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Private Deputies' Business. - Measures for Social Security: Motion (Resumed).
Debate resumed on the following motion:—
Being of opinion that measures for social security for our citizens constitute the first and most urgent consideration in our post-war planning, Dáil Eireann requests the Government to introduce proposals for the establishment of a scheme of social security, in which all the existing social services shall be unified and co-ordinated under a Ministry of Social Services, and all persons in gainful employment brought under the provisions of a comprehensive scheme of social insurance.—(James Everett, James P. Pattison.)
One and a half hours.
Who is in possession?
Deputy McGilligan moved to report progress. He is not here. The Deputy is in order.
I want to support the motion and to say that I think it is long past the time when we ought to have had a thorough examination of proposals for social security, proposals which would be calculated to give us a better code of social services and, incidentally, a measure of security from the adversity which, under our present system of society, is inseparable from life itself. His Lordship the Bishop of Clonfert, with commendable enthusiasm and an energy well worthy of the cause to which he devoted his talents, presented proposals to the nation and to the Minister for Local Government which, in his view and, I think, in the view of every enlightened citizen, would be calculated to give us a code of social services adequate to our requirements, a code of social services suitable to our peculiar needs and the type of agricultural-industrial balance we have here, and, at the same time, give to ordinary citizens that measure of economic security which ought to be the God-given right of every citizen.
I think that every reasonable person will regret the manner in which these proposals by His Lordship were received by the Minister for Local Government. One could scarcely imagine a more intemperate display of pettiness and petulance than was exhibited by the Minister in his tirades in connection with these proposals. I venture to say that in that respect the Minister probably did not speak for the Government, many members of which, I am sure, felt in their hearts, even though it might not be convenient for them to say it publicly, an appreciation of His Lordship for the painstaking care which he bestowed on an examination of the problem of necessary social services in this country.
But the mere fact that the Minister for Local Government has seen fit to engage in what can only be regarded as a disorderly harangue, so far as he was concerned, with His Lordship the Bishop of Clonfert, is no reason why His Lordship's proposals in respect to social services ought not to hold the stage, and is no reason why these proposals ought not to get the careful examination to which they are entitled on their merits. Indeed, I think the least the Taoiseach ought to do in the matter is to remove the humiliation to which His Lordship was subjected by being removed from the position of Chairman of the National Health Insurance Society and that His Lordship ought to be restored to the position so as to indicate that the Government did not share the rather belligerent views with which the Minister for Local Government usually enshrouds himself when the occasion calls for tact and delicacy. As His Lordship rightly pointed out in the document which he submitted to the Government, there is need here for a code of social services, not merely as a matter of economic sanity, but as an essential of social justice. His Lordship took care to sift and to weigh the case for the establishment of these services and he submitted to the Government proposals which were at least worthy of careful consideration.
I think the Minister for Finance in his last Budget speech told us that the Government had examined the cost of the Beveridge proposals so far as their application to this country was concerned and intimated what the cost of the application of those services to this country would mean. It seems to me rather a strange thing that the Government could examine the Beveridge proposals for social services and not be able to devote some time to a careful examination of the proposals submitted by Dr. Dignan. At all events, so far as the Government's public utterances are concerned, I think the only thing we do know definitely is that the Government have been able to find time to estimate the cost of the application to this country of the Beveridge proposals, while we have not yet been able to get from the Government any indication of the cost of the application of Dr. Dignan's proposals, which, I think, are generally admitted to take cognisance of the agricultural and industrial peculiarities of this country to-day. I would urge on the Taoiseach, as this motion does, that the whole question of social services ought to be thoroughly examined by the Government, and, in that connection, Dr. Dignan's proposals afford an opportunity of examining the matter over the range of insurance schemes and medical services set out in his very comprehensive and very commendable scheme.
Two things strike anybody who has given any thought to the question of social services and social security in this country. One is that our present code of social services is grossly inadequate and, in the main, makes available what, in our circumstances to-day, can only be described as a beggarly scheme of allowances, allowances which make no provision whatever for the set of adverse circumstances for which these allowances are supposed to provide. No matter what service you take; if you take, for instance, the first in the form of old age pensions, which goes back to 1908, or the latest in the form of children's allowances, which is about a year or 18 months old, you will find the same characteristic in both. Not only are our social services utterly inadequate for the requirements of our people, but the administration of the schemes rivals in chaos the inadequacy of the services.
For instance, instead of having a Ministry of social services, or a Ministry of public health, concerned with the administration of social services, we appear to have gone deliberately out of our way to avoid the application of any co-ordinated plan to the administration of our social services. To-day we have a situation in which old age pensions are administered by three authorities. In the first instance, a person makes an application for a pension to the local authority. When the application has been considered by the local authority, the case is then remitted to the Department of Local Government and Public Health to see whether the pension ought to be allowed. Then, when you come to the granting of the pension and its administration proper, the administration is carried out through the Revenue Department. Can anybody imagine a more unsatisfactory method of administering old age pensions than to start with an application to the local authority, relay it to the Local Government Department, and then bring in the Revenue Commissioners, in case the matter would be plain sailing and in case it would run smoothly?
Then we have unemployment insurance, administered through the Department of Industry and Commerce. There is, however, a scheme of workmen's compensation, which surely ought to be related to employment, but it is not administered by a State authority at all, not even by the National Health Insurance Society, but made a sort of profit to private insurance companies here. A workman's misfortune in the course of his employment turns out very frequently to be a profitable source of income to the insurance company which carries insurance of that kind.
Then we have national health insurance, not administered by a State Department, nor by any of the existing State organisations, but administered by a kind of autonomous National Health Insurance Society. Whilst that society is empowered to deal with applications from insured persons in respect of hospital treatment, dental treatment, optical treatment, convalescent home treatment, it is not at all empowered to deal with any of these disabilities where they affect the wife or child of the insured person. It concerns itself solely with the insured person.
So far as the society is concerned, his wife may need dentures, but she does not get them, as the scheme does not extend to provide for the health of the insured person's wife or children. This scheme of national health insurance, which provides merely for the insured person and is unconcerned regarding his wife, whose place the Constitution says is in the home, and takes no notice whatever of the disabilities of the children, is not worthy of the description of a national health insurance scheme. It is not "national," and it is obviously not "health," as no one could describe it as a comprehensive scheme. Yet it is part of the code of social services set up in this higgledy-piggledy manner to look after the national health and it masquerades as a national health insurance scheme.
In that connection, I do not want to say a single word of disparagement of the excellent men and women who are concerned in the administration of the society. One has only to talk to them to realise the breadth of vision they have in respect of our social services and to realise, too, how clearly they appreciate the deficiencies in the present scheme and how passionately anxious they are that that scheme should be improved, so as to make the provision which they think is necessary and vitally necessary for extending this scheme until it is entitled to be described as a national health insurance scheme. My main point in making reference to the society was to call attention to the fact that that society administers in a way quite unrelated to the activities of other Departments a scheme of health services of a limited character, not for the citizens of the country but for the limited number of persons—approximately 500,000 out of 3,000,000—who are insured under the scheme.
When we come to the question of children's allowances, we find that that is administered also by the Department of Industry and Commerce. One can scarcely understand how a Department so described comes to administer a scheme of children's allowances, but there you have it. The scheme of widows' and orphans' pensions is administered by the Department of Local Government, but when you come to a scheme of children's allowances the administration is handed over to the Department of Industry and Commerce.
What children's allowances have to do with either industry or commerce is not at all clear to me, and those who assigned the administration of the scheme to that Department might well let us into the secret which induced them to assign the administration of that particular Act to a Department which ought to be concerned with the development of industries and the promotion of commerce, rather than with a social service such as the provision of allowances for children under 16 years of age.
Then we pass to the maternity services, and here all it is necessary to do is to note that it is probably the most inadequate service in Europe to-day. Whatever it may be in the future under the new Public Health Bill, certainly in the past it has been an appallingly bad maternity service, producing deaths that might very easily have been avoided, if only we had the intelligence to apply to our administration of maternity services the up-to-date methods which enlightened countries of Europe have long since applied to them. Is there any wonder that such carnage goes hand in hand with maternity in this country, that this city to-day has probably the highest mortality rate for young children than any other city in Europe? As long as you have the present inadequate maternity services, how can you have anything but the unenviable record of having the highest infantile mortality rate in Europe, which is what we have to-day? When we come to its administration, we find it is not done by a State Department. The State looks after old age pensions—persons going out—but coming into this life you have to go to the local authority, which is concerned with maternity services. Unfortunately, these maternity services in many cases go hand in hand with the wretched poor law system, which still operates in this country, notwithstanding the fact that we have embellished the system with a new, and, perhaps, an Irish name.
Then we come to blind pensions. One would have thought the blind pensioner had every possible facility for exercising his right to claim the pittance to which he is entitled under our blind pensions legislation. Here again we find that a simple thing such as providing some assistance for a blind pensioner is wrapped up with all the obligations associated with the administration of old age pensions. The person has first to go to the local committee. Frequently he has to attend a hospital and have his sight tested or wait until one of the two of the nation's only travelling ophthalmic surgeons calls to see him to test his eyes. When he is certified as having defective sight, his case goes to the local committee, which having considered his application adjudicates on his claim to a pension. Then it goes to the Department of Local Government and Public Health and from there it has to be administered and the payments made by the Revenue Commissioners. After all that procedure has been complied with, the blind pensioner gets his pittance of 10/- a week to help him to make his lot in this life easier and happier. If he wants to get a supplementary amount, he has to go back to the local authority and there, if he is lucky and if the local authority is not hopelessly immersed in the dark recesses of the past, he may get a maximum of 4/- a week, to supplement the miserable 10/- he gets from the State.
One has only to dwell on these services to realise how utterly inadequate they are. Unless we are to contemplate the continuance of a situation in which our people are to be compelled to tolerate for another generation scales of social services which are not even related to subsistence standards, something must obviously be done by the Government to introduce proposals for legislation calculated to give us a decent standard of social services here.
I think what I have said is sufficient to indicate that the scales of benefit provided are utterly inadequate for the requirements of modern life. Our medical services cannot, by any stretch of imagination, be said to be satisfactory. Anyone who has any knowledge of hospitalisation in this country knows that it is harder than ever to-day to get into a hospital, and harder to get into a city hospital than ever it was in the lifetime of anyone now living. Even when you get into some of the hospitals, the admission is through the infamous red ticket, administered by the local authority, the red ticket which, in the British days and in our days, is still a stigma of poverty for those who have to apply for it as a passport to hospital treatment.
One would imagine that illness and disease were the enemies of the nation, and that, as such, the whole nation would make war on illness and disease. The nation does nothing of the kind. So far as wealthy people are concerned, their cheque books give them admission to any nursing home they want to go to, and the best medical attention that can be got. Another class of the community can manage to pay fees in hospitals. But there is a very large number of people, for instance, agricultural workers, who produce the food on which the nation depends; road workers, lowly-paid artisans, small farmers, and persons in that wage grouping, who are compelled to rely on the detestable red ticket as the only means by which their physical disabilities will be attended to in our hospitals to-day.
I put it to the Taoiseach that that concept of illness on the part of a citizen is a pagan concept of our responsibility to our citizens, and that we ought without any further delay to get away from the detestable poor law system introduced originally by the British, carried on by two Governments in this country, and still in our midst, notwithstanding our efforts to disguise it.
If we are ever to get away from the taint of the poor law system in our public services, we can only do it by insisting that there must be a national scheme of hospital services. Why should people in Merrion Square be entitled to get the best medical attention? Why should any gouty old man or dyspeptic old lady in Merrion Square, simply because he or she has a cheque book, be entitled to get the best possible medical service, whilst a poor man or woman in the alleys behind Merrion Square, possibly with six or seven children to maintain, is compelled to wait until such time as he or she can get a red ticket and hope to get a bed in a city hospital? Surely the nation should see to it that a woman with six or seven children, or a father supporting a wife and six or seven children, should get every preference in the matter of hospital treatment. Under our system there is nothing of the kind. The gouty old man or the dyspeptic old lady are told: "If you have a cheque book you will get the best attention, and the devil take the hindmost as far as the others are concerned."
I challenge the whole constitution of our social services under which certain people can get the best medical treatment and the others the worst, if they get any at all. If we are to eliminate the present taint of our poor law system we can only do that by demanding the introduction of a national hospital scheme under which every man, woman and child who is sick and who wants hospital treatment will be able to get it from the best medical authorities available without any means test such as is imposed through the medium of the present system. If we have the courage to demand the introduction of a national hospital scheme which will provide treatment without a means test for every citizen desiring it, then we shall have taken a very radical and vital step on the road towards improving health in this country.
One of the characteristics of our social services is the fact that we make no provision for a variety of things and the introduction of such provision is long overdue. We have to-day a very serious problem in the spread of tuberculosis. It is true that commendable efforts, though belatedly undertaken, are being made to deal with the ravages of that dreaded disease, but it is equally true that we have not been able, so far, to evolve a sound scheme simply because we are too mean and too lazy. We should have some scheme whereby a breadwinner undergoing treatment in a sanatorium for tuberculosis and unable to follow his normal occupation, would be enabled, by means of State allowances, to make provision for his wife and children. So far as the State is concerned, a man stricken with tuberculosis, who has a wife and four or five children to maintain, may go into a sanatorium and anybody may look after his wife and children. The State does not care. It makes no provision for the maintenance of the wife and family, unless on the basis of outdoor relief. That is the only responsibility of the State. It is not otherwise concerned with the sufferings of these unfortunate people.
It is well known by every local authority that cheerfulness of outlook and brightness of mind are essential in order to bring back the health of tubercular persons. How can you bring back health and vitality and vigour to a sufferer from tuberculosis if, whilst he is incarcerated in a sanatorium, he is wondering how his wife will pay the rent, the grocer, the milkman, and how to get food, clothes and boots for the children? As long as we do not make adequate provision to help to cultivate that cheerful outlook by the payment of reasonable State allowances, while the sufferer is undergoing treatment, we are only tinkering with the problem. Every unfortunate victim of that disease at present detained in sanatoria is only too painfully aware of what the absence of a decent means of livelihood means to him when he is fighting the ravages of tuberculosis.
Similarly, in respect of old age pension legislation, one can hardly imagine a more unsympathetic outlook towards the aged and deserving sections of our community. The allowance they get is approximately 10/- a week. They may get a little more after they undergo a means test carried out by a local authority and some not very broadminded home assistance officer. To imagine an old man or woman living in a cottage in rural Ireland on an allowance of 10/- a week is to realise how hollow are the pretentions enshrined in Article 45 of the Constitution. No old age pensioner could possibly live on 10/- a week. In case many of them would get the full 10/- a week, there is an inquisition into their means. They are interrogated in a manner that shows there is very little concern for them in the winter of their lives. Those old people in the spring and summer and autumn of their lives have given the best of their physical and intellectual powers to the nation.
The whole scheme of old age pensions in this country and its administration is nothing short of a scandal. We probably pay to old age pensioners a lower scale of pensions at a later age than in any other country in Europe, or indeed in the world. Many other countries have found it possible to give pensions of 25/- a week to aged people and in those countries the cost of living is lower. These pensions are given to persons of 60 and 65 years. Our taxation has risen from approximately 21 million pounds to 52 million pounds, yet the most we have been able to give our old age pensioners is a beggarly pittance of 10/- a week. If those who want to defend scales of that kind will attempt to get their relatives to live on such inadequate incomes, they will realise how indefensible it is to continue paying such paltry allowances.
There is another class in the community for which no provision is made and that is the person who is born an invalid and who remains an invalid all his life. In many other countries provision is made for such people. An invalid gets sufficient to maintain himself. Here, if a person is unlucky to be born an invalid, crippled from birth, that person goes right through life without any provision being made for him by the State to help him because of the physical disability with which he is inflicted. Many other countries have provided persons of that kind with something which makes life something better than the unrelieved misery it would otherwise be for such unfortunate sufferers.
Similarly, there should be some provision made for elderly spinsters. Many women at 50, 55 and 60 years of age find it impossible to secure employment, so keen is the industrial and commercial demand for young and vigorous people. When people reach 50, 55 or 60 years of age they find it extremely difficult to secure employment in many of our industries, and where they have employment, they very often find that they must relinquish it at 50, 55 or 60 because of the demands of unemployment and because those who employ them find they require younger persons for the work. A number of countries have recognised the problem of providing for the middle-aged spinster and they have recognised it by providing allowances for persons so circumstanced, but in this country we have not yet even begun to talk about the problem much less to make an early approach to its solution.
I notice, too, that in the legislation of some of the newer countries and some of the States which have now got enlightened Governments, an approach is being made to the question of providing a universal superannuation scheme, so that those who can no longer get employment in industry may be enabled to retire on an allowance capable of maintaining them in some degree of comfort for the remainder of their unemployed lives. Here in this country we have not even begun to think of the problem, much less consider the application of a comprehensive scheme of universal superannuation. But these are issues which concern the people of this country.
Many of the tens of thousands of our people who have gone to Britain in the last five or six years and who have gone to the Six Counties will now and in the future be getting the benefit of these schemes, in so far as they are applicable to them, and many of them, when they come back here, will come back to a country in which these schemes are not operative and in which they will find very inadequate provision made for adversity as compared with that made in the country in which they were temporarily employed. If we are not to be a kind of Balkan State, with a low standard of life and living, with the kind of philosophy crystallised in the principle of the survival of the fittest, there must be an examination of the social requirements of our people, with a view to devising a scheme of social services calculated to satisfy the Christian and human demands of our people.
I will concede at once, and only a fool would deny, that any scheme of social services must be financed out of production, that the standard of social services in this or any other country will be measured by the standard of production, and it is a necessary corollary of the introduction of a scheme of social services on a decent scale that we should increase our productivity to the maximum possible level. We cannot increase our productivity to the maximum when we sit idly by while tens of thousands of our people are unemployed—able to work, willing to work and clamouring for an opportunity to get away from the detestable employment exchange, from the workhouse and from the home assistance officers, but still unable to get that opportunity to work in their own land. Nor can we increase our productivity by giving permits to our people to work in other countries, to create wealth for these other countries, while neglecting the possibility of utilising their brains and their brawn to create wealth which would finance an extended scale of social services in this country.
Any examination, therefore, of a scheme of social services and the introduction of a scheme which will provide an adequate standard of security for our people must go hand in hand with an examination of the productivity of the country and of the possibilities of extending that productivity and utilising to the fullest every creative power possessed by our people, and particularly by our unemployed people to-day. That brings me to this point: if we are to have an adequate scheme of social services, it must go hand in hand with a scheme of full employment, because it is nothing short of criminal waste to have, in a relatively undeveloped country, men and women clamouring for the opportunity to work, and denied that opportunity to work, in their own land.
This motion is reasonably phrased. It asks for an examination of the problem and the introduction of a unified and co-ordinated scheme of social security. I commend an examination of the problem of social services in this country to the Government, and say, in conclusion, that they should do the scheme of Most Reverend Dr. Dignan the honour of examining it, because I believe it contains within it the basis of a scheme of social services which could do much to raise the standard of life of the masses of the people of this country. If we fail to examine these proposals or fail to find some substitute proposals, we will have, during the next ten years, what we have had during the past ten years —large-scale unemployment at home, large masses of our people living below the poverty line and large sections of our people looking for the emigrant ship in preference to the economic depression and insecurity which, unfortunately, is the all-too-common lot of tens of thousands of our citizens to-day.
Anyone who considers reasonably and fairly our social services must admit, in the first place, that they are inadequate; in the second place, that they are degrading; and, in the third place, that a very large section of our people are debarred from benefiting by the existing social services. Old age pensions, home assistance, the dispensary system—all the various forms of relief which have been provided— carry with them the stigma of degradation. It is impossible to consider social services generally without reference to the statement issued by the Most Rev. Dr. Dignan and here is his comment on the dispensary system:
"The dispensary is the core, the hub and the heart of the degrading poor law system. To understand the system you have only to visit a dispensary. Most of them have no proper accommodation, no sanitary arrangements, no waiting rooms and from the medical point of view they have few conveniences or appliances to help the doctor to diagnose or to treat."
Grouped around the dispensary system you have the relieving officer, the home assistance officer—call him what you like—the man to whom the person who is in need must go and claim relief. You have the old age pension system under which an applicant must prove that he has been thriftless, that he has not accumulated any savings, that he has absolutely no means of living in order to benefit by this small and inadequate relief. Most Reverend Dr. Dignan sought to make a complete break with the existing system of social services. He sought to set up an independent national insurance body to which citizens would contribute and from which they would derive benefit, and, as contributors, would not have to bear the stigma associated with home assistance and the other forms of relief. It might be said that every citizen of this country is a member of a big society, the society known as the State, and that since every citizen has contributed to that society there is no stigma associated with drawing benefit from the community.
We must, however, consider the tradition under which we work, a tradition which has grown up and dates back to the very origin of the poor law system of relief. Because of that it is necessary to make a complete breakaway from that system, as the Most Reverend Dr. Dignan has suggested. In a national insurance society such as he envisaged, practically every citizen of this State would be a contributor. The worker and the employer would make a contribution, and to their contributions would be added one made by the State. Under such a system a large section of our people who are at present debarred from any relief would benefit. We have, for example, the smallholder, the small farmer and the small business man, but with all the various services which we have at the present time, the small owner of property finds that he is completely excluded from benefiting under them. If a small farmer or a member of his family becomes ill he is faced with two alternatives. He is faced with denying himself the institutional treatment which he urgently requires, or with bankruptcy—the complete loss of his farm, shop or whatever small business he possesses. Individual cases of that kind have come to my notice. Small farmers, when advised by their medical officer to avail of institutional treatment, have simply declined to do so, because their means did not permit, with the result that they eventually lost their lives. Surely, it should be possible to devise a system under which a smallholder, a small farmer—even a large farmer— and a small shopkeeper could make an annual or weekly contribution, and thereby derive the right to the benefit of free institutional treatment or free medical assistance.
We have another evil which has grown up in this country in connection with workmen's compensation. Deputy Norton said that the workmen's compensation legislation tended only to make profits for the insurance companies. I am doubtful about that, but I do know that it provides a very substantial income for the members of the legal profession, and, to a considerable extent, for the members of the medical profession. I think that if the amount of the compensation paid out by the insurance companies was investigated it would be found that a substantial portion of the total goes not to the workers but to the members of the legal and medical professions. Deputy Norton informs me that 11/- out of every £1 goes to the workers. There you have something which urgently needs reform, something which I think should be embodied in our social services. We should have some adequate machinery by which the worker would obtain compensation without having to put himself into the hands of so many professional racketeers.
I think this motion deserves careful consideration and attention. I am not sure that I entirely agree with the complete wording of it, but I think that at the present time we must devise a united, co-ordinated system of social services. We must get away from the disjointed, unorganised and unco-ordinated system that we have, and from the confusion and chaos which exist in the entire administration. At present you have practically every Department of State taking a hand in the administration of the various services—medical, unemployment relief, home assistance and the others. These services are administered by different Departments which act independently of each other without any co-ordination or sense of unity. In any system which we devise we should give special attention to that important section of the community represented by the small property owner, because this State, and every other State, depends for its security and for its progress on having as large a percentage as possible of its population owning property in a small way: in having property distributed over as large a number of people as possible. The position at present is that it is the small property owner that is being crushed out and discouraged. Even where the Land Commission divides land and creates small holdings, the people who obtain the holdings frequently come to Deputies and tell them that because they have obtained these small holdings they are debarred from availing of many of the social services which they hitherto enjoyed. Consequently, they feel a sense of discouragement in their ownership of property, and often desire to go back to the condition in which they were previously. I think that is undesirable, and that it would be well if the Taoiseach carefully considered the Most Reverend Dr. Dignan's report from beginning to end. If he does, possibly with his knowledge and with the co-operation of his Ministers he may be able to improve upon it in certain respects and find in it a foundation on which to build a sound social policy.
I am very glad to see the Taoiseach, as the Head of the Government, here for this very important discussion. This is a matter that certainly deserves his personal attention. No matter how I may differ with him on many other questions, I think that he will probably take a sympathetic interest in this question. Therefore one could expect that, having got to that point, he would take a personal hand in doing something effective towards bringing about a change in the present position with regard to social security in the country.
It seems to me inevitable that, sooner or later—and the sooner the better—we must take a fairly strong and effective step in this connection. We cannot be unmindful of the fact that in Great Britain, during the last two or three weeks, a national insurance scheme was introduced, and will be given effect to in a short time, that will completely revolutionise the position there. It has been stated also that in Northern Ireland a scheme at least on somewhat similar lines will be introduced in a short time. We cannot possibly ignore action of that kind and allow the present position to continue. It would be an extraordinary position if certain people in County Derry, for instance, were benefiting under a scheme of national insurance, while, a few miles away, in our State, no such provision was made. I do not suggest that we can hope to do anything exactly on the lines of the British scheme. We must be realists and have regard to our resources.
A scheme of this kind should be introduced for a number of reasons. One particular reason is that it would be good for the dignity and morale of our people, and the feeling of contentment it would give them because they were not getting anything in the way of charity, but as a right and in return for their contributions. I think it is all too depressing a fact that in recent years we have had an ever-increasing number of people forced to seek assistance of one kind or another. It is deplorable if we have no other remedy in our time than the continual reference of all problems of destitution and poverty to local government, and no other hope for our children than the prospect that many of them will start life getting free boots, provided partly by the State and the local authority, vouchers, free milk, and all those things, the necessity for which I regard as extremely regrettable. While I appreciate that these methods have to be employed for a certain time, they should certainly be regarded as items of a situation that should be as short and as brief as possible.
I join with Deputy Norton and Deputy Cogan, and I make a special plea in regard to the question of hospital benefit. I live in a constituency where the small farmers are very numerous. The average valuation of land in West Cork probably would not exceed £12. I think the average in the county does not very largely exceed that figure. I know the real and terrible problem that is represented by the lack of means, and thereby the lack of facilities in getting hospital treatment for many of these people.
I am satisfied that it is no exaggeration whatever to say that life is very often endangered, and I think I can add sometimes lost, because of the fear of the expense involved in hospital treatment. The Cork County Council makes contributions to the voluntary hospitals in the city and there is a certain unwritten law, which is very generously observed by the authorities of the hospitals, that gives members of local government authorities on the committee of management, and others, the privilege of making recommendations in favour of the admission to the hospital of patients of the kind I have mentioned on the basis of a reduced contribution. I should like to take this opportunity of saying how generously this is done. The provision of hospital treatment is a tremendous difficulty for many people who are not aware of facilities of that kind and who would be reluctant to utilise facilities of that kind. I am quite satisfied that there is a very urgent need in regard to that particular class. I am quite satisfied also that the sooner we alter the poor law system, or dispense with as much of it as we can, in regard to the admission of ordinary people to the hospitals, the better.
Perhaps the most eloquent words used by the Most Reverend Dr. Dignan in his outline of a scheme of social insurance are, that the poor law system as we know it in this country ought to be not alone blotted out from the Statute Book but from the memory of the people. Every person of goodwill in this country will subscribe to that dictum and be glad that we have had the lead we have had in that particular matter from such a very distinguished and responsible quarter.
Clearly, the whole position in regard to national health insurance ought to be revised. I am of the opinion that a scheme of insurance providing for hospital and other benefits on the basis of subscriptions from the people and, therefore, a scheme that would embrace the bulk of the people would be to a large extent a scheme that would meet its own requirements. I am quite satisfied that the co-ordination of the various social services should result in very considerable economies, which could be applied to the support of the scheme. A Poor Law Inquiry Commission was set up in 1925 and, as far as I know, a number of their findings were never given effect to. No attempt has ever been made to give effect to their findings in regard to institutions known as county homes and places of the kind. There is a real need now for a reexamination of the whole poor law system as we know it in this country and to dispense with a number of features of that service and apply the money thus saved to the support of a central and national scheme of insurance.
I also subscribe very heartily to the suggestion made by Deputy Norton that there ought to be some contributory scheme in respect of retiring allowances or superannuation allowances. The position for many people who reach the age of 65 and who are no longer regularly employable and whose services, having regard to the position that a great many younger people are without employment, are not in great demand, is a very distressing one. The bleak years from 65 to 70, when such people qualify for an old age pension, represents, to my mind, the most cheerless period in the lives of many people who have been estimable and hard working people during all the years they were able to work.
Similarly, the position in regard to tuberculosis ought to be examined in this particular light. I do not know whether the view would be generally accepted or not but it is my opinion as a lay man, who does not claim to have any specialised knowledge of this subject, that tuberculosis in this country is largely a poverty disease. Admittedly that is not universally the case but I think that, in the main, the disease is due to poverty conditions, insufficient food of the right kind and the unhealthy surroundings that are the result of poverty. I remember that in a former national health insurance scheme, before the amalgamated societies were formed and before the centralisation of the present scheme, there was provision for what was called sanatorium benefit. A special type of benefit was provided for tuberculosis sufferers. There was a special type of benefit to enable domiciliary or home treatment and support to be extended to the particular sufferer in the period after discharge from an institution. For some reason that I have never heard fully explained that benefit was withdrawn. The benefit was operated through what were then known as county insurance committees. The withdrawal of that benefit has been a serious injustice to many people. A scheme on those lines would be of great assistance in the present circumstances.
I should like to see a scheme of social security inaugurated, not alone from the point of view that it would promote good health in the country and foster a feeling of reasonable security and contentment as far as the future is concerned for the masses of the people but also because I believe it would be good for the dignity and self-respect of the people and would help them to get out of the rut into which the masses of our people are being driven by having to hold out their hands more frequently every day for State charity in one form or another.
The sooner we set our faces against that and provide a Christian alternative, the sooner we will get back to the foundations of self-respect and dignity from which we had departed. I earnestly urge the Taoiseach to give his personal attention to this matter as one of the most important matters requiring consideration.
There were many things said in this debate which would, if time permitted, justify a rather detailed comment from me. But I think the House will realise that time will not permit of anything of the kind. I hope, however, that some member of the Government will have an opportunity of dealing with some of the points raised on another occasion. Deputy Norton is always pleased to have a general subject to deal with. As a rule, he does not care to come down to detail. On the airy heights he has much more liberty. It is not surprising, therefore, that he should find difficulty in understanding a person whose whole training and responsibilities over a number of years have accustomed him to consider matters in detail.
To whom is the Taoiseach referring?
I shall tell the Deputy in a moment. The Minister for Local Government, by training, was an engineer. He was then for a number of years in the Department of Finance and now for a number of years he has been in the Department of Local Government as a responsible Minister.
He was also in the Department of Industry and Commerce.
He was in the Department of Industry and Commerce for a period also. In all these positions, as a responsible administrator, he had not merely to think of general principles, but he had to see to their application in detail. Deputy Norton, no doubt, with an elegant movement of his hand can indicate an arch; but an engineer will want something very much more than that wave of his hand to work out the specifications and the stresses and so on which will enable a bridge to be built. Deputy Norton has never been brought down to the practical test of having to do the things which he talks about.
Is this the same engineer who discovered the white elephants a few years ago?
It is the same engineer who wants details before he can cost them. If you want costings done, it is not enough to talk about them in airy terms or in broad outline. You need to get down to detail. Unless you can get down to detail you cannot give a bill of costs. Deputy Norton always finds an occasion to attack the Minister for Local Government. He spoke just now of tirades. I have here a report of the proceedings on January 24th last year on which the question of Dr. Dignan's proposals was first mentioned in this House. I see a question here by Deputy Norton and the Minister's answer. I find no tirade in it. Deputy Norton's question was:
"To ask the Minister for Local Government and Public Health whether he will authorise an inquiry into the cost of providing the proposed social benefits set out in the memorandum sent to him by his Lordship the Most Rev. Dr. Dignan."
The answer of the Minister was:
"The memorandum to which the Deputy refers is, presumably, the paper entitled ‘Outlines of a Scheme of National Health Insurance', which was read by the Most Rev. Dr. Dignan, chairman of the National Health Insurance Society, at a meeting of the Society on 11th October, 1944, and, by order of the committee, released to the Press. The daily newspapers carried a report of the paper on 18th October, 1944, and on the same day I received a complimentary copy of the paper.
I have had the paper examined in my Department. The examination revealed that the paper in general did not take due cognisance of the several very complex fundamental difficulties which the author's proposals involved, that many of these proposals were impracticable, and that accordingly no further action on the basis of the paper would be warranted."
Deputy Norton pursued the matter and asked:
"Would the Minister say whether an estimate of the cost was prepared in his Department? Can the Minister now, as a matter of information on a subject which is exciting widespread discussion, give the House and the country any indication as to what the cost of providing those benefits would be?"
The Minister said that he had nothing to add to the very comprehensive answer which he had given. I see nothing in that in the way of a tirade.
Did the Taoiseach read the speech which the Minister made at Jury's Hotel?
If the Deputy gives me any speech, I will read it. I believe I will not find in it anything in the way of a tirade. As I understand it, the Minister's position was a very simple one. He, as Minister, had Parliamentary responsibility and local responsibility in connection with the National Health Insurance Society. In view of these responsibilities, he was given, by law, the right to nominate and the responsibility for nominating the chairman, trustees, and certain members of the society. He believed that that established between him and the chairman of the society for the time being, whoever he might be, a certain intimate relationship, and he felt that the publication of the very far-reaching proposals dealing with this service before he had time to have them properly examined did not appear to be consistent with the relationship which was intended, by law, to exist.
By law.
By law. That was his view. He did not get the memorandum in good time, but, neverlesless, he had it examined in his Department, and the result of the examination was to confirm him in the view he expressed. Now, there is no tirade.
I want to correct the Taoiseach there on the word "tirade". I used the word "harangue".
I think, at the present time, I am going to believe my own ears. There are others present who will know, too, that the Deputy did use the word "tirade" in this connection to-night.
We will give it to you.
I am sure there were other people present who will confirm that. Now, the Minister was quite impersonally fulfilling what he regarded as his duties and responsibilities. He wanted to see that he was in a position to undertake that responsibility fully. Those who wanted to make more out of it can do so.
Is he infallible?
He did not pretend to be infallible. He made a very simple statement. The document was published on the same day on which he received a copy. I have read out the Minister's reply as to the date of publication, and the sending of the complimentary copy to him. However, he had it examined, and he gave quite objectively the result of that examination.
I would like to have an opportunity to reply at length to some of the points raised in this debate. Every one of us, naturally, would like to make life as comfortable as possible for every citizen in this land. As far as I remember, only one Deputy—the Deputy who spoke just before I stood up—adverted to the fact that it is not a question merely of our wishes but of what it is possible to do. If there is to be a complaint made, let it be made on the basis: "You could do this, our resources would enable us to do this, but you are not doing it". Once we get down to argue on that basis, we get somewhere. If we are simply met by people who build up the sort of heaven we would all like to create here on this earth and take no cognisance of the hard facts of the situation, we can get nowhere. At any rate, we on this side of the House have to proceed with this question in the same way as the engineer who is asked to build a bridge. Assuming we want a bridge, we must calculate whether we have the means which will enable us to build it.
As the time is so short, I think, perhaps, the best thing I could do with the remainder of it would be to make a short statement, showing in general what the position is as far as the Government decisions are concerned.
As Deputy Everett pointed out when moving it, this is a double-barrelled motion. It asks for the establishment of a scheme of social security and also for the setting up of a Ministry of Social Services, under which all the existing social services would be unified and co-ordinated. It is clear from the Deputy's speech that, in referring to the existing social services, he has in mind not only old age pensions, blind pensions, widows' and orphans' pensions, national health insurance, unemployment insurance and unemployment (intermittent) insurance, unemployment assistance, food allowances, children's allowances—what may be called the income maintenance services—but also the public health and medical services, for which the Minister for Local Government and Public Health with his Parliamentary Secretary is at present responsible.
I think it will help somewhat to clarify the whole matter if I deal first with the question of the health and medical services. For a considerable time this matter has been the subject of a great deal of public attention. Two sets of proposals have been put forward—those associated with the name of the Most Rev. Dr. Dignan, Bishop of Clonfert, and the scheme prepared by the Medical Association. Both schemes have been exhaustively examined by the Department of Local Government and Public Health, and have been carefully considered by the Government. The results of the consideration given to them will be found in a White Paper which will shortly be published. On the whole, the conclusion which the Government has arrived at is that neither scheme is at all satisfactory. I do not propose to state now the reasons on which that conclusion is based. These will be set out fully in the White Paper, which will also contain certain other proposals intended to form the basis for consideration of the reorganisation and extension of the existing public health and medical services.
In a Parliamentary Question addressed to me on the 29th November, 1944, I was asked whether any decision had been arrived at as to the establishment of a Ministry of Health under a separate Minister. In my reply, I pointed out that there is a Parliamentary Secretary to the Minister for Local Government and Public Health, who devotes himself almost exclusively to public health and associated matters, and to whom have been delegated by an Order made by the Government certain powers, duties and functions of the Minister for Local Government and Public Health under the Public Health Acts, the Public Assistance Acts, the National Health Insurance Acts, and so on. I referred also to the fact that many of the public health services carried out by local authorities, and supervised by the Department of Local Government and Public Health, are closely interlinked with questions of general local administration, and that it would be a matter of considerable practical difficulty to separate them completely. I said, however, that the Government considered that the new arrangements made in 1944 should at any rate be given a full trial before any further action was contemplated.
Those arrangements have now been in existence for almost two years and, on the whole, the experience which has been gained suggests that a separate Department of Public Health will have to be established at no very distant date. It has become clear that the needs of the community demand a reorganisation and an extension of the existing medical services. This and the administration of public health and medical services when they have been more fully developed will probably require the whole-time attention of a member of the Government, assisted by the staff and organisation of a Department of State. It would not, I think, be practicable to assign to such a Department, in addition, the functions and duties which relate to the administration of the income maintenance services. In other words, I think it will be necessary to have a separate Department of Public Health.
Now, with regard to the income maintenance services themselves, the question of unifying and co-ordinating their administration has also for a considerable time been engaging the attention of the Government. Deputy McGilligan, in his speech on this motion, indicated that in his view a case for unification and co-ordination could be based on the ground that money would be saved by cutting out over-lapping and waste and extra expense and that with such saving the money available would, to quote his own words, "eventually reach in a more liberal way the beneficiaries under these schemes than it does at the moment". I do not agree with the Deputy that the case could be made on this basis.
In reply to a question by Deputy Norton on the 17th February, 1944, I said that as a result of an investigation which had been made in some detail the general conclusion would seem to be that the present system of administration of the social services is efficient and economical. I pointed out that the services are already co-ordinated in the sense that each of them makes full use of any of the machinery of the other services that is suitable for its purposes and that there is no evidence of over-lapping or duplication. I made it clear that the Government had taken no decision adverse to the setting up of a Department of social services, but that we were at that time of opinion that there was no urgent need for any closer investigation of the matter.
It is now nearly two years since I made these statements. Recently the whole matter of the administration of the income maintenance services has been closely examined by the Departments concerned and the results of their examination have been considered by the Government. The conclusion reached is that a new Department should be established under a separate Minister to administer these services. This conclusion, however, is not based on the ground that any saving in expense will be effected. In fact, the Government is satisfied that a very high degree of co-ordination already exists between the various Departments administering these services and it is quite certain that any saving in expenses which might be effected by placing all the services under the control of a single Minister would not be sufficient to provide for even the smallest increase in benefits.
The real basis for the decision that a new Department should be established to administer the income maintenance services is that if future developments of social services of this character are to be envisaged and adequately planned, supervised and co-ordinated, the Government should have at its disposal the specialist advice of a Minister and a Department established for that purpose. Such a Minister, with his Department, would be a centre of informed opinion, abreast of modern trends and capable of formulating a policy which will maintain a satisfactory balance between modern developments and our own domestic problems, needs and resources. The task of examining the existing services, co-ordinating them and removing any anomalies that may exist would be one to which the new Minister would naturally devote his earliest attention.
I would not like it to be thought, however, that in deciding on this step the Government take it as a matter of course that a considerable extension of the existing social services is practicable. I myself and other members of the Government have frequently pointed out that social services involve expenditure, and often substantial expenditure, from the public funds raised by taxation and that the extent to which we can develop them must accordingly be related not only to the needs of the community but also to our resources; that is to say, the productivity of our industry, the amount of employment which can be provided, the state of our trade and other such factors.
The scope of our social services must be determined by our own domestic circumstances. We could not, for example, accept as a principle of our policy the automatic adoption of schemes deemed suitable by other countries whose needs and resources in no way correspond with our own. Broadly, it may be said that no further considerable expansion of the social services will be possible without an appreciable expansion of our national wealth. It is only by keeping these considerations clearly in mind that we can hope to apply effectively the principle contained in the provision of the Constitution in which the State "pledges itself to safeguard with especial care the economic interests of the weaker sections of the community, and, where necessary, to contribute to the support of the infirm, the widow, the orphan and the aged." In any future development of the social services we must take care also to avoid measures which would weaken individual initiative and responsibility, the foundation on which the social and economic welfare of the community must ultimately rest.
Deputy McGilligan also appeared to take the line that social insurance should be removed as far as possible from a Government Department. His arguments in favour of this were, apparently, that Departmental schemes were administered harshly and unsympathetically and that the administration of a scheme of social insurance or security by a Government Department would involve undue interference with the rights of the individual and of the family. There is no evidence, of course, that social insurance schemes would be administered more sympathetically by independent bodies than by Government Departments—that is, if these bodies had any responsibility for getting the money—and, in any case, the ordinary individual has a much more effective means of calling attention to and remedying his grievances against a scheme administered under the control of a Minister responsible to Parliament than he would have in the case of a scheme administered by a body without any responsibility to a Minister or any public authority.
I have given to the House the position as it stands. Summing up, it may be said to be this, that, having separated, to a large extent, the administration of public health from the other functions and duties of the Minister for Local Government, and having tested it out, we think that the time has come—very soon in any case— when we can establish a separate Department of Public Health with a Minister in charge. With regard to the income maintenance services, we must also set up a Department, and the reason for setting up that Department is not in the hope that any greater amount of co-ordination between the existing services will be got, or any great economies effected, but that in view of the general movement in the world to-day, it would be desirable that the Government should have one Minister who would be constantly looking at these problems and getting the necessary information upon them, so that we would be able to get some view presented to the Government by a member of the Government who would be a specialist, and who would have special information on the whole subject. To a certain extent that will meet the views of members of the House. I must say for myself that I have been very slow about acceding to the demand to establish new Ministries.
Are we to take it that the Taoiseach is replying on behalf of Deputy Everett?
No. I take it that all these things have been addressed to the Government, and I am trying to indicate to the House what the Government's view is.
I must put the question before 9 o'clock.
I take it the proposer of the motion will be given time to reply.
There is not much time left now.
With all Parties in the House so interested in the subject, naturally there was very little time allowed for the Taoiseach to give the Government's view. His statement was rather disappointing to me, although he pointed out that the Government are interested in the matter of benefits for poor people. That was their pledge, and I want it put into operation. If the motion has done nothing else, it has convinced the Government as to the necessity for doing something in this direction.
I must put this motion now.
Is it not in order to suggest that an extension of time might be given to the Taoiseach to conclude his remarks and to the Deputy to reply?
I am afraid it is too late, Deputy, unless the House agrees not to have a division. There can be no division after 9 o'clock, and I have to put the question before 9 o'clock on that account.
Has the Deputy not got the right to reply to the Taoiseach?
Motion put.
The Dáil divided: Tá, 36; Níl, 50.
Tá
- Beirne, John.
- Bennett, George C.
- Blowick, Joseph
- Cafferky, Dominick.
- Coburn, James.
- Cogan, Patrick
- Commons, Bernard.
- Coogan, Eamonn
- Corish, Brendan.
- Cosgrave, Liam.
- Costello, John A.
- Davin, William
- Mulcahy, Richard.
- Murphy, Timothy J.
- Norton, William.
- O'Donnell, William F.
- O'Driscoll, Patrick F.
- O'Higgins, Thomas F.
- Dockrell, Henry M.
- Dockrell, Maurice E.
- Donnellan, Michael.
- Everett, James.
- Finucane, Patrick.
- Flanagan, Oliver J.
- Giles, Patrick.
- Halliden, Patrick J.
- Hughes, James.
- Keyes, Michael.
- McFadden, Michael Og.
- McMenamin, Daniel.
- O'Leary, John.
- O'Sullivan, Martin.
- Pattison, James P.
- Redmond, Bridget M.
- Reidy, James.
- Spring, Daniel.
Níl
- Aiken, Frank.
- Bartley, Gerald.
- Beegan, Patrick.
- Boland, Gerald.
- Bourke, Dan.
- Brady, Brian.
- Breathnach, Cormac.
- Brennan, Martin.
- Brennan, Thomas.
- Briscoe, Robert.
- Buckley, Seán.
- Burke, Patrick (Co. Dublin).
- Butler, Bernard.
- Carter, Thomas
- Colbert, Michael.
- Corry, Martin J.
- Crowley, Honor Mary.
- Derrig, Thomas.
- De Valera, Eamon.
- Fogarty, Andrew.
- Furlong, Walter.
- Gorry, Patrick J.
- Harris, Thomas.
- Hilliard, Michael.
- Humphreys, Francis.
- Kilroy, James.
- Kissane, Eamon.
- Lemass, Seán F.
- Loughman, Frank.
- Lydon, Michael F.
- Lynch, James B.
- McCann, John
- McCarthy, Seán.
- McEllistrim, Thomas.
- O'Connor, John S.
- O'Grady, Seán.
- O'Loghlen, Peter J.
- O'Reilly, Matthew.
- O'Rourke, Daniel.
- O'Sullivan, Ted.
- Rice, Bridget M.
- Ryan, Robert.
- Shanahan, Patrick.
- Sheridan, Michael
- Smith, Patrick.
- Traynor, Oscar.
- Ua Donnchadha, Dómhnall.
- Walsh, Laurence.
- Walsh, Richard.
- Ward, Conn.
Tellers:—Tá, Deputies Everett and Spring; Níl, Deputies Kissane and McCann.
Motion declared negatived.
The Dáil adjourned at 9.10 p.m. until 3 p.m. on Thursday, January 31st.