Deputy Madeleine Taylor-Quinn was in possession.
Private Members' Business. - Limerick Hospital Proposed Closure: Motion (Resumed).
The following motion was moved by Deputy Molloy on Tuesday, 16 February 1988:
That Dáil Éireann, disturbed at the implications of the proposed closure of Barrington's Hospital, Limerick; mindful of the fact that it is a major public hospital facility in the mid-west region, with the busiest out-patient department outside Dublin city, treating approximately 45,000 patients annually, and being open 24 hours a day, seven days a week with 80 per cent of its in-patients being public patients; and in view of the fact that it is a highly cost-efficient hospital and that its facilities will have to be replicated elsewhere at heavy cost to the Exchequer, directs the Minister for Health to rescind his proposal to close the hospital from 31st March, 1988, since such an action is not justified on either financial, medical or social grounds.
Debate resumed on amendment No. 2:
To add to the Motion:
that if, however, in the opinion of the Minister for Health, the rationalisation of the health service in Limerick requires the closure of a voluntary hospital, Dáil Éireann considers that St. John's Hospital, rather than Barringtons Hospital should be closed, and in the event of such closure, Dáil Éireann being aware that private medical interests have offered to purchase St. John's Hospital with a view to keeping it in operation as a private hospital calls on the Minister not to inhibit this, or any other initiative along the lines.
—(Deputy Allen.)
(Limerick East): Deputy Taylor-Quinn concluded. We are dividing the time. I understand I have ten minutes.
Yes, I should think so.
On a point of order, while I do not wish to interrupt Deputy Noonan, I would draw the Chair's attention to the fact that the time is now 7.5 p.m.
I appreciate that but the Chair had no control in that respect.
Therefore, the vote on this motion will not take place tonight in those circumstances.
Yes, Standing Orders provide for a specific amount of time in respect of Private Members' Business and it can spill over to next week if this House decides that be so. The vote can take place tonight, I assume, if the House——
Unless this House decides that the normal time shall not apply.
There will be five minutes to spare. Is it agreed to take the vote this evening? Agreed.
(Limerick East): I regret, as I said previously on the Adjournment matter, the decision by Fianna Fáil and the Government to close Barringtons hospital in Limerick. It was a wrong decision and I do not think the Minister's speech last night has done anything to change it. It was wrong on financial, social and medical grounds. I spoke here previously on the Adjournment two weeks ago and not only did I draw attention to the virtues of Barringtons hospital, an excellent hospital, but I outlined my objections to the decision. I would like to recite some of them again tonight for the record.
I am particularly worried about the manner in which the decision was taken. I know from my experience in Government that Comhairle na nOspidéil had drawn up a list of hospitals to be rationalised and that they said either St. John's, Limerick, or Barringtons, Limerick should go in an amalgamation of both hospitals. Deputy Barry Desmond was Minister for Health then. In a press statement he issued he referred to a number of the memoranda submitted to Government. He recommended that St. John's hospital be closed in this rationalisation. I find it difficult to understand how the Department who recommended this to the previous Minister can now recommend the alternative to the present Minister.
In November last year permission was given to take on student nurses as Deputy O'Malley said last night. That would have been for a three-year course. Surely one does not get permission to do that and then, four weeks later, to close the institution that is supposed to train them. In October we debated here the Estimates that were presented by the Minister for Finance. There were cutbacks in the allocation for both St. John's and Barringtons but an allocation was provided for both which would have been sufficient to run the hospitals for 12 months. An amount of £1.6 million was allocated for Barringtons hospital.
On 1 December the Minister came into this House and answered questions. He gave no explanation last night which solved the question of why the Minister implied in this House that all announcements of a closure of acute beds had been made, that there were no surprises up his sleeve, but one week afterwards we got the decision that Barringtons hospital was to close. The way the decision was taken is peculiar to say the least. Any of us who have had experience in Government know that is not the way in which decisions are taken and that there is something the Minister has not told us about. We are not getting the full information from him.
I do not want to go over the ground covered by other speakers last night as my time is limited. I have just ten minutes to outline the virtues of Barringtons hospital. It is sufficient to say everybody in Limerick would recognise the virtues of the hospital, with an efficient medical staff that, over centuries, has provided an excellent health service, marvellous nursing care, and in particular an enormous service as a public casualty hospital seven days a week, 24 hours a day. This is the aspect of the decision which has caused such emotion in the city. While many people are hospitalised, many more go through casualty and in a year like last year when over 40,000 people received treatment in casualty in Barringtons hospital, is it any wonder that there is an outcry at the closure of the hospital?
There is agreement, I think, not only in Limerick but in this House, that the wrong decision was made, so what would have been the right decision? If the Minister felt he had to rationalise the health services in Limerick by closing a voluntary hospital he should have closed the other hospital, and people have said that here as well. We have written that into the amendment we moved last night and we want it added to the motion. If we think the wrong hospital is to be closed, we should not be afraid to say so and if we want to vote on something we should vote on the real solution. Simplistic solutions to complex problems will not work and we should put our cards on the table, say what we mean, mean what we say and vote accordingly. We know there has to be rationalisation of hospitals and if a hospital has to go in my city I think it should be St. John's rather than Barringtons.
We have been heavily criticised for putting down this amendment but was anybody surprised? Deputy Dukes, the Leader of our party, said in his Tallaght speech that we would put forward alternatives when we disagreed with Government decisions. Did we not do this right through the last session of the Dáil? In all logic can anybody be surprised that we put forward an alternative in our amendment? On top of that we say that a private interest have already put a bid on the table for St. John's hospital. We know that is the reality of the situation and if the formula we are putting forward is followed we can retain the three hospitals in my city — two as a charge on the public purse as public hospitals and one as a private hospital — not a luxury Blackrock Clinic, which will cater for B and C VHI patients — and give approximately 80 or 90 beds at no extra charge to the Exchequer. That is the solution and we have put forward that solution in this case as we have done on other occasions. This is the straight and honest thing to do and I reject the criticisms of other parties that we were motivated by any other consideration.
A protest vote in this House which calls on the Minister to keep Barringtons hospital open is not the solution when the Minister has said time and again, and on several occasions to me that regardless of how that vote goes, he will close the hospital.
The Dáil does not matter.
(Limerick East): If an alternative solution is put forward then we will agree to it.
I heard Deputy O'Malley say on the radio that it would be unconstitutional to ignore Private Members' time. I remember that during the Fieldcrest debate on 29 and 30 June 1982 when Fianna Fáil were in Government, and Deputy O'Malley was a Minister in Cabinet, a motion was passed in this House during Private Members' time and the Government took no notice whatsoever of it. Are Fieldcrest nationalised? He is the man who was in Cabinet and who has said it would be unconstitutional to ignore Private Members' time.
I never said that.
(Interruptions.)
(Limerick East): There are two things which came out of the last election: one is that when there are tough decisions to be taken, “Dessie can do it”. That poster is going to fall into the same disrepute as the other great poster from the other side of the House which said: “Health cuts hurt the old, the sick and the handicapped”.
I should like to deal with the Labour Party objections to our amendment. Deputy Howlin said that the Labour Party have objections in principle to private medicine.
I have not spoken yet.
(Limerick East): You said that in your interjection last night. That is very peculiar because when Mr. Brendan Corish who represented the Deputy's constituency was Tánaiste and Minister for Health from 1973 to 1977 we had private and semi-private beds funded by the VHI.
We are not opposed to privatising hospitals. We are opposed to privatising public beds.
(Limerick East): When Mrs. Eileen Desmond was Minister for Health we had private and semi-private beds funded by the VHI. When Deputy Barry Desmond was Minister for Health for four years we had private and semi-private beds funded by the VHI. Where is the principle in that? They controlled the ministry for ten out of 15 years and they did not lay a hand on the private beds.
We are opposed to privatising beds but not to privatising hospitals.
(Limerick East): Now because it suits you it is a principle.
The Deputy must think the people——
(Limerick East): I have not come to The Workers' Party yet.
The doctor will have to treat them for blood pressure.
(Limerick East): I should like to remind the House that not only was it not a matter of principle with the Labour Party but that Deputy Desmond, as Minister for Health, extended VHI cover to the two great monuments to private medicine in this country, and many of us do not like them very much — the Blackrock Clinic and the Mater Private Hospital. Where is the principle in that? Why is it such a hard thing to swallow a proposal that the Minister should not interfere to prevent a hospital going private? We are not asking him to do anything. Suddenly this is elevated into an enormous principle which the Labour Party cannot swallow tonight. That does not stand up and the phoneys are being exposed in this debate——
Fine Gael are the phoneys.
(Limerick East):—and we will expose them as the night goes on. I am asking the minority parties in this House to support the Fine Gael amendment——
You would drop dead with the fright.
(Limerick East): They are going on the soft option——
Maybe we will call your bluff and do it.
(Limerick East):——and the tough man has turned out to be the teddy bear.
You will get your chance, Deputy O'Malley.
You would drop dead with the fright.
(Limerick East): There is a real hard nosed decision on the table and if the other parties are prepared to take the responsible attitude that we are taking then the hospital can be saved. Otherwise, they will have sentenced it with their soft option politics.
I understand that I was to be allowed five minutes to speak in this debate and I wonder if I might speak now.
I am now calling the Minister for Industry and Commerce.
I am glad to have the opportunity to intervene in this debate. I listened attentively to most of it last night and again tonight. I heard about the posters in the last election that said: "Dessie can do it". Maybe Deputy Noonan wants his name on the top of the next poster saying, "Michael can do it."
Looking at the debate from the outside, far away from Limerick and taking an objective view and considering the various propositions put before the House, I have to say, in relation to what Deputy Noonan has said about retaining St. John's hospital and letting Barringtons close, that St. John's hospital have already refused to sell their hospital to private interests. It is presumptuous of the Deputy, of us or anybody else to assume that.
That is an overstatement.
(Limerick East): As the Minister knows, going concerns do not sell.
So if you want to screw them up the other way you should join that crowd up there, if that is the game you are at.
It is difficult for an outsider with a totally objective view to try to make up his mind as to which way and in which direction various people are going. I do not intend to get into the internal problems of the Progressive Democrats or of Fine Gael and who stands for what. Deputy Allen moved an amendment and spoke about it and yet when all the furore about the North Infirmary in Cork was going on we heard nothing from Deputy Allen. I can understand the Limerick Deputies only because the hospital is in their constituency but being the people of high principles that they are I find their line very difficult.
I listened with interest to some of the phrases Deputy O'Malley used last night and they were very interesting. He said that Deputies in this House cannot have it both ways. I think it is fair and reasonable to throw that back at Deputy O'Malley and say to him and his party "You cannot have it both ways either, you cannot have your loaf and eat it." Deputy O'Malley and his party know well the basis on which that party were founded. We all read with interest their election programme. We know where their support came from. It is very difficult to know in what direction they are facing. They want to get personal taxation down. That is a very laudable objective and one to which I would totally subscribe. But Deputy O'Malley and everyone in his party knows as well as I do that there is no realistic way you can get personal income taxation down unless you cut overheads and expenditure. There are two ways in which the Government get money, by borrowing and by way of taxation. Where are you going to get the money? You either have to cut your overheads, as any common sense businessman would do——
In this case you will cut far more overheads if you close this hospital.
I will come to that statement and also to many of the other wild statements you have made from time to time.
You will save many more overheads.
I heard a wild statement here last night about £2 million.
At least.
It is very easy to take a figure out of the air, toss it around and say it will cost £2 million to close Barringtons Hospital while ignoring the fact that it will cost £1.5 million to update the casualty unit in the hospital. It is easy to throw out a figure off the top of your head. The Deputy said it would cost £2 million to close the hospital but he did not back that up. He spoke about the finances and economics of keeping it open and yet he failed to elaborate on this magic £2 million. It does not stand up and the Deputy knows that.
I said very clearly that we are prepared to stand——
Anyone who makes a decent argument should back it up with the facts and figures.
I do not propose to get into the medical side of this question. I have the fullest confidence in Deputy O'Hanlon to assess that aspect. He is a practitioner in that area and he knows a hell of a lot more about it than I do so I will confine myself more to the financial side.
The Minister, Deputy O'Hanlon is not a man, as Deputy O'Malley asserted in this House last night, to toss up a coin to see whether Barringtons hospital or St. John's hospital would close. That is not the way Deputy Rory O'Hanlon does his business. It is not the way he has done his business since he became Minister for Health. He has had the courage of his convictions to stand up, knowing, as Deputy Clohessy rightly pointed out, that the party is over and that the day of reckoning has come and we have to pay for it. If Barringtons hospital was situated in Dundalk, Wexford or Waterford and was closing down, would Deputy O'Malley come in here and set down a Private Members' motion? I do not believe he would. Deputy O'Malley sold himself and his party to the Irish people as men of integrity, righteousness and men who would stand up and take the tough decisions irrespective of the consequences. Is it a fact that the Progressive Democrats are not what they said they were when they set out? It is a fact that when they began to look at the political reality of what was happening in this House they changed course, which we were told they would never do? Indeed, I am inclined to take that view at present, having read what Deputy Harney said in Cork very recently, that they were now moving towards the working class area.
I did not say that.
I do not know how Deputy O'Malley and some of the people in his party can align themselves with that type of society in Irish life when he set out on a specific course of right wing monetarism and to cut expenditure at whatever the cost, to cut expenditure because it had to be cut. How in the name of God can he come along and try to present himself in a different light?
I would be hard put to keep up with you.
I am sure you would.
Cuts, cuts.
If the Deputy wants to know the real situation he would have a hell of a job to keep up with me. If the Deputy wants to translate his situation to my situation and there is a man sitting here on the benches who can testify to it——
Is it not interesting to see the Minister for Industry and Commerce reduced to this level?
What about the Deputy himself? When I heard the statement made last night by Deputy O'Malley I wondered whether it was the Des O'Malley I used to know and sit around the table with, because what I heard him say last night was not the Des O'Malley I used to hear, to be quite open and honest about it. A previous Minister for Health, Deputy Barry Desmond, closed a hospital in my town when I was in Opposition. He will testify to this day that I did not come into Dáil Éireann and put down a Private Members' motion, or take the matter to the Fianna Fáil front bench so that I would get a Private Members' motion. I did not put down special questions because I recognised the reality of the situation.
That is not true.
Despite the fact that 600 people stood up in Longford town and jeered me for not being prepared to do it, I was not prepared to do it. I will stand by my own analysis of the situation as I have always done and I will make no apologies. For the benefit of Deputy Carey — and I did not hear what he said — I got the biggest vote that I ever got in any general election since I came into Dáil Éireann at the last election: 10,542 people decided that I must have been right.
On a point of order, I would like to correct the Minister. He has given the impression tonight that he did not bring in a motion about Longford hospital.
That is not a point of order. Will the Deputy resume his seat now?
I did not.
It was a consolidated motion.
I challenge the Deputy to go back on the record of the House and produce a motion. There is no motion in the record of the House, and the former Minister for Health is here to prove it, and he would know whether a motion came forward. I ask Deputy Desmond, am I right or wrong.
Deal with Barringtons.
He was right for once.
Now, withdraw your allegations. I will debate this on the facts of the situation.
You are making a circus out of the situation.
Seventy thousand people marched for Barringtons.
I do not have to make a circus out of anything because it is your own party that have made a circus out of this, by dragging the motion into this House. You know in your heart and soul there are three hospitals in Limerick, with three separate managements, with three separate overheads to deliver the same services. This cannot be good business, it does not make economic sense, and it is not the right way if you are serious about getting down the huge health expenditure that Deputy Molloy has referred to on many occasions in this House.
Do not make a fool of yourself.
I am not making a fool of myself. You are making fools of yourselves.
You have the forthcoming weekend at the RDS.
I will debate this motion on the facts as put down, on financial, medical and social grounds and I will stand up ——
The interruptions must cease. Deputy Molloy, if you persist I shall ask you to leave the House. You are showing defiance towards the Chair.
It is a preview of the Fianna Fáil Ard-Fheis.
The Minister without interruption.
I deal with realities. I deal in common sense. There are three hospitals in Limerick, a city the size of Tallaght. Deputy Harney lives out there and represents that constituency. Is that party asking for those hospitals to be retained with more or less the same services in a city with the same population as Tallaght, despite the fact that in this city of Dublin which has over a million people there are two hospitals, north and south? I did not see anybody coming into this House creating such an uproar when the Dublin hospitals were closed.
I know the hype that the hospital charges got. I know the hype that went on all over the place. In fact, I visited a hospital on the southside of Dublin on the day the hospital charges were introduced. I went in for an X-ray and paid my £10. The little girl who took the £10 had a stack of money that high on the desk. It was 4.45 p.m. and she was counting it out. I asked her what all the money was for and she said "that is what I got from collecting the £10 today".
It is a disgrace.
I paid my £10, got my X-ray and left. I sat into my car to drive away at 5.5 p.m. and I heard on a radio programme that no hospital charges were collected anywhere in the Eastern Health Board region on that particular day. Yet, that little lady who took the £10 from everybody who came in had told me when I asked her that not a single person had cribbed about the charges.
Action was taken by Deputy O'Hanlon with regard to abuse of hospital and ambulance services — and we all know that the ambulance services were abused in this city and in some cases used for rural transport. Is that the way the Progressive Democrats would like the management of this economy to continue? I do not believe it for one minute and everybody knows full well that if this hospital was not closing in Deputy O'Malley's backyard he would not and neither would he allow his party to come in here with a notice of motion. It is as simple as that. They are the facts.
If the hospital was half a mile away there would be no motion, because that would make sense.
Does it make sense to keep three hospitals open in a city the size of Limerick?
(Interruptions.)
That is what your amendment says. Three hospitals provide the same services in a city which has the same population as Tallaght, and one hospital there can do more than one hospital can do in south-east Dublin.
It says nothing about three hospitals.
It is an irrational, irresponsible argument that cannot be sustained.
The Minister is ignoring the argument. He has a blind spot.
That is the reality. Let us come back to the job we are trying to do and where it impinges on reducing the health services. If Deputy Molloy thinks I have not looked at any facts or figures, I ask him, because of his interest in the cost of our health services, to research and compare the cost of a public hospital bed in the UK with the cost of a public hospital bed here. He would see exactly what the Minister is setting out to do.
That is not the argument.
We have provided practically the same amount of money this year as last year. The Deputy and everybody in this House know we cannot go on indefinitely spending money. Where are we going to get it? This service mushroomed but not with the right management in place which would have ensured value for money. Very few Deputies with their hands on the hearts could say that we were getting the best value for money from our health services because we are not. We had the highest rate of bed occupancy in Europe. A start must be made not alone in the health services but in every other service. That is exactly what this Government have been about since they came to office.
That is a change of heart.
Is it?
It is.
We looked at a Government that for four and a half years sat down and did nothing. If the country had been allowed to proceed along that road, there would not be enough money from taxation even to service the interest on the national debt which had doubled in four and a half years. The actions taken were necessary. When they hurt there will be screams from certain Deputies but the day of reckoning has come. Politicians will in the future be tested for their honesty and integrity.
Honesty?
It is interesting, looking at a recent opinion poll, to see that opinion has now moved away from supporting the Progressive Democrats. The foundation on which that new party were built has shifted and there is now support for different parties. They are now picking up fringe votes.
At £1.6 million, Barringtons hospital must be the best value there is.
There is no doubt, Deputy Sherlock, that the Minister would not turn his back on the best value offered to him. It is he who has the job of managing the hospital services and with the money allocated he would not look a gift horse in the mouth. The Minister, Deputy O'Hanlon, knows what health is about. He knows what the services need.
God help them.
Somebody has to take out the meat cutter, as they say in America, and cut away the fat. We do not try to say that we get everything right; we are all human beings. This is not speaking off the top of one's head, or tossing a penny in the air, or agreeing with the nonsense talked in this House last night. The Minister knows what he is about and is sticking with it.
For four years Deputy O'Hanlon criticised Deputy Desmond that he was not spending enough.
I helped your colleague, Deputy Howlin, when you were not here. I took a stand when I was asked to take a stand.
For four years Deputy Desmond could not spend enough money.
Minister, perhaps if you did not give to Deputies the attention you are giving and addressed the Chair, you could proceed with fewer interruptions.
The Deputies do not seem to understand now what they understood only 12 months ago. We came into Government and took the decisions that everybody had talked about for many years and the results are already showing. At the end of 1987, inflation was down to its lowest level in 12 years. The current budget deficit had been reduced to a figure dreamed about for many years but never even attempted.
Our health services are shattered.
Deputy Howlin, could you treat the House in the fashion it deserves? I do not know if you have had an opportunity to make your contribution.
I am next.
I will see that you get the consideration you should give to the Minister. We will proceed in a civilised fashion.
I shall address my final comments to people who should know more about what I am talking about, that is, the need to cut public expenditure, the need to get this economy back on the rails because it had gone off the rails. This exercise is only part of that. We brought in a budget in 1987 with targets at which people just sniggered, that the prophets said could not be attained. They were achieved and not alone achieved but surpassed by £72 million. That brought a return of confidence and the outflow of capital was reversed. Interest rates came down and the inflation rate was the lowest in 20 years. Trading accounts had a surplus for the second time and were heading for the greatest surplus of all time.
(Limerick East): Thanks to this side of the House.
That is what Government and management of the economy is all about. Nobody should understand that better than the Deputy who put down the motion, Deputy Desmond O'Malley.
That is a new record for you.
I can tell Deputy Connaughton and anybody else on that side that I would stand in the dock any day of any year. What I said I would do, I did. I shall continue to do that. I shall continue taking unpopular decisions where necessary.
Ballyforan is right.
Ballyforan had £20 million spent on it and the Coalition Government decided to scrap it. The Opposition stand indicted on Ballyforan. This is not the place to start throwing things. They get thrown back. Deputy Desmond O'Malley, Leader of the Progressive Democrats, should know what cutting public expenditure is all about. He should understand what getting the economy back into shape is all about, should understand about changing the mould of Irish politics — what he set out to do. In 11 months he has changed it all right; he set out on one road and has taken a different signpost. I do not know where he stands, neither do those who supported him at the beginning. It is not surprising that his support is disappearing as quickly as it appeared. Deputy Harney would try to move the party towards the left. I do not know whether Deputy Molloy would move it towards the left or right. Deputy Clohessy was the only sensible Deputy that I heard speak from that party last night. He recognises the reality. He as a constituency TD, will be making a case for Barringtons hospital, but making it in a different way from the colleagues in his own party. His colleagues have a brazen neck to try to preach financial rectitude, the policy they reneged on.
There were 70,000 people who signed a petition for Barringtons hospital and Deputy Reynolds should address himself to that.
Where was the motion for the North Infirmary? Does the Deputy not represent Cork? I did not see a Private Members' motion concerning the North Infirmary. The Deputy cried off. No sensible person could expect three hospitals to remain serving that area with £1.3 million to be spent on Barringtons hospital and a wild unsubstantiated statement of £2 million as the cost to close it. The medical side and the social side were dealt with quite adequately, concisely and coherently by my colleague, Deputy O'Hanlon. No one should presume to tell us to ask that St. John's hospital be put up for sale. The authorities took a decision not to sell it. That is their prerogative. There stands the case and I fully support the Minister. This country will thank us at the end of the day for restoring normality, common sense and pragmatism to a health service that had gone wrong and for getting better value for money.
I am calling Deputy Howlin. Before Deputy Howlin speaks, may I remind the House of the sensitivity of the area in which we are involved? Perhaps we would ponder whether the many people in the country who are in need of these services would appreciate the manner in which we are handling their delicate case.
I understand I am being allowed time to speak. Will I be after Deputy Kemmy?
I am not aware of any understanding.
With the consent of the House, I wish to divide my allocated half hour with Deputy Desmond and Deputy Kemmy.
Is that agreed?
Agreed.
I appreciate the Chair's comments. We are certainly straying from the seriousness of the issue that is facing us. There is a saying that there are lies, damn lies and statistics. I would suggest that now there are lies, damn lies, and Fianna Fáil health policy. The experience of the country over the past 12 months shows clearly that what passes for health policy under this Administration is a sick joke.
The Labour Party seek tonight to use this debate to lodge the strongest possible protest at the absence of any rational, sensible or even compassionate approach to the maintenance of our health services. I can best illustrate current Government policy in this area and the false propaganda which surrounds it by referring to a letter which I received in the past two days from two consultant physicians in my own constituency. Both doctors, responsible as they are for medical care in Wexford General Hospital, make the point that the proposed closure of 24 acute medical beds will have a serious and catastrophic effect on the acute medical services in Wexford General Hospital and its catchment area. They sincerely believe it is not workable and it will be impossible to give a service with this number of beds and that there is no way they can discharge patients any earlier without grave and potentially fatal consequences. These remarks are not the comments of any wide-eyed political activist or political ideologue. These are the genuine views of two senior members of the medical profession who are deeply worried by the developments which are taking place in the health services in this country.
This same attack is visible in every county in Ireland from Carlow, where I was last Thursday, to Kilkenny which is losing the gynaecology wing of St. Luke's general hospital, to Ardkeen in Waterford. There is a crisis unfolding which threatens the well-being of the people of this whole country.
The Minister for Industry and Commerce contributed to this debate in a most disgraceful fashion. He flippantly addressed the issue. In the few comments he made on the health issue he said it was a pruning of wasteful transport. I am dealing with cases in Wexford of women in the late stages of pregnancy hitching in for pre-natal care to Wexford General Hospital. I am dealing with people who are faced with bills which they simply cannot afford, and the Minister says nobody is cribbing over the health charges. I do not know where the Minister is living.
In the brief and infamous period this time last year when Fine Gael occupied the Cabinet room on their own, they introduced a budget which, among its other effects, cut the health budget to the bone. That Estimate for Health was adopted by Fianna Fáil when that party came into office, and the situation was exacerbated to an intolerable degree in Fianna Fáil's Book of Estimates for that year when they cut a total of £72 million from an already seriously depleted health budget.
I mention the successive budgetary cuts to make the point that the callous and irrational approach of Fianna Fáil to the health services has been compounded by the total hypocrisy of Fine Gael in relation to this whole issue. Nowhere has that hypocrisy been more evident than in relation to the motion before this House tonight. We have seen rivers of crocodile tears flowing from the Fine Gael benches in relation to Barringtons hospital. Those crocodile tears cannot conceal the fact that it was Fine Gael who set up Barringtons hospital for the fate that is befalling it. These are the basic facts. When Deputy Barry Desmond was Minister for Health the allocation to Barringtons increased from £1.789 million to £2.164 million. The Fine Gael budget, adopted by Fianna Fáil, slashed that allocation by over 15 per cent in real terms to £1.897 million. The 1988 Estimate reduced the allocation for Barringtons further to £1.6 million.
In relation to St. John's hospital, the figures are the following: from 1982 to end of 1986 the allocation increased from £1.825 million to £2.037 million. Fine Gael slashed the allocation by over 30 per cent in real terms to £1.588 million. The 1988 Estimate cut it still further to £1.3 million. These are the irrefutable facts that demonstrate that even before Fianna Fáil had made up their mind about what to do in Limerick Fine Gael had shown them the way. They do, in fairness, indicate clearly that Fine Gael would have closed St. John's first. It was the St. John's budget that took the major cut in the Fine Gael budget, but they clearly embarked on a path which could only end in the closure of both hospitals.
That is why I say that Fine Gael have behaved with such breathtaking cynicism in relation to this issue. Not only in Limerick but all over the country Fine Gael talk about how they would do things differently, how they would operate with more compassion and sensitivity within the same Estimate. Their behaviour, when it comes to the opportunity presented to us tonight to beat the Government and keep Barringtons open, puts all that sensitivity into focus and shows the truth. Of all the cynical actions we have seen from Fine Gael in their frantic anxiety to avoid defeating the Government, nothing caps the amendment they have placed on the Order Paper for tonight.
I have spoken to members of Fine Gael who simply do not understand why their party are carrying a torch for private medicine. There are many members of Fine Gael and many supporters of Fine Gael who can see only too clearly the emerging two-tier health service in our country. They can see how private medicine encourages waiting lists to grow. They can see how it robs the overall service of very scarce resources and they do not believe that their party have any mandate to encourage further developments in this trend.
Deputy Noonan spoke tonight about Labour Party hang-ups. We have no hang-ups. I invite him to address the fundamental issue that has to be faced tonight. Do they want the Government defeated? Do they want Barringtons to be kept open or do they want to play-act and amuse us again? Who, I would like to ask, has given Fine Gael a mandate to campaign for the closure of St. John's? Who gave them or any other Opposition party the right to come before this House and say that one hospital rather than another should be closed? There is no such mandate from the people of Limerick, as far as I am aware. I know for a fact, and so does every Member of this House who reads his mail, that the people of this country as a whole have given no mandate to anyone to dismantle our health services in the crazy and irrational way that is happening now.
Everything I have said about the major Opposition party reflects a view that I know is increasingly widely shared. But I am prepared to take back everything I said, and to acknowledge the sincerity of that party's concern for the health service if they will withdraw the spurious and cynical amendment before the House. I would appeal to them to do so, and to join with the rest of the Opposition in ensuring that real pressure on the Government to keep Barringtons open is kept up.
We should be under no illusion about what is happening to our health service. It is essentially a cynical political exercise. Fianna Fáil are manipulating the inbuilt majority they have to cut and hack at public expenditure, and particularly the health service, together with other essential social services which we provide. The captive majority which Fianna Fáil are manipulating may squirm, but they made a present of that majority to Fianna Fáil in Tallaght in the autumn of last year, and Fianna Fáil are making the most of it.
However, they are not doing so because they believe, as a matter of principle, that a leaner, fitter health service is in the national interest. We all know that there are areas in the health service where substantial savings can be made — the continuing scandal of the common contract comes to mind. Basically, Fianna Fáil do not care what kind of health service they have as long as its cheap. They do not care how many highly-paid professionals are allowed to maximise their own earnings at the expense of the poorest sections of the community, as long as they do not have to foot the bill. The consequence is that every day, beds, wards, whole floors of public hospitals are closing down. The only growth area in health is among the suppliers of deep-pile carpet; which is now being sold by the square mile as public wards are dressed up to attract private patients.
While this is happening, all of us in this House know of cases where families are being made to wait for months for simple tests, unless they can cough up £200 or more. Our health service, which ought to be a national asset, is becoming a national disgrace, thanks to the conspiracy of collusion between the two largest political parties.
I wish to conclude by placing some additional views on the record of the House. They are not mine: they are the views of the group of consultants that offered to buy St. John's hospital. They were contained in a letter that group sent to the Leader of the Labour Party. In that letter, they said:
We would far prefer to see the status quo maintained and the Regional, Barringtons, and St. Johns kept open and all facilities there used...from various Government statements we understood that St. Johns Hospital was to close. It was for this reason that we offered to purchase St. Johns from the Governors...we have no interest whatsoever in establishing a luxury private hospital. Our interest is to provide for our current patients the same care which we can make available to them at present in the three hospitals in Limerick.
If I take that letter at face value, and there is no reason why I should not, it says only one thing to every Member on the Opposition benches of this House — withdraw the spurious and cynical amendment in the name of the Fine Gael Party and vote to put pressure on the Government. If it will assist Fine Gael, the Labour Party will withdraw their amendment so that the decks are cleared and there is just one issue — the motion in the name of the Progressive Democrats, a clear instruction from Dáil Éireann to keep Barringtons open. I will withdraw the Labour Party amendment in that spirit so that we can have a united front, drop ideologies and keep Barringtons open. I invite and beseech Fine Gael to find their conscience and do that honourable thing tonight.
It is no wonder Limerick did not return a Labour Deputy.
The main reason this issue has arisen in this form tonight is that in the Estimates for 1988 which were adopted by this House — our party voted against them — there was a cut of £8.5 million in the hospital services for the mid-west region. The Minister must implement that cut and he has decided, in the process, to close Barringtons hospital. Tonight, as we talk, that policy is being implemented. The Limerick Regional Hospital, with many specialties, will have 78 beds closed as of tonight. Barringtons will be closed and probably privatised thereafter either as a nursing home or a private hospital. The allocation to St. John's has been cut by £750,000 since I left office and it has lost about 30 beds. It now has to survive on a much reduced budget. In St. Camillus hospital, 30 beds have been closed in the paediatric unit; in Croom where there is a new orthopaedic centre 25 or 28 beds are being closed tonight; in Nenagh 30 beds have been closed; in Ennis the number of beds has been reduced from 127 to 96 and in Caharcalla 30 maternity beds have been closed.
The reality is that out of 1,200 beds that the Minister talked about last night 341, including Barringtons, will be closed. That is the net effect of a reduction in the budget of £8.5 million for the mid-west region, including health boards and voluntary hospitals. As a consequence of that, elective surgery for all practical purposes is being abandoned. As the Minister knows, orthopaedic lists in the area are growing, gynaecology services are being restricted, geriatric admissions to voluntary hospitals are down and in the regional hospital people are being turned away except in an emergency. That is the reality of health cuts.
I say to the Minister, this is not a transfer of services. There are no services being transferred. The budget for Barringtons has been cut from £1.6 million to £400,000 and staff are being fired. This is not rationalisation of services. It is not amalgamation of two voluntary hospitals. I effectively amalgamated two hospitals in Cork, the South Infirmary and the Victoria Hospital. That example could have been followed in Limerick. It was a lost opportunity.
There is being a deliberate cut of 90 acute consultant-staffed public beds out of the system because the Minister must find £1.2 million and he has opted for the nearest target — Barringtons. Last night the Minister said I had been ambiguous about it. I want to say to the Minister, and confirm to my colleagues with whom I was in Government, that I never proposed the closure of either Barringtons or St. John's. I have two Government memoranda before me, one dated 6 January which led to my resignation. It states that the Minister for Health will not accept the non-capital figure emerging from the draft Government decisions. I resigned as a result because I knew that the inevitable outcome of a non-capital figure of that size would lead to the closure of the hospital we are talking about tonight and the kind of two-tier health system which is burgeoning in the system.
St. John's will have to operate as a private hospital. Its budget will be down to £1.3 million compared to £2 million when I was in office in 1986.
The Deputy is the best supporter of private medicine in the country — the Blackrock Clinic——
The Minister knows perfectly that it is all about just cutting and has nothing to do with rationalisation. The Minister knows perfectly well, from the memorandum I quoted to him last evening — HSC 81/86/1 of 3 January 1986 and then on 6 January 1987——
Leaking Government documents.
The Minister knows perfectly well that, like all my colleagues in Government at that time, if I did not get a hospital budget of sufficient magnitude to maintain services in that region the vulnerable hospital was St. John's, the hospital of lesser activity and I would have to close it.
In fairness to Deputy Noonan I want to say that in 1984, 1985 and 1986 these debates took place rigorously and trenchantly in Government and I got the money. We kept the hospitals open. I was pilloried in the Dáil for some of the rationalisation which I implemented on a more reasonable basis. I was shocked the Minister did not, for example, amalgamate the two hospitals — as he could have done — even with a much reduced budget. He could have effectively brought about amalgamation and kept the hospitals open. St. John's will now have their activities reduced further, then half-privatised and Barringtons will be sold off. As the Minister well knows we spent £500,000 on St. John's — the floors were falling in, they had no fire escape, we know all the horrors about it, and the Department spent £500,000 to keep St. John's going. We bought houses on either side of Barringtons — to keep its expansion possibility alive — when the hospitals could have been kept going on a reasonable basis. But what happened? The health board budget has been slashed. Seventy-eight beds are gone in the Regional hospital. Two Ministers in Cabinet are in an acute state in relation to both Ennis and Nenagh and the allocations to both those hospitals will be cut because the Minister has got to try to carve out some money, give it to the health board to keep them struggling along. That is the Minister's problem.
I am simply saying that the budget for the mid-west region is not adequate. Equally I am saying there is no justification for taking out 340 acute consultant staffed beds in the region. I say to the Minister that he should go and get the reports from his systems analyst sitting across from him, that there is no recommendation for such closures. The departmental review has never said that there is an excess of acute hospital beds in the region.
Of course it has.
What seems and what is in departmental language can be dramatically different, as the Minister well knows. Indeed Comhairle na nOspidéal have carried out a full scale review of the mid-west region. Comhairle na nOspidéal have not said that there is an excess of acute hospital beds in the mid-west region. We have this nonsense of coming in here talking about Limerick city. It is not Limerick city we are talking about——
If Comhairle na nOspidéal had their way there would be one hospital only in Limerick, not five
We are talking about Limerick city, Limerick county, the county of Clare and North Tipperary, the region. These hospitals serve that region to quite an extent. I make an appeal to the Minister. I have no objection to an amalgamation of the two voluntary hospitals. If the health boards do not agree they can be told in crude terms: there is your budget, we are bringing about an amalgamation and, if they are of a different ethos, so what? I had a different ethos in the Victoria hospital and the South Infirmary in Cork. They now run together on one budget, one budget centre, one section of acute beds, one degree or set of consultant staffing.
They are on exactly the same site.
I appeal to the Minister: this type of departmental Rambo-cutting by people who want to prove themselves to the Minister — I exclude those present with him this evening — is unacceptable. It is not rational, it is not amalgamation and is most unfortunate in timing.
The policy enunciated by the Minister this evening is one which can be changed irrespective of the vote here this evening. We cannot support the contrived motion before the House from the Fine Gael Party. Without in any way imputing motives in this matter, I can support the closure of St. John's hospital. I went into Cabinet in December, 1982 and stayed there until 20 January, 1987. In that period we kept St. John's hospital open. Even if there is private work being done in it it is still a public voluntary hospital. There is a group of rapacious consultants in Limerick who have not got a private hospital all to themselves yet; they will get two of them at the rate we are going. Because of that I cannot support that amendment. I know that in the process the Government, if they abstain — as they now appear to do — on the first vote and then vote against the composite motion, it will be game, set and match for them on this issue. Be that as it may, we are not going to be held responsible for the outcome of that decision.
I implore the Minister to change his mind. He can amalgamate the hospitals on a very controlled budget. Why, in the name of God, do we have to put up for public auction Barringtons building——
I might remind Deputy Desmond that because of the arrangements we will now have a problem of squeezing Deputy Kemmy into four minutes.
I would not like to squeeze Deputy Kemmy; he is very large. I know he wishes to contribute and I regret speaking too long.
Perhaps I will be allowed a minute from the next speaker as well which would give me five minutes. I am grateful to Deputies Howlin, Desmond and the Labour Party for being sufficiently magnanimous in giving me time to contribute to this debate.
As a Deputy representing Limerick East I support the motion before this House which is short, clear, direct and unambiguous. It reflects exactly the wishes of the people in relation to Barringtons hospital. It also reflects exactly the wishes of the Barringtons hospital action committee. For those reasons I cannot support the Fine Gael amendment. Indeed I am disappointed and saddened that there is such an amendment before the House this evening. That amendment is unnecessary and introduces extraneous matters which may well become issues at some future date. Nobody can say what the future holds for St. John's hospital; it may well become a private hospital at some future date.
I see no reason whatsoever this House should encourage a concept of privatisation in health, medicine and the future development of a two-tier system of health services. To introduce the issue of the privatisation of St. John's hospital into the matter of Barringtons hospital serves no useful purpose whatsoever. Indeed it is mischievous, cynical and is designed to split the opposition to the closure of Barringtons hospital, thereby allowing the Government to succeed with their plans to close that hospital.
We should remember that the people who elected us to this House are not fools. Certainly the people of Limerick will not be fooled by the manoeuvrings and brinkmanship in this House last evening and again this evening. They know exactly what is going on. The people of Limerick will not allow themselves be fooled on this issue. They believe that some powerful and influential interests have been at work in bringing about the closure of Barringtons hospital. Contrary to what some people in this House may foolishly think or believe, this is not some trivial, local, petty, hole-in-the corner issue which will blow away in a few days. That is the rock some people will perish on if they think so.
Make no mistake about this: there will be a price to be paid if Barringtons hospital is allowed to close and that price will be high and painful. The people of Limerick, especially the poor, will pay a price in terms of long journeys and long queues to the Regional hospital outside the city. But the matter will not stop there. Limerick East is one of the most volatile constituencies in the country; I should know that, I learned the hard way how volatile it is. Indeed in the last general election two former Deputies of this House learned an even more painful lesson. Deputies will learn a lesson in the future in relation to Barringtons hospital. I am not a prophet but I predict that a price will be paid in political terms.
The Minister, the Government and also the Minister for Industry and Commerce talked about the crusade on which they have embarked to cut costs, save money, to try to introduce public accountability and value for money into public spending. These are all laudable concepts; I go down that road with them. As a Socialist I go along with those concepts 100 per cent. I believe in proper accountability and value for money. Nonetheless, one must ask oneself, how far have the Government gone? There appears to be no crusade on the part of the Government in regard to unpaid income tax and value-added-tax. There was a long list of tax defaulters published in most of the newspapers last week. I am sure if the names of all tax defaulters had been published it would have taken up all of the space in all the newspapers, because they included clergymen, business people, professional people, including a judge, and many more so-called pillars of society. If half those people paid half their taxes all the hospitals could probably be kept open. However, there is no crusade in relation to going after those people. We have a selective morality. Indeed, Lester Piggott, the champion jockey, is serving a prison sentence in Britain for tax evasion. If he was in this country he would probably get a nomination for the Seanad because that is what we think of people like that. Do not be fooled——
If he was speaking now he would be asked to conclude and you must conclude.
To close Barringtons is a slap in the face to the people of Limerick because nobody there has supported its closure. Some people have remained silent and their silence is significant but they have not spoken out in favour of closure. Barringtons hospital has a good record of public service in the city, it has never closed its doors in its 100 years history and it has never turned its back on anybody. This is a crunch issue for Barringtons and the people of Limerick and I will not turn our backs on the hospital. If it is allowed to close, its spectre will haunt Fianna Fáil and Fine Gael in Limerick for years to come. Barringtons will remain a monument to broken promises, of which we had plenty in the last election campaign. A power struggle is taking place in the House this evening. I am not interested in power struggles, I lost my seat in the past on a certain issue and I would willingly do it again tomorrow to keep Barringtons hospital open.
I want to ask the Minister——
Deputy Sherlock, will you behave yourself?
I want to ask the Minister——
You are not getting any time, will you resume your seat, please?
(Interruptions.)
Deputy Sherlock, I ask you not to reduce this great House to the level of a street down in your constituency. You should be ashamed of yourself.
The Minister for Health, Dr. O'Hanlon, made it clear that prior to Fianna Fáil assuming office in March last year, there was no decision by the Department of Health or by the previous Administration on the closure of either Barringtons or St. John's. I should like to reiterate that this is a fact. Consequently, I was amazed to see that Deputy Desmond issued a statement which might be interpreted as an indication that there was a decision on his part as Minister for Health that St. John's would be closed. This, of course, is simply not the case and I welcome the opportunity to put the record straight on this point. What Deputy Desmond referred to in his statement was his response to the Government of the day as to the likely impact of the allocation which the Coalition Government were proposing for health in 1986. The possible closure of St. John's was simply listed to illustrate the effect which the proposed allocation for 1986 might have on the health services. It was not a decision to close St. John's and it is erroneous to even suggest that it was.
There were no decisions to close any hospitals at that stage.
It is difficult to understand what the Deputy is getting at in his statement since he seems to be saying that St. John's is being closed which, as we all know, is not true. Furthermore, contrary to what Deputy Desmond stated, the staff in Barringtons will be redeployed, there will be early retirements or redundancies. They will not be fired, as stated by Deputy Desmond.
(Interruptions.)
I am surprised at the attitude of the Opposition on this issue. In Limerick there are a number of hospitals within a few miles of one another and three more hospitals within 25 miles of the city, at Ennis, Nenagh and Croom. The area is generally acknowledged to be over-provided with acute hospital beds and it was clearly necessary that considerable rationalisation was needed. In Limerick, there are two small voluntary hospitals within 400 yards of each other and it was evident that one of them would have to be phased out as a public voluntary hospital. For all the very good reasons which the Minister outlined last night, he decided that St. John's is the most appropriate institution to be retained as a public hospital.
I am glad that the Fine Gael Party have accepted the inevitable and seem to accept that both hospitals could not continue to receive public funds although they argued that Barringtons should be retained instead of St. John's. The attitude of the Labour Party does not surprise me but the stance taken by the Progressive Democrats is most surprising. This is the party who preached the gospel of fiscal rectitude and campaigned in the most strident terms for a reduction in public expenditure. This is the prescription they advocated for the economy at large and, of course, they are correct in this. The Government are taking this course very successfully but the Progressive Democrats are not prepared to take hard decisions.
I should like to share my time with Deputy McCoy.
Is that agreed? Agreed.
I share my party colleagues' consternation at the Minister's decision to close Barringtons hospital despite the unanimous opinion in Limerick and the local region that this is the wrong decision to take. It is absolutely daft when the local regional hospital is already so sorely stretched to imagine that it can easily absorb the thousands of additional patients who must descend upon its doors if this retrograde move to close Barringtons goes ahead.
I know, from local sources, that already a pattern is emerging in the regional hospital of discharging patients earlier than is advisable so as to free beds in anticipation of the extra demands that will be made on them if the Government get their way in relation to Barringtons. Nobody in the locality wishes to see any hospital close and there is an understandable emotional and job based interest in such an attitude. However, the Progressive Democrats accept the pressure on the public finances and our stance is not unreasonable. We do not claim that no hospital should close in Limerick but the wrong hospital has been chosen. Everybody in the region knew and believed for some time that St. John's faced closure and, so advanced was the assumption, that a group of local consultants made an offer of £1 million last autumn for the purchase of the hospital. This would have come to pass and only the extraordinary decision of the Minister to fly in the face of all local advice and the formal stance of his own Department on this matter brings us to this unacceptable position here tonight. The substance of the Fine Gael amendment is totally unnecessary because they know full well that if they were to withdraw their amendment that what they are looking for precisely would come to pass. However, given that the Minister wants to retain St. John's as a public hospital and to close Barringtons, it is obvious that the real effect of the Fine Gael amendment is to underwrite the Government's stance. This is the case because Fine Gael know full well that their motion cannot be carried and this House is left with no other conclusion but that the Fine Gael amendment is deliberately phrased to divide the Opposition parties and allow the Government to survive unscathed. This kind of play acting will fool nobody, we can either reduce this House to the role of a debating society or we can have real issues and national policies determined by pushing matters to a vote of Members.
Given the minority status of the Government, the Opposition benches have the power at any time to force the reverse of Government policy. Of course, to do this on every issue that arises would be wrong. Look at the situation facing us this evening. It is the stated policy of all Opposition parties that Barringtons hospital should be retained in the public health arena. That is the issue on which the House should vote. Fine Gael are fully aware of the implications of their amendment, to divide the Opposition parties. If they are serious, therefore, in their stated stance to want to save Barringtons, they should also be anxious to ensure that all Opposition parties will vote accordingly but to deliberately frame an amendment that will have the opposite effect is really too glib to cod anybody.
At the outset I should like to state that I am amazed that Fianna Fáil would send in a senior Minister, Deputy Reynolds, to act the clown for half an hour because he had no valid arguments to put in support of their move to close Barringtons. The House would have much more interest in hearing from other Members of that party such as Deputies Willie O'Dea and Síle de Valera or, perhaps, the Minister for Justice or the Minister for Defence, all of whom have sat silent in this debate.
The cynical advice being offered to the Progressive Democrats in the debate by the Minister Deputy O'Hanlon, and by the Minister for Industry and Commerce, Deputy Reynolds, and Deputies Bernard Allen and Michael Noonan of Fine Gael can only be treated with the contempt it deserves. Alone among the political parties, the Progressive Democrats were the only party to publish detailed policies showing for the first time how cuts in State spending in each Department could be effected. We were attacked by Fianna Fáil who were then in Opposition and we were attacked by Fine Gael who were then in office as members of the most spineless Government the country had ever seen.
Deputies Allen and Noonan would do well to remember their U-turn on teachers' pay in 1986. The Progressive Democrats stood alone in Opposition on that issue in supporting the Government of Labour and Fine Gael who, of course, later caved in. Fianna Fáil, then in Opposition, promised the teachers that the full arbitrator's award would be paid if they were returned to office. That was just one of the hundreds of cynical opportunistic promises of a once proud party which, after losing their identity, desperately craved support from any and every quarter in a last ditch bid to survive.
It is really quite pathetic to see Fianna Fáil and Fine Gael spokesmen telling the Progressive Democrats what approach we should take on this issue in order to adhere to our party's firm commitment to cut out waste and inefficiency in the public service and to reduce the State's involvement in so many areas of our lives. What authority do they have? What moral right do they have to give advice on this matter? If one looks at their voting record in Dáil Éireann in the past few years one will see a litany of contradictions.
What example are either of them giving now with the country in a bankrupt state? Millions are spent maintaining 30 Ministers in a Parliament of 166 Members with expensive cars, expensive offices and helicopters at their disposal. Hundreds of civil servants have been diverted to do only political work in constituency offices for those Ministers, some even travelling to their constituency to do political work on the ground and we have an expensive Seanad system duplicating the Dáil work.
I take it that Deputy Molloy is concluding on the motion before the House? The Deputy does not give that impression and I should like to ask him to refer to the motion.
The scandal of waste and abuse of office continues. The taxpayer is being robbed to maintain this corrupt system and still these Ministers lecture, believing they have subdued the public and that angry youth will emigrate instead of demonstrating against them. The Progressive Democrats have not only set the agenda for fiscal rectitude, they have shown the way by deed and example. We know who voted down our Bill dealing with Ministerial pensions — Fianna Fáil and Fine Gael. Time and time again we have voted with the Government on issues they would have opposed had they been the Opposition party. We have voted with the Government on twice as many occasions as Fine Gael have since the change of Government last March. Fianna Fáil never gave a fraction of that level of support to a Government proposal while in Opposition. Time and again we have seen Fine Gael sit on their hands and abstain on votes against the Government. The PDs opposed the most recent pay increases in the public service because the national finances should not be further strained with this additional burden.
It was the Progressive Democrats who voted with the Government on this year's draft Estimates. It was also our party who voted with the Government on budget night and who voted with the Government last week on the Broadcasting Bill. On all those occasions Fine Gael abstained. So much for all their talk about constructive opposition. Of course, they would also sit on their hands tonight if they could get away with it but they have done the next best thing in putting forward an amendment which they hope will divide the Opposition because they are terrified of the prospects of defeating the Government. This is their shameless stance no matter how serious or how fundamental is the issue facing the House and all of us in our role as legislators.
The Progressive Democrats know what they are doing. Our support for Government measures is not blind support. We will not support blunders and expensive alternatives as is being proposed in the case of Barringtons hospital. In this House now we have Fianna Fáil, the wolf in sheep's clothing, and Fine Gael, the sheep in sheep's clothing. That is the reality and it makes a sorry picture.
The Deputy is the black sheep.
It does not make economic sense to close Barringtons because it will cost more than £2 million to provide facilities at St. John's and the Regional hospital that are already available at Barringtons. That is the kernel of the issue and the reason for our stance on it. It does not make sense on medical grounds because the staff of St. John's do not have great experience in dealing with the type of cases that form a big proportion of the work at Barringtons. Nursing staff at St. John's are not familiar with many types of accident work; they rarely took in accident cases but referred them to Barringtons. The theatre in St. John's is old, having been built in 1932, and is very small. A little gynaecological work was done there in recent years and hardly any serious surgical work. Has it not already been announced that the pathology department is being transferred out of St. John's to the Regional? Is it not true that 82 per cent of the huge number of cases dealt with at Barringtons are medical card holders? How in the name of God can these patients expect to receive adequate treatment in St. John's where already 60 per cent of the patients are private?
In his speech the Minister gave his reasons for choosing St. John's and I want to reply to them briefly. He said that St. John's is a more spacious site. That is not a valid argument. In fact, the sites are practically of equal size and Limerick Corporation have also zoned an additional one-third of an acre to facilitate expansion at Barringtons. Also, two houses were purchased with Department funds recently to enlarge the casualty and outpatient departments and to provide physiotherapy and other facilities.
The second point the Minister made was that St. John's is a larger building and that it has a capacity of 120 beds. In fact, Barringtons has a bed capacity of 150. The Minister gave an incorrect figure last night of 90, not having taken into account the extra bed capacity available at the nurses home, which is a concrete structure within floors attached to the main hospital building.
The third point the Minister made was that St. John's provides better potential for adapting to the changing needs of hospital medicine. The first thing one could say in reply to that is, why go to the expense at all of adapting when all the facilities already exist in Barringtons? The Minister says that St. John's has a unit which is well suited for the provision of day hospital services. However, surgeons who worked in this unit during 1986 and 1987 say that it is quite unsuitable for theatre work. To provide additional theatres, X-ray rooms, and the other expensive equipment needed for a modern operating theatre at St. John's could cost up to £2 million. That would be an extraordinary waste of public funds when all these facilities are already available at Barringtons and in excellent condition. One wonders what kind of chaos will exist at St. John's on 1 April when it has to take on the workload of Barringtons if the Minister proceeds with his proposed closure on 31 March next.
The fourth point the Minister made in support of his case was that the St. John's hospital building and services, are superior to those in Barringtons and this was largely due, he said, to the fact that £500,000 was spent on improvements in recent years. He omitted to mention that the improvements in question were largely spent on improving wooden floors at St. John's which were in a critical state and could have forced the closure of that hospital. There is no way that St. John's could be deemed to be comparable in standard with Barringtons where there are concrete floors.
In arguing that £500,000 was spent on St. John's in recent years the Minister conveniently omitted to mention that £500,000 was also spent on providing modern facilities at Barringtons since 1982. Engineering and medical consultants alike do not agree with the Minister's contention that St. John's building and services are superior to those in Barringtons.
The last point the Minister made was that the mechanical and electrical services at St. John's are better. This is a strange contention indeed as mechanical and electrical services at Barringtons hospital were brought up to standard in 1983 in compliance with the Chief Fire Officer's recommendations and had been deemed by him to be fully satisfactory.
It can be seen, therefore, that in all the points relied upon by the Minister in seeking to justify his decision, none of them stands up to close scrutiny. A major blunder has been made here and it must be reversed by Dáil Éireann. It is another typical case of bureaucracy gone wild, where the people who provide the services and would know best are not consulted at all.
The Minister also makes some cost comparisons to try to justify his decision. These I now challenge as being false and inaccurate. The actual revised 1987 figures on average weekly cost per occupied bed for the hospitals is, Barringtons, £656; St. John's, £683 and the Regional hospital, £749. Those figures, which have been certified by an accountant, are 1987 figures. The Minister does not give any source for his figures.
The acid test on cost comparability is the cost per discharged patient and in regard to Barringtons, the Minister last night admitted that the figure was £447, as compared with £672 in St. John's Hospital. That settles the argument on cost, because Barringtons Hospital is seen to be £225 per patient cheaper than St. John's. It is clear that on medical, social and financial grounds the closure of Barringtons Hospital instead of St. John's just cannot be justified.
Deputies
Hear, hear.
Tá sé in am anois chun an cheist a chur. The Question is: "That amendment No. 2 in the names of Deputies Bernard Allen and Michael Noonan (Limerick East) be made.” Na Teachtaí ar thaobh na tairisceana abraidís “Tá”.
Deputies
Tá.
Na Teachtaí in aghaidh na tairisceana abraidís "Níl".
Deputies
Níl.
Sílim go bhfuil an tairiscint rite.
Vótáil
(Interruptions.)
The motion is carried. Dúirt mé go raibh an tairiscint rite.
On a point of order, a Leas-Cheann Comhairle, I was not aware that you were putting the question. Ní raibh mé in ann tú a chloisint. Le do thoil, cuir an cheist arís.
Tá an cheist curtha agus de réir mar a thuigimse tá sé rite. Motion carried. Níor chuala mé éinne ag iarraidh vótáil.
On a point of order, I think, Sir, that you should grant Deputy Howlin the indulgence of a moment's inattention on his part and put the question again.
Most kind.
The Chair is guided by what it hears. I put the question and nobody asked for a vote. I shall put the question again.
When you drop your voice, it is not possible to hear you over here. You should shout it out, so that we can hear you.
If Deputy Molloy has indicated that he is not aware of the technological process here which helps audibility, he should not accuse me of same. I am putting the Question: "That amendment No. 2 in the names of Deputies Bernard Allen and Michael Noonan be made."
Is there an ear, nose and throat section in Barringtons Hospital?
Amendment put.
The Dáil divided: Tá, 49; Níl, 31.
Tá
- Allen, Bernard.
- Barnes, Monica.
- Barrett, Seán.
- Barry, Peter.
- Begley, Michael.
- Birmingham, George.
- Boland, John.
- Boylan, Andrew.
- Bruton, John.
- Bruton, Richard.
- Burke, Liam.
- Carey, Donal.
- Connaughton, Paul.
- Cooney, Patrick Mark.
- Cosgrave, Michael Joe.
- Creed, Donal.
- Crotty, Kieran.
- Crowley, Frank.
- Deasy, Austin.
- Deenihan, Jimmy.
- Donnellan, John.
- Doyle, Avril.
- Dukes, Alan.
- Durkan, Bernard.
- Enright, Thomas.
- FitzGerald, Garret.
- Fitzpatrick, Tom.
- Flaherty, Mary.
- Flanagan, Charles.
- Griffin, Brendan.
- Harte, Paddy.
- Hegarty, Paddy.
- Higgins, Jim.
- Hussey, Gemma.
- Kelly, John.
- Kenny, Enda.
- Lowry, Michael.
- McGahon, Brendan.
- McGinley, Dinny.
- Mitchell, Gay.
- Naughten, Liam.
- Nealon, Ted.
- Noonan, Michael. (Limerick East).
- O'Brien, Fergus.
- O'Keeffe, Jim.
- Shatter, Alan.
- Sheehan, P.J.
- Taylor-Quinn, Madeline
- Yates, Ivan.
Níl
- Blaney, Neil Terence.
- Clohessy, Peadar.
- Colley, Anne.
- Cullen, Martin.
- De Rossa, Proinsias.
- Desmond, Barry.
- Gibbons, Martin Patrick.
- Gregory, Tony.
- Harney, Mary.
- Higgins, Michael D.
- Howlin, Brendan.
- Kavanagh, Liam.
- Keating, Michael.
- Kemmy, Jim.
- Kennedy, Geraldine.
- McCartan, Pat.
- McCoy, John S.
- McDowell, Michael.
- Mac Giolla, Tomás.
- Molloy, Robert.
- O'Malley, Desmond J.
- O'Malley, Pat.
- O'Sullivan, Toddy.
- Pattison, Séamus.
- Quill, Máirín.
- Quinn, Ruairí.
- Sherlock, Joe.
- Spring, Dick.
- Stagg, Emmet.
- Taylor, Mervyn.
- Wyse, Pearse.
Tellers: Tá, Deputies O'Brien and Flanagan; Níl, Deputies Howlin and Harney.
Amendment declared carried.
Question put: "That the motion, as amended, be agreed to."
The Dáil divided: Tá, 80; Níl, 79.
Tá
- Allen, Bernard.
- Barnes, Monica.
- Barrett, Seán.
- Barry, Peter.
- Begley, Michael.
- Birmingham, George.
- Blaney, Neil Terence.
- Boland, John.
- Boylan, Andrew.
- Bruton, John.
- Bruton, Richard.
- Burke, Liam.
- Carey, Donal.
- Clohessy, Peadar.
- Colley, Anne.
- Connaughton, Paul.
- Cooney, Patrick Mark.
- Cosgrave, Michael Joe.
- Creed, Donal.
- Crotty, Kieran.
- Crowley, Frank.
- Cullen, Martin.
- Deasy, Austin.
- Deenihan, Jimmy.
- De Rossa, Proinsias.
- Desmond, Barry.
- Doyle, Avril.
- Dukes, Alan.
- Durkan, Bernard.
- Enright, Thomas.
- FitzGerald, Garret.
- Fitzpatrick, Tom.
- Flaherty, Mary.
- Flanagan, Charles.
- Gibbons, Martin Patrick.
- Gregory, Tony.
- Griffin, Brendan.
- Harney, Mary.
- Harte, Paddy.
- Hegarty, Paddy.
- Higgins, Jim.
- Higgins, Michael D.
- Howlin, Brendan.
- Hussey, Gemma.
- Kavanagh, Liam.
- Keating, Michael.
- Kelly, John.
- Kemmy, Jim.
- Kennedy, Geraldine.
- Kenny, Enda.
- Lowry, Michael.
- McCartan, Pat.
- McCoy, John S.
- McDowell, Michael Alexander.
- McGahon, Brendan.
- McGinley, Dinny.
- Mac Giolla, Tomás.
- Mitchell, Gay.
- Molloy, Robert.
- Naughten, Liam.
- Nealon, Ted.
- Noonan, Michael. (Limerick East).
- O'Brien, Fergus.
- O'Dea, William Gerard.
- O'Keeffe, Jim.
- O'Malley, Desmond J.
- O'Malley, Pat.
- O'Sullivan, Toddy.
- Pattison, Séamus.
- Quill, Máirín.
- Quinn, Ruairí.
- Shatter, Alan.
- Sheehan, P.J.
- Sherlock, Joe.
- Spring, Dick.
- Stagg, Emmet.
- Taylor, Mervyn.
- Taylor-Quinn, Madeline
- Wyse, Pearse.
- Yates, Ivan.
Níl
- Abbott, Henry.
- Ahern, Bertie.
- Ahern, Dermot.
- Ahern, Michael.
- Andrews, David.
- Aylward, Liam.
- Barrett, Michael.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Matthew.
- Brennan, Séamus.
- Briscoe, Ben.
- Browne, John.
- Burke, Ray.
- Byrne, Hugh.
- Calleary, Seán.
- Collins, Gerard.
- Conaghan, Hugh.
- Connolly, Ger.
- Coughlan, Mary T.
- Cowen, Brian.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Leonard, Jimmy.
- Leyden, Terry.
- Lynch, Michael.
- Lyons, Denis.
- McCarthy, Seán.
- McCreevy, Charlie.
- MacSharry, Ray.
- Mooney, Mary.
- Morley, P.J.
- Moynihan, Donal.
- Nolan, M.J.
- Noonan, Michael J. (Limerick West).
- O'Donoghue, John.
- O'Hanlon, Rory.
- Daly, Brendan.
- Davern, Noel.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- Doherty, Seán.
- Ellis, John.
- Fahey, Frank.
- Fahey, Jackie.
- Fitzgerald, Liam.
- Fitzpatrick, Dermott.
- Flood, Chris.
- Flynn, Pádraig.
- Foley, Denis.
- Gallagher, Denis.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Haughey, Charles J.
- Hilliard, Colm Michael.
- Hyland, Liam.
- Jacob, Joe.
- O'Keeffe, Batt.
- O'Keeffe, Ned.
- O'Kennedy, Michael.
- O'Leary, John.
- O'Rourke, Mary.
- Power, Paddy.
- Reynolds, Albert.
- Roche, Dick.
- Smith, Michael.
- Stafford, John.
- Swift, Brian.
- Treacy, Noel.
- Tunney, Jim.
- Wallace, Dan.
- Walsh, Joe.
- Walsh, Seán.
- Wilson, John P.
- Woods, Michael.
- Wright, G.V.
Tellers: Tá, Deputies Harney and Colley; Níl, Deputies V. Brady and Briscoe.
Question declared carried.
The Dáil adjourned at 9.15 p.m. until 10.30 a.m. on Thursday, 18 February 1988.