Seanad Éireann díospóireacht -
Thursday, 16 May 1940

Vol. 24 No. 15

Public Hospitals (Amendment) (No. 2) Bill, 1940—Committee and Final Stages.

Sections 1 to 3, inclusive, agreed to.

SECTION 4.

(1) Where the Hospitals Commission, after consultation with the appropriate advisory committee, complain to the Minister that any person was refused admission as an intern patient to any hospital in relation to which a bureau has been established under this Act or that the treatment of any person admitted as an intern patient to any such hospital was unreasonably delayed, the Minister may, if in his discretion he so thinks proper, cause an inquiry to be held in relation to such complaint and may appoint a person to hold such inquiry.

Dr. Rowlette

I move amendment No. 1:—

In sub-section (1), line 46, after the word "was" to insert the word "unreasonably".

I do not propose to take up the time of the Seanad more than a moment or two in connection with this amendment. The Seanad gave me a certain amount of latitude last night in discussing what is proposed in this amendment, and it would be unfair of me to take up the time of the House in discussing it further now. I gave reasons last night to show how unreasonable complaints might be made which would cause a certain amount of trouble, and I think that anything that would tend to reduce the number of such complaints ought to be in this Bill. Further down in the sub-section, the words "unreasonably delayed" are used in connection with the treatment of any person admitted to a hospital, and I think that there should be a similar provision in regard to any person who is supposed to have been refused admission to a hospital. In this amendment, I am proposing that the word "unreasonably" should be inserted after the word "was" and before the word "refused". In other words, my amendment proposes that, where the Hospitals Commission, after consultation with the appropriate advisory committee, complains to the Minister that any person was unreasonably refused admission as an intern patient to any hospital... the Minister may... cause an inquiry to be held. Apart from that proposed insertion of mine, the sub-section would remain as it is.

Minister for Local Government and Public Health (Mr. Ruttledge)

I do not think there is very much in the amendment. I do not see how any complaints would be entertained if they were unreasonable. In my opinion, that is a matter that could be tightened up under the regulations, and I hardly think it is worth while bringing the matter back to the Dáil on that particular ground. It seems to me that unreasonable complaints would go no distance.

Dr. Rowlette

Yes, but they might be the occasion of some trouble.

Mr. Ruttledge

I do not think so. However, if necessary, that is a matter that could be dealt with under the regulations.

Dr. Rowlette

On the understanding that it is a matter that can be dealt with under the regulations, I shall withdraw my amendment.

Amendment No. 1, by leave, withdrawn.

Sections 4, 5 and 6, inclusive, agreed to.

SECTION 7.

Dr. Rowlette

I move amendment No. 2:—

To add a new sub-section as follows:—

(3) Nothing in this section, or in the principal sub-section, shall operate to authorise any such officer to interfere with the management or control of such hospital or nursing organisation, or with the medical or surgical treatment of any patient.

I did not take much time over the discussion on this matter last night. The Minister had pointed out that, in his opinion, there was no necessity for such an amendment. I admit that, on a thorough reading of the statute, there does not appear to be any substantial reason for such an amendment, but I put it to the Minister that this amendment does not differ from the Minister's own intentions, as he has put them before us, and that it only tends to make the Minister's intentions clear. I think that the inclusion of this amendment would do a great deal to relieve the minds of certain people— perhaps, hyper-sensitive people—who are in control of hospitals. It is not only a matter of people who are in control of, or actually owning, some hospitals; it is rather a question of doing nothing that would deter such people from taking part in the plans that the Minister has in mind. Therefore, I think that anything that would tend to make clear what is, in fact, his intention, should not be resisted by the Minister.

Mr. Barniville

I wish to second the amendment proposed by Dr. Rowlette. I intended to say a few words but it has been hinted by Dr. Rowlette that he got wide scope last night and I do not propose to hold up the passage of the Bill. However, I think this amendment is of extreme importance. The Bill, as originally introduced, as we know, was a Bill we heartily disliked and this particular Bill is disliked by most of the voluntary hospitals, at any rate. I admit that the Minister has watered down the more objectionable clauses and I think he has done his best to make the war a little bit less ruthless on the rather defenceless front of the voluntary system. I call it a war. I admit it is a local attack only, but the voluntary system has received a deathblow. I think an amendment such as Dr. Rowlette has proposed is extremely important and I think it should be pressed. We admit that the Department of Local Government and Public Health as controlled at present is not likely to do anything to which we could take objection and, as the Minister himself has said in the other House in replying to the points raised by Deputy O'Sullivan, there is no intention of anybody inspecting hospitals for any purpose except to see that beds are available. We know we can rely on that statement but it gives us to think when a responsible Deputy in the other House takes upon himself to make an unwarranted and lying attack, not on the voluntary system, but on the biggest voluntary hospital in the Twenty-Six Counties and, I think, in Ireland. The present Government will last a good while. We do not know who is going to succeed them. It might be people of the type of the Deputy who is responsible for that mendacious statement and I simply want to put on record that an amendment such as this is necessary in the Bill to give us any sort of reasonable hope that the voluntary system can possibly be maintained.

Mr. Ruttledge

I am sorry in one sense that I cannot agree to accept the amendment. In Section 25, sub-section (5), of the 1933 Act, there is power in regard to the attaching of conditions to grants. The Senator will see that there is a provision there, at the end of sub-section (5), Section 25—

"provided, however, that no conditions shall be attached to the receipt of any such grants in any way relating to the appointment, dismissal or control of the staff of any hospital or nursing organisation."

So far as inspection with regard to grants is concerned, I think that clause there is definitely what the Senator wants—that it shall not extend to the control of staff and so on, and to the internal management. The only other powers that are being taken are inspection to see if there were beds available or to ascertain whether complaints are being made and that is very rigidly defined in this Bill which is now before the House. I would rather take this line: This is experimental and if the Senator finds that after a year's working of this there has been some sort of unwarrantable interference with the organisation of hospitals, we would be prepared to bring in another Bill to amend that. As I said, this is experimental but what I am afraid of is that if I put in a clause on the lines that the Senator has in mind, in carrying out what I would be entitled to carry out or what the Hospitals Commission would be entitled to carry out, that is, to ascertain that the conditions of the grants had been complied with, or where a deficit has arisen, where you have the right to inspect books and all that, that the matron or authorities of a hospital might refuse to show you the books and the records on the ground that that was interfering with the control and management of the hospital. Perhaps a court might hold that. It is because I am afraid of that and because there is no necessity for it that I cannot accept the amendment. So far as I can see, there is no necessity for these amendments at all because the duties are defined and clearly laid down in the Bill as it stands and are governed by Section 25 and Section 14 of the 1933 Act.

Dr. Rowlette

I am obliged to the Minister for what he has said as to his willingness to consider this matter in future if any danger has arisen. With regard to the objection he has raised, I do not think he has made himself familiar with the principal sub-section to which this section refers of the Act of 1933. If he were familiar with that he would find that the examination of accounts is there precisely provided for in that sub-section and that no authority of a hospital could try to evade that sub-section. The object of this amendment is to limit the visit of this officer to such duties as are provided for in that sub-section and to prevent any possibility of its being carried further. I am sorry I have not the Act with me but if the Minister consults that he will see that that is amply provided for and that no such possibility could arise.

Mr. Ruttledge

Perhaps I have not made myself clear. What I am afraid of is that if I put this provision into this Bill it will be in conflict with Section 14 of the principal Act.

Mr. M. Hayes

Could not the Minister provide for that by leaving Section 14 of the principal Act to still have full force and have it provided that nothing in this particular Bill shall give this power? If that is the only point, that the Minister wants to retain the powers in Section 14 of the Act of 1933, that is not beyond the wit of a draftsman, I think.

Mr. Ruttledge

We will see how it will work out in any case.

Mr. Baxter

Does that mean that the Minister is accepting the amendment?

Mr. Ruttledge

Oh, no.

Mr. Baxter

Could not you try it and then see how it will work out?

Mr. M. Hayes

It is a very familiar Ministerial attitude of mind, common, in my experience, to all Ministers of all Governments, that he wants to bring the full force of the law on his side to enable a particular job to be done. If there is too much power to be taken he does not mind taking it. If his officer exceeds the powers the Minister purports to give him in this Act then the onus is on the aggrieved party of starting a very cumbersome machine in motion to remedy that particular hospital's grievance. But the Minister would do nothing at all which would in any way take from the powers. If there is any doubt it must be on the side of the Department, on the side of the inspector, on the side of the Government and the bureaucrats, not on the side of the voluntary hospital. You could substitute for "voluntary hospital" there a great many other things. The situation is the same everywhere. The Minister does not want this particular power. He makes that quite clear. He wants what is in Section 14 of the principal Act but he does not want to say explicitly that this power is not in this particular Bill when it becomes an Act.

Mr. Baxter

The Minister has no argument left.

Mr. Ruttledge

Because there is no necessity for this.

Mr. M. Hayes

It is the Ministerial attitude. That is all.

Amendment, by leave, withdrawn.

Sections 7, 8 and 9 and the Title agreed to.

Bill received for final consideration and passed.