Skip to main content
Normal View

Dáil Éireann debate -
Thursday, 12 Mar 1936

Vol. 60 No. 15

Public Business. - National Health Insurance and Widows' and Orphans' Pensions Bill, 1935—Final Stage.

I move amendment No. 1:—

In pages 3 and 4, Section 6 (1), to delete paragraph (e), 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 Munster, 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 to say at the outset that I was rather sorry I could not have been here for the Committee Stage of the Bill. I have had an opportunity, however, of reading the debate on the amendments moved, particularly two amendments which stood in my name. I should say that, with one exception, these amendments of mine form a scheme, and I think I can best make my case on amendment No. 1. The Minister, apparently, misunderstood the purpose of the amendments which were before the House the last day, one of which I think he offered to give further consideration to, namely, the amendment with regard to a medical member of the committee. One of the reasons why I proposed my original amendment, that the chairman of the society should also be a trustee, was to enable me to get in the medical member without altering the number of three trustees or enlarging the committee as set out in the Bill. That was one of the reasons. Of course, there were many others which I shall not go into now.

It seems to me that the Minister did not make any case for the rejection of the amendment dealing with the medical member. I have read very carefully what he said and I must say that I was very disappointed. I was of the opinion that the Minister would welcome the suggestion to have a medical member on the committee and I can only come to the conclusion that the Minister's further consideration of that matter has not been favourable, as he has not put down an amendment for this stage dealing with the matter.

To anybody who has any knowledge of the working of national health insurance the necessity for at least one medical member of the committee will be apparent. Deputy Rowlette, I think, made a very good case, perhaps a much better case than I could make. I want to approach this matter from two points of view: one is the point of view of recognising, even in that way, that this is a national health service and that it ought not to be the beginning and end of this service merely to pay certain moneys when persons are sick. It would be of very great advantage to any committee, charged with the management of a society such as this, to have at their disposal the advice and experience of a registered medical practitioner. There is another reason that is, perhaps, the most important reason of all, and I should like the Minister to consider it. One of the great difficulties in dealing with national health insurance in this country has been the question of medical certification. I do not know whether the Minister is aware of that, but probably he is. The Minister ought to be aware that it is one of the big questions that have not been solved. It is one of the questions which committees of management under the old system were unable to deal with, and I suggest to the Minister that it will not be dealt with by the committee of the Unified Society unless they have at their disposal a person who can give them advice from practical experience.

The Minister will probably have some idea of what this question of certification means to the expenditure of the society. I have some experience as a member of a committee of management under the old system. I know it was one of the big problems we had to deal with and which we had to watch very carefully. I do hope, for the sake of the proper and efficient working of the Unified Society, apart altogether from what is perhaps even more important, the question of having proposals dealing with the health of the members continually brought before the committee of management and suggestions made which can be passed on to the Minister, that the Minister will very favourably consider the inclusion of a medical member. There is nothing whatever to be said against including a medical member on the committee. I do not think the Minister was wise in suggesting to the House that there was no difference between suggesting that a lawyer should be put on the committee and that a medical member should be put on it.

To come to this amendment, which is my alternative to the Minister's scheme outlined in the Bill for electing insured members' representatives on the committee of management, I wish to say that it is not a perfect scheme by any means, but it is the best I can think out. I suggest to the House, and I hope to be able to show, that it is infinitely better from every point of view than the scheme in the Bill, to which the Minister appears to be wedded. Many Deputies, I am afraid, and certainly the greater part of the public, do not seem to appreciate what a huge service this national health insurance is. It is perhaps the biggest service we have in the State. It embraces 500,000 members. There is approximately a reserve fund invested amounting to £3,500,000. The yearly income of the society is approximately £1,000,000. The committee of management of this huge society, dealing with millions of pounds and with 500,000 persons, is presumably being set up for the purpose of managing this society, and the committee that is to manage such a huge organisation as this is going to be selected in the haphazard and absurd way set out in the Bill.

It is, perhaps, no harm briefly to outline what the Minister's scheme is. The Minister's scheme is that local authorities shall, having regard to 5,000 and 2,500 insured members in their functional area, nominate so many insured persons to form what is called the electorate. This electorate, formed in this haphazard, loose way by county councils and corporations all over the Free State, will number anything from 100 to 120 persons. There is to be no question as to their knowledge of national health insurance, whether they are completely ignorant of it or not; no qualifications whatever will be required beyond the fact that the person selected by the country council or the corporation must be an insured member.

Eventually, if the scheme works, we will be presented with an electorate of anything from 100 to 120 members. This body is to hold office for three years. The main, the only function of this particular body that is to be brought together in some part of the Free State once a year, is to select from amongst themselves five members to act on the committee of management. Again, there is going to be no question as to whether those persons will be useful members, whether they will have any knowledge of the National Health Insurance Acts or the working of them. We are going to appoint those persons, without any regard to their qualifications, to a committee of management which will be charged with the control of a society dealing with a reserve of £3,500,000, an income of £1,000,000 a year, and with the claims of, roughly, 500,000 people. I think it is the most absurd proposal I have ever heard. I cannot for a moment believe that the Minister has any regard for the scheme outlined in the Bill. I expect he has given considerable thought to this matter, but surely some more feasible scheme might have been devised. I agree it is not easy to get a scheme which will give you direct nomination from the membership.

My proposal, in a nutshell, is that instead of every corporation and every county council—there are 27 county councils in the Free State—functioning in the way set out in the Bill, the General Council of County Councils, one body representative of all the county councils, from amongst the names of insured members submitted to them by the members of each county council, will submit a panel of ten names to the Minister. That will ensure that there will be some selection, some filter if you like, before the panel reaches the Minister. He thus gets a panel of ten names from which he can select three. This will again enable the Minister to use his discretion and knowledge and whatever advice may be given to him so as to ensure that from the ten he will get three men likely to give the best service on the committee of management. That is not a perfect scheme, but I suggest it is infinitely superior to the Minister's. It is less cumbersome and less costly.

The second part of my amendment suggests that a further panel of ten shall be submitted to the Minister by the Council of Municipal Councils and from amongst the ten the Minister can select two names. Again, it is left to the Minister to get from the ten the men he considers will be able to give him the best service. My reason for dividing up the five in that way is this, that it is essential to see that you have as fair representation as possible, and it is desirable that we ought to try, as far as we can, to bring about some local contact between the insured members and the representatives on the Committee of Management. That is also my main reason for setting out in my amendment the provincial representation. One of the drawbacks of the unified scheme is that it removes all local or personal contact between the insured member and his representative on the Committee of Management. Then there is the further point that you have 27 county councils and the active and closely organised insured members in rural areas are mainly road workers. When I say closely organised, I mean those who can be organised and who can use their votes and strength in a particular way much more easily than a scattered and diffused membership.

The Minister suggests that under his scheme, whilst his electorate is going to hold office for three years, the five members appointed by that electorate to the Committee of Management are to hold office only for one year, being, of course, eligible for re-election. On the Second Reading the Minister intimated that he had a very sound reason for making it one year as against three years, but he did not give us the reason, and I shall be very glad to hear it. I will be surprised if the Minister will give a reason that will satisfy the House. You are going to bring 120 persons together from all over the Free State and they will hold office for three years. They will appoint five to act on the Committee of Management for one year. These five men may be completely ignorant of the working of national health insurance. They are to be put on the committee of management, and at the end of 12 months, just when they are getting some knowledge of how the Insurance Acts work and of their responsibilities in regard to membership and the funds, they are thrown out and you get five fresh men who, perhaps, may be men with a fair general knowledge of the Insurance Acts, but it is quite conceivable, on the other hand, that they may be persons who have no knowledge whatever of the working of the Acts.

The Minister knows quite well how these things are worked when it comes to selections by county councils and corporations. The Minister knows it does not always follow that the person who would be best qualified to act will be selected by the county councils. It might conceivably be a person who knows nothing at all about national health insurance, but who is perhaps a sound, a strong and a vocal supporter of Fine Gael or Fianna Fáil and who would be selected for that and for no other reason. I can claim to have some practical knowledge of the working of national health insurance under the old system, and yet to-morrow, if I were an insured person, I have not the slightest doubt that, as it is at present constituted, I would be the last person in North Tipperary who would be selected by the North Tipperary County Council.

I want the Minister to keep these things in mind, and I will ask the House to realise that we are appointing a committee of management, not of a club or anything else of that sort, but of one of the biggest organisations in the country, a committee that will presumably have responsibility with regard to the investment of surpluses and the handling of £1,000,000 a year. Of course, there are certain statutory regulations with regard to the investment of surpluses, etc., but I need not go into that now. Whether the Minister's scheme is to be retained or whether my scheme is to go into the Bill, I have heard no reason advanced why the committee of management, the insured members' representatives, should not hold office for three years instead of one year.

I think there is everything to be said for their holding office for three years. The only reason I think which could conceivably be advanced against that is that the Minister is afraid that the persons he will get in the first election will be so hopelessly incompetent and so hopelessly ignorant of the work they are being called upon to do that he wants to be in a position to remove them and have another gamble as quickly as he can. I think my scheme gives the Minister an opportunity, to say the least of it, of ensuring that he will get a better type of men—a better type in the sense that they will probably know more about the working of the Act or that those of them who do not will probably acquire the knowledge much more quickly than those he will get in the haphazard fashion set out in the scheme contained in the Bill.

As I say, in this speech of mine I am covering all my amendments, with the exception of No. 2, which is rather a separate matter, but is to a certain extent bound up; it is the question of the one or three years. Whether my amendment is carried or not, that will remain, and in my opinion it will be more necessary, perhaps under the Minister's scheme than under my scheme. I shall be very interested to hear the Minister on my scheme as against his own, and I shall be very glad indeed to hear from the Minister that he is prepared to adopt the suggestion of having a medical member on the Committee. I think whatever scheme of selection or nomination is to be adopted finally, it is desirable and essential for the proper working of the society that you should have a medical member. I sincerely trust that the Minister will meet us on that. It is a most important point. I hope that for the sake of the smooth and good working of the society he will adopt my scheme instead of his own. If he does not, I can assure the Minister that it is my honest opinion that the Unified Society will not and cannot work, and that the Minister or his successor will be forced to make this service a State service. That, I think, will happen eventually in any case, whether it is my scheme or the Minister's scheme that is adopted, but I think the Minister's scheme will bring the necessity for it much nearer.

Then perhaps the Deputy ought to be in favour of mine?

That is about the only good thing I can say about the Minister's scheme, because I was always one of those who held the view that once you departed from the old system there was no half-way house. The Unified Society is not getting a fair chance under the scheme set out in the Bill. I want to have it tried out to the fullest, so that when we do go on to a State Service we will go on to it convinced that it is the best. We ought to realise that we are dealing with a big social service. It is perhaps the most valuable social service provided for the workers of this country. Only those who have been dealing with it in a very close way realise how valuable it has been to working men and women. We know how valuable the maternity benefit has been, particularly in the homes of the very poor. It is, in my opinion, a great service. It is because I look on it as a great service, and a service which I hope to see extended in the near future, that I am anxious that we should get the best type of Committee of Management which it is possible to get.

I take it Deputy Morrissey is discussing Nos. 1, 4, 5 and 6?

I should like to support Deputy Morrissey's arguments in reference to such of his amendments as were not already under discussion. I gave my opinion on Friday last on one of the points to which he has adverted now, that is, the appointment of a medical man as a member of the Committee, and I do not intend to touch on that again but to refer rather to amendment No. 1, which deals with the manner in which those members of the Committee who represent the insured persons are to be chosen. It is quite clear that the Minister and his advisers were in considerable difficulty to devise a scheme to get members of the Committee who could fairly be regarded as representing the insured people. I do not think the Minister is likely to be greatly enamoured of the scheme that he has inserted in the Bill. It has certainly the drawbacks that it is cumbrous and that it puts the insured members' representatives a considerable distance away from those they represent; it does not commend itself as likely to be a workable scheme. There was undoubtedly great difficulty in the matter, but I think that Deputy Morrissey is coming nearer to a workable scheme than that which the Bill puts forward. It has a great advantage from that point of view, as well as from another point of view, over that embodied in the Bill. It gives the Minister a considerable choice from a panel put before him by a responsible body. I do not think that the General Council of County Councils or the Council of Municipal Councils would be very suitable bodies to be entrusted with the duty of directly choosing the representatives of insured people, but I think that they could probably put forward a panel which would include a number of people who could properly be regarded as thoroughly representative of insured members. The amendment would then put on the Minister the responsibility of selecting from the names before him those of the people who, in his considered judgment, would be the most suitable and useful members, and most representative of those they were supposed to represent. I believe the Minister would be in a better position to choose useful and representative members than the councils and public bodies whom he has proposed in the Bill to entrust with that duty. From the point of view of getting a useful and representative committee I think Deputy Morrissey's suggestion is a better one than that before us in the Bill.

There is another reason which appeals to me very strongly, as it appeals to Deputy Morrissey, and apparently as it appeals also to the Minister, judging from a remark which he threw out a couple of minutes ago. There is a change which is almost certain to be forced on the Government within, I hope, a comparatively short time, namely, the change of this service from being what it is at present—a monopoly, with the support of the Government behind it—to being a true State service under the control of the Government and, therefore, under the control of this House. Like Deputy Morrissey, I have held for several years that once the change to unification was made there was no defence against the further change of making National Health Insurance a State function.

I think there are two roads open to us. Deputy Morrissey in his amendment suggests giving some more power to the Minister. The Minister put rather a Machiavellian suggestion before us—namely, that the worse the Committee was the sooner he would have to change it to a State service, and therefore, he appealed for Deputy Morrissey's support for what Deputy Morrissey deemed an unworkable scheme in order that he might demonstrate the unworkability of this system and change it to a State service. We have our choice in that matter. We should make a gradual change to a more efficient and useful system. The Minister's suggestion would amount to using a certain amount of sabotaging of the present system. If I were in agreement with the Minister in that I would go into the Lobby with him in order to show the unworkableness of this scheme and, therefore, stimulate him to make a more radical move. On the whole, I think it is better to proceed step by step than by setting out to damage a scheme which is doing useful work. I would rather try to amend the scheme gradually than smash or damage part of it in the hope of putting up something better. I do not think we could manage to secure a better scheme by damaging or destroying part of the administrative scheme we have to work. There is a good deal to be said for competition in industry, and there was also a good deal to be said for competition between the various approved societies. There is a good deal to be said for state control of such services as National Health Insurance. State control, at all events, is under responsible criticism, namely, criticism by this House and criticism by the public. But there is nothing to be said in favour of a monopoly by the present Society or by the Society we are to have in future. Under this scheme there would be no criticism. It is self-governing, and it is dealing with funds contributed by the public though the public has no control over the expenditure.

I do not think that the experience of the Government in the matter of other schemes of monopoly has been altogether happy. I never thought that the experience of a monopoly in National Health Insurance would prove happy either. I rather gathered from what the Minister said as to the desirability of State service that he himself is not altogether happy about the monopoly established some years ago. My second reason for giving my support to Deputy Morrissey's amendment is that it is more workable and it lays down a more easy road for reform in the future and renders that future somewhat nearer. I hope the Minister will consider that amendment with an open mind. It is not brought forward in a contentious spirit. It is brought forward with no motive other than to make National Health Insurance a greater service than the great service it is at the moment.

From my experience in this House I am satisfied that there is hardly anybody here who takes a greater interest in the subject of national health insurance than does Deputy Morrissey, even including Deputy Rowlette, who also takes a great interest in health insurance. I realise that Deputy Morrissey knows a great deal about national health insurance, and I know he has had experience—I do not know how long—on the committee of management of an approved society. Therefore, he is entitled to speak with authority on certain matters that we are discussing to-day. I believe, as Deputy Rowlette has just said, that the amendment put forward now and the suggestions made have been put forward and have been made in the best of good faith and with a view to improving the machinery of the National Health Insurance Society. I have said so much in order to disabuse anybody's mind as to any suggestion there might be that on a matter of this kind which is purely non-contentious and non-Party, there is any tendency towards viewing it in a Party spirit. I think everybody is anxious to do the best he can to make this arrangement for the benefit of the insured persons. That much being said, I must say that as the father of the child—I stand in loco parentis in regard to this Bill—I am as enthusiastic about my child as Deputy Morrissey appears to be about his.

Parents are usually prejudiced, and I am afraid that neither Deputy Morrissey nor I can claim not to be prejudiced for the things that we are responsible for having evolved. I claim that my scheme is better than Deputy Morrissey's. I claim under my scheme that there will be produced as good a type of representative, and perhaps a better type of representative on the Committee of Management than under Deputy Morrissey's. My scheme is more democratic, and it will get into more close touch with the insured person than Deputy Morrissey's suggested scheme would get. Deputy Morrissey talked of the way in which matters are managed in the local councils and bodies. I have had some experience of that too, perhaps not as much as Deputy Morrissey, but I know something of this. Does Deputy Morrissey say there will not be got a good type of representative on the Committee of Management through the General Council of County Councils or the council that controls the municipal authorities? The same procedure will govern. There will be probably a caucus which will say who is to be elected.

It is very much less likely to happen under my amendment if the amendment is adopted.

I do not think so. I think through my scheme you are closer to the insured persons by getting the representatives on the Committee of Management through the county councils. There are only five persons directly elected by the insured persons. If they are all to be elected by the General Council of County Councils they will not be selected by the insured persons. Now on the General Council of County Councils there might not be one member who is himself an insured person. In the ordinary county council there would be some member who would be an insured person, and who would look after their rights.

I want you to select the representatives yourself. I have much more confidence in yourself than in the county councils or corporations.

It is a nominated body and a hand-picked body. It will not be hand-picked in the same way. You will have more freedom of choice. It may turn out as Deputy Morrissey says, that I am entirely wrong and that I ought not to have confidence in the local councils. But I still think that in these matters they will be out to get the best representatives irrespective of Party or any other division of that kind. At any rate that is my opinion. In the past we have not had any reason to regret the delegates sent up by the public bodies to represent the local county councils and the various other institutions. The councils usually selected responsible people. I do not fear that we are likely to get from the county councils as delegates any people except people whose sole concern will be to safeguard the interests of the society, and particularly the interests of the insured persons. It is possible that some people may be selected who will be ignorant of national health insurance, but I imagine that the corporations and county councils will look for people who have experience in these matters. If I myself were a member of a county council I would look for a person like Deputy Morrissey, who knew the subject and was interested. It is such a person I would vote to have put on.

I think that the ordinary person elected to a county council would not have any different idea. There is no profit in it for anybody. There is no great glory in it for anybody, and I think they will look for useful people to represent them at this annual gathering and instruct them to select the type of person who will best govern and manage the affairs of the society.

I have certain ideas with regard to the development of national health insurance. I agree with Deputy Morrissey that it is a very big and important service and has rendered great assistance to the poor in days gone by. In the days to come, the machine can be made to render even greater service. I did not ask Deputy Morrissey or Deputy Rowlette to adopt this scheme with a view to its early scrapping or with a view to proving it unworkable. I believe that the scheme is a good one despite the arguments put forward by Deputy Morrissey, who knows the subject and can put his case with knowledge. I believe the scheme set out in the Bill will prove as good as any I have heard suggested in the debates on this subject.

This being Report Stage, I cannot make a second speech, nor do I desire to do so. I should like, however, if the Minister would state what he proposes to do with reference to the medical member of the committee.

I do not propose to accept any amendment affecting the construction of the committee of management, as outlined in the Bill, save some small amendments which appear on the sheet to-day. I do hope, however, to be able to make an arrangement in respect particularly of the medical member of the board which may satisfy what Deputy Morrissey and Deputy Rowlette have in mind. I hope to be able to find a scheme to settle that question to their satisfaction.

Will the Minister remember that such an arrangement as he appears to have in mind will probably provide only for the immediate future and may not affect the permanent constitution of the committee. It may, therefore, fail in the object Deputy Morrissey and I have in mind.

If the idea were once adopted, it would hardly be departed from. That, of course, will have to be seen; it will not be provided for by law. However, once a thing starts off on a certain line that line is not usually departed from without good reason.

I am glad the Minister has gone even so far as he has done, but I would prefer to have the matter provided for by legislation. I am so strongly opposed to the Minister's scheme that, although this is not a Party matter, I am going to insist on a division on my amendment.

Question put: "That the proposed new paragraphs be there inserted."
The Dáil divided: Tá, 49; Níl, 31.

  • Aiken, Frank.
  • Bartley, Gerald.
  • Beegan, Patrick.
  • Blaney, Neal.
  • Boland, Gerald.
  • Boland, Patrick.
  • Bourke, Daniel.
  • Brady, Brain.
  • Brady, Seán.
  • Briscoe, Robert.
  • Browne, William Fraser.
  • Concannon, Helena.
  • Corbett, Edmond.
  • Crowley, Timothy.
  • Daly, Denis.
  • Davin, William.
  • Derrig, Thomas.
  • De Valera, Eamon.
  • Everett, James.
  • Fogarty, Andrew.
  • Gibbons, Seán.
  • Goulding, John.
  • Harris, Thomas.
  • Kelly, James Patrick.
  • Kelly, Thomas.
  • Kennedy, Michael Joseph.
  • Keyes, Michael.
  • Kissane, Eamonn.
  • Lemass, Seán F.
  • Little, Patrick John.
  • Maguire, Ben.
  • Maguire, Conor Alexander.
  • Moane, Edward.
  • Moore, Seámus.
  • O Brain, Donnchadh.
  • O Ceallaigh, Seá T.
  • O Grady, Seán.
  • O Reilly, Matthew.
  • Pattison, James P.
  • Pearse, Margarat Mary.
  • Rice, Edward.
  • Ryan, James.
  • Ryan, Robert.
  • Sheridan, Michael.
  • Smith, Patrick.
  • Traynor, Oscar.
  • Victory, James.
  • Walsh, Richard.
  • Ward, Francis C.

Níl

  • Beckett, James Walter.
  • Belton, Patrick.
  • Bennett, George Cecil.
  • Brennan, Michael.
  • Brodrick, Seán.
  • Burke, James Michael.
  • Cosgrave, William T.
  • Costello, John Aloysius.
  • Dockrell, Henry Morgan.
  • Dolan, James Nicholas.
  • Doyle, Peadar S.
  • Fagan, Charles.
  • Finlay, John.
  • Fitzgerald-Kenney, James.
  • Keating, John.
  • Lavery, Cecil.
  • Lynch, Finian.
  • MacEoin, Seán.
  • McGilligan, Patrick.
  • McGuire, James Ivan.
  • Minch, Sydney B.
  • Morrisroe, James.
  • Morrissey, Daniel.
  • Murphy, James Edward.
  • O'Donovan, Timothy Joseph.
  • O'Leary, Daniel.
  • O'Neill, Eamonn.
  • O'Sullivan, John Marcus.
  • Redmond, Bridget Mary.
  • Roddy, Martin.
  • Rowlette, Robert James.
Tellers:— Tá: Deputies Little and Smith; Níl: Deputies Doyle and Bennett.
Question declared carried.

I take it that Deputy Morrissey agrees that the question just decided governs amendments Nos. 1, 4, 5 and 6.

Yes. I beg now to move amendment No. 2:—

In page 4, before Section 7, to insert a new section as follows:—

"The insured persons' (trade union nominees) members and the insured persons' members shall hold office for three years and shall be eligible for reappointment."

The object of this amendment is to give the committee of management a life of three years rather than one year. The position of the committee of management, at the moment, is that those nominated by the Minister, that is seven out of fifteen, will hold office, as far as I can understand it, for a period to be prescribed by the Minister. The representatives of the insured persons are to be elected only for a period of 12 months. The electorate, that is this large body of 100 or 120 persons, have to be brought together once a year; because I do not see, so far as the Bill is concerned, that they had any function except to nominate and elect from amongst them five persons to retain office only for a period of 12 months.

The Minister, on the Second Reading, told us he had a very sound reason for that. But he had some reason for refraining from giving that sound reason. I think there is everything to be said for giving the persons nominated and elected a period of three years. These people will have a lot to learn, no matter what their knowledge of the Act may be. They will, from meeting to meeting, get a better grasp of their duties, and of the working of the machinery in general. It seems to me surprising that you are going to deprive the committee of the services of those particular members, at a time when they have acquired sufficient knowledge to make them efficient members. I do not want to delay the House any longer. The Minister knows my views on this matter, and now I am anxious to hear that good reason the Minister told us he had for sticking to one year.

Practically all the committees of management of the old societies were elected annually. In my view, so long as the people were content to attend their meetings, no change was required. Why should not that same procedure be good enough for the Unified Society? There is no reason why it should be changed for us; but there is no reason why the society should not have the opportunity if they wanted a change. So long as they are attending to their work and proving that they are good, efficient, reliable and trustworthy persons, in all probability they will not want to have a change.

Deputy Morrissey provided another reason as to why we should have the elected members for one year when he spoke on the last amendment. He then said that our scheme was bad. If so, that would be one good reason. However, I do not think there is much in that. I do not know any reason why we should not carry on the procedure of the old societies. In those societies, whether small or great, as a rule— there may have been one or two exceptions—they all had annual elections for the committee of management, but the percentage of change in regard to the whole body was small.

One other point. I should like to have the excuse of the annual elections for bringing that body together. I should like to have the opportunity of bringing together the body of delegates to the electoral college, as we might call it, for the purpose of giving them an opportunity of airing their views in regard to National Health Insurance. Probably they could be brought together, and there would be a good reason for doing so for the annual elections. Having done that, there is no reason why they should not meet to discuss all and any aspect of national health insurance, and to call the attention of the public, the Dáil, the Minister or Deputies to whatever grievances they might have or to whatever matter they might be interested in in the way of propaganda for national health insurance purposes.

In reply to the Minister, there is, of course, no comparison between the method of management under the new system and the old system. In the old days an annual meeting was held and a number of members, 20 or 100, who lived adjacent to the headquarters of the society, attended and elected, or reelected, a committee of management with, perhaps, one or two additions. Those who lived in proximity to the headquarters had personal knowledge of their representatives and knew if they were working the society satisfactorily or not. The position is going to be different in future. You may have 100 persons brought together from the Twenty-six Counties to elect five representatives, and they may have no previous knowledge of them or of their connection with the work of national health insurance. Only at the end of 12 months would they know whether the work of their representatives was done in an efficient manner or not. There is no machinery by which attention could be called to the way the business was managed or as to the grasp these five representatives had of the working of the Act. As to bringing them together to air their views, there is very little use in doing that unless there is some person with authority who would take a note of the views expressed by the delegates. Prior to that, some person should give a considered and a written report on the work of the committee of management for the previous 12 months. The Minister knows that as well as I do. It is beside the point to suggest that there is no analogy whatever between what happened under the old system and the present one. I do not suggest that there is any point in what the Minister said, and I believe it is impossible to meet the case I made in favour of three years, as against one. I am satisfied that it is in the interests of the society, as well as securing good service, that the committee should be appointed for three years. I urge the Minister to give the question further considerations. If he consults with people conversant with the working of the Acts, as to the necessity of having people on the committee of management who have at least a general idea of the work that requires to be done, I think my amendment should be accepted.

Question put and declared lost.

I move amendment No. 3:—

In page 4, Section 9 (1), to delete lines 42, 43, 44 and 45 and substitute the following words:—

"A person shall not be qualified to be nominated an insured persons' (trades union nominees) member or to be elected, nominated, or selected as an insured persons' (local authorities' nominees) member if at the date of his nomination, election or selection——"

This is a drafting amendment and is consequential on another amendment.

Amendment agreed to.
Amendments Nos. 4,5 and 6 not moved.

I move amendment No. 7:—

In page 7, to delete sub-sections (1) and (2) of Section 12 and substitute the following three new sub-sections:—

(1) In this section—

the expression "the Leinster electors" means the members of the electorate who, at the date of their nomination under the immediately preceding section, were resident in the province of Leinster;

the expression "the Munster electors" means the members of the electorate who, at the date of their nomination under the immediately preceding section, were resident in the province of Munster;

the expression "the Connaught and Ulster electors" means the members of the electorate who, at the date of their nomination under the immediately preceding section, were resident in a part of Saorstát Eireann, other than the provinces of Leinster and Munster.

(2) In the year 1936 and every subsequent year, but not earlier than the 2nd day of May nor later than the 15th day of June in such year, there shall be elected in the prescribed manner to be insured persons' (local authorities' nominees) members—

(a) by the Leinster electors from amongst their own number, two qualified persons;

(b) by the Munster electors from amongst their own number, two qualified persons;

(c) by the Connaught and Ulster electors from amongst their own number, one qualified person.

(3) If in any year there is default in complying with the provisions of the immediately preceding sub-section, the following provisions shall have effect, that is to say:—

(a) in case of default by the Leinster electors, the Minister may nominate two qualified persons to be insured persons' (local authorities' nominees) members, and the persons so nominated shall be deemed for the purposes of this section to have been elected by the Leinster electors in such year;

(b) in case of default by the Munster electors, the Minister may nominate two qualified persons to be insured persons' (local authorities' nominees) members, and the persons so nominated shall be deemed for the purposes of this section to have been elected by the Munster electors in such year;

(c) in case of default by the Connaught and Ulster electors, the Minister may nominate one qualified person to be an insured persons' (local authorities' nominees) member, and the person so nominated shall be deemed for the purposes of this section to have been elected by the Connaught and Ulster electors in such year.

This amendment arose out of a discussion that took place on Friday when it was suggested that it would be an improvement if the five persons to be elected were elected on a territorial basis.

Amendment put and agreed to.
The following Government amendments were agreed to:—
8. In page 7, Section 12 (3), lines 38 and 39, to delete the brackets and words "(other than a person elected to fill a casual vacancy)".
9. In page 7, Section 12 (4), to delete paragraph (a) and substitute the following three new paragraphs:—
"(a) in case such member was elected by the Leinster electors or selected under this paragraph, there shall be selected in the prescribed manner to fill such vacancy a qualified person who is a Leinster elector;
(b) in case such member was elected by the Munster electors or selected under this paragraph, there shall be selected in the prescribed manner to fill such vacancy a qualified person who is a Munster elector;
(c) in case such member was elected by the Connaught and Ulster electors or selected under this paragraph, there shall be selected in the prescribed manner to fill such vacancy a qualified person who is a Connaught and Ulster elector;"
10. In page 7, Section 12 (4) (b), line 57, to delete the word "nominated" and substitute the word "selected".
Bill reported with amendments.

I want to call attention to the provisions of Section 18. I have no sympathy with an employer who has failed to pay contributions, and I am not making a case on his behalf, but when a section like this is inserted there are other aspects of failure to comply with the regulations to which I would like to draw the Minister's attention. He is, no doubt, aware that a practice has grown up of juvenile employees stating their ages incorrectly. At one time those in charge of the unemployment and national health offices insisted on certificates of birth, but that practice has fallen into disuse, and as a result in a number of cases employers have been called upon to make good the shortage in stamps. I submit that that practice should not be encouraged, and that provision should be made where juvenile employees make incorrect statements as to age, or where the age is incorrectly stated on the cards, whereby some penalty might be inflicted. In such cases employers should not be called upon subsequently to make up the stamps, where cards were stamped in good faith.

There was one other point I put to the Minister in regard to the case of a bankrupt. I do not know whether the Minister recollects that or not. Is there any provision made in respect of that or will the insured person be at a loss?

We have gone into the matter and so far as I have been able to ascertain, up to the present at any rate, it is not possible to make such arrangements as would not in the end probably lead to greater hardship, for this reason, that non-compliance is the greatest evil, practically, that there has been in connection with national health insurance. It has been the most widespread evil. It is thought that anything that relieves the individuals concerned of the responsibility for looking after their own interests—the stamping of their own cards—will lead further to the spread of non-compliance. The matter has been examined before, and it was examined again, and the fear does seem to reside very strongly in those who are expert in the matter that if anything is done further to relieve an insured person from his own, or her own, responsibility to see that his cards or her cards are stamped it will mean that the cure will be worse than the disease. That is the view taken by experts in the Department.

How many people have been affected by bankruptcies in this way?

There have been very few cases.

Has the Minister anything to say with reference to the point I raised?

The point raised by Deputy Dockrell is one that should be looked into. I cannot say anything more about it at present.

Question—"That the Bill, as amended, be received for final consideration"—put and agreed to.

I wonder would the House agree to taking the Final Stage of the Bill now?

It is very objectionable to pass a Bill finally which has only been amended on the same day. However, if the Minister wants the Bill we have no objection.

Question—"That the Bill do now pass"—put and agreed to.
Top
Share