We use Google Analytics to see which pages are read and how the site is used, so we know what to improve. This only runs if you accept. See our privacy notice for details.

Special Committee Public Charitable Hospitals (Temporary Provisions) Bill, 1929

SECTION 1.

Bill Public Charitable Hospitals (Temporary Provisions) Bill, 1929
Enacted

No. 55 of 1929 ›

I move amendment 1—

At the end of sub-section (1), section 1 to add the following:

" provided that such hospitals reserve for non-paying patients a monthly average of twenty-five per cent. of the total number of hospital beds in the institution and that no discrimination is exercised in the filling of these beds on the grounds of the religion of the applicants."

I do not believe that there is any discrimination used in any of the Dublin hospitals. In one hospital in town, however—I shall not mention names—there is a rule that beds are reserved only for patients of a certain religion. It is to meet that case that I move the amendment. In practice, I do not think there is discrimination.

Comment on this

You mean the rule is not enforced there?

Comment on this

Yes, but the rule is there.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

I have no objection to that particular part of the amendment. Trouble may, however, arise in connection with the monthly average of 25 per cent. mentioned in the amendment. Take my own hospital. Out of a total of about 110 beds, we have only 9 set apart for paying patients. On the other hand, there are a number of beds for which we get whatever we can—5/-, 10/- or perhaps £1. The people are asked what they can afford to pay and if they say they can afford 5/- per week that is taken from them. In addition, about 30 per cent of the patients in Sir Patrick Dunn's hospital are charged no fee whatsoever. What I wish to make clear is that while we have 9 beds reserved for paying patients we are getting some amount for quite a large number of the others beds and, in my opinion, there would be some difficulty in arriving at a percentage. Deputy O'Dowd has told me that he would not regard a person paying from 5/- to £1 a week as a paying patient, because the cost per bed in the hospitals would be from £140 to £150 per bed per annum. That is the total cost in the general hospitals. Patients who pay 5/- or 10/- are not paying for their beds.

Comment on this

It would be necessary to put in a clause defining what a non-paying patient is. A non-paying patient for this purpose would, I suppose, be one who did not pay more than £2 per week or thereabouts.

Comment on this

Does not the word " average " in the amendment meet the difficulty? Whether the amount a patient pays is 5/- or £3, if the total does not cover the cost in the hospital the position would be all right.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

I will give you a couple of figures and you can work the matter out for yourself. The total cost per year of Sir Patrick Dunn's hospital is roughly £10,000. There are 110 beds and we receive about £3,300 from patients who are able to pay a certain amount.

Comment on this

You receive about one-third of the cost.

Comment on this

About £30 a year per bed.

Comment on this

Has Deputy Sir J. Craig any suggestion to make that would meet the difficulty?

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

I only want to point out the trouble that would arise in arriving at the 25 per cent. per month.

Comment on this

It struck me that while Deputy O'Dowd's intention was quite admirable there might be difficulty on the part of the hospital authorities in giving it effect. We could, perhaps, provide that a hospital which had a certain number of beds reserved for paying patients would not be admissible.

Comment on this

The question arises all the time: " What is a paying patient?"

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

I do not like to interfere in a matter with which I am not quite conversant, but I think that a larger number of patients in the Richmond Hospital pay something than in most of the other hospitals.

Comment on this

I was a student in Richmond Hospital. There they deal with dispensary patients. The people admitted from the dispensaries are completely non-paying. But Richmond Hospital is run like other hospitals in town. They take patients from the county boards of health throughout the country and they are allowed two guineas each for them by the boards of health. I think Richmond Hospital takes in more patients from the boards of health than any other hospital in town.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

Where an insurance society has adopted hospital treatment as an additional benefit, the insurance people pay 25/- per patient. Some of the societies have not adopted hospital treatment. Those of them which have contribute 25/-, which does not cover even half the cost of the patient.

Comment on this

Although it would be rather anomalous, could we not define, for the purpose of this Bill, a non-paying patient as one who does not pay more than, say, 10/- per week.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

Perhaps we could meet the difficulty by providing that 20 per cent. or 25 per cent. of patients should be admitted absolutely free.

Comment on this

Would that percentage not be too high?

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

Possibly 20 per cent. would meet the case. The Hospitals Board, of course, accepted this provision.

Comment on this

The firm of Arthur Guinness and Co. pay 35/- in respect of any of their employees recommended by the medical staff for hospital treatment. They can go to any hospital they like and 35/- is paid in respect of them for a reasonable period. There is one hospital which is not likely to come in here because they refused to take the Corporation grant. They refused to take the grant from the city rates, so that they would not be bossed in any way. We are not likely to be troubled by these people since they would not take the rate money. Employees of Guinness, however, can select any hospital they chose and 35/- is paid for them.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

What is your point?

Comment on this

If these men are paying 35/-, would you count them as paying patients?

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

They would not be paying the full cost. The total cost would be £2 15s. 0d. or £3 per week. The cost in some of the hospitals would be higher. If we changed 25 to 20 in the amendment, perhaps we could leave it as it stands otherwise. This scheme may be adopted by Limerick, Cork and Waterford, and one would not like to place difficulties in their way.

Comment on this

I know one hospital which is, to a limited extent, helped by rates, the remainder of the money being provided by voluntary subscriptions and contributions by patients. In that hospital, there are 48 beds and there would not be more than 5 absolutely free. The practice is to encourage patients to pay some small amount. They would not pay 8/- on an average and there would be a considerable number who would pay nothing. The practice is to charge a labourer 3/- per week but if he has a wife and family he pays nothing.

Comment on this

Their average would be far more than 20 per cent.

Comment on this

I think that a person paying 10/- or less should not be considered a paying patient.

Comment on this

Consequential amendments would be necessary if this amendment were passed. For instance, would a hospital be compelled to refuse a paying patient simply because they were supposed to reserve a certain number of beds for non-paying patients? If there are beds which are not being claimed by non-paying patients, would the hospital be compelled to refuse paying patients?

Comment on this

I think they would work the matter out on the average for the year.

Comment on this

Could we add a qualification to the amendment to this effect. " For the purpose of this sub-section, a paying patient shall be deemed to be one who pays 75 per cent. of the total cost of upkeep."

Comment on this
Deputy O'Connell

I think it would be better to define a non-paying patient.

Comment on this

We could provide that a non-paying patient should be deemed to be one being treated free or contributing under 10/- per week.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

If that were inserted, I would let the word " twenty-five " stand in the amendment.

Comment on this

I will add to the amendment, by the leave of the Committee, the following provision " For the purpose of this Act, a non-paying patient shall be deemed to be one who does not contribute more than 10/- per week or on whose behalf there is not contributed more than 10/- per week."

Comment on this

I move amendment 2:

To add to Section 1 a new sub-section as follows:—

" No hospital or sanatorium shall be entitled to carry on and conduct sweepstakes or drawings of prizes under this Act if there be any provision in its charter, constitution or regulations debarring any person from election or appointment to the staff thereof solely because of his or her religious belief."

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

I am quite willing to accept this amendment.

Comment on this

I move amendment 3:—

Section 1, sub-section (2), to delete all the words in the sub-section after the word " to " in line 26, and substitute " the Minister for Justice and which before being put into operation shall have received his approval.

The Minister for Justice shall cause to be drawn up regulations governing the conduct of sweepstakes to be carried on under this Act and shall lay a copy of such regulations on the Table of the Oireachtas and these regulations shall become operative thirty days after the date of publication unless the Dáil shall before the expiration of such thirty days have otherwise decided."

Comment on this

As the second portion of this amendment, from the words " the Minister . . . shall cause " to the end, if accepted, would involve the expenditure of public moneys, I am afraid we will have to rule it out. The preparation of the regulations by the Minister for Justice, which are dealt with in the second portion of the amendment, would involve the expenditure of public moneys, and therefore a Money Resolution would be required. The first part of the amendment is in order, but I am afraid the second part will have to go out. Perhaps Deputy O'Dowd, in substitution for the second part of his amendment, would be willing to accept something on the following lines: that the Committee, on submitting a scheme, must specify the amount of prize money or moneys to be awarded; how it is proposed to divide among the parties the amount of money subscribed and where the prize money is to be deposited.

Comment on this
Prof. James Craig Deputy Sir J. Craig Independent

I think this matter is already met in sub-section (2) of Section 1, which provides " that every sweepstake or drawing of prizes shall be held carried on or conducted by a committee to be appointed by the board of such hospital or sanatorium, and subject to a scheme drawn up by such committee which shall be submitted to and shall be subject to the approval of the Minister for Justice." I do not think it is necessary for the Minister for Justice to draw up any more regulations. If he does not approve of a scheme he can return it, stating his decision and saying that he wants it amended.

Comment on this

In order to give committees throughout the country, who might be drawing up schemes for the holding of sweepstakes, an idea of what the Minister might pass or might not pass, would it not be well to have some general regulations?

Comment on this

I think it would be well if the Committee agreed to delete the second portion of the amendment and substitute for it something on the lines that I mentioned a moment ago. The first part of the amendment can stand.

Comment on this

Is it not the case that the Minister, in considering schemes submitted to him, must deal with a great amount of correspondence. The cost involved in dealing with that correspondence may not be held to involve the expenditure of public moneys, whereas we are now told that if he is compelled to draw up regulations that that will involve the expenditure of public moneys. The matter looks a bit curious to me.

Comment on this

The second part of the amendment, as worded, would put the onus on the Minister for Justice of drawing up regulations. That would involve the expenditure of public moneys. If Deputy O'Dowd agreed, I suggest that the first part of the amendment be allow to stand, that the second part of it be deleted and that the following be substituted therefor, the amendment, as amended, then to read:

Section 1, sub-section (2) to delete all the words in the sub-section after the word " to " in line 26, and substitute " the Minister for Justice and which before being put into operation shall have received his approval.

(2) The Committee in submitting a scheme must specify (a) the amount of prize money or moneys to be awarded, (b) how it is proposed to divide among the parties the amount of money subscribed, (c) where prize money is to be deposited, (d) the manner and place in which the drawing will take place, and (e) the name of the accountant or auditor.

Comment on this

I move that amended amendment.

Comment on this

I move amendment 4.

Section 1, sub-section (2), to add at the end of sub-section:—" No member of any such Committee shall receive remuneration for his or her services on such Committee."

Comment on this

The amendment does not provide any safeguard that the members of the Committee will not enjoy remuneration for their services. Perhaps the amendment could be made a little bit more elaborate later on.

Comment on this

When we get the redraft of it we can look into that.

Comment on this