Politics

Post-independence Irish politics provided few characters as compelling as Dr Noël Browne who was born just months before the Easter Rising, a century ago, in December 1915. Raised in a wicked combination of tragedy, poverty and illness, Browne saw his father, an inspector for the National Society for the Prevention of Cruelty to Children, pass away from tuberculosis when he was nine. The destitution which followed led the family to lose their home and most of their possessions before emigrating to Britain, where his mother would die from the same illness just weeks later. In England Browne found some redemptive fortune, first winning a scholarship to the renowned Jesuit school Beaumount College and then befriending the son of a wealthy Dublin surgeon. The Chance family paid the future politician’s way through medical school in Trinity College during the Second World War. But England also offered a sickly Browne, himself now a victim of tuberculosis, an important insight into the early development of socialised medicine, part of the evolution of what became the National Health Service in 1948. Back in Ireland after graduation Browne committed himself to tackling tuberculosis, a disease that killed nearly 10,000 people per year here in the early twentieth century. Frustrated by the impotence of individuals to meet the enormous challenges posed by the disease, and unwilling to profit through private practice from the misfortune of the poor masses consumed by it, Browne settled on politics as the only means to tackle what he saw as “Ireland’s most important social problem”. This was a theme of Browne’s life: it led to politics by moral conviction and a confidence in his ability to solve problems. His ideological progression was shaped by the challenges he aimed to overcome and the frustrations he endured in doing so. In the 1948 general election Browne stood for Seán MacBride’s Clann na Poblachta, a newly-formed republican party that aimed to channel discontent at civil war politics into a social agenda. Browne represented the social-democratic wing of a party that was riven with contradictions but ascendant in the polls. Nominated as the Minister for Health of the first coalition government after claiming a seat in Dublin South-East, Browne began one of Ireland’s most notable political careers at the tender age of thirty-three. In office Browne instigated an enormously successful campaign against tuberculosis, forcing the government to pursue extensive investment in free screening, and providing access to new antibiotics and vaccines as well as a massive construction campaign of hospitals, clinics and sanatoria. This effort is credited with reducing the rate of deaths from tuberculosis from 146 per 100,000 in 1947 to 16 per 100,000 in 1960. Despite this achievement, one of the most impressive in post-independence Irish politics, it was another aspect of his time as Minister for Health which defined his legacy: the attempt to introduce the Mother and Child Scheme. The Mother and Child Scheme was a proposal by Browne, grounded in a provision in the 1947 Health Act introduced by the previous Fianna Fáil government, to legislate for free healthcare, without means-testing, for mothers and children up to the age of 16. The story of the Mother and Child Scheme told today filters it through a modern lens: a contest between Church and state. But this is only part of the story, secured in its particular prominence by Browne’s release of correspondence between the Church hierarchy and political leaders, to the Irish Times. Browne’s political philosophy at the time was weaker in its analysis of Irish capitalism and more focused on the cultural importance of secularism. This blinded him to a degree to the potency of the other opponents of the scheme: the Irish medical profession. The Irish Medical Association was determined to defend private healthcare from socialisation and opposed both the 1947 Act and the 1950 scheme. This followed the path of their colleagues in Britain, who had initially opposed Aneurin Bevan’s NHS, and of their predecessors in 1911 who scuppered the Irish Health Care insurance Act. Although Archbishop John McQuaid later described the face-off over the Mother and Child Scheme, which ended with Browne’s resignation in 1951, as “the greatest challenge to clericalism in Ireland”, its significance was actually even deeper than this. Both the Church and business in Ireland understood the potential of such a scheme, which drew widespread support from the popular classes, as a social-democratic moment for Ireland. Catholic social teaching was not simply an impediment to liberalism gaining a foothold in social and cultural issues, it was the ideological basis of Irish capitalism. Welfare was to be based on the private sphere – the family backed by Church and charity – with services provided on means-tested or modest transfer basis. Catholic corporatism eschewed the concept of universal entitlement, historically a far more potent line of defence for social democratic gains. It also siphoned off large sections of social reproduction to forced labour in carceral institutions. Poverty, rather than be eliminated, was always to be with us. In the end a cheap imitation of the Mother and Child Scheme was introduced in 1953 to satiate public appetite generated by the controversy. Mothers received free health care for infants, but only up to six weeks and on a means-tested basis. The mould Noël Browne had tried to break remained intact. After he was forced to resign from government, Browne went on to join Fianna Fáil, erroneously hoping that the “seed” of social democracy in the party that saw it introduce the widows’ and orphans’ pensions and the sickness allowance and to build social housing could be developed into something more fundamental. Instead he found even more entrenched support for the prevailing economic and social mould than had existed in Clann na Poblachta. Following inevitable expulsion from Fianna Fáil he established the National Progressive Democrats, a social-democratic party in complete contrast to the prophets of the free-market who were later to usurp the name. During his time in the NPD he focused on his favoured role, parliamentary watchdog, teaming up