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——