MEDICAL CHARITIES (IRELAND) BILL. (Hansard, 1 April 1851)

§ SIR W. SOMERVILLE
moved the Second Reading of the Bill.

§ MR. SCULLY
said, the present mode of administering relief under the medical charities in Ireland was very partial, bad, and inoperative, and he believed that the principle of this Bill was an excellent one. But he thought there were certain alterations that ought to be made in the details of the measure, such as in the mode of paying the medical officers of the different districts, their residence, and the appointment of the governors; but these were matters, perhaps, which it would be better to consider when the Bill was in Committee. He would, therefore, ask the right hon. Gentleman the Secretary for Ireland to give the Irish Members another early opportunity of discussing the Bill in Com- 896 mittee. If the right hon. Gentleman would consent to fix the Committee for an early day after Easter, he (Mr. Scully) and the other hon. Members with whom he had conversed on the subject, would not object to the present stage of the measure.

§ LORD NAAS
would not oppose the second reading of the Bill, for he considered it a measure somewhat necessary in all parts of Ireland. The measure was certainly an improvement upon the Bill of last year, and he was glad to see the Medical Board united with the Poor Law Board. By the Bill, as he understood it, all the infirmaries would be done away with, and all the bequests, grants, subscriptions, donations, and other property now belonging to those infirmaries would be handed over to the management of other bodies. This, he thought, was an important alteration, and that the Government was bound to make out a strong case in its favour; he thought, also, that full time ought to be allowed for a careful consideration of the best mode of administering those charities; and he could not help suggesting that it might be doubted whether the same sort of relief would be given in the new hospitals as had heretofore been afforded in the infirmaries. According to his understanding of the matter, the district hospitals might not be, like the infirmaries, open to any poor person, but rather be limited to cases of destitution, and confined solely to paupers—in a word, the labouring classes might not be benefited to the same amount by the new institutions as they were by the old. The words of the Bill were vague, and might be differently interpreted in different places. The Government were bound to show why they had taken those funds out of the hands of the persons who had hitherto administered them; and if a strong case of mismanagement were not made out against them, he would be inclined in Committee to propose the Amendment he had submitted to the House last year, namely, to exclude county infirmaries altogether from the operation of the Bill.

§ COLONEL DUNNE
would follow the example of the other Irish Members who had spoken, and not offer any opposition to the second reading of this Bill. He believed, with them, that legislation was highly necessary; but there were parts in the Bill, very nearly affecting its principle, which ought to be discussed in Committee, and which they ought to have ample time to consider. He therefore trusted that the Bill would not go into Committee before Easter.

§ SIR P. NUGENT
concurred with hon. Members in approving generally of the principle of the Bill; but as regarded the existing infirmaries, he thought great care ought to be taken in dealing with vented interests

§ MR MONSELL
said, that in many districts the poor possessed no means of medical relief, and, unfortunately, it was but too true that at present dispensaries, owing to the impoverished state of the country, were not kept up as in times past. There were two points in the Bill to which lie wished to direct attention. One of these related to the management by the board of guardians. Now, he knew no reason why they should have anything to do with the management. Why should they have anything to do with the districts within which medical relief was to be administered? In his opinion, that ought to be left to the central authority. The second point which he wished to notice was the appointment of medical officers. Why, he would ask, should that appointment rest with the board of guardians? On the contrary, it was his opinion that the district committee ought to appoint the medical officers, for they were the persons most interested in the proper discharge of the duties to be performed by those officers.

§ MR. F. FRENCH
thought that his right hon. Friend the Secretary for Ireland had some reason to complain of the attacks made on him on account of the changes which he had introduced into the Bill. They all agreed in the principle of the measure, and they seemed to wish it pressed on as speedily as possible. In this he concurred for several reasons, and for this among others, that those portions of the country which stood' most in need of medical relief were the portions most neglected. He thought it important, if possible, to get through the Bill before Easter.

§ Mr. VESEY
, although he had many objections to the details of the Bill, would not offer any opposition to it at its present stage, or at least to that portion of it relating to dispensaries. But he could not understand why the infirmaries were to be included in this Bill. The infirmaries were not in the same degree dependent on voluntary subscriptions as the dispensaries; and he was afraid that if the hospitals were placed under the boards of guardians, the effect of the Bill would be to shut out a large class who at present received relief from the infirmaries.

§ VISCOUNT BERNARD
wished very much that due time should be given to Members of that Souse connected with Ireland to give the revisions of the Bill their careful so as to possess a fair opportunity their opinions, and he pressed this the more because the law respecting fever hospitals was in a very unsatisfactory state; and he hoped, therefore, that the Session would not be allowed to pass away without those hospitals being properly provided for.

§ SIR W. SOMERVILLE
said, he agreed with those hon. Members who regarded this as one of the most important Bills that could be proposed for the benefit of Ireland, and he had endeavoured, in conducting it through the House, to conciliate the feelings of the Irish Members as far as possible in framing its provisions. The House was aware that several Committees of both Houses of Parliament had at different times sat to investigate this subject; and the general recommendation of those Committees had been that a separate medical board should be constituted to superintend these establishments. In bringing in his Bill of last Session he had introduced a provision in conformity with that recommendation; but as the Bill was passing through the House, he collected the feeling of the majority of the Irish Members to be that a single board should be entrusted with the management of these medical charities. Therefore, whatever his own opinion might have been, he bowed to the judgment of the House, and he had endeavoured in framing this Bill to comply with what he had believed to be the opinion of the Irish Members. He was glad to find the principle of the Bill in its altered state generally assented to; for the present state of the law was utterly inefficient, and it was unjust to the ratepayers, pressing heavily on the charitable and humane, and enabling those who were contented to neglect their duty to escape without paying any tax whatever. It was unjust also to the medical profession—a highly-educated body in Ireland, who were heavily worked and badly paid. He had introduced the infirmaries into the Bill because he thought the two systems of medical charity ought not to go on separately; and great as were the abuses of the dispensaries in Ireland, the abuses of the infirmaries were not much less. He did not speak of the way in which the infirmaries were managed—that, he thought, was highly creditable; but he thought the infirmary system emi- 899 nently unjust to the ratepayers, and very inadequate to the wants of the poor. Any one looking at the map of Ireland would Bee that some of the infirmaries were placed at the end of one county, and close to the borders of another, and yet perhaps a person living just at the other side of the boundary line, and close by the infirmary in the adjoining county, had to be carried a distance of forty or fifty miles, because he could only be received in the infirmary of his own county. In fact, the Poor Law Commissioners' report on the subject declared that, except within a radius of eight miles from the infirmary, the rest of the county was practically deprived of its fair proportion of the relief, although it was taxed as highly as the places in the immediate vicinity of the institution, and daily receiving its full benefits. It was therefore absolutely necessary that all who were taxed to support the infirmaries in Ireland should be brought within reach of their relief, and that, consequently, a new local distribution of these institutions should take place. No doubt, when they came to consider the Bill in Committee, they might or might not omit the word "infirmary" or the word "dispensary;" and when the proper time came, which he conceived would be in Committee, he should submit his reasons to the House for passing the Bill in its present form. The hon. Member for the county of Limerick seemed to object to some portions of the Bill; but it was to be hoped the House would recollect that the measure had been prepared in obedience to the wishes of hon. Members themselves on both sides of the Hoose. With regard to the mode of forming the districts, last year he had proposed that they should be settled by the central authority; but on this point again, in deference to what he understood to be the feeling of his hon. Friends on both sides, he had consented to modify the present measure so as to meet their views. The appointment of the medical officers for the district hospitals should certainly be vested in the District Committees; but he considered that, as the medical officers for the dispensaries were to be paid from the poor-rates, their appointment should rest with the boards of guardians. It was important that the Bill should be passed as soon as possible, and it was very desirable that before the next assizes, the different grand juries in Ireland should know what they had to rely upon, and what they had to do in order to 900 provide for the poor who were suffering from the want of relief. He would, therefore, fit the Committee on the Bill at present for a day before Easter; and then, if it should be required for the convenience of the Irish Members, it might be postponed till ah early day after the recess.

§ SIR J. YOUNG
wished to know what classes would be entitled to relief Under the Bill?

§ SIR W. SOMERVILLE
said, he apprehended the Bill was not at all intended for the pauper classes; but the same classes who, under the present system, received relief, would still be entitled to receive it. Under the poor-law medical relief could be administered to persons in the character of paupers; and an attempt had been made to stretch that provision, so as to include those who were not strictly paupers. That attempt, however, had failed, and hence arose the very necessity for this Bill.