Dáil Éireann díospóireacht -
Thursday, 4 Nov 1943

Vol. 91 No. 12

Supplementary Estimate. - Vote 44—National Health Insurance.

Mr. MacEntee

I move:—

Go ndeontar suim ná raghaidh thar £77,687 chun slánuithe na suime is gá chun ioctha an Mhuirir a thiocfaidh chun bheith iníoctha i rith na bliana dar críoch an 31adh lá de Mhárta, 1944, chun Tuarastail agus Costaisí i dtaobh na nAchtanna um Arachas Sláinte Náisiúnta, 1911 go 1942, agus na nAchtanna um Pinsin do Bhaintreacha agus do Dhilleachtaithe, 1935 go 1940, do Riaradh; chun Seirbhísí áirithe i dtaobh Liúntaisí Bídh (Acht Comhachta Práinne, 1939), agus chun Ilsintiúisí agus Ildeontaisí ar a n-áirmhítear Deontaisí áirithe i gCabhair alos Costais Sochar agus Costaisí Riaracháin fé na hAchtanna um Arachas Sláinte Náisiúnta.

That a sum, not exceeding £77,687, be granted to complete the sum necessary to defray the Charge which will come in course of payment during the year ending the 31st day of March, 1944, for Salaries and Expenses in connection with the Administration of the National Health Insurance Acts, 1911 to 1942, and the Widows' and Orphans' Pensions Acts, 1935 to 1940; for certain services in connection with Food Allowances (Emergency Powers Act, 1939), and for sundry Contributions and Grants, including certain Grants-in-Aid in respect of the cost of Benefits and Expenses of Administration under the National Health Insurance Acts.

Mr. Norton

During the past 12 months, because of the alteration in the basis of ascertaining the actuarial solvency of the fund, additional sums of money were made available, in the form of additional benefits, and these additional benefits made some contribution towards relieving the plight of afflicted persons who, owing to illness, had occasion to abandon their employment temporarily. I do not know if anybody can pretend that our present National Health Insurance code is satisfactory or in any way comprehensive. At best it is piece meal while the financial benefits made available to sick persons are very far from satisfactory. The House will be aware of the fact that men in employment who earn £3 10s. 0d. or £4 0s. 0d. a week on being stricken by illness have then to depend on 15/- weekly National Health Insurance benefit. They receive no additional allowance in respect of wives or families. If there is one child or six children 15/- is the maximum sum allowed under the Act. That is all that is allowed whether a man normally earns £1 or £4. It is generally agreed in cases of illness that the liability of sick persons is increased considerably. I should like a statement from the Minister as to whether the Department has under consideration any proposals for examining the whole financial and benefit structure of the National Health Insurance Act, with a view to evolving a scheme much more related to the financial needs of workers stricken by illness. I know that the scheme is one which requires a fairly comprehensive examination, but it is an examination which ought to take place without undue delay, and I should like to hear from the Minister whether his Department has any proposals for proceeding with an examination of that kind.

Mr. MacEntee

As Deputy Norton himself has informed the House, it was only quite recently that the finances of the National Health. Insurance Society were the subject of an exhaustive review and examination by an actuary, and subsequently by the Department, and the House, in 1941, passed legislation which set free a considerable sum of money for the provision of new benefits. The committee of management of the society could have applied that money to other purposes than those to which they chose to apply it. A number of heads were laid down and they, as acting on behalf of the members of the society, decided to apply it in a certain way. We have agreed that the money shall be applied in that way, and I do not think it is practicable at this stage to have any review of the existing insurance code.

Mr. Norton rose.

An Ceann Comhairle

A question, Deputy?

Mr. Norton

A question, Sir. Does the Minister realise that a payment of 15/- per week to a person suffering, for instance, from tuberculosis is an inadequate payment? There is no use in telling a person suffering from tuberculosis that if his eyesight were bad, he would get glasses, or that, if his teeth were bad, they would be extracted. He has no toothache and has not got bad sight. He has infection of both lungs, and what he is concerned to know is how much he will get if he is stricken with tuberculosis, and not what he will get if he happens to have toothache.

An Ceann Comhairle

An involved question.

Mr. Norton

I agree, but it is an involved scheme of national health insurance, because it is neither national nor healthy. Would the Minister take into consideration the fact that the main problem in the matter is the provision of some substantial weekly allowance for a sick person? That problem has not been dealt with by the society or by the Department.

Mr. MacEntee

I am aware that this is an insurance society, that the benefits must be related to the premiums paid, and that the committee of management numbers among its members representatives of the workers and insured persons and they have not put forward that suggestion.

Mr. Norton

You broke the heart of the committee of management with your delay.

Question put and agreed to.

The Dáil adjourned at 8.55 p.m. until 3 p.m. on Tuesday, November 9th.