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Dáil Éireann debate -
Wednesday, 28 Nov 1990

Vol. 403 No. 2

Private Members' Business. - AIDS Policy: Motion (Resumed).

The following motion was moved by Deputy Yates on 27 November 1990:
That Dáil Éireann calls on the Government to immediately introduce a National AIDS Plan to respond to the AIDS epidemic in Ireland; to establish a national task force on AIDS with a specific budget; and to ensure that the medical, community care, accommodation, financial and other needs of HIV-AIDS patients are properly provided for now and in the future.
Debate resumed on the following amendment:
To delete all words after "That" and substitute the following:
"Dail Éireann endorses the Governments AIDS strategy which encompasses a programme for the prevention of HIV infection and the care on an integrated basis, of AIDS-HIV patients within existing services and which is responsive to the needs of persons with HIV-AIDS and is up-to-date with international developments in this field."
—[Minister for Health].

I listened with great interest to the debate last night. Contributions have been constructive and sympathetic on this issue.

I take issue with both Deputies Howlin and Yates on a number of issues. It is extremely alarmist of Deputy Yates to say that by the year 2000 there will be approximately 20,000 HIV positive patients in this country and that Dublin will be the AIDS capital of Europe. That statement is without basis in fact. As the Minister said yesterday we should follow the advice in the World Health Organisation statement, that projecting data like that is totally unwise, as the nature and spread of this disease in terms of individual groups and geographical prevalence is unpredictable. In his speech the Minister tackled the problem from the perspective of those who are HIV positive and from the perspective of protecting the general public. It is not necessary to go into this in any detail because the Minister's speech last night covered everything.

Needs in this area are catered for in an integrated network of community services throughout the country. I disagree with Deputy Howlin in that I see no reason to import specialists to deal with AIDS. AIDS is a viral disease that attacks the immune system. The unfortunate victims of this disease usually succumb to secondary illnesses such as pneumonia and so on. These diseases are adequately dealt with by indigenous specialists who are dealing with these illnesses on a daily basis. In the past Deputy Howlin spoke about wanton waste in the medical field. His proposal would cost money. If extra money is to be made available it could be diverted to better use in this sphere.

We have an AIDS problem in Mountjoy Prison. The Minister dealt comprehensively with this yesterday. How could anybody have foreseen the problem of AIDS in the prison system when we were devising our prisons? I am glad that the Minister for Health has announced that a special unit in Mountjoy is nearing completion. I hope this will alleviate the problem and eliminate further criticism in this regard.

Education is obviously a vital component of any campaign to prevent a disease like this. An increasing number of young people are sexually active as is evidenced by the growing number of teenage pregnancies and pregnancies outside of marriage. This age group must be specifically targeted in any education programme. The ideal solution would be a return to our moral values. However, we must be realistic and accept that ideals are hard to maintain. We have had a barrage of advice about condoms, sterile needles and so on. Some of this advice runs counter to the accepted ethical values held by churches, the medical profession and other people. I hope a common approach can be reached to have the desired effect in combating AIDS.

Because of our education programme the problem of AIDS is decreasing among the gay community. It will be hard to get the message across to our wider heterosexual society but we must tackle the problem.

The greatest single cause of the spread of AIDS in Ireland relates to specific individuals who in the early eighties imported large amounts of hard drugs into this country and made junkies of many young people. The kids who started on drugs then did not know what effect they would have. The culprits for the introduction of this tragic disease are the drug barons for whom I have no sympathy. They prospered on the misery of countless young people. I hope the drug barons who are careful not to use the drugs themselves will be wiped off the map. No punishment is too severe for these people.

We have consensus in relation to this issue. We have a lot of common ground. I propose now to give the remainder of my time to Deputy Hillery.

The Deputy has agreed to divide his time between Deputy Hillery and the Minister of State, Miss Harney. Is that agreed? Agreed.

I will be happy to share my time with Minister Harney. I will briefly focus on the role of education in relation to the tragic disease of AIDS, to underline specifically the pro-active role that the Department of Education together with the Department of Health have played. When we think of education in the context of AIDS we realise straightaway that AIDS can only be prevented because a cure has not yet been found. If people are unfortunate enough to be infected with AIDS, it is over to the medical people to tackle it. Unfortunately and typically the disease leads to premature death. Therefore, the preventive role through education is of vital importance. In that context, during the past two years or so a number of initiatives have been taken in respect of education and information on AIDS for young people in our schools. This has been a joint effort between the Department of Education and the Department of Health. When the Minister for Education, Deputy O'Rourke, contacted the schools and school authorities, as well as medical personnel, in this regard she immediately and correctly underlined the importance of the parental role. I think in modern society — I speak as a parent myself — we tend to underestimate the role of parents and the influence we have on our children.

I recall debating not so long ago a joint policy report on youth. An extensive survey was done among teenagers and one of the more interesting findings was that overwhelmingly — over 90 per cent — children turned to their parents when they had problems of any kind. Therefore, parents are particularly influential and it is especially important that they should be involved in the development of initiatives on the educational side, and this of course the Government were keen to do.

The disease itself, of course, is tragic at the personal level. It is important that we underline the gravity of it because, unfortunately, there are those who would minimise the dangers associated with it. It is obviously tragic for the individual, for the family concerned and, as we know from the continent of Africa, it is tragic for whole countries which are affected by the disease. On the other hand, we know the virus is transmitted, but only in specific ways. Transmission is entirely preventable; it can be prevented by avoiding the behaviour which causes a risk of transmission. It follows, therefore, that we all have an educative information type role and responsibility in that regard. When I use the word "all" I mean politicians, parents, teachers, doctors, officials and so forth. There is no single member of the community who does not have a constructive role to play in preventing the spread of AIDS.

This is the reason the Government have been keen to develop and advance a programme as part of the total educational process in the schools. Having contacted the schools, the Department quickly got the message from teachers that it was very important that we have home produced educational materials on AIDS. It is to the credit of the Government that considerable research was done to see what was being done in this regard elsewhere, for example, in Northern Ireland. Detailed research was carried out and some drafts of possible resource materials were prepared and discussed within the Department with individual teachers and others who had a responsibility and interest in the educational area. The Department receive regular feedback from individual schools on their meetings with parents and on what parents consider should or should not be done.

One important message which came through was that parents were very concerned about their children's future welfare and were very positive and relieved to know that schools were taking initiatives in relation to AIDS education. Here we have co-operation between parents and the schools working jointly under the aegis of the Departments of Health and Education. It was decided that the serious situation with regard to AIDS required detailed educational resource materials, not just general guidelines which would leave it up to schools and teachers to develop their own materials or use imported items. Because of this it was decided that it was necessary to carry out a pilot study in a small number of schools. The results of this study proved very valuable because extremely valuable feedback was received in trying to put the correct programme together.

There are those who believe that the only initiative taken by Government Departments and their respective Ministers was the development of resource materials, but in practice not one but two summer schools have been held to tease out the issue further. We now have a programme on AIDS in place in many schools as part of the general education programme. This is found to be acceptable and is being implemented in a non-confrontational way. This is not the end of the matter as it is quite obvious that the effectiveness of the material currently in use will have to be monitored and when further feedback are received, more refinements of the programme will be applied as and when necessary.

Given my undertaking to share my time with the Minister of State, Deputy Harney, I will now pass over to her.

I would like to thank Deputies Hillery and McDaid for sharing their time with me. I will not avail of all the time at my disposal. I would like to begin by congratulating Deputy Yates for bringing forward this motion for debate here this week and the various Deputies who have entered into the discussion. Their contributions have reflected a wide consensus on this crisis and on the urgency and scale of the task presented to us.

In discussing this issue tonight I can only favourably contrast it with the tone of the last occasion on which this House considered an AIDS-related matter — the special funding to compensate the small number of haemophiliacs who had become infected with the HIV virus in the course of a blood trnasfusion. To its shame, this House was then unable to agree to make special provisions for these tragic individuals and it is a source of particular satisfaction to me that one of the least contentious results of the subsequent general election was the allocation of £1 million to this group. I hope tonight's debate proves to be a benchmark in our developing attitude to this disease and to its implications, both national and global. The AIDS crisis, quite simply, is the most serious health and social issue which has ever faced the world.

On their own the statistics relevant to the disease in this country are alarming: 174 people have contracted full blown AIDS — 69 of whom are already dead, over 1,000 people have the HIV virus, the particular problems resulting for our drug problems, the increasing and inevitable spread of the disease throughout society, and so on. Tragically, however, these figures are only the tip of the iceberg. With global increases being measured in hundreds of thousands and forecasts of future trends running into tens of millions, the scale of the crisis facing us is clear.

Our strategy in response to this disease must be guided by three principles. First, to the best of our ability we must prevent the further spread of the disease, second, we must ensure the best possible care for existing and future sufferers and, third, we must take every possible measure to tackle discrimination against those suffering from the disease. Given that the prospects for an effective treatment of this disease are still very far off, preventing the future spread of the disease must be our paramount concern. The proven decline in the rate of transmission of the disease among homosexual men proves beyond doubt that it is imperative to ensure that the full and frank facts of the disease are disseminated not just to those most at risk but throughout society because the threat of the disease can no longer be said to be confined to any particular group.

This campaign must use every resource at our disposal — the full provision of information on every aspect of the disease throughout society — ensuring the availability of exchange needles and condoms to intravenous drug abusers in particular and the widest possible use of an effective media campaign to highlight the problem. The media blitz which accompanied the initial news of the AIDS disease has clearly died. Memories are tragically short and I have no doubt that in the absence of an ongoing and prominent campaign about the seriousness of the disease, young people in particular will be more convinced by the phrase "it will not happen to me" than by a proper concern for their real vulnerability.

The present Minister, to his credit, in the 1987 campaign did show that that campaign was hugely successful in highlighting the disease and in educating the public to its implications and seriousness. For lasting effectiveness, however, I believe such a campaign must be virtually continuous and should be concentrated not just at air and ferry ports but throughout the country. We cannot simply suggest that AIDS is only caught abroad.

While prevention must always be of paramount concern we must also ensure that every effort possible is invested in treating current AIDS and HIV sufferers. I have no doubt, even with the most ambitious estimates for disease prevention, that the coming years will see a huge growth in the number of sufferers. This will have enormous implications not only for our health professionals but for future health planning and budgeting. It is only by taking the proper planned steps now that we can ensure the best treatment for sufferers of this disease.

I am equally concerned, however, at the discrimination problems which affect AIDS sufferers and the people who are HIV positive. The reluctance of individuals to contemplate casual AIDS testing reflects an understandable worry that they and their families will, through ignorance, be virtually ostracised from their communities. This too must be the guiding principle behind any public awareness campaign on the disease. As in any situation, ignorance and fear are the primary factors in discrimination. They must be tackled and the understandable fears of people must be addressed so that there is no excuse for any discriminatory treatment of AIDS sufferers.

In this country we have been slow to come to grips with the seriousness of the AIDS problem and, indeed, with our wide responsibilities as legislators to deal with the situation. However, in the last number of years great progress has been made in our approcah to the problem and a greater understanding and sympathy has been evident. The Minister must be congratulated for this as, indeed, must Dr. James Walsh, National AIDS co-ordinator, who has worked tirelessly on this campaign. A number of points raised in this debate deserve the most careful consideration.

In an almost unique manner the future direction of any AIDS policy cannot be anticipated. I believe the situation and our response to it must be kept under constant and careful supervision. We should be prepared at any stage to alter our approach to the disease and be flexible enough to incorporate any advances which are made in health and public awareness fields in connection with it. We are still very much at the stage of the unknown. As I said earlier, it is the greatest health and social issue currently facing the world and one which all of us as legislators — regardless of what political party we happen to represent — must come together and work on if we are to find a sympathetic and caring solution to the problems it brings to those who suffer from it and their families.

The motion before the House from Fine Gael is a good motion and The Workers' Party will be giving it our support.

AIDS is a killer disease and the numbers infected with AIDS-HIV are growing in this country. Ireland has the unenviable distinction of having the highest proportion of babies born in this country with the HIV virus or with full blown AIDS in Europe. The numbers of people who have contracted this deadly disease through heterosexual activity is also growing. I am, therefore, dismayed that the Government have put down a self-congratulatory amendment seeking to make this issue a party political one and not a human one. The task facing us all in this country is to muster all forces to halt the spread of the AIDS epidemic. I believe the motion in the name of Deputy Yates is an earnest attempt to put forward a way to tackle the AIDS-HIV problem in Ireland.

AIDS has become the major health issue of the late eighties and will now unfortunately be the health issue of the nineties. People with AIDS, HIV or AIDS-related problems are normal people who have contracted this deadly disease in a variety of ways. The Government must show, by example on the ground, that their attitude to this matter is not complacent but an active preventive and caring policy.

The introduction of a national AIDS task force would be an excellent and serious policy decision. There is no point in the Government coming before this House, blandly telling us that in comparison with other European countries our problem with AIDS is not too bad. All people infected with AIDS-HIV are human beings with feelings and families and not mere statistics.

The people who are working on the ground are encountering so much ignorance, prejudice, hostility and human tragedy, that I must congratulate them on their tireless work. These local action groups in different parts of the country are telling anyone who cares to listen the same sorry story, a lack of funding and co-ordination between the statutory and voluntary bodies.

Are we serious about tackling the AIDS epidemic in this country? If we are to be honest with ourselves, the answer at the moment appears to be no. I say this because there is no good reason for not establishing a national AIDS task force which would represent all the groups working on the issue in the country. Such a force could give national direction in the fight against AIDS and give the campaign added seriousness and enthusiasm.

With the hostility to the task force everyone who has fought campaigns in the past will tell you that a nationally co-ordinated group with representatives of local groups, is much better than disparate localised activity. Surely this is the lesson that Fianna Fáil should have learned from the Presidential campaign. Fighting the spread of AIDS deserves our best and most intelligent organisational skills to be deployed.

As a member of the Southern Health Board, I know, from submissions made by the Cork AIDS Alliance to that board, that they are seeking to build a front against AIDS-HIV. The Cork AIDS Alliance have asked for integrated co-operation between the voluntary and statutory sector as the most effective response to the problem. I supported this call in the Southern Health Board and fully support the need for a national task force to be established which would comprise representatives of the voluntary and statutory sector.

I am sure that every Deputy in the House knows of the selfless and thankless work they do on behalf of the country in their voluntary organisations. Their call for integrated co-ordination at national levels to be sincerely taken on board and accepted by the Government as the most appropriate way to tackle the problem.

I am perturbed, and it leaves me somewhat sad, that the vast majority of the funding to combat the spread of AIDS-HIV comes from the national lottery. This is a clear example of lottery money being used to prop up and supplement the Department of Health budget. Lottery money has many uses for the benefit of the country. It should not, in my view, be used for ongoing funding for such a major matter as tackling AIDS-HIV. I believe that lottery funds are for stop gap use to tackle a major problem that has just arisen. AIDS will be with us for many years to come and lottery funding is not appropriate. Funding must come from the Exchequer to deal with this problem. The Department of Health should have sufficient moneys in their budget. That is a demand we will continue to make.

There is a definite feeling in the country that the Government's information and preventive programme is complacent and dominated by the attitudes of one religious group. Information is preventive; ignorance of AIDS-HIV does kill. I fully believe that the publicity campaign in 1987 using billboards, TV, newspapers and local health centres was a good effort at disseminating information.

It amazes me, however, that the Department of Agriculture and Food can regularly run advertisements drawing the public's attention to the danger to farm animals of dogs on the loose. The Department of the Environment regularly advertise and warn the public of the dangers of drinking and driving. The Department of Health confines its warning about AIDS-HIV to small posters hanging on crowded notice boards in health centres.

There is a crying need for information on this subject and it is the Government's responsibility to give the most effective and sensible information to the public. If nothing else is achieved out of this debate the Government will have realised that there is great annoyance at their self-satisfied attitude. Information is urgently needed and wanted now.

The Minister for Health can do something very significant and at no cost to his Department to save the lives of many people. It is difficult to understand why the family planning laws on the sale of condoms are still in existence. Condoms are medically proven to be a major preventive method in halting the spread of AIDS-HIV. It is a ludicrous situation that a retailer can be prosecuted for selling a packet of condoms in a shop which is not a pharmacy. In all the other countries of the European Community members of the public can easily purchase condoms, but not in Ireland after the closure of chemists at say 6 p.m. or on Sundays. I call upon the Minister to amend the family planning laws to make the sale of condoms more accessible.

We like to pride ourselves on being a Christian country, full of charity and a major donor of money to the poor countries of the world but I am disappointed at the way we treat our people at home. Those unfortunate people who have contracted the HIV virus or AIDS tell stories of how they are made feel totally unwanted, like lepers in their own communities. It is wrong to say that Ireland has the best health care and counselling available in the health service.

The Minister for Health coming into the House last night and telling us that there are sufficient staff for the AIDS programmes was nothing short of a farce. AIDS patients need in-depth counselling to help them cope with the disease. There are not enough counsellors available and the result is that those on the staff have to cope with a workload which would not be borne by other counsellors in the health service. That is a terrible indictment of the Department of Health. The provision of counsellors is absolutely necessary to trace other people who may have been in sexual contact with people who have AIDS or HIV. By comparison one full-time counsellor in Britain has to deal with 30 patients only. That is not the case in Ireland and St. James's Hospital in Dublin has been arguing about the need for a third counsellor for some time. When we consider that St. James's Hospital handles all the AIDS-HIV cases in the greater Dublin area it is clear that the number of counsellors in Ireland is far fewer than the rest of Europe. Indeed, at a conference on AIDS held in Copenhagen in March last there was a discussion on the over-burdening of staff and how it can cause staff burn-out.

I am appalled at the intolerance and hostility shown to these unfortunate people or which they believe they receive. People who have learned that they have AIDS-HIV face a traumatic time and often are totally shocked and in distress. There is clear evidence that many of these victims feel they have to emigrate particularly to Britain, to obtain care and counselling. This is not an attack on the dedicated workers in the medical service; it is an attack on prevailing attitudes. It is also a reflection on the poor efforts of the Department of Health to explain the ways AIDS can be contracted in their publicity campaigns.

World AIDS day will be held this weekend, 1 December, when this House would do itself proud by passing this motion in the name of Deputy Yates. The Government parties should consider the human issues involved in this and not regard it as a party political issue. This is a unique opportunity for us to radically approach the problem of AIDS-HIV in Ireland by setting up a national task force which would have its own budget to halt this killer disease. Such measures are taken by the Government in other areas, for example, the setting up of ERAD. Why do they not do the same in regard to this crucially important health issue?

My colleague, Deputy Byrne, has asked me to give him five minutes of my time. Is that in order?

Deputy Sherlock has eight minutes left.

Deputy Hillery referred to schools and the schools programme. Clearly AIDS will be a major health issue into the nineties and the failure of the Department of Education to publish their programme on it is deplorable. Unless young people are alerted at an early age about the dangers of AIDS and to appropriate preventive measures the AIDS epidemic will continue to grow with horrific consequences. I hope the programme which has been mentioned will be published.

I support the motion before us. As a city TD who represents the constituency of Dublin South-Central I am aware at first-hand of the problems facing communities where AIDS exists. I want to congratulate all the workers in the voluntary sector who are tackling the AIDS problem at the coalface. I know my time is extremely limited because of the time allocation but I should like to make a few points on this issue.

As part of my research on this issue, I called to the Merchant's Quay project which is being run in Dublin south inner-city and spoke to some of the voluntary workers. I was incredibly impressed by the work these people are doing in tackling the problem of AIDS.

We are all aware that there is a direct relationship between HIV infection and drug abuse in parts of this city. There have been 75 deaths since 1986 from this disease and there is a rapidly spiralling increase in the number of people who are tested as being HIV positive. For example, in November 1989 there were 865 reported cases of this disease which had risen to 1,005 by this month. In March 1990, 914 people had tested positive to the HIV test of whom 534 or 58 per cent, were intravenous drug users. At the same time 130 people were diagnosed as having AIDS which figure had increased to 174 cases by this month. Of the 130 people diagnosed as having AIDS 51 people, or 35 per cent, were intravenous drug users.

It should be noted that these figures relate only to those people who have been tested for HIV. It is known that at present many of the prison population are trying to avoid being tested because they are afraid of being segregated within the prisons. We also know from the work being carried out by detached workers — people who go out into the community and get to know the people who are using drugs — that new drug users are sharing needles, thus giving rise to an increasing risk of infection.

The plight of the drug using sub-culture in Dublin calls for a series of new initiatives. Hopefully, these will be implemented if this motion is passed. Many of the initiatives needed were listed in a report recently submitted to the Department of Health by the CSSC who are actively involved in the Merchant's Quay project. These proposals have been put forward after research into the needs of drug users in Dublin and include the need for a broader range of treatment options for drug users, better co-ordination of services and access by health workers to the drug using sub-culture.

The drug treatment centre in Pearse Street saw over 200 people in one day in April this year. This gives a clear picture of what is happening in this city. When one balances that picture with the fact that there is only one residential treatment centre for drug users in Dublin one can understand the reason this motion is before us tonight. There are no reliable statistics on the number of drug users in Dublin. The drug treatment centre has dealt with more than 8,000 poly drug users since it opened in the early seventies and they have had an average of 600 new contacts every year since 1984. Research carried out in Dublin secondary schools shows that a further 7,000 young people use drugs other than alcohol on a regular basis. Some of these used opiates and synthetic opiates.

There is sufficent evidence to indicate that this problem is persistent and growing. Drug abuse leads to the spread of HIV and it is for this reason that we support the call for a national AIDS plan. The number of deaths in Dublin from AIDS has heightened people's anxiety about continued drug abuse. The need for supports, education and ongoing care is evident and will become more urgent in the future. Drug abuse has an inbuilt dynamic which gradually pushes the user out to the margins of society. This alienation is like a downward spiral which is rotated by family disruption and imprisonment.

Social prejudice and an inability to find or keep a job serve to fuel this downward trend. Added to this is the constant compulsion to find a fix and to be stoned on drugs. Begging for substances leads to personal neglect that causes both physical and psychological trauma. The process of alienation creates tenuous clusters of drug users who form a sub-culture around the supply of and demand for drugs. At best this group can only offer to themselves an insecure sense of belonging. At worst it reinforces their marginal identity and it is here that growing numbers of drug users experience economic destitution — they are politically impotent — and an existence that is spiritually empty.

The problem is worsened when AIDS or HIV infection is added to this state of alienation. It simply spins the spiral more rapidly. HIV, for example, changes family disruption into a traumatic upheaval and also closes the addiction trap as it feeds a constant anxiety that stopping drugs will only lead to illness and the collapse of the immune system. To a person with HIV, prison is a double segregation. It first cuts the prisoner off from his family and society and then futher segregates him from the mainstream of prison life. The links between such acute social isolation and suicide are well known to the Minister and his colleague, the Minister for Justice.

I want to give credit to those who are involved in the Merchants Quay project. It was the multiple needs of those fathers, mothers and children which gave rise to this centre. I compliment their dedicated workers, some of whom know at first hand the experience of addiction and HIV and who strive to lesson the experience of isolation felt by drug users simply by spending time with them. Their advice and referral centre provides a friendly link to the helping agencies and their service seeks to halt or even reverse the process of alienation. For example, the respite care which is provided by them ensures a safe place where drug users with HIV can step off the spiral of destitution. Here they can find a place that seeks to restore and affirm their capacity to regain some power over their lives. The volunteers are motivated by a deep sense of admiration of those who are struggling to defy those life-threatening forces. It is the commitment of those volunteers that makes projects such as this possible. I want to congratulate them on their enthusiasm which derives its force from the courage and energy of their many clients. In the final analysis it is these alienated people who impart an infectious hope to each of us. It is this hope that is our common bond as it surfaces in each of us with the cry "I want to have a life and to have it to the full."

I wish to share my time with the Minister of State, Deputy Noel Treacy.

Acting Chairman

Is that agreed? Agreed.

I would hope that all Members would be facilitated.

Deputy Yates is some years late in bringing forward this motion. In 1986 as a member of the Eastern Health Board I expressed by way of motion my concern about the development of the acquired immune deficiency syndrome and the spread of the disease. Somewhat to my surprise, the motion did not have the full support of all the political parties at the meeting. The main party supporting was the Fianna Fáil Party. It is nice that some years later Deputy Yates sees the need to address the issue. The need is, however, already being addressed.

The rate per million of AIDS cases in Ireland is the lowest in EC countries other than Greece. The AIDS strategy being implemented by the Government is in line with the strategy in all EC countries. It is continually monitored in the light of the latest international developments to ensure that the most up-to-date services are available to those in need.

In examining the Government's AIDS strategy it is necessary to look at the objectives it sought to achieve. These objectives are twofold, the first being the prevention of the spread of the disease, the second being the care and management of persons with HIV/AIDS in a proper manner. I am satisfied that these objectives are being met in a caring and compassionate way, with the focus at all times on the need of the patient and the protection of the general public.

Deputy Yates is somewhat late in bringing a motion of this nature before the House.

It is the first time it has ever been brought to the floor of the House.

It is somewhat late. The health boards around the country are already implementing policy. I strongly refute the allegations made yesterday by Deputy Yates, in particular the implied criticism of the regional health boards in their response to the serious problem of HIV infection and AIDS. I can speak with some degree of authority on the services being provided in the Eastern Health Board area where the disease is most prevalent. The board lost no time in developing services at street level, community level and hospital level to meet the needs of persons suffering from HIV infection and their families.

At street level the Eastern Health Board have in place a number of programmes. We have a methodone maintenance programme which includes a needle exchange, and an Outreach programme which has counsellors working at pavement level. A number of these counsellors work throughout the Eastern Health Board area and there is a telephone communication available on a regular basis, following a pilot scheme introduced in 1987. There are a number of other schemes, including an AIDS helpline. There are drop-in centres which cater primarily for drug abusers and provide them with a needle exchange and advice. The workers on the Outreach programme are either nurses or social workers who try to make contact at pavement level with drug abusers with a view to persuading them to go along to drug treatment centres. These people are followed up to ensure they have attended and are availing of treatment. We have also run, and now have, a full education programme. In the Eastern Health Board area in recent years there have been different pilot projects, including an educational one.

We are also funding a number of the voluntary organisations who deal with HIV-infected people and drug abusers. I am aware also that a number of organisations are funded directly by the Department of Health. Therefore, there is a range of services provided at community level, in line with Government strategy, and the hospital services are being developed to meet the need. For example, again in the Eastern Health Board area, Cherry Orchard Hospital make available approximately 22 beds — some of which are made available on a respite basis — that have catered for a number of HIV-positive patients on a regular basis as the need arises. There is also co-ordination of the services provided by the Eastern Health Board and all the other authorities, including St. James's Hospital where the main consultant, Dr. Mulcahy, is responsible in regard to access to beds required.

I cannot support Deputy Yates's motion. When I began Deputy Yates mentioned that this was the first time this subject had been discussed on the floor of this House. That may be so but I am sure there are many other issues not discussed in this House while meeting the needs of those in our community. I would imagine that those people requiring services would prefer to have them made available at community level rather than have the matter discussed in this House. I know that, in conjunction with the Department of Health, the Eastern Health Board are providing the necesary services.

They would prefer to have condoms available at community level, that is for sure.

They are available.

That is not the answer; we all know that.

In the Virgin Megastore.

Acting Chairman

There is very little time remaining. Perhaps Deputies would refrain from interrupting.

I have a few minutes only remaining. If they wish I will arrange for Deputies Yates and Barnes to meet some of the people working on the ground in the Eastern Health Board area, when they will become fully informed of the services being provided. Indeed, not alone will they be made fully aware but they will be fully satisfied with what we are providing and — being so aware — might then support the amendment to their motion. In future, before tabling motions that can cause alarm, especially through the use of words such as "epidemic" and so on, perhaps in order to gain——

Those are Dr. Jimmy Walsh's words. Has the Deputy ever spoken to someone with AIDS?

Acting Chairman

Deputy Callely without interruption.

I have been actively involved in the development of the services and am very satisfied with what is being done.

The Deputy must be the only one.

No, indeed, I am not.

I should like to congratulate the Minister for Health on the work he is doing. I congratulate the Minister for Education also on her input by way of educational programmes. Indeed, I congratulate and would like to encourage all the people working in this very delicate area of the development of services for people with HIV-positive who are experiencing difficulties, particularly those working at pavement level. They are doing a great job and hopefully will continue to do so.

I should also like to commend the Minister of State at the Department of Health, Deputy Noel Treacy, on his work in co-ordinating the work of the Committee on Drug Abuse under his chairmanship.

I am, indeed, pleased to have an opportunity, on behalf of the Government, to respond to this motion and the debate thus far.

It is known, from our surveillance data, that the HIV virus is present in our popuation and that we are, therefore, part of the AIDS epidemic worldwide. AIDS and HIV infection by its very nature tends to create strong emotive responses — sometimes bordering on hysteria. This, of course, is understandable given (i) that this disease affects people in the prime of life — most of the cases occurring in people aged between 25 and 40 years and (ii) that, as of the present time, it is a terminal disease.

Strategies dealing with this disease are not, however, well served by emotive reactions based on inaccurate and subjective data. Highly charged emotional statements do not serve the best interests of people infected with the HIV virus or their families. The Government welcome calm and constructive public debate on this major public health problem. They must, however, continue to base their strategies on the established known facts about the disease and continue the balanced and practical response outlined in detail by my colleague, Deputy O'Hanlon, Minister for Health, in this House last night.

We recognise from our ongoing surveillance of the disease in this country and from our constant contacts with international bodies — in particular the EC AIDS Centre in Paris — that the epidemiology and social background of the disease is ever changing. We have long recognised that flexibility of approach is essential in dealing with this complex disease. This approach will underpin our strategy development.

It is important, however, at this point to emphasise again — as the Minister said last night — that we have a comprehensive programme for the prevention, monitoriing, diagnosis, treatment and management of AIDS in line with international strategies — a programme which is being implemented in a caring and compassionate manner consisting of the monitoring of AIDS and the trend in HIV infection; prevention through health education strategies aimed specifically at the young and at at-risk groups; the protection of the blood supply; the provision of services to reduce risk such as Outreach and methodone maintenance and provision of condoms and needle exchange aimed specificaly at certain at-risk groups and linked to counselling at individual level; research into aspects of the disease; the care and management of people suffering from AIDS and HIV within an integrated framework of services including community services, primary care services, respite services, hospice services and acute hospital services; and the co-ordination of policy and its implementation at national and local levels.

The question has been raised whether any evaluation of our health education programmes referred to by the Minister last night have been carried out. I would like to confirm that such evaluations have taken place. We found that first there was increased awareness of drug addicts as a high risk group and an increase in the percentage of people aware that sharing needles was dangerous; second, there was an increased awareness that those who had sexual intercourse with a person infected with the HIV virus, or casual sex, were particularly at risk of becoming infected; third, there was an awareness that the use of condoms was one of the effective things that sexually active people can do to reduce their risk of getting AIDS; fourth, more people recognised that one cannot become infected with the HIV virus by using the same swimming pool as an infected person; fifth, there was an increase in the percentage of people who would be willing to send their children to a school where they knew there was a child infected with the HIV virus; sixth the vast majority of those who read the Department of Health's booklet on AIDS considered that it was easy to understand and that it gave sufficient information for the general public on AIDS and, seventh there has been overwhelming acceptance of the school AIDS programme developed jointly by the Ministers for Health and Education. It is very encouraging to know that this programme has been sent to all 800 second-level schools in the country and that, from these schools, 1,600 teachers will be informed on how to use the materials with their students. The materials are properly viewed as a resource from which teachers can select and adapt in terms of the particular school context in which an AIDS education programme is taking place. As the Ministers for Health and Education have stated, such programmes will be carried out in accordance with the school ethos, the wishes of parents and where pupils have a prior understanding of sexuality and human relationships.

The findings from these surveys confirm that the Government's health educational strategy is the correct one. Education-prevention strategies need to be carefully thought out. We must be sure that the right message is reaching the right people in a way in which they can make use of it. There is no use spending money telling people they cannot get HIV infection in swimming pools if they already know this. Consultation needs to take place and it needs to be followed by action.

Resources are scarce. We must use them wisely. Identifying needs is of the utmost importance; this is being done with appropriate research and appropriate strategies for meeting these needs are selected.

I am satisfied that the Government's approach in this area is soundly based and relevant.

At this point I would like to respond to a number of specific points raised by Deputy Yates in his contribution to last night's debate. Deputy Yates told the House that there would be 20,000 cases of HIV infection in Dublin by the end of the century; that Dublin was becoming the AIDS capital of Europe and that this would lead to what he described as a social disaster. I am astonished at these statements. I would like to know on what data are these Doomsday predictions based. Does Deputy Yates not accept the internationally expressed view that it is not possible at this stage to simply extrapolate figures over such a long period? Does he not accept that all the evidence available shows that the prevalence of HIV infection and AIDS cases in this country is among the lowest in Europe?

How many people will be HIV positive?

In his speech last evening the Minister for Health pointed out that data from the EC AIDS centre in Paris shows that Ireland has a rate of 43.4 cases of AIDS per million of the population. This compares with 173.2 cases per million for France, 158.4 cases per million for Spain and in fact shows that there is only one country in the EC with a lower rate than ourselves.

He would not want to go on today's figures.

Deputy Brendan Howlin, in his contribution to the debate, spoke about the AIDS epidemic in the United States. By way of comparison it is worth noting that the rate in the US of AIDS cases per million of the population is 561.8. This is from the Central Disease Control HIV AIDS Surveillance Report of July last. I make these comments, not to deny that we have an AIDS problem but rather to maintain a sense of balance and proportion in the debate.

Deputy Yates last night gave the impression that there is such a thing as an "AIDS consultant" and that our approach should be to develop specialised services around such specialised units. I would suggest that this is a limited perception of the problem. It is known that AIDS manifests itself in a wide range of clinical symptoms involving almost every discipline of medicine. The commonest manisfestation of AIDS is a type of pneumonia with approximately 70 per cent of patients becoming ill in this way. Presumably Deputy Yates would accept that pulmonary physicians would be the appropriate people to treat those cases. The second most common way in which people become ill from AIDS is by developing various cancers and again the Deputy must accept that an oncologist would be the most appropriate consultant in such cases. While recognising the important role of STD consultants in the management of HIV and AIDS patients, the Government's strategy for the care and treatment of AIDS and HIV cases is based on the provision of services in the patient's appropriate acute hospital by the appropriate consultant, depending on the nature of the clinical presentation. This ongoing policy has recently been reiterated in a circular issued to health boards and voluntary hospitals.

In addition, the Department of Health recognise that HIV-AIDS patients will spend the greater part of their lives in the community and that primary care and domiciliary care services are central to the national AIDS strategy. The general practitioner has played a significant role in our AIDS strategy to date — a point which seems to have been ignored by all of the Opposition speakers in the debate so far — and we are in regular contact with the Irish College of General Practitioners in relation to this involvement. This emphasis on primary health care and community support has always been an integral part of the Department's AIDS programme.

Deputies Yates and Howlin both criticised the Government for what they perceived as a lack of planning of future services. At international level, discussion and debate on the impact of AIDS on the health services is ongoing. We as a country were quick to recognise that it was impossible to assess accurately the impact of AIDS on our future health services without better, hard information on the spread of the virus in the general population. Indeed, during my Government colleague, Deputy O'Hanlon's Presidency of the Council of Health Ministers, he raised this very subject which resulted in the adoption by the Council of a conclusion calling for, and I quote: "more precise epidemiological information to facilitate the development and organisation of services...."

Arising out of this initiative by our Minister, Deputy O'Hanlon, all European Community countries including ourselves are now examining ways and means of obtaining better data on which to plan future services. New methodologies are being considered in Ireland at the moment. However, it is important to ensure that any new system, such as unlinked voluntary HIV testing, is ethically, legally and medically sound. I am satisfied that we are approaching this complex problem responsibly and correctly in order to develop the right services for our people based on accurate sustainable data.

On the subject of the planning of future health services for people suffering from AIDS and HIV-infected people, the outcome of early intervention strategies will have obvious implications. As has already been stated, research studies in the last two years have shown that early diagnosis and treatment can extend the life of people with HIV infection. This development is relatively new and its implications for the planning of future health services is obvious. It is worth noting again that my colleague, Deputy O'Hanlon, in the context of his Presidency of the Council of Health Ministers, recognised this fact and brought it to the notice of his European colleagues resulting in the adoption by them of the following conclusion, and again I quote: "Recent progress made notably in early intervention for HIV sero-positive persons and people with AIDS, which will allow for improvements in the health status of those people and result in an increase in their life expectancy, requires that particular attention be given to the future needs of medical and psycho-social care services for such persons".

I think it is clear, a Chathaoirligh, that, far from ignoring the planning of health services for AIDS patients as suggested by Deputies Yates and Howlin, it will be seen that Ireland has taken a leading role in the international debate on the two major and related issues of early intervention and better surveillance both of which are vital to the future planning of services in this area. In this context the major international meeting being held on Friday next in the Royal College of Physicians of Ireland, announced by the Minister for Health yesterday, on the subject of early intervention and bringing together leading clinicians from America, Africa, where the disease is particularly widespread, and Europe is further evidence of the leading role this country is taking in the international debate on AIDS.

On the question of AIDS and drug abuse I would like, a Cheann Comhairle, to agree with the point raised by Deputy Howlin yesterday when he said that there was a common agenda for these two problems. We know that in this country almost 60 per cent of our HIV positive people are intravenous drug abusers. As a direct consequence of this we have particular problems in the areas of paediatric AIDS, heterosexual spread and AIDS among prisoners. As Deputy Howlin pointed out, there are common strategies to be adopted to deal with both the problems of drug abuse and AIDS and indeed it is fair to say that, if we were to control our drug abuse problem in this country, we would have gone a long way towards the prevention of the spread of the HIV virus. In my capacity as Chairman of the National Co-ordinating Committee on Drug Abuse I am particularly conscious of this link. I am therefore ensuring that the special emphasis placed in the Government's AIDS strategy on the co-ordination between the drug abuse services and the services for the prevention of HIV infection is being implemented on the ground. This has widespread implications for all State services including the prison service. It is a daunting task, but it must be achieved. Not alone are we attempting to confront the complex issue of drug abuse in our community but also, in so doing, endeavouring to deal with the commonest mode of transmission of HIV virus in this country. I have seen at first hand the commitment of the Government and the Minister, Dr. O'Hanlon, the quality and commitment of the staff and the national AIDS co-ordinator, Dr. Walsh, who is one of the foremost voices on AIDS prevention and treatment in the world.

Ask him how many HIV positive people there will be at the end of the century, and see what he says.

In conclusion, I want to reiterate what my colleague, Deputy O'Hanlon, said last night in refuting the allegations made by Deputy Yates in relation to the lack of co-ordinated planned services for AIDS patients and persons suffering from HIV infection. The Government's strategy is soundly based, equitable and compassionate. Continuous monitoring and liaison with international bodies ensures that the most up-to-date services are available and that Ireland's AIDS sufferers will benefit without delay from any breakthrough in medical research dealing with prevention and treatment.

Acting Chairman

There are 19 minutes left. Will the House agree to allow the three Opposition Members to share that time? Agreed.

Thank you very much for your co-operation. This disease cannot be treated on a party political basis. It is much too serious for that. In the few minutes I have I want to pose some questions. We cannot see into the future in the way we would like with regard to this disease and that is really one of the most threatening factors about it.

I know what the Eastern Health Board are doing. I worry about the regional bases and the other health boards. The response in one of the health board areas would seem to indicate that the other regions have no problem with regard to AIDS or that they have not got the facilities to address it.

We would all agree that the care and management of people suffering from AIDS and HIV must be dealt with within an integrated framework of services. I worry because everybody in this House can say, hand on heart, that we do not have any real infrastructure of community care for long-term health care. Doctors, the people on the pavement or at the coal face who were mentioned tonight freely and sorrowfully tell us that. We deal in our clinics, day after day, with heart-breaking cases for whom long-term community care is not available, the care we know is essential for these patients.

On that point, let me add that one of the reasons I will continue pursuing this cause is that the carers who are left to pick up the pieces, to deal with an under-resourced community care service, particularly an under-resourced home care service, are women. Women will carry the burden of this as they have been asked to do in other areas, and they are among the voiceless. That is happening at the moment and what the Minister said does not reassure me in the least.

I deplore the fact that the Minister can come into this House and say that there is an awareness that the use of condoms is one of the effective ways that sexually active people can reduce the risk of getting AIDS while as legislators we stand in this forum with an Irish family planning Act that is so farcical that not alone is it laughed at by the rest of the world but has serious implications for the prevention of the spread of AIDS. One has only to recollect that at the end of 1989, as we approached a bright new decade in Europe, the Family Planning Association were prosecuted for making condoms available through one of the most available youth sources one could get, a record store. Approximately 3,249 people availed of this service in the Virgin record store in 1989 before the prosecution was brought. The increase in the number of people using the service during holiday periods suggests that at those times people from rural areas tend to use the service while visiting Dublin. Why is this? It is because those resources, despite Deputy Callely's optimistic view, are not available at pavement level in a lot of areas in the country.

In the Eastern Health Board area they are.

The Eastern Health Board is not representative of the rest of the country. I worry about the rest of the country, and that is the main thrust of what I have to say tonight.

Our licensing record is there.

If the Minister is serious about countering the spread of AIDS with every available resource we have, the first thing he must do, with the support of the rest of the House, is amend that family planning Act. It is useless for us to say we are taking it seriously until we do that.

Finally, I want to draw attention to a programme I viewed last night on Channel 4 directed to all of us about women and AIDS. In January, 1989 when the clinic for women was first opened it mostly addressed itself to drug users and former drug users. It is now having five to six new referrals every week and 80 to 85 per cent of them have sexually transferred virus, and are proving very vulnerable to infection. I am inclined to believe that Ireland is not unique in the world, so when I hear of patterns emerging in other countries I do believe that we will be part of the same pattern. We are human.

I will conclude in order to allow time to my colleagues. What I have to say, I say in the most serious way, because this is a learning process for all of us. Women particularly are being diagnosed very often quite late, when they are very sick and when, in fact, they are beyond remedy, and that has been the pattern for women for many reasons. I am sorry I cannot go into it any further but that is a dimension that is emerging and it has not been part of the problem up to now.

I regret that there is not more time to debate this issue because there are many Members offering. I support this motion. The AIDS problem is the most serious public health issue for generations. It will not go away. It will not be managed and controlled by some outside force, some third party. It must be managed and controlled by the Government, the Department of Health and the health boards.

The reason there is a need for a co-ordinating body is to monitor all aspects of the disease, treatment, counselling, education, information, public attitudes or prevention. Trying to do this in an ad hoc manner, as is being done at present, is a guarantee of failure. We need a central AIDS plan administered by dynamic and experienced personnel. We need enough of them to attack the problem, set targets and deal efficiently and professionally with the people afflicted and with their families.

Thanks and appreciation should go to the many individuals and organisations who, over the years, have worked with those who have AIDS and HIV. Many of them do not feel they receive adequate support and they certainly do not have confidence that the Government know what they are doing.

We are talking about the rapidly growing disease of AIDS that grew from 11 in 1985 to 146 in 1990 and of HIV that grew from 275 to 948. Of course, we should not cause undue panic or alarm to anybody, but how can we remain calm when in five years HIV sufferers have grown in numbers from 275 to 948? That is only those we know of, but I believe there are at least half as many again undetected.

There is a need for a clear and specific continuous campaign of promotion and advertising of AIDS, as in the case in other countries. This should be based on advertising campaigns that have been successful elsewhere. For instance, in the UK the Government produced a series of educational advertisements, some of which at first tried to shock people into changing their sexual habits. Critics said these images frightened people without encouraging them to practise safer sex. More recent campaigns have concentrated on informing people of the risks by using simple concepts and even humour.

We must stress — I pick up the point made by Deputy Monica Barnes — the concept of safe sex all the time, as is done in other European countries. In the UK no opportunity of public information is missed to push this slogan. What do we mean by safe sex? Of course we mean monogamy, fidelity and so on but, in the context of the young at risk group, this can be little more than aspirational. Most young people throughout the country, as young as 16 years of age, are now sexually active and these are the ones who need guidance. Safe sex for them has to be sex with condoms. The use of condoms is recommended widely, not least in the health promotion unit booklet. But is it not profoundly hypocritical that they are put virtually out of the reach of young people? Why are condoms restricted to chemists, hospitals and clinics? They are not medication or medical aids. They should be in slot machines for people who want them, where men and women can get them easily and confidentially.

Let us end this prissy, narrow-minded attitude which legally elevates doctors and chemists to God status. It is no wonder, as the Minister said in his speech last night, the foreign media programmes ridicule and attack us. Our double standards must appear farcical to them. We have a growing AIDS problem, particularly the problem of babies born with AIDS, and yet we will not reform our out-dated law on contraception. The case has been made for reforming this legislation as soon as possible and enabling us to give this very important protection to young people.

At the outset I would like to thank my colleagues who supported this debate, especially Deputy Howlin from the Labour Party, Deputy Sherlock and his colleagues. It is quite clear that the Opposition are united in ensuring that there is a proper political response to the crisis of AIDS. I understand there is a meeting going on as we speak as to why Fianna Fáil have this hillbilly image——

It is finished.

Perhaps "finished" is an appropriate word. The Taoiseach has survived yet again. This debate, tonight and last night, would have been sound listening material for the Taoiseach and his colleagues.

The Deputy did not run very far.

Time will tell. Fianna Fáil showed in this debate why they have a hillbilly image, because they are not prepared to confront major social issues of our time. The Minister for Health has shown from his speech last night his typical smug, complacent neglect of the AIDS epidemic. He obviously has not discussed directly with AIDS patients their view of his services.

Today a press release was issued by the AIDS Action Alliance calling on all Deputies to support this motion. They made specific note of the fact that next Saturday is World AIDS Day. I will quote one paragraph of their statement: "As we head into World AIDS Day, the 1st of December, 1990, we have a unique opportunity of marking this day by radically rethinking our response to HIV/AIDS by supporting Deputy Yates's Private Members Motion." Those are the people who matter. It is their views that matter. When they say they are denied access to services, they are speaking the truth. The Minister has been misinformed, and he should be listening to those people.

Just because Ireland is in the early stages of this disease does not mean that we, in years to come, will not have an epidemic. The Minister said that I have exaggerated and have been alarmist in my prediction that there will be 20,000 people HIV positive by the turn of the century. The Minister gave no prediction of the level of the virus at the turn of the century.

I accept the information from the World Health Organisation.

I can assure the Minister that I have consulted people in the World Health Organisation as well as experts in his Department, about this and they have told me that a figure of 20,000 is "conservative". They know the real level of this tragedy. If we take away the bluster of the Minister we will see the facts. The facts are that there is no Government advertising or information programme on AIDS today. There is no interdepartmental structure of Government dealing with AIDS. There is no separate AIDS budget within the health service to provide for the special needs of these people. The Minister is not implementing his own working party's report into the review of the health services for persons suffering from AIDS.

Having listened to the Minister and the Minister of State, I am particularly fortunate to have a full photocopy of the Minister's working party's report into what needs to be done about AIDS. This working party was set up under the chairmanship of Deputy Leyden, Minister of State, in February 1989. The group consisted of many eminent people such as Mr. Hickey, the Chief Executive Officer of the Eastern Health Board, Professor Hillery, Mr. Seán Hurley, who went on to greater things in the Southern Health Board, the Irish Haemophilia Society, a principal officer of the Department of Health, Dr John O'Connor, and also Dr. Jimmy Walsh. What do they say about the need for AIDS services? I will refer to some relevant sections of their report.

They said there seems to be a reluctance on the part of general practitioners to accommodate HIV positive persons with regular health checks. The need for additional counselling services was identified. They spoke about the prisons. Mountjoy Prison is not designed to treat HIV-AIDS prisoners. There is only general practitioner service available there. There are difficulties in getting dental treatment for AIDS and HIV-positive prisoners. There is no liaison between the prison and the health and social welfare services. There is evidence of discrimination in the workplace in relation to accommodation for AIDS and HIV sufferers. The group recommend an integrated network of contact points to be established between the Departments of Health, Justice, Social Welfare and Labour.

They are in place.

The Minister has turned his face against setting up a task force, not only that, he made damn sure that this report was not published so that this House would not have an opportunity to debate those points.

The report is two years old. The Deputy should check on what has been done since that report was published.

If the Minister looks at the front page of the report he will see that the group was established in February 1989 and reported later in the year. The report is a little over a year old and its principal recommendations were not even mentioned in the speeches of the Minister or the Minister of State. They have been ignored. The group proposed an integrated network between Departments but that has not been set up. It proposed an integrated model of care but that has not been set up. It outlines the cost to future AIDS patients, at £35,000 a year. On economics alone the reality is being ignored.

The group recommend that the Mater Hospital is the most appropriate location for the provision of the necessary services and should actively participate in providing these services, but what has happened? In three years the Mater Hospital has not taken one step to set up an AIDS unit. The Minister has tolerated the situation in which there is no AIDS facility except in St. James's Hospital. The clear recommendation of the group is that the two hospitals mentioned are appropriate to provide the acute hospital services for AIDS on the most cost-effective basis. The report said that dentists and doctors who ignore AIDS patients, as is happening all over the country, should be dealt with by the medical and dental councils. But the Minister did absolutely nothing in regard to that recommendation.

In relation to prisoners, the group said that the position of prisoners with AIDS was a source of particular concern to them. The problems were compounded by a further number of factors such as the segregation of AIDS prisoners, on which no action has been taken. Neither has anything been done in regard to the fact that only general practitioner service is available in prisons. The group recommended that specialist services for subacute treatment should be available as part of this arrangement, but nothing has been done in that regard. It was also recommended that the Minister for Labour should set up an anti-discrimination code but that has not been done. Therefore, the Minister should not come into this House and say that he is dealing with this disease or that, because, in the whole of Europe, Ireland is not worse than Greece, we do not have a problem. We have a major problem as we do not know the level of HIV-positive sufferers in the community. On voluntary testing alone the figure amounts to over 1,000 and it could be 3,000. The figures are doubling every 14 months and the response is that there will be no change in the law regarding condoms. The Minister lectured us on swimming pools, and the Progressive Democrats — who have opted out of this debate — are full of bland generalities in favour of paying lipservice to the problem.

We have put forward a response to deal with the problem in the same way TB was dealt with in the forties and fifties——

Acting Chairman

The Deputy must conclude.

A task force must be set up to deal with the problem. There must be also a proper budget, medical personnel; trained in this area and proper financial assistance and care for those patients.

The Minister's party stands indicted as a Government if he fails to act on this motion. I should like to thank the Opposition parties for their support and I assure the House that this issue will not go away.

Amendment put.
The Dáil divided: Tá, 71; Níl, 65.

  • Ahern, Dermot.
  • Ahern, Michael.
  • Andrews, David.
  • Barrett, Michael.
  • Brady, Gerard.
  • Brady, Vincent.
  • Brennan, Mattie.
  • Briscoe, Ben.
  • Browne, John (Wexford).
  • Burke, Raphael P.
  • Callely, Ivor.
  • Clohessy, Peadar.
  • Collins, Gerard.
  • Connolly, Ger.
  • Coughlan, Mary Theresa.
  • Cowen, Brian.
  • Cullimore, Séamus.
  • Daly, Brendan.
  • Davern, Noel.
  • Dempsey, Noel.
  • Dennehy, John.
  • de Valera, Síle.
  • Fahey, Frank.
  • Fahey, Jackie.
  • Fitzgerald, Liam Joseph.
  • Fitzpatrick, Dermot.
  • Flood, Chris.
  • Flynn, Pádraig.
  • Gallagher, Pat the Cope.
  • Geoghegan-Quinn, Máire.
  • Harney, Mary.
  • Haughey, Charles J.
  • Hillery, Brian.
  • Hilliard, Colm.
  • Hyland, Liam.
  • Jacob, Joe.
  • Kelly, Laurence.
  • Kenneally, Brendan.
  • Kirk, Séamus.
  • Kitt, Michael P.
  • Kitt, Tom.
  • Lawlor, Liam.
  • Leonard, Jimmy.
  • Martin, Micheál.
  • McCreevy, Charlie.
  • McDaid, Jim.
  • McEllistrim, Tom.
  • Molloy, Robert.
  • Morley, P.J.
  • Nolan, M.J.
  • Noonan, Michael J. (Limerick West).
  • O'Connell, John.
  • O'Dea, Willie.
  • O'Donoghue, John.
  • O'Hanlon, Rory.
  • O'Keeffe, Ned.
  • O'Kennedy, Michael.
  • O'Malley, Desmond.
  • O'Rourke, Mary.
  • O'Toole, Martin Joe.
  • Power, Seán.
  • Reynolds, Albert.
  • Roche, Dick.
  • Stafford, John.
  • Treacy, Noel.
  • Tunney, Jim.
  • Wallace, Dan.
  • Wallace, Mary.
  • Walsh, Joe.
  • Wilson, John P.
  • Wyse, Pearse.

Níl

  • Allen, Bernard.
  • Barnes, Monica.
  • Bell, Michael.
  • Bradford, Paul.
  • Browne, John (Carlow-Kikenny).
  • Bruton, John.
  • Creed, Michael.
  • Crowley, Frank.
  • Currie, Austin.
  • D'Arcy, Michael.
  • Deenihan, Jimmy.
  • De Rossa, Proinsias.
  • Doyle, Joe.
  • Dukes, Alan.
  • Durkan, Bernard.
  • Enright, Thomas W.
  • Farrelly, John V.
  • Fennell, Nuala.
  • Finucane, Michael.
  • FitzGerald, Garret.
  • Flaherty, Mary.
  • Flanagan, Charles.
  • Gregory, Tony.
  • Harte, Paddy.
  • Higgins, Jim.
  • Higgins, Michael D.
  • Hogan, Philip.
  • Howlin, Brendan.
  • Kavanagh, Liam.
  • Kemmy, Jim.
  • Lee, Pat.
  • Lowry, Michael.
  • McCartan, Pat.
  • Bruton, Richard.
  • Byrne, Eric.
  • Carey, Donal.
  • Connaughton, Paul.
  • Cosgrave, Michael Joe.
  • Cotter, Bill.
  • McCormack, Pádraic.
  • McGahon, Brendan.
  • McGinley, Dinny.
  • Mac Giolla, Tomás.
  • McGrath, Paul.
  • Moynihan, Michael.
  • Nealon, Ted.
  • Noonan, Michael. (Limerick East).
  • O'Keeffe, Jim.
  • O'Shea, Brian.
  • O'Sullivan, Toddy.
  • O'Sullivan, Gerry.
  • Owen, Nora.
  • Pattison, Séamus.
  • Quinn, Ruairí.
  • Rabbitte, Pat.
  • Reynolds, Gerry.
  • Ryan, Seán.
  • Shatter, Alan.
  • Sheehan, Patrick J.
  • Sherlock, Joe.
  • Spring, Dick.
  • Stagg, Emmet.
  • Taylor, Mervyn.
  • Taylor-Quinn, Madeleine.
  • Yates, Ivan.
Tellers: Tá, Deputies V. Brady and Clohessy; Níl, Deputies J. Higgins and Browne(Carlow-Kilkenny).
Amendment declared carried.
Question, "That the motion, as amended", so put and agreed to.
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