I move:—
To delete sub-section (8).
It will be within the memory of Senators who were here on the last occasion the Seanad met that the Parliamentary Secretary in charge of the Bill invited Senators to do what they could to make it a better Bill. Senators may remember that Senator Mrs. Concannon when she spoke later referred to that as a very gracious invitation from the Parliamentary Secretary. In my innocence, I thought it was intended seriously and I did my best, and according to my duty as a Senator, to point out that there were certain flaws in the Bill, making certain special reference to those covered by my amendment. I found I was gravely mistaken in believing that the invitation was seriously meant and I was met by a torrent of abuse, personal and otherwise, thrown at me by the Parliamentary Secretary when he got up to reply on the Second Reading. His speech must have struck Senators as being rather unlike, in its nature and tone, the speeches we are accustomed to hear from Ministers who do us the honour to visit us in the Seanad.
Time after time the Parliamentary Secretary in his speech made misrepresentations of what I had urged, and misstatements of what I had said, and deduced the most impossible conclusions from what I had urged. I am convinced that I was urging an important point for the improvement of the Bill and I hoped that it would have impressed the Parliamentary Secretary. I found that he did not intend to be impressed and, instead of welcoming my suggestions, he relied in a manner that was almost offensive. It is necessary to draw the attention of Senators present to this section and to show how it produces a grave change in the nature of the Bill.
When the midwifery legislation under which we have largely lived for the last quarter of a century was first passed it was provided that the best available means of advice on a parturient woman should be obtained by the authority of the Act and it was provided that a midwife was bound, as part of her statutory duty, when she met an emergency in the course of her practice to issue a requisition to a medical practitioner to come to her assistance. That has been the law of the land for the last 26 years, since 1918. The amount of the fee was fixed, I think, by the Minister and if the friends or relatives of the patient were able to pay it, they had to pay it. If they were not able to pay it, the local authority was to pay it. It was a sign of a great humanity in our poor law code, that the midwife, in a difficulty, was commanded by law to obtain a medical officer for her assistance. It must have been presumed that she would obtain what was in her opinion the best medical officer for the purpose and his fee was secured either from the patient's friends or from the local authority.
The present Bill intends to repeal, I think, the whole of the old Act and then a great deal of it is re-enacted, but the particular clause which made that special provision for the case of dangerous illness at the time of confinement is repealed, or practically repealed, because this clause, which I ask the Seanad to-day to delete, leaves it to the Minister to require, if he thinks fit, a midwife of a dispensary district when calling in to her assistance under this section a registered medical practitioner, to call in the medical officer of the district, if he is available.
The Parliamentary Secretary has not explained what is meant by his being available. One can quite understand that it is a matter difficult to define and, I think, impossible to define in an Act of Parliament, but it should be borne in mind that an emergency during the conduct of a midwifery case is often a matter of great urgency and the availability which might be normal enough in the case of ordinary illness would be no use in a case of sudden, rapid and severe illness, causing emergencies that not infrequently occur during the conduct of a midwifery case. Time may be lost in discovering whether the dispensary doctor is available, because not all dispensary doctors are furnished with a telephone, either at their own expense or at the expense of the public authority. There might be very considerable delay in getting the dispensary doctor, or in knowing whether he was available or not. I think it is an unfair responsibility to put on the midwife that she is to get the dispensary doctor, if he is available, and to put on her the decision as to whether he is available or not and the difficulty of making sure of getting him.
The Parliamentary Secretary, when we were discussing this section on the last occasion, drew my attention to a fact with which I have been familiar probably as long as or longer than he: that a dispensary doctor in an emergency, if he feels in any difficulty, has the power of calling another doctor to his assistance. That is a great safeguard. But we are talking about urgent cases, and this scouring around the country to get another dispensary doctor or another doctor to come to his assistance might mean the death of the unfortunate patient.
My whole anxiety in proposing this amendment and discussing it a fortnight ago is to ensure as far as possible the safety of the lives of parturient women who are in the care of certified midwives in the country. The Parliamentary Secretary appeared to be very angry with me the other night —at least, he spoke to me in a very scolding tone—when I drew his attention to the fact that the existing Act was an Act passed by the English Legislature 26 years ago, and when I pointed out that, as in many other matters of poor law service, the service in Great Britain has been both more efficient and more humane than it has been up to the present in this country.
Of course, the Parliamentary Secretary is quite free to tell me that it is being improved and will be improved in the future in the country, but it was one of the brightest spots in our poor law service in this country that in the case of the woman in her confinement, when her life is in danger, the very best arrangement was made by the Legislature to give her whatever assistance could possibly save her life. It is not a pleasant thing for any of us here to think that the most essential —perhaps I am wrong in saying "most essential"; at any rate, the Parliamentary Secretary will think I am wrong—but an essential change which comes in this Bill that is before an Irish Legislature gives a less favourable opportunity to the parturient woman to come safely through her hour of danger than a foreign Legislature thought fit to give 26 years ago.
The Parliamentary Secretary on the last occasion stressed very much that I asked for the introduction—I think he said "intrusion"—into the Bill of a condition which would lead to a great deal of friction between the dispensary doctors and their midwives, and he said that the dispensary midwife is a subordinate officer of the dispensary doctor—of course, naturally— and that, if she calls somebody other than the dispensary doctor to her assistance in case of difficulty, she is holding the dispensary doctor up to contempt in the neighbourhood where he is making his livelihood, probably as a private practitioner. He drew a very alarming picture, to those who did not know the facts of the last quarter of a century, of the terrible turmoil, dissension, disturbance and friction that would take place in a dispensary district. Apparently that consideration had intimidated the Parliamentary Secretary from attempting it. He did not pay any attention to the fact that the condition I want in the Bill is simply a continuation of an old condition that existed for 26 years without, as far as we know, any of this friction, disturbance or upset of a whole dispensary district of which the Parliamentary Secretary made such a case a fortnight ago. No doubt, friction occurs between dispensary doctors and midwives from time to time, but friction occurs in the best regulated places from time to time. To suggest, as he did on the last occasion, that the dispensary doctor is spending his life looking for a snub from the dispensary midwife and carrying on perpetual friction if she does not treat him with the utmost subordination, seems to me to be straining his argument very far and to be making suggestions which we cannot really take seriously.
The Parliamentary Secretary on the last occasion we were discussing this stated that I suggested various things or had asked the House to do various things which had never occurred to me and which I did not ask the House to do at all. The Parliamentary Secretary said of me:
"But he did convey the impression to the House that, if she (the midwife) called in any doctor she liked, she could secure a fee for him, even although the case was a medical charities case. That is not so."
I never suggested that. I knew perfectly well the regulations that govern the practice of midwives and I never suggested such a thing. If the Parliamentary Secretary believes that I tried to mislead the House, whether wittingly or unwittingly, I may say that I certainly did not try to mislead it on that point because I have been familiar with the practice for the past 26 years, at any rate. The Parliamentary Secretary also said:
"The impression was created that that service was available for the medical charities cases".
I do not know who created that impression. I was very familiar with the position and I knew that it was not so available. The Parliamentary Secretary sums up his objection to returning to the older method, which was the law of the country for a long time, in these words:
"What does Senator Rowlette ask us to do? Senator Rowlette asked us to incorporate in this Bill a clause under which that midwife will be able to go over the head of her superior officer, call in another doctor, and hold him up to the ridicule of the district as not being a fit and proper person, as not being the best man to call in in an emergency—that in fact, it is not safe to call him in at all."
Does the Parliamentary Secretary seriously suggest to this House that that has been the position for the past 26 years? If that sort of thing had happened, there would have been scandals long ago. The Parliamentary Secretary asks what I am suggesting. I am suggesting that the law on this point should remain as it has been for the past quarter of a century. I suggest that we should not take advantage of this machinery Bill, as it was correctly described by the Parliamentary Secretary, to effect a change in the law which would give the poor women of the country less efficient treatment than they have had. The Parliamentary Secretary suggests that, if the law as it has been for 26 years still remains, it will destroy the authority of the Minister. Nothing in this Bill deprives the Minister of any statutory power which he has under the Public Assistance Act, 1939. He did not explain to us how the Public Assistance Act, 1939, overrides the provisions of the Midwifery Act or whether it does that specifically. I am not an authority on legislative matters but I think it would be unusual for one Act to override another Act without making specific reference to it. I may be wrong in that. If the Parliamentary Secretary tells us that it is common custom to alter the effect of one Act by another Act without specific reference to it, I shall submit to his opinion but I should like to know the opinion of other Senators on that very radical proposition.
In his speech on the last occasion, the Parliamentary Secretary thought proper to suggest that I was proposing an amendment which was a slight on the dispensary doctors of the country. He said: "I am rather surprised that Senator Rowlette should have adopted the attitude towards this particular section that he has adopted." The object of that remark was clearly to convey that I had made an attack on the competence of the dispensary doctors. I did nothing of the sort. I have known the dispensary doctors intimately for the past 50 years, and I have no reason to think otherwise than highly of their competence, but I do not think that the dispensary doctor of a country district is necessarily the best authority that can be got to save a poor woman's life. My own object in putting this amendment before the House is to give better security, better care and better attendance to these poor women in the most important and most dangerous hours of their lives. I leave the amendment with the House.
