Mr. Ivan Cooper:

On the section 56 circumstance, the same situation could be argued to apply to section 38 and 39 organisations in many respects, especially section 39 organisations. It hinges on the idea of essential services. So that all members of the committee are clear about it, thousands of community and voluntary organisations or charities are funded either by the HSE or Tusla to deliver what are essential services from the perspective of people in the communities who benefit from those services. The people in communities do not make any distinction about whether this service is being funded or delivered directly by HSE employees or by employees of independent organisations funded by the HSE or Tusla to deliver that service. That is not a distinction that is significant to them. To them, it is an essential service in their community. We need to understand that the way we provide services in Ireland is predicated on that reality. That is the nature of it and it has evolved that way over 60 years.

As Ms Garvey indicated, we have a substantial chunk of quasi-public servants who are not public servants but, with the work they are doing, effectively are public servants without the terms and conditions public servants have. There is an issue which can be best understood under the rubric "essential services". I draw the committee's attention to a report from the independent review group, which cannot be seen again here because of the nature of the forum. The independent review group established to examine the role of voluntary organisations in publicly funded health and personal social services published a report in January 2019. Check it out. This is a seminal report which is the foundation for the work of the health dialogue forum which I have described and Ms Garvey indicated we are optimistic about, which is chaired by Peter Cassells. Recommendation 8.1 of the report states:

List of essential services

i. A list of essential services to be funded by the State should be agreed in consultation with the voluntary sector.

ii. Full cost prices for delivery of these services should be agreed centrally.

iii. The list should be updated regularly, with provision for adjustment to meet local circumstances.

It recognised that we have all of these services delivered by thousands of organisations under section 39, running to billions of euro per annum dispersed by the HSE to these organisations to employ individuals on inferior terms and conditions and salary levels, and without the benefits of pension provision that public servants typically have. We essentially have a two-tier labour force delivering the same services and that is the issue. The only way to resolve it is for the State to follow the recommendation in that report I just mentioned and agree a list of essential services, then ensure, as Ms Garvey indicated, full cost provision for the services that are essential and should be recognised as being essential.