When we adjourned last night, I had been addressing myself to what I regarded as certain legitimate criticism of the medical profession and, in particular, of their professional organisation. That criticism was not based on any sense of antipathy to the doctors or failure to realise their services and rights as a profession. It seemed to me essential that in this debate we should try to come back to what should be the main objective of all Parties in this House and of the medical profession, the health and the physical welfare of the citizens as a whole. It seemed to me that we should not allow ourselves to be side-tracked by assumptions made in advance that any particular scheme was to be condemned because it would seem to indicate a tendency towards progress in any particular political or social group. I dealt with what I regarded to be intemperate and exaggerated comments made in the official document by the Irish MedicalAssociation in which they committed themselves to a statement which was quite clearly without foundation and on that basis condemned the scheme put forward.
I am particularly anxious to be fair to the doctors and I can conceive that since 1947 they have met with difficulties in carrying on reasonable discussions with the Department of Health. I personally believe that those discussions are not made easier by the fact that we have had doctors as Ministers for Health. Frankly, I think that a layman is more competent to represent the community in discussions with professions in respect of matters that are largely based on professional techniques, standing and experience of various professional groups in the community. That is only mentioned as an aside but I am concerned that in this situation and particularly in the heat of conflict, debate and interviews the doctors should be fair to themselves and should not permit a situation developing in such a way as to put them in an impossible position. Quite clearly, they are taking up an impossible attitude when they take the view that an Act passed by the Dáil will be rendered nugatory because they will not co-operate. A much more powerful organisation than the Irish Medical Association took the same view in the United Kingdom some time ago and they found that they had to accept the verdict of the people because within their own ranks there was not unanimity, and there is not unanimity within the ranks of the Irish Medical Association in this country.
There are very many doctors, young and old, experienced and highly experienced, who will place their responsibilities to the people before any official viewpoint of a professional association. Not only will they co-operate because an Act has been passed by the Dáil but because they will find within the confines of that Act, limited though the Act may be, opportunities for services to the community greater than will be available to them at present. It is important to remember that we have many very eminent doctors—some ofthem have played a leading rôle in the public controversy carried on—who have given outstanding services to the people of this country. They have given that service under conditions where not only would they themselves not care whether it was private or public medicine but where they were not aware of their own personal position or of the income accruing to them from those services. Their only concern was to give their best knowledge and experience to the people who were sick and required their services. That is the reason why the medical profession will themselves realise that whatever may be in the statement at the moment in regard to lack of co-operation, time and the very force of public opinion will finally compel and induce them to take a more reasonable and sensible attitude.
When I was speaking on the question of State medicine I was not putting forward a point of view either for myself or the Labour Party that we conceive that the only good health scheme that can be offered to the people is a State scheme or a scheme of social medicine. We have got no preconceived idea like that. We want to see the best possible health scheme provided for our people within the limits of the resources of this community. We have got enough sense to understand that. I, personally, feel that the best health scheme can in fact only be made available on a community basis because of the very developments of medical science itself, drugs, equipment and the requirements which the doctors themselves need in order to give of the best of their services. It is as wrong for the doctors to say that they will not have a particular health scheme because it is an advance towards State medicine as it would be for the Labour Party to say that they would not have a scheme because it was not State medicine. The test is, what is best for the people and not what the Labour Party or the doctors like. I think a great many doctors will agree, on examining the present state of medicine in this and other countries, that if we are to give the best of that science to our people in large measure it will have to be on the basis of the resources of the State, resourceswhich can only be made available through the State.
Reference has been made in this House to the British scheme. The one thing that is outstanding about that scheme is that all impartial observers from other countries who have gone to England in recent years, regardless of what may be their political or social outlook, have agreed on one thing, and that is that if the British Labour Government had never done anything else they did, in this British health scheme, erect a monument to their credit which has withstood all the criticism that has been directed against it. I suggest it is a bit invidious for us to question the cost of it. The British people are not questioning the cost, and think that they are getting good value for their money. If we were able, within our resources, to provide the same services for our people, and to make possible for sick people in this country the approach that is available in England then we might be in a better position to support our criticism in regard to so-called pagan England, and might be able to live a little closer to our own standards of Christian morality and ethics.
I am aware that there are individuals receiving treatment under that scheme who, in no conceivable set of circumstances, could have got that treatment from a private scheme of medicine—treatment, drugs and a human approach that are not merely capable of saving the lives of individuals but of giving them a standard of treatment that even the most wealthy people could not afford to secure under a system of private medicine. It is noteworthy that that standard is applied not merely to British citizens but is given generously, and without stint, even to citizens of our own country who are temporarily resident there. It seems to me that any scheme of health, whether it be a State scheme or a private scheme, which can transcend the boundaries of countries and the problem of nationalities, treating all men as human beings, has got something very fine in it. It is something which merits the attention of the doctors in this country.
When speaking on the Bill at anearlier stage, I said that from many points of view it was a poor effort. The Labour Party has indicated its attitude to it. I would like to point out again, in reference to the doctors, the misconceptions that are being broadcast. Only a week or two ago, a very eminent member of the medical profession, frankly, one who has had some association with the Labour Party, in the course of a statement said he deplored the fact that a sensible Party like the Labour Party were not only undermining a great profession but were destroying the middle classes. Did anyone ever hear such fantastic nonsense spoken as that? Does not everyone realise that the Labour movement, in its broadest concepts, has done more to try and protect and sustain the middle classes against the impact of economic developments than any other section of the community? If there is any hope for the middle classes and the professional classes, it is not going to be found in either of the two big political Parties in this House but rather in the Labour Party and in what the Labour Party stands for.
The Labour Party, in its criticism of the medical profession and of the Irish Medical Association, is not making, and has not made, an unfair or an unfriendly criticism of them. It has invited an understanding by the medical profession of this very simple fact, that if the present Bill before the House is not satisfactory it is, at any rate, as Deputy Dr. Browne has said, at least an opening of the door, and in time if that door is to be pushed open much wider, then it will be pushed by the elements in this country represented by the Labour Party. Therefore, if the medical profession desires to see our people afforded health services which only the medical profession, in fact, can give, with the assistance of the community, then I suggest they should find ways and means of association with the elements in the community represented by the Labour Party, because the Labour Party is only too anxious to co-operate with any section that is prepared to put the well-being of the masses of the peoplebefore any vested interest. That offer was made before and is now made again. It is for that reason that I have been concerned to try and make clear what I think should be the attitude of the medical profession. It is, in fact, their responsibility, because it is the profession which they chose to enter.
I want to touch on one final point, and that is the reference that I have already made to a remark that was uttered here by Deputy Dr. Browne. While expressing his satisfaction with the Bill he did indicate that it had its limitations. He regarded it as the application of certain principles on which the Labour Party and himself are in agreement. He expressed the hope of seeing this particular door pushed open a little wider, but Deputy Dr. Browne should also realise with the rest of his professional colleagues, that if we are going to have an advance in the provision of proper health services for our people it is going to come from the efforts of that section of our community which, in its broadest outlook, in respect of social and economic problems, is best represented by the Labour Party. He has the problem facing him that health is not merely a question of medicine. It is, as Deputy Morrissey quite rightly said, a question in the first instance of the economic condition of our people, and neither the Labour Party nor Deputy Dr. Browne, or indeed anybody else, can cover up mistakes in regard to basic economic issues by a correct attitude in regard to the less important question of health, social security and matters of that kind.
It is correct to say that the basis on which rests the health of our people to-day has not the same secure foundation that it had 12 months ago. It is correct to say that the masses of our people to-day have got greater problems to meet in regard to their ordinary daily commitments than they had 12 months ago. I recall that, on the occasion of some of our Budget debates here last year, the point was made by us that the pursuance of that Budget policy was not only going to have social and economic repercussions in regard to trade, industry and employmentbut would be felt directly at the table of working class families: that it would show itself in the form of smaller quantities of food on that table and food of poorer quality, in less clothes and cheaper clothes, and in all the concomitants that can show themselves in the lives of working-class families when their economic conditions become stringent.
That has happened. It is borne out by Deputy Dr. Browne's own statements in this House. On the occasion when we were debating these matters he indicated that he felt the trade union movement would make good that defect. The trade union movement is a very powerful movement but it cannot do the impossible. It has not been able to do the impossible in the last 12 months. The cost of living for the masses of the people has gone up by some 20 to 25 per cent. The best that the trade unions have been able to do is to secure an increase in wages of about 10 per cent. There has been a loss of 15 per cent.
That is the responsibility, not merely of the Fianna Fáil Government, but of those who support them and who support their economic policies, including Deputy Dr. Browne. We cannot pass the responsibility on to the trade unions. It is our responsibility in this House. The responsibility is all the greater in respect of such Deputies as Deputy Dr. Browne, Deputy McQuillan, Deputy ffrench-O'Carroll and I think I can include Deputy Cowan, although he has gone so far over to Fianna Fáil that it is very difficult to distinguish them at all. In regard to the three other Deputies, for whom I have a great deal of respect and a great deal of admiration and whom I have not criticised in public hitherto and do not propose to do so now, I want to point out that when we are dealing with health we are dealing with something that has essentially an economic basis and that it is not right to support economic policies in which you do not believe—because that is the position of these Deputies; they do not believe in the economic policies of the present Government; they cannot justify them and they feel uneasy in having to commit themselvesto support them in this House —and then feel that the ordinary people outside will overlook that very serious political error because they happen to have a correct position on a health scheme.
So far as this Bill is concerned, the Labour Party has put down certain amendments. Some of these amendments have already been ruled out of order. Others remain on the Order Paper. We propose to press these amendments as far as we can in this House. We hope we will secure sufficient support, if the Minister is not prepared to accept them, to carry them by the votes in this House. Frankly, I hope that if we do it, the Government will regard that as a vote of confidence and take the necessary action.
I do point out and I do warn the Deputies who may be prepared to support the Labour Party members on the Health Bill that they will be doing more than supporting these amendments because, if the amendments are carried against the will of the Government or against their votes, they will be taking what I regard as the first and most necessary step to founding a sound basis for dealing with the health of the people because until we correct present economic policies we are only playing with health problems.
I personally invite these Deputies who have found themselves in many difficult positions in this House up to the moment, seriously to consider, not merely their obligation to support any steps that may be taken in this House to remedy the obvious defects in this Health Bill, but also to consider the greater obligation, that in supporting those amendments they will also be rejecting the economic policy which is creating greater health problems in this country than existed up to some 12 or 15 months ago. That will be the biggest contribution they could make to the health of the people.
I hope they will find it possible and I hope that on this occasion—because it has not happened on other occasions in this House where we have had other matters of grave concern to the ordinary working-class people—these Deputies will find it possible to go intothe Division Lobby with the Labour Party. I hope on this occasion, despite the official viewpoint expressed by the Fine Gael Party, that they will find it possible and that, by concerted action, those sections of this House who realise that economics and health cannot be divorced will take such steps as will make the necessary changes, without waiting on the results of the by-election in Wicklow, and that we will be able to bring to an end this present situation which has been so detrimental to the health of the people generally, which has placed 90,000 of our own citizens in a position where, quite clearly, not only their economic welfare but even their health is in jeopardy, and that we will realise, if we are going to deal with health and, in the same way, if we are going to deal with other problems of social security, we must start at the bottom. If we are not prepared to do that, we do not shoulder our responsibilities and we cannot hope to transfer them to others.
