I move amendment No. 1:—
In sub-section (1), to delete paragraph (a) and in paragraph (b), line 25, after the word "has" to insert the words "after the passing of this Act."
Vol. 80 No. 1
I move amendment No. 1:—
In sub-section (1), to delete paragraph (a) and in paragraph (b), line 25, after the word "has" to insert the words "after the passing of this Act."
Amendment No. 1 is related to amendments Nos. 3, 5 and 16.
A case might occur in which a hospital had got a grant unconditionally before the Act of 1933 was passed. It is proposed to put in here "after the passing of this Act". The operation of this section comes under Sections 2, 3 and 4. This would be what is called an assisted hospital. As the Bill is drawn that is the term that is applied to a hospital that joins the bed bureau. The objection to that particular description is that there are to my own personal knowledge two hospitals in Dublin, one of which has received no funds whatever from the Hospital or Sweepstakes Fund, and the other received an unconditional grant some eight or nine years ago. Both of these hospitals might be agreeable to participate in the bed bureau scheme. It is advisable that that should be as extensive as possible. I can conceive a case in which the hospitals would object to being left out of it, but they cannot come in under this scheme without submitting to all these conditions which are regarded as being objectionable to put it as mildly as possible, or while they would be willing to tender cooperation and give information to facilitate the medical profession and the poor in connection with information and accommodation at their disposal, it is impossible for them to consider the sub-section as it stands. I have had no direct contact with either of the two of them on that point, but I can see that they would object to coming in and taking the disadvantages that are proposed under Sections 2, 3 and 4. It would be unreasonable to expect the hospital which came in voluntarily to submit to such a thing as a complaint—a single complaint—more especially when that complaint did not emanate from the Advisory Committee. The purpose of the amendment is to avoid imposing a condition which was not imposed at the time of the receipt of the grant and in the next place to extend and widen as far as possible the number of hospitals that would participate in the bed bureau scheme.
The objection I have to this amendment is this:—the Hospitals Commission, so to speak, had certain powers under the 1933 Act in respect of hospitals which obtained grants before 1933. Now Section 6 of this Bill retains the powers that were given under the 1933 Act. I am advised that it is necessary to oppose that amendment because if I accepted it, it would mean that the Hospitals Commission would not have all the powers they have already. That is the only objection to it. I do not see how any hospitals are being brought in compulsorily. Under amendment No. 5 that I have down any hospital that gets a grant can contract out; that is quite sufficient. If I accept the amendment it would mean that the Hospitals Commission would lose the power they have in regard to buildings and fittings. I am advised that that is the position.
Surely that is not so. That raises the strength of Section 14 (6) of the 1933 Act.
There is nothing at all in that section or in these two subsections here, assuming that they were going to stand, which would limit the powers of the Hospitals Commission or the Minister when he gets those powers in respect of any of these hospitals. It would limit him in respect of a hospital that was receiving no money, but not in respect of any hospital that is receiving it, because the Act of 1933 lays down what are the hospitals that are subject to this inspection. The Act of 1933 sets out first of all in Section 14:—
"As soon as conveniently may be after the passing of this Act, the Minister shall, by order, establish a commission which shall be styled the ‘Hospitals Commission' and shall consist of not less than three ordinary members..."
In sub-section (6) it says:—
"Every member of the Hospitals Commission may visit all or any of the premises of any hospital or nursing organisation which shall have participated in any sweepstakes promoted under the Public Charitable Hospitals Acts, 1930 to 1932,"
and so on. Sub-section (6) of Section 14 of the Act of 1933 brings in the Hospitals Commission in respect of that, and the Minister and the Hospitals Commission still hold the power to inspect. The amendment does not cut out that power. The proposal of the amendment is "after the passing of this Act." So far as this particular amendment is concerned it is only dealing with bed bureaux.
Is not that the situation?
I am afraid it is not. If the Deputy will look at Section 25 of the 1933 Act he will see that point clearly.
Section 14 (6) of the Act of 1933 is what is referred to here.
I am advised that the definition of an assisted hospital must come in for the purpose of Section 6.
I am not objecting to that. What I am objecting to are the two dates, "1930 to 1932," because grants that were received up to 1932 had no conditions attached to them. A hospital may have got a grant under that. That hospital may desire —I believe they all desire—to come into the bed bureau scheme, but it may not come in because of the conditions attached. If a hospital comes in now under the scheme, it is required to nominate a person in order to take part in the scheme. Once a hospital comes into that scheme it will have to give not only the benefit of whatever accommodation, and so on, that it has, but it will be committed to all the disadvantages that flow from the control that is going to be exercised either by the advisory committee or the Hospitals Commission, or by the Minister. That is the objection. In view of all that, is there any particular reason for keeping out a hospital?
Certainly there is not.
If there is not, will it not be admitted that if it is allowed in it must shoulder a lot of obligations and leave itself open to inquiries, and so on?
My only difficulty in the matter is this: whether, by accepting this amendment, I would be cutting out the powers which the Hospitals Commission already has of going in and inspecting. There has been no objection to that in the past. I know the hospital the Deputy has in mind. There never has been any objection to the Hospitals Commission going in and inspecting the books, fittings and so on. If the acceptance of the amendment would not affect the powers which the Hospitals Commission already has, of being able to go in and inspect, I would be quite prepared to meet him.
It is not my intention to do that. Under the Bill as it stands, a hospital can only take part in a bed bureau scheme by placing itself in the same position as an assisted hospital. There is one hospital that has not come in at all, but it is more than likely that, if the bed bureau scheme is going to be a success, that hospital would like to be in. I see no means of getting it in unless it is prepared to submit, like the other hospitals, to inspections and all the rest. At present that hospital is not subject to inspection. It is getting no benefit, and is, therefore, entitled to object to inspection. So far as the working of this scheme is concerned, I can conceive a situation in which that hospital would not like to be out of it. That is the sum and substance of the amendment.
I do not quite get the Minister's point. There is a proposal in the Bill to define an assisted hospital. It is proposed in the amendment to delete paragraph (a) of Section 1, and to amend paragraph (b) by putting in people who have received grants "after the passing of this Act". The Minister is afraid that if he accepts the amendment he may deprive himself of the new power that he is taking in Section 6. Section 6 relates to Section 14 of the old Act in which an assisted hospital is not defined. The latter provides that every member of the Hospitals Commission may visit the premises of any hospital which has participated in any sweepstake promoted under the Public Charitable Hospitals Acts, 1930 to 1932, or under the 1933 Act. Can the Minister think of any hospital that would not come under that, whether it is defined as an assisted hospital or not? Does not that provision cover every hospital? If there is any possibility of doubt about this, I suggest to the Minister that it can be cleared up by dropping from sub-section (2) of Section 6 of this measure the words "in relation to every assisted hospital". That, I think, would give the Minister everything he wants. I do not see how the Minister would be depriving himself of the powers given under another Act.
There is one hospital which got a grant unconditionally from 1930 to 1932. That hospital I believe is willing to take part in this bed bureau scheme. Paragraph (a) of Section 1 speaks of "any hospital which has participated in any sweepstake promoted under Public Charitable Hospitals Acts, 1930 to 1932". The only participation, so far as this hospital is concerned, was that a grant was given to it without conditions. Naturally, there is an objection on the part of the management of this hospital to be brought in by reason of something that was granted unconditionally. If the Minister were prepared to amend sub-section (1) by saying "any hospital which has participated in any sweepstake promoted under the Public Charitable Hospitals Act, 1933", and were to leave out the other Acts referred to, that, I think, would meet the point. Paragraph (b) of the section might be amended by adding the words "from the passing of this Act". I think the hospitals could not complain if we put conditions on them to that extent. By doing that we could not, I think, be said to be legislating retrospectively, and would be making it easier for all concerned to reach accommodation.
I think it would interfere with Section 6.
Is Section 6 intended to be new and retrospective?
It is intended to be retrospective.
Then it is not intended to cover any new group?
Only so far as the powers of the Minister are concerned.
But it is new in that respect and it is intended to be retrospective in that respect?
The point I wish to make is that sub-section (6) of Section 14 covers every hospital. I believe it does, and that the Minister need not have brought in this amendment. It would not weaken the section to leave it out. What I want the Minister to do is this: In the old Act the Hospitals Commission have power to inspect; I want the Minister to have that power, and if he says, "the Minister may exercise any or all of the powers specified in sub-section (6) of Section 14," he gets everything he wants.
I wonder what is the effect of amendment No. 5, which allows them to come in.
I think the difference is that one amendment has to do with one point, and another has to do with a different point—namely, with regard to the complaints section.
When that amendment was put down, I understood it was going a certain distance to meet the case we had put up, but I saw the insuperable objection to it—that it was not an invitation to anybody to join, whereas I understand the Minister's desire ought to be to get hospitals in. As far as the hospitals themselves are concerned, an undesirable situation might arise in which somebody in some part of the country would ask: "Is that hospital one which is attached to the bureau?" and receive the reply: "No." From that, some consequence or disability might flow, and it might be under a stigma because it was not. I am sure that is not the desire. I should prefer that the hospital bureau be of the sort that it would be open to every hospital to join it, but that a hospital would not subject itself to the penalties and inspections unless it desired to do so. If it is going to give something for nothing, I do not see why it should not be acceptable.
Is amendment No. 5 being discussed?
Except in so far as it bears on amendment No. 1. The point seems to be in dispute.
This is possibly extending the matter further, but I think it is relevant. I understand that the Minister gave a promise on the last occasion, and that that promise pretty definitely applied to the whole of the matters objected to in the Bill. He was going to have this matter of complaints refer only to hospitals which under the Act accepted subvention from the Hospitals Sweepstakes. If that was meant—and I understand it was— surely amendment No. 5 does not help us, as the Minister would keep in as a definition of an "assisted hospital" what is there already, and that is retrospective. Then, when you come to Section 4, regarding complaints, they refer to "assisted hospitals". Amendment No. 5 excludes them from the bureau, and simply says you shall not include in the bureau amongst the hospitals any hospital to which no grant has been made out of the Hospitals Trust Fund after the passing of the Act.
What I mean by "assisted hospital" is any hospital that accepts a grant after the passing of the Act.
Does not sub-section (1), paragraph (a) exclude those which received a grant prior to the passing of the Act?
Yes; it includes them in the definition of an "assisted hospital" and then under Section 4 complaints can be made against a hospital which refuses grants hereafter but which has taken them before.
The Minister says that it is his intention to describe an "assisted hospital" only as a hospital which took a grant after the passing of this Act. If that is the Minister's intention, paragraph (a) is clearly bad, and should go, as it brings them into that category of assisted hospitals, that is, hospitals which accept a grant prior to the passing of the Act.
I see that they are included in one exclusion under amendment No. 5, but that exclusion is limited to the bed bureau business and does not extend to the complaints section. If amendment No. 5 were accepted and the present definition of an assisted hospital kept, it would be possible to have the complaints section worked against a hospital which takes no money hereafter but which took it before. I should like to see where the exclusion is with regard to Section 4.
It is in amendment No. 16, which takes out assisted hospitals.
The whole thing, then, turns on the point that, regarding the bureau, the committee would be asked to consent. That leaves only Section 6.
It is the Minister's intention to describe as "assisted" only those hospitals which receive a grant after the passing of the Act. That is not carried into effect by paragraph (a), which includes the lot.
Paragraph (a) describes an assisted hospital as one which received a grant prior to the passing of the Act. Is not that so? Paragraph (a) of sub-section (1) describes an assisted hospital as one which has participated in any sweepstake promoted under the Public Charitable Hospitals Acts, 1930-32, or under the Public Hospitals Act, 1933 (No. 18 of 1933). There is, therefore, included in the category of assisted hospitals certain hospitals which the Minister says he does not wish to include. I take it that the concern of the leader of the Opposition is to have excluded these very hospitals which the Minister says he does not want included. Can we not find a form of words to give effect to the purpose of the Minister, which is common to the purpose of the leader of the Opposition?
If the words "promoted under the Public Charitable Hospitals Act, 1930-32" were taken out, I think it would meet my case.
Then it would be "which participates". Do I understand that we are clear—that the House on both sides is clear—that there is no intention to embrace in the words "assisted hospital" any hospital which up to the present has got a grant?
That is quite clear.
I submit that there is no suggestion of that anywhere in the Bill. The Minister refers to amendment No. 5, but there is no reference there to "assisted hospitals." It concerns the bed bureau. Cannot a hospital join the bed bureau without being an assisted hospital? It can, obviously, because the hospital may join the bed bureau without getting assistance. It may be anxious to do so, and the Hospitals Commission and the advisory committee may be anxious that a hospital not getting any assistance should join it. I put it to the Minister that there is nothing whatsoever in this Bill which applies the definition "assisted hospital" as he now says it is his intention to apply it. In fact, if he put the words "any hospital which participates or which shall participate," it would be all right. But he says that he does not want to include hospitals that have participated up to now. Can we not make that clear? My reason for asking that question is that it seems to be absolutely clear that the Minister's definition does not include what he means. I think that, if the Minister were to make his meaning clear, we could have absolute agreement on that point.
I am only concerned with regard to Section 6.
So long as you have that phrase in the new section, "that he may exercise in relation to every assisted hospital," and so on, then, of course, you are bound to watch the conditions with regard to each assisted hospital. Why do you need that section? How is Section 2 (2) weakened by leaving out the words "every assisted hospital"?
Let us put it this way. Suppose that there is a hospital that has actually received a grant up to the present but that does not now apply for any grant, or will not apply for any grant in future; will the Minister show me where such a hospital is excluded from the operations of various sections of this Bill, including Section 6?
Would it meet the Minister's position if he were to accept, on this Committee Stage, Deputy Cosgrave's amendment, in principle, with a view to bringing in an amendment on the Report Stage? The Minister has stated his intention to bring all hospitals taking grants within the provisions of Section 6. Perhaps the Minister might find it convenient to accept Deputy Cosgrave's amendment in principle, on this Stage, and then bring in an amendment, on the Report Stage, that would be effective in that regard; or else, perhaps, the Minister might accept Deputy McGilligan's proposal—in other words, instead of bringing in such an amendment, to amend Section 6 in such a way as to give himself the same powers as are enjoyed by the Hospitals Commission at the present time in regard to all hospitals.
Or assisted hospitals.
Well, I understand that at present it is in regard to all hospitals.
In regard to all hospitals that would fall under the Minister's definition "assisted hospitals" at the moment.
Under the Act of 1933, the Minister has powers in regard to all hospitals that are being assisted. Now, the plan is to extend those powers, and those powers only, to somebody authorised by the Minister. I suggest, therefore, that if there is just a transfer of the straight powers as expressed in the Public Hospitals Act of 1933, a deletion of paragraph (a) of Section 1 of this Bill might meet the Minister's requirements. However, if that should not meet his requirements, then, perhaps, the Minister might produce, on the Report Stage, a substitute for paragraph (a), clearly manifesting the will of the House in regard to hospitals that may accept grants hereafter—that they shall come within the scope of the Bill that we are at present discussing. There is no need for anybody to apprehend a trap being laid in this case, because I think we are all in substantial agreement.
I do not see why the Minister cannot bring forward an amendment that would put definitely into the Bill what he has just now expressed. Would it meet his views if, in regard to Section 6, we were to have something to the effect that all the powers now enjoyed by the Hospitals Commission shall be enjoyed by the Minister; and would he then bring in an amendment, in connection with Section 1, making it quite clear that "an assisted hospital" does not mean, for the purposes of this Bill, any hospital that received a grant before the passing of this Bill, and also making it quite clear, on Section 6, that he is taking for the Minister powers that already exist, and thus get over his difficulty about the words, "assisted hospital"?
If amendments Nos. 5 and 16 are carried, does the phrase "assisted hospital" come into any section except Section 6 (2)?
Yes, I think it does. It comes into Section 3 (1).
But that is going to be amended.
But the phrase "assisted hospital" appears in the amendment also.
I know it does, but then it goes on to make certain exclusions.
I think that amendments Nos. 5 and 16 make the position quite clear.
When you have defined "an assisted hospital" to mean any hospital which has received a grant, it is quite obvious that you cannot then define it to mean something completely different.
In amendment No. 16 the proposal is to delete the words "an assisted hospital."
But that raises the other point that Deputy Cosgrave raised—that a hospital that receives no assistance, and yet joins this bed bureau system, is subjected to all these things.
Well, if you want to work all the hospitals together in this connection, would it not be right that they should be subject to the same regulations? In other words, I should imagine that you could not operate this thing at all unless they were to be subject to the same regulations.
I would ask the Minister to look at this matter from the point of view of the hospitals. Certain of these hospitals may be willing to forego a very substantial grant for what they consider to be a principle, and also because they are in favour of non-interference, and yet, because they are willing to co-operate in the working of this bureau, they are to be subjected to all these conditions. Is that reasonable? I think it may be taken for granted that a hospital that refuses a grant of £500,000, or whatever the sum may be, must have substantial grounds for refusing such a grant, and I think that they should not be subjected to all these conditions, merely because they are willing to co-operate in this scheme. I think that the Minister should look into the matter from the point of view of these hospitals.
But when you set up a bureau such as this, you have certain regulations there, and how can you operate such a system if you are to make certain exceptions?
The exceptions are these: in so far as this advisory committee, which is in charge of the bureau, is concerned, there would be no objection, but why should there be an objection to an outside body?
I am not referring to objections at all. I can see that they may have objections, and I do not mind that, but what I am trying to convey is that, in order to operate a bed bureau, you cannot have one hospital operating under one set of regulations and another hospital operating under another set of regulations. If we were to make exceptions, I do not see how you can possibly operate such a system as this. In any case, they will know the regulations before they go in.
Surely, that is a new point. The present amendment that we are discussing is in relation to paragraph (a). I think that the point referred to by the Minister would arise on his own amendment, No. 5. We are all agreed as to what we want to do, and that is with regard to the definition of what is "an assisted hospital"—in other words, a hospital that has taken a grant after the passing of this Bill into law. Our difference is that we say that paragraph (a) does more than that, and the Minister says that it does not do more than that. Is not that our difference?
That is so.
That is our difference. Have words lost their meaning? "Each of the following hospitals shall be an assisted hospital for the purposes of this Act." There is no obscurity in that sentence. We have three categories of hospitals liable to that description—category (a)—any hospital which has participated in any sweepstake promoted under the Public Charitable Hospitals Acts. Now, hospital X applied for and got £10,000 in 1934. Is not that an assisted hospital for the purposes of this Act, even though it notifies the Minister that it will never take another grant under any of these Acts? I would ask the Minister either to strike that paragraph out or add to that paragraph the word "hereafter"—making it read: "any hospital which has participated in any sweepstake promoted under the Public Charitable Hospitals Acts, 1930 to 1932, or under the Public Hospitals Act, 1933 (No. 18 of 1933) after the passing of this Act." Either thing will meet the proposal of the leader of the Opposition—strike the paragraph out or make it apply only to participation after the passing of this Act.
The draftsman advised me that amendments Nos. 3 and 5 meet that point.
We all have the greatest sympathy with the Minister in dealing with draftsmen who are a specialised kind of person, but it is not fair for the Minister to ask this House to surrender its entire intellect to the draftsmen.
I am only putting my own view.
I quite agree, but I think the Minister will agree that where the draftsman says that the word "no" means "yes" there comes a point when this House must say that we disagree with the draftsman and we think we ought to change what the draftsman says. I put it to the Minister that if he takes that out no irretrievable damage is done. He can put it back on the Report Stage if he finds that the Bill will not stand without it, but, surely, if he takes that out and deletes the words referred to by Deputy McGilligan in Section 6, the Minister has all he wants. Will the Minister put in the words: "any hospital which has participated in any sweepstake promoted under the Public Charitable Hospitals Acts, 1930 to 1932, or under the Public Hospitals Act, 1933 (No. 18 of 1933), after the passing of this Act"?
If the Deputy likes, I will look into it between now and the Report Stage.
The Minister said a hospital need not join this bureau. The advisory committee is a body that is consulted with regard to the regulations, and why, if it were going to come in, should not it take part in the framing?
And may the regulations not be changed? There is one point I had not noticed before. The Minister has undoubtedly cause to be doubtful as to whether sub-section (2) of Section 6 carries him all the way he wants to go by reference to the other Act. I think that can be met by a simple amendment. If the Minister's amendments are put in, it goes very nearly the whole way with what is sought to be achieved by the amendment we are discussing, with this exception—it is possible to contemplate a hospital which will not take grants because it does not want to get in under the onerous sections of this measure and yet would like to facilitate the establishment of a bed bureau system for the purpose of providing information. The moment it gets into the bed bureau system it definitely then becomes subject to the complaints section. It seems to me to be a little bit odd. I think that was a draftsman's device, but it is a device which has landed us in that rather peculiar position. I can understand that if you are going to take funds from the Hospitals Trust Fund you are going to be subject to inquiry and complaints, but I am speaking—and Deputy Cosgrave is speaking—of the hospitals which will not take grants but which would like to join in the bed bureau system to provide information, but would not want to get into the bed bureau system if it means they are subject to the complaints.
May I inquire is it the Minister's intention to accept the amendment proposed by Deputy Cosgrave to the complaints section, that is amendment No. 13?
It is a reasonable kind of amendment.
That would have the effect of making this advisory committee a management committee.
In any case, the Minister is going to resist 13?
We can debate that when it arises.
I move amendment No. 2:—
In sub-section (1), page 2, line 27, to delete the words "or assisted by."
This is to make it clear that a hospital which may receive a hospital grant from a local authority and not from the Sweepstake Fund can be excluded. I had a certain hospital in mind at the time which I thought was getting a grant from the corporation. I find now that it is not but there may be such hospitals in the city which may be regarded as assisted hospitals, getting some grant from the corporation, which might not like to come into this bed bureau system.
I take it that is on all fours with amendment No. 24 and that is really bringing the hospitals mentioned in sub-section (6) of Section 14 of the Public Hospitals Act, 1933, into line with the definition of assisted hospital. You are cutting out exactly the same phrase.
Section 1, as amended, agreed to?
Subject to the Minister's undertaking to give effect to our common purpose of excluding all hospitals who took the grant prior to the passing of this Act from the definition of assisted hospitals.
I move the following amendments:—
3. In sub-section (1), page 2, line 35, to insert before the words "The Hospitals" the words "Subject to the provisions of the next following sub-section,".
4. In sub-section (1), page 2, to delete all the words from the word "for" in line 37 to the word "information" in line 39, and substitute the words "whereby the admission to some one of such hospitals of persons requiring hospital treatment will be facilitated and whereat information as to the accommodation available from time to time in such hospitals can be given".
5. Before sub-section (2) to insert the following new sub-section:—
(2) Where a bureau in relation to any hospitals is established under this section, there shall not be included amongst those hospitals any hospital to which no grant has been made out of the Hospitals Trust Fund after the passing of this Act, unless the governing body thereof consents to such inclusion.
I think we can take these three amendments together. Amendment No. 3 will ensure, with amendment No. 5, that the Bill will only enable a bureau to be established in relation to hospitals which receive grants after the passing of the Act. I thought that would be wide enough to meet any hospital. That is the intention of that. Any hospital that has not received a grant after the passing of the Act, unless it voluntarily consents to come in, will not be brought in.
Into the bed bureau?
But not into the Act?
I am quite satisfied that, as far as the bureau is concerned, they need not come in if they do not want to.
Amendment No. 5 is very important, and in regard to the viewpoint with which I am concerned, there is very little difference between it and amendment No. 1. I would not be satisfied that this amendment should pass the Dáil unless there were certain reservations, certain safeguards, to put it in its lowest terms, I should say a verbal assurance from the Minister, the nature of which I shall indicate later. With your permission, Sir, I should like to quote from an interview given to the Irish Independent on May 6th by a high medical authority in Dublin. At the beginning of this interview it is stated that the Ministerial amendments to the Public Hospitals (Amendment) Bill do not meet the hospitals objections. Further down it states:
"As far as I understand the situation, not one voluntary hospital will work any scheme which provides any opportunity for State control directly or indirectly.
"We will not tolerate control which would be detrimental not only to the hospitals, but to the whole Dublin School of Medicine. That is something which should not be lost sight of."
It further states:
"State control could lead to imperfections in the training of medical students, and, therefore, impair the future efficiency of the profession as a whole."
Does the Minister realise that if what this esteemed gentleman states has official support from the voluntary hospitals, the victims will be the sick poor of Dublin who have been victims for so long of the inefficiency of the administrative and governing authorities of the voluntary hospitals on the one hand, and of the complacency of the Government on the other, in hoping that this problem would eventually solve itself? If it is true that the voluntary hospitals are not prepared to co-operate in the working of this measure, and are given a chance of backing out at this stage, does the Minister not realise that the voluntary hospitals will become private institutions instead of semi-private institutions as they are at present, and that the suffering poor will suffer on? Does he realise that if the voluntary hospitals take advantage of the loophole it so generously provides, the net result of all these years of messing about with the hospitals problem, all these years of flirtation with and wooing of the voluntary hospitals by the Local Government Department, and all these years of abortive negotiations between the Government and the voluntary hospitals, and between the voluntary hospitals themselves, will be, firstly, to decrease to an alarming degree the few beds available for the poor at present, and secondly, to waste irrevocably the hundreds of thousands of Hospitals Trust funds already showered on these hospitals? The point that strikes me in connection with the rather sharp controversy which has been going on for some time——
The Deputy is going back into a general statement on the whole Bill. He must relate his remarks and quotations to the amendment we are discussing.
If you will give me an opportunity, Sir, I will relate what I am saying to the amendment. I have already quoted the views of a high medical authority in Dublin who interprets the various Government amendments as State control, and has indicated that if these amendments are carried, the voluntary hospitals will not support the bed bureau scheme. I am developing the point, that as a result of that the whole effect of this Bill will be negatived, and I think I am quite in order in referring to these points at this stage. I do not wish to criticise severely the voluntary hospitals, but I should like to know why the voluntary hospitals resent even the minimum degree of State control, and why the voluntary hospitals are so much afraid of what they consider to be State interference.
I had thought I would be quite in order in referring to something which has been stated over and over again in connection with this measure— namely, that the hospitals were in danger of becoming subject to State supervision. I should like to be informed by any Deputy if he seriously believes that the medical profession as a whole accept that the glory of the Dublin medical schools would be in any way dimmed by the direct or indirect supervision by the State over the admission of patients into these voluntary hospitals.
I am afraid the Deputy is wandering a little beyond the scope of the amendment we are discussing.
I have no desire to transgress the rules of order, but I took it for granted that, on account of what might be regarded as authoritative references to this amendment in the public Press, I would be given the opportunity of referring to them. However, I am quite content to abide by your ruling, and I will be satisfied by asking the Minister if he will give the House an assurance that, in the event of the voluntary hospitals withdrawing from the bed bureau scheme, in such a manner as to make its effective working impossible, he will take immediate steps to establish a State hospital. It is only under those circumstances that I could consider supporting this amendment and, if that undertaking is given, I shall readily withdraw my opposition to it.
I do not think the Minister explained amendment No. 4. Perhaps he might do so now.
The purpose of the amendment is to make it clear that the main part of the function of the bed bureau is to facilitate the admission of patients into the hospitals. It is merely designed to make the position clear.
I can read that much. What does it mean?
I suggest that amendments Nos. 3 and 5 be taken together.
I suggest that amendments Nos. 3, 4 and 5 go together. The Minister put them forward together.
The Minister has told me what is in the amendment, but what I want to know is what does "facilitate" mean? We discussed on Second Reading a Bill in which the main purpose of the bureau was to provide information, and we now have an amendment which makes the main purpose one of facilitating, and the providing of information the secondary purpose. I do not know what the Minister means by "facilitating". I presume that it means something more, by reason both of the necessity which the Minister found for putting it in and the place it occupies in the amendment, namely, as the first of the two limbs. It is that which governs the second, and not the second which governs the first. The "facilitating" rules the giving of information—not the giving of information which rules the "facilitating." I must assume, therefore, that the Minister has a great deal more in his mind than was originally in the Bill, and I want to know what it is.
There is nothing more in it than is in the amendment. It is designed to clarify the position as to the purpose of the bed bureau. It is intended that it should obtain the information, and that that information, when obtained, should be at the disposal of medical practitioners and others, so that they may ascertain where they can be facilitated when they ring up this bed bureau. There is nothing more in it.
With all respect then I do not see what is the necessity of the amendment at all. Providing information and having it at the disposal of the people who wanted it had been already covered by the Bill. That was obviously already in the Bill. Now the Minister puts in as the principal portion of the amendment, the facilitating. If what the Minister intends as the main purpose of the Bill is the providing of information, and to see that that information is disseminated to the proper quarters, then the two limbs of the amendment should be reversed so that it will be quite clear that the providing of the information is the principal thing and that the second, namely, the facilitating, has reference, as the Minister has now said, to the information and nothing else. The Minister says it clarifies. My objection is that it does the very opposite because it puts in here a vague phrase that could mean anything. It could mean grave interference——
I do not think it is vague.
It is vague in the sense that it could mean anything. It is not limited, by any means, to giving information; on the contrary, it is far wider than that and, if the bureau functions, it might mean serious interference with the hospitals. I think if the Minister will think it over he will see that that is obvious. Surely it is not designed to do anything but to give information? There are two distinct things.
Surely the purpose of giving the information which the bed-bureau will supply will be to facilitate practitioners in securing the admission of patients? If that is not the purpose of giving such information I do not know what the purpose is. I should like to emphasise this point. If the hospitals withdraw to such an extent as to create an acute shortage of beds, the information provided for practitioners would merely mean that there were no beds available. I should like the Minister to indicate whether he has considered that possibility.
In regard to what Deputy Hannigan has said, I have hopes that when the Bill is passed we shall have the co-operation of hospitals. I do not think that it is going to serve any purpose whatever at this Stage to make threats, either veiled or otherwise. I have seen what some doctor has written in the paper, but, on the other hand, I have met the members of the Medical Union and we have got a fair amount of accommodation from them. I think the spirit is there to co-operate. I should not like at this stage to say that there is no alternative to this being done. I do not think that is the way to get co-operation. With regard to what Deputy O'Sullivan has in mind, that will be governed by the regulations. The phrase is simple enough. There is nothing sinister behind it. There is no intention of anybody inspecting hospitals for any purpose except to see that beds are available.
What the Minister aims at now was already in the Bill.
If the Deputy wants it that way, this is a drafting amendment.
If the Minister will make it absolutely clear that it is limited to information I am satisfied.
The Minister pointed out that he met members of the Medical Union. Am I right in saying that they were the representatives of the hospitals section? Will the Minister tell me the date when he met these representatives?
I think it was Friday last.
What date was that?
The reason I ask the date is that the interview, to which I have previously referred, appeared in the Press on the 6th, and it was given by a person who has been spokesman on at least one or two occasions for the hospitals. That is why I am so keen on pressing the point.
With regard to amendment No. 4, would the Minister consider reversing the two phrases in the amendment, one starting with "whereby", and the other starting with "whereat", so as to put the supplying of the information first? That ties on to the admission, and it makes the information side prominent. The giving of information is the thing that stands out in the Long Title.
Will the information that the bureau gives refer to all the beds in the hospital or to the number of what are erroneously termed free beds only?
It will apply to the whole public hospital. There might be a number of beds for which patients paid 10/- a week which might be available.
Is not the phrase general—"information as to the accommodation available from time to time in such hospitals"?
It applies only to the public hospital.
The phrase is very general.
These regulations will be made in any case by the advisory committee.
Information is not expected as to the accommodation in private hospitals or private homes.
It is not.
As regards amendment No. 5, do I understand that the Minister still objects to the idea of a hospital that does not receive a public grant in future—I mean a grant from the Sweepstakes Fund— coming into the bed bureau system?
I do not see how it could work.
I thought you had objected to it.
It is not right to say I objected to it. If the advisory committee sets up regulations, I do not see how they are ever going to work if you have one hospital that stands outside these regulations. I am quite sure that the bed bureau would be delighted to get information if there were beds available in it, though they would not have these rights.
I assumed that the Minister might have some reason for objecting to it.
I move amendment No. 6:—
In sub-section (2), page 2, line 41, to delete the words "The Minister" and substitute the words "The Hospitals Commission, after consultation with the advisory committee established in respect of such bureau under this Act and with the approval of the Minister,".
This is designed to enable the Hospitals Commission, after consultation with the advisory committee, and with the approval of the Minister, to make these regulations.
Might I ask what is the advantage of this?
Objection was raised the last day to the Minister making the regulations.
I object equally to the Hospitals Commission. I thought it was the advisory committee would have the making of the regulations subject to the approval of the Minister.
The medical people seemed to take the view that the Hospitals Commission should make the regulations.
I gathered from the discussion the last day that it was the advisory committee would have the making of the regulations subject to the approval of the Minister.
I move amendment No. 7:—
In sub-section (2), page 2, lines 43 and 44, to delete the words "impose duties on the governing body or on" and substitute the words "define the duties of the governing body or of"
I indicated on the Second Reading that I would move to delete the word "impose" and put in something more palatable. I propose to substitute the word "define".
A very important point arises in connection with this amendment and I would be grateful to the Minister if he could meet me on it, because I believe it would remove a very grave objection that has arisen in the minds of certain interested parties. The amendment, if incorporated, will cause the sub-section to read as follows: "The Minister may by regulations prescribe the manner in which any bureau established under this section shall be carried on and such regulations may, for the purposes thereof, define the duties of the governing body or of any person taking part in the management of any of the hospitals concerned including, in particular, duties in regard to the admission of patients to such hospital..." The Minister's object is to enable himself to make regulations with regard only to the admission of patients to the hospital and to the demanding of information as to the accommodation available in the hospital. Under the section, as it would stand if amended, he is entitled to define the duties of any person taking part in the management of any of the hospitals concerned and, in particular, duties in regard to the admission of such patients. I ask him to delete the words in lines 45 and 46 "including, in particular, duties", so that his power would relate exclusively to matters arising from the admission of patients to the hospital and the furnishing of returns.
It might appear that the words which I ask him to delete do not extend the scope of his powers beyond that. But I put it to the Minister that any court would read these words as implying that he had the right to make regulations in regard to any matters, but especially in regard to matters of admission and the requisitioning of information as to the accommodation. It is certain that the deletion of the words which I would like to have deleted will not weaken the section for his purpose, and, though in fact it may not improve it from my point of view, I believe it will, and I have good opinion of a legal kind to support my own that the deletion of the words would materially improve it and remove the danger which interested parties greatly apprehend.
The Deputy was kind enough to mention this matter to me beforehand. I have been looking into the matter, and I think this is governed by the phrase, "for the purposes thereof," namely, setting up a bureau. I think that in that general way it governs the rest of the sub-section. You might have such a position as this. Regulations might have to be made to look up records or see what the records were, or the number of patients in the hospital at the particular time. I am afraid that you might confine this too much if you do not leave something there to make general regulations for the purposes set out in the section, which are really relating to these particular duties here. I do not think there is very much in it, and if the Deputy will leave it over until the Report Stage, I will see if it can be done. Perhaps it can be done with safety. The Deputy knows what the purpose is, and if it can be done with safety without limiting this power, which really is the particular power, I would be prepared to meet the Deputy's point.
I am much obliged. It is difficult in choosing a reductio ad absurdum to avoid being extravagant, but it is hard to think of an obvious case at the moment. The Minister, however, will realise that if he has power to make regulations in regard to the admission of patients and the furnishing of information, those words would clearly give him the right to make any regulations which a court would hold were ancillary or vital to the admission of patients to the hospital. But if you widen the scope, the court might reasonably hold that the Legislature did not widen the scope without reason; that they must have meant something, and they would not inquire, as the Minister knows better than I do, into what was in our minds. They would simply read the Act as it stands, and assume that we had not put words into the Act which were not, in fact, necessary. Therefore, if the Minister, between this and the Report Stage, finds that it does not make any difference, I ask him to interpret it in my favour.
What does the phrase "hospitals concerned" mean? I presume it means a hospital in relation to which a bureau has been established and not an assisted hospital?
That is so.
I move amendment No. 8:—
At the end of the section to insert the following new sub-section
(4) Every regulation made under this section shall be laid before each House af the Oireachtas as soon as may be after it is made, and if a resolution annulling such regulation is passed by either such House within the next subsequent twenty-one days on which such House has sat after such regulation is laid before it, such regulation shall be annulled accordingly, but without prejudice to the validity of anything previously done under such regulation.
That is the usual provision for laying regulations on the Table.
I move amendment No. 9:—
To delete sub-section (1) and substitute the following new sub-section:—
(1) Where a bureau is established under this Act in relation to two or more assisted hospitals—
(a) there shall, by virtue of this paragraph, be established an advisory committee in respect of such bureau;
(b) such committee shall consist of a number of members equal to the number of such hospitals;
(c) each of the governing bodies of such hospitals shall, from time to time, as occasion requires, appoint a person to be a member of such committee and notify the Hospitals Commission of such appointment;
(d) whenever the governing body of any of the said hospitals is required to appoint a member of such committee, the Hospitals Commission may, by notice in writing, request such governing body to make such appointment, and if such governing body fails, before the expiration of fourteen days after the giving of such notice, to make such appointment and notify it to the Hospitals Commission the Hospitals Commission shall inform the Minister accordingly, and the Minister shall appoint such person as he thinks fit to be a member of such committee, and the person so appointed by the Minister shall be deemed, for the purposes of this sub-section, to have been appointed by such governing body.
I indicated on the Second Reading that it was not intended to interfere with the nominations of the governing bodies. This amendment makes that position clear.
I move amendment No. 10:—
In sub-section (2), page 3, in line 7, to delete the word "appointed" and substitute the word "established", and in line 9, to delete the words "they were appointed" and substitute the words "such committee was established".
This is a drafting amendment.
I move amendment No. 11:—
To delete sub-section (3) and substitute the following subsection—
(3) The Minister shall fix the tenure of office of the members of any committee established under this section.
This is intended to fix the tenure of office of members of the committees. I suppose it can be fixed. I cannot fix a term of two or three or five years. That will depend a good deal on how these boards of management are constituted, and will be a matter for adjustment afterwards.
In any event, it means that the tenure will be of the committee and not of the members.
Or will be fixed generally.
I move amendment No. 12:—
In sub-section (4), page 3, line 17, to delete the word "appointed" and substitute the word "established".
This is a drafting amendment.
I move amendment No. 13:—
Before sub-section (1) to insert the following new sub-section:—
(1) Where a complaint is made to the advisory committee that any person was unreasonably refused admission as an intern patient to an assisted hospital or that the treatment of any person admitted as an intern patient to an assisted hospital was unreasonably delayed, the advisory committee shall consider such complaint and the grounds thereof and if they are of opinion that such complaint appears to be well founded and of sufficiently serious character to warrant their so doing report thereon to the Minister who may, if in his discretion he so thinks proper, cause an inquiry to be held in relation to such complaint and may appoint a person to hold such inquiry.
This amendment seeks to place the entire responsibility on the advisory committee for dealing with complaints in connection with non-compliance with the regulations. The section as drawn indicated the general trend of this Bill before the amendments came along, and it had all the appearance of one dealing with those Union hospitals worked under the Medical Charities Act. It gave all power into the hands of the Minister, and placed him in a position to receive complaints from all quarters. That is not desirable. What is the purpose of this Bill? Is it for the purpose of finding accommodation for doctors' patients who want to get into hospitals, for the poor, and so on? If so, then those who are going to work the Bill are the persons upon whom responsibility should lie, more than on the Department of Local Government and the Minister. Assuming that a complaint is made, the advisory committee will consider it. No one wants to have a single complaint in the administration of this Bill, but where there would be non-compliance generally with the regulations, and with the principle of providing beds, that should afford scope for investigation, but not for complaints such as obtained under the old regulations where a workhouse patient could demand and get a sworn inquiry. I am sure that is not intended here. If this Bill is to be a success at all it will require the cordial co-operation of the hospitals, the advisory com mittees and others and it should be their responsibility to deal with complaints. If the occasion arises and if a committee is satisfied that any of the hospitals are not doing their duty, then it is a question of having an inquiry held. That should not be a single decision. I am not ruling out a particular case in a matter of that sort.
The next amendment, No. 14, will meet the Deputy's point to some extent. Taking the Minister out for the time being, if a complaint is made to the Hospitals Commission they consult the advisory committee, and any rare case that may occur— and I hope there will be no case—can be reported to the Minister. 90 per cent. of the cases will be satisfactorily dealt with by the committee. If there is still a feeling that there is something more in the complaint, and that it should be investigated by some people who are not interested one way or the other, I suggest, in the interests of the advisory committee, that it should not be investigated by them if the Act is to work smoothly and effectively. You want somebody who can stand between the Minister and this body, and that is why I put in the Hospitals Commission if a complaint is made in any rare case that may arise.
The Minister has more or less crystallised my objection. Assuming that the hospitals are in a class by themselves, and this seeks to inspect and to control them, they will have two masters under the new dispensation, the Minister and the Hospitals Commission. I looked up the personnel of the Hospitals Commission. It changes occasionally. It is a peculiar situation to have an alternating body almost in a supervisory capacity. It is inadvisable to draw comparisons, but some of the advisory committees set up by the hospitals will be much more likely to be responsible bodies than the Hospitals Commission. They have experience of the administration of hospitals, and will be interested in making the bureau scheme a success. They will be representative of the various institutions that have been responsible for treating a very large number of the poor for the last 20 or 30 years. Why should they be placed in an inferior position, and not be allowed to exercise not only the direction in which the bureau should be run but to pronounce whether it is a success? It is very hard to see why they should not be allowed to do so, unless we want to see the country regimented in such a way that nobody but the nominees of the Minister or the Government, as the case may be, will be in a responsible position. It is very undesirable to have the governing committees of ten or 12 hospitals in the City of Dublin in this position. They have administered these hospitals, they know their needs, and have much greater experience in these matters than the Minister, his predecessor, or his predecessor's predecessors, or any officials in the Department.
Why should not those who have been so long associated with the management of the hospitals have this responsibility? The complaint is made to the Hospitals' Commission. I see no reason why it should not go from them to the advisory committee to be dealt with. I am sure the Minister does not desire to have this whole business so regimented that those concerned must always be looking either to the Hospitals' Commission or to the Customs House. I am sure that his desire is to get the co-operation of the representatives of the various hospitals in having the necessary beds available when required. Why should not the committee responsible for running the hospitals consider the complaints?
I agree with Deputy Cosgrave that a great deal of valuable work has been done by the hospital committees, but it will be freely admitted that there have been complaints —and numerous complaints—with regard to the hospitals. I am on a public board which frequently receives complaints with regard to the hospitals. I fail to see why there should be any objection to the personnel of the Hospitals' Commission—why there should be any reason to doubt its ability to function because there are not frequent changes in its personnel. It is interesting to note that in the case of many hospitals the governors never change. The only birds of passage are the representatives of the corporation, and they do not enjoy the same privileges as the governors, and may not vote. Virtually, their only function at the meetings is to criticise or praise.
There are two sides to this question. This bed bureau is being set up to provide accommodation for poor persons. This advisory committee will be mainly constituted of medical men. A poor person would, if this committee had to dispose of his complaint, say that there was no use in going there because the doctors would not admit they were wrong—a remark they would apply to another profession in more disparaging form. I think it would be much better that there should be some body with which the advisory committee could consult or which would consult with them, so that when a poor person made a complaint, the whole blame would not be thrown on persons who would be solely representative of the hospitals. The complaints would arise in respect of a hospital or hospitals. I do not think that it would be in the interest of the hospitals that a committee representing them should have the sole right to dispose of these complaints. Even if there were no foundation for the complaints, the people concerned would say that they had little hope of getting redress when they had to go before a body solely representing the hospitals.
There are, apparently, three sets of people concerned. Three sets of people are referred to in amendments Nos. 13, 14 and 15.
We could take these three amendments together.
The Minister's proposal is that the Hospitals' Commission should be the body to receive the complaint. On receipt of the complaint, they would consult with the Advisory Committee and pass on the complaint, if they approved, to the Minister. The Minister would then hold an inquiry.
If the Hospitals Commission were not satisfied after consultation with the Advisory Committee. If they were still dissatisfied with the Advisory Committee's finding, then, that rare case might be taken to the Minister.
The Hospitals' Commission will receive the complaint and they may make up their own minds. Then, they will take it to the Advisory Committee and, with the assent of the Advisory Committee or contrary to their wishes, they can carry the complaint to the Minister who would hold an inquiry. Under Deputy Cosgrave's amendment, the Advisory Committee is the body which would receive and adjudicate upon the complaint. If they think that the complaint is well-founded, they will cause an inquiry to be held. Under amendment No. 15, also by Deputy Cosgrave, the Advisory Committee would receive the complaint and, if satisfied in respect of it, they would report to the Minister and he would cause an inquiry to be held. On the question as to who should be put in the forefront to receive the complaint, we have three bodies before us. That question does not matter very much. The question that does matter is who should have the voice as to whether or not the complaint is of sufficient substance to be brought to the Minister. I understood the Minister to say, in connection with the previous amendment, that he understood the medical view was that they would prefer the Hospitals' Commission to the Advisory Committee.
I said they would prefer them to the Minister. On this particular matter, I cannot say that I have the representative view of the medical profession.
I thought that the Minister said that those whom he consulted preferred the Hospitals' Commission to the Advisory Committee.
No. I said that they preferred the Hospitals' Commission to the Minister.
I can understand that. I could imagine the medical profession accepting the Hospitals' Commission in preference to the Advisory Committee originally proposed under Section 3, because the Minister had a considerable say in matters under that section. Now that we have, under the amendment which has been passed, a fairly free body, there is something to be said for having the Advisory Committee given something more in the way of decision than the Hospitals' Commission. Would it not be possible to have the Advisory Committee put in the forefront for the purpose of receiving complaints? They would, if necessary, consult with the Hospitals Commission, and in the background would be the Minister who would hold the inquiry. It is a question of securing the goodwill of the profession by giving the people who will be representative a little bit more say in connection with these complaints than they will have under this proposal. There is probably not a great deal in the matter.
Amendment put and negatived.
I move amendment No. 14:—
In sub-section (1), line 20, to delete the words "Where a complaint is made" and substitute the words "Where the Hospitals' Commission, after consultation with the appropriate advisory committee, complain."
Amendment No. 15, in the name of Deputy Cosgrave, is consequential on amendment No. 13.
I move amendment No. 16.
In sub-section (1), lines 21 and 22, to delete the words, "an assisted hospital," and substitute the words, "any hospital in relation to which a bureau has been established under this Act" and, in line 23, to delete the words, "an assisted hospital" and substitute the words "any such hospital."
This was designed to make it clear that complaints can arise only in respect of any hospital in relation to which a bureau has been established.
Does this not raise the other point?
I suppose it does.
It raises the point already made.
I move amendment No. 17:—
Before sub-section (2) to insert a new sub-section as follows:—
(2) Such person shall be a Judge of the Supreme Court, High Court or Circuit Court or a practising barrister or solicitor of at least ten years' standing.
This is in connection with the person who would be appointed to hold an inquiry. These are, of course, voluntary institutions. They are not in the same position as bodies that are under the control of, under the supervision of, or requiring the sanction of the Minister. An inquiry is held into a complaint made in connection with the administration of this bureau. It is a complaint, let us say, against the bona fides of any one of these institutions which are associated with one another in putting up a bed bureau. It is a very serious thing for a hospital. It may not, on its face, appear to be very important, but one must consider that no other organisations in the country have been so long and so favourably connected with the administration of charity, charity in its most acceptable form, with none of the disadvantages attached to its dispensation. This system has been operating over so many decades, one might say centuries. To put those people into the position of being one of the State-aided institutions of the country is unreasonable. To that extent and to ensure that there will be no miscarriage of justice and that there will be perfectly fair treatment for all, I put down this amendment.
I do not think there is any justification for appointing a judge or anybody like that to hold this inquiry. The inquiry will be established to ascertain certain facts, whether a person was refused admission as an intern patient to an assisted hospital, or whether there was delay of an unreasonable kind in the treatment of a person admitted. There cannot be much difficulty in elucidating those facts or in assessing the evidence. Even when the inquiry is held there is no power to inflict any punishment. It may be contemplated that the Minister afterwards might say that he would not give a grant, or that perhaps he would restrict a grant if the case were a very bad one, but there is nothing in the Bill indicating that after an inquiry is held he can inflict any penalty.
I imagine that the usual way of carrying out this type of inquiry would be through a medical inspector from the Department. That is what I have in mind—a man in touch with the medical profession, with the hospitals, a man who would understand the working of the hospitals and who could well appreciate why there might be delays in the matter of admission or for the purpose of treatment; a man who could understand why a doctor at a particular time would think it advisable that there would be some delay. What I have in mind is that if such a case arose we might have one of the medical inspectors who would be attached to the Department. That might be the very best thing in the interests of the medical profession and the hospitals.
The Minister has put his finger on the futility of the section. He mentioned that he can stop the grant. In other words, he is going to interfere still more with the poor and with the dispensation of hospital treatment rather than with the complaint made in connection with the hospital. You cannot fine those people. The majority of them are giving voluntary service.
You can publish the findings.
Yes, but what is the use of it, simply dragging people into the Press? To my mind this is an absolutely futile section. Who is going to hold the inquiry? The Minister said it was his intention to appoint a medical inspector. I presume he would do so, but the present Minister will not be there for all time, and this legislation will be there until it is repealed. Again, the Minister's Department has not been associated with voluntary hospitals as such except during the last few years, and then only to a minor extent. His associations and experiences are entirely in another direction. I regard this as an effort to bring regimentation where it can do nothing and where, if it were to attempt to do anything, it would be defeating itself and making itself a laughing-stock.
The Minister's point against the amendment appears to be based on the fact that there are only two matters which would come within the ambit of an inquiry such as is contemplated, complaint as to delay in treatment, or refusal of admission. Of course, that is so, but we all have experiences of inquiries, and we know that inquiries of the kind on which this is modelled have a habit of wandering over a variety of entirely irrelevant topics, perhaps very remotely related to the subject under inquiry. I imagine that this class of inquiry is peculiarly prone to that type of thing. If a person complains of unreasonable delay in treatment, necessarily there will be a certain amount of direct or indirect accusation against medical people, against the nurses, the staff or the administration of the hospital, and these matters will give rise to very diffuse discussions unless there is someone there to control the discussions, someone trained to keep matters within the ambit of the terms of reference. If there is not such a person, I am afraid that sort of thing will be very likely to occur, and may cause very serious injury to individuals.
Under the section as it is drafted the person who will be holding the inquiry will have very wide powers indeed. Some of Deputy Cosgrave's subsequent amendments are designed to keep these wide powers within strictly legal limits. As the section stands, a person who refuses to answer any questions, however irrelevant, however wrong or inadmissible from the point of view of the law of evidence, will be considered guilty of an offence and shall be liable to a fine. The question of what is or is not relevant would be a simple matter, but what I anticipate is just what happens in all these inquiries.
That inquiry is made a platform, a sounding board from which is broadcast a variety of entirely irrelevant complaints against all and sundry. You have a person, say, appointed by the Minister who does not want the charge made against him that he did not want to let everybody have a fair hearing, and the result is that the inquiry is diffuse, and ranges over entirely irrelevant aspects. In the course of that inquiry damage may be done to particular individuals and professional reputations may suffer. While the inquiry may result in completely disproving the charges made, there is the fact that the mud being thrown very often sticks, and the particular person involved in the charges will have no proper means of redress. It was to meet that that this amendment was put down, so that we should have there some independent person who has had some training in the conduct of inquiries and the laws of evidence. The object of the amendment is to secure that such a person should be appointed to hold the inquiry. Deputy Cosgrave did not put this amendment down in the interests of the legal profession or anything of that kind. It is put down merely for the sake of seeing that the person who will be appointed to hold the inquiry has the necessary training so as to see that the issues are strictly confined to the subject matter under that section.
On the point raised by Deputy Costello, I just want to say that those medical inspectors have experience of these inquiries. From time to time a question will arise, and it has arisen in England before two judges there, and before one in this country, that certain persons were privileged. The question is the privilege a doctor may claim as to his patient being treated for a particular disease; that there was more or less a privacy about it, and when questions like that arise a medical man is much better qualified to deal with it than anybody else. I do not see what objection there could be to a medical inspector carrying out such an inquiry. He has had experience of carrying out these inquiries.
Would the Minister amend the amendment and have the word "doctor" inserted?
No; I want to leave it as "medical inspector."
A medical inspector of ten years' standing?
A qualified doctor?
When a matter is reported to the Minister it becomes a Departmental thing and a medical inspector is appointed to carry out the inquiry. You do not take a person from outside.
Would not "medical inspector" be covered by the phrase "doctor of ten years' standing"?
I do not know; perhaps he would.
That only means that he is qualified for ten years.
Anyway I am not accepting it.
Would the Minister accept it without the ten years' standing—just a qualified doctor? I want to keep the ordinary civil servant out of the inquiry. I do not think they would be the proper individuals to hold it. I have no objection to a doctor the very day after he walks out of a medical school but I do not think it should be in the power of the Minister to appoint an ordinary civil servant to hold an inquiry of this kind.
That is rather unfair to the civil servants.
Nobody has the rights of civil servants more at heart than I have. I am taking no objection to them——
That is what I had in mind.
I have stood up for civil servants at the risk of my seat in this House, but I have no use for bureaucracy.
Could the Minister accept the word "doctor" there?
As it stands the Minister need not appoint even a civil servant. He can appoint anybody off the street.
Witnesses at this inquiry are to have immunities and privileges the same as are given in the High Court, and they are to produce documents, documents that probably may not be admissible at all.
I am afraid, Sir, the amendment is too strong for the Minister.
I move amendment No. 18:—
In sub-section (2) (a), line 29, to add after the word "witnesses" the words and brackets "(other than a member of a religious community)".
I am sure the Minister in his piety will not object.
I do object. These people have, from time to time, given evidence at sworn inquiries.
In 1933 there was an inquiry in Roscommon, and two Sisters gave evidence. I asked for only one or two examples. That inquiry was held in March, 1933, by Doctor McCormack. Surely those are things that we need not provide against, that the inspector is going to insist on a member of a religious community giving evidence against her will. We need not provide for such a thing in a Bill.
If they do not attend they are liable to a fine of £5.
They would not have any money to pay it.
They may be on retreat at the time, and the Minister wants to force them by the throttle.
Is the Minister aware of the extraordinary difficulty of getting the necessary permission for a member of a religious community to give evidence in court?
Surely we need not provide against that. I understand that all right.
I think we will have to divide on it.
I wonder is the amendment constitutional?
Has it come to this, that if you impose something you can relieve nobody? Do you not relieve Ministers of income-tax, and that is not in the Constitution?
I am glad that one Minister is upset about an amendment of the Constitution.
Amendment put and negatived.
I move amendment No. 19:—
In sub-section (2) (c), line 35, after the word "document" to add the words "saving however all just and lawful exceptions to the admissibility in evidence of such document."
I am afraid the person holding the inquiry must have some discretion.
The Minister must see the importance of this amendment. The sub-section provides for a prosecution in the event of a witness refusing to answer any question. The questions are very wide. The person holding the inquiry has power to summon a witness and examine him on oath, and where he considers the document in the power or control of such witness to be necessary for the purpose of such inquiry, he has power to require such witness to produce such document. Then under sub-section (4) we have it that a person, "being duly summoned to attend as a witness at an inquiry," and failing to attend, such person shall be guilty of an offence. Any question, relevant or irrelevant, whether admissible or inadmissible, whether covered by privilege or not covered by privilege, the witness can be made to answer, and if he fails to produce a document he is liable to a criminal prosecution. The object of this amendment is to make it possible that at subsequent proceedings the defence will be open to the person to say that the question was not a proper one to be put to him, and he can give the legal grounds for that.
I think it is a reasonable amendment. It will not hamper the inquiry in any way, and I think that the Minister's reply to it has been entirely inadequate. The person holding an inquiry should not have a discretion to say whether or not a document is or is not privileged. I think that is so well known and established that it only needs to be stated. In reference to certain matters, to say that the person conducting an inquiry should have a discretion is, I think, wholly wrong and inadequate. I hope the Minister will not say that it will have to be left to the discretion of somebody to say whether or not a prosecution should take place, because that would pass all patience. I think this amendment is reasonable and necessary for the protection of individuals coming to an inquiry to make their case.
It is too restrictive.
Can the Minister unrestrict it in this way? What is wrong with it? The words are taken from notices to admit certain facts which are served every day in court, so that it is a well-known legal expression.
I think the person holding an inquiry should be in a position to examine documents.
This will not prevent him from doing that. The only point is that, under the section as it stands, a person must produce every document privileged or not, relevant or irrelevant. The object of this is that every person appearing with a document should be able to submit to the person holding the inquiry that he ought not to be made put that document in evidence because of privilege, or for other particular reason. It will be then for the person holding the inquiry to rule on that. If the person refuses to produce the document he can be prosecuted, and can then make the defence that the document is subject to legal and lawful privilege. At the moment, he has no defence, even in the case of the most sacred documents, documents which are covered by the most exclusive and well known privilege. If a document is privileged, it ought not be subject to production at the request of a person who may not possibly understand the vital nature of it.
I am not accepting the amendment.
Does the Minister admit that this would give the person holding an inquiry greater power than a judge has; that he could order the production of the document which may not be admissible in evidence in court?
There may be the possibility that the person holding an inquiry may want to get some document, and though it might go to the root of the whole inquiry, the person producing it might claim privilege for it. I have not in mind what exactly the document could be.
If the Minister follows out his alleged objection to this he will find that, in that state of facts, the person holding the inquiry may say "I must have this document, I rule that it is not privileged and that it must be produced," whereupon the person says "I think it is privileged, and I will not produce it." He is then prosecuted, and there is a legal decision as to whether he is right or wrong. If he is wrong he will have to produce it and the inquiry can go on. If he is right he ought never have been prosecuted or ordered to produce the document. If the person holding the inquiry rules in a certain way he may get the document. If he rules in another way he may not.
Are we to understand that the Minister is claiming that an inspector ought to have power, in regard to the production of documents which the courts might consider inadmissible?
It might be possible.
I move amendment No. 20:—
Before sub-section (4) to insert two new sub-sections as follows:—
(4) Such inquiry shall be held in public and any person interested in or who considers that his interests are likely to be affected by such enquiry shall be entitled to be present and to be heard by Solicitor or by Solicitor and Counsel and to produce witnesses and tender evidence.
(5) The report of the person appointed to hold an inquiry under this section shall be published and such person shall not in his report or otherwise make findings or comments on any person whose interests may be thereby prejudicially affected unless such person shall prior to the making of such report have been given an adequate opportunity of being heard in his defence.
This proposes to insert two additional sub-sections, one of which is to ensure that if a person's interests are likely to be affected during the course of an inquiry, he will have an opportunity to appear there and be represented by counsel or solicitor, and to produce witnesses and tender evidence. The other portion of the amendment is to ensure also certain rights, in order to give a person who would be likely to be prejudicially affected an opportunity of being heard in his defence.
This section was intended as much in the interests of the institutions as in the interests of the people who make complaints. It might not be advisable, in some instances, to have a public inquiry. In the case of some complaints, it might only be a matter of a simple visit to a hospital. It might be quite possible that a visit to a hospital would suffice, and, even where evidence was taken, the institutions themselves might not desire that that evidence should be published. The practice has always been, with regard to such inquiries held by the Department, that counsel and solicitors very often represent the parties concerned, and there is no reason why that practice should not obtain still. In the case of an inquiry that is about to be held, the parties interested are notified and allowed to have their representatives there. That has been the practice in connection with almost all cases of such inquiries. The second matter with which Deputy Cosgrave is concerned is this question of making the reports public. Now, the practice with regard to all these inquiries in the Department is that the reports are regarded as confidential and it is a matter for the Minister to decide whether these reports should be published or not.
That is the practice that it is proposed to follow. Again, apart from that, the institution concerned might not desire to have publication. For instance, if a complaint were made and, on investigation, that complaint were found to be completely unfounded, it might not be desirable to publish the report because, if you do publish it, even though there was no substance in the complaint, some opinion may hang on in the minds of some people to the effect that there must have been something in the complaint, and such people may be inclined to take the matter from the complainant's point of view.
I agree with the Minister there but, on the other hand, if you do not publish it, and the news is spread around that an inquiry has been held and the findings have not been published, what is going to happen there?
That is a matter for the Minister to decide. All these reports are regarded as confidential, and I do not want to put it on the statute that you must or must not publish them.
I take it that the Minister's argument is, that if an inquiry is ordered on some complaint, and the complaint turns out to be of a rather futile type and with no substance in it, if you make the report public, some odium may hang around as a result of that complaint, but surely the best way of avoiding frivolous and futile complaints would be to publish one or two of these reports? I think it would keep the Minister on the qui vive in this matter of whether he should have an inquiry or not. The only alternative is not to have publication at all, but supposing it gets around that complaints have been made, that an inquiry has been held, and that no report has been published, surely all kinds of rumour will gather around in such a case?
Yes, I quite agree that rumours very often do much more harm in a case like that than if you were to publish the report, but surely what would be done in a case of that sort would be to publish the findings. On the other hand, if the complaint that was made the subject of an inquiry was found to be frivolous or unfounded—although it might not have appeared to be frivolous on its face when made—it might not be desirable to publish the report. The point is that you cannot devise a rule or section that would apply to every inquiry.
That is just my complaint against most of the things that have been done by this Government since they came into office—that they will make rules and regulations of every kind dealing with everybody, which cannot be departed from, but that the utmost latitude must be allowed to themselves, their Departments and their officials. Here is a case which involves only one or two matters: (1) whether or not you undertook to provide a bed and refused it, and (2) whether or not you left a patient there in respect of whom treatment was unreasonably delayed. I do not know of any medical officer in this country at any time allowing that to happen, and, to my mind, there could not be anything more objectionable in connection with legislation in this House. I cannot understand how the Minister's own medical officers did not object to this. I consider that it is a slur on the medical profession. I am only arguing in connection with the case of a bed which, according to the records, is shown to be available and which, when the patient goes there, is not available. According to the Minister's own regulations here, he can examine on oath. That, in common terminology, means a sworn inquiry. If the results of such an inquiry are not going to be published, people will say that there must have been good cause for the complaint, but the Minister, in his excess of generosity, does not like to expose these people in the case of frivolous complaints. I hold that that is not fair to any of the hospitals, and I think that this section should be taken out altogether.
Could not the Minister say, in regard to both proposals: "if the advisory committee so request" that the inquiry will be held in public?
It only arises after consultation between the advisory committee and the Hospitals Commission. I do not see how you can bring back the advisory committee to deal with that.
Why not? Let them be the people to decide whether or not an inquiry should be held, or whether the report should be published.
What I have in mind is that there might be a case where an inspector goes down to a hospital as a result of a complaint, and there might not be any inquiry of that kind at all.
Surely, that would arise in connection with the advisory committee, and they would say that this was not a matter for an inquiry at all, but just for somebody to make a visit and report on the matter. It is only a question of getting somebody who can claim to represent the hospitals to decide whether or not an inquiry should be held, and whether, if held, the report should be published or not. Let the advisory committee say whether the inquiry should be held in public or not, and whether the report should be published. There is nothing else involved.
I move amendment No. 21:—
To delete sub-section (4).
It is obvious that if amendment No. 21 is negatived, Nos. 22 and 23 cannot be moved.
No. 21 is to take out the whole of the sub-section.
If the sub-section stands, the subsequent amendments may not be moved.
I might support it myself, subject to modification, but I would prefer to see it going out.
Is it necessary to put it in that way? Might I make a suggestion—supposing the motion was put in this way: "The motion is that the sub-section be deleted"— then, if it is not deleted, surely the other two amendments could be moved.
As it is proposed to add words, the amendments are permissible.
The Minister told us that he does not know how he can penalise one of these institutions if a report from the person holding the inquiry was found to be against the institution. In other words, if the institution was at fault, he cannot penalise the institution. Under the sub-section a witness at an inquiry shall be deemed guilty of an offence if, after being duly summoned to attend as a witness, he fails to attend. I can conceive the case of a surgeon engaged in an operation. He is liable to a penalty for not attending. Any person who, being in attendance as a witness at such inquiry, refuses to take an oath, produce a document, or answer a question where required so to do by the holder of such inquiry, is liable to a penalty. A person objecting to, or being unable to attend, or, at his own discretion, not answering a question renders himself liable to a penalty, and the hospital, which is the subject of the inquiry, is not liable to any penalty.
The real point with regard to this is that it is an indignity. If an inquiry is an inquiry to discover something, is it necessary to impose penalties such as this in order to get evidence? This assumes all the characteristics of a sworn inquiry under the old Poor Law system, as it was known. You have a suspicion that they will not answer, and you are satisfied that it is necessary to impose a penalty in order to get documents submitted or a question answered. A question might be put to a surgeon as to the nature of an operation he performed. If the person holding the inquiry is to have more power than a judge, surely he would be entitled to ask that question. Would not the surgeon be perfectly entitled to tell him that it was not right to answer such a question, that it was none of his business, and he could add, even without being offensive, that it was an impertinence to ask that question.
If that section is deleted, it will render the whole thing nugatory.
Why? You do not think anybody would come if you had not these powers?
We must have some.
If they do not come, you can assume everything against them.
They might not be doctors. They might be other people.
Would it not be to the interest of the hospital to ensure that every person who is summoned as a witness should appear in a case of this sort, where it is a complaint against a hospital in respect of one of two things: either not providing a bed when, according to the records, a bed is available—which to my mind is ridiculous—or, secondly, that a person's treatment was unreasonably delayed? Is it conceivable that in either one of those cases the hospital itself would not be at pains to send in witnesses?
Supposing this inquiry is held, one of two things happens—either the inquiry goes against the hospital and nothing happens to the hospital, I understand, or the hospital refuses to give evidence and the same result follows. In the second case, I put it to the Minister, public opinion goes more strongly against the hospital than it would even in the first case, and all you have in both cases, it seems to me, is the effect of public opinion.
Is the Deputy pressing amendment No. 21?
I think you might put it to the House.
Is there any objection to amendments Nos. 22 and 23?
I might get some words to meet that part of it.
The Minister is apparently getting on to what the scope of this section is. As it stands at the moment, if a person is ill and does not turn up he must be fined £5. That is what that section does, as it stands at the moment. That is what the Department wants, apparently. If he fails to turn up he must be fined £5. If he met with a motor accident on the way that would be a criminal offence.
He is to be prosecuted in a summary court, and convicted. They are not going to convict a man who is not able to attend.
You are not going to rely on the good sense of the Minister?
We rely on the good sense of the justice.
The justice will have no option. If it goes before him at all he must convict because the offence is failure to turn up.
I will meet you in getting some phrase.
I move amendment No. 24:—
Before Section 6, to insert the following new section:—
Sub-section (6) of Section 14 of the Public Hospitals Act, 1933 (No. 18 of 1933), shall have effect as if the words "or assisted by" were deleted therefrom.
This amendment is consequential on amendment No. 2.
I move amendment No. 25:—
In sub-section (1), page 4, to insert at the end of the sub-section the words "as amended by the immediately preceding section."
This amendment is consequential on amendment No. 24.
I move amendment No. 26:—
At the end of sub-section (2) to add the words "but nothing herein contained shall be deemed to authorise the Minister or the Hospitals Commission to interfere with the administration or control of the hospital by the governing body or management, or in particular to interfere with the medical, surgical or nursing treatment of any patient."
This section, even as amended now, gives authority to the Hospitals Commission to appoint any officer to inspect a hospital, and also gives the Minister authority to appoint any officer to inspect a hospital. The amendment proposes to add "but nothing herein contained shall be deemed to authorise the Minister or the Hospitals Commission to interfere with the administration or control of the hospital by the governing body or management, or in particular to interfere with the medical, surgical or nursing treatment of any patient." As far as the Public Hospitals Act, 1933. is concerned, whatever powers the Minister has there, or the Hospitals Commission has there, it is now proposed to give that power to an official of either of them. This is no limitation of the power of the Minister in his administration of the Act, nor of the Hospitals Commission, but it is inserted with a view to ensuring noninterference to the hospitals, as far as words go.
This only gives to the Minister the powers which the Hospitals Commission have already. These powers are set out in Section 14 (6) of the 1933 Act, and there is no reason whatever to attach these conditions to them. Section 14 (6) is quite clear as to the powers of the Hospitals Commission.
Is it now?
I think it is.
The phrase in the sub-section is: "For the purposes of performing his duties under this Act..." What are the duties?
Section 14 (6) sets out:—
For the purposes of performing his duties under this Act every member of the Hospitals Commission may visit all or any of the premises of any hospital or nursing organisation which shall have participated in any sweepstakes promoted under the Public Charitable Hospitals Acts, 1930 to 1932, or under this Act, or which shall have applied for a grant out of the Hospitals Trust Fund under Section 24 hereof or of any institution under the control of or assisted by local authorities and shall be entitled to inspect and examine such premises and the fittings and equipment thereof, and shall also be entitled to call for and be furnished with full information in relation to the management and the financial position of any hospital or nursing organisation and to see and examine all accounts of the receipts and expenditure of the governing body of such hospital or nursing organisation and also all or any books and other documents containing any record of such receipts and expenditure.
It opens with the phrase: "For the purposes of performing his duties," and I think the duties of a member of the commission under the Act are set out in Section 17. That section opens with the words: "It shall be the duty of the Hospitals Commission to do the following things..." and I presume that that is what is referred to in sub-section (6) of Section 14. Then follows a long section setting out the duties of the Hospitals Commission. There are five paragraphs setting out the various functions, and surely they are very wide.
The Minister, or an officer of the Minister, only comes in here in relation to Section 25 when grants are being made. Sub-section (5) sets out:—
Whenever the Minister makes under this section a grant out of the Hospitals Trust Fund, he shall specify the purposes for which such grant is to be expended and may attach to the receipt of such grant such conditions... provided, however, that no conditions shall be attached to the receipt of any such grant in any way relating to the appointment, dismissal or control of the staff of any hospital or nursing organisation.
When that Act was passed its administration was restricted to a member of the Hospitals Commission. There are the chairman and probably five others, and each and every one of those can go at any time he likes into any hospital, inspect it and see whether various matters satisfy him or the commission. The Minister, under the same Act, took power to make grants and he restricted himself so as not to interfere with the medical or surgical staff. Now we are getting an extension of the power given to the Hospitals Commission. The appointment of an officer of the Hospitals Commission and of the members of the commission are two very different things, as the appointment of an officer of the Minister is very different from the appointment of the Minister. I put down an amendment here setting out in black and white the other side of the bargain. This is only a bargain on the part of one person. The Minister first got his Act of 1933, and we now find that he wants more power, and we find that he wants more power for the Hospitals Commission. There are two bodies now which can carry out these inspections, and not only two bodies, but any officer of the two bodies. I have put down a very simple amendment that nothing shall be deemed to authorise the Minister or the Commission to interfere with the administration or control of a hospital. Does the Minister wish to do that?
I do not, of course.
Does he wish to interfere with the medical, surgical or nursing treatment of any patient? No. What is the objection then?
That power does not exist under Section 14 (6). The Hospitals Commission had no right to interfere, before I brought this in, with the internal organisation or management of a hospital, and neither can these conditions give any more powers than the commission had.
I am tracing the Minister's progression from 1933 to date. He was satisfied then for himself.
I know, but I am not changing the effect of the 1933 Act.
The next thing we will hear is: "I could not operate it".
When I come to the House with that statement, it will be time enough for the Deputy to say that.
But the Minister told us that the other night. He said: "I was not able to administer this." He could not go around ten or 15 hospitals, and he had to get an official. He is not satisfied with one; he must have "any". The Hospitals Commission also want an officer, and the Lord knows how many they will have before this is over. We want to keep them within the limits of what they are to do. Is it intended to interfere with the governing body? No. Is it intended to interfere with the medical, surgical or nursing treatment of a patient? It is not. Then there is no objection to it.
It has not been operated in that fashion, and there is no reason for anybody to read that into Section 14 (6).
Section 17 allows the making and submission to the Minister "of schemes for the improvement and co-ordination of hospital or nursing, or both hospital and nursing facilities, in the whole or any particular part of Saorstát Eireann." I presume that there is some purpose in submitting a scheme—that they will be operated afterwards through grants.
I do not know what that was operated for, if it was operated at all.
It is part of the duties of the Hospitals Commission as set out in Section 17 (c).
Yes. They wanted them to submit schemes before making grants.
Could not a scheme of that kind cover interference with the administration or control of an institution or the treatment of patients?
I imagine it could. I do not know enough about the 1933 Act to know what the purpose of having to make and submit these schemes to the Minister was, except that submission to the Minister meant that he could make the giving of the grant conditional on the scheme being carried out. It seems to me that the phrase about submitting schemes could include that matter.
I do not quite gather from the Minister on what grounds he is relying. Is it that the power is not there?
The power is not there.
But there is a division of opinion about that, and the only way to obtain a definite decision on it is to have the matter brought before a court. Until the matter has been decided in that way, it cannot be definitely ascertained whether the power is there or not. Seeing that a divided opinion exists, is it not reasonable to take precautions?
I see the Deputy's desire for precautions, but I think they are absolutely unnecessary.
The Minister is now going on to another point. If the Minister said: "I have that power already, and I will keep it," I could understand him, but that is not the line he is taking. The line he is taking is that the power is not there.
For the Minister the power is not there. The Hospitals Commission have the power.
Oh, no, not on the things we want to exclude from them.
They have not the power to do the things you exclude, but the Minister is taking no more power than they have.
The question is what powers they have.
I am quite satisfied that they have only the powers I have already indicated.
Has not a different view been advocated from this side?
Why under Section 6 are the Hospitals Commission entitled to ask for full information with regard to the management of the place?
That arises with regard to deficits.
The financial position alone would cover that but management is also there.
Would the Minister agree to insert some provision to make the matter clear? The Minister suggests that the fears expressed on the other side of the House are groundless. Could he not find a few words to make the position quite clear?
They are absolutely groundless. The scheme has been operated since 1933 and no hospital has made a complaint.
It would be no harm to make the matter clear.
It is often difficult to find an acceptable form. If you start making exceptions it may lead to difficulties.
On behalf of Deputy Cosgrave I move amendment No. 27:—
To delete sub-section (3).
This amendment is very much like the amendment that was moved to a previous section. It aims at removing all these paraphernalia of district court prosecutions. I suppose the Minister will not consider this amendment any more than he considered the previous amendment.
I am afraid not.
But the Minister is going to consider some phrase about "wilfully" in the section.
I shall think about "wilfully".
I just want to point out to the Minister that on the last occasion he stated that he did not intend the Bill to be retrospective. It is now clear that it is to be retrospective to some extent.
I am still of the opinion that it is not retrospective.
It is to this extent. The Minister is now getting the powers that the Hospitals Commission previously exercised. In his definition of assisted hospitals, the Minister is taking these powers in relation to hospitals that have accepted grants prior to the passing of this Bill. To that extent the Bill is operating retrospectively. I would suggest that the Minister should look into this question of assisted hospitals and that he should cut out the four or five words in that phrase in relation to assisted hospitals.
I had hoped that we might be able to get the Report and Final Stages of the Bill to-night, but I suppose we cannot get them now. Is the Deputy not satisfied that amendment No. 5 makes it perfectly clear that no hospital is brought under the Bill unless it takes a grant?
I am quite satisfied to give the Deputy any undertaking, if there is any doubt about it. We are not trying to bring hospitals into the bed bureau scheme after the passing of this Act unless they participate in these grants.
We are quite clear on that.
Amendment No. 5 does that.
There was another point raised by Deputy Dillon. I am only referring to these matters to see if there is any prospect of getting the Final Stage in the House to-night. Deputy Dillon wanted the phrase in sub-section (2) of Section 2, "in particular" knocked out. He thought it might widen the duties. I am quite prepared to consider that.
He wanted the phrase "including in particular duties" out.
There was a number of points raised. There was no dispute at all about the effect of amendment No. 5. We were quite clear on that, but we were not at all clear on the definition of assisted hospitals, and how far the Bill is made retrospective. Secondly, a point was raised on an amendment to Section 2—amendment No. 4, I think. Deputy McGilligan suggested that it might be re-drafted so that it might be quite clear that the facilitating was governed by the giving of information. These were the two points.
I think we must confine ourselves to Section 6 for the moment.
When will the Report Stage be taken?
I understood the Minister was asking us to take another Stage of this Bill to-night.
Yes, I wished to have the Final Stages taken. Deputies appear to have a doubt as to whether I am trying to bring into the bureau scheme hospitals which have benefited in the past. That is not so. So far as the bed bureau is concerned, it is not going to apply to any hospital that does not come in after the Bill becomes law. So far as clearing that up is concerned, I will clear it up. I do not think there is any doubt about the assisted hospitals.
There is a grave doubt about the assisted hospitals.
As to the other amendment suggested by Deputy Dillon, I am agreeable to accept it.
What about the recasting of the amendment to sub-section (1)?
I will see how it can be done. In order to clarify the position, I will say that it is not the intention to bring in any hospital which has benefited in any way in the past, unless it participates in grants in the future.
It is intended to keep out an hospital unless it is going to submit, so that it is unworkable from that angle.
It is unworkable from that angle.
Is not that a great fault in the draftsmanship?
I do not see how we could work that—having a certain number of hospitals in the bed bureau scheme, some taking grants and others not taking grants. I think that that would be allowing them to be both inside and outside.
The main purpose, I presume, is to get information for everybody interested. If an hospital foregoes a grant and is still willing to give the information, it is not getting something—it is bringing in something.
I am sure the bureau would be glad to get the information from any hospital.
You may take it for granted that an hospital that refuses a grant of £300,000 or £400,000 does not do so lightly. It does so because it does not want to sacrifice certain principles. If they are willing to join the bureau, I think that, so far as the main purpose is concerned, which is the giving of information, the Minister gains by that.
The Minister is not pressing for the taking of the Report Stage to-night?
I am not pressing it, but I am anxious to get the Bill before the Seanad next week.
What about to-morrow, then, for the Report Stage?
I thought the House would be engaged on the Budget to-morrow.
If the Minister meets us on these points, we can finish the Bill in ten minutes to-morrow.