I think that Deputy Mulcahy has been wasting the time of the House by his long contribution. I do not think many could understand what he was talking about. His idea was to delay the passage of the legislation. I do not propose to press the amendment this morning or later, but I intend to press the intention behind it as long as I am here in the Dáil—for five or ten years or whatever it may be. I would say to Deputy Esmonde that I was very careful to choose my words meticulously in moving the amendment, pointing out that I did not want to upset in any radical way the existing voluntary system. In reply to Deputy Mulcahy, I was particularly careful to say that I did not intend that there should be established statutory boards on the lines of C.I.E. or the G.N.R. I mentioned them merely to show that it is the accepted practice when you are giving a lot of money to a company to see that the representatives of the people have some say in the spending of it and know where it goes. That is perfectly reasonable if we accept our responsibilities as Deputies in a democratic Parliament.
As to the extension of State control, I did not suggest we should have State control of the voluntary hospitals. I suggested that we should have an increase in the democratic control. I was very pleased to hear Deputy McGrath say it exists in the City of Cork, where many Deputies, either as members of local this House or as members of local authorities, have right of access to these boards. The City of Cork seems to be in advance of us here in Dublin in that regard.
I do not think any of the orders who run hospitals in Cork or any of the doctors there are in any way encroached upon by the State—I have had no complaints to that effect—by virtue of these public representatives being on the boards of those institutions. I honestly do not think the average voluntary board in Dublin—lay board, at any rate—would resent very much the inclusion of a public representative, a nominee of the Minister, whether he is a Deputy or a county councillor, possibly because he is anexpert in some particular aspect of public administration. One very prominent member of a voluntary board recently suggested that it would be a good idea if the Government did send along someone to see how the work was done and what work was done. I do not wish to press it on this occasion. I was anxious that a certain view should be made known, I had the right to express my views and did not expect everyone to agree with them enthusiastically. They were reviewed on their merits and I was prepared to hear reasonable arguments made against the case I put up.
The Minister replied most effectively, I thought, to the suggestion that the sweepstake moneys have been misappropriated. This charge has been made elsewhere against myself as well as the Fianna Fáil Government. I think that the refutation, to the effect that 75 per cent. of the money spent has gone to the voluntary hospitals rather than to the State hospitals, was an adequate one. In relation to the stamp money, 25 per cent., I might say I objected to that going to the Department of Finance. Formerly, when I was Minister, I suggested that it was unfair. I may be wrong in that, but that was my view. I felt that it should go to the hospitals—whether voluntary or State did not matter, as it was the sick people we are trying to cure that I was primarily interested in. That suggestion was turned down by Deputy McGilligan as Minister for Finance and in consequence the money continued to flow to the Department of Finance.
Deputy Esmonde referred to the cost of sickness. I am afraid we all differ on the force of that particular argument and on what sickness costs. Personally, I do not know of a limit that I would put, either for myself, for my own family, as a Deputy, as a public representative, or as a Minister, to the money that I would make available or wish was made available to any citizen of the State, rich or poor, adult or child, for the restoration of his health or the saving of his life. I concede to Deputy Esmonde that money shouldnot be misused or misspent, that maladministration should be reduced to the minimum; but it is not a good argument to place on one side the hospitals that spend much money and on the other side those that do not spend so much. The Minister replied even more effectively by showing, as was my own experience, that the most expensively run hospital in Dublin is a voluntary one. I do not know whether the cheapest is a State hospital, but the Minister says it is and I accept that. I would not be terribly impressed by the expenditure argument in relation to health costs.
I was asked if I would be in favour of raising the rates to increase the expenditure in St. Kevin's or St. Mary's. If it were necessary in order to improve the health of people or to save life, I would be quite prepared to stand over the raising of the rates or an increase in taxation. My attitude to these matters is that the community is responsible to the weaker sections, the poor, the aged and the sick; that from the community purse funds should be made available to the extent required, no matter how heavy that burden may be, and that we should readily accept that burden, reducing to the minimum the unnecessary expenditure and administrative costs. The community is responsible for health services for the aged and so on and the dominating practice should be that whatever resources the community has will be redistributed so as to give every boy and girl, every young man and woman, exactly the same opportunities in this aspect of the social life of the community.
I repeat that I would not wish to interfere with the truly magnificent work which religious orders have done for so long in voluntary and State hospitals, particularly, as I said last night, in our very ill-equipped county homes, where they do probably the best work. My main point is that I would like representatives of the public to be on these boards.
At the moment, certainly in the non-community or the non-religious hospitals, the tradition of appointment on these boards has led to the appointment,in the City of Dublin at any rate, of people who belong to a particular section of society. I have no objection whatever to these people being members of boards or governors of boards of hospitals but I do not see why we also, the public representatives, the public patients in the ward, the patient in the public bed in the hospital, should not have right of access in so far as he may want to make a formal complaint and see that something is done about a particular matter.
When I was Minister for Health there were occasions when I was written to to inquire about matters where people were dissatisfied, whether it was in regard to service, bad food, bad treatment, ill manners—whatever it may be. I am not suggesting that these complaints were very frequent. I am merely suggesting that these complaints were there and, although as Deputy Cowan pointed out last night, I, as a representative of the people for the time being, was paying a lot of money for the running of these hospitals, I had absolutely no functions whatever, I had no right of inquiry beyond the right of a private citizen. Many of the voluntary hospitals to whom I wrote at that time making inquiries replied in a most courteous and a most helpful way. Some of them saw fit to point out in an abrupt way that I had no functions in the matter and that there was nothing I could do in relation to a particular incident that occurred.
However, we will have an opportunity again of raising this matter, I hope, on another occasion. Gradually I think we will be able to persuade people that we are not seeking anything which is outrageous or revolutionary and that we are not asking to have any really fundamental change in the organisation and running of these institutions, that we are merely asking that there should be a greater degree of democratic control—democratic in the real sense of the word.
I can understand Deputy Mulcahy's attitude. He has grown up and lived with these institutions and has become particularly attached to them, I haveno doubt, over the years, but he must accept that our generation are now gradually beginning to impose ourselves and to be anxious to impose our will and our wish on the form which our society will take. He must also understand that no society can remain static or fossilised or ossified—such a society would be a dead society—and that anything that these institutions, for which we have all great regard and great respect, can do in order to increase their efficiency—efficiency can be the only consideration that must weigh with us—and to increase their value to our patients, the people for whom we are paying, the sick people for whom we are providing these services, and to give better service to our people is just fine as long as it does not conflict with any of the fundamentals, the natural law or the moral law.
A point has been made by Deputy MacCarthy and Deputy McGrath. I do not wish Deputy MacCarthy to feel that I am bringing him into my rather more advanced views, possibly, than his, but he did mention the fact that these practices are accepted in the City of Cork. In consequence I do not think there can be any suggestion that they are as advanced or as dangerous as Deputy Mulcahy seems to imply.
I do not think that Deputy Dr. Esmonde was serious when he suggested that Deputy Cowan thought the inspector could protect the patient from getting a wrong operation. Deputy Cowan's suggestion was that, if there was an operation carried out which the patient thought was a wrong operation, the inspector would have the right of inquiry and the question could be pursued to the patient's satisfaction.
The points which I wish to raise in relation to it, I hope to raise again on as many occasions as present themselves. Eventually I hope to be able to persuade the House that I am not proposing anything which is unduly revolutionary or which will conflict with the best interests of these fine institutions but something which will merely increase their efficiency and therebyincrease the already high prestige in which they stand with the citizens.