Ms Anna Shakespeare:

The scale of service delivery by members of the National Federation of Voluntary Bodies is, in cost terms, worth €1.3 billion. However, many of them face financial deficits which relate, in the main, to compliance with HIQA regulatory standards and the need to respond to the urgent support needs of children and adults. The required expenditure reduction over the period 2009 to 2016 and the continued maintenance of agreed service levels over that period are central to understanding the current financial sustainability predicament. We cannot close wards as the acute care sector can do. The care our members provide is in people's homes as part of their regular day-to-day lives. As providers, our members have exhausted all possible savings across management, administration, maintenance, and non-pay, in addition to savings achieved through efficiencies such as roster reviews, service innovations and attendance management initiatives. There is a significant risk for the State arising from the lack of financial viability of the voluntary disability provider sector, where verified deficits total some €25 million in the annual financial statements of those companies for 2017.

It is important to note the vulnerable position of volunteer company directors who are faced with intensive demands to deliver services while also meeting extremely demanding regulatory compliance requirements which have created a significant burden in both professional and reputational terms for those concerned. The degree to which these significant stakeholders can maintain their position should be of particular concern in terms of their organisational resilience and capacity to continue indefinitely to maintain organisational service delivery. To be clear, the disability social care sector is in a seriously weakened state in respect of both its financial stability and its organisational resilience. This represents a serious risk for service users who rely on our services. The provision of support from the HSE, including cash liquidity to ensure day-to-day operations are maintained, has provided some remedy for the organisations concerned. However, it cannot and will not provide the necessary ultimate solutions to ensure an ongoing and resilient voluntary provider sector into the future.

I will now outline our main recommendations to establish an immediate and longer-term resolution of the challenges facing the sector. There is an urgent need for the State and voluntary sectors to work together to implement in full the recommendations of the independent review group. Its recommendations challenge all stakeholders, both voluntary and statutory, and provide a framework for addressing the urgent challenges facing us in supporting the future of our citizens with disabilities. There is also a need for urgent financial investment by the State to resolve the unsustainable deficit situation.

Companies will fold. There is an urgent need for a multi-annual investment programme to address the unmet need outlined in the supporting document we have tabled and the working group's report developed by the HSE as part of the Transforming Lives programme. There is a requirement for consideration of a change in the approach to the application of the HIQA regulations that will move from a position of compliance to a model of service user outcomes. It should include a legal obligation to have regard to the financial resources available prior to compliance plans being developed and accepted. The State and service providers must work together to innovate and develop new models of integrated service delivery in accordance with Sláintecare, harnessing the capacity of the community and voluntary sector in the provision of effective social care for persons with disabilities as citizens of Ireland.