The Reluctant Taoiseach

by David McCullagh

  Medical opposition, then, was partly informed by the same concerns bothering the bishops, about excessive State interference with the rights of the family (and the medical profession, of course). But it was also driven by concerns over the financial position of doctors, and Browne seems to have seen this as the primary motivation in the opposition to him. He may have been right too. But his handling of his fellow doctors was less than diplomatic. He told an IMA deputation in October 1950 that his personal preference would be for “a whole time salaried service”, but he accepted that the public and the profession would not accept such a development for many years. He also insisted that while the scheme could be improved, “the decision regarding abolition of a Means Test was immutable and the Association must recognise this fact”.47 Such a hardline approach inevitably stiffened the IMA resistance, prompting Costello to try to negotiate a solution himself.

  The Taoiseach had made a point of making conciliatory noises in a number of speeches to medical bodies. He told a meeting of the IMA that improvements in health services could only be achieved if there was “full understanding and complete co-operation between the medical profession and the Government … Anything in the nature of unfriendly relations or intractable misunderstandings can only bring difficulties and frustration in their train for all of us.”48 He told the annual dinner of the Royal College of Physicians that while some friction might arise between the Government and the medical profession, “there is absolutely no reason why the causes of this friction should not be removed by amicable discussion and friendly cooperation”.49 No reason, except for an obdurate Minister and an equally obdurate profession.

  On 25 November 1950 the Medical Secretary of the IMA, Dr P.J. Delaney, wrote to Costello asking him to receive representatives of the Association to discuss health developments. He said he was acting on a suggestion by Dr T.F. O’Higgins, the Minister for Defence.50 The Taoiseach immediately agreed, and along with Norton met an IMA delegation four days later.51 Costello later told the Dáil that he put forward Browne’s view “as an advocate, a view with which I did not agree. I put it forward as strongly as ever I could …” He claimed that Browne was furious, accusing himself and Norton of selling him down the river, and refusing to allow them to negotiate any further on his behalf.52

  The written record bears out Costello’s version of events, although it is more temperate than the fury Browne allegedly showed in a face to face meeting. A letter from Browne rather stiffly thanked Costello for sending him a report on his meeting with the IMA. He hoped that once they had considered what the Taoiseach had said, “they will realise that the Mother and Child Scheme cannot be changed in its fundamentals and that accordingly the way will be open for me to continue negotiations”. On the same day, he wrote to the Association asking if they had made up their minds on his scheme, “as he is anxious to be in a position to introduce the Scheme early in the New Year”.53 He later explained to Costello that he had done this to avoid the spread of any impression that future negotiations would be conducted by the Taoiseach and the Tánaiste, rather than himself. “I would be very much obliged, therefore, if you would be good enough to communicate with the Association making it clear to them that any future negotiations about the Mother and Child Service will be conducted with the Minister for Health.”54

  The IMA set up a special committee on the strength of its meeting with Costello “in the hope of bridging the difficulties which presently exist”.55 This produced an alternative scheme which was rejected out of hand by Browne as it compromised the principle of not having a means test. At the beginning of March 1951, Browne wrote again to Costello saying he was “still willing and anxious to negotiate with the Association and to consider any reasonable proposals which they may put forward. As, however, its latest letter leads me to believe that it has no sincere desire to reach agreement except on its own terms, I have decided to proceed without further delay with measures for the introduction of a Mother and Child Service, and I enclose a copy of a letter which I am sending to the Association today conveying this decision.”56 This rather rash action by Browne now brought the second strand of opposition to his plans to the centre of the stage.

  As we have seen, the hierarchy had raised concerns about the 1947 Health Act with de Valera before the change of government. After some publicity about Browne’s plans in the summer of 1950, the issue was considered by the bishops at their meeting on 10 October. On their behalf, Bishop James Staunton wrote to Costello once again raising concerns about the powers taken by the State under the proposed scheme. The bishops complained that these were “in direct opposition to the rights of the family and of the individual and are liable to very great abuse … If adopted in law they would constitute a ready-made instrument for future totalitarian aggression.”

  Significantly, the first concern now mentioned by the hierarchy related to the absence of a means test. While the State had the right to intervene in a subsidiary capacity, it did not have the right to supplant the duty of parents to provide for the health of their children. The State “may help indigent or neglectful parents: it may not deprive 90% of their rights because of 10% necessitous or negligent parents”.

  The letter also complained about the State taking over provision of physical education and education in regard to motherhood. There were concerns, too, about gynaecological care, which in some countries was taken to include contraception and abortion. “We have no guarantee that State officials will respect Catholic principles in regard to these matters.” It added that “doctors trained in institutions in which we have no confidence” (a reference to Trinity) might be employed under the scheme and provide care “not in accordance with Catholic principles”. Curiously, despite the fact that the letter was dated 10 October, a note on Costello’s copy states that it was handed to him by McQuaid on 7 November.57 The Taoiseach told the Dáil that the letter was “personally handed” to him on that date, after McQuaid’s return from a visit to Rome.58 The delay seems rather strange, but it would appear to explain why Costello only mentioned the letter to Browne on 9 November.59

  In the meantime, Browne had met three bishops—McQuaid, Staunton and Browne of Galway—on 11 October, the day after the hierarchy’s meeting, but before Costello received the resulting letter. Browne believed he had resolved his difficulties; in fact, according to McQuaid’s later version of events, he had actually made a very poor impression on the prelates (mainly, it would appear, because he was prepared to argue his case, rather than accepting their ruling).

  Browne later recalled that he had told Costello that he had satisfied the misapprehensions of the bishops; further, he even claimed that the Taoiseach, after meeting McQuaid on 12 October, had been “in a position to corroborate His Grace’s and Their Lordships’ satisfaction with the explanation which I gave in relation to their misapprehensions concerning the Scheme”. Costello flatly denied that he had said anything of the kind. “In view of what I had been told by His Grace at my interview with him I certainly could have given you no such assurance.”60

  Costello gave the Staunton letter to Browne in November, asking him to draft a reply. In this reply, Browne claimed that the only “fundamental difference in principle” between the existing Public Assistance system and the Mother and Child Service was the absence of a means test. Browne ventured to suggest that the objections of the hierarchy might be based “on the misapprehension that there will be compulsion on mothers or children to avail of the Scheme … There is no such compulsion.” Parents would retain the right to provide for the health of their children if they wished.

  He insisted that the “education in respect of motherhood” contemplated under the Scheme related to diet during pregnancy and the avoidance of smoking, and care would be taken to ensure that “its operation will include nothing of an objectionable nature under this head”. Responding to the concerns about medical personnel, Browne (himself, of course, a Trinity graduate) said that “this country is predominantly Catholic, the medical
profession is predominantly Catholic and there is an adequate and zealous clergy which will be quick to detect any practices contrary to Catholic teaching and to instruct its flock appropriately”.61

  This draft was given to Costello. Browne later said he believed it had been sent, and as he heard no more about it, he assumed the “misapprehensions” had been laid to rest. Costello told a very different story. He said he had told Browne he had not sent the reply, that he had, “out of consideration for you and in an earnest desire to help you in your difficulties with the Hierarchy … offered my personal help to you as intermediary with the Hierarchy to try to smooth their difficulties and resolve their objections, which I felt could be done by appropriate amendments of the Scheme …”62 Given that the Taoiseach was taking a similar approach with the doctors, this seems reasonably plausible. But in fairness to Browne, he may well have been misled by the date on the hierarchy’s letter. He must also have misinterpreted whatever Costello said to him after the latter’s meeting with McQuaid on 12 October.

  In parallel with his talks with the IMA, the Taoiseach was in close consultation with McQuaid. The Archbishop later told Bishop Browne that he had met Costello immediately after their meeting with Noël Browne, and again on 7 and 25 November. He had also met Norton twice, and MacEoin and the Attorney General (Charles Casey) once each. As a result, he believed the possibility of the Mother and Child proposals being accepted by Cabinet “is not even to be considered”.63

  In mid-January, the Archbishop outlined to the hierarchy’s standing committee what he had been told by Costello. “The Bill is not Government policy. Not a single Minister wants it, except Dr Browne … [The] Taoiseach … has given me the assurance that whatever the Church declares to be right in respect of the Mother and Child Health Service will be unequivocally accepted by him, even if the Minister had to resign or the Government fall. In fact, the Minister is the greatest single embarrassment that the Government endures … I have, by arrangement with the Taoiseach, dealt with the Taoiseach as head of the Government. I have allowed the contest to be fought between the Doctors and Minister. The Taoiseach foresees and fears that Dr B. may resign and carry away the support of the Clann: that would mean the fall of the Government. The Taoiseach proposes to have Dr Browne answer the Hierarchy’s letters, to send to us that answer, to await our decision as to whether Dr B’s answer is in accord with the Bishops’ desires, and thus to put the Hierarchy’s answer squarely to Dr Browne … I do not consider it advisable to give Dr Browne and the Clann the chance of going to the country on the basis that the bishops destroyed the Mother and Child Scheme for poor women and children. But I am convinced that, even at that risk, we may yet be obliged to break the certain introduction within our country of Socialist State medicine.”64

  McQuaid’s mention of the political dimension is interesting, as it is usually overlooked in accounts of the Mother and Child crisis. As we have seen, Browne’s biographer John Horgan argues that he had a dual strategy—on the one hand, he wanted to implement the Mother and Child Scheme; on the other, he wanted to force the Clann out of Government on an issue which would restore its radical credentials. Whatever happened, he would win.65 From what Costello told McQuaid, the Taoiseach was clearly aware of this strategy, and determined to try to outflank Browne. There was little he could do about the Minister resigning if he didn’t get his way on the Mother and Child Scheme. But he could do something to lessen the impact of the resignation—and one way was by enlisting the help of the hierarchy. It might be a stretch to say that Costello was using McQuaid as much as McQuaid was using Costello. But certainly the two men were using each other.

  This, then, was the explosive situation into which Browne tossed his Molotov cocktail by deciding at the beginning of March 1951 to press ahead with the introduction of the scheme. McQuaid was “surprised to read in the daily press of the sudden determination of the Minister for Health to implement the Mother and Child Health Service”. He was even more put out to receive a pamphlet from the Minister “which purports to explain the principles of the Mother and Child Service which the Minister is about to introduce”. McQuaid wrote to Browne setting out his concerns, and copied the letter to Costello. He pointedly thanked the Taoiseach for “the immediate understanding and cooperation I have on every occasion received from you … in all that concerns the provision of a sane and legitimate Mother and Child health service”.66 McQuaid reminded Browne that he had withheld approval from the scheme in October. “Now, as Archbishop of Dublin, I regret that I must reiterate each and every objection made by me on that occasion and unresolved, either then or later.”

  On 15 March, after returning from the funeral in Connemara of Fine Gael T.D. Josie Mongan, the Taoiseach was told Browne was looking for him. The Minister wanted an extra £30,000, saying if he got that sum he would “have the doctors killed on Sunday”. Costello asked Browne about McQuaid’s letter, but the Minister said there was “nothing in that”, an assessment based on his own theological advice. By his own later account in the Dáil, Costello said, “Whatever about fighting the doctors, I am not going to fight the Bishops and whatever about fighting the Bishops, I am not going to fight the doctors and the Bishops. It may come to a point where either you or I will leave the Cabinet on this, unless we can settle the matter with the Bishops.”67

  Costello subsequently wrote to Browne, chiding him for not responding to McQuaid’s letter. “I am afraid you do not appear to realise the serious implications of the view expressed in that letter since you have, by advertisement and otherwise, continued to publicise the Scheme to which objections have been taken. Such action might well seem to be defiance of the Hierarchy … I have no doubt that all my colleagues and, in particular, yourself, would not be party to any proposals affecting moral questions which would or might come into conflict with the definite teachings of the Catholic Church.” He urged Browne to come to an agreement with the hierarchy to remove their objections, adding that any financial problems in relation to the scheme would be immediately resolved “once the larger issues raised in the correspondence from members of the Hierarchy are settled”.68

  An increasingly testy correspondence between the two men ensued. On 19 March, Browne denied that the hierarchy were opposed to the Mother and Child Scheme. He pointed out that he had sent the brochure to each bishop, but only McQuaid had raised objections. He also said he had been in contact with a member of the hierarchy who assured him that “so far as he is aware the Hierarchy as such have expressed no objection to the Mother and Child Scheme whatsoever on the grounds of Faith and Morals”. He then asked a pointed question of the Taoiseach: “I would be interested to know whether your withholding of approval to the M&C Scheme is due either to the supposed opposition of the Hierarchy to the Scheme or to the possible opposition of any individual member of the Hierarchy.”69 Browne’s approach not only challenged Costello’s position as leader of the Government, but McQuaid’s as leader of the hierarchy.

  Relations between Taoiseach and Minister were now close to breaking point. On 21 March, Browne requested the Government Information Bureau to release to the press a letter from the Secretary of his Department to the IMA. Tipped off by Maurice Moynihan, Costello had the publication stopped, as the letter claimed the Mother and Child Scheme was Government policy, a claim with which he disagreed. Costello later told McQuaid that Browne had demanded to know why his statement had been stopped. Costello replied, “Because I am Taoiseach.” Browne then accused Costello of using the hierarchy to defeat the Mother and Child Scheme.70

  As the sense of crisis mounted, Costello was joined by Norton, Mulcahy, Dillon, O’Higgins, Cosgrave and Patrick Lynch, and sent a telegram to MacBride in Washington, requesting him to return at once. He wrote a letter to Browne which was sent by despatch rider to the Custom House. The Minister had left his office, but returned at around 8.40 to receive it.71 Costello’s letter responded to the points raised by Browne two days previously. The Taoiseach pointed out that the October l
etter came from the entire hierarchy “and must be regarded as still expressing the Hierarchy’s views until a contrary expression has been received from the Hierarchy”. He reminded his minister that he had already requested him to have their objections resolved.72

  Browne felt it necessary in his reply to stress his religious credentials, saying he had been concerned from the beginning to ensure that the scheme contained nothing contrary to Catholic moral teaching. “I hope I need not assure you that as a Catholic I will unhesitatingly and immediately accept any pronouncement from the Hierarchy as to what is Catholic moral teaching in reference to this matter.” He then attacked the Taoiseach, noting that he hadn’t mentioned any difficulties with the Church during his negotiations with the doctors. “It seems strange that at this late hour when the discussions with the IMA have reached a crucial point that you advance, as the only remaining objection to the Scheme, the one which of all possible objections … should have first been satisfactorily disposed of …”73

  The air of crisis subsided somewhat the following day. The request to MacBride to return home was withdrawn, in view of his success in arranging a meeting with Truman74 (discussed in the previous chapter). Costello wrote in more conciliatory tones to Browne, stressing that he was motivated solely by “a friendly desire to help a colleague and I take it somewhat amiss to find misconstrued my endeavours”. He added that he had explained to McQuaid why he had delayed responding to Staunton’s letter, and this had been communicated to the hierarchy. “I need hardly say that I accept unreservedly your statement that you would abide by any pronouncement from the Hierarchy as to what is Catholic moral teaching in reference to this matter.”75 That afternoon, Browne rang to report on a meeting with McQuaid, at which he agreed that the hierarchy should adjudicate on the matters arising, and undertook to accept their decision. He also asked the Archbishop to try to secure an early decision “in view of the importance of the matter to him, as it might mean his leaving the Cabinet”.76 This is confirmed by McQuaid’s account. The Archbishop claimed the Minister “apologised abjectly”, and, when McQuaid said he personally believed the scheme to be contrary to Catholic teaching, added that “that was for him the end”.77