National Health Insurance and Widows' and Orphans' Pensions Bill, 1935—Committee.
Sections 1 to 5 inclusive agreed to.
SECTION 6.
(1) On and after the appointed day under the Act of 1933 the committee of management of the Unified Society shall consist of 15 members, namely—
(a) the chairman for the time being of the committee of management of the Unified Society,
(b) the three trustees for the time being of the Unified Society,
(c) three members (in this Act referred to as employers' members) appointed, in the manner provided by this Act, by the Minister,
(d) three members (in this Act referred to as insured persons' (trade union nominees) members) nominated, in the manner provided by this Act by the national executive of the Irish Trades Union Congress,
(e) five members (in this Act referred to as insured persons' (local authorities' nominees) members) elected, in the manner provided by this Act, by the Insured Persons (Local Authorities' Nominees) Members Electorate.
(2) There shall be paid by the Unified Society to each member of the committee of management of the Unified Society such allowances (if any) as the Minister may from time to time determine in respect of such member.
Many amendments have been submitted to Section 6, amendments having for their object the proposal of three alternative schemes. Were the question on amendment No. 1 to be put in the usual form, the whole series would fall. To obviate that result and to afford the Committee an opportunity to decide separate important issues, I propose to put the following questions:—
(1) On amendment No. 1—"that paragraph (a) stand part of the section"—to decide whether the chairman shall be a member of the committee;
(2) On amendment No. 3—to decide whether the chairman shall be a trustee of the Unified Society, and the number of trustees to be members of the committee;
(3) On amendment No. 4—to decide whether the committee of management shall include a medical practitioner;
(4) On amendment No. 2—`that paragraphs (c) and (d) stand'—to decide whether there shall be employers' members, and the number of trades union nominee members;
(5) On amendment No. 5—to decide whether there shall be local authority nominees and the method of their election.
If amendments Nos. 1 to 5 are negatived, the following amendments will fall consequentially—amendments Nos. 9, 12, 13, 14, 15, 16, and 18.
I move amendment No. 1:—
In sub-section (1) to delete the several paragraphs (a) (b) (c) (d) and (e) and substitute the following words:—
(a) the three trustees for the time being of the Unified Society,
(b) 12 members (in this Act referred to as insured persons' representatives) nominated, in the manner provided by this Act by the national executive of the Irish Trades Union Congress.
The purpose of this amendment is to prevent the chairman from being a member of the committee of management. Its aim is to continue control by the insured persons of their own society, as has obtained since the inception of this insurance legislation in 1911 or 1912. During all the years that national health insurance was administered in this country, although it was initiated with little or no previous experience, there was very little failure on the part of the workers or the insured persons to give the best results to the working of this intricate form of insurance, and amongst all the reasons that have been alleged in advance for the necessity for unification, I do not think that lack of administrative capacity or maladministration figured. Having regard to the fact that they have 24 or 25 years' experience of the working of this insurance, there surely can be little reason advanced as to why control by the insured persons themselves should be taken away.
The suggestion of the Minister that the Chairman should be a member of the committee is, to my mind, a very bad one in principle and it will be worse in practice. We think that he, at least, ought to go before the committee to give an account of his stewardship with respect to the control and administration of the office, and the appointment of the chairman should be left in the hands of the people who are directly concerned. I look upon this Unified Society as nothing more or less than an amplified single society. It is taking over the functions of 60 odd societies and control by the Minister is still there. He still can be represented by his three trustees, but we certainly think it is going to be a bad business if the running of this committee is to be a purely Ministerial function, and if it should be expected to be nothing but a representation of the Minister who will have his three trustees there. He proposes in another respect to have a voice in the election of certain other members on the committee, all of which is, I think, quite wrong and against the principles underlying the scheme which has made this insurance a great success in the country notwithstanding great handicaps and hardships.
As I said earlier, I do not think it can be alleged that there was any failure. The number of societies during the entire period of 24 years that failed to give completely good results is almost negligible, and the estimated financial deficit which was expected to accrue on the next quinquennial valuation would not have been due to any maladministration or lack of administrative capacity on the part of members running the societies, but rather to the abnormal period through which we are passing and, perhaps, the lenity with which medical certificates were issued, which caused a strain on the funds which the funds were never intended to bear in normal times. I believe that taking from the insured persons the control of the societies to which they have been accustomed is going to mark a step down in the confidence of the insured persons, and I might say that at the moment that confidence is being shattered by the methods of administration. Every advantage is being taken, not outside the scope of the powers of the Act, but in every shape and form, to wheedle people before the medical referees and to put them through the mill in an effort to prove that they are not entitled to benefit under the Act.
They can be told quite honestly here that they have the machinery at their disposal for an appeal against the referee's decision and to carry the matter as far as they like. In the case of people in rural districts, however, who find themselves called upon to seek benefit from the National Health Insurance Society, because they are suffering from rheumatism or some other form of illness, after sending six or seven certificates, they get this customary questionnaire, and the committee is led to believe that they are not entitled to benefit. If they have any objection, they must go before the medical referee and they can bring all the other appeals, subsequently. That is not very much satisfaction to the poor man or woman who has been contributing in the hope that, in case of illness, he or she receive benefits with the precision and regularity to which they were accustomed in the case of local societies in former days.
There is a feeling abroad that the principal functions of the committee now is to make savings, whether that entails hardships for the people or not. If there is going to be an inclusion in the committee of management of a further quota of Ministerial nominees, to the exclusion of the direct representatives of the people, I say that is going to be a bad thing for the harmonious working of the insurance of the country, because if you once give the people the impression that you have no sympathy with their interests in this form of insurance, it will be very difficult to get them to come along and insure in their full numbers. In the past it was due to the activities of various sub-agents throughout the country that it was possible to make national health insurance so widespread, and so generally observed, but if the people are inclined to get their backs up against it—and I think they will if you are going to adhere to the principle proposed here—you are going to create a certain amount of hostility in that way to the administration or the smooth working of the Act. I think the Minister ought not to interfere with the existing arrangements. He has plenty of protection, he has plenty nominees of his own, and I think he should leave the chairman to be appointed by the members of the committee. There will then be free and healthy discussion amongst the members of the committee, and they will be given a free choice in the selection of a chairman. Insured persons also will have the feeling that their interests will be fully secured, subject, of course, to the Ministerial and inspectorial control that they have been accustomed to when the societies were working as single societies.
I want to support that portion of the amendment, moved by Deputy Keyes, in relation to the appointment of the chairman. It is much less than two years ago since the Minister came to the House and asked it to pass the National Health Insurance Bill, 1933. In that Bill, which presumably had received an exhaustive consideration from the Department, the Minister provided that the committee of management should consist of 15 persons, three of whom would be trustees, three of whom would be employers' representatives, and nine persons representative of the members of the insured society. These 15 members had power to elect their own chairman. Now, after 18 months' experience of the Act and with no experience whatever of the committee electing its own chairman, because the committee has not yet been given the privilege to execute that act, the Minister comes to the House and asks us to give him power not merely to appoint the chairman but to remove the chairman. All this is done without any adequate explanation as to the reason for this fundamental change in policy exhibited in the difference between the proposed Amending Bill and the Bill which the Minister piloted through this House in 1933.
If the Minister thought it right and proper to let the committee elect its own chairman in 1933, what is the reason for depriving the committee of that power in 1936? We have had no evidence in the meantime that the committee has been reckless in exercising that power. We have no evidence that the committee, because of the power thrust upon it, acted in an irresponsible manner. There has been no opportunity, in the meantime, to judge on the merits of the committee's action in electing a chairman of this society, so that without having given his original idea any trial whatever, the Minister comes to the House and asks for power to appoint the chairman and to remove the chairman, to deprive the committee, which must work with that chairman, of any power whatever to appoint the chairman, and leave them without a single voice in the appointment of the chairman. The committee is not even asked to make a nomination to the Minister for the appointment of a chairman. The committee is not to be consulted at all as to the appointment of a chairman. Instead, in this Bill the Minister is given power to appoint the chairman of the society. No matter how disagreeable the chairman may be to the committee, no matter how inefficient or autocratic he may be from the standpoint of the committee, that committee has to take the Minister's nominee as chairman. They cannot even remove him. Only the Minister, having put the chestnut into the committee's fire, has the privilege of coming along and taking it out for them.
I suggest that that is an entirely autocratic procedure, quite unworthy of the Minister for Local Government and Public Health. It is bad enough for the Minister to claim power to appoint a chairman, but also to claim power to remove the chairman seems to me intimidation de luxe. The Minister is to say: "You will be chairman. Lest you might get out of hand, lest you may not do what I desire you should do, lest you may become troublesome from the point of view of seeking too much for insured members, lest you do not act in accordance with the wishes of the Department, I have taken power to remove you from office in this section, and I need not assign any reason for doing it. Remember if you do not conduct yourself in the manner prescribed by the Department, not with reference to any ethical standards of procedure, but with reference solely to the wishes of the Department, I shall in accordance with the powers conferred on me by Section 7 (2) of the Act, remove you from the office of chairman." I suggest to the Minister that that is an entirely undemocratic procedure.
After all, in the scheme of control envisaged in this Bill, there is provision for three representatives of employers, three representatives of trade unions, three trustees appointed by the Minister, three representatives of the Trade Union Congress, and five appointed by the insured members. That is a fairly diversified committee, and surely the Minister ought to allow that committee to appoint its chairman. It is obviously selected in that way to ensure that it would not be too radical, at all events. I do not think it can be urged that it would be too reactionary, from the standpoint of not wanting to implement the policy of the National Health Insurance Act, which is at present in operation. I do not think it can be said that the committee would be likely to be irresponsible or to put a premium on inefficiency. In view of that I think the committee ought to be left power to appoint its own chairman. That was the Minister's idea when the main Bill was going through the House, and without any experience of the working of that provision the Minister now comes to the House, and says that he has changed his mind. His first thoughts were wrong, and his second thoughts are correct apparently, though he has no experience of the manner in which his first thoughts operated. I think the Minister ought to reconsider the position, and allow the committee to elect its own chairman in the way provided for in the Act of 1933.
On behalf of Deputy Morrissey, I am sponsoring the amendments standing in his name. We take a different view from the speakers who have just spoken on the desirability of the chairman being a member of the committee of management. Deputy Morrissey proposes that the chairman for the time being of the committee of management of the Unified Society shall be one of the 15 members, provided he is a trustee of the Unified Society. While one would have to take notice of the objection raised by Deputy Keyes and Deputy Norton, we think a case can and ought to be made in the manner provided by the amendment proposed by Deputy Morrissey—that is, that the chairman shall be a trustee of the Unified Society. In that particular manner it would remove many of the objections that are apparent. I do not know if we can discuss the whole thing generally and take the proposals afterwards.
I think that the second amendment might be discussed with the first, as it refers to the chairmanship. As regards amendment No. 3 on the Order Paper, the Deputy is quite in order; it deals with whether the chairman should be a trustee of the Unified Society.
We think the Chairman should be a trustee of the Unified Society and, if he is not a trustee, he should not be a member of the committee of 15. Later, when we come to deal with Deputy Morrissey's amendment, the reasons for this will be more apparent, as the amendment sets out the new position. We are in favour of the chairman of the Unified Society being a member of the committee of management provided he is a trustee of the Society.
I marvel at the eloquence of Deputy Keyes and Deputy Norton at this early hour on Friday morning. It is extraordinary the flow of language and the ideas they managed to produce. They must have got up early this morning.
One would imagine we were making some radical or some fundamental, to use the word introduced by Deputy Norton, change in the control and management of the National Health Insurance Unified Society as now in operation. There is no fundamental, no radical change proposed. The majority of those who will be members of the committee of management will be insured persons and there will be others, employers and trustees. The principle of control by the insured persons is, therefore, being adopted. As I said on the Second Reading, I think it is being more than just to the insured persons to give them, although they provide only 40 per cent. of the fund, a majority of the membership of the committee of management. Surely even a Minister has the right, after more mature reflection, to be allowed to change his mind? Is no Minister ever to be allowed to say to the Dáil, "I have thought over this thing for the last two years and I think it would be wiser to make a change?"
I hope it will be repeated by other Ministers.
Not too often. I would not like to see too frequent changes. This is not a matter of change on principle, not a matter of a fundamental change of any kind. It is really a matter of the working of a big organisation, the administration of a big organisation with very wide ramifications, the impacts of which come into very intimate association with people all over the country. Watching that administration, having considered it in various aspects, I think the present suggestion—if you like, a change of mind on the part of the Minister—is more practicable and will lead to better working on the part of the committee of management.
As regards the amendment tabled by Deputy Morrissey and proposed by Deputy Bennett, I went into that matter even before the amendment was put down. Somebody else suggested to me that it might be wise to have the chairman a trustee with the three trustees who were there. When the suggestion was made to me at first I thought it was a good idea, but on going into the matter more throughly I discovered it might lead to great difficulties in working; for instance, whenever it became necessary for the trustees to do their work with regard to signing documents. One trustee cannot delegate his work to another and, if there are three trustees, all three must sign a document; if there are four, all four must sign. It is quite possible the three or four trustees may be resident in different parts of the country, and if they wanted to sell some of their stocks and shares or change from one investment to another, these things frequently have to be done in haste and the documents would have to be signed hurriedly and that might create difficulties if the trustees had to be sought out in different parts of the country. I am afraid the difficulty in working would be very great.
Surely the chairman of the society would be probably more accessible than any of the other trustees?
He might be, but the other three might not be so accessible.
We are not interfering with the others so much.
No, but I do not feel that it would be reasonable or practicable to change the other arrangement that we have come to about the trustees. We have gone into the matter very carefully with the various interests involved and it probably is the best arrangement to leave the number of trustees three, as at present suggested. It is always pleasant to listen to eloquence, particularly from the Labour Benches, where Deputies are masters in that respect, but I really do not see that there is any great reason for that flow of eloquence that the Deputies concerned have used this morning in denunciation of this so-called radical and fundamental change in the management of the society. There is no such radical or fundamental change and I am satisfied our arrangement will work out for the better.
The Minister has not given any reason for his change of mind, notwithstanding all the eloquence he has used this morning.
I have not used any eloquence; it is not necessary in my case.
At least, the Minister might give the reasons for the change.
May I point out that Deputy Morrissey's amendment does not propose to increase the number of trustees? It is suggested that there should be three and one will be the chairman of the society.
The Minister ought to look up the question of the possible delay that may take place in transferring securities or that sort of thing. I do not see much point in what the Minister said about a difficulty arising. Obviously, if you have three trustees, and one of them is the chairman, the fact that he is the chairman does not add to any difficulties in transport or cause any delay. In my experience in connection with those matters, haste is not always so necessary as it appears on the surface. There are certain securities in respect of which an earlier transfer may be necessary than in the case of others, but the fact that a man is appointed chairman of the society would not, of itself, occasion any delay in his signing the transfer instruments as the case might arise.
Looking at the matter from the point of view of administration, I am not so sure that the proposers of the amendment have made any case for it—if the desire be to associate the insured persons as closely as possible with the work of the society. That is not enhanced by putting one of them in the chair. The man who should be appointed as chairman is a man with some experience of administration. It might so happen, if the election of chairman were to follow the lines of the division in the committee, one of the eight members might be appointed, and whatever time he would have to devote towards other matters than management of the society would be eaten into by reason of the extra time that would be devoted towards administration, management, and so on. It is quite possible that one might get an excellent administrator amongst the eight representatives, but I should say that the Minister has a certain responsibility with regard to this Unified Society; that he should bear that responsibility, and that he should select a person in regard to whom he would have, at any rate, fairly good grounds for believing that he would make a capable chairman. Chairmanship of the society does impose fairly serious obligations and duties, and if the Minister has a responsibilty for appointment he would require also to have authority in particular cases for removal. Although there is a certain objection to the inclusion of such a clause in the section, one cannot possibly conceive passing the section without such a safeguard. Although Acts of Parliament are littered with such lumber as that, the lumber is necessary for the safeguarding of administration. It is not exercised as a rule. If it were exercised arbitrarily or without cause, there would be abuse. In any case, the second situation could not be worse than the first. If it gets to the point where you have inefficient administration and lack of a sense of responsibility on the part of the Minister, you are likely to have that evidenced in the appointment of the individual just as much as you would in his removal from office. I see no great point in taking exception to that provision. It is a provision which it would be very unwise to exercise without great cause; it would be very foolish to do so.
On the other question, I think that the standing of the chairman should be emphasised if it be possible to emphasise it. If it be possible to get a person who would combine the offices of trustees on the one hand with suitability for chairman on the other, it appears to me to be justifiable that one of the trustees should be chairman. He would speak with greater authority as chairman if he were trustee. He has much more diversified and, at the same time, much more onerous responsibility, and quite possibly his observations from the chair, if he were trustee, would have greater weight than if he spoke as trustee down along the table. I do not think there is very much in the point, but it does seem to add to the suitability of the person presiding. To that extent I think that if there be no other objection than what the Minister has raised—the difficulty regarding the transfer of securities, and so on—it does not appear to me on the face of it that there is much in that contention.
I support the amendment moved by Deputy Bennett in Deputy Morrissey's name. With regard to the objection which the Minister seems to have against having four trustees, I may say that I have some small experience of acting as one of four trustees. By arrangement with the bank any two could sign, and in that way I think the difficulty which appears to upset the Minister is easily got rid of. He referred to the difficulty of bringing those four trustees possibly from different angles of the Free State. I think that difficulty is easily got rid of if you suggest that, say, two of them might sign in the case mentioned by the Minister himself. Again, I think it is most essential that the chairman should be one of the trustees of the society. I know there is very strong feeling in the country to that effect, and I would urge on the Minister the desirability of accepting Deputy Morrissey's amendment.
I think a good deal of the Minister's criticism has been based on misunderstanding of the proposal before the House. I gathered a couple of minutes ago that he seemed to think Deputy Morrissey's amendment proposed an increase in the number of trustees, whereas in reality it simply provides that one of the trustees shall be chairman of the society. I understand, Sir, that we are not at present discussing amendment No. 4?
I merely wish to point out, therefore, that amendment No. 3 is framed with a view to amendment No. 4.
As far as I understand Deputy Morrissey's intention, it is to cut down the number of other members of the committee in order to make provision as proposed in amendment No. 4. I think it is almost altogether in view of amendment No. 4 that he put amendment No. 3 on the Paper, and that consideration—whatever view one takes of the purpose of amendment No. 4—should affect one in considering amendment No. 3. It seems to me that Deputy Morrissey's amendment, apart from its bearing on No. 4, renders the trustees a more manageable group than that provided for in the text of the Bill. It makes sure that one at least of the three will be very readily accessible, whereas under the Bill as it stands the three members may, as the Minister pointed out, be scattered all over the country. Under the amendment one of them at least would be within easy reach. Taking them as a group they would be a more businesslike body and more closely in touch with the working of the society. I hope the Minister will give further consideration to the amendment, and be ready to accept it.
With regard to the amendment proposed by Deputy Keyes, I feel surprised every time I hear members of the Labour Party objecting to any step towards the nationalisation of the social services of the State. In the past, gentlemen who occupied, and who still occupy a high position in the Labour councils, have been strong supporters of nationalisation and favoured increasing the power of the Government in these matters. But to-day Deputy Keyes' argument has been in the opposite direction. He suggests that control over national health insurance by the Government is the most dangerous kind of control that we can have, and that direct control by the members is likely to be more efficient. I will have something more to say on that topic when we come to discuss amendment No. 5 by Deputy Morrissey. I am now merely drawing attention to this matter as it is rather difficult from my point of view at all events to understand the viewpoint of the Labour Party in this connection.
With reference to the contribution by Deputy Rowlette, I must confess that I do not understand the point he is trying to make. He says that in this amendment the Labour members have shown themselves opposed to nationalisation. He makes that statement because I put forward and argument this morning that national health insurance should have its control vested in its own members and not be altogether subject to the control of the Minister. If that is an argument against nationalisation I cannot see it. I am perfectly satisfied that control by its own members is the form of control that we should all desire. In the view of the members of this Party the proposals of the Minister would certainly not represent democratic control. I suggest that control of the type that I see here in the Bill now would take the form not merely of ministerial control but mental control. Our experience in the past is that the Minister in most of these cases has actually been advised by his officers in the various Departments, and the tendency of the Minister's advisers would be quite foreign to what we have in mind—control by the insured persons. I think it is in the interest of the society itself that control should be vested in the members themselves. Control by them has not failed in the past. The Minister scattered around bouquets this morning and smilingly got out of his responsibility of giving a reply as to why he had changed his mind in this matter. Nothing has happened since the Minister introduced the original Bill that should cause him to change his mind. Why did he change his mind? It was in consultation with his advisers that he changed it. I suggest that the Minister is ill-advised in taking these suggestions or dominating against the wishes of the members of the society.
The members are not too well pleased at the way the society is worked at the moment, but they will be less pleased with it when the Minister's control takes such a dominating form as is now suggested. We are told that the principle of democratic control is retained. It is not. The insured person's representatives are brought from various parts of the country. But you have a concentrated force here in Dublin and that force has the point of view dictated by economy—they have got to save and they will use the machinery at their disposal to dominate the society. As is being done already, efforts will be made to save at the expense of the sick person. The members from the country would not always be present. Some member may be unable to attend and we do not have too many from the country kicking up a row about a sick person. If the change is now made in the Bill it will not be very long before the Minister or succeeding Ministers will be coming back to the House to get back that democratic control which has been there since the inception of the Act. The Minister has had handed over to him a perfect machine. Why the Minister at this moment should decide to go away from that form of representation of the people concerned and take further control for himself is a thing that I cannot understand. I believe it is not going to be in the interests of the society as a whole or in the interests of the insured persons as a whole. I really believe that the Minister or his successors will come back here again asking the House to alter this.
The Minister has congratulated some of the speakers on their eloquence. I want to congratulate him on the eloquence of his silence in not having said a single word as to the reasons which induced him to change. We got no reason or argument of any kind in this House for—if I may use the word —this elasticity for which the Minister has become noted. I am not hoping that anything I can say now will change the Minister's mind. I very much regret that he has not seen fit to consult a wider field before he decided to make this change. If he got the views of the people throughout the country he would find that they are entirely opposed to the alteration he is seeking. The matter is entirely immaterial to me, but I am an insured person myself and I do not speak without having some knowledge of the operations of the Act. I tell the Minister that the less interference there is by him in the working of the society, the better it will be for the society. The Minister has his inspectors; he has control at the Custom House and he has his direct representatives on the committee of management already. But with all that he now insists on appointing the chairman. I believe that he is taking a step that is unnecessary and unwise in the interests of the society as a whole.
Does not Deputy Keyes believe that the most democratic form of control would be effected by accepting the amendment standing in the name of Deputy Morrissey? That amendment would give democratic control in the widest sense. I should like that Deputy Keyes would give that matter consideration.
The Minister resorted this morning to the ruse of handing out bouquets instead of an explanation as to the reasons why he changed his mind. I am inclined to think that the flowers in the bouquets were rather artificial, but perhaps they served the Minister's purpose. Why did the Minister come to the House in 1933 with a Bill providing for the election of the chairman of the committee of management by the members themselves? Without any experience of the working of that part of the Act, he is back here again after three years and says: "I have changed my mind; I now want to appoint the chairman myself and I want to do it in such a way as will reduce the representation of the insured persons on the committee of management." That is a proposition the reason for which the Minister should have no hesitation in giving to us. The Minister is not merely taking the power now to appoint the chairman, but he is reducing the number of the insured persons' representatives on the committee of management.
In the 1933 Act it was provided that the committee should consist of 15 persons, three of whom would be trustees appointed by the Minister, three employers' representatives also appointed by the Minister, and nine representatives of the insured persons. That was the Minister's viewpoint in 1933, but now he comes back in 1936 and says: "I want to appoint the chairman of the committee." Instead of reducing the employers' representatives to two, the Minister provides for appointing the chairman by reducing the number of the insured's representatives from nine to eight. We have not any explanation from the Minister as to why he has changed his mind in that respect. On this matter there is a very widespread feeling abroad. The Minister, in his desire to secure unification of the national health insurance societies, was apparently prepared to give, at all events, a gloss of control by the insured persons. But having enshrined unification of national health insurance societies in legislation, he comes back now and takes the gloss of control away. He is providing for a form of representation which gives the insured persons eight representatives on the committee while there are seven appointed by himself; so that on any occasion on which there may be one of the representatives of the insured persons absent from the meeting of the committee, the representatives of the insured persons are in a minority, because the chairman appointed by the Minister will be vested with a casting vote, which he will surely exercise in a way that will take cognisance of the fact that he was appointed by, and removable by, the Minister.
All the efforts of the Minister to say that he does not propose to exercise any rigid personal control of this person are beside the point, because when you hold the title deeds of that man's office in your pocket he has a very insecure tenure, and the chairman of the committee of management will realise that from time to time. Even if the Minister is the most angelic Minister for Local Government that we are likely to be blessed with, he is not likely to live for ever or to be Minister for Local Government for ever. We are passing a Bill providing for permanent legislation in respect to national health insurance. Another Minister for Local Government may not take the same democratic view of his relationship with the chairman of the society, and may desire to exercise an arbitrary kind of control over him. We have no safeguard against that, so long as the chairman is appointed by and removable by the Minister.
Deputy Cosgrave indulged in a rather extraordinary kind of argument in the course of his remarks. He said that bringing an insured person so close up to national health insurance administration as to make him chairman did not necessarily make for efficiency in administration. That is not the point made for the amendment moved from these benches. We have stated in support of our amendment that the Act passed by this House, in 1933, should be allowed to remain as it was, namely, that the chairman should be appointed by the committee of management. Deputy Cosgrave appears to fear that it may be impossible to secure a suitable person if the appointment of the chairman is left to the committee of management.
When we advert to the Bill we find that the Minister is empowered to put in three trustees. He is also empowered to put in three representatives of employers, that local authorities are to nominate an electoral college which will elect five members, and that the national executive of the Trades Union Congress is empowered to elect three others. We find that the representation on the committee of management is likely to be drawn from elements which, no matter what side they represent, would be capable of discharging the functions of chairman of a society of this kind, and I think that the material which would be thrown up by a method of selection such as that would be of a much higher calibre than that apparently envisaged by Deputy Cosgrave. At all events, this House, in 1933, did not see any danger in allowing the committee of management to appoint the chairman and with no experience of any derogatory kind of the management the House is now asked to take the power of appointing the chairman from the committee. That is an entirely undemocratic proceeding, and I think we should, at all events, have from the Minister some explanation as to why he changed his mind in the matter.
I do not want to debate what will subsequently be debated on other amendments, but I should like the Minister to give further consideration to the principle of amendment No. 3. The Minister very fairly admitted that he had considered this matter before, and he rather led us to believe that he at one time perhaps looked favourably upon it. I suggest to the Minister that the difficulties that he assumed do not really exist and that the question of the accessibility of the trustees would not arise in the person of the chairman. In fact, there is a point in the suggestion that the mere fact of the chairman being a trustee would give confidence, and would make the trustee more accessible.
Supposing he lived in Cork, Limerick or Galway, he would not be more accessible.
Generally the chairman of most committees or institutions is more accessible than any other member of the committee. Anyhow, I should like the Minister not to ask us to decide on this particular point until he gives it further consideration before the Report Stage. I think a good case has been made for the chairman being one of the trustees and I appeal to the Minister, as he has considered the matter before, apparently, almost favourably, to allow it to stand over to the Report Stage.
The fear I have in regard to the constitution of the committee of management as now proposed is that a number of the members, perhaps the majority of the committee, will be people who have no administrative experience in the working of national health insurance. It does not matter whether these people will be civil servants or representatives of the employers or, if you like, people nominated in another way. They may have had no contact in the past with, and no experience of the administration of the societies now merged in the Unified Society. I do not think that a civil servant as such has any special qualifications to hold a dominating position in a society like this. If we are to have a committee of management capable of controlling a body of this kind in the most efficient way, it should consist of people who have had some contact in the past with and some experience of the working of national health insurance.
I agree that some such people may be found in the section of the Minister's Department which had responsibility in the past for the working of national health insurance, but it is contrary to the interests of the insured members that there should be any large number on the committee of management who have had no administrative experience of national health insurance. If the Minister for Industry and Commerce, for instance, proposed to set up a transport board I would, for the very same reasons, strongly resent the appointment, either as chairman or as a member of any such board, of a person who had no experience of the working of a technical business of that type. The same applies to national health insurance. The societies, as constituted before they were merged in this society, were administered by committees of management consisting of people who were themselves insured persons, and who knew something about the working of the societies. I think that should apply to the constitution of the new committee of the Unified Society. Employers had no representation on the old societies and this idea of giving them representation —it is not in the amendment before the House, but it is part and parcel of the same policy—is a joke, from my personal point of view. The contributions made by employers to national health insurance represent deferred pay so far as the workers are concerned.
The representation of employers will arise on amendment No. 2.
I have no objection to any civil servant as such, but I contend, and I put it as strongly as I can to the Minister, that a civil servant has no special qualifications for membership of the committee of management of this society. The executive officers and the whole staff, with very few exceptions, I believe, are persons who were previously employed in the societies now merged in the Unified Society. I think it would be very dangerous if the majority of the members of the committee of management had no previous experience of the working of national health insurance and were empowered to give directions to the executive officers and the staff, who would naturally know a great deal more about the administration of national health insurance than civil servants without any previous experience, or employers' representatives who had no previous direct contact with the insured members. I appeal to the Minister to reconsider the matter very carefully and to endeavour to stick to the line he adopted in the original Act.
I do not know what point Deputy Davin is referring to in emphasising the question about the undesirability of civil servants being put on the committee of management. There is no suggestion here that any particular class or any particular profession, except what is provided for in the Bill, is to be put on the committee of management. I do not know what the Deputy is referring to. There is no suggestion that the Minister is bound or not bound to appoint civil servants on the committee of management. At any rate, if there is no special reason why civil servants should not go on the committee I think it is a reasonable argument why he should not put any other class or profession on the committee. As I say, there is no suggestion that the Minister is bound to put civil servants on the committee, and as a matter of fact I doubt if any civil servant would be eligible. I think that any Minister, in looking for suitable people, will certainly try to get people who will have experience, if possible, of the working of national health insurance and its administration through his own work or his own business or profession or through experience gained in control of a similar organisation. At present, and since the 1933 Act was passed here in this House, the control has been provisionally in the hands of three civil servants who were appointed as a provisional committee until the amalgamation of the various societies would be completed. That has now been done for some time and, according to the Act, we must have all the arrangements made before July next for the new committee of management to take control. Accordingly, this Bill is rather urgent. We have to have time to get the necessary regulations passed and to get the new committee formed and ready to take over control before the middle of July.
Before passing from that, I should like to emphasise again, for the benefit of Deputy Keyes in particular, that in principle there is no change in democratic control. There is a modification of what was passed here in the House in the 1933 Act for the control of the National Health Insurance Unified Society. We have two sets of control. We have the control of the new committee of management which is, in principle, democratic. The majority of the members of the committee of management will be democratically chosen. Then, Deputy Norton talked of the great danger that he suggested lay in allowing a chairman and a committee, part of whom would be nominated by the Minister, to have control of this organisation. He suggested that if one of the elected persons happened to be absent and that the chairman had a casting vote, therefore the control immediately would be of an undemocratic kind, and he suggested that it would be to the great disadvantage of the insured persons. Well, one can answer that right away by saying that it is just as likely that the employers' representatives or the trustees would be absent. So there is nothing in that point one way or the other. The principle is that there is a majority of democratically elected persons provided for in the Bill for control. Let us suppose that the chairman were a person who was inclined to be dictatorial. Well, there happens to be a democratically elected House here controlling the Minister. From past experience we know that, if there are any complaints of that kind, the Labour Party and other Parties in the House will certainly let the Minister hear of such complaints, and the Minister has to answer to the House. Is not that the essence of democracy, and if the chairman, whoever he may be, is an unsatisfactory person, as Deputy Cosgrave said, this House has control over the Minister and can oblige the Minister to change his nominee if the person concerned is so undesirable as some of the members of the Labour Party would suggest.
There is thorough democratic control over the whole of this measure just as there is over every other Department of Government in the State, and that is the power residing in this House to control the Minister. There is no Minister of any Government who is not open, here in the House and elsewhere, to suggestions from Deputies when they have serious complaints to make about individuals, whether civil servants or non-civil servants. We hear these complaints every day in the week and certainly any Minister gives consideration to whatever complaints are made and, if they are well-founded, he takes action on the matter. Accordingly, I do not think there is any danger whatsoever that any Minister is likely to appoint a chairman of the committee of management who will not act fairly and squarely between man and man in the national health insurance society and between the State and the society. Whatever Minister may be concerned, he will try to get a man who will have a sound idea of his responsibility and who will act accordingly, fairly and justly, between the officials of the society, and between the State and the society.
Now, as to why I changed my mind with regard to the nomination by the Minister concerned of the person to be chairman—why the Minister took that into his own hands—I think I stated more than once before, and I repeat now, that my reason was that, on going into the matter again, I was struck by the fact that 60 per cent. of the insurance funds were provided by others than the insured persons and that it seems to me, therefore, to be reasonable that those who provided the major portion of the funds ought to have a bigger say in the control of the organisation. That is why I suggested to the Government that the chairman should be nominated by the Minister, and the Government agreed with me and I brought in the suggestion here and recommended it to the House.
There is just one question I should like to put to the Minister, Sir, before the amendment is put. Does the Minister intend that the chairman should be appointed for an indefinite period or for any stated number of years?
I think that is prescribed in the Act.
Well, can the Minister give us any idea as to what he has in mind?
I have not gone into the regulations yet, but I think the chairman ought to be appointed in the same way as the committee, from year to year.
Amendment, by leave, withdrawn.
Amendments Nos. 2 and 3 not moved.
On behalf of Deputy Morrissey I move amendment No. 4—
In sub-section (1) before paragraph (c) to insert a new paragraph as follows:—
"one member, who shall be a registered medical practitioner, appointed by the Minister."
Deputy Rowlette mentioned that according to the distribution of numbers three of the members of the committee of management will be trustees and three will be nominated by employers. There is then the question of a chairman. If the Minister would consider the suggestion that the chairman should be a trustee, it would afford an opportunity for inclusion on the committee of a medical representative. Otherwise, if the chairman was to be a medical officer, his usefulness in that respect would be largely nullified if he had to do administrative work. As far as I see there is no other means of getting in a medical officer as member of the committee. It is unlikely that the employers will nominate a medical practitioner. In consideration of the proposal that the chairman should be one of the trustees, an opportunity is afforded of having on the committee of management a medical practitioner.
This amendment deals with the question of the appointment of a medical practitioner, and a subsequent amendment in the name of Deputy Morrissey is more comprehensive. Perhaps it would be advisable if the Ceann Comhairle would allow me to discuss amendments Nos. 4 and 5 together.
Amendment No. 4 refers to the question of whether or not the committee of management should include a medical practitioner, while amendment No. 5 is to decide whether there should be nominations by local authorities.
We believe that there ought to be a medical practitioner on this committee. A proposal that we previously put before the House, that the chairman should be one of the trustees, would make room for a medical practitioner, in other words, that of the three trustees one would be chairman of the Unified Society. As he would be on the committee if he was a trustee, that would make room for a medical practitioner. I think the inclusion of a medical practitioner on the committee would be accepted with satisfaction by all parties, by the people concerned with insurance, by the representatives of the employers and employees, and by the general public. There are 101 reasons to be adumbrated for the inclusion of a medical practitioner. I appeal with confidence for support for the inclusion of a medical practitioner on the committee.
It is somewhat of an anomaly that, in a scheme calling itself one of National Health Insurance, there is not any machinery for medical opinion and medical expert knowledge to exercise itself on the administration of the work. I am supporting Deputy Morrissey's amendment because if it does nothing else— I think it will do more—it will bring recognition that such insurance has to do with the health of the country, and should not be merely a matter of payment of cash benefit, and provision for benefit which have only an indirect relation to health. Any scheme of National Health Insurance, if it is to be as effective as it could be, and as we would like to see it, should not merely make some cash provision for the period of ill-health, but should do something to insure against the occurrence of ill-health by improving the health of the members. When members are ill it should do something more than supplying them with the bare necessities of life by way of cash benefits, by making some provision for restoring health as soon as possible. Our system, as we have it in this country, is unique in that it takes no regard for the preservation of health, and makes no provision for care of the sick. It only provides cash benefits there. That was not the original intention of the National Health Insurance scheme as applied to this country. I never thought the original scheme was one very suitable to the needs of this country but, at any rate, it included certain provisions which were speedily dropped and have sunk more and more out of sight as the years passed. It proposed to provide a system of treatment, but a rather discreditable public opinion defeated that. It also proposed a certain amount of work in preventive medicine. That has naturally, and I think properly, passed over to the public authorities. The result has been that there has been no regard for treatment or preventive medicine in the administration of National Health Insurance. Neither in a central authority nor in the societies was there regard for the preservation of health and the restoration of health. I think that by bringing into the governing authority of the Unified Society someone whose main concern is with matters of health a somewhat different outlook will be given the Unified Society than was possible in the past or from what the old societies had. Such a point of view present always in the counsels of the Society must make itself felt on the colleagues of the medical man selected to occupy a position on this body. The information he could give and the influence he would bear would eventually have a considerable effect on the work of the Society. It seems almost absurd, looking at it without considering the history of National Health Insurance in this country in the past, that any system of National Health Insurance should be without the guidance of medical opinion. As the system was originally framed here there was provision for medical opinion in the control of the system. The House will remember that in the central authority, until a few years ago, control lay in a Commission, in which it was provided by statute that one of the members should be a medical practitioner. The original staff of the Commission had two medical inspectors, whose duty it was to keep the Commission advised as to the working of the system throughout the country, and who could relieve the Medical Commissioner of some of his duties. Some ten or 11 years ago a number of medical referees were appointed. The medical referees had one function only—to safeguard the funds of the societies in respect of entitlement to sickness and disablement benefit. They had nothing to do with the administration of the system otherwise. They are the only remnants left of the whole medical staff of the old Commission. The Medical Commissioner was abolished. The medical inspectors disappeared and their places have not been taken. I understand that, at present, the controller, who has replaced the Commission, has at his services, when desired, the advice of certain medical officers of the Department of Local Government and Public Health. However competent they are—and I do not question their competence in their own spheres—these gentlemen have no special experience of National Health Insurance and the bulk of the work likely to be given to them can hardly be more than consultative. They can exercise no influence on the control of National Health Insurance. I know of no excuse for the changes which have taken place in recent years which resulted in the abolition not only of the office of Medical Commissioner but in the failure to fill up the vacancies left by the transfer of one of the medical inspectors and the resignation of the other.
I pass on to the work of the Society. It will be within the memory of those who were acquainted with the work of the approved societies, which formerly existed, that most of these societies had in their employment a medical adviser who, when occasion allowed, exercised a very important influence on the policy of the societies. I understand that the present Unified Society has not the services of any medical man for administrative work, and that the only medical man in the employment of the Society is there for the very proper and very necessary purpose of giving medical attention to the staff of the Society itself. There is no medical influence whatever on the administrative authority of the Unified Society, and there is no medical influence whatever on the central authority at the Custom House. That is an anomaly which should, surely, be corrected. All that is asked in this amendment by Deputy Morrissey is that there should be some opportunity —a very slight one—of making medical opinion, knowledge, and influence felt in the counsel of the Unified Society. I hope that the Minister and the House will receive that amendment without hesitation. The need for it is, I think, obvious. I have endeavoured to draw the attention of the House to a few disconcerting points in the history of National Health Insurance in this country, and to point out that the tendency has been to get further and further away from health and to regard national health insurance work as really a business matter—a matter of pounds, shillings, and pence.
I am convinced that a very good case has been made for the acceptance of this amendment. I hope the Minister will arrange the new constitution of the committee of management so as to ensure the selection, election or nomination of a medical representative, as proposed in this amendment. I dare say the Minister is not likely to consider the advisability of making a medical man chairman or altering the constitution of the committee of management so far as the trustees of the Unified Society are concerned. I think that there is no ground for giving the same representation upon this committee of management to the employers as is proposed for the trade unions. I am sure the employers would not be jealous, or strongly object, if their proposed representation on the committee of management were reduced from three to two, and thereby ensure the nomination or selection of a medical representative, as proposed in this amendment. It is generally understood that the employers' contribution to national health insurance or to any other form of statutory insurance or pensions fund is deducted from the wages of the workers. Regard is had to these contributions when the wages of the workers in the various industries are being fixed. On the committees of management of the old societies, which are now absorbed, there was no representation of the employers. I trust the Minister will be able to meet the amendment in the manner I suggest— to reduce the employers' representation from three to two, and make room for the nomination of a medical member. If consulted upon this matter, I am sure the Minister would not object to this proposal. The employers' representatives might welcome the adoption of this amendment in their own interests—if they are going to have any real interest in the future administration of this society. Deputy Rowlette has made a very convincing case for acceptance of the amendment, and I hope the Minister will meet his point of view.
I wonder if Deputy Davin would see the matter in an equally reasonable light if I were to propose to amend the Bill by asking the Trades Congress to drop one of their representatives and allow me to appoint a medical man in his stead, or if I were to propose that one out of the five to be elected through the machinery laid down in the Act should drop out and make room for a medical representative.
It is as possible as the proposal made by Deputy Morrissey and Deputy Rowlette. Deputy Davin is reasonable enough so long as his own interests are protected. He does not object to taking something off the employers or off the Minister. I agree with a great many things that Deputy Rowlette said about national health insurance. As to the type of national health insurance we should have, I have not changed my mind from the days when I was on the other side of the House, criticising Bills then put forward for consideration. But I do not see that that has anything to do with the question of putting in a medical man to administer the national health insurance organisation. The duty of every member of the committee of management will be to administer the affairs of the organisation within the terms of the Act. I do not see any more reason for selecting a doctor as a member of the committee of management than for selecting a lawyer or some other professional man. There does not appear to me to be any special merit in the selection of a doctor. I am entirely with Deputy Rowlette as to the unsatisfactory condition of opinion generally, inside and outside the national health insurance organisation, with regard to what national health insurance ought really to mean and what it is in practice. I should like to see the thing radically altered and arrangements made to have an organisation which would prevent, as far as possible, people getting ill. There is nothing of the kind at present. Deputy Rowlette said this was largely a matter of pounds, shillings and pence, and of giving people small sums to help them over illness. That is not, to my mind, what a national health insurance scheme should be, but that is the scheme as we have it. I am hoping when the new committee gets together, they will, as a result of their management and their experience of the organisation, in connection with, and in close association with the officials of national health insurance organisation, and the officials of the national health insurance section of the Department of Public Health, be able to help us to put up a scheme, at some future date, that will approach, at any rate, to what the majority of the people interested in the matter would like to see as a real scheme based upon the preservation of the health of the people, and not merely an organisation for providing people with small sums of money to help them over periods of unemployment due to illness. I do not know whether employers would be prepared to adopt it. There is no reason in the world why, in order to have good administration, a medical man should be chairman, or why one of the trustees, suggested in the Bill, should be a medical man. I see no objection, but I cannot see that the appointment of a medical man is necessary on a board merely to control an organisation or to administer an organisation within the terms of the Act, or how that would achieve the things Deputy Rowlette wishes to achieve, or which national health insurance is intended to achieve.
I should like to put in a further appeal for this particular amendment. In the latter part of the Minister's speech he rather advocated the inclusion of a medical practitioner himself when he said he hoped that this committee would eventually help him to put up a scheme on the lines that Deputy Rowlette so ably advocated. The Minister said the inclusion of a medical practitioner was not really necessary, any more than the inclusion of a member of the legal profession or any other profession where it was merely a question of administration. I suggest that the inclusion of a medical practitioner, outside the reasons given by Deputy Rowlette, is eminently desirable. The medical profession takes more interest in insurance than any other body of people in this country. Without being personal to Deputy Rowlette because of the great grasp of national health insurance he has shown, I cannot help saying how desirable it would be that some member of the medical profession possessing similar grasp all round should be a member of the committee. I would appeal to the Minister not to ask us to decide this matter just now, any more than the trustee proposal, and to carefully consider the question between this and Report Stage. I am convinced the Minister should consider well the advisability of having a medical practitioner on this committee, not merely because of the wishes of employers or any other particular section. I think we should ask the Minister to set it down in black and white that there should be on this committee a member of the medical profession.
I would ask the Minister to give us some further information upon a particular point. He seemed to anticipate that the functions of the committee would be exclusively and necessarily administrative. Would I be wrong in suggesting that in practice what does happen is that various suggestions for the improvement and development of national health insurance will in all probability come to him from the committee of management? If they find inadequacy manifest itself at any time, they will draw his attention to that matter. I have often emphasised to the Minister that I think the growth and tendency of national health insurance should be prophylactic rather than curative; and that we ought to anticipate the probabilities of disease in later life particularly that class of disease which is calculated to give rise to permanent disability, and calculated to leave people a charge upon others. While we may expect to have able persons drawn from trade unions, and other sections of the community, I do not see how any of these people could hope to give the same valuable information upon that aspect of the case as persons drawn from the medical profession. I think it would be very valuable that any suggestions for improvement of the service should come from a board that had the advantage of the advice of medical practitioners before making such suggestions. I do not see how the board could make intelligible suggestions without that particular advice. There does not seem to me to be any inherent objection to having one member of that board with medical qualifications. If there is one person with these qualifications, on the board, without taking from the legitimate rights of any other person interested in national health insurance, surely the Minister ought to try and meet the suggestion put up by Deputy Rowlette.
I suppose the Minister before appointing the three representatives of the employers would be obliged to consult, and will consult, the various organisations of employers throughout the country? You have three, four, or half a dozen bodies such as the Chambers of Commerce, and you have the Federation of Industries, which represents a very important branch of industrialists in this country. I suggest, if the Minister is prepared to look at this proposal in a favourable light, he might have consultations with these bodies of employers—and they are more numerous than those who claim to be represented through the Trades Union Congress—and make up his mind to select the third member of the employers' representative from the medical profession. The members of the medical profession are themselves employers.
There are some labour people who are employers also.
On the spur of the moment I cannot recollect any.
Does the Deputy not? I think I could assist him.
I feel that from what the Minister said in his concluding remarks he is sympathetic towards the proposal moved in this case and that he might, after consultation with these various bodies and employers' organisations, look into the matter. I am sure Dr. Ward, his Parliamentary Secretary, will help him to come to a conclusion and that he will use his influence—I hope I am not putting it too strongly—with the Minister to persuade him to look at the proposal in a sympathetic way.
I do not know whether I understand Deputy Davin aright in understanding him to suggest that the Employers' Federation should nominate the medical member?
I suggested that the Minister before making the three nominations, would probably consult various employers' organisations.
God forbid. In supporting the amendment, I did not suggest that the medical member of the committee should be appointed by some organisation with which the medical profession has no concern whatever. The amendment is designed to leave it in the hands of the Minister to select a suitable member of the committee, and I am quite content that the Minister would use discretion in such a matter. I am not content, however, that any outside organisation should give the Minister advice on such matters as these. What possible knowledge could an employers' organisation or a trade union have to enable them to advise the Minister as to a suitable member of the profession to appoint on the committee? I am afraid Deputy Davin is running away from his good beginning in this matter.
No, I am not. I want to make room for the representatives.
There is room enough. The Minister in his remarks pointed out, perfectly truly, that acceptance of this amendment would not bring about the revolution in National Health Insurance which he, I, and most of the House desire. I agree it would not, but it would, at any rate, leave some trace in the administration of National Health Insurance of its connection with health. There is none at present.
Is the Minister going to look into the matter?
I would ask the Minister to consider it. Personally I am very much disappointed with the Minister's attitude in relation to this amendment. Surely he will agree that in a committee of this character questions will frequently arise in which the advice of a medical man will be very useful—such questions as are appropriate and proper to his functions as a medical man? I should be rather surprised if the Minister does not accept the amendment. It does not seek to increase the number on the committee by even one, but a previous amendment does suggest that one of the three trustees shall be a medical practitioner. We do not want any divisions in these matters if we can possibly avoid them, and I would ask the Minister seriously to consider this aspect. Deputy Rowlette has made an unanswerable case, in my view, and the Minister is usually open to reason on matters of this character. Where social legislation is concerned I have found the Minister one of the most reasonable and logical men in the House, and I am quite sure he will give a little more consideration to the very good case, the unanswerable case, in my view, made for the amendment to include a medical practitioner on this committee.
I think it is so that the Minister has undertaken to consider a proposal which would, in fact, reduce the proposed membership of the board of management by one, or at least create a vacancy. The original form of this amendment would have operated to increase the membership by one. If the Minister were to meet the earlier amendment in connection with the trustees this addition could be made without increasing the total membership at all. I understand that the Minister has said that he will consider the earlier amendment between now and Report Stage. Might I suggest that he would join, for the purpose of consideration, this amendment to it, and if he determined to create the vacancy in the board to which the first amendment would give rise, he might then find himself able to give more favourable consideration to the proposal contained in amendment No. 4.
It does not necessarily follow that, even if I did agree to make the chairman a trustee, there would be a vacancy. There would be four trustees.
If you reverse the process and made a trustee the chairman? At present, the proposal is that there should be a chairman and three trustees——
Would it meet the wishes of the House if I made the number of the committee of management 16 in order to get in a medical practitioner?
That would be quite fair. One sees the inconvenience of the even number, but it is very slight. It is a fair offer.
So far as we are concerned, that would certainly meet our view. Our principal concern is to have a medical person there who would make the suggestions of the board of management more valuable to the Minister than they otherwise would be.
The Minister this morning, and on Second Reading, pleaded that, under the scheme of election envisaged in this amending Bill, there is control by the insured persons. Now there is a proposal to extend the committee of management from 15 to 16 which is going to deny the insured persons control of the society, and not merely is it going to do that, but it is going to put them in a very definite minority. The Minister is going to appoint the chairman and the chairman is going to have a casting vote which he must exercise in every circumstance when the committee of management numbers 16, and when they are all present. That casting vote is going to be a non-insured person's casting vote. There will be eight representatives of the insured persons and eight representatives of non-insured persons. One of the eight will have a casting vote, so that the insured person's representatives are going to be in a minority on every occasion on which there is a full representation. That may suit Deputy Dillon, but it is obviously unfair to the workers who formerly had absolute control in the matter of the administration of national health insurance societies.
Deputy Davin was very keen on getting a doctor in.
Deputy Davin suggested that the employers' representatives——
Naturally, of course. Take it off the employers.
There is a good case for doing it.
From the Deputy's point of view.
Not merely from our point of view, but from the point of view of the whole tradition of national health insurance in this country.
One would not think there was any great relationship between Mr. Lloyd George and Mr. Seán T. O Ceallaigh, but, in relation to national health insurance legislation, there is an extraordinary connection. Mr. Lloyd George gave the workers control of national health insurance, but Mr. Seán T. O Ceallaigh proposes to take that control away.
Not at all. That is not true.
There are eight, a majority, to be appointed by the insured persons.
In regard to national health insurance legislation in this country, up to 1933 there was absolute control of the societies by the insured persons.
Of the individual societies.
And, therefore, collectively of all the societies. The insured persons had absolute control from 1911 to 1933. In 1933, a Bill providing for unification was passed, and, even in that Bill, the insured persons were given nine representatives as against six non-insured persons' representatives.
They had a majority and they still have a majority here.
The Deputy does not deny that there is a majority.
What I do contend is that you have taken away from the workers the exclusive right to control national health insurance.
That was taken away by the 1933 Bill, for which the Deputy voted.
Quite. I voted for it because I held the view that the unification of national health insurance was very much better than the existence of 65 separate societies.
Therefore there is no difference in principle between what this Bill proposes to do and what was done in the 1933 Act.
It is a question of nine persons representing the insured persons in the 1933 Act and eight in this.
It is not as simple as that by any means. In the Act of 1933 the insured persons had nine representatives as against six non-insured representatives.
They had, therefore, a majority of three insured persons' representatives over the other elements which constituted the committee. The Minister now proposes that they should have a majority of only one instead of a majority of three and the Minister pretends to believe that he does not see any difference in that.
If a majority of three whittled down to a majority of one is not a substantial alteration as against the insured persons I do not know what is.
A modification which reduces a majority of three to a majority of one and in certain circumstances reduces it to a minority.
And in other circumstances increases the majority.
The proposal which we are discussing is whether there should be a medical practitioner or not on the committee.
My intervention in the matter is due entirely to an offer made by the Minister to include a medical practitioner if this House increases the membership of the committee from 15 to 16.
That is merely a suggestion which has not really come before us yet for discussion.
Am I not entitled to point out the grave dangers to insured persons of making such an offer or of the Minister's allowing any such thought into his head? Am I not entitled to say that this amending Bill is bad enough from the point of view of insured persons without making it any worse? I think if the Minister were to put a proposal of that kind into operation it would definitely worsen the Bill against insured persons.
The Deputy will be fully entitled to make these remarks when the Bill is before the House.
Am I to take it from Deputy Norton that it is his view that it would be a grave danger to include a medical man in this committee?
I am willing to include him, but make him one of the six.
This exaggerated language does not get us anywhere. I feel that the majority of insured members would welcome the addition of a medical practitioner. One would think from what Deputy Norton has said that the medical practitioner is always going to take the side of the employer. He might just as easily take the side of the insured member. The medical practitioner will be frequently found on the side of the worker. That has been my experience of the medical profession as a rule and I have had a considerable experience of the medical profession in this matter. Again Deputy Norton pre-supposes a division of 50-50 on the committee in certain circumstances. That is quite likely to happen but the opposite, as pointed out by the Minister, is just as likely to happen—that you may have a majority of the workers' representatives present. That is one of the things that no Act of Parliament can ever control—the attendance of individual groups of members at any committee. Deputy Davin made a contribution to the debate with which I entirely agree. He stated that if a board or a committee of management were set up, to deal with questions of transport, he for one would register his objection to any committee which did not include persons who had an intimate knowledge of transport conditions in the country. I agree with Deputy Davin on that but who is in a better position to judge of the operations of the national health system of this country than a medical practitioner? Isuggest that Deputy Norton need not work himself into a frenzy over the addition of this medical practitioner to the committee of management. It is an addition that will be welcomed by the insured workers all over the country.
I do not want to rush the Minister into making a firm offer or into saying "I am prepared to meet you on these lines". The matter is one, I suggest, that the Minister should take time to reflect upon at his leisure and it will quite meet me, certainly, if the Minister says after having heard representations made to him that he sees there is a case to be considered and that he will examine it at his leisure after he has had an opportunity of consulting the various interests concerned. There is no Party in the House which wishes to jump on the Minister's back now and compel him to come to a decision immediately he throws out this suggestion. I take it the Minister has not yet made up his mind and that, with a view to deciding the matter on a strictly non-Party basis, he has got to ascertain the general feeling of persons interested in the matter. My suggestion is that he should be given time to consider the matter at his leisure after sending for those persons whose opinions he desires to ascertain.
I put it to the Minister that a medical practitioner would be as good an administrator of national health insurance as the manager of any industrial concern or the nominee of the manager.
Is the Minister to consider the matter further?
Amendment No. 4 by leave withdrawn.
The next amendment to be dealt with is amendment No. 2 in the name of Deputy Norton.
Deputy Keyes has an amendment down the purpose of which is to eliminate entirely the employers' representation on the committee. Will that amendment be dealt with before amendment No. 2?
It is portion of the first amendment—No. 1 (b). That issue was not dealt with when amendment No. 1 was being discussed.
I understood that amendment was withdrawn.
The discussion was limited to the question whether the chairman was to be a member of the committee.
Might I suggest, Sir, that you will inform the House what amendments have been disposed of now?
Portion of No. 1, No.3 and No. 4. No.3 has not been moved on a promise of consideration by the Minister. No. 4 has been withdrawn on a similar promise of consideration by the Minister. Paragraph (b) of No. 1 and amendment No. 2 can be considered together.
Are we to take it that amendment No. 1 with the exception of paragraph (b) has been disposed of?
I move amendment No. 2:—
In sub-section (1) to delete paragraphs (a), (d) and (e) and insert after paragraph (c) a new paragraph as follows:—
nine members (in this Act referred to as insured persons' representatives) nominated, in the manner provided by this Act by the national executive of the Irish Trades Union Congress.
Paragraph (b) of No. 1 is much wider in scope than No. 2. Paragraph (b) of amendment No. 1 provides that 12 persons should be elected to the committee to represent insured persons, whereas the purpose of amendment No. 2 is to ensure that the nine persons provided for in the Act of 1933, as representatives of the insured persons, should be nominated in the manner provided by this Bill by the national executive of the Trades Union Congress.
On a point of order. You have directed that the second part of amendment No. 1 should now be disposed of. Is it Deputy Keyes' intention to move the amendment standing in his name?
I think that was moved, but the decision on it was deferred.
Will we not have to dispose of the point whether the committee is to consist of 12 persons nominated by the Trades Union Congress before we can discuss the question whether nine should be nominated?
My reason for this, as I said on my first amendment, is to try to retain for the insured persons, as far as possible, control of the society. I do not see that there is any necessity for making provision for employers' representatives, as they have not hitherto been provided for. The Minister has advanced the reason that as employers are contributing to an extent they are entitled to some representation. That seems to be a fairly reasonable argument on the part of the Minister, but if the employers have any interest in the administration of national health insurance, why do they not appoint their own representatives? I object to the employers' representatives, because they will be merely the Minister's nominees. No doubt the Minister is very amiable, but I flatly object to him taking on himself the task of appointing these nominees, seven as against eight. If this proposal goes through, I suggest the principle of control by the insured persons will mean control of a purely theoretical kind. If the employers throughout the country consider that their interests are not being properly protected, it is up to them to make their own nominations. Why should they leave the selection to the Minister?
The Minister was pressed by all sides to accept a medical man. Deputy Davin said that nobody would have objection to a medical man. At least the Minister could have included a medical man amongst the employers' representatives, but he still persists in nominating his number of employers' representatives. Apparently he could only include a medical man as an additional member, thereby, as Deputy Norton has said, creeping further onwards towards nominal authority, although the control is supposed to be vested in the insured persons. I still insist that the control of the society should be vested in the insured members. To my mind the Minister has departed from the principle governing national health insurance in this country. Leaving us eight as against seven is merely a distinction with a difference. The Minister has retained the right of appointment of employers' representatives. I am against the appointment of such representatives, because in the first place it is an innovation, and in the second place the employers have not sought representation, and these will be the Minister's nominees, with his chairman and his trustees on the committee.
I would like to know from the Minister what body of employers has asked for the inclusion of their representatives on this committee of management. I could understand a good case being made for representatives of employers' organisations on the committee if the employers were in the same position as the insured members, if the employers had any interest either from a benefit point of view or in the administration of the funds of the society. Industrial and other employers are compelled by legislation to pay contributions to national health insurance, unemployment insurance, and other things of that kind. The employers, in turn, make jolly sure that they take these contributions into consideration when they are fixing the remuneration of their workers. That has been admitted by some of the biggest employers in the State.
The insured members naturally have a very personal interest in the administration and the solvency of the society. If the society is not established on a solvent basis, they cannot hope to get the benefits provided under the National Health Insurance Act and other Acts governing the distribution of benefits. I can see no case for equal representation on the part of employers to that of insured members. It was pointed out rightly by Deputy Norton that when Mr. Lloyd George established the national health insurance societies in England in 1911 he handed over complete control of the societies to the insured members. Here in this democratic country, in what is supposed to be a democratic age, we have a republican Minister depriving the workers of some of the rights given to them by Mr. Lloyd George in 1911.
If the Minister has received representations from employers' organisations, he should let us have the names of the organisations. Was it the Irish Cattle Dealers' Association, the Cattle Exporters' Association, the Irish Live-stock Exporters' Association, the two chambers of commerce in Cork, the three or four chambers of commerce in Dublin, the chamber of commerce in Waterford, the Saorstát Federation of Industries—any of these mutual admiration societies, which claim to represent the industrial interests in this State? How is the Minister going to satisfy the wishes of these bodies in regard to reasonable representation on the committee of management, if the number of employers' representatives is going to be confined to three? I know the Minister treats any reasonable suggestion in a sympathetic way, but I think he will create trouble for himself if he is trying to please the employers' organisations by selecting three representatives. I do not know if they have even looked for this representation.
I feel certain the majority of Deputies will agree that the employers are not entitled to the same representation as the insured members. They have no interests in the funds of the society, beyond being compelled by law to make contributions which, in turn, they deduct from the wages of the workers. I hope the Minister will give definite reasons for seeking authority to nominate three employers' representatives on this committee of management. Perhaps he may see his way, as a result of the reasons given in support of this amendment, to provide greater representation for the insured members, who are the only people who have a real interest in the solvency of the National Health Insurance Society.
I am surprised at Deputy Davin's statement that the insured persons are the only people having any interest in the solvency of the society.
Have not the employers just as much an interest as any insured person?
But the employers have to pay, and if the societies are insolvent—suppose the national health insurance organisations became insolvent—would not everybody in the State have to be taxed, including the employers, to meet any deficiency?
Then they would deduct it from the wages of the workers.
Has Deputy Davin forgotten the 1933 Act? In Section 4 of the 1933 Act, it is laid down:—
(a) the said committee shall consist of 15 members, namely:—
(i) the three trustees for the time being of the United Society,
(ii) nine persons (in this section referred to as members' representatives) representative of members of the United Society, and
(iii) three persons (in this section referred to as employers' representatives) representative of employers of insured persons.
That was passed by this House, and I am implementing the law that was passed here in nominating three employers' representatives. There is no change in principle between the terms of that section of the 1933 Act and the section that we are dealing with now with regard to the committee of management. It is a question of degree. There is no question of principle in dispute.
If the Minister changes his mind am I not entitled to do the same?
I am glad the Deputy admits that he can change his mind and does change his mind.
That is one for the Minister.
The Deputy then runs away from the Bill of 1933.
He is chasing the Minister.
Is he coming in the same direction?
He is finding it hard to catch up on him.
He is not the first Deputy who chased the Minister, but they have not caught up on him yet. In any case, we are implementing the 1933 Act in appointing three employers' representatives as also representatives of the insured persons. There is as much interest, or should be, in the employers' organisation and amongst employers generally around the country in the solvency of national health insurance, and in the good management of national health insurance, from the point of view of the health of their own employees as there is amongst any other section of the community. The Deputy agreed in 1933 that the employers are entitled to be represented on the committee of management. We are adhering to that principle and proposing that three members, as provided for in the 1933 Act, should be put on the committee of management to represent the employers. We are not changing so far as that is concerned. Whatever change there is in the construction of the committee of management is not a change in principle; it is a question of a change in degree.
I do not think the Minister need be unduly alarmed by the indignation which Deputy Davin displayed this morning. It is really quite simple. He is giving the workers' republic a trot out. A paragraph appeared in the Irish People——
Did not the Deputy get a good opportunity of dealing with this yesterday? I take it, Sir, that if you allow this to be discussed you will also allow a reply to be made?
There was a paragraph in the Irish People——
On a point of order, may I have a ruling? If the Deputy is allowed to get this out, someone should have a chance of replying to it.
That is purely hypothetical.
Can I make a reply then? Do you rule as to whether a reply will be in order?
Would the Deputy say it was not in the Irish People?
He did not get enough play in the Gate yesterday.
He should have remained on the stage there. There is histrionic talent lost when he is absent.
There was a paragraph in the Irish People last week in which it was set out that Deputy Norton, Deputy Everett and another Deputy of the Labour Party had succeeded in influencing that Party to move to the left, and to promote class war in the workers' republic. Deputy Davin is left out of that flattering reference, and he has to bring out the workers' republic this morning and trot it up and down to show that he is not falling into the rear. Deputy Davin has moved to the left since the 1933 Bill became an Act, and he wants the Minister to know that. He now advocates the workers' republic and the class war, and he wants the Minister to know that in this measure and in every other piece of legislation he proposes to advocate not only the workers' republic but the class war. Down with the employer, and up the red flag!
Of course the Deputy would sooner be holding up the Union Jack.
Or establishing a laundry to wash all the dirty blue shirts.
Amendment, by leave, withdrawn.
I move amendment No. 2:—
In sub-section (1) to delete paragraphs (a) (d) and (e) and insert after paragraph (c) a new paragraph as follows:—
nine members (in this Act referred to as insured persons' representatives) nominated, in the manner provided by this Act by the National Executive of the Irish Trades Union Congress.
It is provided in the 1933 Act that the insured persons would be entitled to nominate nine persons to represent them on the committee of management of the society, but, in the amending Bill which the Minister has before the House, he has reduced the representation of the insured workers from nine to eight. The Minister says of course that that is only a matter of degree; as if the element of degree did not determine the whole thing; as if it were just the same to strike a man and merely injure him, or to strike a man and kill him. It is only a matter of degree according to the Minister, and one offence is not more serious than the other. In order to try to get the insured persons represented to the lesser extent provided for in the amending Bill, the Minister has gone to great pains to create an enormous superstructure. It seems to me to be calculated to beget considerable difficulty for those charged with the administration of the Act on the one hand, and to go to needless trouble from everybody's point of view on the other hand. It is provided in the amending Bill now before us that local authorities may make nominations for the creation of a kind of electoral college. That electoral college will consist of about 120 people, the expense of which will have to be paid by somebody. That electoral college of 120 persons—some of whom do not know the others, drawn from all over the entire country—will meet to elect five persons to be the local authorities' nominees on the committee of management of the society. I suggest to the Minister that that superstructure which he is creating in that way is a needless importation into this Bill and that it would be quite a simple matter to devise a scheme by which he could secure that the insured persons were elected in a much simpler way than that provided for in the Bill.
Quite apart, however, from the enormous amount of machinery created by the Minister in that regard, one has got to consider the method of election proposed by the Minister. He proposes that county councils shall have power to create this electoral college, so that we have got the rather unique spectacle of the employers, by their votes on the county councils, creating an electoral college which in many instances will be the body to elect the representatives of the insured persons. I think in principle that procedure is altogether objectionable, and I think as a matter of administration that the machinery contemplated by the Bill is needlessly heavyweight. Instead of that objectionable procedure and that expensive and inefficient kind of machinery contemplated by the Minister in the amending Bill, the Trades Union Congress, which is obviously an organisation representative of workers of which the Executive is democratically elected annually by the voices and votes of organised trade unionists in the country, should be allowed to nominate the workers' representatives. In that way at all events we could insure that the unorganised workers would be represented by genuine workers' representatives and we can be assured too that those who were charged with the custody of the interests of the organised workers will exercise their standard of judgment in the interests of the unorganised workers.
The Minister is proposing in this Bill to allow all kinds of people, employers themselves, to create an instrument that will be representative of the workers. That is an objectionable procedure. The Minister stated that there were 91,000 organised trade unionists in the Free State. I suggest that these figures are very incomplete They probably represent a membership of the unions which are registered, but quite a number of unions are not registered and consequently make no return to the registrar of the friendly societies, the return from whom the Minister consulted.
At all events, it is nothing new for a Government Department to recognise the Trades Union Congress as a body fitted to represent the interests of the unorganised workers. The Minister may not be aware of that. It is therefore desirable to bring to his attention that the Minister for Industry and Commerce who is responsible for the administration of the trade boards, has found it necessary and has found it desirable to recognise the Trades Union Congress as representing and capable of representing the interests of unorganised workers. The trade boards are constituted of representatives of the employers and organised and unorganised workers. The Minister for Industry and Commerce has recently decided that the Trades Union Congress is to be recognised as the body to represent the unorganised workers. That was because apparently the Minister for Industry and Commerce felt that you could get a better class of representative of the unorganised workers through the medium of the nominees or the nomination of the Trades Union Congress than you could by merely trying to take a representative of the unorganised workers out of a factory or place of business. The Minister thought that some representative of the Trades Union Congress was the person best fitted to represent them. We have here an admission by the Minister for Industry and Commerce that the Trades Union Congress is definitely the organisation to represent the unorganised workers. I suggest to the Minister for Local Government and Public Health that he ought to extend this principle to this Bill so that he would provide that the Trades Union Congress should be allowed to nominate the unorganised workers' representatives on this assembly. By doing that he will find it unnecessary to set up this superstructure and providing it in the form of an electoral college. In that way he would be able to ensure that these representatives will be representative of the insured persons. The principle that should operate in the matter of these insured persons from beginning to end should be that they would control the society and the Minister would thus avoid the inconvenience of an administration which would follow from the electoral college scheme through the medium of the county councils as provided in the Bill.
At all events, we have a definite admission from the Minister for Industry and Commerce that the Trades Union Congress is capable of representing the unorganised workers on the trade boards. There is no difference between one insured person and another insured person in this respect. Their rates of benefit are standardised in their application to one member as to another, except that in the case of persons who were members of a society which provided additional benefits their rates of benefit will be different from those of a society which did not provide additional benefits for its members. But in these other matters there is no essential difference in the benefits provided or in their outlook. I hope the Minister will see his way to meet this demand.
Of course we cannot accept the amendment proposed by Deputy Norton. I think the scheme for retaining members on the committee of management, representative of the insured persons, that I have set out in the Bill, is adequate in every way to get representation for the organised and unorganised employees. I quoted already and I will quote again the figures, to which Deputy Norton has referred, of the members of organised trade unions in the country. According to the statistics that we have published, there are over 91,000 registered organised trade unionists. There may be, as Deputy Norton suggests, some trade organisations that are not registered. If there are, they must be very small and insignificant.
Some very important trade unions are not registered.
But they would be taken into the statistics.
The returns are not published.
I am not aware that some of the most important are not registered. I have to take the figures published, and I have got a return that there are 91,890 persons in organised trade unions affiliated to the Trade Union Congress. There are, I think, 530,000 people insured so that the difference is very marked. I think if we want to get representation for the insured persons who are not affiliated with any organised workers' union that the scheme I have set out in the Bill is as good a one as could be got to get the representation required for those people. It has been suggested to me, in criticism of the suggested arrangement, that in fact by that arrangement we are giving dual representation to the members of trade organisations. They are already getting the special representation of three persons nominated by the national executive of the Irish Trades Union Congress. Those who are in the trade unions can themselves again vote through their representatives on the county council for the nomination of the other five so that they are being represented twice over. That is an argument that can be properly put forward.
I hope the Minister told his critics that he is reducing the representation of the insured persons from nine to eight.
I published the full facts as to their representation being reduced. This scheme does not affect the organised trade unions any more than any others. The Trade Union Congress does not represent them only in the proportion of one to five, because there are over 500,000 insured persons and the Trade Union Congress represents less than 100,000.
What about taking one member off the employers' representation?
I kept to the principle of majority control by the insured persons. I cannot see that anything Deputy Norton has said shows that this is an entirely objectionable procedure. On the contrary, I think it is an entirely democratic procedure, and it is one of the most likely to get thoroughly democratically selected representatives of the insured persons with the least trouble and the best and most democratic machinery we have available for such a matter.
Question put: "That the paragraphs proposed to be deleted stand part of the Bill."
The Committee divided:—Tá, 62; Níl, 4.
Tá
- Aiken, Frank.
- Anthony, Richard.
- Bartley, Gerald.
- Beckett, James Walter.
- Blaney, Neal.
- Boland, Gerald.
- Boland, Patrick.
- Bourke, Daniel.
- Brady, Brian.
- Brady, Seán.
- Brennan, Michael.
- Briscoe, Robert.
- Browne, William Frazer.
- Burke, James Michael.
- Concannon, Helena.
- Cosgrave, William T.
- Crowley, Fred. Hugh.
- Crowley, Timothy.
- Daly, Denis.
- Derrig, Thomas.
- Dillon, James M.
- Doherty, Hugh.
- Dolan, James Nicholas.
- Donnelly, Eamon.
- Doyle, Peadar S.
- Flynn, Stephen.
- Fogarty, Andrew.
- Gibbons, Seán.
- Goulding, John.
- Harris, Thomas.
- Hayes, Seán.
- Keating, John.
- Keely, Séamus P.
- Kehoe, Patrick.
- Kelly, James Patrick.
- Kelly, Thomas.
- Kennedy, Michael Joseph.
- Lemass, Seán F.
- Little. Patrick John.
- McEllistrim, Thomas.
- MacEntee, Seán.
- McMenamin, Daniel.
- Maguire, Ben.
- Maguire, Conor Alexander.
- Moane, Edward.
- Moore, Séamus.
- Morrisroe, James.
- Nally, Martin.
- O Ceallaigh, Seán T.
- O'Leary, Daniel.
- O'Neill, Eamonn.
- O'Reilly, Matthew.
- Pearse, Margaret Mary.
- Redmond, Bridget Mary.
- Rice, Edward.
- Rowlette, Robert James.
- Ryan, James.
- Ryan, Martin.
- Sheridan, Michael.
- Smith, Patrick.
- Victory, James.
- Ward, Francis C.
Níl
- Níl.
- Davin, William.
- Keyes, Michael.
- Norton, William.
- Pattison, James P.
Tellers:—Tá: Deputies Little and Smith; Níl: Deputies Davin and Keyes.
Amendment not moved.
Question declared carried, and paragraphs, proposed to be deleted, ordered to stand part of the Bill.
I ask leave of the House to withdraw the following amendment, No. 5, standing in the name of Deputy Morrissey:—
In sub-section (1) to delete paragraph (e), pages 3 and 4, and substitute two new paragraphs as follows:—
(e) three members (in this Act referred to as insured persons' members) appointed by the Minister from a panel of ten persons to be submitted to him by the General Council of County Councils of whom one shall be from Minister, one from Leinster and one from Connacht or the Ulster counties of the Saorstát, and
(f) two members (in this Act referred to as insured persons' members) appointed by the Minister from a panel of ten persons to be submitted to him by the Council of Municipal Councils.
I should like, with the permission of the House to withdraw this amendment on behalf of Deputy Morrissey, who is ill. I would prefer to withdraw it and have it brought up again on the Report Stage when Deputy Morrissey can introduce it himself.
In the meantime, Sir, perhaps the Minister will consider the proposal contained in the amendment. The idea of it is to give provincial representation on the committee. For instance, three or five persons might come from one of the provinces— quite possibly Leinster—and I expect that the desire would be to associate, in so far as it would be possible, geographical representation with the scheme. Similarly with regard to towns, the proposal in the amendment was that the municipal authorities would be available for getting representation, and I think that between now and the Report Stage the Minister might consider whether, if this were not suitable, it might be possible to have some system which would give that geographical representation which is desirable.
I shall consider the matter.
Are we discussing this amendment, Sir?
No. The amendment is not moved.
Well, Sir, with your permission, I want to put forward certain considerations in connection with it.
The amendment is not moved.
Well, I formally move the amendment, if Deputy Norton wishes to answer anything Deputy Cosgrave said.
I do not ask the Deputy to move the amendment. I only want to get some information as to what is intended by this amendment.
The only answer to that is that I am not in a position to give any information about it. I have explained that Deputy Morrissey is ill. He is confined to his bed. I have not undertaken to explain another Deputy's amendment, because I could not give to the House the information that it is entitled to seek; and therefore I ask leave to take the usual procedure in such cases of postponing the consideration of the amendment until the next Stage, when Deputy Morrissey, we hope, will be in the House to introduce it himself. Now, Deputy Norton wants to raise a discussion and then say that he has not got the information that he seeks. He cannot get the information because, as I have already explained, Deputy Morrissey is ill, and I am not in a position to give the information. However, if Deputy Norton wants to discuss it now—lest he should think that we are taking an unfair advantage of the position—I am quite prepared to move the amendment formally now and let the Report Stage take care of itself.
I do not ask the Deputy to do that, but Deputy Cosgrave made a certain case.
I allowed Deputy Cosgrave to intervene just to put the position to the Minister as to what he might consider between this and the Report Stage in regard to the amendment.
I consent to the withdrawal of the amendment.
The amendment is not withdrawn. It is not moved. I shall allow Deputy Norton to put certain points to the Minister.
I only want to ask Deputy Cosgrave as to whether the electoral college scheme provided for in the Bill should go and that instead there should be a panel as proposed in paragraphs (e) and (f) of the proposed amendment.
I should like to know also how the panel would be constituted. I am referring to the panel referred to in paragraphs (e) and (f) of the amendment.
There are consequential amendments later on, I think, which provide for that. I think that amendment No. 18 is the amendment designed to provide for that.
Well, I am prepared to leave the matter over until the Report Stage.
Very well, the amendment, No. 5, is not moved.
Section 6 put and agreed to.
SECTION 7.
Amendment No. 6 not moved.
I think, Sir, that amendment No. 7 is partly governed by the previous discussion—unless the Minister is prepared to make amends even at this stage.
Amendments Nos. 7 and 8 not moved.
Question proposed: "That Section 7 stand part of the Bill."
On Section 7, Sir. Has the Minister any objection to inserting, after the words contained in paragraph (c), sub-section (2), the words "for cause stated"? As the Bill stands at present, the Minister may remove the chairman from office, and that is a kind of power that I do not think ought to be vested in any individual. Every canon of the common law demands that a man should be entitled to be heard in his own defence before he is removed from any office of profit or of honour. Every canon of justice demands that, if a person is removed from an office of profit or honour, he will be adequately compensated for that removal unless he has merited removal for some failure properly to discharge the duties that were cast upon him. As this section stands at present, we purport to confer on the Minister statutory power to do violence to the established canons of the common law and equity. I do not think we ought to do that. I do not think we ought to deny the Minister the right to get rid of the chairman if he considers it in the best interests of the society to do so, but I do not think we should confer on the Minister the absolute power of removing the chairman without any assigning of cause. Has the Minister any objection to stating cause in the event of his deciding to dismiss the chairman?
I think that this kind of clause is usual in such matters; but anyhow I think that the Minister should have that right, and, as was said by Deputy Cosgrave this morning, the chairman is likely to remain in office unless for very grave reasons, and I think that that clause ought to remain in the Act but to remain unused, except in such cases. Unless there is some grave reason, no Minister will remove a chairman from a position of that kind. It is not a position of profit; it is a position of honour. No Minister, whether he appointed the individual, or whether his predecessors in office appointed him, would be likely to remove a man from a position of that kind unless there were very grave reasons. If there were grave reasons it might not be advisable to announce them to the public. They would have to be grave, and there might be some reason for not announcing them in the Dáil or laying papers on the Table. It might not be in the interests of the Society, or of the individual concerned to do so.
It is not a proviso to prevent the chairman from resigning. Supposing a situation arose that the chairman of the United Society did not want to reveal to the public, and that the Minister put it to him that he had to dismiss him, but that he could resign, and that if he did resign the public should know the reason before that day week; if the chairman said that there was no reason for such action beyond suspicion or scandalous talk or vague rumours that had reached him, the person concerned could deny them, and decline to resign. If the Minister then replied, "I believe them," and as malpractices have been alleged the man may reply: "Very well, then you must dismiss me, and assign a cause. If you lay a charge against me I will defend it." Is not that a reasonable supposition? As the Bill stands, the Minister may say: "I will assign no reason. I believe the rumours. I believe that you are an undesirable person and I will not keep you in the position." There is no remedy against that. You cannot put it to the proof. Yet, that stigma can be put upon a man, and there is no remedy. That is a bad system. I fully recognise that a situation may arise where a Minister may say: "I do not want to injure the man's family or the society by making public something which should remain private." There is always the right to say to the chairman: "It is better that you should go by way of resignation." I want to add words so that a reason will be assigned. Once the Minister is in a position to say that, it is open to the chairman to say, "I claim my rights." I think such a provision should be inserted into every contract of service. It is inserted in every contract of common law. Wrongful dismissal is an actionable tort. I am not sure if it is an actionable tort or a breach of contract. In any case, it is an actionable matter in respect to which damages could be recovered. Paragraph (c) takes this matter out of the run of common law and sets up new procedure. I object to that procedure in respect to any servant of the State.
Does not Deputy Dillon know perfectly well that if a crux arises, as it might arise in future with any Minister, whatever action is taken would be dictated by commonsense? Surely it is not suggested that the Minister would not do justice and right? I do not anticipate that a situation such as Deputy Dillon seems to anticipate would arise. If an official does his duty the Minister would have no complaint, and if he does not do it, no matter what Government is in office, would it not be the obvious duty of a Minister to deal with an official of that kind? There would be reason and justice for doing so. Surely Deputy Dillon does not anticipate anything to the contrary. The matter is open to the courts.
No, it is closed to the courts.
Then this House will be open, and I can visualise Deputy Dillon some day, if a crux arose, making a strong speech, and drawing public attention to it if any outrage was perpetrated by the Minister. Eventually, the matter must be left to the Minister in charge, and we must depend on him to act in a commonsense way, no matter what Government is in office.
This is a matter that the Minister might reconsider, because this House is not the place to have it discussed.
It is what is often done.
I know, but never satisfactorily.
General O'Duffy's case was one in point.
Assuming the Deputy takes that view, he walks into one division lobby without considering the matter, and someone else walks into another lobby without considering it. This is not the place for such questions if the subject matter is one which calls for sober consideration. I have had experience of administration, and I had one case only in which what is called normal procedure was exercised. In that case, two separate bodies considered the case before it came finally to me. In the case of the first body the matter was considered, and in the case of the second one, through some oversight, it was not considered but was simply marked "approval." In the ordinary course, it would come from the first body after previous consideration, and the second body should enter into consideration of it in the same way. The third body, which was the one I had responsibility for, would normally accept the recommendation that was made. I took precautions in all these cases carefully to consider them, and I found that in that particular case there was nothing more than a prima facie case for discharge. That meant that a man in a responsible position in the State had to do work which, in the normal course of events, ought to have been done by others. In this case, there is but the Department, and while we are passing no criticism of any kind on the Department, there is not the safeguard of a second port, if you like to call it such. A man might be able to put up a very good case, but there is no provision for it. The Minister could exercise his discretion. But he hears the facts that are present to the chairman's mind, and so far as judgment is concerned it is prepared if not pronounced. Possibly it is unlikely that a case of the kind could occur.
One thing is certain that, so far as the chairman is concerned, he takes office on that understanding of the situation. We are prepared to concede that the Minister must have a right to act, but some sort of safeguard might be reasonably considered, and it might make the matter more easy for the Minister to decide. Deputies can understand what the position is. Presumably the Department puts up a case, and the Minister has to decide between the Department and the individual. Probably such a case will not occur, but if it did it would be known that parties had a certain standing. As the clause stands, it would be open to the taunt that a person could be removed at will by the Minister. Between now and the Report Stage, if it was possible to have some alternative wording which would effect what is present in the Minister's mind and in the minds of his advisors, while at the same time safeguarding the integrity of the person who would get the position, I do not think any harm would be done to insert it.
Is it contemplated that this shall be a whole-time office?
Not at all. It is an honorary position.
Perhaps the Minister will consider, as it is an honorary position, the insertion of the words "for cause stated." I do not press the Minister to make up his mind at the moment.
Section agreed to.
Section 8 agreed to.
SECTION 9.
(1) A person shall not be qualified to be nominated or elected an insured persons' (trades union nominees) member or an insured persons' (local authorities' nominees) member if at the date of his nomination or election—
(a) he is not an insured person, or
I move amendment No. 10:—
In sub-section (1), before paragraph (a) to insert a new paragraph as follows:—
(a) he is under the age of 21 years, or
It is considered undesirable that a person under 21 years of age should be appointed to the committee of management. For that reason, I should like to have these words inserted.
Are there many insured persons under 21 years of age? What is the percentage?
I do not know. The society could ask for particulars, but they are not included in the statistics available.
Could the Minister say off-hand what is the approximate number? Would they be one in ten or one in 20?
I have not the remotest idea.
Is it the view that there is no case for representation of that age?
There is an idea that the number is very small.
Amendment agreed to.
Section, as amended, agreed to.
Amendments Nos. 11 and 17 are consequential on other amendments and, accordingly, fall.
Section 10 agreed to.
SECTION 11.
(1) There shall be established a body (in this Act referred to as the electorate) to be known as the Insured Persons' (Local Authorities' Nominees) Members Electorate to fulfil the functions assigned to it by this section.
(2) A person shall not be qualified to be nominated a member of the electorate by a local authority or, in case of the default of such local authority, by the Minister if at the date of his nomination—
(a) he is not an insured person, or
(b) he is not resident in the functional area of such local authority, or
(c) he is an officer or employee of the Unified Society.
Amendment No. 18 is consequential on amendment No. 5 and, therefore, falls.
It is not moved. It does not fall consequentially.
It may arise again when the Minister shall have given further consideration to certain matters.
The procedure was that we did not move amendment No. 5, with the intention of moving it on Report Stage. We do not move amendment No. 18 for the same reason.
I think the method of election there is much more democratic than the method provided in the amendment.
The choice is the same; the selection is the difference.
Amendment No. 18 not moved.
The following amendments were agreed to:—
In sub-section (1), line 51, to delete the word "section" and substitute the word "Act".—(Aire Rialtais Aitiúla agus Sláinte Puiblí).
In sub-section (2), between lines 55 and 56 to insert the following:—
(a) he is under the age of 21 years, or.—(Aire Rialtais Aitiúla agus Sláinte Puiblí).
Section 11, as amended, agreed to.
Sections 12 and 13 agreed to.
SECTION 14.
(1) A member of the Reserve force—
(a) who on or after the 6th day of January, 1936, is called out for a continuous period of training of not less than 36 hours' duration, and
(b) who at the time he was so called out is an insured person, within the meaning of the National Health Insurance Acts,
shall during such period be deemed to be employed within the meaning of the said Acts and to be in the sole employment of the Minister for Defence.
I move amendment No. 21:—
In sub-section (1), paragraph (a), line 8, to delete the words "not less" and substitute the word "more".
Amendment agreed to.
Section 14, as amended, agreed to.
Sections 15, 16 and 17 agreed to.
SECTION 18.
Question proposed: "That Section 18 stand part of the Bill."
Does Section 18, in fact, give the widow or insured person the same remedy in respect of pension rights as an insured person has at present against his employer in respect of benefits? A person who ought to be insured at present and who is, in fact, not insured can not only, through the administrative assistance of the Department, compel his employer to stamp his card but can also sue the employer for recovery of any benefits of which he has been deprived as a result of his employer's failure to stamp his card. That is, I think, the existing law. Does this section give the widow a right to sue the employer for her pension if her deceased husband's card was not stamped?
It does, within the same limits as apply in the ordinary case of an insured person under the National Health Insurance Acts. There are limitations.
It struck me when I first read this section, giving a cause of action against an individual employer, that an individual employer might go bankrupt or that something else like that might occur. While a very good case can be made for not allowing any person in respect of whom insurance stamps have not been furnished to get benefits, considering the scheme as a whole and the small number of cases that are likely to arise, it seems a pity that the insured should be liable to suffer loss in certain emergencies. For example, an employer might leave the country or he might sell the business in respect of which the liability was incurred. Alternatively, he might go bankrupt, and the prospects of the person concerned would be damaged to that extent. I think the Minister should consider, between now and Report Stage, whether it would not be possible to put the provision the other way round— that is, to give the person deprived of these benefits through no fault of his own a cause of action against the defaulter, so that he will not escape, but also where he cannot recover against the defaulter, to provide that he should not be at any loss. If I am not mistaken, in a case of bankruptcy, absconding or anything of that sort, if the employer cannot be found, he cannot be made pay, and I should be afraid that the insured person would be at a loss.
Who does the Deputy suggest should bear the loss?
The society. I do not think that many cases of the kind will occur and the idea we ought to have in mind is the protection of the individual insured. We should provide all the safeguards possible but, where these safeguards fail, the big body would be better able to afford the loss than the single individual.
I should like to support the plea for the revision of this section so as to provide that, in case of default in complying with the provisions of the Act, the insured persons shall not be in danger of losing the benefits because of the employer's neglect. They should have whatever rights would be accorded to them if the employer had complied with the Act. If there is any default on the part of the employer, the State should proceed to recover from the employer through the machinery which the State offers to the employees in this particular instance. I have had experience, and I suppose many other Deputies have had experience, of employers declining to stamp national health insurance cards. It is provided under the relevant Acts that the aggrieved person in these cases can sue the employer for the benefit lost and recover the benefit up to 28 days after compliance is ensured. But the aggrieved persons, in such circumstances, probably never have occasion to look for unemployment insurance benefit until such time as they are unemployed. They have no reason probably to look for national health insurance benefit until they are unemployed. There are persons aggrieved who are penniless and it is no satisfaction to them to be afforded an opportunity of suing their employer in court, admission to which is often decided by a person's cheque book. These are needy people, and it is not convenient for them to apply the remedy provided in the Act. It would be much more effective, and a much greater deterrent to the employer if he knew that the State was suing in the case, and if he could, at all events, be induced to believe that the State has a very long arm in these matters and can usually insist upon a person being brought to justice although it may be a costly and tedious task to do so. The aggrieved person very often feels that he is under great difficulty, and that the person with much more money can escape liability.
I suggest that persons should be given their rights under the Acts, and that the State should undertake responsibility to recover the money from the employer. That would be much more effective than giving the needy applicant for a widow's pension the right to sue the employer. The needy person has no money to do that, and that will mean that she will be deprived of a widow's pension because of her inability to sue her employer.
I support the amendment which, in the first place, means safeguarding the rights of insured persons to have stamps put upon their cards. The Minister asked Deputy Cosgrave who is to pay or to accept responsibility. We all answer and say the society, certainly. If the society fails in its inspection scheme, in seeing that the cards are stamped and handed in, the society should accept responsibility. All of us, as members of this House, have had cases brought to our notice where small employers, as well as big employers, have failed to stamp cards, have afterwards gone bankrupt, and left people without stamped cards without any remedy. If there has not been a proper system of inspection, or if the inspector fails in his duty, the State ought to pay.
The number of cases that would arise under the amendment suggested by the leader of the Opposition would be infinitesimal. First of all, there would be the case of the widow, where the insured person would be dead. Secondly, you would require to have cases where cards were not stamped and, thirdly, you would have to have cases where the employers had gone bankrupt. Our point of view is that while the primary liability should devolve upon the society we would not deprive the society of the right of suing, in its own name, the persons who had failed to stamp the cards, or of suing in the name of the widow for the benefit to which she was entitled. So in the vast majority of cases the society would suffer no loss. It would be only in an infinitesimal number of cases that you would have a defaulting or a bankrupt employer and where the society would have to bear the loss without any compensation.
I do not think the society comes into this matter at all under this amendment. If the suggestion of Deputy Cosgrave was adopted somebody would have to bear the expenses, as, for instance, in the case of a bankrupt which the Deputy has in mind. In other cases the employer could be got at. I do not know whether the number of bankrupties, in such cases, is great. I suppose there are some bankrupts and some individuals in such cases have suffered. However, this is a point that I had better examine. I have not gone into the matter, but I suppose there are cases where the employees of bankrupts have suffered.
What I say about the society is this: in normal cases it is not likely that a person who had been in employment with a bankrupt would not have any stamps on his card. Some stamps would have been provided. The original insurance would be there. If my recollection is correct one of the features of the Insurance Act was that a person was not to lose the right to insurance by reason of a lapse if some stamps were there. While the sum due to the society would not in most cases be more than 12 months, the fact that some insurance was paid gives the insured person the right, and the loss to the society would be very small.
I will look into that point later. With regard to Deputy Norton's point about recovery I would draw his attention to Section 18 (b) (iii). I think he will find the power is there already.
It is not easy to get that done; also it may mean that if you are going to wait until that process is proceeded with, the widow is going to lose her pension and the orphans are going to lose their pensions. If the State sues a person who is bankrupt there may be nothing to get. My suggestion is that the State ought to pay every person who is normally entitled to benefit.
Section put and agreed to; Schedule agreed to.
Bill reported with amendments.
When does the Minister propose to take the Report Stage?
I would like to get the Report Stage next week. I will give the suggestions made consideration but I should be glad to have the Report Stage taken next Thursday.
Will the Minister circulate any amendments?
Ordered: That the Report Stage be taken on Thursday, 12th March, 1936.
The Dáil adjourned at 2 p.m. until 3 p.m. on Wednesday, 11th March, 1936.
