Mental Treatment Bill, 1944—Committee Stage (Resumed).

Debate resumed on the following amendment:—
SECTION 90.
In sub-section (7), line 43, to delete the words "The Minister" and substitute the words "The mental hospital committee".

Amendments Nos. 164 and 165 go together and they also affect amendments Nos. 168 and 169.

The purpose of this amendment and of amendment No. 165 is to confer on the committee of a mental hospital authority the power to make regulations governing the powers and duties of visiting committees.

I take it that these also cover amendments Nos. 168 and 169. The principle of all the amendments is the same.

It is not a good principle to take so many powers from local authorities as to curtail to a large extent the interest they would have in the performance of their duties, and especially when already in the Bill, in Section 3, there is a fairly clear and definite line laid down in respect of the duties which visiting committees are required to carry out in relation to the district mental hospitals which they may be appointed to visit. It is set down that they will visit the hospital from time to time, receive complaints from the patients and report on abuses, on repairs and on any other matter on which they have authority to report. All that is left, in so far as prescribing the powers and duties of a visiting committee, is the prescribing of the time and place of meetings and the manner in which the committees shall visit the district hospitals and carry out their duties. It could be quite safely left to the committee of a mental hospital to make these regulations, subject, as set down in amendment No. 165, to subsequent confirmation by the Minister.

I think the Deputy has become somewhat confused as between the terminology of the existing law and the terminology used in the Bill. His amendment refers to a mental hospital committee and the intention is to substitute, as the rule-making authority, a mental hospital committee. The only committee of a mental hospital that will exist when the Bill becomes law is the visiting committee, and, clearly, the Deputy had not in mind that a visiting committee should be given power to make these rules. Where a mental hospital authority is concerned with one county only, the county council will be the mental hospital authority. Where there is more than one county interested in the institution, the institution will be governed by a joint board. Apart from that, the phraseology in sub-section (7) is exactly the same as that in sub-section (5) of Section 34 of the County Management Act, so that the Minister already has the statutory power which this sub-section proposes to give him. What we are doing in this Bill is, we are incorporating the power which the Minister has in sub-section (5) of Section 34 of the County Management Act in this Bill, and deleting it from the County Management Act.

The Parliamentary Secretary was quite correct in the point he made about the terminology of the amendment. I am sure he will pardon my mistake when he remembers the number of drafting amendments that he has found it necessary to move to the Bill as introduced. So far as the amendment is concerned, the fact that this power is in the 1940 Act does not make it any more acceptable to me. I do not see any reason why we should not make our position clear in relation to the feeling that we have, even though the existing statutory law does give this power to the Minister. I think it is a bad thing, and that something should be done to correct it.

I would point out to the Deputy that the sub-section is permissive. The Minister may make regulations. He will not do so unless it should be necessary. Notwithstanding the fact that the Minister has this statutory power already, he has not made such regulations because he has not found it necessary to do so. In this sub-section we are merely empowering the Minister if, in certain eventualities, he considers it necessary to make regulations. In the ordinary course of things the mental hospital authority will make its own regulations. They will not have statutory effect, but such regulations have worked well in the past and probably will work well in the future. I think that is the spirit in which we should approach this matter.

Amendment, by leave, withdrawn.
Amendment No. 165 not moved.
Section 91, as amended, agreed to.
SECTION 92.

I move amendment No. 166:—

In sub-section (3), page 43, line 25, to delete the word "inmate" and substitute the word "patient".

Amendment agreed to.
Amendments Nos. 167, 168 and 169 not moved.
Section 92, as amended, agreed to.
Section 93 agreed to.
SECTION 94.

I move amendment No. 170:—

In sub-section (2), page 45, to delete in lines 6 and 7 the words "resident medical superintendent of their district mental hospital" and substitute the words "chief clerk to the joint board", and to delete in line 13 the words "resident medical superintendent" and substitute the words "chief clerk".

The intention of the amendment is to impose the duty provided for in the sub-section on the chief clerk instead of on the resident medical superintendent.

Amendment agreed to.
Section 94, as amended, agreed to.
SECTION 95.
Question proposed: "That Section 95 stand part of the Bill."

On the section, it speaks of a joint board. Would the Parliamentary Secretary say what is the meaning of that?

In the case of a mental institution serving more than one county a joint board will be set up to administer the mental institution. That joint board will replace the joint mental hospital committee. Where a mental institution serves only one county, the county council will be the mental hospital authority.

Question put and agreed to.
SECTION 96.

I move amendment No. 171:—

In sub-section (1), page 45, lines 19 and 20, to delete the words "the chargeable patients in the mental hospital district of the authority" and substitute the words "their chargeable patients".

Amendment agreed to.
Section 96, as amended, agreed to.
SECTION 97.

I move amendment No. 172:—

In page 45, lines 33, 34 and 35, to delete the words "a temporary or voluntary patient in an approved institution, of any chargeable patient in the mental hospital district of the authority" and substitute the words "temporary patients or voluntary patients in an approved institution, of any of their chargeable patients".

Amendment agreed to.
Section 97, as amended, agreed to.
Sections 98 and 99 agreed to.
SECTION 100.

Mr. Corish

I move amendment No. 173:—

In sub-section (1), line 3, to delete the words "The Minister may make regulations" and substitute the words "A mental hospital authority may make regulations, subject to confirmation by the Minister".

The amendment merely asks that the mental hospital authority, and not the Minister, may make regulations. I think that the Parliamentary Secretary is moving a somewhat similar amendment.

My amendment would be if the Minister so thinks fit." It may not be necessary to make such regulations at all.

Amendment, by leave, withdrawn.

I move amendment No. 174:—

In sub-section (1), page 46, line 3, to insert before the word "make" the words "if he so thinks fit,".

Amendment agreed to.

I move amendment No. 175:—

In page 46, to delete sub-section (2) and substitute the following sub-section:—

(2) Where regulations made under this section are for the time being in force, all contracts made by a mental hospital authority shall be entered into and made in accordance with such regulations and, if any such contract is not so entered into or is not so made, it shall, if the Minister so directs, be wholly void and shall, unless or until the Minister gives such direction, be voidable at the option of any party thereto.

Amendment agreed to.
Section 100, as amended, agreed to.
Section 101 agreed to.
SECTION 102.

I move amendment No. 176:—

In sub-section (1), page 46, lines 33 and 34, to delete the words "in receipt of mental hospital assistance from" and substitute the words "being maintained as a chargeable patient in the mental hospital district of".

Amendment agreed to.

I move amendment No. 177:—

In sub-section (2), page 46, lines 35, 36 and 37, to delete the words "a chargeable patient dies while in receipt of mental hospital assistance outside the mental hospital district of the relevant mental hospital authority" and substitute the words "being maintained as a chargeable patient outside the mental hospital district of the mental hospital authority responsible for such maintenance dies."

Amendment agreed to.
Section 102, as amended, agreed to.
Section 103 agreed to.
SECTION 104.

I move amendment No. 178:—

To delete the word "paying" in page 47, lines 20, 22, 45, 50 and 51, 58 and 61 and page 48, line 4, and substitute in each case the word "private".

Amendment agreed to.

I move amendment No. 179:—

In sub-section (4), before paragraph (b), to insert the following new paragraph:—

(b) shall prescribe the accommodation (including sleeping accommodation) food and other services and the attendance to which the persons admitted as paying patients shall be entitled.

The purpose of proposing the inclusion of this new sub-section is that we are here dealing with a new field into which mental hospital authorities are entering, namely, the provision of accommodation for paying patients. It is laid down that regulations shall be made in relation to an institution which will contain certain provisions in regard to the payment to be made by persons admitted as paying patients and also that no person shall be admitted unless there is available at the time of admission accommodation not required for persons receivable as chargeable patients. In so far as the mental hospital authorities would be entering into a formal contract inasmuch as they would be receiving payment in respect of the accommodation and service to be given to this new type of patient, I feel there should be certain protection afforded to patients in regard to what they will receive in return for the payment they will make. While I accept that it would be wrong to suggest that mental hospital authorities would attempt in any way to take advantage of the patients in so far as not giving them adequate and proper accommodation, food and services, in return for the fees they would pay, nevertheless, it is proper that ordinary simple safeguards should be put in, indicating the minimum accommodation, food, etc., that should be provided for such type of patients, in order to ensure, in the first place, that patients or those acting for them will be clear as to what they are entitled to and, secondly, that mental hospital authorities will not be placed in an invidious position by reason of complaint that the particular accommodation, food, etc., were not up to the standard the patient was entitled to in relation to the payment being made. Also, on general grounds, I think it is far better to have the position clearly defined in cases like this rather than to act upon the assumption that nothing wrong is going to take place. In recent days we read a good deal in the daily Press about a very lamentable happening in another country where regulations were taken to be satisfactory but, because of a loop-hole, a very grievous tragedy occurred. No tragedy can occur in this particular case but it could give rise to a certain degree of dissatisfaction and friction if there were differences of opinion as between the mental hospital authority and those who were making payments in respect of particular patients.

The intention behind the Deputy's amendment is in itself praiseworthy, and I have no criticism to offer on that score, but I do not think it is practicable or necessary. Patients have, within the framework of the measure before the House, ample protection. We have a visiting committee, which will visit the institution at regular intervals, as often as may be necessary. If any patient has any complaint, there will be no difficulty in establishing contact with a member of the visiting committee and securing investigation of the complaint, even before the next ordinary meeting would take place. We have the mental hospital authority as the next court of appeal. We have the county manager superimposed on that. We then have the inspector of mental hospitals who periodically visits these institutions and inquires into the care and treatment of every patient in each one of these institutions and, finally, we have provision for appeal to the Minister by anybody who feels aggrieved in any particular regard. I think that is a very complete machine in so far as protection of the individual patient is concerned.

We cannot prescribe food standards in advance. We must leave the matter of nutritional standards to be determined by the medical superintendent. He will be responsible for the proper care and treatment of patients. The matter of nutrition may be a very important element in the question of treatment. We will have to give him unlimited discretion, again with all the safeguards I have already referred to. In the same way, we cannot determine accommodation in advance because in this particular type of institution the accommodation will have to be related to the form of mental disturbance from which the patient may be suffering. One patient may require restraint, may have to be accommodated in a padded cell, and so on. I need not develop that; the Deputy will appreciate it right away. The idea the Deputy has in mind is quite a sound one, but I think we have taken all reasonable precautions.

I would not be altogether prepared to accept either the visiting committee or the mental hospital authority as being sufficient safeguard because, in this case, there can be a conflict of interests between the cost of maintenance of the institution and the contribution made on behalf of paying patients. Under sub-section (1), certain regulations are to be framed by the mental hospital authority governing the admission of persons as paying patients and their accommodation, and these regulations shall be submitted to the Minister. If the Parliamentary Secretary would say that in considering such regulations the Minister would have regard to the matter I have referred to, I think that would be satisfactory.

Oh, yes.

I had not in mind when I mentioned food and accommodation, the actual nutritional value of the food, but rather the standard.

I appreciate that.

The Parliamentary Secretary appreciates that even in the case of general medical hospitals there has been in the past a good deal of complaint and criticism of the standard of food.

I grant all that.

In the case of mental hospitals there does seem to be in the minds of many people a certain prejudice. I am aware that even where responsible and influential members of joint committees of mental hospitals have assured relatives that the patients in whom they were interested were being treated with the utmost consideration and kindness, there was still the greatest difficulty in convincing them that their conception of life in these institutions was not in accordance with the actual fact. It is because of that atmosphere very often surrounding a mental hospital that I think it is essential that every precaution should be taken to ensure that the good name of the hospital will be protected in every way in relation to the standard of treatment and accommodation of patients, so that there will not be any sense of dissatisfaction in the minds of relatives.

The Minister will bear these considerations in mind in approving rules and regulations.

Amendment, by leave, withdrawn.
Question proposed: "That Section 104, as amended, stand part."

Is there a printing error in your copy, Sir, in sub-section (3) of Section 104?

I have not observed it.

In the third line of that sub-section "under the sub-section (1)" should read "under sub-section (1)".

Very good. It will be noted—in line 32, after the word "in", to delete the word "the" before "sub-section".

Question put and agreed to.
SECTION 105.

There is an amendment to this section in the name of Deputy Keyes. If the Deputy will look at amendment No. 50, I think he will see it is the same amendment.

What was the fate of the amendment? Did the Minister accept it?

Amendment No. 180 falls with amendment No. 50.

I take it there will be a certain amount of consultation between the Minister and the mental hospital authority before such regulations are made.

There will be. There always is.

Amendment No. 180 not moved.
Sections 105 and 106 agreed to.
SECTION 107.

Amendments Nos. 181 and 198, I think, are the same.

I move amendment No. 181:—

In sub-section (2), line 34, after the word "institution" to insert the words "and the number of qualified and the number of unqualified persons having the care or charge of patients in the normal course of their employment".

In this part of the Bill we are coming to one of the most important sections of the whole approach which the Parliamentary Secretary has developed for the treatment of mental disease. It is most essential that we should in every way possible make provision for the most satisfactory treatment being given to any persons who are patients in private institutions. I am speaking now with a certain personal feeling in this matter, because some years ago we had a somewhat unhappy experience and we had to draw the matter to the attention of the inspector of mental hospitals, but he found that his powers and authority were very circumscribed. I think it is not sufficient to ensure that, in a general way, private mental institutions shall be run in a proper and orderly manner, subject to certain control by the Minister in relation to the patients as such and to the general accommodation available in relation to the number of persons it is proposed to cater for, but that it is equally important that the staffs of such private institutions should also be regarded from the point of view of their qualifications and from the point of view of having a sufficiency of staff to care for the number of persons the institution proposes to cater for.

I have in mind an instance in the past where, to my own personal knowledge, as many as 28 patients were left in the care of a man and a boy in the open grounds of an institution of this character. It is to see if the Parliamentary Secretary has given thought to this particular aspect of the matter that I have set down the amendments in my name, that is, that in sub-section (2) of Section 107, in addition to entering in the register of a private institution the number of persons of unsound mind, both male and female, to be taken care of in the institution, there should also be a record of the staff that normally will be employed in that institution to care for the number of persons it is proposed to cater for from the viewpoint, first of all, of the qualified members of the staff and, secondly, of the unqualified members.

I appreciate that there is a certain difficulty in this country as in certain private institutions, I understand, there are not teaching hospitals and certain of them do not wish to undertake that responsibility. We often have had cases where the staff catering for the female patients have been qualified and have been receiving teaching, whereas on the male side the ordinary attendants have been unqualified except for such experience as they might pick up during the course of their work. That is possibly a difficulty that has to be considered. At the same time, I think that due regard should be had by the Parliamentary Secretary, when considering granting to these institutions the privilege of catering for these people, not only to the medical staff as such that will have care of patients but, what is in many ways more important, to the number of qualified men and women who will have to give daily and continuous service to those patients in these private institutions. A further purpose I have in moving my amendment is that, in addition to the registration of the number of patients, there should also be a record of the number of the staff, both qualified and unqualified, who will normally be employed in the institution in relation to the number of persons the institution proposes to take in.

I think the amendment is a reasonable one. I do not know how many private or charitable institutions there are in this country catering for mentally deficient persons; but, from time to time, we have heard complaints that the patients in these institutions do not get the attention to which they are entitled. Now that these institutions are to be registered under this Bill, it seems to me that the Parliamentary Secretary should also take steps to see that the staffs of these institutions are qualified to carry out the duty they purport to carry out. It is inevitable, of course, that the proprietors of the institutions should try to run them on the most economical lines possible, and that they will ensage unqualified persons rather than qualified persons for reasons of economy. But, if it appears only right, proper and just that an institution of that kind should be staffed by persons who are competent to take care of and treat mentally deficient patients, whatever regulations the Parliamentary Secretary proposes to make under the section or other sections should apply not only to the medical staff, but to the nursing staffs as well, of these institutions.

Once again we are in harmony so far as the intention of the amendment is concerned, but I do not think it is necessary. Section 107 (2) sets out that there shall be entered on the register certain particulars. Deputy Larkin wishes to include in the particulars to be entered the number of qualified and unqualified persons having care or charge of patients in the normal course of their employment. I suggest to the Deputy that, if it is considered desirable to have such information recorded, the Minister has power already in sub-section (2), which states, "and such (if any) other particulars as may be prescribed". The Minister can prescribe any particulars he considers may be necessary under sub-section (2) as drafted, and I can assure the House that the Minister will satisfy himself——

"Such other particulars"—the phraseology is rather vague.

I wonder what more accurate expression could be used.

Particulars relating to staff. There might be many other particulars relating to the institution.

Surely the Deputy appreciates that that would restrict it. There may be other matters as well as the staff which may have to be taken into consideration. If Deputies refer to Sections 114 and 115—"Grounds for refusal of registration of private institution" and "Grounds for refusing renewal of registration of private institution"—they will find that the position is fairly and fully covered. One of the difficulties is that you must read a number of sections together in order to get a comprehensive view of the matter. The particular point raised now can be dealt with within the framework of sub-section (2) of Section 107.

So long as it is understood that the other particulars mentioned will refer to the staff.

Amendment, by leave, withdrawn.
Section put and agreed to.
Sections 108, 109, 110, 111, 112 and 113 agreed to.
SECTION 114.

There is a series of amendments here over the name of Deputy Larkin, in which he deals with the unsuitability of staff, food, etc., as good grounds for refusal of registration. I think the whole matter might be best debated on amendment No. 183. Amendment No. 182 simply prepares the way. This arises in amendments Nos. 182 to 187, 199 to 206 for different institutions, and 214. The debate might take the whole point in amendment No. 183 as to these grounds for rejection or refusal of registration.

Amendment No. 182 not moved.

I move amendment No. 183:—

Before paragraph (e), line 25, to insert the following two new paragraphs:—

(e) that the Minister is satisfied that the person or persons of unsound mind to be taken care of in the institution will not receive adequate and proper food, care and attention;

(f) that the Minister is satisfied (i) that the staff of the institution is not sufficiently qualified to have charge of persons of unsound mind, (ii) that the staff is insufficient in numbers or qualifications properly to care for and have charge of the number of persons of unsound mind which the institution proposes to admit, (iii) that the conditions of service for the staff are not satisfactory or are not of such character as to ensure the employment of properly qualified persons to care for or have charge of persons of unsound mind.

The purpose of this amendment is, in a certain way, to amplify the intention in amendment No. 181. I am not altogether satisfied that what the Parliamentary Secretary said in regard to amendment No. 181 will cover the position I have tried to deal with under amendment No. 183. In section 114, the grounds for refusing an application for registration of a private institution are set down in paragraphs (a) to (f). While they cover a fairly wide range of causes which would justify the Minister in refusing registration, there is no definite and specific reference to the question of adequate and proper food, care and attention. Paragraph (a) deals with the suitability of the applicant, (b) deals with the suitability of the person in charge, (c) ensures that the person in charge will reside in the institution, (d) covers the premises, staff or equipment from the point of view of suitability, (e) deals with the patients being under the observation of a registered medical practitioner, and (f) with the furnishing of documents to the Minister within a reasonable time. It may be argued that the Minister has certain general powers to give consideration to the provision of adequate and proper food, care and attention, but this matter is so very important, where we are dealing with private institutions, that the Parliamentary Secretary should be prepared to go further and accept the definite statutory obligation to give consideration to these very important factors.

Private institutions are in a very peculiar position in relation to the treatment of these persons. In certain cases it is quite possible to establish a very lucrative business out of the treatment of persons suffering from mental disease because of certain factors dealing with the sensitivity of the relatives and even of the persons themselves. The private institutions are often able to afford a certain secrecy and provide confidential treatment of such persons. It is well known that it has been the practice of private institutions, not merely to charge fairly substantial fees in the normal way for treatment of patients but to have a system of additional fees for certain additional food luxuries which, added together, very often bring the total fee to quite a substantial figure. I am not convinced that there is any equitable relationship between the additional fees charged and the additional food provided. In that direction, I think it would be to the benefit of the patient and also to the good name of proper institutions that there should be some control and certain standards laid down in this respect.

Similarly, in regard to the new paragraph (f), which, I submit, should be inserted, where we deal with the question of the staff under (d), the Minister has power to refuse the application if he finds that the staff, among other things, is unsuitable, having regard to their duties. I think we should go somewhat further. It is not merely sufficient in any institution to have a qualified staff; it is also essential to have a staff that is carrying on its duties under reasonable conditions, both in regard to number and in regard to conditions of employment. I feel the Parliamentary Secretary would not object if I say that both he himself and the responsible Minister feel that that is something to be aimed at. The very fact that they have given assistance to general nurses employed in various institutions through the country to lay the basis of a pensions scheme shows that they are awake to that factor. It is even more important when dealing with staff engaged in the care of the mentally afflicted people.

On the first day on which we dealt with this Bill in Committee, the Parliamentary Secretary explained at some length the efforts he is making to bring about an improvement of the conditions and salary of certain mental hospital staffs throughout the country. I am sure he was actuated not only by a feeling of the inequitability of the conditions of employment but also by the recognition that it is essential and important that they should be afforded as good conditions as possible so as to relieve them of the ordinary stress and strain. The difficult conditions under which they carry out their duties impose a strain on them and, if we take that view in regard to employment in public institutions, where they undoubtedly enjoy a far greater measure of benevolent protection, as they come under the supervision and control of elected representatives in a general way, and have the county manager, and, eventually, the Minister himself to intercede on their behalf, it is even more important that some power be taken by the Minister to afford protection to the staffs of private institutions in regard to their conditions of work. Therefore, in this paragraph it is suggested that the Minister should also require to be satisfied that, first of all, the staff is sufficiently qualified.

The Parliamentary Secretary has already dealt with the point that it is sufficient in numbers to care for the number of persons of unsound mind. It is most important that the conditions of service of the staff should be satisfactory or of such a character as to secure the employment of persons qualified to take care of those of unsound mind. It may be one thing for the Minister to have power, under an earlier section, to require certain numbers and also to be in a position to say whether the staff in general is suitable, having regard to the number of patients to be cared for; but it is quite another thing to consider that, if the conditions in the institution are not sufficiently attractive to bring qualified persons into that employment, all the provisions we have embodied in the Bill go for nought. We are then left with the position that an institution which normally could cater for these persons will not be able to accept responsibility or provide proper staff there to carry out the work. I do not think there should be any great difficulty, not in prescribing exact and detailed conditions of employment but in setting up certain minimum conditions, say, in relation to hours and minimum scales of salary.

I have in mind one particular case of a man who is performing what we would regard as the duty of a charge attendant in a public institution. In addition to that, he is giving mental therapy to the patients. In this case they are child patients, and therefore it is more difficult. He has had long service, and at the time I was speaking to him his actual cash salary was less than £40 a year. If we take in the value of his emoluments—food and living accommodation; I do not think he receives any uniform—we would find it very hard to add to that cash salary sufficient to give him even the salary of an ordinary boy working in an outside institution. I think steps should be taken to stop that practice, and see that these men and women who take up employment in these private institutions shall be at least afforded minimum conditions in order to ensure that they can carry out their work in the proper atmosphere.

Under Deputy Larkin's amendment, the Minister would have to take into consideration quite a number of things that appear to me to be extraneous to the Bill. It is not proposed to embody in this Bill any section or sub-section that would put a statutory obligation on the Minister to enter into the question of conditions of employment.

I concede that, owing to the type of ailment these private institutions will be dealing with, special protection is necessary in order to ensure that the patients will be properly cared for, but when we are asked to interfere in a private institution to the extent of determining hours of service and rates of remuneration, I submit that a Bill like this is not the proper place to deal with that, if it ought to be dealt with at all. We have not interfered in that respect in the management of any voluntary hospital. The whole scheme of things envisages a new approach to mental disease, and we look upon voluntary mental hospitals as being voluntary hospitals established for the treatment of a particular type of ailment but, nevertheless, voluntary hospitals, and I rather think that the principle of interfering, as Deputy Larkin suggests, in the management of voluntary hospitals, would raise a storm that I would prefer somebody else would take the brunt of than that it should be directed at me.

In so far as it is reasonable to do so, I think we have afforded ample protection in Section 114, which sets out the grounds for refusal of registration to private institutions. First, the Minister must be satisfied the applicant is a fit and proper person. I think a reasonable Minister, with a share of administrative experience and worldly wisdom to guide him, would examine very carefully the credentials of anyone who sought to have his institution registered for the care and treatment of this particular type of patient. The Minister must be satisfied that the person proposing to take charge of the institution is a fit and proper person. As regards the grounds upon which he can refuse re-registration or a renewal of registration of a private institution, he has to be satisfied as to the premises, the staff, the equipment, the qualifications and suitability of the medical practitioner who is in charge of it. I do not think we can reasonably be asked to go any further than that.

For the reasons I have already stated, we cannot enter into the question of diet. The Minister cannot satisfy himself in advance. He is asked, under Deputy Larkin's amendment, to satisfy himself in advance that proper food will be given to the patients. When the question of reregistration comes along, if the Minister has reason to think that the patients have not been properly looked after in the matter of nutrition, as in every other respect, he can refuse registration and I think the owner of the institution or the resident medical superintendent who would conduct an institution in such a way that the patients were not properly nourished and looked after would be deemed by the Minister not to be a fit and proper person to be in charge of such an institution.

I am sure Deputies will appreciate the importance of this point, that, so far as staffs in such an institution are concerned, we cannot determine in advance the numerical strength of the staffs, trained or otherwise, because the strength of the professional or the untrained personnel will depend on the number of patients in the different categories that have to be catered for and that number will naturally vary from time to time. At one time there may be a number of patients who are violent and dangerous to themselves and to other people and they will require much more attention and many more attendants than a corresponding number of a different type of patient. These are some of the difficulties that we have endeavoured to envisage and I think the acceptance of Deputy Larkin's amendment would rather add to the difficulties than tend towards providing a more satisfactory solution. I think the framework of the Bill will reasonably safeguard what the Deputy wishes to safeguard by his amendment.

I agree with the Parliamentary Secretary that it would be a mistake to impose too many restrictions and regulations on persons in charge of private institutions catering for mental patients. Nevertheless, there are certain vitally important regulations from both the human and national standpoint that should be imposed on institutions of that kind. I agree also with the Parliamentary Secretary, and I confess I am sorry to have to disagree with Deputy Larkin, that there are certain things that we cannot enter into in legislation of this kind. For instance, we cannot regulate the hours of duty or the conditions of pay, but we should ensure, at all events, that there is adequate medical supervision, an adequate food supply and an adequate staff to cater for the wants of these unfortunate people.

Two of the most common complaints in regard to these private institutions is, first of all, an inadequate food supply and, secondly, inadequate attendance. Sometimes the attendants are not qualified to discharge the duties for which they are responsible. I want to be assured in relation to certain matters. I want to give the proprietors of these institutions the greatest latitude, but I would like to be assured that in the essential things the patients are adequately safeguarded. I should like to be assured, first of all, so far as it is possible, under the regulations which will be made when this Bill becomes law, that the patients in the institutions will be sure of an adequate food supply. Secondly, it is necessary that these institutions should have adequate medical supervision, and, thirdly, that the patients will have qualified people to attend to their needs. These are the three essential things that concern us in legislation of this kind, and as long as we have an assurance from the Parliamentary Secretary that these things are fully provided for in the Bill, I am quite satisfied to allow this section to go through.

While the Parliamentary Secretary has pointed out the difficulties of dealing with the question of diet, I cannot see in these sections any reference to any form of protection for the patients in respect of adequate food. I agree that it is not possible in a detailed way to prescribe the diet of persons under medical attention, but we should give these patients some general form of protection. We are dealing here with patients mentally afflicted. In the ordinary institution, if patients do not receive food in proportion to the payment they make, they are mentally capable of making a complaint, either to the medical authorities in the hospital or to their relatives, but a patient in a mental hospital frequently cannot be aware of the type of food he or she is being given, not to speak of having any knowledge of its adequacy. When we realise that an additional fee of two guineas has been known to be charged for the provision of one rasher per morning to a patient, we appreciate the abuses which can develop.

I do not expect the Parliamentary Secretary to prescribe in detail the number of slices of bread, the number of potatoes or the number of eggs which should be provided, but surely he can take power, which he has not got under these three sections, whereby his inspector, when making his inspection of these private institutions, will satisfy himself that the food provided for the patients is adequate and of a proper kind. I do not know whether he has the power at present— I do not see anything in the Bill which indicates that he has — but it is necessary that he should have it. It could be put in a general way — that the inspector, in the course of his inspections, would have regard to the matter of food, not from the point of view of its nutritional value but from the point of view of its being the proper kind, properly cooked, of an adequate nature and at least commensurate with the payments being made and that, if he finds an unsatisfactory condition, he would report it to the Minister and it would be considered when the application for renewal came up.

With regard to the second portion of the amendment, dealing with conditions of employment, I can appreciate that the Parliamentary Secretary is somewhat chary of interfering with the voluntary hospitals in relation to the conditions of employment of their staffs, but it is time somebody interfered with them. Probably he feels the task is rather too big for him, but I do not altogether accept the point of view that, as a matter of principle, we should not interfere. There was no such reluctance on the part of the Government when they brought in the wages standstill Order and interfered with everybody in the country in relation to wages.

I did not do that.

The Parliamentary Secretary has to accept part of the responsibility.

Do not bring it up on this Bill.

The submission I make is that we are dealing with a particular, and, if you like, a peculiar, class of people. Many of them, because of the nature of their affliction, are completely incapable of protecting themselves. They are utterly dependent on those in whose care they are, and, if we have a situation in which patients are to be subject to the care and protection of men and women who are not receiving fair and proper treatment in the matter of the conditions of their employment, we can and will have an unhappy state of affairs. Where such people are in receipt of salaries so low as to leave them continuously in a condition of financial embarrassment, we leave the door open to many peculiar abuses and where we have members of a staff working intolerable hours—many of them have worked up to 80 hours per week—kept on continuous night duty or left in continuous charge of the very bad type of patients, which imposes a mental and physical strain, we are not fostering a condition which will be to the best advantage of the patients.

It is one thing to prescribe the actual hours of duty and rates of salary which may, I agree, be a very difficult matter, but it is a far more simple thing to say that, in general, persons employed in these institutions shall not work more than a certain number of hours per week, not from the point of view of conditions of employment but from the point of view of avoiding the imposition of an intolerable strain so that they will be capable of carrying out their duties; and, secondly, shall not be paid less than a certain figure if they are adult men or women. I have already quoted the case of a man, 40 years of age, in receipt of about 30/- or 35/- a week, taking his cash salary and the value of his food and lodging together, and performing the duty of a charge attendant, giving treatment in mental therapy and performing several other additional duties. In return for that, he was paid a salary less than that which many messenger boys in the city receive. I think we are losing the opportunity provided by the Bill of dealing with an intolerable state of affairs such as that and one which requires control and correction on the basis of fixing minimum conditions.

We have no opportunity of dealing with these matters on this Bill. As I have already said, conditions of employment, rates of wages and such matters are not relevant. The other important matters which Deputy Larkin and Deputy Roddy raised are covered in the Bill.

It is hard to know what is covered in the Bill. Some of the expressions are so vague and general that it is difficult to decide what is intended.

Take, for instance, Section 127. It says:—

"The Minister may make regulations—

(a) governing the carrying on of private institutions;

(b) prescribing the medical staffs to be employed in connection with such institutions"

and so on. The section also provides penalties for, non-observance. Section 226 then sets out the duties of the inspector of mental hospitals when making inspection, and I think that, when Deputies consider that comprehensive section, they will agree that there is a statutory duty on the inspector to inquire into almost every conceivable contingency which could arise in a private mental institution. Paragraph (c) of the section sets out that he shall inquire whether the dietary of the patients is satisfactory. Paragraph (e) says he shall inquire into the facilities given to patients to attend religious services, and paragraph (f) as to whether any system of coercion, restraint or seclusion is in operation. Under paragraph (h), he shall inquire as to staffing arrangements; and, finally, in case we have missed anything, there is paragraph (n), under which the inspector shall make such other inquiries in relation to the institution and the patients and the staff and see such other persons as he thinks proper. When all these provisions are related and a comprehensive understanding of them secured, the House will, I think, agree that the position has been fairly well met.

The Parliamentary Secretary is quite correct in drawing attention to the powers given to the inspector, but may I point out that, under these three sections, 114, 115 and 116, we are dealing with certain statutory provisions, and I take it that if the Minister refuses the registration of a private institution, the authorities of that institution would be entitled to question, by the ordinary process of law, whether the Minister had acted in accordance with the statutory grounds provided in the sections.

I am afraid we are merely beating the air. If the inspector of mental hospitals reports abuses under any of the headings I have mentioned, the Minister has a statutory right to determine that the person in charge of that institution is not a fit and proper person to be in charge of such an institution, and that ends the matter. He will not renew registration.

That may be the position, but I am still not satisfied that it is as definite as the Parliamentary Secretary says. Let us take it that the inspector reports that, in a particular institution, the food is unsatisfactory. On the face of that, the Minister decides not to renew registration. Under what section is that power being taken?

If the Deputy will read Section 226 in further detail he will see that the inspector of mental hospitals makes a record of his complaints.

Now, if the complaints are not remedied, as recommended by the inspector of mental hospitals, the Minister, acting in a responsible way, would have no option but to determine that the person who ran that institution was not a fit and proper person.

Agreed, so long as the matters to be remedied fall within the paragraph.

There is one further point which I want to emphasise. The minds of Deputies may be prejudiced somewhat by their knowledge and past experience of these institutions. I would ask them to remember that, for the first time, these institutions are coming under the Minister for Local Government and Public Health. That will constitute a radical change. I can assure the House that so far as I am concerned, and I am sure I can speak for my successor—though it may be a very long time before he arrives—we intend to keep a very close eye on these institutions. We intend to insist that they shall be properly run, and that the patients under their care will be properly looked after.

Take the case of where an inspector found certain abuses and where these were not corrected, would not the Minister be empowered to have regard to that when the application for renewal came up? Would it not be possible to give that point a more definite form?

I will ask the draftsman if he is satisfied whether such a contingency is already covered. If it requires clarification, I shall have it clarified.

Amendment, by leave, withdrawn.
Section 114 agreed to.
Amendments Nos. 184 and 185 not moved.
Section 115 agreed to.
Amendments Nos. 186 and 187 not moved.
Section 116 agreed to.
SECTION 117.

I move amendment No. 188:—

To add at the end of the section the words "and it shall be lawful to carry on the institution during that period for the purposes of effecting such discharge, removal, and transfer".

Amendment agreed to.
Section 117, as amended, agreed to.
SECTION 118.

I move amendment No. 189:—

In page 51, to add at the end of the section the words "or the Minister consents to his being a member of the governing body".

Deputies are aware that the section prohibits every officer or servant of a private institution from being a member of the governing body of the institution. This amendment proposes to give the Minister power to consent to an officer or servant being a member of a governing body. There might be cases where it would be desirable to make an exception. Sometimes the medical officer in charge of a private institution might, because of his specialised knowledge, be useful to the lay members of the governing body. It is not unusual to have a member of the staff also a member of the governing body.

This only applies to private institutions?

And not to religious institutions?

They would be private. Amendment agreed to.

Section 118, as amended, agreed to.
Sections 119 and 120 agreed to.
SECTION 121.

On behalf of Deputy O'Higgins I move amendment No. 190:—

In line 2, page 52, after the word "made" to insert the words "at a cost exceeding one hundred pounds".

I think that the object which the Deputy has in view is to put a limitation on the capacity of a private institution to embark on building enterprises. I think the principle of the amendment has already been discussed.

That is so. I think that if Deputy O'Higgins were here he would not be disposed to press the amendment. What he has in mind, I think, is that these institutions should be free to carry out small alterations without having to go to the Minister. The difficulty, from our point of view, is that we register them in the knowledge that certain accommodation is provided for patients: that there is a certain area of floor space per patient, etc. The taking down of a partition, say, between two rooms, although the work might not cost more than a £5 note, might make a radical alteration from our point of view. I do not think the amendment ought to be pressed.

Amendment, by leave, withdrawn.
Section 121 agreed to.
SECTION 122.

I move amendment No. 191:—

In page 32, line 13, to delete the words "interested person" and substitute the words "person authorised by the Minister to inspect such copy".

Amendment agreed to.
Section 122, as amended, agreed to.
Section 123 agreed to.
Amendment No. 192 not moved.

On behalf of Deputy Norton, I move amendment No. 193:—

At the end of sub-section (2) to add after the word "pounds" the words "and in case of a continuing offence to a further fine not exceeding £5 in respect of each day on which the offence is continued".

The object of the amendment is that where there is a continuing offence there should be a continuing penalty.

The penalty in this case is a fixed penalty and is fairly severe. The point is one that it is hardly worth while debating. I am not disposed to accept the amendment, and I do not think Deputy Norton, if he were here, would be prepared to press it.

Amendment, by leave, withdrawn.
Section 124 agreed to.
SECTION 125.

I move amendment No. 194, in the name of Deputy Murphy:—

In sub-section (1), line 35, after the words "medical practitioner" to insert the words "not being a relative of such person".

I think the principle has been embodied in other sections of the Bill that, where a medical practitioner is required to make an examination of the patient, there should be no degree of relationship.

I do not take too kindly to this amendment and I intend opposing it, at this stage, at any rate. Speaking as a medical man, I rather feel that the principle of depriving a patient, whether mental or otherwise, of the specialised advice of a relative, merely because he is a relative, is scarcely sound. Even a mental patient might have much more confidence in his relative than he might have in a stranger. It is a type of restriction that I would be reluctant to incorporate in a statute.

Amendment, by leave, withdrawn.
Amendment No. 195 not moved.
Sections 125 and 126 agreed to.
SECTION 127.

I move amendment No. 196:—

In sub-section (1) (b), line 11, after the words "medical staffs" to insert the words "and nursing staffs".

We have already accepted the principle of this amendment in relation to medical staffs and the amendment asks the Minister to take power to prescribe the nursing staff.

The difficulty about that is that many of these institutions are run by religious orders and, therefore, we are reluctant to interfere to the extent of determining the number of trained staff and the number of untrained staff that should be employed in such an institution. Apart from that, the argument I put before the House earlier to-day applies with special force here. We can determine with a reasonable degree of accuracy the medical staff that would be required in an institution. We cannot determine the nursing staff because the nursing staff will depend not only on the number of patients but on the type of mental disorder from which the patients are suffering.

First of all, may I point out that there is no suggestion of making regulations which will not have regard to the position of not have regard to the position of religious institutions because here you make regulations for each institution, I take it, so that where the institution is staffed by members of a religious community, due allowances will be made for that? These regulations apply to private institutions registered in the register and they prescribe the medical staff to be employed. I do not know whether or not I am right in saying that there would be regulations in regard to each institution.

There would be.

On the question as to prescribing the number of the nursing staff, I know from experience that while there may be a variation in the number of patients in a particular institution from one period to another, and even a variation in the type of patient being treated, there is no great variation in the number of staff employed. Any sudden demand that has to be met is generally met by the employment of temporary staff. I have seen figures going back over a long number of years which show very little, if any, variation in the number of the basic staff in the institution. It is the basic staff that I would be concerned with to see that within that basic staff there would be sufficient qualified persons, just as the Parliamentary Secretary would be concerned to see that there would be sufficient qualified medical staff.

We will be able to see to .

Amendment, by leave, withdrawn.

That disposes of amendments Nos. 197, 212, 213 and 216, which contain the same idea.

Amendment No. 197 not moved.
Sections 127 and 128 agreed to.
Amendment No. 198 not moved.
Sections 129 to 135, inclusive, agreed to.
Amendments Nos. 199 and 200 not moved.
Section 136 agreed to.
Amendments Nos. 201 to 203, inclusive, not moved.
Section 137 agreed to.
Amendments Nos. 204 to 206, inclusive, not moved.
Section 138 agreed to.
SECTION 139.

I move amendment No. 207:—

To add at the end of the section the words "and it shall be lawful to carry on the institution during that period for the purposes of effecting such discharge, removal and transfer".

This is a drafting amendment. The principle is the same as in amendment No. 188, that we have already dealt with.

Amendment agreed to.
Section 139, as amended, agreed to.
SECTION 140.

I move amendment No. 208:—

In page 57, to add at the end of the section the words "or the Minister consents to his being a member of the governing body".

This is similar to amendment No. 189 and is a drafting amendment.

Amendment agreed to.
Section 140, as amended, agreed to.
Sections 141 and 142 agreed to.
Amendment No. 209 not moved.
Section 143 agreed to.
SECTION 144.

I move amendment No. 210:

In page 57, line 35, to delete the words "interested person" and substitute the words "person authorised by the Minister to inspect such copy".

This is a drafting amendment.

Amendment agreed to.
Section 144, as amended, agreed to.
Section 145 agreed to.
Amendment No. 211 not moved.
Sections 146 and 147 agreed to.
Amendments Nos. 212 and 213 not moved.
Section 148 agreed to.
SECTION 149.
Question proposed: "That section 149 stand part of the Bill."

Does this apply to private charitable institutions as well?

It applies only to private charitable institutions?

It does not apply to religious institutions?

A religious institution may be a private charitable institution.

Question put and agreed to.
Section 150 agreed to.
Amendment No. 214 not moved.
Section 151 agreed to.
SECTION 152.

I move amendment No. 215:—

In page 59, to add at the end of sub-section (3) the words "and it shall be lawful to carry on such institution during that period for the purpose of effecting such discharge, removal and transfer".

This is only a formal amendment of a drafting nature.

Amendment agreed to.
Section 152, as amended, agreed to.
Sections 153, 154 and 155 agreed to.
Amendment No. 216 not moved.
Section 156 agreed to.
SECTION 157.

Section 157 is not being moved. It is found to be adequately covered in other sections of the Bill.

Question—"That Section 157 stand part of the Bill"—put and declared negatived.
SECTION 158.

I move amendment No. 217:—

In sub-section (2), page 61, to insert the word "or" at the end of line 10.

Amendment agreed to.
Section 158, as amended, agreed to.
SECTION 159.

On behalf of Deputy O'Sullivan, I move amendment No. 218:—

In sub-section (1), page 61, line 29, to delete the words "twenty-four" and substitute the word "six".

The section provides that, where application is made for a recommendation for a reception, the authorised medical officer shall within 24 hours after receipt of the application visit and examine the person. We feel that there is no good case to be made for allowing a period of 24 hours to elapse between the time the authorised medical officer receives the application and the time when he visits and examines the person. We are dealing here with the case of a medical practitioner. I am quite sure that if any of us were ill and sent for a doctor we would expect him normally to arrive sooner than 24 hours, except in very exceptional circumstances. In this particular case, where we are dealing with persons suffering possibly from mental trouble, it is even more necessary that the visit and examination should take place as speedily as possible. There may be very good reasons for that. Certainly the whole weight of the argument is against any undue delay. Accordingly, it is proposed in the amendment to substitute a period of six hours for 24 hours and, in a consequential amendment, to make provision whereby, if the authorised medical officer finds that within such a stipulated period of six hours he cannot make the necessary visit, he can arrange with the medical officer for the neighbouring dispensary district to act for him.

The whole purpose of the section I think is to secure that, following upon an application being made for a recommendation for a reception order, within the shortest possible time the person shall be examined and, if found to be suitable for such a recommendation, that forthwith the machinery shall start to operate. This is especially necessary in a case where a person may be suffering from such a form of mental disease that he may be a danger to himself or others or, although he may not be dangerous, because of the conditions in the family, his continued presence in the household may impose a very exceptional strain upon those who may have to care for him.

Unless there is a very strong argument for such an unusually long period of 24 hours in a case like this, I cannot see why a shorter period should not be substituted. Normally, we would all agree that, if a medical practitioner is asked to call in the early hours of the day, he would normally call at least during the afternoon of that day. There may be exceptions, where there is an epidemic or an unusual number of illnesses, and he is not able to call. He also uses his own judgment in cases where his knowledge of the family or of the person sending for him enables him to decide that he can conveniently and safely postpone the particular visit, as the matter would not be serious. However, in a case like this, it is clear that, until the person is examined, there will be no clear idea as to his actual mental state. Very often they will be complete strangers to the medical officer, so it is essential that the visit take place within the normal period that might be expected in the case of an ordinary medical practitioner and not at the end of a period very much in excess of that in which we expect to receive service from a doctor in the ordinary round of his duties.

I take it that it will be obligatory on the medical officer to visit and examine the person within 24 hours, or are we to interpret the section as meaning that he is to visit the patient and keep him under observation for a period of 24 hours before finally reporting on the case?

He is to visit and examine the patient within that time.

I cannot understand why 24 hours was put in, rather than 12 hours or ten hours, or six hours as suggested by Deputy O'Sullivan. I admit that a reasonable time must elapse, as the medical officer might have other cases to attend. The particular case may be a very urgent one, but I do not see that there can be much objection to the 24 hours and I think it would be inadvisable to limit it to the six hours suggested in the amendment. If it can be done in a shorter period than 24 hours, it would be advisable, in the circumstances, but I would not quarrel with it as it stands. I assume that in the 24 hours the visit will have been made and the patient examined, and that the doctor will report on the case.

The main point is that referred to by Deputy Roddy — why 24 hours was fixed for the patient to be left there without anyone attending to him. The idea of the amendment was to ensure that the medical examination would take place within the shortest possible time. Perhaps the Parliamentary Secretary would indicate to us that there is no suggestion that the medical officer shall have a full period of 24 hours, for trivial reasons, to ignore the fact that the patient needs attention.

In this case, it seems that that period of time is necessary. The doctor may like to have the patient under observation for some time and might not be able to make up his mind immediately. It would not be fair to rush him into making a decision in a short period as, in certain circumstances, one can understand that the doctor may want this period.

I think I will be able to satisfy Deputy O'Sullivan that the amendment is unnecessary. It is well to remember that we are dealing in this particular section with the examination and recommendation of chargeable patients. Under this Bill, chargeable patients are in the same category as public assistance patients under the Public Assistance Acts. The dispensary medical officer has already statutory obligations in relation to that class of patient, in the matter of prompt attendance.

I do not think Deputy O'Sullivan would ask the House to assume that the dispensary medical officer will not act up to the traditions of his profession and, if the case appears to be urgent, that he will not attend and examine him within even a much shorter time than six hours. The section provides that he will be under a statutory obligation to attend within 24 hours, but that does not at all mean that the medical officer will wait until the expiration of 24 hours before attending the patient.

Speaking with considerable experience gained in the field on this matter, I can say that the House may assume that, in at least nine cases out of ten, the doctor has been in attendance on this particular patient over a long period. Rarely does mental disorder just come as a bolt from the blue. There is usually a period of considerable anxiety, while palliative remedies are being tried and both the relatives and the doctor are hoping for the best, before they finally decide that the patient must be put under control in an institution. In that way, it will rarely come as a complete surprise to the doctor that he is required to examine and requisition the reception of such a patient. Assuming the exceptional case that may crop up, that there is a considerable degree of urgency and that the doctor is not available, such a contingency is fairly well covered already in Section 5 of the Bill. Section 5 defines the authorised medical officer. It sets out that if the person ordinarily resides in a dispensary district for which there is more than one medical officer, a certain procedure is to be followed. Sub-section (1) (a) says—

"in case none of those medical officers is available or all of them are disqualified in relation to the person, or some are not available and the remainder are disqualified in relation to the person, the nearest available of the medical officers of dispensary districts who are not disqualified in relation to the person."

That means, in somewhat more simple language, that in case of urgency, if the dispensary doctor of the district is not available and if his deputy is not available, one may go to the nearest dispensary doctor. I think that meets every possible consideration that may arise.

Yes. What we had in mind was the question of the distressing circumstances that may surround, not alone the patient but the patient's relatives. We were keen that the shortest possible time should elapse between the incident and the examination of the patient by the medical officer. I am quite prepared to accept the explanation given.

Amendment, by leave, withdrawn.

I move amendment No. 219.

In sub-section (1), page 61, line 36, to delete the word "is" and substitute the words "will, if received, be".

This is a drafting amendment.

Amendment agreed to.
Amendment No. 220 not moved.

I move amendment No. 221:—

In sub-section (2), page 61, line 47, to insert before the word "is" the words "is of unsound mind,".

This is a drafting amendment.

Amendment agreed to.

I move amendment No. 222:—

In sub-section (2), page 61, line 49, to delete the word "three" and substitute the word "six".

This is a drafting amendment. It is consequential upon the proposal that temporary patients should be detained for six months instead of three. The original intention was to detain temporary patients for three months. On further consultation with the psychiatrist, it seems desirable that we should extend the period to six months, as the period of three months seemed rather short.

That would be the full period?

That would be the full period on the first occasion, but then we have power further to extend the period on the recommendation of the resident medical superintendent, with the consent of the Minister.

He can be released before that?

He can be released at any time, if the resident medical superintendent is satisfied that he ought to be released.

Amendment agreed to.

Amendment No. 222 will govern amendments Nos. 236, 248 and 277.

Section 159, as amended, and Section 160 put and agreed to.
SECTION 161.

I move amendment No. 223:—

Before sub-section (4) to insert the following new sub-section:—

(4) Where a recommendation for reception has been made under the preceding sub-section of this section and a relative of the person so recommended for reception is not satisfied that such recommendation should have been made, such relative may by notice to the authorised medical officer have such person further examined by another medical practitioner (selected by such relative) and if upon examination the last-mentioned medical practitioner certifies that the person in respect of whom the recommendation was made is not in his opinion of unsound mind, then such person shall be examined by the resident medical superintendent of the district mental hospital and if the said resident medical superintendent shall certify that such person is of unsound mind, the person aforesaid shall forthwith be admitted to the district mental hospital.

In this section we are dealing with a case where a member of the Gárda Síochána desires to have a person examined because he believes he is of unsound mind. There is a certain procedure set out whereby he applies to the authorised medical officer for a recommendation and, if the recommendation is made, the person will be examined subsequently by the resident medical superintendent. We are dealing with a procedure here which I feel might be open to certain abuse and I believe it is necessary to afford some protection against the unusual case that might arise.

First of all, we have a member of the Gárda Síochána making application. That application is somewhat different from the application envisaged under Section 158, where a husband or wife or the appropriate assistance officer, at the request of the husband or wife or any other person, may make application. Where the application is not made by the husband, wife or relative, I understand there has to be some indication given as to why the application is made by some other person. Where we are dealing with an application made by a member of the Gárda Síochána, we have an unusual set of circumstances. The application is made by a uniformed officer who has no previous knowledge of or contact with the individual, and his opinion as to a person suffering from unsound mind may be based on fortuitous circumstances that have come to his knowledge in the immediate period.

I do not want to suggest—it was suggested earlier—that there is not, in a general way, adequate machinery, or that the machinery may not be adequately utilised; but because we are dealing with mental diseases, we should be careful to see we do not create circumstances which add to the possibility of the person being regarded as of unsound mind rather than safeguarding him from that calamity. Let us take the type of person who may be erratic or peculiar in his behaviour and who has the misfortune to come within the purview of the Gárda Síochána, a member of which feels the individual should be examined. He applies to the authorised medical officer who examines the person and who again has no previous knowledge of that person's life and habits and previous history. On the basis of his examination he may decide that a recommendation should be made.

I feel that the relatives of the person examined should be afforded an opportunity, where they believe there is real ground for thinking that the person is not mentally unsound, of having independent medical testimony and having the person examined by a medical practitioner of their own selection. The final court of appeal in the amendment is the resident medical superintendent. Without casting any aspersion on the Gárda Síochána or on the authorised medical officer, I consider it would be comforting to the relatives of persons who might find themselves dealt with under this section to know that, if they desire, they can call in the family doctor to make the necessary examination.

I agree that, in normal circumstances, if this section goes through without amendment, the authorised medical officer will probably, in nine cases out of ten, take no exception, nor would the Gárda Síochána, to the family doctor being called in. At the same time, I feel there should be as many safeguards in a Bill of this kind as we can possibly provide. I cannot see any reason why we should not make the provision envisaged in the amendment, providing machinery whereby relatives may call in doctors who, to their knowledge, have some acquaintance with the family history of the individual concerned, and in that way satisfy themselves that the person should be brought under supervision and control and that he or she has not been the victim of circumstances of a purely temporary character.

I am afraid I shall have to differ from Deputy Larkin's opinion on that particular point. All through the discussion on this Bill it has been intelligently pointed out that ailment of the mind should be looked upon in the same way as a bodily ailment. The only point on which I differ from Deputy Larkin is that there is a certain suspicion there that the resident medical superintendent, on the one hand, and the medical officer who will recommend an individual, on the other hand, will not do the job sufficiently. I am not saying that was implied, but that was my impression. Take any man suffering from a bodily complaint. The medical practitioner will recommend him to a specialist; whether he suspects it is a case for operation or otherwise, he will send the man to a specialist, to some noted surgeon. The same applies to a man suffering from mental disease. There is no man better able to diagnose that disease than a qualified resident medical superintendent.

In my own experience I came across a case where a man was about to be committed by the Guards and the medical officer and it was suggested that before committing him they should ask the opinion of a resident medical superintendent who happened to be adjacent. The resident medical superintendent expressed the opinion that the man was not a case for a mental hospital. I believe that any man suffering from mental trouble is definitely protected by this particular section. He may be recommended by a dispensary doctor to an institution, but if the resident medical superintendent is not satisfied that the man is suffering from mental disorder, he will not take him into the institution, no matter who sends him there.

These men are men of honour, integrity and experience; they are specialists in that particular disease. I should like the public generally to look upon mental disease as an ordinary complaint and that it is as natural for the mind to be sick as the body.

I am afraid Deputy Burke was not listening to what I said. I accepted the resident medical superintendent as the final court of appeal, but may I point out that what I am concerned with is the position which can quite easily arise? A man or woman is involved in a street scene or is guilty of erratic conduct. The person concerned is taken in charge by a member of the Gárda Síochána, who has no knowledge of the individual. Because of the nature of the conduct, the Guard feels that the person is of unsound mind and he arranges to have an examination, not by a specialist but by an ordinary medical practitioner.

There are no ordinary medical practitioners.

Then what are the specialists?

Mr. Corish

What is the Parliamentary Secretary?

Extraordinary. Medical men are not ordinary at all.

Some of them are very ordinary. However, all medical practitioners are not specialists in mental diseases, and it is a question of having the patient examined by a medical practitioner who very possibly has never had any previous contact with the patient. The Parliamentary Secretary made the point earlier, when we were dealing with the time at which a person should be examined, that, in nine cases out of ten, the dispensary doctor would have had previous contact with the patient, because mental diseases do not come quite suddenly but are a gradual process of mental deterioration. Various remedies are tried for a period and finally a decision has to be made. But here is a different type of case—a complete stranger brought in for examination, of whom the doctor has no previous knowledge. He has no knowledge of the family history and possibly no knowledge of what led to the particular conduct. All he knows is that he is required by the Guards to examine the individual.

I am a layman; Deputy Burke is a specialist in his particular profession with long experience; and the Parliamentary Secretary is a medical man; but both will agree with me that one of the most important factors in considering a case of possible mental illness is to know the history of the individual and his family history. It is especially very helpful to know what went before the particular outbreak that gives rise to anxiety—the particular delusions, mental aberrations, physical actions and so on. None of those is known in a case of this type, and it is only when the person comes to be removed to an institution that he will be examined by a mental expert.

Deputy Burke says that, in the ordinary course, if a person goes to a doctor and the doctor is not quite satisfied as to the condition, he will advise the person to go to a specialist. I am suggesting that a relative of a person who finds himself in this situation should be entitled to bring in a specialist before the person is brought into the atmosphere of an institution. It is no exaggerated view to believe that in certain cases a person may be suffering from temporary excitement, or other form of mental exaltation, and if he remains in a normal atmosphere, will recover, but bring that person into the atmosphere in which he finds himself suspected of suffering from mental disease and he crosses the border. So long as we are dealing with the Bill which has for its object a reducing of the incidence of mental disease, why should we not see that all safeguards are put into the Bill to prevent anything of this nature occurring?

In so far as relatives are concerned, they at least would prefer to have someone near and dear to them examined by a family doctor or specialist before being taken into the atmosphere of an institution. I am not for a moment suggesting that the atmosphere of a mental institution as it appears to the minds of many people is justified in any way. I have the highest regard for them, like Deputy Burke, but we are dealing with people who possibly may not have the same knowledge as Deputy Burke and I have. They are the people for whom we must have regard and not those who may have a deeper insight into the attitude of both the medical and nursing staffs of these institutions towards their patients.

I think Deputy Larkin's arguments are rather far-fetched. I consider it necessary to have some such section as this in the Bill—not that the powers in the section are likely to be exercised very often. It is, however, quite conceivable that in an extreme case, where a person was perhaps a danger to himself or likely to take his own life, it would be necessary to have him removed promptly to the Gárda Síochána barracks. It is only right that some such power should be conferred on somebody. In this case, the power is given to the Gárda Síochána and I think it ridicuculous to assume, as Deputy Larkin assumes, that the Guards are likely to abuse that power. I am quite certain it is one form of duty which the Guards dislike, and it is most unlikely that they will ever exercise their authority under the section except in very extreme cases. I heard of one such case of an unfortunate person who had to be forcibly removed to the Gárda barracks for his own protection. When the Guards do act in this matter, they are likely to act with the co-operation and knowledge of the other members of the household. If, as Deputy Larkin suggests, any members of the family circle object to the action of the Guards in such a matter, I think there is some provision in the later sections whereby any medical officer can be called in to examine the person concerned and to certify that he either is a fit subject for a mental institution or is not suffering from any form of mental disease.

Deputy Larkin has been so completely answered by Deputies Burke and Roddy that it is scarcely necessary for me to reply at all. Deputy Larkin seems to enjoy himself in debates such as this. I do not intend to suggest that in any offensive way, but he conveys the impression that he just delights in arguing. I do not think there is any Deputy who can compete with him in theorising. It is easy enough for anybody to build up the theoretical case, but we have to satisfy ourselves here on the basis of commonsense and the things that are likely to occur in the ordinary course of the operation of a measure such as this, rather than on theoretical possibilities which are very unlikely to arise.

Deputy Larkin may reply to me, and could waste another ten or 15 minutes in telling me that it is the exceptional case we ought to be particularly careful about. The section as it stands does adequately provide for the exceptional case, but it is only in the exceptional case that the Gárda will come into the picture at all under its terms.

Deputies are aware that under the law at the present time an information has to be sworn. The unfortunate patient is placed under arrest, he is brought before two peace commissioners, the dispensary doctor is called in and the patient is committed. There is no machinery under the present law for obtaining any expert opinion until the patient has been actually committed to and institution. We are, at any rate, providing that a patient will not be received until the resident medical superintendent, who is an expert in mental disease, is satisfied that the patient should be so received. In the ordinary course of things, and within the framework of this Bill, the Gárdaí will not come into the matter at all. The reception of the patient will be arranged for between the family doctor and the resident medical superintendent. As Deputies are aware, provision is made in the Bill that, where necessary and expedient, the mental hospital authority will even send out attendants for the purpose of assisting in the removal of a patient. There is the type of case where a person may suddenly become disordered in mind and may wander away from home. The relatives may not know where he is Such a person may be detained by the Gárdaí for his own protection, or for the protection of the public. That is a necessary and essential provision.

Deputy Larkin suggests that, in such circumstances, it is not sufficient to call in the dispensary doctor to determine whether a recommendation should be made for the reception of such a patient. I do not see any reason why that particular type of patient should have the advantage of being examined by a second doctor. Deputy Larkin talked about relatives having the right to call in a second doctor. If the relatives are available the Gárdaí will not be concerned about the reception of the patient. If the relatives are available and ask a doctor to arrange for the reception of the patient, and if the patient is not entitled to free medical care and attention under the Public Assistance Act, then the dispensary doctor does not come into the matter at all, so that the relatives can get, if they wish, not only one doctor but two doctors to secure the reception of the patient. That is all provided for in the Bill. We are only dealing here with the chargeable patient, with the public assistance type of case. I do not think anybody would seriously suggest that there will be any conspiracy between the Gárdaí and the dispensary doctor to get someone put under detention in a mental hospital but if it were possible to envisage such a thing, the position is fully and adequately safeguarded by the fact that the resident medical superintendent has to be satisfied that the patient is a suitable one for reception before he receives the patient.

May I point out that the Parliamentary Secretary has not dealt with the case at all? I dealt with a specific case where a member of the Gárda Síochána takes it upon himself——

He only takes it upon himself for a person's own safety or the safety of the public.

I am not making any accusation against the Gárdaí. If the Parliamentary Secretary has been reading the papers lately he will have seen that while other equally eminent persons carried out their statutory duties, a child died and there was no blame placed on anybody.

Is the Deputy suggesting that we should pay two doctors out of public funds to examine a patient before he can be received in a mental institution?

It is a question of allowing the relatives to employ a doctor.

That type of case would not come under the section at all. We are dealing here with a chargeable patient. The cost of the examination of the patient falls on the rates. If the relatives can afford to pay for the medical examination of a patient, then there will be a private reception of the patient.

The section says: "Where a member of the Gárda Síochána is of opinion". It is not a question, therefore, of a member of the Gárdaí detaining a person and sending for the relatives. It is taken for granted that a member of the Gárdaí will apply for the prescribed form to the resident medical superintendent. That may take place without the relatives being brought into it at all.

How will it take place without the relatives being brought into it at all unless the patient has wandered away from the relatives?

Does it not happen any day in the city?

Nonsense.

It has happened.

Amendment put and negatived.

Section 161 agreed to.
Amendment No. 224 not moved.
Section 162 agreed to.
SECTION 163.

I move amendment No. 225:—

In sub-section (1), page 63, line 11, to insert before the word "may" the words "or, in the case of a recommendation for reception made under Section 161 of this Act, any member of the Gárda Síochána".

Amendment agreed to.
Section 163, as amended, agreed to.
Section 164 agreed to.
Amendments Nos. 226 and 227 not moved.
Section 165 agreed to.
SECTION 166.

I move amendment No. 228:—

To delete sub-sections (1) and (2) and substitute the following sub-section:—

(1) The appropriate assistance officer shall defray the reasonable expenses of the conveyance of the person to whom a recommendation for reception relates to the district mental hospital mentioned in the recommendation save where such person is conveyed thereto by a member of the Gárda Síochána.

Amendment agreed to.
Section 166, as amended, agreed to.
SECTION 167.

I move amendment No. 229:—

In sub-section (1), page 64, line 19, to insert before the word "forthwith" the words "and is a proper person to be taken charge of and detained under care and treatment".

Amendment agreed to.
Section 167, as amended, agreed to.
Sections 168 and 169 agreed to.
SECTION 170.

I move amendment No. 230:—

In sub-section (3), page 65, line 19, to delete the word "he" and substitute the words, "and if the Minister so directs, such person".

Amendment agreed to.
Section 170, as amended, agreed to.
SECTION 171.

I move amendment No. 231:—

In paragraph (a), page 65, line 42, to delete the words "mental hospital authority for the mental hospital" and substitute the words "public assistance authority for the public assistance".

Why the change?

The amendment is intended to provide that, where the Gárda Síochána incur expenses in connection with the removal of a person for examination or in connection with the removal of a person to a district mental hospital the expenses shall be paid by the public assistance authority instead of by the mental hospital authority. All through the Bill the expenses of removal and reception are being paid by the public assistance authority.

Amendment agreed to.

I move amendment No. 232:—

To add to the section a new sub-section as follows:—

(2) Expenses repaid under this section by a public assistance authority shall be recoverable under the Public Assistance Act, 1939 (No. 27 of 1939), by such authority as if the expenses represented the cost of public assistance within the meaning of that Act given by such authority to the person removed.

This is a drafting amendment.

Amendment agreed to.
Section 171, as amended, agreed to.
SECTION 172.

I move amendment No. 233:—

In page 66, lines 8 and 9, to delete the words "of such district mental hospital" and substitute the words "and the dispensary district in which he is for the time being."

The effect of the amendment is that a person who has to be admitted, in case of urgency, to a district mental hospital, not being the mental hospital for the district in which he ordinarily resides, if the district in which he ordinarily resides cannot be readily ascertained, shall be regarded as ordinarily resident in the dispensary district in which he is for the time being. It is merely a machinery amendment to govern such a contingency.

Amendment agreed to.
Section 172, as amended, agreed to.
SECTION 173.

I move amendment No. 234:—

In sub-section (2), page 66, line 20, to delete the word "paying" and substitute the word "private".

This is a drafting amendment. We dealt with the principle earlier.

Amendment agreed to.
Section 173, as amended, agreed to.
SECTION 174.

I move amendment No. 235:—

In sub-section (2), page 67, line 5, to insert before the words "or partner" the words "guardian or trustee,".

The effect of this amendment is to add a guardian or trustee of a person of unsound mind to the list of persons prohibited from signing a private patient's reception order. We had a similar principle much earlier in the course of discussion.

Amendment agreed to.

I move amendment No. 236:—

In sub-section (2), page 67, line 14, to delete the word "three" and substitute the word "six".

This is a consequential amendment.

Amendment agreed to.
Section 174, as amended, agreed to.
SECTION 175.

I move amendment No. 237:—

In sub-section (1), page 67, line 38, to delete the words "or the" and substitute the words "guardian or trustee, or".

This is similar to an amendment we have already agreed to.

Amendment agreed to.
Section 175, as amended, agreed to.
Section 176 agreed to.
SECTION 177.

I move amendment No. 238:—

In sub-section (1), page 68, line 5, to delete the word "appropriate".

The word "appropriate" there is superfluous. It is merely a drafting amendment.

Amendment agreed to.
Section 177, as amended, agreed to.
SECTION 178.

I move amendment No. 239:—

In sub-section (2), page 68, line 45, to delete the word "he" and substitute the words ", if the Minister so directs, such person".

This also is a drafting amendment.

Amendment agreed to.
Section 178, as amended, agreed to.
Section 179 agreed to.
SECTION 180.

I move amendment No. 240:—

In sub-section (2), page 69, to insert the word "or" at the end of line 31 and at the end of line 34.

This is a drafting amendment.

Amendment agreed to.

I move amendment No. 241:—

In page 69, to delete sub-section (4) and substitute the following sub-section:—

(4) An application under this section shall be accompanied by a certificate in the prescribed form of the authorised medical officer certifying that he has examined the person to whom the application relates on a specified date not earlier than seven days before the date of the application and is of opinion either—

(a) that such person—

(i) is suffering from mental illness, and

(ii) requires, for his recovery, not more than six months suitable treatment, and

(iii) is unfit on account of his mental state for treatment as a voluntary patient, or

(b) that such person—

(i) is an addict, and

(ii) requires, for his recovery, at least six months preventive and curative treatment.

I do not quite understand that amendment.

It follows on amendment No. 1, where we brought drug addicts within the category of temporary patients. It is a reconstruction of the section because of the fact that we have brought the addicts in under amendment No. 1.

Amendment agreed to.
Amendment 242 not moved.
Section 180, as amended, agreed to.
SECTION 181.

I move amendment No. 243:—

In sub-section (1), page 70, to delete the word "paying" in line 3 and in line 7 and substitute in each case the word "private".

This is consequential on previous similar amendments.

Amendment agreed to.

I move amendment No. 244:—

In page 70, to delete sub-section (4) and substitute the following sub-section:

(4) An application under this section shall be accompanied by a certificate in the prescribed form signed by two registered medical practitioners certifying that each of them has examined separately the person to whom the application relates on a specified date not earlier than seven days before the date of the application and is of opinion either—

(a) that such person—

(i) is suffering from mental illness, and

(ii) requires, for his recovery, not more than six months' suitable treatment, and

(iii) is unfit on account of his mental state for treatment as a voluntary patient, or

(b) that such person—

(i) is an addict, and

(ii) requires, for his recovery, at least six months' preventive and curative treatment.

Amendment agreed to.
Amendment No. 245 not moved.

I move amendment No. 246:

In sub-section (5), page 70, to delete the word "or" in line 33 and to delete paragraph (d).

Amendment agreed to.
Section 181, as amended, agreed to.
SECTION 182.

I move amendment No. 247:—

In sub-section (1), page 70, line 48, to delete the word "appropriate".

This is a drafting amendment, consequential on a previous similar amendment.

Amendment agreed to.

I move amendment No. 248:—

In sub-section (1), page 70, to delete the word "three" in line 51 and in line 56 and substitute in each case the word "six".

Amendment agreed to.
Section 182, as amended, agreed to.
SECTION 183.

I move amendment No. 249:—

To delete sub-sections (1) and (2) and substitute the following sub-section:—

(1) The appropriate assistance officer shall defray the reasonable expenses of the conveyance of the person to whom a temporary chargeable patient reception order relates to the approved institution mentioned in the order.

This is a drafting amendment.

Amendment agreed to.
Section 183, as amended, agreed to.
Section 184 agreed to.
SECTION 185.

I move amendment No. 250:—

Before Section 185, but in Part XIV, to insert a new section as follows:—

185.—(1) Where the chief medical officer of an approved institution becomes of opinion that a person detained in the institution under a temporary chargeable patient reception order or a temporary private patient reception order will not have recovered on the expiration of the period during which, pursuant to paragraph (b) of sub-section (1) of Section 182 of this Act, he may be detained the person in charge of the institution may request the Minister to extend the said period and thereupon the Minister, if he so thinks fit, may by order extend the said period, by a further period not exceeding six months or by a series of orders extend it by further periods none of which shall exceed six months and the aggregate of which shall not exceed eighteen months.

(2) In sub-section (1) of this section, the reference to a chief medical officer shall, where the relevant approved institution consists of premises for the reception of one person only, be construed as a reference to the medical attendant of the person detained.

This is a new section providing for the extension of the period during which a temporary patient may be detained if he is not expected to recover within the period of six months provided in the Bill. I mentioned this point earlier in the discussion today, that it may be found, at the expiration of the period of six months, that while a patient is not permanently disordered in mind, a further period of detention as a temporary patient would be desirable. This gives power to extend the period of detention as a temporary patient.

Amendment agreed to.

I move amendment No. 251:—

In sub-section (3), page 71, line 48, to delete the word "fourteen" and substitute the word "seven".

This amendment provides that an application for the reception of a person as a temporary patient and a chargeable patient shall be accompanied by a recommendation of the authorised medical officer to the effect that he examined the patient not earlier than seven days before the date of the application, instead of 14 days as in the Bill. The period of 14 days appeared, on full consideration, to be rather long.

Amendment agreed to.
Amendment No. 252 not moved.
Section 185, as amended, agreed to.
SECTION 186.

I move amendment No. 253:

In sub-section (1), page 71, line 52, to delete the word "paying" and substitute the word "private".

This is a consequential drafting amendment.

Amendment agreed to.

I move amendment No. 254:

In sub-section (3), page 72, line 10, to delete the word "fourteen" and substitute the word "seven".

This is consequential on one we have disposed of.

Section 186, as amended, agreed to.
SECTION 187.

I move amendment No. 255:

In page 72, to add at the end of the section the words "and, on his recovery, may be discharged".

This is a drafting amendment.

Amendment agreed to.
Section 187, as amended, agreed to.
SECTION 188.

I move amendment No. 256:

In sub-section (1), page 72, line 21, to delete the words "may, in his discretion" and substitute the word "shall".

Amendment agreed to.
Section 188, as amended, agreed to.
Sections 189, 190, 191, 192, 193, 194, 195, 196 and 197 agreed to.
SECTION 198.

I move amendment No. 257:

In sub-section (2) page 74, line 44, to delete the words "or an approved institution".

This is only a drafting amendment; there is no new principle in it.

Amendment agreed to.
Section 198, as amended, agreed to.
SECTION 199.

I move amendment No. 258:—

Before Section 199 to insert a new section as follows:—

199. (1) The chief medical officer of a mental institution may permit a person detained in such institution who is not dangerous to himself or others to be absent from such institution on parole for any period not exceeding 48 hours.

(2) In sub-section (1) of this section the reference to a chief medical officer shall, where the relevant mental institution consists of premises for the reception of one person only, be construed as a reference to the medical attendant of the person detained.

(3) Where a person absent on parole under this section from a mental institution does not return on the expiration of the period during which he is permitted to be absent, he may at any time within 28 days after the expiration of such period be retaken in like manner as if he had escaped from such institution.

This new section proposes to give power to the chief medical officer of a mental institution to allow a patient who is not dangerous to himself or others to absent himself on parole for a period not exceeding 48 hours.

Amendment agreed to.
Section 199, as amended, agreed to.
SECTION 200.

I move amendment No. 259:—

In sub-section (3), page 75, to delete in lines 48 and 49 the words "subject to the approval of the Inspector of Mental Hospitals".

This is merely a drafting amendment.

Amendment agreed to.

I move amendment No. 260:—

In page 75, to insert before sub-section (4) a new sub-section as follows:—

(4) Where a person is removed under this section from a mental institution, a report containing full particulars of the removal shall be given to the Minister not later than three days after the removal.

The amendment is intended to provide that, where a patient is sent from a mental institution to a hospital or place for treatment full particulars shall be furnished to the Minister.

Amendment agreed to.
Section 200, as amended, agreed to.
SECTION 201.

I move amendment No. 261:—

In page 75, to insert before Section 201 a new section as follows:—

(1) A mental hospital authority may make and carry out an arrangement for the boarding-out in a private dwelling (whether within or outside their mental hospital district) of any person detained as a chargeable patient in their district mental hospital or any other institution maintained by them.

(2) A mental hospital authority may, with the consent of the applicant for the relevant reception order, make and carry out an arrangement for the boarding-out in a private dwelling (whether within or outside their mental hospital district) of any person detained as a private patient in their district mental hospital or any other institution maintained by them.

(3) A person detained in a district mental hospital or other institution maintained by a mental hospital authority shall not be boarded-out under this section save where the following conditions are complied with:—

(a) that the boarding-out of the person is recommended by the resident medical superintendent of such hospital.

(b) that the person is certified by the resident medical superintendent not to require treatment in an institution and not be dangerous to himself or others,

(c) that the mental hospital authority are satisfied that the person will be comfortably housed, sufficiently fed and clothed, and otherwise suitably provided for,

(d) that the mental hospital authority are satisfied that the person in charge of the proposed dwelling is trustworthy and will carry out the directions given to him in relation to the person boarded-out,

(e) that no other person is boarded-out under this section in the same dwelling.

The Bill, as drafted, provided for the boarding out of charitable patients. It is now proposed to make provision for the boarding out of private patients, and this and other amendments embody the necessary reconstruction in order to provide for the possible boarding out of private patients as well as charitable patients.

With reference to the inspection of dwellings where patients are boarded out, I think that will throw a lot of work on the Inspector of Mental Hospitals, and some provision should be put into the Bill in order to give him assistance. The Inspector of Mental Hospitals, as he is situated at present, has a good deal of work to do in going around the mental hospitals. The boarding out of patients is a fine idea because it will bring patients in touch with home life and take them away from life in an institution. It is a step which has to be taken cautiously here because we have not advanced so far as they have on the Continent in that regard. Strict supervision, however, will be needed. In my opinion, the suitability of the dwelling and everything else will have to be taken into consideration, and local inspectors appointed to see that the patients get proper treatment and are not made slaves of in any way.

If the Deputy examines Section 201 and relates the amendment I have submitted to the House to that section as drafted, I think he will find that we have made a very comprehensive effort, at any rate, to afford the widest possible protection to the patient boarded out. If the Deputy can indicate to me, either now or on the Report Stage, how we can further improve the section I shall be very glad to consider his recommendations. But we certainly have provided here very comprehensive machinery, at any rate, so far as it is humanly possible, to safeguard the patient particularly, because we are not so very much concerned in this particular section with anybody other than the patient who, in certain circumstances, may be boarded out.

The Inspector of Mental Hospitals, of course, will not be bound to inspect all these dwellings or homes in which people may be boarded out. Periodical inspections by the resident medical superintendent or a medical officer on the staff of the mental institution will have to be carried out; but I am sure Deputy Burke would not level any criticism at us on that score.

Sub-section (5) (n) says that the Inspector of Mental Hospitals may at any time inspect the dwelling and the person in charge of the dwelling shall give to the inspector all reasonable facilities. It is well to have the power vested in the Inspector of Mental Hospitals, in order to give him a statutory right to inspect. From time to time we might hear complaints that everything was not as it should be in the home and, for the protection of the mental hospital authorities and their staffs and for the protection of the patients, it is well to have the necessary statutory power to send out the Inspector of Mental Hospitals in cases where we receive any complaint, in order that we may have first-hand information as to the actual conditions which obtain.

On the point raised by Deputy Burke, I think it will be agreed that the provisions embodied in the new section are fairly comprehensive. There were three amendments down—two in the name of Deputy O'Sullivan and one in my name.

If the Deputy would look at these three amendments, he will see that 264, 265, and 266 could be resubmitted on Report and all would be to Section 202 and redraftedmutatis mutandis for Report. It might be done now, but it is not a satisfactory procedure.

I accept that. This is just a point of explanation. Deputy Burke has raised the question of the very strict supervision of residences where persons may be boarded out. In that connection, might I ask the Parliamentary Secretary if he would not consider that the shorter period of three months in the case of public assistance officers, and 12 months in the case of the resident medical superintendent, should be put in as the limit in regard to visits? Three months is a fairly considerable period. I am not so concerned about the position of the resident medical superintendent as, if there were short periodical visits by the public assistance officer, he could inform the resident medical superintendent or the Inspector of Mental Hospitals, if he found a fault. In regard to the duties of the Inspector of Mental Hospitals, would there not be a possibility of utilising the members of visiting committees who are prepared to interest themselves in the matter?

I think we have an amendment to be discussed on that point.

Your own amendment?

It is not my own. However, I am prepared to discuss that with the Deputy. I have no objection to the principle of that amendment, which is quite a good one, but the amendment would have to be drafted in a different form. There are such points as the number of members of the committee who should go, whether in groups of two or four, and such matters. I quite agree with the principle. If we can interest members of the visiting committee to go round periodically and see how these people are getting on, they can take any complaints and bring them to the proper quarter.

I was not going to move that amendment, so I raised this as a point of explanation.

I will probably circulate for the Report Stage an amendment that will satisfy the Deputy. On the point of three months, 12 months or one month, I find myself in much the same position as I found myself in in regard to the 24 hours within which the medical officer should visit and examine a patient. It must be done within a certain period, but it does not follow that it is not to be done, if necessary, very much more often. Again, the number of visits that might be necessary will depend very largely on the type of patient that is boarded out. There may be a type of patient that it would not be necessary to see for a period of six months, while there may be another type that it would be necessary to see every month. I am afraid we cannot make a hard and fast rule that will work satisfactorily.

No, it cannot be done.

Is there any machinery that would make it possible to require the public assistance officer to make more frequent visits?

Possibly we could meet that administratively. He would be subject to the same local authority, as public assistance officer, and in that way the public assistance authority could insist on more frequent visits. It would be unnecessary to put in a statutory obligation here. He is not really the officer concerned; we are only borrowing his services.

Amendment agreed to.

I move amendment No. 262:—

To insert before Section 201 a new section as follows:—

(1) Where a person (in this sub-section referred to as the patient) detained as a chargeable patient is boarded-out under Section 201 of this Act in any dwelling by a mental hospital authority, the following provisions shall have effect:—

(a) the mental hospital authority shall inform the Minister of the boarding-out of the patient,

(b) the appropriate assistance officer shall visit the patient from time to time and not less often than once in every three months,

(c) the resident medical superintendent of the district mental hospital of the mental hospital authority or another medical officer of such hospital shall visit the patient from time to time and not less often than twice in each year or, if the Minister directs that he shall be visited more frequently, not less often than may be appropriate in accordance with the direction,

(d) whenever the patient is visited pursuant to paragraph (b) or (c) of this sub-section, the person making the visit shall enter a report of the visit in a book which the person in charge of the dwelling shall keep and shall produce for the purpose of such entry being made,

(e) the appropriate assistance officer or the resident medical superintendent, on being required by the mental hospital authority to furnish any information in relation to the patient or the dwelling, shall give such information,

(f) the appropriate assistance officer or the resident medical superintendent, if he is not satisfied with the condition of the patient or the dwelling or if he considers it necessary to make any recommendation in relation to the patient, shall make a special report on the case to the mental hospital authority,

(g) if the patient becomes at any time in need of medical aid, the person in charge of the dwelling shall—

(i) report the matter to the appropriate assistance officer or, in a case of urgency, call on the services of the medical officer of the dispensary district in which the dwelling is situated or, if that officer is not available, of any other registered medical practitioner, and

(ii) report the matter to the resident medical superintendent and include in such report the name of the medical officer or other registered medical practitioner (if any) whose services have been called on,

(h) if the patient is ill and there is, in the opinion of a medical practitioner attending the patient, anything unusual in the illness calling for the attention of the resident medical superintendent, the practitioner shall report the illness to the resident medical superintendent,

(i) the mental hospital authority may at any time remove the patient to any institution maintained by them or to a different private dwelling, and, if the patient becomes dangerous to himself or others, it shall be the duty of the mental hospital authority to remove him forthwith to an institution maintained by them,

(j) where the mental hospital authority remove the patient pursuant to paragraph (i) of this sub-section, they shall inform the Minister of the removal,

(k) the mental hospital authority may, on the recommendation of the resident medical superintendent, discharge the patient if he ceases to be of unsound mind,

(l) if the patient is discharged, the resident medical superintendent shall, not later than seven days after the discharge, inform the Minister thereof,

(m) if the patient dies, the person in charge of the dwelling shall forthwith report the death to the resident medical superintendent, and the mental hospital authority, if they so think fit, may pay the cost of the burial of the patient,

(n) on receipt of a report of the death of the patient, the resident medical superintendent shall inform the Minister of the death,

(o) the payment to be made by the mental hospital authority in respect of the maintenance, clothing, and care of the patient while boarded-out shall be determined by the mental hospital authority, but shall not exceed such amount as may be approved of by the Minister,

(p) the Inspector of Mental Hospitals may at any time inspect the dwelling and the person in charge of the dwelling shall give the inspector all reasonable facilities for carrying out such inspection, and shall also produce the book kept by him for the purposes of paragraph (d) of this sub-section for inspection by the inspector.

(2) If any person required to do any act by sub-section (1) of this section fails to do such act, he shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding £20.

This is a redraft.

I presume that these three amendments, Nos. 261, 262 and 263, are in substitution for Section 201.

Amendment agreed to.

I move amendment No. 263:—

To insert before Section 201 a new section as follows:—

(1) Where a person (in this sub-section referred to as the patient) detained as a private patient is boarded-out under Section 201 of this Act in any dwelling by a mental hospital authority, the following provisions shall have effect:—

(a) the mental hospital authority shall inform the Minister of the boarding out of the patient.

(b) the resident medical superintendent of the district mental hospital of the mental hospital authority or another medical officer of such hospital shall visit the patient from time to time and not less often than once in every three months or, if the Minister directs that he shall be visited more frequently, not less often than may be appropriate in accordance with the direction,

(c) whenever the patient is visited pursuant to paragraph (b) of this sub-section, the person making the visit shall enter a report of the visit in a book which the person in charge of the dwelling shall keep and shall produce for the purpose of such entry being made,

(d) the resident medical superintendent, on being required by the mental hospital authority to furnish any information in relation to the patient or the dwelling, shall give such information,

(e) the resident medical superintendent, if he is not satisfied with

the condition of the patient or the dwelling, or if he considers it necessary to make any recommendation in relation to the patient, shall make a special report on the case to the mental hospital authority,

(f) if the patient becomes at any time in need of medical aid, the person in charge of the dwelling shall either—

(i) report the matter to the resident medical superintendent, or

(ii) in a case of urgency, call on the services of any registered medical practitioner and report to the resident medical superintendent the name of such practitioner and the fact that his services have been called on,

(g) if the patient is ill and there is, in the opinion of a medical practitioner attending the patient, anything unusual in the illness calling for the attention of the resident medical superintendent, the practitioner shall report the illness to the resident medical superintendent,

(h) the mental hospital authority may at any time remove the patient to any institution maintained by them or to a different private dwelling, and, if the patient becomes dangerous to himself or others, it shall be the duty of the mental hospital authority to remove him forthwith to an institution maintained by them,

(i) where the mental hospital authority remove the patient pursuant to paragraph (h) of this sub-section, they shall inform the Minister of the removal,

(j) the mental hospital authority may, on the recommendation of the resident medical superintendent, discharge the patient if he ceases to be of unsound mind,

(k) if the patient is discharged, the resident medical superintendent shall, not later than seven days after the discharge, inform the Minister thereof,

(1) if the patient dies, the person in charge of the dwelling shall forthwith report the death to the resident medical superintendent,

(m) on receipt of a report of the death of the patient, the resident medical superintendent shall inform the Minister of the death,

(n) the Inspector of Mental Hospitals may at any time inspect the dwelling and the person in charge of the dwelling shall give the inspector all reasonable facilities for carrying out such inspection, and shall also produce the book kept by him for the purposes of paragraph (c) of this sub-section for inspection by the inspector.

(2) If any person required to do any act by sub-section (1) of this section fails to do such act, he shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding twenty pounds.

Amendment agreed to.
Amendments Nos. 264, 265 and 266 not moved.
Section 201 not moved.
Section 202 agreed to.
SECTION 203.

I move amendment No. 267:—

In page 78, to delete sub-section (2) and substitute the following sub-sections:—

(2) The person carrying on a mental institution not maintained by a mental hospital authority may apply to the Minister for an order authorising the transfer of a person detained in the institution under a reception order to another mental institution, and thereupon the Minister, if he so thinks fit, may by order authorise such transfer.

(3) Before the Minister gives a consent under sub-section (1) of this section or makes an order under sub-section (2) of this section, there shall be produced to him an approval in writing of the proposed transfer, signed by the applicant for the reception order relating to the person proposed to be transferred, unless, for due cause shown, the Minister dispenses with the production of such approval.

This amendment is intended to make provision for the transfer to another an institution of a patient maintained in an institution other than one maintained by a mental hospital authority. It is only a machinery amendment.

Amendment agreed to.
Section 203, as amended, agreed to.
Section 204 agreed to.
SECTION 205.

I move amendment No. 268:—

In sub-section (1), page 78, lines 20 and 21, to delete the word "paying" and substitute the word "private".

This is consequential on the previous similar amendments dealing with the question of paying patients and private patients.

Amendment agreed to.
Section 205, as amended, agreed to.
SECTION 206.

I move amendment No. 269:—

To delete sub-section (2), page 78, and substitute the following sub-section:—

(2) The recommendation referred to in sub-section (3) of Section 185 of this Act shall, in the case of an application made in pursuance of sub-section (1) of this section in relation to a person detained in an institution and who does not ordinarily reside in the dispensary district in which the institution is situate, be made by the authorised medical officer who would be appropriate to make the recommendation if such person were ordinarily resident in that dispensary district.

This amendment proposes that the recommendation should be made by the authorised medical officer who would be appropriate if the person were ordinarily resident in the dispensary district in which the institution is situated. It is a machinery amendment.

Amendment agreed to.
Section 206, as amended, agreed to.
SECTION 207.

I move amendment No. 270:—

In sub-section (1), page 79, line 22, to delete the word "paying" and substitute the word "private".

This is a drafting amendment.

Amendment agreed to.
Section 207, as amended, agreed to.
Section 208 agreed to.
SECTION 209.

I move amendment No. 271:—

In sub-section (1), page 80, line 2, to delete the words "mental institution" and substitute the words "district mental hospital or other in stitution maintained by a mental hospital authority".

This amendment is intended to limit the provisions of the section to a patient maintained by a mental hospital authority. There is already similar provision in relation to other patients in Section 205.

Amendment agreed to.

I move amendment No. 272:—

In sub-section (1), page 80, lines 6 and 7, to delete the words "will no longer be a charge on the ratepayers and".

This is really a drafting amendment. There might be circumstances in which a patient would be a charge on the ratepayers. He might be in receipt of home assistance.

Amendment agreed to.
Section 209, as amended, agreed to.
SECTION 210.

I move amendment No. 273:—

In sub-section (1), page 80, lines 14 and 15, to delete the words "subject to the provisions of sub-section (3) of this section" and substitute the words "save where the Minister directs the discharge of such person under this Act".

This is a drafting amendment.

Amendment agreed to.

I move amendment No. 274:—

To delete sub-sections (2) and (3) and substitute the following sub-section:—

(2) Where a certificate is given under this section, the following provisions shall have effect:—

(a) notice in writing of objection to the certificate may be given to the Minister by or on behalf of the person to whom the certificate relates,

(b) on receipt of such notice, the Minister may, by notice in writing given to the person in charge of the relevant mental institution, require such person to give to the Minister a copy of the certificate and such person shall comply with such requisition forthwith,

(c) the Minister, on receipt of such copy of the certificate, may require the Inspector of Mental Hospitals to examine the person to whom the certificate relates,

(d) after consideration of the report of the Inspector of Mental Hospitals on his examination of the person to whom the certificate relates, the Minister, if he so thinks fit and provided that not more than fourteen days have elapsed since he received such copy of the certificate, may direct the discharge of the person to whom the certificate relates and, if the Minister so directs, such person shall be discharged accordingly.

The amendment proposes that where a medical certificate is given the person to whom it relates may give notice in writing to the Minister of objection to the certificate, and the Minister may then require the person in charge of the institution to give him a copy. On receipt of the certificate, the Minister may proceed as before provided. It is a machinery amendment.

Amendment agreed to.
Section 210, as amended, agreed to.
SECTION 211.

I move amendment No. 275:—

In sub-section (2), page 80, lines 48 and 49, to delete the words "his discharge and he" and substitute the words "the discharge of such person and, if the Minister so directs, such person".

This is a drafting amendment.

Amendment agreed to.
Section 211, as amended, agreed to.
Sections 212 and 213 put and agreed to.
NEW SECTION.

I move amendment No. 276:—

Before Section 215 to insert a new section as follows:—

215.— The resident medical superintendent of a district mental hospital shall from time to time make available to the mental hospital authority by whom the hospital is maintained case books showing the mental condition of the persons detained in the hospital and the other institutions maintained by the authority, and shall so make such case books available that a case book showing the condition of each person so detained is submitted to the authority at least once in each year.

This section will replace Section 214. Section 214 requires the resident medical superintendent to submit a report to the mental hospital authority at least once in each year on each person detained in the district mental hospital or other institution. The amendment provides for the submission of case books showing the mental condition of each patient detained.

Does it mean that you will have the history of every case?

The case books will have all the particulars and, instead of making out a separate report, the resident medical superintendent will submit the case books.

Amendment agreed to.

The acceptance of amendment No. 276 involves the deletion of Section 214 of the Bill.

Sections 215, 216 and 217 put and agreed to.
SECTION 218.

I move amendment No. 277:—

In sub-section (2), page 82, line 2, to delete the word "three" and substitute the word "six"

This is a drafting amendment and is consequential on the proposal to provide that a temporary patient may be detained for six instead of three months.

Amendment agreed to.
Section 218, as amended, and Section 219, put and agreed to.
SECTION 220.

I move amendment No. 278:—

In page 83, to delete in lines 4 and 5 the words "receivable as", to delete in line 14 the words "receivable as" and to delete in line 15 the words "so receivable" and substitute the words "a chargeable patient".

This is a drafting amendment.

Amendment agreed to.
Section 220, as amended, and Sections 221, 222, 223, 224, 225 and 226, put and agreed to.
SECTION 227.

I move amendment No. 279:—

In page 86, line 36, to delete the words "not maintained by a mental hospital authority".

Section 227 requires the Inspector of Mental Hospitals, when he visits an institution not being maintained by a mental hospital authority, to give special attention to the state of mind of a patient, the propriety of whose detention he doubts or has been requested to examine. The amendment proposes to delete the words "not maintained by a mental hospital authority". The provisions of the section will then apply to an institution maintained by a mental hospital authority as well as to one not so maintained.

Amendment agreed to.
Section 227, as amended, agreed to.
SECTION 228.

I move amendment No. 280:—

Before Section 228 to insert a new section as follows:—

227. — (1) Where the Inspector of Mental Hospitals becomes of opinion that the propriety of the detention of a patient detained in a district mental hospital or other institution maintained by a mental hospital authority requires further consideration, he shall report the matter to the Minister.

(2) After consideration of a report under sub-section (1) of this section, the Minister may, if he so thinks fit, require the Inspector of Mental Hospitals to visit the patient to whom the report relates and to make a report on his mental condition to the Minister.

(3) After consideration of a report under sub-section (2) of this section, the Minister may, if he so thinks fit, by order direct the discharge of the patient to whom the report relates and, if the Minister so directs, the patient shall be discharged accordingly.

The amendment proposes to insert a new section before Section 228, setting out the procedure to be followed when the propriety of the detention of a patient detained in a district mental hospital or other institution maintained by a mental hospital authority requires further consideration.

Amendment agreed to.

I move amendment No. 281:—

Before Section 229 to insert a new section as follows:—

228. (1) Where the Inspector of Mental Hospitals becomes of opinion that the propriety of the detention of a patient detained in a mental institution not maintained by a mental hospital authority requires further consideration, he shall report the matter to the Minister.

(2) After consideration of a report under sub-section (1) of this section in relation to a patient detained in a mental institution, the Minister may, if he so thinks fit, require the Inspector of Mental Hospitals and the resident medical superintendent of the district mental hospital nearest to such institution (in this section referred to as the visitors) to visit the patient.

(3) On a requisition being made by the Minister under sub-section (2) of this section, the visitors shall make two visits to the patient, the second visit being not less than 18 days after the first visit.

(4) A first visit and a second visit under this section to a patient shall be made by the same persons as the visitors.

(5) Not less than 14 days' notice of a second visit under this section to a patient shall be given by the Inspector of Mental Hospitals—

(a) to the person in charge of the mental institution where the patient is detained, and

(b) if it is practicable, to the person at whose instance the patient is detained.

(6) A notice under sub-section (5) of this section to the person in charge of a mental institution may (without prejudice to the giving of such notice in any other manner authorised by this Act) be given by an appropriate entry in any register of patients kept in the institution.

(7) After a second visit under this section has been made to a patient. the Inspector of Mental Hospitals shall make a report on the patient's mental condition to the Minister.

(8) After consideration of a report under sub-section (7) of this section, the Minister, if he so thinks fit, may by order direct the discharge of the patient to whom the report relates and, if the Minister so directs, the patient shall be discharged accordingly.

(9) The Minister may pay to a resident medical superintendent visiting under this section such sum for his services and expenses as may be prescribed.

These are merely drafting changes.

Amendment agreed to.

Section 228 is not being moved; amendments Nos. 280 and 281 are being substituted for it. The acceptance of amendment No. 281 involves the deletion of Section 228 of the Bill.

Sections 229, 230 and 231 put and agreed to.
SECTION 232.

I move amendment No. 282:—

In sub-section (1), page 87, to delete paragraph (a) and substitute the following paragraph:—

(a) a list of the patients which shall, in the case of a district mental hospital or other institution maintained by a mental hospital authority, distinguish chargeable patients from others and which shall, in all cases, distinguish males from females and indicate the patients believed to be curable.

This is a drafting amendment.

Amendment agreed to.
Section 232, as amended, and Sections 233, 234 and 235, put and agreed to.
SECTION 236.

I move amendment No. 283:—

At the end of the section to add the following new sub-section:—

(8) Every report made under this section shall be laid before each House of the Oireachtas.

In Section 235 provision is made that every report will be laid before each House of the Oireachtas. I wonder why we could not have the same facilities in regard to Section 236?

I will look into the point on the Report Stage.

Amendment, by leave, withdrawn.
Section 236 put and agreed to.

With regard to Section 237, I would like to inform the House that I am not quite satisfied with the section as it stands, and I will submit a redraft of it on the Report Stage. We need not go into that now.

Sections 237, 238, 239, 240, 241, 242 and 243, put and agreed to.
SECTION 244.

I move amendment No. 284:—

In sub-section (2), page 91, to insert in line 25 before the word "to" the words "or any order or regulation made thereunder" and to insert in line 29 before the word "shall" the words "and the orders and regulations made thereunder".

This is a drafting amendment.

Amendment agreed to.
Section 244, as amended, put and agreed to.

Will the Committee continue with this Bill? It is almost finished. Of course, it is for the Committee to decide.

We have no objection.

Very good. It is hardly worth while dropping it now.

Sections 245, 246, 247 and 248, put and agreed to.

As regards Section 248, I may have to submit a redraft of the section on the Report Stage.

SECTION 249.

I move amendment No. 285:—

In page 92, line 6, to insert before the word "boarder" the word "a".

It is a drafting amendment.

Amendment agreed to.
Section 249, as amended, and Sections 250, 251, 252, and 253, put and agreed to.
SECTION 254.

I move amendment No. 286.

In page 92, line 50, to insert before the word "or" the words "a mental hospital authority".

The amendment proposes to make the mental hospital authority one of the parties from whom letters from patients shall be forwarded unopened.

Amendment agreed to.
Section 254, as amended, put and agreed to.
SECTION 255.

On behalf of Deputy Corish, I move amendment No. 287:

In lines 2 and 3 to delete the words "if the Minister so directs".

Apparently, the purpose is to inquire why the notices are to be kept posted only if the Minister so directs. I consider they should be kept posted in any event.

The section provides that notices setting forth the right of a patient to have letters forwarded should be kept posted in prominent positions in a mental institution. It is considered that to adopt that as a uniform practice might have a bad effect on certain patients. There are many of these patients — I am sure Deputy Burke will bear me out — who have a mania for writing letters, and if certain patients are encouraged in the idea that they are going to get well of their mental derangement by writing letters to the Minister, they will spend nearly all their time writing letters. Consequently, it is desirable that the Minister, acting through his Inspector of Mental Hospitals, should have a say as to where these notices should be posted and the particular institutions in which they should be posted.

Amendment, by leave, withdrawn.
Section 255 agreed to.
SECTION 256.

It will not be necessary to move this section, as it is proposed to delete it.

Section 256 not moved.
Sections 257 to 260, inclusive, agreed to.
Amendment No. 288 not moved.
Section 261 agreed to.
SECTION 262.

I move amendment No. 289:—

In sub-section (1), page 93, line 45, to insert before the word "by" the words ", at the time of such retirement, relinquishment of commission, or discharge,"

This is a drafting amendment.

Amendment agreed to.
Section 262, as amended, agreed to.

I move amendment No. 290:—

Before sub-section (4), in page 94, to insert the following new sub-section:—

(4) Where an order under this section has been made and the mental hospital authority of the district mental hospital to which the person to whom the order relates is sent, disagrees with the decision of the Minister for Defence, they may appeal against such decision to the Minister who shall consider the appeal and give a decision on same and in such event his decision shall be final and conclusive.

The purpose of the amendment is to provide some appeal against the Minister for Defence, and in this case we want to appeal to the Minister who exercises authority under the Bill as a whole. Otherwise, it would appear that the Minister for Defence is the final court of appeal in his own cases.

I think it is unusual to provide for an appeal to one Minister against another, but the mental hospital authority will be able to exercise their powers under Section 103 in relation to any such patient. If the Deputy is not satisfied when he examines Section 103 more fully, he can mention the matter on Report.

Amendment, by leave, withdrawn.
Section 262, as amended, agreed to.

I move amendment No. 291:—

In sub-section (5), page 94, line 23, to insert before the word "reception" the words "chargeable patient".

This is a drafting amendment.

Amendment agreed to.
Section 262, as amended, agreed to.
Amendment No. 292 not moved.
Sections 263 and 264 agreed to.
SECTION 265.
Question proposed: "That Section 265 stand part of the Bill".

What is the reason for the change here? The usual provision is a barrister of not less than 10 years' standing.

It was considered that a barrister of six years' standing would have sufficient experience for the purpose, but if the Deputy feels very strongly about it——

Give the young fellows a chance.

I might be talking against myself.

I cannot say that we had the Deputy particularly in mind.

Question put and agreed to.
SECTION 266.

I move amendment No. 293:—

In sub-section (6), page 96, line 27, to delete the word "costs" and substitute the word "sum".

This is a drafting amendment.

Amendment agreed to.
Section 266, as amended, agreed to.
Sections 267 and 268 agreed to.
Amendment 294 not moved.
Section 269 agreed to.
Amendments Nos. 295 and 296 not moved.
Section 270 agreed to.
SECTION 271.

I move amendment No. 297:

In sub-section (1), page 98, line 5, to delete the words "a prepaid registered" and substitute the word "an".

This amendment is intended to provide that notices to the Minister need not be sent in registered envelopes. They will reach us without the sender going to the trouble of registering them.

Amendment agreed to.
Section 271, as amended, agreed to.
SECTION 272.

I move amendment No. 298:

In page 98, to delete in lines 29, 35 and 40 the words "the President" and to substitute in each case the words "a Judge".

This also is a drafting amendment.

Amendment agreed to.
Section 272, as amended, agreed to.

I move amendment No. 299:

In page 98, to insert after Section 272 a new section as follows:—

273 —(1) Each of the following sections shall be a specified section for the purposes of this section:—

(a) Sections 17 and 18 of the Lunacy (Ireland) Act, 1821,

(b) Sections 2 and 3 of the Criminal Lunatics (Ireland) Act, 1938,

(c) Section 12 of the Central Criminal Lunatic Asylum (Ireland) Act, 1845,

(d) Sections 12 and 13 of the Lunatic Asylums (Ireland) Act, 1875,

(e) Section 2 of the Trial of Lunatics Act, 1883,

(f) Section 17 of the Criminal Justice Administration Act, 1914.

(2) Nothing in this Act shall affect any power exercisable immediately before the commencement of this section under any specified section.

(3) No power, restriction or prohibition contained in this Act shall apply in relation to a person detained by virtue of any specified section.

This amendment is intended to provide that the Act shall not affect any power exercisable before the commencement of the section in relation to such enactments.

Amendment agreed to.
FIRST SCHEDULE.

I move amendment No. 300:—

In the third column opposite the mention of the Local Government (Ireland) Act, 1898, to add the following repeal: "proviso (b) to sub-section (2) of Section 110."

This is a drafting amendment.

Amendment agreed to.

I move amendment No. 301:—

In the third column opposite the mention of the County Management Act, 1940, to add the following repeal: "paragraph 8 of the Second Schedule."

Amendment agreed to.
First Schedule, as amended, agreed to.
Second Schedule agreed to.
THIRD SCHEDULE.

I move amendment No. 302:—

In rule 1, page 100, line 4, to delete the words "a number of persons appointed" and substitute the words "the persons appointed in accordance with these Rules."

Amendment agreed to.
Amendment No. 303 not moved.

I move amendment No. 304:—

Before rule 2 to insert the following rule:

2. The total number of the members of a joint board shall be such as the Minister from time to time by order determines in respect of such board.

It is proposed to insert a new rule to enable the Minister to determine the number of members who shall constitute a joint board. It meets the point raised by Deputy M. O'Sullivan in his amendment No. 303, and, I think, by Deputy Larkin.

Amendment agreed to.

I move amendment No. 305:—

Before rule 3 to insert the following rules:—

3. Where an appointment by the council of a county of members of a joint board is being made, two-thirds at least of the members appointed shall be persons who are members of the council.

4. Where an appointment by the corporation of a county borough of members of a joint board is being made, two-thirds at least of the members appointed shall be persons who are members of the city council of the county borough.

Amendment agreed to.

I move amendment No. 306:—

In rule 5, page 100, before sub-paragraph (1) to insert the following new sub-paragraph:—

(1) Every person who shall directly or indirectly have any interest in any contract made with a joint board shall be disqualified to act on or be a member of such joint board or of any committee appointed by or with the approval of such joint board.

The purpose of the amendment is to continue the ordinary disqualification clause as applying to members of the local authority. I am not quite clear as to whether it is necessary, or whether the present disqualifying clause in relation to a member of the borough corporation will continue where that member is a member of a mental hospital authority.

Contracts will be determined by the manager under the Managerial Act.

Amendment by leave, withdrawn.

I move amendment No. 307:—

In rule 6, paragraph (1), page 101, lines 12, 13 and 14, to delete the words "and to the resident medical superintendent of the district mental hospital maintained by the joint board.

The amendment provides that a member of the joint board appointed by a county council may resign membership by giving written notice to the secretary. It is merely a machinery amendment.

Amendment agreed to.

I move amendment No. 308:—

In rule 6, paragraph (2), page 101, lines 19, 20 and 21, to delete the words "and to the resident medical superintendent of the district mental hospital maintained by the joint board".

Amendment agreed to.

I move amendment, No. 309:—

To delete rule 16 and substitute the following rule:—

Chairman and Vice-Chairman.

16.—(1) At every annual meeting of a joint board, the board shall elect one of their members to be chairman of the board and may elect another of their members to be vice-chairman of the board.

(2) Whenever the office of chairman or vice-chairman of a joint board becomes vacant otherwise than by the termination of the ordinary term of the office, the board shall at their next meeting after the vacancy occurs elect one of their members to be chairman or vice-chairman of the board.

(3) A person elected to be chairman or vice-chairman of a joint board shall, unless he sooner ceases to be, or becomes disqualified for being, a member of the board, hold office as chairman or vice-chairman until the day after his successor has been appointed.

(4) The chairman or vice-chairman of a joint board may at any time resign his office as chairman or vice-chairman by giving notice in writing signed by him to the board, but the resignation shall not become effective until the commencement of the meeting of the board held next after the receipt by them of the resignation.

(5) Whenever the chairman or vice-chairman of a joint board ceases to be, or becomes disqualified for being, a member of the board, he shall forthwith cease to be chairman or vice-chairman of the board.

(6) Whenever, at the election of chairman of the joint board, 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 board.

The amendment proposes to make more detailed provision for the election of chairmen and vice-chairmen than that contained in the Bill. It also provides for tenure of office of chairman and vice-chairman, for resignation and disqualification from office.

Amendment agreed to.

I move amendment No. 310:—

To delete rule 23 and substitute the following rule:—

23.—At a meeting of a joint board—

(a) the chairman of the board shall, if he is present, be chairman of the meeting,

(b) if and so long as the chairman of the board is not present or the office of chairman is vacant, the vice-chairman (if any) shall, it he is present, be chairman of the meeting,

(c) if and so long as the chairman of the board is not present or the office of chairman is vacant and there is no office of vice-chairman, the vice-chairman is not present or the office of vice-chairman is vacant, the members of the board who are present shall choose one of their number to be chairman of the meeting.

This is a drafting amendment.

Amendment agreed to.
Third Schedule, as amended, agreed to.
Title agreed to.
Bill reported with amendments.
Report Stage ordered for Wednesday, 11th April.