Amendment No. 9, in the name of Deputy Geoghegan-Quinn, has been ruled out of order because it involves a potential charge on the Revenue.
SECTION 16.
I realise the Chairman was not responsible for ruling this out of order but I was disappointed. Perhaps when discussing the section the Minister might talk about the matter. I felt there should be a provision that local health committees would not be outlawed. I know many of them have ceased to function because of lack of activity on their part but they could be made up of representatives of local authorities, voluntary bodies and communities with concerns and be required to hold a specified number of meetings per year. It would not make any difference to the Exchequer because there is now a new policy on local authority funding and local authority members. It would provide a formal outlet for local communities who have concerns about various health care issues to put their point of view. Is it necessary formally to dissolve local health committees? Could they not be allowed to run as they are and be required to meet, say, four times a year? I am interested to know the basis for the Minister's——
As it is out of order, technically we cannot discuss it but we will commence discussion on the section.
Question proposed: "That section 16 stand part of the Bill."
I am a former member of one of these committees and found it helpful in enabling elected members to respond to community issues as they arose. It is pertinent that locally elected members in urban areas should have an opportunity to meet senior officials of the local health board in a semi-formal way to discuss concerns and to be of assistance to the health board, particularly in planning community care and responses. It was a pity that a previous Government — I am not sure whether it was a Fianna Fáil Government — decided it was not a good idea because, in hindsight, they had an important role to play. They were a safety valve and could be used in urban areas in particular where we are dealing with drug-related issues.
I agree with Deputy Geoghegan-Quinn. I am a former member of one of the local health advisory committees, which also included people from voluntary organisations. They were disbanded in our part of the country but perhaps they could meet once every three months. We know what is happening in the North-Western Health Board and other health boards because we can see the minutes of the meetings. Voluntary organisations and local councillors were playing a good role on local health committees and they should be brought back, not necessarily to meet on a monthly basis but perhaps four times a year.
This section provides for the formal dissolution of the Dublin, Cork and Galway regional hospital boards, the local health committees and the national health council, all of which have ceased to operate. Section 16(1) provides for the formal dissolution of the Dublin, Cork and Galway regional hospital boards which were established under section 41 of the Health Act, 1970 to coordinate the general organisation and development of hospital services. However, it became apparent that this function could be better performed by the Department itself and that the regional hospital boards were unnecessary. In 1978 the then Minister for Health announced in the Dáil that he intended to introduce amending legislation to discontinue the three boards. When the term of office of the members of the boards expired on 30 September 1979 the boards were not reconstituted but the statutory change was not made. Deputies might recall that, in a major re-organisation issue in Cashel/Clonmel, the health board and the Department could not proceed with plans they had agreed because there was a legal requirement to consult the Dublin regional board, which no longer existed. It was a rather neat position to get into but it was before my time.
Subsection (2) provides that any function which should have been performed by a regional hospital board will be deemed to be valid as though it had been performed by the board. This provision ensures that the non-performance over the years of the functions of the regional hospital boards will not affect the validity of anything done by a health board or other body in relation to its functions which fell to be performed by the regional hospital board. That takes in the Tipperary case and ensures we do not get stuck in a legal vacuum.
Subsection (3) provides for the formal dissolution of the local health committees — that is the issue raised by Deputy Geoghegan-Quinn. They were established under section 7 of the Health Act, 1970. In general, every county had a local committee and they were sometimes referred to as county health committees. They were charged with advising the health board on the provision by the board of health services in the functional area of the committee. In July 1987 the Government decided, as part of its expenditure review, that the local health committees should be abolished. An appropriate reduction was made in the health board allocation from 1 January 1988 but the necessary legislative change was never made. The decision was taken at a policy level in 1987 and the budget was reduced to allow for the change in policy but the statutory change was not made.
Subsection 4 provides for the dissolution of the National Health Council which was established under section 98 of the Health Act, 1947. Its function was to advise the Minister on general matters relating to the health services. The council ceased to function in the mid-1980s.
Subsection 5 provides that any function which should have been performed by the National Health Council will be deemed to be valid as though it had been performed by the council. This provision ensures that the non-performance over the years of the functions of the National Health Council will not affect the validity of anything done by the Minister, a health board or other body in relation to which functions fell to be performed by the National Health Council.
Effectively, this is a legislative tidying up of the regional hospital boards which were in Dublin, Cork and Galway, the local health committees and the National Health Council. None of these have been functioning for years but their very existence and the requirement under statute to consult with them was causing legal difficulty and very significant delays in the rearrangements in Cashel/Clonmel.
The committees operated until the late 1980s. Since 1988 the local health committees have not had a negative effect on the provision of services. Locally elected public representatives continue to hold the majority on all health boards.
The case for restoring the local committees has been considerably reduced by the new functions given to local authorities in the Local Government Act, 1991. Section 5 of this Act empowers local authorities to represent the interests of the local community in such manner as they think appropriate and, in particular, to ascertain and communicate to other public authorities, including health boards, the views of the local community on the functions of those authorities. This provision in conjunction with the duty we are imposing on health boards to co-operate with local authorities, further weakens the case for a restoration of the local committees.
The statutory obligation we are now placing on health boards to co-operate with local authorities means chief executive officers must consider carefully what mechanism they will put in place for such co-operation. It may be that the consultation process with local authorities must be formalised. I presume there would be a statutory obligation where there was a cross of function rather than just an advisory role and the exercise of function was of relevance to health boards or a local authority.
Under the Local Government Act, 1991, Members will have experience of local authorities where many committees were set up to deal with different issues. It seems to me if there were a liaison problem between local authorities and a health board in the drugs area, for example, the local authority would have the power to address that by way of committee and that there would be an obligation on the health board to co-operate. We are not changing anything in practice. It is about eight years since a local health committee met. The policy decision was taken in 1987 and the budgets were adjusted accordingly. We are simply involved in tidying up the statutory aspect of the matter. There is scope within what we are doing here, in terms of putting the statutory obligation on the health boards to co-operate with local authorities taken in combination with the provisions of the 1991 Act, which would enable local authorities if they saw fit to attempt to formalise their relationship with the health board.
Question put and agreed to.