Oireachtas Joint and Select Committees

Wednesday, 10 July 2019

Joint Oireachtas Committee on Health

Voluntary Organisations in the Health Sector: Discussion (Resumed)

Mr. Ivan Cooper:

I will engage on a few of the points the Senator Dolan. With regard to respect for public benefit, this respect is articulated at senior leadership level in Departments and agencies and exists formally on paper in strategies and documents. The system knows that it is reliant in many respects on organisations and the work they do on the ground. It is articulated in that way.

There is a danger that the words do not move from that leadership level into practical application in terms of daily realities between funders and organisations. The system, organisations and funding agencies are under stress, as I indicated. Many of our members will report, for example, that they experience this double type of attitude to them. Formally they are respected, but when it comes to the nuts and bolts of the contracts, the service arrangements and the annual negotiations on budgets the relationship is not like that. It is felt more as a relationship that is moving in the direction of control via service contract. Some members will use stronger language, such as "manipulation". Very strong language is used sometimes, so there are mixed messages. It is like the relationship between the funded organisations and their statutory funding partners. It is a marriage that is under intense stress at present and is in danger of coming apart at the seams. One member of the marriage appears to hold all the power in the form of the pay cheque, if members understand what I mean. This is the reality. They are putting a brave face on it in public when they are out and about but that is starting to wear off, to stretch the metaphor. There is an issue in that regard. To answer Senator Dolan's question directly, is it respect if one says one respects somebody but one's actions do not appear to be read by others as being respectful? That issue is coming to a head.

Another point made by the Senator was about whether we have been in this situation previously; we have been. It relates to the same issue. It is the positive language. Something happened ten years ago and everybody in the voluntary sector is awake to the stresses and strains, but Austin O'Sullivan articulated the extent of the cuts that were made. They were never reinstated and demand is continuing to rise.

My final remark comes back to the idea of essential services. We are going to be in a groundhog day conversation until we can get this issue nailed. We have an opportunity to do it through Sláintecare and this report.

It is important for us, given the forum we are in now, to signal very strongly to the officials in the Department, to politicians and to everybody that the sector does not want an adversarial relationship but a relationship of partnership and collaboration. That is what we stand for in terms of our work. Partnership work is difficult. It is like a marriage under stress, it will come apart if positive action is not taken.