Health Bill, 1952—Committee (Resumed).

Debate resumed on amendment No. 20:—

In sub-section (3), page 6, lines 55 and 56, to delete "one pound" and substitute "the appropriate amount"—(An tAire Sláinte).

Dr. Browne

When the debate was adjourned I was in process of trying to persuade the Minister that the new amendment introduced here, suggesting that the health scheme should be reviewed at five-yearly intervals, that in respect of certain other services the scheme should be reviewed in three years' time and the fixed charge proposition now before the House, would mean that a fixed charge of 50per cent. would be levied from the mother who would be attempting to benefit under the scheme. My suggestion is that this in effect destroys the only real benefits that I have seen in this proposed scheme, in so far as I consider that this amendment will entail the re-creation of the existing scheme of medicine where, in effect, there will be a means test. My contention is based on this fact. If the Minister in three years' time is bound by this amendment and if he must assess the total cost of the scheme and distribute that cost over the beneficiaries, this would be a charge to be levied on the mother. Deputy Morrissey is quite correct in saying that this amendment is slipshod in many ways, particularly in regard to the fact that we do not really know what is in the Minister's mind in relation to the expenses which he will take into consideration in assessing the total cost of the scheme. If the Minister means that he would levy half the cost of the doctor's service, that would not be very much possibly. I do not know what fee is to be paid to doctors. Again he might decide to take in the doctor plus the midwife. That will increase the cost. Then he might include the cost of the doctor, the midwife, the consultant and the specialist who might be required from time to time. He might again include the hospital charges bringing in all the ancillary costs which are now going to be levied by the medical profession— and in my view rightly so. That would bring in payments made to the pathologist, bacteriologist, chemist, radiographers, etc. Again the then Minister might decide to include administrative costs and of course there is no knowing what the administrative costs would be assessed at and what they might total. They might include the salaries of the county manager and his staff. They might include the salaries of clerical workers and 101 other things.

In fact, Deputy Morrissey is correct in that regard. It is a slipshod amendment because it seems to me that the costs could rise to any unpredictable figure, that the charge in a single case might be anything from £2 10s. to £25 or £50. That point was made by amember of the Medical Association in the Health Council in support of a somewhat similar point made by myself. I think it is substantially true; it is a substantially fair comment. I can visualise the assessment in such a case being £50. I can visualise the lady being asked to pay £25 and saying that she cannot pay it. She is then covered by the means test and thrown back on the ordinary public assistance services, as we have them to-day, and the position is that the health services are the same as they were before the introduction of this. On those grounds I think the amendment is objectionable.

I support Deputy Morrissey's objection in relation to the fact that the Minister is, in effect, introducing an insurance scheme; indeed, he is deliberately attempting to introduce what he considers to be an actuarially sound insurance scheme. Nobody pretends for one moment that the £1 payment is actuarially sound. I do not think anyone would suggest that. Deputy Morrissey, I think, made the point—but even if he is not prepared to accept responsibility for it, then I put it forward on my own—that one cannot have an actuarially sound maternity scheme.

Again, if the Minister now brings in what is in fact an insurance scheme he must go before the public as having been extremely unfair to the Irish Medical Association. It may surprise him to find me defending that body but the fact is that they did put forward an insurance scheme and the Minister rejected it, on very good grounds I believe, namely, the grounds on which I rejected the Irish Medical Association scheme. It would be practically impossible, I believe, to have an actuarially sound maternity scheme because the insured persons would be, to use the ordinary terms, a bad risk. I cannot see how any pool of wealth could be built up in order to run such a scheme and, therefore, from the point of view of an actuarially sound scheme it seems to be a lunatic proposition. On those narrow grounds I take the same exception to this amendment as the Minister took to the Medical Association scheme and I takeconsolation in that from the fact that I am now joined by Deputy Morrissey.

Mr. Morrissey

Not for the same reasons, though.

Dr. Browne

No. I objected to the Medical Association scheme because it was an insurance scheme. I do not wish to use anybody else's arguments. I am prepared to stand over my own. This section is the most important in our health legislation. In it there was a tiny modicum of the health scheme that I believe to be the only proper health scheme; that is a scheme which will give all our mothers and all our children an equal chance. There is no doubt at all that the Minister in his 1947 Act was with me up to the hilt in that regard. It can be said with truth that most of the politicians here have at some time or other called for a "no means" test principle in relation to health services. I could quote several of them: Deputy MacBride, Deputy Costello, the ex-Taoiseach, Deputy Norton. I am quite sure Deputy Norton would not oppose such a proposition.

Mr. O'Leary

And yourself.

Dr. Browne

And myself. I believe that is the soundest principle on which to base a good medically workable health scheme. The Minister was responsible for laying the foundation of the present T.B. scheme. That scheme has been invaluable and the death rate this year has been reduced by 50 per cent. so far as T.B. is concerned. Deputy MacEntee titled at me in relation to that scheme:—

"He asks why:

The mother and child welfare scheme provided for in the 1947 Act introduced by Dr. Ryan just before Fianna Fáil left office would have been brought into operation if Fianna Fáil had been returned to power.... It was under that Act, which, owing to the Fine Gael opposition, had to be withdrawn and reintroduced, that he said all the allowances to T.B. patients were being paid and all Dr. Browne, Minister for Health, had to do now to bring in the mother and child scheme was to sign the regulations under theAct. He had not done that, and if questions were asked on that subject the answer might be that it was on account of the vested interests which Dr. Browne was not able to stand up to, and who had worked to get Dr. Ryan out of the way. The scheme would have been a costly one as visualised by Fianna Fáil, because they realised that the strength and hope of the nation lay in its children."

I still think that is true. I could quote endlessly on the matter. Deputies may have had different grounds, some medical, some political, some social. In its largest part, this Bill is a perpetuation of poor law medicine. The reason I was able to support it was because there was retained in the mother and child section that tiny modicum of principle to which I have referred and which, I believe, could in time be expanded when the people grew accustomed to the idea that it was a good scheme and accepted the idea that it was a good principle that all mothers and children should be treated equally. I do not think that conception could be repugnant to any group of public representatives in any country.

I propose to oppose this amendment. The Minister has, of course, the right to push it through if he wants to do so. I believe the Minister is fair-minded. He will, I believe, try to suggest that the grounds for this amendment are really sound but they are not grounds which we could justify to our constituents. He could possibly have brought forward medical objections. We would have been prepared to listen to him, though I do not believe myself he could bring forward medical objections. I may be wrong in that. Had he brought forward such objections I would have been compelled at once to point to the magnificent achievements of his own T.B. service. I would have been compelled to point to his own Act in 1947 which has done such wonderful things for our people. I would have been compelled to point to the fever hospitals and the infectious diseases regulations. Fevers have practically been eliminated as a resultof these regulations, a magnificent achievement due primarily to the Minister's work and that of his Government. The same principle underlies that scheme, equal opportunity for treatment of people suffering from particular diseases. Those are facts. The House can examine them for itself. Deputies will find substantial arguments against this particular amendment and against any suggestion that the scheme should be a means test scheme for, if it is a means test scheme, it will be a bad scheme. In view of that, I think there can be no grounds for the introduction of this amendment. I think that the actuarial grounds are unsound. I may be wrong on that. The Minister may be able to correct me because he knows very much more about that than I do. I rejected the medical maternity insurance scheme on what I believed to be very sound technical grounds from the actuarial point of view.

There is another argument which the Minister could have put forward, the political argument or the economic argument. It could have been said that the scheme would put too much of a burden on the rates at present. Deputy Dr. Esmonde here recently used that argument, that the scheme might be too costly. It is an argument which can be used, but one that I do not agree with. No doubt it could be a compelling argument with many taxpayers. But, again, I could not allow that to influence me in my decision as to what is right. I believe that the type of scheme which is the right one is the scheme that gives equal opportunity: where equal opportunity is given to each mother who goes before a doctor and under which there is no inquiry into her means, no segregation into two groups and where each mother is treated exactly the same, and where the only consideration for the doctor is a medical one. There should not be any financial consideration so far as he is concerned. I would hope that he would be paid very well by the State or the community for the services he renders to that person.

I think that is the only, the bestpossible service that can be made available. I think that this amendment completely destroys that particular argument. The Minister did produce the 1947 Act with the mother and child provisions in it, and the White Paper. The White Paper laid down clearly what was intended, a free mother and child scheme for children up to the age of 16. Then there followed the inter-Party period when the unfortunate episode occurred in regard to the scheme formulated by us. There is no point in going into that now beyond saying that what happened on that occasion must have been of considerable assistance to the Fianna Fáil Government in their consideration as to what would be an acceptable or a desirable scheme. In consequence, I assume that they acted with knowledge and understanding as they were in possession of all the facts that were brought forth at that time by reason of the publication of the documents, the arguments and the debates that took place and so on. It was in the light of all that, that the White Paper was brought forward, that the Bill was circulated and got a First Reading.

There is no doubt but that the Taoiseach and the Fianna Fáil Government intended to go ahead with a scheme which was very close indeed —not the same but as far as I was concerned acceptable—to their original intentions in the 1947 Health Act. Consequently I find it difficult to believe that the Minister would put forward the political ground that this was too costly and that the ratepayers or taxpayers would have to pay too much. Looking back over the record of Fianna Fáil on their social legislation generally I do not think that carried much weight with them in their general consideration of what was the best or the correct thing to do. On the whole they seem to have done their best for the under-privileged in their years of office. It would, therefore, appear to me to be a complete reversal of a policy if the Minister were to put forward any suggestion that his objection to this scheme or his introduction of this amendment was on the ground of providing more money.

It seems to me, therefore, that there can be only one other objection—an ethical or moral objection to the scheme. I do not know whether there is such an objection. I should like to know if there is that objection by the Hierarchy to the scheme of £1 contribution as proposed by the Minister. I should like to know if that is unacceptable on moral grounds. I accept that idea or suggestion without qualification. I do not know, but it has been suggested, that this is an attempt to bring the Hierarchy in to carry the burden with a shift in ground by Fianna Fáil because of ratepayer or taxpayer opposition. I think that is a most unworthy suggestion. I think it should be contradicted. It can be contradicted and I am sure will be contradicted by the Minister. It is a most undesirable suggestion and should not be sustained for a moment.

My difficulty in relation to this is that I do not know whether there are definite moral objections to it or not. As I say, this scheme was considered by the Taoiseach and his Government, presumably in the light of all the facts which were made available during the inter-Party period in the debate on the mother and child scheme, and in the correspondence which was published. I accept it that the Minister is a very responsible person. I must assume that there was a certain degree of agreement in the Government that this scheme would be morally and ethically acceptable. The Bill was published and circulated and got a First Reading. None of us received any hint or suggestion that its provisions were in any way morally objectionable. We then had the Second Reading. It was not of very great length. That is now all a matter of history. The whole House agreed to the Second Reading of the Bill and its provisions. The result was that every single Deputy practically, with the exception of Deputy P.D. Lehane— the vast majority of Deputies—were in complete agreement on the original and unamended provisions of the Minister's Bill.

General Mulcahy

The Deputy realises I am sure that he is now justtalking bunkum. He ought to refer to the Dáil debates.

Dr. Browne

If I did I do not think that I would find much difference in the Deputy's own contribution when Deputy McGrath said that the Deputy was in favour of the Bill, and said that Deputy McGilligan was in favour of the Bill.

General Mulcahy

Again, I suggest that the Deputy ought to refer to the debates.

Dr. Browne

The Deputy can make his own speech.

Captain Cowan

May I call the attention of the Chair to fact that there are only two Fine Gael Deputies in the House?

An Ceann Comhairle

That is not a matter for the Chair.

Mr. Morrissey

Fortunately, there is only one Deputy Cowan in the House, and that will be only for a short time.

Dr. Browne

The position in relation to the Bill is that we all accepted the general underlying principles of it; the Government, in the first instance, in the light of their overt or covert knowledge, and Deputies, after long consideration of the Bill, on its Second Reading. The principle of the £1 contribution was accepted right up to then. In so far as the £1 contribution was a departure from the 1947 Health Bill— the provision was free with no means test and no £1 contribution—must we not assume, those of us who do not know exactly what has happened, that up to the insertion of this final amendment —No. 20—that the £1 contribution was an acceptable device for the meeting of any objections that might be made on grounds other than medical or political or actuarial or anything else, that is, on ethical or moral grounds? If that is not so, if this £1 contribution was not acceptable, must we then assume that there was no consultation at all with the Hierarchy in relation to this scheme up to the time that the £1 contribution was agreed upon?

May I say that as far as I am concernedI, of course, completely accept —I think most Deputies do—the principle that in matters of social legislation the Hierarchy and the leading members of all the Churches have not only a right but in my view a responsibility to make their views known to the members of their respective Churches in order that they should guide them and help them in trying to keep within the law as it affects them in their particular religions. So, I do not wish it to be thought that I objected or would object to the Minister having any consultations he wishes with the Hierarchy of any Church or the leading members of any Church. All I say is, that this £1 contribution was put before us here as the solution of the problems arising out of the rejection of the 1947 Health Bill, the scheme put forward by the inter-Party Government, and that it does seem very strange that, six years after the 1947 Act came out, it is suggested that this amendment is there in order to meet certain moral objections.

This may not be so. I hope it is not so. If this proposition is being put here, it is a most serious one in my view because, as far as I can see, the terms of this amendment must colour the terms of all future social legislation, health legislation and legislation concerning the aged, the blind, widows and orphans, and so on, for all time to come. A terribly important principle seems to me to be involved in this amendment.

If this amendment is accepted, if it is accepted because the 1947 scheme or the £1 contribution—the £1 contribution particularly—is unacceptable on grounds of moral or ethical considerations, then we who are in political life, public life, must know what is to be our position in relation to all similar schemes at present operated by our public officials, by the medical profession, the nursing profession and by practically every Department of State. The principle of free no means test runs through practically every Department of State; agricultural grants, housing grants, free no means test school education, free no means test children's allowances. Again, we have the free no means test T.B. schemes, free no means testinfectious diseases scheme—most curiously of all—free no means test neo-natal schemes in the City of Dublin, I understand to be extended to Cork and Galway, the scheme under which there is in existence at this very moment in the three major maternity hospitals a mother and infant scheme very similar to the provisions of this particular scheme before the House. The child born from the district in either the Rotunda, the Coombe or the National Maternity Hospital can get a completely free, first-class, right up to the best European standards, no means test neo-natal service.

All those things are there. All those things are facts. All those things are realities. We must, as public men in public life, probably responsible for the making of social legislation in future, know what is to be the position of those people. Are any of them, are all of them, contravening any moral laws or ethical objections which have, apparently, or which may have been suggested to have become involved in this particular Bill in respect of the £1 contribution? Must we now retrace our steps and, in respect of these benefits, these boons, brought over the years by Governments for our people, see a means test restored to every single one of these things in order that we shall comply with moral objections in relation to free no means test mother and infant schemes?

Again, if this is held, we must know the position of our fellow religionists in Great Britain. We must know why no objection was made to the Socialist medical scheme, free, no means test and, I might add, non-contributory. It is a non-contributory scheme. It is commonly held that it is contributory. I went to the trouble of writing to both the Minister of Health in England and Aneurin Bevan and both confirmed that it is not contributory— that scheme from which so many of our Catholic co-religionists in Great Britain benefit. Surely they cannot obtain these benefits if they are morally objectionable. Again, surely our co-religionists in the Six Counties cannot continue to benefit from the free no means test health scheme operated in the Six Counties by the Governmentthere if our Hierarchy believe that such a basic principle is morally objectionable. I am quite certain—all of us are quite certain, I am sure— that none of our leading churchmen, Cardinal D'Alton, the other Bishops in the Six Counties, would accept for the members of their Church in the Six Counties anything which was morally reprehensible or morally objectionable. I do not think any of us would suggest that they would be silent while there was any such contravention.

I would certainly like guidance on all these points. I know they are terribly thorny points, very difficult points and points on which it will be possible to misrepresent me at a later date. Fortunately, I am quite careless about that. I am anxious merely for the facts and I do not mind what it costs myself in the elucidation of these facts.

If this amendment has been inserted in order to comply with the moral objections raised by our Hierarchy, I would like that to be made clear. I should like that that would be made clear. I should like to know, because it is important for us to know what attitude we must take up in relation to this principle concerning all these mothers going for X-rays. As to the other objections which I mentioned, the political objection, the medical objection or any one of these objections, the Taoiseach and his Government have a perfect right to consider these and to insert this amendment and put it through the House. But we must know which is the real reason. It is only then that we will be in a position to make our decision.

If there is no objection from the point of view of the moral law, then are the objections put forward by the Hierarchy objections of personal prejudice? I know I will be fallen on for using the words "political objections of the Hierarchy". I am asking that blunt question because I feel I must make it clear that as a public representative I could not take either the personal objections or the political objections of the Hierarchy as a compelling argument with me, at any rate, for changing social legislation. They have a perfect right both to their personaland political views and so have I. I do not think I am any the worse Catholic for making that suggestion and I feel that neither would the Hierarchy be anxious that they should go on record as trying to impose on this House as a democratic Parliament either their political or personal objections.

This is a particularly serious matter. So far as I am concerned, it affects political development in Ireland for many years to come. It is because of that I am dealing with this terribly dangerous subject and I think it must be cleared up without delay. If the objections are moral objections, I want to know about these other aspects of our social life. If they are not moral objections, but purely personal objections, I want to make my position clear. I say again that every Deputy is perfectly within his right in accepting a dictate of that kind or a position which would be based on the Hierarchy's views in relation to their personal objections. Each Government has a perfect right to do that. This Government has a perfect right to accept their ruling in that regard. But I should like to know the exact grounds upon which it has been found necessary to insert this section. I do not wish to have any misrepresentation of anything. I merely wish that the position shall be completely clarified. If it is accepted, as it was accepted before, that we should introduce amendments to this social legislation, then the departure from that social legislation must be made only on the soundest possible grounds.

It is quite obvious, as I see it anyway, that the whole principle of health legislation, the whole principle of democratic Government to a certain extent is in the melting-pot here. We must accept the responsibility for making legislation, getting, wherever we can obtain it, the advice of our spiritual advisers but, having considered that advice, then I think we are at liberty to accept or reject it where it is other than a definite ruling on the moral law.

I would urge, therefore, on the Ministerthat he should clear up for all of us all the points I have raised. They are points which many people are discussing and I think it is very bad for democratic Government and very bad for our religion and our Hierarchy that matters such as this should be discussed as they are currently being discussed in the country. There may have been no objections whatsoever from the Hierarchy in relation to the moral law. The objections which impelled the Minister to introduce the amendment may be one or other of the objections which I have mentioned. There may have been objections based on medical reasons, political reasons, reasons of taxation, economic reasons, or actuarial reasons. But I think it is up to the Minister to give us a very much more compelling reason than that which he has given up to the present with regard to this payment of £1 because it is not a good reason.

I ask him to reconsider the amendment and to consider these points. How can one discover that 50 per cent., or half the cost of a scheme, will be costly or not? I am sure the Department has given the Minister the best possible estimate it can of the cost, but health schemes have a way of costing a lot. Why is the Minister fixing a figure of 50 per cent., which may be too high? If he is accepting this idea of 50 per cent., it may be too high or too low. Perhaps 5 per cent. might be a more equitable figure. Perhaps 25 per cent. might be nearer to what the Minister had in mind in the past, or 75 per cent. might even be a more equitable figure. I cannot understand how the figure of 50 per cent. could be arrived at. If the reasons were economic, or if the Government fears taxation, then it may be reasonable. That is the only possible reason that I can see. I find it very difficult to understand why we should say 50 per cent., not 51 or 49 per cent. Possibly there may be a perfectly simple explanation or a perfectly reasonable argument which the Minister has, but on the knowledge before me at the moment I could not support it.

I may be wrong, but it would be out of keeping with the record of the Minister for Health. It would be completelyout of keeping with the record of Fianna Fáil in their social legislation in past years if they were to allow monetary considerations to stand in their way. As Deputy MacEntee, Minister for Finance, said in 1950, the scheme would have been a costly one as visualised by Fianna Fáil, because they realised the strength and hope of the nation lay in the children. I do not think Fianna Fáil put a price on the health of their children. I do not think Fine Gael would put a price on the health of the children. Consequently I would like all these points cleared, a Leas-Cheann Comhairle. First of all, I would like to know if the objections are based on any of these other points, if they are based on moral law. If they are, what is the position with regard to these other considerations which I have raised; if they are based on simple political prejudices? If they are based on personal prejudices—which I do not honestly believe—then of course a terribly serious development will have taken place here with regard to democratic government. Of course the implications with relation to Partition cannot be over-emphasised.

Mr. Morrissey

We have, Sir, just listened to what I think might be described as a very remarkable and illuminating speech. I think the House —and I hope the country—has at long last got a glance at the real mind of Deputy Dr. Browne in relation to this whole matter. The Deputy tried to hang his whole case, from his point of view, on the amendment. May I put it to him that from his point of view the provision—in principle—in the section is just as objectionable as the provision in the amendment? So far as the principle is concerned it does not matter from his point of view whether the charge is 1/- or £50. One must have a very considerable sympathy with the position in which Deputy Dr. Browne now finds himself and some of his colleagues, because they have—to put it very bluntly—been betrayed and Deputy Dr. Browne and his colleagues are now being asked to accept in this Bill something which from their point of view is much more objectionable than anything he wasever asked to insert in the Bill which he was proposing at some time to introduce himself. Again the Bill which Deputy Dr. Browne has described as he described it this afternoon, this Bill which we are now discussing, is just a modicum of a health measure.

The Deputy and his colleagues are in an extremely difficult position. There is no doubt about that. If Deputy Dr. Browne had taken the line that one might expect him to take instead of the line he has taken in the speech he has just delivered, one might feel he had reason to be pained, and reason to feel he had not been fairly treated by the Government and the Minister to whom he has given unswervingly his support. But the Deputy proceeds to pretend that he is ignorant of matters of which he is fully aware. He wants to know from the Minister whether the provision in the section or the amendment is due to some political or financial reason or whether it is a question of morals or ethics and he says flatfootedly he does not know.

Nobody in this House is going to accept that statement from Deputy Dr. Browne. Deputy Dr. Browne does know, at least as well as any other member of this House, if not better. There is no question whatever about that. The Deputy knows quite well the reason, and the Deputy, I suggest, is not going to make his own position in relation to this section or amendment any easier by trying to whitewash the Minister and the Government so that he can, with some appearance of consistency, continue to support him and at the same time impute to others very low motives.

The Deputy knows quite well why this amendment was introduced because the Deputy got a similar direction at his own request on the same principle. That is true. That is on record. No question whatever about that. What I want to suggest, and I hope I am not being unfair in suggesting, is that we did get Deputy Dr. Browne's real mind in relation to this in what he said. He reasoned with regard to the right of the Hierarchy to give a direction on morals or onCatholic social teaching in the same way as I think we could assume Henry VIII reasoned when he wanted to salve his own conscience. The Deputy does not know when the Hierarchy spoke on this matter, he says, whether they were speaking as the authority on the moral law or whether they were giving full play to their political or personal prejudices. That is an extraordinary statement from a responsible and intelligent member of this House who says in one sentence: "Of course I accept the direction on the moral law," but goes on immediately to question it in a number of ways. He even went further to suggest that there was one reading of the moral law in this State by the Church; there was a different one in the Six Counties by the same Church, and a different one in Great Britain by the same Church.

Dr. ffrench-O'Carroll

He did not say that, Deputy. That is not fair.

Mr. Morrissey

The Deputy and his colleagues will get plenty of time to deal with that. I invite the Deputy to put his own interpretation on what Deputy Dr. Browne said. What was the point of Deputy Dr. Browne stressing that the Cardinal in the Six Counties, or those of the Bishops that reside in the Six Counties or whose jurisdiction lies within the Six Counties, had not challenged something which the Bishops in this State are challenging? Did he say that?

Dr. Browne

I have asked the Minister whether that is so.

We will accept the inquisition. We are not good Catholics on this side. Go on with the Bill now.

If the Deputy would listen more often and speak less frequently, he would learn a bit more. I want to make it quite clear that my object is to show again how stupid this Bill is and how stupid this amendment is. There is no Deputy in this House who has given any thought to the amendment who will describe it as anything other than a shot in the dark. As Deputy Dr. Browne said—I think we are in agreement on this—neither the Minister nor anybody else can say under this amendment whether the charge to be borne by the patient will be £5, £20 or £30. The Minister does not know now—he could not know—by what method or on what basis the appropriate amount is to be estimated. The Minister does not know now what charges are to be included in the amount that is to be assessed and for 50 per cent. of which the patient is to be responsible. At least under the £1 charge you could get some idea— even a very accurate idea—of the financial responsibility that was going to fall on the shoulders of the patient. "The appropriate amount" can mean anything. I think it will be agreed on all sides of the House that apart altogether from the grounds on which Deputy Dr. Browne has attacked this amendment, on the ordinary ground of this House being entitled to know what the financial responsibility is going to be, the Minister should make a better case for the amendment than he has made so far.

Mr. Gallagher

There is no uncertainty in the minds of the workers as to where Fine Gael stands in relation to health services. On their record, they have been against health services all along the line. We have no doubt on that score. I do not propose to enter into the political or moral effects of this amendment because I feel that in this amendment we are legislating in the form of prophecy. We cannot say now what this will cost in three years or five years. I think the Minister would be well advised to reconsider the amendment. I come from a working-class constituency in which numbers of people will benefit under this Bill. I think the Minister should find out first of all what the scheme will cost and he should then come and inform the House of that fact and let us decide at that stage what persons availing of this service should pay. I am not an expert. This Bill seems to be providing a field day for lawyers and doctors. I am neither a lawyer nor a doctor. I am giving the ordinary layman's point of view, and it would appear that in this amendment we are legislating in the dark. The Minister would be well advised to find out the cost and inform the House on that matter so that we would then be in a position to know what the worker would be called upon to pay. That is the most reasonable approach.

Mr. Kyne

Deputy Dr. Browne has clearly stated the position; he says we are in exactly the same position now as we were before. I quite agree with Deputy Dr. Browne in that. I believe that health services for expectant mothers should be provided irrespectiveof means. Obviously the present Minister has run into the same difficulties with which Deputy Dr. Browne met in relation to his scheme. The only difference now is that Deputy Dr. Browne's scheme was a much better scheme. Apparently, the difficulties that have arisen are insurmountable. Those who are anxious to see a scheme go through without a means test must take whatever we can get, either a limited amount or some small advance. The Labour Party believes in a health scheme without a means test. We all know now that there is a definite objection to the scheme from the Hierarchy. I cannot understand why the Minister or Deputy Dr. Browne could not deal with this on the basis of the proposals put forward by the T.U.C., that is, introducing a health scheme on an insurance basis. I gathered from Deputy Dr. Browne that it is not possible to work such a scheme on an insurance basis. The T.U.C. put forward a scheme to Deputy Dr. Browne when he was Minister for Health. At the time I understood that he had accepted that scheme. He did not go ahead with it. Would the Minister now examine the position on the basis of an insurance contribution from all workers? The payment of £1 per year was a bluff; that bluff has been called. We all know that. Apparently, the people will not now have to pay £1 per year, but an unspecified sum.

Deputy Cowan, Deputy Dr. Browne and Deputy Dr. ffrench-O'Carroll have now had taken from them the excuse they hitherto had for supporting the present Government in inflicting such hardships on the people. They can no longer shelter behind the excuse that they were supporting the Government in order to have a proper health scheme for our people. That excuse has been removed and they will have to find a better excuse in the future. The Labour Party supports any move to give a good health service to our people. We have tried everything. We believe the solution lies in a contributory scheme on an insurance basis. I believe the solution will have to be found through the co-operation of the Hierarchy and the Medical Association. We have no objection to an all-Party committee sitting downwith the Minister and endeavouring to hammer out a satisfactory scheme.

Captain Cowan

I hope I will steer clear of matters that I do not think are of tremendous importance just at the moment. Deputy Kyne has thrown out the suggestion that there are certain Independent Deputies who should be worried about this. He says the Labour Party will adopt a certain line but "we would like you to do a different thing". That is a rather peculiar attitude for anyone to take up. If the Labour Party considers the principles on which it was founded, the person who founded it and the principle for which James Connolly gave his life in 1916, then they should be standing here four-square on principle. If the attitude Deputy Kyne has taken up is four-square in accordance with principle, then what objection has he to Deputy Dr. Browne or Deputy Dr. ffrench-O'Carroll or myself standing on the same principle? I stand on the principle on which Mr. Bevan stood when he put his Health Bill through in Britain. He was not afraid to run away from his principles. He fought the Medical Association. He was not like Deputy Kyne who says one must come in and take dictation.

Mr. Kyne

We are not afraid of the Medical Association.

Captain Cowan

One must sit down and sup with them and let them eat one up. That is Deputy Kyne's line. I am not going to take that line but I agree with him when he says that one must make as much progress as one can when one can. The Minister has introduced an amendment to a section. I spoke on that section on the Money Resolution and I said it was just a cod. At that stage, the difference between a free scheme and what was in the Bill was a matter of £1 per year. I said that was all cod and that we could readily do without that. Now the Minister has put in a new section. Why he has put it in I do not know. Why did he bring in this amendment? It is a most extraordinary amendment. While one could swallow the £1 on the basis that it was all cod, and it did not matter whether one took it or not, like someof the medicine people get from time to time, there are certain problems raised by this amendment.

I think that Deputy Gallagher has taken a very sensible line in regard to it. This House, and the people, ought not to be asked to support something in blinkers, something that we could not possibly know of. The Minister, in his speech, said that no administrative expenses would be charged —that there will only be charged hospital charges and specialist fees. That is not in the amendment, but if these three things were put into the amendment they would clarify the position, to some extent. In other words, if the Minister were to put into his amendment that no administrative charges will be included, then we would know that there could be no question of including any part of the expenses of the Minister's Department in the charge. If the Minister would further put in that there would be no charges except hospital charges and specialist fees then we would know where we stood.

There is a further thing that I think is necessary. The Minister's amendment speaks of "within three years' experience" of the working of this. In my view, three years is too short. We would want a longer period than that to see how it works out. Perhaps it should be five years. I think that we would want a further protective provision, that whatever it was proposed to charge, after the statistics had been brought before Dáil Éireann, it would be for Dáil Éireann to decide whether these charges would be imposed or not. If we approach it in that way we will have a longer period in which to make up our minds as to what the costs of the Act may be. First of all, we would have the statistics that would be available for every member of the House.

Deputy Morrissey says that I will not be in the House at that time. At any rate, there will be 147 Deputies in that Dáil. They can consider the statistics and the whole matter fully. They can give it all the consideration that is necessary and can decide, (1)whether there should be any charge other than the £1; (2) whether this £1 should be retained or not, and (3) what percentage of the total cost of the scheme should an individual have to pay—whether it is to be 10 per cent., 25 per cent., 50 per cent., 75 per cent. or 100 per cent.

I think that if the Minister were to approach this amendment on the basis of making changes of that kind it would be very simple. We would still have control by this House over the scheme that had been put into operation. These are suggestions which I want to put before the Minister.

I have said on several occasions that what I want is to see a new Health Bill on the Statute Book. I want to see that Bill providing benefits for the people. I have no doubt that, when such a Bill is on the Statute Book and is in operation, there will be a demand for an increase in the facilities available for the people under the scheme. That demand will come from the local councils and boards of health; it will come through Deputies and go right through to the Government. In that way, nobody will be able to stop the pressure of public opinion for the amendments that will be necessary in order to make the scheme a more equitable one than it will be then.

I have always said I am absolutely in favour of a no means tests in regard to a mother - and - child maternity scheme. The Minister, in this Bill, is not going as far as I would like to see him go, but he is travelling some of the way. He is—and it is important always to be on the right road—going in the right direction. I think that is very important. I think that a more serious objection to the amendment is in the way it is worded at the moment. I would ask the Minister to let the House know that the suggestions which I am now making in regard to an improvement in the amendment will be considered, and perhaps on the next stage he will be able to indicate to us that my suggestions have been considered, and, as a result, that an alteration in this particular provision will be made to meet the views which I have expressed.

General Mulcahy

We are tending to the abstract. Deputy Gallagher brings us into the realms of X. I think it might be desirable to go out of them a little bit. The Minister has made it clear what his idea is with regard to X. He said at column 1226: "The cost is not going to be £8, I hope. I think it will be considerably less." The X is arrived at by saying that X is equal to a quarter of half of eight. The Minister finds therefore that his X is equal to £1. When the Minister starts off with his £8 and finds the X from his £8, we are told by him at column 1228, in order to avoid confusion: "I think we should make it clear if it is not already clear that administration should not come into this. It should be only the medical and hospital cost." Let us see what sub-section (1) of the section provides:

"A health authority shall, in accordance with regulations, make available, without charge, medical, surgical, midwifery, hospital and specialist services for attendance to the health of women (being women specified in sub-section (2) of this section) in respect of motherhood."

Surely that does not arise on this amendment.

Dr. ffrench-O'Carroll

I apologise, Sir. It does not arise on this amendment. It is just that questions have been put to us. Let us come back to the amendments. These amendments brought forward by the Minister and similar amendments which were suggested to Deputy Dr. Browne before he resigned as Minister for Health must have been brought forward for, as Deputy Dr. Browne says, various reasons. Let us get down to facts. What are those reasons? Are the reasons brought forward on moral grounds and if the reasons are brought forward on moral grounds I certainly would like to be informed of the fact by persons who are competent to tell us whether if there is an objection on moral grounds to this section?

Are these amendments suggested on economic grounds? It is quite possible that they may be suggested on economic grounds. There may be economic grounds which would necessitate the introduction of a charge here. But, although there may be economic grounds which would necessitate the introduction of a charge, I think the Minister in bringing forward these amendments is, as Deputy Morrissey has said, making a very poor shot in the dark. Why lay down rules which may be quite useless in arriving at the charges which it may be necessary to introduce under this section? A very reasonable case has been made by Deputy Dr. Browne and indeed by all speakers in the House that the position should be reviewed under this section. If it is decided that it is not contrary to moral teaching as it stands, or with the payment of £1 or a small sum, then the Minister, whoever he may be at that time, after the scheme has been in operation, will be in a position to review the cost if it is a question of economic grounds, and make whatever changes he wishes.

Everybody's complaint about this Bill is that there have been so many amendments, that there are so many means tests, that there are so many sections and here we are contemplating putting one of the most involved amendments into a more involved section than exists in any other part of the Bill. I personally think it would be very much better to leave this section as it is and that the position should be reviewed in the light of experience.

I am sorry to criticise the Minister in his difficulties and to bring forward yet more suggestions which are merely an addition to amendments that are there. I appreciate the position the Minister is in. I have the greatest admiration for the very courageous way in which he has handled the whole question of this legislation. He could not have a more difficult task and I personally have complete confidence in him to do the best he can under the circumstances.

Dr. Hillery

I, also, am not quite clear why this amendment has been brought in by the Minister. I had accepted that the £1 contribution to be paid by this section of the community was a device to satisfy the interpretation of the moral law as applied to this Bill. The amendment itself seems to imply that the £1 does satisfy for at least three years. Without being told one way or another what was the etymology of the amendment, I accept that it is economic. It seems to provide an opening for economies to be effected at a later date. I am not quite sure that I could agree now that economies to be effected in the administration of our health legislation should be effected in just one particular section and in regard to one particular group of the people. I am not satisfied either that the first three years of administration of this Bill will give us any satisfactory information. If the contributions were to be higher and are to be higher, I think you will reach the stage where the number contributing will equal the number availing of the service. At £1 a year a bigger number would probably contributethan would afterwards avail of it.

I do not think the Minister should attempt to make any provision now for three years' time or five years' time or ten years' time. I am sure Dáil Éireann at that time will be perfectly capable of effecting any changes in the health legislation that may be necessary. I believe this is an economic question. If economies are to be effected in three years' time I believe they will probably have to be effected on a wider scale. I think the Minister would be well advised to consider withdrawing this amendment.

Mr. McQuillan

First I would like to say that I resent the suggestion by some members of the Opposition that any Deputy who says that he believes in a no means test scheme is growing horns or has a cloven hoof. I am a believer in a mother-and-child scheme without a means test. I make no apologies to anybody in this House or outside it for that statement. Let us get this clear. Deputy Morrissey suggested that there has been a change of attitude by people in this House, like Deputy Dr. Browne who has stood for a no means test scheme all along and that he has now changed his viewpoint in this. That is, of course, untrue. The difficulty arose in the period of the inter-Party régime. We found that Deputy Dr. Browne, when he came to decisions, had very little support from his colleagues when he was up against it. I think that in this matter Fine Gael are unfair to themselves.

Mr. McGilligan

I would like to talk on this afterwards. Surely it is appropriate to discuss the £1 or an appropriate amount or any variety of amounts in between. I suggest it is appropriate.

An Leas-Cheann Comhairle

Deputy McQuillan is discussing another Act.

Mr. McQuillan

I suggest that the question of the £1 charge arose in the beginning during the inter-Party régime and I am going to make a statement which cannot be contradicted, that this very Section 15, which includes the £1 charge, would have been accepted by the inter-Party Government were it not for the fact that the Leader of Clann na Poblachta, Deputy MacBride, knifed his colleague, Deputy Dr. Browne.

An Leas-Cheann Comhairle

The Deputy is travelling very wide of the amendment and I ask him to come to the amendment.

Mr. McQuillan

I wanted to get that clear. I am trying to let the House have a clear picture of how the question of the £1 charge arose in the beginning and to show that there has been no change in the attitude adopted by Deputy Dr. Browne sincehe was a member of the inter-Party Government. I am suggesting that Fine Gael are unfair to themselves at the moment in connection with this particular section. We know perfectly well that Deputy Costello, who was then the Taoiseach, had nothing to do with asking Deputy Dr. Browne to resign. He made it quite clear to Deputy MacBride that if Deputy MacBride asked for the resignation of Deputy Dr. Browne he did so on his own initiative, and that he, as Taoiseach, had nothing to do with it. Deputy Dr. Browne made it clear that where the Hierarchy gave their views on moral aspects he was prepared to abide by them. I think that should be accepted in the House.

I think I am entitled, as a Deputy who has taken an absolutely independent attitude and made it clear that I support a mother-and-child scheme without a means test, no matter who likes it or dislikes it, to say that there should be no misrepresentation allowed with regard to the viewpoint of the former Minister for Health. I may not have seen eye to eye with the former Minister for Health when taking a certain line politically, but I do not think anybody can suggest for a moment that he has swerved from his view that that type of mother-and-child scheme could be brought into operation. This particular section would have been brought in during the inter-Party régime and all this furore would never have taken place if one gentleman in the Cabinet had been restrained from exercising his vindictiveness by excluding politically his Cabinet colleague.

Mr. Morrissey

Who was talking about misrepresentation a moment ago?

Mr. McQuillan

Deputy Morrissey did not happen to be a member of the political Party to which I refer. I hope he will agree that I should know a little more about the workings of that Party than he did. I suggest that Fine Gael are unfair to themselves in regard to this matter.

I think that this amendment should be withdrawn. Deputy Gallagher gavehis views on the matter and I must say I am in thorough agreement with him. I cannot understand why the Minister should at this stage tie his hands by legislation with regard to what the charge will be in three years' time, why he should restrict himself to 50 per cent. of the cost under this section in three years' time and from that time onwards. It would be much better to examine the whole question when the scheme has been in operation for a period of years and as a result of a review of how it works this House could then decide what charge, if any, will be made for the future. No matter how thoroughly his Department may have gone into the question of cost at best it can only give an estimate. As others have pointed out, in the initial stage estimates with regard to health services are not always correct. The cost may amount to far more than the estimate in the first few years. In view of that, I suggest that this amendment is out of place and that the Minister should withdraw it and allow the section to stand as it is and perhaps in three or four years we can consider what action should be taken.

The question of an insurance scheme has been mentioned by Deputy Kyne. I should like to ask Deputy Kyne, as a member of the Labour Party, how they would propose to carry out an insurance scheme in rural Ireland? I represent a constituency in the West of Ireland which is composed mostly of small farmers. In the province of Connaught there are 55,000 holdings under £4 valuation and another 55,000 under £10 valuation. Will Deputy Kyne, as representing the Labour Party, show me, as a representative of these people, how he proposes to put an insurance scheme into operation for these farmers?

Mr. Kyne

Was it not done in England?

Mr. McQuillan

There is no comparison between the West of Ireland and Britain. Britain is an industrial country and the West of Ireland is an agricultural slum to a great extent. I imagine that Deputy Kyne's suggestion would work out all right in Dublin. Ido not represent Dublin, however, and I say that an insurance scheme could not possibly be worked in areas like Roscommon, Galway, Kerry, Donegal and elsewhere. Consequently, I do not believe it will be possible for the Minister to bring in a scheme such as is suggested by Deputy Kyne and the T.U.C. It would not work out in rural areas. It might work out in city areas. As far as the amendment is concerned, I repeat that it would be better to see how the section as it stands works out and not insert the amendment.

Dr. Ryan

As I said about this particular amendment when it was introduced first, putting in the £1 was said by some members to be just a subterfuge to get around the moral principle. I pointed out, in reply to that particular debate, that it was really in my opinion a sum that could be defended. I said that taking statistics of the number of children born per year of 62,000 or 63,000 and the number of women under 44 years of age, it would appear that births occur every four years. If we are going to base calculations like this on statistics we must take the whole section of the population concerned and it would mean that if a substantial number of women were to join this scheme they would have paid in about £4 for every baby that was born and that would roughly work out at at least half the cost or even more. That was said to be a subterfuge to get around the moral principle by the Leader of the Opposition and by others, and I had to consider that point among others. I came to the conclusion that we should try—at least I was quite prepared to defend my calculation, and being prepared to defend it, I was so sure my calculation was not far out that I was prepared to say let it be decided actuarially after three years to see whether I am right or wrong, and if I am wrong let it be increased.

The question arose about an insurance scheme. This is, of course, if you like an insurance scheme. It is run on insurance principles. Women join, they must pay an annual contribution and they get certain benefitfrom that. It is an insurance scheme to that extent.

Deputy McQuillan has answered Deputy Kyne about the big objection to an insurance scheme for general medical services. Take, for instance, hospital services. We know that certain people require hospital services. We know it would be impossible to get a lot of people to insure because they are not working for employers and it is very hard and expensive to collect contributions from people not working for employers. They remain uninsurable and in the end if would come to the point when we would have to hold out or pay from some other fund. In the end we would have to have a scheme like that laid down in this Bill as well as an insurance scheme. For that reason, an insurance scheme was not proceeded with.

I do not see what the difference is, whether I am asked to put it in for moral reasons or not. As far as I understand moral reasons —of course I am talking to a band of veteran theologians opposite and I want to be very careful—the moral reason is this. A contributory scheme is morally sound and there is no objection whatever to it. So far as the Hierarchy of this country are concerned, they say they are not in a position to decide what the contribution should be, that that is a matter for the civil Government to decide. If you take these two propositions together, that they agree that a contributory scheme is morally sound and that the civil Government is the authority to decide the contribution, then this scheme is all right. I want to say this, however. The Leader of the Opposition,Deputy Costello, and some of the Deputies on the other side spoke about this £1 charge as being a subterfuge. I tried to prove it was not. Certain people were disturbed by that—not the Hierarchy officially in this country—but certain people were disturbed about it and I wanted to prove, as I said before, that I was correct, or nearly correct, in my calculation of what the cost was going to be and for that reason I put in the amendment. As I said, I am so sure of being correct or nearly correct that I am prepared to put in the limitation, either that we should take into account what is mentioned in sub-section (1) or alternatively put in a maximum of £2 instead of £1

And if the £2 is required to carry the whole cost it will be there. I do not know if that is going to be acceptable to certain people in this House. The Minister has not yet explained why maintenance is brought in. The Minister told us that he had met the Hierarchy and one member of an opposite Church on many occasions. He accepted that he got a letter raising objections against this particular legislation on the grounds that it was opposed to Catholic social teaching and that he proposed to bring in certain amendments in which he would endeavour to meet these objections. This is clearly one of them. I suggest that the Minister has tried to consider two points of view, one being the point of view expressed in the editorial columns of the Irish Times, in which it was said that in any new legislation of this kind, certain Christian principles must inevitably suffer. That is the standpoint of certain people, that we are going to have progress at the expense of certain Christian principles. As against that the Hierarchy sent a letter to the Government, which it was intended the faithful should eventually get and which certain members of the faithful in this House are complaining that they have not got. I think they are entitled to that support. I understood that the Hierarchy had approved of what they called “graded subvention”; they thought that citizens should be helped by graded subvention according to their means. I understood that the Hierarchy added that that graded subvention according to a person's means would help citizens to get treatment from thedoctor or the hospital of their choice. They are not getting that from this amendment or this section.

Again let us get back to the bedrock of this whole matter. The people referred to in this Section 15 are people in the higher income group— that is people whose family income is higher than £600 a year. That is not a tremendously high income, particularly when one relates it to the 8/- value which the £ of to-day possesses as compared with the £ in 1939. It means that the family income to-day of £600 would be equal to a family income of only £240 in 1939 but when one moves out of that category, one is supposed to be in the higher income group. For these people we are still having the public ward treatment. I understand that the public ward is still in the background of Section 15. As the article in Studiessaid: “Gone forever are the hopes or fears of ‘free-for-all’‘paid-for-by-nobody’ health services.” We are now clearly faced with the withdrawal of the original proposal in favour of an insurance scheme. I suggest that that scheme does not dispose of the hierarchal objection based on Catholic principles. These principles are that you are entitled to help citizens by a graduated subvention according to their means but apparently now the only treatment open to these people is the public ward treatment. This is the particular mess of pottage for which certain people bartered their principles. We had the promises before in regard to the 17 points. One of these points was the maintenance of subsidies. If anything the subsidies were to be increased. But the subsidies were reduced last year. The reduction is continuing this year and the reduction will be in operation for 12 months this year where it was in operation for only eight months last year. People were brought to support the diminution of the subsidies on the plea that the money so saved was to be devoted to paying the cost of certain social welfare schemes. On the credit side there were those social welfare schemes and it was said that there was to be £1,000,000 over for the State. That was said to be reserved for the Health Bill.

Now we have the Health Bill and we realise that the free-for-all has gone and we will now have to provide these midwifery services for the people in the higher income groups still in the public wards; and the Minister laboriously says that he always intended that half the cost would be paid and that he thinks that the £1 would be 50 per cent. of the cost. He told us that was clearly and openly characterised as a subterfuge. Another phrase used was tight-rope walking in an effort to evade a moral issue. He denies that now. Nevertheless he brings in an amendment to have what is called an appropriate amount charged and there is no doubt as to what the appropriate amount is to mean. It is to mean the amount hereafter found to subsidise 50 per cent. of the cost, possibly leaving out the administrative costs. That is the new scheme. Certainly it is a very different scheme from the one that was talked about on public platforms. I cannot see why the suggestion of the Labour Party should not be accepted that there should be a proper insurance scheme in which the premiums could be associated with the benefits that would be got. The premiums would, of course, have to be raised if the cost of giving the benefits increased, as happens in almost every insurance scheme. Of course, it is taken in this House that an insurance scheme is either fatuous because the statistics, calculations or finances have not been worked out right, or else it is something that offends the moral sense of those who defend the political rights of this community and say that our people should have entirely free health services for all sections of the community.

I would ask the Minister to be frank with the House. For some reason or another he has brought in an amendment containing the phrase "the appropriate amount" and the appropriate amount is then defined by an amendment which he proposes later "provided that the appropriate amount shall be £1 and—

shall provide that the appropriate amount referred to in paragraph (a) of this sub-section shall, for each successiveperiod of five years (the first of such periods being the period of five years beginning on the day after the expiration of three years from the commencement of this section or such later day as the Minister may determine to be the earliest practicable day for the beginning of the first of such periods), be—"

Then we get a long rigmarole which, at the end, comes to:—

"One half of the estimated total cost as determined by the Minister by or on behalf of whom such contributions are paid."

The Minister should be frank about this. This is insurance and the phrase introduced here is a recognition of the fact that the £1 was subterfuge and that there was a certain amount of tight-rope walking. The Minister has been coerced, quite properly coerced; perhaps, I should not use the word "coerced"—he has been educated and he did not get that education from theologians here. He got it from outside. He should tell us that that is the case. All the facts point that way.

The Minister is introducing this amendment because certain Catholic social principles have been put to him and he has been told what those principles mean. He has been told how far the original section in his Bill offends against these principles and at this late stage he has decided to mend his hand.

Dr. Browne

First of all, I want to clarify a point made by Deputy Kyne. The scheme put forward by the T.U.C. was in relation to the mother-and-child scheme in the hope that it would meet the position and do away with the objections put forward at the time. The objections were similar to those that Deputy McGilligan has now told us were raised in respect of this scheme. The T.U.C. put forward a contributory scheme only in relation to the mother and child. The arguments for a general health scheme have been dealt with by the Minister and Deputy McQuillan. I ignore Deputy Kyne's remarks about standing up with theLabour Party. The Labour Party will stand when it succeeds in getting off its knees, on which they have been grovelling for the last 20 years.

Mr. Kyne

We will get up when you leave us.

Dr. Browne

Dealing with the Minister's point about the amendment to the first proposition, I think it would be very difficult to consider a section detailing the specific members involved in running a complicated health service from midwife to G.P., specialist, consultant, with a background of pathologist, bacteriologist, chemist, radiologist and all the subsidiary persons who will be brought in. I think it would be very difficult to specify the people one means to include in assessing the cost of implementing any section here. It would make the thing very clumsy. As far as I am concerned it will be perfectly acceptable if we are bound by the decision that it must be a contributory scheme as proposed by the Minister. If he feels that the advice he has up to the present that a limited £2 contribution would meet any objections put forward, then naturally I could not disagree with his taking steps to implement that. I myself have not accepted such objections as being completely out of order. I cannot criticise the Minister for doing what I did myself. If he feels £2 will meet the objections, I am prepared to give him my full support.

Dr. Esmonde

We are dealing now with the higher income group. According to the Minister there are 62,000 births per annum. He hopes to collect £4 per birth, or approximately £248,000. That is to meet half the cost of the scheme for the higher income group. That is an insurance scheme. If the Minister is introducing an insurance scheme he has apparently cast aside any idea of a free-for-all scheme. If we are to have an insurance scheme why not have one which will indicate plainly to the recipients what exactly they will get? We are all agreed that there are considerable difficulties facing the higher income groups in relationto expenses in this connection. Surely it would be better to have a whole-hog insurance scheme. What is the objection to it? Apparently the principle of insurance is acceptable. At the present moment the recipients under such a scheme have no idea what benefits they will get in return for their contribution. They will get a bed in a public ward if they are prepared to take that.

I move to report progress.

Progress reported; Committee to sit again.

Dáil Éireann debate - Wednesday, 17 Jun 1953

Health Bill, 1952—Committee (Resumed).

Dáil Éireann debate -
Wednesday, 17 Jun 1953