andMr. P.J. Burke asked the Minister for Health if he has made progress in allaying the anxieties of voluntary hospital authorities about the implications of the Health Act, 1970, in regard to the management and control of such hospitals; and if he will make a statement in the matter.
Ceisteanna—Questions. Oral Answers. - Voluntary Hospitals Position.
11.
The Health Act, 1970, provides for certain major changes in the organisation of our hospital services, principally through the operations of regional health boards and Comhairle na nOspidéal which are to be established under regulations which will be subject to the approval of the Dáil and Seanad.
As visualised, the regional hospital board for a hospital region can affect the voluntary hospitals in that region in a number of respects. For example—
(1) It will control their budgets;
(2) It will expect them to engage in work and management studies;
(3) It will expect them to apply to themselves the lessons to be learned from the hospital in-patient study being conducted by the Medico-Social Research Board;
(4) It will exercise the functions now exercised by the Hospitals Commission in relation to the supervision of staff numbers, remuneration and hours of work of staff.
Comhairle na nOspidéal, through a control on senior medical appointments and otherwise, will determine where and to what extent new specialties will be developed and in due course will advise the Minister on a method of selection of senior medical staff.
It is only natural, therefore, that the voluntary hospitals should feel uncertain as to how these new bodies will affect them.
I have communicated with the authorities of all these hospitals explaining the situation and I have had discussions with various groups of them. I think I have succeeded in clearing the air to a reasonable extent and in removing many misconceptions and fears. To put certain matters beyond all doubt, however, I have drawn up a statement which I propose to send shortly to each voluntary hospital with the draft of the regulations which later I will be putting before the Dáil and Seanad. As the statement is necessarily a lengthy one I think it would be preferable, a Cheann Comhairle, if you agree, to circulate it with the Official Report.
Following is the statement:
1. In Dáil Éireann on the 26th March, 1969, the then Minister for Health referring to certain voluntary institutions (including hospitals) stated that there was no question arising under the Health Bill proposed at that time (now the Health Act, 1970) which would affect "the ownership, operation, or control" of such institutions. In the event, the Health Act, 1970, as enacted does not take from the proprietors of a voluntary hospital their rights of ownership, operation, or control of the hospital.
2. The Minister for Health, with the approval of the Government, wishes to make it clear that he accepts, as a principle, that the ownership of a voluntary hospital, as in the case of any other private ownership, of itself confers on the proprietors a basic measure of control over the hospital's affairs, and that this basic measure of control should not be so reduced or diluted that the ownership itself ceases to be significant.
3. The Minister further wishes to make it clear that, taking due account of such system of financial control as may be settled between him and the voluntary hospitals, the basic measure of proprietary control by the competent authority of the hospital, referred to in the previous paragraph, includes, inter alia, the following:—
(a) the effective day-to-day administration and management of the hospital;
(b) the effective day-to-day control of all hospital staff—medical and other;
(c) the selection, appointment, remuneration and discharge of staff, other than staff referred to at (d) below, subject to the approval, as now, in relation to numbers, remuneration and hours of duty of the Hospitals Commission and, later, the appropriate regional hospital board when established;
(d) the selection, appointment (or acceptance of assignment from the appropriate regional hospital board when established), remuneration and discharge of consultant medical and other senior medical and senior associated (for example, biochemist) staff who come within the functions of Comhairle na nOspidéal (when established) subject to—
(i) approval of Comhairle na nOspidéal in regard to numbers and types,
(ii) the operation of a method of selection introduced under the provisions of section 41 (1) (v) of the Health Act, 1970, on the understanding that the procedure would reserve to the competent authority in a voluntary hospital the right to refuse, for reasonable cause assigned, to accept the person selected, and
(iii) approval of the Hospitals Commission or the appropriate regional hospital board when established in regard to remuneration.