Virtually all I had to refer to on this Estimate I dealt with on Thursday night. I should like, however, to draw the Minister's attention to the fact that the county councils and the Local Government Department are responsible for the appointment of presiding officers and officials in the polling booths at election times——
Committee on Finance. - Vote 41—Local Government and Public Health (Resumed).
Debate resumed on the following motion:
That a sum not exceeding £523,460, be granted to complete the sum necessary to defray the Charge which will come in course of payment during the year ending the 31st day of March, 1944, for the Salaries and Expenses of the Office of the Minister for Local Government and Public Health, and certain Services administered by that Office, including Grants and other Expenses in connection with Housing, Grants to Local Authorities, sundry Miscellaneous Grants and Grants-in-aid, and certain charges connected with Hospitals—(Minister for Local Government and Public Health).
On a point of order, the Local Government Department is not responsible for the appointment of presiding officers.
The county councils are.
The administration of the county councils cannot be discussed here. They have autonomy in such local matters.
The county registrars make the appointments.
I want to get the Local Government Department interested in stoneware pipes for sewerage schemes. A sewerage scheme in my own town has been a failure simply because concrete pipes were used. The people of Mountmellick protested at the time against the use of concrete pipes. A sewerage scheme is being completed in Clara, Offaly, at present and concrete pipes were used there and sanctioned by the Department of Local Government while stoneware pipes were available.
Stoneware pipes are being manufactured about 40 miles from Clara and about 15 miles from Mountmellick, and yet, when the people demanded that this class of pipe be used, their demand was not acceded to. At the time I made representations about it to the Minister. The Mountmellick Fianna Fáil Cumann strongly protested against the use of pipes other than stoneware, and yet, in spite of that, the concrete pipes were used in the sewerage scheme. Some years ago concrete pipes were listed in a sewerage scheme in Belfast, and they turned out to be a failure. A Royal Commission in Australia came to the same conclusion in regard to the use of concrete pipes in a sewerage scheme in that country. The stoneware pipes have passed the test of time. I would ask the Minister to see that, in future, stoneware pipes are used in these schemes, because I submit that it is up to him to see that the ratepayers get good value for their money.
Deputy Davin raised a point about the officials of various county councils, and said that they were working 105 and 107 hours a week. I have a letter here from an official of the Laoighis County Council in which he states that he sometimes has to work 112 hours a week. He says that there is no question of a half-holiday or a holiday for him, that he must be ready to serve day or night when called upon. The Local Government Department has not taken any steps to look after the interests of such officials.
Another point of great importance is that all hospitals throughout the country should be kept in a first-class condition of repair. The only hospitals that I can speak of are those that I know. There are hospitals in my constituency and they are absolutely falling down. We have, of course, a hospital in Portlaoighise that is second to none in Ireland, and another in Tullamore, but the hospital in Abbeyleix is in such a deplorable state that the rain is coming in. That is very bad for the patients. The Department of Local Government and Public Health should have these matters investigated and reported on.
In regard to the county managers, Deputy Ruttledge, when he was Minister for Local Government and Public Health some years ago, is reported to have said at the Fianna Fáil Ard-Fheis that if a council decided upon a particular work to be carried out and provided the money to do it, the county manager must do it. As far as I can see, the county manager need not do it if he docs not like. I know of several instances in my constituency where the county manager refused to carry out work that the county council instructed him to carry out. In Laoighis, we wanted, in the interests of the public health, to have a number of houses connected with the main sewerage. In my opinion every house should, be connected with the main sewerage and be provided with water. County councils throughout the county compel the owners of house property to put in water and sewerage connections in their houses, and yet these county councils will not do that in the case of their own houses. Why does not the Department of Local Government and Public Health compel them to do it? In the case of labourers' cottages, I know it would be impossible to do that in the rural areas, but the county council should be compelled to do it in the case of labourers' cottages situate in the urban areas.
As regards the provision of residences for medical officers, I want again to put it to the Minister that he should see that this matter is attended to. Deputy Davin and Deputy O'Higgins have already referred to it. The position at the present time is this: a doctor comes to a particular area and he is not well there when he leaves again because no suitable residence is provided for him. In Mountmellick, the doctor's residence is situate threequarters of a mile outside the town. That is a great inconvenience to the local people, especially when his services are required at night. There are several houses in the town which could be purchased by the county council and which, in my opinion, would be suitable as a doctor's residence, but simply because it does not suit the county surveyor or the county manager to do it they are not being purchased.
During the general election circulars which were prepared and typed in the offices of a county council were sent out in support of a certain candidate. I know for a fact that the very same typing and the very same paper that was used in sending out notices to the members to attend a meeting of the local public authority were used in those circulars asking support of a certain candidate because he was a member of the county committee of agriculture. Is that what public officials are being paid for—sitting down electioneering for any candidate? They would not do it for me, because I was put out of every public office until I became a T.D., and then they were afraid to put me out. I think it is the business of the Minister to investigate these matters. I am going to have copies of this circular sent to the Minister. I want him to investigate this matter. The ratepayers of Offaly are not paying officials to sit down and type out appeals for farmers' candidates. It was on behalf of a Clan na Talmhan candidate the appeal was made.
Why should they not do it?
I am surprised to hear Deputy Donnellan say that. If that had been, done for the Fianna Fáil Party, the members of the Farmers' Party would be the first to jump down the neck of that Party's candidate, and would do the same if it was a Fine Gael candidate, but because it was done for a member of their own Party they are inclined to support that kind of thing. I may say that I agree with a lot in the programme of the Clann na Talmhan Party, but, at the same time, I do not care twopence about any Party in this House, whether it be the Farmers, Fianna Fáil, or any other. I admit that I am going away from my point.
That is so.
What I am interested in is in seeing that the matters to which I have referred are investigated by the Minister. The position is bad enough as it is with public officials touring golf links when they should be investigating the various complaints made. I see them time and again—the county manager and the county surveyor. Deputy Davin raised a question about the condition of the roads— the by-roads, the narrow roads and the lanes. They are in a deplorable state, and yet the county council do not seem to be doing anything to improve their condition. Of course, if these roads led to a golf links on which the county manager and the county surveyor could swing their clubs they would be tarred and steamrolled, but because they only lead to farmers' houses and labourers' cottages, nothing is being done. The Department should see that the roads throughout the country are put into a fit condition for the people to travel on. In my constituency some of these roads are in such a condition that the people cannot travel over them to attend church on Sundays, while the doctor and the priest find it very difficult to travel over them when they get a sick call at night from people living in these areas.
I hope the Minister will pay special attention to what I have said about the stoneware pipes. I believe, although I cannot prove it, that certain influences are being used in the Department of Local Government in connection with the concrete pipes. I suppose the people who manufacture the stoneware pipes have not enough pull in the Department. I do not know whether that is the case or not, but it has been reported to me. I hope the Minister will also investigate the details that I have given about the typing of circulars for a certain candidate during the recent general election. Officials, instead of doing that kind of thing, should have been attending to the interests of the ratepayers who are paying them. They should not be spending their time using the council's notepaper and envelopes and typewriters, appealing for support for political candidates. No matter what Party I belonged to, I would be one of the first to stand up and protest against the use of public money in that way.
The last point that I want to touch on concerns the payment of rates. There are certain rates in my constituency which have not been paid for the past five or six years. The county manager is now carrying out seizures. He is taking the necessary step to collect those rates, and severe hardship is going to be inflicted on the ratepayers of Offaly and part of Leix. I should be glad to know if the Department would be prepared to have these proceedings stopped, because seizures are not very nice when we are appealing to farmers to grow more food.
May I intervene to say that the Department has no function in this matter, except to see that the rates prescribed by law are paid?
To see that the law is carried out whether it is just or fair? It does not matter a hang so long as the rates are paid. That is the job of the Department.
The Minister has stated the legal position in the matter.
It is the law, but the people in part of my constituency consider that law to be very unfair. We are the people who make the law.
The law is a h'ass!
I think the proper thing for this House to do is to alter the law and to make laws to suit the people.
The Deputy may not advocate legislation on an Estimate.
I have said all I wish to say on that matter. I am anxiously awaiting the reply of the Minister on the question of the rate that was struck by the Mountmellick Town Commissioners.
When introducing this Estimate the Minister treated the House to a very vigorous discourse or lecture on the efficiency of the Department and on what he appears to think is an admirable piece of legislation, the Managerial Act. One might describe such references as euphemistic descriptions of how that Act has been operating. He told the House that local authorities had full financial control and threatened to take certain action if powers were exercised in an arbitrary or dictatorial fashion. The Minister threatened the dissolution of some bodies, but was not very specific as to what particular bodies. Evidently some bodies are inclined to kick over the traces, and the Minister did his best to convey the impression that if the legislation was properly operated there could be harmonious relations between local authorities and the manager. Of course that is the spirit of the Act, a spirit of co-operation, and harmonious relations. But I am afraid that in actual practice that is far from being the case.
The Minister pointed out all the advantages that local authorities had, that they could dismiss a manager, could institute proceedings and have a sworn inquiry. There was also a reference to the Register of Orders and of being entitled to get copies of such Orders; that they could visit various institutions and ask for all the information they desired. There was, however, no mention of consultation so far as the manager is concerned. He was to have full powers in his executive functions. He could simply tell local authorities to go to the devil. He had full power and could do what he liked as far as the work of local administration was concerned.
The Minister evidently does not appreciate that men anxious to serve on local bodies now find themselves in a most humiliating and undignified position, and because of that it is unlikely that in the future we are going to get the right type of men, who will be prepared to humiliate themselves to perform such duties. That is the real problem. That is inevitably going to react on local administration in a country where we boast of democracy and about the people's right to govern as the final authority. We have undoubtedly bureaucratic administration and, as a result, that spirit of co-operation which the Minister suggested should be there has not shown itself. There has been a good deal of criticism on this subject. The Minister may feel that the fault rests with local authorities because he went on to tell us that personal adjustment of temperament was necessary, and that, in the clamour to get rid of the new system, there was more sound than sense. I think the Minister wound up by reprimanding county councils and, to some extent, warning them. I suppose he thought it was wiser to strike a fairly easy balance between his discourse or lecture and the other aspect. I am afraid the Minister does not appreciate the present position, and that public men who give their time serving on local bodies are, in many cases, getting tired of the treatment meted out to them.
Take the question of public assistance. I have not had an opportunity of looking into the question, but as far as I can remember a county manager can set up an advisory committee to help him when dealing with public assistance. It is not an enviable position for a man who gives voluntary service. It is a very laborious job to examine the applications in detail, to see what can be done about them. Public men are anxious to give their service for the work. While the Minister may be able to give the House some information, I think in Very few cases has action been taken whereby the manager has an advisory committee. I am not a member of a local authority now, but I am stressing this point, because I got an extraordinary number of letters about it. I was chairman of a board of health for a number of years, and I am conversant with the work of dealing with public assistance. When I was on a local body the members were looked upon as a very bad lot, but they are looked upon as gentlemen compared with the county managers.
The position can be understood if I put it this way—that the bureaucrats are anxious to justify their position, and have no human contact with the applicants. There is not that human touch that is wanting where this problem of assistance is concerned. The primary anxiety how is to keep the cost down. It was not the intention of this House that it should be approached in that way. We can all appreciate the position of unfortunate people who have to go to local authorities for public assistance, when people with substantial incomes find it extremely difficult to carry on at present owing to the rise in prices. What is the position of the unfortunate people who have to go to local authorities, to the Society of St. Vincent de Paul, or to other charitable societies for help in times of grave stringency like the present? Does the Minister not appreciate how advantageous it would be to have a representative Committee even in the humiliating position of being an advisory committee?
We are not entitled to criticise the managers having full executive power, but I suggest that, apart from that altogether, there is provision in the Act for the setting-up of committees of this sort, but very few managers have availed of it. Such committees are, in my opinion, absolutely essential, and it is unfortunate that the decisions in respect of applications for home assistance should rest solely with officials. The home assistance officers may be somewhat sympathetic, but I am afraid that the county manager's outlook is that of the bureaucrat who wishes to justify his position and to keep down costs. I think I am justified in saying on behalf of ratepayers generally that there is no ratepayer who is prepared to stand behind that sort of administration. I hope the Minister will have the administration of these three Acts, and the Managerial Act, in particular, fully examined, and I think he might bring up his managers and give them the kind of advice he attempted to give to public men generally through the Dáil.
The Minister gave the House very interesting statistics relating to the general health of the community. It is very gratifying to know that the death rate has fallen and is continuing to fall, that the birth rate is increasing, and that, with the exception of one or two aspects, he is satisfied with the general health of the community. He informed the House that the death rate for 1942 was down by some thousands to 41,640. Classifying this figure, he gave the deaths from cancer as being up, to 4,055; from tuberculosis, 4,347, and diphtheria, 267. The figure for diseases of the circulatory system, mainly heart disease would be about 10,000. I want to point out to the House that diphtheria is a disease which is mainly fatal during the first fifteen years of life and that the preponderance of death from heart disease, which affects about 10,000 persons, occurs between the ages of 45 and 70. Tuberculosis, however, which is alarming quite a number of people at present, occurs mainly between the ages of 15 and 45. In other words, it occurs at the most important working period of an individual's life, the period when he is most valuable to the community and his family, and when his death is all the greater loss and the time of his death more unnatural than in the case of those who die from the other two diseases. For that reason alone, it is a very serious matter for the community. The incidence of the disease shows a very steep increase, the death rate from T.B. being roughly 12 per day. I think it is a well-known fact that the ravages of the disease are worse in Éire than in the neighbouring islands, and it is a well-known fact, too, that it is largely preventable, that if there is a proper system for the treatment of the disease and if the cases are taken in time it can be prevented. In order to bring that about, it must be tackled on a proper national basis. We have not made much progress in that respect.
If we are to tackle this disease with vigour and determination in a national way, not only do we need a construed tive and comprehensive scheme of sanatoria, preventoria and medical and surgical treatment, but we must educate the people and make use of propaganda which will allay their fears and not stampede them into hiding the disease and refusing treatment. That is undoubtedly the big problem. People regard the disease as a stigma, and once it is contracted in a family they hide it and fail to take the necessary precautions until possibly the germs have become rooted in the household, through failure to take the proper precautions to disinfect the household, with the result that it very often runs through a whole family. All this problem is a matter of education, and very little has been done in that respect.
It has been suggested that an extra 2,000 beds are required for the proper treatment of this disease. It has been urged recently by a county medical officer that consideration should be given to the advisability of undertaking the erection of a national chest hospital within easy reach of Dublin City. The site and its suitability, as well as the number of beds, are, of course, matters for experts, but of the 2,000 beds required, he suggests that 600 should be allowed for this purpose, that is, 200 for lung diseases, 200 for heart diseases, and 200 for surgical treatment of tuberculosis and chest surgery, which is making great progress at present.
The reason he gives for this project of a hospital, which appears to me to be an attractive proposal, rather than a sanatorium, is that we need a national clearing hospital for lung diseases which masquerade as bronchitis, pleurisy, recurrent influenza and the like. Such cases are very often missed and it is unlikely that they would ever reach a sanatorium. A man very often has T.B. and one constantly hears him coughing. He refers to it as "that cough of mine", which is more or less chronic. His is a case of this disease masquerading under "that old cough of mine". If that man were not prepared to go to a T.B. hospital for examination and treatment, he would be prepared to go to a chest hospital where his case would be classified, and where, even if he were a heart case, he might be treated as a heart case. In other words, people would much more readily go to a chest hospital than to a T.B. clinic or a sanatorium.
Such a hospital, properly fitted, would undoubtedly filter out many carriers and would control the spread of the infection and lead to the effective treatment of known causes. As I say, it would also lead to the treatment of heart disease, which we know, from the statistics given by the Minister, causes some 10,000 deaths per annum. I suppose such an institution could also serve as a teaching hospital and provide facilities for greater research work in this respect. I fed that this proposal is certainly worthy of consideration as being the proper approach to this problem, when one remembers the mentality of our people generally towards this disease and their fear of being stigmatised as victims of it.
In examining the incidence of the disease generally, I have come across a rather interesting document. It may not be valuable at the moment, but it certainly sets one thinking. It is a report on the health of this country to the British Government by Sir William Wilde. He said that, compared with the total deaths from all specified causes, consumption prevailed most in the counties of Kildare, Down, Carlow, Dublin, Kilkenny, Queen's, Westmeath, Wicklow, and Antrim, and least in Galway town and the counties of Mayo, Cork, Clare and Sligo. About 21 per cent. of the deaths from consumption occurred in civic districts, 70 per cent. in rural districts, and 9 per cent, in hospitals and sanitary institutions. He made a very thorough and exhaustive investigation, so far as statistics can give us any information, as to the incidence of the disease at that time, and he discovered that the incidence of the disease was far greater in the baronies touching the east coast and part of the south coast around Wexford, than in the western and south western coast. Of the total deaths in those districts on the east coast, one in five was attributable to tuberculosis. The incidence was one in 13 on the west and south west coasts.
Later, Dr. Geary, statistician in the Department of Industry and Commerce, investigated in part of County Wexford the relationship between the incidence of tuberculosis and the nature of the sub-soil. He found a definite and significant correlation between the incidence of the disease and the moisture hold in soils.
The discoveries of these statisticians. particularly of Dr. Geary in Wexford, suggested to me, at all events, the necessity of securing a proper site for sanatoria if the Minister or the Government intend to provide any extension of our sanatorium accommodation and, of course, that must be done. If a more comprehensive survey of the whole country were made along those lines, it would give us very valuable information as to the incidence of the disease in relation to certain soil conditions, lack of drainage, and that sort of thing. Dr. Geary has proved beyond doubt, from the statistics he has compiled, that there is a relationship between the incidence of the disease and soil conditions. That would also indicate that in providing sanatoria we should build them in the districts where the incidence of the disease is lowest and, if my contention is correct, it would indicate that sanatoria should be provided in the western or south-western rather than in the eastern counties.
There are other aspects of tuberculosis control to which the Minister might give early consideration. One is the question of compulsory notification. Deputy Cosgrave referred to compulsory notification in Dublin, but the real problem in regard to compulsory notification is that, as the law stands, it applies only where the medical officer is satisfied that the case is liable to spread infection. There are other cases that the medical officer is not bound to notify—surgical and non-pulmonary cases and cases where there may not be danger of infection. In such cases he is not bound to notify the disease. If we are to fight this disease properly, I think the time has arrived when every case where a medical officer is satisfied that the individual is suffering from T.B., whether it is infectious or not, ought to be notified.
There is another suggestion that the Minister might consider implementing, that is, the compulsory examination of sputum in doubtful cases, say, of bronchitis, pleurisy, influenza—the type of cases where, as I said before, tuberculosis is very often masquerading under a different name, and where the patient does not permit his doctor to take a sample of sputum for examination. Surely it is a necessary precaution, if we are to eradicate this disease, that the Minister should take the necessary powers to provide compulsory examination of sputum in doubtful cases, so that the necessary safeguards may he taken.
The Minister referred to the reports of the county medical officers of health as to the causes of tuberculosis, and he said that there was quite a variety of causes, amounting in all, I think, to about nine or ten causes. I think, however, that it must be admitted that, in the main, tuberculosis in human beings is caused by malnutrition, bad housing conditions, and insufficient clothing, and in that respect it seems to me that much could be done. Undoubtedly, much has been done, with our limited resources, with a view to providing proper housing conditions, and also in the provision of school meals. I am quite sure that these school meals have been satisfactorily provided, and that, undoubtedly, is a step in the right direction; but other things have to be taken into consideration. Take, for instance, the treatment of certain employees in Government Departments in this city. Where you have the case that writing assistants are appointed at 18/- a week which, with the cost-of-living bonus. would amount to about 30/- a week, it is almost certain that malnutrition will occur, particularly in the case of girls who are brought up from the country and who are trying to live in the city on such a wage.
Whatever may happen in the case of a young fellow, I think we may take it as inevitable that a young girl will cut down on her diet in order to keep up appearances. Instead of having a decent meal, she may buy a bun and a glass of milk for her mid-day meal. The young man, who is on the same wage-scale, may be more careless about his appearance, but he will generally try to ensure that he will have a well-fed "tummy", thus showing more wisdom in that regard. Surely, in connection with a matter of this kind, the Government ought to put their own house in order. For instance, I have no doubt that, even in the Minister's own Department, it will be found that, a number of girls are working under such conditions as I have described, and there is also the risk that exists when you have a large number of people working in offices under congested conditions.
I do not know what provision has been made by the Department of Local Government and Public Health to provide medical supervision for the large staffs that are working in the various Government Departments in Dublin, but one would expect that one of the first things to be done in that regard would be that the State should pay a salary sufficient to enable their servants to make sure that they would get sufficient for their maintenance and also sufficient to enable them to keep up the appearance that is expected of people who are working for the State. I should like to have some information from the Minister on that aspect of Government Departmental life in the City of Dublin. Of course, I am ignorant of the actual facts, but I should like to know what provision has been made in that regard, because it struck me, in going through various Government offices in the city, that some of them are overcrowded and that there is a real need for medical supervision.
With reference to this question of tuberculosis, I should like to quote a portion of a report made by the County Medical Officer of Health, Tuberculosis Medical Officer and School Medical Officer of the County Carlow, in 1942. In his annual report, the county medical officer of health provides some rather interesting information. He says:
"Tuberculosis is carried by a microbe of which there are several types. Two types are accountable for the disease in man; one, the human type and one the bovine (cattle) type.
"The human type gets into the body from sputum sprayed in the atmosphere, in coughing, sneezing or loud talking, or in a dried state, mixed with dust and breathed into the lungs or swallowed."
Now, that indicates immediately the necessity for education and propaganda in connection with such matters: to the effect that the human type of tuberculosis microbe is carried into the body from sputum sprayed in the atmosphere, through coughing, sneezing, and so on, and breathed into the lungs or swallowed, and that, in fact, there has not been enough education or propaganda as to the proper use of the handkerchief. It would appear that we have not tried to tackle this problem properly at all. We are told that the Red Cross Society is now actively concerning itself with this matter, and I have no doubt that that society will be a great source of education and propaganda, so far as the prevention or cure of this disease is concerned. The report of the county medical officer goes on to say, with regard to bovine tuberculosis:
"The bovine type gets into the body mainly from infected meat or milk and most often from infected milk. In this connection it might be well to mention here, that not every tuberculous cow gives tuberculous milk. The cow must be very diseased or have local tuberculosis in the udder. Moreover, tuberculosis has been found most prevalent amongst those who consume the least amount of milk per person.
From the perusal of figures available it will be seen that the cattle type of microbe: (1) causes little or no disease of the lungs; (2) is accountable for about half of the primary abdominal tuberculosis in children; (3) is accountable for about half of the tuberculous glands of the neck; (4) is accountable for less than one quarter of the other common, tuberculous disease outside the lungs; and (5) is especially likely to attack children under school age. The human type of microbe (which comes from sputum in one way or another) is responsible for (a) practically all lung tuberculosis; (b) say one-fifth of the abdominal cases; (c) one-half of the tuberculous glands of the neck, and (d) about three-quarters of the other common tuberculous diseases outside the lungs."
I was just coming, Sir, to the question of tuberculosis in cattle, and its effect on T.B. in human beings, and I wanted to call attention to our present system of reporting such diseases in our dairy herds. It seems to me that we have made no provision at all, not alone to deal with the question of the disease of T.B. in cattle, but with the effects of that disease on human beings as a result of the incidence of bovine tuberculosis. Take, for instance, the case of the Dublin Abattoir or that of slaughterhouses throughout the country. If a certain portion of the carcass of a beast is found to be infected, that portion is destroyed, but the other portions of the carcass are allowed out to be used for human consumption. I should like to know whether or not that is a wise precaution, or whether it would not be wiser or even necessary to destroy the whole carcass, so as to prevent infection. I wonder whether, in the long run, it would not be better to destroy the whole carcass, where the disease has been found in a portion of it.
I admit that I do not know very much about this myself, and I know also that, as the regulations stand at present, the compensation to be paid in such cases does not amount to very much, but I think that we ought to offer a greater encouragement to people to destroy the whole carcass, where infection has occurred in a portion of it. I understand that in the United States of America they have gone to great expense in trying to deal with this disease. I think that, in the United States, their prevention efforts have cost about £1 per head in the case of cattle infected by tuberculosis; but it has been found there that the cost per head has been more than overbalanced by the results that have been achieved in eradicating the disease. Accordingly, I think that our Minister for Agriculture, or Minister for Local Government, would be well advised to take that into consideration so far as infection through the medium of bovine tuberculosis is concerned. I know that it is not by any means a simple problem and that it will require a good deal of well-planned and well-thoughtout policy if we hope to eradicate this disease. As I said at the outset, the disease can be prevented if it is taken in time, but it must be taken in time, and, of course, in that connection tile early removal of a tuberculous case from the family circle is absolutely essential. At the present time I know that bed accommodation in hospitals is limited, and that our efforts to cope with this disease are hampered accordingly, but the fact remains that if a person suffering from the disease is left at home the results may be fatal, not alone to the person concerned but to the family circle as a whole.
In regard to that matter I should like to add my voice to what other Deputies have said as to the provision of better petrol allowances for doctors, nurses, and the medical profession generally. We have a very elaborate medical service here, bat it is faced with very serious transport difficulties. I do not want to minimise these difficulties. I quite realise what the Minister has to face in regard to supplies for transport, but I think that when it comes to the question of petrol for, medical or nursing associations as against the rest of the community, we ought to err on the side of generosity towards the medical or nursing associations. I suggest that the matter of the provision of an extra few gallons of petrol to enable doctors or nurses to perform services that are so vital to the health of the people should be favourably considered.
The Minister has referred again to hospital deficits, and he has informed the House that they are on the increase year after year. One can appreciate that deficits are almost inevitable during a period like this, and that they will increase during such a period. But the Minister has not indicated that he has any policy to solve this problem even for normal times. These deficits are continually eating into the fund, and it is a problem that will have to be solved sometime. Will the Minister provide capital or make a sufficient sum available from the fund to meet such annual deficits? Coming from a county which before the emergency had a scheme, and in which we were anxiously looking forward to the implementation of that scheme, to provide hospital services for the county, I can appreciate that, while hospital deficits are expanding in the city, there is very little hope of sufficient funds being left in the Hospitals Trust Fund to carry out the proper hospitalisafcion of the country as a whole. We all appreciate the fact that the vast majority of patients, poor law and otherwise, have to come to the city for treatment, and that the medical services here which are causing these deficits are services that are rendered to the community as a whole. Because of that fact we cannot be very critical, but it does appear to me that a definite decision in regard to this matter will have to be made by the Minister some day. I suggest that he must make some capital provision to meet those deficits. I do not think we shall ever get back to the time when charitable donations kept such hospitals going. These donations have practically disappeared, and it is unlikely that they will come back. The Minister should make up his mind to make the necessary capital provision out of the fund to yield a sufficient sum to keep the institutions on a paying basis.
The Minister made some reference to the cost of maintaining roads at the present time, and told us, of course, that owing to the reduction in traffic, expenditure on the roads has definitely decreased. He did not give us any information about the state of the Road Fund. I should like to know from the Minister whether whatever money is going into the Road Fund or whatever money is in the fund, it is being used solely for road maintenance or road improvement, or whether the Minister for Finance is still raiding that fund to help him to balance his Budget? On that matter, I think the 1926 Act served its purpose at the time when we had to build a lot of new arterial roads in the country. It is now more or less obsolete and it is unfair to allocate grants for maintenance and improvement on the basis of that Act because we must remember that the proportion of main roads to country roads is in the ratio of about five to one. Deputy Flanagan wisely suggested that it was unfair to expect those people who contribute to the maintenance of roads to continue to contribute while the funds are devoted to the maintenance and improvement of main roads, and when they find that the roads leading up to their own places in backward parts of the country arc not entitled to grants under present regulations. I think that the Minister should try to alter the regulations so as to permit the county council, the county manager or the county surveyor to make the decision. We should not scarify a good road in order to qualify for an improvement grant.
Another matter to which I should like to call the Minister's attention in passing is the criminal injury code. I think the operation of this code after 20 years of native government does not redound to our credit. It should never be in operation under a native Government, and the sooner it is modified or abolished the better. I look to the Minister to do something in that regard. I think it is very unfair that when a criminal injury does occur, a small section of the people are sometimes mulcted for it. It is an unjust method of making good the injury or damage suffered by the aggrieved person. The system was imposed on this country by an allen Government which never operated it in its own territory and I do not see why we should continue to operate it here. On the whole, the Minister's report of health conditions in the country is very satisfactory. I am sure that He and his Department will maintain close vigilance and take the necessary safeguards against any danger of outbreaks of disease during the emergency.
In view of the criticism of the County Management Act which we have had here to-day and on the last day, I must say, as one who was very definitely opposed to that Act, that I do not think that any representative of a local authority in Cork County will be found to utter one word against the manner in which our county manager is carrying out his duties. I was rather surprised at the comments with regard to the manner in which other county managers are doing their work. Every proposal sent in by any member of a local authority in County Cork is duly submitted, is discussed fully and given effect to just the same as before the County Management Act came into operation. We gave county managers also to two other counties and I must say it is a poor reflection on those counties that those managers preferred to return to Cork to act as sub-managers rather than remain as managers in those counties. From what I have seen up to the present of the working of the County Management Act in County Cork, I think the position is better than it was before the Act was introduced. I say that here honestly, although I was one who spoke against the County Management Act here and condemned it then.
It is not the first time the Deputy changed.
Yet he voted for it.
I am talking of personal experience. The last one to object to the Act should be the representatives of the poor, who call themselves the Labour representatives. I would like to deal with the manner in which vacant labourers' cottages are given to tenants throughout the country.
It is very bad in our county.
The Deputy can talk about his county when his turn comes.
You would need to belong to Fianna Fáil there.
The manner in which the letting is made at present is that the county medical officer gets a list of the applicants and reports on the applicant most in need of a house. What happens in a district generally is that a good agricultural labourer who does his part by his master is probably in a fairly good house. That man will never get a cottage while the present scheme is in operation. The man who gets the cottage in nine cases out of ten is a ne'er-do-well, a man who would not pay 2/- or 3/- for a house and is thrown out, a man who will not work and finds himself living in a hovel.
Mr. Larkin
That is the county manager's doing.
It is not, it is the regulation of the Department of Local Government under which, if this system is not carried out, the county ratepayers lose the subsidy that is given on a house. We have a rather awkward district to deal with in the suburbs of Cork. You have people there who found it impossible to pay for even one room in Cork City; they came out there and got into stables and hovels of various descriptions. To meet that, the South Cork County Board of Health initiated a housing scheme under which about 170 houses were built in the South Cork area, mainly in the suburbs of Cork. When these houses were being built, the question of the grants arose. I attended on at least three deputations to the previous Minister for Local Government and Public Health, Deputy Seán T.O Ceallaigh, in an endeavour to get the grant increased. I received, as a result, a letter from the Minister stating that he could not increase the grant and giving, as one of the reasons, the rents at which some of these houses were to be let. Houses were built by the city manager outside the boundaries of Cork and under grants of up to £450, given on the percentage basis. The grants on the B.O. Health houses were 60 per cent. up to £300. The reason the Minister gave was that the rents under which the corporation houses were let were from 1/4 to 10/6, an average of 4/5 per week, plus rates. The houses proposed to be erected by the board of health would be subsidised at 60 per cent. up to a cost of £300 per house and the rents proposed were 3/- per week.
These houses were built, and a few months afterwards the question of appointing tenants and fixing rents arose. A certain very conservative body on our board of health put those rents at 7/9 per house and not at the 3/- stated by the Minister. On the basis of 7/9 per house, plus 1/10 rates, there is absolutely no hope that the houses will go to the particular class of the community for which they were built or, if they did, that the tenants would be able to remain in possession of them. You can imagine the plight of a man who has found it impossible to pay 4/- or 5/- a week rent and who has been evicted and who goes to live in a stable, for which he pays a couple of shillings a week. In order to wipe out the slum area created in that manner, the board of health built houses which were to be let to those tenants, according to the Minister's letter, at 3/- per week. The board of health fixes a rent of 7/9 and that goes up to the Department and is duly sanctioned, thus depriving those people of any hope of getting houses.
Mr. Larkin
What was the capital cost?
I could not say at the moment. The fact remains that men were evicted because they could not pay 3/- or 4/- a week, and now find that the hovels for which they were paying 2/- a week, which they thought they could pay, were razed to the ground after they were taken out and put into these houses at 7/9 per week. They have nowhere else to go now, and have to try to find the 7/9, plus 1/10½ rates. That is a situation which the Minister should take in hand. It was one of the last acts of the late board of health. I admit that the board of health did its duty: by keeping the pressure on, they built the houses. The Minister should adhere to the decision stated in his letter, and see that rents of 3/- are charged. Some of the people who are asked to pay 7/9 plus 1/10½ are on the dole, and some of them are on home assistance. That condition of affairs should not exist.
We hear a lot of talk about "back to the land". The only hope of bringing people back to the land is by seeing that good houses and labourers' cottages are provided in the country, instead of in the towns. What is happening all over the country is that a young couple getting married find they have no housing facilities in the district, so they go into the nearest town and get a room, or go into the City of Cork and get a room. Naturally, they stop in the city. Probably the same applies in Dublin. That is an aspect of the matter that might be considered.
I think the further we can go ahead with housing schemes the better, but, if we are going to provide houses for certain classes of the community, let us give them houses in which they will be able to live; do not let us build beyond the capacity of the people to pay rent. Let the burden go somewhere, but let it not remain on the unfortunate people who have to live in those houses. When I saw the condition of affairs outside Cork, I endeavoured to lighten the burden by appealing to the Minister to give the same grants on one side of the road as on the other. I refer to two schemes, the distance between which is scarcely 200 yards—the schemes at Spangle Hill and Dublin Hill. There is a grant of £450 given on one side of the road and something like £300 on the other. The difference in the grants makes all the difference in the rents charged.
I can quite understand the position in other counties with respect to county managers. I say that Cork County in that respect is lucky, but Cork City is not. A few months ago some unfortunate people happened to be driven out of the city under a slum clearance scheme and they were forced to live in the Spangle Hill district. There they had a differential rent scheme—according to what you earned, you paid. Those people applied for a bonus under the Emergency Powers Act and they got from 5/- to 8/- a week added to their wages. That bonus was given definitely to meet the increased cost of food and clothing. What those people got would not really cover the increase over pre-war rates. Notwithstanding that, the city manager put in his paw and told those people he was increasing their rent by 10d. to 1/3, simply because they got a bonus of 5/- to 8/- a week.
Appeals were made to the Minister in that connection. The city manager took one of the people who refused to pay, into court. The case was tried in the District Court and the city manager was beaten. Now, I understand he is going to spend more of the ratepayers' money by bringing the case to the High Court in the hope that the unfortunate tenants will not be able to follow him there. I think the Minister should put his foot down in this case. According to the statements, made by the tribunal which granted the bonus, that bonus was definitely given in relation to food and clothing, and not to meet increased rents. It is a scandal in a case like that, where money is given to provide bread for hungry children, that the local authority, in this case the city manager, should be allowed to increase the rents.
I now come to the question of food vouchers, in the district that I have just mentioned, a certain anomaly exists. There are three or four houses within the city boundary and the remainder are outside the boundary and, under the food voucher and other schemes, the people who are just outside the city boundary are not allowed to benefit. For instance, the man living in No. 3 can avail of the food voucher scheme, but the man living in No. 4, although he may have a large family, will not get any consideration. U e endeavoured to widen the voucher scheme as far as possible and we thought that we would get the assistance of the Local Government Department. There was a report from the superintendent of home assistance in which he told us he was already exceeding the grant allocated under the scheme, and that he was dealing only with necessitous cases. We communicated with the Local Government Department asking for an increased grant and they replied that they would not increase it. The grant was allocated on the basis of the previous year's experience and it could not be increased. We had no alternative except to put our hands in the ratepayers' pockets and hand out £750 to meet the deficiency. If we did not do so, it would have meant getting poverty-stricken people go hungry. Those areas outside the Cork City boundary accommodate something like 15,000 to 18,000 people and many of them are finding it difficult to live.
There are grants given for supplies of fuel to necessitous families, and I should like to know what particular class of community those grants are meant to cover. We found that last year we had to put up £1,459 to provide fuel for necessitous families during the winter months. The same thing came up this year and we found that after providing the money the scheme was handed over to the city manager for administration. The city manager fixed up depots and in some cases these were two and a half to three miles away from the residences of the poor people. These people had to travel to the depots and remain in queues on wet as well as fine days in order to get a handful of turf. According to the Local Government Department, Cork City and suburbs constitute a non-turf area. A man living in Midleton is at least 12 miles further away from turf than is the man living in Cork City, yet that man in Midleton is calculated to be living in a turf area while the Cork City man is living in non-turf area. Amendments which I proposed to this Act, when it was a Bill, were defeated, and now the position is that, of the £1,460, £1,022 has to be provided by the rural district and £438 by the city. The unfortunate unemployed man living in the town of Cobh or Passage and having five or six children will have to contribute in his rates to the purchase of fuel for the poor of Cork City and suburbs, while he is allowed no benefit himself under the scheme sent down by the Department of Local Government. That scheme was sent down to us on the 12th October, 1943, so that it is recent enough. The number is 617,375/43. A large number of the people who are getting home assistance are in bad health. On account of the long distances between the depots and the residences of the recipients, they had to hire young lads to go to the depots with carts or bags and take home the turf. They had to pay them for doing so and, in nine cases out of ten, when they arrived home, a share of the turf was sold on the road. We have the anomaly of the poor in one district having to contribute to a scheme to benefit people in another district who are no worse off than themselves, while they themselves derive no benefit. To get rid of that anomaly, we decided to increase the amount from £1,459 to £2,500 and to make the scheme applicable to the whole area of South Cork. Furthermore, we decided to issue vouchers for the fuel so that the recipients of the vouchers—the home assistance cases— could take them to whatever fuel merchant they wished and have their cwt. of turf delivered weekly to their homes instead of having these classifications. We see no reason why, because people are poor, they should be treated in this manner. You will find more poverty-stricken people in the town of Passage than you will find even in Cork City. These people were knocked out because they were in an area classified as a non-turf area. If they pay rates, they contribute to the provision of turf for the poor of Cork City and suburbs.
I should like to know, since we have to provide this money in full, why a grant under J (4) was not applicable to these cases. If there is a Vote of £100,000 under J (4), I think that portion of that sum should find its way to the South Cork Board of Public Assistance instead of having the ratepayers footing the whole bill. It is grossly unfair to have the people of the rural district of Cobh, Passage, Macroom and Youghal having to pay £1,022 of the £1,400, while the big merchants in Cork City have to pay only £438. For every shilling spent in home assistance in Cork, the rural areas have to pay 8d., while the Cork City merchants get away with 4d. That is bad enough, but when you get a regulation stating that you cannot give any assistance to the people who have to contribute three-quarters of the money, it is worse. These are matters that I should like to have rectified, if possible, by the Minister. I should like to know from the Minister if there is any hope of dealing with Cork suburban area in such a manner that these people will no longer be classed as outcasts. There is no doubt that during the last nine or ten years a great many beneficial schemes have been introduced and have been administered by the Local Government Department. Why should unfortunate people who lived in the slums in Cork City, and who, through no fault of their own, were driven out of Cork City by the city manager, be deprived of these benefits simply because they are just outside the borough boundary?
Mr. Larkin
Why did they not go back and chase the city manager?
They would want Deputy Larkin down there to look after them.
Mr. Larkin
There were days when I did it.
You never gave us the pleasure of seeing you down there. It is very unfair that that position should be allowed to continue without any attempt by the Department at rectification. We read in the old histories how, when a person committed a crime, he was driven outside the walls of the city. That is what happened all these poor devils, although they committed no crime at all. They were driven outside the walls of the city, and the city manager follows them there and takes from them a shilling of their 5/- cost-of-living bonus. In the old days, when criminals were driven out of a city, they were not followed and persecuted. But the Cork city manager follows these people out to persecute them. If it is possible to rectify these matters, I hope they will be rectified.
Some allusion was made to the road question. An enormous amount of money has been spent on trunk and main roads within the past 15 or 20 years. In a large number of cases the ratepayers were induced to starve the ordinary second-class roads and put money into the trunk roads in order to collar so much of the grant that was being made available by the Department of Local Government and Public Health. At the present time you cannot get material either for the upkeep of the main roads or for the building of more of them. Tar macadam and the other materials required will not be available during the period of the emergency. The main roads at the present day are not carrying one-twentieth of the traffic they carried pre-war. I can see no reason why, now that we have a native Government in control, we cannot switch over the grants, given up to the present for the trunk roads, towards the maintenance of the ordinary roads that are being used by the rural community. Ninety per cent. of these ordinary roads have been starved out of existence. Many of them are only bog tracks. There are some of them that do not get four loads of stones to the mile in a year. Heavy traffic is passing over them at the present time, far more traffic than ever passed over them before. In the County Cork to-day there are no lorries to take the farmer's produce to the city. It has to be taken with horses and carts. These horses and carts travel along the old second-class roads because if they were to go by the main roads the horses would fall and break their necks. In addition, you have lorries travelling over these second-class roads taking turf from the bogs, roads that were never meant for heavy lorry traffic. I hope, therefore, that the suggestion I have made to switch over the grants that were available for the trunk roads to the ordinary second-class roads which are being used by the farmers will be acted upon. There is no doubt whatever that through the peculiar operations, over a number of years, of the Department of Local Government, these second-class roads have been starved almost out of existence.
Recently, we got a request from the Department of Local Government to pay our share of £20,000 for engineering plans in the case of Youghal bridge. I know, and any sane man knows, that a new bridge is not going to be built there during the emergency for the reason that the materials required cannot be got. Why, therefore, should we spend £20,000 in fees for nine or ten "buskshee" engineers who are to be asked to prepare reports? Youghal bridge is a main artery of traffic. More people from other counties travel over it than people from the County Cork. I cannot see why the ratepayers of the County Cork should be asked to make this contribution for fees to engineers. We do not object to paying our share towards the cost of building the bridge, if it is to be built, but we object to launching out on an expenditure of £20,000 for fees to a bunch of engineers, some of whom, when the bridge comes to be built, may be in Timbuctoo. The plans will be there to be argued about for a couple of years, going from one to another. We have seen too many plans prepared and paid for.
Including the famous Fianna Fáil plan.
That is the plan that kept the Deputy quiet.
You kept them quiet by sending them to England
That is the plan that made you conduct yourself here.
You did not bring back any of the emigrants under it in any case. You exported them instead.
If the plan were not put into operation there would be a hangsight more exported. I speak as one who did a hangsight more labour in my life than the Deputy ever did.
And more people left Ireland under the Fianna Fáil plan.
Deputies who never worked in their lives should not talk about labour.
If the Deputy could think once in his lifetime it would not be bad.
The Deputy ought to go down and give a hand to the sugar cooks, or does he disown them?
I have nothing to do with sugar cooks.
I could give a little bit of information to the Deputy and his colleagues.
Order!
Tell us about the plan.
That is the difference as regards the Deputy's plan. Let me get back to the Estimate. I am afraid the Deputy's unruly interruption has upset me. I am anxious that the Minister should end the anomalies that I have alluded to. There is no use in spending money on the preparation of plans for Youghal bridge at the present time. Four different sets of plans were sent to the Department in regard to a regional hospital for Cork. The ratepayers had to pay for each of them. The plans for a fever hospital at Midleton had to be paid for by the ratepayers, and when the engineers got their fees we were told that there was no fever hospital required. I am opposed to the spending of a penny by Cork County towards the preparation of plans for Youghal bridge. If a new bridge is to be built there, then I think it should be made a national instead of a county job. Before the people of Cork undertake to provide any money for Youghal bridge, we shall want to see in black and white what the Government contribution is going to be towards the cost. In my opinion the Government contribution should be 90 per cent., Cork contributing 5 per cent. and Waterford 5 per cent. That, I think, would be a fair proposition, seeing that this bridge is used far more by people from other counties than it is by Cork people. It is used more by fellows who come to Cork looking for a soft living there.
In Cork?
Deputy Kennedy may be surprised when I tell him that when Ford's factory was going in Cork one heard nothing there but the Dublin accent, so much so that you imagined you were living in Dublin.
The position is reversed so far as Dublin is concerned.
And they did not come down there either to do ordinary common work. They came down for a soft job. That is a general complaint, I believe, against Dublin people. I am sorry I had to delay the House, but Deputy Norton's interruption made it necessary for me to do so.
Like many Deputies who are members of local authorities, this Vote is of extreme interest to me. I regard the Minister as having probably the largest field of social activity so far as any Department of government is concerned. He has a very wide and useful field of administration in his Department, and it is to the extent to which he has succeeded or failed that we are now concerned. I have a few suggestions to make, and I make them in a helpful and constructive spirit. I hope the Minister will accept them in that spirit. The Minister's field is a very wide one, inasmuch as he is associated with school-going children, with people who become ill, as far as hospitals are concerned; with care of the old, with widows and orphans, blind persons and the aged. I am bound to say, as far as the Department is concerned, it has excellent schemes which are excellently administered, but there are others which do not come within that category. I regret to say the one that, in my opinion, does not come within that category concerns public health. I do not know any of the personnel of that Department. I am sure they are capable men, but on the facts as I have seen them for a number of years in the Dublin Corporation, they would seem to have specialised in doing nothing in particular as far as the major consideration is concerned. This House has devoted a good deal of time to the question of tuberculosis, and it has been laid down as an elementary fact that the treatment of tuberculosis should be first of all an early examination, institutional treatment, after-care treatment, and above all, that the home should be preserved during the period of treatment of the patient. The Department is primarily concerned in a very useful function so far as institutional treatment is concerned, and is also interested in the question of early examination.
While perhaps at this stage it might serve no useful purpose, to criticise delays that have occurred as far as institutional treatment is concerned, I may mention, in the hope that the delays of this character will not be charged against the Department in future, that in the City of Dublin there are in our floating population 5,000 cases, or one in every 100, while the actual accommodation, including those that can be treated for pulmonary tuberculosis and surgical tuberculosis, amounts to 748 beds, including our own institutions and ordinary hospitals. As far back as 1931 proposals were made to the Department regarding the abolition of the hospital in Crooksling, which is regarded as unsatisfactory and not adequate to meet the needs of the city. Various proposals were made later, following a commission set up by the Dublin Corporation, culminating in 1935, when a plan was submitted to the Department. The position has now got to the stage that it has been referred to and fro since 1935. While a site was purchased, and everything else was available in the pre-emergency period—the emergency cannot be claimed as an excuse here—I am sure the House will be surprised to learn that that particular hospital to provide the accommodation that is so terribly needed in the city does not now exist, simply because of the procrastination of the Department concerned. Believe it or not that was simply because the Department's technical advisers decided that they should have a certain architectural design, and for that architectural design it would be necessary to introduce an outside board of assessors. I suggest to the Minister in all seriousness that somebody in his Department has blundered, and that as a result the City of Dublin has not to-day the sanatorium that it should have.
It is the same as regards a fever hospital. Prolonged negotiations took place between that particular committee and the Custom House authorities, culminating in an urgent call from the committee—I should say perhaps from the chairman of the committee—to the then Minister—not the present Minister—on the urgency of providing in the city a hospital capable of dealing with 400 infectious cases. Here again there was the same series of delays with the result that the two objectives were defeated. We did not get the hospital that we should have got for tuberculosis or for infectious diseases, while a valuable source of employment was lost to the city, and to workers who would be engaged. The schemes were held up because the opportunity was not availed of when it should have been. Even the emergency may not be claimed as an excuse. In that respect I should point out to the Minister that even during the emergency it was possible for the vocational committee to take action. It is an important committee having control of a number of schools.
That committee, even during the emergency, by their foresight was able to go ahead with contracts for excellent work in Rathmines, representing an expenditure of £30,000. The committee has gone further and, in the north city, at Cabra, have made provision for materials for a school which will also give valuable employment. I suggest that if the same foresight, the same energy and the same driving force were behind the Department in other respects the position I have indicated would not have arisen.
I regret that it should be the case. I prefer that it should not be so because of the relations of that Department with the city. It is perhaps a debatable question whether there should not be a division into two sections at the Custom House, whether ordinary works, sewerage and matters of that kind, as well as general employment should not be the specific duty of the Minister, while alongside that there should be a Ministry of Health having regard to the necessity there is at present for improving the public health. I hope, therefore, when matters of this kind come before the Ministry in future that proposals will be examined in the way in which they are submitted, and that a certain amount of business acumen will be brought to bear on them plus a little sympathy and understanding. As far as sympathy and understanding are concerned may I say in all sincerity that if there is one thing which makes life worth living I would say, so far as the public are concerned, it is association with the public bodies. It provides a channel for useful community service and the record of this country in that respect will bear favourable comparison with that of any other country in the world. I suggest that the Minister should hesitate before proceeding along the line of cutting away that necessary sympathy and understanding which always existed between public bodies and the Minister. He will find in the long run that a policy of sympathy and understanding will pay, and that, individually, the beneficiaries of the various schemes will be a little more happy.
Coming to the question of housing, I think it was Deputy Cosgrave who, not satisfied with the progress made or the policy with regard to housing in this city, indicated that the position was perhaps not much better than it was 20 years ago. The position, I am sorry to say, is that we have to-day 15,176 families living, in houses which have been declared unfit by the medical officer of health; that we have 19,956 families living in single rooms, some of which have been declared fit so far as the public health regulations are concerned; and that we have in this city, believe it or not, stable dwellings numbering 72 declared fit under the Public Health Acts and 275 stable dwellings declared unfit. With that position before us, I say that we need the help of the Minister.
At this stage, I shall pay the officials associated with housing in the Department the compliment of saying that they have perhaps been more closely associated with the Department's activities than those of any of the other Departments I have known. I understand that they are responsive to any suggestions made, but obviously purely on the constructional side. They do not enter the field of finance at all, which is the point on which I want to make a suggestion to the Minister. It is, a suggestion made on various occasions by Deputy Corish in regard to the financing of our housing schemes.
At present the capital indebtedness of the City of Dublin amounts to £11,500,000. I explained here before, and I repeat now, that, in respect of ordinary slum clearance, the arrangement as between the Minister and the corporation under the 1932 Act is that we get two-thirds of the capital loan charges, which goes down to one-third in respect of ordinary schemes. I suggest that whatever may have been the position in 1932, the conditions in 1943 are entirely different. The cost of building has obviously gone up and the maximum figure of £500, on the basis of which a flat qualifies for a grant, bears no relation to the position which obtains to-day, the cost of a flat at present being £800. In the case of ordinary clearance, the maximum figure laid down by the Act is £450. When we come to the question of cottages, we find the most extraordinary anomaly, in that the position is reversed. The maximum amount in respect of cottages for slum clearance is set down at £400, while in respect of ordinary clearance schemes the figure is £450—a reversal of the flat principle which is not easy to understand. The latest figures we have indicate that our cottages are costing £680 and that it is the corporation's own budget which has to bear the difference between the maximum of £400 and the £680 actual cost, which position was never intended when the Act was introduced.
I ask the Minister to have the matter specially examined. It operates, I am sure, in other areas as well, but not to the same degree as in Dublin, because we are still able to continue our building programme—not on the scale we should like, but on a certain limited scale. The result of this imposition on the corporation is that the contribution by the Dublin rates is £200,000 annually, which is equivalent to 2/1 in the £ in respect of housing, which is, and has been, in excess of the annual contribution made by the national authority under its own Housing Acts. In that respect, therefore, the corporation can justly claim more credit for building progress in the city than the Government. I do not think that was the intention of the Acts, but it has worked out in that way.
With regard to the suppression of various public bodies, the Minister will not mind my saying that he appears to have a craze for doing that sort of thing on the slightest provocation. With what has been done elsewhere, I am not concerned, but I am concerned with what was done in relation to the Dublin Board of Assistance. That board was abolished in April, 1942, and its functions placed in the hands of a number of commissioners. Members generally will, I think, join with me in this at least, that the Minister should prescribe, once and for all, a determined and settled policy regarding the manner in which these suppressions shall take place. So far as the Dublin Board of Assistance is concerned, the Minister set himself up as judge and jury, and I think that applies to all the other cases as well. In the case of the Dublin Board of Assistance, no charge was made. An inspector was sent in to hold an inquiry, and, on the basis of that inquiry, which revealed nothing of a major character, the board, because the Minister desired it so, was suppressed. I suggest that that is not a fair method of dealing with a situation of that character, and that the obvious course for the Minister, if he feels that he has cause to intervene in regard to a local authority, is to appoint an independent chairman, some man of standing in the legal world, to decide the matter, the charge against the local authority being set out and the local authority being given an opportunity to reply.
The Dublin Board of Assistance up to the time of its dissolution carried out its duties in a reasonable manner, and I make the suggestion to the Minister that whatever may have been the reasons for his decision on that occasion, and whatever they have done, they have surely purged their crime at this stage, 18 months later. Having regard to the character of that body, a body which, as Deputy Hughes very properly pointed out, needs public assistance, that is, public representatives, so that the beneficiaries, who are the very poor, will have representations of the kind they would like made on their behalf, I suggest that the public as such should be associated with it. It had an expenditure of over £400,000, and, as I say, the beneficiaries are the very poor, and I urge that the time has now arrived when public representatives might be again associated with the board.
Another matter which affects not alone Dublin but other counties and which I am glad to have the opportunity of bringing before the House, is the question of the capitation grant for asylums. So far as Grangegorman aud Portrane institutions are concerned, there is an old provision dating back to a British Act setting out the amount of capitation grant in respect of non-paying patients. Here in Dublin, if I mistake not, it amount to 4/- per head. I do not know whether the sum of 4/- per head bore any relation to the cost at the time it was fixed, but obviously it bears an absurd relation to present-day conditions, and I suggest that the time has arrived when the Minister might examine that position, because its incidence on the rates of the city is heavy, the demand of the Grangegorman Board having to be met by the rates of the city.
I want to refer now to the administration of the Old Age Pensions Act, the Blind Persons Act, and the Widows and Orphans Pensions Act. I can only confess that I was amazed to hear recently in this House the Minister, and the Parliamentary Secretary saying that they were unaware that there was any dissatisfaction under these particular heads. To put it bluntly, they were obviously speaking with their tongues in their cheeks, because their own Departments, to my personal knowledge, are flooded with applications indicating positive distress because of the administration of these particular Acts.
In my present capacity, I have a very heavy morning's post, and I would say that at least a third of that relates to questions under the heads that I have indicated. They are very real grievances. I would suggest to the Minister that he should take his courage in his hands now. In the light of the experience of every one of us, this means test must either go or be modified.
The Children's Allowances Bill is under the care of the Minister for Industry and Commerce. We welcome the fact that, at long last, the principle is enunciated in that Bill that there will be no means test. The allowances will be made without the operation of a means test. If it is desirable that that principle should be recognised in the operation of a children's allowances scheme, is it not much more desirable that it should be operated in regard to people who are actually dependent on the stipends they receive? Take the case of widows. The average widow in the city is forced by stress of circumstances to seek employment. Because she does so, and because she receives a small wage, her pension is immediately cut. I suggest to the Minister that that is not the foundation of social justice. Having regard to the amounts that are allowed under these Acts, might I suggest to the Minister that there should be a graceful interpretation of the means test. A number of officials, obviously more concerned with the letter than the spirit of the Act, are interpreting it as civil servants, perhaps, are bound to do, and the result is that hardship follows. The unfortunate individual who admits to having an income of 2/- or 3/- from any source is immediately cut to that extent in the pension.
On this question of social services generally, I think the Minister might consider if the time has not arrived for the amalgamation of all social services under one head. At the present time the dice is loaded against the ordinary person seeking unemployment insurance, old age pension, or any other social service. He has to fill up an elaborate form. He may be referred to another Department, and has to visit that Department. As members of the House well know, the individuals administering the Act are not concerned about the manner in which the individual makes out his application. If it is made out in wrong form, or against himself in any way, the debit lies to the unfortunate person making the application. I suggest the time has arrived when these services should be amalgamated, and, within the framework of that amalgamation, there should be a welfare information bureau which would indicate to the applicant for any form of pension how to get the maximum pension.
I raised a question recently in regard to the provision of a night dispensary in this city. I would ask the Minister to examine that question again. It is perfectly true, notwithstanding anything that may have occurred under the board of assistance here some years ago, that there is a demand. In any case it should be obvious that there is need for a service of the kind. Unfortunate men who are not prepared to lose their wages, in the ordinary course, remain at their work until they are absolutely crippled. If there were a dispensary of this kind to which they could go after their work, and pay a nominal fee, a good deal of hardship could be eliminated. I do ask the Minister to examine that position in the city again. I think that he will find conditions have changed since that particular matter came under the notice of the authorities of the board of assistance.
Various Deputies have referred to the question of the nursing services. The Minister, in reply to a question recently, stated that it was the function of the local authority to take the initiative in this respect. I suggest to him that it is impossible for the local authority to take the initiative in this respect under Section 56 of his own County Management Act, which precludes any question of wages or salaries of any of the employees being dealt with other than by the city manager. Obviously, therefore, the initiative must come from the city manager. In that respect the city manager, or the county manager, as the case may be, can choose as he likes. There is no force of public opinion behind him, no force of his own council. Therefore, I would suggest that what the Minister might do in that case is what the Minister for Education does in the case of vocational committees, and that is, order that a certain scale of salaries shall be introduced under the various committees, and that is an end of it. Local authorities will have to make their own arrangements to carry out the Minister's instructions. I suggest that the Minister for Local Government might embody in his Bill authority similar to that which is vested in the Minister for Education in regard to vocational committees.
It is necessary for me to emphasise the need for improvement in regard to the nursing staffs of this country. They have been the cinderella of the whole medical service. Without their services the hospitals or private institutions could not be carried on. To take a comparison of salaries in just one grade, the scale of salary for a staff nurse in England and Northern Ireland is £100 to £140; in Scotland, £100 to £120; In Eire, £60 to £75. These figures carry their own condemnation. I think the Minister would be doing something that would be appreciated not only by the nursing staffs but, I venture to say, by the public as a whole if he, were to take up this question immediately.
I do not know that there is any use in my referring to the question of rotational schemes. We have discussed this question at the Dublin Corporation and have made no progress whatsoever. It was a scheme introduced by the Ministry here some four years ago as a solution of the unemployment problem. It has been a miserable failure. It is no solution to suggest that work is to be rationed on the basis of three or four days' work a week. I suggest that the time has arrived when we in the Dublin Corporation, who are paying our contribution towards these particular relief schemes should be permitted to employ these men on the basis of a full week's work.
I do not think that the great Dean Swift was altogether insane when he said: "'Twere better to be in our graves than live in slavery to slaves." From the day the County Management Bill was first introduced, we foresaw that it would lead to the appointment of local dictators. It would seem now, from the Minister's statement and from his heavy-fatherly warning to county managers that they are not only dictators but dictatees. They are expected to live in a condition less than that of a citizen of this State. They are to have rights less than those of citizenship. It is bad enough for local representatives, for ratepayers, for the sick and the poor who depend on local services, to be completely in the hands of a dictator. It is worse still to find that that dictator is a mere slave and messenger boy of the Minister and his Department. No other construction could be put upon the statement of the Minister in which he warned county managers that they are not to seek the limelight by joining any association or organisation.
I have never heard that a citizen of this country can be debarred from joining a lawful association or organisation. Officials of local authorities have joined political parties. Some of them have even become prominent members of this House and have given very valuable service to the country through their activities in this House. Why, then, should a county manager be placed in a position of complete slavery? Why should he be placed in such a position, unless it is intended that he is to be an obedient servant of the Minister and his Department?
The Minister, in his opening statement, dwelt at considerable length on the powers, responsibilities and duties of local authorities. As a member of a local authority, I know that these powers have been restricted as a result of the Act which has been enforced during the past year—perhaps, not so much as a result of the Act itself, but as a result of the way in which it has been administered. I am not one of those who go out trying to bring about revolutionary changes. Whatever law is in force at the moment—and particularly in regard to its administration—I hold that it should be utilised to the best advantage by everybody whom it affects. I believe in evolutionary rather than revolutionary methods, and for that reason I am prepared to offer suggestions to the Minister in regard to the operation of the present system of local administration.
First of all, I am afraid that the county managers started off, as I might say, on the wrong foot, and dill not take the local authorities completely into their confidence. In addition to that, I think that the Minister was wrong in not giving complete and adequate instructions, through his Department, to members of local authorities as to what powers they can still exercise under the existing law. The Minister has told us that the elected members of a local authority have the power to dismiss the county manager if they find that he is not acting properly. In theory, that seems to be all right. For instance, in the case of the manager or foreman of a shop or store, the owner can dismiss that manager or foreman if the owner finds that the manager has been acting wrongfully, but, so far as I can ascertain, the powers of local authorities to get rid of a manager whom they regard as being unsatisfactory in his duties are very slight. I think that Section 6 of the Act states that a manager may not be removed without the sanction of the Minister. I have no objection to that, but I say, definitely, that that leaves very little power in the hands of a local authority when it comes to the question of getting rid of a county manager, since that matter seems to be left entirely in the hands of the Minister. As I understand it, a local authority can suspend a county manager, but here again arises the question of what useful purpose would be served by the suspension of the manager, if it is not possible for the local authority to dismiss him. It would not serve a local authority to suspend a manager for a long period if, during that period, the local authority had to provide his salary.
Mr. Larkin
On a point of order, Sir, I should like to point out that there is not a quorum in the House, and I think that that is unfair to the speaker.
Notice taken that 20 Deputies were not present: House counted, and 20 Deputies being present,
I am suggesting to the Minister that the powers of local authorities to get rid of a county manager who is unsatisfactory are very limited. I think that, at least, the local authorities should be instructed as to what powers they have, and that they should be advised to utilise these powers to a greater extent than they have been permitted to utilise them in the past, to meet such cases. For instance, if we are to take it that a county manager is the servant of the local authority, then it is essential that that local authority should be in a position to supervise every action of the county manager. On the other hand, if, as has happened during the past year, a county manager is only to be called upon to account, once in three months, for his actions, and if the orders of the county manager are not circulated to the members of the local authority, and these members are not in a position to know what the county manager has been doing during the three months which have elapsed since the time of the last meeting, how are they to know whether he has been doing his job properly? I have known of it to happen that a three months' period elapsed in the case of a local authority, where no report was made, and accordingly I would suggest that all orders issued by the county manager should be circulated to the members of the local authority at least once a month, because, otherwise, how are the members of the local authority to know whether or not the manager is doing his job properly?
In addition, all orders made by the county manager in each month should be sent directly to each member of the local authority, so that such member would have ample opportunity of perusing these orders and of making up his mind whether the action taken by the county manager had been wise or otherwise. Then at the meeting all these actions of the county manager could be reviewed. That is the only way in which the limited powers of county councils and other local authorities can be used to any advantage.
There is no doubt that if local authorities—county councils and other councils—were to meet at frequent intervals and if each member had an opportunity of going into the details of the county manager's activities during the month, there would at least be some chance of the ratepayers exercising some influence on local affairs. As it is, a period of three months elapses and during that period very many far-reaching changes may be made in local administration. No information as to those changes is communicated to any member of the county council. The orders made by the county manager are laid on the table of the council chamber but it is obviously impossible for all members of the county council carefully to peruse those orders while the business of the county council is in progerss. What really happens is that the county council is called quarterly to deal with a few matters which are reserved to the county council—perhaps the appointment of a rate collector, the seeking of overdraft accommodation, the striking of a rate or any matter of that kind which is the function of the local authority—but the members have no real opportunity of looking carefully into the activities of the manager over the period in which he has been operating.
I think there is nothing more humiliating to members of county councils than to find themselves completely in ignorance of what has been done in the county. For example, take the position of a county councillor who has been a member of a board of health for years and who has been accustomed to deal in detail with all the activities of that body. A person approaches him and informs him that there is a cottage vacant. The county councillor says: "Well, I shall see the manager in connection with the matter," or makes some like observation if he is satisfied the person is a suitable applicant. The applicant then informs him that he has already got the cottage but that it is in a very bad state of repair. "Well," says the county councillor, "I shall see Mr. Brown, the county engineer, and if you have reported the matter, I shall draw his attention to it." The applicant will then tell him, perhaps, that Mr. Brown is no longer the county engineer and that somebody else has been appointed to replace him. Is that not a humiliating position for a public representative? That perhaps slightly exaggerates the position, but yet it is true of what is happening all over the country. The local representatives do not know as much about the affairs of the county as interested parties—people who are seeking houses, seeking relief or making applications of various kinds to local officials.
While we talk about democracy and about the right of people to manage their own affairs, we have reached a position in which every citizen of the country is to a most humiliating and degrading degree dependent on permanently appointed officials of the State and the locally elected representatives have no voice whatever in safeguarding the interests of the people who elect them. I think that the suggestion which I have offered will help in some way to improve matters and should be availed of immediately. It is not right that members of local authorities should have to rely upon the local Press to find out what the managers or officials are doing in their own county. They should be regularly informed. In many cases now the local Press do not bother to publish reports of the manager's activities. They feel that they have a grievance, too, inasmuch as they have been deprived of a considerable amount of copy.
The Minister drew a very bright picture of improved conditions in the present year as compared with past years. The marriage rate and the birth rate have increased, and the death rate has declined. Those are things upon which the Minister and the nation generally should be congratulated. I am not sure that I agree with the statement that has been made that this is due entirely to the progressive work of the Minister's Department for the last 20 years. As far as the increase in the marriage rate and the birth rate is concerned, I believe it is entirely due to the increased amount of money in circulation, a circumstance with which the Minister has very little to do. It is entirely due to outside conditions and to the fact of the printing presses being in operation outside this country, causing increased circulation here. That is not likely to be a permanent condition of affairs, but it just shows to what extent the lives and livelihood of our people, the very life and existence of our nation, are dependent upon outside circumstances.
So far as the most serious causes of death in this country are concerned, tuberculosis has been dealt with extensively by other Deputies, and I do not intend to dwell on it. Next in order of gravity is the malady of cancer, which is responsible for almost as many deaths as tuberculosis. I think it deserves to be regarded seriously and that there should be very far-reaching research both as regards causation of the malady and remedies. Most lay people are of opinion that this malady is due to various deficiencies in diet, and it is a matter into which most far-reaching research should be made.
I would like to refer to the attitude of the medical profession generally towards those traditional practitioners who have been very successful, in all parts of this country, in dealing with this serious malady. No matter what medical practitioners may say, there is no doubt whatever that tens of thousands of complete cures have been effected by those whom I call traditional practitioners—people who have inherited the cures from their antecedents. I do not think the attitude of the medical profession towards those people is quite justifiable and I think the Minister should impress on his Department the desirability of seeking the assistance of those who have proved successful, particularly in view of the fact that the ordinary medical people, with all their knowledge and with all the resources at their disposal, have failed absolutely and completely to find the remedy for this malady.
So far as housing is concerned, there is need for a big onward drive. That need is particularly great in our rural areas. While much may rightly be said about the conditions under which people live in slum areas in cities and large towns, there is a national need for opportunities for our young people to reside in our rural areas. No matter how far we may go in solving the problem of slum clearance and providing houses for our people in the cities, if the young people continue to drift into the larger towns and cities the problem will never be solved. The most far-reaching measure of concentration upon rural housing should be made immediately.
We know that building materials of all kinds are in short supply. First of all, rural housing does not require the same quantity of imported materials as the bigger urban schemes. For example, one-storey houses could be built with reinforced concrete roofing, and timber and other imported materials could be eliminated to a very great extent. That is one suggestion I would like to have considered carefully. Plans happened to come into my possession some time ago of one-storey rural houses built almost entirely of mass concrete, with arched roofs of mass concrete also, and in the construction of which practically no timber is required. As it is almost impossible to import timber and as home materials are in short supply —and as the home materials available are needed in urban areas where two-storey and other houses are required —the matter should be carefully looked into.
There are three types of people who require houses in rural Ireland. First of all, there is the agricultural labourer, who has been catered for to a great extent in the past, but whose needs have not been met and for whom there is still tremendous need for housing accommodation. There is also need for some scheme of housing accommodation for farmers' sons. Where a farmer's son wishes to marry and settle down before his parents are old enough to give up possession of the holding, he should be able to get a house and marry at a reasonable age. Such houses would then be available for the parents, in the event of their wishing to retire, and in that case it would be only a matter of exchanging with the son and his family. In addition to these two types, we have the older people—the old, unmarried people and the old married people who have families living with them. Old age pensioners have no alternative at present but the county home or some other institution. There should be some scheme for the provision of small houses, even two-roomed houses, for old people. They should be built in a colony scheme, where the old people would be in close contact or in the vicinity of a business house, a village or church, or the local post office. Such a scheme is desirable and long overdue. There is no reason why old people who have no immediate relatives with whom they can live should be driven to seek refuge in various institutions.
With regard to the acquisition of turbary which is taking place all over the country under the Emergency Powers Act, there is provision for compensation for the owners, but in most cases I have found that the compensation is altogether inadequate. Compensation is provided more or less according to the area of turf actually cut. This system of awarding compensation could be quite fair and just in the case of turbary not used for grazing, but when you come to that which is used extensively for grazing and which provides good grass for live stock, it is altogether unjust, especially when these particular lands are in the possession of very small holders, that compensation of a mere 12/- per perch—which is usual in most counties—should be permitted. Some consideration should be given, not only to the amount of turf actually cut away but to the injury to the grass lands caused by turf-cutting. If men are sent into a bog which has been used extensively for grazing and cut holes in various parts of it, that land is no longer fit for grazing and owners should be compensated for the loss.
I have had brought to my notice a number of cases where no compensation has been offered except for the small amount of turf cut, which may only mean a few pounds and which would not compensate for the loss of the entire grazing of the land. There is, first, the temporary loss—that these lands cannot be grazed at all while being utilised for turf-cutting; then there is the permanent damage to the field for grazing afterwards. In many cases grave mistakes have been made by the county surveyors in going in on grass land not at all suitable for turf-cutting. That is happening in every county, and there are widespread complaints about it. These public officials have no respect whatever for the rights of property, and have very little understanding of the rights of the people. There is a tendency simply to trample upon those rights, and it becomes particularly serious when the persons aggrieved are smallholders who have to depend for their livelihood upon the income they derive from their little holdings.
Does that matter come under the jurisdiction of the Minister?
I am not sure, but it certainly is administered by local government officials. County surveyors in all counties carry out this work.
I wonder what jurisdiction the Minister has.
I am not so sure.
Neither am I —hence my query.
As the county managers appoint these county surveyors, they ought to be careful to see that they appoint men competent to carry out their duties without trampling upon the rights of ordinary citizens who are endeavouring to make an honest living.
Does not the Local Appointments Commission select and recommend county surveyors?
There is always the pretence that the county council makes the appointment.
The county manager definitely does control these men; at least, if he is to exercise control over local affairs at all, he must have some voice in the selection of the men who are to work under him—some voice in the allocation of their functions.
I want to support the view that has been expressed so very ably by Deputy O'Higgins. He said that in the provision of housing there is a grave danger that we may be inculcating in the minds of our people a carelessness and a disregard for existing housing accommodation. I agree with his suggestion that there is not sufficient care being taken to preserve existing buildings. The Minister referred to what is being done in Dublin with regard to the renovation of existing houses, and I believe that is very desirable. It is, indeed, essential, both in the city and the country, that existing buildings should be kept in repair to the fullest extent and, wherever there is neglect on the part of the landlord or the occupier, it should be dealt with. Where-ever it is possible for a local authority to carry out repairs in order to extend the life of existing buildings, that power should be availed of.
It must be remembered that building materials of all kinds are not in unlimited supply in this country. The housing needs of the nation are very great and are ever-increasing. It is most essential that the greatest use should be made of existing housing accommodation, and every effort should be made to preserve it. We all know that houses built 20, 30 or 40 years ago by local authorities have gone into disrepair, either because they were neglected or inadequately or inefficiently repaired, or because they were inefficiently constructed at the outset. We know there are tens of thousands of people living in farmhouses and business houses in towns, houses erected possibly 200 or 300 years ago. Those houses have been preserved through the care exercised by the different occupants.
This is a matter to which attention might well be directed. It is a matter in which the medical profession and the education authorities could co-operate. It is most essential that our young people, particularly girls who leave national schools, not only home-loving but house-proud, should be determined to insist upon their houses being kept in proper repair. This also affects to a very large extent the prevention of various infectious diseases. It is a matter which calls for co-operation between the education authorities and the Local Government Department. I do not think there is any reason why that co-operation should not be forthcoming. The Minister called for co-operation from all sections, from the locally elected representatives and from all affected by local administration. It is only right, therefore, that the two Government Departments affected in this particular matter should co-operate. If co-operation between the managers and the locally elected representatives is to be secured, as the Minister professed to desire, it is essential that local authorities should meet as frequently as possible, and every action of the manager, no matter how trivial, should be known to the locally elected representatives, and carefully reviewed by them.
In common with many other Deputies, I take the view that the Estimates for Local Government and Agriculture are the two most important Estimates we could consider. I believe that after this war new and better provision will be made in relation to public health. Due to the progress of time, the methods adopted have improved, but they are still far below the standard we would all desire. I do not think anybody in this country is satisfied with the existing state of affairs. It may be, as the Minister said, that a certain amount of alarm has been occasioned by statements appearing in the Press from medical people and people in public positions with reference to the condition of the public health. One of the things that makes life worth living is sound health, and one of the things we eagerly look forward to is the provision of improved methods to deal with the incidence of disease of every type and, coupled with that, improved conditions under which the people may live, particularly in respect of housing and diet.
As regards the Minister's opening statement, I would have preferred if he had spent a little more time dealing with public health rather than with administration. He dwelt for quite a while with the results which have been achieved by the county managers. I do not propose at this stage, because I think the managers have not yet been given sufficient time, to comment on the question whether the county management system is the best system. There is no doubt whatever, whether it may be popular or unpopular to say so, that the old system was more or less getting to the stage in this country when it was not giving the best return for the money. Some Deputies mentioned that it is undesirable to take away from public representatives the control and management of the affairs of the citizens, as a whole. I should be in favour, wholly and entirely, of taking over every activity of public representatives if we had many Deputies, such as the last speaker, advocating quackery. I hope that we are not going to be subjected much longer to the mentality which considers that the second-best is good enough. We live in a world in which keen competition in every sphere of activity has to be contended with. If we in this country are to be content with a few bad eggs in a cargo and a few quacks to assist the medical people in dealing with public health, I can see no possibility of any advance in any sphere of activity. One of the values which I believe in putting on freedom is to make the best possible use of it.
Now that we have our own institutions in the greater part of the country we should ensure, firstly, that, so far as lies in the power of the Legislature, an adequate, frugal livelihood will be made available to all sections of the people and, secondly, that the health of the people will be so looked after that they can live their lives in comfort and health and so devote themselves to some of the higher things in life—not be continuously wrangling over matters which are of no great importance as to whether a county council or some local authority meets once a month or once every three months. Some Deputies, evidently, attach more importance to the method of calling a public body to its meetings than to the grave problem of tuberculosis, which is getting worse.
The Minister might, I think, have devoted a little more time to giving a more extensive explanation of the results which have been achieved in so far as new and better methods of prevention have been adopted in connection with that disease. There are two stages: the first is prevention. That is the one that should be aimed at. The second is—if you cannot get prevention—cure. Medical officers in their reports give different opinions as to the causes of the disease and, in some cases, as to the causes of the increase in the disease. It would be well if the Minister got some medical people to examine those combined reports and draw from them what, in their opinion, are the main points. It would be informative if, in the light of those reports, a statement was prepared by the Minister's Department giving the view of the Department's advisers as to the causes of the disease and the most satisfactory methods which, having regard to our resources, can be adopted to deal with the disease. The Minister could then put into execution the recommendations of that body. Deputy O'Higgins, who speaks in two capacities—as a Deputy and as a medical officer—gave it as his opinion that lack of transport for medical officers and consequent difficulty in getting around the counties is one cause of the increase in the disease. The medical officers are not able to isolate the people who contract the disease and are not able to immunise the people who come in contact with them, particularly children who come in contact with other children who have contracted the disease. If the Minister made some effort to obtain supplies of petrol for this purpose from the Minister for Supplies, his effort would be well repaid. I am sure that petrol is devoted to numerous other uses which are not by any means as important as the public health, with special regard to the health of the children. If we attend to the children in the schools at present, it will lessen the incidence of the disease in the case of adults later on.
As I am on the question of public health, I should like to point out to the Minister that, for 12 months, we have had no chief medical adviser in the Department of Local Government and Public Health. Two boards were set up to choose a chief medical adviser. They examined individuals by two different methods. On one occasion, Irish was made a qualification and, on another occasion, it was, evidently, not so made. The House is entitled to some explanation as to why no chief medical adviser has been appointed. If it is merely a question of a knowledge of Irish, I think, in the case of so important a position as this, the health of the people is far more important than the question whether the chief medical adviser has a knowledge of any language, provided he can make his opinion felt in the Department. Virtually everybody will agree with that. A few fanatics might not but I am sure an interpreter could be made available to give the benefit of the chief medical adviser's opinion to the people of the Gaeltacht. The Minister would do well to appoint a chief medical adviser. The only conclusion one can come to, seeing that two boards were set up, is that a question of jobbery is involved. No other conclusion is possible seeing that 12 months have elapsed, that two boards sat, that in one instance there were over 100 candidates and in the other instance a lesser number. Out of all those candidates, no person was found to be suitable for the position of chief medical adviser to the Local Government Department.
May I draw your attention to the fact that there is not a quorum present?
May I direct your attention to the fact that a Deputy who raises that point during the hour when dinner is being served in the restaurant and who thus interrupts the business of the House engages in a silly futility?
The Deputy is quite in order.
People outside the House do not know the circumstances.
While Deputy Cosgrave was speaking, no member of his Party was in the House.
That is not a point of order.
The Deputy will live and learn.
Deputy Donnellan wants to demonstrate that he is earning his £480.
As well as Deputy Dillon is.
Notice taken that 20 Deputies were not present: House counted, and 20 Deputies being present,
Mr. Cosgrave
I suggest to the Minister that he should consider the separation of Local Government and Public Health and have two separate Departments. I do not know if, in doing that, I am advocating legislation, but in view of the necessity for increasing attention to the requirements of public health, I think it would be advisable to have two separate Departments. I would not like the Minister to consider just separating himself and his Parliamentary Secretary. I think it would be advisable to get a new Minister for either one or the other of the proposed new Departments.
As regards housing, this is a problem to which it is not possible, owing to the shortage of materials, to devote all the attention that might be given to it. I would, however, like to draw the Minister's attention to the fact that while he claims that even during the emergency great strides have been made in the matter of housing that, in the County Dublin and particularly in the area with which I am closely connected — Tallaght, Ballyboden, Bohernabreena and the country around there—with the exception of two small schemes, no house has been built there during the whole of the last ten years' great housing drive if we are to believe the Minister. There are rows of cottages in that area which are in an almost uninhabitable condition. While it may not be possible at the moment to build new ones, I suggest to the Minister that he should take steps to see that proper sanitary arrangements are installed at the rear of these houses and that, if possible, repairs are carried out to them.
There has been a good deal of comment in the locality I speak of to the effect that no effort, with the exception of the two small schemes that I have referred to, has been made to provide proper sanitation for the houses that are there, to improve housing conditions in any way, or to repair the houses which are falling into disrepair very rapidly. These houses are served by water pumps. In two localities the pumps are at present in an unusable condition. In one case the pump itself is at fault, and in the other the water from it is unusable. It ought to be possible, even during the emergency, for the Minister to ensure that the officers of his Department would carry out inspections, and, further, that they would see that the recommendations made as a result of these inspections are carried into effect. According to the reports furnished by the county medical officer of health, sufficient inspections appear to have been carried out, but the results of these inspections do not appear to have induced the officials of the Department to see that pure water is made available.
There is another matter that ought to be attended to, especially during the coming winter months, and that is the provision of fuel. Under the scheme which the Minister has in operation, people have to travel long distances in order to get fuel. I think it was Deputy Corry who said that in some cases the fuel was deposited three miles away from the people's homes. We all know that necessitous people cannot afford to bring fuel to their own homes. I think that even if the solution of that problem necessitated the employment of horse transport, it should be made available.
As regards the problem of tuberculosis, milk is regarded as being one of the most suitable diets or foods for sufferers. It is agreed that it gives the best results. The report of the medical officer of health for the County Dublin shows that since the outbreak of the foot-and-mouth disease the dairies are not maintaining that degree of cleanliness which is expected from them under the regulations. I believe that heavy penalties, if necessary the maximum penalties, should at all times be imposed on the owners of dairies of that description who are selling milk in the cities and towns. It is an old belief that milk is a disease-carrying food, and is a means of infecting other foods with which it comes in contact. Therefore, if milk comes out of the dairies in a dirty condition, or comes from cows which are kept under dirty conditions, then at the very outset we have a disease-carrier. I draw the Minister's attention to the fact that the regulations dealing with this matter should be fully enforced.
Deputy O'Sullivan dealt with the question of pensions. I believe that all these pensions—widows' and orphans', national health and the rest —should be amalgamated under one scheme. If I am in order in doing so, I would like to make the point, in view of what has been done in other countries, that even during the emergency it ought to be possible to devise a suitable scheme. All the officials in the Minister's Department cannot be so busy that a certain number of them could not be given the task of preparing such a scheme. Apparently that is being done in other countries. I hope we shall not have to wait until an actual scheme dealing with this is seen in operation elsewhere. I think a start should be made now so that the maximum results of benefit may be obtained from it. It would also have the effect of simplifying matters for the present recipients.
Like Deputy O'Sullivan, I also want to impress on the Minister the desirability of relaxing the means test. I do not want to labour the point beyond saying that the means test presses very hardly on people who have practically nothing to live on except a few shillings they may earn in one way or another: for example a woman may earn a few shillings doing housework, or may be running a small business from which an income of 3/- or 4/- a week may be derived. In these cases, the few shillings are deducted from the widow's pension. In view of the more enlightened views which I hope will prevail on the whole question of public health, and on the livelihood of the people in general, I urge that the regulations governing the means test should be relaxed. I should like to draw the Minister's attention to the present condition of the roads. During the debate it was mentioned that roads could be made safer for horses if sand were spread over them. That would not require any expenditure on materials that are scarce. Sanding would make roads a little rougher for horse traffic. In that way it would be possible, particularly in cities and towns, where traffic is heavy, for people to bring in produce or to travel home in safety. With the shortage of frost nails and rubber it is now impossible to shoe horses to travel on the roads with safety.
I should like to know if the Minister is getting the best possible information concerning the method of dealing, with tuberculosis. In that respect he should take cognisance of the importance of diet. One of the best methods of dealing with the disease is concerned with diet. The Minister should take special notice of the recommendation of the medical councils in this respect. I should like to urge on him the necessity of dealing with it a little more expeditiously. If money is not available or if proper hospital accommodation is not available, it should be possible to take over certain houses or institutions, very many of which could be fitted out and made suitable for after-care treatment. The Minister mentioned that it was proposed to increase the number of beds in two or three institutions. I believe that a far greater number of beds could be made available if some institutions or large houses were taken over. By doing that the Minister would make the task of the doctors and nurses much easier, by enabling them to give more attention to the requirements of their patients, and in that way to offset or help to reduce the fairly steep increase in tuberculosis which has taken place during the last few years.
With regard to the Red Cross, the Minister should ensure that the personnel is trained in the best possible manner of dealing with the disease. So far as we are aware, the training of the personnel of the Red Cross is not sufficiently technical to deal with tuberculosis or with serious disease. While I do not want to criticise in any way, before any money is wasted by embarking on a campaign for the prevention of the disease, the Minister should ensure that the personnel is trained in the best possible methods and that the best instructional system is made available. Once the drive is started the Minister could then ensure that there would be no halting and that the campaign against disease will be a success.
One of the most disquieting references in the report of the Minister on the activities of the Department has been the admission again this year of an increase in the incidence of tuberculosis. I think the constant record of that increase must be viewed with considerable disquiet by all those who realise the appalling rational loss which a continuance and extension of this scourge are causing amongst our people. It is fairly generally accepted that tuberculosis has in the main an economic background, that it feeds very largely on malnutrition and that its growth and diffusion are made possible by bad housing conditions. If we are going to take any effective steps to combat the appalling ravages of the disease then we must get down speedily to the eradication of those factors which give impetus to the growth of the disease. We have still unfortunately a very low standard of living for a large number of our people. We have large tracts of country in which we find poverty endemic, where the standard of living is permanently low. We have an economic position in which tens of thousands of our people are not able to buy the amount of food which is considered essential by medical authorities to maintain bodily health, and at a standard to resist even the most commonplace diseases. A good deal must be done by the State, acting as a corporate authority, to grapple with those vital factors which contribute to the growth of the disease before we can ever hope to arrest it in circumstances which will give ground for its complete eradication.
It seems to me that the most appalling evidence of our incompetency and inefficiency is to be found in our refusal to provide adequate sanatoria for the treatment of tuberculosis patients. From time to time I happen to deal with cases of those infected with tuberculosis. If one tries to get a patient in the City of Dublin into a sanatorium one is told that there is a long waiting list.
I handled a case the other day of a young man who was notified by his doctor that both lungs were infected, and that he should get away to a sanatorium at once. The patient has a wife and three children. Could he get away? Not at all. The doctor told him that while he was advising him to get away, he knew perfectly well that there was no hope of doing so at once. The patient was told that at the very earliest he might have a chance of getting away in three months, but there was no certainty about it. In that case the man trekked home dispirited and dejected and had to tell his family that he would have to wait for three months, all the time diffusing the disease with which he was affected. Could anyone justify a continuance of that state of affairs? While there is sufficient money to operate sanatoria, and while taking power to acquire sanatoria, yet no adequate steps have been taken to provide sanatoria treatment for the thousands of unfortunate victims of this appalling disease. Just as one lighted candle will light a dozen candles, so one person infected with T.B. can radiate that disease over each member of a family. We are calmly allowing that state of affairs to continue. A man or a woman who is attacked with the disease must live with a family because we cannot isolate the victim. Probably that person is working with other people. There is no means of providing isolation or it may be the case that the victim is not able to give up work owing to economic circumstances. Is it any wonder then that we have an increase of tuberculosis at such an appalling rate as we find to-day?
I know, of course, it will be pleaded that in present circumstances you cannot build new sanatoria, and it may be said, if you quote the example of what has been done in continental countries, that, in a war situation, we cannot emulate the magnificent example of these countries who value life, human feelings, and human dignity on a much higher plane than we. There is no need to be appalled and no need to despair if we cannot build new sanatoria. There should not be the slightest difficulty, as has been pointed out by other Deputies, in acquiring a sufficiency of large mansions throughout the country which, with very little expenditure, could be converted into sanatoria suitable for the treatment of tuberculosis patients. I read in the papers to-day of a man who inserted an advertisement for a castle, with or without land, and who, after a week, got offers of 300 castles. There were 300 owners of castles bursting to sell them to this man, and I am not at all convinced that it would not be possible for the State or a local authority to acquire some of these mansions throughout the country, and, by adaptation and reconstruction, to make them available for the treatment of patients suffering from tuberculosis who to-day are languishing in insanitary housing accommodation and infecting others with the malady from which they themselves are suffering.
Any consideration of the methods of dealing with tuberculosis has rightly focussed necessary attention on the first step to be taken, namely, the perfection of methods of detecting the disease. It is a very unfortunate fact that our people have the characteristic of being ashamed of suffering from tuberculosis. Many of them are reluctant to admit that there is any danger that they might possibly have tuberculosis, and the mere suggestion that they have, immediately brings a blush of shame to their faces, as if this was an affliction which carried with it any stigma of dishonour. It is an unfortunate fact that because of that type of shyness and reluctance on the part of our people, medical officers find it extremely difficult to get patients at an early stage, where treatment and cure are much more probable than they are if the cases come at a later stage.
I think that any mass attack on tuberculosis must primarily take note of that failing which is a characteristic of our people. Our people must be told that there is nothing dishonourable in having tuberculosis, that it is a human affliction, and must be cured not merely in the interests of the patient and his family, but in the interests of the nation as a whole. For that purpose, large-scale publicity is necessary.
The Press is a very valuable medium for focusing public attention on the necessity for revealing symptoms of tuberculosis at an early stage to medical officers. Indeed I have often listened to stuff on the wireless much less valuable to the health of the nation than advising them to reveal evidences of incipient tuberculosis. I think the radio and the Press ought to be availed of much more extensively, but even that would not be sufficient. If there is to be a mass attack on tuberculosis, mere publicity, advising people to reveal evidences of the presence of tuberculosis, will not be taking adequate steps to combat the problem.
In other countries, and particularly in some States in America, they have recognised the necessity for abandoning the stethoscope as the best method of ascertaining the prevalence of tuberculosis. In some of these States they have now evolved a scheme of mass x-ray, under which citizens generally are x-rayed and the presence of the disease revealed and treated, or the citizens assured that they are free from the disease and advised as to the methods by which they can continue to be free. In this country very little is done in the matter of utilising x-ray to its fullest extent. I have a letter here on the subject of tuberculosis. I happen to have a personal interest in the case. The person was examined by the doctor with a stethoscope and told he had not got T.B. He was advised to have an x-ray, and four days afterwards he was x-rayed, and was told by the doctor who read the x-ray report that he had infection of both lungs, so that, having been told on Monday that he had no T.B. at all, he gets an x-ray on Thursday and both lungs are found to be infected.
Could there be any greater evidence of carelessness in examining patients for T.B. than is revealed in the method by which a doctor puts a stethoscope to a patient and says: "No, you are all right. You have no T.B.," when four days afterwards an x-ray shows both lungs to be infected with T.B.? I think the stethoscope as a method of revealing the presence of T.B. ought long since to have been abandoned, as one must be in a very advanced state of T.B. before it is very obvious to the stethoscope, and it is certainly not nearly as obvious to the stethoscope as to the x-ray, which is regarded as the best method of diagnosing the presence of the disease.
Another aspect of this problem is the economic plight of the person suffering from the disease. I addressed a question to the Minister for Local Government last week in which I asked him to set up a committee to report on the best means by which persons suffering from tuberculosis could be provided with their full wages while undergoing treatment. The Minister's reply was a rather complacent one. He indicated that certain aspects of the tuberculosis problem were being examined and he did not think it necessary to set up a special committee to look into this aspect of the matter. I think most medical officers, and certainly most county medical officers of health, have, in recent years, stressed the importance of providing for, let us say, the bread-winner in the family who has to be removed and detained for the purpose of treatment, because it is physically impossible for a man, who knows that his wife and children are trying to live on a pittance of outdoor relief or home assistance while he is in a sanatorium, to recover from tuberculosis, because of the state of mental anguish which must be that man's lot from day to day.
I observed in a provincial paper recently that a county medical officer of health, reporting on the prevalence of tuberculosis in his particular county, said:
"Its presence was causing very great concern in the inadequacy of the amount of cash set aside for the upkeep of the family at home. When the head of the family, the wage-earner, is undergoing treatment, 10/- or 12/- per week to a wife with two or three small children, is simply ridiculous."
He goes on to say:
"I will ask anyone: Will a patient in a sanatorium make satisfactory progress when his wife and children are starving at home? Let there be a liberal allowance to dependents in such cases and the returning home before the cure is well begun will not occur so often."
Everybody who has any experience of T.B. cases knows that that is a mere recital of the facts of everyday life. A man is unfortunately stricken with tuberculosis and is advised to have sanatorium treatment. He has two choices. He may say: "I will not have sanatorium treatment; I will work on and try to provide for my wife and children until I drop," or he may go into the sanatorium and while he is there his wife will get National Health Insurance benefit at the rate of 15/- per week and, possibly, a few shillings from a home assistance officer to try to make up the amount of the wages of the bread-winner that are lost during his retention, in the national interest, in a sanatorium. I think the Minister must realise that the provision of economic security for the victims of tuberculosis is something that must be undertaken if we are to make any effective attack on the disease. It is simply a cruel mockery of the sufferings of T.B. patients to find them incarcerated in sanatoria while their wives and children endure poverty and misery at home because of our laziness to evolve a scheme which would provide economic security for these innocent victims.
The Minister, in introducing his Estimate, seemed to think that money might present a considerable difficulty in providing additional sanatoria and better hospital accommodation. I do not believe money ought to be allowed to stand in the way. The national loss occasioned by sickness, especially tuberculosis, is one of the most important drains on our national income. Sickness accounts for more lost time than any other cause in this country to-day and the annual cost in low productivity through that cause represents an appalling dissipation of potential national wealth. We can raise £9,000,000 per annum now for an Army which used to cost less than £2,000,000. Surely, it ought to be possible to raise such sums of money as are necessary to combat the ravages of tuberculosis. If it is not combated and if we are to have an invasion of bur homesteads on an increasing scale by tuberculosis then it may be a very much more serious invasion and a much more permanent one than the physical invasion which we are endeavouring to combat by the expenditure of £9,000,000 per annum on the Army.
There is no greater national menace confronting the country to-day than the ever-widening incidence of tuberculosis, occasioning an ever-increasing number of deaths, and our appalling inability to face up to that situation. Hospital accommodation in many places is more difficult to get than sanatorium accommodation. I have had occasion to get in touch with hospitals with a view to having patients admitted and on many occasions it was almost impossible, even in urgent cases, to get beds in city hospitals. So much so, that people run the risk of losing their health or their life because of a shortage of hospital accommodation.
The aspect of hospitalisation to which I now desire to refer is the position of the nursing profession. I think it is nothing short of a scandal that we allow young, energetic, promising, well-educated girls to go into the nursing profession, to spend years acquiring the necessary skill so that they may devote themselves to the noble profession of nursing, and pay them probably the lowest scale of wages in the country for the very onerous, exacting and responsible type of work which they perform. I had a letter during the week from a nurse in a western hospital who told me that she is obliged to work 84 hours per week, even on night duty, and her scale of pay was the customary scale for nurses in district hospitals—£60 rising by increments to £70, sometimes £80.
I think the Minister for Local Government has a responsibility in this matter. He must know—everybody in the House knows; his Department cannot be blind to the fact—that nurses are paid badly, that their hours are unduly long, that many of them work in hospitals which are under-staffed. Practically the entire nursing profession is under the control of the local authority which, in turn, is controlled by the Minister for Local Government. If the Minister for Industry and Commerce, in respect of private employees, could introduce legislation such as the Conditions of Employment Act, which gave industrial workers a certain code of industrial legislation, surely the Minister for Local Government could at least introduce a nurses' charter which would provide a maximum working week for nurses, decent salaries that would attract the best people to the profession, and which would end the scandal of understaffing which exists in many hospitals to-day, reflecting itself not merely in the form of exhausted nurses but in patients who do not get the attention which they ought to get. Having responsibility in the matter, I hope the Minister will discharge it and that it will not be long until the honourable profession of nursing will have its place in the community recognised by legislation guaranteeing it against many of the evils, long hours and low wages, which the profession is compelled to tolerate to-day.
There is one other matter I wish to mention. It is a matter that arises out of a question I asked in this House last week. I asked the Minister would he introduce legislation to compel owners of property to connect with sewerage schemes when these schemes were in operation locally. The Minister made a reply to me on that occasion which I think, on reflection, he must agree was not in accord with the facts. I want to avail of this opportunity, which is more convenient than Question Time, to bring the facts to the Minister for Local Government. Kildare Board of Health installed a sewerage scheme in Kildare town. They sought to make the local property owners—and there are some extensive property owners there—connect the houses with the sewerage scheme. The local authority had paid a very substantial sum to instal this scheme. The local property owners said, "No, we are not going to do any such thing. These people have been living in the houses for years and years without any sewerage, and they will just carry on in the same way. Do not turn their heads now by telling them of the advantages of an up-to-date sewerage scheme." They would not do anything in the matter. The local authority sued the property owners to compel them to connect with the sewerage scheme. The judge who tried the case said he had every sympathy with the object that the board of health sought to secure, but that, unfortunately, under the legislation, he had no power to compel the property owner to connect with the sewerage scheme. That is the law. These are the facts. The Minister for Local Government, apparently, does not know them.
I suggest to the Minister that, these being the facts, and realising that there is a legal impediment which prevents county councils compelling property owners to connect with sewerage schemes, he ought to have the defect remedied so that if the community instals a sewerage scheme or a water scheme, and is willing to tax itself for the purpose, and if the State at the same time assists financially in the scheme for the advantage of local people, a capricious property owner will not be allowed to say: "I am insulated against all progress, and immune from any feeling of sympathy with people who want to instal water or up-to-date sanitation in their homes."
If the Minister does that, not only will he improve public health in towns and villages throughout the country, but he will provide a very substantial amount of employment where it is most needed. If he will examine the position further he will find, as he indicated in his reply last week, that this is a problem which is in urgent need of attention, and if we are to concern ourselves with local government and public health matters, I think the Minister ought not to delay in tackling this very urgent problem.
The Minister, in introducing his Estimate, dealt briefly with the question of county managers. Now, I think that the county managerial system is a good system, and I think it will work out all right in the end, but in order that the system should be given a fair chance, I think that the Minister should be vigilant lest certain county managers—a small minority amongst a large number—might misinterpret their responsibilities. It would appear to me that there is a certain number of county managers who are seized of the idea, since they have been appointed to such a position, that the county councillors who have been elected by the people are not worthy of respect. If the attitude of this small minority of county managers, who have publicly treated the elected representatives of the people with scorn on certain occasions, is to be permitted or condoned, the tendency might be for it to become more general and, if not checked in time, the position—as between the county managers and the elected members of the county councils —would become impossible. Therefore, I think it would be well for the Minister to advise the county managers—some of whom have been giving rather dramatic advice, in public, to the elected members of the county councils—that these county managers are the servants of the people, and not their masters. The Minister might point out to the county managers that if they are to do their job efficiently and expeditiously, the best way of going about that job would be by oiling the wheels, so to speak, of the county management system with ordinary courtesy towards those who have been elected by the people to represent them. After all, a man who has succeeded in getting the suffrages of the people is entitled to courtesy and respect.
It has become the fashion in this country to refer to certain people as professional politicians. Our friends of Clann na Talmhan quite frequently refer to men who have sought and got the suffrages of the people as professional politicians. Now, as a result of that tendency, certain public officials may fall into the same error and think that because a man seeks public honours from his country, that is something for which to disparage him or his activities. I am sure the Minister will agree with me that that view is very ill-founded and that it is calculated to injure the democratic system under which we live. I do not ask for anything more than reasonable treatment of the duly elected members of the county councils. I am quite prepared to support county managers in anything they want to have done, but I think that these county managers, if they desire to remain in their jobs, ought to practise the policy of live and let live. I ask the Minister, accordingly, to impress that on the county managers, because I feel that if these managers are made to realise that fact, the county managerial system will be a better system than the one we had previously.
Now, Sir, I have listened to many orations here about tuberculosis, and to statistics. I have not too much faith in statistics. I am more convinced by what I see happening amongst my own neighbours than by any statistics that could be shown to me; and my own experience has convinced me that the conditions are largely the same in this country as in other countries. There is one question that I should like to put to the Minister. If a person in rural Ireland, suffering from pulmonary tuberculosis, comes to me asking for advice, and if the appropriate treatment is by means of a surgical operation and subsequent rest, or even an operation of a minor character, will the Minister tell me where there is an institution in Ireland to which I can send a boy or girl for adequate and proper treatment after that operation, so that there will be no danger of spreading the infection if they have to return to their own homes before they are cured? In that regard, I endorse what Deputy Norton has said. We are told that such institutions as Peamount are kept for city people, and that it would not be possible to take country people into them. Now, if we in the country arc to reconcile ourselves to the fact that a tubercular person will have to return to his own home, where there may be a number of children who may also become infected, I suppose we may take it for granted, as Deputy Norton has pointed out, that there is a number of city children in the same position.
Personally, I do not doubt the Minister's enthusiastic zeal to meet this situation, and I suggest that it would be a proud boast on the part of any Minister in this country to be able to say that he was the Minister who had put an end to the ravages of tuberculosis here, and I believe that it could be done. The best medical view is that if proper steps were taken, tuberculosis in this country would be as rare in a few years' time as typhus is now, but the position at the moment is that young persons suffering from tuberculosis—and this disease is particularly marked in the case of young persons, boys or girls, between the ages of 18 and 25—have to be sent home after being given treatment, or after having undergone an operation: thus running the risk of spreading the disease further. I have in mind the case of a young girl whose mother brought her to me for advice. She said that the girl had had influenza last winter, that she seemed to be all right now, so far as the influenza was concerned, but never seemed to have recovered her former good spirits. The girl was about 18 or 19, and it became manifest to me that she was suffering from tuberculosis, and, of course, when she was brought to the doctor, the disease was diagnosed as such. Now, I could have brought that young girl to the county sanatorium, but the plain fact is that the general idea down the country is that the county sanatorium is, as one might say, a hospice for the dying, and that nobody comes out of it until they are dead. The woman concerned, faced with that diagnosis, brought the girl from doctor to doctor and, in the end, managed to convince herself that the girl had not tuberculosis at all and kept her at home. Twelve months later her eldest son fell on the road with a haemorrhage. At this hour, I do not know, if that woman comes to me, whether there is any place into which I could get that boy or girl where they would get proper treatment. I have no doubt that I could poke them into one of the county sanatoria, but I feel myself reluctantly obliged to say that I cannot give an unqualified denial to the proposition that the great majority of our county sanatoria are hospices for the dying and that their only purpose is to receive what are regarded as incurable cases.
I think the impression has become widespread and confirmed in the minds of the people of rural Ireland that such sanatoria are not going to serve any useful purpose whatever in putting an end to tuberculosis in this country for the people will not go into them. If I were suffering from the disease, I would be long sorry to go into a place where I found that I was not going to get effective treatment and where I was simply to be thrown on one side, to await the day when I went into a coffin. That might be good enough 30 or 40 years ago when the knowledge of dealing with tuberculosis was quite elementary, but I have no hesitation in saying that, to the best of my judgment, tuberculosis, if taken in its earliest stages, is probably the easiest of all serious diseases to cure. I do not think that I exaggerate when I say that. It was for very long regarded in the minds of our people as incurable but I say deliberately, after considerable discussion on the subject with persons competent to give a valued opinion on this question, that if taken in its earliest stages it is one of the easiest diseases to cure. If it is to be cured, however, effective equipment must be available to the doctors and nursing staffs who are treating patients. Only in a microscopic minority of the sanatoria of this country is such equipment available.
I ask the Minister to provide, in at least a certain number of these institutions, the necessary equipment for the proper treatment of these cases. I do not ask for elaborate permanent buildings. I am advised that very temporary structures will meet the requirements admirably, provided there is in the centre of every such group of buildings for the accommodation of patients, an adequate and well-equipped x-ray, surgical and medical unit. Of course, in the medical division I include such laboratory equipment as may be necessary for correct diagnosis and analogous matters but no sanatorium is properly equipped unless the patients have at their disposal medical and surgical equipment because nobody can argue that it is in the interests of a patient, who requires surgical treatment while suffering from pulmonary tuberculosis, to be carted from one institution to another and, the surgical intervention having taken place, to be carted back again to the sanatorium. I think there should be in each county a good operating theatre, a good x-ray plant, proper laboratory equipment and, above all, doctors and nurses competent to use that equipment.
Now, I do not under-estimate, and I do not think any Deputy would wish to under-estimate, the formidable task with which the Minister is confronted if he is going to do this job. Here is one of the cases where the Department of Finance advisers and the Departmental advisers in his own Department will urge caution and restraint, but here is one of the cases where the mood of our people at present is: "Go ahead, and if you make mistakes in any honest effort to grapple with the problem, we will most readily forgive you." I do not think any section in this House demands that the Minister should be able to answer with 100 per cent. satisfaction for every move he makes in the undertaking to grapple with this problem. On the contrary, what the House and the country want is a bold approach. The Minister has at his disposal the special advice of the tuberculosis section of the Red Cross. I am not going into elaborate detail but I do say, with that body at his disposal, he has something on which he can easily depend. If he comes before the House and says: "I took such an action on the advice of that body," whether he succeeded or failed, he will meet a very sympathetic House. He will have the full sympathy of the House if he has to report any failure or any nugatory expenditure of public money.
I want to raise another aspect of this question which, in many ways, is even more serious than that on which I have so far dwelt. Bad and all as are the circumstances of a person suffering from pulmonary tuberculosis, what are the circumstances of a person suffering from bone tuberculosis? They are truly appalling. For the patients suffering from phthisis there is some prospect of adequate accommodation and treatment, but for the person suffering from bone tuberculosis which will almost invariably call for two years' rest in bed, if he is to be cured at all, there is no place in Ireland to which such a person can go. No public hospital is likely to take a patient who is manifestly going to occupy a bed for at least two years. As far as juveniles are concerned, there are the institutions at Coole and Cappagh. The work they have done is of such glorious dimensions that one would imagine it would stir our people to provide similar accommodation for adults who require treatment. Coole and Cappagh have done marvellous work in the treatment of children afflicted with tuberculosis of the bone, but the treatment of grown-ups afflicted with this disease presents a very pathetic picture.
So far as I know, if you meet the case of a person suffering from Potts disease of the spine and if he is not able to afford to pay for accommodation in a nursing home, the only advice you can give him, if he is to expect to get back to health again, is that he must strap himself in a frame, or be put in a plaster of paris in his own home. If his home has certain expensive amenities he may have a tolerable existence during the very great ordeal with which he is confronted. But in the case of 90 per cent. of my neighbours, I know that there is no accommodation in their houses for a person who has to remain for two years in a surgical frame. Such a patient is a burden to his family and his own progress back to health is grievously impaired by the knowledge of the burden he has thrown on his people many of whom are in no way equipped to bear it.
I would, therefore, ask the Minister whether we cannot find in this country accommodation for the type of patient I here describe. Their numbers must be limited and I feel that for them, much more than for the cases of pulmonary tuberculosis, large unused houses might be effectively adapted. I heard Deputy Cosgrave and Deputy Norton say that they thought that the problem of accommodation for patients suffering from pulmonary tuberculosis could be readily surmounted by taking over some of the unused castles and big houses in the country but I think one wants to walk warily in this connection. The thing to lay emphasis on is not the buildings in which the patients are to be accommodated but the effective equipment of a surgical and medical centre around which the patients will be accommodated. There is no use in buying up large houses and simply shoving tuberculosis patients in them, unless you have doctors and nurses competent to treat the disease; and, unless those doctors and nurses have at their disposal the equipment necessary if their skill is to be used to the utmost limit, no useful purpose would be served. I suggest that, probably, the equipment necessary to deal exclusively with bone tuberculosis may not be so elaborate as that necessary to deal with pulmonary tuberculosis in all its aspects, and I suggest to the Minister that he might reasonably examine the limited problem of bone tuberculosis, with a view to seeing that some institution be established to which people suffering from that condition could have recourse. At present, I know of no building to which they can go.
What is the working man to do, if he walks into the out-patients' department of a hospital to-morrow and is told he is suffering from tubercular disease of one or both lungs? What is the man to do, if he has a wife and four children at home? It is he who has to feed them, it is he who is responsible for them; he knows he is not well but he also knows that he is able to get about. Is he to walk home to his wife, in apparently reasonable health, and say to her: "You and the children must look out for yourselves; I am going into Crooksling and will be there for the next 12 or 18 months." Is it reasonable to suggest that a man can or will do that? Now, let us lay aside all question of Christian charity, let us lay aside all question of doing to others what we would wish to have done by ourselves —and, God knows, on that ground I think one could very rightly justify making an allowance which would enable a man to go to Crooksling or Peamount with a clear conscience, knowing that his wife and family were being provided for whilst he was taking the necessary measures to get cured.
Leave aside that point and look at the purely utilitarian and selfish point of view. We have no right, under the Constitution, to make him go to a sanatorium: if he does not wish to go himself, no one can make him go. There are many men in this country who would be faced with the problem of walking home to their wives, in apparently reasonable health, and saying: "Good-bye, you can do what you like with the children, I am going into a sanatorium for the next 18 months, you can get along as best you can on 15/- a week and as much as you can get from the relieving officer." There are hundreds of men who will not do that. They will keep on working as long as they can and will say: "When I die, I die, and that is all about it, I will do my best." Apart from the hardship that has to fall on those men, what about the hardship on the public? Every time they go into a workshop, every time they stand in a cinema or visit public buildings where people gather, the tuberculosis problem is spreading and growing. It may well be, I do not exaggerate when I say it, that a dozen people will contract tuberculosis from that man while he is in the process of dying on his feet and, ultimately, of that dozen people, five will die, having done their share in spreading the disease. Six people are dead—because we do not think it prudent to provide the man, who is going into a sanatorium for 18 months to get cured, with the wherewithal to keep his wife and family in modest comfort until he is able to come out again and take up the burden of their maintenance, which he laid down with profound reluctance.
I do not want for one moment to minimise the Minister's difficulties. It is easy enough to argue in this House that money should be provided for this and for that; but it has to be found, as we shall discover when the Children's Allowances Bill comes forward next week. However, I think all those with a sense of responsibility will bear in mind the point of view from which the Minister must approach this question. On the other hand, I suggest to the Minister that I have not overstated the case of the man who has to think of the maintenance of his wife and children. Surely, to provide for them for the 18 months would not be an excessive price to pay for the deliverance of six people from the grave —and the man who dies on his feet through pulmonary tuberculosis can be safely reckoned to have brought five into the grave with him before the consequences of his infection are ended.
I do not think one can effectively hope to eradicate this disease from any community unless it is made possible for decent working men to go into sanatoria and get treatment. I do not think it is possible for a man with a long family to leave them destitute while he lies down to recover his health. Therefore, if we are going to put our hands to this job, we ought to make it possible for working men to go into sanatoria for our own sakes, if not for their sakes, and, from the point of view of the Department of Finance, because it is a diminishing charge. The best opinion that can be got is that this problem, firmly grasped now and the necessary expense undertaken now, will mean that in 20 years there will be virtually no expense called for at all. If the present situation is allowed to drag on, the annual charge —which I am sure falls little short of a couple of million pounds for the treatment of tuberculosis by local authorities and central Government—will continue indefinitely and tend to grow. It may be hard to find the money at the moment, but in the long run it would be a real economy to make it available now. I would urge the Minister to realise that what has been said here to-day is being said in no critical vein.
I seldom find myself called upon to sound the praises of a member of the Fianna Fáil Party but, so far as I know, those who are interested in the cure of tuberculosis have had from the present Minister for Local Government and Public Health a sympathetic ear and believe, as most people in the country believe, that he is as solicitous about this problem as anyone else. His progress may not be as rapid as those not in intimate contact with his problems would wish it to be, but he is firmly resolved to press forward on the best lines and, so far as I am concerned, at this stage he has my best wishes in his efforts. I hope they will be successful and I think he will be entitled to an honoured place amongst public men in this country, if his administration of the Department of Local Government and Public Health should succeed in what is not impossible but what is doubtless difficult, that is, the effective control of tuberculosis amongst our people.
I heard the Minister refer to four or five diseases which he described as the gravest and I was astonished that he did not refer to rickets as one of them. It is a disease which I thought had disappeared much as scrofula disappeared. I understood that modern knowledge had made the incidence of rickets very rare, except in a civilisation where there was no good standard of living or no social services at all. I am alarmed to learn that the incidence of rickets is increasing very rapidly in the City of Dublin at the present time. That is a matter which should be inquired into without delay. Doubtless, there are several contributing causes but I should have imagined that the school meals which are at present being distributed ought to provide an opportunity of supplying whatever deficiencies there are in the children's diet. I understand that rickets is a disease primarily caused by a deficiency of vitamins or calcium or a deficiency of both. I am informed that you can have a situation in which the diet contains all the necessary calcium, but if the appropriate quantity of vitamins is not there, the child is unable to absorb the calcium. On the other hand, you may have a diet with the appropriate quantity or surplus of the necessary vitamin, but if the proper quantity of calcium is not there, although the calcium could be used by the child if it were present, it cannot if it is not present. There is a complicating factor if the 100 per cent. extraction bread figures largely in the child's diet.
I do not think there is now any doubt that the phytic acid content of the last 15 per cent. of 100 per cent. flour extraction from wheat does operate to prevent the metabolism of calcium, although there may be a sufficiency of calcium in the children's diet and a sufficiency of the essential vitamin. That is a question which was much canvassed as being one in doubt, until recently McCance of Cambridge embarked on a wide investigation in Great Britain in regard to the 85 per cent. extraction bread being consumed there. I think it is true to say that once McCance published his final findings, every rational physiologist in the world was constrained to conform to his view.
Rickets is a very deplorable disease, because it is not a very dramatic business. People do not ordinarily die of rickets, but those who are brought into contact with the children of the poor will, I think, be able to tell Deputies that it is a grievous disease, and its damage, once wrought, cannot be undone. The child that suffers from calcium deficiency in early childhood, or in the period before it is born, if its mother suffers from that deficiency while the child is in her womb, will suffer all its life from the consequences thereof. Rickets, which are indicative of calcium deficiency or other deficiencies after birth, and in the early years of the child's life, will leave traces of deformity that range from crippledom to disfigurement. It is a disease primarily of the poor, because it is in their diets the deficiencies are most likely to occur. I invite the attention of the Minister to that special problem, and I have no doubt, if he consults some of the orthopaedists in Dublin, and children's doctors in Dublin, they will confirm what I say, and will, perhaps, make concrete suggestions to him of the most expeditious way of ending what seems to me an extremely dangerous situation.
I come now to hospital nurses. Deputy Norton referred to them very effectively. Do Deputies generally understand what it means to become a nurse? Do they realise what it means for a young girl to go into a hospital and to undertake the immensely arduous apprenticeship that is required of a probationer nurse? I am not one of those who believe it is desirable or necessary to interfere with the present system of training for nurses. I know it is hard and rigorous, but I think it has this quality about it, that it does weed out those who were never meant to be nurses. I agree that if people are learning a trade they ought to learn it under conditions which should be carefully supervised. But if people embark on a vocation, something very different arises, because there should not be room in a vocation for mediocre aspirants. It would be much better if the mediocre aspirants found the going too heavy in the period of apprenticeship and dropped out and took up some other profession.
If you want to be a good nurse, you must have some streak of heroism in you. I am sure 99 per cent. of nurses would laugh at you and say they did not feel a bit heroic when they did their work—and perhaps when they were probationers they did not like it a bit. But, if there had not been something more profound than merely a desire to acquire a means of livelihood, the average girl going into a hospital for training would not stick the three years' course; she would go out—and a great many of them do go out. That is probably very good for them and for their patients because, if they had persisted, they never would have made good nurses. But when they have passed through that stern period of probation, and worked as hard as they must work in order to acquire the skill which Irish nurses have, they are products of which any hospital might be proud.
Perhaps I will be permitted here to tell a story which will, possibly, convey to Deputies the value that is set on Irish nurses abroad. I remember on one melancholy occasion, in one of the most fashionable nursing homes in London, having to attend a death-bed. There were two night nurses and two day nurses attending the patient. When that patient was dying, the nurses put their hands under their aprons took out their rosaries, knelt down and said the Rosary. I was astonished to find two Catholic nurses in a big nursing home run under the patronage of a big Protestant doctor in London. I subsequently discovered that the two night and two day nurses had come from St. Vincent's and the Mater and, for the matter of that, so had the matron and all the other nurses. "I would not allow into this home," said the matron, "any but an Irish-trained nurse, and no good home in London would have anyone else if they could get those nurses."
The standard of training in this country is high, far higher, I think, than in any other country in the world. Yet, while that opinion is held of Irish nurses in London, in the institutions where many of these girls go to work at home they get very little more pay than an untrained domestic servant. Indeed, they get very much less pay than a good parlour-maid or cook in London at the present time, and they work as trained nurses under conditions which no domestic in London would even consider for a moment. The odd thing is—it always does strike me as odd—that though they must feel a very considerable resentment at the stringency of the conditions under which they work, I have never heard a patient say he or she suffered as a result of the nurse's resentment. The nurse never takes it out on the patient; she manages to keep going, to keep cheerful and to get her work done, even though she may feel she works long after the hours when she might be expected to have a rest.
Deputy Norton says that £70, £80 or £90 a year is the amount given to nurses in the institutions of this country. I think there are nurses working for less money, and I am bound to say I do not think there will be any improvement unless and until the Minister intervenes and sets some standard, not only of wages but of hours and conditions of service. I would be long sorry to interfere with voluntary hospitals, because I believe there are such immense advantages to be gained by the present system of administration in voluntary hospitals that, although you could imagine certain improvements being made by bureaucratic supervision, I believe the loss would far outweigh the advantages. I would like to see the conditions of nurses in voluntary hospitals improved, but the way I would like to effect the improvement would be to raise the standard of treatment for nurses in the public health institutions so high that the voluntary hospitals would have to come into line or else they would lose all their best staff sisters, who would go to the public health institutions in order to get the better conditions and salaries there available.
I do not mean that the hospital nurses should be treated like princesses, but, if an industrial worker has an eight-hour day, it seems to me an astonishing proposition that a hospital nurse should have to work 12 hours. I do not think I exaggerate when I say that in many institutions in this country nurses are 12 hours on duty. If a nurse has to do night duty, there should be some distinction in the matter of remuneration. There should be some difference between the reward to which a nurse doing night duty single-handed is entitled and that given to a nurse doing day duty, with two or three others to assist her. Surely a nurse is entitled to an income which will give her the ability to save something so that, when she reaches late middle age, and is no longer able for arduous work, she will have a little nest-egg laid by.
We have in nursing a profession to which every citizen of the State, great and small, is at some time deeply beholden, and surely it is not unreasonable to suggest that we should facilitate the institution of some pension scheme which will enable a nurse at 65 years of age to retire honourably from her profession and live in modest comfort—no more than that—for the remainder of her days.
It might be very reasonable that, given improved conditions, the nurses themselves should contribute. I should prefer to see in operation a voluntary scheme which a nurse could join, or not join, as she pleased. I do not believe in thrusting benefits down people's throats, if their personal arrangements make it more suitable for them not to accept them. Would it be too much for us to institute a scheme to which nurses could, out of their improved salaries, make an annual contribution, if they want to, as the national teachers used to do, and, at whatever was deemed to be a suitable age for nurses to retire, become a charge on the pension fund? I do not think that such a scheme would cost a serious sum of money. I do not think that the charge on the Exchequer would be felt at all, and I believe the benefit conferred would be immense. I can conceive each local authority making a contribution in respect of each nurse in its employment, the voluntary hospitals doing the same, and every other body employing nurses being prepared to do likewise. With a modest contribution from the nurses themselves and a contribution from the Exchequer such as was given to the National Health Insurance Fund, a fund would be provided which would allow of a pension commensurate with the nurses' requirements. Very often, a woman in that position could undertake some light work such as that of housekeeper or some form of employment with friends in suitable places which would add to the income the pension would provide. But I think the pension should be such as, taken with the savings that a nurse might reasonably be expected to accumulate during her professional life, would enable her to live in modest comfort if she did not want to work any more.
Summing up, I should like to see the nurses looked after on the modest lines I suggest; I should like to see the accommodation which would be available to myself—because I would be able to pay for it—made available for my neighbours if they get pulmonary or bone tuberculosis, and I should like to see the children delivered from rickets to which they are becoming increasingly liable. I am quite sure that the Minister is as solicitous about these affairs as I am. The only difference between us is that he can do something about it and that, for the time being at any rate, I cannot. But I warn him that, if he does not do something, some day I shall. I hope that the necessity for displacing him to achieve this particular purpose will not arise. When these matters are dealt with, we can raise other bones of contention.
I should like to draw the attention of the House to the fact that there has been agreement amongst all Parties that this debate should conclude to-night. It is now 8.15 and the Minister should get a reasonable time in which to conclude.
The Minister could do what the Minister for Agriculture did last week—start his speech before 9 o'clock and conclude to-morrow.
Mr. Byrne
Surely there is no agreement to finish to-night.
Yes, arrived at by Party whips.
Mr. Byrne
Seven members rose when Deputy Dillon concluded. I stood up a dozen times to-day but failed to catch the Speaker's eye.
Nobody can prevent a Deputy from speaking if he so desires.
The Chair will not prevent any Deputy from speaking, though the Chair was informed that an agreement was arrived at on Thursday last to conclude this Vote to-day.
Let the Party boys sit down.
Mr. Byrne
Some speakers were allowed to speak for an hour, others for half an hour and those who wanted only five minutes could not get that time.
The Chair has no control over the length of speeches, if they are relevant.
Mr. Byrne
We should limit speeches to a reasonable time. Some speeches made to-day lasted an hour.
I shall not take more than five minutes. I want to protest against Deputy Cogan's suggestion that the county managers should enter the field of politics and enter the Dáil.
What is the difference?
He complained about the power they had. Deputy Cogan also wanted more compensation given to the owners of turbary and talked about the rights of private property. By acquiring these bogs, the county councils made them available for the production of turf. They were swamped previously. It was impossible to cut turf on them and the county councils spent thousands of pounds upon them.
When the emergency is over, the bogs will be there for the owners. There is too much talk in this House about the rights of private property. It is like "the divine right of kings". A great deal of the unemployment that exists is occasioned by this respect for private property. Minor relief schemes, and rural improvement schemes, are held up because of difficulty in securing the consent of the persons concerned to the necessary works. Every Deputy is aware of that.
The question of tuberculosis has been referred to from every side of the House. I was chairman of a board of health for seven or eight years, and every attempt we made to build a sanatorium was frustrated by the people of the large towns, who wanted the sanatorium stuck in the middle of the town for the benefit of the town. Whilst we may criticise the Department how we will, the fault in my constituency lay with the people who were interested to get the sanatorium stuck in the middle of a town. When the Minister commences to build sanatoria, I suggest that he do so out in the country where the patients will get fresh air, which they require. These sanatoria should be built high over bogs. The percentage of people living near bogs who suffer from tuberculosis is smaller than amongst people living in any other place. As a lay individual, I say that all over the world people living in the vicinity of bogs are practically free from tuberculosis. Deputy Dillon referred to Coole Orthopaedic Hospital. One thing that made for its success was the fact that it was built high over a big expanse of bog. Experts in the treatment of bone disease who came across from England admitted that its propinquity to the bog was responsible for much of its success. The sooner we get sanatoria away from the big towns—it does not matter what inconvenience is caused to doctors or nurses—the sooner we shall cure tuberculosis. Take the sanatoria out of the towns and you will get the solution of the problem.
I shall be one of the five-minute speakers. I rise to find out from the Minister when we may expect that the Sword of Damocles, which has been hanging over the Kerry County Council, will fall or be definitely lifted. There are three members of the Kerry County Council in this House, one in the Fianna Fáil Party, one in the Clann na Talmhan Party, and one in the Labour Party. I have no doubt they are very anxious to know where they stand. None of them, I think, has spoken so far. The position is that an inquiry was held in the County Kerry several months ago, and I think it is about time that the Minister should have made up his mind on the matter. Probably we have some indication of what his mind is from his opening statement on Thursday in which he said:
"... where an elective body continues to refuse to make proper provision for the maintenance of the local services there can be no other choice but to dissolve it in order to ensure that the services and properties of the local authority and of the local community concerned will be properly preserved."
I think that is a statement that nearly everybody would subscribe to. My interest is not in the county council. My interest is two-fold: In the first place I want to see that the roads of Kerry are not allowed to deteriorate to such an extent that it will require an enormous sum of money in the future to get them back into proper condition. Kerry is a tourist county, and it would be fatal to the tourist industry if the roads were allowed to develop into swamps. With the amount of traffic that is passing over them—the big lorries of the Great Southern Railways Company and other lorries hauling turf, and the lack of road metal, the roads will have developed into what we used to know 40 years ago, if provision is not made to meet the situation. That is a matter that the Minister will have to take cognisance of. The second point concerns the road workers who, after their many years of experience in road-making, have become practically skilled workers. If their jobs cease to be permanent and their employment becomes intermittent, they will follow the rest of what we may call the wild geese of the 1940's and go to England to work in munition factories.
I would like to make a suggestion to the Minister. I can see that it is an embarrassing position for him to be in, especially since the county managerial system has been brought in. It would be an embarrassing thing to have in a county a county manager and a commissioner at the same time, the commissioner exercising the functions of the county council, and the county manager exercising his own functions. I take it that it would not be the Minister's intention to appoint the county manager also as commissioner. I think that in the case of Kerry I might say that the inquiry arose over the fact that the county council failed to provide a sufficient allocation of funds to carry on the road work of the county, with the consequence that the roads have begun to deteriorate, and that quite a number of road men have been thrown out of employment. I suggest to him that he might now indicate to the county council that, while he did not intend to take any action at the moment, he reserved action until the county council would hold its next meeting to strike the rate, and that if they did not then appropriate funds for the purpose for which they failed to provide funds last year, he would peremptorily dissolve them. I think that everybody in the County Kerry would agree with that action of the Minister in those circumstances, because nobody in the County Kerry can face with equanimity seeing the roads on which so much money has been spent in the past deteriorate as they have been doing. Neither can the people of Kerry face with equanimity seeing their skilled roadmen running away to England.
Therefore, I think the Minister would be in a strong position if he were to adopt that attitude: that if the county council again fails to make proper provision for the maintenance of the roads that he will then dissolve them, but that in the meantime he will give them a chance to show what they will do next year. I do not intend to say any more on the matter. As regards the managerial system, I agree with Deputy Dillon that I think it ought to be a good system. At any rate, it is far too early to pass judgment on it now. I think that the Minister was probably right when he said that if the matter were put to the electorate, the electorate would, by a large majority, be in favour of it.
The Minister, in the course of his opening statement on Thursday last, boosted the County Management Act. During the progress of that measure through the Dáil, this Party opposed it in every line. I think there were more divisions on it than on any other measure introduced in this House. As far as I know, my colleagues still hold the same opinion of it. We have not altered our opinions of it in any way. In fact, I think it would be correct to say, on behalf of the Party, that we are more opposed to it now than when it was brought forward.
We had local elections in August of last year when certain new men were elected. Owing to the operations of the County Management Act, those men have not had any opportunity of learning anything at all about local government. My opinion, and it is the opinion of a great many people who have been in public life for a long time, is that at the next election it will be impossible to get men to offer themselves as members of county councils or of urban councils. The Minister, in the course of his opening statement on Thursday, said:—
"The House, of course, is familiar with the fact that the County Management Act of 1940, whilst relieving the elected bodies of responsibility for the details of the local administration, preserves to them full financial control."
I challenge that statement, because of the fact that a Public Bodies Order was issued by the Minister in 1942 which prevented details being given in the estimates to the local authorities, details which hitherto had been available to them. Prior to the application of the County Management Act, the members of county councils, city councils and urban councils were presented with detailed estimates which showed clearly how every penny of the money which was to be raised would be spent during the ensuing financial year. But last year those estimates—perhaps it would not be right to call them estimates because they were not estimates in the accepted sense as members of local authorities knew them for a number of years—came before the local bodies in this way: the county manager merely asked for certain sums of money under certain headings without any details being given, good, bad or indifferent, as to how the money asked for was to be spent. When the members of the county council asked the manager why it was that the estimates were not presented in the manner in which they had hitherto been presented, he told them that he was prohibited from doing so under the Public Bodies Order to which I have referred. The Minister, in the course of his boosting of the Act, stated that if the issue were to be put to the electorate to-morrow, as to whether the managerial principle should be abandoned or maintained, he had no doubt whatever of an overwhelming majority for its retention. I should like to take up that challenge, because I am perfectly satisfied that the people do not want the County Management Act. A certain class of people want that Act, those who have been found out in public life, people who have been rejected by the local electorate, and who tried continuously to become members of local bodies but are always rejected. Taking the common people, I would not hesitate to take up the challenge of the Minister, if he is prepared to have a referendum as to whether the country wishes to have the County Management Act continued in operation or not.
Mr. Larkin
And also in the towns.
All over, I am perfectly satisfied that the Act would be rejected by a large majority. I met Deputies who voted for the County Management Act who told me they did not realise at the time what it really meant, and who were surprised, when re-elected to county councils and urban councils, at the little power they had, and at the humiliating position in which they found themselves when confronted with the Act. In the course of his address the Minister stated that, as a result of the new legislation, the county councils are now the public assistance authorities. The Minister knows that that is not a fact, and that county councils as such have nothing to do with the administration of home assistance. When the Public Assistance Bill was going through some years ago, I thought that public assistance committees were to be set up inside the various county council areas. That has not been the case. The only person who can determine whether an unfortunate applicant is to get a few shillings a week or not, with which to keep body and soul together, is the county manager, and in a great many cases he is not in a position to decide whether the applicant is entitled to home assistance. He is dependent entirely on the advice of relieving officers. I am sorry to say that relieving officers on many occasions are biased by the political affiliations of persons affected. There is no remedy.
I have suggested to the county manager that he should set up an advisory committee to help him in the administration of home assistance. He has not done so. He is considering the matter. I stress the importance of that upon the Minister. It is absolutely essential that there should be intimate touch between the public representatives in every county and unfortunate people who are dependent on home assistance. It is no use for the Minister to talk about county councils being home assistance authorities when he knows that that is not true. The county councils, when referred to in that respect, mean the county managers. I say that a county manager is not able to determine whether a person is or is not entitled to home assistance, and for that reason I urge upon the Minister the necessity of having home assistance committees set up in every county in an advisory capacity.
In this debate a great deal has been said about tuberculosis and about the necessity of providing beds for such patients. I suggest to the Minister that the policy followed by the Government and by the Department has been one which prevents men from getting a decent wage, with which to keep body and soul together. That is doing more to foster tuberculosis than anything else. I had a question on the Order Paper to-day asking why there was discrimination between men employed by local authorities and those employed by private employers, and I was told that it should be remembered that members of local communities, many of whom are themselves hard pressed, are without direct compensation for the increased cost of living, and are required to provide money for the remuneration of local staffs. May I remind the Minister that the people he talked of are directly represented on county councils by men who unanimously, in various counties, repeatedly asked the Minister to sanction increased wages for their staffs and he has refused to do so? In County Wexford a resolution was unanimously passed recommending that the wages of the employees should be increased by 3/-. The recommendation was sent to the Department which went asleep on it. As a matter of fact it is very hard to get a decision at all from the Department recently. I am wondering if the name of the Department might not be changed to the procrastination department. A decision was deferred for a considerable time, but eventually the Minister agreed to permit the county council to concede 1/- per week without any retrospective effect although it had been before the Department for six months. I submit that a policy of that kind does more to spread tuberculosis than any other cause to which we have heard the spread of the complaint attributed.
In connection with wages of people employed by local authorities, and the discrimination practised by the Department, under Order 83 the Minister for Industry and Commerce prevented men from getting increased wages for over two years. He then amended the Order in 1942 and permitted a tribunal to judge whether employers should concede certain increases or not. The figure now permitted is 10/- weekly, but most of those who are working for local authorities are not allowed that amount. Last year when the Government agreed that civil servants should have an increase of 8/- in their remuneration the amount he agreed to be allowed men working for local authorities on the clerical side was 5/-. A woman who would be doing the same work, or perhaps more important work, was only allowed 3/6, while a single man who might be doing still more important work than others was only allowed 2/6 a week.
The Labour Party always voted against such discrimination between married and single men. I suggest to the Minister that that is setting up a bad headline, because if it were adopted by all the employers the tendency would always be to look for single men. Of course, the trade unions would see that that would not happen. I suggest to the Minister that there should not be any discrimination in the payment of a bonus. No effort is made to find out what particular work these people are doing. By a stroke of the pen on the part of the county manager or by some act of the Department discrimination of that type takes place.
As to workers employed by local authorities, questions have been repeatedly put down by the members of this Party asking that there should be a pensions scheme for them. There have been three or four Ministers in the Department since the Fianna Fáil Government assumed office in 1932, and each of them gives the parrot-like answer that the matter is under his consideration. I cannot understand why, in the case of an official under a local authority who has a decent wage during his lifetime, provision is made for a pension when he is beyond his labour, but for an unfortunate working man who uses a brush and shovel, and who has such a small wage that it gives him enough to do to try to live on it, no provision is made for a pension when he can no longer do useful work. I suggest that there is no reason in the world why this matter should any longer be put on the long finger. More intricate problems have been tackled by this and other Governments, and it would be quite an easy matter for the Government, if they so desired, to bring forward a pensions scheme which would cover such men.
Deputy Norton, Deputy Dillon and other Deputies referred to the question of the remuneration of nurses, and I suggest to the Minister that the conditions under which nurses are employed in this country are an absolute scandal. There are nurses employed at a salary as low as £70 a year. Some of these people, as has been indicated, work up to 80 hours per week, and it is certainly a very bad headline that local authorities, with the Minister's sanction and sometimes with the Minister's urge, have people working such long hours for such bad remuneration. To have nurses in hospitals working for long hours, apart altogether from the fact that they are badly treated, is a menace to the patients in their care, because people who have to work for 80 or 90 hours per week cannot be expected to give the attention necessary to patients in their charge.
The same thing applies to attendants in mental hospitals. Here again the Minister has intervened repeatedly to prevent increases of wages being given, notwithstanding the fact that unanimous resolutions have been passed by these mental hospital committees. These committees are representative of Labour, Fianna Fáil, Fine Gael and the Farmers' Party and everybody knows how watchful the Farmers' Party is of the interests of the ratepayers, and when such committees are unanimous in their desire to improve the position of people working under their control, I cannot understand how the Minister can talk in the terms of the answer he gave to me to-day.
There is a Supplementary Estimate before us in respect of food and fuel vouchers and I want to add my voice to the voices of other Deputies in connection with the position of people living in the rural areas. I cannot understand why that food and fuel voucher scheme is not extended to the rural areas. There are people living in villages and hamlets in the rural areas under conditions exactly similar to those under which people are living in cities and towns. Yet these people are not given the advantage of either food or fuel vouchers. In many cases, there are people who live immediately outside a town, but who work in the town when they have work to do. They are subject to the same conditions and have to pay the same prices as people living ten yards inside the town. Yet they are prevented by the regulations made by the Minister from getting either a food or a fuel voucher. That, to say the least of it, is very unfair.
In this connection, when these fuel vouchers are given to people in cities and towns, the people, are expected to bring that fuel, be it timber or turf, to their homes themselves. In a great many cases, these people are old age pensioners. Some of them are hardly able to get out of bed and a good number of them never leave their own homes. Would it be too much to ask that some regulation be made to have that stuff delivered at their houses? In a great many cases, they have to employ people to bring it to them and that to a great extent takes the good out of the voucher. I ask the Minister to try to make some arrangement whereby this fuel will be delivered for them.
So far as housing is concerned, the Minister said that it was well advanced, but did I understand him to say that there was now very little overcrowding? I do not think he can claim that. I think there is as much overcrowding to-day as there ever was, despite the fact that a good number of houses have been built, because it must be remembered that a good number of houses have been demolished also, and that with the best will in the world local authorities to-day are unable to burden themselves with the cost of building at present. Immediately before the war, as the Minister knows, a subsidy of two-thirds, up to £350, was paid in certain towns. At that time, a house could be built for £350, but the position to-day is that that house would cost about £600. Let us assume that such a house costs £550, or £200 more than it cost pre-war. A house built for £350 pre-war, with the subsidy of two-thirds, could be let at 5/9 per week, inclusive of rates; the same house to-day, costing £550, would have to be let at 10/6 per week. The Minister has been asked repeatedly by the Council of Municipal Councils to increase the subsidy in view of the greatly increased cost of building, but he has turned a deaf ear to that request. I suggest to him now that it will have to be done sooner or later, because, even if the war were to end in the morning, it will be a long time before the cost of materials will be reduced.
Mr. Larkin
With regard to the duration of the debate, I suggest that it should continue to a stated hour to-morrow. I am speaking on behalf of those who do not speak as representing Parties. I understand that a gentleman's agreement was entered into, but I do not think it was entered into with the idea of determining the rights of private members. A number of Independent members want to speak on the Estimate, and I suggest that the Parties should agree to continue the debate. There is nothing on the Order Paper to convey to anybody that the debate is to cease at 9 o'clock.
The Chair has no power to enforce such an agreement. It is for Deputies generally to abide by it or not.
Mr. Larkin
I submit, Sir, that the Whips should agree to the carrying on of the debate until a certain hour to-morrow.
I support Deputy Larkin in the suggestion he puts forward. I remained here last week for hours in an effort to speak on this Estimate, and I have sat here since half-past three to-day without leaving the House for more than ten minutes, and I have not got an opportunity of speaking.
I want to support Deputy Larkin's proposal. I come from a county in which there is no county council, no county board of health, no mental hospital committee, and no home assistance committee, and I want to say something in respect of local government administration. I think it unfair that we should be closured in this fashion—I use the word with all respect to you, Sir.
An agreement made by Party Whips may bind the Parties to it, but does not bind the Chair.
The arrangement come to may be a very good arrangement for the carrying on of business in the House, but in future, as well as on this occasion, I, as an Independent Deputy and having no part in any arrangement made between the Parties in regard to the debate, am going to insist on my right to speak. I think it very ungentlemanly and very undemocratic that the Parties should, without consulting every individual interest, come to an arrangement by which the closure would be applied. It is neither democratic nor gentlemanly.
There is no closure.
There is no question whatever of a closure. The position is that the Whips of all the Parties met on Thursday evening last for the purpose of determining whether we should sit on Friday or not. The decision arrived at was that we would not sit on Friday provided there was an agreement entered into to finish the debate on the Estimate for Local Government this evening. It is a very important Estimate, no doubt, and I am sure many members of the House would like to speak on it but we are up against this difficulty, that all the Estimates must be finished before the end of the month and, that being so, I just thought it my duty to meet the Whips of the various Parties to try to get accommodation as to this difficulty.
Mr. Larkin
What about our rights?
I met the Whips of the Labour Party, too.
What about the Independents?
As to the Independents, we have no method of dealing with them.
Mr. Larkin
We are going to insist upon our rights.
As Whip of the Clann na Talmhan Party, I have not been consulted.
In reference to the statement by the Parliamentary Secretary that the Whips acted with the very best of intentions, and had no intention of compelling any closure, I know quite well that you, Sir, would respect the rights of Independent Deputies but, for the progress of the business of the House, they agreed with the Parliamentary Secretary that this would be the best arrangement. Unfortunately, we have now received so much pressure from the members of the various Parties, even from the Parliamentary Secretary's own Party, that it seems this agreement must temporarily fall through.
Seeing that there are dissentient voices from all Parties as to the advisability of finishing the debate to-night, perhaps it may be possible to get accommodation for to-morrow.
Mr. Larkin
Meet the Whips and tell us what you are going to do. At least, we ought to know.
The point is I have met the Whips already and I ascertained their views on this matter. They agreed with me that it would be advisable not to have a sitting of the Dáil on Friday but to meet to-day and conclude the debate on this Estimate to-day.
Mr. Larkin
The Parliamentary Secretary can meet the Whips and try to arrange for a certain hour to-morrow.
The Chair is not bound by an agreement come to by the Parties. The Chair will hear any Deputy who offers, despite any such agreement.
I wish to make a proposition. In view of the fact that so many Deputies want to speak on this Estimate, I would suggest that the Minister be allowed to conclude at 5 o'clock to-morrow evening.
Mr. Larkin
Let the debate continue, and we will try to be as brief as possible.
I suggest 6 o'clock to-morrow evening for the Minister to conclude. Is that agreed on all sides of the House?
I think you could do that.
Has Deputy Corish concluded?
I wish to ask the Minister to reconsider his decision in the matter of increasing the subsidy for the building of houses because, as I said before, it will be a considerable time before there is any reduction in the cost of building and he might as well make up his mind first as last. To proceed with the housing programme as speedily as possible would be a greater contribution to the eradication of tuberculosis than any other method that has been suggested.
The Minister in this case is in a very happy position. As Minister for Local Government he is, one might say, the father and mother of the nation. He looks after us from our birth to our grave. There are some matters concerning my constituency in Galway that I wish to bring before him in regard to tuberculosis. I know very well the Minister does not pay much attention to statements of Deputies in that connection but I would ask him to heed his county medical officers of health. If he takes up the report of his county medical officer of health in Galway, he will find this statement: "The number of deaths from T.B. this year was the largest returned for the past decade and only 17 per 100,000 lower than in the year 1875." That is a rather serious state in our county and I want to bring to the Minister's notice the fact that lack of accommodation in Galway is responsible for that position.
In Galway patients affected with T.B. are in the county hospital for months upon months together with other patients suffering from other diseases. I want to ask the Minister to take a special note of that. Deputy Dillon almost said our sanatoria were dead-houses. I regret that he made that statement, because it does not come well from a meeting of the Dáil. That is not the position in Galway. Our trouble in Galway is that we have not enough accommodation in our sanatorium, Woodlands.
I would also ask the Minister to consider the report of our county medical officer of health, when he says that the law is passed but the services afforded have many defects: first, the conditions of notification are not complete enough; second, no provision is made for the maintenance of the family whose wage-earner is undergoing treatment; third, inadequate sanatorium beds; fourth, no provision to facilitate early detection, and no means of offering appropriate preventive treatment to those especially liable to develop the disease by reason of contact and other conditions.
We all know, Sir, that a father or mother would not consider the cost when it means saving the life of a son or a daughter. They would lose all they had to try to keep a son or daughter alive. The same applies to a son or daughter. They would not consider the cost in connection with the life of their father or mother. The same thing should apply to the nation. There should be no consideration of money as far as T.B. is concerned in this country. We should have sanatoria where we can have our people properly looked after and properly housed. I move to report progress.
Progress reported; Committee to sit again to-morrow.
The Dáil adjourned at 9 p.m. until 3 p.m. on Thursday, 4th November.