This is a Labour document in miniature. I want to go back now to the days when we were in the back bench of the Leaving Cert. class. It is a big change from that to the front bench of the House of Parliament. At page 23, paragraph 27, the Minister states:
It will become increasingly necessary to ensure that doctors in general practice have opportunities for post-graduate study to keep themselves familiar with developments in medicine.
The Minister does not tell us what facilities he will make available to the GP to enable him to do a post-graduate course. How will it be done? I think we will have to prescribe a fine dose of sleeping pills for ourselves, as well as pep pills, so that we may start dreaming. This is nothing but a dream, the most of it. The part stolen from the Labour Party we want to see implemented as quickly as possible, but I fear it will not happen in our time.
In paragraph 31, the Minister says:
A recent projection of the population, prepared by the Central Statistics Office, taking into account the natural increase (that is the excess of births over deaths) and allowing for a reduction in emigration with economic development, suggests that the population by 1976 may be as high as 3,152,000 and that by 1981 it may be almost 3,400,000.
More sleeping pills: more of the dreams. Where did the Minister get that figure? What does he think we are? I want the Minister to answer these questions when he comes to reply.
In paragraph 32, we find:
Secondly, the changing balance as between the rural and the urban population will affect the organisation of the services and, in some degree, the diseases which they will be designed to combat. In 1960, 37.0 per cent of our workers were employed in agriculture, forestry and fishing. By 1970, it is expected that this proportion will have dropped to 28.7 per cent.
What a reflection! We want to see rural Ireland preserved, maintained and populated, and here is the Minister telling the truth for once: the flight from the land is on and he is preparing for it; he hopes and prays it will continue with even greater speed than in the past.
Paragraph 44 deals with proposals for new service.
The details of this service will be discussed with the medical profession...
I repeat what I said last night; the word "discussion" and the phrase "will be discussed" appear on every page of this White Paper. "Discussions will take place: This will be discussed." I am sure every Deputy was circularised by the Medical Association with regard to payment and it is our understanding that there is disagreement already in that matter. However, discussions will take place. I am dizzy from the repetition of the phrase in this document.
... before any final decisions are taken, but it is possible at this stage to indicate that the Government have in mind that the service will be such that an eligible person will have the right to be attended by any doctor participating in the scheme who is living within a reasonable distance...
What is a reasonable distance? That has to be defined.
... who is willing to take him as a patient and who has not already a full list of patients...
Where do we put up the "House full" sign? I want the Minister to tell us that when he is replying. I want to know what this means. I know what the document is all about. I know why it was introduced. I will take the song and dance out of it now once and for all.
In the same paragraph, on page 32, we find:
but that there would probably have to be some restriction on entry into the service by other doctors, to avoid too many doctors participating in any area and each not having a worthwhile panel...
Who is advocating restrictions here and who will administer the restrictions? Who is going to find out whether the panel is worthwhile or not? Some doctors are available the whole round of the clock and some engage in activities like shooting, fishing, golf, and so on. Who will plan the panel?
Paragraph 45 on the same page reads:
... The dispensaries would not be retained by the health boards for the provision of general medical services. Where the premises were suitable and were not needed for other health services, it might sometimes be possible to rent or sell them to doctors for adaptation as general surgeries.
To me that means that the doctor can buy the old dispensary or what remains of it from the health authority. If it is not in good condition, he can put it into a condition where people can visit him. Then he will divide the "haves" from the "have-nots". The men and women with the medical cards, the "have-nots" will go down to the old dispensary, but the "haves" will go up to his parlour and sit down and read Time or whatever is put before them in the waiting room. The rats can continue to run around the dispensary as they are doing at present. I want to see that sort of thing stopped.