I should like to hear somebody defend or justify the proposition that my neighbour should pay for medical attendance on my child. In the name of God, why should that be? I can quite see that it is a good thing to provide, throughout the country, the best medical attention available for anybody who is not able to afford a doctor, so that nobody's child will go unattended simply because that child's parents are poor. But how do you proceed logically from that principle to the proposition that in this country the State will provide medical attention for the children of everybody? Why should you not clothe my child? Why should you not provide him with everything else? I consider that is a daft principle.
I think I know the clues to this foolish proposal. One is the extremely bad example of the Socialist Government in Great Britain and the other is the basis of family allowances in this country. The reason family allowances were made applicable universally here is a purely administrative reason, because we do not want to apply a means test in the case of every applicant. What we provided was that any person who is liable to income-tax would have his income-tax allowance abated by an amount to correspond with what he actually receives under the Children's Allowances Acts so that, in fact, he would not benefit at all. But for purely administrative reasons and to avoid the means test we gave it to everybody. Surely to God we are not going to take that as a precedent for declaring that every citizen, without regard to his income or circumstances, is entitled to bespeak the services of the dispensary doctor and then tell him that is part of his duties for which he is paid by the county council.
I do not choose that the county council should pay for the medical treatment of myself and my family. If I fall on hard times, I prefer to depend on charity; I elect to go to a charitable institution rather than to the State or authorities acting under the State. If I were a resident in Dublin I would go to the Sisters of Charity or the Sisters of Mercy or some charitable institution and there seek assistance rather than go around to a public health dispensary and take State aid. It is no shame for someone who is poor to turn to the source of charity which is provided there for the purpose of consoling and helping those who need medical treatment, but I think any Christian man may feel a very profound reluctance in passing over his family responsibilities to the State.
That we in this House should announce that every man's child hereafter, whether his parents desire it or not, must become the responsibility of the State in so far as the maintenance of its health is concerned, is to me an astonishing and most undesirable proceeding. I think the initiative in bringing the individual child or the individual expectant mother within the scope of this scheme should be most strictly reserved to the family to which that mother or child belongs. There should be every facility for any family requiring such assistance to get it, but the initiative in be speaking it should be a matter for the family, and any attempt to short-circuit that is, in my opinion, a most undesirable development of a trend which is becoming all too strong the world over of abrogating to the State the duties which God Almighty laid upon a man and woman when they chose within the bonds of matrimony to bring children into the world.
There is no use writing Article 41 into the Constitution if, when legislation comes to be passed by this House, Article 41 is treated as if it were clap-trap. Either the State recognises the family "as the natural, primary and fundamental unit group of society and as a moral institution possessing inalienable and imprescriptible rights, antecedent and superior to all positive law", as set out in Article 41, or it does not. If we continue to permit the State to take over one duty after another of the parents of the family, it must be perfectly clear that when Article 41 was enacted by this State, somebody had his tongue in his cheek. I cannot too strongly emphasise a distinction between automatically bringing everybody's children, whether they like it or not, within schemes like this and making this scheme available to any family in the country who desires to avail of it. I am in favour of the latter proposal, but I am radically opposed to the first.
I want to inquire of the Minister, in connection with the powers taken under this section, whether he intends to do anything with a view to remedying the extraordinary situation in the Dublin dispensaries where, in fact, the numbers attending the dispensaries make it utterly impossible for the dispensary doctor adequately to deal with patients who require his aid. Has the Minister looked into that matter and has he any intention, under the powers conferred on him, to require the health authority in the City of Dublin to provide one doctor per so many patients as evidenced by attendances at dispensaries and the calls on dispensary doctors during the last four or five years? If my information is correct, the conditions in the dispensaries in the city are becoming almost farcical in that the doctors are asked or expected to treat numbers of people far in excess of the ability of the most industrious and hard-working man carefully and adequately to diagnose and treat their complaints.
Secondly, I want to express amazement at Deputy Heskin's proposal. If the National Agricultural Party is going to hospitalise every expectant mother in this country a month before confinement and keep her in hospital for a month afterwards, the whole country will be filled with lying-in hospitals and a system will obtain in this country unlike anything which obtains in any other civilised community in the world. I think Deputies generally in the House will agree that it would be deplorable if a suggestion such as Deputy Heskin has put forward were adopted. It may be sometimes necessary in special circumstances that a woman should have her baby in hospital but I think the weight of competent medical opinion would be that any woman who can have her baby in her own home would be very well advised to do so and that the general hospitalisation of expectant mothers is something greatly to be deprecated.
I want lastly to press upon the Minister for Health, of whose goodwill I feel convinced, that the class of juveniles for whom I want clinical treatment falls between the class which is described as mentally deficient and the class which is described as normal. A continually recurrent problem is how to provide for sub-normal children. The urgency of the matter of the clinic which I here propose to the Minister is that, in my submission, the function of this clinic is to prevent the psychotic child from becoming mentally deficient or, more correctly, from becoming mentally deranged. My hope is that we would establish by collaboration between the Minister for Health and the Minister for Justice a clinic of this character primarily designed to take the place of the remand home, and that round it would rapidly grow a child guidance clinic to which the problem child might be referred by the dispensary doctor or the medical practitioner in the City of Dublin. At the present time if any general practitioner or dispensary doctor finds himself charged with the responsibility of advising parents what to do with a child whose conduct has reached such a degree of abnormality as to cause parents to bring it to a doctor, he is constrained to say: "There is nothing we can do because there is no place to which you can bring such a child for treatment."
An essential pre-requisite adequately to treat that child is to get him into some clinic where he can be observed, without his knowing that he is being observed, so as to arrive at a correct diagnosis. That is an essential pre-requisite and that can be done only by a staff highly trained for that purpose. If that is done, the vast majority of psychotic children—in this they are unlike psychotic adults— can be pulled back from the brink of insanity and made perfectly normal children. Undoubtedly, it is only too true that in the case of the psychotic adult the prospects as to what the psychiatrist can do for him, on the evidence of results, are not encouraging, but the very reverse is true in the case of psychotic children. There is abundant evidence of that in the child guidance clinics in London and in the innumerable child clinics that operate at present in the United States and in New Zealand. It is a source of constant amazement to me that public health authorities in this country have evinced so very little interest in this problem and indeed sometimes react to petitions with impatience as if one were an eccentric in being interested in such matters when the problem is recognised and is being effectively dealt with in Great Britain, the United States of America and indeed in most of the Dominions.
I dare to say that with every month that passes without a clinic of the kind at least one child who might have been saved is going over the border of mental derangement which may be diagnosed and bring it within the ambit of a mental hospital or which may be concealed and will wind up by its being shovelled into a recidivist prison as an incurable criminal.
The problem is one which few people outside doctors know much about. I feel certain it is one which has come under the personal attention of the Minister for Health in the course of his professional career and I bespeak his sympathetic and urgent support for the proposal to establish this clinic now, not only to provide for the children referred to it by the courts but in its development to enable every general practitioner and dispensary doctor in this city to take some steps to meet that recurrent and, to my mind, most desperate problem.