Limerick East): I move: “That the Bill be now read a Second Time.”
This is a short Bill to amend section 76 of the Health Act, 1970, and to amend the Hospitals Federation and Amalgamation Act, 1961. Section 76 of the Health Act, 1970, allows the Minister for Health by order to amend the charter of a hospital subject to the order in draft form being approved by both Houses of the Oireachtas following consultation with the Commissioners of Charitable Donations and Bequests for Ireland.
The principal reason for bringing forward this Bill is to allow me as Minister for Health to meet the wishes of the three voluntary hospitals who are combining to form the new voluntary hospital at Tallaght. These transferring voluntary hospitals are the Adelaide Hospital, the Meath Hospital, and the National Children's Hospital. I readily agreed to a request from the board of the Adelaide Hospital to amend the charter of the Adelaide Hospital 1921.
I have been requested to amend this charter because the three hospitals have agreed that the legal basis for the governance of the new hospital at Tallaght will be in the form of an amended charter of the Adelaide Hospital. The hospitals submitted a draft of an agreed text to form the basis of the order amending the Adelaide Charter. However, in consulation with the Office of the Attorney General my Department has been advised that, in order to meet the wishes of the hospitals, certain amendments of a technical legal nature require to be made to both the Health Act, 1970, and to the Hospitals Federation and Amalgamation Act, 1961.
The Hospitals Federation and Amalgamation Act, 1961, created the legislative vehicle for seven voluntary hospitals in Dublin to form themselves into a group or federation. Provision was also made in the Act for eventual amalgamation of the seven hospitals, if they so desired. In practice only the federation provisions came into force. The seven hospitals included the Adelaide, the Meath and the National Children's Hospital who are now coming together to form the new hospital at Tallaght. The executive vehicle created for the federation under the Act was the Central Council of the Federation Dublin Voluntary Hospital. It is now necessary to provide, as is proposed in the Bill, that the provisions of the 1961 Act will not impinge in any way on the functioning of the new hospital at Tallaght.
In 1993, a number of issues relating to the new hospital at Tallaght were agreed by the boards of the three hospitals and approved by the Government. These included agreement on the board structure and other issues. That agreement represented the culmination of a very large amount of difficult work by the three base hospitals and it is to their credit that in the end a resolution was reached. That agreement is the basis on which the legal framework is now being proposed so as to finalise these matters.
The detailed legal framework now before the House has also been agreed by the boards of the three hospitals who are integrating and combining to form the new hospital at Tallaght. At the outset the problems seemed insurmountable but with an enormous amount of hard work, goodwill and co-operation from all sides we have reached the stage which we are at today. We often hear of many different aspects of the health services but in my opinion, far too infrequently we hear about, and acknowledge, the enormous contribution which is made to our health services on a purely voluntary basis by a large number of people.
I regard this as a time to place on record my appreciation of the invaluable contribution, made on a voluntary basis, by the members of the boards of the three hospitals which are moving to Tallaght. In particular, I would like to acknowledge the work of the chairpersons of these boards, Mrs. Rosemary French, Mr. Gerry Brady, Mr. Salters Sterling, chairpersons of the Adelaide Hospital, the Meath Hospital and the National Children's Hospital boards respectively. It is under their leadership that final agreement has been reached on the detailed legislative basis now before the House.
The skills and commitment which these people and, their colleagues in many hospitals and organisations, bring to the health services, while always appreciated, are not often enough acknowledged. Since becoming Minister for Health, I have come to appreciate that an essential feature of our health services is the voluntary nature of many of our services and the contributions being made.
The process of bringing the hospitals together has received a strong impetus from the fact that building of the hospitals premises in Tallaght is progressing at a pace which means it is on schedule for completion. I express my appreciation to all those involved in this complex project but, in particular, I would like to thank the board responsible for the planning and building of this facility under the chairmanship of Professor Richard Conroy.
This Bill, and the motion approving the draft order, received unanimous approval from Seanad Éireann on Wednesday 26 June 1996. In the course of the debate in the Seanad, it was acknowledged that, while the three hospitals were coming from diverse backgrounds, the emphasis should now be on what the hospitals have in common. They each have a long tradition of service to the people of Dublin and, indeed, to patients from throughout the country. They have a strong commitment to serve in the best possible way, those people who need hospital services. I have no doubt that this commitment to excellence and service will be continued at Tallaght together with the staff moving from St. Loman's Hospital who will be providing the acute psychiatric services at the new hospital. The hospitals will share a joint future in Tallaght where together they will, no doubt, create a further centre of excellence.
The point was made in the Seanad by the Minister of State, Deputy Currie, and others that Tallaght Hospital will not simply be an isolated hospital but will reach out into the community by close co-operation with the GP services and the continuing care services in its catchment area so as to provide a seamless service to the people of the region.
I am very glad as Minister for Health to bring these proposals to the House. The proposals reflect good news, compromise, co-operation and the commitment of the Government to put in place at the earliest date a range of major acute hospital services to serve the people of Tallaght and the surrounding area. This is a unique occasion where this House is being asked to facilitate the joining together of three hospitals with a proud history of providing health services to the people of Dublin and, indeed, to many people throughout the country.
The main provisions of the Bill are quite straightforward. Section 2 enhances the powers of the Minister for Health under section 76 of the Health Act, 1970. Section 76 of the Health Act, 1970, empowers the Minister for Health by order to amend the charter of a hospital subject to the order in draft form being approved by both Houses of the Oireachtas following consultation with the Commissioners for Charitable Donations and Bequests for Ireland. Section 2 of the Bill expands the Minister's powers under section 76 of the Health Act, 1970, as the present section does not allow for facilitating the legal arrangements now requested by the three hospitals. That is, it does not provide for the establishment of a new body corporate and the assignment of a title to it. Section 2 (1) (a) provides for this.
Section 2 (1) (b) provides for the application of a charter which is being amended to the new body corporate established under section 2 (1) (a). This allows for the charter of the Adelaide Hospital, 1921, as amended, to be applied to the new body corporate.
Section 2 (2) (a) provides for the transfer to the new body corporate of the functions, property, rights, liabilities and members of staff of the transferring agencies. This provision will allow for the integration of the three base hospitals, of the Tallaght Hospital Board established to construct the hospital, and of the Central Council of the Federated Dublin Voluntary Hospitals.
Section 2 (2) (b) allows for the conferral of such powers on the original body — in this case the Adelaide Hospital — as in the opinion of the Minister are necessary to enable it wind up its affairs or otherwise deal with any property, rights or liabilities of it. This is to ensure that on the disapplication of the charter to the original Adelaide Hospital that hospital will still have powers to take care of its residual affairs.
Section 2 (3) (a) allows the Minister on the application of the new body corporate — in this case the new Tallaght Hospital — established by an order under section 76 of the Health Act, 1970, to amend that order.
Section 2 (4) facilitates the circumstances of this particular case by allowing for the simultaneous movement of this Bill and the draft order establishing the new hospital through the Houses of the Oireachtas.
Section 3 provides that, notwithstanding the provisions of the Hospitals Federation and Amalgamation Act, 1961, in particular the provisions of section 14 of that Act, the new hospital will be able to exercise all functions which are exercised by the Central Council of Federated Dublin Voluntary Hospitals in respect of the three base hospitals. This provision is required to ensure for the avoidance of doubt that the new hospital will be able to exercise those functions.
The three hospitals joining together to provide a major acute voluntary hospital at Tallaght have agreed that the governance of the hospital will be based on the original charter of the Adelaide Hospital, as amended by the draft order. The order provides for the necessary amendments to the charter to meet the wishes of the three base hospitals and to provide for a situation where none of the three hospitals will have a predominant status relative to the other two.
I understand that Deputies will be aware of the agreement of the three hospitals and of the urgency to provide the necessary legislative measures to give effect to that agreement. I have acceded to the request of the board of the Adelaide Hospital to introduce an order providing for an amendment to the Adelaide charter. I do so at this time to facilitate the putting in place of a unified management structure for the three transferring hospitals well in advance of the move to the new premises at Tallaght. This is of great importance as it ensures the integration of services and the smooth transfer of the hospitals to the new premises at Tallaght.
Earlier this year I facilitated the appointment of a board designate which has been functioning now for six months with the goodwill of the hospitals concerned but without the necessary statutory powers. The energy, capacity and commitment of the members of this board has been amply demonstrated over the past six months. It is important to provide the necessary legal basis required for the board of the new hospital and to ensure that the board is established as quickly as possible.
The explanatory memorandum circulated with the draft order explains the amendments contained in the order. The order received unanimous support in the Seanad last week and I have no doubt this House will welcome it provisions in like manner.
I do not propose to refer to each section of the draft order but it is important to bring to attention some of the provisions of the order which would not be considered usual in establishing the necessary governance arrangements for a major acute hospital. These provisions have been included in the draft order to reflect the agreement which has been reached between the hospitals. These include section 4 which establishes a body corporate which will be known as the Adelaide and Meath Hospital, Dublin incorporating the National Children's Hospital. Section 4 applies the charter to this body corporate and provides for the original Adelaide Hospital to have such powers as are necessary to enable it to wind up or otherwise deal with its affairs. Section 5 is the principal section of the draft order and contains all the amendments to and deletions from the charter of the Adelaide Hospital.
Deputies will note that most of these amendments are substituting new clauses for the clauses in the original charter. These amendments are necessary to reflect the terms of the heads of agreement entered into by the three hospitals.
The new clause 5(c) of the charter as outlined on page 7 of the draft Order allows the hospital "to promote and secure the availability, as a matter between the patient and his or her doctor, of such medical and surgical procedures as may lawfully be provided within the State" without prejudice to the rights of conscience of staff. The new clause 5 (j) provides that the fundamental principle of the Adelaide Hospital as an essentially religious and Protestant institution will be maintained, while guaranteeing rights of conscience and providing that the hospital will have a multi-denominational and pluralist character.
The terms of the draft order provide for the composition of the board of the hospital as set out in the new clause 12 of the charter. This new clause provides that there shall be a board of the hospital which will have 23 members. Fifteen members of the board shall be appointed by the three base hospitals as follows: six from the Adelaide Hospital Society, six from the Meath Hospital and three from the National Children's Hospital. Eight members of the board shall be appointed by the Minister for Health, six of whom shall be appointed from among the persons nominated by the president of the hospital and two other members, one of whom shall be nominated by the Eastern Health Board and one of whom shall be nominated by the board of Trinity College, Dublin.
Also of note is the new clause 24 as provided for under section 5(s) on page 30 of the draft order. This establishes a college of nursing at the new hospital which provides that for student nurse entry purposes the Meath, Adelaide and National Children's Hospital will have separate constituent schools of nursing. Each of the schools of nursing will be autonomous for student nurse intake purposes and may take up to 40 entrants in the case of the Adelaide, up to 60 in the case of the Meath and up to 21 in the case of the National Children's Hospital.
The draft order also contains provision for industrial relations matters surrounding the transfer of services and staff to Tallaght to be addressed through a Protocol which has been agreed by the Department of Health and the management and unions representing staff of the transferring agencies comprehended by the draft order. This is to ensure that best industrial relations and personnel practices will be adhered to.
In preparing the draft order, I and officials from my Department were very conscious that the hospitals transferring to Tallaght are three very different institutions, each having its own background and ethos. While it is important that we should focus on the common positive attributes of each of the hospitals as I mentioned earlier, it is also important that each of the three hospitals is enabled to enter into an arrangement where they feel that their interests and their honourable traditions are respected and acknowledged. I am happy that the draft order before us meets this difficult criterion for the integration of the hospitals.
While this legislation is essentially of a technical legal nature, it is most important. It is a necessary statutory measure required to contribute to the reorganisation and extension of the public hospital services. The immediate effect of the Bill will allow for the proper establishment of a much needed acute hospital at Tallaght. I commend the Bill to the House and I ask the Dáil to approve the motion in respect of the draft order which has been laid before the House.