When speaking last night, I referred to the home assistance officers and it was my intention to try to get some sense of appreciation of their difficulties in administering the Health Act. A good number of them have been complaining repeatedly and, in consequence, are on the verge of collapse in most cases. They could be described as suffering a great deal from frustration. When this Committee is set up, a good deal of time could usefully be spent on examining the dispensary system and, in particular, paying strict regard to the dispensary atmosphere.
There is great need for some arrangement to offset the delay involved for many people who must avail of the system. Most people who attend spend three or four hours a day at dispensaries. There is also the problem of the married man with a medical card who is entitled to dispensary services but who does not need to be out of employment although he is ill. No facilities are afforded to that man at night. There is need for night dispensaries for people who want to avail of them. We should have a review of the location of dispensaries so as to ensure that people will have the services of the dispensary near them. Recently, I came across a case where a man living 250 yards from the local dispensary went there for attention and was told he would have to travel three-and-a-half miles because he was living on the wrong side of the road. He was not a resident of County Dublin—he lives in north-west Dublin—but he was told he would have to go into the county to obtain dispensary services.
Other problems exist in regard to the choice of doctor. We have the situation where persons living in Cabra require a doctor late at night. They are given a telephone number to ask for a doctor to come to see them but the doctor is found not to be available. The locum is found to live at Finglas and he cannot come and says: “I shall see you to-morrow.” There is a good deal of that happening all over the city.
Another undoubted grievance is the hospital charges. Very often people are charged 10/- a day while the social welfare benefit they get is £3.12.0 a week. How can anybody expect a person to pay £3.10. a week out of £3.12. and run a home also? I heard of a case recently of a person living in a small dwelling having an income of approximately £12 a week being asked to pay 18/- a day for his child in hospital. He has made several representations about his problem but is told nothing can be done for him. I came across another case of a man with £10.1. a week whose wife has been in hospital for the past three months. He has a son in hospital for the past six weeks and he has four other children. He is expected to pay for them in hospital. Simultaneously he is obliged to pay someone to look after the other children while he is out at work.
I also consider it very wrong that, when the head of the household falls ill, he does not get the relief he anticipates; if members of his family are working, their earnings are taken into account in assessing whether or not he should get a medical card. I know of a case in Finglas. There is a woman there suffering from paralysis. She has to travel from Finglas to James's Street once a week to get the tablets she requires, and she has to pay 12/6d. for them. The income in her home is £9.15. a week. There are eight children. I have come across another case where a man has £9.2s. a week. He has two children in hospital. There is another suffering from a wasting disease in the stomach. He has been told that the child must get special food. He must get a special type of biscuit which costs 1/9d. a packet per day. He must get a block of ice cream and that ice cream must be a certain firm's ice cream. He must be given veal and liver and boiled fish. This family has been refused a medical card. This woman is confronted with the problem of conforming to this diet for this child and, at the same time, feeding the rest of the family. Needless to remark the woman finds herself in difficulty in relation to paying her rent and recently she was threatened with eviction.
These are types of cases that clearly indicate the unsatisfactory position that exists with regard to the medical card system. There is widespread dissatisfaction and I am sure every Deputy is plagued with complaints about the operation of the Health Act so far as the issue of medical cards is concerned. If this proposed committee does nothing else than recommend some proper and positive policy in this matter and does away with the present unsatisfactory position in which a card is given to one and not to another, both having the same means, they will do a good day's work. Last night the Parliamentary Secretary, Deputy Lenihan, said every local authority had a guide or a rule of thumb. It is clearly evident in Dublin that there is no such guide or rule of thumb so far as the issue of medical cards is concerned and there is very grave need for the institution of some guide or rule of thumb.
Another matter to which I should like to refer is the manner in which this Health Act is charged for, or levied, if you like, by way of impost on the rates. We are told that the total demand for next year on the ratepayers of Dublin will be increased by £104,350. At the moment three-quarters of the rates are being expended on the Health Act. That postulates the problem of how this increase will be met. If there are to be improvements will the improvements come about at the expense of the ratepayers? In speaking of ratepayers I have in mind in particular workingclass people endeavouring to buy their own homes. There is no doubt about it; some relief will have to be given to these people. Perhaps the suggested Committee could do a useful job in making recommendations in that regard.
The Labour Party have advocated in their amendment a date line for this Committee to report back. There is good reason for that. We have a motion from Fine Gael; if it is passed, there is no indication of how many years it would take to bring about the reliefs recommended in relation to the operation of the Health Act. Similarly, if the Minister's amendment is accepted without a date line we shall find ourselves in the same unsatisfactory position. I believe that, if this Dáil is to fall on anything, it deserves to fall in relation to the unsatisfactory operation of the Health Act if nothing is done to remedy the present position. What motivated the Labour Party in insisting on a date line was the urgency, the clamour, the repeatedly expressed desire on the part of the people to have improvements in the Health Act, particularly in relation to the issue of medical cards, charges in hospitals, and the operation of the dispensary system. As I said last night, there are many features in the Act that are undoubtedly satisfactory. There are other features which require immediate alteration.
