The purpose of this Bill is to make provision for the registration and inspection of maternity homes. Hitherto there has been no official control over maternity homes. It was quite open to any person to carry on a maternity home, and there was no machinery in existence to ensure that it was efficiently managed or that the premises in which it was carried on were suitable or in a good sanitary condition. Local authorities had power under Section 17 of the Midwives (Ireland) Act, 1918, to enter maternity homes, but that section related merely to the supervision of midwives and not to the home itself or to the persons other than midwives employed therein. It may be contended that there is no more necessity to supervise maternity homes than there is in the case of the voluntary hospitals that are very successfully conducted in different parts of the country. Doubtless there are maternity homes under suitable control and efficient management, but against that it is a well-known fact that in some of our large cities there are maternity homes of a very poor class which are availed of largely by unmarried mothers. We are not at all satisfied that those homes are properly managed. As a matter of fact, we have information to the contrary in the report published in 1927 on the relief of the sick and destitute poor. The Commission drew attention to different evils which they traced to the poor-class maternity homes, or to the not too scrupulous management of those homes, particularly the connivance of the management at the secret disposal of children to unsuitable foster parents, and the consequent high death rate amongst the children.
In the Bill we propose to take steps as far as we can, to remedy those evils. The scope of the Bill is extended as widely as possible. Its provisions will apply to any premises wholly or partly used or intended to be used for the reception of pregnant women or of women immediately after childbirth. The administration of this measure will be entrusted locally to the local authorities who now exercise supervision under the Midwives (Ireland) Act, 1918. These are the county borough councils in the county boroughs and elsewhere the boards of health for the joint county districts. Each local authority will be bound under clause 3 of the Bill to keep a register of the maternity homes in its administrative area. Any person who proposes to carry on a maternity home in the functional area of the local authority may apply to have the home registered in the register kept by the local authority. The local authority will have power to refuse registration but if they do not refuse registration, they must enter the prescribed particulars of the home in the register.
The local authority may refuse registration if satisfied that the applicant is not a fit and proper person to carry on the home, or that the premises are unsuitable, or, in the case of a home which did not exist before the passing of the Act, the superintendent nurse is not a qualified nurse or a certified midwife. The local authority may also cancel registration for similar reasons or if the person registered has been convicted of an offence under the Act. There will be provision for an appeal to the Minister against the decision of the local authority refusing to register a maternity home or cancelling registration. The Minister may, as he thinks proper, uphold or reverse the decision of the local authority. The Minister may, if he so thinks fit, grant exemption from registration to any hospital or institution which is a maternity home but is not carried on for private profit. Any such exemption may, at any time, be withdrawn by the Minister. I might also draw attention to the provision made for the records to be kept in the maternity homes. These records will show particulars of receptions, discharges, confinements, miscarriages, births, deaths, the removal of children and the addresses to which they are removed. The records should contain full details of the work done in the home.
The Bill provides for the inspection of maternity homes and the records kept therein by the Minister's inspectors and by authorised officials of the local authority. When this Bill comes into force it shall not be lawful for any person to carry on a maternity home either registered by the local authority or exempted from registration by the Minister and the penalty for failure to observe this requirement may be a very salutary one, namely, a fine not exceeding £50 and, in case of a continuing offence, a fine not exceeding £10 for every day during which the offence is continued. In the interests of both mothers and children the Minister considers that the provisions proposed by this Bill are essential and he hopes that he may soon be in a position to bring the measure into operation.
