Private Members' Business. - Nursing Profession: Motion (Resumed).

Wednesday, 22 November 1978

Dáil Eireann Debate
Vol. 309 No. 9

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The following motion was moved by Deputy Boland on Tuesday 21 November 1978:

“That Dáil Éireann calls on the Government to establish a Commission of Inquiry into the remuneration and conditions of employment of the nursing profession in relation to other categories of employment in both the public and private sector, bearing in mind (1) the educational requirements on entry (2) the period and degree of training (3) the responsibility (4) the professional proficiency (5) the dedication and nature of service required of members of that profession.”

Debate resumed on following amendment:

1. To delete all words after “Dáil Éireann” and substitute the following:

“approves the measures taken by the Government to date to improve the pay, conditions and status of [1667] the nursing profession and welcomes the recent decision to establish a Commission of Inquiry”.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  Deputy Blaney is in possession, and by agreement he has ten minutes left.

Mr. Blaney: Information on Neil T.C. Blaney  Zoom on Neil T.C. Blaney  Would it be possible to get a copy of the Minister's amendment which I unfortunately have not got?

I covered a fair bit of ground last night in a fairly short time. It would appear that the amendment by the Minister will probably indicate that the motion now before the House has been superseded by the Minister's action in his meeting with the INO on Monday last. The amendment seeks approval of the measures taken by the Government to improve the pay, conditions and status of the nursing profession and welcomes the recent decision to establish a commission of Inquiry. The only thing that counts in this amendment is the recent decision to establish a commission of inquiry. Will the commission report quickly having throughly investigated the entire spectrum of the nursing profession and all of its aspects? Will it be assisted to any degree by the information already gathered by the work study group that has been in operation since 1965? If it ties in with that it would appear that the commission can report with such haste that commissions will get a new complexion far removed from what I mentioned last night.

If the Minister can assure the House that the Commission will report within a matter of six months, and if it is intended that the report will be a comprehensive one, I join with him in the latter part of his amendment which mentions the commission. In the event of the commission not reporting for any reason beyond our control, or their control, in that time I suggest that the Minister give us an assurance that an interim pay increase will be awarded at the end of that six months, particularly if it is obvious that the report will not be forthcoming for a considerable time.

Dr. O'Connell: Information on John F. O'Connell  Zoom on John F. O'Connell  The Minister should give an interim payment now.

[1668]Mr. Blaney: Information on Neil T.C. Blaney  Zoom on Neil T.C. Blaney  While it would appear on the face of it that the claim recently settled by the Minister with the INO was one which dated back to 1974 and that the 15 per cent claimed has been conceded it is short-changing the profession in the circumstances to back-date it to June last and put it on a phased basis, not all of which will be paid until June 1979. The Minister could, without being accused of generosity, have conceded the entire 15 per cent and should have gone back nearer to the date of claim. That would have been a holding operation while the commission was being established and pending their report within six months, as is expected. Even if that 15 per cent was conceded and backdated for the last three years it would not meet the situation if the commission does not report, like commissions in the past, for many years rather than months. In spite of the Minister's best efforts to have it report quickly I am afraid of the commission. I hope his expectations are fulfilled and that the commission will report within six months.

If it is obvious that the commission cannot report within that time the Minister should, in lieu of it and a reasonable final satisfactory settlement on the whole pay structure, conditions and a charter for nurses arising from it, make a commitment to make an interim pay award. There should be a commitment that if the commission does not report within six months claims of the nursing profession will not be dealt with by an answer that the commission are considering all these matters and nothing can be done until it has reported. The Minister should give us an inkling on that matter and help allay the well-grounded fears of the profession who have been badly done by over the years. Admittedly, a lot of this may have been because nurses were too mild in their approach and were too kind and committed to their professional calling, but as is obvious from to-day's demonstration, they can deliver. Now that the no strike clause has been deleted from the association's articles it is clear to all concerned that this body can and will deliver the goods on behalf of its members in future, something which it has not done in the past.

[1669] There are some details which I did not mention last night concerning the way nurses are short-changed at present. One is what is called the overlap in my part of the country. That relates to the change in day and night staffs. That change takes on average about 20 minutes but it is not included in the hours of work attributed to the profession. There should be recognition of this in a definitive way. During that time the nurses involved sort out what is to be done and exchange reports. That is a very necessary part of their operation but they are not given any recognition in time or money for that. The Minister could give the nurses compensation for that without waiting for any commission to report.

To a large degree what we spoke about last night, and what the INO demonstration today was directed at, concerns the problems of nurses in hospitals and in homes but there is another body of nurses who are at loggerheads with the Department, the public health nurses. That row has been going on for too long and, in view of the situation which obtains in that service, the Minister should do something to help them, apart from setting up a commission. He might set a pattern for a more amicable situation in the future than may develop if the nursing profession are continually short-changed in relation to meal times, overlapping times, the various holidays and half-days which the staff to which they are now tied, the clerical staff and health boards, enjoy. It is not necessary to establish a commission to set those matters right. I will be happy if the Minister tells us that the commission is obliged to report within six months. I hope he will tell us that in the event of that report not being presented within that period an interim payment will be made to the nurses. I congratulate the Minister not for changing his mind but for changing the minds of the members of the Government in this regard. I do not think the Minister's mind had to be changed because he was in sympathy with these demands. However, he had to use his best persuasion to encourage his colleagues in Government to make the offer that has been made by way of a commission.

[1670]Mrs. Burke: Information on Joan Burke  Zoom on Joan Burke  I move amendment No. 2:

1. After “Inquiry” to add the following:

“into the remuneration and conditions of employment of the profession”.

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  Is Deputy Burke contributing at this stage?

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  Yes, that is what we arranged last night. The Minister will be called next.

Mrs. Burke: Information on Joan Burke  Zoom on Joan Burke  Speaking as a former member of the nursing profession—and indeed as a patient too at one time after a serious car accident—I feel I am fairly qualified to speak on this matter. The nursing profession has been looked upon as the cinderella profession of this country. Dedication and vocation are being exploited. Nurses have to work non-social hours. Any of us who were in hospital will realise that nurses come on duty at 8 o'clock at night when other people are either preparing for bed or for a night out. They work from 8 o'clock at night until 8 o'clock in the morning, and I mean work. Very often during that period they hardly get time for a meal. It depends on whether they have busy nights or not. They are not even sure of their mealtime.

Every section of the community, without exception, are high in their praise for nurses and the nursing profession. Nurses are said to be considerate and compassionate and must be in a position to reassure their patients at all times. Yet when it comes to translating this praise and appreciation into financial reward for good services rendered, the praising community is found wanting. Do we realise that the salary for nurses does not measure up to the responsibility of their profession? We must remember the nurses have not taken this action lightly. They have taken it not so much from a selfish point of view as from their concern for the patients under their care.

[1671]The Irish Times of 25 September 1978 published a report in regard to overcrowding in hospitals. It was urged that committees be established to examine overcrowding. The report said that serious overcrowding in Irish hospitals led the Irish Nurses' Organisation to resolve, at its annual meeting in Bundoran, that special committees should be set up immediately in all hospitals to examine admissions and discharge policies and to ensure adequate space and staff for the proper care of patients. This is very serious, much more so in geriatric homes than in hospitals. I was speaking to some nurses from a geriatric hospital and they tell me there is one nurse to every eight patients. If this is patient care I do not know what to say because we all know the type of patient to be found in geriatric hospitals. They may be heavy patients; they are aged and possibly suffering from strokes and various other ailments and they need a good deal of nursing care and attention. This cannot be done with one nurse for every eight patients. As a result the wards are understaffed and nurses attend extra patients without any increase in staff levels. Then people talk of productivity deals. How can one count the work of nurses?

I will give one instance where nurses are exploited. Good Friday is an official bank holiday with all the health boards and with local authority offices with the exception of the nurses. Nurses too have a 40 hour week but sometimes they may be in their place of work for at least 48 hours per week. Their mealtime is counted as off duty time whereas in other walks of life mealtime is included in the working hours. This is very unfair.

I am sure too the Minister recognises the educational qualifications and the standard requirements on recruitment, the long period of training and the final qualifications. The high degree of responsibility and the professional proficiency often exceeds that of the doctor. By virtue of the fact that the nurses are always on hand they are the strongest link in the health services here. The large amount of money provided by the Exchequer for the provision of health [1672] services would in no way serve as a substitute for the vocation and the dedication of the nursing staff.

Why on earth did the Minister have to-wait to be pressurised? Is it because of dissention within the Cabinet or in his own party? Why was this commission not set up before now? Over 200 nurses from the North Western Health Board area held a meeting in the region on 7 November 1978 and the meeting called on the Minister for Health to respond to the Irish Nurses' Organisation's demand for the establishment of a special inquiry into nurses' pay and related conditions. Unfortunately, the Minister left this noble profession no alternative but to take the distasteful step of organising this protest march here in town today. The nurses, in their time off, came from north, south, east and west carrying banners of all kinds.

Patients are never neglected; nurses are. Some of them carried banners with “Overworked, underpaid” and others carried “Action now, less talk” while more carried different references to “Charlie's Angels” and so forth. We have now the spectacle of a reluctant Minister being forced into something which he is obviously not in favour of. He is supposed to have made a comment after one of the nurses's rallies throughout the country that they could walk and wear the soles off their shoes but he was not giving in one inch to the nurses. It is only fair that the Minister should be given a chance to deny this statement.

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  I deny it.

Mrs. Burke: Information on Joan Burke  Zoom on Joan Burke  I would be terribly surprised if the Minister did anything else because he might find himself at their mercy another time.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  If the Minister denies a statement it is always accepted by the House.

Mrs. Burke: Information on Joan Burke  Zoom on Joan Burke  I accept it. Can the House take it that our nurses will have the full commitment of the Minister to the setting up of this commission of inquiry and, more important, the implementation of the findings on a pay structure?

[1673] I want to sound a word of warning at this stage. Though the proposal to establish the commission of inquiry, which I hope will deal with the findings, is welcome, I earnestly hope that our nurses will not have to wait three or four years before the findings of this commission are acted on. Will the Minister now tell us when the commission will sit and when he expects to have the report of their findings? Perhaps, as Deputy Blaney said earlier, an interim report might help to expedite the implementation of some of the findings. I cannot emphasise strongly enough that this is a very urgent matter and nothing less than urgent treatment of the nurses' complaints will suffice.

I hope the proposal to establish a commission will not meet with the same fate as another proposal which emanated from this Department concerning my constituency. At the moment a working party are dealing with general nursing, but apparently they cannot discuss salaries or pay claims. This is disgraceful at this time when nurses should have some way of determining their salaries. Their work is so close to the medical profession that I feel their salaries should be tied to that profession.

Minister for Health (Mr. Haughey): Information on Charles J. Haughey  Zoom on Charles J. Haughey  I do not think I need to say that it is my belief that one of the most valuable assets we have in the country in providing a health service for our people is the unrivalled qualities of our nursing profession. It would be grievously irresponsible for any Minister for Health or any health administrator at any level not to recognise that central fact. The standards, traditions, devotion and the competence of our nurses are matters whose value to the health and welfare of our people now and in the past cannot be measured accurately.

It must be an important element of health policy in this country to ensure that the spirit, the tradition and the standard of excellence of the nursing profession will be maintained and strengthened and that the profession as a whole, and each individual member of the profession, is encouraged, helped and sustained in every way to preserve those [1674] qualities. Any assistance we can provide for that important task must be awarded a priority in the administration of our health services.

When I assumed office as Minister for Health I set myself a working principle, a guideline, which was that I would try to administer the health services in partnership with the medical, the nursing and the para-medical professions, that I would try to run the Department on the greatest achievable level of co-operation with those on whom the practical operation and implementation of health policies would devolve. That, to me, seemed an essential thing for success. Indeed, it seemed to me to be the only way to achieve the best results. Following on that principle I arranged meetings with the organisations which represent the different professions working in the health services.

Among the very first I met was the Irish Nurses' Organisation. I wanted to hear from them at first hand an outline of their situation as they saw it, what their problems were, what their possibilities were, and a general indication of the situation as it confronts the nursing profession in Ireland today. I met the Irish Nurses' Organisation representatives on 6 October 1977 and I had a very full and friendly discussion with them. In the course of that conversation I asked them to tell me about the matters which were of concern to them. They raised the following matters; the need for more expert nursing advice inside the Department of Health, the need to have a nursing presence in the planning of our new hospitals, in particular Beaumont hospital, the need to maintain the impetus in the development of the public health nursing service and training programme for public health nurses, the appointment of a nurse as a member of the Hospital Joint Services Board, an expert nurse in midwifery nursing to the working party on general nursing, and the need to give an impetus to the establishment of the advisory committee on nurse training under the EEC nurse directive.

Those are the five main issues they raised and discussed with me on that occasion as being of concern to them. Every one of those matters has been at [1675] tended to. In particular the three extra posts in the Department of Health will be filled in a matter of weeks. I believe that possibly now and in the long term, though it might not appear of any real value or significance to the young nurses who marched today, those who are in charge of the profession see those appointments in the policy formulating sections of the Department of Health as the most important thing to arise out of the meeting of 6 October. We also discussed in a general way the question of overcrowding and understaffing. Since that meeting I have appointed 750 extra nurses to the health service.

I should like to refer to the subject of pay and to refer briefly to a number of things that were said here last night. There is only one phrase that comes to my mind in this connection and that is “crocodile tears”. When I hear Fine Gael Deputies weeping for the nurses, demanding this and that in the area of pay, I am very conscious of the fact, as is every other expert in the staff relations field, that the major cause of trouble to-day, the major cause of the backlog in the nursing profession today, is the restriction on any special salary increases imposed by Deputy Richie Ryan as Minister for Finance throughout 1975 and 1976.

(Interruptions.)

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  Order, please. The Minister without interruption.

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  Towards the end of 1977——

(Interruptions.)

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  If the House does not want to listen to the Minister, that is all right. I will adjourn the House at a minute's notice if the House does not want to listen to him.

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  Up to this moment the debate has proceeded without interruption. Towards the end of 1977 it became clear that the case which the nurses had put forward for equal pay was not going to succeed. My advisers and I immediately [1676] foresaw that that was going to give rise to a great deal of trouble within the profession. It was going to come as a serious disappointment to them. We immediately went to work. We invited the Irish Nurses' Organisation to come and see us and in co-operation with them we embarked on a process whereby a new claim was immediately submitted to the conciliation and arbitration machinery, expedited through that machinery and eventually agreed at 15 per cent, which was to have effect as to half from June 1977, a half of the remainder from January next and a half of the remainder from June next. Although I understand his sympathy in this matter, Deputy Blaney is not correct when he says that this 15 per cent was the result of a claim which had been submitted many years ago. This 15 per cent arose out of positive action on our part in co-operation with the INO to provide some measure of compensation to the profession for the failure of their claim for equal pay. Deputy Blaney also referred to the possibility of interim increases. There will be another part of that on 1 January and another on 1 June.

Following my meeting on 6 October and the agreed settlement, I was justifiably under the impression that in so far as the general nursing profession was concerned the decks were clear, that there was nothing outstanding on my plate. When the INO went to their annual general meeting in Sligo on 23 September there was nothing outstanding between the profession and me at that time. However, that meeting made it clear that there were strong feelings in the profession about pay and conditions. It is my belief that the strength of that expression on the floor of the meeting in Sligo took many people by surprise, apart from myself. However it will have to be recognised that it was there.

The feeling has been expressed, in this House, at the meeting in Sligo and has been building up ever since, that nurses are underpaid, underprivileged, overworked and exploited. Many people feel that they are overworked and underpaid but nurses are probably more highly thought of than the rest of us. How often do we hear the feeling expressed [1677] that we are not giving our nurses a fair deal, that they are not being paid commensurate with their responsibilities and the general exigencies of the profession? I know that that feeling exists. It is impossible to resist that feeling, but how are we to decide levels of pay for the nursing profession. I do not think that anybody in this House could attempt to decide them. How are we to compensate nurses for their responsibilities in the long hours of the night when a crisis arises and they have no one to turn to and have to rely on their experience and training? How are we to compensate a nurse for suddenly being asked to work another five or six hours at the end of a long tedious tour of duty? How are we to compensate a nurse for dealing with difficult patients? How are we to decide the appropriate level of remuneration for this profession? Fortunately, I do not have to decide these things because I am not in a position to do so. There are procedures for deciding them. There is conciliation and arbitration machinery and the Labour Court. I believe that these procedures are regarded as satisfactory by some officials and some experts on the staff relations side of the health services and the profession.

I want to deal with the sequence of events, because Deputy Boland made an effort last night to indicate that I had been patronising or discourteous to the INO. Following the telegram, I received a long reasonable letter from the general secretary of the organisation. I replied to that letter indicating that, in my view and in the view of the Government, the best way for the nurses to pursue their legitimate interests was through the conciliation and arbitration machinery. That is a legitimate point of view to hold. I know that some representatives of the staff association in the nursing profession hold that view. I was not patronising to the nurses. Anybody reading the general secretary's letter to me and my reply would acknowledge that it was a friendly, courteous and co-operative exchange of views. However, the general secretary of the INO wrote to me that, despite the fact that the conciliation and arbitration machinery was there—the nurses organisation had supported the conciliation and arbitration machinery [1678]—they felt that in the present circumstances there was a need for a commission of inquiry and that they wanted to discuss the matter with me. I immediately arranged to meet the INO and discuss their proposal with them. I do not think by any terms of industrial or staff relations or public administration that that series of exchanges could be described as anything but friendly, helpful and co-operative on my part.

Last Monday I met the representative of the Irish Nurses Organisation. We had a long discussion and I proposed that we would establish a commission of inquiry which would deal with the basic fault they found in the conciliation and arbitration machinery. The fault they found was that when they went to pursue a claim for the profession through the conciliation and arbitration machinery, there were no standards to guide them. I proposed that we set up an independent commission immediately to establish standards which will be the basis on which all future negotiations for pay and claims can be considered and which at the same time will look into all the relativities inside the general nursing profession and relativities between general nursing and the other professions involved. I believe that this proposition is receiving favourable consideration from the nurses.

There is one difficulty about this and it is in regard to the conciliation and arbitration machinery. At present before the conciliation and arbitration process there are ten matters of importance to the nursing profession in process of discussion. Those matters are working hours, incremental credit for service, responsibility allowance, standardisation of annual leave, increased annual leave, student nurses' salaries, general nurses' salaries, shift pay, rostering and career structures. The problem is to set up a commission which will endeavour to establish and identify the standards, criteria and principles for the nursing profession for future negotiations which will not interfere with these legitimate claims which are before the conciliation and arbitration procedure at the moment and which are being dealt with.

Another aspect has to be teased out. There is a working party going on at the [1679] moment which was established in response to the demand of the nursing profession. Their terms of reference were in effect written by the nursing profession. Perhaps they have been slower in their operation than many people might have wished but they have done an enormous amount of good work since their establishment. That work and the results which they have produced so far have to be co-ordinated with this new commission.

These matters have to be teased out in consultation and discussion immediately between myself and the Irish Nurses Organisation but there are other bodies which represent our nurses. There is the Irish Transport and General Workers' Union, the Workers' Union of Ireland and the Local Government and Public Services Union. I indicated to the Irish Nurses Organisation on Monday that I would have to discuss this proposal for a commission with these bodies too, because they have a legitimate interest on behalf of their members on anything that is proposed for the nursing profession. I met the representatives of those bodies this morning and we had a long and useful discussion about the problems, and in particular about the problems of overlapping between the conciliation and arbitration claims which are going through at the moment and the work of the working party. From that discussion I can be reasonably confident that these problems can be ironed out and that this commission can go ahead and do the job I proposed for them.

The terms of reference put forward by me for consideration at this stage are as follows: to investigate and establish the standards that apply to general nurses, psychiatric nurses and para-medical staffs in the areas of educational requirements and recruitment, training and final qualifications, responsibility and professional proficiency; to examine the relative grading levels obtaining within these professions and to make recommendations in relation to these matters.

In response to particular questions put to me from the House I want to say there will be no delay about establishing this commission. I visualise that its establishment would be a matter of weeks. [1680] The nurses suggested that the commission be given a period of six months in which to report. I would expect them to report in a much shorter period—within three months.

Dr. O'Connell: Information on John F. O'Connell  Zoom on John F. O'Connell  Is the Minister setting a deadline?

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  My objective would be to get this commission established with satisfactory terms of reference to the different staff organisations concerned within a matter of weeks and to give them an outside deadline of six months, as suggested by the nurses organisation, but with very strict indications that we would prefer them to report much sooner. I know the matters which are of concern to the nursing profession—hours of work, overcrowding, accommodation, changing techniques and evolving responsibility of the nurse—that is something the commission would have to look at very carefully. The whole basis of the nursing profession has changed. Nurses are now being asked to undertake responsibility which in the past was quite unknown to them. They are being asked to take responsibility for increasingly complex equipment and machinery in hospitals. There are 101 small things in the routine running administration of a hospital that upset nurses and cause them inconvenience, frustration and anger far out of proportion to the matters concerned.

I am determined to continue to maintain amicable, friendly co-operative relations with the nursing profession. I place a very high value on that relationship. I want to reject as a gross travesty of what has happened any suggestion in this House that I have either by act of omission or commission done anything to impair that relationship. Exactly the opposite is the case. I have placed myself entirely at the disposal of the Irish Nurses Organisation and the other staff relations organisations. So far I have met every demand they have made. That is something to be able to claim, and I will continue to do that. I deeply resent any attempts by Deputies, for party political purposes, to try to upset the good friendly, amicable working [1681] relationship which I have with the nursing profession. I have far too high a regard for the nursing profession to let anything like that happen. It is not going to happen. I did not have to become Minister for Health to develop an appreciation and regard for the vocation of nursing. I was aware of it, I appreciated and developed that understanding long before I became Minister for Health out of my own personal experience.

I know that the general body of nurses are agitated, upset and angry. That is a perfectly legitimate mood for any profession to be in and they are entitled to give expression to it. I accept that.

At this stage we have to go back to the drawing board and look at all the procedures which are there to enable nurses to give expression to their grievances, complaints and legitimate demands. I want to reiterate that the establishment of this commission will in no way impede any claim before conciliation and arbitration for an increase in pay. Any of the organisations in the nursing profession can go tomorrow morning and lodge a claim before conciliation and arbitration for any amount they wish.

I would hope that, by the time that claim came to be processed, the report of this commission would be available to assist everybody concerned in processing the claim. This commission will be established immediately. It will settle the criteria, the basis, the principles on which these matters can be dealt with for the foreseeable future. It will report quickly. I think the report will be satisfactory and will enable us to deal comprehensively and de novo with pay scales, grades and conditions and all the things worrying the nursing profession and causing them to be angry and agitated. That is my intention and if this does not work we will try something else and I will keep working at this problem until appropriate machinery and solutions are provided for the nursing profession because, as much as any Deputy on the other side of the House, I believe they are entitled to that.

[1682]An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  Deputy Desmond.

Dr. FitzGerald: Information on Garrett Fitzgerald  Zoom on Garrett Fitzgerald  Would it be in order to ask the Minister to repeat the terms of reference?

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  No. Deputy Desmond has been called. Deputy FitzGerald knows quite well that questions are not asked during Private Members' Time. I have called Deputy Desmond.

Mr. Boland: Information on John Boland  Zoom on John Boland  This is the first time they have been announced.

Dr. FitzGerald: Information on Garrett Fitzgerald  Zoom on Garrett Fitzgerald  I do not think any such request has ever previously been refused.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  It has never previously been allowed. I have been here quite a lot longer than Deputy FitzGerald and I have sat in the House at this type of debate for years. Deputy Desmond is in possession.

Dr. FitzGerald: Information on Garrett Fitzgerald  Zoom on Garrett Fitzgerald  The Chair is somewhat on the defensive.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  The Chair is never on the defensive. There is no need for it.

Mrs. Desmond: Information on Eileen Desmond  Zoom on Eileen Desmond  The necessity for action of the sort we have seen today by this very highly-skilled professional body providing the single most important service human beings can provide for each other serves to underscore and bring into focus the very strange set of values which govern our lives in society. This set of values is tolerated by governments, politicians and leaders of public opinion. It highlights the hypocrisy in our society which, while professing to cherish and stand in awe of the wonderful service performed for humanity by nurses, persistently refuses to reward that service by paying salaries in proportion to and providing conditions of employment commensurate with the values they profess. This situation did not begin or end in 1975 or 1976; it has been continuing right throughout life.

By any reasonable assessment of the [1683] relative value of individual jobs, nursing must rank very high indeed. We have all had enough personal or family experience of the need for nursing care and skills which nurses possess to set our priorities right in that regard. It is to the eternal shame of all concerned that nurses have had to engage in actions culminating in the march today in order to highlight their plight. As Deputy O'Connell said last night, nursing is predominantly a female profession. We have tended to treat nurses in particular as we have treated women in general; we have placed them on a pedestal. Irish society makes very unreasonable demands on those it places on pedestals. We might all recall the attitude towards nurses which we faithfully reproduced in essays at school. Our image of the nurse was that of a person with total dedication, who was self-sacrificing, constantly cheerful and who had no personal needs of her own—if she had, she was careful to keep them very much to herself. We looked upon her as a quite extraordinary human being and to the eternal credit of our nurses they have lived up to that image. That does not discharge us from our responsibility to pay them a decent salary.

Nurses are victims of the marriage bar which applied regarding female employment generally up to 1974. The marriage bar placed considerable limitations on all female careers and on the expectations and salary attendant on such careers. The intervening four years have by no means wiped out that legacy and special action is needed now to do so. This is part of what the nurses are bringing to our attention today. We are not far enough removed from the mentality which led to expressions like “A good wage for a girl”. How often we have heard that in our society, regardless of the skills a girl might possess or the value of her job to society. The case can truly be made that positive compensation is needed to make up that defect towards girls in general and in this instance towards the nursing profession.

Nurses are part of a profession which was very hierarchical in its structures and traditions. We are not too far away from the time when bells tolled the arrival [1684] of a hospital surgeon, the number of bells in proportion to the importance of the great man arriving. There was a visiting line strictly in order of rank. That ridiculous position might well be said to have resulted in the situation to which Deputy Blaney referred where, in monetary terms, one doctor equals 12 nurses. Nurses made their first monetary claim in 1972. Doctors have never failed to flex their industrial muscle. The fact that theirs is a vocation has never clouded that fact that it is also a highly-skilled, vital profession and should be paid accordingly. We can take it that from now on nurses will be treated in the same manner.

The basis on which a nurse's salary has been built was the amount needed to sustain a nurse. There has been no regard whatsoever for the skill involved. The ultimate to which a nurse might aspire today is to become matron of the average hospital. I spoke to a matron whose take-home pay is £284 a month, less than £70 a week. I spoke to a sister in charge of a vital kidney unit whose take-home pay is £60 a week. Indeed, the matron of an 800-bed hospital has a maximum salary of £6,000 a year and I am not now talking about take-home pay. That is the salary at the top of the scale and the most to which she might aspire. We must compare that with the wages and salaries paid in top positions in industry. What industrial job can be compared with the control of an 800-bed hospital and the lives and destinies of 800 sick people? Ample reference has been made during the debate to salary scales right through the nursing profession and they are totally inadequate. The Minister has accepted that. He said that any assistance he can provide to maintain the excellence of the nursing profession must be awarded priority. The assistance he can provide in this instance is to pay them a decent salary and he can do it now.

Apart from salaries, what other group would tolerate the situation where post-graduate work must be done in their own time and at their own expense? They study in their own time and pay the fees themselves and it is their own responsibility. At the end of that, there is no financial recognition unless they are [1685] utilising the particular skill or graduation qualification in their daily work. What other group would tolerate a situation where there is no recognition of the time spent on midwifery or any other post-graduate qualification for pension purposes, unless they are employed in health board hospitals? There is no recognition for pension purposes of the three-year training period, nor for English training and service outside the country, possibly in Third World countries. None of these factors is taken into account for pension purposes.

There is no credit in holiday allowances for the seven-day week and the round-the-clock service they provide. There is no laundry or uniform allowance. They are given something like a £75 a year tax free allowance which works out at about £25 per year in hard cash. There is no provision for occupational diseases which must be a real hazard in this profession above all others. Nursing is not taken very seriously by any of us as a life career. There is no incentive to improve qualifications in an era when nursing has become a very highly specialised and sophisticated profession.

Reference was made this evening to county hospitals. The Minister referred to an additional complement of nurses, but county hospitals are still grossly over-crowded and under-staffed. The ratio of nurses to patients is calculated not so much on the individual needs of patients as on the number of patients per nurse, regardless of the nursing needs of the individual patient. The ratio of tutors to sisters is one to 30 in Ireland and, in one hospital in Cork, it is something like one to 100, whereas the ratio in other EEC countries is one to 15. The wage structure in all other countries is far better than it is here. We might take England as the exception. In England there has been a tendency to exploit Irish nurses and Third World nurses and that is not the pattern on which we want to model our pay structures. We are very much behind the type of facilities and wage structures provied for nurses in the other EEC countries.

[1686] We have tended to downgrade, under-value and under-rate the work done by nurses. The daily routine for nurses is very demanding. There is the assessment of patients' needs, the planning of the daily care of patients, the execution of doctors' orders, the teaching of students on the wards, and nurses also have to deal with the public. The Minister quite rightly made the point that nurses have public goodwill but, strangely, we do not put our money where our mouths are all the time. The public do not really see what nurses do. They usually see the wards during visiting time which, by arrangement, is the time of least activity in the wards. It has been organised that way to facilitate visitors. While having a high appreciation of the service nurses are providing, the public do not really see the work they do. Visiting is organised to facilitate visitors and the comfort of patients.

A case has been made for a considerable immediate improvement in salaries for nurses. It has been made by all speakers and I think it has been conceded by the Minister. I do not think the commission the Minister has promised, and which he has told us this evening he intends to set up, meets the case. The Minister mentioned roughly the terms of reference of the commission which I jotted down as he was talking. He talked about education, training, professional proficiency, grading levels, but is there any reference to pay structures or pay relativity? If there is, the Minister did not mention it this evening. I want to ask the Minister across the floor of the House will this commission deal with pay structures and pay relativity?

A Deputy:  Silence is golden.

Dr. FitzGerald: Information on Garrett Fitzgerald  Zoom on Garrett Fitzgerald  Give him time to answer.

Mrs. Desmond: Information on Eileen Desmond  Zoom on Eileen Desmond  The Minister declines to answer and that is the answer.

Dr. FitzGerald: Information on Garrett Fitzgerald  Zoom on Garrett Fitzgerald  That is that. We know what that means.

Mr. Boland: Information on John Boland  Zoom on John Boland  Where is the back-up group now?

[1687]Mr. Harte: Information on Patrick D. Harte  Zoom on Patrick D. Harte  Charlie's Angels are looking down.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  Deputy Desmond is in possession.

Mrs. Desmond: Information on Eileen Desmond  Zoom on Eileen Desmond  We have been highly sceptical about the setting up of this commission. Up to a point, it was accepted by nurses as a step in the right direction, but they too expressed the scepticism we all feel. It is merited by the Minister's silence. Our scepticism is very well founded indeed. The least the nurses expected was that the Minister would put a six months' limit on the commission. In my capacity as a politician I do not think six months is adequate as a limit on the time in which this commission should report.

A commission set up in December would report in late June and the reality from a politician's point of view is that the elections will be over and the political pressure will be off in late June, and the Minister will be let off the hook. We are all politicians and we realise the strength and force of political pressure and that will be off in late June. The Minister said he hoped the commission would report earlier. That is no guarantee. It might not report earlier unless specifically charged by the Minister to do so. We have a sorry history of commissions. Somebody talked last evening about reports of commissions piling up in the Library. Since this Government took office 18 months ago, we had the following commissions: a commission on industrial relations, a commission on Garda pay——

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  The Deputy is getting away from the motion before the House.

Dr. O'Connell: Information on John F. O'Connell  Zoom on John F. O'Connell  She is not.

Mrs. Desmond: Information on Eileen Desmond  Zoom on Eileen Desmond  ——a commission known as the Devlin review and now a nursing commission. The others dealt with pay. This commission does not seem to deal with pay which puts it in a different category from the others which will all sit for longer than six months. That is the reality. I am challenging the Minister across the floor of the House [1688] this evening. He has accepted the case the nurses have made. He has accepted that their pay scales are not commensurate with the value of the work they do. I am asking the Minister to substantiate that by giving an interim payment on account to nurses now, not in six months' time. There are several aspects which must be dealt with by a commission. There are several anomalies which must be dealt with by a commission, but the need for more pay has been substantiated and there was no answer to that. I am asking the Minister by way of supplementary budget in 1978 to give us the money to pay the nurses now.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  It is in order but it is not very usual for Members of the House to clap, but it is not in order for the angels in the gallery to clap.

Mr. L'Estrange: Information on Gerald L'Estrange  Zoom on Gerald L'Estrange  They are not all Charlie's angels.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  It does not matter whose angels they are. All the previous occupants of the Chair have ruled, and it is in the ruling of the House, that no matter how they may feel about anything we cannot have applause from the gallery. That must be accepted by every Member of the House.

Mr. Keating: Information on Michael Keating  Zoom on Michael Keating  On a point of order, could we have clarification on the speaking arrangements?

Mr. B. Desmond: Information on Barry Desmond  Zoom on Barry Desmond  Deputy Boland is to reply at 8.15.

An Leas-Cheann Comhairle: Information on Seán Browne  Zoom on Seán Browne  The speaking arrangements are that Deputy Boland is to reply at 8.15. There is five minutes left and Deputy B. Desmond was the only Deputy to offer so far as the Chair can see. He now has four minutes.

Mr. B. Desmond: Information on Barry Desmond  Zoom on Barry Desmond  I wish to underline the unsatisfactory nature of the Minister's response. We know from long political experience in this House, and I know from watching Deputy Haughey over the past ten years, that he is a consummate political manipulator in the [1689] parliamentary sense. We had a classic example this evening of a rather delicious and charming double bluff. That bluff has been called by my colleague, Deputy Desmond. I took very careful note of the Minister's statement when he referred roughly speaking to the terms of reference of the commission or committee—this peculiar hybrid animal. We do not even know who the members of the commission are; we do not know whether the INO or the ITGWU or the WUI will be represented on it.

Apparently the consultations about the commission are not yet completed. The Minister has said it may include training, that it will probably include education and that it will certainly deal with professional proficiency. Then he used the words “and grading levels”. What precisely is meant by those words? Do they mean merely a structural analysis in terms of job description and appropriate relativities with, say, psychiatric nursing levels or with other levels in the public service or do they mean a real in-depth examination of the actual pay relativities and pay structures of the nursing profession within the context as understood by the Department of Health advisers in the personal division of the Department.

If that is so, the Minister should confirm this but if it is not so we would implore him to include at least in the terms of reference the request of the INO that their pay levels be investigated and that a recommendation be brought forward. The Minister has said that the report may be used in subsequent conciliation and arbitration negotiations. As a former trade union official who had contact for a long time with the Public Services Committee of the ICTU I know exactly what the Minister means when he uses that vocabulary. Therefore, I ask him to clarify precisely during the next few days what is meant by the terms of reference of this commission. If pay relativities and structures are not included the Minister will have to do something more than merely giving nurses a few cups of tea and some biscuits in his room. We want bread not circuses of either commissions or committees.

[1690] The Minister has been very critical of both Labour and Fine Gael. I agree that successive Ministers having responsibility for the public service down through the years have been hypocritical in this area. Indeed, this is an accusation that can be levelled at all of us in that we neglected to ensure that the nursing profession were remunerated sufficiently for the services they rendered. I note that the Minister for Finance has been absent during this debate although in the final analysis he will be the one to foot the bill. We failed to recognise duly the conditions of employment to which nurses were entitled. Perhaps they were more entitled to reasonable conditions than were other groups, ourselves included. Therefore, the Minister for Health and Social Welfare must discharge his responsibility in this regard. I am not convinced that he has done so this evening. I have no wish to score political points but I urge the Minister to broaden the terms of reference and to appoint to the commission representatives of the trade union, and of the public service as well as conciliation and arbitration people as was the case in relation to the Garda. In that way we would at least get the commission off the ground in the best way possible rather than having them begin in a cloud of ambiguity.

Mr. Boland: Information on John Boland  Zoom on John Boland  I have had occasion before to refer to the Minister for Health and Social Welfare as being similar to a three-card-trick man. If ever there was an example of a public audience being invited to find the lady, the lady being pay, we have it here this evening in the Minister's speech because nowhere in that cleverly disguised and adroit use of words by which we have come to know the Minister, has there been any undertaking or even any hint that the nurses would be one penny better off as a result of the establishment of this so-called commission of inquiry.

Last evening Deputy Gerard Brady, speaking for Fianna Fáil, said that this debate is not just about conditions and pay. It is about conditions and pay as our motion states clearly in calling on the Government to establish a commission of inquiry into the remuneration and conditions of employment of the [1691] nursing profession. Set out are certain criteria by which those levels of pay should be judged. Yesterday the Minister tabled his amendment asking merely that the Dáil welcomes the recent decision to establish a commission of inquiry, the terms of reference of which we heard nothing until the Minister read them quickly into the record during his statement to the House this evening. There is no mention whatever in those terms of reference of pay, of cash on the table, the issue which this debate is all about. It is what the nurses' request for a commission is all about and they will not settle for anything else.

The Minister suggested that he understood that prior to the AGM of the INO this year the decks were cleared. As a result of the Minister's contribution, not only have the decks not been cleared but the scene has been set whereby the Minister has invited himself to walk the plank because he has clearly and deliberately engaged in a cynical exercise in public relations, an exercise designed to convince the nursing profession that he was setting up a commission to improve their pay levels and conditions of service.

The terms of reference are to investigate and establish standards that apply to general nurses, psychiatric nurses and para-medical staff in the area of educational requirements and recruitment, training and final qualifications, responsibility and professional proficiency, to examine the relative grading levels obtaining within these professions and to make recommendations in relation to these matters. There is not a word in those terms of reference of pay, of cash. The reference to educational requirements, to training and qualifications and to grading levels are exactly the same as the terms of reference of the working party on nursing set up more than three years ago.

Dr. O'Connell: Information on John F. O'Connell  Zoom on John F. O'Connell  Hear, hear.

Mr. Boland: Information on John Boland  Zoom on John Boland  But the Minister has taken the criteria from our motion and from the petition of the INO on which it was requested that pay levels and conditions of service be based and has set [1692] them out in the terms of reference of the commission but he has scrubbed all reference to money or to conditions of service. In other words he is rendering powerless the commission in terms of their making specific recommendations as to how the pay and conditions of service of nurses are to be improved. Further, he expects the nurses to agree to that.

In addition the Minister went on cleverly in his general wrapping of the candy floss around this insubstantial core, to make vague generalities about how he would like to see improved the pay level of nurses. He did this in the hope that nurses would be deceived into thinking that they would have an opportunity of seeing their relevant and real position improved in relation to other groups as a result of this commission. There is no way that this commission will be in the position of delivering the goods. They will not be in a position to recommend cash on the table. Yesterday we saw the likelihood of this when we read the Minister's amendment and, consequently, Deputy Burke tabled another amendment suggesting that the commission referred to by the Minister should have written into their terms of reference an enquiry into the remuneration and conditions of employment of the nursing profession. Is the Minister prepared to accept that amendment?

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  No.

Mr. Boland: Information on John Boland  Zoom on John Boland  The Minister is not prepared to accept that the commission investigate the remuneration and conditions of employment of the nursing profession.

Dr. FitzGerald: Information on Garrett Fitzgerald  Zoom on Garrett Fitzgerald  That is the card trick exposed.

Mr. Boland: Information on John Boland  Zoom on John Boland  There are only three cards. It is a question of “find the lady” but there is no money involved. I said that this has been a cynical exercise in public relations. We all accept that the Minister is an expert practictioner in the art of public relations. I warned yesterday that he is operating the politics of brinkmanship as far as the nursing profession is concerned. You can go only a certain distance along that road [1693] and then the harsh reality meets you. The harsh reality was in Molesworth Street and Kildare Street to-day. It came from every part of Ireland and it was the voice of the Irish nurses—not just the young nurses to whom the Minister condescendingly referred—which was heard outside the House to-day. There were the young and the young in heart. They were all there and the Members of this House met them, which the Minister did not. Obviously the entire matter seems to be a source of humour to the Minister.

Mr. P. Lalor: Information on Patrick J. Lalor  Zoom on Patrick J. Lalor  The Deputy should keep a straight face himself.

Mr. Boland: Information on John Boland  Zoom on John Boland  The Minister also blandly, in his reformist way, said that his letter to the nurses was helpful. They asked for a commission of inquiry and he replied to them in a letter dated 31 October the final paragraph of which said: “I cannot see that an inquiry of the nature demanded is necessary. I would suggest that you should continue to work for the well-being of your members through the medium of the established and well-tried procedures available”. Is that helpful and not condescending?

Mr. Haughey: Information on Charles J. Haughey  Zoom on Charles J. Haughey  The Deputy should not go too far.

Mr. Boland: Information on John Boland  Zoom on John Boland  Is that not teaching your grandmother how to suck eggs? Is that not telling the general secretary of a national organisation how to go about her business? The Minister says the letter was not condescending. The Minister's letter is clearly in the tones of somebody speaking down in schoolteacher fashion to a group of unruly pupils who were annoying him and who are not prepared to accept what he wants.

The Minister says there is no problem. If there are no problems how is it that resolutions filling an entire page were passed at the annual meeting of the INO relating to the conditions of nursing? The Minister's amendment asks the House to note the improvement in the conditions and status of nurses since this Government came into power. Yet the [1694] nurses are deploring the overcrowding, calling for a solution to the problem of escort duties, suggesting that facilities be made available to nurses to attend refresher courses, suggesting that nurses who undertake special courses should not have to revert to first year staff nurse salary level, suggesting that a realistic pay policy be formulated, and recommending that the present practice in some hospitals where staff nurses are allocated theatre duties without adequate training be eliminated. I could go on and on. The journal Nursing of November/December 1978 devotes the whole of page 5 to these resolutions.

The Minister tabled an amendment asking the House to accept the idea that the status and the working conditions of nurses have been improved. That is as big a con trick as suggesting that the commission of inquiry is going to make recommendations into the levels of pay and conditions of service of the nursing profession. This is just not on and it is not going to work. This party made it clear some weeks ago that we had examined the nurses' case and that we were in favour of their call for a commission of inquiry which would recommend on proper levels of pay and conditions of service in recognition of the work which nurses perform, their unsocial hours, the basic and post-graduate training they have to undergo, and their contribution to society.

The Minister and his colleagues would do well to heed that this is one of the few groups remaining in Irish society where there is still a spirit of public service, where people are still prepared to give above what they are obliged to give. This spirit has been leaving Irish life largely because of the “I am all right, Jack” attitude fostered by the Minister's party. That spirit still obtains on that Public Gallery tonight but it is not going to continue in the face of the cynicism that we heard this evening with the attempt to pull the wool over the eyes of 14,000 people—14,000 people who are providing an invaluable service for Irish society—in relation to a valid claim for recognition of their work and service and for treatment as equals in comparison with other people who do less work for more pay in shorter hours.

[1695] This has been nothing but a whitewash operation. There is no commission here who are going to improve the lot of the nurses. In this, as in his earlier attempts to deal with the nurses, the Minister has displayed the politics of brinkmanship. The joint agreement went to the arbitrator two days before the nurses threatened to march. The Minister agreed to the arbitrator's terms two days before the annual general meeting of the INO. Ostensibly, the Minister changed his mind—now we discover that he did not really change his mind at all—about the setting up of a commission of inquiry two days before the nurses marched here today and the day before our motion was taken here in the House.

The attitude of the INO and the fact that their members are prepared now to see this matter through to finality are at last going to ensure that the Irish nurse and her role in society will be recognised. The Irish Press in its editorial today said, and I quote:

...while the edge has already been taken off their protest by the decision of the Minister for Health, Mr. Haughey, to set up a special commission of inquiry into their claims,

I wonder if they will say that in tomorrow morning's editorial——

[1696] the march will still serve the very useful purpose of allowing the profession to put before the general public its deeply felt sense of grievance.

If I were a nurse I would feel a deeper sense of grievance, having marched here today and attended in this House and heard the Minister's cynical attempt to deceive the members of the nursing profession in what they were getting. This party have endeavoured, since we first discussed and decided on our attitude to this matter, to see that the legitimate claims of the nurses were pursued in the fairest possible way. Last Sunday night I issued a statement calling on the Minister to accept the claims and the terms of the INO prior to their march as an indication of his good faith. I warned that, if he did not, the consequences must be his responsibility. I warn again that the responsibility for the consequences of deciding here this evening to set up a whitewash job and not a commission to award more money and better conditions of service to the nurses rests upon the shoulders of the Minister for Health and his colleagues in Government. We are not prepared to let them away with it and we intend to indicate that through our voting here this evening.

Question put: “That the amendment in the name of Deputy Joan Burke be made”.

Barry, Peter.
Barry, Richard.
Begley, Michael.
Belton, Luke.
Bermingham, Joseph.
Boland, John.
Burke, Joan.
Clinton, Mark.
Cluskey, Frank.
Collins, Edward.
Conlan, John F.
Corish, Brendan.
Cosgrave, Liam.
Crotty, Kieran.
D'Arcy, Michael J.
Deasy, Martin A.
Desmond, Barry.
Desmond, Eileen.
Donnellan, John F.
Enright, Thomas W. [1697]O'Keeffe, Jim.
O'Leary, Michael.
O'Toole, Paddy.
Pattison, Séamus.
Quinn, Ruairí.
Ryan, John J.
FitzGerald, Garret.
Fitzpatrick, Tom (Cavan-Monaghan).
Flanagan, Oliver J.
Gilhawley, Eugene.
Griffin, Brendan.
Harte, Patrick D.
Hegarty, Paddy.
Horgan, John.
Kavanagh, Liam.
Keating, Michael.
Kelly, John.
Kenny, Enda.
L'Estrange, Gerry.
Lipper, Mick.
McMahon, Larry.
Murphy, Michael P.
O'Brien, Fergus.
O'Brien, William.
O'Connell, John.
O'Donnell, Tom. [1698]Spring, Dan.
Taylor, Frank.
Timmins, Godfrey.
Treacy, Seán.
Tully, James.
White, James.

Ahern, Bertie.
Ahern, Kit.
Allen, Lorcan.
Andrews, Niall.
Aylward, Liam.
Barrett, Sylvester.
Brady, Gerard.
Brady, Vincent.
Briscoe, Ben.
Brosnan, Seán.
Browne, Seán.
Burke, Raphael P.
Byrne, Hugh.
Callanan, John.
Calleary, Seán.
Cogan, Barry.
Colley, George.
Collins, Gerard.
Conaghan, Hugh.
Connolly, Gerard.
Cowen, Bernard.
Cronin, Jerry.
Daly, Brendan.
Davern, Noel.
de Valera, Sile.
Doherty, Seán.
Fahey, Jackie.
Farrell, Joe.
Faulkner, Pádraig.
Filgate, Eddie.
Fitzgerald, Gene.
Fitzsimons, James N.
Flynn, Pádraig.
Fox, Christopher J.
French, Seán.
Gallagher, James.
Geoghegan-Quinn, Máire.
Haughey, Charles J.
Herbert, Michael.
Hussey, Thomas.
Kenneally, William.
Killeen, Tim.
Killilea, Mark.
Lalor, Patrick J.
Lawlor, Liam.
Lemass, Eileen.
Leonard, Jimmy.
Leonard, Tom.
Leyden, Terry.
Loughnane, William.
McCreevy, Charlie.
MacSharry, Ray.
Meaney, Tom.
Molloy, Robert.
Moore, Seán.
Morley, P.J.
Murphy, Ciarán P.
Noonan, Michael.
O'Connor, Timothy C.
O'Hanlon, Rory.
O'Kennedy, Michael.
O'Malley, Desmond.
Reynolds, Albert.
Smith, Michael.
Tunney, Jim.
Walsh, Joe.
Walsh, Seán.
Wilson, John P.
Woods, Michael J.
Wyse, Pearse.

Amendment declared lost.

Question put: “That the amendment in the name of the Minister for Health be made.”

Ahern, Bertie.
Ahern, Kit.
Allen, Lorcan.
Andrews, Niall.
Aylward, Liam.
Barrett, Sylvester.
Brady, Gerard.
Brady, Vincent.
Briscoe, Ben.
Brosnan, Seán.
Browne, Seán.
Bruke, Raphael P.
Callanan, John.
Calleary, Seán.
Cogan, Barry. [1699]Fitzsimons, James N.
Flynn, Pádraig.
Fox, Christopher J.
French, Seán.
Gallagher, James.
Geoghegan-Quinn, Máire.
Haughey, Charles J.
Herbert, Michael.
Hussey, Thomas.
Kenneally, William.
Killeen, Tim.
Killilea, Mark.
Lalor, Patrick J.
Lawlor, Liam.
Lemass, Eileen.
Leonard, Jimmy.
Leonard, Tom.
Leyden, Terry.
Loughnane, William.
McCreevy, Charlie.
Colley, George.
Collins, Gerard.
Conaghan, Hugh.
Connolly, Gerard.
Cowen, Bernard.
Cronin, Jerry.
Daly, Brendan.
Davern, Noel.
de Valera, Síle.
Doherty, Seán.
Fahey, Jackie.
Farrell, Joe.
Faulkner, Pádraig.
Filgate, Eddie.
Fitzgerald, Gene. [1700]MacSharry, Ray.
Meaney, Tom.
Molloy, Robert.
Moore, Seán.
Morley, P.J.
Murphy, Ciarán P.
Noonan, Michael.
O'Connor, Timothy C.
O'Hanlon, Rory.
O'Kennedy, Michael.
O'Malley, Desmond.
Reynolds, Albert.
Smith, Michael.
Tunney, Jim.
Walsh, Joe.
Walsh, Seán.
Wilson, John P.
Woods, Michael J.
Wyse, Pearse.

Barry, Peter.
Barry, Richard.
Begley, Michael.
Belton, Luke.
Bermingham, Joseph.
Boland, John.
Burke, Joan.
Clinton, Mark.
Cluskey, Frank.
Collins, Edward.
Conlan, John F.
Corish, Brendan.
Cosgrave, Liam.
Crotty, Kieran.
D'Arcy, Michael J.
Deasy, Martin A.
Desmond, Barry.
Desmond, Eileen.
Donnellan, John F.
Enright, Thomas W.
FitzGerald, Garret.
Fitzpatrick, Tom (Cavan-Monaghan).
Flanagan, Oliver J.
Gilhawley, Eugene.
Griffin, Brendan.
Harte, Patrick D.
Hegarty, Paddy.
Horgan, John.
Kavanagh, Liam.
Keating, Michael.
Kelly, John.
Kenny, Enda.
L'Estrange, Gerry.
Lipper, Mick.
McMahon, Larry.
Murphy, Michael P.
O'Brien, Fergus.
O'Brien, William.
O'Connell, John.
O'Donnell, Tom.
O'Keeffe, Jim.
O'Leary, Michael.
O'Toole, Paddy.
Pattison, Séamus.
Quinn, Ruairí.
Ryan, John J.
Spring, Dan.
Taylor, Frank.
Timmins, Godfrey.
Treacy, Seán.
Tully, James.
White, James.

Amendment declared carried.

Question put: “That the motion, as amended, be agreed to.”

Ahern, Bertie.
Ahern, Kit.
Allen, Lorcan.
Andrews, Niall.
Aylward, Liam.
Barrett, Sylvester.
Brady, Gerard.
Brady, Vincent.
Briscoe, Ben.
Brosnan, Seán.
Browne, Seán. [1701]Davern, Noel.
de Valera, Síle.
Doherty, Seán.
Fahey, Jackie.
Farrell, Joe.
Faulkner, Pádraig.
Filgate, Eddie.
Fitzgerald, Gene.
Fitzsimons, James N.
Flynn, Pádraig.
Fox, Christopher J.
French, Seán.
Gallagher, James.
Geoghegan-Quinn, Máire.
Haughey, Charles J.
Herbert, Michael.
Hussey, Thomas.
Kenneally, William.
Killeen, Tim.
Killilea, Mark.
Lalor, Patrick J.
Lawlor, Liam.
Lemass, Eileen.
Leonard, Jimmy.
Burke, Raphael P.
Callanan, John.
Calleary, Seán.
Cogan, Barry.
Colley, George.
Collins, Gerard.
Conaghan, Hugh.
Connolly, Gerard.
Cowen, Bernard.
Cronin, Jerry.
Daly, Brendan. [1702]Leonard, Tom.
Leyden, Terry.
Loughnane, William.
McCreevy, Charlie.
MacSharry, Ray.
Meaney, Tom.
Molloy, Robert.
Moore, Seán.
Morley, P.J.
Murphy, Ciarán P.
Noonan, Michael.
O'Connor, Timothy C.
O'Hanlon, Rory.
O'Kennedy, Michael.
O'Malley, Desmond.
Reynolds, Albert.
Smith, Michael.
Tunney, Jim.
Walsh, Joe.
Walsh, Seán.
Wilson, John P.
Woods, Michael J.
Wyse, Pearse.

Barry, Peter.
Barry, Richard.
Begley, Michael.
Belton, Luke.
Bermingham, Joseph.
Boland, John.
Burke, Joan.
Clinton, Mark.
Cluskey, Frank.
Collins, Edward.
Conlan, John F.
Corish, Brendan.
Cosgrave, Liam.
Crotty, Kieran.
D'Arcy, Michael J.
Deasy, Martin A.
Desmond, Barry.
Desmond, Eileen.
Donnellan, John F.
Enright, Thomas W.
FitzGerald, Garret.
Fitzpatrick, Tom (Cavan-Monaghan).
Flanagan, Oliver J.
Gilhawley, Eugene.
Griffin, Brendan.
Harte, Patrick D.
Hegarty, Paddy.
Horgan, John.
Kavanagh, Liam.
Keating, Michael.
Kelly, John.
Kenny, Enda.
L'Estrange, Gerry.
Lipper, Mick.
McMahon, Larry.
Murphy, Michael P.
O'Brien, Fergus.
O'Brien, William.
O'Connell, John.
O'Donnell, Tom.
O'Keeffe, Jim.
O'Leary, Michael.
O'Toole, Paddy.
Pattison, Séamus.
Quinn, Ruairí.
Ryan, John J.
Spring, Dan.
Taylor, Frank.
Timmins, Godfrey.
Treacy, Seán.
Tully, James.
White, James.

Question declared carried.


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