Public Health Bill, 1945—Second Stage (Resumed).

Question again proposed: "That the Bill be now read a Second Time."

Mr. Cogan

Yesterday I was dealing with one particular section of this Bill, the section which provides for the isolation and internment of persons suffering from infectious disease. I pointed out the grave danger involved in the enforcement of this section with out adequate protection for the citizen. I candidly admit that there is need for far-reaching power in regard to cases of this kind. On various occasions, when the Estimate for Local Government was under consideration, I have suggested that there was need in certain cases for special powers, but I never envisaged a Bill such as this which provides no safeguard whatever for the citizen except an appeal to the Minister. I maintain that an appeal to the Minister from a decision of the local county medical officer of health is not an adequate protection for the citizen. The Minister has many important functions to perform, many responsibilities, and in matters of this kind he is forced to rely to a great extent on the advice of his Department. When I raised that point yesterday the Parliamentary Secretary rather sneeringly suggested that the type of appeal board might be a farmers' organisation. I do not think the Parliamentary Secretary is wise in referring sneeringly to farmers. Farmers are a rather formidable clan, as the Parliamentary Secretary must know as a result of the recent elections, and they have a habit of cropping up in all constituencies, even the Parliamentary Secretary's constituency. But, while the Parliamentary Secretary may have put that suggestion forward by way of a sneer, I think it would be better to have an appeal board comprised exclusively of farmers rather than an appeal exclusively to the Minister because in a matter of this kind a board comprised of impartial, independent laymen, even though they might be farmers, would be preferable to an appeal board comprised of a Minister who must rely to a very great extent upon his Department for advice.

But I do not suggest that the appeal board which would give protection to people affected by this Bill should be composed exclusively of farmers. In my opinion, the proper appeal board would be one upon which various important interests would be represented. The Parliamentary Secretary in his opening statement referred to the spiritual and material aspects of life which this Bill affected. I think, in administering this Bill, provision should be made not only for the material aspect of life but for the spiritual aspect of life. In my opinion there is nobody more suitable for membership of an appeal board of this kind, which would consider the rights of the citizen as against the rights of officialdom, than the clergy of all denominations. On such a board the Churches should be represented because this is a matter into which the moral law comes to a great extent; it is a matter in which the rights and dignity of the human personality are deeply concerned. There is no one more fit to decide what the rights of the citizens are and what the moral responsibilities of the State are than those who have been divinely appointed to the sacred vocation of religion.

I suggest, therefore, that on a board of this kind the clergy should be represented. Probably the medical profession should be represented and ordinary laymen should also be represented. Thus you would have a board to which the citizen who felt aggrieved could appeal with some confidence; that would provide at least some safeguard to the person who feels that, in the Bill as it stands, he would be exposed possibly to injustice. Injustice arises not only in connection with the arrest and internment of persons suffering from infectious diseases but also in connection with the interference with the rights of parents in respect of their children. I think an appeal board established in each county would be absolutely necessary because quite a large number of cases would probably require to be considered. I suggest that such an appeal board should be a purely voluntary body. We do not want to add to bureaucracy in this State.

Having condemned that particular section of the Bill as it stands, I think it is only fair to say that this measure, while it has many bad points, has some good features also. It is only fair to say that it is a measure which has received considerable thought and it is a thought-provoking matter. It is a measure which I am sure will set everybody who has the best interests of the country and the best interests of social development at heart furiously thinking. That is why I suggest that it would be undesirable to force the Second Reading through the House. It would be better to postpone the Second Reading until after the recess.

The good features of the Bill which we must place on the credit side are the provisions in it for mother and child welfare, for improvement and establishment of bathing facilities, for the regulation of itinerants and people camping out, and so on, and also the regulations which are made for the protection of human food. All these provisions are good and desirable but against them we must weigh the disadvantages and dangers which are definitely and expressly contained in the Bill. We have, first of all, interference with the rights of citizens and the rights of parents. We have also the serious burden which this Bill must inevitably place on local taxation. During the past 12 or 13 years the burden of local rates has increased enormously. In 1931, £4,600,000 odd was collected from the local ratepayers. Last year £7,500,000 was collected. That is a very formidable increase in the burden of direct taxation on the people and, when we consider how inequitably the burden of direct taxation is distributed, we must take cognisance of the fact that a severe burden is placed on our people which it is difficult to justify.

It is particularly difficult to justify this increased burden in view of the fact that a very comprehensive scheme for social services, which included many of the things contained in this Bill, was recently propounded and published by the Most Rev. Dr. Dignan. In that plan there was provision for the financing of better social services out of a scheme of social insurance. I personally believe that it would be better to have any further extension of the social services financed by means of a social insurance scheme rather than that it should be thrown on the rates. For a variety of reasons I think that would be desirable. It would be desirable in the first place because, in the case of social insurance, the burden would be more equitably distributed and, in the second place, it would relieve those benefiting by the scheme from the stigma of pauperism which is to a certain extent implied in the relief schemes which we are at present administering, particularly of the type advocated or prescribed in this Bill. I think it was very unwise and altogether wrong to have ignored completely the plan put forward by the Most Rev. Dr. Dignan and that at least good reason should have been given for rejecting that plan and substituting the provisions contained in this measure.

There is also implied all through this measure a formidable increase in bureaucracy and bureaucratic control over the lives and activities of our people. Provision is made in this Bill for an enormous increase in the staffs of the medical services throughout the country. The Bill will tend to bring more and more of the medical profession directly under the control of the State. The Parliamentary Secretary would have been wise if he had given some attention to the statement recently made by Most Rev. Dr. Browne, Bishop of Galway, when he warned against the increased interference on the part of the State with the rights of parents. He made it very clear that, even where parents were neglectful of their duties, that in itself did not justify the State in taking children away from their parents. There should at least, first of all, be a far-reaching attempt on the part of the officials of the State to persuade the parents to do their duty and, under no circumstances, should we have the hasty removal and the forcible removal of children from their parents and the breaking up of home life.

The Parliamentary Secretary will, of course, in reply tell me that State officials do not act hastily, do not act drastically in matters of this kind. But everyone who has experience of administration on public boards knows that State officials are just as temperamental as anyone else, just as temperamental as politicians, and even as temperamental as Ministers, and that we have had cases in which officials have interfered to an extent which could not be justified in any circumstances. Only recently I had to protest very vigorously against a State official forcibly removing boarded-out children from foster-parents who were treating them properly. The children were being removed on the grounds that they were being transferred to a more prosperous home. But, notwithstanding that, force was used, and the Guards were brought in to take these children away from their foster-parents.

I have no doubt whatever that, if this Bill goes through as it is without amendment, force will be used, and used extensively, in the breaking up of families and the taking of children away from their parents, and in the removal of citizens to places of detention. I have grave reason to fear that the drastic powers we are giving to the Minister and his Department will be used extensively. I do not think that we, as members of this Parliament, can stand over such provisions unless the safeguards which I have suggested are provided. If we ensure that the necessary safeguards are provided, then we will have taken some steps to preserve the rights of the citizens. If the Minister wants to get those powers without any check or control whatever, I think the House will have to refuse to give him those powers.

I am sure that the Parliamentary Secretary, when replying, will devote some time towards extolling the integrity and high standing of those people who will be called upon to enforce the drastic provisions of this Bill. As far as the medical profession generally is concerned, its members are of the highest standard. The medical profession is one of the noblest professions in existence. Its members have inherited a high tradition of devoted service to the community, and particularly to the suffering members of the weakest section of the community. Now that the Parliamentary Secretary is taking increased powers of administration over the medical profession and bringing it more and more under his control, I hope he will take adequate steps to preserve the high traditions of that profession, and will see that its status and dignity are not only maintained and preserved, but are increased.

Weighing up the pros and cons of this Bill, I think we will have to decide that the balance is against it. It sets out to tackle one of the joint evils which beset humanity—sickness and disease—but it proposes to tackle the evil by methods which cannot be justified either on moral grounds or on grounds of expediency. It is always better to seek to achieve good by inducement rather than by force. I commend the sections which provide benefits and compensation and inducements of that kind to people who have to be taken to sanatoria or otherwise interfered with or detained. These features of the Bill are desirable, but nothing that can be said in regard to the evil of the diseases it is sought to eradicate or with regard to the danger they are to the public, can justify the drastic provisions we have here.

Therefore, I ask the Minister to withdraw the Bill and reconsider the whole matter, not only in the light of what has been said in this House, but in the light of the Doctor Dignan report. I am sure that, if the Parliamentary Secretary is given an opportunity to introduce another Bill in the near future, it will be a vast improvement on the one before us now. If this House passes the Second Reading of this Bill, it will be the duty of the House to seek to amend it drastically, but I believe we would not be doing our duty to the people we represent if we were to allow the Bill to pass its Second Stage in its present form.

Mr. M. O'Sullivan

A perusal of this Bill compels the almost immediate conclusion that its terms are very definitely in line with the growing tendency of late to centralise all the affairs of local authorities in the hands of the Minister, while at the same time imposing on local authorities financial obligations which are not primarily theirs. Running through this Bill as a whole, one confirms the idea that the Minister is completely dissociated from the affairs of local authorities. Deputy Mulcahy complained that, apparently, there was no co-operation between the medical profession and the Department in the framing of this Bill. My complaint would lie more with the fact that, since its operation will ultimately be a matter for the local authorities, no consultation appears to have taken place with the individuals who may be said primarily to represent the local authorities in a matter of this kind, that is, the county medical officers of health.

Previous speakers have referred to the undue strain this Bill will place on local authorities. I can well imagine the Parliamentary Secretary replying, as he has done on previous occasions, that it is the obligation of local authorities, particularly where social services are concerned, to ensure that they shall be met with the necessary amount of finance. He naturally will not twit members on this side of the House, particularly on these benches, with our obligations to the ratepapers. Recently the position of the ratepayers has become more clearly defined. There was a time when "ratepayers" was synonymous with industrialists and large shopkeepers, but that no longer obtains. Nowadays, every individual in the community, even those in flats and in small dwellings, is paying rates indirectly, if not directly. They are paying more in the line of direct rates than they have been in the past. For instance, the Dublin Corporation has 24,000 tenants paying rates directly. Their rates are anchored to the rents and, obviously, the rents go up and down in the same ratio as the rates go up and down. The ambit has been widened for people of that character and these individuals are now very deeply concerned.

Those of us who are public representatives, and closely associated with the ratepayers, are placed in a position of responsibility, and on occasions we have to account for that expenditure. We have never hesitated, in my own council—and I am sure other representatives can say the same—where matters relating to social services arose. Local representatives will take the responsibility, but it is an undeniable fact that, in recent years, the policy of the Minister has been to unload his responsibility for local government on to the shoulders of the local authorities. That practice is extending. I can conceive no more easy task than that of the Parliamentary Secretary here this evening. He is interested in public health—a commendable interest, and one we all share—but his duties are comparatively light. He simply gives instructions to the Parliamentary draftsman to draw up a Public Health Bill under certain headings, stating that certain things are required. Then he makes certain that he will have the major portion of the control, and directs the local authority to carry out, with their own finances, the obligations that he places on them in a Bill of this character.

I say that, from a Ministerial point of view, that is work easily done, but it does not end there. To give you an illustration of the points I am making with regard to this Bill—that is, the question of centralisation of control, control in the hands of the Minister, and the financial obligations resting on the local authorities—I could not do better than refer you to Section 13 and Section 73. Section 73 deals with a simple matter; it relates to the examination of samples of food and drink, and it sets out:

"(a) provisions requiring the submission to the Minister by every proprietor of the food of samples of the food for examination of their nature, substance, quality or condition."

Submission to the Minister, mark you. Why to the Minister? Why not to the county medical officer of health, the person most concerned? I will now refer to Section 13, which relates to the provision and maintenance of health institutions, and it says:

"(3) A health authority shall, whenever the Minister, by Order so directs—

(a) restore, enlarge or otherwise alter in accordance with the Order any institution maintained by them pursuant to this section..."

You will observe that a health authority "shall". That means that in the morning we could be directed, as the Bill says, to restore, enlarge, or otherwise alter any institution; but there is no indication from the Government of their share of responsibility in the setting up of that institution. There is a complete disavowal of financial responsibility so far as the Minister is concerned, and it is all unloaded on the shoulders of the local authorities. One might understand that to a degree if the representatives of local authorities were taken into consideration, but so far as I know they have not been consulted.

I object to these two features of the Bill. I recognise the difficulty there will be in having this altered satisfactorily in Committee, particularly in so far as the financial clauses are concerned, because it is not open to any private Deputy to put down an amendment that will make a charge on public funds. This is a feature of the Bill that is agitating the minds of many members of the House, and I suggest the Parliamentary Secretary should recast his ideas in this particular respect.

There is another aspect of the Bill in which I am interested, and that is Section 34, about which we have heard quite a good deal. When the Sanatorium Bill was going through the House the Minister was applauded for his efforts in connection with it—and quite properly. We were all satisfied that it was his intention to give us a scale of allowances for the dependents of tuberculosis patients undergoing treatment in various sanatoria. I listened very carefully to the Parliamentary Secretary's Second Reading speech and I would subscribe to every word he said in so far as tuberculosis patients are concerned. It is perfectly true, and public representatives have experience of this sort of thing every day, that young men who are in employment are wrongly continuing that employment, risking their own health and a danger to the health of others for only one reason. That is, that they are married, there are probably three or four children, and the young father knows full well that the moment he lies down, the moment he goes to a sanatorium, that is the end of his household. No provision is made, except through the medium of public assistance, to keep the roof over his family's head until he returns. Medical men—and the Parliamentary Secretary subscribed to that idea— have said time out of mind that it is almost impossible to attempt curative treatment with a patient of that description. The patient is inevitably worried about what is happening in his home. The answer would be, an adequate scale of allowances.

I was twitted when I raised this matter only two days ago on the Housing (Amendment) Bill. The Minister for Local Government suggested that I must not have read the Bill or the explanatory memorandum, because otherwise I would have observed the great news conveyed in Section 34; that was, that we would be in a position under this Bill to set up a scale of allowances of that particular type. I read the Bill carefully because I was interested, and I know all about Section 34, but my complaint remains as strong as ever it was on this particular subject. When the Sanatorium Bill was going through the Oireachtas the Dublin Corporation had it under observation and there are members of the corporation here, representing all Parties, who gladly took part in the discussion, and they decided, as a gesture of good will towards the Parliamentary Secretary, that they would guarantee, towards the scale of allowances of the type I have referred to, a 50 per cent. grant from the rates, conditional on an equivalent grant being given by the Government.

I put down a Parliamentary Question on the subject and the Parliamentary Secretary disclaimed all responsibility, from a national point of view, so far as a contribution from the Government would be concerned. We are now told we have all we desire in Section 34. I say there is no such provision and the section is in line with practically every other section in the Bill in that responsibility is placed absolutely on the shoulders of the local authority. This section of the Bill is not a solution of a very vexed social question, a question that calls aloud for redress. There is, in my opinion, a lack of the necessary appreciation and recognition of the problem on the one hand, and of the position that the local authority occupies, on the other. I do not know in what way the position can be altered, but that again is purely a matter for the Minister. We have, it appears, an arbitrary decision on the part of the Minister in that the Bill has been introduced in this form without any consultation with people who would know something about the subject and who would have a more sympathetic understanding of the problems to be faced. That is the position that exists and it is to be hoped that the Minister will adopt a different attitude.

With regard to infectious disease, a good deal has been said on this question but I want to draw the Parliamentary Secretary's attention, especially, to Section 28. In my opinion, that section has been very loosely drawn and in its present form it would impose intolerable obligations on the individuals who would be named as in charge of public conveyances, persons such as, for instance, guards of trains and bus conductors in Dublin and other cities. The section says:

"(3) The person in charge of a public conveyance used for the conveyance of passengers at separate fares shall not convey therein a person whom he knows to be a probable source of infection with an infectious disease to which this section applies."

Well, well—"whom he knows to be a probable source of infection." What standard of knowledge must he have? He must know an individual is suffering from an infectious disease—and tuberculosis, in the words of the Parliamentary Secretary, is now listed as such.

General Mulcahy

He has a dictionary.

Mr. O'Sullivan

"... a person whom he knows to be a probable source of infection". You can envisage a state of affairs where malicious and vindictive information could be passed in a matter of that kind and it could lead not alone to all sorts of personal embarrassment and humiliation, but possibly actions in the law courts. I cannot congratulate the draftsman on that particular section. The next sub-section is a good one, too:—

"(4) Where a person in charge of a public conveyance who is not the owner of the conveyance learns that a person has been conveyed in the conveyance while a probable source of infection with an infectious disease..."

That certainly is not legislation, and I am certain the Parliamentary Secretary does not desire that the section should stand in that form. In any case you will have a public outcry against it.

Mr. O'Sullivan

My final remarks are in reference to the regulations under the Bill. A good deal of authority rests with the Minister in relation to the making of regulations and the success or failure of the Bill will depend largely on those regulations. Apparently there has been no co-operation, no consultation, as between the local authorities and those responsible for the Bill, but I appeal to the Parliamentary Secretary to assure us that, in relation to this important section of the Bill dealing with the making of regulations, co-operation will be enlisted, particularly so far as the medical staffs of local authorities are concerned. There is, for instance, the question of standards of food. We have no standard for the simple but useful commodity, cream, in this city, nor have we any standard for the very popular commodity, ice-cream. A whole series of matters relating to public health will arise out of these regulations, and I appeal to the Minister to ensure that there will be the closest co-operation with the local authorities in drafting these regulations.

I agree with Deputy Cogan that there are many excellent features in the Bill which aim at uplifting the standard of public health, but it is a great pity that they have been introduced in this rather arbitrary and unsympathetic manner, so far as a decision between the Minister and the local authorities is concerned.

Mr. Roddy

I agree with Deputy O'Sullivan that the Minister for Local Government, especially in recent years, has endeavoured to unload his responsibility on to the local authorities, and, at the same time, has tried to deprive these authorities of whatever little freedom they enjoy. It is a tendency which is not peculiar to the Minister for Local Government. The same tendency is noticeable in the legislation introduced by all the Ministers in recent years, and it is a tendency which, I suppose, will continue until the local authorities eventually react, and react vigorously, against it. I sincerely hope they will do so very shortly.

The Minister has told us that this Bill is but the first step in the codification of the public health code. He gave us only a faint indication of what the measures to follow this will be like. I do not know how many other measures there will be, but I have a hazy recollection of reading somewhere that there are about 100 Local Government Acts—some of them perhaps intermixed with the legislation of other Government Departments—and assuming that there are about 100, I take it that it will be necessary to introduce three other Bills about the size of this Bill to codify all the public health legislation.

If the other Bills are to contain the same drastic provisions as this, there will not be a scintilla of freedom left to the people of this country. If the other legislation which is in contemplation follows on the same lines as this, every man, woman and child in this country will be reduced to the position of a marionette, whose every action will be controlled by strings pulled by the Parliamentary Secretary in the Custom House.

Some of the sections in this Bill are positively dangerous, because they hold us up to the gaze of the world as a diseased, unclean and verminous people, and suggest that it is necessary to introduce the most drastic legal provisions in order to make us observe the simple, ordinary sanitary decencies of life. I wonder is the Parliamentary Secretary aware of the implication of legislation such as this. Is he aware of the possible reactions of legislation of this kind, of its possible effects on us in various directions? Some of us can recall an anti-tuberculosis campaign started in this country in the early years of the present century by a certain distinguished lady. We know the effect that campaign had on the trade and industry of this country and there are sections in this Bill which bear some analogy to that type of campaign. There are sections which, if they are given legislative effect, are likely to have a harmful effect on the people of the country.

I submit that much of the projected legislation in this Bill is quite unnecessary, and, furthermore, that the Parliamentary Secretary could have achieved his end by propaganda rather than by the introduction of what I regard as insulting proposals of this character, because these proposals are really an insult to the character and habits of our people. If the Minister for Local Government embarked on an intensive propaganda campaign, with the object of bringing home to the people the importance of observing the elementary laws of health and sanitation, and utilised as agencies for the carrying out of that propaganda, the schools, the churches, the newspapers, local councils, the various social welfare and other organisations in the country, he would be more likely to achieve the objects he has in view than by these proposals.

I do not see for the life of me how it is proposed to make the people keep themselves clean by legislation of this type. I have never heard of any country in the world whose people observe the elementary laws of sanitation as a result of legislation. Surely the aims and objects the Minister has in view lend themselves admirably to intensive propaganda. I believe that if the Minister instead of introducing insulting proposals of this character, organised a propaganda campaign of that kind, on the right lines, on intelligent lines, and succeeded in getting the co-operation of influential people and organisations throughout the country, he would succeed in his object.

Mr. Allen

That is what Lady Aberdeen did.

Mr. Roddy

There are many sections in the Bill which cannot be enforced. I cannot see how the sections relating to the owners of houses, public vehicles and the owners of transport vehicles, and so on, are ever to be enforced, unless the Minister is prepared to employ an army of public servants for the purpose of enforcing them.

Mr. D. Morrissey

Of course he is.

Mr. Roddy

They can never hope to be enforced, and is it not making a mockery of legislation to include sections which the Parliamentary Secretary, I believe, knows perfectly well can never be enforced? I submit, furthermore, that proposals of this kind should never have been embodied in such a Bill as this, without the Parliamentary Secretary having first explored fully the propagandist field. It was only when propaganda failed that he should have resorted to drastic measures of this character. Now, the Minister is to unload more responsibilities on the local authorities. They will have to provide all the money for the purpose of giving effect to the Minister's proposals, and will not have a shred of control.

All through the Bill we have such phrases as "by order of the Minister", "the Minister by order directs", "it shall be the duty of the Minister", and so on, but never once does the phrase occur, "after or in consultation with the local authorities". The Minister is taking absolute power to direct the local authorities to spend money in any way he decides. If he wants the local authority to erect a public institution, he directs them to do so. In every respect he can direct them to carry out the provisions of the Bill. If he wants a local authority to embark on a scheme for the purpose of increasing the drainage facilities of an area, they must do so. It is true that in that case they may be able to recover some part of the cost. At all events, the Minister is taking to himself an absolute power of direction, and the local authorities must carry out his directions. That, as Deputy O'Sullivan has said, is autocracy with a vengeance. After all, if the Parliamentary Secretary really believes that this measure is going to be effective for its purpose, does he not think that, if it is to succeed when it becomes an Act, he must enlist and have the support of the local authorities, and that it will be impossible to enforce it without having their assistance and co-operation? He could, and would, get valuable advice and help in various ways from local authorities if only he sought their co-operation and assistance. But no, he apparently has made up his mind that he is the one person in this country who knows anything at all about the administration of public health.

It has been suggested that he did not even consult the medical profession about the terms of the Bill. No matter how able or competent the Parliamentary Secretary is, he surely does not expect the House to accept it that all the knowledge and all the brains in relation to public health can rest in one solitary head. I say that he has made a cardinal mistake in incorporating drastic sections of the character I have referred to in this Bill, sections which will probably do a great deal of harm to this country. Secondly, he has made the mistake of ignoring the local authorities. It should have been his aim and ambition from the outset to enlist their support and assistance during various stages of the operation of the Bill, and to seek their advice wherever it was necessary to do so.

There is no Bill wholly bad. There are undoubtedly some good features in this Bill. I am sorry that they were not incorporated in a separate Bill, and that the dangerous ones were not dropped altogether. I do not propose to discuss in detail the various good features of the Bill, but there is one that is deserving of some comment, namely, the section relating to the provision to be made for the dependents of people suffering from infectious diseases. That, of course, was foreshadowed by the Parliamentary Secretary some 12 months ago. I thought that it would have been incorporated in some earlier measure. However it is better late than never, and it is a good thing to find it in this Bill.

The section relating to consultative councils is rather vague. There is very little information given as to how these councils are to be constituted. Presumably, there is to be a number of them. The Minister can set up any number, apparently, that he likes. Will there be one for each health authority area, and will the local authorities be forced to bear the expenses of these consultative councils? It appears to me that there is already a consultative council in each health area, composed of, say, the county medical officer of health, the local medical officers of health and the county manager. With the chairman of the county council a body of that sort could or should form a consultative council in a health area. Therefore, it should only be necessary to establish a consultative council with headquarters here in Dublin. I take it that these consultative councils will be established for the purpose of giving advice on various forms and types of disease, and that each will be a specialist in its own particular line to give expert advice on particular matters referred to it.

Dr. Ward

That is the purpose of the section.

Mr. Roddy

So that it is not proposed to set up local consultative councils?

Dr. Ward

No.

Mr. Roddy

Section 95 deals with the disposal of bodies otherwise than by burial. I am interested to know how the Parliamentary Secretary proposes to dispose of bodies otherwise than by burial. I hope that he is not going to become too modern.

Dr. Ward

The Minister does not propose to dispose of them.

Mr. D. Morrissey

I am surprised.

Mr. Roddy

That is how it is phrased. That, at all events, is a small point. In Section 102, it is proposed that an officer of a health authority may arrest people because he suspects them to be suffering from some form of contagious disease. That seems to me to be a very drastic power to give to anybody: that an official can stop a person on the street because perhaps he does not look too well at the moment or because, according to his information, the person may be suffering from some disease, and arrest him. It is an unheard of authority to give to anybody, that he may arrest a person because of his looks or of the way he is walking.

Mr. Allen

When this Bill was read by Deputies, I am sure most reasonable Deputies came to the conclusion that it was a comprehensive and far-reaching measure. I am sure the House expected from the Leader of the chief Opposition Party a different line of approach from that indicated yesterday. If the views expressed by Deputy Mulcahy yesterday evening, and to a lesser extent, by Deputy Roddy to-day, are the best available to the chief Opposition on the subject of the public health of this country, we can only pray, God help the country. Deputy Mulcahy occupied half an hour yesterday evening telling us about this revolutionary measure. Of course, he was going to the Supreme Court immediately with it to have it declared to be not in comformity with the Constitution. He as much as told us so yesterday evening. I doubt if the House was ever treated to anything like the piffle and nonsense that he talked here. One would think there was no such measure on the Statute Book and in operation in this country as the Public Health Act, 1878. I wonder have Deputies read that Act. If they read it they will find that there is far more drastic legislation in operation under the Public Health Act, 1878 and certain amending Acts than is embodied in this measure as set out here.

What does this Bill propose to do? It is set out very clearly. Part II prescribes the general duty of the Minister in regard to public health and the establishment by the Minister of consultative councils. Is there anything revolutionary in that or anything that the House can object to? It sets out the duty of the Minister and prescribes that the Minister may establish consultative councils to give the Minister advice and assistance in matters affecting public health. Part III of the Bill provides for the provision and maintenance of health institutions; discontinuance of health institutions; agreement for use of institution; charges for institutional services; management of health institutions. I wonder what is wrong about Part III of the Bill?

Part IV deals purely with infectious disease. Is it suggested that there is no necessity to make regulations or provisions for the reduction of disease and to prevent the spread of infectious disease in this country? Regulations are in operation at the moment for the prevention of the spread of infectious disease. It was found by local authorities all over the country that the powers they had were not sufficient to prevent the spread of infectious disease. Any member of this House who was a member of a board of health, even before the County Management Act came into operation, knows that for the last 12 years boards of health, every time they met, had to consider all kinds of difficulties with regard to the spread of infectious disease. Every member of a board of health in Ireland had the experience, time and again, of not being able to take the necessary steps to prevent the spread of infectious disease in their area. I see nothing in this Bill that I have not heard discussed 101 times at the boards of health in the past and I have heard the necessity for provisions of this kind discussed. I know also that the provisions embodied in this Bill are the recommendations of medical officers of health all over the country. I have heard time and again medical officers of health advocating the provisions embodied in this Bill for the prevention of the spread of infectious disease.

It is absolute nonsense for Deputy Mulcahy or Deputy Roddy or any other Deputy to talk about this Bill as being a revolutionary Bill. The provisions in this Bill are absolutely necessary for the protection of the people of the country. What would Deputy Mulcahy or Deputy Roddy say if there were no protection of the property of the country? Is it not far more important to protect the lives of the human beings in the country? There are drastic regulations in operation in this country at the moment to protect private property. But you have not sufficient laws or regulations to protect the lives of human beings. It is for that purpose the Bill was introduced and for no other reason whatever.

Part IV of the Bill deals with drainage. Does anyone suggest that there is anything in the Bill which is revolutionary in the matter of drainage? Is it wrong or unconstitutional or anything else to try to improve the drainage and sanitation of our towns and villages? It is an extraordinary thing that, when talking about this Bill yesterday, Deputy Mulcahy never refered to a single section of the Bill. One would think that he had taken his advice on the Bill secondhand; that this was the same kind of bug that bit the Fine Gael Party some years ago when they stumped the country telling the people that the Constitution, which was introduced at that time, took away the rights of women. I am sure the House has made a discovery as a result of Deputy Mulcahy's statement yesterday that there is a new type of disease or bug that it did not need a scientist to discover. Part VI of the Bill deals with water supply. Is it suggested that the improvement of our water supplies or the provision of a pure water supply is unconstitutional or revolutionary?

Mr. Hughes

The Deputy knows well that it was not suggested.

Mr. Allen

Part 7 deals with temporary dwellings and the use of land for camping. Have we not heard 50 times in this House about the danger of disease and the danger to the public at large from encampments? We have heard on numerous occasions here about the nuisance that encampments create, whether itinerants' encampments or encampments at seaside places. Have we not heard that on several occasions from different Deputies, even on the Fine Gael side of the House? To take steps to regulate and to see that they are kept in a sanitary condition—there is nothing revolutionary or wrong about that.

Part VIII deals with baths, washhouses, bathing places, etc.; the provision of public baths; life guards and life-saving equipment; use of swimming baths and bathing places for entertainments; instruction in life-saving; contribution to certain societies; by-laws in respect of public bathing. I wonder what is revolutionary or unconstitutional about regulations in that respect. It also deals with bylaws for the regulation of swimming baths and bathing places and public baths or washhouses maintained by commissioners of towns not urban districts. Part IX deals with food and drink; regulation for prevention of danger from food and drink; standards for food and drink; examination of samples of food and drink; enforcement of regulations under Part IX; charges under regulations under Part IX; restrictions on sale of food and drink by dealers in rags, etc. I wonder what is revolutionary or wrong about that? Does anybody suggest that Part IX is revolutionary or unconstitutional or that it should be brought before the Supreme Court to be declared unconstitutional?

Part X deals with county medical officers; assistant county medical officers; city medical officers; assistant city medical officers; district medical officers of health. I wonder what is wrong with that? We have all these medical officers functioning at present in every area in the country. It is only a matter of changing their names. All these medical officers are functioning very effectively at present with the goodwill of the local authorities.

Mr. D. Morrissey

At present.

Mr. Allen

These medical officers of health will tell Deputies that the laws which are in operation at present are insufficient to enable them to do their work as effectively as it could be done. Time and again they have told the local authorities that. Every member of a local authority knows quite well of cases of people going to cinemas and churches and to public market-places when there is contagious disease such as diphtheria or scarlatina in their house. We know of cases of people bringing children to a fever hospital and going directly from that to the cinema. Medical officers of health know that but they have no power to prevent it. They know also that there are carriers of diphtheria, scarlatina, and other diseases which they have no means of dealing with. They have no power to isolate them.

An Leas-Cheann Comhairle

It is becoming more than a matter of interruption. There are two Deputies speaking together.

The Taoiseach and other members of the Government and of the Party are very touchy if it is suggested that there is any taint of dictatorship or any taint of Fascism about the Fianna Fáil Party or Government. Recently, the Taoiseach got very indignant because of the reference made by a Labour leader in this country. I do not purport to quote the exact words, because the Taoiseach had one set of words and the trade union leader concerned said that he was misquoted by the Taoiseach. For once the position was reversed, because it is always the Taoiseach who is misquoted. Anyway, he said—this is according to himself— that if things continued as they were going, this would become the last citadel of Fascism in the world. Was there ever a measure such as this introduced into any democratic parliament in the world? If any measure deserves to be branded as a Fascist measure, with a Fascist mentality behind it, surely it is this measure.

Deputy Allen talked about a consultative council. The Minister did not consult the medical profession. At one time I thought that it was a good thing that we had in charge of the health services of this country a qualified medical practitioner. I have come to the conclusion now that it is a tragedy, because if there were an intelligent layman in the Parliamentary Secretary's position he would know that he had no medical knowledge and he would have the sense to go to the people in this country who could direct him along the proper lines. The Parliamentary Secretary does not do that. There is the mind of the dictator there.

There was an outcry in this country years ago when the people were asked —if you like, compelled—to clean the eggs that they were offering for sale. I want to come down to a point here that I have some personal knowledge of. I have reason to have knowledge of it. A fairly costly price had to be paid with regard to the expression "verminous". I know something about that. The county medical officer of health in my county, in one town there, returned practically every child in the school as being verminous and his interpretation of verminous would apply to every school in the State. It was held that if a child had one nit or two nits in its hair, that child was verminous. None of those children would be allowed to go to school; none of those children would be allowed to go to Mass, to a cinema, or anywhere else. They were to be secluded into cold storage, as it were—a new class of untouchables.

The Minister sneered when Deputy Roddy talked about getting the result which he says he desires to get by a different method. Let me put this to the Minister and to the members of the House who live in rural areas. Do we not know that children in rural areas, some of them fairly adjacent to towns, have often to set off on a winter's morning, perhaps in the pouring rain, to walk two and three miles to a school and, when they arrive at the school, wet through, that they have to sit there, perhaps without a fire—and certainly with not a very good fire—for four, five or six hours, very often without food? They have to sit there in their wet clothes and then trudge home again—and we are surprised because we have disease. Do we not know that in this country to-day, within a fortnight or three weeks of Christmas, there are hundreds, if not thousands of children going barefooted and are otherwise poorly clad? Do we not know that in the towns and cities to-day there are people so poor that they find it utterly impossible to purchase bed clothing and that the clothes they wear over their bodies during the day are thrown over them to keep them warm during the night? In these circumstances, are we surprised that they are verminous?

What is being done in this Bill to deal with that state of affairs? Do we not know that people in this country have been tied back to 3/-, 4/- and 5/- per week of an increase in their wages since 1939 to meet a cost of living that has gone up officially to 293 and actually much higher? Do we not know that, because of the high cost of food, firing and clothing, notwithstanding some of the schemes the Government seem so proud of, there are more people suffering from malnutrition in this country than, perhaps, at any other period? We are told about progressive measures in relation to national health. I challenge the parliamentary Secretary to say that this statement which I am about to utter is not a fact, that there are more people being denied entrance to hospitals to-day than ever before in the history of the country because there are no beds available. It is harder to get a bed in a hospital in the City of Dublin to-day than ever before. Do we not know that there are hundreds of people suffering from what Deputy Allen sneeringly refers to as infectious diseases who are not in hospital because they cannot get into hospital?

I have a letter here which I got yesterday from a man who is one of those recently commended, and properly so, by the Taoiseach and Minister for Defence. He says he joined the National Army at 18½ years of age on 27/10/38 and served until 26/2/42. On that date, he was boarded and passed as medically fit, and he then served with the Army until 11/1/45. Remember that he went into the Army before the emergency, and presumably he had a medical examination going in. He was discharged from the Army on 11/1/45 as medically unfit with tuberculosis trouble. He then goes on to say that he had been told, as a number of these men have been told, that his illness was not due to his service in the Army. He adds: "I have proof for all my statements and medical evidence, if required. Now I am trying to live on 7/6 per week national health insurance benefit." That is the rate of disablement benefit and that is what we are doing for tuberculosis.

We have to get down to the root of things, if we are in earnest. We have to get down to the causes, to the conditions, and face up to this, that, after five years of war, after emigration during that period on an unprecedented scale, and in spite of all the State-aided schemes of employment, we have apparently a hard core of 70,000 unemployed persons. Many of these —I do not know what proportion, but perhaps 30, 40 or 50 per cent—are the heads of families who have to try to bring up a family, to feed and keep them in a healthy condition, on unemployment insurance and unemployment assistance. It cannot be done.

This Bill to preserve and safeguard the health of the country, to cure rather than to prevent, this revolutionary measure, is produced by the same Department as has still in force an Order under which a man, the head of a family, will not get a full week's work, will not get even six days' work in the week. That is the famous, or infamous, rotation scheme Order, under which a man gets three or four days' work, but will not be allowed to work for six days. On what he gets for that work, varying from 5/- to 7/- a day, he is expected not only to keep his family in existence but to provide food that will keep them in good health. It cannot be done, and all the Bills of this type which can be conceived in the mind of the Parliamentary Secretary, of the Minister or of the Department, will not put an end to disease, so long as we have in this country the appalling conditions we have.

What is the redress for anybody affected by the Bill? Again it shows the mentality behind it all. It is an appeal to the Minister. The Minister under the Bill takes complete charge of your body, if you are unfortunate enough not to have good health, to be suffering from an infectious disease, from the day of your birth until you go into the ground.

Dr. Ward

Before your birth in fact.

Mr. D. Morrissey

I might have known that the Parliamentary Secretary would leave very little out. He only stopped short in this measure of the gas chamber, and, if the circumstances were suitable, I am sure the Parliamentary Secretary would have an admirable Belsen Camp. That is the mentality behind it.

Mr. Moran

He would not be short of gas.

Dr. Ward

The Deputy will finish the boys.

Mr. D. Morrissey

There is one thing about it, and that is that, since this Party was first founded, since the first day this House sat in this Chamber in 1922, this Party, whether it was large or small, stood for the rights and liberties of the people all the time. If the people want to surrender their rights and liberties into the hands of the Parliamentary Secretary, and if they disown us for asserting, or trying to assert, these rights, they are at liberty to do so, so far as we are concerned; but let me tell the Parliamentary Secretary that so long as we are here as a Party, so long as we are here as a collection of individuals, we have a responsibility to the people, and we propose, with or without the Parliamentary Secretary's permission, to discharge that responsibility to the full. This Bill is a thoroughly bad Bill. It is a dangerous Bill, and the like of it was never introduced into any democratic Assembly in the world. The only person who will endorse what is in it is the person who either believes in a complete dictatorship, or who, never having read it, knows nothing about it.

Mr. Everett

I am surprised by all the heat engendered in the discussion of this Bill.

Mr. D. Morrissey

There was a time when you would not be.

Mr. Everett

I should have expected that men who had given service on public boards, irrespective of which Party they belonged to, would have welcomed it. If there are certain sections in it to which they object, they could put in amendments on Committee Stage, but to condemn the Bill as it has been condemned here is, to my mind, simply to object because they are in opposition. I think I have, in my capacity as a member of public boards in my own area for the last 22 years, given the Local Government Department more trouble than any other Deputy.

I will say that I welcomed the appointment of the Parliamentary Secretary because I recognised that it was impossible for one man to do all the work that required to be done in the Department. I can say this publicly, that since the Parliamentary Secretary was appointed we in the County Wicklow have found him fair and impartial. I say that as a member of the county council in Wicklow on which the Government Party has not a majority. The Parliamentary Secretary will, I can say, give to Wicklow what he will give to counties in which the county councils are composed of a majority of his supporters. He is greatly interested in the affairs of public health bodies, and in the fact that they should get sewerage and water schemes going, so that they may improve in every possible way the amenities of their areas.

Deputy Morrissey asked if we were going to agree to take away from people the right to have wakes. At the present time, when patients die in a fever hospital, no wakes are held. The deceased is taken from the hospital and buried in the nearest cemetery. We had no protest against that. I welcome the section which gives power to a local authority to have the remains of a deceased person removed for interment in the family cemetery which may be 20 or 30 miles away from the hospital where the death took place. If the ambulances of local authorities are used to take patients a distance of 20 or 30 miles to a hospital, surely the least we can do is to provide that, after death, the remains will be taken back to that person's locality and buried in the local cemetery.

We are told that the rights of parents have been taken away in connection with the school medical service. So far as the public health is concerned, that service has, in my opinion, been a wonderful achievement, and particularly as it is administered in our area. The unfortunate thing is that when the medical officer is expected to attend in connection with the scheme, children, who are often a source of infection to healthy children in the school, are kept away. In reply to what was said about compulsion, I want to say that it cannot be argued that we are interfering with the rights of parents. We have an Act which compels children to attend school and compulsory powers in connection with other measures. Section 21 of the Bill will be welcomed by the public sanitary authorities. The dispensary doctor in my area has been seeking power for the past three years to prevent children from attending cinemas. We have a county fever hospital in Wicklow. We have found that when the local medical officer of health closes a school because of an outbreak of disease cinema performances are attended by other children from that school. I have had experience in the last two years of epidemics of infectious disease in the county and of parents who had carried their children to the fever hospital attending the cinema that night. The local authority had no power to prevent that. There were no compulsory powers to prevent those people from attending places of amusement.

I have consulted the medical officers in the County Wicklow about this Bill, and they are very pleased with it. It contains powers that they have been asking for for the last two or three years, powers which it is hoped will enable them to eradicate infectious disease outbreaks in the county. At the present time the local medical officer of health may find a child in a house suffering from typhoid, scarlatina or diphtheria. The father of the child may be in employment earning £2 or £3 a week. The doctor may ask him to remain at home for a day or so. His employer is informed and says it is all right. The house is disinfected. But under this Bill the medical officer of health can isolate that man. He can keep him at home so that he will not be in contact with his fellow-workers, wherever he may be employed. The local authority will have power to pay the man so that he will suffer no loss. I believe that is the proper way to try to prevent the spread of disease. The Bill makes provision so that that man and the other members of his family will not be hungry during the period of his isolation.

A good deal has been said about what all this is going to cost the rates. I have had a good deal of experience of outbreaks of infectious diseases in my county. I wonder do those Deputies who have been objecting to this Bill realise what the burning of clothes, disinfection and the rest cost the ratepayers? I am of opinion that the public bodies will not object to the cost because they will realise that if these outbreaks can be prevented a saving will result to the rates. We are told that the Minister will have power to do this and that the local authority will have power to do that, but surely we are not living in a fool's paradise. Do we not all know that at the present time more serious forms of infectious disease than those which we have been discussing are being brought into the country? Do we not want to have power, in our seaport towns and in other places, to try to protect our citizens from becoming infected, as some have in the last few years?

I cannot see why there should be all this unnecessary alarm in connection with this measure. If all public representatives had the same experience as some of us have had in connection with infectious disease outbreaks, they would welcome this measure. The pity is that all parents do not realise that it is in their own interest to have their children immunised. In certain areas they will not take the necessary precautions of having their children who are attending school immunised. I remember that at one time, in the town of Wicklow, there was wholesale opposition to immunisation, but when a carrier brought in an infectious disease, when one poor man lost two children and when three children died in another house, the result was that the dispensary doctor had to get an assistant. All the people of the town flocked down to the dispensary to get their children immunised. My point is that it took five deaths to get that done.

I am glad to say that in my constituency there is no opposition to immunisation. Quite a large number of people have got it done voluntarily. If you have here and there a few slackers who object to it, then I think it is right to take power to compel them to get it done. Our public bodies are composed of men of common sense who try to act in a fair and just way to all sections of the community. I am certain that, when they are given the powers proposed in this Bill, they will use them as they have used other powers, wisely and well in the interest of the general community.

I was surprised to hear Deputy Martin O'Sullivan object to the use of a public conveyance for the purpose of bringing a person suffering from an infectious disease to a hospital. We are all well aware that some parents will object to having their child taken away in an ambulance. They will employ a hackney car to take the child to a fever hospital. At present there is no power, other than the power of public opinion, to inform people that that hackney car has been so used. I say it is right to take power to protect innocent people from travelling in a car of that sort. Surely, there is nothing wrong in taking steps to protect people in such circumstances. I appeal to the Opposition to withdraw their opposition to this Bill. If they think it should be amended, they will have an opportunity of doing so on the Committee Stage. The Bill is necessary if the sanitary authority is to carry out properly the work that it is expected to do, namely, to try to eradicate disease from our midst.

Mr. Moran

I am rather surprised at the attitude which the chief Opposition Party has adopted to this particular measure. I thought this measure would be to a large extent non-controversial and that an attempt would be made by the Opposition to improve the law in relation to public health. Instead of that, we had the attack made by Deputy Morrissey, and all these references to the "dirty Irish", and so forth. I do not think that attitude will help in connection with a measure of this kind. If we all put our heads together to see how far we could go for the general good of the community and how far the measures envisaged in this Bill should be allowed to stand, we would be doing much better work. The attitude of Deputy Morrissey on this Bill seems strange to me. He recognises that there is a problem to be met but he does not suggest in what way the problem should be met. He simply wants to sit down and adopt the attitude of the lotus eater—let things drift. He is not prepared to offer constructive criticism by way of amending any section that he objects to. He wants to throw the Bill out in toto.

Personally, I understand the Minister proposes to introduce further legislation of this kind. If the Minister directed his attention more to the dispensary side of the medical services in this country we might achieve some of the results that we are trying to realise. I do not think the dispensary system in this country is at all satisfactory. We are paying quite a lot of money for that system and we are not achieving any good results. We are in the position of paying medical men to live in particular areas without deriving any large benefit as far as the community is concerned. If we were to try a panel system or some other system, we probably would achieve better results.

At all events, there is no doubt about it that numbers of the measures proposed to be taken in this Bill are very necessary. There is no doubt that many of these powers are essential for public health authorities who may be confronted with a certain position when cases of infectious disease arise. One of the most far-reaching effects of the Bill will be achieved by the provisions in regard to the maintenance of persons suffering from disease who are unable to make provision for themselves or their families. The provision made for them is very welcome indeed, and a forward step in dealing with this problem. It will be an inducement to persons suffering from infectious diseases to undergo treatment. Hitherto, many persons suffering from disease tried to keep working when they were not, in fact, fit to work, in order that they might provide for their families. In that way the disease was spread.

Some provisions in the Bill, I think, might be amended in Committee. One difficulty that I see arising under Section 29 is that there are so many different types of infeetious disease that, when you are making these regulations or taking these powers, if they are not exercised in a sensible manner, very peculiar situations could arise. Some of the provisions in Section 29, I think, embody an Emergency Powers Order. I think it was as a result of an outbreak of typhus in County Galway that the Emergency Powers Order was made, in 1942, to give authority to the county medical officer of health compulsorily to take a suspect, as it were, into protective custody. That is all right where you have an epidemic, but I should not like to see that power used where you had simply an isolated case of, say, diphtheria suspected in a child. I should like to see some further safeguard in the section for the individual. The danger that I see in this section is that every county medical officer of health will not be perfect.

In the medical profession, as in every other body of men, you may get a peculiar individual who, possible, to show his authority or for some other peculiar reason, would exercise drastic powers under this section where they were not necessary. In fact, I know a case in which a medical officer of health, under the Emergency Powers Order that was in force, compulsorily took a child that he suspected of having diphtheria, although the child's personal medical adviser certified that the child was not suffering from diphtheria, to the local fever hospital. It transpired when the man in charge of the hospital took a swab and got a report back that the child was not suffering from diphtheria. It seems an extraordinary thing to happen. I do not say that that would be the rule, but I say it is a matter that should be provided against. There should be some method of curtailing the powers proposed in Section 29 in case they would be wrongfully used. I would suggest in respect of these powers, except in the case of epidemic or something like that, where you have to take drastic measures, that before the child is removed, in a simple case, such as diphtheria, the parent of the child should have some means of appeal forthwith to, for instance, a district justice in chambers or to the Minister.

There is another danger in this matter. The medical profession are notoriously one of the strongest trades unions in the world, and the members of that profession are not disposed to oppose each other or to give away the game on each other. Where a wrong diagnosis is made by one man, to a very large extent his colleagues will cover up for him, and you have the danger in this particular section of a child being sent into a place of infection such as a hospital, where there are people suffering from an infectious disease, although in fact a proper diagnosis may not have been made.

Although, as I have said, I agree that these powers are necessary in connection with the number of infectious diseases, it is to make provision against the abuse of these powers, in case there would be abuse of them, that I am suggesting to the Parliamentary Secretary that, on the Committee Stage, some method should be found whereby such a thing as I have instanced here could not happen and whereby parents would not have a child taken forcibly from them where there is any doubt or where it has been proved that the child is not in fact suffering from the particular disease which is suspected. I am not so sure that, without a lot of co-operation, many of the measures envisaged in this Bill would be successful. For instance, in connection with the number of infectious diseases, one of the greatest difficulties has been what I call a hush-hush policy. One of the greatest difficulties of the medical profession in connection with tuberculosis has been that, until comparatively recent times, there was supposed to be a social stigma attached to any family, any member of which was suffering from that disease. The big difficulty was to get people to realise that tuberculosis was an ordinary disease, was not hereditary and, if taken in time, could be cured; that practically every individual in the community at some stage or other of his life had the germs of tuberculosis and that there was nothing socially wrong about having the disease.

I do not know that the Parliamentary Secretary will get the results which he expects under some of the provisions of this Bill. I am not so sure that the provision of certain penalties and the tendency, to a great extent, under this Bill to treat people suffering from infectious diseases as untouchables will have the desired effect. There are instances in which these powers would have to be used, but I think you would want to have very careful use of some of the powers sought in this Bill. If you take some diseases, particularly the disease referred to by Deputy Everett, in many instances the reason why these diseases were not treated in time was the fear of the individuals who contracted them of anybody knowing about it. The big difficulty of medical men was that it was only possibly in the advanced stages of these diseases that the patients came for treatment. Medical men to whom I have spoken about this matter nearly all agree that it has been, in the main, such a fear that has prevented these diseases from being treated in time. When individuals feel that any disease they may contract would tend to exclude them from society, you have the danger of these people trying, by every possible means, to clock and hide the disease. The provisions of this Bill that would tend to fore these people out into the open or that would tend to compel people to give information about their being suffering from certain of these infectious diseases I think would have a particularly bad effect. I think it would only drive such people, who would be afraid of other people finding out what was the matter with them, to all kinds of lengths to cloak these diseases. Any of the provisions in this Bill that would be enforced may have that effect. That is a matter which I should like the Parliamentary Secretary to bear in mind before the Committee Stage.

The suggestion made by certain people that we have not sufficient hospital accommodation does not, to my mind, prove anything. The fact that our hospitals are overcrowded is a good sign of the public mind on disease in general. Many people are making use of the hospital services now who never made use of them before. I think that is due to the advanced state of our hospitalisation system and the fact that the public as a whole realise and appreciate that we have good medical officers and good medical services available for them. That is the main reason for the overcrowding of a number of our hospitals. It is a sign that the public are awake to the provision that has been made for them when they get ill. The better the hospitals are, the more modern they are, and the better the medical services are, the more people you have utilising those services, whether in hospitals or elsewhere.

As regards the financing of this measure, Deputy Cogan made a typical Clann na Talmhan speech. He welcomed the provisions of the Bill but, of course, some unknown persons should pay for all these provisions. The Deputy says that the local authorities should not pay for them. He does not suggest who should pay for the benefits that are being provided in this Bill. He makes some kind of a suggestion about a contributory scheme. To my mind, the people who will be provided for in this Bill to a large extent are people who possibly are not in a position to contribute to any scheme. Many of the people who suffer from some of the diseases envisaged here, many of the families, for instance, who are verminous, due possibly to malnutrition or some other reason, are poor people. In the main, it is these people who will be deriving the benefits under this measure.

Notwithstanding the fact that Deputy Cogan welcomes this Bill, I have no doubt that we will have the same speech as usual from him when the annual Estimates come on complaining of the rising cost of rates on local authorities and the rising cost of government here. I do not know when we are going to get to the stage in this House when Deputies on every side will be prepared to face up to their responsibilities and be prepared to admit candidly that in a measure of this kind, dealing with social services and making provision for the eradication of disease, we are dealing with a necessary measure which is a step in the right direction. When will we be prepared to say we know that this will have to be paid for and, in view of the benefits it will confer on the people we represent, we are prepared to pay for it and we consider it good policy, in the public interest, to do so? There seems to be a particular line taken by some people in this House that, while complaining about the cost of certain measures, they welcome the benefits conferred under them.

In the main, from the Opposition Parties, and from the major Opposition in particular, there has been a completely wrong approach to this Bill. Practically every section in it is necessary, or the principles underlying the sections are necessary. It makes provisions that were long required in the interest of public health and of the community as a whole. On the Committee Stage, there may be some matters which we should endeavour to amend, if necessary. My own regret is that, in addition to the matters being tackled in this measure, the Parliamentary Secretary has not gone further and started on the dispensary system. I hope he will make an exhaustive examination of the dispensary system, such as it is, and let us set about improving it in the near future, if we can, in the same way as he has set about remedying the wrongs indicated in this particular Bill.

Mr. Hughes

Nobody can deny the necessity for codification, extension and modification of the local government law and in regard to much of the subject matter dealt with in this Bill it is necessary to have an enactment. However, I feel that the Parliamentary Secretary has made a wrong approach to the whole problem of providing regulations to ensure a better standard of public health. Compulsion and force by the police method are altogether wrong and are doomed to failure. It appears to me that the Bill is another step towards the progress of an all-powerful State here. You have more regimentation, more State control, more centralisation and greater absolute power for the Minister, with the abrogating and ignoring of the power of the local authority. Right through the whole Bill we have it appearing that the Minister can do this and that, and that the Minister has power to make orders and direct his creature, the county medical officer of health, that he must do this and that, while the local authority is ignored.

Notwithstanding what Deputy Allen has said, I believe the Bill is not only unconstitutional but unchristian as well. It is not merely an infringement of the rights and liberties of the individual but in particular of the right of parents. It is a challenge to their responsibility and control over their children. It is an unwarranted encroachment and intrusion by the State into the most sacred unit of society, the family. Paragraph 11 of the Second Schedule gives extraordinary powers to the county medical officers and their assistants, that they can tap a man on the shoulder in the street and bring him in anywhere, strip him down and have him examined to ensure that he is not suffering from a contagious disease or that he is not verminous or suffers from tuberculosis, and the examination takes place, regardless of his wishes. Parents must provide and afford such officers reasonable facilities for such examination, including permission to take blood tests.

The Minister proposes to usurp not merely the rights of parents but the function and authority of the Church. I say it is an unchristian Bill, because I do not think the State has any moral right whatever to interfere to this extent. The Constitution very specifically lays down the sacredness of the family as the basic unit of society. It stresses that the State cannot interfere with the family, unless the parents completely fail in their responsibility, and it is only then that the State can step in. The right and duty of parents are a sacred and God-given right and the proposals here are incompatible with the moral law. It certainly is a direct negative, so far as democratic principles are concerned.

Cleanliness is desirable and essential and no one is trying to argue against provisions to ensure a better standard in that respect. In comparison with other countries, I do not think we have a high standard of cleanliness and I am not trying to argue that we have. However, there is something more essential to the individual and to society than mere animal existence. If we subordinate everything to the material welfare of the individual, we become destructive of human and Christian rights and are travelling the road towards a socialistic State.

The House must not permit that sort of thing to happen. I do not think the citizen here realises, because of the slow process of transformation, that under this Administration there is a profound and fundamental change in democratic principles taking place. Not merely in this measure, but in other measures that have gone before it, we are approaching the all-power state of absolute dictatorship. The Minister is taking very extraordinary powers here and giving them to officials and to civil servants.

The Parliamentary Secretary made reference to the necessity to ensure an equitable balance between the material and the spiritual aspects of life. Surely, he cannot point to any part of this measure that ensures an equitable balance between the material and spiritual aspects of life. I do not think there is any respect for the spiritual aspects of life in this Bill. It is a pagan measure in that respect. I am afraid the Minister does not appreciate the purpose of life at all. The ultimate purpose of life is eternal salvation and, so far as the Minister is concerned, he has no power to interfere in that respect. So far as our temporal welfare is concerned, he may be charged with some responsibility, but he certainly cannot interfere with the authority of the Church and he has no right whatever to say that a child cannot attend Mass on Sunday because it happens to have a louse in its head. He is possibly, under the Bill, denying the right to children to receive their first Holy Communion because they cannot attend church on a Sunday.

Deputy Allen and other Deputies are trying to suggest that this Party is merely out to criticise this Bill for political reasons. Those Deputies appear to be ignorant of fundamental principles. I say that this legislation will fail and, if I know medical officers in this country, they will not operate it. The county medical officers of health will not operate it. How can the Minister hope to succeed if he sends, in police fashion, a county medical officer of health as an interloper into the family circle? Mark the difference between the two. The medical officer is the confidant of the family. He sits down in the family circle, he knows the family's problems, he knows their troubles, he knows the health history of every member of the family, because that is essential from the medical point of view. They trust that man as their best friend, but is a man who is forced in, who goes in under State authority, armed with certain powers under a measure like this, likely to command the confidence or the respect of the family or to receive the co-operation of that family, or will he get anywhere towards ensuring that there will be a better standard of cleanliness?

Is it not obvious that there is an important psychological aspect to this matter? Compulsion and police methods will not get people to take the necessary precautions to ensure better health standards. I suggest that the psychological approach here is absolutely wrong and if they attempt those methods it is inevitable that the law will break down.

The county medical officer of health will become public enemy No. 1 if he attempts to intrude in that fashion into the family circle, which is a privileged place. There is one place where the individual reigns supreme and has a moral right beyond the authority of this House, and that is in the family circle. No man can intrude there and dictate to him how he is to rear his family. That would be a violation of a very sacred principle and I will be surprised if those responsible for the moral welfare of the people will let this measure go unchallenged.

It seems an extraordinary state of affairs that under this Bill you are ignoring completely the privileged position of the medical officer, the doctor of a family, who can command the confidence of the family. It seems an extraordinary state of affairs that you are authorising the county medical officer to enter schools and, under compulsion, examine the children-strip young girls and examine them in order to see what their condition is. The medical officer can go into private schools, schools that have their paid medical officers— paying them fees for their attendance —and, acting under this type of legislation, have them stripped compulsorily and examined. He can compel them to submit to examination and order anything and everything necessary to preserve the public health.

I think that if the Parliamentary Secretary expects to get a favourable reaction from the people to that sort of thing, then he does not know the people of this country. You give power to a bus conductor so that if he suspects an individual of infection, and that includes vermin and tuberculosis, he can pitch him off a public car. We have had warble fly inspectors in this country and now we are about to create louse inspectors out of county medical officers of health.

What sort of impression will this create outside the country? We are a food-producing country and will the people who are buying food from us, butter and other commodities, be impressed by all this sort of thing? They will get the impression that we are a dirty, verminous people and, if that is so, the food that our people are producing and handling is scarcely fit for human consumption. Is it fair to our people? Is that truly the condition of our people? Is that the general state of the community here? Is the position so dreadful that we have to take drastic measures of this sort, compulsory measures of this sort, to compel an ignorant community to knuckle down to the dictates of a Minister who is going to clean them up? If the Parliamentary Secretary thinks he will get away with that, or that it will be possible to operate such legislation, he is making the greatest mistake of his life.

The law as operated up to the present, so far as better standards of public health are concerned, was started by people who, so far as I know, had the idea of propaganda and co-operation and advice from county medical officers of health and public health nurses. Societies were or ganised along the lines of the Country Women's Association. A public health nurse going into the home of a mother and her family, sitting down for half an hour or an hour discussing home problems and giving advice on how to rear children, would be far more beneficial in the long run than police methods such as are suggested here.

Why should you bring in the Guards? The Guards were never established for work of this sort. I think it is an outrage to suggest that anything like this should be done and I appeal to the Parliamentary Secretary to reconsider his attitude. By all means provide enough staff for the county medical officers. Give them assistance where necessary to deal with the different branches of public health and make provision so that public health nurses will go round and encourage the establishment of societies like the Country Women's Association where mothers will be brought together to discuss their problems and be given advice.

There is a mentality in this country where people question whether it is in the interest of the family that a blood test should be taken. We know that mentality is quite wrong, but you will not change it by compulsory methods. You will change it only by propaganda and education and advice, by confidence in the health authorities working in the interests of the people and not as their enemy. The moment you have recourse to compulsory methods, then the normal reaction will be that people will look upon the service as contrary to their interests and the public health officers will become the enemies of the people. I do not believe you will get the co-operation of any decent medical officer. From what I know of county medical officers and medical officers, they know that they must have the confidence and the willing co-operation of the people, if their work is to succeed. Surely their work cannot succeed, except on the basis of a human approach and of conveying to the individual mother or father that he comes into the family as a friend of the family. Why should the man who is in a position to command that confidence in the family circle, the family doctor, be ignored and passed over? Why is he not the instrument to be used to ensure a better standard of public health?

I have no doubt that measures and regulations are necessary to bring about improved conditions in the matter of public health generally, and there are provisions here for ante-natal clinics, child welfare centres and nursing services and regulations regarding public baths and playing grounds, as well as an admirable provision in regard to maintenance for tuberculous patients, but so far as I can see, all the expenses in this connection appear to be thrown back on the local authority. The whole policy seems to be to unload the financial responsibility for the operation of this measure on to the local authorities and it is characteristic of recent legislation in relation to local authorities. So far as local authorities in the rural areas are concerned, it is thrown back on a particular section. I certainly feel that there should be a contribution from the central authority.

I do not think there has been any consultation. I believe there has been no consultation so far as the county medical officer is concerned, and I believe that a county medical officer would not advise the Parliamentary Secretary to proceed along the lines on which he has proceeded. All these compulsory provisions are backed by severe penalties. It is the one big snag in the measure, and, of course, it destroys the whole piece of legislation.

So far as drainage is concerned, I am not so sure that the proposals here will be an improvement on the old law, because, under the old law, where there were two or more drains, a local authority was bound to provide a sewer. According to this Bill, the local authority will indicate that they will lay a drain a certain distance and the people concerned will connect up by a combined drain. If combined drains are laid, I do not think it will operate in a satisfactory way, because it may give rise to a good deal of trouble in deciding the contribution to be made by each of the beneficiaries. However, that is more a matter for Committee Stage than this stage.

Section 98 sets out:—

"A sanitary authority may take such steps as are reasonably necessary to prevent injury being caused to public health or the amenities of any locality by reason of obstructions in any river or watercourse."

We all know that much injury is done to public health because of the flooding of big rivers on which there is a difficult drainage problem. Annual flooding occurs on several of the big rivers, and not merely is damage done to agricultural land, but tremendous damage is done, in the towns, to houses, and especially the smaller and poorer houses. When the floods subside, a terrible mess is left, and it is these people, who find it very difficult to provide fires to get rid of the damp, that suffer most. We have a national Drainage Act, and I wonder what efforts the Parliamentary Secretary has made to get that Act operated and so ease this problem. It is very little use putting in a section of that sort and throwing on the local authorities the responsibility of removing obstructions from rivers and watercourses, if there are huge problems all over the country arising from flooding. Obviously it is a national problem and nothing is done about it although legislation designed to deal with it is available.

I believe it is necessary to have some power to compel owners, especially of public places, to provide proper sanitary accommodation. We all know that the sanitary accommodation provided is very inadequate, and, as a matter of fact, very bad, and that it is kept in a very insanitary condition. Power to deal with problems of that sort are necessary, but I am afraid the power given in this part of the Bill is rather drastic. The accommodation required is rather too extensive, and while it may be all right in the cities and towns to do it, in the smaller towns and villages the power to compel owners of premises and private houses to provide accommodation and lay in water, could I think, be abused.

Deputy Allen talked about the installation of a water system in a town and about the number of people who would not take the supply. Surely there is another aspect, apart from the fact that some people may have a supply from a private pump. It may be that some people are unable to pay for the supply. The Deputy knows that there is such a thing as a water charge, and, so far as the provision of a water supply under pressure is concerned, surely an individual has the right to decide whether he will take it or not. We have no right to compel him to take these steps if he feels they are not necessary and if he has a private supply sufficient for his requirements.

There is nothing wrong about the provision which aims at controlling camping grounds and the nuisances and abuses which result, except possibly the provision with regard to the period of 14 days. On some camping grounds you have the itinerants who go around the country and are a great nuisance. I believe that regulations are necessary in connection with the manufacture of food, and in regard to the storing and exposing of it for sale. We very often see in shops butter, milk, and cheese cheek by jowl with commodities that are bound to taint that food. We also know that meat is conveyed through the streets in anything but a desirable manner. The same applies to bread, which is often handled by people with dirty hands. I think that regulations are essential to ensure better handling of commodities of food, and that those handling them will keep their persons in a cleaner condition. The Parliamentary Secretary might also consider food which is imported in tins or packages which sometimes cause injury to our people. At present I do not think there is any redress for the individuals who suffer as a consequence of imported food in bad condition. Something should be done about that.

Deputy Morrissey rightly pointed out to the Parliamentary Secretary that it is not by compulsory methods that you are going to get a better standard of health. The county medical officers of health have, time and again, pointed out that the main cause of the incidence of disease in this country, and particularly of tuberculosis, is malnutrition. Therefore, the proper approach to the provision of a better standard of health is to ensure that the people have a good standard of living. The Parliamentary Secretary is setting up a committee to study dietetics. I am sure he knows that the standard of dietary of a lot of our people is exceptionally low and unbalanced. The protective foods that are essential to good standards of health are beyond the purchasing power of a lot of our people. I would ask the Parliamentary Secretary to consider the advice given to him in that respect by Deputy Morrissey. He indicated that working men who are forced to draw benefit and National Health Insurance have to try to maintain their families and themselves on 15/- a week. The rotational system of four days which is operated and approved by the Department of Local Government is not conducive to a decent standard so far as the working classes are concerned. To approach this problem of public health in the right fashion it is necessary to consider a plan to ensure to every family in the country an income that would give them a standard of living conducive to good health.

I want to say in conclusion that you are not going to succeed by regimentation or by police methods or by ignoring the local authorities and taking power to dictate to them what they should or should not do. The Minister has taken exceptional powers so far as decisions regarding hospital accommodation are concerned. We all realise that it is necessary to ensure that we have ample hospital accommodation, but surely that part of the Bill that empowers the Minister to have a sworn inquiry and not publish the report but to come to a decision secretly to close an institution and afterwards compel a local authority, regardless of its financial position or its advice as to the capacity of the local people to pay for the service, is going a bit too far. If we are to succeed we must have the co-operation of the local authorities.

So far as the medical people are concerned and so far as schemes of public health administration by county medical officers are concerned, there also we must have the co-operation of the people. I believe that if the Minister had consulted the medical profession generally or the county medical officers of health that they certainly would not have advised him to approach this matter in the spirit in which it has been approached. I am convinced myself that it just will not work and that you will not get the officials down the country to operate this measure. I would ask the Parliamentary Secretary to withdraw the measure, to reconsider the whole matter and to approach this matter in a different spirit.

Dr. Brennan

I welcome this Bill as a definite advance in the right direction. The powers asked by the Parliamentary Secretary are necessary and to my mind long overdue. I welcome that section which has consideration for the women and for children under 16 years of age, because everybody will appreciate what a hardship it is to have illness in a house. At least any doctor going into a house where there is sickness appreciates that apart from the worry on the part of the parent or relatives about the sick person there is usually a financial worry as well. This Bill is an effort to alleviate the financial side of it as far as young children and women are concerned. I think the Parliamentary Secretary is to be complimented on looking into that side of it. It will have the additional advantage of encouraging people to call in the doctor in time. In some cases, particularly those border-line cases between dispensary patients and those who are just not of the dispensary patient type and who are ashamed to call free medical advice, illness is allowed to progress. We all appreciate how important it is to get early diagnosis and early treatment of disease. This has been brought before the public mind quite well in the Red Cross campaign against tuberculosis: the early diagnosis, rest, proper nourishment and early treatment. These things are envisaged in this Bill and to my mind that is the most pleasing part of the Bill.

Some speakers have referred to the drastic powers which the Parliamentary Secretary is asking for in this Bill. Anybody who is in contact with infectious diseases will appreciate how serious they can be, not only for the patients concerned, but for contacts. When I say contacts I mean not only those confined to the patient's house but those who may have to sleep in beds which have been occupied by persons suffering from infectious diseases, in hotels and elsewhere. It is only by drastic remedies that we can eradicate disease.

It has been mentioned that there is venereal disease in this country. We may as well face up to the fact and try to remedy it and even to eradicate it. The only way we can do that is by giving powers to the Minister to enforce regulations designed to prevent that disease. We should also have a campaign similar to the anti-T.B. campaign in this country. We are only burying our heads in the sand if we do not face up to that fact. Provisions that are considered drastic must, I think, be considered necessary.

There is another point raised by Deputy Hughes about nurses and doctors refusing to co-operate with the Parliamentary Secretary or to administer the Bill. I am quite satisfied that, not only will they be willing to co-operate with the Parliamentary Secretary in the enforcement of this Bill, but they have been looking forward to such a Bill for a long period. We have found from experience that we had not sufficient powers to cope with infectious diseases and I am sure the medical profession will be glad that the Parliamentary Secretary has had the courage to give them powers. The suggestions that have been made about bringing in the Guards and bringing somebody in to strip somebody, and all these things that have been said, are, in my opinion, all nonsense. Doctors and nurses can be relied upon to use tact and discretion and I am sure, when the people are educated properly, they will be willing and anxious to co-operate with the doctors. You have to guard against all possible risk and it is only a remote possibility that some of the provisions contained in this Bill will be enforced. I am quite satisfied that they will not be enforced.

There is another matter that I must refer to. It seems to me that dispensary doctors and nurses will be called upon to perform many extra duties apart from their present work. I am sure they will be quite anxious to do that. Dispensary nurses, as far as I know, will be put on a whole-time basis. I would ask Dr. Ward to consider the question of adequate remuneration for that service. There will be very little scope for dispensary doctors, and none as far as I can see for nurses, to do any private practice and I would ask Dr. Ward to consider that matter when the Bill is going through Committee.

An Ceann Comhairle

Would the Deputy ask the Parliamentary Secretary?

Dr. Brennan

The Parliamentary Secretary. We have all noticed the recent advance in medical science and I think we would be lacking in our duty if we did not bring our public health law up to date and avail of the advances in science which are evident the whole world over.

Mr. Bennett

There are some things in this Bill about which all of us would agree and there are some things in it that the country could have done very well without. The Parliamentary Secretary has approached the good things in the Bill in the spirit in which the Government have been accustomed to approach matters in latter years—a spirit of compulsion rather than of co-operation with the people in general. Nobody denies that there is necessity for some of the provisions in this Bill but most of us believe that the reforms which the Parliamentary Secretary hopes to carry out could be brought about without the compulsory clauses that there are in the Bill. I do not believe that the compulsory clauses will work. The Parliamentary Secretary seeks to treat the Irish people in general as a body of people who are not amenable to any modern advance in the matter of health or the proper conduct of their lives. We are all going to be regimented under the will of the Parliamentary Secretary.

One cannot deny that, reviewing the past 20 years, there has been a great advance here in health matters generally and all things appertaining to health and, all in all, the people have fairly well co-operated. There was perhaps in past years a tendency on the part of the people to resist what one might call work-house methods. There was a tendency on the part of the country people to hide disease so that they would not be sent to the work-house, or work-house hospitals as they were then. But, in latter years, with the provision of good sanatoria and fairly comfortable hospitals, that tendency has not been so great and the people have come gradually to realise that in certain circumstances they have to isolate themselves from their families and secure medical treatment. I believe that further advance in that direction, as far as the treatment of disease is concerned, can be brought about by the co-operation of the people, the clergy and people interested. Societies such as the Red Cross Society, to which Deputy Dr. Brennan referred, are doing a great deal to educate the people in that way. I believe a continuation of that process of education will eventually induce all the people that need treatment to seek the treatment without compulsion.

Nearly every section of the Bill has been covered, directly or indirectly, by previous speakers, and I do not intend to go over the sections. I wish merely to say that I resist the compulsory clauses of this Bill. Everyone in this House is anxious to improve the health conditions of the people. We believe it ought to be a central charge and not a local charge. The tendency, again, of the present Ministry has been to inflict all the cost of all the improvements in health and other conditions on the local farmer. In the last ten years the rates have gone up by an average of 65 per cent. In a certain section they have gone up by more than 65 per cent. When one takes into account that the lower-valued farmer, of £10 or £20 valuation, is relieved of rates, it follows that the people above that valuation—the average comfortable farmer of from £20 to £50 valuation—pays all the rates, practically speaking. He is the man who is going to bear all the cost of this particular measure, and it is going to be a considerable cost if it is put into operation, as we hope it will be. There has been a reluctance on the Government's part to offer any relief whatsoever. We had yesterday a motion put down by Clann na Talmhan to give that particular section some relief, by raising the limit of valuation by £10 or £15 so that the middle-class farmer would get some advantage, but the Minister would not accept it.

That is the section of the people on whom the cost of this particular measure will fall. It will fall definitely on the farmer of from £20 to £60 or £70 valuation. I am not talking of the men of £200 valuation, because they are relatively few and therefore do not count. The burden of taxation in this country falls upon the farmer of from £20 to £60 valuation. These are the men who will bear the cost of this and who can least afford it. These are the men who are already carrying the burden of the rates in the local districts and the bulk of the other expenditure in this country. I should have liked to offer some laudatory remarks in regard to the Bill but, having regard to its compulsory powers, which I do not believe will operate, owing to the manner in which the Parliamentary Secretary presented it, the absence of any Government contribution towards the operation of the Bill, and the fact that all the expenses are going to be passed on to the local rates and, eventually, to the moderately small farmer, I feel compelled to vote against the measure.

Mr. Cosgrave

I move the adjournment of the debate.

Debate adjourned.

Dáil Éireann debate - Thursday, 13 Dec 1945