Dáil Éireann díospóireacht -
Thursday, 19 Nov 1942

Vol. 88 No. 17

Saint Laurence O'Toole Hospital Bill, 1940—Committee (Resumed).

Debate resumed on the following amendment:—

Section 15—Amendment No. 16. In sub-section (1), page 7, to delete paragraph (a).—(Deputy McGilligan.)

Mr. Cosgrave

The purpose of this amendment is to endeavour to restore to this hospital its character as a hospital and to take away the surroundings of pauperism which it is intended to impose on the board by this section. This is an institution which has been in existence for the best part of a century. At any rate, it is almost a century since there was an inquiry into the Dublin hospitals by the British Government. This hospital has since maintained its character as a teaching hospital and as a centre of activity for medical and surgical purposes.

It has been administered by a board over a long period. Although many criticisms may have been passed upon British administration during its period here, at any rate there was one thing that could be said about it: when they appointed a body such as this, they leaned towards an extension rather than a restriction of the autonomy of such a body. And it was right that it should be so. The board is composed both of the medical members of the hospital and of outsiders. It got a Government grant, and up to a few years ago was in receipt of Government money. It is not now in receipt of Government money. There is no staff and no Minister in this State qualified to sit in judgment upon a board of this character, with which the medical and surgical professions are associated.

It is one of the principal hospitals of the city. It is not in competition with other hospitals. It has been and is performing a great public service. Perhaps the most distinguished medical practitioner and surgeon of the 19th century was a member of this board. Having regard to his eminence, we can imagine the horror with which he would regard any attempt on the part of the Government—doing nothing whatever for the hospital—to take control of the appointment of either the charwoman or the matron or, perhaps, a paid surgeon, if there be such. As I have said, there is no experience whatever in the Department of Local Government and Public Health of the control of such a body as this. They are and have been concerned with the functions of the Charities Act, of dispensaries and of county hospitals, but not of a teaching hospital such as this.

Nobody knows what the purpose of it is, nor will anyone ever know, as far as I am aware. The board makes an appointment, let us assume for the moment, to-day, and sends it on to the Minister for Local Government and Public Health. There have been complaints from one end of the country to the other about the length of time it takes that Department to make up its mind about certain matters and, from the information available, they do not seem to have improved in that matter of administration. What knowledge would they have of this matter, assuming now that they enter into consideration of it with the best possible motives? What knowledge have they of any sort or kind regarding this in the Department? What useful purpose is served by giving them this power? Has the administration of the Department during the past ten years been such as would qualify them for any such authority as is proposed to be given to them under this section?

I have mentioned the brother of a distinguished officer giving service here in 1916, having had long service as a surgeon in a hospital in the West of Ireland. He retired from service some time in July of one year. He was a broken and spent man. The Department of Local Government and Public Health took until the following June to give him a pension. They gave him the least possible sum of money they could give him, nevertheless they took 11 months to make up their minds on that subject. This is the body—this same Department, with possibly the very same persons as I believe were in charge then—to which we are now proposing to give authority to supervise, and approve or reject as the case may be, every single appointment made by the board of the hospital. There is no machinery or experience whatever in the whole Department from one end to the other of any association with teaching hospitals. Nobody knows why it should be sought, and it is to be hoped that the Minister will give the House some information on it.

Dr. Ward

Deputy Cosgrave makes a case for what he calls the restoration of the character of the hospital and the removal of restrictions on its autonomy. I submit to the House, and in particular to Deputy Cosgrave, that the character of the hospital is not being altered by any of the terms of this Bill; but that, in fact, if the amendment moved by the Deputy were accepted by the House and incorporated in the Bill, a very radical change in the relationship between the hospital governing board and the Department would be brought about thereby. Listening to Deputy Cosgrave, one would think that this matter of Ministerial sanction to appointments made by the board, of officers or staff of the board, was an entirely new departure—that it has been introduced in this Bill for the first time. Deputy Cosgrave knows well that that is not the position, that these appointments have been subject to sanction since this institution was set up first. In fact, the powers that are vested in the Minister under the Act of 1856 are substantially more extensive powers of control than those sought in the present Bill. Section 4 of the Act of 1856 says:—

"The Lord Lieutenant shall, subject to the Approval of the Commissioners of Her Majesty's Treasury and to the Provisions herein-after contained, regulate and determine the Number and Description of Officers and Servants to be kept for the said House of Industry Hospitals as he may think fit, and the Salaries to be paid to them respectively, and the Lord Lieutenant may from Time to Time appoint or remove such Officers or Servants, and upon every Vacancy by Death, Removal, or otherwise in any such Office may appoint some other Person to such Office, and may fill up or not, as in his Discretion he may think fit, Vacancies among such Officers and Servants."

That very extensive power, which has now devolved on the Minister, is not being repeated in the present Bill. The section which Deputy Cosgrave now proposes to amend provides that, after the passing of this Bill, the Minister can, by Order, exclude such offices as may be agreed upon or as he may determine, from the category of officers or servants that would require Ministerial sanction.

That will be done in consultation with the board and it is not intended to interfere with the discretion of the board in matters of appointment in the ordinary course of events. Not only during the past ten years but even in the period of Deputy Cosgrave's Government, the same system obtained. In April, 1930, the board appointed Mr. Richard Slattery as honorary surgeon. That was submitted to the Governor-General for his approval. The Governor-General sanctioned Mr. Slattery's appointment on the 22nd April, 1930. In October, 1930, Doctor Leonard Abrahamson and Doctor James O'Connor were appointed to the medical staff. On the 28th October, 1930, the Governor-General sanctioned the appointments. In November, 1930, the board recommended the appointment of Mr. Michael Bourke as honorary surgeon, and on the 25th November the Governor-General sanctioned the appointment. The salaries of a pathologist and bacteriologist were increased in 1934, and sanction of the salary of the pathologist was given on the 2nd March, 1935.

In the light of those facts, it is scarcely fair to say that some radical departure in the status of the hospital is being aimed at in this Bill. In fact, it is not. As I have said, the Minister is foregoing substantial powers which he holds at the present time and which he could continue to hold if this Bill were not brought before the House. He is doing that in the belief that, through the medium of this Bill, better machinery of government of the institution will be set up and harmonious relations maintained. It is sometimes of considerable advantage to a board of governors of such an institution—I understand from some of the members of this board that they look upon it as being of some advantage to them—to have this question of Ministerial sanction to fall back upon. Members of a board of governors are sometimes considerably embarrassed in the making of appointments. A good deal of pressure is brought to bear upon them from time to time in favour of a candidate who might not be the most suitable candidate. There might be difficulties for members of the board in refusing to recommend such a candidate for appointment.

It is a useful way out, if I may put it that way, to be able to say: "I am prepared to recommend you all right, but bear in mind the Minister's sanction has to be obtained." That provides a certain amount of protection for members of the board. At least, so it has been represented to me. There may not be a great deal in that but, on ocasions, there might be. We are not encroaching on the autonomy which the board had in the past or which it is enjoying at present.

Mr. Cosgrave

The very small number of cases which the Parliamentary Secretary read out is, in itself, sufficient answer to the case he has made. It is to be remarked that he said that the Governor-General made certain appointments. Obviously, there was no Ministerial interference and, if there were, there would be some justification for it if we are to regard a contribution towards the maintenance of the hospital as qualifying for such interference. Not a penny is being given by the State now, nor has any contribution been made for some years. At one time, this was looked upon as a hospital which depended exclusively for its maintenance upon the Government of the day. In the year 1920, the Government of the day would not accept that liability. The board resigned and a new board was appointed on the recommendation of the medical members. If the operations of the Governor-General were automatic, what is the use of mentioning them? Is it not a joke to put forward that as a reason why the Minister should inherit these powers?

Dr. Ward

I did not say that they were automatic. I do not know whether they were or not.

Mr. Cosgrave

It is fairly obvious that they were. As I have said, the Department of Local Government have no experience whatever of a hospital of this kind. The last argument the Minister put before us appears to me to be the worst of all. Imagine a board of governors hoping that Ministerial sanction will be maintained because the name of a candidate may be submitted by them to the Minister which they, in their better judgment, would not recommend. I do not believe that. Assuming it is so, it is time to put an end to it. The board ought to bear its own responsibility. Parliament has its responsibility. There is no vetoing by anybody of the work done here. Once it leaves us, any imperfections in it are our responsibility. Where a veto exists, it may be availed of occasionally and, in consequence, the better judgment of the body responsible for giving decisions may not be always enshrined in its legislation. Is the board to be invited to resort to what was called at one time here the "backstairs of the Castle"? Are there to be backstairs to the Local Government Department? A communication comes in from a board comprised of a number of the medical men in the hospital and a number of the Minister's nominees. That communication will come in by the front door, but another person may come up the backstairs and say: "Do not make that appointment; the board is not in favour of it." That would be a deplorable degradation of responsibility. A hospital could not be regarded as well run in which the board may make any appointment it likes and look to the Minister to set matters right. I have the gravest doubt that a single member of the medical board would make such a suggestion. If an appointment of a physician or surgeon is to be made, is there not a major responsibility upon the persons best qualified to judge to realise how much the life and death of certain people are involved in the appointment? Is it conceivable that a medical board would solemnly vote in favour of a candidate and, having done so, send somebody up the backstairs— if there is such a staircase—of the Custom House to inform the Minister that the appointment is not to be made, that the better judgment of the medical members of the board is against it? That would not be in the interest of the hospital or of the patients who will go to the hospital.

If that be the intention, there is sufficient reason in that to oppose this Ministerial sanction. Ministerial sanction may have on occasion some right to consideration. If the Minister were putting up public funds for this hospital he would be probably justified, assuming he was inheriting the same right, in maintaining it. I was not aware that this board operated under Ministerial direction or approval. It may have been discovered lately. I did not hear of it until now. Under the Governor-General, yes, but that was merely an automatic business.

Dr. Ward

And the Lord Lieutenant before him.

Mr. Cosgrave

And the Lord Lieutenant before him. As I said, on a certain occasion when there was no board, the medical members, quite irregularly, acquainted the Lord Lieutenant that there was no board and recommended a board on which the medical members were appointed and certain other nominees, and they kept the doors of the hospital open when they would have been closed but for their action. I want to know what advantage there is in having this Ministerial sanction or approval. It is a limitation on the autonomy of the board. It is their responsibility to run the hospital. They will have to be responsible for any operations performed there, and not the Minister. Let us conceive a situation in which Surgeon A. is recommended by the board. The Minister says "No", having been advised by the backstairs method that it was not in the best interests of the hospital. That might be done by somebody who at the time was in a minority on the board, and Surgeon B. is appointed. He may be the second-best. But the people of Dublin are entitled to the best. With whom is the last word in wisdom in connection with an appointment of that sort—the Minister, even if he be a professional man, or the members of the board? I say that if there is any character whatever left in the medical profession it would be amongst the medical members of the board. They have the major responsibility; they carry out the day-to-day work. The Minister comes in and goes out as occasion arises; the medical board continues.

I say it is not in the interests of the hospital that there should be any limitation on the autonomy of the board. It could only be envisaged in case the Minister is doubtful regarding the nominations that he makes to it. He must have some misgivings about his own nominations or about the nominations of his successors. If, arising out of that, it is conceivable that you might have an incompetent board, there may be a case for this. But there would be a better case, in my view, for doing away with the board.

Dr. Ward

Deputy Cosgrave seems to be determined to continue this debate on the basis of the Richmond, Whitworth and Hardwicke institution being, in fact, a voluntary hospital. He appears to close his eyes to the fact that it is incontrovertible that this is a State hospital, that it is not a private hospital. It is a State hospital over which the State has always had complete control. It is a State hospital over which Deputy Cosgrave's Government had complete control and over which the present Government have had complete control for the past ten years. Now Deputy Cosgrave implies, or practically says directly, that because the State has ceased to give an annual grant towards the maintenance of this institution, the State has no further right to interfere in the affairs of this institution; that it ceases to be a State hospital just because of the fact that moneys provided by the Oireachtas are no longer disbursed to that institution. But, in fact, as Deputy Cosgrave and every Deputy in this House know, much larger sums of money, which are under the control of the Minister for Local Government, than ever were given by way of State grant are now disbursed annually to this institution. I think that the annual deficit paid out of the Hospitals Trust funds under the control of the Minister for Local Government in the case of this particular institution is the largest disbursed to any hospital in Ireland. I do not say that there is not good value given for it; I am not making that suggestion at all. But I do say that when the Minister approves of the payment of a deficit amounting to £21,000 in the year, in view of the precarious position of the Hospital Trust funds, the Minister ought not to relax any control he has over that institution.

The case has never been made—in fact it is quite the contrary—that this hospital is a State hospital by virtue of the fact that it has received a State grant. Away back in 1919 this matter was raised in the House of Lords on the question of the grant. Lord Crawford, speaking on behalf of the British Government of that time, took the view that the institution was not, in fact, a State hospital, that it was in much the same position as the other voluntary hospitals or public charitable hospitals here in Ireland. But that view was not accepted by the board of governors or by the secretary of the board of that time. In answer to Lord Crawford, the secretary of the board of governors, Mr. W. Webster Smith, published a letter in the Irish Times on the 15/8/1919 in the course of which he said:—

"By the Act of 1856 the government of the hospitals was retained in the hands of the Lord Lieutenant, who alone could nominate the governors. The Treasury pension regulations were applied to all permanent salaried offices in the hospitals and every foot of ground and every stone in the hospitals was was vested in the Board of Works. These conditions would appear to render the hospitals a State institution, and certainly militate against their recognition by the public as on the same plane as the ordinary charitable hospitals."

The secretary of the board in 1919 claimed that, by reason of the considerations set out, this hospital was a State institution. If it was a State institution because of these considerations in 1919, it is certainly a State institution to-day when, in addition, the Minister for Local Government causes to be disbursed out of the Hospitals Trust funds a sum of £20,000 or £21,000 per annum by way of payment of its annual deficits.

Mr. Cosgrave

The Parliamentary Secretary would be well advised to read on and see what happened after that. The hospital put up that case to the Government, and the Government said: "No. We accept no responsibility. This is not a State hospital." The Government said that.

Dr. Ward

The British Government said it was not a State hospital, but the hospital did not accept that.

Mr. Cosgrave

That is another matter. The Parliamentary Secretary cannot stand on both legs. He must accept one case or the other.

Dr. Ward

This was a foreign Government.

Mr. Cosgrave

Well, the Parliamentary Secretary is only a generation or two away from the same foreign element. He has not a Gaelic name.

Dr. Ward

I only lost the "Mac".

Mr. Cosgrave

Yes, and a little more too, I think. The British Government of the time, in 1920, repudiated absolutely the fact that it was a State hospital.

Dr. Ward

They refused to disgorge any more funds.

Mr. Cosgrave

Precisely, but not only that; they said that they would have to take in patients and contribute towards the maintenance of this hospital, and the board would not do it. In essence, therefore, the hospital was closed, and would have remained closed but for the efforts of the medical staff, who came together, kept it going, and accepted whatever contributions were given to them. I do not accept for the moment the case that has been put up that because the hospital has received certain moneys from the Hospitals Trust Fund that gives the Minister power to go in there. That is a new leg, and the Minister must choose between the old leg and the new leg. This is a new case, if the Minister says that because of the moneys of the Hospitals Trust Fund he has the power to enter and take control here. If he bases his case on that, will he take the same control in the case of all the other hospitals?

Dr. Ward

But this is a State hospital. The State has the control here.

Mr. Cosgrave

The Parliamentary Secretary wants to have it every way. He wants, first of all, to make the case of the hospitals, which was repudiated at the period when the board went out of existence and would not be anything else except a voluntary hospital, and then he takes the other line that it is a State hospital and that the State has control. The Parliamentary Secretary cannot be both the Lord Lieutenant and the secretary to the board of governors of the hospital at the same time. He must be one or the other. If, alternatively, he is taking up the line that it is because the money is coming from the Hospitals Trust Fund, that is another leg—an entirely different case—because these funds cost the State no money and, in fact, the State gets money out of them.

These governors of boards of hospitals are autonomous bodies, and ought to be autonomous. They are the best representatives of the various people concerned, and the interests of the students, doctors and so on, are best served by having them autonomous bodies. I put it to the House that that is the responsibility of the House with regard to this matter. For the past 100 years we have had good teaching hospitals here, free from State control or from State interference, and the mere automatic approval of the Lord-Lieutenant in a matter of this sort is beside the question. The system has been a great success, so why interfere with it?

Dr. Ward

But I am not interfering with it.

Mr. Cosgrave

Take this particular sub-section that we are proposing to take out. Show me where, in that measure, the Lord-Lieutenant has the same power as that you are taking here. Do not tell me that the education of this country is denominational. It is undenominational in name, but denominational in practice.

Dr. Ward

The Deputy asks me to show him where the Lord-Lieutenant has the wide powers to do all these things. I refer him to Section 4 of the Act of 1856, where the Lord-Lieutenant, or the Minister now, as his successor, is able to make all the appointments without consulting the board at all.

Mr. Cosgrave

Yes, and I am sure he did!

Dr. Ward

That is not the point.

Mr. Cosgrave

The difference is that the Lord-Lieutenant pretended to do that because it was according to an Act of Parliament, while actually doing nothing, whereas the Minister pretends to do nothing and does everything. Let us read the two sections concerned in this business. The first says that, subject to the provisions of this section, the board shall not, without the consent of the Minister, exercise, in relation to any office or employment under the board, the powers conferred on the board by sub-section (1) of Section 16, and so on. In other words, the Minister's consent must be given to those things. I am taking out that. Then, sub-section (1) of Section 16 says: "the board may appoint such and so many officers and employ such and so many servants as the board may from time to time think proper."

Dr. Ward

The Deputy will see that the Minister can, by Order, made under sub-sections (2) and (3) of Section 15 exclude any appointment or office from the category requiring Ministerial sanction.

Mr. Cosgrave

Yes, I know that. That is just on a par with all the footy legislation that we have had here for the last ten years. We know now that if you pass an Act of Parliament here, you may have to amend it next week, but to obviate the necessity of amending it the Minister is given power to make an Order amending it, or to revoke the Order or amend the Order. An Act of Parliament is now a matter for civil servants.

Dr. Ward

We will have the board in consultation now.

Mr. Cosgrave

In consultation?

Dr. Ward

Yes.

Mr. Cosgrave

And the board may make up its mind that if it wishes to appoint anybody, the backstairs method will be tried, and then we will be told that it would not be in the best interests of the hospital to appoint that person. I do not like this thing, and I think that that was the weakest argument that was put forward by the Parliamentary Secretary.

Dr. Ward

It was only one of many.

Mr. Cosgrave

Well, I am taking them all, one by one. In the first place, we are told that the Lord Lieutenant appointed the first surgeon, the second surgeon and the third surgeon, and so on, but as a matter of fact the Lord Lieutenant never heard of even one of them.

Dr. Ward

Then he was a very bad administrator.

Mr. Cosgrave

Just imagine the late Sir John French, when he was Lord Lieutenant, when these people were taking out their cheque-books, paying their bills, and making appointments, interfering with them in any way. Does anybody imagine that he knew any of these appointees or ever heard of them?

Dr. Ward

What about the late Tim Healy?

Mr. Cosgrave

The same thing applied there. It was automatic, but this is not automatic. This is where the appointment of everybody, even down to an unfortunate charwoman, must go before the Minister.

Dr. Ward

We will take out the charwoman.

Mr. Cosgrave

Yes, take her out— take them all out now and put the responsibility on this board and, if they are not equal to it, then fire them and appoint another board. At any rate, where there are people rendering such services as these distinguished medical men render on these hospital boards, fix them with the responsibility; do not share it with them. It is their job. They have done it well up to this, and we ought at least to have confidence in their continuing to do it well in the future.

Question proposed: "That the words proposed to be deleted stand."

The Committee divided: Tá, 60; Níl, 20.

Tá

• Aiken, Frank.
• Allen, Denis.
• Bartley, Gerald.
• Beegan, Patrick.
• Bourke, Dan.
• Brady, Brian.
• Brady, Seán.
• Breathnach, Cormac.
• Breen, Daniel.
• Brennan, Martin.
• Breslin, Cormac.
• Buckley, Seán.
• Cooney, Eamonn.
• Corish, Richard.
• Corry, Martin J.
• Crowley, Tadhg.
• Davin, William.
• Derrig, Thomas.
• De Valera, Eamon.
• Everett, James.
• Flynn, John.
• Flynn, Stephen.
• Fogarty, Andrew.
• Fogarty, Patrick J.
• Friel, John.
• Fuller, Stephen.
• Gorry, Patrick J.
• Hickey, James.
• Hogan, Daniel.
• Humphreys, Francis.
• Keane, John J.
• Keyes, Michael.
• Killilea, Mark.
• Lemass, Seán F.
• Little, Patrick J.
• Loughman, Francis.
• Lynch, James B.
• McCann, John.
• McDevitt, Henry A.
• McEllistrim, Thomas.
• Maguire, Ben.
• Meaney, Cornelius.
• Morrissey, Michael.
• Moylan, Seán.
• Norton, William.
• O Briain, Donnchadh.
• O'Grady, Seán.
• O'Loghlen, Peter J.
• O'Rourke, Daniel.
• O'Sullivan, Ted.
• Pattison, James P.
• Rice, Brigid M.
• Ryan, James.
• Ryan, Martin.
• Sheridan, Michael.
• Smith, Patrick.
• Traynor, Oscar.
• Walsh, Laurence J.
• Walsh, Richard.
• Ward, Conn.

Níl

• Bennett, George C.
• Brennan, Michael.
• Byrne, Alfred.
• Byrne, Alfred (Junior).
• Coburn, James.
• Cosgrave, William T.
• Curran, Richard.
• Dockrell, Henry M.
• Doyle, Peadar S.
• Fagan, Charles.
• Giles, Patrick.
• Hughes, James.
• Keating, John.
• Lynch, Finian.
• Mongan, Joseph W.
• Mulcahy, Richard.
• O'Higgins, Thomas F.
• Reynolds, Mary.
• Rogers, Patrick J.
• Ryan, Jeremiah.

Tellers: Tá: Deputies Smith and S. Brady. Níl: Deputies P.S. Doyle and Bennett.

Question declared carried.

Mr. Cosgrave

I move amendment No. 17, standing in the name of Deputy McGilligan:

In sub-section (1), page 7, lines 42 and 43, to delete the words "in relation to any person for the time being holding any office or employment under the board," in line 44, to delete the words "any of," and to delete all words after the word "namely" in line 45 to the word "and" in line 47.

This is a proposal to give those officials who are already in the employment of the hospital immunity from the sanction which, according to this clause, the Minister proposes to exercise in relation to the officers and servants of the board.

Whatever may be done in regard to appointments to be made in the future, at least as regards those who are there —some of them may be there since the period when the Lord Lieutenant had the making of the appointments—they ought to be considered in the usual way in which officials are regarded in Acts of Parliament when changes are proposed. There is no particular reason why they should be included now and brought under the direct control of a Government Department. So far they have not been under that control. As I said before, there is no information whatever in that Department. It cannot get it nor is it likely to get it. I am quite certain that no surgeon in a teaching hospital will ever be a Minister for Local Government or a Parliamentary Secretary, and, in consequence, so far as that part of the administration is concerned, there is not that information there. The same applies to the Department's officials. They are accustomed to dealing with boards of health. Some of them may have been engaged in administering the various Medical Charities Acts under the poor law system, but they have had no experience of a teaching hospital. It was outside their scope. The Lord Lieutenant, in exercising this control, simply put his name to a document when it was submitted to him and there was no more about it.

Dr. Ward

The purpose of the amendment is evidently to extend the powers of the board in regard to the fixing of salaries. Under paragraph (b) of the section as it stands, the board cannot exercise these powers without the consent of the Minister. I do not see much use in going over the same ground in relation to this particular amendment that we went over on the last one. Deputy Cosgrave has not any faith or confidence in the Minister or in the Parliamentary Secretary or in the Department. That is regrettable, but I am afraid that he is not altogether unbiassed. I think that the powers that are being sought under Section 15, in paragraph (b) of it just as much as in paragraph (a), can be well and properly exercised by the ministerial heads and their advisers, and that there is not any danger of hardship or injustice being inflicted on anybody.

Mr. Cosgrave

Will the Parliamentary Secretary try to get off the tangent that I am biassed? I have had some experience of local government, much more than the Parliamentary Secretary. He was a paid official of a local authority. I was a member of a local authority for a great number of years.

Dr. Ward

So was I. I served in both capacities.

Mr. Cosgrave

May I ask, without offence, what experience the Parliamentary Secretary has of a teaching hospital? I have none. My only experience of one was as a member of a local authority in this city which contributed in or about £6,000 a year to various hospitals. Part of the duty of the members of a certain committee of which I was one was to inspect those hospitals. There was something in the nature of an annual inspection. In one year the inspection might be made in the month of May, and in the following year in the month of September. These inspections did not afford us information of any kind regarding the administration of the hospitals. May I put this question: Is it likely that you would have anybody in the Department of Local Government with experience of a teaching hospital? No. The officials there, the best and the worst of them, are civil servants. As regards the professional men in the Department, not one of them has ever been a surgeon in a hospital. They were simply there for a period of six months when doing their course. I suppose we may take it that not one of them has ever been a physician in one of these hospitals. If he had been, he probably would have remained there. Now we are to have this new arrangement under which the Minister is taking more power than the Lord Lieutenant had, and gives nothing. At least, the Lord Lieutenant gave something, or it was given in his name. Then there is the Hospitals' Commission to please, a commission on which there are two doctors. One of them may have had hospital experience, but certainly not the two. In addition, there is the Minister who may be a layman or a medical man. If the latter, then except for the experience he gained when going through his course he will have no knowledge of a teaching hospital. It is proposed that this board should take over control and have a say in regard to every appointment that has been made by the old board, or any alteration made in status, salary or term of office. The proposal is ridiculous.

Dr. Ward

I cannot meet the Deputy on the matter.

Question put: "That the words proposed to be deleted stand."

The Committee divided. Tá: 57; Níl: 21.

Tá

• Aiken, Frank.
• Allen, Denis.
• Bartley, Gerald
• Beegan, Patrick.
• Boland, Gerald.
• Bourke, Dan.
• Brady, Brian.
• Brady, Seán.
• Breen, Daniel.
• Brennan, Martin.
• Breslin, Cormac.
• Buckley, Seán.
• Cooney, Eamonn.
• Corish, Richard.
• Corry, Martin J.
• Crowley, Tadhg.
• Davin, William.
• Derrig, Thomas.
• De Valera, Eamon.
• Everett, James.
• Flynn, John.
• Flynn, Stephen.
• Fogarty, Andrew.
• Fogarty, Patrick J.
• Friel, John.
• Fuller, Stephen.
• Gorry, Patrick J.
• Hogan, Daniel.
• Humphreys, Francis.
• Keane, John J.
• Keyes, Michael.
• Killilea, Mark.
• Lemass, Seán F.
• Little, Patrick J.
• Loughman, Francis.
• McCann, John.
• McDevitt, Henry A.
• McEllistrim, Thomas.
• Maguire, Ben.
• Meaney, Cornelius.
• Morrissey, Michael.
• Moylan, Seán.
• O'Briain, Donnchadh.
• O'Grady, Seán.
• O'Loghlen, Peter J.
• O'Rourke, Daniel.
• O'Sullivan, Ted.
• Pattison, James P.
• Rice, Brigid M.
• Ryan, James.
• Ryan, Martin.
• Sheridan, Michael.
• Smith, Patrick.
• Traynor, Oscar.
• Walsh, Laurence J.
• Walsh, Richard.
• Ward, Conn.

Níl

• Bennett, George C.
• Brennan, Michael.
• Byrne, Alfred.
• Byrne, Alfred (Junior).
• Coburn, James.
• Cosgrave, William T.
• Curran, Richard.
• Dockrell, Henry M.
• Doyle, Peadar S.
• Fagan, Charles.
• Giles, Patrick.
• Hughes, James.
• Keating, John.
• Lynch, Finian.
• McMenamin, Daniel.
• Mongan, Joseph W.
• Mulcahy, Richard.
• O'Higgins, Thomas F.
• Reynolds, Mary.
• Rogers, Patrick J.
• Ryan, Jeremiah.

Tellers:—Tá: Deputies Smith and S. Brady; Níl: Deputies P.S. Doyle and Bennett.

Question declared carried.

Amendments Nos. 18 and 19 not moved.

Section 15 put and declared carried.

SECTION 16.

Dr. Ward

I move:—

In sub-section (2), page 8, line 23, to insert before the word "officer" the word "paid".

This is merely a drafting amendment.

Mr. Cosgrave

It is not a very elegant amendment. I suggest the Parliamentary Secretary might reconsider inserting such words as "to every officer and servant on the pay roll"; that the board "shall pay and make to every officer and servant on the pay-roll". It does not look well to say "to every paid officer".

Dr. Ward

It seems to read all right.

Mr. Cosgrave

If he is a paid officer what are you going to pay him again for? It is a very unhappy description. "Everybody on the pay roll", or something of that sort, would be better.

Dr. Ward

If Deputy Cosgrave agrees to let the amendment go, I will consider some alteration of the wording before the Report Stage.

Amendment agreed to.

Section 16, as amended, agreed to.

Section 17 agreed to.

SECTION 18.

Dr. Ward

I move amendment No. 21:—

In sub-section (1), page 8, line 38, to insert before the word "officers" the word "paid".

This is on the same principle as the last amendment.

Amendment agreed to.

Dr. Ward

I move amendment No. 22:—

To delete sub-section (4) and substitute the following sub-section:—

(4) The board may at any time by a subsequent pension scheme (in this and the next following sub-section referred to as an amending scheme) amend a pension scheme or a previous amending scheme, and any such amending scheme may be expressed to operate retrospectively.

This is merely a change in the drafting which was suggested by the Parliamentary draftsman. It does not alter the substance or meaning. The phraseology will be more easily translated in the new form.

Amendment agreed to.

Dr. Ward

I move amendment No. 23:—

To delete sub-section (5), and substitute the following sub-section:—

(5) An amending scheme shall not be so framed as to terminate or reduce any pension which was, immediately before the coming into force of such an amending scheme, payable under the scheme thereby amended.

This is also a drafting amendment.

Amendment agreed to.

Section 18, as amended, agreed to.

Sections 19 to 25, inclusive, agreed to.

SECTION 26.

Question proposed: "That Section 26 stand part of the Bill."

Mr. Cosgrave

Under this section it is proposed to build a hospital elsewhere than on the present site. So far as I can see through this measure, there is no provision for any loss that would be sustained by certain persons who are either paid by the State or by the local authority and whose income would be affected by reason of the alteration in the situation of the hospital. On the occasion of the changeover of the North Dublin Union Hospital, as it then was, somewhere about 1916 or 1917, and its amalgamation with the South Dublin Union Hospital, my information is that there was provision made to compensate such officers of the local authority who suffered loss in their incomes by reason of the alteration. I have not discovered any such provision as that in this measure. Whether it is to be made elsewhere, I do not know. That it does not come exactly within the scope of this measure appears likely, but surely, if there is damage occasioned to anybody, the person performing the operation has a certain responsibility for it, and in this case the Parliamentary Secretary is doing it. Is he going to leave those unfortunate people, who will be getting reduced incomes by reason of this change, without adequate compensation? Is he going to do anything for them?

We were told a short time ago, when we were pensioning off the Currency Commission, which is to be called in the future the Central Bank, that it is customary, when we are determining the life of any public or corporate body, to pension off the existing members. Here is a case on all fours with that, but there does not appear to be anything like that proposed. My information is that these people are professional colleagues of the Parliamentary Secretary. Of course, the matter may have escaped his attention.

Dr. Ward

Deputy Cosgrave has certainly raised an entirely novel consideration. I did not anticipate, and I do not anticipate now, that the staffs of the existing institution will suffer financially by the bringing into being of a modern hospital to replace it. Deputy Cosgrave presupposes that if the hospital is changed from the present site the staffs will suffer financially. Of course, the staffs will be taken over and a pension scheme will be submitted——

Mr. Cosgrave

I am sure the Parliamentary Secretary does not want to waste time. I have not anybody in the hospital in mind. I am concerned with the registrar of births, deaths and marriages and other officers of that sort who will not perform their customary functions in this new neighbourhood. They were compensated before when the North Dublin Union was removed. Is there any provision for compensation for them here?

Dr. Ward

I shall look into that point. I do not think it will be necessary to cover it in the Bill, and I do not think that this would be the appropriate place, anyway. However, I shall look into it.

Mr. Cosgrave

It may be quite true that this is not the appropriate place. Where that appropriate place is, is beyond my knowledge.

Dr. Ward

I do not think that matter will arise, if it arises at all, for quite a number of years. It is not proposed to close down the existing institution immediately the new hospital is provided. It is anticipated that, with the present bed shortage in the City of Dublin, it will be necessary to retain the existing hospitals for probably a very considerable time after the new hospital has been provided, so that during that period until the existing hospitals are in fact closed, such damage as Deputy Cosgrave has in mind cannot very well occur.

Question put and agreed to.

Sections 27 and 28 agreed to.

SECTION 29.

Dr. Ward

I move amendment No. 24:—

In sub-section (1), page 11, line 19, to delete the words "the Saint Laurence O'Toole" and substitute the words "Saint Laurence's".

This amendment, changing the name, is consequential on amendment No. 7.

Mr. Cosgrave

I propose to divide on one or other of these two amendments. I am not particular as to which.

Dr. Ward

I think we have already divided on this point on amendment No. 7.

Mr. Cosgrave

We are going to change the name, and, as soon as this Bill passes into law, assuming the Minister's amendments are inserted, the title will be St. Laurence's Hospital. Ontside the City of Dublin and the Archdiocese of Dublin, if that is the proper description, St. Laurence O'Toole is known by that name, even in the case of a church on the quays of which he is the patron. There is a St. Lawrence in the Ordo whose feast-day is 10th August and to whom the Escorial in Spain has been dedicated. He has an Octave. St. Laurence O'Toole has an Octave also, but only in the diocese. St. Lawrence of the Gridiron has an Octave and is regarded as one of the principal saints. Once we take “O'Toole” out of this measure, nobody may know what St. Laurence is referred to. I think you can get over the whole thing by putting the name “O'Toole” in somewhere— either here or in the Title.

I suggest also that the name should be "St. Laurence O'Toole's Richmond Hospital". The name "Richmond" is known and has been known for a great many years. As I said before, it is associated with the name of perhaps the most prominent, the most gifted Dublin surgeon, Dominick Corrigan, who has bequeathed, one might say, his great button to posterity. If these amendments are inserted, this will be "St. Laurence's Hospital", and outside of Dublin, the name "St. Laurence" may connote the other saint. I think it is St. Paul who says that there ought not to be competition between the saints, and that people ought not to compare them. I am not doing that; I am simply pointing to a distinction.

The Parliamentary Secretary is not as much interested in this as we are. I happen to be a member of this diocese, while he is just an intruder, and consequently cannot be expected to have that veneration for, and one might almost say, that adoration of the Saint as we here have. His name is not to be mentioned. He came from a great old Irish family, a family as old as the hills, and I want the name O'Toole to be mentioned somewhere in the measure. I should like also to preserve, for the sake of the reputation of the hospital, of those who are engaged in it, of the work it did and of the many very eminent persons who have passed through its halls, the name of "Richmond". It can all be done without offending anybody, and, at the same time, give an intelligent connotation to the name of the hospital.

Dr. Ward

To deal first with the suggestion that the name of "Richmond" should be given statutory recognition, I am not prepared to accept that. The name "Richmond, Whitworth and Hardwicke hospitals" has no statutory recognition at present. The existing institution is known in law as "The House of Industry Hospitals". They came to be known as, and to call themselves, the Richmond, Whitworth and Hardwicke hospitals, and if they continue to call themselves by that title, there is nothing to prevent their doing so, but it is not proposed to give official recognition to a perpetuation of the memory of Richmond, Whitworth and Hardwicke, or to Richmond, leaving out Whitworth and Hardwicke, in the Bill. I think it would make a very unhappy combination to attach Richmond to St. Laurence O'Toole, but we shall leave that there.

Mr. Cosgrave

St. Laurence O'Toole can look after himself, and he is safe.

Dr. Ward

I should not like to leave St. Laurence O'Toole looking after the other man. I quite appreciate Deputy Cosgrave's adoration for St. Laurence O'Toole, and he, perhaps, has a better right to speak with fervour on that matter than I have, but, at the same time, I have some feelings on the matter, too. In the Bill as originally introduced, the name of the hospital was to be "St. Laurence O'Toole's Hospital". Objection was taken to that in the course of the debate by, I think, Deputy McGilligan, and attention was drawn to the fact that the name would be so abbreviated that it would become anything but a reverent reference. That representation seemed to me, on examination, to have a good share of sound sense behind it, and it was for that reason—in order to avoid the possibility of its irreverent use in abbreviated form—that we changed the name.

It is true that we have three Saint Laurences in the Ordo. Our St. Laurence O'Toole is described in the Ordo as St. Laurence, and there is not a word of reference to the surname throughout. St. Lawrence of the Gridiron is down in the Ordo as St. Lawrence with (m) after his name, indicating “martyr”. There is also St. Lawrence Justinian, and it seems to me that if we admit the necessity of attaching the surname in Ireland, we admit that the predominant St. Laurence was not St. Laurence O'Toole. To us, there is only one St. Laurence—St. Laurence O'Toole—but to people outside this country, St. Lawrence of the Gridiron might perhaps be more important. I think that so far from its being any slight, we are paying a tribute to St. Laurence O'Toole by referring to him as St. Laurence in the Title of the Bill, inasmuch as we thereby imply that it is not necessary to attach his surname in order that he may be recognised. It is not a matter about which there can be any feeling. I do not see how you could reconcile calling it St. Laurence's Hospital in one section, and calling it St. Laurence O'Toole's in another section. St. Vincent's Hospital is known all over Ireland, as is also St. Bricin's. I understand that the name of the amalgamated hospital should be St. Luke's. Whatever name you call the hospital it is going to be abbreviated. If we call it St. Laurence O'Toole's it may not be abbreviated to St. Laurence's.

Mr. Cosgrave

In a particular parish here a church is dedicated to the patron saint of this diocese. The Archbishop is in the direct line of descent from St. Laurence O'Toole. Look at one of the stained-glass windows in the ProCathedral. Is St. Laurence the name there? Not at all. It is St. Laurence O'Toole. No one would think of leaving out the name "O'Toole". As far as my memory goes, the late Deputy Thomas Kelly, who was an Alderman in the city and a member of the Government Party—I am sure he was not comfortable in it—he was in it but not of it—expressed indignation on the last occasion this Bill was before the House, when the name "O'Toole" was taken out. The name has been a characteristic one for Irish people for a number of centuries. St. Bricin had not a second name. He belonged to another diocese. In this instance we cannot forget St. Laurence having the name "O'Toole". I ask for a division on this amendment.

Dr. Ward

Did we not divide on this already?

Mr. Cosgrave

We divided, but that is not enough. This is the nominating section and I will take a division on it.

Dr. Ward

It is better to get it over.

Mr. Cosgrave

If there is an operation to be performed the sooner it is over the better.

Dr. Ward

This hospital will be attended by students who will probably shorten the name if we include the surname and it will probably be the surname that will be abbreviated.

Mr. Cosgrave

Whatever they may be, as far as I know them, medical students are not irreverent.

Amendment put.

The Committee divided: Tá, 48; Níl, 25.

Tá

• Allen, Denis.
• Bartley, Gerald.
• Beegan, Patrick.
• Boland, Gerald.
• Bourke, Dan.
• Brady, Brian.
• Brady, Seán.
• Breen, Daniel.
• Brennan, Martin.
• Buckley, Seán.
• Cooney, Eamonn.
• Crowley, Tadhg.
• Derrig, Thomas.
• Flynn, John.
• Fogarty, Andrew.
• Fogarty, Patrick J.
• Friel, John.
• Fuller, Stephen.
• Gorry, Patrick J.
• Hogan, Daniel.
• Humphreys, Francis.
• Keane, John J.
• Killilea, Mark.
• Lemass, Seán F.
• Little, Patrick J.
• Loughman, Francis.
• Lynch, James B.
• McCann, John.
• McEllistrim, Thomas.
• MacEntee, Seán.
• Maguire, Ben.
• Meaney, Cornelius.
• Moran, Michael.
• Morrissey, Michael.
• Moylan, Seán.
• O'Briain, Donnchadh.
• O'Grady, Seán.
• O'Loghlen, Peter J.
• O'Rourke, Daniel.
• O'Sullivan, Ted.
• Rice, Brigid M.
• Ryan, James.
• Ryan, Martin.
• Sheridan, Michael.
• Smith, Patrick.
• Traynor, Oscar.
• Walsh, Richard.
• Ward, Conn.

Níl

• Bennett, George C.
• Brennan, Michael.
• Byrne, Alfred.
• Byrne, Alfred (Junior).
• Cole, John J.
• Corish, Richard.
• Cosgrave, William T.
• Hannigan, Joseph.
• Hickey, James.
• Hughes, James.
• Keating, John.
• Lynch, Finian.
• McMenamin, Daniel.
• Costello, John A.
• Curran, Richard.
• Dockrell, Henry M.
• Doyle, Peadar S.
• Everett, James.
• Fagan, Charles.
• Giles, Patrick.
• Mongan, Joseph W.
• Mulcahy, Richard.
• Reynolds, Mary.
• Rogers, Patrick J.
• Ryan, Jeremiah.

Tellers:—Tá: Deputies Smith and S. Brady; Níl: Deputies Doyle and Bennett.

Amendment declared carried.

Section 29, as amended, agreed to.

Sections 30 to 34, inclusive, agreed to.

An Ceann Comhairle

Section 35 is not being moved as its deletion will be necessitated if amendment No. 27 is adopted.

Sections 36 and 37 agreed to.

SECTION 38.

Dr. Ward

I move amendment No. 25:—

In sub-sections (1), (2), (3), (6) and (7) to delete the word "closing" wherever it occurs and substitute the word "transfer" in each case.

This is a drafting amendment consequential on the proposal to close the hospital from time to time as the Minister after consultation with the board may determine. In the original draft, it was intended to close the existing hospitals after the new hospital was completed. On further consideration it seemed desirable, and indeed will be necessary, to continue the existing institutions until the acute bed shortage in Dublin has been satisfied. Consequently the closing date, which was the pivotal date in the original draft, must now be replaced by the transfer date. There is no other principle involved except to provide the necessary pivotal machinery in the absence of a closing date.

Amendment put and agreed to.

Dr. Ward

I move amendment No. 26:—

To delete sub-section (4), and substitute the following sub-section:

(4) On and after the transfer date the Minister shall hold so much of the lands vested in him by this section as has not been disposed of by him under this section in trust for the board.

This is a consequential amendment, a drafting amendment.

Amendment put and agreed to.

Section 38, as amended, agreed to.

Sections 39 to 41, inclusive, agreed to.

SECTION 42.

Dr. Ward

I move amendment No. 27:—

In sub-section (1), line 12, to delete all words after the word "date" to the end of the section and substitute the following:—

the Minister may, whenever and so often as he thinks fit, by order (in this section referred to as a closing order) direct that a particular part (defined in such manner and by reference to such things as the Minister thinks fit) of the existing hospitals shall be closed on a specified date.

(2) The Minister may, whenever and so often as he thinks fit, by order under this sub-section amend a closing order, including a closing order as amended by an order under this sub-section.

(3) The Minister shall before making an order under this section consult the board.

(4) Whenever a closing order is made the part of the existing hospitals to which such order relates shall be closed on the date specified in that behalf in such order.

This amendment proposes to substitute a new section for Section 42 to enable the Minister to close down the existing hospitals by stages after consultation with the board.

An Ceann Comhairle

Does Section 42 disappear?

Dr. Ward

The first six words "on and after the transfer date" are retained.

Amendment agreed to.

Section 42, as amended, agreed to.

SECTION 43.

Dr. Ward

I move amendment No. 28:—

In page 15, to delete all words from the words "closing date" in line 31 to the words "existing hospitals" in line 32 and substitute the following words "existing hospitals have been closed under the immediately preceding section, the board may, in relation to such parts of the existing hospitals as have not been so closed, manage them and may for this purpose".

This is a drafting amendment.

Amendment agreed to.

Dr. Ward

I move amendment No. 29:—

In page 15, in lines 37 and 38, to delete the words "in the existing hospitals" and substitute the word "therein".

This is also a drafting amendment.

Amendment agreed to.

Section 43, as amended, agreed to.

LONG TITLE.

An Ceann Comhairle

Amendment No. 30 may not be moved as it was decided on amendment No. 3.

Amendment not moved.

Dr. Ward

I move amendment No. 31:—

In page 3, lines 8 and 9, to delete the words "The Saint Laurence O'Toole" and substitute the words "Saint Laurence's".

This is consequential on the change of the name of the hospital from St. Laurence O'Toole to St. Laurence's.

Amendment put and agreed to.

Title, as amended, put and agreed to.

Bill reported with amendments.

Report Stage ordered for Thursday, 26th November.