National Health Insurance and Widows' and Orphans' Pensions Bill, 1935—Second Stage.

Minister for Local Government and Public Health (Mr. S.T. O Ceallaigh)

I move the Second Reading of the National Health Insurance and Widows' and Orphans' Pensions Bill. The matters dealt with in the Bill are four in number and I shall refer to them in the order in which they occur in the Bill as drafted, though that is not necessarily the order of their importance. The four matters are:

(1) An amendment of Section 17 of the National Health Insurance Act, 1923, so far as it refers to the insurability of seamen;

(2) the constitution of the committee of management of Cumann an Árachais Náisiúnta ar Shláinte;

(3) the position of soldiers under both the National Health Insurance Acts and the Widows' and Orphans' Pensions Act, and

(4) the recovery from employers of contributory pensions lost owing to their default.

Amendment of Section 17 of the National Health Insurance Act, 1923.—

Section 17 (1) (d) of the Act of 1923 empowers the Minister to enter into reciprocal arrangements with the British Ministry of Health with a view to determining whether, in the case of a ship registered in the Irish Free State or Great Britain (including Northern Ireland) the owner of which resides or has his principal place of business in Great Britain or the Irish Free State, as the case may be, health insurance contributions payable in respect of the persons employed on the ship are to be paid under the Acts in their application to the country in which the ship is registered, or under the Acts in their application to the country in which the owner resides or has his principal place of business. In 1924, reciprocal arrangements were entered into between the two countries, making the place of registration of the ship the criterion of liability for payment of health insurance contributions. Those arrangements are still operative.

Certain anomalies have emerged under these arrangements and the British seamen's societies are pressing for the amendment of the arrangements with a view to their removal. To change the basis for health insurance from country of registration to country of ownership of the ship would not provide a complete remedy. If, however, it were decided that the question of paying health insurance contributions at the British or Free State rate should be determined by the residence of the seamen, the anomalies would, it is believed, disappear.

The powers held by the Minister under existing legislation do not permit of the reciprocal arrangements being amended so as to make the residence of the seaman the test so far as health insurance is concerned. Any such amendment of the reciprocal arrangements will require enabling legislation and the proposed amendment of Section 17 of the 1923 Act is designed to enable such revised arrangements to be made with Great Britain if it is considered desirable and equitable to do so. In Great Britain, amending legislation to that effect has already been passed in the National Health Insurance and Contributory Pensions Act of 1935. It will be understood that the legislation of itself will make no change in the existing position of seamen, but will merely place the Minister in a position to agree to the amendment of the reciprocal arrangements, subject to the consent of the Minister for Finance, if he is satisfied that it is in the best interests of seamen to do so.

Constitution of the Committee of Management of the Unified Society.—

It will be recalled that the Unified Society was established by an Act passed by the Oireachtas on the 14th July, 1933 (the National Health Insurance Act, 1933). Provision was made in that Act for the appointment by the Minister of three persons to act, for a period not exceeding three years, as a provisional committee of the Society and for their replacement by a committee of management of 15, composed of three trustees appointed by the Minister, three representatives of employers appointed by the Minister, and nine representatives of members of the Unified Society to be elected in the prescribed manner by the members. The provisional committee must go out of office on or before the 13th July next. Unless, therefore, new legislation is passed to alter the composition of the committee of management, it now becomes necessary to make regulations providing for the manner in which the representatives of insured persons are to be elected. This question of the election of members' representatives, however, raises a very difficult problem. An election by ballot by all the members could be carried out at considerable expense, but the real difficulty lies in the nomination of candidates. It is impossible to say how many candidates would be nominated, or whether, if elected, they would be suitable members of a committee of management of an important body like the Unified Society. Moreover, with such a large and widespread electorate, the names of the candidates would convey nothing to the electors and voting, if exercised at all, would be haphazard in the extreme. In all the circumstances, it seems clear that an election by ballot among all the members of the Society is not a practical proposition. The Government have explored every avenue with a view to finding some practical method of overcoming that difficulty without interfering with the principle that the management and control of national health insurance business should be in the hands of the insured persons themselves. To leave the nomination of the members' representatives to labour organisations might possibly have met the difficulty but for the fact that such organisations include in their membership only a small proportion of the working population. (In Table 251, on page 175 of the Statistical Abstract for 1935, the total trade union membership for 1933 is given as 91,890). It is probable also that that membership is mainly concentrated in the borough and urban areas, and that in many cases the labour organisations would have no claim to the nomination of representatives for the rural areas. In these circumstances, the Government believe that the problem of the insured persons' representation on the committee of management can best be solved by giving to labour the right to nominate three insured persons to be members of the committee, and by adopting what may be described as the delegate system of election for the remaining members' representatives.

Under this system, delegates, who must be insured persons, will first be chosen for each county and county borough area, on the basis of one delegate for every 5,000 members. These delegates will meet and elect from among themselves the balance of the members' representatives to the committee of management. The difficulty here is the selection of the delegates. An attempt to elect them would be open to the same objections as apply to the direct election of members of the committee, and it is, therefore, provided that they shall be nominated by bodies which can be regarded as competent for the purpose. In the absence of any body directly representative of the insured persons, it is considered that the county and county borough councils are sufficiently democratic to be entrusted with the duty.

Bearing in mind that the committee of management is responsible for the direction and control of a scheme which is financed by contributions compulsorily collected from insured persons and their employers, and supported to a very appreciable extent at the cost of the taxpayer, the Government take the view that, in order to ensure a proper standard of administration, there should be an independent chairman, who should be appointed by the Minister for Local Government and Public Health.

Accordingly, the proposed new committee of 15 members will be composed as follows:—A chairman to be appointed by the Minister; the three trustees for the time being, appointed by the Minister; three members representative of employers of insured persons, to be appointed by the Minister; three members to be nominated by the National Executive of the Irish Trade Union Congress; and five members to be elected in a manner to be prescribed by delegates nominated by county and county borough councils. It is to be noted that the insured persons will be in the majority on the committee.

The Bill contemplates that the chairman, trustees, and employers' representatives, who are all to be appointed by the Minister, shall hold office for a prescribed period, and that the remaining eight members shall be appointed annually. Provision is made in the Bill for the payment to the members of the committee of such allowances, if any, as the Minister may from time to time determine, and also for the payment of travelling expenses and allowances for maintenance and loss of wages to the delegates, who will hold office for three years.

Position of soldiers.—The present position of serving soldiers under the National Health Insurance Acts is as follows:—(i) a soldier who on enlistment was a member of an approved society continues to be insured during his Army service; (ii) a soldier who was not a member of an approved society on enlistment is not insured during service if the period of service for which he enlists is less than six months; (iii) if, however, a man who is not a member of an approved society on enlistment enlists for a period of service of six months or more, he is insurable during his service provided that within three months from the date of his enlistment he elects to— (a) join an approved society in Saorstát Eireann, if he resided before enlistment in Saorstát Eireann; or (b) join the Military Forces (International Arrangements) Insurance Fund if, before enlistment, he resided in Great Britain or Northern Ireland.

The contribution in respect of an insured soldier is at the rate of 4½d. per week, and is paid by the Minister for Defence, no deduction being made from the man's pay.

Some 1,200 or 1,300 serving soldiers failed or were not afforded an opportunity to exercise the option given them of becoming insured during their Army service. Under the Acts as they stand at present, these men are not entitled to be insured in respect of their Army service, as the option was not exercised within the statutory period of three months allowed for bringing them into insurance.

Power is sought in the amending Bill to bring these men into health insurance as from the 6th January, 1936. It is also proposed in the Bill to make health insurance compulsory in future for all soldiers who enlist for long service, or who re-enter the armed forces for long service. It is not proposed to insure as soldiers men enlisted for short periods of service unless they were already insured persons under the National Health Insurance Acts, in which case they will be insured as ordinary contributors at the full employed contributor rate, 8d. a week.

Furthermore, this opportunity is taken, subject to the general principles just mentioned, to re-enact the main provisions of the National Health Insurance Acts in relation to the armed forces, with a view to clarifying the entire position.

Under the Widows' and Orphans' Pensions Act, provision is made for the payment by the Minister for Defence out of moneys provided by the Oireachtas in respect of every soldier of a contribution for the purposes of that Act at the rate of 8d. per week, of which an amount not exceeding 4d. is recoverable from the soldier. The word "soldier" in that Act is defined as a member of the defence forces of Saorstát Eireann, including the Reserve, in respect of whom contributions under the National Health Insurance Acts are for the time being payable under these Acts. Accordingly, the proposed legislation in regard to soldiers which I have just outlined will have the effect of bringing all long-service soldiers within the scope of the Widows' and Orphans' Pensions Act, as from the 6th January, 1936.

So far as soldiers serving in the armed forces immediately prior to and on 6th January, 1936, are concerned, legislative authority is sought to treat them as if contributions under the National Health Insurance Acts were deemed to have been paid in respect of them for each week of continuous service in the period from the date of enlistment or re-entry, as the case may be, to the 6th January, 1936. The effect of this provision will be that all soldiers with over 104 weeks' continuous service immediately prior to and on the 6th January, 1936, will, on that date, become fully qualified for Widows' and Orphans' Pensions at the contributory rate, and that those with less than 104 weeks' continuous service immediately prior to the 6th January, 1936, will become qualified for contributory pensions on the completion of 104 weeks' service. On discharge from the armed forces, or transfer to the Reserve, the soldier will be treated as an ordinary employed contributor and will become liable to the ordinary statutory tests for widows' and orphans' pensions purposes.

In the course of the debate in the Seanad on the Widows' and Orphans Pensions Bill, Senator Johnson moved an amendment designed to secure that in any case where an employer had failed to pay contributions in respect of an employee, the widow could take steps to recover from the employer any pension or allowances lost through his default. Owing to the difficulty in drafting a suitable clause to meet the point raised and to the importance of ensuring the rapid passage of the Bill through the Oireachtas, it was agreed to leave the matter over to be dealt with in an amending Bill, to be introduced, if possible, before the Widows' and Orphans' Pensions Act came into force. It is proposed, accordingly, to deal with the matter in this Bill.

Recovery from employers.—Under the National Health Insurance Acts and the Regulations made thereunder, where an employer fails to comply with the provisions of the Acts he is liable, during the period up to four weeks after the date on which compliance is effected, for any benefit lost by an employee through his neglect. Either the employee himself or the Minister, can sue the employer to recover the lost benefit. Power is taken in this Bill to secure the recovery of any contributory pension lost by a widow consequent on an employer's failure to pay contributions in respect of her deceased husband. In such cases the widow may, apart from such contributions, on the death of her husband become entitled to receive a non-contributory pension and where this is so it is proposed that the amount for which the defaulting employer would be liable shall be the difference between the amount of the contributory pension and the amount of the non-contributory pension, if any. The period over which his liability will extend will be from the date of the employee's death up to four weeks after the date on which all the contributions in arrears are paid up.

Mr. Morrissey

So far as Parts I and III of this Bill are concerned, there is not very much to be said. I think those parts are an improvement on the existing National Health Insurance Acts and will be a help to insured persons. I cannot say that I congratulate the Minister on what he has brought forth by way of a scheme for the election of his committee of management. The Minister said it was a very difficult matter, and I agree it is a difficult matter to find machinery that will give, first and foremost, the insured members the voice in the election of the committee of management to which they are entitled and that will ensure, so far as it is possible, that the Minister will get members elected to the committee who will be useful members. I imagine that if the Minister and his Department had set out deliberately to evolve the most complicated and unworkable scheme that could be found, they could not have succeeded better than they have by the proposals in this Bill. There are approximately 500,000 insured members in the country and I think I am right in saying that, roughly, one-third of that number are within the city and county of Dublin. Eight members are to be elected altogether, three by the Executive of the Trades Union Congress, who, of course, in order to be qualified, must be insured members, and there are five others to be elected.

The Minister has expressed a desire to see that members will have the management and control of the society, but the members are not even going to have a voice as to who is to represent them on the committee of management. The proposal in the Bill is that an electoral council is to be established by the county councils and the county borough councils, but the members of the county councils and the county borough councils will have no voice in the matter at all, because under another sub-section it is laid down that unless there are at least 2,500 insured members within the functional area of the particular public body they shall not be entitled to elect any person to the electoral council. With the exception of the corporations of the principal cities, the other borough councils will have no voice in the matter. Therefore, it will fall back largely on the county councils. Remember, it is not the members of the society who are to nominate the members of the electoral council, who in turn will nominate the five members of the committee of management, but it will be the county councils or the county borough councils and, as we know, those councils are not composed of members of national health insurance societies.

I think I could say with a good deal of truth that, so far as the county councils are concerned, many members are persons who are prejudiced and always were prejudiced against the National Health Insurance Acts and some of them are openly antagonistic. The Minister is probably aware of that himself and those are the persons who are to be asked to nominate members to serve on the electoral council. The insured member as such will have no voice whatever in the matter. How are county councils to ascertain who are insured members and what is the machinery to be to ensure that the county councils shall select to serve on the electoral council men who are interested in the matter of national health insurance, men who will be suitable to act on the committee of management?

There are, roughly, 500,000 insured workers. The Minister places the number at 5,000 for each member so that in order to get a body to nominate five members to act on the committee of management we are going to have an electoral council of approximately 120 members. It seems to me that that is unnecessary, cumbersome, too costly, and it will be much less satisfactory than many of the schemes which, I could gather from the Minister's statement, he and the Department have rejected. You will have 120 men selected, not by the members themselves, but by persons who are not insured and who in many cases have no sympathy whatever with the scheme of insurance. I am doubtful if the Minister will get a committee of management that will be of any great use in the working of the Society. I agree it is a difficult matter; it is not easy to find machinery that will be suitable and that will get the best results. I shall do all I can on the Committee Stage of the Bill to help the Minister. I hope to make some suggestions which may be a little improvement on the scheme as it is. I will do my best, after some consultation with people who are interested and who have been working most of their lifetime in the national health insurance business.

There is one other matter about which I should like to speak. Having set up this very cumbersome and unwieldy electoral council, the members of that council are to hold office for three years. That body is set up solely for the purpose of nominating five members of the committee of management, but the five members are to hold office for only one year. I am sure there is some reason for that and, if there is, I should like to hear it, because it seems to me to be a bad provision. If you appoint a person on the committee of management, at the end of 12 months, when perhaps he is just getting an idea of the work he has to perform, he is deposed and there is a likelihood that some other person may be substituted in his place who, perhaps, has not the foggiest idea of what the duty of a member of a committee of management will be. I do not say that that will happen, but it is likely to happen and it is all the more likely having regard to the composition of our county borough councils and county councils. The position will be further complicated by having the members of the council selected, not because of their knowledge of the National Health Insurance Acts or their interest in national health insurance, but simply because the particular party that holds a majority on the council or the county borough council are of a certain political persuasion and the person who is the most valuable member and has the loudest voice in the local Fianna Fáil Cumann will probably find himself on the electoral council and, eventually, on the committee of management.

Mr. Donnelly

They are all very able men.

Mr. Morrissey

In the Fianna Fáil Party?

Mr. Donnelly

Yes.

Mr. Morrissey

I have no doubt about that as members of the Fianna Fáil Party, but I should not like to say the same as to their knowledge of the National Health Insurance Acts. The Minister will, I think, admit that these are matters that deserve consideration. This is purely a non-Party measure, and I am sure that every member in the House is anxious to see, now that we have a Unified Society, that it will be made a success. A great deal depends on that. I want to suggest to the Minister that with the best staff in the world he wants a good committee of management, and it will take the best staff and committee of management to make it a success. I am afraid the machinery that is proposed in this Bill is not going to get him the committee of management that is most useful. With other members of this House, I may be able to suggest improvements in Part II of this Bill. With regard to Part I, I am glad that the Minister has introduced the new matters.

Mr. Norton

I want to direct the particular attention of the House to Part II of the Bill which the Minister is now asking the House to read a Second Time. It is rather strange that within two years of the introduction of the National Health Insurance Act of 1933, the Minister should come to the House and ask for new legislation designed to scrap the scheme of election conceived in connection with the 1933 Act, although no trial whatever has been given to the operation in respect of the election of insured members' representatives associated with the 1933 Act. I think it is rather an indication that the method of election conceived in connection with the 1933 Act got no proper consideration at all —that almost anything was put into the Bill at that time, possibly with the desire to get unification through the House, and with the desire not to cause any unnecessary difficulties for the Minister. But the fact remains that the Minister in the 1933 Bill was apparently prepared to commit himself to that particular method of election. He now comes to the House two years after the Bill was passed and asks us for authority to set up an entirely different method of election, although the method conceived in 1933 was never given any trial whatever. I do not deny that the method of election in the 1933 Act was the proper method of election.

I presume that the Minister, before he committed himself to the 1933 method of election, had discussed all possible alternatives. He had nevertheless come to the conclusion that the method of electing insured persons' representatives was the best method, so as to have the election decided on the initiative of, and absolutely controlled by, the insured members themselves. Now apparently the Minister thinks that it is better to get away from the method of election which gave the sole responsibility for the election of the insured persons' representatives to the insured members themselves. The Minister has now proposed a scheme of taking away from the insured members the rights which they had under the 1933 Act. Instead of the method of selecting the representatives of the insured persons, as in the 1933 Act, they are now being handed over to other bodies, I say, because of the magnitude of the task of electing insured persons' representatives as conceived in the 1933 Act.

There may be a strong practical case to be made for modifying the method of election then conceived. But I think in the operation of a Bill dealing with this matter the Minister is doing something more than modifying the method of election then conceived. For instance, in the 1933 Act it is provided that the committee shall consist of 15 persons, three of whom would be trustees appointed by the Minister, three employers' representatives also appointed by the Minister, and nine representatives of the insured persons. So that the insured persons had nine representatives on the committee under the 1933 Act, while the employers had three in addition to the trustees, bringing the total up to 15. It will be seen from that composition of the committee that the insured persons had a majority on the committee. Of course it has been the cardinal feature of our national health insurance legislation in these appointments since the Act was introduced that the insured members should have the right to control the Society. The national health society throughout the country prior to the unification was composed upon that principle. In Great Britain, where individual societies still exist, it is recognised as the cardinal feature of the structure of the individual societies that the insured members are entitled to elect the committee of management, and by virtue of the fact that they are entitled to elect the committee of management they are in control of the policy of the national health insurance society. The Minister even recognised that principle in connection with the 1933 Act. The Minister recognised that it was desirable that insured persons should have the majority of the representatives on the committee of management, because he provided for nine representatives of the insured persons, whereas the other interests on the committee were only represented by six persons. I say to the Minister now that the preservation of that principle was very important from the point of view of the interests of the insured persons.

What is happening under the new scheme proposed by the Minister? It was possible under the 1933 scheme for the committee of management to elect its own chairman, a quite usual procedure for committees of that kind. The insured persons' representatives could be sure that they could elect to the position of chairman one of their own members. If it was desired that the chairmanship should rotate, it was possible for the employers' representatives to appoint the chairman. At all events the principle of electing the chairman by the committee of management was recognised under the 1933 Act. I submit there must have been good reasons which induced the Government to allow the committee of management to have the sole voice in electing the chairman of the society.

Let us now compare the 1933 scheme with the new scheme or provision enshrined in this Bill. The new scheme provides, as formerly, that the three trustees will be appointed by the Minister, and the three representatives of the employers will also be appointed by him. But, not content with maintaining his right to appoint the trustees and the employers' representatives, the Minister is now taking power to ensure that the chairman will also be appointed by himself. I should like to know from the Minister what good grounds he has for claiming that he should be the person to appoint the chairman? If we take the personnel of the committee of management under the new scheme it will mean that the Minister will appoint seven persons, none of them representative of the insured persons. At all events, the insured persons are going to have no voice whatever in the nomination of the seven persons who will be appointed by the Minister. Against the seven appointed by the Minister, there will be eight representatives of the insured workers, so that the committee of management of the Society, which stood in the proportion of 9 to 6 under the 1933 scheme, is now to be altered to the proportion of 8 to 7. The workers' representatives are to lose one member on the committee of management as originally conceived. The non-workers' representatives are to be increased by one. The Minister, of course, may tell us that his aim is to secure a chairman who is impartial to both sides, but let us realise that there can be no impartiality whatever about the chairman, having regard to the manner in which he is to be elected. Insured persons are not to be consulted in the election of the chairman. The Minister may put in anybody he likes there, and may maintain anybody he likes there, notwithstanding any objection by the committee. The independence which the chairman will have will be bordered by his terms of appointment.

When we look at Section 7 of the Bill we find that the chairman is appointed by the Minister, that the Minister is not obliged to consult anybody in appointing the chairman, and that the chairman shall hold office for a period prescribed by the Minister. In Section 7 (2) (c) we are told that the Minister may remove the chairman from office. From that, one can see perfectly clearly that if the chairman of the society is going to stand up for the rights of the insured members and the rights of the committee of management against the Minister's Department, the relations between the chairman and the Minister will not be of the most cordial and amiable character. If the Minister's Department has any trouble from time to time with the committee of management of the National Health Insurance Society we may be sure, no matter what his own desires may be, that the Minister's mind will be inevitably coloured towards the conclusion that this is a particularly troublesome chairman. Although he may be very efficient from the point of view of safeguarding the interests of the insured members, the Minister may be prone to believe that the troublesome chairman—even though he is troublesome on behalf of the insured members—is also an inefficient chairman. This whole method of appointing the chairman of the National Health Insurance Society makes him a creature of the Minister. He will just get a certain amount of latitude from the Minister, but if ever he endeavours to get some more latitude, if ever he becomes troublesome to the Minister and his Department, we all know the kind of atmosphere that can be radiated against him. Consequently, the person appointed to the position of chairman of this National Health Insurance Society will be a person who, if that is his sole employment, will always do what the Minister wants. This chairman, having regard to the manner in which he is appointed, will become a Ministerial yes-yes man, who will do all that the Minister tells him to do. He will not dare to annoy the Minister; any time he is tempted to do so, even in the interests of the insured persons, some one will remind him of Section 7 (2) (c) which provides that the Minister may remove the chairman from office. That is probably calculated to bring the chairman to heel almost immediately. When the Minister, under the new scheme, has appointed three trustees, three employers and one chairman, he has appointed a group of people over whom he has absolute control. He has complete control over the chairman, whom he says in his speech to-day he desires to be as independent as possible. I think the term "independence" is rather incongruous having regard to the rather brusque language in which the Minister's power over the chairman is embodied in Section 7 (2) (c).

At all events, the main principle in connection with the new scheme is that the workers' representation on the committee of management is to be reduced. They are to have eight representatives as against seven nonworkers' representatives. If there should on occasions happen to be one of the workers' representatives absent—which is not improbable I suggest seeing that they will be elected from various parts of the country and may for one reason or another find it difficult to be present on all occasions—a situation will arise where there will be seven representatives of the workers, seven persons who are non-workers' representatives, with a chairman, appointed by the Minister and removable by the Minister, exercising a casting vote. On any day on which the committee of management meets and there are less than eight representatives of the workers present, while the other elements are fully represented, there is no control by the insured workers' representatives over the policy of the society. I suggest to the Minister that it is altogether unfair, even though he is altering the method of election, that the representatives of the workers on the committee of management should be reduced in the manner suggested by the Minister in this Bill. I think it is rather unusual for the Minister, in a Bill of this kind, to claim the power to appoint a chairman. He did not claim that power in the 1933 Act, and I can hardly imagine that that section was allowed to go into the 1933 Act without his Department calling his attention to the fact that the filling of the chairmanship would appear to be left to the discretion of the committee. Now it is proposed that the Minister should appoint the chairman, and I suggest that the only purpose in seeking power to appoint a chairman is to put a particular person into the post, giving the insured workers no voice whatever in the selection of the chairman. Whoever is intended to be chairman of this society under the new scheme may be a most estimable gentleman; he may be an ideal person from every point of view, but it is wrong in principle that the Minister should appoint the chairman and give the workers' representatives no say in his appointment. It is wrong that the workers' representatives should be denied the right to have a chairman of their own choice.

Now I come to the part of the new scheme under which not alone shall the number of the workers' representatives be reduced in the interests of the non-workers' representatives but under which the whole method of electing the workers' representatives is, I think, needlessly cumbersome. The Minister says that the scheme provided for in the 1933 Act was unsatisfactory, was cumbersome and was costly. I rather think that the new scheme, in so far as it provides for the nomination of the insured workers' representatives by loyal authorities, is almost as cumbersome as the original scheme. From the point of view of giving control to the workers' representatives, it is altogether undemocratic, having regard to the provisions of the original scheme. At least under the original scheme the workers were enabled to take the initiative in selecting their representatives. Now it is provided that the county councils and borough councils will nominate the persons, and constitute a kind of electoral college. As Deputy Morrissey has rightly pointed out, that really means that the nomination of the workers' representatives will be in the hands of persons who detest the provisions of the National Health Insurance Acts, and who detest the provisions of many other Acts designed to improve the conditions of the workers in economic and social matters. It is well-known that the members of county councils and other local authorities throughout the country have little knowledge of the provisions of the Act, but they see in legislation of that kind what many of them are pleased to call a burden on industry and on agriculture.

Many of those persons, therefore, who dislike the provisions of the National Health Insurance Act will be the persons who have the right to say who will constitute the electoral college for the purpose of electing the workers' representatives; in other words, it may really turn out in this way, that instead of the workers initiating the movement to select their own representatives, the employers on the county councils and borough councils will be the persons who will initiate the movement for the election of the workers' representatives. Every employer who is represented on a local authority, every large farmer and rancher who is represented on a local authority or county council, will now under this scheme be the person who decides who will constitute the electoral college to select the workers' representatives. We have, therefore, the strange position that instead of giving the workers the power to initiate the movement for the election of their own representatives, we now find ourselves confronted with a scheme where the movement will not originate with the workers themselves, but will originate in many cases with their employers. In any case, it will originate with persons who are not insured contributors themselves, but are persons liable to pay contributions in respect of workers. That seems to me to be a truly undemocratic method of electing workers' representatives.

Then, to have an electoral college of anything from 100 to 120 persons to elect five representatives drawn from all over the country, where members from Cork will not have the slightest notion of the qualities of a nominee of the Donegal County Council is an entirely unsatisfactory method of providing for the election of workers' representatives. Representatives of the Dublin County Council will meet representatives of the Galway County Council and of the Cork and Donegal County Councils and out of that assortment of persons, who meet each other for the first time, five persons are to be elected to represent the workers. All of the 100 or 120 people there will have been sent by county councils and borough councils who are not themselves solely representative of insured persons. I could not imagine a more undemocratic scheme, or a scheme which more effectually takes the power of initiation out of the hands of the workers and puts it into the hands of persons who are not workers, than the scheme provided in the section.

I concede that the National Executive of the Trade Union Congress are permitted to nominate three representatives. There, at all events, we have the safeguard that these are people who are representative of the trade union movement. They are workingclass representatives who hold their positions by virtue of the confidence reposed in them. At least we can ensure that these people are responsible to those who elect them and that the method of their election ensures that they can be held accountable for any of their actions. In that case, at all events, we have a definite guarantee that those who are selected by the Trade Union Congress will be workers' representatives of a type that can be depended on, in the judgment of the Trade Union Congress, to look after the interests of the insured workers. But we have no such guarantee in connection with those who will be nominated, in the first instance, by the county and borough councils.

I would prefer, even though the method may not be entirely satisfactory—it would, however, be more satisfactory than the scheme provided in the Bill—that the Minister should endeavour to see to what extent he can frame a scheme providing that the representatives of the workers should be elected in consultation between himself and the Trade Union Congress so as to ensure that we have workers' representatives who are not nominated by employers in the first instance. It ought to be possible for the National Executive of the Trade Union Congress to co-operate with the Minister so as to ensure that those who will represent the workers, as the result of consultation between the Trade Union Congress and the Minister, would be drawn from the different portions of the country. The Trade Union Congress' assent to the nomination would at least ensure that they were bona fide representatives of the insured persons. We could therefore avoid the possibility of persons being elected through the electoral college, who may not be in fact bona fide representatives of the insured workers and who may just be rubber stamps for persons who can control the greatest amount of influence in the county councils. The method of selecting representatives through the National Executive of the Trade Union Congress offers a better guarantee that those elected to represent the workers will be equipped to do so. I would prefer therefore if the Minister could see his way to have the workers' representatives nominated by the Trade Union Congress in conjunction with himself. He could then feel satisfied that they were genuine representatives of insured persons and he could be satisfied that the difficulties and the objections associated with allowing employers to initiate the movement for the election of workers' representatives would be definitely avoided.

But, whatever the method of election is, the Minister should certainly restore to the workers' representatives on the committee the proportion which existed under the 1933 Act—that is, to give the workers' representatives their original strength on the committee which was then proposed, namely, nine representatives of the workers and six representatives of the non-insured persons. In that way, at all events, the Minister would make it clear that this Bill is designed, not to reduce the workers' representatives, but to give them the same power and the same control as they formerly had. As I said, I hope the Minister between now and the Committee Stage will consider the question of abandoning this method of election, because I think it is ineffective, unsatisfactory and undemocratic, and it is introducing in respect of national health insurance legislation a principle which has never been there before, namely, allowing the employer to initiate the movement for the election of the workers' representatives.

I give the Minister credit for being a democrat. The Minister frequently has protested in this House that he is a democrat, but I am sure that he cannot reconcile this scheme provided in the Bill with any canon of democracy applied to national health insurance legislation in the past. The proposal is undemocratic, and it certainly is not there to serve the best interests of the workers. Not only does this section reduce the representation of the workers, but it allows the movement for the initiation of the election of their representatives to pass into the hands of persons who in many cases will be employers. That is undemocratic. The Minister, I hope, between now and the Committee Stage, will endeavour to devise a scheme by which the election of the representatives of the workers on this committee of management will be at the instigation either of the workers themselves or those who can be guaranteed to ensure that the proper type of workers will be elected to the committee. I imagine that a consultation between the Minister or his Department and the Trade Union Congress would lead to the initiation of a scheme which would be more satisfactory and certainly much more democratic than the scheme provided in the Bill.

Mr. Brennan

There are one or two points which I should like the Minister to explain. I am at sea as to what the functions of the committee of management are to be and what really will be the work which the committee will have to do. I understand that the administration will be carried out generally by the officers, but I do not know what the real functions of the committee will be, and I should like the Minister to tell us. With regard to Section 18, it lays down that if an employer has failed or neglected to pay certain contributions he may be liable to the dependents of a person who has died and who may leave a widow and dependents, and that they can sue him. I think a more reasonable thing to do in a case like that would be that the Department should decide whether or not the person concerned would be entitled to a pension if the contributions were paid. Then the pension should be granted in the ordinary way, and it ought to be the business of the Minister to follow up that employer in law. Of course I see that the Minister has the right to do that, but it ought not to be thrown on the widow or dependents to take action. The Minister himself ought to grant the pension in the ordinary way, and it should be laid down in the Act that he should recover from the person whatever moneys ought to have been paid in the ordinary way. That is really a matter for the Committee Stage, but I think the Minister ought to consider it.

Dr. Rowlette

There are only one or two points to which I should like to draw the Minister's attention in connection with this amending Bill. I was rather disappointed that, when the Minister was bringing in an amending Bill, he had not thought fit to put in the amendment he has committed himself to, and which, I believe, he would like to put in. It is a good many years since the Minister, when in opposition, opposed in an amending Bill on National Health Insurance—a very small measure and one of less importance than the measure now before the House—any amendment of the existing code of national health insurance unless it contained two important reforms: one of them being the unification of the approved societies, and the other—which I think Deputies would consider a very important reform, though the Minister still postpones it—the introduction to the code of some reference to health or of some method of providing for dealing with health. Our code has practically no relation to health except in so far as it makes money payments to those who are temporarily or permanently disabled. There is no provision in the code concerned with the improvement of the health of the community, and none of its funds ought go for that purpose. The Minister himself declared at the time that no reforms should be accepted by this House until that reform was included in the measure, but I am disappointed to see that he has now come for the second time with an amending Bill which does not contain the two reforms of which he approves.

I must confess to some sympathy with the views expressed by the Leader of the Labour Party with regard to the constitution of the committee for the Unified Society. I think he is justified in saying that the provisions for the election of insured members' repretatives are cumbrous and do not give a guarantee that insured members will in fact be represented. My criticism would tend perhaps to the same thing in saying that I think that the constitution of the committee of the Unified Society will not give us a sufficiently progressive management to give us confidence that it will proceed to the important measure of reform that I mentioned a minute ago. As far as we can judge from its constitution, it will be a committee of a somewhat unprogressive nature. We have not found in the past that employers' representatives, with regard to national health insurance, were concerned to any great extent with devoting funds to the preservation of the general good health. There is a good deal of substance in what Deputy Norton has said, to the extent that the so-called insured members' representatives will be, to a considerable extent, persons who are not representative of insured members but rather representative of the employers' interests. I confess that I am not able to suggest another method for appointing this committee. I recognise that some amendment is necessary in the method of appointing the committee, but I cannot suggest a better committee. I cannot say, however, that in some of its provisions the method set forth in this Bill is one that would give confidence as to having a society with a progressive committee at its head.

There is a danger in a unified society in itself through the mere fact of monopoly. There is the danger that it is not likely to be progressive when there is no competition between different societies. That being so, I think it should have been present to the Minister's mind that it was necessary, in framing this constitution, that he should give all the strength he could to progressive elements but, as far as I can see, the constitution does not bear that complexion as the Bill stands.

Dáil Éireann díospóireacht - Thursday, 13 Feb 1936

National Health Insurance and Widows' and Orphans' Pensions Bill, 1935—Second Stage.

Dáil Éireann díospóireacht -
Thursday, 13 Feb 1936