Vol. 190 No. 4
I move:—
That a sum not exceeding £34,800 be granted to complete the sum necessary to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1962, for the Expenses of the Maintenance, etc., of Patients in Dundrum Asylum (8 & 9 Vict., c. 107; and No. 19 of 1945).
In this Vote, there is provision in relation to the payment of salaries, wages and allowances and in relation to the payment of a salary for a resident medical physician and governor of the hospital.
If there is no motion to refer this Vote back, the Deputy will have to speak to the various subheads.
I move:—
"That the Estimate be referred back for reconsideration."
Notice of that motion has not been given.
It is unnecessary; we are entitled to move it and I here and now move it. In speaking to the motion which I have moved, I want to refer to the fact that provision is made in this Vote for the payment of a salary to a doctor and so on. I do not know whether the doctor concerned is or is not a member of the Irish Medical Association but he is certainly entitled to be a member of the Association, despite the attacks that have been made on the Association by the Minister here to-day.
Might I point out that the Deputy would not be in order in discussing the Irish Medical Association on this Vote?
I am not discussing the Irish Medical Association. I am discussing the right of the physician in charge of Dundrum Hospital to be a member of the Irish Medical Association.
There is no question——
The matter does not arise on the Estimate.
I respectfully submit that it does arise. The Chair is aware why I propose to raise the matter. It is the only means available to me to reply to the prepared statement which the Minister made here to-day in a privileged position, hoping it cannot be replied to.
Not at all.
The Minister was entitled to make a statement. It arose out of remarks made in the course of the Estimate last week.
Certainly.
The Deputy will not be in order in carrying forward the debate on to this Estimate.
Is the Chair ruling that I am not entitled to discuss whether the resident physician and governor of Dundrum Hospital is to be a member of the Irish Medical Association or not?
The Chair cannot see the connection between the two.
I submit——
I am on my feet, Sir.
I shall hear the Minister on a point of order.
On a point of order, the debate on the Health Estimate has concluded. The question was put to the House and the Estimate was accepted. No matter relating to the administration of the Department of Health or the policy pursued in relation to that should now be discussed.
With respect, Sir, may I say that here we have a sum of £34,800 which is sought for the maintenance of a hospital which is the only hospital owned by the Minister for Health. I am certainly entitled in relation to that sum to discuss the policy and actions of the Minister for Health and the rights——
Only in relation to——
The Minister is not in charge of the Chair in this House. I am certainly entitled to discuss the rights of medical men in the hospital and that is what I propose to do.
May I put it to the House that no question has at any time arisen as to the right of any qualified member of the Central Mental Hospital to be a member of any medical association whatsoever? This is a mere subterfuge in order to have a resumption of the debate on a business already decided by the House.
The Chair has pointed out to Deputy O'Higgins that there can be no carry-forward of the debate to this Estimate.
What the Minister said today has been a straining of the facts to suit an argument he is anxious to make.
It does not arise on this Estimate.
It does, with respect. The terms and duties to which the Minister referred apply to the resident physician and governor of this hospital.
No, they do not.
Please. I am entitled to speak and I am speaking. Am I to be interrupted?
On a point of order.
Deputies are entitled to interrupt on a point of order.
Very well. Will the Chair rule whether it is a point of order?
The duties which have been the subject of some controversy with the Irish Medical Association are not duties which have been attached to the post of an officer in the Civil Service. They are duties which attach to the post of officers in the service of health authorities.
The Chair has made clear to Deputy O'Higgins that the matter is not in order on this Vote. The Deputy will not be allowed to get around the rulings of the Chair in this fashion.
I do not accept the manner in which the Chair has used words as appropriate to apply to me. I am entitled to discuss why different conditions should be attached to a civil servant holding a medical post in Dundrum Mental Hospital from the conditions attached to local authority posts. I am certainly entitled to discuss the conditions and duties of the resident physician in Dundrum Mental Hospital.
Arising out of this Vote.
Yes. In that regard, I am entitled to know from the Minister, in concluding—not in the way of a disorderly interruption—what the terms and duties and conditions of this post are. Is the resident physician and governor in Dundrum Mental Hospital obliged to provide on request to the Minister clinical and other information in relation to patients within that hospital?
Under the Mental Treatment Acts——
I said I will not have the information given to me by way of disorderly interruption. The Minister may give me the information in concluding the debate. The reason I mention this matter in relation to an obligation to divulge information with regard to patients is that it was, for as long as I was Minister for Health, a matter of grave objection raised to me by the Irish Medical Association. It was raised in relation to a variety of posts. I had to consider——
On a point of order—I am sorry to have to interrupt Deputy O'Higgins—I listened to him with interest when he was debating the Estimate for the Department of Health but the House has already passed that Estimate. The Deputy is endeavouring to open a debate on this Estimate for the Central Mental Hospital on matters which were discussed during the debate on the Estimate for the Department. I suggest he is not in order in trying to do so.
The only matter that falls for discussion on this Estimate is the administration of Dundrum Asylum.
I am discussing the terms, conditions and duties of the resident physician and governor. Provision is made in the Vote for the payment of salary to the resident physician and governor. I take it I am entitled to discuss the duties of his office, the conditions applying to that office and matters of that kind. I was referring to whether or not he is under an obligation to provide to the Minister or to anyone else clinical information which he has obtained as a doctor in relation to patients within that hospital. The reason I want to refer to that matter and want that matter dealt with by the Minister in concluding this debate is that it was a matter raised with me on many occasions by the Irish Medical Association. I had to consider it very carefully. I considered it in relation to the different posts for which I was, as the present Minister is, responsible. I was unable to find a formula which would completely reconcile the interest of the employer of a medical officer and his obligation in relation to secrecy, so far as his patient was concerned. I was compelled to specify in relation to all these posts the obligation to provide reasonable information.
When I ceased to be Minister, I think it was quite reasonable that the Irish Medical Association should renew their objection on this count to the present Minister. I gather that they did in fact do so.
I do not mind Deputy O'Higgins pursuing that line at all. I have no objection to it——
Is this in order? Am I entitled——
I shall not interrupt the Deputy again but I doubt whether it is in order.
Would the Minister subside then and let me proceed? It does appear that the objection was renewed to the Minister and apparently no solution was found. The Minister has been pleased to suggest that the renewal of this objection by the Irish Medical Association was because he was a Minister of the Fianna Fáil Party and that it was not put forward because I, when I was Minister, was a Fine Gael Minister. That suggestion is absurd. In any dealings I had with regard to this matter, I met, as the Minister knows well, prominent members of the Fianna Fáil Party who were amongst the leaders of the Irish Medical Association. I found them reasonable men.
The Deputy is travelling away from the administration of Dundrum Asylum. I think we ought not enlarge the scope of the debate at all but confine ourselves very definitely to the administration of Dundrum Asylum.
Perhaps I will come back very quickly. I just have two more sentences to say in that regard, getting back to the Estimate. The Minister has made the suggestion that this action was taken on political views. He has been pleased to suggest that the discussions I had were reasonable because I was a Fine Gael Minister. I think that may be true.
That is in respect of Dundrum Asylum?
It is related to the duties of the Resident Physician. That is the only thing I am discussing. It may be true that the discussions were reasonable because I was a Fine Gael Minister but not for the reason the Minister thinks. I am, because I am a reasonable man, a member of Fine Gael.
That scarcely arises.
I have said all I wish to say. I do not know whether these duties apply in the case of the resident physician. However, I do not think the long, prepared apologia the Minister read out to-day does anyone any good.
I am sorry I interrupted Deputy O'Higgins. He was quite entitled, in fairness to himself, to make the statement he did make. Perhaps he will agree with me that their boots were heavier when they came to me than they were on him.
Maybe the Minister is more susceptible. He may have a persecution complex.
Would it be in order to ask you to report the Estimates now because I want to make payments under subhead N of the Estimate for Health to these dispensary doctors?
Yes.
