I dealt last night with the Minister's apologia pro vita sua for holding up the building of necessary hospitals and his provision of this money now when that work could have been efficiently proceeding during the past three years. The Minister interjected to defend himself on the ground that his credit would not permit him to provide the employment and the amenities of these hospitals at a time when it was urgently necessary to do so. I think that is a very poor alibi. The event has demonstrated clearly that funds were abundantly available for this work. Now, on the eve of the general election, he announces with a flourish that he intends to put it into operation; but those who might have contributed materially to it form part of the 200,000 who were forced into emigration.
Those who have had to do without the hospital accommodation which they might have had for the benefit of their health, and possibly for the saving of life, have had to do without it simply because the Minister misjudged the situation. There is nothing we can do about that now because these precious years have been lost and these precious people have been lost. But it is right that we should note it and register an emphatic protest against what I believe was the base political gimmick which inspired the Minister to withhold the funds necessary to complete this useful work and to provide this necessary employment for the thousands of skilled and unskilled workers who have had to go to Birmingham, London and Glasgow to build houses and hospitals for the British people when they could have been very much better employed here at home building them for their own.
There are some other matters in regard to this Vote I should like to raise. I want to refer to the voluntary organisations for the rehabilitation of patients who have suffered protracted illness and who find some difficulty in resuming normal employment, owing either to the disability left after their acute illness has been cured or to the protracted nature of the illness which has left them out of touch with their ordinary channels of employment.
Voluntary work of this kind often produces the best results, to judge by the results that have been obtained by the National Rehabilitation Association. The voluntary workers in that body are getting very remarkable results. It is true that where you have a successful voluntary organisation, there is a great deal to be said for letting them rely on their own resources and enjoy the absolute autonomy that independence confers upon them. But there is a danger that, when they reach a certain point in their work, the mere shortage of money to provide certain important equipment makes it impossible for them to carry on, or at least makes it necessary for them indefinitely to postpone activities in which they might efficiently engage.
I had similar problems in another sphere when I was Minister for Agriculture and I eventually persuaded the Government to the view that it was legitimate in certain circumstances to provide a voluntary organisation of that kind with funds for specific purposes, on the clear understanding that that would involve no claim on the part of the Government to control their activities. I do not think one can do that generally, because it is a sound general principle that if public funds are involved, there must be supervision of their expenditure; and that is not a principle from which we should readily depart. But I feel where a voluntary body is doing excellent work it is not unreasonable to suggest that, if funds are required to finance their current activities and they are restricted in the scope of their activities by the want of accommodation or equipment, the Government might in those circumstances offer the capital cost of buildings and equipment so that the voluntary body can carry on its work.
We have accepted the principle that where religious Orders are prepared to undertake the care of the sick, the mentally retarded or the old, we will provide the buildings and equipment they want to carry on their work. I would suggest to the Minister that we should favourably consider the present financial stringency of the National Rehabilitation Association, which they themselves are seeking to relieve by a national campaign for funds. I believe these funds are mainly required for buildings and equipment; and if it appears that, without any unreasonable departure from normal practice, some financial assistance could be provided, the Minister should favourably consider asking the Government's authority to make such provision.
I want to make it quite clear I am in no way authorised to speak for the National Rehabilitation Organisation. So far as I am aware, they are cheerfully going about the business of collecting all the money they require by a campaign to raise funds. I think they aim to raise £250,000. I hope they will get a large part, if not the whole, of that and I would be glad to do anything to help them towards that end. It seems a very formidable burden and it seems a pity that their work should be postponed until the money is available if it were in our power to give them any assurance that they could go forward now in the knowledge that, if their drive for funds falls short of their target, they might confidently look for sympathetic consideration from the Minister for Health in helping them to meet any deficit in which the expansion of their accommodation and equipment might involve them.
I want to mention another matter now, and that is the care of old people. I notice in the Minister's opening statement that he says that he is now committed to an extensive programme of repair and reconstruction of county homes. God knows, the county homes are not very luxurious establishments. I want to renew the suggestion I have made on more than one occasion when discussing the Vote for the Department of Health that we ought to reconsider our whole approach to the problem and care of the old. There are old people living in the city of Dublin and, if they require institutional treatment it is all right, I suppose, that they should be gathered into one centre, because access to that centre from any part of the city of Dublin is readily available to their relatives at low cost and the possibility of the old people seeing familiar faces from time to time is not reduced substantially by their occupancy of institutions.
I should like to ask Deputies to consider the circumstances of old people living in rural Ireland. One of the great tragedies of old age in rural Ireland is the loneliness and the feeling of not being wanted any more. We all know that the great majority of old people spend their declining years in the homes of their children. They are a familiar part of the family circle and, even though there may sometimes be a little friction and upset, that all constitutes part of the natural family life, and the old people feel that they belong somewhere. The great tragedy is the old people whose children have emigrated, or who are the last survivors of the families they brought into the world, and who find themselves living alone in a room on the old age pension till the day comes ultimately when it is no longer safe for them to be alone. They meet with little accidents. Perhaps they get burned at the fire or spill a kettle of hot water on themselves and are ultimately prevailed upon to go to the county home. I have known such cases.
I have often been rebuked for trying to enable some of my old neighbours to hang on to their inadequate rooms which they inhabit in their home town. It was suggested to me that I was obscurantist in trying to make it possible for them to stay on when they were in grave peril to themselves. Maybe I was, but I have always felt that, so long as it is humanly possible for them to live amongst their neighbours and have their own little independence, however humble, that is infinitely preferable to the best of institutional care in the county home 30 miles away from their neighbours, with not a familiar face to be seen, and where they are simply waiting to die, and waiting to die amongst strangers. That is a pressing evil for us all and I doubt if there is a single Deputy in this House who does not share my solicitude for that dilemma.
The county homes are there. These old people are silent. Unfortunately it is also true that, sometimes in rural Ireland, there are those who are anxious to get old people removed to an institution where they no longer constitute a responsibility upon their relatives. Bearing all these things in mind, I want to remind the House that those who went before us in past ages had a very much better solution for this problem that was as real centuries ago as it is today. Their solution for that problem was the establishment of what used to be called charities, of which we have some examples in the country towns of Ireland today. I think there is one such charity in Mitchelstown, for instance, which takes the shape of a group of houses in which old people can be accommodated. Some of these old charities have associated with the tenancies of these houses a modest stipend as well. I think there are several in the city of Waterford.
The great merit in that system is that where the old people find themselves either alone or in very straitened circumstances they can be looked after in circumstances which make it possible for them to see a familiar face, to meet their neighbours and, above all, to "belong". They can go on going to the chapel every evening, as they have gone all their lives, to say their prayers; the little walk up and down brings them in contact with neighbours with whom they can pass the time of day and, from time to time, neighbours will drop in on them to have a cup of tea or bring them a little present, and life continues. They are not doomed to incarceration in an institution, waiting death.
I do not want to reflect on the institution. I remember asking a very distinguished woman, the Reverend Mother of one of them, how could she possibly have spent so many years in the service of these derelict old people who are very often most unrewarding patients because they are lonely and unhappy and consequently prone to complain. And who will blame them? She looked at me and said, "If I did not see the likeness of the Lord in their faces I would not have lasted a month." Those words have stuck in my mind ever since she uttered them close on 30 years ago.
The condition of the old county homes has been very materially improved since that time but, it does not matter how much you improve them ; to take old persons from their familiar surroundings and accommodate them 20 or 30 miles away in an institution and cut them off from everything that makes life worth living for them seems to me to be wholly wrong. Could not we, instead of spending vast capital sums on the county homes, appropriate some of this money to building small groups of houses for the accommodation of the poor and aged in their own parish, albeit that that would involve the employment of a matron or an almoner to exercise general supervision over such a group of patients and to be the friend and helper of old people who wanted some assistance in maintaining their domestic establishment ? I do not think that is an impossible thing. Lots of these old people are active and brisk if only they have some useful work brought within their reach that they are able to do. You would often find amongst the old people who inhabit charities of that kind, of a group of 12 or 14 houses, one of the old ladies very willing and anxious to act in the capacity of almoner to the rest. In fact, you would find that a great many of them would help one another and a kind of community life could be built up which, with the assistance of neighbours, would function very well.
I put it to Deputies from rural Ireland, if some of their old neighbours became unable to look after themselves without some help and they had the alternative of accommodating them in their own parish amongst their neighbours or of sending for the ambulance and carting them to the county home 20 or 30 miles away, which would they prefer ? Would they not infinitely prefer to see them accommodated at home amongst their own people ? If we are all agreed that that is a good thing to do, why do we not try? Those who went before us tried and the charities they established 300 and 400 years ago are still operating. There is no greater testimony to the efficacy of their plan than the fact that it has endured down through the centuries and is still operating. It was during the period of the deplorable Poor Law mentality of the middle of the 19th Century that this whole concept of workhouses emerged. One hundred and fifty years ago there was no workhouse in this country. Workhouses were the fruits of the famine and the evictions. Why should we feel ourselves chained to that system ?
