I move that the Bill be now read a Second Time. For more than a decade now, the need for a variety of ancillary health services of a type which cannot at the moment be readily and conveniently operated by existing statutory bodies has been apparent. In order to meet it successive Ministers for Health have from time to time arranged for the establishment under the Companies Acts of companies, in most cases limited by guarantee, to operate particular services of this kind. The usual practice was for the Minister for Health to invite a number of individuals to incorporate a limited company one of the objects of which would be to provide the specified service. In his invitation the Minister outlined the functions which the proposed company would fulfil and specified particular features of its constitution, including the requisite financial controls, which varied in degree for different companies. These requirements were ultimately incorporated in the Memorandum and Articles of Association of the company as formed. The financial controls imposed by the Minister and the reservation to himself of certain powers were warranted by the fact that in general the companies in question are financed wholly or mainly from public moneys or from charges made for their services and are carrying out important health functions on his behalf and at his instance. The members of each such company and of its Board of Directors were nominated in due course by the Minister.
The health bodies which have been established in this way and are now operating are the National Blood Transfusion Association, the National Mass-Radiography Association, the National Organisation for Rehabilitation, the Dublin Rheumatism Clinic Association and the Cancer Association of Ireland. Another health body established under the Companies Acts is the Medical Research Council of Ireland. Though the majority of its members are not appointed by the Minister, he provides virtually all its income.
While it is within the letter of the law, the use of the Companies Acts in this way is in my opinion hardly consistent with the purpose which Parliament had in view when the statutes were enacted. Company law was created to facilitate groups of individuals in forming themselves into corporate entities for industrial and commercial purposes. The Acts were not intended to meet the case where a Minister of State wished to establish a corporate body to administer under his general supervision a service financed from moneys provided by him. It is only right, however, to emphasise that the resort to the Companies Acts procedure has, in practice, resulted in the satisfactory establishment and operation of the special health services which I have enumerated. Some of the special bodies operating these services have had teething troubles in their earlier stages. In the main, however, where these occurred, they were due to a failure to distinguish between the powers reserved by the Minister to himself and the powers of the members. It is also right to say that in some cases the procedure led to considerable delay in the formal establishment of the services, and, in most cases, to some significant expense which in the future this Bill, if enacted, will obviate.
A further reason for submitting the proposal in the Bill to the Oireachtas is that in my view the procedure which has been availed of heretofore to establish these special or ancillary services is scarcely consistent with the responsibility which the Minister has towards the Oireachtas. There was, of course, a large measure of justification for adopting it when the Department of Health was in the early stages of its development, when the establishment of ancillary services was a rarity, and when so much had to be done quickly that resort to extrastatutory procedures was warranted. On the other hand I am convinced that as our health services expand, and the need for ancillary health organisations, operating outside the statutory health authorities, becomes more manifest, some statutory procedure, other than ad hoc legislation for each particular case, should be laid down. If this be not done, a Minister for Health could proceed to use the funds under his control to establish a succession of such bodies without the consent and perhaps even without the cognisance of the Oireachtas.
On the other hand, the enactment of statute after statute to establish a succession of services on a statutory basis, as the need for each arose, would constitute an inordinate demand on the time of the Oireachtas. I think the difficulty can be resolved if the Minister is given general power to establish such bodies by order, with the proviso that he must submit all orders establishing such bodies to the scrutiny of the Oireachtas. This in brief is what this Bill proposes to do.
Section 3 of the Bill will give the Minister for Health power to make an order establishing a body to perform functions in, or in relation to, the provision of a health service or two or more health services. "Health service" is defined in Section 2 as "any service relating to the protection or improvement of the health of the people or the care and treatment of the sick and infirm." A body so established will be a corporate entity with all the necessary powers to hold land, enter into contracts, employ officers and servants and so on. The new procedure will be straightforward and inexpensive and it will have the overriding advantage that its members will be presented with a clear-cut constitution for their body and will know exactly where their powers and responsibilities will begin and end.
Section 4, to which I would like the House to allow me to move an amendment if we take the Committee Stage this evening, deals with the membership and staffing of a corporate body established under the Bill. The establishment order setting up the body will define the number of members and the terms and conditions of their appointment. It will also deal with the staffing of the body and may include provisions relating to the conditions of service and the tenure of office of members of the staff. Two very useful provisions are included in this section. Under one of them, the machinery of the Local Appointments Commissioners can be used in making appointments to the staff of a corporate body, and under the other, the staff of such a body can be brought within the superannuation code applicable to local officers and servants. This latter provision will mean that there can be transfers of appropriate staff between such a body and a local authority without loss of any accrued superannuation rights.
Under Section 5 the Minister will, in an establishment order, be empowered to define the functions of the corporate body, and the manner in which and the conditions under which these may be performed; and it is provided under Section 6 that the establishment order shall include all necessary provisions relating to the administration of the corporate body.
Section 7 envisages circumstances which might make the dissolution of a corporate body set up under Section 3 desirable. Such a circumstance might arise if the service for which the body was set up was no longer necessary or if the service had expanded to such an extent that it became appropriate for absorption into the local "health authorities" administration. With a view to eventualities such as these, section 7 provides for a wide variety of possibilities in the disposal of the assets of any corporate body which may be dissolved. The property, rights and liabilities could be transferred to the Minister, for instance, or to another corporate body established under the Act, or to a local authority, or they might be distributed among a number of local authorities. Existing contracts could be continued and officers could be transferred to similar posts under appropriate bodies, thus ensuring, where necessary, that the administration of the particular service could be smoothly transferred.
It is not intended that the Bill will automatically apply to any of the existing companies which I have mentioned. These will retain their present constitutions under the Companies Acts, but they will have power, under Section 8, to transform themselves into corporate bodies under the Act on passing a resolution to that effect.
The requirement in Section 10 as to the laying of establishment orders before both Houses will ensure that the Oireachtas is fully informed of the establishment, under the provisions of the Bill, of every new body to perform health functions, and as to the provisions relating to the functions and general administration of that body. Under existing procedure there is no obligation on a Minister for Health to bring the formation of new bodies to the notice of the Oireachtas.
The need for special bodies to provide and to administer on a national or a regional basis particular health services which could not be provided or operated efficiently or economically within the framework of the local government code is now, as I have said, definitely established. Some of the bodies which have already been set up in the guise of limited companies have been entrusted with the expenditure of considerable sums of public money, and, of necessity, continue to spend such moneys in their day-to-day administration. The need for such bodies is likely to continue indefinitely as the health services develop, and it is as well to accept the fact that even now they are in effect an integral part of health administration. Indeed the stage has been reached when there is no justification for continuing to avail of the Companies Acts for the purpose of giving them corporate existence, and when instead there should be appropriate statutory powers for doing this and establishing them with the cognisance and, at least, the acquiescence of the Oireachtas.
Accordingly, I recommend this Bill to the House.
