I would ask the Seanad to reject these amendments. There is not, in fact, any need for them. The Senator has based them on highly exceptional cases. He has referred not merely to persons who are likely to be in general hospitals for terms of six months and of 12 months but, allowing his imagination to go further into the future, has spoken of persons being there for two years.
These examples have no contact with the generality of cases. Very few people are in hospital nowadays for longer than two or three weeks, and six, seven or eight in the case of major operations, because the whole trend of medical and surgical treatment is to get people out of hospital as quickly as possible. But we are asked to consider these amendments seriously on the basis, as I have said, of these highly improbable examples. I suggest that is not how we should deal with the matter at all. We are not legislating for particular cases but for the general condition. In these circumstances, I think we should have regard to the general condition.
There is one satisfactory feature of the amendment, and that is, that it now appears that Senator O'Donovan is convinced that for a period of six months at least, the county managers will act in a humane and reasonable way towards those who have to avail themselves of Section 15 of the Health Act. That is a very considerable advance on the attitude which the Senator adopted here when the Bill was before the Seanad for Second Reading. It is a pity that, having been converted to this reasonable view of the Bill, he should have attempted to put in amendments in which quite obviously, I think, in view of the tenuous arguments which he had to adduce, he himself does not believe.
My case against the amendments is that there is no need for them. Why should we assume that a person who, even in Senator O'Donovan's view, will act reasonably and humanely for a period of six months will, when the six months have elapsed, change his whole character and disposition, and in the case of a person who is suffering a hardship and disability, will proceed to exact the maximum amount which he may take from a patient if, and only if, the local authority is prepared to disregard the fundamental principle upon which Section 15 is based, that is, that no man will be asked to contribute more towards his treatment and maintenance in a general hospital than he is able to afford?
I do not think there is any reason whatever, anything in our past experience of the administration of the Health Acts, which would support such a suggestion as permeates these amendments. On the contrary, I think everybody will admit that the county managers in whose hands the immediate administration of the Act will be, and the members of the local authority to whom they are responsible and by whom they are surrounded, would not for a moment permit a person to act in the inhuman way in which Senator O'Donovan suggests they would act.
I have said there is no need for the amendments. In all cases, when fixing the contribution required from the patient, the local authority takes into account, and, in my view, must necessarily take into account, the duration of the illness and take that factor into account with a view to mitigating the hardship arising out of the illness. Senator O'Donovan suggests that local authorities will disregard that and will act in a contrary and perverse way, and, instead of mitigating the burden, will propose to increase it. It is more than probable — I think it is almost a certainty — that in over 99 per cent. of Section 15 cases, this amendment would not effect anything.
Whether the amendment is justified or not, it would be futile for the purpose for which Senator O'Donovan professes to have put it down because, as I have already pointed out, the vast majority of patients do not remain in general hospitals for six months. The bed occupancy in most of our hospitals is very much less than that period and, therefore, as I have said, over 99 per cent. of the patients would not be affected in any way by this amendment. I am not saying for a moment that the remaining 1 per cent., or that the whole of the remaining 1 per cent. would be, in any way, benefited by the amendment. I want to make that point quite clear. I am saying that 99 per cent. of the cases will not come within the scope of the amendment at all, and that, of the remaining 1 per cent., I am perfectly certain that it would be an exceedingly minute fraction whom the amendment would touch in any way.
What we have to concern ourselves about is whether, in respect of that minute fraction, we will be justified in limiting — for that is what the amendment seeks to do — the right of the authority to charge more than 6/- a week, to ask for a contribution of up to 10/- a week, if, in the opinion of the local authority, the means of the patient justify it. That is the net principle that is involved here. If the means of the patient do not justify a contribution of 10/-, the patient will not be asked to contribute 10/-. What Senator O'Donovan wishes the Oireachtas to prescribe is that even if the means of the patient would justify the local authority asking for the full contribution of 10/- per day, the local authority may not do that.
It could happen by reason of the provisions of Section 15 that a single, unmarried person, without dependents of any sort, could have a continuing assured income of £599 19s. 11¾d. He could have a continuing income just touching on the £600 limit, with no financial fears as to the future. Yet, if we accepted Senator O'Donovan's amendment, the local authority would not be entitled to ask this person, with an income of all but £600 a year, to contribute more than 6/- or, as he put it himself, more than two guineas a week towards his maintenance and treatment in hospital.
Even if he were outside the hospital and living with his family, it would cost more than two guineas a week to maintain him. If he were living in a normal way, it would cost considerably more than two guineas to maintain him. But Senator O'Donovan says that merely because this man is taking advantage of the public services which are provided to assist him through illness, we are not to be entitled to charge him more than two guineas a week, notwithstanding the fact that he will have a surplus of almost £500 a year after that to spend.
I think that is absurd. It is not reasonable to ask anyone in this community to contribute towards the support of such a person. It is not reasonable to ask anyone in this community to contribute anything towards the treatment in hospital of a person who can afford to contribute 10/- a day. That is the net principle. No matter how long he is in hospital, whether for six months, 12 months or two years, if the person can contribute without undue hardship or serious inconvenience up to 10/- a day, then I think, in justice to the community as a whole and in justice indeed to the least well circumstanced of the community, we are not entitled, as Senator O'Donovan asked us to do, to deprive the local authority of the right and power to ask him to contribute up to 10/-.
There is another aspect of this into which we should look. It shows the folly of drafting these catch-penny political amendments. The implication which may be read into these amendments is serious. It is that, in the opinion of the Oireachtas, the local authority should aim at getting 10/- a day, unless the patient is in hospital for more than six weeks; and only if and when he is in hospital for more than six weeks is the target to be lowered to 6/- a day. Indeed, that is what most people would read out of these amendments — that we regarded the 10/- as reasonable in all cases for the first six months and that at the end of that period, the local authority might be justified in reducing its target to 6/-.
I think, having regard to the situation in the country, it is much better to leave the sub-section as it stands and to emphasise that, while it will be permissible for the local authority in appropriate cases to charge up to 10/- a day, nevertheless, they are expected to continue as they have been doing in the past and to exercise their power in this matter humanely and reasonably. I submit, therefore, that in these circumstances the Seanad ought to reject the amendment.