Deputy Donegan gave notice that he would raise a certain matter on the adjournment.
Adjournment Debate: Health Service Policy.
I gave notice that I would raise the policy of the Minister for Health in regard to the provision of information relating to the number of citizens in various parts of the country receiving medical benefits, bearing in mind subhead G. of the Vote for the Department of Health. The amount voted by this House towards grants for health boards, as set out on page 169 of the Book of Estimates, in subhead G. is £37,885,000.
Parliament exists on Standing Orders and precedent, and of the two the more important is precedent. Parliament is superior to, and the source from which the Cabinet get their power. It is related to universal suffrage and the right of the most lowly citizen to have his case raised here when we spend money on his behalf. We are answerable to him at the next election and he makes his decision as to whether or not he will support us. This is his sovereign right.
I wish to refer to the answers given by the Minister for Health to Question No. 11 on 14th July, 1971. In reply to a supplementary question asked by Deputy Murphy—I am quoting from the Official Report, Volume 255, column 1335—the Minister said:
I made it clear to some other Deputies that I was trying to decentralise the answering of questions that can properly be answered by health boards, which are enlarged institutions and have staff available for this purpose. When there is no question of principle in which Government policy is involved, it is far better that Deputies and everybody concerned should take an interest in the statistics they wish to have from the health boards.
At that stage I said:
Surely the Minister is creating a most unwelcome precedent? Would I be right in saying that local authorities which were in fact the health authorities were always subject to Parliamentary question and that information sought from local authorities, from Departments and Ministers was always provided on the basis that there was a large Exchequer contribution, often 100 per cent in the case of roads and 50 per cent or more in the case of health? Is this not a complete break with precedent? The Minister is, in fact, removing from Deputy Begley who is responsible by his vote here and from other Deputies, the opportunity to get the information upon which they can exert pressure and express views within their own political parties and get them to decide how to vote? Is the Minister not directly responsible——
An Ceann Comhairle: The Deputy is making a long speech.
Mr. Childers: I disagree entirely with the Deputy and I shall not answer questions——
and here is where the imperious nature of the statement comes in——
——which relate purely to local matters. If the Deputy wishes to raise a question of principle he can do it but he should remember that within the next six months county advisory health committees will be appointed which can fight if they wish and determine if the policy in relation to a particular area of the health board is being exercised wisely. They can ask this sort of question of the county advisory board. They can have an examination of whether disability allowances are being properly paid or whether there is a difference in the method of payment between one county and another. If a question of a national principle arises, of course, I shall reply to the Deputy here but there is no national principle involved here. I would wish that Members of the House would become acquainted with the operation of the health boards and make the health boards answer questions of a purely local character.
I am a member of the North Eastern Regional Health Board, representing Louth County Council. I have not inquired, nor do I know, if Deputy Begley is a member of a health board. I should like to know from the Minister, having regard to the Estimate for his Department, whether he is responsible for the disbursement of the sum of £37,885,000 set out in the subhead? The principle of democracy— which is far more important than the question Deputy Begley quite correctly asked—is at stake, as to whether the most experienced or the most lowly Member of this House has not the right to question a Minister regarding the disbursement of public funds. I maintain that the disbursement of £37 million is disbursement of public funds for which the Minister is responsible. If Ministers will say to Members of this Parliament that in respect of such a sum they will not answer questions regarding its use, then the Government have adopted an extremely arrogant attitude.
I should like to quote Standing Order No. 32. Again, I emphasise that I regard Standing Orders as second to precedent. It is precedent that ensures the operation of Parliament. The second point that arises is whether the Minister is correct in his interpretation of Standing Orders and whether he is behaving in this instance as a Minister operating in a sovereign democracy, which should cherish all its citizens equally. Standing Order No. 32 states:
The Ceann Comhairle shall examine every question in order to ensure that its purpose is to elicit information upon or to elucidate matters of fact or of policy, that it is as brief as possible, and that it contains no argument or personal imputation. The Ceann Comhairle, or the Clerk under his authority, may amend any question, after consultation with the member responsible for the question, to secure its compliance with Standing Orders.
I submit this House has always been bound by that ruling. The present occupant of the Chair, as well as his predecessors, and those to whom the Chair has delegated duty, have acted properly and courteously to Members. I would describe the Minister for Health normally as the most courteous member of the Government, but the question that arises here is whether he has acted with the same regard for democracy, for Parliament and in accordance with his duty to elucidate regarding the disbursal of funds.
Whether Deputy Begley erred in his question in relation to this Standing Order or whether the Chair was lenient can be judged by Deputy Begley's question. I quote from column 1334, Volume 255, of the Official Report of 14th July, 1971.
Mr. Begley asked the Minister for Health the number of people in receipt of disability benefit from Kerry County Council on 1st January, 1971, and from the Southern Health Board on 1st June, 1971.
If I can ask a question on the disbursal of public funds on a public road, on which there might be a 50 or 100 per cent subvention from this House, or on which there might be no subvention, and if I get a reply from the Minister for Local Government, was it not my right as a Member of this House prior to the setting up of the health boards to ask the Minister for Health information such as that sought by Deputy Begley? I was privileged to receive a reply in relation to the number of persons in County Louth who held medical cards at a certain date and the number of persons who held such medical cards at a later date. The health authority was Louth County Council.
I suggest that the precedent is established and that the facts are the same. If Deputy Begley or any Member of the House—particularly Deputies who are not members of a health board and have not got the right to question a health board except as private citizen—desires to obtain this information, he is fully entitled to get it, in my opinion. On Standing Orders and on precedent, I hold that this Parliament has been degraded and reduced in stature, at a time when there never was more need to maintain that stature, by the fact that the Minister decided, on his own volition, that "I disagree entirely with the Deputy and I shall not answer questions which relate purely to local matters".
The question of how many people are in receipt of free hospital accommodation, or free medical attention outside hospital, or free drugs, is not entirely a local matter. It involves a very large area of this State in County Kerry and a very large proportion of the people of this State in County Kerry. I hold that, in relation to the subhead in the Book of Estimates which I have mentioned, totalling £37 million, Deputy Begley was entirely correct in asking this question. The Minister was entirely incorrect, on precedent and on Standing Orders, in not giving him, in a courteous manner, the reply which he sought. Deputy Begley wishes to take some of my time and, if that is in order, he will now do so.
I have not got very much to add to what Deputy Donegan has said. He very ably presented the case. I put down this question because I am not a member of the Southern Health Board. This type of information was accessible to me when I was Chairman of the Kerry County Council, or a member of the Kerry County Council. When I put down this question I thought that the Minister would reel off two figures to me—£520 or £510—and that would have been that. Unfortunately, I was not present when the question came up. I was on a deputation with Deputy Creed.
As Deputy Donegan asked: where am I to get this information now, if I cannot get it in this House? The Minister pointed out that other health boards will be set up in the county more or less in an advisory capacity. No effort has been made to set up those health boards yet. The health board has been in operation since 1st April and this is almost 1st August, and it looks as if it will be 1st October before anything is done to set up these boards. As I am an elected representative of the ratepayers of County Kerry, and as I had this information at my disposal prior to the setting up of the health board, I feel that I am entitled to get this information. The State is contributing something in the region of £35 million——
£37 million.
——towards health. I have no bone to pick with the Minister. He has been very courteous to all Members of this House since I came into it, and I am sure before that. Deputies who are not members of the Southern Health Board, or any regional board for that matter, have no way of getting this information. I wanted it for statistical purposes only. That is why I took very grave exception to something the Minister said in some of his replies to supplementary questions. He more or less said that I was grousing because more people were getting disability benefit in County Cork than in County Kerry. That was the furthest thought from my mind. I feel that I am entitled to get this information. I appeal to the Minister to re-think the whole matter. There were only two figures involved. He could easily have rung up the Southern Health Board and got the information and given it to the House. We are in the House to get information and if we cannot get it we must be approaching a dictatorship.
We have no way of getting this information. The CEO in Cork, Limerick, Dublin or Waterford, is under no obligation to give it to us because we are not members of a board and we cannot question him. He need not even reply to our letters. I am not saying that will happen. He is in that position. If the Minister's attitude is to be accepted as the "done thing" down the line—that he need not answer—the next thing we will be told is that the CEO need not answer elected representatives either. That is the point. He can say: "When the Minister did not see fit to give you this information, why should I give it to you?" That is what I am worried about. With that thought in mind, I would appeal to the Minister to give us this information, especially since there is no sinister motive behind the question.
I think Deputy Donegan and Deputy Begley have hopelessly misunderstood what I said on the occasion when this question was asked. I want to ensure that the regional health boards develop a powerful personality of their own and that their officers will feel they have a responsibility to inform both Deputies and other persons of importance in the area in regard to any matters which they question them about. One of the reasons for establishing the health boards was that, with a larger area of administration and with programme managers appointed, I should not have to policy the boards from day to day, and from week to week, in the same way as might otherwise be necessary, because these boards have been developed and they are representative not only of local authorities but of medical personnel and medical consultants of various descriptions.
My idea was that information obtained from the health boards of a purely local character, and which does not include any question to me in relation to my responsibility for a particular service, or the implementation of a service, could be more useful to Deputies. If they go to the health board headquarters and get this information, and if they attend meetings of the advisory committee, the information they get will be more significant. They will learn more about what its importance is to the health boards. Then if they want to ask me questions in regard to my responsibilities, their questions might often be more penetrating and more effective in regard to making suggestions as to whether I can make an alteration in policy, or whether something has gone wrong administratively in a health board, or whether there is obviously injustice being committed within the administrative area of the health board. They could actually make their questions more significant to me if they have what I might describe as a first loyalty to the regional health boards and if they have a feeling that they can go to the health boards for this ordinary localised type of organisation.
For example, I had another similar question today. A Deputy asked me for details about all the possible hospital improvement schemes in quite a large area—I think it was Tipperary. Obviously it would be much better for that Deputy to go to the health board and, when he asked about the hospital schemes, he could get far more detail about them. He could learn their significance to a greater degree——
Not necessarily.
——than he could possibly by getting a reply from me. I could not take the time of the House to reply in such detail and the Deputy could ascertain what was the present order of priorities for these hospital schemes devised by the health boards. I have asked the health boards to put in order of priority a great many hospital improvement schemes, and other schemes of that kind, so that, with the finance available, they will know how to proceed. Deputies can have a much better idea of what the significance is of any scheme if they go to a health board. I have been in this House since 1938; I have been here longer than Deputy Donegan has. I am very jealous of the privileges of this House. I believe Deputies have a right to ask Ministers questions relating to national policy and I believe these questions should be answered meaningfully.
Questions on the application of moneys voted here and how the moneys are spent?
Yes. In this particular case, however, the Deputy simply asked the number of persons receiving disability allowance in Kerry and Cork. I have no power to decide whether or not disability allowance should be paid. There was nothing in the question to suggest there was a wrongful comparison as between disability allowances paid in Cork and Kerry and elsewhere. There was nothing in the question which related to something for which I had responsibility.
Oh, yes, there was. Could I ask the Minister does he not agree that Deputy Begley has no right to get this information from the southern board? He is not a member of a local authority and, if the members of that board so wished, they could treat Deputy Begley as a private citizen and not give him the information. Yet, there is £37 million odd leaving here——
I would certainly have to look into that——
Is that not true?
——because I regard Deputies as having the right to get an information service from the health boards and, if they are not going to get an information service, then, pending consideration of this matter, I would naturally answer all these local questions.
If, say, I were to write seeking information relating to Tralee Urban Council. I am not a member of that council but I am a Member of this House. The Minister's reply is quite unsatifactory.
The Dáil adjourned at 10.55 p.m. until 10.30 a.m. on Thursday, 22nd July, 1971.