I move:—
That a sum not exceeding £411,350 be granted to complete the sum necessary to defray the Charge which will come in course of payment during the year ending the 31st day of March, 1948, for the Salaries and Expenses of the Office of the Minister for Health, and certain Services administered by that Office, including Grants to Local Authorities, miscellaneous Grants and Grants-in-Aid, and certain charges connected with Hospitals.
I will deal first with the two conventions which have just been agreed to. Early in 1946, an invitation was received by the Minister for External Affairs from the Secretary-General of the United Nations Organisation to send an Irish observer to the International Health Conference which was to open in New York during that month. That was done. A delegate was sent and was later given power to sign any convention that he thought well, subject, of course, to the approval of the Government and to ratification by the Dáil.
The International Health Conference met in New York from the 19th June to the 22nd July, 1946. There were 51 States represented there, and as a result of the deliberations of the conference the following instruments were drawn up and separately signed: (1) Constitution of the World Health Organisation; (2) Protocol concerning the Office International d'Hygiene Publique; (3) Arrangements for the establishment of an Interim Commission of the World Health Organisation; and (4) Final Act of the International Health Conference. The Interim Commission was established to carry on during the interim period while the Constitution of the Health Organisation would be drawn up and the final Act which is referred to in (4) was merely a copy of the proceedings and of the deliberations.
Therefore we have only two important documents to discuss, the Constitution of the World Health Organisation and the Protocol. The Constitution of the World Health Organisation opens by enunciating principles relating to health, which it is stated, are basic to the "happiness, harmonious relations and security of all peoples". The functions of this organisation are to act as the directing and co-ordinating authority on international health work, to propose conventions, agreements and regulations, and to make recommendations with respect to international health matters. Membership is open to all States and States which were not present at the meeting can join by signing the articles as agreed upon by those present. The assembly may adopt regulations concerning sanitary and quarantine requirements, nomenclature of disease, causes of death and public health practices, standards for certain biological, pharmaceutical and similar products. Members may reject such regulations or accept subject to reservations.
So far as this particular convention is concerned, States may become parties to the constitution by (a) signature without reservation; (b) signature subject to approval followed by acceptance, or (c) acceptance. In our case the document was signed under (b), that is, it was signed subject to approval by the Government and by the Dáil. The constitution will come into force when 26 members of United Nations have become parties to it. The Protocol provides that, as between the signatories to the Protocol, the duties of the office under the 1907 Sanitary Convention will be performed by the health organisation and, in the meantime, by the Interim Commission. That is that the old organisation that was there under the League of Nations will now cease to operate and all the functions and so on will be taken over by the new organisation. By signing and accepting the constitution the Governments accept definite responsibilities and obligations. The new organisation will have authority to adopt conventions and agreements and such agreements will become binding on members, subject to objections or reservations being made within stated periods. But once we signed without reservation we took upon ourselves to bind ourselves by accepting.
I think it will be obvious to Deputies that there is a definite advantage in having an organisation like this. For instance, planes will be coming here from many countries and passengers may bring in, let us say, malaria which, as Deputies are aware, is spread by mosquitoes. If there is a very potent source of mosquitoes in a particular place it might be to our advantage to join with the other nations of the world to destroy the source of malaria rather than try to deal with it when a case crops up here.
The same thing applies to many other diseases. It is better to destroy the source so far as we can. That is one of the advantages of being in this world organisation. Having the advantage of the experience of these other countries through the various publications that will be circulated, the contacts made in meeting their representatives, and the interchange of information, will be useful in helping us in our health services. We should gain by the experience of other countries and we hope we may have something to contribute from this country and that other countries may gain thereby.
I am advised by the medical profession that participation in the organisation should have great advantages from a practical point of view and that is why I ask the Dáil to approve of it.
I now come to the Estimate. I had hoped that before this Estimate came before the Dáil we might have issued the White Paper that I have so often referred to. The Health Bill, of course, deals with a certain number of things which the Department are anxious to get after. The Health Bill deals principally with mother and child welfare, to a certain extent with infectious diseases, including tuberculosis, and with institutional treatment. But there are quite a number of other things which we have not dealt with to any great extent in that Bill. For instance, we have not dealt to any great extent with the ordinary treatment of disease, which has been carried on up to this in dispensaries and in county and voluntary hospitals. The White Paper will give an outline of the type of organisation that we think would be suitable in future and how these types of diseases and services should be tackled in time to come. The issue of the White Paper was delayed on account of the splitting up of the Department of Local Government and Public Health and the establishment of a new Department of Health. The preparation of the White Paper is very advanced and I think I can guarantee that it will be in the hands of Deputies during the summer holidays. If they wish, Deputies will then have an opportunity of discussing the contents of the White Paper when we meet after the summer holidays.
Some figures from the vital statistics might be interesting. For instance, Deputy Morrissey made a statement, which I think is generally believed, that the health of the country is disimproving and that the mortality rate is increasing. That is not altogether true, as the statistics for the last few years issued by the Registrar-General will show. First of all, as regards births, the number in 1946 was 67,547, which was higher than 1945 and 2,000 higher than 1944. The birth rate per 1,000 of the population in 1946 was 22.6. The rates in Northern Ireland, Scotland and England and Wales for 1945 were 22.0, 16.9 and 16.0, respectively. The number of marriages registered during the year 1946 was 17,575, which is also an increase on some of the preceding years. The marriage rate per 1,000 of the population was 5.9. The mortality for the year 1946 showed a decrease, the number of deaths recorded being 41,455, which is fewer than in 1945 and 3,673 fewer than in 1944. The death rate per 1,000 of the population was 13.9.
With regard to the principal infectious diseases, we have a rather encouraging picture, inasmuch as things are improving and on the mend. The position was bad about 1942 or 1943, but since that time they have been improving. The number of deaths from the principal infectious diseases, typhus, typhoid, diphtheria and scarlet fever last year was 163, as compared with 263 in 1945 and 400 in 1943, so that there is a good improvement which, I hope, will not only be maintained but will become still greater as the years go on.