MEDICAL PRACTITIONERS BILL, 1927—COMMITTEE.
The Seanad went into Committee.
Sections 1 and 2 agreed to.
SECTION 3.
Sub-section (3). The Council shall consist of eleven members nominated or elected from time to time as follows, that is to say:—
(a) two shall be nominated by the Executive Council,
(b) one shall be nominated by each of the following bodies, that is to say, University College, Dublin, University College, Cork, University College, Galway, the University of Dublin, the Apothecaries Hall of Ireland, the Royal College of Surgeons in Ireland, and the Royal College of Physicians in Ireland, and
(c) two, who shall be registered medical practitioners resident in Saorstát Eireann, (in this Act referred to as direct representatives) shall be elected by the persons who are for the time being registered medical practitioners resident in Saorstát Eireann.
I move amendment 1:—
Section 3, sub-section (3). After the word "council," line 26, to insert the words "of whom one shall be a member of the Central Midwives Board for Ireland."
My reason for putting forward this amendment is that the whole question of the training of midwives is linked with the training of medical students. There is a very definite relationship to the number of midwives and students which each of the maternity hospitals can receive for training. There is also the further reason that all questions regarding the qualifications of midwives are set out in every issue of the Medical Register. The matter is so important that the Midwives (Ireland) Act is printed in every medical register issued in England. It states the duties of the Board, and it is supplied to every medical man who is qualified, showing what his relationship to midwives is. There has always been a member of the English Midwives Board on the General Medical Council when the regulations were under consideration, and it is essential that there should be some person on this new Council who is familiar with these regulations and who can help to explain any alteration which is necessary from time to time. Furthermore, every medical student, when qualified, receives a "warning notice" which incorporates a provision contained in the Midwives Act, 1902, the Midwives (Scotland) Act, 1915, and the Midwives (Ireland) Act, 1918. This provision states:—
No woman shall habitually and for gain attend women in child-birth otherwise than under the direction of a qualified medical practitioner unless she be certified under this Act.
The warning notice then goes on:—
And whereas it has been made to appear to the Council that certain registered medical practitioners have from time to time by their countenance or assistance or by issuing certificates or notifications or other documents of a kindred character knowingly enabled uncertified women on pretence that such women were under their direction, to attend women in child-birth contrary to law. And whereas such conduct is, in the opinion of the Council, discreditable to the medical profession, and calculated to defeat the purpose of the statute made in the public interest for the protection of mothers and infants, notice is hereby given that any registered practitioner who is proved to have so offended will be liable to have his name erased from the medical register.
It is important that notice be supplied to such practitioners. These men are constantly coming before the Council in England. The practitioners in England are pretty familiar with the law relating to this matter. It is necessary, in my opinion, that there should be a connecting link between the two bodies. It is because I believe it is necessary that I move this amendment.
This is a Medical Practitioners Bill, and the only relation in this Bill to the Central Midwives Board for Ireland is mentioned in Section 44, which states:
On and after the establishment of the register the reference in Section 5 of the Midwives (Ireland) Act. 1918, to the General Medical Council shall be construed as a reference to the Council and the said Section 5 shall have effect accordingly.
Senator Bigger has given us some information with regard to the importance of the Central Midwives Board; but the fact is that all the time the Midwives (Ireland) Act, 1918, was in existence, and even during the period of the legislation that it substituted, there was the same obligation imposed on the General Medical Council to look after regulations as there will be in future imposed upon the Council here. Never in the history of the General Medical Council was there a suggestion that there should be definitely and clearly a representative of the Central Midwives Board on the General Council.
But there always has been, and in England when the regulations came up for consideration on several occasions they always had a member of the Central Midwives Board of England there. They never dreamt of altering anything or going into any matter until he was present and able to explain.
Quite a good procedure and one that may be followed. But I object to the insistance that there shall be a member of the Central Midwives Board necessarily on the Council. There is not any such obligation with regard to the English Council. I have had consultation with medical men generally as to the composition of this Council, and until this paper was brought to my notice I never saw or heard the suggestion that there should be a representative of the Central Midwives Board on the Council.
How far would one have to go if this were admitted? There is a Nursing Board. Why would there not be a representative from that Board admitted? The question of midwifery does come into the students' course, and it is a question that has to be given careful attention by responsible authorities. It is their duty to see that their representative will be able to look after the whole field of education in regard to this particular subject.
Such a demand never was made and never would have been tolerated in England. There is the further point that this would mean an upsetting of the Council. There would have to be a readjustment in the number and the personnel of the Council if this amendment were to be accepted.
The Minister mentioned the Nursing Board. Their regulations do not come before this General Council. They are a body absolutely responsible only to themselves. They can alter the regulations as they desire. They have to conform with regulations made elsewhere but there is no revising body such as this Council.
Amendment put and negatived.
Section 3 agreed to.
Sections 4 to 12. inclusive, agreed to.
Amendment 2 (Senator Dr. O'Sul livan) not moved.
Sections 13 to 28. inclusive, agreed to.
SECTION 29.
(1) Whenever a person registered in the register is judged by the Council, after due inquiry by the Council or due consideration by the Council of a report by the General Council of an inquiry held by them, to have been guilty of infamous conduct in a professional respect, the Council may erase the name of such practitioner from the register.
I move amendment 3:—
Section 29, sub-section (1). After the word "may" in line 7 to insert the words "if it sees fit."
CATHAOIRLEACH
I do not quite follow the meaning of this amendment. Does not "may" in itself involve a discretion? Are you afraid "may" will be held to mean "shall"?
When I had something to do with administration "may" was always interpreted to mean "shall."
CATHAOIRLEACH
Not always. The amendment would make the thing quite plain. The insertion of the words would do no harm. Is there any objection? It prevents it being said that "may" is intended to mean "shall," but perhaps the Bill intends it to?
"May" often does mean "shall."
Amendment agreed to.
I move amendment 4:—
Section 29, sub-section (1). To add at the end of the sub-section the words "or may suspend such practitioner for such period as the Council may think fit."
This is to give power to the Council to suspend a medical practitioner found guilty of an offence, for a definite time. In England the General Medical Council could never suspend a practitioner. They must strike him off the roll and reinstate him at a subsequent period. I think it would save a great deal of bother if a practitioner could be suspended for, say, six months.
What may happen is that he may be restored by an order of the High Court in a certain contingency referred to in another sub-section. The Council, by special direction, may restore him to the rolls. It is much better that any man guilty of infamous conduct in a professional respect should be removed and, if he is to be reinstated, there should be a reconsideration of the case and a definite direction that there should be reinstatement if that is considered advisable.
The position the Senator wishes to bring about is that they may suspend a practitioner and afterwards restore him to his original position. I think the conjunction of sub-section (7) with sub-section (1) of this section absolutely safeguards the position that the Senator wishes to achieve. I gather that the attitude of the medical profession towards this matter of infamous conduct in a professional respect is that the person found guilty should definitely and clearly be struck off for a term stated.
Very often you may have a man coming up who signed a certificate certifying the condition of a patient on, say, the 18th or 19th May, whereas he had not actually seen the patient for a week. That may be called infamous conduct. The practitioner knows perfectly well that the patient is in a certain condition, although he may not have seen him.
CATHAOIRLEACH
I suspected that for a long time, Senator, but I never heard official corroboration of it before.
It is in connection with these minor offences that it might be useful if the Council had power to strike a man off for a short period. The necessity for such power has often been felt by the English Council, and they often regretted they could not do what I am now suggesting.
Amendment put and negatived.
Section 29, as amended, agreed to.
Sections 30 to 39, inclusive, agreed to.
SECTION 40.
(2) For the purpose of the performance of the duty imposed on the Council by the foregoing sub-section the Council may with the approval of the Minister appoint such and so many fit and proper persons as the Council thinks necessary to be inspectors of examinations and may pay to such persons such remuneration as the Council with the sanction of the Minister for Finance shall determine.
Amendment 5 reads:—
Section 40, sub-section (2). To add at the end of the sub-section the words: "The approval of the Minister and the sanction of the Minister for Finance, mentioned in this sub-section, shall be requisite so long as the expenses of the Council are defrayed out of moneys provided by the Oireachtas and no longer."
On consideration, I do not think that I need propose this amendment.
Amendment, by leave, withdrawn.
Sections 40 to 45, inclusive, agreed to.
First, Second and Third Schedules agreed to.
Title agreed to.
The Seanad went out of Committee.
Bill reported.
