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Dáil

IN COMMITTEE ON FINANCE. - MEDICAL PRACTITIONERS BILL, 1927—THIRD STAGE (RESUMED).

Bill Medical Practitioners Bill 1927
Enacted

No. 17 of 1927 ›

Kevin Christopher O'Higgins MINISTER for JUSTICE (Mr. O'Higgins) Cumann na nGaedheal

I move:—

In sub-section (3), page 4, line 24, to delete the word "nine" and substitute the word "eleven," and in line 26 to delete the word "one" and substitute the word "two," in line 30 to delete the word "and," and in line 31 to delete the words "(c) one shall be nominated jointly by."

The effect of the amendment is to alter the number of members of the Council from nine to eleven to provide what was not provided in the Bill as introduced, namely, a separate representation for the College of Physicians and College of Surgeons, and, in order to secure the appropriate balance in the Council, keeping to odd numbers, to take an additional representative for the Executive Council.

Comment on this

The amendment means that the two Colleges, the Royal College of Surgeons (Ireland) and the Royal College of Physicians (Ireland), have each a representative. That was not made quite clear last evening, but it is now quite clear what the amendment means.

Comment on this

I move:—

In sub-section (2), page 5, line 15, to delete the word "sub-section" and substitute the word "Act," and to delete all from the word "the" in line 16 to the end of the sub-section and substitute the words "a registered medical practitioner resident in Saorstát Eireann shall be elected to fill such vacancy by the persons who are for the time being registered medical practitioners resident in Saorstát Eireann."

This is an amendment by the Minister for Industry and Commerce accepting the principle of Deputy Doctor Hennessy's amendment. It provides, in effect, for a bye-election in the event of a casual vacancy, created by the death or resignation of one of the representatives of the medical practitioners.

Comment on this

The point was that, in the case of a vacancy, it was provided in the Bill that the Council should co-opt a member, but it was pointed out that, if two casual vacancies occurred and if two members were co-opted, the medical practitioners would be deprived of representation for three or four years. This amendment seeks to amend that so that an election would take place instead of co-option.

Comment on this

The Minister's amendment meets the principle involved in the amendment which stands in my name. I therefore will not move my amendment.

Comment on this

I move:—

In sub-section (1), page 5, line 40, to delete the words "or join in nominating," and in line 42 to delete the words "or join in nominating (as the case may require)."

This amendment provides for the deletion of the words "or join in nominating." There are a good many amendments of that kind, and they are entirely consequential on the decision to give separate representation to the College of Surgeons and the College of Physicians. These are necessary consequential amendments arising out of the change made in that respect.

Comment on this

I move:—

In sub-section (2), page 5, lines 51 and 52, to delete the words "a member" and substitute the words "two members."

This is a consequential amendment.

Comment on this

I move:—

In sub-section (3), page 5, line 53, to delete the words "a member" and substitute the words "two members."

This is also consequential.

Comment on this

I move:—

In sub-section (4), page 5, lines 60 and 61, to delete the words "or join in nominating" and on page 6, lines 1 and 2, to delete the words "or join in nominating (as the case may be)."

This amendment is also consequential.

Comment on this

I move:—

In sub-section (1), page 6, lines 21 and 22, to delete the words "or join in nominating," and in lines 24 and 25 to delete the words "or join in nominating (as the case may require)."

This is a consequential amendment.

Comment on this

I move:—

In sub-section (2), page 6, lines 27 and 28, to delete the words "or joining in the nomination of," and in line 32 to delete the words "or jointly nominated," and in lines 35 and 36 to delete the words "or all the bodies or authorities."

This amendment is also consequential.

Comment on this

I move:—

Before Section 12 to insert a new section as follows:—

(1) As soon as may be after the occurrence of a casual vacancy in the membership of the Council by reason of the death, resignation, or disqualification of a direct representative or of a person elected under this Act to fill the place of a direct representative the Council shall appoint the President of the Council if he is willing to act or if he is not so willing some other member of the Council willing to act to be the returning officer for the election of a person to fill such vacancy.

(2) Every returning officer appointed under this section shall immediately upon his appointment hold an election in accordance with this Act to fill the vacancy which occasioned his appointment and every such election shall be conducted in accordance with the Rules set forth in the Third Schedule to this Act and such other Rules (if any) not inconsistent therewith as the Minister shall think proper to make.

(3) Every returning officer appointed under this section shall immediately upon the completion of the election for which he was appointed communicate in writing to the Council the name of the person thereat and such other information in relation to such election as may be prescribed by regulations made by the Council.

(4) Every returning officer appointed under this section shall be entitled to the assistance of the officers and servants of the Council in the holding of the election for which he was appointed.

This amendment provides the administrative machinery for carrying out the by-election, about which I spoke a while ago, in connection with a vacancy caused through the death or resignation of one of the medical representatives on the Council.

Comment on this

I move:—

In sub-section (2), page 7, line 33, to delete the words "as the Council shall direct" and substitute therefor the words "as shall be determined by the Council with the approval of the Minister and the consent of the Minister for Finance."

Comment on this

I move:—

On page 8, line 25, after the word "representatives" to insert the words "or of persons to fill casual vacancies."

This is consequential. It is necessary, in addition to the two direct representatives, to mention the persons who are also to fill casual vacancies. This arises out of an amendment which we accepted on that matter.

Comment on this

I move:—

In line 19, page 11, to delete the word "general."

This is a small amendment. The word "general" was inserted twice by mistake.

Comment on this

It is necessary to correct a mistake in the Bill.

Comment on this

I desire to draw attention to the fact that sub-section (4) of Section 28 makes provision for an appeal to the High Court and also for the evidence of persons of standing in the medical profession. I suggest to the Minister that, on the Report Stage, he might consider the propriety of making provision so that the High Court might be assisted by a medical assessor.

Comment on this

The question of providing for a medical assessor was considered and rejected after consideration. A medical assessor on a matter of that kind would, of course, give the court assistance from the point of view of a distinguished member of the profession, a member of standing and repute, but, in point of fact, where matters of professional conduct, or misconduct, are concerned it is not so much the point of view of an individual that one must aim at as the public opinion of the profession, so to speak. One could imagine individuals of quite high standing taking different views on the same issue. I do not think that we could do better than leave it to the appellant on one hand and the Council on the other to marshal as many eminent members of the profession as each can to give the court the assistance of their views. I know that the Minister has discussed and considered the question of assisting the court with something in the nature of an assessor chosen from within the profession, and that he decided not to embody a provision of that kind in the Bill. It is however, open to the Deputy to discuss it further with the Minister on Report.

Comment on this

I move:—

In sub-section (1), page 12, line 25, to delete the word "person" where it first occurs in that line and substitute therefor the words "members or member of the Council" and in lines 28 and 33, in sub-section (1) and line 36 in sub-section (2), to delete the word "person" and substitute therefor in each case the words "member or members."

The point of this amendment is that this body has a very definite set of duties to perform and we feel that if there is to be any question of delegation of its task, or any part of its task, it should be to a special Committee of itself—that it ought not to be open to the Free State Medical Council to assign to some person outside that body the task of investigating charges in a particular case. It might be convenient for the Council to appoint two or three of its members to investigate and report, but the Council ought not, we feel, to go outside its own ranks and delegate to some person, not a member of the Council, any part of its task of investigation.

Comment on this

I am glad this amendment was tabled. It was represented to the Minister the great objection there would be to the process which has been referred to.

Comment on this

Is the Minister satisfied as to the powers of the Council or the persons appointed by this section?

Comment on this

Has the Deputy any criticism to offer or does he suggest that the powers are inadequate?

Comment on this

It is a question as to whether there is not undue power given. I am not quite satisfied as to the wisdom of giving the members of the Council, or the persons appointed, power to administer an oath. I do not know whether the Minister has considered the matter fully.

Comment on this

The General Medical Council has no such power. That was put before the Minister, but he thought it advisable this provision should be inserted in the Bill. Whether it is a good provision or not, I am not in a position to say.

Comment on this

I do not see any objection to the provision. The Local Government Department frequently hold inquiries on oath. Its inspectors, I think, are empowered to hold such inquiries. We do not think it is unwise, where a man's reputation and whole professional career are in the balance, to give to the body that must try that issue the power to take evidence on oath. It is a very serious matter for any practitioner to be struck off the register. His whole life and career are in the balance. The tribunal that must decide that issue ought to have power to put its witnesses on oath. If there is a very serious view to the contrary, we are prepared to consider it, but that is our own view of the matter.

Comment on this

There are different opinions held about the question. The point that occurs to me is that if evidence is to be taken on oath it makes necessary the presence of some legally-qualified person to see that the evidence is taken in a legal manner. Otherwise, it is quite conceivable that difficulties would arise, particularly if there were a subsequent appeal. If the Minister would inquire into the position, I would be prepared to bring the question up on Report.

Comment on this

I have very little doubt that a practitioner fighting for his professional existence will be legally represented before this body. There is nothing in the Bill which would restrict the Council, if they felt that they had need of legal assistance, from engaging some person. I should think that most of the persons appearing before this Council in the position of defendants will probably take the precaution of being represented by a legally qualified person.

Comment on this

I was looking at the matter more from the point of view of the Council.

Comment on this

Would the Minister consider the advisability of empowering the Council, as one of its ordinary functions in an investigation of this kind, to have a legal assessor? I quite agree with him that if there is a question of the professional reputation and future of a man at stake, the evidence tendered against him or for him ought to be on oath, and that witnesses should not be permitted to withhold their evidence under anything less than the penalty prescribed in the Bill. There is always in these cases the technical difficulty of the law of evidence. As the Minister knows, there is nothing more difficult for a court to determine than what exactly is evidence. There is, for instance, the question of hearsay. This section would be, to my mind, highly satisfactory, provided it were clearly stated that the practitioner before the Council should be entitled to be represented by counsel and that the Council should also be empowered to have its legal assessor on such a trial.

Comment on this

At the General Medical Council the defendant has always his own counsel.

Comment on this

I will discuss that with the Minister for Industry and Commerce. It is a question, simply, whether or not the Council would require express powers for this purpose so long as there is nothing prohibitory in the Bill. I should have thought that under the Bill as it stands it would be open to the Council, in any particularly difficult case where they thought there was need for it, to have the assistance of someone who would keep them right on matters arising out of the law of evidence. Clearly, that is a point to be considered—whether there is need for an express provision in the Bill empowering the Council to have such assistance. I will have the point looked into.

Comment on this

There is one point I might draw attention to. The Council "may hold, or appoint any person to hold, an inquiry——"

Comment on this

That has been altered by amendment.

Comment on this

So long as those words were there, they put the Medical Council in a position to employ a legal judge of these affairs. But then the point is still left in doubt as to whether the practitioner is entitled to have the benefit of counsel to represent him, it seems to me, from the reading of the Bill, that the Council would have such complete power that it could refuse this privilege. So long as there is opportunity for the Council to refuse to permit a man, who is practically on his trial before what is practically a court, to have legal assistance, it would scarcely be ideal justice.

Comment on this

These are certainly points of substance which might properly be raised on Report. I take it that the discussion raises two questions —(a) is there need for specific provision to ensure that a person in the position of a defendant may be legally represented before the Council and (b) is there need for specific provision to ensure that the Council may, if they consider it necessary, have the assistance of a legal assessor in matters of evidence, and so on. I will mention those two matters to the Minister in charge of the Bill.

Comment on this

I think this matter should be taken along with sub-section (2) of Section 3, which specifically states that the Council may sue and be sued. It is in connection with that that difficulty may arise.

Comment on this

I move:—

In sub-section (6), page 16, line 34, to delete the word "solely," and in lines 37 and 38 to delete the words "or join in nominating," and to delete all from the word "and" in line 38 to the end of the sub-section.

This amendment is consequential and arises out of our alterations in the composition of the Council.,

Comment on this

I move:—

In the title, page 20, line 23, after the word "representatives" to add the words "and of persons to fill casual vacancies."

Comment on this

I move:—

In Rule 2, page 20, line 28, to delete the words "the election" and substitute the words "an election of direct representatives," and in line 29, after the word "more" to add the words "and every person entitled to vote at an election to fill a casual vacancy shall be entitled to vote for one candidate only."

Comment on this

Rule 2, as it is proposed to amend it, seems to read as follows:—

"Every person entitled to vote at an election of direct representatives shall be entitled to vote for two candidates and no more, and every person entitled to vote at an election to fill a casual vacancy shall be entitled to vote for one candidate only."

There is a possibility that two vacancies might occur at the same time, in the event of two representatives resigning, and there is no provision to meet that.

Comment on this

There would be two separate elections.

Comment on this

I think there ought to be a change made in the direction Deputy Hennessy has pointed out. There might be two casual vacancies, though it would happen but rarely.

Comment on this

The difficulty would be met by treating them as two separate elections.

Comment on this

In point of fact, if we decide to make this change, other changes will have to be made. There is no provision, so far as I know, in the Bill for the contingency of the two direct representatives of the profession vacating office at the same time. I suggest that the practical remedy for that position is that suggested by Deputy Thrift—that there be in fact two elections.

Even suppose you had the very unlikely contingency of those two seats on the Council falling vacant simultaneously, it seems to me there is no special difficulty about the election to fill one seat, being held on one day and an election to fill the second seat on another day. But it just so happens that in a great many sections in which the matter arises there would need to be small drafting changes, if you think it is necessary to provide for that contingency of simultaneous vacancies of the two seats directly representative of the profession.

Comment on this

There is a possibility of two resignations occurring at the same time. Something might arise in the Council that the direct representatives of the profession might not be satisfied about, and the two of them might send in their resignations simultaneously.

Comment on this

Does the Deputy see a great difficulty in dealing with the situation by means of two elections?

Comment on this

I think it would be desirable—even it would save expense —to have the two elected on the one voting paper.

Comment on this

It does not get you a true election.

Comment on this

I suggest to the Minister that unless a definite provision is made the tendency would be to follow the practice laid down in the Electoral Act. We know that when there were two simultaneous vacancies in North Dublin and North Leitrim there were, as a matter of fact, two separate elections.

Comment on this

We are talking about things that are scarcely analogous. In so far as this election would be analogous to any elections of the Dáil, it would be to a University. But there is a point of substance in it. It is a question whether a joint election is a true election, for this reason: Let us suppose that there are two vacancies, and eight or ten candidates, and you vote on the same paper for two persons. That is one position. The other position is that you proceed to fill one of the vacancies and then, with due advertence to the result of that election and who was the person who got in and who were the persons who did not, you proceed to have your second. A man might vote differently, according to the way the election was taken. You might get a different result. I am not sure whether, if you are out for a deadly accurate reflection of the wishes of the resident practitioners, it would not be better to have separate elections, because a man might vote on the second election with advertence to the first, and so on.

Comment on this

Why not put that in for the election that will take place for five years? If it is good for one thing it is good for the other. I am quite willing to accept what the Minister suggests.

Comment on this

I agree that the course suggested by the Minister is more desirable, undoubtedly, but I think we should consider whether some specific provision should not be made, because the returning officer will be liable to copy the Parliamentary practice, even in the Universities, if there are two simultaneous vacancies.

Comment on this

We cannot make provision for any case of hysteria that there is in the country. You must assume that the body elected will be responsible men, and that they are not going to go out in a hurry. If they are they will have to wait until they can get a second man in, and until they get a perfectly true reflection of the electors' opinion for such cases as may arise in which two medical officers elected would retire. I do not think we ought to make provision in the Bill. I think the Bill is all right as it stands.

Comment on this

I move:—

In Rule 10, page 21, line 2, after the word "names," to insert the words "or name," and after the word "persons" to insert the words "or person."

Comment on this