Health Bill, 1952—From the Seanad.

The Dáil went into Committee to consider amendments from the Seanad.

Minister for Health (Dr. Ryan)

I move that the Committee agree with the Seanad in amendment No. 1 :—

Section 14. In sub-section (1), page 5, lines 47 and 48, "ophthalmic and dental" deleted and "ophthalmic, dental and aural" substituted.

The effect of amendments Nos. 1, 2, 3, 5 and 6 is to put aural treatment and appliances on exactly the same level as optical treatment and appliances. It was not clear that that was the case before and, therefore, these amendments are being made, although the legal opinion which I got before the amendments came in was that it appeared to be all right because it was always understood that ordinary surgical treatment included auraltreatment, but to the ordinary person treatment of the ears would appear to be more in line with treatment of the eyes. Therefore we are making doubly sure that aural treatment and appliances will be on the same level as optical treatment and appliances by inserting these five amendments.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 2 :—

Section 14. In sub-section (2), page 5, line 51, "ophthalmic or dental" deleted and "ophthalmic, dental or aural" substituted.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 3 :—

Section 15. In sub-section (10), page 6, line 59, "or aural" inserted after "ophthalmic."

Amendment put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 4:—

Section 19. In sub-section (3), page 8, line 30, "and treatment" deleted.

In Section 19 it is provided that a private primary school which satisfies the Medical Officer of Health that it is carrying out a proper system of medical examinations would be exempt from examinations by the Medical Officer of Health. The section as it stands, however, would put an obligation, I think, on the Medical Officer of Health to be satisfied not only that a school examination would be carried out, but also that treatment service is provided. It would appear unfair to make a private school do more than a national school and, therefore, we are not asking such schools to have a treatment service, only an examination service. This amendment removes "treatment" from it.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 5 :—

Section 20. In page 8, line 39, "dental and ophthalmic" deleted and "dental, ophthalmic and aural" substituted.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 6 :—

Section 21. In page 9, line 4, "dental and ophthalmic" deleted and "dental, ophthalmic and aural" substituted.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 7 :—

Section 23. In sub-section (1), page 9, line 20, "in an institution" inserted after "maintain."

Under Section 23 a local authority does not pay the £4 maternity grant to a woman in the lower income group if she is being maintained by the local authority. What I had intended in that section was to cover the case of a woman who was being maintained in an institution, and generally speaking that would apply only to unmarried mothers. As it stands, it could, however, be read that maintenace by, say, home assistance would absolve the local authority from paying the £4. That was never intended. I am, therefore, inserting the words "in an institution" in order to make it plain that if a woman at a time of confinement is in receipt of home assistance the local authority will be obliged to pay the £4, that they will not be absolved from paying it.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 8:—

Section 24. The following sub-section added:—

(3) The references in sub-sections (1) and (2) of this section to milk shall be construed as including references to such foods derived wholly or mainly from milk as may from time to time be approved of by the Minister.

In the last few years some local authorities have had some difficulty in providing liquid milk under the free milk scheme and they have in some cases to provide milk substitutes. This would enable a local authority where it cannot provide liquid milk to provide some substitute. Some of these substitutes are well known.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 9:—

Section 25. In sub-section (1), page 10, lines 5 and 6, ", on application being made to them," deleted and ", in accordance with such regulations as may be made by the Minister," substituted.

Section 25 deals with the case where a person chooses his or her own hospital, and in sub-section (5) it says: "On application being made." It was, however, thought advisable to make that a little bit more elastic, because the words as they stand, I think, would mean, at any rate, legally, that persons might choose a hospital and then in four or five years' time make an application to the local authority saying that they were eligible for this treatment in a hospital of their own choice and entitled to payment.

There are other matters also. For instance, we have not put in the type of information that might be required from persons who are seeking treatment in a hospital of their own choice and I thought it better on the whole to say "in accordance with such regulations as may be made by the Minister". These regulations will lay down the manner in which application will be made to the local authority for payment, the time limit within which that claim should be made and the type of evidence required in support of the claim. As a matter of fact, it is based almost exactly on the scheme running for some years and which is applicable to those insurable through the National Health Insurance Society and subsequently through the Social Welfare Department. This scheme has workedvery smoothly and very well. It has one advantage anyway, that we will be able to allow a person to go to a hospital without waiting to get permission and make a claim afterwards. I think that will be for the convenience of the persons concerned.

Brendán Mac Fheórais

The Seanad did some good work on that Bill. The fact that it had to go to the Seanad has resulted in improving it.

Dr. Ryan

The Seanad were so reasonable that I accepted a lot of amendments.

Brendán Mac Fheórais

The Minister would not accept similar amendments from this House.

Dr. Ryan

I do not think they were anything like these.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 10 :—

Section 48. Sub-section (5) deleted and a new sub-section substituted as follows :—

( ) Where a meeting of a consultative health committee has been held in any month no further meeting shall be held in that month 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.

It was pointed out to me in the Seanad that the provision that the members of the local advisory committee would have power to summon a meeting of the committee on the requisition of four members is limited to the extent that when six meetings have been held in the year they cannot call another meeting. This is a peculiar arrangement anyway. It means that the county council can call a meeting or that the county manager can call a meeting or that a meeting may be summoned on the requisition of four members; but if six meetings have been held in the year then the power of these four members to requisition a meeting no longer holds. It was pointed out that six meetingsmight be held in the first two or three months of the year and then the members would have lost the power to call a meeting. I was pressed to accept this amendment, that I should at least make it possible for the members to meet of their own volition at least once a month. That is the effect of the amendment.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 11:—

Section 51. Sub-section (2) deleted and the following sub-sections substituted:—

(2) The Minister may by Order vary the division of the functional area of a health authority into dispensary districts.

(3) Where an Order under sub-section (2) of this section has been made, the Minister may by Order provide for such transfers, within the functional area of the health authority, of officers whose districts have been affected by the first-mentioned Order, as he considers necessary or expedient.

(4) Before making an Order under sub-section (3) of this section, the Minister shall send particulars of the transfers proposed to every officer proposed to be transferred and shall consider any representations which may be made by any such officer within such reasonable period as the Minister may determine.

Section 51, as it stands, gives the Minister power to change dispensary boundaries and to allocate the existing men to other dispensaries. In my own constituency, for instance, I have recently by Order divided a dispensary district into two parts. What was visualised was that we could say to a man who was the dispensary doctor acting for half A or half B and he could not say that the dispensary was gone and that he was entitled to retire. It is possible that in certain divisions a man might be allocated outside his own area but it was never intended that he should go very far. It waspointed out that as the section stood the Minister would actually have power to send a Dublin man to Donegal. We have changed that now to the extent that he will remain within the health authority area. In other words, he will remain in his own county. Secondly, if he has a grievance—he will get notice of the Order before the Order is actually made—he can put it in writing to the Minister and the Minister must consider that before actually signing the Order.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 12:—

Section 60. In page 29, line 37 and lines 44 and 45, "rats and mice" deleted and "animals" substituted in each case.

Section 60 mentions destruction of rats and mice. It was pointed out to me in the Seanad that there was recently discovered a very powerful virus which destroys rabbits. As it happens, that particular virus is not dangerous to human beings but some other virus might come that would be dangerous to human beings. It was, therefore, thought advisable to make the section applicable to viruses which would be used for the destruction of any animal.

Question put and agreed to.

Dr. Ryan

I move that the Committee agree with the Seanad in amendment No. 13:—

Section 63. Before sub-section (3) the following new sub-sections inserted:—

(3) Where a health authority provide a course of instruction under this section, they may, at their discretion, permit registered medical practitioners who are not medical officers to attend at such course.

(4) The Minister shall notify the Medical Registration Council of courses of instruction approved under this section.

This amendment was the result of my meeting with the Consultative Council. The Seanad accepted it on my recommendation. Section 63 deals with theprovision of post-graduate courses in local authority hospitals. As the section stood leaving the Dáil, the provision was for local authority officers only. It was put to me at the meeting of the Consultative Council, which met after the Dáil had disposed of the Bill, that it would be well to notify the Medical Registration Council, which is the co-ordinating body dealing with medical education generally. I agreed that they would be notified of any such course being held. Then it was raised in the Dáil before I left by at least one member that if those courses were useful and good there was no reason why they should be confined to local authority hospitals and that they should be open to other medical men outside the local authority service. The Consultative Council agreed with that also.

There are two amendments made, therefore, in the section. The first is that, where a post-graduate course is being arranged, the Medical Registration Council should be notified. Secondly, that, where these courses are arranged, they would be open to medical men outside the local authority service as well as those in the service.

Question put and agreed to.

Amendments reported and agreed to.

Brendán Mac Fheórais

Would it be in order to ask the Minister a question, to clear up a point?

An Ceann Comhairle

I will allow the question provided it is relevant.

Brendán Mac Fheórais

I must confess that I raised this with the Department, but I should like if the Minister would clear up the point. Would a person having over £600 per year but being a voluntary contributor to the widows' and orphans' pension scheme be deemed to be eligible for the midde income group? He would be merely a contributor.

Dáil Éireann debate -
Thursday, 22 Oct 1953