Committee on Finance. - Hospitals Bill, 1938—Committee Stage.
In this Act— the expression "the Minister" means the Minister for Local Government and Public Health; the expression "local authority" means an authority which is—
(a) a county council,
(b) an authority charged with the administration of the Poor Relief (Ireland) Acts, 1878 to 1914, or
(c) a sanitary authority;
(b) that its governing body is not a Department of State, a local authority, a committee of a local authority, two or more local authorities or a joint committee of two or more local authorities.
I move amendment No. 1:—
To delete lines 14 to 18 in page 2. I might mention that amendments Nos. 1 and 2 are merely drafting amendments, a rearrangement of the original draft suggested by the parliamentary draftsman. There is no new principle introduced. It is considered that it is a better draft than the original.
Amendment agreed to.
I move amendment No. 2:—
To delete paragraph (b), lines 33 to 36 in page 2, and substitute the following:—
(b) that its governing body is not—
(i) a department of State, or
(ii) any one or more of the following local authorities, that is to say:—
(I) a county council,
(II) an authority charged with the administration of the Poor Relief (Ireland) Acts, 1878 to 1914,
(III) a sanitary authority, or
(iii) a committee of any one of such local authorities, or
(iv) a joint committee of two or more of such local authorities.
Amendment agreed to.
Section 1, as amended, agreed to.
Question proposed: "That Section 2 stand part of the Bill."
This section sets out that the governing body of any voluntary hospital may, pursuant to a resolution adopted by such governing body, apply to the Minister for an establishment order in relation to such hospital. The Minister informed us the last evening that there would not be any establishment order without entire agreement between the hospital authorities and the local authority concerned. There is apparently a certain fear abroad—I do not know whether it is founded or not—that the Minister, holding, as he does hold, the right to question the payment of deficits in hospital administration, may force a hospital into the position of not being able to carry on and, consequently, having to apply for an establishment order. I should like if the Parliamentary Secretary would put us straight upon that, if he feels that there is anything like that in view, although I can scarcely expect him to say there is.
I wonder if there is any cause for the fears which certain people in the City of Dublin have in that respect? At the moment it seems to be a burning question between the Department and the local authorities with regard to certain amalgamations in the city, and there is an outcry against the delay. Some of these hospitals are afraid that the Minister may utilise the powers he has of refusing to pay a deficit in order to force certain hospitals into the position of applying for an establishment order. If anything like that comes to pass it would be a thing that was not looked for and a thing that ought not to happen. I would like the Parliamentary Secretary to allay the fears of some of the hospital authorities that feel very concerned.
It is news to me that there is any suspicion in the minds of the governing bodies of any of the voluntary hospitals that the machinery proposed to be set up in this Bill will be used for the purpose indicated by Deputy Brennan. I can assure the Deputy, and anybody else concerned in the matter, that such a thought never entered the minds of the people responsible for placing this Bill before the House. The Bill has been put before the House on Second Reading solely for the purpose of enabling voluntary hospitals who wish to merge their interests or pool their resources with the local authority, and if, as has been indicated to us, there are some such voluntary hospital authorities in existence at the present time, the necessary machinery will be provided in this Bill to enable them to seek the establishment order mentioned.
Unless there is complete agreement, both between the local authority and the governing body of the voluntary hospital concerned, the question of an establishment order will not arise at all. I assure the Deputy and the House that it is not the intention of the Minister or the Department to exercise any pressure, financial or otherwise, on the committee of a voluntary hospital to force them to merge their interests with some other body.
I am glad the Parliamentary Secretary has explained the position. It was not in my mind, but it was brought to my notice that the thing was quite possible, and there were certain people in Dublin very much afraid, and I take it now that they will take the assurance that the Parliamentary Secretary has given that there is no such thing going to be done. As I said, I did not expect the Parliamentary Secretary to say it was in view, but I wanted him to assure the people that it is not going to be done, that there is not going to be any financial question of that sort brought to bear on hospitals.
Would the Parliamentary Secretary go a step further and say that hospitals will be invited to apply for an establishment order? What the Parliamentary Secretary has said merely arouses suspicion. In the first place, hospitals here will come under the local authority, and the local authority, if we are prepared to believe all that we read in the papers about their increasing expenditure, can scarcely, unless forced, be desirous of adding to their commitments, and taking over hospitals in these cases will mean that. I presume that if there are establishment orders indulged in, it will lessen the cost that should fall upon the fund over which the Minister exercises some control, and leave perhaps larger sums available for the smaller number of bodies that would be applying for it. This Bill, I understand, has to deal principally with Cork Street Hospital. But it goes beyond that. It is an enabling measure, and once there is an enabling measure there is very great power, and, of course, influence, in connection with the exercise of the provisions that are in it. I would like to know from the Parliamentary Secretary whether or not hospitals are going to be invited, directly there is any difficulty, to apply for an establishment order and bequeath their difficulties to the local authority.
I cannot give any guarantee to the Deputy or to the House that in certain circumstances hospitals will not be invited to seek an establishment order. If it appears to the Minister and perhaps to the governing body of a voluntary hospital that the community would best be served by such a hospital merging its interests with the local authority and seeking an establishment order I certainly could not give any guarantee that they would not be invited to take a course of action that was considered to be the best course of action both for themselves and the community they were called upon to serve.
So that it is not a question of the hospital looking for it then; it would be invited to do it.
No, no. The Deputy has given far too free a translation of my exposition of the position. I say that I will not give a guarantee that, under certain circumstances, they will not be invited to seek an establishment order but, on the other hand, I am quite equally definite in the viewpoint that I expressed earlier that financial or other pressure will not be put upon the committee of a voluntary hospital to force them to seek an establishment order.
The Parliamentary Secretary has at least gone farther than on the Second Reading.
I do not recollect this question being raised on the Second Reading.
It is the Parliamentary Secretary's own explanatory speech. He ought to know what the Bill means and he ought to be able to explain it to the House.
I submit that I have a fairly good idea of what the Bill means. I do not think that is a fair suggestion. I am surprised at Deputy Cosgrave making it. It is rather a cheap remark coming from Deputy Cosgrave.
It ought not to be a part of the duty of the members of this House to drag out of the Parliamentary Secretary what is in the Bill or what he intends to do in administering an enabling Act of this kind.
It ought to be the duty of any Deputy in this House taking an intelligent interest in the business of this House to take the trouble to study the Bill and then he would not have to ask so many innocent questions.
Deputies of the House happen to know their duties far better than the Parliamentary Secretary knows his parliamentary duties and, in consequence, knowing the Parliamentary Secretary, and knowing the way in which he handles his business, it is by question and answer we must get out of him what is in a measure or what his intentions are in connection with it.
If the Deputy feels he has scored with such a contribution he is welcome to it.
Section 2 agreed to.
Section 3 agreed to.
(1) Where the governing body of a voluntary hospital applies to the Minister under and in accordance with this Act for an establishment order, the following provisions shall have effect, that is to say:—
(a) the Minister may decide either to grant such application or not to grant such application,
(b) the Minister shall not make such decision until the expiration of the time within which written statements of objections to the making of such order may be furnished to him under the immediately preceding section and shall, in making such decision, have regard to any such statements which are so furnished,
(c) before making such decision, the Minister may, in any case in which he thinks it proper so to do, hold a public inquiry into the desirability of making such order,
(d) if the Minister decides to grant such application, he shall prepare a draft of such establishment order in such terms as he considers appropriate and submit such draft to such governing body,
(e) if and when agreement is reached between the Minister and such governing body as to what (if any) variations are desirable in such draft, the Minister may make an order (in this Act referred to as an establishment order) in the terms of such draft either, in case it has been agreed as aforesaid that such draft should be varied in any respects, varied in those respects or, in any other case, as prepared originally by the Minister.
(2) Article 32 of the Schedule to the Local Government (Application of Enactments) Order, 1898, shall apply in respect of every public inquiry held under this section into the desirability of making an establishment order in like manner as the said Article applies in respect of the inquiries mentioned therein, and for the purposes of such application the governing body of the voluntary hospital applying for such order shall be deemed to be an authority concerned in such inquiry.
I move amendment No. 3:—
In sub-section (1), page 3, paragraph (d), line 44, to add after the word "body" the words "and to the local authority or local authorities of which the new governing body to be established by such establishment order will be representative."
The object of this amendment is to meet a point raised on the Second Reading that provision should be made to secure the consent of the local authority or local authorities concerned in the terms of an establishment order and providing for their representation on the new governing body. The provision in the Bill, as drafted, did not appear to be adequate to ensure that local authorities would be so consulted and hence this amendment. Deputy Brennan had some anxiety in the matter, and on looking into it more fully it was decided fully to clarify the position.
I am glad the Parliamentary Secretary has introduced the particular amendment, and I did draw the Parliamentary Secretary's attention to it the last time, and although I did get assurance from him that it was in the Bill, I say it was not in the Bill.
You see it is going to be put into it now.
And I am quite pleased. It was not in it the last time the Parliamentary Secretary told me it was in it.
I told you that I thought the point was covered by the Bill.
It was not. However, it is well it is there now in any case, and I am very glad it is there.
Amendment agreed to.
I move amendment No. 4:—
In sub-section (1), page 3, paragraph (e), line 46, to delete the word "and" and insert after the word "body" the words "and such local authority or local authorities".
This amendment is consequential on amendment No. 3.
Amendment agreed to.
I move amendment No 5:—
In sub-section (2), page 4, to insert after the word "order" in line 2 the words "and the local authority or local authorities of which the new governing body to be established by such order will be representative" and to delete the words "an authority" in line 3, and substitute the word "authorities".
This amendment is consequential on amendment No. 3.
Amendment agreed to.
Question:—"That Section 4, as amended, stand part of the Bill"—put and agreed to.
Sections 5 to 10, inclusive, agreed to.
Question proposed: "That Section 11 stand part of the Bill."
On Section 11 where an establishment order has been confirmed the Minister may from time to time by order amend such establishment order. The Minister is taking very extensive powers by order under the section. Once he has an establishment order at all and it has been confirmed he may, by order, then do any blessed thing he likes, apparently without the consent of either of the two parties. Now I am afraid that under that section which is rather innocent looking, the Minister as a matter of fact takes all power into his hands. Where an establishment order is first put into operation and certain conditions are possibly not operating in the beginning the Minister may afterwards, by this kind of omnibus power, which he has in this particular section do any and every thing he desires. I wonder if that is a desirable thing, and I wonder how the hospitals concerned will view that particular section if they are applying for an establishment order.
There is no ground for Deputy Brennan's apprehension in this regard either. The section provides for the amendment of establishment orders in due course but provides that the procedure in connection with such amendment shall be the same as the original procedure in making the establishment order. Exactly the same steps must be taken—consultation, agreement, publication of the various steps in the Press, etc.—all these steps must be gone through in relation to any amendment, in the same manner as if it were an original application for the making of an establishment order.
I do not think the section is at all clear, or that it clearly contains what the Parliamentary Secretary said it contains. I do not think that any local authority would be entitled to insist upon, say, agreement for any further or subsequent order of the Minister, as they would be in the first instance, where they came together and agreed upon a certain principle. I quite realise, of course, the necessity of the Minister, possibly, having certain powers to deal with certain alternations, but in this kind of omnibus clause, he is given the right, after bringing those two bodies together originally on some kind of basis, to depart entirely and completely from that basis, and, by order, to put a new face upon it. It seems to me that this section is rather peculiarly worded. It does not seem to be clear to me at all, and I cannot follow the Parliamentary Secretary's view in this direction. I do not think that he has proved that his reasoning is right.
I can only say that I am satisfied that my reading of it is right. If it is not in a form that is understandable to the Deputy, I am afraid he must blame the draftsman, but that is the intention anyway.
Oh, I know that it may be the intention, but the Parliamentary Secretary knows as well as I do that it is not what we may think is the intention that will carry weight, but what is actually here.
I think that the Parliamentary Secretary ought to get some different wording for this. Unless he gives me some assurance that powers are not going to be taken by the Minister, after he has put an establishment order into operation, as these powers appear to be taken on this particular section, I am afraid we shall have to divide the House. I think that this really ought to be a non-controversial matter between us and that we ought to try to meet each other as far as possible on it. If the Parliamentary Secretary would say that he is going to look into this matter with a view to clearing it up, then we shall know where we are.
Does the Deputy ask me to say that I should give a guarantee to the House that an amendment would be introduced, whether I am satisfied that such an amendment is necessary or not?
I have already assured the Deputy and the House that it is not necessary, but if the Deputy wishes me to examine the matter further, I shall have it examined.
Yes, I should like the Parliamentary Secretary to do so.
Sections 11 to 13, inclusive, and Schedule and Title of the Bill agreed to, and Bill reported with amendments.
Report Stage ordered for Wednesday, 7th December.