Before you proceed, sir, might I raise a point of order? I always do my best to keep within the rules of order.
Private Business. - A Point of Order.
Cathaoirleach
The Senator is not keeping within the rules of order in addressing the Chair as "sir." Did he read the Standing Orders?
A Chathaoirligh, a few minutes ago you stated that I remained standing, and you ordered me to sit down, presumably as if I was proceeding under a breach of the Standing Orders. I complied with your request. I have now seen Standing Order No. 28, which says: "Whenever the Chairman rises during a debate any Senator then speaking or offering to speak shall resume his seat." I considered that as the Cathaoirleach remained seated I could remain standing.
Cathaoirleach
I am sorry if I induced the Senator to sit down when he should not have done so. I am very sorry indeed.
SECTION 13.
I move amendment 4:—
Section 13, sub-section (1). To add at the end of the sub-section the words "such audit shall state the total number of counterfoils placed in the drum."
Every Senator is aware of the object of this amendment. It is not so wide as a previous amendment, which was rejected. There is further evidence that information of this kind is needed or, at least, there is further evidence of great misapprehension on the part of members of the House, and even members of the public, as to the actual position. In the debate last week Senator Foran, according to the Parliamentary Debates, used these words:
"If Senator Johnson knew a little more about gambling he would know that every £5 subscribed represents 12 tickets—and here follow the significant words—in the drum. Every man in the street knows that. It is a simple calculation that any person can make to satisfy himself. Each book represents £5. There are 12 tickets in each book."
From that one was led to believe that to find out the number of tickets in the drum one had only to divide the money by five and multiply by 12. Does Senator Foran hold that that is the position?
I suggest that he is entirely wrong. To what extent he is wrong I do not know, but that he is wrong is common knowledge. Books in quantity can be bought at less than £5. If it were only 1/- less than £5 his calculation would be upset. We know that they are sold at less than £5 per book, but how much less we do not know. One hears of books being sold at £4 10s. 0d. each. There are two points of view to be considered. The first is that of the hospitals. The Minister says that our only responsibility should be for the welfare of the hospitals. He suggests that the welfare of the hospitals is met by getting as much money as possible into the total receipts regardless of the interests of subscribers. By subscribers I mean gamblers—people who pay their money for tickets. The Hospitals' Committee discharge their duty by getting all the money they can, and it is not up to them in any way to have any regard for the backers or the odds that are involved. I consider this House is in a different position. This House has a certain responsibility to subscribers and for the scheme as a whole. We ought not to be satisfied until we have information which will disclose in one way or another the amount of the secret commissions. It is with the sole object of ascertaining this information for the public and protecting the interests of the subscribers as a whole, that I move this amendment.
That considerable sums are certainly paid in commissions everybody knows. I myself know people who received commissions but the mere fact that there are rumours about tickets being sold for smaller sums of money does not prove anything. I have no reason to suppose that the sums actually received per book of 12 tickets is less than £5. I think it is quite conceivable that the commissions which are paid come from some other fund—from the expenses fund. Anyway there is no proof that they do not. The fact that Senator Sir John Keane hears stories and rumours proves nothing. I have heard rumours some of which I know are totally unfounded. The only thing we know is that commissions are paid but that the promoters receive less than £5 per book of tickets, I do not think there is any proof whatsoever.
I fail to follow Senator Robinson. He says that he knows that books are sold at less than £5.
I said nothing of the kind. I said that certain commissions were paid but that there was no proof that the books were sold at less than £5.
Commissions are paid, yet the seller, the person who has the book to sell, sends in £5 per book. Where does the commission come in?
It is not where it comes in; the question is where it comes from.
It is not a commission by way of deduction, we are told. In that case it is set out in the expenses. Are we to assume then that there is no commission paid whatever by way of deduction? That is the whole point. It is because the matter is so obscure that I think the House has a right to some definite assurance from the Parliamentary Secretary. The Senator suggests that no commissions are given by way of deduction although in the scheme as submitted to the Minister, that item is specially provided for. Is the House to assume that although the item is specially provided for in the scheme it has not any practical reality? Suppose the commissions do not take the form of deductions, are we to assume that when a man sells books in quantity he sends in £5 per book and receives a direct payment as reward? I personally know for a fact that is not the method employed.
A Senator
It is the method.
According to the Senator who has interjected there are no commissions by way of deductions. If the Parliamentary Secretary can give us that assurance, I shall be perfectly satisfied and withdraw the amendment. Let him assure the House that there are no commissions paid by way of deduction from the £5 and that all commissions are paid out of the general expenses, the expenses as certified by the auditor. I shall be perfectly satisfied with that assurance.
I think I shall be able to cut the debate short by giving Senator Sir John Keane the assurance he asks for—that there is no deduction from the £5 per book of tickets. There are two free tickets in each book, but there are no further deductions. The payment of commissions is a separate transaction altogether, and is a payment in cash. This matter, having been debated in a more or less disorderly way on a previous occasion, gave me an opportunity of taking it up with the auditors, and I have received from the auditors a written communication which gives the assurance that Senator Sir John Keane asks for.
Would the Parliamentary Secretary read that report from the auditors?
Cathaoirleach
It does not arise.
Is that cash payment part of the expenses as returned by the auditor? Surely I may get a little latitude in asking for an assurance which will enable me to withdraw the amendment. The Parliamentary Secretary has stated that the commissions are paid in cash. Are these cash payments included in the expenses as set out in the audited accounts?
Cathaoirleach
Does the Parliamentary Secretary wish to answer that?
I have already dealt with that. That is the secret commission we have been already discussing.
Cathaoirleach
It really does not arise, and one must realise that this is a matter for those promoting sweepstakes. They are allowed a certain percentage for expenses and they utilise that as best they can for promoting the sweepstakes.
I shall be perfectly satisfied if the Parliamentary Secretary will tell me that these matters are covered by the promoters' expenses. I should be surprised to hear that. The Parliamentary Secretary has said that there is a payment of £5 per book and that those who sell books in quantities get, as a reward, a cash payment. I now want to know whether that cash payment forms part of the audited expenses as published and circulated to all members of the House.
Cathaoirleach
That does not arise under this particular amendment.
It seems to me that when the Minister sanctions a scheme under Clauses 6 and 7 of the Bill, everything is as secure as it can be. The idea of asking that the number of tickets that go into the drum should be accounted for seems to be absolutely ludicrous seeing that they run into millions and having regard to the fact that every purchaser of a ticket gets a written acknowledgment of its receipt.
I had not intended to intervene in the debate, but this particular question has been discussed for several years and people all over the world have some little doubt about this scheme. I agree that Senator Sir John Keane is perfectly right in his contention. There seems in this House to be a definite desire to conceal what appears to be an extremely important item. If anybody goes to Galway races and has a bet, say, in the Galway Plate, he will find that even the "old firm" will have the odds up on the board. I cannot see why in a matter like this we, who have a certain responsibility to the man who contributes by purchasing a 10/- ticket towards our hospitals, should not tell him exactly what the odds are against him.
The last speaker suggested that there was a very definite desire in this House for this information. I have not seen that any such desire exists at all. After all is said and done, where is the money to come from? From the tickets sold, undoubtedly. It is clear that when these tickets are received every individual subscriber is furnished with a receipt. Do the Senators who want this information suggest that some of these tickets have been destroyed, and have not been put into the drum?
There is no suggestion of that kind.
I do not see why there should be any doubt that when 12 tickets are received with £5 cash these 12 tickets go into the drum. It is quite possible, as the Senator suggests, that a book of tickets may be sold for £4 10/- but the 10/- that is paid in that way will undoubtedly be deducted from the general expenses and it has nothing whatever to do with the number of tickets which go into the drum. I think that the discussion in this House is calculated somehow to cast doubt on the validity of this scheme. I should not like to suggest that the opposition to this measure is dictated by a puritanical spirit, the same spirit that opposes all gambling and which looks upon sweeps as a gambling performance, but it is a serious matter for anybody to suggest that this business is not carried out above board and in a thoroughly upright way. The firm of chartered accountants who have charge of the audit are well known. Their fame has very widely extended. Is it suggested for a moment that they would vouch for these accounts if there was any doubt whatever in their minds in regard to the validity of the work or if there was any suggestion that the correct number of tickets, corresponding to each unit of £5, were not put into the drum? I think the whole argument advanced in support of the amendment is ludicrous and has not been substantiated in any way. It should not go forth as the opinion of this House that we desire to probe into matters as between a reputable firm of auditors and the Sweep Committee. I do not think we should have any feelings of conscious doubt as to the rectitude and the thoroughness in which this scheme is carried out. An immense success has attended these sweeps so far. I am quite sure that the House can say, not that they have any doubts, but that it is the consensus of opinion here that the sweep could not be carried out in a more upright and honourable fashion than it has been by the Sweepstakes Committee.
I think I am not wrong in saying that some people in the Seanad as well as others outside have been opposed to the lottery from the beginning. In spite of their opposition the sweep has been a great success all over the world. The only object in bringing these matters up and casting doubt on the working of the sweep, is to break down as far as possible the success of the lottery which is bringing so much money to Ireland. I think that is an extraordinary attitude to take up.
The Senator can put it as he likes but my conscience in this matter is perfectly clear and my action has been perfectly consistent. I do not even resent the unworthy motives the Senator imputes because I think there are a great many people who understand clearly what I want and think I am entitled to what I want. I only want this now: Would the Parliamentary Secretary say if those cash payments which are given for the sale of tickets are included as part of the disclosed and audited expenses? That is the only thing I ask and, if the Parliamentary Secretary says that he cannot tell me or does not wish to tell me, I shall be satisfied.
Cathaoirleach
All you are asking, Senator, is that there should be added, at the end of the sub-section, the words "such audit shall state the total number of counterfoils placed in the drum."
As the Parliamentary Secretary has refused to give me this information, I have to draw my own conclusions.
Would it be possible for the Parliamentary Secretary to answer Senator Sir John Keane's amendment in plain words?
Cathaoirleach
It does not arise, so far as I am aware, on the amendment at all.
"Such audit shall state the total number of counterfoils placed in the drum." That is a plain and distinct question and I think the House would like to know whether the Minister can say "yes" or "no."
Cathaoirleach
The proposal is that the words "such audit shall state the total number of counterfoils placed in the drum" should be added.
It seems to me that if Senator Sir John Keane is so anxious to get an answer to this question, the matter boils itself down to this. We know that sweep tickets are sold all over the world and there is scarcely one country in which it is legal to sell them and the disclosure of the information that he wants means eventually the names, addresses and the amount of commission received by the people selling the tickets in the countries where it is illegal to sell them and that will finish the sweep.
Amendment put and declared lost.
Question proposed: "That Section 13 stand Part of the Bill.
On the section I want to keep strictly in order and, therefore, I want to speak on the audit. I do so because there appears to be a very great difference of opinion in the House as to what are the facts regarding the audit and what it is, in fact, that the auditor is auditing. There appears to be a very great difference of opinion and quite a sincere misunderstanding and I think it is due to the House and to every member of it that they should know exactly what is the position. As I read it—if I am wrong, perhaps the Parliamentary Secretary will correct me—the audit that is provided for, in Section 13, is the audit of the receipts and disbursements of money in relation to such sweepstake that come within the purview of the Commission and these moneys are defined by Section 2 which says:—
When calculating for the purposes of this Act the amount of the moneys received from the sale of tickets in a sweepstake, the value of tickets issued free of charge by way of reward to a seller of tickets shall be excluded from the calculation, and there shall be deducted from the nominal selling price of all other tickets all commissions, prizes, and other remuneration given in relation to the selling of such tickets.
It seems to me, and I know that my reading of this matter is different from that of those who have spoken, that what the auditor is required to audit is the amount of money that is placed to the credit of the Hospitals Commission by the people who organise the sweep, and not, as some people seem to think, the amount of money that comes into the possession of the organisers of the sweep. There is a distinct difference between members of the Seanad on that point, and it is a matter of fact that ought to be made clear. Is it an audit of the moneys that come into the offices of the people who organise the sweep, or is it an audit of the moneys that come into the coffers of the Hospitals Commission, the original promoters of the sweep? I think it is the latter only, and if I am not correct, I think there would be a great relief in some people's minds, and we should be quite sure, then, that the audit is the audit of all the moneys received by anybody for the sale of tickets. If that is true, then, for my part, I have nothing more to say. If it is not correct, we should be told quite clearly that the audit is an audit of the moneys that come into the Hospitals Commission in accordance with the scheme that the Minister has sanctioned. There is a big difference, and it is very important, in view of the responsibilities the Oireachtas is taking on itself, and has taken on itself hitherto, in regard to this whole business, that this matter should be made clear once and for all.
I am surprised at Senator Johnson talking as he has done, seeing that he gets an audited balance sheet of every sweep, and seeing that he has the total receipts there before him. The gross total is there before him, not divided in parts——
The total amount of what? That is the question.
The total amount of revenue.
To whom?
To the Hospitals' Trust.
The Sweepstakes Committee.
They are two different people; that is the point.
The auditors have sent a letter here—the Parliamentary Secretary has indicated that—and if it was read, it might clear the whole atmosphere. This is a very reputable firm and they have sent a statement here and we ought to hear it.
I do not know why Senator Johnson, who is so extra ordinarily careful in the reading of sections of the various Acts of Parliament, should ask for further information as to what this section means. Here is the thing that is to be audited.
Within three months after the drawing of prizes or, where there is more than one drawing, after the last drawing of prizes, in a sweepstake held under this Act the sweepstake committee managing such sweepstake shall cause the accounts of all receipts and disbursements of money in relation to such sweepstake to be audited by the person named ...
That is, all the money they get and what money they pay has to be set out in the account and that is the only thing that has to be audited, according to law.
"What money they get". The point is what proportion of the money that is subscribed by the public from the sale of tickets do they get?
There is another matter. The law does not authorise an audit of that statement. The Sweepstakes Bill was passed after tremendous opposition by Senator Johnson, Senator Sir John Keane and myself. I opposed it very bitterly and strenuously. I did not trust that they could do the job properly but now I find that they are doing the job well and honestly, within the terms of the Act of Parliament, and I do not see why question should be asked by Senator Johnson, the greatest legalist in this assembly, seeking information as to the meaning of a section of an Act of Parliament that is as plain as the eye in one's head.
The moneys dealt with in Clause 13 are clearly the net receipts after all commissions are paid.
Cathaoirleach
What section are you reading, Senator?
Section 13 deals with the net receipts and Section 2 defines these net receipts which is really net amount after the commissions have been paid. The auditors have nothing to do with the amount of commissions paid.
That is quite right.
We are speculating as to what happens and I think this debate shows quite clearly what happens.
In the Seanad, yes,
The auditors take cognisance of all the relevant figures but they do not publish them all. That is where Senator Comyn is wrong. What happens really in the document we see is that the gross receipts are set out at say, £2,000,000, less rewards to sellers, £200,000, leaving net receipts, £1,800,000. That is what we are told. I do not know whether the Minister will deny that but that is actually what is done. On the other side, you get all the open expenses—all the machinery we see in Dublin, the girls, the clothes and the receipts to sellers. The House should know that they do not see the gross figure. They see only the net figure but they seem satisfied with the net figure and I propose to leave it at that.
I wonder how many limited companies set out in the detail which Senator Sir John Keane desires all the information that is asked for? Any information of that sort would be at once availed of by their competitors. I am in exactly the same position as Senator Comyn, because I spoke and voted against this Bill, in the first instance, but, having seen the Bill working, and having seen the safeguards taken not only by the Minister but by those administering the Sweep, and having seen how clean and honest and above board it is, I think that such a discussion as this, whether it is intended or not, is calculated to throw doubt on the bona fides of the administration of the scheme which administration is certainly above board.
Might I say one final word? The last speaker and others have suggested that I am impugning the integrity of the sweep or the integrity of the auditors. Not at all. I am perfectly satisfied that the integrity throughout is absolute and complete, but I am not satisfied that the full information to which it is entitled is given to the House or to the public. That is all I have to say.
For my part, I am satisfied with the integrity of Senator Sir John Keane.
I do not know whether I shall be able to add to the confusion or whether I shall be able to make things clearer than they are. The audited statement circulated to the public relates to the amount of money available after certain deductions by way of commission, etc., have been made, but it would be wrong to assume that there is no check or no audit of the commissions and other payments that are not included in that statement. In connection with this—and this is a rather serious matter, inasmuch as it is liable to be misunderstood outside the House; if we cannot clarify the position here, damage might be done, unwittingly, let us say, to the future financial success of these sweepstakes—I will read for the enlightenment of Senator Sir John Keane in particular, a statement from the auditors on this matter. It reads:
"As auditors of the Sweepstakes, we have to state that, in the provisions of every scheme which has been submitted to and approved by the Minister for Justice, for Sweepstakes under the Public Charitable (Hospitals) Acts, 1930 to 1932, there has been a clause limiting the amount to be allowed by way of commission or remuneration in relation to the sale of tickets to distributing organisers outside the Irish Free State. No commission is payable on tickets sold in the Irish Free State. To satisfy ourselves as auditors that this provision of the scheme is strictly complied with, it has throughout been necessary to record in the books of Hospitals Trust Limited the gross number of tickets sold, the gross amount of proceeds from the sale of tickets, and the commission allowed by way of remuneration to distributing organisers. A complete record has also been kept of the free ticket allotment so that at any time we are in a position to certify from the books of Hospitals' Trust Limited not only the gross amount of the proceeds from the sale of tickets, but also (a) the deduction for free ticket allotment, and (b) the amount payable by way of commission.
"It is hardly necessary for us to state that in each Sweepstake conducted up to the present the amount paid by way of commission has been well within the limit provided by the respective scheme, while the maximum amount of free tickets has never been reached in view of the very large sale of individual tickets at the local receiving offices of Hospitals' Trust Limited."
Section 13 agreed to.
Sections 14, 15, 16 and 17 agreed to.
SECTION 18.
I ask the permission of the House to withdraw amendment 5 which appears on the Order Paper in my name. It is not worded as I intended and does not carry out what I want. I undertake to put in an amendment for Report Stage.
Amendment 5, by leave, withdrawn. Sections 18, 19, 20, 21 agreed to.
SECTION 22.
Question proposed: "That Section 22 stand part of the Bill."
May I make a suggestion to the Parliamentary Secretary on this section? This section affords as good an opportunity as any other to do so. This section deals with the National Hospital Trustees and the Hospitals' Trust Fund. The Parliamentary Secretary has just read out the name "Hospitals' Trust Limited." Now Hospitals' Trust Limited is not the same as the Hospital Trustees, and their possessions are not the Hospitals' Trust Fund. These terms deal with entirely different things but, being very nearly alike, they are liable to cause confusion. I would suggest to the Parliamentary Secretary that he should consider whether it would not be desirable to make some change in the terminology of this fund which is now known as "The Hospitals' Trust Fund" in view of the title that is given to the organisers—Hospitals' Trust Limited.
I will look into the point between this and the Report Stage, though I do not think there is really very much in it.
Section 22 agreed to.
SECTION 23.
(1) The governing body of any hospital or nursing organisation in Saorstát Eireann or any person about to establish any such hospital or nursing organisation may at any time apply to the Minister for a grant out of the Hospitals' Trust Fund for the benefit of such hospital or organisation.
(2) Every application under this section for a grant out of the Hospitals' Trust Fund shall state with such particularity as the circumstances may require the purposes for which such grant is proposed to be expended and the suggested amount of such grant.
I have two amendments down to this section, and I think the House might consider them together. I move:—
Amendment 6. Section 23, sub-section (1). After the words "Saorstát Eireann" in line 21 to insert the words "or any organisation established in Saorstát Eireann for the provision of a pension fund for aged or infirm nurses."
Amendment 7. Section 23, sub-section (2). To insert before the sub-section a new sub-section as follows:
(2) For the purposes of this section, but not further or otherwise, the word "nurse" shall mean a nurse registered by the General Nursing Council or a midwife certified by the Central Midwives Board, who shall have been engaged for not less than 20 years in nursing or in attendance on maternity patients in Saorstát Eireann.
In the definition section "the expression ‘nursing organisation' means an institution or organisation in Saorstát Eireann which has for its sole or principal object the nursing of, and providing of nurses for, poor persons suffering from physical diseases, injuries, or deformities or poor women in child birth."
That deals with nurses who are really ministering to the poor, but the purpose of my amendments is to enable those engaged in general nursing to apply for a grant out of the Hospitals' Trust Fund. Those engaged in general nursing pay a substantial fee for their training. It is something like £50, and they have to spend a number of years in training. During their course of training they have to pass a certain number of examinations as to their proficiency. After that, if they are not retained on the staff of the hospital, they become members of what is called a co-operative nursing association. The Minister, on the Second Reading of the Bill, rather surprised me by saying that these nurses are well paid. I have made inquiries since. I find that their remuneration, when engaged in private nursing, is about two guineas a week, while for night cases the fee is about 2½ guineas a week. Having regard to the fact that they are not in continuous employment—I doubt very much if many of them are engaged for more than 30 weeks out of the 52—their remuneration, I suggest, comes to very little more than £1 or 25/- a week. That is a miserable remuneration for ladies engaged in very useful and important work. For those who have to continue at nursing until they become old and infirm, that is to say after 20 years' professional work, their chances of making provision for the future are very small indeed.
We know, of course, that there is a sort of psychology in nursing: that sick people very naturally prefer to have younger people around them. Those who become old in the service, though ordinarily they would not be regarded as old—they may have reached the age of 40 or 45 years of age—have very little chance or anything like continuous employment as nurses. Nursing is a very racking occupation, particularly for those engaged in night nursing. It is important for the hospitals, as well as for the general health of the community, that an adequate staff of trained nurses should always be available. This Bill gives an opportunity for making such provision. In the case of a very bad epidemic a sufficient number of nurses may not be available if something is not done now to safeguard the future of nurses. My amendment only gives permission to an organisation, such as that referred to, to apply to the Hospitals' Trust Fund for a grant which will be utilised to provide pensions for those who have been engaged for not less than 20 years in public nursing. I desire to say that it is the intention of any scheme put forward for that purpose to make it, as far as possible, a contributory one. Fortunately, a considerable number of those engaged in nursing get married. The circumstances of others may be so affluent that they may not care to continue nursing. If a contributory scheme be decided on the contributions to be made would be small, but with whatever sum may be granted by the Hospitals' Trust a fund would be made available for those who had given 20 years' service in public nursing and could not get employment. Under the proposed scheme provision will be made for those who, after 20 years' service, are no longer able to get employment. I think the amendment is a very fair one, and I hope the Minister and the House will consider it favourably.
I desire to support the amendment. The nurses in this country are perhaps the most important body of people in it. They give help when it is badly wanted, and they are shockingly badly paid. I think it is a disgrace that they should be paid such small sums. Our Irish nurses are very competent people. I would say that they know their work much better than people in other lines know theirs, and I think they ought to be helped in every possible way. I think that after giving 20 years' service as nurses they ought not to be left stranded.
After the very exhaustive and capable statement that we have had from Senator Dowdall in support of the nurses, I am not going to burden the House with a speech. I endorse all that the Senator has said. There is just one point I would like to make, and it is this: there is not the least hesitation on the part of the hospital authorities to put up elaborate housing accommodation for the nurses and provide the most up-to-date equipment for those requiring to use the hospitals. As Senator Dowdall has pointed out, nurses are not able to continue at their work or, at least, to find fairly regular employment at it after they reach the age of 40 or 45. Therefore, in view of the fact that elaborate provision can be made not only for the accommodation of nurses in hospitals but for the equipment of the hospitals and of hospital staffs, I think the nurses themselves should be taken into consideration.
I have very great pleasure in supporting the amendment put forward by Senator Dowdall. Provision has been made for the hospitals out of the sweeps. These nurses give the best part of their lives in the service of the hospitals. Their training period sometimes extends as long as five years. At the end of it, if they are not kept on the hospital staff they may go out and do private nursing. The fees they receive while nursing private cases may be sufficient for the time being, but it has to be remembered that they are frequently idle for very long periods. As a matter of fact, nurses are only engaged for about half the year. Possibly in the winter time they may get a little more employment than in the summer. In that way the amount of money they receive over the whole year is so small that it is quite impossible for them to make provision out of it for their old age. As Senator Dowdall has pointed out, a nurse's life is short. When she comes to the age of 40 or 45 years, as a rule she gets very little private work to do. Doctors would rather have younger nurses. Because of that nurses are very often left in straitened circumstances, if they are not in a position to make other provision for themselves. In England they have the very large organisation: a federated superannuation scheme for nurses. There are 411 participating institutions in it. Of these, 136 are in London and 275 in the provinces and in Scotland, Northern Ireland and Wales. We have no similar organisation here. The sweepstakes give us an opportunity of at least making a beginning in that direction. If a certain amount was set aside for pension purposes a scheme could be formulated and made contributory. I have very great pleasure in supporting Senator Dowdall's amendment.
I think that after the very strong case that has been made for these amendments by Senator Dowdall and other Senators, and knowing as I do very well that the Parliamentary Secretary understands the difficulties that nurses have to contend with and, at the same time, that he has a very kind heart; knowing also that these ladies meet with very great difficulties, I hope that he will give a friendly and a favourable consideration to the amendments that have been moved.
I wish to add a word of approval to what the other Senators have said. I think that it is right that some woman who understands the very hard life nurses lead should support this amendment. I have great pleasure in doing so. I cannot add anything to what has already been said except this —that I am surprised that this provision was not included in the original scheme. It seems to be a necessary part of it.
I am sure that the Parliamentary Secretary when he next speaks will indicate that he has completely changed his mind, because I cannot imagine how he could withstand the barrage of opinion against him today. I should like to answer some of the arguments put forward by the Parliamentary Secretary. On the last day on which this matter was discussed, the Parliamentary Secretary, being a medical man himself, asked: "If you have pensions for nurses, why not have pensions for doctors?" The answer to that is perfectly obvious. A patient requires an old doctor but a young nurse and a patient is wise in that. A doctor's effectual life as a professional man continues until he drops in his traces and the older he is the more likely he is to have paying patients. That is one answer. The second answer is that we are asking for a provision not for future nurses but for the nurses who have given their service in the past 20 years. The Parliamentary Secretary says their salaries should have been better, that they should be well paid. The fact is that they have not been well paid for the past 20 years and that they have no resources now. That is the position with which we are dealing.
The second objection took the form of asking: why not give the money to people on the streets who have no money? I regard this hospital money, as Senator Sir John Keane regards it, as a donum Dei—a gift of God—for the sick people. With a liberal hand you have given money to provide wards for the sick people, and to provide all sorts of arrangements for their curative treatment. The nurse is the most essential person connected with the cure of sick people. Why should not the nurses get some consideration— especially those nurses who are now about 50 years of age? As my friend Senator O'Neill says, the nurses in Dublin 30 years ago got the munificent salary of £8 a year. Their salaries have been very poor during the past 20 years. They have been unable to make any provision for themselves. An infirm nurse of 45 years of age has no chance of getting employment in the nursing of another infirm person. I think that every argument put forward by the Parliamentary Secretary, including the argument of the medical man, has been fully answered. I think that the Parliamentary Secretary should change his opinion in view of the considered and, I hope, unanimous opinion of the Seanad.
I am in favour of this amendment. My only doubt is whether it goes sufficiently far. The Section states:—
The Governing Body of any hospital or nursing organisation in Saorstát Eireann——
The Senator's amendment comes in there and reads:—
"or any organisation established in Saorstát Eireann for the provision of a pension fund for aged or infirm nurses."
They can supply other grants out of the Hospitals' Trust Fund and, if Senator Dowdall's amendment is accepted, it will empower an existing organisation for pensioning nurses to get grants from this fund. But I should like that grants should be made to nursing institutions which are in existence already, not for granting pensions to nurses but for nursing. Take the great body of district nurses who have been doing wonderful work for the poor all these years. Up to last year, they were supported entirely by private contributions. A pension fund of about £14,000 or £15,000 has been established by private contributions. We hope to reach £20,000. But that £20,000 will only provide a miserable pension of about £30 a year to nurses who have spent all their lives in the service of the poor. That institution—the Queen's Institute of District Nursing— got a grant of £10,000 from the Hospitals Fund but with the condition that it should be spent on the provision of nurses for new districts, where they are very badly wanted. That was a very proper provision and condition to make. But the more new districts you establish, the more money you require for pensions for the nurses. And the pension should be more than £30 a year. It should be at least £50. By raising the amount to that figure, you will get a very much higher class of person into this noble institution for the nursing of the poor.
Somebody made a comparison between doctors and nurses. A doctor may have 20 or 30 visitors per day. He charges each person one guinea. If he is a specialist, he will charge two guineas. The unfortunate nurse gets only a guinea for a week's work. To have such a state of affairs is a shocking thing.
The purpose of these amendments is to enable the Minister to make grants to any organisation for the provision of pensions for nurses or midwives. This question was raised in the Second Reading debate here and I advanced a number of arguments, which I had hoped would be convincing, to show how difficult, if not impossible, it would be to accept an amendment on these lines. The Seanad is apparently
Unanimous.
Not unanimous, because I am sure a number of Senators will be impressed with what I have to say. But there is a degree of unanimity in the House that is rarely found. I am sorry I do not find myself in agreement with the majority of the Seanad because my experiences in this House have been rather happy. I think I have had happier relations with members of this House than most of the people who have been associated with legislation here. It looks as if this were going to be the first big clash. I need scarcely say that I am in entire sympathy with the sentiment behind this amendment. I should like to see adequate pensions provided for nurses who have to give up work through incapacity, or infirmity, or old age. I should like to see their remuneration, prospects in life, hours of duty, status and conditions generally improved. But there are difficulties in the way. What do these amendments propose to do? They do not set up a fund or pension scheme, nor do they indicate the nature of the scheme to be subsidised or what organisation is to be responsible for the administration of this new pensions fund. We do not know whether certain nurses will be expected to contribute and certain other nurses will be exempt or whether it will be a sort of benevolent fund, out of which ex-gratia payments will be made from time to time. These are important points and they would require to be cleared up before we could undertake to make the Hospitals' Fund available for financing such a scheme. To the mind of the ordinary member of this House, especially a member associated with local administration. "superannuation" or "pension" means something very definite. It has a twofold object. In the first place, it is an inducement to continue service and, in the second place, it enables an employer to dispense with the services of a person on account of old age or infirmity or reduced efficiency. In that way superannuations bear a certain relation to earning capacity. These amendments would virtually shift from the hospitals, the local authorities and other bodies responsibility for the superannuation of a certain class of their officers and place it on the Hospitals' Trust Fund. That may not be the intention of the movers of the amendment, but in practice that would be the result. Once it was admitted that it was the Minister's business to finance a superannuation scheme out of sweepstake money, it would be regarded as the concern of nobody else. The Minister would either have to make adequate provision for the superannuation of these people or they would have to go without it. I can see the local authorities shaking off any responsibility they might be considered to have in this connection.
In considering these amendments, we must examine the position of nurses in the public service at the present time. We have nurses and midwives who hold office under local authorities. Most of these are whole-time pensionable officers. Some of them—for example, the mental hospital nurses, male and female, numbering about 2,000— have a special pension scheme in operation already. I presume they would be included in any scheme financed as a result of the acceptance of this amendment. They contribute to their pension fund. The amount of the contribution is deducted from their pay. We have, then, the nurses in the public charitable hospitals. Some, but not all, of the public charitable hospitals have superannuation schemes in operation. Nurses in the service of nursing associations, the largest of which is the Jubilee Nurses' Institute, have a pension scheme of their own. Lastly, we should have to provide for nurses working either in co-operation or singly. It would appear to me that, so far as the nurses in the service of the local authorities are concerned, at any rate, no pension scheme is necessary. It will, undoubtedly, be argued, as Senator Comyn has argued, that these people are paid inadequate salaries and that, as a consequence, the retiring allowances by way of pension are inadequate.
While I repeat that the remedy for that is not the subsidising of their pensions out of the Hospitals' Fund, or out of any other fund, but in creating public opinion that will insist on these people being paid adequate salaries— whatever adequate salaries are considered to be. If we go about it in the other way, and if we subsidise the retiring allowances of nurses in the employment of local authorities out of another fund, what must be the result? The inevitable result will be that it would pay a nurse better to get out of the public service, and to take the pension she is entitled to by law, plus the additional pension provided out of this fund. In spite of the arguments put forward by members of this House, whose sincerity is not in question at all, I submit that the acceptance of the amendment it utterly impossible at present, and that it would be impossible to operate it.
Senator Sir Edward Bigger mentioned that a pension scheme was in operation in Gt. Britain and Northern Ireland. I am aware that a federated superannuation scheme for nurses in hospitals was set on foot some five years ago in Great Britain, and that it has attracted considerable support. Already more than half of the voluntary hospitals are participating in it. Senator Sir Edward Bigger did not tell the House that under that scheme the hospitals pay a contribution of 10 per cent. and the nurses 5 per cent. of their salaries and emoluments. There is no apparent reason why the voluntary hospitals in this country should not set up a similar organisation, and why they should not contribute on somewhat the same basis as in Great Britain and Northern Ireland towards a pension scheme. Indirectly it would be financed out of the Hospitals' Fund, in this way, that if they were contributing towards such pension fund, the overhead charges and cost of maintenance would be correspondingly increased. These matters are taken into consideration in the minutest detail when the allocation is being decided, or when the amount of an endowment is being fixed. In that indirect way, if they increase overhead charges, either by paying increased salaries to nurses, or by contributing to a pensions fund, they could, to an extent, at any rate, be recouped later. I do not know if I can say anything more to convince members of this House that the amendment is impracticable. It is very desirable that increased pensions or superannuation allowances should be provided for nurses. Nobody would be better satisfied if such a scheme were in operation than I would be, but I must repeat that this is not the best method of doing it and that there are difficulties in the way that, to me, appear to be insurmountable.
A question was raised by Senator Brown regarding the Jubilee nurses. As the Senator stated we have already contributed towards the Jubilee Nursing Institution and contributed very liberally, but the money has been earmarked for the opening up of new districts. We have never been asked to contribute towards the pensions fund of Jubilee nurses. The Jubilee Nursing Organisation being an institution which has for its sole or principal object the nursing of and the provision of nurses for poor persons, we could contribute towards a pension fund for such nurses. They give their entire services to the poor.
In the Queen's Institute they are all for the poor.
If a nursing institution gives the greater portion of its services to the poor we can contribute towards a pension fund. Here we are asked to contribute to a pension fund for all nurses, just because they are nurses. Nurses are paid; they may be paid inadequately. Coming back to the doctors again—I do not see Senator Comyn here now—I would remind the House that doctors give their services entirely free. Many doctors, to their credit, give their services free in the Dublin hospitals and in some Cork and Galway hospitals. The services of the most eminent men in the medical profession are at the disposal of the poor, absolutely free of charge. Some of these men are not men with money. Regardless of what anyone may say, some of these men are poor, and many of them die in poverty.
Surely no one is making any allegation against the doctors.
I say in all seriousness that if the principle were to be adopted at all, doctors who are in destitution, and who give their whole lives to the services of the people, would be equally entitled to have portion of the fund earmarked for a pensions fund. I question if the same argument could not apply with equal force to wardsmaids and to lay people, who have no professional qualifications at all, but who have devoted their whole lives to the service of the sick poor in public institutions and voluntary hospitals. If a contributory or other scheme is set up, to which an allocation could be made, and if a definite scheme were in operation, if we could see exactly where it was leading, the question might be seriously considered. If such a scheme comes to operate in this country there is nothing to prevent future legislation dealing with it. This is not the last piece of legislation of this kind that will come before this House. An amending Bill could be brought in, and the matter could be met in that way. As things stand at present, I do not think the amendment could be accepted. I hope the House will not force it.
I would like to point out that the amendment is purely permissive. There is nothing mandatory in it. The section says that any organisation "may at any time apply to the Minister for a grant."
God help him if he does not give it.
There is an outlet. The Minister refers the matter to the Hospitals' Commission and takes their opinion upon it, but he reserves to himself the right not to be bound by their report. As the proposal is not mandatory it might await the scheme which the Minister suggests might be got up dealing with a pension fund for nurses. If the amendment is accepted it would allow an organisation to go to the Minister with an application.
I wish to take advantage of the opportunity that is now given to pay a tribute to the noble profession to which the Minister referred, who freely give their services to the sick poor. What the Minister said in connection with the scheme had no regard at all to the nature of it. This may not be the best method of dealing with the matter but, the opportunity may be availed of some other time. I submit to the House that now is the appointed time; now is the day of salvation by accepting the amendment. The next sub-section reads:
Every application under this section for a grant out of the Hospitals' Trust Fund shall state with such particularity as the circumstances may require the purposes for which such grant is proposed to be expended and the suggested amount of such grant.
The Minister has the last word, so that the amendment is merely permissive, permitting an organisation formed by nurses, and not covered by any other scheme, to make an application. The Minister can then insist on such conditions as he thinks necessary. There is really no substance in anything that the Minister said against the real merits of the amendment and I ask the House to pass it.
Amendment put and declared carried.
I move amendment 7:
Section 23, sub-section (2). To insert before the sub-section a new sub-section as follows:—
(2) For the purposes of this section, but not further or otherwise, the word "nurse" shall mean a nurse registered by the General Nursing Council or a midwife certified by the Central Midwives' Board, who shall have been engaged for not less than 20 years in nursing or in attendance on maternity patients in Saorstát Eireann.
This amendment is consequential on the previous amendment.
It is hardly consequential.
Cathaoirleach
It is necessary for the fulfilment of the conditions.
I do not know enough about the organisation of nurses, but I would like to have an assurance that there are no nurses, acting as maternity nurses or otherwise, outside these two bodies. Every argument used with regard to a maternity nurse not certified by the Central Midwives' Board is applicable to this amendment. I would like to have an assurance as to the range of registration, and as to whether any other organisation which caters for nurses would be excluded.
I made inquiries and I think there is not. If there is such an organisation an amendment could be put down before the Report Stage to deal with it.
I think I can answer Senator Johnson's question. Both the General Nursing Council and the Central Midwives' Board are established under Act of Parliament. They include the regulation training and registration of nurses. No midwife can practise in Ireland unless she is on the register and certified by the Central Midwives' Board.
Amendment agreed to.
I move amendment No. 1:—
Section 1. To add at the end of the section the following:—"the word ‘nurse' means a person registered by the General Nursing Council of Saorstát Eireann or certified as a midwife by the Central Midwives' Board of Saorstát Eireann."
I do not know how this will affect the definition of the word "nurse" in the definition of "nursing organisation" under Section 1. The definition there states:
The expression "nursing organisation" means an institution or organisation in Saorstát Eireann which has for its sole or principal object the nursing of, and providing of nurses for, poor persons suffering from physical diseases, injuries or deformities.
Must they be registered?
I think they are practically all registered.
Of course most of them, indeed all of them, practise maternity. It is one of their most useful functions. If Senator Sir Edward Coey Bigger is right they would have to be registered.
I do not wish to limit any benefit that may accrue under this Bill. The definition of "nursing organisation" in Section 1 dealt explicitly with those whose services are offered to poor people.
Cathaoirleach
I think if the amendment were carried it would limit the definition. You are now going to alter the whole framework of the Bill by altering the definition of "nurses" under Section 1. I think it would be well to adjourn the amendment to Report Stage for further consideration.
Will Senator Dowdall also give an assurance that male nurses will be included in this definition?
Cathaoirleach
The matter will stand adjourned for further consideration.
Amendment adjourned to Report Stage.
Section 23, as amended, ordered to stand part of the Bill.
SECTION 24.
(2) A grant made out of the Hospitals Trust Fund under this section shall be made to either (as the case may be) the governing body of the existing hospital or nursing organisation or the person establishing the proposed hospital or nursing organisation for the benefit of which such grant is made and the word "grantee" shall in this section be construed as meaning such governing body or such person, as the case may require.
(5) Whenever the Minister makes under this section a grant out of the Hospitals Trust Fund, he shall specify the purposes for which such grant is to be expended and may attach to the receipt of such grant such conditions (whether to be performed before or after such receipt) as he thinks proper for securing the due expenditure of such grant on the purposes specified by the Minister or for securing or attaining any other object.
(7) A grant made by the Minister under this section for the benefit of any existing or proposed hospital or nursing organisation may be made for all or any of the following purposes, that is to say:—
(a) the purchase of land or buildings, including any superior or outstanding estate or interest in land or buildings;
(b) the construction of buildings;
(c) the reconstruction, extension, alteration or improvement of buildings;
(d) the purchase of hospital, nursing and other equipment;
(e) the endowment of any such hospital or nursing organisation or any part of the activities of any such hospital or nursing organisation, including in the case of any such hospital the endowment or a bed or beds in such hospital;
(f) the payment of maintenance expenses;
(g) the discharge of debts;
I move amendment No. 8:—
Section 24, sub-section (2). After the word "organisation" in line 49 to insert the words "or such organisation for the provision of pensions for nurses as is defined in sub-section (1) of the preceding section."
This is really a consequential amendment on the one just carried. It extends the possibility of making grants for the purpose of providing pensions for nurses.
Amendment put and agreed to.
I move amendment No. 9:—
Section 24, sub-section (5). To add at the end of the sub-section the following:—
"The provisions of this sub-section shall not apply to any scheme for the superannuation or benefit of nurses in sickness or old age such as is specified in sub-section (1) of the preceding section."
In sub-section (5) the Minister takes precautions to see that any grant made is properly expended. I think it would scarcely be practicable for the Minister to supervise the administration of a grant to individual nurses. I am not at all insistent on the amendment but I should like, having regard to what has already passed, to have it referred to the Report Stage and we shall then see if it is necessary to move it.
Before we decide upon that, I think that the Senator would be very ill-advised to ask for the non-application of this sub-section to the proposal because the case that was made was that this was a permissive amendment and that it would be left with the Minister to decide the application of it, and the vetoing of any faulty scheme or otherwise. If this sub-section is not to be applied to the scheme in question, then that argument should not have been used. I think it is essential that the Minister should be able to specify the purpose. He may attach a condition that the new pensions fund shall not be applicable to those in receipt of pension from poor law hospitals but that it should apply only to those who are not otherwise provided for. I think it is essential that the Minister should have power to make conditions in this way just as in any other scheme.
I have no strong view on this matter. I put it down because I thought the difficulties of administration would be too onerous. Let us take the case of a nurse who becomes entitled to a pension, big or small, from a poor law institution, say £30 a year. I think the Minister once it is granted takes no further interest in the way of direction or regulation with regard to the expenditure of the £30 a year. That is simply paid over to the nurse. If Senator Johnson thinks that the provision of any fund that may be applied for nurses' pensions should be subject to control of the Minister, I have no objection whatever but I would ask the Senator to think it over between now and the Report Stage. If he opposes it then I shall not force it. Amendment, by leave, withdrawn.
I move amendment No. 10:—
Section 24, sub-section (7). Before paragraph (f) to insert a new paragraph as follows:—
(f) the establishment of an institution for the treatment of patients by radium and X-ray therapy, the purchase of the necessary equipment for such institution and the endowment of such institution.
The proposed institution or hospital is intended for the use of patients suffering from cancer where they can be treated by radium and X-rays. When cancer is not treated, there is a long trying illness with ever-increasing pain and suffering before death occurs. There is no reason why patients suffering from cancer should not be treated; there is every hope of cure when the disease is treated early and before it has spread. There are only two effective methods of treatment. One is treatment by surgical means which aims at the removal of the growth together with a certain amount of the surrounding tissues. The second is treatment by radium which acts through the rays from the radium. These rays destroy the cancer cell. There is no mutilation of the part affected and if it is an organ, such as the tongue, it can pursue its functions after treatment. Radium is, I think, the only substance in the world that gives off invisible rays which have this effect on cancer cells. It is for that reason that I say that we should have an institution in the Free State where we could not only treat cases by this method but where we could train medical men in the use of radium. Medical men throughout the country could send cases to the central institution to receive this treatment.
I might repeat what I said on Second Reading of this Bill, that nine persons die from cancer every day in the Free State, and that it is estimated that there are between 5,000 and 6,000 persons suffering from cancer in the State. The vast majority of these have no hope of receiving the benefit of radium treatment. I think it is criminal to allow all those who are suffering from cancer without hope or cure, or relief from their suffering, to continue to do so, when we have it in our power to make the necessary provision to relieve them. I should like to quote from an appeal made by a hospital started some years ago for the treatment of cancer by radium. This was an appeal for funds to establish an X-ray department in connection with the hospital in order to supplement the radium treatment given there. The appeal says:—
"The value of radium treatment for cancer is now definitely established.... A large proportion of cases can be cured if treated during the early stages of the disease. Even in the advanced cases, those in which no surgeon could attempt operation, cures have been shown to result from treatment by radium and great alleviation of suffering in most of the cases. It should be available for all. After seven years' work at the clinic the results are very encouraging. To date, 94 per cent. of the early operable cases of cancer and 79 per cent. of the borderline cases are living and with very few exceptions are free from all signs and symptoms of cancer."
I hope that the Seanad will see its way to adopt the amendment.
I should like the Senator to show, for my guidance, why this new proposal is necessary in view of the definition of "hospital" in the Bill. In the Bill we are told that the word "hospital" means an institution or organisation which affords medical, surgical or dental treatment to human beings and includes any institution or organisation for the prevention, treatment or cure of human beings. We are told that it also includes institutions or organisations for carrying on medical research, but does not include any institution or organisation conducted by persons for their private profit. The only assumption I can make as a reason for this amendment, is that no organisation at present exists to cover the purposes desired by the Senator, and that this new proposal conceives of such an organisation, for the establishment of which the Minister is to provide funds. I wonder is that necessary? Is it necessary that this amendment should be inserted to enable the Minister to provide funds, or is the proposal not already covered by the definition of "hospital"?
What is aimed at is a new institution, a central institution situated in Dublin to which patients can be sent from all parts of the Free State. It is not desirable that it should be attached to any hospital because we want the whole medical profession to be interested in it. We desire that they should have full confidence in it. I am aiming really at what is being done on the Continent and in America. In most cases they call it a "radio-therapeutic clinic"; sometimes they call it an "institute" and sometimes a "centre." They very seldom use the word "hospital." I see no reason why we should not use the word "hospital." We do not use the words "cancer hospital" for a very obvious reason—simply because in many of these cases the patients do not believe they are suffering from cancer. That is the time we want to get them under treatment.
That is not the point. The point is that the object the Senator is seeking to serve seems to be included in the last three lines of the definition of the word "hospital"—"and also includes institutions and organisations for carrying on medical research." Then there is the proviso: "which does not include any institution or organisation conducted by persons for their private profit." Is it to get over the last two lines that the Senator wishes to have this new amendment inserted?
It is rather to ensure that an establishment of this kind will be started without delay; without having to go through the procedure of the Hospitals Commission and so forth.
I am in favour of this amendment. I quite anticipated what Senator Johnson would say and what I am sure the Parliamentary Secretary will say, that there is power already under sub-section (7) of Section 24 to make a grant to the proposed hospital, which would include an institution for the treatment of patients by means of radium and X-ray.
I think it is quite likely that the Minister and the trustees could do what Senator Sir Edward Coey Bigger wants under this Bill without any amendment, but the value of the amendment is that it draws a kind of statutory attention to the fact that this is one of the most important things wanted in this country where we have none of it. This is practically the only civilised country that has not got a separate institution—in England, there are several separate institutions—for the treatment, not only of cancer, but every other disease by these means. If it is to be set up otherwise than for private profit, why not? It will be all the better, because anybody can go there without private profit to anybody. I quite admit that it is possible that this can be done without this amendment, but I do think that it is a very good amendment to put into the Bill for the purpose of calling attention to the absolute necessity for that kind of institution.
I should like strongly to support this amendment. In this country at the present time—I am speaking as a layman now—we are very backward in research work. We want more research work into mental diseases and we want research work into cancer and other diseases. As a rule, we leave this to other countries to do for us. We leave it to Vienna and other places where there are big hospitals but, considering that all this money is coming into this country for hospitals at present, I think it is time that we began to stand on our own legs, so to speak. Instead of other countries doing this research work for us, we should be doing it for them. We have doctors in this city and we have hospitals in this city of which any country in the world might well be proud, and there is no reason why they should not be encouraged to do this work instead of letting other nations do it for us. You have in Grangegorman Mental Hospital a research department—I do not know the correct term for it—which has been lying idle for years. The stuff is all there but there is no money to get the doctors to do the research work, which is absolutely essential. Insanity is increasing in this country and, unfortunately, there is no disease increasing more rapidly than cancer. I have not got statistics. Senator Sir Edward Coey Bigger has given some to the House, but I know, amongst my acquaintances, that there is no disease increasing to such an alarming extent as cancer, and I think that, under the circumstances, the amendment should be supported.
The last speaker appears to have wandered into a new field. The question at issue is not the establishment of a research institution. We have already inserted in the Bill a section enabling the Minister to make allocations for financing research. This amendment sets out that, above and before all things, we shall set up a radium institute—for all practical purposes, that is what it means—for the radium and X-ray treatment of cancer in particular and, presumably, skin diseases and so on. That may be very desirable and, very probably, when the question comes to be examined in detail, it will be found to be desirable, but we are setting up a Hospitals' Commission for the specific purpose of advising the Minister as to how far the existing institutions provide adequate and up-to-date scientific treatment for the destitute poor and, before we can commit ourselves to the principle of setting up a central institute, to which, presumably, all cancer cases would be sent, it is necessary to investigate the field of treatment and equipment in the existing institutions and to see how far we can secure the co-operation of these voluntary institutions if we are to set up a Central Institution in the future. If we set up such an institution to-morrow, and the existing hospitals said: "We will continue to treat cancer. We have adequate facilities here and we will continue to treat our own cancer cases and we will not send them to your Central Institution," we would not have got very far. If we cannot get the full co-operation of the voluntary institutions, we can get nowhere in relation to this. As I said, it will, very probably, be found that we will get that co-operation and the desirability of setting up such an institution will be admitted. I am sure that the Hospitals' Commission will eventually report to us to that effect, but we have ample scope in the Bill at the present time to set up and to finance such an institution.
The case has been made that there is greater urgency in relation to this particular matter than in relation to many other matters, but if we were to specify specialised treatment for cancer by setting up a radium institute, other people might say, if not with equal justice, at any rate, with a certain amount of reason, that there are other pressing problems of public health, and other diseases that are not adequately treated or provided for and for the treatment of which we have not proper equipment and that that should be set out in the Bill. In fact if you follow this line to its logical conclusion, you could set out in the Bill every institution that the Minister proposes to set up as a result of the report following the investigation by the Hospitals' Commission and I think that would lead us to a very absurd position.
I discussed all this matter with Senator Sir Edward Coey Bigger and a number of other medical men from the City of Dublin. We had a long and interesting discussion on the subject. I outlined my views and intentions and I pointed out some of the difficulties and stated that I would personally interest myself to the extent of asking the Hospitals' Commission to give this particular branch of medical science their early attention, with a view to giving the Minister a report for his guidance on the existing equipment and institutions at the earliest possible date. They appeared to me to be perfectly satisfied. Even Senator Sir Edward Coey Bigger appeared to be, if not perfectly satisfied, at least moderately well satisfied, and I am rather surprised to-day if he intends to force this amendment through the House. Possibly, he can secure a majority for it but I think it is unreasonable and I think that the objective the Senator has in view will be achieved probably in a shorter space of time in the manner which I indicated to him and the other representatives of the medical profession and which I have now indicated to the House.
The Parliamenttary Secretary has mentioned the deputation. It was composed of very eminent medical men and included two of our experts, one the principal expert in radium and another an expert in X-rays, and there were also other men who are deeply interested, one being a prominent surgeon. The Parliamentary Secretary received them very well and I think he gave them a good deal of encouragement. What I wanted and the object of my amendment was to ensure that there would be no delay and after the Parliamentary Secretary's expression of his opinion that there would be less delay by leaving the matter to him and his announcement that he will recomment the Hospitals' Commission to go into this matter at the earliest possible date, with the leave of the House, I withdraw my amendment.
Amendment, by leave, withdrawn.
SECTION 24.
(1) Subject to the provisions of this Act, the Minister may at any time, either on his own motion or in consequence of an application to him under this Act, make for the benefit of any existing or proposed hospital or nursing organisation in Saorstát Eireann a grant out of the Hospitals' Trust Fund of such amount and for such purposes authorised by this section as the Minister shall think proper.
(2) A grant made out of the Hospitals' Trust Fund under this section shall be made to either (as the case may be) the governing body of the existing hospital or nursing organisation or the person establishing the proposed hospital or nursing organisation for the benefit of which such grant is made and the word "grantee" shall in this section be construed as meaning such governing body or such person, as the case may require.
(3) A grant made out of the Hospitals' Trust Fund under this section may, as the Minister shall in each case think proper, be in the form of a sum to be paid out of the capital of the Hospitals' Trust Fund or in the form of payments to be made annually, for such period as the Minister shall direct, out of the income of the Hospitals' Trust Fund and the National Hospital Trustees shall if so directed by the Minister set aside a portion of the capital of the Hospitals' Trust Fund and invest such portion for the purpose of securing any grant made in the form of payments to be made annually.
(4) Whenever the Minister determines to make under this section a grant out of the Hospitals' Trust Fund he shall direct the National Hospital Trustees to pay such grant out of the Hospitals' Trust Fund and thereupon the said trustees shall pay the amount of such grant out of the said fund to such person and at such time or in instalments at such times as the Minister directs.
(5) Whenever the Minister makes under this section a grant out of the Hospitals' Trust Fund, he shall specify the purposes for which such grant is to be expended and may attach to the receipt of such grant such conditions (whether to be performed before or after such receipt) as he thinks proper for securing the due expenditure of such grant on the purposes specified by the Minister or for securing or attaining any other object.
(6) If, after the making of a grant out of the Hospitals' Trust Fund under this section to any grantee and before payment of such grant or before the making of any particular payment in respect of such grant, the Minister is satisfied that any condition attached under the foregoing sub-section to the receipt of such grant has not been complied with by such grantee, the Minister may certify to the National Hospital Trustees that such condition has not been complied with and upon the Minister so certifying, the National Hospital Trustees shall not make, and such grantee shall cease to be entitled to, any such payment of or in respect of such grant or to any future payment in respect thereof unless and until the Minister otherwise directs.
(7) A grant made by the Minister under this section for the benefit of any existing or proposed hospital or nursing organisation may be made for all or any of the following purposes, that is to say:—
(a) the purchase of land or buildings, including any superior or outstanding estate or interest in land or buildings;
(b) the construction of buildings;
(c) the reconstruction, extension, alteration or improvement of buildings;
(d) the purchase of hospital, nursing and other equipment;
(e) the endowment of any such hospital or nursing organisation or any part of the activities of any such hospital or nursing organisation, including in the case of any such hospital the endowment of a bed or beds in such hospital;
(f) the payment of maintenance expenses;
(g) the discharge of debts.
I move amendment No. 11:—
Section 24, sub-section (7). Before paragraph (f) to insert a new paragraph as follows:—
(f) the endowment of any organisation established in Saorstát Eireann for the provision of a pension fund for aged or infirm nurses or midwives.
This amendment is consequential on the amendment proposed by Senator Dowdall and carried. It deals with Section 24 which is the section which provides for the making of grants out of the Hospitals' Trust Fund. Sub-section (7) says:—
A grant made by the Minister under this section for the benefit of any existing or proposed hospital or nursing organisation may be made for all or any of the following purposes...
There are then seven purposes set out and I want to include this provision in my amendment as an eighth purpose. I submit that the amendment is necessary so as to carry out the purpose the Seanad had in view when it passed Senator Dowdall's amendment.
Amendment 8 to Section 24, sub-section (2), which has been carried, makes the sub-section read:—
A grant made out of the Hospitals' Trust Fund under this section shall be made to either (as the case may be) the governing body of the existing hospital or nursing organisation or the person establishing the proposed hospital or nursing organisation or such organisation for the provision of pensions for nurses as is defined in sub-section (1) of the preceding section...
This amendment surely is not consequential on that. It is redundant now and is not required. These subparagraphs in sub-section (7) are designed to cover anything that is not covered by the Bill as a whole.
Senator Johnson, I think, is mistaken. My view of sub-section (7) is that it is an enacting or authorising sub-section—a sub-section that enables the Minister to make a grant—and I think that if you do not include in that sub-section this paragraph (f) authorising him to make a grant for the particular purpose provided for in Senator Dowdall's amendment, you will have your legislation incomplete. I would ask Senator Johnson to accept my view on that, because I have considered it.
Amendment put and declared carried.
I move amendment 12:—
Section 24. To add at the end of the section a new sub-section as follows:—
(8) The power hereby conferred upon the Minister to make a grant out of the Hospitals' Trust Fund for any of the purposes of this section shall not include or be deemed to include any power or authority to interfere with or in any way to affect the executive, administrative or financial management or control or the internal policy and affairs of any hospital or nursing organisation to which such grant is made.
The purpose of this amendment is simply to reserve to the hospitals the right they formerly enjoyed. I think everybody will admit that the voluntary hospitals in Dublin have been run very efficiently and very well, considering all the circumstances, and I think this amendment should be accepted.
I second the amendment. Its purpose is to prevent Government interference with a grant which was more or less a windfall: the sweeps money which came to relieve the hospitals of an overdraft. If the internal administration of the hospitals is to be made contingent on the amount of money they get it will be a very serious interference on the part of the Government with a system which has hitherto survived on public charity. It would be empowering the Government to hold a pistol to the heads of hospital authorities and saying: "If you do not allow us to arrange your staffs and see after the administration of the hospital you will get no money." Already a Commission has been set up to deal with that, and I do not think the Government should be further empowered to interfere. The purpose of this amendment is to have it set down definitely that there will not be any further interference with the recommendations of the Hospitals Sweeps Committee.
I am sure the Minister will probably say that this amendment is unnecessary because the Bill practically says: "If you do not take a grant there will not be any interference, but if you do take a grant then we can attach conditions." It is under Section 17, I think, that the real danger arises. The object of the amendment that I asked the leave of the House to withdraw earlier this evening and that I intend to move to Section 17 on the Report Stage was intended to deal with that. Under Section 17 of the Bill it shall be the duty of the Hospitals' Commission, on their own motion,
"to inquire into, examine, and survey generally the hospital and nursing facilities existing in Saorstát Eireann and to collect, record and digest information in relation to such facilities, the needs of the people for such facilities, and the adjustment of such facilities to such needs."
Now that applies to all hospitals. It is a very welcome thing because every well conducted, decent hospital will invite inspection of that kind and be perfectly willing to give all the information possible. But the section goes on to say that it shall also be the duty of the Hospitals' Commission:—
"to investigate and report to the Minister on every matter relating to hospital or nursing facilities in Saorstát Eireann which is referred to them by the Minister for such investigation and report; and
(c) at the request of the Minister, to make and submit to the Minister schemes for the improvement and co-ordination of hospital or nursing or both hospital and nursing facilities in the whole or any particular part of Saorstát Eireann;"
Under that particular sub-section the Hospitals' Commission can make a scheme which may involve, and probably will involve, hospitals which are not taking any grant under the Hospitals Bill. In that way they may have power to interfere with the internal administration of these hospitals. That is the real danger in the Bill, and it is to that danger that I intend to move an amendment on the Report Stage.
I am not able to speak with any knowledge of the working of hospitals, but it seems to me that the effect of this amendment would be to destroy the Bill almost wholly. The Minister is taking powers to give grants to hospitals under certain conditions. If the purpose of the amendment is to deny the Minister power "to interfere with or in any way to affect the executive, administrative or financial management or control or the internal policy and affairs of any hospital——"
That is if they take a grant.
But this amendment deals with hospitals that take a grant. The Senator a moment ago was not arguing, not formally at least, his own amendment that he withdrew earlier, but in his argument for the amendment which he withdrew inferentially, I think, proved the unwisdom of Senator Staines's proposal. I think the effect of the amendment would be practically to destroy the Bill.
I find it rather difficult to follow Senator Johnson's argument that the effect of the acceptance of the amendment would be to destroy the Bill. I take it that the purpose of the sweepstakes was to raise funds—not to secure the reform of hospital administration—to relieve the hospitals of charges which they could not defray out of the source of income they had at that time at their disposal. So far as I can recollect, there was never, in connection with any of the previous Bills dealing with this matter, any suggestion that the internal administration of the hospitals should be interfered with. If there had been, I doubt whether there would be a general acceptance of the scheme that has now been working for some years. The purpose of these sweeps was to provide funds to relieve the hospitals of heavy burdens which could not otherwise be raised. Senator Johnson has prophesied that the effect of the amendment would be to destroy the Bill. I confess that I cannot see how it would do anything of the kind. The Senator has not put forward the slightest bit of argument to show that what he has indicated is at all likely to come to pass. I think the amendment is a reasonable one, and unless the Parliamentary Secretary can put forward fairly sound arguments against it, I think the House ought to insist on it.
An amendment in almost identical terms to the one now before the Seanad was discussed in considerable detail in the Dáil. I felt bound to oppose the principle of the amendment in the Dáil, and I feel bound to oppose the principle of it here. Now the power conferred on the Minister
"to make a grant out of the Hospitals' Trust Fund for any of the purposes of this section shall not include or be deemed to include any power or authority to interfere with or in any way to affect the executive, administrative or financial management or control or the internal policy and affairs of any hospital or nursing organisation."
If that amendment is accepted by the House, and it becomes incorporated in the Bill, it can be interpreted in such a way as to make it impossible for the Minister to attach any conditions whatever to a grant. It is so comprehensive that there is no condition that might be attached to a grant, allocation or endowment that could not be interpreted as cutting across "the executive, administrative or financial management or control," and if it did not come under any one of these headings, it would be caught under "the internal policy and affairs."
I inquired in the Dáil from some Deputies who were advocating the acceptance of an amendment in identical terms if they could give me any enlightenment as to what was meant by "internal policy." A very eminent member of that House confessed that he did not know: that it might mean anything. What does "internal policy" mean? Senator Bigger, Senator brown and other Senators have expressed anxiety to have a central radium institution set up in this country for the treatment of cancer. If that institution is to be a success, we must have the co-operation of the existing institutions, in which the treatment of cancer is undertaken, to agree to send their cancer cases in future to our central institution. It might be considered desirable and advisable—it might indeed be necessary—to make it a condition of a grant in the case of such institutions —I merely give this by way of illustration as one of the things that might be necessary—that they would send their cancer cases to the central radium institution that we set up, an institution specially equipped for the special treatment of cancer cases. If we were to attach such a condition and if this amendment were incorporated in the Bill, then these institutions could say to us: "That is an infringement of our internal policy, it is an infringement of our administrative control or, at any rate it is an incursion into our affairs and we cannot agree to it." There is no question about it but that the proposed new section could be relied upon to make it impossible for the Minister to attach any conditions.
Let us consider another aspect of it; another possible condition that it might be considered advisable to attach to a grant. Let us take the case of a children's hospital. Would the medical members of this House agree with me that it would be an advisable thing to attach a condition to an allocation to a children's hospital that the milk supplied to it should be tubercular free? It is an actual fact that, in very recent times in this city, the milk supplied to a children's hospital was not tubercular free. It strikes me that it might be desirable to have power to attach such a condition to a grant. Senators may disagree with me, but I put that forward as a possible condition that it might be desirable to attach in the interests of the children.
Again, in the legislation that is being repealed by this Bill there was a provision that in the year before the passage of the Sweepstakes Act, 25 per cent. of the beds in the participating hospitals should have been available for the poor, free of charge. That condition is not in the present Bill. Why? For two reasons. In the first place, it was found impossible of operation. Legislation was brought in here specifically excluding certain institutions from this condition of making 25 per cent. of the beds free. We did not include it in our legislation for the further reason that we are not, at this stage, in a position to say that 25 per cent. of free beds in any particular institution will satisfy the needs of the community in so far as the poorer sections are concerned. We have first to get the survey that we are setting out to get through the instrumentality of the Hospitals Commission as to the existing provision. In the case of a particular hospital, catering for a particular class of disease, it may be found necessary that it should provide 25 per cent., 30 per cent., or 40 per cent. of its beds free and it will have to be endowed accordingly. Another hospital catering for a different class of disease will not require the same percentage. We have not the figures before us at the moment to guide us as to what particular percentage of free beds may be necessary in any particular institution. When we have carried out our survey, and when the Minister comes to make allocations in future, a condition will be attached to each allocation and to the endowment that a certain percentage of the beds provided in these institutions that are equipped out of the Hospital Fund will be available free to the poor. If we do not preserve that right to the Minister, to attach such a condition, there is no safeguard whatever for the poor in the future.
People have said to me: "You can trust the voluntary hospitals; they have done good work for the poor in the past." I admit all that. They have done excellent work for the poor in the past, but this is essentially a business proposition. We are handing over large sums to secure that certain treatment will be available to the poor. It is our bounden duty to ensure that, as a result of the expenditure or investment of these moneys, the results desired will be available to the poor and that they will not be dependent on the good-will of anybody in the future. People say: "The voluntary hospitals have built up wonderful institutions; they have given a wonderful service to the poor and you ought to trust them." To that, I reply: "Why if it was unnecessary to safeguard the poor for the future, was there a clause put in providing that 25 per cent. of the beds should be free?" If it was necessary then, it is necessary now. If this amendment were accepted, and the Minister, in making an allocation, said: "We require 40 per cent. of your beds free if this extension and equipment is provided without additional cost to you and if we assure you that the future maintenance of these beds will not be a charge on your institution," it could well happen that the management committee of such an institution would say to the Minister that that condition was an interference with their executive, administrative or financial management or control, or that it was against their internal policy, and that they could not comply with it. Or they might take the money first and go to court and ask for an interpretation of this clause afterwards. If it was found that the Minister had imposed a condition which had no statutory authority, they could hold the money and make any provision they liked for the poor. These are the reasons I am opposed to this amendment. Regardless of what attitude the Seanad may adopt, I am satisfied that they are sound and convincing reasons. If we are to safeguard the principle of this Bill, if we are to achieve the objective which every member of this House, I am sure, would like to see achieved—that is, to make the best treatment that medical science can provide available to the sick poor free of charge and available to people who can only pay a moderate sum per week—it is necessary that the House should reject this amendment.
I think that the Parliamentary Secretary has been very far from convincing on this question. I am not in very close touch with the administration of the hospitals and I am not aware if any conditions up to the present have been imposed in connection with grants made. The Parliamentary Secretary has hinged his whole argument upon what might happen if, upon the allocation of a grant to some hospital, a certain quota of free beds was insisted upon as a condition. I am not at all certain that that would be considered by any intelligent person as an interference with the executive, administrative or financial management or control of a hospital. Only in a very far-fetched way would it be so regarded. If this amendment is rejected, whoever has the allocation of grants can not only insist upon a certain number of free beds but can also interfere with the autonomy of these hospitals in much wider and bigger ways. There may be some precautions which the Parliamentary Secretary is in duty bound to provide, but there is obviously a limit to which interference in the internal administration of these institutions should go. Between these two views there is room for some arrangement by which what is aimed at in the amendment can be secured while the very mild interference which the Parliamentary Secretary suggested he aimed at can also be secured. Merely to reject this amendment is to leave the way open for an absolute dictatorship in the affairs of the hospitals. I think that that is not desirable. If the Parliamentary Secretary insists upon resistance to this amendment, he should only obtain the acquiescence of the Seanad by a promise that, on Report Stage, some arrangement will be devised which will secure both what the amendments aim at and what the Parliamentary Secretary wishes to safeguard.
It cannot be done.
I think that it is well to state to the Seanad that beyond and above the very convincing case the Parliamentary Secretary has made, there is a further aspect of this amendment which should be adverted to. The Minister referred to in the Bill is also the Minister for Local Government and Public Health—the Minister who has power to make grants to local government institutions. I can imagine the quandary in which the Minister would find himself if he were precluded from making a grant to one of these poor law institutions if he attempted to interfere with their executive, administrative or financial management or control. That is one of the effects of this amendment.
I am in favour of the amendment, which can be modified to meet the view of the Parliamentary Secretary. The general principle is a very good one. Take the other side of the picture—the side the amendment is trying to frustrate. The Government could go into any hospital and say: "We do not like so and so as your chairman; we do not like that doddering old doctor"—and out they go. We want to prevent that. We want to prevent these institutions which grew from charitable institutions during the years from being refuges for Government nominees. That is putting it, perhaps, too plainly and too bluntly. I do not suggest, of course, that the Government has such ill intentions, but we cannot trust a Government which empowered itself to take a quarter of the money subscribed to the sweepstakes for charitable institutions. We cannot trust a Government capable of doing that to keep its finger out of the internal administration of the hospitals. The Parliamentary Secretary made a very good but a specious argument about a cancer institution which might be set up here. Some hospitals, he said, might say to parents: "You cannot go to this institution; it did not get a grant." But what about the patients? Do you think that you could block them from going to any hospitals where they thought they would get cured? If this beneficent substance— radium—was a cure for cancer—I have never yet known of a cure by that means—nothing would prevent the people from going to a radium institute if it were set up. What we want is to keep the Government's finger out of the pie.
There is a certain sentiment behind this work. Take the case of nurses. They have work to do which is more disgusting than that of any housemaid in the country. They do it owing to the idea that they are raised slightly higher in the social scale than the ordinary housemaid. At 60 or 70 years, they are left to end their days in the kitchen of a hospital as senior sister or they go into private work and are thrown on the scrap heap at 40 or 50. Why do they do this? Because of this idea—service in the cause of charity. That runs through the most underpaid profession in Ireland. And in Ireland nurses are paid worse than in most civilised countries. In a hospital in Liverpool nurses are paid from the day they enter. That ideal of service for nothing continues right through the staffs and boards that administer these hospitals. You will read the names of men in big positions in the business world who give a great portion of their time to the internal administration of the hospitals. These people may not be personae gratae with the Government, and we may have crude interference with the personnel of the committees of the hospitals on the part of a Government which did not keep its fingers off a quarter of the sums subscribed for the hospitals.
This amendment does not mean that the poor should be shut out from any service that is going. It merely means that the door should not be left open to possible victimisation. The internal administration of hospitals may be wasteful but there is already a Hospitals' Commission which considers that in awarding the grants. The Hospitals' Commission prevents enterprise on the part of hospitals if it does not think the enterprise is advisable. You cannot enlarge a hospital without the consent of this Commission and it is somewhat sinister to see resistance to this amendment which is merely an effort to keep the internal administration of the hospitals out of Government control. A condition for the allocation of a grant could easily be made contingent on a change of personnel. It really comes down to a question of saving the personnel of these hospitals. We know already that if you want to apply for a position in a country dispensary you have to pay £1 for the right to present yourself to the Appointments Commission. That is an instance of a tax which is utterly unjustifiable.
I may have exaggerated, but the amendment is perfectly capable, as Senator Milroy said, of being adjusted. If the Parliamentary Secretary agrees with Senator Johnson, that the amendment would stultify the whole Bill, that is a matter for adjustment. It is a question of defining what is "internal administration" of a hospital and not allowing the tempting appointments that hospitals might be considered to offer to be made a condition of the award of money. Though men are paid for attending hospitals, and though some of the hospitals have far too great a proportion of unfree beds, these hospitals up to a few years ago grew and were administered by men who were paid nothing. We want these men who were never rewarded to be saved from possible victimisation. Originally, as we know, the sweep legislation was permitted to go through to save the banks in respect of the overdrafts of the hospitals.
The point we should remember is that the sweepstakes were originally established to help poor patients, and not the hospitals. If the Government are to have the right to interfere there is no protection whatever for the very poor. Upon whom is there greater responsibility for looking after the poor than upon the Government? The Government are administering the funds and it is their duty to see that the poor get a fair deal. Apparently some Senators will not trust the present Government to have any control or any power whatever, yet in the original Act it was felt necessary to ensure that for the poor there should be a percentage of free beds. That lapsed because it could not be enforced. It was not suitable to many of the hospitals and, as I am in touch with the very poor, I know that it is more difficult now than ever for poor persons to get into hospitals. Are we going to allow that state of affairs to continue? It will continue unless we authorise someone in authority to see that the poor get a fair deal. At present the very poor attending the dispensaries of most of the charitable hospitals have to pay a contribution. That is a big sacrifice on the part of the very poor. Are we ever going to have that charged? However much money the hospitals get the poor will have to put their hands in their pockets for contributions. Who will they appeal to unless we give this power to the Government? Interference in hospital management is no new thing, because local authorities that make a contribution to some hospitals in this country insist on being represented on the boards. That is an established fact. Why should we lay it down here that the Government of the country has no right whatever to interfere on behalf of poor patients? Those who want to do that are sacrosanct. They are above the Government. If we pass this amendment no one has any right to say that the poor must get a fair deal, because the Government will be cut out and the hospital authorities will dominate the situation. The amendment is unnecessary and unjustified.
I am afraid Senator Foran is wrong in his argument. This money is subscribed for the hospitals and it is not Government money. The Government has no control, except over 25 per cent. which they are taking for income tax which was not taken before. If the Government wants to run a sweep I venture to suggest it would not be a success. The sweeps are a success because they are run for the hospitals. The Parliamentary Secretary's argument was not convincing. He stated that he could not make an order dealing with certified milk. The public health authorities can do that if the Minister likes to make such an order. I suggest to the Minister that there is no use making an order that the hospitals are to use only certified milk while the children outside the hospitals have to use any milk they can get. Most of the milk sold in Dublin is wholesome, because the public health authorities see to it, but a very small proportion of it is certified milk. It is only lately in Swords and other places that tubercular free herds have been established. While Dublin was supplying certified milk to babies and to infants, a township, which has now been taken into Greater Dublin, was supplying milk that was not certified.
Are we listening to the history of Dublin or are we dealing with this amendment?
Cathaoirleach
I thought the Senator was dealing with the amendment.
I am rebutting the Minister's arguments about certified milk.
May I intervene?
Cathaoirleach
I would be glad if you would.
I did not use that argument at all. I merely said to the House, to the medical members of it, and to the lay members of it who understand the question, that they should consider the advisability of placing the Minister in a position to attach such a condition regarding milk supplies to children's hospitals. It is purely a matter for the judgment of the House to consider if that would be advisable. If not do not give the Minister the powers.
The position of the poor has been stressed that there must be a certain percentage of beds for them. I have had 28 years' experience of the Dublin hospitals. I have never been refused a bed by any hospital for any patient I sent there, whether they were paying patients or not. As I have sent in a good many poor patients I can say that of every hospital in Dublin except one. The one exception is an hospital to which I was never asked to send a patient. If a patient wanted to go to that hospital I am sure the story would be the same. It is unfair to suggest that the hospitals in Dublin have not looked after the poor. They have, and they have done it well.
I am intervening to ask Senator Staines to withdraw this amendment and to bring in one of a milder kind. At present I am bound to vote against it. It is unreasonable to expect that a big sum of money should be handed over to any hospital without having some responsible authority empowered to attach conditions to the grant.
I was about to make the same suggestion. If the Minister indicated that if the amendment was altered, so as to provide that no condition attaching to any grant should include any interference with the hospitals, that would help.
I am agreeable if the Minister desires.
If the amendment of Senator Staines is put in proper form Senator Gogarty could speak to it.
Cathaoirleach
If they want to water down the amendment they must put in a new one.
Obviously there is room for accommodation here. There is solid ground behind the purpose of Senator Staines' amendment, and there is a certain amount of consideration to be given to the point expressed by the Parliamentary Secretary. The matter should not be pressed now.
Cathaoirleach
Better withdraw this amendment and bring on one on the Report Stage.
I would like to have some expression of opinion from the Parliamentary Secretary as to the type of amendment he would require, and some indication as to what restrictions he will be prepared to embody in it. As there is something to be said on both sides, it would be a pity if accommodation could not be reached.
This question was very thoroughly examined under almost similar circumstances on an amendment that was withdrawn in the Dáil, on the understanding that an amendment which would be acceptable would be drafted. When the new amendment came along it was about 50 per cent. worse than the previous one.
Why not draft an amendment and solve the trouble?
I think it is humanly impossible to draft an amendment covering the points Senators have in mind, that cannot be interpreted to interfere with the purposes of the Bill. As I assured members of the Dáil, there is no intention whatever to interfere in the ordinary management or administrative affairs of voluntary hospitals. We can only concern ourselves with the dangers to the present Bill. Members of various Parties have from time to time expressed themselves in similar terms, as having no doubt that the voluntary hospitals had nothing to fear from the present Minister or Parliamentary Secretary, as far as internal policy was concerned. I believe that would represent the feeling of the vast majority of this House, that they have no genuine fear that we are going to interfere in the ordinary day-to-day management of hospitals. Senator Gogarty was not a bit convincing, and I do not think he meant to convince. Certainly he did not appear to be convincing. He did his best to make a case, but he was afraid of the uphill fight.
We have had a good deal of discussion about this matter. If it is not disposed of now we will have all this discussion over again at a later stage, and all to no purpose. I think the principle at stake should be disposed of now. The amendment cuts across the entire principles and intentions of the Bill. Everyone who has given any thought to the subject admits that there is a considerable amount of overlapping in voluntary institutions at the present time. Practically every voluntary institution in the Saorstát has set out to equip itself to deal with every possible form of human disease. That may be a slight exaggeration, but only slight. Obviously we must have duplication of effort there. We cannot have every voluntary hospital filled with the most up-to-date equipment for the treatment of human disease. It cannot be done. We must have co-ordination if we are to get anywhere. How are we to get co-ordination? If the Minister has not power to say when making an allocation to an hospital that certain institutions are earmarked for the treatment of certain diseases and are equipped for the treatment of certain diseases— and I have in mind the Radium Institute—if the hospitals say that they are going to start equipping themselves to treat every form of human disease, and that they are going to continue doing so, the Minister will get nowhere. If he is not in a position to attach conditions to the making of a grant there is going to be no co-ordination. Instead of getting a co-ordinated system and reasonable hospital facilities for the poor, as a result of the financial opportunity offered, we will produce a condition of absolute chaos in hospital service. The members of this House know that, yet they insist on an amendment in these terms, or in a modified form. An amendment cannot be drafted that will not be used by recalcitrant hospitals that do not want to co-operate. There is not a shadow of doubt about it. Yet the House will not trust the present Ministry not to put any Communist policy into operation, if that is what is deep down in the minds of some Senators.
It is not a Communistic policy. It is rather an aristocratic policy. Though the Parliamentary Secretary might have thought I was not sincere, I belong to a club which enjoys a Government grant.
Cathaoirleach
The Senator might allow the Parliamentary Secretary to proceed.
Is there any danger that the present Government are going to exercise the powers they get, in a more or less innocent form, for some sinister or ulterior motive? There may be Senators who think that we are going to do that. The majority apparently do not. If the majority of you do not, let me remind you of this fact: you cannot safeguard the voluntary hospitals from the conduct or action of any future Government. If there are any powers in that Bill that can be abused by a future administration, the fact that these powers are in the Bill will not make the administration abuse them, but if there is a future administration that thinks it has not sufficient control over the voluntary hospitals, it will take the necessary legislative steps to secure that power. It is no protection, so far as any future administration may be concerned, to put a clause into the Bill which you consider may be of a protective nature.
We have the Seanad to stop them.
The Seanad will not be here then.
Amendment put.
The Seanad divided: Tá, 8; Níl, 25.
Tá
- Crosbie, George.
- Duggan, E.J.
- Fanning, Michael.
- Gogarty, Dr. O. St. J.
- Kennedy, Cornelius.
- MacLoughlin, John.
- Milroy, Seán.
- Staines, Michael.
Níl
- Bellingham, Sir Edward.
- Bigger, Sir Edward Coey.
- Browne, Miss Kathleen.
- Chléirigh, Caitlín Bean Uí
- Comyn, Michael, K.C.
- Costello, Mrs.
- Griffith, Sir John Purser.
- Guinness, Henry S.
- Johnson, Thomas.
- Keane, Sir John.
- MacKean, James.
- Moore, Colonel.
- O'Farrell, John T.
- Counihan, John C.
- Cummins, William.
- Dillon, James.
- Dowdall, J.C.
- Foran, Thomas.
- Garahan, Hugh.
- O'Hanlon, M.F.
- Quirke, William.
- Robinson, David L.
- Robinson, Séamus.
- Toal, Thomas.
- Wilson, Richard.
Tellers:— Tá: Senators Staines and Milroy; Níl: Senators S. Robinson and D.L. Robinson.
Amendment declared lost.
Question proposed: "That Section 24 as amended stand part of the Bill."
In sub-section (7) of this section, the various purposes for which grants will be made are set out. As they are set out in detail, I think the courts might hold that any exclusion should act in a positive manner. There is no mention of research amongst these purposes, but I think it is the intention of the Government that grants should be made for research. Yet research is not included in the sub-heads. I suggest that that matter should be considered before the Report Stage.
There is no doubt about its being possible to make money available for research purposes. In Section 1, I think the Senator will find research institutions under the definitions of "hospitals."
Question put and agreed to.
I move amendment No. 13:—
New section. Before Section 25 to insert a new section as follows:—
25.—(1) The Minister may at any time, at the request of any person controlling or about to establish a lending library for supplying books for the use of patients or inmates in hospitals, make a grant (to be known and in this section referred to as a hospital library grant) to such person out of the Hospitals' Trust Fund, of such amount as the Minister shall think proper, for the purpose of defraying all or any of the expenses of such lending library.
(2) A hospital library grant may, as the Minister shall in each case think proper, be in the form of a sum to be paid out of the capital of the Hospitals' Trust Fund or in the form of payments to be made annually, for such period as the Minister shall direct, out of the income of the Hospitals' Trust Fund and the National Hospital Trustees shall, if so directed by the Minister, set aside a portion of the capital of the Hospitals' Trust Fund and invest such portion for the purpose of securing any hospital library grant made in the form of payments to be made annually.
(3) Whenever the Minister determines to make under this section a hospital library grant, he shall direct the National Hospital Trustees to pay such grant out of the Hospitals' Trust Fund and thereupon the said Trustees shall pay the amount of such grant out of the said fund to such person and at such time or in instalments at such times as the Minister directs.
(4) Whenever the Minister makes under this section a hospital library grant, he shall specify the purposes for which such hospital library grant is to be expended and may attach to the receipt of such hospital library grant such conditions (whether to be performed before or after such receipt) as he thinks proper for securing the due expenditure of such hospital library grant on the purposes specified by the Minister.
(5) If, after the making of a hospital library grant under this section to any person and before payment of such hospital library grant or before the making of any particular payment in respect thereof, the Minister is satisfied that any condition attached under the foregoing sub-section to the receipt of such hospital library grant has not been complied with by the person to whom such grant was made, the Minister may certify to the National Hospital Trustees that such condition has not been complied with and, upon the Minister so certifying, the National Hospital Trustees shall not make, and the person to whom such grant was made shall cease to be entitled to, any such payment of or in respect of such hospital library grant or to any future payment in respect thereof unless and until the Minister otherwise directs.
I need not labour the point of this amendment. There is no definite source to supply patients in hospitals with books or magazines except haphazard gifts of old magazines and books. Some hospitals also provide books of a certain character which I think do not promote joyful convalescence. If there was a central distributing library these poorer hospitals which have no books for their patients and the richer hospitals which provide books of a certain character could alike make use of this library. Books would be made available for every hospital from this circulating library. Such libraries already exist in England, America and in Denmark. There is another important aspect of this proposal. The suggestion of a central library from which all hospitals would draw their supplies might make later on for centralisation in other directions. It is quite beside the point to suggest a central laundry for the hospitals because every hospital overlaps in its laundry but it is a just argument that the establishment of this central library might be a precedent for centralisation in other matters. I know that the Minister is anxious to centralise certain services of the hospitals. I need not labour the point that a great need exists to provide books for the patients in all hospitals. In cases such as surgical tuberculosis, you may have children lying up for over six months and at present these children have no place to look to for books which would assist them to bear the tedium of long convalescence. The establishment of this library might lead towards the centralisation of other more or less detached services such as I have mentioned. I am proposing that the Minister be given an unequivocal power in this matter. There is a certain section in the Bill which puts it within his power to earmark funds for certain purposes but lest any over-assiduous accountant might surcharge the Committee, I think it is no harm to have it definitely set down that the Minister be empowered to set up a central distributing library and maintain it.
Amendment put and agreed to.
Section 25 ordered to stand part of the Bill.
Bill reported to the House with amendments.
Report Stage fixed for Wednesday, 12th July.
The Seanad adjourned at 7.30 p.m. until Thursday, 6th July, at 3 p.m.