I am not in any way attempting to decry the Minister regarding the amount of information he gives us. Perhaps this information is unique but, if so, it is unique in a relative way in that the information given to us by previous Ministers of the Fianna Fáil Government has been such that it has prevented Deputies from contributing constructively to debates. All volumes of the McKinsey Report, except volume 4, are in the Dáil Library but where are we to see the one that is missing? I should like to have seen the contents of that volume before making my contribution here.
I have asked questions in the House and I have been insulted by the Minister, to my great surprise, in that he refused to answer questions. When Mr. Kevin Boland and Deputy Blaney were Ministers they answered questions. I have been referred continuously to the health boards and told to write to them for information. This happened to Deputy Begley in December, 1971, and Deputy Donegan suggested on the Adjournment that surely the Minister should not refer every Deputy to the health boards for a reply to questions. This would increase the bureaucracy of the health boards.
This party—and I speak with the full authority of the Fine Gael Party on this—are not totally satisfied with the way in which the health boards are administering the local health services. The Minister supports me in this statement because he said that some health boards questioned the timing for the establishment of these bodies and suggested that the proposed regulations should be deferred for some years, until the new administration under the health boards had settled down. He said that the Eastern Health Board also suggested that the administration of the Dublin Regional Hospital Board should be tied in with that of the health board and that, as regards the timing of the establishment of the new health bodies, it would not be wise to wait.
Let me say this to the officials of the Department of Health. This party are recognised throughout the country as being a responsible party. We do not make wild allegations. In the Minister's statement he admits that some health boards have questioned the timing of the establishment of the hospital bodies. Perhaps in years to come it may be necessary to establish these bodies. If you refer to the powers of the three regional hospitals you will see that many of the committees which they are empowered to set up are duplicated by health boards who can set up similar committees. It would be interesting to know the number of visiting committees and sub-committees which have been set up by health boards since their establishment. It would also be interesting if we could obtain the figure—but I doubt that we could—for the number of times these sub-committees have met. It would be interesting to know the number of times the sub-committees have reported back to the Department of Health.
With regard to the selection and appointment of hospital consultants, this party will not become involved in medical politics as such. The Irish Medical Union and the Irish Medical Association have condemned the powers given to the voluntary hospitals under which they retain the right of appointing consultative staff. When the pool of consultants was set up for county council and local authority hospitals, it was understood that there would be an interchange of consultants, that they would serve so many years down the country and then come up to a city hospital, and that there would be a rotation type of scheme.
Because of Fianna Fáil policy this was dropped and county surgeons and physicians were left in the county hospitals where, I might add, they do a great job of work, a job of work second to none. There is one county surgeon and one county physician. They might have a registrar and they might have a houseman if they are lucky. They are on duty 24 hours a day for 365 days a year. They cannot take holidays unless they can get a locum with the same qualifications as themselves who is willing to go down the country and take the appointment. Having regard to the number of consultants in the country, this is very difficult. It is not surprising to know that many of the services in these hospitals are slowing down.
Any Department, association or union who change for the sake of change can be making a grave mistake. At least at the moment if these appointments are being made they are being made by the boards of the voluntary hospitals and they are not being made by Comhairle na nOspidéal. If that were the case, let me warn the House that every politician north, south, east and west would be lobbied to use their influence to obtain a consultancy appointment for somebody. Our party have stood firm and fast over the past 50 years on the principle of trying to avoid that type of political jobbery. We must not allow that type of corruption in appointments to creep into our hospital services.
We have heard criticism of the voluntary hospitals. I stand wholeheartedly behind them because without the voluntary hospitals we would have no hospital services to talk of. Without the likes of the Reverend Mother building her operating theatre over in Cappagh and without the likes of the nuns in St. Vincent's Hospital building their hospital with a certain amount of State aid, and without long-term planning and years of foresight on the part of people like the Mother Mary Aikenhead nuns who are building one of the best geriatric homes for underprivileged people at Madonna House where would we be?
How could you compare their work with the bureaucratic 40 or 50 hour week of the lay people involved in the services? They deserve the greatest credit. They work non-stop.
Mark you, they would be fairly happy, I believe, to relinquish the authority they have over the administration of these hospitals if they could be assured that those who would replace them would dedicate themselves to the same extent to this particular work. Where, in Europe, would one find better institutions for handicapped children than those run by the St. John of God Brothers here? Nowhere. One of the best hospitals in the British Isles is St. Vincent's Hospital in Elm Park. This hospital has been achieved as the result of the Reverend Mother in 1934 buying the land out there and drawing up plans. The nuns got precious little help from the Government in this project. There were many private contributors to the building of that hospital. One cannot praise enough the dedication and the work done by the nuns and brothers involved in hospital care.
The Minister also stated:
In most cases, I would expect that contracts by the regional hospitals board would apply where a consultant was needed to serve a number of hospitals under different managements. Otherwise, it seems likely that the authority employing the consultant will remain as at present, that is, it will be the health board or the voluntary hospital body concerned.
As far as the effectiveness of the services will be concerned, I do not think that this change which I have made will of itself be very significant.
Here we have change purely for the sake of change.
The Minister goes on to say:
Many views were expressed on the size and membership of the bodies.
Of course, views have been expressed. We know that the majority of the members on Comhairle na nOspidéal will be from the medical profession. The chairman and vice-chairman will be appointed directly by the Minister. The remaining 11 members will be appointed in consultation with the medical profession, the Irish Medical Association and the Irish Medical Union. The majority of those charged with the care of our hospitals will be from the medical profession. There are people who argue that doctors should not have a majority on health boards. Some people whom I had thought responsible in their attitude to health apparently think that doctors might have a vested interest in the administration of the health services and might use their position to forward their own interests. Anyone who has any experience of hospitals knows the work these people do. They are not in the profession for money. If they were in it for material gain they would now be in the United States of America where they could make money.
What kind of remuneration does a consultant in a voluntary hospital get? He gets a great deal less than Deputy L'Estrange or I get here. I was speaking to a consultant recently who attends a voluntary hospital seven days a week. He spends 24 hours a week in the operating theatre and two days a week in the out-patients department, apart from his ward work, and his remuneration is slightly over £2,000. There is no travel allowance or any other allowance. Let nobody think these people are trying to hide their money in farms or that they have a vested interest in this. It may surprise some to learn that a consultant gets 12½p per day for each bed under his control in one Dublin hospital. Let no one try to convince me that these men are attempting to further their own material interests. Those who have experience of hospitals are most appreciative of the services they get in hospitals. Many patients would be surprised to learn that the consultant who visits them at midnight or at 2 o'clock in the morning gets 12½p for his work. I believe there are a number of Deputies who are unaware of this.
Later in his speech, the Minister said:
A number of those consulted suggested increasing the membership of Comhairle na nOspidéal and of the Cork and Galway Regional Hospital Boards. I have also had very many requests for representation on each of the bodies. Clearly, I could not accede to all these requests without having an unmanageable and ineffective membership on the bodies. Accordingly, I have not increased the membership of the bodies and realise that in choosing members I will have a difficult task in balancing the conflicting wishes of many of those who were consulted. I hope it will be taken by all that my final decision on this, when I take it, will be a reasonable one, taken in the interests of the services as a whole.
My party have decided to support the health boards but we have requested the Minister to defer the appointment of the three regional hospital boards and Comhairle na nOspidéal because we think this will lead to more bureaucratic control in the administration of the health services. The health boards, justifiable as they may be, have not served the people at local level as well as the local authorities did. An interesting feature is the fact that four years ago 33.3 per cent of patients were holders of medical cards and entitled to free treatment. On 31st March this year that figure had dropped to 27.6 per cent. The first figure of 33.3 per cent is based on the population figure of the 1966 census and the 27 per cent is based on the 1971 census which showed an increase in the population. The numbers relatively are far less.
The Minister attempted to justify the figures at that time on the grounds of the increased income of people through the country. I dispute this. I think the reason why the number of health cards has dropped is that since the health boards were set up they have adopted a slide-rule, bureaucratic system of administering some health cards and eliminating others. It was greatly appreciated that the CEO of the Eastern Health Board, two days after I had raised the question in the Dáil last week or the week before, announced that he was bringing in a special system whereby—let me quote the example he gave—a person earning £35 a week who had mortgage repayments to meet on his house, rates to pay and insurance premiums and other regular unavoidable expenses, would have all these deducted from the income on which he would be assessed and only the amount of his take-home pay would be considered in regard to the allocation of medical cards. A husband and wife earning £16 net between them would qualify for a full medical card. In qualifying for a full medical card now one does not have the stigma attached to going to a health centre or dispensary and joining a long queue.
Since 1961 our party have advocated, through its Just Society policy document the abolition of dispensary services. We were pleased, and we supported the Minister last year, when he introduced the provisions whereby in the Eastern Health Board area dispensaries were abolished. From my own personal experience I find the hospitalisation rate of medical card holders has been reduced to an absolute minimum and the improvement this means in family environment is tremendous. There is no long queue for the chemist at the dispensary: that has gone. People can now go to a private chemist and get medicine on special prescription. I have never seen such a change in the attitude of patients since 1st April. Instead of people reluctantly accepting the system imposed by previous Fianna Fáil governments, they are relaxed, co-operative, responsive and much of the stress and strain which they suffered has been removed.
I agree that the Minister has made many changes but one of the changes which has resulted in improvement in medical care has been the choice of doctor service in the Eastern Health Board area. I do not know how it will work in other areas but there are still sections of the general medical services which need to be improved. I would mention the armed forces. A private soldier, married, with three or four children, can obtain medical attention in hospitals free of charge. He could do this prior to 1st October, 1971, but since then he has to pay 15p per week under the 1971 Health Contributions Act. He had that free service prior to the introduction of that Act and now 15p per week is being deducted from his pay. He has not had a pay increase since 1970: we know all the difficulties about that and how it has been delayed. There is grave unrest among all ranks in the armed forces because of the medical services which I believe should be controlled by the Minister for Health and not the Minister for Defence who knows nothing about them; neither do his officials. The colonel in charge of the medical services might know something about them but, as far as I know, he is extremely overworked and it is not possible for him to find time to engage in drawing up new health services for the armed forces.
I have met constituents living in Finglas, Navan Road, McKee Park, Blackhorse Avenue, North Circular Road, Willow Park and Ballymun who are in the armed forces and I see the expense they incur should any of their children become sick and need general medical services at home. I mention the matter on this Estimate because I believe it is the responsibility of the Department of Health to provide medical services for everybody in the country. I have asked previously whether the Minister for Health intends to extend the general medical services to the dependants of members of the armed forces and repeatedly I have been told there is no intention at present of doing so. The wives and children of private soldiers are among the most underprivileged if they become ill and have to call in a private doctor. There is no provision for them to get free medicine or free medical attention. I sincerely urge the Department to consider including the armed forces, particularly those under the salary level which the CEO of the Eastern Health Board specified recently, in the new general medical services. They are among the most underprivileged people in the city of Dublin in this regard.
I am sure Deputy Begley will support me when I say that there is a shortage of general practitioners in Sligo, Mayo, Galway, Clare and Kerry. I would ask the Minister for Health to come to some arrangement with the local authorities or the health boards to offer scholarships to some students in the areas who intend to practise medicine on condition that when they qualify they would undertake to spend three years in those areas. In this way you would have a continuous flow of newly-qualified doctors without any family commitments and without any children to educate. They would provide a very essential general medical service in an area of the country where no service is provided at the present time.
I worked for some time in Kenmare dispensary and district hospital and I was aware of the lack of a doctor in the Kilgarvan area which caters for approximately 1,200 people, not all of them medical card holders. A colleague who was in college with me applied for this position and was appointed. A few weeks ago I got a telephone call from him stating that it would not be viable for him to participate in the choice of doctor service. The Department of Health did very little to alleviate the position. I asked a supplementary question in relation to a question tabled by Deputy John O'Leary. It was not adequately answered. We believe that the situation has now been rectified. I quote this exception to prove the rule.
The rule is that the western seaboard area of this country is as undermanned as India, Pakistan or the Central African states as regards doctors. I have practised in those areas and I have been in areas where the nearest doctor is up to 25 miles away. I have seen patients suffer serious illnesses because of the fact that there was no medical attention available. Over a year ago I asked the Minister for Health a question regarding the number of dispensary positions in the western seaboard area from Kerry to Donegal which were not filled and the number of dispensary positions which were filled by temporary appointments. As Deputies we are entitled to a certain amount of information which can help us to contribute to the Health Estimate.
It is sad that after 50 years of home rule we have an ambulance service which has shown very little improvement, that we should have an ambulance service which is duplicated to such an extent that, if one wants to get a patient into hospital in the Eastern Health Board area, that patient can travel by taxi by courtesy of Dermot Ryan, a member of the Fianna Fáil executive. In Dublin you have the Dublin Fire Brigade ambulance service which is run by the Department of Local Government and you have the Eastern Health Board ambulance service. There is close on one million people living in the Eastern Health Board area and when these ambulances are out on calls they are substituted by taxis from the Ryan group. On many occasions I have had a taxi to take an infant into hospital because it would take too long to get an ambulance.
We also have the Stillorgan Ambulance Service, a cardiac ambulance service. It is only fair to say that whereas this is a private service run by Mr. Gleeson it is perhaps one of the most up-to-date cardiac ambulance services in Europe. This was set up soon after the first cardiac ambulance service in the world was set up in Belfast. If you have a coronary in your home you can have full treatment by this ambulance service. This has saved many lives and has minimised cardiac damage to the utmost degree.
I have said on many occasions that this country needs a national ambulance service run by the Department of Health, not by the Department of Local Government. I am fed up listening to Deputies criticising doctors for not travelling to the scene of accidents. Recently an accident happened about 200 yards down the road from where I live. Somebody rang me and I immediately drove down to the scene of the accident. When I got there the patient had already been taken away in an ambulance. It took me only a minute to get there. This type of criticism regarding doctors not travelling to emergency accidents is unjustified.
The Department of Local Government in their bye-laws forbid a doctor to carry an emergency siren or any light, temporary though it may be, on his car. This means that during the months of June, July, August and September, when traffic is heavy on the roads with people going to the seaside, a doctor has no way in which he can indicate to other drivers that he is on an emergency call. The Department of Health should have a look at this regulation. This may be the last time I shall ever speak on a Health Estimate in this House and I want to say that the Department of Health should see if it is possible to change this regulation and whether a doctor can have some type of a flashing light on his car, which is forbidden by the present regulations under the Department of Local Government. In 1968, when I came from County Kerry to this city to practice, I tried to do this because the traffic was extremely heavy. I was informed that under the regulations I was forbidden to do it. Yet I have heard people from Longford and Westmeath, Deputies from my own party, coming in here and criticising doctors for failing to go to the scene of accidents. How can they get through the traffic, and if they get there, how are they to get back? I was recently in a situation which I shall never forget. On Christmas Eve the caretaker of the dispensary in which I work in Ballymun was seriously ill, so ill that I took her into the car to drive her straight to the hospital, and on the way she died. There was no way in which I could get through the traffic. There was no way in which I could indicate to the traffic that I was in a hurry. Perhaps the lady might have lived; perhaps she might not have lived, but at least it would have been some consolation to her family had she arrived in the hospital alive. I know that bureaucracy can get out of hand and that one law can contradict another, that as we go on Parkinson's law takes over. However, let us keep things simple. If we keep things simple they will turn out to be successful. The Minister goes on to say, and I quote:
I hope it will be taken by all that my final decision on this, when I take it, will be a reasonable one taken in the interest of the services as a whole.
Much of what the Minister says in this is vague, non-specific and, to my mind, a lot of it is unworthy of comment except a section on page 3, paragraph 3, which again I quote:
To this end I have arranged for Messrs McKinsey, the firm of management consultants who reported in relation to the health boards, to make recommendations on the administrative procedures and the staffing of the new bodies. I expect that their report on this will be available as soon as the new bodies are ready to become functional.
I have said already, and I repeat it to the officials of the Department, that the McKinsey Report, volume 4, is not available to Deputies in the Library. I shall now refer to something which I have raised in this House time and time again. I have raised it here to the point of being criticised severely as being even a crank. It is the question of drug abuse in this country, which first came to our notice in 1966. Deputy L'Estrange was the first to mention it. Then Deputy Clinton mentioned it. Then it was put on the long finger until 1969. I came in and I was aware of it. I drafted a Private Members Bill which would act as an interim measure until such time as the Minister for Health had a comprehensive Bill to produce in the House for full discussion. I called, with our own shadow spokesman for Health, to the Minister's office and I presented him with a copy of this Bill. It was short, simple and direct. To my mind it would have achieved something in that it would have been an adequate deterrent and would have brought the legislation up to the level of that of Great Britain and France.
The Minister for Health told me and Deputy Dick Barry, our spokesman on Health, that he would have no objection whatsoever to granting us a First Reading of the Bill. The First Reading merely means that it goes into print. He could oppose it on the Second Reading if he wanted to or if he dare. I doubt very much if there were many Deputies in the benches of the Fianna Fáil Party who would have opposed a measure that was going to try to curb the growing problem of drug abuse. In November, 1971, the Minister for Health assured us that he would introduce legislation during that session to curb drug abuse. In March, 1972, he assured us that legislation was in its final form of drafting and that he would have it before the House shortly. Then suddenly the bubble burst. The Taoiseach announced here one day the legislation that was to be taken before the Easter Recess and there was no mention of any legislation in relation to drug abuse.
Recently, in reply to a parliamentary question, the Minister for Health indicated that he intended to introduce legislation in the current session to deal with this problem. Leading up to this in January, 1972—and I believe that I have here in my hand the Bill which the Minister will introduce here—I asked the Minister for Justice whether there was any evidence of increased abuse of heroin or the selling of heroin in this country, and the Parliamentary Secretary, Deputy Michael O'Kennedy, answering for him said "No". I repeated that question about a month ago and the answer I got was that there were two people who had a charge against them for the illegal possession of heroin. One of them had a charge against him for marijuana, barbiturates, morphine, pethedine and many other drugs, which could best be described as a cocktail. The judge at the time of the court case recommended that this man be referred to the Dundrum treatment centre. If I refer to something which has happened under the auspices of the Department of Justice in relation to drugs, the Chair could rule me out of order but I know he will not because he has heard the Minister for Health himself saying that the Bill is the responsibility of the Department of Health.
The Minister for Health has misled this Dáil on two separate occasions in the past two sessions, and I am giving due notice that unless this legislation is introduced during this current session there will be a motion of no confidence in the Minister for Health on the Order Paper which will be taken as soon as possible. The parents of the children of this country are completely and utterly bemused by the attitude of the different Departments at the present time. They may have talked a lot about youth education, about producing a film outlining the dangers. The Minister may have panicked and been pushed into taking the drug diconal off the market following the death of three teenagers in this city. But what about other parts of Ireland? This problem is not confined to Dublin city. I will not mention any other parts of the country because there are Deputies who think the rivers in their constituencies flow with holy water. Some of the largest areas of drug abuse are outside the city, in provincial towns and villages. I know of a case where 24 teenagers were arrested in one town approximately six weeks after certain allegations had been made.
The Minister's Bill, if he introduces it, will contain provisions similar to those in the Misuse of Drugs Act, 1971, presented to the British House of Commons by Reginald Maudling, the Secretary of State for Home Affairs. This contains certain schedules and classification of drugs. The Minister will follow the same pattern he has followed previously in issuing a blueprint of the British health services. The Ministry of Home Affairs in Britain is like our Department of Justice and I have always said that the misuse of drugs should be the responsibility of the Minister for Justice because it is a criminal offence. Yet the Minister for Health has persisted in retaining this responsibility. I do not think it should have anything to do with the Department of Health. The only part the Department of Health should play, as far as drug abuse is concerned, is in providing adequate treatment to ensure that, as far as possible, drug addicts are given a chance to go back to as normal a life as possible following their mistakes.
Schedule II of the Misuse of Drugs Act, 1971, contains a list of approximately 75 drugs which are classified as A drugs and certain other definitions relating to these compounds. If a person is found to be in illegal possession of any one of these drugs he is sentenced to a maximum of 14 years imprisonment. If a person allows the consumption of these drugs on premises he owns, rents or occupies he is guilty of an offence under this section.
Class B drugs contain substances such as amphetamine, codeine, cannabis and marijuana. A person can walk into a chemist in Dublin and buy codeine but in Britian a person in possession of any of these drugs is sentenced to a maximum of five years. There are about ten drugs in that section and provision to add other drugs to it.
Part III contains drugs which are classified as the C drugs. These contain among other things a drug called Pemoline. For any ladies who may be interested, this is a constituent of every slimming tablet prescribed in this country apart from one slimming tablet. If, under the British Act, you are illegally in possession of a slimming tablet you can be sentenced to up to two years.
The Private Members Bill which Deputy Dick Barry and I attempted to introduce here last November would have helped to curb the escalation and the explosion that has been occurring in the sale of heroin in this city since January. We warned the Minister. We pleaded with him in private. We said: "Take our Bill and introduce it yourself as an interim measure, purely as a deterrent. The Garda drug squad will catch these people." Nothing has been done. We are working under the 1934 Act and section 78 of the 1970 Act. What is the penalty for a member of an international drug chain who comes into this city? Where in Europe will they find an easier market with little or no penalty—six months and/ or £50 unless on indictment they go before a jury in which case they can get a heavier sentence. Not one case since 1966 has gone before a jury. It has been said publicly in court by people who are in on drug charges that they would rather be fined and spend a couple of months in prison here than go to England where they have this type of legislation or go to France and risk 15 years or go to Russia and risk the death penalty or to Japan and risk life imprisonment. Only two countries in the world, Russia and Japan, have got rid of the drug problem.
What type of provision is there here? If, on Saturday night, a member of the Garda Síochána suspects that an individual is selling heroin in an establishment in some part of this city, are the officials of the Department of Health aware or is the Parliamentary Secretary aware of what that garda has to do? He must first of all find a chief superintendent and travel with the chief superintendent to a district court judge and there have a search warrant sworn out which will last for 24 hours. We have made such a mess that I cannot help suspecting that the Government have become alcoholic in their attitude, that there is total inability to initiate any activity. Sometimes change is for the best. Not only is change for the best in this particular case but it is demanded by every parent in the country.
I have seen in the city of Dublin as recently as yesterday a male creature about 28 years of age who was a vegetable as a result of being on drugs. He had no mind of his own. Is there no one in the Fianna Fáil Party aware that this is going on? Have Fianna Fáil dissociated themselves from the grass roots so completely that they do not know that there is in fact a problem, relative though it may be, that it exists in the Taoiseach's city of Cork and in many other places? Do they think that because they have many cumainn and plenty of money they will get back into power? Surely, there must be a social conscience? Surely, there must be realisation that the only way to combat the drug problem is by providing adequate deterrent? Has not that been shown in New York? Is the Minister not a great reader of medical journals and research papers? Has it not been shown in New York that the cure rate for heroin addicts is less than 0.01 per cent over five years? Has it not been shown in New York that heroin is being sold to children under ten years of age and that parents have discovered their children injecting it into the pulp of the teeth?
These may be fantastic stories to journalists and others who may not be au fait with the position. The problem continues, and at the present time in the city of Dublin, where the Drug Squad is mainly centred, composed of nine people and one doctor, there are 176 cases before the courts for illegal possession and/or selling of Chinese heroin.
I raised this matter in January and again in March and I was told that no such thing existed. Members of the Drug Squad, concentrated in Dublin as they are, are rendered ineffective because they have to take the drug addict or possessor down to court, put him on remand, prepare the case, go back to court with it. Time is wasted. The accused is in and out of court on remand. An effort is made to sell as much as they can while awaiting trial.
I would not stay in this country if I thought that the present attitude of the authorities would persist. One reason why many people like to live in Ireland is that they love the country and the people in it and the Christian attitude that has prevailed, but if this hazard of the killer heroin is allowed to continue, there is not any point in staying here. We have the weakest drug laws in the world and there is no initiative whatsoever. I did my best. I am not experienced in drafting legislation. I had assistance and I drew up what was regarded by experts as being more than adequate deterrent legislation. At the same time as the heroin epidemic has hit Dublin it has also hit London. Liberal intellectuals smoke marijuana claiming that it is not a drug, that it is only as bad as alcohol. Alcohol has wrecked enough homes in this country. It has driven thousands of people into mental hospitals. It is the main or a contributory factor in 50 per cent of the fatal accidents on the roads. Yet the Minister for Health will claim that the effects on the brain of marijuana and alcohol are similar.
I may be a member of the Pioneer Association but I did take a drink when I was a student. To my mind, the hazards associated with drinking while driving and drinking while working near machinery are very grave. What should be said is that marijuana is every bit as dangerous as alcohol. The consumption of alcohol has been legalised. We realise now that possibly it should never have been legalised. One out of four patients admitted to hospital is admitted because of alcoholism, yet the Minister for Health says that marijuana is only as dangerous as drink. Good God, I hope I never see the day when one out of four patients are admitted to hospital for smoking marijuana, because even if it is only as dangerous as drink, drink is a hazard. The American Medical Association reported last year that 10 per cent of chronic marijuana smokers were born mentally defective. If that figure has not been substantiated it certainly has not been contradicted.
I wish to refer to a section of the British Misuse of Drugs Act, 1971. It contains provisions whereby medical practitioners cannot prescribe certain drugs. Yet in this country we had the unfortunate situation where certain doctors prescribed one or two drugs which possibly, had they been a little au fait or had the Department of Health been a little more aware of the drug problem, might not have happened.
There is one provision in this Act and it is that any member of the police force can apply off his own bat to a justice of the peace, somewhat the equivalent to our peace commissioners, for a search warrant which remains effective for 24 days. This is a great improvement on our existing legislation whereby a member of the Drugs Squad has got to go out on a Saturday night, get a chief superintendent and a district justice together and have a search warrant signed. I will not go further into this except to refer the Minister for Health and the Department to page 639 of the Public General Acts and Measures of 1971, Part I. In that he will find the legislation he will introduce. I know it and I am not boasting or bragging or being complacent about it. He will just copy it straight out. What the British do he does. One would think it is a British Parliament we have here. Everything they do we get. They should drop the word "Republican" altogether.
I mentioned earlier that Deputies are extremely grateful for the speed with which Professor FitzGerald's Committee brought out their report. It makes very interesting reading and it is very simple to read with very little medical jargon. I am severely hampered from further contributing to the debate but I wish to raise two matters arising from this report. There are a few hospitals with which I have had contact. One is the Mallow County Hospital which has been mentioned by Deputy R. Barry. On page 109 of the FitzGerald Report, paragraph 9.43, we find this:
Mallow County Hospital is a 98-bed hospital in a modern building providing a general medical, surgical and maternity service and staffed at consultant level by one surgeon and one physician. This hospital is 23 miles from Cork and is serving an area from which access to Cork is easy. The area north of it, around Rathluirc, is convenient to Limerick. We recommend that the role of this hospital be changed to that of a Community Health Centre and that its acute hospital functions be transferred to Cork and Limerick Hospital Centres as appropriate.
On this I want to say that the Fine Gael Party oppose totally this paragraph of the report. My party have decided that Mallow County Hospital shall retain and improve the medical, surgical, maternity and paediatric services it provided heretofore and that it shall not be downgraded to the status of a community centre. I think the people of that area are grateful for the work and the research Deputy R. Barry has put into this. The report on the same page refers to Bantry County Hospital and at paragraph 9.44 it states:
The position of Bantry County Hospital is not easily resolved. This is a 128-bed modern hospital 56 miles from Cork City and serving the relatively isolated area of West Cork some of which may be up to 100 miles from Cork.
As I mentioned earlier, I practised near that area and I had occasion to use the surgical services in Bantry County Hospital, for which I was very grateful at the time. The report continues:
The present area served by it has a resident population of the order of 40,000 and is a popular tourist centre during the summer. To leave it without a hospital would involve hospital patients and their visitors in journeys to and from Cork and it is open to the objection that medical risk might be involved for some emergency cases. On the other hand it must be accepted that with the proposed reorganisation of the hospital services in a small number of highly developed hospital centres, small isolated hospital units such as that in Bantry, will be limited in the scope and quality of their work and cannot hope to provide a service of the standard available in the major centres.
Let us take that from a national point of view. Bantry County Hospital is 100 miles from Cork. Limerick is 100 miles from Cork. If a doctor had a patient, let us say, in a village in Dublin, and the nearest specialist hospital was in Limerick he will get an ambulance and send a child with an appendix away down there. The best he could do it in would be two hours, driving at 50 miles an hour non-stop, which he could not do with a sick person.
Surely the officials will have to have another look into all this. To have Bantry County Hospital downgraded to the status of a community health centre just is not on. For a start, those roads in West Cork, as mentioned in the report, are not adequate. I have travelled over them on many occasions. They are bumpy, they are twisting and you just could not take a sick person to Cork at great speed for an emergency operation in the type of ambulances we have. The terrain in the south western part of the country is different from that in the rest of the country. This factor should have been taken into account. It is not possible to use a slide rule in a matter like this. I am not accusing the Minister of doing this but certain sections may have received more consideration than others. Bantry Hospital should be retained, extended and sufficient services provided to cope with the requirements of the area. At the moment a maternity patient in County Kerry who might have complications would have to be sent to Cork for treatment.
It would appear that the slide rule was used to a considerable extent with regard to the Roscommon County Hospital. The report of Professor FitzGerald, Senator Alton and others was of considerable importance. Their terms of reference were: to examine the position in regard to general hospital in-patient and out-patient services in the State and to report in outline on the future organisation, extent and location of these services taking into account the changing pattern of demand, the impact of developing specialisation and the introduction of new techniques so as to secure, with due regard to the national resources, that the public is provided in the most effective way with the best possible services. This has been accepted in principle but the Minister has backtracked in one or two instances.
On 30th July, 1970, I raised on the Adjournment the matter of drug abuse. I had been a Member of the House for a year and I thought I should say something about the matter. Perhaps I have said too much about it since, perhaps it has been wrongly edited and documented; these are the hazards of attempting to effect change. On 30th July, 1970, at column 2866, Volume 248 the Minister for Health stated:
Deputy Byrne has been doing a beautiful piece of self-advertising by exaggerating wildly the state of drug-taking in this country. I hope he is pleased with himself for this beautiful piece of self-advertisement.
At column 2867 of the same volume, the Minister stated:
The Deputy knows perfectly well that I and the health authorities have taken every possible step to deal with drug addiction here.
At that time the Minister and the authorities had done nothing. The Minister also stated:
I have also made it absolutely clear to everybody that I cannot stop drug addiction. No Minister for Health in any country in the world can stop it. Let us get rid then of this nonsense of pretending that by making a wordy speech Deputy Byrne can suddenly find a Minister for Health who overnight will eliminate drug abuse. All we can do is control it as far as lies within our power.
The Minister stated "No Minister for Health in any country in the world can stop it." The Minister is condemning himself out of his own mouth. He has shown his inability to initiate any activity in this matter. From the Official Report I have quoted it can be seen that he has made no effort, that he has refused to make any effort to cope with this problem. The Minister continually tells us that a Bill is in the final stages of drafting. I referred earlier to the Bill introduced by Mr. Reginald Maudling—the position in relation to our country is that the Bill is in the final stages of transcription.
I condemn the Minister with regard to this matter. I will table a motion of no confidence in him if this legislation is not brought before the House, as he stated three weeks ago. The people are fed up with the inactivity and the inaccuracies coming from the Government side of the House through the mouth of the Minister for Health.
With regard to the provision of hospital facilities in the north side of Dublin, the situation is disgraceful. In July, 1970, I asked the number of children on the waiting list at Baggot Street Hospital to have their tonsils removed; the answer was 50. The Minister said he was taking active steps, in conjunction with the hospital authorities, to have the waiting list reduced. A month ago I asked a similar question and was told that 458 children were on the waiting list. There is one children's hospital on the north side of the city. There are three on the south side. There are more people living on the north side than on the south side.
I have alleged on a number of occasions here that central heating in places where there is no control over it can have an adverse effect on upper respiratory tract diseases. These diseases include rhinitis, sinusitis, pharyngitis, laryngitis, tracheitis and bronchitis. It has been shown that for office workers who are in their offices for only eight hours each day, five days per week, the incidence of these diseases has increased by 33 per cent. In Wuttenburg in Germany, where troops of the British Army were housed in high rise flats, it has been found that among those living above the third-storey level the incidence of these particular illnesses has increased by more than 30 per cent in adult male personnel. These facts have been well documented and reported.
I have asked the Minister whether he would set up a committee to investigate the effects of central heating which is compulsory in the high rise flats that have been built in this country. In the 3,200 units at Ballymun the flat dwellers have no control over the central heating. The control is in the hands of one person as the boiler house and the temperature is gauged by an outside thermometer. At St. Michael's Estate there is a similar system. I shall explain to the Minister how the system works so that he may understand a little better. There is a boiler house where oil is burned. This heats the water and the hot water then flows through pipes that are underneath the floors of the dwellings and the only control is at the central point. This is the situation in Ballymun where almost 30,000 people are housed. When I worked in that area as a dispensary medical officer I found that the incidence of these illnesses increased phenomenally compared with the incidence of the same illnesses among people living in houses where they had control over their heating systems.
Recently I did a certain amount of preliminary research into this matter. I am not qualified to put forward an elaborate statistical assessment but I have found that two out of every three patients from the Ballymun flats who consult me suffer from respiratory tract infections. There have been women who have come to me suffering from depression and who told me that they never had ill health before coming to live in the Ballymun flats. The Minister for Health has told us that the chief medical officer and no evidence to indicate that there was any association between central heating and upper respiratory tract diseases in so far as Ballymun was concerned. When the Minister's attention was drawn to the report drawn up at Zurich, he, for some inexplicible reason, stated that conditions in Zurich were totally unrelated to conditions at Ballymun. They were only unrelated in so far as they were much more favourable in Zurich than in Ballymun, because in Zurich there was controlled central heating in flats. Regarding the report on the BAOR personnel at Wuttenburg the Minister attempts to criticise the report because of some typographical error. It ill becomes the Minister to adopt such an attitude.
I ask the Minister to sanction any application that may come before him from the Medical Research Centre for research concerning the Ballymun flats. In this respect an invaluable report could be produced and the Minister's Department, I am sure, could obtain the co-operation of the 20 or more doctors who work in the Ballymun area in tabulating these diseases in their own time. When statistical proof came before the Minister I would expect him to act immediately in requesting the Department of Local Government to have the central heating charge removed in respect of each flat at Ballymun. It is a ludicrous situation that a tenant of one of these flats must pay £1 a week for central heating and that this heating results in ill health to his family and which, in turn, costs him more money in terms of medical expenses. When a person is taken from a condemned house in the city and given accommodation in Ballymun he is asked to sign an agreement to pay for, among other things, his central heating.
