On a point of order, is the legislation adjourned previously, dealing with the protection of private part time workers, not being taken at this point?
Private Members' Business. - Health Care: Motion (Resumed).
I will be dealing with your Bill, Deputy, at the conclusion of this time.
At what time will that be, a Cheann Comhairle?
After the votes, if any. This debate is due to conclude at 7.28 p.m.
Thank you.
The following motion was moved by Deputy Yates on Tuesday, 25 October, 1988:
"That Dáil Éireann, sharing the serious public concern about the quality of health care, calls for a fundamental re-organisation of the delivery of health services, in order to free resources which could then be used selectively to improve the quality of service and expand the provision for priority needs. The following reforms are required:
1. The establishment of An Bord Sláinte, a semi-State body, to replace the Health Boards and streamline the management and delivery of health services.
2. Cost-cutting reforms in the areas of administration, the purchase of medical and non-medical supplies, certain consultants fees, the rationalisation of laboratory facilities, the greater use of computerisation and better property management.
3. A revision of the method of funding voluntary public hospitals by the introduction of clinical budgeting and separate ear-marked allocations for National Tertiary Services.
4. The appointment in each hospital of a general manager.
5. Hospital managers and An Bord Sláinte should be specifically charged with ensuring much greater co-ordination between hospitals and Community and Primary Care Services.
6. An Bord Sláinte should draw up and implement a National Hospital Plan for acute services, including the concentration of the most modern equipment and advanced skills in regional centres of excellence, where they can be fully utilised to the benefit of the community. These centres should be backed up by the complementary provision of local hospitals with specified levels of care.
7. Improved medical management through greater development of General Practitioner Services including improved access to Hospital Diagnostic Services and Consultant opinion.
8. The re-examination of methods of payment for health care on the basis of giving incentives to preventative medicine and positive health activities."
Debate resumed on amendment No. 3:
To delete all words after "priority needs" in the fourth line and substitute the following:
"Recognising that it is now estimated that in excess of 10,000 public patients are on waiting lists for hospital admission, many of whom are awaiting hospitalisation for over 12 months, calls on the Minister for Health to:
1. Introduce a new funding system for hospitals which would guarantee equality of access to essential services for public and private patients.
2. Alter the present arrangements where by a large number of hospital beds are currently occupied by long stay patients at a cost of up to £1,400.00 per week, many of whom could be more appropriately cared for in properly regulated nursing homes for a quarter of the cost.
3. Improve the incentives for General Practitioners to become more involved in many diagnostic services and thereby releasing much of the unnecessary pressure on hospital services.
4. Promote practical proposals for the development of community health care, involving an expansion of the home-help and community nursing services, and
5. Rationalise the number of Health Boards given that one of the existing eight, the Eastern Health Board, caters for 41 per cent of the population."
—(Deputy Harney.)
Deputy Howlin is in possession. The Deputy has some 11 minutes left of the time alloted to him.
I am grateful to you, a Cheann Comhairle. I was in the process last week of commenting on the motion in the name of the Fine Gael Party and the substantial amendment put down by the Labour Party on the whole area of health expenditure. Last week I indicated the existing crisis in the health services, a crisis brought about by lack of resources and not in any way by administrative difficulties. I have stated emphatically that the Labour Party have no difficulty in addressing any proposals to restructure the health proposals, or any proposals to deliver services more efficiently. I have also stated quite emphatically that it is a delusion and a smokescreen to suggest that the crisis, which everybody acknowledges now except apparently the Minister, within the health services can be solved by some sleight of hand through reorganising administration. To that end, we do not intend letting the Fianna Fáil Party, or indeed the Fine Gael Party, off the crucial hook, which is that resources must be provided to enable the health services to survive and to provide facilities and services to the people.
I gave comparisons last week, one of which was in relation to our expenditure as expressed as a percentage of GNP. I said that under the stewardship of the former Minister, Deputy Desmond, expenditure on the health services was maintained at 7 per cent of GNP and that from the time of the election of this Government, despite their promises and hypes during the election campaign, expenditure as a percentage of GNP has been consistently curtailed, from 6.6 per cent of GNP in 1987 to 6.4 per cent in 1988 and now to the expected 6.2 per cent for next year according to the Estimates. That was the Estimate that was put before us last week, supported not alone by the Government but by Fine Gael and the Progressive Democrats. The crucial issue is the amount of money to be made available to run the health services.
We heard with interest the Minister of State's contribution last week when he said: "I must confess at being somewhat mystified as to the source of the Labour Party's figure for GNP." To ease the Minister's mystification, I will give him the source. It is page 14 of the Estimates for the Public Services 1989, published by his Government. It would be interesting to hear if the Minister has somehow changed the Estimates, or is he adding in capital expenditure, or something else to come up with the figure of 7.1 per cent that he indicated to the House last week?
We need to get some basic facts straight. The last time international comparisons about health spending were gathered was in 1984, when the OECD published a major study on the subject. I said last week that at that time Ireland spent 6.9 per cent of GNP on health when the overall average there was 5.6 per cent. Our expenditure is not outside the European norm, despite our very high dependency ratios. What we are asking for is simply the maintenance of expenditure, not the savage cuts that have been implemented by this administration. We have asked that the Minister will acknowledge the crisis and not try to fudge the issues.
The Fine Gael Party have produced many red herrings throughout this debate. I see on today's Order Paper a raft of questions from the Fine Gael spokesman on Health directed to the Minister asking again and again for extra expenditure. They cannot play the game both ways. They cannot ask for extra expenditure, playing to every lobby, and at the same time say that they are satisfied with the overall expenditure. The Fine Gael spokesman called for us to establish a target of 3 per cent for administration costs. If we are to meet that target there are at least some parts of the country where additional administrative staff would have to be employed because there are health boards and hospitals where the cost of administration is considerably less than 3 per cent of the total budget.
Even if the total cost of administration is more than 3 per cent, how do Fine Gael propose to add extra beds and nursing and medical staff from the paltry savings that would be made from firing some essential clerical workers now employed? It would be interesting to quantify all those who are designated administrative workers, because, as I have stated before, many of these are people who are front line deliverers of services, community welfare officers, social workers and the like. What experience leads Fine Gael to the view that increased centralisation will lead to less administration? Have they forgotten that the creation of the health boards was a move away from local administration of the health services, which was based on a county administration structure prior to the establishment of the health boards? If the regionalisation of the health services led to more administration, as it did, why would further concentration of power in Dublin be a solution to the problem?
I might suggest to Fine Gael that if they want to see how centralisation affects staffing they might look at another Government Department, the Department of Agriculture, where it takes more than 4,000 civil servants to deliver services that contain a fraction of the complexity of the caring services. The 300 civil servants employed by the Department of Health, looked at in that light, can hardly be accused of being a substantial burden on the service. Health is not like a factory. One cannot decide that what was done with a service like Posts and Telegraphs, or what was done with CIE can apply to the health services and everything will be all right. This issue must be looked at from the perspective of the kind of society we want here. Do we really want a society in which only those who can afford care will get it, because that is what is happening? For entirely material reasons we have begun to abandon the commitment that once reflected us in a better light. Even at its most basic we were people who believed in looking after our own, particularly the weak. Now, that is all gone, or at least Fianna Fáil and Fine Gael are determined to undermine it, to change it to a philosophy in which, in the words of Neil Kinnock, the only word is "me" and the only time is "now". That is not the kind of society for which I want to stand. I do not believe that is the kind of society the vast majority of our people want to create.
That is why, in the Labour Party amendment, we propose that the only acceptable target would be 7 per cent of GNP on health spending. Within that target there is still plenty of room to deliver a health service that, in turn, will deliver care to the point of need as efficiently and effectively as posible. No other target is worth aiming at.
This evening the Labour Party will not allow Fine Gael or the Progressive Democrats to distance themselves from the coalition they have established with this administration, and from the responsibility they share with Fianna Fáil for the savagery that is affecting and dismantling the health services throughout the country.
I am calling Deputy Roche. I should advise the Deputy that I am obliged to call Deputy Yates to conclude at 7.13 p.m. Therefore, Deputy Roche has just two minutes.
I shall be brief. In fact I do not need a great deal of time to pour scorn on this proposal. It strikes me that the central issue before us is the proposition by Deputy Yates that the replacement of the eight single health boards obtaining by a single State-sponsored body in some way would be an improvement. Very seldom do I agree with Deputy Howlin. Had I more time I would deal with some of the mischievous bunkum he put about this House today and last week. The reality is that the proposition before us — that we can improve our delivery of health services by creating a more centralised structure — is a dangerous myth. I am pleased that at least some of the Opposition parties see that it is a myth.
There were a couple of points raised by Deputy Yates last week I must touch on. Throughout a long, detailed speech the word "care" was conspicuously missing. The reality is, if we are to do something about the health services, we will not do so by self-delusion. If the concept is that a State-sponsored body on the lines of, say, Telecom Éireann, An Post or the ESB in some way would be a more caring structure than the eight obtaining health boards or constitute an improvement, well then God help us. It strikes me as extraordinary that anybody should propagate this mythology in this House at this time. A debate on the health services is a serious issue. If there is to be a responsible debate on the health services it must be conducted at a serious level. The argument put forward by Deputy Yates last week is not a serious one, the proposition is not a serious one and is deserving of rejection on those grounds.
As a member of a health board it is my belief that, within the health administration, there is far too much centralisation. The boards, if they have a fault — and particularly the Eastern Health Board of which I am a member — it is that they are centralised. Indeed the movement to the health boards away from county administration of the health services in 1971 was a move that was in accord with thinking in public administration at that time. But to suggest we should move the full way and centralise these services under a State-sponsored body which would deliver caring services in the sort of structure obtaining in, say, the ESB is a dangerous myth. Hopefully that myth will be debunked here this evening.
I must ask the Deputy to conclude now.
The point I have made bears repetition, that if we are to improve the delivery of health services — and that is what we must all aim at in this House — we will not do it, as Deputy Howlin suggests, by simply throwing money at the health services without question. To his credit, that was a point Deputy Yates made last week. If I sat where Deputy Yates now is I can assure him that if I were concerned and a spokesperson of a political party wishing to be considered a serious political party I would not come up with this sort of ráiméis for the improvement of health administration. There is nothing to commend what Deputy Yates had to say last week.
A Cheann Comhairle, I understand I am entitled to 15 minutes to conclude the debate. Perhaps I will be given that indulgence.
That is so, Deputy.
There were a number of issues raised in this debate, an important one, because what the Fine Gael motion set out to do was to acknowledge that there was a health crisis and to say that, yes, some aspects of resolving that crisis need the targeting of money in certain areas towards the patient. I went to the trouble — which is fairly unique in Opposition — of actually saying, within the health budget, where the money would come from. Indeed I have drawn the ire of different sectors in health by saying specifically that they were either ripping off the system, in the case of pathologists, or in relation to over-administration, that we were paying too much for drugs and so on. In response to that motion the Minister had this to say:
I must firstly reject utterly the suggestion that there is a problem about the quality of health care in this country.
— and he underlined the point. Nobody else believes that. It is as simple as that.
Only this afternoon most of my questions to the Minister were ones of information. I asked about three areas and their waiting lists. These are the Minister's figures, not mine: in-patient for orthopaedic surgery — those are people in pain awaiting hip operations — 7,200; out-patient, 9,200; ENT — many children requiring urgent treatment such as tonsillectomies, grommets and so on, 3,000; opthalmology, such as cataracts on eyes, where treatment at the right time is very important, over 3,000. Those are just three areas and I could have gone into many more. Therefore, it will be seen that there is a problem about the quality of the health service.
Not about the quality of the service.
Whether the Minister draws the fine point, as he did on television last week, between the timing and quality of the service, a very subtle point that was lost on the public, with respect——
A very important one.
——the point is lost. If one cannot get the service when it is needed, then it is a poor quality service. There are also major gaps in the service which I have outlined. For example, the dental service is not satisfactory and the Minister knows it.
For the past ten years I have admitted that.
Fair enough. But there was a scheme called the ad hoc scheme whereby a medical card holder could be referred to a general practitioner dentist and avail of his services. That has been abolished. There is not an orthodontic service and there are 23,000 people awaiting such treatment. In relation to geriatric people there is not a comprehensive set of geriatric units across the country. In each community care area, there is not the appropriate care for geriatrics. There is a limbo between psychiatric care, community care and acute care, in some cases, very expensive acute care. Coming into the winter I fear for some geriatric patients. We have closed some less expensive convalescent care hospitals with detrimental effects. Of course it was not the Minister who decided this. He was very clever; he said: we impose a cash limit and an embargo and left the health boards to do the dirty work.
That was the legal position.
That may be good politics but it constitutes bad health care and is no way to run the health services.
The point has been made in relation to the Labour Party — and I listened with interest to what they had to say — that we should really get down to the issue of spending more money on health. There is no doubt but that more money could be spent on health——
——in maintaining the expenditure level of the Coalition administration.
I could willingly convince my colleagues and this House to throw £500 million more at the health services, getting a better service for the mentally handicapped, getting all of the services we need, both in-patient and in relation to community care. It would be a good thing socially and otherwise. But the fact of the matter is that the people who argue for more money for health care argue for more money for education, more money for social welfare to deal with poverty, more money for State industry to create State jobs while at the same time, Deputy Spring comes forward with a policy to reduce the PAYE burden. Each of those is laudable in itself and I will not criticise them——
The last time you did that Rambo act——
If you add up the sum total of all those things the arithmetic does not equal socialism. Unfortunately it equals irresponsibility because, under this Government, the national debt has risen by £2 billion. The Minister wrings his hands and says that the health service is about caring. I received information in answer to a Dáil question that the Minister's public relations advisers are being paid £26,000 to tell him that we need a caring Minister with a good bedside manner——
We have such a Minister.
Let us not be confused by this camouflage. We all care. The reason Fine Gael put down this motion is because we are very concerned. Indeed, we are so concerned that we have gone to the trouble of saying where the money will be found and we have listed the inefficiencies and wastage.
In relation to wastage, yesterday there was a massive increase in the cost of drugs. The Bill for drugs in 1988 is something in the region of £120 million, five years ago it was £85 million. The increase is totally unjustified. The very same drugs can be bought in Belgium, Italy, Spain and France at, in some cases, one-third of the price. If there was an argument that these drugs should be bought to maintain Irish jobs or because of a deal with Irish pharmaceutical companies, it might be justified but only 5 per cent of the drugs used in the health service are made in Ireland. We have linked the prices we pay to the UK.
The Deputy's Government did that.
When the last Government linked prices to those in the UK, the UK were in the middle range of prices but now they are at the top of the range.
Have a word with Deputy Barry Desmond.
It is unjustified and it is remarkable that when there is a lack of care for patients the Minister can stand over a situation where multinationals are ripping off the Irish taxpayer. It is simply unacceptable. When the original deal was completed the climate was totally different. The Minister knows that and he also knows that hospitals do not benefit from major elements of the agreement with the GMS in terms of the 104 per cent trade rated average and the 5 per cent rebate. Hospitals buy in bulk so they are paying even more for drugs.
I was surprised to learn, in reply to another Dáil question, that over 7,000 people are involved in administration in the health service. Some managers, for whom I have a great deal of respect — many of them are underpaid and are moving to the private sector — say that they run very efficient health boards. They are correct but they are confusing management expenditure with administration expenditure. I am trying to point out that, in the non-care areas such as laboratories, medical records and so on as opposed to people behind desks, we are spending too much. In some cases, the Minister has refused to invest small amounts of money in computerisation which could save a lot of money. I will give one example in this regard. Cork Regional Hospital spent £60,000 on a thermostat to control the heating so that it would not be full on with the window open. They needed that money to save £100,000 per year. That is the kind of logic I am trying to bring into the health services and not a bord sláinte to get rid of eight health boards as Deputy Roche said. I am talking about dozens of voluntary public hospitals which operate in total isolation with certain prima donnas saying how things should be run. They are not subject to any control and when there is a disaster and people are on trolleys the Minister has to send his chief medical officer scurrying to do reports on Temple Street and the Meath.
There are no trolleys in Temple Street.
I know that but I have seen the observation ward and the state of the casualty facility is appalling. The Minister should look at it. In the Dublin area none of the hospitals, with the exception of Loughlinstown and Naas, is accountable to the Eastern Health Board——
What about the James Connolly Memorial Hospital in Blanchardstown?
The people responsible for the GP service have little or no relationship with the consumers of £720 million of hospital expenditure. There are scores of voluntary organisations contracting for services and other individual boards. In the delivery of health care they should all be on the same team. The health service is over-administered and undermanaged. It does not focus on the patient or allocate money for patients. Very large sums of money are allocated to individual hospitals but the Minister does not insist on the level of care they provide. In one public statement, he said that is all he intended to do. If there is to be an organised health service it must be streamlined.
I put forward an argument for clinical budgeting which requires a certain amount of information technology but which will save money. The present system says that if a hospital has underbudgeted it will be screwed next year. The Minister penalises efficiency and gives no incentive for good management. The Labour Party are perfectly entitled to give their views on the overall question of resources to all the spending Departments but this motion does not seek to merely get into that debate again. We are talking about the way the health service is run and the important thing is to direct the money towards the patient. That is what this motion seeks to do although I am disappointed that neither private medicine, nor any point of ideology was mentioned——
There is strong ideology.
Deputy Yates without interruption, please.
There is nothing dealing with private ideology——
No wonder the Deputy's party made a mess of the health service.
Who is winning the argument about Cavan hospital?
Let the Deputy in possession talk, please.
What happened in Roscommon?
He does not want the patients to have beds.
(Interruptions.)
(Limerick East): What about the Roscommon-Longford constituency?
The Deputy has only a few minutes left of the time allotted to him. Let us hear him without any further interruptions.
It is imperative for the Opposition parties to get together in this regard. The Minister did not put down an amendment in response to this motion, there is no reference to his own performance or to that of his Minister of State. At the end of the day the Dáil is given an opportunity, through this constructive, positive motion, to state where the resources should be targeted and to do the type of things which the good managers in the health service want to do. The Minister, in his speech, could not make up his mind whether I was being simplistic or facile——
You were.
——or whether I was being helpful. After the Minister receives the report of the commission the issues will still be there. When Deputy Desmond was Minister he was supportive of the bord sláinte proposals. The reform issues have been ducked and dodged by the Minister and he has deliberately stepped back in a very cute political way with the best political advice. The result is that there are cash limits and an embargo. Just because the dental service is nonstatutory it must go. Is that good planning? Does it have regard for the patient? No. The Minister's record on hospital planning leaves a lot to be desired as is evident from his own health board area who passed a judgment on his performance.
Deputy Yates must now bring his speech to a close.
I would appeal to the Opposition parties to use the question of resources on another occasion, on the Estimates debates, and to vote on that issue. They are entitled to have their own amendment but at the end of the day this motion is the only one that can give some sense of direction to that Minister and some sense of priority to the patient.
Amendment No. 3 in the name of Deputy Harney. Is the amendment being pressed?
Yes.
The Dáil divided: Tá, 13; Níl, 119.
Tá
- Clohessy, Peadar.
- Colley, Anne.
- Cullen, Martin.
- Gibbons, Martin Patrick.
- Harney, Mary.
- Keating, Michael.
- Kennedy, Geraldine.
- McDowell, Michael.
- Molloy, Robert.
- O'Malley, Desmond J.
- O'Malley, Pat.
- Quill, Máirín.
- Wyse, Pearse.
Níl
- Abbott, Henry,
- Ahern, Bertie.
- Ahern, Dermot.
- Allen, Bernard.
- Andrews, David.
- Aylward, Liam.
- Barnes, Monica.
- Barrett, Michael.
- Barrett, Seán.
- Barry, Peter.
- Begley, Michael.
- Birmingham, George.
- Boylan, Andrew.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Matthew.
- Brennan, Séamus.
- Browne, John.
- Bruton, John.
- Bruton, Richard.
- Burke, Ray.
- Byrne, Hugh.
- Calleary, Seán.
- Carey, Donal.
- Collins, Gerard.
- Conaghan, Hugh.
- Connaughton, Paul.
- Connolly, Ger.
- Cooney, Patrick Mark.
- Cosgrave, Michael Joe.
- Coughlan, Mary T.
- Cowen, Brian.
- Creed, Donal.
- Crotty, Kieran.
- Daly, Brendan.
- Davern, Noel.
- Deasy, Austin.
- Deenihan, Jimmy.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- McGahon, Brendan.
- MacSharry, Ray.
- Mitchell Gay.
- Mitchell, Jim.
- Mooney, Mary.
- Morley, P. J.
- Moynihan, Donal.
- Naughten, Liam.
- Nolan, M. J.
- Noonan, Michael
- (Limerick East).
- Noonan, Michael J.
- (Limerick West).
- O'Brien, Fergus.
- O'Dea, William Gerard.
- O'Donoghue, John.
- O'Hanlon, Rory.
- O'Keeffe, Batt.
- O'Keeffe, Jim.
- O'Keeffe, Ned.
- Doherty, Seán.
- Doyle, Avril.
- Dukes, Alan.
- Durkan, Bernard.
- Ellis, John.
- Fahey, Frank.
- Fahey, Jackie.
- Farrelly, John V.
- Fitzgerald, Garret.
- Fitzgerald, Liam.
- Fitzpatrick, Dermot.
- Fitzpatrick, Tom.
- Flaherty, Mary.
- Flanagan, Charles.
- Flood, Chris.
- Flynn, Pádraig.
- Foley, Denis.
- Gallagher, Denis.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Griffin, Brendan.
- Harte, Paddy.
- Higgins, Jim.
- Hilliard, Colm Michael.
- Hussey, Gemma.
- Hyland, Liam.
- Jacob, Joe.
- Kenny, Enda.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leyden, Terry.
- Lowry, Michael.
- Lynch, Michael.
- Lyons, Denis.
- McCarthy, Seán.
- McCreevy, Charlie.
- O'Kennedy, Michael.
- O'Leary, John.
- O'Rourke, Mary.
- Power, Paddy.
- Roche, Dick.
- Shatter, Alan.
- Sheehan, P.J.
- Smith, Michael.
- Stafford, John.
- Swift, Brian.
- Taylor-Quinn, Madeleine.
- Treacy, Noel.
- Tunney, Jim.
- Wallace, Dan.
- Walsh, Joe.
- Walsh, Seán.
- Wilson, John P.
- Woods, Michael.
- Wright, G.V.
- Yates, Ivan.
Tellers: Tá, Deputies Kennedy and Colley; Níl, Deputies J. Higgins and Boylan.
Amendment declared lost.
I move amendment No. 2:
To delete all words after "care" in the second line and insert the following:
"(i) notes the Exchequer expenditure on the health services has been progressively cut back each year, from 7 per cent of GNP in 1986 to 6.6 per cent of GNP in 1987, 6.4 per cent of GNP in 1988, and to an expected 6.2 per cent in 1989;
(ii) further notes that as a consequence, health expenditure in Ireland, which was higher than the OECD average until 1986, is now substantially below the OECD average, particularly having regard to the high dependency ratio in Ireland;
(iii) believes that there is now a major crisis in the health services, which will, in the absence of emergency action, cause loss of life and very considerable hardship throughout the community;
(iv) believes also that there are gross inequalities in the delivery of care, as a result of the emergence of a two-tier system of health care, which has already been condemned by many organisations including the Churches;
(v) asserts that these crises must be resolved immediately, and cannot be resolved in the short term by improvements in administration, however desirable they may be in the longer term;
(vi) notes that the Government, in addition to making substantial savings as a result of underspending (in overall terms) in the current year, has also received substantial amounts of revenue over and above expectations, through the Tax Amnesty and other sources;
(vii) resolves therefore that a proportion of those savings and additional revenue, at least sufficient to restore health expenditure to its 1986 level of 7 per cent of GNP, should be set aside and allocated to the Health Estimate for 1989, and instructs the Government to make this additional allocation immediately."
Amendment put.
The Dáil divided: Tá, 17; Níl, 119.
Tá
- Bell, Michael.
- De Rossa, Proinsias.
- Desmond, Barry.
- Gregory, Tony.
- Higgins, Michael D.
- Howlin, Brendan.
- Kavanagh, Liam.
- Kemmy, Jim.
- McCartan, Pat.
- Mac Giolla Tomás.
- O'Sullivan, Toddy.
- Pattison, Séamus.
- Quinn, Ruairí.
- Sherlock, Joe.
- Spring, Dick.
- Stagg, Emmet.
- Taylor, Mervyn.
Níl
- Abbott, Henry,
- Ahern, Bertie.
- Ahern, Dermot.
- Allen, Bernard.
- Andrews, David.
- Aylward, Liam.
- Barnes, Monica.
- Barrett, Michael.
- Barrett, Seán.
- Barry, Peter.
- Begley, Michael.
- Birmingham, George.
- Boylan, Andrew.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Matthew.
- Brennan, Séamus.
- Browne, John.
- Bruton, John.
- Bruton, Richard.
- Burke, Ray.
- Byrne, Hugh.
- Calleary, Seán.
- Carey, Donal.
- Collins, Gerard.
- Conaghan, Hugh.
- Connaughton, Paul.
- Connolly, Ger.
- Cooney, Patrick Mark.
- Cosgrave, Michael Joe.
- Coughlan, Mary T.
- Cowen, Brian.
- Creed, Donal.
- Crotty, Kieran.
- Daly, Brendan.
- Davern, Noel.
- Deasy, Austin.
- Deenihan, Jimmy.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- Doherty, Seán.
- Doyle, Avril.
- Dukes, Alan.
- Durkan, Bernard.
- Ellis, John.
- Fahey, Frank.
- Fahey, Jackie.
- Farrelly, John V.
- Fitzgerald, Garret.
- Fitzgerald, Liam.
- Fitzpatrick, Dermot.
- Fitzpatrick, Tom.
- Flaherty, Mary.
- Flanagan, Charles.
- Swift, Brian.
- Taylor-Quinn, Madeleine.
- Treacy, Noel.
- Tunney, Jim.
- Wallace, Dan.
- Walsh, Joe.
- Flood, Chris.
- Flynn, Pádraig.
- Foley, Denis.
- Gallagher, Denis.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Griffin, Brendan.
- Harte, Paddy.
- Higgins, Jim.
- Hilliard, Colm Michael.
- Hussey, Gemma.
- Hyland, Liam.
- Jacob, Joe.
- Kenny, Enda.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Lenihan, Brian.
- Leonard, Jimmy.
- Leyden, Terry.
- Lowry, Michael.
- Lynch, Michael.
- Lyons, Denis.
- McCarthy, Seán.
- McCreevy, Charlie.
- McGahon, Brendan.
- MacSharry, Ray.
- Mitchell Gay.
- Mitchell, Jim.
- Mooney, Mary.
- Morley, P. J.
- Moynihan, Donal.
- Naughten, Liam.
- Nolan, M. J.
- Noonan, Michael
- (Limerick East).
- Noonan, Michael J.
- (Limerick West).
- O'Brien, Fergus.
- O'Dea, William Gerard.
- O'Donoghue, John.
- O'Hanlon, Rory.
- O'Keeffe, Batt.
- O'Keeffe, Jim.
- O'Keeffe, Ned.
- O'Kennedy, Michael.
- O'Leary, John.
- O'Rourke, Mary.
- Power, Paddy.
- Roche, Dick.
- Shatter, Alan.
- Sheehan, P.J.
- Smith, Michael.
- Stafford, John.
- Walsh, Seán.
- Wilson, John P.
- Woods, Michael.
- Wright, G. V.
- Yates, Ivan.
Tellers: Tá, Deputies Howlin and Quinn; Níl, Deputies J. Higgins and Boylan.
Amendment declared lost.
I move amendment No. 1:
To delete all words after "care" in the second line, and substitute the following:
"and while noting the need for a fundamental re-organisation of the delivery of health services, recognises that the immediate crisis in the health service and particularly in our public hospitals, arises from the cutbacks imposed by the Government, and therefore calls on the Government to end its policy of indiscriminate cutbacks and to ensure that hospitals and other areas of the health services are provided with the finance and resources necessary to provide an acceptable and effective level of health care."
Amendment put and declared lost.
I am now putting the question: "That the motion in the name of Deputy Yates be agreed."
Question put.
The Dáil divided: Tá, 55; Níl, 75.
Tá
- Allen, Bernard.
- Barnes, Monica.
- Barrett, Seán.
- Barry, Peter.
- Begley, Michael.
- Birmingham, George.
- Boylan, Andrew.
- Bruton, John.
- Bruton, Richard.
- Carey, Donal.
- Clohessy, Peadar.
- Colley, Anne.
- Connaughton, Paul.
- Cooney, Patrick M.
- Cosgrave, Michael Joe.
- Creed, Donal.
- Crotty, Kieran.
- Cullen, Martin.
- Deasy, Austin.
- Deenihan, Jimmy.
- Doyle, Avril.
- Dukes, Alan.
- Durkan, Bernard.
- Farrelly, John V.
- FitzGerald, Garret.
- Fitzpatrick, Tom.
- Flaherty, Mary.
- Flanagan, Charles.
- Gibbons, Martin Patrick.
- Griffin, Brendan.
- Harney, Mary.
- Harte, Paddy.
- Higgins, Jim.
- Hussey, Gemma.
- Keating, Michael.
- Kennedy, Geraldine.
- Kenny, Enda.
- Lowry, Michael.
- McDowell, Michael.
- McGahon, Brendan.
- Mitchell, Gay.
- Mitchell, Jim.
- Molloy, Robert.
- Naughten, Liam.
- Noonan Michael
- (Limerick East).
- O'Brien, Fergus.
- O'Keeffe, Jim.
- O'Malley, Desmond J.
- O'Malley, Pat.
- Quill, Máirín.
- Shatter, Alan.
- Sheehan, P.J.
- Taylor-Quinn, Madeleine.
- Wyse, Pearse.
- Yates, Ivan.
Níl
- Abbott, Henry.
- Ahern, Bertie.
- Andrews, David.
- Aylward, Liam.
- Barrett, Michael.
- Brady, Gerard.
- Brady, Vincent.
- Brennan, Matthew.
- Brennan, Séamus.
- Browne, John.
- Burke, Ray.
- Byrne, Hugh.
- Calleary, Seán.
- Collins, Gerard.
- Conaghan, Hugh.
- Connolly, Ger.
- Coughlan, Mary T.
- Cowen, Brian.
- Daly, Brendan.
- Davern, Noel.
- Dempsey, Noel.
- Dennehy, John.
- de Valera, Síle.
- Doherty, Seán.
- Ellis, John.
- Fahey, Frank.
- Fahey, Jackie.
- Fitzgerald, Liam.
- Fitzpatrick, Dermot.
- Flood, Chris.
- Flynn, Pádraig.
- Foley, Denis.
- Gallagher, Denis.
- Gallagher, Pat the Cope.
- Geoghegan-Quinn, Máire.
- Hilliard, Colm Michael.
- Hyland, Liam.
- Kirk, Séamus.
- Kitt, Michael P.
- Kitt, Tom.
- Lawlor, Liam.
- Lenihan, Brian.
- 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'Dea, William Gerard.
- O'Donoghue, John.
- O'Hanlon, Rory.
- O'Keeffe, Bat.
- O'Keeffe, Ned.
- O'Kennedy, Michael.
- O'Leary, John.
- O'Rourke, Mary.
- Power, Paddy.
- 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 J. Higgins and Boylan; Níl, Deputies. V. Brady and Browne.
Question declared lost.
With regard to Item No. 26, Protection of Part-Time Workers (Employment) Bill, 1988, we seem to be hampered for time. There are merely five minutes left. Can I have the advice of the House as to how to deal with this matter? Shall we postpone it until next week?
If it is postponed, will it be taken at 7 o'clock next Tuesday?
Yes, would that be satisfactory?
Unless the Minister wants to withdraw his opposition to the Bill at this time.
The Bill will be deferred until Private Members' Time next week.
Will the Government not agree to the publication of the Bill?
I am proceeding——
On a point of order, the Minister may not be aware that all of the parties in Opposition, including the Independents, have agreed to support the publication of the Bill and I think that in view of that it is only proper for the Minister to withdraw his opposition to it.
I have suggested that it be taken up again next Tuesday during Private Members' Time.
I suggest that the House agrees to having ten minutes of Government time which might help to conclude this particular matter.
That would mean five minutes for the sponsor and five minutes for the Minister to reply. That is as much as we can do. Is that agreed? Agreed.