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Dáil Éireann díospóireacht -
Thursday, 31 Mar 1966

Vol. 222 No. 3

Committee on Finance. - Vote 48—Health.

Debate resumed on the following motion:
That a sum not exceeding £17,337,000 be granted to defray the charge which will come in course of payment during the year ending on 31st day of March, 1967, for the Salaries and Expenses of the Office of the Minister for Health (including Oifig an Ard-Chláraitheora), and certain Services administered by that Office, including Grants to Local Authorities, miscellaneous Grants and a Grant-in-Aid.
—(Minister for Health.)

Mr. O'Malley

Deputy Mullen asked me to clear up the question as to whether the doctors will have a choice of patient. Paragraph 44 of the White Paper says patients will have a right to be attended by any participating doctor who "is living within a reasonable distance and who is willing to take him as a patient." It is not intended to force doctors to accept patients. I cannot see why this should be done when the patient will have the right to go to another doctor, if he is not accepted by the participating doctor. If no doctor will willingly accept a patient, there will be a provision for his being compulsorily assigned to a participating doctor. This is done now under the maternity and infant care service. Cases like this, however, will arise very infrequently.

Deputy Tully referred to the long hours worked by ambulance drivers. As the Deputy is no doubt aware, the hours of duty of these men are fixed by the employing authority. If any ambulance driver is forced to work excessive hours, the remedy is obvious—more drivers should be employed. It is open to any local authority to increase the number of drivers at any time. My approval is not required in a matter of this kind. I would deprecate any arrangement under which a driver is required to remain on duty for unreasonably long hours, and if the Deputy will furnish particulars of any such cases to my Department, I will have them investigated.

Would the Minister be kind enough to comment on the practice in Ballina of employing hackney-cars while the ambulance drivers parade the streets? I think that is a wrong practice.

Mr. O'Malley

There is a misconception about the employment of ambulances and hackney-cars. Even if the local authority were to have 20 or 30 ambulances, it could happen on occasion that all those ambulances would be out.

It does not happen in Ballina.

Mr. O'Malley

As I have said, we are looking at the entire ambulance service in the country and we hope to have a satisfactory improvement.

I would like the Minister to have a quick look at that particular service.

Mr. O'Malley

There is one matter not mentioned in this debate to which I should like to refer. I have been receiving a good many letters from members of the public who complain that they have been frustrated and exasperated in their dealings with health authorities because they were unable to find out who was the correct individual in the health authority office who could help them. What happens in some cases apparently is that a person needs a service, believes he is entitled to it under the Health Acts and wishes either to verify his entitlement or to be told exactly what he must do to obtain the service, or both. He telephones or calls to the authority and finds that it is very difficult to establish contact with the right person— the person who knows the problem and what should be done about it, and who will tell the inquirer clearly and sympathetically what he should do. Again, some of my correspondents suggest that medical officers and pharmacists, officers of the health authority, have not met their requirements in medical care or medicines and drugs.

Now, I do not want the House or health authorities and their officers to get the idea that I believe that all of the public who phone them or make inquiries are dealt with summarily or brusquely or that they are deliberately fobbed off. But I do feel that there is scope for better communications, a better way of handling people when they make their approach to the health authority. We would like to feel that officers of the authority realise fully that the inquirer is either somebody in need of service, or seeking one for one of his family or a neighbour in need, that he or she is very probably legally entitled to it, and that the health authority and each of its officers is there to supply it.

I propose to ask health authorities to overhaul their machinery for handling inquiries from the public. I intend to suggest that in the first place each authority should look at the possibility of designating an officer to handle and follow-up inquiries. The ideal thing to do would be to publicise the name of this officer and to allot him a special, published telephone number, and a private office. I do not want to have these people coming along as they do in some health authorities, talking through a hatch and having their business discussed in a public way. I realise this may be open to certain objections, but at least the authority should set up a specific information office to deal with inquiries and, if they cannot be answered on the spot, to follow them up promptly and get in touch quickly with the inquirer.

I mentioned also the person who feels that the doctor or pharmacist has not met his medical or chemist requirements. I realise, of course, that where the complaint is that the treatment given was not what the patient thought he needed, it is more than likely that what the doctor did or provided was right and that the patient was wrong. Where, however, the complaint relates, for example, to delay on the part of the doctor or delay in getting a prescription for medicine filled, then if the person concerned can speedily contact a sympathetic officer in the authority who will inquire into the matter, do what he can to help out and get in touch with the inquirer quickly, a better service will result.

In conclusion, I would like to say that I think this has been a useful and interesting debate——

And a long one.

Mr. O'Malley

——and I would like to thank those on all sides of the House who have made constructive contributions. There is evidently criticism on all sides as to the length of time I have taken in my reply.

No, interest.

Mr. O'Malley

I am replying to my main Estimate, the Supplementary Estimate and the White Paper proposals. This is the first occasion on which I have introduced my Estimate in full after a year in office. I also think, for the benefit of new Deputies and for my own benefit and edification, the exercise in which I have indulged of giving what appears to be the history of the health services, plus the attitude of the different Parties in the House, will serve a useful purpose. I do not think the differences between us are insurmountable. They may be academic but we are all united in one thing, I think, that our first consideration is the welfare of the patient. I am glad that the general tone of the speeches was one of approval or, at least, I might say, of acceptance of what is proposed in the White Paper, and in the hard work which lies ahead for me in making it effective I shall be considerably guided and helped by this debate. I hope to be back here with my Bill about November.

Vote put and agreed to.
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