I want to move an amendment on Section 19 if you will permit me, Sir.
National Health Insurance Bill, 1947—Fourth and Fifth Stages.
I think the Deputy has had a note from me on that question.
I had a note but I had not a definite decision. I made a statement yesterday to the effect that it is only inferentially that raising the ceiling from £400 to £500 would impose a charge on the Central Fund. It need not necessarily do that because the Minister can quite easily under the provisions of other sections of the Bill, and under the parent Acts, not grant any Exchequer subsidy in respect of the administration of the society for members who were insured above the £400 ceiling limit. Yesterday, we gave the Minister the Committee Stage of the Bill in order to facilitate him on the understanding that we would take the Report Stage to-day and recommit Section 19 of the Bill. I was hoping in order that the views of the House might be tested on this matter, because I think the Minister has an open mind, that you would permit me to move an amendment, the purpose of which is to substitute £500 for £400. I was hoping that you would permit me to do that so as to ascertain the feelings of the House and that the Minister might cooperate in ascertaining the real feelings of the House by permitting the matter to be decided by a free vote.
If the Minister says that the limit can be raised from £400 to £500 without a potential charge on the Exchequer, the amendment may be moved. If not, even accepting the statement that the purpose is to achieve unanimity on the amendment, I am afraid it could not be allowed. If the Deputy can show that it can be done without increasing the charge on the Exchequer, well and good.
That depends on what the Minister does subsequently.
The Minister may move it if he desires. If the Minister moves and if the House is agreeable, the amendment may be inserted but the section will have to be recommitted.
If the Minister does not make the point — and so far he has not made it — that the amendment would impose an additional charges, I think I am in order in moving the amendment.
If the Deputy can show that there is no potential charge.
I concede at once that the Minister may impose a charge on the Central Fund by making a charge for the administration expenses of these additional people but he need not necessarily do so.
Under what section?
For instances, under Section 17, he may decide to make no allocation in respect of those in receipt of salaries over £400. The raising of the ceiling over £400 does not positively impose a charge.
The Deputy seems to have a case. It is possible that under Section 17 there would be no charge imposed.
I agree that legally I need not impose a charge.
That being so, and as the Deputy had not time to put in an amendment yesterday I shall permit him to move it now.
The Dáil went into Committee to consider Section 19.
I move: —
In sub-section (1), line 37, to delete the words "four hundred pounds" and substitute the words "five hundred pounds".
The attitude of the whole House is that they want to facilitate the Minister in getting this Bill through. I do not think it necessary to go over all the ground I travelled yesterday. The sole purpose of my amendment is to provide some cover for the widows and orphans of men who, if this Bill be passed in its present form, will not be covered for widows' and orphans' pension purposes where the remuneration of such men exceeds £400 per year. Everybody knows that that class of person is not able to make provision for his wife and children in the event of his death to insulate them against the inevitable poverty consequent on the death of a bread-winner in such circumstances. I, and many other Deputies I am sure, have had experience of persons in that category. On their death it is found that they made no adequate provision for their widows or children with the result that the unfortunate widows and children have to go from one charitable organisation to another trying to get whatever assistance they can, feeling ashamed at having to do it, and not being in any sense specially or technically qualified for the difficult task of getting assistance from such organisations. I have seen women and children endeavouring, in almost indescribable ways, to get a pittance to keep them out of the work-house.
In all these cases, failure to make provision for the widow and children is due to the fact that the family income is inadequate to make any real and effective provision for the widows and children in such circumstances. I want to try to assure that provision is made for such adversity and that some cover is provided for widows and children of persons who have over £400 per year and up to £500. Personally I should like to see the limit extended beyond £500 but that is not the purpose of my amendment to-day. I would be satisfied if the Minister would raise the ceiling from £400 to £500 so as to provide cover for the widows and children of deceased persons who are unable to make any provision for their wives and children, in the event of their death.
The whole arrangement is on an actuarial basis. It has an insurance foundation. In this case, the State can provide, because of the whole structure of the Widows' and Orphans' Pensions Acts, a better class of cover than can be provided by outside private companies, and when we have the opportunity to-day of providing cover for the widows and children of men with over £400 per year without inflicting any burden on the State, surely we ought not to neglect that opportunity. I venture to say that whatever might be the viewpoint of the male members who would be compulsorily insurable under the National Health Insurance Acts, if this amendment is carried, if the widows and children are consulted, they will regard cover of this kind for widows' and orphans' pension purposes as very valuable.
I want by this amendment to extend the cover to those with up to £500 per year, so as to mitigate the number of cases in which men die without making provision for their widows and children and consequently throw their unfortunate dependents on the generosity of charitable organisations or of such friends as are capable of providing them with temporary assistance. I am sure that, in his heart, the Minister must be in favour of the amendment and I urge him to accept it. If he is prepared to do so, I urge him to leave the question at issue, which is not a Party issue but a purely humanitarian issue, to a free vote of his own Party.
I stated yesterday that it was a question which could be argued from both points of view and that nobody could call it a political question. It is a matter for the judgment of individual members of the House and therefore I said that I was not going to make it a Party issue, but would leave it to the Dáil to decide. I have heard only Deputy Norton in favour of the amendment. I do not know whether the other Parties are taking, as it were, a neutral attitude, but if there is no opposition, I am prepared to agree to the amendment.
I expressed an opinion yesterday and the Minister can take it that it was entirely a personal opinion. What has transpired here to-day does not suggest to me that I ought to change that opinion. I say that, in an unconsidered way, the Dáil ought not to raise the limit from £400 to £500 and thereby, without serious consideration, bring 15,000 additional people into the national health insurance scheme which is passing because of its inadequacy and general unsatisfactory nature. I understand that the Minister is not quite clear as to how many people will be brought in.
The number of 15,000 is an estimate.
When the Minister is on the eve of bringing in a comprehensive scheme, I feel that an additional number of people, 15,000 or more, ought not to be brought into a scheme which, as I say, is unsatisfactory and which is just being patched up now by the addition of a few shillings for each class of beneficiary. Deputy Norton indicates, and it is implied in the amendment, that this need not necessarily put an additional burden on the State. He is, therefore, asking a machinery, which is not too satisfactory at present, a machinery which has been declared, in respect of its lower branches, at any rate, to be less well paid than the lowest classes in the Civil Service, to deal with 15,000 new cases. I cannot conceive that the Minister can leave the wages or salaries position of the workers of the national health insurance society at their present level——
That is outside this amendment.
We are invited to accept this amendment on the ground that it does not necessarily impose, for administrative purposes, any additional cost on the State, that is, that the present underpaid staff is to be asked, until the comprehensive scheme comes in, to do additional work on its present sub-normal standard of payment. I take it that the widows' and orphans' question of which Deputy Norton speaks will, adequately or in a reasonable way, be dealt with under the Minister's new scheme, and all the pressure that can possibly be piled up outside the scheme ought to be left there to force quick conclusions and consideration on the part of the Government with regard to that comprehensive scheme.
I think this proposal contains a possible element of unfairness to 15,000 people rather than the element of conferring a benefit on any of them and it is my personal opinion that we would act wrongly if we brought in the additional people now.
I take it that, before putting his proposals before the House, the Minister and his officials and the authorities of the National Health Insurance Society went carefully and fully into the whole matter and, after mature consideration of every aspect, selected £400 as the ceiling. I have heard no argument and no substantial expression of opinion which might be a substitute for argument for the case put up, but, in speaking in this way, I am stating entirely my own opinion, and I do not intend or wish to bind any other person in the House. I think, however, that the House would make a mistake if it brought in these additional people at this stage. They should be left outside, without the imposition which this Bill will impose on them, to utilise the pressure they can bring to bear, if they want a comprehensive scheme to deal with their widows and orphans, on the Government to speed up their consideration and their proposals in the matter.
I have pleasure in supporting Deputy Norton's proposal and I appeal to the Minister to accept it. Recently, in my constituency, there were two cases in which widows and orphans were left in the position to which the Deputy has referred. We should not defer or postpone doing justice to these people because a number of officials in the National Health Insurance Society seem to be badly paid. If the logic of that argument is applied right through, the Bill should not go through in its present form until their grievances are rectified. I earnestly appeal to the Minister to come to the help of people such as those referred to by Deputy Norton.
I am in agreement with the principle of the amendment, but I do not agree that this is the time at which, or the way in which, it should be done. This is either a national health insurance scheme or it is not. We have been arguing here and outside — some of us, for years — that the scale of benefits even for a man on £2 per week, is hopelessly inadequate. We now get some little increase up to 22/6 per week. I want to suggest that if you bring in people—and this applies to a certain extent to the proposal in the Bill—you are bringing them in without notice — this Bill is going through the House in record time— and compelling 15,000 people and their employers to contribute to an insurance scheme. There is no use in giving people who live and have responsibilities up to the £500 per year mark 22/6 when they are knocked out.
I should like to see this but I should like it to be in a comprehensive scheme. I know, of course, that the National Health Insurance Society is in favour of this amendment. I do not know whether the Minister is in favour of it or not. This would be a help from an actuarial or financial point of view to the society because you are bringing in a class of people now who cannot afford to be in. I would say that the percentage of the additional 15,000 who claim benefit will be far smaller than the percentage of the ordinary members. We are trying to deal with this as if it were a permanent comprehensive measure. It is not. Deputy Norton said yesterday, and very rightly, that it was not a scheme that could be regarded as insurance or that could be helpful so far as the health of the nation or the members is concerned.
I should like Deputies to get it into their minds that when this scheme was originally initiated the scale of benefit was equal to the weekly wage paid at that time to the vast majority of the members of the association. The vast majority of the members of the association in those days were unskilled labourers and domestic servants and the rates of benefit fixed by the British Government at that time were equivalent to their wages and in some cases were in excess of their wages. One of the reasons, if not the main reason, why local insurance societies, before the unification, gave additional benefits in kind rather than in cash was that if at that time they increased the statutory cash benefit it would have equalled and, in some cases, would have exceeded the full wages which would be paid to many of the members. The committees of the societies, which were made up of the members and local people who had a knowledge of local conditions of work and wages, came to the conclusion — I think rightly — that it would be an incentive to malingering if a man found that he could get more in cash at the end of the week by remaining in bed than he could get if he worked.
The scheme contained in this Bill can scarcely be described even as an amendment of the insurance code. The Minister has not had an opportunity of examining it and I feel that it would be a mistake in the present circumstances to have this amendment carried. Personally, I would be one of the most ardent supporters of a raising of the ceiling in this matter if we were dealing with the comprehensive measure that we have been promised by the Minister. This will be a help to the society from the actuarial point of view.
I do not think it will be fair to the 15,000 — or whatever the number may be — who are going to be brought in. Twenty-two and sixpence nowadays is not health insurance. You can call it what you like, but do not call it health insurance. I appeal to the House to be slow in passing this amendment, not because I am against it in principle — I am not; I am entirely for it — but I do not think it should be put into a purely temporary measure such as this is.
I want to make one point. If you are faced, as we are faced from day to day, with cases of a man dying, having an insurance policy for, say, £200, £300 or £400 which passes on to his wife and children as being their only means of existence, with no cover whatever once the insurance policy is expended, surely it is essential that we should endeavour to make provision for such a situation with the utmost expedition. Deputy Mulcahy says, wait until the comprehensive Bill comes along and discuss the matter then. What is the purpose of delay in providing cover for widows and orphan children? I can see only one reason, that is, that as they have suffered all along, they should go on suffering for another while until this House can make up its mind what is a comprehensive National Health Insurance Bill. In my view, every development of national health insurance that takes in a greater number of people and provides the cover contained in this Bill for widows and orphans is a desirable social development. We are living in an age in which only the very wealthy can make provision for themselves. The ordinary wage earner or salary earner has to rely on the resources of the State. He is incapable of making adequate provision and it is only by a nation-wide insurance such as is contained in the Widows' and Orphans' Pensions Act that it is possible to give the contributors under those Acts the cover that is at present provided for them. If I had time and had a blackboard and chalk here I would convince any intelligent person——
Do not become like the Taoiseach.
——that even to get cover for widows' and orphans' pension purposes it is worth his while to pay the entire contribution for widows' and orphans' pension and the entire national health insurance contribution, the employer's and the employee's. I claim that I have convinced a considerable number of people who went out of the national health insurances scheme when they earned a salary in excess of £250 per annum that it is good business for them to pay the entire national health insurance contribution, which must be paid if they are to become voluntary contributors under the Act, and thus get cover for widows' and orphans' pension purposes.
Let any member of the House go into any insurance company's office in Dublin to-morrow and announce that he is prepared to pay, say, 1/6 a week, that he is 50 years of age and that he wants to take out a policy which will give his wife 10/- per week when he dies, the first child 5/- per week and each other child 3/- per week, with a 50 per cent. supplementary allowance on those figures, and find out what the insurance company will quote him. No insurance company would dream of accepting a premium of that kind to provide such cover, and without any medical examination.
It is because I know it is of advantage to the insured person and gives him cover that he could not otherwise get from an insurance company at that premium that I advocate the amendment so strenuously. I am concerned in the matter all the time for the welfare of the widow who, having no income of her own, has to depend on the provision her husband has made for her. I am concerned for the young children who are helpless and who cannot influence the father's investments. These are helpless people. They depend on the wisdom and the affluence of the father for what they get when he dies. Therefore, I want to try to make provision for them and I appeal to all the members of the House who want to provide for them to vote for the amendment. If they do, I do not think they will ever have any reason to regret it, because I know that many orphans and widows in future will get a national cover against widowhood and orphanhood. They will not get it if this amendment is not carried.
Might I ask if there is any limit of income that would prevent a person at the present time becoming a voluntary member of the national health insurance?
No.
One second, he has got to be in. He cannot get a job at £1,000 to-morrow and then say that he is going to join the national health insurance as a voluntary contributor. He has got to be in at under £5 and stay in.
Might I ask then whether in respect of bringing people in here compulsorily the Minister would consider bringing in an amendment that would enable people — no matter what their income is—to come in voluntarily in respect of national health insurance? Put a limit if you like, but I think the limit might be left out. I suggest as a temporary measure, for the purpose of carrying through on the present scheme of national insurance until we get a more comprehensive one, that that would provide a fairer and more equitable way for people who wanted and who desired such facilities as are in this Bill to make provision either for themselves for health benefit or for their widows and orphans. An additional compulsion up to as high a level as £500 in respect of a scheme that we are only hatching at the present time is unsatisfactory.
Would you see any reason why a railway worker would not cover himself?
No.
You are preventing him by this: he has got to pay the railway company's contribution as well as his own.
Deputy Mulcahy's scheme sounds very well but he is leaving out the consideration of what would happen the employer's contribution and, besides that, it does not meet the case where a man is inclined to be improvident. Deputy Norton spoke very truly when he said that this would provide a safeguard to people who cannot at the present moment get it as cheaply and it does provide a safeguard where the breadwinner is not as provident as he should be and where the wife and children have no protection. I cannot see why Deputy Mulcahy should make so much of the fact that this is only a temporary expedient. Even if it is, and even if we could hope that the next 12 months would see a fully comprehensive scheme introduced, would it not be as well in the meantime, now that the opportunity does present itself, to cover as many people as we can reasonably persuade the Minister to include? I cannot see that it is a really serious argument and, without venturing into controversial matters, I would like to remind Deputy Mulcahy that it has very frequently been stated in this House that the purchasing power of the £ now is only equivalent to 10/- pre-war and when the ceiling pre-war was £250 surely there is an additional argument to include £500 now.
Nobody is arguing against the merits at all. It is only a question of the proper way to do it and one of the things that makes me suspicious about it is the Minister's willingness to accept it without having an opportunity of having it examined from an actuarial point of view. I happen to know a little about the National Health Insurance Society over a long number of years and mind you, if they jumped to taking in an additional 15,000 people overnight after, we assume, prolonged investigation and consideration before they came down to this £400, I think there is something in it. I would like the Minister to state here, for the benefit of the House, if Deputy Norton's amendment is passed, how many widows of the people who will be brought in under that amendment compulsorily will benefit within the next six or 12 months. I would like the Minister to answer that, as I say, for the information of the House.
I look on this as a very simple matter. I can see that £500 now is only the equivalent of £250 then and that if £250 was the ceiling pre-war, there seems to be no valid reason why we should not make this alteration. I do not quite agree with Deputy Morrissey that because the Minister has hastily and hurriedly and without very much consultation, apparently, adopted this change or agreed to this amendment there is a catch in it or that there is something wrong with it. The Minister and the Minister's Department are not infallible. I think they have frequently made mistakes and that they have frequently changed their minds before. The fact that they have changed their minds in this matter does not mean that they are trying to put over in this House something which is wrong or that they are trying to fool Deputies in some way or another. I have in mind a particular case of a young married man with a large family who died rather suddenly and who had made a fair provision for himself, to the extent that he had insured his life for £1,000. I found on looking into the matter that the widow was not entitled to a contributory pension, and I found on investigating the matter that £1,000 was a comparatively small sum for a widow with a large family and with no housing accommodation of any kind. The house that she occupied was only rented by reason of her husband's occupation. She had, therefore, to seek housing accommodation and to seek to support her family on an entire capital sum of £1,000. I think that cases will arise in connection with people who have over £400 and under £500 income and, I think, looking on the matter, that there is a sound case for raising the ceiling to £500.
It is true, of course. I agree with what Deputy Cogan said that the fact that I may change my mind does not mean that there is any catch in it. When I was considering this Bill it was a question of putting in £350, £400 or £500 and there were arguments in favour of as low as £350 and arguments in favour of £500 but on the whole, as I explained on the Second Reading, I took what I considered to be the equivalent to the 1939 figure, that is with the rise in wages. That is, that the average rise of a £5 wage in 1939 is up to about £8 now. That is why I decided on these amounts. You can look at it from another point of view. If a pound was worth so much in the thirties, what is it worth now? You might not arrive at any different position. It is really a matter of opinion — individual opinion.
Deputy Morrissey asked how many would come in within the next six or 12 months. Probably not very many. It takes three years to qualify for a widow's pension. The only thing I may put as a counter-argument to Deputy Morrissey is that they will be in sooner. I do not want the House to be under a false impression as to what I said to the Ceann Comhairle, that Deputy Morrissey or Deputy Norton could argue that the Exchequer is not liable under Section 17 to contribute. Now the Exchequer will contribute. That is an argument that could be used, but, in fact, the Exchequer will contribute the two-ninths.
It must contribute.
If it does, the amendment is out of order.
I explained that the Exchequer intends to contribute two-ninths and to pay all the supplementary benefits. Therefore, I do not see that the staff position will be influenced one way or the other.
If what the Minister now states involves a charge, this amendment is out of order.
I say that the Minister does intend——
He is not compelled to do it under the Bill.
——although Deputy Morrissey and Deputy Norton might argue he is not compelled to.
That is not too helpful to the amendment.
I do not think I have anything further to say.
There is no need for the Minister to say anything further. The amendment is now out of order. There is a charge involved. I did not understand that from the Minister at first.
The Minister does not admit that there is necessarily a charge.
He admits, in fact, that there will be.
He says he intends to adopt a certain course.
This will entail a charge. That is the Minister's intention, so the amendment disappears.
May I make this appeal to the Fine Gael Party——
It is not a Party matter; we are not opposing it.
You see the difficulty we are in by reason of the decision of the Ceann Comhairle. I think the Minister will accept £500 if there is general agreement. Will the members of the Fine Gael Party now indicate that they are prepared to agree, thus permitting the Minister to move the amendment and thus ensuring its acceptance? I raised this matter in the Dáil on a number of occasions and the Minister for Local Government and Public Health was strongly opposed to raising the ceiling to £500. That fact alone ought to commend this amendment to Deputy Morrissey and ought to neutralise the suspicion he now has.
We will deal now with the Minister who is in charge of this Bill.
May I appeal to the members of the Fine Gael Party who have, because of their attitude, caused the Minister to hesitate, to save the amendment, by indicating that they want it adopted and thus let the Minister move it?
First and foremost, this is not a Party matter at all. I made it quite clear I was not objecting to the amendment on its merits. I think Deputy Mulcahy mentioned that, too. We have no intention of voting against the amendment. I may have in some way conveyed that I was doubting the Minister's honesty in this matter. I have no doubt at all about that, but one is inclined, after a little experience here, to be a bit suspicious as to whether a particular proposal will work out in the way the House hopes, if the Minister is willing to accept it. Deputy Mulcahy and myself indicated that we were not opposed to the amendment on its merits; we merely questioned whether it was wise to do it in this patch-work way and so hurriedly.
The amendment is not now before the House; it is dead.
In order to cut this discussion short, it might be well for me to move the amendment: —
In page 8, Section 19 (1), line 37, to delete the word "four" and substitute the word "five".
Are we to understand from the Minister's statement that under this amendment now being put in, no widow can benefit for a period of three years?
A person being revived. A person coming in for the first time can. The period is two years.
No person being brought in compulsorily under this measure can leave a widow who will benefit any time within the next two years?
Yes, two years.
Surely Deputy Mulcahy does not envisage this House passing a comprehensive scheme which will wipe out any contributions made under this?
This House has done some very peculiar things.
I have no idea what the Minister's comprehensive scheme is likely to be.
Well, whatever this House might pass.
It is the same thing.
Amendment agreed to.
It is necessary to make an amendment in Section 7. It is a consequential amendment. I move: —
In page 6, Section 7 (4), line 9, to delete the word "four" and substitute the word "five."
Amendment agreed to.
Question —"That the Bill, as amended, be received for final consideration"— agreed to.
Question proposed: "That the Bill do now pass."
I appealed to the Minister to give early consideration to the position created by the attitude of the National Health Insurance Society in saying that they cannot pay increased wages because the funds will not enable them to do, in respect of their staffs, what has been done in respect of staffs outside. That situation cannot be remedied unless in one way, and that is by the Minister stepping up the administration grant. I am sure the Minister does not desire the society to be operated on the basis of under-paying those engaged in such valuable national work. I hope the Minister will give the House an assurance, in view of the situation which has now been reached before the Labour Court, that he will look into the matter with a view to applying a remedy for the difficulties which have manifested themselves.
I do not know anything about the position beyond what I was told had appeared in the papers, but I am sure I will not be allowed to remain ignorant of the position for very long.
Question agreed to.