Letter to John A. Costello, the Taoiseach

5 April 1951

Archbishop John Charles McQuaid

The dispute between Noël Browne, minister for health in the first interparty government from 1948 to 1951, and the Catholic hierarchy over a government medical scheme for mothers and children is one of the landmark events in the history of church-state relations in independent Ireland. Browne resigned from the cabinet, having failed to secure the support of his fellow ministers, and he released copies of the correspondence with the Catholic hierarchy to the Dublin newspapers. The episode led to the fall of the government. A reduced mother and child scheme was introduced by the Fianna Fáil government in 1953.

SEE ALSO Gaelic Catholic State, Making of; Health and Welfare since 1950, Provisions for; Language and Literacy: Irish Language since 1922; McQuaid, John Charles; Mother and Child Crisis; Political Parties in Independent Ireland; Politics: Independent Ireland since 1922; Religion: Since 1690; Roman Catholic Church: Since 1891

Dear Taoiseach,

The archbishops and bishops have considered very carefully your letter of 27th March, 1951, and the memorandum submitted by the minister for health in reply to their letter to you of 10th October, 1950.

The archbishops and bishops wish first to point out that, on 7th October, 1947, they sent to the head of government a letter in which they expressed grave disapproval of certain parts of the then recently enacted Health Act, 1947, especially those dealing with mother and child services. In sections 21–28 the public authority was given the right and duty to provide for the health of all children, to treat their ailments, to educate them in regard to health, to educate women in regard to motherhood, and to provide all women with gynaecological care. They pointed out that to claim such powers for the public authority, without qualification, is entirely and directly contrary to Catholic teaching on the rights of the family, the rights of the church in education, the rights of the medical profession and of voluntary institutions. The then taoiseach replied, deferring a fuller answer to our comments on the ground that the constitutionality of the act was being called into question.

The archbishops and bishops desire to express once again approval of a sane and legitimate health service, which will properly safeguard the health of mothers and children.

The hierarchy cannot approve of any scheme which, in its general tendency, must foster undue control by the state in a sphere so delicate and so intimately concerned with morals as that which deals with gynaecology or obstetrics and with the relations between doctor and patient.

Neither can the bishops approve of any scheme which must have for practical result the undue lessening of the proper initiative of individuals and associations and the undermining of self-reliance.

The bishops do not consider it their duty to enter into an examination of the detailed considerations put forward by the minister for health in his memorandum, save in so far as they wish to point out the fallacy of treating the proposed mother and child health scheme on a basis of parity with the provision by the state of minimum primary education, or the prevention of infectious diseases or a scheme of children's allowances.

It is to be noted that the proposed scheme fails to give clear evidence of the details of implementation. The scheme, as set forth in vague, general terms, has the appearance of conferring a benefit on the mothers and children of the whole nation.

The hierarchy must regard the scheme proposed by the minister for health as opposed to Catholic social teaching:

Firstly—In this particular scheme the state arrogates to itself a function and control, on a nationwide basis, in respect of education, more especially in the very intimate matters of chastity, individual and conjugal. The bishops have noted with satisfaction the statement of the minister for health that he is willing to amend the scheme in this particular. It is the principle which must be amended, and it is the principle which must be set forth correctly, in a legally binding manner and in an enactment of the Oireachtas. The bishops believe that this result cannot be achieved except by the amendment of the relevant sections of the Health Act, 1947.

Secondly—In this particular scheme, the state arrogates to itself a function and control, on a nationwide basis, in respect of health services, which properly ought to be and actually can be, efficiently secured, for the vast majority of the citizens, by individual initiative and by lawful associations.

Thirdly—In this particular scheme, the state must enter unduly and very intimately into the life of patients, both parents and children, and of doctors.

Fourthly—To implement this particular scheme, the state must levy a heavy tax on the whole community, by direct or indirect methods, independently of the necessity or desire of the citizens to use the facilities provided.

Fifthly—In implementing this particular scheme by taxation, direct or indirect, the state will, in practice, morally compel the citizens to avail of the services provided.

Sixthly—This particular scheme, when enacted on a nationwide basis, must succeed in damaging gravely the self-reliance of parents, whose family-wage or income would allow them duly to provide of themselves medical treatment for their dependents.

Seventhly—In implementing this particular scheme, the state must have recourse, in great part, to ministerial regulations, as distinct from legislative enactments of the Oireachtas.

Finally, the bishops are pleased to note that no evidence has been supplied in the letter of the taoiseach that the proposed mother and child health scheme advocated by the minister for health enjoys the support of the government. Accordingly, the hierarchy have firm confidence that it will yet be possible, with reflection and calm consultation, for the government to provide a scheme which, while it affords due facilities for those whom the state, as guardian of the common good, is rightly called upon to assist, will nonetheless respect, in its principles and implementation, the traditional life and spirit of our Christian people.

We have the honour to remain, dear taoiseach,

Yours respectfully and sincerely, (Signed on behalf of the Hierarchy of Ireland) John C. McQuaid, Archbishop of Dublin, Primate of Ireland.

Irish Times, 12 April 1951.