Tuesday, 9 June 1953
Dáil Éireann Debate
Mr. Morrissey: When the debate on this Bill was adjourned, I had finished what I had to say, and I hope some of the things which I was forced to say. I was trying to make the case, in so far as I was allowed to make anything at all, that the Minister on this Bill cannot dismiss the questions which have been put up from this side or the statements made as to the various interpretations which can be placed or which will afterwards be placed either on the section or the amendment in the way he did. I do not think he is properly discharging his duty to the House by refusing to answer the statements which are made from this side of the House, by contenting himself with saying that “this is just pure obstruction by Fine Gael.” That is an easy way out for the Minister if he does not want to try and meet the points which are being made. I do not think it is a line which the Minister should take.
I do not think that the Minister himself believes that Deputy Costello would get up in this House and lightly make statements on a section, or on the interpretation of a section, which he did not believe. When the Minister charges Deputy Costello with doing that, I do not believe that the Minister  himself thinks for a moment that that is what Deputy Costello is trying to do, and nothing more. We get cheap sneers about Fine Gael's attitude in not putting down amendments and at the same time suggesting, as the Minister put it, improvements that could be made.
What Deputy Costello, and other Deputies from this side, have tried to do on this section in particular, is to show the danger that lies in the section. Our consistent line on this matter is based on sound reasons, on reasons which appear at least to us to be sound. We are merely stating views which we are entitled to state, even if certain Deputies do not agree with them. We are being asked, either to support this Bill in its entirely and to accept each section as it stands, or else, to use the Minister's words, “clear out and let the House deal with it.” That statement, by the way, was not an original one. That same statement was made on a former occasion by a distinguished predecessor of the Minister's, but it was not we who cleared out.
I think the Minister is not helping the position very much by contenting himself with accusing this Party, and the members of it, with being just in an obstructionist mood, and for that reason, and no other reason, speaking on any section or amendment to this Bill.
General Mulcahy: The matter of parents and of school children was raised in the discussion on this amendment, as well as the position in which children find themselves subject to influences that are outside any statutory control. The position, in fact, is that these influences are strengthened very much by the whole approach of the Fianna Fáil Government to health legislation, to the coercive powers that are there to impose penalties on, say, the managers of schools who do not co-operate in the general working out of the scheme of things. A certain amount of compulsion is gradually being withdrawn. The amount of compulsion that was enshrined in the whole body of the 1945 Act broke that  Act. The amount of compulsion enshrined in the 1947 Act has taken substantial sections out of that Act, but the elements of compulsion and direction and of forcible interference by the State are still so present that they add—if they are not the principal instigators—to those outside forces of which I speak.
I would ask the Minister to consider the atmosphere in which school medical inspection was originally carried on, the atmosphere that surrounded it up to 1947. I think no one can deny that the scope of the work done up to 1947 was of a highly satisfactory kind. No one can suggest that it was not work that was gradually winning approval. It was winning the willing acceptance, one might say, of the entire people who came in contact with it. It is just questionable whether the Minister will improve, or add to the staff capable of dealing with it.
It was the lack of quantity, rather than of quality in the service, that was most felt up to 1947. But, up to 1947, the spirit in which school medical inspection was carried out was the spirit in which the regulations were prepared under the 1919 Act. Under that Act, the work of school medical inspection was carried out in accordance with regulations made by the Department of Local Government, following the old Local Government Board. The original Act enacted that “the local authority shall act in accordance with the regulations made by the Local Government Board and approved by the Treasury and the Commissioners of National Education in Ireland.”
General Mulcahy: I am continuing the discussion that took place on the situation with regard to the obligation on any person to avail himself of any service provided under the Bill and with the matters that could be raised to excuse himself. That, as well as with the question of children and of children's parents, is included in this  matter. During that discussion, the question was raised that there was no provision in the section which dealt with the case of children whose parents might not wish them to be dealt with under the school medical treatment, but who would actually be dealt with because of extra statutory influences operating around them, such as the influence of the doctor carrying out the inspection, or the influence of the teacher or of some other element in their surroundings.
The Minister says that he cannot very well help that. I am pointing out a very definite thing that is creating and strengthening these influences. I am pointing out that one is the complete change of spirit in the approach to dealing with school medical inspection. One of the things in the 1944 Act was that children would not be allowed to go to school if they had nits in their hair. I want to point out the spirit that surrounded the administration of the School Medical Inspection Act up to 1947 when that Act was changed. Regulations were made under the 1919 Act in accordance with sub-section (2) of the Act.
They provided, in the first place, that the county council must take account of any treatment that parents are getting for their children from private doctors; in the second place, that parents should be invited and, moreover, encouraged to be present at the school inspection of their children; thirdly, that women doctors ought to be provided for girl pupils; fourthly, that any medical advice resulting from this examination should be sent to the parents; that medical inspection in any school must be arranged so as to suit the convenience of the school authorities and teaching staff and so as to bring about the minimum possible interference with, or disturbance of the school arrangements. There was no compulsion on the school. There was no threat of penalties against the managers, nor were the local authorities given any dictatorial powers to run such schemes as they might themselves decide. The whole spirit was the spirit of encouragement, the spirit of education.
The 1947 Act completely changed the  whole spirit of the approach. The compulsory and dictatorial spirit in considering matters in the Government is enshrined in this whole series of legislation, no doubt from the intention of the 1944 Act to the actual details of the 1945 Act, that so misfired. I should not say misfired. It got an awful lot of fire, so much fire that it disappeared. Then there was the 1947 Act. I suggest to the Minister that if he could perhaps arrange to safeguard people in this Bill against that, but at any rate, safeguard children against these outside and extra statutory actions, it would be a change in the approach of his Department and himself to health matters.
Dr. Ryan: To bring all district institutions which are now maintained by public assistance authorities under the health authority. It is only a changeover, which many sections of this Bill will follow. It is changing from the public assistance authority to the health authority and the public assistance authority goes. There will be nothing but the health authority left when this is finished.
 (5) Every regulation made by the Minister under this Act shall be laid before each House of the Oireachtas as soon as may be after it is made and if a resolution annulling the regulation is passed by either House within the next subsequent 21 days on which that House has sat after the regulation is laid before it, the regulation shall be annulled accordingly but without prejudice to the validity of anything previously done thereunder.
Dr. Ryan: This is not necessary because sub-section (5) of Section 5 of the 1947 Act provides for the laying of regulations under that Act before the Houses of the Oireachtas and sub-section (3) of Section 3 of this Act makes that applicable. So, really, this is not necessary. It is already done.
Mr. Larkin: I take the Minister's word but I find it somewhat difficult to follow the advice of his legal advisers. At one point it appears the two Acts are completely separate. When we come to another point they are a combined Act. It is not my responsibility to ensure that the Minister retains the powers that we mentioned in the discussion of Section 4, namely, to deal with cases of infectious diseases. There he told us very definitely that he had been advised that that particular section was not going to interfere with or militate against the powers given under the Principal Act. If there is that chasm between the two Acts, how then do we connect up when we come to deal with Section 8? I am quite prepared to accept the position that regulations made under this present Bill will have to be laid on the Table of the House so far as it is provided for under the Principal Act but I hope the Minister's legal advisers are correct in regard to the effect of Section 4.
Dr. Ryan: Yes. If the Deputy will look at Section 4, he will see that it is a bit different because it applies only to this Act. The general principle appears to be that the Principal Act governs this Act in the way of regulations, and so on. However, I will make sure of that.
This new section, which it is intended to insert before Section 9, is designed to enable the Minister to control the uses to which local health institutions may be put. I want first of all to emphasise, so that there will not be a misunderstanding, that this new section I am now proposing will apply only to local authority institutions and does not apply to voluntary hospitals or private institutions of any kind. Under Section 36 of the Public Assistance Act, 1939, the Minister has similar control at present over the services which can be provided by the individual district institutions maintained by public assistance authorities.
As I said in speaking on another section, it is merely to give the same power, now that institutions are being  handed over to health authorities, to the Minister as he had when these institutions were under the public assistance authority. As far as I know, the section has not been invoked in the past and I hope it will not be necessary to invoke the section in future. On the other hand, it is well that the power should be there in case any health authority is not making the best possible use of its institutions.
General Mulcahy: Do I understand from the Minister that he requires this power for the purpose of directing that certain operations will take place in one particular hospital or that a particular hospital should concentrate on the carrying out of certain operations? The Minister's remarks rather suggest that there may be a possibility under this proposal that in one county the carrying out of certain operations can be prevented and that operations of that particular kind will be carried out in the neighbouring county, thus developing a kind of regional system. The suggestion, at any rate, is that the Minister wants power to interfere ministerially in the type of work that will be carried on in the hospitals. I understand that there is a medical centre in every county and a county surgical hospital in every county. Do I understand that the Minister is taking power to restrict the type of operations which can be carried on in particular county hospitals?
Dr. Ryan: It is rather straining the section to say that it could be used for that purpose. There is no intention of using it for such a purpose. The only reason that I saw any necessity for this section in the past was in the case of setting an institution aside for smallpox. As Deputies are aware, for the last ten or 15 years there has been a remarkable decrease in fever cases, with the result that many fever hospitals were closed and nearly in all cases they were converted into sanatoria for tuberculosis cases. We felt that we should have a certain number of centres marked off for the treatment of smallpox. Smallpox has occurred in the neighbouring islands very frequently in the last ten or 12 years, but we have been lucky enough to escape.
 Should cases of smallpox occur here, it would be necessary to have some hospitals ready to isolate them. Up to this, we have been in a position to get the local authorities to agree, although we found it very hard on a few occasions to get them to agree. That is the only case where it is likely this power will be used. Take the case of four or five counties. We might ask one county to provide a smallpox hospital and have it available for any of the adjoining counties. They might say: “Why do they not provide one for themselves?” It would be uneconomic to have one in every county. I think Deputies will see the difficulty of getting them to agree sometimes, although they have agreed so far. In a case where we could not get agreement we may have to use the section.
Mr. Morrissey: The Minister is taking an extreme case. I do not question what his intentions are, but it seems to me that this gives a rather extraordinary power to the Minister and to the Department. Of course we must keep in the back of our minds always that the effective health authority in each county will be a person subject to the Minister and to the Department in these matters. This new section says that the Minister may, by order made in respect of a specified health institution, direct that institutional services of a specified class shall be given in the institution and that institutional services of a specified class shall not be given in the institution. It goes further and says that the Minister shall direct the type of person to whom treatment shall be given or shall not be given. I do not think it is the intention, but it seems to me that this is a clause that could be open to very great abuse. It is a very wide clause. I do not think that in what the Minister has said so far he has made a case for getting such sweeping powers as are set out in this proposed new section.
Dr. ffrench-O'Carroll: From the point of view of public health alone a very strong case can be made for this new section. In the last few years we had one example where such powers were necessary. When Deputy Dr. Browne was Minister for Health he had  a very long waiting list of T.B. cases and, apparently, there was more accommodation available in certain institutions throughout the country than was actually required in these areas and Deputy Dr. Browne persuaded those in charge of a number of institutions to provide accommodation on a temporary basis for T.B. patients. Similarly, there has been a great decline in the incidence of fevers, and it is quite possible that in future years there may be beds available in considerable numbers in fever hospitals which may be required for some other purpose and, unless the Minister had power to direct them, if he could not persuade the authorities in charge of these fever hospitals to take in certain cases, it would be a great disadvantage to the health of the community. We can foresee a time when many of the beds now available for the treatment of T.B. may not be required for T.B. sufferers. It might be very much in the interests of public health at that time if these could be used for cancer patients or whatever might happen to be the disease at that particular time which had a high mortality rate, and it is essential that the Minister for Health should have power to direct that the accommodation available should be used in the best interests of public health.
Dr. Esmonde: Surely this new section deals with hospitals already under the control of the local authorities, such as county council hospitals. I consider that the Minister has enough power already, and I do not know why he wants this special power delegated to him. The Minister is really being given very considerable power under the new section to direct that institutional services of a specified class shall be given or shall not be given in an institution and that institutional services shall be given to a specified class of person or shall not be given to persons of a specified class. Deputy Dr. ffrench-O'Carroll has just stated that when Deputy Dr. Browne was Minister for Health he required beds for T.B. cases. That is quite true, but he did not need any special powers for that. There was no objection to his getting them.
Dr. Esmonde: Did any institution actually refuse to take these cases? Perhaps Deputy Dr. Browne could enlighten us. I do not know of any. I may have a suspicious mind, but I read this section as endeavouring to give to the Minister the widest possible powers over the hospitals and over any sick person. In other words, it is a case of further State control. I consider it is quite unnecessary. The only case the Minister made for it is in regard to cases of smallpox. Will the Minister tell us how many cases of smallpox we have had in Ireland in the last 12 months?
Mr. A. Byrne: If an ordinary hospital run by a group of people is directed to take in persons suffering from a certain disease, and these people say: “We do not like to take in patients suffering from that disease,” is the Minister now taking power under this section to order them, whether they belong to a religious order or not, to take in persons suffering from that disease whom they do not want to take in? If that is so, it is coercion and I do not think we ought to do such a thing. If the corporation wants to close down an institution catering for a certain type and they have nowhere to put them is the Minister going to say to a certain order, community or medical authority that they must take in, whether they are prepared or not, a person suffering from that certain type of disease about which I am talking?
Dr. Ryan: In introducing this section, I explained that it did not apply to voluntary hospitals at all. It only applies to the institutions under a health authority and no Order can be  made to deal with any other institution whatever. I do not blame the Deputy for raising the matter because the Irish Medical Association, which should have known better, accused me in a leading article of trying to get the voluntary hospitals into this section. That shows how far people can go to misrepresent me. It must be clear that the section deals only with health authority institutions. Deputy Esmonde talked about the trend in regard to taking these powers. There is no trend. I am only re-enacting what is there already. As I said before, there are many clauses in this Bill that are re-enacted from the Public Assistance Act, 1939 because all health services are being handed over from the public assistance authority to the health authority. That is the reason why these clauses are re-enacted.
Mr. Morrissey: Surely the Minister is not continuing the same powers regarding public assistance? The same words may be there. Surely this is for an entirely different purpose? Under this proposed new section the Minister is seeking to take power, not the local authority, to decide that certain classes of disease shall not be treated in institutions in the counties appropriate but shall be treated in Cork. Dublin, Limerick or Galway. The Minister is further taking power to direct the local authority and the local authority must obey.
Mr. Morrissey: They must not. Certain specific classes of persons cannot  be treated in their own institutions in their own counties and they must be sent wherever the Minister directs. Does Deputy Allen tell me that at the moment patients of any particular class specified by the Minister must be sent wherever the Minister directs they are to be sent? If that is in operation it is certainly news to me and I would like to hear any other representative of a local authority on that matter. I quite admit that I am not so closely in touch with these matters as I was when I happened to be a member of a local authority.
I have a very strong objection to this and I can assure the Minister that there is no point of obstruction involved. I certainly object to giving any central authority the right to decide that institutional services of a specified class shall be given or shall not be given and that persons of a specified class shall be treated or shall not be treated. If this Bill becomes law—I am not saying that the Minister will do this—it gives power to say that a person in Tipperary must be sent to Mayo or Donegal for treatment or a person from Wexford or Clare can be sent to any other part of the country that the Minister directs. If the Minister so directs them, then the local authority, under this proposed new section, must carry out that direction. I am not suggesting for a moment that that is the Minister's intention. We are not, as has been said here very often, legislating for the Minister's intentions. We are legislating for what may be done or what can be done. It seems to me to be a very dangerous power to give any central authority, particularly when the driving force of the local authority will be a person who is in a large measure more responsible to the Minister and the central authority than to the local authority.
Mr. Allen: The Opposition know quite well that there is in operation at the moment in each county district a certain type of institution. You have a county hospital, district hospitals, sanatoria, fever hospitals. Since 1922, when such institutions were set up, certain types of treatment were given in those particular institutions. I think the section is quite obvious to anyone. It is a section which, as far as I know, is fully in operation over very many years in regard to specified institutions and specified treatment.
Mr. Allen: It does not go the slightest bit further. I believe that the section is almost word for word the same as the section in the 1939 Act. As the Minister has explained already, the medical assistance portion of the 1939 Act ceases to operate when this Bill becomes law. Deputy Morrissey wants to read into the section something that is not actually there and something that is not actually in operation. Every member of a local authority fully understands and agrees with it at the present time.
I turn to the Health Act, 1947, for a definition of what is included in the expression “institutional services”. It includes “(a) maintenance in an institution; (b) diagnosis, advice and treatment at an institution”. The Minister told us before progress was reported that there is nothing here which enables compulsion to be put on a medical officer to give any special treatment under the Acts. Surely it is  here? He may direct that certain institutional services are to be given in a particular institution and that includes diagnosis, advice and treatment at an institution. It is well known that one of the objections taken by the Hierarchy——
Mr. McGilligan: ——to the health legislation was that it contained no safeguard that patients would not be obliged to accept treatment of different types—treatment in obstetrics, in gynaecology and in psychiatry—from people imbued with a materialistic philosophy or with opinions contrary to the natural law. The Minister will recognise that phrase.
On an earlier section we argued that, with certain limitations and always accepting that the safeguard was within the confines of this legislation, under the health provision for 1952 the patient appeared to be safeguarded but that the doctor was not. Will the Minister tell me if it is not possible under his amendment for a Minister to direct a doctor to give treatment of a type that is contrary to that doctor's lawful conscience? I think the Bill gives scope for that. That was the point I was going to make, before the adjournment for tea, in answer to the Minister's claim. It is here clear that a Minister may enjoin by regulation institutional services of a specified class and those include diagnosis, advice and treatment.
Let me point out, with regard to people imbued with materialistic philosophy and with opinions contrary to the natural law, that a Minister imbued with these particular principles—I am not talking of the probability at the moment—could, under this Bill, compel doctors to give treatment which is contrary to their conscience and scruples and to do something against their conscience. I believe that that point is there.
Captain Cowan: The point raised by Deputy McGilligan is a point in which Deputy McGilligan knows very well there is no substance. It is just a usual  attempt to bedevil this whole matter. We heard him here earlier this evening talk about a letter that the Hierarchy are supposed to have written and now he has just spoken about what the Hierarchy have written. I think it is most unfortunate that we have these references by Deputy McGilligan to a document that this House has never seen—a document that may or may not exist as far as this House is concerned. Deputy McGilligan uses it for what I consider to be an absolutely ulterior purpose which has nothing whatsoever to do with regard to the Bill before the House.
Deputy McGilligan is very worried about what he terms “a materialistic philosophy” and the conception of a Minister in the future who might have views contrary to the natural law and who would direct a doctor to give a certain course of treatment which was contrary to that doctor's conscience. Deputy McGilligan knows that there is no substance at all in that argument. I am sure that he himself would certainly say that no direction given to him by anybody would make him act against his own conscience. I do not know whether he would contend that he would act against his conscience even for money. However, he does not mind suggesting that a doctor—a doctor in one of the health institutions of the country or a dispensary doctor—would act against his conscience just for the sake of maintaining his employment.
I think that that is a slander on our doctors. I have never yet met a doctor in this country who would do anything contrary to his conscience. I have not met many people even of Deputy McGilligan's profession who would act contrary to their own conscience. I cannot say why we should have this presumption on the part of Deputy McGilligan or anybody else that certain people would act contrary to their conscience just for the sake of maintaining their employment.
Captain Cowan: One of the great protections of liberty that we have in this country is the fact that people will not act against their conscience  and that people will not be compelled to act against their conscience. I see all over the country our dispensary medical officers and the doctors who are in our institutions, and I have the high opinion of these doctors that they will not act contrary to their conscience or contrary to their religion. We have reached a very sorry pass when a Deputy of Deputy McGilligan's standing will suggest in this House that the doctors in our local institutions and our dispensary doctors will act contrary to their conscience on any directions from anybody. I think it is time we got rid of this bull—because that is all it is.
Mr. McGilligan: I have not said a word about doctors acting contrary to their conscience. That is merely the type of nonsense at which Deputy Cowan is so good. I have, however, known people to go against their conscience for the sake of votes and to speak against the cutting of subsidies and then walk into the Division Lobby and vote for the cuts.
Mr. McGilligan: Here is an amendment saying that the Minister may, by Order, direct certain things, “and it specifies, in conclusion, “and the health authority maintaining the institution shall comply with the direction.”
I want to avoid a position in which any Minister—any materialistic-minded Minister—might order doctors in health institutions to do certain things and put in law that the health authority shall comply with such directions. Such a provision is nonsensical in a country like this. If an Order like that were made I think that the conscience of doctors would override it, even at the cost of whatever local popularity might be got out of it.
The Minister may direct certain things. The Minister for Health was not specially interested in the School Attendance Act which was passed here. That Act was taken to the Supreme Court. The Supreme Court, on this  piece of legislation which enabled regulations to be made, gave as their judgment on the case that had been made to them, that a responsible Minister, acting with the full sense of his responsibility, would not be likely to make regulations that would be in breach of the Article of the Constitution which was alleged to be impugned by that Act, that it was still open and possible, under a phrase in the School Attendance Act, for a Minister to make regulations which would be in breach of the constitutional provision. That is all I put here. It is quite open here for a Minister to demand that institutional services of a specialised class shall be given in institutions. Once he does that—and this is by Order and not by regulation that comes before this House—then the health authority has to comply with it.
There is no good in passing laws which can be taken to the Supreme Court and, on the analogy of the school attendance legislation, finding that there is room here and an opening for a person to contravene certain things. I am answering the point made before the tea adjournment. The institutional service which may be directed includes diagnosis, advice and treatment in an institution. I know that, notwithstanding what might be said about the conscience of the population or the resort that might be had to the good faith of the people of this country, the ordinary people in the country could not submit themselves to treatment that was contrary to their religious belief.
Notwithstanding that, the Hierarchy found themselves so concerned over this that they addressed the Minister to the point that the Bill had no safeguards that patients might not be compelled to submit themselves to obstetrical, gynaecological and psychiatric treatment which came from people imbued with materialistic principles or who held views contrary to the natural law.
Again, I want to say that, while the Hierarchy made their suggestions about patients and while the matter of patients has been safeguarded to a limited extent in the amendment brought into Section 4, when we raised  the position of the doctor, it was derided and it was put to us that there was no point arising under this legislation at which a doctor could be compelled to do anything that was in violation of his conscience. I say that that point is here. Why can we not have a bit of reason about this? Does anybody here want to have a patient compelled to do something in violation of his conscience? I take it the answer is no. Does anybody here want to have a doctor compelled to do anything in violation of his conscience? Again I take it the answer is no. Why not say so? It is very easy to say so.
Mr. McGilligan: Let us look at the events. It was passed and that meant that the principle of the legislation, as I take it to be, was accepted by the House. I do not know what that principle was. So far as the principle having been accepted is concerned— and it is not the principle overladen with details in this legislation—it was that health services should be provided for people who could not provide these health services themselves. That is the principle I accepted and that principle is overladen by hopelessly bad details in this piece of legislation. I want to find out where we are with regard to this legislation. There are 32 Government amendments. We were told after the Hierarchy had written to the faithful and after the Government had got their letter suppressed that there would be a few minor and insignificant changes.
Captain Cowan: As a matter of order and common decency, Deputy McGilligan has made a suggestion that a document addressed to the faithful by the Hierarchy—the House knows nothing about that—was suppressed by the Government.
Captain Cowan: To say that the Government suppressed a letter sent by the Hierarchy is something which, I submit, should not be said in this House. It has been denied that there was any such suppression.
Mr. McGilligan: And I am entitled to get it out. That letter was sent and was suppressed by the action of the Taoiseach bundling himself across the Border and then seeing the editor of the Irish Times to have it squared.
Mr. McGilligan: It is very relevant to this discussion, but let us get back to the point. Legislation was passed on Second Reading. What is the principle—to give health services to those who could not afford to pay themselves, at the expense of the community, with certain limitations. After that legislation had been passed on Second Reading, the Hierarchy addressed the faithful in a way that meant that they condemned this legislation as being contrary to Catholic social teaching.
Mr. McGilligan: They were not allowed. They did address a letter to the faithful and the Taoiseach bundled himself across the Border to get it stopped and went down to see the editor of the Irish Times after that.
Mr. McGilligan: If Deputy Cowan gets in something, I am entitled to reply to it and I will reply to it. Here is the position we have reached. The Minister has produced 32 amendments. He told us that he had found certain objections being taken to this legislation on moral grounds and that he was endeavouring to meet them, but that they were a few insignificant points. In a later part of the debate, he said there would be two amendments. We have 32. Have we the original Bill at all, or where are we? So far as I am concerned, we are not dealing with the original Bill. The original Bill was condemned in a root and branch condemnation by the Hierarchy of this country.
Mr. McGilligan: The word “filth” is applied here to objections taken by the Hierarchy of the country to the proposals of the Government with regard to treatment on the ground that they were against Catholic teaching.
Mr. McGilligan: The Deputy can screw a few votes here and there by any propaganda he can make, but he will not stop me making my statement on this amendment. The amendment does allow the Minister to impose certain treatment in an institution. How is the treatment to be carried out? Surely by the officers of the institution or by the Minister's officers. Is that not what we were objecting to before the adjournment of the debate earlier, that, while there is in a limited way a protection on the ground of the teaching of religion—but, as we would prefer it, on the ground of violation of conscience—it does not protect the doctor? The Minister told us that there was no necessity to protect him, that he could not order a doctor to do anything. Let me make a distinction. I am not saying he will. Could he? Surely it is clear that he could, and that was the point on which the Supreme Court ruled against the School Attendance Act, that even assuming that the Minister would be responsible, sections in that Act still left it open for some other Minister to impose certain conditions that were contrary to the Constitution.
I say the same with regard to this and I object therefore to giving the Minister this power. If he likes to say that he has it in some other Act— very good let him have it. One of these days we will get a proper objection on moral grounds, on the ground of the natural law, against this particular legislation. Let it not be forgotten that any of these other pieces of legislation which contain these compulsory treatment provisions are all subject to the Constitution.
The Constitution in one Article says that freedom of conscience is guaranteed. It is, of course, guaranteed, subject to certain things, one of which is public order and the other morality, but it is not this Dáil which is the adjudicator in that regard. In the Sinn  Fein Funds case, the courts took the strong step of saying—and a proper step it was—that they would be the guardians of such things as the exigencies of the common good, and so on, and they will establish themselves as the people who will make the standards of public order and morality.
If there is in this or any of the other legislation anything that allows institutional treatment against infectious diseases, in regard to vaccination or anything else, it is all subject to the freedom of conscience guaranteed in the Article about religion. That freedom is guaranteed subject only to two things, public order and morality, and the arbiters of these are not the group of people meeting here, but the courts, and they have already established standards contrary to the standards accepted here with regard to private property.
Dr. Browne: I must confess that I simply cannot hope to compete with the Fine Gael theologians and I want to address myself to the Bill solely as a politician. In passing, it is interesting to hear Deputy McGilligan professing to defend the very socialist proposition, the provision of subsidies, and giving us the general impression that were the Minister for Finance he would restore them or keep them at their former level. I do not believe that. However, let me get back to the Health Bill.
Dr. Browne: Deputy McGilligan referred to what he suggests are the  appalling consequences that will follow from this perfectly innocuous amendment. He referred to institutional services—diagnosis, advice and treatment. He quoted from the 1947 Health Act in which the same provisions were laid down, that any doctor can be asked to carry out institutional services —diagnosis, treatment or care of a patient—under the 1947 Health Act. Indeed, Section 11, part 2, of the 1947 Health Act really contains practically all these provisions:—
(b) the Minister, if he so thinks proper, may by Order direct the authority to provide and maintain at a specified place an institution of a specified character or size in substitution for the discontinued institution or Department.
There is no doubt at all that this particular amendment is desirable and is necessary. I agree with Deputy Cowan; I do not think any medical officers who will be employed under health services in the future are likely to carry out any procedures for money which would be likely to conflict with their consciences.
I do not think they would be asked to do so by any Government or any Minister that we can anticipate. Is it not a fact that if such powers are ever sought by any Government or required by any Government they will be taken by that Government, because they will be able to do so by virtue of a majority in this House? Consequently, I would suggest this hysterical mirage of Deputy McGilligan's is merely another attempt to confuse the issues. Fine Gael are merely obstructing the attempt of the Minister to introduce a Health Bill, and the instrument which proved so valuable to a limited degree on the last occasion on which they obstructed progressive health legislation, is being whisked out again.
Mr. McGilligan: May I just say one word about Deputy Browne. He is an expert on mirages and I have always recognised that as an obsession with him. It has been argued now that no doctor will do for money something beyond the bounds of his lawful preference. The same argument could have been made to the Hierarchy that no patient would take advantage or avail of services or submit to any treatment that was contrary to or in violation of his convictions. The Hierarchy still objected. The Hierarchy's objection was that the Bill contained no safeguards that the patient would not be obliged to undergo treatment against his conscience. There is certainly no lack of appreciation on the part of the Hierarchy in regard to the stability of the Irish character particularly in regard to religious matters; nevertheless they regarded it as wrong that a piece of legislation should go through containing no safeguards for patients, whose lawful scruples might be violated if they were compelled to undergo treatment of a particular type. It was no answer to say: “You can rely on the good faith, on the scruples and on the strength of the religious feeling of your community”.
When I turn this argument to a doctor we are told: “Of course, the doctors are strong with regard to their religion. They will never do this.” Are we going to pass in this House legislation which gives some Minister— perhaps some materialistic Minister not upholding the principles of natural law—the right to say to a lot of Catholic doctors: “You will do that or leave,” and forcing on them a new type of martyrdom? I want to object to legislation proceeding from this House having any such possibility even though it be a bare possibility. When I argue about that possibility being removed I have regard to the objection of the Hierarchy that there was no safeguard in regard to the patient against being compelled to accept treatment of the obstetric, gynaecological or psychiatric type proceeding from people with materialistic principles or people who do not accept the true view in regard to the natural law. If that is true in regard to the patient  why should we not have the same position in regard to the doctors? That is the only point I want to make, but I want to make the case more particularly because the Minister said there was nothing in this legislation originally introduced or amended which gave anybody the power of compelling a doctor to act in violation of his conscience.
I assume nobody wants to ask doctors to act in violation of their conscience. What is the difficulty in saying so? We have apparently the same view with regard to patients in this Irish community that they would not accept treatment in violation of their conscience; yet we have a safeguard. What is shameful in accepting a safeguard in regard to the doctor? I think it is wrong to leave the power there however remote the possibility of enforcing it may be. We in this House agree that if a Minister did try to enforce it, the doctor would be entitled to fight against it and to refuse to give treatment. What is wrong in saying so? I am sure the Minister has made the same excuse to the Hierarchy with regard to the patient; nevertheless he has brought in an amendment saying that a patient may seek to avail of a service and yet may object to a particular treatment if that particular treatment is against the teaching of his religion. Surely the same ought to be said in regard to everybody connected with this—patients, doctors, nurses and anybody else in the service of the health authority.
Dr. Browne: All I can say is that Deputy McGilligan appears to overlook the fact that he has an advantage, certainly over myself, in that I have not read the letter addressed to the faithful—presumably he is more faithful than others. I have not read that letter and in consequence I am not in a position to say—perhaps Deputy McGilligan would let us know—whether the Hierarchy asked for guarantees in relation to the protection of doctors in the administration or the running of these schemes; and if they did not, whether Deputy McGilligan feels that they have been in any way remiss in not advising the Minister that he  should introduce such guarantees. Also, if these guarantees were asked for in relation to the doctor, should we stop there? Surely the nurses, the attendants, the laboratory technicians, the radiographers——
Dr. Browne: ——should be mentioned. Shall we specify them all and where shall we stop, at the hall porter and move right up to the medical superintendent? Perhaps Deputy McGilligan could inform us whether the Hierarchy have been remiss or whether they did specify certain categories to which the Minister should refer this amendment.
Captain Cowan: I should like to draw attention again to a certain matter. Both, before you came in, a Cheann Comhairle, and since you came in, Deputy McGilligan has been referring to a letter which was addressed to the faithful by the Hierarchy. Such a letter is not before this House. It is not on the records of the House. It certainly was not published for the information of the faithful and no person that I know of has an official copy of any such document. According to Deputy McGilligan the document was issued and stopped. If people, particularly the Irish Hierarchy, issue a document and stop it they stop it for a good purpose. I am sure they did not want or do not want Deputy McGilligan to quote in this House from a document which they stopped and did not publish or circulate to the faithful as he says.
I described Deputy McGilligan's conduct in his approach to this matter as being filthy conduct. I think it is filthy, I think it is despicable, I think it is reprehensible and I think Deputy McGilligan should be ashamed of himself for using this House for the purpose of getting in, by the method he has adopted, a reference to a document which, as far as the Irish people are concerned, does not exist. Then we have his further suggestion that the Taoiseach crossed the Border to prevent publication of this document. I  say a suggestion of that kind is filthy and reprehensible.
Captain Cowan: Deputy McGilligan has been asked by Deputy Dr. Browne if in this document to which he has  referred, and from which apparently he seems to be quoting, there is any objection to the amendment before the House at the moment. We are in certain blinkers as far as this is concerned.
Captain Cowan: Deputy McGilligan was asked the question, is there anything in this particular document against the amendment before the House at the moment? Deputy McGilligan has been asked several times to quote, if he would, from the particular document. I think, and I submit to you Sir, that we cannot discuss this in a reasonable manner if one Deputy can come forward and say: “I have a document addressed to the faithful; I have seen it and there are certain things in it to this effect.” That document is not before this House and I submit that there should be no reference to that particular document permitted in this debate because nobody knows anything about this document. I do not think Deputy McGilligan will say that I am wrong when I say it was not circulated to the faithful. It was not published to the faithful and nobody knows anything about it. When I hear Deputy McGilligan using the document in the way he has been using it, I am reminded of the soldier mentioned in one of Goldsmith's Citizen of the World  Letters—the citizen or the soldier with the foul tongue and the foul language who was so worried about religion, if the French invaded Britain.
Dr. Esmonde: I should like to refer for a few moments to the question of institutional treatment. Deputy Dr. Browne said that we would get to the stage where the hall porter could be held responsible for a hospital. Deputy Dr. Browne should know perfectly well as a doctor that the medical officer is in charge of the treatment in a hospital. It has been clearly stated that one of the powers that the Minister is getting under this section has reference to advice in regard to the treatment in an institution. If we pass this legislation, we hand over control of treatment in a hospital, in theory anyway, to the Minister. The person responsible for a hospital is the medical officer but if you pass legislation such as this, ipso facto you remove power from the medical officer and delegate it to the Minister. I am not suggesting, and I do not think that any Deputy here would suggest, that the present Government are going to interfere in a materialistic way with the hospitals but we are asking the House to pass very dangerous legislation. In other words, we are delegating to the Minister absolute control of patients that are treated in our health authority institutions and the treatment they are to receive. We are also giving him power to say who is to be admitted to the hospitals and who is not. That is what the Fine Gael Party maintains is wrong and we do not accept this in any degree whatever.
Dr. Ryan: I stated before the adjournment that it could not be pointed out that any doctor could be made to give a treatment that he did not think proper himself. I hold the position is still the same as far as this section is concerned. I had to draw the attention of the House to Deputy Costello's interpretation of some laws already. Deputy McGilligan has adopted the same tactics here of presuming to interpret the law and of not doing it in an honest way.
He talks about institutional services to a specified class and institutional  services, he says, include treatment. He then goes further and argues that the doctor may be asked to carry out the treatment of a specified class. Anybody who reads this definition will see that that is absolutely ridiculous and absolutely absurd. It says “diagnosis, advice and treatment at an institution”. Does Deputy McGilligan really mean to put before the House that an order could be given to a doctor to carry out diagnosis of a specified class? After all, one cannot specify the class for treatment without taking the whole sentence surely. Diagnosis of a specified class is, of course, absurd and Deputy McGilligan knows it is absurd. I object to Deputies on the Opposition Benches who have some reputation as far as the law goes coming in here with that reputation and interpreting the law for the House, and interpreting it, let me say, in a very dishonest way. As far as I am concerned I am quite satisfied—I am not a trained lawyer; perhaps I should be proud of that when I see what goes on here—that no Minister could direct the doctor in an institution to give treatment to a specified class. Anyhow, that is a queer expression—a specified class of treatment.
Dr. Ryan: The Deputy knows that is absurd. Cannot Deputies on the Opposition Benches try to treat this with honesty, if nothing else, even if they want to obstruct. I am quite prepared to go to the legal adviser to find out if this is all right. I think no one would expect that I should take Deputy McGilligan as my legal adviser on a Bill of this kind and I have no intention of doing so.
General Mulcahy: The Minister complains that Deputies on this side of the House are interpreting the law, but not in an honest way. Deputy Cowan maintains that we are in certain blinkers and that we cannot discuss the matter in a reasonable way. We have just had a fairly long discussion on paragraph (a), one out of four paragraphs in this amendment. Looking at the Minister's presentation of this amendment, remembering that his attention was drawn to the fact that he could do certain things under it, what was the line he took? First of all, it was that he had power under the Public Assistance Act. I do not think that that is so.
“Where a district institution provided by a public assistance authority is available for the assistance of a particular class of persons or provision has been made by a public assistance authority with the consent of the Minister for the assistance of a particular class of persons in a home, hospital or other institution not provided or maintained by such authority, the Minister may, by Order, direct that such particular class of persons shall not be assisted by such public assistance authority in any institution except (as the case may be) such district institution or such home, hospital or other institution, and thereupon it  shall not be lawful for such public assistance authority to assist (except in cases of urgent necessity) any person of such particular class in contravention of such Order.”
The Minister says that Section 36 of the Public Assistance Act, 1939, which he has just read out, is the same as the amendment he has now put in. That is exactly what disturbs me in this matter. We talk about morality. I think there is a certain question of morality involved in the Minister being honest in relation to the things he tells the House. In the first place, the amendment the Minister has put in is entirely different; there is a much  more comprehensive control under this amendment than there is in Section 36. All that is here is that where district institutions exist under a local authority for a particular purpose and where in some of them only particular cases can be dealt with the Minister can prevent patients being dealt with in other institutions. Compare now the restricted proposals in relation to institutions that already exist.
General Mulcahy: Nevertheless, the approach and purpose of Section 36 of the Public Assistance Act, 1939, is entirely different from the proposals here. When we add to that deception the Minister's explanation that this thing was never very much done before, and that the only thing that it probably was useful for was in exceptional cases, such as a smallpox outbreak, we find ourselves faced with a rather extraordinary situation. If an outbreak of smallpox should occur, under the Public Assistance Act patients suffering from that disease would only be allowed into a certain institution. Patients in neighbouring counties would not be allowed into their own institutions. They would have to be sent to this special institution.
What is the kind of presentation that we get of this particular amendment? Following on the Minister's smallpox idea we get Deputy Dr. ffrench-O'Carroll dealing with the development of tuberculosis institutions during the inter-Party régime when, by persuasion, it was possible for the then Minister for Health to have all the necessary institutions he wanted to serve his purpose in dealing with tuberculosis. It was persuasion that did that without any ministerial Order.
Now we have the heavy hand of the Minister coming in and nothing will do him but to be able to do by Order all the things specified in (a), (b), (c) and (d). Knowing the kind of discussion we have had on paragraph (a) one wonders what will be disclosed when discussion takes place on paragraphs (b), (c) and (d). The Minister complains  of the interpretation of the law not being honest. What adjective can be applied to the presentation by the Minister of his amendment? We are told by Deputies supporting the Minister that we are held in certain blinkers. The purpose of this Bill seems to be concealed behind some queer kind of curtain—a curtain of iron or a curtain of brass. I do not know what kind of curtain it is. It seems to be some deliberately developed fog. The Minister tells us that this amendment is similar to provisions that operated heretofore. That is not so.
He told us that what operated before was hardly wanted at all in the last ten years—except that it might be wanted for smallpox—and, apparently, that is a very queer contention and cannot be an honest presentation of what this amendment is meant to be. Either the Minister does not know what the amendment is about or he is deliberately hiding what the amendment is for. What we want to know is who on earth is behind this if the Minister is not and, if the Minister is behind it, he ought to tell the House the real purpose of the amendment.
“The tumult and the shouting have died away, and the captains and the kings have silently or not so silently departed, and we are left with a Bill modestly entitled, ‘An Act to amend and extend the Health Act, 1947, and certain other enactments’. Gone is the first White Paper and its gorgeous retinue of illustrated pamphlets and half-page advertisements; gone are the hopes or fears of ‘free-for-all’‘paid-for-by-nobody’ health services; gone even is a certain amount of the second White Paper.”
“Right in the forefront of the Bill is an ample disclaimer in clear language touching the very first caveat of the Bishops in their letter  of 10th October, 1950. ‘In their opinion,’ said the letter, ‘the powers taken by the State in the proposed mother-and-child health service are in direct opposition to the rights of the family and of the individual and are liable to very great abuse.’”
That is the phrase I want to found on—“the powers are liable to very great abuse”. I do not think the Hierarchy ever put up the contention that they feared any great abuse immediately. They said it was liable to great abuse and that was the main foundation of their argument against the immoral proposals of 1947, arriving at the somewhat amoral proposals of 1952.
“The new Bill meets this caveat in two ways: (1) it repeals every single section (21 to 28) lock, stock and barrel, of Part III of the Health Act, 1947, on which part the whole of the first White Paper's mother-and-child scheme was based, and from which it was to draw its legal force: and (ii) it declares, in Section 4:”
“‘Nothing in this Act or any instrument thereunder shall be construed as imposing an obligation on any person to avail himself of any service provided or to submit himself or any person for whom he is responsible to health examination or treatment.’”
The Bill was presented and passed its Second Reading here and the Hierarchy then addressed a letter to the Faithful, which amounted to a condemnation of the proposals on the ground that they were contrary to Catholic social teaching. The Minister told us he would endeavour to meet  those points of view and one of his endeavours was by bringing in the first amendment, which was to Section 4.
When we began to discuss Section 4 from this side, there was introduced the question of the doctor. The new Section 4, with the additional second sub-section, to some extent, but with great limitations, would meet the objection made by the Hierarchy with regard to the patient. In that connection, we raised whether the doctor's position ought to be safeguarded and the Minister's answer was that the doctor's position was in no way interfered with by anything in this legislation. At that time he was making the argument that the only amelioration he wanted was in this legislation, that is, in the 1952 proposals. He balanced that by saying that in this legislation there is nothing which enables the Minister to impose any compulsion on a doctor.
I had asked the Minister if it was the case that certain sections did. I referred to the difficulty a Deputy had in making his way through the original health proposals and the 32 amendments. Now here it arises immediately on this amendment No. 3. We are to insert a new section enabling the Minister, by an Order made in respect of a specified institution, to direct that institutional services for a specialised class should be given in the institution.
I turn to the 1947 Act to find out the definition of institutional services. It includes “diagnosis, advice and treatment at an institution.” The Minister has made an attempt at replying to me on the basis of diagnosis—can he prescribe a diagnosis? I never said he could, but does the Minister mean that because he cannot prescribe a diagnosis he cannot prescribe the advice or the treatment? I say those arguments do not hang together. He is here entitled to direct institutional services. I ask him to take these things separately, one by one. He can prescribe diagnosis—he will not prescribe it, I hope. He will not prescribe treatment. We know he already did. The Department of Health, through their Minister at various times, did try to prescribe certain treatment from headquarters.
Mr. McGilligan: Certain regulations were issued with regard to certain immunisation matters. Certain proposals were made with regard to certain treatment by drugs. Has not the Minister read the statement at Limerick last week from doctors, objecting vehemently?
Mr. McGilligan: Let us have our own records put together. I will not object to that test. We have here that the Minister may prescribe this treatment. I say you can get from this phrase, this definition section of the 1947 Act, and this amendment, that it is possible for the Minister, by Order, to direct that certain treatment be given in a particular institution. I assert that it is not possible to argue against that as a conclusion.
Mr. McGilligan: It is the conclusion that is to be taken from the run of the words, the substitution of certain things by the appropriate matters that are carried in the 1947 definition. Therefore, the Minister may prescribe treatment and I certainly think headquarters have prescribed treatment. I do not think that is denied any longer.
Mr. McGilligan: I think the Minister's whole answer to me is: “Can you conceive a Minister prescribing treatment that would be contrary to or a violation of the conscience of the mass of the people?” I want to ask him a question.
He must have met the Hierarchy on their objections to his legislation and when they objected to his legislation, to Section 4, and thought that it required further amendment, surely he must have had the same answer as he has given in this House to me. He must have said: “Can your Lordships feel that any Minister would prescribe  or would compel a patient to undergo treatment that was contrary to the teaching of the Church?” Yet the Minister has been, somewhere or another, coerced to bring in an amendment making this part of the legislation. Why did he do that? The Hierarchy did object. They said there was no safeguard. That was all they advanced, that there was no safeguard that patients would not be compelled to accept treatment in either obstetrics, gynaecology or psychiatry, contrary to their own views. They put it in the terms of a phrase, people who were imbued with materialistic principles or who had views contrary to the natural law.
Let me transfer that argument to the doctor. Supposing the Hierarchy's objection were made that there is no safeguard that doctors would not be compelled to administer treatment in obstetrics, gynaecology or psychiatry, directed by people who were imbued with materialistic principles or who were advocating practices contrary to the natural law. Two of the things we know there was objection to were abortion and birth control.
They were two of the special points that were made in the letter. If the Minister feels that there was a strong objection that no representative of any Government likely to be formed in this country for a generation or two would be likely to tell patients they must submit to treatment dealing with birth control or leading towards birth control or tending towards abortive practices, he could certainly say that with regard to the doctor; but his argument apparently did not pass muster with those who were addressing the faithful over his head on the ground that his legislation was contrary to Catholic social teaching, and who made it as one of their points that patients had no safeguard against their being made to give into treatment given by people with those viewpoints. If the argument was good with regard to the doctor, it is good with regard to the patient. The Minister has given in with regard to the patient. All I say to him is that the House is apparently in agreement that they do not want to have anything  in their legislation which would have even the remotest possibility of compulsion in the case of patient or doctor, the one to accept or the other to give, treatment of a type condemned by the social teachings of a particular Church. Why does the Minister not accept that?
Mr. McGilligan: Why not? I thought the Minister could comfortably carry through the legislation we had here on the Second Reading and in answers he said there was nothing wrong. Yet he has produced an amendment which appears to accept the contention that there was something wrong and that wrong was phrased in these terms, that there was no safeguard against the patients being compelled to accept certain treatment. I ask the Minister, and I do not think he can answer me. He certainly cannot deny me when I say there is no safeguard against this, in the case of a doctor.
Mr. McGilligan: Can you compel a doctor to give certain treatment? Can the Minister, by Order, not prescribe that certain services shall be given by the institution, and the health authority must comply with that direction? That direction covers advice and treatment. Suppose the possibility is the most remote thing on the face of the earth. The Minister is safeguarding against this, also remote, in respect to  the patient. Why could he not satisfy scruples and deal with it in respect of the doctor also?
I have been asked whether it is the Hierarchy have taken this objection. I think they have, of course, taken it. In a letter of the 5th April, 1951, they spoke in the following terms. They expressed once again:—
“approval of a sane and legitimate health service which will properly safeguard the health of mothers and children. The Hierarchy cannot approve of any scheme which, in its general tendency, must foster undue control by the State in a sphere so delicate and so intimately concerned with morals as that which deals with gynaecology or obstetrics and with the relation between doctor and patient.”
I think that covers this point. If it does not, quite a number of phrases have been used later. The Hierarchy were, as the Minister knows, very definitely concerned with what they called anything that unduly interfered with the rights of the various people mentioned. Amongst the others was the medical profession.
They went on to speak of birth control and abortion in so-called health clinics and they said that health education often involves the claim to direct the child according to pernicious Freudian and materialistic principles.
Mr. McGilligan: The result was objection because it extended considerably the already wide field of medical service now covered by the State. I understand there was objection to the setting up of a centralised bureaucratic system in a matter of most intimate concern, health and life. There was a statement that the public health authority which would administer the service was not an independent local body but was an official entirely subordinate to the Minister. I understood there was further objection that the Minister was given power, and extremely wide power to make regulations for every detail of the service, so that he could in time seriously modify the intimate doctor-patient relationship. If that is not the objection to this, to the Minister being able by Order to prescribe certain treatment which a health authority will have to comply with, I do not understand the meaning of the English that is in this reference I have taken from the document that apparently no one but myself knows anything about.
Mr. J.A. Costello: The Minister proceeded to say then that doctors cannot do certain things that Deputy McGilligan suggested they could under the proposed amendment. When he was asked why he could not, the answer was: “You can't.”
Mr. J.A. Costello: I got a piece of advice as to how to construe a statute. I am going to give the Minister and the House the benefit of that advice because, of course, if I said it, the Minister would not believe it, but it happens to be the advice of a person who was appointed to the Irish Bench by the present Government, so his advice may be taken. That advice is that when you have a phrase used in a  section of an Act of Parliament which is defined by a definition section in that Act or associated Acts then, in order to see what the section means, take out the phrase and write in the definition and then you know where you are. I am going to do that.
The words “institutional services” of course are defined in Section 2 of the Health Act, 1947. I take out those words from this line and put in the definition as given in the Act of 1947 and the proposed amendment reads as follows:—
Mr. J.A. Costello: “And the health authority maintaining the institution shall comply with the direction.” Taking that method of interpreting the section, the Minister's suggestion, “he cannot, so he cannot”, appears as foolish as the method by which he purported to meet Deputy McGilligan's argument.
Dr. Browne: I asked a specific question of Deputy McGilligan. I do not know if he replied to me but I accepted that he gave me the reply that the Hierarchy referred in general terms to the problems of the doctor. Well, I  think, in general terms the Minister has met the objections of the Hierarchy. There is no request, as far as I am aware, from the Hierarchy to include specifically the different catagories of personnel who are involved in the carrying out of an operation. I do not agree with the view of Deputy Dr. Esmonde. I think the responsibility for doing an immoral act in relation to an operation could extend beyond the doctor. As I have protested on many occasions since this debate began, I am not an authority on the moral law but I would imagine that anybody taking part in the operation, which, as Deputy Esmonde knows, is a fairly complicated thing, involving more than the surgeon, could become involved in the carrying out of an immoral act and consequently would have to be specified by the Minister if he were to cover all the contingencies of inflicting an injury on the conscience of anybody taking part in that act.
Deputy McGilligan also referred to the question of birth control and legal abortion in the 1951 health scheme. The inclusion in the criticism of references to these two practices which are contrary to the natural law implied that the criticism referred to the possible inclusion or the inclusion of a provision in that Bill for the carrying out of instruction in relation to either birth control or that the doctor should carry out legal abortions or anything leading up to abortion. I think the Deputy has been very hard on the Minister, particularly censorious on the Minister. I would suggest that the eloquence which we have listened to for some hours from Deputy McGilligan would have been most useful and most valuable to us all if we, jointly, Deputy McGilligan and I, considering the provisions of the amending Health Bill, or the provisions of the mother-and-child scheme which he now attempts to smear with the suggestion that it contained provisions for these objectionable practices remembered that it was equally, with me, Deputy McGilligan's Health Bill or health provisions or health scheme and, that if it contained anything relating to legal abortion, contraception, euthanasia or any of these frightful propositions which have  been whispered underground or sometimes overground by the Deputy McGilligans of the Fine Gael Party, he must accept full responsibility for those provisions if they were included, but, of course, everybody knows they were not.
“In their opinion” (said the letter), “the powers taken by the State in the proposed mother-and-child health service are in direct opposition to the rights of the family and of the individual and are liable to very great abuse.”
I want to put that to the Minister in regard to this section of his. No assurance of the type we have been getting, that no Minister would ever do this, that or the other thing—no assurance that they would be used in moderation could justify their enactment.
In the letter which has not been issued the Hierarchy said they were glad to note that the present Bill has abandoned Sections 21 to 28, to which they objected on moral and religious grounds. All the time I was a member of a Cabinet I objected to this on the same grounds.
Mr. McGilligan: Not a particle. It was for use under the ordinary health service. There was no scheme. There was not a penny under the mother-and-child scheme, not a particle, not a shilling spent on that.
Mr. McGilligan: It was not. An Attorney-General under our system ruled that these sections were unconstitutional as well as the Bishops ruling that they were immoral, and I accepted the Attorney-General's ruling.
Captain Cowan: If the document is to be quoted, as this has been all the evening, am I entitled to request that that document be placed on the records of the House so that at least we will be able to read what is in it?
Captain Cowan: I want to submit— if Deputy McGilligan, on a point of order, would not mind sitting down— that this document has been quoted in the course of the debate now for hours and the Deputy, every time the matter is referred to, says this document was issued to the faithful. You, Sir, know, as I know, that no such document was issued to the faithful and therefore, if there is to be such an extensive quotation from a document, I ask that it be placed on the records of the House.
An Ceann Comhairle: I know nothing about the document. I do not know whether the document was published. It has been the practice here when a document has been quoted from that it be placed at the disposal of Deputies. No other Deputy seems to have seen that document except Deputy McGilligan, at least no other Deputy has made use of it. If Deputy McGilligan proceeds to make protracted references to that document——
Mr. McGilligan: The source is a letter sent by the Cardinal and by the Bishop of Raphoe and the Bishop of Achonry as secretaries to the Hierarchy. That is the source of my reference. The document has not been published.
Mr. Gilligan: The date is not on the document. It is easy to get the date if you take the date upon which the Taoiseach ran across the Border and then went down to see the Editor of the Irish Times, which was within six hours afterwards.
Captain Cowan: It has been stated by Deputy McGilligan that the document is undated. That indicates clearly, whatever he is quoting from, that that is certainly not the document issued by the Bishops which was referred to.
Mr. McGilligan: I would not give anything to the Deputy. If there is any feeling in the House that the date must be given, I will certainly give it, but I am not giving it in reply to casual observations in the House.
Mr. McGilligan: Will the Minister say that it is an untruth for me to state that a document signed by the Cardinal and two Bishops, as secretaries to the Hierarchy, was issued to four newspapers on or about 4th April this year? Is that an untruth?
Captain Cowan: I thoroughly agree. I hope I am not misinformed, but I understand that we were to have a considerable amount of obstruction in regard to this Bill up to a certain stage, that then there would be a demonstration in the House against it and that the Fine Gael Front Bench would then leave.
Mr. McGilligan: I was just waiting for a ruling of the Chair about disorderly language. I want to make a reference to this document. I have been asked whether the 1947 Act met with my approval. It did not meet with my approval at any time. Sections 21 to 28 were the ones to which we directed our Attorney-General's attention, and he ruled that two of them were distinctly unconstitutional and that regulations made under most of the others would certainly advance the matter to being a breach of the Constitution. We ordered these sections to be removed. These are the sections to which the Hierarchy mainly took exception. I understand at that stage that they spoke of the power of the  public health authorities to treat all the illnesses and defects of children and stated that they were neglecting the pre-existing rights of the parents and of the families, particularly the parents. They spoke of the power to deal with women in respect of the gynaecological and other kinds of treatment and stated that the Catholic view with regard to sex relations was opposed by people in many countries and that these people were making provision for birth control, abortion and so on. On these grounds they were desperately afraid in regard to Sections 21 to 28 of the Act of 1947. They spoke of the claim made to direct the child according to materialistic principles.
Having stated their view of Sections 21 to 28, they went on to say that there was no safeguard provided with regard to Catholic mothers, no respect for the rights of parents, no provision that children and mothers would have to be treated in accordance with Catholic principles. They welcomed the fact that these sections had disappeared. I welcomed the fact that they had disappeared as I always objected to them, at any rate on constitutional grounds. We had discovered when in office that the Archbishop of Dublin had written a letter objecting to these things, not on constitutional grounds, but on moral grounds. These two matters were before the Cabinet to which I belonged and we presevered in that objection all the time.
The position we were in with regard to health legislation was that there never was any health legislation in the offing. There was never any scheme. There was a certain amount of what the Hierarchy called vague promises of a general type, but no detailed information as to their implementation or any principles by which the implementation could be worked out.
Mr. McGilligan: I did not. I do not know anything about it. Money was provided under the health services for making grants to the health authorities, and it was all used. The fact  that it was all used makes it quite clear that there was no scheme. It could not be used under the 1947 Act because there were no regulations made under the 1947 Act in relation to mothers and children. There is the old red ticket business and all that. Money was provided for it. If the Minister wants to find out why certain moneys were provided he will find that recorded in a minute where the officials of the Department of Health came to discuss matters with the officials of the Department of Finance and put up the contention that whatever sum was carried into the Estimate could not be cut down, otherwise the doctors would be able to say that they had beaten the Minister for Health. I understood that the money would be spent for health services.
To come back to the amendment. Deputy Costello put very forcibly what I tried to put in my own limited way— that where there is power taken by Order to direct certain institutional services which the health authority must comply with, and that includes the provision of advice and treatment at an institution, it is possible under that for an Order to be given directing treatment of a type contrary to the principles which the Hierarchy have attempted to make clear to the faithful and which they have made clear to the Government. The Minister would be better advised to accept an enlargement of the first amendment and to provide not merely for patients but for the medicos who are going to comply with the directions. If I again have to meet the argument that people cannot accept, that people will do anything contrary to their conscience, then, if we accept that, we need not have either Section 4 or the first amendment brought in by the Minister because the same argument will apply. Patients in this religious community would not for one moment submit to any treatment contrary to the teachings of their religion. If that is an argument in regard to the doctor—and it is a sound argument—it is apparently not a good argument with regard to the patient. The same reasoning ought to lead the Minister to bring in  a safeguard with regard to the doctor who is going to be made enforce these regulations.
Dr. Browne: I marvel at the arrogant suggestion of Deputy McGilligan that he did not give authority and did not take part in authorising me, as Minister for Health, to undertake to carry out the details for the implementation of a mother-and-child scheme. Section 21 of the Health Act, 1947, provided:
“A health authority shall, in accordance with regulations made under Section 28 of this Act, make arrangements for safeguarding the health of women in respect of motherhood and for their education in that respect.”
“A health authority shall, in accordance with regulations made under Section 28 of this Act, do, in respect of children in their functional area who are not pupils of any school, the following things——”
The Act then goes on to detail, under the headings (a), (b), (c), (d) and (e), full treatment for children up to 16 years of age. All the documents in relation to the decision and the direction put by me and submitted by me, as Minister for Health, to the Cabinet were read by Deputy McGilligan presumably. In the light of those circumstances he was to make his decision. He finally did make his decision. The most important document of all—that which contained the direction to me to bring in a free no means test mother-and-child scheme up to the age of 16 years—and all the other documents are there. It is not a recollection of mine. The documents are extant and available and can be verified by this House or a Committee of this House if such a Committee wishes to go into the matter further.
As I say, I marvel at Deputy McGilligan's incredible brass-bound impudence in standing up to suggest that this very expensive and elaborate scheme, advertised fully and spoken about repeatedly by me as one of his colleagues, was considered without his  knowledge and that he was ignorant of these details and these facts.
Dr. Browne: Deputy McGilligan suggested that none of us are likely to carry out anything in conflict with the dictates of our conscience. From listening to Deputy McGilligan, it is quite obvious that he, as a member of the then Government, readily condoned the carrying out of something by one of his colleagues which was, as we hear to-night, in most flagrant conflict with the dictates of his conscience and his view of what was ethical, moral and socially acceptable and desirable.
Deputy McGilligan suggests that he was not aware of the scheme or of the details of the scheme. Deputy Costello, as Taoiseach, with Deputy Norton negotiated with the Irish Medical Association who were most vehemently aware of the details and objected to the details of the scheme. Deputy Costello, Deputy Norton, Deputy McGilligan and my former colleagues negotiated on the details of this scheme with the Irish Medical Association. Surely they did not negotiate in connection with a mirage or with the vague outline of a plan as suggested by Deputy McGilligan? Surely they had something to discuss and to argue with the Irish Medical Association—something which Deputies Costello and Norton were fully and clearly aware of? We all know that Deputy McGilligan must also have been clear about it. There can be no suggestion that Deputy McGilligan did not play a full and most important part in laying down the underlying principles on which the then mother and child scheme was founded based on Section 1 and 22 of the 1947 Health Act. As I said before, all the documents in that case are extant and are available. If a Committee of this House is set up to investigate the whole matter I shall be delighted.
Again, Deputy McGilligan suggested there was the vague outline of a plan for which he gave me—not very willingly, I admit—the sum of £600,000 but only a tiny part of this vast sum was given by the Minister for Finance  to his colleague, the Minister for Health, to carry out, to implement a scheme, the principles of which had been considered on documents submitted by me. Having been considered— in spite of all the conscientious objections which Deputy McGilligan now throws out so profusely and so readily —it was agreed to by Deputy McGilligan and I was directed to carry on with the scheme.
The £600,000 that appears in a footnote to the Estimates for that year is there because those were Deputy McGilligan's Estimates for the year in respect of which it was decided by the inter-Party Government that the books should be faked to the tune of approximately £4,000,000——
Dr. Browne: ——and that the sum could only be kept within limits by refusing to put forward the full sums required by each Department. I refused to connive at that conspiracy to defraud the public and I accepted the device of letting the public know —as far as I was concerned, at any rate—by means of a footnote that £600,000 would be required for a mother and child scheme. Conscientious objections. Morality. The moral law. Ethics. All these words without meaning—certainly words without any intention of practice, in my experience of the man sitting on those benches, a man who was so well described by the Minister in the two very fitting words which are, I understand, unparliamentary and which I cannot, therefore, repeat.
Mr. Morrissey: Deputy Cowan's view of me does not matter two traneens. It does not matter in the slightest. I will give the facts very briefly inside a few minutes while we are dealing with this Bill now.
Mr. Morrissey: Deputy Dr. Browne was subjected to one major limitation by his colleagues and that was that whatever health legislation he brought in would have to conform to the moral law. He refused to accept that.
Mr. Morrissey: The last occasion on which Deputy Dr. Browne discussed the matter with his colleagues in the Cabinet was after he had got what he had requested from the Church authorities. He got what he said in advance he would accept from them—and which he then refused to accept. His final words were: “Are you going to stand with me or with the Hierarchy?”
Mr. Morrissey: When the Deputy gets up and spits out that venom is he surprised at people's retort to him? When the Deputy levels every sort of unworthy motive at his colleagues, is he surprised at their reply?
Mr. Morrissey: I am giving the facts and I am telling what is known to myself personally—not what I am depending upon to be told by anybody else. Deputy Dr. Browne was given a request, an instruction, a direction— call it what you like—by his colleagues to take the necessary steps to revoke the sections in the 1947 Act to which objection had been taken on moral grounds, and he failed to carry out those instructions of his colleagues  during the whole period he was in office. That is the truth.
Mr. Morrissey: The Minister spoke to-day about obstruction. It seems to me that there is something almost approaching an organised piece of obstruction every time I get on my feet to speak. Why, I do not know.
Mr. Morrissey: The more the interruptions continue the more they grow in weight and in intelligence. Those are the facts. If Deputy Dr. Browne did not want to get all his own way in defiance of those who were competent to deal with the question of the moral law in relation to his proposals, in defiance of the entire medical profession in this country—his own professional colleagues—and in defiance of every one of his own colleagues in the Cabinet——
Mr. Morrissey: He was the only one who was right. Everybody else was wrong. However, the Deputy to-day has to swallow provisions in this legislation, which his successor was forced to introduce by way of amendment, that he refused point blank even to consider when he himself was Minister.
Mr. Morrissey: That is the picture. I do not mind the Deputy trying to get a Bill. I said on former occasions— and perhaps I have as much understanding of the needs and necessities as any ordinary lay man—that I should like to see a decent Health Bill. I would like to see a decent Health Bill.
Mr. Morrissey: May I say in reply to the Minister that I did change on one occasion and on a subject of major importance that was dealt with in this House? The Minister may remember how the wheel turned and similar legislation had to be introduced by the Government of which he was a member.
Mr. Morrissey: If Deputy Dr. Browne wants to give a completely distorted view of what happened at the period and a complete misrepresentation of the facts, we have the right to reply and we are not going to be intimidated either by the Minister's threat to put us out of the House or Deputy Dr. Browne's threat about what he is going to do to us.
Mr. McGilligan: Having got back into history, I want to be allowed to clarify certain points. Deputy Dr. Browne is trying to reinstate himself in public opinion by having it appear that he had a scheme, a scheme which had been approved. He has not to-day gone the length of saying what he said to his colleagues in March, 1951, that he believed the scheme had the goodwill of the Hierarchy. He has not said that to-night, but he did say it in March, 1951.
“Am I correct in thinking from the terms of your letter of March 15th, that you are under the impression that the Hierarchy are opposed to the mother and child health protection scheme? May I point out  that this impression, if held by you, is certainly not borne out by the following facts?”
Mr. McGilligan: This was 19th March, 1951, and that is what he said to his colleagues: “Am I correct in thinking that you are under the impression that the Hierarchy are opposed to the mother and child scheme?” He got a reply from Deputy Costello on 21st March in which the then Taoiseach said:—
“If in the letter delivered to the Government, the Hierarchy continued to speak of the dangers inherent in the proposals one cannot easily understand your opinion that you had completely satisfied the Archbishop of Dublin and the Bishops of Galway and Ferns concerning the removal of these dangers. On the contrary, the Government has received no assurance whatever from the Hierarchy as to its confidence in the scheme.”
“As I have already indicated, I am at a loss to understand how you could feel satisfied that you had at your interview on 11th October last with His Grace the Archbishop of Dublin and their Lordships of Galway and Ferns satisfactorily disposed of their objections.”
“That you are seriously in error in thinking that you had satisfied His Grace and their Lordships at your interview is amply borne out by the letter of 8th March to you from His Grace the Archbishop of Dublin when he specifically stated, in the passages quoted in my recent letter to you, that on the occasion of your interview he stated that he could not approve of the scheme.”
“I would be interested to know whether your withholding of approval to the mother and child scheme is due either to the supposed opposition of the Hierarchy to the scheme or to the possible opposition of any individual member of the Hierarchy.”
The Deputy presents the position to the House that the scheme was approved. How did he come to write to Deputy Costello on 19th March: “I would be interested to know whether your withholding of approval to the mother and child scheme...”
Mr. McGilligan: In your good time. On 19th March, 1951, the Deputy was under the impression that the mother and child scheme had not received the approval of the Cabinet. To-night he says it had. With regard to whether there was a scheme at all or not, I know from my own information what the situation was. Here is the way it affected outsiders, the Hierarchy. In a letter of 5th April, addressed from Archbishop's House to Deputy Costello, there appears:—
“It is to be noted that the proposed scheme fails to give clear evidence of the details of implementation. The scheme, as set forth in vague, general terms, has the appearance of conferring a benefit on the mothers and children of the whole nation.”
Mr. McGilligan: I took this record because I knew this would be bound  to arise. I took a copy from the Government files when I was in Government. It is a copy, and, if it is not right, will you contradict me?
Captain Cowan: I do not care what is bitter or not, but, as I understand the law, if any person takes a document belonging to the Government or to a Department, it is an offence against the Official Secrets Act. I object to any person quoting from a document which has been unlawfully obtained and which is in the possession of a Deputy by virtue of and because of an offence under the Official Secrets Act.
“The actual expenditure in 1951-52 will probably be less than the figure  of £661,000, but I do not think we could ask the Minister for Health to show less than last year as this might be construed as an admission of his difficulties.”
Mr. McGilligan: It means Finance. There are certain civil servants' names on that file which I do not propose to quote. What is the reason for that: “The actual expenditure is likely to be less, but we could not put it down less because the Minister would have his difficulties”? These difficulties were put to us quite clearly—“cut 1/- in last year's Estimates and the Irish Medical Association will chortle and whoop that they have beaten the Minister.”
Mr. McGilligan: I ask that this be placed on the records. I hope that File F.102/67/50, with the minute of 1/1/51, will be placed on the records, and I join in asking that it be put on the Table. If it will not be, I will put the copy on the Table.
Mr. McGilligan: I think a better record would be the official file. The  minute from that File which I wish to quote is dated 1/1/51. I suggest before it is put on the Table excisions would be made in regard to certain civil servants' names.
Mr. McGilligan: I am coming to it by the road which has been travelled by others. On File F. 72/5/49 is a minute—I am leaving out the name of the official from the Department of Health—which says: “As he was unable to say in what area the scheme would start, I regard the Estimate as largely a guess.” That is the way it was, too.
Mr. McGilligan: It was not. We will be able to see now the services for which that was making provision. Can anybody explain to me how on the 19th March, 1951, the Deputy here, then Minister for Health, could write to his Government Leader and say: “Why are you withholding approval for the mother and child service?” I understood it was not approved of. I want to go back a year or two. In 1948—and the records are again in the hands of the Department; if necessary I could produce copies—the Attorney General then serving us, when he was asked to rule upon Sections 21 to 28, ruled all those sections to be unconstitutional and that, as far as others were concerned, while it might be said there was nothing immediately making them a breach of the Constitution there was no doubt that regulations under them could reasonably——
Mr. McQuillan: On a point of order. I do not like to interrupt Deputy McGilligan but I wanted to get clear whether other Deputies will be entitled to travel that ground on the amendment. I understood there was an amendment to include a section before Section 9 and that it was the section alone we were discussing.
Mr. McGilligan: We will put the word “purloined” in inverted commas. Realising how such documents could be used slanderously against me and having had the foresight to provide myself with the documents with which I can reveal the truth, I bring these documents to the notice of all and I challenge contradiction on any single point I have made to-night. I do hope Deputy McQuillan's request will be granted and that this debate will be widened and widened considerably to enable us to traverse the ground Deputy Browne decided he would go and hoped that nobody else would be permitted to travel.
Mr. McGilligan: With all respect, Sir, you were not in the House and it is a complete misrepresentation as far as those who were in the House are concerned. Deputy Dr. Browne made a long statement about his woes. I am answering from documents——
Mr. McGilligan: It may have been a Via Dolorosa for some people who are not feeling very happy over the documents I have but it would be a sorry thing for me if I had not fortified myself with these documents. I am rather happy about the situation.
Mr. McGilligan: We got rid of the Minister for Health before irrevocable harm was done in the sense of our being tied to proposals which we accepted with the Heirarchy as being amoral. We condemned them and Deputy Morrissey has given correctly the situation that developed.
Mr. McGilligan: My record is a record of opposition to mostly bad proposals and we know how sound the views of those were who opposed health proposals that came before this House under the 1952 scheme, the matter we are discussing now, and how eventually what I have described as the scurry and scuffle across the Border took place in order  to save a Minister's reputation by having a few amendments brought in to try to regulate and transform this whole legislation. I was asked what legislation we had in view. On 7th April, 1951, a Cabinet decision was taken.
Mr. McGilligan: Cabinet decisions are hardly confidential to me. I was there and I am fortified in this regard by this document. It is, I am sure, a Via Dolorosa for other people, but it happens to be a good resolution passed by the then Government.
“I am to inform you that following consideration of a letter dated 5th April, 1951, to the Taoiseach from His Grace, the Archbishop of Dublin, Primate of Ireland, on behalf of the Catholic Hierarchy of Ireland, intimating that the particular scheme for a mother and child health service proposed by the Minister for Health is opposed to Catholic social teaching, the Government decided, at a meeting held on the 6th instant,
“(2) that, in the light of the Government's conviction that mothers and children should not be deprived of the best available health care by reason of insufficient means, a scheme or schemes for mother and child health service should, as soon as possible, be prepared and undertaken which would (a) provide the best modern facilities for those whose family wage or income does not permit them to obtain, of themselves, the health care that is necessary for mothers and children and (b) be in  conformity with Catholic social teaching, and
(3) that consideration should be given to the question whether any amendments of the Health Act, 1947, additional to those proposed in the Health Bill, 1950, are necessary or desirable and, if so, that proposals for such amendments should be submitted to the Government.”
I will stand over that type of legislation, legislation which, in particular, does not conflict with Part (b). I do not stand over legislation which is not in conformity with the teaching of the Church to which I belong. The last paragraph refers to the fact that in 1948 the Attorney-General who was then advising us, advised us that certain sections—nearly all of Part (3)— in the Health Act, 1947, were either unconstitutional in themselves or permitted regulations to be made which would be unconstitutional.
Mr. McGilligan: I was trying to deal with it when I was interrupted. We  were advised in 1948 that certain sections in Part III of the Bill were in themselves unconstitutional and that others were likely to lead to a breach of the Constitution. We ordered our then Minister for Health to remove these sections but that legislation was never brought in. These orders were given as we thought these sections were unconstitutional. We had also the other view with regard to morality and that was when this other matter developed. The person responsible now represents himself as having prepared this legislation and says that we withheld approval from this legislation. Was it not because the Hierarchy was against these proposals? The Deputy was apparently of the view, in his obsession, that he had got round the Hierarchy's objection. I really do believe that to the end he believed that was the situation. Quite recently these matters have been referred to again. In this latest letter of April this year, the Hierarchy again returned to their main principles. They spoke of their own objection to the original Act of 1947.
General Mulcahy: On a point of order. I would refer you, Sir, to Volume 63, column 793 of the Official Debates where, when a Deputy was quoting from an extract from a letter received from the Commission of Inquiry into Banking, Currency and  Credit, the Chair said that he was not aware of any ruling to read the whole of any such letter if the House or any member asked for it. There is a precedent there to which, as a point of order, I would direct your attention. I would further direct attention to Volume 48, column 1303, where a decision was given and made a precedent of the House. The statement was then made by the Chair that when a Deputy makes a statement, the House has to accept the bona fides of the Deputy in making that statement so long as it was relevant to the matter under discussion and so long as there was no personal charge on any Deputy's honour involved. As against that, with regard to documents that are not official documents, I would refer you to Volume 48, columns 1787-1788, where it is clearly declared that official documents should be quoted in full since an extract might tend to give a wrong interpretation. I submit these three rulings declare the position in connection with ordinary documents, as against official documents, and make it perfectly clear that even though the House or a member may ask for it a Deputy is not required to read the whole of a letter even if he wants to refer to the actual details.
An Leas-Cheann Comhairle: It has been the accepted practice of the House for years that if a document is quoted and a demand made that that document should be placed on the Table of the House that the document should be so placed. If the Deputy refuses to lay the document on the Table of the House then he must cease quoting from that document.
Mr. McGilligan: I had almost concluded my remarks with regard to the statements that the Hierarchy had made in the letter they had addressed to the faithful, dated the 4th April of this year. I was not quoting from that document. I am referring to it but I deliberately refrained from quoting it.
Mr. McGilligan: I shall relate them to the amendment. I am referring to the amendment which proposes to introduce a new section that the Minister may, by Order, insist that institutional services of a specified  class shall be given in a health institution and that institutional services shall be given in the institution to a specified class of persons. These institutional services are defined to include diagnosis, advice and treatment in the institution. There are two matters to which I wish to refer—that the Minister, by Order, may direct a health authority to give certain treatment in a particular institution and that, if he does so, the health authority maintaining that institution must comply with that direction. I was pointing out that we had already amended that legislation in respect to the teachings of religion and that a patient who elevated this point should not be made to undergo treatment or to submit himself to a health examination contrary to the teaching of his religion. I am asking that a further safeguard be inserted in this clause by having that same exclusion made in respect to the doctor who may be ordered to give certain advice and treatment. In that connection, I was referring to the immoral parts of the Health Act of 1947. The immoral parts occurred in Part II, Sections 22 to 28. These, I suggest, had been condemned early on by the Hierarchy and I read their letters in that connection. Then I went on to say that these particular parts had been made the subject of comment by the Hierarchy in the letter of April 14th, 1953——
Mr. McGilligan: I am not indulging in repetition. I am emphasising, putting a different emphasis on the  matters to which objection had been taken. These particular Section 21 to 28 had been objected to by the Hierarchy on moral and religious grounds as these sections claimed dangerous powers for the public health authority. The sections claimed the power, we were warned, to treat all the illnesses and the defects of children without any recognition of the existent rights of the parents. The Hierarchy spoke of Catholic doctrine in regard to sex which is nowadays violently opposed——
Mr. McGilligan: They did say that health education often involved the claim to direct the child according to certain materialistic principles. They said that there was no safeguard in the Act that people would have the right to be treated or educated according to the lines of Catholic social doctrine. I am applying these phrases to institutional treatment. Where is the safeguard for the doctor? Is there any anywhere?
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