We have now come to the end of the debate which commenced yesterday and in which many Deputies took part. I think anyone who has listened to this debate or who has followed what has been said by Opposition Deputies must come to the conclusion that they have contributed very little to the solution of this Parliament's problem, which is my particular obligation—the provision of proper health services for the people of this country.
I came in here yesterday with a Bill. I put it before the House in as fair a manner as I could. I asked for goodwill; I asked for co-operation; I asked for understanding, and I asked for help from the Deputies elected to this Parliament representing the people of this country and, instead of getting that goodwill or co-operation or help from the Fianna Fáil Opposition, I have had to listen to, and see, for the past two days a political game being played by experienced players.
I do not say that every Deputy of the Opposition who has spoken was indulging in politics. "Briseann an duthchas tré shúilibh an chait," and the innate decency of some Deputies of Fianna Fáil made their approach to this measure what I would expect of a proper public representative. But they were in the minority. The majority of the Deputies opposite once they got to their feet forgot completely about the sick and needy in this country and were prepared merely to score political points off either my colleagues in the Labour Party, or of my own Party, or other Parties supporting this Government. I hope they enjoyed themselves and I hope it gave them some pleasure to add further to the confusion and acrimony that has surrounded the provision of decent health services for the people of this country, because that is the only pleasure they are going to get.
I think it is fair to say that some things have emerged clearly from this debate. I think first of all it is fair to say that from this debate it is clearly established that the case made by me as a member of the Government in proposing this Bill to the Dáil has not been answered even in the slightest by any Deputy from the Opposition. I told the Dáil that the Health Act, 1953, conferred on better-off sections of the community equal rights with the sick poor and the insured workers without the provision of the necessary extra facilities for those added classes. Has any Deputy in the Opposition attempted to deny that? Has there been any shifting of the onus that I believe was placed by the case made for this Bill? Is it not true now as it was when this debate started that unless this Dáil intervenes on August 1st next the distressed people in our community, who total one-third of our population, instead of having prior rights to existing hospital accommodation are going to be forced to take their place in a queue comprised of three added classes? That fact is still a fact and cannot be controverted.
Secondly, I said in opening this debate that prior to August 1st, when the Health Act will come into operation, every poor person in this country has a statutory right—I hope Deputies realise what that means—to get prior treatment in any hospital in this country. That is enshrined in the Public Assistance Act, 1939. It cannot be denied to any poor person who is sick and in need of hospital treatment. The right is there enshrined in the statutes of this Parliament. At the same time, as a result of the contracts and agreements worked out by the Department of Social Welfare, insured workers enjoy also an equal priority right. On August 1st, the Public Assistance Act, 1939, is repealed, torn up, gone away. The charter of the poor disappears and what is given to them instead?—an assurance that they may rub shoulders with every farmer whose valuation does not exceed £50, with every person whose income does not exceed £600, and with everyone else who can prove a bit of hardship in paying hospital bills, and instead of having the prior rights that their circumstances in ordinary Christian decency should dictate, they take their place in a queue comprising a number of added people. Again, that fact has not been controverted or denied. Concealed, of course, it has been, in a web of words spun by different Deputies over there, but the fact still remains that under this legislation, unless we take steps to prevent it, the poor people, instead of being at the head of the queue, will take their place at the end.
Thirdly, I said in opening this debate that every local authority hospital and every voluntary hospital in this country—all our hospitals—are at the moment taxed to capacity in providing for the sick poor and for the insured classes the necessary hospital facilities that their sickness or conditions require. Has that been controverted? Any Deputy who spoke or contributed here either avoided what I said about hospital accommodation, or throughout his speech had to concede that the facts were as I stated.
I said, fourthly, that as a result of these facts and without any argument from me—because facts are the best arguments—with limited hospital accommodation barely able to provide for existing classes, if those classes are added to with the statutory right given to added people to demand hospital accommodation which is not there, someone is going to suffer. It may be a matter that will give some satisfaction to legislators and planners and schemers in this Dáil to put down in black and white on a page in our Statute Books a statutory right that a person who is sick and in need of hospital accommodation can go to a local authority and demand that accommodation.
That may be a source of pleasure to some people, but it is a heartless thing to do to those who expect that an Irish law enacted by an Irish Parliament means something.
As I said yesterday, in promising that by our statutes we were doing something which we were unable to fulfil, we were sponsoring hopes amongest certain needs people of this country, hopes that were bound to be dashed. I think it fair to say, as I said yesterday—and nothing said in this debate has in any way vitiated the conclusion at which the facts must lead everyone to arrive—that someone must suffer if the Health Act of 1953 is not amended in the slight particular I have proposed in this House. As I have said, there was an amazing effort, by Deputies in the Fianna Fáil Party who spoke, to avoid dealing with the hard and unpleasant facts which I placed before the Dáil. Instead, in a side-stepping sort of manner, we had a great number of irrelevant matters drawn into this debate. I am not going to deal with all of these irrelevancies; with some of them I shall deal. Perhaps if I take them in the order in which Deputies spoke in the debate it might be the best way to deal with them.
Deputy Dr. Ryan led off for the Opposition and naturally, being more or less on the defensive, although I was not concerned at that time to be unduly hard on Deputy Dr. Ryan, he felt that some explanation was expected from him because of the appalling situation that his action or inaction had allowed to develop.
He, first of all, denied what he took from my opening statement—that he had no discussions with those whose services would be required to provide the facilities set out in the Health Act of 1953. Of course, Deputy Dr. Ryan had discussions with the doctors. We all know that. We all know also that those discussions led nowhere and that agreement had not been reached. In fact, the last time Deputy Dr. Ryan met the doctors was away back on the 12th January of this year. He never met them after that, never discussed with them the making of the regulations which brought on the situation I have discussed. He met them on the 12th January but not since.
Of course, the voluntary hospitals were informed of what was proposed. They got a circular sent out to each one of them. Some officers of the Department went along to them but no effort, good, bad or indifferent—these are the words I used yesterday and I repeat them now at the end of this debate—was made by my predecessor to get the representatives of the voluntary hospitals together and to try to get an agreement with them as to the terms and the conditions on which they would provide the essential services required for the operation of the Health Act. My predecessor never met the nurses. The nurses are an important organisation to provide the necessary services under the Health Act, 1953. He did not meet them and, in fact, the nurses' organisation and allied bodies are extremely concerned at the fact that regulations have been made affecting their interests without their views, their comments or their recommendations being considered. My predecessor never met the dentists. It is true that a particular meeting was arranged but it did not take place, due to no fault, I hasten to add, of my predecessor. In fact, he did not meet the representatives of the dental profession.
This morning every Deputy will have received a communication which I may assure the Fianna Fáil Party I did not write—a communication from the chemists' organisation in which they write, I assume, to every Deputy and certainly to me:—
"Our organisation, representative of Irish chemists, regards with dismay the proposed regulations which have been issued under the present and previous Health Acts. The ultimate aim of these proposed regulations is the establishment of dispensaries, clinics, and various hospital centres throughout the country, through which every section of the community is to be supplied with all medicines and surgical and medical requirements. The regulations are a directive to abolish our profession and the retail business of over 1,000 chemists."
That may be right or wrong—I do not know—but there is a protest and an objection raised again by a body of persons whose services must be availed of by me, or by whoever from time to time may be charged with the administration of these necessary services. Again, there is the situation now obtaining in relation to that important body.
I am trying to be as fair as I can, but I realise that I am only human and patience is limited, and I feel entitled to ask this of my predecessor. If he did not get agreement with the doctors—apparently, according to the contributions of Fianna Fáil to this debate, it is a bad thing to agree with the doctors, but leave that aside—if he did not get agreement with the dentists, the nurses, the chemists or the hospitals, who was going to work this Health Act? Who was going to provide the services? Were operations to be done by carpenters, by cobblers, by policemen, by Guards or by county managers? Who was supposed to provide the services promised by our legislation for the sick, the needy, the distressed, the hopeless cases and the afflicted in this country? Who was playing politics? Would it be fair to ask what sense of responsibility permitted any Minister in that situation to stand idly by doing nothing—I have no doubt whistling to keep his courage up, believing in the same way as travelling actors always believe, that "although things look bad now, everything will be well to-night." That is a fair question to ask, but no answer to it has been given in this debate.
I am afraid the picture on examination became much worse. In relation to these fundamental matters, the inaction—that is the best word and it is apt in this connection—on my predecessor's part was not of short duration. The Second Reading of the Health Bill 1953 took place in February 1953 and the Bill was eventually passed in October of that year. From October until March no regulations had been made. The Health Council had not been formed, no agreements had been arrived at, but everything was going along smoothly. From time to time, if a public statement had to be made, my predecessor was in the habit of saying: "Oh, well we hope to have the health services on April 1st or as near thereafter as makes no difference". He went on in that sort of way, promising, promising, promising health services but doing nothing until the former Taoiseach announced on 6th March, 1954, that a general election would take place and that the Dáil would be dissolved. Then the lethargy disappeared, the inactivity was thrown to one side, and my predecessor became a bundle of energy, a dynamic force in the Custom House.
On the 22nd March, as I said in opening, a memorandum was suddenly submitted to the Government. The provision of health services had become a matter of urgency for the people of this country. On the 31st March commencement Order was made bringing this Health Act into operation without any preparation, any proper examination—bringing it into operation on August 1st. On the following day the National Health Council was formed.
A few days later, seven sets of regulations were thrown at them and they were told to examine them and give them back to the Minister by the 5th May. On the 15th May, three days before polling, these regulations were made by my predecessor and were published in the daily Press so that every person in this land who went to vote on the 18th May would vote with the assurance on paper that on August 1st if they were sick, distressed or afflicted with any disease or malady, hospitals were there for them, surgeons were there for them, doctors and nurses were there for them. I call that irresponsibility of a high degree. I call that doing a very serious disservice to the people of this country.
I have no doubt that the making of that commencement Order and the issuing and publication of these regulations were intended to constitute an appalling political trick on the man who might succeed my predecessor. I do not in the slightest belittle the acumen, in terms of politics, of the brain that devised this particular episode. As I said to the House yesterday it was not any source of pleasure to me, to this Government, or to any Party supporting this Government to have to come into this Dáil with another Health Bill, to suffer the odium of the jeers and sneers of the Fianna Fáil Opposition. But we have done it because we are a responsible Government; we have done it because we are concerned to see that our people will not suffer, that our poor will not be made pawns in the political game. We have done it because we believe that no matter what the price may be, doing the right thing will be always recognised by our people as best in the long run.
Deputy Dr. Ryan blew a fanfare at Lower Mount Street, Dublin, the other night before this debate started. He got together a meeting of a Fianna Fáil cumann and he made a speech. Just listen to what he said. The heading to the report of the speech in one of the newspapers supporting the Deputy's Party was as follows:—"New Bill Designed to put Health Act in Cold Storage." Here is what Deputy Dr. Ryan said:—
"When the Act was going through the Dáil last year Fine Gael used every conceivable argument against it, and among them was one from the present Minister for Health, Mr. O'Higgins, who said that the Government had no intention of implementing the Act, but was forcing it through the Dáil for political reasons. I replied that it was proposed to bring the Act into operation on April 1st, 1954. We were again accused in the Seanad of having no intention of implementing the Bill, and I reiterated the intention of bringing it into operation on April 1st. When April 1st was approaching, and when I saw that it was not possible to operate the Act on that date, I discussed the position with the Department, whose officers were in a position to give an informed and objective opinion, and I was advised that it would be quite feasible to operate the main portions of the Act on July 1st. With my usual caution, I decided to allow another month, and made the necessary Order to bring the Act into operation on August 1st."
I direct the attention of the House to this sentence: "When April 1st was approaching and when I saw that it was not possible to operate the Act on that date..." I would have expected the Deputy who made that speech to have been able to tell the House what happened after April 1st to make the services under this Act more operable than they were on April 1st. Did anything take place in this country to make it possible to provide, on August 1st, what Deputy Dr. Ryan said could not be provided on April 1st? We all know nothing— except the general election. That is the only new factor, the only new thing, that cropped up or emerged in the situation—nothing except a general election. I charge that, for purposes of that election and for those purposes only, my predecessor made this commencement Order, published these regulations, scrambled the egg, threw it at the public and sat back to see what would happen. I am sure that he may regard that as being smart politics.