I raised the question of Medical Registration by arrangement with Deputy McKenna. I hope the Minister will give a statement which will relieve the public feeling in the matter.
COMMITTEE ON FINANCE. SUPPLEMENTARY ESTIMATES. - MEDICAL REGISTRATION.
Before I begin, I want to know how I am situated— what time is set down for this discussion and whether members will question me on what I wish to say?
On the analogy of an adjournment discussion it would last until 8 o'clock. If the Minister desires more time he will get it.
I hope his statement will be such that at this stage no discussion will be required.
It is possible that people will ask questions.
There is always provision for that.
The history of the position with regard to medical students who got their qualifications in the Saorstát and who were, previously to 1923, validly registered on a general Medical Register, begins, as far as this House is concerned, with the introduction of the Medical Bill, 1924, on the 16th July. On that occasion I outlined the situation this way. I said it had been believed that, through the joint action of a section of the constitution and of a certain adapting Act passed in this House, the position as it existed prior to the setting up of the Free State, had, in fact, continued. Sometime very shortly before the introduction of a Bill into the House, the point had been raised from the other side that there was some doubt. I myself attended a conference to have this point cleared up, and the conclusion arrived at was that doubts still remained as to the exact position. There was no doubt in the minds of the British representatives.
There was still doubt on our side, and it was considered advisable, to avoid the possibility of confusion, and to avoid mistake, that certain legislation should be introduced here and in the British Parliament. That was to validate what had been done in good faith, and it might have been argued to have been done legally. It might also have been interpreted as an illegal act to continue to validate that, and continue in operation the General Medical Council, as established under the Medical Acts, with all its powers and its particular type of constitution, for a period which was defined, as far as the Bill in this House went, to be a year from the passing of the Bill. The legislation was not to be similar or identical. It was to be corresponding, co-relevant and complementary.
I introduced the Bill into this House and it was treated as a matter of urgency at my request, and passed through all stages very speedily. It was almost immediately brought to the Seanad, and while I was engaged, I think, on the Second Reading, and while actually speaking in the Seanad, I was informed that there were certain points, which I thought had been cleared up at our conference, still in dispute, and that it would seem desirable to have further consultations. I had treated the thing as one of great urgency, and asked this House to treat it as such, and asked its indulgence in the matter. I had brought the Bill to the farthest point in the Seanad that admitted of amendment. If I had gone a step further any prospect of amendment was gone. In the position in which I found myself I had not material to come to a decision as to whether amendment was or was not desirable. Under these circumstances I did not proceed with the Committee Stage in the Seanad that day, as, I think, had been intended. Between that and the next day I made inquiries as to whether or not it was intended to introduce the British Bill before the adjournment for Summer. I also reread my notes of the conference, and came to the conclusion that they had no intention of introducing their Bill before the Summer Recess. The critical point in the whole matter was the election, to be held some time in November.
An election held under the old system would have been for representatives from all Ireland, not from the Six Counties, not from the twenty-six counties, but from all Ireland, and if the Bill had not been passed here, and the corresponding legislation in England, there would have to be a decision as to the area for which that election was to have been held. That date seemed far enough away. I had brought my Bill, as I said, to the furthest point possible, compatible with regular amendment, but there was no sign of the British Bill. In the circumstances, not foreseeing the political upheaval that would occur in England, that actually would have prevented them being in a position to bring in their own legislation, I agreed, and asked for a postponement until October. The history of things politically in Britain is known to everyone since, and when I saw that an election was foreshadowed, and that an election would take place, I concluded that the situation, which had been stereotyped by conference, and by definite assurance given in the form of a despatch letter, would continue, inasmuch as the situation had been changed by circumstances not exactly under our control. The Bill was accordingly not brought forward in the Seanad in October, and the election came on under the auspices of the General Medical Council.
It will also be remembered that I had taken this Bill in hand simply because the Minister for Local Government, whose proper function or duty it was to look after the Bill, had broken down, just before the Summer recess, and had not been able to engage in this matter. Before I left for Geneva I considered that, as he was back in his office, and as I was going to be away for some time, it should again return to him, and I handed the matter over to him. However, as I had been in correspondence with some people, I one day received a letter stating that the General Medical Council felt uneasy about the situation, and that they had doubts about proceeding with the elections unless they had some assurance that the elections, when held, would be validated here. I had very little hesitation in giving to the writer my personal assurance for what it was worth, because I knew I did it in good faith and with the will of the Dáil, because the Dáil had previously assented to a Bill which would have continued the General Medical Council in being for that critical period, and, indeed, had passed the Bill at that critical point. So, whether that assurance had any effect on the matter or not, I cannot say, but the election was proceeded with and the disputed point of difference again taken up.
I resumed possession of this file, because, as the Minister for Local Government and Public Health pointed out to me, as he had not been in touch with the matter from the beginning, it seemed more desirable that I should take control of it again. I resumed control of it, and these points which we had been discussing were taken up once more and discussed, and that discussion has continued until to-day. The last date to which I can point was Saturday last, when a legal official of the Government was in London and discussed this matter with certain officials on the other side. Now, up to this very date, as far as anything I have before me on the file dealing with the matter, and as far as an intimate connection with, I think the whole matter itself puts me in a position to say, that I have not the slightest indication that there is likely to be any sudden change in the arrangements which we made at the Conference held in London somewhere about last June, not the slightest indication, and I think I may say I have a closer and more intimate connection with the matter than anyone in this country.
I have various sources of information, official sources, people with whom I am dealing and people whose correspondence I have before me and I am in close touch with the medical people, the members of the Medical Council, and the members of the medical profession in the University that I represent, and I have also close touch here with certain medical and other representatives of Trinity College, Dublin. I have not been made aware of any serious situation such as recent Press utterance would lead one to believe had suddenly come about— nothing whatever to warrant any of these screams that recently emanated from the Press. The position, so far as I can see it to-day is this, that I did get an absolute assurance that the General Medical Council would continue to operate as it did operate before the establishment of the Saorstát and that students will be registered, and would actually be put on the Register up to a particular date. That was up to the end of November. It may be said to me, therefore, that the assurance I have got has lapsed. But I hold that the circumstances, when definitely looked into, show that the assurance must continue, and I have had no advice that that state of things is going to be brought to an end. The circumstances I refer to are simply these. As regards the assurance to continue the old time position up to the end of November, the point raised to me was that about November a critical situation, had again arisen because the election was about to be held, and it might be queried. An assurance, as far as I could give an assurance, was asked from me and that assurance I had no hesitation in giving, pointing to the Bill which had received the assent of the Dáil and which had passed its Second Reading in the Seanad, and there seemed no prospect of defeating it in the Seanad.
On the assurance of that Bill, which had received the assent of the Dáil, I felt I was in a position to give an assurance to the people who questioned it that the General Medical Council, so far as that election was concerned, would be held to have acted in a legal fashion, and that obstacle was got over. The conversations, which had to a certain extent interrupted the passage of the Bill, were resumed, and these conversations have been going on—up to Saturday last. I even approached, through the High Commissioner's office, certain people on the other side, and found that up to Monday they were not in a position to inform me as to what was being done in the matter. This was even as late as Monday. So that nothing has happened that I am aware of to change the situation, nothing whatever. One point that may be queried is that I have only a paper assurance up to a certain date. An assurance of that type requires to come through certain channels. I have approached the Medical Body, through certain channels, and it takes a long time to get letters. But there has been no indication of any likely action to put an end to those things. The position remains as it was after the conference in London.
Now, there are one or two rumours which reached me which I think it well to dispose of here. It has been said that I held up the Bill in the Seanad, that I gave a certain reason, but it was not the real reason, and that the real reason was that objection had been taken very strongly here to the continuance of the General Medical Council, because there was a certain nomination made by the Privy Council. That point, of course, is absurd. The point was raised here in the Dáil on the Committee stage of the Bill. I answered it, and pointed out the position, and after I made the position clear this House assented to the continuance of it. So why it should be supposed that a matter discussed here on the Bill, which was passed here, continuing that particular type of appointment, should now be held to be a serious objection to the Bill I cannot conceive. Further, I have received certain resolutions from groups of students in the country—"viewing"—I think that is the term generally—"with dismay the proposed change tending to the separation of the medical register here from the general medical register." Even one letter went so far as "to protest against the Bill at present before the Dáil to separate the registers." Of course, nothing could be further from the truth.
There is no such prospect, so far as legislation here actually before us is concerned, of separation. In fact, the Bill before us is one designed to give us an opportunity of going into the whole matter, so that the whole thing may be thrashed out before a final decision be come to, and, therefore, of course, there is no Bill before the House separating the registers. What did happen was: the registers seemed to become separated, and we joined them together again for a year's period. So I find myself much in the position that the people in England found themselves in as to what was said here. I did make certain communications to the High Commissioner's Office, and with the text of the reply I received I also had this sentence put to me: "The people over here want to know what all the excitement is about?" Now, if people in England, engaged with this matter, do not know what reason there is for all the excitement, and if I who have had charge of this, right through from the start, cannot see any reason for excitement, and if the people who are naturally expected to advise me if there is anything critical coming along, have not advised me of any such matter, I do not think there can be any very serious critical situation developing.
We have assurances that pending legislation in both Parliaments the position of the General Medical Council was stereotyped up to November. That critical point, when it did arise, seemed to be got over. I gave all the assurances I thought necessary, and I think the assurances were well grounded, that the Dáil was working in connection with the passing of the necessary legislation, and that that legislation will undoubtedly pass when next we meet. Meanwhile, I am confident that the position with regard to the Irish medical practitioners of the Saorstát, and Great Britain, will remain absolutely unaffected by the delay that has arisen. There is one other matter that I would mention, because a particular date is brought before the public.
Speaking at a gathering in Dublin a few nights ago, certain remarks were made by a surgeon of this city which, I think, have been interpreted quite in a different manner from what was intended. He said he received a wire from London that the position would remain unchanged until February, and he went on to say that as there was a medical final examination in January those January students would consequently be saved. Now, the implication that has been founded upon that, by certain people, who are rather nervous, at the moment, is that if you do not get qualified in January, your last chance is gone for the medical register. There, again, of course there is unnecessarily read into a phrase what was never intended. Possibly, to some extent, I personally, am responsible for the idea because when I was endeavouring to get on paper all those assurances I had up to November, I took February or March because the Parliamentary procedure fixed that more or less for me and I was assured of the fact, that the Bill was going through the Seanad and of its being law in February. If I mentioned February, it was because I thought the assurance guaranteed up to February covered all the necessary time until this Bill should be passed into law and that that was the necessary period. So that to read into that casual phrase: "This will last until February and after that the deluge," is quite wrong. What was intended was to give an assurance that the position which was unaffected up to November would remain unaffected up to February, that being the date on which it was presumed legislation here would be passed, and that the year's period would run thereafter.
There is no reason for any feeling of uneasiness in this matter. I believe, even if I had no definite assurances with a time limit on them, that any one cognisant with what is in the papers before me would realise that both in honour and in decency there would have to be some notice given to me of the proposed termination of the arrangements, even if that termination was supposed to be founded upon unnecessary delay, which the newspapers are kind enough to attribute to me in this matter. I do not believe it is possible for any sudden stop to be put to the arrangements already come to, even though it was believed on the other side, even though the Medical Council felt, that I had been criminally negligent in this matter. The whole course of the correspondence and of the conversations that have taken place, the whole course of action of the Medical Council, up to and including the election of new members, showed that some definite warning with a time limit would have to be given before they set about breaking the arrangements which at present exist. Consequently, I believe that there is every reason for people to be reassured on this matter, and I hope that what I have said will succeed in reassuring them. I hope that those people who are unfortunate enough not to be abreast of things, who believe that there is a Bill going through this House to separate the registers, will realise that is not the case.
I think the interested public will read the Minister's statement with very marked feelings of relief. On their behalf I have only one thing to suggest. I think it is quite unnecessary, but if it were added to the Minister's statement it would accentuate the feelings to which I have referred; that is a simple statement on his part that he will do all in his power to hasten matters in order to arrive at a satisfactory termination of the conversations to which he has referred.
I agree with what Deputy Thrift has said that the statement of the Minister will do something to allay the anxiety that has been, to a large extent I think, propagated through the Press for the last week or so. There is no doubt about the effect it has had on the minds of medical students and upon parents whose children are in their last year of medicine. It seems to them a terrible thing that at the last stage of the medical course students should be debarred from being placed upon the General Register. I want to emphasise that word. It is not a British Register, as some people call it. It is a General Register, representing the graduates of England, Ireland, and Scotland. The Council is not a British Council, but a Council composed of representatives of the three countries. There are many points to which I might allude, but I think it quite unnecessary to discuss the matter further at present. I only wish to say that I think the Minister has done a wise thing in allaying the fears created by the scare with regard to the closing of the General Register.
With regard to what Deputy Thrift has said, of course I shall lose no time in getting the few remaining Stages of the Bill completed in the Seanad as soon as we resume. In fact, if the point—there is really only one point under discussion—was completed by whatever day the Seanad meets next week, I could get the Bill through even then. That does not depend upon me. I have to hear what the people on the other side have to say, and to form my opinion as to their arguments. When that is done, I can proceed immediately with the Bill, and I am quite certain that the Seanad will facilitate me in getting it through next week.