I am sorry there has not been a bigger debate on this Department because it is responsible for the expenditure of a vast amount of money. It is more or less a new Department in which there are many snags to be overcome. I know the Minister would like a full dress debate so that points could be clarified to help him improve the Health Act. Much has been said for and against the Health Act. I agree with the provision of reasonable health services, good hospitals and medical attention, but I would not like to go too far. What we want is a living wage. If we had that, we would not need half the health services we have. If we go on as we are and go for a free-for-all, we will wind up as a Socialist State and will not be one bit happy.
I hope the Minister will spend the money at his disposal wisely and well, and that he will think twice before he spends any of it. I hope that he will not be led along by cranks or faddists to go in for more than we can afford. This is a Christian country and we should have more voluntary schemes without having to rely on the State for everything. I should like to see money spent on the school medical services. If we could spend far more money on that, we would be doing good because we want the future generation to have good health.
More money should be spent on educating our people not to be making such fools of themselves smoking and drinking, spending all their wages, finding themselves in bad health and leaving their children with a poor outlook on life. People should be more strict in their diet. A vast number drink and smoke far more than they should. That is why our hospitals are packed out with people who should not be there at all. The public should be made to realise that they can do far more for themselves than the State can do and it will cost them very little. The drink and tobacco bill in this country is colossal. It is the principal cause of ruin in our homes and of filling our hospitals with sick and delicate people.
The Health Act requires careful review month after month. I know the Minister will give it serious review. I have confidence that he will see to it the money is spent wisely and will reject any highfalutin nonsense put up to him. We cannot afford that. The Health Act is costing £16 million or £17 million, a colossal amount of money. It is the biggest burden on the rates. It is a bone of contention at the annual rate review. The cost of the Health Act is increasing and the local authorities cannot give the service because they are bound by statute to pay for the Health Act. The bill is too big. I would ask the Minister to consider means by which the cost of the Act could be undertaken by the State so that county councils will not have to bear huge expense year after year.
The voluntary health insurance scheme is an immense success. I would ask the Minister to widen its scope as quickly as possible. It is good for the people and is not a tax on the community. The lower income group should be brought within its scope. It could embrace far more people. Big industries should follow the example of Guinness and operate their own health schemes so as to relieve the ratepayers. Large industries that give permanent employment to people over a long number of years should have their own health services and should not be a burden on the community.
I am glad that T.B. is being controlled and is more or less eradicated. That is the result of more than hospitalisation. The money spent in providing good housing over a long number of years has done as much as hospitals in the eradication of T.B. There is also the fact that people are better fed now than they were. As this result has been obtained, hospitals have become superfluous. That may be the fault of nobody, but I would suggest that there should be wiser planning. On the road from Dublin to Kilcock there is a beautiful building that cost over £1,000,000, lying empty, with grass growing to the doors. The Department are concerned about what to do with it. There should have been better planning. Projects that cost millions of pounds should not be rushed. The people's money is involved and it should be spent wisely and well. It was not foreseen that T.B. would be controlled at such an early stage but, at the same time, there is waste of public money. It is a matter of bookkeeping. If ordinary business people were to do that sort of thing, it would not be long until they would be in liquidation. I would ask the Minister to keep a constant check on the administration of the Health Act so as to provide good service for the people.
At present, hospitals are full because of the operation of the Health Act. Doctors are sending patients to hospital whether they want to go or not. Half of these people could be attended to at home. It is wrong to have minor ailments treated in hospital for two or three weeks while beds may be needed for other patients requiring hospitalisation. A vast amount of money is spent on medicine bottles and pill boxes. If a patient is given a bottle of medicine at a dispensary and he does not like the taste of it he will throw it over the ditch. There could be a tightening up in regard to these matters. Medicine bottles should be returned to the dispensary. The Minister should issue a circular to the medical officers of health to see that bottles are returned. Many people go to the dispensary when they have only a slight cold. A great deal of unnecessary expense is incurred.
Reference has been made to the question of county homes. I do not believe that a vast amount of money should be spent on county homes as they are today. Deputy Dillon's is the right idea, that we should build a county home for three or four parishes that would cater for the people of those parishes who have no one to look after them. In the county homes as we know them today there are three or four types of people. No matter what money is spent on them or what highfalutin name is given to them, they are still county homes. In them you will find the hoboes who drank all they ever had, sold their land, and scrounged their way into the county home, and are a nuisance to everyone there. You also have there the poor old wayfarers or tramps who are always with us and who do no harm to anybody.
There is a tendency on the part of young people nowadays to shelve responsibility and to send their aged parents, uncles or aunts to the county home because they are an incumbrance. That is a shocking state of affairs in a civilised country. I was brought up in the Christian way of life and if I were starving, I would see that my father and mother got the first bite and would never be forced to leave the home they built for themselves and their children. I would see to it that they would not be sent to the county home in order to make life happy for others. I heard Deputy Russell saying that the county home is the place for them, that they are a nuisance at home and are in the way of the young people. I could not believe that would come from a man who is a Christian gentleman. It is an appalling mentality. We ought to be proud to maintain our parents, our uncles and aunts, as long as possible. Even if they never got the old age pension or any other pension, we should glory in keeping them at home.
Old people are being sent to the county home. There are many people in county homes today who spent their lives building up lovely little homes but, when they became too old to be of service and the daughter or son got married and a child was coming, the in-laws began to growl and the poor old people were pushed out. I have seen old people in the county home crying for weeks, saying that there were grand beds and grand food in the county home but that they wanted to go back to the home which their parents had handed down to them. They cannot do it.
I would ask the Minister not to spend too much money on the present county homes. They are State institutions. A great deal of money has been spent on the county home in Meath but in the eyes of the people it remains a county home. It is not fair that wasters who drank all they ever had and who were suckers all their lives can go there and have a royal time and trample on people who are pushed into the county home. There should be segregation. I have nothing to say against the poor tramp of the road. He is a lovely old man. I would call him an old gentleman. Many of them were born with very little brains. They are handed down to us and, as Christians, we should be proud to help them. I would have a county home for them. The hoboes who drank all they ever had, who are good for nothing, who are a blight on the whole community, should be segregated from decent old people.
I would suggest that a home should be provided for every three or four parishes for decent, honest people who handed on to posterity all they had, who worked hard all their lives and, at the end of their days, had no one to look after them. They should have a home of their own, a nice place, a kindly place, where they can go back over the road once or twice a week to visit their old home. Money spent on such a scheme would be well and wisely spent. I would ask the Minister to see what can be done about providing county homes of that type. I do not want them built for the purpose of encouraging younger people to shelve their responsibility and to push the old people out. I would be afraid of that.
We are fast advancing to the stage of being a Socialist State, whether we like it or not. We will be a pagan race if we continue as we are. There are hundreds of things that people can do for themselves but they will not do them. There are men who fend for themselves and pay for themselves. There are others who spend half their lives trying to get something for nothing. The hospitals we have built at the cost of millions of pounds are to-day nothing but white elephants. The community have to pay the cost of the Health Act. It is a grand thing to read about and to see it put into operation. I spent a few months in hospital. I was not long there until I discovered it would cost me a few hundred pounds. I was proud to pay it because I found myself in a position to do so. I would rather pay it than have the State do so.
The Minister is wise. He sees what is going on. He has seen the efforts made to make an almost socialist State of this country of ours. He should look closely at the Health Act and see where he can prune and cut out the extravagance. There is plenty of waste and extravagance in it. That is not the Minister's fault. Act after Act was passed in this House and you had one side of the House trying to outdo the other, vying with each other as to who would be first with new legislation so that we would be as good as mother England—a vast Empire which can afford those things.
We cannot do it. What we want are decent well-run hospitals with good staffs. The people should realise that they have a responsibility to do a good deal for themselves. Half the people in hospitals are there because they drink too much, smoke too much and gamble too much and they have not sufficient money left to provide themselves with the necessaries of life. The people should be educated how to live, keep healthy and happy. They should be educated how to spend the weekly wage properly. If they knew how to do that, we would not have half the misery we have in this country. This country should be one of the grandest countries on the face of God's earth.
This House does not act in a responsible fashion. None of us acts in a responsible way. We all play act. The result is that we have almost a debt of £400,000,000 on our shoulders. The Health Act will pile up debt year after year. I admit that it has done some good but at the same time it is only in its infancy. Now is the time to prune it. I would ask the Minister and his Department to do everything possible to ensure that not one penny spent is spent unwisely. If he does that, he will get the blessing of the country.
People are sick and tired of paying for too many things. Large sums of money are being spent on county homes which will never be county homes. Decent people are being forced into them and they die there in misery. The beds are good and the surroundings are good, but the whole environment is alien to the people who are in them. These people love to live in the old home, even if it is only an old thatched cabin down a bog road. Their children should try to keep them at home. If the old age pension was £3 instead of 27/6, most of the young people would make the best of it and try to keep these people at home instead of sending them to the county home. Unfortunately, the old age pension at present is insufficient, with the result that those old people are thrown out as they constitute a nuisance.
I am satisfied that the Minister has his hands full, but he is a man who is well able to stand up to responsibility. I believe he is a man who will say black is black and white is white. His Department handles a vast amount of money. If it is properly pruned and if we are given a normal Health Act suited to the needs of a small Christian country, the people will be satisfied. They are not satisfied at the present moment. There is 7/- on the rates in my county which is a colossal amount to ask. Almost one third of the rates is in respect of the Health Act. Fifty per cent. of that is wasted money because the whole thing is topsy-turvy.
We hear a good deal about the medical cards. It will be years before this problem can be solved. Thousands get cards who should not have got them and there are others who should get them but who do not get them. These are some of the things I want the Minister to regulate.
A tremendous number of people go to hospital with nothing wrong with them at all. When I was in hospital, I heard people telling the doctor that they had a little pain. The doctor told them that there was nothing wrong with them. They were taking the wrong kind of food and if they took the right food, they would be all right. When the doctor had gone, they said that the doctor did not know what he was talking about. Then when the time came for them to go home, the pain came back. They were occupying beds which other people badly needed. If you were to examine the problem closely, you would find that 10, 12 or 15 out of every hospital could be sent home. I would ask the local medical men not to send everybody into the hospitals.
The same story can be related in regard to the maternity home. We were all born in our own homes and before we were born, there were 10, 15 or 16 children, perhaps, born there. There was a very low mortality rate, too. All my children were born at home. There was no need then for maternity hospitals, but now everybody from the lady in the mink coat to the one in the old plaid shawl are queueing up to get in because they think they might get something for nothing. Before they come out, they find they can get nothing for nothing.
There is too much nonsense and mollycoddling in the country. We should be realistic and the House should be realistic. We should make this Health Act worthy of the Irish people. We, as a Christian community, should do things for ourselves. I hope what I have said will have some significance for the Minister.
