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Dáil Éireann debate -
Tuesday, 6 Mar 1934

Vol. 51 No. 1

Local Services (Temporary Economies) (No. 2) Bill, 1933—Committee Stage (Resumed).

Debate resumed on Section 2 (3).
(3) In this Act—
the word "officer" means any person in the employment of a local authority;
Amendment No. 7:—
In sub-section (3), line 44, after the word "authority" to add the words "but shall not include any medical officer in the employment of such local authority".—(Mr. McGilligan.)

We were discussing the amendment in connection with the medical officers. I am sorry that the Government has chosen to reject this amendment, because I think that a great deal can be said for it from every point of view. I quite regret that the Minister has not yet spoken in this debate, but the power behind the throne has clearly indicated the views of the Government on the matter. I think Deputy Corry told us on the last day that he really could not accept this amendment. I am sorry to hear that particular announcment of the Government policy because I think a strong case can be put up for the various other bodies of men who were affected by this Bill, and a particularly strong case can be put up for the dispensary medical officers. If there was any truth in the contention of members of the Government and of Deputy Corry that the country was never so prosperous as at present and the people never so well off, if there was any pretence that the Government believe that, it is very hard to understand their attitude in this particular matter. Why should they actually propose to hit these particular professional people? We have heard very strong appeals from different sides of the House. We have heard particularly strong and able appeals from Deputies Rowlette and Davitt, who gave out very strong reasons why this amendment should be accepted by the Government. If I might say so, I think that, instead of adopting the Government's point of view that the country is so prosperous now that there is no justification for the Bill, they should look the actual facts in the face and admit that the community is hard hit and that the farmers particularly are hit.

I suggest, however, that one of the first classes that feels how hard the farmer is hit is the dispensary doctor. Everybody who knows anything about the country knows that it is not on account of the salary attached to the post of dispensary medical officer that that position is sought. It is sought for two reasons. One reason, but it is not the major reason, is the salary attached to the position. There is another reason as well, namely, the desire of the doctor to establish himself in a particular district, and the official position that he has, and the salary that he has, inadequate as it may be, as a dispensary medical officer helps him to the attainment of that end. If the Minister makes inquiries he will find out that the private practice, which with most of them forms the greater portion of their real income every year, is gravely hit by the economic crisis. What the Minister is doing is practically this: The economic crisis having taken away a percentage of the major portion of the doctor's salary, the Minister now proceeds to take away a certain portion of the rest of the salary. Undoubtedly there are many doctors who now, practically speaking, have to attend cases for which before they would get paid and who have now little prospect of getting paid. That is a consideration that particularly hits this class of practitioner. If anybody has been hit severely by the economic war, hit directly and quickly, I say, after a certain amount of inquiry, that it is the dispensary doctor. Therefore, I should be glad if the Minister could see his way for once to revise the opinion of his main force behind the throne and consider this amendment favourably.

A great deal of the salary of the medical officer goes in expenses in connection with carrying out his duty and a great deal of these expenses goes in attending cases for which he is getting no return in the way of private fees. The necessity of a motor car in modern times and the cost of it should be taken into account in this connection.

I suggest that the Minister should not follow the example of others who get up here and be full of sympathy for the doctor, full of appreciation of the services he gives, especially to the poor, and then, not satisfied with what he has suffered in his private practice, seek to inflict this further hardship upon him. If the Minister is not willing to accept the amendment, I suggest that he can, at least, spare the House and the profession his lip sympathy and his appreciation of the excellent work they are doing. It speaks well, not merely for the medical profession, but for humanity in general, the way in which doctors as a whole, or at least the great bulk of them, treat the poor. They may occasionally charge heavy fees to the rich, but the very best service of the profession, even where there is no obligation to give the very best service, is at the disposal of the poor, and especially the very poorest. Everybody knows that. I suggest that it is no real appreciation of that humanitarianism on the part of doctors to come along now when, as I say, the country practitioners, are so severely hit, and, in addition to the blow they have already received gratuitously to inflict this particular blow on them. I ask the Minister, therefore, for once to take his courage in his hands and now, as the Deputy has not yet turned up, accept this amendment before he is caught.

I would not have intervened in this debate were it not for the fact that if I did not do so I might be taken as acquiescing in remarks of Deputy Corry a few weeks ago when this amendment was previously before the House. On that occasion it would have been sufficient for Deputy Corry to confine himself to arguments in favour of the rejection of the amendment without going out of his way to slander the medical profession throughtout the country. Deputy O'Higgins, I think, already very ably refuted those slanderous statements and, because I am associated with Deputy Corry in the same Party, I wish also to let the House know that Deputy Corry in his own viewpoint and his own only. I venture to say that he would not have the support of a single member of the Party here in making those statements.

Deputy Corry said that the dispensary medical officer rushed off to hospital every case without paying it a second visit. Deputy Corry is a member of the Cork County Council and is, no doubt, in possession of a book from which he issues red tickets for the attendance of medical doctors in that area. If the dispensary doctors in that area have been as negligent as Deputy Corry alleges, then it was the duty of Deputy Corry to bring those matters before the notice of the Cork Board of Health. In speaking of the county medical officers of health, Deputy Corry referred to them as the specimens that he had seen going round, just as if they were specimens of chickens on Deputy Corry's own farm. I am very glad to say that public representatives on these benches, holding very responsible positions in the public administration and life of the country, have assured me that there was never a more satisfactory official in the Country Cork than the county medical officer of health for that county. They are all agreed in paying the highest possible tributes both to that official and his assistants in the County Cork, no matter what Deputy Corry may say here or anywhere else about them.

Deputy O'Sullivan asked the Minister to exclude a certain body from the scope of this Bill. I am in these position that I know that these medical officers work very hard. They are called upon at all times of the day and the night to do certain work for which nobody—not even Deputy Corry—can allege they are overpaid. I feel, however, that nobody is more sympathetic towards that section of the profession than the Minister. He showed that when he raised the minimum salary from £210 to £260 yearly, and gave very valuable concessions to dispensary medical officers. The concession may not be as big as the profession would like to see it, but it was, at any rate, a gesture of goodwill on the Minister's part the profession appreciates.

I should like to have seen Deputy Corry and other speakers taking a different line when discussing amendments of this kind. I am sure the Minister when replying will give to dispensary medical officers, to county medical officers of health and to medical officers who are officials of local bodies, the protection that they look for from slanderous statements that are made by persons in a privileged position about people who are unable to reply.

I have no doubt whatever that the Minister will be lavish with the inexpensive solatium that the learned Deputy asked for the medical officers of health and other dispensary doctors. I am sure the Minister will be glad to give them all the praise, and all the expressions of gratitude, which he is apt to command. But, seeing the independent way in which the Deputy looks on this question, I thought that he would have gone on with his speech, and pointed out to the Minister something else which has not been pointed out so far. Quite apart from the merits of the general policy of economy of reducing salaries, there is an element in that policy which requires special consideration, that is that the reduction should be equitably imposed. You should not ask one man to sacrifice 40 per cent. and let another man, equally well off, get away with five per cent. What do dispensary doctors get their salaries for? What work do they do for their salaries? Is it not really attending to the destitute poor? It may be said that a dispensary doctor is paid for the red ticket cases he attends, that outside the red tickets he can charge a fee, and that that fee is part of the income, over and above the salary of a medical officer of health. Admittedly, he has other minor duties as medical officers of health. But the principle duty he discharges for the salary is attendance on red ticket cases. There are two ways of reducing his salary, one is to take off £15 per annum, and another way is to enlarge the district, or to increase his work. The Minister knows, just as well as I do that the rural population have grown much poorer in the last 18 months. The Deputy knows as well as I do that dispensary doctors are getting more red ticket cases now than they were getting two years ago. There are fewer fees available from the average small farmer for the dispensary doctor than there were two years ago, and there are people now going to him on red tickets who never did so before. In so far as that is the case it operates as a reduction in the salary of the dispensary doctor, because he is doing more work for the same pay, and on top of that—which I submit should be regarded as his contribution to the cost of the Government's economic war—the Government is going to impose upon him the cuts provided for in this Bill. Quite apart from the ethics of an Economy Bill along these lines, I submit that that is not common justice, because you are purporting to impose the same percentage of a cut on a dispensary doctor as you are imposing upon everybody else when in fact you are imposing twice the cut on a dispensary doctor that you are imposing on anybody else, because he is losing at both ends. You are burning both ends of the candle, Government policy having created an economic situation which has reduced his revenue from private practice, but which has increased the volume of his work on red tickets. Now Government legislation is going to take from him a percentage of the salary which he enjoys in respect of the work he does on red tickets. That is not equity, and no matter how willing a man is to weigh in with his neighbour and to share the adversity of his neighbour, no man who is human will willingly submit to a double burden.

I would have thought that the Deputy, with his experience of a rural dispensary, and expert knowledge of the truth of what I am saying, would have made bold to make that case to his own Minister. It would come much more strongly from him, and would make a much more profound impression on the Minister, if the Deputy made the case I am making. I do not think the Deputy would attempt to controvert the case I am making. He has had the independence of mind to reprove his colleague, Deputy Corry, but when he has listened to Deputy Corry as long as I have listened to him, he will not waste his time reproving him. Even in his lighter moments Deputy Corry is an individual to whom no sane man in this country pays the slightest attention. Let me reassure the Deputy that when Deputy Corry gets up and says, as well as I remember his words, that the medical officer of health for Country Cork was an extravagant individual, and had a host of assistants—even if Deputy Corry got up and said that the medical officers of health treated patients with something approximating to savagery —that is only Pretty Fanny's way, and the Deputy does not mean it. He said it because he could not think of anything else to say at the time, and no one who knows the Deputy will be in the least perturbed. We are now in Committee and the Deputy may intervene again. I invite him to do so, and to say if I have over-stated the case for the dispensary doctors in any particular. I invite the Deputy to intervene again, and to deny or to correct any contention that I have submitted to the Minister. I invite the Deputy, not rhetorically but sincerely, to intervene again and admit that I have converted him to my point of view. I submit that if he does so it is more than possible, nay, it is highly probable, that we will shake the hitherto impregnable fortress of the Minister for Local Government and Public Health. He is a softhearted man, he is a just man, he is a generous man, and the Deputy and I together may succeed in preventing him, all unwittingly from doing an injustice to the medical officers of health in this country. I invite the Deputy to lend a hand.

I do not for an instant attempt to deny the accuracy of every statement that Deputy Dillon made, but I pointed out that the Minister did certainly make a distinction in the case of medical officers when he gave them, not a very big concession, if you like, but a concession that was not given to other public servants. I speak on behalf of several dispensary medical officers. In the case of those in Deputy Dillon's own town and around it, I speak with authority when I say that if sacrifices are necessary in the present economic distress they are quite willing to make them as well as everybody else. Speaking for the medical officers in the constituency that I represent, I can say that 75 per cent. of them will not be touched at all under this Bill.

And hence their willingness to make the sacrifices.

Hence the value of the Minister's concession.

Are you sorry now that you asked Deputy O'Dowd to intervene?

Deputy Dillon, in asking for the intervention of Deputy O'Dowd, was of course putting him in a rather awkward position, because I am quite satisfied that if Deputy O'Dowd were allowed to give a free vote it would be against the proposed cuts. However, his position is such that one can possibly excuse him if he should vote the other way. The main question here is the Minister's attitude. I think that if we could succeed in getting the Minister to change his mind on this, that Deputy O'Dowd would be just as glad as I would, even though both of us, for obvious reasons, may be prevented from taking too active a part in persuading the Minister to change. It is quite obvious that this proposal to cut the salaries of dispensary doctors has very little support behind it—it was attacked by Deputy Norton, the leader of the Labour Party—apart from Deputy Corry, who, I was glad to see, was brought to book for his wild statements. I had proposed making some comments on that Deputy's speech, but Deputy O'Dowd rather stole my thunder, so that I think the less said about it now the better.

But, apart from Deputy Corry, I have heard no member of the Government Party defend or advocate the cuts in the case of the dispensary doctors or of the county medical officers of health. I believe that a great many members of the Government Party are not in favour of these cuts on public servants who are already underpaid. When Deputy Dillon stated that the present economic conditions had resulted in an indirect cut, by causing an increase in the number of red ticket cases in any given district, he failed to mention, though he meant it by implication, that not only was there an indirect cut in that way, but that there was also a direct cut by the fact that the increase to the red ticket list was accounted for by those who had been taken off the dispensary doctor's list of private patients. We have not only the doctor being overworked, but also the fact that he is losing a great number of his private patients, and that these are being added to his red ticket list. That really is an argument for increasing and not diminishing the salaries of dispensary doctors, because they are getting more work to do as a result of the present economic conditions in the country. As poor law medical officers they are getting more work to do. On that alone the dispensary doctor is entitled to an increase in his salary, but when, in addition, his private practice also suffers, it surely is an added argument for an increase. I suggest to the Minister that we should have the difference and leave the present salaries untouched. No case has been made for cutting down the salaries of unfortunate dispensary doctors who are terribly hard worked and definitely underpaid. I think the Minister will admit that putting this section into operation will not mean much of a financial gain to the Government. The gain to the local bodies will not be considerable either. I should say that the political gain even is a very doubtful thing. The Minister would be likely to reap as many political kudos by omitting the section altogether as by pressing for its retention unchanged.

The expenses that a doctor has to meet have been mentioned, and particularly those that relate to the upkeep of a motor car. A good many people who have talked on that aspect of the question probably do not realise that the upkeep of a motor car is very costly for a doctor whose dispensary district is widespread. Say that a doctor has a car that is value for £200. Everybody knows that a new car costs less to run than an old one. Take a car that has been in use for two or three years. I calculate that the running costs of such a car will be between £130 and £150 a year. A car is an absolute necessity for a dispensary doctor and, as I said here before, some special concessions should be granted to them as regards the amount of tax they have to pay, because a motor car is a necessary part of their business. In comparison with doctors at the other side, who get the same type of car much cheaper than it can be got in the Free State, a doctor here is severely handicapped. A doctor at the other side is also able to run his car at far less than it costs his confrere in Ireland. The question of a car, therefore, is a very important one from a dispensary doctor's point of view. I think the Minister will have to admit that it is a definite injustice to cut down the salaries of dispensary doctors at the present moment. As somebody has stated before, the Minister, probably, will take up the attitude that if you except one class of men from the scope of the Bill you will have to except everybody. That, of course, does not follow, and, in any case, as Deputy O'Higgins stated, if the proposed action is an unjust one, that should take precedence of the value of the opposite proposition, from the point of view of argument.

I do not like to delay too long, as I have spoken already on this section, but I would again appeal to the Minister from all points of view to reconsider his attitude on this—from the point of view of justice and from the point of view of economy, because I do not believe any economy will result from it. Secondly, I do not think there will be any political gain for the Government in it, and I have not heard any Labour representative or farmers' representative indulging in any thunderous phrases in favour of it. Indeed, I do not think the Minister himself is in favour of it.

I only want to say one word in support of Deputies Davitt and Dillon. It is admitted that medical officers, generally, are the worst paid servants of the State and of public bodies in comparison with the services they render. There is no question or doubt about the fact that the medical profession as a whole, including the dispensary doctors, have suffered a very severe cut in their incomes through circumstances over which they have no control, and I think the Minister should consider very seriously accepting the suggested amendment to omit them from the scope of the Bill.

I only feel called upon to enter into this debate because of the fact that dispensary doctors, and the medical profession generally, never thought it too much to give their services voluntarily and freely in every case where suffering humanity demanded their services. In particular, in the days gone by, the medical profession, as a whole, established a standard which I should like to see maintained, and I should be sorry to see any Irish Government, which is more or less the result of these activities, taking it as part of their policy to inflict hardship on that great profession. I ask the Minister to accept the amendment and to give way to the suggestions made by Deputy Dillon, Deputy Davitt and other people who spoke on this.

I was very glad indeed to hear the many tributes paid to the medical profession, and particularly to the dispensary medical officers in the public service, from, I think, all sides of the House. I am quite satisfied that, taking them all round, they do excellent service to the State and to the community as a whole. I am quite happy as Minister for Public Health to bear testimony to the satisfaction the Department gets, generally speaking, from the medical men in the service. I do not think I need say any more, especially to the medical men. I have had deputations from them. I have had deputations from the several committees—local committees, as well as what I might call national committees—of the medical body on this question of cuts, and I told them, through their representatives, my opinion of this question and what my answer must be on this amendment. I think that Deputy O'Dowd was a member of, perhaps, more than one deputation that waited on me on behalf of the medical profession. I do agree that it is probably correct that medical men have suffered some loss of income from their private practice in the last few years. What professional man has not suffered? There has been in this country, as well as, I think one could say without exaggeration, all over the world, a very serious decline in the last six or seven years in the value of agricultural products. That decline has been steady for the last six or seven years, and the decline in the last five years, probably, has been about 50 per cent. In the Irish Free State, which is so very largely an agricultural community, it is natural that we have felt that loss or decline, particularly the farmers and agriculturists of the community generally. As a result of that, doctors as well as others have suffered a decrease in their incomes. I do not think that Deputy Dillon or Deputy Davitt or any other Deputy on the other side of the House can say that the doctors have a greater number of red tickets now than in the last two or three years.

I said it, and Deputy O'Dowd confirmed it.

Deputy O'Dowd did not say it so far as I am aware.

I can assure the Minister that it is true.

I can assure the Deputy that nobody knows that with the exception of the doctors. If the Deputy has had that information from a doctor in his own locality, I shall accept it, of course, but so far as my Department is concerned, officially, we do not know it. We have not had any such figures. I can speak for the Department, and that is our information.

Deputy O'Dowd is there now, and he can bear it out.

I think I can speak with a little more knowledge than any other person in the House, for the time being at any rate, and we have no such information. Perhaps, in the particular area with which Deputy Dillon is acquainted, some dispensary medical officer may have told him of an increase in that area recently and that may be in our returns for the next year, but so far as the returns we have up to the present are concerned that statement is not correct.

I do not wish to interrupt the Minister, but, perhaps, he will allow me to explain that a great many doctors in the country do not bother to get red tickets at all for destitute people. If somebody asks the doctor to come out and visit him and says that he cannot pay the doctor at the moment, no doctor thinks of sending him in to get a red ticket. In 90 cases out of 100 the doctor attends the patient and does not bother about a red ticket.

Deputy Dillon seems to forget that there is an increased population in practically every area, and the Minister is in the position that he can give the actual figures of people who applied for red tickets during the last few years, or during the last 40 years, if the Deputy wants to get them. These figures are available in the Minister's Department. A return is made every half year of the number of patients attended, whether at the patient's home or in the dispensaries. These returns are supplied to the Department of Local Government and Public Health twice every year.

The Deputy knows what these returns are worth.

Deputy Dillon made a definite statement, and now, when he is challenged, he runs away from it.

I was speaking of patients who do not pay fees.

I agree that it is true that doctors do not always insist on red tickets and, probably, when they go out to attend a patient without the formality of red tickets, they do not make a return of such patients, but the Deputy made a definite statement and, when challenged, ran away from it. I need not answer the argument, therefore, that the dispensary medical officers have lost any income because of any such increase. There may be an increase, but we have not had it reported to us.

Posterity will say who ran away—the Minister or I.

Somebody else talked of the heavy cut on the doctors. Now the doctor—the dispensary medical officer—is in a privileged position in this Bill. In every other case, the whole income of the part-time officer is taken into consideration. In the case of the dispensary medical officer, only the salary he derives from the local authority is taken into consideration. The cut is made on that. He is, therefore, in a privileged position. He is similarly privileged in getting advantage of a special allowance of £50—an allowance which is made to no other official of a local authority. Those speaking on behalf of dispensary and county medical officers should bear that in mind. The medical officers have done magnificent work, and I am sure they will continue to do it. I believe, no matter what their pay, they will continue to give loyal and beneficial service to the community. I have read in the last few years, since the economic crisis commenced, claims from responsible men that all classes of the community should bear a share of the loss of income suffered by the agricultural community. Those of us who have read the Lenten pastorals must have noticed the claim put forward by high authority that the salaried people should bear a portion of the fall in values that has taken place recently. That claim has come from responsible people—that salaried officials should not be allowed to go scot free.

Is he responsible for this Bill?

This Bill was introduced a year and a half ago.

He will regret having written that.

We felt that these local officials should be asked to bear a very moderate cut in their salaries. Areas which are dominated by what one might call the agricultural mind have suffered a considerable fall in income over the last eight or nine years, and the gentlemen in those areas who have suffered think that the salaried officials should bear a heavy cut also. They might be inclined to be unjust. In a few cases they would probably be unjust, and I should not like to see that. But I do stand for the principle that the whole community should be prepared to bear a share of the burden.

An equal share?

It would be very difficult to make the share equal. Who is going to say what is an equal share? To do that, you would have to take the case of every individual on its merits. No government, with all the powers that governments are taking to themselves all over the world these days, could make the share of everybody in the community equal. We have to take a rough and ready method and divide whatever cut is imposed as evenly and fairly as we can.

A substantially equal share?

If there is any section I should like to be more generous to than others under this Bill it is the dispensary medical officers. But others have to be considered also.

What would this concession cost?

The £50 concession?

No—the concession outlined in this amendment.

That I could not say. I have not gone into the figures.

Two points arising out of the Minister's reply may cause some confusion. One point is as to the professions. What professional man has not suffered? This Bill is not really aimed at professionals. The majority of people who will suffer under this Bill are not professional people but people with fixed salaries. If they have to do travelling, they have an allowance for that. The salary of the dispensary doctor really covers his travelling expenses. It rarely does more than that. Because of that, his position is not comparable with the positions of public officials with a fixed salary who have no travelling to do, such as secretaries, and other officials of local authorities. So far as the doctors are concerned, the cut is not equitable. The Minister has made a very fair admission when contrasted with other Ministers, like the Minister for Finance and the Minister for Industry and Commerce, who have stated that the country is prosperous. The Minister for Local Government and Public Health does not say that at all and he is quite right. The country is not prosperous. The Minister for Local Government says that these cuts are necessary and that everybody should bear his share. The cuts should, however, be equitably distributed and I do not think they are in the case of the doctors. The Minister ought to reconsider the question of the professions because the Bill does not apply really to professionals but to officials of a different type with fixed salaries. As regards the red tickets, I think that there was a general misunderstanding. It is well known in the country, even if the number of red tickets has not increased, that the services for which doctors are not paid have increased tenfold owing to the conditions which the Minister knows exist in the country. Consequently, I think that the Bill will not apply equitably so far as the medical profession is concerned.

Deputy Dillon asked a question at the close of the Minister's speech as to how much money it was hoped to save by the application of this cut to the salary of medical officers. The Minister was naturally unable to give a figure.

Why "naturally"?

I shall give one reason in a moment. I suggest to the Minister that no money will be saved to the local authorities by this cut, but that greater expense will be placed on them because of the number of men who will claim pensions as a result of the imposition of the cut. The local authorities will be put to the expense of paying pensions and also paying salaries to the newly-appointed successors of the medical officers who have resigned. That point has been made against the Bill by some local authorities—that it will increase the cost to the local authorities. That point was particularly made by the Joint Committee of the Grangegorman Mental Hospital a few days ago. As has been pointed out, there are a large number of men in the medical service who are approaching old age.

What would the Deputy call "old age" in that case?

The Minister will have to consider that point when application is made to him for permission to retire. I am sure he will take a fair view.

A few doctors are nearly 90 years and have not retired yet.

I am getting too near the margin myself to offer a definition to the Minister. I suggest that the cost to the local authorities will be increased for the reason I have stated. The Minister stated that a claim was put up by many responsible men throughout the country that everybody should share equally in the deprivations that may be necessary owing to the present economic position. I take it for granted the Minister will be willing to leave to the local authorities the decision as to whether cuts should be imposed in their particular areas or not and, therefore, will accept the amendment that will be presently before the Committee. The most responsible people, as regards expenses, are the local authorities. If there are to be cuts made it will be fair that they should decide what cuts should be made in their particular area. I would point out, also, to the Minister that the local medical officers have already shared fully in any hardship the community as a whole has to bear.

It is agreed, I think, that farmers are in a bad way at the present time. Medical officers and dispensary doctors are entirely dependent upon the farmers for their private practice. Their private practice has diminished to almost negligible proportions in the last few years. The Minister has made the point, and fairly, that the number of red tickets is not increasing according to official reports. The Minister must be aware, as every dispensary doctor is, that the amount and number of free tickets is no measure of the free work that dispensary doctors do. They attend poor patients whether they have rate tickets or not. The Minister says that the increased number of free attendances does not appear normally on the register. He cannot accept the number of red tickets as an indication of the present state of things. Although a doctor may attend three or four people, perhaps only one goes on the register.

It is said that the depression is only temporary, as we all hope. The dispensary doctor does not wish to transfer to the poor law people those who had formerly been his paying patients, even though what they paid was small. He does not wish to put these people to the humiliation of having to go to the relieving officer, or to procure a ticket from the relieving officer. The Minister, no doubt, is perfectly correct in stating that the number of red tickets has not increased, but the House should know that the amount of work thrown upon the dispensary doctor has increased. The Minister referred to the privileged position into which he puts the dispensary doctor under this Bill. I have already expressed appreciation of the fact that the Minister has given them some consideration though I think he did not give the exact reasons. It is because the dispensary doctor receives, in truth, very small remuneration towards his out-of-pocket expenses for the work done. The Minister very properly took some notice of the fact that the salary must include provision for the doctor's mode of locomotion, for getting around and seeing his patients. I do not think that the Minister would suggest that the £50 provided in the Bill will be able to bridge over the difficulty the ordinary dispensary doctor has to encounter in connection with travelling in his district for poor law purposes only. The Minister, again, has said, and he is right, that the present medical officers will continue to give their services loyally whether paid their due salary or whether they are docked. Of course, these are not the Minister's exact words. I should say that that is so but the Minister must look to the future and he is not likely to get as competent medical services in the future as at the present time if the conditions of to-day are to be applied in the future. I think I have now expressed my opinion on this amendment, and as I do not wish to take up any more time I shall leave it at that.

Does the Minister not think it is a slight hardship on us, that when we asked him what the amendment we submitted is calculated to cost he is unable to tell us? He refuses to make this concession without having even considered the cost.

The Minister said that dispensary doctors were only half-time officers, and that it was only proposed to take a proportion of the salaries they are receiving as dispensary doctors. Deputy Rowlette touched on the point of their private practice, but I do not think he laboured sufficiently the fact that while their remunerative private practice diminished, yet their free private practice has increased, because when persons within their area are sick they will have the doctor whether they are able to pay him or not. In many cases, before the economic crisis, when a family would send for this same doctor to attend and pay him for his visit, they are now reduced to the position of having to send for him on a ticket so that the doctor has to give practically the same service for nothing. He will have more poor to attend and yet we are going to diminish his salary for doing more work.

I wonder would the Minister give the local authorities power to give a travelling allowance to dispensary doctors. Other officials of the local authorities get travelling allowances. For some it is up to 6d. a mile. Now, if the dispensary doctor got the offer of a lump sum, or if power was given to the local authorities to give him a lump sum, or a mileage rate for travelling, it might define what opportunity he has got for his skilled services. County surveyors and assistant county surveyors, and architects to the boards of health, all get their mileage rate. Travelling instructors to the Committee of Agriculture and the Committee of Vocational Education get their travelling allowances. If the dispensary doctor got his reduced emoluments plus allowances he would be in a better way to live. I agree with the Deputy that private practice, for country doctors, has practically ceased to exist, just as practice for the veterinary officers of local authorities, who will also get cut, has ceased to exist. Of course, a man will try to get some remedy rather than die, but in the case of the animal it is hardly worth sending for the veterinary surgeon and if the animal is let go the veterinary surgeon has no chance of a fee. But in the case of the human he is not now able to pay the doctor, and the doctor is asked to come free where formerly he would be asked to come for a fee, or he is at any rate, paid less than he was before. It is argued that this is a Temporary Economies Bill, that the economic situation is a temporary one. Well, during that period the doctor's private practice has been almost annihilated, and at the same time his part-time salary is reduced. Instead of being in a privileged position, as pointed out by the Minister, he is in a worse position than the whole-time official, for the whole-time official loses only a small percentage of his whole-time salary but the dispensary doctor loses a similar percentage of his part-time salary and his private practice has almost disappeared. I think the dispensary doctor would have suffered enough if his salary were left untouched. He would have suffered more than is represented by the percentage reduction in similar salaries. He would suffer more in the loss spread over the income from his private practice and his dispensary salary put together. I think the Minister would be well advised to leave the dispensary doctor as he is.

Amendment put.
The Committee divided: Tá, 30; Níl, 55.

  • Alton, Ernest Henry.
  • Beckett, James Walter.
  • Belton, Patrick.
  • Bennett, George Cecil.
  • Cosgrave, William T.
  • Costello, John Aloysius.
  • Davis, Michael.
  • Davitt, Robert Emmet.
  • Dillon, James M.
  • Dockrell, Henry Morgan.
  • Dolan, James Nicholas.
  • Esmonde, Osmond Grattan.
  • Fitzgerald-Kenney, James.
  • Hogan, Patrick (Clare).
  • Keating, John.
  • McFadden, Michael Og.
  • McGilligan, Patrick.
  • McGuire, James Ivan.
  • McMenamin, Daniel.
  • Morrisroe, James.
  • Morrissey, Daniel.
  • Mulcahy, Richard.
  • Norton, William.
  • O'Leary, Daniel.
  • O'Mahony, The.
  • Pattison, James P.
  • Redmond, Bridget Mary.
  • Rogers, Patrick James.
  • Rowlette, Robert James.
  • Thrift, William Edward.

Níl

  • Aiken, Frank.
  • Bartely, Gerald.
  • Beegan, Patrick.
  • Blaney, Neal.
  • Boland, Gerald.
  • Bourke, Daniel.
  • Brady, Brian.
  • Brady, Seán.
  • Breen, Daniel.
  • Briscoe, Robert.
  • Browne, William Frazer.
  • Carty, Frank.
  • Cleary, Mícheál.
  • Concannon, Helena.
  • Crowely, Fred. Hugh.
  • Crowley, Timothy.
  • Daly, Denis.
  • Derrig, Thomas.
  • Doherty, Hugh.
  • O'Doherty, Joseph.
  • Donnelly, Eamon.
  • Flynn, John.
  • Flynn, Stephen.
  • Goulding, John.
  • Harris, Thomas.
  • Hayes, Seán.
  • Houlihan, Patrick.
  • Kelly, James Patrick.
  • Kelly, Thomas.
  • Kennedy, Michael Joseph.
  • Killilea, Mark.
  • Kilroy, Michael.
  • Kissane, Eamonn.
  • Lemass, Seán F.
  • Little, Patrick John.
  • MacEntee, Seán.
  • Maguire, Ben.
  • Maguire, Conor Alexander.
  • Moane, Edward.
  • Moore, Séamus.
  • Moylan, Seán.
  • O'Dowd, Patrick.
  • O'Grady, Seán.
  • O'Kelly, Seán Thomas.
  • O'Reilly, Matthew.
  • Pearse, Margaret Mary.
  • Rice, Edward.
  • Ruttledge, Patrick Joseph.
  • Ryan, James.
  • Ryan, Martin.
  • Ryan, Robert.
  • Smith, Patrick.
  • Traynor, Oscar.
  • Victory, James.
  • Walsh, Richard.
Tellers:—Tá: Deputies Bennett and O'Leary; Níl: Deputies Little and Traynor.
Amendment declared lost.

I move amendment No. 8:—

In sub-section (3), line 44, after the word "authority" to add the words "but shall not include any veterinary surgeon in the employment of such local authority."

The insertion of those words as indicated would have the effect of removing veterinary surgeons from the cuts which are proposed. There is nothing like the same case to be made on behalf of veterinary surgeons, which could be made for the medical man. There is, however, some case, and in the present circumstances of the whole live stock business I am not sure that in the end there could not be — relative to past conditions—a better case made with reference to the veterinary surgeons. There was, at one time, quite a flourishing business done in this profession. It centred around horses and cattle. As far as veterinary work is concerned at the moment it is based almost entirely upon racing stables. There are a lucky few in the country who live in the neighbourhood of, and have their experience about, certain racing establishments. Those people might still get something in the way of decent professional life. As far as the rest are concerned, I think it can be said without any fear of contradiction that the only people who are those who are anything whatever are those who are in any way attached to or have their services engaged by a local authority. There is next to nothing done in the way of private practice. Live stock has gone to such a point in the way of prices that it is not worth while —even where it once was—to call in a veterinary surgeon to attend to an animal. There has, of course, been an attempt made under the Veterinary Surgeons Act to establish those people in a better professional way, but that Act, of course, was passed in old-time circumstances and envisaged the continuance of them. Although the Act has better bound together the profession it has failed altogether to give them what it was then thought, in the opinion of this House, they were entitled to.

In the special circumstances of the case, because of conditions not of their operation and not of their wish, I do suggest that there would be very little loss to the Exchequer or to the local authorities by the acceptance of an amendment of this type. It would give to those people, who are the remnant of what was once a rather good professional corporation and a rather flourishing business, some idea that there were still people looking after their interests, and that it was not regarded as being wholly in the interests of the country that their profession should be allowed to die out. It is, in fact, almost dead. The number of those who go year by year to veterinary colleges is very small. It is something less than one-eighth of what is used to be. If one goes back to the flourishing days before transport took the change that it has taken, the annual recruitment to the veterinary college is only one-twentieth. After the outflow of those called to the profession there is only about one-twentieth of what there used to be. The cut, if imposed, would lead to still further depressing that profession. There is not much loss involved in accepting this amendment. There is no great breach of principle that can be pointed to. The few who are affected by it would get a corresponding uplift, and there would be some repercussions in the whole business. As I say, on humane grounds there is not the case to be made here that there is for the medical men, but, in the changed circumstances, which they did not bring about, I do suggest that there is some case here, and that the amendment should be accepted.

Deputy McGilligan has properly said that there is not the same case to be made for the veterinary surgeons that can be made for the medical profession. That is quite true. He has stressed the question of the diminution that has taken place in the number of veterinary surgeons. I believe it is considerable. Since the days when horses were more in vogue the number of recruits has become very much smaller. The number of veterinary men practising in the country, at present, according to all I hear, seems to be only about sufficient for the country, with the result that they are able to dictate terms now when they apply for posts. I am told that there are veterinary posts available now for which veterinary surgeons cannot be found, or, if they are available, they will not accept the salaries that are offered. They are, therefore, in a much more privileged position than are the members of the medical profession, because, certainly, as the House knows, there is no scarcity of medical men for any post that is offered. I cannot accept the amendment. I think it would be unfair to other classes of professional men if veterinary surgeons or doctors were to be eliminated from the scope of the Bill.

I should like to support Deputy McGilligan in this amendment. In the present condition of things in this country, our live stock have depreciated to such an extent that the private practice of veterinary surgeons is gone absolutely. The Minister says that the fact that fewer people are now entering the profession means that they are in a position to dictate terms. I do not know to whom they are dictating terms. They are not dictating terms to the farming community, because the farming community are not engaging them. My experience of veterinary surgeons is largely the same as my experience of doctors—they are very bad people to collect their debts, to say the least of it. They have been very generous with their advice and, like doctors, they have very heavy travelling expenses. I do not think that even if this amendment were carried, as Deputy McGilligan pointed out, it is going to affect local authorities or the Executive Council to any great extent financially. I think the effect will be very small, and I think that, in view of what the Minister knows and admits with regard to the live stock business of this country— and, of course, the veterinary surgeon's job is to deal with live stock— the Minister ought to see that whatever little remnant of this profession that we have left should be allowed to keep the little allowance they have at present.

I also support Deputy McGilligan's amendment. Its acceptance will entail very little cost either to the local authorities or to the Ministry. The number of persons affected is not very large and, so far as local bodies are concerned, most of the veterinaries employed are part-time officials and their remuneration is very small indeed. To cut that remuneration, therefore, would be practically to make most of the offices not worth holding. The Minister, in reply to Deputy McGilligan as to the number of veterinary surgeons in the country, said that his information was that there were scarcely enough to cope with the needs of the public. That is not my experience. In my own county and, I am quite certain, in others, there are numbers of them who are practically on the unemployed list or doing very little business. A few years ago they used to do a little in the doctoring of cattle, which business is now practically extinct, and men will grasp at any job whatever. I know that even if the cut were a good deal bigger than it is and some of the present surgeons relinquished their positions, surgeons could be found to take up those positions at very much lower rates, simply as a means of starting some kind of business. That is a state of affairs that nobody will wish for. I know a number of veterinary surgeons employed by local bodies and the remuneration for whose work, mostly part-time, is very small indeed. A cut in their salaries will not produce a very big saving, while it will inflict a very great hardship on a number of veterinary surgeons.

I want to deal with one aspect of this matter to which the Minister referred, that is, the question of dictation. We had a couple of cases of this kind in my constituency, and far from its being a question of dictation, the facts were quite the contrary. The position is that in the present condition of the live stock market, it is quite useless for a veterinary surgeon to take up a local appointment in a district and to receive £100 and have no private practice. That does not suggest that dictation to which the Minister referred. The amounts the surgeons receive are such that a man could not pay for his lodgings, much less run a motor car and do his work. That is the reason why these cases exist. There are no applicants; there will not be any applicants, and we must make up our minds that there will be no applicants. The reason is that the £50 or £100 which a veterinary surgeon would get from a local authority would be quite useless—it would not pay for his motor car. The Minister suggests that that is dictation, but quite the contrary is the case. We have had at least two examples of that in County Donegal.

There is another point I should like to put before the Minister with regard to notifiable diseases of live stock. The duties of veterinary surgeons in that respect have been increased very considerably in the last few years. Originally, when they were appointed, this was not included amongst their duties, and for some years the matter was really in abeyance. It was then put on to the veterinary surgeons, and in most cases the local authorities, I believe, did not give any increase in salary in respect of the extra work imposed on them. The new duty means, of course, a very large increase in travelling expenses, because they have to cover very large areas. On the whole, I think that veterinary surgeons are very poorly paid for the services they give. They are essential so far as these notifiable diseases are concerned. Bad and all as our live stock trade is, we must keep it clean, and for that we have to depend on the veterinary surgeon. I do not think it will be any help to us if the Minister puts the cut into operation against them.

I can hardly believe my ears when I listen to these speeches, and when I remember the speeches I heard some time ago about depression and about the reduction of the agricultural grant. When we say that we are going to spread the weight of this fight —the economic war—the very gentlemen who then denounced us stand up and tell us what must be done in another direction. The broad outline of this matter is that the whole nation will share the weight of this economic war until it is fought to a finish, and I wish that the Opposition would realise that when they stand up and try to talk to us. It is really amazing to listen to them. I hope the Minister does not give way on this.

The Deputy who has just spoken does not appear to remember that the Minister for Finance told us the other night that there was no depression in this country and no need for a reduction of wages, and that if there was it was due to the ramp of the Opposition.

The war is won!

And there is no need for cuts.

The point raised by the last speaker is rather interesting. "The whole nation will have to bear the weight of the economic war"—and yet, amidst pæans of joy by the Vice-President, we were told that the war was over and that we had won. We should be dividing the spoils and not spoiling the vanquished.

Might I ask the Deputy one question?

What is the name of the measure itself?

The Temporary Economies Bill.

The Temporary Economies or Cuts Bill.

A Cuts Bill! Imagine a Cuts Bill introduced in the midst of victory! Is that not rather a contradiction in terms? The Deputy, of course, is at one with me in that he does not believe that the war is won and that he does know that the country is suffering.

Of course, he knows quite well.

But that is not what the Front Bench says. Why put forward that sort of argument here in the midst of all the rejoicings? A year ago the Vice-President said that the prospects were rosy—a neat little word.

Might I ask one other question? What was the Conference in London last year?

What Conference?

You know it as well as I do.

If the Deputy means the abortive Conference to which some of our best and talented people were sent across to achieve results, all I know is that they did not get results.

It was a World Conference.

Oh, the World Conference. It is so bad that although we have won the war and saved, I think, £7,000,000, we are unable to pay a few veterinary surgeons the absurd salaries they used to get. I plead for veterinary surgeons as I plead for any of these professional classes. There ought to be some little regard for education and experience, particularly when that education and that experience have been bought dearly and, particularly, when you have in this profession, in the main, the sons of the small people representing the democracy of this country whose fathers and mothers out of, in the main, the very poor moneys they were receiving paid for their children's education in order to get them into these professional posts, and who made sacrifices to get them into these posts.

The children, when they got into these posts, were very often faced with liquidating the debt which their parents had incurred over their education. It is not fair that because these people happen to be near the Government there should be this blind attack on them and cutting of their salaries. I have not heard it said about the doctors, except the statement bred of the ignorance of Deputy Corry, that they were overpaid or sufficiently paid. I noticed that that particular argument of Deputy Corry's was not accepted by the Vice-President. I have not heard anybody say with regard to the veterinary surgeons that they were over-paid with regard to the work they have to do. If that argument is made it can be met but it has not been put forward here, not even whispered. Instead of that, the Vice-President says that the veterinary surgeons in practice in the country at the moment are so limited in numbers that they can, in fact, dictate their own terms. Let us examine that. I do not believe it. The refutation is clear to anybody who considers the facts. At what age does a boy go to train for the veterinary surgeon's profession? Somewhere about the 17th year. As it used to be, it was a difficult course. Let us assume that that five years' course was, on an average, taken out only in seven years and the man emerges as a veterinary surgeon at 24 years of age. What is the average length of life in the country? Certainly a man can look to have 35 or 40 years in the profession. Does the Vice-President tell me that those who were inclined to enter for the veterinary surgeon's profession 35 years ago saw the depression that we have here to-day and, therefore, refrained from going to the veterinary college to study? If that is not the case where are the veterinary surgeons who trained and became qualified in the last 25 years? I think that the number of people in practice in the country has not gone down. It has gone down by a very small number if at all, the number which would represent the loss by deaths annually, and the failure by natural recruitment to make up for that loss. But to represent, as the Vice-President has done, that the number of qualified veterinary surgeons is very small in the country, and that they are so few that they can make their own terms, is to misrepresent the fact. If there has been a falling-off in the numbers in practice in the country, there has been a much greater falling off in the work to do. If there were the same demand for veterinary surgeons in the country as there was 35 years ago and if, for some reason, better terms were offered abroad and the number in this country had gone down by half, then they would be in a position to dictate their own terms. But you have a very big change in the amount of practice here in this country. I do not suppose there is a quarter of the work to be done to-day that the veterinary surgeon used to do some years ago. Yet in those circumstances the Vice-President says they can dictate terms and, therefore, that this amendment will not be accepted. That was the only argument put forward. I do not suppose that there is a country Deputy who does not know that that is a fantastic argument to put up. Then there is the other side of it that the veterinary surgeons are such a small class that there should not be such pother about them at the moment. My answer to that is that because of the reputation that the Irish horse owner had won, because of the weight that is attached to training in this country, further because of the very big livestock business done in the country and because of the reputation that these animals gained, undoubtedly there was big money in both these businesses. Because of that there was a very good call on the services of the veterinary surgeons who got a very big reputation. The veterinary surgeons trained here had a very high reputation.

The college at Ballsbride had a very big reputation, so much so that when there was a discussion about separation of the college here in Ballsbridge from the college in London, the demand came from London that they should keep in association with us. In order that we might achieve that, they offered terms on the joint board which gave us far more than we were entitled to by our numbers. That was because, as they said, the reputation of the Irish Veterinary College was very big. I do not think anybody who has an eye on the facts at all can deny that the work the veterinary surgeons used do has been, to a very big extent, swept away. We have only to think back on the prices that used to be paid for cattle to realise that in those times the fees paid for cures, when illnesses occurred, were relatively high. A mere collation of these two sets of prices would make anybody understand how it is that to-day when certain animals are sick it is not worth while to call in a veterinary surgeon. If the animal does not cure of itself the animal is let die. There may be some research in the case of a cow doctor. Then in the present circumstances one has only to look to the prices in the main to see what is going to be the result in research to the veterinary surgeons.

Private practice having gone, is it fair to ask that the salaries paid to these men by the public bodies should be kept at some sort of nucleus and to continue the small salary these men have got to the point where it was fixed when their private practice was better and when the livestock business was better? I think the amendment deserves much more consideration than it has got. We may never again get to the point at which we once were with regard to the veterinary surgeon's work. The change in the matter of transport would have brought about a change in the demand for the veterinary surgeon. But there is sufficient hope that again there will be business doing in this country both with regard to horses and cattle. The young people could be kept here and parents should be able to see some outlet for their children who have a disposition towards veterinary science so that they might be inspired to send them again in bigger and better numbers to the college at Ballsbridge to get a training in a big way.

There has been no argument used so far that these men are overpaid. They are not overpaid. There has been no argument that this would mean an enormous load on the local authority, or that if the local authority do not get this section it would mean an enormous sacrifice to them. The only argument used is one that I characterise as being fantastic —that is the argument of the Vice-President that the numbers are so small that the residue can get any salaries they demand in relation to the work offered. That is a most fantastic argument and one that cannot hold.

I would like to ask the Minister not to press this section and to accept the amendment. The income of the veterinary profession has been very much reduced already compared with what it was some years ago. Now, as a result of the economic war when two-year old cattle are being sold for £2 or £3 there is little prospect of the veterinary surgeon getting much private practice. I would like to remind the Vice-President of the statement made by the Minister for Industry and Commerce recently that soon a big percentage of our cattle must be destroyed. As a result of that, the prospect of employment for veterinary surgeons will be a great deal less. It may be, of course, that the Minister may be able to give some hope to the profession that they will find employment superintending the destruction of these cattle.

Amendment put.
The Committee divided: Tá, 28; Níl, 53.

  • Alton, Ernest Henry.
  • Beckett, James Walter.
  • Bennett, George Cecil.
  • Brennan, Michael.
  • Cosgrave, William T.
  • Costello, John Aloysius.
  • Davis, Michael.
  • Davitt, Robert Emmet.
  • Dillon, James M.
  • Dockrell, Henry Morgan.
  • Dolan, James Nicholas.
  • Esmonde, Osmond Grattan.
  • Fitzgerald-Kenney, James.
  • Keating, John.
  • MacDermot, Frank.
  • McGilligan, Patrick.
  • McGuire, James Ivan.
  • McMenamin, Daniel.
  • Morrisroe, James.
  • Mulcahy, Richard.
  • Norton, William.
  • O'Leary, Daniel.
  • O'Mahony, The.
  • Pattison, James P.
  • Redmond, Bridget Mary.
  • Rogers, Patrick James.
  • Rowlette, Robert James.
  • Thrift, William Edward.

Níl

  • Aiken, Frank.
  • Bartley, Gerald.
  • Beegan, Patrick.
  • Blaney, Neal.
  • Boland, Gerald.
  • Bourke, Daniel.
  • Brady, Brian.
  • Brady, Seán.
  • Breen, Daniel.
  • Briscoe, Robert.
  • Browne, William Frazer.
  • Carty, Frank.
  • Cleary, Mícheál.
  • Concannon, Helena.
  • Crowley, Fred. Hugh.
  • Crowley, Timothy.
  • Daly, Denis.
  • Derrig, Thomas.
  • Doherty, Hugh.
  • Donnelly, Eamon.
  • Flynn, John.
  • Flynn, Stephen.
  • Geoghegan, James.
  • Goulding, John.
  • Harris, Thomas.
  • Hayes, Seán.
  • Houlihan, Patrick.
  • Kelly, James Patrick.
  • Kelly, Thomas.
  • Kennedy, Michael Joseph.
  • Killilea, Mark.
  • Kilroy, Michael.
  • Kissane, Eamonn.
  • Lemass, Seán F.
  • Little, Patrick John.
  • Maguire, Ben.
  • Maguire, Conor Alexander.
  • Moane, Edward.
  • Moore, Séamus.
  • Moylan, Seán.
  • O'Doherty, Joseph.
  • O'Dowd, Patrick.
  • O'Grady, Seán.
  • O'Kelly, Seán Thomas.
  • O'Reilly, Matthew.
  • Pearse, Margaret Mary.
  • Ryan, James.
  • Ryan, Martin.
  • Ryan, Robert.
  • Smith, Patrick.
  • Traynor, Oscar.
  • Victory, James.
  • Walsh, Richard.
Tellers:—Tá: Deputies Bennett and O'Leary; Níl: Deputies Little and Traynor.
Amendment declared lost.
Progress reported; Committee to sit again.
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