Prelude
Order of Business.
Estimates for Public Services 1959-60.
Committee on Finance. - Vote 64—Health (Resumed).
Committee on Finance. - Rates on Agricultural Land (Relief) Bill, 1959.—Second Stage.
Committee on Finance. - Rates on Agricultural Land (Relief) Act, 1959—Money Resolution.
Committee on Finance. - Rates on Agricultural Land (Relief) Act, 1959—Committee and Final Stages.
Committee on Finance. - Estimates for Public Services, 1959-60.
Committee on Finance. - Vote 64—Health (Resumed).
Ceisteanna—Questions. Oral Answers. - Ardnacrusha Generating Station.
Ceisteanna—Questions. Oral Answers. - Ballycroy (Mayo) Rural Electrification.
Ceisteanna—Questions. Oral Answers. - Compensation for Bovine Tuberculosis Reactors.
Ceisteanna—Questions. Oral Answers. - Kerry Land Reclamation.
Ceisteanna—Questions. Oral Answers. - Acquisition of Galway Estate.
Ceisteanna—Questions. Oral Answers. - Land Division in East Galway.
Ceisteanna—Questions. Oral Answers. - Development of Mayo Bog.
Ceisteanna—Questions. Oral Answers. - Kerry Turbary.
Ceisteanna—Questions. Oral Answers. - University Professors and Lecturers in Music.
Ceisteanna—Questions. Oral Answers. - Kerry Bridge Order.
Ceisteanna—Questions. Oral Answers. - Tralee Flooding.
Ceisteanna—Questions. Oral Answers. - Salaries of University Professors and Lecturers in Music.
Ceisteanna—Questions. Oral Answers. - Piped Water Supplies for Mayo Gaeltacht Areas.
Estimates for Public Services, 1959-60.
Committee on Finance. - Vote 64—Health (Resumed).
Committee on Finance. - Vote 65—Dundrum Asylum.
Committee on Finance. - Vote 8—Office of Public Works.
[271] Do chuaigh an Ceann Comhairle i goeannas ar 10.30 a.m.
Paidir. Prayer.An Tánaiste: Business, as set out in the Order Paper, will be taken as follows: No. 8 (Votes 64, 65, 8, 9 and 10) and then No. 9. If not already reached, it is proposed to interrupt business at 1 p.m. to take No. 9 and then to resume the order. Questions will be taken at 3 p.m. Next week, the House will sit on Tuesday and Wednesday only—on Wednesday, from 10.30 a.m. to 5 p.m.
Mr. Norton: Can the Minister indicate the position in regard to No. 11— the Apprenticeship Bill? When is it proposed to take that?
An Tánaiste: I should hope to be able to take it some time in the next two or three weeks.
Mr. Sweetman: The Tánaiste promised some time ago to let us have some information about No. 14— Solicitors (Amendment) Bill. Periodically, somebody asks about it.
An Tánaiste: I shall have that checked up.
Mr. Sweetman: Perhaps next week?
The Dáil, according to order, went into Committee on Finance and resumed consideration of Estimates for Public Services for the year ending 31st March, 1960.
Debate resumed on the following motion:—
[272] That the Estimate be referred back for reconsideration.—(Deputy Dillon.)
Mr. Moloney: When I moved to report progress last night, I was referring to the anomaly that exists in regard to the issue of medical cards. I was suggesting that there should be some form of appeal from the decision of the manager. The greatest volume of complaint in regard to the refusal of managers to issue health cards comes from people who are between the wage-earning category and the middle-income group. Such people are mostly small-holders, small shopkeepers and various categories of persons self-employed in a small way. No defined standard seems to be in operation in any health authority so that people may know whether or not they are entitled to a medical card.
In his introductory speech yesterday, the Minister told us that, in some local authority areas, the percentage of the population in receipt of medical cards is as high as 40 while, in other local authority areas, it is as low as 20. That will indicate the very wide gap that exists as between the position in one county and another. It demonstrates that there is no fixed pattern in regard to the allocation of medical cards.
I have found many cases of hardship where self-employed people were unable to get medical cards. As I could not make any progress with the local manager, I was obliged to take up the matter with the Minister and his Department. I avail of this opportunity to compliment the Minister and his officers on the efficient and courteous manner in which all such complaints from me were dealt with. Not alone were they dealt with expeditiously and efficiently but they were treated with the utmost sympathy.
I am glad that, in quite a number of cases, even though I had not the ordinary machinery of appeal, the representations the Minister saw fit to make in respect of the cases I brought to his notice resulted in rectifying the position. In quite a number of instances, the Minister actually relieved [273] great hardship. When hardship does exist, it is rather a pity that Deputies who are members of county councils, and members of local authorities, should have to make representations to the Department of Health. Protracted correspondence and all the other issues that arise on representations of this kind take up a good deal of the time of the Minister and his officials. I am aware that it would not be proper, when discussing the Estimate, to canvass the enactment of legislation to deal with this matter.
Within the scope of existing legislation, I feel, the Minister will have some way of setting up machinery whereby complaints such as those to which I have referred can be dealt with at some central point by an independent and competent officer of the Department. There is a precedent for such a course, in cases where an argument arises between the applicant for medical service and the local authority with regard to the applicant's return of income. I am in a position to know that there is provision made whereby such an issue can be referred to an appeals officer and can be decided by that officer. The purpose that an appeal can serve in every instance is very important. Not alone would it relieve local representatives, whether Deputies or councillors, of quite an amount of work and worry, but it would satisfy the aggrieved party that their case had received a hearing at the highest possible level and that whatever decision was reached eventually was, from the general point of view, fair and reasonable under the circumstances.
Mr. Moher: They do not all agree.
Mr. Moloney: In most cases nowadays I find that people who have recourse to appeals in other fields and have the opportunity of having their case considered at official level are usually satisfied. If it is done by an impartial body, the decision is usually reasonable and just in the circumstances. I shall leave that point as there is no need to labour it further.
Coming now to the Health and Mental Treatment Act passed last year, [274] I am glad that the Minister was able to state in his report that that Act came into operation very smoothly and did not cause any diminution in the standard of services already in operation. My experience as a public representative is that since that Act came into operation a good deal of the complaints hitherto experienced from borderline cases seemed to disappear. It widened the scope in regard to income and generally enlarged the particular category of persons who would be entitled to treatment in the future. As I said, those borderline cases have been agitating for a considerable time for better facilities and the Act met that position and should settle it for many years. It is satisfactory to note that the various sources, hospitals, doctors and other agencies, which were in a position to co-operate did so, and did so wholeheartedly, because otherwise I am sure the transition period would have been difficult.
The Minister also referred to the many complaints that his Department received about the operation of the Health Act in various ways. He referred in particular to the type of person who was never satisfied and who always felt he was entitled to more than the law provided. Unfortunately in any scheme of this kind you will have people who become selfish and who are not prepared to be satisfied with their due. The attitude of most people towards the health services is reasonably co-operative. There are quite a number of people, however, who are not co-operative and who seem to think they are entitled to benefits to which they are not entitled.
The Minister referred to the fact that the local authorities were obliged to circulate pamphlets in connection with the various services provided by the Health Act. I have repeatedly complained, both in this House and at meetings of the local authority in my area, that these pamphlets were not publicised in the most effective manner. I take it that the same type of pamphlet is on issue to all the local authorities throughout the country. After the passing of the Health Act these pamphlets were prepared and a small supply was issued to each member of the health authorities. Unless [275] a member makes an application for more pamphlets he will get no further copies of them.
The only way these pamphlets could be distributed by the Health Authority members to the public was to hand a copy to a person who might come along with a problem on which he wanted information. I remember this matter being discussed on two occasions during consideration of our rates estimates in my county council. A number of members seemed to think that the newspapers should be availed of with a view to publicising the services referred to in these pamphlets. I rather feel, even at this late hour, that if the Minister were satisfied to instruct local authorities to give a more direct form of publicity to the various facilities provided under the Health Act to the different categories of the population, he would save his own Department, and also save members of the local authorities, and members of this House, a great deal of trouble.
We all find people coming to us telling us they are about to go into hospital and they endeavour to get confirmation that the treatment will be free because their valuation is under £50. My experience has been that it is an unpopular course to take to try to explain to them that the treatment will not be free because they are not prepared to listen to reason. They are rather inclined to confuse the treatment for certain specified diseases, which is free, with the treatment for ordinary diseases which is not free. It could be brought home forcibly to the relevant sections of the community, to most business people and particularly to farmers, that the best they can hope for is to find themselves in the middle income group, and whether they have a choice of a hospital, or whether a hospital is allocated to them by the local authorities, their liability comes under the middle income group rates. The Act has now been in operation for five or six years. It is time that those people should understand what they are entitled to under the scheme. We should not be finding ourselves at cross purposes in trying to get people to accept what exactly is their due.
[276] The Minister referred rather briefly to the provision of dental services and told the House that it was more or less the settled policy of the Department that priority in that connection should be given to the treatment of school children. We all accept that that i a very desirable service. There is however, a large volume of complaint in all rural districts, and in urban area as well, from adults in the lower in come group who are unable to ge dentures.
It is rather unfortunate that in some of these cases the persons concerned were influenced to have their teeth extracted a year or two after the passing of the Health Act because they then anticipated that free dentures would be supplied. To their disappointment, they discovered after a year or two that the dentures were not forthcoming because the financial position of the local authorities was rather precarious at that time. While the general financial position of the State differs radically from that of the local authorities, I am sorry to say that the local authority always seems to be in difficulties, and that is the position this year particularly, due to the tendency towards increased rates all over the country. The best the local authority appears to be able to do is to assign a very limited sum of money for the provision of dentures in the cases of persons on the T.B. list. A number of people wonder if such an arrangement was fair, because there are applicants for these services who are not on the T.B. list but are on other lists almost as serious from the health point of view.
Undoubtedly failure to provide dentures will eventually face the local authorities with increased expenditure in the matter of hospital maintenance charges. Therefore, I wonder if this item is not one in regard to which special steps should be taken. I was inclined to suggest to the Minister that, if possible, he should authorise the local authorities to raise a limited amount of money by way of loan to meet this liability. Loans for anything other than capital projects are certainly not to be commended, but when you examine the results that [277] would follow from failure to provide dentures, you find it would lead to an increased demand on hospitals already over-taxed. If something more definite were done to get over the deficiency in this matter of supplying dentures, it would be a step in the right direction and would pay dividends eventually.
The present congestion in hospitals is due to the fact that older people, mostly chronic invalids, are being kept in hospital for too long. Up to nine or ten years ago, aged people were looked after better than at present. When they became old it seemed then to be the ambition of their people that they should die in their own homes, but that situation has changed in recent times. Indeed the change has been very noticeable, and within the past 12 months, we have heard a few important persons in high position condemning the present arrangement whereby old people are encouraged to have recourse to institutional services for the purpose of getting rid of them. That is regrettable from many points of view. Apart from that it causes a lot of congestion in the local hospitals, even though such chronic patients are kept for only six weeks, but they overcome that difficulty by being discharged, going back to their homes and coming back to the hospital again in a couple of weeks. That is a matter the Minister might usefully examine to see if any rule can be introduced whereby the admission of that type of patient is controlled. Other patients requiring operative and other types of treatment should not be held up because of the congestion that problem creates.
I should like to make a few references to the Minister's statement yesterday in regard to the development and general running of the Voluntary Health Insurance Board. I have had some experience of dealing with the Board and I am happy to be able to tell the Minister that even though the Board is a very young organisation, it is working on very solid foundations. I was particularly impressed by the direct manner in which it is able to transact its business. An organisation has been set up in which little or no middlemen are [278] employed. In that way the Board has been able to give a very favourable rate of charge for cover to members of the public who elect to participate in the scheme. The Board has thus been able to manage its affairs at a very low ratio of expense. That is very important and it has been reflected in a very significant way by the fact that after less than two years of existence, the Board is in a position, due to very prudent and efficient management, to extend its benefits without extra charge. I am sure that development pleased the Minister very much and it certainly pleased those members of the public who supported the Board. It is very heartening to hear from the Minister's speech that the Board actually intends to have a further extension of benefits if their claims ratio is such that they will have a surplus to enable them do so.
The Board has settled over 2,500 claims in its two years of existence and during that period has disbursed a sum of £82,000. I think I would be correct in saying that in not more than a couple of cases of claims settlement was their any complaint, and in those few cases the complaints were trivial. There were one or two cases where people thought they were entitled to a higher rate of benefit, but when the matter was gone into fully, it was discovered that the Board had discharged its liabilities in accordance with the contract. The Board takes all reasonable steps when enrolling a member in that scheme to have the facts of family history brought to light in the right way. I should like to congratulate the Board on their policy in that regard. Once a person becomes enrolled in the scheme, he can know with absolute certainty that if and when a claim arises under the terms of the contract entered into, it will be honoured to the full. That is unlike what happens in certain other types of insurance where the person who thinks he is covered finds that it is subject to so many clauses that he is not covered at all.
I should like to join with other Deputies in congratulating the Board on the excellent results achieved in the short period it has been in operation. I would appeal to public representatives to help to extend the activities of [279] the Board by every means at their disposal. It is a very important service, which is exceptionally useful to the middle and higher income groups and, in certain cases, to persons in the lower income group who can manage to pay the premium.
As the Minister said, the premiums are fixed at a very reasonable level and do not amount to more than the cost of a few cigarettes a day. It is very heartening that we now have working so successfully an organisation of this kind and I sincerely hope that the co-operation of the people will be behind the efforts of the Board in carrying out such important work.
The Minister referred to the question of hospital policy. I congratulate him very particularly on dealing so fully with this matter. He has told us that the question of allocating grants from the Hospital Trust Fund for the building of new hospitals is a matter that he has to control. I am rather impressed with this statement that he intends to honour the existing commitments and generally to allow the priority list which has been prepared to remain unaltered. The Minister is correct in adopting that attitude and, even though a number of applications might have to be deferred, which may result in some inconvenience, no other policy would be practicable.
For some years, there was a race between local authorities to get hospital projects carried out. That led to a great deal of irresponsible planning. It is now apparent that a number of hospitals that were erected during that period are not what they should be. The Minister should have the support of every Deputy and that support should be expressed at local council meetings when an application is being discussed and where disapproval might be expressed by some members of the local authority of the Minister's hard and fast attitude.
The Minister has told us that there can be no more lavish spending on the construction of hospitals. I am rather disappointed that the reports [280] on our hospitals which the Minister has received from visiting surgeons and others connected with hospitals in the United States of America are not more satisfactory than they have been. Considerable sums of money have been spent on our hospitals, particularly during the past 15 years, and we thought that they must be second to none. It would appear, however, that even though these vast sums of money went into the building and equipment of hospitals, we have not got the results that one would expect.
I am entirely in agreement with the Minister's statement that, for some time to come, it is probably a wise policy to use certain prefabricated components in the construction of hospitals, particularly in the construction of annexes and auxiliary buildings to existing hospitals. In a number of cases, hospitals which were built more than 30 years ago, are becoming unsuitable for modern requirements. There is also the possibility that certain diseases, the treatment of which is at present taxing hospitals fairly heavily, will be controlled eventually. That is the position with regard to T.B. Let us hope that that position may come to pass in the case of orthopaedic and cancer diseases and that eventually these hospitals will become superfluous.
The question would then arise as to the most suitable method of adapting such hospitals to other purposes. As the Minister has indicated, experience would not suggest that the modern hospitals which have been constructed in grandiose style will give us a type of hospital which is readily adaptable to other purposes. The Minister is wise in his decision that there should be a radical change in hospital design and that he will consider the erection of modern prefabricated accommodation which in many cases will fill the bill just as well as stone and mortar and concrete block buildings.
I have seen a number of prefabricated annexes attached to nursing homes and hospitals and I was greatly impressed. I was slow to believe up to then that a prefabricated structure could give the accommodation provided. At very moderate cost, that [281] type of building is good for 30 or 40 years which would be as long as would be required in the circumstances.
In connection with the staffing of certain voluntary hospitals, especially in Dublin, apparently, the arrangement is that when an appointment is to be made to the visiting staff, advertisements are circulated in the local papers inviting applications. There is a medical board, more or less permanently established, consisting of the senior physicians and surgeons attached to the hospital. In some cases, that board is the authority that receives the applications. Undoubtedly, the medical boards are the only competent body to assess the qualifications of candidates for such appointments.
It has been generally accepted that when medical boards, having examined the qualifications of applicants, make their recommendations, such recommendations are accepted by the governing authorities, whether religious orders or lay persons. In recent times, however, particularly within the past 12 months, the situation has not been satisfactory, especially in Dublin. It has come to notice that a couple of cases recommended by the medical board have been ignored. In one of these cases, I am reliably informed that an applicant who was not rated very high on the final list was appointed by the board of governors, even though the Medical Board was set up to assess the qualifications of the applicants recommended.
That is something which, in my opinion, no Minister could stand for. Moreover, since the Minister has been so liberal and considerate with the voluntary hospitals in meeting their deficits from the Hospitals Trust Fund, surely he ought have a say in the policy of making appointments of medical staff. I should imagine that a matter of this kind is one that should come to the Minister's notice and it is for that reason that I bring it now to his notice. The selection board in these cases was quite disappointed. In fact, in one particular hospital, my information is that the board which heretofore dealt with appointments of this nature is inclined not to act any more. The reason for [282] the hospital governing authorities in these cases ignoring the board is that they wanted to appoint some person, undoubtedly qualified, but not as highly qualified as the board found from investigation of the other applicants' qualifications. The person concerned was what is known as “well-in” with some members of the management committee.
If the management committee want to get a particular person appointed to these positions, they should be quite frank about it. Let them appoint the person straight out and not inconvenience the other applicants who are looking for a job and who have to go to the trouble of putting in their applications and submitting themselves for interview. I am glad to have this opportunity of bringing this matter to the notice of the Minister. I should be glad, if he has not already done so—the matter may have come to his notice from other sources—if the Minister would allow an inquiry into it and see that justice is done so far as it is in his power to do so in the matter of these appointments in future.
Mr. Russell: First of all, I think I might say that the impact which the Minister's speech made on me personally is the fact that, whether we like to admit it or not, we cannot at present afford in this country, apparently, the type of comprehensive health service that we would all in this House wish, I think, to see available to our people. That being so, we must, of necessity, decide what priority we shall give and what type of service we shall allow in strict order of their necessity to the individuals concerned. In other words, I think, as the Minister suggested in his statement, we should be prepared to face the fact realistically that to spend all the money that might be required on a certain service might do a disservice to another and possibly quite as important a section of our health services.
We have to some degree reached the position where, having exhausted the Hospitals Sweepstake Fund and being in the situation that the Exchequer is unable to pay into the health services [283] fund, we must of necessity spend what we have in the best possible manner. It is unfortunate that we have reached this situation at a time when there are certain services crying out for financial assistance. Several of those were mentioned during the discussion last night.
The question of mental defectives is one to which every Deputy who spoke referred. It is a matter on which I should like to add my voice also. There is no doubt that the position, generally speaking, of mental hospitals throughout the country is unsatisfactory, to put it mildly. The position with regard to the availability of accommodation for treatment facilities for child mental defectives is deplorable at the present time. I referred to that fact last year when speaking on this Estimate and, I think, the previous year. A number of other Deputies referred to it also. It is a fact that the number of beds available for these unfortunate children at the present time is completely inadequate to cope with the demand.
I am sure there is no Deputy who does not know of a number of cases where a family has the tragic situation of a small child, mentally retarded, living amongst other children and causing deep, distress to the parents at home. I hope that, when the Minister is deciding on the priority to give to the funds available to his Department, he will put very high on his list the question of mentally retarded children.
In the course of his review, the Minister referred to the work being done by voluntary rehabilitation societies. I do not think he laid particular emphasis on the good work being done by the societies. He did say that some of them secure a State subvention for the work they carried out. I think I am correct in saying that the amount of State subvention in these cases is a very modest one compared with the subventions paid to other sections of our health services. I should like to avail of this opportunity to pay a tribute to the various bodies that have undertaken this type of work in its various phases in this country.
[284] The Minister devoted quite a substantial part of his speech to the question of the operation of the health services and to various complaints that have reached his Department. Naturally, the question of medical cards is one with which any public representative, be he a Dáil Deputy or a county or city councillor, comes very much in touch. There is no doubt that there is generally over the various health areas a very great variation in the interpretation of who is and who is not entitled to a medical card.
I think it is quite understandable that a county or city manager, being a human being, must, of necessity, do the best he can and give his interpretation in the light of the facts put before him. That must again give rise to various interpretations because every city and county manager will not assess a person's entitlement on the same basis. He may go as near as he reasonably can but we are bound to have these variations, not only from area to area but actually within individual cases in each area. That is what is happening. From my own experience, I am satisfied that there is substance in the complaints that people not entitled to medical cards will get them, whilst those entitled are not in some cases being treated as fairly as they should be. I think the situation is bound to continue as long as we have this—what I might describe as—half-way house State medicine. We are bound to have these anomalies until we can afford an all-embracing comprehensive health service.
The Minister said also that complaints in regard to dental services were reaching his Department. I feel that it is again a question of priority. If we cannot afford to give free service to everybody who is unable to pay for it, it is only right that we should lay emphasis on prevention rather than cure and, to my mind, prevention of decay of teeth in the child should come first. From my own experience I know very good work has been done through the school medical service in regard to the preservation of teeth but, due to understaffing, children are not being examined as often as they should. The [285] whole business of preservation of teeth is not being tackled as it should be. I suggest that if the Minister's Department would investigate the schools medical services in the different areas as regards the operation of the dental service for school children, it would be well worth the trouble involved. The same applies to a lesser extent in the ophthalmic services.
I had rather hoped that when the Minister was introducing this Estimate he would have given the House a general review of the health services, their cost and operation and the value, not in £s. d. but from the point of view of return to the community, of the health services since the introduction of the 1953 Health Act. Complaints continue to arise out of the operation of that Act and one oft-repeated complaint is that the Act costs taxpayers and ratepayers considerably more than the modest estimate of—I think—2/- in the £ which the then Minister for Health, Deputy Dr. Ryan, estimated for 1952-53. In most health areas, I think it is a fact that the cost to the ratepayers for the services introduced by the 1953 Act is two or three times the estimate of five or six years ago. I think nobody at that time seriously believed that estimate to be realistic because the cost of health services and everything else is going up continually. Some allowance must be made for the fact that costs in 1952-53 and costs to-day are very much at variance but, having said that, it still strikes me that the estimate then made was very inaccurate and this has been borne out by our experience.
The Minister referred at some length to the charge by hospitals of what was intended to be a maximum figure of 10/- per day. Like medical cards, that charge is a matter about which public representatives are frequently approached. Another aspect of that charge is that in a number of cases the hospitals have difficulty in collecting the 10/- or less per day from the patient. In theory, the hospitals are entitled to levy a charge according to a patient's means of up to 10/- per day but I know of no means whereby the hospital authorities can compel the patient to pay the 10/- or less. Actually [286] I know that a number of hospitals have not collected it and when the time comes to submit the figures for their annual deficit the Minister's Department declines to accept the excuse that these charges cannot be collected from the patients concerned. This all stems from the fact that we have a half-way house system and we are bound to have these anomalies. I think we must put up with them and expect them until we have a more comprehensive health service.
Several Deputies, particularly Deputies T.F. O'Higgins and Dr. Browne, referred to the dispensary system. I agree with the sentiments expressed by them in regard to that system. I think we should regard the dispensary system as a dying one and any effort to maintain or continue it is, in my view, a step in the wrong direction. The view put forward, I think by Deputy O'Higgins, that we should visualise a system whereby any general practitioner should be encouraged and naturally rewarded for examining any patient should be put into effect, if necessary, gradually, over a number of years. Any person who is ill should have the right to see any doctor he chooses and confining him or her of necessity to the dispensary doctor is, to my mind, a violation of the rights of the individual. The mere fact that he cannot pay, or can only pay a certain amount, should not preclude him from going to any doctor he chooses or wants to regard as his family doctor. I think that in the future development of our health scheme we should aim at bringing into a comprehensive scheme the whole body of medical practitioners in the country. I am sure the Minister will agree with me in paying tribute to that body, particularly to the G.P.'s who have done trojan work in looking after their patients over the years.
I am sorry that this year again the Minister could not see his way to extend the free polio injections to all children within a specific age group or groups. I agree with the principle he enunciated when introducing the present scheme that those who can pay should pay and that those who can pay something should pay something [287] but I think in actual fact it is easier to introduce a free scheme for specific age groups than do what he has done —try to divide it into the three categories I have named. I do not think there would be anything fundamentally socially wrong in that.
I am sorry also that in his review of the general health services the Minister paid so little attention to what I would regard, and what he has described, as one of the greatest killers of our day, cancer. The Minister might have given us some indication of the plans of his Department to deal with cancer in future.
No Minister has to my knowledge over the past ten years referred to the work of a body with which I was associated as Chairman for some eight or nine years and from which I resigned, for reasons which I do not wish to discuss at this juncture, some two or three months ago. I refer to the Cancer Association of Ireland. Deputy T.F. O'Higgins made a reference to that body last night and, while I have no intention now of going into details on the subject he touched on, I should like to point out that if one wants a voluntary body to operate effectively in the interests of any particular health service, there are certain conditions that body must enjoy.
First, they must have the confidence of the Minister for Health of the day; secondly, adequate funds must be put at the disposal of the body; and thirdly, there must be a reasonable degree of independence to permit of the body carrying out the work for which it is set up. If the body does not enjoy these three fundamental conditions, it cannot operate effectively or carry out efficiently the task for which it has been established. As one associated with the Cancer Association over the past ten years, I can at least claim that that body did in fact carry out the work committed to its care, although it did not enjoy the three fundamental conditions to which I referred a moment ago.
When the Association was set up in 1950, there were something like 1,300 people or 1,500 people dying [288] every year from cancer—people who had received no treatment for the disease. There were something like 100 beds available to deal with the problem of cancer patients generally. There was an acute shortage of beds. There was also a shortage of expert medical personnel. Some seven or eight years later, the position was completely reversed; and two or three years ago, we had reached the stage where there was no shortage of bed accommodation and anyone requiring treatment for cancer could be taken into any of the three cancer hospitals without delay. In those hospitals, there were trained personnel in sufficient number to deal with every patient. The best facilities possible were available in all three. All that was done at a very modest cost to the State.
I touch on this because the Minister, quite rightly, stressed in his review the exceptionaly heavy cost to a small country like this of providing our present health services. If any Deputy wishes to examine the cost of providing a national cancer service, he will find that it represents only a very small proportion as compared with the cost of dealing with the tuberculosis problem over the same period of years. I like to think that one of the reasons the cost was so modest was that the Minister of the day entrusted the problem of providing this national service to a small voluntary body. It is along those lines the Minister might find the answer to some of his other problems now, and at a far lower cost as against trying to provide services directly through the agency of his Department.
There is one aspect of the cancer problem that has not so far been tackled at all. It is one to which, I think, the Minister should give his early attention. I refer to the question of providing facilities for those who are beyond cure. This is, of course, largely a welfare problem. It is one that has not so far got any serious attention from the Department of Health. In England, the problem has been tackled very largely again through the agency of voluntary bodies. They collect funds through public appeals. They provide [289] homes where trained personnel look after those who have passed beyond the point of treatment by any of the modern forms of anti-cancer research. I should like to see the problem tackled here on the same basis. From my own experience, I am satisfied that a voluntary body would be best fitted to cope with the problem, provided, as I pointed out previously, it has the help and encouragement of the Minister, sufficient independence to enable it to carry out its work efficiently, and sufficient funds. Those moneys might be found by the body itself through public appeals or, in whole or in part, from the Department of Health.
Another matter upon which the Minister touched last year, but about which nothing has been done since, is the question of education in regard to the treatment of cancer. As I mentioned, we now have all the necessary facilities here to treat cancer, but we still lag far behind other more advanced countries in the provision of a proper educational system to encourage people to avail of the facilities that have been provided. Last year, I suggested to the Minister that this might be handled, too, on a voluntary basis, by the Cancer Association itself, through some other body appointed for the purpose, or even through the Department. I am aware that certain steps were taken to deal with that aspect of the problem while I was associated with the Cancer Association. To my knowledge, nothing further has come of them. If I may quote Great Britain again, the position there is that they have found over a period of years that the public respond to a certain type of education and propaganda, provided these are well organised and directed.
I do not know what the Minister's future plans are in regard to cancer care and treatment. The task for which the Cancer Association of Ireland was set up is to a large extent complete. As I am not now associated with that body, I should like to take this opportunity of paying tribute to those dedicated men who over the past eight or nine years have bent all their efforts and their energies, given their time and taken the trouble, to providing cancer [290] sufferers here with the opportunity of securing treatment and alleviation of pain. To a small number in particular, I should like to pay a special tribute. I only wish we had more men prepared to devote their energies and their abilities to helping their fellow citizens so generously and so humanely.
The trouble about voluntary organisations is that, unless they are encouraged and helped, they will not carry out the work for which they are appointed. In some regards at least, I am afraid that considerations other than the welfare of the sufferers have entered into the dictates of the Minister and his Department in dealing with one particular body. I shall say no more on the subject of cancer. I have talked about it for a long time because, to me, anything I could do in that regard was a labour of love, and any small contribution I have been able to make towards the alleviation of suffering has been one that has given me no small degree of comfort.
I was glad to hear from the Minister that he has decided to continue with the scheme for renovating and reconstructing county homes. That is something which is very good news, particularly to Deputies living in the rural areas, where, unfortunately, the only hope for the aged person is to go into one of these county homes. I hope also that the name “county home” will be removed when carrying out the necessary reconstruction on the various buildings and that, for the future, the aim will be to provide some place where the old people can live the remainder of their days in a degree, at least, of comfort, in friendly and decent surroundings. It is, unfortunately, too much to hope that the old people can any longer be accommodated with their families. That would be the most desirable thing of all, but we must have regard to modern conditions, and we must appreciate that nowadays the younger people with families find it difficult enough to manage, without the additional worry and responsibility of the older people.
Several Deputies paid tribute to the voluntary health insurance scheme and [291] I should like to join them in that praise. The only thing that worries me is: Is the voluntary health insurance scheme the answer to the provision of health services for all those who cannot afford to provide the necessary finances from their own resources? I should like to think it is. I should like to see a great expansion of the whole idea of voluntary health insurance, but, having regard to the history of our health services over the years, and looking around to see what is being done in other countries, we must admit to grave doubts as to whether or not we will solve our difficulties through the voluntary system.
We might be well advised to have a closer look at what is happening in Great Britain and Northern Ireland to see whether some adaptation of their scheme might not suit our conditions. That might be worthwhile, but in saying that, I do not wish to be taken as advocating an all-out State medical service. In fact, if at an earlier stage, we had encouraged our people to adopt the voluntary system, we might have been able to solve our problems along those lines. We have now gone too far on the road to State medicine to turn back, and it seems to me the solution must be found on some basis of State-aided hospitalisation and State-aided medicine.
If we could conceive a scheme whereby hospitalisation, perhaps not in its entirety, but with certain exceptions, could be taken over by the State and operated either by a joint health authority or regional health authorities which would be given reasonable freedom of action and which would be subsidised either wholly or partly out of central funds—and the general practitioner should be kept outside this scheme and allowed freedom of action, while, at the same time, being put in a position to see all patients, irrespective of whether they were holders of medical cards or otherwise—we might be able to evolve something which would be economic in terms of pounds, shillings and pence and, at the same time, give a worthwhile service to the community as a whole.
[292] I know it is a very tangled and difficult question, but I am satisfied that the answer is not a complete all-out State medical service. I suggest to the Minister that it might be worthwhile having a look at our neighbours across the Channel. We copy them in so many matters that in this case it might be worthwhile having a look to see if we can take out of their scheme anything that would be capable of adaptation to our conditions.
In his address, the Minister referred in trenchant terms to the fact that he would not be cajoled—he almost suggested “codded”—into financing projects for the extension of existing hospitals or new hospitals, or for schemes for which he had not given prior sanction. He said he would keep rigidly to his decision in that regard. That is a very proper attitude, having regard to the limited funds at his disposal but the Minister might have given some indication as of this date, first of all of the commitments of the Hospital Trust Fund and, secondly, of exactly what hospitals are planned over the next five or ten years.
We should have an agreed scheme for the next five or ten years so that a change of Government or a change of Minister would not necessitate a change in the plans made and agreed on. The Minister would be doing a service to the House if he indicated what, in his view, should be the priority of the schemes to be tackled and if he gave an estimate of the cost of those schemes for the next, say, five years. That would tell the House exactly where we stand in regard to our resources for financing these schemes and what schemes the Minister felt should be tackled. It would also give an opportunity to the House to criticise his views and to put forward their own views as to what they regard as “first things first”.
I have criticised some parts of the Minister's address and I would like to end on a note of congratulation on the progress that has been achieved over the past 12 months, and over the previous years. In this House we may disagree on various aspects of what Ministers for Health do but, by and large, we do give them credit for the [293] best intentions. As I have said, we have not got the necessary funds to do everything we want to do, but we owe it to the Minister for Health to offer him constructive criticism and assure him that, in his efforts to alleviate suffering and pain, he will have the support of every side of the House.
Mr. T. Lynch: I was not here yesterday when the Minister moved the Vote but I read his speech and his review of the past year. I should like my contribution to take the form of a review of the position of our health services. The Health Act, the health services and the Department of Health seem to be a kind of scapegoat to be flogged about by everybody. It is said that the Health Act is a shame, that the amount of money squandered and wasted is a scandal. What I think is wrong is that even Deputies and, of course, ordinary people, do not visit the hospitals and have not seen the changes that were brought about in Irish hospitalisation during the past 10 or 15 years.
The best standard from which any Deputy can speak is his own experience. I have had experience of the Waterford County Hospital. It could be said it was the kind of place which provided a perfect setting for a Dickens picture if one were contemplated. We had the old Poor Law, the flag floors, the cobwebs, and even Bumble there, but that is all changed. At that time, people would not go there; they would rather die on the street than enter the hospital; but now the position in the Waterford County Hospital is that although there are an enormous number of beds, there is a waiting list to get in, because the services are so much better and everything is so much improved. There are skilful surgeons and famous specialists available for all the people who go there. These are the things that should be noted before we come down to counting the cost.
I have seen cases where children were deformed; now they have an equal chance with everybody else because of the fine specialist services provided for them. In reviewing the position, I would say to the Minister [294] that having got the specialists, these very fine doctors, a great load could be taken off their shoulders. They have to spend an enormous amount of time dealing with office work and making out returns. The drudgery of such duties should be taken away from them. All their time should be free to devote to their patients; the drudgery of making returns and the drudgery of office work should not be part of their duties. I make that suggestion to the Minister because I think it would improve the service.
I have heard Deputies speak in this House on health services and afterwards I have asked them outside when were they last in their local hospitals. I do not think they had ever gone to see the hospitals and to talk to the patients, but that is one way in which Deputies can serve both their constituencies and their country—by getting information at first hand and seeing, if things are not what they should be, that they are raised by way of Parliamentary Question and exercising their right of going to see the Minister about them. That is one of the faults. People complain about the cost and the ratepayers scream to high Heaven because they are always reminded of Deputy Doctor Ryan's unfortunate guarantee made to representatives of local authorities in Cork. I was there myself when he said the cost to local authorities would be about 2/- in the £ on the rates, but could not be any more than 2/6 in the £.
A considerable amount of money is being wasted, due to the fact that large numbers of people are very clever and obtained health benefit under the Health Act, though they had no right to it. Unfortunately there are people who would be qualified to come under the Act but they are not clever enough to qualify themselves until they get ill, and then they discover that they are victimised. I know this is a very big problem for the Minister, for his Department, and for his officials down the country, but it is a problem that will have to be taken up and dealt with in a very firm way.
Deputy Russell said that, of course, we could not retrace our steps. I often think if we could, if we did retrace our [295] steps and based these services on the system that existed before, the system under which people got tickets from local representatives and through the relieving officers, it would be an advantage. The local representatives were persons who were very closely in touch with the people and there was never any case brought to my notice, during that time when we had not great hospitals, of people being actually turned away. They asked for tickets and they got them. Sometimes they had to wait for a while, but they were not turned away; they were catered for.
The matter of our hospitals being overcrowded, and of old people being unloaded by their children into institutions at the expense of the taxpayers, is a great problem. We are great hypocrites in this country. We see people reputed to be great practising Christians but in these modern times, as it was said in the House, they find it hard to put up with their parents. They find it hard to support them and they are prepared, if they can, to unload them into mental hospitals even though they might not suffer from any mental ailment. They might be not just as well as they used to be, due to old age. I do not think the Minister can do a great deal about that so long as people are without conscience and so long as they are without any sentiment or love for their people.
I have seen many cases of that kind. I have seen people who have done very well for themselves and, having done so well, would not consider the old age pension any incentive to keep their father and mother at home. They pack them off to an institution, to a hospital or anywhere to get them out of their way. In many cases, where sons and daughters are not so well off, the old age pension is instrumental in keeping old people off the rolls of mental or other hospitals.
In relation to mentally retarded children, there are not sufficient beds or sufficient institutions to which to send the number of children who suffer in this way. However, there are voluntary organisations throughout the [296] country doing great work. There is one in my constituency which is doing an excellent job for these children. I wish to draw the Minister's attention to such institutions, which need very little money. There are rooms in Fanning's Institute, in Waterford, for a nominal sum. Those in charge have decorated the place practically at their own expense. They call for the children at their homes to bring them there and do wonderful work in looking after them. I would recommend this as a worthy organisation to the Minister if and when they apply for a small grant, and a small grant it would be.
I would urge again upon the Minister that he should review the position of the enormous number of people who are receiving full benefit and who are not entitled to it. I am sure he is aware of that and I want to tell him from this side of the House that if there is any assistance we can give him it will be forthcoming. This is important work and we have made great progress. We do not want to go on to full State medicine but we want to make this system as perfect as possible.
Mr. Healy: I welcome the Minister's attitude to the provision of homes for old people. This is a matter which has concerned a good many people in public life for some years. We have had to catch up on so many other things that perhaps we were not able to give this problem the attention it deserves. While realising the motives which prompted the last speaker to deplore the attitude of young people in putting their old folk into institutions and sometimes mental homes, it would be unfair completely to condemn the younger generation as if they were doing it without sound reason or without any reason.
I myself was rather critical a few years back in this regard but when I came to examine the problem closely I found in many cases people were at their wits' end as to what to do for their old folk. They had no room at home. For instance, in the cities where you had families of five or six children growing up and living in one room with their parents and some [297] bedridden old person having to occupy the room also, it was not a good thing either for the old person or for the father and mother trying to bring up five or six children. I am not conversant with the problem in the rural districts where the old person is kept at home when perhaps it would be much better for him to be in some institution. It is generally accepted that when a person reaches an advanced age he may become senile and be quite a problem.
I do not want to be taken in the least as defending any person who would condemn his aged relatives to any institution if it is possible to keep them at home. I am merely pointing out that it is not always possible to make things work as they should and to give due consideration to the rearing of a young family. Therefore, I welcome the Minister's approach on this question and the fact that thought and attention are to be given to the provision of homes for old people. I know of a case in my own constituency where because a building was available 180 old ladies were discharged as being mentally well, restored to their old age pension and other rights and are living very happily in a home at Heatherside. I do know that if such a provision were made for old men we could discharge at least 200 such patients from the Cork Mental Hospital and thus provide room and bed occupation for others who need it so badly.
The cost of the health services is something that worries all of us. Although there is not much sense in going back it seems to me, as a member of some hospital boards and who has some experience in this connection, that if those services had been implemented in easy stages, and in a mariner in which the hospital clerical staff, the nursing and medical staffs would have been prepared to meet this development, rather than by trying to do everything together, that change would have been accepted more easily by all concerned. The implementation of the legislation did involve a tremendous change in the mentality not only of the public but of the medical profession and the nursing staffs. In some cases the buildings were not adequate to deal with the extra number of [298] patients calling for attention.
I listened to some speakers last evening who criticised the Minister because he was being conservative with the Hospitals Trust Fund. As one who has given him as much trouble as any other member of the House in looking for money for buildings, I think his attitude is to be commended. The first step we should take is to see that some capital sum is provided that will in turn provide interest, sufficient money to keep existing buildings going from year to year, irrespective of the fate of the Hospitals Sweepstakes. We can give great credit to those who run the Hospitals Trust Fund. It has been very successful but it would be foolish to accept it as something that will go on for ever. While the going is good we should make provision for the accumulation of a capital sum the interest on which we could devote to the upkeep of existing buildings and institutions. Although, like most Deputies, I would find it irksome if that policy meant restriction on my urging for the provision of more money, I believe the Minister's outlook is right. I am only sorry it was not possible to adopt that policy before now and that we are not able to get from such a fund the moneys that would be required every year to meet the deficits of the voluntary hospitals and other such institutions.
There are, of course, all the time demands for more and better services and for bigger and better institutions. The Minister's statement last night that £17¾ million is being spent on health services to-day should make those who criticise and want more spent on everything, pause to consider where the money is to come from. Then these people will tell you that the £17¾ million could be spent in a much better fashion. It is easy to criticise when you have not to implement the scheme.
I do not think it is necessary to stress this now, from what I have heard and seen in the past 12 months, but it is a pity we cannot spend more on renovating, reconstructing and improving existing hospitals and buildings. The staff is already there and the service is already there. We would not [299] be committed to the same financial problem of building a completely new structure, staffing it and maintaining it over the years. As far as I can gather, that seems to be the Minister's viewpoint and I hope that when he has money to spend, he will spend it in such a fashion.
The Health Act is working more smoothly now than formerly. That is to be expected. There is one criticism which I have to make. Where a patient goes to an extern specialist department in a hospital, very often the patient is referred there by the house surgeon. I do not think that is a good method. It is hard to see how you can always avoid it. It seems to me that extern specialists are now in external departments of hospitals treating patients for minor injuries and abrasions which are really the concern of the casualty department. There, I think, is the key to the problem of the extern specialist. It is imperative that a voluntary hospital should have a casualty department to deal with accidents, minor cuts and abrasions. It is now the custom for the house surgeon to refer every such case to the extern department where the specialists are on a specialist basis and are treating it as a specialist service.
The position of the mental hospitals requires our immediate attention. For that type of patient, I fear we have not advanced in the past 20 years in the provision of accommodation as good as can be found elsewhere in the world. Our existing mental institutions are rather prison-like. We cannot change the structures immediately but a good deal could be done to help to brighten them up. It might be possible to have a change of attire for the inmates. The institutions could be painted and brightened up internally. Something should be done to brighten life for the people there. In this age of stress, many people go voluntarily for treatment in these institutions and expect to be there for only a short time. It seems a pity that there are not special quarters where such patients could be segregated from the, chronic type of mental patient. Something should be done in all mental institutions to help the casual patient.
[300] There is a shortage of hospital beds in Cork city. Without having to build a new institution, I feel something could be done if we had a place to house convalescents and private patients. It is a pity to see a hospital of 120 beds, some of which are occupied by chronics who are there from three months to three years. The institution was never intended for such type of patient who is taking up valuable accommodation. If that happens in two or three hospitals in a city, one can appreciate the difficulties in getting beds for patients who require immediate attention.
Our big difficulty is that we have not homes for the aged or not sufficient accommodation elsewhere for convalescents or chronics. In my constituency, it is a want which is very much felt. I quite realise that the Minister cannot wave a magic wand and remedy the position for all categories of people and patients overnight. I speak on these matters as they arise. It is necessary that the Minister and his Department should be aware of the feeling that exists in relation to the matter in different areas throughout the country.
I have little to say about the dental service, except to urge the Minister to spend as much money as possible on the care and preservation of children's teeth. That is the best investment he could have for the future. However meritorious it may be to give artificial dentures to people over 70 years of age, I think that, if a limited amount of money is available, it should be devoted to the preservation of the teeth of the younger generation. That will prove the best investment for the future.
I congratulate the Minister on what he has done in the past. I say that as one who has not got one per cent. of all he asked for during the past 12 months and who does not expect to get more than two per cent. in the next 12 months. His policy is conservative and good. I hope that, in the not too distant future, we shall have a sufficient capital sum invested to give a return in interest to provide for the deficits we shall meet in county hospitals and other institutions.
[301]Mr. Sherwin: Sometimes a victim is better able to express an opinion on the subject than the man who practises it. Earlier in my life, I was the victim of considerable ill-health. Because of that experience, I now express certain opinions. Otherwise, I have no medical experience.
I spent about 15 years of my life in and out of hospitals but, for the past 15 years, I have not been near a doctor. Like a good many doctors, I realise that most men should be their own doctors. I attribute a good deal of ill-health to ignorance on the part of the sufferer and to inattention to an affliction in its early stages. If people specialised in preventing illness or in following up the matter in the early stage, if they felt there was something wrong, most ailments would be overcome before they even got a grip and there would be no need for half the hospitals.
Since the foundation of the Irish Hospitals Trust, a considerable sum of money has been devoted to Irish hospitals. One would expect that at some stage there would be no need for further money for hospitals. The population is getting smaller, not larger. In view of all that has been spent, one would expect that the full effect of all our efforts would be that only half the number of people now suffering would in fact be suffering. Some people still seem to think we should continue to build hospitals. The Minister is right to cry a halt. Our aim should be to close some of the existing hospitals and to concentrate on the prevention of every ailment.
A real effort was made to come to grips with tuberculosis. The magnificent results of the effort at early diagnosis indicate that if the, same step were taken in relation to every other form of ill-health, we might need very few hospitals. People could then get treatment while they were on their feet, rather than wait until they became chronics, taking up beds which might urgently be required for persons suffering from an ailment through no fault of their own—but the practice, in the past, has been for our medical authorities to build hospitals and wait [302] for the people to come in to them, instead of trying to prevent people from becoming victims of ill-health. It seems to me that hospitals, doctors and chemists' shops have become such big business that they do not wish to reduce ill-health or eliminate it to the best of their ability.
It is rather like what Deputy Dr. Browne referred to last night when he referred to the Minister's effort in regard to reducing the smoking habit. Big business would not like it and the Minister for Finance would not like it. It would be just as if the Minister for Justice said that beer should be prohibited because it is the cause of 70 per cent. of all crime, as it is. The whole thing is a vicious circle. On this question of ill-health, we should specialise in prevention. The Health Act aimed at giving maximum treatment and help to people who could not afford to obtain treatment. By and large, it has succeeded but to some extent it has done some harm. The blue card, as we know it, the subject of so much controversy, was denied to workers with a number of children, but with only a worker's income. There was a means test and it is a well-known fact that a man with £8 a week and children is denied a blue card.
Follow this whole business of prevention and inability to pay to its logical conclusion. The average worker plans his week's expenses. I know that is so. You may have the woman of the house borrowing a loaf from her next-door neighbour to put the family over to the next Friday. I know the conditions of these people because they are consulting me every day because they are not able to pay their rent. I know their problems and I know that when their children get a disease, or even a knock, or a sprain, or something like that, they are not treated in the dispensaries. They were treated in the dispensaries but now they are not. They have not got the blue cards and they must go to a doctor. He wants 5/- or 7/6 for the visit. Then they have got to go to a chemist and he requires another 5/- or 7/6. For any simple ailment common to most children, the parent has to hand out 12/- or 15/- from the week's [303] wages. The parents cannot do that and they are compelled to let their children suffer on. How can a woman put her hand in her pocket to hand out 12/- or 15/- for a bad cold? She cannot do it and she must let the child suffer on.
During winter, when influenza is rampant, whole families are affected and each time the doctor comes, he requires another fee. As a result thousands of workers' children receive no treatment at all, for the simple reason that they have no blue cards. When we think in terms of prevention, here is a case where this Act is not preventing but is encouraging ailments. A child who gets a common cold might get pneumonia and might be absent from school for a much longer period than he would be if he had received early treatment. Let us take the case of a fall. My children are coming in every day with cut knees. If children's cuts receive immediate treatment, they can go to school the next day, but if they do not get treatment poison sets in and they spend several days going to dispensaries and hospitals. The whole aim should be immediate treatment and eventually you would have plenty beds available for those who require them.
It is an extraordinary thing that before the Health Act there were private dispensaries in this town. I knew of one such dispensary at Butt Bridge and any person could be examined and get a bottle of medicine, or whatever he required, for 2/6. If that could be done before the Health Act, how is it that it now costs 10/- to 15/- for the same treatment? Someone is making something out of it. I would ask the Minister to reconsider this whole question of the blue card, especially where dispensary treatment is concerned. Children, whether they have blue cards or not, should be able to get treatment from local dispensaries.
I do not think that would be so costly and it would overcome the problem which I mentioned of children being allowed to suffer because the parents cannot afford to pay for treatment. At least they should be [304] allowed the dispensary treatment which was available before the passing of the Health Act. As I said, in regard to tuberculosis a real effort was made and the results are now showing up. Most of the beds required previously can now be put to another use.
On the question of cancer, I am not an expert but I do take an interest in the matter. I tabled a motion on the matter at Dublin Corporation and I look at the matter from the point of view of early diagnosis. We are going to the trouble of trying to get people to go for early X-rays for tuberculosis and I often wonder why, at the same time, people are not examined for cancer. I understand that when you are examining for tuberculosis, where lung cancer exists it can be detected. Another form of cancer is stomach cancer, and there is also skin cancer, and I always thought that it would be a good idea that when people go in for a tuberculosis X-ray, the occasion should be availed of to examine them for skin cancer, which any expert could observe, or could at least suspect. The person could then be requested to come back again for another examination. One excuse which was given to me for not examining people for stomach cancer at the same time was that a more powerful apparatus was required than was required for tuberculosis or lung cancer.
It should be kept in mind that as science is making so many things smaller—we now have radios small enough to fit in your pocket, while at one time they were the size of trunks—a smaller apparatus for diagnosing stomach cancer may be produced. Cancer is one ailment which gives no hint of its presence until it is chronic. I have not had cancer but I know plenty of people who have had it and I know that it gives no warning. That is especially so of stomach cancer which is responsible for most deaths from this disease. The average person affected by stomach cancer believes that it is just indigestion. He treats himself for indigestion and will not admit to himself that it is cancer. Who wants to convince himself anyhow? He will not go near a hospital as he is afraid to hear what it is.
[305] As I said, we should take the opportunity of examining people thoroughly when they go in for T.B. examination purposes. In other words, we should do our share in trying to ensure that there is early diagnosis and treatment. It is possible that cancer can be cured, if discovered at the early stage. If it is discovered in one spot, it is possible to remove it by surgery, but after a time it roots out like a tree and a cure becomes impossible.
While in regard to most medical matters I profess ignorance, I happen to know a good deal personally about physical deformities and handicaps. I do not want to talk about myself but I did suffer physically. On that account, I went around everywhere to hospitals, even quacks, here and in New York. I saw thousands of people suffering from physical deformity. I looked at them and heard their stories. Others have not got that experience. They see one or two people suffering from physical handicaps, but I saw them en masse. It is disappointing that the medical profession have failed—just as they have failed to some extent in regard to cancer—on this question of physical deformity. It seems that the correction of physical deformities is not part of the curriculum of the average doctor. He knows about medicine and surgery, but not the correction of physical deformity. Many of them specialise in giving patients braces or similar devices, but that is not what I am referring to.
I am interested in the chiropractic treatment advocated by Sir Herbert Barker, a medical authority who specialised in the cure of deformities. At first, the medical profession tried to debar him but later they accepted him. Although some doctors specialise in this, most doctors are ignorant of it. Therefore, it is difficult for people suffering from physical deformity to know where to go. I shall give an example. As a result of an accident, or perhaps from bad habit, children throw the weight of their bodies on to one leg. The habit worsens as time goes on and results not only in hip disease but in curvature of the spine, over-development of one side of the body, causing the muscles to become like indiarubber and causing absolute [306] weakness on the opposite side of the body.
In most cases, it is not so apparent, but nevertheless a considerable number of people suffer from physical deformity due to lack of poise and balance in the body. These deformities could be corrected in childhood if school children were examined not only for T.B. but also to see if they were suffering from any physical deformity. It would be evident to an expert. Such children should be sent for special treatment, but the question then arises: who is to give the special treatment? As I said, it is not part of the training of nine out of ten doctors to give such treatment.
The Minister should examine the need for competent instructors in the schools, men who understand chiropractic treatment and who would give treatment in special cases. The average physical instructor treats the whole class on the same basis. It is like a teacher talking “high” to a mentally retarded child. The child does not know what the teacher is talking about. You have to sort them out. For normal children the average exercises are suitable, but the physically deformed child must get special treatment. With average treatment, he is likely to become worse, not better. In my experience, the condition of most of the deformed people we see on the streets —cripples, semi-cripples and so on— has developed over a long period from childhood. If children could get proper instruction in the schools, when it was seen they were obviously suffering from some physical defect, then we would have fewer cripples and handicapped persons in adult life.
Another matter I wish to deal with —I do not know whether it is a matter for the Minister's Department—comes back again to this question of early diagnosis and treatment. Many children have not got proper food. That is one of the reasons why the school meals scheme was introduced. I should like the Minister to know that many schools do not give school meals for no other reason than the fact that the headmaster does not want the trouble of cleaning up the breadcrumbs. The Minister should make it his business [307] to see that all children at national schools get milk.
An Leas-Cheann Comhairle: The question of school meals is one for another Estimate.
Mr. Sherwin: It has something to do with the health of the children. I shall let it go at that.
I would ask the Minister to try to get hospitals to open clinics for treatment after working hours. The average hospital opens in the morning and expects people to give up their work in order to attend. That is asking too much. Workers should be able to get treatment when they come out of their employment. People suffering from some ailment or another often put a visit on the long finger when they find they will lose a day's work.
The Minister mentioned that he proposes to reconstruct county homes and hospitals to accommodate old people and chronic invalids. I agree with that. All of us have had the experience, when canvassing during elections, of coming across old people in their homes, in bed or curled up and lonely over a fire. We pitied them. It was my experience when canvassing during the last election that some of the old people did not want me to leave because they had had no visitors for weeks. Thousands of our people are in that position. I do not know whether it is callousness or not, but the young people feel that if they visit their people once a week, it is enough. During the week, these old people are on their own. They are helpless. Some people think that it is a good thing to give those people a room of their own but it is like being in jail in solitary confinement. There is no one for them to speak to or to look after them. Their rooms could become verminous. Old people cannot make proper meals and are better in homes. At least, they will have company among their own. They can chat and talk and be looked after.
I visited Crooksling a few weeks ago as a member of the Dublin Board of Assistance and saw 200 old ladies there. They are far better off there than they [308] would be in homes of their own. They get the best treatment. More than anything else, they have company. Without company, they would become demented. That is what happens many old people living on their own—they become demented and talk to themselves. If their children do not want them in their own homes, the best place for old people is in a home where they will lead a normal life and get treatment as required.
I want again to emphasise that we should aim at early diagnosis and early treatment. If we do, we will need fewer hospitals. I feel that it is too much of a big business with many people and that it is nearly time to put half of them out.
Mr. Collins: After some few years of administration of the Health Act, it is time to have an analysis of its operation and a discussion of its flaws. My main object is to point out some flaws that have come to my notice in the operation of the Act, especially in connection with the issue of medical cards, blue cards or green cards, as they are called. The position is very peculiar, for this reason, that the full authority is centred in the county managers. There is no uniformity in the decisions as to the type of people who qualify. For instance, in County Limerick, the manager issues a card to a county council worker in receipt of £5 a week or an annual income of £260, while a small farmer whose valuation is 30/- or £2, who lives in the hill-lands and who through thrift, industry and hard work, has a little farm and a herd of six cows does not qualify. The average income from a cow would not be more than £40. That would be £240 gross income of the family but that type of farmer in County Limerick does not qualify for a card.
The parish where I reside adjoins County Kerry where, apparently, the means test is not so strictly applied. Day after day people who come from across the county border tell me that they have cards, whereas, if they were living on the Limerick side, they would definitely not have them. The system is wrong.
When Deputy O'Higgins was Minister [309] for Health, he visited County Limerick. On that occasion I tried to get from him an undertaking that there would be uniformity of administration for the country to eliminate discrepancies between counties. Too much power is vested in county managers. In a health area like Limerick, there is even variation in decisions. An application for a health card is sent to the local home assistance officer. It would surprise the Minister and those connected with the administration of the Health Act to learn of the discrepancies that occur even in one dispensary area. A great deal depends on the report of the home assistance officer. Even within the county unit, there is not uniformity of operation.
One of the greatest mistakes was to give to managers and deputy managers too much power under the Act and they can abuse it, especially in connection with hospital bills. The Act says that in the case of a person in the middle income group, a county manager may—it does not say he must —demand a payment of 10/- per day for treatment in a public ward in a hospital. In a necessitous case or where hardship is proved, he has the power to reduce or to remit the amount. There are other cases where there is too much discretionary power given to managers and deputy managers. They are human and there are instances where their leanings and affiliations have influenced their decisions, as I hope to prove in a particular case.
In regard to the administration of the disablement allowance, the means test is too rigid. While disabled persons are led to believe that they are entitled to an allowance of £1 a week, in many cases that is not happening. The family income is calculated in assessing the person's means.
The Department of Health should have immediate inspection of the dispensaries all over the country. I am speaking with knowledge and experience of dispensaries in County Limerick. While many dispensary doctors keep a stock of necessary medicines, in other dispensaries, there is nothing at all. Day after day, [310] people who require post-hospital treatment, who are in the lower income group, come to the dispensaries and find that the medicines they require are not available. Under the regulations, the chief health officer for a county cannot order medicine for a dispensary without the requisition of the dispensary doctor. Many dispensary doctors are careless in that respect. I should like the Minister to take note of that point.
Yesterday, Deputy Dillon more or less castigated the Department of Health in regard to the condition of mental hospitals. I should like Deputy Dillon to visit the Limerick District Mental Hospital, where he will see a beautiful job and marvellous progress made over the past five or six years. We have, under the mental hospital committee organisation, visiting committees. They visit that hospital and various other mental hospitals at least once a month and make recommendations. Deputy Dillon gave an overall picture of our mental hospitals as being dark and dreary institutions. We in Limerick have turned the Limerick mental hospital into one of the finest mental hospitals in the country to-day. That is due, in the first instance, to the R.M.S., our manager and, above all, to the committee of management who insisted upon making the necessary improvements and providing the necessary amenities for our patients.
I was delighted to read in the Minister's statement that he has given the green light to his Department to make arrangements for the proper accommodation and care of old people, many of whom are to be found in the mental hospitals and many of whom cannot be discharged owing to the fact that they cannot be nursed at home. On that account, many find their way into the county homes, with the result that you have overcrowding in the existing county homes. It may be possible, with a rationalisation of hospitals, that accommodation can be provided here and there for them. That could be very suitably provided in Limerick, if and when what the Minister has in mind is put into effect.
As a member of a visiting committee, I go to the various wards in [311] The Limerick Mental Hospital very often and meet the old people, a big percentage of whom suffer from senile decay. It would make one sad to see the way they are housed in a congested environment. One would like to see them in some institution where they could sit on a seat on a green lawn where they could meet and feel at the end of their days that they have been cared for. It does not follow that because you have a mental hospital, the aged people there are mentally ill. I met several aged people in the mental hospital who are there because their relatives never claimed them. I felt, from many conversations I had with them and from conversations I have had with the doctors, that the people are fully sane.
There is another matter which might, perhaps, be a very local one but, after all, it is the many local problems that go to make up the overall picture. There is the question of sanatoria. Unfortunately, the people in the County Limerick have to depend upon sanatorium accommodation which is not adequate. The majority of our patients have to go to Glanmire in County Cork. One can easily visualise what hardship it is to the relatives of patients who are miles and miles away from home.
I should like the Minister to take note of our situation in Limerick. In the City Home and Hospital, I think we have plenty of accommodation at the moment and if we could extend our sanatorium, we could give the people from County Limerick who have to be sent to Glanmire an opportunity of going there.
There is one further matter I should like to refer to the Minister. I had a case recently of a family, neighbours of mine, who came to me and asked me would I make representations on their behalf to have a hospital bill reduced or remitted. I made the necessary representations and I duly received a letter which I have in my possession and which I should like to hand to the Minister. I should like this matter pressed to the fullest extent. As a matter of fact, I would even go so far as to demand a sworn inquiry in the matter. I wrote this letter and in [312] 1958 I received a reply from the authorities in Limerick that the person in question was so well off financially that the council could not see its way either to reduce or remit the account.
I did not hear anything about the case until quite recently it was brought to my notice that the account was remitted altogether, as a result of representations made by another person or another member of the council. I took the matter up when I heard it. I did not think it could happen. I wrote on 7th May to the county secretary and asked him to let me know what the present position was in regard to the account issued from the Regional Hospital to Mrs. X.
On 6th May, I received the following letter from him:
I have your letter of the 6th May concerning the account issued from the Regional Hospital to Mrs. X concerning which you made representations last year and wish to inform you that the second account in the sum of £18 12s. Od. was cancelled last year.”
I replied to that letter on 8th May to the deputy manager as follows:
“In reply to yours of the 7th May, ref. No. 80/56, re account issued to Mrs. X for her maintenance in the Regional Hospital, I understood from a reply to my representations to you on Mrs. X's behalf, that following investigation of the circumstances of Mrs. X's family the Council would not feel justified in making any reduction in this case.
From information I have received I understand that the particular councillor made further representations on Mrs. X's behalf, subject to mine, and the account has been remitted by the sum of £18. 12.0.
As this has been the subject of much controversy in this locality I would ask you to have the matter clarified. I might add that I was not notified that any reduction was made in this case.”
On 9th May, I received the following letter from the deputy county manager:
“I have your letter of the 8th inst., concerning the account of Mrs. X from the Regional Hospital.
With reference to the first paragraph of your letter, on looking back on the correspondence I can find no letter stating that the Council would not be justified in reducing the account. The correspondence I have on it shows a number of letters from you regarding this account. One of the letters set out in an explanatory way the circumstances in which a second account was issued. The other letter indicated that we were looking into the question of the amount of the account of your representations.
When a decision was finally taken by the County Manager on the matter, the Staff Officer of the Hospital was informed to amend the account, and it is regretted that at that time, through an oversight, you were not notified.”
There is a case in point of that very apparent danger in the Health Act of giving all this authority to county managers and deputy county managers. What could happen to me in this case could happen to any man in respect of any other case. The whole thing, to my mind, is a result of too much power being vested in county managers. The whole operation of this matter should be directed and controlled in a more rigid and uniform way.
Progress reported; Committee to sit again.
Minister for Local Government (Mr. Blaney): I move that the Bill be now read a Second Time.
The purpose of this Bill is to extend the duration of the Rates on Agricultural Land (Relief) Act, 1953, for a further period of three years from the 1st April, 1959. In other words, the Bill proposes to continue the Agricultural Grant on its present basis for a further three years.
[314] The 1953 Act provided for the making by county councils of the following allowances by way of abatement of rates to occupiers of agricultural land holdings in rural areas:— (a) A primary allowance of three-fifths of the general rate in the £ on the land valuation up to £20; (b) an employment allowance of £17 for each adult workman at work on the holding during the whole of the preceding calendar year, subject to the limitation that the total of the employment allowance shall not exceed the produce of the general rate in the £ on the valuation over £20.
The 1953 Act applied to the financial years 1953/54 to 1955/56. The Rates on Agricultural Land (Relief) Act, 1956, continued the allowances on the basis provided for in the 1953 Act for a further period of three years up to the 31st March, 1959.
The agricultural grant was first given under the Local Government (Ireland) Act, 1898. It was a fixed annual subvention. Between 1898 and 1946 the amount of the grant and its method of distribution were altered on several occasions. The total of the grant in these years was, however, always a fixed amount.
The 1946 Act, which resulted in a large increase in the grant provided that the amount of the grant, instead of being fixed in advance as heretofore, should be related to the actual rates struck by county councils in a particular year. That Act provided that the grant would be the sum needed to give relief on the following basis:
(1) A primary allowance of three-fifths of the general rate in the £ on the land valuation up to £20.
(2) A supplementary allowance of one-fifth of the general rate in the £ on the land valuation over £20.
(3) An employment allowance calculated at the rate of 10/- in the £ on the land valuation over £20, subject to the limitation that the allowance should not exceed £6 10.0. for each adult workman at work on the holding during the whole of the preceding calendar year.
[315] This method of distribution continued to operate until the passing of the 1953 Act, which abolished the supplementary allowance, increased the employment allowance, but left the primary allowance unchanged. While under the revised system of allowances some farmers gained and some lost, the intention of the change was to provide that the farmer who gave most employment would gain most.
The amount of the agricultural grant has increased from £1,870,000 in 1945/ 46 (the last year in which the amount of the grant was fixed in advance) to £4,647,000 in 1952/53 (the year prior to the last revision of the method of distribution) to £5,519,075 in 1958/59. In that year the agricultural grant afforded farmers relief to the extent of 44 per cent. of the rate levy on agricultural land.
The total payable in 1958/59 was divided as follows:—
| Primary allowance | £4,278,595 |
|---|---|
| Employment allowance | £1,224,988 |
| Amount paid to certain county borough corporations and urban district councils | £15,492 |
| TOTAL | £5,519,075 |
Under the Rates on Agricultural Land (Relief) Acts the employment allowance is given to rated occupiers in respect of a workman who was at work on the holding during the whole of the calendar year prior to the financial year in which the claim for the allowance was made and who was otherwise qualified under the Acts. There is also provision that if two or more men are successively at work on a holding, or are employed in such a way that at all times during the calendar year there is one man at work, such workmen may be regarded as one man at work for the purposes of the employment allowance. The Acts also provide that every doubt, question and dispute in relation to employment allowance claims shall be determined by the local authority, whose determination shall be final and conclusive.
A matter which has been raised in discussions in previous Bills is the question of broken time. It has been [316] represented that a too rigid interpretation of the provisions of the law in regard to the continuity of employment might result in hardship to individual farmers especially where, for instance, a break occurs through no fault of the employer. I fully appreciate the difficulties of farmers in this matter. I realise that it is not always possible for a farmer to replace immediately an employee who has left without giving notice, and that breaks in employment often occur through illness. I think, however, that local authorities may be relied on to use their discretion in cases of this kind. I know that some of them allow an employment allowance claim where the length of the break or the total length of the breaks in employment in any year is not greater than one month. I think that is a very reasonable attitude to adopt. Some local authorities may at times have difficulty in deciding as to the authenticity of claims where the break in employment is stated to have been through illness. A test which they might find useful would be whether the workman claimed or received disability benefit or unemployment benefit.
In regard to the present Bill no new principle is involved. The purpose is simply to continue up to 31st March, 1962 the present system of distribution of the agricultural grant.
Mr. O'Donnell: Of course, we offer no objection to this Bill—it is merely a continuing Bill. I know the Minister's difficulties, but it is a pity that we cannot have some permanent legislation on this matter. These are all temporary measures introduced every two or three years and the Minister is just now doing what I did myself. He can always say to me: “Why did you not do it?” I found myself in the same difficulty as he is in, but some day we must tackle this matter and introduce permanent legislation.
The litle of this Bill is a misnomer. The principle behind this relief of rates is to guarantee employment. It is to ensure that the farmer shall employ labourers during the entire year and shall not throw them on the labour market during what might be [317] described as the farming off-season. This legislation was originally introduced for the purpose of ensuring permanent employment for labourers. The Minister has pointed out that there is a period of one month which may elapse in which the labourer is off and in respect of which the farmer would be entitled to claim relief.
I know that in Deputy Corry's district and further west, in West Cork, a practice had grown up whereby the labourers voluntarily leave in or about the week before Christmas and do not return to work until around the first week in February. That practice was very prevalent around Fermoy and that part of the country. The farmers would like to keep these labourers on but the labourers had this habit of clearing out before Christmas. I understand some retainer was usually given to ensure that the labourer would return to the farmer when the spring began, around the month of February. I thought in cases such as that there was some understanding, when it was a local custom to have this broken period of six weeks, that the farmers would be entitled to relief. While the Minister has no function in the matter—it is one for the local authority—I think he has some directive or advisory power so far as the local authority is concerned.
I do not want to hold up the Bill in any way. I only hope that some day the Minister or his successor will get down to producing permanent legislation on the lines now suggested.
Mr. Corry: I had hoped that, with the large increase in the rates and the burden thrown upon local authorities in recent years as a result of legislation passed here, we would have had this year an increase in the agricultural grant. It is high time the position was reviewed from that point of view. I realise the difficulty there is in this labour question. It is a difficulty under which we are all labouring in Cork. I can tell the Minister that the local authority in Cork does not give the relief that is supposed to be given. The county manager is afraid of his life of a gentleman called an auditor who rambles down from the Minister's [318] Department and goes over the books. This gentleman insists on a surcharge and the Minister would be well advised to say a few kind words in his ear before he lets him loose on us. We would get on a lot better if that were done.
If the final say is left with the local authority—in other words, the county manager—well and good. The position will be satisfactory if the county manager is not subsequently faced with the bogey of the Local Government auditor coming in and saying: “There is a gap here of one month. The Act stipulates the calendar year. You have permitted something which you were not entitled to permit, and I am now surcharging you.” That is a difficulty under which successive Ministers have left local authorities labouring. It is a difficulty which grows greater from year to year, so far as the farmers are concerned. In the old days, you hired a man on 25th March. You had another chat with him on 25th March in the following year. That day is gone. Likewise, the day when the farmer had a labourer for nine, ten, and sometimes 20 years, without a break, is also gone. The man who comes in now comes in with one eye on you and the other on Whitegate or Haulbowline, in either of which he will find someone who will pay him more per week for his labour.
The position in the agricultural industry is that the worker gets something like 50 per cent. of the wages paid in manufacturing industries. The position is our responsibility and it is no good talking about the flight from the land while we permit that condition of affairs to continue. A man may come in to you to-day and there will be a job going in some local industry; he will not hum or haw, but you will miss him on Monday morning. He has gone into the local industry and it will take a couple of weeks to find a replacement for him. No labourer works for a farmer now permanently for 12 months. Indeed, if a farmer has a man for 12 months, he is lucky. Generally the farmer has him for three or four months, during which time he is looking around for someone [319] who can afford to pay him more. God bless him for it.
If this statement of the Minister's is to have any beneficial effect, the county manager will have to have some assurance that the auditor will not come along and work on the strict letter of the law and impose a surcharge. As I said, I had hoped, in view of the enormous burden thrown on the ratepayers by legislation over the past few years, that we would have had an increase in the agricultural grant this year.
Mr. T. Lynch: I merely want to make one point which is a matter of some moment to those whom it affects. If a man is the owner of a holding with a valuation of £5 and he goes to work for a farmer, that farmer does not qualify for abatement of rates. That is a hardship on the small holder. He is a marked man and the farmer will employ him only for casual labour in periods when the farmer is very busy. I draw the Minister's attention to that anomaly. I think the valuation should be raised to £8 or £10. That would be a help. It would benefit the man with a holding out of which he cannot get a livelihood.
Mr. O'Malley: I was more than amazed to hear Deputy O'Donnell, a former Minister for Local Government, advocate that this legislation should be of a permanent nature. I would draw the attention of the Deputy and of those who sit with him on that side of the House, to the fact that on 30th November, 1956, the Capital Investment Committee was established by warrant of the Minister for Finance. The terms of reference were:—
To consider and advise, with full regard to the needs and interests of the national economy, on the volume of public investment from time to time desirable, the general priority appropriate for the various investment projects, and the manner in which each project should be financed.
That Committee met and in due course issued their findings. A great many of the recommendations dealt with the agricultural grant. The report [320] was published on 22nd January, 1957. The general election in that year did not take place until some months later. There was no change of Government until March of that year. I now draw the attention of the House to one of the recommendations dealing with the agricultural grant. In the net result of the deliberations, it appeared that the majority of the members of the committee advocated that the agricultural grant was of an unproductive nature and should be scrapped.
Mr. Corry: How many farmers read that?
Mr. O'Malley: That is an interesting point. The point I want to elicit from Deputy O'Donnell is: Is it their policy to accept the recommendations of this Capital Investment Committee which was set up by their own Coalition Government, and their own Minister for Finance? Is it their policy to accept those recommendations, and if they had continued in power, is it not a fact that the agricultural grants would have been scrapped?
Mr. O'Malley: There is an old maxim that if one goes to a solicitor, one should take his advice. One should not go at all if one has already made up one's mind beforehand as to what course of action one will take. That only wastes one's money and time and the solicitor's time. The point I wish to stress is that paragraph 3 of this Report states:—
The Minister for Finance attended the first meeting and stated that the immediate problem was the expected deficit in the capital budget for 1957/58. He indicated that it would be desirable if the Committee were in a position to furnish a report on which decisions could be taken by the Government in relation to the framing of that budget.
In other words, the Minister for Finance urged this advisory committee to bring in their findings in time for the framing of the Budget of 1957/58 and that there would be an expected deficit. He wanted their recommendations in order that he and the Government could consider them. As [321] I say, in January, 1957, in ample time, these recommendations came in——
Mr. O'Donnell: You could not do it in a Budget. The law was there. The Act was still in force.
An Ceann Comhairle: This Bill, of course, is only a Bill to extend the time. It does not raise the principle of the agricultural grant at all.
Mr. O'Malley: With due respect, Sir, the sole point with which I am dealing is that when Deputy O'Donnell spoke after the Minister's opening statement, he welcomed the extension of time, and advocated that this measure now before the House should be made permanent.
Mr. O'Donnell: He said no such thing. He said “some permanent legislation”. He did not advocate that this should be permanent.
Mr. O'Malley: Am I correct in saying that Deputy O'Donnell advocated that the relief of rates on agricultural land should be of a permanent nature?
Mr. O'Malley: That is the one and only point I want to bring out and I think I have done it effectively. I shall be very interested in getting an answer from that side of the House as to whether the recommendations of their own Capital Investment Committee would have been accepted, if they had continued in office, that is, that the agricultural grant would have been scrapped in toto.
Mr. Sweetman: The Minister must have felt like saying: “God preserve me from my friends.” On more than one occasion during the past two years, I asked the Minister for Finance if he had had the time and the opportunity to consider the report of the Capital Investment Committee. In reply he told me that he had not had time. The purpose of a committee such as that is to explore, and to act as an assembler of the facts, and to advise. The decision to be taken on the report of such a committee is the decision of [322] the Minister, or the Government for the time being, and not the decision of the committee.
In so far as this Bill is concerned, my understanding is that the phraseology of the Bill enables us purely to deal with it on the basis of whether instead of the Act being in force for eight years, it should continue for seven years or nine years. It is purely a point of time and we cannot put down amendments to it for any purpose other than to decrease or increase the period of the Act. Anything else would not be in order, and having regard to that, it seems that the Second Reading is the only time when one can make reference to anything else.
Frankly, I am quite intrigued by the last part of the Minister's statement. I understood that the stipulations in relation to employment were absolutely rigid and statutory, but I understand from Deputy O'Donnell that perhaps I am wrong in that respect. What I am interested in at the moment is the type of case where a man leaves a farmer on a Saturday night. That farmer may not be able to get another man to come in and start work on the following Monday morning. It may take him two days, a week or a couple of weeks to get somebody to replace the man and there is, therefore, a gap in the employment of a week or a couple of weeks, a gap which has arisen in no way through the fault of the farmer concerned. Does the fact that such a gap has arisen disqualify that farmer from the employment allowance?
I think the Minister will find that in relation to certain local authorities such a gap has been taken to disqualify. It would be undesirable that the local authorities should be absolutely rigid in that respect. I must confess that if the position is as indicated by the Minister in the last part of his statement, it would be better, but certain local authorities feel that they are completely bound by the letter of the law and have no power of discretion at all. There is, I believe, a custom in Cork that workmen sometimes take a month off of their own [323] volition and are paid a small token retaining fee. It is not that type of case I am talking about. I entirely agree the employment allowance must operate to encourage permanent employment. I could not agree more on that, but I am thinking of the type of case where a man walks out on Saturday night and it takes the farmer, genuinely endeavouring to get another man, a week or two weeks to find a suitable man. That type of case should be covered in some measure.
Mr. Davern: I agree with Deputy O'Donnell who advocated that the 11 months' employment which obtains in many districts should be accepted as the full period of employment. In many cases, it is not the fault of the farmers, as previous speakers have said, and perhaps not the fault of the worker either that the full 52 weeks are not worked. I know that in many local authorities the letter of the law is rigidly enforced and many farmers lose as a result. That is very unfair, and I hope and trust that the Minister, perhaps next year or some year in the near future, will be in a position to agree to what we are now asking.
I hope the time will come when a more substantial rebate will be made with a view to inducing farmers to employ more workers. A rebate of rates is indeed a great inducement and I feel that if that were to happen there would be, perhaps, a corresponding reduction in the Estimate for Social Welfare. There should be a pronouncement that the more people farmers employ the more rebate they will get. I hope and trust that the Minister will go into this question in a few weeks and that people generally should not be deprived of their rebates.
The man who employs for 48 weeks of the year should have a sufficient qualification for the rebate of rates, and rates are at present so very high —ceiling high—that this is a very important matter. In my opinion, high rates are responsible for much of the unemployment on the land at the moment. They absorb a vast portion of the farmers' income, but whether [324] that can be helped or not I do not know. I believe that the Minister should consider the question of the 48 week period; that corresponds to the 11 months in many case. In recent years I know as many people are not applying for the contract as heretofore, because of the fact that overtime, Sunday work and all that is catered for in that time, but I think it would be a good thing if a contract of service for 11 months were found possible as between farm worker and farmer. I would advocate that arrangement at all times because it lends itself to more production, more stability on the land and, consequently, to enrichment of the economy as a whole.
Mr. Blaney: The various points raised by speakers on both sides are not really new, in so far as my mind on this matter is concerned. Taking Deputy O'Donnell's suggestions and queries in regard to the matter, he feels that we should have, if anything, some permanent form of legislation. Possibly I could agree with Deputy O'Donnell but I would point out, of course, that if we were to revert to the permanent legislation readily at hand, we would immediately reduce the grant very considerably—in fact, reduce it from roughly £5 ½ million, the figure at which it is at the moment, to something under £2,000,000.
Again, while we might devise some other system and bring in a new, permanent legislative system, we are backgrounded by various recommendations that seem to have caught the imagination of the general public, which I shall refer to later. Those recommendations are not in favour, indeed, of even temporary relief and continuance on a temporary basis, but are more inclined to suggest we should direct these moneys in other directions.
Deputy O'Donnell has also referred to a question which has been mentioned by, I think, all other Deputies who have spoken, the question of the break in employment, whether or not there is a rigid law carried out by our various local authorities in regard to the full 12 months period required to be properly worked, or that employment [325] should be for a full 12 months without a break and the fact that where breaks do occur, there does not seem to be uniformity in the manner in which they are dealt with by local authorities.
I can only reiterate what has been said by practically all former Ministers for Local Government, including Deputy O'Donnell and the present Minister for Agriculture, in recent years—that, in so far as I and my office are concerned, we do look for a reasonable approach to this matter and we do not consider unreasonable the excuse of a month if there is illness, if there is a change of worker and a month or a few weeks elapse in getting another worker to replace the worker formerly employed. I reiterate that I consider those things to be reasonable and that illness in such a case should be considered. That brings us to the point that some of our auditors—not all of them—take a very strict, stern, and rigid view of this matter and will not allow any such procedure to be adopted. If it is adopted by a local authority, and an auditor takes this particularly rigid view, a surcharge will in all probability be made.
It has been suggested further in regard to that matter, if we have the views I have expressed on the matter, that we should advise or direct the auditors. I think the House will appreciate that auditors, as a profession, are in a very vulnerable position and to suggest that in their operations as auditors and adjudicators on matters of public expenditure they should be subject to directions from a Minister, or from a Department, is not possibly in the best interests of the profession or of the esteem and the high regard for their integrity in which they are now held but, for what it is worth, I want to say again that I believe in approaching this in a reasonable manner. If there are auditors who hold they must take a rigid view, then a surcharge can be made. As a result, that surcharge can, and I am sure will be, appealed to my Department. Again the view I am expressing should surely give to the managers and to the local authorities an indication [326] that, if such does happen, their appeal very likely will not fall on deaf ears, if the case is a reasonable one.
Many of our people, in fact, are operating in this reasonable manner of recognising the fact that it is hard to replace a labourer quickly, that labourers will come and go and also that labourers can, like everybody else, get ill and may not be able to continue their work for the entire time. Where that happens, we recognise it. I recognise it and, as far as I am concerned and where I will be concerned should such changes arise, they will be dealt with in a sympathetic manner in all these cases. More than that I cannot say on that subject at the moment.
The question has also been posed by Deputy Lynch in regard to the £5 valuation limit. I could possibly be very sympathetic personally on this matter, but a few arguments were placed on record here when this matter was discussed and debated on a previous occasion. In fact, I could nearly quote those arguments. One had reference to an occupier of land with a valuation of up to £20 receiving a preliminary allowance in respect of that land and it was argued that an occupier of land with a valuation of over £20 should not also receive an employment allowance in respect of employing him; in other words, a preliminary allowance would already have been allowed and then to allow a man, who had received that benefit on his own valuation under £5, to qualify for an employment allowance would seem to be doubling the benefit under this Act. In addition to that, if we were to remove or extend the limit, particularly if we were to remove it—naturally the tendency always is to shove it up from £5 to £10 and possibly the demand next time is £10 to £20—ultimately the logical conclusion would be to remove it altogether.
If we were even to raise the limit it could be held that it would not be fair to the agricultural labourer who has no holding of any description and no land at all. However, all these arguments could be knocked down if we wanted to take a straight line through that this is something that we should [327] give and the more we give the better it would be for all concerned. I in my own personal capacity would, like many other landholders, be very glad to see a further and a wider extension of all these benefits but in all the approaches to this matter I have had to have regard to the general background of opinion that exists. That opinion is pretty strong and popularly held by various members of our community.
In referring to that I should like to quote from the first report of The Capital Investment Advisory Committee, dated 22nd January, 1957. Paragraph 15 recommends:
(i) Grants to local authorities in relief of rates on agricultural land should be discontinued. These grants, which in the present financial year are estimated to amount to £5.6 million, are not economically justifiable as at present applied since they are made available indiscriminately and are not directly related to increased production. It is a historical fact that the very substantial relief afforded to the farming community by land purchase and relief of rates has not led to any increase in agricultural production. We believe, however, that moneys diverted from such grants should continue to be made available to the farming community but in a way calculated to raise production, namely, by the provision of vouchers for fertilisers and lime.
That is the Capital Advisory Committee's rather definite recommendations, recommendations which as a whole have been well received by those of our people who think about these things.
Later we have the much acclaimed and rightly acclaimed report Economic Development, paragraph 6, chapter 12 of which says in relation to State Aid to Agriculture:
...(f) gradually transforming the Agricultural Grant into forms of aid more directly serving to lower production costs, e.g. subsidisation of [328] fertilisers and increase provision for research (especially in relation to pasture and soil improvement), education, advisory services, development of progeny testing and marketing. A beginning should be made by fixing the Grant at £5 million, thus freeing over £600,000 for subsidisation of phosphates.
I might mention that the Government in the meantime has devoted and earmarked a considerable amount of money for the things recommended and yet we have not in fact reduced the Agricultural Grant in order to do that. Paragraph 14 goes on to say:
“The suggestion in paragraph 6 regarding the Agricultural Grant is not novel. Much attention has been focussed recently on this subvention and on the question of its efficacy as an aid to agricultural production. The employment allowance (some £1.3 million out of a total of £5.62 million) is a wage subsidy, introduced in the early thirties as an inducement to farmers to increase the amount of their hired labour. It was never an effective inducement and in the conditions of to-day is a complete anachronism. The number of workers in respect of whom the allowance is given has declined by over 30 per cent. since its inception though it might perhaps be claimed that it slowed exodus; it is more than likely that the allowance is claimed fraudulently in many cases and there is no evidence that it has ever had any beneficial effect on production.”
When we have discussed the various arguments and the various extensions of the present proposals that might be regarded as beneficial let us revert, a matter to which I adverted at the commencement, to these reports which have been circulated and which as I say, have been widely acclaimed in general and with that background, to have regard to the situation where in the idea seems to be that the allowances should be reduced in one part, that they should be stabilised at a fixed figure lower than the figure now being paid or that they should be diverted and given to the farmers in [329] some other manner. That is the background that is there and while we may have our likes and dislikes in regard to these proposals now before the House, I do feel that in continuing and agreeing to continue these provisions for the period of the next three years, we have, despite our objections to the various details, done well to have maintained our position against the background I have outlined. There is nothing further I can say on this matter and I commend the measure to the House as it now is.
Mr. Corry: Is the Minister aware that our competitors across the Border in the Six Counties and in Britain pay no rates on agricultural land at all?
Mr. Blaney: The Minister is aware of quite a few other things that exist there.
Agreed to take remaining stages to-day.
Minister for Local Government (Mr. Blaney): I move:—
That it is expedient to authorise such payments out of moneys provided by the Oireachtas as are necessary to give effect to any Act of the present session to amend the Rates on Agricultural Land (Relief) Act, 1953, so that that Act shall have effect in relation to the local financial years ending on the 31st day of March, 1960, the 31st day of March, 1961, and the 31st day of March, 1962.
Resolution reported and agreed to.
Question proposed: “That Section I stand part of the Bill.”
[330]Mr. T. Lynch: In relation to the farmer with a valuation of £5, may I point out to the Minister that, as regards making more labour available, many small holders in the country will suffer in this respect? A farmer will not be able to get any abatement from his rates if he employs such a small holder. These men cannot stay at home because of their small holdings. They have to get out and work because they could not make a living on a place that would have such a low valuation. I would suggest to the Minister that if he would put the figure up a few pounds he would make more labour available for farmers and provide employment for small holders.
Mr. Blaney: I am not unsympathetic to the suggestion but if you make an argument for this—and I believe a very sound argument has been made by the Deputy for the making available of more labour for the farmer—and if you relate that to the purpose for which the employment allowances are given, it would seem that the employment allowances would no longer be justified. In other words, we bring it in because there was a pool of labour in order to encourage the farmers to maintain their labour all the year round. We have now reached the stage where, if that argument were to be allowed, it would indicate that the labour pool is no longer large enough to keep the farmers with sufficient employees. While it is a very good argument, it could well be used in the other direction.
Mr. T. Lynch: The Minister is missing the point. I am saying that that man is debarred from getting employment the whole year round. The whole idea behind the measure is that the man would have a continuation of employment and that farmers would not employ them just seasonally. There must be an enormous number of holdings in Donegal on which people would be debarred in the same way. There is one part of my constituency where there is a great number of small holdings. It is a great hardship on these men.
Mr. Blaney: It does not debar a man from getting employment. I can see what the Deputy is leading to. It [331] is a discouragement to his employment as against someone who will qualify. Then, again, the actual conditions of both people in question must be measured: the man who has land over £5 valuation—say, £6 or £7—and the fellow who has none. If there is a discouragement to the employment of the man just at £6 as against the man who has none, a certain amount of justification should be held to exist in that case but it does not debar him from casual employment.
Mr. Corry: In regard to the statement the Minister read from this Commission, the Minister and all Governments in this State in future should be careful when appointing people in sheltered positions who are carried on the backs of the workers of the community. They should be a little more careful about the people they select. I quite realise that a Government looking for money appoints a team to find out where that money can be found or taken from somebody else. The team appointed are very anxious to take the money from somebody else provided they themselves are not touched— particularly when the members of that commission are in sheltered positions and entitled to a pension from the workers when they retire at the end of their days.
Section 2 and Title agreed to.
Bill reported without amendment, received for final consideration and passed.
The Dáil, according to order, went into Committee on Finance and resumed consideration of Estimates for Public Services for the year ending 31st March, 1960.
Debate resumed on the following motion:—
“That the Estimate be referred back for reconsideration.”—(Deputy Dillon.)
[332]Mr. Corry: I want, first, to deal with the question of medical cards. As Deputy Collins said, we have a very wide differentiation in the manner in which this matter is dealt with in one county as against another. I have seen old people who, after full investigation, were passed for the full old age pension but were refused a medical card on the grounds, apparently, that some members of their family were working. We all know what happens, in the ordinary run of things, in a rural area, in particular, when boys and girls from 16 upwards go off to work and bring in a few pounds of which, in the majority of cases, the household sees very little. In many cases, the girl or boy is endeavouring to put by a few pounds to furnish a home for himself or herself. This matter of an old age pensioner who has passed the means test but who is not given a medical card is wrong.
I do not know where we stand in regard to dispensary districts. We have been 12 years now in the South Cork Board of Public Assistance looking to the Department for a recasting of dispensary districts and dispensary areas. It has held up the building of dispensaries. We have got no final answer yet. My main fault with the Minister's Department is the difficulty of getting a decision. They will do anything but decide.
Some 23 or 24 years ago, it was decided to have a regional hospital in Cork. Every time a member of the South Cork Board of Public Assistance interviewed another Minister in connection with a grant, a loan or anything else for the improvement of our hospitals in South Cork we were told, in effect: “Here is the regional hospital you will get. Everything else will be settled under that.” A pretty considerable sum of money has been thrown into that regional hospital project since it was first started in Cork 20 years ago. Within the past month, I was informed that it amounts to somewhere around £30,000, spent between architects, engineers, quantity surveyors—everything on paper. I would say we are further away from the regional hospital now than we were 23 years ago as far as Cork is concerned. My personal opinion is that it [333] is not required. I should like the Minister to come to some final decision on that matter.
I think it was in 1948 that, as Chairman of the South Cork Board of Public Assistance, I came up to interview one Minister in that connection. He said to me, in effect: “You must receive money immediately. There is to be no further delay.” I asked: “Where will the money come from?” His next question was: “How much will it cost?” Somebody said to him: “£2,000,000.” He said: “We will give it.” When all his experts had spoken about the cost of the equipment and said it would cost a pretty considerable sum to equip and prepare the hospital he said, in effect: “We will give you that also and no bother but to go to work and impress upon us the urgency of the matter.”
We were writing to the Department —which wanted this hospital built immediately—for six months asking them for one small thing which we never got. For the period from 1948 to 1959 they were still talking about a regional hospital for Cork. What is the use of talking about finality? I shall settle with the Minister for half of what we were to get. If the Minister will give us £1,000,000 for straightening things out in Cork, I shall settle with him on behalf of Cork and I would think I was getting a good bargain because I know I will never see the £2,000,000.
Mr. O'Sullivan: The Deputy will not claim any interest on it.
Mr. Corry: No. Deputy Dillon complained about the position in regard to mental hospitals. What is required at present is a decent home for our aged people. There is no good pretending that there is anything mental about those people. They are the people who are filling up our mental hospitals to-day. There are some 600 or 700 of them occupying beds in portion of St. Finbarr's Hospital today. I was delighted to hear the Minister's statement in regard to expensive hospitals and the cutting down of expenses in that respect. I wonder could he manage to have the [334] same sentiments adopted by his advisers.
We put forward proposals for adapting our old County Home in Kinsale to hold a considerable number of our aged people. A proposal was sent to the Minister's Department also in connection with Youghal, on the same lines. They were sent some five or six years ago. The idea in the Department then was that, no matter what you had, it was not good enough and you should build something new. It is about time we had a Minister in that Department who adopted an economy line. I suggest that if the Minister would look into the question of reconstructing and fitting up the Homes at Kinsale and Youghal he would find that it would leave us in the position of being able to convert a large portion of St. Finbarr's Hospital, Cork, for receiving acute surgical and other cases, and save annoyance and the expense of building a new regional hospital there. If the Minister could promise us £2,000,000 in 1948 what has become of that money? He told us to go right ahead and that the money would be forthcoming. If it was forthcoming then, where has it gone?
I should like to say here that we owe a tribute to Deputy Dr. Browne for his attack on the tuberculosis problem in Cork. We took over Heatherside, Mallow, Macroom, Skibbereen, Millstreet and Lota. That meant that a lot of people who had been waiting for bed accommodation for a long time were accommodated and we had no waiting list in the end. Unfortunately, I cannot say the same in regard to Sarsfield's Court. If ever there was a white elephant it was Sarsfield's Court. I do not know who the lunatic was who designed it but he should be kept in a home. There are some 30 or 40 acres of land there and eight or nine different hospitals and we have to keep a special transport system for taking the food from the kitchen to the patients, who are half a mile away. If a person set himself out deliberately to do something which would cause the greatest amount of hardship both to the workers, the nurses, and to everybody else he could not have achieved greater success than that achieved at Sarsfield's Court.
[335] Thank God, we have now come to the position where we have closed Millstreet. We have closed Mallow and handed it back. Macroom has gone back to the South Cork Board of Assistance. Skibbereen has been closed and handed back to the West Cork Board of Assistance. We handed Heatherside over to the Mental Hospital and Lota, which was also handed back, is at present being used as an orthopaedic hospital. That change has come about inside a few years. In addition, we have at Sarsfield's Court 60 vacant beds and then we hear of talk about a regional hospital for Cork.
As far as hospital treatment is concerned, it is time that we started to cut our cloth according to measure and got down to hard facts. Mind you, the running of those small hospitals was not such an extra burden as compared with Sarsfield's Court. The Minister has proposals before him at present in regard to Macroom hospital. They are not such an extra expense at all. At least in those hospitals when a poor nurse stops work she will not have to walk half a mile looking for a bed, as she will have to do in the new regional hospital at Sarsfield's Court.
Those are the main points on which I wanted to touch. We have certain worries which, in my opinion, can very easily be rectified with a little commonsense. The most urgent need at present is a decent home for aged persons. That, to my mind, would clear up overcrowding both in the hospitals and in the mental homes. At present there is no place for them to go and they are just packed into St. Finbarr's Hospital or into the mental hospital in Cork. It is a problem we endeavoured to meet fairly. A very simple way of meeting it was to get hospitals reconstructed for that purpose. In that way, very little staffing was needed and we were able to run them economically. Those people were very happy there and more contented than they would be in a mental hospital or some place worse than a jail. The Minister should get down to dealing with this problem seriously.
As far as the Health Act is concerned, [336] it has been a gold mine for the medical profession and some hospitals. If a man wants treatment now, he would nearly want to have a bank roll or have a good job in the Civil Service. You should see some of the bills that come from hospitals. Even our dispensary doctors have a habit of sending to a private or semi-private ward some patient who, in the ordinary course, should have gone to St. Finbarr's or some of the public wards in the hospitals. The patient wakes up to find a partition between himself and the public ward. Heaven help him— he is lucky if he has his shirt on when he comes out because he will be skinned.
The ratepayers and taxpayers are paying enough for health services to ensure that the people entitled to such services will at least get them, but, in my opinion, they do not. On some occasions, it is as hard to get a medical card out of a home assistance officer as it is to get a job in Bord na gCon. I quoted the case of an old-age pensioner who passed all the means tests required to get a full old-age pension but who is not entitled to a medical card. Before we ever heard of the Health Act, an agricultural labourer could go to the dispensary doctor, get a card and go to hospital and receive free treatment. To-day he is refused a medical card if a member of his family brings in a few pounds along with his own wages. That is how this portion of the Health Act is administered in Cork, and those are the cases to which I would direct the Minister's particular attention. Can the Minister give me any reason why an old-age pensioner who has passed the means test for the old-age pension should be refused a medical card and be compelled to pay for hospital treatment out of his pension?
As far as the other matters are concerned, I suggest we should have some decision from the Minister's Department. We have been twelve years waiting, with discussions and everything else, for a decision in regard to the dividing up of the dispensary areas in south Cork. It has caused congestion and prevented the building of dispensaries at a time when they could [337] have been built far cheaper than they could be built today. It is due to neglect by the Minister's Department.
An Leas-Cheann Comhairle: The Minister is responsible for all the decisions of his Department.
Mr. Corry: I hope that if I say anything, the Minister will do what he should do and pass it on to the boys responsible.
Captain Giles: I am sorry there has not been a bigger debate on this Department because it is responsible for the expenditure of a vast amount of money. It is more or less a new Department in which there are many snags to be overcome. I know the Minister would like a full dress debate so that points could be clarified to help him improve the Health Act. Much has been said for and against the Health Act. I agree with the provision of reasonable health services, good hospitals and medical attention, but I would not like to go too far. What we want is a living wage. If we had that, we would not need half the health services we have. If we go on as we are and go for a free-for-all, we will wind up as a Socialist State and will not be one bit happy.
I hope the Minister will spend the money at his disposal wisely and well, and that he will think twice before he spends any of it. I hope that he will not be led along by cranks or faddists to go in for more than we can afford. This is a Christian country and we should have more voluntary schemes without having to rely on the State for everything. I should like to see money spent on the school medical services. If we could spend far more money on that, we would be doing good because we want the future generation to have good health.
More money should be spent on educating our people not to be making such fools of themselves smoking and drinking, spending all their wages, finding themselves in bad health and leaving their children with a poor outlook on life. People should be more strict in their diet. A vast number drink and smoke far more than they should. That is why our hospitals are packed out with people who should not be there [338] at all. The public should be made to realise that they can do far more for themselves than the State can do and it will cost them very little. The drink and tobacco bill in this country is colossal. It is the principal cause of ruin in our homes and of filling our hospitals with sick and delicate people.
The Health Act requires careful review month after month. I know the Minister will give it serious review. I have confidence that he will see to it the money is spent wisely and will reject any highfalutin nonsense put up to him. We cannot afford that. The Health Act is costing £16 million or £17 million, a colossal amount of money. It is the biggest burden on the rates. It is a bone of contention at the annual rate review. The cost of the Health Act is increasing and the local authorities cannot give the service because they are bound by statute to pay for the Health Act. The bill is too big. I would ask the Minister to consider means by which the cost of the Act could be undertaken by the State so that county councils will not have to bear huge expense year after year.
The voluntary health insurance scheme is an immense success. I would ask the Minister to widen its scope as quickly as possible. It is good for the people and is not a tax on the community. The lower income group should be brought within its scope. It could embrace far more people. Big industries should follow the example of Guinness and operate their own health schemes so as to relieve the ratepayers. Large industries that give permanent employment to people over a long number of years should have their own health services and should not be a burden on the community.
I am glad that T.B. is being controlled and is more or less eradicated. That is the result of more than hospitalisation. The money spent in providing good housing over a long number of years has done as much as hospitals in the eradication of T.B. There is also the fact that people are better fed now than they were. As this result has been obtained, hospitals have become superfluous. That may be the fault of nobody, but I would [339] suggest that there should be wiser planning. On the road from Dublin to Kilcock there is a beautiful building that cost over £1,000,000, lying empty, with grass growing to the doors. The Department are concerned about what to do with it. There should have been better planning. Projects that cost millions of pounds should not be rushed. The people's money is involved and it should be spent wisely and well. It was not foreseen that T.B. would be controlled at such an early stage but, at the same time, there is waste of public money. It is a matter of bookkeeping. If ordinary business people were to do that sort of thing, it would not be long until they would be in liquidation. I would ask the Minister to keep a constant check on the administration of the Health Act so as to provide good service for the people.
At present, hospitals are full because of the operation of the Health Act. Doctors are sending patients to hospital whether they want to go or not. Half of these people could be attended to at home. It is wrong to have minor ailments treated in hospital for two or three weeks while beds may be needed for other patients requiring hospitalisation. A vast amount of money is spent on medicine bottles and pill boxes. If a patient is given a bottle of medicine at a dispensary and he does not like the taste of it he will throw it over the ditch. There could be a tightening up in regard to these matters. Medicine bottles should be returned to the dispensary. The Minister should issue a circular to the medical officers of health to see that bottles are returned. Many people go to the dispensary when they have only a slight cold. A great deal of unnecessary expense is incurred.
Reference has been made to the question of county homes. I do not believe that a vast amount of money should be spent on county homes as they are today. Deputy Dillon's is the right idea, that we should build a county home for three or four parishes that would cater for the people of those parishes who have no one to look after them. In the county homes as we know them today there are three or four [340] types of people. No matter what money is spent on them or what highfalutin name is given to them, they are still county homes. In them you will find the hoboes who drank all they ever had, sold their land, and scrounged their way into the county home, and are a nuisance to everyone there. You also have there the poor old wayfarers or tramps who are always with us and who do no harm to anybody.
There is a tendency on the part of young people nowadays to shelve responsibility and to send their aged parents, uncles or aunts to the county home because they are an incumbrance. That is a shocking state of affairs in a civilised country. I was brought up in the Christian way of life and if I were starving, I would see that my father and mother got the first bite and would never be forced to leave the home they built for themselves and their children. I would see to it that they would not be sent to the county home in order to make life happy for others. I heard Deputy Russell saying that the county home is the place for them, that they are a nuisance at home and are in the way of the young people. I could not believe that would come from a man who is a Christian gentleman. It is an appalling mentality. We ought to be proud to maintain our parents, our uncles and aunts, as long as possible. Even if they never got the old age pension or any other pension, we should glory in keeping them at home.
Old people are being sent to the county home. There are many people in county homes today who spent their lives building up lovely little homes but, when they became too old to be of service and the daughter or son got married and a child was coming, the in-laws began to growl and the poor old people were pushed out. I have seen old people in the county home crying for weeks, saying that there were grand beds and grand food in the county home but that they wanted to go back to the home which their parents had handed down to them. They cannot do it.
I would ask the Minister not to spend too much money on the present county homes. They are State institutions. [341] A great deal of money has been spent on the county home in Meath but in the eyes of the people it remains a county home. It is not fair that wasters who drank all they ever had and who were suckers all their lives can go there and have a royal time and trample on people who are pushed into the county home. There should be segregation. I have nothing to say against the poor tramp of the road. He is a lovely old man. I would call him an old gentleman. Many of them were born with very little brains. They are handed down to us and, as Christians, we should be proud to help them. I would have a county home for them. The hoboes who drank all they ever had, who are good for nothing, who are a blight on the whole community, should be segregated from decent old people.
I would suggest that a home should be provided for every three or four parishes for decent, honest people who handed on to posterity all they had, who worked hard all their lives and, at the end of their days, had no one to look after them. They should have a home of their own, a nice place, a kindly place, where they can go back over the road once or twice a week to visit their old home. Money spent on such a scheme would be well and wisely spent. I would ask the Minister to see what can be done about providing county homes of that type. I do not want them built for the purpose of encouraging younger people to shelve their responsibility and to push the old people out. I would be afraid of that.
We are fast advancing to the stage of being a Socialist State, whether we like it or not. We will be a pagan race if we continue as we are. There are hundreds of things that people can do for themselves but they will not do them. There are men who fend for themselves and pay for themselves. There are others who spend half their lives trying to get something for nothing. The hospitals we have built at the cost of millions of pounds are to-day nothing but white elephants. The community have to pay the cost of the Health Act. It is a grand thing to read about and to see it put into operation. I spent a few months [342] in hospital. I was not long there until I discovered it would cost me a few hundred pounds. I was proud to pay it because I found myself in a position to do so. I would rather pay it than have the State do so.
The Minister is wise. He sees what is going on. He has seen the efforts made to make an almost socialist State of this country of ours. He should look closely at the Health Act and see where he can prune and cut out the extravagance. There is plenty of waste and extravagance in it. That is not the Minister's fault. Act after Act was passed in this House and you had one side of the House trying to outdo the other, vying with each other as to who would be first with new legislation so that we would be as good as mother England—a vast Empire which can afford those things.
We cannot do it. What we want are decent well-run hospitals with good staffs. The people should realise that they have a responsibility to do a good deal for themselves. Half the people in hospitals are there because they drink too much, smoke too much and gamble too much and they have not sufficient money left to provide themselves with the necessaries of life. The people should be educated how to live, keep healthy and happy. They should be educated how to spend the weekly wage properly. If they knew how to do that, we would not have half the misery we have in this country. This country should be one of the grandest countries on the face of God's earth.
This House does not act in a responsible fashion. None of us acts in a responsible way. We all play act. The result is that we have almost a debt of £400,000,000 on our shoulders. The Health Act will pile up debt year after year. I admit that it has done some good but at the same time it is only in its infancy. Now is the time to prune it. I would ask the Minister and his Department to do everything possible to ensure that not one penny spent is spent unwisely. If he does that, he will get the blessing of the country.
People are sick and tired of paying for too many things. Large sums of money are being spent on county homes which will never [343] be county homes. Decent people are being forced into them and they die there in misery. The beds are good and the surroundings are good, but the whole environment is alien to the people who are in them. These people love to live in the old home, even if it is only an old thatched cabin down a bog road. Their children should try to keep them at home. If the old age pension was £3 instead of 27/6, most of the young people would make the best of it and try to keep these people at home instead of sending them to the county home. Unfortunately, the old age pension at present is insufficient, with the result that those old people are thrown out as they constitute a nuisance.
I am satisfied that the Minister has his hands full, but he is a man who is well able to stand up to responsibility. I believe he is a man who will say black is black and white is white. His Department handles a vast amount of money. If it is properly pruned and if we are given a normal Health Act suited to the needs of a small Christian country, the people will be satisfied. They are not satisfied at the present moment. There is 7/- on the rates in my county which is a colossal amount to ask. Almost one third of the rates is in respect of the Health Act. Fifty per cent. of that is wasted money because the whole thing is topsy-turvy.
We hear a good deal about the medical cards. It will be years before this problem can be solved. Thousands get cards who should not have got them and there are others who should get them but who do not get them. These are some of the things I want the Minister to regulate.
A tremendous number of people go to hospital with nothing wrong with them at all. When I was in hospital, I heard people telling the doctor that they had a little pain. The doctor told them that there was nothing wrong with them. They were taking the wrong kind of food and if they took the right food, they would be all right. When the doctor had gone, they said that the doctor did not know what he was talking about. Then when the time came for them to go home, the pain [344] came back. They were occupying beds which other people badly needed. If you were to examine the problem closely, you would find that 10, 12 or 15 out of every hospital could be sent home. I would ask the local medical men not to send everybody into the hospitals.
The same story can be related in regard to the maternity home. We were all born in our own homes and before we were born, there were 10, 15 or 16 children, perhaps, born there. There was a very low mortality rate, too. All my children were born at home. There was no need then for maternity hospitals, but now everybody from the lady in the mink coat to the one in the old plaid shawl are queueing up to get in because they think they might get something for nothing. Before they come out, they find they can get nothing for nothing.
There is too much nonsense and mollycoddling in the country. We should be realistic and the House should be realistic. We should make this Health Act worthy of the Irish people. We, as a Christian community, should do things for ourselves. I hope what I have said will have some significance for the Minister.
Mr. O'Sullivan: The debate on this Estimate this year brings to light very many doubts of a gravest character in the minds of Deputies on both sides of the House relative to the operations of the Health Act. We know that it was a revoutionary introduction which was presented as being the be all and end all in relation to health improvement in the country.
We moved the motion to refer back the Estimate so that there would be a wide discussion on the various aspects of the Health Act and the administration of the Department of Health in general. Now that it has been in operation for a number of years, there is in existence, particularly among members of local authorities, who are more conversant with the day-to-day administration of it, considerable misgiving as to its application in many respects. It is time that the whole situation was reviewed. It got off to a bad start because of the high-powered controversy which attended its introduction. [345] It ran into worse weather, as Deputy Healy very constructively pointed out, when he referred to the fact that it was operated too quickly, that sections of it were made operative before the necessary organisation for administration of those sections was created to undertake the responsibilities involved.
An Leas-Cheann Comhairle: We cannot have a discussion on the introduction of the Health Act passed by this House. The Deputy is entitled to refer to the administration of the Health Act but not to its introduction.
Mr. O'Sullivan: Certainly, I have made but a passing reference to the introduction of it; I am concerned with its administration, but Deputy Healy said that a mistake was made in bringing it into operation too quickly. The Act empowered the Minister at the time to make sections operative as the organisation was built up to make it possible for them to be operated successfully. We know that the most serious problem that the Health Act encountered arose from the fact that the Minister's predecessor made an Order, when he knew he was leaving office before the 1954 change of Government, making the sections operative on dates subsequent to the general election.
An Leas-Cheann Comhairle: That does not seem to arise on the debate on this Estimate.
Mr. O'Sullivan: Deputies have adverted to the problems that exist in the administration of the Act and surely I am entitled to go back to the foundation of these troubles so that they can be remedied? I concur with Deputy Healy in what he said this morning—that this was something that created a lot of trouble.
An Leas-Cheann Comhairle: The fact that Deputy Healy may have mentioned this does not mean the matter is in order for debate.
Mr. O'Sullivan: At any rate it is accepted now, having listened to constructive contributions from both sides of the House, that while there is good in the Health Act, particularly in regard to what it has done for disabled [346] persons, we must remember that there has been considerable misgiving and criticism among many people who at the commencement were very enthusiastic about it.
At that time it was intimated from the Opposition benches that there were people enjoying free treatment before the Health Act was introduced who subsequently would have to pay for that treatment. That is now the case and I shall leave it at that point but I emphasise that the warning was given before the Act passed through the Dáil. Having experience of some years of its operation we now find we have the imposition of £8.32 million on the rates to pay for it.
It was regrettable that the voluntary health insurance scheme was not introduced before the Health Act, when that laudable organisation to which the Minister has paid tribute could have got off to a very much better start. If so many people in the community did not now have to pay in taxation to the extent of £8.5 million and in local rates to the extent of £8.32 million, if they did not feel that they are entitled to, and must get something back for their contributions, if before the Health Act was enacted these people were presented with the opportunity of voluntary participation in the voluntary health insurance scheme, it would now be well established and would be catering for an infinitely higher proportion of people than at present.
In spite of the fact that it was a secondary consideration to the State organisation the progress that has been made by the voluntary health insurance scheme has been phenomenal under the circumstances. It is a very good thing that this Government and this Minister have followed in the footsteps of their predecessors in ensuring that proper attention is given to the benefits available from the scheme.
When we come to discuss the state of health of the people and look back with considerable pleasure and gratification on the almost complete elimination of tuberculosis and the improvement in other standards of health, we can surely attribute most of it to the fact that the people of this country have a good food supply. They are [347] careful in their eating habits. The fact that we are among the world's highest consumers of good butter indicates that our people put the best food on their household tables. It is unfortunate that as a consequence of the Government's policy in increasing the cost of living there has been a considerable reduction in the consumption of butter here.
An Leas-Cheann Comhairle: The Minister for Health would have no responsibility for that.
Mr. O'Sullivan: No, other than his collective responsibility with other Ministers, but people with limited incomes find today that they are restricted in the use of butter because of economic considerations. I fear that must be reflected in the lower nutritional value of the food eaten by people in lower income groups.
The Minister referred to the fact that the provision of sanatoria some 11 years ago and the benefits made available to people affected by T.B., in particular ridding the head of the family of the awful problem of maintaining dependants during his period of illness, have resulted in the reduction of mortality from 3,103 per annum to 584. This is a tremendous achievement and yet there are many people in the community who are forever decrying the capital investments of various Governments and saying that various Governments have run the country into debt and that nothing but despair lies ahead. To those people we can point out with pride the consequences of some of the investments under our capital investment programme under the heading of this Estimate and we can say to those, who claim that there is something improper in making such investments, that we have here positive results not alone in the reduction of mortality rates by almost 2,500 per annum but also that there are many thousands whose period of convalescence whilst suffering from T.B. has been considerably shortened. They have been able to return to employment in a much shorter time because we no longer fortunately have waiting lists such as existed prior to this programme. Not [348] alone have the lives of men and women been saved but in hundreds and hundreds of other cases people have been able to return to work and to the full management of their homes much more quickly.
I said earlier that availability of essential foodstuffs to the growing child and even to adults is an important factor in the health of the community. We have an abundant milk supply and the complete pasteurisation of milk throughout the country now is a great contribution towards ensuring that a healthy milk supply is available. I think the time is ripe for the Minister to embark on a “Drink More Milk” campaign because if the Exchequer has been embarrassed in years past by charges upon it to subsidise butter for export because of increased production of milk, it would be a better investment to go all-out on an advertising campaign to bring home to the people that it would be well for them if they consumed more milk.
The Minister referred to the fact that, consequential upon the lowering of the incidence of tuberculosis, many sanatoria are now redundant. These vacant sanatoria should now be utilised, with the minimum of delay, to provide accommodation for aged people or to provide subsidiary hospital accommodation for those in need of it. We have heard a good deal about the shortage of beds in Cork hospitals. The institutions in Mill-street, Macroom and Skibbereen could be utilised without any great expenditure to relieve the pressure on the city hospitals. They could also be used to relieve overcrowding in mental hospitals.
The conversion of Heatherside Sanatorium for the purpose of housing the aged has proved very successful. I can recall some local objections when the scheme was first mooted. Within a month of its conversion, all the objections disappeared and it became apparent that the utilisation of the building for its new purpose was equally as laudable as the purpose for which it was formerly used.
There is a serious problem in relation to mentally retarded children. I urge upon the Minister that no time or money should be spared in the provision [349] of accommodation for these unfortunate children. Tremendous advances have been made in the treatment of these children and the sooner that treatment is available to them the better will be the results. In the case of the aged committed to mental hospitals, thereby aggravating the already existing overcrowding, it is unfortunately true that these are often abandoned by their relatives, relatives whose moral duty it really is to look after them. From the point of view of a Christian community this problem is a serious blot on our national life. In the case of the mentally retarded children, it is unfortunately true that an imprudent but quite natural mother love is actually detrimental to the prospects of the child. The longer the child is kept at home the less likelihood there is of his or her being educated to take a useful place in life.
I should like to pay tribute to the wonderful work being done by the Brothers of Charity at Lota in Cork. These men are doing magnificent work in educating these unfortunate children. I appeal to the Minister—I know this is not really his province—to consult with his colleague, the Minister for Education, on this question of the education of the mentally retarded. This work is fundamentally one of education, even though it may also be simultaneously medical and corrective in character, and there appears to be no reason why these Brothers should not secure the recognition they have been seeking as educators. It would be of tremendous benefit to them if they were recognised as teachers.
On the question of the rehabilitation of T.B. and polio victims, I want to pay tribute to the voluntary work of the Cork Polio Clinic. It is important that the Minister should decide on this question of rehabilitation without any further delay. It is vital that these unfortunate victims should be restored as far as it is humanly possible to do so to the full use of their limbs and bodies.
There is difficulty in Cork in obtaining the services of house surgeons. We have consulted the authorities and we have hearkened to their advice. We have gone more than the full distance to meet the stipulated [350] requirements. In the case of the South Infirmary it was suggested that one of the reasons why it was difficult to obtain the services of house surgeons was because they were required to do clerical and supervisory work—work which is done in Britain and elsewhere by registrars. Despite serious financial difficulty, we appointed medical and surgical registrars. The salary offered for the post of house surgeon compares favourably with the standard generally recognised throughout the country. Nevertheless it is still impossible to obtain the services of house surgeons in our hospitals in Cork.
These young men are assisted by the State in their education and it should be brought home to them that morally they ought to make some return to the State for having brought them to the point at which they could be of some value to it. We recognise that if a young doctor can gain more experience abroad it would be wrong to require him to remain here. But surely these young men owe something to the country. Surely it is not too much to ask them to give at least twelve months to some hospital here.
In some Socialist countries medicine is being brought to the nth degree. That is particularly true of the Scandinavian countries where dental surgeons and others are required to move away from centres of population into more sparsely populated areas and they are replaced by young men emigrating from this country. It seems a rather extraordinary position. We do not order people about like that. It would be undesirable that we should do so. Nevertheless, it should be brought home to these young men that it is incumbent upon them to make some return to the State by filling vacancies that arise in our institutions for positions as house surgeon.
Finally, I urge on the Minister the necessity for taking steps to provide suitable accommodation for our aged people who are abandoned by their relatives. The problem is a pressing one. Likewise, steps must be taken without delay to provide institutional treatment for our mentally handicapped children so that they can have the benefit of expert treatment from [351] those qualified for that task. Many of the children who, in the past, have received this treatment are to-day taking their places in normal life. That is a wonderful tribute to those through whose hands they passed. Nothing must be left undone to cope with the situation and to ensure that the hundreds still on the waiting list will receive institutional treatment with the minimum of delay.
Progress reported; Committee to sit again.
Mr. Millar: asked the Minister for Industry and Commerce if he will state (a) the output of the generating station at Ardnacrusha in terms of kilowatts, and (b) the contribution of that station on a percentage basis to the national grid.
Minister for Industry and Commerce (Mr. S. Lemass): I am informed by the Electricity Supply Board that the output of the generating plant at Ardnacrusha in the year ending 31st March, 1959, was 358,963,000 units, representing 19.8% of the total output of the Board's generating stations.
Mr. Calleary: and Mr. Doherty asked the Minister for Industry and Commerce whether any decision has been reached by the Electricity Supply Board to extend rural electrification to Ballycroy parish.
Parliamentary Secretary to the Minister for Industry and Commerce (Mr. Hilliard): I am informed by the Electricity Supply Board that the Ballycroy rural area has been considered for selection by the Board on a number of occasions but has not so far been selected as the returns for the Area did not compare favourably with those for other areas awaiting development in the Board's Galway district. The Area will be reconsidered by the Board in due course and the decision of the [352] Board will depend on how the returns then compare with those for other areas awaiting development in the Galway district.
Sir Anthony Esmonde: asked the Minister for Agriculture if it is proposed to extend the compensation scheme for reactors to the counties in which no such scheme exists at present; and, if so, when.
Minister for Agriculture (Mr. Smith): At present, arrangements for the compensation of herd-owners in respect of cattle which react to the tuberculin test under the Bovine Tuberculosis Eradication Scheme are in operation in 24 of the 26 counties, and I hope to be able to extend them to the remaining two counties in the near future.
Mr. Finucane: asked the Minister for Agriculture if he will state in regard to work carried out under the land reclamation scheme on the lands of Mrs. Catherine Griffin, Ballymac-donnell, Farranfore, County Kerry, (a) the amount of the original estimate, and (b) the revised cost of carrying out the work which was found necessary as a result of the original work being found defective.
Mr. Smith: It is not the practice to divulge details of individual cases under the Land Project.
Mr. Millar: asked the Minister for Lands whether the Land Commission have considered the propriety of acquiring portion of the Burns Estate, Lawrencetown, County Galway, for the relief of congestion in the area.
Minister for Lands (Mr. Childers): The Land Commission acquired upwards of 1,200 acres of this estate during the years 1934-1941. There have been no proceedings in respect of the residue.
Mr. Millar: asked the Minister for Lands if he will state the acreage of land divided by the Land Commission in East Galway in the period from 1st January to 30th April, 1959; and how this compares with the acreages for similar periods over the past two years.
Mr. Childers: Land Commission records are not kept on a constituency basis. In Co. Galway as a whole, the total area allotted during the period 1st January, 1959, to 30th April, 1959, was 8,113 acres. The areas allotted during the corresponding period of the two previous years were 5,451 and 2,901 acres respectively.
Mr. Calleary: asked the Minister for Lands when it is proposed to develop Clydagh bog, Ballycastle, County Mayo, and to give turbary plots to people requiring them.
Mr. Childers: Preliminary work has commenced on the formulation of a scheme for the extensive turbary at Clydagh and the adjoining townland of Keerglen. There will be no avoidable delay in its completion.
Mr. Spring: asked the Minister for Lands if he will state the total acreage of turbary acquired by the Land Commission at Bawnmore, Listowel, County Kerry; in what year it was taken over; and when is it proposed to allocate it.
Mr. Childers: Ninety-nine acres of this bog were acquired in December, 1954. The possibility of acquiring an adjacent bog, for the purpose of a comprehensive scheme, is being examined and it is not yet possible to indicate when this turbary can be developed and allocated but there will be no avoidable delay.
Mr. Spring: asked the Minister for Lands if he will state the total acreage of turbary in the possession of the Land Commission at Ballingare, Lix-naw, County Kerry; in what year it [354] was acquired; and when it is proposed to divide it.
Mr. Childers: There is a residue of 54 acres of bog on hands at Ballynagare, being the balance of 283 acres acquired in 1928. If possible, this residue will be allocated next spring.
Mr. Barrett: asked the Minister for Education if he will state the number of professors and lecturers in music engaged at University College, Cork, University College, Galway, University College, Dublin and Trinity College, Dublin, respectively, and particulars of the number of professors or lecturers whose salaries are paid or contributed to by any local authority, and the name of any such local authority.
Minister for Local Government (Mr. Blaney) (for the Minister for Education): The number of professors and lecturers in music engaged at the University Colleges is as follows:—
| University College, Dublin | 1 |
|---|---|
| Trinity College Dublin | 1 |
| University College, Cork | 2 |
| University College, Galway | 1 |
The number of professors or lecturers whose salaries are contributed to by a local authority is one; the local authority concerned is the Corporation of Cork.
Mr. Spring: asked the Minister for Local Government if he will state the date on which his Department received an application from the Kerry County Council for the making of an order in connection with the erection of a bridge at Blennerville, Tralee; and if he will indicate the cause of the delay in giving the County Council the necessary order.
Mr. Blaney: An application from the Kerry County Council for a bridge order providing for the erection of a new fixed bridge on the site of the old canal bridge at Blennerville was received in my Department on 11th March, 1959. This application has [355] been examined in my Department. I have now asked the county council to submit a preliminary report under Section 46 of the Local Government Act, 1946. Further consideration of the council's application must await the submission of that report. An application for a bridge order involves a somewhat protracted statutory procedure, but no avoidable delay has occurred in dealing with this case.
Mr. Spring: asked the Minister for Local Government if his Department received proposals from Tralee Urban District Council in connection with flooding in the town; and, if so, if he will state their present position.
Mr. Blaney: Contract documents for a remedial scheme which were submitted to my Department by the urban district council have been approved, subject to minor amendments.
Mr. Barrett: asked the Minister for Local Government if he will state the local authorities which contribute directly towards the payment of the salaries of professors or lecturers in music at the following Universities, viz., University College, Cork, University College, Galway, University College, Dublin, and Trinity College, Dublin; and what statutory power such bodies have to make such direct contributions towards the payment of university professors or lecturers.
Mr. Blaney: The information requested in the first part of the Deputy's question is not available in my Department. As regards the second part of the question, I would refer the Deputy to sub-section (2) of Section 10 of the Irish Universities Act, 1908.
Mr. Calleary: asked the Minister for the Gaeltacht if he has secured any proposals from the Mayo County Council for the provision of piped [356] water supplies to the Gaeltacht areas in the county; and when sanction will be given.
Aire na Gaeltachta (Micheál Ó Móráin): Fé mar a cuireadh in iúl don Teachta cheana féin sna freagraí a tugadh dó ar cheisteanna den tsórt céanna 30 Aibreán, 1958 agus 11 Nollaig, 1958, táthar tar éis roinnt tograí dá leithéid sin d'fháil sa Roinn. Tá cead na Roinne tugtha le haghaidh na gcúig mion-scéimeanna uisce-sholáthair a luadh sa bhfreagra dar dáta 30 Aibreán, 1958. Ní féidir ceist ceadú na dtograí eile a bhreithniú go dtí go bhfaighfear sonraí agus meastacháin ina leith ó Chomhairle Chontae Mhuigheo.
The Dáil, according to order, went into Committee on Finance and resumed consideration of Estimates for Public Services for the year ending 31st March, 1960.
Debate resumed on the following motion:
“That the Estimate be referred back for reconsideration.”—(Deputy Dillon).
Mr. Coogan: We have here a princely sum for this Health Estimate, and on top of that, we have our own local rate burden—a crushing burden indeed. Ministers in the past went around the country for the purpose of vote catching, and told us that this Health Act would cost us only 2/- in the £. We wonder what the full impact of it is today on both the ratepayer and the taxpayer. The Minister has mentioned many points but I was disappointed that he overlooked some of the points in which I myself was interested.
The Minister mentioned the increase in the death rate from lung cancer. One wonders was lung cancer in the past actually written off as T.B. People always smoked—I am not making a case for the tobacco manufacturer but [357] people always did smoke—and, as I say, it may be that what was considered to be T.B. in the past was actually lung cancer. I just put that forward for the Minister's consideration.
He also mentioned the lavish outlay on hospital buildings. We have indeed some beautiful structures but have we the same old happy atmosphere for the people who go into these hospitals? I am not suggesting that the services are not better, but it is very hard to get a bed in a hospital. I have seen cases where old people suffering from cancer have no choice other than the county home or the homes of their own people where they have to suffer, and make their own people suffer as well. They can, of course, use the County Home which is just adding insult to injury.
I have seen cases recently where people travelled long distances and were sent home because they could not be accepted in hospital. Within the past week or two, I have seen the case of a patient suffering from appendicitis who had to journey home again. Of course, it is for the medical people to judge on these matters and say which cases are the more acute, but it is unfortunate that people should make these journeys and then find there are no beds available for them.
I understand that at present there is an officer from the Department of Health investigating the question of effecting economies in the regional hospital in Galway. I should like the Minister to say if he is prepared to ask that officer to listen to some grievances put forward by members of the permanent nursing staff. I know that the Minister might not like to go over the heads of the powers that be, but I have a list of the complaints here and I should like the Minister to ask his officer to investigate them. I shall give that list to the Minister afterwards. Recently the Minister told me in this House that he was not aware of any grievances existing, but I now challenge the Minister to ask his officer to investigate these complaints.
The Minister should have stressed the importance of encouraging more blood donors. There is a growing demand [358] in many hospitals for blood donations and possibly the members of this House could give a lead in that regard. Of course, there is a lot of bad blood here, but that would be for the mobile units to decide. I should like the Minister to give greater encouragement to these people. I know he has delegated this matter to the mobile units, and I can say that they are doing great and very important work.
The Minister has mentioned the necessity for advising girls who take positions as probationers in some of the hospitals in England. He was quite right to do so lest they take a false step but, first of all, he should make sure that they are satisfied with the conditions obtaining in Irish hospitals.
Before concluding I should like to ask the Minister to redouble his efforts to deal with the growing list of mentally defective children requiring treatment. It is easy for the Minister to say that they can be treated overnight by the provision of money, but there is more in the problem than merely that. We have religious groups who are doing wonderful work, and I should like to take this opportunity of paying a tribute to them for the great work they are doing in that respect. I join with the other members of this House who have already paid tribute to them.
I should also like to pay tribute to the wonderful surgeons working in our services. It is not well known—in fact, I think they do not like it to be known —that they have performed some of the most important heart operations in the Merlin Park Hospital in Galway, operations which, if they were performed in England, would make headlines. It is only fair that we should appreciate the wonderful Irish surgeons we have. I would again ask the Minister to ask his officer to investigate the few matters I have mentioned.
Mr. Wycherley: What surprises me most in connection with the health services is the number of people dissatisfied with the way they are administered. At every meeting we attend, at every fair and every cross roads, we hear complaints of one kind or another, whether about getting into hospital or getting out of hospital, the getting of medical cards or the refusal of medical [359] cards, or people who say they got free treatment before the Health Act was introduced and now complain they have to pay for treatment.
The Health Act is costing a tremendous amount of money, and what I wonder most about is how much of it really gets down to benefit the people we expect it to help. I am afraid a very great proportion of it goes in other directions, in administration, and the people who should benefit are often denied benefit because the money is spent on the cost of administration. We have so many inquiries to be made into the means of patients; doctors have to be paid, and there are so many incidental expenses that poor people, who should get free treatment, often-times are fleeced, whereas people in good circumstances who should be able to pay, and for whom I would have very little sympathy, very often get off very cheaply.
In the town of Bantry, in West Cork, we have built a hospital costing over £250,000. I think this would be a very appropriate time for the Minister to enlighten the elected representatives of West Cork, and the public generally, as to what is the real cause of the delay in opening Bantry Central Hospital. We hear various rumours. We are told that the I.M.A. are responsible. We did not hear the I.M.A.'s version but it certainly is a scandalous state of affairs if the people of that vast area are to be a shuttle-cock between the Minister and the I.M.A., and are to be deprived of a service provided for them in West Cork. It is a matter which should be settled without delay.
At the present time I would be very slow to lay the blame at the Minister's door or, indeed, at the door of the I.M.A. I know the I.M.A. are a very strong body, but we would expect them to be a very responsible body, and I would not expect them to use the power and strength they have to deprive the poor people of West Cork of a hospital built for their benefit. I strongly appeal to the Minister to meet the I.M.A. without delay and have this matter rectified once and for all, as it is a matter of grave concern to everybody in West Cork and, in particular, to the elected representatives [360] of the people who have big responsibilities in that area.
Mr. Moher: Does the Deputy believe in peace at any price?
Mr. Wycherley: No, I believe in arbitration and I think the Minister, his Department, and the I.M.A. should be able to make some adequately manageable agreement. I do not want to put the pistol to the Minister's head. It would be a shocking thing for me to do and it would be a shocking thing for the I.M.A. to do also. However, they should both be independent enough to come together, to discuss the problems and if necessary the T.D.s from the area should be consulted so that we would be able to judge for ourselves as to where the blame lies. Even we, the elected representatives who are responsible to the people, know very little about this whole row and it is high time that it was brought out in the open. I strongly appeal to the Minister to make a settlement if it is possible to do so, but I would appeal to the I.M.A. also in their own interest and in the interest of the community at large to try to make an agreement at the earliest possible moment.
Minister for Health (Mr. MacEntee): I should like to express my appreciation to Deputies on all sides of the House for the manner in which they have put their points of view and I am greatly obliged to them for the fact that they have directed my attention to the several matters about which people feel there is some reason to complain in relation to the general administration of the services. In raising these matters they have done a great service to the people and a great service to my Department and to myself. Naturally, we, not being everywhere and not being omniscient, do not hear of all the complaints that may be made about the services. The only way in which we can fulfil our purpose, which is to give the people of this country the finest health service our resources will permit, is when the disadvantages and its defects are brought to our notice.
Of course, no health service is perfect. I pay a great deal of attention [361] to medical literature and study the papers which are available to me from the other side. However, with all the money they are expending in Great Britain there are just as many complaints voiced in respect of that service as is the case with our own. Many of our difficulties, most of the defects which we have had and which have been mentioned here, arise from the fact that we are endeavouring to superimpose a modern health service upon an old and outmoded system of what one might describe as medical relief. That was not done just arbitrarily. It was imposed upon us by our circumstances. We had to adapt the system which was in existence here to the new demands, to the circumstances of the time. It is only in the last three years that the health services have been brought into operation on a general scale. That was done by my predecessor in 1956, and it does take some time even for a well-integrated and co-ordinated service to run itself in. It takes perhaps a longer time to get things running smoothly when you have to graft a new plant on an old stem and that is one of the difficulties which we have to face and which, I think, we are solving.
One of the principal complaints which have been raised here has been about this question of the medical card. The difficulty there is to see what other arrangements we could have than this which is traditional in our country to regulate inscription upon the medical register. It has been and was the custom in the old days to issue red tickets to certain classes of patients. Those tickets were issued in very many cases without any regard to the legal requirements which provided that they were only to be given to those who could not by their own industry or other lawful means provide the necessary medical care for themselves or their dependents. The cards were issued rather lavishly and in the majority of cases they did not entitle a person who received the card to very much and often indeed the person did not get as much as he was entitled to.
The possession now of a medical card entitles a person to a very much [362] wider and a very much higher grade of service. It entitles him to specialist and hospital treatment of a very high standard, specialist and hospital treatment which as we know from what has been said here costs the State a great deal of money. Therefore, if the burden is not going to become intolerable we must be very much more circumspect and rigid in the application of the regulations and conditions which govern the issue of these cards. Deputy Wycherley and other Deputies said the services were costing us a tremendous amount of money but how much more would these services cost us if the cards were to be given out in the lavish and careless way in which they were issued under the old dispensation? We would simply not be able to face up to the financial burden. Therefore, there must be much more careful scrutiny of the circumstances of the person who applies for inscription on the medical register.
As well as that, the tradition also was here that the old poor law authority was more or less autonomous in its own district. It was the authority to determine whether the circumstances of the applicant were such, having regard to the circumstances of the applicant's neighbours and fellow ratepayers, that he should be given the red ticket and should have a claim upon such medical services as were then provided.
That was the traditional system in operation here. When the health services were brought into operation the whole system had to be adjusted to the fact that the health authority, say, in County Leitrim, had the control over the manner in which and the liberality with which these medical cards would be issued, just as the health authorities in Limerick had the same control and the health authority in Cork and the health authority in Dublin. But the circumstances varied in the area of each of these authorities. A comparatively rich community like Dublin, Cork or Limerick, could issue these health cards much more freely than the health authority in a poor county like Leitrim where, if great care is not taken to ensure that only those who really require them get them, an intolerable burden might be imposed upon [363] their fellow-ratepayers. It is the ratepayer who really has to be considered in regard to the manner in which the cards are issued.
It would be very nice and, from the Minister's point of view, much less trouble, if we could get uniformity throughout the country in a matter of this sort but we just cannot, because we know how varied conditions are. We know how different the circumstances and the resources of the various health authorities are. Therefore, I would find it exceedingly difficult to formulate any regulation of countrywide application which would not impose, I think, excessive burdens upon some local authorities and reduce very much the burdens upon other local authorities who might very well be able to carry them.
Again, you have the difficulty between those counties which have a very large urban and industrial population and those counties which have not. Take Louth as an example. I am leaving Dublin out. Take Louth, which has two very large industrial centres—a third, perhaps, developing. Its circumstances are very different from the circumstances of a neighbouring county such as Monaghan or Leitrim where they have not got an industrial population and where, perhaps, on the whole, people are healthier than those living in urban areas or are not so prone to avail of the services of the doctor because they have not got the same convenient access to him as they have if they are living in a town or in an industrial area.
These are the things which make it very difficult to devise any sort of regulation which will ensure that there will be that degree of flat uniformity governing the issue of medical cards which would seem to be the ideal many Deputies think we should aim at. Having said that I want to say that I will ask my departmental officers to examine this question again to see if we cannot find some minimum standard below which a person will more or less get a health card automatically. But remember that that—in my view, at any rate—will be a very low standard. One of its effects may be to exclude [364] people above that standard who are already in receipt of medical cards and that we shall have perhaps even greater complaint under a system of that sort than we have here today.
A question was raised by Deputy Dillon about the desirability of, as he said, refurbishing the old county homes and trying to adapt them as suitable institutions for accommodating the chronic and the aged. I think, in the slashing attack he made upon this proposal, Deputy Dillon was a little bit confused. I think he overlooked the fact that in proceeding to carry out this programme of the adaptation of county homes—I think Deputy Giles also forgot it when he was speaking—we proposed to take out of these county homes, when we do it, all those other classes which are at the present moment housed there, such as unmarried mothers and the hoboes whom the Deputy spoke of, and so on. Our aim will be to make them homes for the treatment of the chronic sick and aged who perhaps because their families have left them, and life has left them behind, have no person left to care for them but who are decent, respectable people and are, therefore, entitled to have, shall we say, comfortable surroundings and circumstances at the end of their lives. That is the type of county home we envisage.
There may be something to be said for the smaller type of home in small towns. That, I am afraid, will be a rather expensive project. It will mean that we might not be able to give the old people in these small homes the same sort of reasonable medical care and attention which they would get in other places. At least, we certainly could not do it without imposing other charges upon the ratepayers and the exchequer.
I do not want the House to think I am ruling out of consideration the type of home Deputy Dillon and Deputy Giles referred to but it would take us a good deal longer to provide it. We will have the difficulty of finding suitable buildings. Then we have the difficulty of finding suitable staffs. In the existing home we have the shell of the structure. In most cases it is very sound, which merely needs a degree of adaptation inside. In addition, [365] we have the nucleus of a suitable staff. That would mean we would be able to get ahead rather faster with the adaptation and reconstruction of the county homes than if we were to adopt an entirely new approach—at least, an approach that has not so far been adopted in this county, such as Deputy Dillon and others suggested.
My predecessor, Deputy T.F. O'Higgins, in the course of his very helpful and constructive speech, for which I should express my indebtedness, referred to the fact that he had contemplated the provision in Dublin city and elsewhere of a choice of doctor for those in possession of a medical card. I should like to be able to do that, too. I doubt whether we can do it without a great deal of consideration. I think we might have to abolish—indeed that is what Deputy T.F. O'Higgins rather hinted—the dispensary system altogether, so far as Dublin is concerned. I think we would have to adopt, say, the panel system such as they have in Great Britain, a system whereby persons in possession of a blue card would have themselves entered on the panel of some particular doctor.
We could not have a patient going to a doctor one month and then, not being satisfied with the treatment given, going off to another doctor. You would have to have a reasonable period involved. The patient, or the person, would perhaps have the choice of a doctor but he would have to remain with that doctor for a certain period, 12 months, or something like that and it might have to be on a fee basis.
But that is a complete departure from the system which has been in operation here for so long. It would be an adaptation of the system in Great Britain with perhaps a couple of modifications necessitated by our special circumstances here. That again is something that I certainly would not like to do in a hurry. We have trouble enough getting the health services to work smoothly on the basis of an existing organisation. If we are to have this other system brought in it would, with the negotiations involved with doctors, health authorities [366] and so on, take an appreciable period of time and I should not like to start the process of introducing that system unless I were satisfied that it would give us better results and that it would not—and this is the overriding factor —involve us in any great additional expense.
There are so many things we have still to do in the existing circumstances for which we have not got the money, and for which nobody wants us to find the money, that we could not think of embarking on anything likely to involve us in any very substantial additional expenditure.
There was one other point to which Deputy O'Higgins referred and which I think I ought to mention. He indicated that he disagreed with the policy which I had been pursuing in relation to the building of hospitals and the general management of the Hospitals' Trust Fund. Well, there is a difference of approach there. I hope that my approach will in time be found to be better justified than that which had characterised the general policy of the Department for some years before I came in. I do want to make it quite clear that I think it would be the height of folly for us to initiate any programme unless we have a very substantial reserve so that if anything should happen the Hospital Sweepstakes, to reduce substantially the income from the Hospital Sweepstakes, we shall at least be able to complete whatever projects we shall have embarked upon.
That is the fundamental principle upon which I am operating. I want to say that we have got to remember that the income from the Hospitals Trust Fund comes from a great many countries outside this country. In the present international situation we have no guarantee that we might not find ourselves in the same situation as in the period from 1939 to 1945 and 1946 when, because there was a war raging outside this country, the income from the Sweepstakes suffered a very great decline. That I think is a fact which we have always to keep in our minds.
I have no doubt whatever that the reputation of the Hospital Sweepstakes grows higher every day. I have no [367] doubt about the energy and enterprise of those who manage the sweepstakes, and I know that so long as conditions in the world remain normal their income is not likely to be reduced and may in fact increase. But we cannot, and we should not, as prudent people, particularly in the world in which we live today, overlook the fact, or ever leave it out of our minds, that there may be such a cataclysm that the sources of income of the Sweepstakes would be very drastically curtailed. That is the insecurity I referred to last year and to which I referred again this year and which I always keep in front of me.
For those reasons I am anxious, before we start any sort of building programme or resume our hospital programme again, to ensure that, as I have said, once we start a project we shall be reasonably certain of being able to carry it through. We do not want to find ourselves in the situation, for instance, in which the hospital authorities found themselves in 1956 and that, let me say, was not due to any defect of judgment on the part of my predecessor. He had continued the policy initiated very many years before but we just found ourselves, by reason of the circumstances, unable to continue that policy. So long as I am Minister for Health I do not want to find myself, or to place the hospital authorities, in that position.
Deputy Healy in his speech this morning mentioned a matter which I think calls for special comment. He referred to the fact that in certain Cork hospitals patients were being referred to specialists by house surgeons. If this practice does in fact exist, it is quite wrong. House surgeons should refer patients to a specialist only where specialist examination is clearly necessary. If there is any evidence that the contrary practice is in any way general, I am afraid we should have to take very sharp notice of it because the whole basis of the arrangement made in relation to the establishment of these specialist clinics was that the hospital which conducted a specialist clinic would at the same time conduct an ordinary out-patient department and that people in the out-patient [368] department would not be given specialist attention unless that was absolutely essential.
Many Deputies referred to the grave deficiencies which exist in the accommodation for mental defectives. I think no Deputy is more conscious than I am of the vast gap which exists between the accommodation which we have available and the demand for it. Over the years we have been endeavouring to close that gap. I think I should give the House some figures to show that some progress—perhaps not as rapid as any of us would like but nevertheless such progress as it has been possible for us to make—is being made.
Prior to the commencement of the post-war building programme in 1948 approximately 1,000 beds were available for mental defectives. Under the programme a total of 1,300 beds has been added, so we have now 2,300 in all. At the present moment an additional number of approximately 450 beds are in course of preparation. As well as that, we have premises at Woodlands, Galway, and Croom, Limerick, in prospect. In one case, if we can get the necessary permission from the Ordinary of the diocese, we may be able to find a religious order who will be prepared to open Woodlands as an institution for mental defectives. In the case of Croom, I do not think we shall have any difficulty. We have both these places in view and they will add between 150 and 200 beds.
As institutions become available, one of our purposes will be to try to utilise them as homes or centres for mental defectives. The problem, however, is not just as easy of solution as people think. Reference has been made to the fact that many religious orders devote themselves to the care of persons falling within this category, but even the religious orders, we have found, cannot always meet the demands made upon them. It has been necessary for us to try to attract religious orders from abroad to take over some of the vacant institutions when they become available and utilise them for that purpose. I can assure the House that, as far as the officers [369] of my Department and myself are concerned, there is not anything we can do to grapple with this problem that will be left undone.
We are very sensible in the Department of the deplorable condition of many of our mental hospitals. They are not all in that condition. This morning Deputy Collins referred to the changes which have been made under an energetic R.M.S. and visiting committee in the Limerick Mental Hospital. There are other mental hospitals where improvements have also been made, but there are many where conditions have been static for a very long time and where little has been done even to maintain the existing fabric. But—and this is the point I want to make—Deputy Dillon suggested that these conditions were unknown to members of this House. He seemed to suggest that, in some way or other, we were trying to cloak or conceal the state of affairs which exists in certain of our mental hospitals. That is just nonsense.
The report of the inspector of mental hospitals is published every year, and I have taken the opportunity of circulating to Deputies whom I thought might be able to do something in their own areas, extracts from that report in the hope that, where conditions seem to be worst, something might be done to get improvement. There is no secrecy about the conditions; the facts are published. The only difficulty is that we just have not got the resources, either in money or personnel, to produce startling or spectacular improvement. We could do with some of the money that was expended some years ago but that is water under the bridge and there is no use talking about it. We just have not got the financial resources to tackle this job as we should like to, nor have we got the personnel.
It will not be easy to get the personnel for the carrying out of new treatments and the staffing of these hospitals as we should like to see them staffed. But we are not unique in that. I was reading the other day, again in a medical journal, about certain conditions in Great Britain. In Great Britain, with the remuneration and [370] conditions being offered in that country, they were complaining they could not get the number of people to devote themselves to this particular branch of medicine they would require. I read indeed of a university in England where there is a Nuffield Psychiatric Foundation and they were saying they had not been able to get sufficient students to fill the course. The fact that we find it difficult to get personnel for our mental hospitals is not unique. We are just sharing that condition with, shall we say, the rest of the world. There is little use having our buildings without money. There is little use having them unless we are able to staff them properly. However, what we can do with our resources in staffing and in finance we shall endeavour to fulfil to the utmost.
Unfortunately it happened last night when Deputy Dr. Browne was talking that I had to leave the House because I had another engagement which called me out and I did not hear him fully. I should like to say I appreciate his anxiety in regard to both lung cancer and poliomyelitis. But my temperament is just not his temperament. Certainly in relation to lung cancer my psychological approach is rather different to his. I do not believe you can get very much done by continuous advertising and pamphleteering in relation to smoking. I think that in general the knowledge that smoking, and particularly cigarette smoking, is likely to be a cause of the incidence of cancer is generally very well known throughout the community. The only thing you can do is rely on those who have care of the young to induce them by precept and, best of all, by example to refrain from cigarette smoking.
Casting my mind back to the days when I was young, I think that when I was told not to do a thing and it was dinned into me, I was sometimes inclined to kick over the traces and do it. I am perfectly certain that is the general view among a great many of the young. An advertising campaign might appear to be very spectacular and might secure for the person responsible for it the reputation that he was trying to do something very drastic or novel, but I think the only effect would be to build up a bogus reputation [371] for himself and that it would do very little to induce people to abstain from smoking.
Again, with regard to polio, it is a very dreadful disease; but it is not so common and it is not so likely to be fatal as many other diseases are and gradually treatments are being evolved for it which are likely to be able to overcome the sequela to the disease, the disablement which it leaves behind. Again, one has to deal with the problem calmly and coolly and there is not anything to be gained by trying to work up a sort of hysterical approach in the minds of the public to it. We have done a great deal and have gone a very long way to make it possible for any persons who wish to have it done to have their children vaccinated against polio. If persons wish to avail of the public service, in the vast majority of cases they will get the vaccination free and if they happen to be in a position to contribute towards it—and I think it is not too much to expect them to do something for their children in this regard—they can have now a full course of vaccinations at the rate of 7/6 per child if there are more than two children vaccinated and at the rate of 10/6 per child if there are only one or two children vaccinated. I do not think that is an undue burden to impose upon any persons who is able to pay it. If persons are not able to pay even the 7/6 or the 10/6, they can have their children vaccinated free and, not only that, they can have them vaccinated up to the age of 18 years. That is a fair contribution to ask the general body of the public, the ratepayer and the taxpayer, to make towards ensuring that other people's children, in many cases, are safeguarded against the disease.
Deputy O'Higgins referred to the change which had taken place in the chairmanship of the National Cancer Association. Here, again, I should like to pay a tribute to the speech which was made by Deputy Russell. Deputy Russell was for many years chairman of the Cancer Association of Ireland. It is possible that the sort of ministerial or departmental control which had to [372] be exercised over the very energetic activities of the association and the expenditure which inevitably followed on them may have nettled Deputy Russell somewhat and, in any event, perhaps, he may have found that other considerations compelled him to resign from the chairmanship. I would just like to say that, whatever differences of view there may have been between himself and myself, I very fully appreciate the great service which he rendered to the association from the day upon which he became chairman and I should say that all successive Ministers for Health, not excluding myself from that category, owe him a debt of gratitude.
The fact is that there was a fundamental mistake made when the Cancer Association was organised because, not merely was it made a sort of directive, consultative body for the whole of the country, but it also was made the managing authority for the St. Luke's Cancer Hospital, which it built. There happen to be other institutions dealing with cancer cases—other cancer hospitals as well as St. Luke's—and I think the arrangement whereby the Cancer Association, which was supposed to co-ordinate the activities of all the hospitals, was at the same time the administrative authority for the newest of these hospitals produced a situation which was illogical and not likely to lead to the smooth development of the cancer services in this country.
The chairman, Deputy Russell, having resigned, it is possible for me to make the change which I satisfied myself over a year ago was desirable and, in order to enable the necessary amendments to be made in the memorandum and Articles of Association, I have appointed an officer of my Department, who has had very considerable experience in relation to the whole question of cancer treatment, for the time being, chairman of the National Cancer Association. I have already conveyed this to the other hospitals concerned—my ultimate purpose will be to have St. Luke's administered by a separate authority but to have, over and above St. Luke's and representative of the various hospital interests and the other [373] interests, the Cancer Association. Probably it will retain that name but, if not, whatever the name may be, to have it, as I have said, much more a representative organisation, one in which no interest will feel that it is prejudiced because some of those represented on the body have a sort of predominant place in the treatment of cancer.
Deputy Wycherley mentioned the question of the Bantry Hospital. I regret that the Bantry Hospital is closed. I regret that it has not been possible for us to have it opened but it would be opened—at least I should have hoped it would be opened—if it had not been for the advertisement which the I.M.A. put in the papers asking people to boycott the competition, which had been advertised, for the posts of County Physician and County Surgeon to the hospital. It is all very well to say that we should meet the I.M.A. I have agreed to meet the I.M.A. provided that they withdraw the bar which they have imposed upon members of the profession in regard to these particular posts and, until they do that, I am afraid, unfortunately, and it is greatly to be regretted the Bantry Hospital will remain closed.
There is a very much bigger issue at stake than the mere opening of the Bantry Hospital. Deputy Wycherley has been complaining about the tremendous cost of the health services. It is my job to keep the cost of the health services within moderate bounds and it is my job to try to ensure that when fair conditions are offered in matters of this sort the will of the Oireachtas prevails. I am not going to have a pistol held to my head by the I.M.A. or any other professional organisation. I feel that the terms and conditions which were offered for these posts were attractive and I have no doubt that if the I.M.A. lifts its ban on the competition for these and other hospital posts we shall get ample competition from first-class practitioners at the salaries and under the conditions we are offering.
Before I sit down, I think I should deal with the question of the dental [374] services. I think it is the one thing I have not referred to. The position in relation to the dental services is very much like that in relation to the mental services. There again it is a question of money in the first case and in the second case, a question of being able to secure the requisite personnel.
So far as the personnel is concerned, here is the position. In the past few years, it has become increasingly difficult to fill approved posts in the local authority dental services. That, of course, is due to the fact that there is still an unfilled demand in Great Britain for dentists. That has left us with the situation that last year 16 vacancies were advertised and it was found possible to fill only two of them. Of the 81 permanent dental posts in the local services, which up to the present have been approved, only 61 are filled. There are, in addition, 13 temporary posts, so that between those who are permanently appointed and temporary officers, we have still only 74 people to fill 81 dental posts. Therefore, it would be quite impossible for us, until this situation rights itself, to extend even the school medical services further.
There is the financial aspect of it. If we were to employ dentists in private practice and pay them at the same scale of fees as they are paid for the Social Welfare services, the additional cost would be something of the order between £750,000 and £1,000,000. I ask Deputies to consider where, in present circumstances, we could get £750,000 or £1,000,000 without imposing further burdens upon our whole economy, upon our agricultural and manufacturing industries, making these industries less competitive.
There was one other issue which was raised and to which I think I should also refer and that was the fact—I think it was Deputy Russell mentioned it—that we were less generous than he thought we should be in regard to the allowances to disabled persons. I think it was he or some other Deputy who suggested that because there was a disabled person living in a house in which his brothers or other members of his family were earning, the local authorities [375] were inclined to refuse to grant any allowance.
The position in relation to disabled persons is that they are costing us all but £750,000. That is a very much higher figure than was anticipated when the Health Act of 1953 was being introduced. It is quite obvious that we cannot go very much higher in a matter of that sort without again imposing the obligation upon the health authorities of increasing the rates and without my having to go to the Minister for Finance to try to get some more money from the taxpayers. Again, it is just a case that, no matter how sympathetic we may be, the general body of the people are doing just as much as they can afford to do in present circumstances in relation to this service.
Certainly, I cannot see any justification for the brothers and sisters or the parents of a disabled person having recourse to the local authority if their own means do not make it absolutely necessary and essential for them to do so. There is not any obligation upon the rest of the community to support any person simply because he happens to be disabled. There is a claim in charity on the community if the person is not only disabled but if he and his family are in such necessitous circumstances that they are not able to support him; but where the means of the parents, the brothers and sisters of a person who happens to be disabled are sufficient to maintain him in frugal comfort, I do not think they have any right to have recourse to the public purse to relieve them of what are their own filial obligations.
I should like to say again how indebted I am to all the Deputies who took the trouble to participate in the debate and raise the matters which have been agitating themselves and their constituents in relation to the administration and scope of the Health Act.
Mr. Cosgrave: Could the Minister say if the free anti-polio treatment is allowed only to persons who come within the Health Act qualifications? Can others benefit from that treatment outside the Health Act qualifications?
[376]Mr. MacEntee: First of all, all those in receipt of a blue card get it and any other persons who can satisfy in the ordinary way by a declaration of means that it would be a hardship upon them to have their children vaccinated. Any person outside that class who is within the middle income group and who is prepared to avail of the public services, can get it on payment of a small fee; and I am at present considering the extension of this facility to groups not at present eligible.
Mr. Corish: Is the Minister satisfied, after consultation with his medical advisers or from the knowledge he has in this country, that there is a definite relationship between smoking and lung cancer? The Minister will appreciate that there is a big controversy about this throughout the world.
Mr. MacEntee: On the whole, speaking for my advisers, too, I think a case has been established that there is some correlation between lung cancer and smoking, particularly cigarette smoking.
Mr. Corish: We should not all be too scared.
Mr. MacEntee: Do not let us be panicky about it.
Mr. Corish: That is the point I am trying to bring out.
Mr. MacEntee: Again, the question of the extent to which a person smokes enters into it, too. Undoubtedly, there seems to be some correlation between excessive cigarette smoking and lung cancer and indeed between excessive smoking and lung cancer, but it seems that its cause and effect above all other possible causes has not, I think, yet been established.
Major de Valera: Is there not also the possibility of lung cancer being caused by other agencies, such as diesel engines?
Mr. MacEntee: There would seem to be no doubt that there are many other possibilities. The whole thing is quite inconclusive.
An Leas-Cheann Comhairle: Deputy Coogan wishes to ask a question.
[377]Mr. Coogan: Would the Minister investigate the few points I raised?
Mr. MacEntee: If the Deputy will be good enough to send me particulars, I shall do so. He should remember that the officer who went down there was not the particular type of officer to investigate grievances. I had received many complaints as to the manner in which the hospital was being administered.
Mr. Coogan: Nevertheless, they are doing good work. Will the Minister consider the points I mentioned?
Mr. MacEntee: Yes, if the Deputy can give me the particulars.
Motion: “That the Estimate be referred back for reconsideration”, by leave, withdrawn.
That a sum not exceeding £30,800 be granted to complete the sum necessary to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1960, for the Expenses of the Maintenance, etc., of Patients in Dundrum Asylum (8 & 9 Vict., c. 107; and No. 19 of 1945).
That a sum not exceeding £285,750 be granted to complete the sum necessary to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1960, for the Salaries and expenses of the Office of Public Works (1 & 2 Will. 4, c. 33, Secs. 5 and 6; 5 & 6 Vict., c. 89, Secs. 1 and 2; 9 & 10 Vict., c. 86, Secs. 2, 7 and 9; etc.).
Rúnaí Parlaiminte an Aire Airgeadais (Gearóid Mac Pharthaláin): Tá sé de nós ag an Dáil Vótanna a 8 agus a 9 a chur idir chamánaí i buil a chéile; agus tá ar intinn agam an nós sin a leanacht an iarraidh seo mar is gnáth.
[378] Is as Vóta a 8 a thaganns tuarastail agus costais na bhfoireann riartha, feidhmiúil agus teicniúil de chuid Oifig na nOibreacha Poiblí a bhfuil freagracht uirri Vóta a 9 a riaradh.
Bíonn Vóta a 9 thíos le cuid mhaith mhírcheann caitheachais agus seo iad na príomh-chinn aca sin: ceannach suíomh agus foirgneamh chun críochanna Stáit; tógáil agus cothabháil Oifigí Rialtais agus áitreabh eile de chuid an Stáit agus troscán a sholáthar ina gcomhair sin; tógáil agus feabhsúchán Tithe Scoile Náisiúnta; tógáil foirgneamh mór don Arm; Siltín Airtéireach agus oibreacha eile innealtóireachta; cothabháil Páirceanna agus Cuan leis an Stát, agus chun críochanna áithride eile.
Níl fúm a chur síos i nGaeilge ar na mirchínn éagsúla as éadan. Déanfaidh mé é sin sa gcuntas a thiúrfas mé uaim i mBéarla ina dhiaidh seo.
Nuair a ceapadh don oifig seo mé dúirt an Taoiseach liom go mba chóir tús áite a thabhairt do thógáil agus do fheabhsúchán tithe scoile. Tá cuntas sásúil ina dtaobh sin le n-aithris ar an Vóta sin. Nílim ag súil go mbeifear sásta leis an dul 'un chinn atá déanta cúns is a bhéas aon riaráiste mór oibre ann; ach is féidir a bheith sásta go bhfuiltear i nglacamas láimhe leis an riaráiste sin, agus go bhfuiltear, do réir a chéile, ag fáil an ceann is fearr air.
Tá ceithre mhíle agus ocht gcéad tithe scoile ann. Ón bhliain a naoi gcéad déag fiche is a dó anall tá scoileanna nua tógtha in áit an cheathrú chuid acu sin. Meastar go dteastaíonn seacht gcéad agus caoga scoileanna nua eile; agus i dtaobh trí chéad eile, go gcaithfear a chur leo nó ath-chaoi a chur orra. Is meall mór oibre atá san méid sin ann fhéin gan trácht ar ghnáth-chúrsa tógála agus feabhsaithe ó bhliain go bliain. Molaim saothar na fóirne atá i bhfeighil na h-oibre seo as ucht a ndearnadar le bliain anuas nuair a chaitheadar an tsuim airgid ba mhó dar caitheadh ariamh ar an seirbhís seo agus nuair a sholáthraigh siad níos mó scoileanna ná mar rinneadh riamh cheana. Fiú aige sin fhéin, deirtear liom go dtógfaidh sé, ar a laghad, cúig bliana déag leis an riaráiste a ghlanadh; ach [379] cuimhnítear ina thaobh seo gur riaráiste é a théigheanns i bhfad siar roimh bhunú féinrialtais ann seo. Níl seirbhís thógáil na scol níos mó chun deiridh ná rudaí eile ar dearnadh neamh-shuim díobh go dtí gur músclaíodh suim ionntu agus gur beartaíodh dá réir sin ar theacht chaoi agus cóir agus cumas chuige sin do mhuinntir na hEireann le rialtas dá gcuid fhéin. Is ceart cuimhniú go bhfuil bacanna i scéal na scol nach bhfuil a réiteach ag Oifig na nOibreacha.
Is ag na bainisteoirí le suímh scol a fháil, ach caithfear a bheith sásta san oifig seo go mbíonn na suímh feiliúnach fóirstineach chun na criche. Scaití, cinneann ar na conrathóirí a gcuid fhéin a chríochnú; agus bíonn fadhbanna eile, seachas a chéile, gur cúntar moille go minic iad. Tríd is tríd, ámthach, ceannsaíonn agus smachtaíonn na h-oifigeoirí iad, agus a shliocht air san tuarascáil is féidir liom a leagan faoi bhráid na Dála i mbliana. Molaim iad as ucht naocha dó scoileanna nua agus seasca dó feabhsúcháin móra a sholáthar sa mbliain dar críoch an t-aonú lá déag ar fhichead den Mharta seo chaite.
Cuirim san darna áit ar an Vóta seo i mbliana siltín airtéireach. Cé go ndéanaim é sin, ní h-é sin le rá nach tábhachtach liom an tseirbhís seo. Ní h-é go cinnte; agus tiubhraidh Teachtaí faoi deara go bhfuil méadú réasúnta mór ar an soláthar di sa mbliain reatha airgeadais. Ba mhaith liom béim a fhágáil, ag cur síos dom ar an Vóta seo, ar an bpríomhchuspóir atá taobh thiar den tseirbhís seo, agus sé sin talamh thalmhíochta a fheabhsú i riocht is go mbeidh ar chumas na bhfeilméaraí toradh talmhaíochta a mhéadú go mór.
Bítear ag tafaint orm as gach ceanntar abhann atá ar an gclár-oibre againn agus nach bhfuil obair ar siúl fós ann, faoin moill gan teacht i gcabhair orra. Ní thógaim orra é; ach tuigfear nach féidir na h-aibhneacha uilig a dhéanamh in éineacht. Tuigfear freisin go bhfuil cuid mhaith den obair seo nárbh féidir é a dhéanamh nó gur ceapadh amach agus gur soláthraíodh innill agus maisíní [380] agus trealamh eile—cuid mhaith díobh do chúrsaí chogaidh. Nuair a bhreathnaítear ar an oiread den chostas a caitear ar a leithéid, tuigfear chomh tábhachtach is atá siad san obair seo. Agus bíonn moill ar a bhfáil go minic, toisc an tóir a bhíonns orra; ach maolaítear an fhadhb roinnt ag an seirbhis anuachainte agus deisithe a chuir an Oifig ar bun roinnt bliain-ó shoin.
Tá tús-ord leagaithe amach ag an Oifig de réir an ghá agus an anróigh ins na ceanntair éagsúla. Ceapadh an órd seo amach as an eolas a bhí cruinnithe i dtaobh na n-abhann éagsúl. Tá sé bunaithe ar mhinice agus ar mhéid na bhfuarloch a bhíonns ionntu agus ar tascaí a bhaineas le líon-daoine agus ganntan nó fairsingeacht talún 7rl. atá ina n-aice. Ar ndóigh, an gad is goire don scórnach is cás le gach duine, agus na daoine a mbíonn tuilte agus fuarloch uisce ar a gcuid talún táid beag-bheann ar an bhfear thall. Ní chuirim milleán orra dá bharr sin. Féadaim an méid seo a rá leo: ardaigí croí; tá an tríú chuid den clár-oibre ar fad idir a bheith críochnaithe nó ar siúl nó faoi shuirbéaracht nó dearadh; agus de réir mar a racfas an obair chun cinn beidh feabhas ag teacht ar an eolas, ar an eagraíocht agus ar an gcleachtú; agus as an bhfeabhas sin is féidir a bheith ag súil go mbeidh an saothar níos scioptha ar an gcuid atá le déanamh nó an chuid atá déanta. Deirtear liom go mbeidh cnámh droma na h-oibre briste i gcionn deich mbliana.
Tá seirbhís innealtóireachta eile dá soláthar ag an Oifig seo; agus bíonn éileamh uirri ag na Ranna Stáit i gcoitian. Baineann sí mórán le cuanta agus oibreacha chalaíochta. Tá foireann an-inniúl i bhfeighil na ndualgas seo. Fearacht na gceanntar siltín, bíonn coimhlint idir na Ranna i dtaobh cén ceann aca a ba chóir tús seirbhíse a bheith aici. Cuireann sí sin as go minic don fhoireann innealtóirí; agus ar nós an tsiltín, braitheann an obair seo ar an aimsir, agus treisíonn sé sin an choimhlint. Má tharlóidh go racfar ró-dhian leis an gcoimlint seo caithfear tús-ord a réiteach i gcomhair na seirbhíse seo freisin.
Ní thagród do na mírchinn eile san [381] Vóta mar beidh mé ag tabhairt cuntais uaim i mBéarla orra anois díreach.
I propose to follow the practice of previous years by taking Votes 8 and 9 together.
Vote 8 bears the salaries and expenses of the administrative, executive and technical staffs of the Office of Public Works, which is the Office responsible for the administration of Vote 9.
Vote 9 provides the necessary funds for the purchase of sites and buildings for State purposes; for the erection, maintenance and furnishing of Government offices and other State-owned premises; for the erection and improvement of national schools; for the erection of major military buildings; for arterial drainage and other engineering works; for the maintenance of State-owned parks and State harbours and for a number of other activities.
There is a net increase of £19,310 in the Estimate for the Office of Public Works compared with the total of the sums voted for 1958-59. Subhead A, which bears the cost of salaries, wages and allowances, shows a gross increase of £37,380 but as last year's Vote was supplemented by the transfer of a sum of £13,000 from the Vote for remuneration the actual increase under this subhead is £24,380. This sum covers in addition to increases in remuneration the cost of additional engineering staff in the Marine and General Division for services in respect of State and commercial harbour undertakings, as well as for surveys and other work in connection with the development of fishery harbours.
An increase of £4,500 in the provision for travelling expenses (Subhead B) covers increased mileage rates for motor cars and expenses arising from increased drainage and marine engineering activities, school building and other works.
Subhead C—incidental expenses-shows an increase of £2,630. This is mainly in respect of additional technical equipment required by the drainage survey programme and the replacement of outworn equipment. The provision—£5,300—in Subhead D for telegrams, telephones and postage, is [382] based on the general trend of outlay on these services.
The increases in the Subheads referred to are partly offset by an increase of £13,000 in estimated receipts under Subhead E—Appropriation-in-Aid. This is mainly due to an anticipated increase in the recoupment from Vote 9 of the salaries and expenses of engineers engaged on construction and maintenance work on arterial drainage schemes and other works and to an increase in the amount recoverable as expenses of management of the Local Loans Fund.
The Estimate of £4,088,870 for Public Works and Buildings shows a net increase of £532,870 on the Estimate for 1958-1959. This is made up of a net increase of £528,104 in estimated expenditure and a reduction of £4,766 in the amount expected to be realised as Appropriations-in-Aid.
The principal increases in expenditure provisions are £180,000 under Subhead B—New Works, Alterations and Additions; £120,000 under Sub-head J. 2—Arterial Drainage Construction Works, and £195,000 under Subhead K—Purchase and Maintenance of Engineering Plant and Machinery and Stores.
Subhead A—Purchase of Sites and Buildings—shows a small increase of £2,000 in respect of the purchase of miscellaneous sites and premises.
As an analysis of the bulk provisions under Subhead B for each Department, as shown in the printed volume, is given in the statement which has been circulated to Deputies it is scarcely necessary for me at this stage to refer to any of the details beyond pointing out that the provision for the building and improvement of national schools is £200,000 more than last year's figure.
The replacement and improvement of national schools is one of the most important features of our work. It is well known that there is a large number of schools throughout the country which are not in as good a condition as we would like them to be. Speaking in round figures there are some 4,800 national schools in all. Since 1922, a little more than one quarter of those have been replaced by new [383] schools. Of the remainder, about 750 are at present listed for replacement. In addition, almost 300 schools require a major scheme of improvement or extension. That presents a sizable programme apart from the additional cases which will fall due for replacement or improvement year by year.
Obviously, the programme must be considered on a long term basis. We have made serious efforts to get to grips with the problem and we have made encouraging progress. Last year, the record sum of nearly £1,500,000 was spent and that meant 92 new schools and 62 major improvement schemes completed in the year. I am somewhat hesitant to enter into the realms of prophecy but, if we can maintain that progress, the arrears will have been disposed of in 15 to 20 years. Thereafter, there should be little difficulty in dealing with the 50 or so new cases a year which is the normal rate of obsolescence and deterioration of the buildings.
This year we are asking for £1,600,000 for the work—a new record. We hope to be able to spend it all. The ground work which has to be done in the acquisition of sites, preparation of plans, etc., often takes an inordinate amount of time. Many difficulties can arise—not the least of which is the maintaining of an adequate professional staff. We have a good team on the job at present and everything possible will be done to maintain the present rate of progress so as to ensure the completion of the programme of work within the period of time estimated for it.
The provision of £6,000 under Sub-head BB—coast protection—is for the continuance of the survey and experimental works in connection with the coast erosion problem at Rosslare Strand, County Wexford.
The increase in Subhead C—Maintenance and Supplies—is due partly to wage increases in the building trades and partly to extensive maintenance works at some of the older public buildings and a higher incidence of routine maintenance at others.
The provision for Furniture, Fittings and Utensils, Subhead D.1., is little [384] changed, and that for the Central Furniture Stores, Subhead D. 2., is the same as before. The increase in Subhead E —Rents, Rates, etc., covers sundry rents and rates increases, the cost of acquisition of additional office accommodation principally in connection with the Bovine Tuberculosis Eradication Scheme and the payment of rent in advance for the premises at Bonn which are occupied by the Irish representative to the Federal Republic of Germany.
The reduction in the provision for Subhead F—Fuel, Light, Water, Cleaning, etc.—is due partly to a decrease in the prices of solid fuel, partly to the transfer of charges for water supplies to Vote 25 and partly to the transfer of certain premises to An Foras Talúntais.
The provision under minor Subheads G., H.I., and I. scarcely calls for any comment.
The provision of £10,500 under Sub-head H. 2.—River Shannon Navigation (Grant in Aid)—is required to make good an anticipated deficit in the Shannon Navigation Fund Account. The increase in the estimated deficit is due to a continued downward trend in traffic coupled with increased maintenance requirements which cannot be deferred.
Under Subhead J.1., provision is made for the continuation of arterial drainage surveys and of the preliminary investigation of the River Shannon Flood Problem.
An increase of £120,000 is made in the provision under Subhead J.2 for arterial drainage construction works, the programme for which will attain a broadened stage of development in 1959-60. In addition to the schemes covered in last year's estimate, provision is made for four new catchment schemes, two major schemes—the Moy and the Inny—which have been exhibited, and two minor schemes—the Clareen and the Ballyteige and Kilmore —on which works have been commenced. A sum of £12,000 is included for the Bunratty-Rineanna Embankment Scheme on which work is proceeding. The provision for expenditure on additional minor schemes expected to be commenced within the year has been raised from £12,000 to [385] £30,000: work on a large embankment scheme in the Fergus estuary will be commenced shortly. The Corrib-Clare Scheme is still at peak level. The provision for the recently commenced Maine Catchment Scheme is increased by £25,000 to allow for development of that work this year. The Nenagh and the Feale Schemes are drawing to a close and require smaller provisions.
The expenditure under Subhead J.5 —Arterial Drainage—Maintenance is recoverable from the county councils concerned.
The largest increase, amounting to £195,000 occurs under Subhead K— Purchase and Maintenance of Engineering Plant and Machinery, and Stores. The increased plant and machinery are required to serve the expanding programme of Arterial Drainage Construction Work. Provision has been made for the addition of a substantial number of excavators to the present fleet and for miscellaneous other plant.
A decrease of £4,766 in Appropriations-in-Aid is due principally to a reduction in the amount of dredging and other marine works carried out for the Department of Industry and Commerce and the impending completion of construction work on the Oweno-garney catchment drainage scheme which is a National Development Fund undertaking. The arterial drainage maintenance expenditure recoverable for 1959-60 from local authorities will also be somewhat less as, last year, maintenance expenditure on the Glyde and Dee Scheme was recoverable for part of 1957-58 as well as for 1958-59.
These reductions are offset in part by an increase of £20,000 in estimated receipts from harbour tolls due to raising the harbour dues payable by mail boats at Dún Laoghaire.
This account of the various subheads is necessarily condensed but it gives the essential information concerning them. I shall endeavour in my reply to give such further information as may appear, from Deputies' discussion of them, to be necessary. There is a general and pressing demand for the main services provided for by these Votes, and a well-organised and vigorous effort is being made to meet it. That effort is becoming [386] more efficient with time, but its increasing output requires progressively more money. That is why the Dáil is now asked to vote a larger sum than was spent in any previous year.
“That the Estimate be referred back for reconsideration.”
These Votes do not bring any joy to me. They never did, coming from the constituency from which I come. I shall not go into that now, but I should like to deal with a matter which I feel would tend towards better administration, and towards giving me or whoever might be in my place here a better opportunity of replying to the Parliamentary Secretary. I refer to my being supplied with a copy of his speech. This is evidently something which happened on another occasion and I want to go on record by quoting from the Dáil Debates of 2nd May, 1957. At column 713, Deputy Sweetman said:—
I regret that the Parliamentary Secretary did not follow the example of the Minister who moved this Estimate, the Minister for Education, who, for the convenience of Deputies, circulated a copy of his speech as he was rising. If the Parliamentary Secretary was ever on these benches in the last three years and did not get that courtesy when I was over there, I regret it, but I think it is a courtesy that assists Deputies on all sides of the House and one which we might agree, no matter who is on that side of the House or on this, should be carried out in the future.
I agree that is something which should be carried out. It is very confusing to have to try to take notes as a Minister or a Parliamentary Secretary is introducing his Vote, not only because the matter is being dealt with in a slipshod way, but it is very serious business when we are dealing with estimated expenditure here in Dáil Éireann.
Mr. Bartley: Might I ask the Deputy if he got a copy of the list of [387] works which I had circulated to Deputies?
Mr. Bartley: The list of works I had circulated?
Mr. T. Lynch: Yes; I got that list.
Mr. Bartley: The list gives the Deputy all the essential information.
Mr. T. Lynch: I know that, but, at the same time, I should like to have got a copy of the speech because I am sure there is some kind of policy behind the Estimate for the Board of Works. Why do they go to certain places? Why do they do certain works? What brings them there? I made a note about Rosslare. When I first came into this House, that was a hardy annual, and at that time Deputy Allen used to thunder about the danger of Rosslare being wiped out by the sea, and about inundation and coast erosion, as did Deputy Esmonde and Deputy Corish, but the thunder did not seems to come and the sea spoke for them, and smashed its way through what I would not call a sea wall—it was a row of sandhills—and threatened Rosslare. Then, and only then, did the Board of Works start this survey they are doing at the present time, and to which I have no objection, which I think is good, because I am always glad to see some of this money from the Board of Works coming to the east of the country. In view of the example the Parliamentary Secretary and his office have got from what has happened in Rosslare, may I remind him that we have a very fine resort in Tramore?
In Tramore, there is a promenade which was built in 1912. That was before the Parliamentary Secretary or any of the people here in this House, had anything to do with building promenades or breakwaters. That promenade goes down only a small portion of the foreshore, and two miles of the foreshore are there with nothing but the sand and the stones which the sea and God put there. A few years ago, the sea burst through and it looked as if the whole of that foreshore [388] would be inundated. Behind that foreshore, there are seven or eight hundred acres of what was once a very fine racecourse, and there was a bank there that kept out the sea, but about 1910, or 1911, that bank was broken down by the sea.
I am informed on very good authority that a few hundred pounds at the time would have repaired it, but it was neglected and the whole thing went to waste. I believe that in another Department a report was obtained from some foreign experts, and these foreign experts said the place was irreclaimable. I think it would be well worth while surveying this, even in the teeth of the foreign experts' report, because it was reclaimed with Irish brawn, when they had nothing but pick-axes and shovels, and baskets to bring the clay there, and they were able to keep the sea out with it. Why it could not be reclaimed now, with modern equipment and modern technique, and with some of the machinery for which we have the big increase of £195,000 on sub-head K, I do not know.
I say this with a certain amount of envy because on going through the Estimates I happened to turn over page 44, Vote 9, and I came across the following heading: “Arterial Drainage —Construction Works (No. 3 of 1945)”. I think it would be better if I read it out. It states “Chatchment Drainage Scheme: Corrib-Clare, £2,120,000; Feale £1,285,000; Maine £760,000”—then we get down to Kerry. That is quite a way from Connacht. How did that happen? It continues “Nenagh, £310,000; Bally teigue and Kilmore, £95,000”—always in the small change—“Clareen, £40,000; Inny, £1,750,000; Moy, £2,960,000; Existing Embankments (Bunratty—Rineanna), £33,000.” I made a rough total and that amounts to £9,260,000, but there is not 2½d. being spent on the eastern side of the country. We must have very well conducted rivers and streams there that do not seem to need anything to be done with them.
I should like to draw attention to the river Suir that flows through the place where I was born, Mooncoin. There [389] is a little tributary of that called St. John's Pill and for the past 100 years, there was a bog in Kilbarryo in Waterford. The people were always trying to drain the Kilbarryo bog. They put up schemes during the famine time. The land was not so bad in those days and something could be done with it, but as time went on, the land became inundated.
In my time in local affairs in Waterford, there was a scheme by the Board of Works, put up during what are called “The hungry 'thirties.” That was not a time to go to farmers and say: “We will reclaim this swamp for you. We will not guarantee it will be the best land in the world, but you will have to pay only so much.” At that time, the farmers were not in a mood to pay anything. As a matter of fact, I do not think they could, but leave that as it is.
Turning to arterial drainage, in recent years, the Tramore road has been flooded and local engineers say it is because the Pill needs to be drained, that is, the St. John's River now, the Pill going down to the Suir. Two streams at each side going out the Tramore road require attention and these innocent people in Waterford could think of nothing but how much it would cost the ratepayers and the harbour board.
Mr. T. Lynch: Yes; they would not be as clever as the Galway people who [390] come down here screaming for a grant of £500,000 and then settle for £200,000. Would the Board of Works make a survey there, or will it be necessary to wait until there are floods up to our necks before they send someone down?
I particularly draw the attention of the Parliamentary Secretary to this matter. They would not be looking for a big sum of money and I think the scheme should be tackled again. The local authority owns practically all of the land concerned, and I think an approach should be made to reclaim it in the same manner as an approach is being made in the other places I have mentioned.
Mr. Coogan: Are the people going into liquidation there?
Mr. T. Lynch: No, they are not. The only trouble is that they are an independent people, and were always keen on doing their own work, and never asking anyone to do anything for them. Now they say they are taxpayers, just the same as taxpayers anywhere else, and they say they are entitled to their share of public moneys, just the same as other taxpayers in other counties, districts, and places throughout the country. We should put our own house in order.
Progress reported; Committee to sit again.
The Dáil adjourned at 5 p.m. until 3 p.m. on Tuesday, 26th May, 1959.