Deputies will have before them two sheets of amendments, one typewritten and the other printed. We follow the enumeration from the printed sheet.
Midwives Bill, 1943—Report and Final Stages.
I move amendment No. 1:—
To delete Section 14 (3) and substitute the following sub-sections:—
(3) The chairman of the board shall act as chairman of every meeting of the board at which he is present.
(4) If the chairman of the board is absent from any meeting of the board or if when any meeting of the board is held there is no chairman of the board in office, the members of the board present shall elect one of themselves to be chairman of the meeting and, where at such election there is an equality of votes for two or more persons, it shall be determined by lot which of those persons shall be chairman of the meeting.
I mentioned this matter on the Committee Stage. It is a drafting amendment to provide for a chairman to preside at the first meeting of the new board.
Amendment agreed to.
I move amendment No. 2:—
To delete Section 20 (1) and substitute the following sub-sections:—
(1) The board may create a contingency fund and may make such payments into that fund as from time to time they think proper.
(2) The board may make any particular payment into the fund created under this section notwithstanding that the making of the payment will result in or increase a balance against the board in the abstract, prepared in pursuance of Section 21 of this Act, relating to the year in which the payment is made.
(3) The board may invest the moneys in the fund created under this section in any securities authorised for the investment of trust funds.
(4) The board may use the fund created under this section to meet contingencies.
This is also a drafting amendment which I have already mentioned in the House. It provides for payments by the board into the contingency fund.
Amendment agreed to.
I move amendment No. 3:—
In Section 21 (1) to insert before the words "of the board" the words "(including payments made to the contingency fund created under Section 20 of this Act)."
This also is a drafting amendment.
Amendment agreed to.
I move amendment No. 4:—
In Section 28 (3), to insert the following paragraph before paragraph (a):
(a) in the case of an appeal to the High Court, the court may award costs against the board, and.
This amendment is submitted to the House to meet the point made by Deputy Dillon that the midwife who won her appeal to the High Court may be awarded costs.
It meets the point completely.
Amendment agreed to.
I move amendment No. 5:—
To add at the end of Section 31 the following sub-section:—
(5) In a prosecution for an offence under this section, it shall be a good defence if it is shown to the satisfaction of the court that there was reasonable cause for the failure of the defendant to comply with the requirement to which the prosecution relates.
This also is submitted to meet Deputy Dillon's point, that a certificate, though not destroyed, might be lost or otherwise mislaid.
The amendment covers the point completely.
Amendment agreed to.
I move amendment No. 6:—
To add at the end of Section 44 the following new sub-section:—
(5) In a prosecution for an offence consisting of a contravention of paragraph (d) or paragraph (f) of sub-section (3) of this section, it shall be a good defence if it is shown to the satisfaction of the court that there was reasonable cause for the failure of the defendant to comply with the requirement to which the prosecution relates.
This is a consequential amendment; it covers somewhat the same principle.
Amendment agreed to.
I move amendment No. 7:—
To delete Section 47 (2) and substitute the following new subsections:—
(2) Rules for the purposes of this section shall provide that a midwife employed by a local authority shall not be required to attend any course of instruction to which the rules relate except in accordance with the arrangements made by the local authority in pursuance of sub-section (3) of this section.
(3) A local authority by whom a midwife is employed shall, in accordance with such directions as the minister may give from time to time—
(a) grant leave of absence to the midwife to attend any course of instruction to which rules for the purposes of this section relate, and
(b) pay a substitute for the midwife during the attendance, and
(c) pay to the midwife travelling expenses in respect of the attendance (including subsistence allowance during the period of the attendance) in accordance with the relevant regulations under sub-section (1) of Section 19 of the Local Government Act, 1941 (No. 23 of 1941), and any relevant authorisation under sub-section (3) of that section in like manner as if the attendance was part of the official duties of the midwife.
This amendment is a redraft, making specific provision for leave of absence to attend a post-graduate course. The amendment provides for payment of substitutes and payment of travelling expenses, including subsistence allowance. In connection with the amendment and the discussion we had on the issues at stake in this section on the Committee Stage, I would like to say that it has been the policy of the Department to make the provision that is being set out here. Deputy Corish mentioned a case from Wexford where, apparently, we refused to sanction the maintenance allowance.
I did not quite mean that. You did sanction the maintenance, but not as much as the board was prepared to allow.
I have not succeeded in tracing that particular case.
I shall send particulars of it to you.
I promise to look into it. I want to avail of the opportunity to convey to the House the policy that has been operated in the past, and that will be operated in the future, in this regard. As I stated yesterday, the matter will turn on the question of whether the allowances will be deemed to be adequate or whether they would be considered reasonable.
Notice taken that 20 Deputies were not present; House counted, and 20 Deputies being present——
On the 8th June, 1943, a circular letter was issued to local authorities in connection with this matter of post-graduate courses for midwives. In the course of that letter it was stated:—
"I am to call your attention to the Department's previous circular letters pointing out that midwives in the employment of local authorities should be encouraged to attend such courses. I am to state that the Minister is prepared to sanction payment of reasonable expenses to midwives in dispensary districts for travelling and subsistence, in addition to the remuneration of substitutes whom it may be necessary to employ during their absence. Subsistence expenses in excess of £2 10s 0d. a week would be considered excessive."
We pay the substitute; the salary continues during leave of absence, and we give a subsistence allowance up to a maximum of £2 10s 0d. a week. I think that is a reasonable provision.
I wonder whether the phraseology of the amendment might not be altered. In (c) of the proposed new sub-section (3), it is stated "pay to the midwife travelling expenses in respect of the attendance (including subsistence allowance...)". Why do you not say there "with subsistence allowance"?
That is purely a matter of drafting.
Would it not be clearer to say "with subsistence allowance"?
That is the draftsman's method of dealing with it.
With regard to subsistence allowances, I am sure the Parliamentary Secretary is aware that little girls from the country who are trained here, and whose parents have spent a certain amount of money on their training, are receiving by way of salary something like £48 or £50 a year. If they are to maintain themselves decently in a district, they must pay at least 25/- or 30/- a week for their upkeep. I should like the Parliamentary Secretary to consider this point. It is not mentioned in the Bill, so far as I can see, but I think it is unjust to the girls who are asked to do this work. They are young women who have the lives of the mothers of this country in their hands.
Is there anything about that matter in the Bill?
No.
It might have been raised on the Second Reading.
I suppose I am late now. I thought perhaps the Parliamentary Secretary would be able to do something.
Perhaps the Deputy has not observed the full purport of the amendment before the House. We are dealing with the question of post-graduate courses for midwives. Under this Bill midwives may be called upon by the Central Midwives Board from time to time to attend post-graduate courses. The amendment makes provision for payment during leave of absence, for the payment of a substitute during absence, and for the payment of travelling and subsistence expenses. In a circular letter issued to the local authorities on 8th June, we mentioned that the maximum subsistence allowance that would be sanctioned would be £2 10s. 0d. per week. I think that sum would be regarded as generous.
As regards salaries, I am not aware that there is any midwife on as small a salary as Deputy Carter has mentioned. All I can say on the matter at this stage, with the permission of the Chair, is that a salary of £40, £42 and £50 a year is, in my opinion, entirely inadequate. It is a matter for the local authority, in the first instance, to pay these officers a reasonable salary. Some of the salaries mentioned here—that is, if they do operate at all—are entirely unreasonable.
Is there any ceiling fixed so far as the Department is concerned?
There has not been any ceiling fixed yet.
Very few of them have reached it, any how.
The ceiling has not been pushed up or disturbed by any local authority so far. It will be time enough to discuss that when we reach the stage when a local authority wants to raise the ceiling a little higher. There are, to my knowledge, many midwives in the employment of local authorities whose salaries are inadequate and, within reasonable limits, if local authorities face up to their responsibilities I do not think there will be any difficulty about having these salaries improved.
In view of that statement, may I point out that at the December meeting of Donegal County Council it was suggested that the small salaries of midwives might be increased by £10 yearly, but it was turned down by the Department?
What is the relation between subsistence allowance plus travelling allowance when calculating salaries? If a nurse retires or gets a marriage gratuity, and if she has done a post-graduate course, would subsistence and travelling allowances be taken into account?
Midwives get salaries, travelling expenses and subsistence allowances.
A substitute is also paid a salary. The nurse gets travelling expenses plus a maximum of £2 10s. 0d.
A midwife's expenses, while doing a post-graduate course, might be left to the option of local authorities, because some of them would like to give an adequate maintenance allowance for that week. If the salary is small—less than £100 yearly—a midwife could not be expected to maintain herself while doing a post-graduate course that would be in the interests of patients. These officials should be given full maintenance expenses. With a return railway ticket to Dublin they get £2 10s. 0d. for seven days. They may have to spend more than seven days when travelling to and from Dublin. Everybody knows that £2 10s. 0d. would not cover the outlay on board and lodgings for seven days. I suggest to the Parliamentary Secretary that he should leave it to the option of a county manager to decide what maintenance expenses should be given.
Whatever the rate may be, I urge the Parliamentary Secretary to make it a uniform one. If there are 30 nurses attending the same class, it would be unfair to have some getting a maintenance allowance of £3 weekly, others £2 and others £5. I suggest to Deputy Allen that the rate should be a uniform one.
I agree.
I am naturally sympathetic with the nurses' claims.
I am sure Deputy Allen is aware of the cases that I mentioned last night. It is not too much to ask the Minister to agree to the payment of the full expenses of these officials. It would cost more than £2 10s. 0d. a week to live in Dublin. As Deputy Allen pointed out, anybody who has to visit the city knows that £2 10s. 0d. would hardly cover maintenance for three days in a decent place. I ask the Minister to agree to the payment of full expenses.
In view of the pressure that is being put on the Minister, I cannot help remembering that these officials, when they come to Dublin, are to get £2 10s. 0d. a week in addition to their salaries. We all hope that the salaries will be put on a more permanent basis, and that they would be something like a minimum of £2 a week. They are to get £2 10s. 0d. subsistence allowance and free travelling facilities. Some of us are not so ancient as not to remember that when we came to Dublin for a special course, we did not spend our whole time at that course. We might often indulge in a picture show or some mild activity of that kind. Under average circumstances, a person who had to spend five or six days in the city, and started out with a free return ticket and £4 10s. 0d., would not be doing too badly.
Deputy Dillon is assuming that the salaries of these nurses is £104 a year, when it is well known that they are often half that amount.
We are hoping that that position will be improved.
I want to point out that this Bill does not fix the amount. I have explained what our policy in the past has been and what I expect it will be in the near future. Deputy Allen advocated a more generous maintenance allowance, but I think Deputy Dillon answered him effectively. I should like to supplement Deputy Dillon's remarks by reminding the House that these are not whole-time nurses-anything but whole-time. As mentioned previously, the number of dispensary cases they attend in the year is small, but, because of the possibility that their services may be called upon, we have to provide nurses in the different districts. It is to these nurses' own advantage that they should return to Dublin from time to time for post-graduate courses. The training and the brushing-up of ideas on such post-graduate courses will be an asset to them when they go back, and will assist them in regard to private practice as well as with the poor whom they will be called upon to attend under the Public Assistance Acts. I would be quite happy about the whole matter to find that the majority of local authorities would be prepared to pay their nurses the maximum maintenance allowance mentioned.
The local authorities in Wexford are particularly generous. I do not say that in any critical sense——
What does the Parliamentary Secretary say about Wexford local authorities?
That they are generous.
By comparison—that is what he means.
Yes, by comparison, and I think it will be quite a long time before local authorities in other parts of the State will adopt and maintain the standards that have been adopted and are being maintained in County Wexford in relation to their nursing staffs.
Of course we are the model county.
It is not necessary to say anything more but I do think that the Departmental policy on balance is a reasonable approach to that problem and provides for a reasonable solution of it.
Amendment put and agreed to.
Question—"That the Bill, as amended, be received for final consideration"—put and agreed to.
Agreed to take the Fifth Stage now.
Question proposed: "That the Bill do now pass."
I should not like to allow the Fifth Stage to pass without pursuing what is a rather unusual course for me, that of expressing my warm appreciation of the way in which the Parliamentary Secretary has met the representations that were made to him on the Committee Stage. I had occasion to make four suggestions to him and within 24 hours he had produced four amendments that fully and generously met every point I raised. May I say that it is a great pleasure to partake in legislation carried on in that spirit, and I think the House has experience that when that spirit prevails legislation passes a great deal more quickly than in the more stormy atmosphere that sometimes rules in our deliberations.
May I say also that the reaction to the representations made to the Parliamentary Secretary is very much appreciated? The Parliamentary Secretary has spoken of the fact that salaries are very low in some areas and that they are not commensurate with what he thinks they should be——
I should not like the Deputy to proceed too far on those lines at this stage.
I do not think it would be too much to ask that the Department should do something to persuade local authorities to treat their nurses properly. After all, midwives have a very responsible job, and I do not think it would be too much to ask the Parliamentary Secretary, through the medium of this Bill. to do something in that connection.
Question put and agreed to.