The Minister, before this stage of the Bill, circulated his proposals, and, indeed, his own memorandum in relation to it was headed "Committee and Later Stages". Therefore, he cannot blame us if we discuss what he put before us because he obviously intended us to have this in our minds when we were discussing this Bill. I feel justified in strongly criticising the Minister for the manner in which he proposes to sell down the drain the people of Dublin by grossly under-representing them in his proposals by giving the people of Dublin only six seats on the proposed Eastern Health Board for a population of 568,000 while he gives three seats on the same board to Wicklow, which has only 60,000, and to Kildare, which has 66,000.
The Minister has given the people of Dublin, the population of which is nine times greater than the population of Wicklow, only twice the representation he has given to Wicklow. He has given the people of Dublin, the population of which is eight times greater than the population of Kildare, only twice the representation he has given to Kildare. He has given the people of Dublin, who spend over £10 million, a representation of only six, while counties which spend less than £1 million on the population of the county, are given half the representation of Dublin. If ever the people of Dublin were handled in a contemptuous way, this is it.
There are 42 hospitals in the Dublin region and yet they are given only twice the representation of Wicklow, which has only four hospitals, and Kildare which has three. Perhaps because Dublin's local authority has been abolished, the Minister is not inclined to listen to the people of Dublin or to give them fair representation. No doubt the appointee of the Government, who for the time being is supposed to be administering the affairs of the city, has not complained because he is incapable, on his own admission, and unwilling on his statement, to represent the people of Dublin on the hospital visiting committee. The Commissioner could not care less if the people of Dublin, with ten times the population, are given only six representatives, while counties with one-tenth of the population are being given half the representation.
This is heavy taxation without adequate representation, and it is simply not good enough. Dublin, out of its own resources, has to provide a much greater percentage of the health bill than the other authorities which are to be represented on the Eastern Health Board. The Minister's own figures, in reply to a question of mine on Tuesday of this week, indicate that as far as the Dublin County Borough is concerned the people are contributing about 50 per cent of the cost of the health services, add a small percentage to take into account what is and what is not a proper health charge, whereas Kildare and Wicklow are only contributing one-third of the cost of the health services in the Dublin region. Yet, the Minister proposes grossly to unrepresent the people who are paying 50 per cent of the cost. This means that the greatest percentage of the cost of the health services comes out of the rates of the people who have ten times the population, ten times the number of hospitals and ten times the expenditure of other health authorities yet they are in a minority vis-à-vis their own local authority colleagues and in an even smaller minority as far as the total membership of the Eastern Health Board is concerned. This is an appalling situation and we feel justified in protesting vehemently about it.
When the Minister eventually brings into this House for approval the regulations which he must bring in under this section, he will have his mind more or less made up by then. No matter how open-minded the Minister may be and no matter how generous his personality it would be contrary to all previous ministerial performance, in this or any other Parliament, for a Minister to come in and substantially change the nature of his proposals as they appeared in the draft regulations. This is, therefore, the only opportunity for us to complain about the unfair manner in which the people of Dublin are being treated under the Minister's proposals.
I have mentioned Kildare and Wicklow and as far as they are concerned they have no reason to grumble population-wise or expenditure-wise, but Dún Laoghaire, which has only one representation, has a population which is greater than the population of either Kildare or Wicklow. No matter how objective that person may be he is unlikely to be able to represent all shades of social, medical and political thinking in Dún Laoghaire and in this way the people of Dún Laoghaire will not gain adequate representation. Unfortunately, I was not given the precise population of Dún Laoghaire by the Minister but I know enough about its electoral status to know that it must have a population greater than that of either Kildare or Wicklow for it to carry representation of four seats in this House.
The Minister has included Dún Laoghaire in his figures for Dublin county and under that arrangement Dublin county, including Dún Laoghaire, is to get four representations for a population less than half of the population of Dublin city while Dublin city is to get only six. On the basis of giving Dún Laoghaire and Dublin city equal representation in relation to its expenditure and its population Dublin should have ten.
While I appreciate what the Minister says, and what Deputy Carter and others have said, about the undesirability of having a huge unwieldy health board which would probably be as inefficient as it would be divergent in its conflicts, the Minister will have to make radical changes in order to give more equal representation relating to population, expenditure and hospitals.
In the region of Dublin county, including Dún Laoghaire, there are 17 hospitals which are to have only four representations against two other areas having only three or four hospitals which are to have three representations. This indicates a dangerous frame of mind and one which the Minister will have to rectify. It may well be that the cure will be to have two health boards instead of one for the eastern region.
The population to be represented by the Eastern Health Board as proposed by the Minister is almost one million. Experience in Britain has shown that a health board providing for one million people is inefficient and incapable of discharging its duty towards its own population. The most recent investigations in England suggest that the population for any health board should be a quarter of a million but the Minister is proposing a population four times greater than that considered more suitable elsewhere.
We have to recognise there are different needs and different levels of a health service. It is possible for a hospital board to cater for a population of one million people but a board which is supposed to look after general medical services is not capable of performing efficiently if it is looking after a population of that number. I suggest that the medical needs of the people in Glencullen would be different from the medical needs of the people in Ballymun. The personal services which a health authority need to give in Athy and Rathdrum are entirely different to the type of services that should be organised in Benburb Street and North Earl Street in Dublin, two thickly populated localities. It is because the Minister has tried to transform the hospital services and the general medical services of rural Ireland into urban services in the new Dublin region that he is in the difficulty that the areas which are most densely populated, most heavily taxed, are the areas most under-represented on the board. I urge on the Minister to make radical alterations in the health board in the eastern region.