Wednesday, 12 February 2003
Private Business. - The Royal College of Surgeons in Ireland (Charters Amendment) Bill 2002: Second Stage.
I move: "That the Bill be now read a Second Time."
The Royal College of Surgeons in Ireland (Charters Amendment) Bill 2002 is a Bill to amend the governing charters of the Royal College of Surgeons in Ireland. The initial driving force behind it was the introduction of a new member of the body to be known as "Member of the Royal College of Surgeons in Ireland". The purpose of the change is to render the body politic of the Royal College of Surgeons in Ireland consistent with those of the Royal College of Surgeons in England and the Royal College of Surgeons in Edinburgh, institutions with which it has a rapport.
In its current form, the Bill contains 37 sections and goes considerably further than previous legislation in tidying up the Government charters so as to allow for the creation of a single text which will govern the college. The Bill also provides for extraneous matters necessary for the proper management of the Royal College of Surgeons in Ireland.
I am delighted to welcome the introduction of The Royal College of Surgeons in Ireland (Charters Amendment) Bill 2002. Founded in 1784, the Royal College of Surgeons in Ireland is a recognised college of the National University of Ireland. As the charter for the Royal College of Surgeons has never been incorporated in law, this legislation will, for the first time, regulate its position.
This amendment is needed to clarify and simplify the position of the Royal College of Surgeons in Ireland. The charters of 1844, 1883 the 1885 and the 1965 Act contained provisions, which amended and-or repealed the charters which preceded them. In certain instances, however, the provision being replaced was not repealed, despite it being rendered redundant, which undoubtedly led to confusion and a degree of ambiguity. In addition, as a result of the number and extent of charters, the governing documentation of the college has become extremely complex and arduous to digest. For these reasons, a considerable portion of this private Bill is aimed at having one referable document regarding the governance of the college.
The Bill also introduces new categories of member and new classes of officer to the institution. The category of "Member" will now be known as "Member of the Royal College of Surgeons in Ireland", a title consistent with those which obtain in the Royal Colleges of Surgeons in England and Scotland, with which the college has an excellent rapport. It must be noted that this new category of member necessitates the removal of the use of the word "member" contained within the charters and the 1965 Act, where it is used interchangeably with the category of member known as "a fellow". This must be changed to avoid confusion in the future. The Bill also creates a new status entitled "Fellow by Special Election of the Royal College of Surgeons in Ireland", whose status will be distinct from and in addition to the category of member currently known as fellow.
It is essential that the position of the Royal College of Surgeons in Ireland is finally regulated in Irish law. It is also important that such an essential Irish institution takes its place on the Statute Book.
The Royal College of Surgeons in Ireland was founded in 1784 by royal charter granted by King George III of Great Britain and Ireland. The college was originally established to educate surgeons at a time when surgeons were trained separately from physicians. In 1886 the undergraduate training of surgeons and physicians was merged and the college formed a medical school for this purpose. The medical school is a recognised college of the National University of Ireland and its graduates receive the MB, BCH and BAO degrees from the university. Graduates also receive the historical qualifying letters testimonial of LRCP & SI, as licentiates of both the royal colleges of physicians and surgeons in Ireland.
The main objective of the medical school is to provide the education and experience that will enable its graduates to enter postgraduate training in any specialty of medicine. To this end, the curriculum is designed to allow the student to develop a balanced perspective of domiciliary, community and hospital care and acquire a sound knowledge of the principles of both the science and art of medicine.
Today, more than 5,000 of the college's graduates – 400 of whom are in Malaysia – are practising worldwide. The highly qualified graduates of the RCSI are a source of great pride to this country and are at the forefront of medical practice at home and abroad. Their expertise is renowned around the world.
I have always wanted to address my colleague, the Leas-Chathaoirleach, Senator Paddy Burke, as Minister. This debate and the Committee and Report Stages of the Bill provide an opportunity to do so. I hope he will be sufficiently remunerated for the task he is undertaking.
This is an historic occasion and a unique opportunity. It is the first time in the lifetime of this Seanad that Members have had an opportunity to debate legislation introduced under a unique parliamentary and legislative device, the Private Bill. When I attempted to discover the distinction between a Private Bill and a public Bill, I was informed that a public Bill involves the population at large, whereas a Private Bill involves bodies incorporated by charter. I understood we had declared a republic in the late 1940s. Delving into our history has certain historical resonances.
I thank the sponsors of the legislation for the deliberate way in which they attempted to inform colleagues on all sides of its importance to the Royal College of Surgeons in Ireland and for their co-operation and courtesy to us all in advancing the purpose behind the legislation.
The Royal College of Surgeons in Ireland is an important school of medicine, of which all citizens should be proud. It has a distinguished history and position in this city occupying one of the most beautiful education buildings. Since the late 17th century it has produced many fine physicians and surgeons throughout Ireland and the world. It is important to state also it has a particular role to play because of the large number of non-nationals who have attended the college during the years. It has made a unique contribution to medical education in that a significant proportion of graduates come from non-Irish backgrounds. It is important to recognise this, particularly in the current climate to which we all have attempted to adapt in recent years. We are learning a great deal from the college, not only in terms of its expertise in the area of medical education but also in terms of what it has done to educate people from other countries and ensure its profession is of the highest possible standard.
This is a technical Bill which attempts to bring together in one consolidated legislative measure the governance of the Royal College of Surgeons in Ireland. There is an obligation on us to pass it, having deliberated on it on Committee Stage. I understand a joint committee will bring it forward in the coming weeks. I offer my party's imprimatur to support its aims and objectives and give it the swiftest possible passage through this and the other House. As Senator Glynn said, its essence is not just consolidation but the establishment of new categories of membership which are important because they fit into the categories of membership between colleges on these islands.
I refer to what might possibly be a divisive point. I have heard mutterings off-stage that a party in the other House may have a certain difficulty with the word "Royal". If that view is advocated by the party in question, it is churlish and selfish because those who argue that tolerance and respect should now become the bywords and the principle in other parts of this island must respect and show tolerance to the history of institutions such as this and their connection to other colleges on these islands. I do not wish to be divisive but to ensure the party to which I refer is listening.
The Royal College of Surgeons in Ireland is an important college, not just from a medical point of view but also in terms of the history of this country and our neighbouring island. If parties use this Bill, which is an attempt to ensure the governance of the Royal College of Surgeons in Ireland is of the highest possible standard and that its rules and regulations are consolidated, as a cynical, political tool with which to say something to other audiences, that should be condemned by us. I say this before others take up the cudgel in that respect.
Like other Senators, I am delighted to be associated with the introduction of this Bill. As Senator Hayes pointed out, it is an historic occasion in that this is the first Private Bill to come before this Seanad.
The updating of the legislation was long awaited. The previous wording was slightly antiquated and narrow. The Royal College of Surgeons in Ireland has moved into such diversified areas of health that the current wording does not cover everything it would want to do. As a result, this legislation is before the House.
I speak with some knowledge in that I am a member of the Medical Council on which I represent the public interest and know a little about the Royal College of Surgeons in Ireland and its great educators. I first came across them when I visited the Royal College of Surgeons in Ireland school of medicine in Beaumont Hospital, a school of excellence providing the best service offered by the State in the line of medical education.
Before it was established as a school for medical training of undergraduates, the Royal College of Surgeons in Ireland was engaged solely in the training of postgraduates. In the middle of the 19th century it joined with University College Dublin and became a school of medicine in its own right. It is now branching out into areas which in recent years have met public demand in the whole area of physiotherapy, for example, in respect of which degree course last autumn it held its first graduation ceremony. Last autumn also saw the establishment of its school of pharmacy which was urgently needed as prior to that the only such school was the one located in Trinity College. Even with an additional three or four schools, we still would not have enough places for the number of undergraduates who want to do pharmacology.
Senator Brian Hayes also pointed out the number of non-national students who study in the college. The State owes the Royal College of Surgeons in Ireland a debt of gratitude because overseas students pay €30,000 per year and the spin-off to the economy in terms of accommodation for students and the money they spend in travelling to and from the country is enormous. I am not a mathematician but imagine the income from the RCSI would amount to approximately €40 million a year, which is not insignificant.
I referred to my involvement with the Medical Council. This day next week I was due to travel to Penang to inspect its medical school, of which the Royal College of Surgeons in Ireland and UCD are overseers. I am greatly disappointed that because of the troubles in the Middle East the trip will not go ahead but hope it will be back on course later in the autumn. The medical school in Penang is a wonderful set-up. Not only is it an educator, it is also educating people in their own environment.
There is also a programme in place which has a vision for 2020 where the Royal College of Surgeons in Ireland is considering only taking foreign students for part, but not all, of their training. While that is a positive step forward because it will meet a demand from other countries, it will close off some of the income it has enjoyed previously. It is important, therefore, that we support it in examining the other areas mentioned. I am also delighted RCSI graduates enjoy equal acceptance throughout the world with their counterparts from the Royal Colleges of Surgeons in London and Edinburgh.
I support Senator Brian Hayes's sentiments on another point. The Royal College of Surgeons in Ireland is the only medical college which enjoys equal status on a 32 county basis. Its postgraduates come from all over the 32 counties. It is intrusive for a member of another party associated with this House to suddenly jump on the bandwagon and say they do not like the word "Royal". Every Member of the House and citizen of the country is as republican-minded as members of that party. The Royal College of Surgeons in Ireland is recognised throughout the world for its excellence and high standards in medical education. It would be a retrograde step for it to lose the word "Royal" because it is a recognised part of its name and not recognised as having any great political significance.
I welcome the Bill and hope it has a speedy passage. The Royal College of Surgeons in Ireland has an illustrious past and its present and future are even brighter. The work I have seen undertaken in the college, not just in the field of medical education but also in research over the last 30 years, has been quite splendid and I see it going from strength to strength. While it wants to change its charter so as to be in line with other colleges such as the Royal College of Surgeons in Edinburgh, it will also want to be in line with colleges such as the Royal College of Physicians in Ireland down the road from it. Recently when some colleagues of mine from the Royal College of Physicians in Ireland asked me what this charter was about, I said I thought it was because the RCSI wanted to be line with their college, which provoked great laughter from them. I congratulate the RCSI on bringing this Bill forward and hope it passes through the House speedily.
It is interesting that this is the only way charters can be changed. Perhaps when we look again at reform of the Seanad, we might look at the way Private Bills are dealt with, a matter which has not been examined for a long time.
I am glad to speak in favour of this Private Bill. Even though I am quite a long time in the parliamentary system and have been a Member of the Seanad in the past, this is quite new to me as we did not deal with a Private Bill at that time. It is interesting that the original charter was granted by George III on 11 February 1784 and today, 12 February 2003, 219 years later, there is a modest commemorative event. Perhaps "shindig" is the wrong word but the college has a little celebration on its charter day, and rightly so.
While we were very well briefed on this issue, I was interested in how Private Bills were dealt with in the Seanad. The procedure for dealing with such Bills was established in 1939 and one wonders who decided it. I agree with Senator Henry that though it seems arcane now, it is novel and interesting, marking out the work of the Royal College of Surgeons in Ireland.
Let us get the "Royal" issue out of the way. I, too, heard what one might call off-stage mutterings, not from anyone associated with the Seanad but from the Dáil. Ours is the Upper House and theirs the Lower House. We can, therefore, leave those low thoughts to those in the Lower House and deal with this when we meet in committee. I see the word "Royal" as a marketing tool. If one is selling one's wares in 50 countries throughout the world and one wants an entree into the various markets where there are bright students for one's college, the word "Royal" is a marketing tool. It conjures up many images, none of them imperialist or subversive. It is plainly just a common sense marketing tool. Those who can be heard muttering nearby should be sat on quickly.
Exactly. If there have been five changes to the charter, there is a clear need to consolidate. The second key aspect of the Bill relates to the distinction between members and fellows. That terminology must be strengthened in order that it is quite clear what people can do.
I thank the promoters of the Bill and I am glad they are present in the Distinguished Visitors Gallery, both the solicitors, Vincent and Beatty, and representatives of the Royal College of Surgeons in Ireland, as befits their position in the matter.
I am interested in the work being done by the Royal College of Surgeons in Ireland, its IT expertise in particular. The college is believed to have the greatest IT expertise of all the medical schools and colleges and every student is presented with a laptop on the day he or she enters the college. It also owns quite a lot of property, particularly Mercers Hospital, which it operates as a community health centre for the people of the area – a feature of its philanthropic approach.
As Senator Feeney said, students from all over Ireland and 50 other countries attend the college. The fees make it independent. Apart from individual trusts and grants for various projects, in general terms it is not dependent on State funding. Senator Feeney is also correct in saying the families of overseas students come to see how their darlings are getting on in Dublin, even if it is the darling of the fifth wife. This forges social and commercial links between our capital city and the many countries where the Royal College of Surgeons in Ireland has an outreach facility linked to Dublin.
I am honoured to bring this Bill before the House, although I defer to the Leas-Chathaoirleach. I wonder who the Leas-Chathaoirleach was in 1939 when the original Bill was laid out. We are delighted that this Bill enjoys the support of all parties. It mentions people of 25 years of age which is somewhat limiting. I hope we can change this because it would rule out many younger applicants. There is also the matter of direction which might cause problems on the basis of equality legislation. Those are details we can correct in these Houses.
The Labour Party supports the aim of this Bill – the provision of a modern framework for the Royal College of Surgeons in Ireland. As with any Bill, public or private, Government or Opposition, we have the responsibility of ensuring the enactment of the best possible legislation. We will suggest a number of changes to the Bill on Committee Stage but are happy to co-operate with the promoters of the Bill in addressing these issues.
There are some areas to do with policy that concern us, one of which has already been mentioned by Senator O'Rourke, the need for section 27 to comply with equality legislation. Section 27(4) contains a crude cut-off point that a person cannot qualify if he or she is under 25 years of age. We believe such a provision is rare in legislation and has not been used since the enactment of the Employment Equality Bill 1998, which prohibits discrimination in vocational training over the age of 18 years. We would not favour this requirement to be expressed in terms of age. It could be redrafted to suggest that seven years study of medicine is required. This would achieve a similar result without offending equality legislation.
We also have problems with sections 12 and 29. Section 12 provides for the revocation of degrees awarded by the college in certain circumstances, such as allegations of fraud. As with any disciplinary procedure, it is important to provide some basic protections for the accused person. These are missing from the Bill and would be dependent on by-laws. We should be reluctant to allow degrees to be revoked on the basis of such notice as the section provides. Firmer guarantees of fair procedure are required. A similar issue arises in section 29(6). It is desirable that we spell out the guarantees of fair procedure that will be afforded rather than ask the Oireachtas to leave everything to the officers of the college.
The Royal College of Surgeons in Ireland has been very responsible in consulting widely in advance of the publication of the Bill, the objectives of which are very worthy. The Labour Party will respond in a similar spirit of co-operation in terms of any changes that should be made. The model undertaken by the college in the Bill is one for any organisation which wishes to introduce private legislation. As a new Senator, I am glad that I have been involved in this process. It has been an interesting and rewarding experience to deal with legislation initiated outside the House. We should look at a broader application of the idea in terms of Seanad reform, with other groups initiating legislation we can take on board.
I am delighted to support this Bill, on which we will be able to work to remove some of the infelicity that Members have noticed. I also pay tribute to the work of the Royal College of Surgeons in Ireland and recognise how important it has been, not only in medical education in Ireland but also as a form of invisible export of knowledge and education, from which there is a spin off because those who are educated in this way are ambassadors and friends of Ireland. The work the college does around the world has great potential for the economic enhancement of the country as well as helping us in other ways.
On the medical education front, it is extremely important that we enable the college to be in the position where its graduates have a tradable and recognisable qualification, particularly within these islands. The health service in Northern Ireland depends on people with qualifications from Dublin, Edinburgh or London. It is vital that they should be on an equal footing and transferable and that standards and validation are the same. I am glad the college is preparing itself for this.
I find the Bill difficult to read because of the necessity of referring to other documents. I get worried when a person needs a shelf of books in front of him or her before a Bill can be read. Anyone affected or influenced by legislation in any field should have one document before him or her where he or she can find out his or her rights and responsibilities. I take heart from the explanatory memorandum which suggests that will be the outcome of the exercise. Why could that not have been the starting point? I would be interested to hear what the draftsmen to say about that, whether there could have been a process of consolidation with everything between the same two covers.
I was worried about the rights of appeal in these difficult disciplinary matters and suggest to the college the possibility of a visitor. I know there is provision for the censors, who seem to have quite an onerous task. However, in this day and age, the idea of a totally self-regulating body is rather passé. It might not be a bad idea to have an external presence among the Senators, as other colleges do, such as a visitor.
I was also somewhat worried about a phrase suggested in the insertion in paragraph 16, stating that the council shall be afforded the widest flexibility as regards the governing of the college. While one should not require people to dot every "i" and cross every "t", I find it difficult to get a satisfactory legal definition that comprehends what "the widest flexibility" is, other than "Let's do whatever we like". I suggest we look at that on Committee Stage.
I acknowledge that the House has a responsibility to recognise the importance of the college and its noble traditions over the centuries; its contribution to medical education, medicine and the health care of people in Ireland and its current work to export that kind of knowledge to many countries across the globe. I am glad the college is also extending its concerns to the other health disciplines. It is hugely important that we begin to consider health in a holistic way and that the people engaged in this are trained together.
I welcome the Bill and the manner in which it has been introduced. During my travels around the world, especially in Asia, I have found that in the case of practically nine out of every ten people whom I met and who were well informed about Ireland, it was due to their having attended the Royal College of Surgeons, which has enormous respect. I support anything that will enhance its value, whether in a marketing sense – and I had not thought of it in that context until the Leader referred to it in marketing terms – and enable it to go forward through the next 219 years. I am even more optimistic than Senator Hayes who spoke of the next decades – I believe it will go even further if we get matters right in this Bill.
I know something about Private Bills and charters, as a member of the board of governors of Hume Street Hospital for some years. In that institution, we have a similar problem and, probably, a similar intention to do something. In that case, it is quite unique, though not as old as the time of King George III – the charter of Hume Street Hospital dates from 1916, under a different King George. That charter specifies that the governing body of the hospital will be made up of "gentlemen" and we have not been able to change it for legal reasons.
We may have to introduce a Private Bill in the Oireachtas very soon in that regard. I wish to touch on some aspects of the Bill, without getting into detail. I have the highest regard for the effort which has been made to ensure that the governance of the college is protected. I commend the work that has gone into making sure that the anomaly of distinguishing between members and fellows is understood.
In relation to the use of the word "Royal", I grew up in what I might call a republican family and I recall my father, a strong republican in those times, pointing out that, whenever a revolution occurred in the Roman empire, people did not get rid of the statues and other memorabilia of the previous administration. On a visit to St. Petersburg some years ago – it was then Leningrad – we were told that on the night before the October revolution, Lenin took the revolutionaries aside and warned them not to damage any of their history and traditions. In fact, the revolutionaries did not damage any of the memorabilia of the previous Czars, even though they hated them. In my view, apart altogether from the marketability of the word "royal", we should not be frightened of holding on to our traditions.
In welcoming the introduction of this Private Bill, I believe it will find general approval, although questions have been raised on some aspects. An aspect which may not be always understood is the distinction between enabling legislation and enforcement legislation. The fact that this Bill will enable the college to award degrees at some future time does not give it the authority to do so. I hope that may put minds at rest; we will have an opportunity to discuss that aspect more fully on Committee Stage. It means they will not have to revise the charter if, at some future time, it is decided that the college should award degrees. In that event, the matter would be in the hands of the Oireachtas.
Some of us who have availed of the facilities of the college for other purposes are aware that it does not confine itself to its better known functions of teaching and research. I and Senator O'Toole have happy memories of the counting of NUI graduate votes in the Seanad elections last July at the college. I wish the Bill well in its passage through the House, with any appropriate improvements.
I welcome the opportunity to speak on this Bill, which I support. My memories of the Seanad election count, to which Senator Quinn has just referred, are slightly mixed. Happily, we were both elected on two occasions. However, while on the first occasion I established my rightful place at the top of the poll, I was displaced from that position by Senator Quinn on the more recent occasion.
Without repeating points made by other speakers, I wish to draw attention to a few matters to which, perhaps, the Leas-Chathaoirleach may wish to respond. The Bill proposes to change the terms of office of certain office holders including, I believe, the president of the college. That is quite appropriate and I fully approve – the term of office was too short otherwise. However, there appears to be a certain contradiction in section 32 which states: "The Council of the College shall have the power to determine by resolution the term of office of any office holder." I believe that is superfluous and, indeed, conflicts somewhat with the earlier provision to lengthen the term of office. It is simply a general enablement and does not add anything to the Bill. However, if there is some particular reason for it, I have no very strong view on the matter. I simply suggest that we look at it more closely.
I also question the provision in section 36: "This Act shall come into operation on the (blank) day of (blank) 2003." I believe it would be more appropriate, in case there may be questions as to how the commencement date is to be established – normally, a Minister establishes a commencement date for parts of an Act – to strengthen that provision by stating that the Act shall come into operation on the day of enactment. Specifically, that would be the date of signature by the President. I suggest that as a simpler and cleaner way of dealing with the matter. I propose to return to those matters on Committee Stage and perhaps the sponsors of the Bill would look at it again in the meantime.
In relation to the use of the word "royal", we should not lose the opportunity of ridiculing revisionists wherever we find them. I fully support the views articulated by Senator Brian Hayes and other Senators in dealing with this aspect. In my office earlier today, when I was dealing with an entirely different matter and trying to find some creative surges in that regard, all I could think of was how to rename the Royal Showband, the Royal county or the Royal Dublin.
Or "the Whatettes". I wondered would we have to find a new name for County Meath, not to mention what would happen in the case of the royal family. I am not sure what the royal family or Jim Royle and his family would make of all of this.
People who cannot accommodate their history should find a different place to live. This is the name of this distinguished college. I might say it is the distinguished name of this distinguished college. In that sense we should reflect on the fact that this is where it is rooted and that is what it means. It is a good reminder of the length of our history and that we should not spend our lives flattening out the spaces in history. That is not the way we do our business; we look at it in the round and we deal with it.
I hope we have matured as a nation. I certainly know that everybody in this House will have grown up and matured to the point where we do not need to blow up Nelson's Pillar once again. We can leave it sitting there and deal with it.
This college has given significant and important service, both to this island and abroad, and has brought the image of Ireland, in practical and special terms, to other places. It has done us much service in that area. It behoves us to be supportive of this attempt by the college authorities to progress and also to look at ways in which they can make changes in the future. To that extent, I welcome the enabling section – section 31 – which allows the college to develop in other ways. It would be my intention to support the Bill in any way possible and to facilitate its passage through the House.
As a matter of information, I would like to point out that the Leas-Chathaoirleach is not in charge of the Bill in the accepted sense as, for example, a Minister would be in respect of a public Bill. The Leas-Chathaoirleach has a formal supervisory role in moving the Stages of each private Bill as it comes to the Seanad.
The Cathaoirleach has defined my role in respect of the Bill. Before I move the motion to establish the joint committee, I thank all the Senators who contributed to the debate. With the Cathaoirleach's permission, I also welcome to the House Mr. Walter Beatty, who is the parliamentary agent to the Bill, his assistant, Audrey O'Reilly of Vincent & Beatty, Solicitors and Professor Kevin O'Malley and Mr. Michael Horgan of the Royal College of Surgeons in Ireland who are the promoters of the Bill.
Question put and agreed to.