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Dáil Éireann díospóireacht -
Tuesday, 30 May 1933

Vol. 47 No. 16

Public Hospitals Bill, 1933—Committee (Resumed.)

Debate resumed on amendments 20 and 21.
20. In sub-section (1), lines 45 and 46, to delete the words "form a single fund to."
21. Before sub-section (2), to insert a new sub-section as follows:—
The National Hospital Trustees shall divide the moneys received in respect of a particular sweepstake under Section 12 (1) hereof into two funds in the proportion of two-thirds and one-third, whereof the first shall be known as the Promoting Hospitals' Fund, and the second, the General Fund.—(Sir James Craig.)

A little aspersion was cast upon me, or rather the Parliamentary Secretary was priding himself, apparently, when he said that I had not been consulted with regard to this measure. I am very glad I was not consulted, because I certainly could not have agreed to the proposals put forward. What he said was that instead of consulting me he had taken the opposite course of consulting the committee representing the various hospitals that came under the sweeps. The Parliamentary Secretary proceeded to say that the Hospitals Committee was perfectly satisfied with the Bill. The House will be rather amazed and amused when it hears that every amendment, except one, standing in my name, was sent to me by the Hospitals Committee. They were sent to me and I was asked to move them on behalf of the Hospitals Committee, although the Parliamentary Secretary said in this House that the Committee was perfectly satisfied with the provisions of the Bill. When the original Bill was brought in, the money was to be for the benefit of voluntary hospitals. Under an amending Bill the available surplus was divided, two-thirds being for charitable hospitals, and one-third for country hospitals. According to the present Bill the Government has gone back upon the provision to divide the money and is putting it into a single fund. That is what the Hospitals Committee objects to most strenuously, and so do I, because this unified fund is to be placed under the control of the Minister for Local Government and he can do what he likes with it. He need not give a single penny to the voluntary hospitals, unless he likes to do so. That has raised a great deal of suspicion, and a great deal of fear, in the minds of those connected with the hospitals. That is why the amendments are moved. The House will see why the amendments put forward by the Hospitals Committee are necessary. Those representing the various hospitals have great fears that the voluntary hospitals may be left out in the cold, seeing that there is no provision in the Bill that they are to get any money, unless the Minister likes to give it.

Deputy Sir James Craig, apparently, is determined to continue on the lines adopted since this Bill was introduced, and as far as it rests with him, at any rate, to develop the atmosphere of suspicion that surrounds the Bill, its intentions, and the likely results, should this Bill become law. I presume, if he persists until the Bill is passed, we must only hope that the people most intimately concerned will become assured that there is no foundation whatever for the atmosphere of suspicion that certain Deputies are endeavouring to create. As I stated more that once during the discussions on this Bill, the one intention in the minds of the promoters is to secure that the best possible results, in the matter of hospitalisation and equipment, will be made available to the poor, as a result of the financial opportunity that the sweepstakes offer. Even Deputy Sir James Craig will, I think, admit that the division into the proportion of two-thirds to the voluntary hospitals, and one-third to be placed at the disposal of the poor law authorities, was purely an arbitrary division. We have nothing to guide us, at the moment, in making up our minds whether the one-third or the two-thirds will give the best possible results. It will be some considerable time before the Hospitals Commission can report. All Deputies are agreed that they are undertaking a very difficult, complicated and delicate task, and if it is 12 or 18 months before the Commission can report, if we were to divide the two-thirds and one-third proportions of the moneys available, we might be holding up schemes ready for operation by local authorities, while the moneys are lying idle.

Many of these schemes—extensions of mental hospitals, the provision of fever hospitals and the provision or extension of county and district hospitals—are ready to be put into operation and the only thing that is holding them back is waiting on the allocation from the Hospitals Sweepstakes Fund of a proportion of the cost. These schemes will require little or no examination from the Commission inasmuch as they have been examined already in detail and reported on by the expert advisers in the Local Government Department. I would like to hear some members of public bodies on the opposite benches who frequently come to the Local Government Department pressing for the immediate allocation of money to help to finance schemes that are about to be put into operation. They have never yet accused me, in so far as I have any responsibility for the distribution of this money, of being over-generous or disbursing money without the most careful consideration of the proposals about to be carried out.

Deputy Sir James Craig need not have anxiety about the fate of the voluntary hospitals. It ought to be remembered that we are extending the period of operation of sweepstakes in order that sufficient money will be made available to solve our hospital problem entirely. In the ordinary course the sweepstakes law would have ceased to operate this year, but we are extending the period indefinitely in order that if the sweepstakes continue to be successful there will be sufficient money available to solve the problem of the voluntary hospitals as well as the institutions run by poor law authorities.

If we accept this amendment it will mean that schemes now ready for operation will have to be held up, schemes that local authorities are anxious to carry out and cannot, because there is no money at the moment available. The problem of the local authorities may be solved in the course of twelve or eighteen months and the entire proceeds from the sweepstakes would then be available for the voluntary hospitals. I find it hard to understand why Deputy Sir James Craig waxes so hot and eloquent on this question. If he approaches the matter in a reasonable frame of mind he ought to admit that the amendment, instead of advancing the hospital schemes, will have the effect of holding up schemes that, with very little further examination, could be put into operation the moment we have the money available.

I must confess the Parliamentary Secretary's reply is, to me, very unsatisfying. The Parliamentary Secretary, if he wished to make a case on the lines on which he was endeavouring to make one, might have come here with specific facts and figures. There is available for local bodies a very considerable sum. That sum will be augmented this week out of the Derby Sweep. If it is not augmented this week, it will be in the immediate future by a sum of something over £300,000. Why does the Parliamentary Secretary not tell us how much money is wanted at present for schemes ripe for completion and which could not be financed out of the money he has already received, out of the money he is going to receive in the immediate future, and also out of one-third of the total sum devoted to hospitals which he will receive from the Cambridgeshire this year? It seems to me that the sweeps were started for the voluntary hospitals and that should be kept in mind. This is a continuation of sweepstakes which were justified by this House because they were helping voluntary hospitals that could not receive adequate help from persons outside. Just as all the past money was primarily theirs, under the whole of this scheme the voluntary hospitals ought to be the owners of the larger share of this money.

So they will.

If it is the intention of the Parliamentary Secretary that they should receive two-thirds of the whole amount, I cannot see for what petty considerations he will not have that embodied in this Bill.

I am surprised at Deputy Fitzgerald-Kenney, though I am aware he has not the local knowledge that some of us who are on local bodies possess. We know the needs of the poor and we know the conditions in local hospitals where they have to try to carry on under very tough conditions. Local bodies have been totally unable to provide properly for the poor. The strain on the ratepayers would be entirely too heavy to provide what should in decency be provided for the poor. Deputies are aware that many schemes are ready and are merely awaiting the money. I have a very decided objection to Deputy Sir James Craig or anybody else interfering with these schemes.

Interfering?

I am not interfering with any schemes and the Deputy ought to know that, nor am I saying a single word against the money given to poor law hospitals. My whole point is why do they not give them the money? What is the use of Deputy Corry standing up and talking about wanting money when the money is actually there and they will not distribute it?

I do not know that the voluntary hospitals are so badly off for immediate relief as Deputy Sir James Craig said. I noticed in the public Press last week that one of the Cork voluntary hospitals invested a large amount of their surplus money in British securities. National Loan is not good enough for them at all now. I suggest to the Minister that when he is advancing any further moneys he should give it in the form of Irish securities or Irish bonds. The Parliamentary Secretary says we could not accuse him of being over generous. We accuse him of not being generous enough.

That is right; make him pay up.

We are anxious to get £200,000 for poor law hospitals and mental hospitals in Cork county. The local bodies have to contribute something like £66,000 in that connection. With these conditions there will be a rather severe strain on the ratepayers. I suggest if the Minister has any money to spare, that instead of giving it to the voluntary hospitals to invest in British securities, he should relieve the ratepayers a little further and be more generous towards the local bodies. Undoubtedly some relief is needed for the local bodies to enable them to put the county hospitals and the district hospitals into a fit position so that the poor will be properly cared for and provided with the proper necessaries in these hospitals when they have to go there. Such relief is long overdue. I for one am glad that the Minister is speaking out and not giving way to those very strange proposals that we had from the Opposition to-day.

I want to say one or two words. As I already told the Parliamentary Secretary, I was not the author of this amendment. The amendment came to me from the Hospitals' Committee—from the gentlemen who are representing the hospitals in connection with it. They briefed me on the very lines I have stated here, namely, that they were afraid that as no part of the money was ear-marked for voluntary hospitals the county hospitals might be badly treated. That fear and that suspicion came from the Hospitals' Committee.

There is one other thing to which I ought to refer. The Parliamentary Secretary on the last occasion said that there was a great deal of reorganisation required in the hospitals here in Dublin. I think he used the expression that they were in a chaotic condition. I want to deny that. I think I am in a position to state what is the condition of the general hospitals in Dublin. I think I am in a very much better position to state what their condition is than is the Parliamentary Secretary. I examine them for various bodies. There is not a hospital that I do not visit in my capacity as examiner and I am satisfied that the poor are well treated and, as far as the main hospitals are concerned, they are kept in a most excellent condition. As far as the teaching goes I do not think there is as good teaching anywhere as the students and nurses get in Dublin. I want to say that it would be a poor thing for people to get it into their minds that the hospitals here in Dublin are in a chaotic condition. Their teaching is good, their nursing is good, the poor are looked after excellently and the hospitals are kept in good condition. I admit that there is no research work. I agree with the suggestion made about research work.

I do not want Deputy Corry to get it into his head that I am in any way opposed to the money going to the local hospitals. I want to see every hospital well provided and I have said so on every occasion, even when fighting about the proportion of money to be given to the county hospitals. On that occasion I said I wanted to see those hospitals put into a good position and the patients made comfortable as far as the nursing is concerned. I want again to say, following the Parliamentary Secretary's remarks, that the fear I entertained with regard to the Bill and the suspicion I entertained are not my own but that they are the suspicions and fears engendered by the Hospitals' Committee. Those amendments would not be handed in by me were it not that I was urged by the Hospitals' Committee to do so. The only amendment put down by me on my own was that the sweepstakes would end five years from now.

I would like the Parliamentary Secretary to consider this point—he is taking great powers under this Bill. He stated in an unguarded moment that he was going to bring pressure to bear on the voluntary hospitals to pursue a certain line——

Could Deputy O'Sullivan quote that?

No. I listened to the Parliamentary Secretary and I understood from him that he was going to bring pressure to bear on the hospitals to do certain things.

Any pressure that is necessary for better accommodation for the poor.

As the Bill stands and if his amendment is accepted he has power to bring pressure. The power will be there for this or any other Government to use.

Hear, hear!

Deputy Corry says "Hear, hear!" Deputy Corry generally reveals the Government's mind more than any other member of the Party. That is one of the disadvantages of the Government Party.

I do not know how he finds out.

Possibly, but it is to his type of mind that the Government is drifting. Owing to the powers elsewhere in this Bill I think it is necessary that a certain proportion of the money should be set aside for voluntary hospitals. That is what is sought for by the amendments. There is no interference with the other hospitals. This is only a last moment effort to save some shred of authority to the voluntary hospitals.

In reply to the point raised by Deputy O'Sullivan I would like the Parliamentary Secretary to stress one matter and that is that the hospitals that have refused to co-operate with the Government at present and that also refused during the period of the Cumann na nGaedheal Government to co-operate in the matter of taking girls from the Gaeltacht as probationers should be made do so. I would ask the Parliamentary Secretary to see that these hospitals should be compelled to co-operate in the scheme set up by the late Government and continued by the present Government in that matter of girls from the Gaeltacht. At that period a certain sum was set aside for the training of the girls to whom I have referred. The matrons of the hospitals in Dublin refused to co-operate with both Governments. The only hospital that did co-operate was the Richmond Hospital. I would go so far as to ask the Parliamentary Secretary to see that those hospitals that still continue to refuse to co-operate to make this scheme for the Gaeltacht girls a success should not receive the consideration that they would receive in ordinary circumstances. By that scheme it was intended that girls from the Gaeltacht would get hospital training. That scheme was started two or three years ago and the promise was made again last year, but the matrons of the hospitals have refused to co-operate.

I am sure Deputy Flynn is aware of the fact that he has strayed far from the amendment before the Committee.

I thank the Deputy for stressing my point.

Amendments 20 and 21 put and negatived.

I move amendment 22:—

In sub-section (2), to delete all words after the words "trust funds", line 53, to the end of the sub-section, line 55.

As the Bill stands, the Hospitals Trust Fund is to be invested and kept invested "by the National Hospital Trustees in securities authorised by law for the investment of trust funds or authorised by order made by the Minister, with the concurrence of the Minister for Finance, for the investment of the Hospitals Trust Fund." The object of the amendment in cutting out these words is that this trustee fund shall be invested like every other trustee fund in what are recognised as trust securities and that it should not be available to be invested in anything of a speculative nature—anything that is not a trust security.

Did the Deputy say that the hospital funds are invested in investments of a speculative nature?

I did not say that. At the present moment, they must be invested in a trustee security, but under this Bill they can be invested in investments of a speculative nature.

Does Deputy Minch realise that all kinds of securities are of a speculative nature at present?

The section, as it stands, directs the trustees to invest the capital of the Trust Fund, so far as it is not required for the time being for making disbursements, in trustee securities or securities authorised by the Minister, with the concurrence of the Minister for Finance. Deputy Fitzgerald-Kenney, I am sure, is very conversant with the law concerning trust funds and the Trustee Act. Where the instrument creating the trust does not give express directions as to the investment, the law assists by giving a list of investments in which property may with safety be invested. The principal list is contained in the Trustee Act of 1893. This list was made up some 40 years ago, and I think even Deputy Fitzgerald-Kenney would hold that the list is in need of revision. In 1931 the question was under discussion in the Dáil and Deputy Little then pointed out that the list should be amended as there were a number of securities mentioned as trustee securities which no same trustee would invest in, and there were other securities that might be properly included. On that occasion, Deputy Fitzgerald-Kenney said: "As far as Deputy Little's point is concerned about trustee securities and the revision of the list of trustee securities, I agree with him that it is a matter to be inquired into, as a certain revision is no doubt necessary." Judging by the expressions of opinion from all sides of the House in 1931, one would think that there would be general agreement now that the trustee list of securities should be brought up to date and that the list does not afford sufficient guidance to trustees at present.

The second part of the section is intended to give the trustees a wider discretion subject to the safeguards mentioned. It is understood that the Department of Finance have under consideration an amendment of the Trustee Act and that the matter is in a fairly advanced stage. In these circumstances, the power given under the second part of the section may never be put into operation. At the same time, I think, there cannot be any great objection, in view of the views expressed already by Deputy Fitzgerald-Kenney, to giving the wider discretion for investments than the terms of the original section provided.

The Parliamentary Secretary has not attempted to argue the matter. He says that the present trustee list is not wide enough and requires revision. Well and good, let it be revised, but let the National Hospital Trustees be in the same position as every other sets of trustees. He says that actually at present revision is under contemplation and should be carried through. Even if it is, that is all the more reason why these particular words which allow the Minister to invest in any single class of security he likes, no matter what its nature is, should come out. Let the National Hospital Trustees stand in the same position as all other trustees, only able to invest in proper trustee securities.

The section as it stands provides that the National Hospital Trustees may be authorised by the Minister for Finance, but it does not contemplate that the Minister for Finance will direct the trustees to invest the money in any other than trust funds. But they may be authorised, provided, presumably, that they request the Minister for Finance for guidance for investment outside trustee funds.

In the event of an investment in which there is a capital appreciation, and there is a difference between the original investment and the appreciation, where does that go?

Amendment put and negatived.

I move amendment 23:—

In sub-section (4), page 11, to delete lines 4 and 5 and substitute the following words:—"save if and in so far as is otherwise directed by the Minister, be added to and form part of the capital of the said fund as from the receipt thereof by the said trustees."

This is a drafting amendment. Under the new sub-section (2) of Section 24 the Minister may make a grant out of capital to the Hospitals' Trust Fund, or out of the income, or he may direct a portion of the capital to be set aside for the purpose of securing an annual grant. The amendment proposed in this section is consequential on this power.

Amendment put and agreed to.

I move amendment 24:—

To delete sub-section (5).

Sub-section (5), I think, is bringing in a very bad new principle, that the National Hospital Trustees, though they are not to solicit contributions to the Hospitals' Trust Fund, may start getting collections. I think that is an endeavour to prevent voluntary subscriptions from the charitable public going direct to the hospitals. It is an endeavour to intercept them and I think it is a very bad principle.

I support that very strongly, because there is a feeling that the meaning of this is to intercept the subscriptions that would be going in the ordinary way towards the hospitals. I think it is a poor thing to suggest that trustees should be accepting contributions towards the fund.

Would Deputy Sir James Craig repeat that? I did not follow it.

I think it is a poor thing that the trustees should be entrusted to receive subscriptions to the fund. There is a feeling—whether it is one of those peculiar feelings that I am supposed to entertain or not— that this is a means of intercepting ordinary voluntary subscriptions that would be going to the hospitals. I do not know whether there is much substance in it or not, but that is what is felt. I am supporting the amendment very strongly.

It strikes me that Deputy Sir James Craig, in so strongly supporting the amendment, is not familiar with the terms of the section.

I have read it, but I suppose I am a stupid sort of fellow.

Sometimes the Deputy can be clear enough, but at other times he is extremely dense. There may be a method in it. He complains that, if the amendment is not accepted, voluntary contributions may pass through the Hospital Trustees, but, as a matter of actual fact, the section as it stands lays down that it shall not be lawful for the National Hospital Trustees to solicit subscriptions to the Hospitals' Trust Fund. It appears to me, at any rate, that it is not the function of the National Hospital Trustees to solicit subscriptions.

Certainly not.

Therefore that portion of the section ought to be very satisfactory to Deputy Sir James Craig, as we say that it shall not be lawful for the National Hospital Trustees to solicit subscriptions. The section merely gives the trustees authority to accept legacies, if there are any, but they are not to solicit money from anybody.

The Parliamentary Secretary will be surprised that even I had the brains to interpret it in that way.

You have brains enough if you would use them in the right way.

If I would agree with you? This is not my amendment. I am only supporting it.

You have such a knack of supporting most of the amendments which come from that side of the House that I suppose you are doing it through force of habit. I very seldom find you supporting anything that comes from this side of the House.

The only argument——

I have not given way to Deputy Sir James Craig, so perhaps he would resume his seat. This amendment merely gives the Hospital Trustees authority to accept any money offered to them. I cannot see that there is any objection to that, and certainly a convincing case has not been made to show that the Bill would be improved by the deletion of this section.

It is perfectly obvious that, no matter how unable the Parliamentary Secretary is to make any case for some of the absurd provisions of this Bill, he is perfectly determined that he will accept no amendments. He gets up here, and apart from the general insolence with which he has been treating the House, and one respected member of it in particular, he does nothing more than read out the section, which we are all perfectly capable of reading and understanding. That the National Hospital Trustees should not be authorised to accept any sums of money at all is the object of this amendment.

He has explained every section.

Question—"That the sub-section stand part of the Bill"—put and declared carried.
Amendment declared negatived.
Section 22 agreed to.
Amendments 25 and 26 not moved.
Section 23 agreed to.
SECTION 24.
(1) Subject to the provisions of this Act, the Minister may at any time, either on his own motion or in consequence of an application to him under this Act, make to any hospital or nursing organisation in Saorstát Eireann a grant out of the Hospitals' Trust Fund of such amount and for such purposes authorised by this section as the Minister shall think proper.
(2) Whenever the Minister determines to make under this section a grant out of the Hospitals' Trust Fund he shall direct the National Hospital Trustees to pay such grant out of the Hospitals' Trust Fund and thereupon the said trustees shall pay the amount of such grant out of the said fund to such person and at such time or times as the Minister so directs.
(3) Whenever the Minister makes under this section a grant out of the Hospitals' Trust Fund to a hospital or a nursing organisation, he shall specify the purposes for which such grant is to be expended and may attach to the receipt of such grant such conditions (whether to be performed before or after such receipt) as he thinks proper for securing the due expenditure of such grant on the purposes specified by the Minister or for securing or attaining any other object.
(4) Grants may be made under this section by the Minister out of the Hospitals' Trust Fund for expenditure on any of the following purposes, that is to say:—
(a) the purchase of buildings, including a site for new buildings and also including any superior or outstanding estate or interest in land or buildings belonging to the grantee;
(b) the construction of new buildings;
(c) the reconstruction, extension, alteration, or improvement of buildings belonging to the grantee;
(d) the purchase of hospital, nursing, and other equipment;
(e) the endowment of the grantee or any part of the activities of the grantee, including, in the case of a hospital, the endowment of a bed or beds in the hospital;
(f) the discharge of the debts or any particular debt or debts owed by the grantee, including debts incurred for the past maintenance of the grantee.
(5) No grant out of the Hospitals' Trust Fund shall be made or applied for or towards the future maintenance of the grantee.
(6) In this section— the expression "the grantee" means the hospital or organisation to whom a grant out of the Hospitals' Trust Fund is made under this section; the word "maintenance" means ordinary day-to-day support and upkeep properly chargeable to income;
the expressions "past maintenance" and "future maintenance" mean respectively maintenance before and maintenance after the making of the grant out of the Hospitals' Trust Fund in relation to which the expression is used.

I move amendment 27:—

In sub-section (1), line 37, to delete the words "either on his own motion or"

The object of this amendment is to prevent the Minister, without consultation with anybody, handing out the money as he likes. When an application is made to him under the Act by any of the promoting hospitals he is bound to refer the matter to the Hospitals' Commission and to get their report, but under this section, if it remains unamended by taking out the words which I propose to take out, the Minister, without any application from the hospitals, and, therefore, without any consultation at all with the Hospitals' Commission, can proceed to divide out this money. I submit to the House that that is a wrong principle. If the Hospitals' Commission is to be set up, and is to be consulted— as I think it is right that they, or a body of experts, at any rate, should be consulted—before the money is distributed when an application is made for a grant by any participating hospital, it ought to be exactly the same principle when the Minister gives it out himself. Therefore, I submit, that the Minister should not be allowed to distribute any money except in consequence of an application.

It ought to be remembered in relation to this section that the definition of "hospital" covers not only voluntary hospitals but also poor law hospitals. In respect of the poor law hospitals and district mental hospitals the Minister stands in a special relation. Where the Minister, through his professional and technical advisers, has become acquainted with the circumstances of a particular institution or area, it would be altogether superfluous to have the work of investigation done all over again by the Hospitals' Commission. It is principally for that reason that provision is made for the Minister to make grants without going through what would be the normal procedure of referring each case and each application to the Hospitals' Commission. If the amendment were accepted the Minister would have to wait passively for applications even from local authorities, and he could not institute schemes for Hospitalisation under the local authorities particularly. Again, it may be necessary to give grants or to make allocations, on the Minister's own motion, for experimental work or in connection with financing particular branches of research. I am advised, at any rate, by the legal advisers to the Minister that in order that he may be in a position to do those things it is necessary to retain the section as it stands.

The Parliamentary Secretary here again is, I know—and I think the whole House must know—impervious to any argument of any kind. He has made up his mind that he is not going to listen or pay any attention. He is simply going through this Bill like a bull charging at a gate. The power which the Minister is taking is not in the case of district hospitals or the hospitals under the control of the local authorities. He is taking it in respect of every single hospital. He can, without consultation with any single living person, out of his own motion, pay out a sum of several million pounds to any particular voluntary hospitals that he likes. That is how the Bill stands at the present moment.

Question—"That the words proposed to be deleted, stand"—put and declared carried.
Amendment accordingly declared defeated.

I move amendment 28:—

In sub-section (1), lines 40-41, to delete the words "authorised by this section".

This amendment is part of general recasting of the section, which has been done since the Second Reading debate. In the course of that debate several Deputies expressed apprehension as to the working of sub-section (5), which barred grants towards future maintenance. It has already been explained that this sub-section merely continues what was contained in the Act of 1931 as provided in Section 6 (2) (b), that the sweepstakes should be in addition to, and not in substitution for, moneys spent by local authorities on ordinary maintenance. The section as it stands provides for endowment, the income of which can, of course, be applied for maintenance and it provides for the payment of debts. If we add to these grants for future maintenance, then all possible purposes will be exhausted and it is scarcely necessary to preserve sub-section (4). It is therefore proposed to delete sub-section (4), which relates to various authorised purposes. The three words in sub-section (1), "authorised by this section," should, therefore, also be deleted. The Minister shall make a grant for such purposes as he may think proper on the report of the Hospitals' Commission.

It is very difficult to debate this amendment without going into later amendments, but I will content myself at the moment just with the remark that while I did not like Section 24 as it appeared originally, the section has been appallingly disimproved by the amendments suggested by the Minister, because the Minister now wishes to make himself absolutely, completely and entirely in all respects, master of the hospitals and every single thing carried on in them.

Amendment put and agreed to.

I move amendment No. 29:—

In page 11 before sub-section (2) to insert a new sub-section as follows:—

(2) A grant made out of the Hospitals' Trust Fund under this section may, as the Minister shall in each case think proper, be in the form of a sum to be paid out of the capital of the Hospitals' Trust Fund or in the form of payments to be made annually, for such period as the Minister shall direct, out of the income of the Hospitals' Trust Fund and the National Hospital Trustees shall if so directed by the Minister set aside a portion of the capital of the Hospitals' Trust Fund and invest such portion for the purpose of securing any grant made in the form of payments to be made annually.

This new sub-section specifies the various forms in which grants may be made. That is, they may be made in the form of capital sums such as would be required for the erection of building, furnishing, equipment, etc. They may be made in annual payments such as may be required for experimental purposes, or they may be endowments which would provide an income for permanent services such as the endowment of beds. With grants in these forms every possible claim for assistance can be met while the Hospitals' Fund has money at its disposal.

Amendment put and agreed to.

I move amendment No. 30:—

In sub-section (3), line 51, after the word "grant" to insert the words "or of any payment to be made in respect thereof."

This is a drafting amendment. Conditions may be attached to any payment of the grant.

Amendment put and agreed to.
The following amendments appeared on the Order Paper:—
In sub-section (3), lines 54-55, to delete the words "or for securing or attaining any other object" and substitute the words, "but save as is hereinafter, provided no other conditions whatever."—James Fitzgerald-Kenney.
In sub-section (3), lines 54-55, to delete the words "or for securing or attaining any other object."—Sir James Craig.

We can discuss amendments 31 and 32 together.

Yes. In addition to these amendments I also desire formally to move amendment 38 which I think goes with them. The amendment is as follows:—

Before sub-section (6), to insert a new sub-section as follows:—

In making a grant out of the Hospitals' Fund to any hospital the Minister shall have regard to the amount of benefit conferred upon the sick poor by the said hospital and may make it a condition of every grant to a hospital that the said hospital shall make available for the sick poor a certain proportion, in all the circumstances reasonable, of the beds therein contained either free of all charge or at a charge not exceeding ten shillings per week.

As the section stands at present the Minister may make any kind of conditions that he likes to secure any single object in connection with the management of the hospitals, At the present moment if he does not like the matron of the hospital, or whoever may be the visiting physician, he may make it a term that they should be removed, or that the offices of surgeon or medical visitors to the hospital, all these honorary posts, should be filled by nominees of his own. That is a power which the Minister should not have. As a matter of fact, in my opinion the less interference there is in the management of the voluntary hospitals the better. The voluntary hospitals that have been built up by subscriptions of the charitable public of many generations, should not now be taken over by the Minister. My suggestion is that the Minister shall not be able to make any terms except what he is allowed by this section definitely, that he can make terms which shall secure the expenditure of such grant on the purposes specified, and also, if my amendment is accepted, that he shall make no other condition except as is hereinafter provided. What is provided hereinafter is set out in amendment No. 38. That is carrying on the old principles which were enshrined in the previous Bills. Except that the Minister shall have power to see the sick poor are looked after in the hospitals, he shall not and ought not have any control over the hospitals.

Deputy Fitzgerald-Kenney seems to think that if the Minister is given any powers at all, under this Bill, it can with safety be assumed that he is going to abuse them. I do not think there is any likelihood that the Minister will do any of the foolish things which the Deputy has mentioned. The Deputy should remember that when he was Minister he took very drastic and terrible powers from time to time. Some people may say he abused some of those powers; at the same time he did not go as far as he might. I certainly feel there is no danger that the powers the Minister has taken, under the Fianna Fáil administration, which will last until the hospitals' problem has been solved, will be abused. If the Minister makes a grant he has to specify the purpose of that grant. Thus, if it is a grant to buy a site, to erect a new building, to pay off an overdraft, or to invest the proceeds to produce an income, or to pay the day to day maintenance of the hospitals and so on, he can attach conditions to secure the due expenditure of the grant for the purposes specified. For instance in the case of a grant for building, he may require the plans, specifications and contract to be submitted to him for approval. In the case of local authorities that would be almost the invariable condition.

During the Second Stage of the Bill Deputy Fitzgerald-Kenney said that while from the earlier Acts the safeguards for the sick poor had been taken out, not a single safeguard had been put in. Here is the very safeguard that has been put in for attaining the purpose that Deputy Fitzgerald-Kenney proclaims he is most anxious to secure.

My amendment would effect that in this Bill.

My legal advisers tell me that if Deputy Fitzgerald-Kenney's amendment is accepted the Minister will not be in a position to attach the conditions to his grant that will be necessary to ensure that a certain proportion of beds will be available for the poor in the future.

In spite of the plain wording of my amendment?

In spite of the plain wording of the amendment and Deputy Fitzgerald-Kenney's knowledge of the law; that is the opinion of my legal advisers. The immediate purpose of the grant would be to erect certain buildings. A limited portion of the grant would be to secure that certain beds would be free to the poor. If we deleted the words that Deputy Fitzgerald-Kenney proposes should be deleted we would not be able to attach the conditions to the grant necessary to be attached in order to ensure that these beds will be apportioned. Consequently this amendment, like many more amendments of Deputy Fitzgerald-Kenney, must be resisted.

The Parliamentary Secretary is talking most absolute nonsense. He says if my amendment were accepted he could not make it a condition that any of the beds would be given to the sick poor. But my amendment 38 makes it a condition of every grant to a hospital that in such hospital beds shall be made available for the sick poor.

We have not yet reached amendment 38.

We are discussing amendments 31, 32 and 38.

Amendment 31 proposes to delete the words "or for securing or attaining any other object" and to substitute the words "but save as hereinafter provided no other conditions whatever." Probably the Parliamentary Secretary did not understand what his law officers told him.

I am not one bit afraid that the Minister is going to do any of the terrible things envisaged by Deputy Fitzgerald-Kenney, but I think the discussion on amendment 38 might well be availed of by the Parliamentary Secretary to indicate what the policy of the Minister is in regard to the provisions suggested and to declare to what extent the Parliamentary Secretary intends that the policy of the Minister would go in this matter. Would he be in the position to say if his policy in regard to compelling the hospitals to make provision for the poor would take the shape of reserving 25 per cent. of the beds for the poor? Is he prepared to go so far, or would he be prepared to go farther? I think it would help to clear up any doubts that exist on that matter if the Parliamentary Secretary could see his way to let a little further light in upon that subject. Deputy Fitzgerald-Kenney is quite inconsistent in this matter. He talks about taking away provisions previously inserted. As a matter of fact, in two or three of the Acts carried in this House the provisions that he tries to insert now in this Bill were not inserted.

I beg your pardon.

Mr. Murphy

I beg your pardon. One Cork City hospital is a notable example of what I say. The fact that such a provision was omitted led to a scandalous abuse in connection with that same hospital. The fact that Deputy Fitzgerald-Kenney is now asking to have inserted something that he failed to insert when his Bills were passing through this House, is no tribute to him. I hope the Parliamentary Secretary will make provision that these things are made hard and fast. No matter how careful he may be the tendency in certain hospitals is, and will be, to evade responsibility in this matter. I greatly regret it. This matter was discussed before in this House when Deputy Norton and myself were responsible for a Bill that sought to check these things. In one hospital to which a substantial sum of money has been paid I know that not one nonpaying patient was admitted, not one patient who could afford to pay only 10/- a week, and no case was admitted except of persons paid for at the full rate by the Board of Health or by private people. The fact that this Bill proposes to check that makes it very acceptable to me and to everybody conversant with the facts, or intimate with the want of proper hospital accommodation in various parts of the country. I hope the Parliamentary Secretary will indicate as definitely as he can to what extent he intends to make provision for the poor in return for the generous assistance the hospitals are going to get.

Will the Parliamentary Secretary accept amendment 32 which stands in my name, to delete the words "or for securing or attaining any other object?"

I think they are absolutely unnecessary.

I went to great pains to try and explain how the retention of the words proposed to be deleted is necessary. According to the legal advice I have got we would be entirely handicapped in putting into operation the provisions of the Bill if this were deleted.

Deputy Murphy has made a statement about some of the Cork hospitals that got money lately. I know the Cork City hospitals very well. I represent one of them on the Hospitals' Committee. I do not know of any case where anyone was turned away because they could not pay. In the hospital that I represent there is about 40 per cent. of free beds.

Mr. Murphy

I dislike mentioning the name of the hospital concerned, but if it will be any ease to Deputy Desmond's mind to know this, I have pleasure in saying that it is neither the North Infirmary nor the South Infirmary. I will give the information as to the hospital I have in mind if the Deputy wishes me to do so, but I do not like mentioning it here.

I do not want the Deputy to do so.

When the first Hospitals Bill was before this House and being examined by the Committee set up to examine it, one of the provisions that the Committee thought most essential in the Bill was a provision that a certain proportion of the beds in the hospitals should be available for the poor. That was enshrined in the original Bill. The Minister has cut that provision out of the amending Bill. I do not pretend to be a lawyer but I do not see any difficulty about reinserting the provision that was in the original Bill. If the Minister's legal advisers advised him to the contrary I can even assume that their ability can provide means to insert in plain language what was thought to be necessary in the original Bill and what appears to be still necessary, according to the assertion made by Deputy Murphy. If Deputy Murphy's assertions are true—and from my experience as a member of the Hospitals' Committee I am loath to believe that they are true—but if the Deputy's assertions are true there is all the more reason for the acceptance of Deputy Fitzgerald-Kenney's amendment, which points out the necessity to make it incumbent on every hospital receiving these funds to provide a certain proportion of its available accommodation in beds for the sick poor.

What proportion? There is not a word about that in the amendment.

Of course it is in the amendment.

What proportion?

The proportion that was set out in the original Bill.

There is no proportion mentioned in the amendment.

Well, a certain proportion. We are leaving something to the discretion of the Minister. I would have preferred the exact proportion to be down in figures and perhaps the Minister would adopt that course. I am merely arguing for the principle of the thing. The Parliamentary Secretary argues that he can bring about this in another way. Perhaps he can. But the Committee that considered the Bill originally thought it was necessary that it should be definitely set down in the Bill, in black and white, that a certain proportion of the beds should be available for the sick poor. Deputy Murphy's speech is in itself an argument for Deputy Fitzgerald-Kenney's amendment. Perhaps it is a better argument than we can make here— that is, if what Deputy Murphy alleges actually happened.

Mr. Murphy

A certain proportion.

The proportion set out in the original Bill was 25 per cent., which could be neither one nor the other. The obligations were there.

Mr. Murphy

They were not carried out.

We can prove it.

It has not been proved yet. As far as any information at my command is concerned, and as Deputy Desmond says, according to his information, and he is also a member of the Hospitals' Committee, we have no evidence of any such thing occurring. If the Cork Deputies have such information they should put it at the disposal of the House or of the Minister.

Mr. Murphy

Plenty of information was put in the possession of the House, when a Bill was introduced in this matter by Deputy Norton and myself.

When this Bill was being considered on the Second Stage the Deputy might have got up and made a speech—and made it much stronger than I can—against this proposal to wipe out the one provision in the Bill which met the Deputy's difficulty; but the Deputy did not.

Mr. Murphy

Indeed I did.

Well, you did not. This amendment is an attempt to put back in the Bill the one and only absolute safeguard to provide what is necessary in the way of relief for the sick poor in regard to the proportion of beds. The Parliamentary Secretary said, I think, that the remote object of the grant was to provide for the poor. If he says that the remote object of it is such-and-such I do not know what his intentions are. I should say that the immediate object should be to make provision for the sick and needy poor.

May I explain—I suppose it is foolish to bother trying to explain to the Deputy—the immediate purpose at the time of the allocation was to provide for buildings; the remote purpose was to provide free beds for the poor. I think it will be agreed that it is necessary to provide the buildings before you can provide the beds.

One of the intentions in the Bill was to provide buildings and equip existing buildings in a better way. That was one of the immediate objects. But it was never an object of the Bill that it was to be in the remote distance that a certain proportion of beds was to be available for the sick and needy poor. The Parliamentary Secretary says that the remote object was the provision of beds for the sick poor. I say that that should be the immediate object. I, certainly, whole-heartedly support Deputy Fitzgerald-Kenney's amendment. It was supported by the Labour representative, Deputy Murphy, perhaps indirectly, but certainly more forcibly than I supported it and I hope the House will press for the reinsertion of this provision in the Bill.

This again raises the thing in which I was particularly interested in this Bill—what is being done under the cloak of providing for the sick poor which is more definitely provided for by the amendment than by the section in the Bill as it stands. Under that pretence and under that banner we have an attack, so far as principle is concerned—and that is what mainly interests me—on the voluntary system. For that reason I would ask the House to consider and support Deputy Fitzgerald-Kenney's amendment. Supposing what Deputy Murphy has said is true, what does it prove?—that a certain power was given in the late Bill——

Mr. Murphy

No, but that it was not in the late Bill at all. With regard to one city hospital in Cork, when I confronted the hospital with what I have already mentioned, they pointed to the Bill and said there was no obligation there.

The section, as it stands now, does not deal with the point raised by Deputy Murphy. It does not make any definite provision in connection with the sick poor. Supposing that is what is aimed at and that there are other powers which the Minister wants, why not provide for these powers? It is said that he is not going to utilise the immense powers that are given, but I suggest that there is a principle at stake and that if he is not going to utilise them the House ought to be very slow to assent to that principle. There are very few voluntary institutions left in this country.

Voluntary institutions so far, for instance, as education and hospitals are concerned, are things that some people attach great importance to. The voluntary principle is something that people attach great importance to. I suggest that, without adequate reason, that whole position so far as it can be done by legislation, ought not to be undermined. If there is any fault to be found with the actual drafting of the amendment the way to meet that is the way that amendments have always been met in this House, namely, that the principle of it be accepted, and then have it re-drafted to get what exactly is aimed at.

So far as one can see, the amendment itself seems perfectly clear. The Minister has met that by saying that his legal advisers assure him that it will not have the effect of carrying out what is its obvious purpose. In that case I suggest that the ordinary line that has been pursued on the Committee Stage in the House is not to find verbal fault with the amendment, but to accept the principle of it and have it redrafted to carry out the intention. If there is full agreement that, in certain matters where money out of the Sweeps Fund is being given, the Minister should lay down certain conditions, I suggest that those conditions ought to be defined, and that the vague power in the Bill as it stands should not be given to the Minister. The House, I suggest, would be doing a very dangerous thing in assenting to that principle. That is mainly the reason why I rose to speak on this. It seems to me that there is a very big principle involved. It is a principle, as I have said, that a large number of people in this country are passionately attached to. That principle seems to me to be endangered by this Bill as the section now stands. Verbal attacks on the amendment, whether justified or unjustified, do not meet that particular case.

Might I interrupt the Deputy by asking him if he would be so good as to state more precisely what that principle is.

The principle of voluntary institutions not being unduly interfered with by the Government, a principle that I stood very strongly for when I was Minister for Education. I know perfectly well that there are many people who are quite as strongly attached to that principle so far as the hospitals are concerned. The tendency of the State is to interfere more and more with voluntary institutions. I think that this House, in the position that we are in, having the traditions that we have, should hesitate very much before it gives any such power into the hands of a Minister.

May I answer Deputy O'Sullivan?

Deputy O'Sullivan argued that the hospitals are to-day in the position of being voluntary hospitals. Before the introduction of the original Sweepstakes Bill I could understand Deputy O'Sullivan's point quite well. The hospitals were then in the real sense voluntary hospitals, but the position is altogether different to-day.

I listened to Deputy O'Sullivan to get his point of view. I appreciate the point of view that he expressed, but I say that the hospitals are no longer voluntary hospitals as they were before the original Sweepstakes Bill was introduced. That being the case, I say that where legislation is providing the means for their existence and continuance and when we take into account the position they have arrived at to-day, the position is altogether different to what it was some years ago. When the original Bill was introduced I remember well Deputy Sir James Craig referring to a certain voluntary hospital which had an overdraft of £5,000. Under the various sweeps that have been held that hospital has now received something in the neighbourhood of £150,000. I would agree with Deputy O'Sullivan's point of view if the returns from the sweeps were very much smaller and if the people who were running the hospitals did not point to the fact that voluntary support for them had now ceased because of the sweeps. I would like to hear Deputy O'Sullivan explain, if he is really convinced as to his point of view, the principle of voluntary hospitals in view of the present situation.

I am very glad that the Deputy has given that exposition.

May I say that I appreciate very much the fact that the Deputy is going to answer me, notwithstanding that he said when I rose to speak "you may not answer."

Again I have to say that I am extremely grateful to the Deputy for so clearly expressing the Fianna Fáil point of view on voluntary hospitals.

I did not express the Fianna Fáil point of view.

I followed the Deputy closely and his statement was that the voluntary principle had ceased to exist. His whole speech was based on that assumption.

That is my view.

Very good. That is precisely what I am arguing against: that the voluntary system has not ceased to exist. The voluntary system does not cease to exist merely because the money comes from the sweepstakes. The interference with the voluntary system is interference by Governmental authority. If the House will bear in mind what Deputy Briscoe has said they will be able to appreciate whether or not the fears that we have given expression to are or are not justified, namely, that the justification for backing up this particular section is that the voluntary hospital is already dead.

I happen to be violently prejudiced against State interference and as a general thing I am a supporter of individual liberty and of the liberty of institutions like hospitals. It seems to me that if an institution decides to receive large sums of money as a result of State action it cannot complain if the State attaches any condition it wishes.

Hear, hear!

It is open to an hospital that wishes to be entirely independent to refuse to receive these moneys. I may be missing some point, but I am open to conviction.

This is not State money—nothing of the kind. May I say that the point of view that Deputy MacDermot and Deputy Briscoe are so fully in accord with strikes at the very foundation of our whole scholastic system in this country for which nearly all the money comes from the taxes. It does away with the whole thing. If Deputy MacDermot would really try to grasp how much some people are attached to this voluntary system he would understand what is at stake. It is quite obvious that neither Deputy Briscoe nor Deputy MacDermot does understand. I was not amazed to hear Deputy Briscoe say "hear, hear" to Deputy MacDermot's exposition which revealed a complete failure to understand what this country struggled for for a couple of generations and has attained.

I want to say that I cannot understand or appreciate the argument of Deputy O'Sullivan because on the one hand he is trying to say that as far as education in this country is concerned there is absolutely no State interference.

I never said that.

The Deputy argued that the State was now getting into the management of voluntary hospitals and that this was the forerunner of interference in educational affairs. I want to say that I agree entirely with what Deputy MacDermot has said. We all know from experience the struggle the voluntary hospitals had to carry on under the voluntary system. There is to be no interference with them now so far as their internal management is concerned. The State is introducing legislation to enable these voluntary hospitals to be put on a better basis, and as far as I can understand it is reserving to itself the right to see that the money raised under its legislation is wisely spent: that it will do all the good that it is possible for it to do for the persons it is intended to serve, namely, the sick poor.

When the original Bill was introduced, the amount of debt in the case of every hospital and the number of years of its struggles were stated and, in every case, the point was made of the number of sick poor attended by these hospitals. I do not say that they were exaggerating. I can only speak for the City of Dublin; but I appreciate, from my own little knowledge of the matter, that they made great efforts notwithstanding all their difficulties, but, since they received these tremendous sums, I must confess they have not improved on their previous generosity to the sick poor. I was amazed at the amount of attention being given to certain structural alterations and to certain internal improvements while, at the same time, there was a neglect, and an almost complete neglect, in some cases, of extending the charity they had been so proudly boasting of in the past to the sick poor.

I had no intention of intervening in the debate, but I was anxious to see the point of view the Opposition were developing, and it was only when Deputy O'Sullivan spoke that I got a clear view of what the arguments were being based on. I maintain that where the State is legislating, as Deputy MacDermot has pointed out, in simple and plain language, with a view to putting the hospitals in a much better position than they had ever hoped or dreamt of being in, the State should have the right to interfere to ensure that the money is being spent in giving service to the sick poor. I want to go a point further. My own personal point of view is this —and I expressed it on a former occasion—I should like to see hospitals run by the State rather than on a voluntary basis. I would prefer to see State management of these institutions because I believe that you would have a far better system in this country than you have at present with far better service for the sick poor. I believe it would be a far better system in view of the fact that we have talked so much of the sweeps being for the benefit of the sick poor, while, as it has turned out, a great deal could be done that has not been done. I say that the Minister is quite right in taking to himself the right to examine and, where he sees it may be necessary to intervene, I think he should intervene and should make his conditions when awarding the various proportions to the particular hospitals.

As I said before, I cannot accept the statement of Deputy O'Sullivan that the hospitals to-day can call themselves voluntary hospitals. They are absolutely dependent to-day—let us face the situation—on the position created by the introduction of this method of raising funds. I do not say that I ever accepted this system as a proper system but, nevertheless, the position is there and you have no longer voluntary hospitals as Deputy O'Sullivan understood them, or as we knew them to be. They are to-day State aided hospitals. It does not matter where the money comes from. It all boils down to this—it is through the legislation of this State that their income comes and they are dependent on that income so long as the State chooses to re-enact legislation to continue this means of raising these funds I say the State has a great responsibility and not only at the present time. I visualise a time when our hospitals will be properly equipped and when there will no longer be any necessity for the income the hospitals have been enjoying in the last few years and, if this money is not wisely spent now and spent in a way that will ensure continual benefit for those whom it is intended to benefit, those who come after us will be able to say that we could have been more wise in our administration of this legislation.

Deputy Bennett finds fault with the frank statement of the Parliamentary Secretary when he says that, primarily, we are interested in seeing that the buildings are there and that, in the second place, comes the consideration of the beds.

And remotely.

Deputy Bennett is emphasising the words "immediate and remote." That is a relative matter. It might mean what we understood it to mean when we were in Opposition—six, ten or even 100 years hence—but, as I understand the Parliamentary Secretary's point of view, it is that he wants to see buildings put in position that will satisfy him as to their desirability and suitability. The remote point of view would be the beds.

The Deputy in his speech has spoken directly contrary to what the Parliamentary Secretary said, when he spoke about some of the Dublin hospitals.

I knew what I was talking about. I happen to have seen some of the Dublin hospitals and I saw a multiplication of services in some cases which were not necessary and a complete disregard of what is known as external treatment of poor patients.

All the more necessity for this amendment.

I have seen those things and I am satisfied that the Minister's intervention will, on occasions, be necessary. The fact that he possesses these powers does not necessarily mean that they will have to be used. From the manner in which Deputy Bennett spoke, one would imagine that he was going in for fresh air treatment and that all he was concerned with was the question of beds in the open air. If he reads his speech when it is circulated to him, he will find that it could be argued from it that he was expressing a desire for fresh air treatment.

Is that how the Deputy interprets the phrase "provision for the sick poor"?

I am interpreting Deputy Bennett's speech and not provision for the sick poor. I interpret that in a practical way and I can interpret Deputy Bennett's "provision for the sick poor" by the experience the sick poor had, as well as the other poor, during the ten years' administration of the Party to which Deputy Bennett belongs. As I said in the beginning, if Deputy O'Sullivan could convince me that the hospitals to-day were purely voluntary hospitals I should be the first to accept his point of view and to agree that there should be no right to interfere on the part of the Minister, but I cannot accept his point of view. I should like to be convinced, if it is possible to convince me, that they are voluntary hospitals. I say that they are no longer voluntary hospitals. On one occasion, some years ago, when the State was seeking to cut down certain expenses and to introduce certain economies by reducing their contribution to the hospitals, I resented it and tried my best to argue against it to Deputy Cosgrave when he was President. I said that I wanted the State to reserve, by its contributions, the right to have some say in the administration and management of the hospitals. The present Minister for Local Government and Public Health was on the Dublin Corporation at the time and, if I remember correctly, he strongly opposed the proposal and succeeded in saving the contributions to the hospitals by the City of Dublin from being reduced. In the Dublin administration, we wanted to have some right, as a civic authority, as regards the sick poor of Dublin and, on that principle, I say that these hospitals are no longer voluntary hospitals. They are voluntary hospitals, if you like, in the sense that the services of a number of eminent physicians and surgeons attached to them are being given gratis and in a generous spirit for the benefit of humanity but, outside that, they are not voluntary hospitals.

I have only a few words to say. I did not intend to intervene in the debate, but I think that the last speaker's remarks are altogether beside the point. We are getting nowhere with this academic discussion as to whether the hospitals are voluntary or not. The principle of the Bill is to provide free treatment for the needy poor and I, for the life of me, cannot see why that should not be explicitly ensured in the Bill. The Minister did not give any reason. Is there any reason why there should not be an assurance to that effect in the Bill? Would it damage the Bill?

It is already in it.

Would it not reinforce the Minister's power and help him in his desire to see that the hospitals make proper provision for such patients?

I support Deputy O'Sullivan for no other reason than that State control ultimately develops into State ownership. That creates a soulless machine. The human tendency gradually slips away in administration and, by degrees, that kindly atmosphere which should prevail in a hospital is absent. Everything is regulated by the filling of forms. I have pleasure in supporting Deputy O'Sullivan's amendment and I hope it will receive the favourable consideration of the House.

It seems to me that you cannot do a worse service to any principle than to try to apply it when it is really not applicable. I am strongly in favour of resisting improper State interference, but it is open to any institution to refuse to receive public moneys if it so desires. We have liberty here to bring in legislation at any time to apply these moneys to some other purpose and that, surely, should give us a right to say what the hospitals ought to do. I am hesitating as to how I should act on this amendment. If it could be shown that the result of the amendment would be to produce better management than is likely as a result of the Minister's action, I should vote for it. I think it is really a question of which method is going to produce better co-ordination and give better results. That is the only thing that interests me. I think that this appeal to the rights of the individual is wholly out of place under the circumstances.

May I point out that there is no appeal to the rights of the individual. It is a question of institutions. With regard to the long speech made by Deputy Briscoe, if this is merely a question of the sick poor, it can be met by definite provision. That is no excuse for the powers which will be taken in this section when the various amendments shall have been incorporated in it. A case for a limited amount of interference constitutes no reason for placing in the hands of the Minister the absolute power we are now about to confer upon him. That is what I object to. State interference may not necessarily mean State control. I know perfectly well that when the State gives money it may affix conditions to the grant, but that is no reason why it should take absolute power. Any case made here to-night has been for only a limited power of interference by the Minister. That was the only case put forward by the Minister himself, by his colleague Deputy Briscoe and by Deputy Murphy. The way to do that is along the line of definite provision and not along the line pursued by the Government of what amounts to an absolute power of interference.

How Deputy MacDermot makes up his mind to vote on this question is a matter primarily for himself, but I can assure him that, in connection with these voluntary institutions, there are serious principles at stake. This is not an academic matter. It is a matter to which many of us attach great importance. A person occupying a responsible position has to watch carefully to ensure that the State, when it has power, does not give way to the temptation to abuse it. The whole tendency is in that direction. Everybody occupying a responsible position—whether in Parliament or as a Minister—has to be continually on the watch against such interference. That is the reason I deprecate any such attempt as is now being made to give absolute power to the Minister, as this section will give when the various amendments standing in his name will have been accepted by the House.

It is rather amusing to hear Deputy Fitzgerald-Kenney and Deputy O'Sullivan complaining of the powers being given the Minister when we think of the powers that they looked for during our four or five years' experience. I do not see why the Minister for the time being should not have whatever powers of interference are necessary to protect the sick poor and see that the hospitals perform their share of the bargain which was struck when this House was introducing sweepstakes. So far as the hospitals of Cork are concerned, I could not speak too highly of the manner in which they have carried out their share of the contract. There was one exception of which Deputy Murphy and I had experience. When the Bill was being passed through the House, the safeguards thought necessary were introduced by Deputies opposite and passed. What was the result? When Deputy Murphy went up to one of them he was told: "Show us in the Bill where our obligation is?" The obligation was not there. These people obtained money under false pretences. The Minister should have power—absolute power—to step in in a case like that, tell the hospital that it had evaded its responsibilities and compel it to act up to the conditions under which it had got the money. The Minister should have unlimited power to deal with any emergency like that. We had bitter experience in one case and we do not want that experience repeated.

The discussion on these amendments has ranged over a very wide field. On one point, there appears to be general agreement— that we should ensure that adequate facilities for the hospital treatment of the poor will be made available consequent on the placing of these moneys at the disposal of these institutions. There appears to be general agreement on that principle. The disagreement would appear to range round the provisions we are making, as compared with the provisions made in previous enactments. Deputy Bennett, for example, laments that we have not included in our Bill a condition that 25 per cent. of the beds of the participating hospitals should be free to the poor. Other Deputies on the opposite benches spoke in a similar strain. They are already aware that certain hospitals were specifically exempted by law from compliance with that condition. They are also aware that, even in relation to hospitals to which that section did apply, while it was necessary that 25 per cent. of the beds should be available to the poor, at the time the allocation was made there was no provision whatever for continuing to place 25 per cent. of the beds at the disposal of the poor.

Deputies on the opposite benches may say that it was quite safe to leave the matter in the hands of the voluntary institutions. They may talk about the great work these institutions did in the past. We all admit that. As I stated on a previous occasion, this money is made available by Government action, and there is a responsibility on the Government to ensure, as a result, that adequate provision and the best that medical science can provide will be made available for the poor of this country as a result of the opportunity presented. What are the safeguards that Deputy Fitzgerald-Kenney proposes in his amendment:

In making a grant out of the Hospitals' Trust Fund to any hospital the Minister shall have regard to the amount of benefit conferred upon the sick poor....

He "shall have regard". What does that mean? If ever there was an example of an empty formula I think Deputy Fitzgerald-Kenney's amendment will answer to that description:

And may make it a condition of every grant to a hospital that the said hospital shall make available for the sick poor a certain proportion....

He may, or may not, make a certain proportion—one per cent. or 100 per cent. I suggest to the House that this is merely the expression of a pious hope, as to what the Minister may do, and that the provisions in Section 24 (3) are real safeguards for the poor. The amendment does not improve the situation. In fact, it makes it possible that conditions governing allocation for the provision of free beds for the poor, may be altogether in the air. Why do we not specify at this stage what particular percentage of beds will be made available for the poor in any institution? For the simple reason that we do not know. That is one of the purposes of the Hospitals' Commission, to examine into the hospital system as it stands, to examine it from the point of view of the needs of the community and, more especially, the poor. They will then be in a position to report and to recommend to the Minister for Local Government and Public Health what proportion of the beds in a particular institution should be made available free. It is quite conceivable, and likely, that in different classes of institutions a different proportion of beds will be necessary. Ten beds might be sufficient in an institution set up for the treatment of certain diseases, while 50 or 60 beds might be required in another class of institution.

I draw the attention of the House to Section 24 (3) in which Deputy Murphy was particularly interested:

Whenever the Minister makes under this section a grant out of the Hospitals Trust Fund to a hospital or a nursing organisation, he shall specify the purposes for which such grant is to be expended and may attach to the receipt of such grant such conditions (whether to be performed before or after such receipt) as he thinks proper for securing the due expenditure of such grant on the purposes specified by the Minister or for securing or attaining any other object.

That section has been drafted deliberately to enable the Minister to attach conditions to the allocation made to any hospital and will safeguard the rights of the poor. As far as the hospital system is concerned in the future that is the only section in the Bill that safeguards the rights of the poor, and it is an absolute safeguard, whereas if we insert the amendment the poor, for all practical purposes, have no safeguard.

If one wished to turn a thing topsy-turvy I do not think anyone could set about it more successfully than the Parliamentary Secretary. As the Bill stands there is not a single provision in it for the sick poor. From beginning to end of the Bill the sick poor are not mentioned, and it is in the power of the Parliamentary Secretary, or the Minister, to make it the condition of a grant that no assistance and no help should be given to the sick poor. There is absolute and unlimited power over the internal arrangements of hospitals, but there is not a single word, and no direction to the Minister from this House, as to how the Bill should be administered. Surely this is a Bill in which the House should give a direction to the Minister, and should set out what matters the Minister is to consider. One of these matters—and here is where the Parliamentary Secretary finds fault with my amendment—if the amendment is accepted, is where it directs the Minister to take into account how hospitals assist persons most in need of assistance. Because this House is giving directions to the Minister that he is not to make a grant, except to an hospital that considers the necessities of the very poor and needy, we are asked to reject the amendment.

We heard a great deal from different persons about the reason why there should be unlimited power, if the Minister is going to interfere with the hospital arrangements. Deputy Briscoe was very strong on that, and wants to see State control. He has got it in the Bill, in the sub-section which gives the State absolute control over all the domestic affairs of every hospital, because the Minister can make any regulation he pleases with reference to any hospital. He has got absolute and complete control. You cannot have more State control than this Bill gives the Minister. He tells us that he does not want it; that he does not intend to use it. Then why take it? We are told that as the State is providing money for the hospitals why should it not have control over them. That statement is utterly inaccurate. The State is not providing one single halfpenny for the hospitals. The one way in which the State is interfering with State money is, that it is taking away, and has taken away over £1,000,000 from the hospitals. I do not know whether that argument does or does not appeal to Deputy MacDermot, who said that the State has given the money, and therefore has a right to control. When the State is actually taking away money, instead of giving it, surely that does not give it a right to control.

Could not the hospitals have got this money without State control?

Yes. Under common law it is the right of every individual to carry out a sweepstake. A person is perfectly entitled to carry out a sweepstake, or lottery, or anything else at common law. A certain number of statutes called the Lottery Acts were passed and they made the holding of sweepstakes illegal. All that the State has done in this country as regards the hospitals is that it has restored to them the common law rights which they possessed, absolutely nothing more. That is the position. I do not suggest that some of the Deputies opposite, who laugh so gaily at that statement, know very much about these matters. If, however, they take the pains to go back on the Lottery Acts and study the reason why they were passed, they will find that it was not out of any great desire to prevent the English people from gambling. The only reason was that they discovered that lotteries were very much more attractive than State loans and, because money was not being subscribed to State loans, lotteries were made illegal. That is what lies behind the Lottery Acts.

All that is being done for the hospitals here is that the Lottery Acts are being repealed so far as they are concerned. That does not give them State money. They are allowed to collect money from ordinary persons by means of sweepstakes, but that is all. They are getting no money from the State and on that ground the State has no right to interfere at all. What we do want is to see that hospitals that have been placed in that position, that have been allowed to collect in this peculiar fashion from the general public, shall utilise the proceeds for the alleviation of suffering amongst those people who are unable to pay for adequate medical and hospital treatment. Further than that we have no right to go. These hospitals should in that way be assisted in order to enable them to bring themselves up to date, to carry out their duties to the sick poor and thus realise the kindly intentions of those who founded them. These hospitals are not State founded. With possibly one exception in Dublin, the old House of Industry, all the others have been built by the donations of charitable and pious persons and they were meant to do a particular class of work. We are simply allowing them to help themselves to carry out that beneficent work. This House has no right to interfere with these institutions, which have been endowed by private individuals, and the Minister has no right to take complete control of them, as by this section he purports to do.

Question put:—"That the words proposed to be deleted stand."
The Committee divided: Tá, 68; Níl, 43.

  • Aiken, Frank.
  • Bartley, Gerald.
  • Beegan, Patrick.
  • Blaney, Neal.
  • Boland, Gerald.
  • Bourke, Daniel.
  • Brady, Brian.
  • Brady, Seán.
  • Breathnach, Cormac.
  • Breen, Daniel.
  • Briscoe, Robert.
  • Browne, William Frazer.
  • Clery, Mícheál.
  • Concannon, Helena.
  • Cooney, Eamonn.
  • Corry, Martin John.
  • Crowley, Fred. Hugh.
  • Crowley, Timothy.
  • Daly, Denis.
  • Derrig, Thomas.
  • Doherty, Hugh.
  • Dowdall, Thomas P.
  • Flynn, John.
  • Flynn, Stephen.
  • Fogarty, Andrew.
  • Geoghegan, James.
  • Gibbons, Seán.
  • Goulding, John.
  • Hales, Thomas.
  • Harris, Thomas.
  • Hayes, Seán.
  • Hogan, Patrick (Clare).
  • Houlihan, Patrick.
  • Jordan, Stephen.
  • Kehoe, Patrick.
  • Kelly, James Patrick.
  • Kelly, Thomas.
  • Kennedy, Michael Joseph.
  • Kent, William Rice.
  • Kilroy, Michael.
  • Kissane, Eamonn.
  • Lemass, Seán F.
  • Little, Patrick John.
  • Lynch, James B.
  • McEllistrim, Thomas.
  • MacEntee, Seán.
  • Maguire, Conor Alexander.
  • Moore, Séamus.
  • Murphy, Patrick Stephen.
  • Murphy, Timothy Joseph.
  • Norton, William.
  • O'Briain, Donnchadh.
  • O'Grady, Seán.
  • O'Kelly, Seán Thomas.
  • O'Reilly, Matthew.
  • Pattison, James P.
  • Pearse, Margaret Mary.
  • Rice, Edward.
  • Ruttledge, Patrick Joseph.
  • Ryan, James.
  • Ryan, Martin.
  • Ryan, Robert.
  • Sheridan, Michael.
  • Smith, Patrick.
  • Traynor, Oscar.
  • Victory, James.
  • Walsh, Richard.
  • Ward, Francis C. (Dr.).

Níl

  • Alton, Ernest Henry.
  • Anthony, Richard.
  • Beckett, James Walter.
  • Belton, Patrick.
  • Bennett, George Cecil.
  • Brennan, Michael.
  • Broderick, William Joseph.
  • Byrne, Alfred.
  • Cosgrave, William T.
  • Costello, John Aloysius.
  • Craig, Sir James.
  • Daly, Patrick.
  • Davitt, Robert Emmet.
  • Desmond, William.
  • Dockrell, Henry Morgan.
  • Dolan, James Nicholas.
  • Doyle, Peadar S.
  • Esmonde, Osmond Grattan.
  • Fitzgerald, Desmond.
  • Fitzgerald-Kenney, James.
  • Holohan, Richard.
  • Keating, John.
  • McFadden, Michael Og.
  • McGilligan, Patrick.
  • McGuire, James Ivan.
  • McMenamin, Daniel.
  • Minch, Sydney B.
  • Morrisroe, James.
  • Morrissey, Daniel.
  • Mulcahy, Richard.
  • O'Connor, Batt.
  • O'Higgins, Thomas Francis.
  • O'Leary, Daniel.
  • O'Mahony, The.
  • O'Neill, Eamonn.
  • O'Sullivan, Gearóid.
  • O'Sullivan, John Marcus.
  • Redmond, Bridget Mary.
  • Reidy, James.
  • Rice, Vincent.
  • Roddy, Martin.
  • Rogers, Patrick James.
  • Thrift, William Edward.
Tellers:—Tá: Deputies Little and Traynor; Níl: Deputies Doyle and Bennett.
Question declared lost.
Progress reported, the Committee to sit again to-morrow.
The Dáil adjourned at 10.35 p.m. until 3 p.m. on Wednesday, 31st May.
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