Dáil Éireann debate -
Wednesday, 14 Nov 1973

Vol. 268 No. 13

Committee on Finance. - Adjournment Debate: Junior Hospital Doctors' Dispute.

Mr. O'Malley

I rise to speak on this matter on a night when this country is in chaos, during a week in which this country has seen the greatest industrial chaos and labour relations situation possible since we achieved our independence. The particular aspect of this chaos I wish to speak about tonight is, in my view, and the view of many people the most serious of all the many things that are happening to us.

It is an appalling situation that for the last three-and-a-quarter hours this House like a lot of Dublin city and the rest of the country, is without light or power——

An Ceann Comhairle

The subject matter of which the Deputy gave me notice related to the junior hospital doctors' dispute and the Deputy should please relate his remarks to that subject matter and nothing else.

Mr. Coogan

——the Deputy is still in the dark.

Mr. O'Malley

What I am saying is that bad and serious as they are even more serious is the situation when we have the threat that tomorrow the junior hospital doctors of the country, who number approximately 980, say they are going to resign or hand in their resignations. These resignations, the doctors say, will take effect 14 days later, on 1st December. We have had a situation over the past two weeks or so in which they have been working very restricted hours. I appealed to the Minister more than once in this House on 25th October, and subsequently in another statement which I issued, to realise the seriousness of the situation, the tremendous danger many of the citizens of this country were placed in and the necessity for him to do his utmost to bring about a solution to this problem. I regret to say that until this very night the Minister for Health has not shown the sort of concern that this terribly serious problem should have demanded of a Minister for Health.

Tonight, the Minister went on radio, and, I presume, on television, to make a plea to the hospital doctors not to resign and to resume their normal working hours. He appears conciliatory tonight and concerned about it. I want to suggest that if this concern, and if this approach we have seen tonight at the eleventh hour, were shown somewhat earlier, if this were done last week, and if what the Minister did last week was done the week before, we might not be in the position we are in now.

A ministerial broadcast was made tonight by the Minister on RTE. He was perfectly right to make it. The matter is terribly serious and it is an appropriate one for a ministerial broadcast. I have no objection to him making it. In fact, I am glad the Minister made this broadcast and I hope his appeal will bear fruit although the possibilities of it bearing fruit are lessened by the fact that it was made so late in the day.

In relation to this broadcast I should like to point out that I gave the Chair notice at 4 o'clock today that I proposed to raise this matter tonight. The Chair kindly agreed to my request. Not long after that, sometime before 5 o'clock, we were informed that the Minister would make a statement tonight. I asked if we could be given a copy of that statement at the earliest possible moment. In view of the fact that I am Opposition spokesman on Health, and that I had given notice of my intention to raise this matter tonight, I expected that I would have been facilitated in this way.

During the afternoon we were told that it was hoped that the statement would be available "around teatime". In any event, the Minister made the broadcast at 9.05 p.m. At that time I still had not received the Minister's statement. At 9.30 p.m., because I felt it was necessary that I should be familiar with its contents before I spoke here tonight, and having failed to get it from the Government Information Service, my Whip telephoned a newspaper. He was informed that they had received three copies of the statement at 8 o'clock and they kindly arranged to send me one copy. Subsequently my Whip did succeed in obtaining a copy of the statement from the Government Information Service at ten minutes to ten. It is unfortunate that this House should be put second in anything of this nature. It is a reflection——

Mr. B. Desmond

We never received copies of the Deputy's statements when he was in Government.

Mr. O'Malley

——on this House.

An Ceann Comhairle

Order. This is a limited debate and I expect that the speakers concerned will be allowed to make their contribution without interruption.

Mr. B. Desmond

The Deputy got a far better service than he gave us.

Mr. Coughlan

The Deputy asks for interruption because he has gone completely off the rail.

An Ceann Comhairle

Order.

Mr. O'Malley

The appeal that was made tonight by the Minister asks the junior hospital doctors not to resign tomorrow and to resume their normal working——

Dr. Byrne

They are not resigning; they are offering their resignations.

An Ceann Comhairle

The Chair is seeking the best order for Deputy O'Malley and for the Minister to reply.

Mr. Coughlan

Deputy O'Malley is completely out of order.

Mr. O'Malley

The Minister goes on to ask the doctors to await the outcome of immediate independent conciliation which has just been agreed, in principle, by the medical organisations. However, the difficulties about this are that firstly it is agreed in principle and no more. When will it be agreed somewhat beyond principle? When will it be agreed to in detail? Secondly, even if it was agreed the first thing tomorrow morning in detail, and if the independent conciliator was agreed in the morning, the situation is that the two medical organisations are not representatives of the junior hospital doctors.

The two medical organisations have been advising the junior hospital doctors all along since this dispute came to a head in the last few weeks not to take the action which they did take. I question whether it is of any value for the Minister to agree on conciliation with the two organisations unless he agrees it with the organisation which seems to be the principal one in this dispute, the Action Committee of the Junior Hospital Doctors.

I am glad that the two medical organisations have agreed, in principle, to conciliation by an independent conciliator, but I wonder whether this is going to lead to any worthwhile conciliation because the junior hospital doctors, as the Minister is well aware, have paid no attention in recent weeks to the urgings and the advice of the two organisations.

A great many of these doctors are not members of either organisation but even those who are members of one or other have, for the most part, tended to ignore their organisations and to disregard the advice tendered to them by these organisations. I know that the Minister will tell us that it is good normal trade union practice to deal only with recognised permanent bodies who represent people engaged in negotiations, but he must face the reality of this situation. This is not just an ordinary strike in a factory or anything of that nature. This is, in health terms, the most serious thing that has happened in the history of this country.

Dr. Byrne

As a result of many years under Fianna Fáil Minister of Health.

Mr. Coughlan

The Deputy is advocating anarchy. Being a former Minister for Justice, he should be taking the opposite line.

Mr. O'Malley

This situation is getting rapidly more serious. I warned the Minister in this House, and in a statement outside this House, of the seriousness of this matter. On 25th October he said he felt I was exaggerating the matter and that the position was not as serious as I had stated. He said then that he did not think it would become as serious as I had forecast. Unfortunately, and I say this sincerely, I was right and the Minister was wrong. It is tragic for everyone that this should be so but, nonetheless, it is so and I was right. From the information I have received tonight I am afraid that the likelihood is that a great many of these junior hospital doctors will send in their resignations tomorrow.

They seem to be adamant in their attitude that they were badly treated in negotiations, that negotiations were not appropriately carried out and they feel they must see this thing through. In the circumstances, I do not think the Minister can rely on what are normal negotiating procedures. This matter is too serious. For all we know deaths may have already occurred as a result of this situation. It is not enough to say that emergencies are dealt with. It is well known that a great many people who would be referred to hospitals for investigations would, as a result, have immediate operations or treatment. If that investigation is delayed for two, three or four weeks, or possibly longer when eventually the investigations are carried out they will disclose in some cases—this is a medical fact—conditions which could have been treated or cured four or five weeks earlier, but not any later.

We are codding ourselves if we say that treating obvious emergencies will get over the worst of the problem. Clearly—and I accept anyone who is acutely and seriously ill will be treated —those who are not acutely or seriously ill at the moment may well be beyond saving in four or five weeks' time. They may have gone into a terminal condition at that stage because they could not get the treatment which this dispute or the continuation of it is preventing them from getting.

Dr. Byrne

On a point of order, Deputy O'Malley is misleading the House.

An Ceann Comhairle

That is not a point of order. The Deputy will please resume his seat.

Mr. Coughlan

Deputy O'Malley stands alone in the Fianna Fáil benches. He has no supporters. Is this the Fianna Fáil backing?

An Ceann Comhairle

This is very disorderly.

(Interruptions.)

Mr. O'Malley

Whenever somebody on these benches is speaking in a way that does not suit the Government their backbenchers jump up very readily to spend a lot of time interrupting in order to shorten the time available and break the chain of thought of the speaker.

Mr. Coughlan

The Deputy has no support.

Mr. O'Malley

It is difficult to speak with these constant interruptions. I want to refer once again to the statement which the Minister made last night and of which I got a copy about a half hour before I began to speak. There is an implication in this that the previous Government was in some way at fault in this matter, that they did something they should not do and created the present situation. I want to make perfectly clear that this situation arose as and from the end of September, 1973 when the arbitration report was accepted by the Minister. After that, the present claims, which on the Tánaiste's own admission in his press release dated 5th November, 1973 are different claims to those which were originally put to the arbitrator in November, 1972 arose. This acute problem arose only as and from the end of September, 1973. I think I am entitled on behalf of the Fianna Fail party and the previous Government to resent the effort made in this Ministerial broadcast to import into it some criticism of the previous Government in regard to this matter and by implication endeavour to score political points. This whole matter should not be used by any side to try to score political points.

(Interruptions.)

Mr. O'Malley

If you want to bring the previous Government into it and in particular the previous Minister for Health, I can say with safety and certainty that if the President, Mr. Erskine Childers were Minister for Health today the situation this country is now facing would not arise. We would not have a situation in which a large number of doctors in hospitals are likely to put in their resignations tomorrow. The record of the previous Government in health matters, and particularly in regard to negotiating with the medical profession generally on matters of concern to them is second to none. The previous Minister for Health was well known for the long and painstaking negotiations which he undertook with the doctors for years before the choice of doctor scheme was introduced. Unfortunately, in the last few weeks lack of proper negotiation has allowed this matter to escalate and has antagonised those who do not lightly take the action they now propose to take or have already taken.

It is absolutely vital that this matter be solved; it is not sufficient to go through the normal procedures. It is not enough for the Tánaiste to call on trade union experience, especially if he is dealing with a group of people who are not members of either of these two organisations or people who are members, but who do not accept the advice of these organisations. The Tánaiste will have to talk directly to those who are making the decisions and forming opinions on these matters.

Mr. B. Desmond

There is a responsible Opposition for you.

Mr. O'Malley

I am not concerned with whether the niceties of trade union procedures are observed in this case or not. I am concerned that lives will be saved and unnecessary suffering avoided.

(Interruptions.)

Mr. O'Malley

It is shameful that in coming here tonight to appeal as fervently as I can, as it is my duty to do, to the Minister to settle this dispute in the interests of keeping people alive and avoiding unnecessary suffering I should be subjected to this barracking and constant interruption almost since I began.

An Ceann Comhairle

The Deputy should now bring his remarks to a close.

Mr. O'Malley

I want to ensure that people will not die, that people——

An Ceann Comhairle

The Deputy's time has elapsed.

Mr. O'Malley

I am endeavouring to close, but I am being interrupted. I ask the Tánaiste to forget about these normal principles that apply to normal situations. This is not a normal situation: it is abnormal and highly dangerous and I ask the Tánaiste, for God's sake, to do anything he can to bring it to an end.

Minister for Health (Mr. Corish)

I have been quite a number of years in this House and I suppose one of my greatest faults is trusting people and taking them at face value. I thought Deputy O'Malley would be of some help tonight, but I discovered from the very beginning that he has an awful neck.

Mr. Coughlan

The Minister does not know him as well as I do.

Mr. Corish

First of all, he tried to accuse this Government or suggested that this was the worst period in this country for strikes. There was a time during the regime of the Fianna Fáil Party over a period of years when we were at the top of the league table in Europe as far as strikes were concerned and Deputy O'Malley knows that and he was in Government when these strikes occurred.

However, I do not have to be reminded of my duty or my concern, either for the sick people in the country or for the doctors. Whilst Deputy O'Malley said that I brought in politics by innuendo or by inference, I have no hesitation in saying that we would not have this situation now if my predecessor had been as concerned as I have been over the last six weeks.

Mr. O'Malley

Rubbish, and you know it well. He was the finest Minister for Health the country ever had, and well you know it.

An Ceann Comhairle

Order.

Mr. Corish

If the Deputy will research a bit further he will quickly find out that all these problems were there for the last three, four and five years prior to the 14th March. My predecessor set up arbitration in September, 1972.

Mr. O'Malley

And was he wrong to do that?

Mr. Corish

He was not wrong to do that because it was by agreement with the IMA and the Medical Union and the other——

Mr. O'Malley

And of the doctors?

An Ceann Comhairle

Deputy O'Malley must cease interrupting.

Mr. Corish

——and the other people to whom he refers were not included in that arbitration. Neither did the now President think that they should have been included in that arbitration. What did Deputy O'Malley want me to do between 14th March and 21st September? Did he want me to discontinue the arbitration?

Mr. O'Malley

I spoke only after the arbitrator reported.

Mr. Corish

Did he want me to discontinue the arbitration? All I could do and all any Minister for Health could do in those circumstances was to wait for the conclusion of the arbitration. Will Deputy O'Malley agree with that?

Mr. O'Malley

The Minister knows well——

Mr. Corish

Let us start from there.

Mr. O'Malley

——it was not done after the arbitration report.

An Ceann Comhairle

Order.

Mr. Corish

On 21st September the arbitrator's decision was announced and was known to the country. What happened on 3rd October was that junior hospital doctors decided on a plan of action if their claim was not met. It was not clear to me or to anybody what their claim was at that stage because the arbitrator had decided that it was not within the context of the national wage agreement. On 10th October I met the representatives of the medical organisations, the Irish Medical Association and the Medical Union, and with these people were the people whom Deputy O'Malley says I have excluded now because, as a matter of fact, there were representatives of those people who described themselves as the junior hospital doctors action committee and they were present at all the negotiations and were on the working party as well.

I suggested in my very first meeting with these two organisations in view of what I regarded as the seriousness of the situation that they would go immediately to conciliation, in other words, with somebody who would be independent of me as Minister for Health and independent of the doctors' organisations; that they would conciliate in order to see that a solution was provided.

There were various claims made. On 3rd October there was a claim made by the Medical Union. There was a claim, then, on 11th October by the Irish Medical Association and a further claim later on by the Medical Union.

If Deputy O'Malley would only look at the reply I gave on 6th November he would have to agree that I certainly have not dragged my feet over the last four or five weeks because this has been preoccupying me over the last three to five weeks because I knew, and still know, that if this action is pursued there will be a very critical situation as far as the hospitals are concerned.

There were five meetings subsequent to the meeting of 10th October in an endeavour to come to a solution. On 30th October I made an offer described by some of the newspapers, I forget which, as generous and reasonable. If Deputy O'Malley were to tell the truth he would agree that when that offer was made it was a reasonable and generous offer. The doctors decided otherwise. Then something else had to be done but I had to wait for the official ballot of the Irish Medical Association and the Medical Union. Does Deputy O'Malley take any exception to that? Should I have regarded the decision that was made in the Mater Hospital or some other place as the decision of two associations who have negotiating licences? Does he think I should have done that?

(Interruptions.)

An Ceann Comhairle

Order.

Mr. Corish

That offer, in any case, was rejected. I accepted the rejection and met the two associations again and there were present members of the action committee that was established by the doctors. Again, I offered them conciliation. Again I said to them: "You are on that side of the table. You have an interest in looking after your members. I am the Minister for Health. I have responsibility to the doctors and to the people of the country." I said: "Will you accept conciliation?" They said, "No. We want to bring another offer back to our members." I made another offer and this week it was rejected by the two associations. I should like to know what Deputy O'Malley wanted me to do over the last four or five weeks. I do not know where he got his information to the effect that negotiations were unsatisfactory. I did not hear that criticism from any of the members of the medical organisation. The only one I heard it from was Deputy O'Malley.

Mr. O'Malley

Is the present situation not proof of the fact that it was unsatisfactory?

Mr. Corish

The present situation was there long before I became Minister for Health. The Deputy knows that and, more than that, the doctors know it.

Mr. O'Malley

The arbitrator brought in his award and these claims were made in September or October.

Mr. Corish

What I am trying to do is again to bring them to conciliation. Deputy O'Malley wants to know what does conciliation in principle mean. Conciliation in principle means that both of the medical organisations have agreed that there will be conciliation. What we have got to do now is to find somebody who is acceptable in any conciliation.

Does Deputy O'Malley, therefore, think that time was wasted over the last four or five weeks? I do not think he has any evidence to substantiate that. I am sorry that I have to go back to the regime of the Fianna Fáil Party, the Minister for Health of which is now the President of Ireland. I do not think his name should be bandied around here but it was Deputy O'Malley who introduced it. I am more concerned, and I hope Deputy O'Malley is concerned, with the situation that has arisen. My concern is for people and for people who are suffering and also for doctors but I would repeat what I said on the radio and television tonight, that if they resume work I am sure a solution can be hammered out if only they accept the conciliation and if they accept the conciliator that is agreed upon between the three parties.

As far as emergency is concerned, I think some newspaper last night or today suggested that the Minister for Health had told the Government that the hospital doctors were bluffing. I do not engage in that sort of talk. I do not usually have that sort of attitude. As far as I am concerned, it is a critical situation and there is a plan which will be discussed with the people with whom it should be discussed, the health boards and the voluntary hospitals, in order to ensure that if the worst does happen all the remaining resources of the State as far as health is concerned are devoted to those people who need hospital attention. Let nobody be under any misapprehension as to what I have done in the matter. I would challenge Deputy O'Malley——

Mr. O'Malley

Have you consulted the doctors who will have to operate that plan?

An Ceann Comhairle

Order, please. The Minister has got a minute in which to conclude.

Mr. Corish

The Deputy is being mischievous, damn downright mischievous.

Mr. O'Malley

I asked a simple question.

Mr. Corish

It is a mischievous question.

Mr. O'Malley

There are a certain number of doctors who have to operate in an emergency.

An Ceann Comhairle

Order, please.

Mr. Corish

I will deal with them but I do not think Deputy O'Malley should provoke them into taking any other action.

I want, therefore, to assure the House, in conclusion, that everything that could be done has been done up to this very date and everything that can be done will be done as long as I am Minister for Health.

The Dáil adjourned at 11 p.m. until 10.30 a.m. on Thursday, 15th November, 1973.