Alan Kelly (Tipperary, Labour) | Oireachtas source

That is fine.

I thank my colleagues to my left for tabling this excellent motion and we will fully support it. In fairness it has been put across in the right manner. It is a genuine issue that I know the Minister of State will not deal with. Collectively this Parliament will morally have to deal with it in the near future. I welcome the representatives of the various unions, including Fórsa and SIPTU, in the Gallery. I particularly welcome my party colleague, Councillor Paul Bell, representing SIPTU. I thank them for all the advocacy and work they have been doing on behalf of the workers.

As many colleagues have said, there is an issue with the range of services being provided. I could list many of them in Tipperary, but I will not do so. The issue of pay needs to be dealt with, particularly in hospice services, education services and a whole range of services that we are so dependent on.

I would like the Minister of State to put a figure on the funding that goes into section 39 organisations. From the replies I have received to parliamentary questions, I know the HSE cannot put a figure on it. How much funding goes to section 38 and section 39 organisations? The Minister of State might ask the officials sitting beside him and at the end of the debate give us the exact figure for 2017, 2018 or any year. I am not sure that they know; in the past, they have not known anyway.

Many of the staff are being paid under the 2013 Department of Health consolidation pay scale rates rather than the 2019 rates. It is becoming a significant issue, and has been borne out dramatically by the many the service providers that cannot employ people. There is a high level of competition for very skilled workers. Many of them are trying to move across into HSE roles or roles in other organisations that have better pay. This is creating competitive issues among different organisations throughout the health service, which is not healthy. They want to continue to work in the sector and, in many cases, in the organisation they are in. Obviously for financial reasons - I cannot blame them - they have to move across. This is not acceptable especially as these organisations are doing work that we collectively as a body politic should be ensuring the State is doing.

The level of discrimination is resulting in major issues with recruitment and service provision. The loss of staff is having major impact directly and it is scaring people. I know families who are concerned about service provision across a range of areas because the staff in some cases are no longer there or will not be there in the future because of the issues relating to pay, which are having a dramatic knock-on effect down the line.

We all know that many of the organisations are operating within a significant deficit and have to fundraise, which is a major issue.

On the issue of staff, we need to collectively get on an even keel when it comes to section 38 and section 39, and HSE employees. I re-emphasise the final paragraph in the motion, which states that the unequal pay terms between section 38 and section 39 organisations must end. We can strengthen this. This pay injustice should be discussed and resolved as part of any potential future public sector agreement.

9 o’clock

We need to link this into the future, because then all of us can have confidence that everybody will be treated on an equal footing.

During my remaining minutes with the Minister of State, I know he would not want me to let him go without mentioning the following topics, which we have discussed previously during debates in the health committee and in this Chamber. The topics are related. How much is the total funding for the section 39 organisations? How many of them are given loans every year and why? What percentage of them are given loans? Why are they asked to sign contracts that will take away 20% of their funding if they do not sign? Is that morally right? Of course it is not. There is a range of organisations that get loans. I have a serious concern, which I have raised on multiple occasions in this Chamber and at the Oireachtas Joint Committee on Health. There are issues abounding here that the Department of Health - through the HSE - is actually pushing, and which may have impacts when it comes to how these organisations are trading and if they are adhering to company law. I have never gotten answers. I am aware that the HSE is running scared from this, and that the Minister of State, Deputy McGrath, is running scared from it. Basically, there has been a continuous push where the loans are increased and the volume of organisations is increasing. The members of the health committee have been told this but every year they are chasing their tails. This cannot continue. These organisations cannot trade recklessly. Some of them are being pushed into a situation where, I believe, it is becoming a real issue.

On a related matter, I believe that full-time residential institutional care is the next big scandal in the health service. I do not want another scandal but I have been trying and failing to get a number of people - young people especially - into full-time residential care. They have complex needs. I have told the story on the record of the House of a young man from Waterford. They cannot handle him anymore. I have tried everything and I have failed in trying to get a full-time residential package for him. Why is this? It is because the State is not providing enough packages and the State does not have enough residential facilities. We are failing these people hugely. The numbers are quite scary. I have asked the Minister of State to look at this when I brought the case to his attention. I brought the case anywhere I could within the HSE. I accept that costs for residential care are quite high but we cannot abdicate the responsibility to protect these people and give them the best service possible. They are being let down. I have seen nothing changed since I first raised the subject some years ago, or since I raised it in the health committee, or since I raised it in the Chamber six months ago. There has been no progress or change, just these people being abandoned. This should not happen and it cannot continue to happen. I ask the Minister of State to please do something before he leaves office that would change the direction of this issue. I would really welcome it.

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