asked the Minister for Health what autonomy he proposes to allow to the owners and management of voluntary hospitals in future; and if he will specify particularly their rights of ownership, disposal and use of equipment and buildings and selection of medical consultants and staff.
Ceisteanna — Questions. Oral Answers. - Autonomy of Voluntary Hospitals.
37.
In answering this question, I should first make it clear that there is no intention on my part, or on the part of my Department, to acquire the ownership of voluntary hospitals.
It is clear, however, that, in order to reach and maintain a high standard of medicine in our hospitals, many changes in the present system of organisation of these hospitals are inevitable. These changes, which have been described in the FitzGerald Report, arise from the need to combine the hospitals into larger units, to avoid unnecessary duplication and overlapping, particularly of highly specialised services, and to break down barriers between hospitals. The need for regrouping of what are now independent and largely isolated hospital units has received a broad measure of acceptance. Such a grouping must lead to modifications in the exercise of some rights of ownership and management of hospital buildings. In Dublin, negotiations are already taking place between some of the voluntary hospitals and the Dublin Health Authority and I am hopeful that agreement will be reached amongst those concerned on the establishment of one or more new bodies, to be representative of the different interests involved, to operate a reorganised grouping of hospitals in the Dublin area.
It is not possible for me at this stage to be precise on the form which the various changes will take—as these will to a considerable extent depend on detailed negotiations—but I expect that reorganisation will be facilitated by the new administrative structure which is proposed in the Health Bill. A major element of this will be Comhairle na nOispidéal on which the voluntary hospitals will have a strong representation.
The Minister indicated earlier that he welcomes medical staffs of county hospitals coming together to co-operate one with the other. Does he welcome staffs of voluntary hospitals and county hospitals doing likewise in the rationalisation programme he is hoping for?
I certainly do.
Is it the policy of the Department to encourage that?
Certainly.
The Minister gave public recognition of the fact that many of our hospitals represent an investment of charitable work and sacrifice by religious communities and other people and by private charitable donation and that, with the ownership of these hospitals and institutions, go certain rights and that no steps will be taken which will put the owners of these properties in the position of being little more than permissive occupants. The fear continues to exist that the Department is endeavouring to use the hospitals and the owners to carry out policies which are at variance with the policies and wishes of the people who set up these institutions.
I am not so aware. There is no such intention on our part. Obviously, we should have to get freely-negotiated and voluntary agreement for any changes that take place. If there is to be joint administration between a hospital administered by a religious order or an order subject to some charter arrangements and a local authority hospital, it is quite evident that, if they make an arrangement to combine, their conditions and rights will have to have due consideration. There would have to be a freely-negotiated contract. There would be no question of a dictatorial attitude. If that were so, I do not think the result would be good.