The report about champagne dinners and strawberries at 7/6 a lb. naturally lead to a considerable amount of suspicion in the minds of the public in regard to army expenditure, and, therefore, the Minister for Defence cannot expect to escape some criticism. I am going to offer some criticism, but not severe criticism. I may tell the Minister for Defence that, as a business man, it would be quite possible for him to arrange his Estimates on lines on which we could make comparisons more easily. I have something to do with a charity known as the Hospital Sunday Fund, and we have been able to tabulate things in such a way that, at any moment, we can see items for comparison clearly. I suggest to the Minister that it might be well for him to look into this matter.
I want to congratulate the Minister on the attempt he has made to reduce expenditure generally. I am going to suggest the possibility of reducing expenditure still further, if something in the nature of what Deputy Cooper already referred to were undertaken. It is a truism, and nobody will deny it, that any hospitals that are State, or municipally controlled, will cost very much more than hospitals that are under the control of a lay body of governors. I suggest it might be possible to have a larger number of the army, when ill, treated in general hospitals, at a much lesser cost, than they could be treated in the military hospitals. I have no desire, of course, to suggest that the military hospital at the Curragh should be done away with. I think that hospital is an absolute necessity, but considering the diminution in the strength of the army, and the disappearance of fighting and therefore of wounds, and that, as Deputy Cooper said, the amount of illness should be small in a young and healthy army, the work could be very easily undertaken by the general hospitals in Dublin and in Cork.
It was my duty, some years ago, to make inquiries into the beds available in Dublin, Belfast, Edinburgh, and Glasgow hospitals, and I was able to show that about 25 per cent. of the beds in Dublin hospitals were not engaged because the hospitals were unable to support those beds. I suggest to the Minister that it is well worth his while to have inquiry made with regard to this matter, as to whether it would not be advisable, and much cheaper, to have some of the hospitals in Dublin and Cork selected as hospitals in which the military sick should be treated.
Now, I want to compare, for a moment, just the actual cost in the general hospitals with those in military hospitals. The Minister for Defence said, in answer to a question by Deputy Bryan Cooper during the week, that in the last year there were 4,842 patients treated as in-patients, without considering the out-patients at all, in the military hospitals. The cost of that very roughly—because it is impossible to get the real figures as to the actual cost of the military establishment, owing to the way in which the figures are scattered through the various heads—I take to be £80,000. The two hospitals that the Minister for Finance has had a report from, in connection with the board of superintendents—namely, Steevens and the Richmond—treat their patients at a total cost of £121 per occupied bed per year. That covers everything—light, heating, food, clothing, and everything required. If we take these two hospitals we find that there were 3,825 cases treated throughout the year at the total cost of £41,000, whereas in the case of the Army 4,842 cases were treated at a cost of £80,000 to the Government. One is unable to get any definite figure, but, at all events, I put it in another way. The Minister for Defence has stated that the actual cost per head per day is 9s.; that is, a cost of £164 per annum; whereas in the two hospitals receiving the grant from the Government—that is, Steevens and Richmond —the cost is 6s. 7d. per day. I hope the Minister will not mind if I suggest that inquiries should be made as to whether it would not be possible to have advantage taken of the cheaper mode of treating patients than what is being at present.
I do not agree with Deputy Cooper's figures. There are 17,600 soldiers, of whom 543 are in the medical establishment—that is, there is one medical unit to every thirty-two of the soldiers, and that is a great deal too many. But I am going to make another point that seems to me extraordinary. In the military hospitals, during the year, 4,842 cases, out of a total army of 18,923 men, were treated; that is, one out of every four men in the Army was treated in hospital during the year as an in-patient. It seems to me an extraordinary figure that one out of every four men in the Army was treated in the hospital wards during the year. I lay stress upon that figure, and I ask the Minister to make some inquiry about it, because it is a very extravagant figure. It must be remembered that we have done away with fighting to a very large extent. So long as fighting was on and men exposed, one was not able to lay down any figure as to the number of men that should be laid up at a time, but during the past year there is nothing to account for the tremendous amount of illness, as suggested here. Of course it is possible that the same man may have been in hospital several times during the year. For that reason I should like to get a figure that the Minister has not been able to give us, namely, the number of beds occupied during the year, with the cost per bed occupied during the year. If one knew that one would have a basis upon which to make some sort of criticism.
I want to say in connection with the figure in last year's Estimates of £3,000 for consultation—that is, £60 per week —I am glad to see that the Minister has this year cut it down to £1,000. I want to know what the policy of the Army Medical Department is towards prophylactics against enteric fevers and allied fevers. Are they using inoculation for this thing in order to prevent enteric fever occurring? Everyone knows that during the South African war there were more deaths from enteric fever than from wounds. Of course that was completely changed during the European war, and because of inoculation against typhoid and the use of toxins there was very little enteric.
Another point I would like to know is what attitude the Medical Department has taken in regard to prophylactics in reference to venereal disease.
I am quite sure that they are properly treating the diseases that have occurred, but I should like to know the attitude of the army medical authorities with regard to prophylaxis or prevention of disease. I want to say that I am not in any way adversely criticising the army medical establishment. I do not want to have it abolished, as, I think, it is very necessary. I agree with the Minister that we cannot have an army medical service too efficient, and that we cannot get efficient men unless they are properly paid. I have no objection to raise regarding the salaries paid to these men. My only wonder is that they have been able to get men for the salaries mentioned here. I have repeatedly said that I am anxious for efficiency. You will not get efficiency in any direction, I do not care whether it is in education or any other direction, unless you pay properly.
It is extremely necessary to keep up the military establishment fully equipped and ready in the case of war. It has been alluded to in various regions of the House that if we are looking out for war we would need to be better prepared, and if, on the other hand, we are not preparing for aggression, or war, we should reduce the amount of our medical establishment to the very lowest point we can attain with due regard to efficiency. I urge upon the Minister the desirability of making some inquiry as to whether, when reducing the number in the Army and consequently lessening the degree of illness that must accrue, it would not be wise to make arrangements with the general hospitals in Dublin and Cork to treat Army patients and to allow the Curragh hospital to remain, for it would be quite a wrong thing to attempt to remove patients from the training school at the Curragh either to Dublin or Cork if they were seriously ill.