Amendment No. 84 has been moved.
Public Health Bill, 1945—Committee (Resumed).
SECTION 85.
Amendment No. 84 put and agreed to.
Amendments Nos. 85, 86 and 87 not moved.
Section 85 deleted.
SECTION 86.
Amendments Nos. 88 to 92, inclusive, not moved.
I move amendment No. 93:—
Before sub-section (2), to insert a new sub-section as follows:—
(2) Notwithstanding sub-section (1) of this section, whenever and so long as the Minister is satisfied that adequate arrangements for medical inspection and treatment are being carried out in relation to the pupils of a school, he shall not make an Order under the said sub-section in relation to the school and, in case the school is of a class in respect of which an Order is made under the said sub-section, the Order shall except the school from such class and shall have effect accordingly.
On the Second Reading of the Bill and subsequent to the Second Reading discussion representations were made to the effect that we should not automatically apply compulsory school medical inspection to all schools other than elementary schools. On full consideration, there seemed to be reasonable grounds for making some concession in this regard. At the same time, it did not appear to me to be judicious to exempt entirely and completely schools other than elementary schools from supervision as to the manner in which the physical needs of their pupils were being looked after. On the other hand, I felt that, if the Minister was satisfied from time to time as to the adequacy of the arrangements that were being made by any particular school in the matter of safeguarding the health of the pupils, he should not apply compulsory medical inspection to such an institution. That, I think, ought to remove and I believe, in fact, does remove any objection there might be to the operation of medical inspection in these schools.
Deputies will agree that from time to time complaint is made that in schools other than elementary schools the physical needs of the pupils are not always adequately safeguarded. It does seem to me appropriate that, if we are not satisfied as to the provision being made and if the school authorities are not in a position to satisfy us that they are in fact making proper provision, we must in the interests of public health and of the general community step in and say: "If you do not maintain an adequate service out of your own resources, if you do not take part in the Government campaign to build up a healthy race, we shall insist on the acceptance of our scheme. If you do make satisfactory provision, we have no intention of interfering with it."
I do not think anybody can say that that is an unreasonable provision. I think that in certain instances it is a necessary provision. However, there it is. If Deputies have any criticisms to offer on it, I should be glad to hear them. While there was a certain amount of disturbance in the public mind, particularly in the minds of the proprietors of schools other than elementary schools regarding this provision, on the whole I think that they are pretty well satisfied as to the distance I have gone to meet their criticism.
As a result of this section, will it be within the competence of a parent to notify a school authority that the family doctor is adequately looking after the health of the children and will a parent be entitled to withdraw his children from the compulsory inspection now provided for?
The Deputy is perhaps confusing two issues. This particular amendment refers to schools other than elementary schools. They will, in the main, be residential schools where, because the child is not living at home, it will not be open to the parents to provide medical supervision and attention. It will be the responsibility of the school authority. The Deputy is probably more concerned with the right of the parent to have his child exempted from inspection in an elementary school.
That is right.
The provision I am making by another amendment in relation to that matter is that, on production of a certificate from a registered medical practitioner in a prescribed form to the effect either (a) that the child is ill and cannot attend for inspection, or (b) has been examined by a medical practitioner within the previous seven days and that its health is being looked after by a medical practitioner, such a child is automatically excluded from inspection. That is a provision that is now being incorporated in the Bill for the obvious purpose of ensuring that, where a parent adequately and properly discharges his responsibility to his children, we will not interfere.
We have no desire to interfere, but, at considerable cost to the communiy, a health service for children is being provided. That service is being provided in order to try to secure that diseases will be brought under control, under observation and under treatment in the earliest possible stage, and if that scheme is to be a success, we must satisfy ourselves that if children are exempted from the scheme, their health is in fact being supervised.
People may say that that is a matter for the parents, and, in a general sense, it is, but everybody must agree that all parents do not properly discharge their parental responsibilities. The State interferes, and has a right to interfere, in the matter of cruelty. A parent is not allowed under the law to brutally ill-treat the children. The State interferes and says: "No, you will be liable to certain penalties if you maltreat your children." Again the State interferes and says: "You will be under a statutory obligation to educate your children", and nobody accuses us, in either the one regard or the other, of interfering with the rights of the parent.
It seems to me that if there is nothing morally wrong, nothing in conflict with ethics, in saying to a parent: "You shall not maltreat your children" or in saying: "You must educate your children", there cannot be anything wrong with saying, if necessary, to the same parent: "You must provide for the physical needs of your child." The community are subscribing the necessary money to provide a service in the interest of the community, for the protection of the community, and in order to ensure, so far as it is possible to ensure, that the burden of invalids which the community have to maintain, because of the fact that the ailments of children have not been looked after in time, will be eased ultimately. For all these reasons, it is claimed, and the claim cannot be challenged, that we are entitled to ensure that, if children are not brought within our scheme of health services, their physical needs will be looked after.
I am pleased that the Parliamentary Secretary agrees with regard to one point on which I have heard a good deal of discussion outside the House, that is, that, where parents are in a position to have their children treated by the family doctor, they may do so. That is a very welcome contribution. I agree with the Parliamentary Secretary on the national need for children to be thoroughly examined in the school and for seeing that everything will be done to ensure that children will grow up healthy and strong and that any impediments they may have will be treated. We know that, in the case of a number of children, had the impediments from which they suffered been treated in early life, they would have grown up into useful citizens. I am glad to note the democratic way in which the Parliamentary Secretary approaches it in agreeing that if parents are anxious to have their children treated by their family doctor, they may do so, and in exempting these children from school inspection and so on.
Amendment agreed to.
Amendments Nos. 94, 95 and 96 not moved.
I move amendment No. 97:—
To delete sub-section (3) and substitute the following sub-section:—
(3) The expenses incurred by a county authority in providing any medical inspection or treatment provided for the pupils of a school by virtue of an Order under sub-section (1) of this section shall be paid to the county authority by the person carrying on the school and such expenses shall be recoverable by the county authority from such person as a simple contract debt in any court of competent jurisdiction.
The effect of this amendment is that, if school authorities desire to have treatment as well as medical inspection provided for the pupils of their schools by a county authority, the county authority can make the necessary arrangements, subject to the school authorities paying for the cost of such treatment. Otherwise, only the cost of medical inspection provided at the school can be recovered by the county authority. Here, again, we are dealing with pupils and pupils are to be found in secondary schools. In some instances, the management of a secondary school may desire inspection only. In other instances, the proprietors of a school, other than an elementary school, may desire to have treatment for their pupils as well as inspection and examination. If they desire to have treatment, it will be made available.
Would this be general in regard to secondary schools and what type of treatment would be provided?
They will come within the full scope of the scheme—domiciliary treatment, hospital treatment or specialised treatment. The pupils will come within the full scope of the scheme, but the local authority would have the right to recover from a school, other than an elementary school, the cost of the treatment. Most of these schools would be residential schools, with pupils drawn from perhaps a wide geographical area entirely outside the jurisdiction of the local authority, and it would not be right or fair that the local authority should have to bear the full cost of such a scheme. The cost will be recoverable from the school.
Such a scheme has never been in operation before?
No, we had not got the statutory power before. We are only taking the power now.
Amendment agreed to.
Amendment No. 98 not moved.
I move amendment No. 99:—
To delete sub-section (4).
I presume the other Deputies whose names are to this amendment will not object. It is really only a drafting amendment, being consequential on an earlier amendment.
Amendment agreed to.
Amendment No. 100 not moved.
Section 86, as amended, agreed to.
SECTION 87.
I move amendment No. 101:—
Before Section 87, to insert a new section as follows:—
(1) The expenses incurred by a county authority in providing any medical inspection or treatment provided for the pupils of a certified school under the Public Health (Medical Treatment of Children) (Ireland) Act, 1919 (not being expenses incurred in relation to pupils from the functional area of the county authority) shall be paid to the county authority by the person carrying on the school and such expenses shall be recoverable by the county authority from such person as a simple contract debt in any court of competent jurisdiction.
(2) Expenses payable by virtue of sub-section (1) of this section in relation to pupils of a certified school shall be deemed for the purposes of Section 74 of the Children Act, 1908, and Section 21 of the Children Act, 1941 (No. 12 of 1941), to be part of the maintenance of such pupils.
(3) In this section, the expression "certified school" means a school which is a certified school for the purposes of the Children Acts, 1908 to 1941.
The purpose of the amendment is to empower a county authority to recover from the authorities of a certified school—that is, a reformatory or industrial school—the cost of providing medical inspection or treatment for the pupils of such school other than expenses incurred in relation to such pupils from the functional area of the county authority. The section also provides that the expenses which are payable shall be deemed for the purpose of the Children's Act, 1908, and the Children's Act, 1941, to be part of the maintenance of such pupils. In a few words, the amendment proposes that, in the case of reformatory and industrial schools, the cost of the inspection and treatment of children from a geographical area outside the area of jurisdiction of the local authority in which the reformatory or industrial school is situate will be recoverable by the local authority. It is the same principle as I have just enunciated in relation to the secondary schools.
It will be recoverable by one local authority from another?
From the authorities of the school, who will, in turn, recover from the school authorities concerned.
Of the area whence the children come.
In cases where industrial schools have a visiting medical officer of their own, will they be permitted to continue that practice?
I do not think they will and, so far as I understand the position, I do not think they so desire, under the terms of the Bill. Industrial schools will be brought within the scope of the Bill.
In an industrial school which I know, it is the practice to have a physician of their own who comes once weekly and makes inspections and at such other times as his services may be required.
While industrial schools will be brought within the scope of the Bill, there is no prohibition on any school, industrial or otherwise, maintaining a service and, if any industrial school desires to maintain a service of its own, our intrusion would be more in the nature of supervision to ensure that everything was being done to a reasonable standard. It will lessen our problem considerably if there is a satisfactory service there already.
That is quite satisfactory.
Amendment agreed to.
I move amendment No. 102:—
To delete sub-section (1) and substitute the following sub-section:—
(1) The parent of a child, unless an exemption in relation to the inspection is granted under sub-section (2) of this section in respect of the child, shall—
(a) in case the child is under the age of six years, submit the child to any medical inspection provided for the child under Section 86 of this Act at the child's home, or
(b) in case—
(i) the child is aged six years or more and less than fourteen years, or
(ii) the child, being aged fourteen years or more, is attending school,
submit the child to any medical inspection provided under the Public Health (Medical Treatment of Children) (Ireland) Act, 1919, or under Section 86 of this Act, for the child, whether at the child's school or elsewhere.
Fears have been expressed that the reference in Section 87 to the submission of children for medical inspection under Section 85 makes it obligatory on parents to send children under the age of 6 years for medical inspection at schools or other places. I have dealt with this matter already by way of general explanation of the effect of certain amendments to the Bill. The proposed amendment has been drafted with a view to allaying the fears that have been expressed. The intention in regard to the medical inspection of any child under the age of six years is confined to the granting of power for medical inspection of such child in its home. During previous discussions on this section, some Deputies appeared to be under the impression that children under six years of age would be brought, under compulsory measures, to a clinic for inspection. That is not intended. If any inspection of such children is necessary, if the medical officer of health of the district has reason to believe that they are not being properly looked after and if he is not finished with a certificate to the effect that they are being looked after, he can inspect them at home. Those are children who have not reached school-going age.
Amendment agreed to.
Amendments Nos. 103 to 107 not moved.
I move amendment No. 108:—
Before sub-section (2), to insert a new sub-section as follows:—
(2) The school medical officer having charge of the arrangements for a medical inspection provided pursuant to the Public Health (Medical Treatment of Children) (Ireland) Act, 1919, or Section 86 of this Act shall grant an exemption in the prescribed form from the inspection in respect of any child in relation to whom there is produced to such officer a certificate in the prescribed form signed by a registered medical practitioner stating either that the child, owing to illness the nature of which is stated in the certificate, is unable to attend the inspection or that the registered medical practitioner has examined the child within the period of seven days preceding the inspection and that, by arrangement with the child's parent, he will be responsible for any treatment required by the child until the next such inspection to which the child should be submitted takes place.
This amendment incorporates the principle we have been discussing to-day of providing for the exemption of a child from medical inspection on the production of a certificate from a registered medical practitioner. I have already explained the purpose of the amendment on previous amendments. It definitely excludes from compulsory inspection in schools any child who is certified to be ill or in respect of whom there is a certificate that the child has been examined by a duly qualified medical practitioner within seven days.
Amendment agreed to.
Amendments Nos. 109 to 114 not moved.
Section 87, as amended, ordered to stand part of the Bill.
SECTION 88.
Amendment No. 115 not moved.
I move amendment No. 116:—
To delete sub-section (2) and substitute the following sub-section:—
(2) A notice under sub-section (1) of this section to the principal of a school may be addressed to "the manager" or "the principal" (as may be appropriate) of the school and may be given by delivering it to such principal, or by sending it by post to the school or by leaving it at the school with an adult person who undertakes to deliver it to such principal.
This amendment is intended to provide for the delivery of the notice required by this section either to the principal of a school or to an adult person who undertakes to deliver it to the principal. The alternative would be to send the notice by post to the school addressed to the manager or principal of the school. The sub-section which it is proposed to delete sets out:—
"A notice under sub-section (1) of this section may be addressed to "the manager" or "the principal" (as may be appropriate) of the school to which the notice relates without naming him and may be given by sending it by post to the school or by leaving it with some person at the school."
It was felt that the provision to leave the notice with some person at the school was scarcely adequate, because the "some person" might be a child or a person without much responsibility. For that reason, it was thought that the person should be, at least, an adult. We came across this principle earlier in the Committee Stage. In the discussion in Committee I indicated to the critics of this Bill that I would further examine it between now and Report Stage with a view to further amendment. One of the methods to be considered for notifying the inspection is notification by registered post. It should not be necessary in all cases to notify by registered post inasmuch as it often happens, as Deputies, particularly from provincial areas are aware, that the medical officer may be in close contact with the manager or with the principal of the school and may very often be able to tell him verbally: "Well, I am coming around to inspect on next Tuesday" or whatever day be names. However, I shall look into the machinery somewhat more closely in the meantime, but the House might accept this amendment which may have further to be amended on the Report Stage.
Would it not be wise, if the manager and the principal were notified particularly in the case of rural schools?
That is what we have to consider. We have to try to avoid cluttering up our medical officers with too much clerical work. They are men with specialist qualifications, professional men, whose time could be used to greater advantage at professional rather than at clerical work. Deputies may ask me: "Why do you not give him the necessary clerical assistance"? That is all right, but there is a limit to that, too. No matter what clerical assistance you have, I think it wise to avoid loading up the machinery with clerical work that can be avoided. However, I shall look into the suggestion. Ordinarily, it should not be necessary to notify both the manager and the principal. I think we may assume that, if the manager is notified, he will convey the good news to the principal and, if the principal is notified, he will probably notify the manager that everything will have to be in good shape the following week, when the inspection takes place.
Mr. Burke
I know of a case where a manager got a notice of an examination for a particular school, and he happened to be on holidays when the letter arrived at his house. The same thing might happen in the case of the school inspection. In support of what Deputy Ó Briain has stated, I might point out that if the principal were definitely notified he would get an opportunity of notifying the parents to have their children at school. It would then be somebody's business definitely to do that work. The suggested sub-section is all right in its way, but I should like to see the matter pinned down more definitely than it is.
When making the suggestion I had rural areas particularly in mind. The principal and the manager might live very far apart in rural parishes. It would be very desirable that the moral support of the manager should be available for this scheme of school inspection, which has not been as effective as it might in certain areas up to the present. It would be very desirable to enlist the support and help of the manager. He may not know that the inspection is taking place unless he is definitely notified.
I shall look into the matter further before Report Stage to see if I can improve the notification machinery.
Amendment agreed to.
Amendments Nos. 117 to 120, inclusive, not moved.
Major de Valera
Would I be in order in referring to the sub-section which amendment No. 121 proposes to delete?
I am afraid not.
Major de Valera
I want to make only one comment.
The Deputy may do that on the section.
Amendments Nos. 121 to 124, inclusive, not moved.
Question proposed: "That Section 88, as amended, stand part of the Bill."
Major de Valera
A perusal of the documents relating to this Bill shows that we have a very lengthy list of amendments. Many of these amendments have come from the gentlemen who should occupy the empty benches opposite—in fact, I should imagine most of the amendments. These amendments have been responsible for the slow passage of the Bill through the House and now these gentlemen leave the House and say that they will not have anything more to do with the Bill, when a proposition is put to prolong the time of the sitting in order to deal with the amendments. In other words, they are the people who are largely responsible for the delay in putting through this Bill and now they are the people who object to the sitting being extended. They want to have it both ways. This is an important section and it has a bearing on what I want to say about the amendments. I am sorry if I have to refer to what happened on Second Reading. Ill-advisedly, they made the political blunder of opposing this Bill in principle. A smoke screen is now being put up to cover their own retreat, a retreat which is a reality as you will see, Sir.
If you will scrutinise amendments Nos. 122 and 123, and if you look at certain amendments to the previous section, which has already been passed, you will observe that they would delete provisions that would make those sections effective. In other words, while not able to come out and oppose what is intended to be done by these sections, resort is had to the subterfuge of trying to delete provisions which would make the sections effective. These are not different tactics from those followed on Second Reading. They could not oppose the principle of the Bill but they have been attacking provisions which would make the Bill effective. In other words, they are blowing hot and cold at the same time with the general idea of sabotaging the whole scheme of the Bill.
Now we have those amendments before us but there is nobody to move them. Why are they not moved? Still we have the pious farce that the House has been emptied on the far side, because we are taking too long over the Bill.
Question put and agreed to.
SECTION 89.
Amendments Nos. 125 and 126 not moved.
I move amendment No. 127:—
To delete sub-section (3), (4) and (5) and substitute the following sub-sections:—
(3) The Minister may grant to a registered medical practitioner a permit for the importation, manufacture, sale or other disposal of a restricted article and may attach to the permit such conditions (if any) as he thinks proper.
(4) Save so far as may be authorised by a permit under sub-section (3) of this section, it shall not be lawful for a person to import, manufacture, sell or otherwise dispose of, or offer or keep for sale or other disposal, a restricted article.
(5) It shall not be lawful for a person to advertise a restricted article.
These are drafting amendments and they do not introduce any new principle into Section 89. The section will require some further examination between this and the Report Stage. It applies to a very limited category of articles that it is necessary definitely to restrict the sale and the disposal of in this country.
I do not think that Deputies will ask me to particularise, inasmuch as there are some delicate aspects related to the articles contemplated. Certain instruments and appliances and other preparations can be used for a purpose other than the purpose for which they were obviously manufactured, and that purpose is very often an objectionable purpose and sometimes borders on a criminal purpose. It is in order to have power to deal with these articles that Section 89 has been incorporated in the Bill. As I have said, the category of articles will be very limited, but there does not appear to be any other effective means—the criminal law cannot deal with this situation—of dealing with it than the machinery set out here.
There is a suggestion that, if an application is made. to the Minister, he should be compelled to grant this permit to a registered medical practitioner. What does the Parliamentary Secretary say to that.
The Deputy in whose name that amendment has been put down is not here to move it. If he were here to move it, I would reply to him. Clearly, if the section is to effect the purpose for which it is intended, the Minister must be the judge as to whether such an article should be imported, and it will be up to the medical practitioner concerned to satisfy the Minister before he can receive a licence to import such a restricted article, that, in fact, the article is necessary and that it will be used for a legitimate and proper purpose.
Major de Valera
The Parliamentary Secretary is taking pretty wide powers with regard to restricted articles. I take it one of the problems he has in mind is the problem of contraceptives. I think everybody will agree with the section, but will the Parliamentary Secretary say whether he has in mind any other type of restriction or whether there is any question of a restriction on one particular brand of excellence as against another because it may not be quite so excellent? If that is not contemplated in this section, I understand it is in other sections—that is, the question of control of the standard of the article. Is this section dealing with such things as contraceptives and things that might be perverted, or is it meant to cover the grading of the excellence of medical articles?
This section is specifically inserted in the Bill to deal with the restricted articles that are manufactured and advertised and that purport to be used for medicinal purposes, but are, in fact, capable of being used for objectionable purposes, including contraceptive purposes. It is not intended that this particular section should have any wider application. We have sections dealing with proprietary medicines and patent medicines and all that other wider category where the claims of these articles to have curative or restorative or other desirable qualities will be the determining factor. In regard to this category, the determining factor is another matter.
Amendment agreed to.
Amendments Nos. 128, 129, 130 and 131 not moved.
I move amendment No. 132:—
Before sub-section (7), to insert the following new sub-sections:—
(7) Any article forfeited under sub-section (6) of this section shall be disposed of in such manner as the Minister may direct.
(8) Where, on an inspection under Section 103 of this Act of any premises, any restricted article is found in relation to which the person making the inspection has reasonable grounds for believing that an offence under this section has been committed, such person may seize, remove and detain the article.
This amendment is intended to provide power for the disposal of restricted articles which are forfeited on the decision of the court and for the seizure, removal and detention of any such article found on the premises.
Amendment agreed to.
I move amendment No. 133:—
To delete sub-section (7).
This sub-section is unnecessary in view of the provisions of Section 2 of the Customs (Temporary Provisions) Act, 1945. Section 2 of that Act sets out:—
"Any goods, the importation of which is for the time being prohibited or restricted by an enactment or statutory instrument, shall be deemed to be included amongst the goods enumerated and described in the Table of Prohibitions and Restrictions Inwards, contained in Section 42 of the Act of 1876, and the provisions of the Act of 1876 shall apply accordingly."
In view of the terms of that section of the Act of 1945, sub-section (7) is unnecessary.
Amendment agreed to.
Section 89, as amended, agreed to.
SECTION 90.
I move amendment No. 134:—
In sub-section (1), page 44, to delete lines 17 to 20 and substitute the following words:—
the expression "medical preparation" means—
(a) a substance which is sold under a proprietary designation and for use for the prevention or treatment of any human ailment, infirmity, injury or defect, or
(b) any other prophylactic, diagnostic or therapeutic substance (not being a therapeutic substance within the meaning of the Therapeutic Substances) Act, 1932 (No. 25 of 1932).) which is sold for use for the prevention or treatment of any human ailment, infirmity, injury or defect;.
The effect of this amendment will be to extend the expression "medical preparation" so as to cover not alone substances sold under proprietary designation, but also any other prophylactic or diagnostic or therapeutic substance sold for use for the prevention or treatment of any human ailment, infirmity, injury or defect. This amendment becomes necessary in order to remedy a defect in the operation of the Therapeutic Substances Act, 1932, particularly in regard to the manufacture and sale of penicillin ointment.
Major de Valera
Arising out of the amendment, I should like to ask the Parliamentary Secretary whether in the wide power he is obtaining here he will consider the question of licensing or authorising reputable general medical practitioners to obtain such things as they want. Whereas we all see the necessity for such a section, and for the extensions provided for in the amendment, every reasonable person will sympathise with the Parliamentary Secretary in his view, and will feel that these powers are necessary, but like all such questions, there are two sides to the story. The difficulty I see is that you will have reputable moral medical practitioners such as we have who will have their own views, perhaps, about new preparations which they will want to prescribe. I should like to see adequate provision made to enable these reputable medical practitioners to secure such preparations which, undoubtedly, will only be used for very moral purposes. The difficulty is to have power enough to curb abuses and, at the same time, make adequate provision for the legitimate use of these substances.
That is the first question I wish to ask the Parliamentary Secretary. Would he be able to tell us that there will be no fetters whatever put upon reputable medical practitioners in this country in securing preparations for their own legitimate ends, or for that matter in prescribing them?
The point raised by Deputy de Valera is one that will call for further examination. I can foresee difficulties in adequately providing for the type of contingency that the Deputy has in mind, and I would be very anxious to try to find some machinery to meet the important viewpoint to which the attention of the House has been directed. When the Deputy mentioned reputable medical practitioners, we are all in agreement with him that, in general, medical practitioners are reputable. Occasionally you meet a medical practitioner who is disreputable. It is not just so easy to provide facilities for the reputable without allowing the disreputable to abuse these facilities. I know some of the reputable members of the fraternity, and a good deal about the disreputable members, and I may be able to devise some plan to meet Deputy de Valera's difficulty, They are all registered. I direct the attention of the House, and of Deputy de Valera in particular, as he raised the matter, to Sections 11 and 12, particularly the latter section, sub-section (1) of which reads:—
"(1) It shall be lawful for the Minister by Order to establish consultative councils to give to the Minister, in the manner prescribed by the Order, advice and assistance in connection with such matters affecting or incidental to the health of the people as may be specified in the Order."
On a matter such as this it would be necessary to establish an advisory council to advise the Minister as to the operation of this section. Undoubtedly, the administration of the section will present great difficulties. There will be no complete uniformity of view amongst medical men as to the effectiveness of a particular remedy. One medical man would have the fullest confidence in a particular preparation, while another medical man would scoff at it, and say it was useless. If he had antiquated views about things or was an old fogey he would not recommend such a remedy at all. There will always be that difficulty. I agree with Deputy de Valera that a reputable medical practitioner must be allowed the fullest freedom of choice of remedy when he accepts responsibility for the life of a patient, and believes that it is the best remedy to apply in a particular illness.
In fact, this matter will have to be examined with the greatest care and in the greatest detail. It seems to me that if this is to be properly and conscientiously administered, with the greatest possible safety to the public, and to the general satisfaction of the medical profession, some of these remedies will have to be submitted to clinical trial before they can be excluded, if they are new remedies of which our practitioners have not much experience. On the other hand, we will all be in agreement at the outset that there is quite an extensive category of patent medicines and proprietary preparations, the sale of which constitutes a fraud on the community at the present time. We read advertisements in the newspapers about these cure-alls. They are pretty expensive cure-alls. Our people are in some respects easily imposed upon. They have a very astute political sense I grant, and are not so easily imposed upon in that regard but, in matters such as are under discussion now, people who are suffering from any kind of chronic ailment when they take up a newspaper see a picture of a man with a hump on his back and his head down, and they read that he got all right after taking some preparation for a short time. These people would sell the last cow in order to buy that remedy and try it. The amount of money that is extracted from the people in that way runs into millions. I want to try to stop that. It will be a difficult job, but I am going to have a try. It is an effort that should have the support of every member in every Party that ought to be in this House.
Major de Valera
Further to the remarks of the Parliamentary Secretary in reply to my query, I should like to ask a few other questions on this section. Everybody will agree that the control of medical and chemical preparations that are liable to immoral or perverted use is not only desirable but a necessity for the welfare of the community as a whole. In so far as this section takes power, in support of the powers taken elsewhere in the Bill, everyone is unanimous in supporting the section. There is no criticism of that. We all admit that provisions of this nature are necessary. The Parliamentary Secretary, however, mentioned a second ground, that of fraud, and stated that he will seek control of certain medicines on the ground that they are a fraud on the public.
He has made his case. Everybody sympathises with it. There must be control of preparations that are liable to be foisted on the public. But straightway a difficulty arises. What authority is to determine that a particular preparation is useless, and that it is a fraudulent means of extracting money from the public? It is quite clear that the Parliamentary Secretary has seen the difficulty when he mentioned that he may have to resort to a clinical test in order to exclude them. I see great difficulty there. There is the question of the freedom of the medical profession in dealing with the problem of life and death, which is involved. As the Parliamentary Secretary stated it is going to be very hard to say in some cases whether the medicine in question has any virtue or not.
Who is going to decide? Is it going to be some officer in the Minister's Department, or some particular analyst, or will it be referred to some board? There you have a great difficulty, because it is just in these controversial cases that practitioners will differ. One practitioner may think that a certain preparation is very useful in a certain condition while another may think it is useless. The fate of that particular preparation will then depend on the views of the man to whom it is then referred. The real danger that I see is this: supposing the machinery is set up in the Department, or under the control of the Minister it will virtually amount to a vetoing Department, with the power of saying "yes" or "no" to what is prescribed by medical practitioners. In matters relating to public health everyone will agree that the Minister has in his Department a number of experts. The Parliamentary Secretary, I know, will not claim to have in his Department all the experts in eye trouble, gynæcology, chest and brain surgery and other things. The experts in these lines lie outside. Is the Minister, within his Department, going to take upon himself to decide these important matters—what is going to be allowed and what is not? In a nutshell, the pressing danger, as far as I can see it, is this: that it would amount to circumscribing the freedom of the medical profession, and, to a certain extent, telling them just what remedies to use. I realise that, in speaking in this way, I am performing the functions of the absent members.
You are worse than they are.
Major de Valera
Still, it is absolutely necessary if democracy is going to work, to have a constructive Opposition, but the people who talk most about democracy have created this difficulty by not being present to perform their functions. That, however, is neither here nor there. The point is, and I am sure the members of Clann na Talmhan and the Fianna Fáil realise it, is this: that there is a problem in this section, and that there are two points of view on it. All that I am asking the Parliamentary Secretary is, in what way can he meet the difficulty? He referred to Section 12. I think there is a solution there if outside people are consulted. I would like him to say that he is not going to confine the administration of the powers that are contained in this section solely to his own advisers who are admittedly experts on public health, but I think that he would be the first, and that they would be the first, to admit that they are not experts on every branch of medicine and surgery.
In considering this question, amendment No. 41, which is to come on later, bears, I think, very much on the matter under discussion. There is grave danger that if the Minister is to take complete control over the sale and advertising of various medical preparations we may reach the stage when there may be unfairness or injustice as between one firm and another. I would like to know how confidence is to be established in regard to that matter. Deputy Dillon has an amendment on the Order Paper which says:—
"Save in so far as is provided for in sub-section (3) of this section no restriction shall be placed on the sale of medical preparations or of substances with proprietary designations by way of confining their distribution to members of specified traders to the exclusion of other wholesale and retail distributors."
I hope that the Parliamentary Secretary intends to accept that amendment.
We have not reached it yet, and I imagine it will not be moved. I will deal with the principle involved in it.
I am anticipating that it may not be moved. I think the principle in it does apply to the matter that we are discussing. If the Parliamentary Secretary is going to take such far-reaching control it is necessary, as Deputy de Valera has pointed out, that he should be equipped with the necessary specialist advice before taking such action. I think that I have discerned from listening to the Parliamentary Secretary that there is a strong prejudice on the part of the medical profession against all outside medical preparations which are advertised. There is no doubt whatever but that a large proportion of such preparations are of very questionable value. It is possible that amongst such preparations, there may be remedies which are of considerable value, of perhaps as great value as the prescriptions recommended by the medical profession. I remember on one occasion going into a chemist with a prescription for something of a treacle nature. I found that it was very expensive and here was the view that he expressed to me. "Those doctors are all faddists; they read up something in a medical journal and they immediately prescribe it because it is new." Perhaps some of the old-fashioned remedies which our fathers and grandfathers knew would be much more effective. The Parliamentary Secretary mentioned that there are reputable and disreputable members of the medical profession. He admitted, and it was a significant admission I hope, that the disreputable members of the profession are not those who take part in politics.
Is the Deputy basing that opinion on his experience of farmers?
I am afraid that doctors do not seem to be coming very actively into our Party.
We have disreputable farmers, too, and I was wondering if they are all in politics.
Our experience of doctors in politics has not been very happy.
The Deputy learned a lot in the last three weeks.
The Parliamentary Secretary admitted that people are easily imposed upon. Having regard to the kind of a Government that has been imposed on our people for the last 13 years, I am inclined to concede that point to him, that people are easily imposed upon. I think it is a good thing that there should be some protection against fraudulent and deceptive remedies being foisted on the people. I remember an old man coming to me with a preparation which he had—a remedy for some kind of rheumatic trouble which he had obtained from Great Britain. He was a very poor man. In answer to an advertisement he applied for and received this preparation free. The instruction with it was that if having tested it he found that it was not doing him any harm he could apply for more and send on a subscription. The man was illiterate, and he asked me to write on his behalf for a further supply. He showed me the material he had received and which was described as having been taken from a spa well which had great remedial properties. It was actually red clay which had been taken from the bottom of a well. That man absolutely believed that it was doing him good and that if he could get a further supply it would make him completely well. That is just an instance of how simple, uneducated people can be imposed upon. I advised him against having anything further to do with it and told him he could get it in any ditch or dyke.
That is a fishy story.
It is absolutely true. That material was advertised in the public Press and this man's attention was drawn to it and he got somebody to write for a supply. The first sample, of course, was free, but then he was encouraged to continue using it and to pay for it. I see a difficulty and a danger that some particular firms may be favoured as against others. We all know of the case of a gentleman named Sigal who was given a licence to import material into this country and to profiteer in its distribution over other people. It is possible that gentlemen of that type may approach the Government and get, perhaps, a monopoly in the distribution of some of these medical preparations. That would be very undesirable.
I am one of the pharmacists who would be greatly concerned with this particular section. When we first read it we had our doubts about it but the Parliamentary Secretary very kindly met a deputation which was representative of the entire pharmaceutical trade, including both the academic and trade interests. We had a long discussion with him but the Parliamentary Secretary completely satisfied the deputation that what he was doing was just and reasonable. We dislike, of course, anything that puts a restriction on the articles which we can sell and I think that when the Minister for Public Health embarks on protecting the people against fraud he is going a bit far. At the same time I agree that it is not right that people should be at liberty to advertise articles which are in themselves fraudulent and do not conform to the claims made for them but I think it is a matter for another Department to consider whether a particular commodity is a fraud on the public or not. I agree that if the article advertised is harmful in its effects there is a case for prohibiting the sale of that particular article. In regard to the case referred to by Deputy Cogan of the man who paid a fabulous sum for a rheumatic remedy, he has a grievance in that respect, but a man might read an advertisement offering to name the winner of a race for £1 and it might cost him another £1 by the time he was finished with the transaction and he might have nothing for it except experience. However, as far as our trade or profession are particularly concerned, I think we have expressed ourselves as completely satisfied with the Parliamentary Secretary's explanation and representatives of other interests in the House might be satisfied with that recommendation.
Deputy de Valera has again emphasised the requirement of having advice on this highly technical and difficult matter from persons outside the Department. Of course, the type of advisory council that is contemplated under Section 12 of the Bill would embrace persons outside the Department. In fact, advisory councils will in the main be constituted of persons who are not in the employment of the Government. In this particular matter the advisory council, of necessity, will have to be drawn from men with the highest and most detailed knowledge of these proprietary articles and their probable therapeutic effect if consumed by human beings. As Deputy Loughman has said, I had the fullest discussion with representatives of the Pharmaceutical Society and representatives of the druggists.
We spent quite a long time on this section and, following the discussion, they were quite satisfied as to the policy that has inspired this particular innovation in the Bill. We all realise that there will be difficulty in effectively operating the section. We are breaking new ground in that regard in this country but it is not new ground in neighbouring countries. In the United States of America and in Canada such control has been instituted long since and very rigid control. If it was found to be necessary there where, perhaps, the people might not be as easily imposed upon as Deputy Cogan has found them to be in this country, it should be necessary here. It is, in fact, necessary and everybody agrees on that. The chemists and druggists were in full agreement also. The difficulty of operating it will only be overcome by experience but in this regard, more than in any other, the advisory council that will advise the Minister as to the restrictions he ought to impose and the articles on which he ought to impose them will have to be drawn from medical scientists, medical practitioners and medical consultants having the most intimate knowledge of the use and effects of such articles. The question that has been raised by Deputy Cogan would arise on a later amendment if the Deputy in whose name that amendment has been put down were here to move it. The possibility of interfering with normal trading relations is apparently contemplated in that amendment. The Minister for Local Government and Public Health will be concerned only with the article in question, with its suitability, with its curative or tonic or restorative powers, and with the determination of the question as to whether it is in the public interest that such an article should be available to the public. His interest begins and ends there. If an article is restricted, if it is prohibited, well then, nobody imports it. If it is not restricted, well then it will be imported through the ordinary trading channels and the Minister for Local Government and Public Health will not be concerned in that regard. In so far as the objectionable article might be manufactured in our own country, the point raised in the amendment will not concern us at all. It will not concern the Minister for Local Government and Public Health. Therefore, the question of that type of favouritism, whatever the inspiration might be behind it, will not in fact arise. The article will be judged from a scientific point of view, from its estimated effect on the human beings who use that particular article in the hope that it will cure a particular ailment. On that, we will require the widest consultation and the fullest scientific advice. But it is on such a basis and on no other basis that the matter will be determined.
It may be necessary, and I think it will be necessary, to examine this further from a purely technical point of view arising out of its impact on the Therapeutic Substances Act and I may have to make a further amendment on Report Stage that will be purely of a drafting nature and will not in any way affect the general purpose of the section.
The statement made by the Parliamentary Secretary that these quack medicines cost millions a year in my opinion is most alarming.
Do not take that literally; it may not be accurate. When I say millions, I am speaking in a figurative sense. Let us say very large sums.
Let us say hundreds.
Much more than hundreds.
Thousands. Even if only pounds were spent on them, the section will prevent that type of business. In rural areas, as Deputies know quite well, at fairs and markets you find certain individuals standing up on a stool with people gathered round them, people who are easily imposed on. If a person suffering from some illness has tried many doctors without being cured, he may be easily imposed on by one of these individuals. In my part of the country before the war we had an individual going round known as the black doctor. He never missed a fair or market in the West. He used to take in a lot of money for these mock preparations. He had a cure for everything; no matter what it was, he could cure it without the slightest trouble. I believe people like that are doing much more damage than the advertisements in the newspapers. If the section prevents people like that from carrying on this class of business, it will be a very good job. If there is any direction in which progress should be made as rapidly as possible it is in connection with that matter. Sometimes it is surprising how quickly people progress. It is a surprise to me to find this Party now the chief and only Opposition in this House. That is progress. That is more than I expected for some time, and I am delighted.
Coming events.
Coming events cast their shadows before. In any event, if the section does away with that class of people, as I believe it will, and prevents this type of mock medicine being distributed amongst our people, it will do a certain amount of good. Of course, as Deputy de Valera said, there may be a danger of the Department being the sole people to decide on the effectiveness of this medicine or that medicine. But, of course, the time will come, I am sure, if things work out in that direction, when there will be people in this House—in case we do not happen to be in it—who will probably bring in some changes, because it is from experience in connection with these matters that we all learn.
From my experience, I believe that this section is definitely necessary. Like Deputy Donnellan, I have seen this black doctor very often.
In Westport?
And survived it?
Poorly. As I say, this section is very necessary, because if people want to get the best possible cure for ill-health, they can only get it on the advice of this medical council. There are, of course, a number of reputable patent medicines that have been recognised by doctors as having curative properties. I am sure the Parliamentary Secretary and the medical council will treat them as they should be treated. There is another point in connection with this. Well-known medical practitioners import certain medicines or ingredients for medicines and I should like the Parliamentary Secretary to give them every facility to do that. Arising out of their experience, some doctors make up a certain medicine to suit a certain person. The ingredients in that medicine may have to be changed in order to suit some other patient. I should like to see complete freedom allowed to the medical profession to formulate their own opinion as to the effectiveness of a particular drug if they think it is necessary in the case of any particular patient.
Amendment put and agreed to.
I move amendment No. 135:—
In sub-section (1), to delete lines 21 to 30.
This is a drafting amendment rendered necessary by the transfer to Section 2 (1) of the Bill of the definition of the word "advertisement".
Amendment agreed to.
I move amendment No. 136:—
In sub-section (3), to delete the word "authorising" in line 36 and line 40, and substitute the word "permitting", and to delete in line 38, line 43 and line 46, the word "authorised" and substitute the word "permitted".
This is a drafting amendment.
Amendment agreed to.
I move amendment No. 137:—
In sub-section (3), to insert before paragraph (c) a new paragraph as follows:—
(c) the requiring of the printing on the outside of packets or containers in which medical preparations are to be sold of the compositions of such preparations and the prohibition of the sale of any medical preparation in a packet or container which has not printed on the outside thereof the composition of the medical preparation.
This is a supplemental power which is necessary for the proper implementing of the provisions of these regulations. It is a machinery amendment.
Amendment agreed to.
Amendment No. 138 not moved.
I move amendment No. 139:—
In sub-section (3), page 44, line 55, to delete the word "relate," and substitute the words "relate and to furnish samples of such preparations,".
It is necessary for the operation of the regulations that applicants for licences should be required to furnish samples of medical preparations to which their applications for licences relate.
The supply of such samples is required for the purpose of analysis and checking the statement furnished by such applicants for, or holders of licences as to the constituents of their medical preparations. Clearly it would be necessary that the Minister should have at his disposal samples of the articles in question in order that he may be in a position to have them analysed and tested and to satisfy himself as to whether in fact the licences should operate.
Is that not being done to a great extent already under the Foods and Drugs Act?
The Food and Drugs Act does not deal with the matters with which we are trying to deal here.
This is the first time any attempt has been made to deal with them?
To deal with this particular problem of the control of patent medicines. We have no statutory powers to enable us to deal with them.
It is very necessary that this power should be provided. Otherwise, how could the Department know what these preparations are made up of?
Major de Valera
Sub-section (2) says:—
The Minister may, with the consent of the Minister for Finance, make regulations for the control of the advertisement or sale of medical preparations.
That is all very well, but who will enforce the regulations? What body will determine the matter? Will it be the Parliamentary Secretary's Department or some independent advisory body, such as is provided for in Section 12?
I dealt with that point a few minutes ago, but, briefly, the advice which the Minister will require for the operation of this section will not be available to him from the personnel within his Department and an advisory council under Section 12 will have to be set up for the purpose. As I explained previously, that advisory council will have to be widely based and drawn from medical scientists immediately concerned in different branches of medical science. It will also be necessary to have available to the Minister the advice of consultants, medical practitioners, pharmacists and analytical chemists. As Deputies appreciate, we are breaking new ground here, and we will have to operate this section on an experimental basis until such time as we find we can make its terms effective within the machinery provided here. If we find that we have not given ourselves adequate powers to deal with the problem with which we are trying to deal, we will have to come back to the House and ask for extended powers.
As I said earlier, this matter of the control of patent medicines and proprietary articles has been developed to a great extent in America, Canada and European countries. We propose to study carefully the machinery set up in these countries and the manner in which they operate control. If it is necessary to modify the powers we have here, we will have to seek any further statutory powers we may require, but within the powers given us in the Bill we can make a substantial inroad on this type of problem, and thus gain the necessary experience to be able to convince the House that further powers may be necessary in order to make a desirable policy fully effective.
Deputies need not have any concern as to the possibility of the Minister acting in a hasty way in a matter such as this, or interfering to any undue extent with the proper discretion and the exercise of the independent judgement of any medical practitioner who takes it upon himself to treat a patient and who, perhaps, from his own limited experience has found that particular remedies have given him satisfactory results. While a neighbouring doctor might contest the value of the preparation, we must always give the fullest consideration to the experience of any individual practitioner who has satisfied himself that a particular remedy gives particularly satisfactory results.
In the early stages, we shall be immediately concerned not with the remedies concerning which there is a difference of opinion amongst medical practitioners, but with the purely fraudulent remedies concerning which there will be little or no difference of opinion amongst medical men. In that field, from my own knowledge of the subject, I think there is fairly wide scope for the operation of the section.
Major de Valera
I thank the Parliamentary Secretary for his answers and I hope he will bear with me a little longer. I should like to say that one of my purposes in pressing this matter is to discharge the function of the Deputies who have not moved their amendments, but, in doing so, I do it as a duty to the Parliamentary Secretary because a certain amount of suggestion and innuendo has been put up and the opportunity for his replying to it has been taken from him by the non-moving of these amendments. I wished to give the Parliamentary Secretary a chance to reply to these very important points which he has clarified and I think everybody will be satisfied with the answer he has given.
In effect, he has told us—he does not propose to rely completely on the experts in his Department — that he will take into his confidence and be guided by outside medical opinion, where appropriate, and will not act in any hasty manner. He has also reassured us that this is aimed at the fraudulent type of patent medicine—in other words, the selling of the bottle of water, with a little colouring matter, as a cure-all, because that in many cases is what it boils down to—and the whole medical profession will agree with him. He has gone further and has assured us that, in the case of any medical practitioner who has found from his experience that a particular remedy is efficacious, even where his brother medical practitioners would not agree with him, he does not propose to interfere with him and that the necessary facilities will be available to him.
I need put only one further matter to the Parliamentary Secretary then. His answer caters for tried remedies, but there is still the position with regard to new remedies. In the medical journals, the scientific journals, there will be continuing research work, suggesting new remedies, and new drugs will be described, and, as is usual in these cases, some writers will praise them and others will discuss their limitations. These preparations will be largely experimental. As I understand it, they are usually circulated by the manufacturing firms as samples, with the usual literature, to medical practitioners who are invited to try them. I take it that nothing in the provisions of this section will hinder the freedom of reputable medical practitioners to avail themselves of new discoveries and to apply them therapeutically as they may think fit, in the course of treating their patients. In other words, I take it that this section will and can in no way be used to restrict the present freedom which medical practitioners enjoy—reputable medical practitioners, of course—to prescribe these preparations for their patients.
This is a very important section of the Bill. I agree with Deputy Donnellan in his reference to the activities of the "black doctor" in the West. I can assure Deputy Donnellan and the House that we, the supposed wise guys of the East, have met the "black doctor", too. There is another matter about which I am somewhat perturbed. I refer to the well-known and successful herb cures, prepared, if you like, by old women. If this Bill will prevent those people from assisting their neighbours, it is a very serious matter, because many of those cures have, beyond yea or nay, been successful where the medical profession have failed. There is no doubt about that. I can see in this provision danger to people who, at no cost to their neighbours and very little cost to themselves, have successfully relieved suffering. I should like an assurance from the Parliamentary Secretary that he will not take strong action to prevent those people from assisting sufferers. That is all I have to say except to comment on the empty benches opposite. I am rather surprised that, in respect of an important piece of legislation, such as this, the Leader of the Opposition, Deputy Mulcahy, should decide upon joining in what I may call the national pastime of going on strike. It is pretty evident that he cares little for the success or failure of this Bill so far as the interest of the masses of the people is concerned.
Would you say that if he was here?
Mr. Walsh
Yes, and I say it to you as well as to him.
You may get away with it with me but you would not get away with it with him.
Mr. Walsh
I appeal to the Parliamentary Secretary to arrange that the people to whom I have referred will not be interfered with in any way.
I am sure he will do that for you.
I am not so sure. Deputy de Valera has raised the question of trial samples for medical practitioners and expressed some anxiety as to the possible curtailment of the trial of new drugs and new preparations by medical practitioners. That is not contemplated under this section. We are well abreast of developments and heading fair to lead our neighbours in matters of public health administration. We do not intend to do anything either by way of statute or administration, which would in any way limit the advance of medical science. All our activities will be in the opposite direction, so that Deputy de Valera, speaking on behalf of the Opposition, need have no particular anxiety on that score.
I regret the departure of Deputy Mulcahy and his team. I have been engaged with that team for the past few weeks and I had got more or less accustomed to their ways. Now, I have a new type of opposition and it will take me some time to study their particular approach before I acquire the same degree of skill in handling it. A position will develop under the Bill in which there will be a general consensus of opinion amongst medical people that the use of particular remedies which are being extensively advertised, distributed or sold should be restricted or, perhaps, prohibited. When such a public opinion, or localised opinion, amongst professional men comes to be presented to the Minister, he will naturally pay attention to it. He will have at his disposal an existing body—the Medical Research Council—to whom he has on more than one occasion referred scientific matters for advice. He will have machinery to set up the other type of advisory council to which I have referred. Within that machinery, there are many safeguards against danger to the community by the operation of this section in any narrow or ill-considered way.
As regards Deputy Walsh's problem, with his old ladies in County Louth who have cures for many things, I should not like to discourage him completely, mainly for the reason that these old ladies have a very limited area of operation. While I might have to challenge Deputy Walsh's views as to the efficacy of those ladies' remedies. they are not sufficiently numerous and their practice is not sufficiently widespread to constitute any great danger to the health of the community. Instances could arise where it would be necessary to interfere in such matters. Most of us have some knowledge, if we have not experience, of domestic cancer cures that have done inestimable damage. In fact, those cures have been responsible, in some instances, for the earlier death of the patient. That is an example of a domestic, scientific activity with which it might be necescary to interfere. I do not know that that is the particular development down in County Louth that Deputy Walsh is so anxious to preserve. I sound a note of warning that I will have to keep an eye on County Louth and see how extensive is this practice which Deputy Walsh is so anxious should not be interfered with.
I can see definite danger in giving those wide powers to the Parliamentary Secretary in respect of types of remedy which have proved effective. It has come to my knowledge that some of those home-manufactured remedies for cancer have proved very effective.
And very radical. They usually remove the patient as well as the cancer.
The remedies to which I allude have proved successful in a large number of cases. A case came to public notice a few years ago in which a patient died some time after using one of those remedies. The unregistered practitioner was brought into court.
One of the immediate results of that man being brought into court was that people came forward from a very wide area, people of education, and of high repute in the community, to subscribe publicly the necessary money to defend that gentleman because people felt, many of them as the result of personal experience, that this man was a public benefactor and that he should be protected. There is no doubt that some of the cancer cures have proved effective and the cures are not confined to a small area. That is where the Parliamentary Secretary comes in because I think he indicated that where a person of this kind is practising in a small area he will not interefere but if practitioners are conducting operations over a wide area, he will take action. The person to whom I referred practised over a wide area. As a matter of fact, he was sending remedies to various parts of the United States and that is wide enough. His practice was a practice based upon experience and merit. I know how deep-rooted the prejudice of the medical profession is against such persons but I think it would be better if the members of the medical profession were to get on their knees at the feet of some of these practitioners and learn something from them because I do not think that anybody, even though he may have obtained many degrees from a university, has reached the stage when he cannot learn something more from somebody else. We know that penicillin is only a sort of mould which was utilised by quacks in years gone by, in a less perfect form perhaps but nevertheless used. The medical profession have a good deal to learn from those who have brought about natural cures of this kind. I think there is a public danger in having at the head of this Department administering a section such as this, a man with the mentality of the Parliamentary Secretary who has displayed, and has not hesitated to display, a deep-rooted prejudice against everybody who seeks to remedy human ailments by methods other than those subscribed to by the medical profession.
Major de Valera
The last speaker somewhat surprised me. I think in all seriousness his remarks call for some kind of answer. There has been as we all know in this country what we might call the local practitioner — the local "wise man" or "wise woman" who did a certain amount of medical prescription. There was also the bone-setter. We shall leave the bone-setter aside, because he is an artist dealing with something mechanical which depends on the skill of his hands. He was really somebody who had a certain transmitted mechanical skill and he did some splendid work, being very often more successful than the ordinary medical practitioner who had only done his course. Doctors would be the very first to admit that that is so. I can see nothing in the Bill that is going to stop the work of a man such as that. There is nothing to prevent a man who is depending on his own manipulative skill carrying on his practice.
Is that so? Is the bone-setter left out?
Major de Valera
That is so. I think we will all agree with Deputy Cogan, Deputy Walsh and Deputy Donnellan in regard to that but there is a much more serious question. You have the person who is going around with remedies—in other words an untrained, unskilled person who is really dabbling in pharmacy and prescription. It is all very well to say he is a skilled man. All that he has got is that he has had transmitted to him for generations certain things that were found by experience to be helpful but the real difficulty is that he does not know the limitations of his own cures and, as the Parliamentary Secretary has very properly stated, he very often succeeds in killing as well as curing because of his lack of discrimination. I think it is highly desirable to have control of such practices in these days. It is one thing to say that cures have been effected and that these remedies have been effective. They have, if they have been applied in the proper way. We know that the drug digitalis, if applied properly, is very beneficial in heart cases but just how many of these quack practitioners know enough to appreciate the harmful effects of drugs when used by unskilled people? Usually these people make up a certain decoction in a haphazard way. The results may be sometimes effective but again the administration of the drug may be very harmful.
With the present availability of pharmaceutical supplies, and the services which are available from qualified medical practitioners under necessary controls, we have reached a stage when it is desirable to control the activities of quack practitioners. The Deputy mentioned cancer. It was actually the Parliamentary Secretary who raised that question first. I think the Deputy opposite made some very extravagant claims for cancer cures. There are large research bodies all over the world who for years have been studying this most serious human ailment under the most careful control with a huge number of subjects for observation. To a certain extent, experimental work has been done on animals also but, after all that, they have not been able really to get at the bottom of this terrible malady. I think the Deputy is really being a little extravagant in claiming that some of our handy men have got a cure for cancer.
Leaving out the question of the doctors at the moment, if we were a court who had to consider evidence, properly sworn and segregated, I think we should have to find that the killing exceeded the curing in the case of these alleged cancer cures. There are other factors which have also to be considered. There is the psychological factor and, again, cancer in some cases may have been wrongly diagnosed. There may be the effect on the patient produced by the mental suggestion that these people are infallible. These practitioners by instilling a certain amount of confidence may produce successful results, but that is no justification for giving them an unlimited licence for dispensing chemical substances. It is also claimed that some of the substances used in these cures have anticipated medical discoveries. The Deputy mentioned penicillin, and the moulds from which it has been evolved. It is now found that some of the remedies of the old days, such as bandaging wounds with a most atrocious mess which medical practitioners nowadays would look upon as dirt, really incorporated some of these moulds out of which penicillin is at present made.
I would like to tell the Deputy that research workers on these lines have a constant eye on these popular cures. Research medical practitioners and chemists are constantly interested in these traditional cures because of the possible line they may get from them. There is the case of ergot used by all the handy midwives in the old days. It was well known to them and was afterwards found to be an important specific drug. Granting the Deputy all these things, I think he should admit that we have reached a stage of knowledge when control is necessary. It is quite obvious the Parliamentary Secretary will not send out an inspector to watch for a little dose of nettle juice, which is a common purgative or spring cure in various parts of the country. Give him credit for being reasonable.
Again, I have to draw attention to the absence of the people responsible for some of these amendments. As in the case of the women clause in the Constitution, and the famous Transport Bill, we have all the bogies dangled before us, as if Ministers were the most outrageous bogies and unreasonable people that ever lived. Experience shows us that these things are administered reasonably, and you must accept that attitude. There is no use in waving bogies. Certain powers have to be taken in order to make the administration effective. I think the Parliamentary Secretary's answer should suffice. The powers are necessary, but they will not be abused.
I felt rather interested in the remarks of the last speaker, and also those of Deputy Cogan. All through the debate on this Bill, for the past 15 days, I have refrained from speaking, simply because I did not consider myself qualified to go into matters connected with public health. But, little as I know about it, I swear I know more than a lot of those who have been blowing hot air about public health, about doctors and other things, for the past 15 days. I will give the Parliamentary Secretary this credit, that I consider he is one of the most reasonable members of the Government.
That is a tribute.
The Parliamentary Secretary has been the subject of very severe criticism from members of the Opposition. I agree fully with every step he has taken in relation to this and other sections of the Bill. I have not voted against it; I have voted for the Bill, and I am prepared to stand by the Parliamentary Secretary on every section, because I believe that, with his medical knowledge, and also with the knowledge of his advisers, he will not put over any legislation unless, in his opinion, it is in the best interests of the community.
Deputy Cogan spoke about the so-called handy people who have effected cures. I would like to defend these people in the strongest possible way. I have known cases where patients were given up by doctors and discharged from hospital and they were afterwards cured of cancer by handy men. I know of one case, and I am sure if Senator Hogan, who at one time was a member of this House, were here, he would bear me out, because he knows the case just as well as I do. A constituent of ours was given up by the highest medical authorities in the Midlands. He was suffering from cancer. He was left on one side to die. We succeeded in discovering one of these people who might be called by the Parliamentary Secretary a quack. We brought him there. No bus or hackney driver would agree to bring that man any distance, he was in such a bad state. He was brought into a public-house, convenient to Naas, but the publican refused to serve him with a drink. He went to two hotels, and the hotels refused to serve him with a meal, his cancer was so bad. A kind neighbour agreed to admit him, and give him refreshment. Afterwards they broke up the vessels he had used. That man was taken to a quack, and to-day he is working between the handles of a plough, enjoying the best of health.
That is only one case. I have known other cases where cancer was definitely cured by these people. I believe it is not right to interfere with them. I do not think that the law should be used to control this gift that Almighty God has given to those people. It is a gift from God. Although the Parliamentary Secretary has power to deal with people who possess that gift, I suggest he should be slow to exercise it. People fortunate enough to have such curing powers should not be interfered with Instead of taking steps to make criminals out of them, they should be regarded as a great asset to the country. They have the prayers of many people, because they have been responsible for restoring those people to normal good health.
Not alone in the case of cancer, but as regards many other diseases that have been considered incurable those people have brought about cures by means of their marvellous gift, and the State should be very slow to take steps that might prevent such people doing the work that Almighty God put them on earth to do. Many citizens are very grateful to those quacks who have the gift. Those people are considered in their areas to be very lucky. I know there are suspicious people who might not be considered as lucky. In part of my constituency there is one person who has the gift, and, as well as curing people suffering from various types of complaint, if a beast becomes ill, he would be called to visit that beast. Say a horse had some complaint. The very moment that man would enter the stable, the horse would get up and walk around. If the man refused to visit the stable, when the owner would go into it he would find the horse stone dead. That type of thing is well known, and I am sure there are other Deputies from my constituency who have an intimate knowledge of the type of person to whom I refer.
It is quite true those people have certain powers, and I would be slow to institute legal proceedings against quacks who have done good jobs. The Parliamentary Secretary may say these quacks have been responsible for killing people. The fact of the matter is that the people would die, whether they were attended by the highest medical authorities or not. So far as these quacks are concerned, no doubt we will hear that they were responsible for shortening the days of one person, but we will hear nothing at all about the scores they have cured. I believe that none of these quacks ever deliberately killed anybody. I can safely say they cured scores of people. The one or two who might have died would have died whether or which. The Minister should be slow to touch the quacks.
Major de Valera
Why do not these people put their extensive knowledge at the disposal of the world, that so badly wants a cure for cancer?
These people cannot be the recipients of any monetary reward arising out of their duties. It is a gift they have, and they find it very hard to explain.
Major de Valera
Then it is purely a psychological thing?
Yes.
Major de Valera
It is merely the presence of that type of person, and there is no chemistry and no drugs involved?
The Deputy has referred to the juice of nettles. There are prayers also, in addition to the juice of the nettles. It is something that the ordinary person has not got— the gift to make those cures.
Major de Valera
This legislation will deal only with the chemical end and whether people have the gift of curing or not they will not be affected.
These people who cure cancer do not say whether it is through certain medicines; they do not indicate how they bring about a cure, nor do they explain the methods they adopt. I understand that as regards the bone setter, this section will not mean interference. We are dealing only with medical preparations. Am I right?
That is right.
There are certain types of people who can perform cures, but it is not with medicine or any medical preparation they do it.
That is right.
There are people who cure cancer. I should like to know if it is by an act of God, which Deputy Flanagan mentioned, or by some method that they prescribe. If it is by something they prepared I have no brief for that. I can testify to cases where certain people succeeded in doing so, not by the use of medical preparations, but by some act of God. The Parliamentary Secretary has heard of what has been done by the seventh son. I have known cases where the seventh son in a family, touched with his hands people who had certain complaints, on certain days of the week and a cure resulted.
I can assure the Deputy that this section does not restrict the hand of God.
I was referring to an ointment that was prepared for the cure of cancer. There are some chemicals in it. I know that it completely removed external cancer.
Major de Valera
If that is a cure for cancer why do these people not put it at the disposal of the medical profession? It is possible to remove the rust from iron, and it is probable that something like what removes the cancer that has been referred to would also remove a wart. The trouble about cancer is that even though you only remove the surface you get certain results. A doctor will do the same thing with a knife, but that does not cure cancer.
The cure to which I referred not only removed the complaint but there was no recurrence of it. The cure was complete and the people concerned lived for years.
That is quite possible. That is possibly a superficial case where a surgical operation would be successful, so that there is nothing proved.
Amendment agreed to.
Amendment No. 140 not moved.
Without doubt there are good points to be made about some of these amendments. I am deeply interested in some of the amendments, and I would have put in amendments, but for the fact that what I wanted to deal with was already covered by amendments in the names of other Deputies. Would it be possible for me to move some of their amendments now?
Acting Chairman (Mr. O'Reilly)
No. They can be moved only by the Deputies in whose names they stand or with their authority.
That is regrettable.
Amendment No. 141 not moved.
Section 90, as amended, agreed to.
SECTION 91.
Amendment No. 142 not moved.
Question proposed: "That Section 91 stand part of the Bill."
Is this section a repetition of a provision that was already in previous Acts dealing with public health and the control of animals in public places?
We had a specific provision under which sanitary authorities have power to make by-laws, but not quite in relation to the control of animals in public places. That is set out in this section. There are sections called to mind by this section concerning the control of fairs and markets on which Deputies might like to have some information. This section empowers a sanitary authority to make by-laws
"imposing duties on owners of animals for the purpose of preventing danger to public health or injury to amenities arising from such animals when they are brought to or allowed to be in any public place".
It does not interfere with such market rights, or the rights to hold fairs as have statutory foundation at the present time. As far as the holding of fairs and markets is concerned, and, as far as they are governed by existing law, that provision is not interfered with under the section. Bearing in mind that local authorities make by-laws and that that is a reserved function, it can be assumed that this section will be biassed in favour of people anxious to hold fairs in the towns. Public health reformers would prefer to see fairs held outside the towns, because of the nuisance that is sometimes created by holding them in narrow streets, where cattle are on the footpaths, and very often actually in shops. The section does not empower local authorities to abolish the existing rights to hold fairs.
It is certainly a pity that there is not a direction in the section to local authorities to prevent fairs being held on the streets. Fairs will continue to be held outside business people's doors until the authorities are compelled to prevent the practice. The first consideration of business people is not public health, or anything else, but the making of money on fair days. As there is competition amongst business people, fairs will be held in the streets, so that greater crowds will be outside their doors.
I regret that power has not been taken under the section to compel local authorities to provide fair greens and to abolish the holding of fairs on the public streets. I believe that in time that will be done. I know that it would not be a popular thing with business people, but from the point of view of the public health the sooner that reform is carried out the better.
I agree with Deputy Donnellan. I think the Parliamentary Secretary should have taken power to prevent fairs being held on the public streets. As Deputy Donnellan has said the business people are in favour of that because it brings farmers and others all the nearer to their business houses. We know that, when fairs are held on the streets, for two or three days after the streets are in a deplorable condition. For the sake of the public health it is a pity the Parliamentary Secretary did not take power for the establishment of fair greens in all our big towns. To have live stock standing for hours on the main streets of our towns is not good for the public health. Local authorities should have the power to fix a venue for the holding of fairs, and to put an end to the present practice in so many of our towns and villages. When fairs are held on the streets the local authority should be compelled to see that the streets are cleaned up within 24 hours after the fair.
In my opinion this section hardly goes far enough. I think the Parliamentary Secretary should make it obligatory on sanitary authorities to provide fair greens. Only recently in my constituency we had very keen rivalry, such as Deputy Donnellan has described, between the traders there. They actually fought the matter out to a division at a meeting of the local town council. One section wanted to have the holding of the fairs removed from the streets, and properly so, in view of the fact that a fair green was already established in this town. I think fair greens should be provided somewhere on the outskirts of towns for the holding of fairs. The Parliamentary Secretary should reconsider the section and compel all sanitary authorities to provide fair greens for the holding of fairs in their areas.
I know certain towns and villages where it would not be possible to provide fair greens. For hundreds of years the fairs have been held on the streets and with no ill effects on the public health. Immediately the fair is over the streets are put into a sanitary condition. I think that if there was to be any change in the present system, the first people to protest would be the farmers who attend the fairs and not the business people. I would be opposed to the granting of powers to a local authority to prevent the holding of fairs on streets, especially in districts where it is impossible to provide fair greens.
I do not know if the Deputy is a rural dweller or a town dweller, but if he were the latter and arrived home for his dinner at one o'clock and found that it took him half an hour to remove the cattle from outside his door on a fair day he might think differently on this.
I desire to support the view put forward by Deputy O'Driscoll. We have many villages in which fairs have been held on the streets from time immemorial. The public health interest is met in these cases by the provision which is made by the public health authority for the cleaning of the streets. It would be unwise, I think, to have any drastic provision put into the Bill in regard to the holding of fairs. If the public health authorities see to it that the streets are cleaned up after the fair, I think that should be sufficient. I am not dealing with towns which are controlled by a local council, but rather with villages.
I would like to say in reply to Deputy Walsh that the fairs that I speak of are over at 10 o'clock in the morning. If the people in Deputy Walsh's district hold fairs at one o'clock in the day, then I am sorry for them.
In my area we have towns where there are fair greens and other towns where there are not. In the latter case the fairs have to be held on the streets. That is very objectionable. The streets are left in a deplorable condition. The local authority, however, sees that they are cleaned up. The position is reversed where you have a fair green. We have one in Claremorris which cannot be cleaned up because the site is just a field. There is no concrete or tar macadam surface. That really creates a greater nuisance from the health point of view than when fairs are held on the public streets which can be cleaned up since they have a concrete or other firm surface. Of course, I admit that in many places it is impossible to have fair greens provided. Down in my county we find it difficult to get land for the provision of burial places. Where, however, fair greens are provided the Parliamentary Secretary should see that it is properly surfaced so that it can be cleaned unlike the one in Claremorris.
Most of the points that have been raised have been dealt with by some of the speakers because every aspect of the question has been advanced by one or other of the Deputies who took part in the discussion. The fact of the matter is, first, that the provision of fair greens would not be appropriate to this Bill and, secondly, this is a much more complicated problem than appears on the surface. Market rights and fair rights are sometimes owned by private individuals, not always by the local authority.
Yes, very often.
And they, of course, have a vested interest that would have to be acquired and, presumably, they would have to be compensated for their interest if they were to be deprived of their market rights. Tools are levied, and so on and, in the same way, in the areas where the market rights are owned by the local authority, these market rights are sometimes a considerable source of revenue.
They are subject to the health authority.
I will sit down in a few minutes and the Deputies who feel that they have not talked enough, if there are any, on the 15th day of this encounter, will find me very patient and interested. It is a most interesting discussion and has been all the time. All these complications enter into the problem. Deputy O'Driscoll is supported by Deputy Commons and others——
And Deputy McCarthy.
I never mention Deputies of my own Party for fear anyone would think I was advertising.
Deputy Walsh will not like to hear that.
Anyhow, the Deputies who talked about the physical difficulty of providing fair greens hit a practical point right on the head. There is no use in talking about coming in in a wholesale revolutionary fashion and declaring: "We will have no fairs in the towns any more; we will abolish all this thing, the after effects of which are very unpleasant and unsightly, and hang the consequences." You just cannot do that. If there is not a fair green within reasonable distance of the towns, you just cannot provide a fair green.
You cannot take it down out of the sky. That practical consideration has to be borne in mind. It would be desirable to provide fair greens, and I agree with Deputy Commons that if we provide fair greens we should not provide a type of fair green that is going to be as big a nuisance as the nuisance we are trying to get rid of. At any rate, that aspect of the question is difficult and complicated and, if it is to be dealt with, it would have to be dealt with by separate legislation. It would involve a number of considerations that were not perhaps, present to the minds of Deputies when this matter first came under discussion. while I say that, a reasonable degree of control of animals in public places can be exercised. There are other public health complications, apart altogether from the accumulation of filth and excreta in a town or on a footpath or in the streets following a fair. There may be, and sometimes are, animals present in the fair, or in the market, or in a public place that may, in fact, themselves be sources of infection and it may be desirable to protect the community from some of the effects of the possibility, at any rate, of contracting certain contagious diseases that we have been talking about. That may be only a comparatively small matter and I merely mention it as a possibility. But the owners of the fairs, whether the market rights are owned by the local authority or owned by private individuals, have a responsibility for removing any nuisance that might be created as a result of the holding of a fair, and local authorities ought to get after them and see that when a fair has been held and the streets and footpaths and the whole appearance of the place have been messed up that the owners of the market rights or fair rights, if it is not the local authority, ought to be made to shoulder some responsibility for cleaning up the place, particularly if they are drawing tolls as a result of their having either acquired or inherited the market rights.
I do not know that I can be of any further assistance to the House on the matter. I have explained the position as clearly as I can and I think the House understands. We are concerned here with the limited extent to which we can interfere in this matter. To such extent as it is possible to control animals in public places, we propose to do it, but there are very definite limitations as to the extent to which this section can operate.
Question put and agreed to.
SECTION 92.
I move amendment No. 143:—
At the end of sub-section (2) to add a new paragraph as follows:—
(d) ground attached to a place of public worship.
I put down this amendment for the purpose of ensuring that where it is proposed to bury the body of a deceased person-in this case it would usually be the body of a deceased clergyman-in the grounds of a place of worship, there would be nothing in the Bill to prevent that from being done. As I read the section it would appear to restrict the burial of the body of a deceased parish priest in the grounds of his own chapel. I may be wrong in that. That is my reading of the section, unless, perhaps, under paragraph (b) they could apply to the Minister for permission. But it would be rather an irksome duty to have to apply for permission and the delay caused might be very inconvenient. There should be no objection to the burial of a deceased clergyman in the grounds of his own place of worship. It is not likely that the ground would be used for the interment of anybody else. Therefore, I think there could be no objection to the amendment.
The amendment as set out could not be accepted, for very obvious reasons. Section 92 provides that a person shall not bury the body of a deceased person in a place which is not a burial ground for the purposes of this section and in sub-section (2) it is set out that the following (and no other) places shall be burial grounds for the purposes of this section: a place which is in lawful use as a burial ground and which was, immediately before the commencement of this section, in lawful use as a burial ground, etc., and then, in paragraph (c), a burial ground provided by a burial board. Now Deputy Cogan suggests "ground attached to a place of public worship". The particular difficulty that Deputy Cogan anticipates might require some examination. Of course, it is not intended that the right of burial of clergymen within the church should be interfered with.
If that is not safeguarded in the section, I am quite prepared to safeguard that in an amendment. But the Deputy's proposal would authorise the burial of a deceased person in any ground attached to a place of public worship. That could not be permitted, for the reason that burial grounds have to be selected in the light of certain considerations as to soil, drainage, suitability, and so on; so that the ground attached to a place of worship is not necessarily ground that could be recognised as a suitable burial ground from the point of view of sanitation and various other things. If the limited point which the Deputy has in mind is not met in the section, I will meet it on the Report Stage.
I am satisfied with that. I should like to point out that it has been customary to bury clergymen in their own chapels, but I think the custom now is to bury them somewhere in the chapel yard. There is no tendency at present to use chapel yards for other interments. If they have been so used in the past, I think it is not customary now, and that the ecclesiastical authorities do not approve of it.
I will look into the matter anyhow.
I hope that the Parliamentary Secretary will not take the parish priest or curates of a parish alone into consideration, because very often a curate in another district is buried in the church or chapel yard of his native parish. I know of an instance where that happened in my own district.
We would not restrict or interfere in that at all.
Having to apply to the Minister for permission would be carrying the matter rather too far.
I would not want that.
I want to bring to the notice of the Parliamentary Secretary a rather unusual case. In the neighbouring parish to that in which I live there are the ruins of an old church and within the walls of that old church two or three families have been buried, perhaps for sentimental reasons. They got the permission of the parish priest to be buried there, probably because in former years some priest was buried there and they wanted to be buried near him. Would the relatives of these people be prevented under this section from being buried there?
I think the case mentioned would come under sub-section (2) (a):—
"a place which is in lawful use as a burial ground and which was, immediately before the commencement of this section, in lawful use as a burial ground."
It is not a recognised burial ground.
It is in lawful use. When it is in lawful use it is all right. At the present time there is no statutory prohibition on burying human remains anywhere. That is an interesting fact, but a fact just the same. That is the reason why this was specifically brought out here. Remains can be buried in the back garden within the law at the present time. It is that position which we have set out to remedy.
Is this the only section in any Act——
That definitely provides that human remains can only be buried in certain recognised places?
Which deals with burial grounds and graveyards?
We have a lot of other laws dealing with graveyards and all that.
I would appeal to the Parliamentary Secretary to see if he could do anything to remove a stigma which attaches to some burial grounds in which the poor have to be interred, and which are commonly known as "the Bully's Acre". We have them in many towns in this country. I think the time has come when the Government should take steps to remove that stigma from such burial grounds. They were established during the period of the clearances. That stigma still remains. Unless a poor person has relatives who can afford the cost of a burial in an ordinary burial ground, that person must be buried in "the Bully's Acre". I think we should have more respect for our poor people than to have that stigma attaching to them.
That does not exist in any place except Drogheda.
It does. Is there power under this Bill or any Act to acquire additional ground for the purpose of a cemetery?
There is power of course within the existing public health and sanitary law.
Amendment, by leave, withdrawn.
Amendment No. 144 not moved.
Section put and agreed to.
Section 93 agreed to.
Amendment No. 145 not moved.
Section 94 agreed to.
SECTION 95.
Amendments Nos. 146 and 147 not moved.
Question proposed: "That Section 95 stand part of the Bill."
I should like to ask the Parliamentary Secretary to explain the purpose of this section under which the Minister may make regulations relating to the burial of bodies of deceased persons and to the disposal of such bodies otherwise than by burial. I did not think that there was any legal manner in which a human body could be disposed of in this country otherwise than by burial. I did not know that we had anything in the nature of gas chambers or crematoria or anything like that. I do not think this section as it stands ought to be accepted without some explanation as to its necessity. The section sets out to provide regulations for the disposal of human bodies. Apparently regulations are contemplated under which human bodies could be disposed of otherwise than by burial. If it is proposed to provide for some other system of disposing of human bodies by burning or otherwise, we want to know what the section is all about.
Is this a new provision or merely a continuation of an old provision?
It is a new provision. The object of the section, as must be apparent to Deputies who have read it, is to provide control of the disposal of bodies other than by burial. Cremation of human remains has in recent years found favour with a limited number of people in other countries, but there has been no demand for it up to the present in this country. Such a demand may arise in future, but there is no law dealing with the matter and it seems desirable to provide statutory powers to enable such procedure to be controlled. The regulations under Section 95 (2) would prohibit such procedure unless when carried out under licence issued by the Minister and under approved conditions. At present, as Deputies are aware, we have no statutory power to regulate the manner of disposal of cremated remains or human ashes. It has not arisen here from within, but it sometimes does occur, and is liable to occur in the future, that people who die in other countries might direct that their ashes be sent over to this country for disposal. In such a contingency, it seems desirable that there should be some control of the manner and method of disposal.
I do not think that anybody in the House has any desire to enter into a discussion from the ethical aspect, but we must arm ourselves with some power, if human ashes are sent to this country to be blown to the four winds of the earth, to prescribe the conditions under which such may be done, if we agree to allow it to be done at all. This does not authorise cremation, but it does provide that the Minister may make regulations in relation to the disposal of the bodies of deceased persons, otherwise than by burial. It may be said that, from the public health point of view, cremated remains are not a danger, and, on that particular aspect, I would have to confess that, following cremation properly carried out, the ashes themselves would not be a danger to the public health, but there are other factors to be considered. There are Deputies, I think, who, while they might not concern themselves very much with whether the relatives of a deceased person thought well to cremate the remains, might concern themselves somewhat if there was a danger or a likelihood that the ashes would be blown in through their dining room windows. That is the consideration behind this section. I think it is a necessary provision. It does not, of itself, authorise or recognise cremation, but it does arm us with powers to say something about it if human remains are cremated and it is proposed to distribute them in this country.
Is cremation legal in this country?
Major de Valelra
No.
This does not make it legal.
What will be the position in relation to a person who dies and who leaves instructions that his body is to be buried at sea?
If it is outside the three-mile limit, we could not claim jurisdiction.
Major de Valera
As I understand it, there is a certain amount of indefiniteness about the law relating to the disposal of bodies and the Parliamentary Secretary aims at providing something more explicit. In principle, we will all have to support him in this, and Deputies will agree that it is absolutely necessary that the disposal of bodies be controlled in such a way as will make it a regular public matter—that all precautions must be taken to guard against abuse in the matter of the disposal of bodies or secrecy in the disposal of bodies.
Or disrespect.
Major de Valera
Or disrespect. Everybody will agree that whatever disposal of bodies is to take place should be a public affair and should be in accordance with the accepted moral views of the community. I think it is to provide fundamentally for that that the Parliamentary Secretary has put in this section. There is also the factor that if loopholes are left in the law relating to the disposal of bodies certain facilities are afforded to people who wish to kill. From the homicide point of view, it is obviously desirable to have very public and very definite control of the disposal of bodies, because murders could take place which could not be dealt with adequately if there were not control of the disposal of bodies. That, in fact, is behind such things as the registration of death, inquests and so on, and this is merely designed to fill a loophole in the law.
That is right.
Major de Valera
There is only one other matter I want to refer to in relation to this section and I regret that the amendment to this section and the previous section has not been moved, as I think we should discuss it. It is the question of summary conviction. The amendment is not before us and I cannot move it, but I should like to ask if the Parliamentary Secretary has considered the desirability of treating these matters as so serious as to warrant their being made indictable offences. I merely ask the question as to whether he has considered the point with regard to dealing with these offences, when it is in the public interest to secure the maximum formality and publicity, by proceding by way of indictment rather than summarily. I am sure the Parliamentary Secretary has considered it as an amendment on the point as tabled, but I should be interested to hear his attitude. It is merely a simple question; I am not urging it one way or the other; but it is a matter which we might have discussed if the gentleman who put down the amendment had moved it.
Dealing with the matter of courts of summary jurisdiction, we have, as the Deputy, I am sure, is aware, met this particular type of amendment several times throughout the Committee Stage. The amendment set out, amendment No. 147, has been repeated some 26 times or so——
Twenty-nine times.
——throughout the amendments. We had, at least, two discussions on the question— not very detailed. The issues which were raised were largely of a constitutional nature. Not considering myself competent to express a firm view on a purely constitutional question, I approached it merely from the point of view of a layman in matters of law. Deputy McGilligan, and Deputy Costello, to a lesser extent, advanced the interesting thesis that we are acting unconstitutionally by putting various types of offences carrying heavy penalties—in one case up to £500 and in many cases up to £100, with an accompanying period of imprisonment—into the courts of summary jurisdiction to be disposed of. That thesis is founded on the assumption that the courts of summary jurisdiction can, under our Constitution, deal only with minor offences. What constitutes a minor offence is a matter in respect of which constitutional lawyers will have to engage themselves. When this matter was raised by Deputies McGilligan and Costello, it seemed to me that, if we were acting unconstitutionally in this regard in the provisions of this Bill, we were acting unconstitutionally in many corresponding matters. It suggested itself to me that the test as to whether an offence was a major offence or a minor offence could only be properly measured in relation to the penalty imposed. That conception may be altogether wrong, as it is not the conception of a lawyer. Corresponding types of offence under various enactments—the Therapeutic Substances Act, the Road Traffic Act and various customs and excise regulations — carrying corresponding penalties, and in many cases greater penalties, have invariably been dealt with in the courts of summary jurisdiction. Consequently, if the test is to be the penalty that the offence carries with it, it seems to me that it is appropriate that the offences contemplated under this Bill should be deemed to be minor offences. I do not know what the constitutional lawyers will say about that layman's thesis on a constitutional matter. I undertook in the course of the discussion to have this matter fully examined with a view to making on Report Stage an authoritative statement, as advised by the legal advisers to the Government.
Major de Valera
I did not wish to put the Parliamentary Secretary to the trouble of giving us what I may describe as the theoretical view. I take it that, notwithstanding that the matter arises so many times, a question of this sort is one for individual decision in respect of each offence. The approach I take is that you decide, in the first place, whether the offence is so serious as to warrant the more formal and rigorous procedure or whether it is so relatively trivial that it should be a matter for summary jurisdiction. The next question would, then, be the penalty. I may have misunderstood the Parliamentary Secretary. I do not agree that one fixes the penalty first and then decides whether the offence is minor or major. I take this opportunity of saying that there may be a tendency in modern times, in all countries, to resort to summary jurisdiction too readily in the case of certain offences. I think that we should guard against that.
The raising of this point is, I think, appropriate to the question before us. I do not want to digress any more than the Parliamentary Secretary on the question of the Constitution and the courts. Examine the provisions under which district justices are appointed, the relative power which the Executive has over them, their status before the law and take, in conjunction with that, the judicial functions you are assigning to them. In modern times, there is a tendency to refer too many serious matters to that court, to the exclusion of the higher tribunals. In the interest of the State, as a whole, we should be careful that the jurisdiction of the higher courts—the Circuit Court and the Central Criminal Court—are not frittered away as multitudinous enactments bring in more crimes and as, what I might call, the fashionable crimes increase and the crimes prevalent in other days decrease. That is the net point. Since the Parliamentary Secretary does not propose to accept the amendment on the paper, I take it that he does not consider this particular offence to be of so serious a nature as would warrant indictment. I accept his answer on that but, in other cases, the broader question I referred to would arise.
Section 95 agreed to.
SECTION 96.
I move amendment No. 148:—
In line 36, to delete the word "appoint" and substitute the words "appoint or provide".
This amendment is designed to enable a sanitary authority to use, if necessary, the services of a nurse employed by any existing nursing organisation in their district.
Amendment agreed to.
Amendment No. 149 not moved.
On the section, I should like to call the attention of the Parliamentary Secretary to the position that exists in the western portion of my constituency. There are five jubilee nurses there. They are serving a congested district. The matter has been already placed before the Parliamentary Secretary but his answer did not completely satisfy some people, because I have some letters about it. These nurses are known in our district as jubilee and Lady Dudley nurses. Portion of their salary is paid by local subscription. That is in the Castletownsend area. Part of the salary is paid by the Somerville Trust. A legacy was, I think, left for that purpose. Contributions are made by the local sports committee, by the Local Government Department, by the West Cork Board of Health and the tuberculosis committee. I should like to know what the position of those nurses will be. I should also like to know what the position of the local committees will be and what the position of the institutions responsible for the nurses—the Lady Dudley Nursing Home and the Saint Lawrence Hospital-will be.
I am aware that these nurses have done good work in the congested districts. They have given advice to expectant mothers; they have visited homes after the births of children, and given advice and instruction to mothers as to how to treat their children in a proper and necessary manner. They have also given free advice and assistance to poor people, to aged people and to people who were sick in their homes and so often avoided the necessity of sending these people to already overcrowded hospitals. I am anxious to know what the position of these nurses will be in future, so far as payment is concerned. I expect that the nurses will be absorbed in the scheme to be operated under the Bill owing to the great scarcity of nurses at present, but I should like to know will the position be much different from the present position? Will the local committees be recognised, or will the nursing institutions which were responsible for the introduction of these very efficient nurses who have done an immense of good in very poor districts, have any status? One of these nurses is stationed at Castletownsend, another in Glengariff, another in Cape Clear Island, another in Adrigole and another in Castletownbere. I would be grateful if the Parliamentary Secretary would give some indication as to the future position of these nurses and if necessary introduce such amendments as might be needed on the Report Stage to secure the position of these nurses.
I should like to support the plea made by Deputy O'Driscoll. These nurses are doing magnificent work.
I move to report progress.
Progress reported; Committee to sit again.