Léim ar aghaidh chuig an bpríomhábhar

Seanad Éireann díospóireacht -
Wednesday, 20 Nov 1935

Vol. 20 No. 15

Nurses' and Midwives' Pension Bill, 1935.—Second Stage.

Question proposed: "That the Bill be now read a Second Time."

In the absence of Senator Dowdall I move the Second Reading of this Bill. It is a Bill entitled "an Act to make provision for pensions for registered nurses and midwives and for the payment of contributions towards such provision and to make provision for divers matters connected with the matters aforesaid including the amendment of the Public Hospitals Act, 1933." The first section deals with definitions. A "nurse" means a woman who has adopted nursing as her sole mode of livelihood and who is registered by the General Nursing Council of Saorstát Eireann. The word "midwife" means a person who carries on no other occupation than that of midwife and who is certified by the Central Midwives Board of Saorstát Eireann. The next section provides that the Minister may by order appoint a day to be the appointed day for the purposes of the Act.

Section 3 deals with the qualification for pension. It states:—

Subject to the provisions of this Act, a pension shall, if the statutory conditions are complied with, be payable to every nurse registered by the General Nursing Council of Saorstát Eireann and to every midwife registered by the Central Midwives Board of Saorstát Eireann who has acted as such nurse or midwife for a period or periods of not less than 20 years in the aggregate from the date of her registration as such nurse or midwife.

The fourth section provides that the pension payable to a nurse or midwife shall be a sum of £30 per annum or such other greater sum as the Minister may from time to time determine. The fifth section sets up a Nurses' Pension Endowment Trust. It states that before the appointed day, the National Hospital Trustees shall out of the Hospitals Trust Fund, transfer to the credit of a separate account, the sum of £250,000 which shall form a separate fund to be known as the Nurses' Pension Endowment Trust and shall be held by the trustees upon trust to invest, manage and apply the same in accordance with the Act.

Section 6 provides that for the purpose of making provision towards the cost of pensions payable under the Bill, contribution shall be paid in such manner as the Minister shall prescribe by each nurse and midwife at the rate of 6d. per week, commencing as from the appointed day. Under Section 7 it is provided that the Minister shall keep a separate fund to be called and known as the Nurses' Pension Fund and shall maintain and manage such fund in accordance with the Bill. There shall be paid into the fund (a) all interest, dividends and income and all sums in the nature of bonus received by the National Hospital trustees in respect of the securities in which the Nurses' Pension Endowment Fund is invested, and (b) all money collected as contributions in pursuance of Section 6 of the Bill. All pensions payable under the Bill shall be paid out of the fund.

Section 9 deals with the form of accounts, audit, etc. Section 10 voids any assignment or charge on a pension. That is, the pension cannot pass to any trustee or to any other person acting on account of creditors. Section 11 deals with the making of regulations. It provides that the Minister may after consultation with the Minister for Finance make regulations generally for carrying the Act into effect and in particular, (a) for prescribing the manner in which pensions may be claimed and the manner in which pensions are to be paid, and (b) for enabling a person to be appointed on behalf of any claimant or person entitled to, or in receipt of a pension, who is by reason of any mental or other incapacity unable to act, to exercise any right to which such claimant or person may be entitled under the Bill.

This Bill does not include mental nurses. It applies only to nurses and midwives engaged in private work or in hospitals. Perhaps I should say something about what is required in the training of a nurse. I might first mention that this is the second attempt by this House to provide pensions for nurses and midwives. The House will remember that over two years ago an amendment to the Hospitals Sweepstakes Bill, 1933, providing pensions for nurses, was unanimously adopted here. That amendment was ultimately withdrawn on the Report Stage on the suggestion of the Parliamentary Secretary. It needs no words of mine to recommend this Bill for the acceptance of the Seanad. It is well known that nurses are scandalously underpaid and for that reason it is quite impossible for them to make provision for their old age, or for the time when they are left without occupation on account of their age or sickness. Nursing is a very strenuous and trying occupation and nurses frequently break down under the strain. It is also common knowledge that no one wants to employ an elderly nurse.

To become a nurse a young woman must enter a clinical or other recognised hospital as a probationer. She must be over 18 years of age, must be in robust health and vigour, and her character must be unimpeachable. She must have attained a high standard of education. When she is appointed a probationer nurse, she is, in most hospitals, required to serve for four years, and almost all the hospitals in Dublin demand fees varying from £30 to £73. In most of the hospitals she receives no salary for the first year's service, and, in many, no salary for the second year's service. She has to pass two State examinations in anatomy, physiology, hygiene, pharmacology, medicine, surgery, etc., and has to pay £5 5s. 0d. for these examinations. These terms and conditions may have had something to be said for them when the hospitals were in straitened circumstance, and were supported by voluntary subscriptions, but they are not justified now. The reason why these conditions continue to exist is because the probationers are only individuals. They are up against large bodies with very conservative rules and regulations. The conditions of service and salaries for young persons have greatly improved during the past 20 years, but, as far as probationer nurses and midwives are concerned, they remain much as they were. It might be asked why do private nurses give their services for inadequate fees; the reason is that if they raised their fees, they would prevent a large section of the public from employing them and consequently they would be worse off. These are only some of the reasons I might put forward for support of the measure, but perhaps I have said sufficient to ask the House to give it a Second Reading.

I do not know when a Bill, that I regarded with more favour than the present Bill, has been introduced into this House. I think the Bill is of great importance. I look upon it as a great social necessity that nurses should be put on some permanent footing in this country. I know that down the country, far away in Connemara and parts of Mayo, there are great stretches of territory where it is very difficult to get a doctor in case of sudden illness. I know from experience gained when I was living down in the West that the nurses in these districts are of the greatest possible assistance to the people. They helped the poor, men and women, when illness came on unexpectedly and doctors could not be found for a long time. Nurses have done infinite good, in my opinion, in such cases. I shall not go into the details of the Bill, but the principle that a pension should be given to nurses who have spent their lives at such noble work is one that should be agreed to by everybody in this House.

I should like to say that, as the Bill stands at present, I am afraid I cannot support it. I am afraid the Bill has been very badly thought-out, and, if I might say so, with all respect, very badly drafted. The Bill provides that every nurse or midwife after 20 years' work shall be entitled to a pension of £30 per annum. We all know that there are certain nurses in this country who richly deserve a pension. I refer to nurses such as Jubilee nurses, some of whom have given 20 years of their lives looking after the poor and the needy. If this Bill were intended to deal with people such as these, there would be no objection to it, but I see a grave objection to giving pensions to a number of people who will be included in the scope of this Bill. Take for example a married woman whose husband is in a position to keep her and who, for a hobby or for some other reason, takes up the profession of midwifery. After being 12 months in one of the hospitals she gets the C.M.B. certificate. She then commences to practise for the purpose of getting some extra pocket money or for some other reason. She may have a private home of her own and she may take in patients for whom she will be paid. After 20 years' work, she is entitled under the provisions of this Bill to get a pension of £30. I think that is all wrong. A lady who may get a C.M.B. certificate may have only one patient in the year, but yet, after 20 years' service, she is entitled to get £30 pension. Anybody who has had experience of private nursing homes or of some of the nursing homes attached to some of the large hospitals knows the high fees that are charged there. Are the people who run these nursing homes, in which a nurse may give 20 years' service, not obliged to look after the people who have given them that service? Nobody will have any objection to giving a pension to nurse who spend 20 years in a public capacity looking after the poor, but I think it is all wrong to say that midwives and people of that kind should come under this scheme. The question of pensions for nurses is a very delicate matter. There are a number of nurses in the country who are entitled to pensions already. Numbers of nurses are employed in mental hospitals and by right of their service——

Mental hospitals are excluded.

Of course they are excluded, because the mental hospitals provide pensions for them. I was going to develop the argument that public authorities who employ nurses in their institutions provide pensions for them at the public charge. I take it that the Bill intends to provide for nurses who are not in public employment, and I have given cases of married women who may take up this profession purely for a hobby or purely for the purpose of making money, and I honestly say that in most of these cases they are not entitled to get a pension under this scheme. I do say that the Jubilee nurses are a very excellent body of women and do excellent work for the poor. I have no objection in the world to some pensions scheme being formulated for the purpose of providing pensions for them, but I do say that this Bill will have to be re-drafted and amended in many particulars before I could agree to support it.

It appears to me, and no doubt to the House generally, that the aim of this Bill is excellent. There is probably no profession in which there is such a combination of devoted service and low remuneration as in that of nursing, but there are one or two questions I should like to ask about the Bill. I think the mover might, with benefit to the House, explain a little more fully the principles followed in making the exceptions in Section 1. The other question I want to ask is one with regard to the contributions. What I should like to know is whether it has been considered that there should be a refund without interest of the amount of contributions made in the case of nurses retiring before 20 years' service. That is a feature which obtains in respect of certain funds, and if it is capable of being done, it has obviously from the financial point of view certain advantages.

The mover mentioned the frequency with which nurses have to retire because they have become broken down in health, because they have been overworked and are not able to stand it. They have given perhaps very devoted service for a number of years. Such people will not get a pension because they have not completed 20 years' service, and are perhaps a long way short of that service, but, in view of the reasons for which they retire, a refund of their contributions, at all events, might serve to tide them over what would be a very difficult period. I should like to know if that has been considered, and if the principle be thought impracticable, the reasons why. These are the two questions I wanted to ask and about which I think the mover might tell the House a little more.

As this Bill stands, I am afraid I cannot see my way to support it, much as I should like to do so. Everybody feels justified, of course, in any action they would take to help to relieve persons who give this service, and everybody admires the profession, but I personally feel that this Bill does not at all deal with the subject in the way in which it ought to be dealt with. I am not at all satisfied that the promoters of the Bill, good as their intentions may be, are fully aware of the work of nurses outside the cities. Nurses' work is very arduous down the country and they are dependent on the offerings and subscriptions of the people, and the proceeds of raffles, dances and concerts organised for the purpose of trying to maintain nurses in the district. Their pay is very poor, and the work is very responsible, and the doctors themselves, who cannot work under as hygienic conditions as they would wish owing to the poverty of the district in which they may be operating, cannot maintain the nurses.

All these matters arise on the question of providing, primarily, a nursing profession for the benefit of the people which is ignored altogether in this Bill, and, secondly, providing the means to pay them adequately, and not to have them, as some of them in my country are, pushing 20 miles on a winter's night across a mountainside in order to attend to a sick person who is more often than not unable to get the nurse at all. When we come to deal with a Pensions Bill such as this I have the impression that it deals merely with nurses here in Dublin, the majority of whom are pretty well paid, or, at least, are living under good conditions, with a dry foot under them and able to get up in the morning to go to their work in the house in which they live. I feel that this Bill does not deal with the subject at all. As we see, hospitals in the city have extended to an extraordinary extent and now offer all sorts of facilities. That does not exist down the country. In outlying districts these services are not given to the people, and I think that if the question is to be dealt with the people should be provided with adequate facilities from the point of view of nurses and motor ambulance transport, which nowadays is very efficient.

If there is any money to be spent it ought to be spent in providing sufficient and adequate staff, well paid so that they will take an interest in their work and so that they will be better able to provide for their years' service than they are under existing conditions. In the circumstances, I strongly advise Senator Sir Edward Coey Bigger to withdraw this Bill and to draft a Bill that will cover all phases of the subject. Such a Bill I would be prepared to support.

I am sorry that Senator Dowdall is not here. The Bill was introduced by him and I might have expected to hear from him some pretty full explanation of the import of the Bill and its financial consequences. I think the case which Senator Sir Edward Coey Bigger has made is not at all adequate and not at all convincing. He referred to the passage of an amendment on the Public Hospitals Bill, as he said, unanimously, and he implied that this Bill was the fulfilment of the intentions of that amendment. I think the Bill fails to do what was intended to be done by that amendment. The particular section of that Bill as drafted provided that the governing body of any hospital or nursing organisation in Saorstát Eireann, or any person about to establish any such hospital or nursing organisation, may at any time apply to the Minister for a grant out of the Hospitals Trust Fund for the benefit of such hospital or organisation. Senator Dowdall moved to insert after "nursing organisation in Saorstát Eireann" the words "or any organisation established in Saorstát Eireann for the provision of a pension fund for aged or infirm nurses". The implication was that an organisation would be in existence which would apply to the Hospitals Trust Fund for a grant for the purpose of pensions, but the Bill so far as I can see does not contemplate the existence of any organisation which would administer such a fund or apply for such a fund.

The Bill is backed by two eminent lawyers—a Senator who has had considerable experience of the administration of the law—business men and local administrators, and it seems to me to carry a distinct lesson as to the difficulty of any private member or members drafting a Bill which would fulfil the intentions of those members. So far as I can gather, what is sought to be attained is that the Hospitals Trust Fund should set aside £250,000, the income from which would be used, along with the funds derivable from the 6d. per week contribution of active nurses and midwives, to provide £30 per year. No information has been given as to any expected number of persons who would subscribe, on the one hand, and might be expected to come into benefit, on the other, and as to whether £250,000 is too large or too small a sum, I cannot find any evidence. I find from the Census returns, for instance, that there are nearly 7,000 women engaged as midwives, as nurses for the sick and as mental attendants, but how many of those 7,000 are engaged in public work, that is, work for public institutions, and how many for private institutions, I cannot find out. This Bill deals only with those nurses and midwives who are dealing in private practice.

Or public nursing.

But who are not working for public institutions. Perhaps Senator Brown will tell us who is to administer this service. I find that Section 11 provides that the Minister for Local Government, after consultation with the Minister for Finance, will make regulations generally. I take it that it is contemplated that the whole business of administering this pension fund and deciding who shall come in and who shall come out, and who shall be knocked off the pension list and who shall come on to it, will be done by the Minister. That depends on what the Minister says. I wonder is that intended? Is it intended that a fund shall be established and that everything else shall be left to the Minister, or to some organisation set up by the Minister?

A certain provision is contained that the Central Fund shall receive some of these moneys and it is contemplated that the Post Office might be brought into the system of administration. I do not know whether that is merely a possibility, but I take it certainly that the contemplation is that the Minister for Local Government and Public Health will be the authority administering this Act. The suggestion is that the hospitals in the beginning are to remain entirely under private control, that hospitals in which these people are trained are to remain as they are, but that the nurses who are being trained are, for one part of their activities, brought under the control and direction of the Minister.

It is stated in Section 4 that the pension shall commence to be payable as from the date on which the nurse or midwife resigns from her occupation. I wonder what is meant by that? Senator Farren has indicated that the midwife may be a married woman and, in pursuance of her practice, when does she resign from her occupation? I take it after 20 years from the receipt of her registration certificate.

Sole means of support.

Then a married woman is not entitled to any pension under this Bill?

Not if her husband is alive and is supporting her.

Her sole means of support must be the earnings she gets from nursing, and she has to pay 26/- per year whether she has a heavy practice or a very light practice. It is important to have it made clear that neither a nurse nor a midwife who is married, comes under this Bill.

If she married and has the misfortune not to be supported by her husband she comes under the Bill.

But if she is supported by her husband part of the time and is deriving her income from her occupation part of the time also? I am sure that the backers of the Bill have made some estimate of the possible cost, as to whether the £250,000 is merely a guess, or whether it has some basis of calculation. If it has a basis of calculation, then I think the House should be informed as to how many would, let us say, to-day come within the benefits of this measure. I am not sure whether it is intended that only from the appointed day, when funds begin to accumulate, will the Act become operative: that is to say, that no person at present, having retired after 20 years' service, will come into a pension. It is not clear at all from the Bill when a person will come into benefit from the funds: whether a person who has given 20 years' service will come into benefit at once or what the position is. That surely should be made clear.

I think it would be a desirable thing if a general scheme of pensions for nurses could be devised, provided there was an organisation in existence which had some sort of general control of nursing to which these nurses would be amenable. They are also supposed to be granted certificates, but so far as I can see, there is no organisation contemplated by this Bill which will have the administration of the fund, the granting of pensions, and the responsibility of deciding whether persons are or are not eligible, except such an organisation as the Minister may set up.

I do not know whether it is intended that, for the purpose of dealing with pensions, a special Ministerial Department is to be established to control nurses and their pensions. It seems to me that the Bill is entirely inadequate. It is not at all clear as to its intentions and is very unsatisfactory as a piece of legislation. If the movers of the Bill want to get merely an expression of opinion from the Seanad that the Minister should be pressed to bring forward a Bill himself, then I think a resolution should be passed to that effect, but I think that this Bill, as a piece of legislation, is quite unworthy of the Seanad and ought not to be passed into law.

I wish merely to give my general support to a scheme which will provide for these most deserving members of the community. I do not know of any people who have to work so hard, who suffer more and who lose more from the health point of view than nurses. I am speaking on this as a mere amateur and am only looking at the question from the general standpoint. Even if, as has been suggested, the Bill has imperfections, I still think it is an admirable thing that this matter has been broached again, and that we have this measure before us. I am sure that Senator Dowdall is admirably qualified to bring in a Bill of this kind. I think we must all admit that Senator Sir E. Coey Bigger has vast experience in these matters, and is probably the best qualified person in the Free State to explain the necessity for such a Bill as this. I think his views should be weighed very carefully by Senators as to whether the Bill in its present form should be accepted or not. I hope that, if the Bill is rejected, it will not be the end of the matter. This Bill proposes to deal with some of the most unselfish women that we have in the country. It is terrible to think that, in their old age, they are thrown on the world without any provision being made for them. Speaking from my own limited experience, I know a number of them whose health has broken down as a result of their work. The pity is that in their old age they are unable to support themselves after their long years of labour in the most unselfish of all occupations. I do not claim to be well qualified to speak on this, but as a woman I desire to say a word to help these nurses. I fancy that if it were men who were concerned in this there would be, although I do not like to say it, more support for this Bill.

Men are excluded from it.

Undoubtedly the Bill is capable of great improvement, and even if it is rejected by the Seanad I hope that this question of pensions for nurses will not be shelved and that some provision will be made for them. I agree to a very large extent with what Senator MacEllin said about the state of the country and with regard to the need for nurses amongst the poor people. There are districts in the country where there are no jubilee nurses operating. The only nurse in these districts is the dispensary midwife. I know myself that the United Irishwomen's Society made herculean efforts to get nurses for some of these poor districts. They succeeded in some cases, but it is only in isolated instance where you have one of their nurses or a jubilee nurse operating. I am very glad that this Bill has been introduced. I hope that, with all its imperfections, some scheme will be evolved from it for providing pensions for nurses. I think it is really a reproach to us that these most unselfish women should be treated as they have been up to the present.

I think that the principal object of this Bill is to endeavour to obtain for the nursing profession some portion of the money which is being made available for hospitals generally. While we have spent, and are likely to continue spending, vast sums of money on bricks and mortar, the idea behind this Bill seems to me to be that the nurses are just as much a necessary part of the hospital services of the country as the material buildings on which so much money has been, and is being, spent. I would like to give my point of view with regard to Senator Johnson's criticisms of the Bill. I did not fully understand all his criticisms; and as I am not one of the promoters of the Bill I do not feel called upon to go into details. The Senator started off by stating, and I think quite rightly, that this Bill is another instance of the extreme difficulty of drawing up a complicated measure without the assistance of officials in Government Departments. It is true, of course, that if a measure of this kind were passed into law it would be administered largely by some Government Department. I would point out to Senator Johnson the fate of certain other Bills that were introduced in the Seanad. The Senator himself was largely responsible for one, namely, the Town Planning Bill, which at the time was considered by the Government Department concerned to be inadequate and unsatisfactory. I doubt very much whether we would have had the present Town Planning Act if it had not been for that Bill which was passed by the Seanad, even in its unsatisfactory form, on the initiative of Senator Johnson and other Senators. The same may be said about the Slaughter of Cattle Bill which, I understand, is likely to come back to us in a new form from the Dáil with the approval of the Government. It is to come back to us in a form in which the Government believe it can be administered. There are other instances of Bills introduced in this House which succeeded in achieving what the promoters of them had at the back of their minds. Most of us know that these Bills could not in the nature of things be adequately dealt with here, and that what we wanted was to get the Government to act. In that we were successful.

I have no doubt that is the object behind this Bill. In the case of Bills of this kind, I think that if the House were simply to reject every effort made to get something done that needed to be done simply because a particular measure could not stand, on Second Stage, minute criticism, criticism such as we heard from Senator Johnson on this Bill to-day, then it seems to me that it is only in very rare cases indeed that this House can introduce and pass legislation unless, of course, the Government give facilities and that may prove to be impracticable. It is not so much a question of drafting. It is rather a question of the time occupied in having a private measure examined by the various Government Departments dealing with a large subject such as the one mentioned in this Bill.

But we want to know the intentions of this measure.

I have given what I believe to be the general intention. I am not attempting to deal with the details of the Bill. Some of us may have sympathy with some of the objections that were raised to the Bill, but I must say that Senator MacEllin's objection to pensions for nurses is beyond my comprehension. Because he considers that the State should come in with a complete scheme for nursing in the country, that seems to him to be a reason why a certain amount of the money that is available should not be used to provide pensions for nurses. That seems to me to be a very poor type of argument. It means that until you get something approaching perfection you should do nothing at all, but there is not money available out of the Hospitals Trust, or likely to be in the future, which would make possible a scheme such as he has outlined. I welcome the criticism that came from Senator Farren. Generally, you have proposals from the Labour Party to include more people, but in this case we have had the suggestion made that too many people are included. I think it is quite possible and, in fact, probable that some kind of a means test, although I do not like the phrase—at least some restriction such as was indicated by Senator Farren—would have to be introduced before a measure of this kind becomes law. At the same time, I want to say that from my reading of the Bill, I do not think that impression of the Bill is an altogether fair or accurate one. You would think by listening to him that the promoters of this Bill intended to provide pensions for all classes of persons who had at any time been engaged in nursing. Let us take the case of the married woman who had one case in the year. The Senator suggested that she would come within the terms of the Bill. We all agree that she should not be included, but he gave the impression that, as it stands, the Bill would cover her case. With great respect, I do not believe it would. I do not believe that she would be covered by the definition of the word "midwife"—"a person who carries on no other occupation than that of midwife." The Bill would be referred to some administrative body and I do not believe that any such body would hold that a woman who had attended one case every year for 20 years would be entitled to a pension of £30 per year. Even if the provision in the Bill be defective, it is clear that that was not the intention of the persons who put their names to the Bill. While there may be a good deal in the Senator's criticism, I think it is a mistake to suggest that the idea of this Bill is to provide pensions for persons who have only been engaged casually in nursing. The object is to provide pensions for nurses who have been working for 20 years on small salaries and who have no other means of livelihood. The Bill was, I believe, introduced mainly for the purpose of making it easier for women to become nurses by assuring them that, though they may receive only a small payment, if they live to a reasonable age some provision will be made for them. I think we should pass the Second Stage of the Bill. I do not think the Bill can be worked unless it is adopted by the Government. However we might amend it, with our limited knowledge of departmental affairs, I do not think that any responsible Government would accept it in the form in which it would reach them. That is no reason why we should not amend the Bill so as to make our intentions clear. We need not worry too much about exact administration. That would have to depend on the Government. But we may hope that the publicity given by a measure of this kind will lead the Government, in the course of a year or two—that is the time it generally takes—to bring in a comprehensive measure to deal with the subject. When the Town Planning Bill and the Slaughter of Animals Bill were passed by this House, the Government seeing that there was public support for the measures, handed them to the Departments concerned for full investigation. After a year, or two years, Bills dealing with these matters were forthcoming from the Government. I should hope that something of the same kind would occur in the present case. It is in that hope that I support the Bill.

It is quite evident that the nurses do not belong to a trade union.

They do.

I am astonished at the bad treatment that they are getting from the sponsors. They are the hardest-worked, most underpaid and most exploited class of workers in this country. I want to enlarge on what I mean by "exploitation." The nurses are usually drawn from the country. When a farmer's daughter comes up to be trained, there is a mulct or fine imposed on her of £75, plus expenses for what is called a uniform. She works for five years or so and, though she may be utterly unqualified, in certain institutions her labours are utilised for attendance on private patients who are paying three guineas per week for the services of a nurse. She has paid £75 to enter into what is really modified white slavery. That is not general, but the system is open to it. Then, again, nurses are subject to a working week of 84 hours, if necessary. They have night work to do and they have to perform duties that are neither safe nor pleasant. A housemaid has a better chance of survival in this country and a better chance of a pleasant life than the ordinary nurse. We cannot forget the great army of borderers on death who must be attended to and the last hours of many people's lives are very difficult for young women to attend to. Their salaries are about £12 a year and there is really no future for the nurse unless where in certain cases she becomes a pet of the board.

The sooner this system of nursing is thoroughly ventilated the better. The sooner their trade union helps the nurses in regard to their 72-hour week the better. The drawback I see in this Bill is that once you vote a pension to nurses, you will enable their employers to underpay them further. Instead of giving money out of the Hospitals Trust Fund to form a pension fund for nurses, it would be far better to get the hospitals to pay the nurses better and let the Hospitals Trust endow the hospitals in return. That would be in accord with the present endowment scheme and no change of policy would be necessary. The increased expenses of the hospitals could be written off by the endowment. Nurses in unions have probably a much harder state of affairs to contend with than nurses in hospitals because the glamour and mesmerism thrown over these unfortunate girls is that they are supposed to be ladies. If they were called housemaids, they could not be exploited and fined £75. That £75 should be handed back to them. In certain colleges and institutions, the entrance fee is handed back on expiration of the course. After three or five years in a hospital, one of these girls has to go out and live in what is called a hostel. She pays so much a week until some leading citizen falls ill. Then she hopes to attend him in his private house. The amount of this work is utterly inadequate to cover the number of nurses. It is a heavily overstocked trade. In the chief Dublin hospitals, there are waiting lists for three or four years, even though the girls who get in have to pay a fine of £75. This £30 a year, if voted, is really only a sort of anticipation of the old age pension for people senilely and prematurely decayed as a result of their work. It is not adequate even as an old age pension.

My purpose was to give an idea of the long hours, with night duties equal to the day duties, which nurses have to work, and to show how they are underpaid and exploited. The one sore point of the whole business in respect of these young people working in Dublin is that they are exploited, not by every hospital, but by certain hospitals. The person who pays three guineas per week for the services of an untrained country lassie is, of course, also exploited. The conduct of the hospital is in the hands of the matrons and the boards and, when the hospital runs private homes, they may not know the circumstances. Hospitals with private homes can feed the private hospital staff from their untrained general nursing staff, although these nurses are supposed to be trained. I have given a slight illustration of the conditions of work. I reiterate that it should fall on the hospitals to increase the payment to their nurses and that the hospitals should be recompensed, if there is enough money in the sweep fund, for that increased expense. Why the Hospital Sweepstake Fund has not been administered and who is getting the interest on it are other questions.

While Senator Gogarty found fault with the Labour Party because of their attitude on this Bill, he himself went on to justify the attitude of the Labour Party and did it very well. It is proposed to allocate a beggarly sum of £30 per year to these worn-out servants of the people. The attitude of the Labour Party is that that is merely putting a plaster on a sore; the sore remains. We know that the nursing profession is one of the most exploited professions in the country. Instead of introducing a Bill to provide a beggarly £30 a year for these nurses in their old age, steps ought to be taken to ensure that the nurses would have a proper standard of living and proper working conditions. We ought to set a headline for other countries in this connection, because we have advantages that no other country has. We have accumulated a hospital fund of £9,000,000, or thereabouts. As somebody has said, this money, instead of being put into bricks and mortar, should be largely used in humanising the conditions under which the nurses work. That is our attitude on this Bill—and not to give these nurses £30 a year. Let them be given a normal working week instead of their present 72 hours, and make it obligatory on all the hospitals which participate in this fund to treat their nurses like human beings. There are also other hospital workers, such as wardsmaids and laundry maids, who are exploited to a degree which is almost incredible in a Christian country. We are not going to remedy that state of affairs with a Bill like this Bill. These conditions will go on. These people will be exploited and, as Senator Gogarty has pointed out, sums of £75 will be forthcoming from struggling farmers who want to put their daughters in a position to render valuable service to the community. There is an opportunity now of putting this matter on a proper basis and humanising the conditions of the workers in the hospitals. In my opinion, the best way to do that would be to bring in a one-clause Bill, amending the original Act, which would ensure that every hospital participating in this fund would establish fair conditions for those in its employ. That is the attitude of the Labour Party towards the Bill. The Bill will accomplish nothing in the way of remedying the evils under which the nurses and the people engaged in the hospitals have to work. These will go on in the same old way. These people will be underpaid and overworked and a sum of £30 a year, at the end of 20 years, is not going to do very much towards assuring them the life to which every ordinary citizen is entitled.

I cannot understand the attitude of the last speaker, and of the Party for which he speaks. He says that the difficulties and the dangers of the nursing profession make it incumbent on us to see that nurses are treated fairly and given larger pensions than £30 a year. The Senator seems to object to the details of the measure, because it does not give nurses what he believes they are entitled to. That seems to be a matter of detail. On the Second Reading I understood it was the general principle of the Bill was dealt with. I subscribe to the general principle of the measure. I cannot understand the attitude of those who criticise it because it does not go far enough. Considering the work that nurses have to do, their hours, and the danger in which they are placed while engaged when alleviating human suffering we cannot compare that calling with the work of civil servants, or primary teachers who work five or six hours in the day, or Civic Guards, or those engaged in banks, offices, or any other branch of the public service. I consider it extraordinary that those on the opposite side of the House should object to this small measure.

Does the Senator support the class distinctions in the Bill?

I object to class distinctions. Senator MacEllin's objection was that the work of nurses in country districts was so arduous that the terms of the Bill were by no means commensurate with it. As Senator Gogarty pointed out, those who go in for nursing must have high qualifications and have to be endowed when they go for training. I suggest that if the Government makes it incumbent on those going for nursing to have high qualifications they should be treated fairly in the way of salaries. I am surprised that it is only now we are awakening to the tremendous difficulties that nurses meet with in their work. If this Bill is a small one it is a beginning and we should subscribe to the principle contained in it. It is a great pity that objections should be raised on matters of detail. The funds will come from the sweepstakes. I consider that the two classes that have not received anything commensurate with the enormous amount of money provided by the sweepstakes are nurses and patients in country places. These patients, if they require special treatment, have to come to Dublin. Taking into account all that we have heard about the difficulties and the dangers of the nursing profession we should support the Second Reading of the Bill.

I am supporting this Bill. I am glad that the supporters and the opponents of the Bill agree on one thing, that nurses are very badly paid in Ireland, and that they work very hard. As I have had experience of nursing in several hospitals, I must say that I would not take on a nurse's job at any price. I would much prefer to be a housemaid.

You would be far better paid.

When the wages paid to nurses in England are compared with the wages paid nurses in Ireland, or compared with the wages paid to housemaids in England, it must be admitted that nurses here have every claim to sympathy. In this Bill they must have 20 years' service before they can get a paltry pension of £30. Certainly the promoters of the Bill did not overdo it in that respect. Senator Johnson asked if £250,000 was too much or too little to ask from the sweepstake funds. The promoters of the Bill had not a Government staff at their disposal in order to ascertain the likely number of nurses that might benefit under the scheme. Personally I think £250,000 is too little with which to make a start on this scheme. I suggest that members of the House should agree that the nurses are not being treated properly. Then when this Stage is passed amendments might be inserted in Committee providing that they should be treated with justice. In my opinion 20 years is too long a period to have to spend in the nursing profession. The position is different with men. In the Free State a man goes into a job and as a rule remains in it for the rest of his life. A girl who goes in for the nursing profession generally marries after a few years, or is sacked. Many of these girls look forward to marrying a professional man, but the people that the Bill proposes to deal with must remain in the profession for 20 years. It is for those who, if you like are "on the shelf," and who have done great work for the suffering, work that no housemaid would be asked to do, that the Bill caters. When a nurse is brought to a house and is paid two or three guineas a week, in many cases she does not get the money. In a Dublin private hospital or in a private nursing home the nurses get their turn of cases. They are unemployed half the time, but in the meantime they have to maintain themselves, and pay laundry and other expenses. As a matter of fact there is a good deal of exploitation of nurses. The reason for that is that we are a very proud people, but girls who go in for the nursing profession submit because nursing is "looked up to," and rightly so. I would certainly prefer to be a housemaid. I ask the House to agree to the Second Reading.

As one of the members of the House whose name is on the back of the Bill I desire to answer some of the criticisms of Senators. The first one I would like to deal with is the objection made by Senator Johnson. He said that this Bill did not carry out a resolution that was unanimously passed by the House on the Committee Stage of the Public Hospitals Bill, 1933. It did not carry that out. The resolution was in fact withdrawn on the Report Stage. The history and the object of this Bill is this: a resolution was passed—and I was one of the members who were responsible for it—that the public hospitals trustees should have power, among other objects, to make provision for pensions for nurses, but only for a particular class of nurse, who were nursing in the country under certain organisations. It was confined to them entirely. That is not the object of this Bill. What happened to that resolution was this, that it was given up on the Report Stage because the Government there and then undertook that they would bring in a wide Bill which would provide pensions for registered nurses and midwives. That is the object of this Bill. It was not to carry out partially the resolution that was passed unanimously, but was to be a beginning in that direction, and to remind the Government of what they undertook two years ago, and before the Seanad ceases to exist. That being the object of the Bill, and that being the reason it has taken this form, to which Senator Johnson now objects, I wish to point out that the Bill does not explain how it is to be carried out. A Bill like this can only be carried out really through a Government Department. It is a great public measure, and it can only be carried out by some public Department, and by some particular part of that Department, which in this case would naturally be the Department for Local Government and Public Health, plus the Minister for Finance. That is the only way in which a scheme of this magnitude could possibly be carried out. There were other small objections to the Bill taken by Senator Johnson. He wanted information about the "appointed day" and whether the 20 years that were to qualify for a pension included any time before the passing of the Bill. The Senator knows perfectly well that that would make the Bill retrospective, and that no Act of Parliament can be retrospective unless it is made so expressly. This Bill is not retrospective and the ordinary construction is that the 20 years must only run from the "appointed day" on which the Bill will come into practical operation.

It is well to know that that is one of the intentions of the movers of this Bill.

Undoubtedly. That was the whole meaning of the "appointed day." Otherwise the Bill would come into operation straight off.

May I ask the Senator a question?

The Senator is trying to explain now.

If the Bill is passed, does the Senator mean that no pension will be paid for 20 years?

No, but that it was not to include nurses who had retired before the "appointed day."

That is not my point at all. The point is, when does the pension begin for any person?

Payment of the pension begins when the Act comes into operation.

It applies to every nurse who has served 20 years, even though part of the service was before the Bill was thought of.

If that is the intention, it is not in the Bill.

I know it is not in the Bill. Will my friend put it in the Bill on the Report Stage if he thinks it is right? A great deal of the criticism of the Bill has been on matters of detail. It had to be prepared in a hurry. The whole object of it is to get the Government to act in the way they promised to act two years ago. My suggestion to the House is that we should accept it with all its existing defects, make it as good as we can on the Committee Stage, pass it through the House and then send it to the Dáil. Then, if they do not approve of this Bill, they will perhaps draft a better Bill of their own. It is to get the Government to do what they promised to do, to do what is a crying necessity in this country, that we have introduced this Bill. I do not know that it is necessary to answer Senator Farren's objections about the lady who has only one patient. Under the definition of midwife, it is clear that the Bill applies only to a person whose sole occupation is ordinary nursing or midwifery. The lady who takes in an occasional patient will not come within that definition.

Provided she does not get any more, and provided she is willing to take them, what happens?

She must have some other means of livelihood then or else she would be in the poorhouse.

She has a husband.

I am perfectly willing to admit that these definitions may be improvable. If that is so the Senator can improve them, and I am sure Senator Dowdall will be willing to accept any proposal that betters the Bill. Senator Johnson, I think, also complained that there was no organisation pointed out which was to be responsible for the control of nurses. There are two bodies already in control of nurses and midwives. There is the General Nursing Council of Saorstát Eireann, referred to in the definition in Section 1, and, in the case of midwives, there is the Central Midwives Board. They are responsible for the qualifications and the conduct of the nurses.

Can you make them administer this Bill?

Could they not be made to administer the Bill?

I do not think so.

Senator, you have already made some very strong criticisms of the Bill, and I cannot allow you to interrupt Senator Brown.

It would be imposing on these bodies functions which they were never intended to perform and which I do not think they are capable of performing. This is a great national matter and it should be a matter for the Government and no other body in this country. One other suggestion I should like to answer, and it has been made by Senators who are entirely in favour of the principle of this Bill. It is that nurses are scandalously underpaid. Goodness knows they are. The suggestion is made that if they were better paid they would themselves provide for their old age by savings. That is an impossible suggestion. The ordinary person who does hard work of an unprofessional kind becomes entitled to an old age pension at 70 years of age, or is it 65?



No nurse could continue working until she was 70, and the reason for putting 20 years' active service into the Bill is that nurses begin to break down very often before they have 20 years' active service. Very few nurses are able—I know this from the statistics of the Jubilee nurses and the Dudley nurses—are able to do hard work after they reach the age of 45 or 50 years, and you could not possibly in this country pay salaries to nurses sufficiently high to enable them to make provision for their old age. It is a very happy thought that they should provide their own pension fund, but it is utterly impossible in this country. I hope the Seanad will adopt the suggestion I have made, to pass the Second Reading of the Bill, to improve it all we can on Committee Stage and send it on to the Dáil to be dealt with by the Government and to better the Bill if they can. I have no doubt it will be bettered in the Dáil, but it should go there with our request to them to carry out as soon as possible the promise they gave so willingly two years ago.

I am sure there is no person in this House who objects to the principle of the Bill or to the object that it seeks to achieve. All the opposition to it has been, not on the question of principle, but on the question of procedure. It is a rather difficult position to put to the House to say that this is an admittedly faulty Bill, that the framework of it is all wrong, but that, its intentions being good, the House is asked as a legislative body to accept it. Notwithstanding all its faults, and what, in my opinion, are the almost insuperable difficulties of amending it within the framework of the general terms of the Bill, I do not think there is anybody here who will refuse it a Second Reading. Frankly, I am myself very doubtful as to whether we can put the Bill by amendments, while observing its general principles, into a form for which the House would like to accept responsibility, if it has any regard for its legislative capacity. We have, as Senator Foran said, raised from the four quarters of the globe £9,000,000 for the endowment of our hospitals. Notwithstanding the fact that a great portion of that has already been paid out, and that the sweepstakes are still running strong, we have here admissions that the human element in our hospitals, in the form of nurses particularly, are still grossly underpaid, and that the State must accept part responsibility for paying them a miserable pension of 12/- per week when they retire. I should like, when we do make an effort to do belated justice to this profession, which is a great, worthy and noble one, that we should make a more vigorous gesture than is contained in this Bill.

Hear, hear!

The principle seems to be wrong. We are, through the State, paying over to hospitals vast sums of money, and I think, as other speakers have suggested, that the State should pay this money on condition—at least as one of the conditions —that the hospitals shall pay fair wages and extend fair conditions to the human element within these hospitals. If we agree to the principle of this Bill, another great amendment of the Public Hospitals Act will be necessary.

Might I remind the Senator that it refers to hundreds of nurses outside the hospitals altogether? It is true that they have been trained in the hospitals, but all these nurses through the country are objects of the Bill.

The Senator is going on very uncharted ground if he tries to cover all these types of nurses.

Registered nurses.

Admittedly registered nurses. I would advise him to be careful as to where he is going to lead the House and lead the country if he is going to include all that type of person and apply a flat rate type of treatment to all out of the Hospitals Fund. Then if this fund, together with the contributions which are being made— the joint contributions—falls short, the State has to make up the deficit. The first essential, of course, is decent conditions of employment and the second is acceptance by the hospitals of a scheme under which both parties would make an annual contribution towards a pension fund.

I should like to quote a statement by the Parliamentary Secretary to the Minister for Local Government and Public Health during the discussion on the Public Hospitals Bill, 1933. He said:

"Senator Sir Edward Coey Bigger mentioned that a pension scheme was in operation in Great Britain and Northern Ireland. I am aware that a federated superannuation scheme for nurses in hospitals was set on foot some five years ago in Great Britain, and that it has attracted considerable support. Already more than half of the voluntary hospitals are participating in it. Senator Sir Edward Bigger did not tell the House that under that scheme the hospitals pay a contribution of 10 per cent. and the nurses 5 per cent. of their salaries and emoluments. There is no apparent reason why the voluntary hospitals in this country should not set up a similar organisation, and why they should not contribute on somewhat the same basis as in Great Britain and Northern Ireland towards a pension scheme. Indirectly it would be financed out of the Hospitals Fund in this way, that if they were contributing towards such pension fund, the overhead charges and cost of maintenance would be correspondingly increased."

I think that is the proper way to deal with a pensions scheme of this kind. Most of these hospitals have private nursing homes attached to them in which patients are charged from five to eight or ten guineas per week. In respect to the nurses they employ, all the hospitals are asked to pay towards the cost of pensions is the munificent contribution of 6d. per week, and they are to be free of all responsibility afterwards. Some of these homes are also run with the help of probationer nurses who are receiving no salary at all but who are, on the contrary, paying a fee. It is rather too much to let the hospitals escape to the extent of their pensions commitments except for this 6d. per week. Then I think it was rather unwise, although it is really only a detail, to fix £30 as the pension. Anything above that has to be authorised by the Minister. The personal responsibility of the Minister or of his Department is brought into the matter. Twelve shillings per week is totally inadequate for human maintenance, especially for a person such as a nurse. Then the period of 20 years is another element that I think should not be brought into the question. For instance, a nurse generally starts at 18 years of age. Because of the bad treatment, perhaps, she receives from the hospital, the inducement will be to leave in order to get a pension which will be very little short of her salary. She can get it without working at 38 years of age. Consequently, she can leave the service and get married.

She could not be registered at 18.

Well, very shortly afterwards she can be registered.

Then at 41 she can retire and get married, if she gets anyone to take her at that age and draw on her pension for the rest of her life. The fact that she has a pension will be an incentive, particularly to a farmer. There is no provision made in the Bill for a break-down pension. I think Senator Bagwell referred to that. In all the pension schemes I have had anything to do with, there is provision for an incapacity pension for the person who falls by the way in the service or has not completed the full term to entitle him to the pension.

I feel that it is really unwise to offer any further criticisms of a Bill which is so lacking in detail and which, at the same time, contains details which I think might have been omitted. I think it would have been better if power had been given to, or, if necessary, an injunction imposed on hospitals or on somebody else to prepare a pension scheme which would be approved by the Minister, or by somebody else, and if necessary, laid on the Table of the House. It is dangerous to go into a certain amount of detail and to stop there. I think the principle upon which the Bill proceeds is faulty, and I doubt very much if we can give effect to our views in regard to it in a legislative way, within the framework of a Bill, but at the same time, lest a vote against this Bill might be taken as an indication by members of this House that we are not convinced of the necessity for drastic action to give nurses the treatment which their services entitle them to, I hope the Bill will get a Second Reading.

So much has been said on this Bill that very little is left for me to say, except to state that I am in thorough sympathy with the idea underlying it. I know many cases of real tragedy in the nursing profession, cases of women who are neither in hospitals nor in institutions, but who serve the public to the best of their ability in their nursing capacity, and who, when they come to the age of 45 or thereabouts, are broken-down women. They are no longer able to keep on at the arduous work of their profession, and they are faced with the poorhouse. They have been unable to make provision for their old age not because their pay is so very small, though it is, but because their work is so broken. They may get a case on which they would have four or five weeks' work, and when they leave that case they have to spend four or five weeks more waiting for another case, which brings the rate of their remuneration down very low altogether—so low that sometimes they are barely able to provide themselves with the necessaries of life when they are out of work.

It is these women in whom I am more interested, these women who are not in institutions or hospitals. The nurses there may be underpaid, but they can still be sure of a roof over their heads and they can be sure of their meals. You have them dotted all over in nurses' homes in Dublin— women who are competent and highly qualified as nurses, but who cannot get positions because of their age and because when they get to that age even the patients do not want them. I know the case of an old lady who wanted a nurse recently, and when an elderly but highly trained and competent nurse was sent down she sent her back and said she wanted a young one. I know an elderly doctor in a hospital who gave this advice to a young nurse: "Missy, get married if you can. Do not get old in the profession. The patients do not want you; they want a bit of fluff." That may seem funny, but it is really a tragedy. They are faced with this at the end of a hard life. Very rarely do they marry as they are so wrapped up in their profession, and after years of hard life, when they reach the age of 45, they have to look forward to 25 or 30 years more of terrible poverty.

The tragedy of the thing is terrible, and although the Labour Senators have criticised the Bill, I feel absolutely sure that they are just as much in sympathy with the idea behind it as any one of us here. I think that if the House gives this Bill a Second Reading it will at least get the Government to move in the matter and to bring in, as they did in other cases, the type of Bill which the Labour Party look for.

I should like to thank the members of the House for their friendly criticism of the Bill. With regard to the details, it would be impossible for a Bill of this kind to include all the details that must arise. It must be remembered that the regulations—and the regulations play a very important part—must be made out before the Bill, if it becomes an Act, can be put into force. That is altogether in the hands of the Minister for Local Government, who fixes the appointed day. I have also to thank Senator Brown, not only for his criticism, but for all the pains and trouble he has gone to in drafting the Bill. He has gone to tremendous trouble and has put into it practically all that could be put into it. There are many things that cannot be put in, but they have been considered.

With regard to the nursing profession, we did try to get actual figures of the number of nurses who would come under the Bill. I went to the expense of appointing an officer to draw up a report. I studied the report and it did not help us very much, but in drafting the Bill we made as much use of it as we could. The case of pensions mentioned by Senator Farren applied only to hospitals, and not to private nurses, and it is the private nurses who require pensions most as the hospitals do make some provision. As Senator Mrs. Clarke has pointed out, there are some distressing cases of nurses, who, when they come to the age of 45 or 50, are broken down in health. Nobody wants them, and it is for that class that this Bill will provide. If it becomes an Act, and if this money from the Hospitals Sweep Fund is placed in the hands of trustees, it will accrue almost at once and will go largely to meet distressed cases until the contributions of the ordinary nurses come into force. Senator Bagwell raised a point as to the return of contributions to nurses who have left the service or given up nursing. That can easily be arranged for and, in fact, it is arranged for in most pension schemes. Senator Douglas and Senator O'Farrell have given very good reasons why the House should pass the Second Reading of the Bill.

Question put and agreed to.

The Committee Stage will be taken on the next day on which we meet. Since I fixed the next Stages of items 1, 2 and 4 I have learned that it is unlikely that there will be business for the House next week, so that there will probably not be a meeting next week.

It might be better to adjourn the Committee Stage for a fortnight.

The next day we meet, whenever that may be.