I referred briefly yesterday to the thalidomide children in this country and said I was very surprised that the Department had refused to disclose details of two scientific reports—I have just checked over my notes now and I find there were two reports—which were presented to it over seven years ago. The Minister's reason for not making this known is that the series of tables on these cases if disclosed might identify thalidomide victims. I have no doubt that we have 60 or 65 thalidomide victims in this country. They present a very serious problem. They will require special appliances for the remainder of their lives. The Department, up to January anyway, had not made known to the parents of these children that they would act on their behalf to secure compensation. It is a serious reflection on the Department that we cannot do anything to protect these children especially when it is known that in Britain compensation was secured a number of years ago. Here the parents are left not knowing how they stand. The Department have not even stated whether they will provide free services and facilities for these children. We all know the tragedy of thalidomide. The German company, the Grunenthal Company, which manufactured this drug, was permitted to market it in this country without any restriction whatever. This is where we want more and more restrictions and regulations regarding drugs. No restrictions whatsoever were enforced about the supply or availability of this drug. It was sold over the counters in chemist shops. No doctor's prescription was needed for thalidomide. The only surprise is that we did not have more victims of this thalidomide drug.
I should like to see the Department making known those two scientific reports which should have been published in medical journals so that we would know exactly the number in the country. The Department have not a right to suppress those reports once they commissioned them. They were carried out by Doctor Victoria Coffey and they should be published, even if only in medical journals.
Secondly, the Department should make it clear that appliances will be provided for those children who will require them for the rest of their lives. The Department should also make it known that all other medical services required by those children will be supplied free, without any other obligation or proviso. Thirdly, I should like the Department to make it known to the parents and to the public, who are concerned about this, that they will pursue on behalf of those children claims for proper and adequate compensation from this German company or their agents. The Department have spent seven years considering this and meanwhile those children are growing up. It is time the Department did something concrete about it. In May, 1968, the then Minister for Health, Deputy Seán Flanagan, said in reply to a question in the Dáil that he would think about it. That is not good enough for those children, who are in need of constant care.
We have been told that under the Health Act there will be some type of uniformity or standardisation about eligibility for the medical card. I am one of the Deputies who are constantly making representations on behalf of people but too often my representations are unsuccessful. The great problem is that people who apply for the medical card are asked to disclose some very personal and intimate details of their lives. While I appreciate that we must have some details, some arrangement should be made whereby those medical reports—details of the medical history in the case and what treatment is needed—should be supplied to medical officers in the health authority and not necessarily to civil servants or public officials. It is very dangerous in this community that those intimate and personal details should have to be supplied in this way.
It is difficult to ascertain why one person is eligible for a medical card and the next is not. I have seen cases where one parent or the other was prevented from obtaining a medical card because the gross income of the household was taken into account. This is a wrong attitude to adopt because in many cases the gross income and what actually comes into the household are two very different things. The gross income has not had taken into account tax deductions, superannuation, social welfare payments and the fact that sons and daughters in the household are saving in many cases to get married. Their income should not be taken into account.
It has been said by the Minister that under the 1970 Health Act only the income of the spouse will be taken into account. I hope this will be done soon. I hope we can have some type of uniformity because it is a terrible situation when we find that 50 per cent of the people in one county can have medical cards whilst in Dublin, where there are so many cases in need of them, we find only 12 to 14 per cent of the people receive medical cards. The system must be wrong when this can happen.
While speaking on the medical cards I have to refer to a great injustice being done to old age pensioners who have to have medical treatment provided in local authority hospitals, and especially in St. Kevin's Hospital, Dublin. Those old age pensioners go into those hospitals for treatment and, as holders of medical cards, they are entitled to this treatment free in the same way as an ordinary person in receipt of a medical card is entitled to treatment and maintenance free in a hospital. We are discriminating against those old age pensioners because their pension books are demanded from them after three weeks in the hospital. Despite the fact that those people are still receiving treatment they are not given the benefit of the medical cards which they hold. This discrimination should stop. I have written to the Minister and I have gone to him about those people, who are no different from ordinary people holding medical cards. It is a terrible injustice to those people that because they are old we say it is only institutional treatment they are receiving. It has been pointed out over and over again that many of those people receive treatment for heart disease, arthritis and many other illnesses which beset people in later life. I can readily understand if those people do not receive treatment that they should be asked to make some contribution towards their institutional care from their pension allowances.
We have, as a Christian country, fallen down very badly in the care of our senior citizens who have done so much for the country and who find themselves at the end of their days as geriatric patients deprived of proper care. If you phone a hospital for a bed for a patient over 65 years of age the chances of getting that bed are very remote. They do not want people of that age in the hospital. Those people may have any serious acute condition but because you say they are over 65 you have not any hope of getting them into hospital. We have to lie and say that patients are 61 or 62 when, in fact, they are over 70 because general hospitals do not want to admit these patients. I saw a patient die from bedsores because she was at home and no proper nursing could be provided. If the Minister telephones St. Kevin's today he will find the waiting list so long that there is no hope of getting an elderly patient in.
I recently had to plead with the hospital to take in a blind woman, who had suffered a stroke and was unconscious. She was living in a two bed-roomed house, with three teenagers in another bed in the same room. She needed medical care on a continuous basis but it was impossible for the family to give it. She died two days after she was admitted to hospital. A health service which will not provide care for geriatric patients is unchristian and unjust. We have to face this problem because more and more people are living longer. We must ensure that, when they fall ill, proper medical and nursing care is provided.
I know the Minister will say we cannot have all geriatric cases in hospital, that the families must provide care for them. I agree that where possible, families must provide care, but when they are medical or surgical cases we must provide beds so that they can be admitted to hospital. I am still trying to get into hospital an 82-year old patient who is bleeding recurrently, but, unfortunately, we may wait indefinitely to get a bed for that patient. We cannot be proud of our health service if we are not able to provide beds for these people.
Would it not be possible to convert some unused barracks into geriatric units? Thanks to my colleague, Deputy Browne, St. Mary's in Phoenix Park was provided. We do not realise the debt we owe Deputy Browne who, when he was Minister for Health, eradicated TB by providing sanatoria My 18 year old sister was one and a half years on the waiting list trying to get into a sanatorium, but unfortunately she was not admitted in time and died at home. Many of these sanatoria are being used as mental homes and St. Mary's caters for geriatric patients. It is a wonderful place and it is serving a useful purpose in the treatment of geriatric cases.
It is a pity there are not more of these buildings available which could be used for this purpose.
I want to pay tribute to the Minister for his decision to ban cigarette advertising on television. I should be even more pleased if he would go one step further and ask his colleague, the Minister for Finance, to offer tax concessions to the publishers of our national papers if they would desist from allowing cigarette advertisements to appear in their papers. National newspapers are under a strain by being taxed as information media and if such tax concessions were offered I feel sure they would avail of them.
I spoke briefly yesterday about the Department of Health information service. I do not think the Department, of itself, can provide an adequate service. I would recommend the establishment of a health education council, because there are other aspects of health education besides educating people about the dangers of smoking.
I am surprised that the Minister and his Department are dilly-dallying over the report of the working party on drug abuse. Drug abuse is a problem in all our major cities but it is particularly prevalent in Dublin. From my experience it is a great pity that the Minister is not acting more quickly than he is on the report from the working party, which he has had in his possession since the beginning of February. It is nearing the end of March and it should have been possible to study the report by now.
I understand about a third of Irish university students have smoked or are smoking marijuana and have taken LSD on occasions. From what I understand young apprentice workers and unskilled workers in the 15 to 18 age bracket are also experimenting with drugs. When I first came into this House in 1965 I had seen cases of drug abuse. I have come across drug addicts who kidded me in order to get narcotic drugs. They used every trick known, and no matter how conversant or alert one was these addicts managed to trick one and get a shot of pethidine or morphine. This happened to me in hospital and I have seen surgeons in Dublin fooled by narcotic drug addicts who feign so many illnesses in order to get drugs. I blame the medical profession and the pharmaceutical industry for this because in our innocence we have prescribed, too often and unnecessarily, amphetamine drugs.
We, indeed, were responsible in no small measure for many of the cases of drug addiction, particularly amphetamine and dexadrine addiction, because of the availability of these. It is to the credit of the Minister that he took steps immediately to ban the manufacture and sale of amphetamines. Unfortunately, because of our proximity to Britain, amphetamines are still coming in and are being used by our youth. I have seen cases of methedrine addiction. I have met cases of people who inject themselves with methedrine to induce a "high." I have come across the speed freak who takes methedrine. The effect is quite deplorable. It produces utter mental deterioration and breakdown.
The onus of providing all the essential information is on the Department and I certainly do not agree with the report I read of a psychiatrist who said he took LSD. Impressionable young people might be encouraged by that report to take LSD. This is a very dangerous drug. It drives people in-sane. We are all aware of the fact that deaths have occurred through the use of LSD. Those who take the drug begin to feel like gods and there are documented cases of people standing in front of express trains in the belief that they could stop the trains, of people jumping out of windows in the belief that they could fly, of people, believing they could walk on water, drowning. LSD is being used in Dublin. I had occasion to speak to a group of about 60 parents and at least 10 per cent of that group told me their children had been offered drugs in cafés in the Grafton Street area. This is a serious problem. These parents were anxious for an education and information service on the dangers of drug abuse.
We are living in an age in which everyone wants a pill of one kind or another as a panacea for all his ills. He thinks a pill will cure everything and doctors are, unfortunately, being pressurised by patients. It is not enough for a doctor to devote some of his time to psychotherapy with a patient and tell the patient not to worry, that all he is suffering from is an anxiety state; the patient thinks that, if he goes to the doctor, and does not get a prescription then the doctor is not doing his job, despite the fact that the doctor has tried to reassure the patient that there is no organic illness. Too often, doctors are tempted to write prescriptions for tranquillisers or sedatives. This is how addiction begins ending ultimately in abuse. It is not unknown—this is no joke, though it may sound like one— for nurses in hospitals to wake sleeping patients to give them a sleeping tablet. They are following the consultant's instructions and they do not see the illogicality of waking a sleeping patient to give that patient a sleeping tablet. More education is required here. Perhaps doctors would be better advised to refrain from prescribing sleeping tablets because barbiturate addiction is a serious one.
Housewives seek sedatives and tranquillisers, particularly barbiturates, and it behoves all of us to be very careful in such cases because addiction is becoming quite a serious problem. There is a pill-popping mania and there are too many pill-popping mommas. It must be remembered that children are very impressionable and if they see a mother taking a tablet at the least sign of stress or tension they grow up with the belief that there is a tablet or a pill to cure every ill.
I have heard of a great deal of experimentation by youth raiding medicine cabinets in the home. Children do not realise what it is they are experimenting with. This is a problem that must be examined. Parents should be very careful about where they put tablets. These should always be outside the range of children, particularly if they are sedatives or tranquillisers. The responsibility is on parents to bring children up properly and not to set a bad example. Drugs or drink can constitute a very bad example and the best education can be given by parents in the home. I have no doubt the Minister agrees with me in that.
I should like the Minister to make regulations which would make it more difficult to have these drugs available. If steps are not taken we will have a bigger and bigger problem of narcotic addiction. I had prescriptions of mine forged. Every doctor and pharmacist should have a narcotic number as a protection against the possibility of forged prescriptions. To give the pharmaceutical profession its due, the members are on the alert, but it is very easy to change a prescription from one month's supply to two months supply. We must wake up to this problem and we, as doctors, must be on the alert too.
I came across a case recently where a patient had been prescribed Vallium by a hospital; the treatment was continued by the doctor but the patient was taking 24 tablets per day instead of one tablet. This is more powerful than a shot of morphine. Addiction had set in. I was consulted because a relative complained that the dispensary pharmacist was not giving a big enough supply at a time. She did not realise this was a drug of addiction and the patient had become an addict. Without meaning it, the doctor was at fault. He just repeated the prescription. I could not solve the problem. I got in touch with the health authority and advised that a placebo that looked identical might be substituted. Unfortunately, officials could not tackle this problem. It is a doctor's problem. I was in touch with the assistant city medical officer and he said it was dangerous ground to thread on because we would have to get back to the doctor and try to indict him and he in turn might indict the hospital. Everyone unwittingly was a culprit in this, without really being so, of course. As doctors we should perhaps be a little more alert to this problem and realise that when we are prescribing drugs which are addictive we must be very careful and get our patients off them as quickly as possible.
I have found that you can get these patients off these drugs, especially in the early stages. I found in regard to one patient who had been getting a shot of morphine every night to make her sleep that I could get her to sleep with a shot of distilled sterile water. She would be asleep within about ten minutes. It is not too difficult to get these people off drugs, especially those who have been given drugs of addiction or narcotics in hospital and must continue on them. You can maintain them and if you are on the alert and smart enough with them you can get them off them very easily. Patients will have to be educated by the Department or by a health education council to the fact that they must not always be seeking drugs or tablets and they must appreciate that the body's normal recuperative powers must be allowed to work.
