The manner in which the Dáil is being asked to agree to this amendment of the health regulations to enable income limits to be increased reflects in miniature the haphazard and erratic approach of this Government to the entire administration of our health services. This proposal has followed the same uncertain course as all the others which have been brought forward over the last few years by the Minister for Health. First of all, we have the bold vote-catching announcement; then follows a long period of uncertainty and confusion during which it becomes abundantly clear that the announcement was made without consultation, without any real assessment of the cost or the implications of what is involved, and without any regard to the possibilities of the effective operation of the proposal. Finally, a deadline approaches. There are frantic discussions, appeals, compromises, and in the end the Dáil is asked to agree to the proposal on an emergency basis, because otherwise the public at large or some section of the public will suffer.
This proposal we are dealing with here today is a classic case of the Coalition on/off/on again approach to administration. The debate on the Health Estimate and on this proposal has been left in a state of suspension now for some considerable time, and we are today, on the eve of the adjournment of the Dáil for the summer recess, asked to rush this proposal through, because if we do not some 5,000 people will be deprived of these limited eligibility benefits on 5th July next. Of course we on this side of the House do not want to see 5,000 persons deprived of these benefits, benefits to which they have up to now been entitled. Therefore we are going to let this motion by the Minister for Health go through unopposed. But I want to place on record our view that this is not the right way to deal with this important, complicated aspect of our health services.
The Minister has at last today in his brief introductory speech given us some estimate of the numbers involved, and he states that there will not, in fact, be any increase in the total proportion of the population covered for these limited eligibility benefits, that all this measure is supposed to do is to keep the same sections of the population covered as have been covered up to now. I believe that proportion is somewhere in the region of 85 per cent of the population, although the Minister did not give that precise statistic in his speech.
I do not want to encroach on the already very limited amount of time which is available to the House to deal with the business that must be disposed of before the summer recess, but there are some points which I feel I must make, however briefly. First, I want to suggest that we in the House, both the Government and the Opposition, regard this measure as no more than an interim, ad hoc emergency adjustment and that we decide to return to this difficult situation later on in the year with a view to straightening it out permanently. I believe the overall aim should be realistically to relate the services which can be provided in our hospitals to those in need of them, to try to assess the cost and what sections of our population the hospitals can cope with and for whom we can afford as a community to provide these services free of charge. This is a concrete question that we must tease out, and decide what exactly is possible in regard to making these limited eligibility services free of charge to certain sections of the population and how that can be implemented.
Secondly, and related to that, is the need to eliminate the anomalies that still exist. The Minister very blandly at the end of his remarks claimed that these regulations will have the effect of doing away with the present anomaly whereby there are different limits for insured non-manual employees and for non-insured persons. In future the limit of £3,000 per annum will apply to both groups and I accept that. But there will still be anomalies and of course the principal one is the one which is causing a great deal of anger and frustration among the people concerned, that is, that non-manual workers are still being discriminated against in relation to their manual colleagues. That is something we must examine with a view to bringing some standard into operation. I do not think anybody can justify a situation where a manual worker with an income of £10,000 a year is entitled to these services free of charge, whereas his colleagues who happens to be in a non-manual type of employment is denied free access to these services if his income is over £3,000 a year. There is also the fact that this anomaly gives rise to artificial distinctions between different types of employment. For instance, an electrician has been held to be a manual employee, whereas a chief electrician has been held not to be and so on. This distinction between manual and non-manual employees is quite artificial.
Thirdly, I want to urge the Minister to resolve his difficulties with the consultants. That is an urgent need now. The willing and whole-hearted co-operation of those consultants and their tradition of dedicated service is absolutely vital to the structure of our health services. The Minister should harness that. He should set out to create the right atmosphere and the climate of goodwill. He should recognise that the services these consultants provide is not a routine, mechanical nine to five sort of service. It involves a very special degree of dedication on their part and very special qualities.
The Minister should now make every effort to resolve any difficulties which still remain in this area. One gathers from what he said here today and from newspaper reports that some progress is being made. He should, in the interests of the general administration of the health services, bring the difficulties which he has with this profession to an end. Those health regulations are one aspect of the administration of the health services which could advantageously be referred to an all-party committee of the House for consideration. The various complications which exist in the situation are the sort that could be properly teased out in a co-operative spirit by all the parties in the House coming together in an all-party committee. We have had general suggestions about the establishment of an all-party committee. This is one aspect of the health services which should be brought before such a committee if and when it is established.
Finally, I want to refer very briefly to a technical aspect of these regulations. I want to make it clear that I do not expect a reply from the Minister on the point I am going to raise, but I would like him to have it examined by his departmental advisers because it is of some importance. I refer to Article 6, paragraph (3), of the Health Services Regulations, 1971, which provides as follows:
The class of persons entitled to avail themselves of services under section 52 or section 56 (2) of the Act shall not include persons who require treatment for injuries received in a road traffic accident except where it is established to the satisfaction of the chief executive officer of the health board that the applicant for such services has not received or is not entitled to receive damages, or compensation in the nature of damages, from another person in respect of the injuries.
On the face of it that seems a reasonable sort of proposal, but I want to draw the Minister's attention to the fact that in cases where there is contributory negligence it can work very unsatisfactorily.
That particular article envisages a situation where damages are awarded in toto but under the present legislation it is possible that a plaintiff, particularly an infant plaintiff, can have the amount of damages to which he is entitled reduced because of contributory negligence. I believe in those circumstances the Bill which the health authority present should similarly be mitigated. It is a technical aspect of these regulations which is causing some difficulty and some hardship in practice. I do not expect the Minister to give me any answer to this now. I ask that it be looked at and perhaps some proposal put forward to deal with the difficulties which arise.
They arise out of a situation where the health authority have a bill for hospital and other medical services which would be perfectly all right if the plaintiff were awarded the full amount of compensation to which he is entitled. Under the present legislation those damages and compensation can be mitigated to the extent that there is contributory negligence. That should have a bearing on the bill which the health authority present.
I do not want to delay the House because we have a very busy day today and we are very pressed for time. These are some comments I wanted to make in regard to this motion, but having said that, this side of the House are prepared to agree to the motion.
