Ms Kathleen O'Meara:

I thank the Chairman and members for the opportunity to address the committee on the report commissioned by the Rehab Group and with which members will be familiar, entitled "Who Cares?" on building a new relationship between the independent voluntary sector and the State. Although there is no direct relationship or connection between our report and that of the independent review group, coincidentally, each report was researched at approximately the same time. Although our report was published first, its recommendations are very similar to those of the independent review group.

I will first address why we commissioned the report. Many members are familiar with it having attended the briefing facilitated by Senator Dolan last November when the report was published. Early in 2017, we asked Dr. Chris McInerney of the University of Limerick to conduct the research because we and our colleagues in the section 39 or disability sector had a sense that in addition to facing many challenges, basically, something was wrong and we wanted to establish what that was. He looked at the larger section 39 organisations which, coincidentally, are providers of disability services. That is interesting because, as members know, section 39 organisations are supposed to provide services ancillary to those provided by the State. However, RehabCare, a division of the Rehab Group with which the committee is familiar, is funded to the tune of €65 million annually to provide disability services, which is hardly ancillary. We are the largest section 39 organisation and would argue that our services and those of other large section 39 organisations are anything but ancillary. They are vital. The day services, residential and respite services we provide are essential for those who use them every day. The first thing to realise is that section 39 organisations are not ancillary. Rather, they are core and central to the delivery of a vital part of health services in this country.

Our report found that our future is very uncertain. The extent of the challenges we face means that our future as a sector is anything but secure and, as such, the services we provide do not have a secure future. The sector stands at a crossroads and the core, immediate and urgent issue is funding. My colleagues will substantially address that issue. The adequacy of funding and our wider relationship with the State as represented by the HSE and more broadly are key. A hangover from the recession years is that many section 39 organisations are carrying a deficit as a result of underfunding and that is making them financially unsustainable. Members will all be aware of the recent efforts of Rehab, particularly during May, to secure more funding. I thank all members for their support of our efforts because, thanks to those efforts, the Minister and the Government agreed to provide us with the essential funding we needed, which means that the services we provide are secure. Rehab is not the only organisation which has been facing financial sustainability issues, as we pointed out to the committee at the time. The issue of deficits was called out by the members of the independent review group. In particular, we strongly support the recommendation that the issue be resolved and ask the committee to call on the Minister for Health to establish an urgent time-bound process to have that happen as soon as possible.

We want this meeting to be the start of something. We are very pleased to be here to outline the issues to the committee. We are very supportive of the clear and powerful recommendations of the independent review group. The key issue is that they must be implemented. We want and need a process to ensure that happens.