Is it appropriate, on the Money Resolution, to raise one point?
Committee on Finance. - Midwives Bill, 1943—Money Resolution.
If it relates to the expenses of this Bill, yes; otherwise, no.
It is about the payment of midwives.
Some Minister must move the Money Resolution.
I move:—
That it is expedient to authorise the payment out of moneys provided by the Oireachtas of any expenses incurred by the Minister for Local Government and Public Health in the administration of any Act of the present Session to make further and better provision for the enrolment, certification, control and training of midwives and for other purposes relating to midwives and the practice of midwifery.
I think all sides of the House have made it manifest that, under the new dispensation, they are solicitous to ensure that these women will be adequately paid. It seems to me that in discussing that question, one fact of the problem was lost sight of, and it is one to which I should like to direct the attention of the Parliamentary Secretary. I think, in order to secure adequate remuneration of midwives in this country, one would want either to zone the country or distinguish clearly between the conditions obtaining in one area and another because I remember being on a local authority at one time and finding that the dispensary midwife was paid an annual salary of something like £52, which seemed to me to be grotesquely inadequate for the kind of work she might be called upon to do, but, when I raised the matter, I discovered that a salary of £52 a year in that particular dispensary district amounted to a fee of approximately 15 guineas for each confinement she attended as a dispensary midwife. Almost all the cases she dealt with were, in fact, patients who gave her some honorarium, if not the full fee, for her work. I have no doubt that there may be other parts of the country in which the services of the dispensary midwife are called upon very much more frequently by way of red ticket, and in these areas it might be that such a salary would be ludicrously inadequate.
I do not know whether it would involve any expense in zoning the country and taking precautions to ensure that each midwife would receive adequate remuneration, due regard being had to her average work, but I think it is a matter to which the Parliamentary Secretary might very well turn his mind, because my experience is that local authorities are not clear in their minds (1) as to the measure of work a midwife has to do in her particular area and (2) as to what is a reasonable wage for a midwife, based on the number of cases she actually attends in her capacity as dispensary midwife, apart from the cases she attends in her private capacity for which she receives a fee or honorarium from the patient.
I am afraid we cannot discuss the question of the salaries of midwives on this Bill.
It is not in the Bill.
I will look into the point raised by Deputy Dillon although it may not be in order to discuss it. There are, however, other difficulties. I do not think the salary can be determined entirely on the number of cases attended. There are geographical and topographical difficulties, and difficulties of travel. The number of cases might be very few, but the difficulties in attending these few cases might be very much greater than the difficulties encountered in attending a larger number of cases in a different type of district.
There are, I think, very few midwives at present on such a small salary as £52 per year. So far as the policy of the Department is concerned, we have encouraged local authorities to improve their conditions of service. I do not recollect during my 12 years in the Custom House refusing to approve of any scale of salary for midwives on the ground that it was extravagant or overgenerous, but, as the Deputy, I presume, appreciates, we cannot very well discuss that matter on this Bill.
Question put and agreed to.
Money Resolution reported and agreed to.