Public Health Bill, 1945—Committee (Resumed).
Debate resumed on amendment No. 121.
I think the Dáil is presented with a rather serious problem when considering this amendment. There is a number of things that concern us. The first is, what is happening inside the Department of Local Government and Public Health that, through the Parliamentary Secretary here attempts to persuade the House that it is dealing efficiently and satisfactorily with new proposals to deal effectively with public health? We are considering in Committee a Bill that was presented to the House on 15th November, 1945, which was dealt with in Second Reading on 14th or 15th December. Now we are discussing an amendment which, if passed, will mean that a person who has vermin in his head or on his body will not be allowed, under penalty of prosecution and the imposition of a severe fine, to come out of his home into any street, shop, church or any other place. We are dealing with that proposal as an amendment to a measure that was introduced in November last with no proposal of that particular kind in it. When we discussed it in September there was no suggestion that powers of that particular kind were to be sought.
Furthermore, as I pointed out on Friday last, the last report of the Department of Local Government and Public Health, covering the year 1943-44, was presented to the Minister in December, 1945, perhaps after if not before the discussion on the Second Reading of this Bill, which was introduced in November last. That report was printed for circulation in this House in January, 1946. After that passage of time we read in that report that very satisfactory steps had been taken from 1923 in an efficient and satisfactory way to deal with the disease of typhus, and the small number of cases that occurred in the country and the small number of deaths are shown in the table which accompany the report as well as the slight increase during the last three or four years of the emergency period, an increase which, nevertheless, only brought the total in 1941 to 25 cases; in 1942, to 28 cases; in 1943, to 20 cases; and in 1944, to nine cases; the deaths in these periods being two, six, five, four and one, respectively. We are told that the reason the total was pushed up to these figures was that a couple of packs of itinerant tinkers of one kind or another went wandering through the country and the last comment in the section of the report on typhus fever says:—
"It is significant that in several instances in recent years the disease has been spread by itinerants and it may be necessary to obtain more power by legislation to ensure that the standard of cleanliness amongst that class will be improved."
With such a considered report of the Department, signed in December and published in January, here on a measure which has been before the House since November we get put before us on the Committee Stage in March a proposal, not that more power by legislation will be taken to ensure that the standard of cleanliness among itinerants will be improved, but that a person who knows he is verminous shall not expose himself in any street, public place, club, hotel or shop. That is introduced after the report says that for a number of years the disease of typhus has been, you might say, practically wiped out in this country. It is introduced at a time when, according to the Parliamentary Secretary, science has put preventatives and cleaners into the hands of the people by which they can keep themselves clean.
In the first place, I ask what has gone wrong and what is operating inside the Department of Local Government that we have had the introduction of this measure without any reference to this problem, and that we have had a report from the Local Government Department, through the Minister, published in the terms in which it has been published. In the second place, on its merits, I want to say that this is as insidious a piece of building up the State as over-lord over the very souls of the people as could be thought of. I do not know whether I misunderstood Deputy O'Sullivan on Friday last when he was pointing out, very properly, that if among any section of the people there was uncleanliness it was due to bad housing and poverty. I understood him to say that until such time as the lack of cleanliness of this kind could be remedied by the erection of houses and the eradication of poverty we should subscribe to any kind of plan to keep our people clean and comfortable. If that is his opinion, I would ask what have we come to in this country, where there is such a grabbing of power by the State to control every aspect of our economic and social life, if in respect of our personal cleanliness we pass a law, no matter how documented and no matter how persuasive any Minister or any Party behind the Minister may be, to hand over control over our own persons and the cleanliness of our own persons into the hands of the police and the new medical constabulary that is apparently to be established in this country, the recompense being that their income will be raised to the pre-war standard of real income. We have not heard a case for that from the Parliamentary Secretary. The case put by the Department in its records is there in detail, with dates given. We have not heard a word from the silent Party behind the Government as to why we should allow the police or the medical fraternity to wash our necks and to take the dirt off our shirts or out of our hair.
I absolutely and utterly resist the whole suggestion and the whole of the implications in this. If any Party or any Deputies are going to surrender on this question, then you can give up talking about asking the Government to take their hands out of your pockets or to take their hands off the control of industry or agriculture. It is bad enough to think of allowing them to put their hands into your pockets to get the price of the D.D.T. or the carbolic soap they are going to dish out to you to clean your shirt or your neck. The Ministry are taking power to do that, I wonder who in this House will stand behind this amendment that will give them this power over the people when their own records have shown that preventive measures were put on a basis which was scientific but simple and easy to operate and had practically wiped out typhus in this country. The Parliamentary Secretary says: "Typhus, typhus; deaths, deaths, deaths." If the Parliamentary Secretary is asking powers for this by an amendment in March, 1946, he ought to tell us what he was thinking about when talking on the measure in December, 1945, and what the Department were thinking about when they wrote the report which is now in their hands and which has been in their hands for a couple of months.
On a point of order, are we discussing Section 21?
Surely we are discussing both?
The acceptance of amendment No. 121 would wipe out Section 21 as it stands in the Bill.
Any amendments to amendment No. 121 may, if suitable, be submitted to the new section on Report. It has been agreed that the new section will then be discussed in Committee.
The main difference between the section and the proposed new section—amendment No. 121—is that the amendment extends the provisions of Section 21 so as to include all persons. Section 21, as originally introduced, was confined to persons under 16. The proposed new section extends the penalties to every person who may be described as verminous, irrespective of age or sex. I should like to know what has happened in the past three months to induce the Department to regard it as necessary to extend this section to all persons, irrespective of age. In addition, I should like to know how sub-section (1) of amendment No. 121 is to be made effective. Sub-section (1) says:—
"A person who knows he is verminous shall not expose himself in any street, public place, club, hotel or shop."
How is that to be enforced? There is no machinery in the proposed sub-section or in any part of the Bill, so far as I know, to make that sub-section effective. If it cannot be given effect, why put it in the Bill? Who is to stop a person who knows he is verminous from going into a street, a shop, hotel or any other place? Is that person to be stopped in the street by some medical officer or by an official of the Department and examined? If not, why put that provision in here?
Up to a point, this is so much window-dressing. In so far as it is not window-dressing, it is positively dangerous. Worse than that, it will not be effective because the Bill does not pretend to deal with the conditions out of which a verminous condition grows. There ought to be some regard for personal rights in this country. I should like to repeat what I said on Friday, that I do not believe for a moment that any normal person goes around in a verminous state merely for pleasure. There is no pleasure in doing that. I suppose there are in this country, as in every other country, certain persons who are so chronically lazy and dirty that, no matter what legislation was passed, and no matter what the conditions under which they lived, it would be hard to change them from an unclean into a clean state. These people are few and far between and they are not normal, using the word in its ordinary sense. I believe that our people are as clean as the people of any other country and that they have as great a desire for personal cleanliness as the people of any other country. In so far as we are dealing with normal, average, people, a verminous condition is due to the shocking conditions under which many of them have to live. I honestly believe that. Until such time as the social conditions under which those people live are changed, no amount of legislation and no amount of D.D.T. will provide a permanent solution of the problem. I should like the Parliamentary Secretary to deal with two points—(1) what has transpired in the past three months, or what fresh information has come to him, which induced him to extend this drastic section to adults and (2) how does he propose to make effective sub-section (1) of the proposed new section?
I had hoped that, as a result of the discussion we had on Friday, it would not be necessary again to deal in any detail with this problem. I made a very exhaustive submission to the House on Friday and even Deputy Morrissey expressed himself as fully satisfied.
Not fully satisfied —impressed.
If I impressed Deputy Morrissey, I must have fully satisfied everybody else, because it is not easy to impress the Deputy.
He welcomed the Parliamentary Secretary's exhaustive statement.
Change of front, if you like.
Deputy Morrissey has been anxiously searching for any new debating points which might emerge. When they do emerge, we had better deal with them. The Deputy wants to know why we have extended the disinfestation provisions of the Bill to adults. May I say that it never causes me any embarrassment to change my mind about anything. If I am satisfied that I can do things in a better way next week than I propose to do them this week, I have no hesitation at all in adopting the better way. Since this Bill first came before the House, I have had very close and intimate discussions with representatives of practically every shade of thought in relation to public health and social matters in this country. I had a particularly interesting interview, lasting some hours, with representatives of the Association of County Medical Officers of Health. Emerging from all these discussions and exchanges of views it appeared to me, as Deputy Cogan said on Friday last, that it was logical, if the louse was dangerous, and if it seemed to be necessary to get after him in the child, to get after him in the adult. I accepted the advice I got in this matter from people who are working in that field, who have an intimate knowledge of these matters and whose particular responsibility it is to protect the people against these outbreaks of infectious diseases and to control these diseases if an outbreak should occur.
Deputy Mulcahy made a few selections from a report, recently signed, and issuing from the Department of Local Government and Public Health. He seems to think that he has got some useful debating material there. I do not think it is of so much value to quote from that report references to simple and easy preventive measures for the control of typhus fever. Simple and easy preventive measures for the control of typhus fever do not necessarily refer to the measures for the prevention of lice infestation but the problems are closely related, as I stated on Friday last, so closely related that if we get rid of the louse we have an absolute assurance that we have got rid of typhus fever. Nevertheless the reference in that report is not to ridding our people entirely of infestation. The reference is to the measures for the control of typhus fever. Let me read a few passages from that report that Deputy Mulcahy did not read:—
"Under the new arrangements every medical officer was required, where there was any doubt as to the nature of the fever, to send blood samples for Widal and Weil-Felix tests. In addition a previous history of any cases of undefined illness in the family (especially among children) was to be noted as highly suspicious and adequate precautions were to be taken until the true nature of the outbreak was established. By means of this procedure early diagnosis was promptly secured in the vast majority of cases.
The prompt removal of the patient to a fever hospital, a rigorous quarantine and efficient cleansing of contacts and the disinfection of clothes and premises were the next steps in the preventive machinery for controlling the spread of the disease. The vital importance of tracing and dealing promptly with all possible contacts was stressed on every occasion because it was fully appreciated that the most thorough and complete investigations concerning contacts are essential to the successful control of any outbreak of typhus fever."
Now it is no harm to have that portion of the report on record side by side with the portion which Deputy Mulcahy quoted.
What point does the Parliamentary Secretary make out of the portion which he quoted? I made some points out of the portion which I quoted.
I was not aware that Deputy Mulcahy made some points. Certainly they did not get home. The Deputy presumably tried to make points that were outside the scope of the Bill.
Perhaps the Parliamentary Secretary would tell us the points he wants to make?
The Parliamentary Secretary will make his own case. He has already made a case that got the support of the House on last Friday. Whether anything has occurred since or not, remains to be seen. Deputies in the course of the discussion on Friday and to-day definitely suggested, and presumably are themselves under the impression, that infestation is peculiar to the poor. They are making a very big mistake. On every conceivable occasion the poor have to be dragged in—housing conditions, unemployment conditions, nutritional state and so on. If it is necessary and desirable to have a debate on housing conditions, nutritional states, or unemployment conditions there are ample opportunities but these factors are of no particular relevancy in relation to the matter we are discussing now—far from it. The occupant of the tenement in the poorest circumstances is often as clean in his person as the occupant of the mansion. The same applies to the occupant of the cabin. He is often as clean in his person and in his habits as the occupier of the castle.
Will Deputies accept the scientific fact—if they do not accept it from me will they go out and consult those medical men who adopt or accept their political views and they will be told the same basic scientific fact—that dirt as such is not the cause of infestation? Lice will not breed outside the human host. If lice are put in a corner of a room that is absolutely filthy with decaying vegetable matter, they will not live. Lice can only live on human blood and blue blood is just as acceptable to them and as palatable to them as any other kind of blood. It is time that was fully realised. In fact not many centuries ago the problem of infestation was more a problem of the wealthy and of the aristocracy than a problem of the very poor. The louse likes comfort. That is an accepted fact. The more miserable the conditions are in which the louse is asked to live, the more anxious is he to get out of them. The one thing he does not like is cold. We have heard the case made here about people who have not a stitch of clothing to put on. If they had not a stitch of clothing to put on there would be no lice on their bodies.
Would the Parliamentary Secretary say very shortly how they are caused at all?
Through breeding. The more layers of clothes an infested person has on him, the more comfortable and warm the female louse is, the more rapidly will she produce eggs and the eggs hatch out into more lice. The fact remains that if people stack the "duds" they have on them during the day on their beds at night—as Deputy Morrissey on Friday stated they did— if they are infested, the lice will reproduce. There is no doubt that if lice get a human host on which they can remain undisturbed for a period, for so long as they do remain undisturbed, they will certainly multiply, but it is as certain as it is that I am addressing the House to-day that poverty is not a factor in this matter. Deputies will tell me about congestion, overcrowding and so on. Commonsense will tell them that if people are herded together in close physical proximity and if there are infested people among them, the infestation will spread, but the herding in any tenement house in the City of Dublin or any cabin down the country does not approximate to the physical proximity we get when people go to the theatre, to the cinema, to a football match, to school and so on, so therefore I am afraid the case as to the influence which housing conditions have on infestation falls. It is disappointing to the Deputies opposite because it is difficult to make a case against this section and if the points brought forward fall to the ground, the confusion becomes worse confounded.
The liberty of the subject, human dignity and all the rest of it will, presumably, he paraded again. So far we have only hinted at it, but I think we are getting close to it. Is there anything wrong with asking people to rid themselves of lice if we present them with a certain remedy? On Friday last, when discussing this matter, I said that no child might be seven days from school, that no child might be one day from school, that nobody might be kept at home from Mass, that the condition could be got rid of in less than seven hours. I may have created a wrong impression. I may have created the impression that it takes seven hours' treatment. As a matter of actual fact, the application of the remedy will take about five minutes, and, in five minutes' time, the most highly infested person in the State can be rid of infestation. I think it is worth trying out. Even though, as Deputy Mulcahy says, we have not had any widespread outbreak of typhus fever, there are other diseases which I think we ought to try to eliminate which are very closely associated with this problem of infestation.
I am coming to them. Let me say, before I come to that point, that I do not accept the viewpoint that even nine cases of typhus fever are not a serious matter for us in this country. It may not be regarded as a serious matter for the people who are not affected, but it is a very serious matter for the families that are. It may not matter much that only one person died of typhus fever in 1944, but to me it matters a lot. The death of that one person meant a lot to the family to which that one person belonged, and I do not think we can boast of the merits of our efforts to guarantee our people against the particular danger of disaster that is ever present in this country so long as a big percentage of our people remain infested. I do not think there should be any difference of opinion on the question of taking a step which is a certain remedy, which is certain to prevent and completely to eliminate typhus fever, if we get the co-operation of political Parties and the general public. Let me say that outside this House—and I have discussed this problem with many people—I have not met a single individual, lay, clerical or medical, who did not say: "It would be a good day's work for the people of the country if you can effectively rid our people of the verminous states which exist rather too widely."
I mentioned here on Friday last—I thought it would not be necessary to mention it again—that there are certain facts and figures which I would prefer not to put on record. Deputies are satisfied as to the extent and magnitude of this problem, or they are not. If they want facts and figures, and if they insist upon them, they will have to get them, but there are certain facts and figures which have been made public, and consequently there is no embarrassment about referring to them. I am coming now to the question of infestation in its relation to impetigo particularly, and typhus to a lesser extent. Various county medical officer of health and the medical officer of health for the City of Dublin have recently referred to this matter and I propose to quote certain extracts from their reports of 1944. Dr. Russell, Medical Supertendent Officer of Health for Dublin, in his report for 1944 says:—
"The increased incidence of scabies and impetigo only too frequently associated with verminous condition of the scalp, especially in girls, is one of the most disturbing features of the past four years."
That is of some value or it is not. That is what Dr. Russell, Medical Superintendent Officer of Health, thinks of the position in Dublin. Dr. Fitzgerald, County Medical Officer of Health for Kerry, in his report for 1944 says:—
"It is well known that typhus fever is conveyed from person to person by lice".
Dr. McCarthy, County Medical Officer of Health for Mayo——
——in his report says:—
"The position with regard to louse infestation remains the same as last year".
He then proceeds to give certain figures which I do not propose to quote
Make sure they are accurate.
They are not accurate, nor are any figures regarding infestation from any county medical officer of health accurate, because of two factors. One factor is that it is more or less a spot check, occurring perhaps once in two or three years, and to that extent is not reliable, but the figures are vitiated to a greater extent by the other factor, that, on the day of the medical inspection, it does not always happen that the most highly infested children are present.
Dr. Maguire, County Medical Officer of Health for Roscommon, in his 1944 report says:—
"More vigorous methods, uniformly adopted everywhere, are certainly called for to prevent infestation."
And listen to this:—
"That these conditions arise from neglect, rather than from lack of amenities like piped water supply, is proved by the fact that the worst cases come from town cottages with all amenities while rural schools are often gratifyingly free."
The report of Dr. Bastible, County Medical Officer of Health for Donegal, says:—
"The presence of such a degree of louse infestation is disquieting in view of the ever-present possibility of another outbreak of typhus fever, which in its epidemic form is spread by lice—both varieties, the head and the body louse, being capable of transmitting the infection."
If we can completely disregard the advice we get from our county and city medical officers of health in this matter, there would not appear to be very much point in building up the public health machine we have been boasting about so much.
As regards the actual figures for impetigo, which we discussed at some length on Friday last, I would inform the House—and particularly Deputy Mulcahy, who has been examining this matter pretty closely—that the number of cases reported by county medical officers of health in 1944 was 1,004. I have here the numbers for the various counties, which show that, generally speaking, it is distributed pretty evenly all over the State.
I do not know what I can do to convince Deputies that this is a matter on which we should have agreement, that it is a matter on which we can hope to achieve success. I cannot do anything more than I have done. I have been accused earlier in the debate of not contributing enough to the debate. More recently, the inclination has been to put the shoe on the other foot: some Deputies would appear to be better satisfied if I said less. I suppose it is the old story, that no matter what I do I will be wrong. I am trying to place all the information at the disposal of the House that can reasonably be supplied. It is discouraging, inasmuch as the more informative I have been in the course of these discussions the less co-operation I appear to get. It is going to be a very tedious business, if we have to continue in that atmosphere and with that type of debate until we wade our way through all these amendments—but if it has to be that way I suppose we will have to put up with it.
After the speech to which we have just listened, I think the Parliamentary Secretary might spare us, for the remainder of this Bill, the little taunts about debating points. His speech was an amazing one. He has told us in plain, blunt language that we are verminous and infested with vermin in this country, not because of our conditions but because of our nature.
I do not recollect having said that.
The Parliamentary Secretary said that the conditions under which people had to live had nothing whatever to do with their being in a verminous condition, that you were as likely to find people living in a mansion as verminous as people living in a slum. If that is not saying we are verminous, that we are dirty by nature and not because of any need, I do not know what the statement meant at all. The Parliamentary Secretary becomes downright dishonest in the debate. He talked about the poor being dragged in, the suggestion being made that only the poor are infested. Neither as a Parliamentary Secretary nor speaking out of the scientific knowledge placed at his disposal, is he convincing when he takes that line. He suggested that a person who can afford a change of clothing once a day, once a week or three times a week is as likely to become infested with lice and remain so as a person who has no change at all. The Parliamentary Secretary's solution for that is quite a simple one —all that those who have no change of clothes have to do is to go naked, and if they go naked the lice will neither live nor breed on them. Is that not putting in straight language what he has just tried to convey? He spoke here last week about not giving a handle to people outside, who were fond of talking about the "dirty Irish", to give us more headlines. What is his statement just made but something which can be made use of by people who want to make use of it outside?
If a family living in a mansion, having at their disposal all the amenities that go with that mansion, are infested with lice and remain so, can we say it was otherwise than because they are unclean and have no desire to be clean in their person or in their homes? I am not dragging in the poor in the sense that the Parliamentary Secretary suggested. I am saying that the poor are infested to a greater extent than any other section of the community, not because of their personal habits but because of the conditions under which they are forced to live; and I defy him or any of his medical advisers to deny the truth or accuracy of that. I have here a letter I received this morning from a person living in County Dublin. Of course, I am sure the condition of affairs described in it would not be more conducive to the breeding of lice than if those people were living in a mansion. The writer says:—
"In view of all the talk on public health and the spread of tuberculosis and infectious diseases, it is annoying that the Public Health Department should allow such conditions as exist in Back Lane, High Street, Dublin. The four walls of my room are wringing wet, but the sanitary authority says they will dry out in the summer. The House is walking with rats. There is only one lavatory for the whole house. The ashbin is in the hall with all kinds of filth in it and next door to me there is a rabbit factory."
There are no lice in the ashbin, you may tell him.
Wait until I finish the letter, and I hope the Parliamentary Secretary will be able to tell me there is not any more likelihood of there being lice or infestation there than if those people were living in the Viceregal Lodge. He continues:—
"We might as well have a slaughterhouse, for the smell that comes up. You would not get worse in the lion house in the Zoo. A friend of mine, on a visit from Australia, asked me if this was the condition under which Irish people had to live. I told him it was not, that if we did not like to live in that way we could go to London, Birmingham or Manchester."
People who know Dublin far better than I know it are aware that that is not a grotesque picture of the conditions under which some people have to live in Dublin. I do not want to labour that point much further.
I asked the Parliamentary Secretary to answer two points in particular. First of all, I asked him a specific question about sub-section (1) of this proposed new section that he did not answer, or even attempt to answer. He may have forgotten. Secondly, I asked him what had happened in the last three months which caused him to make this radical change in the section. What does he tell us? He makes the astounding admission—I repeat the word astounding—whether he was conscious of the full implication of what he was saying or not I do not know, that he made this change because, since the Second Reading of the Bill, he had consulted people who had close touch with public health business and he had a consultation with the county medical officers of health lasting over a number of hours.
I am entitled to ask why these contacts and these discussions with the county medical officers of health and others did not take place before the Bill was introduced. The extraordinary thing about this is that the Parliamentary Secretary is astounded, or pretends to be astounded, that any question should be raised on this side of the House. He was astonished that anybody should dare oppose the Second Reading and he now admits that it was only after the Bill was introduced and had passed the Second Reading that he had those full conferences and consultations with the people in this country best fitted to advise him on the matter. We are told now that there is a big percentage of our people infested.
We are not as bad as we used to be, all the same.
Not as bad as we used to be?
But that is away back a long time.
What does the Parliamentary Secretary mean by a long time—does he mean the time of the Famine?
Away back in the Middle Ages.
Some funny things occurred in the Middle Ages.
That is a rather poor attempt on the Parliamentary Secretary's part to cover up.
I read that George Washington was taught not to kill fleas, lice and ticks in the sight of others.
I have just been reading that one of the laws abolished in 1878 was a law abolishing the words "Crom Abú" and "Butler Abú" and the necessity for having bows and arrows. And that is the year the Parliamentary Secretary relies on.
The Parliamentary Secretary asks is it unreasonable that we should ask people to disinfest themselves. Is that all the Parliamentary Secretary wants in this proposed new section—authority to ask the people to disinfest themselves? If it is, then we can pass on; that is granted freely. But the Parliamentary Secretary knows quite well that he will not be content merely with asking the people to do it. He will not be content merely with a propaganda campaign. He is suggesting to us that the problem is a much more difficult one than any of us supposed. We thought that if not altogether, certainly to a large extent, this sort of infestation was due, not to the people themselves, but to the conditions under which they had to live. Now we are told their living conditions, their incomes, their training and their amenities have nothing to do with it.
The Parliamentary Secretary said the social conditions have nothing whatever to do with it. You are as likely to find people infested in Merrion Square as you are in whatever is supposed to be the worst slum district in Dublin, the most overcrowded district in Dublin. That is the statement of the Parliamentary Secretary. I do not want to emphasise that any further. I described it as, in my opinion, the most amazing and astounding statement that could come from the responsible head of the Public Health Department. If that is the position, then it is a very serious position and the proposed new section will make no impression on it and cannot make any impression on it. As to the position being widespread, and embraces all sections of the community, I doubt it very much.
I must say the Parliamentary Secretary gets more and more difficult to understand. In his last statement everything was put aside and we began a regular hunt with the louse, simply on its own merits. But, nevertheless, the Parliamentary Secretary, in his discourse, had to fall back on deaths from typhus and impetigo, diseases arising out of the existence of vermin. He implied there was something in what he read in pages 41 and 42 of the report to which I have been referring, but he did not indicate what point he wanted to make from the reference. I say that report shows that, under the powers the Minister already had, as far as typhus was concerned, it was brought absolutely under control and that the Department considered that it would have been practically nonexistent but for the itinerant groups who had to be dealt with. All the report suggested was that more power would be got for dealing with itinerant groups of that particular kind.
On the question of impetigo, there is the rather remarkable thing that if impetigo is causing the serious concern that the Parliamentary Secretary suggests to any medical authority, we did not hear anything about it until this amendment was put forward. The Registrar-General publishes a report annually in which he gives, for every county borough, urban district and rural district in the country, particulars of the notifiable infectious diseases. It is remarkable that in spite of the fact that that report accounts for 25 notifiable infectious diseases, there is no reference to impetigo among them. Is it not an astounding thing that impetigo should come out of the clear blue sky now in order to help to persuade us to give the Department authority to take us individually and keep us clean?
I will suggest, as Deputy Morrissey has suggested, that it is a remarkable revelation that after the Bill was brought into the House and discussed here, the Parliamentary Secretary deigns to meet the county medical officers of health and discuss this problem with them.
The Parliamentary Secretary was charged before with this, that he had spurned discussion with the organised medical authorities in the country before he introduced this measure. I do not think he denied that. At any rate, he could not have denied that some of the most important medical organisations in the country were not consulted, and we are now given the information, by implication, that the county medical officers of health, as such, were not consulted either. As the Parliamentary Secretary himself has indicated, the more he says the less confidence we have in what he is doing. The more we find out as regards the way in which he arrived at the point of putting this amendment before us, the better we can understand how this Bill came to be put together. The more we see the kind of anatomy which the Parliamentary Secretary has used for building up his case, the less confidence we have in him, and the more we are opposed to this amendment.
The Committee divided: Tá, 43; Níl, 12.
- Bartley, Gerald.
- Beegan, Patrick.
- Boland, Gerald.
- Bourke, Dan.
- Brady, Brian.
- Brady, Seán.
- Breathnach, Cormac.
- Brennan, Thomas.
- Briscoe, Robert.
- Burke, Patrick (County Dublin).
- Carter, Thomas.
- Childers, Erskine H.
- Colbert, Michael.
- Colley, Harry.
- Commons, Bernard.
- Corish, Brendan.
- Crowley, Honor Mary.
- Derrig, Thomas.
- O'Rourke, Daniel.
- O'Sullivan, Martin.
- Rice, Bridget M.
- Ryan, Robert.
- De Valera, Eamon.
- Donnellan, Michael.
- Furlong, Walter.
- Gorry, Patrick J.
- Harris, Thomas.
- Hilliard, Michael.
- Kennedy, Michael J.
- Kilroy, James.
- Kissane, Eamon.
- Larkin, James (Junior).
- Lemass, Seán F.
- Little, Patrick J.
- Loughman, Frank.
- McCann, John.
- MacEntee, Seán.
- O Briain, Donnchadh.
- O'Grady, Seán.
- O'Reilly, Matthew.
- Sheridan, Michael.
- Traynor, Oscar.
- Ward, Conn.
- Bennett, George C.
- Byrne, Alfred.
- Coogan, Eamonn.
- Cosgrave, Liam.
- Costello John A.
- Dockrell, Henry M.
- Giles, Patrick.
- Hughes, James.
- Keating, John.
- McMenamin, Daniel.
- Morrissey, Daniel.
- Mulcahy, Richard.
Tellers:—Tá: Deputies Kissane and Kennedy; Níl: Deputies Bennett and McMenamin.
Question declared carried.
Question—"That Section 21 be deleted"—put and agreed to.
Amendments Nos. 122 to 163 not moved.
I move amendment No. 164:—
To delete sub-section (2).
The purpose here really is to find out what is the object of the notice required by the sub-section. It would appear that if there is a single case of whooping cough in a school or college —say in Maynooth College—the principal of the college has there and then to compile a list of all the students or pupils, and serve it upon the medical officer, who either puts it in a basket or in the fire. There is nothing in the sub-section to show for what object the information is required, or what is done with the information if and when it is procured.
The purpose of the sub-section, that the amendment proposes to delete, is to enable the district medical officer of health to acquaint himself at the earliest possible moment with the existence of infectious disease in a school or college in his area. There are two reasons for that. The first and obvious reason is to ensure that he, on whom statutory responsibility rests for the control of infectious disease, will be aware of certain potential dangers in his area. On the other hand, a dangerous position might present itself if an infectious disease broke out in a college coming up to holiday time, and if children drawn from a wide geographical area were distributed all over the country without any control. If the disease was confined to the college in the first instance it might, in fact, be transmitted in that way to various other parts of the State. It is true that detailed statutory provisions are not set out here, as to what the medical officer of health will do when he becomes aware, on being supplied with this list, of an outbreak of infectious disease. In fact, the control of infectious disease, and the protection of the health of his little community is part of his statutory obligation. In the course of our consolidating efforts in this Bill we are repealing the existing law in this regard. Sub-section (1) of Section 58 of the Public Health Acts Amendment Act, 1907, dealing with this matter reads:—
"The principal of a school in which any scholar is suffering from an infectious disease shall, if required by the local authority, furnish to them within a reasonable time fixed by them a complete list of the names and addresses of the scholars in or attending at the school or any specified department thereof other than boarders."
I need not put on the records of the House the other detailed provisions of Section 58. This is the operative one with which we are concerned. It is proposed to repeal that sub-section and to replace it by Section 22.
Why bring into the scope of this section what was omitted in the 1907 Act, that is to say, a boarding school?
The particular reason is the danger of dispersion at holiday time.
Has that danger emerged only since 1907?
It has emerged as a real danger many times in recent years.
Amendment, by leave, withdrawn.
Amendment No. 165 not moved.
I move amendment No. 166:—
To delete sub-section (3) and substitute the following sub-section:—
(3) A notice under sub-section (2) of this section to the principal of a school or college may be addressed to "the manager" or "the principal" (as may be appropriate) of the school or college and may be given by delivering it to such principal, by sending it by post to the school or college or by leaving it at the school or college with an adult person who undertakes to deliver it to such principal.
The effect of this amendment is to amend the procedure governing the delivery of notice set out in the preceding sub-section requiring the principal of a school or college in which there has been an outbreak of infectious disease to furnish a list of the names and addresses of the pupils or students attending the school or college, or any specified department thereof.
If a principal of a school is liable to a penalty of £10 for failure to carry out the direction, it is scarcely sufficient that the notice should be served by leaving it at the school or college "with an adult person who undertakes to deliver it to such principal".
Such adult person may or may not be attached to the college.
He undertakes to deliver it.
He may put it in his pocket and forget about it.
If he does, I take it a court would take that into consideration.
I would suggest that the last line might be altered. I do not think it is fair to suggest that it is sufficient merely to leave the notice with an adult person. Multitudes of adult persons may be around schools and colleges. Some of them may be intelligent and competent and may realise what they undertake to do. Others may not be. Anyone who has experience of the ordinary legal notice of summons being served is aware that it is not correct that the court always takes into consideration that the notice has not been properly served, because there is often conflict of evidence as to whether the notice has been properly served or not. This may be only a machinery matter, but I think the amendment should be amended to provide that the notice will be served by post or delivered to the principal or some other authoritative person in the school or college. There may be more than one member of the staff. The sub-section is very wide, merely saying that it should be left with an adult person.
I should like to direct attention to amendments Nos. 168 and 169 to the original sub-section. If the principle of these amendments were adopted, then the Parliamentary Secretary's amendment would read, in the last three or four lines: "May be given by delivering it to such principal or by sending it by registered post to the school or college"—and you could stop there. If a communication is sent by registered post to the principal of the school or college—that is a system that has been adopted before in circumstances like this—it can be proved to have been delivered, because the machinery of the post office is such that a registered letter can be proved to have been delivered.
I do not want to argue against the principle of any of the amendments because in fact there is no great principle involved. It is purely a matter of machinery. Generally speaking, these things work out all right in practice. The medical officer is in close touch with the manager or with the school teacher. I admit right away that that does not always obtain but, generally speaking, he drops in and says: "I will be around on such a day". The registered post method is fool-proof. It is just a little bit cumbersome. I have no rooted objection, if the House thinks it is the best way of doing it.
I have put down amendment No. 171. If the medical officer called, as the Parliamentary Secretary suggests, when the principal is absent, then he would serve the notice on some person holding a position of authority.
The idea is all right but, outside the teacher, who will be in authority about a school—in a primary school at any rate?
In his absence, someone will be in authority.
It should have more limited application than the last two lines in the amendment would carry out.
There is something to be said for the point raised by Deputy Hughes. In a very urgent matter such as we might be dealing with under this section, post, registered or otherwise, might cause delay that should be avoided. I would favour the inclusion of the word, "registered", plus something along the lines Deputy Hughes has in mind enabling a person holding a position of authority to take delivery. I think you could tighten it up in that way by including these two suggestions.
I will look into that. "Person in authority", I think, would be acceptable. We will provide two or three alternatives—registered post, direct personal delivery or delivery to a person in authority. I can take this amendment, subject to further amendment on Report.
Would it not be better to withdraw these amendments and have them reintroduced in new form?
In so far as the amendments to sub-section (3) are concerned, yes.
I am referring to the amendments to sub-section (3).
May I suggest that we agree to amendment No. 166 with a view to further amendment, because it gets us some distance—leaving it at the school or college, delivering it to such principal, sending it by post to the school or college, and now we have to qualify tke type of adult person or substitute for that "a person in authority"? I think we might accept that so far as it goes and further amend it on Report.
Very good. Slow progress.
It brings us some distance on the road.
Amendment No. 166 agreed to.
Amendments Nos. 167 to 171, inclusive, not moved.
On behalf of Deputy McGilligan, I should like to move amendment No. 172 for the purpose of finding out why it is necessary to put down a fine of £10:—
To delete sub-section (4).
I have not the penalty section before me of the existing Acts. I think it was only £5. £10 is not a very big fine. It is a maximum—"not exceeding £10". If the justice is satisfied that the offence is merely technical, he can keep well under the £10.
In practice it will be 5/-.
Amendment, by leave, withdrawn.
On behalf of Deputy McGilligan, I move amendment No. 173:—
In sub-section (4), line 26, to delete the word "summary".
We had a decision on the "summary" question before.
The question in Deputy McGilligan's mind was the question of the Constitutional propriety of a provision of this kind. The Parliamentary Secretary was to look into it on a previous amendment. Perhaps the same situation might arise on this.
I looked over the Official Report of the debate on this principle the first time that we met it in the amendments, and Deputy Costello's exposition of the purpose of the amendment did not make the position completely clear to me. He mentioned a Constitutional point but he did not tell me what the Constitutional point was.
Perhaps Deputy Costello would now tell me what is the Constitutional point that this section might conflict with.
I thought the Parliamentary Secretary was to ask his omniscient draftsman about it.
If the Deputy is satisfied.
On the last debate we had on this measure the Parliamentary draftsman knew everything and I suggested he might know this too and that is why I did not state the Constitutional point. Apparently, the Parliamentary Secretary did not ask him yet.
I suppose we may leave it until Report Stage and, in the meantime, I will draw the Parliamentary draftsman's attention to the matter.
The question really is whether or not there is any Constitutional power to give jurisdiction to a District Court for an offence of this character or whether it should be by the more cumbersome method of indictment, having regard to the provisions of the present Constitution.
I can only say in reply to that that the courts of summary jurisdiction deal with offences carrying corresponding penalties in many cases.
They did, but at a time when the present provisions of the Constitution were not in force.
At the present time they are dealing with them.
The question is, are they in conflict with the Constitution?
If that is to be decided, I presume it can be decided under the Electoral Abuses Act, the Milk and Dairies Act, the Sale of Food and Drugs Act, or under the various Acts where the penalty clauses correspond to the penalty clause here.
Amendment, by leave, withdrawn.
Amendment No. 174 not moved.
Question proposed: "That Section 22, as amended, stand part of the Bill."
Would the Parliamentary Secretary give me some information on one point which I am not quite clear about? This section deals with the notification of an outbreak of infectious disease by the school authority. What is the position in regard to an outbreak in other places where there is a collection of people, either permanently or from day to day, such as a hotel, lodging house, restaurant or cinema, or any other place where there may be a coming together of people? I looked through the section and it does not seem to cover the point. It may be that it is covered by some of the existing regulations, or probably it is intended to be covered by the regulations which the Minister is to be empowered to make.
I do not think it is specifically covered in any section; but the medical practitioner who attends any case of notifiable infectious disease within the district, regardless of whether it is a private patient or a dispensary patient or what category of patient it may be, is required by the existing regulations to notify the medical officer of health of the district. At any rate that provision ensures that, if there is a doctor called in, the case must be brought under the notice of the district medical officer of health.
We are making fairly wide provisions with regard to public conveyances, schools, lodging houses, etc., after the event has taken place. We have got a list of diseases which are supposed to be infectious. In regard to quite a number of them, no medical practitioner may be called in. There is the one referred to by Deputy Mulcahy a while ago. It is quite possible that there might be a person suffering from that disease who might not seek medical attention. Take the case of that person being employed in a cafe, restaurant or cinema. We are being meticulous with regard to what may happen in a house and we are protecting the incoming tenant. Yet we are making it possible to have a number of these diseases, which many people regard as not being very serious, but which are serious from an infectious point of view——
I am sure the Deputy appreciates that we have already covered the position of a person suffering from an infectious disease appearing in a street or public place. Any person suffering from an infectious condition who exposes himself in any street or public place is liable to incur a penalty. I think it would be a rather difficult matter to put the responsibility on somebody in charge of every group of persons, whether two or three or more persons, who are congregated together at work to notify the medical officer of health that a certain person engaged in that employment was suffering from an infectious condition. I am afraid it would be difficult to administer. If we could envisage very large groups of people working together and we could name some person who could be made responsible, that might be worth considering. But I am afraid we would encounter difficulties in the administration. We have specific powers so far as the handling of food or engaging in the production or distribution of food is concerned. However, I will look into the matter between this and the Report Stage and, in the meantime, if the Deputy gets any further inspiration about it, perhaps he will put down an amendment which we can discuss on the Report Stage.
Could the Parliamentary Secretary say in regard to a primary or secondary day school, if any of the children stay at home from school with the explanation given that they are suffering from whooping cough, measles, diphtheria, scarlet fever, tuberculosis, scabies, or impetigo, whether the teacher would be bound to report that fact to the medical officer?
On a strict reading, I think he would be, because the section says:—
"Where a case of an infectious disease occurs among the pupils or students attending or the other persons frequenting a school or college ..."
I think there would be an obligation on the teacher even of a day school, if it came to his notice that in fact a child attending that school was suffering from an infectious disease, to report the matter to the district medical officer.
Question put and agreed to.
I move amendment No. 175:—
In sub-section (1), page 12, line 30, to insert before the word "while" the words "at any time during the preceding three months".
Deputy Mulcahy and Deputy Costello have amendments down corresponding to this amendment, in principle anyhow.
Amendment put and agreed to.
Amendments Nos. 176 and 177 not moved.
I move amendment No. 178 in the name of Deputy Coogan:—
In sub-section (1), paragraph (a), lines 30-31, to delete the words "a probable source of infection with" and substitute therefore the words "suffering from."
There would be a certain amount of difficulty in establishing or knowing whether a person who has been in a house has infectious disease, but I think it would be much more difficult to know whether he was a probable source of infection with an infectious disease. I think there is something in the amendment.
There is a difficulty in knowing, but, if he did not know, he would not incur any penalty.
The section says: "while a probable source of infection with an infectious disease." Can you possibly envisage a person with an infectious disease who would not be a probable source of infection? I am trying to get behind Deputy Coogan's mind. He wants to delete these words: "a probable source of infection with" as superfluous. I am trying to see how the position could arise that an individual suffering from an infectious disease would not be a probable source of infection.
A person might be a contact and be a probable source of infection while not yet suffering from the disease himself. A person might be a carrier and a probable—almost a certain—source of infection and yet not be technically describable as suffering from that particular infection.
Amendment, by leave, withdrawn.
Amendment No. 179 not moved.
I move amendment No. 180 on behalf of Deputy McGilligan:—
In sub-section (1) (a), line 31, after the word "disease" to insert the words "and such first mentioned person has been advised or notified by a registered medical practitioner that such second mentioned person was such a source of infection as to constitute the dwelling at the time of the proposed sale or letting a danger to the health of any person who may occupy such dwelling on such sale or letting."
I think that this amendment involves something which was not fully discussed on other sections when dealing with the words "probable source of infection". The provision deals with a person occupying a dwellinghouse who was suffering from such a disease as to constitute that dwellinghouse a danger to the health of anybody coming in to occupy it. The mere fact that a person who was a probable source of infection resided in the house three months before might not, of itself, render the occupation of that house dangerous to anybody coming into it. I think that that was what Deputy McGilligan had in mind in putting down the amendment.
I do not think there is anything new in the amendment.
Amendment, by leave, withdrawn.
Amendments Nos. 181 to 187 not moved.
I move amendment No. 188:—
To delete sub-section (2).
The provision, as it stands, would appear to impose on the owner of a dwellinghouse far too onerous a burden. Under the first sub-section of the section, he is required to set out a variety of matters and give the information there specified. It would be extraordinarily difficult for the owner of a house to give with precision the information he is required to give in this section under pain of prosecution. He has to set out not merely the situation of the dwellinghouse but the date of the commencement and termination of the period, or each of the periods, during which such person resided in the dwellinghouse while a probable source of infection. Even a medical practitioner of considerable experience might not be able to give the information which this unfortunate house-owner who desires to sell or let his house is required to give. The owner might not be able to state when the person occupying the premises became a probable source of infection and when he ceased to be a probable source of infection. That is far too onerous a duty to impose upon him. Again, the owner of a dwellinghouse who desires to sell or let it has to state in his notice how the person who was a probable source of infection was, in fact, a probable source of infection. I doubt that many medical practitioners would be able to state that in individual cases. I do not know why such particularity should be required in the notice. The owner of such a dwellinghouse would have to call in not only a lawyer but a medical assessor to help him to fill in the form.
The section does, undoubtedly, place considerable responsibility on a person who desires to sell or let a dwellinghouse in which, to his knowledge, a person has resided while a probable source of infection with infectious disease. Again, it is the old story. If he does not know that a person who was a probable source of infection with an infectious disease resided there, he does not incur any liability. That may not be brought out sufficiently clearly. We discussed the word "knows" on other sections. Evidently, Deputy Costello thinks that this is much more indefinite. I shall have the matter looked into and see if the provision requires amendment in that regard. If he does not know the date of the commencement or termination of infection, he ought not to incur any statutory obligation. If he does know, I do not think that any person will quarrel with the terms of the section. As to (d)—how such a person was a probable source of infection——
The Parliamentary Secretary could hardly answer that himself.
I have told my advisers that. I have no hesitation in agreeing that (d) cannot serve any useful purpose.
My amendment has served some useful purpose. The Parliamentary Secretary appreciates some of the motives behind the amendment. It is not a question of knowledge only but, as the Parliamentary Secretary has stated that he will have the matter looked into, I ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Amendment No. 189 deals with much the same point.
Does not sub-section (2) stand as a result of its not being deleted? That would dispose of any further amendment to sub-section (2).
There was no decision on that. If there was a decision and the House divided, these amendments could not be moved.
Amendments Nos. 189, 190 and 191 not moved.
I move amendment No. 192:—
In sub-section (2), page 12, line 49, to insert before the word "during" the words "in the relevant three months".
This is consequential on the principle we adopted earlier to-day—a three months' period instead of an unlimited period.
Amendment agreed to.
Amendments Nos. 193 and 194 not moved.
If the Parliamentary Secretary would accept amendment No. 195, I think he would make some progress.
I have agreed to the principle.
Amendment No. 195 not moved.
Section 23, as amended, ordered to stand part of the Bill.
I move amendment No. 196:—
In sub-section (1), page 13, line 2, to insert before the word "while" the words "at any time during the preceding three months".
This is the old principle of providing for a limited period of three months. There was no limit to the period in the section.
Amendment agreed to.
Amendments Nos. 197 to 204, inclusive, not moved.
Amendment No. 205 gives a period of seven days' grace. There is no period of grace allowed for at all in the section.
I shall look into the question of the period. I think some period should be specified.
Amendments Nos. 205 and 206 not moved.
The principle of amendment No. 207 is the same as that previously debated.
I shall have the rest of it examined to see if any further amendment is necessary.
Amendments Nos. 207 to 211, inclusive, not moved.
I move amendment No. 212:—
In sub-section (2), page 13, line 36, to insert before the word "during" the words "in the relevant three months".
This is the same principle.
Amendment agreed to.
Amendments Nos. 213 and 214 not moved.
Section 24, as amended, agreed to.
AMENDMENTS TO SECTIONS 25 TO 60.
I move amendment No. 1:—
In paragraph (a) (i), line 42, to delete the words "is concerned in".
I do not know how many different types of persons could be concerned in the selling or letting of a house. There would be, I suppose, the solicitor or agent.
The auctioneer or the agent would be the main person other than the owner or the occupier. The acceptance of the amendment would allow persons acting for the owner to make misleading answers with impunity to questions as to whether there had been infectious diseases in the premises during the preceding three months. I do not think it unreasonable to include this provision in the code.
How many different classes of persons can be brought under this description?
I could not give a reliable list of the persons who might be brought under it. It would turn on the legal interpretation of the phrase. Deputy Costello could be of more assistance to the House, to the Deputy and to me as to the legal interpretation of "is concerned in". My conception of it is that it would refer to the agent or auctioneer or to any solicitor carrying through a sale or letting. I cannot conjure up any other types of people who would be concerned in a sale or letting.
Suppose I was looking for a house and was shown through the house but did not go on with the purchase. If I were brought in and questioned as to the information I got, would I be regarded as "a person concerned"?
Possibly, but if you did not knowingly make a false statement you would be all right.
So that anybody who goes asking about a house that is to be sold or that is for letting, can be questioned afterwards by an authorised person as to what he knew about the house or as to what he had heard from an agent?
I do not think that would be the meaning of the section.
The section shows terribly loose drafting at the moment not only with regard to paragraph (a) but also with regard to paragraph (b). Under paragraph (b), any person apparently can question you about the house. A person can stop you in the street and try to get information regarding the house you propose to let or sell.
Or into which you were seen looking.
I am getting at the other point. There are two distinct points in (a) and (b).
Deputy Morrissey has raised a very important question. I suggest that it should be "any person interested in the selling or letting" of the house or "any person concerned in the selling or letting" as used in paragraph (a).
Does the Deputy suggest "any person interested in" or "any person concerned with"?
Yes. He should have some interest in asking the question in order to impose the duty on the other person to give him a correct answer.
There is a point in that. Subject to that all-powerful gentleman we have already referred to, I see no objection to it.
Amendment, by leave, withdrawn.
I move amendment No. 2:—
To delete paragraph (a) (ii).
This paragraph means that a person who occupied a house and left it can be questioned by anybody as to whether any person who was a probable source of disease had been in the house, and without some explanation by the Parliamentary Secretary, it seems an extraordinary proposal.
Again it does not specify for how long he may have left it. There may have been three or five different tenants in the meantime.
Is the Deputy's objection to "questioned by another person"— the unlimited scope of the persons who could be included?
I could understand his being approached by the district medical officer or by the owner, the person from whom he rented the house, and asked whether there had been any infectious disease in the house.
What about the prospective purchaser or tenant?
I could understand his being approached by the intending purchaser or tenant.
These are the classes about which I would be particularly concerned—the intending tenant or purchaser. Deputy Costello's suggestion regarding the corresponding point on the earlier amendment as to "interested in" might meet it.
There ought to be a limit of time and some kind of interest.
The three months' limit, of course, operates there, but I will look into it.
Would it help very much to say "any person who is interested in"? A person might say he was interested in it while not having any interest.
The interest has to be definite.
He must have an interest corresponding to the duty imposed on the other person.
No reference to the three months' limit has been introduced.
"Questioned by another interested person as to whether at any time during the preceding three months a person has resided in the dwelling..."
Suppose he had ceased to occupy the dwellinghouse six months before? The three months' provision requires to be applied in some way to paragraph (a) (2) specifically.
Amendment, by leave; withdrawn.
Amendment No. 3 not moved.
I move amendment No. 4:—
To delete paragraph (c) and substitute therefor a new paragraph:—
(c) he makes to the question an answer which is to his knowledge false or misleading in any material particular.
I do not see much difference between Deputy McGilligan's proposed sub-section and sub-section (c) of the section. The sub-section says: "knowingly makes a false or misleading answer to the question"; and the amendment says: "makes to the question an answer which is to his knowledge false or misleading in any material particular". It seems to be a matter of a difference of opinion as to legal interpretation.
The point is that he might give an answer which might be inaccurate on some point that did not matter, and, notwithstanding that the point whereon the inaccuracy occurred was not important, an offence would have been committed. The object of the amendment is to make it clear that the inaccuracy or incorrect answer must not merely be knowingly made but must be in a matter of importance.
I see no objection to it. Clearly, we should not be concerned about small matters not material to the issue.
Amendment agreed to.
Amendment 5 not moved.
Section 25, as amended, agreed to.
I move amendment No. 6:—
In sub-section (1) (b), line 6, to insert before the word "by" the words "at any time during the preceding three months."
This is the same principle as that which we have discussed.
Amendment agreed to.
Amendments Nos. 7 to 17, inclusive, not moved.
I move amendment No. 18:—
In sub-section (2), line 27, to insert before the word "during" the words "in the relevant three months."
This is consequential on previous amendments.
Amendment agreed to.
Amendment No. 19 not moved.
I move amendment No. 20:—
In sub-section (2), to delete paragraph (d).
The Parliamentary Secretary has accepted this amendment.
Amendment agreed to.
Section 26, as amended, agreed to.
I move amendment No. 21:—
To delete sub-sections (1) and (2) and to delete in lines 40 and 49, page 14, the words "to which this section applies".
This amendment is consequential on the amendment providing for the insertion of a new section before Section 19, empowering the Minister by Order to declare that an infectious disease is an infectious disease for the purposes of Section 27 and certain other sections.
Amendment agreed to.
Amendments Nos. 22 to 27, inclusive, not moved.
I move amendment No. 28:—
In sub-section (3) to delete paragraph (a).
Supposing a man is suffering from tuberculosis and has to attend a clinic, is the Parliamentary Secretary proposing to prevent him from using a public conveyance if he has to go a considerable distance and cannot afford to hire a hackney car to take him there? How does he propose to get the patient to the clinic?
Perhaps the Deputy has not had an opportunity of referring to the list of diseases which it is proposed to include within the terms of Section 27. It does not include tuberculosis. In answer to a question by Deputy Mulcahy, I gave him a tentative list and it did not include tuberculosis under the terms in this particular section.
Supposing a person living down the country has reason to believe he is suffering from an infectious disease and desires to consult some specialist in that disease in Dublin, would that person be debarred from travelling by bus or train?
How is he supposed to get here?
By ambulance or other conveyance.
Supposing he is a person who cannot afford it?
The local authority will send him.
If the local authority has to send by ambulance every person who wants to come to Dublin——
That does not arise under infectious diseases. It would be a serious problem if it referred to every ordinary illness.
Does it not refer to certain skin diseases?
No, they are not included under this section.
Whooping cough is one of the diseases which will come under this section, we are informed. If a child away from home is discovered with whooping cough and the parents want to bring it home, is it suggested that he cannot travel by public conveyance?
Does that not appear to be very drastic in the case of whooping cough?
Yes, it appears to be very drastic, but we have to take very drastic powers in relation to the control of infectious diseases. Whooping cough is regarded as a comparatively harmless disease. It is anything but that. The death rate from it is very high and its incidence is very high. We must try to impose some degree of control as to the extent to which people suffering from that disease may expose themselves. Leading them around the gas works was all right in Deputy Costello's time, but it is not sufficient nowadays and we will have to do something more effective. I do not deny that it is drastic, but we have to take drastic steps in dealing with a very difficult situation. That can be done only by at least having the drastic powers. The Deputy is as well aware as I am that the very fact that you have the power is in itself an assurance that you will seldom have to use it, but if you had not the power you would be up against a very great difficulty.
I would like to get greater clarification on this particular point. Do I understand the position to be now that a person with whooping cough cannot travel in a public conveyance, while a person suffering from a particularly dirty type of skin disease can?
In these matters as to the diseases which can with safety be exposed to public contact, we have to be guided by the experts.
But there are certain types of skin disease that are described as infectious diseases. Is that not so?
They would not come under this section.
That is what I want clarified. Am I to take it that a person suffering from a particularly dirty type of skin disease is free to travel by bus or train, but a person suffering from whooping cough or something similiar is not? That seems to be—with all respect to the Minister's medical advisers—something that requires a little more clarification than we have got so far.
Is whooping cough very contagious?
Regarding the limit of age, it is generally in children?
Yes, but one can get it at a later age.
It is very unusual in adults. There does not seem to be any advance in the treatment, from the old squills.
The treatment of whooping cough has advanced considerably, but we had better not go into that now.
Supposing it is discovered that a patient away from home is suffering from whooping cough and he is not in a position to hire a special conveyance, does the Parliamentary Secretary propose to make any provision putting the responsibility on the local authority to convey him home?
There is full provision, wherever he happens to be.
Supposing he has to be sent a long way to his home, is there any specific authority to send him home?
There is responsibility on the medical officer of health to take such steps as may be necessary.
He can put him into the county home?
If advised by the local authority that it is less expensive to put him into a local home for a few days than to send him 100 miles——
Under the Public Assistance Act, if he were a poor person he could be removed at the expense of the local authority.
Are they put into a fever part in the county hospitals?
They are segregated; they are not put in with the ordinary patients.
In so far as we have isolation accommodation.
I suggest that, once we inconvenience any man by restricting his movements, if it is in the public interest to restrict his movements to the extent we propose to do so under this section, we should provide ample facilities for him to get home, where he can get home. I believe it would not be necessary to isolate him in certain cases and where it is not necessary to isolate him we should make provision to get him home.
We can do all that within the existing law.
Is there a specific provision there? Is the responsibility put on the local authority that they must convey him home?
No. This thing is not as far-fetched as it might appear. Having regard to the number of diseases brought within those sections, it is easy enough to say that a person can get an ambulance or a private car, but in practice the position is quite different. Let us take a case that could quite easily happen. Suppose a traveller, whose home is normally in Dublin and who happens to be in the West, or in Donegal, Clare or Kerry, becomes a victim of one of these diseases. That man, not only for family reasons, but for other reasons, may be very anxious to get back to Dublin in order to get treated. Some of us who have had to hire cars, not to speak of private ambulances, know what it would cost that man to get a vehicle to bring him, say, from Donegal, Kerry, Roscommon or Sligo, to Dublin.
Of course, the local medical officer has all the powers. The Parliamentary Secretary said he had unlimited powers. He will decide to put that man into the local institution, whether or not it is suitable. The Parliamentary Secretary knows as well as I do that some of the institutions that we have in the country are not adequate to meet the cases of people who want voluntarily to go into them, and they are likely to have less adequate accommodation when this Bill becomes law. It is not a question of raising objections, but there is a very definite possibility of extreme hardship under this section.
The Parliamentary Secretary should appreciate the normal reaction in a case of that sort. Supposing a man from the City of Dublin is in the West of Ireland, the normal reaction is "He is not a patient of ours; he is a stranger" and they might not bother too much about him. I suggest, if it is necessary to be as drastic as the Parliamentary Secretary proposes in the section, he ought to put a specific responsibility on the local authority to send that patient home. It is not good enough to leave him to the tender mercies of any individual who may or may not treat him properly.
Can the Parliamentary Secretary say what provision is made for a patient who comes between the type of patient who is able to pay for himself and the public assistance patient? In the normal way the patient with reasonable means comes along and the public assistance authority will say that he is able to make adequate provision for himself. But, while the person suffering from an infectious disease might be normally able to pay whatever costs are involved, the cost of transport from a remote part of the country to Dublin or vice versa might be far above his capacity. In such a case the public assistance authority might consider that he was able to pay for himself, but he would find himself unable to do so. Is there any provision made in such a case for the cost of his transport?
In the ordinary course a patient suffering from infectious disease will be isolated in an institution in the area in which he contracts the disease, or at least in the area in which the attention of the medical officer of health has been brought to his condition. If, in a rare case, there is a possibility that he is caught out away from his own native place and in the area of jurisdiction of another local authority, there is provision, if he is a poor person, for that other local authority to transfer him to an institution under the control of the local authority of his native area.
That is not in this Bill.
It does not matter, so long as it is in the law.
We want to know where it is.
I am talking about persons entitled to medical assistance under the Public Assistance Act.
Deputy Cosgrave raised the question of a person who might not be entitled to medical assistance under the Public Assistance Act, or might not appear to be and yet would not be in a position to pay out of his own resources the full cost of transport from the area in which he is caught out to his own native heath. That, too, is covered by the Public Assistance Act inasmuch as there is not any limitation to the patient's economic circumstances. If a person is so circumstanced that he cannot out of his own resources pay any of the cost involved in his treatment under that Act, the local authority comes to his rescue. The local authority is not bound to pay the full cost. A person may be able to contribute a share of the cost but the determination of that matter is one that rests with the local authority, as to whether the whole cost should be borne out of the rates or only a portion.
In practice it does not work out quite as simply as that. There is a very wide gap between the person who qualifies for a red ticket and the person who can afford to pay the present-day rates for an ambulance. It is all right for the Parliamentary Secretary to say that the local authority may or can do this, but he knows quite well that in practice the local authority will not pay £12 or £20 for an ambulance.
I thought we could trust the local authority to do anything? A week ago I was being abused for curtailing the powers of the local authority.
When I refer to the local authority I am talking about the county manager, as the Parliamentary Secretary well knows, and the county manager is so described in the Act as the local authority.
And the elected representatives provide the money.
At the moment they are allowed to do that, but only for the moment.
That is in case they do not provide enough.
In that connection, we have seen in the papers for the last month that apparently they desire to provide it. That is why they are increasing the rates; every local authority in the country has increased the rates this year. But even that may not be enough to meet the Parliamenary Secretary's requirements. However, that is beside the point. I am talking about what the Parliamentary Secretary knows as well as I do—how these things work out in practice. The Parliamentary Secretary knows that if a person is suffering from an infectious disease away from home, he is clapped into the local institution and the local authority—in this case the county manager—is satisfied when it does that, that it is doing its duty and it will not go to the expense of sending that person 100 or 150 miles, as the case may be
Does the Deputy want to put a statutory obligation on the local authority so that a man caught out in an area other than his native area will be sent back to his own area? I merely want to be clear on the point.
I understood the Parliamentary Secretary to say that that was already the statutory position.
Under the Public Assistance Act, they may at the present time, but does the Deputy want to make it mandatory?
I know what the Parliamentary Secretary is trying to get at.
No, I am prepared to consider it.
If we remember that this is a Public Health Bill, and try not to score petty political points, we may get further with it. The Parliamentary Secretary knows just as well as I do what the mentality of a local authority is with regard to expenditure of this kind. The question at issue is not whether I want this made mandatory or not. Take the case of a person who normally resides in the City of Dublin, and who goes to the country on a Monday morning and remains there until Friday night or Saturday morning, as, for example, many commercial travellers do. If such a person should be so unfortunate as to contract any of these diseases, the first thing he will want to do will be to consult his own medical adviser in the City of Dublin. The second point is that there would be far more facilities for dealing with that particular disease in the City of Dublin than there would be, say, in a remote country town. Therefore, that person's first reaction will be to try to get to Dublin as quickly as he can. If he finds that he cannot get back except he travels in a particular way, then he is going to take measures of his own to get back, and these may result in doing more harm than good. I am putting that case because I can see a case of the kind happening.
Major de Valera
I think that, following the case put by Deputy Morrissey, the matter boils down to this. Take the case of a man who goes to the West and who, let us say, contracts typhoid. In such a case the choice that you are left with, if you are going to do anything, is this: either to provide transport to send the person back to his place of origin, or allow him to travel by train or public bus, the risk in the latter case being this, that he may infect everybody else in the bus. The point, therefore, for the House to consider is whether there should be a mandatory provision on a public authority requiring it to provide the necessary transport for such a person, or whether the situation should be left open with the powers that are already there under the Public Assistance Act. I think that is the net question before the House. The House is faced with a choice of evils. The question is, are you going to put in an explicit provision requiring the public authority, if a man, say, contracts typhoid in one of the western counties, to provide transport to have him transferred back to his area of origin? I can see difficulties in connection with a provision of that nature, and quite obviously Deputy Morrissey sees a difficulty in it, too. On the other hand, is it sufficient, with the powers that are there at the moment, just to let matters take their course, and trust to the way that these things do work out? Personally, I would advocate the latter procedure. I think it would be dangerous to put in a definite, explicit and mandatory provision requiring every infected person to be transferred back to his area of origin. Apart from anything else—I am not speaking on this with any medical knowledge—it would appear to me that it would not be a good thing to transfer the focus of infection from the area where it contracted the disease to another area with the remote possibility, but yet the possibility, that it is going to act as a focus there.
I am afraid that the Deputy does not understand the point that was made from this side of the House. There is nothing in dispute between us so far as typhus or typhoid is concerned. The Parliamentary Secretary has admitted that these cases will be isolated right away in the local institution nearest to the place where the person contracts the disease. What we are thinking of is the case of the man who has whooping cough, or some of those other diseases, in which case the medical officer decides that he cannot go home and is to be isolated there. In other words that man is told by the medical officer that his freedom is to be restricted, and that he cannot use a public conveyance to get home. What we are suggesting to the Parliamentary Secretary is that if that man is permitted by the medical officer to go home, then it ought to be made mandatory on the local authority to provide a conveyance to enable him to do so. One must have sympathy with the man who finds himself a long way from home and is ordered by law not to use a public conveyance to get home. He is told that he must restrict his movements. What we are suggesting is that there ought to be some responsibility on the local authority to provide a conveyance to enable that man to be conveyed to his home.
Major de Valera
While I have every sympathy with the Deputy's point of view, I still think he must admit that where, for example, you are dealing with a case of typhus, or any of these other diseases, it means that you must go further into subdivisions. In the end, you get lost in detail. Would it not be better to work under the permissive powers that are already available under the Public Assistance Act rather than attempt further subdivisions? I think that, if anything, we have been tending to go too far in the direction of legislating in detail.
The Deputy should remember that the person suffering from typhus or typhoid is immediately put into a local institution. We are speaking of the case of a man suffering from whooping cough or some of those other diseases. He contracts the disease when he is in the country on business. He is staying in a hotel and is anxious to get home. He is forbidden to travel in a public conveyance, and it may be that he cannot afford to continue staying in the hotel. I think that when you restrict a man's movements in that way, and deliberately prevent him from using a public conveyance, it is reasonable to ask that provision should be made to enable him to get home.
What I am afraid is going to happen in a case such as that taken as an example by Deputy Hughes is this: the man will remain in the hotel until he is cured. If he cannot afford to remain in the hotel, and if he is not allowed to move around and cannot return to Dublin by a public conveyance, then, I am afraid, he will take the risk of travelling by a public conveyance and render himself liable to a fine of £50 or three months' imprisonment.
Amendment put and declared lost.
Amendments Nos. 29, 30, 31 and 32 not moved.
I move amendment No. 33:—
To delete sub-section (4).
The object of putting down the amendment is to draw attention to the possible hardships which might be inflicted on the unfortunate sufferers of various kinds of disease if the wide scope of the section were permitted to stand. The action of the Parliamentary Secretary in indicating to the House the list of diseases which are to apply in respect of Section 27 has removed to a considerable extent the objections that I had to this sub-section. The only matter I would emphasise is that these diseases, which are within the ambit of Section 27, should be specified in the Act or in the Schedule to the Act. While we, of course, accept the Parliamentary Secretary's word that the list which will be circulated will be a comprehensive one as far as he is concerned, under the existing circumstances of diseases to which the section will apply, nevertheless another Parliamentary Secretary might take a different view, or medical advisers to other Parliamentary Secretaries or Ministers might take a different view and the House would have no control over diseases brought within the scope of the section. The only other matter that arises is, as to the absolute necessity of bringing into this section such diseases as whooping cough and erysipelas.
There is some doubt about whooping cough.
I do not press my views about erysipelas. I think it might be a contagious disease. If the Parliamentary Secretary says that he has received expert advice I am prepared to accept it. I am not so sure that he will find it easy to persuade mothers, whose children have whooping cough, from bringing them to Bray or in a bus to the gas works at Ringsend.
As Deputy Costello has raised the question about erysipelas, it is regarded as a rather serious disease, not so much as being erysipelas, but as the cause of serious illness that might occur from the same type of infection.
I accept at once the Parliamentary Secretary's point.
I would not like to undertake to have the diseases included under different sections of the Act set out in the Schedule, for the reason that that would give an appearance of permanence. I rather think experience will establish the need for modifying this from time to time. We will have to be guided in this matter by the experience we gain, and particularly by people who are trying to operate this Act. Diseases that come within the scope of certain sections in the provisional list I furnished, may, in fact, at a future date be included, or perhaps be transferred from the operation of one section to that of another section. That is inevitable, because of the advance of medical science, and the additional knowledge regarding these diseases that is from day to day coming to our notice. The best arrangement for dealing with a schedule of diseases to which the different restrictive sections will apply is either to have them declared by Order, and to have the Order laid on the Table of the House or published in Iris Oifigiúil. I have no fixed idea about that. I am largely in the hands of the House. I think the House is in favour of having the Order placed on the Table of the House. That procedure will enable the House from time to time to have the opportunity of discussing the propriety of bringing certain diseases within certain sections. It will also give machinery easy to operate for changing the schedule of diseases from time to time. It will be quite a considerable time before there is a final and firm decision.
These schedules are merely for the general guidance of the House, and need not be regarded as firm. The first firm schedule will be when the Bill comes into operation. A schedule of the diseases to which the various sections apply will be placed on the Table of the House. In the meantime, I suggest to Deputies interested that they should invite the views and the criticism of people outside, particularly medical people, and ask them to forward these views to us for consideration before a final determination is reached. All that will be useful. We can at any time change one disease from a particular schedule to a different schedule, or perhaps take it out of all the schedules, unless the schedule listing the infectious diseases. There are diseases that are relatively harmless from the point of view of mortality, but it is necessary to list them as infectious, and make them notifiable, in order that we can keep in touch with their spread and geographical distribution. Deputies need not have any uneasiness as to the manner in which this section or any other part of the Bill will operate. There is no purpose or intention behind this measure other than to safeguard health, and any suggestions of any sort that are of a helpful nature will be always welcomed.
Amendment, by leave, withdrawn.
I move amendment No. 34:—
In sub-section (4), line 47, before the word "care" to insert the words "medical or nursing".
The purpose of this amendment is to get a clarification as to the class upon whom the duty indicated will be imposed by the sub-section. It reads:—
"A person having the care of another person and knowing that such other person is a probable source of infection with an infectious disease to which this section applies shall not permit such person to enter
(a) any public conveyance used for the conveyance of passengers at separate fares, or ..."
Take the obvious case of a parent and child, or a doctor or a nurse in charge of a patient upon whom the section imposes responsibility. It is difficult to say what other class of persons shall have such duty imposed upon them. There have been cases under the Public Health Acts where even medical men have been charged with offences of exposing persons with infectious disease in public places and the courts took the view that it was very difficult to say when a person would be in the charge or care of another person, at least, if that patient or sufferer from infectious disease was an adult person with full possession of his faculties, to what extent any other person has any right to restrict his freedom of movement.
The sub-section sets out that a person having the care of another person and knowing that such other person is a probable source of infection with an infectious disease to which the section applies shall not permit such other person to do certain things. Under the Deputy's amendment the only persons who would be under this obligation would be the persons having medical or nursing care of another person. Such a restriction would not meet the purpose of the section. It would completely exempt the parent or guardian. In fact, it would give the section very limited application. If there is ever any question as to who in fact has the care of another person within the terms of this sub-section it will have to be determined in court; there is no other way of doing it. The parent would have charge of his child but, if the child were, say, in a school, the teacher or headmaster or president of the college, might be the person in charge of the child for the time being. Similarly, a person might contract an infectious disease in another institution. The person in charge of that other institution would be the person who would be responsible, knowing the person was suffering from infectious disease, for seeing that certain precautions for the protection of the public would be taken, one of the precautions being that the person suffering from the infectious disease would not enter upon a public conveyance. While there may be difficulty, and possibly would be difficulty, in giving an explicit definition of the classes of persons who would be included in the category of persons having the care of another person, to confine it to medical or nursing would be so restrictive as to render the sub-section almost useless.
I quite agree. I was only trying to direct attention to the difficulty that exists.
Amendment, by leave, withdrawn.
Amendments Nos. 35 to 44, inclusive, not moved.
On behalf of Deputy Hughes, I move amendment No. 45:—
Before sub-section (5), to insert a new sub-section as follows:—
A person who is a probable source of infection can with the written consent of a registered medical practitioner enter a public conveyance and travel thereon and a registered medical practitioner can exercise his discretion on the issue of such written consent.
Deputy Hughes, apparently, thinks that there might be a stage of a particular disease at which it would be possible for a person suffering from the disease to enter a public conveyance without danger of spreading the disease. The amendment seeks to provide that if such person is armed with a permit from a registered medical practitioner, he should then be in a position to go on the public conveyance. There does not seem to be any great objection to this amendment. If a medical practitioner gives a permit to a man to go on a public conveyance then the permit ought to run in that respect.
There is no great objection to the principle in this amendment but there is objection to the actual machinery proposed. Under this amendment a person who is a probable source of infection could, with the written consent of a registered medical practitioner, enter a public conveyance. That may seem all right and appear quite reasonable on superficial examination. I do not want to say anything very critical of the freedom with which general medical practitioners sometimes issue certificates but I want to make this point, that in regard to the control of infectious diseases there is a special statutory obligation on medical officers of health that is not on the general medical practitioner.
If an epidemic of a deadly infectious disease occurs in a district, perhaps with fatal consequences in a number of cases, it is the medical officer of health of the district who will have to accept responsibility and face public criticism for the fact that the disease has appeared at all in his area and for the consequences of its appearance. Consequently, while I could not accept the amendment in the form in which it appears, I would see no objection to substituting "a medical officer of health" for "a registered medical practitioner". It would seem reasonable that if the medical officer of health was satisfied that there was no particular danger involved in allowing a person to travel by bus, such a certificate would issue but, if such certificate is to be accepted at all, I think the onus of issuing it ought to be put on the man who is responsible for the preservation of the public health.
Is that the district medical officer of health?
I would be prepared to say either district or county. It might be inconvenient to confine it to the county medical officer of health because there is only one and you might not be able to make contact.
That goes a considerable distance to meet the point raised.
Amendment withdrawn on that understanding?
Amendment, by leave, withdrawn.
I move amendment No. 46:—
In sub-section (5), line 1, before the word "contravenes" to insert the words "knowingly and wilfully".
I think the Parliamentary Secretary has indicated so far that in cases where it is not clear that knowledge is essential to create the offence he will make it clear that it is.
Accordingly, I withdraw the amendment.
Amendment, by leave, withdrawn.
Amendment No. 47 not moved.
Section 27, as amended, agreed to.
I move amendment No. 48:—
To delete sub-sections (1) and (2) and to delete in lines 15, 19, 47 and 48, and 54, page 15, the words "to which this section applies".
This amendment is consequential on a previous amendment requiring the insertion of a new section before Section 19, under which the Minister is empowered to include certain diseases within the scope of the section. We have met it a few times already.
We find this in about six amendments. The amendment travels from line 15 to line 54, but I do not think acceptance of the amendment as it stands will interfere with any other amendment submitted. I suppose we may take it as agreed?
Amendment agreed to.
I move amendment No. 49:—
To delete sub-section (3).
The reason we put down this amendment was not that we felt an individual suffering from an infectious disease was not a danger to other persons travelling, but rather because we felt that the section as at present drawn is entirely unworkable and is calculated to place rather serious burdens on the individuals in charge of the public conveyance. There are, for instance, bus conductors and, in a lesser degree, railway guards. I was interested in Deputy Costello's amendment a moment ago, but I did not like to intervene as he was getting on so well with the Parliamentary Secretary. My understanding of the law so far as a person suffering from infectious disease is concerned is that already provision is made in the law for such a person to travel provided he can be isolated. The difficulty I saw in that amendment was that it was unworkable from the point of view of certain conveyances in regard to the matter of isolation.
The point we have in mind in regard to this is the unworkability of the sub-section as it stands at present because of the difficulties for individuals like conductors. How are they to know that an individual is a probable source of infection? What will be the source of their knowledge? How does the Parliamentary Secretary expect them to act? We have put down an amendment deleting the sub-section for the purpose of getting information.
There is one aspect of this sub-section upon which I should like to get some information. I should like to know what is the position of private ambulances under this sub-section. I take it that they are public conveyances in the sense that they can be hired by anybody paying the necessary charge. How will they be affected by this sub-section? It seems to me that they will be excluded under this sub-section from carrying any person suffering from an infectious disease. I should like the Parliamentary Secretary to deal with that point.
Dealing with Deputy Morrissey's point first, so far as I am aware, a private ambulance is not operated on a system of separate fares. It is unusual. I think, for a private ambulance to convey more than one patient at one time. I think it would be a rare occurrence. With regard to Deputy O'Sullivan's difficulty in relation to this sub-section, I cannot just follow it. The sub-section says:—
"The person in charge of a public conveyance used for the conveyance of passengers at separate fares shall not convey therein a person whom he knows to be a probable source of infection with an infectious disease to which this section applies".
It is the old story over again. If he does not know that the person is suffering from an infectious disease to which the section applies, he is not under any statutory obligation. There has been a good deal of misunderstanding and a good deal of misrepresentation about this section, more outside the House than inside. On the 9/3/1946 an article appeared in the Irish Times from somebody called “Civis” on this very matter. I do not know anything about this gentleman except that he is paid, apparently, to write this type of misrepresentation I suppose in the hope that it will do some damage to the Government. It could not have any other purpose behind it.
Surely you are not accusing the Irish Times of trying to damage the Government. I thought it was the other way about.
I draw the attention of the Deputy to the subject matter of this article written by a man, who, presumably, was paid to write it, and the Deputy will have to draw his own conclusions as to what the particular object was. Why the Irish Times or any other newspaper that calls itself Irish, or even the foreign Press for that matter, hate our native institutions so intensely that they present their readers with this type of misleading propaganda is entirely beyond me. The writer says:—
"Even the bus conductor and railway guard are to be penalised should they incur the Minister's displeasure. Giving the Minister the right to say what diseases may be deemed to be ‘infectious', the Bill (Section 28) proceeds:—
‘The person in charge of a public-service vehicle used for the conveyance of passengers shall not convey therein a person who he knows to be a probable source of infection'."
Then he goes on to ask the question that some people are asking in the House:—
"How, one asks, is the busy conductor or guard to ‘know' (a) what are infectious diseases, and (b) who is an infectious person?"
If he does not know this already, there is no harm done. The point is that if he does know it we expect him to act the part of a good citizen.
If he does not know, then it is all right. There are quite a number of circumstances under which he might get to know. At any rate, the point is that, if he does not know, he is not under any statutory obligation. Our friend "Civis" gives himself a sub-heading then, "Amusing". He is really amused; he is enjoying himself, the old rascal:—
"These, and other, of the Bill's provisions, no doubt, may be dismissed as unimportant, or merely amusing. Nevertheless they are significant of the mentality that inspires the whole measure, and of the obvious intention to endow a Minister with arbitary powers that extend from the design, construction and management of hospitals to the design of bathing costumes."
Apparently he read the Bill, unlike many other people in this country, and he understood it.
Apparently he did. I want to show that perhaps he did not understand it as well as he pretended. The man who wrote that article would surely have been expected to have acquainted himself with the law. He is terribly surprised, he is amused, he is chortling to himself at the provisions we are making in this measure. Bear in mind that we are repealing certain provisions. He did not draw the attention of his readers to that. We are repealing certain provisions that make this specific provision. This propagandist apparently never heard of that. He took very good care that his readers would not hear anything about it, at any rate.
In the light of the misrepresentation regarding this section that has gone abroad, I must have set out on the records of the House the powers that have been embodied in the law and operated in this country in regard to this particular matter over a long number of years; that are operating to-day and that would continue to operate if we did not repeal them in our co-ordinating measure. Section 143 of the Public Health (Ireland) Act, 1878, states:—
"Every owner or driver of a public conveyance shall immediately provide for the disinfection of such conveyance after it has to his knowledge conveyed any person suffering from a dangerous infectious disorder, or any bedding, clothing, rags, or other things which have been exposed to infection from such disorder ..."
If he fails, he shall be liable to a penalty. He shall provide for disinfection; so much for that. Then there are Sections 63 and 64 of the Public Health Acts Amendment Act, 1907. Section 63 states:—
"The owner or driver of a public vehicle within the district of the local authority used for the carrying of passengers at separate fares shall not knowingly convey, or any other person shall not knowingly place, in any such public vehicle a person suffering from any infections disease, or a person suffering from any such disease shall not enter any such vehicle, and every person who shall offend against this section shall for every such offence be liable to a penalty not exceeding 40 shillings."
That is the law. That is the provision which has been in operation for the prevention of the spread of infectious disease in this particular way. Those are the statutory restrictions on the owners and drivers of buses and all persons suffering from infectious diseases who enter those buses. Further, those provisions applied not to selected lists of infectious diseases, as will be the position in future, but to all infectious diseases—major and minor. Deputies may tell me that those provisions have not been operative. The fact is that they were operative, as most of the provisions of the public health law were operative, but only a very limited section of the community were affected. Consequently, only a very limited section of the community are aware that such a law exists.
When was disinfection of a public conveyance carried out?
The drivers were under a statutory obligation not to carry persons suffering from infectious disease. Even in the Deputy's time, they did not carry them. He wielded all those powers. Let me quote Section 64 (1) of the same Act:—
"If any person suffering from any infectious disease is conveyed in any public vehicle within the district of the local authority, the owner or driver thereof as soon as it comes to his knowledge shall give notice to the medical officer and shall cause such vehicle to be disinfected, and, if he fails so to do, he shall be liable to a penalty not exceeding five pounds, and the owner or driver of such vehicle shall be entitled to recover in a summary manner from the person so conveyed, or from the person causing that person to be so conveyed, a sufficient sum to cover any loss and expense incurred by him in connection with such disinfection."
Sub-section (2) of the same section says:—
"It shall be the duty of the local authority when so requested by the owner or driver of such public vehicle to provide for the disinfection of the same...."
In the light of that, I wonder how old "Civis" got so much enjoyment out of the innocent-looking provision in the Bill, seeing that we are repealing all these extensive powers and substituting those in the Bill.
If they are so excellent, why are you repealing them?
Because we are co-ordinating the law. Time and again we have been twitted regarding the difficulty, which even lawyers experience, of determining what the law is at present, because it consists of a stack of amendments which would be a couple of feet high if piled one upon another. One enactment amends another enactment, so that the ablest lawyer in the country, as has been demonstrated in the course of this discussion, does not know what the law is at the present time. We are trying to co-ordinate the law. We are repealing 15 Acts and amending 11 others, and that particular line of criticism will not be open when we get a couple more of these Public Health Bills through the House. It will be a tedious process, but it will be worth the trouble. There was a similar state of confusion regarding our lunacy law. We co-ordinated that law, but, if we did, we did not divest ourselves of all the powers we had in regard to the control of mental diseases or the persons suffering from mental diseases. We had a similar inheritance in the poor relief code and we co-ordinated the law in that regard. We introduced a Bill repealing all the old legislation, but, if we did, we had to substitute something for it. If we drop some provisions in the British law dealing with the control of infectious disease, we have to provide ourselves with some effective machinery in lieu of those provisions. Deputies had a bad case against this sub-section, but they approached it very cautiously. Old "Civis" made a fool of himself.
Leaving old "Civis" aside, I shall be perfectly satisfied if the Parliamentary Secretary will indicate to me on what foundation the knowledge of the bus conductor must rest so that he may implement this particular section. Frankly, I do not know. I think that other Deputies are also seeking information on that aspect of the situation.
The Deputy must see quite clearly that no information is available to me other than the information I have placed before the House. If a bus conductor knows that a person is suffering from infectious disease, he must not carry that person in his bus. If he does not know, then there is no statutory obligation upon him.
If he does not know, he cannot be brought into court. If it can be proven in court that he knew and that he knowingly carried such a person, thus endangering the lives and liberties of other passengers and their families, then he should be punished.
At what stage would the prosecution lie?
If he "knowingly" carried a person suffering from infection——
That brings us back to the meaning of "knowingly".
If he is brought into court, the court will determine that.
Suppose a bus conductor or a guard or checker on a train is told by somebody that a person about to board a train or bus is suffering from an infectious disease, that he believes that statement and refuses to carry the person in question, if the person ejected, or refused accommodation, subsequently establishes that he was not, in fact, suffering from any infectious disease, what will be the position of the bus conductor or the guard or checker on the train? I should like to know whether an action at law would lie on the part of the person so ejected.
That can be determined only in court when the case is brought there.
But we are putting certain obligations on those people.
On a person who "knows", not a person who hears about it.
This section is either seriously intended or it is not. How could a bus conductor or the guard or checker of a train know that I was suffering from infectious disease if he were not told by somebody? Are we merely putting this in as filling-up stuff which can never be operative? There is a definite danger that, in attempting to carry out this provision, an official of a carrying company may leave himself open to an action at law.
I am one of those who put down this amendment to delete the sub-section. I have not read the extraordinary letter the Parliamentary Secretary quoted. I have not yet joined the select circle who read the Irish Times, as has the Parliamentary Secretary.
I read less important newspapers. I look on this question mainly from the point of view of the public servant whom I regarded always with deep admiration and respect, that is the bus conductor or the guard on the railway train. We all know that the duties of a bus conductor or a guard are very onerous. They have got not only to keep a check on the number of passengers but to carry out a number of other duties. That is particularly true in the case of a bus conductor. He has to carry out a number of important duties and to keep the details of these duties in his head. He has to keep a time table of the speed at which the bus travels, the number of passengers on board and a number of other particulars and it would be placing an unjustifiable burden on him to have him converted into a sort of medical inspector who has to determine whether certain passengers are suffering from infectious disease or not. Under this section, which is very vague, the bus conductor is confronted with a choice of two evils. If he suspects a would-be passenger of being a carrier of infectious disease, he has two alternatives. He may refuse that intending passenger admission and if he does, he may be open to legal proceedings for having so refused that passenger. It is a very serious thing publicly to accuse a person of suffering from infectious disease. It is a matter which would very seriously affect a bus conductor if brought into court and proved.
On the other hand, if he carries such passengers he may be open to proceedings for having done so. The obligation is placed on him to try to prove that he did not know the person was suffering from an infectious disease. It may be very difficult to prove. I think in fairness to transport companies, and particularly to the officials of the transport companies, this section should be deleted. There is already in the Bill an obligation placed upon persons suffering from an infectious disease not to travel. I think that obligation should be sufficient to safeguard the public interest without placing this additional obligation upon a bus conductor or a guard on a train.
The Parliamentary Secretary himself appreciates the fact that this sub-section will be unworkable in many cases. There is a case in which it can be worked absolutely rigidly, and that is in the case of an ambulance worked under public authorities. I am not making any accusation, because I have not sufficient facts, but I should like to have an assurance from the Parliamentary Secretary that, say, an ambulance attached to a sanatorium, is used exclusively for the conveyance of tuberculosis patients, and that it is not the case that an ambulance attached to a county hospital, a cottage hospital, or other district institution is used for conveying tuberculosis patients or patients having any other type of infectious disease to or from a sanatorium for the purpose of X-ray. The majority of cases in a county hospital are not infectious, but there may be some cases where a patient who is known to be suffering from tuberculosis while in the county hospital or district institution is conveyed to the sanatorium and when that is found out the necessary fumigation or disinfection is carried out immediately. Perhaps the Parliamentary Secretary could reply briefly on that point, because the conveyances used by public authorities are rather numerous, and I should like to have an assurance from him that ambulances from the ordinary institutions are not used to convey patients to and from a fever hospital or to any of the tuberculosis sanatoria.
There are many possibilities of very awkward situations arising under this section. A man may be seen to scratch his head or his arm and if a conductor has to inquire what is the cause of that, it would lead to a very awkward situation. The conductor might as well be asked to say what constitutes the middle-aged spread.
It seems to me that one of the difficulties we are up against in dealing with this section is a lack of logic on the part of the Parliamentary Secretary. A short while ago I asked the Parliamentary Secretary for some information regarding the position of persons who might be suffering from infectious disease and who might work in places frequented by the public. He went the length of pointing out that it would not be fair to place this responsibility on the owner of a factory, or a restaurant, except in regard to the section dealing with the handling of food. He relieves, say, the owner of a café from any responsibility in regard to one of his employees suffering from an infectious disease and letting the public come in and associate with that person. In that case, we are dealing with the owner of the business who may be personally present and very often is. We rely on the medical officer to deal with the case through the ordinary channels and to take the necessary precautions. Yet when we come to deal with public conveyances we have the owner who may not see the conveyance from one week end to the other, put under very serious obligations that do not apply in the case of the owner of the premises to which I have referred. I quite agree that where the owner of a public conveyance realises that a person is suffering from infectious disease the provisions of sub-section (5) should apply, and that would hold also where a person conveying a passenger knows that that particular individual is suffering from an infectious disease but why do we make an allowance in the case of the owner of a café or a factory when in many cases the owner is available on the premises to observe the type of people coming in and going out, while we are so rigid in the case of an owner of a public conveyance who, as I say, never sees that conveyance for a long period?
As to the question of the obligation placed on the particular person in charge of the conveyance, in the list which the Parliamentary Secretary supplied to us regarding the diseases which will be listed under Section 28, we have a peculiar position. We are dealing with ordinary workers. They are not very familiar with legislation as it passes through the House but I presume there will be a certain responsibility on owners of vehicles and other bodies running public conveyances to convey the terms of the Bill to their employees in so far as they affect their duties. As to the two groups of diseases, one of them is included, and the other excluded. We have the peculiar position that unless the conductor or the guard or other responsible person is fairly familiar with the provisions of this section, after it becomes law, it is quite possible that he may make a very grave mistake, a mistake from which the court may not relieve him of responsibility. Amongst the diseases to which the section will apply is whooping cough. I wonder how many citizens regard whooping cough as being infectious, seeing that in everyday life a great number of children are to be found frequenting public places while suffering from this complaint. How many people are able to distinguish between an ordinary cough and whooping cough? I believe that quite a number of laymen would be in doubt as to whether a cough was whooping cough or not. Supposing a child is brought into a bus and starts a fit of coughing, and the conductor decides that the child is suffering from whooping cough, and requires the mother to take the child off the bus. The mother subsequently sues both the conductor and the company and is successful. What is the position of the conductor, who proceeded on the basis that he knew that it was a case of whooping cough and that, therefore, the child should not be allowed on the conveyance?
In the section under which certain diseases are excluded, we find scabies, ringworm and impetigo listed as diseases which are not affected by the section. Most laymen, merely on the basis of their general knowledge of diseases, would regard these three as far more infectious than those listed in the first section and would regard a person suffering from these skin troubles as being in greater need of isolation and of being prevented from using a public conveyance than a child suffering from whooping cough.
We are all anxious to get a section which will be workable and all anxious to see that people who use public conveyances will be protected, but at the same time I do not think it is fair of us either to retain powers provided in an older Act which will raise difficulties for the men or women who have to operate the section in relation to public conveyances, or to put sections into this Bill which will not be workable. If we can find a middle way which will achieve what the Parliamentary Secretary wants which will be workable and which will not be unfair to persons either owning or in charge of public vehicles, all sides of the House will be anxious not only to see such powers inserted in the Bill but to support the Parliamentary Secretary in his request for their inclusion and application. It seems to me, however, that there are a number of anomalies in the section which require further consideration and to which the Parliamentary Secretary should apply his mind, either now or before Report Stage.
With regard to the point raised by Deputy Corish as to the conveyance of tuberculosis cases or other infectious disease cases in local authority ambulances from the county home or county hospital to a sanatorium, I might first point out that only a proportion of persons suffering from tuberculosis are in fact infectious. The Deputy probably knows already that tuberculosis is not infectious, unless the patient is what doctors call sputum positive, unless the actual germs which cause the disease are being exhaled or expectorated in the sputum. So far as the general body of tuberculosis patients is concerned, only a proportion would be deemed to be infectious at all, but if such infectious cases, or any other infectious cases, were transferred from one institution to another, or in fact if a local authority ambulance were used in an emergency for the conveyance of infectious cases—the ambulance which would ordinarily be used for the conveyance of patients suffering from non-infectious conditions —the ambulance would be thoroughly disinfected before being put into use again. The most explicit instructions have been issued by my Department in that regard.
But there is an ambulance which is used exclusively for the conveyance of tuberculosis patients.
If it were being used for the conveyance of any other infectious case, the ambulance would be disinfected after every journey, because the infectious disease carried in it to-day might be different from the infectious disease carried in it the next day, and, consequently, you would be taking a very serious risk of giving your patient another disease in conveying him to hospital.
Deputy Larkin suggests that since cafés, hotels and other institutions where people congregate are not specifically included within the restrictions of the Bill, we should not include bus conductors. Very few Deputies have pleaded with me in the course of the debate for a further extension of the scope of the Bill, and I will be prepared to consider that suggestion. I am glad to have some support for a further extension of its scope and I will consider the point between this stage and Report.
The Parliamentary Secretary will get plenty of support in getting a workable Bill.
I do not know whether it is feasible. A café is not in the same category as a public service vehicle, but we need not argue that at the moment. I think I have said all that can usefully be said on the principles involved in this amendment, and have said it pretty often. Once again, I should like to emphasise that if the owner or driver does not know that a person is suffering from an infectious disease, he is under no obligation. I cannot agree with the Deputies who are pressing this amendment to deprive the Minister of this statutory power. He has had this power in a much more extended form since the institutions of Government were set up in this country. If they have not been brought prominently to the notice of the public, if there have not been a number of prosecutions that would stamp these powers on the minds of the public, it is because of a realisation of the fact that these powers were there, and having them there is in itself a guarantee that certain care will be exercised in this serious matter.
I am still at a loss to know why there should be so much pressure in the course of the discussion designed to divest the Minister of powers in relation to the control of infectious diseases which he has at present. It is as clear as noonday that if we had not bothered to try to co-ordinate the law at all, if we had merely come to the House and asked for the new provisions we deemed to be necessary, a very small Bill would have been sufficient and we would have had considerably less discussion. Notwithstanding the fact that we have these powers and have had them for the past 23 years or so, and that our predecessors in office had them and operated them, we are now being asked to surrender them, and not on the plea that they have been abused, because that suggestion has not been made. I still cannot understand what the reason for it is. Why should we not have unlimited powers in relation to the control of infectious diseases? Why should we not have, at any rate, all the powers our predecessors enjoyed? Why should we not have all the powers a foreign Government enjoyed in this country in relation to the control of infectious diseases, and why should we be deprived of the powers we ourselves have had for the past 14 years and have never abused?
I should like straightway to remove any suggestion that those of us who are interested in this amendment are aiming at divesting the Minister of powers he has or feels he should have. As I think I mentioned earlier, we were looking for information, and, notwithstanding all the Parliamentary Secretary has said on the subject, I think I interpret the sense of the House when I say that he has been entirely unconvincing in that he has given us no reason whatever for the retention in the sub-section of these particular words. When he can convince this House —and might I assure him we are open to be convinced—on this particular point, we will be only too glad to assist. Up to the present, he certainly has not convinced me.
I do not want to prolong the discussion, but I would like to hear the Minister on the point raised. I move to report progress.
Progress reported; Committee to sit again to-day.