Ceisteanna—Questions. Oral Answers. - Medical and Surgical Posts.

6.

asked the Minister for Health if he will give particulars of the medical and surgical posts, medical services and health institutions which the Irish Medical Association are endeavouring to have boycotted by doctors and surgeons; and if he was informed in advance by the executive of the Association that they were proposing to adopt this course and of their reasons for it.

On the 22nd November, 1958, the Irish Medical Association published a notice requesting its members not to apply for or accept the posts of County Surgeon at Bantry, Laois, Monaghan and Sligo without first communicating with the Association.

On 9th December, 1958, a similar advertisement appeared in relation to the posts of County Physician for Tipperary, Laois and Bantry.

On the 22nd January, the ban was extended to the post of Obstetrician and Gynaecologist to the Waterford Board of Public Assistance.

In the February issue of the Journal of the Association, these announcements were repeated with the addition that medical practitioners were requested not to sit on interview boards for any of the foregoing posts.

On the 23rd May, 1959, the Association extended the boycott to all medical posts, either resident or non-resident, in all local authority hospitals.

On the day on which the initial advertisement of the boycott of the County Surgeon posts was published in the Press, the 22nd November last, I received a letter from the Association stating that they had studied "the conditions, terms of appointment and salary" for the positions of County Surgeon which had been advertised and had decided they could not recommend these appointments to doctors. I was not informed, then or since, of the conditions or terms of appointment to which objection was taken. In respect of the other boycotted posts, also, I had no prior notification from the Association of the boycott and no intimation, beyond what has appeared in the public press of the reasons for the boycotts, with the single exception of the Waterford post when the Association communicated its reasons to the local authority. In relation to the latest boycott of all medical posts in all local authority hospitals, all I know of the reason for it is contained in the press advertisement, that is to say that it is in view of my "letters dated 14th April, 1959 to the Cork County Manager as published in the daily press on 21st May, 1959" that this boycott was instituted. I have already explained to the House that these are the letters which conveyed my findings following a sworn inquiry into the circumstances of the death of a patient at Fermoy Hospital.

The various boycotts, if effective, would affect all the various inpatient services and the specialist outpatient services—surgical, medical, obstetrical, radiological and pathological—provided by local authority medical staff. Already they have caused serious delay in the opening of the newly reconstructed Bantry County Hospital and have deprived the people of West Cork of services, convenient to their homes for which facilities were provided in the new hospital at very considerable public expense. They have also necessitated the temporary close-down of surgery at Mallow.

The local authority institutions involved in the most recent boycott are so numerous that I would take up an unreasonable amount of the time of the House in citing them here, but I propose, a Cheann Comhairle, with your permission, to circulate with the official Report, for the convenience of Deputies, the full list, arranged according to counties.

LIST, by Counties, of Hospitals, etc., affected by the recent Irish Medical Association boycott of Medical Posts.

COUNTY CARLOW

District Hospital, Carlow.

District Hospital, Muinebeg.

Sacred Heart Home (Maternity Hospital and County Home), Carlow.

Mental Hospital, Carlow.

Tuberculosis Hospital, Tullow.

COUNTY CAVAN

County Surgical Hospital, Cavan.

St. Felim's Hospital (County Medical Hospital and County Home), Cavan.

Tuberculosis Hospital, Lisdarn.

COUNTY CLARE

County Hospital, Ennis.

District Hospital, Kilrush.

District Hospital, Ennistymon.

District Hospital, Scariff.

Fever Hospital, Ennis.

County Home, Ennis.

Mental Hospital, Ennis.

Tuberculosis Hospital, Grianán an Chléir, Ennis.

COUNTY CORK (NORTH)

County Hospital, Mallow District Hospital, Kanturk.

District Hospital, Millstreet.

District Hospital, Fermoy.

Fever Hospital, Fermoy.

Heatherside Hospital, Buttevant.

COUNTY CORK(SOUTH)

St. Finbarr's Hospital, Cork.

District Hospital, Bandon.

District Hospital, Kinsale.

District Hospital, Macroom.

District Hospital, Youghal.

District Hospital, Midleton.

Our Lady of Lourdes Home (County Home), Midleton.

Mental Hospital, Cork.

Auxiliary Mental Hospital, Youghal.

St. Stephen's Chest Hospital, Sarsfieldscourt, Glanmire.

St. Mary's Orthopaedic Hospital, Gurranebraher.

St. Michael's Orthopaedic Hospital, Lota Park.

COUNTY CORK(WEST)

County Hospital, Bantry.

District Hospital, Castletownbere.

District Hospital, Clonakilty.

District Hospital, Dunmanway.

District Hospital, Schull.

District Hospital, Skibbereen.

County Home, Clonakilty.

COUNTY DONEGAL

District Hospital, Ballyshannon.

District Hospital, Carndonagh.

District Hospital, Donegal.

District Hospital, Letterkenny.

District Hospital, Lifford.

District Hospital, Dungloe.

Fever Hospital, Donegal.

County Home, Stranorlar.

Mental Hospital, Letterkenny.

St. Columba's Tuberculosis Hospital, Killybegs.

Tuberculosis Institution, Glenties.

DUBLIN COUNTY AND COUNTY BOROUGH

St. Kevin's Hospital, Dublin, St. Columcille's Hospital, Loughlinstown.

Dublin Fever Hospital, Clondalkin (not clear if boycott extends to this hospital).

Vergemount Fever Hospital, Clonskeagh.

Mental Hospital, Grange, gorman.

Mental Hospital, Portrane.

St. Mary's Chest Hospital, Phoenix Park.

James Connolly Memorial Hospital, Blanchardstown.

St. Patrick's Home, Navan Road.

Brú Chaoimhin, Cork Street.

St. Clare's Hospital, Ballymun Road.

Crooksling Hospital, Brittas.

COUNTY GALWAY

Regional Hospital, Galway.

District Hospital, Clifden.

St. Brendan's (County) Home, Loughrea.

Mental Hospital, Ballinasloe.

Western Regional Sanatorium, Merlin Park, Galway.

Children's Home and Maternity Hospital, Tuam.

COUNTY KERRY

St. Catherine's County Hospital, Tralee.

District Hospital, Killarney.

District Hospital, Listowel.

District Hospital, Dingle.

District Hospital, Cahirciveen.

District Hospital, Kenmare.

Fever Hospital, Killarney.

County Home, Killarney.

Mental Hospital, Killarney.

Our Lady's and St. Teresa's Tuberculosis Hospital, Edenburn, Tralee.

St. Joseph's Tuberculosis Hospital, Listowel.

COUNTY KILDARE

County Surgical Hospital, Kildare.

District Hospital, Naas.

St. Vincent's Maternity Hospital and County Home, Athy.

St. Conleth's Sanatorium, Firmount, Sallins.

COUNTY KILKENNY

County Hospital, Kilkenny.

Auxiliary County Hospital, Kilkenny.

District Hospital, Castlecomer.

County Home, Thomastown.

Mental Hospital, Kilkenny.

Regional Orthopaedic Hospital, Kilcreene.

County Sanatorium, Kilkenny.

COUNTY LAOIS

County Hospital, Portlaoise.

District Hospital, Abbeyleix.

Fever Hospital, Abbeyleix.

County Home, Mountmellick.

Mental Hospital, Portlaoise.

St. Brigid's Sanatorium, Shaen, Portlaoise.

COUNTY LEITRIM

County, Hospital, Manorhamilton.

District Hospital, Mohill.

County Home, Carrick-onShannon.

St. Joseph's Tuberculosis Hospital, Carrick-on-Shannon.

LIMERICK COUNTY AND COUNTY BOROUGH

Regional Hospital, Limerick.

City Home and Hospital (including Tuberculosis, Fever and Maternity Units), Limerick.

Fever Hospital, Croom.

Maternity Hospital, Croom.

Orthopaedic Hospital, Croom.

Mental Hospital, Limerick.

County Home, Newcastlewest.

St. Senan's Children's Hospital, Foynes.

COUNTY LONGFORD

County Surgical Hospital Longford.

County Medical and Maternity Hospital and County Home, Longford.

Mount Carmel Tuberculosis Hospital, Longford.

COUNTY LOUTH

County Surgical Hospital, Dundalk.

District Hospital, St. Joseph's, Ardee.

District and Fever Hospitals, and County Home, St. Mary's, Drogheda.

District and Tuberculosis Hospitals and County Home, Blessed Oliver Plunket Hospital, Dundalk.

COUNTY MAYO

County Hospital, Castlebar.

District Hospital, Ballina.

District Hospital, Belmullet.

District Hospital, Swinford.

Fever Hospital, Swinford.

County Home, Castlebar.

Mental Hospital, Castlebar.

COUNTY MEATH

County Hospital, An Uaimh.

Orthopaedic Hospital, An Uaimh.

Maternity Hospital, Trim.

County Home, Trim.

COUNTY MONAGHAN

County Hospital, Monaghan.

Fever Hospital, Clones.

County Home, Castleblayney.

Mental Hospital, Monaghan.

COUNTY OFFALY

County Hospital, Tullamore.

District Hospital, Edenderry.

District Hospital, Birr.

County Home, Tullamore.

COUNTY ROSCOMMON

County Hospital, Roscommon District Hospital, Boyle.

Fever Hospital, Roscommon.

County Home, Roscommon.

Mental Hospital, Castlerea.

COUNTY SLIGO

County Hospital, Sligo.

County Home, Sligo.

Mental Hospital, Sligo.

Tuberculosis Hospital (Grianan Padhraig Naomtha), Sligo.

COUNTY TIPPERARY (N.R.)

County Hospital, Nenagh.

District Hospital, Roscrea.

District Hospital, Thurles.

Fever Hospital, Roscrea.

County Home, Thurles.

St. Cronan's Sanatorium, Roscrea.

COUNTY TIPPERARY (S.R.)

County Surgical Hospital, Cashel.

County Medical and Maternity Hospital, Clonmel.

District Hospital, Carrick-onSuir.

District Hospital, Clogheen.

District Hospital, Tipperary.

Fever Hospital, Clonmel.

County Home, Cashel.

Mental Hospital, Clonmel.

WATERFORD COUNTY AND COUNTY BOROUGH

County Hospital (including Chest Unit), Ardkeen, Waterford.

St. Patrick's Hospital, Waterford.

District Hospital, Dungarvan.

District Hospital, Lismore.

Fever Hospital, Waterford.

County Home, Dungarvan.

Mental Hospital, Waterford.

COUNTY WESTMEATH

County Hospital, Mullingar.

District Hospital, Athlone.

County Home, Mullingar.

Mental Hospital, Mullingar.

St. Anne's Tuberculosis Hospital, Mullingar.

COUNTY WEXFORD

County Hospital, Wexford.

District Hospital, Gorey.

District Hospital, New Ross.

Fever Hospital, New Ross.

County Home, Enniscorthy.

Mental Hospital, Enniscorthy.

Grianán Charmain (Tuberculosis Hospital), Enniscorthy.

COUNTY WICKLOW

County Hospital, Wicklow.

District Hospital, Baltinglass.

County Home, Rathdrum.

It is obvious from the Minister's reply that the health services of this country are about to be brought to a stop and is the Minister aware that unless some action is taken immediately, it will be only a matter of time until this boycott will have fatal consequences, as the services will not be available? Will the Minister state whether he has made up his mind to take any action against the Irish Medical Association, and will he consider setting up a judicial inquiry as the people who are entitled to the health services are being held to ransom? It is a most serious and critical position.

I agree with the Deputy that if this boycott were to be persisted in, a very serious situation would arise, but I am hoping that the wisdom of the general body of the Association will percolate through to those who are responsible for this unreasonable and arrogant action. If, however, the action were to be persisted in, it is quite possible that some public investigation of the motives underlying it would be called for.

And ad interim, would the Minister invite these people to come and see him and discuss the situation with him? Is the Minister not aware that in every trade dispute in which obstinate people get involved, nothing good can be achieved by firing manifestos in public between the parties and usually reasonable men can arrive at reasonable solutions if in discreet discussions, they inform one another of their mutual misunderstandings and grievances, however unreasonable these may seem to be to both parties? Perhaps the Minister would take the risk at least of inviting the Irish Medical Association to meet him and discuss the matter with them so that the suspension of all these misunderstandings might be achieved. Without making any more provocative calls for tribunals, inquiries and war, why not simply invite them to come and meet the Minister, which would certainly put the Minister in the right?

Either there is a Government in this country or there is not.

That is true.

I happen to be Minister for Health and responsible for the administration of these services. I received no notice whatsoever before this lightning strike took place that such action was contemplated. I do not know whether it has the support of the general body of the medical profession or not. I hope it has not. I am not anxious to be at loggerheads with these gentlemen, but I have a position to maintain. I have already indicated that I am perfectly prepared to meet them to discuss their claims, provided they lift the boycott which they have imposed and which is jeopardising the health of the whole people. I am not a believer in shooting first and talking afterwards; these gentlemen shot first and now they are proposing that I should talk to them before they restore the status quo ante.

Would the Minister not consider—in view of his declared preference for talking first and shooting afterwards—that issuing an invitation to them to have discussions, the situation would be entirely different? I fully appreciate that the Minister is a member of a Government, and all the rest, but the important thing is to put an end to misunderstanding and ructions. If the Minister issues an invitation to the Association to come and discuss the matter with him, surely his position as Minister for Health will not be prejudiced by making what appears to be a magnanimous gesture in a difficult situation?

Am I to understand from the Minister's reply to Deputy Dillon that if the Irish Medical Association lift this boycott, the Minister will be prepared to open discussions with them about their alleged grievances?

In reply to Deputy O'Malley, I have already conveyed that to the Irish Medical Association in writing on two occasions. So far as Deputy Dillon's supplementary is concerned, I do not see how I would be justified, in the light of the arrogant action taken by the Irish Medical Association, in meeting that body on their own terms. As I said, I am quite prepared to meet them when the unprejudiced situation which existed before they imposed this ban is restored.

Do not commit yourself.

This is just as great an occasion of worry to me as it is to Deputy Dillon, but so far as I am concerned, these gentlemen have to be taught that there is a Government in this country and that the Irish Medical Association is not superior to it. It will have to honour the law and accept the ordinary humanitarian principles which rule us all in their dealings with the Minister for Health and the Government.

Question No. 7.

Does the Minister suggest that the Irish Medical Association have broken the laws of the land?

I have a suspicion they have.

I should like clarification on that point.

Really, this is reckless language. Surely the Minister ought to pause well before, under the protection of privilege in this House, he charges anyone with having broken the law? If he has reason to believe that, he has a duty to act. If there has been no breach of the law, I do urgently appeal to the Minister that he should consider the merits of what appears to him to be magnanimity in this case. I know the situation is a delicate and difficult one and I do not want to push the Minister into making a declaration that would make it even more difficult. We have all had experience of trade disputes, of both sides sitting down and saying: "I shall move when and if you move." The breaking of such a deadlock always arises by one side having the magnanimity and bigness of mind to say: "To hell with formality. Let us try and get it settled." The Minister does himself no harm by making what appears to be a magnanimous gesture, but I beg him not to charge people casually with breaking the law unless he has made up his mind to act on that knowledge and charge them in an arena where they can defend themselves against such an allegation.

I do not think I have anything more that can be usefully added to what I have said. I do not believe in Munichs.

The Minister's Leader did, you know, and wrote to congratulate the then Prime Minister, Mr. Chamberlain.