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Seanad Éireann debate -
Wednesday, 22 Mar 1961

Vol. 53 No. 14

Mental Treatment Bill, 1960— Committee and Final Stages.

Section 1 agreed to.
SECTION 2.
Question proposed: "That Section 2 stand part of the Bill."

This is the section relating to the reception of a patient in a mental institution, who, at the time of reception, is a person who is presumably able to pay for some part of his maintenance and treatment, but ceases to be so capable on leaving the institution. The institution then gives notice to the mental hospital authority which ordinarily should receive and maintain that patient. I can understand a situation in which a person, who is a wage or salary earner, and who, at the date of reception, is liable to pay a certain portion towards his maintenance and who finds, after a certain lapse of time, that that source of income dries up; but I am wondering what is the position with regard to persons who own property. One frequently finds that patients who are received in mental hospitals have certain property which may not be very great and in time a very great burden rests upon that property by reason of the fact that, when the patient is made a ward of court, there is an accumulation of maintenance. I think it would be much better, from the point of view of the preservation of the patient's property, if, from the beginning, there were a proper inquiry or determination as to his capacity to pay, in whole or in part, for his maintenance. That being determined, the question of arrears would not arise again.

I wonder if the Minister can indicate whether under Section 108, as amended, the position would not be created where persons who are detained in a mental hospital, for perhaps fairly prolonged periods, may find themselves on leaving that institution, by reason of the failure of the authority properly to assess their means, burdened with the payment of a large sum out of their capital in discharge of the cost of maintenance and treatment they have received in the mental hospital. I should be glad if the Minister would indicate if any change will be made by mental hospital authorities to ensure that all discharged patients will not be faced with a big bill which could have been paid out of income from property while they were detained in hospital.

I do not think that would properly arise on the amendment.

On Section 2.

It does not arise on Section 2. That section merely proposes to amend, for the purpose of more convenient administration, the existing Section 108. The matter raised by the Senator relates to the whole principle of Section 108 and possibly with its administration. I cannot discuss a hypothetical point which may be raised here in relation to any one of these sections. I respectfully submit we are bound to confine ourselves to the net point.

Normally, chargeable patients, that is, patients broadly entitled under Section 15 to receive treatment free or at a reduced rate in a mental institution — are received into the district hospital in the area in which they reside. Only after a patient has been received into a particular district hospital does it occasionally transpire that he was not ordinarily resident in the district of that hospital. Section 108 of the 1945 Act provides for the transfer of such patient to the hospital for the district in which he ordinarily resides. The proposed amendment is designed to obviate difficulties in the application of the section. At present, persons must be chargeable patients at the time of reception in order that the section as it stands in the Principal Act may apply.

It sometimes happens that patients enter as paying patients and, by reason of a reduction in their means or income, later become chargeable patients. The subsection is intended to deal with that sort of case. I cannot possibly deal with the point raised by Senator O'Quigley and I should not be expected to, either.

We are dealing with the position of a person received in a mental hospital who, at the time of being received, is regarded as being able to pay, in whole or in part, for his treatment. Later, he is no longer able to pay. When the means of the patient are being investigated, the charge should be fixed by the mental hospital authority. On discharge, the patient should not be faced with an accumulated arrear for his maintenance. There is the danger that the whole of the patient's property will be absorbed in paying debts which the mental hospital authority should have collected week by week or month by month. That arises quite relevantly on this section.

I doubt if Senator O'Quigley has read the section.

The Minister will have good reason to learn that I have read the Bill in detail.

Section 2 reads:

The following sentence is hereby added to subsection (1) of section 108 of the Principal Act: "Where a patient in a district mental hospital or other institution maintained by a mental hospital authority, having been received therein otherwise than as a chargeable patient, becomes a chargeable patient, such authority shall, if another mental hospital authority are the mental hospital authority for the mental hospital district in which such person ordinarily resides, give notice of his having become a chargeable patient to the other mental hospital authority."

The net point is whether or not one mental hospital authority shall give notice to the other mental hospital authority in the circumstances I have detailed.

I do not like "are" after "authority". What about "is"? It is a matter of drafting.

I agree that the collective form is better but I am in the hands of the draftsman.

Question put and agreed to.
SECTION 3.
Question proposed : "That Section 3 stand part of the Bill".

The purpose of this new section is to provide that payments may be made to mental hospital patients in respect of work done by them. At present, there is no power to make such payments but, in practice, most authorities make token payments. All psychiatric authorities agree that payments should be made to patients in respect of work done by them. There has not been any provision in the Act to enable that to be done in due and proper form. I must say that, under this provision, only token incentive payments are proposed.

Might I ask the Minister whether the regulations to be made by the Minister will be laid before each House of the Oireachtas? Section 280 of the 1945 Act says:

An order or regulation made by the Minister under this Act and relating to or having effect in every mental hospital district shall be laid before each House of the Oireachtas.

This is a section which provides that the Minister may authorise the making of payments in all or one or more mental hospital districts. Am I right in saying that if the Minister makes a regulation in relation to all mental hospitals under this section, such regulation could be laid before each House of the Oireachtas? I think it might be better to have this matter clarified at this stage for this reason.

This is the kind of thing which the Statutory Instruments Committee frequently find difficulty in determining. If the Minister indicated at this stage what the position is going to be, it would ease the situation at a later stage for his own Department and for the Statutory Instruments Committee.

Section 280 of the 1945 Act says:

An order or regulation made by the Minister under this Act and relating to or having effect in every mental hospital district shall be laid before each House of the Oireachtas as soon as may be after it is made.

I have already read that out. I am asking the Minister whether he proposes to lay regulations made under Section 109A before each House of the Oireachtas?

Section 109A has to be read as part of the Act, of course.

I am merely asking the Minister whether he proposes to implement Section 109A, as inserted by Section 3 of this Bill, by laying the regulations before each House of the Oireachtas?

Under Section 3 of this Bill? Certainly.

That is all I am asking the Minister.

The Minister always obeys the law.

Question put and agreed to.
SECTION 4.
Question proposed: "That Section 4 stand part of the Bill."

This amendment is designed to remove a doubt and make it clear that the reference in Section 128 to persons of unsound mind is to be construed as including all patients in the institution, temporary and voluntary, as well as persons who are medically known as of unsound mind.

Question put and agreed to.
SECTION 5.
Question proposed: "That Section 5 stand part of the Bill."

This applies the same method of reckoning to private institutions.

Question put and agreed to.
SECTION 6.

I move amendment No. 1:

In page 4, subsection (2), line 7, before "step-father" to insert "grandfather" and in line 8 before "step-mother" to insert "grandmother".

This is a new provision whereby any visitor or medical practitioner may certify a person for the purpose of having him received into a mental institution. There are certain exceptions set out in subsection (2) of the Bill and it occurs to me that the grandfather should be inserted among the degrees of relationship of the medical practitioner in relation to the person sought to be committed. If you have a wife, husband, father, stepfather, guardian or trustee, I do not see why you should not insert grandfather. It is quite possible that the grandfather of a relative need not be very old to be a grandfather and to certify in respect of the patient. It seems to me that there are likely to be just as many cases in which the medical practitioner could be an uncle or a father-in-law. I do not understand why so close a relation as a grandfather should not be included among the disqualified medical practitioners under the section.

My answer is that the degrees of kindred which disqualify a person from certifying in a case of this sort is carried right through the 1945 Act. It was thought that it was not necessary to amend this section and about eight other sections, thus making this Bill a little more complicated by including a greater number of items of legislation by reference. We have just preserved the existing framework of the 1945 Act by not having enlarged the ambit of the disqualifications contained in it.

I do not find that a very satisfactory reason. Senator O'Quigley has made a fair case that this relationship is just as close as those already in the measure. It rather seems as if it would be too much trouble to make the change from what the Minister says. I should like a little stronger reason for leaving it out. What distinction is there in the relationship between a grandfather and a stepfather and the rest? It may mean a little more trouble but that is what we are here for. We are here to improve legislation. We should, perhaps, press on with this amendment.

I am in the hands of the Seanad in this matter. I want to point out that if the Senator will turn to the last section of the Bill, he will see that the superannuation provisions of this Bill cannot come into operation except on a first day of April. I am very anxious that it should come into operation on the first day of April next. Any amendment would mean that this Bill would have to be carried over until after Easter.

We are in sympathy with the Minister on this. None of us likes to rush legislation of this kind. This is rushed legislation and with the greatest goodwill in the world, I do not like it and I know the House does not like it.

After all, we are either a House of Parliament or we are not. I think we are a House of Parliament. We have a job and a duty to discharge here. We ought not to allow legislation which may have sections which are meaningless go through. The explanation given by the Minister is by no means a convincing one. The parliamentary draftsmen can be extremely adept at times in boxing a whole lot of different sections into one section and saying: "They are all amended in this way." When we have so much legislation by reference in this Bill, there is no objection in principle to making the amendment apply to ten different sections if that is necessary. The Minister says that there are other sections similarly involved: If there are, the only thing to do is to amend the 10 other sections.

When I first read this — and the more I read it, the more likely it seemed to me — it seemed to me that a grandfather or a grandmother, in modern times should be included in the section.

I know quite a number of relatively young grandfathers and the Minister has not given any explanation whatever, except to say that this Bill has to be in operation on 1st April. He refers to the superannuation provisions. There is nothing to my knowledge that we cannot do by legislation and I cannot see any reasons why we cannot deal with this without insisting that this Bill should always have operated from 1st of April, 1960.

But let me say that it must always be borne in mind, when legislation is being introduced under our system of parliamentary representation and our system of legislation, that ninety days should be allowed to elapse from the date on which a measure passes Dáil Éireann, to its signing by the President, with, another four to seven days within which the President may sign it. It just does not do to come into the House of Parliament established by the constitution and to say: "We have delayed in bringing in this piece of legislation and now we cannot amend it because we did not bring it in in time."

I am going to refer to a Bill which we let through before on which the Minister for Industry and Commerce agreed — and it is on record — that the section did not mean anything. "It has no meaning," he said, "but if we don't pass this, the Dáil being now in recess, a grant due to be paid in September will be held up." That is not the job this House is being paid to do — to enact legislation which has no meaning. We ought to pause and consider whether we should go very much further along that road.

If the Minister cannot give a better explanation for the failure to include grandfathers and grandmothers in sub-paragraph (b) of the new subsection (6) of Section 162, we should as a House insist and say that we will have to amend the Bill. If the Minister wants to bring in an amendment to the other section, we will give every possible assistance in doing that. Otherwise, we ought to take stock of ourselves as a house of Parliament.

Let me repeat what I said at the outset: I am in the hands of the Seanad. So far as I am concerned, the responsibility will not be on me if this section does not come into operation on the next 1st April. As I say, I am in the hands of the Seanad but I have pointed out the consequences of accepting an amendment which I regard as a trivial amendment, because the Senator has made no case whatever for it, except to say that he thinks that a grandparent is of equal kin with the person, in respect of whom a reception order has been applied for, as his mother, or has equal responsibility for him.

Let us look at this in a practical way. Of course we all know grandparents who are comparatively young, but they are not all medical practitioners, in the first instance, and if they are medical practitioners, they are not all itching to commit their sons to mental hospitals.

Grandsons.

What is the purpose of the section at all?

Because he ceases to have regard to practical realities, as the Oireachtas had when it passed the 1945 Act without the assistance of Senator O'Quigley.

Why have we this Bill so?

Because in an Act running to almost 300 sections in untried circumstances, it emerged, in practice, that there were a few minor defects which we have dealt with in this Bill. Now, Sir, I do not claim the degree of omniscience which Senator O'Quigley seems to possess, but I do think that having regard to the practical situation, having regard to the fact that these degrees of kindred are prescribed as disqualifying in the Principal Act, there is no reason, at this stage, why we should hold up the Bill for the sake of inserting these two words. I am putting it to the Seanad — as I said, I am entirely in the hands of the House — that I am not endeavouring to drive this thing through. The House can take it as it stands or make this amendment; but I will say this: when it does go back to the Dáil, I shall say that this amendment went through without due warrant and without any real argument being adduced in support of it.

From my point of view, the logic of this section is that a grandfather or grandmother are as closely involved in the welfare of their grandchildren as, say, a stepfather or stepmother and I cannot see any firm line that one can draw between these; but perhaps the Minister would give us the general principle on which these people mentioned are excluded in the subsection and a grandfather or grandmother is not excluded. Let us not think of this in terms of whether we are going to have a decision division on it or anything like that. We are genuinely trying to see if this section is the best possible. At the moment, a few new minds are being brought to bear on it. The Minister may not think very highly of some of the minds here but they are new minds and that is what Houses of Parliament are for and why we have general elections from time to time. If the Minister would give the basic principle underlying this, we will make up our minds on it but not on the basis of what will happen in the Dáil or on the first of April, an ominous date.

The section, as I read it, is a sort of safeguard to debar certain relatives of a patient from being able to commit the patient to a mental hospital if they happen to be, themselves, doctors. I think it is in the way of life we have that it is necessary that we should have that bar, that a person who might benefit by putting a patient into a mental hospital should be debarred from doing so. It seems to me, however, very unlikely that grandparents would be involved in such a situation. In the nature of things, grandparents would be fairly old by the time the grandchildren would have property of their own and would scarcely be of an age at which they would benefit financially from having a grandchild committed to a mental hospital. For that reason, I do not think there is any real necessity to put grandparents — grandfathers or grandmothers—in this section.

I have an open mind, or I had an open mind about this matter, until I heard the Minister's remarks. I do not know why a Minister should come in and say the 1945 Act was passed without the assistance of Senator O'Quigley. Acts were passed in 1908 without the assistance of the Minister!

Another remark of the Minister was "the degree of omniscience". When people use these kind of remarks, I really see red. I do not mind somebody saying that I am stupid. I may very well be stupid on occasions—but when they refer to "the degree of omniscience", then I do object strongly.

With regard to the other remarks of the Minister to the effect that this Bill should come into operation on April 1st, either we are a House of Parliament, and the Dáil is a House of Parliament, or we are nothing at all. We are just underwriters for the civil service and for their errors. We underwrote an error of the Minister and his civil servants last week and he charged out of the House without saying a word of thanks.

Let us come to this Bill.

It was a mental treatment Bill also, on the same subject, and it is very relevant to this. It is the same Minister and the same subject, and I do not see why the Minister should walk out of the House, even after his attention had been drawn to the fact that he had walked out of the Dáil without a word of thanks, though he got the Bill through there in a day. That kind of offensive behaviour is not right.

You should not have to get thanks for doing your duty.

It was not our duty.

I did not think this section would give rise to such a heated discussion. In my opinion, a heated discussion is entirely unnecessary and out of place, because this is a Bill we should deal with dispassionately. I did not like the way the mover of the amendment brandished his paper in our faces, as much as to say that he was not being given a chance of dealing with the matter as he thought he should.

You are helping!

I, too, have an open mind on many of these things, and nothing the mover of the amendment says convinces me that the Minister would be justified in accepting what is in the amendment, namely, that a grandfather or a grandmother should be included as disqualified persons. I am entirely in agreement with what Senator Murphy said, that it was very unlikely that these people would be involved at all. There are many degrees of kinship mentioned in this section, and if we go on extending them, I do not know where we will end. The Minister is right in sticking to the provisions of the 1945 Act, and we are fully justified in supporting him, unless and until there is a case made for departing from it, and no such case has been made.

I agree with the last two speakers——

On a point of order, Sir, Senator O'Quigley was up before you called on Senator Ó Ciosáin, and I think it is very unfair.

I must give all sides of the House equal opportunity. Senator O'Quigley will be entitled to speak again, and "again, if necessary.

If a man walks in, it is unfair that he should get in before a Senator already here.

Senator to you — not a man who walks in.

The Chair is ruling that Senator Carter is to speak.

I was about to refer to Senator O'Quigley's presumption that if his amendment is not accepted, the section will be bad. I call that the height of presumption. Senator O'Quigley sets himself up as a neo-draftsman in this House. He should have more regard for the fact that the 1945 Act worked reasonably well and, as Senator Ó Ciosáin has said, let us wait and see if this difficulty visualised by Senator O'Quigley will arise. I think it would be a bad thing to extend the degree of kinship because, as Senator Murphy rightly said, you could perhaps have spite and maybe spleen brought into it. You could find yourself in a difficult position arising from that fact.

It is one thing for the Minister to say that he is in the hands of the House, and it is quite another for him to say: "If you do not do what I want you to do, there are people whose superannuation rates will be affected." Whether that be so or not, the Minister had a duty to introduce this measure in sufficient time to enable it to go through all Stages in both Houses and, if necessary, go back as amended by the Seanad to the Dáil. That is his responsibility but we have a new conception of responsibility on the part of the Minister for Health. On the Mental Treatment (Detention in Approved Institutions) Bill, the Minister disclaimed all responsibility. In relation to the state of Castlebar Mental Hospital, he disclaimed all responsibility. Now in relation to this Bill not being enacted in time, he disclaims responsibility, too. When does the Minister's responsibility begin or what is his conception of responsibility? I do not want to press this point any further.

I want to make another remark with regard to what the Minister said about the assistance I have endeavoured to give in the passage of this Bill — that there are many amendments made to Bills in this House as a result of amendments put down by me, and that is a fact, whether the Minister likes it or not. I was not around in 1945 when this other Bill was brought in, but the fact that the Oireachtas at that time thought the position was all right is no reason why we should not raise these matters now, and we ought to be entitled to receive the same courtesy as we extend to the Minister when he introduces a whole series of amendments to existing legislation.

Senator Murphy has given an excellent exposition of one reason sufficient to satisfy me as to why a grandparent ought not to be included in this section. If the Minister had had the grasp of the principle which Senator Stanford asked him to enunciate and which Senator Murphy so ably and lucidly expounded, we would not have been delayed all this time. I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.
Section 6 agreed to.
Sections 7 and 8 agreed to.
SECTION 9.

I move amendment No. 2:—

In subsection (1), line 3, to delete "for the purposes of this section" and substitute "in any case of urgency or emergency".

The Minister, on the Second Stage, indicated that this amendment was being made to the 1945 Act in order to clarify beyond doubt that a member of the Garda Síochána might properly enter upon premises to apprehend a person believed to be in such premises and also believed to be of unsound mind. It strikes me that the power or authority now being given to a member of the Garda Síochána is unduly wide. A person might be resident in the premises, or detained in premises, over quite a long period and be of unsound mind, but the fact that that person was there might not come to the notice of the Garda for months or weeks. It appears to me that it is only where the person is liable to do damage to himself or to life and limb or to property, that the Garda Síochána should be entitled to enter upon the premises to apprehend that person. For that reason, I propose that the power of a member of the Garda Síochána to enter upon premises to apprehend a person believed to be of unsound mind, and believed to be therein, should be limited to cases of urgency or emergency.

The Senator perhaps has not referred to the booklet which I made available to Senators. If he did, he would find on page 35 the section to which this is an amendment.

I have a copy of the 1945 Act.

And there he would see that subsection (1), Section 165, which the section now under discussion proposes to amend, reads:

Where a member of the Garda Síochána is of opinion that it is necessary that a person believed to be of unsound mind should, for the public safety or the safety of the person himself, be placed forthwith under care and control...

Surely it is quite clear that the principle of urgency and emergency is already written into the section and that therefore the Senator's amendment is redundant.

The Minister refers me to a publication which he has been kind enough to circulate. I have a copy of the 1945 Act. I prefer to have the original because there is many a slip that the printers make apparently, which is not detected by those who read proofs on behalf of the Minister. What is contained in subsection (1) applies to a kind of situation that could persist for weeks or months. There may be maintained over a period of months, or living in a dwelling for a period of months, a person who, in his own interests and the interest of the public, should be lodged in a mental institution. We know how lax and slow people are to take the unpleasant step of committing some relation to a mental hospital. That kind of situation can go on for months. I do not think we ought to invest a member of the Garda with power to go in in a case like that and arrest a person or take a person into custody.

He cannot.

If somebody goes berserk and he goes into a particular dwelling, certainly a member of the Garda, in the interests of the person himself, and the public safety, would be entitled to apprehend that person and remove him to the Garda station and follow the other procedures; but I do not think we should allow that in any circumstances other than a case of urgency or emergency where a person goes berserk. Of course, I know that nothing we have to say on this will convince the Minister.

What would the Senator deem to be the offence for which he would allow the Guard in?

Is the amendment withdrawn?

If it is withdrawn, I have nothing more to say.

If the Minister wishes to say anything——

I do not know whether Senator O'Quigley left the Seanad under the same impression as he left me in his opening remarks when, having referred to this publication, this White Paper, he said that he preferred to take the Act itself, the printed text of the Act itself, and suggested that in some way that what I read was not an accurate quotation——

——from the section. He made a reference to slipshod proof-reading, the misuse of commas, all designed, I think, to give the impression — at least, I withdraw the remark "I think"— all of which might give the impression that in one way or another the text quoted in the White Paper was inaccurate and that my remarks were misleading.

The Minister is imagining things.

Here is the Senator's bible:

Where a member of the Garda Síochána is of opinion that it is necessary that a person believed to be of unsound mind should, for the public safety or the safety of the person himself, be placed forthwith under care and control...

Those are the words I read out.

In order to relieve the Minister of any apprehension he may have, I merely expressed a preference for reading from an Act of Parliament rather than from a reproduction of it. When amending some Act——

Why refer to proof-reading?

Because there is no doubt that is the law — what is contained in this document, printed by the Stationery Office. What the Minister has is not the law, prima facie. There is no doubt that this is the authoritative version of the law and when we are amending a particular Act, I prefer to read from this rather than from a reproduction.

Why the insinuation then regarding proof-reading?

We will come to that, because we can see the kind of error that can creep into a public document.

I think the education of the Senator should go a little further. Everybody who is familiar with it knows that that is the first white print of the Bill and this is the standard version now on sale and published by the Stationery Office. That is what I am holding in my hand. I do not think the text in any way differs from that of the publication which the Senator has.

I beg the Minister's pardon. He said he was quoting from page 35 of the new publication circulated. That is what I am talking about.

One moment. The Senator has brandished his paper again.

There are two of you in it.

May I remind the Senator of what I said when I opened my comment upon Senator O'Quigley's speech in support of his amendment. I said I feared the Senator had not read this publication which I had circulated and if he had read it, I said he would find there, on page 35, subsection (1) of Section 165, quoted, and then the Senator made the speech, the whole innuendo of which was that in some way or another this was misleading.

The Minister read out of the 1945 Act a section which starts off "Where a member of the Garda Síochána is of opinion..." This afternoon, no member of the Seanad is entitled to have an opinion or entitled to be here unless he is about 70 years of age. I should not care to be a young man of 22 and to come into this Seanad with the Minister in charge of a Bill. Remarks to the effect that "the education of the Senator might be further advanced" are surely uncalled for. Senator O'Quigley said he would prefer to go to the text of the Act. He is entitled to make that remark, regardless of whether it is proof-reading or misprints or a fall-out of type or a chance word or any one of the many accidents that can occur with documents. The Minister did not do his case any good by pretending he quoted, in the first instance, from the Act when in fact he referred the Senator to the booklet.

Amendment, by leave, withdrawn.
Section 9 agreed to.
Sections 10 to 17, inclusive, agreed to.
SECTION 18

Perhaps amendments Nos. 3 and 4 could be discussed together?

Yes. Amendment No. 4 is consequential. I move amendment No. 3:

In page 8, between lines 53 and 54, to insert:

"(III) give a like notice to each member of the Mental Hospital Authority,".

I read what the Minister said in reply to remarks I made on the Second Stage. He suggested he might possibly be able to deal with the matter by the way of regulation. At Column 1164 of the Official Report of Seanad Éireann, Volume 53, the Minister is reported as saying:

...I should like to draw the Senator's attention to the fact that it is not just as simple a matter as it might appear to the ordinary individual, because, under Section 225 of the existing Mental Treatment Act of 1945, the resident medical superintendent of a district mental hospital is required to make available from time to time to the mental hospital authority case books showing the mental condition of persons detained in the hospital.

I do not want particulars of the mental condition of the patient. I want a list of patients who have been detained for a further period of six months or three months, or whatever the period may be, to be available to the members of the mental hospital authority.

Most members of mental hospital authorities take their work very seriously. They take a great interest in the patients. It is to the members of the authority that the family of the patient turns for information in the first instance. A person might ask me, as a member of a board, something about a patient and I should have to plead complete ignorance. I do not know what has happened the patient and I am not allowed to know. It would be reasonable to get a list of these people. It would be a further safeguard against improper detention in a mental hospital and the more safeguards there are in that respect, the better.

In the original Act a large number of duties are assigned to mental hospital authorities.

On paper, it is they who give power to transfer a patient either for treatment in another institution or because the R.M.S. might advise that removal to another institution might be beneficial to the patient. The relatives should be entitled to know what is happening and therefore lists of people detained for a further period should be supplied to members. They spend a great deal of time on this work. They take a great interest in the patients and visit them regularly. Hardly a patient is admitted into such hospital that some member of the hospital authority does not know some relative of his.

I would ask the Senator not to press the amendment. Perhaps we are a little at cross-purposes. The proposal in Section 18 to which the amendment is put down is that where a reception order in respect of a temporary patient is endorsed by the chief medical officer, thereby authorising the detention of that temporary patient for a further period of six months, up to a maximum of two years in all, the medical officer must give notice to the person to whom the order relates — the patient himself — stating the particulars of the endorsement and informing him that, if he so desires, he may send to the Inspector of Mental Hospitals an objection to the extension of his period of detention. It is also provided that the person who originally asked for the reception order will be informed.

It is quite clear that these two persons have an immediate personal interest. I think it would not be right, if the medical officer decides that for the patient's benefit he had to be detained for a further period of six months, he should inform every member of the mental hospital authority. Surely, the patient's condition, particularly the condition of a temporary patient, is an intimate confidential matter between the patient and his medical adviser or between the patient's near friend, that is, the applicant, and the doctor who is treating him?

I do not think we could justify obliging the person who is treating a mentally ill individual to bring to the knowledge of other people who are not intimately concerned with the patient, nor related to him, the fact that the patient has not recovered and must be detained for a further period of six months. The vast majority of people are very sensitive on a point of this kind. I think most of them would resent very much the idea that if their relative had to be detained for a further six months some of their neighbours would be informed or some people, perhaps people they would not like to know. It would cause them great embarrassment if they knew. Many of the people concerned might perhaps be strangers. I would appeal to the Senator not to press this amendment.

I originally suggested this as a further safeguard against any wrong being done to a patient in a mental hospital. The Minister suggests that it would be wrong for people who are not concerned with the patient to know his condition but it is the duty of the board to know the position. We are entitled, as a mental hospital authority, to see everyone of the patients in a mental hospital and I feel it is very reasonable to suggest that we should be informed as much as possible of what goes on in the hospital.

On a previous occasion, the Minister made certain disparaging remarks about some local authorities. I feel that, perhaps, he does not know some of the local authorities as well as he should because any I have seen working — they are very few, I admit — take their job very seriously. It is to them that the relatives of these patients come, in the first instance. In fact, quite often their only information about a patient is gained through members of the mental hospital authority. Many of them experience difficulty in regard to travelling expenses. They find great difficulty to arrange to travel on public transport to get to see their relatives. Very often, the only connection they have with the patient is through the members of the mental hospital authority. I think it takes away from the dignity of the members that they do not know — and the Minister does not wish them to know — whether a patient who is a relative of one of their constituents is detained for a further period of six months and that they cannot be informed as well as the applicant who may not have an interest in the patient.

Amendment, by leave, withdrawn.
Amendment No. 4 not moved.
Section 18 agreed to.
Section 19 to 21, inclusive, agreed to.
SECTION 22.
Question proposed: "That Section 22 stand part of the Bill."

I take it that this includes an institution which may not be a district mental hospital.

Suppose a difficult case arose in an emergency and that the R.M.S. was absent, it seems to me that under Section 22 and part of Section 23, it might be a very junior official who was in charge at that moment of the mental hospital.

No. The person who has the responsibility is the person officially in charge.

I take it that is what it means but, in actual fact, it could be read the other way. If an emergency arose where a person was absent and had to be re-taken in an emergency, it might be a very delicate situation for a very junior doctor who, perhaps, that day would be in charge of a mental institution. He would have to take responsibility.

Is this on subsection (3)? There is no difficulty about subsection (1) where it is quite clear that it is the R.M.S. Twenty-eight days are given in the subsection where a person may be absent on trial. I think we may take it that those in charge of institutions are responsible and, having regard to the fact that a patient has been placed in their care, in the first place, for his safety and treatment, that they would not allow him easily to go, if there was any doubt as to whether he could be allowed out on trial, with safety to himself and other members of the community.

I agree to a great extent with the Minister. I refer to Section 23, which adds to Section 204 of the Principal Act, the subsection relating to permission to be absent given by the person in charge of the institution. It sets out:

The following subsection is hereby added to section 204 of the Principal Act:

(4) Where a person is absent on parole under this section from an institution, his permission to be absent may be withdrawn, at any time before the expiration of the period during which he is permitted to be absent, by the person in charge of the institution, and, if the permission is so withdrawn, the person absent on parole may, at any time, within twenty-eight days after the withdrawal be re-taken in like manner as if he had escaped from such institution.

These are the words which are important: "In like manner as if he had escaped from such institution." To my mind, it might be very important for the patient's well-being that he be re-taken in some other manner rather than if he escaped. I am thinking of the effect on a patient if a junior official were in charge and he simply rang the Guards, or something like that, and said: "Bring in so and so."

Section 23 does not authorise a particular person. It merely provides that if a parole is given, that parole can be withdrawn. It does not go beyond that and therefore the question of the particular official involved does not enter into it.

In relation to private mental institutions, of course, the person in charge is the person for the time being managing the institution. He may not necessarily be a doctor but he will have to act on the advice of a medical practitioner who will have to sign.

Question put and agreed to.
Section 23 agreed to.
SECTION 24.
Question proposed: "That Section 24 stand part of the Bill."

This perhaps may cover to some extent the point made on Section 18 because it provides that bona fide applicants may be given information as to the detention of a patient in a mental hospital. The information will relate to his detention; it will not give a right to information in relation to his condition. But if a member of a mental hospital authority were to seek from the manager information as to whether such and such a person was detained, he would, assuming that the member had good reason for asking, let him know.

Question put and agreed to.
Sections 25 to 32, inclusive, agreed to.
SECTION 33.

I move amendment No. 5:

To add to the end of the section the following paragraph:

"( ) furnish a copy of the report of each such visit or inspection to every member of the local administrative authority where the visit or inspection concerns a mental hospital maintained by such authority."

This is the section which invests the Inspector of Mental Hospitals with powers somewhat similar to those which he had under Section 37 of the 1945 Act. The Minister has indicated that, so far as one mental institution in this country is concerned, he was not responsible for the state of dilapidation and dereliction into which that institution has fallen. I do not fully accept that to be so. I think the Minister is responsible to Parliament, and to this House perhaps, for the operation and functioning of the Inspector of Mental Hospitals and if the Inspector of Mental Hospitals, in a particular case, fails to report upon the condition of a building, the manner in which the institution is run, the condition in which the patients are kept and so forth, then I think the Minister must accept responsibility for these things not having been done properly.

However, if the Minister does take the view that he is not wholly responsible for the condition in which mental hospitals are maintained and managed, then I think that, once we have mental hospital authorities in existence, we ought to supply them with the information which will enable them effectively to discharge their role and function as mental hospital authorities.

The purpose of this amendment is to provide that in addition to the Inspector of Mental Hospitals furnishing the Minister with details in his report of each visit of inspection, he shall furnish it to the members of the mental hospital authority concerned with the institution. I do not for a moment say that the particular wording of the amendment I have put down is as precise as might be necessary, but, as I said before, when I came to the House first, I paid particular attention to the drafting of amendments but very quickly realised that this was not necessarily a function of members of Parliament, that all that was necessary was the incorporation of a principle. That is all that is being indicated in this amendment.

I know that the Minister for Health has no great view and no high opinion of members of local authorities. He gave expression to that in the debate on the Health (Fluoridation of Water Supplies) Bill. He showed that he had nothing but the height of contempt for the deliberations of these local authorities. That may be the Minister's view but it is not the view of the vast majority of the members of this House who are members of local authorities, nor is it the view of the public at large. There is no doubt in my mind that the situation is frequently reached, both in relation to Government Departments and local authority departments, in which the private person, the citizen, can get no information that is satisfactory and the function of officials in many local authorities is conceived by them to be to give as little information as possible to people who are unquestionably entitled to it. Hence it is that people like Senator Cole and others on local authorities form an invaluable link between persons detained in institutions, whether medical institutions, surgical hospitals or mental hospitals, and relatives outside.

Therefore, it is right and proper that in the interests of the persons detained in mental institutions, members of the mental health authorities should be given as much information as the Minister for Health sitting up in the Custom House, far removed from the realities of the situation, gets from the Inspector of Mental Hospitals. It seems to me to be an eminently sensible thing that the people on the spot who have immediate personal concern in the particular institution which they are charged to administer should be given the fullest possible information to be derived from the inspections and visits of the Inspector of Mental Hospitals. Consequently, I strongly commend that this section be incorporated to provide that the reports of the inspector will be made available to the members of the mental hospital authorities.

In doing that, no queer, strange or weird new principle is being established. It is doing in relation to local authorities what the Minister does in relation to Parliament. The Minister is constantly answering questions in Parliament in relation to the functioning of his Department, and is constantly presenting to Parliament reports of every kind. There does not seem to me to be any reason why a similar facility should not be given on a local level to the members of local authorities. I would urge the Minister to give serious consideration to the acceptance of this amendment.

This proposal is unnecessary. As any person who has any knowledge of the matter is aware, and as Senator Cole has told us, the members of every mental hospital committee make frequent inspections of the buildings and therefore there is nothing about the building and structure that they cannot see with their own eyes. All the mental hospital authorities in the country are well aware of the defects in the existing institutions, and their difficulty has been to find the cash to cure them. That has been the great drawback.

The fact that the report of the Inspector of Mental Hospitals would be made available, as it is presented to the Minister, to the members of the mental health authority, would not remedy that situation. The only thing that can in any way improve the existing condition of these institutions is money, and if I may make bold to say so in front of Senator O'Quigley, I am the first Minister for Health for many years who has indicated that I am prepared to provide for the expenditure of up to one million pounds for the improvement of these mental institutions; and, as I mentioned when this Bill was being debated on Second Reading in the Seanad, it was at my insistence that the report from which Senator O'Quigley quoted at length was prepared.

It was as a result of a report made to me by the Inspector of Mental Hospitals in November, 1959, that I urged and ultimately persuaded the authority of the mental hospital concerned to appoint an architect to make a report upon the condition of the building. That was done at my urgent insistence, and, as I have said, the responsibility for the condition of that institution does not rest on me as the present Minister for Health, on whomsoever else that responsibility may be laid.

That, however, is not the point. The point is whether it is necessary, in the first instance, that the report of the Inspector of Mental Hospitals made as a result of his visit should be submitted in full to each member of a mental hospital authority. That is what Senator O'Quigley's amendment proposes. That report is a very comprehensive one and in many instances deals with the condition of certain patients. It would be a breach of medical secrecy to submit details of the condition of certain patients, and make them available quite unnecessarily, to members of the mental hospital authority. What is done is that the reports are carefully considered in the Department by the Inspector in the first instance, then by those who are concerned with the maintenance of the fabric of the institutions and so on, and eventually a letter setting out all the matters which, in the Minister's view, require attention on the part of the mental health authority is issued to the mental hospital authority without any reference to particular patients or certain conditions.

That is the right way to deal with it. It may happen that sometimes these communications from the Department may not be read or made available to all the members of the hospital authority, but if there is any member who does not get them, he has an easy remedy, because he can require the Manager to produce these communications. I suggest that there is no need for this amendment, and that we should not impose on the Minister or any officer of his Department an obligation which is unnecessary and which, in the circumstances as I have detailed them, would serve no useful purpose.

We all know that there are visiting committees of mental hospitals. I take it that they go to visit the hospitals on certain dates that are prescribed. The Inspector of Mental Hospitals can go in at any hour of the day or night he likes to inspect a mental hospital, and he may find quite a different state of affairs when he exercises his discretion and authority to go in at any time from what the members of the visiting committee may find on their set dates. In any event, the Minister concedes that the most the visiting committee can know about is the physical state of the buildings, but there are other things the Inspector of Mental Hospitals has to be concerned with. One is the condition of patients, and whether patients have been detained and whether their detention has been extended since the previous visit. The Minister then says that we should not furnish details of that kind to the members of the local authorities because that would be a breach of medical secrecy. I entirely agree with the Minister, but there are a whole lot of other useful things contained in the report of the Inspector of Mental Hospitals that would form valuable material and information for the members of mental hospital authorities. The Minister says that the only real cure for the condition of mental hospitals to-day is the provision of money, and I am glad to see to-day that the £500,000 which he undertook to supply the last day has gone up now to £1,000,000.

It is all to the good that the Minister is providing that money but the Minister should be quite well aware that money is not everything when it comes to running an institution. The best meat and the best food can be bought with the money provided by the local authorities. That is not to say that the food will be served up palatably and properly to the patients. You may have lots of money and still have bad service and a bad return for it. I would like the members of the visiting committee to know, at the various times when the hospital is visited and inspected, the dietary of the patients so that they would be able to tell the mental hospital committee that the food was well, badly or indifferently cooked, that there was too much monotony or sameness about the diet. That is a valuable kind of information which involves no disclosure of medical secrets of any kind. Will the Minister tell us what is the objection to giving that information to a visiting committee?

There are other matters on which the Inspector of Mental Hospitals can report: whether the accommodation is suitable and adequate; whether the care and treatment provided for the patients is adequate; whether or not the facilities provided for occupational therapy are adequate and so on. I suggest to the Minister that if a good deal more information of that kind were available to members of local authorities, and indeed to the public, mental hospitals would not be the dreadful places they appear to be to members of the public at present and this would be all part of the useful propaganda and information which could be disseminated about mental hospitals.

It is perfectly clear that all the Minister wants is to have the semblance of local administration and to deprive the local administration of any substance and effectively to keep from the mental hospital authorities the real information that would assist them in the discharge of their duties as authorities. He has given no reason, except that in regard to medical secrecy, which we all concede should be maintained, as to why this would not prove most valuable in the running of mental hospitals.

That last statement of Senator O'Quigley is quite in keeping with his very adroit attempt to convey the impression that the Minister a few minutes ago was reading from a document which had not been properly proof-read. I think the Senator is completely out in space orbiting around and getting lost in his own verbosity. There is no attempt by the Minister or anybody else to deny local representatives any information to which they are duly and properly entitled. As I said on the Second Stage, there is no reason in the world why the mental hospital committees themselves could not undertake quite an amount of the work which Senator O'Quigley suggests should be done by the Minister and by the Inspector of Mental Hospitals.

When I was much younger than I am now and was as curious about everything as I am glad to see Senator O'Quigley is——

I am glad there is some virtue which we share.

——I was a member of a visiting committee for some years. I do not think members of mental hospital committees have changed in their outlook to a very great extent since I was on that committee. I can assure the Senator that we did not wait on any report from any inspector or Minister and we did not confine ourselves to the set days on which one may visit a mental hospital, according to Senator O'Quigley. We went to the hospital any time we felt like going to find out what was going on. That I conceive to be the duty of any member of a visiting committee. We were not satisfied with anything we were given on a plate by the resident medical officer or anybody else. We went around looking at the dining-rooms, the meals, the diet charts; we interviewed the nursing staff, and inspected the building, and did our best to make certain that nothing was going on within that building which was not in accordance with fair play and in the best interests of the patients in our charge.

I cannot for the life of me see why Senator O'Quigley should have to rely, to the extent to which he apparently does, on reports of other people when there are committees whose duty it is to ensure, for instance, that the accommodation provided in the institution is adequate and suitable. Surely hospital committees should be aware of the type of accommodation provided and whether there is overcrowding. These committees are on the spot and are composed of commonsense men and women who can go around and see any defects which may have arisen. Surely they have sufficient interest in the ratepayers' money, about which we hear so much talk, and the national finances, to insist that action is taken to correct any defects they may see. I feel that too much of this mentality is growing up, this attitude of "passing the buck" and getting somebody else to do a job which the committees are quite capable of doing themselves.

I have listened to this debate without intervening up to now. I am a member of a local authority but not of a local hospital committee, although virtually I was one because I drove my father to the meetings of one such committee for ten years and I went around with him. Senator O'Quigley has made a very valid case for the giving of certain information to members of mental hospital committees and even the entire authority, county council or whatever body is in charge of a mental hospital.

I can see the Minister's point about medical secrecy quite clearly. Of course, he is right about that, but in regard to diets, conditions and everything else, as Senator O'Quigley said, it is quite right that the information contained in the Inspector's report should be given, if not to the entire local authority, certainly to the members of the mental hospital visiting committee. That information might well be a spur to the local authorities to do more about their mental hospitals. That could be a good thing because on the day of the estimates we cut down the rates — that goes without saying — but if we do, we might have more regard for the needs of our mental hospitals if in fact we had before us the Inspector's report giving us the position in regard to certain services provided in the hospitals and could compare them with other hospitals.

In my local authority, we have had a change of R.M.S. We had two excellent men; the man who retired was an excellent man and the man who succeeded him was an excellent man. He is reckoned one of the best R.M.S. in the country. The difference in the approach of the two men was such that we on the local authority had to realign our thinking on St. Brigid's Hospital. Doctors differ and patients die. He started outdoor clinics and other things which were not done by the previous man and yet, in his way, the previous man was excellent.

If the Inspector would draw attention even in a general way to what might be going on in various mental hospitals, he would prove a valuable asset to the local authority. It would tend to raise the standard of service and of medicine in the different mental hospitals.

A valid case was made by Senator O'Quigley, with the one reservation that medical secrecy should not be infringed. The Minister might reconsider the position.

I have been a member of a mental hospital committee for about 33 years. We are entitled to interview all of the patients and not on any one particular day. They may visit the male side on one day and the female side on another day. Every question asked is answered by the doctor. The report of the visiting committee goes back to the county council. Is every member of the local authority not fully conversant, therefore, with what really happens.?

We were very fortunate in Clare. We proceeded to remedy the position in Ennis where there was grave congestion. Thanks to the generosity of the Minister, to grants from the Hospitals Trust, and so on, we have excellent accommodation there now. If other local authorities have failed to keep up with the times, they can blame themselves and not the Minister.

Senator O'Quigley spoke of the withholding of information. I fail to see where any information is withheld. I agree with what he said about diet. That can be remedied. There was always plenty of food in the mental hospitals. Perhaps there may be a defect in the cooking. We appointed a dietician in Ennis years ago. That was very satisfactory. We followed it up with an appointment in the county hospital. The diet is varied twice or three times a week. Without exaggeration, the diet served to the patients can compare more than favourably with the diet available in farmers' houses in County Clare.

Everything is done to further mental treatment. There are all kinds of amusements. Pictures are shown twice weekly by the assistant mechanic. There are concerts and visits. All patients are visited by the mental hospital committee. The report comes up for review at the following meeting of the county council.

I am in agreement that there must be absolute secrecy. Painting and brightening up the hospital can be undertaken in sections over a period of years. This subject should not be a political plaything. We should have a deep reverence for it. It is the duty of every person to do everything possible to improve the position.

Because we moved with the times, we now have no congestion in Ennis Mental Hospital. We even have a beautiful new church there, situated in its own grounds, for the patients. I remember when the church was in an old attic. Local committees can do much to improve the conditions and amenities in mental hospitals.

This is not a political game. Everybody's effort here is directed towards helping in every way possible. A fair and valid case was made that, with medical secrecy not being infringed upon, the reports of the Inspector of Mental Hospitals should be available to the members of the visiting committee or to all members of the local authority. There is nothing wrong with that suggestion and there is nothing political about it. The fact that people make these suggestions is good. On the opposite side of the House, everybody is muzzled.

That is a lie.

Only those who speak in accordance with the view of the Minister will stay in the sun. Anybody who makes any other contribution will be sent into the shade.

That is a most unworthy statement.

The reports of the visiting committee of the mental hospital in my county are always the same. Month after month, at the county council meeting the report is that the visiting committee visited St. Brigid's Hospital, Ardee, on a certain day and found the wards, the dayrooms, and so on, in order. This report is so identical month after month that it is now the subject of fun and witticism on the part of members of the county council who are not members of the mental hospital visiting committee. I feel that those men who are doing a good job could be helped if they had further information as to the views of the Inspector of Mental Hospitals and what changes he would like. I am quite certain that those reports of the Inspector of Mental Hospitals would in almost every case be merely a substantiation of the views of the R.M.S., when he comes on estimates day to seek further amenities and further facilities for his patients. There is nothing political about that; there is nothing wrong about that; and there is nothing unworthy about that.

My contribution was merely the result of listening to the debate. I had not, in fact, intended to contribute at all. I felt that the Bill in general was a good step forward. I did not feel I had any amendment to make. Having heard the debate, I feel, from whatever experience I have, that the amendment is a good one so long as the question of individual medical secrecy is not infringed. I take exception to anybody being called a playactor. There is no such person on any side of the House.

Nobody made that statement but the Senator himself.

Senator Brady has given us a long disquisition on the activities——

Thirty-three years' experience.

And not in a nursery, either.

Senator Brady has given us a long disquisition on his experience of visiting mental hospitals in Co. Clare.

Every month.

That is very helpful.

It was intended to be for inexperienced men like the Senator.

Exactly.

I think that everybody can only do the best he can.

When I came into the House to-day, the Senator said I was absent last Wednesday. I was sick. I thought his remark was most uncalled for.

It is a sad day when we cannot make a pleasant social remark to a Senator——

Is it in order to have this back-chat across the floor of the House?

An Leas-Chathaoirleach

I think it would be advisable if Senator O'Quigley started to speak on the amendment.

That is what happens when you have interruptions.

The Senator is highly controversial.

I want to refer to Section 96 of the Mental Treatment Act, 1945. That Act has been in operation for only 16 years. If Senator Brady and others will refer to Section 96, they will see the number of things you are entitled to inquire into is much smaller and a great deal less extensive than the number of things which the Inspector of Mental Hospitals is entitled, was entitled and will be entitled, under this new Section, to inquire into. Consequently, if the report of the Inspector of Mental Hospitals is available, then the members of the mental hospital authorities will have a great deal more information than they are entitled to look for at the present time. That is the first point.

The second point is that the Inspector of Mental Hospitals, as I understand it, is a qualified medical practitioner. I am certain that, however experienced you may be and if you had all the experience in the world, you will not be able to say whether or not the care and treatment provided for the patients is adequate, if you are a member of a mental hospital visiting committee because you will not know, as you have not got the capacity to know, whether the treatment and care provided are adequate. That is another of the things that can be obtained by a perusal of the report of the Inspector of Mental Hospitals. There are other things that it would take too long to enumerate.

These are the things I suggest which should be made available to the visiting committee. I have yet to learn any reason for withholding that kind of information from the members of a mental hospital authority. Is there any reason why the report of the Inspector of Mental Hospitals in relation to a mental hospital which says the treatment of this type of patient is obsolete, that such and such equipment ought to be installed and such a course of treatment provided should not be made available? Is there any reason why that information should not be made available via the Inspector of Mental Hospitals to the members of the mental hospital committee? I do not see any reason.

The Minister in the Dáil and in this House invited the assistance of both Houses in improving this Bill and making it a better Bill. I firmly believe and I am convinced that the dissemination of more and more information of that kind, the awakening of consciousness, first of all, among public representatives and, thereafter, among the public at large, is one of the ways of advancing early mental treatment in this country.

I believe, having grown up in the country, that there is no paper read so much and as widely as the local paper which gives an account of meetings of county councils, county committees of agriculture, mental hospital committees and so on. The papers remain in the house for the whole week, whether it is winter or summer. Between showers of rain the farmers are looking out, as they frequently have to do, at their crops being destroyed and their tillage delayed, but they always read a few columns of the local paper. It is the local paper and not the Sunday Press, the Independent or the Times.

Will the Senator tell us what papers he reads?

I am not telling anybody what papers to read. I am reciting some of the facts as I know them. I am going to do that, no matter what interruptions Senator Brady or Senator Carter may make.

Indoctrinated.

On the Senator's side of the House.

That is my belief. That is where you get these reports. Reports of this kind are the most effective way of bringing home to the people the less certain aspects of mental treatment which people should be in possession of. Members of local authorities do not want to increase rates to a higher degree than the public will tolerate. The public will not tolerate high rates, unless there is good reason for them, but if they know that an increase in rates is wanted by the particular conditions in mental hospitals, then the members of the local authorities will be less reluctant to increase the rates than they would be if they felt there would be a public outcry against the increase.

I do not expect that at this stage, having regard to the strong support the Minister has got from that side of the House, I can persuade the Minister as to the wisdom of accepting the amendment.

A Senator

Educate him.

That calls for a comment which I will not make.

Indeed, it does.

An Leas-Chathaoirleach

Order!

It is an entirely unwarranted reflection upon the capacity and mental development of the Minister for Health. I do not think I will persuade him — this is directed to the Minister's will rather than to his intellectual development — to accept this amendment. I believe it is a good one and has been adequately heard. Perhaps, at some future date another Minister for Health may take a different view.

In order that members of the Seanad may not be under any misapprehension as to the powers of the visiting committee, I want to refer to some of the remarks made by Senator O'Quigley. He has been at pains, on several occasions, this afternoon, to stress that he had available the Principal Act of 1945 and that he had read it with care. He must not have a very retentive memory if he read it with care, not even in relation to Section 96, because he must have overlooked subsection (6) of that section, when he opened in support of his amendment. He endeavoured to create the impression that the visiting committee could visit a mental hospital only on appointed days at appointed times. But subsection (6) says that the visiting committee of a district mental hospital either acting collectively or by any two or more members shall be entitled at all times to visit the district mental hospital. So that there is no question of just limiting the right of entry. They may enter at any time, day or night, to visit and inspect a district mental hospital.

Provided notice is given.

The Senator also endeavoured to convey the impression to the House that the powers of a visiting committee were limited by subsection (3) of Section 96. He advised Senator Brady to read that section and said he would see that whatever authority a visiting committee had to investigate and inquire, it was strictly limited, he suggested, by paragraphs (a), (b), (c) and (d) of that subsection. Now, I am sure that in the Senator's careful study of the Act of 1945, about which he has spoken to us on several occasions this evening, he did not overlook subsection (7) which empowers the Minister — at that time, the Minister for Local Government and Public Health — to make rules for and prescribe the duties of visiting committees of district mental hospitals. Here are the rules made in 1946 and here are the duties. I had better read them at length so that there may be no person who feels that this amendment should not be accepted, who will be under any misapprehension or will feel that he is, in any way, limiting the power of a visiting committee, to bring to the notice of the mental hospital authority constituting it, any defect or any deficiency which may exist in the institutions under its care.

Here are the Rules as prescribed for the visiting committee:

The following Rules shall apply to the visiting committee of a district mental hospital or other institution maintained by a mental hospital authority and to the visiting committees of an auxiliary mental hospital:

(a) The visiting committee or any two or more members thereof shall inspect the hospital or institution at least once in each month.

It is obligatory on them to make that inspection. The committee collectively or two or more members nominated by them may visit it at all times, but they are bound to visit the institution at least once a month.

(b) On the occasion of each visit of inspection to a hospital or an institution the visiting members of a visiting committee shall be accompanied on their visit by the chief medical officer of the institution or by an assistant medical officer acting on his behalf;

for the purpose of answering any questions or answering any inquiries they may put to him as to the care and treatment of patients.

(c) on the occasion of each visit of inspection the visiting members of a visiting committee shall do the following things, that is to say:—

(i) inspect the premises including the buildings, out-offices, yards and farm buildings;

I do not think that their inspection could be more comprehensive than that.

(ii) inquire into the need for repairs to the buildings;

(iii) inspect the different wards and apartments and see whether cleanliness is observed therein;

(iv) inspect the furnishing of the different apartments in the buildings and inquire as to the state of repair of the furniture;

(v) examine the heating, ventilation, lighting, sanitation and water supply of the buildings and see whether any repairs or improvements are required;

(vi) inquire into the health and general condition of the patients;

(vii) make inquiries as regards the dietary of the patients;

(viii) make inquiries into and examine the occupations pursued by the patients and see whether any improvements can be suggested;

(ix) afford patients an opportunity of seeing them and making complaints if they desire to do so;

(x) inspect the work on the farms and in the gardens and ascertain whether any improvements can be effected;

(xi) enter in the visitors' book any remarks which they think proper in regard to the condition and management of the hospital or institution and the patients therein;

(d) within one week after a visit by the visiting members of a visiting committee to a hospital or institution the committee shall submit a report on the visit to the mental hospital authority.

Could there be any more comprehensive inspection of an institution than that? Could the Inspector of Mental Hospitals make any more comprehensive inspection?

Wait now. Who says "Yes".

This is the Senator who proclaimed he had never been on a visiting committee of a mental hospital. That is one of the statements the Senator made—a Senator who has never visited, as a member of a committee entitled to make these inquiries, a mental hospital in his life.

Mind you, he did.

Though he did say this—and it is an indication of a rather queer psychological state—that he had driven his father——

Yes, for 15 years.

To the gate of the mental hospital.

He said: "and had gone around with him".

I did not hear him say "around". If he did, it creates another rather curious situation to be explained away. I do not think he did say it.

All right; I will say it now.

Let us have no heeltaps now. The Senator having proclaimed that he had not been inside a mental institution as a member of a visiting committee, now feels that these inspections are not quite worthwhile, because he said when the visiting committee make its report to the members of his local authority—I am not doubting the Senator's word in relation to his own local authority but I do not think it would apply to any other County Council—the members of Louth County Council proceeded to make fun of the reports, to jibe and jeer at the reports made by the visiting committee.

In fact, the Senator said that it was becoming a source of fun.

Of fun, yes.

I have been attacked because I am supposed to have a poor opinion of local authorities. That is, of course, quite untrue. I have the highest regard for local authorities, but I also know this, though it may not have dawned upon some people listening to me on previous occasions, that there are limits to their competency. Having reached agreement on that point, and having disposed, I hope, of the suggestion that I have the same poor opinion of the local authorities of this country as Senator Donegan has of his local authority——

I hope I will have an opportunity to reply.

An Leas-Chathaoirleach

The Senator will have an opportunity.

Thank you very much.

You certainly will have an opportunity of replying. We have arrived at this, that the visiting committee have power to inspect and report upon everything which lay people are entitled to know in relation to these institutions. Of course, the care and treatment of the inmates is a matter which should be treated with some care and confidence and should not be broadcast in reports to be published in the newspapers. The visiting committee being fully empowered to make as searching a visit as any Inspector of Mental Hospitals or any other persons could make, there is no need to compel the duplicating of their report to the mental hospital authority. There is nothing that the Inspector of Mental Hospitals or any other inspector visiting an institution could tell them that they cannot see for themselves and I am perfectly certain they do see for themselves.

Let us remember that the people on these committees are acting out of a sense of public duty. They are devoting their time to this gratuitously and voluntarily. Therefore they must do it out of a sense of obligation to the inmates of the institutions which will, I am sure, at least move them to make certain that the institutions are properly maintained in so far as the finances of the local authority will permit.

What then, is the position of the Inspector of Mental Hospitals? His purpose is to inspect these institutions on behalf of the Minister and to investigate one aspect of the institutions which a visiting committee is not competent to do, that is, the care and treatment given to the patients in them. In relation to that matter, the Inspector of Mental Hospitals must often refer to individual cases in his report to the Minister. The report to the Minister is, like all other reports of this kind, a confidential document. It is not a document which is ignored by the Minister. It is very carefully studied and read by the Minister, and from that document, the Minister extracts and conveys to the mental hospital authority everything which he thinks they ought to know about the condition of their institution and about the care of their patients—everything which he feels at liberty to tell them, having regard to the fact that there is a certain secrecy and a certain reserve which must be maintained in relation to individual cases or to statements which might lead to the identification of particular patients. That has been accepted even by Senator O'Quigley and Senator Donegan. They have at once realised that it would not be possible to give the Inspector's report in full, even if it were otherwise desirable to do it.

It is, however, neither desirable nor necessary to circulate to all the members of the health authority concerned the full report of the Inspector of Mental Hospitals. What is desirable and necessary is, as I have said, to extract from that report the particular matters which the local authority are competent to deal with and to which they should give care and attention, and that is what is done. Having regard to the fact that the Inspector's report is indivisible, is one document, which covers ground which Senator Donegan and Senator O'Quigley have both agreed should be treated with reserve and should not form part of any report submitted to a mental hospital authority, I do not see how we could accept the amendment which Senator O'Quigley has moved and which he is now, I gather, withdrawing, but I think it should be on the records of the House that the Senator, in withdrawing this amendment, is not depriving local authorities of another opportunity of knowing everything that should be known about the institution by the members as lay members of that authority and that, therefore, nothing is lost by its withdrawal.

I must first address myself to the statement of the Minister as to what I said about the local authority of which I am a member. If I had said what the Minister attributes to me, it would have been absurd. Here one is normally in very good humour, so we will take the Minister as being in his normal good humour, and will not take umbrage. What I said was that the fact that the reports of the visiting committee were always identical was a subject of fun and witticism. As a matter of fact, the members of the local authority say to the members of the visiting committee: "Could you not make it a little different this month, because it is exactly the same report each month?" That does not mean that there is a jibe or a jeer or anything else. Fun and witticisms are very different from jibes and jeers. I have only the highest opinion of the members of my local authority and of the members seconded to St. Brigid's Hospital visiting committee.

I would refer the Minister to one particular point. He asked me and Senator O'Quigley to name one thing which would be of use from the Inspector's report. The Minister is quite aware that over the past five or ten years in no branch of medicine have there been such great strides as in the care of mental health, and the use of new drugs, largely tranquillisers, has meant that many mental patients could leave the mental homes and go home to live a normal life, merely attending a weekly clinic run by the R.M.S. or some other member of the staff skilled in the use of tranquillisers who prescribes for them and provides the new drugs.

If a mental hospital were lagging behind the other mental hospitals in the country and the use of these new drugs, and that was in the inspector's report, that is a matter which should be considered at the meeting of the County Council or the mental hospital visiting committee and set to rights. That is no criticism of our R.M.S. or the past R.M.S. Everything in our case has been excellent, but there are 20 or 25 mental hospitals in this country and in the nature of things, it is just impossible that they would all step abreast. If there is a mental hospital which is not using these new drugs, which has not increased the use of these new techniques to the extent to which the rest have, that is valid subject matter for the mental hospital committee—the members of which, after all, are the people to whom the care of the patient is given—to discuss and to do something about. That is a matter which does not involve any question of medical secrecy and so it is necessary that the Inspector's report should be available.

The list of rules read out by the Minister makes it quite clear that as well as inquiries into the general health of patients and the diet provided, the other main duties of the visiting committee are to examine the buildings, sanitation and so on. Now, the members of the visiting committee visit only one mental hospital and therefore as far as they are concerned, by their standards, the matters they are instructed to inspect may be all right but the Inspector who has the advantage of examining every mental hospital may have something else to say in regard to the sanitation, or sleeping accommodation or in regard to the diet and all other matters they have in their charge. Therefore, the second opinion of somebody who not only inspects that hospital but every mental hospital in the country is of value. On those two points, I would recommend to the Minister that the amendment is certainly worth considering.

Notwithstanding the fact that the amendment has been withdrawn——

An Leas-Chathaoirleach

The leave of the Seanad must be got to withdraw an amendment. The Minister indicated that he wished to speak and I allowed him to do so and technically the amendment is still before the House.

I do not wish to prolong this debate unduly and I would not have intervened at all but for a certain remark I heard from the last speaker. It was a remark that is worth considering and one that we should take into account in our discussion of this measure. He said that the modern treatment of mental patients should be the subject of investigation by members of the visiting committee. Does he actually believe that?

Not at all.

Does he believe that specialist treatment——

The report of the investigation officer.

——is a suitable matter to be conveyed to and discussed by members of a local authority? I think that is outrageous.

The investigating officer is a medical man and his report——

Did I not hear the Senator say that the modern treatment of mental patients, such as the administration of tranquillisers and so on, should be discussed with the members of the local committee?

You did not hear me say that. I said the report of the investigating officer should be put before them. He is a medical man——

Did I not hear the Senator say——

An Leas-Chathaoirleach

Order!

Not alone that it be conveyed but discussed by them.

The report of the investigating officer.

Certainly, on treatment.

It goes to the Minister who is not a medical man.

I have been a member of the Louth mental hospital committee and I cannot allow this to pass without expressing my view, particularly in regard to the attitude of Senator Donegan. We have some 400 patients in the Louth mental hospital and I can say without fear of contradiction that it is examined each month the committee meets and there is not a department in the hospital that we do not visit on those occasions. Perhaps Senator Donegan will tell me where he got his information about the way the Louth county committee furnishes their report to the county council once a month? Do they or do they not? I am asking the Senator a question, through the Chair.

I get the information from the agenda of the county council where it is set out. It is read out and it is identical——

Has the Senator on any occasion objected or found any fault——

How could I? It has been the same since I went there five years ago.

That is the position with regard to the Louth mental hospital. I am at a loss to know what is the complaint——

There is no complaint.

——if there is a complaint. The Senator has complained about the methods adopted——

I am looking for more information.

The Senator had ample opportunity to raise these matters at home and have them discussed and thrashed out. I can tell this House that as far as the Louth mental hospital is concerned, it holds its own with any mental hospital in the country. There are 400 patients looked after minutely and we have as fine a staff in the hospital as could be got in any hospital.

Hear, hear!

For that reason, I challenge Senator Donegan to point to anything that we have complained of.

I am looking for more information for the Senator.

The Minister has attempted to say that the visiting committees of mental hospitals can, on the occasion of their visits, acquire as much information about the mental hospital and everything associated with it as the Inspector.

I did not say that —I referred to the fabrics.

He said the visiting committee can carry out as searching a visit as an inspector can make.

In relation to its functions.

I am well able to make my case without the assistance of Senator Carter. I said I agreed with the Minister that there was a limit to the competency of local authorities and I still agree with the Minister on that. It is reasonable that no visiting committee of laymen is able to ascertain, on the occasion of their monthly visits, whether or not the care and treatment provided for the patients is adequate. I think the Minister will agree that that is so—or whether or not the accommodation provided in the institution is adequate and suitable. They will not see whether the facilities for occupational therapy are adequate. That does not seem to be a matter on which the visiting committee is able to express a worthwhile opinion, or whether or not the diet is adequate. They can see whether a man got a sufficient amount of what he is having when they go in, but they may not be able to say whether it is suitable for different types of patients in the hospital. That is a matter for medical people, not for the visiting committee.

To say whether the classification of the patients is carried out presupposes a knowledge of the different types of patients who should be classified and they cannot know—unless they know the different types of patients who should be classified—unless they have the prior information. All that information can readily be supplied by the Inspector of Mental Hospitals in his report. There is nothing secret about that and nothing need be contained in a report of that kind which will identify any patient to members of the public.

The Inspector of Mental Hospitals is also charged to ascertain whether or not due regard is being had in the management of the institution to the provisions of this Act. I do not think the Minister for Health suggested that the visiting committee of a mental hospital would know all the regulations under this Act and all the provisions of this Act and could say in relation to a mental hospital: "Yes, we are satisfied"—or "We are not satisfied the provisions of this Act and the regulations made thereunder are being carried out." In this amendment, we are asking that the members of the local authority be given all the information contained in paragraphs (c) to the end, excluding anything touching upon medical secrecy.

That is not in the Senator's amendment. He walked into it and now he should withdraw it.

If the Minister is prepared to allow the Inspector of Mental Hospitals to furnish the matters referred to in paragraph (c) to the end, excluding anything touching upon medical secrecy, we can have that on Report Stage. The Minister is not prepared to do that and he makes a debating point. He is not correct in saying that the members of local authorities or the visiting committee have access to as much information as the Inspector of Mental Hospitals can provide in the report. They are not in possession of that information. The sole reason the Minister has not yet disclosed it is that he does not want to put the members of local authorities in possession of that information.

I was about to say that that was a most unworthy statement, even from Senator O'Quigley. Apparently there is a division of opinion between Senator Donegan and Senator O'Quigley as to what this amendment is intended to achieve. Senator O'Quigley said there was no virtue in having any reference to the methods of treatment submitted to the local authority. Senator Donegan thinks the main use of this amendment is that there would be a report by the Inspector of Mental Hospitals on the treatments carried out in mental institutions by their chief medical officer. I assume that if the report is of any use it will be discussed by the local authority. The purpose apparently Senator Donegan sees would be accomplished if this amendment were accepted would be that anything the Inspector of Mental Hospitals might wish to say about the professional procedures, the specialist procedures, followed in these institutions would be discussed by a body of laymen.

He never said that.

That is what I understood Senator Donegan to say and that is what Senator O'Quigley told us might be achieved as a sort of by-product of the report. He was not as forthright about it as Senator Donegan who seemed to see as its chief merit the idea that a body of laymen would have an opportunity of discussing the professional procedures adopted and pursued in the local mental hospital.

Could anybody think of anything less acceptable to public opinion than that? If I were to accept an amendment carrying that implication, as it does—what Senator Donegan thinks would be the result of the amendment is now on record—what then would be the position? Would it not be that I have a super-specialists or maybe two super-specialists in the Department of Health whose duty it is to regiment and discipline in relation to the treatment of their patients the chief medical officers of all the mental hospitals in Ireland? Then I should certainly be told I was dragooning the profession. Then we would hear a lot about State medicine and State interference in this most delicate matter. Yet, that is what Senator Donegan wants me to agree to.

I cannot see any merit in that. I certainly can see a great many objections from the point of view of the general public, of the medical profession and, most of all, from the point of view of the patients and their friends. Are we to have these questions debated in public? Think of the uneasiness you would cause to every relative of a patient in the local mental hospital if there were any question as to the wisdom or otherwise of certain treatments which were being pursued in the mental hospitals. The whole thing is ridiculous.

The reports which the Inspector of Mental Hospitals makes are to enable the Minister to satisfy himself as to whether these institutions are properly run. They can contain a great deal of matter which it would not be fitting should be published. Anything which is relevant to the management of the institution, anything which is relevant to the physical care of the patients is communicated without fail by the Minister in due course to the mental hospital authority concerned. That is as far as anybody would want us to go.

If there is any suggestion that the chief medical officer is not doing his duty, is not discharging his functions properly, the matters on which he is supposed to have failed are drawn to his attention and he is asked to say why he has not done such and such a thing. However, we do not say "How is it you have not tried this or that treatment on particular classes of patients?"

Senator O'Quigley spoke, I think, without full thought and without knowledge about the classification of patients. If the Senator will read the report of the recent Royal Commission in Great Britain on that matter he will see what delicate and difficult grounds a local authority would be entering upon if it had the report of the Inspector of Mental Hospitals in which the subject of classification of patients in an institution were dealt with. Then he would realise how utterly impossible it would be to submit the report of the Inspector of Mental Hospitals covering all the matters detailed in this section to the members of a local authority.

The Senator will have to be satisfied with the assurance I have given that all my predecessors and myself and, I am certain, my successors, will always convey to the local authorities all the matters in the report relating to the proper discharge of their functions by them and their officers with which they are competent to deal.

Amendment, by leave, withdrawn.
Question proposed: "That Section 33 stand part of the Bill."

We had some talk earlier about printing. The Minister has great feeling for language. At all times, he is anxious and careful to express himself with the utmost felicity from the point of view of language, whatever about sweetness of content at times. I trust it will not be amiss to point out to the Minister that Section 33, subparagraph (f) does not make sense as it stands. The section being amended is Section 237 of the 1945 Act which reads as follows:

When making a visit and inspection of a mental institution required by this Act, the Inspector of Mental Hospitals shall...

and then follow subparagraphs (b), (c), (d), (e). Then we come to this in the Bill:

When making a visit and inspection of a mental institution required by this Act, the Inspector of Mental Hospitals shall include...

Perhaps the Minister would agree that there are occasions when it is desirable for a member of the House to have regard to the originals as enacted by the Oireachtas and published with the authority of the Government by the Stationery Office. That evidently is one of the misprints, errors of the draftsmen, slips or whatever you like to call them to which I referred earlier this evening. It is quite clear that it does not make sense at the present time and that the Bill would have to be amended. I regret to say that I did not observe this slip in time; otherwise I should have put down an amendment. I have no doubt the matter can be dealt with on Report Stage.

We are dealing with (f) and it relates to a report to be furnished under Section 243 of the 1945 Act to the Minister. What Section 243 says is:

The Inspector of Mental Hospitals shall furnish a report on each visit and inspection of a mental institution made by him to the Minister.

The Minister does not see my point. Would the Minister refer to Section 237? This is what the Minister terms my bible. It says: "When making a visit and inspection of a mental institution required by this Act, the Inspector of Mental Hospitals shall" and then follow the various subparagraphs until you come to paragraph (f), when you have a "shall" too many. That is my point.

An Leas-Chathaoirleach

If the Minister would agree that the Senator's point is correct, this could be treated as a verbal amendment and could be dealt with by deleting the second "shall". I should like the Minister to agree that that is correct before we do it.

Two "shalls" do not make sense.

I agree. I am greatly indebted to the Senator for pointing out the tautology in the section.

An Leas-Chathaoirleach

If it is agreed to, it will be dealt with as a verbal amendment.

I trust, when the Minister reads the report, it will be duly seen that the Minister recorded his indebtedness to me for my assistance.

Question put and agreed to.
Sections 34 to 43, inclusive, agreed to.
First and Second Schedules agreed to.
Title agreed to.
Bill reported without amendment.
Agreed to take Remaining Stages to-day.
Bill received for final consideration.
Question proposed: "That the Bill do now pass".

May I just say this? I think I owe it to the Seanad to say that I am indebted for the very enjoyable and interesting discussion we had here this afternoon. I trust that I have not offended anybody in any of the things I felt compelled to say. My main anxiety about the Bill was that, due to no fault of my own, it has come late to the Seanad. I am very anxious that the persons affected by the superannuation provisions of the Bill should begin to enjoy them as from 1st April next. For that reason, I am indebted to the consideration which the Seanad extended to me in giving all Stages of the Bill to-day.

Question put and agreed to.
Business suspended at 6 p.m. and resumed at 7.15 p.m.
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