asked the Minister for Health if he will explain the circumstances under which the junior intern doctors threatened to withdraw their services; and if he is now satisfied with the position.
4.
Ceisteanna — Questions. Oral Answers. - Doctors' Dispute.
3.
asked the Minister for Health if he is aware that the widespread publicity given to the recent strike action by doctors at the County Hospital, Castlebar, County Mayo is causing serious anxiety throughout the country; and if he will make a statement on the matter.
With your permission, a Cheann Comhairle, I propose to take Questions Nos. 3 and 4 together.
It is misleading to suggest that junior hospital doctors as a whole threatened to withdraw their services. This happened only in relation to a relatively limited number of hospitals.
When it came to notice in the Department of Health that a number of claims for hours, above the normal, worked or on call were, prima facie, excessive the chairman of the working party which was set up to consider various aspects of the conditions of service of these junior doctors and which consists of representatives of the Department, the Hospitals Commission, the local authority hospitals and the two organisations representing the junior doctors, that is to say, the Irish Medical Association and the Medical Union wrote on 28th May, 1971 to the chairmen of all voluntary hospitals and to the chief executive officers of health boards asking them to defer payment until the position had been looked into. The working party met the following week and as a result of their deliberations, a method of dealing with claims, endorsed by the respective councils of the organisations representing the doctors, was settled and an appropriate notification was issued on 3rd instant to all hospital authorities. In view of this I do not expect that difficulties will arise in the future.
Would the Minister agree, in spite of the lengthy reply which he has now made, that there was a threat by the junior doctors to withdraw services and that the threat was in the main caused by the action of the Minister and his Department?
I would not agree at all. I addressed two letters to the voluntary hospitals and to the health board hospitals on 18th March and 26th March. It would take too long to read them, but they set out explicitly the conditions under which overtime would be paid and they made it absolutely clear that it was not the intention to pay large amounts of overtime or to pay any overtime at all unless it was necessary. Apparently the hospitals did not fully comprehend the import and the meaning of these two very lengthy statements which were addressed to them. The position is now being reviewed. When the new group of students come for appointment in the hospitals in July it should be possible to increase the number of junior staff so that we can avoid all but absolutely essential overtime. I will send the Deputy a copy of the letters to the voluntary hospitals. The Deputy will see that there was no dereliction on the part of the Department in making absolutely clear the conditions under which overtime should be established and paid.
Would the Minister agree that what constitutes overtime was what was at issue here and not the overtime itself?
That is made quite clear in the letters which were addressed to the hospitals.
The Minister has not explained why the Department took the unprecedented step of stopping these cheques when they were in the course of being transferred to the recipients' accounts. In so far as this happened the Department agreed to make the payments to the doctors despite the panic decision taken. I think the Department made the mistake. The Minister should tell us what exactly happended.
We cannot have a debate on this.
The Minister said last week that he was sure I would not pursue this matter until it had been resolved. May I ask the Minister why the cheques were stopped?
Because the amounts of overtime being paid were excessive and the position had to be examined.
Was the money paid?
We paid up to a certain limit.
Despite the fact that this was stopped originally? The Minister admits the mistake?
We have not admitted the mistake.
Does the Minister appreciate the serious anxiety which this caused, not alone in Mayo but throughout the country? Can the Minister say that in future a situation like this will not be allowed to happen?
I cannot be responsible for threatened industrial disputes occurring.
Would the Minister state the total amount of money involved?
Does the Minister appreciate the difficulty of working a system whereby no overtime, or practically no overtime, can be ensured unless doctors are agreeable to working on a shift basis? I do not think that this would be agreed to.
We have recommended that the doctors should work on a rota basis and that there should be a cross-over basis of working overtime. I realise that there are difficulties. Perhaps there are a limited number of consultants who are looking after seriously ill patients and who demand the service of a particular registrar in their absence. All this must be examined. One of the reasons why we are establishing voluntary regional hospital boards and appointing work-study experts is that it has been revealed here, as in other countries, that the administration of the hospitals, in the light of the very great hospital expenditure which the public now have to pay will have to be tightened up. I am not blaming anybody. If one examines reports from all over the world it will be seen that hospital administration in its essence is not yet perfect. The letters, which were so clearly addressed to the hospitals but were not fully appreciated by the hospital boards concerned, are proof of the fact that we hope, in conjunction with them, to get a better conception of hospital management accepted. There were hospitals who replied in the very best way but there were hospitals in this city whose overtime was very much less than that of other hospitals. Nobody is to be blamed. I am not saying that junior doctors were taking advantage of the situation or that the administration was wrong in the case of other hospitals, but I am merely pointing out that the hospitals themselves appreciate the need for greater tightness and efficiency in administration.
(Interruptions.)
Arising out of the Minister's reply——
May I ask the Minister——
I have allowed six supplementaries.
——was the overtime vouched for by the consultants or is there a means of establishing what overtime they worked, especially when it was retrospective?
Question No.5.