In the few minutes during which I spoke on the Bill last night, I had commenced dealing with the difficulty experienced by local authorities in recruiting technical staff. I pointed out that one of the reasons for this was because of the salary scale of officers with particular reference to engineers and architects. There is also the competition which local authorities have to face from industry and commerce in general.
Any competent engineer or architect will choose the private sector rather than the local government sector because of the salary differential. Representations have been made to the Minister for Local Government to bring the salaries of engineers, architects and technical officers up to a level that would enable the local authorities to compete for their services with the private sector.
Before the House rose last night I was dealing with this matter of the large turnover in technical staff because of the methods of the appointments commission in allocating certain marks for experience. Some of these commissions insist on trying to get the best man for the job and take into account the different local authorities that those people have been in. That leads to the position where an engineer—I use the engineering profession as a prototype of what I am speaking—who comes into a local authority on a certain scale will first of all have to get to know the district and the various jobs involved in that district. It will take him from three to six months to familiarise himself with these aspects before he is au fait with the engineering running of the local authority. During that time he sees advertisements for other jobs that may give him a higher salary but even if they do not offer a higher salary, they would enhance his chances before the appointments commission if he moves out. This is a slight defect in the appointments commission. Large local authorities may be slightly at fault in that they do not move technical officers into other types of jobs within their profession.
I should like the Minister for Local Government to take note of this because the problem is becoming very serious for local authorities, at least in the two with which I am associated and, I am sure, other Senators also have this experience. Sometimes they are engineers, assistant engineers or engineers junior to them. The prolonged vacancies are there and they stand to be filled. It is a recurring problem to local authorities today and it is a serious problem. Somebody may say that it would be wrong to pay them more in comparison with other employees of local authorities. In the long run it is cheaper because it accelerates for instance the installation of roads and the development of housing sites if you have got proper experienced staff and staff who have been with the particular local authority for some time. That is one point I wish to make.
I should like, having done that, to go on to an issue which also affects local authorities. I want to advert here to the dispute which is current at the present time between the Irish Medical Union and another party. Different people have different views as to who that party is. Some people maintain the dispute is with the Minister for Health, some people say it is with the local manager and some people say it is with the Managers' Association. This has been going on for some time and it has resulted in an impasse. The impasse itself might not be so serious but it has been reflected in the general public not so much in the populous areas but in the other areas, if I might use the term, the more thinly populated areas, of this country.
The union have instructed their members not to take up locums for a medical officer who might be ill. He can do that and I will explain it later. That is the broad statement and I will explain it also. This of course may be, could be and has been injurious to the general public.
In order to put the situation in some perspective I want to refer to some circulars from the Irish Medical Union. This matter actually came up, I should explain, under their request for getting time off from their duties, weekends, half days and days. That is being done at the moment of course by an arrangement with nearby doctors and doctors in neighbouring dispensaries or in neighbouring practices. The Irish Medical Union wanted this to be on a stronger basis. They wanted it to be recognised by the responsible authority, be he the Minister, the Department, the manager or the Managers' Association. In view of that they tried to initiate negotiations as far back as 29th March, 1967, in a letter to the Department of Health. They pointed out the various grades of medical officers and stated that there should be adequate and recognised time off from official duties.
Considerable correspondence followed and the Department said the question of time off should be raised in the first instance with the county managers in particular cases or with the County Managers' Association. Some county managers were approached by us. Their circular states that while not unsympathetic to the claim, they indicated the question should be raised at national level through the Managers' Association. The claim was referred by us to the Managers' Association on the 16th September and following various reminders from us the association replied on the 16th February, 1968, suggesting we should take the matter up with any health authority where the existing arrangements are not considered satisfactory.
This went on further and the attention of the association was drawn to the fact that certain county managers had been approached. They indicated to us they wished the matter to be dealt with by the association. The association, that is the County Managers' Association, replied in July, 1968, stating: "It was decided the Association's previous decision in this matter should be confirmed." I do not want to bore you too much with dates but it is necessary that I show where this matter started.
The meeting with the Minister and his officials took place on the 4th December, 1968 and following prolonged discussion the Minister stated he had every sympathy with the claim, that he accepted the principle of the claim and that he would approach the Government for the funds necessary to meet the claim. Following much correspondence we again met the Minister on the 30th June, 1969 and pointed out that our claim had still not been met. The Minister stated he already accepted the principle of the claim and that he would not go back on his word. He agreed to endeavour to arrange a meeting with the Managers' Association on the subject.
Shortly after that there was a change of Ministers and Deputy Childers became Minister for Health. We promptly informed him of the history of our claim. A meeting between the union delegates, that is the Medical Union, and a representative of the Managers' Association took place on 17th July, 1969, as a result of Ministerial intervention. The managerial representative stated that if the Minister were prepared to subvent completely the cost of local payment, the Managers' Association would consider operating a local scheme but that managers are not prepared to approach their councils to seek the necessary funds to meet the cost of local payments and that as our claim involved additional expenditure it could not be considered. As a result of that, certain actions were taken by the council and this is what I adverted to at the opening of my statement on this item.
The council have now directed that a union member should not undertake a local authority locum in the event of the absence through illness of a district medical officer. This is the serious position. They also state:
The council have directed me to inform all members of the union of this. The direction is limited for the present to the locums acting for DMOs, district medical officers, during illness. It is not the intention that there should be any withholding of essential medical services in any dispensary area but it is the intention that medical services should not be provided through the dispensary system. In the event of absence through illness of a dispensary medical officer, local arrangements on a private practice basis should be made in the ordinary way and the doctor undertaking the locum should deal with all patients on a sick doctor and on a private practice basis. The local doctor should make the position clear to dispensary patients who require his services. Persons unable to pay for services must be treated in accordance with the traditions of the profession. Some public patients will be unable to pay anything, others can well afford to pay something. No one must be left without attention.
Complaints reached our party through various centres and Deputies about crises that arose on foot of various things like this or the misinterpretation of that direction from the Medical Union. We have a sub-committee which deals with health among other things. At a meeting of that committee it was decided to ask the representatives of the Irish Medical Union and the Irish Medical Association to meet the sub-committee. These two gentlemen met the health sub-committee of the Fine Gael Party on 26th November last. We heard their views and we decided that this matter should be aired and that there had been undue delay in bringing the two sides of this dispute together, whether it is the Minister, his Department, an individual manager or the Managers' Association who are at fault. The Minister for Health, in my view, has power to direct a meeting to be called. I do not want to infer that I am taking sides in this dispute. I want that made very clear. The point I am trying to bring out is the delay in getting negotiations commenced. This has been going on between the Minister and his Department and individual managers and the Managers' Association and nobody has started negotiations on any basis whatever and the ordinary public are the sufferers.
The claim of the medical officers through their unions is for every second week-end off, one half-day off per week and one evening off per week. They say:
Our claim, if met, would result in our members concerned being on duty for over 100 hours per week.
I have not calculated this. I am quoting from this document. Most Senators will have seen this document and know what it contains. I presume it is correct. Even if the claim is met for the time off they will still be working 100 hours per week. If this is so I consider that this is a reasonable claim. This brings us to the method of financing time off.
Up to this it was the custom that a doctor himself arranged to have somebody take up duty in his place when he needed time off to go to the races, play golf or dig his garden. Those who are not married may find some other method of spending their time. He defrayed the expenses of providing this locum. They want to put this on a footing which I think is probably correct. They want it recognised that they are due their time off, that it is a right of theirs to have time off and that locums should be appointed by the manager and paid either through local taxation or central taxation. When we met these people we asked them what their estimate was of the cost of providing this. They gave us a figure of approximately £350,000 but said that the Minister—that was the previous Minister—estimated that the cost would be approximately £½ million. Finance is one aspect of the difficulty but I do not think it is a great difficulty considering that they still would have to work 100 hours per week. Whether it costs £350,000 or £½ million to give these people some freedom to enjoy their recreation it is well worth it.
Another difficulty that arises is that in certain under-populated areas, especially along the west coast, it may not be possible to provide a locum. Even the manager may not be able to provide a locum although it is his function and duty to do so. Suggestions were made at a meeting we had and perhaps somebody would convey them to the Minister for Health. One was that for week-ends the Minister should allow assistant medical officers of health who only work five days a week until 5 o'clock approximately, to do week-end locum for the medical officers and to be paid for it, of course. Some of us made inquiries and found that assistant medical officers of health in general, perhaps not all of them, would be quite willing to do week-end locum.
Another suggestion made, which I would not consider quite so good, was to appoint a doctor in a large county like Galway, Mayo or Donegal who would rotate different week-ends to allow doctors to get the time off to which they would have a statutory right. I am not so sure that that would work out as well as it looks on paper but I would commend the first one and mention the second to the Minister to help find a solution to this problem. Many people on county and city councils would like to know whether the Managers' Association is a statutory negotiating body. That might tie in here to some extent. It can be answered in the reply to the debate.
I want to deal now with the subject of pollution in a very broad sense. Perhaps I should not advert to the pollution of the two Houses of the Oireachtas at the moment. It might not be taken too kindly if I made reference to that.