Court Opinion

ID: 9741753
Source: CourtListenerOpinion
Date Created: 2023-08-26 21:01:24.741779+00
Date Added: 2024-06-11T07:24:25.727726
License: Public Domain

*196Blair Moody, Jr., J.
(concurring). The question of law on this appeal is whether the activities conducted by a municipally owned general hospital providing the public medical service for a fee constitute a governmental function within the meaning of MCL 691.1407; MSA 3.996(107).
It is determined that the activities of such a municipally owned general hospital do not constitute a governmental function. Therefore, this opinion concurs with the result reached by Justice Fitzgerald. However, the reasons for reaching this conclusion differ to some extent from the analysis of my colleagues.
I
Governmental tort immunity in Michigan was originally created by court decision. Early in the state’s history, this Court began a slow process of extending protection from tort liability to municipal and state governing units. Often, contrary to strong indications from the Legislature to allow governmental liability, this Court enlarged the scope of governmental immunity. It fashioned the present theory of protection embodied in the "governmental function” concept.1
The momentum of these protective decisions continued unabated until the relatively recent case of Williams v Detroit, 364 Mich 231; 111 NW2d 1 (1961). The Court in Williams held that "the judicial doctrine of governmental immunity” was henceforth abolished in Michigan. However, this Court later restricted the broad sweep of Williams *197to apply only to municipal corporations. McDowell v State Highway Commissioner, 365 Mich 268; 112 NW2d 491 (1961).
In response to the Williams initiative, the Legislature passed 1964 PA 170. That statute, as amended by 1970 PA 155, included a general provision for immunity:
"Except as in this act otherwise provided, all governmental agencies shall be immune from tort liability in all cases wherein the government agency is engaged in the exercise and discharge of a governmental function. Except as otherwise provided herein, this act shall not be construed as modifying or restricting the immunity of the state from tort liability as it existed heretofore, which immunity is affirmed.” MCL 691.1407; MSA 3.996(107).
Although not defining the term "governmental function”, the Legislature did define the concept of "proprietary function”:
"The immunity of the state shall not apply to actions to recover for bodily injury or property damage arising out of the performance of a proprietary function as herein defined. Proprietary function shall mean any activity which is conducted primarily for the purpose of producing a pecuniary profit for the state, excluding, however, any activity normally supported by taxes or fees.” MCL 691.1413; MSA 3.996(113).
The evolution of common-law precedent is committed to the judicial branch of the government. No more striking example of judicial alteration in order to accommodate the needs and responsibilities of the times exists than the ringing pronouncement by this Court in Pittman v City of Taylor, 398 Mich 41; 247 NW2d 512 (1976). In Pittman, this Court expressly abrogated the an*198cient and maligned common-law doctrine of state governmental immunity.
Likewise, the concepts of governmental and proprietary functions have evolved different meanings over the years.2 These terms have been judicially manipulated to fit contemporary requirements. In Thomas v Dep’t of State Highways, 398 Mich 1; 247 NW2d 530 (1976), this Court interpreted the present governmental immunity statute. It was fully recognized that the concept of governmental function was dependent for its meaning upon judicial interpretation.
Several of my colleagues hold the position that the second sentence of the immunity provision requires past precedent to bind our present response to the statute:
"Obviously this language must be construed as an 'affirmation’ of case-law precedent on the subject of the state’s immunity.” Thomas, supra, 11.
Thus, since this Court previously held the operation of a general hospital to be a governmental function, the Court would be statutorily bound by the old law. See Martinson v Alpena, 328 Mich 595; 44 NW2d 148 (1950).
Rather than adopt this position, particularly in the face of Pittman, supra, which erased all common-law immunity precedent, this Court should begin anew its analysis of what a governmental function means under this statute.
Although the Legislature saw fit to statutorily define the term "proprietary”, significantly it did not define "governmental” function. Further, it may be discerned that there are actually three *199categories of activities: proprietary, governmental and an area wherein activities are neither clearly governmental nor proprietary.3 It is within this presently undifferentiated area that this Court must chart a modern course.
This conclusion was aptly stated by the minority in Thomas:
"We do not, however, construe this sentence [the second sentence of the statutory immunity provision] to be an 'affirmation’ of case-law precedent preserving for all time state governmental immunity heretofore recognized by case law. To read it in such a manner would be to assume that the Legislature failed to recognize that the evolution of case-law precedent is exclusively committed to the judicial branch of government.” 398 Mich 17, fn 4.
II
Participation of modern government in our everyday existence is so pervasive that any presumption must rightly run to government responsibility and consequent liability rather than to immunity. Present realities dictate viewing immunity as a privilege, limited to those activities uniquely associated with governmental enterprise.
It is held today that activity conducted in a general hospital operated by a municipality is not a governmental function for immunity purposes. This conclusion is predicated on the basis that the term "governmental function” is limited to those activities sui generis governmental — of essence to governing.
In Thomas, it was suggested that this test meant that a function is not governmental unless the *200particular activity involved has "no common analogy in the private sector”. Furthermore, it was observed that the perimeter of governmental function will most often "run along the line of distinction between decisional and planning aspects of governmental duties on the one hand, and operational aspects on the other”. 398 Mich 21, 22.
Although these concepts may have some significance in given cases when applying the "governmental essence” test, in other instances they could be misleading or inapplicable. For instance, it would be incongruous to find that the operational activities of some public agencies are other than governmental. Likewise, conceivably there could be essential governmental activity which would have some common analogy in the private sector.
To delineate a complete and balanced definition of governmental function within a simplistic format would be presumptuous. However, as a basic guideline, the crux of the governmental essence test should be founded upon the inquiry whether the purpose, planning and carrying out of the activity, due to its unique character or governmental mandate,, can be effectively accomplished only by the government. Unless liability would be an unacceptable interference with government’s ability to govern, activities that fall outside this perimeter, although performed by a government agency, are not governmental functions and therefore not immune.
Ill
The municipal ownership and operation of a general hospital clearly indicates government participation. The question is whether this participation is uniquely associated with governmental enterprise.
*201Although not necessarily decisive, the number of private general hospitals is far greater than the number of governmental hospitals in this state.4 This statistic alone would indicate that the function performed by municipal general hospitals is not uniquely served by government, however much the need for public participation remains.
Further, though the purpose of maintaining public general hospitals is to enhance the health of the citizens of Michigan, the purpose is not one which can only be effectively accomplished in society by the government. It is recognized that public general hospitals in most instances are maintained substantially by patient user charges. The fiscal involvement of government is significantly displaced by private payment.
Moreover, a significant consideration is the fact that government has little direct responsibility for placing patients in public general hospitals. Admitting and discharging patients there is usually a matter of private concern. This situation may be contrasted with public mental hospitals where patients are committed into an institution, often by court order, to fulfill the clear governmental responsibility of caring for those who cannot care for themselves or who present a danger to society. See the Mental Health Code, MCL 330.1001 et seq.; MSA 14.800(1) et seq.
The day-to-day care afforded to the substantial *202majority of patients in general hospitals is not of a unique character or precipitated by governmental mandate. Activities conducted by the staff of general hospitals are not such as can effectively be accomplished only through government participation. The medical practice performed in the emergency room of a municipal general hospital falls outside the scope of a governmental function contemplated by the statute. See Lykins v Peoples Community Hospital, 355 F Supp 52 (ED Mich, 1973).
Further, holding negligent activities of hospital personnel in general hospitals subject to liability is not an unacceptable interference with government’s ability to govern.
It also should be noted that a full trial is still forthcoming. At trial, plaintiffs will be required to prove their allegations of malpractice by a preponderance of the evidence. Defendant will have a full day in court. Therefore, though the defense of governmental immunity for public general hospitals is removed, all the safeguards of a trial remain.
Since defendant Highland Park General Hospital was improperly granted summary judgment in this case, I concur in reversing the trial court and remanding the matter for trial.

 See, generally, Cooperrider, The Court, the Legislature, and Governmental Tort Liability in Michigan, 72 Mich L Rev 187 (1973).

 See, generally, Anno: Immunity from liability for damages in tort of state or governmental unit or agency in operating hospital, 25 ALR2d 203, §§ 12-14. See, also, Cooperrider, supra, 219-237.

 See Thomas, supra, 18-19, fn 7.

 As Justice Fitzgerald noted in his opinion, the ownership of hospitals in Michigan registered with the American Hospital Association is heavily weighted toward private ownership:
State and local government 70
Federal government 9
Non-government, not for profit 167
Investor owned, for profit 6
Osteopathic (non-government, not for profit) 2
American Hospital Association, Guide to the Health Care Field, 1977 Edition, pp 108-116.