Deputy Corry has given notice that, on the motion for the Adjournment, he wishes to raise the subject matter of Question No. 33 on to-day's Order Paper.
Private Members' Business. - Adjournment Debate: Cork Hospital Bed Complement.
I asked a question of the Minister for Health today as follows:—
"To ask the Minister for Health if he will state (a) the date of receipt in his Department of a letter from the South Cork Board of Public Assistance, requesting sanction for the increase of the bed complement in the Orthopaedic Hospital, Gurranebraher, by some 20 beds, (b) the date on which the letter was replied to, (c) the date on which sanction was notified by his Department, and (d) the reason for the delay."
In the reply the Minister said that the previous Minister for Health orally authorised the manager to equip the ward for 20 patients and to obtain the necessary equipment locally—and that that was on the 27th July, 1956.
It is very extraordinary that we had this whisper over the phone to the manager and that the manager apparently forgot all about it. On the 28th August, just a month after we were supposed to have received sanction, the Board of Public Assistance wrote saying it was desired, as a matter of urgency, to increase immediately the number of beds, including cots, in that hospital to 200, on account of the outbreak of polio. It is extraordinary that, if the Minister had whispered over the phone to the manager, giving sanction, the manager would sit silent whilst his secretary, on the instructions of the committee, wrote back to the Minister's Department looking for sanction. That was on the 28th August, 1956.
A further letter was sent on the 2nd October, 1956, looking for an increase, and 20 beds were sanctioned. This was looking for an increase, for the provision of 67 beds—47 for polio, 13 for Block 4 Ward and the balance seven, and appropriate equipment for the full bed complement up to 200. That was sent on the 2nd October. That was the second letter, reminding the Department of our application of the 28th August.
A further letter was sent on the 19th December, 1956, again appealing for the necessary sanction to bring the bed complement up to 200. It is extraordinary that the Minister should have given sanction, according to this, on the 27th July, 1956. Following our letter of the 28th August, this is the excuse given here:—
"No reply issued at the time in response to this application, as it was necessary, in view of the stringent financial situation, to defer decisions on a number of projects for which grants had been sought."
I do not know what 67 beds are thought to cost, but I do know what the amount of the stake in the Dublin Sweepstakes was handed over. The amount for 50 per cent. of the cost of 67 beds would be roughly about £300, at a period when the people of Cork and the hospital authorities of Cork were driven to their wit's ends to find beds for an epidemic of polio. Of course, this did not trouble the gentlemen in Dublin, who had no money, despite the fact that they had collected over £1,500,000 out of the sweepstakes the previous year. My objection is that when the local authority instructs its secretary to write to a Department, the least we might expect is an answer. Three letters are written to the Department of Health here. None of the three was answered and the first reply we got was on the 25th November, 1957, 14 months after the application was made—that is after we got sanction for the 20 beds. I do not know what Departments of State think, but I know what the people think about them. Since we are supposed to have democratic rule, it is about time we had a little democratic rule and not be ruled by a kind of ring which has been formed up here in Dublin.
During that period we had to put patients into the old Richmond Hill Fever Hospital, a large number of them; we also had to take over the fever hospital in St. Finbarr's and put patients in there and we had to go to the Cork County Sanatorium Committee and apply to them for beds under those circumstances. At the same time, we had room in our own hospital for extra beds and the Minister and his Department were too busy to send down a letter of sanction. They were depending, apparently, on an oral message delivered, or supposed to be delivered, by a Minister on the 26th July, 1956. If the message had been delivered, it is extraordinary that the manager forgot all about it when the matter was discussed a month afterwards, on the 28th August, 1956. It is extraordinary that he should forget all about it when he instructed the secretary to write again on the 2nd October, 1956, looking for sanction for 67 beds.
I suggest the Deputy should not repeat himself.
Those are the facts and they are very straight facts. I do not want to read here the letters, copies of which I hold in my hand, that were sent to the Department on each occasion I have mentioned. I have them here. It is rather extraordinary that a manager would instruct his secretary in that way. The first letter was on the 28th August and was written as a matter of urgency, to obtain sanction. In the second letter it was stated: "The Minister's sanction is now applied for to the provision of 67 beds, 47 for polio, 13 for Block 4 Ward and the balance seven and appropriate equipment to cater for the full bed complement of 200." It was on the 2nd October, 1956, that that letter was sent. It is extraordinary that a manager who had got sanction from a Minister on the 27th July, 1956, would come along in August and October and write to the Minister looking for sanction again. Does the Department think that we are all idiots in this country? I cannot blame the present Minister. I blame the Department who were completely callous——
The Minister is responsible to the House and the blame must be brought home to the Minister.
I cannot blame the present Minister. He was not there at the time.
The Minister is responsible.
They were so completely callous to the conditions of affairs in Cork as to turn a deaf ear and not even to have the decency to reply to a letter sent to them. If there is any doubt as to whether or not sanction was given I would refer the Minister to his own letter of the 25th November last. It is an extraordinary thing that on the 25th November he had to sanction something that his predecossor was supposed to have sanctioned on the 27th July, 1956. My reason for drawing attention to this matter is to endeavour to bring home to the civil servants of this country——
To bring home to the Minister.
To the Department and the Minister that they have some responsibility in the Department of which they are in charge. The people are paying them to do a job.
I told the Deputy before that the responsibility lies on the Minister. The Deputy had better remember that in future reference in this matter.
Finding ourselves in a difficult position, with 300 people on the waiting list, we tried to get some accommodation from the sanatorium committee. With tuberculosis on the wane they found themselves with extra accommodation, and last July they gave us a small hospital containing some 40 odd beds. It took from July to November to get sanction from the Minister's Department for that and, in the course of their reasons for not giving sanction they had the nerve to tell us that we had room for a further complement of 20 beds in the Orthopaedic Hospital, Gurranebraher, to bring the number up to 200. They were telling us to do something for which they had refused sanction and for which we had written, asking to be allowed to do it, on the 28th August, 1956, in October, 1956, and in December, 1956. If that is the manner in which Departments of State are to be worked, the sooner we get something else besides what is a mockery of democratic government, the better for everybody.
I gave a very full answer to-day because I wanted to give the Deputy the background of the situation as I was able to ascertain it from the correspondence in my Department. I could have given him a different answer. I could have answered the precise question which he asked, that was: the date of receipt in the Department of Health of a letter from the South Cork Board of Assistance requesting sanction for the increase of the bed complement in the Orthopaedic Hospital, Gurranebraher, by some 20 beds.
The truthful and literal answer to that question would be that the first letter from the local authority, which referred to an increase of 20 beds in the bed accommodation in St. Mary's Hospital, was received in my Department on the 24th October, 1957. I do not want to ascribe any blame to the Cork Board of Assistance or the officers of that board. I shall deal with them rather more fairly than the Deputy has been prepared to deal with the officers of my Department.
This whole matter arose out of a very difficult situation in Cork. The Deputy himself knows of it; he has referred to it—the polio outbreak of last year. It did happen that the Cork Board of Assistance, on the 27th June, 1956, wrote to the Department proposing an increase of 13 in the bed complement at St. Mary's Orthopaedic Hospital, that is, to increase the number of beds there from 137 to 146. It happened that my predecessor was in Cork a month after that request had been received. He visited the polio unit and he then saw the county manager and told him that he gave him authority to proceed to equip not 13 extra beds but 20 extra beds at St. Mary's.
On the 28th August a letter came from the South Cork Board stating that the board had decided to increase the bed complement in St. Mary's by 67 beds, from 133 to 200. That was the origin of the proposal to increase the number of beds. There was no request for sanction contained in that letter. The letter merely indicated that the board had decided to increase the number of beds and the board is perfectly entitled to do that. It did not involve any consideration but merely involved an increase in the number of beds. Therefore, the sanction of the Minister was not necessary unless, at the same time, a grant from the Hospitals' Trust Fund or from such funds as the Minister might have at his disposal, was requested. Such a request did not accompany the letter of the 28th August.
On the 17th September, almost three weeks later, the Department agreed to a suggestion by the county manager that 20 beds at Sarsfield Court sanatorium should be used by orthopaedic patients as a temporary measure. So then, in a couple of months, there were 40 additional beds sanctioned and authorised as against the 67 which the South Cork Board of Assistance had decided they would provide.
It happened that on 2nd October, 1956, we received a further letter from the South Cork Board requesting formal sanction to increase the accommodation in St. Mary's Hospital by 67 beds, 47 for post-polio patients, and 20 for other orthopaedic patients, and seeking grants for equipment much of which had been ordered. That was the first letter seeking a grant. Unfortunately, as Deputy Corry must be aware, it reached the Department at a time when it was not possible for the Minister to give any answer.
To find £300?
It was not a case of finding £300. He was not in a position at that time, having regard to the general financial situation, to give an answer and, if he had been compelled to give an answer, the answer would have been a refusal. A little later a medical inspector from the Department visited Gurranebraher and found the bed accommodation there had already been increased from 133 to 171 beds, and they were gradually increasing the number of beds to 180.
The 180 beds at Gurranebraher, plus the 20 beds in Sarsfield Court which had been placed at the disposal of the South Cork Board, totalled the actual number of 200 beds which had been the first proposal emanating from the board.
Again, in November, it was not possible to decide whether a grant could be given by the Minister but the fact was that the 200 beds were there, 171 if you like in November, but it was proposed to increase that by a further 9 to 180, plus the 20 beds which had been placed at the disposal of the South Cork Board in Sarsfield Court. No patient in Cork was deprived of the use of these additional 67 beds, which was the original proposal, because the Minister was not able to say at that time that money would or would not be provided.
I agree there was a long delay in dealing with the letter of 2nd October, 1956, which was the first letter in which any request, or any indication, had been given that a grant was being sought. The matter then hung fire because I found myself with a situation, when we took over, that we were going to be hard put to meet our existing and pressing commitments. It arose again in a letter dated 21st September and, arising out of that letter, the question of a grant was considered. As I have already indicated, on the 25th November a letter was written to the South Cork Board of Assistance approving of the increase in bed accommodation in St. Mary's Hospital to 200 beds and making a grant to the hospital from the Hospitals' Trust Fund of 50 per cent., subject to certain conditions. That is the position.
I do not say the Deputy was not entitled to raise this because, without the explanation I have given, it would be very difficult to believe the Department had not been remiss in replying to the letter of 2nd October. The fact of the matter was that, with the general tightening up and restriction on expenditure, my predecessor was not in a position to give sanction to the request, and I was not in a position to do it until last month.
I should like to know if Deputy Corry, as Chairman of the South Cork Board, on any occasion asked the Minister to give him the information he has now received? Could he not have done that, through his position as chairman, without taking this course, keeping the House here in what was blatantly a stunt?
I think that is not fair. Deputy Corry is a zealous member of the House and if he, or any Deputy, thinks that any Department for which I am responsible is remiss in dealing with the public I shall welcome their raising the matter here.
The Dáil adjourned at 10.55 p.m. until 10.30 a.m. on Thursday, 5th December, 1957.