Vol. 100 No. 1
I move:—
That it is expedient to authorise such payments out of moneys provided by the Oireachtas as are necessary to give effect to any Act of the present Session to make further and better provision in relation to the health of the people, to amend and extend the Public Health Acts, 1878 to 1931, and to provide for the making of regulations by virtue of which certain charges may be imposed.
There is on the paper an amendment by Deputy Dillon with which perhaps I had better deal now. It is not in order and I want to explain in case it might be of some importance on other occasions. There is no provision in the procedure of the Dáil for an amendment of this kind to a motion for a Money Resolution. Standing Orders provide specifically for this form of reasoned or procrastinating amendment in regard to proposed legislation only on the Second Reading of Bills. The Chair holds, and must hold, that the specific provision referred to exhausts the opportunities for such a proposal. The Chair furthermore in regard to the drafting of motions for Money Resolutions must have advertence to their sole function, namely, the authorisation of expenditure. Such motions should be drawn in stereotyped form and should not contain, either as originally moved or by way of amendment, arguments or other considerations.
There are a few other points to which it might not be amiss to draw attention. The habit has grown up of treating a Money Resolution as an opportunity of repeating the Second Stage debate. The purpose of a Money Resolution in the Dáil's legislative procedure is to enable the Exchequer expenses involved in a Bill's proposals to be considered, apart from the proposals themselves, under financial procedure conditions. The debate on a Money Resolution, therefore, should not be a repeat of the debate on the main principles which are decided on the Second Stage, nor an anticipation of the details which come out in Committee. It is difficult to define what exactly is in order on a Money Resolution, but I think the House would agree that a repeat of the Second Stage debate or an anticipation of the Committee Stage is scarcely in order.
Has the Money Resolution been moved?
Yes.
Has it been spoken to?
I understand that the Money Resolution has been moved, but that nothing has been said about it. We are all anxious that something should be said about it from the Government side.
Is it not unusual to make a speech on a Money Resolution?
As we are in Committee, perhaps the Parliamentary Secretary would begin to think about the things which might be said on the Money Resolution to this Bill. I agree that it may be difficult to define what can be said on a Money Resolution, but what ought to be said are those things which would give the House an idea of what money will have to come out of the pockets of the people as a result of the passing of this measure which we are now about to discuss in Committee. I should like to ask the Parliamentary Secretary whether he can give us any idea as to the amount of money which it is likely will have to be raised by rates or taxes as a result of the passing of this measure —for its administration or for the carrying on of the services which will be required if the Bill is passed into law. As I understand it, from the nature of the measure, it is possible that the greatest burden of taxation in relation to this measure will fall on the people through the medium of rates, and you, Sir, might possibly argue——
It is not our concern.
It certainly is the concern of this House.
Strictly, we are limited to the demands on the Exchequer. However, some of the burden may fall on the ratepayers.
A shocking burden will fall on the ratepayers.
That will come up on the sections—Section 75.
It begins earlier than that. I begin at Section 13.
That would relate to the Financial Resolution and not the Money Resolution.
A position has gradually grown up in which a very substantial part of the cost of Government is, through legislation passed here, being shifted over from the taxpayer as such to the ratepayer as such, who is largely the same person, but there is a tendency to forget the ratepayer while arguing here about the interests of the taxpayer. I should like to give three or four figures to indicate the position which has grown up in relation to the ratepayer. In the year ended March, 1927, before the Government Party came into the Oireachtas, the total amount of money raised by rates in rural districts was £3,286,000. That has fallen, by March, 1932, to £2,445,000 and had risen by March, 1943, to £4,302,000. The total amount of rates collected from the ratepayers of both rural and urban areas in the year ended March, 1927, was £5,223,000. That was the amount collected in the year before the Government Party came into the Oireachtas. In the year ended March, 1932—the year before they came into Government—that amount had fallen to £4,677,000 and for the year ended March, 1943—the last year for which figures are available in the Report of the Department of Local Government —the rates collected went up to £7,814,000. It is because that amount was collected in the year ended March, 1943, that we are so concerned to know now, before we enter on the discussion of this measure, what effect the passing of it into law will have on the rural and urban ratepayer.
The Deputy might remember that on this Resolution we are concerned only with the charge on the Exchequer for the administration of this Bill.
I am putting that to the Parliamentary Secretary.
The Deputy will have opportunities on several sections, as he has himself said, of putting that question—sections in respect of which increases of rates will arise.
If the Parliamentary Secretary has this information, I would appeal to you not to discourage him from giving it to us at this stage.
I should be inclined to discourage him because we are in Committee and it might lead to several other speakers following him on lines not relevant to this motion.
It is ridiculous that the House should enter on the Committee discussion of this measure and that we should pass something called a Money Resolution, without knowing in round figures what the Bill will cost the ratepayer and the taxpayer, as well as what it will cost in respect of additions to the Minister's Department to assist in administering it. I suggest that the cost of these additions may be very small compared with the total cost, and, in the light of the figures I have quoted, showing that increases of rates arise from the fact that we are passing legislation here and shoving over the cost of it on to the people as rates, we ought, in relation to this measure which is an outstanding example of how this House is passing burdens over to the ratepayers, to have an answer to the question I put. In addition, we should get some idea from the Parliamentary Secretary as to how it is going to affect the taxpayer, both in putting the Bill into operation and in administering it.
While I would not like to press the Parliamentary Secretary for any detailed information in regard to the cost of this Bill, I think it would be very helpful to the House, in dealing with the various sections, if he were to give us an approximate estimate of the cost, first to the National Exchequer, and secondly to the local authorities. Such an approximate estimate would help us in considering whether we should accept or reject certain sections.
I would like the Minister to say how much of the proposed charges would be devoted to the nursing service, and if he could estimate how many nurses he intends to employ under this Bill. Last year, on the Tuberculosis (Establishment of Sanatoria) Bill, the question arose concerning deficits of the voluntary hospitals. On that occasion, the Parliamentary Secretary said that when the voluntary hospitals treated patients from the country, the local authorities concerned paid the cost of upkeep and maintenance of those patients. As I understand the position in Dublin, the amount paid by the local authorities does not meet the full cost of the patients, and the balance has to be met either from Hospitals Trust funds or from any voluntary subscriptions that may be available. I wonder if the Parliamentary Secretary can say, in view of the imposition he is requesting the Dublin Corporation to put on the rates, 1/- in the £ to deal with public health matters, what the future imposition is likely to be under the provisions of this Bill.
Also, perhaps he could say whether that will increase substantially, and, if so, whether in the case of patients sent to Dublin by local authorities throughout the country for specified treatment or for particular operations, the full cost of those patients will be discharged by the local authorities; or whether portion of that cost will be borne by the ratepayers of Dublin. As far as I can see, Dublin is at the moment a haven of rest, not alone for many people from rural Ireland, but for a number of aliens also. The increased burden on the ratepayers of Dublin, due to the maintenance of some of those people in hospitals, is bound to be very considerable. They will have already an advance instalment of 1/- in the £, which it is proposed to put on the rates for the coming year. If many sections of this Bill are enacted, that burden will be increased considerably. It is desirable that the Parliamentary Secretary should say, approximately, at any rate, what the future cost of public health is likely to be, if the provisions of this Bill are enacted as they stand at the moment.
I also would like to hear from the Parliamentary Secretary as to whether there is any intention to interfere with voluntary nursing services under the administration about to be set up in this Public Health Bill.
Will that arise on the Money Resolution?
It arises here, as, if the voluntary services are to be taken over, it will impose an increased charge on local rates. Throughout this Bill we have powers being handed to the Minister to order such institutions and services to be imposed on local authorities, and that, undoubtedly, will lead to a charge on the rates. There is some anxiety in various parts of the country where voluntary nursing has been established as to the future of these services. They are at present conducted on a voluntary basis, as the organisation finds about three-quarters of the expenditure and public funds find a quarter. If these services are to be taken over, that 75 per cent. will fall on the local rates. It might help to allay a certain amount of anxiety throughout the country if the Parliamentary Secretary would clear the public mind, in relation to this public service, as to the Ministerial intention. Is it proposed to absorb them, now or in the near or distant future, into local government services proper, or is it intended to let them function, as at present, as voluntary services?
Another matter which indirectly arises here is the extra duties which will be imposed on dispensary medical officers who will become, by virtue of this Bill, district public health officers. These officers will, as far as I can see, have a multitude of new duties to perform and I want to ask the Parliamentary Secretary whether it is intended that these duties would be performed within the salary and emoluments they are at present receiving, or whether it is intended to give them extra remuneration for the purpose of any extra duties which may be imposed on them under this Bill.
Finally, I want to support the plea put forward by Deputy Mulcahy and previous speakers, that we should have some indication from the Parliamentary Secretary of the total cost to the community of these new services. We would like to know the cost to central taxation and some indication of the likely increase in local taxation. There are indications that the Ministerial policy henceforth will be to divert as much as possible from central taxation on to local authorities. Indications of that development are already there this year in many counties. It is particularly noticeable in the case of the Dublin Corporation. Is it intended that that tendency will develop and that rates will be allowed to grow to any extent, just because the Department or the Government may see fit to impose that charge on the local community?
Quite recently, on the 6th of this month, we had an article in the Government organ, more or less pooh-poohing the idea that there should be any increase in rates and saying that the only persons who complained of increases were what the leader described as substantial ratepayers. It is not the substantial ratepayers who will have to find the money for this Bill, but the local middleman, who finds himself ground between the upper and nether millstones, the man of fixed income, who finds it hard to carry on if he has to pay an extra £5 or £10 every year. An extra jump of £10 may seem nothing to the Minister, but to the middleman it is a big thing when it has to be paid. There is every reason to believe that the Minister intends to throw all the cost of the extra public health services on to local rates, without any idea being given to this House as to the ultimate limit. In the case of our own local authority in Dún Laoghaire, we will eventually have to find a rate of not less than 30/- in the £, and I would say we will have to find that sum within the next five years, if not sooner. Our rates are up by 2/- in the £ this year, without taking into consideration the charges that this Bill may impose upon us. In our case, I have no doubt if a charge such as has been imposed on Dublin is made on us, it will ultimately mean another 1/- to 2/- in the £. We are entitled to know what is the ultimate limit of expenditure likely to be imposed on the local rates and the ultimate limit likely to be found from central taxation.
I should like, with the last speaker, to know if we could get even an estimate of the cost of the legislation which we are now being asked to pass in connection with public health. I think the House ought to keep in mind that we have been told that this is merely the first of a series of Bills that will be introduced, dealing with public health. I think the least the House is entitled to be told, and the country to know, is what this is going to cost. Surely, this legislation has not been embarked upon by the Department of Local Government without some effort being made to arrive even at an approximate estimate of the cost? There is a general sort of—if I may use the word—looseness in connection with this whole question of public health, and the statements made by various Ministers and Parliamentary Secretaries are so conflicting that, far from giving us any enlightenment, they merely serve to confuse not only members of the House, but people through the country.
I should like to know to what extent the costs arising under this Bill are tied up in the £24,000,000 for public health and public assistance institutions, about which the Parliamentary Secretary has already told us. I understood it was £14,000,000 for public health and £10,000,000 for public assistance hospitals or institutions, or whatever they are called. In any case, is the cost of this measure, both to the central authority and the local authorities, covered in the £24,000,000? If it is, then we ought to be told what proportion of the £24,000,000 will go towards putting into operation what is set out in this Bill. I may say that £24,000,000 is, for this State, an immense sum; it is equivalent to £8 per head of the population. When we are informed that the measure which we are now about to discuss in Committee is only an instalment of the measures which are to be introduced at a later stage, or at later stages, to deal with public health, then it is essential —I think it is absolutely an obligation on the Parliamentary Secretary—that he should be able to tell the House how much money he requires.
The motion before us merely asks the House to give a completely blank cheque to the Department of Local Government. I do not know whether it has been referred to by previous speakers on this motion, but, if it has not, I should like to remind Deputies that the Most Rev. Dr. Dignan's scheme was condemned immediately, and the only real objection to his scheme was that he had given no indication of the cost, that he had not gone to the trouble to ascertain the cost and, therefore, in the words of the Minister, it was an ill-considered scheme. Can we apply the same test to this Bill? I want to be satisfied, first, about the amount of money we are being asked to vote and, second, that we will get value for the amount we are asked to vote. Frankly, I do not believe we are going to get value for it, because I believe we are beginning at the wrong end. There is no money being spent to prevent disease, to prevent sickness, to sustain and maintain public health. This money which we are being asked to vote is to cure a situation, or to cure the result of a situation, that we are not facing up to or trying to deal with. Unless we face up to what is causing disease, causing sickness in this country, all the money—even the £24,000,000 —that we may spend on the curing of it, will not give us the results that we should get.
However, I do not want to develop that angle. We are embarking on a completely new code of legislation to deal with public health. We are going to great extremes if this Bill becomes law in its present form. We have been asked to vote money to enable the central and local authorities, and the officials of the central and local authorities, to do things which it is very doubtful they should be allowed to do. I should like to hear from the Parliamentary Secretary a statement as to the amount he wants voted by the House under this motion. I do not think the House will be satisfied if he refuses or says he is unwilling or unable to give that information. We must assume that the figure already given by the Parliamentary Secretary, namely, £24,000,000, was given publicity only after it had been carefully and fully considered. I take it that is the total sum to meet all the activities contemplated under the public health system or in relation to any legislation which may be passed, and that total was arrived at, I presume, after totting up the cost of the various branches of that public health activity. Therefore, the Parliamentary Secretary must have at his disposal what it will cost to put the machinery of this Bill into operation. At any time that is an essential requirement.
I think the fact is that a very substantial portion of what we must only guess at as being a very large sum will be put on top of the local authorities, and the local authorities will have no say as to whether the obligation put on them is going to result in an increase of one penny, one shilling, or one pound in the rates. That is a matter which will be determined without any reference whatever to the local authority, or without the local authority having any power to say whether the sum is reasonable or extravagant. I do not think in putting these points, and in asking for this information, this House is asking for too much. It is merely asking for what it is in duty bound to ask, so that it may know what this particular legislation is going to cost the community. I do not think the House would be justified in giving a blank cheque to the Parliamentary Secretary or to any Minister or Department. I do not think any Minister or Parliamentary Secretary would be doing his duty if he came before this House, asking for legislation, and asking for money to implement that legislation, if he was unable or unwilling to give the House the information it required.
Reference has been made to this code of public health but, as far as I am concerned, I am very much in the dark as to what it is going to do. Although figures have been mentioned, it seems that what we have to do is to relate the motion we are discussing to the Bill, when it is passed. We have to regard any expenditure of money that we are called upon to make in connection with the administration of the Bill, in relation to what it is proposed to achieve under the Public Health Bill. I do not want to trespass on the proposals in the Public Health Bill which, I think, is going to have a very limited scope as far as it affects public health, but, in fairness to those who may anticipate such a discussion, the Parliamentary Secretary should, in the first place, give some indication, say, in round figures, of what it is proposed the Central Fund shall contribute on administration. In view of the powers taken by the Minister, these administrative powers will largely determine the extent to which the Bill will be given effect. Secondly, he might say the amount which the Exchequer will contribute toward carrying out the provisions of the Bill; and, thirdly, he might give some general indication of the additional burden that is going to be placed on local authorities. Unless we have some general financial knowledge in these respects, it would be very difficult for Deputies to treat impartially the provisions of the Bill that will have to be discussed on the Committee Stage. We have to relate what we are going to ensure for the public, in the way of improving health, to the amount of money we have to spend on administration, as well as to the amount we are prepared to contribute and what we will require local authorities to contribute when deciding the future of this public health code. While I generally support the principle of the Bill, although I recognise its limitations, I feel that, to a large extent, its success will be measured by what the Parliamentary Secretary will tell us concerning the amount of money that will be spent on its administration and the amount that will have to be contributed by local authorities to give it effect.
It is scarcely possible to comply with the wishes of Deputies who have spoken on this motion and, at the same time, to obey the ruling of the Chair. The Ceann Comhairle has ruled that it would not be in order to discuss on this motion items of expenditure that may arise under various sections of the Bill, other than the administrative expenses contemplated within the terms of the motion. In so far as I have any information or figures at my disposal, I have no reluctance at all to tell the House what the indications are, subject to the Leas-Cheann Comhairle being more lenient than the Ceann Comhairle while he was in the Chair. Deputies will appreciate that any figures that we can discuss, arising out of the services contemplated in this Bill, when it becomes an Act, must be mere estimates. The biggest item of expenditure under this Bill when it becomes law—if it will ever become law—will, of course, arise under the section that will provide the necessary machinery to establish the mother and child service to which I referred on Second Reading. It is scarcely necessary at this stage to deal with that service in any great detail. Speaking in general terms, it is proposed that a full medical service will be provided for expectant and nursing mothers and for children up to 16 years of age. As to the extent to which that service will be availed of, and as to the increased financial burden that will arise under the heading of medicines, appliances, institutional accommodation, dental treatment and ophthalmic treatment it is just impossible to put a firm figure before the House.
As I mentioned already, it is proposed to provide a domiciliary nursing service, to appoint in each dispensary district a general trained nurse, who will devote the whole of her time to assisting in school medical inspection work, and domiciliary service, arising out of the mother and child scheme. There will be, approximately, 750 districts. It is proposed to have a whole-time maternity nurse in each district. We have, for all practical purposes, the necessary personnel of the maternity service, but they are part-time. If, as is proposed when this Bill becomes law, we provide a full mother and child service, it is clear that we will require the whole-time services of a maternity nurse. From the examination I have given the matter, with the assistance of my technical staff, I think it would be safe to assume that the mother and child service will cost in the neighbourhood of from £500,000 to £600,000 per annum. While I mention that figure, as I already explained to the House, circumstances that obtain and operate make it utterly impossible to put a firm figure before the House, but I think it will be in the order of the figure I mentioned.
I think it was Deputy Coogan who mentioned the question of salaries of dispensary medical officers arising out of the increased duties that will be imposed upon them. There is not any doubt that very serious additions to the duties of dispensary medical officers will arise under this Bill, at least, under the policy behind it, and it must be assumed that a reasonable increase in the remuneration of dispensary medical officers will have to be given. On that matter discussions will naturally take place between representatives of the dispensary medical officers and representatives of the Ministry. I have no doubt that the medical profession will be found reasonable in this matter and I hope that the medical profession will find the Ministry adopting a reasonable attitude also.
Has the Parliamentary Secretary made an unfirm estimate of the amount that that might cost?
I could not really.
Not even an unfirm estimate?
I should not like to give an unfirm estimate.
That is just a promise?
Well, call it a promise or a gesture—an indication, anyhow, of an appreciation of the fact that some considerable increase in the salaries of dispensary doctors may be anticipated. While I am engaged in the purely financial aspect of this discussion I might direct the attention of the House to the important fact—I mentioned it in the concluding statement on the Second Reading, if Deputies have not forgotten everything I said on that occasion—that the State will bear 50 per cent. of the cost of the mother-and-child scheme. Therefore, it may be assumed that, if the all-in cost of the mother-and-child scheme is £500,000, £250,000 of that amount will come out of the Exchequer. Deputy Cosgrave talked about patients from the provinces not paying the full cost of their maintenance in the Dublin hospitals. I do not know how he can relate the Money Resolution to the Dublin hospitals. At any rate, I am not very particular on that point. It would be true to say that patients sent by local authorities for specialised treatment in the Dublin hospitals do not pay the full cost of maintenance or, it would be more accurate to say, the full cost of maintenance is not paid in respect of them. At the same time, I fail to understand how the patients from the provinces come to be a burden on the ratepayers of Dublin. I just have not been able to follow that line of reasoning, because the sum of £2 12s. 6d. per week is paid in respect of each patient from the provinces and in respect of the vast bulk of the patients from the City of Dublin there is nothing at all paid up to the present. However, that position will be remedied.
I take it that some of the proposed shilling in the £ will go to defray the charges of the patients from the country?
No, no. We are getting into deep water now, and I think it is very far from the motion before the House. At the present time the local authorities pay £2 12s. 6d. per week towards the maintenance of their patients in the voluntary hospitals in Dublin. The shilling in the £ will not raise a sum equivalent to £2 12s. 6d. in respect of each patient from the City of Dublin who is maintained in a city hospital. So long as the ratepayers of Dublin pay less towards the voluntary hospitals for the maintenance of their patients than the people from the provinces pay, I cannot see how it can be argued that the ratepayers of Dublin are paying anything towards the cost of maintenance of the patients from the provinces.
Is the debt not an inclusive one? Does not the hospital deficit include all rate-aided patients?
In so far as patients are being maintained at less than the cost of maintenance, in respect of every patient for whom the full cost is not being obtained, a certain element of deficit will arise but clearly a much bigger deficit will arise in respect of patients regarding whom nothing is paid than will arise in respect of patients regarding whom £2 12s. 6d. per week is paid. In fact, if £2 12s. 6d. per week were paid in respect of every patient maintained by the voluntary hospital, the deficit would be reduced to very small dimensions and would almost disappear.
Deputy Coogan mentioned the question of the voluntary nursing services, and asked would they be taken over. The voluntary nursing services that operate at the present time only touch on the fringe of our nursing problem. Deputies will appreciate that it will be many years before the necessary nursing personnel will be available to man the local authorities' services. If we require 700 general nurses for this mother-and-child service, clearly it will take quite a considerable time—a number of years, I am sure—to recruit the necessary staff. In that way it can, at any rate with absolute safety, be assumed that the present nursing services will all be required. Again expressing a personal opinion as to the ultimate position, it is this, that I believe that in many districts one nurse will not be sufficient. I believe that we will require the services of these voluntary organisations in addition to the local authorities' services. Experience alone will put us right on that. It is one of those things in regard to which one opinion may be very much as good as another until we get actual experience of the work. Clearly, the degree of poverty existing in an area will have a bearing upon it because in a very poor district, where not many people in the area will be economically in a position to pay for their own nursing services, the services of the public nurse will be very much in demand. On the other hand, in a district where the people are substantially better off and a considerable proportion of them are able to engage their own nursing services, there will be less demand for the public nurse. It is mainly, though not entirely, in the poorer areas and the congested districts that a voluntary organisation is required. So far as personnel is concerned, there can be no doubt that we will require all the nurses that will be available in this country for quite a number of years.
Deputy Morrissey complained that no money has been spent on the prevention of disease. I can only say in reply to that that the main purpose of the development of the mother-and-child services, beginning at the pre-natal service and following the child through infancy and right through the school-going period, is to prevent disease, to try to anticipate disease, to try, if disease does make its appearance, to get abreast of it in the earlier stages before it has done irreparable damage and before you are presented with a position in which medical science is not able to effect a cure afterwards. Deputy Morrissey probably has in mind something wider than that in the line of prevention. I am not going to be drawn into a discussion of that. Probably he has in mind the economic conditions and the other ancillary matters closely related to health. In this particular measure we have to confine ourselves as closely as possible to problems of health. I do not think I can give the House much further assistance in the matter of finances. These are the indications as clearly as I can put them before the House.
The Parliamentary Secretary confined his attention to the mother-and-child service in so far as it involves an increase in the nursing service and dispensary medical officers. Throughout the Bill there are other points implying a very considerable increase in expenditure, capital and otherwise. There is to be an increase in the number of institutions of various kinds throughout the country. The Minister is taking sweeping powers to see that additional institutions are set up. The Minister makes provision for the maintenance of families where infectious disease takes place. In neither of these respects has the Parliamentary Secretary given us any idea as to the burden which will fall either on the taxpayer or on the rates. I suggest that a comprehensive review of the expenditure likely to be incurred under this Bill is necessary.
I was not here when Deputy Morrissey made the remarks which drew the recent remarks from the Parliamentary Secretary. But, in accordance with the spirit of the Bill, which is to prevent the spread of disease and to try to secure that disease shall be reduced to as low a point as possible, I put down an amendment to Section II. Section II gives a kind of directive to the Minister, but says that all the pious directions given there shall only be exercised in so far as laws are passed to enable him to deal with these. In order to round out the picture, I put down amendment No. 25 to that section, which says that it shall be the duty of the Minister to take such steps as he considers necessary to do certain things conducive to the health of the people, that there will be added to what is in the section an additional paragraph that it will be the duty of the Minister to secure the preparation and effective carrying out of measures affecting housing, feeding and employment in such a way that diseases arising out of economic conditions will be avoided. There is no doubt that even in some official reports which we have had very serious circumstances have been disclosed in which a lack of employment and a lack of suitable housing are likely to be very great sources of disease.
Is the Deputy not anticipating the details of the proposals?
I am pointing out that because the Ceann Comhairle ruled out of order an amendment of mine to Section 11 on the lines I have mentioned on the ground that it would interfere with the responsibility of other Ministers——
Will that not come up on the section?
I will not be allowed to raise it on the section. Therefore, I think it is important that we should at least glance at the additional ground that has to be covered by the expenditure of money by local authorities and the Government if the health of the people is to be properly secured. So much has to be done from the point of view of providing employment on the one hand and housing on the other which will fall as a burden on the rates and taxes, we should have a full picture, including some kind of picture of the amount likely to be spent from a capital point of view on providing additional institutions and the normal annual expenditure in maintaining these institutions subsequently and in providing for the maintenance of families who, under Section 34, will have to be maintained by the local authority if infectious disease eats into their homes.
In Appendix 9 of the Report of the Inquiry into the Housing of the Working Classes in the City of Dublin figures are given with regard to a survey which the corporation carried out in 1938 in respect of 11,000 houses, housing 33,000 families, with a population of 130,000 persons. Taking at random 9,000 of these 33,000 families, they give particulars of the income of these families and what would be left for the payment of rent after mere subsistence had been provided for out of their wages. Appendix 23 shows that, having examined these 9,000 families taken at random, in 30 per cent. of them, after making allowance for 20/- for the subsistence of the first two members and certain allowances for the others, there was nothing left to pay rent or for any other thing that a person would add to the expenditure after subsistence. It shows that in the case of 7.4 per cent. they would only have 5/- per family left and, in the case of 8.6 per cent., they would only have 10/- left over the mere subsistence line.
I say that there is a problem in relation to housing, in relation to the incidence of disease, and, perhaps, the incidence of infectious disease that implies both capital costs for housing falling on the local authority and maintenance costs falling on them under Section 34. Therefore, I say that there are big problems involving the expenditure of money, both from rates and taxes, facing our people around the foundation of a public health policy in connection with homes and wages. We cannot shut our eyes to these when considering this measure. I think the Parliamentary Secretary has given us a very inadequate review of the headings under which the moneys are to be spent, if the measure is passed, and the total amount of money likely to be spent.
I can only express——
I am afraid we are getting away from the terms of this Money Resolution.
But I have not opened my mouth at all.
I am speaking of the general debate. I think it nearly time that the House came back to the Money Resolution, the sole function of which is the authorisation of expenditure. We cannot go into details.
I must have a disorderly name in this House.
You have the reputation, anyway.
It is apparently worse than I thought. I can assure you, Sir, that I have no intention at all of being out of order. I want to say that I can only express the keenest disappointment with the Parliamentary Secretary's statement. In effect, he gave us an approximate figure for one service with which it is proposed to deal in the Bill—a figure of £500,000, half of which will be met out of central funds and the other half placed on the local authorities. But there are other provisions in the Bill which may call for enormous expenditure of money, and enormous expenditure of money by local authorities. Let me take just one. I refer Deputies to sub-section (2) of Section 13.
The Deputy is now going into details.
I am not. If you will allow me to read this very short section——
It is a positive section in the Bill.
May I with all respect put this point? A Money Resolution is required to give effect to the sections and without the Money Resolution the sections would be of no use. That is why, before we can proceed to discuss this Bill in Committee, the Parliamentary Secretary has to get authority to spend the money to make the sections workable. All I am asking is that the Parliamentary Secretary will indicate to the House how much money he wants us to vote. I object to giving the Minister a blank cheque and I think the House has no right to give the Minister a blank cheque.
The Deputy said that before; he is repeating himself.
Let me quote sub-section (2) of Section 13:—
"A health authority shall provide and maintain any institution which the Minister, by Order, directs them to provide and maintain."
I ask Deputies, and particularly those who are members of local authorities, to look, before they vote for this Money Resolution, at the potential dangers of that sub-section. I want to know from the Parliamentary Secretary whether any estimate has been made by his Department as to the institutions which will have to be erected or enlarged when this Bill becomes law, and what the cost of these new buildings or enlargements of present buildings will be. That, I submit, with all respect, is perfectly relevant to the motion. The only person who is out of order in this whole matter is the Parliamentary Secretary, because he refuses to give the House the information which I think the House must get before it can pass this Resolution.
We know that, if this Bill becomes law in its present form and is put into operation, we shall require to double or treble our present institutions. It is a notorious fact that at the moment, without any of these coercive measures in operation, people who are not only willing but desperately anxious to go into institutions for treatment cannot get a bed. It is notorious that people suffering from tuberculosis are left in their own homes because there are no institutions into which they can go for treatment, and that, if they do succeed in getting into one of the existing institutions, the demand is so great that they can stay there for only a comparatively short time and are shifted out before there is time for any cure to become effective.
What estimate has been made by the Department—and this is the information which the Parliamentary Secretary ought to be able to give the House, if this Bill has been properly and fully considered and if it is based on proper and accurate information—of the number of additional institutions and beds which will have to be provided to meet the requirements of the Bill if it is put into operation and what they will cost? When we pass this Resolution, when this Bill becomes law and the oil for its machinery is provided by the passing of this Resolution, the Parliamentary Secretary may direct any local authority to provide as many institutions as he thinks are necessary and they must provide them forthwith, no matter what the cost and no matter what their own views may be.
This is a measure of far-reaching importance. I do not know—the Parliamentary Secretary may know—whether it will cost £2,000,000, £3,000,000, £4,000,000, £5,000,000 or £10,000,000 to implement it. Neither, I venture to suggest, does any other member, and I think we are entitled to know, when voting for this motion, whether we are voting for an expenditure of £1,000,000, £10,000,000 or £20,000,000. I am trying to argue—and I think I am arguing within the rules of order—that the House ought to get that information before agreeing to give the Parliamentary Secretary this Money Resolution. If we do not get that information, we can only conclude either that the Parliamentary Secretary is unwilling to give it or that this measure has been drafted and brought before the House without the Department, the Minister or the Parliamentary Secretary having the slightest idea of what it will cost the community.
This is a very important matter. Not only do we propose to impose financial obligations over which we shall have some control here so far as money from the Central Fund is concerned, but we propose to impose enormous financial obligations on local authorities who will have no voice whatever in the matter. It is we who are imposing these financial obligations on local authorities when we pass this Resolution, and this is the only place in which and the only time at which the matter can be questioned. I again appeal to members to insist on getting this information now, because now is the only time at which they can insist on getting it and now is the only time they will get the opportunity. If the Resolution is passed in its present form and without the giving of the information which we seek, we will oblige not only this Oireachtas but every local authority to put up whatever sum of money, without limit, the Department may decide is necessary to implement the legislation now before us.
Will the Parliamentary Secretary say what is likely to be the cost, in the first place, for capital purposes, and, in the second place, for additional maintenance purposes, and what is likely to be the cost under Section 34 and who will bear that cost?
Or has the cost been considered? Are we to assume that it has not? Does the Parliamentary Secretary refuse to give any further information on the matter, beyond what he has given in relation to one particular service? I should like to be clear on that. Are we to take it that the Parliamentary Secretary refuses to give the information as to what this Bill will cost? Now we know where we are.
I would like to make a protest against the Parliamentary Secretary treating the House in this way. Apparently, he proceeded in a reasonable kind of way to give a figure, as far as he could go, and no matter how we may be dissatisfied with his lack of information on the matter, we could understand his saying he knew very little about it. We could accept the limitations of the Parliamentary Secretary and his Department in respect of a matter he was putting before the House. However, in the light of the terms of Section 13, where health authorities "shall provide and maintain any institution which the Minister by Order directs them to provide and maintain", and particularly in the light of the statements he made to the Dublin Corporation recently, about the expenditure of £24,000,000 on additional hospitals and institutions and of £10,000,000 on public assistance and the subsequent information he gave us here that some of that would be put on the rates, some would be paid by the Government and some would come from the Hospitals Trust Funds, we would expect him to confirm some figure in relation to Section 13.
When we consider the information we have had regarding the incidence of infectious disease, some kind of an estimate might have been made as to the cost of Section 34. I quite agree that there is money needed to meet the type of payment contemplated under that section, that the number of cases of infectious disease which might have to be dealt with in hospitals may be very much greater in the future and that there may be a greater incidence of infectious disease, from the point of view of public knowledge, than there has been in the past. It is absolutely unreasonable for the Parliamentary Secretary to say that he has no information to give in respect of Sections 13 or 34, that he is not going to tell the House, even if he has that information. I submit to the Parliamentary Secretary that, in view of what is involved in this Bill, if he is going to meet the House in that spirit and is not going to give information, he is not serving the interests he suggests he is serving by the introduction of this Bill.
Before the question is put, may I ask the Parliamentary Secretary if the annual cost likely to fall on the Central Fund as a result of the passing of this Resolution is approximately a sum of £250,000, being 50 per cent. of the estimated cost of £500,000 or £600,000 on the mother and child service, and if that is the annual cost which the taxpayers, as distinct from the ratepayers, will have to meet, if this Bill is enacted in its present form?
I could not say that.
There are nine members of the Government Party in the House besides the Parliamentary Secretary and we are dealing with a measure supposed to be required to secure the foundations upon which our public health will be built up and to remedy ills that arise where our foundations are not strong enough to prevent those ills arising. I ask the members of the Government Party now present if they are going to assist us in discussing what is at issue in this Bill, both in regard to public health on the one hand and to central finance on the other hand. I think it is a matter which should be discussed in a reasonable way, with such facts as are available put in front of us, with such information as we, as representatives of the people, can obtain in relation to public health and public finance. Our discussions should take place with as full an exchange of information between us, as representatives of the people conscientiously trying to discharge our duties here. I appeal, therefore, to representatives of the Fianna Fáil Party present, other than the Parliamentary Secretary, and I ask them in what spirit we are to discuss this measure.
