It is regrettable that the Deputies who are opposed to Section 12 seem to be so, not merely from a lack of full information as to the background to this section, but from a misconception of its purpose. I am sorry that when Deputy McCann, chairman of the Select Committee, was speaking last night, he did not take more time to explain, particularly to fellow Deputies of his own Party, the background to this section and the approach which brought the Bill in its present form before the House.
We are dealing here, not with the problems of members of the medical profession or of members of the joint committee. When this Bill came before the House on Second Reading, the House, as part of the law-making machinery of this country, saw fit to adopt the principle embodied in the long title to the Bill, namely, that it was necessary and desirable to provide suitable machinery for the constitution of the governing committee of this hospital.
The manner in which the House received the Bill on Second Reading was a compliment to the House and to the Deputies. The Bill was approached solely on the basis that we were dealing here with an institution which exists primarily, not for the benefit of the medical profession, or the members of any joint committee, or administrators of a hospital, but for the purpose of the treatment and care of sick people and that, therefore, the sole concern of the House was to ensure that that hospital, that centre of medical treatment for sick people, would be provided not with the personnel of a joint committee, but with the machinery whereby a committee could be provided which would be suitable to the high purpose of the institution. No member of the House, on Second Reading, had any regard to the background of this whole matter; but solely concerned himself with the question that we are dealing here, not merely with a hospital, but with a public hospital whose area of responsibility extends over the whole of the Twenty-Six Counties, whose existence and future is dependent on public moneys and whose sole purpose is the treatment and care of the sick.
The House referred the Bill to a Select Committee representative not merely of all Parties in the House but of all non-Party groups as well. Those of us who served on that Select Committee found that the atmosphere was a happy one and an unusual one in the sense that all of the matters that came before the Select Committee were decided, almost without exception, by a unanimous decision. From the first meeting of that committee, it was unanimously decided that the responsibility handed to us by this House was to confine ourselves exclusively to the problem of providing by way of the Bill the most suitable and the most acceptable type of machinery for the carrying on of the government of the hospital.
When, on the completion of the Second Reading of the Bill by this House, that became publicly known, especially to all parties interested in and concerned with the Meath Hospital, and the progress of the Bill through the House, it must have become equally apparent to those parties that this House, as part of the law-making machinery of the community and also as one of the highest representative public bodies in the community, had passed judgment, not on the personnel of the existing joint committee or on its legality, but on the desirability of providing a more suitable and more acceptable type of machinery for the provision of the governing committee of the hospital.
The members who submitted the amendment which is now embodied in Section 12—and again it is well to stress that the supporters of that amendment were drawn from all Parties and all shades of opinion—had in mind that, the Dáil having indicated its opinion upon the principle, if, as had been indicated by the decision on Second Reading, there was going to be provided machinery which, in the mind of the members of the corporate body of the Oireachtas, was a suitable and a preferable type of machinery for the provision of the governing body of the hospital, it was not merely a question of public interest, but a matter of courtesy to this House, that nothing should be done which would create a new and drastically changed situation from the time when that decision upon principle was taken until such time as the new governing body would be elected in accordance with the machinery finally decided upon by the Oireachtas.
In that they were actuated by their concern, not merely to avoid becoming embroiled in the general atmosphere that had surrounded the hospital for some time, but to confine themselves to the terms of reference given to them by the House and to discharge the responsibility that had been placed upon them. It was, therefore, from that point of view that the amendment was submitted. Not merely was the amendment submitted by a group of members of the Select Committee which was representative of all shades of opinion in the House, but the amendment was adopted by a unanimous decision of the Select Committee. Therefore, when the amendment is examined, it should be examined not in the light of special pleading for any group or any individual who may be affected in any way by its operation, but it should be examined in relation to the principle underlying it and the purpose for which it was put forward and adopted by the Select Committee.
That is the background in so far as the section is concerned. When we examine the amendment itself, we will recollect that it has already been pointed out that what in effect is proposed by the section is that a joint committee will be elected by the machinery finally decided upon by the Oireachtas and embodied in legislation. More important still is the fact that the machinery now set out represents a fundamental, a basic change from the machinery already provided in the Bill on the occasion of its First Reading.
It has been emphasised that this is not merely a hospital, that it is a public hospital dependent on public funds and able to continue only to the extent that it is provided for by public funds. The viewpoint of members who are interested in the Bill and the viewpoint now before the House in the form of the report of the Select Committee is that the decisive authority should repose in the representatives of public authorities who, by their representative character, have been charged with speaking—and they are entitled to speak on behalf of the public—not merely as individual representatives, but as the representatives of large and most important corporate bodies. These are the representative type—whoever the individuals may be is another matter—who, when the Bill becomes law, will be charged with the major authority under the new joint committee.
To suggest that men and women of such a representative character will concern themselves with anything but the primary purpose of the hospital— that is, the welfare of the patients—is unfair and is contrary to the whole experience of the manner in which members of public authorities discharge their particular functions.
In so far as the powers proposed to be given to them under Section 12 are concerned, it has been indicated that they are permissive. Does any Deputy suggest that in respect of appointments—and I have in mind the particular appointments that have already been made—the power given under Section 12 is to be used by representative public men and women, sitting on the joint committee, not merely in their individual capacity, but as representing corporate bodies from whom they have been selected, is going to be used in an arbitrary fashion, in an unfair fashion or in a manner that will be harmful to the main purpose of the hospital, which is the welfare of the patients?
It must be remembered that appointments do not consist merely of the appointment of individuals to particular posts. A hospital is a machine; it may be an efficient or an inefficient machine—that is a matter to be determined by those charged with the government of the hospital. The government of the hospital, in so far as this Bill is concerned, is intended to be vested primarily in the hands of those public representatives who will sit on the committee, duly advised and guided by experts who are members of the medical profession. But the final authority will lie with the members of the joint committee, and from that point of view they must have regard, not merely to existing or future appointments, but to the administrative side and the medical system which is represented by those appointed. Changes in appointments, or additions to appointments, may not merely raise the question of the professional qualifications of the appointees, but may, in fact, raise the question of drastic and fundamental changes in the administration and in the medical practice.
It is sufficient for those who support the section that the Dáil has decided on the principle that it is desirable to provide better and more acceptable machinery in respect of the government of this hospital, and it is only fair that those who will be charged as public representatives, under the machinery devised by the Oireachtas, with the responsibility of carrying on the hospital, should not be hampered or interfered with, but should be given a completely unqualified opportunity of making their decisions in regard to maintenance or the changes they desire in the existing administration or the medical practice of the hospital; in other words, that it is desirable that the Dáil, having given attention to this matter, should see to it that the status quo is maintained until a new joint committee arising out of the machinery provided in this measure has taken up office. Whether that is a reasonable point of view or not is a matter that can be discussed. It is not an unfair point of view; it has no ulterior purpose and it is in keeping with, and fully justified by, the decision of the Dáil on the Second Reading. It is represented by the section as it now stands.
It has been indicated that the section is permissive. I have no doubt that, in so far as the gentlemen who have been appointed are concerned, no question, so far as I can see as a layman, can arise in regard to their medical qualifications. Why there should be this special pleading, I fail to understand. The only question that could conceivably arise, and it is a matter for the new joint committee, is the final overriding question as to what extent the changes that have taken place, the appointments, are for the ultimate benefit of the sick people who will have to be treated in the hospital.
On that aspect, I feel that if we, as the Dáil, are of the opinion that the changes are desirable—the machinery to constitute the joint committee—we should equally have faith in this, that the machinery we are providing is going to produce a joint committee of men and women who will accept their fundamental responsibility to the patients and place that above all other considerations. If they do that, there can be no doubt and no nervousness on the part of any individual, whether he be a lay administrator or a member of the medical profession, that if he has the qualifications and competency to discharge his responsibility to the patients, he will not be in any jeopardy.
That, I think, is the most important aspect of this section. Listening to the viewpoints expressed in opposition to the section, I was somewhat concerned with the high level on which the House dealt with the Bill on Second Reading, and the high level at which the Select Committee considered it and were able to arrive at a unanimous expression of opinion. They brought back to the House a Bill which clearly sets out the purpose and the principle which this House approved and had in mind on the Second Reading, and it would be regrettable if we were to step down a little from that high level. I think it is important to note that the Deputies from all sides of the House who so far have spoken in opposition to the Bill——