In one rather short section of this Bill the Minister proposes to make revolutionary changes in the administration of the Health Services in the county and city of Cork. Where did this demand for such changes come from? Did it come from the people of the county and city of Cork? Did it come from the members of Cork Corporation or did it come from the members of the Cork county council? Indeed, it did not. There was no suggestion for any changes made either by the Oireachtas Members in Cork county, county councillors, local representatives or the general community.
This move to establish a unified health service authority in Cork originated in the Custom House because we heard about this some years ago. The idea is not a new one. Some four or five years ago, when Deputy O'Higgins was Minister for Health, in a democratic manner he put the viewpoint that Cork Corporation and Cork county council should consider the feasibility of establishing a unified health authority. It was rejected unanimously by the Cork County Council and there was no more vehement opponent to it on that body than the previous speaker here this morning, Deputy Corry. Having regard to the unanimity of its rejection by the Cork County Council and, I understand, by Cork Corporation, Deputy O'Higgins in a democratic way accepted the viewpoint of the public representatives of those two authorities and waived his proposal to implement a unified health authority in Cork City and County.
That was all very well until the present Minister came into office. Naturally the same promptings were at his disposal in the Department and what was his attitude to them? Did he consult Cork County Council or Cork Corporation, or did he consult any authority on health legislation in Cork County? He certainly did not. At least that is the information I have. Instead he introduced this Bill, with Section 3 in it, changing the health administration in Cork County. We had a rather lengthy discussion in Cork County Council on the proposed change and I feel the Minister will agree that the members of that body, with their local knowledge, are just as much conversant with health administration in Cork, and with the advantages and disadvantages of the proposed change, as are the people in the Custom House who have no personal knowledge of the difficulties to be faced in satisfactorily administering a health service in an area such as Cork, which comprises more than one seventh of this State.
The proposed change was rejected by Cork County Council and Deputy Healy will correct me if I am wrong when I say it was rejected by Cork Corporation. However, the opinions of these bodies were not acceptable to the Minister and now he proposes to make a change in the original section to increase the membership of the unified health authority, from 16 to 28 in the case of the council, and from eight to 12 in the case of the corporation. He further informed us this morning that even though he intends wiping out Cork Mental Hospital Board and the Cork Sanatoria Board as statutory bodies, he intends allowing the establishment of these same bodies under the title of "sub-committees". It seems ridiculous to me that with the passing of this Bill the Cork Mental Hospital Board will be wiped out but as a sub-committee it will be restored. The same thing will happen with the Sanatoria Board and I cannot see how economy will be effected by that.
If these Boards are to be established in the form of sub-committees it is natural to assume that the staffs attached to them will be retained and, along with their retention, is it not also reasonable to assume that new staffs will be recruited for the unified health authority? The Minister says that at present we have four or five different authorities in the country and city of Cork dealing with health administration but, judging from the statement he made a short time ago, it does not seem likely that he will reduce the number of these bodies.
The Sanatoria Board will continue to function as a sub-committee. I think there is very little in that because everybody knows that, so far as the administration of health services are concerned in any part of the country, the main functions rest with the county managers and it could be said that bodies like the Mental Hospital Board and the Sanatoria Board are only keeping a watchful eye on the manner in which the managers administer the moneys provided at the annual meetings of these bodies. Everybody knows that their functions are very limited because the Government and the Minister have the right to abolish a body or board that does not act in conformity with Governmental and Departmental regulations. Several such bodies who adopted an independent attitude were abolished in the past and it is not unlikely they will be abolished in the future.
I was amused to hear my colleague from Cork changing his viewpoint on this measure. Deputy Corry now says that the only nice thing about it is that the people in Cork City who are in receipt of home assistance, and who qualify under the free footwear scheme will have to pay for these services within the city confines. That is a very peculiar statement and I understand he has anticipated the Minister's approach to Section 11 of the Bill, that there will be a system of local charges. I am entirely and completely opposed to a system of local charges.
Deputy Corry seems to think that if the citizens within the South Cork Board of Assistance area get assistance, either in the shape of home assistance or free footwear, the Cork Corporation area should pay. I do not agree with that viewpoint and I do not agree that it should happen if we have a unified health service in Cork. I think if the rural part of the South Cork area is in the favourable position that much fewer of its citizens need public assistance in the way of allowances or free footwear, Deputy Corry and others on that body should be very pleased that is the position— that much fewer of their population need help and assistance from local authorities than do, say, residents of Cork City. That is a peculiar approach to the support of this measure because, if that is carried to its logical conclusion, it could be said that benefits given in a particular area should be charged to that area and that we should have a system of local charges.
It could be said that different electoral areas in the county should bear their local charges. I believe that is entirely out of place. I feel that if this unified health authority comes into being the proposals of Deputy Corry should be ignored. Charges should be on a uniform scale, extending over the city and the county as a whole. I make that statement even though I am completely opposed to the section and have my name down sponsoring its rejection. However, should the section be passed, I have a feeling the Minister will ignore the move being made to set up a series of local charges.
I represent possibly the poorest part of Cork County. I am a firm believer that wherever a local authority functions there should be the same rate of charges all over the area, irrespective of where the special or additional services are being provided. Deputy Manley has referred to this question that has agitated the minds of all of us in Cork County. It is more than 100 miles in length. Furthermore, within the county, there is a large population residing in Cork City.
What may be said to be applicable to people and to areas in West Cork or maybe in other parts of the county would not be applicable to Cork City. If a board, say, of 40 members is set up and say, Deputy Healy has some special case to make for residents within the Cork Corporation area, will opposition to the provision of benefits for the people of Cork City, as expounded here to-day, prevail and will the members, say, from West or North Cork adopt the attitude "What is happening in the city is not a close concern of ours; we will try to keep down the rates even in respect of a service that may be absolutely essential." I am not too positive that that will happen but if we have too many Deputy Corrys on the board it is quite within reason that it may happen.
I believe that once a person is on a board, whether a council or a health authority, he must approach questions coming before it on an equitable basis irrespective of where they come from, whether they come from the area from which he himself is getting his votes or from opposite parts of the area. If there is no uniformity of approach by the members, I am afraid such a body would not do much useful work.
I do not want to delay the House. I should not, however, like to resume my seat without asking the Minister, instead of expressing disapproval, to review once more the proposals submitted to him by the county health services committee regarding mentally defective children in County Cork. To give the Minister a résumé of the position, this has been a very serious problem in Cork County for the past number of years. We have several mentally defective children, divided into four classifications by the county medical officer, who cannot get suitable accommodation.