I move:
That Dáil Éireann approves the following Regulations in draft:—
Health (Hospital Bodies) Regulations, 1972 (Amendment) Regulations, 1978, a copy of which Regulations in draft was laid before Dáil Éireann on 21 November 1978.
The motion before the House seeks approval of the draft Health (Hospital Bodies) Regulations, 1972 (Amendment) Regulations, 1978.
The explanatory memorandum which I have circulated with the draft sets out the legal background to these regulations and the necessity for them. Very briefly, the regulations provide for a continuance of the arrangement whereby all the members of Comhairle na nOspidéal are appointed direct by the Minister for Health and for an increase in the total membership from 23 to 27.
The 1972 Regulations provided that all members of Comhairle na nOspidéal would be appointed by the Minister for Health during the period ending on 31 December 1975. The five-year term of office of the members appointed in accordance with those regulations will expire on 31 December next. It is necessary, therefore, to make appropriate legal provisions to enable members to be appointed after that date. This the draft regulations now before the House will do.
The rules in relation to membership of the comhairle are contained in the Second Schedule to the Health Act, 1970. Rule 6 of that schedule provides that members shall be appointed for such term of office not exceeding five years as the Minister for Health may specify. It would be my intention to continue the practice of appointing members for a three-year term of office.
The functions of Comhairle na nOspidéal are set out in section 41 of the Health Act, 1970, and in the explanatory memorandum. One of its main functions is to regulate the number and type of appointments of consultant medical staffs in hospitals engaged in the provision of services under the Act. Since the hospital system is by far the most costly element in the health services, it is essential that advances in medical specialisation should proceed in a rational manner, that over-lapping and possible wasteful expenditure should be avoided and that in general the development of hospital services should be carried out on a controlled basis. The comhairle was established mainly for this purpose. Because of the importance and far-reaching effects of its discharge of these functions, the selection of members for appointment to the comhairle is obviously a matter of serious concern to all involved in the hospital services of the country. The ideal would be to have persons on the comhairle who could speak on behalf of all the interests involved. This is not, of course, capable of being achieved without a very substantial increase in the membership of the comhairle, which in turn would lead to an unmanageable and largely ineffective body. The comhairle has authority to appoint committees for specific purposes and to appoint to such committees persons who are not members of the comhairle. Representations for each and every interest and speciality in the actual membership of the comhairle is not therefore essential for the purpose of securing a completely balanced representation of interests.
I consulted various interests before putting the draft regulations before the House. These included medical and nursing organisations, health boards, voluntary hospitals and medical teaching authorities. Nearly all of the views which I received favoured a continuance of the existing method of appointment to the comhairle, that is, by direct appointment. The draft regulations provide accordingly. It would be my intention, when making the appointments, to take into consideration the names submitted by the various interests concerned of persons willing to act on the comhairle.
The views which I received from the various bodies consulted seem to indicate that some increase in the present membership of 23 would be desirable. It would allow better geographic representation and would enable me to go some way towards meeting requests for greater representation of health board areas and for wider representations generally. These considerations were put forward by many of the bodies consulted, and I have decided to make provision in the regulations for an increase of four in the membership of the comhairle. This increase will bring the total membership to 27, of whom 14 will, as required by the 1970 Act, be hospital consultants. I should like to take this opportunity to express my appreciation of the interest shown by the various bodies which I consulted and of the reasoned and constructive views which they put forward. I am confident that they appreciate the fact that, in an exercise such as this, it is not possible to meet fully the viewpoints of all interests.
I recommend that the House approve of the draft of the Regulations which is before it.