Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I apologise for missing the start of the meeting and thank the witnesses for their contributions. From a broader perspective, we are talking about trying to develop a health strategy for the country for the next ten years. That is the purpose of this committee. In that context, the role of the charities and advocacy sector and how it should fit into the broader model is an important issue for discussion. We all tend to look to the State to do everything in the area of health care provision but it is important to recognise the very important role for civic society in this regard and the need to encourage continued charitable giving. This can be done by giving of one's time, service and support or via donation. The charitable instinct is a noble attribute which we should encourage in our society. We must not, however, have a situation where society is totally dependent on charity, with the State abdicating its responsibility.

There is a large number of advocacy groups working, with varying levels of success, on particular campaigns and to raise awareness of specific illnesses and diseases. Some of these organisations move from advocacy to service provision, which is where things become more complex. In the area of counselling or disability, for example, how does one encourage as much effort as possible while also ensuring the service being provided gives the best clinical outcomes for individuals? There is a need for clarity on this question of the regulation of services.

Another important question is how we can build the work of charities into the primary care sector.

I do not wish to pre-empt the work of the committee but primary care is certainly viewed by most people and most expert groups and organisations as the way to deliver health care in the years ahead so that we keep chronic illness out of hospitals and deal with most things in the primary care setting. How can we complement charities working with primary care and broader community services? Meals on Wheels is an example. It is a very simple concept but it is a very important issue in Ireland where people give of their time to give meals to people who need them. It is more than just the nutritional value; it is the contact. The issue concerns complementing or supplementing that with home help hours with the public health nurse feeding in. Where do the witnesses see the charitable sector fitting with State services in a co-ordinated way that does not stymie individuals who want to set up charities or advocacy groups? Where do the witnesses see that sitting in terms of trying to deliver a health strategy?