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Seanad Éireann díospóireacht -
Thursday, 21 Jan 1982

Vol. 97 No. 3

Army Medical Corps: Motion.

I move:

That Seanad Éireann considers that the status and efficiency of the Army Medical Corps should be improved as a matter or urgency in the interests of the Defence Forces as a whole.

At the outset I should like to welcome the Minister. I think it is his first appearance here as Minister for Defence, although I think he put in an appearance for another Minister on one occassion.

What I have to say is in no way political. I am not here to, as it were, bash the Minister. In fact, I think he will recall an event which happened five or six years ago in County Clare where I had the pleasure of coming to his rescue in a very practical way and I think both of us got a fair degree of enjoyment from that event. I am not here to criticise the Minister, Deputy Tully, and I am not here to criticise past Ministers. I know, in so far as Deputy Tully is concerned, that he has inherited the problem which I will outline. I will be asking him to remedy the situation. I am here to highlight a problem that exists in so far as the Army Medical Corps is concerned. What I say I would be saying to any Minister for Defence, irrespective of which political party he belonged to. I want to set the record straight from the word go.

This problem of the Army Medical Corps is one that I have been watching and listening to over the years. I have read about it in newspapers. Army men have mentioned it to me. I have made my own inquiries and have read about it in the Irish Medical Times. I read the Supplementary Estimate for the Minister's Department with great interest. I take a particular interest in matters of defence for the obvious reason that I come from an Army town. We have a very proud tradition and a very fine barracks, one of the best in the country. Many of my friends are there and therefore I take a particular interest in matters of defence. I studied the parliamentary debate dealing with the Supplementary Estimate but I found no reference to the Army Medical Corps. Other areas like housing and promotions were mentioned. Even Deputy Hugh Byrne, who I understand is a medical doctor, made no reference to the Army Medical Corps. In fact the only reference I saw in the whole debate was the word “medicines” with a figure of a very small amount. I was a bit disappointed that Deputy Byrne referred to an aspect of another corps and made the point that people convicted of vandalism and some of the layabouts of the city should be recruited into this new corps. At a recent corporals' mess dinner at Custume Barracks I publicly congratulated the Minister for saying that that type of person is no longer wanted in the Irish Army. The Army nowadays is too good a job for layabouts. The Minister was quite right, and I congratulate him for saying so so quickly in that debate. Down the years district justices for some reason or other used to say to people who got into trouble with the law: “Why don't you join the Army?” That day is gone, thank God. The Army is now a good job, a good career, and the best type of young men should be recruited to it.

In so far as the Army Medical Corps itself is concerned, it is known that the figure for establishment as recommended by Public Service and the Department is 72; in other words, there should be 72 medical people in the Army Medical Corps. That is the requirement and the figure generally accepted and recommended. Possibly a bit less might suffice. But, in fact, the total strength this week of the Army Medical Corps is 31. In the debate the Minister referred to the fact that the Army has almost 15,000 personnel.

It has 31 medical staff and, of the 31 medical people, two are overseas; each battalion of roughly 600 men that goes overseas brings with it two doctors. This is very good. That is a good doctor-patient ratio and obviously we hope it will not be interfered with in any way. Two more are presently on study leave — that is another problem that I will touch on later. There is a total of 16 in administration doing routine, perhaps important, paperwork, but it is administration. There are four specialists working in the three hospitals of St. Bricin's, the Curragh and Cork. That leaves a total of seven who might be called non-consultant, non-administrative, ordinary, decent practising medical men doing routine doctoring work. So the ratio is seven to 15,000. I am wondering how that could, by any stretch of the imagination, be considered to be sufficient, bearing in mind that 72 is the establishment figure. The four specialists, as I said, engaged in hospital work are working at general medical work also.

The motion refers to the efficiency and the status of the Army Medical Corps, but let me quickly say that I am in no way commenting on the efficiency of the doctors who are presently there or who have been there over the past few years. They are excellent people; they are known to be excellent doctors. But they must be working under some very serious strain. There are no doctors available for the Air Corps. There is no doctor available for the Naval Service. The medical care for the Defence Forces is totally inadequate countrywide. As a result of it being that way, it must be seen to be operating with minimal efficiency.

The question of pay for Army doctors is a burning question. The pay is unrealistic having regard to the present rate of inflation. There is no index-linking; it is not related to the national wage rounds. I feel that at all times the professional pay should be at least 33? per cent more than the regimental pay. Regimental pay and professional pay should be linked. It is wrong that the pension of an Army medical man should be based on regimental pay only. Why should this be? It does not make sense.

The status of the doctor in the Irish Army does not compare favourably with the status of doctors in the medical corps of other armies. If we take our nearest neighbouring army, a comparison might be no harm. When one joins the medical corps one does so as a captain. The promotion from captain to commandant, depending on vacancies, can take up to nine years. In our nearest neighbouring army promotion from captain to major will take place after five years. I understand that the Irish Medical Association has requested on a number of occasions that this change should take place. So the normal age of an infantry officer, that is captain to commandant, would be about 32 years. The normal age of an Army medical commandant after promotion would be 38/39, despite the fact that an Army medical man would have about seven years' training to be a doctor, whereas the other person would have most likely a leaving certificate standard qualification. That is not fair.

In the Irish Army promotion from commandant to lieutenant-colonel depends on a number of factors — deaths, retirements and resignations. It may take up to 30 years, or it might never happen. On the other hand, in our nearest neighbouring army, promotion from major to lieutenant-colonel takes place after 13 years. That is pretty well guaranteed. As regards promotion from lieutenant-colonel to colonel for an Army medical man, for the majority of them this will never happen. Promotion from lieutenant-colonel to colonel takes place after 23 years in our nearest neighbouring army. The Irish Army Medical Corps has no worthwhile career structure for the majority of its members.

Another aspect which is clearly worrying for young doctors joining, and it should not be, is the scope for post-graduate training. Apart from ordinary medical officer courses, there is no encouragement to allow them to do post-graduate training. The opposite is the case. If a person obtains a place on some of these training schemes and wants leave of absence with or without pay in most cases he will not get it. The general attitude would be not to allow this to happen. That is not right. Obviously if a young Army medical officer goes off and improves himself with or without pay it will be to the benefit of the Army subsequently. They can obviously make a contract with him that he stay with the Army for a period of 20 or 25 years. The Army would be the clear beneficiaries in that situation.

For the Army Medical Corps there has been no adequate provision for widows and orphans since 1978. For example, if an ordinary officer was killed in overseas activity, his widow would be looked after, and rightly so. But if an Army medical officer was killed overseas on duty his widow would not have the same benefit at all. This is totally unfair. I cannot understand why it should be. I am told it is a fact.

There is always the problem of retirements, deaths and resignations. From 1977 to 1981 six young medical officers of the Army resigned out of sheer frustration at the conditions in which they were asked to work.

Since July we know there has been an embargo on jobs in the public service. It applies to the Army although there is an obvious scarcity of people here. The Army regularly advertise for medical officers and the response has been totally hopeless. The Irish Medical Times of 24 July 1981 makes the point that a Dr. Flanagan, who is a lady doctor——

The Chair would prefer if names were not mentioned.

I understand that there are three lady doctors. They are not asked to go overseas although they would like to do so. That is wrong. If they want to go overseas to work as their male counterparts are doing, the opportunity should be there for them. Perhaps the Minister would comment on why this is so. The Irish Medical Times, dealing with the aspect of recruiting people to the Army Medical Corps, stated that the Army was looking for 15 doctors at the time but the response appeared to be so bad that the Department of Defence readvertised for doctors in January of 1981. This seems to be the trend. The response seems to be very bad for the reasons I have given.

There is no Army doctor in Donegal. There is no Army doctor in Mullingar where there are about 200 people. There is no Army doctor in Longford. The same applies in many other areas.

If advertisements were inserted or perhaps if they were done on a different basis — for example, if one could specify in some way that these advertisements were for specific areas of the country — perhaps one would have a better response. I know and appreciate that if one recruits a doctor or an Army man generally, he could be in Cork for a year, spend another year in the Curragh or be transferred anywhere. Having regard to the problems in getting people to join the Army, it might be a good idea perhaps if some changes took place. Of the 450 graduates from the various medical schools of Ireland, approximately 150 or thereabouts obtain employment immediately, some emigrate and some pursue further studies, but almost none will join the Irish Army. That should not be the case. I understand that England has a medical cadet scheme whereby second-year medical students are commissioned to the rank of lieutenant and from there on they are taken and kept in the Army as medical people. Perhaps some such scheme could operate here. The Minister might look at this.

It would be interesting to find out the amount of money paid annually to civilian doctors doing work for the Army as is the case all over Ireland. It would be very interesting to find out the number of not just the doctors but also the consultants and other specialists who give this service. Perhaps the funds given to these people, if put towards better wages or salaries for the Army medical people, would attract more people to this service for the Army. Something will have to be done in this regard.

I cannot help feeling that we are lucky to have such a very healthy Army of 15,000. At the same time, if a medical examination is carried out on any one in, say, July, it could happen that a kidney complaint, heart condition or whatever would arise later in a reasonably short time. While we have a specimen of a healthy people in our Army, it is very important to have a good back-up medical team right across the country. I suggest that the figure I have given is totally inadequate. If the present trend continues the present crisis with the Army Medical Corps will become much worse. In my opinion, it is a crisis situation now which arises out of lack of recruiting and other reasons which I have given in my address. Unless radical improvements take place we will have a total collapse within two or three years. We would not like that and it would not be good for any of us, for the morale of our soldiers and for the nation in general.

I have attempted to highlight in the presence of the Minister the problems that exist with the Army Medical Corps. I hope that as a result of this debate — which is intended to highlight, not to criticise, the inadequacies — much improvement will come about and that the Minister will investigate the matter and, more important, will endeavour to rectify this terrible sad situation.

I conclude by saying, looking at the Minister, what a fine Athlone man he is, and I have been his friend for many years.

I wish formally to second the motion and will speak later on it.

I have some personal feeling for this question because my father was a member of the Army Medical Corps for a number of years and from discussions and so on I know something about it. First of all, in joining in the welcome that Senator Fallon extended to the Minister, I would also like to extend to the Minister my personal congratulations on the wonderful job of work done by him and the Army during the recent very adverse period we went through. There is no doubt that the Army Air Corps and the ordinary soldiers who were out on the streets, the drivers and all the others who were involved in helping during that period, did a fantastic job of work and deserve the highest credit from all of us. Of itself that experience establishes, as Senator Fallon said, that within the Army we have a high standard of not alone personal efficiency in respect of individuals but a high standard of health. These lads were able to respond to fantastic demands on their time and on their personal resources and they responded very well and showed all of us that so much is to be gained by having a public commitment, a code of conduct and a standard to aim at and to maintain. Such a code would benefit this community as a whole if it could find an equal level through all sectors in our society. We can draw from that example the conclusion that the Army are reasonably well-fed, well-clothed and well-looked after within the resources available to us, and therefore we have a lot to be thankful for.

At the same time I go along with the broad basis on which Senator Fallon made his submission, which is that we should always be looking to improve whatever services are required either within the Army or on the social scene generally so that we can be always aiming at the highest possible standards and for a general contribution towards the improvement in these standards within the nation. I imagine that when evaluating the question of the medical services for the Army we must have regard, not alone immediately to the financial resources available to the Army itself, but to the other medical and health services available within the State as a whole. I hope that the authorities concerned will ensure that whatever particular consultation or diagnostic or treatment services are required to handle special problems will be available from the ordinary public health services. I am quite sure that there is a very efficient arrangement whereby the hospital services and general health services can provide the type of special service or attention that may be needed from time to time to meet difficulties such as a kidney problem, heart problem and so on.

It would seem illogical to anticipate a situation where every county or regional area — I do not know how the Army is broken up — should carry its own total medical service and equipment. Apart from the economics of it I imagine that we could have much redundant service if we approached it in that way because the demand would not be there for that high level of applied service on a regional or area basis.

I agree with Senator Fallon that, if there is not an adequate link-up with the public health services, the hospital services and so on and the Army authorities, then this is a failure; but that failure cannot be laid at anybody's door. It is something that we have inherited over the last 20, 30 or 40 years. It is not the responsibility of any one Government other than to ensure that if they are recruiting medical personnel or any other professional expertise into the Army the terms of recruitment should be such as to attract the best people possible. It would be wrong — if it is so — that any Army medical people would be discriminated against either in the reward they would expect to get for their expertise and professionalism or in the opportunity available to them to advance in their career. I am upset to have heard — I do not know how factual it is — that some impediment seems to be in the way of Army medical people developing their careers. This may be due to the fact that so many vacancies are unfilled that those within the service are over-committed and their workload excessively heavy and, therefore, they cannot be released to take post-graduate courses or refresher courses.

If this is a problem I would join Senator Fallon in requesting that the matter receive urgent examination. Not having the facts, I am not being assertive on this but I agree with the broad principle that the Army Medical Corps should be appropriate to the needs of soldiers in a modern army in which there may be different types of tensions and stresses from those experienced years ago. The Army are now more involved in the social scene and their role may expand. They may need a different type of medical service and the Minister might tell us whether studies are being done to determine the manner in which the medical service may best operate.

While I agree with the broad principle that the Army should have the best possible service, it is implicit in the wording of the motion that there is something seriously amiss in respect of the Army medical services. If there were something seriously amiss I should imagine that the Irish Medical Union and other medical authorities as well as the representative organs within the Defence Forces would have brought this matter to the attention of successive Governments. It will be interesting to hear from the Minister the position in that regard. I would not wish to be identified with a motion of censure if that censure cannot be established as bona fide.

The general services available to the community should be available to the Defence Forces so that they can get the best treatment and service. If this can best be done by bringing in outside consultants or admitting soldiers to public hospitals for operations, this should be done. Medical personnel would, of course, be needed to deal with day-to-day minor ailments with which all of us are afflicted and there are areas of residence where families of soldiers need a local service.

I have already seconded this motion and I join Senator Fallon in welcoming the Minister for Defence. I come from Athlone and share a common concern with Senator Fallon on this subject. I should like to correct a misapprehension by Senator Carroll. It was not intended that this should be a motion of censure and Senator Fallon explained that it was a motion expressing concern and designed to highlight a particular area.

Senator Fallon mentioned several aspects of this matter which he wished to highlight and perhaps the most salient point concerns the numerical disproportion. The statistic upon which we must concentrate is that there are 31 medical doctors to serve 15,000 people. If two of these are overseas, two are on study leave, 16 are working in administration and four are specialists, the number of doctors who attend to the everyday ailments of the soldiers is very scant. The proportion of medical officers to personnel cannot be seen as equitable.

Pay and status are also very important. Naturally we are all interested in pay in order to live but men and women within the Army Medical Corps must also be very concerned about status and promotion and the lack of career opportunities. The latter point would be an obstacle to any person considering entering the Army Medical Corps because the idealistic young person who has been well trained obviously seeks a position where there is a possibility of advancement and for specialist development and post-graduate work in order to further his or her education and better to serve the interests of those whom he or she is employed to help. Further training in any job can only be to the benefit not only of the person receiving that training but also to the benefit of those being served.

The Army have expanded and evolved in every way and the image and status of the Defence Forces have improved enormously. Successive Governments have been well served by Ministers for Defence and this has never been seen as a Cinderella posting. The task of the Minister for Defence has been seen as highly important and relevant to our everyday life. I come from an Army town and Custume Barracks has a large number of Army personnel both men and women. The idea of recruiting women to the Army was initiated by Deputy Robert Molloy when Minister for Defence and taken up by his successor, Deputy Barrett, and by the present Minister. The Army have developed their scope and their rôle and they appear to be modern and forward-thinking. We can be proud of their rôle not only at home but treasna na dúnta in far-off lands.

It would be a pity if there were a lacuna in any aspect of Army life and it is this concern which has prompted the putting down of this motion. Napoleon said that an Army marches on its stomach and the culinary aspects of Army life are very well looked after. It would be a pity if such an important matter as the health of Army personnel were to be adversely affected through any lack of numbers in the Army Medical Corps. I would imagine that this situation has arisen over the years and that while the Army has evolved in other areas this aspect has not. I do not speak with authority on this point but it seems that the rôle of the medical corps was allowed to be obscured and the system under which personnel were recruited, served and retired remained static.

I am very glad that the Minister has taken the trouble to come here to listen to our viewpoints. I reiterate that this is not a motion of censure but is designed to express concern for the Army in general and particularly for an improvement in the status and efficiency of the Army Medical Corps.

Is mian liomsa, ar dtús, fáilte a chur roimh an Aire Cosanta agus fáilte a chur roimh an rún seo atá ar an gclár agus buíochas agus comhghairdeas a ghabháil leis na Forsaí Cosanta as ucht a bhfuil déanta acu ó bunaíodh an Stáit seo chun síocháin a chaomhnú agus a chosaint sa tír seo agus in áiteanna eile ar fud an domhain.

I am pleased to support this motion that the position of the Army Medical Corps should be reviewed in the interests of the Defence Forces as a whole. The time is opportune, as the Leader of the Opposition in the House said yesterday, for a comprehensive and constructive review, embracing all aspects of the working conditions of our Defence Forces.

The primary function of the Army Medical Corps in peacetime is to provide for the preservation of the health and physical fitness of the Defence Forces. While it is true to say that the actual strength of the corps falls short of the establishment, it is also true to say this is not of recent development. The corps, nevertheless, have been able to carry out their responsibilities assisted by civilian doctors, dentists and specialists. The Army Medical Corps have at the moment a current strength of 29 non-specialist medical officers compared to an establishment of 46, a strength of four specialist medical officers against an establishment of 25, a strength of eight dental officers as against an establishment of 14, a strength of four pharmaceutical officers as against an establishment of five, a strength of four line officers as against an establishment of eight, a strength of 149 non-commissioned officers as against an establishment of 171, a strength of 172 privates as against an establishment of 326 and a strength of 86 Army nursing staff as against an establishment of 93. These figures pinpoint the necessity for a comprehensive review. They do not indicate, however, a very serious crisis situation. They indicate the need for a constructive and comprehensive review.

I would like to take the opportunity here, as this is the first occasion the Minister has come to this House as Minister for Defence, to pay tribute to the Permanent Defence Forces and the FCA for the great work they have done since the foundation of the State in advancing and promoting peace in this country. The effective strength of the Permanent Defence Forces at the moment is 15,000 as against a total peacetime establishment of 18,000 including all ranks. The effective strength of the FCA is 21,700 as against a total establishment of 22,200 all ranks. I would like also to pay tribute to the Slua Muirí for the work they are doing in assisting the Naval Service in sea defence, port control and vessel investigations.

It is appropriate to pay a well-deserved tribute to all our personnel who have been engaged in maintaining and fostering international peace overseas since this country became a member of the United Nations in 1955. The importance of the peace-keeping missions that have gone from this country overseas can be seen from the fact that 6,400 members of all ranks served in the UN force in the Congo between 1960 and 1964, 9,400 of all ranks served in the UN force in Cyprus since its inception in 1964 and over 4,000 have served in the Lebanon. At present 650 Irish personnel are with UNIFIL, the United Nations Interim Force in the Lebanon. This mission, in particular, has faced one of the most difficult tasks that this country——

I am afraid the Senator is getting away from the Army Medical Corps of the moment.

I was paying a well-deserved tribute to these forces in view of the presence of the Minister in the House for the first time. I would like, seeing that I have singled out certain units of our Defence Forces, to pay tribute to the Naval Service and to the Air Corps. I would like to compliment the Army and the Air Corps for the great work that they did leading up to and during the historic visit of Pope John Paul II to this country. In conclusion, I would like to support this motion, to welcome the Minister to this House, and to congratulate him, the Army and all the units under him for the work they are doing for this country.

Since Senator Kennedy has gone through the motions of defending the Defence Forces and has given us the statistics dealing with Defence Force activities, I hope I will be permitted to make a few comments. I have a little knowledge of the Army Medical Corps in the sense that I had an uncle in the Army who died in an Army hospital and I have a first-cousin who is a nurse in the Army Medical Corps. Indeed, one of the things that has concerned me in the last few years is that the nurses in the Army Medical Corps did not get officer status, non-commissioned officer status and private status within the Department of Defence. The nurses who operate the majority of the medical services in the Army have no status. It is about time they were given the right to wear a flash on their uniforms. They are given a uniform but they do not have even the status of a private in the Army.

I am a member of the Organisation of National Ex-servicemen as an ex-corporal in the FCA. I have a reasonable knowledge of what goes on in the Army and of what status means. One of the things that has always annoyed me is that if I go to university and get myself a degree as a doctor I can walk into the Army as a commandant. If I am a nurse I get a job in the Army as a nurse but I get no status under the Department of Defence. A nurse in the Army Medical Corps goes in as a nurse and goes out as a nurse. There is no promotional prospect. A doctor goes in with possibly the same amount of training. He starts off as a commandant and comes out as a lieutenant-colonel. This is an area of concern. I do not feel the doctor should have any more promotional prospects in the Army than a nurse. I would like to see within the terms of the motion that nurses in the Army be given a status within the Army. Senator Kennedy mentioned the number of people who served at home and abroad under the Department of Defence and I accept all his figures.

It is very noticeable, if one goes abroad to visit the Irish forces working with UNIFIL, UNWRA and other international organisations, that there is not one medical person from the Irish Army working in those areas. We have every grade within the Army working in the Lebanon from general to private, but, as far as I know, there is not one medical officer or nurse working there. Senator Kiely and Senator Fallon proposed that there be an upgrading of the Army Medical Corps.

In Kilkenny we have about 350 Army personnel, but there is no nurse or doctor. There is no place in that town where a member of the Army can go for medical attention except to a private doctor. In Dublin we have an Army hospital but there is no hospital in Limerick, Cork, Kilkenny or Athlone. Why should Army personnel in Kilkenny have to go to a private doctor for medical attention? Why is there not a doctor or a nurse? No private industry with an establishment of 350 would be allowed to operate without a doctor or nurse on their staff.

Our Army have done a fantastic job and, from the establishment of the State, have been faithful to the Government of the day. However, in my view, they do not get the support they deserve. This motion, as drafted, allows us to discuss this aspect of our Defence Forces. Successive Ministers — when I say "successive Ministers" I am going back to the establishment of the Army — accepted the support of the Army but have never given them the status they deserve. Thank God the day has gone when district justices used to say "Join the Army or go to England". A career in the Army is one of the most admirable professions. If one visits South Lebanon one will see that even the youngest member of our Army is a professional. Therefore, these men should be given more support than they are getting at present. What is the status of a member of the FCA serving full-time in the Army? There are many of these people. They cannot go to an Army doctor; they have to go to a private doctor for medical treatment. This situation should be changed.

The Minister is doing a very necessary job. He has shown his concern for Army personnel. Within the terms of this motion there is no doubt that every Army establishment should have its own doctor, nurse and medical centre. I am not concerned about their promotion prospects of if they are paid enough, because a person joining knows in advance what work is ahead of them, their promotion prospects and their income. The Minister should improve standards so that our Army personnel should get as good if not better treatment than anybody else.

Before I address myself to one possible role for the Army Medical Corps, I should like to thank the movers of this motion for giving us an opportunity to discuss this matter. This is an example of how we can address ourselves to matters of national importance on a non-partisan basis in an intelligent and constructive way.

The debate has addressed itself in the main to the immediate practical role of the Army Medical Corps. One might define that by saying that it provides medical services for the Defence Forces. I would like to put forward a suggestion for the Minister's consideration. It is a suggestion which would require very careful thought because there are as many disadvantages to the proposal as there are likely advantages to it. I have in mind the question of how the Army Medical Corps might provide one particular area of service to the country at large. Down through the years one has heard of, maybe participated in private debates or discussions on the whole question of conscription or national service or the inclusion under the general umbrella of the Defence Forces of some kind of volunteer service. There are many advantages to such a proposal, but on the other hand there are some very substantial disadvantages. If that question ever were to come up for serious consideration it is something we should devote very careful consideration to before embarking on such a project. I am talking here in terms of the general idea of using service in the Defence Forces for what essentially are non-military purposes.

Those of us who have experience of living in Great Britain and who are of a certain age will possibly know something about the experience of that country with regard to national service. It was an experience which was of great benefit to some people but it was also an incredible waste of time for many others. It was something which did not give unmitigated benefits either to those who participated in it or to the country itself. Therefore any proposals that might come forward in that regard should be thought about very carefully. There is also, particularly in this country, the possibility of the political dangers that might arise, if one had large numbers of young people together in a disciplined situation, possibly a captive audience, from particular doctrinaire, political or ideological ideas.

However, I should like to put forward to the Minister for his consideration, possibly on a long-term basis, the possibility of using the Army Medical Corps as a means of medical service to the community at large on a volunteer basis. Reference has been made here to the difficulty of recruiting suitable people as fully-qualified medical doctors. This is not a problem that is limited to this country. It arises on a worldwide level and is very much related to the kind of financial remuneration available to the medical profession outside the public service. What I would suggest is that in a situation where some qualified medical staff are faced with emigration some means might be considered for providing them with outlets through some kind of short service commission.

My professional experience as a guidance councillor has brought me into contact with a great many young people who would like to be involved in some kind of paramedical service either of a temporary nature or something with more long-term career prospects. They find themselves caught in a situation in which the medical profession and careers of that kind tend to be divided between what can be classified as high-qualification situations — medical doctors and, within that category, all the complexes of high grades — and also other outlets, say, the nursing profession, which may not be attractive to many people. This applies to males rather than females, males who may not be interested specifically in nursing or who may be subject to the remnants of sexist prejudice which are still attached to the nursing profession, males who would like to be involved in some kind of paramedical service but find very few outlets in this area.

Basically what I am suggesting to the Minister is that he should give consideration to the possibility of some kind of volunteer service through the medium of the Army Medical Corps by which a certain number of people would have an opportunity for a certain degree of medical training, medical education and at a level substantially below that which is required under our system for qualification for a medical doctor. Such people would be available to the community, not just on an emergency basis but possibly through the hospitals, in particular in areas where hospitals are understaffed.

In conclusion, I would stress the point that in any project which involves the idea of using the Defence Forces for civilian purposes we should tread very carefully. By and large our history is one in which the Defence Forces have carried out, in relation to the civil power, a role which excels honour, excels the kind of duty that one would expect in a democracy of our kind. We should be careful in any kind of project of this nature not to upset that balance and not to put people in a situation where they become involved possibly in a political role in the community as has happened in other countries — for instance, in Portugal and in France. This is an an area where the Army could make a contribution and it would be something which would be of direct benefit to many individual young people who want to serve the community.

First, I should like to thank those Senators who contributed to the debate, which has been very interesting. I have learned something from the debate, though some of what I have heard is not correct. However, in any debate here, one gains some extra information from the wide experience of the various Senators. I thank Senator Fallon for his kind remarks. I always found him an able debater and a very fair-minded person. I thank Senator Carroll for his reference to the actions of the Army in general. I am grateful to all the people who have sent their thanks as a result of what happened in the past two weeks. We are all very proud of the Army. I want to thank those people on my own behalf and on behalf of the Army. When there is an emergency the Army are needed and everybody appreciates them but when there is no emergency people tend to take them for granted. I hope that as a result of last week's episode people will appreciate that we have a dedicated Army of men and women who are prepared to help their fellow citizens when they are needed. The Army carried out so many mercy missions that it seemed they had taken over from the medical service. The Army hospital in the Curragh had to deal even with maternity cases.

I am also grateful to Senators who referred to soldiers serving abroad. They have been attempting to keep the peace in the Middle East and I feel they are not appreciated. We are not prepared to try to find out what they are doing, not alone in Cyprus and in Lebanon, but also in Syria, Egypt and Israel. People seem to think these people are going abroad for excitement when in fact they are doing a fantastic peacekeeping job. Many of them told me that they went there as boys and became men overnight. Nothing will bring somebody to his senses more quickly than being under fire, not once but several times over a period of a few months. One old man, a native of Lebanon, told me that the Irish troops were respected by the local people because they respected the local people. This is a record of which we are very proud.

There are two medical officers and a dentist in Lebanon. In his spare time, one of the medical officers looks after hospitals and many local people who in a war-torn country would not be able to get any medical assistance without him. This is something which is provided free and we are very glad of it.

This is my first opportunity to address the Seanad as Minister for Defence and I look forward to having a constructive and harmonious relationship with all Members. While I regret that the tenor of the motion might suggest that our Medical Corps is a less than efficient body, I am sure the movers did not mean that. I accept what they said and am very glad to be able to correct any false impression which may exist and to speak of the excellent record of the Corps and its very high standards of application as evidenced by the fine health and physical record of our Defence Forces.

The primary functions of the Corps in peacetime are to provide for the preservation of the health and physical fitness of the Defence Forces and to help to fulfil the Corps' operational role in wartime. In wartime a number of main headings would be: advice on the health of troops and prevention of disease; evacuation and treatment of sick and wounded; advice on positioning of medical units; supply and replenishment of medical supplies and equipment; provision of nursing and dental services; compilation of records and statistics regarding sick and wounded for military and medical use. These are very onerous and widespread responsibilities and we appreciate that the peacetime organisation of the Corps can provide no more than a nucleus around which the Corps could expand and develop to cope with wartime functions.

In order that the Medical Corps would be in a position to fulfil their role in wartime, it is necessary to maintain a peacetime military medical establishment that will provide (a) the personnel to command units of the Medical Corps, (b) the personnel and facilities for the training of non-commissioned officers and privates of the Medical Corps, (c) facilities for military training, including training in providing medical support to combat troops, (d) opportunity in medicine that would attract young doctors to the Corps and (e) facilities for the development of medical expertise and for professional advancement. The under strength of the establishment is not a recent development as has been said here. The last time it was anywhere near the full establishment was around the early forties during the time of the Emergency when there was a very large Army of which I was happy to be a member.

The Minister has stressed the importance of the Army Medical Corps. Will he reply to the question asked about the status of a nurse within the Medical Corps?

Yes, During the Emergency we had, as we had before and since, people who were of all sorts of different political opinions serving the country faithfully. Nobody could have been more opposed to the Government in power at that time than I was. It did not stop me and thousands like me from joining the Army and doing what we considered to be the right thing. I see an usher across the floor who was in the same company with me so there are a few of us still around. While the Corps are actually short of their establishment, and this has been so for some time, they have been able to carry out their responsibilities, assisted where necessary by the employment on a full-time, part-time or free basis of civilian doctors, specialists and dentists.

It would be unreasonable to suggest that where there are small units established there should be all the medical facilities which might be required. The arrangements that exist mean that the people who are there have the right to avail of the same type of medical facilities from a local doctor, whether he is private or otherwise. Those who are members of the FCA have exactly the same right as soldiers in places where there are Army medical officers available, so they are at no loss.

I have been Minister for only six months or so and there are a lot of things to be looked at. The decisions which my predecessors reached may be entirely different from the ones I will reach. That does not mean I am right and they are wrong but this is one of the places where we may have to make a change. While it is true that quite a number of areas are very well served by private medical doctors, it does not make sense that we should have private doctors when we could get Army doctors.

There has been the question of competing for the services of those doctors. For some reason young doctors have not been keen to join the Army, possibly under a mistaken impression that it was not as well paid as outside service. It is true, if we believe what we read, that there are quite a number of doctors who make very large amounts of money. It is also true that there are young doctors who are just able to make a living. In case it is not known by doctors who might consider joining the Army Medical Corps, I should like to emphasise that they can get credits for their service outside if they come into the corps.

They all start at the level of captain and, after nine years, normally they become commandants. There is a proposal that this should be reduced, and it probably will be reduced, perhaps not as much as the association want it reduced. With their captains' pay they get a service pay, a substantial amount of money. If the House wishes I can give the details of the amounts which can be paid which show that they are entitled to very large amounts in addition to their ordinary pay.

For instance, captains who come in on a minimum of £9,132, get £1,303 added as professional pay, and a military service allowance of £544, making a total of £10,979. For each year in rank they receive an increment and eventually, after six years, the ordinary line pay of captains is £10,040; the professional pay is an addition of £1,778, plus a military allowance service of £544 making a total of £12,362. Apparently that is not generally understood. If it is, I can see no reason why young doctors should not avail of the opportunity to serve in the Army. I should like to see them joining the corps.

Some of them have said that the pay and conditions are not attractive enough. Despite that, in the past few months we have taken in four, three of them ladies, and we are very glad to have them in the Army. The number who resigned over the past few years is very small, since 1970 about three or four only. The remainder of them have stayed. A number have died and a number have left because they reached pensionable age. I am not taking them into consideration. I am talking about those who were dissatisfied and left, which is a different matter.

It is true that the nurses are not officers, NCOs, or privates. There is quite a big number of them. We would have something like the Chinese Army if they were all officers. It would be rather an embarrassment. They can go up the line, and they are entitled to promotion. The pressure to have them commissioned as officers is not very great. As nurses they are in a different category. Many of them would not want to be under Army discipline which they would be if they were officers.

From my experience, the ladies in the nursing services have all the rights which an officer has. They are treated, and rightly so, very much better than officers. They can tell the highest ranking officer to do something, and I do not think anybody else could try to do that and get away with it. There are not many complaints. If there are, I should be glad to have them looked into to see if we can help. At present there is a proposal that a number of them should be commissioned as officers, but it is not being pressed as hard as I thought it might be.

I am not concerned about whether Army nurses should be designated as officers, but they should have a rank rather than be treated as uniformed civilians as they are at present.

There is a slight problem. They are recruited in the grade of sister. That is the equivalent of a staff nurse. They may be promoted to theatre sister, or staff sister, or assistant matron, or matron. Their pay and conditions of service at all levels are generally the same as those of their counterparts in the health boards. They might not be too anxious to get away from that. I will have a look at it to see if it needs attention. I do not think it is as urgent as has been suggested. As I said, we would like young doctors to come forward and join the corps but we must consider the question of supply and demand.

The peacetime function of the corps is the preservation of the health and physical fitness of the Defence Forces. This function is carried out by ensuring that the highest standards are laid down for admission to the Defence Forces. I was very glad to hear Senator Fallon saying he agrees with me that we do not want people who are not of good character in the Army. Literally we do not want them and we will not have them. This has been the standard for quite some time and it will continue to be the standard.

As I said, the preservation of the health and physical fitness of the Defence Forces is carried out by ensuring that the highest standards are laid down for admission to the Defence Forces, for advancement within the forces and for retention in service and, through a system of regular examination and grading, that these standards are adhered to. In addition, the Medical Corps administers and staffs three military hospitals — St. Bricins in Dublin and the Curragh and Cork Hospitals. That these measures have been very successfully operated by the corps is self-evident. Indeed, I would say that our standards widely displayed both at home and on overseas service are the envy of many.

The corps also provides an outpatient's clinic on Saturday mornings for all pensioners under the Military Service Pensions Acts, 1924 and 1934, and disablement pensioners whose disability is due to services in the period 1916 to 1924. During 1981 over 350 pensioners were seen at this clinic. Additionally, an Army medical officer acts as a member of the Army Pensions Board established under the Army Pensions Act, 1924.

Another function of the corps is to provide a medical officer to act as President of the Civil Aviation Medical Board which medically examines applicants for the issue and renewal of civil aviation licences on behalf of the Department of Transport. At present, up to 1,000 examinations are carried out annually by this board.

It is my intention that the Medical Corps will continue to develop so that it will be fully capable of fulfilling its own very important role of ensuring that our Army is composed of personnel whose health and physical fitness are maintained in peak condition so that they will be able to undertake the many and varied demands made on them in these troubled times both at home and overseas. This, to my mind, is the most important role of the Medical Corps at present and I think events have proved that it has been very successful in this respect.

At present arrangements are in hands for the amendment of the Defence Forces Pensions Schemes to make certain improvements in the conditions for the grant of retired pay and gratuity to, among others, medical, dental and chemist officers of the Army Medical Corps.

It is worthy of mention that members of the Medical Corps — including medical and dental officers — have the opportunity of service abroad with contingents of the Permanent Defence Forces serving with United Nations Peacekeeping Forces. Two medical officers and one dental officer are currently serving with the Irish contingent in the Lebanon. The experience gained during such service is a great asset to these officers on their return home.

Medical officers are, when circumstances permit, released to attend courses of study leading to specialist qualifications. At present two officers are attending such courses — one for three years and the second for four years. Every effort is made to encourage the most highly qualified doctors to join the corps and special incremental credit is now given for higher qualifications and post registration experience.

When we were in office before, an ambitious programme was embarked upon which has since produced highly efficient, well-equipped Defence Forces. Many improvements in organisation, pay rates, allowances, accommodation, equipment, clothing and conditions of service generally have taken place. The Medical Corps, in common with all other elements of the Defence Forces, has benefited from these improvements. As I stated recently in the other House in the course of a debate on the Supplementary Estimate for my Department, it is my aim as Minister for Defence to provide, in men and equipment, a modern well-trained Army capable of meeting the many demands made on them in these troubled times. I can assure Senators that, in the achievement of this aim, the importance of the role being performed by the Medical Corps will not be overlooked.

I should like to thank the Medical Corps for the way in which they have carried out their duties over the years. Of course the people in the Medical Corps can get a substantial pension; when they retire they get a plus-pension as well as pay. Incidentally, the actual number of the establishment is 70, not 72 and the current strength is 32. I would be much happier were it much nearer its full strength, but that is the way it is.

There is no statutory bar on overseas service by female medical officers. The question of permitting women to serve overseas will be considered in the very near future. Overall I think the Army and the Medical Corps do a very good job. I quite appreciate that it was never the intention to cast any slur on the Medical Corps by putting down this motion. I thank those Senators who took part in the debate and those who introduced it, because it is refreshing to hear people's views on these things. If there is something I have said in my reply in respect of which Senator Fallon is not quite clear and if he will so indicate, I will reply to him by letter.

An Leas-Chathaoirleach

Senator Fallon has 15 minutes to conclude.

I thank the Minister for the courtesy of a very fine reply. He departed from his script on many occasions. he spoke very much from the heart. Clearly he is a man who has a great interest in the Army and Army affairs generally. Indeed, I did not comment on the great work done by the Army during our recent harsh weather. I congratulate them and should like the Minister to express my appreciation to them. On many occasions at functions held in Athlone I have had the pleasure of congratulating the Army on the great work they do on our behalf in so many areas overseas. That goes without saying and is deserving of our fullest praise. I agree with the Minister when he says that many young men learn a lot when they go abroad. As he said, they go out as young men and return fully mature, as it were, in every sense of the word.

To revert to the motion, my main concern would be that there are not sufficient men joining the Army Medical Corps. The Minister has mentioned this fact on many occasions. Senator O'Rourke stressed this concern also. Young men are not joining the Medical Corps. I understood there had been an embargo on recruitment since July last. The Minister mentioned there had been a number of recruits recently to the Medical Corps. Accepting my error in the establishment figure of 72, which should be 70, the Minister said there were 32 whereas I had given a figure of 31. I wondered if my figure is not more correct, because I understand there was one retirement on Friday last. I make the point, and have been at pains to stress that while there are 31 or 32, there are 16 engaged in administration, two overseas, two at study level, four specialists and seven non-consultant, non-administrative personnel endeavouring to cover the whole country.

Senator Lanigan made a good point that in a factory employing, say, 350 there would be a medical attendant. That is the number of personnel in the barracks in Kilkenny. I agree with the Minister when he says that every little outpost should not have a medical attendant. But thinking of Donegal, with four barracks, they should have at least one between them. Perhaps a barracks with 350 personnel should have one. I do not agree with Senator Lanigan that the salary does not matter. Salary is vital. A young medical person today in private life will make £25,000 per annum whereas an Army medical man with the same qualifications will not make anything like that. As the Minister outlined, the maximum he can earn is £11,000 or £12,000 per annum.

Retirements will continue to represent a problem and over the next three years there will be eight or nine. My information is that in 1982 there will be three, in 1983, two and in 1984, three retirements. Given the level of recruitment into the corps, the fact that 450 people qualify from medical schools every year, and we must strive to get between one and three, we will encounter severe difficulties in the future. I understood that six young doctors resigned from the Irish Army between the years 1977 and 1981. The Minister said the figure was four, but why should even four have to resign? It is a reflection on our system that this should be allowed to happen. Unless the whole scheme is rendered much more attractive in terms of salary, pensions, post-graduate training, widows' and orphans' allowances and so on, we will not attract young medical men into the Army in the numbers we would like.

Let me stress again that the establishment figure is 70. The Irish Medical Association give a figure of 100. They have been critical generally of the role played by the Department of Defence vis-á-vis the Army Medical Corps. I read in The Irish Medical Times that the Army would be content with a figure of 50, but we are not attracting anything like that figure. My whole worry is that people are not joining the Army Medical Corps and they will not do so unless we can offer better conditions overall. Having seven or eight general practitioners — if one can call them such — endeavouring to cover the whole country must be seen as representing very nearly an unworkable system. I am sorry to repeat it, but unless we offer much more attractive conditions in terms of salary and so on we will not attract in young men, we will not attract any of the 450 who qualify each year. This would be a terrible pity and a reflection on us all.

The purpose of putting down this motion was to highlight a problem. I think the debate has been worthwhile. I should like to think the Minister learned something from it and will go back to his Department and examine the whole system in order to ascertain how it can be improved. If this debate has done nothing else but highlight the problem, I suppose something will have been achieved. But, hopefully, the Department of Defence will see fit to remedy the situation obtaining. Then, perhaps, in two or three years' time my pessimism will be converted to utter optimism, something which would please me enormously and would constitute a good day's work on behalf of the Department and the Army generally.

I thank the Minister and his officers for having attended and sincerely hope this debate has been a worthwhile exercise.

An Leas-Chathaoirleach

Is the motion withdrawn?

Might I ask the Minister one specific question with regard to the Army Medical Corps. On the question of entry into the Army Medical Corps, as into the commissioned ranks, there is a stipulation that one must have a number of natural teeth opposing natural teeth. I wonder why that regulation is still relevant.

I was not aware that such a regulation existed. I have all my natural teeth but I am sure I would not qualify. As I told the House, a number of regulations have been handed down in the past 40 years that might do with some updating.

It is a fact that a person cannot get into the Army today unless he has a number of natural teeth opposing natural teeth and that appears ludicrous to me.

Motion, by leave, withdrawn.
The Seanad adjourned at 4.15 p.m.sine die.
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