The purpose of this Bill is to give legislative power to provide a new general hospital in or near the City of Dublin in place of the House of Industry hospitals. It is necessary to provide a site for the new hospital, and although the Minister for Local Government and Public Health is invested with extensive powers in relation to the existing hospitals, he has no power to acquire land for the hospitals. Neither does the board of governors possess that power. In fact, the board of governors is a body with very limited powers, to explain which it may be well here to make a brief reference to the history preceding the establishment of the board.
Houses of industry were established in pursuance of an Act of the Irish Parliament passed in the year 1771-2, which provided for the creation of a corporation in every city and county, with power to build hospitals to be called workhouses or houses of industry for the relief of the poor. The Corporation for the City of Dublin was constituted in the year 1773, and it established a house of industry in North Brunswick Street, Dublin. Subsequently buildings in the nature of hospitals were erected at the institution, such as a hospital for infectious and contagious diseases, completed in 1803, a surgical hospital provided in 1811, and a medical block in 1817. After the passing of the Irish Poor Relief Act of 1838, the portion of the House of Industry which had been used solely for the relief of the poor was converted into a workhouse, and became known as the workhouse of North Dublin Union. The medical, surgical and fever hospitals continued to function separately as hospitals, and became known as the House of Industry hospitals.
An Act passed in the year 1856, entitled the Dublin Hospitals Regulation Act, made special provision for these hospitals. The Act vested the lands on which the hospitals were situated in the Commissioners of Public Works in Ireland in trust for and to the use of the hospitals, and it gave the Lord-Lieutenant extensive powers in relation to the hospitals. The Lord-Lieutenant, with the approval of the Treasury Commissioners, was empowered to regulate as he thought fit the number and description of the officers and servants to be kept in the hospitals, and the salaries to be paid to them, and he could from time to time appoint and remove such officers or servants, and upon the occurrence of a vacancy make an appointment or otherwise as he thought fit.
This provision gave the Lord Lieutenant full powers of management over the hospitals, but he was given an additional power—he could, when he deemed it expedient so to do, direct that the management of the hospitals be vested in a board of governors to be partly nominated by him and partly nominated by the subscribers to the hospitals in such proportions as he determined from time to time, and he could from time to time fix the number of members of which the board should consist and the qualifications necessary for the members to be elected by subscribers.
The Act of 1856 also set out the powers in relation to officers and servants of the hospitals which could be exercised by a board of governors if and when appointed, and the extent of the control and supervisory power to be exercised by the Lord Lieutenant and the Treasury Commissioners in regard to officers and servants in the event of the appointment of a board. After the establishment of the Irish Free State, the powers and functions of the Lord Lieutenant under the Act of 1856 were transferred to the Minister for Local Government and Public Health and the powers of the Treasury Commissioners to the Minister for Finance. The first board established in pursuance of the Act of 1856 was constituted in the year 1857. As there were no subscribers to the hospitals, all the members of the board were appointed by the Lord Lieutenant. Subsequently, new boards were appointed at different times by the Lord Lieutenant and by the Minister.
As indicated above, the Lord Lieutenant was empowered to delegate the management of the hospital to a board of governors. He could not delegate any power beyond the power of management. The board were given no power to acquire land; neither was power to acquire land on behalf of the hospitals given to any other authority. The powers of management delegated did not include the power to erect buildings. Even the comparatively minor power to alter and repair the existing buildings was given to the Commissioners of Public Works. It is, therefore, proposed to ask the Legislature to give powers both for the acquisition of land and the erection of the new buildings.
The Bill which is now before the House proposes to empower the Minister to acquire land for the purposes of the hospital. He may acquire the land either by agreement or compulsorily, and for the purposes of compulsory acquisition the provisions of the Acquisition of Land (Assessment of Compensation) Act and of the Land Clauses Acts may be applied. The Minister may, before making an Order for the compulsory acquisition of land, hold a public inquiry at which any person interested may appear personally, or by counsel or solicitor, and adduce evidence. All land so acquired by the Minister shall be held by him in trust for or to the use of the hospital.
The Bill provides that the hospital to take the place of the existing hospitals shall be known as St. Laurence's Hospital. A new board, to be known as the Board of Governors of St. Laurence's Hospital, is to be constituted. The personnel of the existing board will become the new board. The Minister is given power to alter the constitution of the board, and to make appointments to casual vacancies on the board. The Bill contains the usual provisions in relation to the meetings and proceedings of the board. The appointment and removal of officers and servants, and the salaries to be paid to them are matters to be dealt with by the board, subject to the consent of the Minister, and the Bill contains a new provision which enables the Minister to delegate to the board full power to appoint, remove, abolish and fix remuneration in relation to any office. The board of governors are required by the Bill to prepare and submit to the Minister for confirmation a pension scheme for providing pensions and gratuities for or in respect of paid officers and servants of the board.
When the Minister has acquired the necessary land, the board must, with all convenient speed, prepare and submit to him a scheme for the erection and equipment of the hospital. The Minister may approve of the scheme without modification, or may modify it whether by addition, omission or variation, or he may require the board to submit a new scheme. After the scheme has been approved by the Minister, the board shall proceed to erect and equip the hospital. The unexpended balance of any moneys received by the existing board of governors under the Public Charitable Hospitals Acts, 1930 to 1932, and any accumulations on such moneys are to be applied by the new board towards the cost of preparing the scheme and erecting and equipping the new hospital. The Minister is required to pay the balance of the cost out of the Hospitals Trust Fund so far as in his opinion such cost has been reasonably incurred. The board of governors are given power, with the consent of the Minister, to extend, alter, enlarge or otherwise improve the hospital. The board are empowered to control and manage the hospital, and for that purpose to do all such things as the governing body of a hospital are usually authorised to do in relation to a hospital controlled by such governing body. Other powers given to the board of governors include power to invest funds in trustee securities, to accept real or personal property as endowment, to hold land and to borrow by means of bank overdraft or otherwise.
The property, debts and liabilities of the existing board of governors are transferred by the Bill to the new board. The officers and servants are also transferred. The Bill provides for the preservation of their status and remuneration. The lands upon which the existing hospitals are built are transferred to the Minister, and he may sell or dispose of the lands or any part of them. The moneys received by the Minister from the disposal of lands, after payment of the costs and expenses incurred by him in connection with such disposal, are to be paid into the Hospitals Trust Fund.
The transitory provisions of the Bill empower the Minister, when the new hospital has been erected and equipped and is ready for the reception of patients, to arrange for the closing of the existing hospitals in parts from time to time as he sees fit. It is not expected that it will be possible to close the existing hospitals entirely when the new hospital is completed. Having regard to the position as regards bed availability in Dublin, it may be necessary to keep portions of the hospitals open for some time. Furthermore, the provisions of the Bill will enable an outpatients' department to be continued on the existing premises so long as it is considered desirable. In regard to the portions of the old hospitals which are retained, the new board are empowered, subject to the provisions of the Bill, to do all such things as the governing body of a hospital are usually authorised to do in relation to their hospital.