Deputy Boland received permission to raise on the Adjournment the subject matter of Question No. 11 on today's Order Paper.
Adjournment Debate. - Health Bodies' Members.
I would like to thank the Chair for the opportunity to expand further on the reply to this question which read;
Deputy Boland asked the Minister for Health the number of bodies under the aegis of his Department whose terms of office have expired; the date of expiry; and the reasons in each case for failure to appoint new members.
According to the Minister's reply, there are six bodies under the aegis of his Department who have run out of time and in each case he has not appointed or reappointed members so that effectively those organisations have not been able to function.
In relation to some of them, and one in particular, the Council for Post-Graduate Medical and Dental Education whose term of office expired on 19 December, I can understand the reason for the delay. I understand that it is consequent on the new Medical Council which is in course of being set up and that there will be a delay of some months for that reason, but I cannot accept, and I do not believe the House will say that the Minister was discharging his responsibilities properly, when the National Health Council, whose terms of office expired last March, have not been re-appointed in the interim. I asked a question on 19 October last, about the date on which the current National Health Council completed their term of office and the reason for the delay on appointing a new council. The Minister replied, at column 852, Volume 308, of the Official Report:
The term of office of all members of the National Health Council expired on 31 March 1978. Consideration of the re-appointment of the council is at present taking place and I hope to be in a position to make an announcement in the near future.
I then asked the Minister:
Would the Minister comment on the suggestion that the reason for the extension was because many of the areas in which the NHC had been engaged in are now caught up on or have been replaced by changes in legislation and the setting up of other bodies?
The Minister answered:
No.
I then asked him:
Is there any reason why the period for the NHC has been extended by four or five months?
The Minister replied:
No. I was giving consideration to perhaps some different kind of functions for the council——
The Ceann Comhairle then interjected and the Minister continued his reply:
—and the reappointment of the council will be undertaken shortly.
That was on 19 October last. I let it go at that. This was after a delay of six months when the Minister was considering some possible different functions for the National Health Council but had decided against assigning any new functions to them. He said then that "the reappointment of the council will be undertaken shortly".
A further four months has now elapsed and the National Health Council has still not been re-appointed. I have been contacted by members of that council who served over many years and who understood they were serving on an important body. They understood that the National Health Council were the primary health advisory body on all matters relating to health, with the exception of remuneration. They diligently discharged their functions and presented regular reports to the Minister on a wide range of topics. When their term of office came to an end the Minister made no effort to reappoint them although he undertook to do so in October.
I understood one of the very important functions of the National Health Council was to have referred to them all new Bills in regard to health matters so that they would examine those Bills and their impact on health matters and advise the Minister accordingly. The Minister has apparently decided that he can do without that type of advice. He has behaved rather disgracefully to the outgoing members of the National Health Council and has indicated by his refusal to reconstitute that body that he does not place very much value on their contributions. There are members of that council who feel very disappointed that their services over the years were treated so shabbily. Even if they were not to be re-appointed there is still a reflection on the level of the contribution they made.
With regard to the lack of a comprehensive social system in this country and the fact that very many people are not aware of their rights or entitlements, there has been a great move over the last few years to involve as many as possible of the voluntary organisations in informing social welfare recipients of their rights. There has been a great recognition of the lack of care by the State in the social services field. Surely it would have been appropriate to reappoint the members of the National Social Services Council in less than seven months after the former membership of that council had expired on 30 June last. No Minister for Health could claim any great credit for the working of his Department if after a period of seven months the members of the National Social Services Council have not been reappointed.
Comhairle na Nimheanna, whose term of office expired on 31 August 1978, have not been reappointed. I have referred already to the Council for Post-Graduate Medical and Dental Education and I accept that there are extenuating circumstances in regard to that council. We now come to Comhairle na nOspidéal and the Dublin Dental Hospital Board, whose term of office expired on 31 December 1978. Comhairle na nOspidéal are the most important body to decide, recommend and regulate the appointment of specialist doctors to hospitals and health institutions throughout the country. This body have been intimately involved in the development of the hospital services. There was a debate in the House before Christmas on that body because a time factor was involved in the setting up of the new Comhairle. The Minister wanted to change slightly the composition of the Comhairle and he had to have that authorisation through before the end of 1978 because the Comhairle were due to go out of existence at the end of December. A little over a month later we find that Comhairle na nOspidéal, who normally met several times each month and who had a number of subcommittees who met most actively—some on a weekly basis—to deal with the complex matters of requests for appointments and the creation of new posts at specialist level throughout the country, have not been allowed to function during the first month of 1979 because the Minister has not appointed any members.
The Minister merely said in his reply today that there were questions relating to possible revision of the future format of the organisation which needed to be determined. I do not accept that that can be the case in relation to Comhairle na nOspidéal. Those decisions were decided on and publicly debated in the House early last December. The constraints the Minister referred to do not apply to Comhairle na nOspidéal, the most sensitive body involved in health affairs in the country.
In relation to those six bodies the two most important matters which the Minister has failed to attend to are the reappointment of the former members or the appointment of new members to Comhairle na nOspidéal, which is now a month overdue, and the shameful treatment of the National Health Council, whose members have not been appointed for ten months. I would be grateful if the Minister would deal with the position in relation to the Hospitals' Joint Services Board, whose term of office I understood was very nearly ended, and the term of office of An Board Altranais, which I understand are in the same position. I would have liked to ask supplementary questions about those matters today but did not get an opportunity. There is no justification for the ten-month failure by the Minister to appoint members to the National Health Council, which was to be the primary body to advise on health matters. They were charged with advising on and examining new legislation as it goes through the House. The Minister has brought several Bills through the House in the last few months and has one before the House at the moment. The National Health Council have not been in a position to give any advice, make recommendations or reports in relation to that Bill. They have not been in a position to give any advice or make recommendations in relation to health matters during the past ten months.
It is a rather unique position for a Minister for Health to find himself in. It is perhaps not an unacceptable or an unpalatable position for a Minister for Health to find himself in if these bodies were to make recommendations or submissions which did not meet with his favour. There are ways of dealing with situations and if the Minister does not like the membership of a particular body or if he does not like what it is going to say, perhaps the easiest thing to do is not to appoint it at all because then he can effectively muzzle it by not allowing it to be in existence. I do not accept that the Minister has operated in good faith as Minister for Health in relation to these matters and in particular in relation to the National Health Council and in relation to Comhairle na nOspidéal. I would suggest to the Minister that it would be more in keeping with the functions of a Minister for Health to decide either to continue the statutory bodies in existence to fulfil the role they were set up to achieve or to replace them if he feels they no longer serve the function they were set up to serve, which he obviously does not feel in relation to the National Health Council in view of his reply in the Dáil on 19 October last. It would be more in keeping with his role as Minister were he to do that than to engage in some of the spurious neo-health and fitness-keeping activities he has been engaged in of late and which appear to have taken up so much of his time.
A Leas-Cheann Comhairle, I am sorry that you and the staff of the House have been brought back after 5 o'clock to deal with this absolutely trivial statement by Deputy Boland. I completely reject any suggestion that the administration of our health services is in any way interfered with by any of the matters about which Deputy Boland has seen fit to complain and go to the extent of bringing this House back here on the Adjournment.
As I explained today quite fully in answer to the question the reconstitution of these bodies is under active consideration. In many cases questions relating to the possible revision of the future role or format of the organisations need to be determined and the selection of the individuals for any one body may affect decision on the membership of others. I do not anticipate that there will be any undue delay in the appointment of these various boards where they need to be appointed. On no occasion has any significant matter of policy or administration been interfered with in any way and there are very good reasons for any delays that there may have been in the appointment of these bodies, in particular as I mentioned today, in cases where the membership of one body might affect decisions in regard to the others. I will in due course make all the appointments that are necessary. In the meantime there is no disadvantage whatever in the situation carrying on as it has carried on during the last few months.
The Dáil adjourned at 5.15 p.m. until 2.30 p.m. on Tuesday, 6 February 1979.