Billy Kelleher (Cork North Central, Fianna Fail)
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I refer to HIQA. I accept it is conflated but it is inextricably linked in another way. A block grant comes from the HSE to a section 39 organisation. HIQA then arrives on the scene and says additional staff are needed to provide a service and that the organisation is in breach of guidelines or regulations if it does not do so. Following that, two things can happen. The organisation can reduce the service to the complement of staff it has, which effectively means that some of those requiring services can no longer access them, which can have an impact. Alternatively, the service can try to manage around the situation in a way which skirts very close to a breach of regulations. That is a fact.

Services do not want to send people home or tell people they cannot send their son or sister to a service because the organisation can longer provide it. Not a week goes by without Senators Dolan and Burke and I making representations on this issue on behalf of families who have been told that services have been cut because of HIQA regulations and inspections. More often than not, it is down to staffing levels. Staff pay cannot be reduced any further, because there will be even fewer staff due to the fact they will go elsewhere. As Senator Dolan said, there is a market. Qualified nurses, therapists and others specialising in this area will go elsewhere, which further diminishes services. It is creating significant difficulties.

The issue is inextricably linked to pay because HIQA is now stating quite clearly in reports that it is disappointed with the level of training standards of agency or transient staff because organisations cannot retain them in the first place. Services are being diminished on a continual basis. When everything else is stripped away, it primarily comes down to the pay of individuals as opposed to the block grants given to section 39 organisations.