Brendan Howlin (Wexford, Labour)
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The Chairman again has asked a number of questions. While different service delivery models are being sought, I note we already have a highly complicated matrix of delivery models. Speaking as a former Minister for Health, I can tell the Chairman that many of the services we provide in the health area built up over time on the basis of charitable organisations that provided services that suddenly were taken into an umbrella. This is the reason we had a highly disparate patchwork of services. In some areas, there were very high-quality services for children because good charities had operated in them while in other areas, services for children, the elderly or the disabled were non-existent. One of the original rationales for the creation of the Health Service Executive, flawed and all as was that architecture, was to have a national, rather than a regional and disparate overview, to pull together all those strands. There are a number of points to make to answer directly the Chairman's question as to how this should be done. If there are to be different service delivery models, whether through NGOs, charities or statutory agencies, the main thing is to have absolute transparency regarding both the funding that is available and what is expected from it or in other words, transparent service level agreements. This is what the Department is driving at because, as those colleagues opposite who have been tabling parliamentary questions in respect of section 38 or 39 organisations are aware, there is a great deal of opacity that has built up over decades and through which the Government must now get to have transparency in the models, how they are funded, the level of administrative costs and so on if quality public services are to be delivered. However, I am under no illusions as to how challenging is the job of getting the optimum service delivery system, because one cannot change fundamentally and provide a service at the same time. Some of the questions the Chairman asked reflect some of the challenges the Government will face in the next phase of carrying out that analysis. However, I am strongly of the view that the more transparency there is and the more open the access to data, the better will be one's confidence that value for money is being achieved and the service delivery model is the best.