Private Business. - The Royal College of Surgeons in Ireland (Charters Amendment) Bill 2002: Report and Final Stages.

In accordance with Standing Order 117 of the Standing Orders relative to private business, the Leas-Cheann Comhairle has a supervisory role regarding the proceedings on the Bill. However, he is not in charge of the Bill in the way a Minister would be in charge of a public Bill. We now dispose of the amendments. Amendment No. 1 is in the name of Deputy Ó Caoláin. Amendment No. 2 is consequential on amendment No. 1. Amendments Nos. 1 and 2 may be discussed together by agreement.

I move amendment No. 1:

In page 4, line 25, after "Paragraphs", to insert "2".

The basis of my approach to this Bill is that it should be coming before this Dáil as a public Bill. I base that assertion on the Standing Order for private Bills which states:

Every Bill promoted for the particular interest or benefit of any person or locality as distinguished from a measure of public policy shall be treated as a Private Bill.

I acknowledge that the Royal College of Surgeons in Ireland is an excellent educational institution which trains professionals to a very high standard, which has deservedly been recognised worldwide. However, I have a number of serious questions regarding this Bill and its passage through the Houses of the Oireachtas. I outlined these to Mr. Kevin O'Malley, a representative of the RCSI, when I had the opportunity to meet him recently, an opportunity I acknowledge today.

I question the college's charitable status and its corporate activities. Most of all, I challenge the lack of public accountability of this institution, which is subsidised to the tune of perhaps many millions of euro annually in tax breaks by this State. We have a totally anomalous situation whereby the National University of Ireland is a public body subject to the scrutiny of the Houses of the Oireachtas, while the RCSI medical school, which under the 1977 agreement, is a recognised college of the NUI, is not subject to the same accountability.

The activities of the Royal College of Surgeons in Ireland are clearly a matter of public policy. That is the essence of my argument. Its activities must concern this Dáil. The RCSI is a key institution in both our education and health systems and it plays a central role in the education of medical professionals. It has an important role in the deployment of personnel into the hospital system. This is because the college controls – and this is critically important – the in-hospital train ing regime of trainee surgeons. I have made the point privately and publicly that the withdrawal by the RCSI of training recognition has a hugely negative impact, not only on the hospitals but on the wider community it serves. It means the withdrawal of junior hospital doctors and the consequent loss of services in terms of decisions taken by the college.

We are discussing amendment No. 1.

The Ceann Comhairle stated that amendments Nos. 1 and 2 could be discussed together.

I am not sure what point the Deputy is making.

I am coming to my point and I hope the Ceann Comhairle will accord me the opportunity to conclude these remarks.

The new training rules introduced this year by the RCSI and the Irish Medical Organisation have a knock-on effect in terms of the delivery of accident and emergency services in hospitals throughout the State, and this is clearly part of the drive for more accident and emergency specialists. In the absence of such specialists, we have a situation where accident and emergency units are closing. I must ask whether the college examines the real effects of its decision.

The Deputy's contribution would be more appropriate to debates on the health Estimates.

Or to a Second Stage debate if such an opportunity were provided.

It is not appropriate to a Second Stage debate because it is not remotely related to the Bill.

The Ceann Comhairle must acknowledge that this is the only opportunity Deputies have to present their challenge.

It may well be the only opportunity the Deputy has today, but he will have to find another opportunity to address the matter. Only half an hour has been allocated for discussion of the Bill to which a number of amendments have been tabled.

I find this highly objectionable. The Ceann Comhairle is objecting to the points I am making.

The decision the Ceann Comhairle has already taken today to rule three of my amendments out of order –

Yes, and the Deputy knows the reasons.

I know the reasons, but I do not accept them. I regard this as highly objectionable.

I ask the Deputy to return to the Bill.

I have tabled these amendments to highlight what I regard as the anomaly regarding the charitable status of the RCSI. This status allows it to avoid stamp duties, corporation tax, capital gains tax and capital acquisitions tax, while corporate and personal donations to the college are tax-deductible. If the RCSI were legally a corporation rather than a charity, it would have incurred stamp duty of €4.5 million on its purchase of the Ardilaun Centre on St. Stephen's Green. The college agreed at the time to pay Green Properties €75 million for the Ardilaun Centre in December – just before the Minister for Finance, Deputy McCreevy, raised the stamp duty to 9%. The stamp duty that applied prior to that was 6%.

I could go further into detail regarding the college's extensive properties in this city. It just so happens that this is the first raft of amendments in the very limited time open to me. Suffice to say that the Revenue Commissioners are on public record as saying they are not aware of any other charitable trust in Ireland that owns a property development company. These amendments therefore focus on that aspect of the college's activities, and what value or return the taxpayer receives for granting such concessions to a major property developer. This is one of the questions I ask of the Minister of State, Deputy Brian Lenihan, although I understand he is also curtailed in terms of the responses he may be able to make. We shall see.

These amendments are my only means of addressing this issue, and I commend them to the House.

In the short time available, the only opportunity any of us will have to address the issue will be by way of the amendments tabled by Deputy Ó Caoláin.

I do not think these particular amendments are appropriate in terms of what Deputy Ó Caoláin is trying to achieve. He may well have a very good argument for bringing the RCSI under more public scrutiny and more into the public system of third level education. The financial issues the Deputy raised are genuine, but I do not think they are appropriate on Report Stage.

It is also a pity that Deputy Ó Caoláin could not participate in the Committee Stage debate in the Joint Committee on the Royal College of Surgeons in Ireland (Charter Amendment) Bill 2002. Neither did the Labour Party have a right to be on that committee, due to the numbers situation, with only three representatives from the Dáil and three from the Seanad. The Joint Committee on Standing Orders [Private Business], should examine this for the future due to the diverse nature of representation in both Houses of the Oireachtas.

The Labour Party and I wanted to table amendments, so I sought a position on that committee and my request was granted. I was able to put forward amendments which were accepted on Committee Stage, and my party was able to contribute to and strengthen the Bill. It is certainly difficult for smaller groupings within the Oireachtas to have a say in private Bills, and that point needs to be addressed in the future.

I do not see why it is not possible for Deputy Ó Caoláin and his party to propose a public Bill if they so wish, on this issue, but I do not think these amendments will address the core issues Deputy Ó Caoláin raises. We should support the Bill in its current form in regard to its proposals for a college set up under charter over 200 years ago, which charter has been amended at various times in the past.

There are serious points to be made. The issue of the training regime is obviously a serious one in various parts of the country. That needs to be addressed, but in a different way.

I welcome the fact that the amendments I proposed on Committee Stage have been incorporated into the Bill, which is now better. However, there are issues that need to be addressed at another forum. On behalf of my party, I will be taking up the issue of the membership of the committee directly. All sections of the Oireachtas should have an opportunity to participate at the appropriate stage on Private Bills.

I support the Bill. I understand Deputy Ó Caoláin's frustration at the way the system works and the fact that his party was not represented on the committee that discussed the Bill. That committee gave us the opportunity to tease out the issues and put questions to representatives of the Royal College of Surgeons in Ireland and their legal counsel, who were present that day. This process left those of us on the committee in the position of being happy with the Bill and we were able to accept its contents.

For various reasons, individual hospitals throughout the country are in considerable difficulty. Much of the responsibility for this lies with the Department of Health and Children rather than with any educational institution. However, without the Royal College of Surgeons in Ireland, the provision of medical personnel here would be far worse. In the past year, the college has been extremely progressive in offering new courses in specialised areas where we have an extreme shortage of people in a position to provide the necessary services.

I do not have difficulty with the Bill amending the charters or letters patent that existed previously. I support Deputy O'Sullivan's comments about the Standing Orders, which date back to 1939, although amendments have been made to them. It is time to look at Standing Orders on this matter and in general.

It is important to realise what we are doing here today. We are dealing with private business, not public business. This is a Private Bill.

Deputy Ó Caoláin raised a number of matters of legitimate public discussion, but they are not apposite to a discussion on a Private Bill. The Bill is here because in order to amend its charters, the Royal College of Surgeons in Ireland must promote a Private Bill through the House. Not every body is obliged to do so. If, as is the case with most corporate bodies, a body is incorporated under the companies legislation, procedures are available under that legislation whereby it can amend its own articles of memorandum and association by resolution of the company.

In the case of bodies formed under charters or letters patent from the Crown in former times, however, it is necessary to promote a Private Bill, which imposes a substantial expense on such bodies. From the terms of this legislation, I note that the college has had to retain solicitors as agents to act on its behalf and instructed counsel at an earlier stage of the Bill. The consideration of a Private Bill should always be influenced by the fact that the body in question, to amend its own constitution, cannot do so itself but is obliged to come to the House to do so. That is the purpose of the Bill.

The Oireachtas has full power to legislate on matters by way of public Act and the Private Bill procedure does not take away from that in any way. The Oireachtas has the sole and exclusive right to pass laws for the State. If Deputy Ó Caoláin has concerns along the lines he suggests, it is open to him to initiate legislation by way of Acts of the Oireachtas to deal with those concerns. I would be concerned if the Private Bill procedure were used to ventilate matters of that sort when it has a clearly defined purpose under the Standing Orders. I assume that is why Standing Orders provide for a very limited membership on committees to consider these Bills. The House must act judicially in considering a matter of this nature. We are looking at an application by a body corporate to change its own constitution where that body corporate has so determined that these changes are desirable.

Deputy Ó Caoláin raised the question of charitable status, which is a general matter of law. Various purposes are viewed as charitable, one of which is education. All educational bodies benefit from the concept of charitable status. Deputy Ó Caoláin raised a particular issue about the extent of tax concession or the advantage that charitable status confers. If there is an issue, it is open to the Minister for Finance to deal in a legislative manner by way of an Act of the Oireachtas with any particular concern that might lead to a shortfall in the revenue. That is not an appropriate matter for the Private Bill procedure. If the Mini ster for Finance felt that there was a loss to the Exchequer through the operation by colleges of particular tax schemes associated with charitable status, it would be open to him to address that through his proposals in the budget as subsequently enacted in finance legislation. However, it does not arise on a Private Bill before the House.

Deputy Ó Caoláin got close to the sore as far as he was concerned in mentioning the question of the professional standards. The Royal College of Surgeons in Ireland, in conjunction with other bodies of eminent physicians, decides what is appropriate in terms of treatment in hospitals. It is an incontestable scientific fact that the treatment of trauma after accidents nowadays requires an immense concentration of technology, personnel and resources. We all want to see the best standard of care for the patient.

Everyone knows that this cannot be sustained in the number of locations we have in Ireland. I know that I am going beyond the Private Bill here, but that is the reality. The various local agitations that have been promoted by Deputy Ó Caoláin in his county and by other Deputies in their counties, remind me of creationists in US Bible belt. The patient should come first in this matter and we should not say that science is incorrect and our locality is right, which, as I see it, is the case that is being made in these matters. However, this does not arise in the Bill either and I should not have trespassed into that area.

In this particular institution, 80% of the students are non-EU nationals. Some €60 million is brought into the national economy through the operations of this institution. That is a sensible point of departure in the consideration of this Private Bill. This is a successful institution that is earning money for Ireland and is doing its job well. The institution has promoted a Private Bill asking the Oireachtas to amend its charter in various convenient ways.

Curiously, one amendment we could have pressed by way of this Private Bill procedure, but did not on this occasion, would have been the deletion of "Royal" from the name of the institution which could then have been called the "National College of Surgeons" if we had so wished. It is not for us to go into wider questions on this matter.

With regard to the two amendments we are discussing, section 3 of the Bill revises paragraph 2 of the 1828 charter. The main objective of the revision is to remove a limit of £2,000 sterling, which was imposed on the college in respect of property. This is an anachronism that should be removed. The amendment proposed by Deputy Ó Caoláin, far from ameliorating the position, would remove altogether the capacity of the college to own property, which would be untenable for any large and expanding higher educational institution. The college needs that power to own property as is normal in any corporate body. As the simplest company, incorporated under the Companies Act has a capacity to own property, I cannot see how we could accept this amendment.

The Minister of State strayed into a number of areas. While I do not have a problem with that, it is a pity that we have only 30 minutes for the debate on the Bill. He made a point about locality. The reality is that what the RCSI decides has effect on the daily life condition of individual and quite ordinary citizens. It is not about locality. Some day, when the problem visits the Minister of State in a more direct way, he may appreciate exactly from where I am coming. My viewpoint, contrary to the accusation of parochialism, is that any diminution of services at any of our hospital sites diminishes each and every one of us, irrespective of where we live. I wish to make—

I would prefer if the Deputy came back to the amendment.

With all respect, a Cheann Comhairle, the Minister of State has had a degree of leniency directed towards him in his contribution.

Unfortunately the Chair is in a dilemma as the Minister of State responded to the questions that were raised by the Deputy.

I am about to respond to the Minister of State's comments but the Ceann Comhairle seems determined to use my time up.

No, Deputy, the Chair rules impartially and will continue to do so as my predecessors have done.

The Ceann Comhairle has not stopped any other speaker. I will not continue until he is finished.

I am asking the Deputy to stay with the amendment. He has made the point that there is only half an hour for the debate. A number of amendments have been put down and I would like to get through them. If the Deputy stays within the amendment, then the Minister of State will have to as well. If the Deputy goes all over the place, it is hard to stop the Minister of State following suit.

The Ceann Comhairle will have to accept that there are a number of key and critical factors in this Bill and the approach to it. My principle and primary objection is that it is being taken in this format. I re-emphasise the point that the Minister of State talked about in his response about bodies. This is a body but Standing Orders do not provide for bodies to promote private Bills. The Standing Order is specific when it refers to any "person" or "locality". I am questioning procedure which is totally inappropriate to this institution.

There is also an ideological issue. I wish the Royal College of Surgeons every success in all its educational endeavours. I have no difficulty, despite what some of the backbenchers of the Government party have suggested, with the word "royal". It does not offend me and I say "Good luck to them".

The issue is accountability and it is at the core of all the amendments I have tabled. I will have to leave that in order to go on to the next amendment as the Ceann Comhairle will cut me off, telling me it is not relevant to this raft of amendments with the limited time. It is accountability I will next address.

Amendment put and declared lost.
Amendment No. 2 not moved.

Amendment Nos. 3 and 14 are related and will be taken together. Is that agreed? Agreed.

I move amendment No. 3:

In page 8, to delete lines 51 to 57.

I do not have a copy of the grouping of the amendments which leaves me at some disadvantage. They are normally circulated at the beginning of proceedings.

Amendments Nos. 3 and 14 come back to the same point of accountability. I have no doubt that if this Bill was presented by the Government as a public Bill, we would all benefit from a proper debate albeit our debating system is imperfect. However, what we have is the college as the proposers of this Private Bill and we are denied an opportunity to directly engage with them. The proposers are off-stage yet welcome in the House. There is no opportunity to get to the kernel of these amendments. I know that some of my amendments, as the Minister of State has pointed out, might be deemed technically deficient. I am prepared to accept that could be the case in an open engagement where I would be happy to withdraw or tweak them. However, as this legislation is being taken as a Private Bill, we ware denied that opportunity.

I have put down these amendments to highlight various points already alluded to, particularly the status of the college and the accountability factor. Until such time that the Department of Education and Science and the public purse take responsibility for the role of the college, we are failing in our responsibilities to properly provide for the training and provision for key essential professionals within our health care system.

The role the college performs is an absolute necessity and is acknowledged by everyone in this House. What we need to see is the introduction of real accountability. I commend these amend ments to the Minister of State and the House with the limited opportunity now available to me.

The amendments proposed by the Deputy relate to the powers of the college. The point of departure again is that this is a Private Bill, not a public one. In a Private Bill we deal with the corporate capacity of a corporation. It is a well established trend in modern jurisprudence in connection with corporate bodies that one has to widen the legal capacity of any body corporate. This is to ensure that no question of ultra vires can arise or no suggestion that the corporate body was acting outside the proper scope of its authority.

The proposed amendments to the charter will broaden the powers of the college in the management of its affairs, the admission of students and the conduct of research. The effect of accepting the Deputy's amendments in the context of a Private Bill would reduce the capacity of the college to engage in any of these activities.

The points on public interest and policy, the admission of students and the need for more training for medical graduates are acceptable in the context of a debate on the health services. However, the basic point of departure is that 80% of the students in the college are non-EU nationals and the college is earning €60 million in overseas earnings. I accept the Deputy's point on the domestic provision of medical graduates. If we so wish, negotiations can take place between the college and the relevant Ministers. I have no doubt the college would be co-operative and favourable to such an approach. However it is not an issue that arises in the context of the Private Bill. In these sections of the Private Bill, we are simply providing that as a private body, the college has the maximum freedom of manoeuvre in law. There is nothing offensive in that. However, were questions of public interest or policy to arise, they could be regulated by an Act of the Oireachtas.

Deputy Ó Caoláin.

How many minutes remain to debate the Bill?

There are only about two minutes.

I hope everyone in the House – our visitors and those who may take note of this debate – will recognise the total unacceptability of the procedures in the passage of this legislation. The time constraints make the point stronger than even I could articulate.

There are two critical areas in terms of powers. With regard to accountability, I am concerned about the potential expansion of the college's activities into further areas of business other than education. Concerns have been expressed to me on a number of sections of the Bill where the college would be allowed the opportunity to expand into pharmaceutical promotion. As this is a Private Bill, again the opportunity to tease this out will be denied me. Examining sections 16 and 31, there is unquestionably a concern about the removal of certain restrictions that have applied heretofore. This would be an objectionable development and has echoes of the recent reports of some 40 members of the medical profession, at the behest of a pharmaceutical company, attending a special weekend break in County Kerry. That type of relationship is inappropriate between the pharmaceutical industry and people at the coalface of either medical or surgical provisions.

I will conclude by mentioning the unquestionable concern in the wider community at the increased levels of specialisation. I referred earlier to the accident and emergency sector in particular. This continuing drive towards specialisation is not in the interests of the service user—

I ask the Deputy to conclude because we are well outside the scope of the amendment.

—nor is the introduction of thresholds that communities will not be able to reach, with the dire consequences all too sadly recorded, not only in months past, but in recent days. That is the reality with which we are dealing. I will not be able to press my amendments but I hope I have at least excited some attention to this Bill and its passage and the need for major reform in this area.

Amendment, by leave, withdrawn.
Question, "That Fourth Stage is hereby completed", put and declared carried.
Question put: "That the Bill do now pass."



Will the Deputies who are claiming a division please rise?

Deputies Ó Caoláin, Crowe, Ferris, Ó Snodaigh, Gregory, Healy and Finian McGrath rose.

As fewer than ten Members have risen, I declare the question carried. In accordance with Standing Order 68 the names of the Deputies dissenting will be recorded in the Journal of the Proceedings of the Dáil.

Question declared carried.