Éamon Ó Cuív (Galway West, Fianna Fail) | Oireachtas source

This is a major topic in need of very serious consideration and detailed changes.

The first issue we must confront is that every year, as the hospitals overspend in the health budget, funding is withdrawn, not only from the hospitals to try deal with the overspend but from primary care. When one looks at primary care, all of the permanent staff have salaries, yet the Government moves on the easy touches such as respite care, home care packages and home help. I believe that one structural change we need now is that from 1 January, no funding given to primary care can be removed to shore up overspends in the hospitals. It is a simple structural change but it would avoid the constant shifting of funding by the HSE from the primary care front-line services to the hospital services.

The second matter I want to deal with is work that I was doing as Minister for Social Protection. I brought in the partial capacity provisions under invalidity pensions and for the first time, we were grading or separating those with a very severe disability, those with a moderate disability and those with a mild disability. The idea was that those on invalidity pension could go back into the workforce and, depending on the level of disability, they could retain part or all of the payment. The Minister has developed the regulation but I do not see any push to implement it on the ground. That was meant to be the first step in trying to look at what we can do to help those with particularly severe disabilities or moderate disabilities.

There had been talk for a long time about the cost of disability allowance. Given the numbers who are in receipt of social welfare disability payments between invalidity pension and disability allowance, the payment of such an allowance across the board has significant cost implications. It also, at the margins, has implications of migration. However, if one follows what the Department was developing and what it advised me could be done, and one separates and grades it in the way that we were doing so for the partial capacity scheme, then it would be possible to ensure there would be a disability payment or whatever one would like to call it that would be graded according to the level of disability.

On the Order Paper today there is a large Supplementary Estimate for the Department of Social Protection. It understates the position because whether by accident or design, the Department of Social Protection takes inordinate amounts of time to process simple forms. It takes a year to process an application for carer's allowance, and that is unacceptable. It could not take that long to check the income details and the medicals. In some cases, the medicals are so obvious there is no checking to be done on them. The only logical explanation is that this is a handy way of kicking the can down the road in terms of payments, and this is unacceptable. There was somebody in contact with my office in the past two days about a person who was going caring for a person with a terminal illness and it was put bluntly by the family to me that the person will be dead before a decision is made on the carer's allowance application. That is unacceptable.

It is important that we look at the effect of possible cuts on the disability service. I was given details by the Brothers of Charity in Galway of the services they provide and the effect of a possible cut in the funding provided to them.

At the moment, they provide services for 943 people, comprising 428 children and 515 adults. That does not include the 386 children in the Galway early intervention service provided in partnership with the HSE and Enable Ireland. They have had budget cuts of €8.3 million or 18% in the last four years, which totally ignore pay cuts and the pension levy. Therefore these are extra cuts outside the pay cuts because they are paid as public servants.

They have done everything to achieve efficiencies, including restructuring and reducing management and administration posts. Staff posts have been reduced by 98. They have also restructured rosters and have achieved savings of approximately €1 million on the skill mix. Their back office support, i.e. human resources, finance, IT and quality, is about 2.61% of budget. The Minister of State can look at her own Department to check how much that back office costs. In my view, 2.61% of the budget is very efficient.

Some 85% of the budget is pay, while 91% of the jobs are exclusively front line. If there is a 5% cut it will require the closure of 24 residential places, which would mean a discharge of 24 people, making them homeless. It would mean the closure of 34 day places and, consequently, individuals would have to remain in residential services at an even greater cost. It would mean the loss of 506 respite beds and the loss of 4,939 family support hours.

One would have to let 52 staff go but since these are covered by the Croke Park agreement there is no mechanism for doing it, even if the Minister of State wanted to cause all this devastation. They have been benchmarked against a value for money report and the average costs have already been achieved in full. Some 85% of the budget is pay and therefore there are no savings.

There has been a lot of loose talk about extra efficiencies and that they will somehow survive. It is important to understand that whatever savings were there to be made by efficiencies have been made in recent years. Possible savings in shared services which I am very keen on, including amalgamations, would be totally inadequate, slow to implement and insignificant. I have a lot of data from the Department on how little money is being saved from all this quangoitis they told us they would get rid of.

There cannot and must not be any cuts to disability services this year. The easy answer we will get is whether we cut money, and yes we did, but there comes a point when there is no more to cut. There comes a point when an organisation does not have any more to give because it has cut everything that could be cut. Therefore this year it is vital that there is no further reduction to organisations like that.

If the Minister of State goes around the country to other similar organisations dealing with people with moderate or severe disabilities, she will find that story repeated everywhere. This year, no money was provided for school leavers and parents are wondering what will happen to next year's school leavers. That was always looked after until 2012.

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