Deputy Mrs. Hogan O'Higgins has given notice that she wishes to raise, on the Adjournment of the House, the subject matter of Question No. 6 on today's Order Paper.
Adjournment Debate. - Ardrahan (Galway) Dispensary.
This question of the Ardrahan dispensary has been a sore problem in the area for the past two years. I should like to remind the House of the facts. In living memory, Ardrahan always had a doctor in residence, even in the British time. After that there were three doctors in the area: one in Ardrahan, one in Gort and one in Kinvara. The Gort dispensary became vacant in 1962 when Dr. Fallon retired. At that time in Ardrahan there were 173 medical card holders, in Gort 179 and in Kinvara, 213. I should like the House to remember these figures because they are significant. The Minister knows what happened, but the House does not, and I should like briefly to run through the events.
In 1962 the doctor at Gort retired. In 1963 a motion was proposed at the county council to amalgamate the Ardrahan dispensary with Gort and Kinvara. The reasons given at that time were, first, that the number of medical card holders in the Ardrahan area had gone down. The second reason—and this, to my mind, is the meanest reason of all—was that by amalgamation of the three dispensaries the county council would save money. Surely the county council and the Minister cannot justify the saving of money when human life is at stake?
All this was done without consulting any of the local people. In fact, the only people consulted were the two doctors concerned. When the decision of the county council became known, the local people formed a protest committee headed by their parish priest, Father O'Donoghue. They got together and approached Senator Lahiffe, who had proposed a motion at the county council. To give him his due, Senator Lahiffe told Father O'Donoghue: "If you can convince me of the validity of your case, I will propose another motion to rescind the first one." Apparently, he did that. Senator Lahiffe proposed a second motion, which was carried by a two-thirds majority.
Then the matter passed on to the Minister for his decision. The Minister decided to let the amalgamation take place at that time, on the ground that there were now only 146 medical card holders in the area as compared with 173 in 1962. It is significant to note the large reduction in the number of medical cards. I am told by the people in Ardrahan that there was a drive to abolish medical cards; in fact, the parish priest described it as a ruthless drive, completely unchristian. These were the figures produced at the time. I understand there were a number of people in the area entitled to medical cards but who, for some reason or other, never applied for them. Some people prefer to pay for the doctor, even if they can pay for nothing else. I know of five such cases—three farm labourers and two old age pensioners. I have the names if the Minister wishes to have them. I am sure there were other such cases I am not aware of. This proves that the figures issued by the council and the Minister were not true.
The amalgamation of this area means, in fact, that the people are getting poorer service. They have to pay increased car hire to get to the dispensary area, because there are parts of Ardrahan as much as 14 miles from Kinvara; and as Ardrahan has no night exchange, it makes it even more difficult. The people say they suffer tremendous hardship. I have a long list of signed statements, which I will give to the Minister if he wants them. I think he has them. I shall quote just two of them:
I live within half a mile of the Ardrahan dispensary. I am now in the Kinvara dispensary area. On Sunday morning, 23rd of February last, my husband got suddenly ill. We rushed to Ardrahan for a doctor but there was none there. We then tried Kinvara but there was no doctor there either. We then rang Oranmore for Dr. O'Connor who was doing duty for Dr. Greene but he was not available. We then contacted Dr. Marlborough of Gort who came some hours later. My husband was then unconscious. He was removed to hospital and died that night. I regret that I could not have a doctor sooner for my husband as he could have been saved. I am now left with one child of twelve months.
I cannot say whether or not this man's life could have been saved if he had got medical attention in time, but this I can say: his wife and the people of Ardrahan believe he could have been saved.
I have another letter, also signed, which reads:
On Sunday 24th May at about 5.30 p.m. I came home from my sister's house and found that the baby was ill. About 6 p.m. I and the baby and mother got into the car to go to Ardrahan to Dr. Joyce. He was not there. Dr. Joyce's girl rang Kinvara for Dr. Greene and he was not there. I told her to ring Gort for Dr. Marlborough and this took over a half an hour ringing between both doctors. Dr. Marlborough was at home and I went back to Gort to him. This took over another half hour. He examined the baby and told us to go straight to Galway hospital and that took nearly three-quarters of an hour before the child was taken in to hospital. I arrived there about 8.45 p.m. I feel that the child could have been saved by going to hospital straight from Ardrahan.
To my mind these letters make shocking reading. I have a complete list of them and I will let the Minister have them. Surely no economy can justify the loss of life?
I should like the Minister to note that these hardships occurred while the doctor was still in residence in Ardrahan. Surely the position is bound to be worse when he goes to Gort?
I should like to remind the Minister of a letter written in regard to this matter by the Irish Consul General in Boston, in reply to whom the Minister's secretary wrote:
It appears that the main body of objectors are persons who wish to avail of the services of the dispensary medical officer in his private capacity but who are too few in number to provide him with the private practice that would be sufficient to induce him to remain in the area.
Let us be fair to the doctor. Why would the doctor remain in the area when he is given a large populous area adjoining his dispensary and also a bonus of £250 per annum and the promise of a new dispensary residence reported to cost £11,000? That would not induce anyone to stay in the area. I should like to remind the House that at the time Dr. Joyce applied, I am told, there were at least 20 other applicants for the area.
To say that the council will save money by this move is very misleading. The two doctors involved are to get an extra £250 per annum. A new house, costing approximately £11,000, has to be built in Gort. Besides, there will be extra hospital bills. When people find they cannot get a doctor in the area, they will go straight to the hospital, and the hospital will have to take them in.
It seems to me there is a certain amount of discrimination being practised against the people of Ardrahan. I have a list of dispensary areas, showing area and acreage, secured since Ardrahan was to be abolished. The figures are: Ardrahan, 31,843 acres; population, 2,191; Avoca, County Wicklow, 17,758; population, 2,178; Ballinameen, County Roscommon, 28,769 acres; population 2,192; Tulla-roan, County Kilkenny, 18,990 acres; population 1,113; Glasson, County Westmeath, 24,794 acres; population 2,307; Clonbur, County Galway, 31,426 acres; population 658. In all of these cases, the Ardrahan dispensary area is the largest and there are only two of these with a larger population, a little over 100 in these two.
I cannot see why Ardrahan has to be picked on as an example. When all of these other areas can be filled, surely Ardrahan is as entitled as the rest of them? The dispensary should be restored to Ardrahan because the county council recommended it. A motion was proposed, seconded and passed to restore the dispensary. An examination of the case and of the hardships that occurred since the dispensary was abolished proves that the plan is inoperable. It will lead only to further hardship and even further loss of life.
I ask the Minister whether or not he has the power to abolish this district. I understand that under the Health Act he may alter the boundaries of dispensaries but I doubt if he can abolish them completely. The only people consulted about the whole business were the doctors concerned. The people of Ardrahan were left completely in the dark until it was a fait accompli. The making of the Order was preceded by a drive to abolish a number of medical cards in an effort to justify the amalgamation of the dispensary area. The only people to benefit, as far as I can see, are the doctors.
There is no point in the Minister's telling me that there is another doctor available. I know there is another doctor in Gort. He has been there for years. He has given long and very good service to the people there. He is now an old man and cannot be expected to get up at all hours of the night to travel a wide area to attend patients.
I cannot understand why the Minister will not receive a deputation from the area. Is it because he does not want the facts or because, having once made a decision, he wants to dig in his heels and stand over it, right or wrong?
I wish to join in the appeal to have the Ardrahan dispensary restored. It is not in my County Council area but, like Deputy Mrs. Hogan O'Higgins, I am one of the T.D.s for the East Galway constituency and I realise the position. The Minister made an Order in 1963, after having been requested by the Galway County Council to have this dispensary abolished. I cannot recollect, offhand, how long it was before that date in April that this came before the Galway County Council but I see now, when there is a by-election in East Galway, that political propaganda is being made of this affair. At the time the Health Act was passed by Fianna Fáil certain people were saying it was costting too much. These people were shouting about the high cost but when there was a dispensary vacant and the Minister's experts said that instead of having three doctors now looking after the area two would do the job at a saving of at least £1,000 per annum the very people who were most vocal at that time about saving money are the very people who are now most vocal to have the dispensary restored. In Galway County Council, Fianna Fáil have a majority. We were always looked upon by the Opposition as the squandermania Party. I support this appeal and I support every progressive step for the good of the people of my constituency or my area.
When this matter was first mooted at the Galway County Council a resolution was put before the members. I am a councillor for the Ballinasloe area. Deputy Geoghegan is a Councillor for the Connemara area and Deputy Coogan is a Councillor for Galway area. We were not concerned as there was a local Councillor, Senator Lahiffe—he cannot speak in this House though his name was mentioned by Deputy Mrs. Hogan O'Higgins—and a Fine Gael Councillor Lambert. Not alone did the council unanimously agree to abolish the Ardrahan dispensary but the Fianna Fáil and the Fine Gael councillors for the area proposed and seconded that, as a saving, this dispensary be abolished. Naturally, we being from different areas, agreed and the matter went through. There was no such thing as a protest and no notice was taken of it. It was published in the local papers including the Connaught Tribune: everybody reads that.
After some time had elapsed, it was realised that the step imposed a terrible hardship on the people of that area. I have here the same letters as Deputy Mrs. Hogan O'Higgins has. I got further letters since. On 24th January last, the two local councillors who in the first case proposed and seconded that the dispensary be abolished in order to save money for the rate-payers came along and put down a motion that it be restored. I read all the letters I got. I read the cases of hardship. I have them here. I had deputations to my house at all hours of the day and night. I was one of the councillors and a TD for the constituency who voted to have it restored. That is the reason why I am adding my appeal to the former appeal in this House tonight to have this dispensary restored. That is as high as I can put it.
I am behind the people because in Galway County Council we did not realise at the time that we were imposing a hardship. I would ask for a truce on this matter. Things have happened and things have been said that should not have happened nor been said. There were protest meetings. Deputations with placards have come to the Galway County Council and banged on the windows. I believe that if some of the things done and said had not been done and said we might have got a lot further in this case. I am willing to forget all that and to forget the past. I am behind the people in this appeal to have the dispensary restored and I should like it to be done in a nice and quiet and orderly way.
We had a further proposal before us to amalgamate two other dispensaries in the Connemara area, Clonbur No. 1 and No. 2. The council, having seen the faux pas made in the first instance, unanimously agreed to ask the Minister not to amalgamate these two dispensaries. He has not done so or forced us to do so since. I appeal to him now to reconsider the matter.
I know of the letters Deputy Mrs. Hogan O'Higgins has read as I have similar copies in my possession which are also signed. I should like an investigation of the cases of the people who made these complaints. They claim they did not get a proper hearing when they came before the Council and that the complaints they made were not explained to them. I think they should at least have got a reply to say that this or that did or did not happen. We are all human beings and we cannot afford the loss of a life. I am not saying they are right or wrong but if there is an explanation for the complaints these people have made I am sure it would be satisfactory. I again appeal to the Minister to reconsider the matter and if possible to have this dispensary restored.
Half a minute?
I am not giving way. I am entitled to ten minutes to reply.
It is just on the tick of the ten minutes. I am calling on the Minister.
And I call on him to come to Ardrahan on Sunday.
It is right that I should put this matter in its proper perspective. What we are concerned with here is the provision that must be made under the Health Act, 1963, for medical care for those entitled to it under that Act, that is to say, for those who are medical card holders.
Deputy Mrs. Hogan O'Higgins put before this House this evening two moving cases, moving, that is, if the statements contained in the letters which the Deputy received should be true, substantiated and relevant. I should like to put the facts before the House in both these cases because when I received these complaints, I asked that they should be investigated. These complaints have been investigated by the county manager of Galway, where the County Council is the health authority.
The first is a case in which a widow said that her husband had become ill on a Sunday morning in February. She sent a messenger, his brother apparently, to Ardrahan—to Ardrahan remember—to contact the doctor there and bring him to attend the patient. The first thing to note about this case is that it was not a medical card case; it was a case of a private person going to his family physician in Ardrahan— Ardrahan, where the abolition of the dispensary is being challenged, not Gort or Kinvara. The doctor in Ardrahan was not at home to his private patient——
Or to a medical card holder either.
He was resident in Ardrahan but he did not happen, unfortunately, to be at home. So it was suggested by his housekeeper that the messenger should contact the doctor whom the Ardrahan doctor had asked to act for him on that Sunday. The messenger refused to do this and endeavoured to contact somebody else. He is also alleged to have phoned a doctor in Oranmore, a doctor who denies receiving the phone message. Ultimately, at 11 a.m., just an hour after the messenger had arrived at the house of the Ardrahan doctor, the doctor the messenger had been told was acting for the Ardrahan doctor, met this messenger and went to the house of the sick man.
The unfortunate patient died; but he had with him the doctor who had been rejected by the messenger in the first instance. This doctor summoned the ambulance and had the patient brought to the hospital where, as I have said, he died. It has been reported to me that the case was, in fact, hopeless from the outset——
It is easy to say that now.
——so that he died, not because there was no doctor in Ardrahan, but because, as has been reported to me, his case was hopeless from the outset.
Your case is hopeless, anyway.
The next case was that of a baby——
It is not the first one.
No, I remember one that suffered from constipation.
It is better than verbal diarrhoea.
The next case was the case of a baby whose father arrived home at 5.30 and found that the baby was ill. He took the baby with its mother, got the car and went to Ardrahan to the doctor there. The doctor was absent but he had requested another doctor to do duty for him. This doctor's house was contacted and he was not there but the housekeeper of the Ardrahan doctor contacted another doctor—he was contacted by telephone —and he immediately agreed to attend the baby. He arrived at the baby's house at about 6.20, less than one hour after the father of the baby had returned home to find the baby ill. I am not mentioning names and therefore I may appear to be a little circumlocutory. Within less than an hour, the baby, whose parents lived some distance from Ardrahan, was seen by the doctor, and he had the baby removed to hospital without delay.
Again, unfortunately, the baby died but in neither of these cases was it a fact that a doctor could not be contacted in Ardrahan so this could not be responsible for the deaths. They were entirely due to the illnesses from which both patients suffered.
Try telling that to the people of Ardrahan.
Why do not those who have been writing those letters tell the truth? It is not the case that the people behind this agitation are concerned with the position of the medical card holders. I have here a number of cases, 14 in all, and of these not more than four or five are medical card holders.
They might have been.
Not only that, but in no case can it be shown that their deaths or inconveniences were due to the fact that there was not a doctor in Ardrahan. Because there was a doctor resident there. In fact, so far as the abolition of the Ardrahan dispensary is concerned, it is in no way responsible for these complaints. The main fact is this: it is quite clear from the figures that those who might be eligible under the Health Act to avail of the dispensary service are much too few to support three doctors; and that, even with two doctors, the workload on each is comparatively light——
If that is so, why can they not be found?
I know that ladies like to have the last word——
So do many Ministers.
I listened with some patience to Deputy Mrs. Hogan O'Higgins because I know that she is tender hearted and likely to be imposed upon by sob stories. But I have taken the precaution of having the cases she mentioned investigated and most of them have been found to be flimsy cases, flimsy in the sense that they are not relevant to the complaint which has been made that because of the abolition of the dispensary district, a doctor was not available in Ardrahan and the patients suffered. In fact, it was the other way round. The doctor concerned resides in Ardrahan, and the cases where fatalities occurred were hopeless from the beginning.
(Interruptions.)
The order for the abolition of the dispensary will stand.
(Interruptions.)
Will the Minister meet the local deputation?
Deputy Carter and Councillor Hussey voted against restoring it; at least Deputy Kitt supported it.
We are all soft-hearted in Galway when a by-election is coming.
You are softheaded.
The Dáil adjourned at 11 p.m. until 10.30 a.m. on Thursday, 19th November, 1964.