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Dáil Éireann debate -
Wednesday, 6 Dec 1950

Vol. 123 No. 11

Meath Hospital Bill, 1950—Second Stage.

I move that the Bill be now read a Second Time. The Meath Hospital is one of the oldest, and in some respects, one of the most famous medical institutions in Dublin. Originally it was opened on the Coombe in 1753, where it was intended to afford medical assistance to the working population in that neighbourhood. It was moved to Skinner's Alley in 1757; to Meath Street in 1760 and to Earl Street in 1766. In 1770 the erection of a new building was commenced which now forms part of the Coombe Lying-in Hospital. In 1774 another hospital was erected by private subscriptions of £2,000, which served as the county infirmary and since 1867 financial grants have been made to the hospital by the Dublin Corporation. In 1816, the present site in Heytesbury Street was taken. It formerly belonged to Dean Swift and was called the Dean's Vineyard. On the 24th December, 1882, the present hospital was opened and £6,000 towards the cost of the building was a gift from a Thomas Pleasants. The County Dublin granted £5,000 and donations and subscriptions defrayed the balance of the building expenses. Since that date, 1882, the hospital has continued to serve the sick poor of Dublin unceasingly and the generations of students and nurses who have passed through its wards have brought the medical fame of Dublin and of the Meath Hospital throughout the length and breadth of the civilised world.

Looking back over the work of those who gave their services to the various Dublin hospitals, under conditions far different from those of to-day, I consider that we must record our keen appreciation of the services rendered. Some of the leading men of the then famous Old Dublin School of Medicine were attached to the Meath Hospital. Sir Philip Crampton, William Stokes, R.J. Graves and John Cheyne were amongst the many who served on the staff with distinction. The first member of the illustrious Stokes family to become associated with the hospital was Whitley Stokes, who was appointed physician to the hospital in the year 1818. He it was of whom Wolfe Tone wrote: "He was the very best man that I have ever known." Apart from his medical career, he was a prominent member of the United Irishmen prior to 1792. His more famous son, William Stokes, was attached to the hospital from 1826 to 1875, and he, together with his colleague, Robert Graves, first instituted the system of clinical instruction at the bedside, which revolutionised medical teaching throughout the world and brought well-merited fame, not only to the Dublin School of Medicine but to the Meath Hospital. It may indeed be said that Stokes laid the solid foundations for all our present knowledge of the heart, while Graves was the father of all modern glandular therapy.

In more recent years the Meath Hospital has not failed to keep its position in the forefront of Dublin medicine and, together with St. Laurence's Hospital, was amongst the first of the Dublin institutions to start intensive specialisation within it walls. It would be impossible to enumerate in detail the development of the Meath Hospital throughout the years, but the hospital has invariably been at the disposal of the sick poor of Dublin, and to-day I am pleased to record that the tradition of this hospital, in the matter of medical science, has been very definitely maintained by a fully qualified medical staff specialising in various treatments.

No provision was made in the Act of 1816 for a register of electors, that is of Governors or Governesses. This omission is rectified in the Bill. Under the Act of 1816 payment of a subscription of £2 2s. 0d. immediately prior to the annual meeting—and it might be that the payment of £2 2s. 0d. was made while the annual meeting was in progress—qualified the subscriber to vote for the election of members who would act during the year as the committee controlling the hospital. Originally, and down to the passing of the Local Government Act, 1898, it was prescribed that an annual general meeting should be held at which the election of the joint committee members took place. By an Order under the Act of 1898 the election of the joint committee was ordered to take place triennially. It might be that a person to qualify as a governor and to be entitled to vote, might subscribe £2 2s. 0d. only in the year of the election provided the subscription was paid prior to the date of the election.

There is no provision for holding a ballot under the law at present. This Bill provides:

"(1) That a person to be qualified as an elector for the control of the hospital must have contributed since 1944 £10 10s. 0d. to the hospital;

(2) that a register of electors be compiled and that a person must be qualified to vote;

(3) that each elector gets an opportunity of registering his vote by post."

Two prohibitions in the Act of 1816 are repealed—the limitation regarding acquisition of land and the exclusion of graduates of any medical school other than the College of Surgeons and Physicians. There may be some difference of opinion amongst Deputies regarding some sections of the Bill, notably that requiring the payment of a £10 subscription, but I think that whatever little difficulties present themselves in that way will be overcome during the Committee Stages.

I formally second the motion.

I move the amendment standing in my name:—

To delete the word "now" and add at the end of the motion the words "this day twelve months."

The amendment was tabled by me at a time when the affairs of the Meath Hospital and the method of government of that hospital were the subject matter of an action in prospect before our courts. Because I felt that it was undesirable that matters which were to be dealt with and issues which were to be decided by the courts should be the subject matter, even at one stage removed, of legislation by this House, I tabled the amendment which stands in my name.

The fact that the court of first instance has dealt with the matters which were argued before it does not essentially change my approach to this Bill. I am not in a position to say to the House that the courts will not be further troubled with the issues which separate the two disputing sets of controversialists who contend for control over the Meath Hospital. I am not in a position to say definitely to the House that the matter is finished as far as the courts are concerned. That is something upon which, perhaps, the sponsors of the Bill might be in a better position to enlighten us. What I do feel is that it is improper that the time of this House should be taken up for the purpose of giving, or attempting to give, legislative sanction and the sanction of this House to the view held by one particular set of disputants for control of this hospital. I have no views as to the rights or wrongs of the matters in dispute, but I do feel that it is not by the introduction of a Private Members' Bill before the Dáil that the issues which separate them can best be determined, particularly when we are so close to the situation which gave rise to the recent litigation, so close to the situation in which the two parties to this dispute have been locked in contentious argument.

I would urge on the sponsors of this Bill that the proper course for them to adopt is to withdraw this Bill for a period of 12 months. I would hope that, before that period would have elapsed, the Minister for Health would have come into this House with his definite and concrete proposals as to the future government and management of this hospital.

I think I can say without fear of correction that all Dublin Deputies and Deputies from constituencies other than Dublin constituencies realise the very splendid and excellent work that has been done by this institution and by the very eminent medical men who have been associated with it both in the recent past and in the more distant past. I would urge as strongly as I can on Deputy Doyle, who sponsors this Bill, and upon Deputy O'Higgins, who seconds it, that if they have at heart the proper government and proper management of this hospital, in the interests of the plain, ordinary citizens of this city, it is unwise for them to come into this House as partisans in a dispute and to ask this House, in effect, to take sides in that dispute, because that, I suggest, is the effect of the Bill.

I do not think that this House should be asked to take sides in that dispute. I would hope, if they took the course which I suggest to them, that within the period mentioned in the amendment, namely, a period of 12 months, the Minister for Health would bring before the Dáil definite and concrete proposals as to the future government and management of the hospital, in the interests of the citizens.

Retrospective legislation or legislation intended to achieve a setting aside, as it were, of the decision of a court, is something which this House should not view with approval. I believe that I am not unfair in suggesting to the House that the present measure could come within that category. Do not ask Deputies to take sides in this dispute. Do not seek to deal with what is a matter for the Department of Health, for the Minister for Health. Do not seek to deal with that by a Private Members' Bill. Let the appropriate Minister come before the House with his proposals. Do not ask Deputies to come down on one side as partisans in a dispute between two groups of private citizens, both of whom, I am sure, are animated by the most unselfish and highest possible ideals.

Deputy Lehane has laid emphasis on the fact that the effect of the Bill which is now before the House might be that it would be taken as an action operating against a decision of the courts. In that respect, may I say I think it is desirable that it should be pointed out that this Bill was introduced into the House before the case actually came before the courts? So far as my personal view goes, and I have no hesitation in expressing it, I would say that the action of the people concerned in bringing a matter into the courts when a Bill had been submitted in this House was unwise; I say very definitely it was an unwise course to adopt. But the matter did proceed along those lines, and may I put it to Deputy Lehane, as one who understands the position of governors in a hospital in this city, that he is extremely innocent if he expects that because the court has given a particular decision, the administration of the particular hospital concerned is going to be along lines that everybody desires? I do not think so. My experience is against it, and my knowledge of the facts would be completely against it.

I can envisage what might happen if the matter is left where it is, and in order that the House may understand where it is, may I put this point of view, that in all the voluntary hospitals, and this Bill might serve as a pattern or headline for most, if not all of them, so far as their meetings and the election of governors would be concerned there is no franchise that can be easily distinguished; there are no standing orders and very little in so far as procedure is concerned. I put it to Deputy Lehane that what might happen at the next general election, if matters remain as they are, is something along the lines of what our sports writers are wont to say; there will be a clash of styles at that particular meeting, to put it mildly, and medical interests and the interests of the poor are bound to suffer in consequence.

This Bill very properly purports to lay down a franchise that will be recognised. Certain qualifications will have to be obtained and due notice of an election, with the names of the candidates, will have to be circulated. All that will give an opportunity to those interested in the welfare of the hospital to know what is going to happen and the type of people they are called upon to represent. I am authorised to say this on behalf of my colleagues.

Strange though it may seem, there are two weaknesses in this Bill. One is in connection with what might be termed a penal clause relating to the qualifications. I can say that will be altered in Committee. It is open to any member to do so, if the members responsible for the Bill will not already have done so, in order to ensure that it will be brought more into line with what might be regarded as the accepted procedure in a House like this.

There is a second point, and that is again one that I understand my colleagues have agreed on. It will be amended in Committee. It is this, that the representation of the hospital will be brought on a more acceptable scale than even the Bill proposes. My experience in hospitals of this character where you have in relation to governors something that changes from year to year is this, that the hospital is likely to suffer from the point of view of continuity of policy. I can very well envisage that if the position of the Meath Hospital remains as it is, you may very well have a perpetuation of that state of affairs. The solution to me, and it is a view shared by my colleagues, is that there should be a broader representation of the local authorities. I think nobody will object to that. You have types of people coming from the local authorities who are representatives of all sections and in themselves they form the continuity so far as policy is concerned.

The men sponsoring the Bill will be prepared to accept in Committee an amendment suggesting a broader representation so far as the Dublin Corporation is concerned and so far as the Dublin County Council is concerned. It must be remembered that this hospital is doing a remarkable amount of work for local authorities throughout the country. We will be open in Committee to consider an amendment that representatives might be accepted from the general council of county councils. With an improvement of that character, I suggest that the objections of Deputy Lehane might be removed. You will have a better understanding and you will have a feeling of confidence.

As regards the people who are responsible for the hospital, there is one gentleman—I presume it would not be right to mention his name—whose lifework is known with gratitude and appreciation, not alone throughout this country but in other countries as well. This Bill will enable a committee of that character to ensure that they will have the services of a surgeon of that type. I appeal to those who may feel that there is anything in the nature of partisanship in this Bill to put that idea out of their minds. I say there is not. The aim that inspired us to move the Bill was to ensure that the Meath Hospital and the people it serves, not only the poor of Dublin, but the poor of the county, will have the best service that can be placed at their disposal.

I want to assure the House that what Deputy O'Sullivan has said represents exactly my own view. I agree with the objections to which he has referred. I hope that in Committee we will be able to decide upon a broader representation, and that we can meet those who may object on the question of the annual subscription. My approach and the approach of the other sponsors of the Bill is simply this, that we want to see the Meath Hospital run as efficiently as possible. As Deputy Doyle mentioned in the course of his remarks, the Meath Hospital has a very old tradition. It has a splendid tradition in relation to surgery and medicine, and a fine reputation in relation to its service to the poor.

We believe that this Bill is necessary. I do not for one moment want to refer to the recent law case. I do not think that that matter arises. I have thought for a considerable time that a Bill of this kind is needed. The Meath Hospital is more than a Dublin institution; it is a national institution. Consequently, I feel that when we are amending this Bill in Committee there might be representation provided for, say, the general council of county councils on account of the contributions which come from the various boards of health throughout the country. These are briefly my reasons for supporting the Bill. On the Committee Stage, when amendments are tabled, I will have an opportunity perhaps to make some other remarks in relation to the Bill.

I think Deputy Martin O'Sullivan and Deputy McCann have adequately met the points raised by Deputy Lehane. I do not think I need delay the House very much further in regard to this measure, but I appeal to Deputies to give it a Second Reading.

Is Deputy Lehane pressing his amendment?

In view of the remarks of Deputy Martin O'Sullivan, I do not propose to press the amendment on the House. However, I should like to know from Deputy O'Sullivan or Deputy Doyle, through the Chair, if the sponsors would be prepared to accept an amendment of Section 3 (1) (d)—that is, as to the number of elected members?

That is a matter that could be considered more appropriately on the Committee Stage.

Amendment, by leave, withdrawn.
Question—"That the Bill be now read a Second Time"—put and agreed to.

I move that the Meath Hospital Bill, 1950, be referred to a Select Committee, consisting of 15 members, with powers to send for persons, papers and records, the committee to be nominated by the Committee of Selection; that the quorum of the committee be six; that the first meeting of the committee be held on the 14th December, 1950.