Last night I undertook to give some figures to the Minister to prove my statement that the State is not giving 50 per cent or more in respect of health services. When speaking last night, I asserted and I now assert again, that the State is giving 45 or 46 per cent towards the subsidisation of the health services and not 55 per cent of the cost, which is the figure that is frequently boasted about.
I based my assertion on the national figures and on the Dublin figures in particular. If the Minister will make a note of the figures I give him now, he will realise that I am justified in making this assertion. The total cost of the health services operated by the Dublin Health Authority, which is the largest in the country, is £14,300,000 and the State's contribution to this amount is only £6,700,000—a contribution of only 46 per cent of the total cost. The figure which the Minister so often advances is arrived at by excluding many of the heaviest items of health authority expenditure which the State refuses to accept as ones for which the health services are entitled to get assistance from the State.
Some of the items are classified as non-health items but they are expenditures which directly and indirectly keep people in good health who, otherwise, would have to be maintained at public expense in costly institutions. The kind of expenses which we consider as expenses which ought to be classified as health services are supplements paid by health authorities to persons who are in receipt of infectious diseases maintenance allowances, supplements for disabled persons, supplements to social welfare disabled beneficiaries and allowances to sick persons having no other income, including persons awaiting social welfare benefits.
Again and again health authorities are required to make good the delay and inefficiency on the part of the Department of Social Welfare in making payments to people who lose their income through illness, accidents or unemployment. For this, the health authorities receive no compensation from the State, even when the State acknowledges that the illness or disability exists. Other items for which health authorities receive no subsidy from the State are supplements to noncontributory old age pensioners and supplements to contributory old age pensioners, which are necessary because of the inadequacy of the State pensions to maintain people in a satisfactory state of health. These supplements have a large bearing on the rates.
Contributions are also made by health authorities towards lodgings for old people who are discharged from hospitals because they are fit to be discharged but who could not be discharged if they had to pay an economic rent for accommodation occupied by them. The alternative is either to keep such people in costly institutions, with the State paying 50 per cent of the cost, or to release them into the community, which is the humanitarian thing to do, and to stabilise them. The latter course would be by far the better one for the sake of their health, but here again, the State makes no contribution towards the cost of rent and other outgoings of such people.
In urban areas health authorities are spending an increased amount of money on the delivery of fuel to disabled old persons. The State operates an antiquated and inhuman system of providing turf, sometimes free, sometimes for a small charge, for people who are classified as being in serious need. But this scheme is of little value to people who have not sufficient physical health or strength left to convey fuel from the turf depots to their homes. Because of this serious defect in the system, urban health authorities are accepting the obligation, which the State should be carrying, of paying for the conveyance of turf to the home of these old people.
Here again, the total cost must be borne by the local health authorities. The health authorities are also making immense contributions towards the cost of delivering meals to elderly and disabled people who, because they can receive wholesome meals on a number of days per week, are maintained in good health outside institutions. Until now the State has made no contribution towards the cost of this kind of service. In relation to this item, however, we can look forward with some hope that the contribution to be made by the State will be of considerable assistance.
With regard to the provision of home-help for aged persons, which is a developing service in some urban areas, the State is making no contribution towards the cost of such home-help for the old people. We have an immense amount of money being spent by local authorities in respect of blind welfare payments. In the Dublin region £75,000 is being spent on blind welfare and not one halfpenny is contributed by the State towards this cost. The result of all this is that throughout the country the State is defaulting seriously in the contribution which it ought to be making towards real health costs, defaulting to an extent which, in rates, would mean, if the State accepted its responsibility, a reduction of three to six shillings in the £. If the State were to accept its responsibility for all the items which the State say at present are outside the scope of its statutory obligation to make a 50 per cent contribution, there would be a reduction in the rates.
We are less concerned with what the law says may be done. We are concerned with what charity, justice and reason say ought to be done. The sooner the State accepts its Christian obligations, the sooner can we become a Christian community in reality, rather than one indulging in mere selfpraise and boasting. The rates burden is unbearable. It has been so far many years. At present this country is suffering because of the fact that for the last 37 years we have been ruled by the one Party for 31 of those 37 years, and for the last 12 years we have been ruled by that Party continuously. The result is that we have in power a Government which are driven more and more to defending the status quo which they have created. We have in power a Government more and more inclined to justify the systems for which they are responsible. The result is that, notwithstanding their admission that health services should not be paid for by the rates, they declined to do anything about it other than to talk about it, consider the matter, examine the matter and reappraise the matter. One would think that Fianna Fáil were not in power and were not in a position to do something about it. They are in a position and are the only people who can do anything about it. When the indignant ratepayers of this city and of other urban areas of this country want to protest they are wasting time walking on the streets to city halls and town halls because the local representatives can do nothing about it. The only people with power to do it are the Government and the only people who will do nothing about it are the Government. This is why we say the Government must be condemned.
The rates system is wrong and unfair. The Government acknowledge it should not be used to finance existing health services, much less for future development. Having acknowledged this, after denying it for years, they still do nothing about it, although three years ago they went on record as admitting that the rates system was a wholly wrong system for financing the health services. I am looking for the Minister's latest description of what the Government are doing about financing the health services, but unfortunately I have lost it just for the moment. One would have reasonably expected that there would have been some promise and some undertaking to come to the assistance of the ratepayers in this year when we have the worst increase in health charges in the whole sorry history of our health services. Instead, we have received absolutely nothing. We, in Fine Gael, want to say that there is no use in the ratepayers protesting in marches in the streets if they fail to take the most sensible action available to them to end the present unchristian and inefficient way of financing health services, which is to express their feelings through the ballot box.
If the ballot box had been used in 1965 by many of these people who are now indignant ratepayers to put out Fianna Fáil, then we would not be in this position in 1969 where we have a colossal increase in rates, which varies from five to nine shillings in the £ for health services alone. People would not be suffering in 1969 an increase in respect of health services alone eight to twelve shillings over 1965. There is only one way to do it and that is to replace the Government which want to discuss, talk, examine, consider and reappraise the situation with a Government which will do something about it. Such a Government are the Fine Gael Government. It would be a sorry day, however, if people did not use the ballot box. Apparently they are prepared to accept, time and time again, promises of consideration instead of action. They ought by now to see that consideration from Fianna Fáil means nothing, that reappraisal means nothing, that re-examining means doing nothing except to fleece again and again the unfortunate ratepayer.
The Government are quite content about this because they realise every spring of every year that the local representatives are blamed for the continuing and ever-increasing spiral of health costs. The reality is that it is due to the Government's failure to spread the load more evenly by taking health services off the rates. It is due also to Ministerial directions handed down from the Minister's office to the health authorities telling them to increase the capitation rate for the voluntary hospitals, or to increase the rates of pay— all directions from the Minister's office without any corresponding assistance from the Minister towards meeting these costs. The Third Programme for Economic Development—the first programme of Fianna Fáil for social development—was published within the last few weeks. This records very properly what we in Fine Gael consider to be the greatest condemnation of our health services, that is, that our health services are selective. But there is no offer in this so-called programme of development to do anything about our health services other than to leave them on the selective basis on which they operate at present.
It is a serious condemnation of the Government that they are to continue to operate our health services on a selective basis. This means class distinction. This means disqualifying many people who ought to be receiving assistance towards health costs. This means leaving many people suffering from physical or mental disabilities which might not appear on the statistics but which are nevertheless very real and difficult to bear for the people who are afflicted by them. We of Fine Gael want to get rid of the mendicity atmosphere, the public exercise of class differential and the unequal treatment and selectivity in our health services. I do not think it is proper in a Christian community to have a mendicity test or selectivity as canons on which to operate the health services.