When we adjourned last night, the Parliamentary Secretary had had a number of questions put to him and his position at 10.27½ p.m. was that he could not hope to answer them in the 1½ minutes left. I wonder if we could hear his replies now.
Public Health Bill, 1945—Committee Stage (Resumed).
SECTION 19 (Resumed).
Debate resumed on amendment No. 103.
In the course of the discussion on this amendment last night, there appeared to be a good deal of misunderstanding. Deputy McGilligan was very much concerned as to the far-reaching effect of sub-section (3), which sets out that a person who knows that he is a probable source of infection with an infectious disease shall not expose himself in any street, public place, club, hotel or shop. Deputy McGilligan was anxious to know what constituted a public place in the legal sense and if it included a place of worship. I might reply that a public place to-day appears to mean what it meant in 1878. Various changes have taken place all down the years since then, but I think a public place has remained a public place. The Opposition Parties are concerned as to whether a place of worship should be considered to be a public place. Well, I would suggest, in all sincerity, that that particular aspect of our difficulties in the control of infectious disease and any question of ethics in relation to it might be left with safety to the ecclesiastical authorities. I do not want to pursue that further than to say that I dislike lay theologians as thoroughly as I do quack doctors.
It is safe to assume that if, by our legislation or proposed legislation, we interfere with religious liberties and right of freedom of worship, we can depend upon the hierarchy to keep us right. I am not aware that the ecclesiastical authorities in this country feel any concern as to the effect of this particular proposal, but I would point out again that the law to-day and the law when this Bill will be passed, in relation to this particular matter, will be very much the same as it was in 1878 and as it has continued all down the years since then, including the period during which the Opposition Party were the Government in this country. Once again I would put before the House the terms of Section 142 of the Public Health (Ireland) Act, 1878, and I would ask the House to relate them to the proposed terms of sub-section (3) of Section 19. Section 142 of the 1878 Act sets out:—
"Any person who—
(1) While suffering from any dangerous infectious disorder wilfully exposes himself without proper precautions against spreading the said disorder in any street, public place, shop, inn, or public conveyance, or enters any public conveyance without previously notifying to the owner, conductor, or driver thereof that he is so suffering, or
(2) Being in charge of any person so suffering, so exposes such sufferer, . . . "
shall be liable to a penalty. The phrasing is the same. Whatever a public place has meant all down the years, it appears to have the same meaning now. It is clear that, under this Bill, a person who knows he is a probable source of infection cannot appear in a street or public place; and I confess right away it is going to be very difficult to get to Church, even if you are supposed to go, if you cannot appear in the street. I assumed that, when I did not interfere with the law, as it has stood the test of ages in that particular respect. I would not be open to criticism. Clearly, there can be no divergence of opinion on the principle at issue—that a person who is a probable source of infection with an infectious disease must not incur the risk of transmitting it to anybody else. We have dealt with that particular matter fairly thoroughly over quite a long period here.
I might mention, in case it may not be clearly understood already, that it is proposed in this co-ordinating measure to repeal Section 142 of the 1878 Act. If we did not repeal it, the law would be there, but, having repealed it, we have to give ourselves the corresponding power in the Bill before the House. Notwithstanding the fact that that section is 68 years old, it seems to have stood the test of time and is still going strong.
I have just dealt with sub-sections (3) and (4). Sub-section (5) of the amendment sets out that the parent of a child shall not send the child to any school, or permit the child to attend any school, if he has reason to believe the child is a probable source of infection. I will refer Deputies, in relation to that particular provision, to Section 146 of the Public Health Act, 1878, which, too, is being repealed. Section 146 says:—
"Any person who shall knowingly or negligently send a child to school who, within the space of three months, has been suffering from any dangerous infectious disorder, or who has been resident in any house in which such dangerous infectious disorder shall have existed within the space of six weeks, without a certificate from some duly qualified medical practitioner that such child is free from disease and infection and unless his or her clothes have been properly disinfected, shall be liable to a penalty not exceeding 40/-."
Sub-section (9) of the amendment is the counterpart of Section 57, sub-sections (1) and (2) of the Public Health Act, 1907. The relevant sub-sections set out:—
"No person being the parent or having the care or charge of a child within the district of the local authority who is or has been suffering from infectious disease or has been exposed to infection shall, after a notice from the medical officer that the child is not to be sent to school, permit such child to attend school. . . . "
Then comes the penalty clause. The fact of the matter is that the law is not being changed in this particular sub-section, in principle, at any rate; any changes made are of a drafting or verbal nature.
Deputy McGilligan tells us that he thought that the medical profession could have been relied upon to compel parents to keep their children from school. The medical profession has not been relied upon in the past. There has been a statutory obligation in relation to the matter. Deputy McGilligan also complains that the family doctor is now being placed under an obligation, in sub-section (6) of this amendment, to notify the medical officer of health if he is aware that a child is a probable source of infection with infectious disease.
We are accused, by making these provisions, of converting the medical profession into spies. I can only say again that the statutory obligation on a medical practitioner to notify the medical officer of health is not of my making. It was made before I was born and it has continued through the years since with universal application. It is scarcely necessary to take up the time of the House in reading it. So far as the terms and provisions of this amendment are concerned, they are substantially the statutory provisions in our existing law that we propose to repeal. Having repealed them, we have to arm ourselves with corresponding powers if we are to discharge effectively the responsibilities placed upon us.
I rather think, in connection with the question raised by Deputy Mulcahy at Question Time to-day, and to which he referred last night, it will be necessary to break up that amendment on the Report Stage, but not introduce any new principle. From the closer examination I have been able to give to that matter, I am satisfied that the group of diseases that would apply to particular portions of it would not properly apply to the whole of the section and I think the most satisfactory way of dealing with that position is to break it up on Report Stage into different sections and we will then be able to show the House the particular diseases it is proposed to include in the operation of the different constituents of the present amendment.
The Parliamentary Secretary is making it very difficult for the House. This Bill, as originally introduced, provided for the repeal of Section 142 of the Act of 1878. When we come to the Committee Stage we find a new amendment introduced which, admittedly, introduces into the Bill in a positive way some of the matters that were provided for under Section 142 of the Act of 1878. Why this matter was thought of only when we were coming to Committee Stage is more than I know, particularly in view of the importance of the provisions contained therein. We discussed last night sub-section (3) of the new amendment, which says:—
"A person who knows that he is a probable source of infection with an infectious disease shall not expose himself in any street, public place, club, hotel or shop."
The Parliamentary Secretary gave a review of the places outlined in the Act of 1878 and he covered it in what he would call a realistic kind of way when he was dealing with the provisions of Section 21. He specifically dealt with any school, any place of public worship, any theatre, concert hall or cinema. These are the places marked down, no doubt, as the public places specifically named by him in the original Bill. In view of the fact that the ordinary person attending places of public worship specifically mentioned in Section 21 was never, to the recollection of anybody that we ever met or, I suppose, anybody in this House, charged with an offence under the Act of 1878 for attending a place of worship when he might have been in contact with infectious diseases, naturally we had to take cognisance of what was apparently a substantial change in the mentality of the Minister and the Government towards either the law or the administration of the law.
The Parliamentary Secretary, while making that move, which appeared to have had, and which must have had, some significance, is now going back from that position to a phase that existed in the Act of 1878. We are still labouring under thoughts that were brought into our minds when we saw the Parliamentary Secretary's draft in the original Bill, under Section 21. A place of public worship was specifically mentioned. I think we are entitled to know whether it is intended that there should be any change in the administration of the Public Health Acts with regard to the attendance of people at places of public worship.
I can say "no" right off. May I also say that a person suffering from an infectious disease should never have been allowed to attend a place of public worship. The law is that he cannot appear in a street or public place.
The position is that they cannot have been attending there, or we would have greater epidemics than we have had up to the present, or it may be, perhaps, that the ordinary curative effects of sun and air on the way to the church may have had a kind of protective influence that some of the doctors are not able to provide.
I would have more faith in the spiritual effects.
Why did the Parliamentary Secretary begin to waver in his faith in the spiritual effect of these things when he had to introduce into Section 21——
Because of misrepresentation.
By whom?
Shall I say misunderstanding? The section is all right. It gives me all the power I require as it stands.
I am speaking of the section as originally planned. In Section 21, the Parliamentary Secretary now declares that the phraseology which he has introduced into it had no significance with regard either to a different approach from the Government or a different approach from the Department in the matter of attendance at places of public worship. The Parliamentary Secretary, in asking us to accept this amendment, and further to wait for the Report Stage to be told whether a person is going to be guilty of an offence if he goes into the public street suffering from mumps, ringworm or whooping cough, is asking the House to delay too long over a matter that it ought not to be asked to delay over, except in the light of the plain facts. As I said earlier, there was no provision in the Bill as originally drafted to prevent a person going on the street or into a public place, into a club, hotel or shop, even if suffering from an infectious disease, except in relation to the regulations that the Minister proposed to make under Section 20.
Does not the Deputy know that a person appearing in the public street and suffering from any infectious disease was, at any time, during the last 60 years or so, committing a breach of the law?
What does the Parliamentary Secretary mean then by saying that he is going to break up the list of these infectious diseases which are referred to in Section 19?
For the reason that some of the minor diseases, some of which have been mentioned by the Deputy, can be exempted from the more rigid restrictions. It is not necessary to apply these rigid restrictions to every disease that is classified as an infectious disease. That is the only reason. If I did not do that, then every disease, including the minor ones scheduled under the regulations as infectious diseases, would have to be set out in every section and every sub-section in the amendment and in the reconstructed Section 19.
The Parliamentary Secretary has broken up the diseases between the ones that are going to be regarded as infectious and the ones that are not going to be so regarded in respect to Sections 22 to 29, inclusive, but, in respect to Section 19, he gives us a list which we object to, because it contains whooping cough, tuberculosis, scabies, ringworm, mumps, and certain venereal diseases. According to the proposals now put before us, the passage of the Parliamentary Secretary's amendment would mean that a person suffering from these diseases would not be able to go into a public street or into any public place.
And is not to-day, and was not during the ten years that the Deputy sat over here.
I think the Parliamentary Secretary must be stuck in some cobwebs that have not yet been swept away from the past. I certainly oppose the insertion of a new amendment to this Bill which would prevent a person with whooping cough going out into the public street, or a person with scabies or ringworm, or even with mumps, if he was able to move about, or with tuberculosis. These are only some of the diseases that are mentioned in the list of 34 that we have before us.
I think this is a valuable sub-section, especially in so far as it deals with the health of children. It is protective in the case of children whose parents take proper care of their children's health, and even more so, of children whose parents are careless about their health, particularly when the children are suffering from infectious diseases. If you take the parents who can afford to send their children to a boarding school, as soon as the children arrive for a new term at a properly run boarding school, there is a medical inspection of them. If any of them are found to be suffering from an infectious disease they are isolated and put in the school infirmary. They are not allowed to mix with the other school children, and certainly are not allowed to attend classes, school entertainments or the school chapel. I think that all sections in the community should be able to benefit from medical inspection in the same way as the children of those better-off parents benefit from going to a boarding school. The children of to-day are the men and women of to-morrow. They are the nation's greatest asset. The mothers of the country who have the welfare of their children at heart are doing a very valuable job, and because they are doing it unobtrusively, and because everybody thinks it is their duty, they do not get any special credit for it. I think that they should get all the help that the nation can give them to do their job effectively. That is why I think this sub-section is so valuable from the parents' point of view.
Amendment put.
The Committee divided: Tá, 56; Níl, 21.
Tá
- Aiken, Frank.
- Bartley, Gerald.
- Beegan, Patrick.
- Boland, Gerald.
- Brady, Brian.
- Brady, Seán.
- Breathnach, Cormac.
- Brennan, Martin.
- Brennan, Thomas.
- Breslin, Cormac.
- Briscoc, Robert.
- Buckley, Seán.
- Burke, Patrick (County Dublin).
- Carter, Thomas.
- Childers, Erskine H.
- Colley, Harry.
- Crowley, Honor Mary.
- De Valera, Eamon.
- Everett, James.
- Fogarty, Andrew.
- Gorry, Patrick J.
- Healy, John B.
- Humphreys, Francis.
- Kennedy, Michael J.
- Killilea, Mark.
- Kilroy, James.
- Kissane, Eamon.
- Lemass, Seán F.
- Little, Patrick J.
- Loughman, Frank.
- McCann, John.
- McCarthy, Seán.
- McEllistrim, Thomas.
- MacEntee, Seán.
- Moran, Michael.
- Morrissey, Michael.
- Moylan, Seán.
- O Briain, Donnchadh.
- O'Grady, Seán.
- O'Loghlen, Peter J.
- O'Reilly, Matthew.
- O'Rourke, Daniel.
- Pattison, James P.
- Rice, Bridget M.
- Ryan, James.
- Ryan, Mary B.
- Shanahan, Patrick.
- Sheridan, Michael.
- Skinner, Leo B.
- Smith, Patrick.
- Spring, Daniel.
- Traynor, Oscar.
- Ua Donnchadha, Dómhnall.
- Walsh, Laurence.
- Walsh, Richard.
- Ward, Conn.
Níl
- Anthony, Richard S.
- Beirne, John.
- Bennett, George C.
- Browne, Patrick.
- Byrne, Alfred.
- Coburn, James.
- Cogan, Patrick.
- Coogan, Eamonn.
- Cosgrave, Liam.
- Dockrell, Henry M.
- Dockrell, Maurice E.
- Donnellan, Michael.
- Doyle, Peadar S.
- Halliden, Patrick J.
- Keating, John.
- Keyes, Michael.
- McMenamin, Daniel.
- Mulcahy, Richard.
- O'Sullivan, Martin.
- Roddy, Martin.
- Sheldon, William A.W.
Tellers:—Tá: Deputies Kissane and Kennedy: Níl: Deputies Doyle and Bennett.
Amendment declared carried.
Amendment No. 104 not moved.
Question proposed: "That Section 19, as amended, stand part of the Bill."
On Section 19, Sir. What I am about to say should probably have been raised on the last amendment, but I missed the point, and I should like to raise it now on the section. The Parliamentary Secretary said that in effect this was doing no more than making a drafting change in the relevant part of the Act of 1878. In the 1878 Act the phrase used is: "A person suffering from an infectious disorder". Would the Parliamentary Secretary not agree that the new phrase: "A probable source of infection", amounts to much more than merely a drafting change? We have now the question of a person knowing himself to be a probable source of infection. In the 1878 Act it was a question of an individual who might be affected, but now, possibly, a whole family might be concerned, and for that reason I think that to say that this is merely a drafting amendment is going a little bit beyond the mere question of drafting. For instance, if you take a family living in an isolated house in the country, if one member suffers from an infectious disease, the probability is that every member of the family will become a source of infection. Under this section we are providing that if the family lives in an isolated place there may be nobody to do the shopping.
The Deputy knows that we have regulations to deal with that.
I raised this matter in order to get information. For instance, at an election this section might affect a large number of people. It is only fair to say that it would have in that case as much influence on one side as on another, but if the section is going to remove the power to vote that is important. I am not sure if a polling station is a public place, but there certainly will be difficulty in getting to a polling station without passing through a public place.
Or passing through a street. A person could never make it.
No. The position here is much wider than under the Act of 1878. Under the latter Act only the person suffering from an infectious disease was affected.
The regulations brought in the contacts.
That does not make the position better.
We are not trying to make it better in that respect.
The section states that a person "shall not expose himself in any street, public place, club, hotel or shop". Supposing a person is in a motor car is he technically in a street or in a shop?
I do not know how he would get into a motor car without appearing in a public place, unless he is taken there in a sack.
Supposing that person brought the motor car inside his front gate.
Or upstairs.
Inside his own walls.
The Deputy appreciates that if there is a question of infringement, or penalties under the section, if I might call them so, that will be decided by the court. What a justice might decide in that case I would not take upon myself to say.
So that it is being left open.
If he offends against the Act a charge will be laid against him. He will not incur a penalty unless he is convicted of an infringement of the Act by the court.
I was prepared to move an amendment to this section but was delayed after the division.
On Report.
May I raise the point on the section?
Yes.
The penalty mentioned for each offence under this section is £50. I suggest that the type of people likely to be affected will, in the main, be poor people, for whom that would be an outrageously heavy penalty.
Unfortunately that is not the case.
In any case, I suggest that since the Minister will expect co-operation in the working of the Act he might have much less harsher penalties, as £50 would seem to be beyond all reason. I suggest that that penalty should be reduced.
I want to appeal to the Parliamentary Secretary to try to redraft this section, so that it will, at least, have some common-sense provisions when it leaves this House. As framed, I think it would be just as obsolete as some of the sections of the 1878 Act. To my knowledge the provisions of the 1878 Act were never enforced or, if they were it was rarely. If there are any statistics of prosecutions for those tried for offences under that Act I should like to hear them. I have measles in my house at present and, as the section stands, I could not go to the doctor, if I had not a telephone. I cannot expose myself in the street under the Act of 1878.
"Street" includes any highway, and any public bridge, and any road, lane, footway, square, court, alley, or passage whether a thoroughfare or not.
I am not concerned with the religious aspect at all. I do not want to be accused of being a lay theologian or a quack doctor. If there is an outbreak of measles in my house can I go out for the doctor without infringing this section? As I read it I cannot, because I cannot expose myself in any of these places and, in addition to these places, in any church, chapel, school, cinema or football ground. I cannot go anywhere outside my house. I cannot even open my own door and look out in the street to hail the doctor. If my head was so far outside the door that my body was held to be on the thoroughfare, I should be offending against the law.
This is an extraordinary provision. I do not think we should reduce legislation to absurdity. On the strict interpretation of the section as it stands, I cannot go out of my house because I am a probable source of infection. I am a contact. I think measles are air borne. Take any disease that is not air borne. I see a difficulty in the section there, if it is not going to be reduced to a farce, because a working man or a farmer who has not a telephone, strictly speaking, cannot leave his house. He must take not only the statutory precautions which the Department of Local Government prescribes, but every other reasonable precaution, whatever that may be. There is a whole bundle of these precautions. We have had all this already, and I do not want to go over the ground again. The Parliamentary Secretary is trying to create the impression that he is making no change. He is making a definite change. Section 142 prescribes the penalties in the case of persons who expose themselves in the public street. The phraseology is as follows:—
"Any person who while suffering from any dangerous infectious disorder wilfully exposes himself without proper precautions against spreading the said disorder in any street, public place, shop, inn, or public conveyance" and so on.
That is certainly an entirely different provision from the provision we are getting here. The word "wilfully" has been dropped before "exposes himself" and after "himself" the words "without proper precautions against spreading the said disorder" have been dropped.
How would he expose himself other than wilfully?
I say "wilfully" in that sense would mean culpably, that he did it recklessly without regard to the consequences. But under this provision he is prevented from going out, or any member of his household, to fetch the doctor or a nurse and, if he does that, he is committing an offence. How is he to get out to tell a neighbour to do the needful for him? May I ask the Parliamentary Secretary is he going to wipe out the corporal works of mercy? Is visiting the sick now to be a penal offence in this glorious Republic? That is what you are getting to.
We are not getting much assistance from the Deputy, anyhow.
You are getting plenty of assistance. I am trying to put you right.
Plenty of propaganda, and nonsense and misrepresentation.
I am not talking nonsense. I say you are perpetrating a legal absurdity.
The Deputy ought to bring back the Bible. He had it here on the last day.
I am not bringing back the Bible. I am referring to one of the corporal works of mercy.
We know as much about them and we practise them too.
I am sure you do. So do I. We are not going to enter into the merits of our religious fervour or practice, but I say you are perpetrating a legal absurdity and you are asking the Gárda Síochána and the medical constabulary to enforce legal absurdities in respect of a statutory offence which will have no practical effect once it is written into the Statute Book. It cannot simply be enforced. My objection to this is that it is absolutely and utterly unreasonable and incapable of enforcement either by the medical profession or the Gárda Síochána. It is utterly absurd. Any common-sense man reading that section as now amended can only come to one conclusion, that once there is infectious disease inside a household then every person, member of the family and servant, in that household, is a probable source of infection, and from that moment they are all bound to take these prescribed precautions and every other reasonable precaution and must stay within the household; they cannot move; they must all proceed to get themselves interned in the detention institutions. That is the position and I think that will be simply a reductio ad absurdum in practice. I want again to stress that aspect of the matter. Look at the inconsistency. The parent of a child may not send the child to school, but apparently the parent of the child may let the child out on the street. You want to be very clear as to the legal effect of this provision. In sub-section (3) you start off by saying that a person who knows that he is a probable source of infection may not go into any street, public place, club, hotel or shop, and I take it that there you are referring to an adult person, but in sub-section (4) you say a person having the care of another person—you again refer to a person—shall not permit that person to go into the street.
Surely a child is a person.
A child is a person but a child has been defined as a person under the age of 16 and when you specifically provide for the case of a child, as you do in sub-section (5), then you exclude any provisions relating to the child unless you include them in sub-section (5). You have not done so and you say that a parent shall not send the child to school, but you do not say anything about sending the child into a street. Are you leaving a loop-hole there?
The draftsman says no and I prefer the draftsman's view of the law.
Let the draftsman be tested in due course by the courts. That is the real test.
I would be surprised if he is wrong and the Deputy is right.
I am just pointing out one humble lawyer's view of this, that in the manner the draftsman has done it he has left the door open for the children to be sent into the street to cause this infection while the adult is to be confined—another absurdity, apart from the gross absurdity of the whole section. I do not think there is any necessity for heat or extravagance or anything else in this.
Extravagance.
I am only trying to point out the unreasonableness, the utter absurdity of the position and I, for one, hold that it is wrong to legislate when you cannot enforce the legislation. The 1878 Act, so far as I know, has been virtually a dead letter in this country. Are you going to perpetrate another dead letter now?
On Tuesday evening, when this section was first before the House, I appealed to the Parliamentary Secretary to withdraw the entire section and to see if he could revise it before the Report Stage. The Parliamentary Secretary would have saved much Parliamentary time if he had taken my advice. We spent the greater part of yesterday and will probably have to spend some part of to-day trying to straighten out this matter which the Parliamentary Secretary failed to put right in the original draft and in the amendments. We laymen would be inclined to place a good deal of confidence in a member of the medical profession as long as he adhered to any decision which he had taken but when we find the Parliamentary Secretary changing the original draft to a very considerable extent, when we find him in the position of a doctor attending a patient who changes the medicine from day to day, we naturally feel that he has not a grasp of the position and that he is floundering from one blunder to another. Evidently the section as originally introduced was all wrong because the Parliamentary Secretary has introduced seven entirely new subsections. In sub-section (3) it is stated that a person who knows he is a probable source of infectious disease shall not expose himself in a public street or a public place. The Parliamentary Secretary has not attempted to define the word "exposes" in this case. It would, apparently, be no offence for a person to be in a public place if he were not exposed; if the night was very dark, he could probably proceed to any place he wished, but the Act prohibits him, in broad daylight, from being in any public place. The Parliamentary Secretary admitted that he took that particular section out of an Act that is 60 years old. He probably did not consider all its implications. He states now that he will leave it to the courts to define. That has been in existence for 60 years and it has not been defined simply because nobody attempted to enforce it because they realised it was futile and absurd. It was left to the Parliamentary Secretary to perpetuate that absurdity.
One other objectionable sub-section is that which imposes a severe penalty upon a medical officer who fails to notify the district medical officer of the existence of the disease. That penalty is not necessary or desirable. We should have sufficient confidence in the medical officers of this country and in the medical profession generally to acknowledge that if an infectious disease is brought to their notice or comes to their notice in the course of their practice they will take all possible steps to deal with it. It is wrong that a medical officer attending a private patient should feel himself obliged by law to seek out an infectious disease and, if he finds it, to report it immediately. The compulsory provisions of this sub-section are a grave reflection on the honour and integrity of the medical profession. I suggested when the section was introduced that the first obligation which should be placed on a person who believes that he is a probable source of infection is to get in touch with his medical doctor as speedily as possible and report his condition to him or, in the case of a member of his family, the condition of that member of his family, and leave it to the medical doctor to do the best that can be done in the circumstances and accept his advice and instructions. Now, in this peculiar section we have the ordinary citizen prohibited from getting in touch with his medical doctor. He cannot go out into the street or in any other way get in touch with him unless, as Deputy Coogan said, he has a telephone in his house. There are so many absurdities in this section that the Parliamentary Secretary ought to agree to have it considered before the Report Stage. It is a pity that he has been so stubborn and thus has wasted so much time. I am afraid his bedside manner is not impressing this House.
The principal objection I have to this section, or to the amendment which has been included in it, is that the object is to try to throw dust in the eyes of Deputies and the public. When the Bill was originally discussed there was general criticism by Deputies and also outside the House and in the Press of certain provisions in Section 21. The Parliamentary Secretary evidently was so impressed by the criticism in this House and outside it that he felt bound to make some move to obviate a repetition of the criticism when we came to discuss the Bill in Committee. He proceeded to try to bamboozle the people by changing these provisions from Section 21 to Section 19. He has in this amendment of his all the things that were objectionable in the original Section 21; in fact they are probably more objectionable now than they were originally, because there was one merit in Section 21 as it stood originally, namely, that the places that infected persons might not go to were specifically defined. Section 21 provided that the parent of a child suffering from an infectious disease could not send the child to any place to which that section applied, namely, any school, place of public worship, theatre, concert hall or cinema. Under the amendment which the Parliamentary Secretary has substituted for Section 21 a parent could not send such a child to any place whatever.
Take this list of diseases to which the sub-section applies. The Parliamentary Secretary said that persons suffering from infectious disease were already prohibited from attending certain places, such as places of worship, schools, etc. I do not profess to be a lawyer or to know anything about the law or the Act of 1878. I have so little knowledge of that Act that it might not have existed so far as I am concerned and I think there are many other people in that position. But I do know that I myself, and I am sure a lot of Deputies, from time to time have suffered from many of the infectious diseases mentioned in this schedule, and we never thought we were injuring anyone very much by going to Church or attending school when we were youngsters, or going to many other places. I venture to say that when the Bill becomes law we will do so still, but we will probably be hauled up by the Parliamentary Secretary and fined £50.
Every Deputy who has anything to do with a farm knows that in dressing ringworm in cattle you very often get ringworm on your hand. There is hardly any person connected with a farm who has not got it at some time or other. I got it several times. I always put some dressing on it and bound up my hand as well as I could and proceeded on my ordinary business and I do not think I ever gave it to anybody. I went to Church and met the people there. Nobody prevented me from going to Church. I was not held up by a Civic Guard and told that I had broken the law and that they would proceed against me. That is one particular disease that everybody knows was very common. There is another disease which might be more serious and that is anthrax. A member of my family some years ago got boils, as they call them, and they were treated at home. After some time he went to the doctor who said he was suffering from anthrax. The doctor applied dressings of cotton wool, etc. He did not tell that member of my family that he was not to go to Church or anywhere else. That particular member of my family proceeded to go to the places that he was accustomed to go to and, so far as I know, nobody else suffered as a result of that. That is the sort of thing we have to meet in this Bill. Deputies criticised it severely on the Second Reading, and the general public, Church representatives, and everybody else are up in arms against it. The Parliamentary Secretary in a backhand way is trying to put it over on the public by putting in this amendment in Section 19. I do not think that either the House or the country will stand for it.
I have listened to the discussion on this section for a long time and I feel that Deputies are without some of the relevant information that they require in order to see what the section proposes to do. When we started discussing this section we did not know what diseases were included under it. The Parliamentary Secretary has now furnished us with that information and that objection has been disposed of.
You thought of another.
Mr. Dockrell
I did not think of it; it was there all the time. It has emerged. I will tell you what the objection is to—the regulations. The Parliamentary Secretary by steepening the regulations can very much tighten up this section or, by leaving them more open, he can very much reduce the force of the section. I suppose nobody is more aware than the Parliamentary Secretary that, if the general public do not accept laws as being proper laws that ought to be enforced, it will not be very long until they have no force of law. I would like to put that matter before the Parliamentary Secretary. We sympathise with his effort to improve the public health. You can go too slow or you can go too fast. The trouble is that we do not know at what pace the Parliamentary Secretary proposes to go.
A terrific pace.
He has not made terrific haste with the Committee Stage of the Bill.
There are 54,000 cases of infectious disease and we have to smarten up our pace a bit.
Mr. Dockrell
It would be very interesting if the Parliamentary Secretary would tell us what, when this Bill is passed, he considers the percentage reduction will be.
Oh! now.
Mr. Dockrell
That is the essence of the matter. If there is to be no reduction, then we shall have wasted our time.
That would be a nice calculation.
Mr. Dockrell
I want to make my third attempt to obtain information from the Parliamentary Secretary as regards the impact on a family or a household when one of its members gets an infectious or contagious disease. According to the definitions, "infectious" includes "contagious". We all agree that a person with such a disease is a source of infection and that there ought to be some restraint on his movements. This section, as drafted, and when assisted by stern regulations which we have not yet seen, may result in a house in which there is an infectious or a contagious disease being converted into something like a quarantine camp. The people will not be allowed out. I should think that the milkman who steps inside the door to deliver the milk for the family and the butcher who brings in a tray, which he may use in other places, will be affected by the regulations and I have several times asked the Parliamentary Secretary what the impact will be on a father or mother one of whose household has an infectious disease. Will limitations be imposed on their going out and coming in? If that is so, a more serious issue will have arisen for this House than this Public Health Bill. All sorts of questions will arise. Who is going to maintain those people? I renew my request to the Parliamentary Secretary for the third time for information regarding limitations to be imposed on a father or a mother in a house where there is infectious disease. May the father go to his work or is he liable to a penalty if he leaves the infected house?
This is the first time I have risen in the House since Deputy Mrs. Crowley spoke, and I should like to express the pleasure we had in hearing her. We were extremely pleased to hear her and particularly pleased that she intervened on a Committee Stage. We hope that she will join the small band of workers who take part in the proceedings in Committee and that she will give us the benefit of her realistic woman's mind on the problems before us. It gave me great pleasure to hear the Deputy and I should like to give expression to that pleasure. Deputy Dockrell has put a plain question to the Parliamentary Secretary and the fact that he should have to put that question at this hour illuminates the whole position.
It surely does.
The whole performance in connection with this Bill and the amendments to it is an astonishing one. Nobody knows where he stands with regard to the relationship between the Minister and persons who may contract infectious disease.
I am afraid they will have to read the debate.
Nobody who reads this debate will come away with any idea in his mind save that this was an astounding performance. He will completely forget what the debate was about. He will be discussing the anatomy of it and the proceedings in the Department of Local Government which preceded the debate. The approach of the Department to the framing of this measure was, indeed, extraordinary. To deal with Deputy Dockrell's point, what is to be required under this section of the father or mother in a house where there is infectious disease, so declared for the purpose of this section? It is important to have that information from the point of view of the individual, but it is also important having regard to Section 34. That section provides that, where a person is suffering from an infectious disease and because of requirements in that connection is unable to carry on in business and maintain his dependents, the country or county borough in which the person ordinarily resides shall make provision to maintain his dependents. That is where the person himself is suffering from infectious disease. When a person is a probable source of infection, he may not be able to go about his business and maintain his family because of the operation of this section and the county or county borough will have to maintain himself and his family. In the interest of the individual, of the local authority and of the State, or whoever will ultimately bear the cost in this connection, and for the benefit of Deputies who, when they pass laws, should know what they are passing and what their effect will be, we should have a reply from the Parliamentary Secretary to the question put by Deputy Dockrell.
I might as well be talking to a stone wall.
Shall we see the regulations?
The regulations have been in existence for 20 years and the Deputy never saw them. Why did he not look at them?
We shall never get through a stone wall with the pointless remarks and the pointless pieces of information with which the Parliamentary Secretary has presented the House. Is the Parliamentary Secretary able to say now whether a person with whooping cough will be allowed to enter the street after the passing of this section and its Ministerial administration?
He is not allowed to go out at present.
And he will not be allowed to do so when this section is passed?
Why should he?
The Parliamentary Secretary is, apparently, as little aware of what is happening in the town as he appears to be of what is happening in his Department.
Is the Deputy aware of the number of deaths from whooping cough?
I am aware of the number of persons I meet suffering from whooping cough.
The figures of deaths are interesting, too.
We can take it that, under this section, in a case of whooping cough, the bread-winner of the house will not be allowed to go out to do his work. As Deputy Dockrell has pointed out, he and his family will have to be maintained by the rates, with whatever assistance the State will give. Having got that information, will the Parliamentary Secretary say whether other inmates of a house in which there is a case of whooping cough will be allowed to go into the street? Could we have any kind of answer to that?
The Deputy only thinks he is smart.
I must say that I think I am only trying to get information.
You are trying to be as difficult as you can and you are welcome to it but you are doing a bad day's work.
That may be, but I am doing it with the greatest possible bona fides.
Oh.
We are in an Irish Parliament and we are passing a section in an Act which the Parliamentary Secretary intends to become law. We are passing a section here which provides that where a person is a probable source of disease he will not be allowed to go into the street.
He will not be allowed to put his neighbours in danger of their lives.
I am only going as far as the street yet.
He might meet somebody in the street you know.
As far as we can understand, what the Parliamentary Secretary is trying to convey, is that as far as whooping cough and contacts are concerned people affected under the new dispensation will not be allowed to go out to the streets. We have to consider the effect of that on both their social and economic life and on local and State finances. Our difficulty in trying to interpret the Minister, even with the small chance he gives us, is increased when he makes use of statements such as he used when interrupting Deputy Bennett. When Deputy Bennett was describing what would happen when a man suffering from infectious disease went into the street, the Parliamentary Secretary intervened to say: "He should take proper precautions." In sub-section (3) there is no question about a person taking proper precautions. The section expressly states:—
"A person who knows that he is a probable source of infection with an infectious disease shall not expose himself in any street, public place, club, hotel or shop."
There is no question about taking proper precautions or precautions of any kind there.
The Deputy had that power for a number of years when he was Minister and he did not know it.
We apparently did not approach the matter in the new administrative spirit in which the Parliamentary Secretary is approaching it. We did not make elaborate provisions to see that persons affected should not only keep to their houses if they suffered from these diseases, but that, if necessary, they should be forcibly taken away to institutions. Now with a great sweep to clear up the whole infectious disease situation in the country, we are going possibly to saddle the rates with the maintenance of their families. The Parliamentary Secretary has given no review of the situation or no outline of his approach to the situation that would persuade us that we are not going out in a mad wild kind of way, to do a thing that can only be done by public education, using the whole of the nursing and medical services to persuade people in a reasonable way as to how infectious disease is to be treated. The Minister has come here and behaved in a most peculiar and uneven way. When we read the stuff that he has put before us and listen to what is said, when we realise how lopsided the whole approach to this situation is, when we consider the way in which Section 19 as amended is now being pieced together and built up, we get some idea of the administrative mind that is behind the present scheme. When we consider the build-up of this section, the inevitable peep we have to give in our imagination as to what went on behind the scenes in the Department before this section was framed, gives us some insight into the most astonishing episode that ever took place in the framing of legislation in any Parliament.
I have listened very carefully to the debate and I must say that I am not at all impressed by the arguments which have come from the other side of the House. Deputy Coogan's argument about inability to go for a doctor in certain circumstances falls to the ground unless he first puts himself in the position of being the medical officer who diagnoses the disease. Surely most diseases have certain breeding stages during which a person takes precautions. Surely, nobody is going to be debarred from leaving his house until a medical practitioner diagnoses the disease and has advised the people why it is in their own best interests and the best interests of the community that they should remain in the house. Surely the normal precautions which any family will take for the safety of their own members and the safety of the community in general will not be considered an offence?
Mr. Dockrell
I should like to ask the Parliamentary Secretary a question. He said that the regulations for which I was looking, had been in operation for the past 20 years. Under Section 20, the Minister may make regulations for preventing the spread of infectious disease. Are these the old regulations that are going to be brought in holus-bolus or is the Parliamentary Secretary going completely to alter those regulations by, as I previously said, stiffening them? That is why it is so difficult to consider this section without seeing the regulations with which it is going to be interpreted. I take it that if a question comes before the courts, the courts will look up this section and look also at the regulations. At present we are looking at this section but we are waiting the advent of the regulations.
Surely the Deputy appreciates that the regulations cannot be made until the Minister gets statutory power to make them? You first have to give him the statutory power.
Mr. Dockrell
Is there any objection to your giving us an idea of what these regulations will be like?
What is the objection to the Deputy reading the existing regulations, to start with? He will learn a terrible lot without going any further.
I do not know whether these are the regulations with which we will finish up.
They will be until the Minister gets power to make alternative regulations.
The Parliamentary Secretary has indicated that some changes will be required in this section. It is practically a new section of a very elaborate kind, and containing proposals which were not in the original Bill, and I ask if the Dáil can go into Committee on Report Stage in respect of this amendment. There are two sections in respect of which it appears to me that the Dáil should go into Committee on Report. We have a very large number of amendments down to Section 21 on somewhat the same lines and of the same type as those which we would desire to put down to the new part of Section 19 from sub-section (3) to sub-section (10), but, apart from that, the Parliamentary Secretary has indicated that he has some amendments to introduce dealing with the types of infectious diseases which will be dealt with under various sections, and I ask whether, in relation to Sections 19 and 21, the House will be able to consider them in Committee.
I have no objection to the fullest discussion.
The old Section 21 will probably go out.
I quite approve of this new sub-section, for the simple reason that it will be a deterrent to those members of the better-off classes who can afford to isolate cases of disease in their homes. I happen to know of houses in which scarlatina and diphtheria broke out and in which the people concerned were able to isolate the patients, but the maidservants and other attendants in those homes went into shops and places of worship. If anything, the fine of £50 prescribed is not sufficient in respect of people convicted of that offence. When we turn to another section prescribing penalties in relation to the masses of the people for breaches of the law, the Bill is very moderate in fixing a fine of £5. Deputy Costello last night recommended a walk round the gasworks as a cure for whooping cough. I wonder if the Deputy and his wife and family take a walk around the gasworks when their family is suffering from whooping cough? Evidently that is good enough for the families of workers. The fact that the Parliamentary Secretary has made it known that there were no less than 54,000 notifiable diseases last year and no fewer than 6,000 deaths does not seem to have impressed itself on Deputies, and particularly on opposition Deputies. One Deputy wanted the Parliamentary Secretary to be a prophet and to tell him what percentage could be saved. It is beyond all imagination that people in these days should ask the Parliamentary Secretary to prophesy what effect these diseases have on the community and to what extent it will be prevented. Time and time only is the test of that. For these reasons, I support the Parliamentary Secretary.
It is bad enough for us to have to deal with the Parliamentary Secretary and some of the difficulties we have encountered, but Deputy Walsh now introduces a street corner argument which has no more truth in it than many of the arguments which Deputies use at street corners. I challenge the Parliamentary Secretary to say that what Deputy Walsh suggests is correct—that there is any discrimination between poor and rich in respect of the penalties set out in this measure.
It is quite obvious.
Give us the sections. We are not now at a street corner; we are in an Irish Parliament. We have a Bill before us in an Irish Parliament of which the sections are numbered. Will the Deputy tell us where is the section which puts a fine of £5 on a poor man and £50 on a rich man?
It is there.
Where?
In this Bill.
This is a printed measure, and I want the Deputy to tell me the sections.
Sections 19 and 21.
The Deputy says something about Sections 19 and 21. Does he suggest that the £5 penalty is in relation to poor people and the £50 penalty to rich people?
Very definitely.
The Deputy should be at a street corner, because he is not able to read well enough or to speak intelligently enough to speak in an Irish Parliament. Might I reply to the Deputy's reference to Deputy Costello? Deputy Costello told the House last night that he was taken around the gasworks as a child when he had whooping cough.
He did not do any such thing. He said it was an old Dublin remedy, but he did not say he was taken around.
And I added that far away from Dublin, in Waterford, we as children were taken into the gasworks when we had whooping cough.
I never knew before what happened to the Deputy.
It is bad enough to have to deal with the Parliamentary Secretary and his obscurities without bringing the more virulent obscurities of the street corner into the debate. There is no such thing as suggested by Deputy Walsh in the Bill. In defence of the Parliamentary Secretary, I say that.
Good man.
We can all sympathise with the Parliamentary Secretary in his efforts to make the people as healthy as possible and his efforts to take all possible steps to reduce to a minimum the spread of disease and the sources of infection. I am sure the Parliamentary Secretary must be aware, when he mentions the 50,000 cases of notification and the 6,000 deaths, that all that took place at a time when exactly the same law was in operation as is proposed here, and therefore it does not follow that if and when this Bill passes, the health of the people will improve. We all hope it will, but, being a realist, I fancy that the Irish people as a whole will just carry on as if this Bill did not exist. I feel that much more effective work could be done through the medium of propaganda and instruction of the people. The Parliamentary Secretary was keen on that. He called for co-operation and personally I should be prepared to give it to him. Candidly, these different things about a person "knowing", etc., etc., cannot possibly be carried out. All a person has to say is that he does not know and who is to prove that he does know? Again, I was sorry to hear my colleague, Deputy Walsh, propounding the view that certain people would be fined £50 and others £5.
He cannot read.
I will get you to read it for me.
It applies to particular sections. In so far as the notification is concerned, there should be no differentiation. I would go so far as to tell the Parliamentary Secretary that the commonsense of the Irish people themselves—the parents, especially—will be the greatest help he will receive in making this Bill effective. Therefore, I suggest that the fine be left out altogether. I think Deputy Walsh is quite wrong in saying there is a fine of £50 for one class and £5 for another. There is not, and I would be sorry if there were.
On a point of explanation, I have not stated there was one fine for one case and another fine for another. I pointed out my reasons when referring to it.
There is a tendency, unfortunately, when certain legislation is passed here, to try to give the view throughout the length and breadth of the country that that legislation is only for a certain class of people. We should get away from that. The better class, so to speak, may not be so numerous as the poorer class, but we pride ourselves on the fact that once legislation is passed it must be obeyed by the millionaire as well as by the labourer. I remember a case in my own family and I had not the slightest hesitation in notifying the authorities and using the public conveyance provided. I would be long sorry to go for a private car in that case. It did not turn out to be an infectious case, but even so I carried out the law as it existed and brought the public van to the house. I would think bad of allowing such a member of the family to go out and mix with the general public. The Parliamentary Secretary should rely more on the commonsense of the people and, in time, he will get the co-operation he hopes for. Therefore, I do not like this coercion business and think he should leave out the question of fine altogether. After all, £50 is rather a heavy penalty to impose on somebody who may not know he is committing an offence. It should be left out or reduced, so as not to create the impression that there is any such thing as differentiation in regard to offences which may be committed under this Bill.
Question—"That Section 19, as amended, stand part of the Bill"—put and declared carried.
SECTION 20.
Amendment No. 106 is not being moved.
It is.
It has been dealt with already.
That was in relation to a particular section— Section 19.
Surely we are not going to have the whole thing again?
Well, I am going to move it, with your permission, since here it is an amendment that deals with the whole Bill. When we last discussed this, we discussed it in relation to Section 19 alone.
The point has been discussed for two days.
In relation to Section 19.
The Deputy is entitled to move it and have a decision taken on it, but surely he will not ask us to traverse the ground again?
I am not seeking to traverse the ground again at any great length.
As the Deputy very properly says, it goes through the whole Bill. Should not one decision of the House be sufficient on it?
On what amendment has the House taken a decision which prevents me from moving this?
The decision does not prevent the Deputy from moving the amendment.
I desire to move it. I move amendment No. 106:—
Before Section 20 to insert a new section as follows:—
A person shall not be regarded for purposes of this Act as knowing either in respect of himself or of another person that he or such other person is a probable source of infection with a supervised infectious disease unless he has been so warned by a competent medical authority.
Amendment put and declared negatived.
I move amendment No. 107, standing in the name of Deputy Costello:—
In sub-section (1), to delete all words from the word "therefrom" in line 38, and substitute the words "and such regulations shall provide only for the matters specifically mentioned in the Second Schedule to this Act".
Sub-section (1) of Section 20 says:—
"The Minister may make regulations providing for the prevention of the spread (including the spread outside the State) of an infectious disease or of infectious diseases generally and for the treatment of persons suffering therefrom and the regulations may, in particular, provide for any of the matters mentioned in the Second Schedule to this Act."
The amendment proposes to delete the words "and the regulations may, in particular, provide for any of the matters mentioned in the Second Schedule to this Act" and to replace them by the words "and such regulations shall provide only for the matters specifically mentioned in the Second Schedule to this Act." Following the discussion on Section 19 and on the amendment to that section moved by the Minister, to insert therein all the new sub-sections from (3) down to (10), we have seen certain provisions put into the Bill dealing with the precautions that must be taken or the things that are forbidden in the case of persons who are probable sources of infection. The new sub-section (3) says:—
"A person who knows that he is a probable source of infection with an infectious disease shall not expose himself in any street, public place, club, hotel or shop."
The Minister has explained that that was a provision contained in Section 142 of the Act of 1878 which this Bill, as originally drafted, repealed. As far as we can understand, if there was not a complete forgetfulness on the part of the Department or the draftsman of the fact that it was desired to hold the terms of that Section 142, then the only way in which the important powers of that Section 142 could be introduced into the Bill was by regulations under Section 20. This gives us a greater sense of what it is possible to do under regulations made under Section 20. If it was not contemplated when the Bill was drafted, that the regulations it was proposed to take power to make under Section 20 would include power to prevent persons suffering from an infectious disease from exposing themselves on the streets or in public places, I ask the Parliamentary Secretary where else in the Bill he proposed to take those powers.
Under the Second Schedule, very elaborate powers are taken in 14 different paragraphs to make regulations covering all kinds of things. Now that the Minister apparently has brought out into the open, in a definite section of the Bill, the powers he wanted in the shape of the new sub-section (3) of Section 19, I think that, if there are any other powers of any like kind, they should either be put as additional paragraphs into the Second Schedule or should be embodied in some section of the Bill. We ought not to pass this Section 20 in the form in which it is, giving the Minister authority to put into regulations apparently very extraordinary powers. We ought to know what powers he proposes to take while we are in the process of discussing the Bill in Committee.
What strikes me is that the Second Schedule does envisage a very wide field of operations. I should like to hear from the Parliamentary Secretary what other operations he foresees, having regard to the words used in this section in particular. It is obvious that there must be at the back of his mind a number of other operations and I think the House would be interested to hear what they are.
Once again I have to point out to the House that in the section we are not seeking any powers that we have not at the present time. Why are we to be restricted in a manner in which the previous Government was not restricted, in a manner in which an alien Government was not restricted here before our own institutions of government were set up? Why are we to be so restricted in this important matter of the control of infectious diseases? What is the idea behind it? While Cumann na nGaedheal was in office the sky was the limit in so far as power to make regulations to govern and control infectious diseases was concerned. I will try to satisfy the House on that—that is, if the members can be satisfied. I will satisfy any impartial, interested person, either inside or outside the House.
Unfortunately, when these matters are being discussed, and they arise on different sections of the Bill, every Deputy who is interested is not here. It is rather a trial to ask me day after day to explain in detail the principles which I have explained the day before, and perhaps on two or three other occasions. Yesterday I occupied a considerable portion of the time of the House in trying to satisfy Deputies— and I succeeded to a very great extent —that there are certain circumstances and certain contingencies relating to infectious diseases that cannot be provided for, either by law or by regulation. I was challenged to give examples, and I gave examples. I do not know how many of the Deputies who are listening to me now were listening to me yesterday when I gave these examples.
I cited the difficulty of dealing with the typhoid carrier who, after a period of institutional treatment and training and advice, could, with safety to himself and his neighbours, be released, provided he continued to observe certain practices and certain hygienic observances which it would be very difficult to define in regulations. I referred to the case of trachoma, where a sufferer might go into a public lavatory and subsequently use a towel there and convey that rather dreadful disease to some innocent person who, perhaps, might use the same towel. I referred to the same set of circumstances regarding venereal disease, and I told the House, to the astonishment of many people listening to me, that innocent people have contracted venereal disease in that way.
Why should we be restricted in trying to save the community from these visitations? Why should we be restricted in a manner in which no Minister has ever been restricted who has had to accept responsibility for safeguarding the people in relation to these matters?
Where do we get our power from for the purpose of making regulations? Where did Deputy Mulcahy get it in his time? How were the people protected in the past, in so far as they have been protected? They got the power in Section 148 of the Public Health (Ireland) Act, 1878. We got unlimited power there, absolutely unrestricted power in the matter of making regulations, and if that Section 148 were not being repealed in the present Bill I might drop the half of it because there would be enough power in that section, if I were not trying to coordinate the law, to serve the purposes of any Minister.
I do not know whether it would be necessary to put the terms of that section on the records of the House. It is quite apparent, at any rate, that it is necessary that some of the outstanding features of that section should be referred to:—
"The Local Government Board may from time to time make, alter and revoke such regulations as to the said board may seem fit"?
Will Deputies allow these words to sink in—"such regulations as to the said board may seem fit"?
"with a view to the treatment of persons affected with"
the diseases that are cited here
"and such other diseases as well on the seas, rivers, and waters of the United Kingdom, and on the high seas within three miles of the coasts thereof, as on land; and may declare by what authority or authorities such regulations shall be enforced and executed. Regulations so made shall be published in the Dublin Gazette, and such publication shall be for all purposes conclusive evidence of such regulations.”
Not only had we unrestricted power as to what we might incorporate in these regulations, but we were under no obligation to place these regulations on the Table of the House. Now we are deliberately accepting that statutory obligation, so that whatever is in the regulations will be subject to review by the House. Then we are asked: "Why cannot you think of every possible contingency and cover it by the regulations you place before the House?" Because it cannot be done, and because Deputies know it cannot be done, but, apparently, they think that this is of some value, but what on earth value it can be to pursue this line of conduct is beyond my comprehension.
The Parliamentary Secretary speaks now of certain difficulties with regard to the typhoid carrier, trachoma and venereal diseases.
As examples.
As examples that he dealt with last night of the things that you could not make regulations for: as examples that made it necessary for him to put into Section 19 the provision that, as well as taking the precautions specifically provided for under this part of the Act, persons should be required by law to take every other reasonable precaution, and he mentioned the typhoid carrier and trachoma as instances of the things that you could not make specific regulations for. We are asking him in the amendment to put into the Second Schedule any additional serious things in respect of which he thinks it may be necessary to make regulations. Personally, I think it is important that the House should accept Deputy Costello's amendment. I do not know on what line Deputy Costello wanted to approach this matter. I approach it from this point of view, that it would appear to me that if the Parliamentary Secretary did not bring forward amendment No. 103, containing the extraordinary powers taken from the Public Health Act of 1878, he intended to secure these powers by regulation. I think that powers of such magnitude should not be secured by regulation.
The Deputy did not always think that.
Oh, well.
The Deputy has since changed his mind.
No. I must say that I do not carry with me, for ready use here, a mental index of all the things that I ever did or thought of. It might not be helpful to debate if I did that.
Some of them might not look well on the record.
I am prepared to discuss anything that I ever thought of that may be relevant to the matter before us. What is really important is that we should be allowed to discuss what the Parliamentary Secretary is thinking of. We are asking him to give us a chance of doing that. I again put this question to him: is it not a fact that, if he did not introduce amendment No. 103, he would have had, under regulations, to provide himself with those powers, if he wanted them, under Section 20?
Is it not a fact that, if I had left Section 148 in the 1878 Act alone, I would not require any of these powers at all?
It would save us a lot of trouble if the Parliamentary Secretary had left Section 148 where it was.
If I thought that the Deputy would have behaved in the way that he has behaved, I think I would have left it there.
The Parliamentary Secretary must have had some experience of us by this time.
Since the Deputy had taken those powers to himself, I thought that he would not refuse them to his successor.
I am not conscious that the inquiry that I am making here, or the type of discussion that we are carrying on, conflicts in any way with the responsible attitude towards the care of the public health that we on this side have always manifested either as individual members of a Party, or with the decisions that we may have taken at any time when holding responsible positions. What the Parliamentary Secretary is really saying to an Irish Parliament is this: "Here are regulations in a British Act, and if they were good enough to be there they are good enough for you here, and swallow them".
The Deputy himself swallowed them for ten years.
I do not know what questions may have been put in the British House of Commons when Section 148 was being inserted in the 1878 Act. It would be only a waste of time to try to think of the kind of questions that may have been asked.
What about the regulations of 1929?
Well, taking the regulations of 1929, would the Parliamentary Secretary tell us something about them?
They are here.
Speaking for myself, if the Parliamentary Secretary is making it a personal thing——
No.
I lead a fairly active life and many things that happen from day to day pass out of my mind, things that I have no necessity to recall again. If the Parliamentary Secretary thinks that it is necessary for me to brush up my recollection about some old things, and gives me notice of that, I shall do my best to assist him. The Parliamentary Secretary has come here with his Bill. He has a whole Department behind him. All that we have been asking from him is a clear exposition of what his intentions are. We did not get that from him. We had to drag things out of him in discussion. That, in spite of all our experience, not only surprised us but shocked us. The Parliamentary Secretary is taking extraordinary powers here, powers that we never knew of until he disclosed some of them when he introduced amendment No. 103. Section 20 can, apparently, be very powerful in its operation, even though it is quite innocuous looking. In view of that and the fact that the Parliamentary Secretary has been able to put such a considerable amount of information into the Second Schedule as to what he proposes to do, I am suggesting to him that he should tell us what other things, outside those that are in the Second Schedule, he proposes to do? I am asking him to give us the main lines of his thought, and that if we find that we are not satisfied, he will assist the House by enabling us to put down amendments for the Report Stage to secure that we will not give him the extraordinary powers that he is seeking under regulations, even should these regulations be put before the House.
Question—"That the words proposed to be deleted, stand"—put, and declared carried.
Amendment negatived.
Amendment No. 108 not moved.
I move amendment No. 109:—
In sub-section (3), page 10, to add after paragraph (b) the following word and paragraph:—
and
(c) with the consent of the Minister for Industry and Commerce, provide for their enforcement and execution in any free airport by specified officers of that Minister.
The necessity for including this provision in regard to the enforcement and execution of the regulations in a free airport is that the officers of customs and excise and of the Minister for Justice will not be in attendance at such airport. The officers of customs are first line defence against the introduction of infectious diseases by aircraft coming from abroad. They have the duty of questioning the masters of aircraft in regard to any suspicious illness which may have occurred amongst the passengers or crew on the voyage. It is necessary, in the case of a free airport, to employ for a similar purpose officers of the Minister for Industry and Commerce who will be in attendance at the airport. This is really a machinery amendment. There is no contentious principle at stake.
Amendment agreed to.
I move amendment No. 110 on behalf of Deputy Coogan:—
To delete sub-section (4).
The object of the amendment is to ascertain from the Parliamentary Secretary what type of duty it is intended to impose by regulations on the officers mentioned in the sub-section.
There is nothing very far-reaching intended. The duties would relate to statistical records, deaths from different diseases, deaths according to age groups and that kind of thing, and keeping the county medical officer of health fully informed as to trends of vital statistics in his area.
Amendment, by leave, withdrawn.
Amendment No. 111 not moved.
I move amendment No. 112:—
To delete sub-section (5).
The sub-section says that:—
"Regulations under this section may provide for the recovery of expenses incurred in respect of cleansing, disinfection and disinfestation, and may authorise the making of charges for the purposes of the regulations or for services performed thereunder and provide for the recovery of such charges."
I submit that if the Minister is to proceed in the way in which he evidently proposes to proceed to deal with cases of infectious diseases, the cost of any cleansing, disinfection, or disinfestation, which may be necessary, should be borne by the public authority.
There are certain circumstances under which the local authority may carry out disinfection or disinfestation on behalf of other persons, such as, for example, the case of the owner of a vehicle who has contravened the section, perhaps knowingly, or who at any rate may not have availed of the facilities placed at his disposal by the local authorities, and in that case it might be unreasonable to expect the local authorities to pay the cost. There are other cases, however, such as cases concerned with international conventions, in respect of seagoing vessels or aircraft, and, consequently, in order to be able to secure recoupment from the owners of these vessels or aircraft, power should be given to the local authorities to recover.
Yes, I can understand that, but in the case of a person who becomes infected in a public vehicle, in one way or another, I cannot understand why the owner of the vehicle cannot get his vehicle disinfected without any cost.
Supposing he knowingly carried a person who was suffering from an infectious disease?
Well, then, if so, he would be liable.
Yes, but surely the local authorities should not have to bear the cost of cleansing, disinfection, and so on, in that case.
At any rate, I suggest that the regulations should not be so all-embracing as this sub-section is. The sub-section, as it reads, in my opinion, should not be allowed to stand at all. If the Parliamentary Secretary wants to cover specific cases, then he should define them.
They will be defined by regulation.
Very well. I shall take the Parliamentary Secretary's assurance on that.
Amendment, by leave, withdrawn.
I move amendment No. 113:—
In sub-section (5), line 2, after the word "of" to insert the word "reasonable" and in line 3, after the word "of" to insert the word "reasonable" and at the end of the sub-section, line 5, to add the words "provided however that no such charges shall be recoverable unless the financial circumstances of the person from whom it is sought to recover such charges shall reasonably permit him to pay the same".
I think that the purpose of this amendment is obvious. It only purports to insert the word "reasonable" in certain lines of the sub-section and to add the words:—
"provided however that no such charges shall be recoverable unless the financial circumstances of the person from whom it is sought to recover such charges shall reasonably permit him to pay the same".
Possibly Deputy Costello would be a much better authority as to what the effect of this amendment would be than I am, but it seems to me that it would be scarcely fair to ask the local authorities to bear expenses in excess of what the court considers reasonable. Perhaps that is not a sound interpretation of the probable outcome of the case in court, but as the case has been put to me, the question of the reasonableness or otherwise of expense is a matter to be determined by the court. However, I am quite prepared to look into the matter again.
In the absence of the word "reasonableness" there might be no question of any power to go into that matter.
Well, I shall look into that.
I think that there can be no question of looking into the matter unless there is some agreement as to what is "reasonable".
I agree, in principle, with what the Deputy has said, and I shall look into the matter.
Amendment, by leave, withdrawn.
Amendment No. 114 not moved.
I move amendment No. 115:—
Before sub-section (7) to insert a new sub-section as follows:—
No person shall be required to submit to immunisation, inoculation, or any other form of special treatment provided for in this section and the Second Schedule of this Act where such person objects to such treatment on grounds of conscience, or in the case of a child where his parents so object.
I intend to speak only briefly on this amendment. I notice that Deputy Cosgrave has put down an amendment which is similar to it.
I do not think so. Deputy Cosgrave's amendment deals with the question of treatment.
Well, my amendment deals, not only with children, but also with adults. It is intended by the amendment to give to any person who is expected to comply with the regulations under this section and the Second Schedule of the Act the right to object on conscientious grounds if they believe, conscientiously, that the treatment prescribed would be injurious to health, or if people have an objection on any ground to inoculation or immunisation. We all know that there are many people in this country who have very strong objection to inoculation or immunisation. We know that there are people who believe that such treatment is injurious to health, and we should give consideration to their views, particularly to those of parents in respect of their children. It is natural that parents should feel very strongly about the health of their children, and it is right and proper that the State should recognise that they have a special interest in their welfare. If a parent considers that inoculation or immunisation exposes a child to the danger of a certain type of infection or disease, the State should be prepared to recognise a reasonable objection.
This amendment is drafted rather roughly, and if the Minister is prepared to accept the principle of it I should like to see it elaborated. What I intended was that the right to object on conscientious grounds should be definitely outlined, as well as the procedure under which objection could be made. If a person is prepared to assert on oath that he believes such treatment is injurious to the health of children, that objection should be accepted. Provision was made for the exemption of conscientious objectors under the Vaccination Acts. I see no reason why such a provision should not be made in this Bill. There is not only a conflict of opinion amongst lay people, which may not be considered seriously by the medical profession, but there is also a conflict of opinion amongst the medical profession regarding the wisdom or unwisdom of certain forms of immunisation, inoculation and vaccination. We know that vaccination against smallpox was compulsory for 100 years. Under the present Bill it is proposed to suspend that compulsory provision for the time being. When we find that the medical profession can be so mistaken on such a question for such a long period, is it not reasonable to assume that the medical profession, and the medical authorities attached to the Department, could make a serious mistake regarding the immunisation and inoculation that is now prescribed? We know that a serum was provided for immunisation against diphtheria, and that it has been changed from year to year. That does not indicate that the medical authorities are very confident about the position. Until there is a greater measure of confidence as to the usefulness or otherwise of immunisation, or its effects, it should not be made compulsory, without having some means of exemption for those who feel very strongly on the matter.
It is only a few years since a number of children immunised against diphtheria were, in the course of the treatment, infected with tuberculosis, and I think one or two of them actually died. It must, therefore, be acknowledged that there is grave danger in such immunisation. Take the case of the average parent, who has a perfectly healthy child, surely that parent is entitled to ask for exemption when the State proceeds to inoculate the child with what is, I think, admitted to be diseased matter. It may be a preventative of diphtheria, but there might be a grave doubt. If the Minister accepts the principle of the amendment he will be able to put it into more appropriate form. I want to draw attention to a distinction between this amendment and one in the name of Deputy Cosgrave. My amendment makes provision for the doing of whatever is required by law for objecting on conscientious grounds, in the case of a parent who feels that he has a healthy child, and that he should have the right to object to a form of treatment which he considers to be dangerous to health.
Are we discussing the two amendments?
I should like to hear the Parliamentary Secretary now on Deputy Cogan's amendment.
I have no objection to intervene at this stage, but it might be more profitable and less laborious if we had the views of other sections of the House. I should like first to make the point, if necessary, that the immunisation or protective measures taken are for the protection and safety of the community, that is, if we are satisfied at all that such measures have protective effect. I should like to draw the attention of the House to the fact that the compulsory vaccination law is being repealed in this Bill. I am not aware of any volume of informed medical opinion in this country that holds the view, either that immunisation against diphtheria is not effective, and does not bring about an effective form of protection, or that vaccination against smallpox is not an effective weapon against that disease. I do not deny that there is a certain number of societies and organisations and individuals and even medical people who take the opposite view, but I do not know any medical people of any scientific repute who hold that viewpoint. The reason why the Vaccination Acts are being repealed in this Bill—and everybody might not agree that that is a wise step either—is, either by reason of immunity that our people have developed or by reason of more hygienic conditions under which we are living, whatever the reason——
No reason of politics?
I do not think so—smallpox has become almost unknown in this country and to me, at any rate, it did seem illogical that when we compulsorily vaccinated a child we did not revaccinate periodically in order to maintain the immunity that scientists agree is brought about as a result of vaccination. At the same time there is the possibility, at any rate— we all hope that it will never become a reality—that smallpox might make its appearance again. Consequently, it seems prudent to have power to enforce compulsory vaccination should circumstances arise under which it would be desirable to adopt that course. As far as immunisation against diphtheria is concerned, I can only say that no decision has been taken to make immunisation against diphtheria compulsory but I do say, and Deputies on all sides of the House are aware of it, that most of our medical scientists in this country—and we have medical scientists of high repute in this country in relation to infectious diseases as we have in relation to every other branch of medical science—strongly believe that immunisation against diphtheria ought to be compulsory, particularly in the areas, such as the City of Dublin, for example, where unfortunately we have had a very heavy incidence rate and a very heavy death rate.
In regard to what disease?
Diphtheria, we are talking about at the moment. Deputy Cogan has some doubts as to whether these scientific preventive measures are in fact effective and I presume he will tell us in so far as smallpox is concerned what propagandists tell us, that we did not get rid of smallpox by reason of compulsory vaccination; we got rid of it for other reasons. We can leave that anyhow because, thanks be to God, it is not a problem of to-day. The figures in regard to diphtheria are impressive. I have in recent times in one way or another delivered quite a number of lectures in this House on public health matters and I have succeeded, so far, with short intervals of storm, in generally getting the support and the understanding of the House in relation to these matters, but it would be too much to expect me, I think, to satisfy lay Deputies on a purely scientific problem like this that is rather puzzling even to men with substantial scientific training. I want to put some figures at any rate that are indicative, even to the lay man, that there is something in this matter of diphtheria immunisation. In 1940, in the whole of the State, we had 1,891 cases of diphtheria notified. We have been carrying out immunisation on a fairly extensive scale. I can give the figures later on, if necessary, in the different years. In that year we had 178 deaths from diphtheria; 177 of them were amongst persons who were not immunised; there was one death of a person who was immunised.
Is this 1940?
1940. In 1941 there were 1,447 cases, four deaths amongst immunised persons, 161 deaths among unimmunised persons. In 1942 there were 2,853 cases, six deaths amongst immunised persons, 261 deaths amongst unimmunised persons. In 1943 there were 4,585 cases, 11 deaths amongst immunised persons, 299 deaths amongst unimmunised persons. In 1944, the latest firm figures that are available, there were 5,086 cases, five deaths amongst immunised persons, and 288 deaths amongst persons unimmunised. The argument might be put forward that here we appear to have a rising incidence notwithstanding the fact that immunisation schemes were being fairly extensively carried out. The only reply I can give to that is the obvious reply, that from time to time we are struck by waves of outbreaks of infectious diseases. It seems to move in cycles. But what does appear to be established, by these figures at any rate, is that when we are struck by such a wave, the death rate amongst the immunised is very small as compared with the death rate amongst the unimmunised. That lesson seems to be brought home pretty strongly. Dublin City has been particularly badly hit with diphtheria over a number of years. I hope I am not keeping the House too long but I think it is a rather important matter. Taking Dublin City which, so far as diphtheria is concerned, is, I suppose, the worst area in the State: in 1940 we had 720 cases in Dublin City; there were 56 deaths, all of them of unimmunised persons; no death of an immunised person. In 1941 there were 450 cases, 53 deaths, one of an immunised person. In 1942, 624 cases, three deaths amongst immunised persons, 54 deaths amongst unimmunised persons. In 1943, 1,351 cases, two deaths amongst immunised persons, 83 amongst unimmunised persons. In 1944, 1,330 cases, no death amongst immunised persons, 72 deaths amongst unimmunised persons. That is the picture as we see it. The outbreak for some years past in Dublin has been of a particularly virulent nature. There are particular outbreaks in many other areas where the infection is not so virulent and the fatal consequences, of course, are not so widespread. But Dublin has been very severely hit. It was, of course, mostly children and young people who were struck by this disease. Thirteen hundred is a staggering figure for one disease. I need not say that a matter like that must be a cause of considerable concern to people who have responsibilities and who are immediately interested. It has been of concern to public representatives and to both local authorities and the central authority, and it has been of very serious concern to me. But, at any rate, I would not like to be disarmed of the power to immunise compulsorily in a particular area at a particular time in particular circumstances. Such a scheme would not be put into compulsory operation without the most careful consideration and only after consultation with people who are very competent to advise on these matters. I do not think I can be of further assistance to the House in this matter. That is the picture as it is presented to me.
There is in my name on the Order Paper later a somewhat similar amendment to this amendment, but I think wider in scope. In that amendment I had intended to put forward, not my own personal views, but the views of certain of my constituents who expressed themselves strongly on the subject of compulsory vaccination and immunisation. The amendment in my name is much wider in scope and, accordingly, I will deal only with the amendment here which refers to immunisation and inoculation. So far as my own personal views are concerned, I am, speaking broadly, always guided by informed medical opinion. I am prepared to take the views of people who are experts in their job, who devote their lives to it, and who are, particularly in our own country as, I think, the Parliamentary Secretary has said, very highly skilled in all branches of pathology and that part of medicine which deals with immunisation and inoculation. These are my own personal views. At the same time, it must be recognised that there is a very small minority which, from conviction in many cases and conscientious scruples in other cases, object to the particular type of inoculation and immunisation which may be put into force under the provisions of this Bill. It is on their behalf that I speak on this amendment and that I hope to speak at some greater length on my own amendment, No. 212, when we come to it.
A number of my own constituents did communicate with me on this matter and I felt that I would be lacking in my duty as their representative if I did not put forward their views in this House. There may be a number of people who would endeavour, without any conviction and certainly without any conscience, to evade the provisions of a Bill of this kind. For that class of people I have no sympathy whatever. But for those people who do genuinely object on grounds with which medical men or scientists might not agree, from motives of conviction and, very frequently, from motives of conscience, I make the appeal here. There is only a very small number who would be affected. I do not think that it would be beyond the wit of the Parliamentary draftsman so to frame provisions dealing with these people as to make it quite clear that people who were not genuinely convinced or who had not genuine scruples of conscience in this matter could get away with evading the law. I think it would be simple enough to provide safeguards against evasion by resort to so-called conscientious objections or so-called convictions against inoculation or immunisation. But I think that there ought to be something put in the Bill to safeguard the principles and views of these people who do genuinely hold the views that they advocate. The Parliamentary Secretary has said that he is unaware of any volume of individual opinion in this country which is contrary to compulsory vaccination or immunisation. That probably is so; it may be so. But in the circular sent to me there was certainly an impressive number of medical gentlemen with all sorts of degrees after their names——
And no addresses.
——who had subscribed their names. I am not in a position to say whether in the scientific or pathological world they carry any weight at all, but the Parliamentary Secretary may be in a position to assess the value of their opinions. Whether they do carry any weight or not, there is a very small number of people in this country who do genuinely believe that it would be against their convictions and their consciences to submit to compulsory immunisation or inoculation. A lot of people will refer to them as cranks. Most medical men will refer to them as such in contemptuous terms. But, whether they are or not, they are individual citizens with a right to their own private views and, so long as the expression of those views and the practical effect of those views do not sensibly injure the well-being of the community, I think it would be fair and just to provide for them in this measure.
I want to intervene briefly in reply to what the Parliamentary Secretary said. I think that in all parts of the House we are agreed that everything possible should be done to prevent the spread of infectious diseases, particularly of such a disease as diphtheria which takes such a toll of human life. At first glance, the figures which the Parliamentary Secretary has submitted appear to be very impressive; they appear to be almost devastatingly impressive. But they do not carry any conviction unless they are related to the total number of persons immunised. For example, if the Parliamentary Secretary said that only 1 per cent. of the persons who died from diphtheria were immunised, it would appear very impressive. But, if we were to learn that 1 per cent. of the total population were immunised, it would completely demolish the force of his argument. Therefore, in addition to giving us the number of people who have died from diphtheria, he should also give us the total number immunised or the percentage of the total population that has been immunised.
There is another factor which would occur to me at first glance and that is: amongst the number described as non-immunised would be many infants and very young children. The mortality might be very high amongst that section. A large number of the tiny infants would not be immunised. Until we get the proportion of the total population who are immunised and the proportion of those who are not immunised, there is very little point in comparing the death rates between the two. If the Minister and his Department are fully convinced of the effectiveness of immunisation or inoculation, it is not easy to oppose that opinion, but we might be prepared to consider the small section of the community who have a conscientious objection to this treatment. The number of persons likely to avail of such a provision as is embodied in this amendment would be small and would hardly affect the general usefulness of immunisation or inoculation. The fact that a small percentage of the population might remain non-immunised as a result of this amendment would hardly affect the general position.
Another point which strikes me is that if the Parliamentary Secretary and the Department of Health succeed in convincing the public of the efficacy of immunisation against diphtheria we may have a campaign for immunisation and inoculation in regard to all kinds of diseases. We may be inclined to go too far in that respect. Nothing, we are told, succeeds like success and it might be desirable to have some little check in regard to the enthusiasm or extravagance of the medical profession. Whatever the medical profession in this country may think or believe—and we are generally inclined to accept their opinion—we know that, behind inoculation and immunisation, there is a strong vested interest. There is money in the business—particularly the business of manufacturing sera of various kinds. I remember hearing of a person in charge of a laboratory in New York who claimed that he had made a profit of £48,000 out of one horse which he named "Old Faithful". It was certainly a very faithful animal. I am sure the Aga Khan would be jealous of so profitable an animal. A very considerable profit is to be made out of the manufacture of sera and there may be a strong vested interest in such an industry. While immunisation in respect of the diphtheria may be as effective as the Parliamentary Secretary claims, that does not prove that every form of immunisation and inoculation is equally effective. The Parliamentary Secretary should clear up the point which I have raised in regard to the figures quoted. He should give us the exact proportions of the total population who are immunised and non-immunised, so that we could see how these figures compare with the death rates he has mentioned.
As Deputy Costello said, it is very difficult for the ordinary layman to have an opinion on subjects of this character which would be deemed to be of any great value. We cannot, however, ignore the importance of the statistics which have been given to us. Deputy Cogan was not satisfied because the ratio was not given, but I happen to be in touch with those who are running the immunisation scheme for diphtheria in the city. I know that their opinion is that that scheme is of tremendous value to the health of the city. Because of that opinion, I should not care to do anything to obstruct the granting of the powers regarding immunisation provided for in this Bill. I recognise the point of view of those who have conscientious scruples on this matter, but I see a difficulty in implementing a proposal to meet their point of view. Individuals might, for frivolous or other purposes, seek to avail of that concession and might negative the whole value of the immunisation scheme. So far as a personal opinion goes, I favour retention of schemes of immunisation as, in the light of my experience and the knowledge I have gained, such schemes are of immense value to the public health.
Amendment, by leave, withdrawn.
I move amendment No. 116:—
Before sub-section (7), to insert a new sub-section as follows:—
(a) no parent of a child under 16 years of age shall be liable to any penalty under this section, if within 14 days of the receipt of a notice or regulation made under this section, directing such parent to present such child for treatment in the manner set out in the notice or regulation, he makes a statutory declaration that he conscientiously believes that such treatment would be prejudicial to the health of the child and within seven days thereafter delivers or sends by post the declaration to the chief medical officer of the county authority;
(b) a statutory declaration made for the purposes of this section shall be exempt from stamp duty;
(c) a statutory declaration for the purposes of this section shall be made in the form set out in the Third Schedule to this Act, or in a form to the like effect.
I entirely subscribe to the view that, in matters of this kind, we should be guided by informed medical opinion. I put down this amendment because representations were made to me, as Deputy Costello stated they were made to him, by people who hold certain opinions on this subject. Some of them have very strong objections to compulsory immunisation or inoculation. Frankly, I accept whatever medical opinion dictates in this regard in respect of diphtheria or smallpox. I put the amendment down because I think that the views of those who have a strong conviction concerning immunisation or inoculation should be considered. It is true that immunisation and inoculation are for the benefit of the health of the community. The statistics available would seem to show overwhelmingly that they have been successful, although, according to the figures given by the Parliamentary Secretary, there has been an increase in recent years in the incidence of diphtheria, particularly in Dublin.
On the other hand it is obvious that the number of deaths amongst people treated for or immunised against diphtheria was considerably fewer than the number of deaths amongst those who were not so treated. There is at any rate this obvious result, that if immunisation did not eradicate diphtheria entirely, it mitigated the severity of the disease. The statutory declaration which I have provided in this amendment is taken from an earlier Act, the 1907 or 1909 Public Health Act, where a similar provision was made. I have modified it slightly to meet this section. In fact, it may be too wide, because it covers matters other than immunisation and inoculation. Paragraph (b) which provides that the statutory declaration shall be exempt from stamp duty, might conveniently be deleted because it would test the sincerity of the person by whom the declaration is made if he had to pay some duty. I have put it down for the purpose of getting the Minister's opinion on it. I do think that when people hold these opinions as a number do, though I am not prepared to say that there is a big amount of either lay or medical opinion on this matter, that is evidence of the necessity for a provision of this kind. If people hold these views some provision should be made to cater for them.
I think I understood from the Parliamentary Secretary that he thought that generally the medical profession believed in vaccination against smallpox and in immunisation against diphtheria. I think that is generally the case but there is a section of medical opinion which stresses the case in regard to vaccination much more than in regard to the case of diphtheria. The problem of diphtheria is a complicated one and has shown certain aspects in different districts that are not quite fully appreciated as yet by the medical profession. The figures quoted by the Minister in regard to deaths show that as between 1940 and 1944 the deaths have increased considerably, from something like 178 to something like 288. I wonder if there is any particular explanation for that.
The Parliamentary Secretary provided us earlier in the year with the figures in regard to the number of persons immunised in the various county health districts and the number of cases reported in these districts. These figures would refer to the whole country outside the county boroughs. The figures show that, in 1939, the number of persons immunised against diphtheria in the county health districts totalled 14,353, and the number of cases reported was 821; for 1940 the number of persons immunised was 15,460 and the number of cases reported 762; for 1941 the number of persons immunised was 58,646 and the number reported was 621; for 1942 the number of persons immunised was 43,799 and the number of cases reported 1,191; in 1943 the number of persons immunised was 62,982 and the number of cases reported was 2,112; and in 1944 the number of persons immunised was 43,551 and the number of cases reported 2,611. There are indications that, as immunisation has been carried out in rural districts, the number of cases of diphtheria has tended to rise. That has been rather marked in a number of cases.
There is also the position reported in the journal of the Medical Association for January last, by Dr. R. A. Q. O'Meara, who, in an article on diphtheria, with special reference to this country, writes:—
"Diphtheria in Eire, and more especially in Dublin, is a disease of many problems and absorbing interest. Its most striking features are the relative failure of modern diphtheria antitoxin to cope with the severer forms of toxaemia frequently encountered in cases occurring in the city and the comparatively poor results which have been obtained in prevention by the use of current diphtheria prophylactics."
Later on he says:—
"This question has been investigated for Dublin by Gaffney (1943) who finds that in some years the prophylactic influence of artificial immunisation is of a low order. Thus in some years the protection afforded by immunisation is such that the chances of an immunised child contracting the disease are only reduced to one in three whereas in other years they may be reduced to as little as one in ten. There is not much doubt, however, that the use of prophylactics lowers substantially the fatality-rate in those who contract the disease following immunisation and for this reason, if for no other, the administration of diphtheria prophylactics is justified."
The position shown by Dr. O'Meara from this point of view and the experience in rural districts, would show that the case for immunisation against diphtheria in a widespread way has not been proved at all as clearly as the case appears to have been proved for vaccination against smallpox. Those who object to vaccination are able to mobilise a particular kind of case against vaccination and they are even able to have the support of a very considerable non-political and political opinion that has a kind of medical halo around it. If people are able to do that with regard to vaccination, there is under present circumstances a lot more material on which people who object to immunisation against diphtheria might make a case. I think the Parliamentary Secretary would be very sensible to understand that there are people who take a conscientious line upon these matters and I think he should make some arrangement by which there would be some kind of a court of appeal, or some means by which people who genuinely object to treatment of this kind would be able to state their conscientious objections and have them respected.
There is not much more that I can usefully say on this very interesting subject. Deputy Mulcahy in relating the immunisation figures to the number of notifications is liable, I think, to reach unsound conclusions. The figures for immunisation will rise as a consequence of the spread of diphtheria for the reason that an epidemic generally has made considerable headway in an area before immunisation schemes are initiated. It is because of the fact that diphtheria is spreading in various areas that there is an intensification of immunisation. In that way the immunisation and the incidence figures are sometimes misleading.
I am afraid the other thing has been observed too by people competent to observe.
On the question of serum potency and the potency of prophylactics, as Deputies will appreciate, this is a highly technical matter. All I need say at this stage is that we have had more than one conference in the Department on that very matter, and that Professor O'Meara himself participated in these conferences, in association with a number of other medical scientists in and around Dublin, and indeed from as far away as Cork, who have particular knowledge of this problem. We have got, as a result of that, the joint advice of these medical scientists as to the best prophylactic in present circumstances which we can use, the intervals between the doses, the amount of the dose and so on. There is a difference of opinion even amongst the scientists on these matters—on the finer points, but not on the general principle of the propriety or desirability of carrying out immunisation, but on such other technical aspects as the particular agent which ought to be used, the interval which ought to elapse between the doses, the number of doses which ought to be given, the size of the dose and so on. All I can say on that is that the best advice, in addition to the advice available to the Minister through the medical personnel of his Department, from medical scientists in this country has been secured, and consequently we may hope for the best results possible within certain limitations.
On the particular point raised in Deputy Cosgrave's amendment, I thought it referred to treatment rather than immunisation. The section of the community about whom Deputies are concerning themselves in these amendments have made their case to the Minister, and as a result of their presentation of their viewpoint, which is, that it is a matter of conscience, amendment No. 122 to Section 29 was introduced. That amendment reads:—
In sub-section (2), page 17, to insert before paragraph (j) a new paragraph as follows:—
"(j) medical or surgical treatment shall not be given to the patient in such hospital or other place without the consent of the appropriate person,".
I felt that, having fully considered the views of these conscientious objectors, there was a strong case in so far as compulsory treatment is concerned, but I felt that I could not concede the case so far as trying to prevent the disease is concerned, which is a different matter. Immunisation is for the purpose of preventing the disease and consequently there is more at stake than the individual concerned. There is the community and the danger to the community if people contract this disease and pass it on to other people and refuse to co-operate in the preventative measures which can be carried out. I thought we had disposed of that problem when we had conceded to them that, while in the interest of the community we would ask them to submit to protective measures, we would not claim any right to enforce treatment upon them, either of a medical or surgical nature, without their consent. That is the position. I think it is not an unreasonable position and we might nearly all stand together on it.
It is very hard to ask us to stand together when what the Parliamentary Secretary says to the House is that he will not stand for compulsory vaccination but will stand for compulsory immunisation against diphtheria.
I do not think I have said that.
I think that is what the Parliamentary Secretary implies. If it misrepresents him, I think we ought to get a little clarity as to the processes of immunisation and in respect of what diseases the Parliamentary Secretary stands for taking compulsory power to immunise. The Parliamentary Secretary implies that he wants compulsory powers of immunisation and that he will not recognise that conscientious objectors may object to it. He looks for powers to persist in carrying out the process of immunisation on people who may have conscientious objections to being so treated. What are the diseases in respect of which he demands such powers against every person in the country?
The Deputy must see clearly that I cannot bind myself to any set number of diseases in advance of the knowledge of how medical science may advance in these matters while responsibility rests upon me. Immunisation against diphtheria was not in general operation not so very many years ago and protective measures against typhoid are of comparatively recent discovery. The future may provide us with protective measures against other diseases. If Deputy Mulcahy seeks to bind me in such a way that, if medical science should make such discovery or such advance, I will not be able to avail of it without coming to the House, I am not prepared to concede it.
Do I understand that at present, so far as the law is concerned, there are compulsory powers simply for vaccination, that these are the only compulsory powers the Minister has by statute?
That is so.
The Minister in this Bill is dropping these powers, and, while dropping them in respect of a disease in respect of which he admits that the case has been practically proved, he seeks compulsory powers of immunisation for every other disease he may think of, and he is not prepared to tell the House whether there is any disease, or any two or three diseases, at present in respect of which he would proceed—
The only one which would be seriously considered at the moment, in addition to smallpox, if we were threatened with smallpox, is diphtheria, but I have not firmly made up my mind even on that. If I had the power, however, with the volume of medical opinion in favour of it and in the light of the position in Dublin City, I would spend anxious days trying to decide whether compulsory immunisation against diphtheria ought to be applied in Dublin City.
It is a very poor background——
Everything is very poor.
——against which to take up the attitude that he will have no respect for people who have conscientious scruples about or conscientious objections to treatment of that kind.
We might get smallpox, too.
There is one factor which I do not think has been mentioned and on which I should like to hear the Parliamentary Secretary, that is, the risk of accident or mistake involved in the immunisation process. Is it now so small that you can with equanimity ignore all such objections and enforce such a process on the community generally?
I am advised that it is almost negligible.
The Parliamentary Secretary will appreciate that, not so many years ago, a few cases occurred which caused considerable public alarm and, flowing from that public alarm, created a certain amount of apprehension in the minds of the parents in the whole matter of immunisation. To my mind, it is one of the things which might be considered as a ground for a parent having a conscientious objection to this process being inflicted on his child. There have been notorious cases of mistakes and there have been deaths, both in this country and elsewhere. Apart altogether from that aspect, the figures which the Parliamentary Secretary has given just now indicate that, despite the increasing numbers of children who are being immunised, we are getting an increased outbreak of diphtheria year after year. The figures are going up steadily. As a layman, I cannot follow that and think it should be in the reverse order. Incidentally, I understand that the deaths per 100,000 of the population are showing a steady increase in the case of diphtheria. It may be very small, but nevertheless there is an increase. I believe these factors should be taken into consideration while we are on this question of conscientious objectors.
I think the House will agree with the Parliamentary Secretary that, in this matter of immunisation, we are not considering only the views, the feelings and the rights of the individuals concerned but also those of the entire community. Immunisation is designed to protect not only the person immunised but the entire community. Even taking that view, however, we must admit that there is a reasonable ground for providing for the conscientious objector. When conscription was introduced into Great Britain at a time of national danger——
Now we are on conscription. It is not infectious.
It is in almost the same position. The object of conscription was to safeguard the whole community, yet in the Conscription Acts provision was made for the conscientious objector. In a matter of such grave importance to the entire community as compulsory military service, it was found desirable to allow for the conscientious objector. Surely, in a matter of this kind there is an equal right to the individual to object on conscience grounds, if he so desires? I am not suggesting that there should be an easy way out for anybody or that exemption should be made particularly easy, but I think it should be possible to find a means by which a person who feels very strongly on this matter could obtain exemption.
Recently, a decision was taken to confer the Freedom of the City of Dublin upon an English writer named Shaw. I can envisage the feelings of that particular individual if he were submitted to inoculation or immunisation. I know that he has expressed his views frequently very strongly on this matter and I am sure there are other people in this and other countries who feel equally strongly. Such people should be allowed their right to obtain exemption on reasonable grounds. I do not think it would be in the interests of public health that people who feel very strongly on a matter of this kind should be made, by this statute, into martyrs and thus, perhaps, help to build up public opinion against this particular form of treatment.
Amendment, by leave, withdrawn.
I move amendment No. 117:—
In sub-section (7), line 9, before the word "contravenes" to insert the word "knowingly".
This is for the purpose of putting in the word "knowingly" before the word "contravenes", in order to make is clear that a person who inadvertently contravenes a regulation will not be guilty of an offence. That would be in conformity with the general scheme of previous sections. For example, in Section 19 the provision refers to a person "who knows" he is a probable source of infection. This is to run that idea right through the section.
I will ask the draftsman to look into it, though the suggestion has been put to me that it is not necessary to put in "knowingly", that it would be no protection to him if he contravenes the law. He ought to know the law and it is no defence to say he does not.
If it does not do any harm or any good, why not put it in? There is no doubt that there is a contrast between the first and the second lines of this sub-section. "A person who contravenes a regulation under this section"—that is one matter; "or who wilfully obstructs the execution of a regulation"—that is another, thereby founding an argument that, whether you contravene a regulation knowingly or not you are guilty of the offence, whereas if you obstruct the execution of a regulation, proof must be given, before you are convicted, that it was wilful. I think the amendment I put down is very necessary, indeed.
There is no objection in principle.
If not, why should it be given to the draftsman? The draftsman has no point of view, in my submission, but to carry out the instructions he gets to give effect to the principle agreed upon. The draftsman's view is not to be taken into account on the principle. If we agree in principle that the person should be guilty of an offence only if he knowingly commits it, then the word "knowingly" should go in, draftsman's view or no draftsman's view.
It will be considered, in any event.
Amendment, by leave, withdrawn.
Perhaps Deputy Costello would move amendment No. 118 for Deputy McGilligan. The point is that this is the first of 29 similar amendments and, as far as I can make out, the circumstances in any case—through there may be one or two exceptions—would not warrant the discussion being repeated on later amendments.
I move amendment No. 118, standing in the name of Deputy McGilligan:—
In sub-section (7), line 12, to delete the word "summary".
I do not want to say anything that may preclude Deputy McGilligan making such points as he may wish on one amendment or another. I do not think the intention is to have a series of discussions. The point is—and now I am speaking without consultation with Deputy McGilligan—that there is a constitutional consideration involved in this matter. The sub-section provides for summary conviction and as it stands at the moment that would appear to be an unconstitutional provision. Perhaps the Parliamentary Secretary would consult his omniscient draftsman about it?
I will do so. The principle is based on Section 249 of the 1878 Act, which says:—
"All offences under this Act, and all penalties, forfeitures, costs and expenses under this Act directed to be recovered in a summary manner, or the recovery of which is not otherwise provided for, may be prosecuted and recovered in manner directed by the Summary Jurisdiction Acts before a court of summary jurisdiction. . . ."
There is no question that the British could do that.
And the Irish, too.
There is no constitution in Britain. Apparently, Deputy McGilligan sees the constitutional danger, and he thought it his duty to direct the attention of the House to the matter.
I shall have it examined.
Will the Parliamentary Secretary tell us where, in the 1878 Act, there is an offence in respect of which a fine of £100 can be imposed?
I would need notice of that. If I have to search through the whole 1878 Act, I shall do so.
Take sub-section (7) of this Bill. It says that a person guilty of an offence shall be liable on summary conviction thereof to a fine not exceeding £100. Is there any section in the 1878 Act where provision is made for a fine of £100?
I wonder what would be the equivalent to-day of £100 in 1878?
We would not be allowed to discuss that if we were talking of road workers' wages.
There are some people who say the pound is worth very little now.
I shall not press the amendment, but I want to point out that the amount of the penalty is involved in a constitutional point. I was not irrevelant in any way. It is the gravity of the offence.
Amendment, by leave, withdrawn.
I move amendment No. 119:—
In sub-section (7), line 15, to delete all words after the word "continued" to the end of the sub-section.
Again I want to direct attention to the gravity of the offence that is being created for the first time in this section. There is a discretion in the court to inflict imprisonment, or both fine and imprisonment. It occurred to me that the House might think it was too drastic a punishment for the offence that is being created.
The corresponding provision in the 1896 Act is Section 1 (3), which says:—
"If any person wilfully neglects or refuses to obey or carry out, or obstructs the execution of, any regulation. . . he shall be liable to a penalty not exceeding £100, and in the case of a continuing offence to a further penalty not exceeding £50 for every day during which the offence continues. . ."
The same constitutional point may arise there, but that is and has been the law so far as the penalty clause is concerned.
Amendment, by leave, withdrawn.
I move amendment No. 120:—
To delete sub-section (8).
Sub-section (8) seems to me to be entirely too drastic in its proposals. The sub-section provides that where-ever the Act makes specific provision for special precautions, regulations can still be made dealing with the same subject-matter as the section. I do not understand the necessity for that. If the Act requires special precautions to be taken, why should it be necessary to enable the Minister to make regulations dealing with the same subject-matter? I do not know whether sub-section (8) can be related to sub-section (2) of Section 19 of this Part of the Bill. I had an amendment down which, unfortunately, I was not present to move, with the view of ascertaining what was the necessity for the provision in sub-section (2) of Section 19. Perhaps I should refer to sub-section (1) as covering the same point. That sub-section states:—
"A person who knows that he is a probable source of infection with an infectious disease shall, in addition to taking the precautions specifically provided for by or under this Part of this Act, take every other reasonable precaution to prevent his infecting others with such disease by his presence or conduct or by means of any article with which he has been in contact."
I wanted to point out on that amendment, and I think it is tied up with the present amendment, that if the House, on the recommendation of the Minister, provides in this Bill for the taking of special precautions, and if there are regulations also providing for other precautions, then apparently the unfortunate citizen has himself to discover something else that the Minister and the House has not discovered and he has to take that other precaution or be guilty of an offence.
I am afraid that is it.
That is why I object to sub-section (8). These are very drastic provisions. The individual who is supposed to carry out the law must know what he has to do. The views of medical men change from day to day. I am not casting any reflection on the medical profession by saying that. They would be a very poor profession if they did not have the courage to change their views from day to day. What is fashionable one moment, what is believed to be scientific truth one day, may be disproved—I will not say debunked—perhaps in a few years. What is the position of the unfortunate layman, the unfortunate citizen who has under penalty to do what the Act says, to do what the regulations say, and who has to find out for himself some other precautions? I think there ought to be some limit in this Bill.
We have argued that for a long time.
That is no answer to me.
As Deputy Coogan remarked, "We could talk on that until the cows come home".
I do not want to talk on it until the cows come home. I want the position to be remedied in the Bill. Perhaps I might use the jurisprudential cliché that we learned as students—that it is better for the law to be certain than just. This Bill provides everything possible to enable the Department to catch unfortunate citizens. Apart from the fact that its provisions are drastic, this legislation is not going to succeed by its enforcement in the criminal courts. If this legislation has to be enforced in the courts, it will be an abject failure. There will be no success for those portions of the Bill when it becomes an Act which many people believe to be an essential for the public health of the community unless public opinion is solidly behind its enforcement. If the provisions are such as not to commend themselves to the citizens, then, rightly or wrongly, you will not get behind it the public opinion that is necessary and essential.
Criminal law will never enforce legislation of this kind. Every case brought before the criminal courts in an endeavour to enforce it is, in my view, a milestone in the direction of its failure. Public opinion must be informed and educated, not coerced. That is the point of most of my amendments. We are in favour, on this side of the House, of the necessity for taking adequate and proper and reasonable precautions to safeguard the public health, but we think that can best be achieved by the education and the informing of public opinion and getting public opinion behind the people who are endeavouring to secure the maintenance and the improvement of the public health.
I think the introduction of the criminal law into every line of every section of this Bill will secure the failure of the Bill if the Parliamentary Secretary persists in the attitude he has taken and if, for the enforcement of the Bill, it is necessary to clutter up the criminal courts with prosecutions then, even though this may be the law of the land, you may as well resign yourselves to the fact that it will never be really enforced, or, if enforced, it will not be enforced with the goodwill of the people.
I should like, after what Deputy Costello has said, to hear what kind of response the Parliamentary Secretary has to make.
Does not the Deputy know that I have talked on every possible aspect of Deputy Costello's argument?
No. During the discussions that we have had here over a number of days, I do not think that the Parliamentary Secretary has approached us with any conception of the fact that we were implying the kind of warning which Deputy Costello has now put in such a straight way to him. I think it would be a great pity if, after the way in which Deputy Costello, with all his knowledge and experience, with his general approach to the work of this House as well as his knowledge of the courts, has spoken that we were to pass the Bill without any reconsideration of all that by the Parliamentary Secretary. We should be able to feel that, when the Bill leaves the Oireachtas as an Act, it will stand some kind of chance of commending itself to an informed people.
The Deputy must know that it would be quite out of order to have a general discussion on an amendment of this kind.
If the Parliamentary Secretary has nothing to say in reply to what Deputy Costello has said, I do not think that either the Chair or myself can help him.
Question—"That the words proposed to be deleted, stand"—put and declared carried.
Amendment negatived.
Question proposed: "That Section 20, as amended, stand part of the Bill."
There is just one small point that I would like to put to the Parliamentary Secretary. There is a reference in sub-section (3), paragraph (b), to "specified officers of that Minister", the Minister being the Minister for Justice. I take it that officers of the Minister for Justice would mean members of the Gárda Síochána. The point that I want to put is this, that in the House recently I heard the Minister for Justice disclaim that the members of the Gárda Síochána were his officers. He said that they were under the direct control of the Commissioner, and that all that he could do in the matter that was under discussion at the time would be to make a recommendation. I was wondering if the phrase used here had some other meaning than that the officers in question were not members of the Gárda Síochána.
They are special officers of the Minister for Justice.
Does it mean that they are members of the Gárda Síochána?
Yes, but they will be specially assigned to this duty.
As I have said, I heard the Minister say here that the members of the Gárda Síochána were not his officers, that they were the officers of the Commissioner.
Question put and agreed to.
NEW SECTION.
I move amendment No. 121:—
Before Section 21 to insert a new section as follows:—
(1) A person who knows that he is verminous shall not expose himself in any street, public place, club, hotel or shop.
(2) A person having the care of another person and knowing that such other person is verminous shall not permit such other person to expose himself in any street, public place, club, hotel or shop.
(3) The parent of a child shall not send the child to any school, or permit the child to attend any school, if he has reason to believe that the child is verminous.
(4) Where a registered medical practitioner attending a person in a dwelling becomes aware that the said person or any other person residing in the dwelling is verminous, he shall, within a period of seven days, so inform the district medical officer for the district in which such dwelling is situate, unless such practitioner is satisfied prior to the expiration of such period that effective disinfestation of the verminous person has been carried out.
(5) Where a school medical officer finds, on inspection of a child, that the child is verminous, he shall so inform the district medical officer for the district in which the child resides.
(6) Where a district medical officer becomes aware, whether from information given under sub-section (4) or (5) of this section or otherwise, that a child residing in his district is verminous, he shall serve notice on the parent of the child prohibiting the attendance of the child at any school until such district medical officer gives a certificate (for which no charge shall be made) that the child is fit to attend school.
(7) Where a notice is served on a person under sub-section (6) of this section, he shall be deemed conclusively to have, during the period between the service of the notice and the giving of the certificate referred to in the said sub-section (6), reason to believe that the child to whom the notice relates is verminous.
(8) A person who contravenes subsections (1), (2), (3) or (4) of this section shall be guilty of an offence under this section and shall be liable on summary conviction thereof to a fine not exceeding £5.
(9) In this section, the word "verminous" means infested with lice, whether of the species—
(a) pediculus capitis (head louse),
(b) pediculus corporis (body louse), or
(c) phthirus pubis (public louse),
or of any two or more of those species.
Is the Parliamentary Secretary so tired that he is not going to explain the new section to the House?
I would like to hear the objections to it first.
The Parliamentary Secretary has moved a new section which is introducing something that was not in the Bill before. Has he anything to say to persuade the House that there is any case to be made for the new section?
On the Second Reading I think I made a convincing case as to why steps were necessary to deal with the problem of infestation, and the particular dangers arising out of it. The provisions relating to infestation were contained in Section 21 and submitted to the House. Already, we have transposed portions of Section 21, which deals with infectious diseases, into Section 19, and I am now presenting to the House a new section which is confined to infestation, and which reduces infestation, for the purposes of this Bill, to the types of body lice that are set out in sub-section (9). Infestation, in the original section, had a much wider meaning.
On the Second Reading, Deputies were very critical of the possible uses that might be made of the powers sought in the original Section 21 because of the wide meaning of infestation as it there appeared. Consequently, we have come down in this new section to the particular type of infestation that is looked upon as a potential danger to the community at the present time. I move to report progress.
Amendments Nos. 122 to 163 are down to be moved to Section 21. As the section will be completely changed, these amendments may be submitted on Report. It may be that many of them can be discussed in general terms on this new section. If Deputies think that they should mutatis mutandis put them down for Report, they can do so. It would be possible to submit some of them to this new section, but the Chair does not think that would be satisfactory.
I raised this matter when we were dealing with Section 19. I referred to Section 21, and I think the Parliamentary Secretary agreed that when we came to Section 19 and 21 on Report we might go into Committee to enable us to put down amendments and to get a discussion on them.
If Deputies desire to submit these amendments on Report they can make the necessary changes in them and resubmit them.
Very good.
Progress reported; Committee to sit again to-morrow.