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Seanad Éireann debate -
Wednesday, 8 Jul 1931

Vol. 14 No. 27

Public Business. - Public Charitable Hospitals (Amendment) Bill, 1931—Fourth Stage.

Question proposed: "That the Bill be received for final consideration."

I move amendment 1:

"Section 2. To add at the end of the section a new paragraph as follows:—‘(vii) St. Patrick's Hospital for Cancer and Consumption, Wellington Road, Cork."

This hospital has about 75 beds, and 40 per cent. of the patients are treated free. A payment is made in respect of the others. In many cases, the patients who have been treated there have been discharged improved. I do not say that they have recovered, but they have lived a long time after their discharge, and have been able to earn their livelihood. I suggest that this is a hospital which ought to be included in the Bill. That, of course, will require the sanction of the Minister, as it will be necessary to include the hospital in a scheme. I respectfully suggest to the Minister that he should permit this hospital to be included with the others mentioned in this Bill.

I second the amendment.

I have had the advantage of seeing the documents relating to this hospital which Senator Linehan kindly sent me. It appears to me that, from the point of view of the hospital, there is practically no advantage in including it specially in this Bill. The hospital appears to me to be one which would come under the Bill in the same way as an ordinary general hospital. It does a great deal of work for the poor, and it would come under the ordinary voluntary scheme. It would not require to be named specially in the Bill at all. I think it would be better for the hospital if it were not mentioned in the Bill. The hospitals mentioned in the Bill do not do the necessary amount of charitable works to bring them within the scheme. This particular hospital does the necessary amount of charitable work, and, from its point of view, I think it would be better if it were not included in the Bill.

Who will decide whether or not this hospital will come in with the other hospitals ?

It will apply to the ordinary committee, and the facts will be looked into by the committee. It will come in as the Mater Hospital or St. Vincent's Hospital does.

Cathaoirleach

For a later sweep?

Cathaoirleach

But not for the present one?

Is it any part of the Minister's function to make a recommendation to that committee in favour of a hospital of this kind?

The hospital makes the application itself. If it is dissatisfied with the result, it can appeal to me. I could refuse to sanction a scheme presented by the committee, and would refuse to sanction it, if I were of opinion that a hospital had been wantonly omitted. But I am perfectly certain that the Hospitals Committee would never dream of keeping out of a scheme a bona fide hospital doing good work.

Perhaps I should say, on behalf of the Hospitals Committee, that inquiry was made into this case, and that the members of the committee are at one with the Minister. They are quite prepared to admit this hospital to a scheme in the ordinary way. There is no question about that.

Are we to understand from Senator Barrington that the committee is in favour of the inclusion of this hospital?

Senator Linehan's intention, I think, was to have it included for this particular sweep.

It will not lose by not being included for this sweep. If it is not included, it will get greater advantage out of the next sweep. This is not the last of the sweeps.

In view of what the Minister says—that the claim of the hospital will be favourably considered by the committee in charge—and in view of the favourable reception of the proposal by the House, I ask leave to withdraw the amendment. I shall suggest to the governors of the hospital that application be made as suggested.

Amendment, by leave, withdrawn.

There are two amendments down in my name. The first of these amendments reads:

Section 3, sub-section (1). After the word "Minister" in line 35, to insert the words "after consultation with the Minister for Local Government and Public Health."

The second amendment is as follows:

Section 6, sub-section (1). After the word "he," in line 4, to insert the words "in consultation with the committee of reference."

The first amendment is really consequential on the second amendment, and I presume the proper course is to discuss the second amendment first. If the second amendment is not carried, the need for the first amendment will not arise. I shall now deal with the second amendment. On the Second Stage of this Bill I protested against the absolute powers given to the Minister for Local Government and Public Health to decide as to the distribution of the one-third surplus arising on this sweep and subsequent sweeps. I put forward my arguments then, and I think that a great number of Senators agreed with me. It is not desirable, from the point of view of the Department of Local Government and Public Health, from the point of view of the House, or from the point of view of the Minister, that this power should be placed absolutely in the hands of an individual Minister. I think it will involve the Minister in serious conflict with the different bodies throughout the country. Divisions on the question of the needs of the various hospitals and county homes, and as to the proportions which they should receive, will lead to dissatisfaction. I suggested on the Second Stage that if the distribution was to be made on the basis of population or valuation, or on any similar basis, we should know exactly what we were legislating for. Failing that, I feel that the safest course is that the committee of reference should act with the Minister in deciding the amounts to be distributed, and to whom they are to be distributed. The committee of reference already provided for would probably be willing to co-operate with the Minister and to advise him as regards the distribution. I take it that there will be a considerable number of medical men on the committee of reference.

These three medical men would see that an equitable distribution would take place, and would advise the Minister as to how best that distribution should be made. That is the purpose of my amendment, and I think it ought to appeal to the Seanad. No departmental Minister should have such absolute power in his hands as is given in the Bill.

I second the amendment. On the Committee Stage of this Bill I made it as clear as I could that I considered the Minister unwise in taking on this enormous burthen, and leaving himself open to the probable political pressure which it would entail. I think that this proposal of Senator Connolly is a protection, to a small extent, to the Minister, and will secure that the money will be equitably distributed and spent to the best advantage.

As regards political pressure, I do not know how Ministers could live without it. Political pressure is the breath of their nostrils. Perhaps the Minister for Justice would tell us the reason why this money is to be handed over to the Minister for Local Government and Public Health without any restriction as to its being devoted to poor law institutions? Apparently, the Minister for Local Government and Public Health has power to spend this money in any way he chooses, even in a manner outside the purview of his own office. I cannot quite see the reason of that. The Bill lays down carefully that certain hospitals shall come within the scheme and then certain institutions which are on the border line are mentioned specifically. But the Minister for Local Government and Public Health is given power to distribute this third part in any way he likes and not merely to hospitals under a local authority.

Read Section 2, lines 11 and 12.

Perhaps I was mistaken in my reading of the Bill.

I support the amendment but not for the same reason that Senator Connolly advanced. I support it because I think it will bring about more uniformity. It would be almost impossible for the Minister to distribute this one-third surplus amongst institutions "wholly or partly maintained by a local authority." That applies practically to every hospital. It would apply to the hospitals who will come in for a share of the two-thirds and to the hospitals to which it is intended to give a part of the one-third and unless you have some person to deal with the entire matter I can see nothing but confusion resulting. There is no definition in the Act of an institution "wholly or partly maintained by a local authority" and, if we interpret it logically, it will include practically all the voluntary hospitals, because these hospitals receive a certain amount from the rates either directly or indirectly. I can see nothing but confusion resulting from the present arrangement and I support Senator Connolly's amendment.

I ask the House to reject this amendment. This question was very fully debated here on the Committee Stage of this Bill. A more moderate amendment proposed by Senators Connolly and Comyn was then rejected by the House. That amendment proposed that the Minister should consult with the committee of reference. Not satisfied with that rejection, Senator Connolly now wishes— this is a sort of Sibyline Book affair— to bring forward a very much stronger amendment—that the Minister, in consultation with the committee of reference, shall distribute the money. For the reasons that I gave on the last occasion, which I shall not weary the House by repeating, I urge the Seanad to reject this amendment. In addition I should like to ask: How on earth could this arrangement conceivably work? The Minister is to decide "in consultation with the committee of reference." Suppose the Minister has one view and the committee of reference has another, how is the question to be decided? In another part of the Bill, there is a provision under which the Minister for Justice receives a report from the committee, and on that report he makes up his mind. His decision is final. Here, if two members of the committee of reference held one view and the Minister held another, how would a decision be arrived at? The whole arrangement would be completely and entirely unworkable.

The amendment is not happily worded. I think the Senator probably intended that the Minister should decide after consultation with the committee.

That the Minister should receive a report from the committee?

Apart from that, I would ask the House to reject the amendment for the reason that they rejected a similar amendment the other day. All the committee of reference is set up to do is to consider the position of the other hospitals. Those other hospitals, as Senator Sir Edward Bigger has pointed out, may be rate-aided hospitals, but they are under the management of private hospital boards. It is not desirable that a Government Department should interfere in their management nor is it desirable that a Government Department should have too much to do with them. In the other part of the Bill where there are poor law hospitals catered for, where the needs of institutions are known to the Department of Local Government and Public Health and where the officials of the Department are available to make any desired inquiries, it is quite unnecessary to bring in any other persons. If this committee of reference has—as I trust it will have—a competent architect, it seems to me that it would be completely unnecessary to send round that architect to visit every one of these local institutions before it would receive a single penny.

Cathaoirleach

The Minister has stated that this amendment is practically the same as an amendment rejected on Committee Stage. If that were so, I would not have allowed the amendment to appear on the Order Paper. I do not think the amendment is similar to the amendment moved on the last Stage. The amendment then moved was in the following terms: "To add at the end of the sub-section the words ‘and for this purpose the Minister for Local Government and Public Health shall prepare a scheme'". The words "shall prepare a scheme" were put in the amendment, in my opinion, to bring it into conformity with Section 3, where the committee of reference is set up for a specific purpose. Senator Connolly desired to have a specific scheme provided for the purpose of using the committee of reference. That is quite different from the present amendment. If the Minister for Local Government is to consult with the committee of reference, he must have a scheme and there is no scheme provided for. The appropriate Standing Order states: "... No amendment previously rejected in Committee of the whole Seanad shall be in order except by leave of the Cathaoirleach, which leave shall only be given on the ground that the subject matter thereof has been insufficiently debated."

If you will allow me to say so, I was not in the slightest degree impugning your ruling. The amendment I had in mind was the other amendment which stated "The committee of reference appointed under Section 3 of this Act shall, when requested by the Minister for Local Government and Public Health so to do, report to the Minister for Local Government and Public Health as to the proportions in which the said one-third of such available surplus should be divided between the institutions mentioned in such scheme." I do not say that that amendment is identical with the present amendment but the principle running through it is very similar.

Cathaoirleach

That amendment was tabled, but not moved. It was not rejected.

In connection with this I do not think that the Senator fully realises the difficulties that might arise if the Seanad adopted his amendment. The committee of reference in the first instance is appointed, as the Minister has stated, to advise him as regards the other hospitals of which there are a considerable number and which are stated fully in the scheme. But this 33? per cent. of the total receipts is to be placed at the disposal of the Minister for Local Government and he has to administer these funds to the various public hospitals such as county infirmaries that did not come under the scheme, and hospitals in connection with what were the old workhouses and so on, and if the committee of reference were to go into every one of these all through the country and make a report it would delay the thing considerably, and it would be Tibb's Eve before the money was distributed.

The consensus of opinion of those who have had practical experience of hospital work and administration was, on the last occasion, in the direction of emphasising the importance of some co-ordination of the work of hospitals throughout the country. I think it was admitted that private hospitals and public hospitals are doing similar work in many cases. There is a certain amount of overlapping and, at any rate, the dividing line between the class of work they are doing is very fine indeed. I support the amendment on the ground that it will give some grounds for hope that there will be an attempt at co-ordination of hospital work throughout the country. For instance, there was talk about certain big undertakings in Dublin. I wonder ought they to have any relation to the development of country hospitals and poor law institutions? I think they ought, and I think the Minister who is administering the one-third ought to have a direct means of knowing what is being done by the other private hospitals throughout the country. In that way there will be some way of relating the hospital needs of the country to the facilities available, whether they are poor law institutions or private hospitals, and I think this committee of reference would at least help the Minister for Local Government to administer his one-third, having regard to the requirements of and means available in the private hospitals throughout the country.

What Senator Johnson simply wishes to see is the setting up of a commission to inquire into the administration of all hospitals in this country. I do not venture any opinion as to whether such a commission is or is not necessary. I do not see how it can assist in deciding how much money should go to individual hospitals. There will be a sum available for large hospitals. It would take a committee all its time to examine the books and the structural needs of all the voluntary hospitals, of which there are a large number. If you double that number, as Senator Barrington has pointed out, you will never get there at all, whereas the individual needs are probably now known to the Department.

I agree entirely with Senator Johnson. I think that the requirements of the rate-aided hospitals must inevitably depend upon the development of other institutions in the area that are getting benefit under the sweepstakes. I have in mind where such an arrangement as this would be of great benefit. It is in reference to the town of Navan. If my information is correct, you have a hospital there which benefits under the present sweep. It is a voluntary hospital, but you also have in the town of Navan a county infirmary. The voluntary hospital has been equipped with an X-ray apparatus, and I understand that provision has been made by the board of health to instal an X-ray apparatus in the county infirmary. Speaking purely as a layman, I cannot see any necessity for two X-ray installations in the small town of Navan. If such a committee as this were in operation, it could advise the Minister to make arrangements for the county infirmary to provide X-ray treatment for those patients who were going into the public institution. I support the amendment.

Does the Senator think that the officials of the Department of Local Government will not ask immediately what equipment there is in the town? If there is suitable equipment they will say: "You do not want it; you won't get a grant for it." Unless I am totally mistaken —I hate trusting my memory—no hospital in Meath has received any benefit under any scheme up to the present, nor is one even included.

With regard to this amendment, the committee to be appointed will consist of three, for the purpose of advising the Minister with regard to the voluntary hospitals coming under the scheme. I should like to know what position would the committee of three be in to advise the Minister in regard to the county infirmaries? What knowledge would they have of the condition of affairs in the rate-aided hospitals? I should like to know what useful purpose could be served with regard to the allocation of the grant to the county infirmaries. If the case can be made that these people would be in a position to give useful information to the Minister, if these people were familiar with the work and the organisation of the charitable and voluntary hospitals, well and good; but I fail to see how they can advise the Minister as to which county infirmary would be entitled to a larger grant than the other. For that reason, I think the amendment would not serve a useful purpose.

I will try to answer Senator Farren's objection in order to get his vote in favour of this amendment. I suggest to the House that the committee of three will not be selected because of any knowledge they have of the existing voluntary hospitals. As I understand it, one is to be a lawyer of ten years' standing or more.

Is that in the Bill?

If it is not in the Bill it is in some of the regulations.

The lawyers have got in first.

I have no interest in the personnel of this committee, but I should imagine that the members would be selected for the judgment they would bring to bear upon the allocation of the fund for voluntary hospitals. If that is the purpose for which they are required, I do urge that they could bring the same knowledge and judgment to bear in relation to the rate-aided hospitals. The best argument in favour of this amendment has been put forward by Senator Johnson, because this committee of three will be a co-ordinating influence between the two Departments. They will advise the Minister for Justice in relation to the voluntary hospitals, and they will advise the Minister for Local Government in relation to the other hospitals, which are wrongly called rate-aided hospitals. All the hospitals in Ireland are rate-aided one way or the other. It is because of the element of co-ordination that this committee will function, not by way of over-riding any of the Ministers, but by way of advising the Ministers. That is the chief advantage of this amendment, and it is the reason I would ask Senator Farren to support it.

In the first place we have our committee, who are advised by our medical doctor. If Senator Comyn thinks that it is necessary to have a lawyer there, we have a lawyer always at hand and, of course, we have a medical inspector who is appointed by the Local Government Department to visit all the hospitals in the Saorstát. I consider the amendment is unnecessary.

I think that, having voted for the idea of a consultative body being associated with the Minister in regard to these county hospitals, I ought to explain the reason now why I do not think it is right to vote for this amendment. I do not think this amendment would accomplish what I had in my mind when I voted for a scheme to be prepared by the Minister that we could have approved of. I do not believe this committee of reference appointed to assist the Minister for Justice would be the right committee at all to deal with the counties, and for that reason I do not think it an amendment I can vote for. I think the Seanad ought to consider its position. We did everything we could to persuade the Seanad the last day about the principle that there should be a consultative body, and we were definitely defeated. If the Seanad were to vote for this now, I think it would be going back on a thing it had defeated. It would not be dignified or right, and I should not like to ask the Seanad to do a thing reversing a decision they had already arrived at.

I feel that nearly all the points that have been raised have been answered one by one. The Minister for Justice falls back on the fact that the officials of the Department and the Minister for Local Government have all the details and all the information necessary to guide them in the distribution of this one-third. It surely applies to more Ministries than one, and if it is so in one Ministry and so in another Ministry, why is the Minister for Justice fortified by a committee of reference of three? Senator Toal is, of course, perfectly happy with the Minister for Local Government, and quite content to abide by his decision so far as he is interested in county council operations. I mentioned to the Senator yesterday that there are other county councils that would not be quite so happy to leave their fate in the hands of the Minister for Local Government. They are, perhaps, not so satisfied as our friend from the County Monaghan.

I wish to acknowledge the fact that the Seanad was defended by the Cathaoirleach against the Minister to-day. The Minister, like a good many Ministers here, tries to put an occasional one over and it is a relief to know that the Cathaoirleach was in a position to deal with that in a proper way. The Minister referred to architects visiting homes all through the country, and some Senators said it was practically impossible to get a committee of reference. The committee of reference, whether it is three or five, would, it is to be presumed, be intelligent men who would analyse the merits, the rights and the interests of the various county homes and hospitals throughout the country, and would, on evidence submitted to them by the local government bodies, or any other evidence they could get, submit what would be right in the distribution of one-third of the funds. We are giving one-third of what is charity money. We are not dealing with rates. We do believe it will go to the alleviation of rates. It is going to absolve the Minister, and the Minister's subsidiary Departments throughout the country from a certain rating.

I do claim, as it is charity money, that there is no reason why a Minister, and particularly the Minister for Local Government, should be entrusted with this gigantic sum which is likely to be left entirely at his discretion. In spite of what Senator Toal says, that his county and his area would be well looked after, I am quite certain people in other areas might not be so well looked after. Ordinary common justice and common sense dictate that a certain advisory body should be available to advise the Minister. Senator Johnson and Senator Bigger raised very important points which I had in mind, not so distinctly and clearly, however, as they made in their arguments.

The question of the co-ordination of the work throughout the country should be dealt with by such a committee of reference. I stress the fact that the Minister for Justice has got to have this committee of reference for his activities, and I do argue that it is much more vital to the distribution of this money that the Minister for Local Government should have a committee of reference which would, at least, check the distribution of it. While the Minister was out I stressed the point concerning the officials of the Local Government Board. I am satisfied regarding the integrity of these men, but I am also satisfied that all sorts of opinions will operate with the Minister and that the official head —as in the case of all good officials— will do what he is told.

I propose to go on with this amendment and I do urge on the House that it is essential for the distribution of this great amount of money, which is charitable money, not out of the Exchequer, that this committee of reference can be availed of and, accordingly, I ask the favourable consideration of the Seanad for the amendment.

Amendment put.
The Seanad divided: Tá, 9; Níl, 28.

  • Sir Edward Coey Bigger.
  • Michael Comyn, K.C.
  • Joseph Connolly.
  • Thomas Johnson.
  • Seán E. MacEllin.
  • The McGillycuddy of the Reeks.
  • Colonel Moore.
  • Joseph O'Doherty.
  • Séumas Robinson.

Níl

  • John Bagwell.
  • William Barrington.
  • Sir Edward Bellingham.
  • Samuel L. Brown, K.C.
  • Miss Kathleen Browne.
  • R. A. Butler.
  • Mrs. Costello.
  • John C. Counihan.
  • The Countess of Desart.
  • James G. Douglas.
  • Michael Duffy.
  • Sir Thomas Grattan Esmonde.
  • Michael Fanning.
  • Thomas Farren.
  • Major-General Sir William Hickie.
  • P.J. Hooper.
  • Right Hon. Andrew Jameson.
  • Cornelius Kennedy.
  • Thomas Linehan.
  • James MacKean.
  • James Moran.
  • Sir Walter Nugent.
  • Joseph O'Connor.
  • L. O'Neill.
  • Bernard O'Rourke.
  • Michael Staines.
  • Thomas Toal.
  • Richard Wilson.
Tellers: Tá, Senator Connolly and Senator Sir Edward Bigger; Níl, Senator Barrington and Senator Jameson.
Amendment declared lost.

Cathaoirleach

Does the Senator propose to move the other amendment?

Question—"That the Bill be received for final consideration"—put and agreed to.
Fifth Stage fixed for Wednesday, 15th July.
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