Seanad Éireann debate -
Wednesday, 13 May 1964

Vol. 57 No. 11

Health (Homes for Incapacitated Persons) Bill, 1963 ( Seanad Bill Amended by Dáil ) —Report Stage.

An Cathaoirleach

Pursuant to Standing Order 75, a Bill which has been initiated in the Seanad and amended by the Dáil is, after its receipt back from the Dáil, deemed to have passed its First, Second and Third Stages in the Seanad and is placed on the Order Paper for Report Stage.

On Report Stage, the Minister, on the Question "that the Bill be received for final consideration", explains the purport of the amendments made by the Dáil and this is looked upon as the report of the Dáil amendments to the Seanad. Seanad amendments on Report Stage are in order provided they arise out of the amendments made by the Dáil. The only matter that may be discussed are the Dáil amendments or any Seanad amendments arising out of them. There are no Seanad amendments tabled.

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

Minister for Health (Mr. MacEntee)

The single amendment adopted by the Dáil consisted of the insertion of the following paragraph in section 1 (1) as presented to Dáil Éireann:

(c) premises in which a majority of the persons being maintained are being treated for acute ailments by or under the control of medical or surgical specialists,

I made it clear to the Dáil that the intention was to devise some procedure which would prevent the exploitation of the aged and the infirm without, at the same time, involving unnecessary interference with establishments such as nursing homes, the majority of which are well conducted. It is noteworthy in this connection that nowhere in the Bill is the term "nursing home" used. My intentions were that the type of homes in respect of which a measure of control was necessary was those homes kept for private profit in which people not acutely ill but who may be suffering from chronic illness are cared for and maintained. Those are the types of homes which I intended the Bill to deal with. The amendment which was made by Dáil Éireann makes that intention of mine more specific and more precisely defines it. I accordingly recommend the Seanad to adopt the amendment.

Miss Davidson

I take it that I am precluded from saying a few words to the Minister that might make him be more generous when he comes to amend this Bill in future years. Can I proceed on this line?

An Cathaoirleach

The Senator must confine herself to the terms of the change in the Bill. She can refer only to the amendment made by the Dáil. The Senator may refer to the contents of the Bill on the Final Stage.

Miss Davidson

Very well; thank you. I wanted to be clear.

Mr. Desmond

On a point of information, regarding the statement made by the Minister on the changes decided by the Dáil, have those been circulated?

An Cathaoirleach

They have been circulated in the Bill as it stands.

Professor Stanford

May I just ask does this mean that fewer institutions will come under the Bill than would have come under it as passed by the Seanad, or does it mean that more institutions will come under the Bill than would have come under it as the Seanad passed it? Does this extend the scope of the Bill or reduce it? I am not quite clear on that.

Mr. MacEntee

I thought that I was sufficiently explicit in recommending this amendment to the Seanad when informing the Seanad that the purpose of it is to confine the Bill to those institutions to which it was originally intended to apply, and in the sense that it states my intentions more precisely, it may be said to restrict somewhat the scope of the Bill.

Miss Davidson

I much regret that the Minister has kept the Bill in such a narrow scope. I should have liked to see him take a wider view and make it easier for people confined in these establishments to draw attention to their cases if it should happen that they were——

An Cathaoirleach

The Senator's comments would more appropriately be made on the Fifth Stage.

Question put and agreed to.

Question proposed: "That the Bill do now pass".

Miss Davidson

I would have hoped that the Minister's amendment which has been inserted would have been framed in such a way that a person in a home who felt that he was being illtreated would have some means by which he would be able to convey his complaint to the outside world. I hold that the Minister's amendment does not do that.

Mr. MacEntee

On a point of order, if I may make one, it is not the Minister's amendment, though I was responsible for introducing it. It was an amendment put down by me to meet the point made by the Opposition in Dáil Éireann. It is an amendment made by Dáil Éireann.

Miss Davidson

Perhaps what the Minister said is quite true but I want to point out that I consider it a useless amendment, because, as the Minister told us, he himself did not know how the person in the home would use the amendment to convey his complaint outside the confines of the particular establishment. I just want to express the hope that if there is legislation in the future, the Minister will be so kind as to consider my point, which is not put forward in any narrow or narking sense but really because I believe, with the Minister, that there is no way in which a complaint can reach the outside world.

The Minister kept on reminding us that if he followed our theory in regard to inspection and supervision, we would be doing a great harm to the charitable institutions and would be very unfair to them. With interest, I received a note from one of those very fine institutions in the course of the week which carries this message to me: "You will always be welcome to come to see us and——"

An Cathaoirleach

Might I ask the Senator in what way this matter is connected with the Bill itself? The Senator must confine herself to the Bill before us.

Miss Davidson

Well, on the Bill before us, as the Minister himself said: "I do not know how the Bill as it stands will help a poor person——"

Mr. MacEntee

I did not say that, Sir. The Senator elsewhere has been misinterpreting me. I did not say that.

Miss Davidson

I am sorry that I did not bring the report of the debate, but if the Minister will read it, he will see that my question was how I—I used myself as the example—would convey my complaint outside the confines of the institution, I being friendless and helpless. The Minister replied : "I do not know—some kind person, some charitable person." I have not a copy of what was said in front of me, but the Minister repeated "I do not know". He then went on to say "some kind person". I cannot just remember the words. It seemed to me that it was merely a chance that somebody would do so. I do not want to leave the matter to chance; I want certainty. I am asking the Minister if, in future legislation, he will bear this in mind.

If I am insistent on this perhaps the Minister will forgive me. I was really misled because I had been reading a book and came across the following, which I should like to quote, if the Seanad will bear with me:

When as my weary feet no further fare,

And all my wayward wandering is done,

And from the glass my life is nearly run,

And all my days are spent beyond repair:

When my parched lips no more can shape a prayer,

Nor my eyes face the glory of God's sun,

An Cathaoirleach

This is not at all relevant.

Miss Davidson

I think it is.

An Cathaoirleach

I am ruling it is not relevant. The Senator must come back to the terms of the Bill.

Miss Davidson

I am now back to the terms of the Bill. I just wanted to point out that the Minister misled me. I thought he was so kindhearted about this matter when he wrote this poem and talked about:

And of my friends there is not even one

To lave my brow nor soothe my dying care

Tomás Ó Maoláin

What has a poem by John Francis MacEntee to do with this Bill?

Miss Davidson

That is the Minister's poem. I thought he would be more kindhearted to those people than he is in this Bill.

Professor Stanford

We must be fair to the Minister in this. He brought us a new Bill which goes a certain distance and we are grateful to him for that. Some of us would like to go a good deal further but I think it is only right we should end on a note of gratitude to him for taking the initiative in this matter.

Mr. Fitzpatrick

In the first place, I should like to refer to the fact that this Bill was initiated in this House. I think there were very useful discussions on the Bill here during all its Stages, before it went to the Dáil. It has now come back to us here with one minor amendment only. I think we have an example of a valuable procedure that might well be followed on future occasions of introducing Bills of this sort in this House. The Bill, as it stands at the present time, meets with my approval, for what that is worth. I think, by and large, all our nursing homes, hospitals and institutions, which the Bill is meant to deal with, are properly run. There are, of course, abuses but I should like to feel that these abuses are isolated instances. I think the Bill, as it stands at the present time, is adequate to deal with those cases of isolated abuses without subjecting properly run institutions to unnecessary investigation and inspection.

There are two schools of thought on this subject. One school is of the opinion that all these institutions, which cater for elderly incapacitated people, should be subject to registration. It follows, if they are subject to registration, they must be subject to inspection before they can be registered. The other school of thought takes the view that as long as a health authority has power to go in and inspect an institution, where it is alleged abuses are taking place, it is sufficient. At any rate, for the time being, the latter school of thought is the more correct.

As I say, I think the Bill meets the case and I am sure, where any abuses have been taking place in the past, reports will be made to the health authorities and these institutions will be inspected again, with all the consequences that follow, if they are not being properly conducted. I am sure if, at any time in the future it appears that this Bill is not adequate to deal with cases, then the position can be reviewed but I think it would be a mistake to impose compulsory inspection and registration until a case has been made that it is absolutely necessary to do so.

Mr. MacEntee

This Bill, which I brought in in the hope that it would be regarded as a humanitarian measure, has provoked, as sometimes social questions do, an extraordinary amount of controversy. I must plead guilty of being exasperated myself. I am glad to say Senator Hayes did not interrupt me at an earlier stage or I might be even more exasperated.

I want to say, in regard to the remarks of Senator Miss Davidson, for whom I have the highest regard, that I think she was unfair. When she asked me a question, I answered in general terms. I went on to say "some person, any person, a kind person, a person concerned with the condition of a particular patient." It might even be done by letter. I admit there is some difficulty. Who would make the complaint regarding a person who is penniless and without relatives, where he or she is maintained for profit in a home? We have to consider the matter of the person living in the world, as we know, an old person with money and who is able to pay for his or her maintenance. That person might have a bank manager of his or her own, or might be a ward of court. The only complaint I have in regard to what Senator Miss Davidson said is that she took a single sentence out and omitted to quote my full statement.

Miss Davidson

I should like to say, with respect, to the Minister, that I had not the report with me and I did not intend to misquote him in any way.

Mr. MacEntee

I shall certainly accept that. The Senator also flattered me when she quoted extracts from a poem written in my distant past. When I came to deal with this Bill, I dealt with it, not as a poet, but as a public man with some responsibility for the legislation which I wished the Oireachtas to pass. I have tried to get positive, substantiated evidence that these abuses were so widespread that the measures which were proposed, that is to say, registration and periodic inspection, were necessary to deal with them. I failed to secure substantial evidence in regard to this matter and I decided to proceed on another basis. If a complaint were made by a responsible person, I would have power to conduct an inspection of the premises complained about. If it should happen that the health authorities themselves, from knowledge they had obtained, or merely by complaint, felt that it was necessary to inspect certain premises where elderly people were maintained for profit, they would be authorised to enter these premises and conduct an inspection.

This Bill does not provide for registration. It provides that where a complaint is made, the widest possible powers of inspection are conferred on the health authority concerned. The main point is that if, by inspection, we establish that it is necessary to go further and ensure that before premises are opened for the care and maintenance of elderly people for profit, first of all, they will be subject to a character inspection, and the premises in which they propose to conduct their business will be inspected, then it is open to the Oireachtas to legislate to that effect.

The main purpose of the measure is to enable these very generalised complaints, which I hear from time to time, to be investigated, if necessary, in order to establish whether or not the abuses are so widespread as to warrant drastic restrictions upon the liberty of the person embarking on the enterprise. That is the purpose of the Bill. Now that it has had this somewhat frenzied passage through the Seanad, my approach will be found to be justified. I am not wedded to it and if it appears that I am wrong and Senator Miss Davidson is right, then it is open to any successor of mine to introduce legislation and give his point of view.

Miss Davidson

I am quite pleased about the powers of inspection which the Minister has taken to himself, or put on the health authorities. I am still worried, however, about how to initiate that inspection. I cannot see how that is to be done.

An Cathaoirleach

The Senator may ask a question but may not make a speech.

Question put and agreed to.