May I suggest that amendments Nos. 1 and 4 be discussed together?
Health (Homes for Incapacitated Persons) Bill, 1963—Report and Final Stages.
Government amendment No. 1:
In page 3, between lines 26 and 27, to insert the following paragraph:
"(g) prescribe requirements as to the description of homes in written communications and the display in homes of notices specified in the regulations."
When the Bill was in Committee, I said during discussion on Senator Stanford's amendment that, without committing myself in any way to accepting the amendment, I would consider how far I could go to meet his point of view. This amendment represents the extent to which I have found myself able to do so. The purpose of it is to enable the Minister to prescribe that notification will be given in a specified form to those who may wish to avail of the services of a home that the local authority concerned have been notified of the existence of such a home.
I have not, at the moment, formulated the exact terms of the regulations to this effect which I propose to make, but I can say that the amendment will at least ensure that those who entrust friends or relatives to the care of a person will know that the local authority concerned have had notification of the existence of the premises in which such person is maintained and that, if necessary, they may call the attention of the local authority to any complaint they may have in relation to the home.
If I may speak on this point for a moment, we understood earlier on that in Section 2 "may" had the effect of "shall". I think the point raised in the amendment in Senator Stanford's name and in mine has been met by what the Minister has said and by the amendment he has put down. If I understood the Minister correctly, he will, in effect, produce such regulations as will in due course make the point effective.
Yes, but I should like it to be quite clear that the regulations will not be in anything like the form which the Senator's amendment suggested. It will, however, have the effect that the name of the proprietor of the home will be carried on the notepaper and that all stationery issuing from the home will also carry a statement that this home has been brought to the notice of the health authority under the Act. It will also bear particulars of the name of the person to whom further communications in relation to the home should be addressed.
One point of importance is that there is some certificate or some statement available in the home itself so that a person going into the home is able to see, apart from the notepaper, that the home has been approved.
The regulation will provide that there will be displayed in a prominent place a notice stating that the health authority has been notified of the existence of the home in question.
I can see no relationship between amendment No. 1 and amendment No. 4. The former, as I see it, gives the Minister power to prescribe requirements as to the description of homes in written communications and the display in homes of notices specified in the regulations. That is perfectly all right. It means that if a person running one of these homes has letter headings or billheads, the Minister can prescribe what will go on these. I am not suggesting that the Minister should accept amendment No. 4 but to say that amendment No. 1 meets amendment No. 4 is, I think, entirely incorrect.
I did not say that. I said it represented as far as I could go——
I thought Senator Ross had stated that amendment No. 1 was meeting the case of amendment No. 4. Amendment No. 4, as I see it, seeks to insist that each home be inspected after notification has been given to the health authority and that a certificate be issued by the health authority saying it has been inspected and is satisfactory. In effect, that, in my opinion, is registration. I am only making the point to clarify the two amendments as they appear to me. I am not to be taken as supporting amendment No. 4 because I made my position perfectly clear on that matter on Committee Stage.
I am personally grateful to the Minister for going so far. What it amounts to—and I should like to assure the House on this—is that we shall have a certificate displayed in a prominent place in these homes. If we get that, it is quite a considerable step forward. What we shall not get, I take it, is the inspection. I should like to get that inspection; we are not going to get it and so I think the best thing to do is to express our limited but sincere gratitude to the Minister in this case.
How is the Minister to give a certificate if he does not have an inspection?
I want to correct that point if I may. There will not be a certificate in the sense in which the Senator has used the word. What will happen is that a person running a home will be obliged to display on the notepaper a statement that the health authority has been notified of its existence. I may go further and require the proprietor to state that any complaint to be made in regard to the premises should be addressed to the health authority. That will make every person concerned aware that there is an authority which can investigate complaints about conditions in the home. If necessary, arising out of a complaint, a health authority, having received a reasonable complaint, can have the home inspected but I am not conceding the point that the home must be inspected before a complaint concerning it has been made, or that there will be a certificate to the effect that it has been inspected displayed anywhere.
Amendment agreed to.
May we take amendments Nos. 2 and 3 together?
Government amendment No. 2:
In page 3, between lines 26 and 27, to insert the following paragraph:
"(g) provide for the conduct of interviews (including interviews in private) of persons (including staff) in a home where the health authority have reasonable cause to believe that a person in the home is not receiving proper care,".
This amendment is the best I can do to meet the point of view which has been put forward in amendment No. 3. I think that is as far as any person can go. It must be a reasonable complaint and a prima facie case must be made and established by some responsible person. If that is the case, then the inspector investigating the complaint and inspecting the home may interview in private not merely a patient but a member of the staff, if he feels it necessary to do so.
Did the Minister say "the inspector inspecting the homes"?
The person who follows up the complaint. If a complaint is made, the home has to be inspected but the inspection will follow the complaint; it will not precede it.
Might I ask who would make the complaint in the case of a person who had no relatives?
I do not know— some person, any person, a kind person, a person concerned with the condition of a particular patient. It might, perhaps, even be made by letter.
If the patient were put in a home perhaps by an institution in England? I think there is an association, referred to in the letters the Minister sent, through which—if I understand it correctly—relatives of service people are put in homes when they are ill or aged. How would that person convey a complaint if he or she were unable to write?
I do not know. I cannot answer that nor do I think anybody could answer it. It would depend upon the circumstances and the person's ability to deal with the situation.
I may be wrong but I had thought that the Minister for Health was there to help the least of our people in cases of this kind.
This is an honest and sincere attempt to meet a point of view which I thought was sincerely held but I shall not press the amendment if the Senator is not satisfied with it.
I came in to thank the Minister most graciously for this amendment but when I heard on a previous amendment that there is no inspection, I am a little unsure if this amendment is workable. At first glance, it appears to be practically what I want but a lone person in a home has no contact with the outside world. I am not being awkward: I am sincerely trying to help a person such as myself, say, if I had no relatives and if I were being badly treated or not treated at all in a home of this kind into which some organisation, to which some of my relatives have contributed before they disappeared, had enabled me to go. What is my contact with the outside world?
If I may interrupt—I think the Senator mentioned an organisation which was responsible for sending patients to homes here. As far as I am aware, that organisation has a representative who regularly visits any home to which the annuitants of the organisation are sent for treatment and any complaint that should be made could be made to that representative.
Thank you very much. I am glad to know that; I did not know. It still leaves a little doubt in my mind. Again to refer to myself, I do not belong to any organisation. I do not see anybody paying for me. I could see myself being in such a situation and I feel that I would be very lost. I am sorry that on looking it over again, I do not think I would care to be responsible for accepting the Minister's amendment, although, as I have said, at first sight I did think it gave me what I wanted. When the Minister says that there is no inspection at official level, I am extremely doubtful of its value.
I think Senator Miss Davidson has put her finger on the point when she asks as to who would make a complaint, who would establish that there were reasonable grounds for complaint in respect of an old person who had no relatives, no visitors, nobody to look after him and who is put away in a home like this.
We might remind ourselves that what the Seanad is dealing with is a complaint that some homes—a very small minority—operating for old people are not up to a proper standard. It is that sort of home that we have been pressing the Minister to deal with. The ultimate result of this Bill appears to me to be that the homes which are good will continue to be good but that there is nobody to make the complaint, nobody who will inspect, nobody who will put pressure on the small number—I hope it is a small number—of places where the standard is not good, where proper attention is not paid to people and where people have been left who have no relatives or who have relatives who do not accept responsibility or have not a great deal of care for them.
I am very unhappy about the small degree the Minister has come to meet us in this respect. He has given an explanation for the other amendment to which we have just agreed. Taking these two together as they appear on the paper, they seemed to amount to more than the Minister now indicates they will amount to in actual fact. I thought in relation to the first amendment that there would be a certificate or some sort of indication in the hall of such a home that the home had complied with standards, that it had been inspected by the authority and was up to the standard required by the local authority. The Minister has indicated that that is not his intention, that he will not make regulations along these lines.
In this amendment we are told that reasonable grounds for a complaint have to be established and Senator Miss Davidson rightly asks who will move in respect of an old person who has no relatives or who has relatives who are not bothering about him or visiting him. It is quite right that we should expect the Minister to have regard to those helpless individuals, even though they may be few in number. I do not think that under this Bill or the regulations the Minister will make under this Bill, he will go to the extent that is necessary in order to provide for those people.
I shall be returning to the point on the next amendment, No. 5, which, to my mind, is a much more satisfactory way of dealing with the matter.
We are on Report and I have been rather disorderly in rising on two or three occasions. If I am to rise now, I should like to rise to conclude.
Yes, the Minister to conclude. The House understands that amendment No. 3 is also under discussion—amendments Nos. 2 and 3?
No.
I asked the House if amendments Nos. 2 and 3 would be taken together.
I should like to press the point that Senator Murphy and Senator Miss Davidson are absolutely right about this. The fundamental weakness in the Bill is this lack of inspection and we must press it as far as we can at this stage. The case has been made of a helpless person without anyone to complain for him. These are the very cases this House should keep very strongly in mind and I agree with Senator Murphy and Senator Miss Davidson that this amendment does not go far enough.
If I am in order, I should like to say that I understood the Minister to suggest that he might not press this amendment. If by that he means that he is contemplating withdrawing the amendment, I think it would be a mistake because the amendment as it stands is, in my opinion, an improvement on the Bill and the Bill would be better with this amendment than without any amendment.
As I understand it, an inspection will take place only when the health authority has reason to believe that there is necessity to check up on a particular institution. The inspecting authority is the local health authority. On the local health authority there are public representatives and I assume that if a complaint of a general nature were made by a public representative or by any other responsible person to the health authority, the institution concerned would then be inspected. Under the Bill as it stands, the inspecting officer might not have authority to interview an inmate of the institution alone or to interview a member of the staff of the institution alone and in private. The amendment as it stands will give such authority to an inspecting officer in case of an inspection. That in itself is an improvement and a valuable addition to the Bill.
It seems to me a good deal of stress has been laid on what may happen in very rare cases. A previous speaker has said that the number of homes that would be guilty of ill-treating old persons is very small, and we all believe that. The number of persons who would have no relatives, no organisation or nobody to look after them from the time of their admission to the home would be very small.
The Bill will provide that homes may be inspected if a complaint is made. Complaints may be made by the staff of such homes. It is not possible to close the mouths of everybody. If a person is ill-treated in an institution, that cannot continue for very long. There are public representatives on the local health authority. There are various social bodies interesting themselves in the welfare of lonely and elderly people. Such persons would always be able to investigate complaints. It would be a pity at this stage to over-emphasise rare cases. I should not like to trammel the 95 per cent or 98 per cent of homes which are doing excellent work by making them liable to inspection by local authorities and others and thereby hinder the work they are doing. It would be a reflection on them. Inspection would not solve the problem.
Could we have clarification on a point of order? If this amendment is passed now, does the second amendment automatically fall? Is that the situation?
I have asked the House to take amendments Nos. 2 and 3 together because if No. 2 is accepted, then No. 3, naturally, will be withdrawn or falls. There is the implication.
"Naturally withdrawn?"
My understanding is that if No. 2 is accepted, it meets the point of No. 3. That is the reason.
Senators
No.
On the other hand, I think it is the opinion of the House that if we cannot get No. 3 we should like No. 2.
That is the point I was trying to make.
I do not agree that amendment No. 2 in any way meets what we asked for in amendment No. 3 because, on the point made by Senator Fitzpatrick——
I would remind the Senator that only one speech may be made.
These are two entirely distinct and separate amendments. I am not at all satisfied that No. 2 meets the point made in No. 3. I was not under the impression that we were taking these two amendments together. I would be quite prepared to facilitate the Minister and to approve the passage of amendment No. 2, provided amendment No. 3 is taken on its merits as it appears on the Order Paper.
Apparently some magic is thought by some Senators to reside in the word "inspect". This amendment No. 2 is being rejected because it does not provide for inspection. Inspection in what circumstances? In the circumstances in which an irresponsible person may make any allegation about a home and then the whole machinery of the local administration is to be brought to bear upon the unfortunate individual who owns the home and operates it.
Why does the Minister——
I listened to the Senator with great respect and now I should like him to try to listen to me. The one thing I have found in connection with this problem of premises in which the elderly and infirm are cared for is that I have heard many general allegations concerning the conduct of these homes and I have challenged from time to time those who have made these allegations to prove that there is some substance in them. Some couple of years or more ago, perhaps. Senator Miss Davidson brought to my notice three homes. It was found by my officers that there was no substance in the complaints when they brought in the people who made them. First, they found that some of these homes were approved premises under the Maternity Homes Act.
Therefore, Senator Miss Davidson is irresponsible?
I do not think she is irresponsible but I think she is too credulous.
I mentioned no homes to the Minister.
I see.
The Minister must be allowed to speak without interruption.
I am sorry if I have misrepresented Senator Miss Davidson in the matter. I am speaking from a hazy recollection of some correspondence with her some time ago. If she says she did not mention any homes to me then I am completely in error.
On the last occasion the Bill was discussed here, a letter was read out making allegations against certain homes. I did not follow those up; I did not have any inspection of the homes carried out. I thought that if this Bill went through, then, if abuses such as were alleged to exist, did in fact exist, a responsible organisation would take care to bring the premises in question under the notice of the health authority, and so I did nothing about the letter. But the fact that the names of their nursing homes had been mentioned in this House in connection with this Bill came I think to the notice of two people and they wrote to me. I have sent a copy of the correspondence in that matter to Senator Crowley.
I would read, for the information of the House, what was written to me by the two persons whose homes were mentioned in the course of the debate. Here is one which was addressed to the Secretary of the Department of Health:
4 Willow Bank,
Dún Laoghaire,
Co. Dublin.
11 January, 1964.
To
The Secretary,
Dept. of Health.
Dear Sir,
It was with shock and dismay that I read in the Senate Debate of December 11th, 1963, that this premises (a Home for retired people) was submitted by Senator Crowley to Mr. MacEntee, Minister of Health, in a letter dated August 1st, 1962, from the Irish Nurses Organisation, to be a Home that was unsatisfactory and in need of investigation and without night attention.
I cannot think of who the person or persons might be that made these grave allegations to the Irish Nurses Organisation and why the said Organisation made no attempt to investigate them before submitting such reports to any member of Seanad Éireann. I hope that these references to my home may not have any effect on my livelihood.
In 1943, I qualified at the Mater Hospital, Dublin, and subsequently held many responsible posts, including a permanent position at St. Kevin's Hospital.
On a point of order, is this relevant to this particular amendment?
It is most relevant.
It is in reply to certain statements that have been made. The Minister is in order in dealing with the matter.
The writer of the letter continued:
After my husband suffered a severe financial crash in business in 1957 I was compelled to take in retired people. Having worked very hard I established an excellent business, and from any source of income continued to improve my property with the building of an additional bedroom, wash-up and toilet on hall floor. Later I had central oil fired heating installed throughout the Home.
Finding some of my residents more helpless and in need of round the clock supervision, from August, 1961 I have had constant night attention. In addition, at all times I was in residence; if on holiday, a qualified Nurse was available. Prior to August, 1961, in the event of night duty being necessary, it was available, at no time did any of those placed under my jurisdiction be neglected. I realised my first duty was to them, to their next of kin and to God.
My staff and I are thoroughly devoted to the care of the aged and infirm. The premises are kept clean and at all times open to inspection. Meals are served punctually and the menu is varied. Evidence of the high esteem of which this accommodation is regarded is available to the Minister in the enclosed letters. I also enclose a list of Doctors who are in attendance here and can furnish the Minister with further reference if required. The Sisters of St. Michael's Hospital have visited here, various representatives of the Royal United Kingdom Beneficent Association, London, Drs. Fitzgerald and McCracken from the Award of Courts and finally an inspector of the Adoption Board.
It would give me great pleasure to welcome a visit from the Minister or an official of his Department. Then I could prove to the Irish Nurses Organisation that their allegations were false and without foundation.
I was deeply moved by the consideration given to me by you on the telephone and now I await a favourable reply from the Minister.
Yours respectfully,
Bridget Royce.
Attached to that letter are letters from the Royal United Kingdom Beneficent Association, in the course of which this Home is referred to in the very highest terms. I have also a very large collection of names of people who have been in that Home. I have a similar letter from another one of the homes which was mentioned and which I think I should also read since a great deal of harm may have been caused to the persons concerned. I am sorry I cannot put my hand on it at the moment.
May I give the Minister a copy?
I am sorry; I have it here. It was not a laughing matter for the people whose good reputation was affected by what transpired here. It was no laughing matter.
They smiled on the Minister's side also. Do not get cross. The political correspondent of the Irish Times put the Minister in his place recently when he had to apologise to him.
Am I entitled to rebut the allegations made by Senator L'Estrange which are completely irresponsible?
The Senator will allow the Minister to continue.
Let the Minister attack others as well as me.
The Senator will allow the Minister to continue.
This letter is addressed to the Secretary of the Department of Health. The address is St. Jude's, 18 Clarinda Park East, Dún Laoghaire, 10th January, 1963, and reads as follows:
Dear Sir,
I am writing on behalf of my partner (Mary I. Long) and myself, who are both deeply shocked and distressed on reading in the Seanad Report (Wed. 11th Dec.) a letter from the Private Nurses' Section of the Organisation (Date 1st August, 1962) addressed to Mr. Crowley— referring amongst others to our Home St. Jude's, 18 Clarinda Park East, Dun Laoghaire.
These allegations are completely unfounded. We are both trained State Registered Nurses and have a very wide and varied experience in all branches of nursing, especially with old people.
Our Home at all times has been well run, respectable, and never left without one or other on duty (day and night).
Our Home is well equipped, H & C. each room. Electric bells. Carpets. Everything for the care of the aged.
A resident maid. Daily woman. We never pretended to be a Nursing Home, mostly paying guests are our main source. We have had old people, who became ill and in failing health.
We immediately had night attention provided, or on Doctor's orders, removed to hospital.
We have been established here for the past 15 years; returning from England after years of nursing and war service. For reference I quote—
then follow the names of several doctors——
who have supported us for the past 15 years and you can refer to them for reference. May I add our premises are open to inspection at any time. We gladly invite you to inspect. We would also like proof and names of informant.
I am grateful to you, Sir, for permitting me to refer to these letters because, since the complaint is on the records of this House, the refutation of the complaint in the cases of these two homes should also be on the records.
I want to go further. I want to draw the moral from that. I have on several occasions challenged those who made the allegation that there are homes in which the inmates are treated inhumanely. I have said that no person has ever brought an allegation of that sort which, on investigation, could be substantiated. I do not think we are warranted in instituting a system of inspection in the case of any premises, any home, or any undertaking unless the facts will justify giving authority to a servant of the State or the local authority to enter into what are private premises and to inspect and investigate them and to contact and interrogate the people who happen to reside on these premises. It seems to me at any rate that there would be the possibility that the rights of private individuals would be very gravely infringed by that sort of procedure. Therefore, until I am satisfied that a case has been established for the inspection of places of this sort I am not going to accept the principle that a nursing home can be inspected in the way suggested here that it should be, without any facts being given, any well-founded facts which would justify such an inspection.
For that reason I have said here that I will oppose inspection and oppose registration until at least we have seen how this Bill works out. I have said the measure may not be the last word—it may be the last word but it does not inevitably follow that it is. If, as a result of its operation, it is found that we must go further, then some other Minister for Health will go further. At the moment I am not prepared to do it. That is why I have strenuously opposed the idea that we must inspect and register these homes because if we do it in the case of these homes where are we going to stop? Are we going to go into the reputable private hospitals in this city and inspect them and call to account those responsible for the treatment of this, that, or the other person, or are we going to call to account the doctors who patronise these homes? It is all very well to talk about inspection but we must bear in mind the consequences that will flow from these inspections and you cannot treat the premises to which this Bill relates and those who operate them as conforming less to the general standards of humanity and decency than any other similar institution might. Therefore, I oppose these amendments.
Let us take these two amendments. Senator Stanford and Senator Murphy both suggested there were grave differences between the purport of both amendments. It seemed to them that there was some vital principle embodied in amendment No. 3 which was absent from amendment No. 2. What does amendment No. 3 say? We will take it first. It says that a person authorised by regulations may visit and interview in private any person in the home. That is the first thing that amendment No. 3 proposes. What does amendment No. 2 propose? This amendment which according to the Senators differs so radically from amendment No. 3 says the Minister may make regulations to provide for the conduct of interviews (including interviews in private) of persons, includng staff, in a home. But the Minister can only make regulations for this interview and this visit where the health authority have reasonable cause to believe that a person in the home is not receiving proper care.
I am sure that no Senator will say that this whole process of inquisition and interrogation should be undertaken in a case where the health authority is not satisfied that there was reasonable cause to undertake it. Yet that is what is implied by those who have been supporting this amendment. The amendment seems to take the view that whether there is cause or not for seeking inspection the inspector can, on his own volition, interview in private any inmate of the home or any member of the staff. I contend that this would be a serious infringement of the liberty of the citizen.
What is the other part? Part (b) of amendment No. 3 provides that this authorised person may visit the premises in any case where the person so authorised has reasonable cause to believe that a person in the home is not receiving proper care. What can be the difference in practice between empowering an individual who, having been authorised by a local authority, has reasonable cause to believe something and empowering the health authority itself when it has reasonable cause to believe? The expression "health authority" in this case connotes the officers of the health authority and any member of the health authority who makes a complaint to the manager will, of course, be regarded as a responsible person. I was asked who will make the complaint and I answered quite frankly that I did not know. Certainly I do not know who will make the complaint in the case of a person who is friendless and without relatives, but is a person who is friendless and without relatives likely to be in a home where she or he is being maintained for profit? Of course he is not. Someone will have to foot the bill.
They may have money themselves. That is not unknown, is it?
They may have money themselves. One cannot, of course, legislate to cover purely hypothetical conditions ad infinitum. We have to consider the matter as reasonable people living in the world as we know it. A person, of course, may have money of his own. Is it likely he will keep that money in the home? Is it not much more likely he will keep it in the bank? Is the bank manager not likely to have some interest in his client? Perhaps he will have a solicitor. Perhaps he will be a ward of court. One can reduce this measure to an absurdity by providing for every circumstance which may, but is not likely to occur.
What we have to consider is the day-to-day operation of these places. If a person is maintained in a home, which is run for profit, then that person will be paying for maintenance in that home and can legitimately complain. If the person is being paid for, then it is more than probable that those who are paying for that maintenance will make a complaint if that person is not being properly treated. There must be more than one inmate in a home before it can come within the scope of this measure. There may be two, three or four. Will they not all be in the same circumstances? Conditions which apply to one will apply to all and there will, therefore, be several sources from which a complaint can emanate if, by any chance, conditions are not what they ought to be.
Amendment No. 3 provides for an interview in private. Amendment No. 2 provides for the making of regulations which will enable interviews to be held in private. Not merely a patient but any member of the staff may be interviewed in private. It provides that this will take place only in cases in which the health authority has reasonable cause to believe that a person in the home is not receiving proper care. What is the difference? The difference is that my amendment is a much more flexible amendment. Within the limits of the regulations, we will be able to cover every conceivable case which is likely to be met in practice. I defy anybody to go further than that and to write into a statute a definition which will cover every conceivable case and yet be flexible enough to cover all the types of premises to which this Bill may apply. On the other hand, we will be able to amend readily our regulations if it is shown that such amendment is necessary and we can give much more thought to the framing of them than can be given to it here. We can frame the regulations in such a way as to cover every possible contingency.
Senator Desmond rose.
The discussion has now concluded.
The Minister has made a point which was not made by any other speaker and I should like to reply to it.
The Senator can make his submission on the Fifth Stage.
The Chair called on the Minister to conclude. The question is that the amendment be agreed. Should this amendment be defeated, there will naturally be a vote on the second one.
On a point of order, I have certainly no recollection of the Chair ruling that these two amendments should be taken together. Had I heard such a ruling, I should have been on my feet to oppose it.
The Chair asked the House to take the two amendments together, on the understanding that amendment No. 3 was met by amendment No. 2. That was the reason for asking the House to take the two together. No objection was raised and, in accordance with procedure, it was understood that that was accepted.
Amendment put and agreed to.
Amendments Nos. 3 and 4 not moved.
Bill, as amended, received for final consideration.
Question proposed: "That the Bill do now pass."
With regard to inspection, the Minister seemed to be quite convinced that it was not right to have inspection on the lines, he alleged, this side of the House sought to have such inspection. I cannot understand why the Minister was so emphatic in his view on that matter. If someone is running a concern as a business operation, and that concern is run on the right lines, such a person generally welcomes inspection. Certainly such a person would never oppose inspection.
Inspection is not provided for in the Bill. The Senator must confine his remarks to what is in the Bill.
I do not agree with the Minister's point of view that we cannot have inspection of this type of business. Indeed, I am surprised at the Minister's approach. Are we to take it now that a business which is run for profit cannot be inspected because the Minister objects to such inspection?
We have, on this Stage, to deal with what is in the Bill, not what we should like to see in the Bill. Inspection is, in fact, in the Bill, but not compulsory registration. There is provision for inspection before registration. There is provision to enable a local authority to see to it that an establishment is up to the standards prescribed by the Minister. We have heard this afternoon about homes which maintain they are up to a reasonably good standard. I hope it is correct that they are up to a proper standard and that their desire will be to comply with the regulations the Minister will eventually make.
The Minister has, I think, left the House with the impression that anybody who is anxious about the care of elderly people, who has heard complaints, and who voices these complaints, is irresponsible. Miss Davidson has made such a complaint. I think the Minister thinks Miss Davidson irresponsible. However, he backed down a bit and said she was a bit too credulous. No doubt Senator Crowley is also irresponsible. We have heard the replies read from some of the people whose homes were mentioned when we debated the Committee Stage of this Bill. Might I remind the House, as inspection is in the Bill to a limited extent, that Senator Crowley was making the point that without registration, it was clearly impossible for anybody to satisfy himself that these abuses do not exist? He was pressed and urged by the Minister to put on the Table of the House the names of the establishments about which complaints had been made to Senator Crowley. I do not think Senator Crowley did this irresponsibly. I do not think he rushed into speech or print about it. He was urged by the Minister. The Minister was making the point that he had no evidence of these complaints at all, and I think Senator Crowley then grudgingly put this information before the Minister. I am sure Senator Crowley will be equally delighted to know that these establishments are up to standard.
Are we going to have inspection of these establishments? Is the Minister or the local authority going to satisfy themselves that, in fact, these establishments are up to standard? If an organisation like the Irish Nurses Organisation say they have complaints from their members that these establishments are not up to standard—this was mentioned in the House; a reply has been quoted and it is perfectly right that a reply should be read here by the Minister—is the Minister going to accept the invitation of these people, the few who have replied, and satisfy himself that their establishments are up to a reasonable standard?
It does not require and has not required up to now any legislation by the Minister to accept the kind invitation issued by these people to go along himself or send some of his officials to visit these places. I am sorry the Minister has not done so. It would only be correct and just that, after these charges had been made, the Minister could come here this afternoon and say he had accepted this invitation, that he had somebody go out and that he could categorically state to the House that these homes were of a good and reasonable standard. Even now, when the Bill eventually weathers the storm that, I am sure, awaits it in the Dáil, will these homes that have been mentioned be inspected? Can we be assured that anybody making an allegation or a complaint, such as the Irish Nurses Organisation and Senators and Deputies, will not be regarded as irresponsible? Can we be assured that the Minister will urge on the health authorities that these inspections be made, see to it that the terms of this Bill, as it will eventually come from the Dáil, will be applied and that at least the limited number of homes which will be inspected will be up to a reasonable standard?
Senator Murphy has saved me the trouble of commenting at any great length on this Stage, but there is one point on which I should like to be very clear, particularly in view of the correspondence which the Minister has put on the records of the House. Like Senator Murphy, I welcome the spirit of these people who saw fit to write in and put their position in order on this matter. But this must also be said: I am perfectly satisfied that in communicating with me in August, 1962, the Irish Nurses Organisation were not acting in any one of these individual cases mentioned out of any spirit of malevolence or malice of any kind. I am satisfied that an organisation such as this, a well-organised, responsible trade union, representing one of the most important sections in our public service, were but conveying to me obvious complaints which had been lodged with them by some of their members. In communicating that information to me as a public representative, I am satisfied they were not acting out of malice and had no intention of doing more than what was their plain duty. I, in turn, had no other intent when I very reluctantly agreed to have that letter put on the records of the House at the insistence of the Minister and some Senators on the other side of the House.
It was stated on another Stage that the Bill was introduced for the purpose of dealing with possible cases of hardship or neglect in these homes. The Bill is sufficient to do that, for the time being at any rate.
I should like to refer to Sections 1 and 4. Section I defines a "home" and excludes from the definition of a home premises in which no incapacitated person is maintained for private profit. The Minister seems to think that means that if any person pays his way or is paid for in such a home, that home is brought outside that exception. For what my opinion is worth, I disagree with the Minister in that. The Bill applies only to what I will describe, for want of a better term, as commercial homes—homes run for private profit. I think it does not apply at all to what I would call charitable institutions run by communities or other groups of charitable people. Even if a charge is made for the maintenance of people in that home, that is not a charge for private profit. This is a charitable institution, but it has to get money to discharge its charitable obligations. However, I say such a home cannot be said to be maintaining a person for private profit.
Having said that, the case made by the Minister in support of Section 4, particularly subsection (2), falls to the ground. The Minister made the case that it was necessary for him to take power to grant exemption to any home from the provisions of the Bill because a home might not be able to bring itself within the exception mentioned in subsection (1) of Section 1. Section 4 (2) of the Bill as it stands reads as follows:
The Minister may, if he so thinks fit, on the application of any home, grant exemption from the provisions of this Act to that home.
On principle I oppose that provision because it is too wide. It gives the Minister power to nullify the provisions of the Bill by a stroke of his pen.
I think the Senator misunderstood me when he seemed to think that, when I was referring to a home in which an incapacitated person was being kept for private profit, I felt I was covering homes in which people might be maintained for reward, that is to say, that this did not exclude these charitable institutions to which the Senator referred where a person might be maintained for a small sum or a small fee which would not permit of the person operating the home making a profit but which might merely be a contribution to his keep and would not be sufficient to fully provide for the person. These are the charitable homes which the Senator has in mind.
I do not wish to interrupt the Minister but I think the Minister said several times on the Committee Stage discussion on Section 4 of the Bill that there were cases of institutions which were, generally speaking, charitable institutions but in which some person was paid for because a trust fund had been set up or because he had money or some relative had paid for him. Certainly the Minister gave me the impression that even if one or two such persons existed it would exclude the home from the exception to which I have referred and I respectfully disagree with the Minister.
All right, but I am advised to the contrary. That is why the provision went in, in order to make certain we were covering that case.
I wish to refer to the remarks of Senator Murphy. Senator Murphy is the most astute debater I have listened to for a long time and I know no person who can create a smokescreen or muddy the waters with the same dexterity and expertise as he does.
I mentioned the case of these two homes in respect of which letters had been written to me, and Senator Murphy proceeded to suggest to the House that in one way or another I had lured Senator Crowley to commit an indiscretion here in the Seanad. I am paraphrasing Senator Murphy's remarks. I wish to deny that absolutely. I am perfectly certain I could not induce Senator Crowley to say anything he was not prepared to say, that I could not trick or dupe him into being indiscreet in any way. I think I should refresh Senator Murphy's mind about what did take place on the Committee Stage of this Bill. I am quoting from column 124, volume 57, of the Seanad Debates of the 11th December, 1963, where Senator Crowley, having set out the reasons why he felt registration was necessary, went on to say:
I want merely to make this observation on that aspect of this problem, that I find it extremely difficult to accept a contention that either the Minister or his Department or his Departmental officials are not very well aware by now that abuses do exist and I do not think it is quite fair to suggest that they do not.
I had the ill manners to interrupt Senator Crowley to say:
That is to suggest that I am misleading the House.
Senator Crowley began to speak and I interrupted him again to state:
You must assume that I am speaking truthfully when I say that we have no record of these abuses.
Senator Crowley then said:
I accepted the Minister's statement as made now but I think I am entitled to make the observation that I find it extremely difficult to accept a situation in which the Minister for Health and his Department at this stage of our knowledge of this problem are still looking for absolute evidence of abuses.
I interrupted to say:
I am looking for evidence. You cannot make a charge without trying to support it.
Then the Senator preceded:
Very well. If you will allow me....
He then went into detail and said he had a letter in his possession which he was going to pass to me. I said he should put that letter on the records of the House and he did. I am sure Senator Crowley would be the last to concede the point Senator Murphy was making that in some way or another I had lured him into the position in which he felt it necessary to put that letter on the records.
On a point of explanation, if the Minister will continue, he will find that Senators Ó Maoláin and O'Reilly raised a point of order and demanded that the letter be read publicly and not passed privately to the Minister.
Precisely. There is a Standing Order in the other House that if a document is quoted, it must be produced. I do not know whether there is such a Standing Order here or not but that is quite true as regards the Dáil.
Perhaps the Minister will continue reading quotations until he comes to where the letter was produced.
I was trying to spare Senators the ordeal of listening to me at even greater length than they have been patient enough to do so far.
Question put and agreed to.
Ordered: That the Bill be sent to the Dáil.