Dáil Éireann debate -
Thursday, 25 Jun 1953

Vol. 139 No. 14

Health Bill, 1952—Committee (Resumed)

Debate resumed on amendment No. 55.

Dr. Esmonde

I want to question the Minister again as to the personnel of the consultative and advisory council. He agreed that not less than half should be nominated. The Bill says:—

"Not less than half of the persons who are appointed to be members of the National Health Council shall be appointed by the Minister on nominations of bodies which, in the opinion of the Minister, are representative of the medical and ancillary professions (including particular branches thereof) and of persons concerned with the management of voluntary hospitals."

On further discussion this morning, the question was mentioned by Deputy Kyne as to whether there would be trade union representation. I then asked the Minister if that was proposed and the Minister, I think, agreed with that. It was agreed that those representatives other than the medical and ancillary professions would be the elected voice of that particular representation. I have been looking through this amendment and the Principal Act in the interval. The Minister said that would be the case, but I cannot find anything in this to substantiate it.

It says: "Not less than half of the persons ... shall be ... representative of the medical and ancillary professions ...." I do not say the Minister will do this, but there is nothing to stop him appointing as the other half Custom House officials. There is nothing in this to suggest that the other half of the council will be representative of anybody. There does not seem to be brought out clearly here the idea Deputy Kyne mentioned regarding trade union officials. I would think it desirableto have someone representative of business interests, possibly the chambers of commerce, and other societies might be represented also. There is nothing in this amendment to show that that is the intended programme.

Dr. Ryan

No, there is not.

Dr. Esmonde

The answer the Minister gave this morning, with the best will in the world, was those elected would be representative of the interest concerned. There is nothing to guarantee that that will be so. It brings us back to the point that we have not got a clear picture of the personnel of this body. I place great stress on this council because, as I said this morning, I believe it will dispel all the friction there has been over the improvement of health services over the years here. It is necessary to have a clear picture as to how it is going to be formed. At present there is nothing to stop the Minister choosing Custom House officials. The medical and ancillary professions and those associated with the voluntary hospitals will constitute one half. The rest could be Custom House officials.

An Ceann Comhairle

Amendment No. 55.

Dr. Esmonde

I am sorry, Sir, there is another point, if the Minister does not care to answer the last one. Deputy Byrne raised it this morning also. In discussing the question of the report to be issued by this advisory council, it was agreed that it would be made available to Deputies. It would be possible to discuss it on the annual Estimate for Health, but that is only once a year. An occasion may arise in between in which the council may have advised the Minister on a certain point and it may have come to the notice of certain Deputies that they considered that a good point. Will it be possible for Deputies, if they raise this as a parliamentary question, to be referred back? Can the Minister say he has no function in the matter, one way or another? It should be possible to raise it in that way rather than wait until the Minister's Estimate comes around again.

If such is not the case, if the Minister does not see his way to accept this as being a reasonable proposition, it means that the Health Council could be in commission for a period of 12 months and we would have to wait for the result of their findings before the nation as a whole could develop.

Mr. Allen

Could you not write a letter to the paper?

Dr. Esmonde

The Deputy will agree that a Deputy's function is other than writing letters to the Press. Would the Deputy agree with that?

Dr. Ryan

If the Deputy has any point like that, or if he thinks the Minister unreasonable, he has only to put down a question and ask if it is true that such and such an opinion was given by the consultative council and the Minister has not accepted it. How can I say that is not my function? It is my function to listen to the advice, though free to accept or reject it, and the reasons can be given in the Dáil. All these consultative councils have been chosen by the Minister, in all the years since the State was set up, and this is the very first time in the case of any consultative council over the last 30 years—there are 40 or 50 of them going now, so hundreds must have been set up in that time—that it was ever laid down that even half would be chosen by another person. If we are going half way, it is far enough for the present; let the Minister choose the other half.

Dr. Esmonde

I appreciate what the Minister says, but in discussing this this morning the Minister intimated that he would be prepared—he cited a particular interest—to choose the nominee put forward to him by the trade unions. He said that, but that does not appear to be the actual fact now.

Dr. Ryan

Not by law. I said that the best way to judge what may be done in the future is to see what has been done in the past. I said it had been my practice—and I think it was the practice of every Minister—to get nominees from the various bodies concerned. We asked the Trade UnionCongress and the Congress of Irish Unions for nominees; we asked also the Association of Chambers of Commerce. That is how we got our people.

Dr. Esmonde

The Minister means he is giving his own personal guarantee, but he is not embodying it in legislation?

Dr. Ryan

I am giving the practice. There is no guarantee, because there is a difficulty. A difficulty has arisen about the trade unions and I do not know how to get over it, so I could not give a guarantee there. I do not want to bring that out now, as it would not improve matters to bring it out here.

Dr. Esmonde

I appreciate that the Minister is not giving a guarantee, but as far as possible——

Dr. Ryan

Yes, certainly, as far as possible.

Dr. Esmonde

Would the Minister not consider embodying it in legislation, so that we would have a democratically elected advisory health council?

Dr. Ryan

We are moving that way. Do not go too fast.

Amendment agreed to.

An Ceann Comhairle

This governs amendments Nos. 57, 58, 59, 60 and 61.

Dr. Ryan

I move amendment No. 56:—

Before Section 39 to insert a new section as follows:—

Section 103 of the Principal Act is hereby amended:—

(a) by the substitution of "the Minister" for "the Minister for Local Government" in sub-section (1), and

(b) by the addition to the section of the following sub-section:—

"(4) The amount standing at any particular time borrowed by a health authority under this section shall not exceed such sum as may be fixed in respectof that time for that health authority by an Order made by the Minister with the consent of the Minister for Local Government."

Since the Department of Health was set up, in laying down the division of the two Departments, Local Government and Health, certain powers were given to the Minister for Health and certain powers were retained by the Minister for Local Government.

Amongst the powers retained was the power of borrowing, which was retained entirely by the Minister for Local Government. Since then, of course, we have had time to consider the matter and both the Minister for Local Government and I agree that the sanctioning of borrowing for any particular item should be within the power of the Minister for Health, as he knows more about what a particular item may be and what the justification for it is. On the other hand, it would perhaps be dangerous to have two Ministers with power to authorise unlimited borrowing by the local authority. The compromise in this is that the Minister for Health must consult the Minister for Local Government in regard to the total amount of borrowing allowed to any local authority, but within that total the Minister for Health would have complete freedom with regard to the sanctioning of any particular project.

General Mulcahy

Does the Minister mean that he shall agree with the Minister for Local Government on the total amount of borrowing for health purposes?

Dr. Ryan

Yes.

General Mulcahy

And that the borrowing referred to here is borrowing covering the whole gamut of health services?

Dr. Ryan

Yes.

Dr. Browne

Does this proposal work in reverse? Does the Minister for Local Government have to refer his proposals in relation to borrowing to the Minister for Health? I do not feel very strongly about it, but why shouldthe Minister for Health have to defer to the Minister for Local Government in this matter and the Minister for Local Government not have to defer to the Minister for Health in relation to borrowing? Why should they not be independent? I presume this does not work in reverse, that the Minister for Local Government does not have to get the consent of the Minister for Health.

Dr. Ryan

I think that in theory and, I should say, in practice up to this, the Minister for Local Government is regarded as the Minister who keeps an eye on the general finances of the local authority. He deals with all these things with regard to rating, and so forth. He is supposed to watch the total indebtedness of the local council and, where necessary, to draw their attention that they are going too high. That principle is maintained—the principle that the Minister for Local Government should watch the general situation of the council. He would then have to agree with the Minister for Health with regard to the total burden that might be permitted for health purposes. I suppose that, logically, Deputy Dr. Browne is right in saying that the Minister for Local Government should consult the Minister for Health with regard to borrowing for local government purposes. The Minister for Local Government being there all the time as the guardian of local authorities in this respect, we think that perhaps that should remain.

General Mulcahy

Is the Minister for Local Government the auditing authority in relation to the health authority?

Dr. Ryan

Yes.

Amendment put and agreed to.

Amendments Nos. 57 to 61, inclusive, not moved.

Section 39, as amended, put and agreed to.

SECTION 40.

Question proposed: "That Section 40 stand part of the Bill."

Dr. Ryan

A case arose in one of the Dublin courts as to whether or not the local authority had power to prosecute. One side argued that they had the power and another side argued that they had not. In order to remove any doubts, the purpose of this section is to make it clear that the local authority have power to prosecute.

Question put and agreed to.

SECTION 41.

Amendments Nos. 62 and 63 not moved.

Mr. Larkin

I move amendment No. 64:—

Before Section 41 to insert a new section as follows:—

(1) A health authority shall, upon the coming into operation of any section of this Act, establish a health committee which shall perform such functions in respect of the provisions of this Act as the health authority may from time to time delegate to it.

(2) A health committee appointed under the preceding sub-section shall consist of the county manager, the medical officer of health for the county; the county surgeon; the matron of the county hospital and not less than eight members of the council of the county.

In the Minister's introductory speech on the Second Reading of this Bill, when explaining the approach to the question of devising an improved health scheme, the Minister dwelt very strongly on what he regarded as one of the outstanding features of the Government's scheme as embodied in the present Bill—that is, that the machinery to operate the Bill had been selected by the Government in the form of the democratic machinery of local government and that it was through that democratic machinery that it was proposed to operate the provisions of the Bill, when it became law.

The purpose of this amendment is to clothe the Minister's words in flesh and to give to what is, in effect, the only democratic form of local government—namely, the elected members of local authorities—the machinery not tooperate in detail the provisions of the Bill but to control and direct its general operation.

For that purpose, the amendment proposes that a health authority shall, upon the coming into operation of any section of this Act, establish a health committee which shall perform such functions in respect of the provisions of this Act as the health authority may from time to time delegate to it. The amendment then goes on to indicate the manner in which the health committee shall be appointed:

"A health committee appointed under the preceding sub-section shall consist of the county manager, the medical officer of health for the county, the county surgeon, the matron of the county hospital and not less than eight members of the council of the county."

From the point of view of the health code, two factors, to our minds, arise. The first factor is that, no matter how good a code of health legislation may be, if it is to operate for the utmost benefit of the citizens, it must have a humane atmosphere and it must be removed as far as possible from what we generally regard as the cold-blooded routine approach of permanent officials.

It is true that, in local government, as far as the localities are concerned, we have two divisions of authority. We have the county manager, with the powers given to him by the Managerial Act, and we have the elected representatives. The general experience is that, in so far as the functioning of local government is concerned, from the point of view of the ratepayers and the citizens, the closest and the most direct approach between the citizens and the ratepayers is that between them and their elected representatives. While accepting, for the sake of argument, the argument in favour of the retention of the county manager, it still remains that the purpose of the county manager is to ensure efficient administration, but that the purpose of the elected representatives is to afford the ratepayers and the citizens in their localities control and direction over their own system oflocal government. That is given expression to in the form that the final control is vested in the elected representatives in so far as they have the power to raise the necessary finance through rates.

In this Bill, we are setting out to amplify in many directions the existing health services of the country. Many of the services are new altogether. Much of the machinery proposed has not hitherto been utilised in this country. This machinery, if it is successful, will, in time, come to play a very important part in the ordinary life of the people of the country. It seems to us essential, even from the point of view of the Minister and the Government, to ensure that that machinery devised by the Government and passed by Dáil Éireann is used for the purpose behind it—to benefit the citizens and to improve their health standards—and that, in the local health councils, there should be those elements of Local Government whose primary concern is not so much with merely efficient administration, not so much with merely conforming to regulations and the dictates coming either from the Department of Local Government or the Department of Health but that the ratepayers and the individuals who constitute the families in the locality will be afforded the utmost benefits that can flow from this new machine. That is, in fact, the purpose of the amendment—to make available, and enlist behind the whole purpose of the Bill, the active and the intelligent and the local initiative of the elected local government representatives of the citizens so that the general application of the health measures being devised in this Bill and in conformity with the regulations made by the Minister from time to time will so operate under the direction and control of the elected representatives that the ordinary people will receive the utmost value.

If the whole administration of the health scheme is to be left completely in the hands of officials, many of us have this experience—I have repeatedly defended both local and central officials in this House and I am not proposing now to criticise them—that no matterhow good the official is there is always the difficulty that he is still an official and there is a world of difference in many cases between his approach to the human needs of the ordinary citizen and that of the men or women who regard themselves as the elected representatives of the citizens and who have a direct responsibility to the individual citizens.

So far as the practical nature of the amendment is concerned, it is confined, first of all, by the fact that the powers of the health committee are to be such as are given to it by the health authority and, therefore, the whole council in a particular area will in the first instance determine exactly within what limits the health committee should operate and to what extent authority should be delegated by them. Secondly, the health committee will combine in itself all the elements of local government from the county manager down through the medical officer and including the elected representatives, and they will all go to constitute the actual functional part of the local machinery. A noteworthy feature is that in the formation of the health committee a majority of the members are to be members of the council and you, therefore, retain the control which the elected representatives of the citizens should have, in our opinion, both on the council and on the health committee.

If the Minister will consider the matter from the point of view of ensuring that, not merely will central machinery be available for the operation of the Bill, not merely will local machinery in the person of the county manager and the medical officer be available, but, more important still, that tied into the whole machinery of the Bill will be control directly by the representatives of the citizens who have got, in the last resort, the greatest concern, the greatest interest and the greatest need for making the machinery in the Bill a success, then I think he will find, as he said in his Second Reading speech, that if we are to operate a satisfactory health scheme it is essential that it be based upon a democratic organ of local government,and the only democratic organ is that composed of elected representatives, and not the county manager or the other officials. The test is applied so far as this amendment is concerned, and I trust the Minister will see his way to accept it and, therefore, add what, in our opinion, would be a valuable adjunct to the machinery already set out in the Bill as drafted.

Dr. Ryan

I must say that I look on the matter very differently from Deputy Larkin. To commence with, I look upon the law as it is there at the moment, and the law as it will be affected when this Bill is passed. It gives the local authority certain powers and puts certain obligations on them to provide facilities of all kinds for various classes of the population. They also have the obligation, of course, of looking after public health and these other health functions applicable to a local authority. It is the local authority, that is the county council composed of the elected representatives, who have all these powers. The county manager has certain executive functions it is true, and the county council may delegate certain other functions to the county manager if they so wish. But, in the administration, the policy to be pursued, and all these other matters, it is the elected members of the county council who will have the say.

I would prefer to leave to the county council with its full membership all matters of that kind. At the moment the county councils are carrying out all the health functions and I believe a good part of the time of council meetings is devoted to health matters. That will continue when the Bill goes through; in fact more time may be given to them. I think every member of the county council would like to be present when these things are discussed and that they would not like to delegate any part of their functions to a committee composed of members and some officials as set out in the amendment.

I am proposing an amendment, No. 66, but that provides for an advisory committee to advise thecounty manager in whatever executive functions he may be asked to perform. I would ask Deputy Larkin to consider whether it is not a better proposition to leave all the policy and all the big administrative details of our health scheme to the full council. They may hand over to the county manager executive functions, and there will be a small committee to advise the county manager on these particular executive functions. The composition of the committee is much the same in both cases. There is no great difference, except perhaps that in my case there are fewer public representatives proportionately than is proposed in the Deputy's amendment. That is a matter that can be made right if the Dáil feels very strongly about it.

I am advocating that the scheme outlined by me, both in this section and in the amendment put down by me, of leaving all policy to the full council and the executive functions to the county manager, as delegated by the full council and carried out on the advice of a committee of this kind, is better than what appears to me to be going back somewhat to the old system of the board of health which was found on the whole to be impracticable. It may be that the board of health system was a good system, but it was found at the time to be impracticable and all health matters went back to the full council.

Dr. ffrench-O'Carroll

I have a very high regard, generally speaking, for the civil servants. It is not necessary to go into it, but I think they did very fine work in this country in many spheres. I do, however, agree very much with the views put forward by Deputy Larkin. From my own limited experience of a local authority, particularly a local authority responsible to a large population such as you have in large cities, I feel that the great danger is that the ratepayer or the citizen is dealt with by a very minor official of the local authority who is, in turn, responsible to a more senior official, and so on, the result being that the members of local authorities who deal with the public tend to be very limited in the authority they have.There is the danger that officials dealing with members of the public in these matters may be less human and rather harsh on account of the system under which they operate than, say, somebody who has wider powers.

I have noticed again and again that the really principal function which members of a local authority fulfil is to add the human touch to these problems. Where a system is administered by the county manager and rules and regulations laid down and passed through a series of officials, it does often mean that the minor official who eventually deals with the public does so in a rather harsh and inhuman way. I see the point of the Minister's amendment that the members of a local authority, as a body, should be, as far as possible, associated with the working of sections such as we are discussing, but I think where you have a local authority with a vast amount of work to do—and that work is increasing out of all proportion to their resources—it is not possible for each member to be in contact with all the details of the different types of schemes for which the local authority is responsible.

I feel that these committees of local authorities dealing with big matters like health and housing, are not really practical on account of the many other committees which members have to attend. That is why I feel that the suggestion of Deputy Larkin, that there should be a small number of members of the local authorities who would be associated with the experts in medical and administrative ways, would mean you would have a group of people in much more intimate touch with the actual working of the scheme.

There is a danger in local authorities where the manager has such responsibilities that most of the decisions are already made before they come before the manager, and that the ordinary members would have to delve through a long series of regulations and Acts and negotiations and so on, to get down to the human side of all this. I think, certainly so far as the larger group is concerned, the suggestion put forward by Deputy Larkin is the more practicable one.

Mr. Larkin

The Minister's method of debating is very clever. I asked for machinery to ensure that the elected members of the local authority would have an opportunity of dealing with this problem of health and he meets me by saying: is it not far better, Deputy Larkin, to ensure that all members of the local authority are in that position? In other words, he offers me perfection. That is true in theory but not in practice. It just does not work out that way. If you have a good official, he is good and if you have a bad official he is a terrible pain in the head, and when you have a bad official under the present system there is no remedy.

Whatever may be the argument in favour of leaving the interests of the ratepayers and the citizens in the hands of the manager and his officers so far as the whole range of local government activities is concerned, I do not think anybody in this House will argue that that should be the position in regard to health where one of the most important factors is the human approach.

I am not a member of a local authority but I do know that in Dublin where we have a very excellent city manager, so far as he is personally concerned, and many good officers, that where we want to deal with the problem of one man or one woman, and we go to the top, we find that the top is too high. They are not even aware of the mass of the citizens. When we go to a lower official, we find he is so near to the mass that he is afraid to do anything. Time after time, the only way you will get things done is to go to a member of the corporation and get him to act as an intermediary.

I think that happens outside Dublin, too. It is even more important from the public health point of view, in so far as all the members of the health authority desire to interest themselves and concern themselves in connection with policy and broad administrative questions. It will be the members of the health authority who will define the powers and functions of the committee. They can limit the committee very strictly or give it an unlimitedfield, and that will meet the question as to whether or not members find it possible to interest themselves or concern themselves in the multifarious questions now devolving upon them. If they want to place the whole field of administration and policy in the hands of the health committee they can do it in defining the functions of the health committee. If they find they cannot devote, individually, time—particularly where this expanded health system is coming into operation—they can hand over the majority of functions to the health committee. They will be handing over not merely to their own colleagues but to people who will be experts in a sense on such questions.

I cannot find anything in the amendment of the Minister to justify his rejection of my amendment. His other suggestion is that I would accept the position as being met in regard to amendment No. 66. But amendment No. 66 merely proposes to set up the committee to advise the county manager. There is no indication as to whether the county manager is bound to accept that advice. There is no indication whether he is even bound to give information on which they can base advice. Again, it is a question that where you have a good manager there is no difficulty in working with him, and where you have a bad manager the whole system of democratic local government becomes impaired. All of us have experience of both sides. That is why I am more impressed with the approach in our amendment rather than that of the Minister. The argument is in favour of a type of machinery as proposed in my amendment rather than that of the Minister.

The other question is the rough division of functions between the manager and the council. At the moment the city manager concerns himself with executive functions, but it is executive functions that bring policy through a scheme of administration and bring it actually into the individual lives of the people who are going to benefit from the scheme. A decision by the health authority on some question of policy or the application of services set out in the Bill hasno effect on the individual ratepayer or on members of a family. It is merely on paper. But it is when that decision is translated into actual care or attention or service that the manner in which it was reached makes it of particular importance not merely in the eyes of the individual who has to have recourse to the service, but equally in the eyes of the elected representatives. I am particularly concerned that the elected representatives of the people will be directly associated with the function of ensuring that this health legislation has that human approach which is the basis of successful functioning of any kind of health legislation. If we remove that, we might as well do without health legislation altogether.

I feel it is necessary to ensure that the machinery and the members who staff the machinery from the county manager down are at least kept in contact with the more human or, if you like, the broader forms of the social and health legislation. It is an entirely different position from that of an advisory committee who may find themselves faced with difficulties in obtaining the requisite information to consider a problem and, having got through that procedure, find that they are told by the manager that he does not propose to accept their advice. That does not bring us very much further. We will find that these consultative committees will tend then to become moribund. It is to avoid that position and to ensure that what the Minister stated in this House will be realised, that this health code will operate through a democratic form of local government that we have set down this amendment.

Mr. Allen

The amendment proposed by Deputy Larkin sets out that this committee shall discharge such functions as the health authority may delegate to it—in other words, such functions as the elected council can delegate to it. The elected council can delegate to it only such powers as they have themselves. They cannot delegate any power they have not got. It is all nonsense, therefore, to suggest, as Deputy Larkin did, that you are giving this committee some powers which thehealth authority have not got. You propose to give them only the authority that the elected representatives as a whole have and nothing else. What advantage can be derived from such a committee apart from that available under the full health authority? We shall take a county council in which you may have 21 or perhaps 30 members. If you take eight of these members, that is one-third or one-fourth of the whole council, to form a committee, they cannot perform any function that the whole 30 cannot legally perform. I cannot for the life of me see what advantage it will be to have the county medical officer of health, the county surgeon and the matron of the county hospital on the committee. I suggest that the matron of the sanatorium, a very important health institution, might as well be included. I can see no way in which that would help.

Deputy Larkin must be aware further that the health authority is the council of the county. They have power to set up committees and to delegate portions of their functions to them. Many of these councils do set up committees under the County Management Act and under previous Acts. There is no necessity to provide in this Bill powers to enable them to set up a committee if they think well of it, because it gives them no powers that they have not already. I remember working for a dozen years on a board of health. Because we were only one-third of the elected representatives of the county, the other two-thirds discovered they had a grievance because, as they said, they were not aware of what was going on at the meetings of the board of health. If problems do arise in carrying out the provisions of this Bill I think it would be much better to have the whole council as a committee. Later on, when the times comes fully to implement the Bill, the council, if they think that there are some small problems arising in the functioning of the Act, can set up a committee from amongst their members to deal with these matters. The power is there under previous Acts to do that, the very same power as they would have under the amendment of Deputy Larkin.

Dr. Browne

Not being a member of a local authority I cannot speak with any great knowledge of the duties of local authorities but I would ask the Minister to give careful consideration to the basic point involved in this amendment. I cannot quite see Deputy Larkin's point that the development of our institutions and services is such that you are up against the question of the bad official. I have heard of the bad official and I know that the bad official can destroy all our attempts to set up democratic machinery which will provide a good health service. That is why I think the whole question is a very serious one indeed, but I am not clear in my own mind as to the way in which the Minister should proceed in attempting to ensure what Deputy Larkin says he would achieve with this sub-committee of the health authority. Of course from my point of view, in so far as I am a firm believer in this type of service, it is very important indeed that there should be no bureaucracy, that inhuman soulless bureaucracy to which Deputy Dr. ffrench-O'Carroll and Deputy Larkin referred and of which I am also aware. I believe that is something which many officials in their approach to the people with whom they deal, have learned from the time when people took things as charity, charity in the worst sense of the word. They tend to carry that attitude over into our public services when the people are getting whatever they are getting from these services as of right.

My main interest here is that the Minister should seriously consider the question as to how he is to get the flexibility so necessary in health services. Of course it is absolutely essential to the powers at the disposal of the executive advisory authority, whoever they may be, to allow them to deal in a reasonably broad way with the thousand and one problems that will come up for consideration under this health legislation. I do not know that Deputy Larkin's amendment meets that. I simply could not say whether it does or not. Equally I think that leaving the matter to the county council, the health authority and the manager, could not meet it either because the responsibilities thatwill be placed on all of them in the next five years, in the earlier years of the expansion of the health service, will be rather too big. Deputy Dr. ffrench-O'Carroll, who has considerable experience of the activities of local authorities, has made the point that it is generally the most active members of local authorities who are called upon to sit on the health committees. The result is that the best of them cannot get round to all the committees and frequently you have no action taken by virtue of the fact that it would be a physical impossibility for these members to do all the work.

There is no doubt that the point raised is a very important one. I really do not think that the advisory part of the suggestion made by the Minister would meet the case. My own acceptance in relation to the National Health Council in a much broader way was largely due to the fact that it was purely advisory. Being purely advisory, my view was that it was largely useless, but I do not want to pursue that point at the moment. It certainly would not interfere with the extension of our health services. Where we are dealing with democratically elected committees, whatever we do we should do bona fidewith a real intention to see that whatever powers we give to the authorities are effective powers. I do not think that advisory powers are going to be effective powers. Their effect on the health services would, I should imagine, be largely illusory.

Again, on the question of the necessity of the authority having all the power, in so far as it is a democratically elected body, I would concede that the members who are mentioned in the amendment have a right, by virtue of being employees of the health authority, to take part in a sub-committee of a democratically elected body, quite contrary to our acceptance in relation to, say, a voluntary hospital board which is not democratically elected but which will spend a lot of our money under this health legislation. I think that some sort of middle road should be considered in relation to this section and the point raised by Deputy Larkin. You may pay lip service todemocratic usage by saying that they all consider it, but most of us are more interested in getting the work done, in making the service effective and ridding it of any chance of its being bedevilled by bureaucracy. This, of course, is the contention of the opponents of this kind of health legislation.

There is some substance in their charge, I believe, at present, but my explanation is that that has arisen out of the fact that most of the officials administering our public assistance services—I do not wish to attack officials, because I think it is the most cowardly form of dialectics or behaviour in a public man—through environment or their general attitude in the past, have the feeling that what they are giving out is something of their own rather than something which is the recipient's right as a ratepayer or taxpayer. Until that atmosphere is completely got rid of in our social services generally, we will tend to have the bad official, the autocrat and the petty tyrant, but, as time goes on, and as the local health authorities, the local authorities, democratic councils, explain to the people that what they are getting is theirs as a right, that they are beholden to nobody for it and that they must receive the attention they would expect to get from an employee, as the health authority official is, no matter whether in high or low rank, I feel that we will get rid of the red tape, the bureaucracy, the inflexibility and the inhumanity which, to a certain extent, still prevails in some of our health services.

I would ask the Minister to give very careful consideration to this particular part of the legislation, because upon it, I believe, hinges the whole success or failure of the scheme, and on it are centred our hopes, and the hopes of Deputies on the other side—probably that is an over-statement and I should say "the beliefs of Deputies on the other side"—that our health legislation cannot succeed because it will be ultimately bedevilled and destroyed by the bureaucrat. I do not think that is necessary. Other schemes have been tried in other countries and have worked. I believe this scheme willwork as well, but I think that much of the likelihood of its being a success depends on the administrators and the executive authority.

I suggest that the Minister seriously consider the amendment, that he take what is good out of it and incorporate it in a proposal of his own, to ensure that this principle will be very carefully constructed and that the evils and dangers to which Deputy Larkin and Deputy ffrench-O'Carroll drew attention will be avoided. Would it be of any help to Deputy Larkin if the Minister considered the substitution of the word "may" for the word "shall"? That might destroy the whole amendment. However, that is only a small point—the main principle is there and is very important.

Dr. Ryan

I quite agree with Deputy Browne that this aspect of the entire legislation is most important and I agree also with Deputy Larkin that we want, as it were, the human touch rather than the official touch in this whole system, but I think that Deputy Allen has dealt very effectively with his arguments. The idea Deputy Larkin has in mind can be put into force by the local authority without any legislation at all—perhaps not in relation to the personnel but in relation to the idea. Deputy Larkin had in mind that the individual who is looking for a certain benefit and perhaps fails to get it deserves sympathy. I agree. On the other hand, the Deputy thinks it is a great pity that he should have to go to a member of the local authority in order to get that benefit. That is one of the greatest difficulties we have in relation to social legislation generally. We go to great pains to publish social welfare regulations, to set out what people are entitled to and so on, but still there are people who are entitled to these things but who do not get them because, for some reason or other, they do not apply in the proper way. That is a very difficult matter to get over and what happens is that some local person decides that this person has a grievance and writes to a T.D., who gets on to me. I get on to the officials and am told: "Yes, that person should have got that benefit,but, through a mistake, he did not get it". The result is that Deputies are dragged into these things unnecessarily, if you like, but I suppose until we all become better educated that will go on.

As Deputy Allen pointed out, the local authority will have power over policy and the raising of money. In other words, they will decide that a certain benefit should be given to a certain class of people and then, roughly speaking, it is the county manager's business to see that it is implemented. In all legislation so far, since the county managers were set up, it has been an accepted principle that the individual benefit would be decided by the county manager and not by the council. That is not just my idea but an idea which has been held by every Minister before me, on both the social welfare and local authority side. When I speak of the social welfare side, I refer to home assistance. Even when the last Government were bringing in a Bill to amend the County Management Act, they specifically provided that the chief executive officer, as they called the county manager, would be the authority for giving decisions on individual health functions, so I think it is fairly clear that any Minister who may be there, whether Fianna Fáil or Labour or anything else, will come to the decision that an individual health function must be decided by one man and cannot possibly be discussed by a committee. People would not like to have their cases discussed by a number of people, whether it be the whole council open to the Press or a committee of that council at which the Press is not present. Prospective patients would not as a rule like to have their cases discussed by a number of people. They would much prefer to have one person decide without any publicity or anything of that kind.

Up to this at any rate all Parties were of the opinion that the new health function should be a function for the county manager. Bearing that in mind and bearing in mind also what Deputy Allen pointed out, that this committee proposed by the majority could only have whatever function was delegated to it by the full council, it really shows that at both ends, as it were, it will not achieve very much and for thatreason I am still opposed to the amendment.

Dr. ffrench-O'Carroll

There is a point to which I should have referred. So far as the doctor is concerned under this Bill and so far as the health services are concerned the Minister proposes a considerable unification and centralisation. The Dublin Corporation and the Dublin County Council will, it is envisaged, come together as one health authority. That in itself will separate the ordinary members of the Dublin Corporation still further away from the intimate problems of the working of the health services in Dublin, quite apart from the considerable extra administration which the Dublin Corporation and the Dublin County Council will have to shoulder as a result of these extended services. From the point of view of personnel and accommodation duties will be involved which they will, in some instances in my opinion, have very great difficulty in carrying out. For that reason I would ask the Minister, since we are all anxious to try to avoid this rather inherent danger in building up a scheme like this, to consider as far as possible integrating the members of the various local authorities at various levels into the health services. There will be 45 members on this health authority for Dublin City and County. It does not need much imagination to see how very remote a member of that central authority will be from the complaints or problems arising in connection with a patient perhaps in Grangegorman Mental Hospital, a patient in St. Kevin's or someone with a grievance in connection with tuberculosis services.

I might again remind the Minister that it is envisaged that a number of existing boards working under the Dublin Corporation, such as the board of assistance, will eventually be abolished. Centralisation of control is envisaged in so far as Dublin City and County are concerned. I think it is vital that the greatest consideration should be given to this question of endeavouring to integrate elected representatives in so far as possible at all levels of administration in health services.

Dr. Ryan

Undoubtedly there is a point there in relation to Dublin City and County because these will require a very, very big board. It is, however, visualised that many sub-committees will be appointed for local purposes.

Mr. Larkin

No one has suggested that the individual application of health services should be dealt with by all the members of the health authority or by a committee. The Minister has merely put up something in order to knock it down again for the sake of argument. I see here a difference in principle between the Minister and not only myself but other members of the House. We want to ensure that not merely are the health services properly administered and made available to those citizens in need of them but we want to have associated as far as possible with the actual administration and executive carrying-out of these functions representatives of the ratepayers and the citizens. That is why the committee suggested here is made up, not merely of elected representatives, but also of the county manager and his experts.

It is all very well for Deputy Allen to say that all the members of the council might prefer to deal with health questions. Of course, they may, but how many in practice will concern themselves in detail? I have been a member of a local authority. I know what happens very well when there are 20, 30 or, as in the case of Dublin Corporation, 45 members dealing with the question of health. First of all, not all of them find it possible to attend every meeting. Not all of them find it possible to read the minutes and reports made available. Not all are as deeply concerned with health as they may be with housing or some other aspect of local authority work. On every council, however, there are always individuals who take a particular interest in one particular aspect of the functions of local authorities.

It is my concern to ensure that the elected representatives are closely associated with the officials and medical experts, not in determining whether John Murphy will get a particular service, but whether the manner inwhich John Murphy, and many hundreds of John Murphys, are dealt with and treated by the officials administering the service is satisfactory. I want to ensure that John Murphy and his fellow-citizens will know that, having applied for a particular service whether hospital, institutional or any other form set out in the Bill and having been given the particular service sought and found that it is not satisfactory and not meeting the purpose for which it was intended, will then have some other recourse other than an official. Remember, it is not to the county or city manager he will go. It is to some minor official and if he gets no satisfaction from that official he will be told that it is a matter for the county manager.

The particular official cannot do any more and by the time John Murphy reaches the county manager he will probably require to go into hospital again. The officials are recruited from amongst the people; they are known and in direct contact with them. Any feeling of uneasiness that may be aroused in the minds of ratepayers can immediately be brought to the attention of the elected representatives. They will not then be sitting as a general council meeting, dealing with the multiplicity of local functions, but as a council specifically concerned with health. They will be in direct association with the leading officials carrying out the executive and administrative functions as laid down by the health authority.

Deputy Allen says local authorities can already appoint these committees. Possibly they can. When it comes down to actual power we all know it is the county manager who is the official authority. I think we will find that will be the position in the future as it has been the position in the past. He also made the point, and so did the Minister, that the committee cannot have more functions than the health authority itself but if the health authority has the functions and jurisdiction that the Minister apparently suggests he is giving it under this Bill, that is sufficient for me. If he is not giving the health authority thesefunctions and authority, then we know where we are. In fact, the whole scheme will be administered by the county manager.

I am not asking for any more for the health committee than is given in the Bill to the health authority. All I am suggesting is that the committee will be little more than an advisory committee dependent upon the goodwill, patience and tolerance of a particular county manager as to whether he will listen or not. I am suggesting that we should establish the principle of directly associating so far as health is concerned those who represent democracy in local government with the actual function and executive control of the health services. That is an entirely different principle from the one embodied in the Minister's amendment.

The Minister proposes an advisory council which has no life unless somebody puts a spark into it. My amendment is in terms of a properly established committee given definite powers by the health authority to go ahead in association with the experts and provide the services set out in the Bill in such a manner that they will be appreciated by the ratepayers and the citizens and which will function on a broad human basis far removed from the cold official atmosphere. There is an issue of principle involved between the two principles and I feel that I have to stand by mine.

Mr. A. Byrne

Has the Minister nothing further to say? Is it his intention to steamroll all his own views through the Dáil? He has heard Deputy Dr. Browne and Deputy Dr. ffrench-O'Carroll give their wholehearted support to the view expressed by Deputy Larkin. I give it my wholehearted support in the light of my experience of the work of public health committees in Dublin Corporation over the past 40 years. I know it is essential to have sympathy for the man who has a grievance outside. I knew many cases where an aggrieved person came to a member of the council who was a member of the committee. The case when taken up appeared to be hopeless and it was turned down by theofficials. But after some time and when the matter was given attention, some redress was given to that aggrieved person. I think that the suggestion of Deputy Larkin is one which the Minister ought to meet in some way. Is it the Minister's intention to completely steamroll his own views through the Dáil, especially when the medical men in the Dáil are directly opposed to his views on this section?

Dr. Ryan

I am sorry to say that if I had any intention to waver the Deputy would certainly drive me the other way. He comes in here after I have been here for the past eight days. He says that I am steamrolling my own views through the Dáil, but the fact is that I have been steamrolled for the past eight days. I gave in on most things and now the Deputy comes in with this sort of political balderdash. After eight days he has a half an hour to spare. The Deputy can vote against the measure if he wants to and it will give him some sort of satisfaction.

Mr. A. Byrne

I have 40 years' experience in relation to public health matters.

Dr. Ryan

Deputy Larkin is quite right to stick to his own view but I want to put this view to him. The full council can appoint a committee giving whatever powers they have or less. That committee, under the various Acts, have powers to compel a county surgeon, a medical officer and the county manager to attend. I think I am right in saying that any council can get what Deputy Larkin proposes.

Mr. Larkin

I do not see why the amendment cannot be accepted.

General Mulcahy

The Minister speaks in regard to the powers a council has. The Minister spoke earlier of a distinction in regard to big administrative details. He said that policy and big administrative details belonged to the full council and he implied that executive functions belonged only to the manager. Now he indicates that whatever powers the council have themselves can be transferred to any kind of body they desire,including a body such as Deputy Larkin suggested. Will the Minister indicate where in this Bill are any powers that are reserved functions for the local body? If there are no reserved functions for the local body, will he say what aspect of policy other than the policy of accepting this Act and arranging to have it put into force remains to a council in this case? The Minister indicated that he was not going to bring pressure to bear on a council in the matter. He was apparently going to wait until a certan number of councils accepted the policy enshrined in this measure and go ahead with it and then he would enforce it on the others. Assuming that the policy of this measure was accepted by a council and gone ahead with where in this Bill in connection with a decision on anything is the local elected body to come in with any powers?

Dr. Ryan

I do not know whether the Deputy is really ignorant or trying to make a point. Surely the Deputy realises—he was a Minister for a long time—that we are not dealing either with the local authority or the county manager in this Bill. In this Bill we say that the local authority must provide so-and-so or we compel the local authority to do so-and-so but the County Management Act lays down what the local authority will do themselves and what the county manager will do. I am not interfering with that system. There is a County Management Act coming before the Dáil and the matter can be dealt with at that stage. This Bill is not changing anything in the law. It would not be appropriate that it should do so.

General Mulcahy

Since it is not changing anything in the law, I suggest to the Minister that there is not any part of this Bill that is the function of the elected group who are the local authority.

Dr. Ryan

There is.

General Mulcahy

Once this Bill is accepted for operation in a local area then there is no reserved function for the local authority in this Bill. Except that they deal with implementing thecost in relation to the rate every detail of this Bill is a function of the county manager.

Dr. Ryan

Not at all. The local authority will decide whether or not they will provide institutional service, medical care, child welfare service, school examinations, dental and ophthalmic services, maternity cash grants, milk for children, institutional service for paying patients and so on. In respect of every section practically the local authority will decide whether they will adopt it or not. It will be the local authority and not the county manager who will decide. The law remains as it was as between the local authority and the county manager. The Government of which the Deputy is a member did bring in a Bill which purported to take some of the functions from the county manager, but you would have to have a microscope to examine what they were. The Government of which I am a member are drafting a Bill on the same lines. I do not know how far they will go, but they will go as far as the previous Government went in that direction.

Dr. Esmonde

Am I to take it that the implementation of any part of this scheme will come before the local authority which is, as the Minister stated, the democratically elected representatives of the people and that they will decide what sections of the scheme will be implemented and how they will be carried into effect? Will they and not the county manager do that? That is not how I understand it. Perhaps, the Minister would advise us further on that point. I understand that the local authority have been asked to provide half the money in connection with this Health Bill. As far as I know they have objected. That is the only say the duly elected representatives of the local authority have in relation to this Bill.

Dr. Ryan

They have the power to object to providing the money.

Mr. A. Byrne

The Minister must be aware that he is putting the city manager or the county manager in the position of saying over the heads of everybody that he refuses to acceptanything. That is the power that is being given.

Dr. Ryan

I am not interfering.

Dr. Esmonde

If a local health authority is asked to implement any part of this Bill and refuses, has the county manager power to have it implemented?

An Leas-Cheann Comhairle

Is amendment No. 64 agreed to?

Dr. Esmonde

Would the Minister clarify the point that I have put to him?

Dr. Ryan

I have said on more than one occasion that the manager cannot do that.

Mr. A. Byrne

Then Deputy Dr. ffrench-O'Carroll counts for nothing in giving advice to the Minister.

Dr. Esmonde

I understood that the health authority was the county manager.

Dr. Ryan

Well, you are wrong.

Dr. Esmonde

This Act will be put into effect by the health authority. Who is the health authority?

Dr. Ryan

The council.

General Mulcahy

Will the Minister say if the council has any authority, other than inside its reserved functions, and whether the powers of the county council, outside its reserved functions, do not rest in the county manager?

Dr. Ryan

I do not remember the working of the County Management Act, but I know that there are certain functions reserved to the council and certain functions reserved to the manager. As far as this Bill is concerned, they remain as they are.

General Mulcahy

Will the Minister say what section of this Bill is a reserved function of the county authority? If we cannot be told what part of this Bill is a reserved function of the county authority, then it rests with the county manager.

Dr. Ryan

I have read out all the things which the council will have to decide.

General Mulcahy

Read out the reserved functions.

Dr. Ryan

I am not dealing with the reserved functions. The Deputy has now some sort of a technical point. As I say, I have read out these before. The first one I mentioned was institutional services, that is hospital services for certain classes. If the local authority says it will not provide them, the county manager cannot provide them. That is the point.

General Mulcahy

Suppose the county authority says that it will provide them, what is the position?

Dr. Ryan

The county manager will agree.

General Mulcahy

And it is the county manager who administers them?

Dr. Ryan

Yes.

General Mulcahy

So that all the council has to say is: "We accept this Bill in so far as section so-and-so goes".

Dr. Ryan

A remarkable change has come over the Deputy. There was no Deputy in this House who was so much in favour of county managers as Deputy Mulcahy, but he has been blackguarding them all over the place for the last ten or 12 days, because it suits him politically. That sort of thing is not going to deceive anybody. It is done in order to attack this Bill.

General Mulcahy

On a point of order. The Minister has stated that I have been blackguarding the county managers.

Dr. Ryan

Of course you have, over the last ten or 12 days.

General Mulcahy

Is that in order?

Dr. Ryan

It is true. Whether it is in order or not, I do not know.

An Leas-Cheann Comhairle

It is a word that should not be used.

Dr. Ryan

I withdraw the word then.

General Mulcahy

The Minister has implied that I am criticising the county managers. I am asking for information as to how this Bill will be worked, and the Minister has attempted to say that the elected councils have power themselves to do certain things. He has implied, without stating it exactly, that they have power to set up a body such as Deputy Larkin is suggesting, and power to give it certain functions to discharge. I am saying that, as far as the law is concerned, there is no power given in this Bill to a local authority that will not be absolutely one to be discharged by the county manager except that power is a reserved function specified either here or described as a reserved function in the County Management Act. The Minister tells us that he does not know anything about what is or is not a reserved function, and goes so far as to say that he does not know whether the reserved functions are those ascribed to the county manager or the county council. I think that, at least, we ought to get a clear expression of opinion from the Minister as to what are the powers provided in this Bill that are expressly those of the elected body, and that are a reserved function of the local body.

Mr. McCann

I think that the question Deputy Mulcahy is on does not arise on Deputy Larkin's amendment which proposes to have a new section inserted. I fail to see how, on this stage of the Bill, we should traverse the whole business of county management vis-à-vishealth services. While I would be in agreement in principle with Deputy Larkin, I would like to say this, that if the county councils can operate as a public health committee as well as we are doing in the City of Dublin there will not be any cause for complaint.

I imagine they can have their public health committee in the same way as we in Dublin Corporation have one. In spite of what Deputy Byrne has said with, as he has said, his 40 years'experience, I should like to give my experience extending over the last 20 years. As chairman of the Public Health Committee of the Dublin Corporation, I do not know of any person, with any grievance, who has not found an outlet for it. There are 45 members on the Dublin Corporation. The public health committee we have is representative of these 45 members. The quorum is nine. Sometimes it is difficult to get one. I can say this, that any person who is aggrieved or feels that he or she is not getting a particular allowance, or proper service under the Health Bill, has his local representative to go to. The matter may then be brought up at the public health committee. It will be brought up and will be thoroughly investigated to the satisfaction of the member who raises it or to the satisfaction of the committee.

Now, with regard to hospitals and sanatoria. The hospitals are not under our control, but the sanatoria are. In connection with these, we have a system of visiting. I suggest that is a most practical system. It could also be employed by the county councils. Let the county councils appoint a public health committee, and let that committee appoint visitors to visit the hospitals or sanatoria under their control. That is what we do. No objection whatever has been raised in any way by the city manager. Indeed, if every county manager in Ireland were as good as the city manager in Dublin in the way he co-operates with the members of the council and listens to everything we have to say, there could be no complaint. Indeed, he is largely directed by us even in regard to matters which are his functions. I should like to say that for him, that he is most democratic in that way. Personally, I do not see any necessity really for this amendment.

Mr. Larkin

You are a happy man, Deputy.

General Mulcahy

He is trying to make the Minister happy.

Mr. McCann

I have been in on these discussions from the start, and I certainlycan make a case for this out of my own experience. So far as Dublin is concerned, Deputy Dr. ffrench-O'Carroll need not worry about the unification of health services when they come about Councillor Denis Larkin made the point, in the corporation and in consultation with the Minister, that we wanted specifically these local committees together with the big committee. It will not be 45 members as Deputy Dr. ffrench-O'Carroll suggested but it was suggested that there should be 18 from our body and half that number from the county council. The Minister said: "We will leave that to another day. We do not have to decide now what number of people will be on this unified health authority." One thing he has conceded and on which he agreed immediately was that the system of local committees which operated under the Balrothery Board of Assistance and the other bodies that were abolished will be instituted under the proposed new scheme in Dublin and county. Personally I do not see what all the argument has been about. Deputy Larkin is a man who takes a very keen interest in local matters but I do not think he fully understands the system as it works under the corporations and the county councils. The elected representatives have in effect the power to appoint these committees, to visit or supervise and investigate claims by aggrieved citizens.

Mr. Larkin

Deputy McCann is in the unfortunate position of being a member of the Dublin Corporation and I have already pointed out that the experience of elected representatives in Dublin is much different from that of elected representatives in other parts of the country. So far as this amendment is concerned. while it was put down in my name, its origin is in the minds of members of the Labour Party in this House who are members of local authorities in other parts of the country and in Dublin. Possibly, if every member of the councils throughout the country had the same experience as Deputy McCann has had and as I had years before in regard to the Managerial Act in Dublin, maybe this amendment would not bedown. But then the experience is not common to everybody.

I have no doubt at all as to the relative functions of the county manager in regard to this Bill. I can accept what the Minister says that there are certain services which he listed that it is the function of the county council to decide whether they are going to put them into effect and provide the money, but it is the function and authority of the county manager to determine the character of those services in the final analysis. Everybody knows that that is what I am concerned with. Possibly the Minister may feel that by a roundabout or by a back-door method I am trying to ease off the exceptionally impregnable position the managers have under the Managerial Act. If he thinks that, he is quite right. It is very important that it should be done in regard to the health question. The question in regard to local government generally is a matter we can argue another day.

As far as health is concerned, even though the local authority decide, for example, that they are going to provide a scheme of medical care for mothers, decide the broad principles of that scheme, have an estimate from the county council and medical officer as to the cost and decide to provide the necessary finance, at that point the matter must be taken over by the county manager and the experts.

The county manager determines the type of building, the employment of the persons who operate the scheme and all the factors that go with the provision of services, and as to the women who will have recourse to the services concerned. The county manager determines the character of that scheme in these important aspects. It is no use kidding ourselves in this connection. If there is anything wrong with the way in which the scheme ultimately operates the members of the county council may object and they may question the county manager, but there is only one way they can bring him to heel and that is by saying that they are not going to provide any further money to carry on the scheme. We know it does not work that way,get away with his point of view except when he comes across a very stubborn member of the local authority, and that does not always happen. In the meantime the individual woman or man depending on that scheme is suffering because the scheme is not the type the members of the local authority originally wanted.

I agree that it might be desirable to substitute the word "shall" for the word "may." That is a matter that could be seen to as far as the amendment is concerned. However, I see in this a question of principle, and the principle I am concerned with is the division of authority between the elected representatives and the manager. If each section of that divided authority stand upon the powers given to them under the Managerial Act then we can have a very unfortunate position so far as the ordinary citizen is concerned. There is no remedy for it unless the local authority decides to invoke this final and absolute authority in regard to finance.

We know very well that the experience in Dublin has been quite the opposite and I accept what Deputy McCann has said, that the thing has worked smoothly and there have been practically no complaints but Deputy McCann will recall that on the occasion when the managerial system started to operate in Dublin the first city manager said that he intended to work in co-operation with the council and that has been the practice carried on by his successor since. If that had not been the case and if he had the experience in Dublin that has been met with in other counties he would not feel so happy about it. Deputy McCann has a keen interest in health matters and knows the position well because of the fact that he is chairman of the health committee in the Dublin Corporation and because of his assocciation with Dublin hospitals, but if he had the experience which elected representatives had outside of Dublin he would be pressing this amendment just as much as I do.

Mr. MacCarthy

I think Deputy Larkin and other members here must be framing in their minds things thathave never occurred. In my experience, both in the Cork Corporation and the county council, I have never come across any situation such as they envisage. In the Cork County Council we have three health authorities. I am a member of one of them attached to the central area. We have the same committee there for health as for housing and sanitary services, and that includes all the elected representatives for that particular area. On the occasion of the meeting the county medical officer attends. The officials who are responsible for administration and the assistant county manager attend. The health items on the agenda are first dealt with in the presence of the county medical officer of health and all the officials concerned. Matters of administration or of individual complaints are dealt with at the meeting. If complaints are not decided at that meeting they are referred for further inquiry to the county medical officer of health and his officials for further consideration and a decision in accordance with the regulations and the law.

If that is not carried into effect the matter goes to the next meeting and is dealt with. In the meantime, the public representatives will have their say and will perhaps appeal from, perhaps, the Minister, misinformed, to the manager, better informed, and perhaps get a more favourable decision in consequence. When health has been dealt with, housing and sanitary services, which are associate services, are dealt with in the presence of the county medical officer of health if he is required. He is released if there is nothing on the agenda requiring his immediate attention. In the working of that system complaints have arisen but it never has been my experience that these complaints have not been dealt with to the satisfaction of all concerned when they are properly investigated.

Mr. Kyne

Deputy MacCarthy is speaking in all honesty in relation to Cork. Could he tell me what other county council in Ireland is in the same happy position as Cork, having a separate health authority? I doubt if he could name another. There are, as Deputy Larkin says, 25 others, but He is in a strong position and he canthey are not in that happy position. In County Waterford, there is no health authority as such. The county council meets and in a general discussion one has the right to bring up a question of health but there is no assurance that the medical officer will be there or anyone attached to his department and you will get a very offhand reply and be told to communicate in writing with the manager. You will probably get the reply but it is not dealt with in the way the Labour Party think it should be dealt with. They think that the whole code of health should be taken by a special committee detailed to sit with the county manager and that the county manager should be a member. The county manager, when he deals with an advisory body, can always listen and just refuse to answer, if he so wishes. Our experience has been that there are county managers like that. They are not all as co-operative as the gentleman who operates in Dublin or even the man in Cork. Take a typical case.

In Cork, the county manager, receiving a certain document from Dublin thought fit to put a copy before each member of the health authority. Our county manager, getting the same document, believed it was confidential and refused us the right to see it. That is a typical instance of different interpretations. I can prove that. I got a copy that the Cork County Manager thought the members should have. Our county manager thought I had a document improperly, that it was confidential between him and the Minister. From a point of view it was. It illustrates the point. If the county manager were a common member with those selected by the public representatives, we would have as much information as he would have and we would be in a position to question him on matters and get an answer. There is a question of principle in our amendment.

Mr. MacCarthy

Are not we operating the same laws and was it not up to the public representatives in Waterford or any other county to appoint a separate health committee to deal with this matter? If they consider it advisablefrom their point of view to let the county council deal with it, who had a lot of other business to perform on the same day, I do not think the county manager or anybody else is to be blamed. It is the public representatives who did not make their decision and their request to have a county health authority appointed as a separate committee.

General Mulcahy

We are dealing here with the making of a law. I contend that the local authority in respect of the law that it is proposed to pass here will have no authority in the world except in so far as they can control it by the striking of the rate, and that their position is not so much that they can willingly acquiesce in accepting putting this Act into force but that the Minister can tell them some day or another to put it into force and, if they say that they will not strike a rate for it, the Minister can instruct the county manager to strike the rate and to collect the rate.

We are concerned with what are reserved functions. In view of the gloss that the Minister has put on the powers of local authorities here in his comment on Deputy Larkin's amendment, I find it necessary to draw the attention of the House to the position with regard to local authorities and their reserved functions. It is imperative that in discussing what we are discussing here we would advert to that because, when we are discussing the position of the county manager and his powers and the powers that the elected local authorities will have, we cannot know where we stand unless we refer to the County Management Act, 1940, and Section 16 and the Second Schedule to that Act, where reserved functions are defined. The elected representatives have no power of a statutory kind except in so far as there are reserved functions defined here and they will have no power with regard to this Bill unless there is enshrined in this Bill a statutory provision that certain aspects of the Bill are reserved functions. In order to help the House generally to be clear as to the position, I shall read out Section 16 of the County ManagementAct, 1940, and the Second Schedule thereto.

Section 16 of the County Management Act (12) of 1940 deals with the reserved functions. It says:—

"(1) Neither the council of a county nor any elective body shall directly exercise or perform any power, (other than a power which is vested by law (including this Act) in such council or body and is by this Act expressly made exercisable by resolution of such council or body), function, or duty of such council or body, in relation to the officers or servants of such council or body, or the control, supervision, service, remuneration, privileges, or superannuation of such officers or servants or any of them.

(2) Subject to the provisions of the next preceding sub-section of this section, every council of a county and every elective body shall directly exercise and perform the powers, functions, and duties (if any) of such council or body in relation to each of the several matters mentioned in the Second Schedule to this Act.

(3) Save as is otherwise provided by this section, the Minister whenever he so thinks proper, may by Order, direct that the powers functions, and duties of every or of any particular council of a county, or of every elective body of a specified class, or of any particular elective body in relation to any matter specified in such Order (not being a matter mentioned in the Second Schedule to this Act) shall be exercised and performed directly by such council or such body, as the case may be.

(4) The Minister, whenever he so thinks proper, may revoke or amend any Order made by him under the next preceding sub-section of this section or any Order (made under this sub-section) amending any such Order.

(5) Whenever and so long as an Order made by the Minister under this section is in force, the powers, functions, and duties specified in such Order shall be exerciseddirectly by the council or councils, or the elective body or bodies in respect of which such Order is made.

(6) No Order made by the Minister under this section shall extend or apply to any power, function, or duty to which the first sub-section applies.

(7) Every appointment by the council of a county of a rate collector for a rate collection district lawfully established in such county shall be made by such council directly by resolution, but no such appointment shall have effect unless or until approved of by the Minister.

(8) Every power, function, or duty of the council of a county, or of an elective body, which is required by this section to be exercised directly by such council or body shall, for the purposes of this Act, be a reserved function of such council or body, and the expression "reserved function" shall in this Act be construed and have effect accordingly."

The Second Schedule to the Act describes the matters in respect of which the powers, functions and duties are reserved functions:—

"1. The making of a rate.

2. The borrowing of money.

3. The demanding under any enactment of the whole or part of the expenses of the council of a county or of an elective body from any other local authority.

4. The making, amending, or revoking a by-law.

5. The making or revoking an Order or the passing or rescinding a resolution by virtue of which an enactment is brought into operation in or is made to apply to the functional area or a part of the functional area of the council of a county or of an elective body.

6. The application to be made to any authority in respect of the making or revoking of any such Order as is mentioned in the next preceding paragraph of this Schedule.

7. The powers conferred by the Borough Funds (Ireland) Act, 1888, or by that Act as extended by any subsequent enactment, in relation to promoting or opposing legislation or in relation to the prosecution or defence of any such legal proceedings as are mentioned in Section 3 of the said Act and the application of public funds or rates for any of those purposes.

8. The making under Section 9 of the Local Government (Ireland) Act, 1898, of regulations in respect of the admission, detention, or discharge of patients to, in, or from a mental hospital or in respect of the conditions as to payment or accommodation under which private patients may be admitted to or detained in a mental hospital.

9. The following matters under the Town and Regional Planning Act, 1934 (No. 22 of 1934), that is to say:—

(a) the passing of a resolution under Section 18 of the said Act for the constitution of a planning region;

(b) the making of an application for an Order under Section 21 of the said Act extending a planning district;

(c) the consideration and the making of a decision under Section 26 of the said Act to make a planning scheme;

(d) the making and submission of a planning scheme under Section 29 of the said Act."

Mr. Allen

On a point of order——

An Leas-Cheann Comhairle

A good deal of this is not relevant to the amendment.

General Mulcahy

We are dealing with the powers of a local authority.

Mr. Allen

Is it in order to read the whole County Management Act in this House?

General Mulcahy

No.

Mr. Allen

In that way?

An Leas-Cheann Comhairle

It is not necessary to read the whole County Management Act, but the Deputy is entitled to refer to any portions of the Act relevant to the amendment and nothing else.

Mr. Allen

Has he referred only to the portions that are relevant to this particular Bill before the House?

Dr. Esmonde

Yes.

General Mulcahy

I am reading out what the reserved functions are in which the Minister declares that under this Bill the local authority will have certain power and I am declaring that except they are reserved functions the elective body will not have any power.

Mr. Allen

Deputy Larkin's amendment gives him powers.

General Mulcahy

The Minister has told Deputy Larkin that a local authority will have the power if it so desires to set up a body such as Deputy Larkin's amendment suggests and give that body any powers which Deputy Larkin thinks they would like.

Dr. Ryan

I did not. Not at all. Do not twist what I said.

General Mulcahy

I am reading out Section 16 of the County Management Act, which refers to the Second Schedule to the County Management Act, which defines what are reserved functions.

Dr. Ryan

Are you not expressing regret for twisting my words?

General Mulcahy

Not for the moment. I want to make the thing clear which the Minister's statement, in my opinion, requires to be made clear and I submit that this is in order.

Dr. Ryan

Does not a Deputy always accept another fellow's word—but perhaps I should not include the Deputy in that description?

General Mulcahy

I submit that it is in order for me to quote that part of the County Management Act, Section16, and the Second Schedule, which defines what the reserved functions of a local authority are, for the purpose of demonstrating in the only way in which it can be clearly demonstrated here that no part of this Bill here can in any way be brought in under the reserved functions of a local authority except in some way or another under the Bill. There is included in the Bill a statement that something or another in this Bill is defined as a reserved function. I am quoting from Section 9 of the Second Schedule certain matters which deal with town planning.

Dr. Ryan

You need not quote it.

An Leas-Cheann Comhairle

Surely that would not have any relation to——

General Mulcahy

If it is accepted that I can simply say that Section 9 deals with certain matters under town and regional planning and can be found on page 256 of the statutes for 1940, I pass on to No. 10. No. 10 deals with powers of the local authority in relation to alteration of boundaries.

No. 11 deals with certain matters with regard to the Housing (Miscellaneous Provisions) Act, 1931; No. 12 deals with parliamentary and local elections. No. 13 says: "The making of Orders and the giving of directions for the purposes of Article 7 of the Schedule to the Local Government (Application of Enactments) Order, 1898." No. 14 deals with the constitution of the council of a county or of an elective body, including the election of a chairman or vice-chairman of such council or such elective body, and the election and remuneration of the mayor of a borough or, in the case of the Borough of Dún Laoghaire the chairman of the borough. No. 15: "The procedure of the council of a county or of an elective body including the procedure at any meeting of such council or elective body". No. 16: "The appointment or election of a person to be a member of another body".

Mr. MacCarthy

Even making allowance for the fact that Deputy Mulcahyis on very familiar ground because he introduced the first Managerial Act ever applied to a county borough I think he is going outside the scope of this discussion here.

General Mulcahy

I again submit, a Leas-Cheann Comhairle, that for the purpose of showing in the clearest and most systematic way that there is no reserved function to any authority in relation to any aspect of a Public Health Bill, I am entitled to read to the House five more points in the Second Schedule to this Act, and I submit that if discussions here are going to be informed by fact—and we are dealing with important matters— one of the most important things we should discuss in relation to this Bill is the extent to which a local body shall have power under it. No. 17 deals with the nomination of a person to be President of Ireland.

An Leas-Cheann Comhairle

Surely that can have no bearing on this. The Chair feels that there is no necessity to quote the County Management Act in extensoexcept in so far as it relates to the Bill before the House and the amendment before the House. Anything else would not be in order.

General Mulcahy

I submit that it is relevant to a discussion here whether a local authority has under defined reserved functions any power to deal with anything in this matter, and I have pointed out that the County Management Act, 1940, declares positively what these reserved functions are, and I am reading out what they are for the purpose of an argument which it is imperative to make here—that is, that there is nothing in the reserved functions of a local authority which gives them any power in this matter.

An Leas-Cheann Comhairle

Have their reserved functians any relation whatever to the Health Bill? The Chair cannot see how it arises.

General Mulcahy

I am making that positive statement and the Minister does not believe me.

Dr. Ryan

I do not.

General Mulcahy

The Minister has told this House that the local authority has power under this Bill——

Dr. Ryan

When you are finished I will prove it.

General Mulcahy

I am prepared to let the Minister prove it.

Dr. Ryan

Certainly.

General Mulcahy

I was giving him and the House positive clear ground on which they could take some kind of stand in arguing the matter. Again, Sir, subject to your ruling, I submit that I am entitled within the rules of order to finish reading the reserved functions of a local authority.

An Leas-Cheann Comhairle

The opinion of the Chair is that the reserved functions of a local authority can be debated in so far as the Bill is concerned but anything else would not be in order and does not arise on the amendment or in the Bill.

General Mulcahy

I am listing the reserved functions of a local authority, for the purpose of showing that, no matter what the Minister may prove or suggest now, there is no power in this Bill. I submit that I am entitled to use that argument.

Mr. Allen

There is nothing in the section or the amendment, a Leas-Cheann Comhairle, about reserved functions.

General Mulcahy

If I am to stop I would like to be told positively by you, Sir, that I am to stop, but it is unreasonable to prevent me describing exactly what the reserved functions are.

Dr. Ryan

The quicker you let him finish the better.

General Mulcahy

I ask permission to finish reading the Second Schedule.

An Leas-Cheann Comhairle

The Chair has told the Deputy on two occasions that it would not be in order to discuss the County Management Act or the reserved functions, except in so far as they relate to the Health Bill. Anything else would not be in order.

General Mulcahy

I take it you are not preventing me from reading the Second Schedule. There is only one ruling I can understand from you on this matter, that it is not in order for me to continue reading the Schedule; and as you have not so ruled, I consider I am in order in reading it.

Mr. Allen

If it is solely to kill time, it is all right.

General Mulcahy

No, it is not. I would like to see this Bill printed at the earliest possible moment, with the Minister's last stamp on it.

Mr. Allen

It is purely and simply killing time. It has been made a farce of by the Opposition for the past three weeks.

General Mulcahy

Paragraph 18 deals with the disposition of certain lands, tenements or hereditaments under the Municipal Corporations (Ireland) Acts, 1840 to 1888.

An Leas-Cheann Comhairle

That again has no bearing on the Bill or the amendments.

General Mulcahy

Paragraph 19 relates to the freedom of the borough. Paragraph 20 deals with the suspension or removal of a county manager.

Mr. Allen

Is there nothing about the Vikings?

General Mulcahy

Paragraph 21 deals with the granting of superannuation allowances. Paragraph 22 concerns "the exercise of power which is vested by law (including this Act) in the council of a county or an elective body and is by this Act expressly made exercisable by resolution of such council or body." With that evidence in front of us, I submit that there is no power there. First and foremost, there is nothing in this Act that gives any local authority reserved powers over any aspect of the public health legislation. Here in this Bill there is no specific statement that would give to a local authority as a reserved function any power within that Act. Unless there is such a provision, the terms of the statute that I have read out preclude the local authority fromhaving any power in relation to the Bill in front of us now.

Dr. Ryan

I was reading out certain things that can be done under this Bill and which we are telling the local authority should be done. I read out several of them. Take, for instance, the provision of hospital accommodation for certain types of people, providing services for women in the case of maternity, providing for schools' medical examination. Take it that the county manager and the local authority are not agreed.

If it is the case that the county manager wants to do it and the local authority do not want to do it, the local authority can say: "We will not give you the money," and the manager cannot do it, since under that very long list of things read out by Deputy Mulcahy it is laid down specifically that the local authority provides the rate and if they do not provide the rate the county manager cannot do it. If the converse is the case, that the county manager says he does not want to do it and the local authority say they do, what happens? According to Deputy Mulcahy, the council cannot do anything, but I will just proceed where he stopped. The last thing he read was:—

"The exercise of a power which is vested by law (including this Act) in the council of a county or an elective body and is by this Act expressly made exercisable by resolution of such council or body."

Go back to Section 29 of the County Management Act:—

"(1) Any council of a county or any elective body, at a meeting specially summoned for the purpose under this section, may by resolution proposed and passed in accordance with this section require any particular act, matter, or thing specifically mentioned in such resolution and which such council or the county manager for such county or such elective body or the manager for such elective body (as the case may be) can lawfully do, to be done in exercise of performance of the executive functions of such council or body."

There is no doubt that when we pass this Bill it will be lawful for either the county council or the county manager to do the thing. We need not bother about it now, because this section says that the elected council can pass the resolution, and if it is lawful or either the council or the manager to do it, it must be done and that is the end of it.

Mr. MacCarthy

Or they can suspend the county manager.

Dr. Ryan

It would be illegal if he did not do it. So you can add that to the reserved function under Section 29. We are not dealing with the county manager but with the local authority. We are telling the local authority in some cases what they must do and in other cases what they may do, and it is a matter for them to decide whether it is their function or the county manager's. That is decided by the County Management Act.

At any rate, any service that we say in this Bill the local authority ought to provide must be provided. It is quite plain that the county manager cannot stop the local authority from doing it if they want to do it. That is certain, anyway. We need not put it into this Bill because it is in Section 29 of the County Management Act. There is no doubt about it.

Going back to Deputy Larkin's amendment, which we got a long way from in the meantime, the Local Government Act of 1925, Section 58, says:—

"A county council may from time to time appoint such and so many committees as they think fit for purposes connected with the exercise or performance of any of their powers, duties, and functions which in the opinion of the council would be better or more conveniently regulated or managed by or through a committee."

I need not read the whole section, though I have no objection to reading it.

General Mulcahy

I think it would be no harm to read the whole section.

Dr. Ryan

The Deputy likes to read pages when he starts.

General Mulcahy

Would the Minister say if Section 29 is for the purpose of directing a county manager to do some specific or particular act?

Dr. Ryan

If the council want the county manager to carry out any particular act or do any specific thing that is lawful to be done, the county manager must do it.

General Mulcahy

They can order a county manager to do a particular act —and the the Minister thinks that is appropriate?

Dr. Ryan

I am not going to be trapped by the Deputy. I could have gone on with Section 29. They cannot change the manager's powers and say: "Hand us over the appointment of doorkeepers". They cannot do that. If I wanted to hold up the House, I could read it. I suppose I had better do it.

General Mulcahy

I think it would be important.

Dr. Ryan

Not the slightest bit important. If the Deputy has that sort of mind, it would be better to give in to it.

Sub-section (2) reads:—

"Notice of the intention to propose any such resolution as is authorised by the foregoing sub-section of this section shall be given in writing to the county manager concerned and shall be signed by not less than one-third of the members of the county council or elective body at a meeting of which such resolution be proposed and shall contain a copy of such resolution and shall specify a day (not less than seven nor more than 14 days after the day on which such notice is received by the county manager) for the holding of such meeting."

Are you any better off now, after hearing me read that out? There are two pages of them.

General Mulcahy

You might as well read the whole lot.

Mr. McGrath

It will waste time, anyway.

Dr. Ryan

Sub-section (3) provides:—

"Whenever a county manager receives any such notice as is mentioned in the foregoing sub-section of this section, he shall as soon as possible send a copy of such notice to every member of the county council or elective body concerned and a special meeting of such council or body shall be summoned for the date specified in that behalf in such notice at the usual hour for meetings of such council or body."

Sub-section (4) provides:—

"When a resolution of which notice has been given under this section has been proposed at the meeting of the county council or elective body concerned summoned for the purpose under this section, such council or body and the county manager concerned shall consider such resolution and, if after such consideration such council or body passes such resolution and the number of members voting for such resolution exceeds either half the total membership of such council or body or two-thirds of the members present and voting, such county manager shall, if and when and so far as money for the purpose is or has been provided, do in accordance with such resolution the act, matter, or thing which is required by such resolution to be done."

I think that is quite reasonable. The county council could not expect the county manager to pay it out of his own pocket. The county council would naturally have to provide the money. Sub-section (5) provides:—

"A resolution passed under this section shall not ..."

—these are all the exceptions I mentioned—

"(a) apply or extend to the exercise or performance of any power, function, or duty of a county council or an elective body generally or to every case or occasion of the exercise or performance of any such power, function, or duty or to a number or class of such cases or occasions so extended as to besubstantially or in effect every case or occasion on which such power, function, or duty is exercised or performed, or"

—I hope you all understand that.—

"(b) apply or extend to the exercise or performance of any power, or duty conferred or imposed on a county manager by or under this Act in relation to the officers or servants of a county council or an elective body or the control, supervision, service, remuneration, privileges or superannuation of such officers or servants or any of them, or

(c) require a county manager to give or to withhold public assistance to or from any particular individual, or

(d) require a county manager to prosecute or to refrain from prosecuting any particular person or to discontinue any particular prosecution.

Any resolution purporting to be passed by the council of a county or by an elective body under this section which contravenes this sub-section shall be void and of no effect."

Sub-section (6) provides:—

"Every dispute which shall arise between the council of a county or an elective body and a county manager as to whether a resolution passed by such council or body (as the case may be) under this section does or does not contravene the next preceding sub-section of this section shall be referred to the Minister for decision, and the decision of the Minister thereon shall be final and conclusive."

That is the whole of Section 29 of the County Management Act, 1940. I think nobody will argue that it does not apply absolutely to this Bill—that if a particular service is provided under this Bill and the county manager is slow or reluctant or refuses to apply it to a particular county, the county council can call a special meeting, pass a resolution and compel the countymanager to adopt the scheme. There is no way out of it under the County Management Act or anything else.

Now I come to the Local Government Act of 1925. I pointed out already that, under sub-section (1) of Section 58 of that Act, a county council may from time to time appoint such and so many committees as they think fit for purposes connected with the exercise or performance of any of their powers, duties, and functions which in the opinion of the council would be better or more conveniently regulated or managed by or through a committee. As was pointed out by Deputy Allen, that would enable a council to appoint a sub-committee and to delegate to that sub-committee all or any of their powers. Sub-section (2) of the same section provides:—

"A committee appointed under this section may be either a general committee empowered to exercise or perform powers, duties, and functions in relation to the whole of the county or a local committee empowered to exercise or perform powers, duties, and functions in relation to a limited portion only of the county."

Sub-section (3) provides:—

"Every committee appointed under this section shall consist of not less than three members, and may be composed either wholly of members of the council or partly of such members and partly of other persons."

Sub-section (4) provides:—

"The acts of every committee appointed under this section shall be subject to confirmation by the council save that the council may with the sanction of the Minister empower any particular committee to do any act (including the institution of legal proceedings) within the authority conferred on the committee by the council which the council itself could lawfully do."

The next sub-section concerns the quorum, procedure and so forth. It provides:—

"The quorum, procedure, and place of meeting of any committee appointed under this section and thearea (if any) within which any such committee is to exercise its functions, shall be such as may be appointed by regulations to be made by the council with the approval of the Minister."

The last sub-section provides:—

"Save as is authorised by this section or otherwise by law it shall not be lawful for a county council to delegate any of its powers or duties to a committee."

That, I think, makes very plain what Deputy Allen pointed out—that a county council could appoint a committee, as outlined by Deputy Larkin, under this section of the Local Government Act and could delegate whatever parts of its powers it likes to that committee and then the committee may meet as often as it wishes. I think the powers are there so far as Deputy Larkin's amendment is concerned.

General Mulcahy

I do not want to misrepresent the Minister in any way and I assure the Minister that, when dealing with the Second Schedule, it was not deliberate. I want to be quite clear now as to the Minister's reaction to my remarks as far as the law is concerned. I understood the Minister to tell me now that—there being no arrangements to make any aspect of this Bill a reserved function under the County Management Act—the council, for the exercise of their will, must rely on the operation by them of Section 29 of the County Management Act to take any power in regard to the implementation or the operation of this Bill.

Dr. Esmonde

I have not the advantage of having the County Management Act before me. However, listening to the Minister's statement, I took it to mean that the county council have the power to delegate whatever authority they have to a sub-committee, or a health committee or whatever you like to call it. But what authority have they got? I understand, from this discussion, that the authority they have is to strike the rate and provide the money. As I read it, the manager has the executive authority to implement the different sections of this Act as it applies to the local authority. The function of the county council, if theydisagree with the manager, is to say that they will not supply the money. They can appoint any committee they want to appoint but will that committee have any function other than the function which they themselves have of providing the money? After that, the health authority decides what happens.

I am not going to try to put words into the Minister's mouth. Let us try and be practical about it. During the discussion on different sections of this Bill we heard a lot of talk about the payment of a subvention. It was categorically stated here yesterday that the county manager would decide what subvention would be paid. Is it seriously suggested now that the county council would have control over the county manager and that, if they did not agree with him about the payment of a subvention, they would have the power to say: "We will not strike the rate"? That is nonsense. What authority does it give them to control the executive authority of the county manager? In my opinion, first, last and all the time, the health authority is the county manager. He has to have the power. As far as I can read it, the elected representatives of the people have no authority other than that of collecting the rate and providing the money.

Dr. Ryan

I wonder will the Deputy give me some idea of what county councils spend their time at during the meetings?

Dr. Esmonde

They spend their time, as far as I can gather, producing money for the county manager who is to make the regulations.

Dr. Browne

The discussion of this matter has certainly covered a fairly wide area. We have been discussing the County Management Act on a health matter. I think that a certain amount of misrepresentation is taking place in relation, particularly, to the functions of the health authority and the manager. It seems to me that the manager is quite obviously the managing director and that the directors are the health authority. The health authority decide policy and the manager isthe executive. There must be one executive and the manager is the executive, but he can only operate within the general policy decisions of the health authority. That is perfectly understandable.

As to the question of sub-committees of the council, not only the Dublin County Council and the Cork County Council, of which I was aware, but all the county councils have power to delegate their functions, and their functions are policy functions, to sub-committees of the council. As far as I can see, that meets to a large extent the suggestions put forward by me. How far it will be effective is for the future to decide. At any rate, themanager must have certain specific functions of an executive kind and the county council have the power of making the policy decisions. I do not see how they can have anything else or ask for anything else.

Mr. Larkin

As to the last point raised by Deputy Dr. Browne, if the health authority make the policy decisions, and the manager's carrying out of the executive functions for the execution and administration of the policy is not satisfactory, where is the remedy then?

Mr. Allen

The council have the remedy then.

Amendment put.

The Committee divided: Tá, 10; Níl, 60.

Tá

• Beirne, John.
• Byrne, Alfred.
• Corish, Brendan.
• Davin, William.
• Donnellan, Michael.
• Dunne, Seán.
• Everett, James.
• Kyne, Thomas A.
• Larkin, James.
• Norton, William.

Níl

• Aiken, Frank.
• Allen, Denis.
• Bartley, Gerald.
• Beegan, Patrick.
• Blaney, Neil T.
• Brady, Philip A.
• Brady, Seán.
• Breen, Dan.
• Brennan, Joseph.
• Breslin, Cormac.
• Briscoe, Robert.
• Browne, Noel C.
• Burke, Patrick.
• Butler, Bernard.
• Calleary, Phelim A.
• Carter, Frank.
• Childers, Erskine.
• Cogan, Patrick.
• Colley, Harry.
• Collins, James J.
• Corry, Martin J.
• Crowley, Honor Mary.
• Crowley, Tadhg.
• Cunningham, Liam.
• Davern, Michael J.
• Derrig, Thomas.
• de Valera, Eamon.
• de Valera, Vivion.
• Fanning, John.
• ffrench-O'Carroll, Michael.
• Flanagan, Seán.
• Flynn, John.
• Flynn, Stephen.
• Gallagher, Colm.
• Gilbride, Eugene.
• Harris, Thomas.
• Hillery, Patrick J.
• Hilliard, Michael.
• Humphreys, Francis.
• Kenneally, William.
• Kennedy, Michael J.
• Lemass, Seán.
• Little, Patrick J.
• Lynch, Jack (Cork Borough).
• McCann, John.
• MacCarthy, Seán.
• McEllistrim, Thomas.
• MacEntee, Seán.
• McGrath, Patrick.
• Maguire, Patrick J.
• Maher, Peadar.
• Ó Briain, Donnchadh.
• Ormonde, John.
• O'Sullivan, Ted.
• Rice, Bridget M.
• Ryan, James.
• Ryan, Mary B.
• Smith, Patrick.
• Traynor, Oscar.
• Walsh, Laurence J.

Tellers:—Tá: Deputies Mac Fheórais and Kyne; Níl: Deputies Ó Briain and Hilliard.

Amendment declared negatived.

Dr. Ryan

I move amendment No. 65:—

To add to the section the following sub-sections:—

(9) The Minister may by Order revoke any Order made or deemed to be made under this section, and the revoking Order shall contain such provisions as the Minister thinks necessary or expedient consequential on the revocation and in particular where the Order to be revoked relates to a joint board, may make provision for—

(a) the dissolution of the joint board and the transfer of the property, rights and liabilities thereof to a health authority or to two or more health authorities or to another joint board or to two or more other joint boards,

(b) the preservation of continuing contracts made by the dissolved joint board,

(c) the continuance of pending legal proceedings,

(d) the transfer of the holder of any office under the dissolved joint board to a similar office under one of the health authorities who appointed the members of the dissolved joint board or under another joint board whose functional area is coterminous with, includes or is included in that of the dissolved joint board.

(10) Where, under an Order under sub-section (9) of this section, the holder of an office under a joint board is transferred to another office, the first-mentioned office shall, for the purpose of any enactment relating to superannuation be deemed not to have been abolished.

This amendment is designed to cover the case where a joint board is dissolved under Section 41 of the Bill. It follows the usual lines and sets out how to dispose of the property and also to see that legal proceedings will be carried on and any contracts taken over and so on. There is nothing in it, except that where the joint board is dissolved, all the usual procedure takes place.

Dr. Esmonde

I am afraid I did not hear the Minister very well. Will he clarify what particular board is concerned in this case?

Dr. Ryan

In the case of a joint board being dissolved—the ordinary board has already been dealt with— we want to cover that matter. It covers the usual lines and the property is transferred over to the new board or to two new boards, as the case may be, and existing contracts are carried on by the new board. If law proceedings are there, the new board takes on the law proceedings, etc.

General Mulcahy

I do not know if the Minister is speaking to the amendment.

Dr. Ryan

Yes.

General Mulcahy

I understand this amendment gives the Minister power so that when he acts under Section 41 he can undo the act, if he wishes. But, perhaps, it would be more satisfactory if the Minister could explain what he proposes under Section 41 first?

Dr. Ryan

Section 41, first of all, replaces Section 101 of the Health Act, 1947 which authorised joint action by the two boards—or two authorities I should say—in the performance of any function given them under that Act. The main change which is made between Section 101 and Section 41 of this Bill is that the board set up under Section 41 will be a corporate body. That would mean that, for instance, it would have power to borrow, which it had not before. Sub-section (5) of Section 41 enables the Dublin Board of Assistance and the South Cork and Waterford Boards of Public Assistance which function in the areas of two health authorities to carry out joint action for their constituent health authorities. These are the only changes from Section 101 of the Principal Act. They are, if you like, important changes. Now we come along, and in order to implement, as it were, any dissolution—in order to follow up the dissolution of a joint board—we lay down what becomes of the property and the contracts, etc.

Amendment agreed to.

Section 41, as amended, agreed to.

SECTION 42.

Question proposed: "That Section 42 stand part of the Bill."

General Mulcahy

Will the Minister say what is his intention in this section? I understand he has made certain changes with regard to these councils.

Dr. Ryan

I think it is simple. Section 42 says:—

"(1) The Minister may by Order authorise the Balrothery Board of Assistance or the Rathdown Board of Assistance to perform any functions of the council of the County of Dublin under the Principal Act or this Act and, for that purpose, may apply to such a board any provisions of the Principal Act or this Act or of any regulations thereunder and may so apply such provisions with any specific modifications or limitations."

Sub-section (2) of Section 42 says:—

"An Order under this section applying to a board the provisions of Section 103 of the Principal Act shall not be made save with the consent of the Minister for Local Government."

Section 103 of the Principal Act gives the power of borrowing and it is laid down here that where a sub-health authority is set up in this way by the Minister, or given functions by him, he cannot give them borrowing powers except with the consent of the Minister for Local Government.

Dr. Esmonde

I take it that the Minister's line of argument is that it would not be made a corporate body?

Dr. Ryan

Not exactly.

Dr. Esmonde

The boards concerned, the Balrothery Board of Assistance and the Rathdown Board of Assistance have the functions of the other boards except that they are not corporate bodies and that they are not able to borrow?

Dr. Ryan

Any power except thepower of borrowing may be given to them. They do not have it unless it is given to them specifically.

General Mulcahy

I understand that certain changes were brought about in the City and County of Dublin recently. Is it the intention that the Balrothery Board of Assistance, the Rathdown Board of Assistance and the Dublin Board of Assistance will continue as three separate bodies?

Dr. Ryan

For the moment they will. I had certain negotiations with the various bodies concerned—that is the Dublin Corporation, the Dublin County Council and these three bodies —with a view to having a unified health authority. Under the scheme that was put up, after the health authority is unified, it was intended that these boards in some capacity or other would be continued.

Dr. Esmonde

These boards already in fact exist?

Dr. Ryan

Yes.

Dr. Esmonde

Does the Minister consider that they should continue?

Dr. Ryan

There are just a few of the old boards of guardians remaining. There are relics of the old régime. There are three of them in Dublin, some in Cork and some in Waterford. In the ordinary county, there is no such body.

Dr. Esmonde

I take it this is a temporary arrangement?

Dr. Ryan

Yes. It is hoped to deal with this matter in another Bill.

Question put and agreed to.

SECTION 43.

Question proposed: "That Section 43 stand part of the Bill".

General Mulcahy

What type of interaction does the Minister contemplate here between the two health authorities?

Dr. Ryan

This enables the local authority to make certan agreements with the urban council, say, within thearea. Sometimes, perhaps, the urban council may have an ambulance or a fire brigade apparatus and this is to enable the county council to make the necessary arrangements for the use of such facilities.

General Mulcahy

Does it apply to the extension of sewerage systems, lighting systems or water supplies?

Dr. Ryan

That would not come under the health authority I think. If the Deputy is referring to lighting or water for an institution, of course, it would cover that.

Dr. Esmonde

It is simply providing for an arrangement between the parent body and the urban council for the use of any appliances they have appertaining to health, which may be at the joint command of both of them?

Dr. Ryan

Yes.

Question put and agreed to.

SECTION 44.

Dr. Ryan

I move amendment No. 66:—

Before Section 44 to insert a new section as follows:—

(1) The council of a county (other than Dublin, Cork or Waterford) shall by resolution appoint a consultative health committee to advise the county manager on general matters (other than conditions of employment of officers and servants, the amount or payment of grants or allowances or the making of any service available to an individual) relating to the exercise of the functions of the council in relation to the operation of the Principal Act or this Act.

(2) An appointment under sub-section (1) of this section shall be made by the council of a county as soon as conveniently may be—

(a) after the commencement of this section, and

(b) after each election of the members of the council.

(3) A consultative health committeeshall consist of ten members, including—

(a) not less than four members of the council of the county,

(b) the county medical officer for the county,

(c) the county surgeon for the county or, if there is no such officer, a senior medical officer in a health institution maintained by the council of the county,

(d) two other registered medical practitioners residing in the county, each of whom is nominated by a body which, in the opinion of the council of the county, is representative of registered medical practitioners practising in the county.

(4) A consultative health committee shall meet—

(a) when requested to meet by resolution of the council of the county or by the county manager,

(b) subject to sub-section (5) of this section, at such other times as the committee may determine, and

(c) subject to sub-section (5) of this section, upon a requisition to call a meeting of the committee signed by not less than four members of the committee, being presented to the county manager.

(5) Where meetings of a consultative health committee have been held on six or more days in any year, no further meeting shall be held in that year save at the request by resolution of the council of the county or at the request of, or with the consent of, the county manager.

(6) Every meeting of a consultative health committee shall be held in private.

(7) The foregoing sub-sections of this section shall apply to the Limerick City Council as if they were the council of a county, with the following modifications:—

(a) any reference to the county manager shall be construed as a reference to the Limerick City Manager,

(b) the reference in paragraph (b) of sub-section (3) to the county medical officer shall be construed as a reference to the Limerick City Medical Officer.

(8) The Minister shall by regulations provide for the establishment of a consultative health committee for each of the following areas:—

(a) the county borough of Dublin and the county of Dublin,

(b) the county borough of Cork and the county of Cork, and

(c) the county borough of Waterford and the county of Waterford,

and any such regulations shall provide for the application to the committee of the provisions of sub-sections (4), (5) and (6) of this section with any modifications which the Minister thinks fit.

This deals with the local consultative committee to which I referred already. As I have said the local consultative committee will be purely advisory to the county manager and it will be appointed by each local authority. Roughly speaking, it will consist of at least four members from the elected members of the council, the county medical officer of health, the county surgeon, if there is such an official as the county surgeon—in some counties there are no county surgeons and in that case he will be replaced by another medical officer—and two representatives of the county medical association. That makes eight. Then if the county council likes to appoint two other people of their own choice they can do so. The committee, of course, will be purely advisory to the county manager—not to the county council— and the manager will have his functions, whatever these functions may be. The committee will have the right to meet at certain times. They will have the right to call a meeting or to have a meeting called at certain times, subject to certain limitations, but the county council can have a meeting of this advisory commitee called at any time they like. If they think that anything should be investigated or that any of the actions of the county manager require to be investigated orconsidered, then they are in a position to make a report to the county council on anything they may find. I should mention that we exempt from this provision Dublin City and County, Cork City and County and Waterford City and County. An advisory council will be appointed by regulation in these cases. The reason for that is this: we have just been talking about Dublin City and County and the three boards of assistance. It would be so difficult to know how we could get representation distributed amongst these councils that we thought it better not to do it by a specific provision in the Bill but to have it done by regulation. It will have to be done by regulation and that regulation will be laid on the Table of the House.

Dr. Esmonde

This is a purely advisory council?

Dr. Ryan

Yes.

Dr. Esmonde

Will the two medical practitioners be nominated by the practitioners' group in the county?

Dr. Ryan

Lest the I.M.A. might be broken up—I was going to say with God's help—sometime, the section provides that two medical practitioners nominated by a body which, in the opinion of the county council, is representative of registered practitioners practising in the county, shall be appointed. If there is a county association that will be asked to make the nominations.

Dr. Esmonde

I did not quite get the personnel.

Dr. Ryan

Two members of the Medical Association, the county medical officer of health and the county surgeon, if there is one.

Dr. Esmonde

Is there anybody else on the committee?

Dr. Ryan

There will be four members of the county council itself. Then they are free to appoint two others, whomsoever they like.

Dr. Esmonde

Their function is to advise the county manager? Their position is very much the same as thatof the National Health Council in regard to the Minister?

Dr. Ryan

That is right.

Dr. Esmonde

The county manager need not accept any advice they give him?

Dr. Ryan

No.

Dr. Esmonde

And they meet on certain specified occasions. Have they any way of endeavouring to implement their advice if it is not accepted? Would the Minister give us some case in point? Could the Minister enlarge on a case where they give advice to the county manager and the county manager says: "I am not going to accept your advice; I do not think there is any sense it it"?

Dr. Ryan

We have not made out any elaborate procedure. It is considered that if there are four members of the county council on this body and if they think that the county managerhas been unreasonable, or if you like, impertinent or in any way offensive to the committee, of course they will naturally raise the matter at the county council meeting and they will ventilate any grievance they may have there. I do not think it will be necessary to do anything beyond that.

General Mulcahy

The amendment says that the appointment of the committee shall take place after the commencement of this section. What machinery, could the Minister say, is to be operated for the purpose of bringing this particular section into operation? Is it to be put in operation in connection with the operation of some particular part of the Bill or is there to be a separate date for its commencement? I move to report progress.

Progress reported; Committee to sit again.

The Dáil adjourned at 6 p.m. until Tuesday, 30th June, at 3 p.m.