John Dolan (Independent) | Oireachtas source

I thank the Minister for attending. It is my first opportunity to engage with him. The Minister's presentation referred to public sector and private sector. While those two sectors certainly do exist, I believe there is a bit more nuance to it. One of two issues I particularly want to address today arises in the context of the current pay negotiations, in that a number of section 38-funded organisations funded through the Health Acts in the health sector are effectively in those negotiations. There are also other civil society organisations, pretty much all charities, which are by definition public or community benefit organisations. As I would put it, they are first cousins of the public services in that they are not private for-profit entities but rather are there to provide a public benefit or public service. Those organisations funded under section 39 are, however, outside of this arrangement. Nonetheless, they are both in the same labour market, which is currently tight in respect of the supply of many of the skill sets that are needed. That is simply a matter of fact, in particular in regard to occupational therapists, physiotherapists and those with backgrounds in social services, disability and so on. Therefore, of two organisations working in the same area, one is designated under section 38 and will rise as though it is in a marina with whatever comes out of these negotiations, while the other is bolted down at the low-water mark. However, the second organisation still has the same pressures, the same trade unions and the same staff interests who will point to what is happening to their colleagues while they are stuck.

I am not here to do the work of staff representatives or trade unions. They are well capable of doing that and must be heard by the employers. I am here to make the point that those people are only employed because there is a public service to be provided, whether it is provided by one kind of organisation or another or by the HSE itself. There is a conundrum here. My understanding is the HSE is telling the section 39 organisations that this is their issue and that they have to go through all the industrial relations drill to see what comes out of it. However, if somebody starts their career in a section 39 organisation and there are better pay and conditions across the road, they will migrate. The people being served and supported in one organisation will find themselves in an area where there is more churning of staff, where staff are coming in and then making a commonsensical, practical decision for themselves and rightly so. The butt end of that is not so much the organisation but the infrastructure of services they need. I cannot too strongly say to the Minister that this needs to be dealt with in a timely fashion, now rather than later.

I will give one example. More than 1,000 young people with disabilities have gone into nursing homes in recent years and that number has increased given there is the draw of the statutorily-underpinned fair deal scheme. Other community-based services, such as personal assistants, home support and so on, do not have the protection of having statutory underpinning as they are provided on an administrative basis. That is causing a push. The first thing a trainee doctor is taught is, for God's sake, do no harm. The way things are structured publicly is causing a bias that is doing harm and making the services that some organisations provide more unsustainable, which is unfair to the people supported by them.

I will leave the point at that as I do not believe I can say it any more clearly but that is an important unintended consequence of the current work in which the Minister is involved. I do not suggest we should turn them all into section 38 organisations.I am not making the case for that, but something has to be done even if it involves appointing more staff. Action must be taken to ensure there is a level playing field for people with disabilities.

I consider the Department of Public Expenditure and Reform to be in a position that no other Department is in. It has an influence over how the funding that goes out to a range of other Departments is prioritised and focused. There is more than €14 billion going into health, €1.7 billion of which is allocated in respect of disability, although that excludes the mental health side. Ireland has very poor outcomes for disabled people in terms of their getting into employment or returning to employment. We see this every year in the context of school leavers as we ask what we should do with them. What tends to happen is they go to day programmes and they remain in them. Adults who become disabled and who already have a range of employment and community skills are also finding it very difficult to obtain employment. If a lot of public money is being spent on the health side in respect of social programmes and if people are bottled up in that area because the pathways back to employment or into employment are not being opened up, this is bad value for public investment. It is a poor outcome and a very bad return on investment. The key to unlocking that is to consider what is happening across Departments. An example of this is people with disabilities - be they blind, deaf or physically impaired - being able to use public transport. This would apply especially to transport in rural areas because public transport in urban areas has improved quite a lot. These factors are all enablers to allow people to be out and about and able to access further education, return to training and use the different modules. I ask the Minister to monitor what is happening across Departments. We need all the investment that is allocated to health, but an awful lot more could achieved as a result of it if complementary things happen in other Departments.

With the Leas-Chathaoirleach's indulgence, I have one final thing to say. The budget comes up every year and that is the context in which to look at this. There is also more than €50 billion in the base. How could this be used differently? The commitment to the UN convention and the public sector duty are two strong drivers. I have indulged and I thank the Leas-Chathaoirleach.