Friday, 14 December 1945
Dáil Éireann Debate
Mr. O'Donnell: I resume my stance on the water-wagon again this morning. I have read this Bill through and would say that the most important part of it is Part VI, headed “Water supply”, in which there are nine sections and 45 sub-sections. Air, water and light are the most important things, and, without a pure water supply, the house, the individual and the nation are in a sorry plight. Some time ago, I moved a motion here calling for a national survey of the water supplies of Ireland with a view to getting an adequate supply of pure water into every home, from the cottage to the mansion, in rural Ireland. The towns and cities have a supply, but I am dealing with the rural areas, which are at least of equal importance.
A census will reveal the great need there is for this water supply and I wish I had the ability to impress on the Parliamentary Secretary and on the Deputies the great need that exists. To my mind, it is Ireland's  greatest need at the moment. How that census should be taken, I could not suggest. The Guards go round and take a census of the ducks, the drakes and the geese, and of the number of acres of this, that and the other, but this is more important than any of these. It does not matter very much whether there are a couple of hundred more horses in a county this year than last year, and I can never understand why there is all this tosh about a census of this kind. It is all right in war time, but a census by which every householder would be asked to say how he stands with regard to water would reveal a terrible state of affairs. The motion which I proposed some time ago was seconded by Deputy Halliden in whose constituency in Cork, I understand, there is the very same want.
It was suggested here recently by the Minister for Finance that it would cost £100,000,000. I do not know where he got his figures, because, strange as it may seem—it sounds a little egotistical, but I do not mean it that way—after I had moved that motion, the matter was taken up shortly after in the British Parliament by Lord Beaverbrook, who was able, with the driving power he has through his syndicate of newspapers, to get the Party not in power at the time, the Labour Party, to adopt it. A survey was made, or the statistics were found in the archives of the Commons—I do not know which—and it was found that £18,000,000 would give an adequate supply of pure water in every home in rural England and Wales and £7,500,000 in Scotland.
I base my figures pretty much on the estimate for Scotland with which we are to a great extent on a par, although their rivers are quicker running than ours. I should say that £8,000,000 would be sufficient, and if that money were borrowed at 4 per cent. interest charges would amount to only £320,000 and it would be very easy to repay the capital. We were told yesterday by a Minister that there were 380,000 farmers in the country—I have seen the figure of 400,000, but I accept the Minister's figure as being correct—and if water were put into every home, a sum of £2 or £3 per  year would pay capital and interest charges.
I suggest that this census I refer to be taken and that every householder be asked how he stands. A terrible state of affairs will be revealed. Seven counties adjoin my native county and I asked for a national survey for that reason. There would certainly be differences of opinion between the county surveyors and county councils if it were a county census, because streams and rivers do not recognise county boundaries, and the census would require to be on a national basis for that reason.
We are all interested in the wants of our particular areas, counties and districts. It is a good basis to go on. There are quite a number of rural houses that do not need water, but you want to control our water supplies. It reminds one of the story in the Old Testament of Rebecca going to the well with the jug. We have the whole South Riding of Tipperary, and there is very little of that area that is not in need of water. Yet we have the River Suir running idly to the sea. It strikes your eye first at Thurles which has a population of 5,000 people. You have the sewerage of that town and of the beet factory running into the river. The village of Golden, five miles distant, has not a drop of pure drinking water. You have sporadic outbreaks of disease there. You have 1,500 people in Chair. You have the village of Ardfinnan and then you have Clonmel with a population of 9,000. You have the sewerage of that town, where there is a fever hospital, going into the Suir. In Carrick-on-Suir, 12 miles lower down, with a population of 5,000 you have the sewerage from that town also going into the river. One may say that the people in the households of Tipperary are drinking water that is taken out of that stinkpot. There are some people who have to go two miles for their water supply. That is not a very nice state of affairs. It is dreadful to think of people drinking water out of that pool. An engineer told me that water clears itself in about half a mile. It is horrible to think of what the people are drinking.
 Quite a lot of the water used for domestic purposes is taken out of wells. We also have quite a number of pumps. Mr. Brinsley McNamara, the author, has alluded to these in one of his books. These pumps did good work in their time, but frequently there was a bit of jobbery in connection with the provision of them. Many of them are relies of hydraulic inefficiency. At present half of them are idle in my county. There is a well about four miles from my residence, and it is not unusual to see a procession of 15 cars there at dawn. It is the only source from which the people can get their water supply. In my opinion, water would want to be controlled. The effect of pure water could be shown in this way. I have heard from people of an earlier generation that the best water in Ireland is at Tobberadora, in my native county. Deputies are familiar, I am sure, with the exploits of the hurlers of Tobberadora who, in their day, won three All-Ireland Hurling Championships. I am sure the water had something to do with their success. Perhaps there was some whiskey in it, too. There is a spot in the County Tipperary that I am sure is well known to the Ceann Comhairle and many members of the House. It is on the road between Rockwell College and Cahir and is known as Céad Sruthain. I am not too good at Irish myself, but I am picking up some knowledge of it. I believe the meaning of these Irish words is the hundred wells or the hundred streams. At all events, there is water in 100 places in that townland. Yet people have come a distance of five miles to get their water supply there. The water from these streams flows into the Suir. That should not happen. On the old maps Suir is spelled Suire. It is rather a pity that they cut the “e” out. In view of present conditions I think that the spelling might be altered to Suer. We have the best water in Ireland at Céad Sruthain and Tobberadora. We have enough water to supply not only our own county but half the neighbouring counties. It comes down from the Tipperary mountains. It must be said that the average farmer and cottier do not go out shouting about their  grievances, but in this matter of a water supply I must say they have a grievance. They do not shout as much about things as the townsmen. If the survey I have been speaking about were proceeded with I believe it would reveal a most glaring want in Irish life at the moment.
Some Deputies said, in the course of this debate, that there was no control of the ice cream which is sold in our cities and towns. I am not interested in ice cream, though I am aware that now and for many years past there is a big trade in it. During my residence in Dublin there was a big outbreak of typhoid in the city. At the time it was traced back to a gentleman who was making ice cream in Golden Lane. During my residence in Dublin 30 years ago I contracted typhoid due to the fact that I ate some cockles. There was an investigation carried out at the time by Sir Edgar Flinn who was a medical inspector in the old Local Government Board. There were a lot of cockles and mussels being sold in Dublin at the time. Deputies are familiar with the words of the song, but certainly in my case the cockles were alive with a vengeance. The attack I got nearly cost me my life. I am sure that is a matter that is well looked after now by the Parliamentary Secretary.
The tone of part of the debate on this Bill struck me as being a sort of personal attack on the attitude of the Parliamentary Secretary, and that he was, so to speak, on his defence. I have read the Bill through, and I must confess that I could not see anything in it that should create that atmosphere. I think that, in the main, it is a very decent Bill, that is provided my particular want is taken notice of. I certainly would not adopt the prisoner-in-the-dock attitude towards the Parliamentary Secretary. There is a stream running through my land. The water comes down from the Galtee Mountains. It is pure when it enters the river three miles down the centre of the valley. There is a national school in the area that is attended by 70 or 80 pupils. Sir Charles Cameron,  who was city analyst as well as being analyst for most of the counties in Ireland, pronounced the drinking water coming out of a stream there as being unfit for human consumption. You have 25 or 30 families taking water from it. Some of them come through my yard for it. I filter it as best I can with layers of gravel. It is not a very pleasant thought, but there is not one of those houses in which there was not a snowy breasted pearl or a fine young fellow buried, in every generation. That is typical of all the waterless farms of Ireland. I submit that the cottier has a right to water also. A kinsman of mine left a small farm of 35 Irish acres and bought a farm of 70 acres. In the 35 acre farm he had water ad lib. Some time after he had bought the larger farm his friends, meeting him, would remark how well he was looking. He was embittered one day and he said to them: “It would have been better for me, the day I went to that farm, to have gone to Spike Island, the convict settlement.” The Parliamentary Secretary has nothing to do with it, but if I had the Minister for Agriculture here I could tell him a few things about the effect of water on cattle. I will have to reserve that. How can there be a pure supply of milk and butter when there is an impure water supply?
There was a picture published in The Farmers' Weekly, a Lord Beaverbrook publication, which could have been made practically in every second townland in Ireland. It depicted a pool of 40 to 50 yards, on what was obviously a very hot day. It was a lovely old pool in a sylvan setting. About 40 cows were in the picture. There were 12 or 14 in the water; their tails were flicking, for a very obvious reason—the flies were active. There was a cow drinking in the middle of the pool and, on her left, a cow emitting excrement and on her right a cow emitting excrement. How could the milk from these cows be fit for human consumption? A cow's interior is a purifying station, if you like, but it would need to be. That is typical of the pools throughout Ireland.  They are, to about 18 inches or two feet, cow filth. About once in every nine years the pool goes dry and it is cleaned out. If it is cleaned out too closely it will never hold water again and if it is cemented the supply of water will cease.
That condition is going to have a terrible effect on the cattle trade. I will not go into that aspect. I reserve that for the Minister for Agriculture. Recently there was a row raised in England and the Irish veterinary surgeons came to the rescue. They said that only 8 per cent. of Irish cattle were returned as being affected with tuberculosis. These are the ones exported to England but how many die and are buried in the haggards and orchards adjoining the farms of Ireland? Are the animals that are killed at home fit for human use? In towns, boroughs and urban districts the vet. examines the carcases but, where there is no urban council, they can kill what they like, and they do. One knows what happens—first they die and then they slaughter them.
The Parliamentary Secretary has been pilloried in regard to this Bill and told that the last vestige of liberty was lost. This question of the liberty of the subject is a very big one but I think that when a person contracts an infectious disease something must be done to look after that person if his immediate people do not do it. I have been up against it myself. After the last election campaign a member of my household was stricken down with diphtheria and there was not another case of diphtheria for miles around. We could not tell where it came from. That person had to be moved to the county hospital. I would have given £100 or £200 to keep him at home but I had to let him go. What is one to do? There is all this talk about the liberty of the subject but no one has the right to contaminate the whole countryside. I have great sympathy with the Parliamentary Secretary there.
In my native county we have another problem. Though we have magnificent water, the Tobberadora and Cead-Sruthan water, there are other waters from the Galtees, Knockmealdown,  Slievenamon, Keeper Hill, that lack some mineral. The Parliamentary Secretary has been made aware of that and a specialist was brought over, a lady, who had qualifications in this matter. She had taken a special course in Derbyshire from whence the name Derbyshire neck or goitre is derived. That condition is endemic in that area. I think it was suggested that the addition of iodine to the water would improve it. I do not know if that is practicable or not. I have never seen any report published. The lady has since resigned on marriage and has been succeeded by a male doctor.
There are many sub-sections in the Bill dealing with camps and tinkers' caravans. These must be hot-beds of disease. It is a good thing that these things are being brought under the aegis of the Department. Some comment was made yesterday about bathing pools. I wonder could you convert the hole that Deputy Keyes alluded to yesterday, in respect of which the valuation was raised from 10/- to £12? If you could fill it up with water you could convert it into a bathing pool.
Mr. O'Donnell: That is right. Take care that somebody does not put their eye on it. Some of the County Tipperary hospitals are not all that they should be. I was through the diphtheria hospital and I thought it was very primitive. There is a splendid doctor there and good nurses and they are doing their jobs well. The district hospital is equally poor. Of course, it is not easy to have everything up to date. The Minister, I must say, has done a fairly good job so far as I can see. As to public health, I do say that without a pure water supply you are going on wrong lines altogether. The  Government that give a pure water supply to every home in rural Ireland —I do not care what name they call themselves—will last. I am not here as a beggar or mendicant because we will pay for the water that we get.
Mr. P. Burke (County Dublin): From listening to the speeches of Opposition Deputies on this Bill, and trying to interpret them in regard to infectious diseases, so far as I could understand they imply that in places like Cork Street Hospital, where infectious diseases are treated, any persons can walk in or out there at their own will and that anybody suffering from an infectious disease should not be confined at all. Such a person was to be asked if he would go to hospital, and if he did not wish to go, it was all right. If he was able to walk around amongst his neighbours, no remarks were to be passed. That was my interpretation of some of the Opposition speeches yesterday and the day before. It is a rather serious thing to imply that anybody suffering from infectious disease should not be controlled by some method.
If we are to be honest about the provisions of this Bill, I do not see anything compulsory in them. I see every protection for the general good and well-being of the people. We heard about policing the people and constabulary methods and taking away the rights of the citizens. I contracted an infectious disease some years ago and I was sent to a fever hospital, and justly so. When people are suffering from an infectious disease, there must be some law to protect other people from infection. In dealing with any infectious diseases doctors take every precaution to find out whether persons are suffering from them or not. It has been suggested that a doctor may say that a person is suffering from an infectious disease and that that person would just be put away. We have so advanced in this country now that we have up-to-date laboratories. In the case of diphtheria and other infectious diseases swabs are taken and various other means adopted to find if the reason is suffering from  the disease before he is sent to hospital. I cannot understand why any public representative should condemn anyone for dealing with cases of infectious diseases in the way they should be dealt with in the public interest.
When people are suffering from an infectious or a contagious disease, I think it is only reasonable that steps should be taken to keep them away from schools, picture-houses and places of worship, because it is generally accepted that, when a disease in a district is cloaked, it is bound to spread. We have had in this country very severe epidemics of infectious and contagious diseases in the past. These were mainly due to the fact that the public health authorities and the people generally did not cooperate as they should have done and people suffering from these diseases were allowed to mix with other people. Now, when the Parliamentary Secretary brings in a Bill for which he deserves congratulation, we find people picking holes in it and indulging in very destructive criticism. As a democrat, I welcome constructive criticism, but the criticism I heard from Opposition speakers, who worked themselves into a fury on the matter, was, to say the least, very disappointing. I say it is only right that school-children suffering from scabies or any other infectious or contagious disease should be kept away from school so that they may not infect other children. Any father or mother sending children to school would like to know that there were not any infected children in the school who would be responsible for conveying disease to their children.
As to the medical examination of school children, I think that is very desirable. I heard one Deputy making a rather coarse suggestion about the examination of little girls. I know that the medical officer and a nurse go around the schools in County Dublin and that the greatest possible discretion is used in the examination of the children. When the children are to be examined the mothers are sent for and consulted in every way. They may be advised that a child is  suffering from malnutrition, heart trouble, or bad sight, and, in a nice way, they are advised how to treat and improve the health of the child. That is a very good contribution to the public health of the country because, if the next generation are to have good health, we will definitely have to look after the health of the children. That can be done only by early diagnosis. As a matter of fact, I would like to see more of it, as in some schools it is very essential, even for the child in after life, that he should be taken and treated in time, if he is suffering from any impediment or disease. Goodness knows, we have had enough experience of hospitals to know the results of disease not treated properly in its early stages. I cannot see that we are taking liberty away from anybody by such action. Even under this Bill, if the medical officers have definite powers to do that, surely doctors, as we know them in this country, are at least Christian gentlemen still and discretion will definitely be used.
I would go further in regard to infectious disease. We might as well realise that there is a clause here dealing with venereal disease. I know definitely of reports here from time to time dealing with that disease, and I say that those people who are found in any place suffering from that disease should be put away definitely until such time as they are cured. Again, that is not taking away liberty. It is only saving the people, saving the whole community from a further scourge through a disease of that kind.
In regard to public conveyances, I am delighted that the Parliamentary Secretary has inserted the provision. People who have been suffering from infectious diseases, and who use public conveyances, are a definite danger to the public. I would also like to deal with ambulances. Where there are ambulances conveying patients suffering from infectious diseases, they might, after bringing in a typhoid or scarlatina case to a hospital, be used for something else. I would like the Parliamentary Secretary to be harder on a case of that kind and make sure that an ambulance is disinfected before  it goes out to bring in a case of pneumonia or an accident case. I am not saying, or even insinuating, that that has occurred, but the possibility is there.
The question of public libraries must be considered, so as to do whatever is possible, especially where a librarian happens to know the people very well in a rural district. It is very hard to deal with this matter in a city. A lending library is definitely a source of infection, but the matter is too complicated to do more than refer to it now.
With reference to sewerage and water I am also glad that special provision has been introduced into the Bill. There are some people even in County Dublin in a position to get sewerage and water into their homes and they are not taking advantage of it. In one particular area in which I am very interested, the Dublin Corporation should give a good headline, that is, in Baldoyle, where they have some property. Stagnant drains are another source of infection. In my rounds in County Dublin, I have often found stagnant drains which I had to refer to. They are also a source of infection and I would like to see them piped and removed, so that they would not give further infection.
I wish to compliment the Parliamentary Secretary on what he is doing for mothers and in regard to the welfare of children up to 16 years of age. I happen to come across cases of persons who, had they been treated when they were two or three years of age, would be useful citizens afterwards, instead of having to spend their young lives in institutions, through the ignorance of some father or mother. I do not see anything of the police or constabulary method in dealing with cases like that and it is very hard to understand why such remarks are made. If the medical officer decides, in the child's interest, to send him away for treatment, that should be done. I know of one case where a child was born deformed and the old grandmother came along and said that it was God's will and the child should not be sent away. Fortunately for that child, there happened to be an intelligent doctor dealing with it and  he practically had to take the child away compulsorily and get an operation performed. That child has since done a fine course in the National University and has got two or three degrees, whereas if she had been left alone she would have finished up in some institution with somebody looking after her. That is only one instance of many I could give. Again that is not compulsion, but is in the interests of the community as a whole.
With reference to public baths, I would like to see more swimming pools and public baths throughout the country, as they are very desirable and essential. In regard to food restrictions, we hear again that we are interfering with the liberty of the individual. We find that A, B, C and D can come along and manufacture food in any particular area, without any authority at all and can advertise it. When people see that food advertised, they will buy it. We have also heard a good deal about various medicines. Is it not very essential, in the public interest, that something should be done to control these matters, so that the public as a whole would get the very best produced and not anything shoddy, which might be responsible for injuring the public hereafter, even when advertised as medicine? Again we are told that that is interfering with the liberty of the individual, but I cannot see where that is so.
I should like to refer again for a moment to infectious disease and the provisions in this Bill regarding it. One good point that I see about this is that a person who is suffering from infectious disease, if he is a breadwinner, will have decent remuneration provided while he is away, in order to help his family to live.
In regard to dispensaries and dispensary doctors; I would like to see more up-to-date dispensaries in every area. I know that the Parliamentary Secretary has done a good deal, and that, even during the last year, he has done a good deal in County Dublin in the provision of new dispensary buildings. It is very essential that dispensaries have at least a decent  waiting room, so that people should not have to stand outside, as occurs in the case of some of the small dispensaries I know of in County Dublin at the present time. If it is at all possible, I would like to see small clinics established in each area for the treatment of disease. That could be done in conjunction with the dispensaries. But, of course, that again will cost a lot of money.
There is another point and I am delighted to get a chance of mentioning it. I refer to the need for decent halls for the convenience of rural communities. Unfortunately, we have some halls in various parts of the country and they are not conducive to the public interest or to public health. If a grant could be given towards the building of such halls, I am sure the people would be only too delighted to give every assistance, even to the extent of repayment.
As regards burial grounds, I must say that we in Ireland, for the most part, do not keep our burial grounds very well. I do not know what is the reason for that. In recent years there has been a big advance in this respect. There certainly has been an improvement in the condition of burial grounds. The public health laws are being enforced fairly well.
I am glad to note that the Parliamentary Secretary has decided to send trained nurses to each district. There will be a lot of work for the medical officers. Some of the dispensary areas are rather large and it might be in the public interest if the dispensary districts were not too large. It is essential that the doctor should be able to carry out his work in the dispensary district without being hampered in any way by having to cover too large an area.
As regards camping sites along the sea coast, I am glad to observe that the Parliamentary Secretary will deal with them. We are not anxious to interfere with the right of any man to erect a camp, but it is essential that that man should have some civic outlook and should arrange to keep his camp properly. There were serveral complaints, especially in North County  Dublin, with reference to campers, and we had to deal with them in a rather diplomatic way by asking them to refrain from committing a nuisance. Fortunately, there were only a few people who carried on like that.
Generally speaking, the Parliamentary Secretary has done a very good job. He has even brought in the hospitals, and I believe that is essential if the hospitals are to be what they should be. I heard Deputy Costello speaking last night and I thought that instead of a Public Health Bill we were dealing with the Penal Laws. He worked himself into such a fury that I had to ask myself was I sitting in Dáil Eireann or was I back 100 years listening to some person speaking on the Penal Laws or dealing with a conscription Bill or something of that sort.
Mr. Burke: I went carefully through the Bill to see if there was any foundation for what the Deputy was saying, but so far as I can see there is nothing in the Bill only provisions for the common good of the people of this country. The Deputy spoke of housing. Housing is the work of the local authorities. If the Government, in the morning, took over control of housing, I believe Deputy Costello would be the first to declare that the Government were taking everything out of the hands of the local authorities. The Government definitely subsidises housing.
I think this is a very fine Bill and, if it is properly worked and properly interpreted, it will confer many benefits on the people. We should endeavour to have a better outlook in these matters and it should not be accepted from the Press or elsewhere that this measure was brought in to interfere with the rights of individuals. So far as I can see, this Bill was brought in purely for the protection of the individual.
Mr. Cosgrave: In the normal way this should be a Bill on which there would be agreement. A measure of this kind depends for its success on its acceptance by as wide a number of sections of the community as possible.  Its success depends particularly on the medical profession and, of course, ultimately on the people of the country. Unfortunately, the manner in which this Bill was introduced was not conducive to the belief that the medical profession was consulted. Their views are not available. Public health measures and all laws with the object of furthering public health depend in a large degree on the strength of public opinion.
The Public Health Bill introduced in 1878 was a distinct advance. For quite a while there was vigorous opposition to it. After a few years the success of that legislation was quite obvious and in 1925, when the Public Health Act was introduced here, it continued and extended certain provisions of the 1878 Act which had been found wanting or which had been found unequal to the task of dealing with modern conditions. It is true to say that when people lived a pastoral existence public health measures, as we now know them, were unnecessary. A few individuals lived in isolation and, consequently, the risk of infecting other people was limited. Such restrictions and provisions as are now generally accepted in relation to certain infectious diseases were not needed. But, as people began to live in large towns and cities, the need for certain precautions became obvious.
In this measure provision is made under Section 12 for consultative councils, which will be established by the Minister. I presume these councils will advise him on various aspects of public health. It is rather strange that provision of this kind is made in the Bill, yet prior to the introduction of the measure no such consultation took place with the medical association. I think Deputies will agree, looking at public health in its broader aspects, that consultation with the various interests affected is, if not essential, certainly desirable.
It is very significant that almost every article written shows a sense of mutual distrust as between that profession and the Department of Local Government. It is a matter which everyone should deplore, because it is in the interest of the Department,  the medical profession and of Deputies that they should endeavour so to fram legislation and so to influence public opinion that that distrust will disappear, because the sooner there is co-operation between the Department and the medical profession in general, the sooner will the various desirable reforms be made. In a very learned article, which won the Carmichael Prize, Dr. Collis referred to this unfortunate position, and neither this measure nor any recent activities of the Department tend towards more harmony in that direction.
In passing, I should like to say that, that being the position, one wonders what kind of consultative councils will be established and what advantage will be derived from them, and one is led to the conclusion that if these consultative councils are to have any value, their opinion should be based on the widest possible experience in the medical profession from the point of view of the surgical and various other aspects. Having drawn from that experience and having established these councils, it is only reasonable to assume that their opinions will be accepted, or, at any rate, that whatever differences are likely to arise will be settled in a satisfactory manner. As this Bill, however, was not made available, prior to its introduction, to the medical profession, one is tempted to believe that these consultative councils, when established, will have only one function. If they disagree with the Minister, they are likely to be disbanded. One would expect that a measure of this kind would have been submitted, as was done by another Department in the case of a measure affecting harbours, to the people concerned for their observations, if not their recommendations, and that, if their recommendations were not acceptable, their views would have been considered.
I should like to know if the Parliamentary Secretary can say what the estimated cost of this measure is. Various provisions are set out under which local authorities may be directed to establish all forms of health institutions to provide various services, but  no indication is given of the estimated cost, nor is any option given to the local authorities in the matter. It may be that unnecessary expense will be incurred and these local authorities will have no option but to transfer the burden to the rates. The ratepayers are already seriously overburdened and a measure of this kind, however desirable certain of its aims may be, must inevitably result in a serious increase in rates.
If democracy is to have any practical effect in this country; if it is not to be, as a number of Deputies appear to think, a matter of believing that, so long as you keep saying you are a democrat, whatever you do is good for the people, local authorities must be allowed to exercise their rights. Democracy gives the people the right to say what they want and to put their wishes in that respect into operation. Under this Bill as it stands, very heavy costs will fall on the ratepayers and they have no option but to pay them. If they do not, an inquiry will ensure and the matter will no longer be left in their hands.
It would be interesting to know how many medical officers and how many nurses it is intended to recruit and whether the Parliamentary Secretary has consulted the medical profession or intends to take control of the medical and nursing registers. Hitherto, the nursing profession has been the Cinderella of medicine. Nurses are inadequately paid and many of the positions are non-pensionable, with the result that when these people, after arduous years of work, reach the age of retirement, there is no provision for them or their dependents. I wonder if the Parliamentary Secretary can give any indication as to whether these nurses will be available and, if so, on what terms they will be appointed, if they will be pensionable and whether the rate of pay will be greater than the rate hitherto paid.
In Section 13 provision is made for health institutions, and if more than one health authority is involved, a joint health institution will be established. It would be interesting to know whether the cost of these institutions  will be apportioned equally or, if one administrative area is larger, whether it will pay the bulk of the expense. Again, no indication is given in the measure and one must only wait until the Parliamentary Secretary replies.
Section 15 makes provision for an agreement between a health authority and an institution. It does not say whether that institution will be consulted as to the cost of the upkeep of a patient or patients. Hitherto, I understand that a weekly maximum of two guineas was fixed by the national health insurance authorities, although a hospital bed, on the average, costs £3. It is quite obvious also that, in this as in other matters, present-day costs bear no relation to the figure originally fixed, and in future if these facilities are to be provided, the contribution will have to be increased. Again, the contribution depends on the amount available from the ratepayers, and no provision is made for consideration of their view on the matter.
Section 29 has been the subject of much discussion. It contains very drastic powers, powers which Deputy Costello last night lucidly and vigorously showed could react very unfavourably on the individual and particularly on the innocent individual. He informed the House that only quite recently has medical science discovered that there is such a person as an intermittent typhoid carrier. In the particular case with which he was concerned the typhoid carrier was certified by a doctor as being free. Subsequently, she secured employment, and later a local medical officer—I think the case actually occurred in the city— informed her employers that they could no longer employ her. I think that in such a case there should be the right of appeal for the individual affected. It is quite true that doctors very often differ in the case of the particular diseases in question where medical science has not, in any respect, reached optimum knowledge. It is difficult for a doctor who is anxious to preserve the health of the citizens in general to accede to the request to allow such a person to continue in employment where he or she  may infect a large number. If professional people who are distinguished in their particular spheres say that such a person is no longer a danger, and that, subsequently, she loses her employment because another medical officer considers she is a danger, in these circumstances that individual should have the right to appeal for an examination by an independent doctor or tribunal.
In Section 36 provision is made whereby the onus is thrown on individuals that they must prove that they were not the source of infection—that is in a civil action if the person who has been infected takes such proceedings. Now, in the particular case which was mentioned last night, I think it would be highly unfair and definitely objectionable from every point of view, as well as a serious infringement of the rights of the citizen, to have that person adjudged an infector, placing on that person the responsibility of proving that he or she was not the cause of the infection. I suggest that some amendment to the section is, in these circumstances, desirable.
Part V of the Bill deals with drainage. I think it is a quite desirable provision. It will, in many respects, improve the drainage law which, hitherto, has been defective in certain particulars. I think that while it is desirable that everyone should drain their premises and should connect with public drainage, if such is available, in cases where a house is isolated, or comparatively isolated, and as long as there is no danger to the public health by non-connection with the main drainage system, it should not be incumbent on an individual to drain. People have some rights, and as long as these drains are not a source of danger to the public health, no compulsion should be employed. That also applies to water supplies. The section dealing with itinerants and camps is an improvement on anything hitherto adopted, and should improve the situation from the public health point of view.
Section 90, which deals with the control of medicines, is a good section.  I would like to ascertain from the Parliamentary Secretary if it would be considered advisable to compel the manufacturers of patent medicines to declare the contents on the outside. In the case of many preparations their ingredients are declared. I think if that was made obligatory in the case of all preparations, it would improve, not only the standard, but would enable people to know the actual ingredients in a particular preparation, and would, accordingly, enable them to assess its merits or otherwise. As the law stands at the moment, this is not obligatory in many cases, and, in fact, much rubbish is being sold. It is true to say that doctors occasionally recommend patent medicines because they know their value, and also in-many cases they know they may have a psychological effect. In that way they are of some advantage to individuals and families.
Provision is made in Section 85 for the inspection of school children, and for the presentation by parents of their children for inspection. The Parliamentary Secretary rather bluntly said that these sections contain the necessary legal provision for the maternity and child welfare schemes provided in the country. He certainly admitted that the sections did contain a legal provision. I think it is not enough that the section should contain a legal provision in order to compel people to present their children for inspection. It is provided in this section that secondary schools may be compelled to make their pupils available for inspection. It is true to say, I think, that all the secondary schools in the country, the colleges and the convents, provide a medical attendant of their own, and it must be presumed that he is qualified in every way to look after the welfare of the pupils. It would be wholly undesirable to super-impose a medical inspector over the head of that medical attendant to inspect the children. Parents still have rights, and their rights will be seriously abrogated if this section is put into operation as it stands. Not only will the rights of parents be abrogated, but friction is bound to ensue if a medical inspector, with presumably similar  qualifications to those of the medical attendant — his qualifications might easily not be as high—is imposed on secondary schools. I think that where secondary schools provide a medical attendant—in most cases I think they provide not only a medical attendant and medical equipment but a nurse as well—that they should be at liberty to cater for the health of their pupils without interference.
Provision is also made for the notification of certain diseases. Tuberculosis, of course, is one of them. I would suggest to the Parliamentary Secretary that venereal disease is one of the diseases that should be made notifiable. I think it was in Sweden that this disease made very rapid headway until it was made notifiable, and until compulsory immunisation was adopted. It is a very serious disease, and one in relation to which the same historical objection to inspection or isolation as prevails in the case of tuberculosis cannot be used as an argument. Most people who have the misfortune to contract this disease are the authors of their own misfortune, and however objectionable it may be, it is the responsibility of public health authorities to see that the danger accruing should not be allowed to interfere with the general health of the community. Therefore, I suggest that it should be made notifiable.
Section 34 is, in many respects, one of the most important sections in the Bill. It makes provision for the maintenance of the dependents of individuals suffering from an infectious disease. I think the provisions of the section should be extended to a person who meets with a serious accident and has dependents, and is no longer able to provide for them. National health insurance is fixed at a maximum of 15/- a week, and that, of course, bears no relation to the cost of maintenance. In such a situation it will be impossible for persons in the position I speak of to maintain themselves or their dependents. There is no use whatever in imagining that this section, which makes provision for the maintenance of the dependents of people suffering from infectious disease, can provide them with proper  nourishment. As long as a person who is unfortunate enough to meet with a serious accident, or has to have an operation which necessitates ceasing work, is unable to provide for himself and his dependents, then so long will there be that demand for an improvement in the public health which everyone desires.
The real basis of improving public health is to raise the standard of living. That will never be achieved by regulations or control or by merely maintaining at a subsistence level the dependents of people who are misfortunate enough to find themselves in an institution or hospital. The standard of living can be raised only by increased production and by making available more money, not by the imposition of taxation or higher rates, but by enabling people who have dependents to secure better wages and better conditions of employment. It is absolutely idle to consider this measure as a great advance as long as the standard of living in this country remains at its present level. The Parliamentary Secretary in his speech said he was not setting out as a reformer to try to improve the health by regulation or control or inspection. I would feel far more confident of that assertion if I could see in this measure, by way of sub-section or part of a schedule, the particular controls and the particular regulations which it is intended to apply.
Neither the medical profession, this House nor the public yet can estimate the cost of the Bill or the degree of interference or the degree of control which will result from its enactment. Unless we can legislate in such a manner that we will realise the effect of the legislation, then we can never advance sufficiently.
Before the Second Reading of this measure was moved, I consulted a distinguished medical man, who is not interested in politics. He gave me certain suggestions on certain points. He has no political affiliations; possibly, like a number of people, he realises the shortcomings of political parties in this country, and the failure of the present political make-up to  give this country a better standard of health and a better standard all round. He realises that unless we take positive measures to improve the general standard of living and the general living conditions, housing, food and other requirements, and to make available for every section of the people at least sufficient to keep them physically satisfied, it is absolutely idle to advocate or to press for the introduction of a measure such as this.
This measure undoubtedly has many good points. As I said at the outset, it is a Bill which should be considered as being non-controversial and should receive in the normal way the widest acceptance by the Dáil and the country. But, as long as it is introduced without consultation with the medical profession and possibly without their agreement, certainly without their opinions being considered, then it is idle for Deputies to come in and praise it in that slave-minded way of so many Fianna Fáil Deputies, who failed to realise the implications of the Bill, many of whom, obviously, had not read it and some of whom, having read it, did not understand its provisions, and it is utterly idle to expect the people of this country to regard it as an advance.
Mr. Norton: I regard this Bill as containing many very valuable features, many features which tend to promote a better standard of public health in the country and many provisions which are progressive in their tendency and calculated, on implementation, to give a higher standard of public health in future. One thing the Bill does, and that cannot be denied by anybody, is that it provides new services, services which are not at present available to the ordinary citizen and particularly to the poorer sections of the population. In a country where the standard of public health is not high and where in fact the social services are notoriously low, I think any Bill which helps to promote new social services or tends to produce a higher standard of public health is something to be commended by all Parties in the House.
 Like many other Deputies, I take the view that you cannot, merely by a piece of legislation, promote a higher standard of public health. A large measure of the ill-health of this country is brought about by economic and social factors. The biggest enemy of good health in this country is low wages and unemployment. Low wages and unemployment wage constant war on good health in this country. It is never possible to maintain a standard of good health where you have an unemployment problem of our dimensions and where you have a low wage policy implemented with the efficiency with which that policy is implemented here. The slum is the relentless enemy of good health, and so long as we have slums we can never have good health. Therefore, if we really want to lead the nation on to the high road which leads to good health we have to get rid of unemployment and the low wage policy; we have to make ceaseless war on the slums. It is only by the elimination of these three evils that the people can be given the basic foundation of good health here, just as the elimination of these evils has been the basic foundation of good health in other progressive and more enlightened countries.
I think the Parliamentary Secretary will recognise that the mere passage of this Bill, unaccompanied by a more enlightened social and industrial policy, will not give the nation the standard of health which everybody desires. This Bill will make some contribution. It can never, however, be effective unless this or some future Government determines that the nation is going to harness its enthusiasms and energies to the task of evolving a policy of full employment at decent rates of wages and the provision of proper housing for our people in circumstances which will enable them to enjoy life in decent surroundings instead of condemning them to live in slums in cities and rain-soaked mud cabins in rural areas.
Therefore, in so far as the Bill contains progressive features, I welcome it. I am not unaware of the fact that there are certain objectionable  features in the Bill, notably the attempt to deprive local authorities of powers which are properly theirs and of functions which in the past have always been regarded as those of the local authorities. In the main, from my point of view, the Bill is a welcome innovation and it is calculated to give us in future a higher standard of public health, especially if we take the necessary corollary action in the sphere of providing regular employment at decent wages and an adequate supply of decent houses. Some of the opposition to this Bill has, frankly, amazed me. It has been assailed on the ground that it is a danger to the liberty of the citizen. Deputy Hughes last night pictured a situation in which a man, woman or child could be stripped and examined, as if these powers were going to be exercised in such a capricious or evil-minded way as to inflict suffering and indignity on the victims. If there is to be a stripping of persons for the purpose of medical examination, we have to recognise that that is the only way in which you can examine people; that you do not, when you want to examine a person to ascertain whether he has an infectious or contagious disease, advise him to put on his overcoat and put up his umbrella. The normal way is to strip and examine a person.
Unless we are going to say that every nurse and doctor is an inveterate enemy of the people, then I think we have to assume that these services will be administered in a sympathetic and understanding way. I, at all events, refuse to believe that the doctor and the nurse are going to be of the variety portrayed at the recent Belsen trial. I prefer to believe that they will carry out their duties in an Irish way when dealing with Irish citizens and that there will be none of this brusque examination such as Deputy Hughes pictured last night. In any case, if a person is to be examined because he or she is likely to be suffering from infectious or contagious disease, I think the person has to put up with the examination in the interests of the public health of the country. If persons are stripped for the purpose of examining them, they  are being stripped for the purpose of treating them and making them well, in some cases in spite of themselves. If that is an invasion of the right of the citizen, I think we had better put up with that kind of invasion of the right of the citizen in the interest of making the citizen a healthy citizen and avoiding the dissemination of contagion throughout the rest of the community.
Mr. Norton: He said that up to the present it has been assumed that a man reigned supreme in his own house. That is all right. That will be accepted as a general proposition. But, if a man—and we all know it happens in various places — decides to live in squalor and filth and in a verminous condition, or is infected with a contagious disease or is suffering from an infectious disease, or decides to live the life of a recluse in some little cabin here or there, or, because of his peculiarities or eccentricities, declines to have any kind of treatment what soever, are we to acknowledge his right to be supreme in his own house, so supreme that he can live in filth and squalor and vermin, and that nobody is entitled to enter his house for the purpose of taking him out of these conditions, cleansing him, making him a decent citizen, rescuing him from the peculiarities to which he is a slave, and generally enabling him to enjoy life as good healthy citizens do? If Deputy Hughes' argument is that every man is entitled to lock himself up in his house, to suffer from any disease he likes, and to be as vermin-ridden as he likes, lest you invade the sanctity of his home, that is a form of liberty which I think good citizens do not claim for themselves.
Mr. Norton: It is not a case of the removal of the unfit. It is a case of cleansing the person who does not want to be cleaned and of getting after that peculiar mentality of persons who decline to disclose the fact that they are suffering from an infectious disease.
Mr. Norton: The most appalling mentality we have in this country is the attitude of superstition and ignorance which surrounds tuberculosis. People do not mind saying that they had an accident and broke a leg or an arm. They do not mind even having the public know that they managed to get diphtheria. But, if anybody suggests to them that they are suffering from tuberculosis, there is an unholy outcry. You get that kind of artificial dignity and that classic nonsense which takes the form of people averring: “There was never any tuberculosis in our family”, as if it were something of an infamy from the point of view of the character and rectitude of the family. Everybody knows that people frequently suppress the fact that they are suffering from tuberculosis because they would like people to think that there was no tuberculosis in the family. Is not the big problem of the medical profession to try to get people to disclose at an early stage that they have symptoms of tuberculosis? I think every doctor in the country is confronted with that problem from time to time. I think it reflects the mentality of our people in respect to certain types of infectious diseases. I think we would be doing well if we tried by every reasonable means possible to induce people to abandon that mentality and to make a contribution to the elimination of disease, which is the enemy of good health and a decent standard of living in the country.
I am one who has very considerable admiration for Deputy Costello's  sense of human values and for his devotion to the rights of the citizens, but, frankly, as he spoke last night, I could not help thinking that the Deputy was carried away almost to the limit of extravagance by his opposition to this Bill. His speech contrasted very strangely with the speech we have heard from Deputy Cosgrave this morning. Deputy Costello, last night, in an almost atomic denunciation of the Bill, pictured for us a situation in which people would be arrested and imprisoned, their livelihood taken away from them, removed from all that is near and dear to them, and, finally, capped his description of the Bill by telling us that the possibility was that somebody might be arrested and have organs taken from his body. He said it was because he did not stand for a policy of that kind that he was opposed to the Bill.
Deputy Cosgrave, this morning, did not seem terribly worried about the possibility of a person losing these organs. He made no reference to them. I think it is really carrying the thing to grotesque extremes when you conjure up the possibility that persons may be stopped in the street, stripped, examined and imprisoned, taken from their wives and children, may lose their employment, and then, as a crescendo to this indignity, have some vital organ removed from their body.
Mr. Norton: I do not believe it is going to happen and I am perfectly cold over that possibility. If it does happen, there is no public opinion or sense of democracy left. I refuse to believe that it is going to happen. There is a Parliament where attention can be focussed on that matter, we  have a people which at times can be very intractable when they feel there is some injustice being inflicted on them. I can hardly imagine that the Government, whatever its complexion may be, elected by popular representation, will be so foolish as to permit, while it has power, a situation to arise in which a man can be arrested, imprisoned, removed from his family, from his wife and children, deprived of his means of livelihood and then, to finish up with, his organs taken from him. I do not imagine that that kind of thing is going to happen and, on reflection, most sensible people will console themselves with the very profound belief that no such thing is likely to happen. If I thought it were, I probably would take another view of this Bill. It is because I do not think so that I take the view I do.
A plea has been made that the best way to promote public health is to assemble as many types of voluntary services as we can. There is probably some propaganda value in assembling and infusing with as much enthusiasm as possible any type of voluntary agency for the promotion of public health; but we have to realise—and one has only to visit other countries to realise—that, notwithstanding all the voluntary effort in the past, we are to-day without many essential public health services, we still have a low standard of public health and in some respects we have standards of cleanliness which stand in urgent need of improvement. The voluntary effort so far has given us these appallingly bad results and, if we are to have better results in the future, we must have voluntary effort plus something else— plus the reasonable inspection which this Bill provides. That is likely to give better results in the future.
Deputy Hughes' method of promoting public health was to suggest the establishing of branches of the Countrywomen's Association. Does anybody seriously believe that to be a contribution to the promotion of public health or that it is a task which can be accomplished in a reasonable space of time? Let us have voluntary organisations by all means, but if they  are to have a standing in the community there must be powers behind the local authority and the central authority enabling them to make reasonable inspections and to require infected citizens to comply with reasonable requirements, in order that their own bad health may be transformed into good health and that they may not be a source of infection for other citizens.
An effort has been made by certain Deputies to suggest that some of these powers are opposed almost unanimously by the medical profession. My information is quite to the contrary. Anyone who takes the trouble to consult dispensary officers or county medical officers of health will find that one of their complaints in the past has been that they have no powers to do the thing they want to do, to build up a better standard of health. It is completely erroneous to suggest that the dispensary doctors or county medical officers of health would complete absence of power, in certain respects, to deal with the citizen suffering from an infectious or contagious disease. My information in the matter is that these powers would be welcomed generally by medical officers, particularly those associated with municipal services. If they are administered in a reasonable way, there will be no cause for fear. Those who hold the pathetic belief that you can deal with problems such as confront us to-day by means of public health organisations on a voluntary basis are asking us to believe something we know will give only the appallingly bad results of the past.
I will be revealing no secret by telling of a problem which arose at one time on the Defence Conference. It has nothing to do with defence, but deals with public health. At one stage, the question of the evacuation of people from areas which were likely to be in danger to other areas was discussed. It was examined by the medical profession attached to the municipality concerned and the health of the people to be evacuated and their habits and  social conditions were the subject of investigation. It would appall this House, and probably would appall this and other countries, if the problem were revealed in all its nakedness; and, therefore, I refrain from doing so. That problem has grown up in generation after generation. No effort is being made to deal with it and there are no effective powers in the hands of the local authority to deal with it. This House would be aghast if it knew the problem that confronted the Defence Conference when it came up in connection with the evacuation of people from one area to another. That will be dealt with in this Bill. It cannot be dealt with on the basis of appeals to the persons concerned. It can be done only by giving local authorities power of inspection and power to apply a remedy; and it is because the local authority is given, in this Bill, the power of inspection and the power to apply a remedy that I think it is in the interest of the people concerned. From their point of view, having regard to the fact that they have tolerated this evil for generations, it may prove to be a very irksome power. However, in the course of time and with the advancement of education and enlightenment, these folk will ultimately realise that, in the long run, it was to their advantage. Whether they believe that or not, most enlightened people and most medical people will believe that it is a process they have to undergo in the interests of improved national health.
There is one feature of this Bill with which I am distinctly displeased, that is the provision under which the local authority has imposed on it the obligation to provide allowances for tuberculosis sufferers. I am not at all impressed by the provision making the maintenance of tuberculosis sufferers an obligation on the local authority. Tuberculosis has been a national scourge, it is a national scourge, and it will be a national scourge. We should recognise that it is a problem which must be dealt with nationally, that the central authority must take the responsibility for paying the unfortunate victims of that scourge an adequate scale of allowances. It is  impossible to imagine a patient in a sanatorium being able to create that necessary calmness of mind which is essential to recover, in cases of tuberculosis, whilst he knows that his wife is trying to maintain his five or six children on 15/- a week national health insurance benefit. She must pay rent, buy milk, boots, shoes, clothes and groceries for them, on such a scandalously inadequate sum. I think the State must recognise that the war on tuberculosis has got to have a fair chance, and the efforts to eradicate the disease must get every possible assistance from the State and the community.
I think the one blot in this Bill is the section which puts an obligation on the local authority to provide a scale of allowances for tuberculosis sufferers. I have never seen local authorities do anything decent when it comes to providing a scale of allowances for victims of that type or for persons in necessitous circumstances. The scale of allowances at present provided in the form of outdoor relief and home assistance is simply appalling. You could not keep a greyhound on what some local authorities give to women for the purpose of maintaining themselves and their few children, and yet the local authority is being invited here to repeat that kind of performance with tuberculosis sufferers. You might as well ask some of the home assistance authorities for a blood transfusion as for a few shillings to enable an unfortunate widow to maintain her children.
It is the devil's own job to get a local authority to provide a supplementary allowance for blind persons. Where they do provide an allowance, it is a miserable, beggarly pittance, which makes no perceptible contribution towards improving the economic plight of the sightless person. If you put the obligation on the local authorities to provide allowances for tuberculosis patients, then the children and the wives of male tuberculosis sufferers will continue to live in the same misery, in the same state of depression and in the same squalor as they live in to-day.
 In Britain there has been a very enlightened view taken by the administration of the necessity for making adequate provision for those undergoing treatment for tuberculosis or awaiting admission to sanatoria or when undergoing aftercare treatment on discharge from sanatoria preparatory to resuming work. There the allowance for a man with a wife and four children is £3 12s. od. a week. Every possible effort is made in Britain to give the person the best possible chance of recovery. If this obligation is put on our local authorities to provide allowances for tuberculosis suffers you will find some Scrooge-like gentleman on the local authority offering them 5/- or 7/6 and haggling and arguing as to whether that is not too much or what the burden on the local rates will be.
I suggest to the Parliamentary Secretary that he should reconsider that aspect of the Bill and provide, from the central authority, adequate allowances for tuberculosis patients. Even if the scheme has to be administered locally, the scale of charges should be fixed centrally and should be administered centrally. If the Parliamentary Secretary is not prepared to go that far, at least in this Bill he should take power to prescribe the scale of allowances which will be paid to tuberculosis sufferers and require the local authority to comply with that scale such as fixed by him and such as can be reviewed from time to time.
There are many welcome and progressive features in the Bill and I welcome every one of them. There are some aspects of it which I do not think are very practicable. Some of them, I am afraid, will not work with the enthusiasm which the authors of the Bill believe, but, on the whole, taking the fat with the lean, the Bill is a very progressive one. There are very useful features in it. I think I am as much concerned with the liberty of the citizen as any other Deputy and I am not prepared to believe, as Deputy Hughes suggests, that the liberty of the citizen is violated. If you want to prevent a man locking himself up in a  cabin or in a slum in a tenement—a man suffering from any type of contagious or infectious disease who declines to attend to his infection—and if you have to invade the sanctity of his home, I am satisfied that, no matter what you may appear to show this Bill is capable of by playing on words and using picturesque language, the fact remains that this Bill will be administered in a sympathetic way. If it is not so administered, there are ways and means by which a public outcry will be raised such as will make it impossible for people to implement the Bill in the rather sensational way which Deputy Hughes and Deputy Costello described last night.
Domhnall Ua Donnchadha: I am particularly interested in Part V of the Bill, beginning with Section 38, which deals with drainage. Within the past few weeks I received a deputation from one of our rising towns in Kerry. I refer to the town of Rathmore where, within the past seven or eight years, the population has increased by something like 50 or 60 per cent. In Rathmore within the past few years the creamery industry has flourished and there is a factory which brings in people from the surrounding districts and employs some of them for 12 months and others for nine or eight months each year. There is a monthly fair held in that town. It was established within the past six or eight months and we are now anticipating the erection there of another factory. A site has been acquired and steps have been taken to ensure a supply of raw material which will keep that factory working and which, I expect, will employ 200 or 300 people, and possibly more.
The deputation which waited on me recently informed me that in Rathmore, even though they have a water supply, there is no proper sewerage system. The chairman of the deputation, who happens to be the local creamery manager, told me that he lived in constant anxiety lest there might be an outbreak of contagious disease in the locality. He has in mind what happened in Dingle in the early years of the war when the spread of contagious disease there was attributed  to the supply to the local creamery of infected milk. It pauperised the district, not only from the point of view of the loss to the farmers, but because it scared people from visiting that part of Kerry, which is the fíor-Ghaeltacht of Kerry. I remember going there one year and it was almost impossible to find accommodation, but in the year following the outbreak of the fever it was almost impossible to get a visitor to go there —they were scared out of the place.
What will happen in Rathmore if there is an outbreak of contagious disease? It is not an urban district; it has no local council; the affairs there are administered by the county council. We have now in Kerry a county manager and a county commissioner and they are near enough to the Minister to be able to introduce into that rising town of Rathmore a sewerage system which will remove the danger threatening the people if there is an outbreak of contagious disease. For that reason, I welcome this section and I congratulate the Parliamentary Secretary on his thoughtfulness in introducing it. I wish him good luck with this Bill.
Mr. Coogan: My first reaction on reading this Bill took me back to the years when certain lawless gentlemen sold protection in the United States of America. These parasites upon the social community of that great republic muscled in, unwanted and unlooked for by the recipients of their protection, and the unfortunate citizen was faced with two choices—to get the protection and pay through the nose for it, or to refuse the protection and go out of business, be bombed or shot out. We are in exactly the same position under this Bill. No public opinion in this country, no professional opinion, has asked for this measure, but the experts of the Department of Local Government have decided to muscle in and sell public health in exactly typical gangster fashion. They tell us under this Bill: “If you do not take it we will punish you and punish you severely, but if you do take it, you will pay for it”. That is our position. The local authority has no voice, good,  bad or indifferent, in this matter. Everything under the Bill will be implemented by Order of the Minister. Health institutions may come and go but the local authority will have no choice as to whether they shall come or they shall go. The Minister will decide that. If the Minister decides you shall have health institutions and services and he tells you, you will have to pay for them.
In introducing this Bill, the Parliamentary Secretary has given us no indication good, bad or indifferent of what the probable cost will be to the average local authority in this country of the new proposed health institutions, the new health services and the extra personnel, medical, nursing and otherwise, which will have to be employed to administer public health services. We have no indication of any kind of what these costs are going to be. Furthermore, we have had no indication from the Parliamentary Secretary as to what the public health situation is, or what the incidence of the various infectious diseases is which has given rise to the introduction of this measure. So far as we as laymen are aware, there have been no recent epidemics causing a state of public alarm such as happened in the long distant past in the case of smallpox and typhoid. In the past, advances in public health legislation came about largely as a result of serious epidemics and of the public alarm caused by these epidemics, and the shock to public opinion which the incidence of these epidemics caused. In this instance no effort has been made to put forward a case of that kind. So far as I can see, this is a case where the bureaucratic experts, led by the Parliamentary Secretary, have decided that the public will have to take this, willy-nilly. We have had cases in the past where expert opinion, in advance of public opinion, has sought to impose its ideas on the communities with disastrous results, to themselves in the first place and to the communities in the second place.
We have the extraordinary spectacle here this morning of the Leader of the  Labour Party—whose people will be the hardest hit by this particular measure, whose people will be singled out by the medical inspectors, the nursing inspectors and the various officers of the local authority under this measure, whose lives are going to be harassed by these people, whose homes will be invaded, whose persons, hitherto considered inviolate and inviolable, are now reduced to the position that they can be assaulted by any officer of a local authority— defending this system which, brought to its logical conclusion, is no different from that tried by Hitler's experts in Germany, the system by which he decided to get rid of the unfit by various methods, including sterilisation and the gas chamber. We have not got sterilisation or the gas chamber under this Bill, but they are about the only two things that the Parliamentary Secretary has omitted from the measure.
I should like to have seen the Parliamentary Secretary give us the case for the Bill—not a history of public health legislation, as he did give us, and give us very lucidly—the statistics in regard to the various infectious diseases, the attitude of the parents, the number of times the parents refused medical inspection, the number of cases in which they withdrew their children from medical inspection or where they kept their children away from such inspection. Statistics of that kind would have been considerable assistance inplacing this problem in its proper perspective, but we have just got a mere résué of the history of public health legislation in this country. The case for this Bill should not have been based merely on that. It should have been based upon the utilitarian principle of serving the common good. The case should have been shown to us clearly that the common good demanded that this measure was necessary to safeguard the public health of the people of this country. Far from making the case that the common good demanded this measure, far from showing us the problem in its true perspective, the Parliamentary Secretary to my mind skipped rather skilfully over the  dangerous features of this Bill and gave us, very lucidly, the good points of this Bill, whether he decided that as a matter of tactics, to let us waste our ammunition and then have a crack at us in the wind up, I do not know. Perhaps that may have been his object, but we shall see in due course.
I should like to put the point of view that under this Bill we are usurping to a large extent the function of the parent and the family. We are invading family rights and parental rights and we are definitely invading the personal liberties of the individual which are guaranteed to him by the Constitution. There are certain natural personal rights which every person should have and these rights are declared to be inviolate and inviolable by the Constitution. They are imprescriptible. They are guaranteed by the Constitution. In so far as education is concerned — which, mind you, includes not only the intellectual and social education of the children, but also their physical education—that, too, is guaranteed under the Constitution to the parents and the family. In this Bill we are definitely invading that province sacred to the parent and the family. We are usurping their function. I could understand a Bill being brought in to deal with the delinquent parent but in this Bill we are not dealing with the delinquent parent. We are giving powers to the Minister for Local Government to usurp the functions of the parent. As to whether he has or has not exceeded constitutionality, I am not going to venture an opinion at this stage, but an eminent lawyer has expressed the view that we are dangerously near unconstitutionality in this measure.
When this measure is enforced, in whatever final form it may take, it will be enforced not by the local authority, not by the elected body of the members of the local authority, but by the paid bureaucrat taking his orders from the Custom House. Public opinion can be ignored, and, so far as the local authority is concerned, it will not know what is going on. It will not have the opportunity. As has already been said in this House, we have a new machinery set up, a medical constabulary  with the most extraordinary powers that were ever given to any medical constabulary. I have already said on another occasion, quoting a famous French saying: “Plus ca change, plus c'est la même chose”, the more things change the more they are the same, to give a literal translation; in other words, we are perpetually moving in circles. History is perpetually repeating itself, and in what the Parliamentary Secretary is doing here he is merely endeavouring to turn the wheel back, to weigh it back towards mediæval times. The only grouse I have with him in this is that he rather showed a lack of courage when he did decide to put back the wheel. He might as well have gone the whole hog and treated this nation as if it were a leper colony. May I quote for the Parliamentary Secretary from Leviticus, Book 13, Chapter 45:—
“And the leper in whom the plague is, his clothes shall be rent and the hair of his head shall grow loose, and he shall cover his upper lip and shall cry: `Unclean, unclean'. All the days wherein the plague is in him he shall be unclean, he is unclean, he shall dwell alone. Without the camp shall his dwelling be”.
Anybody who has taken the trouble to read the story of leprosy will remember that when leprosy was a plague afflicting various communities the greatest handicap that the leper had to put up with was not his affliction but the outlawry which was cast upon him by Church and State. I will quote some of the restrictions—mind you, the Parliamentary Secretary has put some of them in this Bill—which were imposed upon the leper of those times:—
“The leper must not go without his black cowl. He must not enter churches, mills or bakeries. He must not come to fairs or markets. He must not wash his face or hands at public drinking fountains. He must not touch anything except with his stick. He must not answer if spoken to until he who speaks to him is on the windward side of him. He must not walk along the narrow ways at eventide. He must not live in town or village. His only dwelling  must be in the open country, far from men and far from the roads”.
He was sent away into the open. Later, when a more enlightened opinion on leprosy came to manifest itself, the lazar houses were set up. Mind you, in the case of the lazar houses, the leper was admitted on the principle that he was to be treated as if he were Christ Himself. But, under this measure which we are getting here, the unfortunate individual who happens to suffer from an infectious disease is to be treated not even as the leper was treated in the worst days of leprosy but as a criminal, as if he were a man who had committed some grave offence against the community, some serious criminal offence. He is liable to arrest on the public street without warrant; to detention in a Gárda station for a period of 24 hours, again without warrant; and then, when the medical constabulary are brought to the Gárda station, he can be switched away, without the knowledge or consent either of his parents or of his family, to some institution which the Parliamentary Secretary will have designed for his reception. That is the serious position which I see in regard to this Bill, that we are setting up a machinery of compulsion, of criminality, of treating those unfortunate people as criminals, as lepers, when the proper approach, at least as a preliminary, should have been through voluntary effort.
Now, I do not care what the Parliamentary Secretary will have to say professionally to what I am about to state now: there are only three things which concern the human being living in this world to-day—good food, fresh air and exercise, and the freedom to enjoy those in his own way. Add to that, if you like, the observance of physiological laws which man must follow to ensure good health, and you need to medical doctor, you need no medical institution, and you need no health institution. The right of a man to live the natural life is challenged in this measure, and challenged in a way which in my opinion will provoke serious opposition in this country. The expert may feel the necessity for all  those measures. The expert may feel that he must compel those people who will not look after themselves to take certain measures, but surely to goodness the expert might at least have attempted in the first instance, through our schools and colleges and universities, through propaganda in the Press and on the cinema and by lectures, to inculcate into our people habits of personal hyglene which would have, in the ultimate, the same results. Voluntary efforts have not been attempted on the scale on which they might have been attempted in this country, to my mind, and I feel that better and bigger results can be achieved through propaganda in education rather than through compulsory and police methods.
The average doctor attending his patient who is seriously ill is not dependent entirely upon the medicine bottle. He knows full well that, unless he gets the desired reaction from his patient, the progress of that patient will be very slow. He knows full well that, if the patient is suffering from a serious ailment likely to result in death, unless he can get that patient to rally, unless he can encourage him to do of his own volition the things which he wants him to do, that patient will pass out. The relationship between doctor and patient is largely the relationship which I should like to see brought about through any public health measures introduced in this House. In other words, unless you treat the public in the same way as the private practitioner treats his own private patient, unless you can bring them along with you and encourage them, if you like by cajoling them, by coaxing them and, above all, by putting before them the right thing to do as against the wrong thing to do, in that way creating a healthy public opinion, you are going to fail. Compulsion has never succeeded in Ireland, and if this measure had been introduced by an alien Administration 25 years ago there would have been a revolution in this country. I do not want to go further on that particular line, except again to emphasise that I think the powers which are sought in this Bill are so extraordinary that no  Deputy should vote for them until he has absolutely satisfied himself that they are necessary, and we have heard no case yet from the Parliamentary Secretary to show that those powers are either necessary or desirable. I have already spoken of leprosy, and I did that in all seriousness. I do not want to overdraw the picture. In Sections 27 and 28 of the Bill certain restrictions are provided for on the use of public conveyances by a person who may be suffering from an infectious disease. Under Section 27, a person suffering from an infectious disease cannot enter a public conveyance, such as a bus, a train, and so on, and, if he does enter such a public conveyance, the conductor of the conveyance can throw him out. Not only that, but if the conductor of the bus or train, or whatever public conveyance it may be, fails to do so, the conductor is also held to be guilty of an offence, and both the person concerned and the conductor will have to go through a process of disinfection, or whatever it may be.
Mr. Coogan: It is not a shame but in the days of old, to which I have already referred, when a leper came along and rattled his stone and cried “Unclean, unclean”, it was understood what was meant. What is going to happen in the case of people suffering from an infectious disease who get on buses or trains in this country? Some of the people will cry “Unclean”, while others will cross themselves, as their ancestors did, and others will insist on that person being thrown out of the public conveyance. Speaking as a lawyer, I cannot see how this will work. I cannot see, for instance, how the conductor of a Dalkey or Dún Laoghaire bus will be able to determine whether or not a person is suffering from an infectious disease and, accordingly, eject him from the bus. The Parliamentary Secretary may have something in mind as to how that is to be done, but I cannot see how it is to be done, and I would much prefer to see measures being brought before this House with a view to their effectiveness rather than to be asked  to pass such measures if they are going to be honoured merely in the breach.
I will not say that this Bill is all bad, or anything like it. A great deal of the Bill is very good, but I will say that where it is bad it is horrific. Under this Bill you have the extraordinary position that you are going to set up a most elaborate machinery of county medical officers of health, district medical officers of health, child welfare nurses, maternity nurses, authorised medical officers, and so on, but having set up that machinery, we then proceed, under Section 104, to look for the assistance of the police. May I say, in forewarning, that you will need the assistance of the police very definitely? Not only may the local authorities look for the assistance of the police, but the enforcement of this entire measure may, if the Minister for Justice is so weak as to consent to it, be thrown over entirely upon the Gárda Síochána, and prosecutions in connection with any offence under this Act may be handed over to the Gárdai. Any power handed over to the medical officer of health or any of the others mentioned in the Act may be handed over to the Gárda Síochána. As a result, you will have the kind of thing that occurred a few years ago in this country, where a number of extra police were sent to a county against the wishes of the county concerned, but that unfortunate county had to pay for the cost of the extra police. It will mean that the extra cost involved to the Commissioner of Police for the provision of extra Gárdai will have to be borne by the local authority. In other words, the local authority have to pay, not only for the medical staffs, nursing staffs, and so on, but for the extra police. I think that that is a very obnoxious proceeding. As I have mentioned, it was very obnoxious during the British régime to certain counties where extra police were sent down to these counties—police which they did not want—and where the local authority had to pay for the extra cost.
Now, the Gárda Síochána, in addition to their ordinary duties of the prevention and detection of crime, have also to perform many duties in  relation to the payment of unemployment assistance, old age pensions, compulsory tillage, the exercise of the franchise, and a whole host of other things which are too numerous to mention—duties which, normally, are entirely outside the province of a policeman. A police force is primarily established for the purpose of the prevention and detection of crime, but if this measure is to go through in its present form, the Gárda Síochána will be diverted from that duty to a large extent and will be asked to discover what persons are suffering from an infectious disease—a duty which they are not qualified, by their training or education, to discharge. I suggest that that provision is unfair both to the police and to the public. I can visualise cases, if this is passed, where people suffering from infectious diseases may be brought to a police station, and the police station will have to be disinfected forthwith. It appears to me that we seem to be running around in circles in this matter, and I, personally—and I am sure the other members of my Party— would ask the Minister seriously to reconsider this whole matter. If this job has to be done, then let it be done by people with the necessary professional knowledge and professional training and experience which would enable them to discharge this duty in their own particular way, but, for Heaven's sake, leave the Gárda Síochána out of it.
A great deal is being done under this Bill, and a great deal has been done under other measures, but I should like to direct the Parliamentary Secretary's attention to the fact that, under the present system of school inspection, the inspections are inadequate—to my mind, at least. They are not thorough, and I believe that if a more thorough examination of the children were made by the present school medical inspectors, better results would be achieved, particularly in connection with the incidence of diphtheria. So far as my information goes, I do not believe that at the present time the medical school inspectors examine the children's  respiratory organs, and I am told by a high medical authority that one of the primary causes of diphtheria at the moment is due to the unclean noses of the children attending schools in this country. I would ask the Parliamentary Secretary to cause attention to be given to the condition of children's noses. Nasal diphtheria is probably one of the most serious causes at the moment of our present epidemic of diphtheria. There is a shocking position, particularly in Dublin and in the Borough of Dun Laoghaire, under the tuberculosis scheme at present in operation. Tuberculosis patients in a dying condition are being discharged from various tuberculosis institutions, and are being sent home to tenements, in some cases one-room tenements, to die. I know the answer I will get from the Parliamentary Secretary will be that it is better they should be sent out to die, in order to let somebody who has a chance of being cured come into a bed. I just wonder if that is so. These people are being sent back amidst their families, and are being given a bottle of cod liver oil, a bottle of milk and an egg, or something like that.
Mr. Coogan: They are forced to go. The Parliamentary Secretary knows that they get a bottle of milk, or a bottle of cod liver oil for 12 months or so before dying. What I want to stress is this, that while the Parliamentary Secretary and the Department of Local Government are stationary, sitting down on the job, tuberculosis is progressing and advancing.
Mr. Coogan: I was told last night that in the Borough of Dún Laoghaire, if I lined applicants for beds at the Forty-Foot, they would reach to St. Michael's Hospital in a line two deep, and not one of these would get into a bed in that area within the next five years. The Parliamentary Secretary can correct me if I am wrong, but that was the picture given me by a reliable authority. It is a very serious position. I know that there are difficulties in the way, such as housing and in providing hospitals, but I feel that something has to be done either by taking mansions or empty houses or, if necessary, seizing them forcibly in order to provide accommodation for these people, and to safeguard the lives of their families.
Mr. Coogan: The rights of citizens cut both ways. We had Deputy Norton very worried about certain cases that were put forward by Deputy Costello and Deputy Hughes. I say that citizens have rights. I say that a citizen has the right to pursue his life in his own way without interference by the State. I say also that unless a citizen by his own way of living becomes a menace through mental derangement or otherwise, he has a right to stay in his own home. Deputy Norton did not worry about the legal assaults on the individual which are provided for in this Bill. Deputy Norton forgot the fact that under our present law, when an individual goes into a hospital, perhaps for a surgical operation, the surgeon will not operate without his consent, or the consent of the parent, guardian or some other member of the family. Why? Because, without that consent a surgeon would be committing an assault upon the person of the individual. That is the existing law. The Parliamentary Secretary is going to legalise all that. He is going to provide for legal assault on every Tom, Dick and Harry that the local authority chooses to assault. That is what we are getting in this Bill.
There are several parts of the Bill  with which I find myself in agreement. The only reference I want to make to the drainage and water provisions is this, that they would want to be exercised with great discrimination. Local authorities in the past, by their inactivity and neglect, left a legacy in various parts of the country which it would be unfair to pass on to individual householders in the implementation of this measure. I can see serious financial imposts being placed on individual householders. It is essential, when these parts come to be operated, that every consideration should be given to the past history of local administration in particular areas, to ensure that individual holders are not asked to do out of their own pockets what local authorities should have done in the past.
As regards Section 54, and the provision with regard to wells in rural areas, I think that is an important one. I should like to know from the Parliamentary Secretary, whether it is intended that grants would be given to enable artesian wells to be sunk. There are areas in my constituency where farmers have to draw water a distance of two or three miles. The only water to be found on these farms is at a considerable depth, so that the cost to the average farmer of sinking an artesian well would be beyond his capacity to pay. If Section 54 is intended to help people in that position, it is a very desirable provision. There is an extraordinary provision in Section 91:—
“A sanitary authority may make bye-laws imposing duties on owners of animals for the purpose of preventing danger to public health or injury to amenities arising from such animals when they are brought to or allowed to be in any public place.”
My reading of that is that the provision could be implemented to preclude the holding of fairs in certain towns and villages, particularly on the public streets. If that is the intention, I suggest that the Parliamentary Secretary should hasten slowly, because many of these fairs have been held there from time immemorial, and while they are a certain nuisance on  a particular day, these places are cleaned up the following morning. I know of no case where any disease was contracted by the holding of fairs or markets on particular thoroughfares. As the Bill stands, it seems to me that fairs or markets could be prohibited. If that is the intention, I suggest that the Parliamentary Secretary should qualify the provision in some way, which would ensure that recognised fairs, which have been held from time immemorial, very often because there is no fairgreen nearby, would be permitted. Any disturbance of these fairs would have a serious effect on local trading conditions, and would be a serious interference with trading rights. I welcome the provisions contained in Section 98:—
“A sanitary authority may take such steps as are reasonably necessary to prevent injury being caused to public health or the amenities of any locality by reason of obstruction in any river or watercourse.”
If I had any fault to find with that provision it is that the State makes no provision for authority to remove obstructions in the rivers and watercourses. When the Arterial Drainage Bill was before the House I failed to get a provision inserted which would deal with urban flooding, the ground of objection being that the Arterial Bill was designed primarily for the drainage of agricultural land. We have an extraordinary position in Kilkenny. Each year the town is flooded, in parts, to a depth of 5 feet to 6 feet. Likewise, in the town of Thomastown. Boats have to be used to get about the streets there on account of the flooding of the Nore. Graiguenamanagh and Inistioge are also affected by the flooding of the Barrow. These floodings leave dampness which remains in the houses for months and many of these unfortunate people are unable to provide the necessary extra fuel to dry out the dampness. I was in Kilkenny City when one of these floodings occurred. I saw up to five feet of water sweep through sitting-rooms and kitchens. It was flowing at about 40 miles an hour, entering by the front door and sweeping furniture and  everything before it out by the back door. It was a miracle that lives were not lost. I saw babies' perambulators floating in three and four feet of water and it was due to the providence of God that those infants were not drowned. That condition is recurring in Kilkenny and the towns I have mentioned almost yearly. I have been told by the Parliamentary Secretary to the Minister for Finance that this is not a job that will be done for years under the Arterial Drainage Act. Therefore, I ask the Minister, through the Parliamentary Secretary, to consider problems of this kind and deal with them in this Bill. Those conditions are definitely detrimental to the public health. In parts of the areas flooded in Kilkenny—Irishtown particularly—the houses are permanently damp and many of those houses are occupied by tubercular persons. That can be entirely attributed to the dampness caused by these inundations. I want the Minister to consider not only enabling the sanitary authority to deal with the flooding but to give grants to the sanitary authority to ensure that the job will be effectively done.
Again, I ask the Minister to reconsider his approach to this problem of infectious disease and to abandon—at least for the present—the compulsory, or police, methods contemplated by the Bill. I ask him to consider a propagandist and educational drive, through the medium of the school, the college, the home, the cinema and the Press. If voluntary efforts on these lines fail, he can come back to the House, which will then, I am sure, give him the compulsory powers he seeks, on the ground that voluntary effort has failed to shock our people into an appreciation of the seriousness of their position. I believe that, as doctor and patient get on well together, the patient improves. I also believe that if public health services be brought into the same relationship, you will get better results.
Vast machinery, the cost of which has not been indicated by the Parliamentary Secretary, is to be set up. Is this machinery intended to interfere  with such voluntary services as are at present functioning? In my constituency, we have many nursing services. We have, for example, special medical and nursing services for our mine workers in the Castlecomer area. Is it intended that those services should continue on a voluntary basis, or will they be merged in these public health services? Is it intended that on the voluntary organisations compulsory public health services will be superimposed? Are our people to be medicinised and inspected to death? Where there is a voluntary organisation rendering satisfactory service, it would be better to leave individuals to be treated under that service than to bring them under the compulsory system. In the long run, the voluntary service produces the best results and a better relationship between officialdom and the public.
Mr. Donnellan: For the past two days I have listened with interest to the debate on this Bill. As the previous speaker said, we appear to be going around in circles. Many arguments have been adduced against the Bill. Some Deputies say that the great snag is that the Gárdaí will have to interfere. Others say that the snag will be in the cost of administration. The principal case put up was concerned with the rights of the citizen. I do not think that this Bill should be approached by any member of the House in a Party spirit. Certainly, I shall not approach it in that spirit. It is a Bill which is necessary, regardless of what any Party—even the Party to which I belong—may say. It is a Bill against which I would not vote, simply because I believe that something must be done. I do not give any credit to the Government who are bringing in this Bill. It is the duty of those who constitute the Government to bring in such a Bill, and, in my opinion, such a Bill was long overdue. As regards interference with the rights of the citizen, I have as much respect for the rights of the citizen as any man in this House, but, in some respects, as regards public health, it is necessary that the rights of some of our people should be interfered  with. The question has been asked: “How would you like if the Gárdaí were to come along and tell you to get your children examined?” I believe that that would be only right if it were necessary.
I believe that, as regards the public health, we must not confine ourselves to the kid-glove method of dealing with it. If we do, we shall never succeed, because the section of the community with whose rights we are supposed to be interfering never did, and never will, submit to kid-glove methods. Why should there be such objection to the Bill? Deputies realise that, if this nation of ours is ever to come to anything, it must be built up from the health point of view. Why anybody should object to the cost of the Bill, I cannot understand. The cost of the scheme may be very heavy, but what greater value can we get for money than improvement in the health and strength of our people?
The last Deputy referred to voluntary effort. I do not believe that voluntary effort would ever get us a bit further than we are. The case is made that the Gárdaí should not be brought into the administration of the scheme. The very Deputies who say that the cost of the scheme will be extremely high say also that the Gárdaí should not interfere. If not, we must have some other force to administer this measure, which will involve additional cost. I agree that the Gárdaí have many duties, but they are servants of the State, and if some of their time can be devoted to this work, I do not see why they should not be told to do it.
Mr. Donnellan: I believe that the Bill is necessary and I would be acting against my conscience if I were to vote against it. We have heard of the state of health of some of our people. That is stated to be due to malnutrition. That may be right, but it is my opinion that there should be some law so that some of our citizens—not making little of any of them—who, at the moment, roam around our towns and streets, should be cleaned—that is the word.  I fail to see why any Deputy should have objection to the Bill. It does not interfere with the rights of the citizen. Does it interfere with anybody's rights if a Guard or a medical officer of health says “You must come and stand an examination”? I say that that is a good thing and I am the last man in the world who would stand for interference with the rights of the citizen. If it is necessary to interfere with a certain section, it is a good job to do so. I do not compliment the Parliamentary Secretary or the Government at all on introducing the Bill, because it is the duty of any Government with any interest in the building of a clean, healthy people and in giving us the State that we all look forward to seeing to introduce such a Bill.
Seán MacCárthaigh: Ba mhaith liom cúpla focal a rá ar an mBille seo. Deputy Costello last night, with fluent and flexible tongue, lashed with indignant, fiery wrath, not the constructive intentions of this measure, but rather the proposed special provisions for the ultimate enforcement of certain sections. The Bill was described as unChristian and unconstitutional, but I fail to see how the bringing about of personal cleanliness and healthy environment is either unChristian or unconstitutional. Deputy Cosgrave has said that it is the right of the people to ask for what they want and, to my mind, Deputy Donnellan has rightly interpreted the functions of the Government elected by a democratic people to interpret their wants and to implement such measures as may serve the national interest.
This undoubtedly is a good measure in all its aspects. There may be certain details which we would like to see amended, but the day for considering these matters will come. At the moment, the Bill is designed to improve the health of the nation, to remedy sources of infection in the rather backward state of our public health services and in many other ways to repair defects in the public health system. Everybody agrees that such provision as is made in the Bill  for cleaner and healthier food for the people should be encouraged and supported, and I think everybody will also agree that the Parliamentary Secretary is to be congratulated on making it incumbent on those who advertise various patent medicines and cure-alls to specify in their advertisements and on their products the exact ingredients, so that public authorities may analyse them, if necessary, in the same way as milk distributed to the community may be analysed.
We are told that the Bill interferes with personal dignity. The great bulk of the people will obey the natural laws and those measures which are designed for their advantage and the advantage of the State, without any legislation, but there are in the community people who do not realise either their responsibilities to their families and their neighbours or to the nation in general for whom legislation is necessary. When there is some exposure, following an inquest, in the Press, the public conscience is shocked and people ask: “What have the public health authorities done about it?” or “Why did the public health authorities not do something about it?”; but with an enabling Bill such as this, which not only gives the necessary powers to a local authority but brings to the people the sense of their responsibility which discussion of any such measure will bring, we are getting further along the road towards the promotion of the better health of the community.
We are told that the examinations in the schools are not thorough. Deputy Coogan said they were not effective, but, as one who has some experience in that regard, I beg to disagree. I think they are excellent. The only defect at the moment is that some of our schools are unfortunately so bad. I agree with the Deputies who said there are many things in that connection which must be remedied, but must our public health services stand still until such time as all these defects are wiped out, until these flaws in the national system are got rid of? Even a prison cell must be kept clean, and no matter how small  the room, the dwelling, the home or the school, it is the duty of those responsible to discharge their public duty in that regard. What I see about the schools is that it is very difficult to have adequate provision in them for these medical examinations. They are badly heated and very often are small. In many cases it would be necessary for the medical officer to bring with him portable screens or other equipment to serve for the privacy of those who are being examined. I would see nothing wrong in having a provision of that kind. It is said that these examinations are not very effective. I hold otherwise, and that the children who are examined at school are very often advised in such a way that their whole future career and health are benefited.
There is not much else that I have to say. The Bill will be considered in Committee and any amendments that it is thought fit to propose will be brought forward. I am sure that if they are wise amendments, the Parliamentary Secretary will give them due consideration and, where he thinks fit, will accept them.
A reference was made to the section dealing with people who are responsible for public conveyances. I think these sub-sections are very loosely worded because even a person who, in the opinion of the responsible officer, is regarded as a probable source of infection, is kept off these vehicles. In my opinion some of those sections would be impossible of implementation. These are matters that I am sure will be remedied. I, personally, welcome the Bill. I think it will help to remove much cause of complaint and much of the drabness from many of our villages. In these we have at the moment no sewerage schemes. It will enable us to get a domestic water supply into our homes, so that the woman of the house will be able to carry out her duties with less drudgery than at present. The Parliamentary Secretary has in my opinion taken a step which will be of general advantage to the people and I, accordingly, welcome the Bill.
Mr. McGilligan: The last Deputy made his preamble to the Bill in the  usual formula: “Ba mhaith liom cupla focal a rá”. He did not continue very far in that tongue. Obviously, he is one of those people who know sufficient about the language to be impressed by the great strength of all that we have heard about the famous Keating Branch of the Gaelic League, and should easily move forward to the view, with regard to this Department and its duties, that it is going to earn for itself hereafter the title of Keating's Branch of the Government.
Mr. McGilligan: He agrees with Deputy Donnellan in his view with regard to this Bill. If Deputy Donnellan confined himself to saying that there was great need for an improvement in the public health everyone would applaud that. But the Deputy went on to say that this Bill was going to improve the public health. That is where I quarrel with him. The Bill has a certain number of plus signs to its credit, but it has a very big number of minus signs which, I think, should make anyone hesitate before giving the Government the measure as it stands. As far as the good things are concerned, I think they are mainly on paper. I think we will find, if the measure is passed, that we will have to wait for at least a generation before we get any movement for a betterment of the public health in the way of a real provision towards that.
There is a great deal in this Bill about providing this country with swimming pools and playing fields. We know that when the Drainage Bill was discussed about a year ago, and when there was talk about the expenditure under it, the Parliamentary Secretary hastened to say that the expenditure was not going to reach a higher maximum than £250,000 a year, and that the drainage was to last out over 33 years. When will we see an accomplishment of any of the good things that are in this Bill? I think it is going to be a long time. There are certain easy things to do, things which may attract the public attention and  that may get for a Department that is a notoriously lazy one the reputation that, at last, it is doing something with regard to public health. I think there are some dangerous clauses which may be operated immediately, but I see nothing in the Bill which is going to bring about, as far as I can judge, any great improvement in the public health. I can see nothing in it which is going to ensure for the ordinary citizen any real guardianship against the contagion to which he is exposed at present. I have not heard the case made that infection or contagion, or anything that is supposed to be guarded against in this Bill, has been responsible for any great deterioration in the public health. I have not heard the case made that the precautions outlined here are going to produce a tremendous improvement in the people's health. I do see one very unusual thing in the measure, and that is that a Minister sitting in Dublin may order certain things to be done and may impose these as an obligation on the local authorities—the necessity to raise the money to carry out his views. That is getting beyond the ordinary idea of representation and taxation.
I should like to discuss soberly the danger there is to certain things that are regarded as much more substantial than even the public health. Deputy Coogan called attention to Sections 102, 103, 104 and 105. These are very important sections and one could discuss them either in the context of a public health Bill, or in the context of a crime Bill, or in the context of anything that has to do with the common good. It will be recognised, I am sure, by Deputies, even though they may deride the fears of people in this connection, that there are certain personal rights that every individual ought to have, and that he should be guarded in his keeping of them. These human rights are very old. They are sometimes wrongly expressed as being the fruits of the French Revolution. People who have studied deeper know that they go back much farther, that they are a product of the natural law,  and are a heritage of the Christian and classical tradition. They include such things as the right to live one's own life in private if one so desires. They include the right that one is not to be held up at various moments and asked who he is and where he lives. There is the natural right that a person shall have his house to himself and that the privacy of that house should be regarded, and certainly that force should not be used to break down the barriers that he imposes against all such people coming in on his privacy. Finally, he is to be guarded against being brought into court or being put into jail, except for very serious offences. Sections 102, 103, 104 and 105 say, just casually and generally, that the Guards may be called in to deal with what somebody regards as an infraction of the public health law. When somebody has reasonable grounds for believing that a person has contravened provisions, then we get the whole machinery of the law and the upset of privacy, the upset of the right to the home, the upset of a person's right to walk freely about the streets and to remain at liberty. All that, because somebody has reasonable grounds for believing that there has been some infraction.
I think everybody who has dealt with these matters of the natural law and these fundamental rights knows that these rights are not absolute, that they can be broken in on, but generally there is at least such respect for these rights that one does not casually break them. They are respected unless there is a good case made on the foot of the common good that these individual rights or these family rights should be broached. Has anybody in this House heard that case being made? Has anybody here heard that people have been indifferent to the public good? Has any statistical information been given as to the spread of epidemics? Has any indication been given to this House that individuals, either in areas or all over the country, have been so negligent that what I want to have preserved to them as their liberties have, in fact, degenerated into something that may be called licence? Have we been told  with regard to children, say, that parents, either as a class or in specified areas of the country, have been so regardless of the health of their own families that they have allowed these children to become so verminous as to be a danger to the public health or so riddled with contagion or infection that they are in that way also a danger to the public health? Has there been any case made that those who are in charge of the schools of this country, and, I take it, particularly the secondary schools, have also been indifferent to their obligations, that epidemics can be traced to certain schools or convents and that, in fact, one can say the blame lies on the authorities of the colleges or the convents or on the parents who refused to allow medical inspection of their children at these colleges or convents?
Finally, has any case here been made that the group of family doctors as a whole have been indifferent to their obligations in regard to the common good? Are there any cases in which it can be said that people who got their children attended to by the family doctor have found that family doctor allowed them to permit their children to spread infectious or contagious disease through the community or allowed the parents to have their children in such a verminous state that this vermin has been the cause of infection or contagion throughout the community?
I should imagine that anybody who wanted to bring forward a measure of this sort would at least have produced a case on some one or other, if not all, of the heads I have mentioned. The measure is presented to us simply with the statement: “Here are a lot of provisions which we may enforce”. I want to analyse one or two of them, but with reference to the provisions all that was given was a history of the health legislation, proving nothing more than what any intelligent member of the community knew already, that this country was lagging 40 or 50 years behind the provision for the public health in other countries.
Deputy Donnellan, apparently, believes in these paper safeguards.  Deputy Norton does not, although Deputy Norton, strangely, does not object to some of the things that have been objected to by most people in connection with this measure. But Deputy Norton has said—it is the comment that has to be made on most of this type of patchwork legislation that we have produced here—that trying to make people clean by compulsion and trying to make people even healthy by compulsion does no great good as long as other Governmental activities tend to make people poor. Poverty is a condition that creates dirt and helps to breed disease and helps to beget the habit of mind that Deputy Norton deplored, the habit of mind that regards dirt, vermin and disease as something that is just part of the common lot and has to be borne as it cannot be avoided.
Deputy Donnellan queried whether malnutrition was the cause of the increase of disease in this country. The medical officers of health in this country in a series of reports that they produced in the last couple of years had no doubt upon that score. There was hardly any of them who did not put malnutrition in the forefront with regard to disease and the increased incidence of disease in the country and more particularly with regard to tuberculosis. We have got to the position in which we have a larger number of diseased folk amongst those who remain to us. We are emigrating at a very fast rate. Those who go leave us in a healthy condition after, I believe, being compulsorily cleansed before they go and the compulsion being insisted upon by the folk to whom they do go. We readily clean up our people for export.
I look at these Sections 102 to 106 because they give me the warning bell about this whole Bill. These are the sections which may allow the Guards to be brought in, as I say, because somebody has reasonable belief that a provision of the Public Health Acts is being contravened. But, there are other matters which one may deal with more particularly. The biggest danger I can see in this Bill is that we are clearly up against the expert. We are  up against the person who is efficient; we are up against a group of persons who, being both expert and efficient and, apparently, enthusiastic about this sort of matter—I am referring to the Minister's medical advisers—are the most dangerous people, the people who being expert in the matter and being efficient are also imbued with the belief that a programme which they have set before themselves can be carried out and, if carried out, will bring about a result which the community would desire. That sort of person is apt to be rather of a single-track mind and ordinarily turns out to be rather a person who works in disregard of the general rights of the community. The expert with regard to public health would be apt to think that anything is worth sacrificing as long as the public health is improved. That is a viewpoint that I do not agree with at all. Even an improvement of public health—and I do not believe that this Bill is going to give us that—could be dearly bought if certain other things were going to be disregarded.
I take these sections that deal with the treatment of children—Section 86 and a few others that follow from that. It is extremely difficult here, because of this legislation by reference, to find out the full meaning of this but I do not think I exaggerate when I express it in this way: Up to this there has been allowed an inspection of primary schools; that is now going to be enlarged and it is going to be applied in relation to a particular school which is not an elementary school; it may be applied to one such school or to all schools which are not of the elementary class. Where does that stop? It certainly goes to secondary schools. I presume it goes to vocational classes. Does it go to university establishments? It may go the whole way. And in the inspection what then may happen? As far as the inspection is concerned there is simply a day ordered upon which a medical inspector is to visit the school. When he does, the school must be kept and settled for him, and when he goes there the whole school may be  examined and, after examination, as far as I can trace it through the relevant law, either the whole of the pupils of the school or certain selected people may be asked to undergo treatment and the treatment may involve injection or immunisation and I do not think it necessarily stops short of operation. It certainly goes to injections and immunisation.
Mr. McGilligan: I am not talking about intention, but what may be contained in the Act. I take the application of this, say, to a Dublin convent. The Minister orders a medical inspector to go to that convent. Young children are often found to be rather reluctant to undergo medical inspection at all. The medical man is apt to be a bit of a bogey-man in the house because, if he ever does anything, it is to prescribe nasty stuff which has to be taken. He may annoy the children by having to feel them and he may annoy delicately-minded children merely because they have to appear naked before him. Parents are well aware of that. Often parents change the family doctor, the person who attends to themselves, because he does not just work himself into the good graces of the child and somebody else, with more wheedling ways or a better or more trustworthy manner has to be got to attend to the youngster.
In any event, it is surely a rather sacred matter. It certainly is a very solemn matter not to be approached lightly—the consideration of who is to be the medical person chosen freely by the parents as the person to cause a child to appear naked before him and to be subjected to examination and, understand it, it is a matter to which most parents give considerable thought. Even in schools where children are boarded out and where there is medical attention provided, most of the good schools make arrangements to notify, if there is time for notification, the parents with regard to anything which calls for examination of a child, particularly a girl child, and allow the parents, if there is time  for it, to send the personal medical attendant of that child to the school, without any derogation of or disrespect to the medical attendant called in or ordinarily attached to the institution itself.
As I say, if a case could be made here—I do not know whether the case can be made; we certainly have not heard of it—that the secondary schools have been found lacking in this matter of public health, of the health of the children under their care, something could be said for this. If a case were made that an outbreak could be traced to a particular secondary school and that either the heads of that secondary school had not enough foresight or nous to see what was happening under their eyes, or that if what was there in the way of disease was allowed to develop, it would spread into the locality, and if they failed to call in a medical attendant or, if the medical attendant of the school, being called in, was also negligent or failed in some way or other about performing his duties properly, then one could see some reason for asking that the Minister should be empowered to send in his medical inspector. But that the medical inspector, so far as this measure is concerned, without any collaboration with either the medical attendant of the child or the medical attendant of the school is to conduct his personal and independent examination, I think that is going to a point that is not at the moment authorised by any case that the Parliamentary Secretary has made.
I do insist that one of the duties of a family man is that he should provide —and most of them do provide—carefully for medical attendance on his children. Most parents are quite careful about that. Most parents realise the delicate matter it is. But, just here, casually, we have introduced the provisions already applying to elementary schools. I do not know how far the Parliamentary Secretary can make the case that they have been found necessary even in elementary schools, or could make the case that, if this medical inspection in elementary schools had not been carried out, there  would have been a serious set of epidemics throughout the country. The Parliamentary Secretary has made no such case. He might try to make the case that the medical inspection of elementary schools has, at times, checked the growth of epidemics in elementary schools. No such case has has been made.
I suggest that, without a case, a strong case, it is a wrong thing to allow somebody, who is a complete stranger to the parents, and, much more emphatically, a complete stranger to the child, to be thrust in, say, to a convent and that the children should be asked to undergo an examination which may involve their appearing naked before that person without the children's knowing what is happening and certainly with the children knowing that their parents have not been consulted and, possibly, even knowing that there is some antagonism between the head of the school and the medical attendant of the school to which the inspector is sent.
At the end of it all, if this measure becomes the law, the child must be submitted to this medical examination and, if it is not so submitted, an offence is committed and the offender may be prosecuted by any county authority who gives the relevant notice under the section, and the person is liable, on summary conviction, to a fine not exceeding £10. I think that is a serious encroachment upon the natural right, the right which the community have beyond what is in the Constitution, the right founded upon the natural law, the right which the Constitution pretends to guarantee with the backing of the natural law.
I go from that to this other amazing series of sections, starting with Section 29, which says that, where the chief medical officer of a county or county borough, or the medical officer of a port sanitary authority, is of opinion that a person is a probable source of infection and that his isolation is necessary or expedient, he may order his detention or isolation. That may be consequent on the medical officer's own observation, or it may be founded on what he hears from another medical  practitioner. But, if he reaches the conclusion that isolation is necessary and expedient, then the medical officer may order the detention of the person. Not even the Minister is to be approached in this matter. Certainly there is no question of any magistrate or any independent person of a judicial mind-somebody separate, somebody who is not involved in the profession, somebody who, nevertheless, will be appreciative of the public good and will take seriously what any medical practitioner will say. Without any such intervention of an outside authority, the medical officer may order, in writing, the detention and isolation of such a person; and, not merely that, but he may say where the person is to be isolated or detained. He may specify the particular place.
That, peculiarly enough, is a proviso repeated in another general section, Section 101, where the Minister is given power to prescribe a particular place for the treatment of particular diseases or infirmities. In any event, with regard to this person, about whom somebody has an idea that he ought to be isolated, he may be detained in such place as that medical officer orders. He is to remain there until the medical officer gives a certificate that he is no longer a probable source of infection.
We go on then through the series of sections, arriving at the amazing proposition in paragraph (k) of sub-section (2), that the patient, or parent of the patient if it is a person under a certain age, may appeal against the detention. To whom is the appeal? To the Minister. Most detentions have a right of appeal in respect of them. Detention, whether it be in a cell in a jail or in an isolation ward in a hospital, is an infringement of a person's liberty, criminal as it may be in a prison, for the betterment of society. It is quite possible and it may often happen that people who are ill with infectious diseases may have to be imprisoned for the good of society, but in nearly every case there can be an application by way of habeas corpus as to whether the person should be released or not and, unless the case is made to the satisfaction of the court, the person may be released from detention. Here the appeal is to the Minister.
I do not know whether this section is supposed to preclude habeas corpus applications, but I know that the ordinary run of the statutes seems to be that, where a statute prescribes a particular right, that particular right operates to the detriment of a general right. Therefore, it would seem as if the ordinary right of appeal to the courts does not apply and that detention in an isolation ward in a hospital —which is certainly as grave as detention in a cell—may not be appealed against to the court but only to the Minister. I again suggest that that is an amazing provision in itself. I do not know what case can be made for it. I know that none has been made. I would like to know how many cases there have been in the last decade under which it was found necessary to isolate people. I understand there was one group of people who moved from some part of the West and eventually were found in Donegal and had to be put in. I understand that is the only lot since the war began and they were collared under an Emergency Powers Order. This, by the way, changes the situation under the Emergency Powers Order, as now the county medical officer of health or some medical officer is given power to order the detention or isolation.
After we realise that amazing provision in itself, we can see what happens if the person against whom such an order is made resists, if detained, or does any act of insubordination to any officer of such hospital or place, or does any other act, whether by omission or commission, of misbehaviour, prejudicial to the good government thereof or, if you please, escapes from the isolation ward or does not submit himself in peaceful and orderly manner to the exercise of the powers.
Mr. McGilligan: I would rather keep to the milder things. That person who is charged with having done some act of misbehaviour prejudicial to the discipline and good government of the hospital, is going to be liable to a fine not exceeding £50 or a term of imprisonment not exceeding three months, or both fine and imprisonment. Is not this bureaucracy run stark, staring mad?
If a man is lifted by the county medical officer of health and stuck into an isolation ward in a hospital and, naturally aggrieved over his treatment, he resists or is what somebody may call insubordinate, or if he does some act of misbehaviour, then the sanctified terms “prejudicial to the discipline and good government thereof” shall apply—the terms which, I think, were used in the Offences Against the State Act, which allowed people to be detained if, in the opinion of the Minister, they were doing something prejudicial to the good government of the country. The unfortunate man, detained against his will and very definitely aggrieved at the treatment put upon him, who does something which can be described later as misbehaviour and prejudicial to the good government of the hospital, may be fined £50 or given a term of three months' imprisonment. Again I ask if a case can be made for it. It has not been made yet. Is a wandering collection of tramps and tinkers, who caused trouble from the West up to Donegal, responsible for this? Are we really building up the public health provisions for this country in the future in a permanent way upon the vagaries of some group of tinkers operating in the most curious times of the last few years?
I turn finally to the infectious disease provisions in the early portion of Part IV. I want to deal particularly with Section 21. I want to point out to the House, first of all, that we are going to deal here with what parents may have to do with children, and particularly with regard to children who are verminous. There is no definition in this Bill as to what “a child” is. There are various descriptions of “child” in various bits of law. The ordinary description, as far as the ordinary law is concerned, is “a person up to the age of 14”. After that, certain other phrases are used, such as “young persons” or “juvenile adults”, but it must be remembered that, for the purposes of the civil law, a person is an infant until he reaches the age of 21. I do not know what “child” is supposed to cover here and there is no definition of it. Neither is there a definition of “verminous”. The dictionary describes “verminous” as “a person having vermin”. I do not know whether that is the intention here, but there is no specialised description of the term and no limitation put upon it.
I want to put this in a broad, general way, as a principle. Section 21, first of all, says that a parent shall not send to any place to which the section applies a child, or permit a child to attend any such place, if he has reason to believe that the child is verminous. I am leaving out the question of infectious disease now. The places mentioned are a school, a place of public worship, a theatre, a concert hall and a cinema. How is the parent to have reason to believe? In this way, the family doctor is going to be made the spotter. I remember at one time I used to be attached to tales called The Head-hunters of Borneo. Now we are to have the “head-hunters of Éire”. The family doctor, who gets into the house on terms of intimate relationship with the parents and children, a man chosen by the parent to deal with disease, visiting a house to deal with, say, some disease affecting some member of the family, may become aware that a child is verminous. He must report that to the district medical officer. Surely, that is a very serious encroachment upon the relationships which have existed and which should exist, relationships of intimate personal contact and great confidence as between the family doctor and the member of the family who calls that doctor in for the treatment of disease? For the future, that doctor, called into a house to deal with disease, has been asked to spot for lice, for vermin, for anything that comes  under the heading of vermin. When he does become aware of it, he must report to the district medical officer. If a school medical officer discovers that, of course, he also must report.
Then look at the run of the sections. There is no responsibility imposed upon the family doctor. He is not asked to pass his judgment upon whether the vermin he may become aware of in the child's hair or on the child's body are likely to cause infection to anybody else or not. It is just the presence of vermin. The family doctor visiting the house to deal with disease in the home becomes aware of vermin on a child and he reports that fact. Then sub-section (4) swings in:—
Therefore, he may not send the child to any of the places that are indicated. A simple situation occurs where a doctor goes in to attend some ailment of a parent and he becomes aware that one of the children has vermin, whatever it may be. He tells the district medical officer, who serves a notice on the parent, and from that moment the parent is forbidden to let the child go to school, to any place of public worship, to any theatre, concert hall or cinema. Is not that a shocking  encroachment upon the rights of individuals?
The question has been asked whether the medical profession was consulted, or whether the Church authorities were consulted over this provision. I would like to know whether the Church authorities have agreed that these are things that are Cæsar's, so to speak, and that it is for the State to see that a child may go to Church, to Confession, to Communion, and what degree of vermin or what number of lice in a child's head will be regarded as sufficient to preclude that child from attending at Mass, going to Confession, or receiving Communion. I wonder have the Church authorities been consulted about this? I wonder do the enthusiasts at the back of the Bill not think that if, in a particular area, vermin—lice of a certain type may, I understand, spread typhus—or typhus-infested lice were to be found in the clothing or the heads of children, that that would be an opportunity to go to the ecclesiastical authority of the district, and say to him: “If children congregate at Mass there may be a further spread of this disease, and it might be well to have an exhortation given to children to keep away.” But that is not done.
The whole section is automatic. The family doctor must report, if he thinks that a child is verminous, or is a probable source of infection. From that moment the whole machinery is geared. The district medical officer must serve a notice prohibiting the attendance of the child at school, at a place of public worship, at a theatre, concert hall or cinema, and the parent, by the very act of getting the certificate, is deemed conclusively to have reason to believe that the child is verminous or is a source of infection. From that moment until the new certificate is given, the child is not permitted to attend school or those other places which I have mentioned.
This is undoubtedly bringing in a sort of Gestapo system into the home. The family doctor who is brought in to deal with ordinary disease is now made to deal with dirt. We had the  warble fly inspectors with regard to cattle; now we have the lice inspectors with regard to human beings. The family doctor is now to be made the louse inspector with regard to human beings, and he is bound to do certain things. I say that if there was any case made that in some areas of the country family doctors visiting houses had become aware that children were so verminous as to be a source of danger to their neighbours, and had failed to acquaint the public health authority of that fact, and consequently some epidemic broke out, the Parliamentary Secretary might have his feet on reality, but that case has not been made.
These provisions are to take effect if and when a child, whatever age it may be, is discovered to be verminous, whatever may be the meaning of that term. If it were put in this way, that a doctor attending to a family became aware that a child was so verminous that in his opinion it was likely to be a danger to the community, then one could imagine a further spread of the infection; but the unfortunate doctor is not given any power to exercise his judgment except as to where he spots the vermin or whether he is aware the children are verminous, and then he must report and everything else swings in after that. That I regard as the most serious encroachment there is on the rights of citizens.
We are entitled to say that that is a section which should be excluded from this Bill until a case is made for it, and even then I think the section should be packed around with safeguards, so as to prevent this particular thing occurring. I should like to hear whether any ecclesiastical authority has pronounced on this section, and whether it is regarded as good morals, apart from being good public health. The funny thing about this section is that even when the parent does get this notice, and is forbidden to send the child to school, to church, to a theatre, concert hall or cinema, he can allow the child to go in a public conveyance all over the place. That is one of the things not particularly prohibited.
It is when you get to the wider area  of the infectious disease that the other sections up to Section 28 apply. Where could there be found anybody except a single-track enthusiast who would ever allow a section such as Section 28 to be framed?
The Parliamentary Secretary will prescribe what are infectious diseases. The ordinary common cold is one, but I do not suppose that will be prescribed. You can go from that to a whole line of things. Has the ordinary bus conductor to acquire a knowledge of the various things which the Parliamentary Secretary will prescribe as infectious diseases? I gather that if the Parliamentary Secretary says it is an infectious disease, it becomes one. It is a funny change of nature. Has the bus conductor to get some list of his own which will include all the diseases to which the Act will apply? Are bus conductors to be given any course of training? Will there be a notice posted up in the office, setting out the infectious diseases to which this measure applies? Will conductors be trained so as to enable them to discover how a person may be a probable source of infection?
What does the section mean? Is it only to create an impression in the public mind that something is being done, whereas nothing is expected of the section at all? What evidence will the bus conductor have to have to make him come to the conclusion that a person is a probable source of infection? Apart from all that, there is the amazing sub-section (7), where the owner of the conveyance is not the conductor or, to put it the other way, where the conductor is not the owner, and where the conductor lets into the bus some person adjudged afterwards to be a person the conductor should have known to be a probable source of infection. Then the owner, who has probably never heard of the passenger,  may be fined a sum not exceeding £50. What is the object of this? Does it mean that it is an effort to impose on the proprietors of a bus company the duty of teaching bus conductors what the infectious diseases are, and how it is possible to recognise a probable source of infection with a particular infectious disease?
Apart from that particular matter, we have Sections 19 and 20, under which, in case the Minister would not prescribe enough, if a person knows that he is a probable source of infection, he shall, in addition to taking the precautions specially provided for under this Bill, “take every other reasonable precaution to prevent his infecting others with such disease by his presence or conduct or by means of any article with which he has been in contact.” If he contravenes these sections he is a liable on summary conviction to a fine not exceeding £50. That is to say, the Minister is given power under these sections to make all sorts of regulations covering a variety of matters which are particularised in the Second Schedule and, in addition, the Minister may prescribe a variety of other matters. If the Minister prescribes an enormous number of matters and if a person feels: “Well, I am safe if I obey all these,” and succeeds in obeying them all, but nevertheless fails to take every other reasonable precaution, as well as the ones prescribed, he may be hauled into court and he will be liable to pay a fine of £50. Again, I imagine that if these sections had been based on experience, the Minister would have told us: “I want this section because it is necessary,” and he would have given us an example of the sort of person who failed to take reasonable precautions beyond the ones prescribed. The Minister says that we must have these far-flung sections, and even a person who has taken all reasonable precautions may be penalised under them. I have already stated that even though people may have rights under the natural law, these things are not absolute and they must be limited by the idea of the public good. Nevertheless I do say that these rights are something we should respect and safeguard  and we should not permit any encroachment of them until a really strong case has been made, proven from experience, that unless we have these regulations encroaching on human rights, the public health is going to suffer.
Deputy Coogan referred to lepers. Leprosy is a hideous disease, one that is very dangerous from the public health point of view. We equate dirt almost to leprosy, almost as if children with nits in their hair are being told to shout, or their parents are being told to shout for them: “Unclean, unclean” and not let them near a church. If the enthusiast at the back of this Bill had been alive at the time the Gospels were written, some of the passages in the Gospel would not have been the same. Lazarus, whose sores were licked by the dogs, would not have been carried to the home of Father Abraham. The people who stood by the pool of Bethsaida, the halt, the lame and the withered, and who waited for the moving of the waters, would have been moved themselves by the inspectors of the Department of Public Health in these days. There were ten lepers who, in the Gospel, stood afar off and claimed a miraculous cure and got it. There was even one person, a named leper, a general of the army of the King of Syria, who was allowed to bathe in the waters of the Jordan to become whole and cured. That is all dealing with leprosy and the withered, which some commentators say is a kind of reference to leprosy. This Bill gets down to the level of dirt and vermin, and the whole power of the State—isolation hospitals, hauling people into court, finding people guilty of offences, fines, imprisonment, and breach of rights with regard to the privacy and security of the home, parents' rights over children and their health—is to be utilised. The matter is being approached at the lowest level, vermin and dirt. Even in the Bill itself we have references to dirt which may be a source of infection. I do say that that is the enthusiast run mad. I believe in helping the enthusiast, particularly where he is an efficient man, to get his work done but I also believe in imposing  upon him the view that there are other rights as well as those relating to public health and that these should be safeguarded, even against the well-meaning enthusiast who probably thinks that everything should be sacrificed for the sake of the public health. I think the enthusiast has been allowed to run wild in this Bill. I think he should not be permitted to run wild or given the very wide powers which these sections confer upon him. As for the rest, I think this Bill will entail a very big public expenditure without any corresponding gain to public health. I recognise certain plus signs and while disagreeing with the Minister on certain important aspects of this Bill, lest there be any mistake about it, I want to say that as far as we are concerned, we should like to see infectious diseases controlled and as far as vermin and dirt are going to help infection or contagion, we should like to see them controlled also, but we want to see a case made, before we pass these enormous powers to people who, we think, will abuse them as they have abused other powers previously.
Mr. Flanagan: Since I became a member of this House I think I can say that I never heard so much of the Gospel being quoted in reference to legislation passing through the House as on this Bill. Deputy Coogan and Deputy McGilligan referred to it. If I may go a step further I should like to make a comparison with the passage in the Gospel about the man who was beaten by the beggars and was left on the roadside to die. The Good Samaritan came along and did what he possibly could to relieve this poor victim. He brought him to an in where he said to the innkeeper: “Take this man in, care him, and I shall pay anything over and above——”
Mr. Flanagan: He said: “Anything over and above, I on my return shall repay thee.” The Good Samaritan  catered for that man who was in very great need of assistance at the time. If I may say so, I look upon the Government as acting the part of the Good Samaritan because they are introducing this legislation which will be most beneficial to those in great need of it. I remember at two general elections in my constituency telling my constituents that whenever the Government introduced legislation the object of which was to help the people of the country I would support them wholeheartedly in every possible respect, and that whenever legislation was introduced here which I considered detrimental to the people I would bitterly oppose it. This is the first Bill introduced in this House by the Fianna Fáil Government, since I became a member, every possible section of which I am prepared to stand over. I think the Bill is long overdue. I think the Bill is one under which steps may be taken to ensure a great improvement in the public health of this country. What is really responsible in my opinion for the low state of health of our people generally is, as Deputy Norton pointed out this morning, low wages, unemployment and bad housing. If in this country every citizen had the three essentials of life mentioned by Deputy Coogan—good food, fresh air and exercise—I think there would be very little need for this House to be dealing with any type of legislation for the improvement of public health. A great deal has been said by the Fine Gael Party about this Bill interfering with the rights of the citizens. If the Parliamentary Secretary had brought to the House a Bill which did not provide for compulsion in the case of those who are suffering from infectious diseases, I am convinced that we would have had an amendment from the Fine Gael Party to insert a clause providing for compulsion. It is only because that Party wishes to justify the continuance of its opposition to the Government that it is opposing this measure. I am convinced that there is not one iota of sincerity in their opposition.
What should be considered as the very first step towards securing and maintaining the good health of the nation? As Deputy Norton pointed  out, the payments made from State funds and from local authorities to those who are suffering, say, from tuberculosis or some other serious complaint, are altogether too small to enable those people to secure the extra nourishment which a citizen who is in a very poor state of health requires. As the Leader of the Labour Party pointed out, an allowance of only 15/- a week under the National Health Insurance Act is a serious hindrance to the improvement of the health of a married man with a large family, living in a rural area in a labourer's cottage. By the time that man supports his wife and family, and pays the rent to keep a roof over their heads, it is absolutely impossible for him to secure the necessary nourishment to restore him to his normal good health. He is forced to live under a system of starvation which is only a slow death for him.
Great anxiety has been aroused in this House by the insertion of a clause in this Bill providing for interference by the Gárda Síochána. I have no objection whatever to it. I honestly believe that this does not interfere with the democratic rights of any citizen. If I thought it did, I would be the first Deputy here to oppose it bitterly and strongly. On the contrary, I believe it is most essential. Let us assume that there is in a certain area a citizen who is suffering from some contagious disease, say cancer. We have some people with a very strange and queer outlook, who will not see a doctor in the first instance. Secondly, we have people who are very anxious to hide their ailments from the general public. In cases where it is well known that certain citizens are spreading a dangerous disease, I think there should be some authority with full powers vested in them to see that those citizens are brought to a place where they will receive proper attention, and where they will not be a danger to the health of the community in general. I honestly believe that it will not be necessary to fall back upon the clause which gives the Gárda Síochána power to interfere, but, if it were necessary, I think it would be very wise that they should interfere.  I believe that that section of the Bill is an asset. I congratulate the Department of Local Government, for the first time, on bringing before this House a Bill which I honestly believe is a step in the right direction. But I do not believe that the Bill will have the effect desired by the Parliamentary Secretary—that is to say, that after 14 or 20 years we will have nobody in this country with any complaint—because I honestly believe that we will never have a healthy nation until we are free from unemployment, and until the wages paid to workers are on such a level as to enable them to live, marry, and rear families in Christian decency.
In regard to further steps to improve public health conditions, I would suggest to the Parliamentary Secretary that in every town and in every village where there is anything approaching a large population he should compel the local authorities to erect public conveniences for tourists and the general public. I would also strongly urge that, where possible, in every town and village, swimming facilities should be provided. In every town or village where there is a population of over 400, steps should be taken by the Local Government Department to see that all those people are protected in every possible way from outbreaks of fever. Such precautions should include proper sewerage and water facilities for every house in the town or village. In a district where those facilities are available, it should be made an offence for any landlord to set a house which lacks them. Financial assistance should be provided by the local authority or the Local Government Department in cases where the owner or tenant is unable to meet the expense involved. I am glad to see that this Bill refers to the question of clean water. In my constituency, I would say that an impure or an insufficient water supply was responsible for the majority of the cases of scarlet fever or diphtheria. A good supply of purified water in every area is essential for the maintenance of public health.
In regard to our hospitals, there is one matter to which I want to call attention.  Patients, young and old, suffering from all types of diseases are put into the same ward. Could not the Department, or the Parliamentary Secretary, strongly recommend that necessary action should be taken to see that where you have, in a hospital, a number of cases suffering from a seriously infectious type of disease, these patients should be segregated in one ward and kept away from people who might be suffering only from such things as broken bones, and so on, and who might be regarded as healthy cases? Down in Portlaoighise, for instance, I have seen a man being brought to a hospital who was merely suffering from a broken ankle, and yet he was placed in a ward where a number of people were suffering from cancer and from infectious diseases. We all admit that, in cases where sufficient accommodation is not available, that cannot be helped, but surely there should be some arrangement whereby patients, who might be regarded as healthy patients in the ordinary sense, and who are suffering from broken bones or something of that nature, should be separated from people who are suffering from infectious diseases.
Section 38 of the Bill is very important, and I am glad to see that some steps are being taken in regard to drains and sewers. I have had repeated complaints about this matter in connection with my own constituency, and this is one clause in the Bill that I am glad to see introduced. Deputy Coogan referred to the case of Kilkenny, and particularly Graiguenamanagh, and I can certainly bear out what he said, so far as Graiguenamanagh is concerned. I could give the House particulars of where the river was flowing at over 30 miles an hour, and where I saw perambulators, pots, pans, and so on, floating down the river. Now, in the case of many of the people residing in these low-lying areas —they are usually poor people—you have cases of tuberculosis. It has been my duty to see that those people were removed to other places while the floods were on, but as soon as the floods were over, those people had to go back into those damp cottages or houses, and surely it is impossible for  a man to rear a good, healthy family under those conditions.
Now, with regard to schools, I think it will be admitted that the vast majority of children, in the rural districts at any rate, are attending schools which are of a very damp and insanitary condition, and are dangerous to public health. Whilst I realise that the manager of the school is the person who is responsible for its repair— not that I would like to see that authority taken out of the hands of the managers—I would much prefer to see those schools come under the full jurisdiction of the local authority. I do not wish to detain the House much longer, but I should like to advert to the statement made by the last speaker, Deputy McGilligan. Deputy McGilligan, I think, inquired from the Parliamentary Secretary as to whether any ecclesiastical views had been obtained in connection with the proposed legislation. In my honest opinion —and it is only my own personal opinion—the ecclesiastical authorities would welcome such legislation, because the Bishops of this country are most sympathetic towards any steps that are likely to be taken which would be likely to promote a better standard of public health here. We have no greater example of that from Deputy McGilligan than the attitude which was taken by the Bishop of Clonfert, Dr. Dignan, and I am satisfied that, so far as the ecclesiastical authorities are concerned, they would not have the slightest objection to such legislation, because they would be as anxious as any member of this House to see that everything possible was being done to have a good, strong and healthy nation here. Furthermore, I think that the Parliamentary Secretary, in his legislation, could easily have included some of the proposals with regard to public health that were suggested by His Lordship the Bishop of Clonfert. He is one of those Irish Bishops who has taken more than a keen interest in the welfare of the poorer people of our community, and his views would have been most valuable on this occasion.
Deputy Donnellan, the leader of the Clann na Talmhan Party, said this  morning that he was prepared to stand over any legislation proposed in this House which would lead to a greater efficiency in the administration of public health services. I agree with him because, Deputy Donnellan, living in a rural constituency, as I am, must realise the necessity for very serious action in this matter, and no matter how water-tight the regulations that are introduced may appear, I think that the tighter they are the better. I should be very pleased if, when this Bill becomes law, all possible steps would be taken by the Government to see that every clause and every iota of the Bill will be put into operation. There is no use in leaving this matter, as Deputy Norton pointed out this morning, to people who are suffering from infectious diseases of a serious nature. Those people, unfortunately for themselves and for those connected with them, do not want it to be made public that they are suffering from such a disease, and the only way to save them from themselves, and to save other members of the community from the spread of the infection, is to use compulsion. I believe that any common-sense people, and particularly the people in my own constituency, who have common sense, will welcome this. At any rate, in supporting this Bill, I honestly believe that I am complying with the wishes of my constituents.
Major de Valera: The speakers who are against this Bill, as I understand it, have not indicated to the House on what general grounds they oppose the Bill, and I am still in some doubt as to what some Deputies on the other side of the House have been driving at. There are, perhaps, some provisions in this Bill which are arguable, but the Deputies have not yet told us conclusively whether they stand for a purely voluntary system of public health or whether a compulsory system of public health of some sort will have to be resorted to. I think that that is very nearly the kernel of the debate about this Bill. In the first instance, you have a large amount of general agreement with regard to some of the provisions of the Bill, but the contest  seemed to centre around Part IV of the Bill.
If I understand some of the Deputies aright, there are some who are completely against the mandatory provisions of Part IV, while other Deputies have said that no case has been made for that Part of the Bill. Now, the case for it appears to me to be as follows: You have a situation in regard to infectious diseases which is a purely natural one. You have the fact, the physical fact, that there are certain diseases that are communicable to other people by contact with infected persons, through infected excreta or, perhaps, transmitted through vermin. That is the first natural fact. The second natural fact is that people associate. The third fact is that every person in the community cannot be relied upon to keep before him the general good at all times, and further that, unfortunately, there is a large class of uneducated people who might not realise the gravity of the situation. Now, in order to preserve the public health you must prevent the spread of the disease, whether through personal contact, through excreta or vermin, such as lice. We have up to the present more or less got along with a purely voluntary system. Epidemics have occurred, and epidemics have gone, and practically in all epidemics there has been a measure of organisation against them because that was the only way to deal with them.
If I might take a specialised type of community as an example, bodies of men in armies for instance. There the problem became extremely acute, so much so that, in wars up to recently, the casualties caused by diseases of this nature were greater than the battle casualties. In the war before the last one, and also in the recent war, that situation was remedied by medical organisation of what might be called the public health. How was that achieved? It was achieved by disciplined organisation of the health services in these armies.
There seems to be no prospect of guarding the community generally against infectious disease unless there is an efficient organisation against that disease. In the case of the community  at large, just as in the case of an army, you cannot have an efficient organisation that will safeguard the community efficiently unless you have some sanctions. You simply cannot rely on general voluntary co-operation. Even in the case quoted of the leper, it was necessary to isolate him in those days as medical science itself could do very little positively for him. It was necessary to have sanctions, to insist upon segregation, and to-day, in the very natural circumstances of these diseases, it is still necessary to take similar precautions, even though medical science has advanced to where something positive can very often be done. I think the kernel of this debate is as to whether you are going to leave the question of public health to a purely voluntary organisation, which can only be efficient at most in parts of the community or whether you must leave it to something to cover the community as a whole by some code with sanctions.
Following that further, you have, if you like, this unfortunate fact that neglect on the part of one section of the community, or by one small group within the community—it may be the least educated or it may be careless people—will set up the possible centre of infection, acting as a distributing point, and thereafter it will be very difficult to control the disease. To be more precise, suppose somebody who is careless allows children to go verminous into large assemblies—we will take cinemas or schools. It is well known that lice are great carriers of typhus. When verminous children come into contact with typhus infection the lice become infected, and it only needs one of these parasites to enter a clean and healthy person to inoculate that person. That is not the strongest case I could make. It is much stronger still if you have the question of an infectious carrier going into a crowd. A child infected with diphtheria may go into a schoolroom and as a result many children are infected. That is the essential difficulty in a purely voluntary organisation for meeting the position. Unless you can have an organisation that covers the whole community all your voluntary efforts fail and go for nothing. That  is why I think this point is an essential one, that we have to make up our minds—just as Deputies on the opposite side will have to make up their minds—that there is no use in dealing with this matter section by section— these should be dealt with in Committee-until we have fixed the principle.
We must face up to the position. Are you going to say, on the one hand, that the disadvantages so outweigh the advantages, that you are going to insist that the organisation of public health must be on a completely voluntary basis, or, are you going to say that the disadvantages of the voluntary system so outweigh the advantages of the principles proposed in the Bill, that you will be driven to some method of organising on the basis in the Bill, or a similar proposal to deal with public health? Once that is decided, thereafter we can come to an understanding of the sections of the Bill. To push the case a little further in regard to the provisions of the Bill generally, I take it from reading the Bill that, at this stage, it is the general principle is involved. There is a peculiar public health situation to face in the future that, perhaps, may render the subject of public health one for more serious thought.
In the immediate future we have the fact that conditions in Europe are still at a stage that is favourable to the spread of frequent epidemics. I know the answer that could be given, that these will be transitory, and that maybe next year or the year after there would be only transitory outbreaks. Very good. As against that, you have a general tendency in the world to-day of ease of communication and ease of transport. In other words, you have a greater facility for transmitting disease over the world than there was before. Under these particular circumstances, I submit that it is necessary to take into account power to organise the public health of this country positively, not only to deal with epidemics of infectious disease but with the public health generally. I am virtually confining myself to infectious disease, Part IV, because I understand that most of the controversy rages round it. So much for the general principles.
 To come down to some of the specific arguments used in the House, a great deal has been said about the rights of the subject, about the liberty of the individual, as well as the infringement of constitutional rights. But there are other rights of individuals which should be considered, too. If I am a typhoid carrier, it is all very well to get up and talk about my natural rights, but what about the rights of the people with whom I associate? If I be so infected, I am a public danger. If I go into a bus or cinema or church, what about the rights of other people there? What about the danger of my infecting those other people? As is ever the case in these problems, you have rights on both sides and, in dealing with human problems, you have very often to strike a balance. Something similar arises here. It is not as new a question as some of the Deputies who have spoken would have us understand. We have heard no talk about provisions that are generally accepted—for instance, the commission of a criminal lunatic to a criminal lunatic asylum. When a Deputy was speaking, he was interrupted and it was suggested that the logical conclusion of his argument would be the complete abrogation of individual rights. It might as well be submitted to the interrupter that the logical conclusion of that Deputy's argument was that you should abolish Dundrum Asylum. You can push to extremes on either side but, in the practical problem to be faced, you have got to steer a middle course.
I have referred to the rights of people who are in association with persons who are carriers or who are suffering from infectious disease. That leads me to two sections which have been the cause of a certain amount of discussion. Section 19 has been criticised by more than one speaker. It was referred to by Deputy Costello last night. Section 19 simply says that a person who knows that he is a probable source of infection with an infectious disease shall take the prescribed precautions and then other reasonable precautions. Is there anything  unreasonable in sub-section (1) of that section?
Here is a man who knows—note the word “knows”—that he is a probable source of infection with an infectious disease—an infectious disease is not a common cold. It is an infectious disease as defined under the powers given in Section 18. You must assume that the Minister will not define a disease as infectious without serious cause—that the diseases so defined will be diseases such as smallpox and typhoid. If a person knows—“knows” is the important word—that he is suffering from an infectious disease, everybody will admit, on reflection, I think, that he should take precautions owing to the public danger involved. If there were no definition, everybody would admit that the precautions to be taken should be necessary and reasonable precautions as appearing to a reasonable and prudent man. The point is that, under the empowering sections, the Minister can go a good way towards helping that man in appreciating what are reasonable precautions by prescribing the precautions. In the nature of things, he cannot prescribe everything. He may prescribe, for instance, that a man who knows he is suffering from infectious disease should not enter a crowded cinema. It would be perfectly reasonable so to prescribe but he cannot cover every case. There are things which an infected person might do which, we all know, would be dangerous but which cannot easily be covered by a regulation. For instance, if a person who had been warned by a medical man that he was a possible carrier of typhoid were to go into a children's playground and mix with some of the children, would it not be dangerous? The Deputy who so insisted on definition knows as well as I do that you cannot provide for everything. The case which I have mentioned is of the type for which you cannot easily provide. Still, I think that that Deputy will agree with me that a man who did such a thing would not be taking a reasonable precaution —that he would be acting dangerously. I suggest that not only is it reasonable for this House to approve of the section that provides that such a man  should take the precautions prescribed but that it is also eminently reasonable to require that he should take all reasonable precautions. There is no danger to individual or personal rights in requiring that that be done. He can go to the courts to have the question of reasonableness decided, so that he is perfectly safeguarded.
From Section 19, I pass to Section 36, which was the subject last night of rather caustic remarks by Deputy Costello. If Deputies look at the section, they will find that where a person contracts an infectious disease from another, the former person is taken to have a right of action against him. It is provided that, in the circumstances set out in the section, the court shall presume that such infection was the direct result of failure to take precautions. The impression given was that that section implied that, if I had an infectious disease and communicated it to somebody else, because of that fact alone, the matter would be actionable and, further, that if the case came to hearing, the court would have to presume what would be equivalent to negligence on my part. If Deputies will read these two sections, they will see their true meaning and will not be misled by such general and erroneous statements.
What Section 36 does provide is that where a person fails to take precautions—that is the essential qualification which was conveniently omitted— and where, in effect, another person is exposed to infection from him and contracts a disease, there is then a presumption that the disease was so communicated, and the section says the court shall presume that such infection was the direct result of failure to take precautions, unless the court is satisfied that it was impossible for such failure to have caused the infection, and the onus in that respect lies on the defendant. Let us get it in plain language and let us see what the section means and whether it is so unreasonable. Is it unreasonable, as I have already asked, that a man who knows he is suffering from an infectious disease should take all reasonable precautions or that a man should take the precautions prescribed by the public health code of the country?  There is nothing wrong from the point of view of the community in demanding that that man shall take these precautions. That is the first condition.
If another person became infected from him, what is wrong in that person having an action against him, if an action lies? I say “if”, though it seems to me to be assumed on the face of the section that an action does lie. Suppose I put a gun in my pocket, and through my gross negligence, while going about with that gun, it goes off and wounds somebody——
Major de Valera: Indeed it has, but the point is that that person has an action against me for damages by reason of my negligence. Where is the difference in principle? Why should that same person not have an action for damages against me for negligence, if I injure him by giving him an infectious disease? What is the reason for the outcry about this section? Surely it is as reasonable in the one case as in the other, and, if I have rights, so has the other man. I am not saying that there may be words or clauses in the Bill which should not be reconsidered, which should not be adjusted, and which might not be perfected, but that is a matter for Committee Stage. I am speaking for the general principle, which, I understand, under Standing Orders, is the proper subject for discussion, and I do not wish to be taken as dealing completely with the sections. What, then, is the reason for the outcry by Deputy Costello last night about the atrocious assault on the personal rights of the individual in Sections 19 and 36? The whole thing can be resolved into a matter of ordinary commonsense.
Moving from that, I come to the much controverted Section 29. Speaking for myself, I had better say straight out here and now that, for my part, I think there should be something corresponding to an appeal provision in that section, but that matter can be dealt with on Committee Stage. If it were a matter of inserting provision for an independent medical opinion, or  even a court appeal, I would say that the people who argue on these lines were, in principle, reasonable, but there is one thing I should like to say— it is not quite relevant to my main argument, but to something another Deputy said—and it is that, when you speak of an appeal in connection with a section like this there is not much sense in insisting that the appeal should be to a court, because a properly constituted court would be composed of lawyers, and lawyers are no more capable of determining by themselves the technical question of whether a man's condition is infectious or not than any other men, and they will have to have an independent medical opinion. In other words, the court would be only the vehicle for carrying out the recommendation of some doctor, so that, in principle, if the Minister were to decide that independent medical advice would do and that he would be the vehicle for carrying it out, I could see no objection to it. I am admitting, however, in case I might be taken up wrongly, that there is a case to be made for an appeal provision of some sort.
On the other hand—and again we are back on this section to the principle of the Bill—are you going to leave it to the person himself, say, a person suffering from smallpox, typhus or diphtheria to wander around; are you going to leave it to the discretion of parents of children in a verminous condition or who have diphtheria as to whether they will exercise due precautions to prevent the infection spreading, or are you going to bring in a mechanism to deal with the situation? That is the kernel of the problem. We all know that there will be people who will be either careless or ignorant, and I submit that you cannot possibly rely in such a serious matter on the mere hope that everybody will co-operate.
I know that I am to a certain extent repeating what I have said generally about the Bill, but it leads to something which was stressed by Deputy McGilligan. There is the question of whether you will have a mechanism which will deal with these cases and what other mechanism can you have than one of isolation and a mechanism  for determining, so far as possible, the condition of people suspected? Admittedly, you cannot have a 100 per cent. check on every individual every day, but you can have a general scheme, and when conditions come to notice, as they do, through a local epidemic starting, there can be a check. When the matter is notified and it is known that some person or some group is infectious, or that some person is a carrier, what can you do but isolate them until they are free of the disease? You can do nothing else.
I take it that nobody is very much in opposition to the idea of isolating a person suffering from a disease and in danger of communicating it and starting an epidemic, but there has been a good deal of talk about the possibility of isolating such people for an indefinite period. Again we are up against a natural problem. You have, in the case of typhoid, the question of carriers, and Deputy Costello last night was rather caustic and eloquent on the subject of carriers, but in very general terms. I think I am in a position to be rather more specific on the question, and the position in that regard is this—and he can have chapter and verse if he wants them— that heretofore in this country, if a person were infected, say, with typhoid, and if his was a manifestable case, he went into hospital as a patient, and if he were a carrier located through contacts, he was put under restraint. After a while, it is found that he is giving a negative reaction to tests; in other words, he is not excreting the dangerous germ. The practice, as I understand it, is that a number of checks are carried out on that individual for a short period, and if, at the end of that time, he gives a negative reaction, he is allowed to go. There is no option but to let him go and to say that he is free.
The unfortunate fact, however, with regard to that disease is, that there is such a thing as an intermittent carrier. A person can be negative for periods and can then come up positive again, and he is dangerous in the period in which he is positive. That may go on for a matter of years. One reputable textbook puts it that repeated medical  examination at convalescence does not establish freedom, and, in fact, one case is quoted of 100 people who were discharged and certified free and after a considerable time—about 12 months or so—three of them were found to be dangerous carriers of the disease.
The Minister and this House, in trying to face up to this problem of public health, are up against that kind of thing and, as I say, there is no way of dealing with such a difficult problem except on the basis of fairly definite and far-reaching powers. There is also the question of diphtheria carriers, who are very difficult, so that I respectfully submit that there is no option, if you are to have a public health code at all, but to retain Section 29 in some form or other.
This is another instance in which you have to take your choice. If the medical officer decides that a person is dangerous and isolates him for the benefit of the remainder of the community, are you going to have the whole scheme disrupted by a non-cooperation or civil disobedience campaign, if someone thought of it? That is what you have to face. For instance, what is the use of having power to commit me if I am dangerous to the community—it really does not matter whether it is a danger because of criminal lunacy, a danger which would be accepted without question, or the danger of an infectious disease, because it is only a matter of degree— when I have still the power to disrupt and negative to a large extent the provision? If patients who are compulsorily segregated make it impossible for you to cure them, or to administer the scheme, you wipe the whole thing out. There, again, we are back to principle. You have to face up to the question whether you are going to  have a purely voluntary system or whether you are going to have an organised system, but whichever you have, face it to its logical conclusion and take the necessary steps to put it into effect. That, I think, disposes of Section 29, for the moment at any rate. As I have said already, I personally would favour the question of an appeal, some mechanism for another medical opinion or some such thing. The other things that were talked about are matters that, I think, will arise more properly for consideration on the Committee Stage. So far as most of the remaining provisions are concerned, it appears to me that they are tacitly, if not explicitly, accepted by the House. I submit now that I have answered the question of the previous speaker: What is the case?
There is just one point on Section 21. If I understood the last speaker aright—I am open to correction on this if I took him up wrongly—I think that he distinguished between verminous and infectious diseases. If I took him up aright, I understand that he had not very much to quarrel with the section on the point about infectious diseases, but that he thought it was going too far on the question of what he called dirt. Again, the answer to that is a purely physical one.
It is unfortunately the position that in the scheme of nature for transmitting dangerous infectious diseases vermin plays, in some cases, a paramount part in the transmission of these diseases, and unless you make provision for dealing adequately with vermin you are excluding certain very well-known dangerous diseases— typhus, and others—from the provisions of the Bill, leaving them free to work their havoc on the community if an epidemic arises.
Lastly, I think I should mention a question that was brought up repeatedly during the debate, namely, that of how to deal with public health. In this Bill we have organised provisions for dealing with public health. There is the further advantage that the Bill is an attempt to consolidate some provisions which are scattered here and there in earlier legislation. This is a Bill dealing specifically with certain problems. Now, everyone will  admit that the public health question, considered by and large, depends on other factors. It depends on good housing and on a good standard of living, but even if you had the most perfect standard of living that could be conceived and the most perfect housing those micro-organisms which cause disease could still exist, and get around through the people. By all means let us do all we can in regard to housing, but along with that the public health problem involves the putting into operation of some positive scheme. On the negative side would be the creating of good conditions, making conditions unfavourable for the spread of the disease. By all means do everything in your power to make the conditions as unfavourable as possible to the spread of the disease and worse for the germ; but, on the other hand, you have to take positive steps. The positive steps are two-fold. There are, first, the disciplinary steps which have proved so extraordinarily efficacious in the case of armies; and, secondly, the remedies of medical science. There is your whole co-ordinated scheme for public health.
If I understood some Deputies on the far side, they criticised because the question of housing was not included in this Public Health Bill. Some of them did say that you can solve the public health problem purely by considering housing, environment, and things like that. The fact is that the two must go together. The question of housing and slum clearance is a subject for another Bill, and as everybody knows—as the Deputies opposite know —that has been a big item in the programme of the Party on this side of the House. I do not wish to take up the time of the House by going into that in detail, as Deputies can consult the official records any time they like. If Deputies seriously contend that public health can be handled purely by dealing with the negative side of it, then I disagree with them. On the other hand, if they mean that it is an essential part of the problem, I agree, and I add that so is a Bill of this nature.
For these reasons I think that on  this stage, the principle of the Bill should be accepted. The question of amendment of the Bill on the Committee Stage is a totally different thing. I would say that the greater part of the arguments against the Bill have been directed to details which would more properly arise on the Committee Stage, or else they were just a fuzzy suggestion that a completely voluntary system should be substituted. If that be the suggestion, then let somebody put it forward in a tangible, concrete form, so that we can argue about it. Let it be put forward as a positive alternative, and it can be considered. In default of that, I submit that, in principle, anyway, there is no option but to work on the lines that the Bill proposes.
General MacEoin: May I congratulate the Deputy who has sat down on applying himself to the problems that confront us in this particular Bill. It is indeed a very great pleasure to hear the back benchers of Fianna Fáil opening their months at long last, because for a considerable length of time all back benchers of Fianna Fáil have remained mute of malice.
General MacEoin: That is all right. I hope the Deputy whom I am trying to compliment will understand, and I hope the Chair will understand if the Deputy is unable. The Deputy has applied himself to this problem in a very positive way, and in so far as he has applied himself to that problem I wish to congratulate him upon the ability which he has displayed. He has done well. It was a maiden speech and I am glad and proud to know that there are young men coming into this Parliament who are going to apply themselves to the problems that confront us. I am prepared to give way to youth when they apply themselves,  without prejudice, to the questions confronting the country. Deputy de Valera has made a case and, while I cannot accept it, I must congratulats and compliment him on the way in which he put it forward. I hope he will continue to apply himself to the problems that confront the country, and I wish him long life to employ the brains that God has given him in the service of his country.
This Public Health Bill is a very serious matter. It is not as simple as Deputy Major de Valera thinks. He made great play about the word “knows” in Section 19, but who knows anything about himself except what a doctor tells him? Doctors may know a lot of things and lawyers may know a lot of things but I will take the Deputy to the section in which a Civic Guard has the right to arrest me on the street, whether I am three years old, 15, 20 or 50 years old. I may be carrying a disease, I may come from a district in which the disease is endemic, but it is left to the discretion of the Civic Guard to arrest and intern me. Nothwithstanding all the acumen and the justice even of Deputy de Valera, I will not leave that to the discretion of the Civic Guard, because he is not a doctor. For that reason, I am not going to allow this Bill to pass without entering a protest against this infringement of the rights of the ordinary citizen. I have heard the case made in America that the nigger should not be allowed into church because of some smell. I heard somebody else say that it was because he carried something else. There is nobody in this world who can prevent a person from entering a church in this country, not even a Civic Guard or the Fianna Fáil Government that claims omniscience in this country.
I should like the young Deputy to examine the philosophy of the rights of free men and, before he pontificates in the very positive way that he has, to examine every aspect of the question. Remember, there are people in this country and in every country who have their personal rights. This year the Minister for Local Government and Public Health brought in a Mental  Hospital Bill. What did he do there? He changed the whole basis of mental hospital treatment from compulsory treatment to voluntary treatment. The question has been asked by Deputy de Valera: what are we going to do in this matter? Are we going to make it compulsory or are we going to make it voluntary? I assert that the Irish Red Cross Society, by the great campaign they have undertaken, have made people aware of the danger of infectious disease and if that society were allowed to function in regard to this question, by lectures and talks in all the small branches of the Red Cross Society and by sending out disciples of cleanliness, good health and so on, such a voluntary system would do more to establish good health in this country than can otherwise be done.
The Government think otherwise. They are going to dragoon the people of this country and, because a child goes into school and somebody sees a louse on his back, that child is to be arrested forthwith. I put it to Deputy de Valera that if that should some day he would take a very poor view of it. It can happen. Nobody can deny that that is possible to the best person in this country. It could happen to a queen. That being so, there is only one thing to do and that is, to try to get ordinary precautions taken. The people must be asked to do the best they can. I agree that housing goes with this question. I go further and say that soap and hot water go with it. If, instead of setting up this regiment of inspectors, the Government provided, in the country areas, as well as in the cities, newly built houses with hot and cold water laid on, the danger of infection would be so insignificant as not to be worth worrying about.
I have to oppose this Bill, not indeed that it does not contain very great provisions, but because of the hardships that are being unduly imposed. I must oppose it and, as far as I can, in Committee I will try to amend it. If the Government think otherwise, if they will not amend it, I hope I will have the support of Deputy de Valera in amending the sections which he and I agree should be  amended. In that sense, we may, perhaps, be able to give a good public health code to this country.
Mr. M.E. Dockrell: I should like to take this opportunity of associating myself with the congratulations offered by Deputy MacEoin to the previous speaker. I liked the reasoned way in which Deputy de Valera put his arguments forward and, if I may say so, I liked the assurance with which that was done. I do not think the House very often hears a maiden speech so well delivered and thought out. In connection with the principles of the Bill he made me think further along the lines upon which I had been moving. I have listened to most of the speeches on this Bill and, when I say that those on this side of the House are not against a great deal that is contained in the Bill, I am speaking sincerely. Our argument against it is that there are degrees in regard to principles. There are some which are fundamental, and we think that the fundamental rights of the individual have been unnecessarily tampered with in certain sections of this Bill. That is the kernel of the whole thing.
Nobody wants to allow infected persons to infect other people. I would be the last to sympathise with an infected man, woman or child who went into a 'bus, a railway carriage, a cinema, a concert hall, or a church, and thereby infected other persons. If I thought they did it wilfully, I should like them to be punished, and to be severely punished. But, how often do we find that happening? I do not think it happens very often. I am not a medical practitioner, but I think one of the reasons for the survival of a lot of infectious diseases is the fact that before persons know they have an infectious disease they are at the dangerous stage, at the contagious or infectious stage of the disease. I am sure the Parliamentary Secretary will agree with me in that. For instance, there is that children's disease, whooping-cough. I do not say that that is a very serious thing, but, in that disease, a child gets a cough and has the cough for something like a fortnight  before it whoops. Therefore, it is extraordinarily difficult to know when a child has whooping-cough. I suppose these diseases would cease to exist if, through some provision of nature, persons could know they were suffering from them in time to avoid transmitting them to other people. Deputy de Valera spoke about a man with a gun and a man with a disease, and said that both are lethal weapons. That is so. But I think the essential difference is that a man can take a gun out of his pocket and put it in a safe place and that he should do that. But a man cannot divest himself of a disease, especially if he does not know he is suffering from it.
The important thing about this Bill is the underlying principle, and the underlying principle undoubtedly is to improve the public health of the country. But, unfortunately, we in this House have had no valid reasons from the Parliamentary Secretary that would lead us to believe that a lot of the far-reaching provision in it are necessary. That is one of the reasons why we take objection to the Bill. When I say that we take objection to it, I do not mean that we take objection to the whole of the Bill. This is the Second Reading of the Bill, but I think the Chair will agree with me that, where a matter of detail in a section is of fundamental importance and may profoundly affect people's lives, you are inevitably forced on the Second Reading to discuss a section or a sub-section. It would be rather difficult to discuss what may be details of the measure, but which happen, in our opinion, to be principles, without making a speech which is something in the nature of a Committee Stage speech and something in the nature of a Second Reading speech.
There is, for instance, Section 14. I do not know that many people have discussed it. That section deals with the Minister's right to discontinue a health institution. We have had an instance of interference with a health institution on the part of the Minister's Department. I refer to the Cork Street Fever Hospital. The powers given to the Minister under this section are very great and I, for one, view with  alarm that power being handed over to any Minister, because everybody knows that there was interference in connection with the affairs of an hospital which many of us are of opinion was unwarranted.
The section which deals with the use of force in connection with a patient has been very widely covered by other speakers. I welcome the suggestion that there should be a source of appeal other than the Minister, because there might be considerable delay before a patient would be able to get in touch with the Minister. I certainly do not like force being used. In principle, it seems to me that the Government has the right to use force under certain circumstances, where a man is harming another man, but I still am not of the opinion that the Government has the right to use force in carrying out tests. I am not going to believe willingly that men and women will be cut to pieces at the whim of a doctor, but again there are degrees. Undoubtedly, if we hand over that power, we will have trouble later, perhaps not now, but in years to come.
We know that medical opinion on matters changes, and that there are fashions. There was a time when every child with bad tonsils had his tonsils whipped out. Nowadays, there seems to be a medical fashion that it should be treated in a different way—not in all cases but in some cases—and the fashion has changed from whipping out every tonsil to the more sensible method of seeing whether the tonsils are bad enough to need taking out, or whether they can be medically treated. We know that these fashions change and that persons have their own opinions. Someone may go into a hospital, under this Bill, and for the purposes of the disease force may be used on him to do something to his body that, in a few years, another doctor would criticise and say: “Well, that was an awful thing, we never do it nowadays; you lost such and such a harmless enough organ out of your body, but it should never have been taken out.” That is rather too big a power to give to an individual medical man. I know that medical men are interested in the pursuit of science  and scientific inquiry of all sorts. That is their metier, and they are interested in it, but still they do not want any more responsibility forced on to them in connection with patients. Doctors nowadays have enough in the way of heavy loads of responsibility, without having it almost mandatory on them to use force.
Again, there is the question of the presumption of guilt. The underlying point about the whole question which deals with the presumption of guilt is that guilt lies where the person did not carry out a certain duty. That seems sensible enough in a way, but why could it not have been left that an action would lie? The presumption of guilt seems to cut across the ordinary common-law rights of the individual. Surely the same result could have been achieved by framing this particular section of the Bill so that an action would lie, and let the courts decide it. For a man to walk into the witness-box, with the court presuming he is guilty, seems to be an innovation in our law. Quite good results could have been obtained in a milder manner.
In connection with drains, the Minister may make a drainage Order, and serve notice on the owner or occupier of a premises, and that man has the right of objection. It is only a matter of detail, but I think it would have been fairer if, when the drainage Order is served, there were an intimation to that man as to his rights and the manner in which they could be protected. In other words, he should be informed as to how he can appeal. On the question of the appeals themselves, under Section 45, the owner is allowed to object, but my reading of the section is that he can do so only once. If he succeeds, a new apportionment is made, which becomes mandatory and the amount apportioned to each such owner by the new apportionment shall be paid by him to the authority. He has the second chance, and that is all. Some method could be devised by which he could have an appeal to the courts. His appeal to the Minister might not have been satisfactory, and an injustice might be done, even with the granting of a small relief by the Minister.
 Section 103—the right of entry on premises—seems to cut across the rights of the individual, too. We all know there are cases when it is advisable to give the health officers wide powers for dealing with people who do not want to be cleansed or disinfected. I can remember a case a very short time ago in the West of Ireland, where a medical man got a crack on the head. We do not want to stand over treatment like that of medical officers who are carrying out their duties. At the same time, it seems, under this section, that the man who knocks at the door has only to show his appointment as an authorised person. He does not have to show the reasons for his calling at that particular house. That is the way I read the section. The citizen should be safeguarded in some way, and there should be an official order for the forcible entry into his house, not just a card showing that the man who pushes his way in is an authorised person.
I am glad to see that provision is being made in this Bill for payment to tuberculosis patients whilst they are away from their families, something to ease their minds and enable them to avoid worry. That provision is long overdue, but the Minister might have told us what it would cost.
I am very pleased with the provisions in relation to maternity and ante-natal and post-natal welfare. I think these are long overdue, particularly the sections that deal with the care of children. In that connection I should like to know, where there is a reference to medical services for schoolchildren, if that includes dental services. Perhaps the Parliamentary Secretary will deal with that matter.
Mr. Dockrell: I missed that particular portion, apparently. I am glad that this Bill dealing with public health has come before us. I think we are all glad that the State is taking public health seriously in hand, but unfortunately, the way in which it has  been done has not commended itself to everyone. It is a delicate matter to interfere with individuals. It is bound to create trouble and difficulty, even where this interference is safeguarded as much as possible. Unfortunately, in this Bill there are certain fundamental principles which have been offended—I think unnecessarily offended. I believe the same degree of public health could have been achieved by a different method; in other words, where compulsion is to be used, I think that compulsion will be unnecessarily severe.
The whole trend of this legislation seems to be to cope with the most ignorant and recalcitrant sections of the nation. I know that such sections exist, but they do not exist to anything like the extent that one might imagine on reading the Bill. I shall be glad to hear the Parliamentary Secretary's explanation of those matters, and perhaps he will tell us what really are the reasons for the very severe clauses in the Bill. If he does not make a case for that, I hope he will think the matter over and, on the Committee Stage, alter those parts of the Bill which have quite genuinely caused a good deal of alarm among members of the Opposition.
Mr. O'Leary: For the past two days we have been listening to Deputies from all Parties discussing this most important Bill. To my mind the public health of the country should come first. I have listened to Deputies of the Fine Gael Party and I wonder what would Deputy Hughes and his colleagues think if there were no precautions taken to deal with an outbreak of foot-and-mouth disease. With such an outbreak, is not the farm isolated? Now, apparently, it is a sin in the eyes of the Deputy's Party to isolate the people who have an infectious disease. Objection has been taken to Section 104, under which a person may require a member of the Gárda Síochána to assist him in the exercise of any power conferred on him by the Public Health Acts. That is no crime. If a person refuses to have his house disinfected or his child sent to the fever hospital, what is the good of having a law if you cannot enforce it?
 References have been made to food and houses. There is an old saying that if health is a thing that money could buy, the rich would live and the poor would die. That really would happen. We were told by Deputies about the dirty Irish. We are not dirty; the dirt has been allowed to come into our country from other shores, simply because the laws were not tightened up. I knew families in years gone bye that were wiped out through buying second-hand clothes. Take up the papers any day in the week and you will see that there are thousands of second-hand boots for sale —the most dangerous things you could wear. They are probably taken from the battle-fields. Is it not necessary to guard us from all this? Is this Bill not wanted now? Deputy de Valera told us that Europe is not yet safe from disease. We have had scabies all over this country, but the people hid that disease; they did not want to acknowledge they had it.
We were told by members of the Opposition last night that the girls and the boys would be stripped. I have members of my family going to school and any time the doctor was to visit the school people were notified and the mother can go to the school with the child. I do not think there is anything wrong in that.
We also have people talking about new houses. No doubt they are necessary, but if we had all the new houses in the world we would still have some disease. We will never cure disease, no matter what Bills we may bring in. The hospitals are filled to-day with people who could afford to buy the necessaries of life if first they could cure themselves. But that is God's will.
I visit the sanatorium in my area every Sunday, and the men and women there to whom I speak have one worry, and that is that some of them may get benefit from the national health insurance to the extent of 15/- a week, but there are others who get only 7/6 a week, and these have to depend on the home assistance officer to give them a few extra shillings. That is the great worry about the tuberculosis  cases. There is one very good point in this Bill, and that is that the local authority will be responsible for any family that is deprived of its bread-winner when he has to enter a sanatorium. It will be their bounden duty to give that family the necessaries of life while the bread-winner is away.
We heard some references to itinerants, but I ask any Deputy who are the healthiest people in the country? The healthiest people, to my mind, are the tinkers. You will see their womenfolk with fine, healthy children in their arms; yet the sky is their roof. They live to a ripe old age. They get plenty of hardship, but they survive. I know the Parliamentary Secretary will not be influenced by a good deal of what has been said here. It is a remarkable fact that many of those who spoke against the Bill have now left the House, although they should be here to listen to the views of other Deputies. They are not even here to listen to the Parliamentary Secretary when he gets up to reply. Their criticism of many sections in the Bill is, in my opinion, just propaganda.
Mr. O'Leary: I think that Deputies who criticised this Bill so strongly, especially members of the Opposition Front Bench, should be here when the debate is coming to a close. We have been kept here to listen to this debate when we should have gone home. I think this is one of the most important Bills for the country that has been  introduced for many a long day and it is long overdue. We have heard a lot of talk about vermin but were it not for the National Society for the Prevention of Cruelty to Children inspectors what would happen? Somebody would have to take these youngsters in and keep them clean. The Opposition Party, apparently, want nothing that is likely to improve the lot of the poor. This Bill, to my mind, will protect the interests of the poor because it is the poor who suffer most from ill health. I heard some Deputies object to the employment of the Guards to enforce the Bill. They might as well have said that they objected to the employment of the Guards to compel children to go to school. There must be somebody to enforce the law. If a man locks himself into a house and refuses to leave, and if you have not a law to force that man to go into an institution where he will be kept clean, what is the good of a Bill of this kind? We often hear of laws in which there are so many loopholes that you can drive a coach and four through them. I heard other Deputies speak of the necessity of providing the necessaries of life for children whose father and mother may be in a sanatorium. I have a case at the moment of a married man at present in a sanatorium who had to go before a court of referees.
The Court of Referees granted him national health insurance but the National Health Insurance Society is appealing against that decision although the amount involved is only 7/6 per week. I should like to quote from a letter addressed to me by a number of patients in the local sanatorium in my constituency. They said:—
To make the matter clear I should perhaps explain that we got a grant of £50 from the Red Cross to provide these patients with extra comforts. Each patient was paid 3/6 a week until the fund was exhausted.
 I have mentioned it to the county manager so that we might get another allowance to provide the people of this institution with some extra comfort as the relatives of many of them are dead and gone. They have nothing to look to, not even national health insurance. I say that if the Red Cross Society is so well in funds that it can afford to send gifts to people of other countries, it is up to the Society to use some of the money at their disposal to help people at home who are suffering from tuberculosis. I shall conclude by saying that I am strongly in favour of this Bill. It should have been introduced years ago and to those who are seeking to pick holes in it, I would say that it should not have been opposed at all. It should have been accepted by all Parties seeing that its object is to promote the good of the community as a whole and to improve health standards generally.
Mr. Cafferky: This Bill has been welcomed by most Parties and I think most Deputies realise its importance in relation to the health of the community. No doubt some Deputies have offered criticisms of the measure. It is not for me to judge of the sincerity of that criticism. It is the duty of the Opposition to offer constructive criticism and it is difficult for anybody to judge the sincerity of a Deputy who criticises a particular schedule or section in the Bill.
I want to make it clear that the Party with which I am associated appreciate the motives behind the Bill and that we are in complete agreement with many of the good features it contains. It is, of course, hard to know what will be the ultimate result if the Bill becomes law as it now stands or how the powers with which the Minister and his Department will be vested will be exercised, but I do not believe that any Government, whether it be Fianna Fáil, Fine Gael, Clann na Talmhan or Labour, would be desirous to enact anything drastic, if such drastic measures were not necessary. Infectious diseases are no doubt very dangerous and it is the duty of the State to make every effort to safeguard the people against infection. I appreciate of course that in this country, as in every other country,  there is a very small section of people whom it is very difficult to persuade to take proper steps to avoid contact with other people when they become infected.
I understand also that this very small percentage are very reluctant to avail of the facilities, inadequate as they are, to deal with whatever diseases they may contract. For that reason, I can understand the Minister and the Government seeking powers to deal with them. I do not believe that they are seeking those powers for any other reason than the good of the community as a whole, but I think it is my duty— as it is the duty of every Deputy—to have a complete assurance from the Government that those powers will be used only in the final analysis, and after due consideration of the difficulties confronting each individual concerned, with particular reference to the social environment in which he lived when he contracted the disease.
Some Deputies have pointed out that it is important to have some sort of appeal board established. To a certain extent I am in agreement with that. Section 29 says that force may, if necessary, be used for the purpose of carrying out any provision of the section. Force undoubtedly may be necessary in some cases, but in a free country it is only right that anybody who was subjected to force, and may feel that he was unjustly treated, should have an opportunity to put his case before an appeal board, which would have the deciding voice. That would also serve to relieve the Minister and the Government from blame. The Minister will appreciate what a serious matter it would be if misrepresentation were to arise as a result of drastic steps taken by officials, working under his orders, in relation to any particular individual. If this appeal board were set up, a person who was forcibly taken to a sanatorium could lay his case before it, and could not subsequently accuse the Department of having done something which was not justifiable. Even for that reason alone it would be advisable to have a section in this Bill making provision for the establishment of such an appeal board. That appeal board, in my opinion,  should be composed of at least one or two eminent medical men, one or two eminent clergymen, and one or two laymen. This Bill is a very important one from the moral aspect as well as from the health aspect. For that reason I believe that you should have medical men, clergymen and laymen on the board.
I intend to vote for this Bill. I intend to vote for it because I think it is necessary. I feel it is long overdue, and that the Bill, as a whole, is worthy of support. It is certainly a credit to the Minister, to his Parliamentary Secretary and to the draftsman. On the Committee Stage, there are a few features of the Bill to which we may object. We will put down amendments, and it will be up to the Minister to accept or reject them. It has been argued that the health of the people would be better served by concentrating on housing, on better wages, on better clothing, and so on. No doubt those matters are very important. We do not minimise the importance of good housing or of good food, or of the provision of employment through which the people can earn enough to purchase at least the necessaries of life.
All those things help, but we must remember that we are liable to disease whether we are wealthy, or whether we are poor, so the Government must be armed with power to deal with outbreaks of infectious disease. It cannot be denied that a small percentage of our people are not very interested in keeping themselves clean. It is not very wholesome, when sitting in a bus, to find that a very dirty man is sitting beside you, and not only beside you but almost on top of you. You are very anxious to get out. You will always find individuals of that kind, especially in large cities. I am not suggesting for a moment that the Irish people are a dirty race. On the whole, I think we can hold our own with any race in the world as far as cleanliness is concerned.
I am convinced, when this Bill becomes an Act, the powers conferred by it will not be abused. I am convinced that it will be administered reasonably and considerately, and that  the drastic powers contained in it will be resorted to only when everything else fails. In relation to cleanliness, the importance of propaganda cannot be questioned. If our elementary schools curriculum included short talks on cleanliness, it would be a step in the right direction. Even if the children were given bad example at home, those talks during school hours would impress them with the importance of cleanliness. As I have said already, we are supporting this Bill now, but when it comes to the Committee Stage we will put down a number of amendments in order to let the Minister hear about our grievances in relation to some of its provisions.
Mr. L.J. Walsh: I want to add my voice to the welcome and appreciation of the very concise and effective speech on this Bill to which we have listened from Deputy de Valera. As a representative of a populous urban centre, I welcome the Bill. It is also welcomed by the various people, especially public representatives, with whom I have discussed it. It deals with many anomalies which existed in the administration of public health in the provincial towns throughout the State.
I am particularly glad of the provisions of Part IV, dealing with the spread of infectious diseases. Like the last speaker, Deputy Cafferky, I have had experience, not alone in this country but, indeed, in many other countries also, of the class of passengers referred to by Deputy Cafferky, and I can certainly say that it is not confined to the cities, towns or rural parts of Ireland. In England, Scotland, the United States and Canada, I have found the same kind of thing; so that we have nothing to apologise for when we meet with such people in this country. However, taking that particular part of the Bill as a whole, I particularly welcome it. According to the Opposition, the spread of infectious diseases should not be dealt with in the manner prescribed in this Bill, but no member of the Opposition, when speaking on this Bill, has outlined an alternative for dealing with the problem.
We all know—fathers of families  especially—that children attending public schools come up against this kind of thing from time to time. I, for one, as the father of a family, do not blame the children; rather do I blame the parents although, unfortunately, some of the parents cannot be blamed either because, for one cause or another, they are incapable of discharging their duties to their families. I know that that is a very hard thing to say, but, unfortunately, I make that statement from experience, and I know that it is a matter of considerable difficulty, and particularly in my own town. I admit that under Part IV of the Bill wide and drastic powers are being taken, but in my opinion, all of them are necessary. Now, there was one member of the Opposition Party who was particularly conspicuous by his absence during the debate on this particular Bill. One would have expected that he would be the one member of his Party who would be an authority on this matter, and, therefore, I was surprised at his absence. I am referring to Deputy Dr. O'Higgins.
So much for the prevention of the spread of infectious disease. I heard Deputy Morrissey yesterday shedding crocodile tears and weeping tears of woe at the alleged loss of democracy which would result from the passing of this Bill. Well, I think that the Fine Gael Party should wake up to the realisation of what democracy really is. The time was when they had very little realisation of the meaning of democracy, and I, personally, had bitter experience of their idea of democracy. To me, at any rate, democracy means the greatest conceivable good to the largest number of the community, and there certainly is no infringement of the principle of democracy contained in this Bill, so far as the people of this country are concerned. Deputy Mulcahy, of course, knows very well how to use a majority  or a minority when it suits his purpose to do so. We know all about that. I, however, see no infringement of the principle of democracy or the rights of the people in making provision to save people from themselves and to enable them to help themselves, and that is all that is meant in this Bill.
To-day I heard cases being cited of people being taken away from their families, while nobody was left to provide for their families. Under Section 34 of this Bill there is a provision which sets out that the local authority responsible must provide for the family or dependents of anyone who is removed. What more does anybody want? The responsibility is placed upon the local authority and, in my opinion, rightly so, because the local authorities are the best people to judge of the circumstances of the particular family in the locality concerned. It was even suggested here that all of those maintenance charges should be made charges upon the Central Fund. Why does not the Fine Gael Party, in opposing this, become completely Bolshevik and advocate the entire abolition of private property and the setting up of State ownership? They do not like to go that far, but evidently their policy is that if they cannot go that far, and control everything, they will destroy. Well, thanks be to God, we have a Government which is determined to see that the rights of the people of this country will be protected, and there will be no more vested interests. That is the policy of Fianna Fáil and it is the policy which will be pursued.
Part III of the Bill deals with drainage and so on, and I have a particular reason for welcoming that part of the Bill. In one part of my town about 340 new houses—a colony, one might say—were erected, and on part of that scheme there were eight houses, adjacent to the Lourdes Hospital, not one of which was connected with a water supply. I must say that the public health authority was not the actual owner of those cottages, but yet they refused the application for a water supply to these houses, and we found, afterwards, that we had no power to compel these people to instal  a water supply. Now, under this Bill we have that power, and for that reason I welcome the Bill and hope that the Government will take the necessary steps to see that every section of the Bill will be implemented for the benefit of the people of this country, with, of course, whatever amendments may be found to be necessary.
Parliamentary Secretary to the Minister for Local Government and Public Health (Dr. Ward): I have listened now, Sir, to practically two whole days of a debate on this important measure, to which I had looked forward, not with anxiety but with considerable interest. I had hoped to find that when a measure such as this was introduced in this Assembly, there would be an enlightened and intelligent response. I am glad to say that, in so far as all the Opposition Parties, but one, are concerned, that enlightenment has been shown. The dying Fine Gael Party alone showed their sense of irresponsibility because, apparently, they had hoped that they might stage some kind of publicity come-back in connection with this particular Bill. It is not my concern as to how quickly they may completely eliminate themselves as a political Party in this country. That is not my concern. I suggest that in selecting this particular Bill for their vicious and dishonest attack they have done a bad political day's work for themselves.
Dr. Ward: They were led into this irresponsible attack upon the Bill by an ex-Minister for Local Government, who now leads the Fine Gael Party, or what is left of it. With absolute abandon, and without any regard for facts, they have attempted, through this Bill, to mislead the country, but I venture to hope, and I believe, that they will fail in that attempt. The country has proved itself fairly intelligent so far as the Fine Gael Party is concerned. With regard to their attitude on this Bill, I think they will find that the people are intelligent still. Before dealing with some of the  matters raised in connection with this measure, I want to refer to a statement made by Deputy Mulcahy which I consider to have been entirely improper. In the course of his speech on this Bill, Deputy Mulcahy said that there were rumours abroad that the Minister and his Parliamentary Secretary were at loggerheads with almost all sections of the community; with the medical association and, he suggested, with the Church, and, if you please, with the chief medical adviser to the Department of Local Government and Public Health. The Minister was in the House at the time, and immediately denied that. Deputy Mulcahy challenged him to deny it, and the Minister did so but, notwithstanding his denial, Deputy Mulcahy did not withdraw that highly improper suggestion. Even if it were true, or if there was any evidence of it, I say that it would have been improper and wrong to mention such a matter in debate in this House.
I repeat what the Minister said to Deputy Mulcahy, on the occasion when he improperly raised the matter, that there is no foundation for the suggestion. When the new chief medical adviser came into my Department, I outlined to him the Government's immediate policy in relation to public health and, in particular, I discussed with him the defects in the law as we had found them by experience. In particular, I discussed with him the measures of immediate reform that we had in contemplation. So far from any disagreement arising between the chief medical adviser and the Ministerial heads, it is due to him to say that he showed not only willing co-operation but enthusiasm for the reforms we had in mind.
From that day to this, lest there should be any misunderstanding on this matter—one which should not have been raised here, and one that I should not be called upon to deal with—let me say that we have got the most loyal co-operation from our chief medical adviser that could be got from any man. No man could have worked harder, no man could have worked  more loyally, and the same applies to every member of our staff, lay and medical. I hope, therefore, that if there has been any misunderstanding created by Deputy Mulcahy's irresponsible action on this matter, I have succeeded in clearing it up. I do not know what the Deputy's object was. It is quite possible that Deputy Mulcahy would prefer if the position were otherwise. It is quite possible that he would prefer if there was disagreement and friction as between our advisers in the Department and the Ministerial heads. It is even possible that he may have been inspired with the hope that he would create suspicion and, perhaps, distrust. If he had any such idea he may dismiss it right away. It will not succeed.
Deputy Mulcahy adopted a very strange attitude on this Bill. I do not know whether he is going to retreat from that attitude. I noticed to-day that the speeches made by members of the Fine Gael Party were considerably milder than those made yesterday. I would not be at all surprised if Deputy Mulcahy did not challenge a division on the Bill. I hope he does not run away. I should like to have it on the records of the House that the Deputy was opposed to this Bill.
General Mulcahy: Will the Chair endeavour to prevent the Parliamentary Secretary misrepresenting statements that were made in the House? I stated that this Bill, as it was, was a bigger fraud than the fraudulent advertisements about which the Parliamentary Secretary was speaking at the time. It is a fraud all right.
Dr. Ward: Deputies can draw their own conclusions. Deputy Mulcahy proceeded to tell the House that the existing machinery was due to the fact that he and his Party had relied on the classical way—that Deputy Mulcahy, when he was Minister for Local Government, was the soul of gentility; he treated everybody alike; he coaxed the birds out of the bushes, so gentle was he when he was Minister for Local Government. The House may not remember, and Deputy Mulcahy would not remind it, that the 1925 Act upon which our administrative structure has been framed, which was passed by Deputy Mulcahy's Party, made it mandatory on the local authorities to appoint county medical officers of health. I am not finding fault with that. It was quite a proper thing to do, but it was not done in what would be called a coaxing way, but by telling local authorities they had to do it whether they liked it or not. In fact, when Deputy Mulcahy and his Party went out of office they had gone the distance of leaving 18 out of 27 county councils supplied with county medical officers of health. The House will be interested to know that, in order to reach that achievement, the gentle Deputy had threatened mandamus proceedings against many county councils—quite rightly. I am not objecting to that either. I am merely referring to his coaxing ways. He had to threaten mandamus proceedings against many of those councils to get the figure up to 18. We had to take rather strong measures in order to complete the work.
Deputy Mulcahy next suggested that the maternity and child welfare service provided for in this Bill should have been provided for in a separate Bill. That is a strange complaint. Time and again, this Party has been challenged in the House on its failure to consolidate our statutory laws. We have consolidated the public assistance code and our mental treatment code and we are proceeding to consolidate our local  government code. In this measure, we have completely repealed 11 Public Health Acts.
Deputy Mulcahy suggests that, because we are making further public health provision here for the mother and her child, because we are extending the provision that exists to-day, a separate Bill should be introduced. Deputy Mulcahy may not be aware that the statutory provision under which maternity and child welfare schemes have been provided up to the present is the Registration of Births Act, 1915. It seems to me appropriate that so important a provision as that should be incorporated in a Public Health Bill.
The Deputy said that he would oppose the Bill because it interferes with the liberty of the subject. That question has been effectively dealt with by other speakers. I shall have to revert to it and refer to it more fully than I propose to do at the moment. It was very effectively dealt with by Deputy de Valera in his maiden speech. All I shall say at this stage is that, when we talk about the liberty of the subject, we ought to try to think clearly on the matter. The subject is entitled to his liberty, but the liberty of the subject does not extend to the point at which it endangers the liberty of the community. If a man conveys, through his carelessness or negligence, infectious disease to another person he deprives that person of his liberty. He has interfered with the liberty of the subject and it is my purpose to see, so far as it is humanly possible to do it, that the rights and liberties of the community will be protected. If it should be necessary to deprive a subject of his liberty in order to achieve that, I shall ask the House to support me in doing so.
Deputy Mulcahy proceeded to read extracts from the Vocational Organisation. Report and to criticise us because we had not set up a consultative council of health. I need not delay the House in dealing with that point. I do not know how or why the Deputy showed such stupidity. He will find in Section 12 full provision for the establishment of consultative and advisory  councils. He proceeded to tell us that this Bill will supersede any remnant of local government in the hands of local authorities and will provide a full and complete dictatorship. We heard more about this dictatorship later.
Dr. Ward: Other Deputies emphasised the dictatorship idea. It is becoming rather popular with Deputies of late. We are told that Hitler is not dead yet, that Mussolini is only sleeping and that Stalin has been re-born in the Department of Local Government and Public Health. What are the facts? Will Deputy Mulcahy, ex-Minister for Local Government and Public Health, or any other Deputy, show me where, in this Bill, we have deprived local authorities of powers they enjoyed when he was Minister? On the contrary, in this Bill, local authorities are being given extensive powers which they do not enjoy to-day. Under Section 28, they are being given a power regarding disinfection which they have not under the existing law. In Section 30, they are being given power in relation to the burial of infectious-disease patients dying in extern institutions. In Section 34, they get a very extensive and important power— power of payment for the maintenance of persons suffering from infectious disease and for the maintenance of their dependents. The importance of that power has been adverted to by most of the speakers who were not blinded by vicious opposition to the Government Party. Its importance has been recognised inside the House and will be recognised outside it. Yet, we are accused of completely denuding the local authorities of any vestige of power that remains in their hands. Section 45 gives power regarding the apportionment of cost of drainage works as between owners of premises —a completely new power for local authorities. Section 46 gives power to prevent nuisances pending a decision as to the making of a drainage order— a completely new power. Section 51 gives power regarding the making of a water system on certain lands—a new  power. Section 53 gives powers of apportionment regarding water systems —a new power. Section 54 gives power of contribution to the cost of private water supplies. That is the provision about which Deputy O'Donnell was so enthusiastic—and quite properly. Section 55 gives power in relation to the repair of water pipes on certain lands—a completely new power. If I had time, I could go on reciting the list of additional powers. The matters I have mentioned represent about half the new powers which this Bill confers on local authorities.
While on this subject, I should like to direct attention to the Third, Fourth and Fifth Schedules to the Bill. The Third Schedule refers to matters for which provision may be made by by-laws in respect of the use of temporary dwellings. These by-laws will be made by the local authority and not by the Minister. The making of these by-laws is a reserved function, so that we cannot be twitted with giving this power to the manager under the managerial system. The Fourth Schedule deals with matters for which provision may be made by by-laws in respect of public bathing. Deputy Costello paraded here on that subject, but Deputy de Valera dealt with many of his misrepresentations. One of his misrepresentations, made in a sneering kind of way, was that the Minister was to decide, let us say, the anatomical areas of bathers which were to be covered. He was in great form about that and seemed to think that it was very funny. It is the local authority which will make these by-laws and decide this matter. I do not know what Deputy Costello's particular tastes in this regard are. I am not a prude. I am rather broad-minded in these matters, but I think that most local authorities would agree that by-laws should be made regarding this question. I think we ought not to allow in this country, and I think that local authorities would not permit, such modern innovations as nudist colonies, for example. If you want to avoid that sort of thing, you have to have statutory powers to prevent it, and the local authorities are given statutory powers.
 Another of the matters in the Fourth Schedule is “The regulation, so far as decency requires, of the costumes worn by bathers and persons exposing their bodies to sun or air and the manner in which such costumes are worn.” We are interfering with the liberty of the subject—the right of the individual to go nude. I think it is a proper provision, and if the House thinks it is a proper provision, it can support me when Deputy Mulcahy brings us into the Division Lobby, as I am sure, or, at least, as I hope, he will.
In discussing our new mother and child service, he talked about our interference with the family doctor. He tried to convey the impression that the family doctor would be prohibited from attending a family in future. Could anything be more nonsensical? We are not interfering with the family doctor. We are providing a free service for the mother and her child—ante-natal, during birth and following birth, until the child is 16 years of age. It is a full free service, with a specialist service attached to it, but nobody is bound to avail of it. If people want to make other provisions for their families; if anybody wants to say: “I do not want the district medical officer attending my children and I do not want him attending my wife. I will make my own arrangements and bring in my own doctor,” nobody will interfere. Surely Deputy Mulcahy knows that nobody will interfere, or perhaps he hoped that a little misrepresentation on this matter, too, would have some good effect.
He talked at length, and repeated himself many times, about the new constabulary. It is not a great tribute to the medical profession and not a great tribute to our county medical officers of health that the Leader of the Opposition, who was at one time Minister for Local Government and Public Health, should describe them now as the new constabulary because we give them the statutory powers necessary to enable them properly to discharge their duties to the community. I wonder did the Deputy consult Deputy O'Higgins on this matter? Deputy O'Higgins, as a county medical officer of health, will be a head constable  under this scheme. I feel pretty certain that, although he is Deputy Leader of the Fine Gael Party, he will scarcely agree that we have done anything wrong.
Deputy Mulcahy, of course, blazed the trail and others loyally followed, and he is outraged that we should talk about taking compulsory powers to isolate. “An unprecedented attack on personal liberty.” He talks about police methods and about the rights of parents. One would think that compulsory powers in relation to the control of infectious diseases had never been heard of before, that they were entirely new. He bitterly complains about the Minister taking power to declare by Order that a disease is infectious. It is very interesting, in the light of the fact that Deputy Mulcahy was Minister for Local Government for quite a long period. The type of unprecedented attack which we are now about to make on the liberty of the subject is the statute law of to-day and has been for many long years. It was the law when Deputy Mulcahy was Minister for Local Government.
I do not know if it is necessary to quote, but perhaps it is. If Deputies are interested in this matter and refer to Sections 148 and 149 of the Public Health (Ireland) Act, 1878, they will find that, by these two sections, the Minister is empowered to make such regulations as to him may seem fit with a view to the treatment of persons affected with any epidemic, endemic or infectious disease and to preventing the spread of such infectious disease. “Such regulations as to him may seem fit”—absolutely unlimited power, and exercised by Deputy Mulcahy himself when he was Minister for Local Government, and he was not a dictator. He was the gentle, cooing General, who coaxed everybody along. I think he signed some of these orders himself, and I may perhaps turn some of them up at a later time.
We have had a lot of talk—again following the lead of Deputy Mulcahy —about the provision to deprive parents of what they consider to be their right, according to their spokesman here, to send their children to school when suffering from infectious  conditions. If anybody wants to know the law on that at present, I refer him to Section 146 of the 1878 Act, which prohibits under penalty the sending of a child to school who, within the space of three months, has been suffering from an infectious disease or who has been resident in a house in which a case of such disease existed. I may be told that we are going further inasmuch as we are now dealing with verminous children. If we are dealing with verminous children and taking the powers regarding verminous children which are enshrined in this Bill, there is a very good reason for it.
Other Deputies have referred already to this matter, but I presume I would be expected to refer to it in further detail. The fact of the matter is that the louse—and we have to talk in plain language here—is the vector of typhus fever. That is a fact. A further fact is that epidemics of typhus fever have been traced to infested children in schools. What are you going to do about it? Is that something which ought to be stopped? Would any Deputy like to take the risk of having his child infested with the body louse from a carrier and having that disease brought into his home, in the name of the liberty of the subject? I do not think he would.
Again the rights of parents ought to be respected, and on that there can be no disagreement; but, once again, the rights of the community must come before the rights of the individual. On the question of all these dictatorial powers that we are taking, I have, because of the attitude adopted by Deputy Mulcahy, to delay the House in referring in some detail to the actual provisions that the Deputy himself signed when Minister for Local Government and Public Health. This document is entitled “The Public Health (Infectious Diseases) Regulations, 1929”. On page 3 we find this:
“The sanitary authority shall forthwith cause notice to be given to all medical practitioners resident or practising within the district of the sanitary authority of the duties imposed on them by these regulations, and of the alterations which have been effected by these regulations in the duties which were imposed upon them by the regulations of 1919.”
“Any expenses incurred by a medical officer of health in carrying out the duties imposed upon him by these regulations shall be defrayed by the sanitary authority of the district in which he is medical officer of health.”
That was Deputy Mulcahy's cooing way of securing the co-operation of the local authorities and of the public Article 15 deals with immunisation against diphtheria. We heard a good deal in the last couple of days about the tyranny of immunising people against a preventable disease, and of trying to prevent them contracting it in  the interests of themselves, their families and the community. Deputy Mulcahy seemed to think, as far back as 1929, that that was a good sound policy. In Article 15, it says:
“A sanitary authority to which this article applies, may, from time to time, in accordance with the advice of their medical officer of health and shall, if at any time required by the Minister, do all or any of the following things.”
“In any case of typhus fever or relapsing fever occurring in his area of which the medical officer of health becomes aware, he shall immediately send the name and address of the patient to the Minister, and if he is satisfied that it is necessary he shall report accordingly to the sanitary authority.
“The temporary segregation, for a period to be specified in the notice, of other inmates of the building or of other persons recently in contact with the patient until their persons and clothing have been completely freed from lice.”
A very proper order, very properly made by the former Minister for Local Government. We did not accuse him of dictatorship when he made it. He was acting in the best interests of the community when he did these things. Similarly, when we enact these powers, and extend them to deal with present circumstances, we claim to be acting in  the best interests of the community. In Part III we find that:
“If a medical officer of health has grounds for suspecting that any person in his area who is employed in any trade or business concerned with the preparation or handling of food or drink for human consumption is a carrier of enteric fever or diphtheria or dysentery infection, he shall report accordingly to the sanitary authority, who may give notice in writing to the responsible manager of the trade or business concerned certifying that for the purpose of preventing the spread of the disease they consider it necessary for the medical officer of health or a medical officer acting on his behalf to make a medical examination of such suspected person.”
That seems to me to be fairly wide and to cover almost everything. This Order is given under the seal of “Risteard Ua Maolchatha, Minister for Local Government and Public Health,” and is dated “the 6th March, in the year of Our Lord, One Thousand Nine Hundred and Twenty-nine”. Then there is this postscript. We heard a good deal during the debate about the harshness of the penalties incorporated in the Bill before the House for an infringement of the public health laws. This is the postscript under the heading “Notice”:
“Section 1 (3) and Section 4 (b) of the Public Health Act, 1896, provide that if any person wilfully neglects or refuses to obey or carry out or obstructs the execution of any regulation made under Section 148 of the Public Health (Ireland) Act, 1878, he shall be liable to a penalty not exceeding £100, and in the case of a continuing offence to a further penalty not exceeding £50 for every day during which the offence continues.”
That was very persuasive and bound to get results. It is something like that that we are attempting to do,  though the circumstances have changed somewhat since Deputy Mulcahy was over in Custom House in that particular capacity. Deputy Mulcahy actually complained that the Minister would dare to take power to declare that a disease was infectious. He wanted to know were we going to consult the outside medical world about it, and if it would be possible that the Minister would sign such an Order declaring a disease to be an infectious disease on his own authority in the discharge of his ministerial duty.
Again, we find that not only was it the legal procedure and that not only is it the law to-day, but that Deputy Mulcahy himself exercised the function and apparently did not know about it. I cannot help that. It is no new power to give to the Minister to declare that a disease is an infectious disease. As I have said, Deputy Mulcahy enjoyed the power and exercised it, but I cannot just say what enjoyment he got out of it because apparently he did not know that he was exercising it.
In connection with this question of compulsory isolation of persons suffering from an infectious disease, I just want to develop that aspect of our problem by giving a few examples that perhaps may bring the matter more clearly to the attention of the House.
I said already that we have had recent epidemics that were traceable to many of the causes that we are trying to remove. The Deputies from the area are probably aware of the recent Spiddal typhus outbreak. It was traced to an infested child in a national school. Typhus. Human life was lost. We have to ask ourselves the question, does that matter We had a recent outbreak in Donegal. It was traced to a contact in a cinema, and yet we are being blamed for taking steps to see that that will not occur again. There was a recent outbreak of typhoid which got a good deal of publicity. I need not give any further particulars that might identify the particular outbreak, but, at any rate, through an admirable process of medical detection, this outbreak was traced back a long distance, but definitely traced back to a carrier.  When we had all the circumstantial evidence that appeared to establish the case, we said, “We must bring this lady into hospital and we must have her examined; we must establish beyond any doubt, scientifically, that she is a carrier. Having done that, we must do everything possible that medical science can do to rid her of the carrier condition.” But the lady, acting within her statutory rights, said, “You will not examine me or you will not bring me into your institution to investigate my condition or to try to cure me of the condition so that I will no longer be a danger to the community.”
I do not think that that position ought to obtain. I think that we ought to have power to bring that lady along, whether she likes it or not and to say, “We cannot allow you to endanger the general body of our people. We cannot even allow you to endanger your own family. You must come in for treatment. If we cannot cure you, at any rate we must provide such conditions and train you in such a manner that it will be safe to release you to your own home and that your release will not endanger the community.” That is what we aim at.
There is another matter that we are aiming at, a delicate matter, to which I think I must refer. We have heard a lot of talk about this drastic power, this dictatorial power, that is going to be exercised by the bureaucrats in the Custom House, the Hitlerites and the Mussolinis, and the rest of them. I want to put this type of case to the House, apart from the typhus case, apart from the tuberculosis case, about which a lot may be said, apart from the typhoid case or from the diphtheria case. Bear in mind that this Bill provides the necessary statutory machinery to make venereal disease an infectious disease. It is a serious problem. It is a difficult and a delicate problem. But suppose that through our venereal disease clinics it comes to our knowledge that almost beyond doubt a certain lady, leading a promiscuous life, has a very serious form of venereal disease. Deputies may have different views on these matters Some Deputies may be concerned with  the moral aspect of it. Other Deputies may have views as to how such a problem ought to be handled. I too have views and I ask Deputies to believe what I believe—in the first place, that a considerable majority of these unfortunate women are the victims of society. They have broken the Commandments, I grant you. They have outraged the conventions, I grant you; but, if they have, bear in mind that our civilised society treats them more harshly because of the fact that they have violated the conventions than because they have violated the laws of God. And bear in mind that if every case were traced back to the original downfall of that unfortunate person, it would be found that society had treated her harshly.
In my opinion, we ought to exercise Christian charity towards these human beings. Instead of treating that unfortunate outcast from society at the present time as somebody untouchable, we should make an effort to reclaim her. While I do not want to preach morality—that is not my function here—I do say this, that if we can go to such a person and say: “We want to cure your unfortunate, broken body, we want to restore you to health,” and if we could get these people to undergo treatment and if we could restore healthy bodies to them, it would be an easier matter for the Church, for example, to restore a healthy soul to that healthy body. That is my opinion.
We have to face the facts. Some of these people will be hardened and some of them will say: “I owe nothing to society. Your civilisation and your society have brought me to what I am”, and they may continue to create the havoc that is being caused by these carriers of venereal disease. Remember, that havoc is very terrible when an unfortunate man has lost the higher controls of his moral standards, perhaps through inebriation, and falls a victim and his innocent wife becomes a victim and innocent children are brought into the world with that hereditary disease, and we have there the material for our mental defective institutions for the future. That is a problem that has to be faced and has  to be handled with tact and care and understanding, but we can never hope to solve that problem unless we can say to the recalcitrant carrier: “We will not allow you to remain at large while you are a carrier of that disease.” That is my policy. If Deputies do not agree with it, let them go into the Division Lobby with General Mulcahy and back him up, but I think that it is a sound policy, that it is a Christian policy, and that it is a policy which, if not calculated completely to solve that problem, because, I suppose, we can never completely solve it, is calculated at any rate to mitigate it.
Deputy Coogan, in the course of his remarks, complained that no figures had been put before the House as to the magnitude of the problem we are trying to solve. I did not think it was necessary. I thought I made a fairly exhaustive statement on the Second Reading. If I had thought it was necessary to quote figures, they certainly would have been quoted. He wanted figures to show the extent of the various infectious diseases and so on. It would be a long story. I will give them to him in bulk and, if he wants them in regard to any particular infectious disease, I can supply them to him.
The fact of the matter is, anyhow, that in the year 1944, excluding tuberculosis, 2,211 people died in this country from infectious diseases. If we add the 3,839 deaths from tuberculosis, we get a total of 6,050 people. These are the people who died. The number of people infected was 54,000. Is not that a problem which calls for drastic action? Is the extent of the problem sufficient to justify me in coming to the House and asking for the admittedly drastic powers that I am seeking? Has human life any value, or are we merely bluffing when we talk about the sanctity of human life? These diseases are, in the main, preventable diseases and, if the public health authorities got the backing that they ought to get from all responsible citizens in this State, then, if we could not completely eliminate infectious diseases—and we could not—we certainly could make  substantial inroads on that terrible toll.
Deputy Mulcahy and many other Deputies—they all followed the General, whose troops are becoming depleted, they followed his lead in the debate; how many of them will follow him into the division lobby we have yet to see—complain that we did not consult medical opinion outside. I might, I think, reasonably ask Deputy Mulcahy how often did he, when he was Minister for Local Government and Public Health, consult outside medical opinion? When he was making the Order declaring the diseases which were to be regarded as infectious diseases, he certainly did not consult any outside authority. I would say this, that I have had more consultations with medical scientists in the past 12 months than Deputy Mulcahy had in his entire period of administration, and I think he was there for five years or more. During the time he was Minister for Local Government, he had one conference with county medical officers of health.
I presume Deputy Mulcahy is aware that some two or three years ago, when we were faced with a very serious problem, which, unfortunately, we have not got rid of—the terrible toll of deaths in the City of Dublin from gastro enteritis—I presided at a conference of all the leading medical specialists and bacteriologists and authorities in Dublin City on that particular ailment in the hope that, by pooling our joint wisdom, knowledge and experience, we might be able to solve that problem. Tribute was actually paid in this House by the Minister and by me to those eminent scientists who voluntarily placed their services at our disposal and worked very hard to help us in the solution of the problem. It seems to have passed over Deputy Mulcahy's head. Perhaps the fact is that it got under his skin.
Deputy Mulcahy must be aware that, in 1944, we had in the Custom House a two-day conference with the county medical officers of health. I do not know if he is aware, but, if not, I will tell him now, that for four days in the week ending on 14th April, 1945, for  four whole days, a conference sat here in Dublin, presided over by the chief medical officer in my Department, and attended by six representative medical officers of health, ten pathological experts, six specialist medical practitioners, five university professors and two public analysts. Much valuable information has been furnished to my Department and on such information are measures such as this based.
We have not consulted anyone, according to Deputy Mulcahy. Deputy Mulcahy must know—he is in a position to know—that we have been in the closest touch with medical scientific thought over a very long period and that, even in relation to the Bill before the House at present, the association of county medical officers of health met and discussed it and expressed approval of it in principle. I do not know whether Deputy Mulcahy knows these things or not. If he does, I would have to charge him with dishonesty, I think. Perhaps it is only that he has not been particularly well-informed. But I would be entitled to complain that he has not taken more pains, at any rate, to ensure that he would be properly informed.
I find myself in a rather strange position here. On the one hand, the policy enshrined in this Bill is violently attacked by Fine Gael, presumably in the hope that the country will be misled as to its real intent and purpose. But, on the other hand, over a period of years, a campaign has been conducted in the section of the Press opposed to this Government blaming us for not dealing with the problems with which this Bill is calculated to deal. Even Deputy Dockrell pretended to be puzzled as to the inspiration behind this Bill or the need for it or the public demand for it. Surely Deputy Dockrell reads the Irish Times. I presume he does. I will not delay the House in reading the articles in the Irish Times on the subject of venereal disease, but I would refer Deputy Dockrell to the issue dated 24th May, 1944. We have heard lots about it. I would also refer to the issue of 2nd June, 1944. That article summarises an article on the control of venereal disease, in the current Journal of the Medical Association  of Eire, which we heard a share about in the course of this debate. The article in the journal is quoted as saying that venereal disease has now reached almost epidemic proportions in Eire. It refers to the system of compulsory notification in England and to the special laws in force in Sweden. The special laws in Sweden are something along the lines of the special provisions we are trying to make here.
I also refer to the Irish Times of 27th October, 1944. I hope the other papers will not be jealous that I have quoted so much from the Irish Times: I could quote also from other papers hostile to the Government. The Irish Times in that issue reported a meeting of the T.C.D. Philosophical Society and a paper read by the President, Mr. P.R. Oliver, B.A. I think that anybody who will read the Press report will say that there was a volume of opinion in favour of taking the measures in relation to venereal disease that we are proposing to take in this Bill.
Coming to the question of the control of foods, we find another Press campaign conducted against us. Nearly all the papers took a hand in it. Even the Irish Press did not like to be left behind. The Irish Times of the 11th July, 1944, reported an interview with Dr. Elcock, Resident Medical Superintendent, Clonskea Fever Hospital. The need for the examination of hotel, restaurant, etc., staffs at definite intervals by bacteriologists was stressed in that among many other things. Dr. Elcock is a medical authority of high repute. The Irish Times of the 16th August, 1944, published the views of the mysterious person called a “well known doctor”. Who he is is not disclosed, of course, if he is attacking Government policy or public health policy. I do not know whether they would allow him to be identified if he said anything by way of praise. This “well known doctor” was given very considerable publicity. He talked about the desirability of having some measure of control over carriers of infectious disease and suggested the compilation of a register of carriers. He said local authorities were hampered in controlling outbreaks, as they had not the  legal powers to take steps in regard to the disease. Again there is an article in a newspaper—it is time to give the Independent a show now—on the 30th November, 1944, when the Irish Independent came out very strongly on the limitations of the existing law in regard to the handling of food. Further articles have been published in the Irish Independent and I fully approve of them, and I think they are very sensible and constructive articles. What I wish to emphasise to the House is that we are attacked by the Press opposed to the Government for not making provision, and we are accused of dictatorship when we come to the House and ask for the necessary powers.
Dr. Ward: It just so happened that for once—and it is a rare thing—the Irish Times was on sound lines. I would not abandon a proper course merely because the Irish Times advocated it. I do not suppose we will travel together very long, because the Irish Times did not give a lot of publicity to this Bill—but that is between the Deputy and me, and he should not tell.
Dr. Ward: On the whole, I do not think I need offer much criticism of Deputy Cogan's attitude towards the Bill. Like other Deputies, he found fault with some sections, but looked upon it as a good Bill. He reminded me of that very popular song Don't Fence Me In. He complained that we were inclined to fence people in too much. Some people ought to be fenced in—I do not suggest Deputy Cogan—in the interest of the community. I think we will have to disregard that song to which he refers. He complains about citizens who committed no offence being sent to an institution and deprived of liberty. It is a question of approach. I do not agree that it is no offence to endanger the lives of one's neighbours. I think that is a serious offence. If we had a few poisoners at large, who  went round dropping poison into food and gradually killing off people, to the number of 6,000 a year, with another 50,000 just recovering and invalided for life, I rather think we would be getting after those poisoners and that we would say they should be incarcerated.
I am very much afraid that, with the time at my disposal, I cannot deal with many matters I would like to mention. I have only another quarter of an hour and must give Deputy Mulcahy sufficient time to challenge a division. Consequently, I will have to dispose of other important matters fairly quickly.
There has not been much real advertence by the intelligent members of this House to the scheme for the mother and child that is being incorporated in this Bill. I look upon that as being a very substantial advance in our public health facilities. It is true that we have provision for the establishment, under the existing law, of maternity and child welfare schemes, but there are certain flaws in the scheme to which I want to draw the attention of the House. Because of these flaws and because of flaws in the provisions for the medical treatment of school children, the new provisions are being put before the House.
The first great flaw, that, by the way, will have to be more definitely remedied in this Bill is that the adoption of these maternity and child welfare schemes was optional. We did not follow Deputy Mulcahy's gentle ways and make it mandatory. If these schemes must be made mandatory, there is no use in bringing in a public health scheme that will be operable at the will of the local authority, so that we may have the scheme operable in one area and not in another. It must operate uniformly. Consequently, if the local authority does not undertake voluntarily to establish these schemes, it is proposed to take such steps as may be necessary to make the schemes uniformly apply. The fact that it was not generally applied was the biggest drawback.
The next drawback was the limitation of these schemes to children under  five years of age. When the child reached five years of age, even in the areas where these schemes were adopted, the child passed out of the scheme. Even if our school medical services scheme had been the most satisfactory that could be devised, there would be that flaw that the maternity or child welfare service ceases at five and the school age is six, so there is a year's interval when there is no provision for medical treatment for the child. The other great drawback, which was very evident indeed from the debate, was that very few local authorities adopted the maternity and child welfare scheme at all. We are going to get away from all that by merging it in the school medical service. What is wrong with the school medical service? Every intelligent Deputy in the House knows what is wrong with it. It has done great good. There is no doubt whatever about that. However, with the staffs that the local authorities have made available it is only possible for these medical inspections to be carried out at intervals of about three years. As a public health service, of what on earth use is that? It is true that such persons as are detected with physical or mental defects on the day of the medical inspection will be got after, but how many hundreds of children will be missed in the intervals between those inspections?
Unfortunately, there is no provision for domestic treatment. The removal of tonsils and adenoids may be looked after already, but the scheme is hopeless as a public health scheme unless we can follow up the children who are found to be defective, unless we can follow them to their homes and send the nurse to have a talk with the mother and say: “The doctor has examined your child to-day. You will need to do this, that and the other and the treatment will cost you nothing. We will provide the nursing service, because we want you to rear healthy children.” I think it is sound. Deputy Mulcahy does not think much of it, but I think the fact is that he realises how much it does mean to the community, and he is afraid the community will realise it, too. I believe  they will, in the course of time.
I must pass over some things that are so important. Deputy Mulcahy complains that we have not consulted the medical association. I dealt with that, but not altogether completely. He said that we did not consult the medical association in particular matters. Well, we have consulted the best-informed medical and scientific opinion to be found in this country. I am not prepared to admit, even for the sake of scoring a point in this debate or contradicting Deputy Mulcahy, that the medical association is entirely representative of the medical profession. It would be interesting if we had the figures showing the entire number of medical practitioners in this country and the number in the medical association. I think it would be found that, though they represent a considerable section, they are not entirely representative of the medical profession. But, leaving that aside, do not forget for a moment, when you hear Deputy Mulcahy talking about the medical association and the need for the most cordial relations with them, that you have a number of rabid politicians in the medical association. I will not develop that any further, but commonsense will tell you what that means. There are men in that association whose particular purpose in life is much the same as Deputy Mulcahy's——
Dr. Ward: ——to misrepresent this Party before the country, to mislead the people both by the spoken word and the written word in their journal. The representatives of the medical profession will always be welcome to the fullest consultation with the Minister and with me, but we have to be wary of these rabid politicians who would like to obstruct us rather than co-operate with us.
Deputy Martin O'Sullivan mentioned that he thought the food sampling should be carried out by the county medical officers of health. That is  absurd, because no county medical officer of health is equipped to carry out that work. However, that is anticipated in this Bill.
Dr. Ward: I will make one point, a rather important point, which has been missed by all the Deputies. It is surprising it has been missed by Deputy O'Sullivan and other Deputies from Dublin, and still more surprising that it should be missed by the for mer Minister for Local Government, Deputy Mulcahy. There has been a reasonable amount of criticism—it was not too bad, but still there was a good deal of criticism—of the fact that this Bill will cost local authorities an enormous amount of money. So it will. There is no denying that. It will cost a lot when it is put into full operation.
But under the maternity and child welfare scheme, which has been extended now to cover all expectant and nursing mothers, and children up to the age of 16 years, the State pays 50 per cent. of the cost. It is a fifty-fifty arrangement with the local authority and if Deputies, particularly rural Deputies, realised that, they would have shown greater enthusiasm for this Bill than some of them have shown. The Dáil divided:—Tá: 56; Níl: 8:—
Crowley, Honor Mary.
De Valera, Eamon.
De Valera, Vivion.
Flanagan, Oliver J.
Fogarty, Patrick J.
Gorry, Patrick J.
Lemass, Seán F.
Little, Patrick J.
Lydon, Michael F.
O Briain, Donnchadh.
O'Donnell, William F.
O'Loghlen, Peter J.
Rice, Bridget M.
Ruttledge, Patrick J.
Skinner, Leo B.
Ua Donnchadha, Dómhnall.
|Bennett, George C.
Dockrell, Maurice E.
|Doyle, Peadar S.
|Last Updated: 18/05/2011 18:18:40||Page of 5|