When the debate was adjourned, I had made a special plea for spina bifida and hydrocephalus and cytology. It is important that these diseases should be prevented rather than cured and that we should have preventive rather than curative medicine. This Bill fulfils a rather important function, particularly in relation to Part IV and onwards, in providing for thorough diagnostic services. On Wednesday last I pointed out the special position in regard to the diagnosing of spina bifida and hydrocephalus. Spina bifida is the condition of split spine and hydrocephalus is the condition of water on the brain. If either of these ailments is discovered within 12 hours it can be dealt with adequately. The importance of a quick diagnosis is to ensure that these terrible ailments do not take hold.
I gave many figures in relation to percentages. I pointed out that in 1956 some 90 per cent of the children who were born with either of these ailments died purely because we did not know anything about the diseases. Now this figure has been reduced considerably, due primarily to the medical procedures now being applied in the Richmond Hospital and Crumlin Children's Hospital, Dublin. I do not wish to take up too much of the time of the House repeating what I said on behalf of the victims of this type of illness. My contribution is to be found in the Official Report of Wednesday last.
I dealt with the special position of the parents of mentally handicapped or disabled children. I urged the Minister that before Wednesday next he should prevail on the Minister for Finance to increase the disablement allowance for those mentally ill or disabled children who remain at home and/or to give some considerable tax-free benefits to the parents of such children who are kept at home. I suggested that this should be done regardless of income. Mental illness, as we know, hits all strata of society regardless of whether the parent is poor, in the middle-income group, wealthy or very wealthy. I urged that if it was at all possible the Health Authority in the city and county of Dublin — an excellent and efficient authority for which I have always the highest praise arising out of my experience with them—should issue a medical card to each mentally-ill child or disabled person, and not specifically to the family, because in some instances the family are well enough off to look after themselves in terms of medicine. If they can afford it they can be members of the Voluntary Health Insurance scheme which is another excellent organisation. Once more I would appeal to the Minister for Health to urge the Minister for Finance to recognise the special position of the parents of mentally-ill or disabled children.
This also applies to adults. If a family with an adult mentally sick keep him at home their work in maintaining him at home should also be recognised. I was reading a series of articles by Mary McCutcheon in the Irish Independent. It was a first-class series of articles and well worth reading. She pointed out that mentally-ill children have emotions and experience the usual disturbances recognised in normal children. It has become fashionable to think that mentally-ill children are some type of vegetable, and I do not wish to use too harsh a word. This is not true. Psychologists, psychiatrists and sociologists say that they have the same emotions as normal children, to some degree.
We, as a society, have an important part to play here. Our function is that in the first instance we should ensure that mentally-ill children should be kept at home and that parents should be encouraged to keep them there. We would be discharging our obligations as a society to the parents of those children in that way. I do not think that at this point of time we are discharging fully our obligations to them. This is not to suggest that nothing is being done. Much has been done in the field of the mentally-ill and the disabled. Much has been done for paraplegics and so on, but much more must be done and we must keep on pointing out the areas in which we consider that more should be done until the position has been reached in which everything has been done that should be done.
I pointed out the need for an increasing awareness of the practice of cytology—the smear test on women. Some years ago I tabled Parliamentary questions asking that cyto-analytical centres be set up in which such women would be cared for from the point of view of pre- and post-maternity and so on. A situation has now come about where we are discharging our obligations to these pregnant, and indeed non-pregnant, women in cyto-analytical centres.
All of these are matters of which we are only now becoming aware. If, in this House, and outside it in voluntary organisations, we keep on pointing out the areas of weakness in sociological medicine and health, and if we in this House make moneys available to ensure that everything possible is being done to sustain the good health of our community.
We should become aware of the various ailments I have mentioned before, they run their terrible courses and before their consequences are felt in terms of human happiness. If we did so it would be cheaper in terms of human suffering and financially it would be much cheaper to prevent them than to try to cure them. This brings me back to the matter of cyto-analysis. When we take a smear test and realise the existence of cancer, would it not be cheaper to point it out at that stage rather than to cure or to attempt to cure terminal cancer at a later stage. Terminal cancer, by definition, of course, has its own terrible consequences and that is what I mean by human suffering.
These are points which must be made and I ask the Minister to remember them when he is replying. Deputy Dillon made the point that sometimes one has to keep on asking, to keep on urging, and that one may have the label of a bore, but I make no apology for mentioning some of the areas of health in which I am interested, and I take Deputy Dillon's advice.
At this point I come back to my friends, the paraplegics. The other day two of them came to me. One of them experienced some difficulty in getting a grant towards the conversion of a car; the other had difficulty in getting a grant for the purchase of a car. Both types of grants are freely available because of a very important provision brought in recently. The availability of these grants should be made known to the people suffering from this terrible defect which arises primarily from accidents. Such people are affected from the waist down and when people appreciate that, they will realise why cars have to be converted to suit such people. I have given the Minister details of these cases and I hope he will treat both as being of extreme urgency.
This applies to the blind also, though, of course, I am not suggesting that the blind should be able to drive cars. We have given encouragement in this country to people willing to engage in gainful employment. By engaging in gainful employment, such disabled people cease to be a burden on us. These people are entitled to involve themselves in gainful employment. The State owes them assistance—it is their entitlement. If we have paraplegics and blind people in gainful employment, therefore, why should we not realise our duty to them and put it into effect by way of encouragement, by giving them the various allowances to which they are entitled? Why should we not give them recognition by extending to them tax-free allowances? Why should we not treat them like normal persons when encouragement is the main thing they need?
I have made several efforts during my short term in the House to bring about that situation but without much success. I will follow Deputy Dillon's dictum and keep after it and it will come. But, for God's sake, let us recognise the disability and let us appreciate that those of them who are in gainful employment are not a burden on the State. Let us recognise their effort by allowing them something in terms of income tax.
I wonder will the Minister tell us when the White Paper on mental illness is to be produced? I look forward to hearing that from the Minister in his reply.
The dispensary service has been dealt with at considerable length by many speakers. The experience of a number of my constituents of the dispensary service has not been good, on the contrary. I always feel about State institutions—and imagine that a dispensary is an institution of a nature—that when you go into them they are dark and there is nothing welcoming about them. They are bare; they are clinical; they are mean. Why the State do not apply their minds to the creation of decent dispensaries I do not understand. They are used in the main by old and retired people. Can we not make these people more comfortable while they are waiting? In some institutions the length of time these senior citizens have to wait for medical treatment can only be described as criminal. I have on a number of occasions brought these matters to the attention of the Department of Health, with some little success I must admit but not very considerable.
I believe that as many of these dispensaries as possible should be knocked down and new buildings erected. However, we must recognise our priorities and we do not have that sort of money to throw around. Failing that, could we not send a couple of squads of decent painters in to brighten up some of the dispensaries? I do not suggest that we should have tassels and murals or anything like that around the place. Brighter colours and even knocking out some of the ceilings and putting in glass would not be a costly operation. Indeed the placing of a couple of decent chairs would help, as would the provision of magazines. There are many voluntary organisations that would be only too glad to supply magazines for people visiting dispensaries. I agree this affects constituents of mine, but the effect of this type of dungeon on the staff of the dispensary and on the medical profession is bad also. I know that my personal feeling when I go into a dreary building is a sort of automatic turning in on oneself. One thinks: "How quickly can I get out of this place?" I believe that by creating better dispensaries people would be willing to wait longer than they normally would.
I would ask the Minister to consider these few points in terms of the creation of a better type dispensary, in the first instance, and the placing of some awful dispensaries in some sort of worthwhile, habitable condition until such time as they can be replaced. Some of them must be replaced, as the Minister is aware. The staff suffer in a badly laid out building and it has a bad effect on work. I do not have to go into that; the Minister has paid people to tell us all that.
I came home rather late last night from a meeting in my constituency. I came in at the end of the Telefís Éireann sports programme. There was a plea on by a Mr. McDonagh of Bord Luithchleas Éireann for increased grants. I had already written to the Minister for Finance making a number of suggestions as to what he could do to give grants to finance sports activities, community centres and that sort of thing if he has the money available for it in the Budget. I made some of these suggestions to him in a long letter and last night I heard this gentleman, Mr. McDonagh, repeating almost exactly what I had suggested. I had no communication with him. I welcome his statement. If we examine it we will be doing a lot for physical education. The physical well-being of the individual is very important. I got a rather garbled version of it but I think what he was saying was consistent with what I had already expressed to the Minister for Finance in a long memorandum regarding assistance towards community activity and grants towards sporting organisations—Comhairle le Leas Óige is one—to encourage young people to take an active interest in sport.
In recent times this activity has been taken over by voluntary organisations and the more assistance we can give them in terms of capital the better. A healthy nation is a wealthy nation. I do not know who said that—perhaps it is original—but it is true. From health derives many consequences— active minds, active bodies—all for the betterment of the nation. We are still not very conscious of the great outdoors in this country, of the advantages of getting out and about our beautiful countryside. I would ask the Minister to examine Mr. McDonagh's statement, which probably appeared in this morning's newspapers, and do what he can. I would look forward to some statement by the Minister for Finance in his Budget in terms of a comprehensive programme, a more professional approach to the sporting activities of the nation. We are doing it piecemeal at the moment. Indeed, some of the organisations could examine their consciences as to more co-operation between one and the other. Coordination is very important. Pull together rather than pull apart should be the motto for these organisations. They should be coming together for the reasons I have outlined.
I do not wish to be political on this but I feel that the motion introduced by the Fine Gael Party which is a direct negative to the Bill is, to say the least of it, tragic. Whereas some of us might suggest, rightly or wrongly, that this Bill does not offer as much as we had hoped it would, nevertheless it does a lot and to put in a direct negative to it is, in my opinion, obscurantist. Let us go some of the way towards solving some of our many problems. Certainly, a political Party that puts a direct negative into Part IV of this Bill deserves nothing but condemnation and pity in my opinion. The wording of the amendment is:
To delete all words after "That" and substitute "Dáil Éireann refuses to give a Second Reading to the Bill on the grounds that: (a) it fails to provide a comprehensive health service available to everybody based upon insurance principles;
(b) it retains the injustice of financing half of the cost of health services out of local rates; and
(c) it gives, at the expense of local authorities and hospital administrators, excessive powers to central government.
It is important that the good that is in this Bill should be recognised, and there is a lot of good in it. There are improvements to be made on it, and I am sure the Minister would be the first person to make that point. No one suggests it is perfect. I will have a number of amendments to propose to the Minister on a number of sections. I always feel that the substitution of the word "shall" for the word "may" in a section makes it far more definitive. The Minister may say this is merely a matter of semantics. If it is, "you shall do something" rather than "you may do something", I think it is stronger. The word "shall" is more demanding and more definitive. However, for what the Minister has done in this instance I should like to thank him, and I assure him that he will have my views on Committee Stage.
