomas.
- O'Connell, Richard.
- O'Connor, Bartholomew.
- O'Donovan, Timothy Joseph.
- O'Hanlon, John F.
- O'Higgins, Thomas.
- O'Kelly, Seán T.
- O'Leary, Daniel.
- O'Mahony, Dermot Gun.
- O'Reilly, John J.
- O'Reilly, Matthew.
- O'Reilly, Thomas.
- O'Sullivan, Gearóid.
- O'Sullivan, John Marcus.
- Powell, Thomas P.
- Rice, Vincent.
- Roddy, Martin.
- Ryan, James.
- Sexton, Martin.
- Shaw, Patrick W.
- Sheehy, Timothy (West Cork).
- Sheehy, Timothy (Tipp.).
- Smith, Patrick.
- Thrift, William Edward.
- Tierney, Michael.
- Tubridy, John.
- Walsh, Richard.
- Ward, Francis C.
- Wolfe, George.
Níl
- Broderick, Henry.
- Cassidy, Archie J.
- Coburn, James.
- Colohan, Hugh.
- Corry, Martin John.
- Davin, William.
- Doyle, Edward.
- Everett, James.
- Hogan, Patrick (Clare).
- Kennedy, Michael Joseph.
- O'Connell, Thomas J.
- O'Dowd, Patrick Joseph.
Tellers. Tá, Deputies Duggan and P.S. Doyle; Níl, Deputies Cassidy and Davin.
Question declared carried.
— Amendments 11 and 15 might be discussed together, and a decision taken upon No. 11.
On behalf of Deputy T. Murphy I move amendment 11:—
To add at the end of sub-section (1) the words—"but every insured person shall be entitled, in accordance with regulations made by the Minister for Local Government and Public Health, to receive from the council of the county or county borough in which he is resident or from any committee thereof authorised to provide treatment for tuberculosis such treatment and in the same conditions as he would have been entitled to receive as sanatorium treatment if recommended therefor by an Insurance Committee."
As the Bill stands, an insured person has no guarantee that he will receive sanatorium benefit. We want to ensure that the £27,000 which is to be allocated to the public bodies shall be used solely in the interests of insured persons and that it cannot be devoted to any other service—in other words, that an insured person recommended by the tuberculosis medical officer or any dispensary doctor for sanatorium treatment shall be entitled to receive that treatment, because of the fact that the public body had received a grant from the sanatorium fund. At the present time, a certain amount of money is spent by public bodies and insurance committees on the treatment of tubercular cases. I hold that under the Bill, as it stands, a large number of people who will find themselves at the mercy of members of boards of health and dependent upon charity will not look for treatment for themselves or their families if they have to go round and canvass members of the board of health or a sub-committee of the county council. If insured persons have to appeal to these members by way of charity instead of by right, men who are in employment and whose children require treatment for tuberculosis will not seek to have them treated. They would not like that the fact should be published that a member of their family was suffering from this disease, because it might affect them in their employment if their employers knew that their wives or children were suffering from tuberculosis, and they might find themselves out of employment. The amendment asks that the insured person will be in no worse position under the Bill than under the old system. I have fifteen years' experience of sanatorium committees and I have never yet known a case that was refused sanatorium treatment or surgical or medical treatment in a Dublin hospital.
If an insured person has been paying for what he has been promised under the 1911 Act, he should be entitled to sanatorium treatment, if recommended for it. He is not getting any increased benefit, and is paying the same contribution, but he is now placed at the mercy of whatever committee the Minister may appoint—a sub-committee of the board of health or otherwise—if he himself or his wife or children want sanatorium treatment. It is not in the interests of insured persons, and it will not help to stamp out this dreadful disease if insured persons have to go round and appeal to members of these public bodies, and it will not make for the success of the county medical officers scheme. Under the old system all cases were dealt with in secret and there was no publication of the names of persons receiving benefit, so that an insured person could rest assured that no one outside the committee and the doctor knew anything of the matter. As I said, this amendment is moved to ensure that insured persons shall have the right to which they were entitled up to this.
My amendment, No. 15 on the Paper, is in similar terms to that moved by Deputy Everett on behalf of Deputy Murphy. We are anxious, as well as Deputy Murphy and Deputy Everett, to secure, as far as we can, that the insured persons shall feel that they have a right, which they have had up to now under the Act, to sanatorium treatment, even though abolished by an Act of this House just now, and that they have it under the same conditions as they had it heretofore. Since the Act came into operation seventeen years ago, those insured persons had been paying for sanatorium treatment. That was part of the benefits they had paid for and the payment was demanded from them by law—under the Insurance Act. We have deprived them to a certain extent of that right by the abolition of sanatorium committees.
Many of us on this side of the House would not vote for the abolition of sanatorium benefits or sanatorium committees if it were to mean that all the rights hitherto enjoyed by insured persons under the Act with relation to sanatorium treatment were to be filched from them. The Minister made a statement earlier, which more or less reassured us, that those people would not lose their rights, but that the funds for the treatment of tuberculosis would be in proportion available for insured persons. We are anxious to go a little further and, if possible, to secure from the Minister a guarantee that under the sum of £27,500 now allocated to the local body insured persons will be guaranteed sanatorium treatment to the same extent, at least, as it was guaranteed to them under the Insurance Act heretofore. The Minister told us, of course, that they could not expect to have that sanatorium treatment free; that in the past the funds of the insured committees did not allow in all cases of insured persons getting sanatorium benefit absolutely free, and that some insured persons had to pay a proportion of the cost. We think that when insured persons have paid they ought to get such sanatorium treatment free. My belief is that if the Insurance Acts were fully worked, and if all people that ought to be insured were brought within the ambit of the Acts, and paid their insurance tax and stamped their cards—employers and employees—there would be funds enough. But the proportion of non-compliance in the Free State is very considerable. It is probably decreasing, if we are to judge by the figures, but still it must be very high, and if the Acts were worked and the machinery available were used to a greater extent to prevent that non-compliance, the insured persons would probably in the past have been able to get free sanatorium treatment. At least, some of us think so. I would like the Minister to give a guarantee that the amount of sanatorium treatment given to insured persons in the past under the Act, and the rights that they had, will not be absolutely filched from them by the passing of this Bill, and that they will have a feeling that sanatorium treatment to which they were entitled, in so far as they were entitled to it, free, from the county committees or boards of health, will be preserved to them in the future.
I should like to support to a large extent what has been said by Deputy Everett and Deputy O'Kelly. What is causing a great deal of disturbance in the minds of the insured people at the present moment and in the minds of the societies with whom they are insured is that there should be no falling off in sanatorium benefit that has been the right of those people in the past. If the Minister could give an asurance that there would be no falling away from or interference with the benefits given to the insured people in the past, I for one would be perfectly satisfied.
I think that if the Minister could give an undertaking with regard to the sum of £27,000 to be transferred to the local bodies that would ensure that the insured persons would enjoy or receive sanatorium treatment to the extent and under the same conditions as existing at the present time, I would feel satisfied. I want to be sure that the sum that morally belongs to the insured persons is earmarked for their benefit. I would be glad if the Minister could go further and accept Deputy O'Kelly's proposition, that every insured person, if requiring it, should receive sanatorium treatment. I see, of course, the Minister's difficulty. I learn that the fund hitherto has not been sufficient to secure that benefit, but I would like to see that the benefit which insured persons have been receiving up to the present is not impaired in any way by the present Bill.
The only thing that I can ensure is that the £27,750, referred to in Section 23, shall be applied to tuberculosis treatment.
To all insured persons?
No, but as far as the statute goes. I do not say that I can ensure that it will be applied to all insured persons. Take the situation that the House is dealing with. Deputy Everett, who has moved this amendment, comes from Wicklow. In spite of the fact that throughout the country we are spending this year £118,000 on tuberculosis schemes, the County Wicklow is not spending anything. Whether that is due to the fact that County Wicklow has no tuberculosis to deal with except the cases of tuberculosis that find themselves amongst insured persons I do not know, but the insurance committee has about £760 to spend. Under a particular section of the 1911 Act, it is possible for an insurance committee to give sanatorium treatment to the dependants of insured persons. There is possibly not a second county in the country in which it has been possible, out of the funds at the disposal of the insurance committee to do that. Wicklow is a county in which it has been possible to do that. While the rest of the country is spending £118,000 through public moneys this year on tuberculosis schemes, Wicklow is a country which is spending nothing.
I do not want to say anything that will reflect on the good record of the county. I do, however, want to say that if all the other statements made by the Minister are as correct as the one he has just made, then I would suggest to him that, in future, he should make inquiries before committing himself to such statements.
At any rate, Wicklow has no tuberculosis scheme.
Has the Minister any information as to what it has cost the County Wicklow Board of Health for the treatment of tuberculosis cases?
If the County Wicklow are dealing, and are satisfied to deal, with tuberculosis entirely out of their own funds without getting the 50 per cent. recoupment that they could get out of State funds, then I suggest the position there is not very serious.
The Minister threatened, in connection with the appointment of the County Medical Officer of Health, to send a sealed order down to our county, and that is what we feared in connection with tuberculosis.
As I have said, it is possible for a particular county, out of its insured funds, to give sanatorium benefit not only to insured persons, but to the dependants of insured persons. You have other places where the money does not satisfy the demand at all, and where insured persons, either at the present moment or in years past, although they were insured persons, and although sanatorium benefit was included in the Act, had to depend on the expenditure of local or other State moneys in order to get tuberculosis treatment. How could we enshrine in a statute a statement such as that which is embodied in the amendment before the House, a statement to the effect that insured persons shall get such treatment "and in the same conditions as he would have been entitled to receive as sanatorium treatment if recommended therefor by an insurance committee?" If recommended therefor by an insurance committee he might get treatment for his dependants in Wicklow, but in the County Borough of Cork, or in most of our other counties, he would not have got anything, perhaps, if he applied late in the year.
All that can be ensured is that the £27,000 will be spent upon tuberculosis. Insured persons, as well as other people, have this assurance: that tuberculosis treatment and tuberculosis schemes have so developed that we are spending £76,000 more this year than we were spending even seven years ago. Deputies quoted the figures of certain societies and the figures of certain members. There are big representative societies which make representations to the effect that they do not see why a disease, such as tuberculosis, should be specially dealt with by sanatorium funds at all; why tuberculosis any more than, say, dental treatment, should be specially provided for as a statutory benefit under an Act. I think there is a good deal to be said for that. We are taking sanatorium treatment from under the National Health Insurance Act. We are giving £27,000 to local bodies because of the change made with regard to insurance committees, and we are ensuring that this £27,000 shall be absolutely ear-marked for the treatment of tuberculosis.
I think the attitude of the Minister on this question cannot be described as satisfactory, but as the amendment before the House has been advocated by more than two groups or parties in the House, it is possible that we may be able to induce the Minister to change his mind. The Minister says that the most he will be able to ensure is that the £27,000 odd which will go to the local bodies under Section 23 of the Act, will be used for the treatment of tuberculosis. That, of course, is obvious from the terms of the Bill, but surely it should be possible in this Bill to impose upon those local bodies the obligation to expend whatever proportion of the £27,000 they receive for the purpose of providing for insured persons, free of charge and as of right, sanatorium treatment similar to the treatment they received when recommended by insurance committees in the past.
I would like the Deputy to consider whether the fact of ear-marking a certain amount of money for insured persons might not have the effect of local bodies discriminating against insured persons once the amount of money allocated to a particular county under the grant of £27,000 had been spent. They might feel —it would be easy for such a tradition to grow up—that a certain amount of money had been sent to provide for insured persons, and as between the residue of insured persons and the ordinary population —once that amount of money had been spent—they might discriminate against the insured persons.
Surely, if that mentality is going to exist in the minds of members of local bodies in the future it would have existed in the past. These bodies are not going to get any more nor any less than they got in the past for the treatment of tuberculosis. The only difference that this Bill will involve, as far as they are concerned, is that the £27,000 which they would have got from insurance funds in this year will instead come from the Exchequer, and that they will not be under the obligation, which they would have been if this Bill were not passed to give in respect of that £27,000 free sanatorium treatment as of right to insured persons. We voted against Deputy Corish's amendment to delete sub-section (1) and retain sanatorium treatment because of the reasons mentioned by the Minister himself. Sanatorium treatment has not been anything more than a term in the Act for a large number of people. Sanatorium benefit as provided in the Act of 1911 could only be given in so far as funds were available to give it. The retention of that particular section in the Act, therefore, is of no benefit to insured persons. What is of benefit is that the amount of treatment which was available for insured persons under the Act should not be diminished in consequence of that particular section.
There is a sum of £27,000 going to local bodies for the purpose of giving treatment to insured persons. The local bodies will continue to get that £27,000 and they will continue to get other Government grants for the treatment of tuberculosis. The only thing that the amendment of Deputy Murphy and Deputy O'Kelly asks is that in respect of the £27,000 they will be obliged to give free treatment to such persons as are recommended to them until the £27,000 is exhausted. I admit that there will be certain areas in which the amount allotted will be exhausted, and there will be other areas in which it will be sufficient to meet the claims on it for the year. Why should not the money be expended for the benefit of insured persons? I admit that there is the possibility that the effect of such an obligation being placed on local bodies might be that they might discriminate against insured persons. In respect of ordinary tuberculosis funds I cannot see that becoming serious, but if it became serious I cannot see why the Minister should not be able to deal with the development of such a mentality so as to ensure that if persons will be asked to pay the same contribution as in the past they should have in respect of sanatorium treatment the same possibility of securing free treatment. That is not asking too much. It is possible for the Minister by accepting one of these amendments, or drafting an amendment which he would consider more suitable, to ensure that taking place.
He says he does not think he has the power under any of the statutes to impose on local bodies the obligation to give free treatment to insured persons, but the powers he has in existing statutes do not matter. It is the powers he is taking under this Bill that matter. He can in this Bill take powers to compel local bodies to give free treatment to insured persons in so far as the £27,000 available for the purpose will cover it. The fact that in certain areas that amount will not go very far, or meet any big proportion of the applications, does not alter the justice of the claim that the £27,000 which is still being made available, and indirectly is being made available out of insurance funds, should be used for the benefit of insured persons. The point, perhaps, has been lost sight of that the State in giving this money to local bodies for tuberculosis treatment is taking steps to ensure that it will not lose, for it is releasing itself from the obligation to pay a similar amount in respect of medical certification, the cost of which will have to be met entirely out of insurance funds. Because of the fact that insurance funds are being used to make this contribution to local bodies for the upkeep of sanatoria and that insured persons are paying it, steps should be taken in this Bill that the benefits, no matter how incomplete, of the past should be retained in the future.
I am afraid that Deputies have put down roundly-phrased amendments, and they cannot be clear as to what exactly they want to achieve. You have a sliding position, if I might so call it, in different counties. You could have a changing position in different counties at different times. For instance, while you might have a position, say this year or last year, in Wicklow, in which not only some insured persons but some of their dependants might be able to get all the tuberculosis treatment they applied for, in certain counties, you might have the position that the number of insured persons applying for tuberculosis treatment might exhaust all the funds. How then is the local body to deal with the residue that finds itself up against an amendment such as No. 11 or No. 15? Deputy Lemass speaks of persons recommended. Amendment No. 15 speaks of persons "duly recommended" to a local body. "Duly recommended" by whom— by the approved societies?
Is not that a condition that obtained up to the present? What is asked is to give an assurance that there will be no change. Up to the present where the amount was not sufficient to give all the people who required it sanatorium benefit, it had to be withheld. We recognise that. We want an assurance that insured persons will, in the future, have as good a chance of getting treatment as in the past.
It seems to me that the only possible way in which we could clearly arrive at that would be that there should be a condition under which these sums of money supplied to local bodies would not be less than the amount of money used in giving free treatment to insured persons. Assuming that there was a demand on the part of insured persons for treatment up to that particular amount it seems to me that that is the only way in which you can deal with the matter at all.
Would the Minister consider the advisability of making that explicit in the Bill instead of having it a matter to be fixed up by regulation?
If we can be clear as to what we desire we can see whether we cannot be explicit about it.
What the Minister has said does not cover the point. If that was made one of the conditions it would still involve insured persons giving proof of means and establishing the fact that they could not pay, and the money made available under Section 23 would be used for giving free treatment only to persons who could not pay for it, and who would get it free in any case.
The Minister said that there is a possibility of county boards of health discriminating against insured persons suffering from tuberculosis. It strikes me that the just thing to do would be, seeing that it is possible the £27,000 will not go round, to relieve these people of the amount of the contribution which goes towards T.B., as otherwise you are taking money from them that you should not. It is a small sum per capita but it amounts to the big total of £27,000 in the year. If insured persons are only going to get the same treatment as members of the public who are not insured, and even if they are to be, as the Minister suggested, discriminated against, I think they should be exempt from paying the contribution.
I think it is quite clear what we want to do. As I understand the matter, at present insured persons can get free sanatorium treatment up to the amount of £27,000 a year. Clearly what we want to secure is that insured persons shall still have the right to free sanatorium treatment to the extent of £27,000 a year. In future, that money shall come through the local boards of health instead of through the insurance committees. As the Minister pointed out, it ought to be easy to do that. I can understand his objection to the amendments, because in the form in which they appear they give an absolutely nebulous right, and therefore it would be a matter of chance whether these persons got free sanatorium treatment or not. As I say, these persons at present get free sanatorium treatment up to the amount of £27,000. Surely we can secure in the Bill that that amount shall be spent if there are cases requiring it.
What is involved in the matter, so far as I see it, is that in connection with Section 23 we could consider the introduction of an amendment that would secure not only that £27,000 will be spent upon free sanatorium treatment but, assuming that there are applications from insured persons for such treatment, that at least that amount of money will be spent on free treatment.
Yes.
May we take it that the Minister will consider the introduction of an amendment to that effect on the next stage?
Yes.
Will the Minister say whether there are any statutory conditions imposed on boards of health in regard to preventing sanatorium treatment being given? Can they give it to anyone who asks for it or must a person be a pauper in order to get it?
It is left to their discretion as to whom they give it. If there is a person whose means were such as would allow him to pay part of the cost they often ask him to pay portion of it, but very often they find it difficult to get it.
Mr. Hogan (Clare):
It is obvious that the £27,000 is a variable amount.
No.
Mr. Hogan (Clare):
It was not £27,000 each year previously.
No.
Mr. Hogan
It went up and down —it varied.
Yes.
Mr. Hogan
The Minister should find a form of words that would enable him not to set it down at £27,000 but as an amount that would be available for free sanatorium treatment if other conditions prevailed—if it went up or down, and I am sure it will go up.
The intention is to stabilise the amount payable to local bodies at the present figure.
Will the Minister state how that figure was arrived at? Does it represent the amount for this year or is it the average for a number of years?
It is the estimated amount that is due this year.
Can the Minister say how it compares with the average for the past five years?
Mr. Hogan (Clare):
If the Minister stabilises the amount he will not give insured persons their full rights. More persons may come in.
They will come in under the Insurance Act, for the sanatorium benefit has been withdrawn.
Mr. Hogan (Clare):
That is a complete technicality.
Amendment by leave withdrawn.
I think that amendments 12 and 16 should be discussed together.
I move:—
Before sub-section (4) to insert a new sub-section as follows:—
"(4) Every official of an insurance committee serving at the date of the passing of this Act whose appointment has been sanctioned by the Insurance Commissioners and who is not transferred with the consent of the Minister for Local Government and Public Health to the service of the council of a county or county borough or a committee thereof shall be entitled to receive compensation for abolition of office in accordance with the rules contained in the Third Schedule to this Act.
(5) For the purpose of making provision for the compensation of officials of insurance committees in accordance with the preceding sub-section a fund shall be created, to be called the "Insurance Committee Officials Compensation Fund," to which shall be credited such sums as are hereinafter provided and out of which shall be paid such compensation as may be awarded as compensation to insurance committees in accordance with this Act."
The proposal contained in this amendment is with the object of making it certain that the small number of persons likely to be affected, about thirty in all, will receive the compensation to which they are entitled as a result of the passage of this measure. The Bill, in the first instance, has been introduced in the public interest, and if it was necessary in the public interest to deprive certain individuals of their positions, I think it is desirable that they should be fairly and generously compensated. Under sub-section (4) the Minister may make certain regulations in regard to compensation, but he is not obliged to do so, that is, he is not obliged to make regulations providing for compensation to the thirty individuals who are likely to be affected. From our point of view, that is a great weakness in the wording of the sub-section. Paragraph (a) of sub-section (4) says that the Insurance Commissioners may, with the consent of the Minister for Finance, make regulations in relation to the manner in which any surplus standing to the credit of the Sanatorium Benefit Fund or the administration fund of any insurance committee after all liabilities have been met, is to be disposed of. The words "any surplus" constitute the trouble there.
I would like to know whether the Minister has at his disposal any figures showing the amount of any surplus which may be in existence after the passing of this measure. If no surplus is available there will be no money to give compensation and my amendment is to make it certain that a solvent fund will be created to pay compensation to those who are likely to be affected by this Bill. That is the serious difference between my amendment and that in the name of Deputy P.S. Doyle because, if the latter is accepted, it will not make it obligatory on the Minister to give compensation. The whole principle involved in Deputy Doyle's amendment will allow compensation to be paid only if a surplus is available. I would advise the Minister to pay due regard to the obligations which his predecessor undertook in the Local Government Act, 1925, and which the Minister for Industry and Commerce undertook in the Electricity Act, and which were also undertaken but not at the expense of the ratepayers in the Railways Act, 1924. If the policy has been adopted in the case of those Acts to give compensation to individuals removed from their positions in the public interest it is a public duty and responsibility on the part of this House to see that there is a fund to give suitable compensation to those deprived of their livelihood by the passing of this Bill.
I move:
16. To add at the end of the section a new sub-section as follows:
"(6) Secretaries and other officials of not less than five years' service and whose income from other employment does not exceed £200 per annum employed by County or Borough Insurance Committees abolished under this section shall unless provided with equivalent employment under the County Council or Board of Health of such County or Borough Council be granted compensation for loss of office, such compensation to be on a scale not less favourable than that provided for officials compulsorily retired under the Railways Act, 1924."
Deputy Davin has made the case that I wish to make in moving my amendment. These officials of County Committees are being dispensed with, as Deputy Davin said, in the public interest. Their employment is being taken from them and it has not been the practice here— at any rate I do not presume that the Minister would wish to introduce a new precedent—that such people should have their appointments taken from them without compensation being offered to them. The Minister did say on Second Reading that under sub-section (4) of Section 22 funds would be available. I understand, but I do not know if it is correct, that the administration funds would have a surplus. The funds of the County Committees have been pooled. In some cases there was a surplus, and in some cases there were deficiencies, but whatever monies were available were pooled, and as a result of the pooling there is a surplus on the administration fund. What the amount of the surplus is, is known to the Minister. We do not know it, and we do not know whether out of that surplus, which is said to be available, there would be much money for the compensation of those people. There are not very many of those people, but some of them have been in the employment of the insurance committees for 17 years, since the Act came into operation, and in justice to them, they should not have their employment taken from them and be thrown out of office without compensation of any kind.
We think, of course, that there is a limit to the way in which public funds can be used in that manner, and Deputies on this side are of opinion that where a person has a living wage already, public funds should not be used to an unlimited extent in granting even compensation for the taking away of employment. In our amendment we set down that those who have already an income from other sources, of £200 per annum, ought not necessarily receive compensation out of those funds. We suggest that all those officials who can be profitably employed by local bodies under the Board of Health, who are now taking over the work of the insurance committees, such of them as are available for such work, and where the services of somebody like them would be needed, should be taken over by the local authorities, either the county councils or the boards of health. Of course, the Minister could not order that, but if, as the Minister pointed out, these bodies have power to set up subcommittees to look after such matters as tuberculosis work, we think that if the Minister strongly recommended the appointment of voluntary committees of that kind, to take charge particularly of the work of looking after tubercular people, good work could be done by boards of health in that way, better work than a board of health could do through its own members at present.
I think nobody who has any association with the work of a board of health in any county can deny the fact that these boards are overworked in many cases. I understand that they cannot meet very frequently. Of course, people have other duties to attend to, and when they do meet they have a long day's session. Frequently towards the end of the day after long discussions on various matters relating to the health of the county, the secretary submits a recommendation from some committee. The board perhaps have not time to go into it, and the secretary says: "I suppose you will adopt the recommendation of such-and-such a committee." That is how the work is done even by boards who would be willing and anxious to go into every phase of the work in the county. They cannot do it. They cannot overtake the work. The Minister has pointed out that they have the powers to appoint sub-committees, and he should strongly recommend the appointment of voluntary committees to look after matter of that kind, especially after the abolition of the insurance committees which were doing a small circumscribed kind of work. This other work to be performed, in general, would be more difficult work, but it would be work to which he could get people in every county who are interested in the matter to give the benefit of their services. If such committees were formed, the services of the employees of the late insurance committees could be utilised, and if they were so utilised, of course, compensation would not be necessary. The Public Health services of the county in general would benefit. The services devoted to the people who are suffering from tuberculosis would in particular benefit, and it would be an improvement all round. It would save some expense for the public bodies, and these people having a knowledge of this class of work would do it probably more efficiently than those who have not such experience.
I should like to give qualified support to the amendment proposed by Deputy O'Kelly. There is a limit to the amount of public moneys which can be spent and there is certainly a limit to the amount of pensions that should be given. The country is pretty full of pensioners at the present time and I would not be at all prepared to support pensions for people who have not been giving their full time to this work. At the same time I think it would be hard on people who have been employed for periods such as Deputy O'Kelly has mentioned, 17 years, and who have given their full time to the office, to be dependent on the very vague provision which is contained in this Bill. However, I think there are very many people who have other employment, to which this office has been a little addition. The cutting off of this work, therefore, would not be of very great consequence to them. On the other hand I think it should be possible to make an effort to absorb these officials in the new work contemplated. As far as possible the Commissioners should endeavour to absorb particularly people who have been giving their wholetime service to this work. That is the suggestion I would make in support of Deputy O'Kelly's amendment, namely, that an effort should be made to absorb these officials engaged in this wholetime work, and secondly, I think it is only fair that people who have been employed as wholetime servants should be compensated. The other matter is one with which I am not sufficiently familiar to speak with any confidence. But I think that people who have already good salaries and who had little appointments added on, in connection with insurance work could not have the same claim for compensation as those who were deprived of offices to which they gave fulltime service.
I move to report progress.
Progress ordered to be reported.
The Dáil went out of Committee.
Progress reported, Committee to sit again on Thursday, November 7.