Dáil Éireann debate -
Thursday, 9 May 1940

Vol. 80 No. 2

Committee on Finance. - Saint Laurence O'Toole Hospital Bill, 1940—Committee Stage.

1. This Act may be cited as the Saint Laurence O'Toole Hospital Act, 1940.

Parliamentary Secretary to the Minister for Local Government and Public Health (Dr. Ward)

I move amendment No. 1:—

In page 3, line 18, to delete the words "Laurence O'Toole" and substitute the word "Laurence's."

This was put forward for the purpose of changing the name from "Saint Laurence O'Toole" to "Saint Laurence's." Representations have been made from various quarters that the name of the hospital was rather unwieldy, and that it would certainly be abbreviated by popular usage, and that the abbreviation would probably reduce it to a surname or the abbreviation of the surname. Having considered these representations, it appeared desirable to alter the name to "Saint Laurence's."

Mr. McGilligan

This will necessitate a change in the Long and Short Titles?

An Ceann Comhairle

Yes. Amendment No. 31 is submitted to meet that alteration.

Mr. McGilligan

Before we get on to that, will it not be necessary to change the name of the Bill?

General Mulcahy

Is the Irish Title going to be changed from "Bille Ospideil Lorcain Ui Thuathail"? I noticed that "Saint" is left out in the Irish Title.

Mr. Corish

There are no saints in Ireland.

An Ceann Comhairle

Without wishing to pose as an authority, I suggest it was because our ancestors were so familiar with saints that they did not think it necessary to add the title "Saint"; for instance, Cill Bhrighde, etc.

Mr. McGilligan

If the name of Deputy Ruttledge appeared in the Bill there surely should be "Saint" before it.

Mr. T. Kelly

I would like to have my name mentioned as protesting against this change. That name is illustrious in Irish history for the last seven or eight centuries. It is the name of a man who stood out predominantly when Ireland needed a man to stand out for her.

An Ceann Comhairle

The Deputy wishes to be recorded as dissenting?

Mr. Kelly

I do.

Mr. McGilligan

Does the change do what Deputy Kelly says it does?

Dr. Ward

I do not think so.

Mr. McGilligan

Is not the background of "Laurence's""Saint Laurence O'Toole?"

Dr. Ward

Yes; it will, in fact, come to be known as an abbreviation of that name. The people of Ireland will consider it certainly to mean Saint Laurence O'Toole. The hospital will not be called after any other Saint Laurence.

Mr. Kelly

I do not see that there would be anything wrong in giving the name of Saint Laurence O'Toole to this hospital. One would imagine that there was some solid reason for the change when you have a parliamentary amendment introduced to alter the title of the Bill. Saint Laurence O'Toole is a great figure in Dublin's history.

Mr. McGilligan

But not on that side of the river.

Amendment put and declared carried, Deputy Kelly being recorded as dissenting.

Section 1, as amended, agreed to.

SECTION 2.

In this Act—

the expression "the existing governing body" means the board of governors of the existing hospitals established under the Act of 1856;

Dr. Ward

I move amendment No. 2:—

In page 3, between lines 30 and 31, to insert the following words:—

The expression, "paid officer" means an officer who is, by the terms of his appointment, entitled to be paid remuneration by the body whose officer he is."

The purpose of the amendment is to define the term "paid officer" so as to distinguish between paid officers and unpaid officers.

Amendment agreed to.

Question proposed: "That Section 2, as amended, stand part of the Bill."

Mr. Corish

On the section, the expression "the new hospital" is defined to mean a hospital to be erected and established under the Act. Surely the word "new" is unnecessary.

Dr. Ward

The word "new" is necessary, since the Long Title sets out that this is "An Act to provide for the establishment, in or near the City of Dublin, of a new general hospital."

Mr. McGilligan

The phrase "new hospital" is one that recurs through the Bill and will have to be defined.

Question put and agreed to.

Section 3 agreed to.

SECTION 4.

(1) The Minister may, for the purpose of providing a site for the new hospital, acquire, either by agreement or compulsorily, land in or near the City of Dublin.

(2) The Minister may, for the purpose of facilitating the extension or enlargement of the new hospital, acquire from time to time, either by agreement or compulsorily, land adjacent to the site of the new hospital.

Mr. McGilligan

I move amendment No. 3:—

In sub-section (1), page 3, line 43, to delete the words "or near" and to add after the word "Dublin" the words "adjacent to the site of the existing hospitals".

The purpose of the amendment is to see if we can fix the site for this hospital. In the course of the discussion on the Second Reading, it was variously debated whether or not any decision had been taken to have the site of the new hospital otherwise than either on or adjacent to the site of the existing hospitals. There was definitely a rumour current in the city, a rumour which was ventilated in this House, that a decision had been taken, or at least that there was a proposal to move the hospital from the present site up to Cabra. Towards the end of the debate a statement was made that no clear decision had been taken to move the new hospital up to Cabra. Later, I think, Deputy Hannigan asked if the House could get an assurance that the site at Cabra would not be lightly decided upon. I understood from the answer given to that question that, so far from there being any idea of lightly deciding on a transfer of the hospital from its present position to somewhere else, it was almost outside the consideration of the Parliamentary Secretary that the site should be so moved. I would like to have it definitely stated now that the site is not merely to be in the City of Dublin— that, of course, would include Cabra— but that it is to be adjacent to the existing hospitals.

I want, as far as I can, to tie the Parliamentary Secretary down to this: that the new hospital will be built either on the site of the existing hospitals, or will be convenient to it. In that connection the Parliamentary Secretary, on the last occasion the Bill was before the House, conveyed to Deputies the idea that it would not be possible to erect a 550-bed hospital on the present site. Dublin members know something about the site of the existing hospitals, but whether they know the amount of space available there is another matter. Country members, I think, would have gained the impression from the debate on the last occasion that the present Richmond Hospital is in an area where it is completely surrounded by buildings, huddled together and almost on top of it, and that even if the site was cleared, or in some way reconstructed, it would not permit of a proper hospital of the 550-bed type being erected there. If that is the impression that was thought to be created it is an erroneous one, because there is plenty of room there. I think it can be said that of all the public hospitals in Dublin the Richmond has probably more room for extension than any of them. The Hospitals Commission, so far from reporting against the present site, reported in favour of it. The commission had certainly in their viewpoint the necessity for a hospital of at least the 550-bed type. It is right to say that if the new hospital were to be extended beyond 600 beds it might be a bit cramped. I am told that medical authorities do not favour going beyond the 550-bed type of hospital. If provision is to be made for a hospital over and beyond that figure, I understand it becomes rather uneconomic. Circumstances will drive towards making for the building of a hospital of the 550-bed type.

There is plenty of room for that on the present site, and the Hospitals Commission have so reported. In addition, a number of architects have been engaged in investigating the possibilities of the Richmond site, and of the type of hospital that could be erected there. Without a single exception the architects believe that there is the fullest scope for a hospital of the 550-bed type on the present site. I, personally, from previous acquaintance with the medical world, had opportunities of visiting the Richmond site. I made it my business to visit it recently, and up to the date of my last visit I was not at all aware of the possibilities of extension that are there. The site would have to be cleared, and while that was being done, no doubt some transitory arrangements would have to be made so as to provide for patients while portion of the new building was going up. But, from the point of view of space, there is ample room on the present site. There is a tradition about the present Richmond Hospital. It serves an enormous proportion of the citizens of Dublin. I do not think that the proposals spoken of here as regards a site elsewhere, and of providing transport facilities for students and for visitors wishing to visit patients would at all equate the convenience of the present site, and the opportunity it offers for students to get their teaching there.

Mr. McCann

I hope the Minister will not accept this amendment. In my opinion the ideal place to build a modern hospital is in the suburbs. The three indispensable factors in the struggle against disease are sunlight, fresh air and quiet, and I cannot understand the arguments put forward here in an effort to deny the sick poor of Dublin that boon. From my reading of the position in other countries I learn that modern public health planning would seem to place hospitals on the outskirts of the cities. I can cite the Manchester Royal Infirmary which has recently been completed, the new General Hospital in Birmingham, which has been built well outside the city, and the new L.C.C. Hospital in London, which is to be as far out as Tooting.

In spite of Deputy McGilligan's assertions that a proper transport service would not equate the loss, I think that if we had a proper bus service running right up to the door at a cheap fare, that would more than compensate for the inconvenience which might to caused to students or to visitors generally. The patient is the first person to be considered in relation to a hospital, and after that the nurses; and I do not think either patients or nurses would have anything to lose by this hospital being placed on the outskirts of the city, in proper surroundings in its own grounds, where the patients would have the opportunity to recuperate.

Dr. Ward

At the outset, I might repeat what I stated on the Second Reading, that no decision has been taken in the matter of the site. It is true that the Cabra site was suggested in the course of discussions with representatives of the governing body of the present institutions, but beyond that no further definite action has been taken as regards the Cabra area. At the same time, if I conveyed the impression that Cabra was outside consideration as a possible site, I should like to disabuse the minds of any Deputies who may have come to that conclusion as a result of the discussion on the Second Reading.

In that connection I should like to draw the attention of the House to the fact that the north-western suburb is rapidly becoming an extensive housing area. Already the Corporation has provided 1,634 houses and developed an additional area for 2,085 houses. As I stated before, on the Second Reading, the density of population is moving, and if the city continues to extend—as it may reasonably be anticipated to extend—in the Cabra area, a future time might find us in the position that we would have a very large area of the city and a very considerable proportion of the city's population outside the range of any of our big hospitals. All these matters will have to be taken into consideration, and I cannot accept the Deputy's amendment, which would definitely tie the Minister to the selection of a site adjacent to the present site. The town planning committee have views on that matter too, and it is quite possible that the building of the hospital on the existing site would come into conflict with the intentions of the town planning committee. At any rate, the question of site will be very carefully considered on its merits, and points in favour of building on the existing site, or adjacent to it, will be fully examined, but I could not agree to tie the Minister definitely to that site, or to any other site.

General Mulcahy

It seems to me to be an astonishing thing that Parliament should be asked to pass a measure for setting up a hospital without any clear idea having been arrived at by the Department or by the hospital authorities or by those others concerned with the work to be done in the new hospital, as to what the hospital scheme is going to be. Not only do we not know what the scheme is going to be, but we know so little about the scheme that we have no idea as to the location of the site on which the hospital will be built. I should like to ask the Parliamentary Secretary if there is any reason in the world why the time of Parliament should be taken up in discussing this Bill, when sufficient time has not yet been given to bring together those concerned in this future hospital and to get them to proceed with their discussions, that they may have such a picture of the hospital and of the work to be done in it and of its relationship to the city that they can say whether they are going to have the Cabra site or the present site. This is an absurd way to treat the House and it is a scandalous waste of time in the House. Let those in the Department who bear responsibility for looking after this work, those concerned with the present hospital, those upon whom the work of the hospital in future is likely to fall and the municipal authorities sit down together and do their work, that they may get their brains clear as to what is being and ought to be done and then it would be time enough to ask Parliament to consider the question. The idea of discussing a Bill of this kind when no one is able to say where the hospital is going to be built is absurd. Until we know the site and its particular relationship to the Richmond Hospital we cannot know the conditions which should exist between it and its neighbours and we can have no conception of the general hospital scheme.

Dr. Ward

Deputy Mulcahy seems to have overlooked one important point in his contribution to the debate. Neither the board nor the Minister has power to acquire a site. The first essential step to take is to get power to acquire a site. Having got the power, we can proceed then, in consultation with the board and having considered all the representations which may be made by any interested parties, to select the most suitable site.

General Mulcahy

Surely the power to acquire a site depends on sites being available. If the Parliamentary Secretary desires power to acquire a site, he should know what he wants the site for.

Dr. Ward

For a hospital.

General Mulcahy

For a hospital doing what? When he knows what he wants the site for he will know what particular relationship it will bear to the city. He cannot go any farther until he looks around the geography of the area and sees where the sites are. When he sees where the sites are, then he can consider whether it is for the purpose of acquiring this or that particular site that powers are required.

Dr. Hannigan

Can the Minister give any indication at this stage as to how soon the site will be selected?

Dr. Ward

The site cannot be selected until the Minister has power.

Dr. Hannigan

I want to know whether it will be this year, next year or five years hence.

Dr. Ward

I would be in a better position to say if I knew how long it would take to get this Bill through.

General Mulcahy

Is nobody going to look around with open eyes until we get this Bill through? Is Parliament to discuss this matter with its eyes in blinkers? Has the Minister looked at any sites?

Dr. Ward

No, as the Minister has no power to acquire a site.

Mr. T. Kelly

I would suggest that the Minister should look around before making up his mind. The Dublin Corporation are building very large modern flats in the vicinity of the Richmond Hospital and they propose to continue that when money is available. To deprive people who now desire to live in those flats—and in the flats to be erected—of a convenient hospital is a question which should receive very great consideration. Besides, I would point out that North Brunswick Street and its vicinity is a very decaying neighbourhood—very decaying indeed —and must soon, I hope, be cleansed, cleared up and rebuilt, and in this case you will be removing these hospitals, the Richmond, Hardwicke and Whitworth, some miles away from that neighbourhood. I think that the Minister should treat that matter with very grave concern before suddenly deciding to take away facilities for medical treatment some miles from that locality. I do not say that the Minister should not do so, if it is considered to be necessary, but I think that the Minister should survey the matter properly first and then make up his mind.

Mr. McGilligan

The proposal with regard to Cabra, which is still in the offing, is to remove a hospital that is conveniently situated to another situation about three miles from O'Connell Bridge, and about four miles from the nearest medical school. I understood that the proposal was based on a number of grounds; the first, that the present Richmond site did not permit of the erection of a 550-bed hospital, but, as I am informed, that contention is a mistaken one. I understand that the present site of the Richmond Hospital would allow for the erection of a 550-bed hospital, or one with even greater accommodation. It is my information, however, that anything beyond a 600-bed hospital would be uneconomic, but if it is considered desirable to extend it, then there might be occasion for extending beyond the Richmond site. The second objection was that there were certain institutions of a charitable nature that could not be removed, and that the only thing that was left was to move in either of two directions, one of which might encroach upon a certain medical institution in the city, and the other, alternatively, upon one of these charities. Now, I understand that these difficulties have been overcome by co-operation between the staff of the Richmond Hospital and that of Grangegorman. With regard to the charity, the person concerned there is open to co-operation, and if co-operation is called for from the person concerned, accommodation will readily be found, and accommodation is sought for, and eagerly sought for, by those who are connected with the other public institution, because they believe that a conjunction between the two institutions would benefit the public, and also benefit each of the institutions.

The only other objection that I thought I would hear more about was that voiced on the Third Reading by Deputy McCann. It is peculiar that it was not voiced by the Minister. Deputy McCann said that there is better air, and that there are more salubrious surroundings in Cabra than on the Richmond site. That, however, was not the Minister's contention. The Minister said—perhaps I may be allowed to parody his words— something to the effect that the slums were getting out to Cabra, and that we ought to try to get ahead of them. That was his contention.

Dr. Hannigan

I do not think there was any suggestion of that.

Mr. McGilligan

Yes, it was definitely mentioned. The Minister's attitude was not concerned with the question of fresh air, but with the question of the slums moving out. As against that, Deputy Kelly's suggestion is that this area in the vicinity of the Richmond is to be cleared, and that it will be better and more salubrious than it is at the moment. In addition to that, you have in the vicinity the grounds of Grangegorman and of the King's Inns. You have a certain breathing space, or lung, as it is called, in that area, which allows definitely for the provision of fresh air and the salubrious surroundings that Deputy McCann wants in Cabra. Now, this question of fresh air, and so on, does not cut much ice with me, because I understand that the average length of stay of a patient in a hospital is about three weeks, and the difference of three weeks, as between the present site and Cabra—particularly when, as we are told, the slums are moving out to Cabra—in the case of a patient, is not going to be very great.

Against the proposal to move outside the present area there are certain important considerations, and the main one is this: if one takes the area where the Richmond Hospital is at the moment and gets a survey of the population in the immediate vicinity—not the population from which patients are drawn, because they come even from across the river on the south side—but if you take the population adjacent, as you may call it, to the hospital, you find that it includes about one-sixth of Dublin's population. Why should a hospital that is convenient to one-sixth of Dublin's population be shifted out to Cabra? There are three lots of people concerned there. Firstly, you have the patients; secondly, the relatives who may want to visit them; and, thirdly, the medical staff—those who must be in touch with some teaching institution.

I move to report progress.

Progress reported; Committee to sit again to-morrow.

Mr. McGilligan

To-morrow?

An Ceann Comhairle

Yes.