At last we are catching up on Estimates. At least we know that we are discussing current Estimates. Any Minister would need great patience and endurance to have to listen to Estimates for his Department being discussed within three or four months of each other. As the House is aware we discussed in March the Estimate for last year's health services but I have no intention of going over all that ground again.
There is a large area of agreement between what the Minister is doing and what I think should be done in the provision of health services but there are other areas and other aspects of his policy with which I disagree. When I criticise, I hope the Minister will understand that I am doing so because, in one way or another for a long period, I have been associated with the provision of health services so that naturally I have certain views but views which may not necessarily be the same as the views of the Minister. My intention at all times is to be helpful and I am as anxious for progress in the field of health as is the Minister.
There is considerable alarm at the cost of the health services. I know that the Minister is alarmed at the rapidly rising costs of the services. Of course, the services are improving. Certainly they have improved in the region with which I am familiar. One of the criticisms I have regarding that particular region is that there is not sufficient anticipation of the growing need for services and of the vast expansion that is taking place in the area. I am thinking in particular of the hospital needs and health centre needs also. I shall say more on that later.
I think most of us agree with the Minister's policy that because institutional services are costing about two-thirds of the total moneys expended on health services, this is the area where we must try to save. There are various ways in which we can save in this area. First of all, we must do everything possible to keep people out of hospital. Much can be done in this regard. The form of the health services is conducive to people going into hospital. I am thinking of the middleincome group. At a cost of 15p per week, or £7 per year, they are entitled to full institutional services. If these people are kept out of hospital and receive services at an outpatient department they have to pay. There is pressure on local practitioners to put people into hospital because people know that they can get these services free when they are actually in hospital.
A serious look should be taken at this position. The spokesman on health for this party advocated last March that consideration should be given to providing the necessary expenditure to bring in the people described as the middle-income group. At present 30 per cent of the population are covered for full health services. They are covered for institutional care and the ordinary service of the doctor at home and for whatever the doctor requires. It was estimated that the service was costing somewhere in the region of £7.5 million or £7.8 million. That covered 30 per cent of the people. If an additional 60 per cent of the people were added to give cover for 90 per cent of the population, the additional cost would be, it is estimated, £15 million or £16 million. There might be quite a considerable saving having regard to the number of people who could be kept out of hospital. Hospital accommodation and care cost considerably more now. A strong case can be made for the Minister and his Department examining this matter carefully. I do not know how the extra expenditure could be covered. Perhaps it could be covered by direct taxation or partially by insurance and taxation. Few people in the middle-income group can afford to pay heavy hospital charges and they would be glad to bear some little additional cost in order to cover themselves.
Under the voluntary health insurance scheme there is a tendency for people to go into hospital because they are not covered for services outside hospital. The VHI scheme should be examined carefully to see whether this difficulty could be overcome. Another service which keeps people out of hospital is the domiciliary care and home help services. Many people are in institutions but they could be in their own homes or in much cheaper accommodation adjacent to their homes if housing, home help and district nursing services were improved. It would cost much less to keep people in this manner than to have them in institutions where they do not belong. They receive the best of care and food in the institutions and they are kept clean, but they still do not belong there. If these people could be brought back near their own homes they would be interested in what was happening around them. Every effort should be made to develop the home help and domiciliary nursing services.
I know that this is the Minister's policy. My only criticism is that the schemes are not progressing fast enough. Before the FitzGerald Report was issued, the Dublin Health Authority were surreptitiously providing home help on a limited scale. They were doing this mainly through the Little Sisters of the Poor and the Little Sisters of the Assumption who were doing such work at full stretch over a very long period. Perhaps we do not make full use of the nursing contribution that these religious orders make in various areas. When the sisters build a convent, as I know they have done in one case, they can give a nursing service to a considerable area around them. Such work should be left to them; there should be some arrangement between them and the health board so that the sisters would provide the nursing cover over that area, with assistance from the health board. The sisters do not work office hours or shut down at 5 p.m.; they give nursing care and assistance at the times most needed. They know where assistance is needed. Nobody is better equipped than they are to provide it. This city and this country owe these orders a deep debt of gratitude for the work they have done over the years and the enormous comfort they have provided for people in great difficulty.
The health charges are enormous. Every step must be taken to keep these costs down and to ensure that they are equitably distributed among the various sections of the people. The Minister's policy is proceeding along these lines and I could not agree more with it. We should have a better development of the local health centres in the Dublin areas where we have a big concentration of population. Every possible diagnostic and investigatory service and equipment should be provided for the medical practitioners in such areas. The medical practitioners who were working from these centres prior to the choice of doctor scheme have a right to use the health centres. Every doctor operating in a locality should have accommodation in these centres, if they are large enough, if not, the centres should be enlarged. They should also be enlarged to accommodate dentistry in all cases.
Reference has been made to the FitzGerald Report. No doubt this report has its good points but I am afraid, as some people have said in criticism of it, that there seems to be inflexibility in regard to it. The Department do not seem to be able to depart from that report, which was written by a number of eminent consultants. These consultants were certainly thinking of their own working conditions, something which would have had priority in their minds. They were ensuring that at the top level, where the most complicated cases had to be dealt with, all the equipment and accommodation necessary should be in the regional hospitals which they spoke so much about. There will have to be a couple of such places in the country, but they would not be my priority. I hold fast to the idea that 85 per cent of the work required can be done at local level. The concentration in the first instance should be on upgrading the local hospitals and providing a better service. I accept the view that we can no longer continue with the idea of one surgeon or single consultant in a hospital. That is not enough. People will not continue to provide this service any longer. There were individual surgeons who worked like slaves. The people had extraordinary confidence in them. There was good reason for such confidence. However, these men had no home lives. They were dedicated people. We have examples without number all over the country where these men give this extraordinary service, much of it at very charitable rates and much of it free. That situation must be improved. The least one should have in any hospital is two such consultants. That would reduce to a minimum the number of persons having to go to the expensive institution where you must employ the scarce resources of skilled personnel and expensive equipment. Therefore, it is there the concentration should be and should have been in the first instance.
It may be that the regional hospital idea was picked out of the FitzGerald Report but it has certainly annoyed many people and they are resisting it. The more resistance that develops the more difficult it will be for the Department to get a gradual changeover in the user of certain institutions without giving the impression that these are being downgraded. Nobody wants to see downgraded a local institution which has provided a reasonably good service over the years. I, in common with others, was very disturbed at the fight put up to keep Mallow Hospital in existence. Where you have a situation in which all the local people and all concerned with the provision of health services in the area come down on the side of retaining the hospital, improving and upgrading it, it is a dangerous thing for a Minister to say: "No, I shall have none of it." This is the same Minister who is always saying: "I shall have the fullest possible consultation. The local committees must be consulted and what they say must be taken into consideration." What does that mean if after an overwhelming vote to retain the hospital as it stands, the Minister says "no"? I am a long way from Mallow but we all saw this argument in the papers. I do not think a Minister is doing his job, or a Government doing its job, if all the people over a wide area say: "We want this institution retained" and the Minister says: "No. That would not be reasonable because we shall have a top-class institution 25 or 35 miles away." The people must be heeded in a democracy.
I had much disagreement with the Minister on certain aspects of the 1970 Act when it was going through the House and I disagreed violently with the idea of health boards. I could not understand how you would have three apparently autonomous bodies working alongside each other without undue overlapping and administrative difficulties arising. I know the Minister was handed a readymade Bill when he changed over to the Department of Health and told to put it through the House. He did it very ably, but he certainly did not attempt to explain how this could be an efficient administration. I think he could not see it, and the proof of that, and that he could not know how it would work effectively or efficiently, is that he has brought in McKinsey who has been almost constantly employed since the introduction of the 1970 Act trying to explain to the Minister how it will work.
The last assignment given to McKinsey has been to tell the Minister and the Department how Comhairle na nOspidéal and the regional health boards can be launched. The Minister, in commenting on this, says it is consistent with the advice given in the Devlin Report, that it represents the devolution of authority from the Department to the Minister and that is what he wants. Many people would call this a confidence trick. I do not want to do so because the Minister is a hardworking man and I think he is sincere in what he is trying to do. This does not represent the devolution of authority; in my view it represents the concentration of power and authority in the Department of Health.
Take Comhairle na nOspidéal. When the Bill was going through the House most of us looked on the Comhairle as perhaps a necessary and desirable body where you would have uniformity in regard to the qualifications of consultants of all sorts and in regard to the number necessary and desirable in the various institutions. There was very little resistance to Comhairle na nOspidéal but it now emerges as a very different body from the one we spoke about then. The Minister now gives it very wide functions and says he will take the necessary steps to ensure that it is a prestigious body—I think that was his description—with all the powers required to do its job. It will advise on hospitals throughout the country and will, as far as I can see, direct the co-ordination of hospital services, decide on the use of hospitals and decide whether a hospital should be kept open or not in the last analysis.
Mark you, the Minister appoints the whole Comhairle, all 23. He appoints the chairman and vice-chairman and the executive. As I see it now, the executive will either be composed of civil servants or seconded civil servants on whom he will have his thumb from the word "go". There is nothing wrong in a Minister having an advisory body. Perhaps every Minister could do his job better if he had an advisory body of people, perhaps currently in practice and up-to-date in their ideas. We know that if people go into the Department as advisers they stay for life. I am not criticising them but there is the tendency, I suppose, not to be "with it" and not to give the views of the people actually doing the job. Much can be said for an advisory body but there is no point in misleading the people here and throughout the country and pretending this represents devolution of authority. It is nothing more than a pretence and we should recognise it as such.
Comhairle na nOspidéal now seems to be emerging as the top body in this structure. It seems they tell the health boards the areas in which they should be operating and how they should go about it. They are the Minister's mouthpiece. The health boards then, will have to carry out what I would describe as the dirty work. There is a good political reason for setting them up. The Minister for Health knows, and his predecessor also knew, that if we set out to follow slavishly, as the Department appear to be doing, the recommendations in the FitzGerald Report, this will cause an uproar throughout the country because of the downgrading of hospitals, the closing of hospitals and their change of use. No Minister wants to be in the position where he can be directly hammered for what is happening. It seems that we have the same situation here as we have in regard to CIE, the ESB and all the other semi-State bodies where the Minister can disown responsibility and refuse to answer questions in the House. That is all wrong.
These bodies are taking over from the Department work for which the Department of Health should be directly responsible. I never saw any objection to discussing matters with the Department of Health because you realised you were with the people who had to make the decisions. In the setting up of Comhairle na nOspidéal and the regional hospital boards we are setting up further protection for the Minister and the Department. We are setting up another extremely expensive machine and another set of officers alongside the health board officers who will overlap. There will be a great amount of friction if this thing is not carefully done.
I can see a need for an advisory body to the voluntary hospitals and to the health boards for their own hospitals. It is amazing that these advisory boards were not there long ago and that this lack of co-ordination has existed for so long. The Department of Health have no function if they cannot do this. We have many examples of one institution being half used and the next one being overused because we had no co-ordination in regard to accommodation and the potential existing in the hospitals run by the local authorities and those run by the voluntary bodies.
I believe that the health boards could adequately provide this co-ordination without setting up another body. The Eastern Health Board had gone a long way towards co-ordinating the work of the voluntary hospitals and the hospitals run by the health boards and the health boards themselves. We all know of the setting up of St. James's Hospital Board where you had a membership of 50 per cent from the health board and 50 per cent from the Federated Dublin Hospitals. I am confident that this combination will upgrade that hospital substantially. I hope the board of St. James's Hospital will be facilitated in every way to get on with the job. If they cannot do this you will have a lot of disillusionment and many disgruntled people who would otherwise work very hard to improve the health services in this region.
We should be realistic about the federated group of hospitals and we should no longer talk about them as seven hospitals which will be integrated in St. James's Hospital. You will have three hospitals fully integrated. You will have Sir Patrick Dun's, the Royal City of Dublin, and Mercers. You will not have the Meath, Steevens or the Adelaide. These institutions should be allowed develop in their own separate ways wherever development is desirable. Development work should not be held up by telling them that they will be integrated into St. James's Hospital. They should be permitted to provide adequate services before their boards lose interest.
I would like to hear the Minister saying that he will consider carefully any proposals put up to him and that he will try to establish the extent to which these separate institutions should be developed. The teaching link with Trinity College comes into this and that cannot be disregarded. There would be some difficulty if the link with Trinity College was to be transferred to St. James's Hospital. This is something which can be overcome and which can be arranged between the medical schools. As well as a large hospital in St. James's we will also need those other hospitals to provide a very high standard, for which they should be equipped.
You have the board set up in the James Connolly Memorial Hospital where you have the three voluntary hospitals and the members from the Eastern Health Board working together. Deputy Timmons spoke at some length about the great need for hospital services on the north side of the city. I know the Department intend to develop good hospitals here, that very shortly the necessary reconstruction work will be done in the James Connolly Memorial Hospital, that 120 beds will be working effectively there and that we will have a suite of theatres and the back-up services. We will also have a few wards into which patients can be transferred when recuperating. This will give a sizeable unit.
There was a promise given, when this work was started, that as soon as the 120 beds were functioning the board would be allowed to proceed on the planning of the much larger general hospital unit of perhaps up to 500 beds, that in the meantime some assessment of the position would be made in the Department and that somebody from the Department might work with the team planning the new hospital unit. I hope the Department have not postponed their intentions too long because many top level consultants have agreed to work in the James Connolly Memorial Hospital and I would hate to see their interest waning.
I now want to refer to the great shortage of maternity service on the north side of the city. The James Connolly Memorial has again come to the aid of the Coombe but it is a stopgap arrangement. We are providing accommodation there in a 40 bed unit for post-natal cases to relieve the overcrowding at the Coombe but this will not work for very long.
The Department do not need further evidence of the fact that in the Connolly Memorial Hospital there should be set up a viable maternity unit. There is vast expansion in the area in which it is situated, and it is unsatisfactory that services should be provided on an agency basis in it for maternity cases. There should be a complete unit for which the hospital board would have full responsibility and not have divided responsibility between the two institutions. It does not work and will not work. It provides relief and the hospital board were pleased to provide that relief. I want to impress on the Minister that it is an emergency relief and should be regarded as such. He should direct the planning of a complete maternity unit there.
In relation to the hospital in Blanchardstown, a good local health centre is badly needed and there has been agitation and demand for such a centre over a long period. A vast population is building up. The logical place for the health centre is the hospital grounds, where the general practitioners in the area could work in close association with the hospital and would have the use of the diagnostic and investigatory facilities there. This would be consistent with the FitzGerald Report and is what was demanded, namely, that there would be close association and integration.
For far too long the general practitioners have been working in isolation, with no assistance whatever. It is deplorable that in an aspect of the health services where 85 per cent was being provided there was so little done to assist them. I would encourage this development. I would like to bring the local practitioners into the James Connolly Hospital at every opportunity. I would like to see cover provided for some of the consultants there on occasion so that they would be able to see at first hand the progress of their patients. There is a great opportunity for development along these lines and such development should be encouraged.
I have made the case that the health boards were of themselves adequate to deal with this type of co-ordination and the kind of work that it is proposed the hospital boards should be involved in. In addition to the developments I have just described in the two institutions I have referred to, there were the developments that took place in the most diplomatic way. People from the health board, principally officers of the health board, were invited to take up positions as board members in the voluntary hospitals. This is the type of development we want. There was no friction, no difficulty. The suspicion and distrust that existed between the voluntary hospitals in the region and the health board hospitals and the health board itself have been disappearing rapidly. I would deplore anything that would upset that development.
The same applies in the appointment of geriatricians. Two geriatricians have been appointed in the north side on a basis of complete co-operation and co-ordination between the voluntary hospitals and the health boards. This is as it should be.
There is another reason why this body is not only superfluous but dangerous. It is concerned only with institutional services and the level and size of the institutional service required depend entirely, or to a large extent, on the development of domiciliary nursing, home health, housing and all the other services to which I have referred. They are at present the responsibility of the health board. If you separate those two things, how can you get them working as they should work? If you have two separate bodies dealing with various aspects and overlapping how can they work? I should like to comment on the Minister's statement on this, which does not seem to make sense. He said:
It must be recognised that the health boards could not, on their own, achieve full co-ordination of the hospital services, for two reasons. The first was that the pattern of the eight health board areas does not allow sufficiently for the fact that the influence of the major hospital and teaching centres in Dublin, Cork and Galway extends beyond the areas of the health boards where they are situated.
I say, "So what?" That is no explanation to me as to why the health boards or a combination of health boards could not do the job, because the co-ordinating links can be very easily established.
The Minister went on to say:
The second reason arises from the fact that about half of all the hospital beds in the country are in voluntary hospitals.
Again I say "So what?" I continue the quotation:
Even if the health boards were otherwise suitable, they could not be regarded quite as the appropriate bodies to co-ordinate the activities of the voluntary hospitals and those of their own institutions: participation by the voluntary hospitals in this co-ordination was regarded as essential.
Nobody else regards it as essential. None of the persons involved in the provision of health services, outside the Department, regards it as essential. It is regarded as something that is extremely dangerous and it will be more dangerous in view of the fact that the Department and the Minister are not prepared to listen to recommendations.
The Minister employs McKinsey and says that this is the most expert firm of consultants. I agree that it is. The Minister comes into the House before they report back to him and before they have time to make their recommendations. If the Minister tells the House the whole truth—I have no reason to believe that he will not— he will tell us that McKinsey will not recommend, and could not recommend, the health boards. The directive to McKinsey must be: "Tell us how we can set up this organisation. We have it in the Health Acts. Tell us how we can work it." In my view they will quietly come back to the Minister and tell him that he is in a jam, that the whole concept was crazy but that, as he has employed them to indicate how it can work, they must set out to do that.
The Minister said:
In this respect, I would draw the attention of the House to my statement of 22nd July, 1971 (Dáil Debates, columns 2363 to 2365): We are indebted to the voluntary hospitals for the services which they have rendered in the past and we are confident that they will continue to play an essential part in our health services. I think, however, that it is fair to say that all concerned, including the voluntary hospitals, recognise that in a modern hospital system separate units cannot be given the resources to act in isolation.
Everybody agrees with that. I ask, why did not the Department say that long ago and take the necessary steps to bring about this co-ordination directly? If we had an inspection service they would know what was going on and they would know that this was a field in which they should have been working.
Since Comhairle na nOspidéal is being set up as the prestigious body why are they not let do the full job? Why is it necessary to set up a third body? We do not know where it will end. We do not know whether we will have a fourth and a fifth body if we are not careful. The various health boards were asked to consider this recently. This is described as consultation but it is consultation without any reaction to the result of the consultation. The Eastern Health Board stated strongly that this was an unnecessary and superfluous body but it is in the Act and, like the tide, it cannot be kept back. It must come into existence in some form. It can be given a certain amount of useful work to do in an advisory role and a consultancy role on certain aspects of hospital management and development. We must not have overlapping with a lot of difficulties arising at administrative level between the health boards and the hospital boards.
The Eastern Health Board put forward the very sane suggestion that it was unnecessary to set up another separate expensive administration. In the Eastern Health Board area we have 55 per cent of the population and about 76 per cent of the total bed complement. They suggested that the CEO of the Eastern Health Board should also be the chief executive officer of the hospital board and that a programmes manager from each of the other three health boards should be involved in the Dublin hospital board and perhaps three secretary managers from the voluntary hospitals and one or two officers from the Department. These would be people who had other jobs and who were involved up to their tonsils in the provision of health services. This would provide a co-ordinating link and we would not have one authority going in one direction and another authority going in another direction.
This was regarded as a very sensible recommendation but the Minister "downed" it early on in his statement and said that it was unacceptable. He said:
Some health boards questioned the timing for the establishment of these bodies and suggested that the proposed regulations be deferred for some years, until the new administration under the health boards had settled down. The Eastern Health Board also suggested that the administration of the Dublin Regional Hospital Board should be tied in with that for the health board. As regards the timing of the establishment of the new bodies, I do not think it would be wise to wait. To do so would leave a hiatus, as it would be difficult to maintain adequate continuing machinery for co-ordination between the hospitals of the health boards and those of the voluntary bodies.
This machine was working already. I am very sorry the Minister is not here and I hope he will read what I am saying. These bodies were working already on this job of co-ordination and, in my view, working very effectively. They were not disturbing anybody. The Minister has given this House an assurance that he will not interfere unduly with the work of the voluntary hospital boards and that they will maintain full independence. He came back to this time and time again. If we are to have this co-ordination we must achieve it in a diplomatic way. This job was going on by invitation and by getting the voluntary hospitals to see that the health boards had something to give them and that, working together, they could do far more far better than if they were not working together.
The Minister said:
Neither could I accept the proposition that the health board personnel should also act to provide the administration for the regional hospital boards. In my view, it will probably be better that the personnel administering the regional hospital boards and Comhairle na nOspidéal, should be seen to be independent of both the health boards and the voluntary hospitals, but of course acting in close association with them.
Why is this independence necessary? They are all doing the same job. We are all trying to achieve the same end, that is, to provide better institutional services, better health services all round. If this job is given to three bodies, we will have three bodies working in opposite directions to a considerable extent. We are creating unnecessary friction. The recommendations made by the Eastern Health Board were extremely sensible and should have been accepted by the Minister.
The health boards were asked to comment on finance, personnel, management and the executive of the regional hospital boards. Under the heading of personnel the Eastern Health Board said that it was agreed that the function of the regional hospital boards governing the number of hospital personnel should be exercised only through the appraisal of estimates prepared on the PPB principle. This is planned programme budgeting for those who might not know what it is all about. They said that under this arrangement there would be the least delay in recruitment and the least interference with forward planning of staff requirement and that the absence of conciliation and arbitration machinery to deal with pay disputes was noted.
If the hospital boards and Comhairle na nOspidéal are to decide the exact number who should be employed, how will it be possible for health boards to plan five years ahead unless they can also plan for the recruitment and employment of the necessary staff to deal with the programme? This is consistent with the Devlin Report recommendation. When it suits the Minister to accept what is consistent he accepts it and when it does not he throws it out. He quotes it when it suits his purpose. We feel that there is an unnecessary interference and an unnecessary restriction, that there should be a budget and that, within that budget, an immense amount of freedom should be allowed to either the voluntary hospital boards or the health board concerned with the running and development of voluntary hospitals.
It is unfortunate that it is not possible to get the Minister to step back from the edge of the precipice because untold harm will be done if the health boards are wrongly launched. This would be a great pity because there is no doubt that immense changes are taking place in the health services and that there is a great deal of criticism of these changes. There is criticism of the fact that the people who are providing the money have little or no say in the development of the services. I am surprised and disappointed that it has not been possible to get the Minister to see that there was wisdom in the recommendation of the Eastern Health Board in an area with 55 per cent of the population and 76 per cent of the beds. They are not listened to and yet we hear talk about the fullest possible co-operation. I will leave the setting up of these bodies with the comments I have made.
I would appeal again for rethinking on this whole situation particularly in regard to the personnel who will be involved in the executives of these organisations. As far as we are concerned, regional hospital boards are a new concept and we do not know whether they will work. Some of us are completely satisfied it is a wrong concept if they are set up in this way and if we do not appoint people to their secretariats who will be in a position to go back to their jobs after a period when they will have been seen to be interfering unnecessarily with the programme and when it has become clear that these organisations never should have been set up.
I had meant to comment on a number of points in the Minister's speech. I made some notes here and there but I am afraid I am not referring very much to them. We have all had a surfeit of discussion on the health services in all their aspects this year but the point that is current and causing serious concern to me and to many other people is that which involves the regulations before the House for consideration, approval or disapproval. They certainly have my disapproval.
There was reference early on to health charges and conditions for eligibility. Deputy Timmons said that in the Eastern Health Board we recently issued guidelines for eligibility. In the circumstances they seem to me to be reasonable enough so long as we retain a means test but it is my considered view that the time has come to remove this means test as to 90 per cent of the people. While we are waiting to do that, it is good that we have these guidelines so that public representatives, and others to whom so many unfortunate people come, will know the yardstick that has been used and how it is being used.
I want to say something about the health charge for emergency cases. The Minister will recall that before the 1970 legislation public representatives had the right to allow an emergency health charge, so to speak, to somebody in dire hardship. The degree to which that system was abused was very small. Indeed, I was not aware of it being abused to any worthwhile extent in the Dublin region. It was extremely useful and I could count the number of times I used it on my fingers, and I represented a very densely populated area of working-class people. Nevertheless, it was a mistake to take it out because nothing has taken its place. You can have an extreme hardship case which will take a month or six weeks to be caught up with in present circumstances. There is, therefore, a great need for another look at this matter with a view to reintroducing something like it at local level because the authority now responsible for health services are no longer local. At local level somebody should have the power to say: "This is a hardship case and until a full investigation is made relief must be provided." It is always a mistake to do away with something until you have something else to take its place.
That is all I want to say on the health services. I wish to ask the Department to look at the overall health service concept and to say it is a job for one organisation and not for three. I can see a limited function for the hospital boards but I should like to hear the Minister openly say that it is to be an advisory body instead of talking about a devolutionary body.
