Dáil Éireann debate -
Wednesday, 8 Jul 1953

Vol. 140 No. 5

Health Bill, 1952—Committee (Resumed).

Debate resumed on amendment No. 66.

General Mulcahy

I might emphasise, in practically opening the discussion on this amendment, because we had not progressed very far on the previous day, that this amendment, while it sets up a consultative committee for each local authority is an amendment which discloses very nakedly what we were trying to get the Minister to realise, or even admit, when discussing the previous amendment, that is, that the only person who has any functions in the administration of health matters, the only person who will have any overriding functions in the administration of this Bill under a local authority, is the county manager and that the elected representatives on the county council will have no power at all, except in relation to particular things to which the Minister rather indelicately drew attention when he said that they will have power in a most elaborate way to direct that something will be done under Section 29 of the County Management Act.

I referred on a previous occasion to Section 16 of that Act which deals with reserved functions for the local authority, and I think I established very clearly that, under no heading of the reserved functions indicated in the Second Schedule, had the elected body any detailed function in relation to the administration of health legislation. The Minister drew attention to Section 29 under which, if a county council require a particular thing to be done, they can use a certain number of bulldozing propositions contained in the section, which would involve two meetings of the county council and perhaps a mandamus from the Minister to get a thing done; but I set that completely aside as an ordinary part of administrative machinery, and, setting that aside, I say that there is no statutory provision which gives any power to the elected members of a local authority to interfere in any way with the administration of health services.

In this case, the policy is going to bedirected from the Minister when the Minister sees that the situation in the country is ripe enough for him to dictate policy, and, when that is done, the only function the elected members will have will be to examine the cost and strike the rate and then the Minister has power even to override the local authority and have a rate struck.

An Leas-Cheann Comhairle

The amendment deals with consultative health committees.

General Mulcahy

It deals with consultative health committees, and at column 2171 of the Dáil Debates of Thursday, 25th June last, introducing the amendment, the Minister said:—

"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."

This revelation, if you like, to people who have been rather bemused or misled by the Minister's statement on the previous amendments and who thought that the elected representatives had some function in relation to the administration of health matters, will enable them to realise. I think, from that statement that the consultative committee which is elaborately arranged for here will be an advisory committee, but advisory to the county manager.

Again, the Minister says:—

"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 committee 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 or considered, then they are in a position to make a report to the county council on anything they may find."

But if they do investigate, even at the request of the county council, and make a report to the county council on anything they may find, the county council have no power under this Act to interfere in any way with the administration of the Act by the manager, no matter what the advisory committee may recommend or suggest.

If the Minister thinks that Section 29 of the County Management Act, 1940 is any help in the matter, I suggest he should read that section again. It sets out that if the county council is dissatisfied with regard to anything which they want the manager to do they can hold a meeting and pass a resolution. If they pass such a resolution, the county manager will distribute copies of it to the members of the county council and they shall hold another meeting. If they decide that they require the county manager to do something, the manager will be required to do it, unless the county manager says: "I will not," in which circumstances it becomes a matter for the Minister. I suggest again to the Minister that he ought to be straightforward in stating categorically here that the local authority have no function in relation to this Bill, except that of collecting the rates from the ratepayers.

Minister for Health (Dr. Ryan)

I have only one comment to make on that speech. It is amusing to hear the Deputy asking me to be straightforward.

Dr. Esmonde

When discussing this matter on the previous day, I was putting it to the Minister that we were in favour of a consultative advisory committee such as this, but that it was very hard to see how they can implement their function, if I may put it that way. This advisory body can be summoned, according to the Minister, by the county council to have a meeting at any time and it can send a report to the county council. At column 2173 the Minister goes so far as to say:—

"...if they think that the county manager has been unreasonable, or, if you like, impertinent or in any way offensive to the committee, of coursethey 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."

We appreciate that. The position now is that you have a consultative advisory council who are to give the county manager advice. The county manager need not accept the advice. That is all right; we do not dispute that. The county manager, apparently, is accepted now as the health authority. The position is that an advisory council to be effective must be in a position to force their arguments home, so to speak. If the advisory council advise the manager and they think the manager has been unreasonable, the matter is returned to the county council and there will be a meeting of the county council on the subject. It may be ventilated in the public Press, but they have no executive authority whatsoever. That is the whole point which appears to arise here. The county council, according to the County Management Act—I am not holding the Minister responsible for that law which exists—have no executive authority whatever. That really nullifies the force of this advisory council.

We place a good deal of stress on the advisory council because we think advisory councils or any other such bodies are a great advantage in State medical services in order to maintain the freedom of the individual. In effect, however, they can only offer advice to the county manager. If he does not accept the advice they cannot object. They can bring the matter before the county council and the county council can discuss it, but the advisory council have no executive authority and therefore their authority is really nil. That is what we are asking the Minister to explain. We are not accusing the Minister of being responsible for the present state of affairs. We appreciate the fact that the Minister is introducing the principle of a local advisory council and we welcome that, but we cannot see that there will be any real benefit from the advisory council as matters stand at present.

I asked the Minister the last day if he would give instances of some cases, hypothetical cases, if he liked, in which the advisory council might advise the manager to do so-and-so and how the thing would work out. That is the position now. They simply can give advice, but the county manager need not accept the advice and they have really no way of voicing their grievance other than through the county council. The county council have no authority to support them. They can only strike the rate. That brings us back to the position we have been discussing all through this Bill and I should like the Minister to make a statement to clear up the position.

Dr. Browne

Is it intended that these consultative councils will have any function in relation to the voluntary health institutions? Will they have any advisory or executive functions as part of the health institutions being used in the health scheme or will the proposition be accepted at all?

Dr. Ryan

It is an advisory council and has no executive functions. It is called an advisory council and it is purely advisory. There is no more than that in it. If the local authority, which is the health authority, as this does not prove that the county manager is the health authority, want to set up a sub-committee of their own, they are at liberty to do so, but they must set up this advisory council. As I pointed out here, it can make itself felt by publicity; that is all. It cannot make itself felt by executive action because, if it could, it would not be an advisory council but an executive committee. It only purports to be an advisory council; that is all.

Bringing in this propaganda which Deputy Mulcahy is so fond of bringing in—he was the father of the county manager system—about the county manager and so on will not help in this discussion. I explained that a County Management Bill is coming along which will, I believe, define more precisely what powers the county manager will have and what the local authority will have, and there will be an opportunity then, if the Party opposite are more liberal than they were when they werein Government about giving more power to the local authorities, of making that suggestion. I do not see what purpose is being served by this attempt on behalf of Deputy Mulcahy to father the county management system on me or on this Government considering that it was he who brought this in first in the City Management Act for Dublin. Could he not leave that aside and deal with the Bill in a serious way? Then we might make some headway. There is no use in trying to read into this amendment anything but that the council's function will be that of an advisory body and that is all it is meant to be.

General Mulcahy

I should like to emphasise that we have been endeavouring from the time we began this discussion to help the Minister.

Dr. Ryan

You do not appear to be.

General Mulcahy

The Minister is introducing a Bill in complete opposition to the organised medical profession in this country and when we were dealing with this amendment the other day he expressed the hope that the representative body of the Irish Medical Association would pass out of existence, and he said he would almost add "with God's help". What we want to establish here is the fact that for the purpose of dealing with the administration of this Bill the health authority is the county manager and no gibes from the Minister with regard to who is responsible for the County Management Act should be allowed to hide that.

Dr. Ryan

Is not that pure politics?

General Mulcahy

I should like to say in reply to the Minister that I introduced the City of Dublin and the Cork City Management Acts. I did that against the fierce opposition of the Minister's Party when they were on this side of the House. When the Minister's Party got into office they introduced the Limerick City Management Bill, all the stages being passed in one day. As to the County Management Act, the whole idiotic frameworkwas the conception completely of the Minister's Party and the person in the Minister's Government who was responsible for it.

An Leas-Cheann Comhairle

Surely we cannot discuss the County Management Act on this Bill.

General Mulcahy

I am making it clear that there shall not be dragged across the important point under discussion here unnecessary references to the County Management Act.

Dr. Ryan

Who is dragging it across?

General Mulcahy

Or who was responsible for it.

Dr. Ryan

You talked about nothing else for the last three days.

General Mulcahy

Because the Minister is deliberately attempting to hide the fact that the county manager, who is entirely in the Minister's power, entirely in the hands of the Minister, to be ruled by the Minister if he so desires, is the one authority in any local area that will have complete power with regard to the organisation, the working and the administration of this Bill.

Dr. Ryan

Try and be honest.

General Mulcahy

I am trying to be honest.

Dr. Ryan

You are not succeeding.

General Mulcahy

I have given the Minister every opportunity of showing what power in relation to any sections of this Bill the elected body has. Beyond the general power that is given for the striking of the rate, there is no other power that I am aware of. The Minister has been given every opportunity of saying what the situation is, but he is hedging and dodging and asking who is responsible for the County Management Act and that sort of thing.

Dr. Ryan

I am not hedging and dodging.

General Mulcahy

He is hedging and dodging when he says that I was the father of the County Management Act.

Dr. Ryan

You were. Everybody knows that you were the first Hitler in the country.

General Mulcahy

Then I will have to go to the Oxford dictionary to find out.

Dr. Ryan

You should have gone there long ago.

General Mulcahy

The people who conceived the County Management Act and brought it in and passed it here with all its absurdities were the Fianna Fáil Government of that time.

Mr. Allen

Are we discussing the merits of the County Management Act on this Bill?

An Leas-Cheann Comhairle

The County Management Act cannot be discussed on this section.

General Mulcahy

Could we then, Sir, get rid of the obscurities that have been brought into the discussion by the Minister?

Dr. Ryan

Not as long as you are here.

General Mulcahy

And could we get down to the examination of this one point, that the manager to whom this consultative body is appointed, and with whom he will deal, is the official completely responsible for the organisation and administration of the Health Act, because that is a point that we want to make clear.

Captain Cowan

But is it not clear?

General Mulcahy

The Minister has twisted and turned in every possible way to hide that fact.

Dr. Ryan

Do not call me a twister anyhow.

General Mulcahy

You have twisted.

Dr. Ryan

If you are a twister and you twist again then I suppose you will be straight.

General Mulcahy

I do not call the Minister a twister.

Dr. Ryan

That is a nice distinction.

General Mulcahy

Could we bring all the clarity of mind with which we can see distinctions of that particular kind to see whether we can say the manager is not to be completely responsible in the local areas for the administration of those arrangements that are provided for here?

Mr. Cunningham

Say that again.

Mr. Allen

Forty-eight times already.

General Mulcahy

It would not be necessary for me to say it if, sparing the Minister's feelings, either Deputy Allen or Deputy Cunningham would say whether they agree with me that the county manager is the official who will be completely and ultimately responsible for the administration of all health matters that are being provided for here. It may be no harm to have a consultative committee of this type. It will give some kind of a group looking in over the shoulder of the manager and the shoulders of those who are carrying out the work. It is not the kind of statute that we should be passing here dealing with lives and health which is so intimately connected with individual lives and personalities. This is particularly so when the position is that the Bill is being brought in with a certain amount of cloud over it from the moral point of view and with indefinite opposition from the organised medical profession.

Mr. Morrissey

I do not know what all this pother is about.

Dr. Ryan

None of us do. I am glad you say that now.

Mr. Morrissey

There was no necessity for the Minister to say what he said a few moments ago, because if there is anything clear in this Bill from beginning to end, it is that there is only one authority charged with the complete and detailed administration of this measure if it becomes law, and that is the county manager. No other authority in this country, neither the county council nor the corporation nor the consultative nor advisory committee have anything to do with it. That is absolutely clear.

Dr. Ryan

Is it?

Mr. Morrissey

The Minister can look at the Official Report. I invite the Minister, if I am wrong in that, to correct me, and I shall be glad to withdraw.

Dr. Ryan

I wonder would you?

Mr. Morrissey

In so far as I can understand this measure, even in the amendment we are discussing, there is only one authority and that is the county manager. Let us be clear on that. There is no necessity for crosstalk about who introduced which. That is a fact which cannot be challenged.

Dr. Ryan

It can be challenged.

Mr. Morrissey

If so, I want the Minister to point out to me where any individual or body other than the county council or the Minister has anything to do with this measure.

Captain Cowan

I think this is entirely out of order.

An Leas-Cheann Comhairle

Deputy Morrissey is widening the scope of the amendment. We are dealing with amendment No. 66.

Mr. Morrissey

If Deputy Cowan would occasionally look at the amendment or the Bill——

Captain Cowan

That is all nonsense. You are notorious.

An Leas-Cheann Comhairle

Deputy Morrissey.

Mr. Morrissey

It is not easy to keep quiet. As the amendment here sets out quite clearly—this amendment we are dealing with—the proposed consultative or advisory committee is to have functions only to a limited extent. Even in this amendment, there are certain functions which are reserved exclusively to the county manager and I submit, with respect, that I am entitled to point that out. The Minister is setting up this committee.

Dr. Ryan

What are the functions reserved to the county manager?

Mr. Morrissey

If the Minister will read sub-section (1) he will see functions reserved away from the committee. I wish we could hear some of the views of Deputies opposite by way of speech and not interruption.

Mr. O'Leary

They are all silent men —nothing but yes men over there.

Mr. Morrissey

If Deputies think they are going to put us off our stride or prevent us from examining this Bill they are wrong.

Captain Cowan

We can all wait until 7.30 p.m. and we can talk about that.

Mr. Morrissey

The Deputy cannot sit quiet.

Captain Cowan

We will just show you now.

Mr. O'Leary

It is a pity you did not sit quiet.

An Leas-Cheann Comhairle

Order!

General Mulcahy

Are we paying for the printing of all this?

Mr. Morrissey

That is not the greatest price the people will pay. I will wait until the rest of them are finished talking.

An Ceann Comhairle

If we had quietness itself and less talk about it.

Mr. Morrissey

I was endeavouring to get that. The Minister very rightly said that this committee is purely an advisory committee, and as I was pointing out, the matters on which they can give advice are limited by the amendment itself. The Minister says in the amendment that they can report to the county councils, but the county councils have no more power than the advisory committee itself. The county council has not even the status conferred on it that this committee will have of acting even as an advisory committee. It can nominate a number of its own members, not fewer than four, on the committee. The Minister says the committee willhave the advantage of publicity and that they can use the county council for that purpose. Is that going to work out in practice? If it were to work out in practice, is it something that we all desire—that the only way in which publicity can be obtained for the views of the consultative advisory committee is by way of a public conflict between the county council and the manager? That is the only way in which the publicity to which the Minister refers can be obtained. I doubt if that is even advisable. I want to make it as clear as I can that my understanding of this measure—and if I am wrong I shall be thankful to anybody who will put me right; I do not pretend, like some people in this House, to be infallible on everything that is introduced here—is that there is only one authority and that that is the county manager.

Mr. Allen

I wonder how the Opposition have faced the public in this country for quite a number of years, about 12 years——

Mr. Morrissey

You prevented us from facing them again last week.

Mr. Allen

——knowing, as they do, that the same authority has been operating health services for a great number of years? I do not believe there was a single question on the Order Paper for the last 12 years about the manner in which these health services were being operated. Since the advent of the County Management Act —and it has been 12 years in operation now—the very same authority has been operating the health services, so far as almost 50 per cent. of the population of the country are concerned, as will operate this Bill when it becomes an Act. There was not a word, not a single word, from the leader of the Opposition, Deputy Mulcahy, with regard to the manner in which these services were being operated. He was not the slightest bit concerned with the interests of that 50 per cent., the poorer sections of the community.

General Mulcahy

I have been talking of it since 1945.

Mr. Allen

The Deputy never raised a single question as to who was administering the health services that were available to that section of the community during all these years.

General Mulcahy

I have been speaking about it since 1945.

Mr. Allen

There was not a single complaint or a single question asked as to how the health services were being administered.

General Mulcahy

That is not true.

Dr. Ryan

He was not concerned about these people.

Mr. Allen

I repeat that not one single question was asked. Hypocritical is not a sufficiently strong word to apply to the attitude of Deputy Mulcahy on this Bill. He wants to know who is going to administer this Bill when it becomes an Act or who will administer the health services in future, but he never thought of asking a question for the last dozen years as to who was administering the health services for 50 per cent. or more of the population who happened to be the poorest section of the community.

There is one matter arising out of the amendment to which I should like to call the Minister's attention and, if it is possible to do so, I should like if he would bring in an amendment on the Report Stage to deal with it. I refer to the proposal that not less than four members of the council should be appointed to this committee. I want to suggest that such members of the council should be elected or selected for the committee through the system of proportional representation, because it will give general satisfaction.

Mr. MacBride

That is at the county council meetings?

Mr. Allen

Yes. They should be selected by the council in that way. I think it would improve the committee in some counties.

Brendán Mac Fheórais

Where Fianna Fáil had been wiped out.

Mr. Allen

In counties where Fianna Fáil are in a majority. I should like to see all sections represented. Thereis no doubt but that this amendment setting up a health committee will be of advantage. There has been a lot of talk about the county manager having absolute control, as if the county council were not in existence or as if the manager could function without the council of a county. An effort has been made to put that view across to the country for quite a while now. The Fine Gael Party are only echoing what has been said by other organised groups in the country but Deputies here should know, and Deputy Mulcahy knows it well, that the county manager cannot function without the council of a county. He knows that the council of a county have the right in law to provide the moneys for any particular service and they can determine in what way these moneys will be spent. They have also the determining voice in respect to each individual item, each individual service for which they provide money. They are all-powerful in that respect. They can override the manager in every single instance if they so will.

Mr. O'Leary

You never saw it done in Wexford.

Mr. Allen

They, as the determining body in providing the rate or any section of the rate, will have control in respect to any service of the council.

An Ceann Comhairle

The Deputy is widening the issue very much. He is going away from the question of consultative committees.

Mr. Allen

If you were in the House, Sir, half-an-hour ago you would have said that very often. Deputy Mulcahy spent three parts of an hour examining and analysing the County Management Act.

An Ceann Comhairle

I do not know what Deputy Mulcahy did but Deputy Allen should not go on that line.

General Mulcahy

We have been on this Bill only since 5.30 and I wonder how I could have spent three-quarters of an hour on it. The rest of the Deputy's statements are just as exaggerated as that.

Mr. Allen

I should not like to be as disorderly as he was during that time.

Mr. D.J. O'Sullivan

That is a reflection on the occupant of the Chair at the time.

An Ceann Comhairle

We shall pass on to consultative committees.

Mr. Allen

I wonder how we ever got as far as Section 44? I suppose we had the same argument on every section. So far as I heard Deputy Mulcahy, on every section he spoke about the county managers. I just want to say that the county manager under this Bill or any other Act, cannot operate without the county council or the local authority. They can determine policy in respect to every single section in the Bill because they are going to provide the money for it. I hope the Minister will consider bringing in an amendment on a later stage of the Bill to provide that the nominees of the local authority on this committee will be elected by the system of proportional representation.

Mr. MacBride

Before dealing with a number of matters arising on this amendment I should like, lest I forget, to endorse the suggestion made by Deputy Allen as to the method which could be used in regard to the election of the four members by the council to the consultative committees which are to be chosen by the county councils. I have no intention of discussing the merits or demerits of the County Management Acts or even of attempting to discuss who was responsible for these Acts. I think, however, we have to face up to the situation that this Bill widens very considerably the powers that the county managers have. It increases their functions very considerably. I suppose it is very hard to avoid that in any extended system of medical services but I think we should take every step we can to prevent this widening and increase of powers of county managers from being abused— from becoming a dangerous form of bureaucratic dictatorship.

Dr. Esmonde

Hear, hear!

Mr. MacBride

I know that it is easy to say that county managers will behave reasonably, that they will be subject to public criticism and that that will act as a brake to ensure their reasonableness. Unfortunately, however, I think the experience is, as it generally is with human nature, that when a person gets certain functions and certain powers that are unchecked, the tendency is to use these powers very fully and to resent criticism. I think that members of the Government —not necessarily of the present Government but of any Government— resent criticism even though, God knows, the whole political system is devised to ensure that political criticism will be forthcoming on every political issue. Therefore, I think it is certainly of value to have these consultative committees, but I think that some more specific powers might have been given to them.

The functions and duties of county managers have been increased very considerably in recent years, not merely by this legislation, but by other legislation also. This particular legislation will increase them still further. Would it not be advisable to have the health services administered in the county or county borough by a specially appointed officer who would deal with health services and nothing else? The county manager already has a tremendous number of duties of a varied nature to perform—the administration of the finances of the county, the question of roads, the maintenance of institutions, rate collection, and so forth. When these health services are in operation they will entail a tremendous amount of additional administrative work. I think the Minister should consider whether better results will not be achieved by making provision for the appointment of a special officer who would, in effect, be director of medical services in the county and who would be responsible directly to the council for the administration of the health services in that particular area. By all means leave the county manager with his general powers in regard to expenditure, and so forth, but I think therewould be a good deal to be said for having the medical services administered by a specially appointed officer rather than by the county manager who is already overburdened with a considerable amount of work. I would ask the Minister to consider that position and examine it carefully himself.

Another matter which I should like to raise concerns the composition of the consultative health committees. I know that, apart from the four members who are to be elected by the county council, the county medical officer and the county surgeon will also be members of the committee. I appreciate fully the reasons that prompted the Minister to include these two medical officers as members of the committee. Is it not, however, creating rather a difficult position? You will have a consultative committee whose function will be, according to the Minister, to criticise and voice public criticism, if needs be, in regard to the manner in which the health services are administered. These two officers will, at the same time, be paid officials of the council and under the control and jurisdiction of the manager. Will they be free agents, and will they feel themselves free to criticise their boss, their chief, who is the county manager, as if they were outsiders? I can see a certain amount of difficulty there. I appreciate fully the reasons why the Minister included them on the committee. He felt they should be members of the committee. I should be more inclined to suggest that they should be officers of the consultative committee rather than members of it. I suggest to the Minister that the members of the committee should, in no sense, be paid officials of the council or officers of the council. By all means make provisions whereby the county medical officer of health and the county surgeon will be officers of the committee, if you like, who will attend meetings of the committee and be able to supply information and to answer questions. I wonder, however, if it is wise to make them members of the committee? I think this is a matter that the Minister should consider. Probably he hasalready considered it to a certain extent. It is making rather a dangerous precedent whereby paid officials, in effect, are placed on the committee whose function it is to criticise the services administered by the council.

I also feel that the county medical officer of health and the county surgeon might not feel themselves as free to voice their criticism as some persons who are not in the employment of the council and who are not subject to the control of the county manager. I know that in a great many cases no difficulty of that kind will arise but the position in regard to legislation is that we have to legislate not only for the normal course of events but also for the exceptional circumstances. I would like the Minister to examine the provisions covering the composition of these committees, not in the light of what will happen in 90 per cent. of the cases but in the light of the situations that might arise in 10 per cent. where any kind of conflict develops between the county manager and the consultative committee. Presumably the function of the committee is to decide as to the essential health services. Otherwise, it would be of no value to have such a committee. Paragraph (d) of sub-section (3) also provides for the appointment of two doctors nominated by a body which, in the opinion of the council, is representative of the medical practitioners in the country. Again I appreciate what the Minister is trying to do, but I wonder if the position is sufficiently clearly set out in the section. How will the council decide that? Is the council the best body to decide that? I do not know how many organisations there are which embody medical practitioners at the moment, but should there be three or four, five or six different organisations at some future date, I could see that some difficulty would arise on the part of the county council in deciding which of them should be taken as representative of the medical profession in the county, particularly if there were any kind of political issue.

As for sub-section (4), this is the sub-section which provides when the consultative committee shall meet. Itprovides, first of all, that the consultative committee shall meet when requested by the council or by the manager. That is fair enough. It then provides that, subject to sub-section (5), it shall meet at such other times as the committee may determine. That throws us on to an examination of sub-section (5). Sub-section (5) is extraordinary in that it limits the number of meetings to six in the year. Is that wise? Why limit the meetings of the consultative committee to six in the year? I do not imagine the consultative committee will want to meet more often than is necessary. If the consultative committee is doing useful work, why not let them meet once a month; why not let them meet once a week, even; it might be convenient to have them meet once a week. I think the experience in England is that a lot of the local health committees do extremely valuable work, voluntary work.

Captain Cowan

Will we not have the health committee operating here as distinct from the consultative committee?

Mr. MacBride

At the moment I am discussing this health committee. I do not see why they should be prevented from meeting more often than six times a year. It seems an unnecessary limit to impose, unless there is some very good reason for imposing it. The mere fact that you set up a committee and then tell it: "You are forbidden to meet more than six times a year", is starting off on the wrong footing. I would urge the Minister to drop that provision and let them use common sense as to how often to meet. If they are difficult cranks, irrational people, they should not be on the committee; but if you have a committee charged with responsibility of this kind it is to be assumed that they are reasonable and rational and will not want to meet more often than is necessary for the purpose of fulfilling their function.

The next sub-section, sub-section (6), is one that also needs attention. Indeed, it seems hard to reconcile it with the statement the Minister made, that while these committees hadno power they had at least the power of publicity and in that way they could ventilate grievances and protect the interests of the public by means of publicity. Sub-section (6) provides that every meeting of the consultative health committee shall be held in private. I could quite well understand that these committees would normally meet in private, but I do not think that I would include a provision of that kind in the Bill. Again, I would give complete freedom to the committee as to whether it should meet in private or in public. I do not think that daylight and a bit of fresh air is any harm if criticism is to be levelled. The function of these committees, as the Minister told us, is to act as a curb on any undemocratic tendencies by means of publicity. If the committee is prevented from meeting in public, it is hard to see how it can serve any useful function in that direction. I am quite certain that 95 per cent. of the time the committee will probably meet in private. I would leave that to the discretion of the committee.

I make these suggestions not by way of destructive criticism but rather to indicate to the Minister a number of things he should look into very carefully. I think these are matters which deserve consideration.

Captain Cowan

I want to make just a few observations in regard to the working of this machinery. It is necessary to have some practical knowledge of health affairs either in a city or in a county, to understand really how this machinery will work. In Dublin Corporation we have a public health committee—all the members are on it—and we have a very considerable amount of work to-do, but we find we can do it by meeting regularly one day in the month. We never had any difficulty with the city manager. The city medical officer of health attends the meeting with officials and every problem that comes before us is considered. Whatever our views are, they are adopted, so that in practice there is no difficulty at all in the working of the machinery.

I try to keep myself informed as to what is happening in the differentcounties, particularly right across the whole of the Midlands. I read the local papers every week and I am in pretty close touch with what is reported, at least, of the activities of the local councils down the country. I think we have reached the stage where the members of local authorities have much more power in practice than they are supposed to have in theory. That is my experience as a member of a local council. I can see that this consultative council will meet very infrequently. Certainly, as far as Dublin is concerned, I do not see very many reasons why it should operate at all. However, the Minister has endeavoured to meet some point by the provision of these consultative councils. They may fulfil a useful function during a certain stage of evolution in the machinery of our health services.

Deputy MacBride referred to his experience of people who gain a certain amount of power and who resent criticism. We realise there are people like that. In my experience in relation to Dublin, as far as the city manager is concerned—and he has most extensive powers—he is a very sensible man and he does not exercise any of these powers without consultation with the city council, the housing committee, the health committee, the town planning committee or some committee. Although in theory one can say that he has tremendous power, in practice he does what the elected representatives of the local authority require. That is a stage in evolution in so far as county managers are concerned.

In a couple of counties in the past, we had a type of manager of whom Deputy MacBride says he has had personal experience, the type that resents criticism or even advice from the other members of the local authority. That day has passed and at the moment one would have difficulty in getting that type of manager. If one had a county manager always ready to fly in the face of his local council, the position would be very unsatisfactory. In 99 per cent. of the cases at the moment, there is no friction and the 1 per cent. can always be dealt with.

This question of the county manager and the local authority is bound to give rise to a good deal of discussion as to which is the best machine for progress. If society endeavours to improve medical services for the community generally it is a neat question as to whether the county manager will do the work more quickly than the local councils, bodies which are apt to raise questions of expenditure, rates, and this, that and the other. When it is a matter of life and death and health generally the question of whether or not any action taken will increase the rates by one-tenth of a penny ought not to enter into the discussion.

The Minister is here making provision to meet some objections raised. Anyone who has any experience of the actual working of the machinery of local government can see whether this provision can operate and function, for the time being at any rate, in a satisfactory manner. I see nothing wrong in principle in the county medical officer of health or the county surgeon being asked to sit on a consultative committee. I do not think that because a person is a paid servant he cannot have a voice and cannot explain his views. The point has been made that the county medical officer of health would be afraid to express his views because they might conflict with the views of the county manager.

Mr. MacBride

It would work both ways.

Captain Cowan

These two officers might feel they could not express their own views or that, if they did express them, that might prejudice their position. Having had practical experience I have no fear of that. At the moment everything is discussed and debated on a man-to-man basis. The meetings are held in secret. No members of the Press are present and the result is that the elected representatives and the county medical officer for health are able to express their views quite freely. No sensible person could have any fears as a result of a discussion of that kind.

In discussing this section in the wayit is being discussed here we are raising hares. Generally speaking, the views of the elected representatives prevail in the long run. The Minister has pointed out that there is on the stocks at the moment a Bill to amend the County Management Act. A former Bill for that purpose had gone a good distance here before the change of Government. With our experience since, it is possible that any defects which may appear here will be removed when the proposed new Bill becomes law. This amendment has been put in for the purpose of meeting the viewpoint that there should be this type of consultative committee. Because of that I think we ought now to accept it and get the Bill passed into law as quickly as possible. The longer we hold it up the more we may endanger the life of some individual. That would be poor satisfaction to those members who do not like this Bill, who want to obstruct it in every possible way and keep it from being passed into law as long as they possibly can.

Mr. MacBride

I want to raise one point in relation to the composition of these committees. In paragraph (a) it is provided that:

"not less than four members of the council of the county..."

Is it wise to insist that the four members elected by the county council should actually be members of that council? Why not leave it to the discretion of the county council? Some member of the county council with long experience of public administration may retire or not be re-elected; the county council might decide that because of his long experience and particular knowledge of some aspect of the council's working they would like to have him on the consultative committee. If the members of the committee must be members of the county council that provision might easily debar a number of very useful people. I suggest it should be left to the discretion of the county council to appoint any four members they like. Let them choose I can see cases where there would be a very strong argument for having some person who is not a member of the county council but who hasspecial qualifications and a wide experience having worked on a county council for many years.

Dr. Ryan

Deputy Cowan has shown one thing anyway, that he has experience in regard to the working of health cases in the past. That is what some of the members opposite very seriously lack and, indeed, show in their speeches. Deputy Cowan has given his views on how these various councils and consultative bodies may be expected to get on under this Bill as the councils have got on in the past. I am sure that all are glad to have the benefit of his experience and his opinion of how things are likely to work out. Deputy Allen, who has also experience for many years in regard to these health cases, would, I think, largely bear out Deputy Cowan. Deputy Allen truly said that whatever may be the functions of the local authority and the county managers they are not being changed by this Bill. These functions have been there for the last 12 years. I never had any complaint. As Minister for Health for one year before and two years now, I never got a complaint from any member of the Fine Gael Party. I do not know whether I should put it that they are more interested now because a different class of people are coming in.

Mr. Morrissey

That is a charitable, straight way of putting it.

Dr. Ryan

A more charitable way would be to say that they are just playing politics.

Mr. Morrissey

That is a very helpful remark.

Dr. Ryan

Just a political stunt.

Mr. Morrissey

All right.

Dr. Ryan

That is all it is.

Mr. Morrissey

If that is the way it is to be, that is the way it will be.

Captain Cowan

It is being obstructed.

Dr. Ryan

What motive will I attribute then? There has been for three days an attack on the county managers. The county manager has beenthere for the past 12 years in health matters and there have been no complaints whatever.

Mr. O'Leary

There have been plenty of complaints.

Mr. Morrissey

Since 1945 we have always objected.

Dr. Ryan

You have kept it to yourself.

Mr. Morrissey

We did not.

Dr. Ryan

I have been Minister for Health for three years and I have never got a complaint from a Fine Gael T.D.

Mr. Morrissey

It is on the record of the House.

Dr. Ryan

There was never a question asked about the county manager. Now this barrage is raised.

Mr. O'Leary

Did you ever get a complaint from your own constituency?

Dr. Ryan

Never—not even from Deputy O'Leary and he is never behind the door when complaints are being made.

Mr. O'Leary

You do not go down except at election times.

Dr. Ryan

I only want to know why this barrage is being raised. Is it because a different class of people is being brought in or is it because some political stunt is being inaugurated for the purpose? When Deputy MacBride was speaking I took a few notes. As far as I could see he was the first member on the opposite benches who had read the amendment. We had a couple of days' discussion by some of the other members opposite, and as far as I could see they had not read the amendment at all. At least Deputy MacBride read the amendment because he took it line by line and gave his views. If we had that type of discussion on this amendment from the beginning instead of the political manæuvring of Deputy Mulcahy and the rest of them we might have got somewhere.

Deputy MacBride says that this widens the power of the county manager.Again, he says that the function and powers of the county manager are vastly increased. I must say that I cannot see that. This Bill is brought in to deal with health matters. Whatever are the powers of the local authority and whatever are the powers of the county manager they are not being changed so far as this Bill is concerned. That is settled by the County Management Act and they will each learn what their own part of the business is under the Act but not under this Bill. I am not finding fault with Deputy MacBride. He may have a point.

Mr. MacBride

Might I be permitted to explain what I mean? Say that it costs £4,000,000 per year to administer it. That is £4,000,000 more of services that the county manager will have to administer.

Dr. Ryan

If you put it that way, the county manager will have £4,000,000 more to spend and, therefore, he will have more power. There is something in that, but the local council will have £4,000,000 more to distribute. Therefore, they will have more powers. I take it that the matter will go pari passu.

Mr. O'Leary

The local authority will have to raise half.

Dr. Ryan

Deputy O'Leary will not give much of a hand to raise the money, but he will give a hand to spend it.

Mr. O'Leary

I know the form of Deputy Ryan and Deputy Allen.

Dr. Ryan

The Deputy is starting his impudence again.

An Ceann Comhairle

Deputy O'Leary should allow the Minister to speak without interruption.

Dr. Ryan

He is a real gentleman. Deputy MacBride advocates a specially qualified officer because the county manager has too much administrative work. When I was setting out on this Bill in the begininng, I had the same opinion and I was inclined to have an executive officer especially for healthpurposes. By discussing this matter with the Department of Local Government who have a fair amount of knowledge of the subject and by making what inquiries I could, I came to the conclusion that the county manager, so far as his functions are concerned, could administer the health services as well as the local government services. It would not be fair to have another person appointed at an additional salary and that expense put on the local authority. For that reason it was not done. I can assure Deputy MacBride that the matter got very full consideration. If the business of the local authorities grows, we may come to the point where it will be necessary to have an executive officer for local government matters and another for health. I think we should not do that at the moment. We should let things go for a while to see how they may pan out.

It is true, as Deputy MacBride points out, that the function of the advisory committee we are dealing with is to advise on and criticise the manner in which the health services are administered. He goes on to say that that being so he thinks it is hardly advisable to have officials such as county surgeons and medical officers of health on this advisory committee. That is a point of view too. I must say, again, that in the beginning I was rather averse to the inclusion of any official on the committee. I thought it was rather an anomalous position to have a paid member of the council on this advisory committee sitting beside county councillors and others and criticising their own work.

It was then put to me that if they were only present as officials they would not have the same right to interfere, as it were, in the discussions and that they might be slow to interfere unless they were asked to interfere on any particular issue. I came to the conclusion that in an advisory committee of this kind it would be well to have a few officers at least who would be familiar with the working of the health services and who would be in a position to voice their opinion and, perhaps, have an opportunity of putting a point of view which they hadalready put to the county manager and got nowhere. They can put that point of view to this advisory committee and in that way may have some good idea adopted.

It is very hard to say, of course, which way is the better, whether it is better to exclude the officials from any committee of this kind or to include them. I can quite see the point of view either way, but at any rate we came down on the side of including them. The inclusion of these particular officials is in the scheme now, and I would say that, on the whole, we should let it have a trial on that basis.

With regard to Deputy MacBride's point that we should not have put in the words "not less than four members of the committe", may I say this? The committee is to consist of ten. We are only, as it were, nominating eight out of the ten. There will be four county councillors, two medical men from the county, the county surgeon and the county medical officer of health. There are two places left. That was purposely done so that the county council could put on one or two people whom it thought would be useful on this advisory body, who were not members of the county council, and who were not doctors. It is free, at least, to put these two extra people on. It may be argued, of course, that that is not giving the council sufficient scope but, on the whole, I think it is. It will have the opportunity of nominating one or two very useful people.

We had the difficulty, of course, that Deputy MacBride referred to, that, if you were to select two medical officers from the county, the council might have some difficulty in selecting them. The medical men of the county who will be taking part in these health services, whether as dispensary doctors or in other sections of the health services, would probably like to be officially represented through their own organisation. That is why it is put in that the council would take two medical practitioners nominated by the organisation which represents medical practitioners. Under present circumstances we might, perhaps, have said "the county medical association",but you never know—there might be a split and there might be two organisations in the county. In that case the council would be at sea to know what it should do. I think that the simplest thing to do is to say that the council will take them from whatever organisation is, in its opinion, representative of the medical men of the county. I am afraid we will have to leave it to the council to decide, although I can see Deputy MacBride's point. If there was a split, the council would, perhaps, not be the best body to decide, but then can we say who would be? I think we will have to leave it at that.

Mr. MacBride

Would the Minister say whether he considered the possibility of having someone representing the nurses?

Dr. Ryan

I did, but we did not want to have this body too big. The whole trouble is that if you had a big advisory council it would, in my opinion, be useless.

Deputy MacBride raised another point with regard to the six meetings in the year. I do not think it will be necessary for an advisory council like this to meet more than once every two months or so. If, for any reason, it is required to meet for some special investigation or consider some special recommendation which might require more than one meeting, the council can, by a resolution, settle that. That will make it all right as far as the meetings are concerned, or if, on the other hand, the county manager is a man of the type described by Deputy Cowan, that is a man who is very anxious to get advice, well he can call them together as often as he likes. The only thing we want to avoid here is that four members of the council who are perhaps in a minority and who are trying to push some certain idea that the majority do not agree with, will have the power to call meetings at any time they like. If they had that power they could make it nearly impossible for the other six members to attend as often as they might like to have meetings. That is why some limit has to be put on the number of meetings to be held. Youhave the same idea in the case of the central consultative council that meetings cannot be held oftener than a certain number of times in the year. I think, therefore, it is necessary to put some limit to the number of meetings that may be called in that way.

The meetings are to be held in private. I think that a body like this is not going to do good work unless it meets in private. I think that we have only to listen to the debates here to realise that. You might have a member like, say, Deputy Mulcahy, who would like to attack the county manager for political kudos, and who would like to have the Press present for the purpose. No good work would be done if you had a member of that kind.

The only way to muzzle a man of that type is to have the meetings in private. I think that if you want to get work done, therefore, these meetings should be held in private. As I have mentioned already, if there is a good sustainable case to be made the members of the council who are members of the county council will, I am sure, be impressed by it, and if they think that something should be reported to the county council they are in a position to do so. In that case, publicity will be given to anything that may be reported.

A point was raised by Deputy Dr. Browne as to whether this council would have any function in regard to voluntary hospitals with which a council may have agreements. It would, of course, in this way, that if there were any complaint that a voluntary hospital, with which a local authority had a contract for sending its patients to, that would come before this advisory council and be discussed. If a member had any question to raise of that kind he could raise it at the meeting and get whatever explanation or evidence was available from the county manager and the officials present, such as the county surgeon, have it discussed and see whether there was any justification for the complaint or not.

I do not think there was anything else arising out of this discussion thatwas purely related to the amendment that I need deal with. I know that we had quite a lot of a discussion on points that were not related to the amendment but which might properly be raised if the County Management Act ever came up for discussion. I have said already that I do not know exactly what is in the County Management Act except in a rough way, but I do know that as far as this Government are concerned they are certainly going to go further than the Coalition Government proposed to go by giving wider powers to the local authorities.

Mr. O'Leary

You are going to scrap them all together.

Dr. Ryan

You were changing their them altogether.

Dr. Maguire

I want to assure the House that, in my opinion, the establishment of this consultative committee will go a long way towards meeting the wishes of the Irish Medical Association in their quest for the establishment of regional councils such as obtain in England for the working of the Health Act. I consider that these consultative committees, such as we propose to establish here, will be even more effective than the regional councils at the other side, for the reason that their members will be more au faitwith local conditions. I think there is an unfounded fear abroad that these consultative committees will result in the county managers being a bit dictatorial. I cannot imagine that particularly in regard to health matters. I have never found him asserting authority unduly in matters of this kind. I had cause to consult him on many occasions and he had cause to consult me on many occasions; there are times when he is in consultation with the medical officer of health, the county surgeon or the county physician and I have no reason to believe that he is dictatorial in this connection.

The question of paid officials being members of this consultative committee is rather a difficult one but I cannot see how that can be avoided. I believe that if critcism even of their own duties came up at meetings of theconsultative committee, they would appreciate more their being criticised in their presence than behind their backs. The question of paid officials being on this consultative committee is absolutely inseparable from the successful functioning of the committee.

Mr. MacBride

May I put this to Deputy Dr. Maguire? Supposing there is a complaint as to the administration of health services involving the county medical officer of health or the county surgeon, surely it is asking him to pass judgment on himself.

Dr. Maguire

Yes, but eventually he would have to be criticised in his presence.

Mr. MacBride

Yes, in his presence, but he should not be the tribunal.

Dr. Ryan

It will not be a tribunal.

Dr. Maguire

I do not think he would object.

Mr. MacBride

He will not object, of course.

Dr. Maguire

I do not say he would get any particular privilege from being a member of the committee and being present on such occasions.

Mr. MacBride

It is not a desirable principle.

An Ceann Comhairle

Let us have debate, not conversation.

Dr. Maguire

There is the question of the appointment of two other registered medical practitioners. It occurred to me when Deputy MacBride was speaking that the selection of these two medical practitioners should be left to the county medical association. There seems to be more fear surrounding that selection. I do not think it is necessary to meet the devil half way in this regard. I cannot imagine anybody visualising two county medical associations. It is pretty far-fetched.

General Mulcahy

The Minister contemplates none.

Dr. Maguire

I do not believe that any danger exists or will exist that two medical associations would operate in competition with one another.

When one considers that over 90 per cent. of the county medical officers of health, county surgeons, and so forth, are members of the county association, it can be safely and wisely left to that association to make a suitable selection.

It is difficult to understand the objection to the committee meeting six times a year. The explanation the Minister has given is quite reasonable. I would not imagine that they should meet oftener unless in times of unusual difficulty or unless something unusual arises. The fact of the meetings being private rather surprised me at first. There is a lot to be said against it and a lot to be said in favour of it. Personally I would be in favour of meetings being held in public unless conditions warranted otherwise or some particular subject for discussion would justify the meeting being held in private.

Brendán Mac Fheórais

In the present circumstances and under the present local government code practically every county manager in the country will welcome the setting up of a consultative committee. My criticism, however, would be much the same as Deputy MacBride's. The amendment here says that the consultative health committee will advise the county manager on the general administration and general operation of this Act and the Principal Act. My criticism would be with regard to the actual membership of the consultative committee. If I am to interpret the Minister's remarks properly, he is himself quite satisfied with the representation on the health committee, but most of us will agree that the weight of membership should be in favour of the elected representatives of the people. I cannot see at all why the county medical officer of health for a county should be a member of the council. Some weeks ago when we were in the initial stages of the debate on the Committee Stage many members in the House—and especially members on the Government side, including the Minister, who also fell into it—pointed out that in actual fact it would be the county medical officer of health who wouldadminister the health affairs of the county. I think that is the practice to a very large extent at the present time. While I am not a member of a local body I know that the county medical officer of health has the very last word in matters on which the ordinary public would imagine that the county manager should have the last word.

Mr. Morrissey

That is only because the county manager has delegated his powers to the county medical officer.

Brendán Mac Fheórais

Not necessarily. The county medical officer of health, to my knowledge, has certain decisions to make which, to say the least of it, are very hard for the county manager to question. I submit that if the county medical officer for a county —not so much a county surgeon—is a member of this council he or she would be in the position of being adviser or critic to himself or herself.

Captain Cowan

Is it so in actual fact?

Brendán Mac Fheórais

It is not so now, but it will be.

Captain Cowan

I do not think so.

Brendán Mac Fheórais

My point is that it will be. The Minister and, I think, Deputy Dr. Maguire stated that the function of this committee was to advise and criticise. I submit that in the committee as proposed here the county medical officer of health will be giving advice to himself and that in regard to the general administration of health matters very important decisions are taken by the county medical officer of health. I do not think it is important whether or not the county surgeon would be attached to the committee except in a consultative capacity to the members. I would not have the county medical officer of health or the county surgeon as members of the committee at all. On the committee of which Deputy Cowan is a member it seems to be the practice that they are there to give information. I do not think the lay public is represented strongly enough on this committee. There is power to have four members out of ten from a county council. There should bemuch wider representation of members of the council who themselves constitute a very wide representation of the people.

Captain Cowan

Would the Deputy not agree that this is an experiment; that although this may not be the best idea it is a start?

An Ceann Comhairle

Deputy Cowan has made his speech already.

Brendán Mac Fheórais

The first proposal is very limited indeed.

Dr. Maguire

There are still two to be appointed.

Brendán Mac Fheórais

I would suggest in that respect, even though the ordinary representation is still too small, that people like public health nurses or, say, child welfare officers would be in a far better position to relate experiences, to give advice and to make criticisms than, for instance, a person like the county medical officer or the county surgeon, and they might be in a better position to give advice and make criticisms than even the two appointees who are described here, the registered medical practitioners. This would apply particularly to public health nurses whose duty it is to travel their own areas—and they are very extensive areas at times—into the houses of the people. I do not suggest that the dispensary doctor does not do that but it is intensified in respect of the duties of, say, public health nurses and child welfare officers. They see actual living conditions, health conditions and conditions generally and the relating of their experience to this committee would be a tremendous advantage.

Captain Cowan

The ordinary elected member does not lose his rights——

An Ceann Comhairle

Deputy Cowan can make another speech.

Captain Cowan

I am just putting a question to the Deputy. I am putting it with his permission and the Chair's permission.

An Ceann Comhairle

Deputy Corish's permission does not matter if it is discrderly.

Brendán Mac Fheórais

My permission is no good to the Deputy. I would suggest that the Minister should widen the scope. I assume that when advice is to be given, there should be a vote taken as to what type of advice to give or as to what kind of criticism to make. The county surgeon, the county medical officer of health and the two medical practitioners will always find it possible to be present. As members of public bodies in this House know, it is not always possible for the members to be present. It is in no offensive manner that I state that the county medical officer of health and the county surgeon and, to some extent, the practitioners, are being paid as officers of the local authority and it will not be the same burden on them to attend meetings as it would be for the four or six public representatives. In some cases we might find that a majority decision in respect of advice is taken by four persons who may be, and two of whom at least will be, paid public officials.

I know that many bodies will seek representation—the Red Cross, the Order of Malta, the trade unions, Muintir na Tíre, Young Farmers' Society. All these people will be looking for representation on this consultative health committee. If the Minister has difficulty in selecting bodies to whom he might give representation, it is my opinion that it would be far better to have the health council composed entirely of members of the county council, with the stipulation that there be present to give information such people, if the Minister so desires, as the county medical officer, the county surgeon and any other two medical practitioners who are officials of the local authority.

I would not advise the Minister at this stage to accept the suggestion of Deputy Allen, to adopt the system of proportional representation in electing the members from the county council to this consultative health council. I would agree that all these committees within the public body should be elected by the system of proportional representation, but I would say that that would be certainly much more appropriate to any Bill that might beintroduced to amend the County Management Act. Just to take this one particular committee out and to adopt a system of election by proportional representation would not be just right.

Mr. Allen

No objection?

Brendán Mac Fheórais

I would not have any objection in the world to all these sub-committees of local bodies being elected by proportional representation.

Mr. Kyne

I agree mainly with what Deputy Corish has said. The point I want to make is: why did the Minister think it necessary to insert the provision that these sittings should be in private? As I see this committee, it replaces either the board of health, which was the county council proper, or the public assistance committee. Take my own constituency. It was a joint committee of the corporation and the county council. If it replaces that committee, I feel it should have the very same functions as that committee.

Captain Cowan

It does not replace it. I did not understand that.

Dr. Ryan

It does not replace it.

Mr. Kyne

Does the Minister then suggest that the board of public assistance as such will continue? Is that so?

Dr. Ryan

Yes.

Mr. Kyne

All right. It still does not take away from what I am going to say. What is the need of privacy? There will be no individual case dealt with. It will be on basic principles.

Dr. Ryan

There might, you know.

Mr. Kyne

I thought the individual cases were excluded completely in sub-section (1), that that was a complete power of the manager. I have read this. I have not had the happy experience of Deputy Cowan in regard to all county managers or officials. In our county, I found a case where people were starving and it was only by public opinion and bringing it out in the Public Press that we forced action. If that power is being taken from public representatives, the powerof having the Press behind us to expose what is happening, I feel we will have very little function left. This is the first attempt—a thing I will resist to the end—at complete and utter dictation, where the officials will strangle us. The only power we have lies in the fact that the members are able to talk and criticise, which hurts and causes wrongs to be redressed. That is the very function we have. What are we going to be doing in this matter? Are we not going to be charging, say, doctors with neglecting their duties and asking the manager to deal with the matter?

Dr. Ryan

The county council will still have the powers so far as that goes.

Mr. Kyne

Then you would be accused of breaking confidence.

Dr. Ryan

Even if you are not on the committee at all.

Mr. Kyne

Can the Minister not see that the public have the right to have the Press present if they so wish? One very bad effect of excluding the Press would be that it would give the public to think that there is something queer going on. If that impression gets around, people lose confidence. The fact that you are excluding the Press is very bad. It is a thing that I will always oppose as long as I am in public life.

Dr. Ryan

This will not in any way interfere with any powers the county council has or the board of assistance or any of these boards have. If you want to raise the question that a doctor has not done his duty to his patient, that can still be done by the county council.

Mr. Kyne

But if it is discussed you may be told that it is a matter for the consultative council.

Dr. Ryan

Oh no.

Brendán Mac Fheórais

I do not know whether I am right or wrong in this, I think I am right: every subsidiary committee of a local body in the country at the present time has the right itself to determine whetheror not its meetings will be open to the Press, whether they will be public or private. I think that is right. Even a general purposes committee can determine that themselves.

Mr. Kennedy

They can determine it in committee.

Captain Cowan

As I see it, we are getting bogged down a little bit here. I agree with the Minister. It is my reading of the amendment that what the Minister says is right, that whatever powers of publicity exist at the moment still remain. This consultative council is a peculiar sort of body.

It is set up for a peculiar purpose and for peculiar reasons but anyway it is going to be set up, and there will be a new consultative council with experienced officials, experienced members of the council and a couple of other experienced men and they are going to advise the county manager in a consultative capacity on certain matters that may come before them. Now it seems to me that this is a sort of thing where the county manager up to the present may have been consulted and advised by his county medical officer of health or by his county surgeon or by some other official but it is obtained here by exchange between these particular people and that advice will be transmitted or given to the county manager, who may be personally at the meeting, whether it is provided for or not I do not know. I do not think that it is provided for but I think he should be present. That is the sort of thing that strikes me where perhaps publicity would not be desirable. This is advice tendered to the city manager or the county manager who proceeds to act on that advice. It is open to any elected member to raise the thing in the ordinary way. That is as I see it and I do not think that this is the sort of thing that should be discussed in public. It is just as if the county medical officer of health would be advising the county manager, to put up the pros and cons of a particular thing before the members hear of it. When the manager receives the advice and acts on it it is open to any elected member of the council to take suchaction as he might wish to in regard to it.

Dr. Esmonde

I am glad that this matter has been brought out so clearly by Deputies. They have clearly outlined, to my mind, the object for which this amendment was introduced. I take it that the object of this amendment, the appointment of an advisory consultative health council to advise the health authority, which I presume is the county manager, is for the purpose of creating a situation whereby the general public may be protected against bureaucracy. We had better read the section, which distinctly states here in Section 6, sub-section (6) that every meeting of the consultative health council shall be held in private. I take that to mean that it must be held in private. There would be some point in it if it said may be held in private. In fact, this health council are going to meet and to offer advice to the health authority. We think it is very desirable that they should be created and that they should be in a position to offer this advice. I was asking the Minister what redress they would have should the county manager or whoever the health authority is— there seems to be some doubt here as to who it is, but we believe it should be the county manager—intend not to accept that advice, and the Minister replied to me saying that the publicity would give them the authority they desired. Section 6 obliterates that straight away. They have not got the publicity. It seems to me that if this body is going to meet it is quite natural that there must be some things they would like to discuss around the table without having unnecessary publicity but there are other matters which it would be better to discuss in public in the interests of the health authority itself. Supposing that definite charges were being made against the health authority, against the county manager, that he was not carrying out his duties efficiently and in the best interests of all concerned would it not surely be in his interest to have the matter discussed in public and strengthen his authority, strengthen his morale, clear him of any accusations, if you had a discussionof these matters coming before this consultative body, and they entirely exonerated the county manager or whoever was being charged with carrying out his duties in an unsatisfactory manner?

I think it cuts both ways. It is in the interest of the health authority to have a matter public. The Minister might easily do that if he introduces "may" there instead of "shall" but under the section as it reads at present it says that these meetings must be held in private. One of the Labour Deputies, I think it was Deputy Kyne, said that that immediately creates a bad impression as if there is something here that we want to hide, that we want to muzzle the discussion. The very purpose for which this council is established is to enable the people to see what is going on and to see that these services are administered in a satisfactory manner. I think that the Minister would be very well advised to accept that point. I think it was first brought out by Deputy MacBride and later by a variety of other Deputies and that it would be reasonable for him to do so.

With regard to the composition of this council, as to whether the medical officer of health and the county surgeon should or should not be members of the council, in view of the fact that they are paid officials of the health authority already it raises a very difficult point. There are many arguments in favour of it and many against it. Somebody stated that the medical officer of health already administered the health authority, acting more or less as the health authority, as Deputy Morrissey intervened quite rightly to say, on occasion on powers delegated to him by the county manager. I think that Deputy Captain Cowan intervened with one of his numerous interjections then to say that in housing the medical officer of health was responsible. That is not the position. The position with regard to housing in my constituency anyway is that if there is a vacant county council or local authority house it is referred to the medical officer of health for an opinion but the medical officer of health is not the final arbitratorin the matter. He only advises the county manager and it is the county manager who decides who gets the house. So we get a position where the medical officer of health is really acting with powers delegated to him or her as the case may be by the county manager.

This advisory council is for the purpose of advising the health authority, whom we consider to be the county manager, and therefore, an official acting for the county manager who has powers delegated to him to carry out these health services will have a certain say in them as a member of the advisory council. So some of the health authority's own officials are put in the position that they are acting in an advisory capacity upon the very functions that they are carrying out themselves. It certainly creates an anomalous situation, and it is a very difficult question. I am inclined to agree that by and large it would be better to exclude the medical officer of health from this. Of course I think it is extremely desirable that he should be present and, if I heard Deputy Cowan aright when he was talking about the way they managed these things, which apparently they do so well in the Dublin Corporation, they had the medical officer of health there but he does not act on the council. They meet him there as an official. Perhaps I did not hear him aright, but that is what I understood him to say.

Captain Cowan

I gave a different interpretation.

Dr. Esmonde

As Deputy Cowan is so fond of interjections in these debates it is very often hard to hear what he says, but it seems to me to be more reasonable that the medical officer should be present as an official rather than as a member of the advisory council. With regard to the other matter, the question which arises of the county surgeon, I think it would be a good thing that the county surgeon should be a member of this body. Probably the discussion will in many cases turn on the question that we have been discussing in the past in this, the question of the hospitals.

An Leas-Cheann Comhairle

Will the Deputy move to report progress?

Dr. Esmonde

I move to report progress.

Progress reported; Committee to sit again.