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Dáil Éireann debate -
Wednesday, 12 May 1982

Vol. 334 No. 5

European Association of Programmes in Health Services Studies (Corporate Status) Order, 1982: Motion.

I move:

That Dáil Éireann approves the following Order in draft:—

European Association of Programmes in Health Services Studies (Corporate Status) Order, 1982 — a copy of which Order in draft form was laid before Dáil Éireann in 1980.

This draft order is being made under the International Health Bodies (Corporate Status) Act, 1971. The only other corporate status order that has been made under the Act is the International Federation of Voluntary Health Services Funds (Corporate Status) Order, 1971.

The association has now established a permanent secretariat in Dublin. The order sought will enable the association to be incorporated in Ireland.

The European Association of Programmes in Health Services Studies was established in 1966. It consists of 29 corporate members from 13 countries. These members are universities and institutes with educational, training and/or research programmes in health administration or health services studies. The Institute of Public Administration is the Irish corporate member of the association. Membership of the association is also open to individuals, associates and honorary members. It is a charitable non-profit-making organisation.

The aims and objectives of the association are to promote collaboration between European countries in the organisation and conduct of educational and training programmes in health services studies.

The association arranges for information to be exchanged, organises study visits, encourages studies and research and runs an annual symposium and workshop for faculty of its corporate members. It has, in co-operation with the World Health Organisation, and on its own initiative, conducted surveys and issued reports on training in health services and hospital administration in Europe.

The scale of the association's activities has, however, been restricted by lack of resources. During the past year, however, the W. K. Kellogg Foundation in the USA made a grant of £174,000, to the Institute of Public Administration on behalf of the association. The grant, which is to extend over a period of four years, is to enable the association to reach its full potential in fostering co-operation in education and training for the health services. The grant will be used to pay for a full-time director and secretariat; to organise symposia and study teams e.g. to upgrade curricula; to arrange faculty development fellowships on a basis of exchange within Europe and between Europe and North America; and to support visits for study purposes.

I am satisfied that the association is a body that should be welcomed to this country and its status is such that I consider the corporate status order should be approved. I have, in accordance with the Act, consulted the Minister for Trade, Commerce and Tourism and he has no objection to granting corporate statute to this body. I have consulted the Minister for Finance and he has no objection to the proposal on the understanding that it involves no commitment for the Exchequer to provide financial assistance for this body. I have no proposal before me to give financial assistance to this body. Should the question arise in future years, the matter will be taken up with the Department of Finance. I have consulted the Minister for the Public Service and Foreign Affairs and they have no objections.

I, therefore, commend this resolution to the House.

I am happy to support the making of this order and the granting of corporate status to the European Association of Programmes in Health Services Studies. The aims as outlined by the Minister are to promote collaboration between European countries in the organisation of conduct of education and training programmes in health services studies. This is a very commendable aim which deserves credit and support. There are 13 countries involved and our country is represented at this point by the IPA, but it is interesting to note that membership is also open to individuals. The value of this for individuals and organisations associated with studies into training in the health services is unquestionable. That in this case the demand on the Exchequer will be virtually nil is obviously an extra attraction and the association, who have established themselves here in Dublin, are to be commended for their initiative in gaining the kind of funds from the Kellogg Foundation that will enable them to expand their activities, to set up a directorate and to expand the secretariat which is already established. The new phase of their activity which will see increased activity in this area is to be welcomed. Certainly many of our health services could benefit from the cross-reference with the experiences of other countries where advances ahead of ours have been made or where we might like to avoid repeating experiences they have had.

I would indicate one area where there is a great need for training development in this country, and that is the training of child care workers who themselves have identified a great need for development. The European Association of Programmes in Health Services Studies may fill the gap in this area and expand understanding of the need for development in training.

I am happy to support the making of this order.

The Minister for Health has recommended this resolution to the House and I am sure, and we accept his word, that no risks are involved in relation to the European Association of Programmes in Health Services Studies. The European association was established in 1966 and this is the first occasion on which we have had anything official about this association in this House.

I have a few questions for the attention of the Minister. I would give a cautious welcome to the association simply because I do not know very much about them and for that reason I accept the Minister's recommendation to the House for approval. In Europe a movement in relation to world and European population growth is growing steadily. Here we find that, while the great problem of providing food, clothing and shelter for the steadily growing population exists, European movements and organisations are recommending for study ways and means of restricting population growth. Ireland is one of the countries in Europe that can take pride in having a steady growth in population and the fact that we have a higher proportion of people under 30 years of age than most other European countries. In Strasbourg recently my attention was directed to the increasing trend towards the promotion of family planning. The methods of family planning advocated in most European states are not, in my opinion, to be recommended for this country, but I am expressing only my views for the record on the motion now before the House. I have studied a document circulated to parliamentarians in Europe relating to the grave concern of European states at the growth of the population. An atheistic view is adopted that European states should consider ways and means of bringing about a steady decrease in the present rate of population growth. One of these is research into various forms of contraception and the application of what they describe as modern methods of contraception and contraceptives. It is well that this association be forewarned in relation to family planning. The vast majority of people in this country are prepared to take only very cautious steps in this connection. If this association are to carry out this research and these surveys and investigations I hope that it will be borne in mind by all 13 countries referred to by the Minister that we have a certain quality of life in this country, perhaps not as good as we would wish, but we have a rich heritage. I am glad that the question of abortion will be dealt with by a referendum, I hope during the present year, and that for all time the result of that referendum will show our concern for the protection of human life and of the unborn child. It is right that we should make it clear to all and sundry, particularly in relation to investigations which will be undertaken by this movement in relation to population growth, that we want to have a frequent opportunity of discussing their progress and their reports and to comment accordingly.

Study which has been done in Europe in relation to the curbing of population is not only designed in pagan fashion but designed to restrict the greatest gift which God can give, the gift of human life and the gift of maintaining and preserving life. I am glad that the Government have decided to hold a referendum in relation to abortion because we will be enabled to proclaim with a loud voice to Europe and the world that the Irish people are prepared to defend the great gift of human life, the dignity of human life and respect for human life from the moment of conception to the grave.

I am not suggesting that this organisation will devote all their studies to devising a remedy for the growth in population but I am advising them to be cautious in what they apply to Ireland and advising them also that our membership and approval of this movement does not commit us to any recommendation they may make as a result of research or surveys.

We recommend that this association concerned with health should give more thought to the necessity for cancer research. This country contributes next to nothing for cancer research and it is extraordinary that vast numbers of our people are dying each day from two diseases, cancer and heart diseases of various forms. If research is to be undertaken, can we expect to receive from this association information as to the part we can play in preventive measures in relation to cancer? We have some of Europe's best cancer experts and they have revealed that most forms of cancer can be cured in the early stages. Can we expect this association to supply the necessary data to bring about a greater public awareness of measures to be taken for the prevention of cancer? Can they also state what amount is being contributed by Europe as a unit for world research into a cure for cancer, a disease which is responsible for depriving mothers and fathers of their children? It is alarming that in recent years very young children have been dying from cancer. They cannot be said to have developed the disease as a result of smoking because children of such tender years do not smoke. I have detailed the kinds of information we would be grateful to receive. We should also like to know what forms of cancer are hereditary.

People should be more familiar with cancer and preventive measures should be known to every citizen. Schools should give instruction in preventive measures and cancer should be freely spoken of without fear so that we can wage war on this horrid disease which is killing so many of our people.

The expertise of our cancer experts can be associated with the very best but their expertise and the results of research will be to no avail unless the relevant information penetrates every home and unless the knowledge is imparted to each citizen. I hope we will hear more from this association about cancer research, that the personnel and the secretariat of the organisation will be available to various organisations concerned with health and that they will also supply relevant statistics to individuals and groups.

Such an association will be able to obtain statistics relating to the dangers of smoking. I say to the Minister that no Department is more vital than his and every penny spent on health propaganda and publicity is a sound investment. I hope that this association will be able to give us the results of their research into the effects of smoking which has been carried out since 1966. I refer to cigarette, cigar and pipe smoking which I believe are responsible to a large degree for cancer. Those who are dying from lung cancer are mainly pipe and cigarette smokers. There must be some move by some group in the interests of public health to sound a note of warning about smoking. I should like the Minister to give us some information about what this association have been doing in Europe since 1966 in relation to this matter. Will the establishment of a secretariat in Dublin help to educate people about the causes of cancer and heart disease and how those diseases might be prevented? Any move in this area would be a help in the right direction.

Whatever may be said about Dr. Browne, a former Member of this House, he has one thing to his credit, because he was the person who courageously tackled the problem of tuberculosis. He arranged for the building of sanitoria and the provision of beds for people whom I saw dying in hovels in my constituency and elsewhere. In the 1945-47 period they had not a pillow on which to rest their heads until Dr. Browne undertook to tackle the serious problem of tuberculosis. Because that disease was tackled at that time by a courageous young Minister the result was satisfactory. Now the Minister for Health has an opportunity of leading the way in relation to dealing with heart disease and cancer in the same way that Dr. Browne had in 1948.

Research is necessary to deal with the problem of alcoholism. As a country we must try to cut our high consumption of spirits. Our mental hospitals are crowded with alcoholics. Any information from this association on how to deal with this problem will be welcomed.

The association is to report on health administration. Members of this House know that the health boards are top heavy with officials and the bulk of money being provided by this House for health services is going on administration and bureaucracy instead of spending the money on the sick, the aged and on those people who want to be restored to health. It is about time we considered the whole question of health administration from the point of view of the taxpayers. We should compare the clumsy administrative means by which health boards are administered with the way the county health authorities administered the health services many years ago. I do not know if the present system is the right one, any more than if the system in the past was right, but it is no harm to study the whole question of health administration. I know that a considerable amount is needed for the health services but I do not think we should spend so much on administration and any savings under this heading must be welcomed.

It is my view that the association should educate the Irish people on how to eat and drink. Our eating habits are wrong and our drinking habits are disastrous. The Irish do not know how to drink. We mix drink and we take drink on an empty stomach. We eat the wrong foods. Here is an opportunity to educate the people about the foods they should avoid, such as white bread and white sugar. They should be encouraged to use brown sugar and brown bread. They should have a balanced diet with vegetables and fruits. If we consume the right type of foods our population will have better health standards. If this association guide us on this way I would be all for it.

I welcome the statement of the Minister. However, I am more cautious about welcoming the European association until I read more about them and see some results. If they carry out research and studies, that would be welcomed. They will be given an encouraging hand so long as they do not force on us recommendations that may be alien to our way of life and to our long-standing traditions.

I should like to thank Deputies for their contributions. I will see to it that the association hear of the views expressed by Deputy Flaherty and Deputy Flanagan. Deputy Flaherty emphasised the need for co-ordination of training programmes in respect of the health services. This is one of the areas in which the association will be involved.

Deputy Flanagan issued a word of caution and he was concerned that Ireland's position should be clearly seen by the association. He referred to the fact that we have had a steady growth in population, something of which we are all very proud and glad to see, and he expressed his concern from what he hears about Europe in relation to suggestions that a population might be reduced as a means of curing some of the present difficulties.

I should like to endorse what has been said in this House. We plan to bring in a constitutional amendment by referendum to provide against abortion. Deputy Flanagan was concerned about this. I want it to go out loud and clear from this House what is our intention as a Government. We intend to provide in our Constitution a clear right to life for the unborn so that this position will be clearly stated. We intend to do this very early: it will be done this year. I wish to give Deputy Flanagan that assurance. We recognise the danger, which is one to which he has referred, of not putting an amendment into our Constitution. I support the views put forward by the society which is pressing for the protection of the unborn child.

Deputy Flanagan raised the question of cancer research and the great urgency for co-operation in this area. I agree with what he says about this because this area must be tackled very vigorously on an international basis. He referred to Dr. Browne's achievements in clearing up tuberculosis. The original tubercular bacillus was discovered in 1882 and that provided the basis for the identification of the bacillus.

I do not have time to go into the other points raised by Deputy Flanagan, but we have recently established a bone marrow for leukemia unit on cancer and we will pursue that. I am sure the association will take the deputy's views into account.

Question put and agreed to.
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