To afford an opportunity for full discussion of the amendments, I move that the Bill be recommitted in respect of the amendments.
Vol. 48 No. 2
To afford an opportunity for full discussion of the amendments, I move that the Bill be recommitted in respect of the amendments.
I move amendment 1:—
In page 2, Section 1, to insert after the word "institution" where it occurs in lines 40 and 42 the words "or organisation" and to insert after the word "institutions" in line 49 the words "or organisations".
This is a drafting amendment. The words "or organisation" are used after the word "institution" in line 38 and it was considered advisable to repeat them after the word "institutions" wherever it occurs in the definition.
What type of organisation does the Parliamentary Secretary intend to cover?
Nursing organisations; it it is merely a drafting amendment. We are merely repeating the words which appear further up in the section. It is a pure formality.
Can the Parliamentary Secretary say in what way he intends to help by the granting of this money?
A hospital is defined as meaning an institution or an organisation, and then it goes on to say it includes any institution or organisation. I presume that is the meaning of it. The words "nursing organisation" have a place in the Bill.
I move amendment No. 2:—
In page 2, line 43, Section 1, to insert before the word "mentally" the words "blind, deaf, dumb, or".
This amendment is supposed to meet a general wish expressed on the Second Reading Stage. Deputy Fitzgerald-Kenney, and Deputy Davitt, raised the question of deaf and dumb institutions. It is proposed under this amendment to include these institutions as being entitled to benefit under this scheme.
I move amendment 3:—
In page 8, Section 14 (6) to insert after the word "hospital" where it occurs in lines 20, 29 and 31 the words "or nursing organisation".
This is a drafting amendment. Nursing organisations are to be on the same footing as hospitals, and can be given grants. This amendment gives the Hospitals Commission, on getting information as to the work of the nursing organisation, much the same power as they have in regard to hospitals under Section 14.
I move amendment No. 4:—
In page 11, line 21, Section 23 (1), after the word "Eireann" to insert the words "or any person about to establish any such hospital or nursing institution."
On a point of order, it appears to me that this is an extension of the measure as originally drawn, for which no provision was made. I submit, as it stands, the amendment is out of order. This is "an Act for the granting of powers to enable funds to be raised by means of sweepstakes and drawings of prizes for the benefit of certain classes of institutions and organisations ..." All these institutions and organisations are in existence and the inclusion now, on the Report Stage, of such words as those in the amendment, extending the scope of the measure beyond those originally intended, or indicated, would, I submit, be out of order.
The Leader of the Opposition courteously gave me notice of his intention to raise this point. But before receiving that notification I had examined the Bill very carefully, and these amendments, in relation to it, and it seemed to me that amendments 4 and 5 definitely came within the ambit and scope of the Bill. I am still of that opinion. Incidentally the matter was discussed in Committee. As to the advisability of accepting No. 4, which would extend the scope of the Bill to persons about to establish hospitals and nursing organisations, that is a matter for the House to decide. The Chair could not pronounce upon the merits of the case. It is my considered opinion that these amendments are quite in order.
I presume you are not taking it that the discussion of these in Committee would put them in order for discussion now on the measure as originally drawn?
I think it will be necessary to discuss amendments 4 and 5 together. They are intended to cover the points raised by Deputy Fitzgerald-Kenney on the Second Stage, that before a grant was given to a hospital it would have to be in existence and that the Minister had no power under the Bill to make a grant to a new hospital unconnected with any existing institution or body. The intention of the Bill was to provide for financing such new institutions. There appeared to be some reasonable doubt as to whether that intention could be carried out without this amendment. The amendment is now submitted for the purpose of removing any possible doubt that might exist.
The Bill, as drawn, makes provision for a scheme being submitted to the Minister for Justice by the Sweepstake Committee under the Act. I do not know whether it is intended to amend the section so as to allow any one of these bodies to formulate schemes. But it would appear that if a certain number of persons, from A to Z, came together and formulated a scheme, the scheme having been formulated, it is open to people who had nothing to do with the formulation of the scheme proposed to make a claim in connection with a new institution about to be established. On the merits, generally, I would say that the existing hospital accommodation in the country would be better served by extension rather than by the creation of other hospitals. Considerable attention was directed towards the policy of the amalgamation of hospitals. Now we appear to be going to the other extreme and making provision for the institution of others. Unless the Minister has some particular institution in mind, or the starting of some institution for nursing or the extension of hospital accommodation, I think it is not good policy to extend the number of those institutions already in the country.
It is true that certain bodies would be entitled to participate under this amendment without taking part in preparing a scheme. Apart altogether from this amendment, various boards and authorities, for example, which will benefit considerably under the scheme, are precluded from taking part in promoting schemes so that principle is already dealt with in the Bill. First, there are new institutions that might be set up, and in order that they be set up it might be necessary to have this amendment incorporated in the Bill. I am not clear that we could set up a research institution at the present time. It is possible we could, but there is some doubt about it. A research institution might be set up on the recommendation of the Hospitals Commission. There has been much discussion on the question of an institution for research such as a Paediatric Institute. These are some of the points that strike me at the moment. This would possibly be a new institution and governed possibly by an entirely new governing body. In the original draft of the Bill I was definitely under the impression that we could make allocations to such institutions, but Deputy Fitzgerald-Kenney threw some doubt upon that position, and this amendment is meant to ensure that the Minister will not be hampered in making allocations for the classes of institutions that I have indicated.
On what the Parliamentary Secretary has said, there is the provision, in page 2 "...and also includes institutions for the carrying on of medical research, but does not include any institution or organisation conducted by persons for their private profit". That would appear to have covered one portion of the Parliamentary Secretary's recommendation for this amendment. So far as paediatrics are concerned, there are institutions for children, I should say, but extension of these institutions would be better than the inauguration of others. With the inauguration of every new institution, there comes expense as regards management and so on, and it would be very much easier and better, deferring, of course, to the Parliamentary Secretary's expert knowledge in that connection, if extensions were to be carried out rather than the inauguration of new institutions.
It does not follow that, because the Minister has power to make allocations to new institutions he is bound to do it.
I quite understand that, but there is always the temptation. I do not like to see the Parliamentary Secretary tempted.
Yes, I suppose the Deputy knows what that means.
I know the Parliamentary Secretary's weakness.
The Deputy knows his own, which is more important.
I move amendment 5:—
In page 11, line 39, Section 24 (1), to delete the words "to any" and substitute the words "for the benefit of any existing or proposed".
I move amendment 6:—
In page 11, line 41, Section 24 (1), after the word "purposes" to insert the words "authorised by this section".
The words now to be added were originally in the Bill and were taken out in Committee as part of the general re-drafting of Section 24 but the section in its re-drafted form was not generally acceptable to the House and it was considered desirable to retain the sub-section specifying the purposes for which grants could be made. These purposes are now set out in amendment 13 and, accordingly, it becomes necessary to insert the words previously deleted from the section.
I move amendment 7:—
In page 11, before Section 24 (2), to insert a new sub-section as follows:—
(2) A grant made out of the Hospitals' Trust Fund under this section shall be made to either (as the case may be) the governing body of the existing hospital or nursing organisation or the person establishing the proposed hospital or nursing organisation for the benefit of which such grant is made and the word "grantee" shall in this section be construed as meaning such governing body or such person, as the case may require.
This is also a drafting amendment.
I move amendment 8:—
In page 11, line 58, Section 24 (3), after the word "or" to insert the words "in instalments at such" and to delete the word "so".
Would the Parliamentary Secretary say why No. 8 is necessary? Is there any other intention with regard to it except building grants?
Some grants will be paid in one sum and others will be paid by instalments as they are required. For example, if the Minister makes a grant for building work, the money will be paid out according as the expense is incurred.
According as it is certified by the architect, I presume?
Is there any other meaning?
On receipt of the architect's certificate, payment will be made from time to time.
Is there any other intention with regard to the instalments except as regards building?
No, that is the intention of this amendment.
Amendments 9 and 14, possibly, could go together.
I move amendment 9:—
In page 11, before Section 24 (4), to insert a new sub-section as follows:—
In specifying the purposes for which a grant out of the Hospitals Trust Fund is to be expended and in attaching any conditions to the receipt of such grant or of any payment to be made in respect thereof the Minister shall not specify any purpose or attach any condition which would directly or indirectly enable the Minister to interfere with, direct or in any way affect the executive, administrative or financial management or control or the internal policy or affairs of any hospital or nursing organisation to which such grant is made.
I suppose Deputy Sir James Craig will not press his amendment, No. 14, if my amendment is accepted. They may be slightly different, but I think they are, in substance, the same. This was discussed on Committee Stage and the amendment seeks to retain for the hospitals the autonomy which they have had up to this, which has not been interfered with in any way and with which, so far as I know, it was not the intention of the Minister to interfere. It would retain to the hospital management the executive, administrative and financial management and control of the internal policy and affairs of any hospital or nursing organisation to which such grant is made. As I said on Committee Stage, there is no objection to conditions being made in respect of how money should be spent but there is apprehension on the part of many of these institutions, or some of them, that their position may be affected. The Minister said that it was not intended to affect the autonomy of the various institutions, in any way, by means of those grants.
We had a considerable amount of discussion on a somewhat similar amendment by Deputy Sir James Craig on Committee Stage. He withdrew the amendment standing in his name and I think there was general understanding that Deputy Cosgrave would endeavour to frame an amendment that would be possible of acceptance and that would be consistent with the principles of the Bill and the intentions as expressed, from time to time, during the course of the debate. The present amendment appears to me to be much more far-reaching in its scope and open to more serious objection than even the amendment Deputy Sir James Craig tabled on the earlier stage. The purposes for which the grants can be expended will be set out in the Bill under a later amendment and the Minister will be bound to specify one or other of these purposes. It seems clear that, in specifying any of the purposes, he cannot interfere in the management of the hospitals but would merely have to see that the money is spent for the purpose for which it was intended. That part of the amendment, therefore, appears to be unnecessary.
The amendment also prohibits the Minister from attaching conditions which would enable him to interfere with the financial management or control or internal policy or affairs of a hospital or nursing organisation. The words "internal policy or affairs" are so vague and indefinite that I do not think the Deputy could reasonably hope to have the amendment accepted and these words inserted. The Minister will not be in a position to say what these words might cover and, in making an allocation, he could not be sure, at any time, that any condition that he attached to a grant was not an infringement of the internal policy or a direct or indirect interference in the affairs of the hospitals. With regard to interference with the management, it must be borne in mind that the Minister has certain powers in so far as the administration of the rate-supported hospitals is concerned and any amendment which might be construed as curtailing these powers would be unacceptable from that point of view. I might again emphasise the fact that there is no likelihood whatever that the Minister will intervene in the ordinary management of voluntary hospitals or attempt to interfere actively with their administration and supervision and, if any particular institution felt that the conditions attaching to a grant would constitute an undue interference with its autonomy or affairs or their internal policy, such an institution would not be bound to accept the grant. It can say: "We would prefer to have autonomy in our internal policy, and to have our institution run without any condition being imposed by anybody, and we will not accept any grant out of the sweepstakes fund." At any rate, the main purpose in the mind of the Minister is to ensure that, as a result of the allocations and the buildings and equipment provided, and the endowment for the maintenance of free beds for the future, hospital facilities will be available for the poorer sections of the community. There is no other particular interest in the mind of the Minister at the present time. As it appears to me, it is impossible to ensure that that accommodation and equipment will be available, if the Minister is not entirely free to attach the necessary conditions to the grants that will ensure that result. A comprehensive amendment of this kind might, in practice, be used to defeat even the simplest reform the Minister might wish to inaugurate.
For example, the Minister might make it a condition, when giving a grant, that an hospital should keep proper accounts, that the accounts should be audited, and that statistical tables should be available showing the numbers in the in-patients and in the out-patients departments and the average number of occupied beds during the year. There would be nothing unprecedented in that. For the past 20 years that condition has been imposed on London hospitals by the governing body of the King's Fund. It is an English fund which was founded about 36 years ago for the benefit of the hospitals. Such a simple and necessary condition as that, for example, might possibly be attached to a grant or to an allocation, and it might be ruled out, or might be held to be an interference with the internal administration, or with internal policy, or the affairs of the hospital, and the Minister might find that he had no power to impose it. He might attach a condition that a grant might be made, and subsequently it might be held by a competent authority that the Minister had attached a condition that he had no statutory or no special right to attach. Of course, such a condition would not be binding, but the allocation would have been made, and the Minister would have discovered that he had done something which cut across the internal policy, or interfered, directly or indirectly, in the affairs of the hospital. In fact, it would be difficult to imagine any condition that might not be held to affect the executive administration, the financial administration or the control of the internal policy or affairs of an hospital. The Minister might very well find himself in the position that he could not attach any condition whatever, that even if he attached the condition that 25 per cent. of the beds should be free, that might be held as an infringement of the internal affairs or on the internal policy of the hospital.
It was understood when Deputy Sir James Craig's amendment was withdrawn that a less far-reaching one would be circulated for discussion at this stage. The present amendment goes far beyond the original amendment, and from that point of view is open to much more serious objections. The amendment was evidently drafted in an atmosphere of suspicion. We have had that atmosphere of suspicion since the Bill was introduced. I am at a loss to understand why that atmosphere should be created. I do not suggest that Deputies deliberately tried to create that atmosphere or, at any rate, to make it any worse than it is at present, but I repeat that there is no ground whatever for it. We hope to have the friendly co-operation of the voluntary hospitals, and when conditions are being attached to the giving of a grant, prior to attaching these conditions, we will endeavour to have exchanges of views with the governing bodies of the hospitals. We will endeavour to consult with them, the Hospitals' Commission will consult with them, and the Minister will consult with them, to see how far the conditions it is proposed to attach might, or might not, be calculated to interfere with the ordinary autonomy of the hospitals, or with their policy.
I do not know if there is anything behind this amendment, or behind the general lines of the discussion, in relation to this Bill that does not appear on the surface. I hope there is not. I hope there is not any suggestion behind this amendment, or behind some of the other amendments that we have dealt with, that the religious communities are in any danger from the present administration. If the case is made that it is not what the present administration might do, but some future administration, I should say, in that regard, that a future administration will not be bound by the terms of this Bill. If a future administration wants to take complete control of the voluntary hospitals, and has a majority in this House to support them, there is nothing in the Bill to prevent a future administration from doing so. The present administration can be trusted not to abuse the powers sought in the Bill, and I think that ought to satisfy the House, and satisfy the governing bodies of the hospitals.
I am afraid I cannot regard the Parliamentary Secretary's speech as being at all satisfactory. He comes here and tells us that he may want certain powers, and he asks for absolutely unlimited powers of control over the hospitals. He made the argument at the beginning of his speech that he can give the sums which he allocates to the hospitals for certain purposes, and for certain purposes only, to be set out in the new sub-section. But before he makes a single attempt to do so he is in a position, as the Bill stands, to make his condition precedent to the grant of a single penny for the various purposes set out—any single thing he likes. For instance, an hospital may wish to get a building grant. It may be necessary that it should receive a building grant. As the Bill stands the Minister can say: "There is an allocation for a doctor; if you do not elect my nominee you will not get the grant"; or he may say: "You did not elect my nominee so your grant stops." He is made absolute controller of the hospitals under this Bill. He tells us that that is not the purpose in his mind; that, having this control, he will not exercise it; but that is most unsatisfactory. The Minister can only speak for himself as one individual, and the Parliamentary Secretary can only speak for himself as one individual. It is not right for this House to give unlimited powers to a Minister, simply on the word of an individual. I am not suggesting that the individual will not honour his word, but it is not right to give unlimited powers to an individual upon the word of an individual, or the promise of an individual, which can, after all, only bind himself. It is for this House to give such powers to the Minister only as the House thinks that the Minister requires them, and not to give him unlimited powers on the implied understanding—because it can only be implied since it is not expressed in this Bill—that he will not exercise these powers improperly. Let us have what are the purposes in the Minister's mind if he thinks it is necessary to interfere with the autonomy of the hospitals, and let those be set out here. He asked the House, and asked especially Deputy Cosgrave, to make an attempt to produce a satisfactory amendment. The Minister himself has made absolutely no attempt to do so. As far as the Minister's attitude at the present moment, or the attitude of the Parliamentary Secretary at the present moment, is concerned, he seems to be retiring from the position he took up before, that he was willing that his powers should not be unlimited. He said that under this amendment he would not have power to make it a condition that 25 per cent. of the beds should be free. I had down an amendment the other day which would have given him that specific power. He rejected that amendment. I do not know why, but he did reject it, and now, having rejected it, he says: "I am very sorry it is not there."
I am not a bit sorry it is gone.
But it was one of the arguments he put forward, that under the amendment I proposed he could not do certain things. He induced the House to reject that amendment, the amendment being that he could make it a special condition that a certain proportion of the beds should be given to poor persons. The Minister said that "Suppose we do put terms so onerous upon the hospitals, and interfere so greatly with the hospitals that they object to what we are doing, there is a very easy course open to them; they can refuse to accept the grant." That is the Minister's argument. Why should they be put in that position? After all, the money is not the Minister's money; the money is not money belonging to this House; it is not money which is voted by this House; it is money which is the private property of the promoting hospitals. That is the position. Why should a hospital that has promoted a scheme be compelled to refuse to accept a grant of money which is justly and properly its property? I am afraid that all through the minds of the promoters of this Bill, the Minister and the Parliamentary Secretary, there seems to run the idea that in some way or other those moneys which are collected through the hospital sweeps are State moneys. They are not State moneys. The State has nothing to do with them. They are the private property of the hospitals. As far as they belong to the voluntary hospitals, they are the private property of the voluntary hospitals. I will only just repeat now the way I put it on another occasion, that the Minister, under Statute or otherwise, has nothing else than a power of appointment amongst the various beneficial owners of the fund. It is, therefore, very unfair to say that the hospitals are not bound to accept the grant, that they have got a locus penitentiae, that they can get out if they like and take nothing if they refuse the Minister's terms. I would ask the House to accept this amendment. The Minister says that possibly it is too wide, but he has put forward no alternative to it. It is perfectly obvious that a limitation of the powers of any Minister must be imposed by this House.
I was prepared to accept what the Minister stated on the last occasion, that there was no intention to interfere with the autonomy of the hospitals or with the continuance of the voluntary work in which they are engaged, until the Minister made the statement this afternoon. In the course of that statement, having again expressed the intention of the Ministry with regard to their desire not to interfere with the hospitals, he went on to say that it would not be possible to impose the simplest reform in hospital management if this amendment were to be carried. What is the meaning of the simplest reform? The Minister says at one moment: "I have no desire to interfere with the internal administration, management, control, or other disposition in connection with the hospitals," and he proceeds at once to say: "If I wish to have the simplest reform this amendment would take from me the power to impose it." He went further; he went on to say that it would not be possible for him to impose a condition upon the hospitals to keep proper accounts, to have satisfactory statistical information as regards bed accommodation and so on, mentioning several of the matters which are outlined in very elaborate and spectacular form in the publications of the late Committee of Reference. At that time the Minister had no power to command or direct the hospitals to keep those accounts, or to furnish tabulated information when requested by the Committee of Reference, and yet, without having that power at all, that information was vouchsafed to the Committee of Reference. The Minister now complains that if this particular amendment were put in he would not be in a position to demand the simplest reform. His interpretation of the simplest reform is audited accounts, statistical information regarding patients, bed accommodation, and so on, all of which, as I have said, are set out in the various reports that have been recently published.
There was no intention whatever in putting down this amendment to affect in any way—and I do not believe it would affect in any way—those institutions comprised in what is known as the Poor Law. The Minister has other powers to deal with them. He has already power to interfere in the Poor Law administration according to Statute, and this particular amendment would not limit in any way his power in that connection. I take it that the Minister simply threw that out as a sort of suggestion of interference, although I am quite sure that in his innermost heart he does not believe any such thing. "Simplest reform" merely gives vocal expression to the fears that the hospitals management, generally, have got as regards what is intended. The Minister, as Deputy Fitzgerald-Kenney has pointed out, has power to impose as a condition that a certain number of beds should be available for the poor—any number; he need not confine himself to 25 per cent. He can take power to make that a condition, and there is no objection, and ought to be none, on the part of any hospital to a condition such as that in connection with the distribution of the hospitals sweeps moneys.
The Minister is not, as Deputy Fitzgerald-Kenney has pointed out, in the position of being a beneficial trustee in this matter at all. Those are not State moneys. There is no comparison between those funds and what the Minister has mentioned as a sort of parallel case, the King's Fund. This is not the same as the King's Fund. Those moneys may come from the King's subjects in Great Britain, or a very considerable portion of them, but once they have parted with them they have parted with them for a purpose, and that purpose is enshrined in the Acts that have been passed up to this—for the benefit of the hospitals. The Minister is only in the position of a Civic Guard on point duty, regulating the traffic of this money into the funds of the various hospitals. He is not creating the traffic. He has not found this money. He has really got no authority over it other than what this Parliament will give him. He correctly expressed the opinion of the Dáil here when he said there was no desire on the part of anybody to interfere with the internal policy or control of the hospitals. I understood from the Parliamentary Secretary on the last day that this Bill was discussed that if the amendment which I then proposed to submit were not found to be acceptable, the Parliamentary Secretary would at least take the trouble to offer an alternative amendment or to make some suggestions as to how this amendment might be accepted in order to give some security to the hospitals that there was no intention of interfering with them. I submit that these two words "simplest reform," which the Parliamentary Secretary used, disclose that there is something in the mind of the Parliamentary Secretary on this whole question of interference which has not been disclosed before this. What does it mean? Surely it does not mean the keeping of proper accounts, the getting of statistical information and the information with regard to beds, of which the Parliamentary Secretary spoke. Surely there is something else, because that information has been given already and is already in the possession of the Minister or of his Committee of Reference. Has there been an objection on the part of the hospital controlling bodies all over the country to have standard accounts or to submit plans for improvements or extensions or anything of that sort, or an objection to giving particulars regarding costs per head or any other information that the Minister has asked for? If not, what then is the real objection to this amendment? It must be that there is an intention of interfering in some way or other with the hospitals. We had a lot of talk on the last day as to the internal policy of these hospitals and how they should be run. Let it be remembered that these institutions were there before this Dáil existed; that they helped the poor before this Dáil came into existence; that they gave assistance and medical treatment to people long before there was any thought of the hospitals sweepstakes and that the sweepstakes, while a benefit to the hospitals, nevertheless have dried up sources of income of these institutions which we cannot restore, and which the Minister cannot restore. The hospitals have at least a prima facie case in respect of those losses which ought to be considered without any possible interference on the part of the Ministry. I do say that, whatever apprehensions there may be regarding the question of interference, they are not in any way helped by the statement the Parliamentary Secretary has made.
The amendment which stood in my name and which was withdrawn was an amendment to the effect that the Minister should not interfere with the internal policy of any hospital to which a grant was made. That amendment was withdrawn on the condition, as I understood it, that the Parliamentary Secretary himself would look into it and that Deputy Cosgrave would look into it, in order to try to find an amendment that would be more in keeping with what our desire was, and to have things cleared up. The state of affairs now is that my amendment is gone and cannot be brought up again, and it was withdrawn on the understanding that either the Parliamentary Secretary or Deputy Cosgrave would produce an amendment that would meet the situation.
I beg to move amendment 10:
In page 11, Section 24 (4), to delete all from the word "to" in line 60 to the word "organisation" in line 61.
These words are being deleted because they are considered to be superfluous. Grants can only be made to a hospital as defined by Section 1. It is considered unnecessary to have these words retained in the section.
Amendments 11 and 12 go together. I move:
11. In page 12, line 2, Section 24 (4), to delete all from the word "or" to the word "thereof."
12. In page 12, line 12, Section 24 (5), to delete the words "or of any such particular payment."
The words to be deleted gave rise to some apprehension that the Minister might possibly vary the original conditions when making the payment of an instalment. Deputy Cosgrave on the 31st May said: "As it stands, it looks as if there might be a hold up .... the Minister might propose something that was not contemplated under the contract." As has been stated already, in the case of a grant certain conditions will be imposed and a contract will be entered into. Once that is done no new conditions will be added. The words to be deleted are not really material to the sub-section. They can be omitted without giving rise to any difficulty or inconvenience. I think that meets the point on which Deputy Cosgrave expressed some anxiety on the Committee Stage.
I beg to move amendment 13:
In page 12, Section 24, to delete sub-sections (6), (7), and (8) and substitute a new sub-section as follows:—
(6) A grant made by the Minister under this section for the benefit of any existing or proposed hospital or nursing organisation may be made for all or any of the following purposes, that is to say:—
(a) the purchase of land or buildings, including any superior or outstanding estate or interest in land or buildings;
(b) the construction of buildings;
(c) the reconstruction, extension, alteration or improvement of buildings;
(d) the purchase of hospital, nursing and other equipment;
(e) the endowment of any such hospital or nursing organisation or any part of the activities of any such hospital or nursing organisation, including in the case of any such hospital the endowment of a bed or beds in such hospital;
(f) the payment of maintenance expenses;
(g) the discharge of debts.
Apart from the slight verbal changes the only difference between this sub-section and sub-section (4) as introduced is the addition of paragraph (f) dealing with the payment of maintenance expenses. The position now is that a grant can be made for every conceivable purpose connected with hospitals: land, purchase of sites for building, equipment, maintenance and endowment and for the payment of debts. Sub-sections (7) and (8) are no longer necessary as the prohibition against grants being made towards future maintenance has been dropped and the definition of grantee has been transferred to the new sub-section.
Two points arise on this new sub-section. The first is as regards its construction. I should say that the discharge of debts ought to be placed first in connection with the distribution of moneys. The payment of maintenance expenses ought to be placed second, and then let the others follow in the order set out. I can quite understand that it is more stylish as it stands, but I would suggest to the Parliamentary Secretary that, as I am interested in his salvation, I would not like him to appear before the Judgment Seat without having all his obligations in this world discharged, and, apparently, he is undertaking an obligation here. The second point is as regards the maintenance expenses. Apparently what the Parliamentary Secretary feels in connection with that is that the disposition of his Department would be to evade payment until the last moment. In other words, to let the debts run to the end of the year before payment is made. I do not think that is a good system. People ought to know what they have to spend, and even though it may mean an imprest account I should say that would be more satisfactory than the other arrangement. I think the maintenance expenses ought to be provided for rather than met at the end of the period. As the sub-section is drawn it is not clear which way it is intended to go. What will happen if people have to wait until the end of the year is that it will be some time after its expiration before the accounts will be made up. Then there is always a doubt in the minds of persons or of committees as to whether the full amount will be forthcoming or whether there would be any objection to it. I would like to hear what the Parliamentary Secretary's interpretation of the new sub-section is in the light of what I have said.
The purposes to which the grant should be made are set out in paragraphs (a) to (g), but that is not necessarily the order of their importance.
I hope not.
It might be considered, perhaps, by the institutions in which Deputy Cosgrave is particularly interested that the discharge of debts should be a primary consideration. Maintenance will be largely provided for by endowment. Hence, once an endowment is made, it will provide in perpetuity a certain annual income which will go to the maintenance of an institution, or to the maintenance of patients.
Is it proposed to hand over a certain sum in each case, or is it intended to keep that sum and pay interest?
Does the Deputy mean a certain sum for the purpose of endowment?
My interpretation of the position is that a certain sum will be ear-marked for endowment, and the endowment will be the future maintenance. It will obviously take a considerable time to investigate the needs of the various hospitals that will ultimately participate, and to arrive at the figure that could reasonably be calculated to cover all future endowments. In the meantime, it may be necessary to make year to year advances in the form of grants to cover maintenance. Whether it would be possible to make such grants at the beginning of the year, to estimate in advance what the probable outlay under any particular heading would be, I am not in a position to say at the moment. But if necessary a rough estimate could be prepared and a grant made during the transfer period, while the Commission is investigating and reporting. If it were found that the grants made were not sufficient to cover the entire maintenance expenses, then a supplementary grant could be made at the end of the year.
I strongly recommend the method of making a grant, and for two reasons. One is that if the hospitals have an overdraft the costs incidental to that are high. On the other hand, the saving which would be effected by not paying until the end of the year—I have in mind the interest side of it—would not be so great.
I move amendment 14:—
In page 12, before Section 25, to insert a new section as follows:—
The Minister shall not have power to alter the constitution or to interfere in the administration of any hospital which does not receive any benefit from any sweepstake promoted under the Public Charitable Hospitals Acts, 1930 to 1932, or under this Act, or which does not receive any grant from any local authority.
I do not know, a Chinn Chomhairle, whether you were in the Chair when this amendment was before the House on a previous occasion, but I agreed to withdraw it, because I understood very clearly from the Parliamentary Secretary that he was willing either to bring in a slightly altered amendment in this form, or to insert some change in the definitions by which a hospital would be defined as one that was going to get a benefit from the sweepstakes. I found, however, when the amendments for Report Stage were circulated that such an amendment did not appear, and accordingly I put down this amendment, which I had moved in Committee, again. I want to say this: that I do not want to be at all nasty to the Parliamentary Secretary, but on several occasions he gave me to understand that he was quite willing to accept the amendment. In following out the promise that he made to me I went so far as to tell the people who had asked me to propose the amendment that the Parliamentary Secretary was willing to accept it. On the Committee Stage of the Bill, the Parliamentary Secretary in answer to a point made by Deputy O'Sullivan said: "That is so, we are not going to interfere with any hospital that is not looking for any money out of the sweepstakes." I quote further:—
"Professor O'Sullivan: That will be made clear in the Bill.
Dr. Ward: Yes, we will accept that amendment.
Professor Thrift: Will the point not arise in connection with other sections?
Dr. Ward: Anywhere it arises."
I do not want to press this matter too much. I only want to say this, that I was led to believe that the Parliamentary Secretary was quite willing to accept the amendment. I told the people interested that he had told me that he was willing to accept it. If he now refuses to accept the amendment, he will be putting me in a more or less awkward position. I do not see any reason for not accepting the amendment as it stands, and I accordingly move.
There is no going back whatever of the undertaking I gave in earlier discussions of this Bill to Deputy Sir James Craig and other Deputies who were interested in this matter. There is no intention whatever of interfering in the manner suggested in the amendment. I am definitely advised by the legal advisers and by the Parliamentary draftsman that the Minister has no power to interfere where the hospital is not a participating hospital and that it is altogether foolish to insert an amendment to try to prevent the Minister doing something which he has no legal power to do. It is on that basis I am opposing the amendment. I have no objection to the amendment except that I am advised that it is entirely superfluous and there is no need for it.
Even if it is superfluous what is the harm of putting it in?
What on earth is the use of putting in an amendment to prevent the Minister from doing something which he has no power to do?
It will satisfy quite a number of people.
I think if Deputy Sir James Craig discussed this matter with me or with the legal advisers he would be very easily satisfied that the amendment is unnecessary. If we were to insert amendments in the Bill prohibiting the Minister from doing everything under the sun that the Bill gives him no power to do, the Bill would become a very unwieldy measure.
Is the amendment withdrawn?
I do not like to withdraw it. I want to carry out my promise to the people to whom I gave it. I am, however, a very decent sort.