I regret it is necessary for me to delay the House in raising this question this evening, but the Minister acting for the Minister for Health in the course of his replies to my questions in the Dáil to-day gave me no alternative. In my question, I asked the Minister for Health his reasons for precluding the appointment of a permanent doctor to Schull dispensary district and hospital and also to the neighbouring dispensary district of Goleen.
Schull medical officership is vacant some two and a half years and Goleen for a somewhat lesser period. When these vacancies arose, the Health Authority in the ordinary way submitted both posts for permanent appointment, but it appears that the Department stepped in and issued an order that permanent appointments should not be made. Consequently, this was the subject matter of the discussions at the meetings of the Cork Health Authority and its subsidiary body, the Western Health Committee of the Cork Health Authority.
Surprise was expressed by the members at the delay in making the permanent appointments. As a result, after waiting for some 21 months in the case of Schull, I addressed a question to the Minister for Health, on 10th April last, relative to the post of medical officer in Schull hospital. I asked him the reasons for the delay in making the appointment and at what date it was proposed to make the appointment.
The Minister did not answer that question directly, but stated in the course of the answer he gave, that the post was filled in a temporary capacity for the period mentioned and that the future organisation of medical services in this area had been under consideration. He was not yet in a position to state when a decision would be arrived at. He emphasised that the people of the district were not being deprived of a satisfactory temporary service.
He went on to state in the course of replies to supplementaries that Schull and its neighbouring district of Goleen appeared to be exceedingly small for each to carry a separate dispensary district and that he would make a decision when proposals were submitted to him, which proposals were to be submitted in the near future. That was his reply on 10th April, 1962.
I inquired at the next meeting of the Cork Health Authority whether that authority or any of its officers had been asked to submit proposals to the Minister relative to the Schull dispensary district and Schull hospital in regard to the appointment of a doctor. The Health Authority knew nothing about it and neither do they know anything about these proposals to the present day.
I do not want to generate any heat on this matter even though there is very strong feeling in the Mizen Head Peninsula as a result of the Department's action. I am hopeful that, when the Minister is conversant with the position as it obtains in the Schull area, he will take appropriate action and give his approval forthwith to both appointments.
I could ask at this stage from whom is the Minister getting the proposals. It is not from the Health Authority officers. So they informed me and so they informed the Health Authority. It is not from the elected representatives of the people. Who are making the proposals for these appointments to the Minister? It must be some people either in the Custom House or in the Department of Health. If that is so, I assume, and reasonably so, that they are not conversant with the geographical layout of the two dispensary districts in question.
They embrace the greater portion of the Mizen Head Peninsula and both dispensary districts are some 27 miles in length from one extreme to the other. Both districts embrace the town of Schull, as well as Ballydehob, Goleen and Crookhaven, together with the hospital in Schull. Is it seriously suggested by the Minister or by his agents in the Department of Health that one doctor could cater for that widespread area? I say there is no justification for that assertion, an assertion which comes at a time when we are supposed to be improving the health services. The emphasis is on the improvement of the health services and the provision of better medical services, particularly in the more remote areas.
What of the efficient temporary service the Minister speaks of? I live in the town of Schull which is in the centre of this area and to the present day we have one doctor covering both areas as well as catering for the local hospital. He lives, as I mentioned at Question Time today, more than a mile to the west of Goleen village which, as the House knows, is not too far removed from the extreme end of the peninsula. The patients further away from him are more than 17 miles —probably closer to 20 miles—from his residence. He has no phone in the house. He is only a temporary man and he has taken up lodgings with a local person. If anyone in Schull, Ballydehob or Crookhaven or in any of these areas comprising both dispensary districts were to fall ill, what would his position be? Whether he is a medical card holder or otherwise, he would have to get a car if he wanted to avail of the local doctor's services or the services of the doctor catering for both places and travel that long journey.
Is that a satisfactory temporary service? What of the alternative? The alternative is that outside doctors have been brought in when they are available. Recently, I understand that it is exceptionally difficult to get them. Naturally, the charge is much higher than the local doctor would charge, by virtue of the distance they have to travel to their patients.
Taking it on average, the charge of the outside doctors for attending a person, say, in Ballydehob or Schull today would be at least twice more than the normal charge. The people of both areas are not in very affluent circumstances. This is a matter that interests all the people, irrespective of whether they are in the lower income group or medical card holders and entitled to free dispensary services or whether they are in the middle income group. They have to bring along their doctor in most instances from outside places and even the medical card holders have to pay.
Temporary appointments are not deemed by anybody, and should not be deemed by any State bodies, to be satisfactory. We have had a succession of doctors, naturally, since the permanent post became vacant. As I mentioned earlier today, some of the doctors have outside districts and are catering for either Schull or Goleen, in addition to their own. It actually happens that the Goleen doctor is catering for both districts.
The service is most unsatisfactory. The people are crying out against it. As the local representative, I have been asked to bring the matter to the notice of the Minister for Health as forcibly as I possibly can, bearing in mind that the Cork Health Authority has nothing at all to do with this question. I am acceding to the wishes of the people in bringing this matter to the notice of the Minister here this afternoon and in delaying you, Sir, and the other members and the officials of the House to do so.
As I mentioned at the outset, I regret that it is necessary for me to bring up this question on the Adjournment but I think it is of sufficient importance to do so in view of the unsatisfactory statements made by the Minister replying for the Minister for Health today. I am putting the question now to the Minister for Health, whether he is satisfied, as his answers imply, that one doctor can adequately cater for a reasonably populous area, 27 miles in length, embracing the greater portion of the Mizen Head Peninsula. Is the Minister satisfied that the health services provided in the Mizen Head Peninsula and in both dispensary districts are at present satisfactory? Is he satisfied that they are what the people are paying for by way of rates and taxation? Surely no sane person—not to mind our friend, the Minister—could make such an assertion. I hope that, now that the Minister is conversant with the position, the need will not arise to bring this matter to his notice again. I hope appropriate action will be taken and that his immediate sanction will be forthcoming to fill the vacant post in Schull and also the vacant post in Goleen.
In conclusion, then, I urge the Minister not to leave this district without services which the people living there have enjoyed for years and years. I believe both dispensary districts have been in existence for more than 100 years. I would further ask the Minister to take into account the fact that, in the summer, we have a big influx of tourists to the area. Having regard to all the factors—the population, the geographical layout of both areas—I think there is no justification for the Minister's implication that they should be amalgamated. I am asking him to heed the representations made to him and to sanction both appointments forthwith.
