Wednesday, 24 February 1971
Dáil Eireann Debate
The Bill started its journey through the Houses of the Oireachtas in the Seanad and I must say, in this regard, that the decision to introduce the Bill in the Seanad was a most fortunate one. It was given a very detailed scrutiny on all Stages and due particularly  to the hard work of certain legally expert Senators, notably Senator FitzGerald, an improved Bill has emerged. I think the instrument now before you is a happy blend giving reasonable safeguards for everyone including the citizens of this country, and easing the incorporation for international organisations seeking this facility in Ireland which is so essential if we are to attract them here.
The need for the Bill arose because the International Federation of Voluntary Health Service Funds was anxious to be incorporated in Ireland but found our existing legislation unsuitable. This body, which had its origins at the first international conference on voluntary health insurance held in Dublin in September, 1966, has as its aim the development and study of voluntary non-profit making health insurance services throughout the world. It is not itself a commercial organisation but rather a deliberative, study and research organisation in the field of voluntary health insurance. Its membership at present consists of 90 organisations which provide health insurance services, broadly speaking, similar to those which are being provided by the Voluntary Health Insurance Board which is the Irish organisation in membership. The then general manager of the Voluntary Health Insurance Board was appointed the first secretary general and treasurer of the federation.
An examination of existing legislation confirmed that such legislation was not, in fact, appropriate to the type of body such as the International Federation of Voluntary Health Service Funds is. I felt it desirable that a body of this kind should be encouraged to set up its headquarters in this country and, indeed, I feel that this might be the first of many international health organisations who might be attracted to come here. The House will readily appreciate the significance to the country and the economy, in prestige and economic terms, if we were to become a recognised centre of international activity in the health field. We have much to offer in location and facilities and the benefit to our tourist industry would not be inconsiderable. For these reasons, therefore, I agreed  to sponsor the Bill now before the House and, as you will note, it applies to international health bodies generally and not solely to the federation.
In sponsoring the Bill I have borne in mind the type of body that we wish to encourage to set up here. These will be organisations of an international character whose aims and functions will relate wholly or mainly to deliberation about the health of persons, health insurance, the care and treatment of the sick or infirm, the administration of health services or medical, including dental, research. These will all be organisations who will not engage in commercial or trading activities in this country. I will have to be satisfied that their standing and reputation is above reproach before I would consider making a corporate status order. Moreover, I have built into the Bill an additional safeguard under which a corporate status order cannot be made until the draft order has been laid before each House of the Oireachtas and until a resolution approving the draft has been passed by each House. If there were anything questionable about such a body, or about the way it might conduct its affairs, both Houses of the Oireachtas would, in effect, have the power of veto over its incorporation.
A corporate status order, which can only be made after consultation with the Minister for Industry and Commerce, will confer on the body the right to be called and known by the title specified in the order, the power to sue and be sued in its corporate name, and the right to hold land. It will be required to maintain an office in the State to which communications may be addressed and at which documents may be served, to supply the Minister for Health with any information, including copies of annual or other duly audited accounts and a copy of its constitution together with where necessary a translation, as he may reasonably require. The Minister, on the other hand, must maintain a register of bodies to which corporate status orders relate and make this register available for public inspection. The Minister must also submit an annual report to both Houses of  the Oireachtas on the exercise of his functions.
In the course of the debate in the Seanad I accepted a number of amendments and refused to accept others. Perhaps this is the appropriate time to comment on one proposed amendment which I did not accept and which I promised to look at again. The proposed amendment provided that the corporate status order made by the Minister in relation to a body would be conclusive evidence that all the requirements of the Act and all matters precedent and incidental thereto had been complied with and that the body was a body corporate duly incorporated under this enactment. I have considered the proposed amendment again, as I promised I would, and I am advised that the amendment is unnecessary. What the Senator concerned—Senator FitzGerald —aims at achieving has been done already by section 4 of the Documentary Evidence Act, 1925 and section 17 of the Minister and Secretaries Act, 1924. These two provisions oblige courts to accept certain copies of orders of the Minister as prima facie evidence of the order which was made until evidence is given to the contrary.
Mr. O'Higgins: It is a happy and a pleasing thing that the Minister in introducing this Bill in this House should have referred to its initiation and passage through the Seanad and in doing so should have paid a well-deserved tribute to the work done on the Bill by many of the Senators there, and in particular by Senator FitzGerald. Undoubtedly Senator FitzGerald in dealing with the Bill in the Seanad did bring to it a great deal of expert legal knowledge which the Minister has frankly acknowledged and has benefited from, so that the Bill has undoubtedly been improved as it emerged from the Seanad.
I am pleased to see that the idea of this Bill springs from the first international  conference on voluntary health insurance which was held here in September, 1966. It is a good thing that from that conference the idea which led to this Bill being introduced has come. While the Bill is intended to meet the organisation mentioned here which is going to set up its headquarters in this country, very correctly the Minister has made the Bill to be of such a nature that it can be used and can be suitable for other similar organisations should they wish to set up a headquarters here.
I notice in the Seanad debate that questions were raised as to the need in law for a Bill of this kind. My own assessment of that debate would rather indicate that the matter is still an open question. Nevertheless, I would feel, on balance, that it is more desirable to have this kind of legislation which can be easily used and which can provide in a very quick way for the setting up of a suitable body corporate here. I join with the Minister in hoping that the example being set here may be followed by other countries, and that we may get the name and the prestige of being a country where suitable legal machinery is available for international organisations dealing with health. So far as we are concerned, this Bill is agreeable and we accept it.
Dr. Browne: Anyone who has read the Seanad debate on this Bill must concur with what has been said here by the Minister and Deputy O'Higgins, that Senator FitzGerald and Senator Robinson made very useful contributions to the Bill and obviously to its improvement by the amendments they suggested and which the Minister accepted. This is a very technical Bill in some respect and I certainly do not feel in any way competent to criticise it at the level at which they dealt with it.
I wonder why the Bill was brought into the House. Why was it given priority over what I would have felt were more urgent matters relevant to our own community here? Has the Minister for Health no other legislation that could have been introduced, such as an amendment of the Mental Treatment Acts? Surely other Departments of State could have used the time of  the two Houses to provide additional and better services in relation to their Departments than are likely to follow on the passage of this Bill through the House.
The Minister could have spared us the suggestion that this will alter or improve in any significant way the tourist industry or our economy. This kind of silly euphoria about matters of this kind, and such arguments in promoting a provision of this kind, bear no relation to the facts, quite obviously. This Bill will make little or no difference in that regard.
The wording “deliberation of the health of persons” seems to be very clumsy phraseology. “Deliberation” means the careful consideration or discussion of reasons for and against something. In his opening statement the Minister used the phrase “development and study of voluntary non-profit making health insurance services throughout the world” which seem to be a very much clearer set of objectives.
If it is accepted that the function of this body is to concern itself with consideration and discussion and research of bodies of this kind, why is it necessary to include the word “mainly” in the section? Why not just say “whose constitution consists wholly of the deliberation of the health of persons” or “the development and study of voluntary non-profit making health insurance services throughout the world”? I am worried about this and I hope the Minister will be able to reassure me. This whole activity of the health or the care of sick people and the expansion of health services is an extremely controversial subject.
One aspect which might possibly be concerned here is the possibility of people using Ireland as an accommodation address for a purpose such as fund raising of one kind or another of a reputable or possibly a disreputable nature. To what extent could this happen under these powers? I presume that when the Minister sees the constitution of these various bodies which compose the federation—and the aims and objections will no doubt be included in the constitution—will it be possible also to see the balance sheet relating to past activities? Will all of this information be available to  the public in English? I see that the Minister says that where needed translations can be made available.
Will all this be made available to any member of the public who wants to inquire into the proposed activities and past activities of any group or body who may choose to use this facility which we are now providing? Is there to be a central secretariat here? If there is, has the Minister any idea of its proposed size?
If there is to be a secretariat what is the position in relation to employees of that body? Will non-nationals, for instance, be facilitated in getting permission for employment here? Will they have any special rights as a result of the passage of this Bill which will allow an international federation to employ anybody it wishes? Is there any kind of provision whereby a certain number of Irish nationals will be employed in either the central body or any of the 90 or so organisations which may decide to set up here? I do not know whether my fears are justified but the Minister will recall that there has been a good deal of exploitation of illness for illicit fund-raising purposes both here and elsewhere. Are we protected sufficiently well from any such possibility in this Bill?
It is strange that this body should decide to set up in Dublin when it has generally been accepted that Geneva was the city in which most of these bodies have been chosen to establish themselves. Even from the Minister's speech and from reading the speeches in the Seanad I am still at a loss to know what the ultimate purpose of this body is likely to be and in what way it can be of any great value to those concerned in the methods used in different communities for funding health services of one kind or another. Does this body have a central organisation? Does it have an executive and does it have formal discussions in the organisation established in Dublin? Is that what is likely to happen? Is it something like the World Health Organisation? Does it restrict itself exclusively to the various forms of voluntary health insurance schemes or has it a wider function?
When the Minister says that we have  the right to veto any order he makes I presume he will allow us to see an annual report in regard to its function. What would our position be if we wanted access to the balance sheets of these various organisations as well as a general report from the Minister as to what he might consider to be the various activities of this body? Apart from these few points as far as I am concerned, the sooner the Bill is passed the better so that we can get on with some worthwhile work in the House.
Mr. L'Estrange: This Bill was first introduced in the Seanad in 1970 and objections and exceptions were taken to certain sections of it. Many Senators wondered why the provisions of the Companies Act were not suitable or adequate to deal with this particular type of organisation. Company law was updated a few years ago and the late Deputy Sweetman, who was an expert on company law, had a big hand in the 1963 Act. Many Senators were, however, of the opinion that as our company law had been updated it could cover this type of body, but it was found inappropriate. The Minister in his introductory remarks today mentioned the fact that the decision to introduce the Bill in the Seanad was a most fortunate one and I entirely agree with him. It shows the excellent type of work that can be done in the Seanad and I hope the Government in future will introduce many more such Bills there because some Senators are expert in this particular type of work and certainly as far as this Bill is concerned they did a very good job on it.
 I entirely agree with that. The Minister should be congratulated and complimented for his helpful and co-operative approach towards the many amendments that were proposed in the Seanad. I believe in giving credit where credit is due and so far as the present Minister for Health is concerned he listens to what people have to say and he endeavours to meet their wishes. After all, that is what Ministers are for. The present Minister for Health is one of the few Ministers who tries to meet people half-way and he certainly did so as far as this Bill was concerned. It is a pity that some of his colleagues would not follow in his footsteps.
As far as the Fine Gael Party are concerned we welcome the Bill without reservation. We should encourage in every way possible the setting up of international bodies here. We should do our utmost to expedite the setting up of the headquarters of this international organisation. The establishment of such an organisation will be of enormous benefit to the country as a whole and of great benefit to the Irish medical profession. I hope that other bodies will follow in their footsteps. I am inclined to disagree with Deputy Dr. Browne who did not think such a body would attract tourists. I think such a body can help to bring prestige to a small country like ours and help to focus the proper type of attention on our country.
This Bill was introduced into the Seanad on 24th May and was finally passed in June. What was the reason for the delay in introducing it into this House? I should have thought the Government would have tried to deal with it during the Autumn Session but perhaps they may not be setting up here for another few months. At the present time the Food and Agriculture Organisation has its headquarters in Rome, the World Health Organisation has its headquarters in Geneva, the International Atomic Energy Authority has its headquarters in Vienna, the Council of Europe has its headquarters in Strasbourg and the new International Organisation for Cancer Research has its headquarters in Lyons. Many distinguished Irish men and women are working at all levels in those institutions.  The benefits of an international organisation like the International Health Bodies cannot be overemphasised. It will help to put this country on the international map. It will provide much-needed employment and Deputies on all sides of the House are interested in giving employment to people at home. Any type of international conference brings a constant stream of visitors to the country in which it is being held. No doubt the same would happen in this case. We would expect to have a constant stream of visitors attending conferences and the scientific aspects of those organisations, and we would expect a great stimulus to local development in the various areas that those organisations would cover.
If this Bill goes through and if these bodies are acting as agents for local authorities, local authority employees will in effect be working for some authority other than that which first employed them. If given the chance such an employee might not like to work for that particular authority. It is only a technical point but I was asked to raise it by an employee. I suppose he could opt out. We welcome this Bill and we are prepared to give the Minister all Stages now.
Mr. Childers: I thank Deputies for their kind reception of this Bill. The matter of employment of staff by any international body would be a matter entirely for themselves but they would have to observe the laws regarding the employment of non-nationals—that, of course, does not include British citizens with whom we have reciprocal rights —so that the likelihood of anybody employing an undesirable number of non-nationals when nationals could perform the task is very remote.
Deputy Dr. Browne asked why we used the word “deliberation”. We decided to use that word because it seemed to be the best word to describe an organisation which, above all, was not going to be a trading body. If it were a trading body, then, obviously, it would have to observe the whole of the Company's Act legislation. It was because this Bill applies only to international deliberative organisations who come together to consider the latest medical techniques, to discuss every  possible subject related to health but who do not trade themselves that we use the word “deliberation”. The Deputy need not worry about international bodies who are going to raise funds for some wrong purpose coming here. It would be quite possible for me when submitting an incorporation order to the House to be assured of that. I do not think that the kind of bodies which are likely to apply here would be ones for which I would have to provide the balance sheet to be scrutinised by Members of the Dáil.
The immediate body, the International Federation of Voluntary Health Service Funds has as its general secretary the now retired manager of the Voluntary Health Insurance Board here. He is a person of such integrity that I would never dream of questioning him or the activities of his body when he comes before us and, as I hope, presents the constitution in full of the International Federation of Voluntary Health Service Funds. I do not think the House will have any difficulty agreeing to the incorporation of that body in this country knowing the reputation of the ex-manager of the Voluntary Health Board and the splendid work he did when he held that office. The board is one of the most successful boards of voluntary health insurance that could be conceived and they have made tremendous progress. He and his staff were responsible for that and we can be happy that the first body is one of whom he is the secretary.
The expression “wholly or mainly” is put in for a purely legalistic purpose. While these bodies who wish to be incorporated are deliberative they will employ staff and, therefore, are not totally deliberative. They must employ staff and they must rent premises: therefore, we use “wholly or mainly”. It could be possible that a body whose deliberations were 90 per cent concerned with health could on occasion examine some other aspect of sociological work of one kind or another and it would be a pity to be unable to incorporate them if they so desired if their objectives went slightly beyond what strictly could be regarded as a health matter but also included matters  relating to studies of sociological aspects of services in various countries.
If one were to ask what we shall gain in health knowledge from this international federation the answer is that one of their objectives is to try to get reciprocity between various countries by the nationals of those countries if they leave one country and go to another, that they should be able to carry the insurance they have accumulated and have it applied in the other country. Then of course this body engages in the complex studies of the whole principles of insurance, of actuarial values, makes comparisons of sickness rates and so forth and much useful work can be done by making these comparisons and examining changes which have taken place in the scope of the various voluntary health insurance schemes in different countries. That is the kind of deliberative work in which this body engages. I do not think we need worry about the body forming an accommodation address for some nefarious purpose because the provisions of section 6 would quickly uncover any such address.
This body is not a large one and would employ a comparatively small staff. We look forward, if we can, to seeing other international organisations here. As the House knows, we have a very considerable number of international medical conferences every year and we hope that some of them may establish their headquarters here. There is already a very considerable tourism income from the many international associations who have their annual conferences here. We have two or three, if not more, coming in the next financial year for whom receptions have been arranged.
I would be very glad if the House could give me all Stages now because in the Seanad no less than ten changes were made all designed to ensure that bodies that came here would be properly supervised and to protect the public against any body that might come here for a nefarious purpose or to protect the public in case the body became bankrupt. I have asked my officers and they cannot recall the disappearance through bankruptcy or the  failure of any major international health organisation. There is an enormous number of these international colleges of cardiologists, and there is an international association for almost every discipline in the world, and we cannot recall a scandal connected with any one. Bearing that in mind, with the safeguards in the Bill, the House can be satisfied that they will have sufficient control over the arrangements made for the incorporation, or, as we hope will never happen, the revocation of corporate status orders.
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