Tuesday, 17 December 2019
Section 39 Organisations: Motion [Private Members]
“That Dáil Éireann: acknowledges that:— the independent not-for-profit Section 39 sector provides vital services for many thousands of people with disabilities across Ireland;agrees that:
— the Section 39 sector also provide healthcare, elderly, youth, substance abuse, suicide prevention, social inclusion, education, community development and many other services in communities across the State;
— this independent not-for-profit group of providers, while part-funded by the Government, are accountable to the State and while standards of accountability, compliance and regulatory structures have increased substantially over the last decade, necessary additional funding to assist this work has not been put in place;
— this group of providers stepped up, when the Government did not, to ensure that people with disabilities had at least the prospect of the life they deserved, and they want to continue to do so;
— the independent not-for-profit sector is recognised in legislation as providing services that enable people requiring supports to live the best quality of life they can;
— these organisations seek to improve society and communities rather than focus on delivering profits, unlike the private sector; and
— there is a growing sense of crisis in this sector, not least the crisis of financial sustainability confronting many not-for-profit organisations;— according to Census 2016, 13.5 per cent of those resident in Ireland, 643,131 people, stated that they had a disability;calls for:
— for many years the approach of the Irish State towards the needs of people with disabilities has not been to provide services directly, but to instead rely on the delivery of services by a variety of voluntary/not-for-profit organisations, albeit with funding provided by the State;
— over the years the nature of this provision has radically changed, given that in the early years it was driven by religious orders, whereas now it is the remit of a range of secular and increasingly specialised and professionalised organisations;
— the significance of these organisations cannot be underestimated;
— in 2018, the Health budget for the provision of disability services was more than €1.81 billion;
— of this, more than 60 per cent was allocated to provide residential services, 20 per cent was allocated to provide day places and supports, with the remaining amount providing respite services and personal assistant and home support hours;
— these organisations sustain the communities they serve, building unique relationships with service users, their families and their network of friends;
— these organisations should always be prepared to be innovative, flexible and adaptable to the often complex needs of all marginalised groups they provide services to, including those living with a disability;
— these organisations should operate from a ‘naturally person-centred approach’ as opposed to being dominated by the requirements of a system of bureaucracy;
— there is a distinct feeling amongst these organisations that the State does not value their contribution as much as it did in years gone by; and
— there is a need to establish a renewed relationship between not-for-profit organisations and any future Governments who will provide adequate funding to enable the continued provision of services to people with disabilities and promote independent living and de-congregation; and— the Department of the Taoiseach to intensively engage with the not-for-profit sector to develop a long-term vision that would allow both the sector and future Governments to provide services through a more integrated approach, underpinned by any new legislative changes required and with sustainable levels of funding;
— the not-for-profit sector to establish a forum, which would include service users, to develop a plan to provide enhanced services into the future and agree to develop a compact agreement with the State that will govern this vital future relationship and that this would be completed within a three-year period;
— future Governments to give due recognition to the sector and create a junior ministerial portfolio for the community and these sectors;
— a complete review of current legislative provisions governing the relationship between the State and not-for-profit organisations in the disability sector to take place at the earliest opportunity, and any changes to current legislation or identified new legislation required to be given priority in any new Programme for Government; and
— the Government to agree that the unequal pay terms that exist between Section 38 and Section 39 organisations must end without delay, and that full pay restoration for these workers must be delivered as a priority.”
I want to say at the outset that I am deeply disappointed that the business has commenced earlier than was scheduled by the Business Committee, with the result that the people directly affected are not here, though they will be. It is disrespectful to them. Cuirim fáilte is fiche roimh na daoine a oibríonn ar son daoine faoi mhíchumas atá anseo linn anocht. Gach lá, déanann siad obair a chuidíonn linn ar fad. Ar son ár dteaghlaigh agus ár gcairde, gabhaim buíochas leo. Creideann Sinn Féin gur cheart go mbeadh cothrom na Féinne ag dul dóibh uilig.
I wish to acknowledge, in advance, it seems, those visitors who will join us in the Public Gallery later this evening, especially the many workers employed by organisations that this Private Members' motion addresses. I pay tribute to the tenacity and determination demonstrated in their campaign to have their pay and conditions restored in line with all other public sector workers, as they should be. In 2018 the health budget for the provision of disability services was more than €1.81 billion. Out of this, more than 60% was allocated to the provision of residential services, 20% was allocated to the provision of day places and supports and the remainder was allocated to the provision of respite services and personal assistant and home support hours. These organisations sustain the communities they serve, building unique relationships with service users, their families and their networks of friends. They are unique and irreplaceable. It was wrong for public service pay to be cut to bail out banks and developers. Sinn Féin opposed those cuts and we still do. That is why we are here tonight. Nearly every week, An Taoiseach responds to my colleagues' questions in this House by telling us that things are not as bad as they used to be. Let him tell that and prove that to the section 39 workers who will join us here this evening and the more than 9,000 of their colleagues across this State. Let him ask them how they are getting on.
This motion is about these workers and those who rely on them; our families and our communities. The focus of the motion can clearly be seen in the cry for justice that it represents. These workers carry out vital work and provide key services in areas where the State has failed to provide. This is not the first time that the plight of these workers has been raised. I was completely despondent when last year the Minister of State, Deputy Finian McGrath, denied that these workers had their pay cut by the Government. Níl sé sin fíor ar chor ar bith. These workers did have their pay cut, and it was cut because it was judged that they would kick up the least fuss. The Minister of State went on to claim that he did not know how the Government would even go about the business of restoring pay to the section 39 employees, the women and men who look after our most vulnerable family members and friends. I have a simple message for Deputy McGrath tonight. It is time to think harder. If the Minister of State and his Government colleagues could spend months drawing up the Finance Bill, which includes a tax relief allowing multinational executives earning up to €7 million a year to write off a third of their annual salary for income tax purposes, they can get their heads around restoring fairness and dignity to our friends across this land who provide these critical services.
That provision in the Finance Bill did not fall out of the sky. The Minister of State and his Government colleagues thought it up. I ask that he affords the workers who will be joining us this evening the same collective effort and think up a scheme to value their work in the same manner as all other public servants. There should be no differential in pay and conditions between workers doing essentially the same work. What is good for section 38 employees is good for section 39 employees, no ifs and no buts. Níor tháinig me anseo chun leithscéalta agus brón a chloisteáil. Mar a dúirt mé, tá mé ag iarraidh cothrom na Féinne.
Some might think it a miracle that we still have so many workers in section 39 organisations. I know from my work as a Dáil Deputy and as vice-chairperson of the Oireachtas disability group that it is a sense of duty, genuine care and dedication that has sustained the overwhelming majority of these workers. They had to watch as announcements were made to great fanfare that the harshest elements of the financial emergency measures in the public interest, FEMPI, legislation were being reversed while they were left behind. In previous commentary on efforts to address the plight of these workers, the Government has insinuated that the sector has recovered sufficiently and should address these financial shortcomings independently, without the need for restoration of grants. This is a diversion and takes away from the lived reality facing these workers.
The scale of the work of section 39 organisations becomes clear when it is estimated that more than 1,700 separate organisations are affected by the lack of any movement, legislative or otherwise, on this issue. They especially focus on the needs of people with physical, intellectual and learning difficulties and an ever-growing number of senior citizens. They are people who face all the same demands and responsibilities in life as everyone else. They are not different, and in a recovering economy they must not be left behind.
The Minister has sought to put the blame on these some 1,700 organisations rather than address the issue head on, as he must. The recently established forum under the chair of a senior Department of Health representative has yet to demonstrate its potential, never mind its capacity to effect real and substantive change in the relationship between section 39 organisations and the State. If this is only a fig-leaf exercise it will not be long before it is fully exposed for what it is. On the other hand, real intent backed up by a clear mission statement and a demonstration of Government commitment to address the under-resourcing of section 39 organisations could make it a groundbreaking initiative deserving of a welcome from all.
What is clearly required is a compact agreement with the State that will govern what should be a vital future relationship and that should be completed within a three-year period. While addressing the issue of finances this evening, let us not forget how careless and brazen this Government can be with taxpayers' money. We are all acutely aware of the huge cost overrun in the building of the new national children's hospital. This cost overrun will be required because of sheer mismanagement and shoddy tendering practices by the Government and the State agencies. If only they were as careful and circumspect with spend on these projects as section 39 organisations have had to be with their services, but they were not. The Government has squandered millions of euro of taxpayers' money and will make up the shortfall by targeting those who provide care, services and supports for those very same taxpayers who are least able to absorb the blow.
I want to stress the importance of tonight's motion, if accepted by a vote of the House tomorrow. If accepted, this motion will be the express will of Teachtaí Dála, the elected representatives of the people. As Chair of the Oireachtas Joint Committee on Justice and Equality I have stressed time after time that publishing reports and recommendations is not enough. Action is what is needed. If tonight's motion is accepted, the Government must immediately take steps to not only ameliorate the condition of those who work so hard on our behalf, and on the behalf of those dear to each and every one of us. It must set in train the necessary steps to ensure full pay restoration to section 39 workers. That is what they deserve. Nothing less will suffice.
Two things occurred to me before I came into the Chamber to speak tonight. The first is the enormous footprint of section 39 organisations in Cork, for example, the Cork Association for Autism, Enable Ireland, the Cope Foundation and Marymount Hospice where my grandmother is currently and where she is receiving incredible care. Every Christmas, Marymount Hospice is one of the favourite charities of Cork people. It is an incredible place and it is extraordinary what it can do. It is organisations like it that we are talking about when we discuss section 39 organisations. People rely on their staff. Such a topic can sound dry, abstract and artificial, but we are talking about key services such as those I have described.
It also occurred to me that in most countries across Europe or other parts of the world these would be services provided by the state. The State cannot abdicate responsibility for these services and their staff because they are not direct employees of the State. They are there because the State failed to provide the necessary services over many years and allowed charitable, voluntary and religious organisations to provide them. Whatever about the rights and wrongs of that, people are now relying on those organisations for essential services in the area of education, end-of-life support, disability services, therapies and other such services. That is what this debate is about. Section 39 organisations deserve parity and the respect to which all public servants should be entitled. Every day of the year we hear stories of section 39 agencies limping from crisis to crisis, often because of funding issues but also issues concerning legislation. The relationship between the State and not-for-profit organisations in the disability sector is just one example. There is a complete lack of respect from successive Governments for the vital work they do. Budgets are cut, skilled employees are treated as a low-pay workforce, and investment in beds and equipment is constantly put on the long finger. Their work, however, cannot and must not be undervalued. We must address the inequitable pay terms that exist between section 38 organisations and section 39 organisations. That must end without delay. Pay restoration must be delivered as a priority.
I thank my colleague, Deputy Ó Caoláin, not just for tabling this Private Members' motion tonight and giving us the opportunity to discuss it, but also for the work he does day in, day out, hand in hand with these organisations. One can hear the passion in his voice for the organisations, not just for the people who deliver the services but for those who are recipients of the services. We all know the work that is done by these agencies. The HSE most definitely knows because it is so heavily reliant on them. In my constituency I am acutely aware of the work that is done by Prosper Fingal across north County Dublin. I acknowledge its CEO, Pat Reen, whom I know is watching proceedings this evening. It is true to say that like all of the other agencies, the very existence of Prosper Fingal is threatened. That makes it a very worrying time for service users, their families and the staff.
These organisations were established because there were no statutory services. Very often they came into being because communities themselves organised and put services in place when they were let down by the State. Funding cuts from the austerity years, which have never been restored, and inadequate budgets, have caused huge damage and have left service providers unable to meet service demands and that has put significant pressure on them because they want to be able to maintain a high level of service but they cannot do it in the face of continued cuts. The pay cuts to section 39 workers during the austerity years and the imposition of a recruitment moratorium have had a long lasting and devastating impact on these services. We know there is a recruitment and retention crisis right across the health service and it is being acutely felt in section 39 agencies because they are already in a position where they do not have comparable pension rates and now they do not have comparable pay rates to the rest of the public service. It is not fair to say to them that they are regarded as public servants for the purposes of cutting their wages and cutting their funding but they are not regarded as public servants for the purposes of pay restoration. I represented many workers at the time and I know the pay cuts were in or around 8%. The workers themselves feel that they have been left high and dry. They do not believe that the political will exists in order to be able to address the issue. What is happening is that section 39 organisations are losing staff to the private sector because it is chasing after the National Treatment Purchase Fund, NTPF, money the Government is so anxious to pump into the private sector and away from the public service, or they are losing staff to the public service. It is really not fair. All that happens every time there is funding uncertainty is there is a threat to cut services and that sends a shock wave through communities and service users. It is most unfair. These staff undertake exactly the same work as directly-employed HSE staff but they do not have comparable pensions. They have comparable qualifications but there is a significant difference in their pay packet. We seek to have this addressed as a matter of urgency out of recognition for the fact that these organisations are providing vital, front-line health services.
Gabhaim buíochas leis an Teachta Ó Caoláin fá choinne an ábhar seo a ardú agus, go háirithe, as ucht an rún seo a chur os comhair na Dála. This motion maps out the key elements of a long-term strategy for section 39 users based on equality, and for the protection of section 39 employees in this not-for-profit sector upon which so many citizens depend.
The 1916 Proclamation states the Republic guarantees "equal rights and equal opportunities to all its citizens, and declares its resolve to pursue the happiness and prosperity of the whole nation". It does not, as the Minister of State knows, state: "except for those who have a disability, those who need healthcare or those who suffer from mental health issues." It does not state that bankers, landlords or insurance companies should have extra rights but, of course, we do not have a Republic based on the Proclamation. In this State, citizens with a disability suffer from higher levels of poverty. They have to fight for public services they should be entitled to. They survive on the lowest annual average disposable income. This situation has been made even worse by years of service cutbacks and a lack of service provision.
Section 39 organisations provide essential services. The WALK PEER programme in Louth, which enables young people with a disability to access opportunities in education, training and employment, has had to constantly fight for funding and resources. Respite services for Louth have been a constant battleground. In February 2013 the Fine Gael-Labour Party Government scrapped the mobility allowance scheme and the motorised transport grants. That was almost seven years ago. The grants have still not been replaced. In September, the Government published its legislative programme for the autumn session. Nowhere does it even reference the Health (Transport Support) Bill, which is supposed to plug the gap left by the 2013 decision.
There are 643,000 citizens in this State with a disability. That is 13.5% of the population. Louth has a higher-than-average percentage of citizens with a disability, at almost 14%. The section 39 public sector provides an indispensable service for these citizens as well as the elderly, the young, those suffering from substance abuse or those at risk of suicide, and it is the backbone of community development projects. They include SOSAD Ireland, which deals with citizens at risk from suicide, Louth Age Friendly, Dundalk Parents and Friends of the Intellectually Disabled, and Louth Community Drug and Alcohol Team. Without their dedication and commitment, many would fall through the cracks into even more dire circumstances. This motion seeks to resolve effectively the many difficulties currently within the section 39 sector.
This Government is in government just for the sake of it. If tomorrow this motion is passed, as I hope will be the case, the Government will have to act on it. There should be no more nonsense of supply and confidence from our friends in Fianna Fáil, which is propping up the Government. Let us deal with the needs of the citizens by making this motion a reality.
I move amendment No. 1:
To delete all words after "Dáil Éireann" and substitute the following: "acknowledges:
— the valuable contribution that voluntary organisations make across Irish society and in particular their integral role in the health and social care sector, where the State relies on these organisations to deliver core health and social care services through various contractual arrangements;
— the wider role played by the sector in social inclusion, community and rural development and youth and education services;
— the Report of the Independent Review Group established to examine the role of voluntary organisations in publicly funded health and personal social services, which recognised the continuing important contribution of the voluntary sector and recommended placing the relationship between the State and the voluntary sector on a new footing;
— the establishment by the Minister for Health of a new dialogue forum, in response to the Independent Review Group's report, with the aim of building a stronger working relationship between the State and the voluntary sector based on trust and partnership and to facilitate regular dialogue with the voluntary sector on future policy and strategic developments;
— that Ireland has ratified the United Nations Convention on the Rights of Persons with Disabilities and the United Nations Convention on the Rights of the Child, which place a duty on Ireland to ensure that children and adults with mental or physical disabilities should enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate active participation in the community;
— the significant progress being made under the Transforming Lives disability reform programme, which aims to provide a more person-centred, integrated and cost-effective model of disability service provision; and
— that the Government has significantly increased investment in disability services since it came into office and the overall budget for disability services will exceed €2 billion in 2020, an increase of 31 per cent (€490 million) since 2016;
— over 2,000 voluntary organisations receive funding from the Health Service Executive (HSE), spanning almost all areas of health and social care, including acute hospitals, disability, mental health, older persons and hospice services;
— Sections 38 and 39 of the Health Act 2004 legally underpin:— the provision of services by non-statutory providers on behalf of the HSE (Section 38); and— the HSE fund Section 39 organisations to assist them in providing services to the population, and a majority of these agencies provide essential services to people with disabilities;
— the provision of services similar or ancillary to a service that the HSE may provide (Section 39);
— the issue of pay restoration for Section 39 workers has been the subject of intense engagement between the parties under the auspices of the Workplace Relations Commission (WRC);
— an agreement reached in October 2018 in relation to pay restoration for employees of these organisations provided for pay restoration in relation to 50 'pilot organisations' in the first instance, including the larger organisations that are funded in the main by the HSE;
— pay restoration for the 50 organisations commenced in April of this year, with further payments due in 2020 and 2021 as appropriate;
— the WRC agreement recognised that some of the remaining Section 39 organisations (estimated 250 approximately) are likely to have pay restoration issues and a process to address these will be agreed, and the parties will commence engagement on this issue during 2019;
— the call for pay restoration is premature as the WRC agreement did not guarantee pay restoration for every Section 39 organisation which receives funding from the HSE and that an agreed process is underway regarding the remaining 250 agencies; and
— Section 39 services and pay agreements extend beyond those that provide services for health and social care; and
calls on the Government to commit to:
— the full implementation of 'Sustainable, Inclusive and Empowered Communities strategy to support the community and voluntary sector in Ireland 2019 – 2024', which sets out a long-term vision for communities in Ireland and a general direction of travel for Government policy in relation to the community and voluntary sector for the coming years;
— strengthening the State's relationship with the voluntary sector through meaningful participation in the new dialogue forum between the Department of Health, relevant health agencies and representation from voluntary organisations in the health and social care sector;
— working within the parameters of the WRC agreement in relation to pay restoration for Section 39 agencies; and
— a continued whole-of-Government approach to improving access to and quality of services for people with a disability in line with the National Disability Inclusion Strategy 2017–2021 and Transforming Lives."
I thank the Deputies for raising these important matters and allowing us time to discuss them here tonight. Let me deal with some of the facts regarding this debate. First, I did not cause the banking crisis and I did not cause austerity. I went into government to support people with disabilities and also to support staff in section 39 organisations. I will outline my strategy and response later.
Voluntary organisations have long made a significant contribution to Irish society and in the past, offered care and support when the State did not. However, I believe this country has moved on from that time and there is now a high level of mutual interdependence between the State and the voluntary sector.
While the Government fully agrees on the importance of ensuring support for the role of the voluntary sector, the approach proposed in the Sinn Féin motion does not have regard for the significant initiatives under way to put the relationship between the State and the voluntary sector on a firmer footing. Therefore, the Government is opposing the motion this evening, for the reasons I will outline in the course of my address.
The importance of the community and voluntary sector is recognised in Sustainable, Inclusive and Empowered Communities, the Government's five-year strategy for community and voluntary sector development in Ireland. I was asked about a strategy. The strategy covers the period 2019 to 2024. This strategy sets out a long-term vision for communities in Ireland and a general direction of travel for Government policy in regard to the community and voluntary sector for the coming years. It also copper-fastens the renewed relationship and partnership between the Government and the community and voluntary sector that has developed over time.
Ireland's health and social care system is characterised by a mix of public, voluntary and private providers that has evolved over many years and is reflective of historical and societal developments. More than 2,000 voluntary organisations receive funding from the HSE to provide health and social care services, including acute hospitals and disability, mental health, older persons and hospice services.
The House will recall that the Minister, Deputy Harris, announced the establishment of an independent review group to examine the role of voluntary organisations in publicly funded health and personal social services in July 2017. The report recognised the continuing important contribution of the voluntary sector and recommended placing the relationship between the State and the voluntary sector on a new footing.
In response to the independent review group's report, the Minister for Health recently established a new dialogue forum, with the aim of building a stronger working relationship between the State and the voluntary sector based on trust and partnership and to facilitate regular dialogue with the voluntary sector on future policy and strategic developments.
The forum is being chaired by an independent chairman, Mr. Peter Cassells. Forum membership includes the Department, HSE, HIQA, the Mental Health Commission and eight of the main representative bodies of voluntary providers of health and social care services.
At the first meeting of the dialogue forum on 2 December, it was agreed that change is needed on all sides to improve the relationship between voluntary organisations and the State. The establishment of the forum is an important foundational step in this regard. There is a deep commitment among voluntary sector representatives at the forum to build a strong, effective relationship with statutory partners so that we can collectively act in the best interest of service users.
As regards the suggestion that future Governments would give consideration to a junior ministerial portfolio for the community and voluntary sectors, it is worth noting that the Taoiseach has established a dedicated Department of Rural and Community Development, led by its Minister, Deputy Ring. The brief of its Minister of State, Deputy Canney, includes community affairs. In my case, as Minister of State responsible for disability issues, I also have a seat at the Cabinet table. This reflects the level of the commitment of this Government to the community and voluntary sector. I am keenly aware that the voluntary sector plays an integral role in the delivery of health and social care services and has made a valuable contribution to the development of services for people with disabilities in this country.
About one in seven people in Ireland, amounting to about 635,000, reported having a disability in the 2016 census. In line with the mainstream-first approach of the Disability Act 2005, more than 90% of those with a disability are supported through general community health and social services, with about 9%, or about 56,000, receiving specialist community-based disability services.
Health and personal social services are, by their nature, varied and complex. In some instances, the HSE delivers these services directly and in other circumstances it relies on funded providers to deliver these services on its behalf. Sections 38 and 39 of the Health Act 2004 legally underpin the provision of services by non-statutory providers on behalf of the HSE - section 38 - and the provision of services similar or ancillary to a service that the HSE may provide - section 39. Among section 39 voluntary organisations are hospices, mental health providers, nursing home and homecare providers, small community-based groups and social care services. The voluntary sector provides some two thirds of all disability services and 80% of residential services.
A small number of national-level service providers receive significant levels of funding, in excess of €30 million, but the majority receive much smaller amounts.
I would like to turn to the issue of pay restoration for section 39 workers, which has been the subject of earlier debate in this House. The people employed by these organisations are not public servants and are not subject to the terms of the public service stability agreements. Having said that, it is important to note that a pay restoration process, where it is warranted, is already under way. Some 43 organisations, totalling about 12,000 people, have been paid almost €7 million. This was part of the agreement reached in the Workplace Relations Commission, WRC, in October 2018 on pay restoration for staff in 50 pilot organisations.
The HSE conducted a data-gathering exercise regarding the 50 pilot organisations, which showed that in some places pay was cut, in others pay was not cut and, in a number of instances, pay had already been restored. That is the actual research. Following this significant and complex piece of work, pay restoration, where warranted, for these bodies commenced in April of this year, with further payments due in 2020 and 2021. It should be noted that the sole objective of the WRC agreement is to ensure that staff in the 50 pilot organisations who received direct pay reductions over the period 2010 to 2013 are restored back to the pay levels they were on before the reductions. I strongly support that. It is not intended to encompass any future pay progression for employees of these bodies or to fund any pension costs.
There are approximately 250 bodies that have not yet received pay restoration under this agreement. The parties have agreed, and I support this point, that there will be a phase 2 of pay restoration to look at these bodies. Management is willing to undertake the necessary preparatory work around this next group. A dedicated resource in the HSE will be assigned to commence this work in January 2020. The HSE will meet the unions to provide them with updates as this work progresses. I meet them regularly. In summary, the WRC agreement has resulted in significant progress and a continuing dialogue between all parties. I ask the House to be cognisant of this ongoing process and let the WRC, which is the appropriate mechanism, continue its important work.
Finally, I would like to emphasise that the State is committed to a whole-of-government approach to improving access to and quality of services for people with disabilities. In recognition of the cross-departmental nature of the supports required by people with disabilities, the Department of Justice and Equality published the National Disability Inclusion Strategy 2017-2021, which I chair. Furthermore, in 2018 Ireland ratified the UN Convention on the Rights of Persons with Disabilities, UNCRPD. In line with Time to Move on from Congregated Settings: A Strategy for Community Inclusion, 2011, almost two-thirds of the 8,300 people with disabilities who avail of residential care now live in ordinary houses or group homes in the community, rather than large-scale institutional settings. I accept that work has to be done and we are moving in that direction. This year we are spending more than €2 billion on disability in the HSE service plan for 2020. Even today, in the last couple of hours of the service plan, we managed to negotiate extra money for residential places and also new funding for personal assistance hours. There are, therefore, changes and reforms going on and we intend to ensure that everybody is treated fairly in Ireland.
What do section 39 organisations do? They run about two thirds of the disability services in the country, as well as many of the hospices and much of the education services. They work in our communities in every county and in every town with vulnerable people. They probably work directly with hundreds of thousands of people. Given the importance of section 39 organisations, the importance of hospices, the importance of supporting people with disabilities and the importance of supporting families battling with cancer, we would think that a single Fine Gael Teachta Dála would have come into the House to show a bit of support. The Minister of State cuts a lonely figure on the Government benches this evening.
Fianna Fáil will be supporting this motion. It is a sensible motion and it is disappointing not only that the Government could not be bothered turning up, but that it felt the need to put down a countermotion. I compliment the Deputy on what is a very sensible and non-political motion. This is clearly just trying to help. We have tabled a short amendment that brings some extra focus on the hospices, including those such as Marymount in Cork and we hope the House will support this amendment.
This Government is crippling our entire public healthcare system. I will read one tweet from yesterday, from a father called Declan Ward. It reads: "Had a terrible day in @Temple_Street today. Not enough ICU nurses for our son Eoin's scoliosis surgery. Two years waiting. Cancelled when prepped for theatre". So, we have an empty operating theatre and surgeons, but we did not have the ICU nurses afterwards. Why? A hiring embargo is in place which this Government pretends does not exist. What happens? What happens is that the section 39 organisations are put under increasing pressure. They are meant to work complementing our public healthcare system, but when our public healthcare system has been vandalised by Government, the section 39 organisations have to take on more and more responsibilities. They also have to take on increasing compliance and regulation, which is right and proper, but then they do not get the funding.
Not only does the Government refuse to reverse the pay cuts, the Taoiseach has repeatedly come in here and stated brazenly to this House that the pay cuts never happened and that they were nothing to do with the Government and the HSE, when there is documentary evidence showing that section 39 organisations had to impose financial emergency measures in the public interest, FEMPI. The Minister of State then comes in here and talks about pilot schemes nearly a decade after the FEMPI cuts were introduced. In the meantime, our section 39 organisations struggle more and more. They are not getting the support they need. Purple House Cancer Support Centre in Bray had promises made to it about a new premises. The promises do not seem to be kept.
We will be supporting this motion. We have an amendment down which we hope is also supported. This Government needs to take the section 39 organisations seriously and reverse the cuts that very much did happen.
Section 39 health organisations provide vital health services to society and to local communities throughout the country. We cannot underestimate the services they provide. Those include hospices and disability organisations and other agencies, including rest homes. Those are unique to the south east in Waterford and Kilkenny and provide low to medium and medium care levels. There is one rest home in Lismore, St. Carthage's, and another in Waterford city, the Holy Ghost residential home. Those rest homes provide low and medium care for our elderly people who can no longer live at home on their own. They might be living in rural isolation, but they only need low to medium supports. They have a hot meal every day, a warm bed every night and they also have their medication handed out to them. It is a fantastic model. Only for the section 39 health organisations and a voluntary board this would not happen. The local communities also fundraise every year to support these activities.
The independent review group established to examine the role of voluntary organisations in health and social services has found that two thirds of disability services are provided by the section 39 sector. However, those organisations are enduring a funding crisis and there is concern about the viability of many organisations. The lack of resources is a common thread running through these organisations as they try to deal with increased demand with limited resources. Waiting lists for assessment and intervention have been allowed to spiral out of control under this Government and there are serious issues with staffing and access to residential care. This combination is resulting in families waiting months and, in some cases, years for help. We must realise that our health system would not be able to function without organisations such as the Pinegrove Day Care Centre in Waterford, which delivers much needed dementia specific, person-centred care to meet the needs of the person with dementia. Outreach support services are also provided for those with dementia who are not in a position to attend the centre.
I spoke recently with the service provider looking for supports for several constituents who had contacted me. However, due to funding constraints, only those deemed to be in crisis would receive the supports. There were many families in crisis but they did not meet the qualifying criteria. We have an ageing population, meaning more supports are required every year. The State needs to stop short-changing the voluntary sector and its staff when it comes to pay agreements.
I am delighted to have an opportunity to speak on this subject. We must first recognise there is a crisis in the sector in question, services are not available, young people cannot get the assessments or psychological services they need and they cannot get respite or, in extreme cases, residential care. This is all a significant challenge.
We are all agreed that we want higher standards in the disability sector. The Minister of State spoke about that. There are many more people living a lot longer with more complex needs. Accordingly, more money is needed to stand still. While he claims he is giving more money, it still is not adequate for the services being provided.
The Government's response to every issue is how can it get as many years out of inaction as possible but appearing to be busy. Busy inaction I call it. The Government set up the independent review group, which ran from July 2017 to 2019, buying it two years. Having got that far, it then set up the dialogue forum. We are now into December 2019. The forum will not make any conclusions before late spring next year. The Government will have, again, bought time to get over the line.
I do not believe the people are fooled by this process of constant dialogue and no action. When there is not enough money for the basic services they need, they know the Government's policies are not working.
Disability is another issue that seems to have eluded the Government in terms of a solution. It is another one of those issues that requires caring and progressive policies. The Taoiseach is keen to tell us about the wonderful job he is doing restoring the country’s economic success. When one scratches the surface of the issues that are important, however, such as housing, health, education and disability, he and the Government are failing miserably.
It is not a coincidence that these issues are those that affect the less well-off in our society the most. There is a clear theme running through the work of the Government, particularly in the attitude of the Taoiseach. This theme impacts the issues that require thoughtful policies and will provide empathy to people in our society who are challenged. It is not a priority for the Government, however. According to the Taoiseach, the homeless figures are not the worst when compared to other countries. His solution for the provision of social and affordable housing is to invest hundreds of millions of euro in housing assistance payment, HAP. The blame for the problems in our health system is landed at the doors of our doctors, consultants and nurses. Despite our so-called economic prosperity, no progress has been made in education either.
Regarding section 39 workers, the Taoiseach wants cash-starved disability organisations, hospices and other voluntary agencies to solve the problem for him. Based on the evidence I have offered, it could be claimed that the Government just does not get it. I argue, however, that it does get it. It is just that it is stuck in a right-wing ideology time warp where ordinary people do not matter and all problems must be solved by market forces.
We in Fianna Fáil fundamentally disagree with this. It is a key difference between our two parties. When the people get their chance to make their decision on the Government in due course through the ballot box, these issues will influence their decision.
Section 39 health organisations provide vital health services to society and local communities across the country. Under the Health Act 2004, there are section 38 and section 39 organisations. Employees of section 38 organisations are public sector workers and, therefore, will receive pay restoration. Section 39 employees, however, are not technically public sector workers. Traditionally, they have been paid the same as employees of section 38 organisations and the public sector. The HSE communicated with section 39 organisations that a cut in funding was to be applied to each organisation's payroll. While a process of pay restoration has commenced, many organisations remain on a financial cliff edge. If we are to maintain an effective service for those with disabilities, those who work in section 39 organisations must be recognised and treated like all other HSE employees with their pay and conditions restored.
I welcome the opportunity to contribute to this debate and commend Sinn Féin on bringing forward this motion.
I want to give an example of a facility in my constituency that shows the effects of the Government’s inaction on section 39 workers. I have been working closely with my colleague, Councillor Joe Flaherty, on highlighting the issues facing St. Christopher's Services in Longford. It provides day services for 140 adults, full-time respite care for 37 adults, respite care for 36 adults and day and weekend respite for 15 children. The Minister of State is aware of this service because he met me and its CEO earlier this year.
Unfortunately, while he gave us a listening ear on that occasion, nothing has happened since. The biggest challenge facing an organisation such as St. Christopher's with a staff of 220 people is the variance in pay with the other HSE services, section 38 organisations and private providers. I have been informed that, on average, there is a shortfall of €6,500 per annum in the terms and conditions for the pay of the staff in St. Christopher's. How does the Minister of State expect such services to be able to retain and attract staff? I have outlined the number of service users who rely on theses services in Longford. If it cannot retain existing staff or attract new staff, the organisation will not last into the future. The Minister of State must examine this critically without any further delay.
The other areas of challenge for this service are the lack of an appropriate multidisciplinary team, the lack of psychological supports and poor infrastructural investments. When we met the Minister of State earlier this year, we gave two examples of where money could be saved. It involved shared services with smaller section 39 organisations working together, reducing duplication, making savings and re-investing them into services. We highlighted how St. Christopher's Services is covered under clinical medical negligence insurance but not covered for general indemnity insurance. If it was covered for the latter, there would be savings of €138,000, which could be put back into services.
The Minister of State came out with good words. He gave us a welcome ear. However, section 39 organisations want tangible action.
Two weeks ago, we celebrated International Day of Persons with Disabilities. Today, as previously raised in a Fianna Fail Private Members' motion in 2018, we are again highlighting the massive discrepancies in pay for section 39 health organisation and not-for-profit sector workers, many of whom work directly with those with special needs and disabilities. This sector provides health and educational services across the country, including hospices, disability organisations and other advocacy groups. Every Deputy is acutely aware of the pay disparity, in particular between sections 38 and 39 workers. Every Deputy can also attest to the fact that both workers essentially provide the same level of service to their clients.
Why do we then persist in penalising section 39 workers in respect of their rights to pay restoration? We cannot continue to sit idly by while this pay inequality persists. This is about fairness. Why should two people who do exactly the same job, have the exact same responsibilities and perform the same tasks as one another be treated differently? The fact is that they should not.
Worse still than the lack of fairness in the sector in terms of pay inequality is the real challenge that the disparity poses for the voluntary sector in terms of sustainability.
If the State continues to oversee a pay structure that directly undermines the magnificent work of those in the voluntary sector, I fear for the future of that sector in terms of its ability to attract and retain workers who carry out some of the most important work for the most vulnerable in our society.
The independent review group, which was established to examine the role of organisations in this sector, concluded that disability services in particular are continually underfunded. Many of these voluntary bodies are now under significant threat. The fact that Mr. Seán Abbott, CEO of the Cope Foundation in Cork, has said that the challenges facing the sector are the worst he has seen in his 38 years speaks volumes for where we are at. Our health and education systems are reliant on organisations such as the Cope Foundation to provide early intervention supports, training supports for people who have left school, housing and alternative therapies for families, and to help people with special needs, including people on the autistic spectrum.
We need to appreciate and cherish our voluntary sector. That means treating those involved with fairness and with respect to ensure services are secure for the families and communities that use them.
I am delighted to support the motion. This issue has been going on for some time. Section 39 organisations are doing unbelievable work throughout the country. I refer specifically to St. Joseph's in Charleville, which the Minister of State visited with me in January 2017. One of the issues outlined at the time was the escalating cost of insurance, a matter I raised earlier on the Order of Business. There were also concerns over respite and the shared care initiatives in St. Joseph's as well as the restoration of pay for the workers.
These organisations have become reliant on agency workers. They do Trojan work in looking after the most vulnerable in our society. They are locked in a continual battle each year with the HSE over funding and different streams of funding. There are long waiting lists for basic assessments for children. We have heard all the fine talk. When people look back at this period they will see how we neglected children with intellectual disabilities by not providing assessments in time. There are no therapies available. People need to wait two years for an assessment and another two years for therapies, which is simply not good enough.
When I have raised this issue, the Minister of State has claimed that additional funding has been allocated for respite. I know of families who are told they have two or three weekends a year of respite but not continuous respite. It is a shameful indictment. These organisations, and in particular St. Joseph's, have been managing a reduced budget to try to spread as thinly as possible their services in north County Cork and south County Limerick. It is a fantastic organisation but the staff are at their wits' end over funding and particularly over the restoration of pay for their workers. As previous speakers have said, it is a no-brainer. We need to ensure these people are looked after and that the people who are working at the coalface of disability services are looked after and put to the forefront of our debates.
I wholeheartedly support the motion tabled by Sinn Féin. I echo what Deputy Michael Moynihan said about the invaluable work done by the management and staff at St. Joseph's in Charleville. They work beyond the call of duty.
We heard the Minister of State announce earlier that he welcomed the increase in funding in the HSE service plan. I hope he will deliver accordingly and fairly around the country. At the end of the day, if the staff are not paid proper wages, we cannot expect them to continue the way they are going. In recent years, Cobh community hospital has operated on a shoestring budget. Up to a few weeks ago there was a threat to close down the hospital, the only community hospital on the great island of Cobh.
While section 38 and section 39 organisations have different paymasters, they do the same work and provide the same services. I ask the Minister of State to support the motion.
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.
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.
I thank Deputy Ó Caoláin and Sinn Féin for tabling this motion under Private Members' business. The issue needs to be dealt with. I fully support elements of the motion, and especially that unequal pay and conditions between the workers of section 38 and section 39 organisations must be ended. Full pay restoration for these workers must be delivered as a priority.
In his contribution earlier the Minister of State said that the people who are employed by section 39 organisations are not public servants and not subject to the terms of the public service stability agreements. They were, however, treated the same way as section 38 workers when their wages were cut and when funding was cut under FEMPI. I reiterate that these workers should have their pay restored as a priority.
I am not convinced that the level of outsourcing of essential public services - and healthcare in particular- to charities, voluntary hospitals, NGOs and religious bodies, is the best way to provide these essential services. I believe we need to establish which public services are essential and must be provided by the State as a right. The failure of the State to do this contrasts sharply with other European states, and especially in the post-war period, and it is a key factor as to why we have such poor public services generally in contrast to similar European states.
In 2015 I fully supported the Sláintecare all-party report, which has been quietly shelved by the Minister for Health and by the Government. The failure to deal with the numbers of charities, religious bodies, NGOs and State agencies was a major weakness in that report. As a member of the committee I tried to establish how many section 38 and 39 bodies were receiving funding from the HSE. I have never received a clear answer from the Minister, the Department of Health or the HSE. The HSE did provide a list of up to 550 to 560 agencies in receipt of more than €100,000 in 2015. Some digging around, however, shows that some 3,000 section 38 and section 39 agencies received some €3 billion from the HSE in 2015. This is almost one quarter of the overall HSE budget for that year. The scale of this level of outsourcing is staggering and it is a fundamental problem in the provision of a proper health service, fit for purpose, where workers can work and deliver services properly, and the provision of good public services generally. Until we confront the situation and introduce radical change in how we provide and fund front-line essential services we will not get the services we need for our elderly, our sick, our children, or for those with a disability or suffering from a mental health issue.
This is not to say there is not a role for advocacy groups that are independent of the State, and grant aided by the State. Advocacy groups have a key role in identifying problems and weaknesses in public services. Rather than the forum as proposed in the motion I would support a forum for advocacy groups to develop a broad campaign to fight for public services as a right, and to break once and for all with the Victorian notions of the poorhouse and the deserving poor. We need high quality, adequately funded public services that are fit for the 21st century, and fit for section 39 workers to work in and deliver services.
I want to make it clear that there is no criticism in these remarks for the thousands of volunteers who give up their time freely to provide services that the State - in the main - should provide, or those workers who work full time in section 39 bodies. I commend the motion and I will support it when we vote for it.
I do not in any way doubt the Minister of State's sincerity in dealing with disability services. I do, however, believe that the voices of section 39 organisations are not being properly heard by the Government. We can see this problem across our health service. Section 39 organisations are supplying services that would normally be delivered by the State. These are front-line services that are very difficult to deliver. Some 35% of the disability budget is spent by section 39 organisations but 2/3 of disability services are delivered by section 39 organisations. The State is heavily reliant on the sector and gets excellent value for the money it spends in the sector. Unfortunately, the level of funding is the real problem. A lack of funding leads to a struggle in delivering the range of services, in delivering the quality of services, and in the delivery of the absolutely essential governance that section 39 organisations require, and which is demanded of them. Essentially, the lack of funding leads to difficulties in recruitment and retention of staff. This is one of the huge problems facing section 39 organisations. They recruit and train staff, who then are tempted to go to work with section 38 organisations or to the HSE, where conditions of service and pay are much better. Non-delivery of section 39 services leads to huge unmet need. This leads to additional costs down the road.
Many, if not all, section 39 organisations are operating at a financial deficit. They have to beg for proper funding, not only from the Government but also from the public. They invariably provided services that are excellent value for money, with tight financial control underpinning elimination of any unnecessary costs. They are dependent on fundraising and the kindness of strangers to meet their bills and to bridge the deficit in their funding.
They are not funded at the real cost of providing these desperately-needed, essential services that are delivered to people who are most dependent and most vulnerable.
Recently, I visited an acquired brain injury service in Clarecastle in County Clare. It provides an excellent service to those who have suffered road traffic accident, strokes or serious assault. Acquired Brain Injury Ireland is a section 39 organisation that is unable to provide occupational therapy services, speech and language services and physiotherapy services. If it does have these essential components they are either half time or not sufficiently present to deliver a proper service. However, this organisation takes people out of our acute hospitals and delivers them to community services, allowing them to live within their communities, either independently or supported. This is an example of a section 39 organisation that is struggling to deliver excellent services and is underfunded.
I am happy to speak on this motion. As we all know, not-for-profit organisations provide vital services for all communities throughout Ireland. They provide healthcare, social inclusion, community development and support services for people with disabilities, the youth and the elderly. These groups took the lead when the Government did not. I fully understand and see first-hand the good that section 39 funding has done for community and voluntary organisations.
I am involved in a couple of these voluntary organisations. They are the Goleen and District Community Council and Schull Community Care. These organisations, as do many other community and voluntary organisations throughout the country, simply provide meals in the local community building and in the local social centre where people can come in a couple of times a week for a hot meal. In my community between Goleen and Schull, thanks to section 39 we can provide a hot meal for people in the local community centre or meals on wheels to their door. This in turn saves the State millions of euro as a hot meal for an elderly person seven days a week keeps that elderly person in his or her home and not in the local hospital.
Do people realise that the local community and voluntary group run section 39 funds in many communities? This creates a lot of headaches for volunteers sorting out payments for workers. These workers, who diligently work long, hard hours, are poorly paid because the Government fails to realise their value. This is because community and voluntary groups are at the bottom of the Government's list. Most section 39 workers work for the community and voluntary sector. All we have from the Government year after year is that it will be sorted out next year. It will not sort itself out. The reason the Government cannot sort it out is because it threw billions of euro into a pet project, a huge hole in the ground in the children's hospital in Dublin, which showed massive incompetence. We have no home help service because of it. We have no transport for children with disabilities over 18 years of age. The Government has let people go blind begging for a cataract operation. This weekend, the 50th bus will leave Cork for Belfast in a desperate attempt by people to save their eyesight. It is a 15-minute procedure that the Government cannot fund. It is no wonder that section 39 workers are poorly treated. I fully support the motion.
I am happy to speak on this important topic. As have my colleagues, I have been raising this issue on behalf of HSE employed staff in my constituency for some time. I am delighted to see Senator John Dolan, the CEO of the Disability Federation of Ireland in the Chamber. I compliment him and his organisation on all of the work they do.
I tabled a parliamentary question to the Minister for Health on the need to restore pay for staff in section 39 organisations. I accept the view put forward in the motion that the independent, not-for-profit section 39 sector provides vital services for many thousands of people with disabilities throughout Ireland and that the section 39 sector also provides healthcare and services for the elderly and youth, substance abuse, suicide prevention, social inclusion, education and community development services, meals on wheels services as Deputy Collins mentioned, and many other services. There can be no doubt that it is a sector that needs our support and our assistance. The organisations cannot wait for it.
More broadly speaking, I remain deeply concerned around the provision of funding, not just to the workers but to the services infrastructure, especially in the area of disabilities and mental health. The voluntary sector and disability sector came before the Oireachtas health committee earlier this year. The Chairman of that committee, Deputy Harty, is sitting behind me. The witnesses described the service as a house that is falling down. They said that while scaffolding is being provided, the house could still fall and this is entirely unacceptable. The independent voluntary disability service providers said they operate in the absence of a Government strategy for their role and future, and also in the absence of adequate funding for services. Their warning is that this will soon be unsustainable. It is already unsustainable. Those impacted because of this uncertain future are the people who rely on residential, respite and day services and who deserve to live full lives as citizens of this State with the support they need.
I salute the many volunteers and board members of not-for-profit organisations who give gallant service and, along with the staff, keep those services going. They have to beg and scrounge and do church gate collections and God knows what to try to top up the wages. This is of the people by the people. People leave those jobs and go into a HSE job because they are pensionable positions and everything else. We are abandoning these people. They are the most needy people of all. As others have said, I am aware of countless cases where people cannot get a full residential place because of funding. The lives of parents and others are in danger because of adult children with many emotional and mental difficulties. The danger to people's health is another crisis. I believe the Minister of State, Deputy Daly, has done his best. The Minister of State, Deputy Finian McGrath, is gone. He is all promises and no action. That is the problem. When he was on this side of the House he was great but I am so disappointed with him during his term for paying lipservice to this area. It needs to change. We need to look after these people.
I welcome the opportunity to speak on this very important motion. I congratulate my colleague, Deputy Ó Caoláin, for bringing it forward. I thank most of the House for their genuine support. For the people outside who are wondering what we are debating I will put it in basic simple terms. The heart of the motion is calling on the Department of the Taoiseach to intensively engage with the not-for-profit sector to develop a long-term vision that would allow the sector and future Governments to provide services in a more integrated approach, underpinned by any new legislative change required and with substantial levels of funding. It also calls for future Governments to give due recognition to the not-for-profit sector by creating a portfolio for a Minister of State for the community, voluntary and not-for-profit sectors.
Who are we letting down if we do not support the motion and try to push matters forward? As has been mentioned so many times during the debate, we will leave down the very people who work with young people, the disabled, the elderly and people suffering from substance abuse and mental health issues. The list goes on and on. I can mention community and voluntary organisations in east Cork, from Cobh to Carrigtwohill, Connagh, Mallow, Fermoy, Mitchelstown and Midleton. I could go on. These services are vital.
What is really worrying is what would happen if on 1 January 2020 all of the organisations decided not to do it any more. Who would suffer? Absolutely everyone. This is about equality. The Minister of State, Deputy Finian McGrath, mentioned the UN Convention on the Rights of Persons with Disabilities in his speech. We have not even driven it forward yet. We are the last in Europe to do so. We are lagging behind. I cannot understand how many times I have come to the Chamber and said the two hardest things to do in this country are to tell the truth and help people. I have found something else for the list, which is do the right thing.
I also want to talk about invisible carers. The latest data from the CSO frightened me, as it states that 44,227 hours of care per week are provided by children under 15. That is 2.2 million hours of care provided by children under the age of 15 in one year. It is absolutely frightening.
My mother has been a carer for 30 years and she is very proud of what she does but it is stressful and there is a catch-22 situation. She does not want to leave people down. She has been a volunteer with the Irish Wheelchair Association since I could hardly walk. My mother is now in her 70s but she will not give it up because she feels like she would be letting people down.
The motion is about helping people and giving people the supports they need to live life in a manner where they can be satisfied that they have the best quality of life available to them.
All of us here are very lucky in that tomorrow morning we will be able to get out of bed. There are many people in this country who in the morning will be waiting for carers to come and help them out of bed. If we lose these vital services we will be facing a tsunami. As stated many times on the record, we have an ageing population. If we do not support section 39 organisations in the same way as we support 38 organisations and recognise the work of these voluntary organisations, everybody in the country will suffer.
This Private Members' motion is about delivering fairness for everyone. I am glad that the majority of Members of the House will support it. I call on the Government to withdraw its countermotion and to do the right thing before the new year.
Ba mhaith liom fáilte a chur roimh na daoine sa Ghailearaí atá ag féachaint ar na rudaí atá ar siúl anseo. Tá mé an-bhuíoch go bhfuil deis agam mo thacaíocht a thabhairt don Bhille seo, atá curtha chun cinn ag mo chomrádaí, an Teachta Ó Caoláin.
I welcome the people in the Visitors Gallery and those watching in and I express my support and that of my party for their just demands. Section 39 workers have faced a huge injustice and a deplorable lack of understanding on the part of this Government, which cannot fathom that workers should be paid fairly and should, at the very least, receive pay increases on a par with others in the service.
Section 39 workers fulfil a vital role in the voluntary sector, providing a valuable service to many community groups and non-profit organisations. For example, in Finglas, organisations which depend on section 39 workers include the Finglas Addiction Support Team, FAST, the Finglas Home Help Care Organisation Limited, and in Ballymun, the Ballymun Regional Youth Resource, BRYR, Ballymun Youth Action Project, The Star Project and the PoppinTree Youth Project. These organisations provide crucial local services and they apply them with not just expert knowledge but great local knowledge. Many employed in these organisations come directly from the local community and have the trust of the local community. Employees in these organisations and groups suffered large cuts to their income when public sector pay was cut. While those working alongside them, who are regarded as public servants, have had some restoration in terms of pay, the section 39 organisations have not had an increase in funding allocation that would allow for pay restoration similar to that given to public servants, who are benefitting from increases provided for in the public service stability agreement.
Services in areas of my constituency of Dublin North-West have already been cut and remaining section 39 employees are being made redundant or are having their hours reduced. These organisations need a certain level of staffing to provide their much needed services. It is not feasible for them to continue to provide activities and services without sufficient resources and staff. The Ballymun Youth Action Project is a community-led response to drug and alcohol misuse. It provides vital services for the communities and families suffering from the negative impacts of drugs and alcohol. The Ballymun Regional Youth Resource, BRYR, project works with vulnerable young people from Ballymun by supporting them in their personal development and social education and providing a healthy and nurturing environment for them. BRYR is a safe place for young people to interact and a place which promotes positive mental health and wellbeing for young people growing up, often in very stressful environments. The Finglas Addiction Support Team, FAST, was set up by a group of volunteers from the Finglas community to provide services in the area for drug users and their family members, which at the time were not sufficiently available. Finglas Home Help and Care Organisation helps elderly and infirm people in their homes.
If we lose these organisations or if they have to vastly reduce the services they offer, where will the communities they serve find alternatives? They will not find them. The groups I mentioned exist because services did not exist in the first instance or they were very limited. These groups and workers serve a purpose. Without them, our communities will be worse off and in greater despair. We cannot afford to allow generations of young people to be lost and families to be devastated on an issue of funding. We need these organisations and these workers and our communities need these services.
I thank all Deputies for their contributions to the debate on this very important matter that has been raised in the Private Members' motion this evening. It is important when discussing this issue that we do not forget that the role of voluntary organisations play is an issue which extends beyond the health sector. My colleagues in the Department of Rural and Community Development lead on the Government's five-year strategy for community and voluntary sector development in Ireland and conduct ongoing consultations and interactions which enhance the effectiveness and positive impacts of the voluntary sector.
My colleagues in the Department of Justice and Equality lead on the national disability and inclusion strategy. Along with the Department of Health, they are working across Government, in transport, housing, employment and social protection to maximise opportunities for children, young people and adults with a disability. As outlined by the Minister of State, Deputy Finian McGrath, in his address to the House earlier, the first meeting of the new dialogue forum established in response to the report of the independent review group took place recently. I am sure that the House will agree that we need to continue this positive progress and to continue to build on the relationships between voluntary organisations and relevant Departments and officials.
Regarding voluntary organisations providing health and social care services under section 39 of the Health Act 2004, it would be appropriate to set forth again the differences between section 38 and section 39 organisations. Section 38 agencies are organisations that are funded under section 38 of the Health Act 2004 to provide a defined level of health and personal social services on behalf of the HSE. Section 38 agencies include both acute and non-acute organisations. The employees of bodies that are funded under section 38 are classified as public servants. They are subject to the standard salary scales for the health sector and have access, in the main, to public service pension schemes. The employees of section 38 agencies are included in public service employment numbers.
Section 39 of the Health Act 2004 provides that the HSE may give assistance to any person or body that provides or proposes to provide a service similar or ancillary to a service that the HSE may provide. The HSE provides a grant to a range of private sector service providers under section 39. The HSE puts in place a service level agreement that sets out the level of service to be provided for the grant. The employees of section 39 organisations are not HSE employees; they are not public servants; they are not encompassed by public service pay agreements; they are not subject to the FEMPI legislation; they are not members of public sector pension schemes; and, unlike their section 38 counterparts, they are not directly bound by the Department of Health consolidated pay scales.
While it is understood that pay cuts were implemented in many section 39 organisations during the financial crisis, it is not clear if these cuts were applied in a universally consistent manner or if the cuts were to the same extent as those applied to public servants. The Minister for Health is aware that some section 39 organisations have raised concerns about financial sustainability with the HSE, including a number of organisations in the disability sector. The HSE has assured the Department of Health that it is committed to working intensively with such organisations to support them as appropriate to address such issues in the context of the service level agreement process. Where it is identified that a genuine issue is arising that may impede the effective and efficient delivery of services by section 38 or 39 social care service providers, any remedial action will need to be considered by central Government as a resolution cannot be addressed within the current health Vote resources.
The motion also raises the issue of forward planning. This House has given its support to Sláintecare, the ten-year cross-party plan to significantly improve and modernise the health service. Sláintecare will reform Ireland's health and social care service to create a modern, responsive service that offers the right care in the right place at the right time. Earlier this year, the Minister, Deputy Harris, and Ministers of State, Deputy Finian McGrath, Deputy Byrne and I welcomed the publication of the Sláintecare action plan and the announcement of the 122 successful applicants for the €20 million Sláintecare integration fund. It is essential at this time that we continue to work collaboratively with voluntary organisations to deliver existing services and move forward together with Sláintecare reforms. The vision of Sláintecare is central to the disability reform programme we are implementing under Transforming Lives. As outlined earlier by the Minister of State, Deputy Finian McGrath, the quality of life for service users is improving as a result of the implementation of person-centred policies, such as moving people from congregated to decongregated settings and developing more community-based, person-centred services.
Since this Government came to office, it has focussed on restoring the budget for disability services, which will exceed €2 billion for the first time ever in 2020. We have also been successful in agreeing a pay restoration process for nearly 12,000 individuals employed at 50 pilot bodies to the value of €7 million.
I want to highlight the valuable contribution that voluntary organisations make across Irish society. Ireland continues to benefit from having a voluntary sector and we all agree on the need to ensure that it is preserved into the future. I want to thank the House for the opportunity to address these issues this evening and for the valuable contributions to this very important debate.
I wish to address a few words to the representatives of the Disability Action Coalition, the member organisations of the Oireachtas disability group and others who are present in the Visitors Gallery. I apologise that debate on the motion began far in advance of the time set by the Business Committee, with the result that many of them missed some of the earlier contributions. I extend a sincere welcome to them all. Their effort is greatly appreciated.
I note that amendment No. 1 refers to actions the Government claims to have already been taken in an effort to try to resolve the outstanding section 39 issues. As I stated in my opening contribution, the recent establishment of the forum must not be used as a means to kick the issue down the road. I sincerely hope that the forum will be a valuable means to collectively address all that needs to change. Indeed, recommendation 8.4 of the report of the independent review group called for the establishment of a new forum. The amendment also references the ratification by the State of the United Nations Convention on the Rights of Persons with Disabilities. In order for the convention to take effect, the optional protocol must be ratified. We also need the Disabilities (Miscellaneous Provisions) Bill 2016 to be progressed to Report and Final Stages. One cannot happen without the other. Committee Stage of the Bill has concluded and it is long past time it moved to Report and Final Stages.
The amendment refers to pay restoration as "premature". My goodness. Given that many of these workers have spent nearly a decade seeking pay restoration, I find that claim by the Government hard to fathom. One cannot in one breath recognise the fantastic work done by these workers and, in the next, state that they must wait until some arbitrary future date for that which is their due to be restored. The Minister of State, Deputy Finian McGrath, boasted of a pilot approach to pay restoration involving 50 of the more than 1,700 section 39 organisations of which I am aware. The amendment refers to more than 2,000 such organisations. Clearly, the Minister of State is aware of more of them than I have been able to uncover in my research. What of the rest of the organisations? Even those on the list of so-called pilot organisations must keep waiting, hang in there and hope that the Government will get to them by 2021.
The Minister of State, Deputy McGrath, stated that the people employed by these organisations are not public servants. That statement was reflected in the contribution of the Minister of State, Deputy Daly. Technically, the Ministers of State may be right but they are far off the reality of those persons' service and motivation. How would those who depend on them view their contribution and worth? How do the families of those who receive their care view them? I know many of them well. They are the epitome of public service at its best. That is a universal view which has been echoed by Deputies from a variety of political outlooks who have spoken on this issue tonight. Shame on any elected voice, or anyone else, who would seek to portray them as being less entitled than others. That contention is at the core of the arguments put forward by the Minister of State, Deputy McGrath, and, sadly, is reflected in the comments of the Minister of State, Deputy Daly. Those people are not less entitled than others. They provide an equal service and are entitled to full pay restoration in recognition of their true worth.
I accept the Fianna Fáil addendum to the motion. It has accepted the motion and added to it, which I welcome. I thank the members of Fianna Fáil who spoke on the motion. Their support for the Sinn Féin motion on this key issue is appreciated. I also thank Deputy Kelly and the Labour Party for their support, as well as all Independent colleagues who spoke on the motion.
Until the arrival of the Minister of State, Deputy Daly, the Minister of State, Deputy McGrath, cut a very lonely figure in the Chamber for the greater part of the debate. He was carrying the can for the Fine Gael-led coalition and its head-in-the-sand attitude on this issue. The contribution of the Minister of State, Deputy Daly, could not cover for the shame of the Fine Gael Deputies who have stayed away from this debate. The empty Fine Gael benches have spoken volumes. The Deputies who spoke on the motion put the case well. They had the opportunity to outline the key and important issues.
What are we demanding? In summary, we are calling for the Department of the Taoiseach to intensively engage with the not-for-profit sector to develop a long-term vision. We are calling for the establishment of a forum - which was initiated and met for the first time on 2 December - to develop a plan to provide enhanced services and agree to develop a compact agreement with the State. We have yet to reach a stage whereby we could make a judgment on its potential and whether it will fulfil our hopes for it. We are calling for future Governments to give due recognition to the section 39 sector and to create a junior ministerial portfolio with responsibility for its component parts. We are calling for a complete review of current legislative provisions governing the relationship between the State and not-for-profit organisations. Finally, we are loudly calling for the Government to agree that the unequal pay terms as between section 38 and section 39 organisations must end without delay and that full pay restoration must be delivered for these workers as a priority.
A statement was issued by the chair of the Disability Action Coalition, Rosemary Keogh, to mark the International Day of Persons with Disabilities a little over a week ago. She stated:
The funding crisis in the disability sector has become so critical that the future of services for up to 65,000 men, women and children are now at serious risk. These are services which are critical to their day-to-day lives, critical to giving people the care they need to stay alive, a chance to live a life of their choosing, a voice.
I absolutely endorse those remarks and am confident that they have the support of the overwhelming majority of Members of this House. We are the voice to which Rosemary Keogh referred. Tomorrow evening, we will exercise our right to vote on behalf of those affected by this issue. The Government should withdraw its amendment. It should support the motion, the section 39 organisations, their staff and those who depend on their services. In all conscience, it should take no other position.