By agreement and notwithstanding anything in Standing Orders Members will be called on Private Members' Time this evening as follows: 7 o'clock to 7.15 p.m., a Fianna Fáil speaker; 7.15 p.m. to 7.42 p.m., a Government speaker; 7.42 p.m. to 7.57 p.m., a Fianna Fáil speaker, 7.57 p.m. to 8.02½ p.m., a Government speaker——
Private Members' Business. - Beaumont (Dublin) Hospital: Motion.
We do not have a stop watch here.
——from 8.02½ p.m. to 8.15 p.m. a Fianna Fáil speaker and from 8.15 to 8.30 p.m., a Fianna Fáil speaker.
The Minister of State is spoofing because the Minister is not here.
In deference to Deputy Wilson, I am facilitating his colleague, the Whip, in allocating times.
(Interruptions.)
Are the arrangements agreed?
Yes. I move:
That Dáil Éireann, concerned at the acute shortage of hospital beds in north Dublin, condemns the Government for their failure to open Beaumont Hospital and calls on the Government to arrange for its immediate opening.
The reason for this motion is that we are concerned at the delay in opening Beaumont Hospital which, in the Minister's words, is badly needed. In north Dublin there are 50,000 people and the Mater Hospital is the only major hospital. Blanchardstown it to get a major general hospital in the future but here this hospital has been completed for two years and there is not a sign of the Minister opening it. We intend to confine tonight's debate to Beaumont Hospital and we do not intend to go down different avenues in criticising the Minister and the Government on health policy generally.
The building of Beaumont Hospital was completed in 1984 at a gross cost of £53 million. At present 40 people are employed in the hospital at an annual cost of £1.2 million of taxpayers' money. To date there is no patient in that hospital. That is an indictment of the Minister and the Government and it is due to intransigence and doctrinaire, socialist ideology on the part of the Government and the Minister. The hospital has 730 beds and will replace Jervis Street and the Richmond Hospitals which are doing excellent work at present but whose conditions are not suitable either to the patients or staff to continue work. Beaumont Hospital was due to open in July 1985. The Minister stated in the House on 7 February 1985 that he was determined to open Beaumont Hospital in July of that year. One of the tragic effects of not opening it is that the staff involved who, despite the disturbance caused by moving out to the north side of the city, were looking forward to the move, have suffered a loss of morale. This will create a problem and the Minister must accept responsibility for it.
The reason for the delay in opening the hospital is that in July 1984 the Minister wrote to the board of the hospital and informed them that he intended to reverse a decision of his predecessors to allow consultants have private facilities on the campus. The consultants already knew that because they had read it in The Irish Medical Times in April 1983 when the Minister had clearly stated that he would not either give away, sell or lease land for private facilities as long as he was Minister. The Leader of my party, and Deputy Woods as Minister for Health, both promised that they would provide a site for private facilities for the consultants at the hospital. They gave that commitment in writing to the board of the hospital. When the Taoiseach got a letter in September 1984 from a member of the staff who was concerned at the decision to reverse the commitment to allocate land, he replied that he understood that the Minister had written to the board of the hospital that he would not allow private facilities. It was a Government decision so it is not absolutely fair to blame the Minister entirely.
I question the logic of that decision. I put it to the Minister in November 1985 that it was a purely doctrinaire, socialist ideology and the Minister in reply to a supplementary question said that of course it was ideology. That sort of ideology is not in the best interests of the people. Anybody with commonsense would agree that it is in the interests of the patients in a public hospital to keep the consultant staff on the campus, as long as possible during the day, and if their private work is on the campus, all the better. The Minister apparently did not mind where they had their private facilities, Bray, Dún Laoghaire or Mount Carmel, so long as they did not have them on the Beaumont campus. If I were a public patient in Beaumont having hadserious surgery I would like to think that the consultant would be on the campus in the afternoon or evening if a complication arose. I would not like to think that he would be a two hours drive away across the city.
The Minister did a U-turn since his original decision and has offered the consultants to lease them land to build their private consulting rooms. In so far as that goes it is welcome. Fianna Fáil have always supported the right of the consultants to have their private facilities at Beaumont Hospital. It is something they have in their existing employment. The Minister has referred to the cost to the Exchequer and says that this is what puts him off. However, there is no cost to the Exchequer because the consultants were prepared to lease or buy the land. In fact there would be an income to the health services through leasing or selling the land that would not be needed in the foreseeable future for the public service.
I want to ask the Minister the nature of the lease he has offered the consultants. How fair is it to the consultants? How much control is the Minister keeping? Is it a good lease for the consultants to raise money to build their private consulting rooms? The Minister offered the consultants 70 beds out of the 730 beds for public patients. How does he reconcile that with his doctrinaire attitude that public funds should not be spent on providing private beds in a public hospital? Surely those 70 beds would have been paid for out of public funds. It is most unfair of the Minister to blame the consultants because he has not succeeded in opening that hospital.
In answer to a Parliamentary Question on 6 December 1983 the Minister told me it was planned to commence building a nurses home at Beaumont Hospital in the autumn of 1984, but he did a U-turn on that. He showed no regard for the fact that young people coming to train in this hospital — young people who would be involved in the care of the dying and looking after those who are at their most vulnerable — would be working irregular hours on a large campus. The Minister dismissed their need for residential accommodation. He said these trainee nurses were the same as any other trainee working with AnCO or any person working in the centre of the city. He showed no regard for the need to provide accommodation for these nurses in the first six to nine months of their training. The nurses' organisation recently issued a statement in which they condemned the Minister and the Department for refusing to enter into meaningful discussions with them. They have been making representations since December 1984 — 15 months — without any success.
It has been suggested that the Minister will use the 50 beds to open a long stay psychiatric unit. This would be a disgrace because he would be getting into conflict with the whole purpose of the psychiatric unit which is for acutely pyschiatrically ill patients in the general hospitals. I believe it would be a retrograde step for the Minister to do such a thing. The only reason he would do so is the bungling in Carlow and the suggestion is that he will transfer patients from other health board hospitals. I do not know if he intends to do that over the heads of the Beaumont board and the consultants working in Jervis Street and the Richmond. He might tell up this evening.
Has the Minister consulted with the board of Beaumont or the consultants in Jervis Street and St. Laurence's Hospitals on the staffing of the pyschiatric unit — that is, if he intends to do such a ludicrous thing at this stage as to open a psychiatric unit in what is a major general and teaching hospital. Some of the essential equipment has not been ordered yet. Negotiations have not been held with any of the 14 unions. There is no reason why the Minister could not have negotiated concurrently with all the unions. Is he serious in his desire to open this hospital?
In conclusion I will quote from a very worthwhile letter which appeared in The Irish Times, 11 March 1986, signed by Harold J. Browne and Patrick J. Collins, two very eminent surgeons in Richmond and Jervis Street hospitals:
It is long past time for the Minister to come down from his pedestal and make reasonable concessions to various concerned parties so that this much needed new hospital can be opened to urgently relieve the severe pressure on the hospitals involved.
The emphasis is on "reasonable concessions".
The Minister for Health has until 7.42 p.m.
I have some difficulty in dealing with this motion because I am not quite sure precisely what the Opposition want for Beaumont Hospital. Do they want to see it opened? Do they want to see this issue dragging on for another 18 months or two years and then perhaps there will be some movement on it? Do they want to urge the parties to co-operate in an open and constructive way so that the people of north-east Dublin will have a hospital facility available to them as a matter of urgency?
The Opposition do not appear to know what they want. Like the rest of us they want to see the hospital open but Fianna Fáil, being the party they are, could not care less on what terms this hospital is opened. That is the best way I can sum up what has been the attitude of the Fianna Fáil Party to hospital building down the years, including Beaumont. I do not believe Deputy Haughey cared what kind of hospital was built as long as he had a hospital in his constituency, and all the better if that hospital had 700 beds.
With all speed he set about having that hospital built, without working out in advance the implications of such a move. That is typical of the Fianna Fáil Party.
I want to reassure Deputy O'Hanlon in particular of my full commitment to the opening of the hospital. This is on the record of this House. I look forward to the opening of the hospital later this year. If everyone works hard it should be possible to have the hospital in operation on a phased basis. I am very conscious of the need to replace the inadequate facilities in Jervis Street and St. Laurence's hospitals by the provision of a modern hospital at Beaumont. Whatever reservations I may have had about the hospital, be they in terms of design or otherwise, I am putting them to one side now because a hospital has been built and we have to get it opened and operating.
I am acutely aware that the population of north-east Dublin need a proper, fully available acute hospital service and the national specialities in these hospitals should be taken into account in the transition. Beaumont will be a general teaching hospital with 730 beds and will provide a full range of specialities. The building cost about £52 million. So far we have spent over £3 million on equipping the hospital. It is estimated that, when the total equipping of all of the hospital is completed, we will have spent an additional £7 million, or a total of £10 million in all. I made provision last year and the year before, in the capital moneys of my Department, so that, had we received the co-operation we sought, the money was there for the spending. At the end of the day the money was spent elsewhere in the country. That is a measure of how difficult the situation was in terms of getting the co-operation of people. I have been prepared to make the necessary resources available to enable the equipping to be completed and the hospital to be opened. Deputy O'Hanlon rightly alluded to the serious difficulties which arose with the consultants in relation to their exceptional demands. Their demands were exceptional.
They were reasonable demands.
They were quite exceptional. In relation to St. James' Hospital, I do not know if any group of consultants demanded that within the St James' campus there should be an additional, entirely separate, privatelyowned, privately controlled, paid for in terms of loss of revenue to the taxpayer——
There would be no loss of revenue to the taxpayer.
The Minister should prove it.
The Minister is going to explain the loss of revenue.
There never has been such a demand. The Deputy will have ample time to reply. I have a mere 25 minutes. I draw that analogy in terms of a major hospital now being constructed in Dublin where we are spending tens of millions of pounds — just one example of one hospital where at no stage was there a demand within the hospital campus that there be a public property given to a group of people on which to build their own private hospital, getting revenue out of it for themselves and denying the public hospital the right of revenue. As in St. James' when it is completed, there will be private beds, as there are now. The money out of those private beds in St. James' Hospital will go into the budget of that hospital, not into the pocket of any private company. That is the issue. I regard it as a scandal, a matter of grave public concern that Deputy Woods, who did not know what the hell he was doing anyway, he was so infrequently there——
The Minister should withdraw that remark. I was there more often than he was. I was there constantly.
——and Deputy Haughey, who when Minister for Health, was so busy courting favour that he had to get the backing of every consultant in this country in his anxiety to become Taoiseach that he made an offer of that nature.
No wonder the Minister is unable to open it.
That is the background. I want to give a further brief background. I have been making strenuous efforts to resolve these difficulties. I have had discussions with the Irish Medical Organisation on a limited question, namely, the fact that I am prepared to provide private consulting rooms at the hospital. I am not prepared to provide, as long as I am Minister for Health, a site for a private hospital on public lands which would reduce the budget of the public hospital. I am not prepared to do that. That is a positive and definite position which is now accepted by the Irish Medical Organisation. It may not be accepted for all time but, in so far as my term of office is concerned, it is accepted. I think it is a right decision. If Deputy O'Hanlon regards it as being excessively ideological, so be it. I regard it as pragmatic commonsense in the public interest. If that is ideology, then it is the best form of ideology in the public, in the national, interest of delivering the health services.
In October 1985 I indicated to the Irish Medical Organisation that I was prepared to lease to the consultants a site on the Beaumont Hospital complex on which they could construct a building for use as private medical consulting rooms. An outline of the terms on which the site would be leased to the consultants was sent to the Irish Medical Organisation at that time. They did inform me, fair dues to them, that they were prepared to enter into negotiations on the terms of such a lease. A very detailed lease has been prepared by the Chief State Solicitor to allow the consultants to construct private medical consulting rooms on the Beaumont site. Every effort has been made in that lease to safeguard two things, the rights of the consultants themselves — which I do not particularly propose to deny — to have private consultation with their patients and the rights of the Beaumont Hospital authorities to preserve the general integrity of that site. That is all that I am interested in. I forwarded the draft lease to the Irish Medical Organisation on 31 January last. As of today — I stress as of today — I am still awaiting their formal views as to the contents of that lease. I have kept away from The Sunday Press, I have kept away from the Sunday Independent, I have kept away from the date of the next general election. I am anxious to resolve the issue. I am not interested in medical or political rhetoric, or any other aspect of confrontation. I am anxious to resolve the issue. Therefore, I strongly urge the Irish Medical Organisation that there should not be any further delay on their part in coming back to me with their legal views, if they have any, or whatever modifications they want to propose. I have told them they are quite welcome to come to me when the matter will be dealt with with absolute expedition. Any day of the week we will work overnight to resolve the issue.
Deputies will be interested to know that, since then I have received notification that the medical board of St. Laurence's Hospital, at their meeting on 3 March 1986, passed the following motion:
That an early meeting of the Richmond/Jervis Street Staffs Association be arranged. The Richmond will indicate at this meeting their intention to directly meet the Department of Health to secure an early opening date for Beaumont and to finish negotiations on the lease for the site of the private clinic forthwith.
I welcome that resolution by the consultant staff. It is a very constructive approach. I understand also that at a meeting of the joint staff associations of St. Laurence's and Jervis Street Hospitals on 4 February 1986, it was decided by a majority vote that the consultant staff of both hospitals would co-operate fully with all concerned to get the hospital open. Therefore, I share the concern of the consultant staff of the two hospitals in relation to the early commissioning of Beaumont Hospital. I am encouraged to expect that, in the light of these indications of co-operation, the matter of agreeing on the lease for the site will now move towards a rapid conclusion. In anticipation of a satisfactory outcome of this matter I propose now to proceed without further delay with arrangements for the opening of the hospital.
First, we come to the staffing requirements. It is necessary to understand that Beaumont will replace the existing St. Laurence's and Jervis Street hospitals. It will be financed from the budgets of these two hospitals, which this year aggregate £28 million, and will be operated by the staff of the two hospitals. There will be no redundancies, no difficulty. I would point out that there are already some 27 staff now working in Beaumont, new, additional staff, working in anticipation of full commissioning. We are paying every one of their salaries out of the general health vote. That is a measure of our earnest to have the hospital open. The boards of the two hospitals have already been informed that the staffing of the new hospital must be carried out within the limits of the current combined — I stress "combined"— pay budgets of the two hospitals; they will both transfer up to Beaumont. It is a reasonable deal, plus the 27 staff working there at present.
I would stress that there are at present 1,700 staff employed in the two hospitals. The structures for determining the staff requirements of Beaumont are already in place. I am confident that it will be possible to reach agreement on those requirements at an early date. So that there be no misunderstanding about this, I would stress also that I cannot afford to pay — there is a Government decision on the matter anyway and even if there were not a Government decision I would not be disposed to paying — disturbance money to anybody going up to that hospital. There will be no disturbance money paid. Therefore negotiations will be relatively simple. As a former trade union official I know how very difficult such negotiations can be but, with goodwill on both sides, we can move up to Beaumont quite rapidly.
Regarding the consultant medical staffing requirement for Beaumont Hospital, the Beaumont Hospital Board have agreed to finalise their proposals in this regard and to forward them to my Department by the end of May, prior to their submission for approval to Comhairle na nOspidéal. Deputy O'Hanlon knows that is the procedure now in relation to any revision of consultant staffing in any hospital and there will be no delay on my part in deciding immediately on that submission.
Regarding nursing and other staff, I am concerned to ensure the fullest consultation with representatives of the other staff involved in the transfer of services to Beaumont and my Department are now making arrangements in this regard. I stress that we will make concurrent arrangements, the phrase used by Deputy O'Hanlon and I agree with him that there should be concurrent negotiations, and these will go ahead in the immediate future.
Deputy O'Hanlon referred to residential accommodation. It has been stated that extra residential accommodation should be provided for certain staff working in the hospital. I accept entirely that accommodation is required for those staff whose presence on the hospital site is essential in their ordinary day to day work for the proper operation of the hospital. However, I do not think I would be justified in funding residential accommodation for all other categories of staff, given the present levels of remuneration and the availability of private accommodation, and bearing in mind that many of the staff live within a reasonable distance from the hospital.
I am quite prepared to give sympathetic consideration to any proposal from the hospital board concerning the provision of staff accommodation on a commercial, rented basis. Otherwise I propose to conserve public funds and I understand that the board are at present negotiating with developers in an area close to the hospital on the possibility of residential accommodation being provided for certain categories of staff. I stress that this is on a commercial basis. The days are gone when we provide free accommodation all over the country for student nurses. I hold the view strongly that in enlightened hospital administration young nursing staff should not be institutionalised on a training basis.
Indeed, I have seen the trauma of nurses who were circumscribed in such residential accommodation and it is a very interesting argument to have, but as far as the on call staff are concerned, medical, nursing, administrative, chaplains and so on, adequate facilities within the hospital framework of residential accommodation will be fully provided. There is no difficulty in that regard and I have requested the board to keep in close touch with me about the prospect of outside accommodation on a rental basis being provided for staff who might need or require such accommodation. There should be no great difficulty in that regard either.
Regarding the opening of the psychiatric unit, I do not accept at all the argument put forward by Deputy O'Hanlon that nothing should happen until the whole lot goes in en bloc and then you open the psychiatric beds in the hospital. I think there are about 33 psychiatric beds within the framework of the hospital. In view of the large scale of the facilities at Beaumont I intend to commission the hospital on a phased basis and in this context I have decided to proceed with the opening of the new psychiatric unit in Beaumont immediately. The plans of the EHB, which I am delighted to accept in spite of the appalling reaction from a psychiatric consultant who should know better — I was appalled I must confess and I am glad that his views were not accepted and were overwhelmingly rejected by the EHB — for a sectoralised psychiatric service for north-east Dublin include a psychiatric unit at Beaumont Hospital. The new psychiatric unit will provide an in-patient service for the Dublin north-east catchment area and will form part of a comprehensive community oriented psychiatric service as outlined in the policy report “Planning for the Future”.
The health board are prepared to co-operate in the early opening of the psychiatric unit. This proposal has now been advised to the chairman of the Beaumont Hospital Board and I await the board's formal response. I envisage that staffing and related issues associated with the commissioning of this facility will be subject to consultation between the health board and the hospital board and between both boards and the staff interests concerned. I have asked that those discussions take place as a matter of urgency, and the full co-operation of my Department is assured.
I have been asked by the board recently to give some additional staff to expedite the general commissioning and to assist in this work and have now given approval to the hospital board to appoint a personnel officer who in the first instance will act as commissioning officer for the opening of the new hospital, and that aspect will go ahead immediately.
I want to deal with the question of private hospitals generally because serious issues are involved. Some Members of the House still wonder why I am so strongly opposed to the building of a new privately owned hospital on Beaumont site. I want to outline the current position with particular reference to the three new privately owned hospitals coming on stream this year.
First we have in Galway the Galvia private hospital which will open with about 40 beds on Easter Monday, although it will ultimately provide 65 beds. The Deputies know that it is the Old Calvary hospital in Galway which was bought, refurbished and re-equipped by local medical practitioners backed by community hospitals who are an English based health care and private hospital development company with seven or eight hospitals in the UK, and of course local financial interests in Galway were involved. This hospital will add no new beds to the overall total in the country, but it is of considerable interest to note that there seems to be plenty of money among such interests for such investment at a time when the health services are allegedly in such acute straits.
The new Mater private hospital will provide a total of 156 beds, replacing a total of 146 private and semi-private beds in the existing Mater private and public hospitals. The Blackrock privately owned clinic will also provide a total of 115 beds which in effect, are additions to the overall hospital bed stock in the country.
The important point about those hospitals is that they are high cost, high technology centres and the average daily costs, including medical extras, are estimated to emerge in the region of £280 a day for private rooms and £240 for shared accommodation. These charges are far in excess of the charges applying in the existing range of private hospitals the highest cost of which would be at the moment in the region of £100 a day. Therefore, the cost difference is enormous in terms of total annual expenditure. For instance, it is estimated that these two hospitals alone, the Mater and Blackrock, will generate an annual expenditure of about £20 million which is roughly one quarter of all claims made against the VHIB in 1984-85. The cost of operating private hospitals of this nature is so great that it simply could not be accommodated within the premium structure supporting the existing B and C hospital plans offered by the VHIB.
As Minister responsible for approving the various VHI schemes and in particular any increases in subscriptions for quite some time, I thought that it might prove absolutely impossible to devise a scheme to provide cover for these hospitals. Deputy O'Hanlon knows well that pressures on me and my Department to impose massive increases on VHI subscribers in 1986-87 to accommodate these hospitals were extreme. I am proud to say to this House that I resisted them to the last in the public interest. However, in the event, proposals were formulated to offer a new VHI hospital plan to accommodate them but at much higher premiums. I approved these proposals and the details will be notified by the VHIB to their subscribers in the near future. Indeed, there is still a real danger that the ordinary VHI subscription, even with the generous tax relief still available, could become prohibitive to the ordinary subscribing family should such hospitals proliferate.
I mention all this simply to highlight my view that there is little, if any, further scope for the development of this type of high cost, privately owned hospital within the structure of our Irish health services. Otherwise the VHIB will go the way the PMPA and the ICI went. As Minister for Health in the past three years I predicted that that could happen. It did not happen and I have no doubt that it will not happen provided this House acts sensibly. Therefore, I am convinced that a proliferation of separate privately owned hospital facilities can only lead to a diminution in the level of services provided for public patients by the public hospitals and it will reduce the budgets of those public hospitals resulting in a two tier hospital service with all the inherent deterioration in the health services involved.
I make those points in passing because they are of critical importance. If Deputy O'Hanlon regards them as an outpouring of doctrinaire, socialist philosophy he has yet to learn a great deal about what socialism is all about. That is the issue.
It is a U-turn. Nobody could support the Minister's amendment.
I move amendment No. 1:
To delele all words after "That" and substitute the following: "Dáil Éireann approves of the continued efforts of the Minister for Health to have Beaumont Hospital opened as soon as possible."
I should like to emphasise that, with the other members of the Government, I am concerned that Beaumont Hospital should be commissioned at an early date. I cannot accept the Fianna Fáil motion. We have made significant progress in resolving the difficulties involved. I do not want to see any party political confrontation on this issue. Deputies on the north side of Dublin, and my self in the Custom House representing their best interests, can build on the progress made. I do not want any confrontation with consultants or nursing staff on this, despite all the propaganda, suspicions and emotions which hospitals give rise to.
It is the reality started by the Minister. He reversed a decision made by Deputy Woods when in office.
I readily confess that when I feel strongly about issues I never hold back and the Deputy is aware of that.
The Minister did two U-turns.'
The Minister should let us hear his feelings about going to hospital. Socialism for others and not for himself.
Let us build on this progress and proceed to the commissioning of this much needed facility. I hope, with the chairman of the board, to issue invitations on a joint basis to my colleagues in the Opposition to join me, probably on a September or October date, in Beaumont. They will be most welcome and we will do the job together. I will be so magnanimous as to invite the Leader of the Opposition to join me on that occasion.
I seem to recall the Minister issuing a similar invitation to us to join him in July 1985 at the opening of Beaumont Hospital. That month has gone but Beaumont remains closed.
Since coming into office the Minister for Health has caused a great deal of concern to all those who are genuinely interested in promoting better care and facilities for the sick within our community. He has, unfortunately, made many disastrous decisions and presided over massive cutbacks in health services, including the withdrawal of treatment facilities for thousands of deserving cases, a reduction in the number of beds in hospitals all over the country resulting in the closing of complete wards and units and, of course, the closure of so many hospitals instanced by his recent announcement to close eight hospitals without having made any provision for alternative accommodation and care for those in need. The extraordinary thing about the Minister is the apparent relish he shows for his actions which have caused heartbreak, dismay and distress to so many patients, their families and to the medical profession.
Our motion calls on the Minister to open Beaumont Hospital and I have no doubt whatever that this issue is one of the greatest scandals that we have ever witnessed. Beaumont Hospital would appear to have presented the Minister with the greatest challenge of all to behave in a most irresponsible manner. His irresponsibility has not only caused distress and hardship to the people needing hospital treatment, and to their families, but has also caused concern and distress to hospital management and to the medical and nursing professions. On top of all that, the Minister is deliberately spending £1.5 million a year on maintaining an empty hospital that has to date cost almost £50 million to build, all in the pursuit of some ideological, or political motivation that one finds very difficult to understand or appreciate.
Dublin city and county, with a population of more than one million people, is very badly served as far as hospitals are concerned but the north side is affected much more by having to depend mainly on a smaller number of older hospitals which have given excellent service to past generations. However, during the past ten or 20 years these hospitals — the Richmond and Jervis Street — have deteriorated to such an extent that management, and the medical profession, are now working under severe handicaps and in dreadful conditions that would not be accepted anywhere else in Europe. Most of the time the staff find themselves apologising to the patients, visitors and others who have come to the hospital.
The saga of Beaumont has gone on for many years and the fact that it was to replace the existing Jervis Street and Richmond Hospitals meant that those two institutions were allowed to run down over the years with no effort made to improve the buildings or conditions in any way. It is difficult to understand why any Minister should allow such a magnificent new hospital as Beaumont to remain unused, particularly after so much State money has been poured into it. At present nobody appears to be quite sure What are the reasons the Minister now has. We do know that he is still in confrontation with the medical profession.
The Minister, firstly, reversed a decision of his predecessors to allow the building of a private hospital on the site and the only reason that he gave was that he could not allow public funds to be used for such a project. The extraordinary thing about this argument was that the consultants had made it clear that they were anxious to build a private hospital on location and were prepared either to buy or lease the site, as the Minister preferred, and the cost of building would come totally from their own resources. This proposal, therefore, would not have cost the State one single penny and, indeed, to a layman appeared to have all the ingredients that would go to make up a first class hospital facility for private and public patients alike, which as I have said, is a very badly needed facility, particularly on the north side of Dublin.
Beaumont is in the heart of my constituency and I am therefore only too well aware of how the local people feel about this terrible travesty that has been going on for far too long. Does the Minister not realise that the total cost of the building to date has been borne by the taxpayer? It is morally wrong that this asset should be allowed go unutilised where there is such a heavy demand for the facility.
The advantage of having a private hospital on location is very obvious as it would mean that consultants would be in the vicinity of the hospital for a longer period during the day. That surely is in the interests of public patients in the hospital and in the management of the hospital. It is not in the interests of the public patient that a consultant, if required urgently, is not available in Beaumont and could be, for example, operating in a private nursing home on the south side, in Rathgar, Dún Laoghaire, or wherever. The time taken in getting back to Beaumont could be fatal and, certainly, in my view, does not lead to good management or to good medicine in the interests of the public patient as well as the general management of the hospital itself.
I am aware that negotiations have been taking place recently between the private consultants and the Department on another proposal put forward by the Minister but, once again, that proposal does not appear to have mutual agreement. Meanwhile the magnificent Beaumont Hospital that could be a monument to Irish medicine is instead today a monument to the failure of the Minister for Health to come to terms with the requirements and needs of the people. It seems that the Minister is grieved that Beaumont Hospital was ever built and credence to this would arise from a statement by the Minister reported in the issue of the Irish Independent of 1 December 1984 when he said that millions of pounds were wasted on Beaumont and was money ill spent. That was a most extraordinary statement coming from a Labour Minister and one could be excused for thinking that the Minister's actions in refusing to open this hospital are tied up with his political opposition to this side of the House whose Leader decided to cut all the red tape when he was in office so that this urgently needed hospital could be provided at minimum cost and in the fastest time possible.
It is now two years since the building of the hospital was completed. To date the hospital has cost almost £50 million to build and interest charges in those two years since its completion on the capital outlay have been £1 million plus a further £1.5 million per year to maintain. Interest charges, we are told, are continuing at £500,000 per year along with the everincreasing maintenance costs. In the meantime, patients badly needing hospital attention are being forced to use overcrowded facilities elsewhere. The consultants, I understand, are prepared to go into the hospital any time if the Minister would only honour the terms of the agreement entered into with them by his predecessors and his Department. In recent negotiations there has been a willingness on their part to water down these terms in return for an acceptance of the right to build a hospital with beds in the future under a mutual agreement. The Minister must know that in a complex such as Beaumont to extend the provision only for a clinic with no beds is not only unwise but is not fair either to the thousands of people living on the north side who would prefer to have the facility of private hospitalisation as is their right just as it is the right of many thousands of people living on the south side who have those facilities in a number of hospitals located there.
Another very serious and reprehensible aspect of this whole unhappy situation is the fact that, even if the Minister were to reach agreement with the consultants, the hospital could not be opened in 1986. No arrangements have been made whatever for the ordering of basic technological equipment needed for the hospital and in recent replies to questions the Minister indicated that it could take at least ten months from the date of order before this equipment could be supplied and fitted in the hospital.
Even more appalling is the fact that a further dispute looms ahead between the Minister, his Department and the Nurses' Organisation. Here again the Minister refuses to acknowledge that a complex such as Beaumont should have any residential accommodation for nurses on duty or student nurses. This is once again a more than strange decision in view of the size of the complex and the fact that in emergencies a number of nurses could be on call on site.
Despite numerous representations from the Irish Nurses Organisation dating back to 1984, negotiations have not taken place between that organisation and the Minister or his Department. It is very evident that experienced officials in the Minister's Department could not possibly fall into the trap of such gross inefficiency in failing to advise the Minister on the correct approaches that should be taken in this respect and one must therefore conclude that the reasons can only be put down to the actions of this Minister in adopting a complete and totally hostile attitude to Beaumont Hospital.
A Government who allow their Minister to behave in such a draconian fashion must be indicted with him and it is an absolute disgrace that to date about £57 million of taxpayers money is being used as a weapon by the Minister in his private quarrels with the medical profession. He tried earlier this year to act the bullyboy with them and some time ago even issued a statement threatening to remove funding from the Richmond Hospital thereby forcing that hospital into a situation where it might have to close down its present inadequate facilities to the public.
The Minister has repeatedly put up the pretence of being interested in getting the best possible services for the poorer sectors of our community and using the funds available to his Department in the most appropriate ways. He has shown scant regard for either in this whole unhappy episode. We have the crazy situation also where the cost of a private room in a public hospital is more expensive than a room in one of our most exclusive private hospitals. That is an attack on already hard pressed taxpayers who go to the trouble and expense of providing for their own accommodation in the event of future illness.
We on this side of the House in our motion call on the Minister to set the machinery in train immediately to open Beaumont Hospital without further delay as a general hospital, as originally envisaged. Any other form of provisional opening of, for example, a psychiatric section, in advance will not be in the better interests of the hospital and would obviously downgrade the hospital stature and attraction to medicine from the very outset. The Minister may have the idea of facilitating an immediate transfer of Eastern Health Board patients from the Carlow mental hospital as a short term solution to his other difficulties. This is not acceptable to Beaumont Hospital as it was never envisaged that it should cater for long term psychiatric patients. It would create also serious difficulties and confusion between the hospital's own board and the Eastern Health Board.
The very large population in areas such as Coolock, Clontarf, Artane, Beaumont, Santry and so on have had to depend on only one major hospital on the north side and, due to scarcity of beds, many patients were not able to obtain necessary treatment for illness. They are entitled to better treatment and consideration. This hospital which is intended to cater very much for their needs should even now, at this late stage, receive the priority it is entitled to.
The Minister's amendment to our motion asking Dáil Éireann to approve of his efforts cannot be taken seriously and I would therefore urge the Government to re-consider their attitude to Beaumont Hospital and to commence the steps that are necessary now for its opening as soon as possible.
This evening the Minister adopted a cynical attitude to this whole issue. Everyone was to blame except he. He accused us of using this issue for political expediency. That is not the case. We are sincere in our efforts to have the hospital in operation as soon as possible. This is in the interest of the people and for their benefit. One would have thought that it would be for the benefit of the Minister also that this magnificent hospital should be opened as soon as possible. There is no question of a loss of revenue to the State or to the Department in the event of the location at Beaumont of a private hospital. The consultants were anxious to lease the site.
These arguments which the Minister puts forward in a bizarre way are incomprehensible. He has not on any occasion given a single detail as to how the operation would have meant a loss of revenue to the State. If there are grounds for such assertion, the Minister should tell us what they are. Anything I have read in relation to this hospital in the past number of years would not indicate that there would be any loss of revenue by reason of accommodating the consultants.
Where would the VHI maintenance money go?
We can only hope that, even at this late stage, the Minister will accept our motion which is tabled in good faith and not for the purpose of causing any political embarrassment.
We must recognise first that the halcyon days of 1977 to 1980 are well and truly over and that promises made in those days when money was flowing freely and borrowing did not matter cannot be honoured always in the way indicated when the promises were made. That is the economic reality of living in the mid eighties and the sooner we realise that is what must inform public decisions on spending the better.
I can understand readily the sense of having private consultants on site at the Beaumont Hospital complex for as long as is possible in terms of feasibility, but where is the sense in building a second hospital side by side with one that has been built? If one were to make such a proposal to some stranger, he would very likely regard it as ludicrous. The abiding principle that must inform in relation to care for the sick is that scarce resources are used in the areas of greatest need. Plainly, that is not happening now. We must realise that public patients face long delays, that there is a crying need for this facility to be opened. The sooner we engage in genuine negotiations to open the hospital as a matter of urgency the better.
The delay is causing a huge waste of taxpayers' money. I would estimate conservatively that in this context we are talking about £600,000 per month. Meanwhile there is a crying need for health care on the north side. We need better health care. We need to eliminate waiting times for important medical operations. In my constituency where this hospital would be located, we need the boost to activity that it would bring. I am unashamed in saying that. It can help. We must now build on the co-operation which the Minister says now exists between the consultants and other members of the staff to ensure that this hospital is opened within the shortest possible time. The Minister should now set a date for its opening. He should recognise that there is a real cost of £600,000 per month to the taxpayer to have it idle. He should be willing to offer every member of staff in the two hospitals a sum if they beat his target date. I see the possibility of offering £250 to £300 across the board to every member of the staff to beat that date. We must look at an idea like that. There will be other hitches if we just leave it to delayed negotiations. We have heard that the nurses are not satisfied on one issue and I am sure there will be other members of the staff who will be dissatisfied on an issue. For every month that the staff beat a reasonable target date there should be some recognition from the taxpayer that that is ground gained.
I return to the abiding principle that must inform all our discussions about health spending, that is, that scarce medical resources must go to areas of greatest need. That is not happening when a hospital stands idle. The Minister and the people medically involved must recognise that. I hope that a little charity and understanding will inform the discussions which will proceed and that the Minister's start to use this facility will quickly be followed by this badly needed hospital being in full use for the community of the north side.
Having listened to the Minister for Health, I am quite aghast at his attitude to this issue. Quite frankly, he appears to be glorifying the fact that he has a principle here that he will stick by through thick and thin, irrespective of the damage it is doing to the health services, of the sufferings caused, the disruption and the interruption of programmes. Irrespective of any scenario that emerges, the Minister is firm in his mind on a little personal hobbyhorse of his that this supersedes anything that might be said in this House or by any of the interest groups involved. Coming from a Minister in an area so sensitive and important as the health services, that is very sad; coming from a Minister of the Labour Party, it is even sadder that he is prepared to cast aside what I presume was traditionally associated with his party — the care of all those misfortunate enough to need health care urgently and who in many cases cannot afford it.
It was sad, over the last 12 months, to hear the Minister making public statements in relation to his position on this matter and paying no regard to the very urgent and vital needs obtaining on the north side of the city, making no reference to the part that this hospital plays and has been envisaged to play from the early seventies in the overall plan for the provision of hospital services throughout the city. At all times the only emphasis comes in terms of cost to the taxpayer, by acceding to what was regarded in the seventies and even subsequent to the seventies—I might remind other speakers—as a very reasonable, logical plan to bring the best medical services available and the best standards to the people of the north side. I make no apologies in this House for demanding that level of service and that standard. It was regarded by the Minister's Department as being reasonable, feasible, logical and necessary in the early seventies; it is equally so today.
Again we come back to this question of cost. Deputy Brady took up this issue and I also wish to take it up. I do not know what the Minister is referring to when he talks about the enormous cost to the taxpayer if we were to accede to the plans designed and agreed to and into which so much care and attention, time and effort were put by his predecessors. I cannot see where the Minister has identified this phenomenal cost. Has the Minister a bee in his bonnet about a certain sector of the health services and is he putting these arguments forward, spurious as they might be, without any validity or back-up of proof, in an effort to camouflage the bias which he has allowed to creep into his own vision of what he should do as Minister for Health? I believe that that is the case. If so, it is indeed a sad indictment of the Minister.
This Private Members' motion put down by our party spokesman, Deputy O'Hanlon, states:
That Dáil Éireann, concerned at the acute shortage of hospital beds in north Dublin, condemns the Government for its failure to open Beaumont Hospital and calls on the Government to arrange for its immediate opening.
This is a very well reasoned but vitally urgent plea from that Deputy to the Minister here present and the Government immediately to make available for the people of north Dublin a hospital service—a level of hospital care that was not needed just today or yesterday, but a few years ago. It is a sad reflection on any Government that a much needed facility, such as this 730 bed hospital unit at a cost of, to use the Minister's own figures, "£50 million for the overburdened Irish taxpayer", should be left idle for over a year without any valid reason. It surely must rank as an unparalleled insult to the taxpayer and the public that such a huge investment should be left in mothballs solely on the basis of some vague ideological hang-up on the part of the Minister. Whatever personal grounds he might have or whatever reasons he has worked out with such intransigence as being valid, sound and important to him, these must be put aside immediately in the interests of responsible administration of our health services.
I know that this is not usually considered an appropriate time for tracing the history of the development of any programme. Nevertheless, given the manner in which this project has been bungled at its latter stages, it is important that we should get the issue properly in perspective. How did this hospital come to be in Beaumont in the first instance? It was part of a very thoroughly worked out plan. In the early seventies, Mr. Corish was Minister for Health. A programme of hospital provision for the entire Dublin region was deemed to be needed. Rationalisation and updating of the health services were deemed urgent and should have been taken on board. There was in existence at that time within the Minister's Department a team of experts and planners, also those who could make projections as to the requirements right up to the nineties. We had then, as now, old hospitals on the north and south sides that had not been modernised. The question was whether they should be modernised in the absence of an expanded programme.
The decision was taken at that time that six hospitals should be built, three on the north side and three on the south side, to replace some of the older hospitals around the inner city. These decisions were taken on the basis of thoroughly worked out research as to population projections and the need and level of health care requirements through the eighties and nineties. There was not just an airyfairy approach to this. There was a very professional approach and the plan was drawn up by 1977, according to my information, for a programme that would match the best level of medical and professional services and the best standards possible and feasible. The three hospitals referred to on the north side were to be Blanchardstown, The Mater and Beaumont.
When the then Minister, Mr. Corish, was asked in 1976 how long it would take for such a programme to be completed, he said that Beaumont would not be ready for upwards of 17 years. However, in 1977 he was succeeded by Deputy Haughey as Minister for Health and he very quickly cut through the red tape and problems and efficiently and professionally took on the task of updating the hospital services. What was earlier deemed to be a 17 year programme was cut to four years. The target of four years was met because of the attention, care and concern for the increasing needs of northsiders for health care.
Deputy Haughey's successor, Deputy Woods, helped to bring the plan to completion on target. Looking at the attention and care given to this programme, it is sad that the Minister treats us with derision, sarcasm and cynicism with regard to the concerns we are legitimately voicing on behalf of all northsiders. Originally the Minister took issue with the consultants and made the point that he was not prepared to spend taxpayers' money to give a facility to private consultants. However, when this plan was initially agreed it was on the basis of what was best for the people of the north side in terms of private and public care and how these needs could best be catered for. It was decided that their needs could best be met in one complex. Given that kind of attention and commitment to the development of that programme, it is sad that the Minister has seen fit, on the basis of some vague, ideological fantasy, to interrupt it and to bring it to a halt.
It is public knowledge that there was agreement for the provision of a site at a commercial rate to enable consultants to build a private hospital within the complex. I am not aware of any strong public opposition in that regard from the north side or anywhere else. The Minister, for reasons best known to himself, saw fit to initiate and promote a public debate on the issue.
Lack of consultation is nothing new as far as this Minister is concerned. On 6 December 1983 the Minister, in reply to a Dáil question from Deputy O'Hanlon, stated that the building of the nurses' home would commence around autumn 1984. There was no indication that he intended to reconsider the position. The Minister cannot now say that he and the Government were unaware of the financial position, given all the public statements which had been made over the preceding 12 months. He has now reneged on a promise given and it is indicative of his refusal to consult, co-operate and to manage the affairs of the health services constructively, logically, positively and in the best interest of the public. The Minister should look at the serious rundown of medical facilities on the north side. It is a terrible disservice by a Labour Minister to the urgent needs of the area. It is an indictment of his attitude and that of his Department—if they agree with him—to these needs. The Minister spoke about costs but it does not make economic sense for him to procrastinate and to dig in his heels on this issue. I call on him to be logical, reasonable, responsible and sensitive to the needs of the people. He should open this hospital immediately.
The Minister has shown a striking lack of sensitivity to the needs of the people on the north side of Dublin. He has been busy undermining the long established mix of public and private medicine which has been and will continue to be a valuable attribute of our health services. This is the first element in regard to which we disagree with the Minister. We believe that the mix which we have is our strength and the Minister knows quite well that when he looks at the costings in the different elements of the mix that in the voluntary and private hospitals he gets a keenness in cost which he will not find elsewhere.
There is an acknowledged demand for the provision of private and semi-private facilities in this country. We are used to being provided with these services and when my predecessor, Deputy Haughey, set about establishing that hospital he was thinking of the needs of the people of the northside as they perceived them. He knows á lot more about their needs than the Minister and has shown greater sensitivity to their requirements. I know that the people in Clontarf, Coolock, Raheny and Howth make demands for private and semi-private facilities as do the people in Dún Laoghaire and Dublin 4. The Minister should try his experiment somewhere else as we do not want it on the north side. His theories are insensitive to the needs of the people on the north side and this is reflected in the fact that more than one million citizens opt for and contribute to the services provided under the voluntary health insurance scheme. The Minister knows that this is also the trend in the UK and that many leaders of Labour organisations looked for private and semi-private facilities and joined BUPA. They brought the managing director of our voluntary health insurance board over to run their organisation for them. Let us look at what we have developed instead of trying to damage it. People living on the north side have a right to the facilities enjoyed by those on the south side. No expense to the taxpayer is involved in this case. The consultants from Jervis Street and the Richmond merely wanted a lease on a site of 1.3 acres but, because the Minister had his personal views——
That is not correct.
They could have provided consulting rooms and a private hospital. These consultants who have been providing services for the citizens of the north side for generations saw this as a desirable development and plans were well under way when the Coalition came into office at the end of 1982. I was Minister for Health at that time and I had given an undertaking in writing that the site would be provided. Negotiations on the lease were under way. I say to the Minister——
The Deputy could not even get the size of the site right.
The first element in the memorandum and articles of association of Jervis Street-Richmond Limited is to establish and operate on a non-profit making basis. Of course, the Minister forgets all that. He is prepared to provide and build the facilities and make them available otherwise in the general hospital at this stage — he was not initially. The board of Beaumont Hospital were happy with the arrangements; the consultants were happy; and the new hospital was handed over on target in July 1983, thereby meeting the target which the previous Minister, Deputy Haughey, had set in trying to get this hospital built quickly, accepting the most modern design available at the time, despite what the Minister has said here tonight.
That is a lot of rubbish. It was ten years old then.
Let the Minister take his medicine and squirm in his seat as he looks around to see what colleagues he has to support him tonight. The old, dilapidated facilities at Jervis Street and the Richmond hospitals were soon to be discarded and the sick and infirm patients on the north side were to have the most modern hospital in the country with first class accident and emergency services. This is still lacking.
Then came the dead hand of the Coalition Minister for Health as far as development in Beaumont was concerned, as well as every other fact of economic development. That is why we have so many people unemployed. He reneged on the agreements reached and publicly attempted to attack and vilify the consultants, those men and women, extremely well educated, who give their lives and services to this country. We are fortunate to have available people of that calibre. It is because of the Minister's predecessors that such people are working in this country and have not joined the brain drain to America or elsewhere.
Having failed to deliver on jobs or welfare nationally, the Minister for Health selected the consultants as the whipping boys. That was his approach to the problem. He tries to mislead people by talking about the costings of hospitals, referring to those being built for a very wealthy segment of the market. The Minister knows that the cost in St. Vincent's Private Nursing Home is about £77 a day for a private bed. He does not quote figures like that. He quotes the figure of £250 which he got somewhere.
It is not from somewhere. It is from the hospitals themselves. The Deputy has made five mistakes so far.
The Minister should try to control himself. We are looking for similar facilities to those which exist on the south side. There is a first-class example in St. Vincent's Hospital, with the private consulting rooms and the private hospital in the same grounds. I am sure the Minister is very familiar with them. They are not talking about costs like that.
The Taoiseach supported him throughout because he needed the Minister for Health to cut back the services provided under the Health Estimates. This he has done consistently in each year he has been there. His arrogance in setting aside normal procedures for consultation and his consistent policy of centralised bureaucracy and authoritarianism have brought him into conflict with the health boards, voluntary and private hospitals and consultants. What we are seeing tonight is one small facet of this Minister's misdoings. The Minister neither understands nor cares for delegation. He strives for the nationalisation of the health services on the same basis as in the UK. Apparently it is not within his capacity to countenance or visualise systems other than those in the UK. His constant striving to achieve this has brought him into conflict with sections of the health services.
We know that the Taoiseach lost confidence in the Minister but could not move him away from Health where he has done so much damage. He was very anxious to get rid of him but the House and the whole country know that even the Taoiseach was not able to do it. Having at first used him very skilfully, he felt it was time to get rid of him. He had done his Thatcherlike job on the health services — forget about the handicapped, the sick and infirm but whip up the public against the consultants who are making their contribution to the country.
I do not spend my time singing songs to the elderly.
It was only by request. His own Taoiseach lost confidence in the Minister and now he is in a sort of limbo. He does not know what day they will get the courage to shift him somewhere else. Probably the sooner they do it the better for the health services and certainly for those who require health services on the north side of Dublin. How can this House now vote confidence in his efforts? All we are asking the Minister to do is get on with the job which he should have been doing from the beginning. He has lost approximately three years by this stage and has cost the State a fortune. What he has done is a public scandal.
Various Members on both sides of the House have pointed tonight to the fact that each year's delay costs between £1.3 million and £1.5 million. In the meantime the Richmond and St. Laurence's Hospital should have been sold off, which would have raised a couple of million. He has also lost the deal on Jervis Street Hospital because circumstances have changed and he will not do as well now as he would have done if he had gone ahead in the beginning.
I would be very interested to hear about that.
The handling of this matter is a public scandal. The waste of public money and the delay in the provision of facilities should be inquired into.
The Minister says he does not intend to provide nurse training facilities or a nurses' home on the site. This is to be a major teaching hospital and the normal approach is to provide for first-year students on the site so that they become fully integrated with the hospital and its way of life. That is why the nurses and others are looking for the facilities.
On 11 March The Irish Times carried the comments of two distinguished surgeons, Harold J. Browne and Patrick G. Collins, one working in Jervis Street and the other in St. Laurence's. It was pointed out that, despite the modern advances in almost 21st century medicines, care of the dying, witnessing suffering, preparation of the dead for the mortuary remain arduous tasks. The bonding together with mutual support at this early stage in their careers, particularly during stress, has been incorporated for many years in the training of Irish nurses and has made them outstanding the world over for their unique qualities of gentleness, enormous compassion and empathy towards sick people. That is the kind of thing for which the Minister has no sensitivity. He does not realise the damage he is doing and the value of what he has. That has been the tragedy of this Minister's occupancy of his office and that is why the Taoiseach is anxious to get him out of there as quickly as possible.
The Minister talks about the cost of the lease. The site which is being spoken of amounts to approximately 1.3 acres and it cost approximately £24,000 in 1977. The Minister has held up a hospital costing £62 million because of an argument over £24,000.
The Deputy is wrong. He has made seven mistakes now.
This puts matters into their proper context. The purchase cost of the site was approximately £18,000 an acre. Because of the Minister's ideological hang-ups over amounts like this, he has acted in this way. What does he offer to the people on the north side of Dublin? He proposes to turn this hospital into a psychiatric hospital so that he can conceal his embarrassment.
Wrong again. Mistake number eight. This is the greatest load of rubbish.
After three years delay he can go ahead and open the hospital. This major, multi-discipline hospital is now to be opened for psychiatry. We know that he does not have the equipment to open the hospital otherwise at this stage, but he wants to conceal his embarrassment by going ahead and giving the hospital at the outset the image of a psychiatric hospital. Deputy R. Bruton said that the promises of the eighties are out of date now. He is a north side Deputy. For many years we were looking for a hospital on the north side and it was not until the present Fianna Fáil Leader came along that we got it. If he had not gone ahead with the design at that time we would never have that hospital. It has been available for three years but that crowd over there will not open it. I am asking Deputy Bruton what kind of crowd is he associated with?
Deputy Bruton spoke about the consultants and said there is not much reason in our arguments. In my experience, these consultants are reasonable and dedicated people and we are very lucky to have them. Deputy Bruton should bring pressure to bear on the Minister to stop fooling about with the north side hospitals. Get this hospital open. Deputy Bruton should get in behind the Taoiseach and get the Minister shifted out of there as quickly as possible.
Question put: "That amendment No. 1 be made."
The Dáil divided: Tá, 67; Níl, 62.
Tá
- Allen, Bernard.
- Barnes, Monica.
- Barry, Myra.
- Barry, Peter.
- Begley, Michael.
- Bell, Michael.
- Bermingham, Joe.
- Bruton, John.
- Bruton, Richard.
- Carey, Donal.
- Collins, Edward.
- Conlon, John F.
- Connaughton, Paul.
- Coogan, Fintan.
- Dukes, Alan.
- Durkan, Bernard J.
- Enright, Thomas W.
- Farrelly, John V.
- Fennell, Nuala.
- Glenn, Alice.
- Griffin, Brendan.
- Harte, Patrick D.
- Hegarty, Paddy.
- Kelly, John.
- Kenny, Enda.
- L'Estrange, Gerry.
- McGahon, Brendan.
- McGinley, Dinny.
- McLoughlin, Frank.
- Manning, Maurice.
- Mitchell, Gay.
- Mitchell, Jim.
- Molony, David.
- Naughten, Liam.
- Cooney, Patrick Mark.
- Cosgrave, Liam T.
- Cosgrave, Michael Joe.
- Coveney, Hugh.
- Creed, Donal.
- Crotty, Kieran.
- Crowley, Frank.
- D'Arcy, Michael.
- Deasy, Martin Austin.
- Desmond, Barry.
- Donnellan, John.
- Dowling, Dick.
- Doyle, Avril.
- Doyle, Joe.
- Nealon, Ted.
- O'Brien, Fergus.
- O'Brien, Willie.
- O'Keeffe, Jim.
- O'Leary, Michael.
- O'Sullivan, Toddy.
- O'Toole, Paddy.
- Owen, Nora.
- Pattison, Séamus.
- Prendergast, Frank.
- Quinn, Ruairí.
- Ryan, John.
- Shatter, Alan.
- Sheehan, Patrick Joseph.
- Skelly, Liam.
- Taylor, Mervyn.
- Taylor-Quinn, Madeline.
- Timmins, Godfrey.
- Yates, Ivan.
Níl
- Ahern, Bertie.
- Aylward, Liam.
- Barrett, Michael.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Mattie.
- Brennan, Paudge.
- Brennan, Séamus.
- Browne, John.
- Burke, Raphael P.
- Byrne, Seán.
- Calleary, Seán.
- Collins, Gerard.
- Conaghan, Hugh.
- Coughlan, Cathal Seán.
- Cowen, Brian.
- Daly, Brendan.
- De Rossa, Proinsias.
- Doherty, Seán.
- Fahey, Francis.
- Fahey, Jackie.
- Faulkner, Pádraig.
- Fitzgerald, Liam Joseph.
- Flynn, Pádraig.
- Foley, Denis.
- Gallagher, Denis.
- Geoghegan-Quinn, Máire.
- Harney, Mary.
- Haughey, Charles J.
- Hilliard, Colm.
- Hyland, Liam.
- Kirk, Séamus.
- Kitt, Michael.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leonard, Tom.
- Leyden, Terry.
- Lyons, Denis.
- McCarthy, Seán.
- McCreevy, Charlie.
- McEllistrim, Tom.
- Mac Giolla, Tomás.
- Molloy, Robert.
- Morley, P.J.
- Moynihan, Donal.
- Nolan, M.J.
- Noonan, Michael J.
- (Limerick West)
- O'Dea, William.
- O'Hanlon, Rory.
- O'Keeffe, Edmond.
- O'Leary, John.
- O'Malley, Desmond J.
- Ormonde, Donal.
- O'Rourke, Mary.
- Power, Paddy.
- Reynolds, Albert.
- Wallace, Dan.
- Walsh, Joe.
- Walsh, Seán.
- Wilson, John P.
- Woods, Michael.
- Wyse, Pearse.
Tellers: Tá, Deputies F. O'Brien and M. Taylor; Níl, Deputies V. Brady and Barrett(Dublin North-West).
Question declared carried.
Motion, as amended, put and agreed to.