Brian Cowen (Laois-Offaly, Fianna Fail)

The whole purpose of the money that is allocated is to protect frontline services to the greatest extent possible. As the Deputy has said, when I was Minister for Health and Children and Minister for Finance, I was anxious to support the area of disability services and brought forward a five year plan by Government to improve and greatly extend the range of services for people with disabilities, be they sensory, physical or intellectual. More than €1 billion is being spent on intellectual disabilities alone.

There are 178 service providers under sections 38 and 39 of the Health Act. Up to 90% of services are provided by 25 of them. The important point, given that there are limited resources generally and against a background of increased resources being given to this sector, is that the provision of services in the non-frontline areas ensures there is enough money at the frontline. The Minister of State with responsibility in this area, Deputy Moloney, and the Minister for Health and Children are working to see how we can ensure that for the future. Changes must take place in the support services behind the frontline services. We cannot have 178, or even 25, service providers, even if they provide an excellent service. There must be room for change so we can release resources to the frontline against the background of strict budgetary parameters.

That being said, we must do everything we can to assist the most vulnerable. That is being worked on as a priority by the Minister and the Department. In the context of sustaining services for the future, there must be changes in how organisations cooperate. Why should there be 25 different payroll systems, why should there be a series of different approaches by various organisations? Those all must be pulled together so there are sufficient services at the frontline.

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