Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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Deputy Pauline Tully will substitute for Deputy John Brady. On 21 November, the Dáil ordered that the Supplementary Estimates for public Services in respect to the following Votes be referred to this committee for consideration: Vote 40 - Children, Equality, Disability, Integration and Youth, and Vote 25 - Irish Human Rights and Equality Commission. At today's meeting, the select committee will consider these Supplementary Estimates and report back to the Dáil.

I remind members that only matters relevant to the Supplementary Estimates should be discussed at this meeting.

I welcome the Minister for Children, Equality, Disability, Integration and Youth, Deputy Roderic O'Gorman, and the Minister of State, Deputy Anne Rabbitte, and their officials. I thank them for the briefing material that was provided to the committee in advance of the meeting.

The proposed format of the meeting is that we will invite the Minister and Minister of State to deliver an opening statement, after which we will open the debate to questions from members of the committee.

I will address the usual housekeeping matters. Members accessing the meeting through Microsoft Teams should use the chat function only to let us know of any technical or urgent matters and it should not be used to make general comments or statements. I remind members of the constitutional requirement that they must be physically present within the confines of the Leinster House complex in order to participate in public meetings. I will not permit a member to participate where he or she is not adhering to this constitutional requirement. In this regard, I ask members participating via Microsoft Teams that, prior to making their contribution to the meeting, they confirm they are on the grounds of the Leinster House campus.

With regard to parliamentary privilege, I remind Ministers and members of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way to make him, her or it identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity, they will be directed to discontinue the remarks and it is imperative that they comply with any such direction.

I invite the Minister to make his opening statement.

Roderic O'Gorman (Dublin West, Green Party)
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I thank the committee for making time available today to consider the second Supplementary Estimate for the Department of Children, Equality, Disability, Integration and Youth. In October last, I sought and received €1.090 billion of additional funding by way of an initial Supplementary Estimate. The funding utilised the remaining balance available for non-core, or contingency, funding as was provided under the 2023 Government expenditure ceiling and was split between funding for Ukraine, at €871 million, and international protection accommodation services, at €219 million.

This second Supplementary Estimate addresses cost overruns of €221 million for this year, including €20.5 million in relation to the Workplace Relations Commission, WRC, pay agreement, double payments in foster care, the blind welfare allowance and the monthly mobility allowance payment. Offsetting savings of €52.1 million are also forecast across various subheads, principally early years and pay. This brings the overall value of the Supplementary Estimate to €171 million.

The need for this second Supplementary Estimate occurs principally due to cost pressures associated with the growing demand for services being provided by Tusla the Child and Family Agency and the HSE, as well as the continuing demands associated with the Ukraine response and international protection arrival numbers. Pressures are also arising in respect of the Adoption Authority of Ireland and the asylum, migration and integration fund.

I will now turn to the various components of the Supplementary Estimates. In respect of Tusla, there is a forecast supplementary requirement of €84.1 million. Tusla is dealing with very significant and increasing service demands in 2023. The lack of available residential placements from all legacy providers, including statutory, private, and the community and voluntary sector respectively, means that there is huge reliance on the more costly special emergency arrangements, SEA, to provide accommodation and staff to care for high-risk and emergency placements. Tusla has experienced significant growth in service demand, and particularly in the area of separated children seeking international protection. As of 15 October, Tusla had 203 children in SEA. Over the course of 12 months, there has been a 244% increase in number of SEAs, predominantly driven by the need for such placements for these separated children. In addition to the service demands, the supplementary requirement of €84.1 million includes: €4.08 million in relation to the 2023 costs of the WRC settlement in relation to pay adjustments; and €1.8 million relating to the foster care double payment in 2023.

Specialist community-based disability services, which are delivered directly by the HSE or through service level arrangements with section 38, section 39 and for-profit providers, are also experiencing pressure at this time. The Department is forecasting a supplementary requirement in this area of €112.5 million. This is made up of a service delivery requirement of €98 million, a further €14.2 million in respect of the recent WRC negotiated settlement, and €0.37 million relating to double payments for the blind welfare allowance and the monthly mobility allowance payment respectively. The service delivery requirement of €98 million incorporates a transfer of funding from the Department of Health of €27 million. The main drivers of the service delivery requirement of €98 million are in the areas of residential services at €66 million, agency and overtime at €22 million, and other smaller areas at €10 million.

Cost pressures are also being felt in respect of international protection accommodation services, IPAS, Ukraine, the Adoption Authority, and the asylum migration and integration fund, but to a lesser extent. In contrast, there are savings across a number of areas of my Department with the largest of these in respect of the Department’s payroll budget at €11 million, and in the early learning and childcare and school age childcare budget at €20 million. Savings are also occurring on the mother and baby institutions programmes and schemes as work continues to fully implement the recommendations of the commission.

In addition, I am also presenting a request for a Supplementary Estimate for €0.224 million on Vote 25 in relation to the Irish Human Rights and Equality Commission, IHREC. The majority of this relates to legal casework costs of €158,000. The balance relates to ICT expenditure at €27,000 and payroll matters at €39,000.

I note to the committee that officials from my Department and the Department of public expenditure have been monitoring and continue to monitor the expenditure and allocation to the Department by way of fortnightly meetings since the start of the year. I bring a memo to Government on a quarterly basis in respect of my Department’s expenditure position.

In conclusion, I recommend these Supplementary Estimates for the Children, Equality, Disability, Integration and Youth Vote and the Irish Human Rights and Equality Commission Vote to the committee. I am happy to address any questions that members may have. The Minister of State, Deputy Rabbitte will make a statement also.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister.

Anne Rabbitte (Galway East, Fianna Fail)
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I welcome the opportunity to speak to the committee here today in relation to expenditure for disability services and the important work it is funding. The Government is committed to providing services and supports for people with disabilities, which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs. Ultimately, our aim is to provide supports and services that will allow people with disabilities to live ordinary lives in ordinary places, in line with commitments under the UN Convention on the Rights of Persons with Disabilities.

We must acknowledge the difficult environment in which our service providers often operate. As we all know, 2023 has been a difficult year for households and businesses alike, with cost-of-living pressures affecting all of us. Furthermore, the provision of disability services is demand-led and therefore somewhat unpredictable, meaning that precise planning for the year ahead can be difficult. It is, however, of utmost importance that the management of public moneys be subject to the strictest scrutiny so that we can balance our twin objectives of providing services for citizens with disabilities, as well as spending prudently and efficiently.

I welcome the opportunity to re-state that the priority for the Government for 2024 will be the enhancement of person-centred supports and services, supporting the progressive roll out of the action plan for disability services, and implementing the roadmap for children’s disability services. In recent years, significant resources have been invested in disability services. This is reflected in the budget for disabilities services, which has increased from €1.7 billion at the close of 2017 to just under €2.8 billion in 2024. The additional funding allocation of €195.1 million for 2024 represents an increase of 7.6% for disability services and demonstrates the Government’s strong commitment to building capacity in this area. This funding includes €61.1 million for new developments and will help provide: extra residential places; extra therapy assistant positions for children's disability network teams; further day services places for next year’s school leavers; an increase in the provision of personal assistance development of further respite provision; and development of capacity for community neurorehabilitation.

The extra funding sought in this Supplementary Estimate is €112.5 million. This funding is required to cover demand for additional services, increased service costs, the 2023 cost of the pay deal for the section 39 organisations, as well as the extra Christmas payments for those in receipt of blind welfare, the mobility allowance and the rehabilitative training grant.

The bulk of the supplementary ask, which is €98 million, relates to meeting cost pressures in service delivery, primarily residential services, through the provision of crisis-driven placements procured from for-profit providers, the changing profile of those seeking services, as well the cost of funding placements for young people with disabilities ageing out of Tusla’s care.

The funding received for new developments in 2024 will be used in areas specifically targeted to mitigate these pressures. For example, we will be aiming to provide a larger portion of new residential places, as well as increasing provision of respite to promote family resilience. Though the extra funding in budget 2024 is welcome, we know there is more to do, which is why we have developed a comprehensive action plan to help improve and expand services out to 2026. I very much look forward to launching this plan very soon. This action plan contains a range of actions designed to increase service capacity and increase our forward-planning capability. It is, however, a plan that will take time to come to fruition and allow us to comprehensively meet people’s evolving needs. We can, therefore, reasonably expect cost pressures to arise in the coming years, which will be closely monitored and mitigated. Part of our programme of improvement post-transfer also involves implementing better controls and oversight of spending to ensure we are providing the vital community services for people with disabilities, while responsibly and effectively managing public moneys.

This is a period of transition and transformation for community disability services, following the transfer of functions last March. As the Minister of State with responsibility for disabilities in the Department of Children, Equality, Disability, Integration and Youth, I am committed to seizing this opportunity to make a real tangible difference in the lives of people with disabilities.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister of State.

Patrick Costello (Dublin South Central, Green Party)
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If extra money is needed for foster care it is very welcome in the context of the need to increase payments, but perhaps I am a little naive to hope that it is also a reflection of an increased number of foster carers. There is an absolutely huge need to improve the conditions of foster carers in order that we can recruit more foster carers. We absolutely need more foster carers.

The Minister spoke of the challenge of urgent placements, but there is a real challenge facing Tusla where it is relying on private placements for foster care and residential care, in that they just do not offer the same value for money. Certainly with private foster care placements, there is a huge marginal cost. The children are frequently placed much further away, which eats into that most precious of social work resources, which is the social worker's time. This impacts on the young people who are removed from their communities.

We seem to be stuck in a vicious cycle of paying huge sums of money to private providers while getting much less value for money. What action is being taken to address the reliance on the private sector for the provision of foster care and residential care placements?

The Minister's opening statement also made reference to the complexity of cases coming in. One of the issues that Bernard Gloster spoke about when he was CEO of Tusla was that the unmet needs of children with disabilities was having an impact on the number of children coming into care and on the complexity of their needs when they come into care. Overlapping the remit of both of the Ministers we have in front of us is this issue of the complexity of cases. There is a need to support young people in care and to recognise that the trauma of coming into care creates further needs. How are we meeting that specific and special need of young people in care? Equally, that increased complexity is only happening because our disability services are not providing services in the first place. Certainly, the CDNT on the Armagh Road in my constituency, with which I am sure the Minister of State, Deputy Rabbitte, is deeply familiar, has had huge problems with staffing. There is a belief among some parents that the team is simply being wound down and this is why no new staff are coming in. I welcome the extra funding the Minister talked about but when will the families feel the benefit of this extra money? Certainly, they do not seem to be getting any benefit from the existing funding in terms of services or service delivery.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I will let the Minister, Deputy O'Gorman, come in first and then the Minister of State, Deputy Rabbitte, can respond.

Roderic O'Gorman (Dublin West, Green Party)
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The Deputy made a number of points there. Of course we want to protect foster care and foster carers and recognise the vital work they do. A full 90% of children in care in Ireland are in foster care and it still compares very favourably internationally. The first step we are taking is a double payment of the foster care payment. That will be paid on 8 December in recognition of the immediate cost-of-living pressures. Last year I made a commitment to bring about a substantial increase in the base rate of the foster care payment and through budget 2024, I have achieved that. It is happening in two steps. There will be a €25 increase on 1 January and a further increase of €50 on 1 November. I know that some foster carers have expressed disappointment that it is divided up like that but we only had a certain amount of money to achieve this in 2024 and my core goal was that we would have a substantial increase in the rate by the end of the year because that is then built into the base for the following year. That is how we were able to achieve it. There is an immediate recognition from 1 January 2024 by way of a €25 increase and following on from that a €50 increase from 1 November.

In 2024, a foster carer family with one foster child will be €1,700 better off but in 2025 and successive years, the family will be €3,900 better off. That is a significant and much-needed increase which recognises that for so long we did not increase that particular payment. That is part of the wider response to the needs of foster carers that is set out in Tusla's foster care strategy. Tusla has three strategies under its broad alternative care heading covering foster care, residential care and aftercare, with a particular focus on the foster care strategy, including an increase in the foster care allowance and changes within Tusla itself. I am really pleased to see that Tusla has now appointed a national lead for fostering. I was surprised, considering how important fostering is, that there was not such a position previously. There is such a position now and that is something I recognise is an important step. We are also seeing better supports for fostering families being put in place, including therapeutic supports. We are seeing a roll-out of therapeutic supports, via Tusla, dedicated towards children in foster care in recognition of the higher level of complexity among that particular group, about which the Deputy just spoke.

On residential care, we have provided Tusla with its largest one-year increase in funding ever in 2024. A significant part of that will be directed at developing new residential care in Tusla's own capacity, rather than relying on the private sector. My understanding is that nine new residential houses will be delivered by Tusla in 2024 as part of the use of the aforementioned additional funding. Now that both Tusla and the HSE sit under my Department, we will be looking for a much better integration of those really complex cases involving children in care who also have very significant disability needs. There is a protocol in place covering how the two agencies interact and there is funding behind that. We all recognise that the implementation previously was not what it should have been but now that both organisations fall within my Department, we will be ensuring that the protocol is fully and properly implemented.

Finally, the Deputy is absolutely right that recruitment and retention within the CDNTs is the biggest challenge we face and I am sure the Minister of State will elaborate on that. When we took over the disability area from March of this year, we recognised that this was our biggest challenge and our number one priority. We have published the roadmap for improving progressing disability services, PDS, and recruitment and retention is central to that. It is about opening up new CAO places for therapists and bringing in new therapist grades. That is something that the Minister of State, Deputy Rabbitte, has led out on. It is also about bringing in new Masters courses, where people can convert an existing science degree, for example, into a therapist qualification within a two-year period. We are looking to fund that as well because it is central to the PDS roadmap.

Anne Rabbitte (Galway East, Fianna Fail)
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In relation to Tusla, the Minister has put it very well. There is a joint protocol there and we are both in the one Department with the two line agencies reporting straight in. This means that it will be far more cohesive. When I came into the Department in 2020, the line of sight was not as clear as it is now and the funding was not as great as it is now. My budget was €2.3 million in 2020 whereas now my the budget is €9 million, for my side of the House. The Minister, Deputy O'Gorman, still has to come with his side of the House in relation to Tusla. Mine is the HSE side of the House.

The Deputy is right that this all stems from the crisis piece and the crisis piece stems from a lack of respite care and not enough therapists on our teams. Families are breaking down and are left with no option but to seek support for their loved ones in the form of residential care, which is not where families want to be by any manner or means. It is incumbent on us to ensure that we address the recruitment and retention crisis so that we have proper staffing levels. We have a suite of measures in place when it comes to respite support so that families feel supported in their communities and schools and children have access to resources in order to prevent crisis-like breaking down.

The Minister has spoken about workforce planning and working with the Department of Further and Higher Education, Research, Innovation and Science on bringing other layers on board to address the staffing need and the retention piece. It is important to put on the record that we do not have a pause on staffing at the moment in the HSE. There is a pause on administrative and management staff but there is no pause on the other layers that ensure that disability services function. The disability service has to function. Disability is in crisis and we need to ensure that the 700 therapist posts that I have funded and that are in our base are filled. I also want to ensure that section 38 organisations and the HSE itself can fill any vacancies they have. There is no embargo whatsoever on any layer within the section 39 organisations.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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Deputy Tully is next.

Pauline Tully (Cavan-Monaghan, Sinn Fein)
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Good afternoon. I welcome the Minister, the Minister of State and their officials. My questions are generally disability related. The Minister said in his statement that the service delivery requirement of €98 million incorporates the transfer of funds from the Department of Health of €27 million. Why is this so low? I thought that when disability was transferring from the Department of Health there was an assurance that the money that was allocated to the disability area within that Department would transfer to the Department of Children, Equality, Disability, Integration and Youth. Has that happened? Will the Minister of State please clarify that for me?

On the supplementary requirement of €112.5 million, is it €66 million for a specialist community-based disability services residential placement? What level of planning goes into finding residential placements? Is there sufficient data? We hear it all the time, as does the Minister of State, Deputy Rabbitte, about the number of adults who live with elderly parents. All those parents want to see is a residential placement for their son or daughter before they die but often times the placement is not provided until they do die, and it is then an emergency but nobody's wishes are taken into account.

We still have a lot of people in congregated settings and people under 65 in nursing homes when it is not their choice to be there, plus it is not the best place for most of them. We have heard recently from the Ombudsman for Children about parents leaving children in respite services or hospitals because they cannot cope any more. That is due to the lack of community-based services for those children so their parents can take care of them. The last thing parents want to do is leave their children in those sort of settings.

Our CDNTs are still under staffed. The pay agreement for section 39s has been agreed by the members and their unions but there is still a pay differential. How confident is the Minister of State that recruitment to section 39 organisations will not be affected by the pay differential that still exists? Can more measures be taken to address the matter?

On section 38 organisations or HSE services, I thought all staff were not subject to the recruitment pause but the Minister of State has just said that administrative staff are subject to that. Administrative staff are vital to these services and many services cannot cope without these staff. The provision of other staff is welcome and essential. Section 38 workers are extremely worried, having heard that administrative staff are subject to the recruitment pause. They want the matter clarified and, if it is so, to reconsider and reverse the decision.

An additional €10 million is required for disabilities under other home supports, inflation, etc. I ask the Minister to explain what is covered by the funding.

Roderic O'Gorman (Dublin West, Green Party)
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When the transfer of functions took place, €2.4 billion of the HSE's budget, which it would formerly have received from the Department of Health, transferred to our Department thus creating very large additional responsibilities across our Department that covers all areas of specialised community-based disability services. When the final tally was done for the pay element required for us to support everyone across disability, there was an additional €27 million. So that funding has just been transferred from the Department of Health's Vote into our Vote. It is the final rounding out of the overall cost of running disability services by the HSE, formerly for the Department of Health and now for our Department. That is the reason for the €27 million.

As I said, going into 2023 the budget for disability was €2.4 million. As a result of budget 2024 and the increases that myself and Minister of State, Deputy Rabbitte, secured, the funding will be just short of €2.6 billion in 2024.

The Deputy mentioned the pay agreement. I am very pleased the pay agreement has been agreed. I have no doubt Deputy Sherlock is about to praise us for getting the pay agreement over the line as it is something he has raised on many occasions over the years.

Seán Sherlock (Cork East, Labour)
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The Minister is trying to flatter me now before I leave.

Roderic O'Gorman (Dublin West, Green Party)
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The pay agreement was extremely necessary to address a very legitimate grievance of the differential between HSE workers and people who work in agencies, both section 56s and section 39s. The pay agreement has a big impact in Tusla as well. It has a cost of €20 million this year and a cost of €56 million in 2024. So our overall budget in disability in 2024 will be increasing by another €41 million and that will be dealt with in the course of 2024. It is a very significant additional investment supporting staff. I believe it will have an impact by enhancing the ability of section 39s to recruit and, particularly, to retain staff because we know retention is as significant an issue.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for her volume of questions. I will start by answering the most pressing one, which is clarity around the recruitment post.

In regard to management and administrative, the other day when I read out the list I still did not bring enough clarity to the matter. It is easier to say that the pause is on management and administrative. Though the pause is on management and administrative it is risk assessed. If one has a CDNT then one needs a CDNT manager, so there is a proposal gone into a national office for approval for that manager because a team cannot function without one, and the same applies to administrative vacancies. The Deputy is quite right when she said that services cannot function without administrative staff but we need to ensure we do not over do it and ensure we have the right proportionality. Proposals can be lodged which will be risk assessed and, as I say, a CDNT manager is a classic example because one cannot run a team without a manager. Proposals will go through the national office for approval. It is just a process. All the rest do not have a process.

The Deputy mentioned ageing parents, of which myself, the Minister and the team here are acutely aware, and the Deputy mentioned an additional requirement of €10 million. Some of that money will be used by the Department and the HSE to support and bring other resources to that ageing parent whether it is providing teatime or Saturday clubs to support first the individual but also the ageing parents. I have sought funding to address the matter. FEDVOL provided us with data following research and I think there are 2,300 people who have parents over the age of 65 years. The proposal is to bring support to all, not just to one, who wish to access it and we are putting together a plan for that.

I agree with the Deputy that there is a lack of community-based therapies. The lack is due to not having enough staff on our teams, hence we have put in place workforce planning. We have had two meetings and the third meeting will take place next week where we are working not just in a silo of ourselves within our own Department with the HSE. We are working across Departments. Everybody is at the table so as to ensure we can have a co-ordinated plan to put in place courses. As my Minister, Deputy O'Gorman, has said, with the Department of Further and Higher Education, Research, Innovation and Science we can create masters programmes and we can work with the Psychological Society of Ireland, PSI, on clinical placements. We are putting in place a suite of measures that addresses everything from a course in an education and training board, ETB, which is a assistant therapist course, to conversion courses and a masters course. Plus, we will work with our partners in the UK because some people who have trained as speech and language therapists there are missing a module that is necessary here, and we can remedy the situation by working with CORU. By next September, there should be a very clear pathway within our progressing disability services or PDS, which is funded by as much as €8.5 million to ensure there is a pathway put in place to work with our partners in education and the various Departments. Most importantly, we want to let the young people know there are opportunities available and we would like them to avail of them.

On the pay differential, I welcome where we are now. As part of Building Momentum in 2024, the most important piece for me is the word "alignment". There is a differential. Not all pay grades are aligned by no manner or means. Most importantly, I talk about front-line healthcare assistant where, in some cases, the difference can range between 10% and 17% in the HSE and what they are paid by various providers. That alignment piece is important for me and over time they can achieve proper alignment and equality with others.

I did not leave any money behind. I brought every last penny of it out of the Department of Health.

On €10 million for home supports and inflation, there are a range of other cost pressures arising from another increased cost associated with providing home support, inflation, pay costs, maintenance and transport costs. The funding for minor capital works from HIQA is net of time-related savings and they make up the remaining €10 million in overspend on disabilities.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister and Minister of State.

Seán Sherlock (Cork East, Labour)
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At the outset, as I always do, I acknowledge what I perceive to be a whole ministerial activity that by its nature deals with vulnerable people or people who need the State to intervene on their behalf, whether it is the early years with sector, disabilities, or those people who find themselves in temporary accommodation or who are from other countries. We in my party have always tried to approach this from a non-partisan point of view and try to be as supportive as possible. We fully acknowledge that there has been a significant increase in budget across a number of sectors in the last years. That has to be acknowledged. While we acknowledge this, there are challenges whether it is in the disability sector or certainly in the early years sector. With that in mind I just have a few short questions.

On the early years sector - and I tend to drill down into bread and butter issues - there is an issue around the financial reporting mechanism for the early years sector at present. We had a very good engagement with the Minister, Deputy O'Gorman's, officials here last week. To be fair they were very forthright with us. I felt it was a very good engagement and I felt there was an understanding by Department officials of the challenges that are faced by early years providers around the current requirements under the core funding model to report financially. It is my understanding that possibly within the last 24 hours a further missive or communication has gone out to providers. I have literally only just had sight of a copy of one such missive. My question will follow but I just want to quote from it:

These essential data will inform the allocation model for year 3 of Core funding as well as our preparations for the next Estimates process, ensuring we can continue to make progress on our shared objectives of affordable, quality, inclusive and sustainable early learning and childcare services. We appreciate your understanding [this is to the providers] and patience as we finalise updated financial reporting requirements in conjunction with ELSCF members and nominees.

I want to get a read-out from the Minister as to where that sits at the moment. I certainly felt from the last committee hearings that there was a sympathy and empathy towards the providers such that the Department was going to try to retrofit or come up with some sort of solution there. I am speaking for those providers who are arguably small sole traders that have been in the sector for decades in some cases. Perhaps the Minister could give us words of comfort to allow for some headroom to be given to those people who are under the cosh at the moment because they are incurring increased costs as they must go back to their accountants again. They are finding it very difficult and very stressful. If the Minister can give us some words of comfort, we would be grateful for that. This is my first point.

Roderic O'Gorman (Dublin West, Green Party)
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To put this in context, while we are looking for this financial reporting it is to understand exactly how the current money and the additional money that core represents-----

Seán Sherlock (Cork East, Labour)
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To be helpful to the Minister, the sector understands that and we in this committee understand that. I could be very helpful to the Minister. The context is understood. We are looking for clarification on whether the Minister is going to offer something to the sector now either by way of financial supports to meet the cost or in allowing for a greater amount of time for the sector to report or something that takes the burden away from them they are currently undergoing. There is a lot of stress in the sector and some are thinking of getting out of the sector at this stage.

Roderic O'Gorman (Dublin West, Green Party)
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There have been three meetings between representatives of the sector and representatives of my Department through the early years forum over the last week. I spoke to some of the sector representatives and the provider representatives leaving it yesterday. I spoke to my officials. There was a sense that there had been a really good meeting yesterday. My officials notified me last night that they were looking to write up the details of the proposals. They will come to me first and then they will go out to the sector, which is why that email yesterday asked for some patience. I have not seen the details yet - but I hope. I have asked my officials to undertake this work having heard the concern across the sector. I am hoping we will have something good, some clarity and something that will be welcomed, in the next in the next day or two.

Seán Sherlock (Cork East, Labour)
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I really do appreciate that. I am not misquoting the Minister but I believe he is saying, and what I heard, is "something good". That gives me comfort. If I am messaging back to the people who are contacting me, and if people are watching these proceedings, there is hope in what the Minister is saying that a solution can be found. I will draw the line under that piece and I thank the Minister.

On Building Momentum, on pay parity and all of those, we all recognise there is a process under way. I acknowledge fully that part of the reason for this Supplementary Estimates process is to fund or to underpin the costs of that. This is absolutely acknowledged and we recognise that there are processes under way that are outside of these walls that have to be gone through. This is acknowledged. I get a little bit confused, however, on the number of initiatives. I will try to distil it down. A family approaches a constituency TD like me with a child who needs access to a range of services. I try to interpret the language coming from the Department and the Minister of State, Deputy Rabbitte's section, in relation to what is the roadmap for children's disability services or what the action plan for disability services looks like. I get a little bit confused between the two initiatives to be honest. What would I say to a family that will need access to any number of services, one or all, an assessment or whatever it is? What comfort can we give families in respect of what the Minister is seeking to achieve through the various policy initiatives that the Minister has outlined in his statement here today? For instance, the Minister stated:

we have developed a comprehensive action plan to help improve and expand services out to 2026. I very much look forward to launching this plan very soon.

What does that actually mean for a family that will approach me this afternoon or tomorrow about their child or about a family member who will need services? Can the Minister just delve a little bit deeper into that for me?

Roderic O'Gorman (Dublin West, Green Party)
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I will begin the response to this and the Minister of State, Deputy Rabbitte, will come in after. That family does approach me in my own constituency and no doubt approaches the Minister of State also. On a daily basis, canvassing, I meet that family. I say to them that we recognise the huge challenges in the area of disability and that we are looking to make change. This is why we moved it out of the Department of Health and into our Department. That is going to take some time. I have to be honest with people that it is going to take some time. We see the most immediate challenge in children's disabilities. That is what the roadmap is for. The roadmap is focused on children's disabilities and primarily the CDNTs, trying to look at every mechanism that we can to help keep the existing staff and bring more staff in. Some of them are more quickly done than others. The CAO is the most important thing and that we are training more every year but obviously this takes four years before they are delivered.

Seán Sherlock (Cork East, Labour)
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Why is that? Why is there a disparity between the regions? Is this a CHO mapping issue?

Roderic O'Gorman (Dublin West, Green Party)
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I meant CAO, as in CAO courses.

Seán Sherlock (Cork East, Labour)
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Forgive me. My thinking was always aligned to the CHOs. When we are looking for information through parliamentary questions in relation to waiting lists, typically we get the CHO-based statistics. It seems to me that there is a geographical disparity. Some teams are up and running and under way. I am thinking of two geographical locations. Why should there be a difference, for instance, between Sligo or Galway? If I am being political about it, why should there be a difference between Galway and Cork, for instance? Surely there should be consistency right across the board. I am trying to understand.

It comes down to the experience of the constituent who approaches a constituency TD about wanting to get into a service, and if they happen to be from a certain part of the country, they are more or less likely to get access to the service, depending on where they are. What I am coming at here is the need for consistency right across the board. If I had some words of comfort that this is where it is going and that is the journey or the direction of travel, to use that awful expression, that would give us some comfort.

Anne Rabbitte (Galway East, Fianna Fail)
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That is exactly why PDS was rolled out in the first place. There was an inequality in that there was the postcode lottery and it was not standardised. There were not X number of therapists to whom children could have access. In Cork, there could have been OT and speech and language, but from a multidisciplinary point of view, there might not have been psychology, whereas, in Galway, there might be four speech and language therapists but no SLT or OT. PDS is based on the geographical spread to ensure that children have access to all therapies. Anybody watching today will ask what planet I am on because we do not have OT and that is the reality of it. However, what we hope PDS will aspire to is bringing equity of access to all children right across the country. Regardless of their geographical location or whether they are in Dublin, Cork or Galway, they should be able to access services.

In the meantime, the PDS roadmap and the reinvention of it - or “take two” - was when we discovered there were an awful lot of gaps in it and it did not flesh this out enough. The Deputy and I will agree that OT, speech and language, physiotherapy and psychology are the clinical side of it, but there are other pieces that can also be added to it, such as social work, link work, music therapy, art therapy, play therapy and behavioural support. It is about looking at how we can support it and not just leave it clinically based, when there are other supports - even equine therapy - that can bring far more respite hours and interventions. For a child with no muscle function, having a trike that meets their needs is equally as good as having an hour with an OT so long as the child is exercising. It is about understanding that not everything needs to be one-to-one on a one-hour basis. We can meet the needs with universal support and team delivery, whether that is in the classroom, at a club in the evening or by going to things like Rainbow Clubs or groups dealing with neurodiversity. It is having the proper clinicians in front of the kids and meeting their needs.

PDS “take two” addressed that. Where we found the shortfall was that we did not have the therapists coming through, as the Minister, Deputy O'Gorman, said. That is why we looked to the assistant therapy grade, the master’s programme and the clinical supports. It is a question of how we can spread it out and how we can add value to the art therapist, the equine therapist and the music therapist. We heard from the autism committee the wonderful work that they did and they were able to tell us all of the other things that can be brought into the conversation without staying blinkered. That is what PDS “take one” was to me. It was too blinkered, even though it was all about saying that we wanted to deliver a more equitable service. It was not equitable because we were staying blinkered and it was going to take us four years to bring people on, whereas we need to hit the ground running now.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I call Deputy Creed. I ask him to confirm that he is on the grounds of Leinster House.

Michael Creed (Cork North West, Fine Gael)
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Yes, I am. I am trying to keep an eye on multiple committee proceedings so please forgive me for not being present in person in the committee room.

I welcome the Minister, Deputy O'Gorman, and the Minister of State, Deputy Rabbitte, and commend them on the sustained progress and budget lines that they have secured for their Department. That is always a critical indicator of service capacity and delivery and, in that context, fair credit is due in terms of securing budget allocations.

I want to zone in on two points raised by the previous contributor, the early years childcare sector and residential placements for adults with disabilities. First, on the early years sector, it is abundantly clear, not just from the budget allocations but by any metrics, that very significant progress has been made in early childhood care and education. I often look at this as a kind of three-legged stool in that we have the parents and children who are receiving the care on one leg, the staff working there on another and then the service provider. I want to focus my question to the Minister, Deputy O'Gorman, on the service providers. They are generally a mix of the private sector and the community not-for-profit sector. I have raised this matter previously with officials from the Minister's Department. I am concerned about what I would categorise as the smaller private sector providers who generally tend to be both proprietors and people working at the coalface in terms of the delivery of early childhood care. Notwithstanding the words of comfort that the Minister delivered in response to a question by Deputy Sherlock, I am significantly concerned that there is going to be a very significant exodus of these small-scale service providers out of the early childhood sector.

These providers are both urban and rural. I represent a constituency that is substantially rural but has probably one of the biggest towns in County Cork within it. I come across these smaller, privately owned providers on a regular basis and the constant refrain is that they are drowning in administrative requirements. I welcome the fact there is ongoing engagement. It might well be the last straw that breaks the camel's back, but the increased reporting obligations recently communicated have driven many over the edge. That is a real tragedy in the context of the very substantial progress that has been made in the sector. Affordability for parents and the issue of retention of staff have been addressed, but this is a critical issue. It will be a tragedy and will impact in a myriad of different ways societally if we lose a substantial number of providers.

Has the Minister or his Department any handle on the likely exit from the sector of these smaller, privately owned providers and what specific comfort can he offer them? Something is required urgently to address their specific problems. The new funding model, welcome as it is in terms of increased funding, does not specifically give any comfort to them, particularly that cohort of smaller, privately owned providers who are delivering the ECCE-only model and not providing the full day-care service, who are particularly disadvantaged.

I will ask my second question and the Minister and Minister of State can then reply comprehensively. On the issue of residential placements for adults with disabilities, my experience is informed, like all of us in the House, by constituency representations and I deal with a myriad of organisations, from the HSE, which would be considered the State's own service provider, to organisations like CoAction, St. Joseph’s Foundation, the Brothers of Charity and Cope. Within all of the aforementioned, there is the good and the not-so-good, and some who were very good but have fallen from that perch. This is a problem that is quantifiable in terms of numbers, and it is quantifiable consequently in terms of the financial resources that are required to address it.

We are all aware of elderly couples living with their children with disabilities who are desperately concerned about what is going to happen at an undetermined point in the near future, when these elderly parents will no longer be in a position to deliver residential accommodation to their children. Is the model that we are pursuing - that of outsourcing it to the aforementioned organisations, including the HSE - the best model, or is there a better model available?

I do not have the answer but I am frustrated by the perceived lack of progress. I know the Minister will say that progress is being made incrementally but this is a quantifiable problem that we have not been able to solve yet and it is a stain on our collective endeavours. I would like to see accelerated progress but this raises the question of whether the model we are pursuing to deliver these residential opportunities is fit for purpose. If not, has any consideration been given to approaching the issue in a different way that is perhaps more community based or voluntary? I am not sure but I am frustrated by the lack of progress and the engagement with some of the service providers.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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Before I invite the Ministers in, I will note that there have been a lot of questions about the early years sector. These have been prompted by the fact that there have been savings in that sector. That is why I am allowing the questions, in case there a question mark as regards remit. It is important that the Ministers be given the opportunity to clarify those matters.

Roderic O'Gorman (Dublin West, Green Party)
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I thank the Deputy for his question and for his comments on the progress that the Minister of State, Deputy Rabbitte, and I have made in significantly increasing the budget across wide parts of this Department. It is my policy and that of this Department to welcome a variety of providers in the early years area from the large full-day services to part-time services and smaller ECCE-only services. We want a diversity of services providing early learning and care because different parents want and need different things and we want a sector that responds to that. The Department and I are sometimes accused of wanting to get rid of small providers and I want to put it very clearly on the record that this is in no way the case.

With regard to raw numbers, we are close to the end of the year now and our figures are normally a month behind. We get them from Tusla. However, in 2023 to date, we are seeing some of the lowest numbers of service closures in the last five years and some of the highest numbers of new services joining. Those are the raw figures. They are important because I am told about this mass exodus from the sector but the data does not back that particular point up.

Smaller providers, including ECCE-only providers, have particular concerns. I spoke earlier about the issue of financial reporting. That has been raised by providers across the sector over the last month or so. We have come back with a very comprehensive series of engagements between my Department and the early years forum. I hope the information we will provide in the next two days will give some comfort on that specific point.

There are questions about the level of wider administration across the early years sector. Two months ago, I announced a full review of the entire administrative process that all services, big and small, have to undertake. A team in my Department has been appointed to undertake this review. It will present me with an action plan early next year. We will start to implement that action plan and see how duplicate administration, inefficient administration and unneeded administration can be removed to make life easier for all our services. That will be particularly beneficial to those smaller services, which do not have the economies of scale associated with having large numbers of staff. I have started the process of reviewing the administration burden. We have put staff behind it. We have brought in a consultative group of providers who are experiencing these systems so that they can advise our staff. They will tell us what the problems are and what are the systems that do not work for them right now. We are getting that direct response from providers.

On the issue of funding, the Deputy will know we have brought in core funding. It is a brand-new scheme that we brought in two years ago. It has grown from an initial €200 million to approximately €330 million in its third year, starting next September. In the second year, we recognised that the one-size-fits-all model that core funding was originally based on, which looked at capacity alone, was not working everywhere so we brought forward a specific payment of €4,000 for small services and set a floor below which a service's core funding could not fall. This meant that every service would get at least €8,100. This ties into the financial reporting issue. The reason we are asking for these quite detailed returns from services is that they will allow us to understand the cost pressures different services are experiencing. They let us know what extra cost pressures ECCE-only services are experiencing versus full-day services. The more detail we get, the more we can shape the new core funding model. We have €45 million extra in core funding. We have grown the pot of core funding for year 3 by €45 million. We can use some of that money to support those smaller services and direct additional funding to them. We need the evidence for that, however. That is why we asked for this financial reporting.

We are addressing the very recently raised concerns regarding financial reporting. I hope to be able to give real clarity on that issue in the coming days. We are addressing the wider administration burdens through the action plan we are bringing forward and we have money in year 3 of core funding to continue to shape, tailor and target core funding to those services we believe need additional support. Through all of this, we will continue to see falls in the number of services closing each year and growth in the number of new services. Finally, I reiterate that we want to see a diversity of services across the sector. I hope that address the issues the Deputy has raised.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Creed for his question, which gives me the opportunity to speak on this matter, because I share his frustrations. To be quite honest, I do not believe the one model works when it comes to residential care on a number of fronts because most of it only responds to crises and we are not building capacity in the system. That is why I welcome the fact that, on 13 December, we are going to launch the disability action plan. The whole purpose of that action plan is to look at building capacity and providing extra capacity in respect of that residential piece. However, if you are only every responding to crises, you can never build that capacity. When you look at the number delivered in the residential area in a year, the figure hangs between 100 and 110. If you divide that by the nine CHOs, it comes to a residential placement for nine or ten. That is far too small a number.

That is why we did a pilot project. We started funding it last year but only started delivery this year. It is called the Living my Life project. It is aimed at younger people who want to live independently, with support, within their communities. It was set up by a group of parents, Proactive Carers Galway. Regardless of the day centres their young people attended, they came together to look at organising this Living my Life project. I will explain the project to the Deputy. Some 32 young individuals have their care needs supported to allow them to live independently in their community at a cost of €1.3 million. This model is much more cost-efficient than dealing with individuals in their 40s, when needs have changed and are a little bit more complex. It is better if you put in the supports at the beginning and provide the early interventions as opposed to waiting for a crisis such as a parent passing away. Unfortunately, that is the story of some of these people. A parent will pass away and the person will have to be assisted with the transition. We have to determine where a house is available, which might not be within their county, never mind within their community, in that emergency period. That is extremely expensive.

We need to do both and that is why, within the disability capacity action plan, we will start doing both. There is going to be a review of residential placement as well. The most important question is whether we are meeting the needs of the individuals. Are we getting a good return for what we are doing? What capacity do providers across the country have? What properties do they have available and what capacity do they have to recruit staff? How can they bring more people who are waiting on stream more quickly? That is why multi-annual funding will be built into the disability capacity action plan. As some of the providers will tell you, they cannot do it unless they know the money is there.

We are going to address that. We started the Living My Life demonstration project this year which will assist in getting 32 young people, aged from their late 20s to their 40s, access to housing, in partnership with the local authorities. It is not just a health piece; it is also cross-departmental, involving the Department of housing as well. When there is so much housing development going on, the disability sector needs to get its fair share. The CAS funding in the context of decongregation is far too complex and it takes too long to get houses on stream. We need to simplify the process and we are working with HSE estates to make sure that happens. I hope that answers Deputy Creed's question.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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Did the Minister want to add something?

Roderic O'Gorman (Dublin West, Green Party)
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Yes. I did not answer your questions on the underspend on early years education.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I was just making the point that that is where those questions were coming from. They were not necessarily budget related as such.

Roderic O'Gorman (Dublin West, Green Party)
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Just to say that in this Estimate, there is a small underspend on the early years side. It is primarily because unfortunately, we do not have a new employment regulation order, ERO, agreed for year two of core funding. Some of the money that was put aside to remove the three-year waiting requirement before staff got their graduate premium had to be given back because we have not got that new ERO. I am eager for that to be agreed. I know the JLC, which is an independent process, is meeting but the sooner a new ERO is signed, the sooner that additional money can flow to graduate child care professionals.

There was also a small underspend related to the national childcare scheme, NCS, because a lot of the uptake on that has been for school-age childcare, rather than full-day childcare. School-age childcare uses fewer hours, obviously, because it just covers periods after school. There is also an increase in the uptake of AIM hours and we have made provision for additional funding for that, both in terms of this Estimate but also going on into 2024. We are hoping to see AIM hours being extended, which is something everyone has been seeking for some time and everyone welcomes.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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I thank the Minister. I have one additional question, which is also related to savings. In your opening statement, you spoke about savings occurring under the mother and baby home institution programmes. Could we get a little more information on that and on the same subject, do we have a date for the redress to start?

Roderic O'Gorman (Dublin West, Green Party)
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The Tuam agency has now been established and we have appointed Mr. Daniel MacSweeney as the director. Significant work is under way to prepare the agency to be in a position to begin excavations but the excavations themselves have not yet begun. That will probably be the most costly element. It is important to say that Mr. MacSweeney has been very clear that he wants all of the scientific, technical and forensic services ready once excavation takes place, rather than doing it at the same time, and that sounds like the correct way to proceed.

In the 2023 budget we did not have an allocation for the payment of the redress scheme but an allocation for its establishment. A lot of work is being undertaken in the Department to put in place the infrastructure for a scheme that will have tens of thousands of people apply to it. I had hoped that people would be able to make claims this year but obviously that is not going to happen at this stage. I would hope that within quarter 1 of next year, people will be in a position to make claims. Importantly, in the Department's budget allocation for 2024, €225 million has been allocated for the beginning of payments. Unlike this year, the first tranche of a large amount of money will be paid out next year. As we know, it will be paid over a five-year period so it is not all in our budget in year one. The full €800 million is not in our budget in year one but a very substantial allocation has been made for the beginning of payments in 2024.

Kathleen Funchion (Carlow-Kilkenny, Sinn Fein)
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Thanks very much. On behalf of the committee, I thank both Ministers and their officials for attending today and for dealing with all of our questions.

It is proposed to publish the opening statements and briefing material provided to the committee on the Oireachtas website. Is that agreed? Agreed.