Dáil debates

Thursday, 12 May 2011

Adjournment Debate

Health Service Funding

3:00 pm

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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I am delighted to have the opportunity to raise this matter. The HSE has made a decision to terminate the funding of Rape Crisis Network Ireland and SAFE Ireland, the national network for domestic violence services. These two networks between them deliver an expert national programme of work on sexual and domestic violence. They join up services across Ireland and establish standards and access for survivors. They also deliver evidence and knowledge without which the Government, specifically Ministers across six Departments, would be hard pressed to form coherent or effective policy.

The HSE will effectively terminate many of these valuable services on 1 June. I understand the Minister for Health and Children, Deputy James Reilly, has extended this deadline for one month while he conducts a review, which is very welcome, of the decisions taken by the HSE. Some of the networks' functions have now gone out to a limited tender. In regard to one of those functions, data collection, I have to hand an independent, expert assessment conducted by Dr. Maureen Lyons, the director of research design and methodology in the equality studies department in UCD, of the RCNI data collection system, which is due to be terminated, and a comparison with the HSE replacement. Dr Lyons's assessment is that the HSE data collection is not fit for purpose. That is an important point to note. It is clear that the HSE does not have adequate capacity in this regard. Who assesses the HSE and its capacity? Clearly it does not have adequate capacity in this respect. Where is the Health Information and Quality Authority, HIQA, and the other groups when it comes to these vital services and the survivors who are lucky to be alive and are trying to live with the effects of what they have suffered daily? We are all aware from articles in the newspapers today of the situation in Donegal affecting 25 assault victims.

The HSE has decided to terminate all funding to the Rape Crisis Network Ireland and SAFE Ireland affecting all existing and planned work on preventing and addressing child sexual abuse and sexual and domestic violence, and the terms of reference issued for the selection of a future service provider are totally inadequate. I would like to know who drew up the terms of reference. They are inadequate and betray a lack of expertise in and knowledge of the area. They indicate a lack of capacity on the part of the HSE to fulfil its functions to protect those affected by abuse and domestic and sexual violence. The HSE is effectively dismissing the gold standard data collection system which it has funded and which has been developed by Rape Crisis Network Ireland over seven years. It is an international model of best practice.

I seek a reversal of the HSE decision and suspension of actions under implementation by the HSE. This is very alarming for groups locally and national umbrella bodies. If it is considered that there is some fat at the top in the national bodies, which I do not believe there is, we will accept change. The tender documents that have been issued are totally inadequate. We need a reversal of these decisions. The Secretary General of the Department of Justice and Equality, Mr. Sean Aylward, has also sought a reversal of this decision. The Minister has stood down that board of the HSE and who is in charge there now? There are senior officials of the Department in place. Accountability and transparency are vital but above all what is badly needed is certainty regarding the continuation of services. The angst and anxiety experienced by all the groups and their users - the service users are the people this is all about - must be alleviated by confirming certainty regarding the continuation of services.

Photo of Róisín ShortallRóisín Shortall (Dublin North West, Labour)
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I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy James Reilly. I thank Deputy Mattie McGrath for raising it as it provides an opportunity to clarify any confusion and address any concerns on this issue.

Domestic, sexual and gender-based violence are a serious health and human rights issue. The Government's commitment to tackling this problem is clearly demonstrated by its continued support of Cosc, the National Office for the Prevention of Domestic, Sexual and Gender-based Violence. It was established in 2007 under the aegis of the Department of Justice and Equality. Cosc's key task is to ensure the delivery of a well co-ordinated whole-of-government response to domestic, sexual and gender-based violence against women, men and older people in the community.

In March 2010 Cosc launched a four-year strategy to provide a framework for sustainable intervention to prevent and effectively respond to domestic, sexual and gender-based violence. The Health Service Executive published its policy on domestic, sexual and gender-based violence which dovetails into Cosc's national strategy. The HSE's policy states a health-focused analysis of violence is crucial, not only because the consequences of such violence require a significant amount of health care system resources, but most important because the health care system is often the first route through which victims seek to access supports.

The HSE, as per its statutory responsibility, is committed to funding organisations that provide domestic, sexual and gender-based violence services. Based on the level of resources available, the HSE is examining how to meet the needs of victims of domestic and sexual abuse and to ensure that value for money and accountability are paramount with the avoidance of duplication.

As part of this process, changes to funding arrangements have been proposed by the HSE. The Minister for Health and Children has instructed the HSE to extend the current funding to the Rape Crisis Network and SAFE Ireland until 1 August. This will allow him and his officials time to continue their review of these proposals and to satisfy themselves as to their nature.

These two network organisations, the Rape Crisis Network and SAFE Ireland, do not provide any direct services to victims of abuse. These are provided by 62 other organisations funded by the HSE, including 20 crisis refuges, 27 domestic violence support services and 16 rape crisis centres. Total expenditure in this area in 2009 came to over €19 million.

HSE officials in the directorate of families and children social services have assured the Minister that if the changes to the funding arrangements are put in place, all current funding will be staying in this sector of service provision, aimed at supporting victims of domestic, sexual and gender-based violence. However, it is planned that some of the funding will be redirected towards activities identified by the national strategy. I will relay Deputy Mattie McGrath's points about data collection to the Minister.

This initiative is not a cost-containment project but rather seeks to ensure value for money, to reduce duplication and promote a greater focus on victims. There is no plan to decrease the financial allocation to support domestic and sexual violence services in excess of any agreement between the HSE and Government allocation. The terms of reference for the selection of providers for future projects were agreed between the HSE and Cosc and include, among other factors, the capacity and relevant experience of the organisations applying.

The Minister is committed to ensuring all efforts are made to make adequate provision for the victims of violence.

The Dáil adjourned at 5.15 p.m. until 2.30 p.m. on Tuesday, 17 May 2011.