Mr. Pat Healy:

We set up the national summit following Áras Attracta and a six-step programme is now in place. Some of that requires additional resources, such as for our new quality improvement teams at a cost of €750,000 this year. The teams have already visited 50 of the centres and we want to support those centres as they aim to meet HIQA standards. The service improvement team approach is in line with the service arrangements and we are trying to link funding to quality and put the focus on outcomes.

In the disability sector, the congregated settings report of 2009 identified the fact that, in the transition to the new person-centred model, significant capital investment was required in moving from old, long-stay institutions and nightingale wards to person-centred independent living. We are trying to develop mechanisms to support that and discussions are ongoing involving the Department of the Environment, Community and Local Government, the Department of Health and the HSE to see how the housing component can be supported by local government. We are looking at developing a reform fund for the transition.

The costs in 2014 for the implementation of standards and the new approaches for the disability resource were between €12 million and €15 million. That had to be managed by ourselves, the community health care organisations and the individual voluntary sector agencies. There is a significant capital requirement but training and staffing also need to be addressed and we are working with organisations to do that within the existing resource, which brings challenges. A further dimension is the fact that in trying to transform a sector, taking on new capacity, new referrals and new places becomes more challenging for the existing voluntary sector organisations, meaning we face a bill for private placements. These places are not there now to the same extent as in the past because organisations coming to grips with the implementation of the new standards are not able to take on new referrals to the same extent.

As the director general said, the service user is at the forefront of our minds at all times and safeguarding vulnerable people through our safeguarding teams is fundamental to that, which means cost issues arise.