Michael Mullins (Fine Gael)
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I welcome the Minister of State, Deputy Kathleen Lynch, to the House.

Marc MacSharry (Fianna Fail)
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I welcome, as always, the Minister of State to the House and acknowledge she is well aware of this important issue. A number of issues arise from my perspective and I am not satisfied the Minister of State's office has been briefed adequately on the facts relevant to this case. I do not seek to cause an issue to arise between the Minister of State and me. She is focused on her brief and I often have praised her in this Chamber for her determination and commitment to it. In this case, I ask the Minister of State to provide a detailed statement regarding reports on the underfunding of the care of people with intellectual disabilities at Wisdom Services at Cregg House. In particular, the notes to editors accompanying her press release of last week, which indicated that services would continue, mentioned the Department did not accept there was an underfunding issue. However, the HSE publishes an annual report containing details of revenue and capital funding paid to section 38 voluntary service providers, of which Wisdom Services is an example. An analysis of all the published reports from 2005 to the present day reveals that Wisdom Services received a lower percentage increase throughout all those years when compared with comparable service providers in the sector. I do not know the reason this should have been the case and consider it to be fundamentally wrong. Moreover, an exercise conducted by the working group appointed jointly by the HSE and Wisdom Services on foot of a meeting between Oireachtas Members and the Minister of State when this issue first arose last April, revealed that HSE facilities are better funded than the services provided by Wisdom Services at Cregg House. The difference is apparent in the case of residential services, services in community homes and day services.

Wisdom Services is a section 38 health service provider, that is, a designated provider of services on behalf of the HSE and its costs are lower than those of comparable services provided directly by the HSE to persons with intellectual disabilities. I understand these facts are reflected in two reports. While I am uncertain whether the Minister of State has yet had sight of the national value for money review, I am reliably informed this is the case when compared with other section 38 voluntary agencies. It also is reflected in a report, which again I gather the Minister of State may not yet have seen, namely, the result of the collaborative process between the HSE and representatives from Wisdom Services over the past month or so, which has culminated with the announcement by the Daughters of Wisdom that they were obliged to pull out on the basis that they could not stand over the continued underfunding.

I take the Minister of State's view that the services will continue, although I have questions to ask about that shortly. Apart from that issue, I have a concern as a public representative for the people of the north west. The representatives from Wisdom Services, under the auspices of the Daughters of Wisdom, are providing a service that is more cost effective and which provides greater value for money than the HSE can provide directly in the area. In the face of present difficulties and given the scarcity of resources, everything possible should be done to ask them to stay on and to ensure their effective management is replicated elsewhere among section 38 providers, as well as in the directly-provided HSE services, rather than pursuing an agenda which I consider to be pushing them out. I believe there are agendas at play in this regard. While I do not believe it is the agenda of the Minister of State, and I acknowledge this sounds strange, I believe the Government is being used as a pawn to ensure these service providers are pushed out in order that the HSE can take control of the services. I do not believe this is in the best interests of either the clients, that is, the people who use those services and their families, or those of the State because, as I stated it is alleged that two value for money reports, the most recent of which was conducted between Wisdom Services and the HSE directly, as well as the national value for money review carried out on section 38 voluntary agencies, show Wisdom Services is providing better value for money.

The other point with which I take issue concerns the notes to editors contained in the Minister of State's press release on this issue. The Minister of State has stated-----

Michael Mullins (Fine Gael)
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The Senator's time has concluded.

Marc MacSharry (Fianna Fail)
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I know but I ask the Acting Chairman to indulge me slightly because I have a couple of brief points to make. As the Minister of State has made the effort to be present in the Chamber, the least I can do is to make the points outlining my rationale for raising this matter. The aforementioned notes stated Wisdom Services has received 38% of the funding and have 23% of the people with intellectual disabilities. That is a ridiculous statement and clearly was written by a spindoctor, rather than someone who is involved in the delivery of services to those with intellectual disabilities. Anyone familiar with this issue is aware that those who receive the services at Cregg House are the people with the most complexities. As other people's intellectual disabilities might be mild, when compared with the more severe to profound intellectual disabilities dealt with at Cregg House, it is only right the latter receives a higher proportion of funding relative to the complexities of the services that are delivered in that area.

Third, the Minister of State must have been misinformed because the person I know would never have been as flippant with language as to state there were difficulties for quite some time at Wisdom Services. This suggests a level of incompetence and recklessness with funding which-----

Michael Mullins (Fine Gael)
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I have given the Senator great leeway.

Marc MacSharry (Fianna Fail)
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----- simply was not present. The Minister of State should correct the record in this regard because an audio version of her contribution was disgraceful, in respect of the complexion it created regarding the facts, which include the brilliance and expertise that was delivered by the people operating under the auspices of Wisdom Services over the years. At this late stage, I ask the Minister of State to engage in a process to attempt to persuade the Daughters of Wisdom to stay on-----

Michael Mullins (Fine Gael)
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I call on the Minister of State.

Marc MacSharry (Fianna Fail)
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----- and to continue to deliver the aforementioned services. Moreover, if it is necessary to deflect a portion of the national budget to that particular HSE area, it should be done. I believe it is in the best interests of the State from a value-for-money perspective and more important-----

Michael Mullins (Fine Gael)
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Senator MacSharry is repeating himself.

Marc MacSharry (Fianna Fail)
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----- it is in the best interests of those who use those services. I thank the Acting Chairman for his indulgence.

Kathleen Lynch (Cork North Central, Labour)
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I thank the Senator and acknowledge this is not the first time he has shown an interest in this issue. I thank him for raising this matter, which gives me an opportunity to outline the current position in respect of Wisdom Services. To correct one point, when I stated that there had been difficulties, it was never to indicate there was mismanagement or something untoward with the service. I believe this contribution probably will confirm this was never the intention. As the Senator is aware, Wisdom Services is a voluntary body operated by the Daughters of Wisdom, which provides services for people with disabilities in the north-western region. It supports more than 200 service users, with 111 on campus, 75 in the community and 20 day attendees. I was disappointed to learn that the Daughters of Wisdom, who operate Wisdom Services, have advised the HSE they intend to withdraw from the provision of services on behalf of the HSE. The decision was made in the light of serious concerns on the part of Wisdom Services regarding a deficit built up in 2010 and 2011 which continues to increase in 2012, and other financial concerns. When I stated there were difficulties in arrears that is what I meant.

Wisdom Services have written to all families of service users. Sister Quinn informed me in writing that all families were telephoned as well, which is only what I would expect from a service that has been in operation for a considerable time and which, from everything I have heard, has delivered an excellent service. They also arranged staff briefings to outline their reasons for withdrawal. Wisdom Services have been funded consistently by the HSE over the years and also benefited from additional intellectual disability developmental funding in the period 2006 to 2011, along with additional capital funding in this period. All services need to update and I am sure that is what this money was about. This compared favourably with the percentage of intellectually disabled, or ID, clients from this area who were covered by their services. I do not accept that this service has been underfunded, allowing for the necessary reductions which have been applied to all service providers in recent years.

The HSE has been working with Wisdom Services for some time to address their financial concerns and identify opportunities for efficiencies and savings through potential new combinations of service deliveries in the north-west area. Wisdom Services had a cost containment plan for 2012 which has had some success but in spite of the detailed engagement by the HSE in an effort to resolve the various issues, and faced with significant financial concerns, Wisdom Services decided to voluntarily withdraw from service provision.

The HSE is working closely with Wisdom Services to ensure continuity of service for service users during an agreed transition phase for the service. The process for transition has now commenced and the first meeting of a steering group of Wisdom Services management and HSE officials was held yesterday, Monday, 18 June. The process will include a due diligence exercise to establish the options for future management of these services.

It is regrettable that the Daughters of Wisdom made the decision they were no longer in a position to augment or subsidise the services provided and that they have decided to cease as a provider. The HSE respects this view and all parties have agreed a co-operative approach to the transition process to ensure the needs of service users and their families will continue to be met.

On behalf of the Minister for Health, I express thanks to Wisdom Services for their dedication and commitment to providing services to children and adults within the north west since 1955, and wish them well for the future. That is a substantial period during which to have delivered a service. I regret that the Daughters of Wisdom have withdrawn from the service. I believe a solution could have been found. However, the deficits that continued to increase could not be sustained. The Daughters of Wisdom have provided an excellent service down through the years at a time when, as I have stated consistently, the State was not providing that service. We owe a debt of gratitude to these people that we will find very difficult to repay.

Marc MacSharry (Fianna Fail)
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I accept the response of the Minister of State but I do not like it. It is worth remembering it was at the invitation of the State that these people provided the services. Applying the basic business common sense I may have, I do not see how we expected Wisdom Services to run a deficit they would subsidise from the religious order and at the same time, in spite of the fact that they did this more cheaply and cost effectively than the HSE can do directly, how we expect a third party or the HSE to be able to take over this service, do as good a job with fewer resources and not run a deficit. I do not see how that is possible. If the Minister of State wishes to take upon herself to engage directly with the Daughters of Wisdom I am sure they could be convinced or influenced to stay on and continue the service if a way can be found to ensure that adequate funding can be made available. Along with the Minister of State, I believe there is a solution. For that reason, I say to her that outside the Department of Health and beyond the office of the Minister, there is an agenda at work that may not be the purest. I hate to see such an excellent service used as a pawn in a game that does not at all involve them.

Michael Mullins (Fine Gael)
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The final word from the Minister of State.

Kathleen Lynch (Cork North Central, Labour)
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As to the value for money review, I have not seen it and although there have been discussions around it there has been no detail. I do not know where the figures come from in terms of the HSE providing the service along with voluntary organisations. I do not know where that argument comes from because I have seen nothing to support it.

Marc MacSharry (Fianna Fail)
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Surely then, we should wait until we see that review before we allow Wisdom Services to disengage.

Kathleen Lynch (Cork North Central, Labour)
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I cannot demand that people who are free to make these decisions should make a different decision. I was disappointed that this happened. I believed there could have been a solution but that did not happen. The service will continue for the people who need it. The pay costs will be the same and the increments will have to be paid. There will be a new management structure rather than a new service but a different service will have to be looked at because in every service we are looking at a different way of doing things.

Marc MacSharry (Fianna Fail)
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Are we potentially downscaling the service?

Kathleen Lynch (Cork North Central, Labour)
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No. There will be no downscaling of the service. The service, as it exists, will continue.

Michael Mullins (Fine Gael)
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That clarifies the situation. I thank the Minister of State. I now call my constituency colleague, Senator Lorraine Higgins.