Editing Mother and Child Scheme

{{Short description|Former healthcare programme in Ireland}}
{{EngvarB|date=October 2013}}
{{Use dmy dates|date=May 2024}}
{{more citations needed|date=January 2013}}
The '''Mother and Child Scheme''' was a [[health care in the Republic of Ireland|healthcare]] programme in Ireland that would later become remembered as a major political crisis involving primarily the [[Irish Government]] and [[Roman Catholic Church]] in the early 1950s.

The scheme was referred to as the '''Mother and Child Service''' in legislation. A brochure, "What the new service means to every family", was prepared. It explained the new service but was not issued to the public. The scheme was engulfed in crisis before this could happen.

==Background==
Since the establishment of the [[Irish Free State]] in 1922 responsibility in the government for healthcare had lain with the [[Minister for Housing, Local Government and Heritage|Minister for Local Government and Public Health]]. No significant reform of healthcare occurred in this time and the Catholic Church still retained effective control through the ownership of hospitals and schools, while family doctors still largely practised in isolation of other medical professionals.

The [[Fianna Fáil]] [[Teachta Dála|TD]] [[Seán MacEntee]] started the process of reform as Minister for Local Government & Public Health in 1943. After the [[Second World War]] there was renewed optimism after the depression of the preceding decades. Once [[The Emergency (Ireland)|the Emergency]] was over the political agenda started to shift from [[Irish Civil War]] politics, which had dominated politics, to the domestic agenda and social issues. In particular issues like employment, health and housing came to the fore and this manifested itself in a move away from [[Fianna Fáil]] and [[Fine Gael]].

Regarding healthcare, international trends such as in the [[National Health Service]] of the United Kingdom and elsewhere in Europe were noticed by the Irish political system. The office of [[Minister for Health (Ireland)|Minister for Health]] was created as a separate "Minister of the Government" by the 1946 Ministers and Secretaries (Amendment) Act;<ref>[http://www.irishstatutebook.ie/1946_38.html Ministers and Secretaries (Amendment) Act, 1946] {{webarchive|url=https://web.archive.org/web/20051130113234/http://www.irishstatutebook.ie/1946_38.html |date=30 November 2005 }}</ref> this act also created the [[Minister for Social Protection|Minister for Social Welfare]]. Problems such as high infant mortality rates led to an increase in support for health reform{{citation needed|date=December 2019}}. The Fianna Fáil government published a much delayed [[White Paper]] in 1947. This paper was followed by the 1947 Health Act,<ref>[http://www.irishstatutebook.ie/1947_28.html Health Act, 1947] {{webarchive|url=https://web.archive.org/web/20051128142738/http://www.irishstatutebook.ie/1947_28.html |date=28 November 2005 }}</ref> in which the scheme was provided for in Part III of the act. President [[Seán T. O'Kelly|O'Kelly]] convened a meeting of the [[Council of State (Ireland)|Council of State]] to consider whether Part III should be referred to the [[Supreme Court (Ireland)|Supreme Court]], but he decided against doing so.<ref>{{Cite book |last=Kelly |title=The Irish Constitution |last2=Hogan |last3=Whyte |date=2003 |publisher=LexisNexis Butterworth |edition=4th |page=§4.5.110 |no-pp=y}}</ref> However, the [[1948 Irish general election|1948 general election]] resulted in the surprise fall of Fianna Fáil from government and instead the [[First Inter-Party Government]] would be left with the responsibility of implementing the scheme.

==The scheme==
In 1948 [[Noël Browne|Dr. Noël Browne]], a new [[Teachta Dála|T.D.]] for [[Clann na Poblachta]], and a socialist, became [[Minister for Health (Ireland)|Minister for Health]] in a coalition government. Browne was an admirer of Fianna Fáil's 1947 Health Act<ref name="browne149">{{Harv|Browne|1986|p=149}}</ref> and intended to implement its provisions as part of a plan to reduce the alarmingly high rate of child mortality (especially from tuberculosis) in Ireland,<ref>{{Cite web |last=Kelly |first=S. |date=2011 |title=Stigma and silence: oral histories of tuberculosis |url=http://eprints.ulster.ac.uk/24908/1/Kelly_Oral_history.pdf |access-date=2 January 2015}}</ref><ref>{{Cite web |last=Condon |first=D. |date=2008 |title=Pre-immunisation — Ireland in the bad old days |url=http://www.irishhealth.com/article.html?id=19092 |access-date=2 January 2015 |publisher=Irish Health}}</ref><ref>{{Cite web |last=Hunter |first=N |date=2013 |title=Record low TB rate in Ireland |url=http://www.irishhealth.com/article.html?id=21870 |access-date=2 January 2015 |publisher=Irish Health}}</ref> modernise the Irish healthcare system and make it free and without means-testing for mothers and their children up to the age of 16.<ref name="browne149" /> He was impressed with the National Health Service in the United Kingdom<ref name="browne157" /> and successful medical procedural reforms in Denmark which reduced child mortality.<ref>{{Harv|Browne|1986|p=111}}</ref> He tackled the domestic health issues and was acclaimed for the results.<ref name="obrien161">{{Cite book |last=O'Brien |first=M. |title=A Concise History of Ireland |last2=O'Brien |first2=C.C. |date=1977 |publisher=Thames & Hudson |location=London |page=161}}</ref>

In July 1950, Browne's department formally submitted the scheme to the [[Irish Medical Association]].<ref>{{Harv|Browne|1986|p=156}}</ref> The Association had originally opposed the 1947 bill, mentioning the "socialisation of medicine."<ref name="browne149" /><ref name="obrien161" /> In this opposition it was supported by at least one member of the coalition cabinet: Fine Gael [[Teachta Dála|T.D.]] [[Thomas F. O'Higgins|Dr. Thomas F. O'Higgins]], the [[Minister for Defence (Ireland)|Minister for Defence]] and a former member of the executive of the Association.

More important was the opposition of the [[Archbishop of Dublin (Roman Catholic)|Archbishop of Dublin]], [[John Charles McQuaid]], who summoned Browne to his palace<ref name="browne157">{{Harv|Browne|1986|p=157}}</ref> and read out a letter to be sent to the [[Taoiseach]], [[John A. Costello]], penned by Dr. James Staunton, [[Bishop of Ferns]], which included the words "...they [the Archbishops and bishops] feel bound by their office to consider whether the proposals are in accordance with Catholic moral teaching," and, "Doctors trained in institutions in which we have no confidence may be appointed as medical officers ... and may give gynaecological care not in accordance with Catholic principles".<ref>[letter quoted from] O'Dowd, M. (ed.) (2002) ''The Field Day Anthology of Irish Writing Volume V: Irish Women's writing and traditions.'' New York: New York University Press, p170</ref><ref>{{Harv|Browne|1986|p=158}}</ref> The letter stated that health provision and physical education for children were solely the right of parents and not the State's concern. Archbishop McQuaid was the chairman of some boards of directors of Dublin hospitals. He exercised considerable influence concerning medical appointments and control over the religious orders whose members made up much of the administrative and management staff in hospitals, sanatoria etc.<ref>''A medical stalwart now happy in exile.'' Irish Health [online] http://www.irishhealth.com/clin/sexual_health/features2.html?artid=18437. [accessed 2 January 2015]</ref><ref>{{Harv|Browne|1986|p=142}}</ref> Concerning the term "moral teaching" in the letter to the Taoiseach, Browne received supportive advice{{snd}}in secret{{snd}}from [[Francis Cremin]], a Maynooth professor of theology and canon law.<ref name="browne157" />

Several bishops, McQuaid included, feared that the scheme could pave the way for [[Abortion in the Republic of Ireland|abortion]] and birth control. Though some clergy might have been privately sympathetic to Browne and wished to reach an accommodation, what was viewed as Browne's tactless handling of the Catholic Church forced the moderates into silence, allowing the anti-Mother and Child Scheme members of the hierarchy under McQuaid to set the agenda.<ref>According to [[James Dillon (Fine Gael politician)|James Dillon]], Browne's cabinet colleague, he (Dillon) had a quiet word with the moderate [[Archbishop of Tuam]], Dr Walsh, in an attempt to defuse the row. Walsh agreed to try to calm down the controversy and secretly meet Browne. When Dillon told Browne of this development, Browne went down to Walsh's residence without first arranging an appointment. Walsh was away on Church business. In what Dillon saw as a disastrous error, Browne travelled to meet the neighbouring bishop, Dr. Dignan, a "lunatic" in Dillon's view and one of Browne's most trenchant critics. They had an argument that inflamed the situation. In revealing that he had originally gone down to see Walsh, Browne compromised the position of the potential go-between, who was forced to accede to the demands of his more hardline colleagues.</ref>

Many in the [[Anglicanism|Anglican]] [[Church of Ireland]] community also disagreed with the scheme. The ''Church of Ireland Gazette'' saw it as 'communist' interference in the family.{{citation needed|date=December 2023}}

Numerous doctors disapproved of the scheme, some on principle, others because they feared a loss of income and a fear of becoming a kind of [[Civil service of the Republic of Ireland|civil servant]], referring to the plan as "[[socialised medicine]]". Browne refused to back down on the issue but received little support even from his cabinet colleagues, most of whom he had alienated on other matters, notably his failure to attend many cabinet meetings and the lack of support which he had shown them in other crises. Isolated in cabinet as a 'loner' who did not consult with his more experienced cabinet colleagues,<ref>Gabriel Kelly et al. (eds), ''Irish Social Policy in Context'' (UCD Press, 1999) p. 29.</ref> he also faced the hostility of his own party leader, [[Seán MacBride]], with whom he had also fallen out, as he had with most members of the [[Clann na Poblachta]] Parliamentary Party, who resented his appointment to cabinet over the heads of more senior colleagues, and who were also offended by his treatment of them.<ref>Maurice Manning, ''James Dillon: A Biography'' (Wolfhound Press, 2000) p. 228.</ref>

In April 1951, MacBride demanded Browne's resignation as a minister. Browne duly submitted his resignation to the [[Taoiseach]] [[John A. Costello]] for submission to [[Seán T. O'Kelly|President O'Kelly]].<ref>Dáil Debates: 11 April 1951 [https://www.oireachtas.ie/en/debates/debate/dail/1951-04-11/57/ Vol. 125 Col. 641].</ref> The resignation took effect from 11 April 1951. In his resignation statement, Browne told the House:

<blockquote>''I had been led to believe that my insistence on the exclusion of a means test had the full support of my colleagues in the Government. I now know that it had not. Furthermore, the Hierarchy has informed the Government that they must regard the mother and child scheme proposed by me as opposed to Catholic social teaching. This decision I, as a Catholic, immediately accepted without hesitation.''<ref>Dáil Debates: 12 April 1951 [https://www.oireachtas.ie/en/debates/debate/dail/1951-04-12/41/ Vol 125 Col 667].</ref></blockquote>

During the subsequent Dáil debate on the resignation, [[Tánaiste]] and Labour Party leader [[William Norton]] claimed:

<blockquote>''...if this matter had been handled with tact, with understanding and with forbearance by the Minister responsible, I believe we would not have had the situation which has been brought about to-day.''<ref>Dáil Debates: 17 April 1951 [https://www.oireachtas.ie/en/debates/debate/dail/1951-04-17/42/ Vol 125 Col 954].</ref></blockquote>

Browne explained his approach to the Dáil by saying:

<blockquote>''I might say that my question to their Lordships was: Is this contrary to Catholic moral teaching? The reply, as you all know, was that it is contrary to Catholic social teaching. I was not aware — the Taoiseach can verify this — until I had asked each member of the Cabinet separately what he proposed to do, what he had been given to understand by Dr. McQuaid when that decision was taken. He then told us that that morning he had been informed by Dr. McQuaid that Catholic social teaching and Catholic moral teaching were one and the same thing.''<ref>Dáil Debates: 17 April 1951 [https://www.oireachtas.ie/en/debates/debate/dail/1951-04-17/42/ Vol 125 Col 947–948].</ref></blockquote>

==Aftermath==
The following month a [[1951 Irish general election|general election]] was called and in June 1951 a new government was formed as a result.

A derivative of the scheme was implemented subsequently by the [[Fianna Fáil]] government which returned to power as a result of the general election. This achieved legislative effect in the 1953 Health Act;<ref>[http://www.irishstatutebook.ie/eli/1953/act/26/enacted/en/html Health Act, 1954]</ref> this and later legislation that created the [[Voluntary Health Insurance Board]] in 1957. Although a single-payer system emerged in Ireland, the 1957 Act ended immediate attempts to implement a [[National Health Service]]-style healthcare model. Thus the private and public systems existing side-by-side, later reinforced by the [[1970 Health Act]], which changed healthcare from the responsibility of the county to a smaller number of regional health boards.<ref>[http://www.irishstatutebook.ie/eli/1970/act/1/enacted/en/html Health Act, 1970]</ref><ref>{{Cite web |last=Corbett |first=Teresa |date=2015-01-27 |title=A brief history of healthcare in Ireland |url=https://nuighealthpsychology.wordpress.com/2015/01/27/a-brief-history-of-healthcare-in-ireland/ |access-date=2021-07-17 |website=NUIG Health Psychology Blog |language=en}}</ref> The transfer of responsibility from local authority to state led to the introduction of the Unmarried Mother's Allowance in 1973, the first direct State payment to assist an unmarried woman to rear her child in the community.<ref>{{Cite web |date=1973 |title=Unwed mums and deserted wives to get benefits |url=https://www.independent.ie/regionals/argus/news/unwed-mums-and-deserted-wives-to-get-benefits-29497463.html |access-date=2021-07-17 |website=[[Independent.ie]] |publisher=The Argus |language=en}}</ref>

==References==
===Citations===
{{Reflist}}

===Sources===
* {{Cite book |last=Browne |first=Noel |title=Against The Tide |date=1986 |publisher=Gill & McMillan |location=Dublin}}
* {{Cite journal |last=Counihan |first=H. E. |year=2002 |title=The Medical Association and the Mother and Child Scheme |journal=Irish Journal of Medical Science |volume=171 |issue=2 |pages=110–115 |doi=10.1007/BF03168964 |issn=0021-1265 |ref=none}}
* {{Cite book |last=Department of Health |url=http://opac.oireachtas.ie/AWData/Library3/Library2/DL011492.pdf |title=Proposals for improved and extended health services July, 1952 |date=July 1952 |publisher=Stationery Office |series=Official publications |volume=Pr.1333 |location=Dublin |ref=none |access-date=13 November 2016}}
* {{Cite journal |last=McKee |first=Eamonn |date=November 1986 |title=Church-State Relations and the Development of Irish Health Policy: The Mother-and-Child Scheme, 1944-53 |journal=Irish Historical Studies |volume=25 |issue=98 |pages=159–194 |jstor=30008527 |ref=none}}


==External links==
* [http://historyhub.ie/mother-and-child-scheme-controversy Mother and Child Scheme Controversy] History Hub, [[University College Dublin]]
* [http://www.oireachtas.ie/parliament/about/libraryresearchservice/onlinecataloguecollections/documentslaidthroughthedecades/1950s-motherandchildscheme/ 1950s - Mother and Child Scheme] Oireachtas Library & Research Service

{{Clann na Poblachta}}

[[Category:Health in the Republic of Ireland]]
[[Category:1951 in Irish politics]]
[[Category:13th Dáil]]
[[Category:Medical controversies in the Republic of Ireland]]
[[Category:Catholic social teaching]]