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Seanad Éireann debate -
Wednesday, 25 Apr 1945

Vol. 29 No. 26

Mental Treatment Bill, 1944—Committee.

Sections 1 and 2 agreed to.
SECTION 3.

I move amendment No. 1:—

In page 10, line 24, to delete the words "or of ordinary proper conduct".

In the definition relating to an addict, it seems to me that the Parliamentary Secretary is taking a very wide scope and that there is considerable danger in giving the definition the scope which is proposed. It is provided here that an addict means a person who, by reason of his addiction to drugs or intoxicants, is either dangerous to himself or others, or incapable of the management of his affairs, or of ordinary proper conduct. While we all sympathise with the desire of the Parliamentary Secretary to make the power given here as effective as possible, we will have to jib at the suggestion that a person can be treated as a lunatic, if, in the opinion of certain people, he is not capable of ordinary proper conduct, unless we can be told what is meant by the expression "ordinary proper conduct".

There will be differences of opinion, even among experts, as to what is meant, or what should, in fact, constitute ordinary proper conduct, and the section as it stands is quite strong and goes far enough without the insertion of these words. I want to move that they be deleted.

I ask the House not to accept this amendment. Senator Duffy adverts to the possibility of a person who is incapable of what is termed "ordinary proper conduct" being treated as a lunatic. I should like to take advantage of this discussion to remind him that under this Bill nobody will be treated as a lunatic. We are dealing now with persons of unsound mind or suffering from mental disorders, and we have, I hope, got away from the previous conception of lunacy and all that it implies.

We look, as I stated on the Second Reading, on mental disorders or derangements as having no particular stigma attached to them. We look upon them as being much in the same category as diseases of the body. I do not think it is necessary to label them, but I should be sorry to find the House reverting to the old conception, which lasted far too long in this country, regarding disorders of the mind. Although this definition of addict is new to the House, and to our statutory code, it is very old in its origin. On this whole question of the inclusion of addicts in the scope of the Bill, a tremendous lot could be said. We could have very interesting debates on the question of addiction to drugs, and perhaps more particularly addiction to alcohol, and as to how far that constitutes a contributing factor to subsequent mental disorder. In fact, five years ago, I raised this matter in the Department. Many members of the House will, in their own experience, have come across such cases where people have been addicted to drugs, particularly to alcohol, and where, by reason of the fact that no machinery had been provided for dealing properly with these unfortunate people, tragedies very often occurred.

I have in my experience and practice met with a considerable number of such cases. The law relating to inebriates is of no assistance to us in the solution of this particular problem. Under the law relating to inebriates and drunkards, a person has to be convicted a number of times in court, and then the court has the power to commit such people to a term of detention in an institution provided for the purpose. Again, that is the old criminal setting, and it does not deal with the problem in accordance with the present-day approach to it at all.

The case with which most of us would be concerned is that which we are trying to provide for in this particular measure—the type of case which never comes before the court at all. When it reaches the stage that a person is brought into the criminal courts or the ordinary courts, and convicted of drunkenness a number of times, and sent to an institution because of these convictions, the case has reached a stage where, very possibly, scientific treatment might not have very much chance to produce the best results.

Senator Duffy invites me to define what constitutes "proper conduct". Well, I shall not undertake to do that. The House will bear in mind that a person will not be recommended for reception in an institution as a temporary patient under this section unless he is incapable of ordinary proper conduct by reason of his addiction to drugs. If the Senator has in mind, or if it should be passing through the mind of any member of the House, that there is a possibility of the reception of a person who might occasionally indulge in alcohol, or, let us say, any other drug, that is not the intention of the Bill. In fact, the section could not apply to such persons. The point is that their incapacity properly to conduct themselves must be due to their addiction to drugs. I do not think that it would be possible for anybody to define in this or in any other Act how improper the conduct would be in such a setting, and we must bear in mind that the medical advisers who will make the recommendation will have intimate knowledge of the patient's conduct and habits. In case he should err—and medical men can err and sometimes do —the patient will not be received in the institution until the resident medical superintendent is satisfied that by reason of his addiction to drugs he ought to be detained, either because he constitutes a danger to himself or a danger to others, or is guilty of improper conduct by reason of his addiction to drugs.

I do not suppose that it is necessary to delay the House on this subject, unless I refer to a definition of inebriates which I find in the report of a commission set up as far back as 1908. When I raised this matter with the Department some five years ago all my technical and professional advisers were very keen on the idea of trying to make some statutory provision under which people addicted to drugs could be detained for a sufficient period to permit of scientific treatment and of bringing the craving to an end. They were all very keen on it, but the trouble was that it was a very difficult matter to cover in law. The result of my raising the point brought to light a very comprehensive report of an inquiry set up in 1908 by Mr. Gladstone. It is interesting to note that the machinery recommended by that commission for the treatment of addicts bears close resemblance to the machinery we are now providing for the treatment of mental diseases. A definition was constructed by that commission for the purpose of suggested legislation. It was:

"An inebriate is a person who habitually takes or uses any intoxicant or toxic thing, and while under the influence of such thing or things or under the influence of the effects thereof is (a) a danger to himself or others, (b) a cause of harm or serious annoyance to his family or others, (c) incapable of managing himself or his affairs or of ordinary proper conduct."

It is a much more far-reaching definition than we have attached to the word "addict" in the Bill.

Perhaps I misunderstand but it appears to me that there is a limitation in respect of the clause "incapable of managing his affairs and of ordinary proper conduct".

No, it is "incapable of managing himself or his affairs or of ordinary proper conduct". There is no limitation whatever in it.

On this section I should also like to draw attention to three matters which would seem to require attention. I refer to the definition given to the expression "joint board". It is on page 11, line 27. The expression "joint board" means "board appointed jointly in pursuance of Section 15 of this Act". Later on I find that the expression "mental hospital authority" is defined as meaning "local administrative authority" under Section 15 of this Act. It seems to me that both definitions cannot be in that section. I suggest that where the joint board is defined is not in Section 15 but is in Section 16.

Section 15 gives the procedure and the definition is referred to Section 16.

You have to read them together. It is all right. The Senator need not worry about them.

All right. It seems to me that there is a number of cases where there are duplicate definitions. I do not know whether they are necessary. I am not criticising it. On page 10 the expression "assistant inspector of a mental hospital" is defined. It is defined again in Section 13 and the same thing occurs in regard to "authorised medical officer". There is a number of cases of that kind. I do not know whether it makes any difference. In regard to the expression "Inspector of the Mental Hospital" it is defined on page 11 and again in page 12. The definitions in both cases do not quite correspond.

If there is anything in it we will draw the draftsman's attention to it.

I wonder would the Parliamentary Secretary also consider the question of defining the word "patient." There is a definition of "chargeable patient," and a definition of "temporary patient." There is a sort of negative definition of "patient" in Sections 32 and 38, but it might be as well to define "patient," a person who is an addict or a person who is suffering from a mental disease. Perhaps the Parliamentary Secretary would consider that question.

Yes, I will look into it.

I do not think it right to pass away from this section without drawing attention to the fact that it is providing for the possibility of control of a class of person which, to the knowledge of every Senator, has never been adequately treated. That is the person addicted to intoxicating drink. Everybody has within the sphere of their acquaintance knowledge of people who have ruined themselves mentally and physically by intoxicating drink. Because of the fact that in the main they belong very often to respectable families, the ordinary process of the law—that is, being charged in the courts the requisite number of times to permit of their being kept in custody—has never been invoked. In practice it is never invoked against that class of person. We are bringing in a measure which may be of great benefit to that class. The person who will be kept in a mental hospital as the result of the passing into law of this section will be deemed by a competent medical officer to be a person who can be treated, and in all probability cured by detention, and even a person who after a bout of drunkenness resumed his normal outlook on life will find that if a medical doctor authorised under this Bill deems him to be an addict, provision is made for his detention until the prospect of a permanent cure is reasonably assured. I do not want to exaggerate, but this is a very great advance in the treatment of what was undoubtedly an evil, though luckily it may not be an evil of great degree. Certainly it is there, and in this section it is being dealt with in a manner which demands the commendation of all right-thinking people.

Question put and agreed to.
Section 4 put and agreed to.
SECTION 5.

I move amendment No. 2:—

In sub-section (2), page 13, line 51, before the word "or" where it occurs the second time to insert the words "uncle or uncle-in-law, aunt or aunt-in-law".

I do not know whether the Parliamentary Secretary has a particular objection to the inclusion here of the uncle or uncle-in-law, the aunt or aunt-in-law. It relates to the disqualification of certain doctors. The sub-section provides that a doctor who bears a certain relationship to the patient may not be called in for any purpose under the Bill. It will be observed that those who are disqualified include the husband or wife, the father or stepfather, and so on. What I am endeavouring to do is to bring in those on the other side, that is the in-laws, for the purpose of being disqualified, in the same way for instance that the brother or step-brother is disqualified. The difficulty I have is that, while the brother-in-law or sister-in-law is disqualified, the uncle or uncle-in-law or the aunt or aunt-in-law is not disqualified.

It seems to me that the section is sufficiently exclusive, or inclusive if you put it another way, to meet with all normal requirements. This matter was raised in the Dáil and we had a considerable amount of discussion on it. It just comes to this, that we must draw the line somewhere. We cannot include, and it is unnecessary to include, all possible degrees of relationship. In fact, I have no great enthusiasm for the exclusion at all, for the reason that under the existing law, and it has operated for a number of years, there was no restriction as regards relationship. The dispensary doctor was doing something more then than certifying a patient for admission; he was committing the patient as a dangerous lunatic. As far as the law was concerned, he could commit his own brother. There was no restriction, and, as far as I am aware, there was no abuse. It was thought well to put in some exclusions here but I think the section is all right as it is.

I should be inclined to press this amendment, because from experience I think uncles and aunts are inclined to be very managing people, rather more so than sisters and brothers. When a case comes before the Chief Justice in which a person is quite properly taken into charge, it is remarkable how often it is the uncle or aunt who is appointed the committee of the person or the committee of the fortune. They are the people who move in the matter. I rather think uncles and aunts should come in here, if the Seanad thinks exclusions are necessary, because experience of life shows that they are the people who very often are inclined to think that the parents are very inefficient and negligent in the treatment of their children, and that they could show them how to do it better. Accordingly, I would suggest to the Parliamentary Secretary that possibly the danger might be anticipated from uncles and aunts just as much as from sisters and brothers. I do it very tentatively; it is purely a matter for the opinion of the House as to the degree of busy-ness which corresponds to the degree of relationship.

While I agree with Senators Duffy and Kingsmill Moore that uncles and uncles-in-law, aunts and aunts-in-law ought to be in the section, I must agree with the Parliamentary Secretary that the line must be drawn somewhere, because if uncles or uncles-in-law, aunts or aunts-in-law are in the section there is no reason why nephews and nephews-in-law, nieces and nieces-in-law should not also be in the section.

None at all.

Therefore, once you begin to extend it, you will have to extend it very widely indeed. For that reason, while I do think that it might be desirable in some cases that an uncle should not certify his nephew or vice versa, in practice that will hardly ever take place. I think the amendment ought not to be pressed.

Amendment, by leave, withdrawn.
Sections 5 to 8, inclusive, put and agreed to.
Question proposed: "That Section 9 stand part of the Bill."

I should have looked this matter up for myself, but I did not do so. Sub-section (2) says that the Public Offices Fees Act, 1879, shall not apply in respect of any moneys payable under this Act to the Minister. Perhaps the Parliamentary Secretary will tell us what that means.

I will tell the Senator on the Report Stage.

That means that the Parliamentary Secretary did not look it up either.

It does not mean that. It is not of any significance at all. It is merely a machinery measure, but I do not want to give the House a definite reply until I have a check-up, because, since the Senator has raised it at all, it is essentially a matter upon which one must be precise.

In many of these cases, when I see a thing of this kind, I have a feeling that the Department of Finance is sticking its hand in.

No. There is no new principle in it at all. I think I can now satisfy the Senator in regard to sub-section (2), which provides that the Public Offices Fees Act, 1879, shall not apply. The Act of 1879 made provision for the collection of fees payable into the Exchequer. It provided that the collection might be made by means of stamps or in other ways; that the Treasury might make regulations governing the collection, and that the moneys collected after payment of salaries and expenses of collection should be paid into the Exchequer. It is purely a machinery measure.

Question put, and agreed to.
Sections 10, 11 and 12 put and agreed to.
SECTION 13.

I move amendment No. 3.

In sub-section (2), page 14, line 57, before the word "have" to insert the words "when so acting."

I do not feel very strongly about the matter but it seemed to me, on reading sub-section (2), that greater power was conferred on the assistant inspectors than was strictly intended. The sub-section provides that the Inspector of Mental Hospitals may act by assistants and then goes on to say that the assistant inspector shall have all the powers for the time being conferred by law on the inspector. I take it that many powers are conferred on the inspector which will not pass on to the assistant inspector or assistant inspectors. In other words, the inspector will be the chief officer of the Department and he will remain in that position no matter how much he may be helped by assistants. I take it that what will happen, in practice, is that he will delegate certain of his powers to the assistant inspectors for the purpose of inspection. In the long run, however, he will be personally responsible to the Minister. It seems to me that we will have met the case if we say that the assistant inspector will have all the powers of the inspector which are delegated to him during the time he is acting in that capacity. However, if the Parliamentary Secretary considers that the provisions are sufficiently explicit, I am satisfied.

I rather think that the nicety of legal construction has escaped Senator Duffy. Under this section, the Inspector of Mental Hospitals can act by his assistant. It is the inspector who is acting but he is acting through the medium of an assistant. It is in that setting that we have to consider the section. If the Senator has in mind the appointment, from time to time, of an inspector for a particular purpose, that is not the intention in this section. That matter is dealt with in Section 12 (4):

"The Minister may appoint any of his medical inspectors to act as substitute for the Inspector of Mental Hospitals during any particular period or for any particular purpose and, during that period or for that purpose (as the case may be), the person so appointed shall be regarded as being the Inspector of Mental Hospitals and every reference in this Act to the Inspector of Mental Hospitals shall be construed accordingly."

In such circumstances, the person appointed as substitute will have the powers of the Inspector of Mental Hospitals while discharging those duties and at no other time. We now come to assistant inspectors. We have to contemplate the Inspector of Mental Hospitals acting through an assistant. But it is the inspector who will be acting.

Amendment, by leave, withdrawn.
Sections 13 to 15 agreed to.
SECTION 16.
Question proposed: "That Section 16 stand part of the Bill."

The phraseology of this section is not very clear. It is provided that a joint board shall be appointed "in accordance with the provisions in that behalf of the rules contained in the Third Schedule to this Act and the other provisions of those rules shall also have effect in relation to a joint board". I do not follow what is meant by "the other provisions of those rules".

There are provisions other than those relating to appointment.

Section agreed to
Sections 17 to 19 agreed to.

I should like to know why Section 21 does not precede Section 20.

I am afraid I could not answer that. The draftsman is the expert so far as construction is concerned.

The marginal note explains why Sections 21 and 22 follow Section 20. Section 20 provides for the general duty of providing accommodation, while Sections 21 and 22 deal, respectively, with a district mental hospital and an auxiliary mental hospital.

Sections 20 to 24 agreed to.

On Section 25, I should like to know if the fees referred to in sub-section (2) are to be paid to the authority or to the doctor.

To the authority, of course.

Sections 25 to 28 agreed to.
Business suspended at 6 p.m. and resumed at 7 p.m.
SECTION 29.

I move amendment No. 4:—

In page 18, lines 48 and 49, to delete the words "may with the consent of the Minister, and shall if the Minister so directs" and substitute the word "shall".

This section deals with the provision of staff residences. I am not at all sure that the Parliamentary Secretary should sponsor a provision which leaves it to the discretion, in the first instance, of mental hospital authorities whether they will or will not provide accommodation for their staffs. The provision of such accommodation becomes mandatory only if the Minister orders them to provide it. There are a number of instances in the Bill where the expression occurs "the mental hospital authority may, with the consent of the Minister, and shall, if the Minister so directs". I think this is one instance where that form of words should not be retained and the purpose of the amendment is to make it perfectly clear that the mental hospital authority must provide and maintain, in connection with any institution administered by them, suitable residences. I am not attempting to say what would be a suitable residence in relation to any particular institution. That I assume will still be a matter for the committee—the county council in certain cases and the joint committee in others—in consultation with the Minister and his officers. I think so far as the Bill is concerned we should definitely see that the authority responsible for these institutions will maintain suitable buildings and accommodation for the staffs.

It is rather surprising, in view of the amount of talk we have had about centralisation of authority, that such an amendment as this should be proposed. I think it is assuming that mental hospital committees or authorities will not discharge a duty that as far as I know it is their whole inclination to discharge, namely to supply the housing needs of the attendants. The discretion, in the first instance, that is left to the mental hospital committees is a discretion that is properly left to a local authority composed of popularly elected people. I, in common with a good many Senators here, am reluctant to take any authority that may be given to local bodies under this or similar Bills away from them unless a very clear case can be made for it, or unless actual proof that they will refuse to do something they should do is brought forward. In this case a discretion is left to the local authority, in the first instance in any case, and the initiation of the matter should be left with them. I think in actual practice mental hospital committees will avail of the power and avail of it to the full. The section leaves with them some powers that, I think, they should have; and the attempt to impose upon them a direction, before they have actually failed in their duty, is something to which I certainly could not agree.

With regard to what the last speaker said, I do not think there is any discretion at all left there. The wording in this section follows the wording of every section in connection with local authorities. You have to empower them to do certain things, and the word "may" empowers them to do these things, and if they do not do them, the Minister has power to compel them.

The position is, in fact, as explained by Senator O'Dea. The mental hospital authority is empowered to provide and maintain, in connection with any of its institutions, suitable residential accommodation for members of the staff, but if they fail to do so, the Minister can come in then and give them a direction, upon which they must act. Senator Duffy suggests that the power of the Minister to direct should be deleted from the section and that it should be made directly obligatory upon the mental hospital committee to make the necessary provision. I do not think it would work out in just the way the Senator has in mind. It is not just so simple as that. For instance, there are members of the staffs of mental hospital authorities who do not reside on the premises, or for whom it is neither necessary nor desirable that residential accommodation should be provided. For example, the clerical staff employed by the mental hospital authorities would not ordinarily be accommodated with residences on the premises. Similarly, married attendants very often live out. Now, I do not think it would be in the interests of the attendants themselves that they should be compelled to live in residences provided for them by the local authority, nor do I think it would be wise to put a statutory obligation on the local authority, regardless of the circumstances and conditions, to provide residences for each and every person employed by them.

The machinery of the Bill, I think, will operate satisfactorily to everybody. If a particular class or classes of officers require accommodation, and if the mental hospital authorities fail to provide it, the Minister can then, in the exercise of his judgment, issue a direction. If, on the other hand, the mental hospital authority in its wisdom decides that certain individual officers or groups of officers ought to reside outside the institution, then clearly they will not be asked to provide residential accommodation.

I do not feel like pressing this very far, but I think there is some misconception involved here. Senator Hearne, for instance, urged that the amendment should not be accepted because in this case we are dealing with the elected representatives of the people to whom, he suggested, we should leave wide discretion. We are doing nothing of the kind. We are dealing with the county manager or the city manager. It is not a question of the representatives of the people at all; it is an official who will decide this, and, in my view, there must be some sympathy with this. If there is going to be a direction given in a matter so clear as this, that direction should be given by this House and there should be no discretion given so far as a matter of this kind, the provision of residential accommodation for the staff, is concerned. I think the Parliamentary Secretary read more into the amendment than is here or than is intended because, if this amendment were inserted, the section would then read that the mental hospital authority should provide suitable residence or residential accommodation. That is not an obligation to provide it for everybody.

"Any members of the staff"—read on.

"——provide and maintain in connection with any institution maintained by them suitable residences or residential accommodation——"

That is for members of the staff.

If the Parliamentary Secretary says it is for members of the staff I will accept it. It certainly did not occur to me that there was any new obligation to provide accommodation for those for whom accommodation is not normally provided.

Amendment, by leave, withdrawn.
Sections 29 to 42, inclusive, put and agreed to.
Question proposed: "That Section 43 stand part of the Bill."

I do not know whether the Parliamentary Secretary has given any more study to the question I raised on the Second Reading regarding the financial implication of this and the following sections. We are committing ourselves in this Bill to a very big scheme of curative treatment, at an expenditure of which we had been given no indication. Frankly, I think the Parliamentary Secretary did not sponsor this plan without having some calculation made as to the cost of it.

He has not given us an idea, roughly, of how much expenditure we have to face so that this scheme may be carried out. I know that it may be possible to provide funds for the erection of additional buildings, equipment, and so on. That expenditure might fall into one category, but you have also to consider the cost of maintaining, staffing and running all these institutions. I have no wish to open up a discussion on local taxation and rating, although I would be quite entitled to do so if I desired, but I feel that the House and the country ought to get some idea of our commitments under these sections. Section 43 indicates that the moneys will be raised in the hospital districts by the poor rate. I would like to ask the Parliamentary Secretary to give us some enlightenment, because the House and the country, while anxious for better treatment of mental diseases, will want to know whether it will bear very heavily on the ratepayers of the country. In the long run, the expenses of administration of the scheme must be borne by the local ratepayers.

I do not want to delay the Parliamentary Secretary and the House on this question. I do not want to hold up the measure, but Senators from the country would like to know what we are being committed to. On paper, the plan is an excellent one. It is a plan which we wholeheartedly approve, but, unfortunately, many people, while subscribing to good ideas, like to see the responsibility for carrying them out placed on the shoulders of other people.

It may well be that local authorities will be alarmed by the financial results of our action to-day, and I would like, therefore, to have some indication of the cost and how the Parliamentary Secretary views the financing of his plan. We are, I feel, asking local authorities to commit themselves to a great deal—we may say that we are giving the Parliamentary Secretary a blank cheque. He has authority to give directions that must be carried out. If the local authority do not carry out his directions, he can do it himself, but they will pay. It is not expecting too much that a Minister in charge of a measure of this kind should give us some estimate, even with a margin of £100,000 or greater, to indicate what a grandiose scheme, planned like this, is likely to cost when it is working to the limit of its extent.

In sub-sections (4) and (5) a provision is made in respect of the methods by which the sum required under Section 43, will be raised in the case of a county council. In other words, the proportion of the sum payable to a joint board by each county council concerned will be raised as a county-at-large charge on the poor rate. No similar provision is inserted regarding the raising of moneys required to be paid by a borough council. I do not know if it was necessary or not that that should be done.

Perhaps I might dispose of Senator Duffy's point, if I understand it correctly. In the case of a joint authority, the money will be raised in proportion to the cost of chargeable patients maintained in each institution on behalf of the different counties constituting the joint body. In the case of a borough council, the amount will be raised over the entire borough. In the case of a county council, the necessary money will be raised by way of a county-at-large charge. Is that what the Senator had in mind?

Is that the present plan?

There is no departure from it.

I merely want to know whether it is necessary to make special provision in the Bill?

Oh, no. As regards Senator Baxter's point about the general financial repercussions of bringing this measure into full operation, we had some discussion on the Second Reading——

But no enlightenment.

I am sure Senator Baxter appreciates, just as any other Senator, and perhaps better than a number, that it is utterly impossible for me, or for anybody else, to give an estimate of the probable expenditure that may be incurred in bringing this Bill into full operation. It depends on factors which we cannot estimate— the number of institutions, the classes and the number of persons suffering from mental diseases in the different categories. In so far as our preventtive measures are concerned, to such extent as they are successful, the ultimate cost of the maintenance of our institutions will correspondingly fall, but I cannot predict, and nobody else can, to what extent the preventive measures may be successful.

We venture to be hopeful. We have reason for a modified degree of optimism. If we get this Bill into full operation, if we can provide clinics, and get hold of cases in the early stages before any gross disorder of mind occurs, a much less period of detention in a mental hospital, if any at all, would become necessary. I do not intend to indulge in any prophecies on that score. I hope that the effect of this Bill after it is fully in operation will be up to our anticipations. Beyond that I cannot go.

The Bill is a machinery measure. Everybody agrees that it is a good and a necessary machine. Many Senators have commented upon the fact that our lunacy law is very much out of date, and entirely out of harmony with modern ideas of mental treatment. We are now providing the best machinery that human ingenuity can devise. If the Bill is to be made fully effective we have to spend money, and we have to ask ourselves—is it worth while spending money in order to prevent mental disease? Senator Baxter has anxieties on that score. I have none. I believe that the taxpayers will back us in this measure. I believe that the people will willingly contribute if we can satisfy them that the steps we propose to take are sound and well conceived. I may be wrong. I know, particularly in rural districts, that the public representatives and contributing public will not like to see rates having to be raised. At the same time I feel—and I have always been in fairly close touch with public feeling on these matters—that if they think we are lessening some of the social evils that are so prevalent amongst our people they will give us the necessary money. If they do not give us the necessary money we cannot do the job.

I have a good deal of sympathy with what Senator Baxter said. I agree that whatever is done by this Bill will be well worth the expense. I feel that the local authorities will have to do a great deal. They will have to erect different hospitals. A great deal of expense will have to be met, and as far as I can see the Bill provides that the local authorities shall erect these institutions. In this Bill we provide for institutions for inebriates. There were one or two institutions to which people were sent if convicted of drunkenness for the third time. Very seldom people qualified for admission to these institutions. It was very hard to get three convictions, particularly, as Senator Hearne said, when they were respectable persons. The police would see a man home instead of prosecuting a third time. We are now to have a number of institutions, and I should like to know if it is the intention that these are to be erected by the State rather than by the local authorities. There is also provision in Section 14 whereby the Minister may make regulations for the erection of hospitals. I shall be glad to know if the regulation provides that the expense will be met by the State. In the previous debate it was mentioned that the capitation grant was only 4/- per week for those in mental hospitals. That amount is entirely out of date, considering the cost of maintaining patients now. I wonder is it the intention of the Parliamentary Secretary to improve that position, so far as the local authorities are concerned.

I do not want to appear at cross purposes with the Parliamentary Secretary. I am prepared to subscribe to the view that our people will support a measure like this for the cure and prevention of disease, but it is of vital importance to know who pays. The Parliamentary Secretary knows that.

Have I not made it clear who will pay? The ratepayers will pay.

What I am trying to get at is how this measure will be worked. In the area of which I have knowledge I want to know how many subsidiary institutions are we going to have. We have not had a survey but I would like to know if there is any statistical examination of the position to indicate what we are facing.

The country is faced with nothing until this Bill is in operation.

When in operation how much information is available, that is, how many institutions have to be provided?

We will provide only the ones that are necessary.

Perhaps by a process of question and answer I may get the information I want. I am asking the Parliamentary Secretary if he has made any calculation of the cost. I am trying to reveal to the Parliamentary Secretary what is in my mind. In my own area I want to know, for instance, what additions may have to be made to buildings or medical services when this Bill is passed.

That has yet to be examined. There is only the machinery here.

We have the machinery. Who is to determine how many clinics we will have? Have we got any figures? Are we to erect clinics without knowing how many people are to be treated? Do I gather from the Parliamentary Secretary that he does not know until he gets the Bill? If we are to do a certain amount of this work in the dark I do not know what we are committing ourselves to. I would not like to believe that the Parliamentary Secretary and his Department will be a party to expending money for the treatment of patients without having some information as to the incidence of the disease and how many there are to be treated. If there is information on that score we might have some data as to what this is going to cost.

If that is so the Parliamentary Secretary has some idea of the cost, and I am trying to get it. I think we ought to know the worst. The problem is there to be solved even if it is going to cost a considerable sum of money It would be better to face that position. When it comes to the question of who is going to pay, it is there the ratepayers are concerned. Perhaps we would get a bit of a fright if we were told how much the ratepayers will have to pay. I wish the Parliamentary Secretary would inform us.

Quite recently I heard somebody say that what we get for what we pay is far more important than what we pay for what we get. It seems to me that that trite saying applies to this very laudable measure before the House now. I was diffident about saying anything on it, but I have been encouraged by the remarks of Senator Baxter because it seems to me that we all are in hearty accord with the Government in introducing so splendid a measure as this undoubtedly is in its general principles, but I am wondering whether it precludes the possibility that, having got the powers which the Bill seeks to get for the Government, they could be applied to the setting up of national institutions for the treatment of what is really a national calamity. It might be that in one area the incidence of this mental disturbance would be greater than in another. It could easily happen that in a poor part of the country there would be more of this disease than in a richer part. Since we have given our whole-hearted support to the general principles underlying this Bill, I think we might urge the Government to go a step further and decide that mental disturbance of any kind is really a national matter, and not one to be dealt with entirely by the local ratepayer. It might be that it would be better if we were to set up one large institution. Here, I share with Senator Baxter the view that perhaps it would be well if the House were furnished with some idea of the incidence of mental disturbance in the country. We do not know whether there are 1,000, 2,000, 5,000 or 20,000 people so afflicted.

It may be that there are relatively so few people afflicted in this way that they could be housed in one or two or, if you like, three centrally situated institutions, where by reason of their very size the treatment of the disease itself would be far more skilled and far more concentrated than it could possibly be in a number of widely scattered, small clinics. This is so important a Bill that I feel the Parliamentary Secretary will not mind even a layman like myself throwing out suggestions of this kind, because the Government's desire is one which is shared by every member of the community who has any interest in his unfortunate fellow-citizens—to see that this helpless section of the community is given the very best service that this State can afford to give them. I feel that, by concentration of the kind I have suggested, it might be possible to give far more skilled treatment at a lower cost than might be the case with a number of widely scattered clinics. I throw out that suggestion to the Parliamentary Secretary in the hope that he might find it possible to look into it.

Senator O'Dea asked whether the institutions to be provided under this Bill will be provided by the State or will be provided by the local authorities. Senator Summerfield, from a somewhat different angle, raised practically the same question. From a still further angle, Senator Baxter was interested in the financing of the provision of those institutions.

I was referring to certain institutions for inebriates, for addicts.

It is not the intention of the Government to provide out of State funds any of the institutions contemplated under this Bill.

That is a consolation. Is it not?

That is specific. I think it is understandable, and I thought I had made it quite clear. In fact, I thought that any amendment for such a purpose would not be in order at all. I thought, when the Bill came to the House, it might have been assumed that we could not, in a strictly orderly way, discuss the principles involved between State and local taxation for the purpose of giving effect to this Bill.

Oh, now.

It is all right. I am not reflecting on the Chair at all. The Chair, as I have previously remarked, is particularly generous in this House. That is quite a good thing. On a matter such as this, I think it is well that we should not be confined strictly to rules of order. The matter is very important, and it is better that we should discuss every aspect of it which is agitating the minds of Senators. Senators are aware that, in the very considerable extensions and new provisions which we have in relation to our mental institutions, very generous grants have been given towards the provision of those institutions out of the Hospitals Trust fund. We all hope that the Hospitals Trust fund will, in the early future, recover itself, and if that fund is able to bear the additional financial burden of assisting in the provision of these institutions the same line of policy that has operated in the past in relation to mental institutions will operate in the future. Again, we cannot give any firm undertakings on that, because we are not in a position to know what money may be at our disposal in that regard.

Once again, our old friend the 4/- capitation rate has been raised. I hope we will not get into a full dress debate on the failure of the State to increase this 4/- grant per head in proportion to the rising cost of maintenance of patients. If we were to debate that, I would have to demonstrate to the satisfaction of the House that the amount which was provided out of State funds when this 4/- capitation grant was made available would be only a drop in the ocean compared with the amount that is now provided out of State funds for the relief of local rates, but if we have to go into that we will be getting into deep water which is not strictly proper to the Bill. This 4/- grant out of State funds towards the maintenance of patients in mental institutions was never intended to represent 25 per cent., 40 per cent., 50 per cent., or any other particular percentage of the cost of maintenance of patients in mental hospitals. It was intended as an inducement to mental hospital authorities at the time to take those unfortunate people out of gaols and workhouses and make separate provision for them. It was merely an inducement. It bore no relationship at all, and never was intended to bear any relationship, to the cost of maintenance of those people in the institutions. On every Bill that I bring before the House which involves increased expenditure, we have our old friend central taxation versus local taxation. Perhaps it is a good thing, because the last time we debated this matter I converted Senator Duffy. I believe I now have his support and the support of the Labour Party—at least that section of the Labour Party to which Senator Duffy belongs—for local taxation rather than central taxation for the purpose of financing those schemes.

Perhaps the Parliamentary Secretary will permit me to say one word.

Later on. The Chair will not allow it now.

The Parliamentary Secretary is not giving way, Senator.

I do not want to be misrepresented, but if it is desired that I should not be heard——

If the Chair has no objection, I should like to hear Senator Duffy.

There is a danger that the discussion will be further widened by these interruptions, and I suggest that the debate is wide enough.

On the question of the provision of national institutions, we are, perhaps, at cross purposes. National institutions may be necessary for certain purposes—for addicts, for instance, as mentioned by Senator O'Dea—in the sense of one or two institutions serving the geographical area that constitutes the State. I have not in mind national institutions of the type which would be built, equipped and maintained by the State. There is provision within the machinery of the Bill to enable a number of mental hospital authorities to combine for the purpose of providing a particular institution. As regards the question which Senator Baxter has harped back upon again and again, if I have not answered it to his satisfaction it is because I cannot make the matter any clearer. He brings the question home to himself and the Parliamentary Secretary when he mentions the conditions which might obtain under this Bill in Cavan and Monaghan. I have no reliable data as to the number of people in Cavan and Monaghan suffering from minor degrees of mental disorder who are not under care and treatment and who ought to be. There may be quite a number.

The development which I would like to see in that area, and every area of the State, would be the provision of clinics. My idea would be that, once a month or so, the resident medical superintendent or deputy-resident medical superintendent or a specially trained member of the medical staff of the mental hospital should visit each of the principal towns in the area and hold a clinic. I think that there is not a full understanding of what is meant by "clinics". I do not contemplate the erection of residential institutions. Perhaps, I would have been better understood if I had used the word "dispensaries" instead of "clinics". What I mean is that a clinic or dispensary should be held for people suffering from various nervous complaints and, perhaps, from incipient mental disease, that their doctor should say to them: "The R.M.S., who is a specialist in that class of work, will be in this town holding a clinic on such a day, and you had better come in and see him; he will understand more about your case than I do."

In that way, we would try to put the advice of the specialist and his scientific skill within reach of those people before they would become mentally disordered. That is the idea behind the Bill. To get it operated would be difficult, but I do not think that that particular development would be an expensive development, because we ought to avail of existing dispensaries, health centres and clinics to accommodate this particular clinic once a month or once a week. A similar idea will have to be brought into operation in the cities and large towns. In the cities—particularly in the City of Dublin—we have another problem which does not exist to anything like the same extent in provincial Ireland. That is the problem of juvenile delinquency. I do not say that we have not the criminal type amongst juveniles; we have. But we have a considerable proportion of juveniles suffering from psychocic conditions who, if they received proper treatment, would not enter either a jail or a mental hospital. I should be anxious to bring that service within the reach of that class, particularly in the cities, as soon as possible. I do not think that these provisions will be very expensive. Senator Baxter and other Senators will, of course, raise questions here for debating purposes and in the hope that they may draw out something which, otherwise, would not be drawn out, but, approaching the problem in a reasonable, commonsense way, it must be clear to everybody that we cannot give firm estimates as to the cost of the full development of the purpose and policy behind this Bill.

Senator Summerfield asked for figures. I can give the House figures regarding the number of persons suffering from mental disorder who are in our district mental hospitals. I have not figures as to the number of persons who may be similarly detained in private institutions but that number would be comparatively small. On the 28th February, 1945, the number detained in our mental hospitals was 17,539. If Senator Summerfield is under the impression that we have a large number of those institutions scattered all over the State, some of them not fully occupied and many of them not wholly staffed, he is under a misapprehension. Our trouble was that most of our mental hospitals were overcrowded. Our problem was to provide additional accommodation in existing institutions. Those figures cannot convey a full picture of the problem, for the reason that our real problem is not one of the 17,000 persons at present detained in our mental hospitals but of the 17,000 potential patients whom we want to save from entering the hospitals, if we can.

I do not know whether you would permit me to remove a misapprehension with regard to what I said on the last occasion on the subject of financing local administration.

On a point of order, is Senator O Maille in order in reading a newspaper in the House?

Newspapers should not be read in the House while a debate is proceeding.

The Parliamentary Secretary is under a misapprehension in two important respects. He told us that he had converted me to some view which he holds. I do not know whether he has or not because I am not sure that I follow his view in this matter. It has been my opinion for a long time that people who are making a claim for large subsidies in relief of rates from central funds are misled, or misleading themselves, as regards the effect of that operation on the general community.

What I said in this respect I qualified by pointing out that I understood the case made by Senator Baxter, and those who spoke with him, because of the manner in which local rates were levied. Anybody interested who looks at column 2217 of the Official Debates of April 19, will find that while I recognised that I could not go into the matter in detail, I did point out that the rating system was entirely unjust, and that this injustice gave rise to the claims which are made by Senator Baxter and others. I do not like to be misrepresented, as suggesting that I am swallowing the case put up by the Parliamentary Secretary, because I am not.

Going back to the point I raised, while it may not be welcome to the Parliamentary Secretary, I am sure he feels he is quite competent to deal with it. I have elicited from the Parliamentary Secretary that, apparently, there is the intention to establish the equivalent of what is to-day recognised as a dispensary and that to this dispensary people who are mentally afflicted, are to be invited. We are told that the resident medical superintendent can come from the mental hospital to inspect people and that that can be carried on without new buildings of any kind.

Oh, no.

I gathered from the Parliamentary Secretary that his view was that we could utilise existing buildings.

As far as they go.

I was just going to say that I think nothing could be more unhelpful, in the effort to start an effective policy of curative treatment, than to have any of these buildings other than in a remote place. I ask Senators to imagine the position of people who are troubled with nerves having to go to the local dispensary doctor. A special day in the week is set aside in a county town when the resident medical superintendent from the adjoining county will attend. This arrangement is publicised to a certain extent. A building is provided and into it the people go. I do not mind what the building is called but these are the conditions under which you will not get people to attend. That is how it strikes me. We as a people are sensitive about a great many things, but there is nothing about which we are more sensitive than about a person's state of mind. It seems to me that I have elicited from the Parliamentary Secretary, that while he thinks we are not committing ourselves to the provision of even subsidiary institutions to any considerable extent, to make this scheme effective we shall be involved in a very considerable cost in the matter of the construction of buildings and the procuring of sites in suitable places. I think I am justified in the belief that it is going to cost the ratepayers more than the Parliamentary Secretary would like to tell at the moment.

Oh, no. I cannot let Senator Baxter away with that statement. I have no desire whatever to minimise the amount that this Bill will eventually cost. I have said repeatedly that it will cost money, and lots of money, if we are to make this measure effective. I have not pretended at all that it will not cost money, but I said that a particular aspect—and I did particularise, and made it very clear to Senator Baxter what I had in mind— of our policy could, I thought, be brought into operation without involving any serious expenditure. I did not suggest, and I hope I did not convey to the House the suggestion, that every dispensary in the country is a suitable place for the treatment of mental disease or for any other purpose, because the vast majority of them are not suitable for anything. One of the first problems—and again it means expenditure, but we can discuss that on an other occasion—will be to provide proper health centres, where not only mental disease, but every other disease, can be treated, and where the necessary advice can be afforded to people under proper conditions. To such an extent as existing institutions will serve our purpose, we shall use them. To such an extent as they do not serve our purpose, we shall have to turn our minds to the provision of suitable institutions. Now, the provision of a clinic or the provision of a centre does not entail a very big expenditure. I think Senators' minds are running rather more along the provision of residential institutions than the health centre, or the clinic where advice, mainly advice, is afforded.

Leaving that aside for the moment, I do not find myself at all in agreement with Senator Baxter's idea of the provision of special clinics or dispensaries in remote parts of the country where these people, ashamed of their stigma, can steal in. There is no stigma associated with mental disease, and the sooner we get that into our heads, and get the public to realise it, the more progress we can achieve, and I did hope that the enactment of this Bill would get us out of that atmosphere. So far from making provision in isolated places where these people could seek and obtain advice and treatment without anybody seeing them, I think we should head in the other direction—that of indicating our belief that there is nothing more extraordinary about an ailment of the mind than about any other ailment, and that we believe it can be treated in the same type of institutions as those in which other ailments are treated. If we could do the same thing with mental disease, even where it reaches the stage when people have to be put under restraint, it would be a good thing. We are dealing here, however, only with people who have reached the first stage of mental illness, what may be, perhaps, very little more than insomnia. Mind you, if any of you went without sleep for about two weeks at a stretch, your nerves would get pretty rattled. Some people would get into a rattled condition of mind without loss of sleep—even Senators.

No, Parliamentary Secretaries.

I got in before the Senator. I saw the idea forming in his mind. We have given a good deal of attention to this particular aspect of our problem. I think it is quite a good thing we did, because it cannot be too much discussed. The one thing I did want to bring home to the House, in contradiction of the impression Senator Baxter conveyed as to my attitude, is that I believe—I always have believed—that if the machinery that we provide here, machinery to which so much tribute has been paid, is to become fully effective, it is an absolute certainty that we must spend money and lots of it if we are to get the full effect of the provisions we are now making.

As to where that money is to come from, we cannot determine it the moment, but the whole machinery of the Bill is constructed on the idea that the local authorities will bear the cost of the maintenance and treatment of persons suffering from mental disorder, that the State subvention will not be increased, and that in so far as the Hospitals Trust. Funds are available to assist in the provision of the necessary capital for the erection and equipment of new institutions, the policy of the past will be the policy of the future.

I am sorry to have to disagree with the Parliamentary Secretary. My disagreement is very largely on the point of the desirability of having dispensaries in populous areas rather than in remote places. I agree with what Senator Baxter has said. It is far better for us to be realists as to what we may call the shyness of our people in connection with any form of disease, no matter what it is. There is a natural tendency to shyness about disease amongst our country people, and it is better for us to realise that. While it is highly desirable for the people to get rid of that feeling, and do what the Parliamentary Secretary wants to have done, and that is to come out in the open and get treatment as early as possible, the fact remains, unfortunately—and it is unfortunate—that there is that tendency in the Irish people. That is the actual fact, and I am afraid it will take a long time and a good deal of publicity and enlightenment to induce our people to get away from that.

Where would the Senator build the clinics?

I do not know. That is the Parliamentary Secretary's business, not mine.

Certainly not in the main streets of a town.

Perhaps the Senator would suggest where we would build the clinics.

What section are we discussing?

An Leas-Chathaoirleach

Section 43.

If Senator McEllin holds that what I suggest is not a proper policy, surely he can suggest where they should be built?

I am expressing my opinion to the best of my ability.

Where does the Senator want them placed?

That is the Parliamentary Secretary's business; it is not mine.

But the Senator could say where he wants them placed.

I do not think it is at all proper for me to be checked in this way on such a matter as this. We are here in this House to express our opinions freely to the best of our ability.

That is what I am searching for—the Senator's opinion.

Well, let the Parliamentary Secretary take it.

But I have not got it.

I think that this is altogether improper.

An Leas-Chathaoirleach

The Senator might now come to the question before the House.

With regard to the general hospitalisation of mentally defective people, I think that, generally speaking, the hospitals are very good. Speaking for Mayo, I can say that we have a hospital there that is a magnificent structure. As far as I know, it has been magnificently run in the past. It is also my opinion that it is largely self-sufficient, and the people there are occupied with work on the land which helps their general disposition in life.

What has that to do with the section?

An Leas-Chathaoirleach

There is nothing in Section 43 dealing with that matter.

Sections 43 to 62, inclusive, put and agreed to.
SECTION 63.

I move amendment No. 5:—

In sub-section (1), page 27, line 19, to delete the words "payments for overtime".

This is the first of the many sections which deals with the superannuation of the staffs of the mental hospital authorities, and the portion of it with which I am concerned in the amendment is somewhat narrow in its compass. It is the definition for the purpose of part of the Act of the expression "salary and wages". The section provides that the words "salary and wages" include emoluments but do not include payments for overtime, travelling expenses, or any allowances paid to cover the cost of office accommodation or clerical assistance. I think it will be obvious, generally, that the inclusion of the item "payments for overtime" is hardly relevant to the other payments mentioned here. Travelling expenses are something given to a person to cover out-of-pocket expenses when he is away from his home station doing the work of the mental hospital authorities; or if he is paid an allowance to cover the cost of an office, he is paid it merely as an agent, handing it out later to somebody else for the use of the office. In other words, it means nothing to him personally whether they are travelling expenses or not. He derives no personal advantage from them, but the payments received by an employee or officer of a mental hospital authority in respect of overtime are in a completely different category. Some people may be required at certain periods in the year to work many hours overtime. They are paid for it, and it is a common feature that if they are required to work overtime in that way, they derive a certain regular income from that source year after year. It seems to me reasonable, therefore, that the payments which they earn by way of overtime should be taken into account when you are calculating their salaries, wages or emoluments for the purpose of determining the rate of pension on retirement.

I think that the question I am raising now was raised in the Dáil. Unfortunately, I did not have an opportunity of following up the views which the Parliamentary Secretary expressed in regard to the matter, but I can hardly imagine that he is personally opposed to having payments for overtime calculated—at any rate, if they are frequent and regular payments—when determining the emoluments, salary and income of an officer who is about to retire on pension. My proposal, therefore, is that that reference to payments of overtime should be deleted. The section will then read that the words "salary and wages" would include emoluments, but would not include travelling expenses, or any allowance paid to cover the cost of officers' accommodation or clerical assistance, and I would urge the Parliamentary Secretary to accept the proposal.

I am not in favour of the principle embodied in this amendment. In case Senators have any doubt as to the effect of it, it means in simple language, that if the amendment is accepted, payments received for overtime will be included in the calculation of income for pension purposes. That is the principle that is involved. Now, the rejection of the amendment does not mean that in future there will be no overtime under any circumstances. It means that if there is overtime payment in respect of overtime, it will not be counted as income for pension purposes. I think that is a sound principle. I do not think that we ought to make the working of overtime an attractive proposition. Personally, I am not in favour of the principle of overtime.

I grant that in certain circumstances, it may be necessary on occasion to ask employees to work overtime for short periods, but it should not be permitted to operate to the point of depriving other persons of normal employment, and that is the danger if we make it attractive as a pensionable emolument. If we make it attractive, there will be a tendency to develop overtime rather than to give the additional employment that would become available if overtime were not worked. I suggest that a person who periodically gets overtime is already in a privileged position compared with the man who gets only a weekly wage. He is paid full time and a quarter for his overtime, but his fellow-worker who is not so privileged has to do with his ordinary wages, without extra emoluments. If this principle were embodied in the Bill, I rather think that in the later years of service there would be a definite tendency to encourage overtime so as to influence superannuation. In my judgment that would be a bad development, and I think it ought to be discouraged. While we do not put any prohibition on overtime, we ought to discourage it in the sense that it will not be calculable for pension purposes.

May I say that I agree with the Parliamentary Secretary in what he has said regarding the discouragement of overtime? I am not advocating that anyone should work overtime. I do not want it to be attractive, but, as the Parliamentary Secretary said, it is attractive. It is attractive because people whose incomes are low are able to increase them substantially by working overtime. But may I put this to the Parliamentary Secretary—the person who will work overtime is not the boss in this case? He does not decide whether or not he will work overtime— somebody else decides that. Let us take the case of a clerk—I do not mean the clerk in charge, but a junior officer. He is ordered to get books, documents, files and vouchers ready for audit or some other purpose—let us say coming to stocktaking. The clerk must get all this work done. There may be a limit to the time in which he must get it done, and there are two courses open to the people in charge, either to get in additional assistance or instruct the existing staff to do the job in overtime.

I do not want to encourage the employment of staff on overtime. I would prefer that additional staff would be employed, but the case is often made that work will not be done efficiently unless it is done by people already on the job. The only case I make in respect of this is that where it is a practice of a mental hospital authority to employ some of their staff on overtime, and to pay them overtime, that sum earned under the heading of overtime should be calculated, the same as any other emolument, in determining the rate of the pension.

As I said, the staff, whether they are getting old or not, are not going to decide the issue whether or not they will work overtime. That will be decided by other people, the resident medical superintendent, the manager, or whoever else is in charge. It cannot be decided by the clerk who is going to work the overtime, and I may say that, in many instances, the staff would readily forgo the privilege of working overtime if they had a free choice in the matter.

If the amendment is being pressed, I would like to say something about it. I must say frankly that I regard it as a most revolutionary proposal. It is far more than an amendment to a clause in a particular Bill. It brings up something which challenges the whole fabric of our association with one another. Very speedily it would create a precedent, and it would be sought to introduce it into every activity in which overtime is worked at any particular time. I think it is a proposal to which the House must give very serious consideration. I feel that the question whether overtime is to be regarded as part of the normal wage or salary is a revolutionary idea and I hope that the House will reject the amendment without difficulty.

The only comment I want to make on Senator Summerfield's remarks is that when there was a proposal made 80 years ago to limit the time juveniles could work underground to ten hours a day, it was also described as revolutionary.

Perhaps Senator Summerfield will give the House some illustration of how the amendment would revolutionise relationships between employers and trade unions, if it were adopted.

It will not be adopted.

I do not see how it would influence any question of the provision of pensions based on the amount of earnings. I do not think that Senator Summerfield could produce any agreement between his association and the union concerned that would make any difference whatsoever or could, by any stretch, even of Senator Summerfield's imagination, if it is imagination, produce such a result.

I would be glad to know if Senator Kyle could give us any instances, in fact, in which overtime is regarded as part of the emoluments on which pensions are based.

Amendment put and declared lost.

I move amendment No. 6:—

To add to the section a new sub-section as follows:—

(6) Notwithstanding anything contained in the first sub-section of this section a clergyman of any recognised denomination who has given continuous whole or part-time service as chaplain to a mental hospital shall be eligible for a superannuation allowance on the same terms as were in operation before the year 1926.

This amendment in one respect cannot be regarded as a small matter in that it involves very big principles. In the first place it merely seeks to restore the situation that existed before 1926 with regard to pensions for chaplains. The salaries paid to chaplains who, as a rule, if not universally, are only part-time servants of such institutions, are trifling. I think they are of the order of £50 a year, and in view of the work that they do in consideration of these salaries their services cannot be regarded as anything but extremely important. I am assured on the highest authority that the responsible medical officers regard the services of chaplains of the various Churches as an essential element in the treatment and cure of mental diseases. One of the reasons I urge the restoration of the pensionable rights of the chaplain is the recognition by the State of the important services that such people are rendering and that they may be expected to render to an even greater extent in future.

If this amendment is enacted, as I hope it will be, the number of persons affected is likely to be extremely small and the cost a mere trifle. At any given moment it is extremely unlikely that more than one or two of each of the Churches' chaplains would be drawing a pension. A pension of two-thirds of £50 a year is not a very great amount. The amendment is framed in such a way as to apply to the clergy of all Churches. In common sense and in equity the rule should be the same for clergy in all Churches, but in practice there are certain differences in the operation of the rule as it existed before 1926 to which I should perhaps draw the attention of the House. The clergy of the Church of Ireland when they secure parochial standing often remain in the same parish for 20, 30 or more years. They have what I may call fixity of tenure. Consequently it happens quite frequently, at all events in a number of cases, that the clergy who happen to be in a parish where there happens to be a mental hospital may have served 20 or 30 years as chaplain before they reach the age of retirement. In the case of the clergy of the Church of the majority of the people I believe that the senior curate is generally appointed chaplain. The clergy of that Church as the House knows are much more mobile than the clergy of the Protestant Church and are liable to be sent from one parish to another. In actual practice it has happened in the past that the chaplains of the Church of the majority rarely serve for more than five or ten years. Possibly in the next parish to which they are moved there is no mental hospital to which the clergyman can be appointed. That is a mere accident of the case. If I may have the temerity, and I think Senators will agree that I have more temerity than most, I would suggest that the Church of the majority——

The Senator had better keep from that.

I suggest that it is worth the consideration of the dignitaries of that Church, that a priest who has shown the talent and capacity for giving valuable service in a mental hospital, even if he has to be moved from such a centre should be moved to some other centre where there is a mental hospital, and where he can continue to develop his special knowledge and capacity for rendering special services to the mentally deficient. It may be argued that a person who spends only a year or two as a chaplain to a mental hospital is a mere amateur, and has no experience of mental patients, and consequently that his services are not as important as they would be if he spent longer and acquired greater experience.

If that be so, then the case for recognising the longer service of those who do, in fact, remain 25 years or more as a chaplain in a mental hospital is rather stronger, and my argument for so arranging matters that the clergy of the Church of the majority should be encouraged to specialise is strengthened. This is a matter I should like the House to consider with all possible sympathy. Even if, in the first instance, in actual fact it affects the clergy of the Protestant Church it should be borne in mind that under the changing conditions it can include the clergy of every Church. The really important point I want the House to recognise is the status of chaplains. As a matter of fact, the chaplaincy to a mental home can be no sinecure for any clergyman. I imagine an important part of the work, apart from holding religious services on regular occasions, must be the maintaining of correspondence with the families of patients, and reporting to families how patients are getting on, and so on. All that kind of thing can be extremely worrying, and involve a good deal of time. I think their salaries are well earned, and that they have a very strong claim to be recognised in equity, and to recognition for the part they play in the therapy of mental disease. They should be regarded as eligible for pension rights.

I realise from listening to Senator Joseph Johnston how difficult it is to satisfy all sections of the House. A short while ago we were urged to advance, and advance very rapidly. Reference was made to conditions that existed 80 years ago among certain sections of the community, and it was suggested that we should forget about that now. Senator Johnston wants us to go back to a policy that was pursued 19 years ago. I am disposed to keep moving forward. I am not impressed by the strength of the case that has been made by Senator Johnston. In fact, if I were to express my personal reaction I would have to confess that I have no enthusiasm for the payment of salaries to part-time chaplains. However, that does not arise in the Bill. The principle in the Bill of paying salaries to chaplains has already been adopted by the Dáil, and is clearly acceptable to the House. I merely express a personal reaction. Now, we naturally have to examine how such a proposal would affect the persons concerned if this amendment were carried.

If this amendment were inserted, all part-time chaplains employed in mental hospitals would become pensionable. The House may not realise that in many of our mental hospitals we have quite a number of chaplains. We have a Catholic chaplain—sometimes whole-time, dependent on the size of the institution; sometimes part-time. His responsibility, by reason of the proportion of the Catholic community in the State, would, of course, extend to the greater number of the people whose spiritual needs have to be looked after Then we have various other communities—Protestant, Methodist, Presbyterian. We have as many as three or four chaplains in some institutions. All those people would become pensionable. In fact, in some of those institutions a period of months or perhaps even years might elapse before we would have any patient of the particular denomination. The chaplain is retained in order that his services may be available if and when patients of that particular denomination come to be accommodated in the institution. That is, I think, a very proper provision. But when we are presented with the proposition that not only should they be paid a salary, notwithstanding the fact that they have little or no duties——

I did not advocate that they should be paid a salary for doing no work whatever.

——but that they should as well become pensionable officers, it is a proposition which I cannot recommend to the House. Let us take a number of institutions as an example. In Ardee, the number of inmates of all denominations other than Catholic, is eight. In Castlebar, the number of Protestant inmates is three. We have a Protestant chaplain there. In Cork, the number of Presbyterian inmates is two. We have a Presbyterian chaplain there. In Ennis the number of Protestant inmates is three. We have a Protestant chaplain there. In Monaghan the number of Methodist inmates is one, and we have a Methodist chaplain there. In Mullingar, the number of Presbyterian inmates is four, and we have a Presbyterian chaplain there. Surely we will not be asked to make all those pensionable officers? I do not think the House would ask me to accept such a proposition.

What is the number of Church of Ireland patients in some of these institutions?

I am dealing with the amendment. The amendment refers to chaplains—part-time chaplains and whole-time chaplains. I am explaining to the House how that amendment would operate if it were incorporated in the Bill. Regarding the Senator's suggestion to the Catholic ecclesiastical authorities as to how they might more properly discharge their ecclesiastical functions, I can only say that I will not undertake to transmit the Senator's recommendation to them.

I can understand perfectly the view of the Parliamentary Secretary that a person who has a vocation should perform that vocation without reward or emolument. That is a view of great antiquity, and of a very respectable authority. But, dealing with the matter governmentally, it has never been accepted. In fact, people are paid for the work they do. In the vocational schools, where religious education is given, clergymen of all denominations are paid for it. If you accept the principle that a clergyman of any denomination who gives time and thought and services to a mental hospital should be paid in proportion to the amount of time he devotes to those services, I cannot see any reason why the payment should not be extended in the same manner as in all other professions by recognising that when he has grown old in his job, and is no longer physically capable of carrying on, there should be some reward for his services in addition to the payment made to him when he was in his heyday. The Parliamentary Secretary has pointed out that in a number of those institutions you may have very few patients of a particular denomination for whom it is necessary or customary to provide a chaplain. I notice that his selection was one which was apparently haphazard but was, in fact, very careful. He went through the mental institutions, found out the particular denomination which in the institution he was dealing with was represented by the smallest number of people, and said: "We have a chaplain there" for that denomination. Judging by the smile on the face of the Parliamentary Secretary, I think he rather agrees that that was the method adopted.

I am sorry; I was not listening to the Senator at the time.

I thought I had at least got what I might call winning acquiescence from him.

It was a suggestion which had been made by somebody that chaplains should work for reward in the next world.

I can understand that that is a perfectly laudable point of view. But, when you are dealing with the matter from the State point of view, you adopt the principle that a person who does a job of work is entitled to be paid for it. I can quite understand the Parliamentary Secretary's suggestion that, in a place where the work is small, the remuneration should be small, and that the pension which is subsequently given should also be correspondingly small as it is based on the remuneration. I am not suggesting that a chaplain whose flock is represented by one person, whom he would probably have to visit only twice in the year, should get the same payment as a chaplain whose flock ran into hundreds, and whose visiting of those patients might occupy a great deal of what would otherwise be his leisure, but I am saying that the State recognises the principle that a person should be paid for the work he does while he is doing it. This Bill should not exclude the corresponding obligation that he should receive some small amount by way of competence when he is no longer able to work. The payment of superannuation allowances or gratuities to part-time officers has been perfectly well recognised by the State and by the local Government authorities in a number of different types of occupations. It was the custom up to 1926 as far as chaplains are concerned, and I am interested to find that the Parliamentary Secretary regards it as a retrograde step to continue to recognise people's services not only by payment at the time but by a subsequent small pension. If it is a retrograde step in the case of chaplains, why is it not a retrograde step in any other case? I am under the impression—I speak subject to correction by the Parliamentary Secretary—that the tendency in legislation has been to provide more gratuities and more pensions than there were in 1926. If that is so, why should it be a retrograde step that the system of giving a pension, which prevailed in 1926, should be included in this Bill? I press this upon the House. If a man has done his work faithfully and well, if he has done his best to give spiritual consolation and mental healing to the inmates who belong to his flock, surely when he has grown old the State will not be so parsimonious as not to give some recognition of his services, measured upon the scale which they thought fit to pay during the time when he was active?

In spite of the Parliamentary Secretary's statistics, I should like to assure the House that, in proportion to our numbers, we Protestants are just as mad as you are. These figures were carefully chosen to suggest that there was hardly any insanity at all amongst certain sects of Protestants. The fact is that there are very few Methodists or Protestants in Cork or Ennis neighbourhood, but if the Parliamentary Secretary had been completely frank with the House, he would have mentioned that in at least one institution of which I am aware there are 40 Church of Ireland patients. The chaplain of that institution has a serious amount of work to do in looking after that flock of 40 mentally-afflicted persons. I am not suggesting that a pension should be given for having been merely nominally chaplain of an almost non-existent flock in a mental hospital. I think that the payment both of salary and pension should be related to the number of persons who had to be looked after over a certain number of years, and that it should be based, to some extent, on capitation. I am prepared to modify the terms of my amendment in such a way as to make it obvious that the number of persons concerned will be the material factor in determining both the amount of the salary and the pension. The principle is one which I must insist on the House regarding seriously. The services rendered by the clergy of all denominations are an essential element in the treatment of mental disease. They are not nominal services by any means, as the Parliamentary Secretary, by an unfortunate slip of the tongue, said on the last occasion we discussed this matter——

I beg your pardon!

I regard attention of this kind as an essential element in the treatment of mental disease, and it will look badly in this House and in the country if we treat this matter in any other way than the way it deserves to be treated.

Amendment put and negatived.

Question proposed: "That Section 63 stand part of the Bill."

On the section, there is one question on which I should like an answer from the Parliamentary Secretary. He has defined, in the beginning of the section, the words "officer" and "servant". He has defined the word "officer" by confining it to a particular type of officer, and he has defined the word "servant" by confining it to a particular type of servant. There is nothing in the section to show what the broad word "officer" means or what the broad word "servant" means. This has been a very old problem in local government law, and I am under the impression that some recent Acts made an attempt to clear up what has always been a difficulty to lawyers. It is quite clear that you do not get very far with a definition of the term "officer" by saying that it means an officer of a limited type because you are still left to find out what are the characteristics of the officer as opposed to the servant. If the Parliamentary Secretary is relying on any recent legislation, I suggest that the matter might be cleared up by stating that the word "officer" has the same meaning as it has in such and such an Act, or he could adopt the expedient, which, I think, he adopted before, of saying that, in cases of doubt, the Minister may decide whether a person is an officer or a servant. That is not an expedient I favour, but it may be better than leaving it undefined, because I think that you may have a good deal of trouble in deciding who is an "officer" and who is a "servant". You may have cases coming to the courts and we do not want to make money out of arguing again a subject which gave us a lot of trouble previously.

I do not think that there is any real ground for apprehension. "Officer" and "servant" are comprehensive terms, intended to embrace all employees. Who is an "officer" and who is a "servant" does not really matter, so far as I understand. The original intention was that we would use only the term "officer". Then, we thought that a point might be made that every employee was not an "officer". In order to make sure that the terms of the Bill would apply to every employee, we put in the words "officer" and "servant". The purpose of that was to ensure that everybody employed by a mental hospital authority would be regarded either as an "officer" or a "servant". Who is an "officer" or who is a "servant" is not material.

Does the Bill draw any distinction anywhere between officers and servants?

I do not think so.

Then, the matter may not be of any importance, though I deprecate the form of drafting.

Sub-section (5) of this section makes provision to enable people not covered by the Act of 1909 to come in under this measure, subject to certain conditions. The important point is that they must pay up arrears of contributions and that is the aspect of the sub-section to which I should like to refer. It seems to me that, if a person coming in now under the Act of 1909, after ten or 15 years, is required to pay, at the rate of 3 per cent. of his wages, the whole of the arrears of contributions, a very substantial sum will be involved. So far as I can gather, it would be necessary to pay that sum at once. I suggest that the Parliamentary Secretary should make provision to enable the lump sum concerned to be paid in instalments over a period of a year or two or three years, depending on the amount involved.

The necessity for this provision arose from the fact that, under this Bill, certain types of officers and servants will become pensionable who are not pensionable under the 1909 Act. If they are to enjoy pension rights, they must pay their contributions. I think that I moved the amendment in the other House to cover this matter. It would be a hardship if contributions over a period of years were to be demanded at one particular time. Provision governing that will be found in Section 85 (1), which states:—

"Subject to the provisions of this Part of this Act, an officer or servant of a mental hospital authority shall contribute in each year for the purposes of this Part of this Act 3 per cent of his salary or wages for that year and the amount of such contribution shall from time to time be deducted from his salary or wages."

That does not say that the money must be deducted at any particular time. There will be discretion as to the spread-over which may be necessary to facilitate such person in paying contributions.

I tabled an amendment to that sub-section. I was wondering whether it will cover the payment of back money under the Act of 1909 in respect of those who were not pensionable in the past but who were, under this measure, made pensionable but entitled to come in under the 1909 Act rather than under this Bill.

Section put and agreed to.
Section 64 agreed to.
Progress reported; Committee to sit again to-morrow.
The Seanad adjourned at 9 p.m. until 3 p.m. on Thursday, April 26th, 1945.
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