Wednesday, 21 November 1956
Dáil Éireann Debate
That, for the purpose of any Act of the present session to provide for the establishment of a board to be known as the Voluntary Health Insurance Board, to make provision for the making and carrying out by that board of schemes of voluntary health insurance and to provide for matters connected with the matters aforesaid it is expedient to authorise:—
Mr. MacEntee: Can the Minister give the House any information as to what expenditure is visualised under the Money Resolution? It is usual for the Minister on occasions like this to indicate to the House what the expenditure under the Bill is anticipated to be.
Mr. T.F. O'Higgins: If the Deputy had read the Bill he would not have found it necessary to raise that question, because in Sections 16 and 17 of the Bill provision is made for two sums of £25,000 being advanced to the new board. The purpose of the Money Resolution is to authorise that expenditure, if necessary.
Mr. MacEntee: I take it then that this Bill which is being introduced with a flourish of trumpets, this Bill which has been held up to the public as representing a great advance in  enabling people of what we might describe as the lower middle income class to have facilities for medical treatment when they are suffering from diseases or physical disabilities which require surgical or medical treatment of a radical kind, will cost only £25,000.
“That, for the purpose of any Act of the present session to provide for the establishment of a board to be known as the Voluntary Health Insurance Board, to make provision for the making and carrying out by that board of schemes of voluntary health insurance and to provide for matters connected with the matters aforesaid it is expedient to authorise:—
Mr. MacEntee: I have read the Money Resolution to the House in order that the House may see that it is a wide and comprehensive Resolution under which I am quite entitled to discuss any provisions of the Bill which will lead to expenditure which, in the opinion of the House, is either insufficient or unjustifiable.
“An Act to provide for the establishment of a board to be known as the Voluntary Health Insurance Board, to make provision for the making and carrying out by that board of schemes of voluntary health  insurance and to provide for matters connected with the matters aforesaid.”
The whole purpose of this Bill is to save the face of the Government. The whole purpose of this Bill is to enable the Government to refuse to implement the provisions contained in the Health Acts which are on the Statute Book of this State and to enable them by such refusal to deprive the people who bear the heaviest share of the expenses which are incurred under the Health Acts of the rights to receive proper medical treatment when their circumstances so require. This is the Bill which is supposed to give effect to the principle of insurance in relation to medical services. This is the Bill which is supposed to appeal to the white collar worker. This is the Bill which is supposed to provide for the needs of the farmer whose valuation happens to be £51 instead of £50.
Mr. M.J. O'Higgins: On a point of order. I understand, if Deputy MacEntee was correct in his reading of the Rules and Standing Orders of this House, that Deputy MacEntee was entitled to say whether the amount of money being provided was sufficient or was too much. I would suggest  that Deputy MacEntee answers the question he posed himself.
“That, for the purpose of any Act of the present session to provide for the establishment of a board to be known as the Voluntary Health Insurance Board, to make provision for the making and carrying out by that board of schemes of voluntary health insurance and to provide for matters connected with the matters aforesaid it is expendient to authorise:—
The purpose of this Bill, let us be quite clear, is to appear to provide treatment in certain cases and I am entitled to ask the House whether, having regard to the nature of the cases for which the treatment is to be provided, the amount to be provided under the Bill is either too much or too little and I cannot discuss that question in any rational way unless I am permitted to say to the House that this Bill is a Bill which, in wide and general terms—I am not going into the matter in any detail—is to provide medical treatment for a family whose breadwinner happens to have an income of £605 instead of £600. That is the purpose of the Bill.
Mr. MacEntee: The purpose of this Bill is to fill the gap which is being deliberately created by the present Government in the health services which are being provided for the people. I say that the money to fill that gap is insufficient. I say that it is contemptuous.
Mr. MacEntee: I say it is contemptuous. I say it is a gesture of contempt —put it that way—a gesture of contempt extended to the lower middle income groups, in the circumstances of to-day, when prices are soaring and soaring, when medical expenses and the expenses of hospital treatment are going higher and higher, to state that, if this scheme ever comes into operation, if it is availed of in any general way, the sole cost to the State will be £25,000.
Mr. MacEntee: The man with £605 a year may be suffering from cancer; he may be suffering from a surgical condition which necessitates a radical operation—and there are thousands of people in this country in these circumstances.
Mr. MacEntee: The Minister may treat his responsibility as Minister for Health lightly; he may be in the pocket of the Irish Medical Association. But I am talking of the people who require surgical and medical treatment and I am saying that it is just a contemptible gesture; it is cocking a snook, as the saying is, at those who are sick and ailing in this country to say——
Mr. MacEntee: I am coming to the question whether, in respect of a Bill which proposes to set up an expensive body to do what the Minister and his advisers should do, the House is justified in spending £25,000, even in advancing £25,000, because this Bill—let us be quite frank about it—is merely another one of those face-saving subterfuges which the Government avails of whenever it is driven to extremes, whenever it finds itself in extremity of need, when it must find an excuse for failing to fulfil the promises which it gave to the people.
The purpose of this Bill is to set up an expensive board of directors with all the paraphernalia of an insurance company—actuaries, secretaries, typists, clerical officers, and so on, to do for the Government and the Minister what the Minister for Health and the Department of Health ought to be able to do for themselves. There are two actuaries, one in the Department of Health and one, I believe, is Secretary to the Department of Social Welfare.
Mr. MacEntee: What my colleagues have said about it has not any relevance in this debate. What is relevant here is why the House should be asked to provide an additional £25,000 to do the work that ought to be done by the Minister and his colleagues. I would agree that as far as this side of the  House is concerned, since the merits of the Bill are now in question——
Mr. MacEntee: Then perhaps the Parliamentary Secretary would withdraw from the Chamber and allow me to address the intelligent members of the House. We can accept this Bill in principle and we have accepted it in principle for this reason: if we did not accept this Bill then nothing would be done for this hapless class by the Minister for Health. Therefore, since anything is better than nothing, we have accepted it and we are even prepared because of the extremity of need——
Mr. MacEntee: I am not suggesting it but I do say that on other occasions Money Resolutions have been discussed at great length. However, I was saying that if this Bill were not accepted and if this money were not voted by the House then nothing would be done for the farmer whose valuation was £51 or over, or for the man whose income was £601 or over. His needs would go completely unprovided for.
Mr. MacEntee: The last Government brought in a Bill and the purpose of this Bill is to torpedo certain of the provisions of that Bill. I do not know whether I am at liberty to deal with this matter since Deputy Michael O'Higgins has raised it.
Mr. MacEntee: I am not over-conscientious but I am conscientious, and I am also very conscious of the fact that the Chair must be respected. I was coming to say that because there is no alternative to this Bill, that if we do not accept the implications of the Second Reading and provide the money, if it is not agreed that the Minister for Finance out of his generosity will lend £25,000 to a number of men who are going to be appointed as directors of this company, to pay the salaries of their officials, nothing will be done for the class to whom I have referred. In these circumstances, we do not seem to have any option except to agree to the  Money Resolution unless we are prepared to do what apparently the Minister would be prepared to do, that is to say, let these people who require to take out insurance against ill-health, die, in their need, because otherwise this Government will not provide for them.
Mr. T.F. O'Higgins: Listening to Deputy MacEntee, I find it very hard to know to whom exactly is he speaking and why exactly he is speaking. All the Members in this House know Deputy MacEntee's form. He is the political Peter Pan of Irish politics and he will break a lance at anything, but he generally tilts at windmills. However, I am a little bit concerned that people reading the account of Deputy MacEntee's outburst here might perhaps think that he was taken seriously even by his own Party, and for fear that people might think that, I propose to correct the impression that he might have created. In case Deputy MacEntee does not know, his own Party are delighted with this Bill and have welcomed it in this House. I have here the report of the Second Reading. I notice that Deputy Dr. Hillery at column 715, Volume 160 of the Official Debates of 7th November, 1956, said:—
“I welcome this Bill and the establishment of a board for voluntary health insurance. I sincerely hope that the work of that board will be successful, for two reasons. The scheme is calculated to give coverage against illness to that part of our population which at present is not very well, or much better able, to meet these accident...”
I do not know to whom he has been talking since, but I propose to put a  few questions to Deputy MacEntee now because he is obviously a very worried man. If this Bill were not introduced, would Deputy MacEntee like to tell us what should be done? Does he believe in State medicine the same as his running partner in SouthEast Dublin believes in it? Is he as great a Socialist as his stablemate in that constituency?
Mr. T.F. O'Higgins: The Deputy, as I was saying, posed the question here as to what would happen if this Bill were not introduced. He is obviously concerned because the conservative people in his own constituency are worried about his running partner in that constituency, who declares himself to be a Socialist and who believes in State medicine.
Mr. T.F. O'Higgins: Deputy MacEntee thought fit to make some suggestions here to the effect that I, as Minister responsible in the Government of which I am a member, have no concern for those who need health services, for those who may be sick, for those who may require hospitalisation. I do not think it is extravagant for me to claim that in the last two and a half years I have done far more than Deputy MacEntee or any of his colleagues in providing effective health services. I was left a mess by Deputy MacEntee and his colleagues, who were obviously only concerned with the political aspect of health. I have had the job of clearing up the mess. I think I have successfully done so.
Deputy MacEntee suggested that this Bill was designed as an alibi for not providing services under the 1953 Health Act. Apparently Deputy MacEntee does not realise that it is due to the work of this Government, and to my Department in particular, that the services under the Health Act of 1953 are fully in operation and they have been provided in a way in which they would never have been provided by Deputy MacEntee and his colleagues.
The purpose of this Bill is to provide for those who are not covered by the Health Act of 1953 and even for those who are covered by that Act but who prefer to pay their own way. Deputy MacEntee regards that as something reprehensible. I do not. I applaud anyone who is prepared to stand on his own feet, meet his own costs and pay his own way. I do not think that is anything of which to be ashamed. Apparently Deputy MacEntee thinks that is something he can twist in order  to gain some political kudos for himself in his own constituency. He can work as hard as he likes on that, but I think most people, particularly the ratepayers in Deputy MacEntee's constituency, have some worries with regard to the present cost of health services. Yet, Deputy MacEntee suggests here that we are not providing enough. Does he want us to go further and increase the liability still further on the ratepayers and taxpayers in the provision of more and more expensive health services? Or does he merely think that what is done in England should be done here simply because it is done in England?
I commend this quotation from Deputy Seán Flanagan, a member of Deputy MacEntee's own Party, to Deputy MacEntee's attention. Speaking on this Bill, to which this Money Resolution is directed, Deputy Seán Flanagan said:—
“As far as I am concerned, I not merely welcome the Bill but the principle enshrined in it, and I regret it has not been extended and that the idea has not been used before this in regard to the health service and indeed, to some extent, in regard to social welfare. At least, at long last, we are putting through a scheme designed to benefit the people without going to the taxpayer's pocket.”
Now there is a Deputy of the Fianna Fáil Party. In the name of Heaven, is it possible for that Party to make up its mind on anything? They do not know what their policy is in relation to this, or anything else, and they come in here wasting the time of this House, talking with diverse tongues and expressing different opinions. I would suggest to Deputy MacEntee that he should not intervene in debates here until he at least knows what his own Party thinks of the matter under discussion and particularly not until he has read the Bill upon which he seeks to talk.
Mr. MacEntee: The Minister has referred to the Health Act of 1953. He has quoted from the Second Reading debate on this Bill. I would like if he would go back and read what he and  his colleagues said about the Health Act of 1953.
Mr. T.F. O'Higgins: Is this in order? Will the Deputy kindly resume his seat? I am on a point of order. Is it in order for Deputy MacEntee to seek now to have a discussion in relation to legislation passed in 1953 on a Money Resolution directed to cover the expenses of a Voluntary Health Insurance Bill?
An Leas-Cheann Comhairle: A discussion on the Health Act of 1953 is not relevant on the Money Resolution before the House. I understood Deputy MacEntee was making a passing reference to the Health Act and I allowed him to continue.
Mr. MacEntee: The Minister has boasted in this debate that he has been spending more money under the 1953 Act than was ever spent before. That is what the Minister has said. He said that the reason why I have raised this question on this Money Resolution is because my constituents, the people whom I represent, were becoming alarmed as ratepayers and, therefore, I had addressed myself to this question. Does the Minister remember what he said? I remember it.
Mr. MacEntee: I am not discussing  the 1953 Health Act on this Money Resolution. What I am discussing is what the Minister has just said in this House. He has said that he has given full effect to the provisions of the 1953 Act, with one exception, and a very marked exception, for this Bill is designed to carry on——
Mr. MacEntee: ——is this that we are being asked to pay out £25,000, let me recall, for the purpose of providing the salaries of the chairman and managing director and members of the board for this Voluntary Health Insurance Company which is to be set up. We are asked to vote £25,000 to pay the salaries of all their staffs, and this Bill contains provision for the superannuation of that staff——
Mr. MacEntee: The Minister for Health has a very expensive organisation behind him. The Department of Health costs this country a pretty penny. I have pointed out that there is at least one highly-paid actuary in this Department and I think that before the House is asked to vote this £25,000 the Minister should come here and tell the people what are the benefits likely to be under this voluntary health insurance scheme——
Mr. MacEntee: ——and what premiums will be collected? How many people does he think, having regard to the benefits which are to be granted and the premiums to be demanded, will wish to take advantage of the scheme?
Under this Money Resolution we are asked to advance £25,000 to the company and we are also asked to provide another £25,000 for the expenses of the Minister in administering this scheme. What is this money intended for? Can the Minister tell us that? What will be the salaries paid to the Chairman, Managing Director and other members of the Board of this Voluntary Insurance Company? Will this company engage the services of an actuary? Everybody knows that among the professions, that of an actuary is one of the highest paid. Everybody knows that an actuary in any substantial insurance company will have a salary running into four figures certainly, and in some cases, into five. Surely we are entitled to know from the Minister what this money is intended for and how this sum of £25,000 has been arrived at?
This Government with the usual disregard for the taxpayers' interest which has characterised it since it took office, comes here and asks us calmly to advance £25,000 for the purpose of setting up this company, and to provide the Minister with another £25,000, and the Minister has not given any information as to the basis on which these figures have been reached. Does the Minister know? Is it merely a sort of compromise between appearing to do a great deal, on the one hand, for the unfortunate middle class who have to provide for themselves and to whom this Bill is thrown as a sort of sop and, at the same time, saying to the people: “It is not going to cost you very much”?
Mr. MacEntee: The Deputy is a good judge of disgraceful expressions because he is the father of many of them. I say again why is it that the Minister has not come to this House and said: “Here is our voluntary insurance scheme to the public?” Why has he not done that? These are the old tactics of the Social Welfare Act of 1950 and 1951 over again. As soon as the public had seen what they were getting under the Bill and what they would have to pay for the benefits, then, of course, the
Mr. O'Sullivan: Deputy MacEntee has entered into this discussion on the  voluntary health insurance scheme having lost the opportunity of the Second Reading debate when many of his colleagues spoke, and are to be complimented on the character of their contributions at that time. It was clearly understood that the Party, for which Deputy MacEntee purports to speak to-day, accepted the provisions of this Bill.
Mr. O'Sullivan: They welcomed it, yet here to-day we have listened to a harangue sustained we know for a particular purpose. We have listened to it since the discussion started and we cannot find out what objections Deputy MacEntee really has to this scheme. At one moment, he said there was not sufficient money in the Money Resolution to cater for the purposes of the Bill and he wants to look after the rights of his constituents. At another moment, as he has just said, he tells us that the Bill is intended to provide well-paid jobs for our pals or for the pals of the Minister.
Let us see who, in the opinion of Deputy MacEntee, are the people who will get these well-paid jobs. They are the members of the National Farmers' Association, the members of Macra na Feirme and the members of Muintir na Tíre——
Mr. MacEntee: On a point of order. Would you, Sir, be good enough to ask the Deputy to show us where the members of the Beet Growers' Association, of the N.F.A., Macra na Feirme or any of other such associations are mentioned in this Bill?
Mr. O'Sullivan: I cite these bodies because Deputy MacEntee has a habit in these days of describing these people in company with whatever citizens will be charged with the administration of this scheme as being “well-paid pals” of the members of this Government. This is a repetition of allegations made on another occasion which he is again introducing here in reference to the people who will administer the voluntary health insurance scheme. On the one hand, we have had criticism from him on the basis that there is not sufficient money being voted and on the other hand we have been criticised by him because he thinks there should be more money there because of the work involved.
If he had taken the trouble to read the Bill in the first place, he would find that the provision is negligible in relation to the benefits which will accrue to those sections of the community that were left out of the provisions of the Health Act that his Party introduced. It is time that such incentives were provided for the community as Deputy Seán Flanagan and others said during the Second Stage. It is time that the people were given a chance to look after themselves.
Mr. MacEntee: Nobody is objecting to this Government providing incentives to any section of the community. The difficulty is that, instead of providing incentives, the Government are giving what one might call disincentives. The Government are keeping the people from earning money; they are keeping the people from maintaining  themselves by honest labour. It is just a mockery for the Parliamentary Secretary to talk about incentives in connection with this Bill.
This Bill provides for the setting up of a board; there is nothing in it referring to the National Farmers' Association, to the Beet Growers' Association, to Macra na Feirme or to any other body associated with agriculture or industry. All it proposes is to provide £25,000 in order that the board may be in a position to spend that amount of money. On what? On providing and carrying out a scheme of voluntary health insurance.
Why should not the Department of Health, with all the expert advice at its disposal in relation to insurance, in relation to medical matters, in relation to administration matters, make the scheme to which Section 4 of the Bill refers? Could the Parliamentary Secretary or the Minister answer that? The reason, of course, why the Department of Health could not make the scheme is set out in Section 5. Section 5 provides that the board consist of a chairman and a managing director and such number of other members as the Minister may, from time to time, determine.
Mr. T.F. O'Higgins: On a point of order, surely if the Deputy purports to quote from a section in a Bill he should read the section correctly. What the Deputy read out as a quotation is in fact not in the Bill.
Mr. MacEntee: Unless, of course, it is going to be a Pooh-Bah board, with a chairman and managing director and the other three rolled into one. The House is asked to be grateful to the Minister because he proposes to make five jobs instead of six. After all, what will the board do?
Mr. MacEntee: It is going to make a scheme of voluntary health insurance. I am suggesting to the House that that is work which the Minister should do in his own Department. They have in the Department more knowledge; they have sources of information available to them in the Central Statistics Office and from their own statistical returns. All this knowledge is fortified and backed up by the experience the Department of Health have gained over the past five or six years. I am putting this question simply to the House and to the country: why is it that the Department of Health have not made the scheme themselves? Why has the Minister not come to the Dáil with a Bill, if you like, to set up a voluntary health insurance body to administer a particular and definite scheme?
Is not the main reason why this £25,000 is required because the Minister has not done that? That again is a case of passing the buck, as the Americans say. Some other body will have the duty imposed upon them—for a consideration, of course—and they will have to carry the responsibility of eventually saying to the country: “We are not able to put before you a scheme of voluntary health insurance which would be generally accepted”. Is that not the position?
Mr. MacEntee: If not, why would not the Minister come in and say: “Here are the benefits: so many weeks of hospital treatment, so much of a  contribution towards surgical expenses and here, on the other hand, are the premiums which you will have to pay in order to enjoy those benefits if you happen to require them”. Is that not the whole reason the Bill is brought in in its present form; is that not why we are asked to advance this £25,000? If we do advance the money—as we will because we have got to show up——
Mr. MacEntee: ——the sham, what chance is there of having it repaid? Has the House considered that? There is not anything more certain, in my view, judging by the experiences of other voluntary insurance schemes, than that the board will come along and say they cannot repay the money. They will say: “We just have not got the spondulicks”. Therefore, what is now before the House in the guise of a loan will ultimately turn out to be a grant, and the Minister will say to the House and to his constituents: “We promised that, if you put us in power, we would produce a health scheme based upon the principle of voluntary insurance just as we told you, before you elected us in 1954, that we would reduce prices and create employment. We are terribly sorry but we set up this board and lent them £25,000 and they now say they greatly regret they are not able to repay the amount”.
The Minister will come along and he will have a great big basin in front of him. There will be a little attendant with a towel and the Minister will wash his hands in public and, like Pilate, he will say: “I am sorry, Gentlemen. I set up this board. I hand-picked this board as the Minister for Agriculture did in relation to the Greyhound Industry Committee. We are terribly sorry. They advised us this thing cannot be done and therefore we must ask you to release us from our promises.”
Mr. M.J. O'Higgins: ——what is his line on this Bill. I understood when he commenced speaking to the Money Resolution that the weight of his complaint was that the money which the Money Resolution sought to provide was insufficient——
Mr. M.J. O'Higgins: The entire weight of his argument at that stage, something under an hour ago, was that the money was insufficient, that it was an insult to the people to ask Dáil Eireann to give only £25,000 for a Voluntary Health Insurance Scheme. A few minutes ago Deputy MacEntee appeared to be making the case that there is something that has to be watched for in this Bill because we might not get the £25,000 back. I would like to ask Deputy MacEntee just what is his line on that. What is the whole idea of discussing this Money Resolution in the manner in which it has been approached by him? Deputy Bartley, Deputy Seán Flanagan, Deputy Dr. Hillery, Deputy Dr. Ryan, and others made worthwhile contributions to the discussion on the Voluntary Health Insurance Bill during the Second Reading. I would just like to remind Deputy MacEntee.
“We all agree with the Minister's opinion that some subvention is necessary in the early stages, and the Minister is taking steps to provide that it will be possible for him to give the board two sums, each of £25,000, if necessary. I do not think anybody will quarrel very much with that——”
“We are not discussing this question from this side of the House on the ground of principle. We feel anything that it is necessary to do for the health of the public should be done quickly by whatever means are most practicable. I think that was the attitude we adopted in relation to other legislation.”
The Minister has already quoted from Deputy Seán Flanagan's speech and I again commend that quotation to Deputy MacEntee. The leader of the Fianna Fáil Party, in relation to the discussion on this measure, was Deputy Dr. Ryan. Deputy Dr. Ryan had this to say, and again I would ask Deputy MacEntee to pay some attention to it. At column 670 of the same volume from which I have already quoted, Deputy Dr. Ryan, having referred to reading the report of the Advisory Body said he thought it strange that, without giving much by way of reason, they had recommended a scheme, and he went on:—
“As a matter of fact, in my dealings with the Irish Medical Association when I was Minister for Health and when they were pushing a voluntary health scheme at that time instead of the Health Bill, I offered to introduce the necessary legislation to enable them to carry on the health scheme side by side with the Health Bill when the Health Bill would go through the Oireachtas. That is why I am not opposing the Bill, but I have always had doubts as to whether it could be successful. I am only voicing my doubts now and warning the Minister not to go too far in the way of commitments and finances until we see whether this can be made successful or not.”
Mr. M.J. O'Higgins: I imagine that the Minister for Finance under the Fianna Fáil Government would have had some consultation with the then Minister for Health when the Minister for Health apparently offered to the Irish Medical Association to introduce a voluntary health scheme.
Mr. M.J. O'Higgins: I assume Deputy MacEntee was not here to listen to Deputy Dr. Ryan's contribution on the Second Reading, but I will suggest that it might be well worth his while reading it and getting some ideas with regard to it. I do not understand what Deputy MacEntee's point is in dealing with the Money Resolution in this way.
Mr. M.J. O'Higgins: I doubt if Deputy MacEntee would even have the support of his own Party in that  attitude. So far he has not had that support. No member of his own Party has supported the attitude he has taken up. I want to finish by again calling Deputy MacEntee's attention to the words of a member of his own Party when this Bill was being read for the second time. They are the words of Deputy Dr. Hillery at column 166 of the Volume from which I quoted previously. Concluding his Second Reading contribution to the discussion, Deputy Dr. Hillery said:
“We all wish this scheme well, but the Minister will have to take some steps to give it a continuous life. This is a very interesting experiment. It is a very essential step in our health services. In its principles, it is very suited to the needs of our people who have to meet unexpected contingencies of sickness, accidents and ill-health. The Minister must do his best to make it a success and that success will depend on its continued financing.”
In view of the remarks I have quoted and in view of the manner in which this Bill was received on all sides of the Dáil and by the public outside, I again want to express astonishment at Deputy MacEntee's approach to it here to-day.
Mr. Bartley: I have been quoted by the last Deputy but let me repeat the essential part of what I said. Deputy Michael O'Higgins has chosen to quote a certain part of what I said. The sentiments expressed by me in the quotation he gave here were a repetition of what had been said by other speakers on this side, and followed by other speakers on this side, that, in so far as the Minister was trying to induce people to provide against their own ill-health, his effort had the full backing and co-operation of the people on this side of the House——
Mr. Bartley: No. What Deputy Michael O'Higgins has not stated is that we expressed a very grave doubt as to whether the Minister was achieving the high ideal which we referred  to, and I think it is quite unfair and I think it is unwise for a new Minister coming in here with an important piece of legislation to abuse the goodwill which was offered to him in such full measure on the Second Reading——
Mr. Bartley: ——for any worthwhile or even plausible attempt to provide voluntary insurance against ill-health. The Minister will remember that we drew his attention to the fact that bureaucracy was plastered all over this measure, that you could not read a section or sub-section that did not refer to directors, managing directors, chairmen and boards.
Mr. Bartley: Yes. In relation to the money, it was suggested to the Minister that a sum of £50,000 would possibly finance a genuine scheme of voluntary health insurance. If the State is prepared to chance a total sum of £50,000, is it beyond the bounds of possibility that organisations which had been engaged on this type of insurance for a very long time could produce a scheme for the Minister and that, by removing the necessity for a board such as he now proposes, the Minister could in fact remove all the elements of State socialism with which he has surrounded this piece of legislation? The Minister has talked a great deal about State socialism and State medicine and he has produced a measure which gives the impression  that to the Minister it is more important to see that the State will have the controlling voice.
An Leas-Cheann Comhairle: Second Reading speeches are out of order on the Money Resolution and the Deputy should endeavour to confine his remarks to the purposes for which the Dáil is being asked to vote the money.
An Leas-Cheann Comhairle: That is why the Chair allowed certain latitude to Deputy Bartley, in order to give him an opportunity to reply to the statements  made by Deputy O'Higgins, but the Deputy should now come to the Money Resolution.
Mr. Bartley: All right, I will come to it. I have very little to say on it. I protest as much as I can against the Minister's change of front. He got the goodwill of this side of the House for his effort, no matter how lame it may have been, to produce a worthwhile scheme of voluntary insurance and we were willing to give him all the assistance of which we were capable.
Mr. T.F. O'Higgins: The Deputy is an expert on it. I want to say to Deputy Bartley that I appreciate very much, more than I can possibly say, the very remarkable, fine, public-spirited attitude of Deputy Bartley, Deputy Seán Flanagan, Deputy Dr. Ryan, Deputy Dr. Hillery and every Fianna Fáil Deputy who spoke on the Second Reading.
Mr. T.F. O'Higgins: It is relevant to important public business because Deputy MacEntee's efforts here at sabotage will not succeed in preventing the scheme coming. I was particularly conscious of the concluding words of Deputy Seán Flanagan in the Second Reading debate and I should like to repeat them because I think they represent the views of the Fianna Fáil Party.
Mr. Bartley: On a point of order. I was not allowed to proceed. Is this in order on the Money Resolution? Fair play is good sport. I want the Minister to submit himself to the extent that I did to the Rules of the House.
Mr. T.F. O'Higgins: I want to assure Deputy Bartley that I welcome the help offered by the Opposition in relation to this measure. There is the story of the fond father who saw his son in the Army out of step. We know who the little Johnnie who is out of step is.
Mr. T.F. O'Higgins: That is what I am doing, Sir, very carefully. I should like to remind Deputy Bartley and the House that Deputy Seán Flanagan has said that he welcomes this Bill, that he will do everything he can personally to help and that any effort he can make inside this House or outside it to extend the principle, he will always make it because he believes that we would be making a better country for ourselves by so doing. I would suggest to Deputy Seán Flanagan that he should take Deputy MacEntee outside, dip his head in a pail of cold water and he will be helping in getting some business done here.
Mr. S. Flanagan: There has been a great deal of discussion and I think the whole point of the discussion has been mistaken by the Government. We expressed agreement in principle with this Bill. Deputy MacEntee, speaking in my presence this afternoon, said several times that he also was in agreement with the Bill in principle. He also said—and I think it was quite relevant to the Money Resolution, just as I think the other discussion was irrelevant to it—that he thinks that we should not pay out £25,000 or any other sum of money until such time as a concrete scheme has been prepared which will carry the principle into effect, so that we will be able then to judge whether the principle enshrined in the Bill and the principle that we should like to see put into operation have in fact been carried out in the scheme as prepared. I think that is the point that Deputy Bartley made also. I know it is relevant to this particular motion. Deputy MacEntee feels that we should not pay out £25,000 or any other sum of money. Whether I agree or disagree with that point of view, or whether Deputy Bartley agrees with it or not, I submit is entirely irrelevant but it is a relevant point of view and one that Deputy MacEntee was entitled to make. It is not relevant to read the speeches made by myself and other people on Second Reading, in which we expressed our solid agreement with the principle of the Bill. I am not even going to express a view as to whether I agree or disagree with Deputy MacEntee.
Mr. S. Flanagan: But I can say this much, that he made the point that we do not have to buy a pig in a poke and that we are entitled to see the kind of scheme that is being put forward by the Government in pursuance of the principle enshrined in the Bill. It is a perfectly valid point and I do not have to agree or disagree with it, but I do have to say it is an intelligent one and seeing that this afternoon the Taoiseach started pouting because 16 Bills had gone through and the Opposition had not taken an intelligent interest in them, I would remind the House that whatever else Deputy MacEntee's point is, it is intelligent. Are we going to be accused of holding up the House because we make this point or are we going to be accused of making the business of the House collapse because we do not take an interest? Let the Government side have it one way or the other. They cannot have it both ways.
Mr. Finlay: It does seem to me that the matter about which Deputy Flanagan has been speaking is of some interest, that is, whether the money should be advanced until the nature of the scheme and the type of scheme has been considered. I think it must be quite manifest to anybody who has been at this debate which began about 4 o'clock that it was some time around 4.30 before Deputy MacEntee got around to reading the Bill. I assume he has not read the report of the Advisory Council or the Second Reading debate. Anybody who was here during the Second Reading debate or anyone who read the Advisory Council's report which was referred to extensively in the Second Reading debate should have very little doubt about what is the nature of the scheme as regards premium and benefits. In fact many of the details of the scheme as contained in the Advisory Council's report were canvassed here at some length and some of the Deputies opposite as well as the Deputies on this side actually expressed views on various aspects of the scheme.
 The House is not therefore being asked in any way to buy a pig in a poke. The House is not being asked to vote money for a scheme the nature and type of which is in any way hidden. It is hidden from anyone who did not have the time to spare to attend either the Second Reading or to consider this report. Anyone who had the time to spare, and fortunately many members of the Opposition had, knows the position in regard to the scheme. The House is not being asked to vote money for something in regard to which it has not a good knowledge as to its nature and extent.
Mr. MacEntee: One thing which distinguishes the members on the Government Benches is the assumption of omniscience of which we have just had an example from Deputy Finlay. He suggested I had not read this Bill. I read this Bill.
Mr. MacEntee: I studied it, very carefully and I came to my own conclusions as to what the purport of the Bill was. I could not come into this House on the Second Reading of the Bill and say I was opposed to the principle of voluntary health insurance. I have to address myself to the fact that my personal attitude towards this Bill has been in question by the Government. I said I could not come into this House on the Second Reading of the Bill and say I was opposed to the principle of voluntary health insurance.
Mr. MacEntee: These remarks are being hurled across the House by the Minister and it is very difficult to refrain from replying to them. Let me come back to Deputy Finlay. I was saying I could not come into this House on the Second Reading and oppose the Second Reading because I am not opposed to the principle of voluntary health insurance.
Mr. MacEntee: Let the Minister control himself. Let him offer it up for his political sins. I could not come into this House and oppose the Second Reading of this Bill. Neither, having regard to the facility with which the Minister can misrepresent that position, could I come in here and point out what were the obvious defects in this Bill. However, we are entitled on the Money Resolution, when we are being asked to vote money, to refer to the purposes for which that money is being voted, and I mentioned one of the purposes was to set up a board with directors and officers of all sorts to make a scheme which, let me repeat, ought to be made by the Minister and his advisers who cost the country quite a substantial sum.
 We are asked to advance money to a board over whom this House will have no control to do the work that the Minister ought to do for himself and for which the Minister ought to take responsibility and ought to stand over. One of the things behind this Bill and one of the objects of the Bill is to enable the Minister to evade responsibility for the fact that ultimately no scheme of voluntary health insurance that will be acceptable to the general body of the people who are supposed to avail of it, will be forthcoming. In that connection I referred to Section 4. I could not have referred to Section 4 if I had not studied that Bill before I came into the House. Similarly I referred to Section 5 and to sub-section (1) and I was subjected to the same sort of irresponsible interruptions to which I have been subjected over the last five or ten minutes when I have been speaking. I pointed out that the board which was going to be set up was to consist of five persons.
I was going on, if I had been permitted without interruption, to refer to Section 6, which proposes to give the Minister power to fix the terms and conditions of appointment and the remuneration of the members of the board, all to come out of the £25,000. Then I was going to turn to Section 15 which is a very important section of the Bill, a section to defray the cost of which some part of the £25,000 will no doubt be devoted.
“The board may, with the approval of the Minister, make a scheme ... for the provision of pensions or gratuities, or pensions and gratuities, for and in respect of such officers or servants of the board as it may think fit, and any scheme so made shall be carried out by the board.”
If the Minister, therefore, sets up his board of directors, and they have appointed all their friends and relations as officers of the board, and the board of directors proceeds to make a scheme and their efforts are found to be abortive and there is no real, tangible scheme forthcoming,  nevertheless the persons whom the board has appointed will be well provided for because the Minister may approve of pensions and gratuities in respect of these officers of the board.
Mr. MacEntee: We have asked the Minister to tell us what the £25,000 is for. When he was asked to do that, he did not answer. He took refuge in these unmannerly interruptions, these descriptions of me, of all persons, as a devotee of the principles of socialism. When the Minister was running around trying to set up a totalitarian system in this country, I opposed it.
Mr. MacEntee: The Minister has not done his job. He has not carried out the preparatory work which should precede the introduction of a measure of this kind. What the Minister is really annoyed at is that, on this Money Resolution, he is now being shown up. Instead of being able to come to this House and say: “Here are the purposes, (a), (b), (c), (d) and (e) for which we propose to advance the £25,000 and here is the reason why we have set up a board to draw up a voluntary health insurance scheme”— the Minister is responsible for his Department, and I have no doubt, if the Minister gave a direction to his Department, that a voluntary health  insurance scheme would be forthcoming—the Minister comes in here and says: “Here is the reason why I have not discharged my function as Minister for Health, here is the reason why I am not fulfilling the pledge I held out to the people in 1954 that, if they elected me, I would introduce a voluntary health insurance scheme.”
This Bill does not introduce any such scheme. No part of this £25,000 that we are asked to lend to this board is being devoted to the purpose of this scheme. That £25,000, let me repeat again, is being used in order to finance a certain number of individuals—not members of the public service and not people who are under the control of this House. Indeed, I doubt if, under this Bill, they will be under the control even of the Minister. That £25,000 is being used to finance a certain number of people to set out and implement an insurance scheme.
We are not opposing the idea of voluntary health insurance. Nothing that I said in my opening remarks and nothing that I am saying now can be interpreted as opposition towards the principle of voluntary health insurance or a voluntary health insurance scheme. What I am opposed to and what I am now exposing is the trick which the Minister is trying to play upon the people who supported him in 1954. There is no, let me repeat again, voluntary health insurance scheme being introduced by this Bill. All this Bill proposes to do is to set up a body to make such a scheme.
If the Minister were in earnest, if the Minister had considered this scheme, he would now come along and say to this House, in introducing this Bill: “Here are the benefits we propose to confer and here are the premiums that will have to be paid.” There is no use in the Minister trying to get out of the dilemma in which he finds himself by referring to anything which was published outside this House. So far as the House is concerned, it has nothing before it. If any private body of advisers which the Minister set up made certain suggestions to him, they are not in debate on this Bill because the Minister did not, in introducing this Bill, submit a  White Paper to the House setting out what his expectations were. The Minister has carefully avoided endorsing any recommendations or suggestions made to him by anybody. But he proposes to try to confuse the issue by referring to a document which was published elsewhere. We are not discussing that document here. We are discussing this Money Resolution in relation to proposals which the Minister has put before us. While the Minister, as a lawyer, may be adept at confusing issues, he will not get away with that here.
If he was really in earnest about this—let us be quite clear about it— he would not have brought in this Bill in this way. He would have come to certain conclusions first regarding any document which had been submitted to him by any body of advisers he had set up. He would have had a certain sense of responsibility. He would have been able to tell us he had considered such and such proposals. He would have been able to tell us that, in his view, these proposals were practicable, these proposals would be acceptable to the people. But the Minister has not chosen to do that. The Minister has not circulated to the members of this House any document which received publication elsewhere. No Deputy has received from the Minister—certainly I have not received it— any report.
Mr. T.F. O'Higgins: May I just intervene? That statement seems to illustrate that the Deputy does not even open his post, because he got a copy of the Advisory Body's report in the same way as every other Deputy did.
Mr. MacEntee: I open my post and I read all the documents. I am putting it on fact. I put this to the Minister now: the Minister has not even chosen to stand upon the recommendations which were made to him. I have read these recommendations elsewhere. There is nothing in this Bill and no Schedule to this Bill showing the benefits which will be conferred. There is nothing showing the premiums which will have to be paid. There is no provision which says that, if the premiums  are not sufficient to meet the cost of the benefits under this scheme, the State will come in and defray the difference. There is nothing in this Bill which says that. The Minister admits that, so he is not standing on the proposals. What is he standing on? Is this another case of sending the fool further? Let me repeat we are not opposed to the principle of voluntary health insurance. We welcome it and we would like to see it put into operation but certainly so far as I am concerned even though I have not opposed the Second Reading of the Bill, I am not going to be a party to the trick which the Minister in relation to this particular Bill is trying to play, the trick of trying to send the fool further.
Mr. MacEntee: That is why I am criticising the attitude of the Minister in relation to the Bill and in particular on this Money Resolution. He has not yet given the House the basis upon which this sum of £25,000 has been arrived at. We do not know whether it will be sufficient; we do not know how much of it will be spent on the remuneration of the chairman and managing director and other members of the board. We do not know how much will be spent on the remuneration of the officers of the board and we do not know how much will be devoted to providing the officers of the board with pensions and gratuities. We do not know this because the Minister had not the courtesy when he was bringing in the Money Resolution to the House to disclose what his own mind was in relation to these matters. That is why we have had this prolonged debate this evening. The Taoiseach twitted us with having let 16 measures through, but there was not any one of them that offered any matter for discussions. Most of them were of the most trivial kind that ever occupied the time of the House, but this is, from the monetary point of view and the point of view of the public, an important measure but the Minister flung the Money Resolution  to the House as if he was asking us to vote him 25 pence instead of £25,000.
|Last Updated: 19/05/2011 22:41:46||Page of 59|