I shall let the Minister have the relevant particulars later. The Minister will realise that, in the majority of counties, we have many complaints at present about the dental services. There are very long delays as regards the school system and there are many difficulties and defects to be ironed out as soon as possible. Whether or not the unsatisfactory position is due to the remuneration offered to dentists, I do not know. However, it is a pity to see the pain that is often inflicted on young children due to the long delays. It would, indeed, be well if that could be ironed out. I suppose the people in every county in the country would be delighted if our dental services were put on a proper footing.
The Minister answered a question here yesterday about unrest among nurses over working hours, wages and conditions. I think he said they will get an increase in the very near future but I think their salaries should be brought up to a proper standard. They are doing important work and they should be properly remunerated for it.
We are all very disappointed as regards the financing of this Bill. In the booklet "The Health Services and their Further Development", laid by the Government before each House of the Oireachtas in January 1966, we read on page 59 that the Government at that time stated:
The Government, having studied this issue, are satisfied that the local rates are not a form of taxation suitable for collecting additional money on this scale. They propose, therefore, that the cost of the further extensions of the services should not be met in any proportion by the local rates. Following this decision, other possible sources of revenue to meet the additional costs are being considered but it seems likely that the general body of central taxation must bear the major part of the burden. Pending further consideration of the methods by which extensions of the health services will be financed in future years, the Government have decided to make arrangements which will ensure that the total cost of the services falling on local rates in respect of the year 1966-67 will not exceed the cost in respect of the year 1965-66.
I remember that year quite will. I remember it was an election year. I remember the comments in the local papers in my county. We were told at county council meetings and even by county managers—although they may have been led astray from the wording of this—to spend what we liked as the extra amount on health would be borne by the taxpayers. The then Minister for Health, the late Deputy Donogh O'Malley, made a speech about that around the same time.
We in Fine Gael have believed for a long time that rates are an inequitable form of taxation and that such an inequitable form of taxation needs to be reformed. We now find that when members of local authorities were faced this year—as every local authority in Ireland was faced—with a huge increased demand under the rates heading, when we asked the Government to do what they then promised, we were threatened with dire consequences. Consider the treatment of members of the corporation here in the city of Dublin who acted according to their conscience and who were prepared to say to a Minister and to a Government: "We do not believe in paying lip-service to the burden the taxpayers are carrying and to the promises you made in the past. We now want to test you to see if you will do what you said you would do in the past and act on what this White Paper stated, namely, that the rates are not a form of taxation suitable for collecting additional money on this scale". Those people dug their heels in and said: "Thus far shall we go and no farther". They believe the present health estimate is necessary to give to the poor and to the people of the city the facilities, the amenities and the treatment— hospitalisation or otherwise—they are entitled to but that it is time for the Government to honour their obligation and to share a greater portion of the burden, as they promised. It is five years since the Government stated they were examining this situation and that they believed the central authority should bear a greater cost.
Because those bodies agreed to do this and to stand together, we now find that they have been abolished. I want to object to this system of financing the health scheme. We believe it will place too great a burden on the already overburdened ratepayers of this city and of this country. This Government were considering this in 1965—over four years ago. Surely we should know the result of their consideration by now? On Wednesday, 19th February, 1969, Deputy Liam Cosgrave asked the following Parliamentary Question, as reported at column 1241 of the Official Report of that date:
To ask the Minister for Health if in view of the substantial projected increase in the estimates for health authorities for the coming financial year he is in a position to say what contribution will be made from the Central Fund to ease this burden.
The Minister replied as follows:
I am not yet in a position to say what contribution additional to the statutory grant at the rate of 50 per cent, will be made from the Central Fund towards the cost of health services in 1969-70. In view of the very substantial increase in estimates of health expenditure, I have asked the health authorities to re-examine their estimates and to try to achieve substantial reductions. The amount of the contribution that can be provided from Central Funds will be determined when details of the reduced estimates are available.
I would put it to the Minister that either he was trying to fool the people at that time or else to throw dust in their eyes. I daresay the Government had their mind made up at that time, knew where they stood, and were not prepared to pay any more than what they had been paying up to that time. Was there any reduction or did any health authority come up with any saving under that heading? We in the health authorities claim that either the Department of Health or the Minister tried to fool the representatives of the different health authorities this year. We received a circular, dated 12th February, 1969, from the Department with the reference "HSG 221" which stated:
The Minister feels that in the health services substantial economies can be found without detriment to the efficiency or availability of the present services. He accordingly asks that each health authority should examine critically their forecast of expenditure for the coming year and that they should endeavour to achieve substantial reductions in their projected expenditure.
He went on to ask that they examine their estimates in respect of the health service and he stated that "officers of this Department will be available for discussion on any matters of difficulty which may arise." All local authorities had increased their estimates but the Minister pointed out that substantial reductions could be made. In our county we asked him to send down officials to point out where the reductions could be made but he refused to send them down, or they were not sent down.
We may take it that this circular, which got great publicity on television on the radio and in the Press, was a political gimmick to pretend to the ratepayers that the Department of Health were trying to do something tangible to help reduce the rates in the different counties. They had not told us where the substantial reductions could be made. We took them at their word and said "If you believe they can be made, then send down officials to tell us where they can be made" because the Minister said, and I repeat it, "officers of this Department will be available for discussion on any matters of difficulty which may arise." A very big difficulty arose with us because we were putting an additional three or four shillings on the backs of the already overburdened ratepayers. We adjourned our estimates meeting for a week and asked for officers to be sent down to enlighten us in regard to where the reductions could be made, but our request was ignored and the rate had to be struck.
In general, in this Bill a democratic approach is lacking. Too many members of the different boards will be appointed by the Minister. Ministers come and go and in many cases, perhaps, the appointments will be made by civil servants.