Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I acknowledge that the Deputy has raised the importance and value of our hospices and the hospice movement on many occasions. He often mentions Marymount, which he knows well, and St. Francis Hospice in Blanchardstown and Raheny, which I know well as a constituency Deputy. We have seen enormous improvements in recent years in end-of-life care and palliative care, ensuring more people die in a hospice or at home than in a hospital. This means that, in general, people who are in their final few days or weeks can pass away with dignity and comfort, managed in a pain-free environment, in a way that is much more difficult to do in a busy hospital. Those improvements will continue and new hospitals are being provided in Wicklow and Castlebar, for example. There are also plans to develop palliative care in Drogheda and Waterford as well as the midlands, should we be able to come to an agreement among the different counties on an appropriate site.

As the Deputy mentioned, Sláíntecare proposes that palliative care become universal, but it does not specifically propose that it be taken into the public sector as a section 38 agency. Rather, it proposes that it be universal. When I asked the Sláintecare team what that means, it said that it should be provided in all parts of the country because it is not now, or at least not to the extent that it is in other parts. There has been much Government support for hospices in recent years, such as for St. Francis Hospice, to which the Deputy referred, where the land by the Government through my predecessor, the late Deputy Brian Lenihan, while the equipment and staffing were provided by this Government when we came to office.

The agreement to which the Deputy refers was brokered at the WRC. It acknowledges there is a difference between section 39 and section 38 bodies, as he will understand. The difference is that section 39 bodies are typically charities, private institutions and, in some cases, companies. They are not part of the public service and they are not owned by the public. The land and the buildings are not owned by the public, and nor are the pension liabilities or the debts. If some bodies want to move their classification from section 39 to section 38, we can consider and talk about that, but there will also be consequences to that, namely, relating to ownership, legacy pension liabilities, legacy debts, control, membership of boards and so on. These matters would have to be resolved. If some section 39 bodies are willing to give up some or all of their independence and transfer their lands and ownerships in return for becoming part of the public service, that is the type of thing we could discuss. The board of each individual section 39 body, however, would have to decide for itself that it wants to go down that road and it would have to be negotiated.

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