Dáil Éireann debate -
Tuesday, 27 Feb 1990

Vol. 396 No. 3

Health Boards (Amendment) Regulations, 1989:Motion.

Minister of State at the Department of Health (Mr. N. Treacy)

I move:

That Dáil Éireann approves the following Regulations in draft:

Health Boards (Amendment) Regulations, 1989.

A copy of which Regulations in draft was laid before Dáil Éireann on 10th April, 1989."

The Government have been considering for some time the question of appropriate representation on the Western Health Board arising from the revised local administrative arrangements in Galway. It is now proposed to amend the present statutory provisions to enable Galway Borough Council to appoint two members to the Western Health Board. To amend the relevant legislation the approval of both Houses of the Oireachtas is required. The Seanad passed a resolution approving these draft regulations on 14 December 1989.

Galway city was up-graded to county borough status with effect from 1 January 1986 and became a separate administrative unit distinct from the county. At present the Western Health Board comprise nominees as follows: Three nominees of the Minister for Health; six nominees of Galway Councy Council; five nominees of Mayo County Council; four nominees of Roscommon County Council; seven nominee members elected by registered medical practitioners; and one nominee each of registered pharmacists, registered dentists, registered nurses and registered psychiatric nurses. These provisions are specified in the Health Board Regulations, 1970, but to date they contain no legal basis for representation on the Western Health Board of members of the new Galway Borough Council.

Accordingly, the Government now propose to proceed with the statutory arrangements necessary to enable Galway Borough Council to be represented on the board. The legal provision takes the form of an amendment to the Health Board Regulations, 1970, which, before promulgation, requires a positive motion from both Dáil Éireann and Seanad Éireann.

Agreement has been reached with Galway Borough Council, Galway County Council and the Western Health Board that the borough council will be empowered to appoint two members to the Western Health Board. The amendment of the regulations, therefore increases the number of health board representatives from 29 to 31 and specifies that the two extra members will be drawn from Galway Borough Council.

Since the Commission on Health Funding reported in October 1989, the Government have been considering the most appropriate means of administering health services at local level. The Minister is anxious to ensure that the mechanism for planning, organising and delivering health services is thorougly efficient and responsive to the needs of a complex health care system. He is, therefore, considering the whole administrative structure to ensure that it will perform in the most cost-effective and efficient manner possible and the views of a wide variety of interests have been sought on the Commission's proposals in this regard.

The Minister and I have not yet completed this examination, but have decided that there is no reason in the meantime for not granting Galway Borough Council representation on the Western Health Board. Under the existing administrative arrangements it is only proper that the borough council should have an adequate input into the local health structure.

The amendment is, of course, without prejudice to any future proposals on the reorganisation of the health system.

I commend the Motion for Approval of the Health Boards (Amendment) Regulations, 1989, to the House.

Mr. Yates

I propose to allot most of my time to the local Deputy, Deputy McCormack. My party will not oppose this move. We regret that it has taken so long for the borough council of Galway city to be recognised in this way. It is long overdue. I hope this change will mark an improvement in the hospital services in Galway which have been a matter of great concern in recent times. A report has been compiled by consultants regarding the regional hospital which is of great concern.

Our view on this is without prejudice to our belief that health boards are not the most appropriate bodies to deliver health care services in future. As this is principally a local matter, I propose to allocate the rest of my five minutes to Deputy McCormack.

Acting Chairman (Mr. Doyle)

Only spokespersons for each group may speak on this issue. That is an order of the House.

Mr. Yates

Surely this can be done by agreement of the House.

Acting Chairman

It is quite specific. Five minutes are allowed for the spokespersons of each group, as defined under Standing Orders.

Mr. Yates

I very much regret that because I was informed by my Whip that this arrangement could be entered into. There seems to be some breakdown in communications. The loss is not mine but that of Deputy McCormack. He has been pressing this matter for some years and it is of particular concern to him that the Government have dragged their feet in bringing this forward. The likelihood of the two representatives of Galway Borough Council being of the principal Government party is very improbable. Our suspicion is that the reason for delaying this matter is tied into that fact and the forthcoming local elections. Overall we will not be opposed to it. I hope this will mark a point at which we will see that adequate beds will be made available in the regional hospital, that services there will be built up and that the services at Merlin Park Hospital will not be neglected. These matters were highlighted in the post-Christmas period when members of the staff of those hospitals spoke out openly about the horrendous overcrowding and the premature discharging of patients. All of this is quite unsatisfactory.

I hope this will mark a turning point and that Galway can look forward to a proper level of hospital services. We will therefore not be opposing the appointment of two further members to the Western Health Board from Galway Borough Council.

Acting Chairman

Deputy McCormack, I regret I could not allow you to share time. My hands are tied by an order of the House.

Mr. McCormack

Was it not always the procedure that the sharing of time was allowed where there was agreement of the House? In my short time here I have seen several precedents. The sharing of time was allowed by spokespersons or other Members.

Acting Chairman

The proposal on the Order of Business was as follows:

It is further proposed that in the debate on item No. 5, which shall not exceed 20 minutes, the following arrangements shall apply: speeches shall be confined to the Minister for Health and the spokespersons for each of the groups (as defined in Standing Order 89) and shall not exceed five minutes in each case.

Mr. McCormack

If the spokesperson for a group wishes to share his time, is it not a matter for the House?

Mr. Sherlock

If the time allowed for this debate is 20 minutes——

Acting Chairman

It is quite clear in my mind that it is confined to the spokesperson for each group.

Proinsias De Rossa

The order refers to "spokespersons" for each of the groups. It is not singular.

Mr. Howlin

I have no objection to Deputy McCormack saying a few words. We have a 20-minute debate. It is a very non-contentious proposal.

Minister of State at the Department of the Taoiseach (Mr. V. Brady)

Spokespersons.

Mr. Howlin

I see the Government Whip is adamant.

Mr. McCormack

I am only representative of Galway Borough Council in the Chamber.

Acting Chairman

We must allow the debate to continue. I have explained the matter and the order is quite clear.

Mr. McCormack

Everybody except the Whip on the Government side is willing to share time. It is extraordinary that the Government Whip is the only one objecting. Probably they anticipate that I might have a few things to say about the four-year delay in having this matter dealt with.

Mr. V. Brady

This debate is limited to 20 minutes and should be allowed to continue on the basis of the order of the House this afternoon.

Acting Chairman

In order to share time there must be agreement by the House. There is not agreement on this issue. I am sorry, I must carry out the order of the House.

Mr. McCormack

You are not as sorry as I am.

Acting Chairman

I accept that.

Mr. McCormack

I am the person in this House who has been most affected by the delay. Galway City Borough with a population of 47,000 has been denied representation on the health board.

Acting Chairman

You are out of order.

Mr. Yates

My Whip's office contacted me asking me to give some time to Deputy McCormack and I cannot understand how my Whip is simultaneously supposed to have agreed to something else.

Acting Chairman

My hands are tied by the order of the House in front of me. I am not privy to private arrangements between the Whips.

Mr. McCormack

My hands are tied by the people I represent, the 47,000 people in Galway city who have been denied representation on the health board.

Acting Chairman

Deputy McCormack, you must allow Deputy Howlin to make his contribution.

Mr. McCormack

He has about 15 minutes.

Acting Chairman

Only 20 minutes have been allowed for this debate and you are eating into Deputy Howlin's time.

Mr. Howlin

I am anxious to facilitate a local Deputy and it would have been possible for Fine Gael to nominate that Deputy to be their spokesman had they been so minded.

Mr. V. Brady

That is right.

Mr. Howlin

My colleague, Deputy Michael D. Higgins, with whom I have discussed this issue, is very much in support of the amendment and has sought it for a long time. Had he not been absent on parliamentary business, he would have been the spokesman for the Labour Party today.

I welcome the proposal which has finally come before the House to extend democracy in the Western Health Board region by the inclusion of two extra members from Galway Borough Council. It is my firm view that local democracy is the bedrock of the operation of all our services. I approach this matter on the basis of what needs to be centralised— everything else should be decentralised. Local members are most in touch with local needs. They can best define the requirements of their own administrative areas. They are the people answerable to the local community at election times. Any broadening of franchise and the inclusion of extra representation of elected members is to be welcomed.

I also hope that this extension of democracy to the borough of Galway will act as an extra pressure on the Western Health Board and on the Department of Health to fund services adequately which are clearly inadequately funded in that region, as we have seen in the past three months when a calamitous situation arose at Galway Regional Hospital.

This is an interesting extension of local democracy in one health board area. My view is that it is welcome but the Government's view is not clear. The Minister says he has received the report of the Commission on Health Funding. He received that report last summer and has had umpteen other reports for longer periods. While this Minister is very good at commissioning reports and establishing review committees he is very poor at acting upon their recommendations or taking actions of any description other than cutting back on expenditure and budgets. What are the Minister's views in relation to the future structure of health boards? When we are dealing with this legislation which will impact on the structure of health boards, it is incumbent on the Minister to acknowledge at least that he and the Government have a view on it. When will this Minister and Government make a decision? They are forever seeking views, and the Minister has come into this Chamber again today and said that more views are being sought. We are a population of 3.5 million people. Before this Minister makes a decision he obviously wants to consult all 3.5 million people.

The Minister and the Government are statutorily charged with administering the health services. They have made a bad job of it for three years now. The people gave their verdict on the performance of the Minister in a recent opinion poll and the least this House and the country deserve now is a clear indication of what structural changes the Minister and the Government propose, if any, in the administration of the health services.

Mr. Sherlock

The Workers' Party welcome this motion to extend the membership of the Western Health Board to facilitate the appointment of two representatives from Galway Corporation. Indeed, The Workers' Party members of Galway Corporation spearheaded this campaign for representation of the authority on the Western Health Board. It is most unsatisfactory that it has taken the Government four years to implement this measure. The Minister could have made this order at any time since January 1986. The fact that the Minister decided not to do so until now has meant that the city with the biggest hospital and the biggest urban area in the west was without representation on the Western Health Board. Clearly the Fianna Fáil Government considered that the political complexion of Galway Corporation made it undesirable to extend their democratic rights to the people of the city. Of course many things were changed with the political marriage of Fianna Fáil and the Progressive Democrats, and this is one of the changes.

The health board have been criticised recently, sometimes justifiably. The health boards provide the only area of democratic control over our health services and the health services are a matter of concern to the vast majority of people. The right of the democratically elected representatives of the people to have an input into health policy matters is a principle that should be defended. The Government seem determined to restrict that input as much as possible. The decision to effectively abolish the health advisory committees was just one example of this. In 1987 a directive issued to the health boards that the functions of health advisory committees would be taken over by the health boards. This was when financial constraints were being imposed on the health boards and these constraints have continued to be imposed. I would remind the Minister that health committees were established under section 7 (2) of the 1970 Health Act and they have statutory authority to advise the health boards of the functions in the area that require the attention of the health board. That function has been completely abolished. The democratic right of the people to have that representation has been taken away. I would call on the Minister to have that restored as well.

Mr. N. Treacy

Neither the Government Whip nor I have any desire to prevent anyone from speaking, but Standing Orders are very explicit——

Mr. McCormack

You stopped me anyway, yourself and the Whip.

Mr. N. Treacy

I have not intervened at all. As Deputy Howlin said, I cannot understand how your party would not have allowed you make your contribution on this occasion.

Mr. McCormack

I am surprised at you.

(Interruptions.)

Mr. N. Treacy

It is very clear from the contribution of Deputy Yates that the Fine Gael Party have no commitment to the health boards, that they want to abolish them. I cannot reconcile how the Deputy wants to have representation on them and also wants them abolished. There is a conflict, so far as I am concerned.

(Interruptions.)

Mr. N. Treacy

A review of the health board structures was in train when the new Galway Borough Council was established and the request for representation was made. The review was made redundant by the establishment of the Commission on Health Funding. The commission were asked to review the efficiency of the delivery of the health services including the local administrative structure. This review has been going on for the past two years. The commission's report was only published in October last. Thereafter, we took this motion before Seanad Éireann where it was unanimously agreed. I am very pleased, as a person living in the Western Health Board area and recognising the rights of Galway Borough Council, to be represented on the board, as a member for that area, and as a junior Minister in the Department of Health, to maximise the representation on the board. I look forward to the contributions that will be made by those members and I hope they will be very postive. I am confident that the health board will continue to discharge and deliver the health care services in the western region as they have done so well for so long.

Mr. McCormack

God help us. Question put and agreed to.