Having listened carefully to all that the Minister had to say on this motion, it is safe to say that his approach is undoubtedly a reasonable approach. It has indeed been most conciliatory, but while that is so, we are still left wondering what is his intention in regard to the White Paper. Every speaker in this debate had something to say in favour of the motion and the Minister himself made statements which contribute to the motion. If nothing else this motion has evoked from all those who spoke a positive indication that there is a need for an improvement in the health services. I noticed that the Minister, speaking at the Árd Fheis last week, said that one of his main objections to a free, comprehensive medical service is that the people would be treated like cattle. I am sure the Minister will agree with me that under the present system people are being treated like cattle. I am very pleased to know that he realises that there is a need for a change. I know that when I was on the Select Committee with him, he recognised the need then but unfortunately his predecessor did not think the same way. The same can be said for the advisers in the Department. I hope the Minister will keep pushing towards this objective of bringing satisfactory services to our people.
In that connection, I am satisfied that the people who plan health services are too far removed from the people's needs to know exactly what they do need. This is the cause of all our trouble and it is quite true to say that the university of adversity is the best type of university for this exercise. One has only to spend a little time in any of our local dispensaries to see our people being treated like cattle herded together, waiting and watching for assistance, assistance which they should be given as an entitlement. This is something which has caused people to cry out for a free choice of doctor. We believe that every Party has adopted the view that there should be a free choice of doctor. There is no real trouble about that. If we have a free choice of doctor, perhaps it will result in the elimination of the antiquated pauper houses which are described as dispensaries.
If nothing else, we have got to get this system away from this hand-out treatment. I know from my experience of looking after my constituents what it would mean to have a free choice of doctor. It would mean an awful lot because I have known people who had medical cards but who did not avail of the benefits which they could have had because of the absence of a choice of doctor, because of the rude way in which they were treated and because of the obvious lack of interest in them when they went to avail of the existing system.
Mention has been made of the expenses borne by people who come within the ambit of the present scheme in regard to medicines and drugs. I have known some such cases. I have known, for example, the case of a man who had £10 16s. a week, whose wife was in a mental home, and who had a son working and who was required to pay consistently for his wife's upkeep in the mental home. The reason he was required to pay for her upkeep was that his son had an income. We have all grown up sufficiently to realise now that unfortunately the majority of boys and girls who are working do not contribute in the way we would imagine they would, or the way a civil servant imagines they should contribute, to the upkeep of their homes. These are things that have to be taken into consideration.
There is of course an appeal but this is something that requires a lot of doing. No matter whether they have £8, £9 or £10 a week, you find people not wishing to appeal, as if they were begging, for entitlement. That consistently happens. You also have the situation in which a number of people do not know what they are entitled to. In some cases they apply for a medical card, do not get it and do not pursue the matter further. No matter what happens, even if this motion is not passed, it will certainly inspire a movement and whatever is done must be an improvement. If nothing more, I appeal to the Minister to take steps to ensure that the administration of health services is taken out of the hands of the local authority in the person of the county or city manager. It should not be left to the whim of an individual, or the people who work for him and who must carry out his instructions, to determine whether a person should or should not have something to keep them well. This matter cries out for attention.
The Minister said he had not quite made up his mind on what was to be done about the health services but this is something that must be done. This is one of the reasons why we in the Labour Party advocate free, comprehensive medical services. A number of people are described as ratepayers, people who could be described as tenants of small dwellings, and each one of them could safely be described as a member of the working classes. A considerable number of these just eke out an existence but they are denied medical cards and medical services because of what appear to be their possessions. If a real investigation were made it would be found that object poverty exists in a number of homes occupied by the tenants of small dwellings. This also cries out for attention. Such people are very often left to the mercy of a manager or his employees who are conditioned by the whim of the manager who feels obliged to keep down the rates.
I had an experience in connection with the choice of doctor in my own constituency—indeed, more than one. I had a group of people signing a petition to have something done about a doctor who was supposed to be attending to their needs. Nothing was done. In his good time the doctor went but in the case of one woman that he attended—she was expecting a baby—he promised to come back. In the meantime he was transferred. The baby died and there was a suggestion that this was as a result of the doctor's bad handling of the case. The father decided to take it up with the medical officer but needless to say the city medical officer took the stand of his profession and did nothing about it. These things are very hard to prove but they indicate the need for a choice of doctor.
Before the promised White Paper comes out—I hope it will not be too long—the Minister should take serious notice of the present position in the Six Counties and here. By now I am sure it is common knowledge that one of the main planks in the Unionist platform in the present election is the social welfare and health services. They have actually issued a brochure showing the services existing in what they describe as Northern Ireland and in the Republic of Ireland. This is a revelation to anybody making comparisons. It should urge us, if we are sincere about desiring unification of the country, to do something about our own services.
When Deputy Kyne spoke on this motion, he indicated that we were prepared to assist the Minister and the Government in finding money for this project. It is easy to ask: "Where will the money come from?" The situation calls for a close examination but I think it reasonable to ask the Minister to consider seriously the priorities of the matter. Far more money has been spent over a number of years in the maintenance of animal health than on the health of human beings. I got this information recently in reply to parliamentary questions I addressed to the Minister for Agriculture and the Minister for Health. The replies showed clearly that we had not been looking after human beings as we should. It was about time to consider the human beings because if we fail to look after them our cattle will not be much use to us.
It would not be a bad thing, as regards the matter of payments, if the Minister for Social Welfare and the Minister for Health got together. I and my colleagues have had occasion to try to ascertain if certain things could be done through the health services and we have had the Minister for Health saying—not the present Minister but his predecessor—that he is waiting for the Minister for Social Welfare. Similarly, we were told the Minister for Social Welfare was waiting for the Minister for Health. Before the White Paper comes out there should be consultations between these Ministers with a view to ensuring proper health and social services.
At the moment we are paying directly or indirectly for services which are absolutely unsatisfactory. I am sure the Minister has taken notice of the fact that whenever there is an increase in the social welfare contribution from the worker there is never a complaint despite the fact that there are continual complaints about the benefits. From my knowledge and experience of the working people I am satisfied that they are quite prepared to pay for proper services and the only way in which we can obtain proper services is by having free, comprehensive services. The idea of discrimination is bad and discrimination will come about even if we have a Minister as well intentioned as we have now.
The Minister indicated that he had in mind the choice of doctor but he also said that where people did not obtain benefit they would be entitled to appeal. This right of appeal will prevent proper health services from operating. We must stop thinking in terms of appeal and have more regard to entitlement. A person is either entitled to something or he is not. You make application for something to which you are entitled, but if somebody judges you are not entitled to it, you have to go through the exercise of arm-twisting, cajoling or string-pulling to get that to which you feel you are entitled.
Under the present system, medical appeals are dragged out and, in the meantime, the applicant is left without the service to which he is entitled. In view of what has already happened, I do not believe an appeal meets the case. For example, I know of a case of a woman who required surgical boots for two of her children. Her husband had £10 5s. a week. She was denied a medical card because her daughter, who was saving up to get married, was working. There was an appeal, but it took four months to reach a decision. In the meantime, the surgical boots had to be provided. It is all very well to say that, if there is an appeal, it means something will be done in the case of a person not being rightly treated; but you cannot make an appeal when somebody urgently requires medical service. I am asking the Minister to get away from that. Comparisons have been made with the "Black North", and comparisons can be made with other parts of Europe. There has been a lot of talk about free trade and the Common Market, but we will have to improve our social and health services if we are not to continue to be described as an underdeveloped country. We keep on preaching that we are not underdeveloped. Let us put more value on our people's health than on anything else. Let us put first things first, and the health of our people is undoubtedly our first priority.
