My first function this morning is to welcome the Tánaiste to this House on the occasion of his first visit here as Minister for Health. Perhaps after 20 months of Coalition Government it is significant, to say the least, that this is the first occasion on which a Minister for Health of that Government should bring legislation to this House.
For the last 12 months the Minister for Foreign Affairs has been running around Europe trying to extract from the EEC Regional Fund a sufficient amount of money for this nation. The climax was reached last week when the Taoiseach went to Paris and managed to get the sum of £8 million for this country for the year 1975. One would get the impression from Government Ministers, and indeed from some sections of the media, that they had achieved something worthwhile. But when one compares this sum of £8 million with the amount of money being raised by colleagues of the Minister for Foreign Affairs for the Exchequer one realises it is a mere pittance.
The Minister for Posts and Telegraphs managed during the year to get for the Exchequer a considerable amount of money by increasing the cost of telephone calls, postage and televisions licences. With a stroke of his pen the Minister for Finance, by placing a 15p tax on every gallon of petrol, managed to secure for the Exchequer a sum varying from £27½ million to £35 million. By another stroke of the pen the Government managed to get for the Exchequer the sum of £2.4 million by withdrawing the subsidy from butter and by increasing the price of butter to the Irish people by 4p per lb.
This morning we reach the final straw by the visit to this House of the Minister for Health and the Leader of the Labour Party who is asking us to give to the Exchequer the sum of £3½ million by taxing the workers, small farmers and small businessmen.
I cannot understand the attitude of this Government, composed of socialists on the one hand and advocates of the just society on the other. Throughout their years in opposition, members of this Government scoffed at the 5 per cent in this country who between them enjoyed the maximum share of the nation's wealth. That 5 per cent do not suffer unduly because of increases in the cost of petrol, stamps, TV licences, phones or buses. That 5 per cent do not suffer this morning by this Bill. Robin Hood robbed the rich to help the poor. The policy of the National Coalition Government, the socialist just society, appears to be the reverse of the philosophy of Robin Hood. They robbed the poor to help the rich.
In this measure before the House the Minister is asking the workers to provide £3½ million in order that the Government can give free hospitalisation to the 5 per cent who control the nation's wealth. I cannot understand how any member of the Labour Party could subscribe to this philosophy. We have in the Government today a Robin Hood in reverse. We have a Government who believe that the worker should be taxed in order to provide free hospitalisation to a section of this community who can well afford to provide it for themselves. We have been told that a considerable amount of money is being provided for the health services at present. We have been told that it has increased from £86 million in the financial year 1971-72 to £166 million. We have also been told that the figure for next year is £40 million more than was provided last year.
That could convey the impression that the health services will be vastly improved in the coming year. If we study the breakdown of this £40.5 million we shall discover that there is absolutely no new thinking on an extension to the medical services. A breakdown of the £40.5 million shows us that £20 million will be spent on pay increases and price increases and £9 million will be spent on the relief of rates. Thus the amount of money spent on new services will be relatively small; £1.3 million will be spent on the extra cost of increases in rates of allowances and in expenditure on new allowances for domiciliary care of handicapped children provided in the last budget; £1.2 million will be spent on increases in the rates of allowance; £4.5 million will be spent on general and psychiatric hospitals, including new units and improving staffing and services standards; £1.5 million will be spent on extra places in homes for mentally handicapped persons and new welfare homes for old people; £1.3 million will be spent on development under the general medical services scheme, and £1.7 million on improvements in community care services.
If we deduct what will be spent on paying increases, on price increases and the money provided for the relief of rates, we shall discover that only £11 million extra is being devoted to actual health matters in the coming year. Of that sum there is only one item that is the brainchild of the present Government, that is, the very welcome new allowances for domiciliary care for handicapped children. That covers a sum of £1.3 million.
The rest of the money is being devoted to the continuation of the schemes provided by Fianna Fáil. If we examine them closely we will see that the amount provided for these services is a miserable pittance at a time when practically every county is crying out for an improvement to general and psychiatric hospitals. Surely we must agree that the extra sum of £4.5 million for this purpose is very small indeed. According to the capital budget for 1975, £10 million is being allotted for capital purposes for health for the coming year as against £7.35 million in the nine-month period of 1974. When one turns that into a 12-month period we see that the Government are providing a miserable sum of £200,000 extra for capital purposes for the health service in the year that lies ahead.
No consideration has been given to galloping inflation, to the weekly price rises which are occurring. I would have thought that if the Government were really serious in this matter they would have provided at least double the sum of money for the development of our hospital services in the coming year. Of the £40.5 million increase for 1975 we see that £9 million is for the relief of rates. This was one of the carrots dangled by the National Coalition Government before the Irish electorate in February of 1973. This was one of the ways in which they bought themselves into office. I would submit this morning that, in making the promise to the electorate that they would take health services off the rates, this Government were not honest with the people. They should have told the people that, while the big ratepayers would no longer have to pay rates on health, the workers, the small farmers and the small business people would be asked to subsidise the big ratepayers. On the one hand, the relief of rates on health charges in 1975 will save the ratepayers £9 million. The workers and others are now being asked to pay £3½ million of this amount. The workers must realise that they were codded and fooled by this Government in their 14-point plan. They were codded in other ways as well. They were codded in a much more serious way, in that the balance of this £9 million is being obtained by slowing up the health services. In the 1970 Health Act Fianna Fáil gave the people a blueprint to the finest health services that could be provided. Fianna Fáil gave the green light to the Irish people and to the health boards to provide the people with an excellent health service.
A few months after the arrival of the National Coalition Government, that green light turned to amber and was very quickly followed by red— red for stop. For almost 18 months those lights have been red: stop to the expansion of the health services in the way that they should have expanded; stop to the development of our hospitals both general and psychiatric in the way that they should have developed; stop to the provision of long staying units and welfare homes as envisaged by Fianna Fáil.
The Government applied the red light to compensate for the money they had to provide for the relief of rates. The Government brought their way into office by making this promise to the people. In the health board of which I am a member, the estimate was cut by almost £1 million. If one is to assume that a similar cut took place in other regions, it is very easy to explain how this Government could provide relief of rates.
On the other hand, Fianna Fáil believe that only the occupants of private dwellings should have such relief. Fianna Fáil would not play Robin Hood—we would not ask the workers of Ireland, as the Minister is doing, to subsidise the 5 per cent of the Irish nation who control the vast majority of this nation's wealth.
In the Dáil last week I listened to the amusing contribution made on this Bill by the Labour Deputy from Limerick. I was particularly amused when at column 1516, volume 276, on 11th December, 1974, the Labour Deputy stated as follows:
We have given the people a health service Fianna Fáil could never have provided for them.
I naturally asked myself which party were in office when the Health Bill, 1970, was introduced. I wondered if that Deputy was making a mistake or was he doing something that most Government supporters like to do, that is, to give the people the impression that the National Coalition Government are responsible for many of the tremendous schemes initiated by Fianna Fáil?
I am glad the Minister, spelled out in his speech that the free hospitalisation for insured workers was initiated as a result of the Health Contributions Bill, 1971. That was a Bill pioneered and introduced by Fianna Fáil. Some Deputies who support the National Coalition Government go around the country trying to give the impression that this measure was introduced by that Government since their election in 1973. I should like to read a short extract from the Donegal Democrat of 26th January, 1974. It reads as follows:
Deputy Jim White, speaking in Fintown, told the meeting that as from January 1st the following increases in means for medical cards had come into operation: persons whose incomes do not exceed the following limits are eligible:——
and he proceeded to give the limits.
——Mr. White said that he was glad that this long overdue increase in means was taking place as there were very many people in Donegal who should have got medical cards, but were turned down due to the very small means test. He said that he had kept in constant touch with the Department to have the means increased——
and he advised people to apply for it.
Mr. White also stated that this change was part of the Government policy to see that the weaker sections of the community get the maximum amount of assistance.
Then we go on to the main point.
Deputy White went on to speak about the £7 contribution under the Health Acts, whereby everyone in the country in the scheme would be entitled to "free" hospitalisation from——
When?
——April, 1974. This contribution covered a married man, his wife and family for full maintenance in a public ward, "free" doctors and surgeon's attention in hospital; "free" drugs and X-rays and, indeed, all hospital services. These two schemes——
the Deputy said
——showed a big step forward in health services and proved that this Government was doing something constructive with the problems that face the weaker sections of the community.
Here we have a Deputy supporting the Government going into a small village and no doubt hoping that none of his listeners had to have hospitalisation for three years before and hoping that they would accept from him the message that he was trying to convey— that this Government were responsible for providing free hospitalisation for insured workers. They even tried to tell them in January, 1974, that free hospitalisation would not be introduced until the following April, whereas we all know that this came about as a result of Fianna Fáil's Health Contribution Act, 1971, and that it commenced on 1st October of that year.
Here we have a situation where a Labour Deputy from Limerick and a Fine Gael Deputy from Donegal are attempting to give to this Government credit for the health services that they do not deserve. When this Government assumed office, Fianna Fáil had left them excellent health legislation that would have improved the lot of the people if this Government had continued to have the same interest in health matters as the last Government.
Fianna Fáil's record was so good that in 1970 there were 12 doctors in this country per 10,000 of the population as against 12.3 in England and Wales. We had 2.2 dentists per 10,000 of the population as against 2.7 in England and Wales and we had 64.7 nurses per 10,000 of the population as against 42.7 in England and Wales.
Fianna Fáil pioneered the health services and set up a service which has provided tremendous improvements in the lot of the people who could not afford to do it for themselves. They provided free medicines, free nursing services, a dental service for medical card holders, an eye service, an ear service, a chiropody service, free medical appliances, walking aids, wheelchairs and so on. They provided a hospital service, free milk for mothers with children under five and gave special consideration to travelling allowances for people who could not afford to visit relatives in hospital. They provided social workers, home helps, blind welfare, set up local social service councils and gave them considerable grants to provide coal and other vital necessities for the needy. We have a record in the field of medicine of which we have every reason to feel proud.
After 20 months of Coalition Government—a Government of socialists-cum-advocates of the just society—we are entitled to ask what has been their contribution to the health services. The only contribution they appear to have made is the legislation before this House today. It is legislation to extract from the workers, from the small farmers and small businessmen, the sum of £3½ million. If we were told that this money would be used to provide better hospitalisation or the extra staff that have been demanded and denied in every hospital in this land, or if we were told that this £3½ million would be spent on increasing allowances under the Disabled Persons' Maintenance Scheme; or, better still, if the money was to be spent to provide for dependants of applicants for disabled person's maintenance allowances; or if we were told that this was being spent to provide more social workers or more home helps or to increase the hours home helps give to the needy—because two hours a day, while useful, is not enough—or if we were told that this £3½ million would go to committees looking after the aged, then possibly we would welcome this legislation this morning and we would have to admit that it was being spent in a very important and useful manner. But this money is not going to any of these schemes.
These excellent schemes, introduced and pioneered by Fianna Fáil, have not been making the progress in the last two years that they should, because the Government are not providing the money that they should. Because the Government bought their way into office by reducing the rates contribution to the health services, they had to reduce the amount of money being spent on the needy by the amount of money they have to pay out in rates relief.
Fianna Fáil adopted the report on the care of the aged presented by the inter-departmental committee set up in 1968 and agreed that institutional care should be provided by general hospitals, geriatric assessment units, long-stay units and welfare homes.
Terms were drawn up to ensure that these recommendations would be given effect. I submit that the present Government are deliberately holding up the provision of this accommodation for as many years as they can in order to save them making the investment in health that they should be making.
It is two-and-a-half years since the North-Western Health Board took a decision to provide welfare homes in the towns of Ramelton and Falcarragh in County Donegal. After two-and-a-half years of planning, postponement and so on, the Department of Health are still examining the cost—two-and-a-half years spent on postponement because the Government have to pay out £9 million or £10 million extra per year on relief of rates to keep their election promise, and they had to find this money by slowing up the health services.
This Government have no reason whatsoever to feel proud of their record. It is easy for the Minister for Health to stand up and say that so many extra millions are being spent now than was spent two years ago. The Government have to spend this extra money on the schemes that were introduced by Fianna Fáil. The standards for full eligibility under the general medical services was provided for in section 45 of the Health Act. Each year the chief executive officers review the guidelines, and only on Monday last the board of which I am a member were told that the income limit had been increased from £20 to £24.50 for a husband and wife, with an allowance of £2.25 per child under the age of 16, as against £1.75; £14.75 for a single person living with his family and £17 per week for single persons living alone.
This would cost the health services more money and that was envisaged by Fianna Fáil when the Health Bill of 1970 was introduced. That was provided for by Fianna Fáil in that section of the Bill which stated that adult persons unable without undue hardship to arrange general practitioner, medical and surgical services for themselves and their dependants would be entitled to free general medical services.
If the amount of money allocated to health is growing, there is only one reason for it and that is that the schemes initiated by Fianna Fáil will have to continue or be stopped by this Government. The only contribution that this Government have made to the health services has been the provision of a domiciliary care allowance. After 20 or 21 months of Government, it is a very poor record indeed. It demonstrates clearly to me, having studied the record of Fianna Fáil in this field and compared it with the record of this Government, that Fianna Fáil had and have a social conscience.
Nowhere in the workings of this Government during the last two years can we find evidence of a social conscience. Over the last three years, many people whose incomes far exceeded the limit received demands for the health contributions. This may apply only in the north-western region, or, indeed, only to Donegal, but it has happened many times. A businessman whose taxable income exceeds the limits laid down has a small farm. He receives a demand for his contribution and, believing that this would give free hospitalisation for himself and his children, pays the £7 each year. He does not read the small print in the demand. As far as I remember this clearly states that, if the income exceeds the maximum, even though a person may have his £7 receipt that person is not entitled to the health service.
These demand notices are sent out by using the rate book. A few weeks ago I had a woman in with me whose brother has been living in England for 30 years and who has not been home since. He owns a small mountain bog farm. This lady received a final demand note from the health board for this brother. If I owned a small farm the health board officials would simply see my name in a rate book and issue me with this demand. If a number of people who year by year pay this contribution were to challenge their claim to medical services they would find they were not entitled to the service for which they are paying. I know of one consultant who, even though handed a receipt by a lady, claimed that the family were not entitled to the service. He presented his bill and was paid.
Something will have to be done about this. Now that the demand is for £12 per year, the health services, the Department and the health boards will be subject to considerable criticism from people who even though year by year they pay the demand, may be later denied the service. I realise that this is provided for in the small print but I do not think that this is good enough. People should be told that, if their income limit is in excess, they will be stricken off. I do not consider that this is a Health Bill.
This morning I read over some of the speeches made in this House on the Bill in 1971 by Fine Gael Senators, who then claimed that that was not a health measure but another measure to increase taxation. In 1971 the Government were introducing a new service, tremendous facility for Irish workers and small business people. Today, in asking the workers of Ireland to pay 80 per cent more, the Government are not providing an improvement in this service. They are doing nothing new. The time has come for the National Coalition Government to stop playing the role of robbing the poor to subsidise the rich. It is time they began, if they have a social conscience at all, to emulate Robin Hood's work in the past.